bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral neuropathy in liver cirrhosis
Authors: KHARBANDA PARAMPREET S , PRABHAKAR SUDESH , CHAWLA YOGESH K , DAS CHANDI P , SYAL PUNEET 
Published: July 2003

AbstractBackground and Aims:  Neuropathy in association with chronic liver disease, including cirrhosis, is recognized; however, there are differences in the incidence and type of neuropathy reported. The causal relationship of liver disease to neuropathy has been questioned. This study was designed to evaluate the incidence and character of peripheral neuropathy in patients with liver cirrhosis. The effect of alcohol consumption, severity of liver disease and encephalopathy on the incidence and severity of neuropathy were also studied.Methods:  Patients having an identifiable cause of peripheral neuropathy, except alcohol, were excluded from the study. Patients with evidence of vitamin B12 deficiency or diabetes were also excluded from the study. In this study, 33 patients with liver cirrhosis were evaluated clinically and electrophysiologically to detect any evidence of peripheral neuropathy. Nerve conduction studies were performed in the upper and lower limbs using surface electrodes. These patients also underwent a detailed clinical examination.Results:  Clinical signs of peripheral neuropathy were found in seven (21%) patients. Nerve conduction studies were abnormal in 24 (73%) patients. The pattern of involvement was predominantly of an axonal sensory motor polyneuropathy. Neuropathy was found both in patients with alcohol‐related and non‐alcohol‐related cirrhosis. The presence of encephalopathy did not have a significant bearing on the incidence and severity of neuropathy. The neuropathy was also not significantly related to the severity of liver disease.Conclusions:  The present study reveals that a significant number of patients with liver cirrhosis show evidence of peripheral neuropathy, which is present regardless of the etiology of cirrhosis, and is subclinical in a majority of these patients. The cause of neuropathy was probably the liver disease itself, as the incidence and severity of neuropathy in the alcohol‐related cirrhosis, although higher, was not significantly different from the neuropathy in patients with non‐alcohol‐related cirrhosis.
Clinicopathological features and management of gallbladder cancer in Pakistan: A prospective study of 233 cases
Authors: MALIK IMTIAZ A 
Published: July 2003

AbstractBackground and Aims:  Gallbladder cancer is common in Pakistan and has an extremely poor prognosis. Treatment is primarily surgical. Chemotherapy is frequently used in patients with advanced disease. This study was performed to evaluate and compare the clinicopathological features and management of gallbladder cancer in Pakistani patients, with particular emphasis on factors that influence survival.Methods:  Two hundred and thirty‐three patients with histologically proven gallbladder cancer were studied. Information was prospectively collected on demographic features, clinical and laboratory findings at the time of presentation, influence of therapy, and survival. Data were analyzed to evaluate variables that influenced survival. Kaplan–Meier analysis was used to calculate survival.Results:  Most patients were women (77%). Mean age was 55 years (±11 years). Fourteen per cent of females were nulliparous. Twenty‐six per cent had five or more children. Only 4% of patients had a documented history of typhoid fever. The majority (69%) had a history of symptomatic gallbladder disease. The commonest presenting symptom was pain (89%), followed by nausea and vomiting (52%), weight loss (42%), and jaundice (33%). One‐quarter of patients had a palpable abdominal mass. Most had abnormal hepatic function tests and 58% had elevated carcinoma embryonic antigen levels. Stage (P < 0.001), jaundice (P = 0.01) and palpable mass (P = 0.02) were statistically significant variables. However, on multivariate analysis, tumor node metastases (TNM) stage was the only factor influencing survival. Median survival of the patients was 44 months for patients with stage I disease, 23 months for stage II, 17 months for stage III and 6 months for stage IV.Conclusion:  These data are comparable with those reported from other developing countries. Most patients presented at an advanced stage of disease and had an extremely poor prognosis. Systemic therapy did not provide any survival benefit. The TNM stage remains the most important factor influencing survival.
Gallbladder cancer in northern Jordan
Authors: BANI‐HANI KAMAL E , YAGHAN RAMI J , MATALKA ISMAIL I , SHATNAWI NAWAF J 
Published: July 2003

AbstractBackground and Aim:  To highlight the epidemiological, clinical, and pathological features of gallbladder cancer in Jordan as a model for the Middle East. Only scattered reports are available from this region.Methods:  The histopathological reports and the hospital records for all cholecystectomies performed at Princess Basma Teaching Hospital between 1994–2000 were retrospectively reviewed to identify all patients with gallbladder carcinoma. All the histological slides for the cancer group were reviewed and reclassified by a single pathologist.Results:  Of 4502 cholecystectomies performed, 33 cases (0.73%) of gallbladder carcinoma were found. The mean age was 61.4 years (range 39–80 years). The male : female ratio was 1 : 3.7. Biliary colic and/or acute cholecystitis were the main presentations. Gallstones were present in 88% (29/33) of the patients. The spectrum of histological subtypes was similar to other series. Only three cases were diagnosed preoperatively, making the incidence of incidental gallbladder cancer 0.66% (30/4502). Simple cholecystectomy was performed for 13 patients. The remaining 20 patients underwent cholecystectomy and portal lymphadenectomy with (five cases) or without (15 cases) extrahepatic resection of the bile ducts. The mean follow up was 22 months (SD ± 18.95 months; range 1–96 months). The 2‐year survival rates for stages I, II, III, and IV were 100%, 42.9%, 10.8%, and 0%, respectively (P = 0.0013).Conclusions:  The importance of a high index of suspicion when dealing with cholelithiasis in elderly patients, particularly with large sized stones, cannot be over‐emphasized. Proper gross inspection in the theater should be a routine procedure performed by all surgeons. Routine ultrasound for suspected gallbladder stones should always be performed under the supervision of senior radiologists.
Simplified acute physiology score II: A valid role in the assessment of patients with medically refractory upper gastrointestinal bleeding?
Authors: HURLSTONE DAVID P , SANDERS DAVID S , CARTER MARTIN J , GOODMAN‐JONES BETHAN , BATTEN JANE , JOHNSON ALAN G , LOBO ALAN J 
Published: July 2003

AbstractBackground and Aim:  Medically refractory upper gastrointestinal hemorrhage (UGIH) is a complex clinical problem. Selection of patients suitable for surgery is difficult and often involves subjective clinical judgment. The simplified acute physiology score (SAPS) II is a validated predictor of mortality in the intensive care setting. Our aim was to assess the SAPS II score in patients with medically refractory UGIH who were referred for a surgical opinion. Patients were subsequently classed as ‘accepted’ or ‘declined’ for surgery and SAPS II scores were compared between these two groups.Methods:  From July 1996 to July 1999, patients referred for surgical intervention with UGIH were included (varices excluded). The SAPS II was calculated at the time of surgical referral. This was converted into a mortality probability using multiple regression analysis. Clinical outcome was defined as either survival to discharge or death while an inpatient.Results:  Ninety‐nine patients were referred for surgical review. Sixty‐five patients were accepted for surgery and 34 were declined. The mean SAPS II score for those who were accepted was 31.7 (mortality probability 0.16, actual mortality 15.4%, 10/65) and 30.2 (mortality probability 0.15, actual mortality 29.4%, 10/34) for those who were declined.Conclusion:  The SAPS II scores were no different between the two groups. Observed mortality was consistent with mortality predicted in the operated group but twice that predicted in those where surgical intervention was declined. This suggests that clinical selection criteria for patients undergoing surgery for UGIH are inconsistent.
Acute pancreatitis associated with biliary disease in children
Authors: CHOI BO HWA , LIM YEAN JUNG , YOON CHONG HYUN , KIM ELLEN AI‐RAN , PARK YOUNG SEO , KIM KYUNG MO 
Published: July 2003

AbstractBackground and Aims:  Biliary disease is one of the most common causes of acute pancreatitis in adults; however, this cause and outcome in children have rarely been described in the literature. Therefore, the present study was conducted to evaluate the role of biliary disease as a cause of acute pancreatitis in children.Methods:  The present study included 56 children with acute pancreatitis, of which 16 (29%) cases were associated with biliary disease. The 16 cases consisted of four boys and 12 girls ranging in age from 2 to 13 years. The underlying causes of the biliary disease were evaluated, as well as its clinical presentations, management modalities, and outcomes.Results:  The causes of biliary disease in the 16 children included choledochal cyst in seven, biliary sludge in six, gallstone in two, and anomalous pancreaticobiliary junction in one. Acute pancreatitis with biliary disease showed increased presentation of jaundice and abnormalities in a liver‐function test. Therapeutic interventions were performed more frequently in acute pancreatitis associated with biliary disease. All seven children with choledochal cysts needed hepaticojejunostomy. Of eight children with biliary sludge or gallstones, five children remained free of and two suffered from repeated attacks of pancreatitis after endoscopic papillotomy. Mortality did not occur.Conclusion:  The present study suggests that biliary disease can be one of the causes of acute pancreatitis in children and has the clinical characteristics of jaundice and/or abnormalities in a liver‐function test. Appropriate therapeutic interventions should be considered as the treatment modality.
Recent increase in antibiotic‐resistant microorganisms in patients with spontaneous bacterial peritonitis adversely affects the clinical outcome in Korea
Authors: PARK YOUNG HWAN , LEE HAN CHU , SONG HEE GON , JUNG SAERA , RYU SOO HYUNG , SHIN JUNG WOO , CHUNG YOUNG‐HWA , LEE YUNG SANG , SUH DONG JIN 
Published: July 2003

AbstractBackground and Aim:  Recently, antibiotic‐resistant microorganisms have been increasingly noted in Korean patients with spontaneous bacterial peritonitis (SBP). The present study investigated the changing pattern of antibiotic resistance and its effects on the clinical outcome in treating SBP.Methods:  The present study retrospectively analyzed 87 episodes of SBP in 1995, 222 in 1998, and 271 in 1999. The isolated microorganisms and their antibiotic susceptibility were compared, and prognostic factors for survival were analyzed.Results:  Microorganisms were isolated in 41% of total episodes. The three most frequently isolated organisms were Escherichia coli (48%), Klebsiella pneumoniae (15%), and Aeromonas (8%). Strains that were resistant to cefotaxime in Gram‐negative bacilli significantly increased from 7% in 1995 to 28% in 1999, and those to ciprofloxacin increased from 10% to 32%. Treatment failure also increased from 6% to 23%. Combined hepatocellular carcinoma and SBP caused by extended‐spectrum β‐lactamase‐producing strains were two independent prognostic factors for survival.Conclusion:  Considering the increase in antibiotic‐resistant microorganisms related to SBP, measures to prevent the in‐hospital spread of resistant strains and the indiscriminate use of antibiotics should be instituted more stringently.
Balloon‐occluded retrograde transvenous obliteration improves liver function in patients with cirrhosis and portal hypertension
Authors: MIYAMOTO YASUNAO , OHO KAZUHIKO , KUMAMOTO MASAFUMI , TOYONAGA ATSUSHI , SATA MICHIO 
Published: July 2003

AbstractBackground and Aim:  Balloon‐occluded retrograde transvenous obliteration (B‐RTO) is a novel therapeutic method for the treatment of large gastric fundal varices with spontaneous splenorenal shunt (SRS). However, the effects of B‐RTO on liver function remain unknown.Methods:  Fourteen patients with portal hypertension and gastric varices with SRS were studied, consisting of four patients with acute bleeding, five with high‐risk varices, and five with refractory portosystemic encephalopathy. Hepatic venous catheterization was performed to evaluate hepatic blood flow and liver function using the continuous indocyanine green (ICG) infusion method. To assess the metabolic activity of the hepatocyte, the intrinsic clearance of ICG was calculated. In all patients, endoscopic study was performed before and 1 week and 1 month after the B‐RTO, and followed every 6 months thereafter. After baseline measurements, B‐RTO was performed. Four weeks after the B‐RTO, the same catheter measurements were repeated.Results:  The B‐RTO was successful in all patients. Contrast‐enhanced computed tomography showed complete obliteration of the SRS prior to the follow‐up measurements. Endoscopic eradication of the fundal varices was obtained 6 months after B‐RTO in all patients and encephalopathy was improved within 1 week after B‐RTO. Following the B‐RTO, hepatic blood flow (441 ± 214 vs 668 ± 299 mL/min, P < 0.0001) and the intrinsic clearance of ICG (233 ± 123 vs 285 ± 148 mL/min, P < 0.05) were significantly increased. Furthermore, intrahepatic resistance decreased after the B‐RTO (P < 0.005).Conclusion:  From short‐term assessment, B‐RTO increases hepatic blood flow and improves the metabolic activity of the liver in patients with portal hypertension.
Combined passive and active immunoprophylaxis for preventing perinatal transmission of the hepatitis B virus carrier state in Shizuoka, Japan during 1980–1994
Authors: NOTO HIROSHI , TERAO TOSHIHIKO , RYOU SHIGEO , HIROSE YASUYUKI , YOSHIDA TAKAMI , OOKUBO HIDEO , MITO HIDETOSHI , YOSHIZAWA HIROSHI ,   FOR THE SPECIAL COMMITTEE FOR PREVENTING HEPATITIS B IN SHIZUOKA
Published: July 2003

AbstractBackground:  Efficacy and limits in preventing perinatal infection with hepatitis B virus (HBV) have been examined in a model area in Japan.Methods:  In Shizuoka (population of 3.6 million), immunoprophylaxis of perinatal HBV infection was started in 1980 in four institutions (Hamamatsu Medical College, Shimada City Hospital, Shizuoka Kodomo Hospital and Numazu City Hospital). Babies born to carrier mothers with hepatitis B e antigen (HBeAg) in serum received hepatitis B immune globulins at birth and 2 months thereafter and vaccines at 2, 3 and 5 months after birth.Results:  Overall, 980 of the 1030 babies born to HBeAg‐positive carrier mothers were protected by the immunoprophylaxis during the 15 years from 1980 to 1994 with an efficacy of 95.1%. From 1986 to 1994 while the national immunoprophylaxis was conducted, 329 674 of the 346 637 (95.1%) expectant mothers were tested, and 2081 (0.63%) of them were positive for hepatitis B surface antigen (HBsAg). The immunoprophylaxis was given only to babies born to 764 (36.7%) of the 2081 mothers who tested positive for HBeAg. Of the 494 babies receiving immunoprophylaxis, in whom HBsAg was followed monthly after birth, 462 (93.5%) were protected. The HBV carrier state developed in the remaining 32 (6.5%) babies, 10 of whom (31.3% of the 32) turned positive for HBsAg within 1 month after birth, most likely owing to infection in utero.Conclusions:  Passive–active immunoprophylasxis of high‐risk babies was highly efficacious in preventing perinatal transmission of the HBV carrier state. Most failures (approximately 70%) occurred in the high‐risk babies who were exposed to HBV after birth, and would have been avoided by careful and extensive execution of the immunoprophylaxis.
Pleuropulmonary complications of esophageal variceal sclerotherapy with absolute alcohol
Authors: SETHY PRADEEPTA K , KOCHHAR RAKESH , BEHERA DIGAMBAR , BHASIN DEEPAK K , RAJA KAISER , SINGH KARTAR 
Published: July 2003

AbstractBackground:  Esophageal variceal sclerotherapy (EVS) is an effective means of controlling variceal hemorrhage. However, it causes a wide variety of local and systemic complications. The present study was performed to document pleuropulmonary complications of EVS with absolute alcohol.Methods:  Twenty‐six patients of portal hypertension of different etiologies were subjected to EVS with absolute alcohol. Baseline arterial blood gas analysis (PaO2, PaCO2, pH, HCO3, SaO2), chest X‐ray and pulmonary function tests (forced expiratory volume at 1 s (FEV1), forced expiratory vital capacity (FVC), FEV1/FVC, maximum mid‐expiratory flow rate (MMFR), and peak expiratory flow rate (PEFR)) were performed 4–6 h before the first session of EVS. These investigations were repeated within 24 h of EVS. Patients were asked to maintain a symptom diary and to record symptoms such as fever, chest pain, dysphagia and dyspnea during the study period.Results:  Ten patients (38.46%) had chest pain and four patients (15.68%) had fever after sclerotherapy. Eight patients (30.54%) complained of dyspnea and six patients (23.08%) developed pleural effusion. There was a significant decline in FVC and FEV1 after EVS as compared with baseline values. However, FEV1/FVC ratio, MMFR and PEFR did not have any significant change.Conclusions:  Chest pain (38.46%), dyspnea (30.54%) and fever (15.68%) were the common symptoms after EVS while chest X‐ray showed pleural effusion in 23.08%. Pulmonary function tests revealed a significant decline in FEV1 and FVC without change in FEV1/FVC ratio after EVS, suggesting a restrictive type of defect.
Expression of adhesion molecules in the rectum‐associated lymph nodules of pre‐ and postnatal specific pathogen‐free rats
Authors: ICHIKAWA SANAE , YAMASHITA AKIRA 
Published: July 2003

AbstractBackground and Aim:  The developmental process of lymphoid tissues in the gastrointestinal tract is still unclear. The aim of the present study was to explore the expression of adhesion molecule in rectum‐associated lymph nodules (RALN) of specific pathogen‐free (SPF) rats at fetal and early postnatal periods of development.Methods:  Immunohistochemical analysis was carried out of select adhesion molecules and lymphocyte subsets in lymph nodules of the rat rectal region.Results:  Mucosal addressin cell adhesion molecule (MAdCAM)‐1 expression was detected in the colonic mucosa on day 16 of gestation. Expression was strong in endothelial cells of all blood vessels in the entire colonic mucosa until day 7 after birth. On day 10 after birth, MAdCAM‐1 was strongly expressed and confined to the high endothelial venule (HEV) in the submucosa of RALN, and was rarely detected in the blood vessels other than the HEV. In contrast, intercellular adhesion molecule (ICAM)‐1 expression was absent in fetal colonic mucosa but appeared just after birth. Only a very small number of lymphocyte‐function associated antigen (LFA)‐1‐positive cells appeared in the mucosa on day 16 of gestation but by day 19 of gestation a large number of these cells had rapidly aggregated in the mucosa of the ante‐mesenteric side of the developing colon. These cells also expressed interleukin‐7 receptor (IL‐7R), and some were positive for CD4 and Mar‐1 markers.Conclusion:  The region of RALN undergoes rapid and dynamic changes in adhesion molecule expression during gestation, which may regulate interactions with intestine‐associated immune cells shortly after birth.
Interleukin‐18 overproduction exacerbates the development of colitis with markedly infiltrated macrophages in interleukin‐18 transgenic mice
Authors: ISHIKURA TAKAHIRO , KANAI TAKANORI , URAUSHIHARA KOJI , IIYAMA RYOICHI , MAKITA SHIN , TOTSUKA TERUJI , YAMAZAKI MOTOMI , SAWADA TAISUKE , NAKAMURA TETSUYA , MIYATA TATSUYA , KITAHORA TETSUJI , HIBI TOSHIFUMI , HOSHINO TOMOAKI , WATANABE MAMORU 
Published: July 2003

AbstractBackground and Aim:  The authors have previously shown that production of interleukin (IL)‐18 was increased in the inflamed mucosa of patients with Crohn's disease (CD) and blockade of IL‐18 ameliorated the murine model of CD. This demonstrated that IL‐18 plays a significant role during intestinal inflammation. However, the initial role of IL‐18 during intestinal inflammation was unclear; therefore the susceptibility of IL‐18 transgenic (Tg) mice to acute dextran sulfate sodium (DSS)‐induced colitis was examined.Methods:  Interleukin‐18 Tg and wild‐type (WT) mice were fed 2.0% of DSS for 8 days. The total clinical scores (bodyweight loss, stool consistency, and rectal bleeding), colon length and histological scores were assessed. The expressions of surface markers and IL‐18 on infiltrating lamina propria mononuclear cells were analyzed immunohistochemistrically. Mesenteric lymph node (MLN) cells were isolated and the expressions of CD4+ T‐cell activation markers (CD69, CD25 and IL18R) were analyzed by flow cytometry.Results:  The IL‐18 Tg mice exhibited an increased susceptibility to DSS‐induced colitis, as shown by significantly increased clinical, histological scores, and more severe colonic shortening compared with WT mice. Immunohistochemical analysis revealed a significant increase of IL‐18 production and CD11b+ macrophages but not CD4+ T cells in the inflamed mucosa in DSS‐fed IL‐18 Tg compared with DSS‐fed WT mice. Furthermore, MLN cells revealed no evidence of increased CD4+ T‐cell activation in DSS‐fed IL‐18 Tg.Conclusions:  These findings suggest that IL‐18 overproduction in the mucosa plays an important role in the marked infiltration of macrophages and exacerbates colitis in IL‐18 Tg mice.
Lactoferrin sequestration and its contribution to iron‐deficiency anemia in Helicobacter pylori‐infected gastric mucosa
Authors: CHOE YON HO , OH YOO JOUNG , LEE NA GYONG , IMOTO ICHIRO , ADACHI YUKIHIKO , TOYODA NAGAHITO , GABAZZA ESTEBAN C 
Published: July 2003

AbstractBackground and Aim:  It is known that lactoferrin serves as a source of iron for Helicobacter pylori in gastric mucosa. The present study was undertaken to investigate the relationship between lactoferrin and H. pylori infection coexistent with iron‐deficiency anemia by determining the lactoferrin levels in gastric biopsy specimens, and by locating the major sites of lactoferrin expression, according to the presence or absence of iron‐deficiency anemia.Methods:  One hundred and one adolescents who underwent gastroduodenoscopy were divided into four groups: controls without H. pylori infection (NL; n =43); patients with H. pylori infection (HP; n = 26); patients with iron‐deficiency anemia (IDA; n = 6); and patients with H. pylori gastritis and coexisting iron‐deficiency anemia (HPIDA; n = 26). The gastric mucosal levels of lactoferrin were measured by immunoassay. Immunohistochemical technique was used to allow identification of the location and quantification of the lactoferrin expression.Results:  The mucosal level of lactoferrin was highest (3.93 ± 2.73 ng/µg protein) in HPIDA, followed by 2.67 ± 1.79 ng/µg protein in HP, 0.59 ± 0.57 ng/µg protein in NL and 0.14 ± 0.10 ng/µg protein in IDA. Their multiple comparisons were statistically significant at the 0.05 level. After the eradication of H. pylori in 12 HPIDA patients who underwent follow‐up endoscopy, the mean mucosal level of lactoferrin decreased significantly, while the blood hemoglobin level correspondingly increased. The major sites of lactoferrin expression by immunohistochemistry were in glands and neutrophils within epithelium. Lactoferrin was stained weakly in NL and IDA, and strongly in HP and HPIDA.Conclusion:  The lactoferrin sequestration in the gastric mucosa of HPIDA was remarkable, and this finding seems to give a clue that leads to the clarification of the mechanism by which H. pylori infection contributes to iron‐deficiency anemia.