bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of primary hepatocellular carcinoma treatment: An 8‐year experience with 368 patients in Thailand
Authors: Pawarode Attaphol , Tangkijvanich Pisit , Voravud Narin 
Published: March 2003

Abstract
Background and Aims
: Primary hepatocellular carcinoma (HCC) is common in Thailand and its prognosis is extremely poor. Hepatic resection and liver transplantation are modes of curative therapy and various therapies have been developed to treat inoperable HCC. This study was performed to determine the outcome of therapy and to identify prognostic factors for survival among Thai patients with HCC.
Methods
: Three hundred and sixty‐eight patients with tissue‐proven or serodiagnosed HCC were studied. Differences in laboratory investigations, patient survival, treatment outcomes and prognostic factors were analysed. The Kaplan–Meier method and the log‐rank test were used to calculate and compare survival of patients receiving different therapies.
Results
: Of the 368 patients 317 were males (86.1%, M : F ratio 6.2 : 1). The median age of all patients was 52 years range (2–85 years). Fifty‐nine patients were specifically treated and 209 were conservatively treated. Among those tested, 70% had hepatitis B virus‐related HCC. The overall median survival (range) after diagnosis and that of the treated and untreated patients were 5.6 (0–92.1), 9.0 (0–92.1) and 2.3 (0–25.9) months, respectively. More than 50% of the Okuda I patients survived beyond 30 months. The Okuda II and III patients had a median survival (range) of 5.7 (0.1–75.2) and 1.6 (0.1–25.9) months, respectively. Those patients treated by surgery, transcatheter oil chemoembolization and systemic chemotherapy had a better survival rate than did the conservatively managed patients. Surgery was found to be a better treatment than systemic chemotherapy. However, no differences between other pairs of treatment groups were identified. Subgroup analysis of the Okuda II group patients revealed the same results. Independent predictors of death were multiple lesions, advanced Okuda stage and treatment modality.
Conclusion
: Despite various kinds of therapy, the treatment outcomes for Thai HCC patients remain poor and largely depend on the disease extent and treatment received. Most Thai HCC patients are at an advanced stage at diagnosis. Thai patients who received disease‐specific treatment other than intra‐arterial chemotherapy had a better survival rate than did supportive treatment patients.
Inhibition of mitogen‐induced murine lymphocyte proliferation by Helicobacter pylori cell‐free extract
Authors: Chen Wangxue , Shu Dairu , Chadwick Vinton S 
Published: March 2003

Abstract
Background and Aims
: Previous studies have shown that lysates of Helicobacter pylori inhibit mitogen‐induced proliferation of human peripheral blood mononuclear cells. The objective of the present study was to determine whether H. pylori cell‐free extract (HPCE) has similar effects on murine lymphoid cells and could, therefore, be used to further delineate the mechanisms of alteration of lymphocyte function by H. pylori.
Methods
: The HPCE was prepared from a H. pylori reference strain and from five clinical strains with varying status of cagA and vacA. Mouse splenic and mesenteric lymph node cells were cultured in microwell plates in the presence or absence of varying concentrations of HPCE (0.625–12.5 μg/mL). T cell mitogens were added into the culture 2 h later and the cells were cultured at 37°C in 5% CO2 for a further 72 h. Cell proliferation was determined by a non‐radioactive rapid dye assay and the percentage inhibition caused by HPCE was calculated.
Results
: Pre‐exposure to HPCE significantly inhibited concanavalin A‐induced proliferation of murine spleen and mesenteric lymph node cells (up to 100% inhibition; P≤ 0.01). The HPCE also inhibited lymphocyte proliferation stimulated by mitogens phorbol‐myristate‐acetate and ionomycin and by the anti‐CD3ɛ monoclonal antibody (P≤ 0.05). The inhibition was dose‐dependent, but independent of the presence of virulence genes cagA or vacA. Treatment of HPCE at 80°C for 30 min, but not at 55°C for 60 min, completely abolished its inhibitory action. The HPCE, pretreated with pronase E, proteinase K, trypsin, acid or alkali also completely lost its inhibitory effect (P≤ 0.01), while in contrast, treatment with carboxypeptidase and leucine aminopeptidase had no effect.
Conclusion
: Helicobacter pylori produces heat‐labile proteins or peptides that suppress T cell mitogen‐induced proliferation of murine lymphoid cells in a similar manner to that observed with human peripheral blood mononuclear cells. The mouse cell culture system can, therefore, be used as a model to further study the mechanisms of action and antigen specificity of these immunomodulatory factors.
Prevention of proteolysis in cold‐stored rat liver by addition of amino acids to the preservation solution
Authors: Charrueau Christine , Blondé‐Cynober Françoise , Coudray‐Lucas Colette , Poupon Raoul , Chaumeil Jean‐Claude , Hannoun Laurent , Cynober Luc 
Published: March 2003

Abstract Background: One process identified as detrimental in liver preservation is proteolysis.Methods: We tested the effects of adding antiproteolytic amino acids (L‐alanine, L‐glutamine, L‐histidine, L‐leucine, L‐methionine, L‐phenylalanine, L‐proline, L‐tryptophan) to the preservation medium, in a model of reperfusion of 24 h cold‐stored rat livers.Results: During the preservation period, antiproteolytic amino acids inhibited the proteolysis observed in stored livers as shown by branched‐chain amino acid fluxes, which switched from release to uptake. During reperfusion, cold storage of lives without the addition of antiproteolytic amino acids resulted in a decrease in the total amino acid and branched‐chain amino acid uptake and a lower perfusion flow rate. The addition of antiproteolytic amino acids during liver storage resulted in the maintenance of total amino acid and branched‐chain amino acid uptake and a significant improvement in the perfusion flow rate during reperfusion.Conclusions: The presence of antiproteolytic amino acids in the preservation medium might be of interest in improving hepatic graft viability in transplantation.
Troglitazone prevents fatty changes of the liver in obese diabetic rats
Authors: Jia Dong Mei , Tabaru Akinari , Akiyama Toshiharu , Abe Shintaro , Otsuki Makoto 
Published: March 2003

AbstractBackground and Aims:Troglitazone is a newly developed antidiabetic drug and is indicated to be useful for the treatment of patients with type II diabetes mellitus. Recently, however, it became clear that troglitazone could cause liver dysfunction in some patients. In addition, a relationship between the activation of the peroxisome proliferator‐activated receptor gamma receptor by troglitazone and colon tumorigenesis has been suggested. The present study was undertaken to examine the effects of long‐term administration of troglitazone on the liver and intestine in genetically obese and diabetic Otsuka Long‐Evans Tokushima Fatty (OLETF) and control Long‐Evans Tokushima Otsuka (LETO) rats.Methods:A troglitazone‐rich diet (200 mg/100 g normal chow) or a standard rat chow, free of troglitazone (control), was given to OLETF and LETO rats from 12 or 28 weeks of age until 72 weeks of age. Serum levels of glucose, insulin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were determined at several time points. In addition, histology of the liver and intestine and serum levels of cholesterol and triglycerides were examined at 72 weeks of age.Results:Troglitazone prevented age‐related increases in fasting glucose and insulin concentrations in OLETF rats, but had no significant influences on serum levels of AST and ALT in both strains of rats. The liver weights in the control OLETF rats were significantly heavier than in the LETO rats. Troglitazone significantly reduced serum cholesterol and triglyceride levels and the liver weight. However, it had no influence on the large intestine weight and the number of colonic polyps in both OLETF and LETO rats. Sections of the liver from the untreated OLETF rats showed mild fatty changes in the central zone of the hepatic lobule, whereas those from the troglitazone‐treated OLETF rats appeared normal with no fat deposition in the hepatocytes. Troglitazone in LETO rats also caused no significant histopathologic changes of the liver tissue.Conclusion:Our present study demonstrated that long‐term administration of troglitazone prevents the progress of the metabolic derangement and fatty changes of the liver in genetically determined obese diabetes.
Evaluation of pancreatic secretion after administration of secretin: Application of magnetic resonance imaging
Authors: Nanashima Atsushi , Yamaguchi Hiroyuki , Fukuda Toshio , Sakamoto Ichiro , Kuroda Akinori , Sawai Terumitsu , Nakagoe Tohru , Ayabe Hiroyoshi 
Published: March 2003

AbstractBackground: To evaluate pancreatic exocrine function, we measured the changes in T2 enhanced hydrograhic intensity on magnetic resonance (MR) images of the pancreas following an injection of secretin, which is representative of the changes in duodenal fluid volume.Methods: The subjects were 10 patients with normal pancreatic function (N > 70% detected by using a pancreatic function diagnostant test) and 12 patients with hypo‐function, including those with mild hypo‐function (MH, 50–70%, six patients) and severe hypo‐function (SH < 50%, six patients).Results: In the N group, T2 enhanced intensity of the pancreas increased to a maximum value (more than 10% compared with baseline) within 5 min of stimulation, then gradually decreased. No significant difference in the response was observed between the head and body of the pancreas. Changes in the MH group were similar to those of the N group. In contrast, significantly lower changes in T2 enhanced intensity were observed in SH group, relative to both the N and MH group (P < 0.05). The amount of secretin‐induced increase in duodenal fluid after 16 min was not significantly different among the three groups. Furthermore, an evaluation of the residual pancreatic tissue after a pancreatoduodenectomy was also feasible.Conclusions: Our results indicate that the MR‐secretin test is useful for the evaluation of severe pancreatic exocrine dysfunction. The diagnostic test is simple, direct and non‐invasive.
A phase one study of the hepatic arterial administration of 1,25‐dihydroxyvitamin D3 for liver cancers
Authors: Finlay Ian G , Stewart Graham J , Ahkter Javed , Morris David L 
Published: March 2003

AbstractBackground and Aims: It is well established that exposure to 1,25‐dihydroxyvitamin D3 (1,25(OH)2D3) inhibits the proliferation of human colorectal cancer and hepatoma cell lines, both in vitro and in vivo. However, clinical trials of the administration of 1,25(OH)2D3 and analogs for the treatment of malignancy have been limited by the development of hypercalcemia. 1,25‐dihydroxyvitamin D3 is principally excreted in bile following hepatic catabolism. This suggested the hypothesis that hepatic regional administration may allow high doses of 1,25(OH)2D3 to be administered for the treatment of liver cancers without producing hypercalcemia, caused by a clinically significant first pass effect. This phase one study investigates the effect of hepatic regional administration of 1,25(OH)2D3 on serum calcium levels, together with other markers of renal and liver function.Methods: Six subjects with hepatic colorectal cancer metastases and one with primary hepatocellular cancer were given continuous hepatic arterial infusions of 1,25(OH)2D3, for periods of 1–4 weeks. Blood samples were taken regularly and assayed for calcium levels, liver function tests and urea and electrolyte levels.Results: Patients remained normocalcemic at dosages of up to 10 mcg/day. No patient experienced any side‐effects from the treatment.Conclusions: Administration of 1,25(OH)2D3 as a continuous hepatic arterial infusion allows a high dosage to be administered without inducing hypercalcemia. This route of administration may allow the potential of 1,25(OH)2D3 in the treatment of hepatic cancers to be realized.
Imaging and clinical characteristics of focal atrophy of segments 2 and 3 in primary sclerosing cholangitis
Authors: Caldwell Stephen H , Hespenheide Elizabeth E , Harris Danielle , De Lange Eduard E 
Published: March 2003

AbstractBackground and Aims: Focal atrophy in primary sclerosing cholangitis (PSC) is usually thought to result from severe biliary stricture and focal biliary cirrhosis. Atrophy of the left lateral segments (segments 2 and 3) are striking when observed grossly. This type of atrophy may be subtle on cross‐sectional imaging and by endoscopic retrograde cholangiopancreatography (ERCP) because of the peripheral location and compensatory hypertrophy of other parts of the liver. We examined 44 consecutive PSC patients to determine the incidence and clinical characteristics of this abnormality, and to correlate imaging studies with the gross appearance.Methods: We reviewed all cases of PSC encountered over a 3 year period ascertained from the liver disease registry. Magnetic resonance imaging or CT images were re‐examined for evidence of segment 2 and 3 atrophy.Results: Four of 44 patients had focal segment 2 and 3 atrophy. These four had been confirmed laparoscopically or by inspection of the liver explant. The remaining segments of the liver were relatively spared of injury in two of the patients, and three of the four patients had preserved synthetic function without evidence of portal hypertension. While the abnormality is clearly visible on cross‐sectional imaging, its peripheral location caused it to be an unobtrusive. Likewise, ERCP did not clearly reveal the abnormality on initial inspection.Conclusions: We conclude that focal atrophy of segments 2 and 3 is a sometimes early and subtle finding in PSC that may be overlooked in cross‐sectional imaging or ERCP unless specifically sought.
Radioisotope scintigraphy in the diagnosis of hepatic hydrothorax
Authors: Bhattacharya Anish , Mittal Bhagwant Rai , Biswas Tapas , Dhiman Radha Krishan , Singh Baljinder , Jindal Surinder Kumar , Chawla Yogesh 
Published: March 2003

AbstractBackground: Pleural effusion in cirrhotic patients (hepatic hydrothorax) may result from migration of ascitic fluid across defects in the diaphragm. Biochemical analysis of ascitic and pleural fluid provides only indirect information about the nature and origin of the effusion. The present study was performed in order to demonstrate the presence/absence of peritoneo–pleural communication by radioisotope imaging.Methods: Ten patients with cirrhotic ascites and pleural effusion were studied with 99mTc sulfur colloid scintigraphy to look for movement of the radiotracer from the peritoneal to the pleural cavity. Serum–ascitic albumin gradient (SAAG) and serum–pleural fluid albumin gradient (SPAG) values were determined in eight patients to examine the nature of the ascitic and pleural fluids.Results: Transdiaphragmatic movement of ascitic fluid into the pleural space was demonstrated (generally within 2 h of intraperitoneal injection of the radiotracer) in eight of 10 patients; six on the right side, one on the left and one bilaterally. Two patients in whom pleural fluid was transudative on SPAG values were negative for peritoneo–pleural communications.Conclusions: Radionuclide scintigraphy is a simple, safe and relatively non‐invasive method to confirm passage of ascitic fluid across the diaphragm.
Cerebral vascular resistance assessed by transcranial color Doppler ultrasonography in patients with chronic liver diseases
Authors: Kawakami Manri , Koda Masahiko , Murawaki Yoshikazu , Kawasaki Hironaka , Ikawa Shiro 
Published: March 2003

AbstractBackground and Aim: Cerebral hemodynamic derangement is well known in patients with liver cirrhosis. The advent of transcranial Doppler enables a non‐invasive observation of cerebral hemodynamics. To evaluate the clinical usefulness we examined cross‐sectionally and longitudinally cerebral hemodynamic parameters in patients with cirrhosis.Methods: The subjects of the cross‐sectional study were 117 patients with cirrhosis, 15 patients with chronic hepatitis and 25 healthy controls. The longitudinal study included 26 cirrhotic patients without encephalopathy, and 27 cirrhotic patients with encephalopathy. The pulsatility and resistive indices of the right middle cerebral artery were used as parameters of cerebral hemodynamics.Results: Cerebral pulsatility and resistive indices were significantly higher in patients with cirrhosis (1.05 ± 0.23, P < 0.0001 and 0.63 ± 0.07, P < 0.0001, respectively) than in the controls (0.75 ± 0.11 and 0.55 ± 0.05, respectively) and patients with chronic hepatitis (0.81 ± 0.11 and 0.52 ± 0.05, respectively). Cerebral pulsatility and resistive indices were significantly related with the severity of liver cirrhosis. Patients with encephalopathy had higher cerebral pulsatility and resistive indices than patients without encephalopathy. In the longitudinal studies, cerebral pulsatility and resistive indices were changed in parallel with the severity of cirrhosis and encephalopathy. Cerebral pulsatility and resistive indices were significantly correlated with the blood ammonia level and serum levels of bilirubin and albumin.Conclusion: These cross‐sectional and longitudinal studies showed that cerebral vascular resistance indices measured by using transcranial Doppler were increased in association with the severity of cirrhosis and encephalopathy. Cerebral pulsatility and resistive indices are real‐time and useful parameters to assess and monitor cirrhotic patients.
High viral loads, serum alanine aminotransferase and gender are predictive factors for the development of hepatocellular carcinoma from viral compensated liver cirrhosis
Authors: Ishikawa Toru , Ichida Takafumi , Yamagiwa Satoshi , Sugahara Satoshi , Uehara Kazuhiro , Okoshi Shogo , Asakura Hitoshi 
Published: March 2003

AbstractBackground and Aims:The aims of the present study were to determine the occurrence rate of hepatocellular carcinoma (HCC) and to assess the risk factors for the development of HCC in compensated viral liver cirrhosis.Methods:Two hundred and thirty‐nine cirrhotic patients (65 hepatitis B surface antigen (HBsAg) positive, 165 hepatitis C virus (HCV) antibody positive (anti‐HCV), and nine with both HBsAg and anti‐HCV positivity) were studied. The Kaplan–Meier method evaluated by a log–rank test was used to estimate the cumulative probability of HCC development. Independent predictors of HCC development were estimated by using the Cox proportional hazard regression analysis.Results:Dual infection manifested as HBsAg and anti‐HCV positive was the highest risk of HCC. Multivariate analysis indicated that anti‐HCV positive, HBsAg positive, and lactate dehydrogenase were independent predictors of the development of HCC among individuals with viral cirrhosis. In the HBsAg‐positive group, a high‐titer of HBV‐DNA (more than 3.7 log genome equivalents (LGE)/mL) was most predictive of HCC development. In the anti‐HCV‐positive group, male gender and a high‐titer of HCV‐RNA (more than 1.0 Meq/mL) were predictive factors for the development of HCC.Conclusions:Individuals with high viral loads should be monitored for the development of HCC. Clinical efforts at eradicating or reducing the viral load may reduce the risk for HCC.
A case of Behçet’s disease accompanied by colitis with longitudinal ulcers and granuloma
Authors: NAGANUMA MAKOTO , IWAO YASUSHI , KASHIWAGI KAZUHIRO , FUNAKOSHI SHINSUKE , ISHII HIROMASA , HIBI TOSHIFUMI 
Published: March 2003

AbstractA 37‐year‐old female presenting with oral and genital ulcers and erythema nodosum on both arms was diagnosed as having Behçet’s disease. The symptoms resolved spontaneously. However, she was admitted to our hospital (Keio University Hospital) several months later because of fever, aphthous ulcers of the oral cavity, lower abdominal pain and frequent diarrhea. A colonoscopic examination revealed multiple ulcers including longitudinal ulcers in the ascending and transverse colon, and histological examination of biopsied specimens demonstrated non‐caseating epithelioid granuloma. Treatment with prednisolone and 5‐aminosalicylic acid was started, and the patient responded well clinically. One month later, a repeated colonoscopy confirmed that the lesions including longitudinal ulcers had disappeared. In this report, we describe our experience of this rare case of Behçet’s disease concomitant with colonic longitudinal ulcers and epithelioid granuloma, and discuss the difficulties in making a differential diagnosis, primarily with regard to Crohn’s disease.
Different outcomes of vertical transmission of hepatitis C virus in a twin pregnancy
Authors: INUI AYANO , FUJISAWA TOMOO , SOGO TSUYOSHI , KOMATSU HARUKI , ISOZAKI ATSUSHI , SEKINE ISAO 
Published: March 2003

AbstractThe risk of vertical transmission of hepatitis C virus (HCV) from mother to infant has been well documented, but the exact mode of transmission is still unclear. In a set of monochorionic diamniotic monozygous twins, only the second baby was infected with HCV from the mother who was positive for serum HCV‐RNA. The babies had an uncomplicated vaginal delivery 3 min apart and they were both bottle fed from the outset. The second baby developed clinical hepatitis that persisted to 30 months follow up. The intrauterine environment should have been identical for these twins, and therefore, the maternal HCV factors, including viral load are not the sole determining factors for mother‐to‐infant transmission of HCV.© 2002 Blackwell Publishing Asia Pty Ltd
The additive effect of opioids and nitric oxide in increasing pentylenetetrazole‐induced seizure threshold in cholestatic mice
Authors: HOMAYOUN HOUMAN , SAYYAH MOHAMMAD , DEHPOUR AHMAD REZA 
Published: March 2003

AbstractBackground: Accumulation of endogenous opioids and overproduction of nitric oxide has been reported in cholestatic mice. It is well known that endogenous opioids and nitric oxide alter the susceptibility of experimental animals to different models of seizure.Methods: The alterations in clonic seizure thresholds, induced by pentylenetetrazole from 1 to 6 days after bile duct ligation, were evaluated in mice. Whether the pretreatment of cholestatic mice with different doses of opioid receptor antagonist naltrexone, or nitric oxide inhibitor Nω‐nitro‐L‐arginine methyl ester would have changed the clonic seizure threshold was also examined.Results: While in sham‐operated mice the clonic seizure threshold was similar to that of the thresholds in unoperated controls, a time‐dependent increase in the threshold was observed in cholestatic mice, reaching a peak on day 3 after bile duct ligation and declining partially after the 4th day. Chronic pretreatment with naltrexone (2, 5 and 10 mg/kg, i.p.) reversed the increased threshold in cholestatic mice on day 3 after operation in a dose‐dependent manner with the highest doses used restoring the threshold to that of the control animals. A similar reversal of the increased threshold was observed after acute (1, 3 and 10 mg/kg, i.p.) or chronic (10 mg/kg, i.p. for 4 days) pretreatment with Nω‐nitro‐L‐arginine

methyl ester. Moreover, concurrent administration of doses of Nω‐nitro‐L‐arginine methyl ester and naltrexone that each separately induced a partial reversal of increased seizure threshold in cholestasis caused a complete restoring of the threshold to the control level.Conclusions: Based on these findings, both opioid receptors and nitric oxide may be involved in the dramatic increase in pentylenetetrazole‐induced seizure threshold in cholestasis.