bluuebunny/crossref_metadata_2025_split huggingface dataset:
High sustained response to daily dosing of interferon with ribavirin in chronic hepatitis C patients naïve to therapy
Authors: ABBAS ZAIGHAM , HAMID SAEED , TABASSUM SHAESTA 
Published: March 2003

Abstract
Background
: Viral kinetics suggests that daily administration of α‐interferon (IFN) will clear hepatitis C virus (HCV) RNA earlier and more frequently compared with standard t.i.w. To reduce the likelihood of viral replication, mutation and subsequent development of resistance, daily dosing with IFN may be appropriate. To determine the safety and efficacy of daily IFN with ribavirin in chronic HCV infection we performed a prospective study.
Methods
: Thirty‐five naïve adult HCV‐positive patients (25 male/10 female) were treated with IFN‐α2b; 5 MU daily for 2 weeks followed by 3 MU daily for 22 weeks and ribavirin 800–1200 mg/day depending on weight. Liver biopsy, performed in 25 patients, showed mild to moderate activity in 19 patients (76%) and severe activity in six patients (24%). Two patients showed staged IV fibrosis. Serotyping was performed in 29 patients by an enzyme immunoassay‐based Murex assay. Type 3 was the predominant serotype, present in 14 cases. Hepatitis C virus RNA was measured by the Chiron bDNA assay.
Results
: Mean baseline HCV‐RNA level was 14.2 ± 18.7 MEq/mL (median 6.09; range 0.2–92.5), which became undetectable in all but three patients at week 4. Normalization of alanine aminotransferase (ALT) at week 4 was seen in 27 patients. Three patients withdrew due to non‐compliance. Thirty‐two patients completed 24 weeks of therapy as per the protocol. At the end of treatment, the HCV‐RNA level was negative in 29 of 32 patients (90.6%) and ALT was normal in 31 of 32 patients (97%). Sustained viral response at 6 months follow up was seen in 28 of 32 patients (88%). The ALT level was normal in 28 of 32 patients (88%).
Conclusion
: Daily administration of IFN with ribavirin is well tolerated in the majority of patients. There is rapid elimination of virus with normalization of ALT and a significantly high sustained viral response.© 2002 Blackwell Publishing Asia Pty Ltd
Eight‐year nationwide survival analysis in relatives of patients with hepatocellular carcinoma: Role of viral infection
Authors: Tai Dar‐In , Chen Chien‐Hung , Chang Ting‐Tsung , Chen Shinn‐Cherng , Liao Li‐Ying , Kuo Chung‐Huang , Chen YangYuan , Chen Gran‐Hum , Yang Sien‐Sing , Tang Huang‐Shang , Lin Hsien Hong , Lin Deng‐Yn , Lo Sing Kai , Du Jeng‐Ming , Lin Kwo‐Chuan , Changchien Chi‐Sin , Chang Wen‐Yu , Sheu Jin‐Chuan , Liaw Yun‐Fan , Chen Ding‐Shinn , Sung Juei‐Low 
Published: March 2003

Abstract Background: Families of patients with hepatocellular carcinoma (HCC) carry a high risk of developing HCC. We determine the number of fatalities in relatives of HCC patients during an 8‐year period to understand the risk and cause of HCC in relatives of patients with HCC.Methods: From 1992 to 1997, 15 410 relatives of HCC patients in three generations were screened prospectively for HCC by ultrasonography, α‐fetoprotein, liver biochemistry and viral markers. By using national citizen identification numbers, we searched the total fatalities in relatives of HCC patients between 1992 and 1999 from the national mortality data bank. The results were compared among different viral infection groups.Results: Of the relatives studied, 37.8% were hepatitis B s antigen (HBsAg) positive (+), 4.3% were anti‐hepatitis C virus (HCV) (+) and 1.7% were both HBsAg (+) and anti‐HCV (+). A total of 399 fatalities, including 139 because of HCC (34.8%), 37 because of liver diseases (9.3%), 88 because of other cancers (22.1%) and 135 because of other diseases (33.8%), were found. Relatives who were HBsAg (+) or anti‐HCV (+)showed a lower cumulative survival than did relatives who were negative for both HBsAg and anti‐HCV. Relatives with dual infection of hepatitis B and C virus showed the highest mortality due to HCC or terminal liver diseases.Conclusions: Chronic viral infection rather than a hereditary factor is the main cause of a familial tendency for HCC. Dual infection of hepatitis B and C virus increases the risk of HCC or decompensated liver diseases.
Roles of tumor necrosis factor‐α‐receptor type 1 and Fas in the Helicobacter pylori‐induced apoptosis of gastric epithelial cells
Authors: HASUMI KEIZO , TANAKA KAZUO , SAITOH SHIN , TAKAGI ATSUSHI , MIWA TAKESHI , MINE TETSUYA , KOGA YASUHIRO 
Published: March 2003

AbstractObjectives Helicobacter pylori (HP) infection has been reported to accelerate the apoptosis of gastric epithelial cells. This bacteria has also been known to enhance the expression levels of molecules such as Fas antigen and a receptor for tumor necrosis factor‐α‐receptor type 1 (TNF‐R1). However, whether Fas and/or TNF‐R1 is actually involved in HP‐mediated apoptosis has yet to be evaluated. The purpose of this study was therefore to examine the roles of Fas and TNF‐R1 in HP‐mediated apoptosis.MethodsBiopsy samples were collected from 10 HP‐negative healthy volunteers and from 39 HP‐positive ulcer patients. Gastric epithelial cells were obtained from the samples. The cells were then stained with anti‐Fas, anti‐TNF‐R1 and Annexin V, which detected apoptotic cells. The findings were analyzed by three‐color flow cytometry.ResultsThe percentages of apoptotic cells were significantly higher in HP‐positive patients than in the controls. In HP‐negative controls, almost all of the apoptotic cells lacked both Fas and TNF‐R1. On the other hand, in HP‐positive patients, HP upregulated the expression levels of Fas and TNF‐R1 and, consequently, enhanced the apoptosis mediated by receptors such as Fas and TNF‐R1. However, even in HP‐positive patients, apoptosis was also observed in the cells that lacked both Fas and TNF‐R1.ConclusionsFas and TNF‐R1 expressed on gastric epithelial cells from HP‐infected patients were responsible for the accelerated apoptosis of the cells.
Oral administration of lactoferrin reduces colitis in rats via modulation of the immune system and correction of cytokine imbalance
Authors: TOGAWA JUN‐ICHI , NAGASE HAJIME , TANAKA KATSUAKI , INAMORI MASAHIKO , NAKAJIMA ATSUSHI , UENO NORIO , SAITO TOSHIFUMI , SEKIHARA HISAHIKO 
Published: March 2003

Abstract
Background and Aims
: The natural immunomodulator, lactoferrin, is widespread among various biological fluids and is known to exert an anti‐inflammatory effect. However, there has been only one study that examined the mode of action of lactoferrin in reducing intestinal damage. We investigated the therapeutic role of lactoferrin and its effect on the levels of pro‐inflammatory and anti‐inflammatory cytokines, by using a rat model of dextran sulfate sodium (DSS) induced‐colitis.
Methods:
Male Sprague–Dawley rats were given distilled drinking water containing 2.5% (wt/vol) synthetic DSS ad libitum. Bovine lactoferrin was given once daily through gavage, starting 3 days before beginning the DSS administration, until death. The whole colon was removed to be examined macroscopically and histologically. Myeloperoxidase activity, and pro‐inflammatory and anti‐inflammatory cytokines in the colonic tissue were also measured.
Results:
Dextran sulfate sodium‐induced colitis was attenuated by oral administration of lactoferrin in a dose‐dependent manner, as reflected by improvement in clinical disease activity index, white blood cell count and hemoglobin concentration, macroscopic and histological scores, and myeloperoxidase activity. Reduced inflammation in response to lactoferrin was correlated with the significant induction of the anti‐inflammatory cytokines, interleukin‐4 and interleukin‐10, and with significant reductions in the pro‐inflammatory cytokines, tumor necrosis factor α, interleukin‐1β, and interleukin‐6.
Conclusions:
We concluded that oral administration of lactoferrin exerts a protective effect against the development of colitis in rats via modulation of the immune system and correction of cytokine imbalance. Lactoferrin has potential as a new therapeutic agent for inflammatory bowel disease.© 2002 Blackwell Publishing Asia Pty Ltd
New method for the determination of fecal consistency and its optimal value in the general population
Authors: NAKAJI SHIGEYUKI , FUKUDA SHINSAKU , IWANE SATORU , MURAKAMI HIDEKI , TAMURA KEN , MUNAKATA AKIHIRO , SUGAWARA KAZUO 
Published: March 2003

Abstract
Background
: Although fecal consistency is an important factor, there has been only one study measuring this parameter. We developed a new method to measure fecal consistency and studied the relationship between fecal consistency and other fecal factors, including water content and weight.
Methods
: The new method is a modification of the method of Exton‐Smith and used an even balance. Subjects in the initial trial were 26 healthy women. Subsequently, fecal consistency was measured in a representative sample of the general Japanese population, in order to evaluate the optimal value to maintain large bowel function.
Results
: Correlations between fecal consistency and fecal water content and weight were statistically consistent, although not highly correlated with each other. The optimal mean value was around 300 cm2: ‘normal’ in ‘subjective defecatory state’, 295.5 cm2 and 305.2 cm2; ‘once/day’ in ‘defecation frequency’, 296.1 cm2 and 310.2 cm2; ‘soft and plump’ in ‘fecal characteristics’, 293.6 cm2 and 298.3 cm2, in males and females, respectively. The coefficient of variation of this method ranged from 5.2% to 6.3%.
Conclusions
: This method is thought to be applicable to large‐scale epidemiological surveys. The optimal value of fecal consistency in the general population was evaluated at approximately 300 g/cm2.© 2002 Blackwell Publishing Asia Pty Ltd
Examination of small bowel enzymes in chronic diarrhea
Authors: SIMADIBRATA MARCELLUS , WANDERS RONALD JA , JAN GERRIT , TYTGAT GUIDO NJ , LESMANA LAURENTIUS A , DALDIYONO  , ARIAWAN IWAN 
Published: March 2003

AbstractBackground: In Indonesia, the proportion of daily carbohydrate intake is approximately 60–80%. A number of small bowel disorders can result in the impairment of absorption and enzyme deficiency. Chronic diarrhea is common in Indonesia.Methods: Thirty‐four functional dyspeptic patients with an endoscopically normal small bowel as a control group, and 17 chronic diarrhea patients from the Division of Gastroenterology, University of Indonesia/Cipto Mangunkusumo Hospital were included in this study. All patients underwent a gastroduodenojejunoscopy and an ileocolonoscopy examination. Biopsies were taken from the jejunum (two specimens) and the biopsy specimens were examined for enzyme analysis (lactase, maltase, sucrase). The data were analyzed by using the Kruskal–Wallis or anova.Results: The lactase level of the chronic diarrhea group was significantly lower compared with that of the control group (1.941 ± 1.621 vs 2.502 ± 2.098 µmol/min mg protein; P < 0.001). The maltase level of the chronic diarrhea group was significantly lower compared with that of the control group (280.942 ± 148.173 vs 371.920 ± 250.177 µmol/min mg protein; P < 0.001). The sucrase level of the chronic diarrhea group was significantly lower compared with that of the control group (48.474 ± 28.553 vs 66.727 ± 49.685 µmol/min mg protein; P < 0.001).Conclusion: The enzyme activity concentrations (lactase, maltase, sucrase) were much lower in chronic diarrhea cases compared with the controls.© 2003 Blackwell Publishing Asia Pty Ltd
Clinical use of hyaluronic acid as a predictor of fibrosis change in hepatitis C
Authors: PATEL KEYUR , LAJOIE ADRIANNE , HEATON SHANON , PIANKO STEPHEN , BEHLING CYNTHIA A , BYLUND DAVID , POCKROS PAULJ , BLATT LAWRENCE M , CONRAD ANDREW , MCHUTCHISON JOHN G 
Published: March 2003

AbstractBackground and Aim: Hyaluronic acid (HA) is a glycosaminoglycan synthesized by hepatic stellate cells that has been shown to correlate with liver fibrosis in chronic hepatitis C (HCV) patients. However, its use in monitoring fibrosis over time has not been established. The aim of the present study was to assess the serial relationships between HA and liver fibrosis before and after treatment.Methods: Seventy‐six previously untreated chronic HCV patients received interferon‐based therapy over 48 weeks. Serum HA levels were measured and liver biopsies were obtained at baseline, and 24 weeks post‐treatment. Histological fibrosis was assessed by using the Knodell and METAVIR scoring systems.Results: Knodell fibrosis was evaluated in 76 patients; METAVIR fibrosis in 72 patients. Following treatment, patients were grouped into those with increased fibrosis (Knodell = 17; METAVIR = 16), no change (Knodell = 50; METAVIR = 45), or decreased fibrosis (Knodell = 9; METAVIR = 11), relative to baseline. Moderate correlations between HA and fibrosis scores were found before treatment (Knodell R = 0.45; METAVIR R = 0.40) and post‐treatment (Knodell R = 0.45; METAVIR R = 0.61). However, changes in HA correlated poorly with changes in fibrosis scores over the study period (Knodell R = 0.11; METAVIR R = 0.06). There was poor qualitative agreement between the direction of HA change and the direction of change in fibrosis scores (Knodell kappa = 0.04; METAVIR kappa = 0.08). The sus‐tained virological response group (n = 18) had a significantly decreased mean HA compared with non‐responders (−27.9 vs 21.7 µg/L; P = 0.009), but pretreatment HA did not predict a response.Conclusions: Serum HA showed a modest association with hepatic fibrosis, and remains a useful non‐invasive marker. However, serum HA alone has limited value in predicting histological changes over a treatment period.
Role of para‐esophageal collateral veins in patients with portal hypertension based on the results of endoscopic ultrasonography and liver scintigraphy analysis
Authors: IRISAWA ATSUSHI , OBARA KATSUTOSHI , BHUTANI MANOOP S , SAITO AYAKO , SHISHIDO HIDEO , SHIBUKAWA GORO , TAKAGI TADAYUKI , YAMAMOTO GO , SEINO OSAMU , SHISHIDO FUMIO , KASUKAWA REIJI , SATO YUKIO 
Published: March 2003

AbstractBackground and Aims: Para‐esophageal collateral veins (para‐ECV) are observed by endoscopic ultrasonography (EUS) in patients with portal hypertension. However, the role of para‐ECV in the portal venous system is not clear. To verify the role of para‐ECV in the portal venous system, we investigated the relationship between the development of para‐ECV as determined by EUS, and the portal blood flow ratio (PBFR) as determined by liver scintigraphy using 99mTc‐phytate.Methods: Eighteen patients who did not have fundal gastric varices were studied before the start of and after the completion of all endoscopic sclerotherapy sessions for esophageal varices. EUS was performed to observe veins around the esophagus, para‐ECV and perforating veins. To quantify the degree of development of para‐ECV, the cross‐sectional area of each para‐ECV observed by EUS was measured. The sum total of these areas was used as an index of development of para‐ECV. The PBFR was calculated by liver scintigraphy using 99mTc‐phytate. The correlation between the sum total cross‐sectional area of para‐ECV and PBFR was examined.Results: After all endoscopic injection sclerotherapy sessions, the total cross‐sectional area of para‐ECV was 29.32 (26.72) mm2 (mean (SD)) and the PBFR was 48.47 (17.87)% (mean (SD)). A significant correlation between them was noted after treatment (r = − 0.70, P < 0.01). Variceal recurrence was observed in three of the patients who had perforating veins connected with para‐ECV, regardless of degree of the para‐ECV.Conclusion: The para‐ECV are collaterals, which reflect the portal blood flow after endoscopic sclerotherapy. para‐ECV without perforating veins were considered to be important collaterals after treatment.
Assessment of cancer cell differentiation in small hepatocellular carcinoma by computed tomography and magnetic resonance imaging
Authors: AMANO SUSUMU , EBARA MASAAKI , YAJIMA TAKAYUKI , FUKUDA HIROYUKI , YOSHIKAWA MASAHARU , SUGIURA NOBUYUKI , KATO KAZUKI , KONDO FUKUO , MATSUMOTO TOORU , SAISHO HIROMITSU 
Published: March 2003

AbstractAim: To study whether cancer cell differentiation in small hepatocellular carcinoma (HCC) can be assessed by computed tomography (CT) and magnetic resonance (MR) imaging.Methods: We retrospectively evaluated the relationship between cancer cell differentiation in 127 HCC 3 cm or less in diameter (113 patients) and CT and MR images. Images were reviewed in a consensus conference by three authors (SA, TY, and ME). Histopathological diagnosis of HCC was made from liver specimens obtained by sonographically guided biopsy.Results: The degree of histological differentiation of cancer cells was significantly different between HCC that were isodense with liver parenchyma in both artery‐dominant and equilibrium phases in contrast‐enhanced CT and tumors that were hyperdense in the artery‐dominant phase and iso‐ or hypodense in the equilibrium phase (P = 0.0054), as well as tumors that were iso‐ or hypodense artery‐dominant and hypodense equilibrium (P = 0.0002). Histological differentiation of lesions that were hyperintense in T1‐weighted images and hypointense in T2‐weighted images differed significantly from those with the opposite MR characteristics (P = 0.0122). In T1‐weighted fat‐suppression images and T2‐weighted images, respectively, the degree of histological differentiation was significant between the hypointense/hyperintense and the hyperintense/hypointense patterns (P < 0.0001), as well as the hyperintense/isointense (P = 0.0296), the hyperintense/hyperintense (P = 0.0434), and the isointense/hyperintense (P = 0.0171). Using these differences an equation was developed that could determine with 76% accuracy whether the tumors were well or less‐well differentiated.Conclusion: CT and MR imaging patterns were useful in predicting the degree of histological differentiation of cancer cells in HCC.
Retinopathy of prematurity in infants < 32 weeks’ gestation at birth in New South Wales in 1993 and 1994
Authors: Todd DA , Cassell C , Kennedy J , John E ,   The New South Wales Neonatal Intensive Care Units Study Group
Published: March 2003

Objective: To study the incidence and severity of retinopathy of prematurity (ROP) in infants < 32 weeks’ gestation. Design: Review of the records maintained in the New South Wales Neonatal Intensive Care Unit Study (NICUS) database on infants admitted to the neonatal intensive care units (NICU) in NSW from 1 January 1993 to 31 December 1994. Results: In the more premature infants, 23–26 weeks’ gestation, 65% developed ROP (102 of 157 examined for ROP). Forty‐four infants (28%) developed severe ROP (Stage ≥ 3 ROP), 19 infants (12.1%) required cryo/laser therapy and one infant (0.6%) in this group had a retinal detachment. One hundred and fifty‐seven of 159 surviving infants (98.7%) were examined for ROP. In the infants 27–28 weeks’ gestation, 38.3% developed ROP (103 of 269 examined for ROP). Fifteen infants (5.6%) developed severe ROP, seven infants (2.6%) required cryo/laser therapy for threshold ROP and three infants (1.1%) in this group had a retinal detachment. Two hundred and sixty‐nine of 299 surviving infants (90%) were examined for ROP. In the infants 29–31 weeks’ gestation, 10.8% developed ROP (48 of 443 examined for ROP). Six infants (1.4%) developed severe ROP, one infant (0.2%) required cryo/laser therapy for threshold ROP and no infant in this group had a retinal detachment. However, only 443 of 681 surviving infants (65.1%) in this group were examined for ROP. Of the four infants with detached retinas, one was a 25 week gestation infant weighing 840 g, two were 27 weeks’ gestation weighing 960 and 980 g and one infant was a 28 week gestation infant weighing 620 g. No infant developed Stage 5 ROP. Conclusion: In the more mature infants 29–31 weeks’ gestation, the rate of ROP is low, although severe ROP still occurs. However, only 65.1% of these infants were examined for ROP and we should be diligent in screening for ROP in the sicker infants in this group. The incidence of severe ROP as well as the rate of cryo/laser therapy in premature infants 23–26 weeks’ in NSW has not changed since the increases seen in the early 1990s. Retinal detachment also occurs in the infants 27–28 weeks’ gestation and it is important that all these infants are screened for ROP.
Risk factors associated with umbilical vascular catheter‐associated thrombosis in newborn infants
Authors: Boo N‐Y , Wong N‐C , Zulkifli SZ SYED , Lye M‐S 
Published: March 2003

Objective: To determine the risk factors associated with umbilical vascular catheter‐associated thrombosis. Methods: All consecutive inborn infants with umbilical arterial (UAC) and/or umbilical venous catheters (UVC) inserted for more than 6 h duration were included in the study. Each infant was screened for thrombosis in the abdominal aorta and inferior vena cava by 2‐D abdominal ultrasonography within 48–72 h of insertion of umbilical vascular catheters. Subsequent serial scanning was performed at intervals of every 5–7 days, and within 48 h after removal of catheters. Results: Upon removal of umbilical catheters, abdominal aortic thrombi were detected in 32/99 (32.3%) infants with UAC. Small thrombi were detected in the inferior vena cava of 2/49 (4.1%) infants with UVC (one of whom had both UAC and UVC). When compared with those who received only UVC (n = 18), infants who received either UAC alone (n = 68) or both UAC and UVC (n = 31) had significantly higher risk of developing thrombosis (odds ratio (OR): 7.6, 95% confidence interval (CI): 1.1, 325.5)). Logistic regression analysis of various potential risk factors showed that the only significant risk factor associated with the development of abdominal aortic thrombosis following insertion of UAC was longer duration of UAC in situ (for every additional day of UAC in situ, adjusted OR of developing thrombosis was: 1.2, 95% CI: 1.1, 1.3; P = 0.002). Conclusion: Umbilical arterial catheter‐associated thrombosis was common. Umbilical arterial catheter should be removed as soon as possible when not needed. Upon removal of UAC, all infants should be screened for abdominal aortic thrombus by 2‐D ultrasonography.
Utilization of alternative therapies in attention‐deficit hyperactivity disorder
Authors: Stubberfield TG , Wray JA , Parry TS 
Published: March 2003

Objective: To identify the prevalence of use, the referral patterns and the perceived benefit of alternative therapy in children with attention‐deficit hyperactivity disorder (ADHD). Methodology: A mailed questionnaire survey was undertaken in June 1993, of the use of various therapies by families of 381 children with ADHD. The respondent rate was 76%. Results: Of respondents, 69% were using stimulant medication and 64% had used or were using a non‐prescriptional therapy. Diet therapies were the most commonly used alternative therapy (60%). There was no statistical difference in the prevalence of use of other therapies between the medicated and non‐medicated groups. The non‐medicated group reported more benefit from some alternative therapies. Physicians were commonly involved in the suggestion to try a modified diet. School teachers, family and friends were the main source of suggestion of alternative therapies. Conclusions: Clinicians should be aware of the range of alternative therapies and of their frequent use by families of children with attentional problems.