bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of anti‐hepatitis C virus‐positive sera not genotyped by restriction fragment length polymorphism or serology
Authors: Gish Robert , Qian Keping , Brooks Linda , Leung Janet , Xu Yiling , Pike Ian , Lau Johnson 
Published: March 2003

Background: The hepatitis C virus genome is extremely heterogeneous and has been classified into six major genotypes. Genotyping of hepatitis C has been achieved through both direct molecular approach and indirect detection of host genotype‐specific antibodies by serological methods. The purpose of this study was to characterize anti‐hepatitis C positive sera samples that were not genotyped either by restriction fragment length polymorphism or by serology. Methods: Two hundred and two patients from northern California with established chronic hepatitis C virus infection were studied by restriction fragment length polymorphism analysis of the 5′‐ untranslated region amplicon. A serological genotyping assay, based on synthetic peptides derived from non‐structural region 4 of the hepatitis C virus genome, was used to determine serological genotype. Results: Of the 202 patients studied, 187 (93%) were polymerase chain reaction‐positive. One hundred and eighty‐six patients were able to be genotyped by restriction fragment length polymorphism, compared with 144/202 (71%) of patients genotyped by serology (P < 0.0001). Only two of 202 samples showed discordant genotyping results. The distribution of hepatitis C virus genotypes in northern California was found to be type 1a, 41%; 1b, 35%; 2a, 3%; 2b, 10%; 3a, 11%; and 4, < 1%. There was no association between hepatitis C genotypes and age, gender distribution, ethnic origin, presumptive mode of transmission, serum alanine aminotransferase levels and the proportion of patients with cirrhosis. Of the 15 patients who were not genotypable by the molecular assay, four patients were genotyped by serology, with hepatitis C virus genotypes 1, 2 and 3 represented. Of the 58 samples that were not genotyped by serology, 47 were genotyped based on the molecular assay, and the distribution of hepatitis C virus genotypes was similar to that of the overall study population. Conclusions: These data showed that: (i) molecular genotyping assay based on 5′‐untranslated region is more sensitive than serologic genotyping based on the non‐structural‐4 region but the results were highly concordant; (ii) hepatitis C virus genotypes 1–4 are present in northern California, with genotype 1 being the most prevalent; and (iii) the failure to determine hepatitis C virus genotype based on molecular or serological genotyping assay does not appear to be related to specific hepatitis C genotypes.
Relationship between the effect of interferon therapy and the change of hepatitis C virus non‐structural 5B gene
Authors: Horiike Norio , Michitaka Kojiro , Masumoto Toshikazu , Okura Izumi , Akbar Sm , Onji Morikazu 
Published: March 2003

Background: Hepatitis C virus (HCV)‐RNA titre has been regarded as a factor affecting the response to interferon (IFN) therapy of patients with chronic hepatitis C (CHC). The focus of our study is the investigation of the nucleotide sequence of HCV‐RNA NS5B, which may code RNA‐dependent RNA polymerase and NS5A in the sera of 33 patients with CHC prior to IFN therapy. Methods: Hepatitis C virus genotype and HCV‐RNA titre were examined by polymerase chain reaction (PCR) and competitive reverse transcriptase‐PCR. Results: The sequence for HCV‐RNA NS5B (nt 8331–8600 in 1b and 8410–8679 in 2a) was determined by direct sequencing. The changes of the predicted amino acids in the genotype‐specific sites of HCV‐J, HCV‐BK, HC‐J4/83, HCV‐JT, HCV‐N, HC‐J6 and HCV‐K2a were examined, and the mutation was defined when changes of amino acids in sites specific to different reported genotypes were revealed. The mutations were observed in 6/19 (32%) in genotype 1b and 9/14 (64%) in 2a. In the 1b group, complete response (CR) was achieved in 5/6 of the mutant and in 2/13 of the wild type groups (P < 0.05). No relationship was observed between IFN effectiveness and HCV‐RNA titre in the 1b wild type group. In the 2a group, CR was achieved in 4/9 of the mutant and in 4/5 of the wild type groups. An inverse relationship between IFN responsiveness and HCV‐RNA titre was apparent in 1b mutant, 2a wild and 2a mutant. Conclusions: These data suggest the possible relationship between changes in the HCV‐NS5B gene and the effect of IFN therapy in CHC patients with genotype 1b.
Rapid elimination of Helicobacter pylori and reduction of histocompatibility leucocyte antigen‐DR expression 12 h after a single dose of omeprazole, amoxycillin and metronidazole triple therapy
Authors: Chen Wangxue , Shu Dairu , Wilson Ian R , Tie Andy , Chadwick Vint 
Published: March 2003

Background: Studies of eradication of Helicobacter pylori and subsequent resolution of H. pylori‐related gastritis, have focused mainly on medium and long‐term change following eradication therapies. Results from those studies have shown that both acute and chronic inflammatory changes found in gastric mucosa eventually return to normal. However, the early events in the stomach, particularly the effects on bacterial density and acute inflammatory markers of anti‐H. pylori treatment, are largely unknown. The objective of this study was therefore to examine changes in the number of H. pylori, and the severity of gastric mucosal inflammation in the gastric biopsy specimens of patients before (0 h group, n = 14) and 12 h (12 h group, n = 14) after initiating anti‐H. pylori treatment. Methods: Biopsies were assessed, either quantitatively or semi‐quantitatively, for the presence of H. pylori, neutrophils, mast cells, intraepithelial lymphocytes and the expression of histocompatibility leucocyte antigen (HLA)‐DR by gastric epithelium and the results were compared between groups. Results: Median H. pylori scores were 5 (range 2–5) and 0 (range 0–2) in biopsies from untreated and 12 h post‐treatment groups, respectively (P < 0.001). In most 12 h post‐treatment biopsies, H. pylori organisms could not be identified. There was a significant reduction in HLA‐DR expression by gastric epithelium (median 3.5 with range 2–4 at 0 h group vs median 2 with range 0–4, P < 0.05), but there was no significant difference in the number of intraepithelial lymphocytes, CD3+ cells, mast cells or the distribution and density of neutrophils (all P > 0.05). Furthermore, the severity of gastritis as scored with the Sydney system was similar in both untreated and treated groups. Conclusions: The results of this study indicate that elimination of H. pylori organisms and resolution of some inflammatory markers occurs as early as 12 h following a single dose of omeprazole 40 mg, amoxycillin 1.0 g and metronidazole 400 mg, which suggests that rational therapeutic strategies with shorter duration using the currently available drugs may be possible.
Helicobacter pylori in Meckel’s diverticulum with heterotopic gastric mucosa in a population with relatively high H. pylori prevalence rate
Authors: Chan Gavin , Yuen Siu , Chu Kent , Ho Judy , Leung Suet , Ho Joana 
Published: March 2003

Background: Helicobacter pylori (H. pylori) colonize only foveolar gastric‐type mucosa and are associated with active chronic gastritis and peptic ulcer. The aim of this study was to investigate whether H. pylori can also be found in Meckel’s diverticulum which contains heterotopic gastric mucosa. Methods: Biopsy specimens of Meckel’s diverticulum resected in Queen Mary Hospital, University of Hong Kong, during the 10 year period 1986–1995 were retrieved and reviewed. Those containing gastric heterotopia were examined for the presence of H. pylori, using Warthin–Starry silver stain. Results: In the 59 cases of Meckel’s diverticula studied, 16 were found to contain heterotopic gastric mucosa. Helicobacter pylori were not identified in any of these cases. In one of the 16 patients a concomitant gastric biopsy was performed. Although the gastric mucosa of this patient was heavily colonized by H. pylori, again no H. pylori was found in the heterotopic gastric mucosa in the Meckel’s diverticulum. Conclusions: The absence of H. pylori in all the Meckel’s diverticula examined, even when the stomach was heavily colonized by the organisms, suggests that colonization of Meckel’s diverticulum by H. pylori is a rare event. This, together with the overall rarity of H. pylori in all reported series of Meckel’s diverticulum, argues against its causative role in complications of Meckel’s diverticulum.
Comparison of two methods for quantification of hepatitis B viral DNA
Authors: Kao Jia‐Horng , Wood Michael , Chen Pei‐Jer , Lai Ming‐Yang , Chen Ding‐Shinn 
Published: March 2003

Background: Quantitation of serum hepatitis B virus (HBV) DNA has proven useful in assisting with patient management and treatment and several commercially available assays have been developed to quantify serum HBV‐DNA levels. Methods: The performance of the cross‐linking assay and the branched‐DNA signal amplification (bDNA) assay for the quantitative measurement of HBV‐DNA was studied in 99 hepatitis B surface antigen‐positive and viraemic patients. Results: Of these samples, 82 (83%) were positive for HBV‐DNA by both assays and four (4%) were below the cut‐off for both assays. Of the remaining 13 samples, 10 contained measurable levels of HBV‐DNA by the cross‐linking assay alone and three other samples contained measurable levels of HBV‐DNA by the bDNA assay alone. The sensitivity gain of the cross‐linking assay relative to bDNA assay in this study population was 10/92 (11%). In addition, a linear regression analysis showed that the HBV‐DNA levels obtained from both assays was significantly correlated (γ = 0.974, P < 0.0001). Conclusions: These findings suggest that the recently developed cross‐linking assay is more sensitive than the bDNA assay for the quantitative determination of HBV‐DNA.
Haemodynamic changes in non‐alcoholic (viral) liver cirrhosis studied by computed tomography (CT) arterial portography and CT arteriography
Authors: Takayasu Kenichi , Yoshie Kouichi , Muramatsu Yukio , Iwata Ryoko , Nakanishi Yukihiro , Sakamoto Michiie , Fukuda Haruhiko , Satake Mitsuo , Moriyama Noriyuki , Makino Yasuhiro 
Published: March 2003

Abstract
Aims
: To evaluate haemodynamic and vascular changes in non‐alcoholic (viral) cirrhosis on conventional computed tomography (CT), CT arteriography (CTA) and CT arterial portography (CTAP), and to determine the cause of the observed reticular stain on angiography.
Methods
: Using surgically resected liver specimens from 31 patients with viral hepatitis associated hepatocellular carcinoma, images of conventional CT, CTA, CTAP and the sinusoidal phase of hepatic arteriography were retrospectively analysed and compared with pathology of the non‐cancerous portion of the liver.
Results
: Computed tomography arteriography showed inhomogeneous enhancement (diffuse, low‐density nodules) in a total of 16 samples (52%); in eight of 10 (80%) cirrhotic livers, three of six (50%) precirrhotic livers, five of 12 (42%) livers with chronic active hepatitis and none of three with no active liver disease. The frequency of inhomogeneous enhancement became significantly higher with increasing severity of parenchymal damage (P < 0.05). In contrast, conventional CT and CTAP showed homogeneous enhancement in all 31 (100%) patients. There was no correlation between inhomogeneous enhancement on CTA and reticular staining on sinusoidal‐phase hepatic angiograms. Inhomogeneous enhancement was frequently seen in patients with hepatitis B surface antigen and/or anti‐hepatitis C virus antibody compared with those without them (P < 0.05).
Conclusion
: The CTA was much more sensitive in detecting haemodynamic changes in the cirrhotic liver than CTAP, conventional CT and sinusoidal‐phased hepatic angiography. Further study is required to clarify the mechanism of inhomogeneous enhancement on CTA and homogeneous enhancement on CTAP seen in cirrhosis.
Intravenous glycyrrhizin for the treatment of chronic hepatitis C: A double‐blind, randomized, placebo‐controlled phase I/II trial
Authors: Rossum Tekla Gj Van , Vulto Arnold G , Hop Wim Cj , Brouwer Johannes T , Niesters Hubert Gm , Schalm Solko W 
Published: March 2003

Abstract
Background
: In Japan, glycyrrhizin therapy is widely used for chronic hepatitis C and reportedly reduces the progression of liver disease to hepatocellular carcinoma. The aims of this study were to evaluate the effect of glycyrrhizin on serum alanine aminotransferase (ALT), hepatitis C virus (HCV)‐RNA and its safety in European patients.
Methods
: Fifty‐seven patients with chronic hepatitis C, non‐responders or unlikely to respond (genotype 1/cirrhosis) to interferon therapy, were randomized to one of the four dose groups: 240, 160 or 80 mg glycyrrhizin or placebo (0 mg glycyrrhizin). Medication was administered intravenously thrice weekly for 4 weeks; follow up also lasted for 4 weeks.
Results
: Within 2 days of start of therapy, serum ALT had dropped 15% below baseline in the three dosage groups (P < 0.02). The mean ALT decrease at the end of active treatment was 26%, significantly higher than the placebo group (6%). A clear dose–response effect was not observed (29, 26, 23% ALT decrease for 240, 160 and 80 mg, respectively). Normalization of ALT at the end of treatment occurred in 10% (four of 41). The effect on ALT disappeared after cessation of therapy. During treatment, viral clearance was not observed: the mean decrease in plasma HCV‐RNA after active treatment was 4.1 × 106 genome equivalents/mL (95% confidence interval, 0–8.2 × 106; P > 0.1). No major side‐effects were noted. None of the patients withdrew from the study because of intolerance.
Conclusions
: Glycyrrhizin up to 240 mg, thrice weekly, lowers serum ALT during treatment, but has no effect on HCV‐RNA levels. The drug appears to be safe and is well tolerated. In view of the reported long‐term effect of glycyrrhizin, further controlled investigation of the Japanese mode of administration (six times weekly) for induction appears of interest.© 1999 Blackwell Science Asia Pty Ltd
Magnesium citrate–bisacodyl regimen proves better than castor oil for colonoscopic preparation
Authors: Chen Chun‐Chia , Ng Wai‐Wah , Chang Full‐Young , Lee Shou‐Dong 
Published: March 2003

AbstractBackground: A clean colon preparation prior to endoscopy or X‐ray examination is essential to obtain an accurate diagnosis. In order to determine which of two easily made preparations is better, this study compares colon cleansing efficacy, patient acceptance and side effects in patients given either a magnesium citrate–bisacodyl or a castor oil regimen prior to colonoscopy.Methods: Seventy outpatients scheduled for colonoscopy were randomized to receive one of two bowel evacuation regimens on the day prior to the examination. Group 1 (n= 36) received a magnesium citrate solution (250 mL) and bisacodyl (10 mg, orally). Group 2 (n= 34) received castor oil (60 mL, orally).Results: The cleansing effect of the magnesium citrate–bisacodyl regimen was significantly better than that of castor oil in the ascending colon and caecum (cleansing scores 5.2 ± 1.2vs3.5 ± 1.3,P< 0.0001), but similar to that of castor oil in the recto‐sigmoid, descending and transverse colon. Abdominal pain (38vs11%,P< 0.01) and nausea (29vs8%,P< 0.05) were significantly more common in patients receiving the castor oil preparation than in patients administered with the magnesium citrate–bisacodyl regimen. More patients complained of poor acceptance with the castor oil regimen than with the magnesium citrate–bisacodyl regimen (24vs8%,P= 0.06).Conclusions: A combined oral magnesium citrate and bisacodyl regimen is effective and better than castor oil for colonoscopic preparation.© 1999 Blackwell Science Asia Pty Ltd
Mucosa‐associated lymphoid tissue lymphoma of the rectum that regressed spontaneously
Authors: Takenaka Ryuta , Tomoda Jun , Sakata Tatsuro , Ichiba Toshio , Motoi Makoto , Mizuno Motowo , Tsuji Takao 
Published: March 2003

AbstractWe report a case of mucosa‐associated lymphoid tissue (MALT) lymphoma of the rectum that regressed spontaneously. A 76‐year‐old man visited our hospital because of positive faecal occult blood testing. Colonoscopic examination revealed a slightly yellowish protruded lesion with a grooved depression in the lower rectum and two flat elevations in the upper rectum. Microscopic and immunohistological studies led to a diagnosis of MALT lymphoma. As the patient exhibited severe renal dysfunction and angina pectoris, the lesions were left untreated. Three months later, the protruded lesion became flat and the other lesions became unclear. He was followed up closely with endoscopy, but no relapse of these lesions was detected 19 months after the diagnosis.© 2000 Blackwell Science Asia Pty Ltd
Indications for liver transplantation in patients with chronic hepatitis B and C virus infection and hepatocellular carcinoma
Authors: Fan St , Cheung St , Lo Cm 
Published: March 2003

AbstractPatients with chronic hepatitis B virus (HBV) infection were not accepted for liver transplantation in Asia in the past because the hepatitis B immune globulin (HBIG) used to prevent post‐transplantation recurrence was very expensive and it was generally believed that Asians with hepatitis B fared worse than Caucasians after liver transplantation. The availability of lamivudine has altered the indication of liver transplantation for these patients. Twenty‐five Chinese patients with chronic HBV infection were given lamivudine as primary prophylaxis against HBV re‐infection before transplantation. Five patients died within 40 days of transplantation. After a median follow‐up period of 14 months (range, 5–39), 17 patients had lost serum HBsAg from 4 days to 27 months post transplantation, but it reappeared in three patients 4–12 months later. Antibody to HBsAg was detected periodically in the serum of 11 patients who had lost HBsAg. At the last follow‐up, six patients were HBsAg‐positive and HBV DNA was detected in only one of them. The indication for liver transplantation for chronic hepatitis C virus (HCV) infection is not as strict as for patients with chronic HBV infection because the long‐term survival is similar to that of non‐hepatitis C patients, even though re‐infection by HCV in the recipients is nearly universal. The main issue in the selection of patients with HCV for liver transplantation is therefore identification of criteria that can predict re‐infection and development of cirrhosis. These include factors such as multiple episodes of rejection, use of OKT3, pre‐transplant viral load and genotype, but reports are not consistent and so there are no well‐defined selection criteria. The selection criteria for patients with hepatocellular carcinoma are now well defined. Many studies have confirmed that a tumour > 5 cm, and showing vascular invasion, and poor differentiation adversely affects survival. In practice, only patients with a tumour < 5 cm and Child’s C cirrhosis are accepted for liver transplantation. Transarterial oily chemoembolization and intralesional alcohol injection are used to control or down‐stage the tumour while patients wait for a cadaveric liver graft.
Gastro‐oesophageal reflux disease in Asia
Authors: Goh Khean‐Lee , Chang Chi‐Sen , Fock Kwong‐Ming , Ke Meiyun , Park Hyo‐Jin , Lam Shiu‐Kum 
Published: March 2003

AbstractGastro‐oesophageal reflux disease (GORD) occurs more frequently in Europe and North America than in Asia but its prevalence is now increasing in many Asian countries. Many reasons have been given for the lower prevalence of GORD in Asia. Low dietary fat and genetically determined factors, such as body mass index and maximal acid output, may be important. Other dietary factors appear to be less relevant. Increased intake of carbonated drinks or aggravating medicines may influence the increasing rates of GORD in some Asian countries but no strong evidence links other factors, such as the age of the population, smoking or alcohol consumption, to GORD. The management of GORD in Asia is similar to that in Europe and North America but the lower incidence of severe oesophagitis in Asia may alter the approach slightly. Also, because Asians tend to develop stomach cancer at an earlier age, endoscopy is used routinely at an earlier stage of investigation. Gastro‐oesophageal reflux disease is essentially a motility disorder, so short‐term management of the disease can usually be achieved using prokinetic agents (or histamine (H2)‐receptor antagonists). More severe and recurrent GORD may require proton pump inhibitors (PPI) or a combination of prokinetic agents and PPI. The choice of long‐term treatment may be influenced by the relative costs of prokinetic agents and PPI.© 2000 Blackwell Science Asia Pty Ltd
Probiotics in infective diarrhoea and inflammatory bowel diseases
Authors: Gionchetti Paolo , Rizzello Fernando , Venturi Alessandro , Campieri Massimo 
Published: March 2003

AbstractBacteria are present throughout the gastrointestinal tract, but their pattern and concentration vary greatly. Probiotics are living organisms that supply beneficial health effects to the host. So far the beneficial effects of probiotics have been shown, almost exclusively, under poorly defined experimental conditions. There are little convincing data from well‐designed, double‐blind controlled trials supporting health‐promoting effects. The use of probiotics to treat gastrointestinal infections has produced contrasting results. Apart from information on rotavirus infection in children, there is no convincing evidence from controlled studies on the efficacy of probiotics in the prevention or treatment of infective diarrhoea. However, experimental and clinical studies suggest that there are potential therapeutic roles for probiotics in the treatment of inflammatory bowel diseases. This review focuses on the available data concerning the mechanisms of action of probiotics, and on the results from clinical studies using probiotics to treat infective diarrhoea and inflammatory bowel disease.
Pathophysiological role of cholecystokinin in humans
Authors: Otsuki Makoto 
Published: March 2003

AbstractCholecystokinin (CCK) is a major gastrointestinal hormone that plays an important role in stimulation of pancreatic secretion and gall‐bladder contraction, regulation of gastrointestinal motility and induction of satiety. Ingestion of fat and protein induces significant increases in plasma CCK. Intraluminal mediators of CCK secretion, luminal CCK releasing factor and diazepam‐binding inhibitor, were purified from rat intestinal secretion. These CCK‐releasing factors (RF) are secreted tonically by the small intestine and stimulate CCK release. Another kind of CCK‐RF named ‘monitor peptide’ was purified from the rat pancreatic juice that stimulates CCK secretion when introduced into rat intestine. Bile exclusion from the duodenum causes an increase in basal CCK and enhances stimulated plasma CCK release, and bile salt replacement reverses these effects. Thus, the CCK‐RF are spontaneously secreted into the intestinal lumen in humans, while the CCK‐producing cells are under constant suppression by intraduodenal bile acids. In acute pancreatitis, plasma CCK levels are high in patients with gallstone pancreatitis, but not in patients with pancreatitis from other causes, such as alcoholic and idiopathic pancreatitis. A transient disturbance of bile flow into the duodenum by stones or oedema of the pancreas together with impairment of pancreatic exocrine function might cause the increase in plasma CCK release in gallstone pancreatitis. Patients with chronic pancreatitis with mild to moderate impairment of exocrine function and abdominal pain, had significantly higher plasma CCK concentrations, whereas patients with pancreatic insufficiency had a significantly lower plasma CCK response to a test meal than the healthy subjects. The increased CCK may further aggravate pancreatitis and worsen the prognosis of pancreatitis by stimulating the injured pancreas, resulting in the vicious circle via endogenous CCK release. The CCK‐A receptor antagonist might be therapeutically useful in acute pancreatitis by stopping the vicious circle.