bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transdermal hormone replacement therapy improves vertebral bone density in primary biliary cirrhosis: results of a 1‐year controlled trial
Authors: Pereira S. P. , O'Donohue J. , Moniz C. , Phillips M. G. , Abraha H. , Buxton‐Thomas M. , Williams R. 
Published: December 2004

SummaryBackground : Retrospective studies have suggested that hormone replacement therapy may reduce the rate of bone loss in primary biliary cirrhosis, but no controlled data are available.Methods : Forty‐two post‐menopausal women with primary biliary cirrhosis were treated with calcium and vitamin D, either alone (n = 21) or together with transdermal hormone replacement therapy (n = 21). Bone densitometry was performed at baseline and at 1 year, and serum and urinary markers of bone turnover were measured at three‐monthly intervals.Results : At entry, 17 patients (40%) had spinal or femoral osteopenia (T score − 1 to − 2.5) and nine (21%) had osteoporosis (T < − 2.5). In those given hormone replacement therapy, there was a significant decrease in the mean urinary deoxypyridinoline :creatinine ratios at 3 months (7.8 vs. 6.1 nm/mm creatinine for no hormone replacement therapy vs. hormone replacement therapy; P = 0.04) and a 48% reduction in urinary calcium excretion at 1 year (0.66 vs. 0.32 mm/mm creatinine; P = 0.01). Repeat bone densitometry at 1 year revealed a 2.25% increase in the hormone replacement therapy group (P = 0.02), compared with a non‐significant 0.87% decrease in L2–L4 bone mineral density in those not given hormone replacement therapy. Both treatment regimens were well tolerated, with no increase in cholestasis.Conclusions : Compared with calcium and vitamin D alone, supplemental treatment with transdermal hormone replacement therapy for 1 year improved the vertebral bone density and urinary markers of bone turnover in post‐menopausal women with primary biliary cirrhosis.
DNA typing for Helicobacter pylori isolates from eradication‐failed patients: comparison of the isolates before and after therapy
Authors: Nada T. , Ando T. , Nobata K. , Tsuzuki T. , Minami M. , Ina K. , Iinuma Y. , Ichiyama S. , Ohta M. , El‐Omar E. , Kusugami K. , Goto H. 
Published: December 2004

SummaryBackground : Failure of Helicobacter pylori eradication occurs frequently despite use of multiple microbial agents.Aim : We aimed to study differences between H. pylori strains isolated before and after eradication failure.Methods : We treated 87 patients with peptic ulcer using triple therapy consisting of omeprazole plus combinations of clarithromycin, amoxicillin, or metronidazole. We studied the status of cagA, vacA, and iceA by PCR, and examined the differences in H. pylori isolates by pulsed‐field gel electrophoresis and arbitrary primer polymerase chain reaction. The minimum inhibitory concentration of clarithromycin, amoxicillin, or metronidazole was determined by an agar dilution method.Results : Eradication therapy failed in 12 patients (14%); H. pylori isolates were obtained from all of these both before and after therapy. After eradication therapy, 10 patients were colonized with the same strain as before therapy, while the other two patients were colonized with different strains from those before therapy. In the former group, one isolate changed from metronidazole‐sensitive to ‐resistant, one changed from clarithromycin‐ and metronidazole‐sensitive to ‐resistant, and four were resistant to clarithromycin or metronidazole both before and after therapy. The other four isolates remained sensitive to clarithromycin and metronidazole after therapy. In the two patients who yielded apparently different isolates after therapy, they changed from clarithromycin‐ and metronidazole‐sensitive to ‐resistant.Conclusion : Eradication of H. pylori by first‐line therapy is an important goal in the treatment of H. pylori‐positive peptic ulcer, and that appropriate antimicrobial sensitivity testing should be conducted in patients with eradication failure.
Elemental diet modulates the growth of Clostridium difficile in the gut flora
Authors: Iizuka M. , Itou H. , Konno S. , Chihara J. , Tobita M. , Oyamada H. , Toyoshima I. , Sasaki K. , Sato A. , Horie Y. , Watanabe S. 
Published: December 2004

SummaryBackground and aims : Tube feeding is regarded as a risk factor for Clostridium difficile‐associated diarrhoea. Recently, we reported that C. difficile toxin was frequently found in patients receiving an elemental diet. The present study was conducted to clarify whether elemental diets are associated with the growth of C. difficile in the gut flora.Methods : C. difficile was cultured for 72 h in various concentrations of elemental diet containing 3% thioglycollate, and the growth rate or activity of C. difficile was evaluated by Gram stain or by measuring optical density at 560 nm. Faecal samples from 10 healthy adults were cultured in elemental diet + 3% thioglycollate. RNA was extracted from faeces with glass powder, which can eliminate PCR inhibitors, and mRNA of C. difficile toxin B was measured by reverse transcription PCR.Results : Maximum OD560 value during culture in thioglycollate‐containing elemental diet was 2.4 times higher than that in thioglycollate alone (P = 0.0163). Viability of C. difficile was decreased in thioglycollate but not in thioglycollate‐containing elemental diet. Toxin B mRNA was detected in five faecal samples (50%) before culture and in all samples after culture.Conclusions : Our results suggest that an elemental diet can modulate the growth of C. difficile in the gut flora.
Helicobacter pylori eradication treatment modulates epithelial cell proliferation and tissue content of hepatocyte growth factor in the gastric mucosa
Authors: Suzuki M. , Suzuki H. , Masaoka T. , Tanaka S. , Suzuki K. , Ishii H. 
Published: December 2004

SummaryBackground : Although Helicobacter pylori infection is now acknowledged as a major promoter of gastric cancer in humans, the carcinogenetic process of this effect has not been fully elucidated. Precancerous lesions such as intestinal metaplasia, enhanced proliferation of epithelial cells and elevated level of growth factors have been postulated to play a role.Aim : To analyse a relationship between gastric mucosal proliferation, mucosal content of hepatocyte growth factor and prevalence of intestinal metaplasia before and after successful H. pylori eradication therapy.Methods : We evaluated 25 H. pylori‐eradicated patients. At initial endoscopic examination, two biopsy tissue samples each were obtained from the antrum and great curvature of the corpus. Tissue content of hepatocyte growth factor and neutrophil myeloperoxidase were measured using an ELISA method, and histological assessment of intestinal metaplasia (haematoxylin and eosin) and proliferating cells (Ki‐67 immunostaining) was performed. The patients were treated with a 1‐week course of triple therapy. At 10 months after successful eradication, biochemical and histological assessments were repeated.Results : Among all patients (n = 25), no intestinal metaplasia was detected in the corpus mucosa, but was observed in 10 patients (40%) in the antrum. This prevalence ratio was not changed after eradication. A slight decrease in HGF content was demonstrated in both sites, but the level of antral hepatocyte growth factor was significantly decreased in patients with intestinal metaplasia but not in those without. Proliferative index (Ki‐67 positive cells/epithelium) was decreased after eradication therapy in both sites. An increase in proliferative index was observed in the antrum with intestinal metaplasia compared with that without, which significantly decreased after eradication therapy.Conclusions : H. pylori eradication therapy in the present study afforded an inhibitory effect on epithelial cell proliferation and on the mucosal content of HGF.
Helicobacter bilis infection in biliary tract cancer
Authors: Murata H. , Tsuji S. , Tsujii M. , Fu H. Y. , Tanimura H. , Tsujimoto M. , Matsuura N. , Kawano S. , Hori M. 
Published: December 2004

SummaryBackground:  Biliary tract cancer is a highly fatal disease with poor prognosis, but the aetiology is poorly understood.Aim:  We aimed to identify Helicobacter bilis infection in the gallbladder in patients with biliary tract disease.Methods:  Archival gallbladder specimens from 34 patients (14 males and 20 females) with an average age of 61.4 ± 12.2 years (mean ± SE) were retrieved, consisting of 11 cases of gallbladder cancer, three of bile duct cancer, 16 of cholecystolithiasis and four of pancreatic cancer. DNA was extracted and nested PCR using primers specific for 16S rRNA of H. bilis was performed.Results : Amplification was observed in 3 of 11 gallbladder cancer cases (27.2%) and one of three cases with biliary duct cancer (33.3%). In total, four of 14 cases with biliary tract cancer were positive for H. bilis (28.6%). In addition, the presence of H. bilis was shown in two of 16 cases (12.5%) with cholecystolithiasis. Notably, although the number of cases examined was small, none of the four cases with pancreatic cancer showed the presence of H. bilis infection in the gallbladder without apparent abnormalities.Conclusion:  H. bilis infection may play a role in biliary tract disease, particularly in biliary tract cancer.
Prevalence of symptomatic gastro‐oesophageal reflux disease in Japanese patients with peptic ulcer disease after eradication of Helicobacter pylori infection
Authors: Yamamori K. , Fujiwara Y. , Shiba M. , Watanabe T. , Tominaga K. , Oshitani N. , Matsumoto T. , Higuchi K. , Arakawa T. 
Published: December 2004

SummaryBackground : The association between cure of Helicobacter pylori infection and the development of gastro‐oesophageal reflux disease is controversial.Aim : To examine the prevalence of symptomatic GERD (sGERD) in Japanese patients with peptic ulcer disease after successful eradication and identify associated factors affecting sGERD development.Methods : We retrospectively examined 72 patients (40 gastric ulcer and 32 duodenal ulcer) with successful eradication. Associated factors such as age, gender, drinking and smoking habits, body mass index, presence of gastric atrophy and hiatal hernia were analysed.Results : Seven (9.7%) of 72 peptic ulcer patients newly developed sGERD. There were no differences in mean age, gender, smoking habit, drinking habit, body mass index, or presence of gastric atrophy and hiatal hernia between the sGERD and non‐sGERD groups, while the proportion of subjects aged over 70 was significantly higher in the sGERD than the non‐sGERD group. Six of 40 patients with gastric ulcer newly developed sGERD while only one of 32 patients with duodenal ulcer developed it.Conclusion : Approximately 10% of Japanese patients with peptic ulcer disease newly developed sGERD after cure of H. pylori infection. Age > 70 years was associated with development of sGERD. Eradication in patients in this age group should be carefully determined.
Impairment of gastrointestinal motility by nitrate administration: evaluation based on electrogastrographic changes and autonomic nerve activity
Authors: Nomura M. , Uehara K. , Harada K. , Uemura E. , Iga A. , Kawano T. , Nishikado A. , Saito K. , Nakaya Y. , Ito S. 
Published: December 2004

SummaryBackground : Nitrates decrease the tone of the lower oesophageal sphincter, and may thus induce gastro‐oesophageal reflux.Aim : In the present study, we evaluated electrogastrographic changes and heart‐rate variability before and after the administration of nitrates.Methods : In 15 patients with chest pain treated with nitrates, electrocardiography and percutaneous electrogastrography were performed before and after administration of nitrates. Autonomic nervous system function was evaluated by spectral analysis of heart‐rate variability and serial changes in low frequency and high frequency power, and the low frequency/high frequency ratio were compared. Electrogastrograms were analysed by obtaining peak power amplitudes and their dominant frequencies.Results : After the administration of nitrates (isosorbide dinitrate), high frequency power, an index of parasympathetic nervous activity, was significantly decreased, whereas the low frequency/high frequency ratio, an index of sympathetic nervous activity, was significantly increased. The mean peak amplitude of the electrogastrogram significantly increased postprandially both before and after treatment. After isosorbide dinitrate treatment, however, mean peak amplitudes after a meal were significantly lower than those obtained before treatment. The mean dominant frequency of the electrogastrogram did not vary before and after treatment.Conclusions : The present study suggests that nitrates inhibit gastrointestinal motility by decreasing autonomic nervous activity.
Diversity of vacA and cagA genes of Helicobacter pylori in Japanese children
Authors: Azuma T. , Kato S. , Zhou W. , Yamazaki S. , Yamakawa A. , Ohtani M. , Fujiwara S. , Minoura T. , Iinuma K. , Kato T. 
Published: December 2004

SummaryBackground : Helicobacter pylori infection is generally acquired in childhood and persists as an asymptomatic infection for decades in most infected individuals. Only a minority develops a clinical outcome even in childhood, such as peptic ulcer. It has been reported that H. pylori infection with the type I strain, which expresses the VacA and CagA antigen, is associated with peptic ulcer.Aim : We examined the diversity of vacA and cagA genes in isolates obtained from Japanese paediatric patients with peptic ulcer or chronic gastritis to investigate the relationship between genetic diversity and clinical outcome.Methods : The diversity of vacA and cagA genes was investigated by PCR and sequence analysis in 30 isolates obtained from Japanese paediatric patients with peptic ulcer (eight strains) or chronic gastritis (22 strains).Results : All isolates from Japanese children were cagA‐positive strains. Twenty‐six strains (86.7%) had East Asian type CagA, and 4 (13.3%) had Western type CagA. The predominant vacA genotype was s1c/m1b (22/30, 73.3%). There was no significant association between the diversity of cagA and vacA genes and clinical outcome. All four children infected with Western CagA strain had a history of overseas travel or residence.Conclusion : The predominant genotype of H. pylori in Japanese children is East Asian CagA and vacA s1c/m1b genotype, regardless of clinical outcome. Japanese H. pylori strains are homogeneously of the East Asian type; however, Western strains can be introduced into Japan concomitant with host movement from foreign countries in childhood.
Evaluation of treatment for gastro‐oesophageal reflux disease with a proton pump inhibitor, and relationship between gastro‐oesophageal reflux disease and Helicobacter pylori infection in Japan
Authors: Muramatsu A. , Azuma T. , Okajima T. , Ohtani M. , Dojo M. , Yamazaki Y. , Kuriyama M. 
Published: December 2004

SummaryBackground : Effective therapy for gastro‐oesophageal reflux disease (GERD) is associated with improvement in health‐related quality of life. It remains unclear whether Helicobacter pylori infection protects against GERD.Aim : We evaluated the relationship between GERD and H. pylori, and whether the health‐related quality of life score improved after medical treatment.Methods : We enrolled 151 outpatients with upper abdominal symptoms; 81 patients received omeprazole 20 mg/day for 2 weeks. Health‐related quality of life was assessed using the Gastrointestinal Symptom Rating Scale (GSRS) and the Psychological General Well‐Being (PGWB) index. H. pylori infection was diagnosed by serum antibody or endoscopy and the relationship between GERD and H. pylori was evaluated.Results : In GERD patients, the mean GSRS score improved from 2.20 to 1.67 following treatment (P < 0.01). The mean GSRS reflux symptom score improved from 2.96 to 1.67 (P < 0.01). The mean PGWB score improved from 96.36 to 107.34 (P < 0.01). All scores in GERD patients significantly improved compared with non‐GERD patients. The H. pylori‐positive ratio was 66.15% in GERD patients and 65.21% in non‐GERD patients (P = 0.94).Conclusions : Health‐related quality of life is useful for evaluation of proton pump inhibitor treatment in GERD. The presence of H. pylori was not associated with the prevalence of GERD.
Sex differences in mucosal response to Helicobacter pylori infection in the stomach and variations in interleukin‐8, COX‐2 and trefoil factor family 1 gene expression
Authors: Kato S. , Matsukura N. , Togashi A. , Masuda G. , Matsuda N. , Yamada N. , Naito Z. , Matsuhisa T. , Tajiri T. 
Published: December 2004

SummaryBackground : Gastric cancer incidence in men is almost double that in women. We investigated mucosal responses in the stomach against Helicobacter pylori (H. pylori) infections to elucidate the interindividual or sex‐related differences, which may in turn be associated with gastric cancer incidence, mucosal changes of stomach as measured by the Sydney System, and interleukin‐8, cyclooxygenase‐2 and trefoil factor family 1 (TFF1) gene expression.Methods : An age‐, sex‐, H. pylori status‐ and disease‐matched case−control study was performed in 574 H. pylori‐positive and 225 H. pylori‐negative patients selected from 4125 patients with a diagnosis of benign disease of the stomach. Levels of acute and chronic inflammations, atrophy and intestinal metaplasia scored according to the Sydney System were compared by stomach site and by sex. Two biopsy specimens (antral and corpus gastric mucosa) from patients with benign gastric diseases (142 patients; 72 men, 70 women) were analysed for interleukin‐8, cyclooxygenase‐2 and TFF1 mRNA expression as measured by real‐time PCR.Results : Inflammation and activity scores in antrum with H. pylori infection were higher in men, but scores declined according to age. Atrophy and intestinal metaplasia scores in corpus with H. pylori infection appeared more severe in men than in women, especially in older patients. In women, atrophy score increased with increasing age, particularly in postmenopausal H. pylori‐negative patients. Interleukin‐8 mRNA induction was detected in both antrum and corpus mucosa in H. pylori infection, but sex differences were not found. Response of cyclooxygenase‐2 mRNA expression against H. pylori infection in the mucosa was higher in men than women. In H. pylori‐negative patients, TFF1 mRNA levels in women were significantly higher than in men, and TFF1 mRNA was significantly lower in positive than negative women.Conclusions : Sex differences in mucosal responses to H. pylori infection in the stomach may be correlated with sex differences in the incidence of stomach cancer.
Relationship between Helicobacter pylori infection and the prevalence, site and histological type of gastric cancer
Authors: Kato M. , Asaka M. , Shimizu Y. , Nobuta A. , Takeda H. , Sugiyama T. ,   the Members of the Multi‐Centre Study Group
Published: December 2004

SummaryAim : To evaluate the relationship between Helicobacter pylori infection and gastric cancer in Japan.Methods : This was a multicentre study conducted in various regions in Japan. A total of 6578 individuals as controls and 2503 with histologically confirmed gastric cancer were enrolled. H. pylori status was determined by enzyme‐linked immunosorbent assay (ELISA) for anti‐H. pylori immunoglobulin G (IgG).Results : The prevalence of H. pylori infection in gastric cancer patients was markedly high in all age groups. In contrast, the rate increased with age among control subjects. The overall prevalence of H. pylori infection in control subjects was 50.2% (3300/6578) vs. 82.8% in gastric cancer patients (2072/2503) (OR = 2.47; 95% CI: 2.19–2.79). The prevalence of H. pylori in early gastric cancer was significantly higher than that in advanced gastric cancer (86.5% vs. 75.7%; OR = 2.06; 95% CI: 1.66–2.55). There were no significant differences in the prevalence of H. pylori between the intestinal and diffuse types of gastric cancer or among gastric cancer in antrum, body and cardia.Conclusion : H. pylori infection is strongly associated with the development of gastric cancer. The difference in odds ratios among younger and older persons with gastric cancer likely reflects the decrease in prevalence of H. pylori in the population, and is more reflective of the actual risks associated with the infection.
Diagnostic value of culture, histology and PCR for Helicobacter pylori in the remnant stomach after surgery
Authors: Matsukura N. , Tajiri T. , Kato S. , Togashi A. , Masuda G. , Tokunaga A. , Yamada N. 
Published: December 2004

SummaryBackground : Diagnosis of Helicobacter pylori infection in the remnant stomach has not been established.Aims : To investigate the diagnostic value of culture, histology, PCR and serum IgG against H. pylori (ELISA) with and without eradication therapy in the remnant stomach, compared with the unoperated stomach.Methods : Biopsy samples for bacterial culture and histological diagnosis of H. pylori were taken from the stoma and upper corpus of the remnant stomach and gastric juice was used for PCR assay.Results : Bacterial culture‐based diagnosis in the remnant stomach, sensitivity and specificity of culture were 95.1%, 100%; histology 89%, 92.3%; PCR 66%, 89.7%; and ELISA 100%, 50%, respectively, in cases without H. pylori eradication therapy. In assessment of the results of therapy for the remnant stomach, sensitivity and specificity of culture were 100%, 100%; histology 80%, 96.8%; PCR 80%, 91.7%; and ELISA 100%, 0%, respectively.Conclusion : Bacterial culture had the highest diagnostic value in the remnant stomach as well as unoperated stomach. Sensitivity by histology and PCR was lower in the remnant stomach than the unoperated stomach, but specificity values were equal. Serum ELISA assay was not suitable for the remnant stomach.
Joint involvement in inflammatory bowel disease
Authors: De Vos M. 
Published: December 2004

SummaryPeripheral involvement of the joints, including pauciarticular, asymmetrical, transitory and migrating synovitis and enthesiopathy, is observed in 10–20% of affected inflammatory bowel disease patients. Recurrence is common and frequently coincides with a flare‐up of intestinal disease. The true prevalence of axial involvement is less well established. Sacroiliitis is a hallmark of spondylitis, but is under‐reported due to its insidious onset and sometimes asymptomatic nature. Radiographic evidence of sacroiliitis is present in about 20–25% of patients. Ankylosing spondylitis, as defined by the Rome criteria, is present in 3–10% of inflammatory bowel disease patients, and is thought to have a different genetic predisposition in these patients compared with ‘classic’ ankylosing spondylitis: whereas the human leucocyte antigen B27 phenotype is present in 90% of patients with ‘classic’ ankylosing spondylitis, the prevalence decreases to only 30% in patients with ankylosing spondylitis secondary to Crohn's disease. Polymorphisms involving CARD15 appear to be a possible genetic trigger: 78% of patients with Crohn's disease and symptomatic or asymptomatic sacroiliitis carry at least one mutation, compared with only 48% of control Crohn's disease patients. Moreover, in other forms of spondyloarthropathy, a similar association has been reported: 42% of patients with spondyloarthropathy and associated asymptomatic chronic gut inflammation, who are considered likely to develop Crohn's disease and ankylosing spondylitis, are carriers of at least one CARD15 mutation, compared with only 7% of patients with normal histology. In addition to genetic markers, clinical features support the relationship between gut and joint pathophysiology. In cases of spondyloarthropathy, a very rapid, substantial and sustained improvement in symptoms has been reported following treatment with infliximab, suggesting an essential role for tumour necrosis factor‐α in spondyloarthropathy, similar to that observed in Crohn's disease.