bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and treatment of gastro‐oesophageal reflux disease in infants and children
Authors: Vandenplas Yvan , Hegar Badriul 
Published: March 2003

AbstractGastro‐oesophageal reflux is a frequent, aspecific phenomenon in infants and children. The recommended approach in infants with uncomplicated regurgitation consists of reassurance of the parents and, if this fails, dietary recommendations in formula‐fed infants. If, despite these efforts, symptoms persist, administration of prokinetics, such as cisapride, is recommended prior to investigations such as oesophageal pH monitoring. Oesophageal pH monitoring is also recommended to document gastro‐oesophageal reflux disease in children with unusual presentations such as chronic respiratory disease. Today, cisapride is the drug of choice because it has the best efficacy and safety profile. In infants and children presenting with symptoms suggesting oesophagitis, endoscopy of the upper gastrointestinal tract is recommended. If there is severe oesophagitis, acid suppression with histamine H2‐receptor antagonists or proton pump inhibitors in combination with prokinetics, are recommended. In life‐threatening situations, or in patients that are resistant to or dependent on acid‐suppressive medication, a surgical procedure such as laparascopic Nissen procedure should be considered.
Elevation of TFF1 gene expression during healing of gastric ulcer at non‐ulcerated sites in the stomach: Semiquantification using the single tube method of polymerase chain reaction
Authors: Saitoh Takashi , Mochizuki Tsutomu , Suda Takeshi , Aoyagi Yutaka , Tsukada Yoshihisa , Narisawa Rintaroh , Asakura Hitoshi 
Published: March 2003

Abstract
Background
: The Trefoil factor family 1 (TFF1), one of the trefoil peptides, has been considered to play protective and reparative roles of experimentally induced ulcers in the stomach. However, the alteration of the TFF1 mRNA in the non‐ulcerated areas of living human gastric mucosa in gastric ulcer is not well known. We examined TFF1 gene expression at non‐ulcerated sites during the healing of a gastric ulcer by semiquantitative determination of the TFF1 mRNA.
Methods
: Gastric mucosal biopsy specimens were taken before and after the healing of the gastric ulcer from seven consecutive patients and from seven patients diagnosed with non‐ulcer dyspepsia (NUD). The relative value of TFF1 mRNA (RTFF1) was calculated by the single tube method of polymerase chain reaction (ST‐PCR) and Southern hybridization. Immunohistochemistry using monoclonal antibodies was performed to confirm the presence of the TFF1 peptide. The status of Helicobacter pylori and the severity of gastritis were investigated simultaneously.
Results
: The mean relative values of TFF1 mRNA at both the gastric angle (RTFF1AS) and the gastric body (RTFF1BS) of patients with gastric ulcers at the healed stage were significantly higher than those at the open stage (P < 0.05). The mean RTFF1AS at both the open and healed stages were lower than those of RTFF1BS at the open and healed stages, respectively. The mean RTFF1B at the open stage was lower than that in NUD (not significant), but the mean of RTFF1B at the healed stage was significantly higher than that in NUD. The RTFF1AS and RTFF1BS of all patients did not correlate with H. pylori status nor with the severity of gastritis. The induction of TFF1 mRNA at the non‐ulcerated background sites seemed not to be related to the status of H. pylori or to the severity of gastritis.
Conclusions
: These results suggest that the increased levels TFF1 mRNA during the healing of gastric ulcers might be closely related to the protection and the cell differentiation at the non‐ulcerated areas of living human gastric mucosa.
Diagnostic criteria for gastrointestinal carcinomas in Japan and Western countries: Proposal for a new classification system of gastrointestinal epithelial neoplasia
Authors: Schlemper Ronald J , Kato Yo , Stolte Manfred 
Published: March 2003

Abstract Background: Large differences have been found between Western and Japanese pathologists in their diagnosis of adenoma/dysplasia and early carcinoma for gastric, colorectal and oesophageal epithelial neoplastic lesions. Common worldwide terminology based on clinical usefulness, that is, on neoplastic severity and depth of invasion, is needed.Methods: Thirty‐one pathologists from 12 countries reviewed 35 gastric, 20 colorectal and 21 oesophageal biopsy and resection specimens. The extent of diagnostic agreement between those with Western and Japanese viewpoints was assessed by kappa statistics.Results: Suspected or definite carcinoma was diagnosed in 17–66% of gastric, in 5–40% of colorectal, and in 10–67% of oesophageal slides by pathologists with a Western viewpoint, but in 77–94% of gastric, in 45–75% of colorectal and in 81–100% of oesophageal slides by pathologists with a Japanese viewpoint (from Japan, Germany, Austria and UK). Overall, there was poor agreement between the conventional Western and Japanese diagnoses (kappa values lower than 0.3 for gastric, colorectal and oesophageal lesions). There was much better agreement among the pathologists (kappa values higher than 0.5 for gastric and colorectal lesions) when the original assessments of the slides were regrouped into the five categories of the following classification of GI epithelial neoplasia we hereby propose: C1, negative for neoplasia; C2, indefinite for neoplasia; C3, mucosal low‐grade neoplasia (low‐grade adenoma/dysplasia); C4, mucosal high‐grade neoplasia (high‐grade adenoma/dysplasia plus mucosal carcinoma); C5, submucosal invasion of neoplasia.Conclusions: The intercountry differences in the diagnoses of adenoma/dysplasia and early carcinoma can, in large part, be resolved by adopting terminology based on neoplastic severity and depth of invasion. Problems with defining intramucosal invasion are thus avoided. Moreover, grouping high‐grade adenoma/dysplasia and mucosal carcinoma together in one category is clinically useful, as patients with small mucosal neoplastic lesions can be cured by endoscopic local resection.
Hepatitis C virus clearance is prominent in women in an endemic area
Authors: Inoue Gaku , Horiike Norio , Michitaka Kojiro , Onji Morikazu 
Published: March 2003

Abstract
Background
: The clinical and virological backgrounds of cases with previous hepatitis C virus (HCV) infection (positive for HCV antibody (anti‐HCV) and HCV‐RNA negative) in an HCV endemic area were examined to identify factors related to the clearance of HCV.
Methods
: The study population comprised 3117 inhabitants, 1037 male and 2080 female, from an HCV endemic area. Hepatitis C virus antibody was detected by a passive haemagglutination test. The HCV‐RNA and the HCV genotype were detected by using the polymerase chain reaction method. The HCV serotype was determined by enzyme immunoassay by using the peptides of the core region.
Results
: Twenty‐two per cent of the inhabitants were positive for anti‐HCV, with males and the elderly having a significantly higher antibody titre (P < 0.01) than youths and females. Hepatitis C virus‐RNA was detected in 78% of the HCV antibody‐positive cases. The rate of HCV‐RNA positivity was significantly higher in males than in females (P < 0.01). No relationship was found between HCV‐RNA positivity and age. The HCV genotype 1b was the predominant genotype among the HCV‐RNA‐positive cases. Mixed genotypes (1b + 2a) were observed in 12% of cases, primarily in elderly males and females. In cases with previous HCV infection, serotype 1 was the most common serotype, and there appeared to be no relationship between the distribution of HCV serotypes and age and gender. There was a female predominance with regard to previous HCV infection, but not to being HCV carriers (P < 0.01).
Conclusions
: Gender, not HCV genotype, is the primary factor influencing HCV clearance.
A balanced 5:1 carbohydrate : protein diet: A new method for supplementing protein to patients with chronic liver disease
Authors: Ilan Yaron , Sobol Tamar , Sasson Odelia , Ashur Yafa 
Published: March 2003

AbstractBackground and AimsProtein malnutrition in patients with chronic liver disease contributes to bone and muscle weakness and compromises immune function and survival. In contrast, high‐protein diets may induce or exacerbate hepatic encephalopathy. The aim of the present study was to test whether increased amounts of protein, balanced by dietary carbohydrate in a 1:5 ratio, may be given to chronic liver disease patients in order to minimize postprandial increases in plasma amino acid (AA) concentrations.MethodsEight patients with chronic liver disease were studied. Each received, in a randomized order, three different diets of 2510 kJ of either high protein (37:50:28, carbohydrate : protein : fat), high carbohydrate (126:10:6) or a balanced 5:1 carbohydrate : protein diet (105:21:11). All patients were followed for plasma AA, glucose and insulin levels, as well as for cognitive and behavioral changes.ResultsFollowing the high protein diet, AA concentrations were significantly increased. In contrast, after the balanced diet, AA levels were practically constant enabled. All diets was well tolerated and no cognitive or behavioral changes appeared.ConclusionThe administration of a balanced 5:1 carbohydrate : protein diet may enable patients with chronic liver disease to tolerate increased amounts of dietary protein, without altering plasma amino acid concentrations.
Detection of intracellular interleukin‐2 production in peripheral T lymphocytes by flow cytometry in patients with pancreatobiliary malignancies
Authors: Uchida Moriaki , Ichida Takafumi , Sato Kazunari , Yonekura Kenji , Yamagiwa Satoshi , Sugahara Satoshi , Asakura Hitoshi 
Published: March 2003

Abstract Background and Aims: To date, it has been reported that cellular immunity is decreased in patients with cancer and investigations into cytokine production has been insufficient. Therefore, we examined intracellular cytokine production by using flow cytometry in patients with cancer and discussed the reasons for the impairment of their immune system.Methods: Eleven patients with hepatobiliary malignancies (68.5 ± 11.8 years of age), eight age‐matched controls (70.0 ± 12.0 years of age) and 10 young volunteers (31.9 ± 3.1 years of age) were used in the present study. Stimulated peripheral blood mononuclear cells from these patients were stained with fluorescence‐labeled anticytokine monoclonal antibodies and analyzed with a Fluorescence activated cell sorter (FAC)Scan™.Results: The percentage of positively stained T cells was calculated and compared with controls. Repeated measured ANOVA was used for statistical analysis. Interleukin (IL)‐2 production was significantly decreased in patients with cancer compared to controls (P = 0.0122), and it may suggest decreased cellular immune activity of the patients. Simultaneously, spontaneous intracellular IL‐4 production was observed in patients and age‐matched controls, but levels were significantly increased when compared with the young volunteers (P = 0.0052, P = 0.031, respectively).Conclusions: It was of interest that spontaneous intracellular IL‐4 production was detected in elderly subjects.
Endoscopic characteristics of low‐grade gastric mucosa‐associated lymphoid tissue lymphoma after eradication of Helicobacter pylori
Authors: Urakami Yoshihito , Sano Toshiaki , Begum Shahnaz , Endo Hideko , Kawamata Hitoshi , Oki Yuko 
Published: March 2003

Abstract Background and Aims: It was recently reported that low‐grade gastric lymphoma of mucosa‐associated lymphoid tissue (MALT) was regressed by the eradication of Helicobacter pylori. The aim of this study was to confirm the effect of H. pylori eradication on low‐grade gastric MALT lymphoma and to investigate the whitish mucosa that appeared with regression of the lesions.Methods: Forty‐seven H. pylori‐positive patients with low‐grade gastric MALT lymphoma were treated by using triple therapy. Biopsy specimens were histologically graded and B cell clonality was examined by using reverse transcription–polymerase chain reaction before and after eradication treatment. The relationship between the appearance of whitish mucosa and the degree of gastric gland loss was evaluated.Results: Histologic regression was observed 2 months after eradication therapy in 42 of 47 patients. However, B cell monoclonality changed to polyclonality in only 23 patients during the follow‐up period. The appearance of whitish mucosa in patients who showed histologic regression became more frequent as the degree of gastric gland loss increased (P < 0.001).Conclusions: Most low‐grade gastric MALT lymphoma histologically regressed after H. pylori eradication. The appearance of whitish mucosa after histologic regression reflected the degree of gastric gland loss. Whitish mucosa is an endoscopic characteristic and may be an endoscopic marker for regression of low‐grade gastric MALT lymphoma.
Hemodynamics in the left gastric vein after endoscopic ligation of esophageal varices combined with sclerotherapy
Authors: Mizumoto Hideaki , Matsutani Shoichi , Fukuzawa Takeshi , Ishii Hiroshi , Sato Goro , Maruyama Hitoshi , Saisho Hiromitsu 
Published: March 2003

AbstractBackground and Methods: We examined the changes in portal hemodynamics after endoscopic variceal ligation (EVL) combined with endoscopic injection sclerotherapy (EIS) in relation to post‐treatment relapse. The present study included 93 patients who underwent EVL–EIS combination therapy. Portal hemodynamics were examined by Doppler ultrasonography and percutaneous transhepatic portography (PTP).Results: Therapy with EVL–EIS resulted in the complete disappearance of varices in 89 of 93 patients. Cumulative relapse‐free rates (Kaplan–Meier method) were 75.8 and 50.2%, respectively, 1 and 3–5 years after treatment. At the end of treatment, the flow in the left gastric vein was examined by Doppler ultrasonography. In 50 of 63 patients, the flow remained hepatofugal. In 23 of these patients, PTP was performed at the end of treatment; selective left gastric venography did not reveal any palisade zone vessels or varices. However, fine blood vessels were seen around the lower esophagus in nine patients, only the paraesophageal vein was found in 10 patients and these two findings were present in four patients, indicating that collateral blood flow remained in the lower esophagus in 13 of 23 patients. These findings suggest that frequent relapse of varices results from insufficient blockage of blood flow from the left gastric vein to the lower esophagus. However, in patients with a patent paraesophageal vein, long‐term effects obtained by EVL–EIS combination therapy were satisfactory.Conclusions: The pattern of the development of collateral left gastric veins represents important hemodynamic changes that predict the long‐term prognosis of patients after treatment.
Pancreatitis‐associated protein‐I mRNA expression in mouse pancreas is upregulated by lipopolysaccharide independent of cerulein‐pancreatitis
Authors: Wang Xingpeng , Wang Bingxian , Wu Jianxin 
Published: March 2003

AbstractBackground and Aims: It is well known that endotoxemia, which is caused by a bacterial infection, can exacerbate acute pancreatitis, whereas pancreatitis‐associated protein (PAP) has the ability to induce bacterial aggregation. Pancreatitis‐associated protein is supposed to protect the tissue from infection during inflammation. In order to clarify the relationship between PAP mRNA expression and endotoxemia during acute pancreatitis, the kinetic patterns of PAP‐I mRNA in mouse pancreas treated with either cerulein or lipopolysaccharide (LPS) or both were investigated in this study.Methods and Results: The administration of LPS (5 mg/kg) intraperitoneally resulted in a dramatic upregulation of PAP‐I mRNA expression, increasing 18.61‐fold to a maximum at 12 h, then decreasing, but still sustaining at a high level and reaching baseline on day five. These changes were accompanied by the upregulation of tumor necrosis factor (TNF)‐α, interleukin‐1β (IL‐1β), interleukin 6 (IL‐6) and interferon γ (IFNγ) mRNA expressions in the pancreas, but not by marked alterations of serum amylase, lactic dehydrogenase (LDH) and histology. Cerulein also increased PAP‐I mRNA expression. However, the combination of cerulein and LPS was not able to enhance PAP‐I mRNA expression further, although more prominent pancreatitis based on significant changes of serum amylase, LDH and histology were observed.Conclusion: These results suggest that PAP‐I mRNA might be modulated by endotoxemia, independent of cerulein‐pancreatitis. There were no strong correlations between PAP‐I mRNA expression and the severity of pancreatitis.
Ulcer in the gastric tube for esophageal replacement: A comparison of 12 esophageal cancer patients with or without postoperative radiotherapy
Authors: Koide Naohiko , Hiraguri Manabu , Nishio Akihito , Hanazaki Kazuhiro , Adachi Wataru , Shikama Naoto , Oguchi Masahiko , Maezawa Takeshi , Amano Jun 
Published: March 2003

AbstractBackground and Aims: Ulcer in the gastric tube for esophageal replacement, which was caused by peptic factors or postoperative radiotherapy (Rx), are occasionally reported. The aim of this study was to clarify the clinicopathologic features of the ulcers in the gastric tube.Methods: In 62 patients with a reconstructed gastric tube, after esophagectomy for esophageal cancer, esophagogastroduodenoscopy was performed. Ulcers of the gastric tube were detected in 12 patients: six with postoperative Rx and six without Rx. The 12 patients with gastric tube ulcers (GU‐group) were reviewed and compared to the remaining 50 patients without ulcers of the gastric tube (Control‐group). Clinicopathologic features of gastric tube ulcers were compared between the patients with and without Rx.Results: There was no difference in any parameter between the patients of the GU‐ and Control‐groups. Comparing the patients of the GU‐group with and without Rx, the ulcers of the gastric tube in the patients without Rx were frequently located in the lower part of the gastric tube (P = 0.067), detected in a later period after surgery (P = 0.055), associated with cervical esophagitis (P = 0.03), and less associated with gastritis (P = 0.03). In three patients of the GU‐group without Rx, Helicobacter pylori was detected in the gastric tube. Two of the three patients had a history of peptic ulcers before surgery, and had recurrence of the gastric tube ulcers.Conclusions: Gastric tube ulcers without postoperative Rx may have different characteristics compared to those induced by Rx.
Endotoxin treatment causes an upregulation of the endothelin system in the liver: Amelioration of increased portal resistance by endothelin receptor antagonism
Authors: Gandhi Chandrashekhar R , Kuddus Ruhul H , Nemoto Edwin M , Murase Noriko 
Published: March 2003

AbstractBackground:Mechanisms underlying hepatic microcirculatory failure during endotoxemia are incompletely understood. Because endothelin‐1 (ET‐1) has been implicated in endotoxin‐induced liver injury, we investigated the hepatic ET‐1 system in endotoxin‐treated rats.Methods:Rats were treated with endotoxin (Escherichia colilipopolysaccharide; 3 mg/kg, i.p.), and various determinations were made 24 h later.Results:Endotoxin treatment caused 11.2 ± 1.6% weight loss, a decrease in mean arterial pressure (MAP; 96 ± 5 mmHgvs108 ± 3 mmHg;P< 0.05) and an increase in portal pressure (11.6 ± 1.3 mmHgvs7.4 ± 1 mmHg;P< 0.02). No significant changes in the serum levels of liver enzymes or hepatocellular necrosis were observed. Endotoxin caused increases in hepatic ET‐1 (from 345 ± 31 to 565 ± 38 pg/g;P< 0.01), ET‐1 receptor density (from 179 ± 16 to 340 ± 26 fmol/mg;P< 0.02), and mRNA expression of preproendothelin‐1, and ETAand ETBreceptors. While the serum nitric oxide (nitrite + nitrate) concentration was increased in endotoxin‐treated rats, that of ET‐1 remained unchanged. A mixed ETA/ETBreceptor antagonist, TAK‐044 (10 mg/kg, i.v.), reduced the weight loss from 11.2 ± 1.6% to 5.9 ± 2.9% (P< 0.05) and the portal pressure from 11.6 ± 1.3 mmHg to 8.6 ± 0.7 mmHg (P< 0.05) in endotoxin‐treated rats. The mixed ETA/ETBreceptor antagonist also caused an increase in serum ET‐1 concentration, but did not affect serum nitric oxide and MAP in endotoxin‐treated rats.Conclusions:These results suggest that the upregulated hepatic ET‐1 system is an important mechanism of increased portal resistance and related complications of endotoxemia.
Long‐term interferon therapy for 1 year or longer reduces the hepatocellular carcinogenesis rate in patients with liver cirrhosis caused by hepatitis C virus: A pilot study
Authors: Ikeda Kenji , Saitoh Satoshi , Kobayashi Masahiro , Suzuki Yoshiyuki , Suzuki Fumitaka , Tsubota Akihito , Arase Yasuji , Murashima Naoya , Chayama Kazuaki , Kumada Hiromitsu 
Published: March 2003

AbstractBackground and Methods: In order to elucidate the influence of a long‐term administration of interferon on the appearance rates of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)‐related cirrhosis, we retrospectively analyzed 694 patients with cirrhosis. A total of 113 patients underwent interferon therapy, including 25 patients with a long‐term administration of interferon for 1 year or more, and the other 581 patients received no antiviral drugs.Results: Crude cumulative appearance rates of HCC in the interferon and the untreated groups were 14.1, and 28.4% at the end of the 5th year, and 36.7 and 52.5% at the end of the 10th year, respectively (P = 0.0028). As there was a waiting time between diagnosis and treatment (median 2.0 months, average 21.3 months) in the treated group, Cox proportional hazard analysis using a time‐dependent covariate was introduced to evaluate the anticarcinogenic effect of interferon. Although male sex, higher α‐fetoprotein, older age, lower albumin concentration, and lower platelet count significantly increased the carcinogenesis rate, interferon was not a significant contributing factor to the carcinogenesis rate as a whole (hazard ratio = 0.83, P = 0.32). When the patients with interferon were divided into two groups according to therapy duration, long‐term interferon therapy significantly decreased the hepatocellular carcinogenesis rate after an adjustment by significant covariates (hazard ratio = 0.28, P = 0.0048).Conclusion: When interferon is administered for 12 months or longer, effective cancer prevention will be achieved, even in patients with HCV‐related cirrhosis.
Prevalence of endoscopic reflux esophagitis among Koreans
Authors: Lee Seong J , Song Chi W , Jeen Yoon T , Chun Hoon J , Lee Hong S , Um Soon H , Lee Sang W , Choi Jai H , Kim Chang D , Ryu Ho S , Hyun Jin H 
Published: March 2003

AbstractBackground and Aim: Although reflux esophagitis is believed to be common in the Western population, very few epidemiologic data on reflux esophagitis in Koreans are available. The aims of this study were to evaluate the prevalence of endoscopic reflux esophagitis in patients who came for a physical check‐up at Korea University Hospital, and to study the relationship between various factors relevant to reflux disease.Methods: This study was carried out prospectively on 7015 patients who received an esophagogastroduodenoscopy from September 1996 to December 1997. Most of the patients were free of symptoms and had come for their self‐paid check‐up.Results: The overall prevalence of reflux esophagitis was 3.4%, and most of the patients had a mild degree of esophagitis representing grade 1 in 98.3% and grade 2 in 1.7%. The male : female ratio for esophagitis was 7 : 1, and the body mass index (BMI) was significantly higher in patients with reflux esophagitis. A hiatal hernia was found in 166 patients with esophagitis (68.6%), but only in 9.2% patients without esophagitis (P < 0.05). Smoking and alcohol consumption were associated with the development of reflux esophagitis (P < 0.05).Conclusions: The prevalence of endoscopic reflux esophagitis among Koreans is 3.4%, and most of the patients had a mild grade esophagitis. Smoking, alcohol consumption, the presence of a hiatal hernia and a higher BMI are associated with the development of reflux esophagitis.