Search PubMed⌕ Search

Biomedical subjects

C Y Chen

Publications and source records attributed to C Y Chen.

At least 145 records · Page 8Linked to original sources

Lactoferrin protects gut mucosal integrity during endotoxemia induced by lipopolysaccharide in mice.

The hypothesis that lactoferrin protects mice against lethal effects of bacterial lipopolysaccharide (LPS) is the subject of experimental investigations described in this article. Lipopolysaccharide is a powerful toxin produced by gram negative bacteria that when injected into humans or experimental animals reproduce many of the pathophysiologic and immune responses caused by live bacteria. Lactoferrin administered intraperitoneally 1 hr prior to injection of LPS significantly enhanced the survival of mice, reducing LPS-induced mortality from 83.3% to 16.7%. Changes in locomotor and other behavioral activities resulting from LPS injection were not present in mice treated with lactoferrin. Also, histological examination of intestine revealed remarkable resistance to injury produced by LPS if mice were pretreated with lactoferrin. Severe villus atrophy, edema and epithelial vacuolation were observed in LPS-treated animals but not in lactoferrin-treated counterparts. Electrophysiological parameters were used to assess secretory and absorptive functions in the small intestine. In mice treated with LPS, transmural electrical resistance was reduced and absorption of glucose was increased. Lactoferrin treatment had no significant influence on basal electrophysiological correlates of net ion secretion or glucose absorption nor on changes induced by LPS. Collectively, these results suggest that lactoferrin attenuates the lethal effect of LPS and modulates behavioral and histopathological sequela of endotoxemia.

Animals↗

Life-threatening haemorrhage from a sternal metastatic hepatocellular carcinoma.

Rupture of the tumour is a catastrophic complication of hepatocellular carcinoma. The prognosis in patients with a ruptured hepatocellular carcinoma is usually unfavourable. We describe a 46-year-old man who suffered from visible massive tumour haemorrhage due to a hepatitis B-related hepatocellular carcinoma that metastasized to the sternal bone. The prominent tumour mass was bulging over the anterior chest wall on the sternum of the patient, and bled spontaneously. This episode of life-threatening haemorrhage was stopped by surgical ligation of the bleeding site. Palliative radiotherapy shrank the tumour mass size and prevented further possible bleeding. This is likely to be the first reported case with a visible spontaneous tumour bleeding from a sternal metastatic hepatocellular carcinoma.

Bone Neoplasms↗

Effect of a calcium channel blocker and antispasmodic in diarrhoea-predominant irritable bowel syndrome.

BACKGROUND: Irritable bowel syndrome (IBS) is a colonic function disorder. Both pinaverlum bromide (a selective calcium channel blocker) and mebeverine (an antispasmodic) are reported to be effective in the long-term (12-16 weeks) treatment of IBS patients. Their efficacy in the short-term treatment of IBS patients and colonic transit time is unclear. Furthermore, substance P and neuropeptide Y have either excitatory or inhibitory effects on colonic motility. Whether the efficacy of both drugs is mediated through these neuropeptides remains unknown. METHODS AND RESULTS: A clinical trial was conducted with 91 patients with diarrhoea-predominant IBS. After basal measurement of the total colonic transit time, IBS patients were randomized to receive either pinaverlum bromide (50 mg, t.i.d.) or mebeverine (100 mg, t.i.d.) for 2 weeks. The symptomatic scores regarding defaecation, total colonic transit time and serum levels of substance P and neuropeptide Y were measured before and after treatments. The daily defaecation frequency was markedly decreased after treatment (pinaverlum bromide, 2.9+/-1.2 vs 2.0+/-1.0, P< 0.05; mebeverine, 2.7+/-1.1 vs 2.1+/-1.0, P< 0.05). The stool consistency became well formed after both treatments (P< 0.05). Both drugs similarly improved the global well-being in these IBS patients (pinaverlum bromide vs mebeverine 73.4 vs 71.8%, P> 0.05). The total colonic transit time was significantly prolonged only after pinaverlum bromide treatment (21.4+/-15.5 vs 30.8+/-14.8 h, P< 0.01). Neither substance P nor neuropeptide Y serum level was significantly changed after either treatments. CONCLUSION: Pinaverlum bromide and mebeverine have similar therapeutic efficacies on diarrhoea-predominant IBS patients. Prolonged colonic transit time may be one of the factors responsible for the efficacy of pinaverlum bromide on the IBS patients. Substance P and neuropeptideY appear less important in the pathogenesis of diarrhoea-predominant IBS.

Calcium Channel Blockers↗

Human biliary beta-glucuronidase activity before and after relief of bile duct obstruction: is it the major role in the formation of pigment gallstones?

BACKGROUND AND AIMS: The bacterial beta-glucuronidase (bBG) can deconjugate conjugated bilirubin to form calcium bilirubinate gallstone. Yet, the role of the human biliary beta-glucuronidase (hBG) in the pathogenesis of pigment gallstone formation still remains unsolved. METHODS: Hepatic bile was collected from bile-duct-obstructed patients on the day of, and 3 days after, biliary drainage. Patients were divided into pigment-stone (PS) group (n = 34) and stone-free (SF) group (n = 29). All patients of the PS group had the complication of cholangitis. The concentrations of bile contents and the activities of bBG and hBG were measured. RESULTS: The activities of hBG and bBG in bile obtained on the day of biliary drainage were higher in the PS group than in the SF group (activities corrected for bile salt concentration: hBG 128.7 +/- 340.0 vs 13.1 +/- 25.0 U/mmol; bBG 12.5 +/- 22.2 vs 4.6 +/- 7.7 U/mmol, P < 0.05). This difference disappeared after biliary drainage. The changes of enzyme activity in the bile of the SF group were unremarkable before and after biliary drainage. The mean concentrations of bile pigments and free calcium in the PS group were lower than those in the SF group. CONCLUSIONS: An increase in the activity of hBG may be a secondary response, developed after bile duct inflammation because it was elevated only when the bile duct obstruction was associated with infection.

Bile↗

Altered heel-pad mechanical properties in patients with Type 2 diabetes mellitus.

AIMS: To compare the heel-pad mechanical properties in patients with Type 2 diabetes mellitus with forefoot ulceration, without forefoot ulceration and age-matched healthy subjects. METHODS: Heel-pad mechanical properties in 40 heels of 20 healthy subjects (group I) age-matched with the other groups, 42 heels of 21 diabetic patients without forefoot ulceration (group II), and 14 heels of 12 diabetic patients with active forefoot ulceration (group III) were assessed using a self-constructed loading-unloading device and a 10-MHz linear-array ultrasound transducer. RESULTS: There were no differences in the unloaded heel-pad thickness, compressibility index and elastic modulus between the three groups. When compared with group I subjects (mean +/- SD, 27.9 +/- 6.1%), a significant increase (P < 0.001) was found in both group II (36.1 +/- 8.7%) and group III patients (43.2 +/- 6.6%) for the energy dissipation ratio. This ratio was also significantly different (P = 0.003) between groups II and III. CONCLUSIONS: The higher impact energy dissipated in the heel-pad may put patients with Type 2 diabetes at higher risk for developing foot ulceration.

Adult↗

Bone-marrow microinvolvement in non-small cell lung cancer is not a reliable indicator of tumour recurrence and prognosis.

AIMS: This study aimed to examine the incidence of bone-marrow microinvolvement in non-small cell lung cancer (NSCLC) patients and its correlation with tumour recurrence and prognosis. METHODS: Between March 1997 and August 1998, we analysed 96 bone-marrow specimens (from the posterior iliac crest) of NSCLC patients before surgery. Tumour differentiation showed well differentiated carcinoma in six, moderately differentiated carcinoma in 69, and poorly differentiated carcinoma in 21. p-TNM staging showed stage Ia in five, stage Ib in 33, stage IIb in 19, stage IIIa in 26, stage IIIb in eight, and stage IV in five. The specimens were examined by immunohistochemical staining with anti-human cytokeratin AE1/AE3 and clone MNF116 mixed solution (Ab1, n=96) and/or Ber-EP4 (Ab2, n=80) to detect the presence of malignant epithelial cells in the bone marrow. RESULTS: Positive results were observed in 21 patients (21. 9%). The occurrence of bone-marrow microinvolvement was not related to patient age, sex, cell type, or TNM status. The 30-month disease-free survival rates were 50.2% and 53.9% in bone-marrow negative and bone-marrow positive patients, respectively (P=0.5670); the 30-month cumulative survival rates were 66.7% and 67.6% in bone-marrow negative and bone-marrow positive patients, respectively (P=0.9351). Multivariate analysis failed to demonstrate bone-marrow microinvolvement as an independent prognostic factor. CONCLUSIONS: Our results show that bone-marrow microinvolvement is not unusual, and its occurrence cannot be translated into early tumour recurrence or poor outcome during an intermediate-term follow-up, which means bone-marrow microinvolvement may be an epiphenomenon rather than true metastasis in NSCLC.

Adult↗

Melatonin prevents pigment gallstone formation induced by bile duct ligation in guinea pigs.

Free radical-mediated oxidative stress has been implicated in the genesis of gallstone in vitro. This study was designed to examine the oxidative stress changes during pigment gallstone formation and to investigate whether melatonin (MLT) could act as a chemopreventive agent for cholelithiasis in a guinea pig model. The common bile duct of guinea pigs was ligated with or without MLT pretreatment. Animals were studied on day 7, 9, 12, and 14 after surgery. Stone and/or sludge developed in ligated guinea pigs without MLT. Fourier transform infrared spectra of the sludge showed the presence of calcium bilirubinate, whose peak height per milligram of sludge gradually increased with time after ligation. Total antioxidant activity (TAA) in bile of guinea pigs at day 14 after ligation reduced to one third of the level in sham-operated controls (P <.001). In addition, the bile of ligated guinea pigs had increased pH (P <.001), bile salts (P <.01), and malondialdehyde (MDA) (P <.05), compared to sham controls. Pretreatment of guinea pigs with MLT at a dose of 1,000 microg/kg significantly decreased the incidence of pigment gallstone formation at day 14 after ligation, as compared to no pretreatment (0/7 vs. 8/10). MLT also reverted the ligation-induced changes in biliary bile salts, pH, MDA, and TAA to control levels. These in vivo findings support a causative role of oxidative stress in the bile duct ligation-induced pigment gallstone formation. Antioxidants may prove useful in preventing pigment gallstone formation in humans.

Animals↗

Association of CYP1A1 and microsomal epoxide hydrolase polymorphisms with lung squamous cell carcinoma.

Lung cancer is the leading cause of death among cancers in Taiwan. Although the etiology of lung cancer has yet to be defined, genetic variability in activities of metabolic enzymes has been correlated with lung cancer. In the present study, the possibility of association of CYP1A1 and microsomal epoxide hydrolase (HYL1) genetic polymorphisms with lung cancer was examined among 132 lung cancer patients and 259 controls in Taiwan. No significant association was observed for either CYP1A1 or HYL1 polymorphism alone and the overall incidence of lung cancer after adjusting for age, gender and smoking status. When cases were stratified according to histological type, there was significant association between CYP1A1*2A homozygote and squamous cell carcinoma (SCC) (odds ratio (OR) 2.86; 95% confidence interval (CI) 1.33-6.12). Similarly, the proportion of HYL1 genotypes corresponding to high or normal enzyme activities was higher in SCC than in controls (OR 1.96; 95% CI 1.04-3.70). A combination of susceptible CYP1A1 and HYL1 genotypes was found to be highly associated with lung cancer, especially with SCC (OR 6.76; 95% CI 2.29-19.10). Our results suggest that the combination of CYP1A1 and HYL1 polymorphisms is an important risk factor for lung SCC.

Base Sequence↗

Vastus lateralis fibrosis in habitual patella dislocation: an MRI study in 28 patients.

We studied 28 patients with habitual or recurrent dislocation of the patella with MRI of both thighs. Apart from the 2 patients whose dislocation could be related to trauma, we found signs of fibrosis of the vastus lateralis muscle in all the affected limbs of the 26 patients with an insidious onset of dislocation. This was seen as low signal intensity cords in the muscles in the T2 weighted image. Muscle degeneration was seen as high intensity signals in the T1 weighted image. In patients with unilateral disease, the vastus lateralis muscle of the affected side was hypotrophic, compared to that of the normal side. 2 patients underwent a biopsy of the affected muscle area. Histopathological examination revealed inflammatory cell infiltration, fibrosis, and muscle fiber degeneration. Fibrosis of the vastus lateralis muscle appears to be common in patients with habitual patella dislocation in our population, and may be the cause of the dislocation. Since release of such a contracture may be of value, MRI study of the thigh muscles is helpful in the evaluation of patients with this disorder.

Adolescent↗

Continuous arteriovenous hemodiafiltration in the acute treatment of hyperammonaemia due to ornithine transcarbamylase deficiency.

BACKGROUND: Acute hyperammonemia caused by urea cycle disorder is a medical emergency for which immediate managements should be taken to minimize permanent brain damage. Among different enzyme defects, ornithine transcarbamylase deficiency (OTC) is one of the most common enzyme defect in urea cycle disorders. We utilized continuous renal replacement therapy techniques in the acute treatment of hyperammonemia due to ornithine transcarbamylase deficiency. PATIENTS AND METHODS: Three male neonates with elevated serum ammonia levels were shown, based on urine organic acid analysis and serum amino acid studies, to have OTC deficiency. Administration of sodium benzoate and sodium phenylacetate for activating alternative nitrogen waste pathway were used associated with protein restriction. Other modalities, including blood exchange transfusion, peritoneal dialysis, continuous renal replacement therapy were utilized in an attempt to lower serum ammonia concentration. RESULTS: We report the successful use of continuous arteriovenous hemofiltration (CAVH), continuous arteriovenous hemodialysis (CAVHD), continuous arteriovenous hemodiafiltration (CAVHDF) in the acute management of hyperammonemia due to OTC deficiency. We also compared the ammonia clearance between peritoneal dialysis, exchange transfusion, CAVH, CAVHD and CAVHDF. It demonstrated the evidence that CAVHDF provides the best ammonia clearance. CONCLUSION: Continuous renal replacement therapy including CAVH, CAVHD, and CAVHDF may be the alternative techniques for acute management of hyperammonemia in inborn error of metabolism when dialysis machine is not available. Our data suggests CAVHDF provides the best ammonia clearance.

Hemodiafiltration↗

The bioavailability of beta-carotene in stir- or deep-fried vegetables in men determined by measuring the serum response to a single ingestion.

To evaluate the bioavailability of beta-carotene from plant foods, the serum beta-carotene response to a single ingestion of various beta-carotene sources was determined in 10 healthy men. Tested beta-carotene sources included stir-fried shredded carrot, stir-fried water convolvulus leaves, deep-fried sweet potato ball, purified beta-carotene in a capsule (beadlets) and beadlets with beta-carotene free oriental radish (beadlets + radish). The maximal change in serum beta-carotene concentration occurred at 24 or 32 h post ingestion. This response to beadlets was significantly higher than that to the other four tested beta-carotene sources (P < 0.05). The maximal serum response to beadlets + radish was also significantly higher than that to the three food beta-carotene sources (P < 0.05). The maximal serum response to sweet potato was significantly higher than that to water convolvulus leaves (P < 0. 05). The bioavailability relative to beta-carotene beadlets was calculated by dividing the maximal change in serum concentration to each test meal of each subject by his own serum maximal change in response to beadlets. Accordingly, the bioavailability was 65% for beadlets + radish, 33% for carrots, 26% for water convolvulus leaves and 37% for sweet potatoes. Concurrent ingestion of oriental radish reduced the bioavailability of beadlets to two-thirds of its original value, which partially accounted for the difference between the bioavailability of beadlets and natural foods. The relative bioavailability of beta-carotene from stir-fried and deep-fried vegetables was about one-third to one-fourth that of the purified beta-carotene beadlets. These bioavailabilities are higher than previously reported values.

Adult↗

Antibiotic-impregnated autogenic cancellous bone grafting is an effective and safe method for the management of small infected tibial defects: a comparison study.

OBJECTIVE: Bone grafting plays an important role in reconstructing infected tibial nonunions. The effects of antibiotic-impregnated bone grafting in infection elimination and bone incorporation was reported in this retrospective study. METHODS: Ninety-six patients treated for infected tibial nonunions were evaluated. These patients were managed with local antibiotic bead therapy and staged antibiotic-impregnated autogenous cancellous bone graft or pure autogenous cancellous bone graft. Patients were randomized to antibiotic-impregnated bone grafting or bone grafting-only groups on the basis of whether the admission date was odd or even. Patients were divided into two groups (antibiotic-impregnated bone grafting group and pure cancellous bone grafting group), according to the procedure used in preparing the bone grafts. The antibiotic-impregnated bone grafting group included 37 men and 9 women whose average age was 36 years (range, 17 to 72 years). The average follow-up period was 4.8 years. By using the Cierny-Mader staging classification of chronic osteomyelitis, 32 of 46 patients (70%) were stage 4A, and 14 of 36 patients (30%) were stage 4B. The pure cancellous bone grafting group included 39 men and 11 women whose average age was 37 years (range, 18 to 72 years). The average follow-up period was 4.5 years (range, 4 to 6 years). Thirty-nine of 50 patients (78%) were stage 4A, and 11 of 50 patients (22%) were stage 4B. The bone defects in both groups ranged from 2 to 4 cm. RESULTS: Wound healing and bony union were achieved in the antibiotic-impregnated bone grafting group. Only two patients had recurrent infections. The infection arrest rate was 95.6%. However, 9 of 50 patients in the pure cancellous bone grafting group had recurrent infections. The infection arrest rate was 82%. The antibiotic-impregnated bone grafting group had significantly superior results (95.6% vs. 82% chi2 test, p < 0.05) in infection elimination than the pure cancellous bone grafting group. CONCLUSION: After 4 to 6 years of follow-up, our results suggest that the use of impregnating antibiotics have no adverse effects on autogenic cancellous bone graft incorporation and could help to eliminate infection effectively.

Adolescent↗

Endoscopic management of skull base osteoradionecrosis.

OBJECTIVE: Osteoradionecrosis is one of the most serious complications in radiotherapy of nasopharyngeal carcinoma. We describe a new endoscopic approach to resolve resultant skull base osteoradionecrosis. The objective of this study is to evaluate the efficacy of endoscopic management of skull base osteoradionecrosis. STUDY DESIGN: A prospective study of the outcome of endoscopic management for patients with skull base osteoradionecrosis. METHODS: Between 1994 and 1998 six patients who had irradiation previously for nasopharyngeal carcinoma had skull base osteoradionecrosis. A sinoscopic approach was applied for diagnosis and sequestrectomy. This diagnosis was based on the criterion of exposed necrotic bone after removing all crust in the nasopharynx and further confirmed on pathological examination after sequestrectomy. Effective cure was defined as intact mucosal coverage without any ulcer or exposed necrotic bone observed in the nasopharynx and the absence of antecedent accompanying symptoms after management. RESULTS: Six patients (10%) were symptom free. Five (83.3%) patients had effective cure. There was no surgical morbidity or mortality. CONCLUSION: Endoscopic sequestrectomy is a justified approach to skull base osteoradionecrosis.

Adult↗

Human immunodeficiency virus infection and genital ulcer disease in South Africa: the herpetic connection.

BACKGROUND AND OBJECTIVES: While genital ulcers are a risk factor in HIV infection, the association of specific agents of genital ulcer disease (GUD) with HIV infection may vary. GOAL: To determine the etiology of GUD in HIV-infected and HIV-uninfected men attending sexually transmitted disease (STD) clinics in Durban, Johannesburg, and Cape Town, South Africa, and the association of previous and current sexually transmitted infections with HIV infection in men with ulcerative and nonulcerative STDs. STUDY DESIGN: A cross-sectional study of 558 men with genital ulcers and 602 men with urethritis. RESULTS: Patients with GUD were more likely to be infected with HIV than patients with urethritis (39.4% versus 21.4%, P< or =0.001). Herpes simplex virus 2 (HSV-2) was the most common agent identified in ulcer specimens (35.9%), and was detected in a significantly higher proportion of ulcer specimens from HIV-infected patients than in specimens from HIV-uninfected patients (47.4% versus 28.2%, P< or =0.001). Patients infected with HIV-1 were significantly more likely to have HSV-2 infection, as measured by the presence of the antibody to glycoprotein G-2, than patients not infected with HIV (63.1% versus 38.5%, P< or =0.001). Patients infected with HIV-1 were also significantly more likely to have initial HSV-2 infection than HIV-uninfected patients with GUD (50.0% versus 31.6%, P = 0.007). Haemophilus ducreyi was detected in 31.7% of ulcer specimens; prevalence did not vary by HIV-infection status. Treponema pallidum DNA was detected significantly less frequently in ulcer specimens from patients infected with HIV than in specimens from patients not infected with HIV (10.2% versus 26%, P< or =0.001); no association was found between HIV-infection status and fluorescent treponemal antibody absorption test seroreactivity, even when men with M-PCR-positive syphilis lesions were excluded from the analyses. CONCLUSION: The authors found that HSV-2 is a more common etiology of GUD than has been suggested by previous studies conducted in South Africa; serologic evidence of HSV-2 infection and current cases of genital herpes are strongly associated with HIV infection among men who present to STD clinics with GUD or urethritis.

Adolescent↗

The impact of chronic hepatitis B viral infection on gastrointestinal motility.

OBJECTIVES: Disturbed gastrointestinal (GI) motility probably exists in alcoholic cirrhotic patients; however, the influence of chronic hepatitis B virus (HBV) infection on GI motility remains unknown. The purpose of this prospective study was to determine the impact of chronic HBV infection on human GI transit, and to explore the possible patient factors modulating GI motility. METHODS: We used a non-invasive hydrogen breath test measuring the oro-caecal transit time (OCTT) to assess the GI motility in 45 asymptomatic HBV carriers, 26 patients with chronic hepatitis B, 23 patients with HBV-related liver cirrhosis, and 45 age- and sex-matched healthy volunteers. Their clinical symptoms and various blood parameters, such as platelet count, prothrombin time, etc. were recorded. Plasma substance P, nitrate/nitrite and endothelin-1 levels were also measured. RESULTS: The OCTTs in controls, HBV carriers, chronic hepatitis B and liver cirrhosis patients were (mean +/- SEM) 78.4 +/- 5.8, 80.9 +/- 4.2, 93.9 +/- 8.8 and 106.5 +/- 12.4 min, respectively. The OCTT was delayed in patients with HBV-related liver cirrhosis compared to that of controls (P=0.039). Among the cirrhotic patients, presentation with ascites delayed OCTT (145.7 +/- 27.2 versus 91.3 +/- 11.9 min, P=0.039). Neither Child- Pugh grade, portal hypertension, various blood parameters, plasma substance P, nitrate/nitrite or endothelin-1 levels had any influence on OCTT. CONCLUSIONS: HBV infection alone does not alter GI motility, whereas the patients with liver cirrhosis may have delayed GI motility. Ascites is most likely a factor responsible for the delayed GI transit among chronic HBV-infected subjects.

Aged↗

Measurement of percutaneous uptake of 2-methoxy ethanol vapor in humans.

Absorption of vapors through skin has been largely ignored in occupational health, although for ethylene glycol ethers this route of exposure could be more important than inhalation. We used an automated concentration and humidity controlled system to measure real-time percutaneous absorption of 2-methoxy ethanol (ME) vapor in seven volunteers. The exposure concentration (300 +/- 10 ppm or 25 +/- 0.5 ppm), humidity (80 +/- 2%), and temperature (27.5 +/- 0.5 degrees C) were controlled throughout the experiments. Uptakes during 4-hour single-arm exposure at 25 ppm and 300 ppm were 7.0 mg and 65.3 +/- 25.0 mg, respectively, with corresponding uptake rates of 1.36 micrograms/cm2/hr and 13.2 +/- 5.0 micrograms/cm2/hr. Percutaneous absorption was consistent and unsaturated during exposure. Because the permeability constant of ME vapor (14.0 +/- 5.3 cm/hr) was much higher than that of many widely used organic chemicals, we concluded that vapor absorption through skin is a significant contributor to overall ME exposure.

Adult↗

The association between Helicobacter pylori infection and functional dyspepsia in patients with irritable bowel syndrome.

OBJECTIVE: Irritable bowel syndrome (IBS) is associated with an exaggerated response to a variety of physiological and nonphysiological gastrointestinal stimuli. Many patients with IBS also have functional dyspepsia. Our aim was to examine the hypothesis that Helicobacter pylori (H. pylori) infection may predispose IBS patients to functional dyspepsia. METHODS: In 69 IBS patients, dyspeptic symptoms, H. pylori status, and sociodemographic and psychological variables (perceived stress, trait anxiety, and depression) were assessed. Sociodemographic and psychological variables were also evaluated in 52 control subjects. RESULTS: Mean scores for perceived stress (17.1 +/- 6.0 vs 14.9 +/- 6.0, p = 0.05), trait anxiety (45.6 +/- 9.1 vs 41.1 +/- 7.8, p = 0.004) and depression (9.9 +/- 8.4 vs 5.0 +/- 5.5, p = 0.0002) were higher in IBS patients than in controls. In all, 33 of the 69 patients (47.8%) had H. pylori infection, and this was associated with relevant symptoms of epigastric pain (odds ratio [OR] = 6.77, 95% confidence interval [CI] 1.89-24.3) and postprandial upper abdominal fullness (OR = 4.23, 95% CI 1.38-13.2). H. pylori infection and female gender were independent predictors of the presence of relevant dyspepsia (OR = 8.31, 95% CI 2.35-29.5 and 6.06, 95% CI 1.71-21.5, respectively). Symptom intensity was associated with the level of perceived stress (total relevant symptom number > or =3 vs <3, OR = 1.16 per point on a 40-point perceived stress scale, 95% CI 1.01-1.34). CONCLUSIONS: In IBS patients, the presence of dyspepsia is associated with H. pylori infection, female gender, and perceived stress.

Adult↗

Delayed liquid gastric emptying in patients with hepatocellular carcinoma.

OBJECTIVE: Liver cirrhotic patients sometimes have disturbed gastric emptying (GE). Apparently there is no study addressing the issue of whether patients with hepatocellular carcinoma (HCC) have similarly impaired GE. Using impedance tomography to measure liquid GE, we attempted to assess the characteristics of GE in HCC patients. METHODS: We enrolled 34 healthy controls and 45 HCC patients in the current study, and compared their GE according to certain defined criteria. After each subject drank 500 ml of water, 12 electrodes were placed in a circular array around the subject's upper abdomen. One pair of electrodes was applied with electrical current, and the remaining 10 electrodes recorded signals consecutively in a rotating order. Based on tomographic calculation, serial changes in the averaged signals of altered resistivities were constructed to display liquid GE. Meanwhile, the demographic and clinical data, various blood parameters, and gut peptide levels of the patients were recorded. RESULTS: The half-emptying times in controls and HCC patients were 15.14 +/- 1.56 and 21.38 +/- 1.84 min, respectively (p < 0.05), whereas the areas under the emptying curve were 1732.2 +/- 106.4 and 2246.6 +/- 109.8 arbitrary units, respectively (p < 0.05). Delayed GE was observed in the HCC patients, as demonstrated by vomiting and anorexia. The cirrhotic component in HCC patients only resulted in a shorter period needed for full distention of the stomach after drinking (4.33 +/- 1.02 vs 8.78 +/- 2.1 min; p < 0.05). Other characteristics, including demographics, clinical state, tumor size, ascites, blood parameters, and gut peptides, had no influence on GE. CONCLUSIONS: Liquid GE is inhibited in HCC patients, particularly in those mainly showing symptoms of vomiting and anorexia. Other demographic and tumor characteristics are not responsible for delayed liquid GE; however, the cirrhotic component may promote stomach distention.

Carcinoma, Hepatocellular↗