Prevalence and knowledge of hepatitis C in a middle-aged population, Dunedin, New Zealand.

Aim: To determine the prevalence of infection with hepatitis C virus (HCV) in those most at risk of advanced liver disease and to identify gaps in knowledge of HCV.

Methods: Questionnaires were mailed to randomly selected residents aged 40-59 to assess the extent of their general knowledge about HCV. The questionnaire assessed demographics, the extent of general knowledge about viral hepatitis, potential risks for infection and the prevalence of risk factors associated with increased progression of liver fibrosis.

Use of pethidine for percutaneous liver biopsy - a randomised, placebo-controlled, double blind study.

Background: Percutaneous liver biopsy (PLB) is the "gold standard" in the diagnosis of liver diseases. A pilot trial has shown pethidine may reduce anxiety and the need for post-procedural pain relief. The aim of this study was to investigate the role of pre-procedural pethidine.

The role of aspirin in post-polypectomy bleeding--a retrospective survey.

Background: Bleeding following colonoscopic polypectomy is a common complication and has been reported to occur in up to 6.1% of patients. Several risk factors have been discussed but their overall contribution to post-polypectomy bleeding remains controversial.

Fulminant ulcerative colitis despite maximal immunosuppression following liver transplantation: a case report and literature review.

Inflammatory Bowel Disease (IBD) is thought to be the result of an overly aggressive immune response to ubiquitous antigens. Immuno -modulation and -suppression is therefore currently the treatment of choice. It was long anticipated that the course of pre-existing IBD should improve after orthotopic liver transplantation (OLT) due to increased immunosuppression.

Unusual manifestation of Erdheim-Chester disease.

Background: Erdheim-Chester disease (ECD) is a rare multisystem non-Langerhans cell histiocytosis that is characterized histologically by xanthogranulomatous infiltrates and radiologically by symmetrical sclerosis of long bones. The xanthomatous process is characterized by prominent foamy histiocytes staining positive for CD68, occasionally for PS100 and negative for S100 and CD1a. Gastroenterological involvement is exceedingly rare.

Instrument for high-speed recording of accommodation of the human eye.

We developed an instrument used for recording the dynamics of accommodation of the eye. With this new technique, a recording speed of up to 95 Hz can be achieved. As components used in our system are mechanically fixed, artifacts owing to movable mechanical parts are excluded.

Quantitative and individualized assessment of the learning curve using LC-CUSUM.

Background: Current methods available for assessing the learning curve, such as a predefined number of procedures or direct observation by a tutor, are unsatisfactory. A new tool, the cumulative summation test for learning curve (LC-CUSUM), has been developed that allows quantitative and individual assessment of the learning curve.

Methods: Some 532 endoscopic retrograde cholangiopancreatographies (ERCPs) performed by one endoscopist over 8 years were analysed retrospectively using LC-CUSUM to assess the learning curve.

Barrett's esophagus: a retrospective analysis of 13 years surveillance.

Background And Aims: The incidence of esophageal adenocarcinoma has increased significantly. Barrett's esophagus (BE), a known precursor, has a high prevalence but only few patients with this condition progress to malignancy--surveillance and screening programs are controversial and lack proven efficacy. This retrospective analysis reviews the 13-year outcome for patients entered into a surveillance program.

Omeprazole therapy decreases the need for dilatation of peptic oesophageal strictures.

Background: Better control of gastric acid secretion with omeprazole appeared to decrease the need for dilatation of oesophageal strictures complicating gastro-oesophageal reflux disease in our hospital-based endoscopy service.

Aim: To investigate whether the perceived decrease in the need for oesophageal dilatation could be documented from endoscopy records, and, if confirmed, whether this could be related to the treatment used.

Patients And Methods: Retrospective study of the records of 69 patients who had peptic oesophageal strictures dilated, followed by treatment with acid inhibition for at least 6 months.

ERCP: a review of technical competency and workload in a small unit.

Background: ERCP is increasingly performed not only in large referral centers but also in smaller units. We sought to analyze the success rates of selective cannulation and intervention using the cumulative sum method and to document the workload in a small unit.

Methods: Indications, results, and interventions performed by one endoscopist were recorded for all patients undergoing ERCP at Dunedin Hospital.

Mycobacterium paratuberculosis and inflammatory bowel disease: frequency distribution in serial colonoscopic biopsies using the polymerase chain reaction.

An association between Mycobacterium paratuberculosis and Crohn's disease is suspected but the evidence remains controversial. Using a one-step DNA extraction procedure with the thermophilic protease PRETAQ and amplification by the polymerase chain reaction, M. paratuberculosis DNA was detected in 22% of patients with Crohn's disease, and in 13% of patients with ulcerative colitis.

Flexible sigmoidoscopy or colonoscopy for colorectal screening: a randomized trial of performance and acceptability.

In a randomized clinical trail to assess acceptability, yields, costs, and unwanted effects of screening procedures, 232 subjects (137 with family history of colorectal carcinoma or adenoma, 95 without) were offered either flexible sigmoidoscopy or colonoscopy. Subjects with polyps found on sigmoidoscopy were followed up by colonoscopy. The two procedures were similar in compliance (65%) and yield (19% adenoma, 15% hyperplastic polyps).

Potential of measurements of unsaturated vitamin B12-binding capacity in serial colonoscopic biopsy specimens for global and regional assessments of disease severity in inflammatory bowel disease.

We investigated whether measurements of unsaturated vitamin B12-binding capacity (UBBC), in homogenates of serial colonoscopic biopsy specimens, could be used as objective measures of disease severity in ulcerative colitis (UC) and Crohn's disease (CD). On a regional basis UBBC activity correlated with and showed good agreement with endoscopic and histologic activity scores (r = 0.8 and 0.

Measurements of unsaturated vitamin B12-binding capacity and myeloperoxidase as indices of severity of acute inflammation in serial colonoscopy biopsy specimens from patients with inflammatory bowel disease.

Measurements of tissue content of myeloperoxidase, a constituent of neutrophil azurophil granules and of unsaturated vitamin B12-binding protein from neutrophil-specific granules, have been used to assess intestinal inflammation. This paper reports results of a prospective evaluation of such measurements in serial colonoscopy biopsy specimens from patients with inflammatory bowel disease. Histologic grading of acute inflammation was based on perceived numbers of neutrophil polymorphs in sections from an immediately adjacent biopsy specimen.

Enzymes degrading bacterial chemotactic F-met peptides in human ileal and colonic mucosa.

Bacterial chemotactic F-met peptides have been identified in culture supernatants of intestinal bacteria and in human faecal dialysates. These potent inflammatory agents could play a role in intestinal inflammatory disorders should they cross the epithelial barrier of the gut. We have identified mucosal peptidases which degrade F-met-leu-phe (FMLP) in ileal and colonic mucosal biopsies obtained at colonoscopy.

Evaluation of a new fine needle technique in routine percutaneous liver biopsy.

A new fine needle aspiration biopsy technique (Vacu-Cut, 19.5 G) was compared to the 17 G Menghini needle in 20 consecutive patients scheduled for routine percutaneous liver biopsy (10 at random with each needle). The Menghini system was superior in producing sufficient material for histological assessment with 90% success on first pass biopsy (100% with 12 passes in 11 patients) as compared to 60% with the Vacu-Cut needle (90% with 16 passes in 10 patients).

[Long-term suppression of acid secretion with omeprazole use in metastatic gastrinoma].

We report on the clinical signs, diagnosis and 8-year course in a 54-year-old female patient with myeloma and gastrinoma with liver metastasis and associated Cushing syndrome treated for the last 3 years with the new H+/K+-ATPase inhibitor omeprazole which has successfully suppressed the massive gastric acid hypersecretion.

Crohn's disease: a ten year retrospective review at Dunedin hospitals.

Based on strictly defined criteria, 48 patients were judged to have Crohn's disease in a retrospective 10 year survey of Dunedin Hospital case notes. An apparent increase in the frequency of this disease in the Otago area is documented. Age (mean 39.

Prospective evaluation of patients with upper gastrointestinal haemorrhage.

A prospective study was conducted to collect data on clinical and endoscopic diagnosis, associated factors and outcome of 112 consecutive patients with acute upper gastrointestinal haemorrhage admitted to the Dunedin public hospitals over an 18 month period. The mean interval between admission and endoscopy was 20.2 hours.

A comparison of oxmetidine and cimetidine in the treatment of duodenal ulcer.

Oxmetidine (1 g/day), a new histamine H2-receptor antagonist, or cimetidine (1 g/day) was given to 30 patients with endoscopically proven duodenal ulcers in a randomised, double-blind trial. Ulcer healing was assessed endoscopically after four weeks' treatment, and again at eight weeks in those who had not healed in the first four weeks. Of the 15 patients receiving oxmetidine, 11 (73 percent) had healed their ulcers in four weeks, while 14 (93 percent) had healed their ulcers in eight weeks.