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Review of primary sclerosing cholangitis with increased IgG4 levels

world Journal of Gastroenterology 2020年第23期26卷 3126-3144页

作者： Charis D Manganis roger w chapman Emma L Culver Translational Gastroenterology Unit and Oxford NIHR Biomedical Research Centre John Radcliffe HospitalOxford OX39DUUnited Kingdom

Primary sclerosing cholangitis(PSC) is a chronic progressive liver disease. Subtypes of PSC have been described, most recently PSC with elevated serum and/or tissue IgG4 subclass. we aim to summarise the clinical phenotype,disease associations, differential diagnosis, response to therapy and pathogenic mechanisms underlying PSC-high IgG4 subtype. we reviewed Pub Med,MEDLINE and Embase with the search terms "primary sclerosing cholangitis","IgG4", and "IgG4-related sclerosing cholangitis(IgG4-SC)". Elevated serum IgG4 are found in up-to one-quarter, and abundant IgG4-plasma cell infiltrates in the liver and bile ducts are found in up-to one-fifth of PSC patients. This group have a distinct clinical phenotype, with some studies reporting a more aggressive course of liver and associated inflammatory bowel disease, compared to PSCnormal IgG4 and the disease mimic IgG4-SC. Distinguishing PSC-high IgG4 from IgG4-SC remains challenging, requiring careful assessment of clinical features,organ involvement and tissue morphology. Calculation of serum IgG4:IgG1 ratios and use of a novel IgG4:IgG RNA ratio have been reported to have excellent specificity to distinguish IgG4-SC and PSC-high IgG4 but require validation in larger cohorts. A role for corticosteroid therapy in PSC-high IgG4 remains unanswered, with concerns of increased toxicity and lack of outcome data. The immunological drivers underlying prominent IgG4 antibodies in PSC are incompletely defined. An association with PSC-high IgG4 and HLA class-II haplotypes(B*07, DRB1*15), T-helper2 and T-regulatory cytokines(IL4, IL10,IL13) and chemokines(CCL1, CCR8) have been described. PSC-high IgG4 have a distinct clinical phenotype and need careful discrimination from IgG4-SC,although response to immunosuppressive treatments and long-term outcome remains unresolved. The presence of IgG4 likely represents chronic activation to persistent antigenic exposure in genetically predisposed individuals.

关键词： Primary sclerosing cholangitis IgG4 IgG4-related disease IgG4-related sclerosing cholangitis

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Addition of senna improves quality of colonoscopy preparation with magnesium citrate

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world Journal of Gastroenterology 2009年第14期15卷 1759-1763页

作者： Stergios Vradelis Evangelos Kalaitzakis Yalda Sharifi Otto Buchel Satish Keshav roger w chapman Barbara Braden Department of Gastroenterology John Radcliffe Hospital Oxford OX3 9DU United Kingdom Section of Gastroenterology and Hepatology Department of Internal Medicine Sahlgrenska University Hospital 41345 Gothenburg Sweden

AIM: To prospectively investigate the effectiveness and patient’s tolerance of two low-cost bowel cleansing preparation protocols based on magnesium citrate only or the combination of magnesium citrate and senna. METHODS: A total of 342 patients who were referred for colonoscopy underwent a colon cleansing protocol with magnesium citrate alone (n = 160) or magnesium citrate and senna granules (n = 182). The colonoscopist rated the overall efficacy of colon cleansing using an established score on a 4-point scale. Patients were questioned before undergoing colonoscopy for side effects and symptoms during bowel preparation. RESULTS: The percentage of procedures rescheduled because ofinsufficient colon cleansing was 7% in the magnesium citrate group and 4% in the magnesium citrate/senna group (P = 0.44). Adequate visualization of the colonic mucosa was rated superior under the citramag/senna regimen (P = 0.004). Both regimens were well tolerated, and did not significantly differ in the occurrence of nausea, bloating or ***, abdominal cramps were observed more often under the senna protocol (29.2%) compared to the magnesium citrate only protocol (9.9%, P wel preparation protocol with magnesium citrate significantly improves the cleansing outcome.

关键词： Colonoscopy Bowel preparation Senna Magnesium citrate Polyp

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Evolving role of magnetic resonance techniques in primary sclerosing cholangitis

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world Journal of Gastroenterology 2019年第6期25卷 644-658页

作者： Emmanuel A Selvaraj Emma L Culver Helen Bungay Adam Bailey roger w chapman Michael Pavlides Oxford Centre for Clinical Magnetic Resonance Research Division of Cardiovascular Medicine Radcliffe Department of Medicine University of Oxford John Radcliffe Hospital Translational Gastroenterology Unit Nuffield Department of Medicine University of OxfordJohn Radcliffe Hospital Oxford NIHR Biomedical Research Centre Oxford University Hospitals NHS Foundation Trust and the University of Oxford Department of Radiology John Radcliffe Hospital

Development of non-invasive methods to risk-stratify patients and predict clinical endpoints have been identified as one of the key research priorities in primary sclerosing cholangitis(PSC). In addition to serum and histological biomarkers, there has been much recent interest in developing imaging biomarkers that can predict disease course and clinical outcomes in *** resonance imaging/magnetic resonance cholangiopancreatography(MRI/MRCP) continue to play a central role in the diagnosis and follow-up of PSC patients. Magnetic resonance(MR) techniques have undergone significant advancement over the last three decades both in MR data acquisition and interpretation. The progression from a qualitative to quantitative approach in MR acquisition techniques and data interpretation, offers the opportunity for the development of objective and reproducible imaging biomarkers that can potentially be incorporated as an additional endpoint in clinical trials. This review article will discuss how the role of MR techniques have evolved over the last three decades from emerging as an alternative diagnostic tool to endoscopic retrograde cholangiopancreatography, to being instrumental in the ongoing search for imaging biomarker of disease stage, progression and prognosis in PSC.

关键词： Primary sclerosing cholangitis Magnetic resonance imaging Magnetic

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Mitigating Carbon Emissions:A Comprehensive Analysis of Transitioning to Hydrogen-Powered Plants in Japan’s Energy Landscape Post-Fukushima

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Energy Engineering 2024年第5期121卷 1143-1159页

作者： Nugroho Agung Pambudi Andrew chapman Alfan Sarifudin Desita Kamila Ulfa Iksan Riva Nanda Department of Mechanical Engineering Education Universitas Sebelas MaretSukoharjo57161Indonesia International Institute for Carbon-Neutral Reserch(wPI-I2CNER) Kyushu UniversityFukuoka819-0395Japan Postgraduate of Mechanical Engineering Universitas Sebelas MaretSurakarta57126Indonesia Energy and Society Laboratory Department of Mechanical Engineering EducationUniversitas Sebelas MaretSukoharjo57161Indonesia Department of Metallurgical and Material Engineering Universitas IndonesiaDepok16424Indonesia

One of the impacts of the Fukushima disaster was the shutdown of all nuclear power plants in Japan,reaching zero production in *** response,the country started importing more fossil energy including coal,oil,and natural gas to fill the energy ***,this led to a significant increase in carbon emissions,hindering the efforts to reduce its carbon *** the current situation,Japan is actively working to balance its energy requirements with environmental considerations,including the utilization of hydrogen ***,this paper aims to explore the feasibility and implications of using hydrogen power plants as a means to reduce emissions,and this analysis will be conducted using the energy modeling of the MARKAL-TIMES Japan *** hydrogen scenario(HS)is assumed with the extensive integration of hydrogen into the power generation sector,supported by a hydrogen import ***,this scenario will be compared with the Business as Usual(BAU)*** results showed that the generation capacities of the BAU and HS scenarios have significantly different primary energy *** BAU scenario is highly dependent on fossil fuels,while the HS scenario integrates hydrogen contribution along with an increase in renewable energy,reaching a peak contribution of 2,160 PJ in *** the HS scenario,the target of reducing CO_(2) emissions by 80%is achieved through significant hydrogen *** 2050,the total CO_(2) emissions are estimated to be 939 million tons for the BAU scenario and 261 million tons for the Hydrogen *** addition,the contribution of hydrogen to electricity generation is expected to be 153 Twh,smaller than PV and wind power.

关键词： Business as usual(BAU)scenario hydrogen scenario CO_(2)emissions power generation sector

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Palliative long-term abdominal drains vs large volume paracenteses for the management of refractory ascites in end-stage liver disease

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world Journal of Hepatology 2024年第3期16卷 428-438页

作者： Senamjit Kaur Rodrigo V Motta Bryony chapman Victoria wharton Jane D Collier Francesca Saffioti Oxford Liver Unit Department of Gastroenterology and HepatologyOxford University Hospitals NHS Foundation TrustOxford OX39DUUnited Kingdom Oxford Liver Unit and Translational Gastroenterology Unit Nuffield Department of MedicineUniversity of OxfordOxford OX39DUUnited Kingdom

BACKGROUND Long-term abdominal drains(LTAD)are a cost-effective palliative measure to manage malignant ascites in the community,but their use in patients with end-stage chronic liver disease and refractory ascites is not routine *** safety and cost-effectiveness of LTAD are currently being studied in this setting,with preliminary positive *** hypothesised that palliative LTAD are as effective and safe as repeat palliative large volume paracentesis(LVP)in patients with cirrhosis and refractory ascites and may offer advantages in patients’quality of *** To compare the effectiveness and safety of palliative LTAD and LVP in refractory ascites secondary to end-stage chronic liver *** A retrospective,observational cohort study comparing the effectiveness and safety outcomes of palliative LTAD and regular palliative LVP as a treatment for refractory ascites in consecutive patients with end-stage chronic liver disease followed-up at our United Kingdom tertiary centre between 2018 and 2022 was ***’s exact tests and the Mann-whitney U test were used to compare qualitative and quantitative variables,***-Meier survival estimates were generated to stratify time-related outcomes according to the type of *** Thirty patients had a total of 35 indwelling abdominal drains and nineteen patients underwent regular *** baseline characteristics were similar between the *** antibiotics were more frequently prescribed in patients with LTAD(P=0.012),while the incidence of peritonitis did not differ between the two groups(P=0.46).The incidence of acute kidney injury(P=0.014)and ascites/drain-related hospital admissions(P=0.004)were significantly higher in the LVP *** overall survival was similar in the two groups(log-rank P=0.26),but the endpoint-free survival was significantly shorter in the LVP group(P=0.003,P<0.001,P=0.018 for first ascites/drain-related admission,acute kidney injury and drain

关键词： Decompensated liver cirrhosis Indwelling abdominal catheter Rocket drain Palliative care Safety Quality of life

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Genomic variation,environmental adaptation,and feralization in ramie,an ancient fiber crop

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Plant Communications 2024年第8期5卷 189-207页

作者： Zeng-Yuan wu Mark A.chapman Jie Liu Richard I.Milne Ying Zhao Ya-Huang Luo Guang-Fu Zhu Marc w.Cadotte Ming-Bao Luan Peng-Zhen Fan Alex K.Monro Zhi-Peng Li Richard T.Corlett De-Zhu Li Germplasm Bank of wild Species&Yunnan Key Laboratory of Crop wild Relatives Omics Kunming Institute of BotanyChinese Academy of SciencesKunmingYunnan 650201China School of Biological Sciences University of SouthamptonSouthampton SO171BJUK CAS Key Laboratory for Plant Diversity and Biogeography of East Asia Kunming Institute of BotanyChinese Academy of SciencesKunmingYunnan 650201China Institute of Molecular Plant Sciences School of Biological SciencesUniversity of EdinburghEdinburgh EH93JHUK Department of Biological Sciences University of Toronto-ScarboroughTorontoOntarioCanada Institute of Bast Fiber Crops Chinese Academy of Agricultural SciencesChangshaHunan 410205China Royal Botanic Gardens Kew RichmondSurrey TW93AEUK Center for Integrative Conservation and Yunnan Key Laboratory for the Conservation of Tropical Rainforests and Asian Elephants Xishuangbanna Tropical Botanical GardenChinese Academy of SciencesMenglunYunnan 666303China

Feralization is an important evolutionary process,but the mechanisms behind it remain poorly ***,we use the ancient fiber crop ramie(Boehmeria nivea(L.)Gaudich.)as a model to investigate genomic changes associated with both domestication and *** first produced a chromosome-scale de novo genome assembly of feral ramie and investigated structural variations between feral and domesticated ramie ***,we gathered 915 accessions from 23 countries,comprising cultivars,major landraces,feral populations,and the wild *** on whole-genome resequencing of these accessions,we constructed the most comprehensive ramie genomic variation map to ***,demographic,and admixture signal detection analyses indicated that feral ramie is of exoferal or exo-endo origin,i.e.,descended from hybridization between domesticated ramie and the wild progenitor or ancient *** ramie has higher genetic diversity than wild or domesticated ramie,and genomic regions affected by natural selection during feralization differ from those under selection during *** analyses showed that feral and domesticated ramie have similar ecological niches that differ substantially from the niche of the wild progenitor,and three environmental variables are associated with habitat-specific adaptation in feral *** findings advance our understanding of feralization,providing a scientific basis for the excavation of new crop germplasm resources and offering novel insights into the evolution of feralization in nature.

关键词： ramie fiber offering

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Primary sclerosing cholangitis, autoimmune hepatitis and overlap syndromes in inflammatory bowel disease

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world Journal of Gastroenterology 2008年第3期14卷 331-337页

作者： Rebecca Saich roger chapman The Department of Gastroenterology The John Radcliffe Hospital Headley Way Headington Oxford Oxfordshire OX3 9DU United Kingdom

Primary sclerosing cholangitis （PSC） is a chronic progressive disorder of unknown aetiology characterised by chronic inflammation and stricture formation of the biliary tree. Symptoms include itch and lethargy and in advanced cases cholangitis and end-stage liver disease, however increasing numbers of asymptomatic individuals are being identified. The disease is rare in the general population but is strongly associated with inflammatory bowel disease （IBD） affecting up to 5% of patients with Ulcerative Colitis, with a slightly lower prevalence （up to 3.6%） in Crohns disease. The strength of this association means that the vast majority （〉 90%） of patients with PSC also have IBD, although many may have only mild gastro-intestinal symptoms. Usually IBD presents before PSC, although vice-versa can occur and the onset of both conditions can be separated in some cases by many years. Mean age of diagnosis of PSC is in the fitch decade of life with a strong male predominance. Risk is increased in those with a family history of PSC, suggesting a genetic predisposition and the disease is almost exclusive to non-smokers. The ulcerative colitis associated with PSC is characteristically mild, runs a quiescent course, is associated with rectal sparing, more severe right sided disease, backwash ilieitis and has a high risk of pouchitis post-colectomy. Most worrisome is the high risk of colorectal malignancy which necessitates routine colonoscopic surveillance. Cholangiocarcinoma is also a frequent complication of PSC with a 10%-15% lifetime risk of developing this condition. Treatment with high dose ursodeoxycholic acid offers some chemoprotective effects against colorectal malignancy and may decrease symptoms, biochemical and histological progression of liver disease. Small duct PSC patients characteristically have normal cholangiography, and liver biopsy is required for diagnosis, it appears to have a more favourable prognosis. Autoimmune Hepatitis （AIH） is also more prevalent

关键词： Primary sclerosing cholangitis Autoimmunehepatitis Liver disease Inflammatory bowel disease Crohns disease Ulcerative colitis

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Etiopathogenesis of primary sclerosing cholangitis

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world Journal of Gastroenterology 2008年第21期14卷 3350-3359页

作者： roger chapman Sue Cullen Department of Gastroen-terology John Radcliffe HospitalHeadingtonOxford OX3 9DUUnited Kingdom

Primary sclerosing cholangitis(PSC) is a chronic cholestatic liver disease of unknown etiology but lymphocytic portal tract infiltration is suggestive of an immune-mediated basis for this *** with inflammatory bowel disease(IBD) especially ulcerative colitis(UC),and with particular autoimmune diseases,as well as the genetic associations further suggest PSC may be an immune-mediated *** immunogenetics of PSC have been the subject of active research and several HLA and non-HLA associated genes have been implicated in the development of the *** derived from the inflamed gut may enter the liver via the enterohepatic circulation to cause hepatic *** may be triggered in genetically susceptible individuals by infections or toxins entering the portal circulation through a permeable colon and hence evoking an abnormal immune response.

关键词： Autoantibody Immunogenetics Biliaryepithelial cells T cell receptor Lymphocytes

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Intraductal papillary mucinous neoplasm in chronic calcifying pancreatitis:Egg or hen?

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world Journal of Gastroenterology 2009年第10期15卷 1273-1275页

作者： Evangelos Kalaitzakis Barbara Braden Palak Trivedi Yalda Sharifi roger chapman Department of Gastroenterology John Radcliffe HospitalOxford OX3 9DUUnited Kingdom Section of Gastroenterology and Hepatology Department of Internal MedicineSahlgrenska University Hospital41345 GothenburgSweden

Intraductal papillary mucinous neoplasm(IPMN)is an increasingly reported *** pancreatic calcification is generally thought to be a sign of chronic pancreatitis,but it may occur simultaneously with IPMN leading to diagnostic *** report a case of a patient initially diagnosed with chronic calcifying pancreatitis who was later shown to have a malignant *** case illustrates potential pitfalls in the diagnosis of IPMN in the case of extensive pancreatic calcification as well as clues that may lead the clinician to suspecting the *** possible mechanisms of the relation between pancreatic calcification and IPMN are also reviewed.

关键词： Intraductal papillary mucinous neoplasm Endoscopic ultrasound Calcifying pancreatitis Carcinoembryonic antigen Endoscopic retrogradecholangiopancreatography

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Erratum to “A gyroscope-based system for intraoperative measurement of tibia coronal plane alignment in total knee arthroplasty” [Med Nov Technol Dev, 13, 2022, 100112]

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Medicine in Novel Technology and Devices 2024年第1期21卷 120-120页

作者： Michael A.Kokko Ryan M.chapman Martin w.Roche Douglas w.Van Citters Thayer School of Engineering at Dartmouth College 14 Engineering DriveHanoverNH03755USA Department of Kinesiology College of Health SciencesUniversity of Rhode Island25 W.Independence WayKingstonRI02881USA Orthopedic Research Institute Holy Cross Hospital 4725 N Federal Hwy.FtLauderdaleFL33308USA

The publisher would like to include the Ethical approval and informed consent statement for this *** study did not involve human subjects or animal research,and was therefore not subject to institutional ethics approval and did not require informed *** single cadaveric specimen used in ex vivo evaluation was obtained from Science Care(https://***/)and was handled in accordance with applicable Science Care policy.

关键词： approval statement alignment

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