May 2009 Volume 136 . Number 5
`
`www.gastrojournal.org
`
`
`
`ApoptosisApoptosis
`
`Ethanol
`Ethanol
`
`HGF
`
`c-Met
`
`Nucleus
`
`Sp1
`
`CL-Sp1
`
`Cross-
`linking
`
`Plasma
`membrane
`
`Normal liver
`
`Cross-linked Sp1
`
`Alcoholic liver disease
`
`Physiology of Abdominal Distention
`Monitoring of Sedation for ERCP and EUS
`Regulation of COX-2 in Colon Cancer
`Notch-Signaling and Pancreatic Acinar–Beta
`Cell Differentiation
`
`Inside:
`DDW Program & Abstracts
`Supplement on CD
`
`MYLAN - EXHIBIT 1009
`
`

`

`Gastroenterology
`
`Official Journal of the American Gastroenterological Association (AGA) Institute
`
`Editor
`Anil K. Rustgi
`University of Pennsylvania
`Philadelphia, Pennsylvania
`
`Rexford S. Ahima
`University of Pennsylvania
`Philadelphia, Pennsylvania
`Bruce R. Bacon
`Saint Louis University
`St. Louis, Missouri
`Kyong-Mi Chang
`Philadelphia VA and
`University of Pennsylvania
`Philadelphia, Pennsylvania
`Raymond T. Chung
`Massachusetts General Hospital
`Harvard Medical School
`Boston, Massachusetts
`
`Co-Senior
`Associate Editors
`Vincent W. Yang
`Gary D. Wu
`Emory University School of Medicine
`University of Pennsylvania
`Atlanta, Georgia
`Philadelphia, Pennsylvania
`Associate Editors
`Hashem B. El-Serag
`Houston VA Medical Center
`and Baylor College of Medicine
`Houston, Texas
`Gail Hecht
`University of Illinois
`Chicago, Illinois
`James D. Lewis
`University of Pennsylvania
`Philadelphia, Pennsylvania
`Emeran A. Mayer
`University of California
`Los Angeles, California
`
`Editorial Staff
`Erin Dubnansky, Senior Director of Scholarly Publishing
`Christopher Lowe, Assistant Managing Editor
`Sarah Williamson, Medical Illustrator
`Kristine Novak, Science Editor
`Laura Claus, Publications Coordinator
`Naeemah McDuffey, Editorial Assistant
`Christine Charlip, Division Director of Publications
`Online Editor
`John F. Kuemmerle
`Medical College of Virginia Campus
`Virginia Commonwealth University
`Richmond, VA
`Richmond, Virginia
`Biostatistical Editors
`Nandita Mitra
`University of Pennsylvania
`Philadelphia, Pennsylvania
`Mary E. Putt
`University of Pennsylvania
`Philadelphia, Pennsylvania
`
`M. Bishr Omary
`University of Michigan
`School of Medicine
`Ann Arbor, Michigan
`Roland M. Schmid
`Technical University of Munich
`Munich, Germany
`Timothy C. Wang
`Columbia University Medical Center
`New York, New York
`Michael B. Wallace
`Mayo Clinic
`Jacksonville, Florida
`Rebecca G. Wells
`University of Pennsylvania
`Philadelphia, Pennsylvania
`Special Section Editors
`Imaging and Advanced Technology
`Michael B. Wallace
`Mayo Clinic at Jacksonville
`Clinical Challenges and Images in GI
`David A. Katzka
`University of Pennsylvania
`David L. Jaffe
`University of Pennsylvania
`Consultants
`
`This Month in Gastroenterology
`John M. Carethers
`University of California
`at San Diego
`Jan F. Tack
`University Hospital
`Gasthuisberg
`
`Gastroenterology and Hepatology News
`Richard M. Peek, Jr.
`Vanderbilt University
`K. Rajender Reddy
`University of Pennsylvania
`
`Selected Summaries
`Gary R. Lichtenstein
`University of Pennsylvania
`Print and Media Reviews
`Gary R. Lichtenstein
`University of Pennsylvania
`
`Reviews in Basic and Clinical Gastroenterology
`John P. Lynch
`University of Pennsylvania
`David C. Metz
`University of Pennsylvania
`Continuing Medical Education
`Michael B. Wallace
`Mayo Clinic at Jacksonville
`
`Jean-Michel Pawlotsky
`Cre´teil, France
`
`Gianfranco Alpini, Temple, Texas
`Shrikant Anant, St. Louis, Missouri
`Nadir Arber, Tel-Aviv, Israel
`Gavin Arteel, Louisville, Kentucky
`Kim E. Barrett, San Diego, California
`Ramon Bataller, Barcelona, Spain
`Anthony Bauer, Pittsburgh, PA
`Pennsylvania
`Edmund Bini, New York, New York
`James L. Boyer, New Haven, Connecticut
`Jonathan Braun, Los Angeles, California
`David A. Brenner, New York, New York
`Randall Burt, Salt Lake City, Utah
`Naga Chalasani, Indianapolis, Indiana
`Eugene B. Chang, Chicago, Illinois
`Hans Clevers, Utrecht, Holland
`Mark Czaja, Bronx, New York
`Paul Dawson, Winston-Salem, North Carolina
`Christopher P. Day, Newcastle Upon Tyne,
`United Kingdom
`Anna Mae Diehl, Durham, North Carolina
`
`David A. Brenner
`Daniel K. Podolsky
`Nicholas F. LaRusso
`Raj K. Goyal
`
`President Robert S. Sandler
`Chapel Hill, North Carolina
`Ian L. Taylor
`Vice President
`Brooklyn, New York
`AGA Institute: AGA Education, Practice and Research
`
`III
`
`Paul Rutgeerts
`Leuven, Belgium
`Editorial Board
`Daniel K. Podolsky, Chair, Boston, Massachusetts
`Daniel J. Drucker, Toronto, Ontario
`Peter Ferenci, Wien, Austria
`Michael D. Gershon, New York, New York
`M. Eric Gershwin, Davis, California
`William Grady, Seattle, Washington
`Thomas Gress, Marburg, Germany
`Toshifumi Hibi, Tokyo, Japan
`Kenichi Ikejima, Tokyo, Japan
`John M. Inadomi, San Francisco, California
`Christian Jobin, Chapel Hill, North Carolina
`Emmet B. Keeffe, Palo Alto, California
`Stanley M. Lemmon, Galveston, Texas
`Andrew B. Leiter, Worcester, Massachusetts
`Edward V. Loftus, Rochester, Minnesota
`Fabio Marra, Florence, Italy
`Atsushi Mizoguchi, Boston, Massachusetts
`Bruce Naliboff, Los Angeles, California
`Kari North, Chapel Hill, North Carolina
`Pankaj Jay Pasricha, Galveston, Texas
`Jean-Michel Pawlotsky, Creteil, France
`Editors Emeriti
`Robert K. Ockner
`John S. Fordtran
`Robert M. Donaldson
`Marvin H. Sleisenger
`Officers of the AGA Institute
`President-Elect Gail Hecht
`Chicago, Illinois
`Secretary/Treasurer Damian H. Augustyn
`San Francisco, California
`
`Lawrie W. Powell, Brisbane, Australia
`Jesu´ s Prieto, Pamplona, Spain
`Douglas J. Robertson, White River Junction,
`Vermont
`Vinod K. Rustgi, Fairfax, Virginia
`Ashok Saluja, Minneapolis, Minnesota
`Linda C. Samuelson, Ann Arbor, Michigan
`Jack Satsangi, Edinburgh, Scotland
`Stefan Schreiber, Kiel, Germany
`Robert Schwabe, New York, New York
`Ramesh A. Shivdasani, Boston, Massachusetts
`Shanti Sitaraman, Atlanta, Georgia
`Scott Snapper, Boston, Massachusetts
`William F. Stenson, St. Louis, Missouri
`Jayant A. Talwalkar, Rochester, Minnesota
`Michael Trauner, Graz, Austria
`Jerrold Turner, Chicago, Illinois
`John Wallace, Calgary, Alberta, Canada
`Mamoru Watanabe, Tokyo, Japan
`
`Morton I. Grossman
`Abraham H. Aaron
`Andrew C. Ivy
`Walter C. Alvarez
`
`

`

`AGAAbstracts
`
`nonlinear mixed-effect modelling (NONMEM, version VI). RESULTS: The PK of PF-
`00547659 was best described by a 2-compartment disposition model incorporating first-
`order absorption following SC dosing. Following SC doses 0.3 to 3.0 mg/kg, Cmax was
`observed on day 7 in the majority of subjects. Elimination was best described by 2 parallel
`pathways: A linear, non-specific pathway typical of monoclonal antibodies (half-life ~28
`days) and a specific pathway represented by PF-00547659 binding to MAdCAM with
`subsequent internalization and elimination of the complex (termed target mediated disposi-
`tion, TMD). TMD was fully saturated at doses ≥1mg/kg. Incorporation of MAdCAM into
`the model allowed estimation of the turnover rate and degree of suppression of MAdCAM.
`The volume of distribution (~5 L) indicated that the antibody remained predominately
`within the vasculature which is ideal since MAdCAM is located on high endothelial venules.
`The model predicted that MAdCAM levels were completely suppressed for 10 to 12 weeks
`in the majority of subjects following single doses of 3 to 10 mg/kg. No anti-drug antibodies
`were detected. CONCLUSION: The pharmacokinetics of PF-00547659 was typical of a
`monoclonal antibody with sustained concentrations at high doses. TMD was observed at
`low doses due to MAdCAM binding and clearance. PF-00547659 remained primarily within
`the vasculature near its target site. Following a single dose of 3 or 10 mg/kg, serum levels
`were maintained for up to 3 months with model-predicted complete suppression of free
`MAdCAM for the same duration in the majority of subjects and in the absence of any anti-
`drug antibodies being detected.
`
`W1043
`
`GI Consultations in Pregnancy
`Sumona Saha, Joseph Manlolo, Christopher E. McGowan, Steven E. Reinert, Silvia Degli
`Esposti
`
`Background: Training in gastroenterology requires understanding gastrointestinal (GI) dis-
`orders in pregnancy. While broad understanding is ideal, determining which conditions are
`most commonly referred for consultation may be helpful in focusing trainee education and
`preparing for future practice. However, this has not been done. The purpose of this study
`was to review the GI consultations at a high-volume obstetrics hospital to determine the
`reasons for consultation in pregnancy and the final diagnoses. Methods: A chart review of
`all consecutive outpatient consultations for pregnant women at Women & Infants' Hospital
`between October 1, 2004 and October 17, 2007 was performed. 370 charts were reviewed.
`Referring source, patient characteristics, reason for consultation, diagnosis (based on ICD-
`9 code), change in management after consultation and need for follow-up were recorded.
`Established patients who became pregnant during the study period were excluded. Results:
`75.6% of women requiring GI consultation in pregnancy were referred by Ob/Gyn. Primigra-
`vidas comprised 36.7% of patients. The mean weeks gestation at the time of consultation
`was 21.3 + 8.8. 35.4% of consultations were for new GI symptoms arising in pregnancy,
`24.4% for worsening of a pre-existing GI disorder, 15.1% for GI symptoms recurring in a
`subsequent pregnancy and 3.0% for medication safety recommendations. The most common
`reasons for consultation were viral hepatitis (20.2%), nausea and vomiting (18.9%) and
`abdominal pain (13.5%). 30.5% of patients were diagnosed with a liver disorder in pregnancy
`(viral hepatitis 11.6%, chronic non-viral hepatitis 5.5%, abnormal LFTs 5.4%, liver disorder
`unique to pregnancy-e.g. cholestasis of pregnancy, HELLP syndrome-3.8%, other 4.2%).
`The most frequent non-hepatologic diagnoses were hyperemesis gravidarum (20.8%), GERD
`(16.2%) and constipation (13.0%). As a result of consultation, 84.5% of patients underwent
`diagnostic testing. Consultation led to a change in diagnosis in 25.1% of cases and to a
`change in management in 78.6%. 77.3% of patients required GI follow-up during pregnancy
`and 37.8% required follow-up post-partum. Conclusions: Viral hepatitis, nausea and vomiting
`and abdominal pain are the most common reasons for GI consultation in pregnancy. One-
`third of patients were diagnosed with a liver disorder. The most common non-hepatologic
`diagnoses were hyperemesis gravidarum, GERD and constipation. GI consultation changed
`patient management in the majority of cases. Gastroenterologists should be familiar with
`the evaluation and management of these conditions in pregnancy as they are most likely to
`be the reasons for consultation.
`
`W1044
`
`Introducing GI Wiki: An Online Point-of-Care Resource for Gastroenterology
`Fellows, Faculty and Clinicians
`Ashish Atreja, Neil Mehta, James B. McGee
`
`The Gastroenterology Core Curriculum represents the collective wisdom of multiple gastroen-
`terology (GI) societies regarding the scope of gastroenterology training. While the curriculum
`outlines the knowledge and skills expected to be acquired during fellowship training, it
`does not provide the actual content per se. The main aim of GI Wiki is to provide a
`comprehensive, continuously updated point-of-care reference for GI trainees and faculty
`based on the Gastroenterology Core Curriculum. The GI Wiki (http://giwiki.org) is built on
`a web-based wiki platform that allows users to create, edit, and link web pages easily. This
`allows fellows to assimilate and share their learning as they are being exposed to various
`clinical cases and seminars during their fellowship. Content authors (GI trainees and faculty)
`are required to log-in and verify their credentials before given privileges to add or modify
`content. The wiki editorial board tracks revisions and has ability to correct or roll back to
`a previous version. The GI Wiki consists of chapters outlined according to the core curric-
`ulum, and links to resources: online pharmacopoeia, recommended reading list, guidelines;
`and GI-specific online calculators (see Figure). By restricting authoring and editing access
`to GI trainees and practitioners, our hope is to develop a high-quality, peer-authored, reliable
`resource as a ready reference for fellowship training programs. As the user-community of
`GI Wiki expands, and with it new content gets created or edited, we plan to formally
`evaluate the relevance and accuracy of content in GI Wiki. The beta version of the GI Wiki
`(available online at http://giwiki.org) went live on July 2008 and currently has 15 complete
`chapters and links to online resources. Audience will get a chance to interact with GI Wiki
`and add/edit content from a networked workstation at the meeting.
`
`W1040
`
`Optimal Treatment Duration of Glyceryl Trinitrate (GTN) for Chronic Anal
`Fissure (CAF): Results of a Prospective Randomized Multicenter Trial
`Giuseppe Gagliardi, Donato F. Altomare, Annalisa Pascariello, Francesco Arcanà, Danilo
`Cafaro, Filippo La Torre, Marcella Rinaldi, Paola De Nardi, Luigi Basso, Ines De Stefano,
`Vincenzo J. Greco, Leoluca Vasapollo, Antonio Amato, Antonino Pulvirenti D'Urso,
`Domenico Aiello, Antonio Bove
`
`Background: Optimal treatment duration of GTN for CAF is unknown. Methods: Prospective
`randomized trial comparing 40 vs. 80 days with twice daily topical 0.4% GTN treatment
`(Rectogesic®, Prostrakan Group) for CAF. Chronicity was defined as presence of fibrosis
`or skin tag or visible sphincter fibers or hypertrophied anal papilla and symptoms present
`for more than 2 months or with pain of less duration but similar episodes in the past. A
`chronicity score (the sum of anatomical chronic features) and a validated gravity score were
`used. Fissure healing, the primary aim of the study and maximum pain at defecation measured
`with VAS were assessed at baseline (which included manometry) and at 2, 4, 6, 8 weeks
`and at 80 days, when data was gathered. Results: Of 188 patients with chronic fissure 96
`were randomized to the 40 days treatment and 92 to the 80 days treatment. Patients were
`well matched for sex, age, presence of chronic features, fissure scores. There were 35 (19%)
`patients (21 in the 40 days group and 14 in the 80 days group) who did not complete
`treatment 14 (40%) because of side effects 5 (11%) because of worsening symptoms, 3 (9%)
`for both and 13 (37%) did not attend scheduled visits. Of 151 patients who completed the
`assigned treatment 79 (52%) had their fissures healed and 92 (61%) were pain free. There
`was no difference in healing and absence of symptoms between the two groups. At the
`analysis of variance there was a significant improvement in the paired VAS scores between
`baseline, 2 weeks, 4 weeks and 6 weeks (p<0.001) while there was no additional improvement
`between 6 weeks and 80 days. Average VAS scores were lower among patients assigned to
`80 days (p<0.01). Final pain score was not different between groups (P=0.33). Persistence
`of pain was associated with presence of fibrosis (p<0.05), advanced age (p<0.05), high
`maximum resting pressure (p<0.005), high fissure gravity score (p=0.005) and longer dura-
`tion of symptoms (p<0.01). Failure to heal was correlated with higher chronicity score
`(p<0.05) and visible sphincter fibers (p<0.05). Conclusion: Pain at defecation from CAF
`continues to improve up to 6 weeks of topical GTN treatment and is on average lower in
`patients treated longer then 40 days. Fissures with more chronic features are less likely to
`heal even after 80 days of treatment.
`
`W1041
`
`SP-304 to Treat GI Disorders - Effects of a Single, Oral-Dose of SP-304 On
`Safety, Tolerability, Pharmacokinetics and Pharmacodynamics in Healthy
`Volunteers
`Kunwar Shailubhai, William A. Gerson, Craig Talluto, Gary S. Jacob
`
`Purpose: SP-304 is a new member of a novel class of non-systemic drugs for treatment of
`chronic constipation (CC), irritable bowel syndrome with constipation (IBS-C) and other
`GI diseases. SP-304 is a synthetic analog of uroguanylin, a natriuretic hormone that regulates
`ion and fluid transport in the GI tract. Orally administered SP-304 binds to and activates
`guanylate cyclase C (GC-C) expressed on the epithelial cells lining the GI mucosa, resulting
`in activation of the cystic fibrosis transmembrane conductance regulator (CFTR), and leading
`to an augmented flow of chloride and water into the lumen of the gut to facilitate bowel
`movement. In animal models, oral administration of SP-304 promotes intestinal secretion
`and ameliorates gastrointestinal inflammation. The purpose of this first clinical study with
`SP-304 was to characterize the safety, tolerability, pharmacokinetic (PK) and pharmacodyn-
`amic (PD) effects of the drug in healthy volunteers. Methods: A double-blind, placebo-
`controlled, randomized single, oral, ascending dose (0.1 mg to 48.6 mg) study was performed
`in 71 healthy male and female volunteers. Subjects were evaluated for safety, tolerability,
`PK and PD effects of SP-304. Adverse events (AE) were evaluated using Common Terminology
`Criteria for Adverse Events (CTCAE), version 3. Pharmacodynamic effects were evaluated
`by the time to first stool and by the 7-point Bristol Stool Form Scale (BSFS) to monitor
`stool consistency. Results: SP-304 was well-tolerated at all dose levels with no unexpected
`side effects reported. No SAEs were observed at all dose levels throughout this study. No
`measurable systemic absorption of orally administered SP-304 occurred at all dose levels
`studied ranging from 0.1 mg to 48.6 mg (validated SP-304 serum assay sensitive down to
`10 ng/ml). Although this trial was not powered for statistical significance, SP-304 appeared
`to decrease the time to first bowel movement and elicited an increase in the post-dose BSFS
`versus placebo. Conclusions: In this single-dose Phase I study in volunteers, SP-304 was
`well-tolerated across all doses (0.1 mg to 48.6 mg) and exhibited pharmacodynamic activity
`in healthy volunteers with no detectable systemic absorption. We intend to pursue further
`clinical development of SP-304 to treat patients with CC and IBS-C.
`
`W1042
`
`Mechanistic Population Pharmacokinetics (PK) Model of PF-00547659, a Fully
`Human IgG2 Anti-MAdCAM Antibody, in Ulcerative Colitis Patients: Results
`of a First in Human (Fih) Study
`Steven W. Martin, Matts O. Magnusson, Ivan T. Matthews, Gary Burgess, Wojciech
`Niezychowski
`
`INTRODUCTION: MAdCAM (mucosal adressin cell adhesion molecule) is expressed on
`high endothelial venules of intestinal lymphoid tissue and expression is increased at sites
`of GI inflammation. MAdCAM binds a4b7 integrin on lymphocytes facilitating their migration
`to the inflamed intestinal tract. PF-00547659 is a fully human IgG2 anti-MAdCAM antibody
`which by blocking MAdCAM/a4b7 dependent lymphocyte recruitment to the gut is anticip-
`ated to reduce gut inflammation and mucosal damage. METHODS: This double-blind pla-
`cebo-controlled FIH study was designed to test efficacy, safety and PK endpoints. Thirty
`patients were included in 6 single-dose cohorts (0.03 to 10 mg/kg IV, 3.0 mg/kg SC or
`placebo) and an additional fifty in 5 multiple-dose cohorts (0.1 to 3.0 mg/kg IV and 0.3 to
`1 mg/kg SC or placebo). The PK characteristics of PF-00547659 were determined through
`
`A-641
`
`AGA Abstracts
`
`

`

`Acute Liver Failure and Artificial Liver
`Support / AO1 Acute Liver Failure and
`Artificial Liver Support
`An Analysis of Viral Testing in N ..................... S1003(810)
`Anti-High Mobility Group Box Chro................ S1001(810)
`Co-Medication with Adrenoreceptor ................ S1002(810)
`Incidence of Acute Kidney Injury ................... S1000(810)
`Basic / Biliary
`Cardiopulmonary Changes in NOTES .......... W1754(934)
`The National Mortality Burden and.................... 1024(884)
`Transvaginal Cholecystectomy With ................... 1012(882)
`Basic / Colon-Rectal
`Effective Combination of mTOR-Inh................T1843(921)
`Exploring Combination Epigenetic ............... W1755(934)
`Expression of the Cancer Testis A ...................W1756(935)
`Genomic Instability in Cultured H...................T1844(921)
`Increase in the Tight Junction (T ....................M1748(904)
`Influence of Colonic Bacteria On ........................ 624(874)
`Influence of Granulocyte-Colony S .................M1749(904)
`Molecular Predictors of Response ........................ 810(880)
`Plasma Levels of Placenta Growth ..................M1750(904)
`Spatial Colonic Expression of Adi ...................M1751(904)
`The Effects of Sympathetic and Pa ..................... 1080(887)
`Tumor Associated Macrophage (TAM)..............T1845(922)
`Basic / Esophageal
`Anti-ERBB2 SI- and sh-RNAs Suppre................... 626(875)
`Bile Acid Induced Activation of C...................M1752(905)
`Dendritic Cell-Associated Disturb.....................T1848(922)
`Dihydropyrimidine Dehydrogenase a ...............T1846(922)
`Interstitial Cells of Cajal in Ac ....................... W1757(935)
`Laparoscopic Fundoplication: New ............... W1758(935)
`Optical Fiber Spectroscopy: A Nov ..................T1847(922)
`SPRR3, MELK, MAGE-4, and EGFR Gen........M1754(905)
`Survivin Gene Expression in Blood .................M1753(905)
`Transoral Endoscopic Esophagectom....................288(869)
`Basic / Hepatic
`Activation of Hepatic AMP-Protein....................... 452(871)
`Changes in Liver Mitochondrial Fu..................T1851(923)
`Hypertonic Saline and Pentoxifyll ....................T1849(922)
`Inhibition of IκB Kinase Attenua........................ 1033(886)
`Mediators of Immune System and Th .............M1755(905)
`Molecular Identification & Clinic.....................T1850(923)
`Murine Functional Liver Mass Is R .................... 1025(884)
`Timing-Dependent Protection of Hy............... W1759(935)
`Basic / Pancreas
`Acute Pancreatitis (AP) in Aging ......................... 635(877)
`Additive Inhibitory Effects of In..................... W1762(936)
`Angiotensin II Regulates the Expr ........................ 634(877)
`Does Adiponectin Upregulation Att.................M1759(906)
`EP300 - A miRNA Regulated Metasta .................. 637(877)
`Expression of Chemokine Receptor .................... 625(874)
`Genetic Expression Profile Sugges .................. W1761(936)
`Human Tissue Slice Model for Eval ............... W1760(935)
`Naturally Occurring K Vitamins In .................M1758(906)
`Pancreatic Cancer Alters CD4+ T L.................M1757(906)
`Pterostilbene Disrupts Pancreatic......................T1853(923)
`Role of Metastasis Suppressor Gen ..................M1756(905)
`Taurolidine in Pancreatic Cancer......................T1852(923)
`Triptolide and Anti-Death Recepto ....................... 622(874)
`Basic / Small Bowel
`Central Vagal Activation During t................... W1764(936)
`Changes in Plasma Amino Acid Leve ...............T1855(924)
`Duodenal-Jejunal Exclusion Increa..................M1761(906)
`Expression Pattern of mSHISA Sugg .............. W1765(936)
`Immunonutrition with Long Chain F................. 1013(882)
`Induced Expression of Interaction........................ 623(874)
`Intestinal Alkaline Phosphatase P .....................T1856(924)
`Intestinal Preconditioning Causes....................M1762(907)
`Role of Vagal Innervation in Diur......................... 636(877)
`Sphingosine-1-Phosphate Promotes ................M1760(906)
`The Hindgut Improves Glucose Home................. 315(870)
`The Influence of Nutrients, Bilia .................... W1763(936)
`TNFα and Soluble MD-2 (sMD2) Inc ..............T1854(923)
`Basic / Stomach
`[18F]-Fluorodeoxyglucose-Positron .................... 1011(882)
`A Novel Laparoscopic Device for t ................. W1766(937)
`EGF-Receptor Targeting in Combina ...............M1763(907)
`Biliary Physiology, Transport, Cholangiocyte
`Biology, Experimental Cholestasis / BO1
`Organic Ion Transport, Bilirubin Metabolism
`Neonatal FC Receptor in the Liver................... S1576(817)
`Biliary Physiology, Transport, Cholangiocyte
`Biology, Experimental Cholestasis / BO2
`Cholesterol, Lipid, Bile Acid Metabolism
`Farnesoid X Receptor-Mediated Reg..................... 345(800)
`Increased Hepatic Bile Acid (BA) ........................ 346(800)
`Biliary Physiology, Transport, Cholangiocyte
`Biology, Experimental Cholestasis / BO3
`Cholangiocyte Biology
`Bile Duct Damage Following Hepati ................ S1579(818)
`Endothelin Inhibits Both In Vivo ...................... S1577(817)
`Identification and Functional Cha ............................ 6(790)
`Identification of Biliary Epithel......................... S1582(818)
`Myofibroblasts Promote the Growth..................... 343(800)
`Novel Evidence for An Autocrine M .................... 342(799)
`PKCα Signaling Regulates the Inh.................... S1580(818)
`Stimulation of Biliary Proliferat ........................ S1581(818)
`The Differential Effects of Hista........................ S1578(817)
`The HMG-CoA Reductase Inhibitor S .............. S1583(818)
`
`SUBJECT INDEX
`
`Biliary Physiology, Transport, Cholangiocyte
`Biology, Experimental Cholestasis / BO4
`Experimental Cholestasis
`Carbon Monoxide Reduces Cholestat............... S1584(819)
`Novel Evidence for CaMK I-Depende .................. 344(800)
`Suppression of the Hypothalamic-P ..................... 341(799)
`Cell and Molecular Biology / CO1 Cell
`Structure: Function Relationship
`Dysfunction of Hepatocyte Nuclear........................ 86(792)
`PI3 Kinase/AKT Signaling Mediates.................. S1571(816)
`RAC1, Caveolin-1 and VEGF Mediate.............. S1570(816)
`Cell and Molecular Biology / CO2 Signal
`Transduction, Nuclear Receptors
`Epimorphin Protects Hepatocytes f .................. S1572(816)
`Expression of YAP Protein and Eva .................. S1573(816)
`Cell and Molecular Biology / CO3 Gene
`Expression and Therapy
`Correlation Between Oncoprotein 1 ................. S1574(817)
`Nucleoplasmic Calcium Regulates P....................... 87(792)
`The MicroRNA miR-181b Is Involved...................... 3(789)
`Cell and Molecular Biology / CO4 Stem Cell
`Biology
`Blockade of Endogenous CD26 Activ............... S1575(817)
`Cultured Mouse Menchymal Stem Cel ................... 85(791)
`TGF-β Signaling Modulates Hepato ....................... 88(792)
`Clinical / Biliary
`Bacterial Flora in the Bile of Pa ........................T1542(908)
`Bile Duct Injuries Associated wit.....................M1526(889)
`Can Pre-Operative Clinical and Im .................M1524(888)
`Complete Laparoscopic Cholecystec................M1527(889)
`First Experiences with Transvagin .................. W1495(925)
`Further Advances in the Alternati ....................T1541(908)
`Gallbladder Cancer Found After La..................T1544(908)
`Laparoscopic Cholecystectomy in t ...................... 633(876)
`Long-Term Outcomes After Palliati ..................T1543(908)
`Major Complications After Laparos ....................1030(885)
`Mirizzi Syndrome Type IV: An Atyp................M1528(889)
`Prognosis After Surgery of Cholan ..................M1522(888)
`Registration of Health Related Qu .................. W1496(925)
`Selective Management of Patients ........................ 628(875)
`Single-Port Access (SPA™) Surgery ..................... 314(869)
`Success- and Complication Rates f ....................... 815(881)
`Surgical Gastrostomy for Pancreat .................. W1494(925)
`Surgical Treatment for the Patien ................... W1493(924)
`Survival After Proximal, Local an ....................... 1031(886)
`The Rate of Post Operative Infect......................... 638(878)
`Tissue Cytokines Reveal Gender Di.................M1525(889)
`Unilateral vs Bilateral Plastic S ........................M1523(888)
`Clinical / Colon-Rectal
`A Systematic Review On the Surgic ............... W1506(927)
`Access Related Complications Afte ...................T1553(910)
`Advantages of the Hand-Assisted A..................T1560(911)
`Appendicitis in the Elderly: Why ....................T1545(908)
`Benefits of Laparoscopy: Does the ...................M1532(890)
`Bowel Preparation in the West of ....................T1557(911)
`Caspase-Cleaved Cytokeratin 18 Fr.................M1531(890)
`Characteristics At Presentation a .......................... 631(876)
`Circulationg Tumor Cells in Porta ....................T1558(911)
`Colonic Inertia Has No Adverse Im .................T1547(909)
`Colonoscopic Splenic Injuries: In....................M1544(893)
`Comparison of the Prognostic Valu .................... 1081(887)
`Disparities in Presentation and T ......................... 450(871)
`Emergent Colorectal Surgery Is As ...................T1551(910)
`Esophagus to Anus: Epidemiology o .............. W1501(926)
`Experience with An Alternate Wipe .................T1564(912)
`Feasibility of a Colorectal Surge ......................M1540(892)
`General Surgery in Nonagenarians: ................ W1497(925)
`Hand-Assisted Laparoscopic Colect ..................T1550(909)
`Health Related Quality of Life Af .....................T1562(912)
`Hybrid Laparoscopic-Open Resectio................M1541(893)
`Immediate Versus Tailored Immunop................... 813(880)
`Impact of Perioperative Immunosup .............. W1500(926)
`Improved Mortality for Same Hospi..................... 451(871)
`In Modern Era, Recurrent Abdomina ............. W1507(927)
`Infection Rates in a Large Invest ........................ 1010(882)
`Laparoscopic Colectomy: Does the ................M1536(891)
`Laparoscopic Colectomy for Crohn' ................M1538(892)
`Laparoscopic Total Proctocolectom..................M1535(891)
`Laparoscopic-Assisted Versus Open................ W1499(926)
`Laparoscopy: A Safe Approach to A .................T1546(909)
`Laproscopic Surgery Decreases Ana.................M1537(892)
`Malignancy in Fistulous Anorectal ................. W1502(926)
`Medical and Surgical Treatment of ....................... 449(871)
`Medina Catheter Use Following Ile ................ W1503(926)
`Minimally Invasive Treatment of D................. W1505(927)
`Neoadjuvant Radiochemotherapy for ..............M1530(890)
`Outcomes for Organ Transplant Pat .................T1554(910)
`Outcomes from Liver Resection for..................T1555(910)
`Outcomes of Ileal Pouch-Anal Anas ................M1529(890)
`Population-Based Patient Characte ..................M1542(893)
`Predicting Organ Space Surgical S......................1026(884)
`Predictive Factors for Conversion....................M1533(891)
`Prospective Evaluation of Risk Fa.....................T1548(909)
`Racial Disparities in Complicated.....................T1552(910)
`Risk Factors for Postoperative Il.......................T1559(911)
`ScopeGuide® Reduces Pain During C .............T1563(912)
`Short- and Long-Term Costs of Lap .................T1549(909)
`Surgery for Fistula-in-Ano in a S ....................M1534(891)
`Surgical Treatment of Rectocele: .................... W1498(925)
`System Time and Patient Factors i ..................M1543(893)
`Systematic Review of Atraumatic S................. W1508(927)
`The Role of Genotype and Phenotyp ...............T1556(911)
`The Stage of Recurrence Is a Majo ..................M1539(892)
`Transvaginal Laparoscopic Appende ............... W1504(927)
`Utility of Pelvic CT with Rectal ......................M1545(893)
`Variation in Number of Lymph Node................... 632(876)
`
`AA-65
`
`Clinical / Esophageal
`A Broad Assessment of Clinical Ou...................... 818(881)
`A Comprehensive Review of Laparos ..............M1573(899)
`A Safe and Reproducible Anastomot .............. W1516(929)
`CEA and SCC-Antigen mRNA Expressi.......... W1509(928)
`Clinicopathological Significance ......................T1572(914)
`Comparing Esophagectomy Technique........... W1517(929)
`Comparison of the Conventional Ma ...............T1566(912)
`Diet Restriction Reduces Day-to-D ................. W1512(928)
`Does the Value of PET-CT Extend B................M1570(898)
`Effect of Multiple Pre-Operative .......................... 285(869)
`Electron Microscopic Studies of E .................. W1511(928)
`Endoluminal Fundoplication (ELF) ..................... 456(872)
`Endoscopic Therapy for Benign and ................T1570(913)
`Esophageal Adenocarcinoma Arising .............. W1510(928)
`Esophagectomy for Cancer in Octog ...............M1574(899)
`Evaluation of 102 Redo Fundoplica ................M1582(901)
`Evolution and Management of Esoph...............T1569(913)
`High Resolution Manometry Has Les ................. 1023(884)
`Impact of Institutional Case Volu ......................... 455(872)
`Intrathoracic Manifestations of C .....................T1568(913)
`Is Laparoscopic Heller Myotomy St...................... 819(882)
`Is Mesh Reinforcement Beneficial ...................M1577(900)
`Lack of Association Between a Sel...................... 1084(887)
`Laparoscopic Adjustable Gastric B....................T1575(914)
`Laparoscopic and Open Gastroplast .................T1574(914)
`Laparoscopic Heller Myotomy with .............. W1515(929)
`Laparoscopic Ischemic Pre-Conditi...................T1567(913)
`