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Biomedical subjects

I S Sheen

Publications and source records attributed to I S Sheen.

At least 109 records · Page 6Linked to original sources
PubMed1984

Age-specific prevalence and significance of hepatitis B e antigen and antibody in chronic hepatitis B virus infection in Taiwan: a comparison among asymptomatic carriers, chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma.

The age-specific prevalence of hepatitis B e antigen (HBeAg) and its antibody (anti-HBe) were studied by radioimmunoassay, and compared in a large series of patients with chronic hepatitis B virus (HBV) infection, including 268 asymptomatic carriers, 389 chronic hepatitis, 114 liver cirrhosis, and 278 hepatocellular carcinoma (HCC). The prevalence of HBeAg/anti-HBe in asymptomatic carriers and patients with chronic hepatitis correlated closely with age as HBeAg prevalence decreased and anti-HBe prevalence increased with increasing age (P less than 0.0005), and is probably due to high infection rate at young age in Taiwan. The prevalence of HBeAg in patients with both cirrhosis and HCC are much significantly lower and had no correlation with age. Two peaks of age-specific prevalence of HBeAg and anti-HBe were observed in patients with HCC, implicating two patterns of HBV infection in these patients. The difference in the prevalence of HBeAg and anti-HBe might indicate that asymptomatic carriers, chronic hepatitis, liver cirrhosis, and HCC are sequential sequelae of HBV infection.

Adolescent↗
PubMed1984

Peripheral T-cell subsets in chronic type B hepatitis: correlation with biochemical and histological activities and hepatitis B e antigen/antibody status.

Peripheral T-cell subsets in 77 patients with hepatitis B surface antigen (HBsAg)-positive chronic liver diseases were studied by indirect immunofluorescence using murine monoclonal antibodies against all peripheral T cells (OKT3), T-helper/inducer cells (OKT4), and T-cytoxic/suppressor cells (OKT8). OKT4/OKT8 ratios were significantly reduced in patients with hepatitis B e antigen (HBeAg)-positive chronic liver diseases, including 28 patients with chronic active hepatitis (CAH) (P less than 0.001) and 15 with chronic persistent hepatitis (CPH) (P less than 0.001). OKT4/OKT8 ratios were significantly lower in 21 HBeAg-negative patients with CAH (P less than 0.05), as compared to those of 17 normal controls, while T-cell subsets in 13 patients with HBeAg-negative CPH were essentially normal. Low OKT4/OKT8 ratios significantly correlated with HBeAg positivity (P less than 0.001) and CAH (P less than 0.05), as assessed with multiple regression. There was a significant negative correlation between OKT4/OKT8 ratios and serum glutamic-pyruvic transaminase (SGPT) levels (r = -0.37; P less than 0.01). It was concluded that in chronic hepatitis B virus infection, low OKT4/OKT8 ratios are closely related to active viral replication and more severe histological and biochemical activity.

Adolescent↗
PubMed1984

Chronic hepatitis with nonspecific histological changes. Is it a distinct variant of chronic hepatitis?

A longitudinal follow-up study has been undertaken in 62 patients with clinicopathologically verified chronic hepatitis with non-specific reactive histological changes (NSRH) in comparison with 28 patients with chronic persistent hepatitis (CPH), the clinical features of which are quite similar to NSRH. In contrast to the stationary and non-progressive course of CPH, 45.2% of patients with NSRH, either HBsAg positive or negative, ran a fluctuating course with moderate to marked elevation of SGPT (greater than 200 IU/l) In HBsAg-positive patients, only those positive for HBeAg and a few negative for both HBeAg and anti-HBe had fluctuating courses. In addition, patients with apparent clinical and biochemical changes could show histological features of chronic lobular hepatitis (CLH). A few developed chronic active hepatitis and/or cirrhosis on follow-up biopsy. It is concluded that NSRH is a form of chronic hepatitis different from CPH, but similar to or representing a phase of CLH. It is suggested that NSRH should be categorized as CLH in the classification of chronic hepatitis.

Adolescent↗
PubMed1984

Determinants for hepatitis B e antigen clearance in chronic type B hepatitis.

A 6-year (mean 24.5 months) longitudinal study has been undertaken in 237 HBeAg-positive patients with clinicopathologically verified chronic hepatitis. HBeAg clearance occurred in 74 patients at a rate of 16% per year, and a cumulative probability of 67% at the end of a 5-year follow-up. HBeAg clearance was preceded by a temporary "exacerbation" with SGPT greater than 300 IU/L in 62% of the patients. On the other hand, irrespective of the level of SGPT elevation, only 23% of such exacerbations were followed by HBeAg clearance. Further analysis indicates that alphafetoprotein greater than 100 ng/ml, frequently associated with bridging hepatic necrosis, during "exacerbation" predicts HBeAg clearance. In addition, patients with chronic lobular hepatitis and chronic active hepatitis have a higher annual HBeAg clearance rate than patients with chronic persistent hepatitis and nonspecific histologic changes (greater than 15% vs less than 8%, P less than 0.03). Short-term immunosuppressive treatment did not delay HBeAg seroconversion. Male patients had a higher annual HBeAg clearance rate than female patients (18.2% vs 8.7%, P less than 0.05). It was concluded that, in addition to the time factor, the nature of chronic hepatitis, the extent of hepatic damage during "exacerbation", and the sex of the patients are important determinants for HBeAg clearance.

Female↗
PubMedDate not supplied

Sex difference in chronic hepatitis B virus infection: an appraisal based on the status of hepatitis B e antigen and antibody.

Hepatitis B e antigen (HBeAg) and antibody (anti-HBe) were studied by radioimmunoassay in consecutive series of 145 asymptomatic hepatitis B surface antigen (HBsAg) carriers, 389 patients with HBsAg-positive chronic liver disease and 194 patients with HBsAg-positive hepatocellular carcinoma, and compared between male and female subjects. The male to female ratio increased from 1.2 in asymptomatic carriers to 6.3 in chronic liver disease and 9.8 in hepatocellular carcinoma. Abnormal SGPT was much more frequently seen in male carriers than in females (p less than 0.01). Contrary to female patients with chronic liver disease, the positive rate for HBeAg in males is lower and tended to decrease with increasing age. It is postulated that male patients with chronic hepatis B virus infection might have higher HBeAg clearance ability that resulted in more frequent hepatitis B virus DNA integration and subsequent development of hepatocellular carcinoma. However, the ultimate mechanism regulating this difference awaits further study.

Adolescent↗
PubMedDate not supplied

The window period between hepatitis B e antigen and antibody in chronic type hepatitis.

To examine the period between disappearance of hepatitis B e antigen (HBeAg) and appearance of anti-HBe, 48 patients with clinicopathologically verified chronic B hepatitis were followed every 1 to 3 months after HBeAg clearance. Sera were tested by radioimmunoassay for HBeAg and anti-HBe. Anti-HBe appeared in days to years, mostly (78.7%) within 1 year, after disappearance of HBeAg. Only 40.5% of patients had an "e-window" shorter than 1 month. Clinical and histological exacerbation preceding HBeAg clearance precipitated or accelerated appearance of anti-HBe. Since the patients in the "e-window" period were positive for DNA polymerase, it is suggested that the "e-window" reflects relative insensitivity of the radioimmunoassay rather than absence of HBeAg/anti-HBe. Therefore, HBeAg can reappear and clinical activity can relapse particularly during immunosuppressive therapy.

Adult↗
PubMedDate not supplied

White count, pH and lactate in ascites in the diagnosis of spontaneous bacterial peritonitis.

In order to evaluate the diagnostic accuracy of ascitic pH and lactate for early confirmation of spontaneous bacterial peritonitis (SBP), 109 consecutive patients with ascites were studied. The mean ascitic leukocyte [white blood cell (WBC)] and polymorphonuclear cell (PMN) counts, pH and lactate levels in 42 patients with sterile "normal" ascites were 124 +/- 157 per mm3, 41 +/- 77 per mm3, 7.502 +/- 0.097 and 11.1 +/- 7.9 mg per dl, respectively. Mean ascitic WBC and PMN counts were significantly increased in 10 patients with SBP (10,452 +/- 8,091 and 9,522 +/- 7,470 per mm3), in 10 patients with bloody ascites (2,591 +/- 4,284 and 1,057 +/- 1,494 per mm3) and in 11 patients with cytology positive malignant ascites (1,529 +/- 2,071 and 868 +/- 1,601 per mm3) (p less than 0.001). Mean ascitic pH was significantly reduced in SBP (7.335 +/- 0.048), in bloody ascites (7.384 +/- 0.037) and in cytology positive malignant ascites (7.355 +/- 0.167) (p less than 0.001). Mean ascitic lactate was also significantly elevated in these three groups of patients (36.8 +/- 17.0, 42.8 +/- 35.8 and 24.0 +/- 17.5 mg per dl, respectively; p less than 0.001) as well as in patients with bacteremia (51.6 +/- 78.0 mg per dl, p less than 0.005). However, ascitic pH less than 7.31, ascitic lactate greater than 33 mg per dl were observed only in three of the patients with SBP.(ABSTRACT TRUNCATED AT 250 WORDS)

Ascitic Fluid↗
PubMedDate not supplied

Changes of serum hepatitis B virus DNA in two types of clinical events preceding spontaneous hepatitis B e antigen seroconversion in chronic type B hepatitis.

Two types of clinical events, acute exacerbation and uneventful course, precede spontaneous HBeAg seroconversion to its antibody (anti-HBe) in chronic type B hepatitis. To examine the possible mechanism responsible for these two types of clinical events, serial serum specimens from 75 patients who underwent spontaneous HBeAg seroconversion were assayed for hepatitis B virus DNA by slot blot hybridization with 32P-labeled cloned hepatitis B virus DNA as probe. Of these 75 patients, 47 (62.7%) had episodes of acute exacerbation (ALT greater than 300 IU per liter) within 3 months prior to HBeAg seroconversion. All of these 47 patients had high hepatitis B virus DNA levels (greater than 1,000 pg per ml) at the onset of acute exacerbation. Their serum hepatitis B virus DNA disappears shortly before or simultaneously with the HBeAg clearance in 27 patients (57.4%) and persisted but with decreasing levels for 2 to 40 months in 20 patients. Most of these patients had high alpha-fetoprotein levels or evidence of bridging hepatic necrosis. In contrast, the serum hepatitis B virus DNA was undetectable for a minimum of 3 (3-17) months in the 28 patients who had an uneventful course before HBeAg seroconversion. Twenty of these 28 patients had well-documented episodes of acute exacerbation with high hepatitis B virus DNA levels, but with normal alpha-fetoprotein and little evidence of extensive necrosis as far back as 6 to 27 months before HBeAg seroconversion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

The real-time ultrasonography of pancreatic pseudocyst: comparison of infected and noninfected pseudocysts.

The real-time ultrasonograms of 15 patients with pancreatic pseudocysts (10 infected and 5 noninfected) were analyzed to evaluate difference in ultrasound characteristics between the infected and noninfected pseudocysts. Only those who underwent ultrasound-guided aspiration or operation within one week after sonography were reviewed according to the size, multiplicity, air content, internal echoes, and wall characteristics (such as thickness, regularity, and calcification) of pseudocysts. Among these ultrasonographic features of pseudocysts, there was no statistically significant difference between the infected and noninfected pseudocysts in cyst size, wall characteristics (thickness, regularity, and calcification), multiplicity, and air content. The most important and unique feature was the internal echoes within the pseudocyst. The internal echoes were classified into three grades. All the infected pseudocysts and one noninfected pseudocysts had internal echoes of grade 1. The difference is statistically significant (p = 0.0037). These results indicate that grading internal echogenicity of the pseudocysts with real-time ultrasonographies can add additional information important in differentiating infected from noninfected pseudocysts.

Abscess↗
PubMedDate not supplied

Clinicopathological response of HBsAg-positive chronic active hepatitis to adenine arabinoside: lack of correlation with DNA polymerase response.

Fifteen patients with HBsAg-positive, severe chronic active hepatitis, nine DNA polymerase (DNAP)-positive and six negative were treated with intravenous adenine arabinoside (Ara-A) in a dose of 10 mg/kg/day for five consecutive days during each of two consecutive weeks. Of the DNAP-positive patients, two responded with histological and clinical remission as well as permanent loss of DNAP. However, histological and clinical remission were also observed in patients with unsatisfactory DNAP response and even in DNAP-negative patients. It is suggested that, in addition to its antiviral effect, Ara-A might have another mechanism, such as immunosuppression, that induced histological and clinical remission. Alternatively, the discrepancy of response might relate to the natural course of chronic type B hepatitis. Accordingly, controlled trial is mandatory for assessing the effect of Ara-A or any other agent in the treatment of chronic type B hepatitis.

Adolescent↗