Biomedical subjects

J C Sheu

Publications and source records attributed to J C Sheu.

At least 91 records · Page 5Linked to original sources

PubMed1994

Congenital biliary tract dilatation in infancy and childhood--74 cases experience.

This report presented a twelve-year experience from 1981 to 1992. Seventy-four cases of congenital biliary tract dilatation were at diagnosed an age of 6 days to 16 years. Twenty-two cases were infants. There were 54 females and 20 males. The ratio of female to male was 2.7:1. The classic triad of abdominal pain, jaundice and a palpable mass was seen in eleven cases (14.9%). Most children suffered from abdominal pain (50/74), vomiting (45/74), anorexia (42/74) and jaundice (34/74). Prolonged jaundice was the main symptom in infancy (15/22). A long common pancreatico-biliary channel was seen in six cases (6/47); the bile amylase level was elevated in five cases (5/20), one patient had a complex union with obstructive jaundice. All these cases were diagnosed by preoperative sonography accurately (100%). According to the Todani's classification, type Ia was the most common (40/74), followed by type IV-A (25/74) and type Ic (8/74). Cholelithiasis (13/74), perforation (9/74), and atresia/stenosis of distal choledochus (8/74) were the most common associated conditions. Cyst excision with biliary tract reconstruction was performed in all cases. Reoperation was needed in ten cases. Two cases died postoperatively due to sepsis and cholangitis induced hepatic failure.

Adolescent↗

PubMed1994

Use of microwave tissue coagulator in hepatocellular carcinoma resection: compared with Lin's hepatic clamp.

Fifty-nine patients with hepatocellular carcinoma (HCC) underwent resection with the aid of a microwave tissue coagulator at the Department of Surgery, National Taiwan University Hospital from July 1987 to December 1992. There were 41 men and 18 women with an average age of 59.2 years (range, 32-79 years). The intraoperative blood transfusion included packed RBC 1.53 +/- 1.34 U, fresh frozen plasma 3.85 +/- 1.69 U and/or platelet 1.58 +/- 3.07 U. The operation time from skin incision to skin closure was 250 +/- 74.9 minutes (range, 125 range, 495 minutes) and the average hospital stay was 20 +/- 9.7 days (nine to 50 days, median 17 days). The complication rate was 16.9% (10/59), including two with biliary fistula, prolonged impaired liver function and pleural effusion. Subphrenic abscess was seen in one patient and ascites in three. There was no operative mortality. Compared to 34 patients who underwent similar hepatic resections for HCC carcinoma with the aid of Lin's hepatic clamp, there was no statistical difference between the operation time, and intraoperative blood transfusion. However, the hospital stay was shorter in the microwave group. The change in liver function was also less remarkable in the microwave group and the postoperative complication rate was lower. We conclude that the application of microwave tissue coagulator is useful and safe in the resection of HCC.

Adult↗

PubMed1994

Hepatocellular carcinoma with metastasis to the kidney: report of a case.

A patient was found to have coincidental right hepatic and right renal tumors on abdominal ultrasonographic and computed tomographic examinations. On operation, the right lobe of the liver was occupied by a massive tumor measuring 15 x 10 cm in size. There was another tumor measuring 12 x 11 cm on the upper pole of the right kidney. The two large tumors were very closely located, separated only by a thin peritoneum. Hepatocellular carcinoma with renal metastasis or renal cell carcinoma with hepatic metastasis was suspected. Histopathologic and immunohistochemical studies ultimately confirmed the diagnosis of hepatocellular carcinoma with renal metastasis.

Carcinoma, Hepatocellular↗

PubMed1993

Characterization of hepatocyte growth factor expressed by baculovirus.

To express recombinant hepatocyte growth factor (HGF), we cloned the cDNA by polymerase chain reaction. Functional recombinant HGF was expressed in insect cells by a baculovirus expression system. The recombinant HGF is a mixture of a single-chain precursor and a two-chain heterodimer. Under non-reducing conditions, they migrate together as a single band with MW 67 kDa on Western blots. Under reducing conditions, the precursor migrates at 91 kDa, alpha-chain at 64 kDa and beta-chain at 34 kDa. About 25% of the expressed HGF is in the expression medium, which does have scatter activity on HepG2 and MDCK cells and proliferation activity on BN CL.2 cells (a mouse hepatocytes cell line) in a dose-dependent manner.

Animals↗

PubMed1993

Splicing mutations of the p53 gene in human hepatocellular carcinoma.

Point mutations in exons of the tumor suppressor p53 gene occur frequently in many human tumors including hepatocellular carcinoma and are extensively studied. However, intronic point mutations are rare and are totally unknown for hepatocellular carcinoma. By reverse transcription and polymerase chain reaction amplification of p53 RNA from hepatocellular carcinoma tissues of 45 Taiwanese patients, we found amplified complementary DNA fragments of abnormal size in 4 (9%) tumor samples. Sequence analysis of these complementary DNA products revealed aberrant retention of intron 7 in one sample, insertion of 49 base pairs of the 3' end of intron 6 in 2 samples, and deletion of exon 4 in the other sample. Direct sequencing of their genomic DNA revealed relevant point mutations at consensus sequence at either the 5' or 3' splice site of intron 7, 6, 6, and 3, respectively. The splicing mutations produced p53 mutants with truncation of COOH-terminus that are identical to those found in lung cancers. Three of the 4 patients with splicing mutations were younger and had huge tumors. The results suggest a possible role of these p53 mutants in the development of human cancers.

Adolescent↗

PubMed1993

Detection of Helicobacter pylori in gastric biopsy tissue by polymerase chain reaction.

To evaluate the sensitivity of a polymerase chain reaction (PCR) assay using nested primers in detecting Helicobacter pylori, gastric tissue biopsy specimens were collected on endoscopy from 17 patients with a duodenal ulcer. DNA was extracted by phenol/chloroform treatment or boiling in water, and then subjected to a nested PCR using two primer pairs from the urease gene of Helicobacter pylori. Fourteen of the 17 patients were positive for Helicobacter pylori using DNA samples extracted by either method. The PCR results correlated well with the results of an enzyme immunoassay to detect IgG antibody. However, there were two culture negative patients. The three PCR negative patients were both culture negative and serologically negative. DNA from 9 of the 14 patients was randomly selected and subjected to semiquantification by serial dilutions, and then PCR. The results showed that phenol/chloroform extraction yielded 10-1000 times more DNA than the boiling method. It is concluded that the PCR assay is a rapid and sensitive method for detecting Helicobacter pylori, and that phenol/chloroform extraction is superior to simple boiling in obtaining DNA samples for PCR.

Antibodies, Bacterial↗

PubMed1993

Multiple hepatocellular carcinomas at the early stage have different clonality.

BACKGROUND: The clonality of hepatocellular carcinoma is still controversial. To evaluate the clonality of this cancer, mostly small multiple hepatocellular carcinomas of 18 patients were analyzed by DNA fingerprinting. METHODS: DNA from the liver tissues was digested with HinfI. After gel electrophoresis, in gel-hybridization with a synthetic oligonucleotide probe GTGGTGGTGGTGGTG was performed. The band patterns were compared among the tumors and the nontumor part. In patients positive for hepatitis B surface antigen (HBsAg), the integration pattern of hepatitis B viral DNA in liver tissues was also analyzed. RESULTS: Seven of the 9 HBsAg-positive patients had tumors with different clonalities by both methods. In the remaining 9 HBsAg-negative patients, 4 had different band patterns in their tumors by DNA fingerprinting. CONCLUSIONS: Multiple hepatocellular carcinomas frequently have different clonalities; this finding reiterates the importance of eliminating the underlying cause and the contributing factors of hepatocarcinogenesis.

Adult↗

PubMed1993

Prevalence of hepatitis C viral infection in a community in Taiwan. Detection by synthetic peptide-based assay and polymerase chain reaction.

The prevalence of antibodies to hepatitis C virus (anti-HCV) in a hepatitis B virus hyperendemic region was evaluated with a second-generation enzyme immunoassay. A general population of 1500 from Northern Taiwan was tested with this immunoassay which includes synthetic peptides from the capsid and non-structural protein region as the solid-phase antigen. A total of 37 subjects out of 1500 (2.5%) were positive, with no significant difference in distribution between hepatitis B antigenemic and non-antigenemic samples. The prevalence of anti-HCV was higher in subjects with abnormal than those with normal liver function tests (8.2% vs. 1.5%). Prevalence increased with age. By polymerase chain reaction, 43% of anti-HCV-positive samples were HCV-RNA-positive. However, only 1 (0.6%) of 150 anti-HCV-negative subjects had HCV-RNA. Comparison of the results with those from a conventional recombinant C100-3-based assay showed that the capsid/non-structural region synthetic antigen system provided more accurate sensitivity and specificity. The more sensitive assay revealed a high prevalence for HCV infection of 2.5% among this general population in Taiwan.

Adult↗

PubMed1993

Direct DNA amplification and restriction pattern analysis of Helicobacter pylori in patients with duodenal ulcer and their families.

Sera from 14 patients with duodenal ulcer and their families were tested for IgG antibodies to Helicobacter pylori. Fourteen serologically negative patients and their families served as controls. Index patients and their family members who were serologically positive were advised to undergo endoscopic biopsy. Gastric biopsy tissues were subjected to HaeIII restriction analysis of nested polymerase chain reaction products of the urease gene. By serology, 28 (49.0%) of 57 in index families and 11 (27.5%) of 40 in control families tested positive. A higher prevalence rate was found in children of index patients (11/31, 35.5%) than in those of control patients (1/18, 5.6%; P < .05). On DNA analysis, 11 patterns were found in 13 patients, and 6 families underwent endoscopy. Children in 5 families exhibited identical patterns to those of their siblings and, in 3 of the 5 families, identical to the pattern of 1 of the parents. These results suggest that parent-to-child transmission and common infection source are probable causes of intrafamilial clustering of H. pylori.

Adult↗

PubMed1993

Hepatitis C virus infection in volunteer blood donors in Taiwan. Evaluation by hepatitis C antibody assays and the polymerase chain reaction.

A total of 2671 plasma samples that were selected from 22,500 volunteer blood donors in Taiwan were studied for hepatitis C virus (HCV) infection. The donors were stratified into three groups by serum alanine aminotransferase (ALT) levels. Of the donors, 20,768 (92.3%) had an ALT level less than 30 IU/L (group 1), 1080 (4.8%) had an ALT level between 31 and 45 IU/L (group 2), and 652 (2.9%) had an ALT level greater than 45 IU/L (group 3). To study anti-C100-3 hepatitis C antibody, 2023 plasma samples (10%) from group 1, 321 (30%) from group 2, and 327 (50%) from group 3 were randomly selected and tested. Twenty-one (1.04%) of group 1 donors, 13 (4.05%) of group 2 donors, and 26 (7.95%) of group 3 donors were positive for anti-C100-3, respectively. These seropositive samples were further tested by a recombinant immunoblot assay, by a polymerase chain reaction for HCV RNA, by a second-generation recombinant antigen-based immunoassay (r-HCV), and by a synthetic peptide-based immunoassay (EIA3) for HCV antibodies. By the polymerase chain reaction, 26 of the 60 donors were positive for HCV RNA. The HCV RNA was more frequently found in donors with an ALT level greater than 45 IU/L than in those with an ALT level less than 45 IU/L (15 of 26 vs nine of 34, respectively); in donors who were recombinant immunoblot assay reactive or indeterminate than in those who were recombinant immunoblot assay negative (17 of 21 or seven of 14 vs two of 25, respectively); and in donors who were EIA3 positive (25 of 33 vs one of 27) or r-HCV positive (25 of 35 vs one of 25). Based on these data, we anticipate that screening by anti-C100-3 in Taiwan will exclude approximately 3280 potentially infectious donations under the current screening policy but will result in the loss of 6860 donations that will be negative for HCV RNA per year. Because of its high sensitivity and specificity, EIA3 or r-HCV seems to be a potentially better screening method for HCV carriers.

Antigens, Viral↗

PubMed1992

Mutation of p53 gene in hepatocellular carcinoma in Taiwan.

To elucidate the role of p53 mutation in hepatocarcinogenesis in Taiwan, a hepatitis B viral infection hyperendemic area, exons 5 to 8 of the p53 gene in the tumor tissue of 61 hepatocellular carcinomas were amplified and sequenced. A total of 20 cases (32.8%) were found to have mutations; 36.6% (15 of 41) for the hepatitis B surface antigen positive group and 25.0% (5 of 20) for the hepatitis B surface antigen negative group. The corresponding normal liver showed no mutation. The mutation is widely distributed throughout exons 5 to 8. Only 4 cases (6.6%), all positive for hepatitis B surface antigen, had a specific hot spot mutation at codon 249 with G to T transversion. Our results show that scattered point mutations in p53 are not uncommon in hepatocellular carcinoma samples from Taiwan and may be important in the development of this cancer. However, the aflatoxin related specific mutation seems much less related to the genesis of hepatocellular carcinoma in Taiwan.

Adult↗

PubMed1992

Transient immunoglobulin M antibody response to hepatitis C virus capsid antigen in posttransfusion hepatitis C: putative serological marker for acute viral infection.

The development of serological assays for hepatitis C virus (HCV) has made specific diagnosis possible. However, markers useful in indicating acute-phase HCV infection have not been identified. By an immunoblotting method, we characterized the IgM and IgG antibody response against HCV capsid antigen in patients with HCV infection. Among 88% of patients with acute posttransfusion hepatitis C recruited in a prospective study, there was a transient IgM antibody response. The IgM antibody appeared shortly after onset of hepatitis (average 3.7 weeks), persisted for several months (average 18 weeks), and then disappeared. In contrast, the IgG antibody persisted long-term once it appeared. Among patients with chronic hepatitis C with milder disease activities (serum aminotransferase increase above normal levels of less than 4-fold), the IgM antibody was negative in the majority (72%). In those with acute exacerbations (aminotransferase increase of greater than 10-fold), about 55% were negative for the IgM antibody. The reactivity of the IgM antibody in the rest was weaker or became negative upon further dilution of serum. The results suggest that IgM anti-capsid antibody may serve as a marker indicating acute or active HCV infection.

Acute Disease↗

PubMed1992

Hepatitis C virus RNA in saliva of patients with posttransfusion hepatitis and low efficiency of transmission among spouses.

In a prospective study of posttransfusion hepatitis, 14 patients who were diagnosed with posttransfusion hepatitis C were enrolled randomly for the study of hepatitis C virus (HCV) RNA in saliva. Saliva and serum samples were collected on the same day. Spouses of 11 married patients were also tested for anti-C100 and HCV RNA. Paired serum and saliva samples were tested for HCV RNA by a nested polymerase chain reaction (PCR). Two primer pairs specific for the non-coding region of HCV were used for the PCR and a oligonucleotide sequence between the primers was used as the probe for Southern hybridization. Six patients were positive for HCV RNA by first round PCR amplification and an additional four patients were detected after second round PCR. All patients were negative for HCV RNA in saliva after first round PCR, while seven were positive after second round PCR amplification. All seven patients were positive for HCV RNA in paired serum samples. HCV RNA was detectable in saliva from 1 week to 38 months after the onset of hepatitis. All spouses were negative for anti-C100 and HCV RNA. We conclude that HCV RNA is present in the saliva of approximately half of patients with acute and chronic hepatitis C, and the presence of HCV RNA correlates with HCV viremia. The efficiency of HCV transmission is low among spouses.

Adult↗

PubMed1992

Prevalence of anti-HCV and HCV viremia in hemodialysis patients in Taiwan.

Hepatitis C viral infection in 125 hemodialysis patients from Taiwan was studied using a second-generation anti-HCV immunoassay (EIA II) (Abbott HCV 2.0 EIA) and the polymerase chain reaction (PCR) to detect the HCV RNA in the serum. A total of 59 patients (47.2%) were positive by EIA II. In comparison, the conventional C100-3 anti-HCV assay was positive in 40 (32.0%). HCV RNA was found in 47 patients (37.6%). Patients with elevated serum transaminase level had a higher positive rate of anti-HCV and HCV RNA. The dialysis time was longer for those patients positive for anti-HCV than for those who were negative. A total of 57 of the 59 EIA II-positive cases had a history of blood transfusion. The HBsAg status did not influence the anti-HCV positivity. Among the 59 EIA II-positive patients, 66.1% were also positive for HCV RNA, and of the 47 HCV RNA-positive cases 83.0% were positive for EIA II. It is concluded that the high prevalence of specific HCV infection and HCV viremia was present in these patients. Prevention of cross-contamination during dialysis and blood screening before transfusion are important for the control of HCV infection in these patients.

Adult↗

PubMed1992

Posttransfusion hepatitis revisited by hepatitis C antibody assays and polymerase chain reaction.

Sera of 40 patients with posttransfusion non-A, non-B hepatitis were tested for hepatitis C and B viral genomes by polymerase chain reaction and for hepatitis C antibodies by synthetic peptide immunoassays. Five were then considered to have chronic hepatitis before transfusion. Six patients without hepatitis C markers and hepatitis B virus DNA recovered. In 29 recipients who became positive for hepatitis C virus RNA, posttransfusion hepatitis C was diagnosed. Of them, 5 were hepatitis B surface antigen carriers. Synthetic peptide immunoassays detected 28 whereas anti-C100 assay detected 23 of the 29 acute hepatitis C patients. Anticapsid antibody appeared earlier than the antinonstructural antibody in 10 seroconverters. They appeared simultaneously in 15 seroconverters but anticapsid antibody appeared later then the antinonstructural antibody in 3 hepatitis B carriers. Transient suppression of hepatitis B surface antigenemia was found in 2, whereas elevated hepatitis B virus DNA was found in 3 carriers during acute hepatitis C superinfection. In 2 carriers whose hepatitis C became chronic, both hepatitis B and C viral genomes persisted throughout 2 years of followup. Therefore these assays define posttransfusion hepatitis C more precisely, and there seems no significant interference between chronic hepatitis B and C virus infections.

Adult↗

PubMed1992

Hepatitis C and B viruses in hepatitis B surface antigen-negative hepatocellular carcinoma.

The relative role of hepatitis C virus and hepatitis B virus in hepatitis B surface antigen-negative hepatocellular carcinoma was evaluated by polymerase chain reaction in 31 patients from Taiwan. Twenty-one were positive for antibody to hepatitis C virus (group 1) and 10 were negative (group 2). Of the group 1 patients, hepatitis C viral RNA was detected in the serum by polymerase chain reaction in 16 and in the liver tissue in 17, whereas hepatitis B viral DNA was found in the liver tissue in only 4, and none were found in the serum. In group 2 patients, hepatitis C viral RNA was detected in the serum of 1 and in the liver tissue of another. In contrast, hepatitis B viral DNA was found in the serum of 4 patients and in the liver tissues of 5. It was concluded that hepatitis C virus plays an important role in hepatocarcinogenesis in hepatitis B surface antigen-negative patients in Taiwan, especially in those who had antibody to hepatitis C virus; in those without antibody to hepatitis C virus, hepatitis B virus might still be associated with the development of hepatocellular carcinoma in a significant proportion of such patients.

Adult↗

PubMed1992

Meconium ileus-like condition in Chinese neonates.

Between January 1985 and May 1990, 16 neonates were treated for meconium ileus (MI) at this hospital. All babies were born to Chinese couples. Seven of them were premature, but none of them weighed less than 1,000 g. Eight patients underwent operations either because of mistaken diagnosis, as ileal atresia or long-segment Hirschsprung's disease, or because of complicated MI, including two meconium peritonitis and one associated with ileal atresia. Gastrograffin enema was successful in management of eight uncomplicated MI. The albumin content in the meconium of the last nine cases, including four complicated cases, ranged from 9.2 to 93.3 mg/g dry meconium. Usually, albumin is not present in normal meconium. All cases received sweat test, which were negative. Three patients died in the follow-up period. Sepsis of unknown origin, multiple congenital anomalies, and severe metabolic problems were the causes of death. The other 13 patients are doing well. They have exhibited no pulmonary or digestive problems during their follow-up period, which ranged from 11 months to 5 years. They are healthy and receive regular diets. Growth and development are appropriate for their age groups.

Albumins↗

PubMed1992

Intrafamilial transmission of hepatitis C virus: the important role of infections between spouses.

To investigate the intrafamilial transmission of hepatitis C virus (HCV) and related risk factors, anti-HCV antibodies in 186 family members of 48 index patients were studied. The index patients were anti-HCV-positive and had chronic liver disease. Overall, 10 family members (5.4%) were positive for anti-HCV, indicating a higher prevalence of anti-HCV among family members than among the Taiwanese general population. Spouses had the highest prevalence (21%) of anti-HCV, with older age and longer duration of marriage of index patients the most evident risk factors. HCV RNA, recovered from the infected couples by reverse transcription-nested polymerase chain reaction and subsequently sequenced directly, was identical at the nucleotide level in 3 of the 4 couples studied, and the remaining couple had a homology of greater than 96%. These results strongly support that interspousal transmission may be the most important route of intrafamilial spreading of HCV, and thus sexual transmission, although with low efficiency, should be considered important in HCV infection.

Adolescent↗