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Biomedical subjects

J C Sheu

Publications and source records attributed to J C Sheu.

At least 109 records · Page 6Linked to original sources
PubMed1992

Detection of replicative form of hepatitis C virus RNA in peripheral blood mononuclear cells.

Paired samples of plasma and peripheral blood mononuclear cells (PBMC) from 7 patients with posttransfusion hepatitis C were collected and studied for the presence of replicative forms of hepatitis C virus (HCV). RNA was extracted and tested for both positive and negative strands of HCV RNA by polymerase chain reaction. Positive-strand RNA of HCV was found in both plasma and PBMC of all 7 patients. However, negative-strand RNA was found in PBMC of 3 patients while none was found in the plasma. Levels of negative-strand RNA were about 10-100 times less than those of positive-strand RNA by semiquantification with serial dilution of viral cDNA. The results suggest that active infection and replication of HCV in PBMC is present in patients with posttransfusion hepatitis C and implicate the extrahepatic infection of HCV.

Adult↗
PubMed1992

Improved serodiagnosis of posttransfusion hepatitis C virus infection by a second-generation immunoassay based on multiple recombinant antigens.

Serial serum samples from 35 patients with posttransfusion non-A, non-B hepatitis in a prospective study were tested for antibody to hepatitis C virus (HCV) by a multiple recombinant antigen based immunoassay [anti-HCV (2nd); Abbott]. Of them, 23 were positive for anti-C100, and 27 were positive for HCV RNA by polymerase chain reaction. By anti-HCV (2nd), 28 patients were positive, and all except 1 of the 28 patients were positive for HCV RNA. A total of 24 patients, who became HCV RNA positive at the acute stage and who were negative for both anti-C100 and anti-HCV (2nd) before transfusion, were considered to have posttransfusion hepatitis C. The mean time to seroconversion for anti-HCV (2nd) was 7.5 or 12.1 weeks after the onset of hepatitis or the date of transfusion, respectively, and was generally 6 weeks earlier than that detected by anti-C100. However, seroconversion was delayed in 2 hepatitis B surface antigen carriers as compared with anti-C100. The anti-C100 assay detected 20 (83%) and the anti-HCV (2nd) all 24 patients with documented posttransfusion hepatitis C. The second-generation test is, therefore, better than conventional anti-C100 for the early diagnosis of HCV infection.

Adult↗
PubMed1992

Effects of anticoagulants and storage of blood samples on efficacy of the polymerase chain reaction assay for hepatitis C virus.

Blood samples from 11 patients with posttransfusion hepatitis C virus infection were collected. Each sample was divided into three fractions to obtain sera, sodium-citrated plasma, and heparinized plasma and then tested for HCV RNA by a nested polymerase chain reaction (PCR). Of them, eight sodium-citrated plasma samples, seven serum samples, and no heparinized plasma samples were PCR positive. Eight PCR-positive sodium-citrated plasma samples were exposed to different physical conditions and semiquantified for HCV RNA after serial dilutions. Samples stored at -70 degrees C showed the best preservation of HCV RNA, and storage at the other conditions resulted in only minimal loss of the PCR signal. Therefore, serum or sodium-citrated plasma specimens are satisfactory for detecting HCV RNA by PCR, but heparinized blood specimens are not.

Anticoagulants↗
PubMed1992

Conservative treatment of neonatal hydronephrosis.

From February 1990 to January 1991, 19 cases of hydronephrosis in children of less than one year of age were managed at Mackay Memorial Hospital. In the majority of these patients, there were evident causes such as ureteropelvic junction stenosis, ureterovesical reflux or a posterior urethral valve for which definite therapeutic measures were performed. However, some cases had no obvious origins and the hydronephrosis was speculated to be from nonobstructive or physiologic dilatation of the kidneys. The conventional tools, such as intravenous pyelogram or renal ultrasound, which comprise the mainstay of diagnosis, provide limited information on renal functional status. Recent introduction of the Tc-99m diethylene triamine penta-acetic acid (DTPA) diuretic renal scan has enabled us to distinguish between obstructive and nonobstructive hydronephrosis and helps us to determine whether or not surgery is necessary. In the past year, eight patients with hydronephrosis of less than one year of age were diagnosed as nonobstructive after a series of evaluations using renal ultrasound, voiding cystourethrography (VCUG) and Tc-99m DTPA diuretic renal scan. Follow-up studies by echography or DTPA renal scan revealed spontaneous resolution of the dilated collecting systems in these cases and confirms our belief that some hydronephrosis in neonates and infants may resolve spontaneously and may just be a manifestation of physiologic change during development. The value of the Tc-99m DTPA diuretic renal scan in the diagnosis of obstructive uropathy is discussed.

Female↗
PubMed1992

Experience with treatment of gastroschisis and omphalocele.

From 1982 to 1990, 31 neonates with omphalocele and 54 with gastroschisis were treated at Mackay Memorial Hospital. The overall survival rate for omphalocele was 71%, while it was 85% for gastroschisis. The rate of primary fascial closure for omphalocele (85%) and gastroschisis (87%) was similar. The mortality from omphalocele was almost exclusively due to the presence of serious associated congenital anomalies. Two cases of Cantrell's pentalogy and two of cloacal exstrophy were found. The incidence of major malformation with gastroschisis was 6%. Sepsis, inadequate perioperative resuscitation and prolonged gastrointestinal dysfunction were the major causes of death in gastroschisis. Among survivors, the hospital stay was significantly longer in the silon pouch group than in the primary fascial closure group (71.5 vs 31.3 days for gastroschisis, 41 vs 14 days for omphalocele). Advances in surgical technique, neonatal intensive care and ventilatory support have made primary fascial closure a superior approach without jeopardizing the babies' chance for survival. An improved survival rate and increased primary closure rate are the main features in the treatment of abdominal wall defects in the last decade.

Abdominal Muscles↗
PubMed1991

Recombinant immunoblot assay for hepatitis C antibody in patients with posttransfusion non-A, non-B hepatitis.

In a prospective study of 287 patients who received blood transfusion, 26 who were found positive for hepatitis C antibody (anti-HCV) by an enzyme-linked immunosorbent assay (ELISA) were studied by a recombinant immunoblot assay (RIBA). Nineteen of the 26 patients had posttransfusion non-A, non-B (NANB) hepatitis. Sixteen (84.2%) of the 19 patients with hepatitis had positive results by RIBA, 2 had indeterminate results, and 1 was negative. By contrast, five of the 7 recipients without hepatitis were negative, 1 indeterminate, and 1 positive by RIBA. Those with negative RIBA results had significantly lower optical density (OD) readings by ELISA than those with positive RIBA tests. Therefore, patients without hepatitis or lower OD value have a higher false-positive rate in anti-HCV ELISA than did those with a high OD value or with evidence of hepatitis.

Adult↗
PubMed1991

A prospective study of posttransfusion hepatitis in Taiwan.

In a follow-up study of 6 months or more of two hundred and ninety-six patients who had received blood transfusion, 37 (12.5%) developed acute posttransfusion hepatitis. Patients with posttransfusion hepatitis had significantly higher donor numbers and transfusion amounts than patients without hepatitis. Frequency was not related to the age, sex or hepatitis B carriage of recipients. There were no cases of fulminant hepatitis. Of 37 patients with hepatitis, 36 were diagnosed as non-A, non-B hepatitis and one as hepatitis B. Twenty-two (59.5%) of the 36 patients with non-A, non-B hepatitis seroconverted to hepatitis C antibody. Two of these were positive for hepatitis C antibody before transfusion and 12 were negative for hepatitis C antibody. Thirty-three of the 36 patients were followed-up for more than 6 months after the onset of hepatitis. While 13 of the 33 patients recovered, the remaining 20 (60.6%) patients still had persistent liver test abnormalities 6 months after the onset of hepatitis. Seventeen (85%) of the 20 patients who developed chronic hepatitis were hepatitis C antibody positive. In contrast, only four (30%) of the 13 patients who recovered after acute hepatitis were positive for the hepatitis C antibody. Chronicity rate was not related to the patient's sex, age, transfusion amount or donor number. Our results suggest a high frequency of posttransfusion hepatitis C in Taiwan and that the infection has a high risk of chronicity.

Adolescent↗
PubMed1991

Low-power laserthermia for the treatment of small hepatocellular carcinoma.

Laserthermia by a novel interstitial probe adapted to low power Nd-YAG laser machine was used to treat small hepatocellular carcinoma (HCC). The set condition was 43-45 degrees C in thermocouple with power of 2-3 W and the duration 20-30 min. In the 5 cases studied, 1 had a good result with total necrosis of the tumour without recurrence in 16 months. 1 died of liver failure 2.5 months later although death was not related to the procedure. 1 patient died of progressive disease 18 months later. The remaining 2 had recurrent tumours 5 and 12 months later, although the treated small tumours showed good response. Histological examination showed cell degeneration and necrosis. It is concluded that laserthermia is potentially useful in the treatment of the patients with small HCC.

Aged↗
PubMed1991

Laserthermia for the treatment of small hepatocellular carcinoma: a preliminary study.

A newly designed interstitial probe (hybrid probe) was used to treat small hepatocellular carcinoma (HCC) with laserthermia. Before the human study, testing in normal rabbit liver was done to measure the thermal map. Laserthermia was then studied in human small HCC. The set condition was 43-45 degrees C in thermocouple and the duration of laserthermia was 20 minutes. On follow-up computed tomography and liver biopsies, laserthermia had tumorcidal effect. It is concluded that laserthermia may be helpful to patients with small HCC.

Animals↗
PubMed1991

Detection of hepatitis B virus DNA by polymerase chain reaction in plasma of volunteer blood donors negative for hepatitis B surface antigen.

Plasma samples from 206 volunteer blood donors were tested for hepatitis B virus (HBV) DNA by dot blot hybridization and polymerase chain reaction (PCR). All donors were negative for hepatitis B surface antigen (HBsAg) and had normal serum alanine aminotransferase levels. None of the 206 plasma samples was positive for HBV DNA by dot blot hybridization assay. However, nine samples were positive for HBV DNA by PCR using two primer pairs specific for surface and core regions. Nine persons received the HBV-DNA-positive plasma, and one developed posttransfusion non-A, non-B hepatitis; the others remained well 6 months later. Therefore, approximately 4% of blood donors in Taiwan have low titers of HBV DNA, and a more sensitive method to screen donors may be needed in the future, although the current serologic test remains the most practical at present.

Autoradiography↗
PubMed1991

Minimal role of hepatitis B virus in posttransfusion non-A, non-B hepatitis in Taiwan: a study by polymerase chain reaction.

Using the polymerase chain reaction (PCR) for hepatitis B virus (HBV) DNA and an enzyme linked immunosorbant assay for the antibody to the hepatitis C virus (anti-HCV), we studied the serum samples of 18 patients with posttransfusion non-A, non-B (NANB) hepatitis in a prospective study. They were all negative for both the hepatitis B surface antigen (HBsAg) and the IgM antibody to the hepatitis B core antigen (IgM anti-HBc) by radioimmunoassay and were all negative for hepatitis B virus (HBV) DNA by dot blot hybridization. Eleven patients were positive for anti-HCV in the posttransfusion sera and 2 were already positive in the pretransfusion sera. Therefore, seroconversion of anti-HCV was noted in 9 patients. Two of these 18 patients were positive for HBV DNA by PCR in the posttransfusion sera and one of the 2 patients was also positive in the pretransfusion serum sample. The patient positive for HBV DNA in both pre and posttransfusion sera seroconverted to anti-HCV, while the patient positive for HBV DNA only in the posttransfusion sera was not seroconverted. We conclude that HBV plays minimal role in patients with posttransfusion NANB hepatitis in Taiwan even studied by PCR.

Adult↗
PubMed1991

Therapeutic effect of ursodeoxycholic acid on early-stage primary biliary cirrhosis.

Primary biliary cirrhosis is a rare chronic liver disease in Taiwan, which eventually causes mortality. As yet, no safe and effective treatment has been found. To investigate the safety and therapeutic efficacy of recently introduced ursodeoxycholic acid (UDCA) in the treatment of primary biliary cirrhosis, an uncontrolled trial was conducted in 6 patients in the early stages (I-II) and 5 patients in the late stages (III-IV). Five patients in stage I and one patient in stage II were treated with 10-15 mg/kg/day UDCA for a mean administration period of 13 +/- 9 months. Levels of laboratory tests including serum alkaline phosphatase (ALP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) improved significantly within one month and were sustained at the new lower levels for the period of observation. The symptoms of one patient with pruritus were reduced after long-term therapy. No major side effects were found during the treatment period. In contrast to early-stage patients, patients with late-stage primary biliary cirrhosis who received UDCA therapy for a mean duration of 25 +/- 5 months showed no beneficial effects either clinically or biochemically. From these preliminary results, UDCA appears to be safe and effective in the treatment of early-stage primary biliary cirrhosis, although further controlled clinical trials in conjunction with histological follow-up are mandatory to evaluate the critical role of UDCA in primary biliary cirrhosis.

Adult↗
PubMed1990

Plasma des-gamma-carboxyprothrombin in the early stage of hepatocellular carcinoma.

To evaluate the role of plasma des-gamma-carboxyprothrombin in the early diagnosis of hepatocellular carcinoma, we simultaneously studied both des-gamma-carboxyprothrombin activities by staphylocoagulase method and des-gamma-carboxyprothrombin antigen levels by enzyme immunoassay in 39 patients with early stage hepatocellular carcinoma (tumor size less than 3 cm in 21 patients, 3 to 5 cm in 18 patients); 68 patients had large hepatocellular carcinoma and 54 patients had chronic hepatitis or cirrhosis. Des-gamma-carboxyprothrombin levels by staphylocoagulase method (X) and enzyme immunoassay method (Y) on the same plasma specimens of hepatocellular carcinoma patients showed a linear correlation (Y = 0.15X - 10.5, r = 0.533, n = 67, p less than 0.001). Elevated des-gamma-carboxyprothrombin activities were present in 10 of 21 patients (47.6%) with hepatocellular carcinoma less than 3 cm, 66.7% of 18 with hepatocellular carcinoma 3 to 5 cm, 67.6% of 68 with hepatocellular carcinomas greater than 5 cm and 27.8% of 54 with chronic hepatitis or cirrhosis. The plasma des-gamma-carboxyprothrombin levels did not correlate with the tumor size or serum alpha-fetoprotein levels. Plasma des-gamma-carboxyprothrombin and serum alpha-fetoprotein measurements were comparable in the diagnosis of hepatocellular carcinoma because 22 (56.4%) and 21 (53.8%) of 39 patients with hepatocellular carcinoma less than 5 cm had increased des-gamma-carboxyprothrombin and alpha-fetoprotein levels, respectively. Up to 77% had an abnormal elevation in either marker.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Identification and characterization of intrahepatic hepatitis B virus DNA in HBsAg-seronegative patients with chronic liver disease and hepatocellular carcinoma in Taiwan.

To clarify the role of hepatitis B virus infection in HBsAg-seronegative patients with chronic liver disease and hepatocellular carcinoma in Taiwan, we examined the hepatitis B virus DNA in liver biopsy tissues of 112 patients by Southern blot analysis. The patients studied included 43 patients with nonalcoholic chronic liver disease, 21 patients with hepatocellular carcinoma and 48 control patients with other hepatobiliary and gastrointestinal diseases. To confirm the specificity of the intrahepatic hepatitis B virus DNA signal and to understand the structure of the integrated viral sequences, molecular cloning and DNA sequencing of an integrated hepatitis B virus DNA were done in one patient. Among 13 patients without serological evidence of previous hepatitis B virus infection, no hepatitis B virus sequences were found in the liver. In other HBsAg-negative patients with evidence of previous hepatitis B virus exposure, a substantial positive rate of intrahepatic hepatitis B virus DNA was found (7%). The intrahepatic hepatitis B virus DNA was all in integrated form. The positive rate among patients with nonalcoholic chronic hepatitis and cirrhosis (2%) was not different from that of the control group with other hepatobiliary and gastrointestinal diseases (4%). However, the positive rate of integrated hepatitis B virus DNA between hepatocellular carcinoma patients and nonhepatocellular carcinoma patients was statistically significant (19% vs. 3%, p less than 0.05). Molecular cloning and sequencing of a 3.0 kb EcoRI fragment of an integrated hepatitis B virus DNA from an anti-HBs-positive patient revealed that it was a partial copy of the hepatitis B virus genome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Detection of hepatitis B viral DNA by polymerase chain reaction in patients with hepatitis B surface antigen.

Hepatitis B virus (HBV) DNA was assayed using the polymerase chain reaction in serum samples of 116 hepatitis B surface antigen (HBsAg) carriers, including 30 positive for hepatitis B e antigen (HBeAg) and 86 negative for HBeAg. In the HBeAg-positive group, all were positive for HBV DNA. In the HBeAg-negative group, 80.2% were positive for HBV DNA (80.0% in the healthy carrier group, 90.0% in the chronic active liver disease group, and 69.2% in patients with cirrhosis). This study indicated that every HBeAg-positive carrier as well as the majority of HBeAg-negative carriers were infectious and, in the latter group, that viral replication is most active in patients with chronic active liver disease.

Adult↗
PubMed1990

Hepatitis C virus in a prospective study of posttransfusion non-A, non-B hepatitis in Taiwan.

Using an enzyme-linked immunosorbant assay for antibody against hepatitis C virus (anti-HCV), serial serum samples from 26 non-A, non-B (NANB) posttransfusion hepatitis (PTH) patients were studied in a prospective study in Taiwan. Sixteen (61.5%) of the 26 patients were positive for anti-HCV antibodies. Two of the 16 patients were positive for anti-HCV before transfusion. The remaining 10 patients were negative for anti-HCV antibodies. The rate of anti-HCV seroconversion is, therefore, 58.5%. Of the 14 patients with anti-HCV seroconversion, three were hepatitis B surface antigen (HBsAg) carriers. The time of seroconversion for anti-HCV ranges from 2 to 24 weeks after the first elevation of ALT (mean: of 8.7 weeks,) or 6-32 weeks from the date of transfusion (mean: 13 weeks). Twelve (85.7%) of the 14 anti-HCV seroconverted patients had persistent abnormal ALT 6 months after the onset of hepatitis in contrast to 30% of chronicity in the anti-HCV-negative patients. The results suggest that HCV is the major causative agent in NANB PTH in Taiwan, and patients positive for anti-HCV have a higher risk of chronicity.

Adult↗