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Biomedical subjects

J E Jeng

Publications and source records attributed to J E Jeng.

34 records · Page 2Linked to original sources

Clinical evaluation of serum alpha-fetoprotein and circulating immune complexes as tumour markers of hepatocellular carcinoma.

To evaluate the diagnostic application of serum alpha-fetoprotein (AFP) and circulating immune complexes (CICs), AFP, 3% polyethylene glycol (PEG)-CICs, 4% PEG-CICs, and C1q-CICs were determined in 101 patients with cirrhosis alone, 101 sex-matched and age-matched cirrhotic patients with hepatocellular carcinoma (HCC) and 54 healthy controls. Multivariate analysis indicated that AFP (odds ratio 1.014; 95% confidence interval 1.004-1.024) and 3% PEG-CICs (odds ratio 1.011; 95% confidence interval 1.005-1.017) are associated, in a dose-related fashion, with an increased risk for HCC. A receiver operative characteristic (ROC) curve was used to determine the optimal cut-off values of AFP (120 ng ml-1) and 3% PEG-CICs (310 micrograms aggregated IgG equivalent ml-1). The area under ROC curve was 0.875 for AFP and 0.812 for 3% PEG-CIC. Both AFP and 3% PEG-CICs show a high specificity (100%) and positive likelihood ratio. The sensitivity was 65.3% for 3% PEG-CICs and 67.3% for AFP. Determination of both markers in parallel significantly increase the diagnostic accuracy (92.1%) and sensitivity (84%), with a high specificity (100%) and positive likelihood ratio (> 84). In conclusion, both 3% PEG-CICs and AFP are independent risk factors of HCC, and may be used as complementary tumour markers to discriminate HCC from cirrhosis. Determination of 3% PEG-CICs should be performed in cirrhotics negative for AFP to improve detection of HCC.

Adult↗

Increased IgM-containing circulating immune complexes in patients co-infected with hepatitis C and hepatitis B.

To assess the role of circulating immune complexes (CIC) in chronic hepatitis C virus (HCV) infection, the relative frequency of CIC was determined in 60 patients with chronic hepatitis C alone, 19 patients co-infected with hepatitis B and C, 15 asymptomatic HCV carriers, and 54 healthy controls. Levels of CIC were determined with immunoglobulin-specific C1q-binding and conglutinin (K)-binding immune complex assays. Although there was no statistical difference in the levels of each type of CIC between asymptomatic HCV carriers and healthy controls, elevated levels of CIC containing IgM and IgG were common in patients with chronic HCV infection. Compared to patients with hepatitis C alone, patients co-infected with hepatitis B and C have a higher frequency of abnormal IgM-containing CIC and significantly higher levels of IgM-containing CIC. CIC levels in patients with chronic active hepatitis were significantly higher than those in patients with chronic lobular hepatitis or chronic persistent hepatitis. In conclusion, although CIC containing IgM and IgG were common in patients with chronic hepatitis C, abnormal IgM-containing CIC are the major types of CIC in patients co-infected with hepatitis B and C. An immune-mediated mechanism may play a role in the pathogenesis of chronic hepatitis C.

Adult↗

[The re-evaluation of the prevalence of trachoma in primary school children in Kaohsiung City].

For years, trachoma screening has been a routine part of the health examination program for all primary school children. In order to ascertain the current prevalence of trachoma in primary school children, we used clinical examination, immunofluorescein-monoclonal antibody and McCoy cell culture technique to examine 771 children from 5 primary schools in Kaohsiung City. Using the results of the McCoy cell culture as a judgement standard, we found that 118 children (15.3%) had chlamydia trachomatis infections. The infection rates of children were statistically insignificant for sex, grade and location of school of children. Among the 118 infected children, most had none or mild (96.6%) conjunctival inflammation. Only 3 children (0.4%) had conjunctival cicatrization complications. These results showed that the repeated reinfections among these children were quite few. The McCoy cell culture was used to test the result of clinical diagnosis made by the senior ophthalmologists. The sensitivity of the clinical diagnosis was 50% and the predictive positive rate was 26.6%. It revealed that the diagnosis of trachoma made by clinical observation only was unreliable. The results of immunofluorescein-monoclonal antibody test showed that 120 children (15.6%) had trachomatous infections. Its sensitivity was 68.4%, and specificity was 91.7%. It revealed that more care should be taken in quality control of laboratory techniques. From these results, we conclude: 1) the trachomatous infections of primary school children in Kaohsiung City are not serious; the repeated infections among

Child↗

Hepatitis B and C virus infection as risk factors for hepatocellular carcinoma in Chinese: a case-control study.

To assess whether hepatitis B and C virus infection were risk factors for hepatocellular carcinoma (HCC), antibody to hepatitis C virus (anti-HCV), hepatitis B surface antigen and e antigen (HBsAg and HBeAg) were tested in 150 HCC patients. Another 150 case-control pairs matched individually by sex and age were also enrolled. Univariate analysis demonstrated that both the anti-HCV and the carrier status of HBsAg and HBeAg were significantly associated with HCC. Multi-variate analysis revealed that both anti-HCV and HBsAg were risk factors for HCC. The population-attributable risk was estimated as 14.2% for anti-HCV alone, 59.4% for HBsAg alone and 8.0% for both anti-HCV and HBsAg in Taiwan. In conclusion, both hepatitis B and C virus infection are independent risk factors for HCC in Chinese in southern Taiwan.

Aged↗

Antibodies to hepatitis E virus among Chinese patients with acute hepatitis in Taiwan.

The prevalence of antibodies to hepatitis E virus (anti-HEV) was investigated in patients with acute hepatitis, and correlated with the clinical features. Sera from 110 patients with acute hepatitis and 60 healthy controls were tested for anti-HEV, antibody to hepatitis C virus (anti-HCV), and hepatitis B surface antigen (HBsAg). There were significant differences in the prevalence of anti-HEV, anti-HCV, and HBsAg between patients and controls (21.8% vs. 0%, 16.3% vs. 1.6% and 58.1% vs. 18.0%, respectively). Anti-HEV was detected in 6 (25.0%) of 24 patients with anti-HCV, 6 (9.3%) of 64 patients with HBsAg, and another 6 (22.2%) of 27 patients with acute hepatitis non-A, non-B, non-C. Anti-HEV was found in 15 men and three women, whose ages ranged from 34 to 75 (median, 57) years old. The median age of patients with anti-HEV was older than that in patients without this antibody (57 vs. 38 years; P = 0.001). The prevalence of anti-HEV in patients with anti-HCV alone (35.2%) was higher than that (11.1%) in patients with HBsAg alone (P = 0.03). Compared to patients without anti-HEV, HEV-infected patients had a higher frequency of travel to a foreign country (P = 0.0001), had a lower HBsAg rate (P = 0.019), and had higher serum alkaline phosphatase levels (P = 0.04) and gamma-glutamyl transpeptidase levels (P = 0.01). In conclusion, HEV infection occurs in 22.2% of patients with acute hepatitis non-A, non-B, non-C. HEV superinfection may occur in patients with chronic hepatitis B or C virus infection.

Acute Disease↗

Effects of hepatitis C and B viruses infection on the development of hepatocellular carcinoma.

A case control study consisting of 102 patients with HCC, 102 sex-matched and age-matched patients with nonhepatic disease, and 204 matched healthy controls was carried out to investigate the effect of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection on the development of hepatocellular carcinoma (HCC). The prevalence of antibody to HCV (anti-HCV) in HCC (34.3%) was higher than in nonhepatic disease (10.7%, P < 0.001) or in healthy controls (2.4%, P < 0.001). The prevalence of hepatitis B surface antigen (HBsAg) in HCC (77.4%) was higher than in nonhepatic disease (16.6%, P < 0.001) or in healthy controls (19.6%, P < 0.001). Anti-HCV positivity in nonhepatic disease was higher than in healthy controls (P < 0.01). Using patients with nonhepatic disease as controls, stepwise logistic regression analysis indicated that both anti-HCV (odds ratio, 3.4; 95% confidence interval, 2.1-5.6) and HBsAg (odds ratio, 5.6; 95% confidence interval, 3.6-8.5) are independent risk factors for HCC. Using healthy controls, the development of HCC was also strongly associated with anti-HCV (odds ratio, 8.0; 95% confidence interval, 4.3-14.6) and HBsAg (odds ratio, 5.5; 95% confidence interval, 3.7-8.2). Calculation of incremental odds ratio indicated that there is no interaction between HBV and HCV. In conclusion, HBV and HCV are risk factors of HCC. They act independently and without interaction.

Adult↗

Hepatitis B and C virus infection as risk factors for liver cirrhosis and cirrhotic hepatocellular carcinoma: a case-control study.

To investigate whether hepatitis B virus (HBV) and hepatitis C virus (HCV) infection are risk factors for liver cirrhosis and hepatocellular carcinoma (HCC), a case-control study of 102 cirrhotic HCC patients, 102 sex-matched and age-matched patients with liver cirrhosis, and 102 matched patients with non-hepatic disease controls was performed. The prevalences of hepatitis B surface antigen (HBsAg) and antibody to HCV (anti-HCV) in HCC (70.5%, 39.2%) and liver cirrhosis (74.5%, 27.4%) were higher than controls (16.6%, 10.5%) (P = 0.0001). In HBsAg-negative patients, the prevalence of anti-HCV in cirrhotic HCC (66.6%) and liver cirrhosis (46.1%) was higher than in controls (10.5%; P = 0.0001). There was no such difference in HBsAg-positive patients. Multivariate analysis revealed that both HBsAg and anti-HCV were important risk factors for HCC (odds ratio, 6.52 and 4.59, respectively) and liver cirrhosis (odds ratio, 4.22 and 2.29, respectively). There was no difference in odds ratio when HCC and liver cirrhosis were compared. Our result implies that both HBV and HCV are independent risk factors for cirrhotic HCC and liver cirrhosis in Taiwan.

Carcinoma, Hepatocellular↗

Hepatitis C virus infection among patients with chronic liver disease in an area hyperendemic for hepatitis B.

BACKGROUND: The prevalence of hepatitis C virus (HCV) infection was assessed in patients with non-alcoholic chronic liver disease (CLD). METHODS: Antibody levels to HCV (anti-HCV) were assessed in 100 pairs of CLD patients and healthy controls. RESULTS: The prevalence of anti-HCV was higher in patients (26.0%) than in controls (2.0%; p = 0.0001). The patient group with anti-HCV was older (p = 0.0001) and had more smokers (p = 0.034), fewer hepatitis B surface antigen carriers (p = 0.0001), and more patients with active liver disease (p = 0.023) and a history of blood transfusion (p = 0.026). Multivariate analysis showed that anti-HCV (odds ratio, 8.1; 95% confidence intervals, 3.7-17.6) was strongly associated with CLD. CONCLUSIONS: HCV infection is a risk factor of non-alcoholic CLD, and HCV causes more severe hepatocellular damage than HBV.

Adult↗

Antibodies to hepatitis E and A viruses among patients with non-alcoholic chronic liver disease in Taiwan.

BACKGROUND: The prevalence of hepatitis E virus (HEV) and hepatitis A virus (HAV) infection in patients with non-alcoholic chronic liver disease (CLD) was assessed. METHODS: Antibody levels to HEV (anti-HEV) and HAV (anti-HAV) were evaluated in 100 pairs of CLD patients and healthy controls. RESULTS: The prevalence of anti-HEV was higher in patients (10.0%) than in controls (0%; p = 0.0001). There was no difference in anti-HAV positivity between patients (95%) and controls (93%). The patient group with anti-HEV was older (p = 0.024) and had more smokers (p = 0.03), having a higher prevalence of antibodies to hepatitis C virus (p = 0.02). Patients with anti-HAV were older than patients without (p = 0.0001). The prevalence of anti-HAV in patients more than 30 years old was higher than younger patients (95.1% versus 73.6%, p = 0.011). CONCLUSION: HEV may superinfect on chronic liver disease in an area hyperendemic for hepatitis A and B.

Adult↗

Study on the children of Kaohsiung with acute viral infection of lower respiratory tract by direct immunofluorescence assay.

This study retrospectively reviewed those pediatric patients of acute lower respiratory tract infection with positive virus identification by direct immunofluorescence assay (Direct IF) from Jan, 1992 to Dec, 1993. One hundred and eighteen patients with 133 positive Direct IF results (107 cases with single virus identified, and 11 cases with more than one) were included. The sex ratio was 1.6:1 with males predominant; age, 22.1 (1 approximately 154.8) (months); duration of admission, 5.7 (1 approximately 69) (days); peripheral white blood cell count, 10,600 +/- 3,800/mm3; C-reactive protein, 17.0 (0 approximately 163.3) mu/ml; body temperature, 37.1 +/- 1.1 degrees C in those cases with single virus. The symptoms were cough 105 cases (98.1%), rhinorrhea 46 cases (43.0%), dyspnea and/or tachypnea 43 cases (40.2%) and diarrhea 15 cases (14.0%). The viruses identified were: Adenovirus (52 cases, 39.1%). Influenza B (45 cases, 33.8%), Parainfluenza 1 (28 cases, 20.1%), Parainfluenza 3 (19 cases 14.3%), Respiratory Syncytial virus (17 cases, 12.8%), and Influenza A (9 cases, 6.8%). The seasonal incidence rates were spring (49 cases, 36.8%), summer (46 cases, 34.6%), autumn (23 cases, 17.3%), and winter (15 cases, 11.3%). The results showed much similarity with others, except the commonest viral type (Adenovirus in this study; Respiratory Syncytial virus in others) and the seasonal incidence rate (higher in spring and summer in this study but not in others). In conclusion, most children with acute viral lower respiratory tract infection had an uneventful course and Direct IF is a reliable method for viral detection in that disease.

Acute Disease↗

Hepatitis C virus infection as a risk factor for non-alcoholic liver cirrhosis in Taiwan.

To assess whether hepatitis C virus infection was a risk factor for the development of non-alcoholic liver cirrhosis, antibody to hepatitis C virus (anti-HCV; detected by a second generation HCV enzyme immunoassay), hepatitis B surface antigen (HBsAg; detected by radioimmunoassay) were tested in 150 cirrhotics and 150 sex-matched and age-matched healthy controls. The prevalence of anti-HCV and HBsAg in cirrhotics was higher than in controls (22.0%, 73.3% vs. 2%, 18.7%; P = 0.001). The prevalence of anti-HCV in HBsAg-negative cirrhotics (45.0%) was higher than that in HBsAg-positive patients (13.6%; P = 0.001). Both the anti-HCV and carriage of HBsAg were associated significantly with liver cirrhosis, showing odds ratio of 12.0 for HBsAg carriers and 13.8 for patients with anti-HCV. Compared with those without HBsAg and anti-HCV, there was a significantly positive linear trend for developing cirrhosis with the presence of HBsAg alone (odds ratio = 19.9), anti-HCV alone (odds ratio = 49.0), and those positive for HBsAg and anti-HCV (odds ratio = 81.8) (P = 0.00001). The population-attributable risk for developing liver cirrhosis was estimated as 10.8% for anti-HCV alone, 55.2% for HBsAg alone, and 9.4% for both anti-HCV and HBsAg in southern Taiwan. In conclusion, this study shows that hepatitis B and C virus infection act independently and synergistically in the development of non-alcoholic liver cirrhosis among Chinese in Taiwan.

Age Factors↗

Hepatitis C virus antibody in hepatocellular carcinoma in Taiwan.

The prevalence of antibody to hepatitis C virus (anti-HCV) was investigated in patients with hepatocellular carcinoma (HCC), and correlated with the clinical features. Anti-HCV was detected in 129 histology or aspiration cytology proven HCC patients and 54 healthy controls. Anti-HCV was examined by the HCV EIA (Abbott Laboratories). All healthy controls were anti-HCV-negative. Nineteen of 81 (23.5%) hepatitis B surface antigen (HBsAg)-positive HCC patients were positive for anti-HCV. Anti-HCV was found among 60.4% (29/48) of HCC patients without detectable HB-sAg. Forty-eight of 129 (37.2%) HCC patients were positive for anti-HCV. There was a significant difference in the prevalence of anti-HCV between patients with HBsAg (23.5%) and those without HBsAg (60.4%, P = 0.0001). However, irrespective of the status of HBsAg, there was no statistical difference in sex, age, routine liver function tests, alpha-fetoprotein concentration, or associated cirrhosis between patients with anti-HCV and those without. The results imply that hepatitis C virus may play a role in the pathogenesis of HCC.

Adult↗

Clinical observations and virological study of aseptic meningitis in the Kaohsiung area.

During 1988, an endemic outbreak of aseptic meningitis was noted in the Kaohsiung area. Throughout the year, a total of 89 cases were identified by cerebrospinal fluid (CSF) examination at the Pediatric Department of Kaohsiung Medical College. The peak incidence was from June to October. Scattered cases still occurred during November and December. The male to female ratio was 1.7:1 and the age distribution ranged from 1 month to 15 years old. Two peaks of age distribution were observed; one in infancy and the other in the 4-7 year old age group. Most of them exhibited fever (94.4%), headache (68.9%), and vomiting (68.5%). Other associated symptoms and signs included neck stiffness, sore throat, cough, Brudzinski's sign, abdominal pain, seizure, dizziness, rhinorrhea, diarrhea, Kernig's sign, skin rash, hyperemic conjunctiva, apnea, and oral ulcers. Most of them had CSF white blood cell (WBC) counts less than 1000/mm3, normal or mild elevated protein, and normal CSF/plasma sugar ratio. Three patients were found to have a virus in their CSF without pleocytosis. Virus isolations from CSF throat swabs and/or rectal swabs were performed in 65 patients, half of them (35/65, 53.8%) had positive results including echovirus type 9 (sixteen), echovirus type 30 (eighteen), and adenovirus type 3 (one). Echovirus type 9 was predominant during July and August whereas echovirus type 30 became predominant after September. All patients recovered spontaneously without any sequelae.

Adolescent↗

Fc receptors in corneal epithelium.

The corneal epithelia of the mouse, rabbit and human were shown to contain Fc receptors by an indirect method with immunoglobulins, labelled second antibody and the avidin-biotin peroxidase complex (ABC); and a direct method with the peroxidase conjugated Fc fragment. The cornea epithelia of all three species exhibited a high concentration of the Fc gamma R with either homologous or heterologous immunoglobulins. The binding specificity of Fc receptors was further supported by competitive inhibition of binding of labeled antibody by homologous, unlabeled antibody. Although Fc alpha R was also present it was at a much lower concentration. The Fc receptor for IgM (Fc microR) was difficult to demonstrate. However, it appeared to be present in very low concentration on only the mouse and rabbit corneal epithelium.

Animals↗

Serum insulin-like growth factor-II and alpha-fetoprotein as tumor markers of hepatocellular carcinoma.

To evaluate the diagnostic application of serum insulin-like growth factor-II (IGF-II) and alpha-fetoprotein (AFP) levels in hepatocellular carcinoma (HCC), IGF-II and AFP were determined in 100 cirrhotic patients with HCC, 100 sex- and age-matched patients with cirrhosis alone and 50 healthy controls. The results indicated that IGF-II and AFP levels in patients with HCC were higher than in those with cirrhosis alone (p = 0.0001). There is an inverse correlation between IGF-II and (log)AFP (r = -0.410, p = 0.0001) in patients with HCC. Multivariate analysis indicated that IGF-II and AFP were closely associated, in a dose-related fashion, with the presence of HCC. Receiver operating characteristic curves were used to determine the optimal cutoff values of IGF-II (4.5 mg/g prealbumin) and AFP (100 ng/ml), respectively. Both IGF-II and AFP show a high specificity and positive likelihood ratio. The sensitivity was 42.0% for IGF-II and 73.0% for AFP. Determination of both markers in parallel significantly increased the diagnostic accuracy (96.5%) and sensitivity (97.9%), with a high specificity (95.1%) and positive likelihood ratio (19.9). In conclusion, IGF-II and AFP may be used as complementary tumor markers to discriminate HCC from cirrhosis.

Adult↗