Malignant mixed tumour of the liver and its response to adriamycin.
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Doxorubicin↗
Biomedical subjects
K C Lam
Publications and source records attributed to K C Lam.
Hepatitis B virus and cigarette smoking: risk factors for hepatocellular carcinoma in Hong Kong.
One hundred seven Chinese patients with primary hepatocellular carcinoma (PHC) were compared with 107 hospital controls for the presence of hepatitis B surface antigen and smoking, drinking, and dietary habits. Eighty-two % of PHC cases were hepatitis B surface antigen positive compared to 18% of controls (relative risk, 21.3; 95% confidence limits, 10.1 and 45.9). Prior history of jaundice was significantly related to PHC, independent of hepatitis B surface antigen status. There was a significant association between cigarette smoking and PHC negative for hepatitis B surface antigen. The relative risk of hepatitis B surface antigen-negative PHC for heavy smokers (20 + cigarettes/day) was 3.3 compared to light smokers and nonsmokers (95% confidence limits, 1.0 and 13.4). Our data indicated that infection by the hepatitis B virus and cigarette smoking were independent risk factors for PHC.
Carcinoma, Hepatocellular↗
Analytical epidemiology of primary liver carcinoma in the Pacific Basin.
In the Pacific Basin, the hepatitis B virus is closely associated with hepatocellular carcinoma in its geographic distribution and familial clustering, and its presence in liver tissues. The contribution of aflatoxin to the development of hepatocellular carcinoma in different regions varies from negligible to probably major. Neither the hepatitis B virus nor aflatoxin can account for the varied epidemiology of hepatocarcinogenesis in the Pacific Basin. Many potential carcinogens for the liver have been identified in food, drugs, industrial chemicals, and in the general environment, but their importance in hepatocarcinogenesis remains to be defined.
Aflatoxins↗
Clinical features of hepatocellular carcinoma: review of 211 patients in Hong Kong.
A retrospective study of 211 patients with proven hepatocellular carcinoma (HCC) was made. The commonest symptoms were anorexia and malaise (73%). Five patients (2.5%) had near-normal biochemical tests despite the presence of massive tumors. Diagnostic yield from angiography, percutaneous peritoneoscopic biopsy, or scintiscanning was 87-98%. Three percent of the patients had resectable tumors. Median survival for patients with untreated disease was 3.5 weeks. Apart from histology, the total serum bilirubin level was the only factor of prognostic value. Only 12 patients had preexisting symptomatic cirrhosis. When compared with 80 patients with symptomatic postnecrotic cirrhosis without malignancy, patients with HCC had higher SGOT:SGPT ratio, Higher serum albumin levels, and higher platelet counts. There was only minimal overlap of patients with symptomatic postnecrotic cirrhosis and those with HCC. The authors conclude that their patients with HCC appeared late for treatment. A probable difference in the development of symptomatic postnecrotic cirrhosis and of HCC with asymptomatic postnecrotic cirrhosis is suggested.
Adolescent↗
Deleterious effect of prednisolone in HBsAg-positive chronic active hepatitis.
To study the efficacy of corticosteroids in chronic active hepatitis (CAH) positive for hepatitis B surface antigen (HBsAg), we pair-randomized 51 patients to receive either 15 to 20 mg of prednisolone per day or a placebo. After initial remission, the maintenance dosage of prednisolone was 10 mg per day, and the patients were prospectively followed for up to 3 1/2 years. Prednisolone decreased serum bilirubin (P < 0.05) and globulin (P < 0.01) at three months; it delayed other biochemical remission occurring after the second month of medication (P < 0.001); it hastened biochemical relapse (P < 0.0001); and it increased the frequency of complications (P < 0.0001) and the death rate (P < 0.01). We conclude that prednisolone has an overall harmful effect in patients with HBsAg-positive CAH.
Adult↗
Spontaneous portosystemic shunt: relationship to spontaneous encephalopathy and gastrointestinal hemorrhage.
This study examined the effect of large spontaneous portosystemic shunts on the incidence of variceal hemorrhage and hepatic encephalopathy. Twenty cases of chronic liver disease with large spontaneous shunts were compared with a group of patients with liver disease and with Cruveilhier-Baumgarten (C-B) murmurs and with a control group having liver disease and absence of large shunts on angiography. Gastrointestinal hemorrhage was present in similar proportions of patients in the three groups. Hepatic encephalopathy occurred more frequently in the spontaneous shunt group and C-B murmur group. The encephalopathy was spontaneous in 12 of 14 patients with large natural shunts whereas it was precipitated by events such as gastrointestinal bleeding, diuretics, or infection in 14 of 15 of the patients with C-B murmur and five of the seven controls. Therefore, spontaneous portosystemic shunts do not protect against gastrointestinal hemorrhage and are associated with an increased risk of spontaneous hepatic encephalopathy.
Adolescent↗
Haemodynamic responses to intravenous cimetidine in subjects with normal lung function and in subjects with chronic airway obstruction.
1 The haemodynamic responses to a bolus intravenous injection of 400 mg cimetidine were studied in eight subjects with normal lung function and sixteen with chronic obstructive airway disease (COAD), under continuous systemic and pulmonary arterial monitoring. In all subjects there were significant immediate but transient (less than 10 min) drops in the systemic and pulmonary arterial pressures (both systolic and diastolic), the systemic vascular resistance and total pulmonary resistance. The percentage drops were significant more marked in the COAD group in the following: systemic arterial pressures (systolic and diastolic), systemic vascular resistance and total pulmonary resistance. The cardiac output showed no significant change in the group with normal lung function but rose significantly in the COAD group. None of the subjects had any symptoms associated with the haemodynamic changes. 2 These results can be explained by a generalized vasodilatory effect of cimetidine, but the relationship to its H2-receptor blocking effect is undetermined. Hypoxia and/or hypercapnia may sensitize an individual to the vasodilatory effect of cimetidine.
Adult↗
Clinical features and natural mortality of chronic active hepatitis in Hong Kong.
To study the clinical picture and survival of chronic active hepatitis (CAH) in Hong Kong, the records of 298 non-alcoholic patients with histologically proven CAH were reviewed. The male:female ratio was 3:1. The mean age (+/- SD) on presentation was 47.3 (+/- 13.1) years. The liver was shrunken and the mean mass (+/- SD) at autopsy was 887 gm (+/- 266) compared to 1343 gm (+/- 172) in cases without liver disease. The spleen was enlarged to 2 to 20 cm below the left costal margin in 98% of cases. The survival graph showed an annual mortality of approximately 13%, without a tendency to flatten out within ten years of diagnosis. Survival was best in patients presenting with splenomegaly alone, average in those presenting with ascites or gastrointestinal haemorrhage and worst in those presenting with hepatic decompensation. The modes of death were significantly correlated with the chief complaints on first presentation (p less than 0.001). The study documented the clinical aspects of CAH in Hong Kong and amplified the differences reported among CAH patients between Australia and Asia.
Adult↗
Management of chronic hepatitis. Part two: treatment.
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Azathioprine↗
Management of chronic hepatitis. Part one: diagnosis.
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Biopsy↗
Etiological spectrum of liver cirrhosis in the Chinese.
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China↗
Prevalence of Toxoplasma gondii antibodies in the Chinese population of Hong Kong.
Sera from 2,499 randomly selected Chinese inhabitants of Hong Kong were tested for the presence of Toxoplasma gondii antibodies using the indirect fluorescent antibody test. The over-all prevalence was 9.8%. The prevalence was significantly higher in the 10 to 19 and 30 to 39 year age group and the highest level of titres was found in the 20 to 29 group. There was no significant difference in prevalence between the male and female population and between the rural and city dwellers. The distinctly low prevalence of toxoplasmosis in Hong Kong can probably be attributed to the absence of cats in most domestic households and the preference of the people to eat well-cooked meat (commonly beef and pork).
Adolescent↗
Treatment of chronic active hepatitis.
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Azathioprine↗
HBV markers in Chinese in Hong Kong.
A study was carried out on 779 hospital patients in the Orthopaedic and Paediatric Unit of Queen Mary Hospital, Hong Kong. Patients who had no clinical evidence of liver disease, previous history of transfusion with blood or blood products and no major surgery in the past were entered into the study. Markers of previous exposure to Hepatitis B virus (HBV) were HBsAg, anti-HBc and anti-HBs (radioimmunoassay) were done. The results showed that (a) Chinese living in Hong Kong are exposed to HBV infection throughout life (b) horizontal transmission is the dominant mode of transmission and (c) cpronic HBsAg carriers probably do not carry HBV for life but may clear HBs antigenaemia with age.
Adolescent↗
Histologic prognostic indicators in hepatocellular carcinoma.
Survival and histologic features were studied in 80 patients with proven hepatocellular carcinoma (HCC). The overall survival was 50% at 3.5 weeks with a statistically significant drop in mortality rate after 8.5 weeks. Patients with diffuse clear-cell pattern, focal clear-cell pattern, and no clear cells in their tumors had a 50% survival rate at 14 weeks, 6 weeks, and 3 weeks respectively; the differences in survival rates were statistically significant between any pair (p less than 0.001). No correlation was found between survival and (1) cytologic differentiation, (2) histologic architecture, (3) degree of pleomorphism, or (4) presence of bile production, proteinaceous secretion, giant cells, or cytoplasmic hyaline bodies. Eosinophilic HCC with lamellar fibrosis was not observed in any of our materials. We concluded that the presence of clear cells was the only histologic feature of prognostic significance in our patients.
Carcinoma, Hepatocellular↗
Cytoplasmic hepatitis B surface antigen and the ground-glass appearance in hepatocellular carcinoma.
Hepatitis B surface antigen (HBsAg) was identified with aldehyde fuchsin and immunoperoxidase stain and by immunofluorescence in malignant hepatocytes with a ground-glass appearance in only one needle biopsy specimen of a series of biopsies from 130 consecutive cases of hepatocellular carcinoma. The patient was 14 years old. HBsAg was identified by aldehyde fuchsin stain in nonmalignant hepatocytes of 48 (58%) of 83 biopsy specimens that contained nonmalignant liver tissue. The antigen was demonstrable in significantly greater proportions of cases in younger age groups. A similar but not identical age relationship has been found for hepatitis B antigenemia in Hong Kong. It appears that the ability to produce HBsAg declines with age. The usual absence of demonstrable HBsAg in cells of hepatocellular carcinoma may be due to a failure of this characteristic to survive into the malignant cell line, and so does not invalidate the possibility that the hepatitis B virus (HBV) plays a direct role in the pathogenesis of hepatocellular carcinoma. In exceptional circumstances, as when hepatocellular carcinoma appears at an unusually early age, this marker is identifiable in cells of the tumor.
Adolescent↗
Dizygosity of discordant twins with Noonan syndrome.
A pair of discordant twins, one of whom had Noonan syndrome, is reported. Most of the cardinal signs of Noonan syndrome were demonstrated by the affected twin. The etiology of the syndrome is briefly reviewed. The dizygosity of the twins was proved by ABO blood grouping and mixed lymphocyte reaction. The findings are interpreted as reasonably good evidence that genetic factors are the prime etiology in the pathogenesis of Noonan syndrome.
Adolescent↗
Treatment of duodenal ulcer with antacid and sulpiride. A double-blind controlled study.
The effect of aluminum-magnesium hydroxide tablets (800 mg seven times per day) and that of sulpiride, a hypothalamic neurolaptic, were studied in 101 patients with duodenal ulcer in a double-blind controlled 4-wk trial. Significantly more of the patients treated with antacid, sulpiride, or antacid-sulpiride combination showed a greater than 50% reduction in ulcer size than did the patients treated with placebo. However, only in the antacid- and antacid-sulpiride-treated groups did the ulcer, with and without residual inflammation, disappear statistically more often than in the placebo-treated group. Furthermore, only in the antacid-sulpiride-treated group did complete healing, with no trace of inflammation, occur statistically more often than in the placebo-treated group. Disappearance of ulcer pain was likewise statistically more frequent in the antacid-sulpiride group than in the placebo-treated group. Antacid therapy with aluminum-magnesium hydroxide tablets appears to accelerate the rate of ulcer healing. Sulpiride appears to have a minor but definite synergism with antacids. Cigarette smoking affected ulcer healing adversely; on the other hand, factors favorable to healing were the early onset age of ulcer symptoms and acid hypersecretion. Male patients also healed more favorably than females.
Administration, Oral↗