Biomedical subjects

X Z Lin

Publications and source records attributed to X Z Lin.

97 records · Page 6Linked to original sources

PubMedDate not supplied

Hepatic adenoma: an observation from asymptomatic stage to rupture.

A 39 year old female, who took oral contraceptives for about ten years, was found to have an asymptomatic hepatic adenoma during an episode of acute hyperlipidemic pancreatitis. The diagnosis was confirmed by sonography, CT scan, angiography, and liver biopsy. She refused operation and was followed at the outpatient clinic. Initially, the tumor decreased its size after withdrawal of oral contraceptives, but enlarged again on subsequent examinations. She came back to emergency room with hemoperitoneum and intratumoral hemorrhage eighteen months after the initial diagnosis. Her hepatic adenoma was removed surgically and was found to be ruptured. She has been well for two years.

Adenoma↗

PubMedDate not supplied

Sequential changes of bile contents in patients with obstructive jaundice from different etiologies.

BACKGROUND/AIMS: The decreasing of serum concentration of bilirubin and the ability of hepatocytes to excrete various biliary contents after release of obstructive jaundice are good indicators of recovery of liver function. We conducted this study to clarify whether different causes of obstructive jaundice have different effects on the biliary excretion and how they are different when obstruction is released. PATIENTS AND METHODS: Fifteen patients with obstructive jaundice undergoing percutaneous transhepatic catheter drainage or endoscopic nasobiliary drainage were classified into two groups, depending on the cause of obstruction: common bile duct stones (n = 7) and biliary tract tumors (n = 8). All patients in the gallstone group presented with acute cholangitis while only three patients in the tumor group had a positive bacteria culture in bile. Fasting biles were collected on the day of catheter placement and the 2nd, 4th, 6th, 8th, 10th day thereafter. The sequential changes of biliary concentration of bilirubin, phospholipid, cholesterol, bile salts and serum bilirubin were checked and compared between the two groups. RESULTS: The difference in the improvement of jaundice between the stone and tumor group (p > 0.05) were not significant, nor were the excretion of biliary contents after relief of obstruction. The reduction of serum bilirubin paralleled with the increased excretion of biliary bile salts and bilirubin (gamma = -0.51, p < 0.01 and gamma = -0.4, p < 0.05) in tumor group, but not in the stone group. CONCLUSIONS: The decrease of serum bilirubin and the sequential changes of bile contents after relief of obstruction are quite similar in stone and tumor induced obstructive jaundice.

Aged↗

PubMedDate not supplied

Chronic calcifying pancreatitis in Taiwan: a multicentric study and comparison with western countries.

BACKGROUND/AIMS: This study investigates the clinical features of chronic calcifying pancreatitis (CCP) in Taiwan and also the comparative differences in the disorder as it affects orientals and occidentals. MATERIALS AND METHODS: Medical records at seven tertiary hospitals relating to patients diagnosed with CCP between 1976 and 1996 are reviewed and analyzed. Ninety patients were enrolled. Defining the calcification of the pancreas is achieved by plain film, ultrasonography, computed tomography, or histology. RESULTS: CCP afflicts men more frequently than it does women, by a ratio of 3.5:1 (70 men and 20 women). The mean age is 45 years (male: 46 female: 41.4). For fifty-two patients (57.8%), alcohol is the major cause of the condition, while in others, the causes are non-alcoholic (idiopathic: 31; biliary: 4; hereditary: 3). Alcoholism is mainly associated with males and younger sufferers. The major complications are diabetes mellitus (53.3%), cysts or pseudocysts (21.1%), and biliary stricture or stones (20%). Pancreatic adenocarcinoma and splenic vein thrombosis were found in six and five patients, respectively. Three patients died from cancers of other than pancreatic origin (lung: 1;liver: 1;bile duct: 1). Thirty-three patients were treated surgically of which thirteen (39.4%), including one with pancreatic auto transplantation, improved. Fifty-seven patients received medical treatment but only eleven (19.3%) improved. CONCLUSIONS: The clinical features of CCP in Taiwan are notably similar to those manifesting in western countries and in Japan. With the changes in life style and increased alcoholic consumption in Taiwan, the prevalence of CCP may increase and its demographic features may alter in the future.

Adolescent↗

PubMedDate not supplied

Implications of serum basic fibroblast growth factor levels in chronic liver diseases and hepatocellular carcinoma.

Angiogenesis occurs in response to tissue damage, and is of vital importance for tumor growth and metastasis. Basic fibroblast growth factor (bFGF), a well-known angiogenic factor, has been suggested to be a useful diagnostic marker in certain hypervascular tumors. However, the relevance of its detection has not been well evaluated in patients with hepatocellular carcinoma (HCC) and benign chronic liver diseases. In the current study, immunoassay of bFGF was performed on serum samples from 39 patients with HCC, 21 with liver cirrhosis, 22 with chronic hepatitis and 40 normal subjects. The serum bFGF level was significantly increased in patients with liver cirrhosis and HCC when compared with those with chronic hepatitis or normal subjects (all p-values < 0.001). However, no difference was observed between the groups with liver cirrhosis and HCC (p > 0.05). If we set 9.6 pg/ml (mean + 3 standard deviations of bFGF in the control group) as the upper limit of normal serum level of bFGF, elevated bFGF concentrations were noted in 9.1%, 42.9% and 51.3% of patients with chronic hepatitis, liver cirrhosis and HCC respectively. In non-cancer patients, the coexistence of acute illness (p = 0.000) was an independent factor related to the elevation of serum bFGF. On the other hand, a multivariate analysis demonstrated that both advanced stage of cancer (p = 0.026) and coexistence of acute illness (p = 0.000) influence the serum level of bFGF in patients with HCC. We conclude that serum bFGF levels are significantly higher in patients with HCC and are positively correlated with advanced tumor stage. Nevertheless, elevation of serum bFGF may also be observed in a significant number of patients with liver cirrhosis. Therefore, measurement of serum bFGF alone cannot be satisfactory as a tumor marker for diagnosis of HCC. In addition, it is important to point out that coexistence of acute illness may be a crucial confounding factor in the diagnosis or monitoring of any cancer by the estimation of serum bFGF.

Adult↗

PubMedDate not supplied

Indicators of liver excretory function in patients undergoing biliary decompression for obstructive jaundice.

BACKGROUND/AIMS: The recovery of liver function after biliary drainage in patients with obstructive jaundice may be different depending on the severity and duration of the obstruction. We conducted this study to determine whether there are any clinical factors that can be used to monitor the course of recovery. METHODOLOGY: Serum and bile from 12 patients were collected for biochemical testing on the day of drainage and every 3 days for 6 days. Liver function was evaluated by the indocyanine green retention test (ICG R15) before and 6 days after decompression. Patients with an ICG R15 reduction ratio of less than 50% were considered to have a poor recovery (group 1, n = 6), while a good recovery was indicated by a reduction ratio higher than 50% (group 2, n = 6). Sequential data were compared between the groups and correlated with the results of the ICG test. RESULTS: After drainage, the patients in group 1 had less bile acid excretion on day 3 (1.0 +/- 0.8 vs. 3.4 +/- 1.1 mmol/day, p < 0.05), a slower reduction ratio of serum bilirubin on day 3 (0.38 +/- 0.14 vs. 0.60 +/- 0.12, p < 0.05) and more biliary output on day 6 (1.11 +/- 0.25 vs. 0.60 +/- 0.25 L/day, p < 0.05). The ICG R15 reduction ratio was well correlated with the bilirubin reduction ratio, the bile volume and the amount of excreted bile acids checked on day 3 (gamma = 0.73, -0.71 and 0.74, respectively, p < 0.01). CONCLUSIONS: The presence of choleresis implies ductular cell hyperplasia, while decreased excretion of bile acids and a slow reduction of hyperbilirubinemia represents severe liver damage. Both conditions are sequelae of prolonged obstruction; therefore, they might indicate a long and poor recovery.

Aged↗

PubMedDate not supplied

Liver volume in patients with or without chronic liver diseases.

BACKGROUND/AIMS: The size of the liver is an important clinical parameter; the aim of this study is to examine the correlation between liver volume and etiology and the severity of disease, and to evaluate its usefulness in predicting survival. METHODOLOGY: Patients observed in this study were comprised of thirty three patients with non-liver disease and 44 patients with chronic liver disease (alcoholic hepatitis, 9; hepatitis B, 24; and hepatitis C, 11). The liver volume was measured from digitized CT scan images. Techniques of planimetry and summation of areas were utilized for calculation. RESULTS: The prediction model to estimate liver volume in patients without liver disease was: liver volume (ml)= [13 x height (cm)] +[12 x weight (Kg)] - 1530. The volume ratio (%) [(volume from reconstructed image /predicted volume) x 100] of alcoholic patients was 135.9+/-25.8, which was significantly higher than that of chronic hepatitis B (73.6+/-15.4) and chronic hepatitis C (74.5+/-20.7). Patients with chronic viral hepatitis were classified into Child-Pugh class A (N=10), B (N=14) and C (N=11). Analysis of variance and trend test revealed that the volume ratio had a significant decreasing trend from the control group (100.5+/-8.1), class A (83.4+/-13.9), class B (72.2+/-13.2) to class C (63.3+/-14.4). CONCLUSIONS: Liver volume can be predicted from patients' weight and height if they have no liver disease. The liver volume ratio correlates much better with etiology and severity of the disease and is a reliable predictor for patient's survival.

Adult↗

PubMedDate not supplied

Eradiction of H. pylori results in regression of B-cell low grade gastric MALToma with evident B-symptoms.

Although it is well known that eradication of H. pylori may result in either complete or partial regression of low-grade B-cell mucosa-associated lymphoid tissue lymphoma (MALToma), it would be of clinical interest to determine whether the B-symptoms of patients with MALToma could be relieved by eradication of H. pylori. Here, we report on a 29 year-old female case with B-cell low-grade gastric MALToma with apparent B-symptoms. Her peripheral blood also disclosed large granular lymphocytes (LGL). The B-symptoms of this patient were quickly relieved within 2 weeks after starting an anti-H. pylori regimen; peripheral blood LGLs were clearly decreased as well. Complete regression of MALToma was determined 4 months after the anti-H. pylori regimen. Thereafter, the patient has been disease-free and in good general condition during a 2-year follow-up.

Adult↗