Biomedical subjects

Chi-Sin Changchien

Publications and source records attributed to Chi-Sin Changchien.

59 records · Page 4Linked to original sources

PubMedDate not supplied

Cellular interpretation of hepatocellular carcinoma by using cell blocks technique.

BACKGROUND/AIMS: The purpose of this study was to investigate the cellular interpretation of hepatocellular carcinoma in specimens obtained by needle aspiration with preparation of cell blocks. METHODOLOGY: We consecutively collected 58 patients who were histologically proved to have hepatocellular carcinoma. Corresponding to the size of hepatocellular carcinoma, the cellular dysplasia of specimens obtained by both aspirations with cell blocks and conventional liver biopsy from each hepatocellular carcinoma was investigated according to Edmondson-Steiner 's grading (Gr). RESULTS: Of 16 small hepatocellular carcinomas (diameter < 3.0 cm), the occurrence rate of dysplasic grading of Gr-I, Gr-II, Gr-III and Gr-IV was 31.3%, 43.8%, 18.8% and 6.3% in aspiration with cell blocks, and 46.2%, 38.5%, 15.4% and 0.0% in liver biopsy respectively. There was no Gr-I of cellular dysplasia in the 15 moderate size (3.1-6.0 cm) and 27 large size (> 6.1 cm) hepatocellular carcinomas. The occurrence rate of Gr-III cellular dysplasia in small hepatocellular carcinoma was lower than that in large hepatocellular carcinoma (18.8% vs. 55.6%, p = 0.019). The larger the tumor is, the more poorly differentiated it became. Four of six histologic false-negative hepatocellular carcinoma in aspiration with cell blocks were large size hepatocellular carcinoma (> 6.5 cm in diameter) with necrosis. CONCLUSIONS: These results suggest that the interpretation of the cell grading of hepatocellular carcinoma by aspiration with cell blocks is not inferior to that by conventional liver biopsy. This technique seems to provide another route to study the cellular dysplasia of hepatocellular carcinoma in living patients even to follow-up their treatment response.

Adult↗

PubMedDate not supplied

One-week low-dose triple therapy without anti-acid treatment has sufficient efficacy on Helicobacter pylori eradication and ulcer healing.

BACKGROUND/AIMS: The aim of this study was to determine the efficacy of a 1-week low-dose proton pump inhibitor-based triple therapy without further acid suppression for cure of Helicobacter pylori infection and the ulcer healing in peptic ulcer disease. METHODOLOGY: Patients with endoscopically proven peptic ulcers who were H. pylori positive participated in this study. All patients were treated for 1 week with omeprazole 20 mg b.d., clarithromycin 250 mg b.d. and tinidazole 500 mg b.d., then patients were treated randomly for another 4 weeks with either omeprazole 20 mg once daily (OCM-O group; n = 40) or without acid suppressing agents (OCM group; n = 39). Patients were investigated endoscopically for H. pylori and ulcer status before treatment, four weeks (week 5) and 8 weeks later (week 9) after anti-H. pylori treatment. H. pylori infection was assessed by rapid urease test and histology. RESULTS: The eradication rates of H. pylori were 72.5% (95% CI: 59-86%) and 76.3% (95% CI: 63-90%) by intention-to-treat analysis and by per protocol analysis respectively in the OCM-O group and were 87.2% (95% CI: 77-98%) and 97.1% (95% CI: 92-100%) by intention-to-treat analysis and by per protocol analysis respectively in the OCM group (p < 0.05 in per protocol analysis). In respect to ulcer healing status at week 5, 89.5% (34/38) of patients in the OCM-O group and 80% (28/35) of patients in the OCM group had healed ulcers; at week 9, 86.8% (33/38) of patients in the OCM-O group and 88.6% (31/35) of patients in the OCM group had healed ulcers (p = NS). When the ulcer status was analyzed in relation to the H. pylori status, at week 5 ulcer had healed in 84.4% (54/64) of patients with clearance of H. pylori infection and in 88.9% (8/9) of those with persistent infection. At week 9, ulcer healing increased up to 93.8% (60/64) of patients with clearance of H. pylori infection and decreased to 44.4% (4/9) of patients with persistent infection. The adverse events (20%) were mild in these two treatment groups and no patients required discontinuation of the study medications. CONCLUSIONS: Continuation of antisecretory drug therapy beyond a one-week low-dose triple therapy consisting of omeprazole, clarithromycin and tinidazole is actually excessive regarding eradication efficacy and peptic ulcer healing.

Adult↗

PubMedDate not supplied

Correlations between hepatitis B virus genotype and cirrhotic or non-cirrhotic hepatoma.

BACKGROUND/AIMS: Hepatoma arising in cirrhotic and non-cirrhotic livers might have different virological and clinical factors in hepatitis B virus carriers. This study was performed to elucidate the correlation between hepatitis B virus genotypes and clinical characteristics of patients with cirrhotic and non-cirrhotic hepatoma. METHODOLOGY: One hundred and fifty-five hepatitis B virus carriers who received hepatic resection for hepatoma were investigated to determine hepatitis B virus genotypes and clinical features. RESULTS: Of 155 patients, 84 were genotype B infection, and 67 genotype C. Compared to genotype C carriers, genotype B analogs had a significantly lower rate of liver cirrhosis (p=0.005), lower hepatitis B e antigen positive rates (p=0.0008), and lower fibrosis scores (p=0.003). In comparison to cirrhotic hepatoma patients, non-cirrhotic counterparts were younger (p=0.041), had a higher platelet count (p<0.001), lower hepatitis B e antigen positive rates (p=0.023), predominantly genotype B (p=0.005), lower inflammation scores (p<0.001). Using multivariate analysis, non-cirrhotic hepatoma was associated with genotype B infection (OR=2.85, 95% CI=1.44-5.64) and younger age (OR=0.967, 95% CI=0.94-0.99) in hepatitis B virus carriers. CONCLUSIONS: Our study suggested that hepatitis B virus genotype B infection might be an important factor for non-cirrhotic hepatoma.

Adult↗

PubMedDate not supplied

Telomerase activity and telomerase catalytic subunit in hepatocellular carcinoma.

BACKGROUND/AIMS: Telomerase activation has been found in most malignant tumors. Human telomerase reverse transcriptase is a catalytic subunit of human telomerase and a rate-limiting factor of the enzymatic activity of telomerase. The present study was designed to examine the usefulness of detecting human telomerase catalytic subunit mRNA and telomerase activity as a molecular diagnostic marker for human liver cancers. METHODOLOGY: Thirty-one specimens of hepatocellular carcinoma and corresponding adjacent tissues were analyzed for human telomerase reverse transcriptase expression by reverse transcription polymerase chain reaction and for telomerase activity by polymerase chain reaction-based telomeric repeat amplification protocol. RESULTS: Human telomerase reverse transcriptase mRNA expression was observed in 97% of hepatocellular carcinoma tissues, in contrast none of the non-tumorous liver tissues did. Telomerase activity was detected in 94% of hepatocellular carcinoma and in only 16% of adjacent liver tissues. Human telomerase reverse transcriptase mRNA expression and telomerase activity were observed in all 3 grade I (well-differentiated) hepatocellular carcinoma. Significant correlations between human telomerase reverse transcriptase mRNA expression and hepatocellular carcinoma and also between telomerase activity and HCC were found (both p<0.001). CONCLUSIONS: The results indicate that human telomerase catalytic subunit mRNA expression and telomerase activity might be associated with hepatocellular carcinogenesis and could be as markers for diagnosis of hepatocellular carcinoma.

Adult↗

PubMedDate not supplied

One-week versus two-week H2-receptor antagonist in combination with amoxicillin and tinidazole for eradication of Helicobacter pylori infection.

BACKGROUND/AIMS: Eradication regimens combining two antibiotics with a proton pump inhibitor have been studied intensively in Helicobacter pylori (H. pylori) infection; however, only a few reports have focused on the role of H2-receptor antagonists (H2-RAs) in eradication therapy. The mechanism involved in the synergy between antibiotics and H2RAs are still elusive. So we compared the efficacy of two regimens: a 1-week or 2-week course of high-dose H2-RA-based triple therapy in patients with H. pylori infection, and assessed the impact of primary resistance for metronidazole on the treatment outcome. METHODOLOGY: One hundred and twenty patients with peptic ulcers and nonulcer dyspepsia were randomly assigned to a one-week course of famotidine 40mg b.i.d., amoxicillin lg b.i.d. and tinidazole 500 mg b.i.d. (FAT1 group; n = 60) or a 2-week course of famotidine 40 mg b.i.d., amoxicillin lg b.i.d. and tinidazole 500 mg b.i.d. (FAT2 group; n = 60). Upper endoscopy was performed prior to treatment and at least 4 weeks after completion of treatment and discontinuation of the antisecretory therapy. H. pylori status was assessed by biopsy urease test, histology and culture. RESULTS: In the intention-to-treat analysis, eradication of H. pylori was achieved in 38 of 60 patients (63.3%; 95% CI: 51-76%) in the FAT1 group, compared to 48 of 60 patients (80%; 95% CI: 70-92%) in the FAT2 group (NS). In the per protocol analysis, eradication therapy was achieved in 38 of 54 patients (70.4%; 95% CI: 58-82%) in the FAT1 group and 48 of 53 patients (90.6%; 95% CI: 83-98%) in the FAT2 group (p < 0.05). The overall eradication rates for strains susceptible and resistant to metronidazole were 79.7% (95% CI: 71-89%) vs. 60% (95% CI: 44-74%) in the intention-to-treat analysis (p = 0.016) and 84% (95% CI: 76-92%) vs. 71.9% (95% CI: 56-88%) in the per protocol analysis (p = 0.12). Seven patients in the FAT1 group and six patients in the FAT2 group available for follow-up reported adverse events (11.7% and 10% respectively) without necessity of discontinuation of the study medications. Serious adverse events were not observed. CONCLUSIONS: A 2-week course of high-dose H2-RA-based triple therapy is well tolerated and sufficiently effective in eradicating H. pylori infection. Presence of metronidazole resistance has a negative impact on the treatment efficacy.

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