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Biomedical subjects

I S Sheen

Publications and source records attributed to I S Sheen.

At least 91 records · Page 5Linked to original sources
PubMed1989

Resolution of liver abscesses: comparison of pyogenic and amebic liver abscesses.

To examine the resolution of liver abscesses, a prospective ultrasonographic follow-up study was conducted in 51 patients, each with a solitary abscess (26 pyogenic and 25 amebic) which had been treated successfully by non-surgical measures. The rate of complete abscess resolution for each of the initial 6 months was 0%, 5%, 10%, 23%, 30%, and 30% in the amebic group; and 20%, 54%, 77%, 89%, 94%, and 94% in the pyogenic group. The absorption volume of the pyogenic group in the first month was also greater than that of the amebic group (3.0 +/- 5.0 ml/day vs. 1.1 +/- 0.8 ml/day, P less than 0.05). The resolution ratio of pyogenic and amebic liver abscesses in the first month was 74% +/- 38% and 36% +/- 23%, respectively. In 3 patients in the amebic group, the abscess was still detectable 2 years after treatment. These results suggest that pyogenic liver abscesses resolve more rapidly than amebic abscesses. These findings should be considered in the differential diagnosis of asymptomatic space-taking lesion in the liver.

Actuarial Analysis↗
PubMed1988

Treatment of chronic type B hepatitis in Southeast Asia.

In Southeast Asia, 15 to 20 percent of the population are hepatitis B surface antigen carriers. The majority of these carriers have chronic hepatitis and would progress to cirrhosis or hepatocellular carcinoma at an annual incidence of 2 percent and 1 percent, respectively. Previous studies from Southeast Asia suggested that immunosuppressive therapy could be harmful, or at best of no value, and antiviral treatment with vidarabine, picibanil, or even interferon was also unsatisfactory. Currently, a randomized controlled trial of human lymphoblastoid interferon, with or without prednisolone pretreatment, versus placebo in patients with hepatitis B core antigen in the liver and hepatitis B e antigen in the serum is being conducted. Forty-five patients (29 receiving interferon, 16 receiving placebo) have been entered in the trial for at least two months. Actuarial analysis shows that the response to interferon therapy was better than that to placebo. Although flu-like symptoms, hair loss, and body weight loss were seen, no side effect requiring specific treatment has been encountered. These preliminary results suggest that human lymphoblastoid interferon is effective and safe in Oriental patients.

Asia, Southeastern↗
PubMed1988

Different implications of stigmata of recent hemorrhage in gastric and duodenal ulcers.

A prospective study was conducted to evaluate the prognostic value of stigmata of recent hemorrhage in patients with bleeding peptic ulcer. Of 193 patients suffering from peptic ulcer bleeding identified by emergency gastrointestinoscopy, 52 patients were found to have bleeding gastric ulcer (spurt 5, active oozing 9, fresh clot 11, black clot 17, protruding vessel 4, and clear base without stigmata 6); the other 141 had bleeding duodenal ulcer (spurt 5, active oozing 26, fresh clot 43, black clot 23, protruding vessel 15, and clear base without stigmata 31). Patient with continuous bleeding or rebleeding was grouped as unstable bleeders. The rate of unstable bleeders was 39.1% (continuous bleeding 23.9% and rebleeding 15.2%) in patients with gastric ulcer, compared to 9.0% (4.5% and 4.5%) in duodenal ulcer (P less than 0.001). The unstable bleeder rate of ulcers with spurt, active oozing, clot, and protruding vessel was 80%, 44%, 35.7%, and 0%, respectively, in patients with bleeding gastric ulcer; and 33.3%, 19.2%, 6%, and 0%, respectively, in patients with bleeding duodenal ulcer. The data suggest that the stigmata of recent hemorrhage, excluding protruding vessel, has prognostic significance in bleeding gastric ulcer but less in bleeding duodenal ulcer.

Duodenal Ulcer↗
PubMed1987

Diagnosis of acute type B hepatitis by a solid phase u-antibody capture radioimmunoassay for IgM class antibody to hepatitis B core antigen: a diagnostic proposal based on a prospective study.

The diagnostic and prognostic significance of IgM anti-HBc, studied by a solid phase u-antibody capture radioimmunoassay at a serum dilution of 1:4000, was prospectively evaluated in 73 adult patients with acute hepatitis seropositive for hepatitis B surface antigen (HBsAg). Of the 73 cases, 20 (27.4%) cleared their HBsAg within 6 months, while the remaining 53 (72.6%) did not. HBsAg seroconversion to its antibody occurred in 15 (93.8%) of the 16 patients positive for IgM anti-HBc with S/N ratios above 5.0, as did 5 (26.3%) of the 19 with S/N ratios between 2.1 to 5.0, and none (0%) of the 38 negative for IgM anti-HBc (S/N ratios less than 2.1). Therefore, a S/N ratio of IgM anti-HBc above 5.0 is diagnostic for acute type B hepatitis. However, low S/N ratios (2.1-5.0) of IgM anti-HBc were observed in the early stage of some patients with acute type B hepatitis, and would increase to a level greater than 5.0 when assayed again 1-2 weeks later. It was therefore suggested that repeated testing of anti-HBc IgM is mandatory for accurate diagnosis of acute type B hepatitis in patients whose initial serum specimens showed low S/N ratios of IgM anti-HBc. According to this criterion, only 22 (30.1%) of the 73 patients with acute hepatitis seropositive for HBsAg in Taiwan were true acute type B hepatitis, of whom 2 (9.1%) subsequently became chronic HBsAg carriers, while the remaining 51 (69.9%) were chronic HBsAg carriers with other superimposed forms of acute hepatic injury.

Adult↗
PubMed1987

Hepatitis delta virus infection in Taiwan.

In Taiwan the prevalence of anti-Delta was low among asymptomatic HBsAg carriers, patients with HCC and acute type B hepatitis, intermediate in HBsAg carriers on hemodialysis, patients with chronic type B hepatitis and liver cirrhosis, particularly HBeAg negative ones, and very high in intravenous drug abusers. It is important to prevent the spread of HDV infection in this hyperendemic area of HBV.

Carrier State↗
PubMed1986

Early detection of hepatocellular carcinoma in patients with chronic type B hepatitis. A prospective study.

A prospective surveillance of hepatocellular carcinoma (HCC) using serum alpha-fetoprotein and high-resolution, linear-array, real-time ultrasonography was carried out in 432 patients with clinicopathologically proven chronic type B hepatitis. During a follow-up period of 6-85 mo (median 23, mean 26.9 +/- 16.8 mo), asymptomatic HCC was identified in 8 patients, with a calculated annual incidence of 826/100,000, and 2768/100,000 for patients over age 35 yr. The relative risk of developing HCC in hepatitis B surface antigen-positive chronic hepatitis patients was 2 when compared to those that were hepatitis B surface antigen-negative, and was 5 when compared in patients over age 35 yr. Hepatocellular carcinomas detected by these methods were in a relatively early stage as most tumors were small, only 50% were associated with cirrhosis, 37.5% were positive for hepatitis B e antibody, and most were still resectable. We, therefore, recommend a combination of alpha-fetoprotein and ultrasonography surveillance in patients with chronic hepatitis in order to improve the chance of early HCC detection as well as the chance for successful resection. In addition, the low incidence of cirrhosis and hepatitis B e antibody in these patients with "early" HCCs and the occurrence of hepatitis B e antigen/hepatitis B e antibody seroconversion after HCC had developed suggest that the development of HCC and progression from hepatitis to cirrhosis were two independent (though related) sequelae of chronic hepatitis B virus infection.

Adolescent↗
PubMed1985

Hepatic decompensation associated with hepatitis B e antigen clearance in chronic type B hepatitis.

To examine hepatic decompensation associated with acute exacerbation preceding hepatitis B e antigen clearance in chronic type B hepatitis, 376 patients with chronic hepatitis who were hepatitis B e antigen-positive were prospectively studied for up to 7 yr (mean 25 mo). Among the 165 patients who underwent hepatitis B e antigen clearance, 4 patients experienced hepatic decompensation and one of them eventually developed hepatic encephalopathy and died. The incidence of hepatic decompensation associated with hepatitis B e antigen clearance was 2.4%. We suggest that such an event in previously unrecognized chronic hepatitis B carriers could have been erroneously interpreted as acute or subacute hepatic failure, and that it might have been the result of a stronger enhancement of the host immune response.

Acute Disease↗
PubMed1985

Correlation of age with the status of hepatitis B virus replication and histological changes in chronic type B hepatitis.

The interrelationships of age, hepatitis B virus (HBV)-DNA, hepatitis B e antigen (HBeAg)/antibody (anti-HBe) and hepatic histological changes were examined in a large series of patients with chronic type B hepatitis. A significant inverse relationship between serum levels of HBV-DNA and the age of patients was demonstrated:a high level of HBV-DNA (greater than 500 pg/ml) was found in 100%, 50%, 34%, 10% and 0% of patients in the second, third, fourth, fifth and sixth decade, respectively (P less than 0.001), whereas serum HBV-DNA was negative in 0%, 6%, 8%, 40%, and 50% of cases in the respective decades (P less than 0.001). The correlation of HBV-DNA with age was more pronounced in the HBeAg-negative cases, of whom 81.3% (13/16) of patients below age 40 were positive for HBV-DNA, in contrast to 33.3% (3/9) of those over 40 years (P less than 0.05). In addition, the mean age increased from 25.3 years for HBeAg-positive patients with chronic persistent hepatitis (CPH) and nonspecific reactive histological changes (NSRH), to 32.7 years for HBeAg-positive and 34.9 years for anti-HBe positive patients with chronic active hepatitis and chronic lobular hepatitis (P less than 0.001), and 40.9 years for anti-HBe positive CPH and NSRH (P less than 0.001). These data suggested that age correlated closely with the status of HBV replication and hepatic changes in chronic type B hepatitis.

Adolescent↗
PubMed1984

Hepatocellular carcinoma in noncirrhotic patients. A laparoscopic study of 92 cases in Taiwan.

Clinical and laboratory findings of 92 cases of pathologically verified noncirrhotic primary hepatocellular carcinoma (HCC) were analyzed and compared with that of 174 cases of cirrhotic HCC during the same period. Ninety-two cases of noncirrhotic HCC constitute one third of all the cases of HCC. They comprised 74 men (80.4%) and 18 women (19.6%) with a male:female ratio of 4.1. The mean age was 52.0 +/- 14.5 years. Among them, 17.4% had a history of hepatitis; 65.2% were HBsAg positive. Compared with cirrhotic HCC, patients with noncirrhotic HCC had less frequent past history of hepatitis, lower positive rate for HBsAg, higher albumin/globulin ratio, and lower frequency in the elevation of serum alpha-fetoprotein. The results might imply that noncirrhotic and cirrhotic HCC have different pathogenetic backgrounds.

Adolescent↗