PubMed Health⌕ Search

Biomedical subjects

K J Lo

Publications and source records attributed to K J Lo.

At least 73 records · Page 4Linked to original sources
PubMed1989

Serum C-reactive protein as a serum marker for the diagnosis of hepatocellular carcinoma.

An abnormal serum C-reactive protein (CRP) level (greater than 10 mg/l) was found in 78% of 104 patients with hepatocellular carcinoma (HCC), 8% of 12 asymptomatic hepatitis B surface antigen carriers, 5% of 77 patients with chronic hepatitis, and 9% of 55 cirrhotic patients without complications. It was also discovered in 72% of 25 cirrhotic patients complicated with bacterial infections, gastrointestinal bleeding, hepatic encephalopathy, or massive ascites, 67% of nine common bile duct stone patients, and 79% of 14 patients with malignancies other than HCC. A dramatic decrease in serum CRP levels was found in two HCC patients receiving a successful surgical tumor resection, four cirrhotic patients recovering from complications, and all six patients with common bile duct stones and cholangitis controlled by antibiotics, but not in untreated HCC or other malignancy patients. Serum alpha-fetoprotein (AFP) levels correlated poorly with CRP levels. A combination of these two serum markers identified 94% of 104 patients with HCC. Since serum CRP levels were also abnormal in 57% of 14 patients with resectable HCC (less than or equal to 5 cm), in conjunction with AFP, it may be useful in the diagnosis of HCC or other malignancies.

Adult↗
PubMed1989

HBsAg carrier infants with serum anti-HBc negativity.

A total of 128 HBsAg carrier infants born to HBeAg-positive HBsAg carrier mothers were tested for serum HBsAg, HBeAg, hepatitis B virus DNA and anti-HBc. Ninety-three of them had received hepatitis B vaccination. Anti-HBc had been found to be negative in sera of 12 infants who were HBsAg, HBeAg and hepatitis B virus DNA positive during the follow-up period of 3 to 5 years. Liver damage, as measured by serum ALT levels, was found to be normal among the 12 HBsAg carrier infants with serum anti-HBc negativity, whereas 39.7% of the 116 anti-HBc-positive HBsAg carrier infants had abnormal ALT levels during the follow-up period. Anti-HBe and anti-HBs also were not detected in sera of these anti-HBc-negative HBsAg carrier infants. Thus, HBsAg carrier infants with anti-HBc negativity probably result from immune incompetency of the hepatitis B virus antigens.

Carrier State↗
PubMed1989

Lack of effects of isosorbide-5-mononitrate on hepatic hemodynamics in HBsAg-positive cirrhosis.

We conducted a randomized controlled hemodynamic study to evaluate the effect of placebo and 20 mg isosorbide-5-mononitrate, a long-acting organic nitrate, in 19 patients with HBsAg-positive cirrhosis by the simultaneous measurement of portal venous pressure and wedged hepatic venous pressure. Baseline values for the two groups were similar. One hour after oral administration of 20 mg isosorbide-5-mononitrate in 10 patients, mean arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure significantly decreased from 92 +/- 13 (mean +/- S.D.) to 82 +/- 14 mmHg, from 12.9 +/- 4.5 to 9.3 +/- 2.4 mmHg and from 6.9 +/- 3.4 to 4.3 +/- 1.8 mmHg, respectively. However, both portal venous pressure gradient (from 18.1 +/- 3.6 to 17.5 +/- 3.0 mmHg) and hepatic venous pressure gradient (from 17.8 +/- 5.2 to 16.6 +/- 5.3 mmHg) remained unchanged during the study. In six patients who received 20 mg isosorbide-5-mononitrate twice daily for 7 days, hepatic venous pressure gradient remained unaltered as compared to basal and 1-hr values. There was no significant change in cardiac index, heart rate or systemic vascular resistance in either immediate (1-hr) or delayed (7-day) studies. Three patients (30%) developed mild headache or dizziness and two patients (20%) demonstrated systolic hypotension (less than mmHg) during the immediate study. This study shows that isosorbide-5-mononitrate appears to have no effect in treating portal hypertension in patients with HBsAg-positive cirrhosis. In addition, the isosorbide-5-mononitrate may affect the systemic circulation more than the portal circulation.

Aged↗
PubMed1989

Comparison between portal vein pressure and wedged hepatic vein pressure in hepatitis B-related cirrhosis.

Portal vein pressure and wedged hepatic vein pressure were measured simultaneously in 21 patients with hepatitis B-related cirrhosis of the liver and were compared to pressure measured in six patients with idiopathic portal hypertension. No significant difference in the portal venous pressure gradient was found between patients with cirrhosis and those with idiopathic portal hypertension (17.3 +/- 4.3 mmHg (mean +/- S.D.) vs. 19.7 +/- 3.1 mmHg, P greater than 0.05). However, the difference between the portal and the hepatic venous pressure gradient was significantly smaller in patients with cirrhosis than in idiopathic portal hypertension patients (1.3 +/- 1.7 vs. 10.8 +/- 2.1 mmHg, P less than 0.001). An excellent correlation was found between portal vein pressure and wedged hepatic vein pressure in hepatitis B-related cirrhosis (r = 0.94, P less than 0.001). There was no linear relationship between the portal venous pressure gradient and varix size or bleeding episodes. We concluded that a close agreement existed between portal vein pressure and wedged hepatic vein pressure in hepatitis B-related liver cirrhosis. Therefore, measurement of wedged hepatic vein pressure reliably reflects portal vein pressure in these patients.

Aged↗
PubMed1989

Application of des-gamma-carboxy prothrombin as a complementary tumor marker with alpha-fetoprotein in the diagnosis of hepatocellular carcinoma.

By means of staphylocoagulase, plasma des-gamma-carboxy prothrombin (DCP) was measured in 255 subjects. Of these, 59 were healthy controls, 100 had primary hepatocellular carcinoma (PHC), 33 had cirrhosis of the liver, 16 had hepatitis, 11 had metastatic carcinoma of the liver (MCL), and 36 subjects had previously been treated with anti-vitamin K drugs. The mean plasma DCP level in the healthy subjects was 3.02 VGH U/l. Of PHC patients 80% had DCP levels greater than 6 VGH U/l, which we regarded as probably abnormal. None of the patients with benign liver diseases (cirrhosis of liver or hepatitis) had DCP greater than 10 VGH U/l. Of the patients with MCL 54.54% had DCP greater than 6 VGH U/l. In our study DCP was found to be as sensitive a tumor marker as alpha-fetoprotein (AFP) in the diagnosis of PHC and was better in distinguishing PHC from benign liver disease. Of PHC patients 92% had at least one of the two tumor markers. Simultaneous determination of DCP and AFP should be applied in mass survey programs for detecting PHC, especially in countries with a high prevalence of hepatitis B virus infection.

Biomarkers↗
PubMed1989

Clinical significance of serum type-III procollagen aminopropeptide in hepatitis B virus-related liver diseases.

Serum type-III procollagen aminopropeptide (PIIIP) has been considered a marker of hepatic fibrogenesis. In an attempt to evaluate the clinical significance of serum PIIIP in patients with hepatitis B virus (HBV)-related liver diseases, the levels of the peptide were measured in 66 healthy adults and 200 patients with HBV-related liver diseases. As compared with the healthy adults (12.3 +/- 3.1 ng/ml), the serum PIIIP levels were significantly elevated in patients with acute hepatitis (17.4 +/- 6.6 ng/ml), chronic persistent hepatitis (18.3 +/- 4.9 ng/ml), and inactive liver cirrhosis (22.1 +/- 7.1 ng/ml). The PIIIP levels in patients with chronic active hepatitis (CAH) (33.9 +/- 23.1 ng/ml) were the highest among HBV-related liver diseases and had a tendency to increase with the severity of CAH. Of the liver-diseased patients with serum PIIIP levels greater than 30 ng/ml, 91% had a recent episode of severe hepatocellular damage, whereas 56% of patients with greatly elevated serum liver aminotransferase levels had no associated high increase in serum PIIIP levels. Thus, we suggest that fibrogenesis in HBV-related liver diseases is initiated by severe hepatocellular damage, but liver damage can also take place without prominent hepatic fibrogenesis. Serum PIIIP may be a serum marker to predict the active fibrogenesis of HBV-related liver diseases.

Adult↗
PubMed1988

Role of caesarean section in prevention of mother-infant transmission of hepatitis B virus.

447 infants, born to mothers positive for hepatitis B e antigen and hepatitis B surface antigen (HBsAg), received hepatitis B immunisation. A higher rate of hepatitis B virus (HBV) infection was found at birth in infants delivered vaginally (96/385, 24.9%) than in infants delivered by caesarean section (6/62, less than 10%). At birth, serum HBV-DNA was detected in 13 of 67 infants delivered vaginally, but in none of 30 infants delivered by caesarean section. Caesarean section combined with hepatitis B immunisation is advisable in infants of mothers who are chronic HBsAg carriers with high serum HBV-DNA levels.

Cesarean Section↗
PubMed1988

Symptomatic anti-HBe positive chronic hepatitis B in Taiwan with special reference to persistent HBV replication and HDV superinfection.

Ninety-four patients, who were admitted with symptoms of liver disease and found to be positive for hepatitis B surface antigen and antibody to hepatitis B e antigen (anti-HBe), were examined for hepatitis B virus (HBV) DNA in serum and immunoglobulin antibody to hepatitis B core antigen and liver biopsies were stained for hepatic hepatitis B core antigen. Of 94 patients, 34 (36%) had evidence of HBV replication and 35 (37%) evidence of hepatitis D virus (HDV) superinfection. Most of the latter two groups of patients (greater than 70%) had evidence of chronic active hepatitis or active cirrhosis in their liver biopsies. The majority of these patients (greater than 80%) also had high levels of serum alanine aminotransferase (greater than 200 U/L) during the acute stage of their illness, and suffered from prolonged hepatic inflammation (greater than 1 year). Many of the patients (59%) also experienced frequent (1-6 episodes) relapsing exacerbations during a two-year follow-up period. Thus, persistent replication or reactivation of HBV and HDV superinfection were the two major causes of clinical exacerbations in anti-HBe-positive chronic HBV carriers in Taiwan, and also played an important role in the progression of their liver diseases and unfavorable outcomes.

Female↗
PubMed1988

The influence of verapamil and nifedipine on hepatic indocyanine green clearance in patients with HBsAg-positive cirrhosis and ascites.

The influence of verapamil and nifedipine on hepatic indocyanine green kinetics was studied in 12 patients with HBsAg-positive cirrhosis and ascites. Hepatic clearance and its two biologic determinants, hepatic blood flow and metabolic activity (intrinsic clearance [maximum velocity/metabolite elimination rate constant, or Vmax/km]), were determined from hepatic indocyanine green elimination at steady state in patients with cirrhosis. Acute intravenous administration 10 mg verapamil significantly increased the hepatic indocyanine green blood flow (p less than 0.05), but significantly decreased the hepatic clearance (p less than 0.05), extraction ratio (p less than 0.05) and Vmax/km (p less than 0.05). However, acute sublingual administration of 10 mg nifedipine resulted in no significant change in any parameters of hepatic elimination function. These results show that verapamil, but not nifedipine, might impair the transhepatic extraction activity of hepatocytes in patients with HBsAg-positive cirrhosis and ascites.

Aged↗
PubMed1988

Mass screening of primary hepatocellular carcinoma by alpha-fetoprotein in a rural area of Taiwan--a dried blood spot method.

A prospective survey of primary hepatocellular carcinoma (PHC) was conducted in a rural area of Taiwan using a two-site enzyme immunoassay for alpha-fetoprotein (AFP) in dried blood samples collected on filter paper. Of 1894 men over 40 years of age who were tested, 20 (1%) had AFP levels of greater than 20 ng/ml of blood on screening. Nineteen of these men received ultrasound examinations, and small PHCs were detected in 4 (21%). The remaining 15 cases had other types of hepatobiliary tract diseases, and 6 (40%) were also serum HBsAg positive. They should all be closely followed up by AFP determination and ultrasound examination of the liver. In contrast to the low resection rate of PHC in symptomatic patients who were admitted through the outpatient clinic during the period of this survey, the four cases with small PHC discovered by AFP screening had their tumors successfully removed (5/57 vs. 4/4, p less than 0.005). Our preliminary results showed that this method is a simple, sensitive and convenient assay for AFP and may be used as a first-line screening test in mass population surveillance programs for PHC, particularly in areas where PHC is highly prevalent.

Adult↗
PubMed1988

Comparison of enzyme- and radio-immunoassay kits to detect hepatitis B surface antibody response among hepatitis B vaccinees.

A total of 288 of sera was obtained from 96 hepatitis B vaccinees to test antibody to hepatitis B surface antigen (anti-HBs) by enzyme immunoassay (EIA) and radioimmunoassay (RIA), respectively. An anti-HBs titer greater than 10 mIU/mL is required for immunity; 172 (59.7%) were positive by EIA and 173 (60.1%) were positive by RIA. A correlation study of anti-HBs titers tested by these two methods showed a correlation coefficient r = 0.889 (n = 162, p less than 0.001). Of 173 serum specimens whose anti-HBs were positive by RIA, 10 were negative by EIA; those 10 had had anti-HBs titers between 11 to 20 mIU/mL by RIA. Among 172 serum specimens whose anti-HBs were positive by EIA, 9 were negative by RIA; 3 of those were between 21 to 70 mIU/mL, and 6 were between 11 to 20 mIU/mL by EIA. Of the 96 vaccinees, following first dose of hepatitis B vaccination their anti-HBs response rates were found to be 20.8% by EIA and 17.7% by RIA. Following second and third vaccinations, their anti-HBs response rates were 65.6% and 92.7% by EIA, and 71.9% and 90.6% by RIA, respectively. Thus, EIA correlates well with RIA for anti-HBs testing especially when its titers are greater than 70 mIU/ml.

Adolescent↗
PubMed1988

Effects of verapamil on estimated hepatic blood flow in patients with HBsAg-positive cirrhosis.

Acute and chronic effect of verapamil on estimated hepatic blood flow were investigated in 12 patients with HBsAg-positive cirrhosis and portal hypertension. Acute administration of verapamil results in a significant increase (8%) in estimated hepatic blood flow (p less than 0.05). However, after chronic continued administration of verapamil, the mean value of estimated hepatic blood flow remains unchanged vis-a-vis basal values. Acute and chronic use of verapamil significantly reduced the hepatic venous pressure gradient for about an average of 20% at 1 hr after drug administration (p less than 0.05) and 18% 2 weeks later (p less than 0.05). This drop was associated with a significant reduction in hepatic vascular resistance by 39% at 1 hr later and by 37% 2 weeks later. Furthermore, the drop in hepatic vascular resistance was independent of any verapamil-induced changes in systemic hemodynamics. Verapamil significantly increased the indocyanine green plasma clearance and extraction ratio after acute or chronic use of the drug. We conclude that in patients with HBsAg-positive cirrhosis, the mechanism of verapamil in reducing the hepatic venous pressure gradient is predominantly by inducing a drop in hepatic portal vascular resistance.

Hepatitis B Surface Antigens↗
PubMed1987

A mass vaccination program in Taiwan against hepatitis B virus infection in infants of hepatitis B surface antigen-carrier mothers.

To combat hepatitis B virus (HBV) infection in Taiwan, a mass immunoprophylaxis program was launched on July 1, 1984, aiming first at prevention of chronic HBV carriage from perinatal mother-to-infant infection. In the first 15-month period, 352,721 (78%) of 450,585 pregnant women were screened for hepatitis B surface antigen (HBsAg); HBsAg was present in 62,359 (18%), with 50% of them categorized as highly infectious. Infants born to HBsAg-positive women were given 5 micrograms of a plasma-derived hepatitis B vaccine at ages 1, 5, and 9 weeks, with a booster at age 12 months. Infants of highly infectious carrier mothers received an additional 0.5 mL of hepatitis B immune globulin within 24 hours after birth. The coverage rate of the hepatitis B immune globulin was 77% in 27,375 infants born to highly infectious mothers, and that of the first, second, third, and the fourth doses of vaccine was 88%, 86%, 84%, and 71%, respectively, in infants of 55,620 carrier mothers. The reported untoward reactions to immunization were negligible. We conclude that a mass hepatitis B vaccination program is feasible in hyperendemic areas such as Taiwan; this should be a significant step toward the effective control of HBV infection in these areas.

Carrier State↗
PubMed1987

Hepatitis B vaccination in healthy Chinese adults with low dose regimens.

Three hundred seronegative healthy Chinese adults were divided randomly into three groups to receive 5, 2 and 1 micrograms of Pasteur's hepatitis B vaccine on a four dose schedule. No difference between the three groups was observed in the antibody to hepatitis B surface antigen (anti-HBs) response rate (96, 92 and 94%, respectively) a month following the fourth dose of vaccination. Young vaccinees had a faster and higher anti-HBs response than older ones. There was no difference in antibody response rate by sex. This study shows a good immunogenic effect for low dose hepatitis B vaccine in Chinese adults. The use of low dose (1 microgram) hepatitis B vaccine in susceptible adults would make mass hepatitis B vaccination more economically feasible.

Adult↗
PubMed1987

Lack of effects of nifedipine on hepatic hemodynamics in patients with HBsAg-positive cirrhosis.

The acute effects of Nifedipine on hepatic venous pressure gradient (HVPG) and estimated hepatic blood flow (EHBF) were investigated in six patients with HBsAg-positive cirrhosis and portal hypertension by simultaneous hepatic venous catheterization. The mean arterial pressure significantly decreased by 18% at 1 h after sublingual administration of 10 mg Nifedipine. Significant increases in heart rate (13%) and cardiac output (20%) were also demonstrated in our patients 1 h after administration of Nifedipine. However, there were no significant changes in HVPG and EHBF after Nifedipine. We conclude that in patients with HBsAg-positive cirrhosis who receive Nifedipine, EHBF is maintained despite a substantial change in systemic hemodynamics, and that Nifedipine is not effective in acutely reducing HVPG.

Female↗