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Biomedical subjects

M H Chang

Publications and source records attributed to M H Chang.

At least 199 records · Page 11Linked to original sources
PubMed1987

Biologic and prognostic significance of hepatocyte hepatitis B core antigen expressions in the natural course of chronic hepatitis B virus infection.

To elucidate the biologic significance of hepatocyte hepatitis B core antigen (HBcAg) expression and its relation to the natural course of hepatitis B virus (HBV) infection, the patterns of HBcAg were correlated with HBV virus replication state and the disease activity in 598 needle liver biopsies performed on 569 hepatitis B surface antigen (HBsAg) carriers aged 1-81 years. A good correlation of liver HBcAg with serum HBeAg and HBV DNA status was demonstrated. HBcAg was present in the hepatocyte nuclei (nHBcAg) or cytoplasm (cHBcAg), or in both (mixed). Pure nHBcAg was seen mainly in children and young adults; 86% of the patients had non-aggressive disease, but rare cases of chronic active hepatitis (CAH) and HBeAg seroconversion were observed. In contrast, cHBcAg was predominantly associated with CAH (52%) and accompanied by a significantly higher HBeAg seroconversion rate (27%). The HBeAg-negative group, particularly the liver HBcAg-negative subgroup, had a lower frequency of CAH, but an increased incidence of non-aggressive disease as well as cirrhosis and/or hepatocellular carcinoma, indicating that HBeAg seroconversion to anti-HBe does not necessarily mean a favorable prognosis. The results suggest that expression of HBcAg correlates with the liver pathology and the three phases of chronic HBV infection: (1) the early immune tolerance phase is characterized by nHBcAg, mild disease and low HBeAg seroconversion rate; (2) the virus replication/elimination phase by cHBcAg or negative HBcAg, frequent CAH, and high HBeAg seroconversion rate; and (3) the inactive virus replication phase by negative HBcAg and a bipolar disease spectrum.

Age Factors↗
PubMed1986

Baseline seroepidemiology of hepatitis B virus infection in children in Taipei, 1984: a study just before mass hepatitis B vaccination program in Taiwan.

Hepatitis B virus (HBV) markers were studied by radioimmunoassays in serum samples of 1,200 (647 male, 553 female) apparently healthy children under 15 years of age in Taipei between June and October 1984. The prevalence rate of hepatitis B surface antigen (HBsAg) was 5.1% in infancy, increased to 10.7% between 1 and 2 years of age, and then remained constant at about 10% thereafter. The prevalence rate of surface antibody (anti-HBs), core antibody (anti-HBc), and seropositivity (at least one marker of hepatitis B detectable) were 39.0, 30.5, and 52.5%, respectively, in infancy, then decreased to 10.7, 14.3, and 17.9%, respectively, between 1 and 2 years of age. Thereafter, the antibody prevalence increased in parallel with age. By the age of 13-14 years, nearly half of the children were infected by HBV. The results suggested that in our children, most HBsAg carriers resulted from infections before 3 years of age, and HBV infections after 3 years of age infrequently resulted in a carrier state. One hundred (83.3%) of the 120 HBsAg-positive children had hepatitis B e antigen (HBeAg), indicating high prevalence in young asymptomatic HBsAg carriers. The prevalence rate of HBeAg tended to decrease with age and a reversed trend was observed with anti-HBe. Our study, just before our government extends mass hepatitis B vaccination program from newborns to children, provides background seroepidemiologic data of HBV infections in the healthy children in Taiwan.

Adolescent↗
PubMed1986

Congenital bile duct dilatation in children.

Fifteen children under the age of 15 were identified to have congenital dilatation of the biliary tree. Thirteen of them (87%) had dilatation of both intrahepatic and extrahepatic bile ducts, while two had extrahepatic biliary dilatation only. Visualization of both intrahepatic and extrahepatic biliary tree in small children before operation is possible by ultrasonography, endoscopic retrograde cholangio-pancreatography, or percutaneous transhepatic cholangiography. The advantage and disadvantage of those methods of examinations in children are discussed here. Dilatation of intrahepatic bile ducts is common in children with extrahepatic biliary dilatation. Assessment of both the intrahepatic and extrahepatic bile ducts bears a crucial role in the management of congenital biliary dilatation at operation and during the postoperative follow-up. Rouxen-Y hepaticojejunostomy with hepaticocutaneous arm was performed in our patients with satisfactory results. Residual intrahepatic stones could be removed through the hepaticocutaneous arm by choledochoscopy.

Adolescent↗
PubMed1985

Inadequacy of immunoglobulin M hepatitis B core antibody in detecting acute hepatitis B virus infection in infants of HBsAg carrier mothers.

To study the usefulness of IgM hepatitis B core antibody (anti-HBc IgM) for detecting hepatitis B virus infections in infants of hepatitis B surface antigen (HBsAg) carrier mothers, serial serum samples from 86 infants of carrier mothers were tested for anti-HBc IgM with a highly specific enzyme immunoassay. Asymptomatic hepatitis B infection occurred frequently in infants under 12 mo of age. Anti-HBc IgM never became positive in 25 infants infected under 9 mo old. It was positive in only 1 of 6 infected at 9 mo and 4 of 13 infected at 12 mo of age. The IgM antibody lasted for less than 6 mo. Although the infection was delayed in 28 infants receiving hepatitis B immune globulin, the poor anti-HBc IgM response did not seem to be due to the immune prophylaxis. Our study clearly indicates the limitation of anti-HBc IgM for detecting acute hepatitis B infection in infants born to HBsAg carrier mothers.

Adult↗
PubMed1985

Changing seroepidemiology of hepatitis A virus infection in Taiwan.

Hepatitis A antibody (anti-HAV) in serum was studied from June to October, 1984, by radioimmunoassay in 647 male and 553 female apparently healthy children under 15 years of age in Taipei City. The prevalence rate of anti-HAV was 27.0% in infants, decreased to around 1% during the preschool age, then increased and remained around 5% until 11-12 years of age, when another increase was noted, and reached 13.6% among the early teenagers. The age-specific prevalence of anti-HAV increased with age but differed in three age ranges, which reflected three apparently different calculated annual incidences. Compared with previous studies in Taipei, the results showed a significant reduction in the prevalence of anti-HAV in almost every age group from 3 to 14 years. This fact probably reflects the marked improvement of hygienic conditions and progress in health education in recent years, which reduced the exposure to HAV infection among young children. The age of primary infection in the children was older than in previous studies, and it is expected that the susceptibility of HAV will extend to early adulthood.

Adolescent↗
PubMed1984

Fraternal hepatocellular carcinoma in young children in two families.

Two pairs of young brothers from two families with histologically verified hepatocellular carcinoma (HCC) occurred with almost simultaneous onset in each family. In the first family, the boys were 5 and 7 years of age, respectively. Both of them, their parents, and a younger sister were hepatitis-B-surface-antigen (HBsAg)-positive. In the second family, the two brothers were 9 and 7 years of age, respectively. Both patients, their mother, and maternal grandmother were HBsAg-positive. The fraternal occurrence of HCC in children under the age of 10 years has not been reported in the literature. The pattern of HBsAg on these families suggests the HCC cases were infected by their mothers, most possibly in the perinatal period, and is additional support for the important role of hepatitis-B virus in the etiology of HCC. The very early and almost simultaneous onset, however, suggests that additional genetic and/or environmental factors are also important.

Adult↗
PubMed1983

Endoscopic examination of the upper gastrointestinal tract in infancy.

Forty endoscopic examinations of the upper gastrointestinal tract were performed in 38 infants with an age range from 2 days to 12 months. The main indications were upper gastrointestinal bleeding, chronic intractable vomiting, and small intestinal biopsy. Duodenal ulcer, hemorrhagic gastritis, and gastric erosions were the most common causes of upper gastrointestinal bleeding in infancy. An acute viral infection with fever, aspirin ingestion, and diarrhea frequently preceded gastrointestinal bleeding from duodenal ulcer and gastric erosion. Four of the 27 bleeding patients demonstrated no abnormality endoscopically.

Duodenal Diseases↗
PubMed1983

Association of hepatitis B surface (HBs) antigenemia and membranous nephropathy in children in Taiwan.

Fourteen out of 63 children with primary glomerular disease had membranous nephropathy (MN) that was not associated with systemic lupus erythematosus. Hepatitis B surface antigen (HBsAg) was detected in the sera of all 13 patients tested, but was found in only 6.25% of their parents, in 28.57% of their siblings, and in 18.8% of the children with other types of primary glomerular disease. These findings strongly suggest that MN in children in Taiwan is closely related to hepatitis B virus (HBV) infection, and that, in most, if not all, instances it is due to horizontal infection rather than vertical transmission. However, the antigen antibody system involved remains to be identified. In this study, 4 out of 12 cases also showed abnormal elevation of SGOT and SGPT. Liver biopsies obtained from 9 patients demonstrated chronic persistent hepatitis in 3 cases, focal necrosis in 2, and minimal change or normal histology in 4. Although both the liver and kidney diseases appeared to be relatively benign during a limited period of observation, the long-term influence of the diseases and their final outcomes remain to be clarified. With the strong association of HBs antigenemia and MN in children, and the high incidence of HBsAg-positive chronic hepatitis in MN, an investigation of liver function and HBsAg carriage in patients with MN and a study of renal function in HBsAg carriers are highly recommended.

Child↗
PubMedDate not supplied

Prospective study of asymptomatic HBsAg carrier children infected in the perinatal period: clinical and liver histologic studies.

Liver histologic findings were studied in 18 children who were 4 to 9 years old, and who had been HBsAg carriers since having been infected by their mothers in the perinatal period. All were born to HBeAg-HBsAg carrier mothers; the children were followed periodically from birth. Throughout their entire course, none developed symptoms or signs suggestive of liver disease. All of the 18 children showed mild but definite liver histologic changes: 15 had nonspecific histologic changes, and three had chronic persistent hepatitis. In 13 of 18 children, follow-up aminotransferase activities were abnormal, but none exceeded 100 KU. At the time of biopsy, ALTs on four children were above the upper limit of normal. All children were HBeAg-positive in early infancy, but five lost this antigen and developed antibody during follow-up. The histologic findings in HBeAg-positive children did not differ from those in children with antibody. Perinatal hepatitis B virus infection has been thought to play an important role in chronic liver disease, including hepatocellular carcinoma. This study indicates that some pathologic changes following perinatal infection begin very early.

Alanine Transaminase↗