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Biomedical subjects

W L Chuang

Publications and source records attributed to W L Chuang.

At least 73 records · Page 4Linked to original sources
PubMed1992

Duplex pulsed Doppler sonography in the differential diagnosis of hepatocellular carcinoma and other common hepatic tumours.

180 previously untreated consecutive patients with liver tumours (308 lesions), including 104 hepatocellular carcinomas (148 lesions), 43 metastases (116 lesions) and 33 haemangiomas (44 lesions), were studied to determine the value of duplex sonography in the differentiation of hepatocellular carcinoma from other tumours. For lesions measuring less than or equal to 5 cm in diameter, hepatocellular carcinoma demonstrated the highest rate and haemangioma demonstrated the lowest rate of Doppler signals from within the lesions. To differentiate malignancy from haemangioma, the presence or absence of Doppler signals from these lesions were used as criteria. The specificity and positive predictive value were very high (100%, 100%), but the sensitivity, negative predictive value and accuracy were low (61.5%, 48.3%, 71.7%, respectively). With one exception, all lesions measuring less than 3 cm in diameter with detectable Doppler signals were hepatocellular carcinoma. Using these results it is possible to differentiate hepatocellular carcinoma from metastases and haemangioma with high sensitivity, specificity, positive and negative predictive value, and accuracy (80.8%, 96.4%, 95.5%, 84.4%, 88.9%, respectively, for metastases; 80.8%, 100%. 100%, 81.5%, 89.6%, respectively, for haemangioma). We conclude that Doppler signals from within a lesion in combination with its size can aid differentiation of hepatocellular carcinoma from two other kinds of common hepatic tumour.

Adult↗
PubMed1992

Clinical utility of pulsed Doppler in the detection of arterioportal shunting in patients with hepatocellular carcinoma.

Ninety-seven patients with hepatocellular carcinoma had duplex scanning from the patent or residual portal lumen and comparative angiography. Duplex ultrasonography identified five of nine patients with angiographic evidence of arterioportal shunting. Furthermore, Doppler results indicated the presence of the shunt in one patient without angiographic evidence. Duplex scanning from the portal lumen may be useful in the detection of arterioportal shunting. This procedure can be used to evaluate the hemodynamic change of the recipient portal vein under natural physiologic conditions. However, small shunts without hepatofugal portal blood cannot be detected by this procedure.

Adult↗
PubMed1991

Natural killer cell activity in patients with liver cirrhosis relative to severity of liver damage.

To evaluate the role of severe liver damage on natural killer cell activity, 29 patients with liver cirrhosis were examined. The natural killer cell activity was measured with a 4-hr chromium release assay, and the K562 cell line was employed as target cells. The natural killer cell activity was significantly decreased in cirrhotic patients compared with normal controls and patients with chronic active hepatitis. Cirrhotic patients with Pugh's C grade of severity of liver disease had lower natural killer cell activity. The depression of natural killer cell activity in cirrhotic patients was inversely correlated with prothrombin time ratios, and the natural killer cell activity in cirrhotic patients with hepatic encephalopathy was lower than in patients without hepatic encephalopathy. Thus, the diminished natural killer cell activity in cirrhotic patients might be related to the severity of liver damage.

Female↗
PubMed1991

Systemic amyloidosis presenting as splenic tumor.

We report a case of amyloidosis manifesting as a splenic tumor and pleural effusion. Only one case of a splenic amyloid tumor has been reported in the literature, but its radiological findings were not described. Therefore, we present the computed tomographic (CT), sonographic, and angiographic features of splenic amyloid tumor.

Amyloidosis↗
PubMed1991

Duplex pulsed Doppler sonography of hepatocellular carcinoma treated with transcatheter arterial embolization.

Thirty-one patients with hepatocellular carcinoma underwent duplex scanning of their lesions with comparative angiography and serum alpha-fetoprotein determinations before and after transcatheter arterial embolization. Duplex ultrasound correctly identified 26 patients with patent tumor vessels after embolization. The Doppler signals became undetectable after embolization in the other five patients. Comparative angiography demonstrated good devascularization of their lesions. However, tiny tumor blush or small satellite nodules around the periphery of the devascularized masses were found. Therefore, the presence of signals after therapy indubitably needs further embolization. The timing of the second embolization for the patient with undetectable Doppler signals after the first embolization needs to be justified by further evaluations.

Adult↗
PubMed1991

Duplex pulsed Doppler sonography of portal vein thrombosis in hepatocellular carcinoma.

Sixteen patients with hepatocellular carcinoma had duplex pulsed Doppler scanning of the portal thrombus and comparative angiography. Fifteen patients demonstrated detectable Doppler signals from the thrombus. The Doppler signals were corroborated by the "thread-and-streaks" sign on angiography in eight patients. This suggests that signals come from tumor vessels within the thrombus. Therefore, the presence of Doppler signals in the thrombotic portal venous system is not only due to partial obstruction of the lumen. Tumor thrombus from hepatocellular carcinoma must be considered, especially when the detectable signals are pulsatile waves.

Adult↗
PubMed1990

Natural killer cell activity in patients with hepatocellular carcinoma relative to early development and tumor invasion.

To evaluate the significance of natural killer (NK) cell activity in the clinical assessment of patients with hepatocellular carcinoma (HCC), 32 patients combined with liver cirrhosis (LC) and HCC, and 29 LC patients were studied. The NK cell activity was markedly decreased in HCC patients and the LC group as compared with the control group, but there was no statistical difference between the NK cell activity of the HCC group and the LC group. The depression of NK cell activity in HCC patients was inversely correlated with the patient's age, and the HCC patients with venous invasion or with both lobes involved had lower NK cell activity. These results suggest that the decreased NK cell activity in HCC patients might be related to the coexistent liver disease, and marked decrease in NK cell activity might be one of the causes for the early development and invasion of HCC.

Adult↗
PubMed1990

Risk factors for gallstones among Chinese in Taiwan. A community sonographic survey.

A health survey of adults aged 30 years or more was carried out in southwest Taiwan to determine the prevalence of gallstones and to study risk factors associated with gallstones. Blood samples were collected and abdominal sonographic examination and anthropometric measurements were performed on a total of 923 people. The 40 gallstone cases detected resulted in a prevalence of 4.3%. The risk factors explored included age, sex, hepatitis, obesity, hyperlipidemia, and diabetes mellitus (DM). Age and DM were the only significant factors associated with gallstones in our study. With a reference group of 30-39-year-olds as a comparison, multiple logistic regression analysis showed a trend effect with odds ratios of 1.73, 3.74, and 6.32 for age groups of 40-49, 50-59, and 60 or above, respectively. The odds ratio for DM was as high as 2.59. However, sex, body weight index, chronic hepatitis B, and hyperlipidemia were not significantly associated with gallstones.

Adult↗
PubMed1990

The effect of pitressin and glypressin in variceal bleeding--a preliminary clinical trial.

Effects of hemostatic and various side effects were compared between glypressin and pitressin. Fifty-five episodes of esophageal variceal bleeding in 29 patients were studied. Although the glypressin group included more patients in Pugh's classification C than the pitressin group, the result of hemostasis was not influenced. The effect of hemostasis was evaluated in 24 episodes receiving either glypressin or pitressin. The hemostatic effects of glypressin and pitressin were 6/11, 54.5% and 7/13, 53.8% respectively. Eighteen episodes in six patients, with multiple episodes, were used to observe the effect of these two drugs in the same person. No difference was observed. The number of side effects in the glypressin group and the pitressin group were 5 and 10 respectively. Although the side effects of glypressin might be fewer than those of pitressin, chest pain was observed in patients receiving glypressin treatment. The use of glypressin in the patients with cardiac diseases should be studied further. Glypressin is more convenient in clinical use. However, pitressin doses is easily modified. Both drugs might be selected in the control of variceal bleeding.

Adult↗
PubMed1990

Abdominal sonographic screening in a single community.

A health survey, on adults aged 30 years or more, was carried out at 3 villages on the southwest coast of Taiwan. A total of 923 cases (42.6%) of the 2,166 population participated in the survey. The estimated total population prevalence rates were as follows: no gross lesion (60.5%), fatty liver (25.2%), biliary stone (5.2%), gall bladder polyp (1.9%), hepatic hemangioma (1.4%), liver cyst (0.9%) and renal cyst (2.9%). The prevalence rates of gall bladder polyp and renal cyst were higher in men, while that of fatty liver was higher in women. There was an increase in the prevalence with age for fatty liver in females. The results might be a reference about the above findings among Chinese in Taiwan.

Abdomen↗
PubMed1989

Lymphocyte transformation in patients with HBsAg-positive chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma.

To evaluate cellular immunity, mitogen-induced lymphocyte transformation was assessed in 146 patients with chronic hepatitis B virus (HBV) infection, including 63 patients with chronic hepatitis (CH), 34 with liver cirrhosis (LC), and 49 patients combined with liver cirrhosis and hepatocellular carcinoma (HCC). The PHA-induced transformation indices (TI) were lower in patients with chronic HBV infection, especially in the LC and the HCC groups. The Con A-induced TI were also diminished in patients with chronic HBV infection. The mitogen-induced TI in patients with CH showed no significant difference in regards to different histological patterns, HBeAg/anti-HBe statuses, sex groups, age distributions, and SGPT levels. However, the mitogen-induced TI were substantially higher in CH patients with elevated serum AFP levels, especially in the group with AFP levels over 100 ng/ml. From these data, we conclude that: (1) impaired PHA-induced TI in patients with LC may partly explain the high risk factor of LC in the occurrence of HCC; (2) the reduction in TI induced by optimal concentration of Con A reflects the defective suppressor cell activity in patients with chronic HBV infection, even in patients with HCC; (3) no significant difference among the control group and patients with chronic HBV infection in PWM-induced TI implies that the response of B cells may be normal in patients with chronic HBV infection; (4) elevated mitogen-induced TI in CH patients with high AFP levels indicate that the activation of lymphocyte may contribute to the severity of inflammation and tissue damage.

Adult↗
PubMed1989

Factor analysis for the presence of serum HBV DNA in chronic hepatitis B virus infection.

To elucidate the role of HBeAg and other influential factors for the presence of serum HBV DNA and their interactions, serum HBV DNA was examined in 68 patients with chronic HBV infections and 23 HBsAg negative persons by molecular hybridization. Based on the univariate analysis, the positive rate of HBV DNA was higher in patients with HBeAg (31/43, 72.1%) than in patients with anti-HBe (5/22, 22.7%) with an odd ratio of 8.78. The positive rates of HBV DNA between men and women were not significantly different, and the positive rates of HBV DNA were not related to the SGPT levels. The mean age of patients without HBV DNA was higher than that of patients with HBV DNA (p value less than 0.025), and the positive rate and concentration of HBV DNA were decreased with increasing age (p value less than 0.005). The positive rates of serum HBV DNA among different histological changes were not statistically different. However, the discordance of HBV DNA and HBeAg/anti-HBe was increased when the liver parenchymal damage became severe (p less than 0.05). Only 5 patients were anti-D positive and 3 of them had serum HBV DNA. To exclude interactions of the influential factors, multivariate analysis was also performed. HBeAg was the only significant factor for the presence of serum HBV DNA when logistic regression was used (p less than 0.001). The age was an important factor when the concentration of serum HBV DNA was considered.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Complements as new diagnostic tools of hepatocellular carcinoma in cirrhotic patients.

Serum complements, C3, C4, and C3 proactivator (C3PA), were evaluated prospectively for their diagnostic power in detecting hepatocellular carcinoma (HCC) in patients with liver cirrhosis (LC). Sixty-three LC patients, including 36 LC with HCC patients, were recruited for this study during the period from March to November 1986. The cutoff values of the complements were set according to retrospective study including 17 LC patients and 20 HCC patients. The values with highest accuracy, 75 mg/dl C3, 16 mg/dl C4, and 18 mg/dl C3PA, were selected. Based on these data, the positive predictive values, negative predictive values, and the accuracies of complements were as follows: C3, 88.9%, 85.2%, and 87.3%; C4, 93.8%, 80.6%, and 87.3%; and C3PA, 66.7%, 90.9%, and 70.9%, respectively. The accuracy elevated to 93.7% when C3, C4, and alpha-fetoprotein were combined as the diagnostic criteria. This study supports the use of complement testing as a new diagnostic tool for HCC screening in LC patients and for follow-up evaluation in posttherapy patients of LC with HCC.

Adult↗