AIM: Hepatocellular carcinoma (HCC) patients manifest a variety of paraneoplastic syndromes. Thrombocytosis was reported in children with hepatoblastoma. The aims of this study were to evaluate the prevalence and dini...AIM: Hepatocellular carcinoma (HCC) patients manifest a variety of paraneoplastic syndromes. Thrombocytosis was reported in children with hepatoblastoma. The aims of this study were to evaluate the prevalence and dinical significance of thrombocytosis in HCC patients and its relationships with serum thrombopoietin (TPO).METHODS: We retrospectively reviewed clinical, biochemical and image data of 1 154 HCC patients. In addition, we measured platelet count and serum TPO in HCC patients with and without thrombocytosis, in patients with cirrhosis,chronic hepatitis and healthy subjects in a Eoss-sedJonal study.RESULTS: Thirty-one (2.7%) of 1 154 HCC patients had thrombocytosis (platelet count ≥400 K/mm^3). HCC patients with thrombocytosis were significantly younger, had a higher serum α-fetoprotein, higher rate of main portal vein thrombosis, larger tumor volume, shorter survival, and were less likely to receive therapy than HCC patients without thrombocytosis. Multivariate logistic regression analyses showed that tumor volumes ≥30% and serum α-fetoprotein≥ 140 000 ng/mL could significantly predict thrombocytosis.HCC patients with thrombocytosis had a significantly higher mean serum TPO than those without, as well as patients with cirrhosis, chronic hepatitis and healthy subjects.Platelet count and serum TPO dropped significantly after tumor resection in HCC patients with thrombocytosis and re-elevated after tumor recurred. Furthermore, the expression of TPO mRNA was found to be more in tumor tissues than in non-tumor tissues of liver in an HCC patient with thrombocytosis.CONCLUSION: Thrombocytosis is a paraneoplastic syndrome of HCC patients due to the overproduction of TPO by HCC.It is frequently associated with a large tumor volume and high serum α-fetoprotein.展开更多
AIM: To explore the seropositive rate of antibodies against H. pylori(anti-HP) in Taipei City and to compare the relationship of ABO blood groups and H. pylori infection.METHODS:In 1993, high school students in Shih-L...AIM: To explore the seropositive rate of antibodies against H. pylori(anti-HP) in Taipei City and to compare the relationship of ABO blood groups and H. pylori infection.METHODS:In 1993, high school students in Shih-Lin District were randomly selected for blood samplings by their registration number at school. In addition, similar procedures were performed on the well-children clinics of Taipei Veterans General Hospital. Besides, randomly selected sera from the adults who took the physical examination were recruited for evaluation. Informed consents were obtained from all the subjects before blood samplings and parents were simultaneously informed for those who were younger than 18-year-old. Blood tests for anti-HP and ABO blood groupings were performed by enzyme-linked immunosorbent assay.Chi square tests were used for the comparisons between seroprevalence of H. pylori and ABO blood groups.RESULTS: Totally, 685 subjects were recruited (260 children aged 1-14 years, 425 high school students aged 15-18 years)were evaluated, and another 88 adult healthy volunteers were studied as well for comparison. The age-specific seropositive rate of anti-HP was 1.3 % at age 1-5 years,7.7 % at age 6-10 years, and 11.5 % at age 11-14 years.The seroprevalence of H. pylori infection was abruptly increased in young adolescence: 18.6 % at age 15 years,28.1% at age 16 years, 32.4 % at age 17 years and 41.0%at age 18 years, respectively. In the 425 high school students,ABO blood groupings were performed, which disclosed 48.5 % (206/425) of blood group O, 24 % (102/425) of blood group A, 21.8 % (93/425) of blood group B and 5.6 %(24/425) of blood group AB. In comparison of the subjects with blood group O and the other blood groups, no statistical significance could be identified in the seroprevalence of H. pylori(P=0.99).CONCLUSION: The seroprevalence of H. pylori infection in Taipei City in adults is similar to the developed countries,and the abrupt increase of H. pylori during high school may be resulted from marked increase of interpersonal social activities. Although blood group O was reported to be related to H. pylori infection in previous literature, we found no association between H. pylori infection and ABO blood groups.展开更多
AIM: To investigate the prevalence and the risk factors of glucose intolerance in Chinese patients with chronic hepatitis C and to evaluate the relationship between interferon (IFN)treatment and glucose intolerance in...AIM: To investigate the prevalence and the risk factors of glucose intolerance in Chinese patients with chronic hepatitis C and to evaluate the relationship between interferon (IFN)treatment and glucose intolerance in these patients.METHODS: Prospective cross-sectional study was done to evaluate the prevalence of glucose intolerance in Chinese patients with chronic hepatitis C virus (HCV) infection from the outpatient clinic of Department of Family Medicine, Taipei Veterans General Hospital. Chronic hepatitis C was defined as persistent presence of anti-HCV and persistent elevation of liver transaminase for at least 1.5 folds for at least 6 months. Moreover, patients were further categorized into normal fasting glucose and glucose intolerance (diabetes mellitus (DM) and impaired fasting glucose) according to the diagnostic criteria of American Diabetic Association. RESULTS: Totally, 359 Chinese patients with chronic hepatitis C were enrolled (212 males and 147 females, mean age=58.1±13.0 years). One hundred and twenty-three patients (34.3 %) had various forms of IFN treatment. One hundred and twenty-five patients (34.6 %)had glucose intolerance, including 99 patients (27.6 %) with DM and 26 patients (7.0 %) with impaired fasting glucose.Tn comparison with those with normal fasting glucose levels,patients with chronic hepatitis C with glucose intolerance were significantly older, had a significantly higher body mass index, and they were more likely to suffer from obesity, to have family history of diabetes and to have had previous IFN treatment. Stepwise multivariate logistic regression revealed significantly that age ≥ 57 years, obesity,previous history of IFN treatment and the presence of family history of diabetes were independent risk factors associated with the presence of glucose intolerance in chronic hepatitis C patients.CONCLUSION: In conclusion, 34.6 % of Chinese patients with chronic hepatitis C had glucose intolerance. Chronic hepatitis C patients who were older in age, obese, had previous IFN treatment history and had family history of diabetes were prone to develop glucose intolerance. To our knowledge, this is the first population-based report to confirm that interferon treatment to be an independent risk factor to develop glucose intolerance.展开更多
AIM: To estimate the age-specific prevalence of anti-ulcer drug use and to calculate the usage of different anti-ulcer drugs over 5 years within the universal health insurance program in Taiwan Region.METHODS: The Nat...AIM: To estimate the age-specific prevalence of anti-ulcer drug use and to calculate the usage of different anti-ulcer drugs over 5 years within the universal health insurance program in Taiwan Region.METHODS: The National Health Insurance Research Database in Taipei supplied the cohort data sets of 200 000people. The ambulatory and inpatient claims of the cohort from 1997 to 2001 were analyzed. The anti-ulcer drugs included all drug items of the group A02B (drugs for treatment of peptic ulcer) in the Anatomical Therapeutic Chemical classification system (version 2000). The amount of drug usage was measured in unit of defined daily dose.RESULTS: Among bhe totally 13 034 393 visits wibh 56 672 631ambulatory prescription items, there were 398 150 (0.7 %)prescribed items of anti-ulcer drugs in 378 855 (2.9 %)visits. Among the 107 649 admissions with 5 762 312inpatient prescription items, there were 24 598 (0.4 %)prescribed items of anti-ulcer drugs in 11 548 (10.7 %)admissions. The annual prevalence of anti-ulcer drug use was 9.6 % in 1997, 11.6 % in 1998, 15.4 % in 1999, 14.5 %in 2000, and 15.9 % in 2001 respectively. The 5-year prevalence was 36.1%. The age-specific prevalence among the people younger than 20 years was 9.2 % in 2001 and 23.7 % during the 5-year period. Cimetidine not only was the most popular ingredient among anti-ulcer drugs (57 634cimetidine users in 70 729 all anti-ulcer drug users during the 5-year period) but also had the largest prescribed amount (42.3 % of DDDs for all anti-ulcer drug users during the 5-year period). The annually prescribed amount of anti-ulcer drugs had grown from 4.9 DDDs/1000 inhabitants/day in 1997 to 7.5 in 2001. This increase was largely attributed to H2-receptor antagonists and the expanding number of users.CONCLUSION: Prescribing of anti-ulcer drugs is indeed popular among the Chinese population in Taiwan Region. The disproportionate use of anti-ulcer drugs by children demands further investigation.展开更多
基金Supported by a grant from Taipei Veterans General Hospital,Taiwan,No.VGH88-299
文摘AIM: Hepatocellular carcinoma (HCC) patients manifest a variety of paraneoplastic syndromes. Thrombocytosis was reported in children with hepatoblastoma. The aims of this study were to evaluate the prevalence and dinical significance of thrombocytosis in HCC patients and its relationships with serum thrombopoietin (TPO).METHODS: We retrospectively reviewed clinical, biochemical and image data of 1 154 HCC patients. In addition, we measured platelet count and serum TPO in HCC patients with and without thrombocytosis, in patients with cirrhosis,chronic hepatitis and healthy subjects in a Eoss-sedJonal study.RESULTS: Thirty-one (2.7%) of 1 154 HCC patients had thrombocytosis (platelet count ≥400 K/mm^3). HCC patients with thrombocytosis were significantly younger, had a higher serum α-fetoprotein, higher rate of main portal vein thrombosis, larger tumor volume, shorter survival, and were less likely to receive therapy than HCC patients without thrombocytosis. Multivariate logistic regression analyses showed that tumor volumes ≥30% and serum α-fetoprotein≥ 140 000 ng/mL could significantly predict thrombocytosis.HCC patients with thrombocytosis had a significantly higher mean serum TPO than those without, as well as patients with cirrhosis, chronic hepatitis and healthy subjects.Platelet count and serum TPO dropped significantly after tumor resection in HCC patients with thrombocytosis and re-elevated after tumor recurred. Furthermore, the expression of TPO mRNA was found to be more in tumor tissues than in non-tumor tissues of liver in an HCC patient with thrombocytosis.CONCLUSION: Thrombocytosis is a paraneoplastic syndrome of HCC patients due to the overproduction of TPO by HCC.It is frequently associated with a large tumor volume and high serum α-fetoprotein.
文摘AIM: To explore the seropositive rate of antibodies against H. pylori(anti-HP) in Taipei City and to compare the relationship of ABO blood groups and H. pylori infection.METHODS:In 1993, high school students in Shih-Lin District were randomly selected for blood samplings by their registration number at school. In addition, similar procedures were performed on the well-children clinics of Taipei Veterans General Hospital. Besides, randomly selected sera from the adults who took the physical examination were recruited for evaluation. Informed consents were obtained from all the subjects before blood samplings and parents were simultaneously informed for those who were younger than 18-year-old. Blood tests for anti-HP and ABO blood groupings were performed by enzyme-linked immunosorbent assay.Chi square tests were used for the comparisons between seroprevalence of H. pylori and ABO blood groups.RESULTS: Totally, 685 subjects were recruited (260 children aged 1-14 years, 425 high school students aged 15-18 years)were evaluated, and another 88 adult healthy volunteers were studied as well for comparison. The age-specific seropositive rate of anti-HP was 1.3 % at age 1-5 years,7.7 % at age 6-10 years, and 11.5 % at age 11-14 years.The seroprevalence of H. pylori infection was abruptly increased in young adolescence: 18.6 % at age 15 years,28.1% at age 16 years, 32.4 % at age 17 years and 41.0%at age 18 years, respectively. In the 425 high school students,ABO blood groupings were performed, which disclosed 48.5 % (206/425) of blood group O, 24 % (102/425) of blood group A, 21.8 % (93/425) of blood group B and 5.6 %(24/425) of blood group AB. In comparison of the subjects with blood group O and the other blood groups, no statistical significance could be identified in the seroprevalence of H. pylori(P=0.99).CONCLUSION: The seroprevalence of H. pylori infection in Taipei City in adults is similar to the developed countries,and the abrupt increase of H. pylori during high school may be resulted from marked increase of interpersonal social activities. Although blood group O was reported to be related to H. pylori infection in previous literature, we found no association between H. pylori infection and ABO blood groups.
文摘AIM: To investigate the prevalence and the risk factors of glucose intolerance in Chinese patients with chronic hepatitis C and to evaluate the relationship between interferon (IFN)treatment and glucose intolerance in these patients.METHODS: Prospective cross-sectional study was done to evaluate the prevalence of glucose intolerance in Chinese patients with chronic hepatitis C virus (HCV) infection from the outpatient clinic of Department of Family Medicine, Taipei Veterans General Hospital. Chronic hepatitis C was defined as persistent presence of anti-HCV and persistent elevation of liver transaminase for at least 1.5 folds for at least 6 months. Moreover, patients were further categorized into normal fasting glucose and glucose intolerance (diabetes mellitus (DM) and impaired fasting glucose) according to the diagnostic criteria of American Diabetic Association. RESULTS: Totally, 359 Chinese patients with chronic hepatitis C were enrolled (212 males and 147 females, mean age=58.1±13.0 years). One hundred and twenty-three patients (34.3 %) had various forms of IFN treatment. One hundred and twenty-five patients (34.6 %)had glucose intolerance, including 99 patients (27.6 %) with DM and 26 patients (7.0 %) with impaired fasting glucose.Tn comparison with those with normal fasting glucose levels,patients with chronic hepatitis C with glucose intolerance were significantly older, had a significantly higher body mass index, and they were more likely to suffer from obesity, to have family history of diabetes and to have had previous IFN treatment. Stepwise multivariate logistic regression revealed significantly that age ≥ 57 years, obesity,previous history of IFN treatment and the presence of family history of diabetes were independent risk factors associated with the presence of glucose intolerance in chronic hepatitis C patients.CONCLUSION: In conclusion, 34.6 % of Chinese patients with chronic hepatitis C had glucose intolerance. Chronic hepatitis C patients who were older in age, obese, had previous IFN treatment history and had family history of diabetes were prone to develop glucose intolerance. To our knowledge, this is the first population-based report to confirm that interferon treatment to be an independent risk factor to develop glucose intolerance.
文摘AIM: To estimate the age-specific prevalence of anti-ulcer drug use and to calculate the usage of different anti-ulcer drugs over 5 years within the universal health insurance program in Taiwan Region.METHODS: The National Health Insurance Research Database in Taipei supplied the cohort data sets of 200 000people. The ambulatory and inpatient claims of the cohort from 1997 to 2001 were analyzed. The anti-ulcer drugs included all drug items of the group A02B (drugs for treatment of peptic ulcer) in the Anatomical Therapeutic Chemical classification system (version 2000). The amount of drug usage was measured in unit of defined daily dose.RESULTS: Among bhe totally 13 034 393 visits wibh 56 672 631ambulatory prescription items, there were 398 150 (0.7 %)prescribed items of anti-ulcer drugs in 378 855 (2.9 %)visits. Among the 107 649 admissions with 5 762 312inpatient prescription items, there were 24 598 (0.4 %)prescribed items of anti-ulcer drugs in 11 548 (10.7 %)admissions. The annual prevalence of anti-ulcer drug use was 9.6 % in 1997, 11.6 % in 1998, 15.4 % in 1999, 14.5 %in 2000, and 15.9 % in 2001 respectively. The 5-year prevalence was 36.1%. The age-specific prevalence among the people younger than 20 years was 9.2 % in 2001 and 23.7 % during the 5-year period. Cimetidine not only was the most popular ingredient among anti-ulcer drugs (57 634cimetidine users in 70 729 all anti-ulcer drug users during the 5-year period) but also had the largest prescribed amount (42.3 % of DDDs for all anti-ulcer drug users during the 5-year period). The annually prescribed amount of anti-ulcer drugs had grown from 4.9 DDDs/1000 inhabitants/day in 1997 to 7.5 in 2001. This increase was largely attributed to H2-receptor antagonists and the expanding number of users.CONCLUSION: Prescribing of anti-ulcer drugs is indeed popular among the Chinese population in Taiwan Region. The disproportionate use of anti-ulcer drugs by children demands further investigation.
