DSpace community: 附設醫院肝炎研究中心

Pancreaticobiliary Anomalies Is the Leading Cause of Childhood Recurrent Pancreatitis

Tue, 29 Sep 2009 08:36:42 GMT

title: Pancreaticobiliary Anomalies Is the Leading Cause of Childhood Recurrent Pancreatitis abstract: Background/Purpose: To explore the etiology, age and gender distribution, complications, and prognosis of recurrent pediatric pancreatitis. Methods : Between 1993 and 2005, 92 children were hospitalized at the National Taiwan University Hospital with pancreatitis. Only 25 diagnosed with recurrent pancreatitis, based on two or more episodes of pancreatitis, elevated serum amylase and/or lipase levels >= 3 times the upper limit of normal, radiographic evidence, and clinical symptoms, were enrolled. Results: A total of 85 episodes of pancreatitis in 25 patients (16 girls, 9 boys; mean age, 9.5 +/- 4.4 years; 3.4 +/- 1.9 episodes per person ) were documented. The recurrence rate of pediatric pancreatitis was 27.2%. Recurrent pancreatitis was associated with pancreaticobiliary structural anomalies (n=7 ), biliary stones or sludge (n=4), hyperlipidemia (n=3), pseudopapillary tumor of the pancreas (n=2), trauma (n=2), hypoxic encephalopathy with recurrent bacteremia and sepsis( n=1), and idiopathic (n=6). The age and gender distribution according to etiologies were not different (p=0.301 for age , p=0.137 for gender). Complications included cholangitis or cholestasis (16%), pancreatic necrosis (16%), pseudocyst formation (12%), shock (8%), hemorrhagic pancreatitis (4%), and diabetes mellitus (4%). No patient died of recurrent pancreatitis. Long-term morbidity after recurrent pancreatitis presented as gout, diabetes mellitus, non- alcoholic steatohepatitis, and chronic pancreatitis. Conclusion: For children who suffer from recurrent pancreatitis, pancreaticobiliary structural anomalies should be considered first.

Apri-M6 for Predicting Long-Term Outcome of Chronic Hepatitis C Patients after Interferon-Based Therapy: More Questions Than Answers

Tue, 29 Sep 2009 08:35:53 GMT

title: Apri-M6 for Predicting Long-Term Outcome of Chronic Hepatitis C Patients after Interferon-Based Therapy: More Questions Than Answers

Asian-Pacific Consensus Statement on the Management of Chronic Hepatitis B: A 2005 Update

Tue, 29 Sep 2009 08:35:16 GMT

title: Asian-Pacific Consensus Statement on the Management of Chronic Hepatitis B: A 2005 Update abstract: Background/Aims: A large amount of new data on the treatment of chronic hepatitis B has become available such that the 2003 consensus statement requires revision and update. Methods: New data were presented, discussed and debated in an expert pre-meeting to draft a revision. The revised contents were finalized after discussion in a general meeting of APASL. Results: Conceptual background, including the efficacy and safety profile of currently available and emerging drugs, was reviewed. Nineteen recommendations were formed and unresolved issues and areas for further study were suggested. Conclusion: The current therapy of chronic hepatitis B is modestly effective but not satisfactory. The development of new drugs and new strategies is required to further improve the outcomes of treatment.

Changes of Soluble Cd26 and Cd30 Levels Correlate with Response to Interferon Plus Ribavirin Therapy in Patients with Chronic Hepatitis C

Tue, 29 Sep 2009 08:34:21 GMT

title: Changes of Soluble Cd26 and Cd30 Levels Correlate with Response to Interferon Plus Ribavirin Therapy in Patients with Chronic Hepatitis C abstract: Background: Clearance of hepatitis C virus (HCV) is attributed to host cellular immune responses, in which T helper cells play a critical role. The purpose of the present paper was therefore to study the serial changes of serum soluble markers released from T helper 1 (Th1) and 2 ( Th2) and their correlations with treatment responses in chronic hepatitis C patients receiving interferon-a plus ribavirin for 24 weeks. Methods: Serum markers (soluble CD26 and CD30 levels) of T helper cells were quantified before and 6 months after combination therapy in 33 chronic hepatitis C patients and in 20 healthy controls. Results: Compared to healthy controls, chronic hepatitis C patients had significantly lower serum soluble CD26 levels before ( 140.4 +/- 63.9 ng/mL vs 200.6 +/- 60.3 ng/mL, P < 0.0001) and after (115.9 +/- 32.9 ng/mL vs 200.6 +/- 60.3 ng/mL , P < 0.0001) combination therapy. The level was even lower in those with non-sustained virologic response (non-SVR; 139.0+ /- 50.9 ng/mL vs 117.7 + /- 40.3 ng/mL, P = 0.039). In contrast, soluble CD30 levels at 6 months after combination therapy were significantly lower in patients with SVR than those with non-SVR (6.4 +/- 3.5 U/mL vs 10.4 +/- 5.4 U/mL, P = 0.021) . Conclusion: Chronic hepatitis C patients have a weak Th1 response as reflected by lower soluble CD26 levels and the levels are even lower in non-sustained responders. In sharp contrast, downregulation of Th2 response with serial changes of soluble CD30 level is associated with successful treatment of HCV infection.