Showing papers by "Jaw-Town Lin published in 2003"

Interleukin-10 genotypes associate with the risk of gastric carcinoma in Taiwanese Chinese.

Abstract: The association of cytokine genotypes with gastric carcinoma (GC) may be influenced by environmental factors and varies among different populations. Few studies have addressed the impact of different cytokine genotypes on the development and progression of GC. We analyzed 11 functional polymorphisms in tumor necrosis factor-α (TNF-α), interleukin (IL)-1, IL-4 and IL-10 genes in 220 Taiwanese Chinese with GC and in 230 healthy controls. The risk of genotypes was adjusted with confounding environmental risks. Our results revealed that the frequency of Helicobacter pylori infection [odds ratio (OR) 1.7, 95% confidence interval (CI) 1.19–2.56], cigarette smoking (OR 2.02, 95% CI 1.38–2.95) and high IL-10 producer genotype (OR 2.67, 95% CI 1.29–5.50) was significantly increased in the entire GC patients. Among different subtypes of GC, a higher risk of developing diffuse type (OR 1.64, 95% CI 1.01–2.67) or cardia cancer (OR 2.44, 95% CI 1.13–2.67) was observed for the CT/CC genotype of IL-4 at the position −590, whereas the high IL-10 producer genotype was significantly linked with the risk of cardia cancer (OR 3.21, 95% CI 1.06–9.73) or advanced stage (OR 2.29, 95% CI 1.12–4.64). No association was noted between GC and controls in the distribution of IL-1 and TNF-α genotypes. Logistic regression analyses revealed that H. pylori infection (OR 1.7, 95% CI 1.14–2.52), cigarette smoking (OR 1.87, 95% CI 1.27–-2.96) and IL-10 genotype (OR 2.54, 95% CI 1.24–5.61) are independent risks for GC. Independent effects of IL-10 genotype, H. pylori infection and cigarette smoking indicate that carcinogenesis of GC is influenced by a variety of host and environmental factors. © 2003 Wiley-Liss, Inc.

Etiology of acute pancreatitis--a multi-center study in Taiwan.

Abstract: Background/Aims: Little is known about the etiology of acute pancreatitis in Taiwan. The aim of this study was to evaluate the current etiology of acute pancreatitis in Taiwan by a multi-center cooperative study. Methodology: Patients with acute pancreatitis were collected from 8 major leading hospitals located at northern, southern, middle and eastern Taiwan from July 1, 1998 to June 30, 2000. The diagnosis of acute pancreatitis was based on characteristic clinical signs an symptoms and three-fold elevation of serum amylase/lipase level or positive evidence in imaging studies. The etiology was attributed to alcohol. gallstones, hypertriglyceridemia, miscellaneous causes, and idiopathic causes. Resalts: In total 1,193 patients with acute pancreatitis were identified. There were 852 (71.4%) men and 341 (28.6%) women with mean age of 52.5 years, ranging from 9 to 100 years. Etiology was identified as alcohol in 423 (33.6%), gallstones in 407 (34.1%), hypertriglyceridemia in 147 (12.3%), miscellaneous causes in in 109 (9.1%), and idiopathic causes in 107 (9.0%). Patients with alcohol-related acute pancreatitis were the youngest (mean age: 41.5 years), which those with gallstone pancreatitis were the eldest (mean age: 64.1 years) (p<0.001). The predominant cause of acute pancreatitis in women is gallstones, while alcohol is the leading cause of acute pancreatis in Taiwanese males. In northern Taiwan, gallstone is the major cause of acute pancreatitis, while alcohol is the predominant etiology in middle, southern, and eastern Taiwan, Conclusions: Alcohol has become the predominant cause of acute pancreatitis in Taiwan recently. Ecological and gender differences play important roles in tile etiology of acute pancreatitis in Taiwan.

Simplified 13C-urea breath test with a new infrared spectrometer for diagnosis of Helicobacter pylori infection.

Abstract: Background and Aim: Infrared spectrometry has correlated excellently with mass spectrometry in detecting the ratio of 13 CO 2 to 12 CO 2 in breath samples. The present study aimed to evaluate the accuracy of the 13 C-urea breath test ( 13 C-UBT) using a new model of infrared analyzer. Methods: A total of 600 patients who were undergoing upper endoscopy without receiving eradication therapy were entered into the study. Culture, histology, and rapid urease test on biopsies from the antrum and corpus of the stomach were used for the determination of Helicobacter pylori infection. Breath samples were collected before and 20 min after drinking 100 mg 13 C-urea in 100 mL water. The optimal cutoff value was determined by the receiver operating characteristic curve. Results: Of the 586 patients who were eligible for analysis, 369 were positive for H. pylori infection, 185 were negative for H. pylori infection, and 32 were indeterminate. When the appropriate cutoff value was set at 3.5‰, a sensitivity of 97.8%, a specificity of 96.8% and an accuracy of 97.5% were obtained using the 13 C-UBT. The accuracy of the 13 C-UBT decreased when CO 2 concentration in the breath sample was <2%, as compared with ≥2% (93.6% vs 97.7%), mainly because of a decrease in specificity (81.8% vs 97.7%). There were 2.7% of patients with Δ 13 CO 2 values that fell between 3.0-4.5%o, in whom the risk of error was 47%. Conclusions: The 13 C-UBT performed with infrared spectrometry is a highly sensitive, specific, and non-invasive method for the detection of H. pylori infection. The immediate availability of the test result and technical simplicity make it particularly effective in routine clinical practice.

CagA tyrosine phosphorylation in gastric epithelial cells caused by Helicobacter pylori in patients with gastric adenocarcinoma

Abstract: Background. Tyrosine phosphorylation of Helicobacter pylori cytotoxin-associated protein of in gastric epithelial cells is reported. The goals of this study are first to examine the occurrence of CagA tyrosine phosphorylation in H. pylori strains isolated from patients with gastric adenocarcinoma and gastritis, and second to clarify the relationship between the diversity of tyrosine phosphorylation motifs and the presence of CagA tyrosine phosphorylation. Methods. Fifty-eight clinical isolates of H. pylori from patients with gastric adenocarcinoma (29 cases) and gastritis (29 cases) were studied for CagA tyrosine phosphorylation by Western blotting. Sequence diversity of tyrosine phosphorylation motifs was analysed among positive- or negative-CagA tyrosine phosphorylation isolates. Results. Positive CagA tyrosine phosphorylation was found in 93.1% (27 of 29) of strains from gastric adenocarcinoma patients and 51.7% (15 of 29) of strains from gastritis patients (p < 0.001). Intact motifs were found in H. pylori isolates with CagA tyrosine phosphorylation. Of the 16 negative CagA tyrosine phosphorylation isolates, intact tyrosine phosphorylation motifs were found in 15 isolates. Conclusions. CagA tyrosine phosphorylation, which is significantly greater in strains from gastric adenocarcinoma patients, may play a role in gastric carcinogenesis, and could be a better marker of more virulent strains than the cag pathogenicity island in Asia, where the cag pathogenicity island is present in nearly all H. pylori strains. Sequence diversity of tyrosine phosphorylation motifs on CagA was not related to the presence of tyrosine phosphorylation. The absence of tyrosine phosphorylation motif might result in negative tyrosine phosphorylation phenotypes, but such motifs are not the sole factors associated with CagA tyrosine phosphorylation.

Clinicopathologic significance of immunohistochemical fecal occult blood test in subjects receiving bidirectional endoscopy.

Abstract: Background/Aims: Fecal occult blood test has been utilized to screen for lower gastrointestinal pathologies, such as colorectal cancer and polyps that bleed. Recent studies have revealed a relatively high frequency of upper gastrointestinal abnormalities in subjects with positive fecal occult blood by guaiacbased method. Although immunohistochemical tests of fecal occult blood were assumed to have greater diagnostic validity, the distribution of gastrointestinal pathology using such examinations is not well established. This study aims to investigate the efficacy of immunohistochemical analysis of fecal occult blood in detecting upper and lower gastrointestinal lesions in asymptomatic individuals. Methodology: Subjects who underwent regular health checkups were enrolled if they received both esophagogastroscopic and colonoscopic examinations. Each subject was tested by an immunohistochemical fecal occult blood test. The fecal occult blood results were evaluated and correlated with lesions identified in endoscopic examinations. Results: In total 655 males and 722 females with age 46.2±12.1 years were enrolled. 287 cases (20.7%) had polypoid lesions of colon, including 6 colon cancers, 37 with polyps ≥1cm, 104 with polyp 5-9mm, and 140 with polyp <5mm. FOB was positive in 31 cases, of which 15 (15/31, 48.4%) were polypoid lesions of colon, 1 was colonic ulcer, 9 (29.0%) were active gastroduodenal ulcers but 6 (19.4%) had no significant lesions. The positive and negative predictive value for colon polyps was 48.4% and 80%, respectively. The sensitivity was 50% (3/6) for colon cancer and varied among polyps with different sizes: 16.2% (6/37) for polyps ≥1cm; 5.8% (6/104) for polyps 5-9mm and 0% (0/140) for polyps <5mm. Conclusions: A substantial portion of subjects (29%) with positive fecal occult blood reaction of immunohistochemical analysis but negative colonoscopy still needs esophagogastroscopic examination to disclose upper gastrointestinal lesions. Immunohistochemical determination of fecal occult blood remains imperfect for polypoid lesions of colon in view of its sensitivity and specificity.

Urgent bedside endoscopy for clinically significant upper gastrointestinal hemorrhage after admission to the intensive care unit

Abstract: Objective To investigate the sources of hemorrhage and use of endoscopic hemostasis in patients with clinically significant upper gastrointestinal (UGI) hemorrhage after admission to the intensive care unit (ICU).

Cyclooxygenase-2 expression correlates with nuclear p53 accumulation in gastric carcinoma.

Abstract: BACKGROUND/AIMS: COX-2 (Cyclooxygenase-2) is the inducible isoform of cyclooxygenase in response to cytokines, mitogens, and growth factors and may induce carcinogenesis through the mechanisms of inhibiting apoptosis, increasing cell proliferation, and enhancing angiogenesis. This study aimed to clarify the relationship of COX-2 and p53, a well-known tumor suppressor gene, in gastric carcinoma. METHODOLOGY: Immunohistochemical staining of nuclear p53 protein and cytoplasmic COX-2 protein were utilized on tumor tissue sections from 65 surgical specimens. Their correlation was further analyzed according to pathologic characteristics. RESULTS: There were 47% (16/34) of high COX-2 expression in the high p53 immunoreactivity group but only 19% (6/31) of high COX-2 expression in the low p53 immunoreactivity group. COX-2 overexpression significantly correlated with the accumulation of nuclear p53 protein in general (p = 0.035). Analysis based on different pathologic characteristics revealed that COX-2 correlates with p53 in subsets of advanced, cardiac, and H. pylori (-) gastric carcinomas (p = 0.027, 0.048, 0.036, respectively). But the relationship does not differ between Lauren's intestinal- and diffuse-type gastric carcinomas. CONCLUSIONS: Our work provides evidence linking COX-2 and p53 in gastric carcinogenesis, but the mechanism how they interact to promote tumorigenesis remains to be elucidated.

Ultrasonographic diagnosis of inflammatory pseudotumor of the ileum complicating with intussusception: a case report.

Abstract: Inflammatory pseudotumor is one of the etiologies that may cause small bowel intussusception. Because of its emergency, early diagnosis plays a pivotal role in successful management. Ultrasonography is a safe and handy diagnostic tool without invasiveness and it is advantageous for early preoperative diagnosis. We present a case of ileal intussusception caused by inflammatory pseudotumor, which was diagnosed preoperatively with ultrasonography and was proven by operation. The ultrasonographic feature of the inflammatory pseudotumor was heterogeneously hyperechoic and it should be included in the differential diagnosis of hyperechoic leading lesions of small bowel intussusception in adults.