https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1053/jhep.2001.29401

Chronic hepatitis B

Chronic hepatitis B remains a major public health problem, affecting more than 350 million people worldwide. Cirrhosis, liver failure, or hepatocellular carcinoma will develop in approximately 15 t...

Chronic hepatitis B.

Hepatitis B vaccines.

Phytogenic agents have traditionally been used by herbalists and indigenous healers for the prevention and treatment of peptic ulcer. This article reviews the anti-acid/anti-peptic, gastro-protective and/or anti-ulcer properties of the most commonly employed herbal medicines and their identified active constituents. Botanical compounds with anti-ulcer activity include flavonoids (i.e. quercetin, naringin, silymarin, anthocyanosides, sophoradin derivatives) saponins (i.e. from Panax japonicus and Kochia scoparia), tannins (i.e. from Linderae umbellatae), gums and mucilages (i.e. gum guar and myrrh). Among herbal drugs, liquorice, aloe gel and capsicum (chilli) have been used extensively and their clinical efficacy documented. Also, ethnomedical systems employ several plant extracts for the treatment of peptic ulcer. Despite progress in conventional chemistry and pharmacology in producing effective drugs, the plant kingdom might provide a useful source of new anti-ulcer compounds for development as pharmaceutical entities or, alternatively, as simple dietary adjuncts to existing therapies.

The plant kingdom as a source of anti‐ulcer remedies

Virus-like particles: passport to immune recognition.

Capsaicin, the pungent ingredient of chili, has a gastroprotective effect against experimental gastric mucosal injury in animals. Such an effect has not, however, been documented in humans to date. Eighteen healthy volunteers with normal index endoscopies underwent two studies four weeks apart. Each subject took 20 g chili orally with 200 ml water in one study and 200 ml water in another study. In each case this was followed half an hour later by 600 mg aspirin BP with 200 ml water. Endoscopy was repeated 6 hr later. Gastroduodenal mucosal damage was assessed by a previously validated scoring system. The median gastric injury score after chili was 1.5 compared to 4 in the control group (P < 0.05), demonstrating a gastroprotective effect of chili in human subjects.

Chili protects against aspirin-induced gastroduodenal mucosal injury in humans.

Recombinant DNA hepatitis B vaccine containing Pre-S components of the HBV coat protein--a preliminary study on immunogenicity.

A diagnostic dilemma exists at the extreme ends of the spectrum in the cytodiagnosis of hepatocellular carcinoma (HCC). The cytologic features of fine needle aspiration biopsies from 30 well- and 16 poorly differentiated HCC were reviewed and the adjunctive role of serum alpha-fetoprotein (AFP), hepatitis B virus (HBV) markers and radiologic findings evaluated. Some subtle features noted in very well differentiated HCC include small tumor cell size with increased nuclear/cytoplasmic ratio, monotony of atypia, hepatocytic tumor giant cells and narrow trabeculae with tendency for cell dissociation. Useful features in poorly differentiated HCC include cell dehiscence, large cells with ovoid nuclei and thickened nuclear membranes, and one or more increasingly prominent nucleoli, with some assuming a reniform configuration. The serum AFP levels are not always elevated. Positive HBV markers, cirrhosis and compatible imaging findings are suggestive but not diagnostic. The general inclination, however, is still toward a diagnosis of HCC if the aspirate is from a focal lesion or lesions in a hepatitis B surface antigen-positive, cirrhotic liver. Cell block sections provide histologic confirmation.

Fine needle aspiration biopsy of hepatocellular carcinoma: diagnostic dilemma at the ends of the spectrum

A mathematical model was used to calculate the efficacy of screening to detect hepatocellular carcinoma at a resectable stage in hepatitis B virus carriers. Data relating to tumour incidence, efficacy of screening tests and tumour growth times were obtained from a literature review. Various tests were costed according to charges currently prevailing at the authors' institution. The cost per early tumour detected is inversely proportional to tumour incidence. It is relatively low for populations with high incidences of hepatocellular carcinoma for example, male carriers over the age of 30. Both the costs and the proportions of early tumour detected increase with increasing frequency of screening. However, the use of ultrasonography at 10 monthly intervals or both ultrasonography and alpha-fetoprotein estimation at yearly intervals will detect 90% of tumours early at a cost of S$20,000 (US$11,800) per early tumour detected. The results would be significantly altered if tumour growth times were markedly different from those reported in the literature.

Analysis of cost-effectiveness of different strategies for hepatocellular carcinoma screening in hepatitis B virus carriers.

The cytologic features of fine needle aspiration smears from 28 hepatocellular carcinomas (HCC) were reviewed. All aspirations except one were guided. There were 14 well-, 11 moderately and 3 poorly differentiated HCC. The better-differentiated HCC were characterized by similarity of the tumor cells to hepatocytes (83%), cohesive cell clusters with a trabecular arrangement (72%) and presence of sinusoidal endothelial cells (66%). Other features included bile production (38%), atypical hepatocytic naked nuclei (52%), acinar formation (31%), intracytoplasmic vacuoles (14%) and abnormal vascular patterns (14%). Poorly differentiated HCC showed dyshesive pleomorphic cells. Unusual cytologic features from a well-differentiated HCC with fatty change and an HCC with a prominent acinar component are described. The identification of fatty change in dissociated well-differentiated hepatocytes or cytologic features suggestive of an adenocarcinoma do not preclude the diagnosis of HCC. The usefulness of cell blocks is emphasized.

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Papers

Chili protects against aspirin-induced gastroduodenal mucosal injury in humans.

Recombinant DNA hepatitis B vaccine containing Pre-S components of the HBV coat protein--a preliminary study on immunogenicity.

Fine needle aspiration biopsy of hepatocellular carcinoma: diagnostic dilemma at the ends of the spectrum

Analysis of cost-effectiveness of different strategies for hepatocellular carcinoma screening in hepatitis B virus carriers.

Fine needle aspiration biopsy of hepatocellular carcinoma. Some unusual features.