Inflammatory fibroid polyp of the jejunum causing intussusception.

Inflammatory fibroid polyp of jejunum is a very rare nonneoplastic lesion of gastrointestinal tract. We reported a 66-year-old male who presented with abdominal fullness, colicky pain, and vomiting for 4 days. Plain abdomen showed intestinal obstruction with dilated small bowel loops. The exploratory laparotomy was performed under the clinical impression of intussusception caused by small bowel tumor. The diagnosis of an inflammatory fibroid polyp causing jejunojejunal intussusception was confirmed after surgery.

Prevalence of hepatitis C viral infection in a community in Taiwan. Detection by synthetic peptide-based assay and polymerase chain reaction.

The prevalence of antibodies to hepatitis C virus (anti-HCV) in a hepatitis B virus hyperendemic region was evaluated with a second-generation enzyme immunoassay. A general population of 1500 from Northern Taiwan was tested with this immunoassay which includes synthetic peptides from the capsid and non-structural protein region as the solid-phase antigen. A total of 37 subjects out of 1500 (2.5%) were positive, with no significant difference in distribution between hepatitis B antigenemic and non-antigenemic samples. The prevalence of anti-HCV was higher in subjects with abnormal than those with normal liver function tests (8.2% vs. 1.5%). Prevalence increased with age. By polymerase chain reaction, 43% of anti-HCV-positive samples were HCV-RNA-positive. However, only 1 (0.6%) of 150 anti-HCV-negative subjects had HCV-RNA. Comparison of the results with those from a conventional recombinant C100-3-based assay showed that the capsid/non-structural region synthetic antigen system provided more accurate sensitivity and specificity. The more sensitive assay revealed a high prevalence for HCV infection of 2.5% among this general population in Taiwan.

Mutation of p53 gene in hepatocellular carcinoma in Taiwan.

To elucidate the role of p53 mutation in hepatocarcinogenesis in Taiwan, a hepatitis B viral infection hyperendemic area, exons 5 to 8 of the p53 gene in the tumor tissue of 61 hepatocellular carcinomas were amplified and sequenced. A total of 20 cases (32.8%) were found to have mutations; 36.6% (15 of 41) for the hepatitis B surface antigen positive group and 25.0% (5 of 20) for the hepatitis B surface antigen negative group. The corresponding normal liver showed no mutation. The mutation is widely distributed throughout exons 5 to 8. Only 4 cases (6.6%), all positive for hepatitis B surface antigen, had a specific hot spot mutation at codon 249 with G to T transversion. Our results show that scattered point mutations in p53 are not uncommon in hepatocellular carcinoma samples from Taiwan and may be important in the development of this cancer. However, the aflatoxin related specific mutation seems much less related to the genesis of hepatocellular carcinoma in Taiwan.

Hepatitis C and B viruses in hepatitis B surface antigen-negative hepatocellular carcinoma.

The relative role of hepatitis C virus and hepatitis B virus in hepatitis B surface antigen-negative hepatocellular carcinoma was evaluated by polymerase chain reaction in 31 patients from Taiwan. Twenty-one were positive for antibody to hepatitis C virus (group 1) and 10 were negative (group 2). Of the group 1 patients, hepatitis C viral RNA was detected in the serum by polymerase chain reaction in 16 and in the liver tissue in 17, whereas hepatitis B viral DNA was found in the liver tissue in only 4, and none were found in the serum. In group 2 patients, hepatitis C viral RNA was detected in the serum of 1 and in the liver tissue of another. In contrast, hepatitis B viral DNA was found in the serum of 4 patients and in the liver tissues of 5. It was concluded that hepatitis C virus plays an important role in hepatocarcinogenesis in hepatitis B surface antigen-negative patients in Taiwan, especially in those who had antibody to hepatitis C virus; in those without antibody to hepatitis C virus, hepatitis B virus might still be associated with the development of hepatocellular carcinoma in a significant proportion of such patients.

Prevalence of anti-HCV and HCV viremia in hemodialysis patients in Taiwan.

Hepatitis C viral infection in 125 hemodialysis patients from Taiwan was studied using a second-generation anti-HCV immunoassay (EIA II) (Abbott HCV 2.0 EIA) and the polymerase chain reaction (PCR) to detect the HCV RNA in the serum. A total of 59 patients (47.2%) were positive by EIA II. In comparison, the conventional C100-3 anti-HCV assay was positive in 40 (32.0%). HCV RNA was found in 47 patients (37.6%). Patients with elevated serum transaminase level had a higher positive rate of anti-HCV and HCV RNA. The dialysis time was longer for those patients positive for anti-HCV than for those who were negative. A total of 57 of the 59 EIA II-positive cases had a history of blood transfusion. The HBsAg status did not influence the anti-HCV positivity. Among the 59 EIA II-positive patients, 66.1% were also positive for HCV RNA, and of the 47 HCV RNA-positive cases 83.0% were positive for EIA II. It is concluded that the high prevalence of specific HCV infection and HCV viremia was present in these patients. Prevention of cross-contamination during dialysis and blood screening before transfusion are important for the control of HCV infection in these patients.

Minimal role of hepatitis B virus in posttransfusion non-A, non-B hepatitis in Taiwan: a study by polymerase chain reaction.

Using the polymerase chain reaction (PCR) for hepatitis B virus (HBV) DNA and an enzyme linked immunosorbant assay for the antibody to the hepatitis C virus (anti-HCV), we studied the serum samples of 18 patients with posttransfusion non-A, non-B (NANB) hepatitis in a prospective study. They were all negative for both the hepatitis B surface antigen (HBsAg) and the IgM antibody to the hepatitis B core antigen (IgM anti-HBc) by radioimmunoassay and were all negative for hepatitis B virus (HBV) DNA by dot blot hybridization. Eleven patients were positive for anti-HCV in the posttransfusion sera and 2 were already positive in the pretransfusion sera. Therefore, seroconversion of anti-HCV was noted in 9 patients. Two of these 18 patients were positive for HBV DNA by PCR in the posttransfusion sera and one of the 2 patients was also positive in the pretransfusion serum sample. The patient positive for HBV DNA in both pre and posttransfusion sera seroconverted to anti-HCV, while the patient positive for HBV DNA only in the posttransfusion sera was not seroconverted. We conclude that HBV plays minimal role in patients with posttransfusion NANB hepatitis in Taiwan even studied by PCR.

Detection of hepatitis B virus DNA by polymerase chain reaction in plasma of volunteer blood donors negative for hepatitis B surface antigen.

Plasma samples from 206 volunteer blood donors were tested for hepatitis B virus (HBV) DNA by dot blot hybridization and polymerase chain reaction (PCR). All donors were negative for hepatitis B surface antigen (HBsAg) and had normal serum alanine aminotransferase levels. None of the 206 plasma samples was positive for HBV DNA by dot blot hybridization assay. However, nine samples were positive for HBV DNA by PCR using two primer pairs specific for surface and core regions. Nine persons received the HBV-DNA-positive plasma, and one developed posttransfusion non-A, non-B hepatitis; the others remained well 6 months later. Therefore, approximately 4% of blood donors in Taiwan have low titers of HBV DNA, and a more sensitive method to screen donors may be needed in the future, although the current serologic test remains the most practical at present.

Serum hepatitis B virus DNA in healthy HBsAg-negative Chinese adults evaluated by polymerase chain reaction.

Serum hepatitis B virus (HBV) DNA was assayed using polymerase chain reaction, in 107 HBsAg-negative normal Chinese subjects. The results showed that eight subjects (7.5%) had HBV DNA. In the subgroup with antibody to hepatitis B surface antigen (anti-HBs) and to hepatitis B core antigen (anti-HBc), 7.3% (5/68) were positive for HBV DNA; HBV DNA was not detected in six individuals with anti-HBs only and in nine with anti-HBc only. In four persons with anti-HBc and anti-HBe, one had HBV DNA. In 20 subjects negative for all hepatitis B serological markers, two (10%) were found to have HBV DNA. This study indicates that serological markers are not adequate to rule out HBV infection, and it further implies that present blood donor screening methods may need improving.

Detection of hepatitis B viral DNA by polymerase chain reaction in patients with hepatitis B surface antigen.

Hepatitis B virus (HBV) DNA was assayed using the polymerase chain reaction in serum samples of 116 hepatitis B surface antigen (HBsAg) carriers, including 30 positive for hepatitis B e antigen (HBeAg) and 86 negative for HBeAg. In the HBeAg-positive group, all were positive for HBV DNA. In the HBeAg-negative group, 80.2% were positive for HBV DNA (80.0% in the healthy carrier group, 90.0% in the chronic active liver disease group, and 69.2% in patients with cirrhosis). This study indicated that every HBeAg-positive carrier as well as the majority of HBeAg-negative carriers were infectious and, in the latter group, that viral replication is most active in patients with chronic active liver disease.

Effect of haloperidol, suckling, oxytocin and hand milking on plasma relaxin and prolactin concentrations in cyclic and lactating pigs.

Prolactin secretion was stimulated in 5 cyclic gilts during the luteal phase (Day 10-13) with 5 mg haloperidol given i.v. Stimulation of prolactin secretion was also attempted by inducing milk let-down by suckling (4 sows), or by the injection of 1 mg oxytocin i.v. followed by hand milking (3 sows). Plasma prolactin concentrations increased significantly 1-2 h after haloperidol injection, and in 3 of 4 sows during suckling (P = 0.001); plasma relaxin concentrations did not change significantly at these times. No change was observed in plasma prolactin or relaxin concentrations at 15 min or 1-2 h after oxytocin injection and hand milking. Plasma relaxin concentrations ranged from below the sensitivity of the assay (100 pg/ml) to 450 pg/ml in lactating sows and from 100 to 2000 pg/ml in cyclic gilts. The results suggest that in cyclic gilts treated in the luteal phase with a dopaminergic receptor blocker, and in lactating sows during suckling, elevations in plasma prolactin concentrations were not accompanied, during the same period, by detectable changes in relaxin concentrations.