• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.7011-7016
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• 2013

Background: The liver fluke, Opisthorchis viverrini, and the associated incidence of subsequent cholangiocarcinoma (CCA) are still a public health problem in Thailand, and praziquantel (PZQ) remains the antihelminthic drug of choice for treatment. Evidence in hamsters shows that repeated infection and PZQ treatments could increase the risk of CCA. However, the existing evidence in humans is inconclusive regarding increased risk of CCA with frequency of PZQ intake. Objectives: To investigate the relationship between number of repeated PZQ treatments and CCA in patients with O viverrini infection. Materials and Methods: The reviewed studies were searched in EMBASE, MEDLINE, ProQuest, PubMed and SCOPUS from inception to October, 2012 using prespecified keywords. The risk of bias (ROB) of included studies was independently assessed by two reviewers using a quality scale from the Newcastle-Ottawa Scale (NOS). Risk effect of PZQ was estimated as a pooled odds ratio (OR) with its 95% confidence interval (95%CI) in the random-effects model using DerSimonian and Laird's estimator. Results: Three studies involving 637 patients were included. Based on the random effects model performed in two included studies of 237 patients, the association between PZQ treatments and CCA was not statistical significant with a pooled OR of 1.8 (95%CI; 0.81 to 4.16). Conclusions: The present systematic review and meta-analysis provides inconclusive evidence of risk effect of PZQ on increasing the risk of CCA and significant methodological limitations. Further research is urgently needed to address the shortcomings found in this review, especially the requirement for histological confirmation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.1
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• pp.38-43
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• 2012

Purpose: Epstein-Barr virus (EBV) hepatitis is a usually asymptomatic and self-limiting disease in immunocompetent patients. However, the range of severity is wide, and the serological diagnosis is typically difficult until the convalescent phase. Thus, we examined the value of plasma EBV DNA real-time quantitative polymerase chain reaction (RT-qPCR) in EBV hepatitis for the timely diagnosis and the relationship between EBV viral load and clinical severity. Methods: Sixty samples were confirmed as having EBV infection by RT-qPCR with the EBV BALF5 gene sequence. We examined the clinical characteristics of EBV hepatitis by reviewing medical records. Results: The median total duration of fever was 8 days (range: 0-13 days). The mean peak value of aspartate aminotransferase (AST) was $241{\pm}214$ U/L, and the mean peak value of alanine aminotransferase (ALT) was $298{\pm}312$ U/L. There was no correlation between the serum levels of liver enzyme and plasma EBV DNA titer ($p$=0.1) or between median total duration of fever and EBV DNA titer ($p$=0.056). The median age of the EBV VCA IgM-negative group was lower compared with the EBV VCA IgM-positive group in EBV hepatitis (2 years vs. 6 years, $p$=0.0009). Conclusion: The severity of EBV hepatitis does not correlate with circulating EBV DNA load according to our data. Furthermore, we suggest that plasma EBV PCR may be valuable in young infants in whom the results of serology test for EBV infection commonly are negative.

• Asian-Australasian Journal of Animal Sciences
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• v.18 no.5
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• pp.728-733
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• 2005

The frequency and distribution of lymphoma caused by bovine leukemia virus (BLV) infection in various organs were investigated. Lymphoma samples were obtained from slaughtered cattle or from cattle submitted to the National Veterinary Research and Quarantine Service, Korea. Thirty female Holstein-Friesian dairy cattle aged over three years with the BLV-associated lymphoma were studied. None of the Korean native cattle (Hanwoo) had lymphoma in this study however. Lymphoma tissues were gray to pink in color, soft in consistency, and bulged from the cut surface. In advanced lymphoma tissues, there was great variety in the appearance of involved structures due to hemorrhage, necrosis, and/or calcification. Neoplastic tissues were observed in lymph nodes in all lymphoma cases. Intestine (96.4%), heart (88.9%), stomach (73.1%), and diaphragm (62.5%) were frequently involved with lymphoma. However, there was no lymphoma detected in liver. Large neoplastic masses, sometimes reaching the size of over 20 cm, were found in the abdominal cavities. It is suggested that metastasis of lymphomas occurs mainly via lymph based on gross observations; neoplasia may have been initiated in the serosal surface of the lung, heart, peritoneum, and numerous hollow organs in the abdominal cavity. Also many organs in the abdominal and thoracic cavity were affected by neoplastic tissues simultaneously. Characteristics observed in this study could be used as criteria to differentiate BLV-associated lymphoma from other nodular lesions in the slaughterhouse and as fundamental data to make clear the mechanism of metastasis or pathogenesis of EBL.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1037-1040
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• 2015

Hepatitis C is a blood-borne infectious disease of liver, caused by a small enveloped, positive-single stranded RNA virus, called the hepatitis C virus (HCV). HCV belongs to the Flaviviridae family and has 6 genotypes and more than 100 subtypes. It is estimated that 185 million people are infected with HCV worldwide and 5% of these are in Pakistan. The study was designed to evaluate different genotypes of HCV circulating in District Mardan and to know about the behavior of these genotypes to different anti-viral regimes. In this study 3,800 patients were exposed to interferon alfa-2a plus Ribavirin treatment for 6-months and subjected to real-time PCR to check the viral response. Among these 3,677 (97%) patients showed no detectable HCV RNA while 123 (3%) patients (non-responders) remained positive for HCV RNA. Genotypes of their analyzed showed that most of them belonged to the 3a genotype. Non-responders (123) and relapsed (5) patients were subjected to PEG-interferon and Ribavirin therapy for next 6 months, which resulted into elimination of HCV RNA from 110 patients. The genotypes of the persisting resistant samples to anti-viral treatment were 3b, 2a, 1a and 1b. Furthermore, viral RNA from 6 patients remained un-typed while 4 patients showed mixed infections. HCV was found more resistant to antiviral therapy in females as compared to mals. The age group 36-45 in both females and males was found most affected by infection. In general 3a is the most prevalent genotype circulating in district Mardan and the best anti-viral therapy is PEG-interferon plus Ribavirin but it is common practice that due to the high cost patients receive interferon alfa-2a plus Ribavirin with consequent resistance in 3% patients given this treatment regime.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2865-2869
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• 2013

Hepatitis B virus (HBV) infection can become chronic and if left untreated can progress to hepatocellular carcinoma (HCC).Thailand is endemic for HBV and HCC is one of the top five cancers, causing deaths among Thai HBV-infected males. A single nucleotide polymorphism (SNP) at the KIF1B gene locus, rs17401966, has been shown to be strongly associated with the development of HBV-related HCC. However, there are no Thai data on genotypic distribution and allele frequencies of rs17401966. Thai HBV patients seropositive for HBsAg (n=398) were therefore divided into two groups: a case group (chronic HBV with HCC; n=202) and a control group (HBV carriers without HCC; n=196). rs17401966 was amplified by polymerase chain reaction (PCR) and analyzed by direct nucleotide sequencing. The genotypic distribution of rs174019660 for homozygous major genotype (AA), heterozygous minor genotype (AG) and homozygous minor genotype (GG) in the case group was 49.5% (n=100), 40.1% (n=81) and 10.4% (n=21), respectively, and in controls was 49.5% (n=97), 42.3% (n=83) and 8.2% (n=16). Binary logistic regression showed that rs17401966 was not statistically associated with the risk of HCC development in Thai chronic HBV patients (p-value=0.998, OR=1.00 and 95% CI=0.68-1.48). In conclusion, the KIF1B gene SNP (rs174019660) investigated in this study showed no significant association with HBV-related HCC in Thai patients infected with HBV, indicating that there must be other mechanisms or pathways involved in the development of HCC.

• Korean Journal of Poultry Science
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• v.38 no.1
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• pp.45-50
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• 2011

A case of aspergillosis in 39-day-old layer chickens having a history of gradual emaciation and subsequently death with nervous signs such as torticollis and lack of equilibrium was documented. Based on the results from serology and polymerase chain reaction (PCR) test, this flock was not affected with known viral or bacterial diseases. On postmortem examination of the affected birds, multiple white to yellow nodules measuring 1~5 mm in diameter were observed in the lungs, cerebrum, liver and kidney. Microscopically, these nodules were identified as granulomatous lesions characterized by mixed population of multinucleated giant cells and lymphocytes. By periodic acid-schiff staining and nucleotide sequencing analysis, Aspergillus flavus with characteristic septate and branched hyphae were identified in the granuloma of lung and cerebrum. This case was a chronic and multisystemic aspergillosis specialized to central nervous system caused by Aspergillus flavus infection in the layer flocks.

• Parasites, Hosts and Diseases
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• v.30 no.1
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• pp.15-20
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• 1992

The Taenia species in East Asia, hitherto identified as Taenia saginata, has been recognized as differing from the classical descriptions of life cycles and was recently named Taenia saginata taiwanensis (tentatively until 1992) . Major differences between T. saginata and the newly recognized Asian T. saginata are their intermediate hosts and the infected tissues. Asian T. saginata metacestodes are found in the livers of pigs rather than in the muscles of cattle. In this study, we observed the natural infection status of Asian T saginata metacestodes in the livers of 25,358 pigs at an abattoir in Cheongju City, Korea, from 1989 to 1990. Total 256 livers(1.01%) were infected with 1∼96 (mean 2.5 per capita) metacestodes. Most of the metacestodes, however, were either calcified (87.1%) or highly degenerated (12.9%). Living metacestodes were found in only 0.01% (3/25,358) of the examined livers. And these were distributed randomly in each lobe of the livers. The liver of pigs in Korea was con- firmed as an organ hosting the Asian T. saginata metacestode. But its epidemiological significance as a source of human infections should be properly evaluated because of the rarity of the living metacestodes.

• Parasites, Hosts and Diseases
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• v.31 no.2
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• pp.83-90
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• 1993

We performed bromodeoxyuridine (BrdU) staining to observe the proliferation pattern of epithelial cells on the biliaJy mucosa in Clonorchis sinensis infection. Albino rats were infected with 100 metacercariae each and their livers were processed for histopathological observation after BrdU injection. Five to six sites in the liver of a rat were selected for paraffin section, and stained immunohistochemically to visualize BrdU incorporating cells. The flukes were mainly in the common bile duct and right or left hepatic bile ducts. The proportion of stained epithelial cells in the infected bile ducts where the worms were found on the section was 2.9-10.2% at 1 week after infection. 7.3-12.8% at 2 weeks, 7.3-13.4% at 5 weeks, and 8.4-14.8% at 15 weeks while in the non-infected ducts o to 2.7% cells were stained. The stained cells were mainly at the base of the mucosal layer. It is suggested that mucosal epithelial cells of the bile ducts infected with C. sinensis become hyperplastic mainly by direct and local stimulation of the worms.

• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.230-235
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• 2002

We experienced a case of herpes zoster in a 9-months aged infant as followings; The patient had no history of chickenpox or varicella vaccination. Also, her mother had no history of varicella infection and no contact history with varicella during pregnancy. The patient had only a history of exposure to chickenpox patient at 7th days after birth, but fortunately chickenpox was not developed. Sequentially, symptoms of cough with fever and tachypnea were developed on admission date(7 days had passed already after development of the initial skin lesion). On physical examination, multiple grouped painless erythematous papulovesicles with small crusts were observed on the right lower back, flank and abdomen along the T11 dermatome. Coarse breathing sound was osculated, and increased linear infiltrations on both parahilar areas were seen on chest radiography. Liver enzymes were slightly elevated. Tzanck test was negative. The initial titers of anti-VZV IgM and IgG on admission were negative, but the following titers of anti-VZV IgM and IgG were positive. The patient received treatment of acyclovir for 7 days, and healed completely without sequelae. We report this case with brief review of related literatures.

• Journal of Trauma and Injury
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• v.29 no.2
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• pp.56-59
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• 2016

Patients with pelvic bone fractures with gastrointestinal perforations are reported in 4.4% of the cases and in very rare cases jejunum (0.15) is involved. However, intestinal perforations are often undiagnosed on the first examination before peritonitis is evident. We are presenting a report where a patient with anteroposterior compression injury, who was expected to undergo an internal fixation procedure, did not show any jejunum perforations on abdominal CT or other physical exams but was found on abdominal CT 1 week after right before surgery, therefore excision and anastomosis surgery, pelvic open reduction and internal fixation was simultaneously done with favorable results. In our case, we present a 61 year old male patient with liver trauma, adhesion at the abdominal cavity, with a past history of gallbladder excision, but without abdominal pain, fever, or infection symptoms. Therefore, this was a case that was difficult to initially diagnose the patient with jejunum perforation and peritonitis. The diagnosis was further supported during laparotomy when peritonitis around the area of intestinal perforation was observed. Generally, it is understood that pelvic bone fracture surgery is not immediately done on patients with peritonitis. However, this kind of patient who had peritonitis with intestinal adhesion and other complications could undergo surgery immediately as infection or other related symptoms did not coexist and the patient was rather stable, and as a result the treatment was successful.