Chun-Yen Huang

Prevalence and clinical implications of hepatitis B virus genotypes in southern Taiwan

Background: Hepatitis B virus (HBV) infection is a major health problem. HBV genotypes may be associated with progression of liver disease. The distribution and clinical implications of HBV genotypes in southern Taiwan are evaluated. Methods: We used a polymerase chain reaction-restriction fragment length polymorphism genotyping method to determine HBV genotypes. Results: The genotype distribution for 265 patients with chronic HBV infection was as follows: A, 3 (1%); B, 158 (60%); C, 90 (34%); D, 7 (2.5%); E, 0; F, 0; and unclassified, 7 (2.5%). Compared with genotype B patients, genotype C patients had a higher hepatitis B e antigen positive rate and higher fibrosis score. There was no significant difference in the mean age between genotype B and genotype C patients with hepatocellular carcinoma (HCC). However, when patients were stratified by age, the prevalence of genotype C was significantly higher in young HCC patients (around 50 years of age) than in age-matched asymptomatic carriers (40% versus 10%, P ≺ 0.001). Using multivariate analysis, the significant risk factors for advanced liver disease (cirrhosis or HCC) for patients with chronic HBV infection were old age, male gender and genotype C. Conclusions: These results suggest that genotype C is associated with more severe liver diseases than the B variant.

Early detection of Blunt traumatic brachial artery pseudoaneurysm by point of care ultrasound: case report

Patient and method A 61-year-old man with hypertension history, presented with progressive left elbow pain and swelling after blunt injury. He was fell down 1 week ago and direct contusion to his arm. He reported no numbness or weakness. His vital signs were stable except high blood pressure (188/108mHg) Physical examination revealed ecchymosis of his arm (Figure 1) and palpable pulsation over brachial, radial and ulnar artery. Laboratory exam showed elevatingCK(793 IU/L) otherwise normal. X-ray exam revealed normal. US revealed an anechoiclesion over elbow with pulsation.(Figures 2 and 3) and some heterogenic lesion over muscle layer, PA and hematoma were considered. CTA of extremity showed PA of brachial artery.(Figures 4 and 5) Patient received endografting and fasciotomy, patient was discharged smoothly after 10 days admission.

Gas-forming pyogenic liver abscess

A 74-year-old male with medical history of diabetes mellitus, hypertension and lung cancer, visited our emergency department (ED) because of fever and decreased consciousness level. At the ED, vital signs were normal except tachycardia (134 beats/min), physical examination revealed mild right-upper quadrant tenderness. Laboratory data showed increased leukocyte count (13 010/μl), glucose (919 mg/dl), serum …

Isolated gallbladder hematoma after a blunt abdominal trauma: case report

Background Sonography has played an important role on detection of intraabdominal injuries with a sensitivity of 86%, a specificity of 98%, and an accuracy of 97% [1]. Negative predictive value achieved about 98% [1]. However, gallbladder injury is rare with incidence around 2.1% [2,3] in blunt abdominal trauma [2], and commonly associated with the solid organ injury or abdominal vascular injury [4]. Isolated gallbladder injury were very few[3] including traumatic cholecystitis, gallbladder tear, and gallbladder perforation ...etc. Ultrasound is very sensitive to gallbladder disease. We presented a rare case of isolated gallbladder hematoma after a blunt abdominal trauma which diagnosis by Focused Gallbladder ultrasound.

A novel role of ultrasonography in identification of the tract of abdominal stab injury

Background Abdominal stab injury is potential life-threatening injuries. Operation should be considered if wound violate the peritoneal layer and/or complicated with hemodynamic compromise, peritonitis, impalement, or evisceration. It is well known there are several diagnostic tools to evaluate the necessity of operation for a patient with abdominal stab injury. Despite numerous diagnostic tools, including local wound exploration, CT, diagnostic peritoneal lavage, or FAST, were currently performed in emergent department neither of them has satisfying sensitivity and specificity. Abdominal wall ultrasonography has been used many abdominal wall disease, like hernia, abdominal wall hematoma. We used abdominal wall ultrasonography for diagnosis of abdominal wall stabbing injury