Sheng Hung Chen

Further evidence for the decay K+ ---> pi+ neutrino anti-neutrino

Additional evidence for the rare kaon decay K+ to pi+ neutrino-antineutrino has been found in a new data set with comparable sensitivity to the previously reported result. One new event was observed in the pion momentum region examined, 211<P<229 MeV/c, bringing the total for the combined data set to two. Including all data taken, the backgrounds were estimated to contribute 0.15 pm 0.05 events. The branching ratio is B=1.57^{+1.75}_{-0.82} 10^{-10}.

Further Evidence for the DecayK+→π+νν¯

Additional evidence for the rare kaon decay K+ to pi+ neutrino-antineutrino has been found in a new data set with comparable sensitivity to the previously reported result. One new event was observed in the pion momentum region examined, 211<P<229 MeV/c, bringing the total for the combined data set to two. Including all data taken, the backgrounds were estimated to contribute 0.15 pm 0.05 events. The branching ratio is B=1.57^{+1.75}_{-0.82} 10^{-10}.

Clinical Analysis of Ectopic Pancreas with Endoscopic Ultrasonography: An Experience in a Medical Center

ObjectiveTo describe the endosonographic features of gastrointestinal ectopic pancreas, especially when histopathological diagnosis is unachievable with nonsurgical modalities.MethodsEndoscopic ultrasonography was performed in 20 patients with endoscopically recognized ectopic pancreas. We then analyzed the endosonographic features of the lesions and the clinical aspects of the patients, including age, gender, symptoms, and lesion locations.ResultsEndoscopic ultrasonography revealed that the lesions originated from the second, third, and/or fourth layers of the gastrointestinal wall. Most lesions (95%, 19/20) were heterogenous, mainly hypoechoic or mixed, in echogenicity. The borders of the lesions were indistinct in 13 (13/20, 65%) and distinct in 7 (7/20, 35%) patients. Anechoic cystic or tubular structures within the lesions appeared in 7 of the 20 lesions (35%).ConclusionEctopic pancreas usually appears as a submucosal lesion with characteristic central dimpling. Furthermore, characteristic endoscopic ultrasonographic features can readily assist in the diagnosis of ectopic pancreas without having to perform endoscopic biopsy or surgery. However, either endoscopic ultrasonography-guided fine needle aspiration or endoscopic removal of lesions should still be considered mandatory for the differential diagnosis of ectopic pancreas whenever typical endosonographic features cannot be well demonstrated.

Study of the decay K+ ---> pi+ nu anti-nu in the momentum region 140 < P(pi) < 199-MeV/c

Experiment E949 at Brookhaven National Laboratory has observed three new events consistent with the decay K+ => pi+,nu,nubar in the pion momentum region 140 pi+,nu,nubar events to seven. Combining this observation with previous results, assuming the pion spectrum predicted by the standard model, results in a branching ratio of (1.73+1.15-1.05)e-10. An interpretation of the results for alternative models of the decay K^ => pi+,nothing is also presented.

AN INDEX TO PREDICT RIBAVIRIN-INDUCED ANEMIA IN ASIAN PATIENTS WITH CHRONIC GENOTYPE 1 HEPATITIS C

Background: Single-nucleotide polymorphisms (SNP) in the inosine triphosphate pyrophosphatase (ITPA) gene correlate with ribavirin (RBV)-induced anemia in patients with chronic hepatitis C (CHC) receiving combination therapy. Managing anemia is an early priority in the treatment process. Objectives: The aim was to develop a predictive index based on ITPA SNP status to identify CHC patients at risk of anemia. Patients and Methods: A total of 418 eligible East Asian patients diagnosed with CHC genotype 1 (G1) received combination therapy in this study. Participant DNA was genotyped for a functional ITPA SNP (C/C, A/A or C/A) on chromosome 20 at rs1127354. A predictive index was constructed by incorporating independent factors identified for severe anemia events (hemoglobin < 10 g/dL). Areas under the receiver-operating characteristic curves (AUCs) represented the diagnostic accuracies of the predictive index in randomly assigned development and validation cohorts. Results: Multiple logistic regressions identified age (≥ 50 y: OR = 9.7, 95% CI = 5.0 - 18.6), ITPA rs1127354 (C/C: OR = 3.3, 95% CI = 1.8 - 5.8) and baseline hemoglobin (< 14.0 g/dL: OR 6.4, 95% CI = 3.3 - 12.1; 14.0 - 14.9: OR = 2.4, 95% CI = 1.2 - 4.6) as predictors of severe anemia throughout the treatment. For severe anemia, the predictive index incorporating age, ITPA SNP status and baseline hemoglobin yielded diagnostic accuracies (AUCs) of 0.830 (95% CI = 0.783 - 0.871) in the development (n = 324) and 0.902 (0.826 - 0.925) in the validation (n = 81) cohorts. Conclusions: In patients with CHC G1 and receiving combination therapy, ITPA SNP-based index was an accurate and practical solution for prediction of severe anemia.

Early hepatitis B surface antigen decline predicts treatment response to entecavir in patients with chronic hepatitis B

Early declines in serum hepatitis B surface (HBsAg) levels, their optimal cutoffs, and association with therapeutic endpoints in chronic hepatitis B (CHB) patients receiving entecavir treatment remain unclear. We prospectively enrolled 529 patients (195 hepatitis B e antigen [HBeAg]-positive and 334 HBeAg-negative) with a median treatment duration of 49.2 months. Median HBsAg levels declined significantly in both groups at Month 3, but only at Months 6–12 in the HBeAg-negative group. Both groups exhibited a significant HBsAg decline with each successive year of treatment. An HBsAg decline of ≥75% from baseline, assessed at Months 3 and 12 of treatment in the HBeAg-positive and -negative patients, respectively, independently predicted a virological response and HBeAg seroconversion in the HBeAg-positive patients, an HBsAg level of <100 IU/mL in the HBeAg-negative patients, and HBsAg loss in all the patients during treatment. HBsAg levels of <3,000 IU/mL at baseline combined with an HBsAg decline of ≥75% from baseline provided a predictive algorithm for HBsAg loss (positive and negative predictive values: 70% and 100%, respectively) during 5 years of treatment. The proposed cutoffs for defining an HBsAg decline may assist clinicians in early assessments of treatment responses in genotype B-infected or C-infected CHB patients receiving entecavir therapy.

Changes in liver stiffness measurement using acoustic radiation force impulse elastography after antiviral therapy in patients with chronic hepatitis C

Background To compare on-treatment and off-treatment parameters acquired using acoustic radiation force impulse elastography, the Fibrosis-4 (FIB-4) index, and aspartate aminotransferase-to-platelet ratio index (APRI) in patients with chronic hepatitis C (CHC). Methods Patients received therapies based on pegylated interferon or direct-acting antiviral agents. The changes in paired patient parameters, including liver stiffness (LS) values, the FIB-4 index, and APRI, from baseline to sustained virologic response (SVR) visit (24 weeks after the end of treatment) were compared. Multiple regression models were used to identify significant factors that explained the correlations with LS, FIB-4, and APRI values and SVR. Results A total of 256 patients were included, of which 219 (85.5%) achieved SVR. The paired LS values declined significantly from baseline to SVR visit in all groups and subgroups except the nonresponder subgroup (n = 10). Body mass index (P = 0.0062) and baseline LS (P < 0.0001) were identified as independent factors that explained the LS declines. Likewise, the baseline FIB-4 (P < 0.0001) and APRI (P < 0.0001) values independently explained the declines in the FIB-4 index and APRI, respectively. Moreover, interleukin-28B polymorphisms, baseline LS, and rapid virologic response were identified as independent correlates with SVR. Conclusions Paired LS measurements in patients treated for CHC exhibited significant declines comparable to those in FIB-4 and APRI values. These declines may have correlated with the resolution of necroinflammation. Baseline LS values predicted SVR.

New measurement of the K+ ---> pi+ nu anti-nu branching ratio

A.V. Artamonov, B. Bassalleck, B. Bhuyan, ∗ E.W. Blackmore, D.A. Bryman, S. Chen, 4 I-H. Chiang, I.-A. Christidi, † P.S. Cooper, M.V. Diwan, J.S. Frank, T. Fujiwara, J. Hu, J. Ives, D.E. Jaffe, S. Kabe, S.H. Kettell, M.M. Khabibullin, A.N. Khotjantsev, P. Kitching, M. Kobayashi, T.K. Komatsubara, A. Konaka, A.P. Kozhevnikov, Yu.G. Kudenko, A. Kushnirenko, ‡ L.G. Landsberg, § B. Lewis, K.K. Li, L.S. Littenberg, J.A. Macdonald, § J. Mildenberger, O.V. Mineev, M. Miyajima, K. Mizouchi, V.A. Mukhin, N. Muramatsu, T. Nakano, M. Nomachi, T. Nomura, T. Numao, V.F. Obraztsov, K. Omata, D.I. Patalakha, S.V. Petrenko, R. Poutissou, E.J. Ramberg, G. Redlinger, T. Sato, T. Sekiguchi, T. Shinkawa, R.C. Strand, S. Sugimoto, Y. Tamagawa, R. Tschirhart, T. Tsunemi, ¶ D.V. Vavilov, B. Viren, Zhe Wang, 3 N.V. Yershov, Y. Yoshimura, and T. Yoshioka

Trajectories of serum hepatitis B surface antigen kinetics in patients with chronic hepatitis B receiving long-term nucleos(t)ide analogue therapy.

The kinetics of serum hepatitis B surface antigen (HBsAg) levels during long‐term nucleos(t)ide analogue (NA) therapy in chronic hepatitis B (CHB) patients remains unclear. We investigated the patterns of serum HBsAg kinetics and their association with therapeutic outcomes in genotype B‐ or C‐infected CHB patients receiving long‐term NA therapy.

New noninvasive index for predicting liver fibrosis in Asian patients with chronic viral hepatitis

We developed an optimal noninvasive index comprising routine laboratory parameters for predicting cirrhosis in chronic hepatitis B (CHB) and chronic hepatitis C (CHC) patients. This study included 992 CHB patients and 1,284 CHC patients who received liver biopsy. We developed the new index, named modified Fibrosis-4 (mFIB-4) according to four independent variables of the model: age, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count. The formula of the mFIB-4 index is 10 × Age(years) × AST(U/L)/Platelet count(109/L) × ALT(U/L). For predicting cirrhosis, the bootstrap areas under the receiver operating characteristic curve for platelet count, AST/ALT ratio (AAR), AAR/platelet ratio index (AARPRI), AST/platelet ratio index (APRI), FIB-4, Pohl score, age-platelet (AP) index, Lok index, fibrosis quotient (FibroQ), and mFIB-4 were 0.7680, 0.7400, 0.8070, 0.6090, 0.7690, 0.6990, 0.7850, 0.7960, 0.8110, and 0.8070 in CHB patients, and 0.8170, 0.7210, 0.8400, 0.7310, 0.8310, 0.6730, 0.8220, 0.8440, 0.8570, and 0.8480 in CHC patients, respectively. FibroQ and mFIB-4 exhibited the highest diagnostic performance levels for liver cirrhosis in CHB and CHC despite the inclusion of the international normalised ratio in the formulation of FibroQ. Thus, mFIB-4 is a simple, inexpensive, and readily available method for assessing the liver fibrosis stage of Asian patients with CHB or CHC.