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Dive into the research topics where Tsung-Ming Chen is active.

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Featured researches published by Tsung-Ming Chen.


Journal of Gastroenterology | 2003

Correlation between ultrasonographic and pathologic diagnoses of hepatitis B and C virus-related cirrhosis

Chao-Hung Hung; Sheng-Nan Lu; Jing-Houng Wang; Chuan-Mo Lee; Tsung-Ming Chen; Hung-Da Tung; Chien-Hung Chen; Wu-Shiung Huang; Chi-Sin Changchien

Background. We aimed to evaluate the validity of ultrasonography (US) in the diagnosis of cirrhosis in patients with chronic hepatitis B virus (HBV) or C virus (HCV) infection. Methods: A total of 210 patients, 67 with chronic HBV and 143 with HCV infection, were evaluated for the cirrhotic status of liver by both needle biopsy and US. According to the pathological findings, a fibrosis score 4 on the histology activity index was the gold standard for the diagnosis of cirrhosis. A US scoring system consisting of liver surface, parenchyma, vascular structure, and splenic size was used to describe the severity of hepatic parenchymal damage. Results: Cirrhosis was found in 27 (40%) of the 67 HBV patients and in 51 (36%) of the 143 HCV patients pathologically. The mean fibrosis scores were 0.95, 1.24, 2.35, 2.95, 3.8 and 3.7 in patients with US scores of 4, 5, 6, 7, 8, and 9 or more, respectively. The US scores were significantly correlated with the hepatic fibrosis scores (P < 0.05). Based on the receiver operating characteristic (ROC) curve, a US score of 7 was the best cutoff point for the prediction of HBV-related cirrhosis, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 77.8%, 92.5%, 87.5%, 86.0%, and 86.6%, respectively. In HCV-related cirrhosis, a US score of 6 provided results of 82.4%, 70.7%, 60.9%, 87.8%, and 74.8%, respectively. The specificity, positive predictive value, and accuracy were significantly higher in patients with HBV than in those with HCV infection (P = 0.012, P = 0.032, and P = 0.079, respectively). Conclusions: Cirrhosis can be predicted well by US, especially in patients with HBV infection.


Cancer | 2006

Thrombocytopenia as a surrogate for cirrhosis and a marker for the identification of patients at high-risk for hepatocellular carcinoma.

Sheng-Nan Lu; Jing-Houng Wang; Shiann-Long Liu; Chao-Hung Hung; Chien-Hung Chen; Hung-Da Tung; Tsung-Ming Chen; Wu-Shiung Huang; Chuan-Mo Lee; Chia-Cheng Chen; Chi-Sin Changchien

The objective of this study was to examine the usefulness of platelet counts in the diagnosis of cirrhosis and for identifying high‐risk individuals in a community‐based hepatocellular carcinoma (HCC) screening program.


Journal of Hepatology | 2002

Durability of lamivudine-induced HBeAg seroconversion for chronic hepatitis B patients with acute exacerbation

Chuan-Mo Lee; Guan-Yeow Ong; Sheng-Nan Lu; Jing-Houng Wang; Chun-Ann Liao; Hung-Da Tung; Tsung-Ming Chen; Chi-Sin Changchien

BACKGROUND/AIMS Lamivudine-induced hepatitis B e antigen (HBeAg) seroconversion in patients with chronic hepatitis B was reported to be durable by several studies but controversy still exists. The aim of this study was to evaluate the durability of the responses of lamivudine treatment. METHODS Among 53 chronic hepatitis B patients who had acute exacerbation and had finished lamivudine therapy after at least 6 months of treatment, 31 patients achieved full HBeAg seroconversion twice at least 1 month apart, and subsequently stopped lamivudine therapy. Post-treatment monitoring was continued for up to 87 weeks. Alanine transaminase (ALT), HBeAg and hepatitis B virus (HBV) DNA were used as indicators for relapse. RESULTS The cumulative relapse rates at 48 and 72 weeks post-treatment were 45.4% and 56.3%, respectively. During follow up, normal ALT levels precluded relapse while ALT levels over two times the upper limit of normal indicated relapse, which correlated well with HBeAg or HBV DNA reappearance. Patients older than 25 years were more likely to experience post-treatment relapse. CONCLUSIONS Lamivudine-induced full HBeAg seroconversion was not durable in the Taiwanese population. ALT levels were useful for relapse detection. Age was the only independent predictive factor for relapse.


Journal of Gastroenterology and Hepatology | 1997

Histopathology and pathobiology of hepatotropic virus‐induced liver injury

Huang Sn; Tsung-Ming Chen; Sun-Lung Tsai; Yun-Fan Liaw

The present report concerns current knowledge regarding immunopathogenesis that can be applied in the interpretation of histopathological changes in acute and chronic viral hepatitis. The histopathological features of viral hepatitis have not been changed and light microscopic examination remains essential for making a diagnosis and classification of chronic hepatitis and for the provision of objective parameters on grading and staging. However, new understanding and knowledge of viral pathogenesis, host immune responses, the biological behaviour of the causative viral agents and, in particular, viral interference in multiple hepatotropic viral infections must be taken into consideration in the interpretation of histopathological and immunopathological findings of liver tissues. This report also presents some histopathological analyses on multiple hepatotropic viral infections. It can be concluded that the diagnostic histological criteria for acute hepatitis remain applicable in such settings. However, the cause of acute flare up in chronic hepatitis could not be determined without clinical, virological and serological information. Routine histopathology cannot distinguish a new infection from an acute exacerbation due to a high level of viral replication or mutant virus. A repertoire of immunocyto‐chemical stainings for viral antigens is helpful, but caution must be exercised in suggesting a specific viral aetiology due to the fact that suppression of pre‐existing viral antigens can be pronounced when the new or concurrent infection is hepatitis C virus related.


Journal of Gastroenterology and Hepatology | 2002

Is delayed normalization of alanine aminotransferase a poor prognostic predictor in chronic hepatitis C patients treated with a combined interferon and ribavirin therapy

Chao-Hung Hung; Chuan-Mo Lee; Sheng-Nan Lu; Jing-Houng Wang; Hung-Da Tung; Tsung-Ming Chen; Chien-Hung Chen; Chi-Sin Changchien

Background and Aims : Decreased alanine aminotransferase (ALT) level is the accepted basic indicator of an interferon (IFN) therapeutic effect in chronic hepatitis C. This study assessed whether delayed normalization of ALT predicts a poor response to a combined therapy of IFN and ribavirin in patients with chronic hepatitis C virus (HCV) infection.


Kaohsiung Journal of Medical Sciences | 2013

Comparisons of noninvasive indices based on daily practice parameters for predicting liver cirrhosis in chronic hepatitis B and hepatitis C patients in hospital and community populations.

Po-Lin Tseng; Jing-Houng Wang; Chao-Hung Hung; Hung-Da Tung; Tsung-Ming Chen; Wu-Shiung Huang; Shiann-Long Liu; Tsung-Hui Hu; Chuan-Mo Lee; Sheng-Nan Lu

Several noninvasive indices have been proposed for predicting liver cirrhosis (LC), particularly in chronic hepatitis C (CHC). In this study, noninvasive indices for predicting LC and hepatocellular carcinoma (HCC) were compared. A total of 119 chronic hepatitis B (CHB) patients and 240 CHC patients were evaluated in a hospital‐based setting using various predictors for pathologic LC such as aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio (AAR), AAR‐to‐platelet ratio index (AARPRI), AST‐to‐platelet ratio index (APRI), age‐platelet (AP) index, and platelet counts. In addition, these indices were used to predict LC [based on ultrasound (US)] in a community‐based population of 201 patients with endemic hepatitis C virus (HCV). These indices were evaluated for their ability to predict HCC in CHB and CHC patients (n = 200). In CHB patients, the diagnostic performance of all indices was inadequate for predicting LC (areas under receiver operating characteristic curves < 0.7). Thrombocytopenia consistently demonstrated comparable accuracy to AARPRI ≥ 0.7 in CHB and AP index ≥ 7.0 in CHC patients. The best cut‐off values for APRI, AARPRI, and AP index in predicting LC in CHC were 1.3, 0.8, and 7.0, respectively. The best cut‐off values for APRI, AARPRI, and AP index in predicting LC (based on US) were 1.0, 1.2, and 8.0, respectively, in a HCV endemic community. An AAR > 1.4 might be a useful tool to identify candidates at high risk for HCC. In conclusion, platelet count was both consistent and accurate in predicting LC. An AAR > 1.4 is proposed as a possible surrogate marker for identifying patients at high risk for developing HCC.


Journal of Ultrasound in Medicine | 2002

Color Doppler Sonography of Bile Duct Tumor Thrombi in Hepatocellular Carcinoma

Jing-Houng Wang; Tsung-Ming Chen; Hung-Da Tung; Chuan-Mo Lee; Chi-Sin Changchien; Sheng-Nan Lu

Objective. To determine with the use of color Doppler sonography whether bile duct tumor thrombi had detectable vasculature in hepatocellular carcinoma. Methods. Among 491 patients with tissue‐proven hepatocellular carcinoma, 9 (1.8%) had bile duct tumor thrombi. All 9 patients had spectral Doppler sonography guided by color Doppler sonography (3.75‐MHz convex probe). Results. All 9 patients had dilated bile ducts with isoechoic thrombi. Eight patients had tumors infiltrating into and obstructing adjacent major bile ducts. The other patient had common hepatic duct tumor emboli that were not adjacent to primary tumors. Color signals were detectable within bile duct tumor thrombi in 7 patients. All of them had pulsatile waveforms on spectral analyses. Conclusions. Bile duct tumor thrombosis with obstructive jaundice was a rare complication of hepatocellular carcinoma. A detectable color signal with pulsatile waveforms was shown in most cases by color Doppler sonography with spectral analyses.


Journal of Ultrasound in Medicine | 2002

Relationship Between Flash Echo Gray Scale Imaging Features and Pathologic Findings in Hepatic Adenoma

Tsung-Ming Chen; Sheng-Nan Lu; Jing-Houng Wang; Chao-Hung Hung; Hung-Da Tung

Hepatic adenoma is a rare solid liver lesion consisting of normal hepato-cytes in cords or sheets without portal tracts and bile ducts. Because the potential for malignant transformation and risk of hemorrhage is substantial, it is important to differentiate this lesion from other hepatic tumors such as hepatocellular carcinoma, focal nodular hyperplasia, and hemangioma. 1 A number of imaging modalities are used for the diagnosis of hepatic adenoma. 2-4 To the best our knowledge, however, no report has characterized the pathologic features of hepatic adenoma with the use of flash echo imaging (FEI) 1 of the newly developed interval delay, contrast-enhanced, secondary-harmonic sonographic types.


Vaccine | 2006

Hepatitis B virus infection in adolescents in a rural township—15 years subsequent to mass hepatitis B vaccination in Taiwan

Sheng-Nan Lu; Chien-Hung Chen; Tsung-Ming Chen; Pei-Lun Lee; Jing-Houng Wang; Hung-Da Tung; Chao-Hung Hung; Chuan-Mo Lee; Chi-Sin Changchien


Journal of Medical Virology | 2003

Molecular epidemiological and clinical aspects of hepatitis D virus in a unique triple hepatitis viruses (B, C, D) endemic community in Taiwan.

Sheng-Nan Lu; Tsung-Ming Chen; Chuan-Mo Lee; Jing-Houng Wang; Hung-Da Tung; Jaw-Ching Wu

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Hung-Da Tung

Memorial Hospital of South Bend

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Chao-Hung Hung

Memorial Hospital of South Bend

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Chien-Hung Chen

Memorial Hospital of South Bend

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Wu-Shiung Huang

Memorial Hospital of South Bend

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Chao-Hung Hung

Memorial Hospital of South Bend

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