Jen-Jung Pan

Interests

Research

Liver diseases, nonalcoholic fatty liver disease

Courses

No activities entered.

Scholarly Contributions

Chapters

• Pan, J., & Fallon, M. B. (2015). Acute and Chronic Hepatitis. In Andreoli & Carpenter's Cecil Essentials of Medicine, 9th Edition. chapter 43.

Journals/Publications

• Aggarwal, A., Balogun, R., Carr, T. F., Desai, A. P., Jie, T., & Pan, J. J. (2019). Transfer of peanut allergy from donor to recipient after liver transplant. Annals of hepatology, 18(3), 508-513.
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  31 years old female with a history of contact dermatitis, eczema, allergic rhinitis, pernicious anemia, alopecia areata and latent tuberculosis was treated concurrently with methotrexate along with isoniazid and pyridoxine. Five months into the therapy she developed acute onset jaundice progressing into fulminant liver failure with altered mentation and worsening liver function tests. Extensive workup including serological and histopathological evaluation revealed drug-induced liver injury as the etiology of her liver failure and she underwent a successful orthotropic liver transplant. On post-transplant follow-up at four months, she was noted to have an allergic reaction consisting of a perioral rash and swelling (without anaphylaxis) after receiving a kiss from her significant other who had just eaten a peanut butter chocolate. She denied any history of allergic reaction to peanuts prior to the transplant. Percutaneous skin testing revealed immediate hypersensitivity to peanut, hazelnut, and pecan believed to be acquired newly post-transplant. Further investigation revealed that the organ donor had a documented history of systemic anaphylaxis from the peanut allergy and a positive peanut-specific IgE level. Also, another parallel solid organ recipient (lung transplant) from the same organ donor experienced a serious anaphylactic reaction after peanut exposure. This is a case of food (peanut) allergy transfer from the donor to the recipient after the liver transplant. This case highlights the importance of incorporating known donor allergies as a part of pre-transplant screening, given the potentially serious consequences from the transfer of allergies to a previously anergic recipient.
• Mubder, M., Azab, M., Jayaraj, M., Cross, C., Lankarani, D., Dhindsa, B., Pan, J. J., & Ohning, G. (2019). Autoimmune hepatitis in patients with human immunodeficiency virus infection: A systematic review of the published literature. Medicine, 98(37), e17094.
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  Liver disease in patients with HIV is common and typically has complex and multifactorial presentations that represent a major cause of morbidity and mortality. Autoimmune hepatitis (AIH) is rarely reported in patient with HIV and the disease course and clinical outcomes for treatment have not been well characterized. We are aiming to determine the patient characteristics, disease prevalence, and treatment outcomes from published articles of patients with HIV and AIH.
• Watt, G. P., Lee, M., Pan, J. J., Fallon, M. B., Loomba, R., Beretta, L., McCormick, J. B., & Fisher-Hoch, S. P. (2019). High Prevalence of Hepatic Fibrosis, Measured by Elastography, in a Population-Based Study of Mexican Americans. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 17(5), 968-975.e5.
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  Hepatic fibrosis is a primary risk factor for cirrhosis and hepatocellular carcinoma, which affect a disproportionate number of Hispanics in the United States. We aimed to determine the prevalence of significant fibrosis, measured by point shear-wave elastography (pSWE), and determine characteristics of hepatic fibrosis and simple steatosis in a population-based study of Mexican American Hispanics in south Texas.
• Kuo, C. N., Pan, J. J., Huang, Y. W., Tsai, H. J., & Chang, W. C. (2018). Association between Nonsteroidal Anti-Inflammatory Drugs and Colorectal Cancer: A Population-Based Case-Control Study. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 27(7), 737-745.
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  COX-2 overexpression may contribute to colorectal cancer occurrence. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce colorectal cancer recurrence, but the efficacy of primary prevention in Asian populations is still elusive. Thus, we examined the primary preventive efficacy of aspirin and NSAIDs on colorectal cancer incidence in Taiwan. A nested case-control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. We identified patients with diagnosis of colorectal cancer from 2005 to 2013 in the Registry of Catastrophic Illness Patient Database. We selected patients without colorectal cancer from the Longitudinal Health Insurance Database as the controls and matched them with cases. NSAID exposure was defined as at least two prescriptions 13 to 48 months prior to the index date. Conditional logistic regression models were performed to evaluate the association between NSAID use and colorectal cancer. A total of 65,208 colorectal cancer cases and 65,208 matched controls were identified. Patients with aspirin use had a lower risk of colorectal cancer compared with nonusers [adjusted OR (AOR) = 0.94, 95% confidence interval (CI) = 0.90-0.99]. NSAID use was associated with lower incidence of colorectal cancer (AOR = 0.96; 95% CI = 0.92-1.00). When examining colon or rectal cancer, similar decreased risks were observed. Patients taking more cumulative days of NSAIDs use tended to experience a more protective effect on colorectal cancer, but no dose-response effects were noted. Aspirin and NSAIDs were associated with a reduced risk of colorectal cancer development among a study cohort in an Asian population. This study provided a possible chemoprevention for colorectal cancer in an Asian population. .
• Liu, X., Shen, J., Kim, P., Park, S. M., Chun, S., Pan, J. J., Azab, M., Choi, H., Yeom, H., Lee, Y. J., & Yoo, J. W. (2018). Hepatitis C Infection Screening and Management in Opioid Use Epidemics in the United States. The American journal of medicine, 131(11), 1276-1278.
• Mukherjee, S., Jana, T., & Pan, J. (2018). Adverse Effects of Proton Pump Inhibitors on Platelet Count: A Case Report and Review of the Literature.. Case Rep Gastrointest Med, 4294805. doi:10.1155/2018/4294805
• Mukherjee, S., Jana, T., & Pan, J. J. (2018). Adverse Effects of Proton Pump Inhibitors on Platelet Count: A Case Report and Review of the Literature. Case reports in gastrointestinal medicine, 2018, 4294805.
• Pan, J. J., Chu, C. J., Chang, F. Y., & Lee, S. D. (2018). The clinical experience of Chinese patients with Wilson's disease. Hepato-gastroenterology, 52(61), 166-9.
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  Wilson's disease has protean presentations. Most patients manifested as either hepatic or neurologic symptoms and signs initially. No study has investigated the predictor of presentation and differences in laboratory tests and survival between patients presented with hepatic or neurological disease so far.
• Pan, J. J., Yang, C. F., Chu, C. J., Chang, F. Y., & Lee, S. D. (2007). Prediction of liver fibrosis in patients with chronic hepatitis B by serum markers. Hepato-gastroenterology, 54(77), 1503-6.
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  Liver biopsy has been considered as the gold standard for assessing fibrosis in patients with chronic hepatitis. The objective of this study was to explore the feasibility of using serum tests to predict the presence of fibrosis in patients with chronic hepatitis B.
• Watt, G. P., Lee, M., Pan, J., Fallon, M. B., Loomba, R., Beretta, L., McCormick, J. B., & Fisher-Hoch, S. P. (2018). High prevalence of hepatic fibrosis, measured by Elastography, in a Population-based study of Mexican Americans. Clinical Gastroenterology Hepatology. doi:10.1016/j.cgh.2018.05.046
• Gill, C., Vatcheva, K. P., Pan, J. J., Smulevitz, B., McPherson, D. D., Fallon, M., McCormick, J. B., Fisher-Hoch, S. P., & Laing, S. T. (2017). Frequency of Nonalcoholic Fatty Liver Disease and Subclinical Atherosclerosis Among Young Mexican Americans. The American journal of cardiology, 119(11), 1717-1722.
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  Nonalcoholic fatty liver disease (NAFLD) is considered as the hepatic manifestation of the metabolic syndrome, whose criteria are risk factors for atherosclerotic cardiovascular disease. We aimed to evaluate the prevalence of NAFLD, its association with subclinical atherosclerosis, and factors that may account for this association in Mexican Americans. In a population-based cross-sectional sample drawn from the Cameron County Hispanic Cohort in Texas, carotid intima media thickness (cIMT), an indicator of subclinical atherosclerosis, was measured. Abnormal carotid ultrasound study was defined as mean cIMT >75th percentile for age and gender and/or plaque presence. NAFLD was defined as steatosis by ultrasound in the absence of other causes of liver disease. Multivariable weighted regression analyses were performed to evaluate associations between NAFLD and cIMT. Mean age was 50.4 ± 1.2 years with 58.3% women. Mean body mass index was 31.0 ± 0.4 kg/m2, and 54.0% had the metabolic syndrome. NAFLD was highly prevalent (48.80%); subjects with NAFLD had greater body mass index, central obesity, fasting glucose levels, and dyslipidemia and were more likely to have the metabolic syndrome. Nearly 1/3 of subjects with NAFLD also had evidence of subclinical atherosclerosis (31.2%). After adjusting for covariates, there was an independent association between NAFLD and increased cIMT only in younger subjects
• Ha, J., Chaudhri, A., Avirineni, A., & Pan, J. J. (2017). Burden of hepatocellular carcinoma among hispanics in South Texas: a systematic review. Biomarker research, 5, 15.
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  Hepatocellular carcinoma (HCC) is one of the fastest rising causes of cancer-related mortality in the United States (U.S.). Despite improved HCC screening and surveillance guidelines, significant race/ethnicity-specific disparities in hepatocellular carcinoma remain, disproportionately affecting at risk racial minorities in the U.S. The current review aims to provide an updated analysis on race/ethnicity-specific disparities in HCC epidemiology with a focus on predisposing risk factors.
• Pan, J. (2017). Frequency of Nonalcoholic Fatty Liver Disease and Subclinical Atherosclerosis Among Young Mexican Americans. The American Journal of Cardiology.
• Garza, A. L., Vatcheva, K. P., Pan, J. J., Rahbar, M. H., Fallon, M. B., McCormick, J. B., & Fisher-Hoch, S. P. (2016). Liver and Other Gastrointestinal Cancers Are Frequent in Mexican Americans. Journal of racial and ethnic health disparities, 3(1), 1-10.
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  Disease patterns in Mexican American health-disparity populations differ from larger US populations.
• Gill, C. D., Vatcheva, K. P., Pan, J., Smulevitz, B., Fallon, M. B., McPherson, D. D., McCormick, J. B., Fisher-Hoch, S. P., & Laing, S. T. (2016). Non-alcoholic fatty liver disease and subclinical atherosclerosis in Mexican-Americans. Circulation, 134, A11635.
• Jiao, J., Watt, G. P., Lee, M., Rahbar, M. H., Vatcheva, K. P., Pan, J. J., McCormick, J. B., Fisher-Hoch, S. P., Fallon, M. B., & Beretta, L. (2016). Cirrhosis and Advanced Fibrosis in Hispanics in Texas: The Dominant Contribution of Central Obesity. PloS one, 11(3), e0150978.
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  Liver cirrhosis is a leading cause of death in Hispanics and Hispanics who live in South Texas have the highest incidence of liver cancer in the United States. We aimed at determining the prevalence and associated risk factors of cirrhosis in this population. Clinical and demographic variables were extracted for 2466 participants in the community-based Cameron County Hispanic Cohort in South Texas. Aspartate transaminase to Platelet Ratio Index (APRI) was used to predict cirrhosis in Cameron County Hispanic Cohort. The prevalence of cirrhosis using APRI≥2 was 0.94%, which is nearly 4-fold higher than the national prevalence. Using APRI≥1, the overall prevalence of cirrhosis/advanced fibrosis was 3.54%. In both analyses, highest prevalence was observed in males, specifically in the 25-34 age group. Risk factors independently associated with APRI≥2 and APRI≥1 included hepatitis C, diabetes and central obesity with a remarkable population attributable fraction of 52.5% and 65.3% from central obesity, respectively. Excess alcohol consumption was also independently associated with APRI≥2. The presence of patatin-like phospholipase domain-containing-3 gene variants was independently associated with APRI≥1 in participants >50 years old. Males with both central obesity and excess alcohol consumption presented with cirrhosis/advanced fibrosis at a young age. Alarmingly high prevalence of cirrhosis and advanced fibrosis was identified in Hispanics in South Texas, affecting young males in particular. Central obesity was identified as the major risk factor. Public health efforts are urgently needed to increase awareness and diagnosis of advanced liver fibrosis in Hispanics.
• Watt, G. P., Vatcheva, K. P., Beretta, L., Pan, J. J., Fallon, M. B., McCormick, J. B., & Fisher-Hoch, S. P. (2016). Hepatitis C virus in Mexican Americans: a population-based study reveals relatively high prevalence and negative association with diabetes. Epidemiology and infection, 144(2), 297-305.
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  This study aimed to estimate the prevalence and risk factors for hepatitis C virus (HCV) infection in Mexican Americans living in South Texas. We tested plasma for the presence of HCV antibody from the Cameron County Hispanic Cohort (CCHC), a randomized, population-based cohort in an economically disadvantaged Mexican American community on the United States/Mexico border with high rates of chronic disease. A weighted prevalence of HCV antibody of 2·3% [n = 1131, 95% confidence interval (CI) 1·2-3·4] was found. Participants with diabetes had low rates of HCV antibody (0·4%, 95% CI 0·0-0·9) and logistic regression revealed a statistically significant negative association between HCV and diabetes (OR 0·20, 95% CI 0·05-0·77) after adjusting for sociodemographic and clinical factors. This conflicts with reported positive associations of diabetes and HCV infection. No classic risk factors were identified, but important differences between genders emerged in analysis. This population-based study of HCV in Mexican Americans suggests that national studies do not adequately describe the epidemiology of HCV in this border community and that unique risk factors may be involved.
• Jewett, A., Garg, A., Meyer, K., Wagner, L. D., Krauskopf, K., Brown, K. A., Pan, J. J., Massoud, O., Smith, B. D., & Rein, D. B. (2015). Hepatitis C virus testing perspectives among primary care physicians in four large primary care settings. Health promotion practice, 16(2), 256-63.
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  In 1998, the Centers for Disease Control and Prevention (CDC) published Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease, recommending HCV testing for populations most likely to be infected with HCV. However, the implementation of risk-based screening has not been widely adopted in health care settings, and 45% to 85% of infected U.S. adults remain unidentified.
• Lamberth, J. R., Reddy, S. C., Pan, J. J., & Dasher, K. J. (2015). Chronic hepatitis B infection in pregnancy. World journal of hepatology, 7(9), 1233-7.
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  There are no standard guidelines to follow when a patient with chronic hepatitis B infection becomes pregnant or desires pregnancy. Topics to consider include which patients to treat, when to start treatment, what treatment to use and when to stop treatment. Without any prophylaxis or antiviral therapy, a hepatitis B surface antigen and E antigen positive mother has up to a 90% likelihood of vertical transmission of hepatitis B virus (HBV) to child. Standard of care in the United States to prevent perinatal transmission consists of administration of hepatitis B immune globulin and HBV vaccination to the infant. The two strongest risk factors of mother to child transmission (MTCT) of HBV infection despite immunoprophylaxis are high maternal HBV viral load and high activity of viral replication. The goal is to prevent transmission of HBV at birth by decreasing viral load and/or decreasing activity of the virus. Although it is still somewhat controversial, most evidence shows that starting antivirals in the third trimester is effective in decreasing MTCT without affecting fetal development. There is a growing body of literature supporting the safety and efficacy of antiviral therapies to reduce MTCT of hepatitis B. There are no formal recommendations regarding which agent to choose. Tenofovir, lamivudine and telbivudine have all been proven efficacious in decreasing viral load at birth without known birth defects, but final decision of which antiviral medication to use will have to be determined by physician and patient. The antivirals may be discontinued immediately if patient is breastfeeding, or within first four weeks if infant is being formula fed.
• Pan, J. J., Fisher-Hoch, S. P., Chen, C., Feldstein, A. E., McCormick, J. B., Rahbar, M. H., Beretta, L., & Fallon, M. B. (2015). Burden of nonalcoholic fatty liver disease and advanced fibrosis in a Texas Hispanic community cohort. World journal of hepatology, 7(11), 1586-94.
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  To investigate the potential burden of nonalcoholic steatohepatitis (NASH) and advanced fibrosis in a hispanic community.
• Rahimi, E., & Pan, J. J. (2015). Prognostic models for alcoholic hepatitis. Biomarker research, 3, 20.
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  Alcoholic hepatitis (AH) is caused by acute inflammation of the liver in patients that consume excessive amounts of alcohol, usually in a background of cirrhosis. AH can range from mild to severe, life threatening disease with a high rate of short and long-term mortality. Prognostic models have been used to estimate mortality in order to identify those that may benefit from corticosteroids or pentoxifylline. This review focuses on the different prognostic models proposed. While limitations of the prognostic models exist, combining models may be beneficial in order to identify responders to therapy versus non-responders.
• Jana, T., Machicado, J. D., Davogustto, G. E., & Pan, J. J. (2014). Methicillin-Resistant Staphylococcus aureus Prostatic Abscess in a Liver Transplant Recipient. Case reports in transplantation, 2014, 854824.
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  Prostatic abscesses are usually related to gram-negative bacilli. However, methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a substantial cause of prostatic abscesses in recent years. Herein, we report the case of a 31-year-old man with a history of orthotopic liver transplantation 10 years ago who presented with acute onset dysuria and abdominal pain and was diagnosed with a MRSA prostatic abscess. To our knowledge, this is the first case describing a prostatic abscess in a liver transplant recipient and the first reporting MRSA as the causative organism of a prostatic abscess in a solid organ transplant recipient.
• Pan, J. J., & Fallon, M. B. (2014). Gender and racial differences in nonalcoholic fatty liver disease. World journal of hepatology, 6(5), 274-83.
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  Due to the worldwide epidemic of obesity, nonalcoholic fatty liver disease (NAFLD) has become the most common cause of elevated liver enzymes. NAFLD represents a spectrum of liver injury ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) which may progress to advanced fibrosis and cirrhosis. Individuals with NAFLD, especially those with metabolic syndrome, have higher overall mortality, cardiovascular mortality, and liver-related mortality compared with the general population. According to the population-based studies, NAFLD and NASH are more prevalent in males and in Hispanics. Both the gender and racial ethnic differences in NAFLD and NASH are likely attributed to interaction between environmental, behavioral, and genetic factors. Using genome-wide association studies, several genetic variants have been identified to be associated with NAFLD/NASH. However, these variants account for only a small amount of variation in hepatic steatosis among ethnic groups and may serve as modifiers of the natural history of NAFLD. Alternatively, these variants may not be the causative variants but simply markers representing a larger body of genetic variations. In this article, we provide a concise review of the gender and racial differences in the prevalence of NAFLD and NASH in adults. We also discuss the possible mechanisms for these disparities.
• Machicao, V. I., Batra, S., Mehta, S., Dasher, K. J., Pan, J., Dar, W. A., Hobeika, M. J., Bynon, S., & Fallon, M. B. (2013). Regional differences in the outcome of liver transplantation for hepatocellular carcinoma beyond Milan criteria. Hepatology, 58(4), 1017A.
• Pearce, S. G., Thosani, N. C., & Pan, J. J. (2013). Noninvasive biomarkers for the diagnosis of steatohepatitis and advanced fibrosis in NAFLD. Biomarker research, 1(1), 7.
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  Nonalcoholic fatty liver disease (NAFLD) is the most common cause of abnormal liver enzymes in both adults and children. NAFLD has a histologic spectrum ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), advanced fibrosis, and cirrhosis. It is imperative to distinguish simple steatosis from NASH since the latter has a progressive disease course and can lead to end-stage liver disease. Liver biopsy has been considered as the gold standard for the diagnosis of NASH. However, liver biopsy is invasive, costly, and can rarely cause significant morbidity (risk of morbidity, 0.06-0.35%; risk of mortality, 0.1-0.01%). Imaging studies such as ultrasonography, computed tomography, and magnetic resonance imaging have limited sensitivity in detecting steatosis and cannot distinguish steatosis from NASH. Alanine aminotransferase (ALT) has been used as a surrogate marker for liver injuries. However, ALT is not an ideal marker for either diagnosis of NAFLD or distinguishing steatosis from NASH. Better noninvasive biomarkers or panels of biomarkers that are cheaper, reliable, and reproducible are urgently needed for patients with NASH to assist in establishing diagnosis, providing risk information, and monitoring disease progression and treatment response. In this article, we plan to concisely review the current advances in the use of biomarkers for the diagnosis of NASH.
• Thosani, N., Younes, M., & Pan, J. J. (2013). A heart of stone. Gastroenterology, 145(1), e6-7.
• Batra, S., Mehta, S., Tanikella, R., Nevah Rubin, M. I., Pan, J., Machicao, V. I., & Fallon, M. B. (2012). Left ventricular hypertrophy is a strong predictor of poor post-liver transplantation survival. Hepatology, 56(4), 48A.
• Mehta, S., Batra, S., Nevah Rubin, M. I., Pan, J., Machicao, V. I., & Fallon, M. B. (2012). The role of pre-liver transplantation tricuspid regurgitation in post-liver transplantation survival. Hepatology, 56(4), 111A.
• Mehta, S., Batra, S., Thosani, N., Pan, J., Guha, S., Fallon, M. B., & Machicao, V. I. (2012). Radiofrequency ablation for hepatocellular carcinoma in the elderly provides adequate survival effect: a systematic review and meta-analysis.. Hepatology, 56(4), 107A.
• Nevah Rubin, M. I., Mehta, S., Batra, S., Khanijow, V., Nguyen, V. Q., Cohen, A. M., Pan, J., Fallon, M. B., & Machicao, V. I. (2012). Change in model for end-stage liver disease and prolonged QTc may predict of post-TIPS outcomes. Hepatology, 56(4), 141A.
• Pan, J., Thosani, N., & Fallon, M. B. (2012). Sclerosing encapsulating peritonitis: a report of 2 cases and reciew of literature.. Gastroenterology Insights, 4(3).
• Qu, H. Q., Li, Q., Grove, M. L., Lu, Y., Pan, J. J., Rentfro, A. R., Bickel, P. E., Fallon, M. B., Hanis, C. L., Boerwinkle, E., McCormick, J. B., & Fisher-Hoch, S. P. (2012). Population-based risk factors for elevated alanine aminotransferase in a South Texas Mexican-American population. Archives of medical research, 43(6), 482-8.
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  Elevated alanine aminotransferase (ALT >40 IU/mL) is a marker of liver injury but provides little insight into etiology. We aimed to identify and stratify risk factors associated with elevated ALT in a randomly selected population with a high prevalence of elevated ALT (39%), obesity (49%) and diabetes (30%).
• Doycheva, I., Chen, C., Pan, J. J., & Levy, C. (2011). Asymptomatic primary biliary cirrhosis is not associated with increased frequency of cardiovascular disease. World journal of hepatology, 3(4), 93-8.
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  To estimate the prevalence of cardiovascular events in Primary biliary cirrhosis (PBC) and to determine whether this risk is higher within specific subgroups of patients with PBC.
• Pan, J. J., & Yang, M. H. (2011). The role of epithelial-mesenchymal transition in pancreatic cancer. Journal of gastrointestinal oncology, 2(3), 151-6.
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  Pancreatic cancer is the fourth leading cause of cancer related death in the US. Despite the advances in medical and surgical treatment, the 5-year survival rate for such cancer is only approximately 5% when considering all stages of disease. The lethal nature of pancreatic cancer stems from its high metastatic potential to the lymphatic system and distant organs. Lack of effective chemotherapies, which is believed to be due to drug-resistance, also contributes to the high mortality of pancreatic cancer. Recent evidence suggests that epithelial-mesenchymal transition of pancreatic cancer cells contributes to the development of drug resistance and an increase in invasiveness. Future strategies that specifically target against epithelial-mesenchymal transition phenotype could potentially reduce tumoral drug resistance and invasiveness and hence prolong the survival of patients with pancreatic cancer.
• Pan, J. J., Qu, H. Q., Rentfro, A., McCormick, J. B., Fisher-Hoch, S. P., & Fallon, M. B. (2011). Prevalence of metabolic syndrome and risks of abnormal serum alanine aminotransferase in Hispanics: a population-based study. PloS one, 6(6), e21515.
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  Study the prevalence of metabolic syndrome (MS) and risk factors for and association with elevated alanine aminotransferase (ALT) as markers of hepatic injury in a large Hispanic health disparity cohort with high rates of obesity.
• Pan, J. J., Thosani, N., Machicao, V. I., & Fallon, M. B. (2011). Current use of hepatitis B immune globulin for prevention of de novo hepatitis B in recipients receiving anti-HBc-positive livers. Hepatology international, 5(2), 635-43.
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  Livers from donors positive for antibody against anti-HBc can potentially transmit de novo hepatitis B (DNH) to their recipients. Despite a good outcome, prophylaxis is usually offered to such recipients. There is no consensus on the standard prophylactic regimen and hence prophylaxis varies among different transplant centres. Nonetheless, hepatitis B immune globulin (HBIG) is considered the mainstay of such prophylaxis, either alone or in combination with an oral antiviral treatment. We aim to provide a concise review of the current use of HBIG in prevention of DNH. We also address a few important questions regarding HBIG use.
• Pan, J., Oh, S., Soldevila-Pico, C., Nelson, D. R., & Liu, C. (2011). Low prevalence of HBV DNA in the liver allograft from anti-HBc-positive donors: a single-center experience. CLINICAL TRANSPLANTATION, 25(1), 164-170.
• Qu, H., Li, Q., Pan, J., Rentfro, A., Bickel, P. E., Fallon, M. B., Fisher-Hoch, S. P., & McCormick, J. B. (2011). Modeling the risk of liver injury in Mexican-Americans in the Cameron County Cohort. Diabetes, 60.
• Draganov, P. V., Kowalczyk, L., Fazel, A., Moezardalan, K., Pan, J. J., & Forsmark, C. E. (2010). Prospective randomized blinded comparison of a short-wire endoscopic retrograde cholangiopancreatography system with traditional long-wire devices. Digestive diseases and sciences, 55(2), 510-5.
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  Short-wire endoscopic retrograde cholangiopancreatography (ERCP) systems are perceived to carry advantage over traditional long-wire devices. To date, this potential advantage has not been well documented, and gastroenterologists are confronted in everyday practice with the dilemma of choosing a particular system without the benefit of having objective comparative data.
• Draganov, P. V., Kowalczyk, L., Fazel, A., Moezardalan, K., Pan, J., & Forsmark, C. E. (2010). Prospective Randomized Blinded Comparison of a Short-Wire Endoscopic Retrograde Cholangiopancreatography System with Traditional Long-Wire Devices. DIGESTIVE DISEASES AND SCIENCES, 55(2), 510-515.
• Pan, J. J., Javle, M., Thinn, M. M., Hsueh, C. T., & Hsueh, C. T. (2010). Critical appraisal of the role of sorafenib in the management of hepatocellular carcinoma. Hepatic medicine : evidence and research, 2, 147-55.
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  Sorafenib is an oral multiple kinase inhibitor that blocks Raf, vascular endothelial growth factor receptor, and platelet-derived growth factor receptor. It has been approved in the US and Europe for the treatment of advanced hepatocellular carcinoma (HCC). Sorafenib has demonstrated a 44% increase in survival for advanced HCC patients, compared with best supportive care alone. We have reviewed the pharmacology, pivotal studies, and safety data for this agent. Sorafenib is the first systemic drug demonstrating a significant survival benefit, and is the standard of care for patients with advanced HCC for whom no potential curative option is available.
• Pan, J., & Crippin, J. S. (2010). Hepatitis C and autoimmune hepatitis: what gets treated first?. Current Hepatitis Reports, 9, 15-19.
• Cabrera, R., Ararat, M., Soldevila-Pico, C., Dixon, L., Pan, J., Firpi, R., Machicao, V., Levy, C., Nelson, D., & Morelli, G. (2009). Using an Immune Functional Assay To Differentiate Acute Cellular Rejection from Recurrent Hepatitis C in Liver Transplant Patients. LIVER TRANSPLANTATION, 15(2), 216-222.
• Pan, J. J., & Draganov, P. V. (2009). Adverse reactions to iodinated contrast media administered at the time of endoscopic retrograde cholangiopancreatography (ERCP). Inflammation & allergy drug targets, 8(1), 17-20.
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  Adverse reactions after intravascular administration of iodine contrast media are common and prophylactic regiments consisting of the use of steroids and low osmolality contrast media are highly effective in significantly decreasing the adverse reactions rate. The same type of contrast media are also used for opacification of the biliary tree and the pancreatic duct at the time of endoscopic retrograde cholangiopancreatography (ERCP). Systemic absorption of contrast media after ERCP routinely occurs. Although the adverse reaction rate appears to be very low the exact incidence remains unknown due to the retrospective nature of all reports. Despite the lack of formal recommendations, numerous prophylactic regiments are routinely used prior to ERCP in patients with history of prior reaction to intravascular contrast media. Moreover, the use of prophylaxis has even expanded to patients with no prior reaction to intravascular contrast media who are somehow perceived to be at increase risk (e.g. shellfish allergy). Recently, the first large scale prospective study reported exceedingly low incidence of adverse reaction to high oslmolality iodine-containing contrast media administered at the time of ERCP done without prophylactic premedication even in patients considered to be at the highest risk (prior severe reaction to intravascular contrast media administration). These data suggest that the use of prophylactic regiments prior to ERCP appears to be unnecessary.
• Pan, J. J., & Firpi, R. J. (2009). The management of hepatitis C. Minerva gastroenterologica e dietologica, 55(1), 23-35.
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  Hepatitis C is a serious public health problem with more than 170 million chronic carriers worldwide. Although hepatitis C infection can be cured in up to 40% of patients, current treatment is not ideal and is associated with a wide spectrum of side effects and complications. Therefore, emerging evidence suggests that patients can receive tailored therapy based on their viral kinetic changes during treatment. With better knowledge of hepatitis C viral genome and life cycle, compounds so called ''Specifically Targeted Antiviral Therapy for HCV or STAT-C'' are under development. This review will discuss current therapies and recent advances in new therapies for hepatitis C.
• Pan, J. J., Oh, S. H., Lee, W. C., & Petersen, B. E. (2009). Bone marrow-derived progenitor cells could modulate pancreatic cancer tumorigenesis via peritumoral microenvironment in a rat model. Oncology research, 17(8), 339-45.
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  Metaplastic tubular complexes (MTC) have been proposed as precursor lesions for pancreatic adenocarcinoma (PDAC). In this study, we investigated the potential role of bone marrow-derived progenitor cells (BMPC) in the formation of MTC and PDAC in a rat model. F344 rats defective for CD26 (dipeptidyl peptidase IV, DPPIV) expression were sublethally irradiated and received rescue bone marrow cells from wild-type F344 rats that express CD26. After confirming engraftment, recipient animals received dimethylbenzanthracene (DMBA) implantation in their pancreas. Animals were sacrificed monthly from 3 to 7 months. We observed both MTC and tumors in animals that received DMBA. These MTC were ductal complexes because they stained positive for cytokeratin but were negative for chymotrypsin and chromogranin A. Cells that expressed both CD26 and cytokeratin were rarely observed in the MTC. Cells expressing either both CD26 and CD45 or CD26 and smooth muscle actin were also found near the MTC. However, no CD26 signal was detected in the tumors. Within this model, there appeared to be no evidence supporting that BMPC turned into tumor cells directly. BMPC could modulate pancreatic cancer growth through tumor microenvironment.
• Pan, J., & Firpi, R. J. (2009). Autoantibody in Hepatitis C: What do they mean?. Current Hepatitis Reports, 8, 153-157.
• Pan, J., Oh, S., Soldevila-Pico, C., Nelson, D. R., & Liu, C. (2009). Hepatitis B viral DNA seldom present in the transplant liver from anti-HBc-positive donors.. Hepatology, 50, 558A.
• Walston, S., Finamore, M., Varacallo, C. P., Heh, V., Pan, J., Kao, T., & Gau, J. (2009). Association between risk factors for constipation and severity of stool retention as analyzed by abdominal x-ray.. Gastroenterology, 136(supplement 1), A144.
• Draganov, P., Pan, J., & Forsmark, C. E. (2008). Prospective evaluation of adverse reactions to iodine-containing contrast media (CM) after ERCP.. Gastrointestinal Endoscopy, 67(5).
• Morelli, G., Fazel, A., Judah, J., Pan, J. J., Forsmark, C., & Draganov, P. (2008). Rapid-sequence endoscopic management of posttransplant anastomotic biliary strictures. Gastrointestinal endoscopy, 67(6), 879-85.
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  Post-liver-transplant anastomotic biliary strictures generally have been managed through ERCP with gradual balloon dilation and placement of multiple stents over an extended period of time.
• Pan, J. J., Chen, C., Caridi, J. G., Geller, B., Firpi, R., Machicao, V. I., Hawkins, I. F., Soldevila-Pico, C., Nelson, D. R., & Morelli, G. (2008). Factors predicting survival after transjugular intrahepatic portosystemic shunt creation: 15 years' experience from a single tertiary medical center. Journal of vascular and interventional radiology : JVIR, 19(11), 1576-81.
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  This retrospective analysis was conducted to identify factors predictive of survival after transjugular intrahepatic portosystemic shunt (TIPS) creation.
• Pan, J. J., Chen, C., Geller, B., Firpi, R., Machicao, V. I., Caridi, J. G., Nelson, D. R., & Morelli, G. (2008). Is sonographic surveillance of polytetrafluoroethylene-covered transjugular intrahepatic portosystemic shunts (TIPS) necessary? A single centre experience comparing both types of stents. Clinical radiology, 63(10), 1142-8.
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  To investigate whether sonographic (US) surveillance of polytetrafluoroethylene covered transjugular intrahepatic portosystemic shunts (TIPS) is necessary.
• Pi, L., Ding, X., Jorgensen, M., Pan, J. J., Oh, S. H., Pintilie, D., Brown, A., Song, W. Y., & Petersen, B. E. (2008). Connective tissue growth factor with a novel fibronectin binding site promotes cell adhesion and migration during rat oval cell activation. Hepatology (Baltimore, Md.), 47(3), 996-1004.
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  Oval cell activation, as part of the regenerative process after liver injury, involves considerable cell-matrix interaction. The matricellular protein, connective tissue growth factor (CTGF), has been shown to be critical for oval cell activation during liver regeneration following N-2-acetylaminofluorene/partial hepatectomy. To understand the mode of action of CTGF during this process, N-terminal CTGF was used as bait to screen a yeast two-hybrid complementary DNA library specific for regenerating livers with massive oval cell presence. Fibronectin (FN), a prominent component of hepatic extracellular matrix (ECM), was found to specifically bind to a new site on CTGF. In addition to module IV, this study showed that module I of CTGF was sufficient for binding to FN in both solid-phase in vitro binding assays and immunoprecipitation. Immunofluorescent staining revealed a dynamic ECM remodeling characterized by an FN-concentrated provisional matrix during oval cell-aided liver regeneration. Abundant CTGF protein was colocalized with FN in the provisional matrix. When expressed as recombinant proteins and immobilized on plastic surfaces, modules I and IV of CTGF were selectively adhesive to thymus cell antigen 1-positive (Thy1(+)) oval cells, stellate cells, and sinusoidal endothelial cells but not to hepatocytes. The adhesion of these two modules on Thy1(+) oval cells required heparan sulfate proteoglycan and integrin alpha(5)beta(1). Recombinant CTGF promoted an integrin alpha(5)beta(1)-dependent migration but not proliferation on Thy1(+) oval cells.
• Pan, J. J., Chang, W. J., Barone, T. A., Plunkett, R. J., Ostrow, P. T., & Greenberg, S. J. (2006). Increased expression of TGF-beta1 reduces tumor growth of human U-87 Glioblastoma Cells in vivo. Cancer immunology, immunotherapy : CII, 55(8), 918-27.
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  The role that transforming growth factor beta1 (TGF-beta1) plays in influencing growth of glioma cells is somewhat controversial. To further understand the potential growth-regulatory effects of TGF-beta1,we constructed an animal astroglial tumor model by injecting either wild-type or virally transduced human U-87 glioblastoma cells into nude rat brains. Wild type U-87 cells produced very low amounts of TGF-beta1 and were highly tumorigenic. In contrast, U-87 cells transduced to express high levels of TGF-beta1 showed reduced tumor size in vivo, in a dose-dependent manner. This reduction in tumor size was not due to either decreased vascularity or increased apoptosis. To test whether TGF-beta1 overproduction inhibited tumor growth through an autocrine mechanism, the highest TGF-beta1 producing cells were then double transduced with a vector expressing the kinase-truncated type II TGF-beta receptor. Cells expressing high levels of truncated TGF-beta receptor were less sensitive to TGF-beta1 mediated growth inhibition in vitro and produced more aggressive tumors in vivo. The data suggest that the degree of tumorigenicity of the U-87 high-grade glioblastoma cell line may be associated with correspondingly low level of production of TGF-beta1. These results also would tend to support the possibility that TGF-beta1 may be useful in treating some high-grade gliomas.
• Pan, J., Chu, C., Chang, F., & Lee, S. (2005). The clinical experience of Chinese patients with Wilson's disease.. Hepato-Gastroenterology, 52((61)), 166-169.

Others

• Jewett, A., Wagner, D., Meyer, K., Krauskopf, K., Brown, K., Pan, J., Massoud, O., Smith, B. D., & Rein, D. (2012, June). Hepatitis C screening practices among primary care physicians in four large primary care settings.. National Summit on HIV and Viral Hepatitis Diagnosis, Prevention, and Access to Care.
• Machicada, J. D., Machiacao, V. I., Nevah, M., Tchakarov, A., Pan, J., Buja, M., & Fallon, M. B. (2012, July). Hepatic compartment syndrome after percutaneous liver biopsy in a liver transplant patient. American College of Gastroenterology Annual Meeting.
• Machicado, J. D., Nevah, M., Machicao, V. I., Lopez, F., Pan, J., & Fallon, M. B. (2012, October). Tuberculous liver abscess: a rare complication after liver transplantation.. American College of Gastroenterology Annual Meeting.
• Mank, G., Richards, D., Reddy, S., DuPont, A., Pan, J., & Fallon, M. B. (2011, July). Two Cases of weird foreign bodies lodged at the cricopharyngeus successfully managed with flexible endoscopic extraction. American College of Gastroenterology Annual Meeting.
• Thosani, N., & Pan, J. (2011, July). Tombstone. American College of Gastroenterology Annual Meeting.
• Cabrera, R., Ararat, M., Soldevila-Pico, C., Pan, J., Firpi, R. J., Levy, C., Machicao, V. I., Nelson, D. R., & Morelli, G. (2008, November). Using immune functional assay to differentiate acute cellular rejection from recurrent hepatitis C in liver transplant patients. American Association for the Study of Liver Diseases Annual Meeting.
• Pan, J., Oh, S., & Peterson, B. E. (2008, January). The role of bone marrow derived progenitor cells in teh pancreatic tumorigenesis. Gastrointeestinal Cancer Symposium.
• Pan, J. (2006, June). A 53-year-old female developed fever and right upper quadrant abdominal pain after dental extraction at home.. American College of Gastroenterology National Fellows' Forum.
• Pan, J., Chu, C., Chang, F., & Lee, S. (2003, June). Clinical presentation and survival analysis of patients with Wilson disease: Report of a center's experience.. Annual Meeting of the Gastroenterology Society of Taiwan.
• Greenberg, S. J., Pan, J., Plunkett, R. J., Barone, T. A., Choi, U., Stiles, J. D., Spence, P. O., & Ostrow, P. T. (2001, January). Transforming growth factor - beta 1/receptor regulation of human astroglioma.. Neurology.
• Pan, J. (1999, September). Modulation of growth of human astroglial tumor by the transforming growth factor - beta 1/receptor system.. PhD dissertation.
• Greenberg, S. J., Pan, J., Plunkett, R. J., Barone, T. A., Spence, P. O., Choi, U., Zhang, H., Balos, L., & Ostrow, P. T. (1998, April). Regulation of astroglial phenotype by the TGF-beta 1 ligand/receptor signaling pathway.. Neurology.