Long-term outcome in hepatitis B sero-positive oriental renal transplant recipients.
Explore the source record for details and available documents.
Cause of Death↗
Biomedical subjects
C S Li
Publications and source records attributed to C S Li.
Fungus allergens inside and outside the residences of atopic and control children.
Airborne fungi were collected during the peak fungus season, using the N6 Andersen sampler inside and outside the homes of 46 asthmatic children, 20 atopic children, and 26 nonatopic control children in the Taipei area. The geometric mean fungus concentrations of the asthmatic, atopic, and control groups were found to be 565, 411, and 608 colony-forming units (CFU) per m3 in the living rooms; 659, 464, and 602 CFU m3 in the bedrooms; and 547, 449, and 668 CFU m3 outdoors; respectively. Aspergillus, Cladosporium, and Penicillium were observed to be the most common microfungi, both indoors and outdoors. High correlations between indoor fungus levels (living rooms or bedrooms) and the corresponding outdoor levels were observed for these predominant genera. With regard to the Aspergillus species composition, A. flavus and A. niger were observed to be predominant and are, therefore, recommended to be included on a skin test panel. Moreover, among these three groups, there were statistically significant concentration differences for Cladosporium and Penicillium.
Adolescent↗
Home dampness and childhood respiratory symptoms in a subtropical climate.
The association between measures of home dampness and symptoms of respiratory illness was evaluated in 1 340 8- to 12-y-old children in the Taipei area. The following were reported to occur in the homes: self-dampness (i.e., home considered damp by residents), 36.8% of the homes; "classified" dampness (i.e., presence of mold, water damage, or flooding), 72.3%; visible mold, 38.3%; stuffy odor, 33.9%; water damage, 47.8%; and flooding, 15.1%. Moreover, the prevalence of all respiratory symptoms was consistently higher in homes for which the occurrence of molds or dampness was reported. The adjusted odds ratios ranged from 1.37 (95% confidence interval: 1.03-1.83) for allergic rhinitis to 5.74 (95% confidence interval: 2.20-14.95) for cough. In addition, the observed high prevalence of home dampness/mold indicated that dampness in the home was very common in the subtropical region studied, and home dampness was a strong predictor of respiratory symptoms.
Age Factors↗
Indoor pollution and sick building syndrome symptoms among workers in day-care centers.
In this study, we investigated indoor air quality and symptoms of respiratory illness in 264 nursing workers at 28 day-care centers in Taipei. Geometric mean concentrations of indoor and outdoor bacteria were 735 colony-forming units in air (CFU/m3) and 384 CFU/m3, respectively. In addition, geometric mean concentrations of indoor and outdoor fungi were 1,212 CFU/m3 and 1,032 CFU/m3, respectively. Aspergillus, Cladosporium, and Penicillium-microfungi that occurred most commonly-were found indoors and outdoors. Geometric mean concentrations of house dust mite allergens, Der p I and Der p V, were 58 ng/g dust and 14 ng/g dust, respectively. In addition, the observed high prevalence of dampness or mold problems in the day-care centers indicated that dampness was very common in this subtropical region. We found a significant relationship between dampness and work-related sick building syndrome in the day-care-center workers. Furthermore, concentrations of fungi were lower in the day-care centers equipped with air conditioners/air cleaners than in centers that lacked such equipment. Also, Aspergillus was associated strongly with work-related sick building syndrome in the day-care-center workers.
Air Microbiology↗
House dust mite allergens (Der p I and Der p V) within domestic environments of atopic and control children.
We used allergen-specific ELISA to evaluate environmental distributions of house dust mite allergens (Der p I and Der p V) in the homes of 46 asthmatic, 20 atopic, and 26 nonatopic control children during the summer and winter. Geometric mean Der p I levels were approximately 10 times higher than geometric mean Der p V concentrations. The concentrations of Der p I and Der p V in winter were significantly higher than concentrations found in summer. In addition, we found no differences in Der p I concentrations among the three groups in summer; however, in winter, Der p I levels in the control group were significantly higher than levels in the homes of both asthmatic and atopic children. During the summer, concentrations of Der p V were lower in the control group, compared with the asthmatic group, but during the winter, concentrations in the control group were higher than levels found in either asthmatic or atopic children's homes. In this study, we did not establish an important relationship between mite allergen exposure and atopy/asthma.
Adolescent↗
Dampness and respiratory symptoms among workers in daycare centers in a subtropical climate.
We evaluated the association between measures of dampness in daycare centers (N = 56) in the Taipei area and symptoms of respiratory illness in 612 employees. Dampness was found in 75.3% of the centers, visible mold in 25.8%, stuffy odor in 50.0%, water damage in 49.3%, and flooding in 57.2%. Furthermore, prevalence of sick building syndrome symptoms in the daycare workers was statistically significant among those who worked in centers that had mold or dampness. Also, the observed numerous incidences of dampness or mold in centers were very common in this subtropical region, and dampness was a strong predictor of sick building syndrome symptoms.
Child Day Care Centers↗
Airborne fungus allergen in association with residential characteristics in atopic and control children in a subtropical region.
Airborne fungi were collected during the summer and winter seasons. A N6 Andersen sampler was used inside and outside the homes of 46 asthmatic children, 20 atopic children, and 26 nonatopic control children in the Taipei area. In addition, host and house characteristics were obtained by questionnaire. The indoor fungus concentrations of asthmatic and control groups were higher than those in atopic groups in summer, but there were no differences in total fungus concentrations among three groups in winter. Concentration differences among these three groups also occurred for Cladosporium and Penicillium in summer and for Aspergillus, Cladosporium, Penicillium, and yeast in the winter. Moreover, it was demonstrated that no differences in fungus concentration were observed between damp and dry homes. Penicillium concentrations appeared to be related to home dampness. Home dampness was associated with allergic symptoms in children with asthma and rhinitis. An association was also observed between the occurrence of Cladosporium and history of asthma.
Allergens↗
Dampness and airway inflammation and systemic symptoms in office building workers.
To evaluate dose-response relationships between airway inflammation/systemic symptoms and dampness exposure, we conducted a self-reported questionnaire study on risk factors among 1237 employees in 19 air-conditioned office buildings in the Taipei area. The odds ratio for eye irritation was 1.34 when either stuffy odor or mold was present in the buildings. The odds ratio increased to 1.72 when both stuffy odor and mold were present, to 3.14 when water damage was also present, and to 5.03 when four dampness exposure factors were present. Dampness in the building had a dose-response effect on eye irritation, cough, and lethargy/fatigue.
Adult↗
Indoor endotoxin and glucan in association with airway inflammation and systemic symptoms.
Indoor bioaerosols (i.e., bacteria, fungi, endotoxin, and beta-1,3-glucan) were determined in daycare centers, office buildings, and domestic environments in the Taipei area. In addition, we used a questionnaire survey to determine associations between indoor dampness, bioaerosols, and airway inflammation and systemic symptoms. We demonstrated that the median levels of indoor bacteria and fungi were the highest in daycare centers, followed by those in homes and office buildings. Similar patterns were observed for endotoxin and beta-1,3-glucan. The prevalences of airway inflammation and systemic symptoms were higher for females in office buildings than for employees in daycare centers; all symptoms were more prevalent in females than males. With respect to the relationship between bioaerosol exposure and airway inflammation and systemic symptoms, we found a strong association between beta-1,3-glucan and lethargy/fatigue.
Adult↗
Subcutaneous nodules attributed to nocardiosis in a renal transplant recipient on tacrolimus therapy.
We report a renal transplant patient who suffered from disseminated nocardiosis after empirical tacrolimus rescue therapy for chronic allograft rejection. The nocardiosis presented initially as only mildly tender subcutaneous calf nodules without any other signs of inflammation nor constitutional upset, which later spread to the lung and brain causing bronchopneumonia and brain abscesses. The risk factors for nocardial infection in our patient include the use of potent immunosuppressive agents such as tacrolimus, poorly controlled diabetes mellitus and kidney dysfunction. She responded well to combination antibiotic therapy comprising parenteral meropenem, cefotaxime and oral minocycline. We conclude that in transplant recipients, especially those receiving newer and more potent immunosuppressive agents like tacrolimus, nocardial infection can present as apparently 'cold' subcutaneous nodules without any systemic upset. An associated brain lesion should be excluded even in patients without neurological symptoms.
Anti-Bacterial Agents↗
Cytomegalovirus-induced tubulointerstitial nephritis in a renal allograft treated by foscarnet therapy.
We report a female patient suffering from cytomegalovirus (CMV)-induced tubulointerstitial nephritis in a renal allograft 70 days after a cadaveric renal transplantation. CMV-induced renal allograft injury reported in the literature mainly related to immune-mediated mechanisms. In our patient, acute tubulointerstitial nephritis, associated with histological evidence of CMV infection, was demonstrated in the renal allograft biopsy. There were no histological features of allograft rejection, cyclosporin nephrotoxicity nor 'CMV glomerulopathy'. She was successfully treated by foscarnet therapy and a reduction in immunosuppression. Her renal function returned to baseline afterwards.
Adult↗
A randomized prospective comparison of oral levofloxacin plus intraperitoneal (IP) vancomycin and IP netromycin plus IP vancomycin as primary treatment of peritonitis complicating CAPD.
OBJECTIVE: To compare the therapeutic efficacy of daily oral levofloxacin plus intermittent intraperitoneal (IP) vancomycin (group 1) versus daily IP netromycin and intermittent IP vancomycin (group 2) in the primary treatment of peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD). DESIGN: A randomized multicenter prospective open-label comparative clinical study. SETTING: University and Hospital Authority hospitals in Hong Kong. PATIENTS: All CAPD patients who developed bacterial or culture-negative peritonitis beyond 28 days of a previous episode and without evidence of septicemia, associated tunnel infection, or known sensitivity to trial medications were accepted into the clinical trial. RESULTS: A total of 101 patients entered the trial. The primary cure rate was 74.5% for group 1 and 73.6% for group 2. Baseline culture results appeared to influence the clinical outcome: the primary cure rate for culture-negative, gram-positive, and gram-negative episodes was 83.3%, 78.6%, and 42.9% for group 1 and 69.1%, 76.9%, and 71.3% for group 2, respectively. The primary cure rate also varied considerably among individual centers and was particularly noticeable in group 1. In the latter group, it correlated closely with in vitro levofloxacin resistance which in turn correlated closely with previous exposure to fluoroquinolones. CONCLUSION: Oral levofloxacin in combination with intermittent IP vancomycin has comparable efficacy to IP netromycin combined with intermittent IP vancomycin as primary treatment in CAPD peritonitis, but is simpler and more cost-effective to administer. It may be recommended as primary therapy in centers with relatively low exposure and, therefore, low background resistance to fluoroquinolones.
Administration, Oral↗
Relationship between adequacy of dialysis and nutritional status, and their impact on patient survival on CAPD in Hong Kong.
OBJECTIVE: Superior patient survival on continuous ambulatory peritoneal dialysis (CAPD) with 3 x 2-L exchanges has been reported from Hong Kong. This study examined the relationship between indices of dialysis adequacy and nutrition and patient survival on CAPD in Hong Kong. DESIGN: A cross-sectional study on prevalent CAPD patients. Patients were assessed for indices of dialysis adequacy and nutritional status with a composite nutritional index (CNI). Patients were then followed for 24 months. Survival data were analyzed according to adequacy indices and nutritional status. SETTING: All prevalent CAPD patients in nine dialysis centers in Hong Kong as of 1 April 1996. MAIN OUTCOME MEASURE: Mortality. RESULTS: 937 patients were assessed: 68.2% were using 3 x 2-L exchanges per day; mean age was 54.6 +/- 13 years. Mean total Kt/V was 1.83 +/- 0.42 and total creatinine clearance was 55.6 +/- 19.5 L/week/1.73 m2. 19% of patients were moderately to severely malnourished according to the CNI. There was no significant correlation between indices of adequacy and serum albumin or CNI. The 1- and 2-year patient survival from the time of assessment was 90.9% and 79.8%. There was a trend toward better survival in patients with Kt/V greater than 2.0, but it was not statistically significant. Peritoneal Kt/V did not impact survival in anuric patients. Malnourished patients had poorer survival than patients who were better nourished (p = 0.0259). After adjusting for age and diabetes, CNI was predictive of mortality but Kt/V and creatinine clearance were not. CONCLUSIONS: This study demonstrates the importance of nutritional status over adequacy indices in predicting patient survival. There was a lack of correlation between nutritional status and conventional indices of dialysis adequacy.
Adult↗