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Biomedical subjects

C Y Chuang

Publications and source records attributed to C Y Chuang.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Secular trends in the etiology of nosocomial infection at a teaching hospital in Taiwan, 1981-1994].

Surveillance system of nosocomial infection was established in 1980 at the National Taiwan University Hospital (NTUH). To identify pathogens and the secular trends in the etiology of nosocomial infection from 1981 to 1994, the prospective, hospital-wide nosocomial surveillance data were analysed. During this period, 22,146 pathogens causing nosocomial infections were isolated. Gram-negative aerobic bacteria remained the major pathogens, but gram-positive cocci and fungi increased rapidly in the past 14 years. When the overall pathogen distribution is examined, Pseudomonas areuginosa was the most frequently isolated pathogen, but Candida albicans and other yeasts have taken the leading position since 1993. Staphylococcus aureus and coagulase-negative staphylococci also increase significantly in recent years. When the pathogens causing infection at the 4 major sites were examined. P. aeruginosa was the pathogen most often associated with respiratory tract and surgical wound infections. In blood stream and urinary tract infections, we observed Escherichia coli was replaced by C. albicans and other yeasts as a most common isolate in these years. In addition, C. albicans and other yeasts and methicillin-resistant S. aureus (MRSA) are emerging as major nosocomial pathogens at NTUH. C. albicans and other yeast increased from 1.8% in 1981 to 14.9% in 1994 in the overall nosocomial infection. The increase was found in the blood stream (2.1% to 16.2%) and urinary tract infections (5.4% to 24.7%). Of 1,742 nosocomial S. aureus isolates, the percentage of MRSA rose from 12.5% in 1981 to 55.2% in 1994. The high percentage of MRSA was observed at 4 major anatomic sites of infection. In summary, significant shifts in the pathogens of nosocomial infection have occurred in the past 14 years at NTUH, and the distribution of nosocomial pathogens was similar to those reported in the United States in recent years.

Bacteremia↗
PubMed1994

Anticardiolipin antisera from lupus patients with seizures reduce a GABA receptor-mediated chloride current in snail neurons.

The effects of circulating anticardiolipin (ACL) antisera in lupus patients on the LP5 central neuron of snail were studied. Both GABA and glutamate increased a chloride conductance of the LP5 neuron. The ACL antisera decreased the GABA-elicited responses in a concentration dependent manner while it had no effect on glutamate-elicited responses. The ACL antisera affected neither the resting membrane current, nor the membrane conductivity of neuron. Antisera without the activity of anticardiolipin did not decrease the GABA-elicited responses. The seizure incidence of the patients with higher ACL antisera levels is also higher. It is concluded that ACL antisera inhibited the GABA ionophore receptor complex in a snail central neuron.

Animals↗
PubMed1994

The study of anticardiolipin antibodies and interleukin-6 in cerebrospinal fluid and blood of Chinese patients with systemic lupus erythematosus and central nervous system involvement.

Anticardiolipin (ACL) antibodies and interleukin-6 (IL-6) in cerebrospinal fluid (CSF) may be involved in the mechanism of lupus patients with central nervous system (CNS) involvement. ACL antibodies of 3 isotypes and IL-6 were measured in paired CSF and serum samples from 14 lupus patients with CNS involvement, 5 lupus patients without CNS involvement and 7 patients with non-inflammatory neurological diseases. ACL antibodies, IgG and IgM isotypes, and IL-6 were significantly increased in CSF from lupus patients with CNS involvement as compared with other 2 groups of patients. Both ACL antibodies and IL-6 decreased after neurological activity subsided. These results suggest increased ACL antibodies and IL-6 in CSF are involved in immune responses within CNS in lupus patients. Quantitation of CSF ACL antibodies may be helpful in evaluating neurological activity of lupus patients with CNS involvement.

Adolescent↗
PubMed1993

Thyroid disorders in Chinese patients with systemic lupus erythematosus.

To clarify the prevalence of thyroid disorders in Chinese patients with systemic lupus erythematosus (SLE), 45 SLE patients not receiving corticosteroid therapy for at least 6 months were selected over a period of 1 year. They were investigated by utilizing thyroid ultrasonography and by determinations of thyroid antibodies and thyroid function. Of these patients, 24 (53.3%) showed abnormal sonographic findings. Thyroid antibodies (microsomal and/or thyroglobulin) were detected in 21 patients (46.7%), but a low index of thyrotropin-binding inhibitory immunoglobulin (TBII) was found in only one euthyroid patients with a normal echogram. Ten patients (22.2%) had abnormal thyroid function. The mean disease duration was longer in patients with thyroid anomalies (p < 0.05). Hashimoto's thyroiditis was found in four patients (8.8%), two of whom had hypothyroidism. We concluded that thyroid anomalies are frequently found in patients with SLE in the area of this study. The possibility of the coexistence of thyroid disorders in systemic lupus erythematosus should be carefully considered throughout the course of patients' follow-up, especially in those with a long disease duration.

Adult↗
PubMed1993

Circulating intercellular adhesion molecules-1 and autoantibodies including anti-endothelial cell, anti-cardiolipin, and anti-neutrophil cytoplasma antibodies in patients with vasculitis.

Circulating intercellular adhesion molecule-1 (ICAM-1) and 3 types of autoantibodies were measured in 30 patients with angiographical or pathological proved vasculitis. There were 18 patients with systemic vasculitis and 12 patients with cutaneous vasculitis. The measured antibodies included anti-endothelial cell antibodies (AECA), anti-cardiolipin (ACL) antibodies of 3 isotypes and anti-neutrophil cytoplasma antibodies (ANCA). The results showed that patients with systemic vasculitis had elevated levels of ICAM-1, AECA and IgG isotype antibody as compared with none or lower in patients with cutaneous vasculitis. Levels of ICAM-1 and IgG isotype ACL antibodies also decreased significantly after disease activity subsided in patients with systemic vasculitis. Measurement of ICAM-1 and autoantibodies may be useful in evaluating the extent of involvement and in following the disease activity of patients with vasculitis.

Adolescent↗
PubMed1993

Lupus patients with peripheral vascular thrombosis: the significance of measuring anticardiolipin antibody.

The purpose of this study was to determine the significance of measuring anticardiolipin (ACL) antibodies in Chinese lupus patients with peripheral vascular thrombosis. A total of 252 lupus patients were evaluated prospectively for the presence of peripheral vascular thrombosis in a 3-year period. Tests of ACL antibodies with three isotypes were done serially during follow-up. There were 10 lupus patients with five episodes of arterial thrombosis and seven episodes of venous thrombosis by the evidence of angiographical and/or pathological findings. The ACL antibody status was negative (< 2 standard deviation [SD]), low (2 to 5 SD) and high (> 5 SD) for 43.3%, 22.6%, and 34.1% patients, respectively. Patients with high levels (> 5 SD) of ACL antibodies had a high frequency of peripheral vascular thrombosis than patients with negative levels (> 2 SD) of ACL antibodies (P < .05). It is concluded that serial measurement of ACL antibodies in lupus patients is useful in predicting the occurrence of peripheral vascular thrombosis. Clinicians should be alert to the possibility of such complication in lupus patients with high ACL antibodies levels when visiting the emergency service.

Adolescent↗
PubMed1993

Acute pancreatitis related to anticardiolipin antibodies in lupus patients visiting an emergency department.

Four patients with systemic lupus erythematosus visiting an emergency department were reported with clinical presentation of acute pancreatitis. All had high levels of anticardiolipin antibodies (aCL); at autopsy, one had multiple thrombi within the blood vessels of the pancreas. The aCL antibody might play an important role in the pathogenesis of acute pancreatitis. Three patients had multiple organ involvement, especially the central nervous system, concomitant with an acute attack of pancreatitis; all died from these complications. Thus it was suggested that initial acute pancreatitis is an omnious prognostic factor in lupus patients visiting an emergency department. When evaluating lupus patients visiting an emergency department, clinicians should be alert to the status of aCL and the possibility of pancreatitis in these patients.

Acute Disease↗
PubMed1993

AIDS in the Republic of China, 1992.

From May 1985 to December 1992, a total of 5,931,032 serum samples from eight population groups were tested for antibody to human immunodeficiency virus type 1 (HIV). Mandatory testing is carried out for blood donors, military recruits, immigrants, and prisoners. The other population groups were tested anonymously with consent. A total of 407 samples were seropositive. Of those HIV carriers, 63 developed AIDS: 37 were homosexuals, 6 were hemophiliacs, 1 was an intravenous drug user, 15 were heterosexuals, and 4 had no known risk factors. Although the prevalence of HIV infection and AIDS in Taiwan has remained low, the increase since 1988 has been rapid. Before 1987, all of the 48 persons with HIV infection were homosexuals or hemophiliacs. Thereafter, the risk groups diversified, with the main group shifting from homosexuals to heterosexuals and the number of intravenous drug users surpassing the number of hemophiliacs. Among the 63 patients with AIDS, 59 were male and only 4 were female; 53 have died (3 committed suicide).

Acquired Immunodeficiency Syndrome↗
PubMed1993

Circulating intercellular adhesion molecule-1 and lymphocyte subsets involved in immune response of breast cancer.

To understand the immune responses of patients with breast cancer, circulating intercellular adhesion molecules-1 (ICAM-1) and lymphocyte subsets were measured in patients with breast cancer and in healthy persons. There were 10 patients of with metastasis, 11 patients breast cancer without metastasis and 9 age-and-sex matched healthy persons. Their serum samples were counted for circulating ICAM-1 levels, and blood cells were calculated for lymphocyte subpopulation including CD3, CD4, CD8 and CD19 by using flow cytometry. Higher levels of circulating ICAM-1 were noted in patients with breast cancer and metastasis than those without metastasis (p < 0.01). Lower percentage of CD8 lymphocyte subset were found ih patients with breast cancer and metastasis than those without metastasis (p < 0.05). Shedding of ICAM-1 antigens from the tumor may block the attachment of cytotoxic T cells, and decreased numbers of cytotoxic T cells may be unable to inhibit the spread of cancer cells. Immune responses of patients with breast cancer may be different between metastatic status and limited status. Further investigations should correlate the results of tissue stains of breast cancer with ICAM-1 and lymphocyte markers with those from peripheral blood.

Adult↗
PubMed1993

Successful treatment of Kaposi's sarcoma with interferon-alpha in a patient with acquired immunodeficiency syndrome.

Although combined therapy with interferon-alpha and zidovudine may be safely administered to some patients with the acquired immunodeficiency syndrome (AIDS) and Kaposi sarcoma, no ethnic Chinese patient has been successfully treated before in this area. This case report concerns a 47-year-old male with a history of bisexuality who had suffered from oral ulcers for half a year, Human immunodeficiency virus (HIV) serology was positive, and pathology of the oral ulcers disclosed Kaposi sarcoma. Combination therapy with zidovudine and interferon-alpha was initiated. The patient received a low-dose regimen of 5.0 million U interferon-alpha s.c. per day for 8 weeks and 5 million U twice a week for another 8 weeks. The oral ulcers faded away without recurrence. This report also reviews the literatures on treatment of AIDS-related Kaposi sarcoma with interferon.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Salbutamol in treatment of bronchial asthma--comparison of controlled release tablet with standard tablet.

Salbutamol in controlled release tablet form was compared to salbutamol in standard tablet form for the management of patients with bronchial asthma. A total of twenty asthmatic patients enrolled in the study were classified into two groups, ten patients each, for a cross-over study. Group 1 received controlled release tablets for a 2 to 3 week period, and were then shifted to standard tablets for another similar period. Group 2 received standard tablets first and was then shifted to controlled release tablets. Patients were required to record symptom scores during therapy, including sleep disturbance, chest tightness, wheezing, cough, sputum production and inhalational bronchodilator use. Measurements of peak expiratory flow rate (PEFR) were also done, as well as record made of side effects experienced. The result showed that a lower symptom score was found in patients receiving controlled release tablets than in patients receiving standard tablets (p < 0.001 for sleep disturbance, p < 0.005 for sputum formation and p < 0.001 for total score). There was a higher PEFR in patients receiving controlled-release tablets than in patients receiving standard tablets (p < 0.001). Side effects with tremor were observed in 30% of both groups of patients with a slightly higher degree in the patients receiving standard tablets (statistically not significant). In conclusion, salbutamol of controlled release tablet form obtains a better therapeutic response than standard tablets in the management of patients with bronchial asthma.

Adult↗
PubMed1993

Analysis of a new subtype of HIV-1 gag sequence from a case of vertical transmission in Taiwan.

A Taiwanese woman who lived with a presumably bisexual man of German nationality, and her infant daughter were found to be seropositive for HIV-1. From DNA preparations of peripheral blood mononuclear cells of the mother-infant pair, we amplified a segment, about 560 base pairs (bp), of gag portion of HIV-1 provirus by using polymerase chain reaction (PCR). The high degree of homology (94.7-97.5%) among clones (TM-1 and TM-2 from the mother, and TC-1 and TC-2 from the infant) of gag sequence provided a molecular epidemiological evidence for vertical transmission. However, these sequences exhibited lower degrees of homology (85.1-87.0%) with the corresponding gag segment of a North American HIV-1 subtype (HXB2), and that of a Zairean HIV-1 subtype (Z2Z6). The disparity of sequences between these Taiwanese clones and those of HXB2 and Z2Z6 was particularly prominent in the first (5' proximal) 200 bp, as shown by the low degree of homology (74.8-79.6%) when sequences of TM and TC clones which represented the first 200 bp were compared with those of HXB2 and Z2Z6. The sequence dissimilarity of these clones as compared with HXB2 manifested as transitions more frequently than transversions. Transitions involving G/A to A/G changes were more frequent than those involving T/C to C/T. Transversions involving G/A to T/C changes were slightly more frequent than those involving T/C to G/A changes for all clones except for TM-2 which showed an equal frequency. Presence of stop codons in each of the reading frames of these clones suggests that these may represent defective viral quasispecies. The deduced amino acid sequences from available open reading frames of these clones showed also distinct dissimilarities to HXB2 or Z2Z6. These findings indicate the presence of a gag subtype of HIV-1 which, according to the phylogenetic tree analysis, would represent a new subtype distinct from other known subtypes.

Adult↗
PubMed1993

Measurement of anti-endothelial and anti-cardiolipin autoantibodies and intercellular adhesion molecules-1 in patients with systemic and cutaneous vasculitis.

Two types of autoantibodies and intercellular adhesion molecule-1 (ICAM-1) were measured in patients with vasculitis. There were 13 patients with systemic vasculitis, and 12 with cutaneous vasculitis. The measured antibodies included antiendothelial cell antibodies (AECA) and anti-cardiolipin (ACL) antibodies of three isotypes. Results showed that patients with systemic vasculitis had elevated levels of ICAM-1 and IgG isotype ACL antibodies. Higher levels of ICAM-1 and IgG isotype ACL antibody were found in patients with systemic vasculitis than in those with cutaneous vasculitis. Levels of ICAM-1 and IgG isotype ACL antibodies also decreased after disease activity subsided in patients with systemic vasculitis. Measurement of ICAM-1 and autoantibodies may be useful in evaluating the extent of involvement, and for following the disease course.

Adolescent↗
PubMed1993

Myopathy associated with human immunodeficiency virus infection: report of a case.

Neuromuscular manifestations, including a variety of peripheral neuropathies and myopathies, can occur either as isolated clinical phenomena or concurrently with other clinical manifestations, and are common in acquired immunodeficiency syndrome (AIDS). A 33-year-old male patient had a four-year history of increasing proximal muscle weakness of the extremities. Elevated muscle enzymes, a muscle biopsy and interstitial lung disease all suggested a diagnosis of polymyositis with lung involvement. However, a transbronchial lung biopsy revealed Pneumocystis carinii pneumonia, and serology for HIV infection disclosed positive results. Zidovudine and cotrimoxazole were instituted and the patient improved. HIV-associated myopathy should be considered by practicing clinicians in cases presenting with myopathy, since the number of patients with HIV infection is increasing in Taiwan.

Adult↗
PubMed1993

Non-excretory myeloma with diffuse osteolytic lesions caused by tumor necrosis factor: report of a case.

A 63-year-old male patient was admitted to the hospital after a six-month complaint of low back pain. Anemia, hypercalcemia and 5 to 18% giant abnormal binucleated plasma cells infiltrations in the bone marrow suggested a diagnosis of multiple myeloma. However, repeated serum and urine immunofixation electrophoresis failed to demonstrate any abnormal monoclonal band. Diagnosis of non-excretory myeloma was verified by immunocytochemical stains demonstrating intracellular kappa chain in these neoplastic cells. Some authors have claimed that there were fewer bone lytic changes, less bone marrow infiltration, more preservation of normal immunoglobulin but with more neurological presentations among non-excretors. However, this patient had severely generalized bone lytic lesions and high serum level of tumor necrosis factor. The former might be attributed to the latter. Literatures about multiple myeloma and the tumor necrosis factor are also reviewed.

Humans↗
PubMed1993

Plasminogen activation activity of urokinase determined via a cascade enzymatic reaction system.

A method for determining the plasminogen activation rate by urokinase via a cascade enzymatic reaction system is presented. A procedure of parameter estimation has been proposed for the determination of the activity of urokinase and the kinetic constants. Urokinase from urine has been successfully assayed through use of a plasminogen concentration lower than its saturating level. The methodology presented in this work may be adopted for the analysis of other cascade enzymatic reaction systems.

Humans↗