Biomedical subjects

F Y Chang

Publications and source records attributed to F Y Chang.

At least 217 records · Page 12Linked to original sources

PubMed1997

Primary biliary cirrhosis associated with mixed type autoimmune hemolytic anemia and sicca syndrome: a case report and review of literature.

A case presenting with an unusual association of primary biliary cirrhosis and mixed type autoimmune hemolytic anemia plus sicca syndrome is described. The 49-yr-old female primary biliary cirrhosis patient had a confirmed sicca syndrome and presented with jaundice and life-threatening anemia. Laboratory tests revealed positive Coombs' test with coexisting cold and warm autoantibodies. She was successfully treated by blood transfusion with packed red cells lacking any red cell antigens corresponding to serum alloantibodies and pulse methylprednisolone therapy. The patient remained stable under maintenance treatment using oral steroids and ursodeoxycholic acid. This case is probably the first reported showing an association between primary biliary cirrhosis and mixed type autoimmune hemolytic anemia plus sicca syndrome and was probably induced by heterogenous and complicated autoimmune reactions.

Administration, Oral↗

PubMed1997

Risk factors for gallbladder polyps in the Chinese population.

OBJECTIVES: To assess the prevalence of and risk factors for gallbladder (GB) polyps in the Chinese population. METHODS: A prospective ultrasonographic study of GB polyps was conducted in 3647 Chinese subjects who received a paid physical checkup at this hospital. Their demographic characteristics and biochemical parameters were recorded. Ultrasonographic diagnosis revealed a normal GB in 2946 subjects (1838 men, 1108 women), polyps in 243 (174 men, 69 women), gallstones in 286 (196 men, 90 women), a history of cholecystectomy in 100 (56 men, 44 women), mixed gallstones/GB polyps in 17 (10 men, seven women), and miscellaneous results in 35. RESULTS: Excluding subjects with cholecystectomy and mixed gallstones/GB polyps, the overall prevalence of GB polyps in the study group was 6.9%. The studied risk factors manifesting an increased odds ratio (OR) for the development of GB polyps were glucose intolerance (OR 1.506, p < 0.05) and male gender (OR 1.723, p < 0.05) in multivariate analysis. Other demographic characteristics and biochemical parameters, such as age, body mass index, cigarette smoking, alcohol consumption, blood pressure, lipid profile, hepatitis B virus carrier, liver function, and parity, did not exhibit any correlation to GB polyps. CONCLUSIONS: Among Chinese of higher socioeconomic status, men and individuals with glucose intolerance tend to have a high risk for developing GB polyps.

Adult↗

PubMed1997

Plasma substance P levels in patients with liver cirrhosis: relationship to systemic and portal hemodynamics.

OBJECTIVES: Nitric oxide has been proposed as being responsible for the hyperdynamic circulation observed in portal hypertensive states. Substance P, a neuropeptide partly cleared by liver, induces vasodilation through the activation of the endothelial nitric oxide pathway. This study investigated the plasma levels of substance P in cirrhotic patients and the relationship of these levels to systemic and portal hemodynamics. METHODS: Sixty-four patients with cirrhosis and 53 healthy controls had blood samples taken for determining plasma values of substance P by ELISA. Systemic and portal hemodynamics were measured on the same day of blood sampling using a Swan-Ganz catheterization and thermodilution technique. RESULTS: Plasma levels of substance P were higher in cirrhotic patients than in healthy controls (45.7 +/- 2.0 vs 32.9 +/- 1.0 pg/ml, p < 0.001) and directly correlated with Child-Pugh's score (r = 0.52, p < 0.0001). Compared with compensated cirrhotic patients, decompensated cirrhotic patients had higher plasma levels of substance P accompanied by a lower systemic vascular resistance and higher hepatic venous pressure gradient. There was no significant correlation between plasma levels of substance P and systemic vascular resistance and hepatic venous pressure gradient. In addition, no significant difference in plasma levels of substance P was observed between cirrhotic patients with and cirrhotic patients without a hepatic venous pressure gradient > 12 mm Hg or between patients with and patients without large esophageal varices. CONCLUSIONS: Plasma levels of substance P are increased in patients with cirrhosis and may contribute to the pathogenesis and/or maintenance of hyperdynamic circulation in decompensated patients. The severity of cirrhosis is more important than portal hypertension and the severity of esophageal varices for the development of increased plasma substance P levels.

Female↗

PubMed1997

Factors responsible for computed electrogastrographic parameters in humans.

OBJECTIVES: Clinical knowledge about myoelectrical frequency is well known, but the factors responsible for recorded myoelectrical amplitude remain less clear. METHODS: We assembled an electrogastrographic system that could automatically compute the dominant myoelectrical frequency and power and power ratio. We enrolled 50 healthy volunteers (25 men and 25 women) to study their myoelectrical characteristics. Three surface electrodes were placed in the fundic, stomach body, and antral positions for two 30-min recordings in the fasting and postprandial states. RESULTS: The three different electrodes recorded similar dominant frequencies of about 3 cpm before and after a meal. The fasting dominant powers from these electrodes were 52.9 +/- 14.7, 44.6 +/- 11.5, and 50.1 +/- 15.1 dB, respectively (p < 0.01), whereas the postprandial dominant powers were 61.6 +/- 28.8, 54.3 +/- 26.6, and 61.9 +/- 27.8 dB, respectively (p < 0.01). Meal ingestion did increase the power (p < 0.05). Women had a lower dominant power than men (p < 0.001). Moreover, the dominant powers of each electrode were significantly correlated with body mass index (r = 0.3-0.36, p < 0.05) regardless of meal ingestion. The postprandial power ratio was not influenced by electrode position, gender, or body mass index. CONCLUSIONS: Myoelectrical dominant frequencies and power ratios are similar throughout the whole stomach area, whereas a lower power area exists on the stomach body. Gender-related variation in dominant power seems to be an effect of body size. The power ratio is the only reliable parameter for expressing myoelectrical amplitude.

Adult↗

PubMed1997

Sequential changes of esophageal motility after endoscopic injection sclerotherapy or variceal ligation for esophageal variceal bleeding: a scintigraphic study.

OBJECTIVE: Endoscopic injection sclerotherapy and variceal ligation are two popular endoscopic methods used to treat esophageal variceal hemorrhage. These two methods have not been compared with regard to esophageal dysfunction after treatment. This is a prospective investigation of esophageal dysmotility after endoscopic injection sclerotherapy and variceal ligation. METHODS: Sequential changes of esophageal motility after endoscopic injection sclerotherapy (n = 25) and variceal ligation (n = 25) were investigated in 50 cirrhotic patients with recent variceal bleeding. Another 22 cirrhotics without esophageal varices were included as controls. Radionuclide esophageal transit tests were performed before initial endoscopic treatment, and 1 and 3 months after variceal eradication. RESULTS: The baseline esophageal transit time was longer in both the sclerotherapy (n = 25, 7.8 +/- 1.4 s) and ligation groups (n = 25, 8.2 +/- 1.8 s) than in controls (n = 22, 6.7 +/- 0.7 s, p < 0.005). The transit time was longer in patients with large varices than in those with small varices (8.3 +/- 1.7 vs. 7.2 +/- 0.7 s, p < 0.05). In the sclerotherapy group, the transit time was prolonged 1 month after variceal eradication, compared with its pretreatment state (n = 20, 7.6 +/- 1.5 vs. 10.0 +/- 2.2 s, p < 0.0001) but was shortened at 3 months compared with 1 month after variceal eradication (n = 12, 10.7 +/- 1.5 vs. 8.6 +/- 2.2 s, p < 0.05). Multiple regression analysis showed that the number of treatment sessions required to eradicate varices was the only significant factor associated with prolonged transit time (p < 0.05). In the ligation group, the transit time changed little at 1 month or 3 months after variceal eradication. CONCLUSIONS: Impairment of esophageal motility can be significant with endoscopic injection sclerotherapy but is reversible. However, endoscopic variceal ligation exerts no significant impact on esophageal motility.

Esophageal and Gastric Varices↗

PubMed1997

The effects of ursodeoxycholic acid in patients with severe obstructive jaundice after drainage procedure.

BACKGROUND: The aim of this study is to evaluate the therapeutic effect of ursodeoxycholic acid (UDCA) for patients with severe obstructive jaundice after drainage procedure. METHODS: From September 1993 to December 1994, patients admitted with severe obstructive jaundice (serum bilirubin > 15 mg/dl) and successful drainage were enrolled into our study. They were randomly divided into two groups to receive UDCA 600 mg per day (UDCA group) or a placebo (placebo group) until operation or discharge. Bile drainage amount, clinical symptoms and signs and adverse effects of drugs were recorded daily. Biochemical tests, including albumin, total bilirubin, cholesterol, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase and prothrombin time, were checked first, on the third and seventh days, and then two weeks after drainage. RESULTS: Thirty-eight patients (M/F = 36/ 2, mean age 66.6 +/- 6.4 years) completed the study, 18 in the UDCA group and 20 in the placebo group. There were no differences in age, sex, causes of obstructive jaundice or methods of drainage procedure between the UDCA and placebo groups. Improvement in biochemical test results were noted in both groups. However, bile drainage amount and changes in liver biochemical test, especially the decrement of serum bilirubin, were not significantly different between both groups. CONCLUSIONS: UDCA seemed not to benefit patients with severe obstructive jaundice after successful drainage.

Aged↗

PubMed1996

Influence of blood glucose levels on rat liquid gastric emptying.

The glycemic influence on liquid gastric emptying in rats was studied. Diabetic hyperglycemia was induced by streptozotocin-treated rats further received a daily insulin injection ( 2.5 or 10 IU/kg). Immediate hyperglycemia was induced in a separate group of rats by continuous intravenous glucose infusion (44 or 88 mg/kg/min) 10 min before the experiment. Rats were killed 15 min after radiochromium feeding; then the radioactivity of stomach and small intestine were counted to obtain the gastric emptying value. Emptying in diabetic rats was delayed compared with controls (mean +/- SE: 40.9 +/- 2.6% vs. 54.2 +/- 2.8%, P < 0.01). Low-dose insulin treatment reversed the impairment, while high-dose treatment even enhanced emptying. Immediate hyperglycemia induced with two glucose infusions also inhibited gastric emptying. Present results indicate that hyperglycemia elicited with any hyperglycemic model is at least one of the important mechanisms to delay liquid gastric emptying.

Analysis of Variance↗

PubMed1996

Nosocomial Legionnaires' disease caused by Legionella pneumophila serogroup 5: laboratory and epidemiologic implications.

Environmental monitoring and clinical surveillance for Legionella species were done for 12 months as recommended by the Allegheny County Health Department (Pittsburgh). The water system of a hospital was found to be colonized with Legionella pneumophila serogroup 5. Three patients with nosocomial L. pneumophila serogroup 5 disease were subsequently diagnosed after laboratory tests for legionellae were made available for all patients with nosocomial pneumonia. All serogroup 5 isolates from the hospital water matched the 3 patient isolates by pulsed-field gel electrophoresis (PFGE). Furthermore, isolates found in the water supply dating back 10 years showed the same PFGE pattern. In contrast, 12 L. pneumophila serogroup 5 isolates from eight other institutions had different PFGE patterns. Routine environmental cultures were important in stimulating the application of Legionella laboratory testing, which subsequently identified unsuspected patients with nosocomial legionnaires' disease.

Aged↗

PubMed1996

Pentoxifylline pretreatment enhances the oxidative burst activity of human peripheral blood mononuclear cells.

The effect of pentoxifylline pretreatment on the lucigenin-augmented chemiluminescence and dismutase-inhibitable superoxide production of human neutrophils and mononuclear cells (MNCs) was studied. Pentoxifylline at 20-2,000 micrograms/ml enhanced the lucigenin-augmented chemiluminescence (118-165% of the control, P < 0.01) of phorbol myristate acetate (PMA)-stimulated MNC. Pentoxifylline at 20-2,000 micrograms/ml increased the MNC superoxide production, i.e., 142-171% of the control (P < 0.05) using PMA stimulation and 145-159% of the control (P < 0.01) using opsonized zymosan stimulation. In contrast, pentoxifylline (up to 2,000 micrograms/ml) did not influence the lucigenin-augmented chemiluminescence and superoxide production of human neutrophils, stimulated by either PMA or opsonized zymosan. These results suggest that pentoxifylline is an immunomodulator and may have potential usefulness in the enhancement of immune defenses in compromised hosts.

Acridines↗

PubMed1996

Risk factors for pancreatic cancer in orientals.

In order to assess what the risk factors for patients with pancreatic cancer (PC) in Taiwan are, a retrospective study was undertaken among 282 consecutively enrolled inpatients with confirmed pancreatic cancer within the past 5 years. For comparison, 282 age- and sex-matched controls were consecutively enrolled. A history of smoking, consumption of alcohol, diabetes mellitus, cholecystectomy and gastric surgery were thoroughly reviewed. Smoking and diabetes mellitus were very common among patients with pancreatic cancer compared with controls (P < 0.01). A significant linear trend towards an increased odds ratios (OR) for the development of PC with a higher level of smoking was seen (P < 0.001). Diabetes mellitus (DM) also exhibited an increased risk (OR: 2.84; P < 0.01), while the risk still existed among those patients who had a diabetic history of more than 3 years. Among 129 histologically established PC patients, smoking remained as a risk factor for PC, while the linear trend with an increasing OR with increasing levels of smoking was confirmed again (P < 0.01). DM, particularly over the long-term, was also a risk factor for those histologically established PC patients. In summary, cigarette smoking and existing diabetes mellitus are probable risk factors for the development of pancreatic cancer in Taiwan.

Aged↗

PubMed1996

An assembled electrogastrographic device to examine the meal effect on gastric slow wave.

We have assembled an electrogastrographic device based on the main components of amplifiers, a band-pass filter, an analogue/digital converter, low band-pass digital filters and a personal computer. The analysis software uses autoregressive moving average modelling to compute the frequency of slow waves and uses fast Fourier transformation for power spectral computation. Twenty healthy young male volunteers were enrolled in the study to test meal-elicited responses of the slow wave. Subjects underwent a 15 min recording while fasting and then a standard breakfast, which included 250 mL milk and a cake with a total of 1.45 kj, was ingested within 5 min. The post-prandial 15 min recording was immediately resumed after the meal. A slight but significant increase in the frequency of slow waves was seen in post-prandial measurement (mean +/- s.d., 0.0506 +/- 0.0005 vs 0.0497 +/- 0.0005 Hz; P < 0.0001). Moreover, a significant enhancement of the power of slow waves was elicited following the meal (36.0 +/- 3.1 vs 27.6 +/- 3.1 dB; P < 0.0001). We conclude that this assembled electrogastrographic device is a reliable means of monitoring gastric myoelectrical activity because the phenomenon of post-prandial responses of slow waves in either frequency or power is well demonstrated.

Eating↗

PubMed1996

Assessment of enzyme immunoassay versus radioimmunoassay for detection of Legionella pneumophila serogroup 1 antigen in frozen urine specimens.

An enzyme immunoassay (EIA) was compared with a radioimmunoassay (RIA) for detection of Legionella pneumophila serogroup 1 antigen in 37 frozen urine samples. Among 18 samples positive by the RIA at the time of collection, 50% (9 of 18) of stored specimens retained positivity when retested by the RIA whereas 78% (14 of 18) of stored specimens retained positivity when retested by the EIA (P < 0.02). A false-negative result occurred after storage for 5 months or less if the original RIA result showed weak positivity.

Humans↗

PubMed1996

Effect of transcutaneous nerve stimulation on esophageal function in normal subjects--evidence for a somatovisceral reflex.

Transcutaneous stimulation (TNS) at esophageal acupuncture points decreases lower esophageal sphincter (LES) pressures in patients with achalasia. We examined the effect of TNS on esophageal motility and vasoactive intestinal peptide (VIP) levels in normal subjects. TNS was applied to either hand or foot (placebo) in 10 volunteers. Esophageal and LES pressures were recorded and blood was drawn for VIP analysis. Hand TNS improved LES relaxation and percent of peristaltic contractions to swallows, and decreased the number of spontaneous contractions. Foot TNS decreased only spontaneous contractions while LES pressures and VIP levels were unchanged. We conclude that a somatovisceral pathway involving the esophagus exists.

Acupuncture Points↗

PubMed1996

Characteristics of endoscopic retrograde cholangiopancreatogram in patients with primary biliary cirrhosis.

BACKGROUND: The findings of cholangiopancreatograms in patients with primary biliary cirrhosis vary markedly in literature. We tried to evaluate the changes of endoscopic retrograde cholangiopancreatograms in Chinese patients with primary biliary cirrhosis. METHODS: Twenty-nine patients with primary biliary cirrhosis underwent endoscopic retrograde cholangiopancreatography over the past 8 years. Three patients with a negative antimitochondrial antibody test were excluded. Well opacified cholangiograms and pancreatograms were obtained in 24 patients. Meanwhile, 16 subjects with normal cholangiopancreatogram served as controls. The characteristics and prevalence of abnormal cholangiopancreatograms in the patients and the correlation of radiography with clinical severity of the disease were evaluated. RESULTS: The maximum diameters of the common bile duct (9.7 +/- 4.0 vs. 7.6 +/- 0.9 mm, NS), right (5.0 +/- 1.6 vs. 4.4 +/- 1.2 mm, NS) and left (5.1 +/- 1.2 vs. 4.9 +/- 1.4 mm, NS) intrahepatic ducts did not show significant difference between the patients with primary biliary cirrhosis and the controls. Abnormal intrahepatic cholangiograms were obtained in 12 (50%) patients including eight with diminished arborization and focal stenosis, three with crowding and tortuous branches and one with focal stenosis alone. A hepatic hilum notch on the common hepatic duct was found in eight (33.3%) patients. The abnormalities of intrahepatic ducts did not correlate with age, sex, Pugh's scores, various liver function tests or histologically cirrhotic change. One (4.2%) patient had an abnormal pancreatogram. CONCLUSIONS: Abnormal intrahepatic cholangiograms are present in half of patients with primary biliary cirrhosis, but are not related to clinical severity.

Adult↗

PubMed1996

The effect of cimetidine on serum acidic markers and Helicobacter pylori in gastric ulcer subjects.

BACKGROUND: This study was conducted to investigate the influence of cimetidine on the Helicobacter [correction of Helilcobacter] pylori(HP) colonization and serum acidic markers in gastric ulcer patients. METHODS: Forty-eight patients with gastric ulcer confirmed by endoscopy were consecutively enrolled. HP colonization was confirmed by either urease test or histological examination. Fasting serum gastrin and pepsinogen I (PGI) levels were measured before and after 8 weeks of cimetidine treatment. RESULTS: Healing of ulcer at the end of treatment was 75%. Initially, the infection rate of HP was 87.5% (42/48). After 8 weeks of treatment, HP clearance rate was only 7.1% (3/42). A significant elevation of serum gastrin level was seen in HP positive subjects after treatment (86.3 +/- 22.2 pg/ml vs. 103.1 +/- 44.36 pg/ml, p <0.05) while HP negative patients did not show the effect. There was no significant change in the mean serum PGI concentration before and after cimetidine treatment (91.5 +/- 36.6 ng/ml vs. 95.6 +/- 43.8 ng/ml, NS). CONCLUSIONS: Cimetidine is not able to clear HP despite its good efficacy in healing gastric ulcers. HP should play an important role in the elevation of serum gastrin levels during cimetidine therapy while serum PGI levels are not influenced by the antisecretory ability of cimetidine.

Aged↗

PubMed1996

Parvovirus B19 infection in a liver transplant recipient: case report and review in organ transplant recipients.

We report an adult liver transplant recipient with parvovirus B19 infection, presenting as chronic transfusion-dependent anemia ensuing 1 month post-transplantation. Both serum and bone marrow cells were positive for parvovirus B19 DNA detected by polymerase chain reaction. The bone marrow biopsy revealed erythroid hypoplasia with a selective decrease of nucleated red cell precursors, and giant pronormoblasts with prominent intranuclear inclusions, characteristic of parvovirus B19 infection. Anemia and viremia resolved shortly after administration of immunoglobulin, suggesting a therapeutic role. This case and several similar ones in the literature provide justification for a controlled clinical trial of immunoglobulin for parvovirus-induced anemia in transplant recipients.

Adult↗

PubMed1996

Analysis of 109 cases of infective endocarditis in a tertiary care hospital.

BACKGROUND: Early diagnosis and treatment can benefit the outcome of patients with infective endocarditis. The older diagnostic criteria (von Reyn criteria) relied upon tissue pathology and blood culture results, but the sensitivity was low. A newly proposed criteria, Duke criteria which apply echocardiographic findings as a major factor in diagnosis, have shown a better sensitivity in the diagnosis of infective endocarditis. METHODS: From 1984 to 1994, 120 episodes of endocarditis in 119 patients were reviewed retrospectively. One hundred and nine episodes fulfilling the Duke criteria were enrolled. The demographic data, antecedent disease, predisposing factors for infective endocarditis including systemic disease, prosthetic valve, intravenous drug abuse, dental or surgical manipulation, culture results, echocardiographic findings, complications and outcome were recorded and analyzed. RESULTS: Sixty-six percent (72/109) was definite endocarditis, and 34% (37/109) was possible endocarditis, as categorized by Duke criteria. Eleven percent (12/109) of the patients were rejected by von Reyn criteria. The common possible predisposing factors were rheumatic heart disease, congenital heart disease, mitral valve prolapse, dental manipulation and intravenous drug abuse. Both patients with positive blood culture and negative blood culture results had one-fourth mortality rate. A notably higher mortality rate was found in patients with S. aureus endocarditis as compared with those of endocarditis caused by viridans streptococci(44% vs. 8%, p < 0.05). Patients with echocardiographic vegetations had a higher mortality rate (32% vs. 11%, p < 0.05) and more peripheral or organ embolic events (26% vs. 6%, p < 0.05) than those without vegetation. CONCLUSIONS: The Duke criteria are more sensitive than the von Reyn criteria for diagnosis of infective endocarditis. S. aureus endocarditis carried a higher mortality rate than viridans streptococci endocarditis. The present study also indicated that patients with discernible valvular vegetation on echocardiogram had a high mortality rate and occurrence of peripheral or organ embolic events. However, there was no statistical significance in the development of congestive heart failure and CNS complications between the patients with and without vegetation.

Adolescent↗

PubMed1995

Gastric inhibitory polypeptide and gastric acid secretion in pregnant rats.

The effects of pregnancy on the basal and pentagastrin-stimulated gastric acid secretion and the level of plasma gastric inhibitory polypeptide (GIP) in rats were studied on pentobarbital-anaesthetized non-pregnant rats and rats in the 1st, 2nd, or 3rd week of gestation. Acid output was determined by titration of the gastric perfusate. Basal secretion was collected for 45 min before a 30 min infusion of pentagastrin (8 micrograms/ml/300 g body weight). Concentration of plasma GIP was measured by a radioimmunoassay (RIA). The immunoreactivity of GIP-like substance in the extract of the rat placenta collected from the rat at day 21 of gestation was examined by RIA. The biological activity of GIP-like substance in the rat placenta extract was tested by the reduction of pentagastrin-stimulated gastric acid secretion in male rats. The basal level of gastric secretion was higher in late pregnancy as compared with the non-pregnant rats. Pentagastrin induced a greater increase of gastric acid secretion in early but not late pregnant rats as compared with the non-pregnant animals. The basal and post-pentagastrin level of plasma GIP was higher in rats in late pregnancy. Both immunoreactivity and biological activity of GIP exist in the rat placenta extract. These results suggest that the normalization of gastric acid secretion in late pregnant rats is at least in part due to the production of GIP-like substance from placenta.

Animals↗