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Biomedical subjects

F Y Chang

Publications and source records attributed to F Y Chang.

At least 235 records · Page 13Linked to original sources
PubMed1995

Decreased cell-mediated immunity in patients with non-insulin-dependent diabetes mellitus.

Peripheral blood mononuclear cells from patients with non-insulin-dependent diabetes mellitus (NIDDM) show reduced proliferative response to phytohemagglutinin (PHA) and other mitogens. This study was undertaken to determine whether this reduced lymphocyte proliferation is mediated by a decreased production of cytokine or decreased expression of interleukin-2 receptor (IL-2R). Mononuclear cells from NIDDM patients (n = 34) and healthy controls (n = 22) were cultured in RPMI-1640 media containing PHA, concanavalin-A and phorbol myristate acetate. NIDDM patients showed reduced [3H]thymidine uptake (57% of controls, P < 0.01), reduced percentage of IL-2R-positive cells (61% of controls, P < 0.02) and increased level of tumor necrosis factor (TNF)-alpha (200% of controls, P < 0.05). The percentage of complement receptor (CR) 3-positive monocytes from NIDDM patients was also decreased (72% of controls, P < 0.05). However, the production of IL-1 beta, IL-2 and interferon-gamma, the percentages of pan T cells (CD3), T helper cells (CD4), T suppressor cells (CD8), the ratio of CD4/CD8 and the expression of CR1 and Fc receptors for immunoglobulin G (Fc gamma RII and Fc gamma RIII) were not significantly different between NIDDM patients and healthy subjects. Human recombinant IL-2 was unable to restore the [3H]thymidine uptake by PHA-stimulated mononuclear cells from NIDDM patients. Elevation of glucose concentration up to 27.8 mmol/l in the culture medium did not suppress the [3H]thymidine uptake and IL-2R expression by activated lymphocytes from healthy subjects. The decreased expression of IL-2R on activated lymphocytes might be responsible for the insufficient lymphocyte proliferation in NIDDM patients. These findings suggest that decreased expression of CR3 on monocytes, decreased lymphocyte proliferation and decreased IL-2R expression despite a higher production of TNF-alpha may explain the impaired cell-mediated immunity seen in NIDDM patients.

CD4-CD8 Ratio↗
PubMed1995

Respiratory burst activity of monocytes from patients with non-insulin-dependent diabetes mellitus.

Monocytes from patients with poorly controlled non-insulin-dependent diabetes mellitus (NIDDM) show a decrease in intracellular bactericidal function. To determine whether this reduced bactericidal function is mediated by an impaired oxygen-dependent mechanism, we assayed the production of superoxide (O2-) and hydrogen peroxide (H2O2) by monocytes from poorly controlled NIDDM patients (n = 12), well controlled NIDDM patients (n = 12) and healthy subjects (n = 16). Using phorbol myristate acetate (PMA) as stimulant, the production of O2- by fresh monocytes was significantly decreased in poorly controlled NIDDM patients (231 +/- 30 nmol/mg protein/2-h) as compared with that of well controlled NIDDM patients (430 +/- 81 nmol/mg protein/2-h) and that of healthy subjects (399 +/- 61 nmol/mg protein/2-h), respectively (P < 0.05). Using opsonized zymosan (OZ) as stimulant, the production of O2- by fresh monocytes was also notably decreased in patients with poorly controlled NIDDM (312 +/- 42 nmol/mg protein/2-h) as compared with that of patients with well controlled NIDDM (688 +/- 92 nmol/mg protein/2-h) and that of healthy subjects (539 +/- 96 nmol/mg protein/2-h), respectively (P < 0.05). Poorly controlled NIDDM patients had a significant decrease in the production of H2O2 by monocytes, either stimulated by PMA or OZ, as compared with that of well controlled NIDDM patients and that of healthy subjects, respectively (P < 0.05). Enhancement of the production of O2- and H2O2 occurred in healthy subjects (150% increase) as well as NIDDM patients (170% increase) after a preincubation of monocytes with interferon-gamma (IFN-gamma 100 U/ml) for 48 h. The respiratory burst activity of both fresh and cultured monocytes from well controlled NIDDM patients was not significantly different from that of healthy subjects. This study suggests that both, strict metabolic control and in vitro culture with IFN-gamma may improve the monocyte oxygen-dependent bactericidal mechanism in NIDDM patients.

Cells, Cultured↗
PubMed1995

Hyperglycaemia is responsible for the inhibited gastrointestinal transit in the early diabetic rat.

The effect of plasma glucose levels on the gastrointestinal motility of the rat was studied. Chronic hyperglycaemia was induced by i.v. injection of streptozotocin 1 week before the motility experiment. Some rats received additional daily insulin therapy (1.25, 2.5 or 10 IU kg-1) after induction of diabetes mellitus. Acute hyperglycaemia was induced by the continuous i.v. infusion of glucose solution (11, 22, 44 or 88 mg kg-1 min-1) 10 min before the motility experiments. The rats were killed 15 min after successful orogastric feeding of a charcoal-contained suspension. Gastrointestinal transit was calculated as the percentage of the overall length of the small intestine to which the charcoal moved during this time period. The diabetic rats were found to have delayed transit compared with controls (mean +/- SEM: 32.2 +/- 2.1% vs. 42.9 +/- 4.2%, P < 0.05). Correction of hyperglycaemia with moderate doses of insulin therapy failed to inhibit transit, whereas hypoglycaemia induced by high-dose insulin treatment enhanced transit. High doses of glucose elicited acute hyperglycaemia and delayed transit when compared with saline infused non-diabetic rats. In early diabetes, hyperglycaemia probably mediates the inhibited gastrointestinal transit, since correction of hyperglycaemia usually restores the delayed transit.

Acute Disease↗
PubMed1995

Effects of sex steroid hormones on gastric emptying and gastrointestinal transit in rats.

In vitro studies have shown that estrogen and progesterone can affect the contractile response and myoelectric activity of the gastrointestinal smooth muscle. The present study was designed to investigate the effect of sex steroid hormones on gastric emptying and gastrointestinal transit were assessed in rats 15 min after intragastric instillation of a test meal containing charcoal and 51Cr. Gastric emptying was determined by measuring the amount of labeled chromium contained in the small intestine as a percentage of the initial amount received. Gastrointestinal transit was evaluated by calculating both the geometric center of distribution of the radiolabeled marker and the charcoal transit in the intestine. The experimental animals included diestrus rats; ovariectomized rats treated with vehicle, estradiol, and/or progesterone; and normal male and orchiectomized rats treated with vehicle or testosterone. Female rats in diestrus had a slower gastric emptying and a lesser geometric center value than ovariectomized rats. Estradiol inhibited gastric emptying but did not affect gastrointestinal transit. Progesterone increased gastric emptying. Progesterone at lower dose (10 mg/kg) decreased the geometric center compared with higher doses (20 or 40 mg/kg) or vehicle controls. A mixture of estradiol (10 micrograms/kg) and progesterone (20 mg/kg) inhibited gastric emptying to a similar degree as estradiol (10 micrograms/kg) did. Testosterone had no influence on gastric emptying or gastrointestinal transit. These results suggest that estradiol and a mixture of estradiol and progesterone inhibit, whereas progesterone enhances, gastric emptying. Testosterone did not play a role in gastrointestinal motility.

Animals↗
PubMed1995

A randomized study comparing glucagon and hyoscine N-butyl bromide before endoscopic retrograde cholangiopancreatography.

BACKGROUND: This study tried to resolve whether glucagon is a better premedication for endoscopic retrograde cholangiopancreatography (ERCP). METHODS: We first measured the basal blood sugar and amylase levels. Then an endoscope was placed in the duodenum without premedication, and basal pulse and duodenal peristaltic rates were measured. ERCP began after studied subjects were randomly premedicated with either 1 mg glucagon (n = 38) or 40 mg hyoscine N-butyl bromide (n = 36) intravenously. Ten minutes later the variables were measured again. RESULTS: Glucagon elicited hyperglycemia whereas hyoscine N-butyl bromide manifested an anticholinergic effect. No difference was found between these two groups with regard to the necessary interval for ERCP (20.6 +/- 14.1 min versus 21.4 +/- 14.7 min; NS) or the success rate for cholangiopancreatography (92.1% versus 91.7%; NS). Neither hyperamylasemia nor pancreatitis was preventable when glucagon was used. CONCLUSIONS: The two premedications appear equally effective in the performance of ERCP.

Aged↗
PubMed1995

Comparison of pyogenic liver abscesses caused by Klebsiella pneumoniae and non-K. pneumoniae pathogens.

A retrospective study on patients with pyogenic liver abscesses was conducted to clarify the different clinical presentations among patients with Klebsiella pneumoniae abscesses and those with non-K. pneumoniae abscesses. From 1981 to 1993, the medical records of 146 adults with culture-confirmed pyogenic liver abscesses who attended Tri-Service General Hospital in Taipei were studied. Abscesses due to K. pneumoniae accounted for 114 (78%) of pyogenic liver abscesses. When compared to patients with non-K. pneumoniae abscesses, patients with K. pneumoniae liver abscesses had significantly higher proportions of monomicrobial infections, unknown sources of infection and solitary abscesses. Patients with K. pneumoniae liver abscesses were found to have diabetes mellitus more often than patients with non-K. pneumoniae liver abscesses (66% vs 19%). Septicemia was found more frequently in patients with K. pneumoniae liver abscesses than in patients with non-K. pneumoniae liver abscesses (50% vs 27%). The clinical presentations among the two groups were, otherwise, not significantly different. Regardless of the microbial etiology, patients with diabetes mellitus had longer periods of fever after treatment and hospitalization than patients without diabetes. The reason for the high relative frequency of liver abscesses in Taiwan and its more frequent occurrence in diabetes mellitus remains unclear.

Adult↗
PubMed1995

A biopsy urease test in the detection of Helicobacter pylori: comparison of antral and body specimens.

BACKGROUND: This study was to compare the difference of positive rate and reaction time between the antrum and the body specimens in duodenal ulcer (n = 124) and non-duodenal ulcer (n = 181) patients. METHODS: A total of 305 subjects with positive urease test were evaluated. During endoscopy each biopsy specimen from the greater curvature side of the antrum and the body was immediately incubated in a thermostatically controlled 37 degrees C waterbath and examined regularly in the first 6 h, and if there was no response, reexamined after 24 hours. A change from orange to pinkish red was considered positive. RESULTS: There was no difference in the positive rate of urease test between the antrum and the body in patients with duodenal ulcer (95.2% vs. 94.4%); whereas, the positive rate was higher in the body specimens than in the antral specimens in patients without duodenal ulcer (p < 0.05, 97.8% vs. 89%). Antral specimens had more rapid color change of urease test than the body specimens patients with duodenal ulcer; whereas no such difference was found in patients without duodenal ulcer. In the antral specimens of patients without duodenal ulcer who were less than 60 years old, the color change was more rapid than in those older than 60 (median 1.0 hr vs. 1.5 hr, p < 0.05). CONCLUSIONS: For better detection of H. pylori colonization using a urease test, it is critical to choose a suitable biopsy site. In non-duodenal ulcer disease, biopsy of the greater curve of the body has a higher detection rate than that of the antrum. In duodenal ulcer disease, biopsy of the antrum is better than that of the body for its quicker reaction.

Adolescent↗
PubMed1995

Pseudomelanosis duodeni: report of eight cases.

Pseudomelanosis duodeni is an uncommon endoscopic sign characterized by diffuse small black spots on the first and second portions of the duodenum. It occurs predominantly in female and elderly patients and is linked to chronic illnesses and related medications. Between 1988 and 1994, the authors saw eight patients with pseudomelanosis duodeni. To evaluate the nature of the pigments, special staining was performed in seven cases. Iron stain was strongly positive in three cases. Electron microscopy was performed in two cases. This revealed amorphous bodies within macrophage lysosomes in one case and angular crystals in another case. These tests suggest that in pseudomelanosis duodeni iron metabolism may be impaired and iron is pooled within macrophages.

Aged↗
PubMed1995

Correlation of esophageal manometry and radionuclide esophageal transit in normal subjects.

What was the correlation of esophageal manometry and scintigraphy in Chinese was studied. Thirty-two volunteers (M/F: 18/14, age: 20-57) without evident esophageal motor disturbance and chest deformity underwent manometric measurement in the spine position using a low compliance pneumohydraulic infusion system. These measurements included the location of both upper and lower esophageal sphincter from nostril, and dry or wet swallow elicited peristaltic speed in the lower esophageal segment. Within one week after manometry, they swallowed a technetium-99m colloid bolus to measure radionuclide manifested esophageal transit time in the supine position beneath a gamma-camera. Body heights of enrolled subjects exhibited a significant positive correlation (r = 0.458, p < 0.01) with manometry measured esophageal lengths. Mean radionuclide esophageal transit time was 7.61 +/- 2.51 sec (3.1-13.57 sec). These transit times exhibited a positive correlation with esophageal lengths (r = 0.6, p < 0.001). Radionuclide transit speed was actually slower than either dry swallow or wet swallow elicited speed (p < 0.05). In conclusion, either manometry or scintigraphy manifests their specific benefits to diagnose esophageal motility disorders. Some correlations of measured variables can be obtained if they are simultaneously employed.

Adult↗
PubMed1994

Endoscopic injection for the treatment of bleeding ulcers: local tamponade or drug effect?

Fifty-two patients with Forrest Ia or Ib bleeding ulcers were randomized to receive endoscopic injection therapy with either 1:10,000 epinephrine in water (Group I) or distilled water (Group II). Twenty-five out of 27 patients in group I, versus 22 out of 25 patients in group II, achieved initial hemostasis after endoscopic injection therapy (p > 0.05). Five patients who did not respond to local injection had bleeding controlled by heater probe thermocoagulation or surgical intervention. Three patients in each group developed rebleeding after initial hemostasis. Four of these patients had bleeding controlled by surgical intervention, while the other two died of underlying diseases. No change in systemic blood pressure, but a significant drop in the pulse rate were noted in both groups after injection therapy. Patients with shock at admission or ulcer size greater than 2 cm had a significantly higher rebleeding rate after initial hemostasis than patients with normal blood pressure and ulcers under 2 cm (p < 0.05). No serious complications were observed after injection therapy, and no significant difference in the amounts of solution required for successful hemostasis was noted between the two groups. We conclude that a local tamponade with distilled water is as effective and safe as diluted epinephrine solution for endoscopic injection therapy.

Double-Blind Method↗
PubMed1994

Comparison of two orogastric feeding markers for measuring gastrointestinal motor functions in rats.

Rat gastrointestinal (GI) transit parameters measured with charcoal and radiochromium were compared. Animals were fed with a calorie-free liquid test meal which contained 10% charcoal and radiochromium (0.5 microCi ml-1) via a transiently placed orogastric catheter. The rats were sacrificed at 1, 5, 15, 30, 60 and 120 min, respectively, since feeding. Various motor parameters were measured. Charcoal transit ratio, gastric emptying and geometric center were time dependent. Charcoal transit ratio occasionally showed a positive correlation with gastric emptying in the very late experimental periods. Concerning the correlation of charcoal transit ratio and geometric center, negative and positive correlations were seen in the very early and late periods, respectively. We conclude that the rat charcoal transit ratio has limited value to replace the GI transit parameters determined by feeding radiochromium.

Animals↗
PubMed1994

The influence of body size to the parameters of gastric slow wave: studied with an assembled electrogastrography.

An electrogastrographic (EGG) device has been assembled, it consisted of the following main components: amplifiers, band-pass filter, analog/digital converter, low band-pass digital filters which could pick up signals between 0.02 Hz (1.2 cpm) and 0.1 Hz (6 cpm), and a personal computer. The analysis softwares employed autoregressive moving average modelling to compute frequency of slow wave, and overlapping Welch periodogram of fast Fourier transform for power computation. In order to study the influence of body size to the EGG parameters, 28 healthy males (age: 18-45 years) without any gastric dysmotor disorders were enrolled to record fasting EGG. Another 28 age-matched females were enrolled to record and to compare the EGG parameters. Of the EGG frequencies, both males and females were approximate to 0.05 Hz (NS). However, the EGG power values were markedly different between the male and female measurements (Mean +/- SD: 57.3 +/- 16.6 dB vs. 46.8 +/- 14.7 dB, p < 0.01). Correction with body mass index eliminated this difference. Of all measured EGG power values, a positive correlation with body mass index was seen (r = 0.39, p < 0.005). We conclude that a different EGG power value exists between the male and female subjects, body size is probable an important factor to elicit this difference.

Adult↗
PubMed1994

Radial asymmetry characterized the upper esophageal sphincter pressures.

The characteristics of the upper esophageal sphincter (UES) motor functions remain unknown in Chinese. Twenty-three volunteers (M/F: 10/13, age: 19-40) without any pharyngeal/esophageal motor disturbance underwent UES measurement in the left decubitus position using a low compliance pneumohydraulic infusion system. These measurements included the location of UES from nostril, its resting pressure, and the responses to swallow. Mean UES resting pressures measured with three 120 degrees oriented manometric orifices were 22.6 +/- 7.7 mmHg, 16.9 +/- 8.6 mm Hg and 20.7 +/- 9.6 mmHg respectively (p < 0.05). In regard with the swallow-induced UES relax ability, the relax interval, the post-relax contractile amplitude and interval, neither dry swallow nor wet swallow led to a different result. Mean measured UES location from the nostril with the most proximal orifice of probe was 29.3 +/- 2.3 cm. This location did correlate very well with body height (r = 0.60, p < 0.01). In conclusion, this study demonstrates that the UES resting pressures exhibit a radial asymmetry, and that the type of swallow does not influence UES responses. Furthermore, an equation based on the body height may predict the most appropriate UES position.

Adult↗
PubMed1994

Coexistent duodenal ulcer among patients with gastric carcinoma.

To examine the prevalence of coexistent duodenal ulcers among patients with gastric carcinoma in an otherwise intact stomach, we surveyed 604 endoscopically and pathologically diagnosed gastric carcinoma patients and thoroughly inspected their duodenums. Twenty-two (3.6%) of them had either active ulcers or scars in the duodenum. This prevalence was significantly less than that among 99 (16.4%) of 604 age- and gender-matched controls with endoscopically confirmed duodenal ulcers (P < 0.0001). Almost one-half of patients with coexistent cancer and duodenal ulcer experienced no change in abdominal symptoms when gastric cancer was diagnosed. Barium meal study appeared not to be sensitive enough to diagnose the coexistent ulcers. However, the nature of the lesions, including disease location, macroscopic appearance, chance of early cancer and metastasis, was no different in 22 patients with coexistent cancer and duodenal ulcer than in 582 patients with cancer alone. The present study suggests that although duodenal ulcer is unlikely to be a predisposing factor for gastric cancer, thorough screening by means of endoscopy is necessary in dyspepsic ulcer patients since duodenal ulcer and gastric cancer are not incompatible.

Aged↗
PubMed1994

Effect of eradication of Helicobacter pylori on serum pepsinogen I, gastrin, and insulin in duodenal ulcer patients: a 12-month follow-up study.

OBJECTIVES: To understand the short-term and long-term effects of the eradication of Helicobacter pylori on serum pepsinogen I, gastrin, and insulin concentration, we studied 53 patients with endoscopically proven duodenal ulceration and H. pylori infection. METHODS: All patients received a 2-wk course of colloidal bismuth subcitrate, amoxycillin, and metronidazole, and endoscopy was performed at 1.5, 3, 6, and 12 months after entry. H. pylori status was assessed by a urease test and histology. RESULTS: Among 43 patients in whom H. pylori was eradicated throughout the follow-up year, the mean basal pepsinogen I was 108 ng/ml at pretreatment, decreasing significantly to 85, 77, 80, and 75 ng/ml at 1.5, 3, 6, and 12 months, respectively, at posttreatment. The basal gastrin was 100 pg/ml at pretreatment and fell significantly to 72, 64, 65, and 59 pg/ml, respectively, posttreatment. Of the four patients in whom the H. pylori was not eradicated, there was no significant change in the median basal pepsinogen I and gastrin concentration. Among the six patients in whom the H. pylori was again detectable within the follow-up year, the fallen serum concentration of pepsinogen I and gastrin returned to the pretreatment level. There was no significant change of basal insulin concentration after triple therapy in either the successfully eradicated or failed group. CONCLUSION: We conclude that H. pylori is the leading and direct cause of higher serum concentration of pepsinogen I and gastrin in duodenal ulcer patients.

Amoxicillin↗
PubMed1994

The changes of serum acidic markers in human subjects receiving pharmacological dosage of antispasmodics.

BACKGROUND: Anticholinergic and glucagon result in the diminished gastric acid secretion, it is unknown whether these agents may again influence serum acidic markers. METHODS: The changes of serum levels of acidic markers represented with gastrin and pepsinogen I at 10 min after the injection of either hyoscine-N-butyl-bromide (HNBB) 20 mg (n = 31) or glucagon 1 mg (n = 32) were investigated when these subjects were receiving endoscopic retrograde cholangiopancreatography for various reasons. RESULTS: At this period, both medications exerted an antispasmodic action on the duodenum. An anticholinergic effect was seen only among the HNBB group, whereas hyperglycemia appeared among the glucagon group. HNBB did significantly inhibit serum pepsinogen I levels when compared with their basal levels (mean +/- SD: 92.1 +/- 33.2 ng/ml vs. 83.2 +/- 27.4 ng/ml, P < 0.01). However, HNBB did not influence serum gastrin levels. Glucagon inhibited both serum pepsinogen I (89.1 +/- 39.7 ng/ml vs. 80.5 +/- 37.4 ng/ml, P < 0.005) and gastrin (79.3 +/- 31.3 pg/ml vs. 71.3 +/- 23.8 pg/ml, P < 0.01) levels compared with their basal levels. CONCLUSIONS: Present observations indicate that glucagon and HNBB may inhibit serum PGI level, whereas the former has the additional effect of inhibiting serum gastrin level.

Butylscopolammonium Bromide↗
PubMed1994

[Seroprevalence of human immunodeficiency virus infection in Guinea-Bissau, west Africa].

The seroprevalence of human immunodeficiency virus (HIV) infection in Guinea-Bissau, West Africa, was determined by enzyme-linked immunosorbent assay (ELISA). From January 1987 to February 1993, 590 patients from the outpatient and inpatient departments of Regional Hospital at Canchungo, Cacheu, Guinea-Bissau were studied. The overall seropositive rate was 16%. Patients in the age between 25 and 54 accounted for 78% of HIV-positive cases. The seropositive rate according to the diagnosis was: 6% in pregnant women, 40% in patients with gonorrhea/syphilis, 14% in patients with vaginitis and 22% in patients with active pulmonary tuberculosis. The seropositivity for HIV-1/2 in the pregnant women might reflect the seroprevalence in general population of Guinea-Bissau. Accordingly, the estimated population infected by HIV would be sixty thousands in Guinea-Bissau. Both sexually-transmitted diseases and tuberculosis were the risk factors for HIV infection. This study shows that HIV infection is a critical problem of public health in Guinea-Bissau. Strategies to prevent the seeding of HIV are of great importance. Moreover, the members of medical mission from our country must keep alert for preventing HIV infection.

Adult↗