Sonohysterographic findings of endometrial malacoplakia.
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Diagnosis, Differential↗
Biomedical subjects
M Y Chen
Publications and source records attributed to M Y Chen.
Geographical differences in human herpesvirus 8 seroepidemiology: a survey of 1,201 individuals in Asia.
Since the discovery of human herpesvirus 8 (HHV8) as a contributory cause of Kaposis sarcoma, the clinical role of this virus has been actively investigated. An understanding of HHV8 seroepidemiology is critical for the study of its pathogenesis within a specific environment. A sero-survey is described in Taiwan of 1,201 individuals ranging in age from under 1 year to over 70. Indirect immunofluorescence assay was used to determine antibody titers against both latent and lytic antigens of HHV8. The results indicate that very few individuals (3-4%) were exposed to HHV8 before 10 years of age. Infection rate peaked (19.2%) between the ages of 21 to 40. Females showed a slightly higher seroprevalence for HHV8 than males, but the difference was not statistically significant. Pregnancy did not correlate with increased HHV8 infection rate nor with augmented HHV8 antibody titers. It is concluded that HHV8 in Taiwan is predominantly an infectious agent for adults. In this geographical locale, HHV8 is similar to herpes simplex virus type 2 in its likely transmission occurring presumptively through sexual routes. However, the study also indicates that a smaller portion of HHV8-transmission could occur through nonsexual contacts.
Adolescent↗
Immunoglobulin M and G immunoblots in the diagnosis of parvovirus B19 infection.
BACKGROUND AND PURPOSE: To identify parvovirus B19 infection by means of immunoglobulin (Ig) G and IgM immunoblots among immunocompetent patients who tested negative or had low-titer B19 IgM antibodies in enzyme-linked immunosorbent assays (ELISA). METHODS: Serum samples were obtained from 20 patients with parvovirus B19 infection. Another 130 study subjects presumed to be without B19 infection (40 medical personnel and 90 prisoners) were also included. All sera from the patient and study groups tested positive for IgG or IgM with ELISA and were further evaluated using the immunoblot method. Detection of B19 DNA by nested polymerase chain reaction (PCR) was also performed on IgG and IgM positive sera. RESULTS: IgM immunoblots disclosed one false positive IgM ELISA result in the patient group and three false positive results in the study group. In the patient group, four patients were in the latter stage of antibody response to B19 infection as suggested by the low titer of anti-B19 IgM, incomplete IgM immunoblots, with only a weak viral capsid protein VP-N reaction band, and fading but still strong reaction bands on IgG immunoblots. Strong reaction bands on IgG immunoblots comparable to these four patients were found in three of the 130 study group sera. Furthermore, B19 DNA was detected in three of the four patients and one of the three study subjects by means of nested-PCR. A serum sample from one study subject showed strong IgG but no IgM reactivity to viral capsid protein VP2; nested PCR identified B19 DNA in this serum sample. CONCLUSIONS: Immunoblots and nested PCR should be applied in the diagnosis of B19 infection for patients with low-titer anti-B19 IgM tested by means of ELISA. For diagnosis of B19 infections in certain clinical entities such as chronic arthritis of recent onset and hydrops fetalis, B19 IgM antibodies may have disappeared but B19 infection can still be recognized by the intensity of the reaction bands on IgG immunoblots. The correlation between chronic B19 infection and persistence of antilinear VP2 epitopes requires further study.
Adult↗
Pulmonary infection in human immunodeficiency virus-infected patients in Taiwan.
BACKGROUND: Pulmonary infection is a major cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected patients. METHODS: We conducted a retrospective analysis of the pathogens causing pulmonary infection in 272 HIV-infected patients admitted to a university hospital from January 1993 through December 1998. RESULTS: A total of 158 (58%) patients had pulmonary complications, all but two of whom had acquired immunodeficiency syndrome (AIDS). There were 156 episodes of pulmonary infection, involving 124 patients. The most common pulmonary infection was Pneumocystis carinii pneumonia (PCP): 66 patients had 77 episodes of PCP, all of which occurred in patients with CD4+ lymphocyte counts below 0.2 x 10(9)/L (200/microL). Pulmonary tuberculosis (TB), diagnosed in 47 patients, was the second most common pulmonary infection. Twenty TB patients had open TB. HIV-infected patients who were immigrants from Southeast Asia (9/23, 39%) had a higher risk of developing pulmonary TB than nonimmigrants (38/249, 15%) (p = 0.004). Only one of 17 episodes of community-acquired bacterial pneumonia was caused by Streptococcus pneumoniae. Less common opportunistic pulmonary pathogens included cytomegalovirus (5 cases), Aspergillus species (3), Cryptococcus neoformans (3), Mycobacterium avium complex (2), Penicillium marneffei (1), Nocardia species (1), and Rhodococcus equi (1). CONCLUSIONS: PCP and pulmonary TB are the two leading pulmonary infections in Taiwanese HIV/AIDS patients. These findings should be taken into consideration when developing management strategies and public health policies.
Adolescent↗
Molecular biology of human immunodeficiency virus type 1.
Since the discovery of human immunodeficiency virus (HIV) as the etiologic agent of acquired immune deficiency syndrome (AIDS) more than a decade ago, tremendous progress has been made in various aspects of this virus and its interplay with the host immune system. The advent of potent combination therapy has made it possible to achieve effective and durable control of HIV-1 replication in vivo, yet the persistence of the latent reservoirs pose a new challenge. The recent identifications of several cellular proteins interacting with different viral gene products have not only shed new insights into our understanding of the HIV-1 and the host cell biology, but also provided the bases for developing novel strategies to block HIV-1 replication. It is from this perspective that we review the current understanding of the molecular mechanisms governing the HIV-1 life cycle.
Base Sequence↗
Assessment of nutritional status in continuous ambulatory peritoneal dialysis patients: a comparison of bioelectric impedance and conventional methods.
BACKGROUND: Nutritional status is an important factor in long term continuous ambulatory peritoneal dialysis (CAPD) prognoses. Conventionally, serum albumin is an indicator of nutritional status. More recently, protein catabolic rate and lean body mass have been calculated during peritoneal equilibrium testing to assess nutritional status. These have the advantage of providing an early indication of malnutrition before the serum albumin decreases. Bioelectric impedance analysis (BIA) of nutrition has the advantage of being the simplest procedure among all nutritional assessments. Standard nutritional assessments was compared with the BIA method. METHODS: The protein catabolic rate and lean body mass was measured by the Keshaviah method. At the same time BIA was used to assess lean body mass, fat mass and fixed percentage of fat in 27 long-term CAPD patients, with and without peritoneal fluids. RESULTS: Among the 27 patients, the protein catabolic rate was 0.95+/-0.5 g/kg/day and lean body mass was 37.4+/-0.5 kg measured by the conventional method. Using BIA, the lean body mass was 37.8+/-11.0 kg with peritoneal dialysate, which was strongly correlated with the conventional method (p<0.001). BIA of lean body mass was 37.4+/-9.2 kg without peritoneal dialysate, which was also significantly correlated to the conventional method (p<0.001). CONCLUSIONS: BIA nutritional assessment of lean body mass was comparable to the conventional method of nutritional assessment. The presence or absence of peritoneal dialysate did not influence the BIA method for detection of lean body mass. BIA has the advantage of being a more simple procedure and can be used for the long-term assessment of nutritional status in CAPD patients.
Blood Urea Nitrogen↗
[Study on the association between interleukin-5 and eosinophil in nasal polyp].
OBJECTIVE: To explore the expression of IL-5 and its role in the formation and development of nasal polyp. METHOD: 31 patients with nasal polyp, 11 patients with chronic sinusitis(CS) and 6 control cases were chosen. Their IL-5 concentration in tissue homogenate were measured by ELISA. All patients with chronic sinusitis, control cases and 15 patients with nasal polyp were chosen to be counted eosinophils in their HE slice. RESULT: 1. The values of IL-5(pg/ml) in nasal polyp, CS and control group separately were: 23.44 +/- 6.68, 16.41 +/- 3.09, 12.86 +/- 4.17. IL-5 concentration in nasal polyp group was higher than that in the other two groups(P < 0.001). 2. The numbers of eosinophils in nasal polyp, CS and control group were 7.42 +/- 2.33, 1.30 +/- 0.59, 1.07 +/- 0.70 separately, the numbers of eosinophils in nasal polyp group were higher than that in CR or control group (P < 0.05). CONCLUSION: Nasal polyp is a disease characterized by eosinophilia, and IL-5 which activates eosinophil plays part role in the formation of nasal polyp.
Adolescent↗
Invasive amoebiasis: an emerging parasitic disease in patients infected with HIV in an area endemic for amoebic infection.
OBJECTIVES: To describe the incidence and presentations of invasive amoebiasis (IA) in patients with HIV infection in an area endemic for amoebic infection and to assess the role of the indirect haemagglutination (IHA) assay in the diagnosis of IA in HIV-infected patients. DESIGN: Retrospective study of 18 cases of IA and HIV infection. SETTING: A university hospital, the largest centre for management of HIV-associated complications in Taiwan. METHODS: Medical, microbiological and histopathological records of 296 HIV-infected patients and serological data of IHA assay of 126 HIV-infected patients were reviewed to identify cases of IA from 23 June 1994 to 31 March 1999. An IHA titre > or = 1 : 128 was considered positive. Clinical characteristics of HIV-infected patients with IA and without IA were compared. RESULTS: Eighteen of the 296 patients (6.1%) with HIV infection were diagnosed with IA: 12 patients were diagnosed with definite IA and six with probable IA. The clinical manifestations included amoebic colitis (13 patients), amoebic liver abscess (nine), both colitis and abscess (four), and pleural effusion (two). IA was the initial presentation of HIV infection in nine patients. Co-infection with other enteric pathogens was diagnosed in six patients with IA. Compared with the 161 patients without IA who were newly diagnosed with HIV infection, the nine patients with IA had a higher median CD4+ lymphocyte count (202 x 10(6)/l versus 33 x 10(6)/l; P = 0.0017), were less likely to be diagnosed with AIDS (55.6% versus 85.4%; P = 0.039), and had fewer concurrent AIDS-defining illnesses (median number 0 versus 2; P = 0.003). Estimated mean survival duration was not significantly different between the two groups (597 days versus 611 days). Fourteen out of 126 patients (11.1%) had an IHA titre > or = 1 : 128. Of the 18 patients diagnosed with IA, 13 had a titre > or = 1 : 128. The sensitivity of IHA assay in the diagnosis of IA was 72.2% (13 out of 18) and the specificity was 99.1% (107 out of 108). The positive predictive value of IHA test for IA of this patient population was 92.9% (13 out of 14) whereas the negative predictive value was 95.5% (107 out of 112). CONCLUSION: IA is an increasingly important parasitic disease among patients with HIV infection in Taiwan. IHA assay has a good specificity and high negative predictive value in diagnosis of IA.
AIDS-Related Opportunistic Infections↗
Genetic variation at nine STR loci in populations from the Philippines and Thailand living in Taiwan.
In order to apply a set of nine STR loci and the amelogenin locus in forensic testing, we have performed a population study on individuals from the Philippines and Thailand living in Taiwan (273 Philippine and 146 Thai individuals were typed by commercially available kits and an automated sequencer). A total of 73 alleles for all systems for both populations could be observed in these two populations. No new intermediate fragments were found. Allele frequencies showed no deviation from Hardy-Weinberg equilibrium. The mean exclusion power (MEP) ranged from 0.327 (TPOX) to 0.706 (FGA), the discriminating power (DP) ranged from 0.790 (TPOX) to 0.963 (FGA) for Philippinos, MEP ranged from 0.247 (TPOX) to 0.723 (FGA), DP ranged from 0.761 (TPOX) to 0.968 (FGA) for Thais, the combined MEP is > 0.9988 and the combined DP is > 0.9999999993 for both Philippinos and Thais.
Alleles↗
Domestic transmission of HIV type 1 subtype G strains in Taiwan.
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Adolescent↗
Dynamics of plasma cytokine levels in patients with advanced HIV infection and active tuberculosis: implications for early recognition of patients with poor response to anti-tuberculosis treatment.
OBJECTIVE: To examine whether the serial measurement of plasma cytokine levels can assist in the early recognition of AIDS/tuberculosis patients with poor response to anti-tuberculosis treatment. DESIGN: Longitudinal, prospective cohort study. SETTING: A university hospital, the largest centre for HIV/AIDS patients in Taiwan. METHODS: Between January 1997 and September 1998, 25 consecutive patients with advanced HIV infection and suspected tuberculosis were enrolled in the study. Plasma samples were obtained on day 1 (baseline), 3, 7 and 14 of anti-tuberculosis treatment and the levels of tumour necrosis factor-alpha (TNF-alpha) were measured. Patients were classified as either responders or non-responders according to the results of assessment of symptoms and follow-up cultures during the sixth and eighth week of anti-tuberculosis treatment. Thirty consecutive HIV-negative tuberculosis patients were also enrolled in the study. RESULTS: The data of a total of 16 AIDS patients (median CD4 cell count 16 x 10(6)/l; 12 responders and four non-responders) and 21 HIV-negative patients (16 responders and five non-responders), whose tuberculosis was culture-proven, were included for analysis. In responders, TNF-alpha levels declined remarkably within the first week of anti-tuberculosis treatment; however, the decline of TNF-alpha levels in non-responders was significantly less [the median ratio of TNF-alpha level on day 7 to that at baseline was 0.32 versus 0.85 (P < 0.001) in AIDS patients; 0.34 versus 0.80 (P = 0.001) in HIV-negative patients). The lack of a > or = 50% reduction in pre-treatment TNF-alpha levels during the first week of treatment was strongly associated with a poor response to anti-tuberculosis treatment (P = 0.001 in AIDS patients; P < 0.001 in HIV-negative patients). CONCLUSION: Serial measurement of plasma TNF-alpha levels may help to assess the response to anti-tuberculosis treatment in AIDS patients, in spite of very low CD4 cell counts. Failure of TNF-alpha levels to decline by > or = 50 % of pre-treatment levels in the first week of treatment may be an early surrogate marker of a poor response.
AIDS-Related Opportunistic Infections↗
Alleles that may influence HIV-1 pathogenesis in Chinese subjects.
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Alleles↗
Free jejunal grafts of the pharynx: surgical methods, complications, and radiographic evaluation.
Free jejunal grafts have been used in the surgical treatment of patients with carcinoma of the pharynx and upper esophagus. Post-operative complications, including swallowing difficulty, are frequent and radiographic assessment may be required. In this pictorial paper, we describe the surgical technique of free jejunal grafting of the pharyngoesophagus, and the radiographic appearances and clinical importance of early and delayed complications following the procedure. Dysphagia after placement of a jejunal graft is a common occurrence which is often multifactorial, and may be related to functional, anatomic, or a combination of factors.
Carcinoma, Squamous Cell↗
Radiographic measurement of prevertebral soft tissue thickness on lateral radiographs of the neck.
PURPOSE: The prevertebral soft tissue measurement is commonly used for assessing prevertebral pathology such as abscesses or hematomas after injury. Very few references concerning the ratio of retrotracheal thickness to C5 diameter are available in the literature. The purpose of this study was to measure the normal soft tissue thickness at the C5 level of the neck and to establish the normal ratio of retrotracheal soft tissue thickness to the diameter of C5 for daily use. DESIGN AND PATIENTS: We measured soft tissue thickness in the neck of 54 normal subjects and calculated the mean and standard deviation. RESULTS AND CONCLUSION: Using mean plus one standard deviation the maximum retrocricoid soft tissue thickness was 0.7xC5 diameter and maximum retrotracheal thickness was 1.0xC5 diameter. Soft tissue thickness that exceeds this limit must be studied further for signs of potential disease.
Adult↗
The CT appearance of pleural and extrapleural disease in lymphoma.
OBJECTIVE: Pleural effusions in patients with lymphoma that are assumed to be related to malignancy are attributed to either lymphatic obstruction by tumour with resultant decreased clearance of pleural fluid, or direct tumour involvement of the pleura. The purpose of our study was to determine how often pleural or extrapleural disease was detected by computed tomography (CT) of patients with pleural effusions and primary or recurrent lymphoma. METHODS AND MATERIALS: We reviewed CT examinations showing evidence of pleural effusion in 61 patients with a diagnosis of primary or recurrent lymphoma and no history of other systemic disorders, including infection. The study population consisted of patients with non-Hodgkin's lymphoma (n = 44) or Hodgkin's disease (n = 17); both primary disease (n = 11) and recurrent disease (n = 50) were represented. Each CT examination was evaluated for the presence of disease involving the visceral and parietal pleura and extrapleural space, mediastinal adenopathy, and pulmonary parenchymal disease. RESULTS: Fourteen patients (23%) (nine with non-Hodgkin's lymphoma and five with Hodgkin's disease) had parietal pleural disease (thickening or nodules). Eighteen patients (30%) (14 with non-Hodgkin's lymphoma, four with Hodgkin's disease) had tumour or enlarged lymph nodes in the extrapleural space. Forty-three patients (70%) had mediastinal lymphadenopathy. Patients who received intravenous contrast did not have evidence of visceral pleural abnormalities or underlying pulmonary parenchymal disease. CONCLUSION: Forty-one percent of the patients with lymphoma and pleural effusions had CT evidence of pleural and/or extrapleural disease. The majority of the patients with extrapleural disease had adjacent posterior mediastinal disease.
Adult↗
Endoscopic diagnosis of intestinal penicilliosis marneffei: report of three cases and review of the literature.
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AIDS-Related Opportunistic Infections↗
Correlation of laryngeal and pharyngeal carcinomas and 24-hour pH monitoring of the esophagus and pharynx.
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Retraction Notice↗
Reflux evaluation: correlation between pH results, esophagitis, esophageal dysmotility, patient age, and esophageal caliber.
The purpose of this study was to correlate gastroesophageal reflux evaluated by 24-h pH study to esophageal motility, diameter of the esophagus and diaphragmatic hiatus, and patient age. We recorded radiographic findings from barium esophagrams in 91 patients (47 women, 44 men) with a mean age of 52 years (range 17-18 years), who had 24-h pH monitoring of the esophagus. All patients had one or more symptoms related to the upper aerodigestive system, and both studies were performed within 2 days of each other. The average diameters of the esophagus and hiatus were 24 mm and 19 mm respectively. The correlation coefficient (r) between patient age and diameter of the esophagus was -0.22. No correlation was found between the diameter of the hiatus and the size of the esophagus or patient age. Esophageal diameter is significantly wider in patients with esophagitis than in patients who have no esophagitis. Thirteen of 27 patients with absent primary peristalsis had abnormal pH results. The diameter of the esophagus may be affected by aging, but was not affected by the presence of dysmotility. The caliber of the hiatus was stable and was narrower than the diameter of the esophagus. The hiatus tended to be wider when esophagitis existed.
Adolescent↗