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Biomedical subjects

W K Chang

Publications and source records attributed to W K Chang.

72 records · Page 4Linked to original sources
PubMed1979

Salmonella gastroenteritis in Hong Kong--a clinical review of 200 patients.

A sudden increase in Salmonella gastroenteritis affecting infants and children in Hong Kong in 1971 prompted a clinical review of 200 such patients seen over a 6 year period. It showed unprecedented prevalence of Salmonella johannesburg infections and unusually protracted diarrhoea. Only 3.5 per cent of patients were breast fed. Factors causing this chronicity are discussed. All 8 fatal cases were under 7 1/2 months old, with protracted diarrhoea starting within 1 month after birth in 7. The invasiveness of Salmonella johannesburg is low although its infectivity high. Bacteraemia occurred in only 1 patient and focal infections other than gastroenteritis in none. Antibiotics did not improve diarrhoea nor eliminate faecal excretion in the majority of those treated. Prolonged and intermittent faecal excretion of Salmonella was common. Nineteen per cent of patients acquired diarrhoea in hospital; some after a course of antibiotics given for other infections. Experience from this series does not recommend administration of antibiotics to patients with uncomplicated Salmonella johannesburg gastroenteritis. As chronicity of diarrhoea seemed to be the major prognostic factor with regard to mortality and morbidity in this series, further search for causes and control measures of this chronicity is required.

Child, Preschool↗
PubMed1979

Epidemiological aspects of neonatal jaundice in Chinese infants.

A study of 200 full-term Chinese newborns within a twelve months period has not demonstrated any significant effect of early immunizations on the incidence of neonatal jaundice in the first seven days of life. Study of cord serum immunoglobulin M (IgM) levels has also failed to establish an association between raised IgM levels with more severe degrees of jaundice. The significantly higher serum bilirubin levels seen in normal Chinese neonates cannot be attributed to infection, either natural or attenuated, and further investigations are indicated.

Bilirubin↗
PubMed1977

Acute haemorrhagic conjunctivitis in Hong Kong 1971-1975.

Acute haemorrhagic conjunctivitis occurred in epidemic in Hong Kong in 1971 and 1975 respectively. Two picornaviruses, the Enterovirus type 70 and an antigenic variant of Coxsackie virus type A24, were isolated during the 1971 outbreak, while only the latter virus was detected in the 1975 outbreak. In 1972 and 1974, sporadic cases of conjunctivitis associated with Enterovirus type 70 were observed. Serological survey in late 1975 showed a high proportion of the population might still be susceptible to both viruses. Recrudescence of the disease is conceivable when environmental condition is favourable for the spread of these viruses.

Adenoviruses, Human↗
PubMed1975

1,5-ethano-2,3,4,5-tetrahydro-1H-3-benzazepines.

1,5-Ethano-2,3,4,5-tetrahydro-1H-3-benzazepine, from the LiA1H4 reduction of 2-benzyloxy-1,5-ethano-4-oxo-2,3,4,5-tetrahydro-1H-3-benzazepine, was converted to N-alkyl, aralkyl, cycloalkyl, and alkenyl derivatives which were inactive as morphine type analgetics in mice. The LiA1H4 reduction of 2-benzyloxy-1,5-etheno-4-oxo-2,3,4,5-tetrahydro-1H-3-benzazepine gave unstable products from which only the skeletally rearranged dihydro- and tetrahydrobenzo[e]isoindolines, were isolated.

Administration, Oral↗
PubMed1973

Antigenic variants of influenza B virus.

From 1967 to 1971 little antigenic variation was detected in the prevalent influenza B viruses but in December 1972 a new antigenic variant of influenza B was isolated in Hong Kong from sporadic cases of influenza. The new variant, B/Hong Kong/5/72, possessed a haemagglutinin antigen which showed considerable antigenic differences from that of former influenza B strains while its neuraminidase antigen was closely related to that of the earlier, 1967-71, isolates. The B/Hong Kong/5/72 variant became the predominant influenza B strain in the United Kingdom by early summer 1973, and in both the United Kingdom and Japan this strain was associated with outbreaks of influenza. Strains antigenically intermediate between the 1967-71 isolates and B/Hong Kong/5/72 were isolated in a number of countries, often concurrently with B/Hong Kong/5/72-like strains.Serological studies indicated that antibody to B/Hong Kong/5/72 was infrequent in the populations in the United Kingdom and the U.S.A., suggesting the possibility of future epidemic activity associated with the new variant. In addition, conventional inactivated influenza vaccines containing the older influenza B isolates given to volunteers stimulated poor antibody responses to B/Hong Kong/5/72 virus. These studies indicate the desirability of immunizing high risk patients against B/Hong Kong/5/72-like viruses before the coming influenza season. Vaccine containing the new variant influenza B strain are currently available in the United Kingdom.

Antibodies, Viral↗
PubMed1973

Antigenic variation in current human type A influenza viruses: antigenic characteristics of the variants and their geographic distribution.

Outbreaks of influenza due to the virus A/Hong Kong/1/68 (H3N2) began in 1968 and are still occurring. The haemagglutinin of this virus is different from that of the A/Singapore/1/57 virus (the "Asian" strain) but the neuraminidase antigens are the same. Between 1968 and 1971 only minor antigenic "drift" in the haemagglutinin was noted, but in recent months 2 isolates have been identified in which considerable "drift" has occurred in the haemagglutinin and in the neuraminidase antigens. One, A/Hong Kong/5/72 (H3N2), was first detected in outbreaks in Hong Kong between November 1971 and January 1972 and was predominant there and in Korea but did not become widely disseminated. The second strain, A/England/42/72 (H3N2), has been isolated in winter outbreaks in the southern hemisphere and now appears to be the predominant strain in the northern hemisphere. The characteristics of the strains are described.

Africa↗
PubMed1969

National influenza experience in Hong Kong, 1968.

Although its origin is uncertain, the 1968 influenza epidemic in Hong Kong may have spread from the mainland of China. It began in Hong Kong on 13 July and reached its maximum intensity in 2 weeks, lasting some 6 weeks in all. About 15% of the population was affected, but the mortality rate was low and the clinical symptoms were mild. The causative strain was isolated on 17 July and, because of its antigenic deviation from 1967 A2 strains, was sent to the World Influenza Centre in London and the International Influenza Center for the Americas in Atlanta, Ga., It was then proved to be a distinct antigenic variant of A2 virus, and the World Health Organization warned of its possible world-wide spread on 16 August.The rapid spread of influenza virus variants within and from Hong Kong is facilitated by the overcrowding of the population and by the constant communication both with the Chinese mainland and with the rest of the world. The population density is such that an epidemic can occur even in the hot subtropical summer.

Disease Outbreaks↗
PubMedDate not supplied

Chronic fatigue in long-term peritoneal dialysis patients.

OBJECTIVE: Fatigue is a common symptom in long-term dialysis patients. This study investigated possible clinical factors which may cause the development of fatigue in patients receiving peritoneal dialysis (PD). We also investigated the relationship between total solute clearance (TSC) and fatigue symptoms in PD patients. DESIGN: A cross-sectional study design was used to compare the clinical characteristics among groups of PD patients classified by different degrees of fatigue. The relationship among dialysis adequacy (including Kt/V(urea) and weekly creatinine clearance; C(cr)), clinical characteristics and fatigue symptoms were also assessed. SETTING: The PD unit of a major university teaching hospital in Taipei, Taiwan. PATIENTS: Consecutive patients who had received PD for a minimum duration of 4 months were recruited for participation in the study. Patients were excluded if they had a history of ischemic heart disease, severe heart failure (NYHA function III or IV), malignant neoplasm, active infection, major psychiatric problems, chronic obstructive pulmonary disease, or disturbed consciousness. Finally, a total of 64 patients, 31 of whom were receiving continuous ambulatory peritoneal dialysis and 33 who were receiving continuous cycling-assisted peritoneal dialysis, were enrolled in the study. METHODS: Fatigue was evaluated using a specially designed questionnaire that includes fourteen items. Patients were divided into three groups according to their fatigue scores (FS): mild (FS, 0-3), moderate (FS, 4-8), and severe (FS, 9-14) fatigue. The demographic data, dialysis variables, and clinical parameters of patients were compared among these groups. The relationship between fatigue and TSC was also examined. RESULTS: The FS were correlated with serum intact parathyroid hormone (iPTH) level and total cholesterol concentration (p < 0.05). A linear correlation was also noted between serum iPTH level and total cholesterol level. When the patients were divided into an adequate- and an inadequate-dialysis group according to values of TSC, Kt/V(urea) as well as weekly creatinine clearance, a significant correlation was found between weekly C(cr) and FS. CONCLUSION: This study has demonstrated that dialysis adequacy plays a key role in the development chronic fatigue. In addition, weekly C(cr) was better correlated with fatigue than Kt/V(urea).

Adult↗
PubMedDate not supplied

Effects of extra-carbohydrate supplementation in the late evening on energy expenditure and substrate oxidation in patients with liver cirrhosis.

BACKGROUND: The purpose of this study was to demonstrate the effects of extra-carbohydrate supplementation before bedtime on energy metabolism and substrate oxidation in patients with liver cirrhosis. METHODS: Sixteen cirrhotic patients and eight control subjects were included in this study. To compare the effect of energy metabolism and substrate oxidation with or without a bedtime snack, indirect calorimetry was assessed at 7 to 8 AM after overnight fasting, following either dinner (6 PM) or a bedtime snack (11 PM) the evening before. The bedtime snack contained about 50 g of carbohydrate. The energy expenditure and substrate oxidation were calculated from the indirect calorimetry measurement and 24-hour urinary nitrogen excretion. RESULTS: In those who fasted since dinner, the respiratory quotient (RQ) was significantly lower in cirrhotic patients than in control subjects. Also, the energy utilized by cirrhotic patients was derived primarily from fat oxidation (58%), whereas the main energy source for controls was carbohydrate (55%). An extra-carbohydrate supplement before bedtime did not influence the indirect calorimetry measurement in the controls, but there were significant increases in both RQ and carbon dioxide production (Vco2) in cirrhotic patients. The extra-carbohydrate supplementation did not significantly change the absolute resting energy expenditure utilization in control subjects; however, the utilization of carbohydrate significantly increased with a decrease in fat and protein oxidation in the cirrhotic patients. CONCLUSIONS: These preliminary data suggest that extra-carbohydrate supplementation before bedtime can shorten nocturnal fasting with a more economic fuel utilization and effectively diminish fat and protein oxidation in cirrhotic patients.

Adult↗
PubMedDate not supplied

Association of hypertriglyceridemia and insulin resistance in uremic patients undergoing CAPD.

OBJECTIVE: Hyperlipidemia is frequently encountered in uremic patients and may be worsened by continuous ambulatory peritoneal dialysis (CAPD) treatment. The lipid abnormalities in these patients may be multifactorial. Insulin resistance (or its compensatory hyperinsulinemia) is commonly observed in uremic patients, but its association with hyperlipidemia in these patients has not been studied. PATIENTS AND METHODS: Lipid profiles of 35 nondiabetic nonobese patients undergoing CAPD for more than 1 year (mean 52.3 months) were studied. Current laboratory data and parameters related to peritoneal dialysis (PD) within the previous 3 months were recorded. After overnight fasting and interruption of PD, an oral 75-g glucose tolerance test (OGTT) was examined. RESULTS: After CAPD treatment for more than 12 months, these patients had higher serum triglyceride (TG) (p = 0.001) and total cholesterol (p = 0.0058) levels than their values before commencing CAPD. Twelve of 14 patients with serum TG higher than 200 mg/dL (high-TG) were diagnosed de novo, in contrast with only 1 patient diagnosed of de novo hypercholesterolemia (total cholesterol > 240 mg/dL). There was no difference in age, gender, body mass index (BMI), duration of PD treatment, serum albumin, hematocrit, intact serum parathyroid hormone (iPTH), peritoneal glucose load, solute transport, or weekly Kt/V urea between normal-TG and high-TG patients. After adjusting for age, gender, BMI, weekly Kt/V urea, and iPTH, the high-TG patients had higher levels of area under the curve for glucose (AUC(Glu)), area under the curve for insulin (AUC(Ins)), and AUC(Ins)/AUC(Glu) ratios (F = 10.63, 10.14, and 8.65; p = 0.0029, 0.0035, and 0.0065, respectively), indicating that the high-TG patients were more insulin resistant. There were 24 patients with normal glucose tolerance (NGT), and 11 patients with impaired glucose tolerance (IGT). The IGT group had higher serum TG (F = 10.43, p = 0.003) and total cholesterol (F = 8.05, p = 0.009) than the NGT group, after adjusting for BMI, duration of CAPD treatment, peritoneal glucose load, solute transport, serum albumin, and lipid levels before PD treatment. TheTG levels after CAPD treatment were positively correlated with AUC(Glu), AUC(Ins), and AUC(Ins)/AUC(Glu) ratio (r = 0.48, 0.53, and 0.49; p = 0.0037, 0.001, and 0.0028, respectively). CONCLUSIONS: These results indicate that insulin resistance is an important factor in the development of hypertriglyceridemia in CAPD patients.

Adult↗