Biomedical subjects

C Y Chuang

Publications and source records attributed to C Y Chuang.

At least 73 records · Page 4Linked to original sources

PubMed1992

Monoclonal gammopathies and the related autoimmune manifestations in Taiwan.

A total of 50,000 patients were surveyed for the presence of monoclonal immunoglobulins during the past two decades. There were 411 cases of monoclonal gammopathies including 243 cases of plasma cell neoplasms and 168 cases of secondary plasma-cell dyscrasia. Among the 227 cases of multiple myeloma and Waldenström's macroglobulinemia, there were 49.3% IgG class, 22.9% IgA class, 9.7% IgM class and 13.2% light chain type. In addition, there were 1.3% of nonexcretory myeloma including an IgM type. A relatively high frequency (4.8%) of IgD M-proteins was detected but heavy chain disease was not encountered in the present series. Purified M-components from patients with possible autoimmune manifestations were subjected to immunofluorescence studies. Autoimmune activity of M-proteins was found in a patient of Waldenström's macroglobulinemia with peripheral neuropathy, and another patient of cryofibrinogenemia with recurrent purpura and gangrene. In conclusion, a high frequency of IgD myeloma is found in Chinese patients of this area. M-components may have autoimmune activity resulting in unusual clinical manifestations.

Adolescent↗

PubMed1992

Autoantibodies and related immunity of leprosy patients from leprosarium in Taiwan.

Autoantibodies and related immunological examinations were measured in 60 leprosy patients from a leprosarium in Taiwan. Thirty-one lepromatous type, 24 tuberculoid type and 5 borderline type patients were identified. The measured autoantibodies included antinuclear antibodies, anti-nDNA, anti-cardiolipin and rheumatoid factor. Serum protein electrophoresis and immunofixation were also performed to detect the monoclonal and polyclonal status of immunoglobulins. Circulating immune complex and complements were also quantitated. Delayed type skin tests were performed during patients' visits. A higher frequency of autoantibodies, especially the antinuclear antibodies and anticardiolipin antibodies, were detected in lepromatous type patients. Higher levels of circulating immune complex and frequency of polyclonal and monoclonal gammopathy were also noted in lepromatous type patients. Anergy skin tests were only noted in lepromatous type patients. It was concluded that the more impared cell-mediated immunity in leprosy patients, with lepromatous type in particular, the greater the production of autoantibodies.

Adult↗

PubMed1992

Increased production of interleukin-6 and autoantibodies in patients with Sjögren's syndrome.

The occurrence of autoantibodies including antinuclear antibody, anti-nDNA, anti-Sm, anti-RNP, anti-SSA, anti-SSB, anticardiolipin (aCL) antibody, M-Proteins, and interleukin-6 (IL-6) and circulating immune complex (CIC) were studied in 18 patients with primary Sjögren's syndrome (SS) and 20 patients with secondary SS. Another 15 healthy individuals were served as a control group. The differences between primary and secondary SS in these autoantibodies, IL-6 and M-protein were also compared. The result showed a high incidence of autoantibodies and CIC in patients with SS. Higher frequencies of anti-nDNA and anti-Sm antibodies were noted in patients with secondary SS. There were also elevated levels of IL-6, much higher in primary than in secondary SS. In addition, higher frequencies of M-protein were detected in patients with primary SS. In conclusion, through immune dysregulations, higher levels of IL-6 were found in patients with SS. Autoantibodies produced in these patients might be derived from IL-6 stimulated B cells.

Adult↗

PubMed1992

Status and trend of HIV-1 infection and AIDS in Taiwan, December, 1991.

From May 1, 1985 to December 31, 1991, a total of 4,962,707 serum samples from 8 population groups in Taiwan were tested for anti-human immunodeficiency virus type 1 (anti-HIV-1). In total, 256 samples were seropositive; of these individuals, 43 developed acquired immunodeficiency syndrome (AIDS): 29 were homosexuals; 5 were hemophiliacs; 8 were heterosexuals and 1 was of unknown risk. Although the prevalence of HIV-1 infection and AIDS remains low compared with other countries, since 1988 the increase has been rapid. Before 1977 the majority were homosexuals and hemophiliacs; thereafter the risk groups diversified, with a trend away from homosexuals and hemophiliacs towards heterosexuals and intravenous drug abusers (IVDAs). A few patients have caused serious social problems for the public, health care workers and families. Active community efforts are needed to achieve future success in the control of HIV-1 infection and AIDS in Taiwan.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Immunochemical characterization and therapeutic effect of house dust extract in bronchial asthma.

The immunochemical characteristics of house dust extract used in hyposensitization were studied by SDS-polyacrylamide gel, isoelectrofocusing, counterimmunoelectrophoresis and Western blot. The gel electrophoregram and isoelectrofocusing plate demonstrated a complex mixture of acid proteins with molecular weights ranging from 56 to 12 KD and isoelectric point distributing from 4.6 to 5.6. The counterimmunoelectrophoresis revealed as many as five precipitating bands in sera from 60% asthmatic patients after hyposensitization. The Western blot showed heterogeneous IgE reaction bands varied from 45 to 22 KD, including a strong 27 KD reaction band found in 40% of the asthmatic patients not receiving hyposensitization. The efficacy of house dust extract hyposensitization was evaluated in 102 asthmatic patients, followed up at the Allergic Clinic since 1980. There were 42 malea and 60 females with a mean age of 30.8 (16 to 60), and the total follow-up patient-year was 512.6 with a mean of 5.0 year per patient (1 to 11). Complete remission of asthmatic symptoms and medication was found in 5% patients, and 12% patients had little or no improvement. The majority of patients (83%) had improvement in asthmatic symptoms and medication dosage. The average serum IgE levels and total eosinophil count dropped significantly after hyposensitization (p < 0.001). In conclusion, the immunochemical characteristics of house dust extract were analyzed and mite allergens, especially Group I antigens, may be the important constituents. Good therapeutic effect, both clinically and with laboratory evaluation, was obtained with more than 80% of the asthmatic patients achieving improvement under house dust hyposensitization.

Adolescent↗

PubMed1992

Pancreatitis related to antiphospholipid antibody syndrome in a patient with systemic lupus erythematosus.

A 39-year-old woman was admitted with abdominal pain and dyspnea, and a diagnosis of systemic lupus erythematosus with renal involvement was established. Laboratory tests revealed highly elevated anticardiolipin antibody, thrombocytopenia and false positive VDRL. Generalized thrombus formation and Libman-Sacks endocarditis were found at postmortem examination. The pancreas showed chronic inflammation with thrombi in pancreatic arteries, but no vasculitic change was observed. Lowering of pancreatic blood flow because of arterial thrombi was a possible cause of pancreatitis in this patient. The spectrum of antiphospholipid antibody associated diseases may be extended to include pancreatitis as a thrombotic complication.

Adult↗

PubMed1991

Changes in T-lymphocyte subpopulations in patients splenectomized for trauma.

Surface markers of peripheral mononuclear cells, using a monoclonal antibody, were characterized, and the serum immunoglobulins (IgG, IgM, IgA) as well as complement proteins (C3, C4) were determined in 20 adult patients with splenectomy because of trauma. A similar analysis was performed on 20 healthy individuals and the results compared. The average interval from splenectomy to testing was two years. The percentages of total T-cells (CD3), T-helper cells (CD4), and T-suppressor cells (CD8) were reduced in all subjects the splenectomized, but the results were statistically significant only for the CD4 cells (p less than 0.01). The proportion of B-cells (OKB7) showed no difference in either group. However, the ratio of CD4/CD8 cells was significantly decreased in splenectomized subjects (p less than 0.05). Measurement of serum immunoglobulins (IgG, IgA, IgM) and complement proteins (C3, C4) revealed no significant differences between the two groups. These data suggest that healthy adults undergoing splenectomy for trauma have a specific and persistent immunological deficit. Our results suggest that a more cautious and conservative attitude toward the splenic trauma should be adopted.

Adolescent↗

PubMed1991

The diagnostic value of IgM to natural trisaccharide phenylpropionyl bovine serum albumin in leprosy patients: a preliminary report from Taiwan.

An evaluation was made of the serum anti-phenolic-glycolipid-I (PGL-I) IgM levels of leprosy patients in the Taiwan area by enzyme-linked immunosorbent assay (ELISA) with a specific synthetic PGL-I antigen and natural trisaccharide phenylpropionyl bovine serum albumin (NT-P-BSA). Fifty-five blood samples were collected from 24 tuberculoid and 31 lepromatous leprosy patients and 21 healthy age- and sex-matched subjects. Among these groups, lepromatous patients had the highest levels of IgM and anti-NT-P-BSA IgM with a good correlation between these two levels (p less than 0.01). Tuberculoid patients also had higher levels than normal subjects. Wide variation in the standard deviation and decreased levels within the cutoff value of some lepromatous patients may be due to various periods of anti-leprosy treatment. Serial anti-NT-P-BSA IgM assessments in response to anti-leprosy treatment may provide more information and serve as a guideline for therapy.

Adult↗

PubMed1991

Biclonal gammopathy--report of a case with primary gastrointestinal lymphoma.

A 61-year-old female patient had had abdominal pain for two months; primary gastrointestinal lymphoma of diffuse, large cell type histology was diagnosed. Bone marrow study was negative. Bimodal gamma globulin was found on serum protein electrophoresis. Immunoelectrophoresis and immunofixation confirmed the nature of biclonal gammopathy with a fast-migrating IgM-kappa band and a slow-migrating IgG-kappa band. Biclonal gammopathy is unusual, and only rarely have cases been reported. The immunologic and molecular implications of biclonal gammopathy are discussed.

Female↗

PubMed1991

Anticardiolipin antibodies in patients with acute myocardial infarction.

Fifty-six consecutive patients, 53 males and 3 females aged from 36 to 83 with a mean age of 61.0, all with acute myocardial infarction (AMI), were screened for anticardiolipin antibodies (ACA) by single sampling at time of admission to the medical intensive care unit; results were compared with those for age-matched, healthy controls. IgM and IgG-ACA were measured by an enzyme-linked immunosorbant assay technique. IgG-ACA were detected in 9 patients (16.1%); IgM-ACA were detected in 9 patients (16.1%). Only one of the patients had raised ACA of both isotypes. There was on difference in either ACA levels or frequency of ACA elevation between patients and controls. Risk factors of coronary artery disease showed no significant difference between patients with and without ACA. Low titer of IgG-ACA was found in one of ten patients with reinfarction and/or previous cerebral infarction. In conclusion, single measurements of anticardiolipin antibodies in general AMI patients are unlikely to yield diagnostically important information. The implication of occasional significant elevation of such antibodies in a general AMI population remains to be speculated.

Adult↗

PubMed1991

Diagnostic value of measuring BCG sonicate antigen and anti-BCG antibodies in the cerebrospinal fluid and blood of patients with tuberculous meningitis.

Fourteen cerebrospinal fluid (CSF) and paired blood samples were obtained from patients with tuberculous meningitis, seven with positive culture and seven clinical/laboratory diagnosis. Another 14 paired specimens served as control, including 7 infectious meningitis and 7 non-inflammatory neurological diseases. Four groups were thus classified, including confirmed and suspected patients, and controls with infectious meningitis and neurological diseases. Measurements of Bacillus Calmette-Guérin (BCG) sonicate antigen and IgG antibody were performed using enzyme-linked immunosorbent assay. Generally, CSF BCG sonicate antigen level and anti-BCG sonicate antibody of patients with tuberculosis meningitis were higher than in control groups; greater antigen levels were found in confirmed patients than in non-inflammatory subjects (p less than 0.05), and in suspected patients than in infectious and non-inflammatory subjects (p less than 0.05 and p less than 0.01). For serum anti-BCG sonicate levels, confirmed patients had higher antibody value than non-inflammatory subjects (p less than 0.05). To conclude, detection of high levels of both BCG sonicate antigen and antibody in CSF and blood samples shows great value in the diagnosis of tuberculous meningitis. However, given the limited samples of the current research, more data are needed to elucidate the sensitivity and specificity of such tests.

Adolescent↗

PubMed1990

Intrathecal anti-myelin basic protein antibody production in Chinese patients with multiple sclerosis.

Cerebrospinal fluids and paired serums from 23 patients with multiple sclerosis (MS) were studied for intrathecal synthesis of oligoclonal band and antimyelin basic protein (MBP) antibody. Three parameters for anti-MBP antibody were designed to represent three different pathophysiological meanings, including value, index and ratio of anti-MBP antibody. Oligoclonal band was detected by agarose gel electrophoresis in 23 MS patients, and anti-MBP was assayed by enzyme-linked immunosorbent assay in 11 MS patients to investigate these anti-MBP parameters in MS group and non-inflammatory control group. The anti-MBP assay revealed that intrathecal anti-MBP antibody production was increased during active stage of MS. However, anti-MBP antibody production correlated poorly with the IgG index, nor was it conspicuously higher than IgG production. This might imply that, except for MBP, still other protein components are involved in this immune process.

Adolescent↗

PubMed1990

Low oxygenation index and pulmonary artery hypertension in predicting early death from adult respiratory distress syndrome (ARDS).

Hemodynamic and respiratory parameters were continuously monitored in 45 septic shock patients, 15 of whom developed adult respiratory distress syndrome (ARDS). Low oxygenation index (OI = PaO2/FIO2), pulmonary artery hypertension (high mean pulmonary artery pressure, MPAP) and elevated pulmonary vascular resistance (PVR) were observed in all ARDS, as well as in non-ARDS septic patients, as a baseline. These same pulmonary factors were compared between those who survived and those who died during the first few days (early fatalities) in both the ARDS group (5 patients) and the non-ARDS group (8 patients). The results showed that the early fatalities in the ARDS group had a significantly lower (p less than 0.001) OI than the survivors, as well as a lower MPAP (p less than 0.01). In the non-ARDS group, the MPAP of the early fatalities was significantly lower (p less than 0.01) than that of survivors, but their OI was not significantly lower. PVR, when compared between groups (ARDS versus non-ARDS) or between subgroups within each group, was elevated concurrently with the elevation of MPAP. It is concluded that patients with septic shock and ARDS who show a severely depressed OI and a modestly elevated MPAP and PVR during the first few days can be predicted to have a poor outcome.

Adult↗

PubMed1990

Evaluation of host defense in critically ill patients in medical intensive care unit.

Thirty three patients, 24 male and 9 female, aged from 19 to 90 with an average of 58.8, were admitted to the medical intensive care unit (ICU) from 1988 December to 1989 December. Their host defenses were evaluated. Cell-mediated immunity (CMI) included delayed type skin test (MULTITEST CMI), total lymphocyte count and lymphocyte subpopulations (CD3, CD4 and CD8) were determined. Investigation of humoral immunity (HI) included use of serum levels of immunoglobulins (IgG, IgA and IgM) and complements (C3 and C4). Episodes of nosocomial infection were documented by patients' clinical and laboratory data, including positive culture. The CMI, especially for total lymphocyte count, T lymphocyte count and skin test, was impaired by underlying diabetes mellitus and such associated conditions as malnutrition, steroid administration and surgical procedures. The longer the admission period, the lower was the CMI including total lymphocyte count, CD3 percentage, CD4 percentage and skin test response. The HI was less impaired by underlying conditions and not influenced by admission duration. More infection episodes were found in patients with longer admission duration. In conclusion, the host defense was impaired in patients hospitalized longer in medical ICU, and the combination of compromised immunity and impaired mucocutaneous barriers made them more susceptible to infections.

Adult↗

PubMed1990

Continuous methacholine inhalation provocation with resistance monitoring in asthmatic patients.

Continuous methacholine inhalation with simultaneous bronchial resistance monitoring was performed in 15 controls and 26 asthmatic patients. The subjects were in quiet tidal breathing, and the airway resistance measured by forced oscillation method were continuously recorded with X-Y recorder. The mean airway resistance of the asthmatic patients was higher than that of the control group, so was the conductance of the asthmatics lower than that of the control. All the asthmatics were responsive to the methacholine test, while only two controls had the response. No correlation could be obtained between bronchial reactivity and sensitivity, but the bronchial sensitivity was correlated with serum total IgE (r = 0.448; p less than 0.05), and suggest that the higher the IgE is, the more sensitive the asthmatic patients respond to methacholine. Continuous methacholine provocation is useful in the diagnosis of bronchial asthma and is more safe and time-saving compared with conventional intermittent method.

Airway Resistance↗

PubMed1989

Improvement of systemic absorption of insulin through eyes with absorption enhancers.

A painless, simple, and practical method has been developed for systemic delivery of peptide drugs through eyes. In order to increase the amount of peptides absorbed into systemic circulation, effects of enhancers on insulin absorption into systemic circulation and reduction of blood glucose concentration have been studied. Saponin showed the highest potency to enhance insulin absorption, while Tween 20 was the least effective. The efficacy order of seven compounds studied can be arranged as follows: saponin greater than fusidic acid greater than BL-9 = EDTA greater than glycocholate = decamethonium greater than Tween 20. Since 1% of saponin reached the maximum effect to enhance insulin absorption and decrease blood glucose concentration, not more than 1% of saponin should be used for enhancing peptide absorption through eyes.

Absorption↗

PubMed1989

Systemic delivery of insulin through eyes to lower the glucose concentration.

An attempt has been made in this study to develop a simple, economical and painless method for the delivery of insulin systemically without using parenteral routes. Insulin was shown to be absorbed effectively into systemic circulation through the eyes. With 0.125% (0.031 mg/25 microliters), 1% (0.25 mg/25 mg/25 microliters) insulin instilled topically into the eyes, systemic blood concentrations of 1.3 ng/ml, 9 ng/ml, and 24 ng/ml, respectively, could be attained. When 25 microliters of 1%, 2% and 5% insulin plus 1% saponin solution were instilled into eyes they reached 63 ng/ml, 89 ng/ml and 195 ng/ml, respectively in the systemic circulation. These results indicate that the systemic absorption of 1% insulin through the eyes can be enhanced at least 7-fold when 1% of the surfactant, saponin, was added to the solution. However, the insulin absorption was not affected by aminopeptidase inhibition nor by the change of pH in the range of 5 to 8. Most importantly, the blood glucose was reduced concomitantly with the increase of blood insulin when 50 microliters of 1% insulin in 1% saponin solution was instilled in the eyes. The blood glucose of alloxan-treated diabetic animals reduced drastically from 370 mg % to 185 mg % in 90 min and further to 75 mg % in another 150 min. In normal animals, 25 microliters of 1% insulin in 1% saponin reduced blood glucose from 102 mg % to 50 mg % in an hour and blood glucose remained low for at least 3 hrs. These results indicate that insulin can be delivered systemically through the eyes, particularly with the surfactant enhancers, such as saponin. This new method is economical and simple as compared with parenteral administration and/or minipump implantation. It is hoped that this new method would improve patients' compliancy in using insulin for diabetes treatment.

Animals↗

PubMed1989

[AIDS and the oral cavity].

The oral cavity is the site for a number of diseases associated with an infection of the human immunodeficiency virus. Often the oral lesions may appear before the establishment of an AIDS diagnosis; and occasionally, the diagnosis may depend solely on the oral manifestations. The most commonly reported oral infections are those caused by Candida albicans and the herpes simplex virus. Hairy leukoplakia, a newly described lesion, may also be of viral origin. Kaposi's sarcoma is the most frequently reported oral malignancy in patients with AIDS. Oral squamous cell carcinoma and non-Hodgkin's lymphomas have also been reported.

Acquired Immunodeficiency Syndrome↗