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Chung-Tei Chou

Publications and source records attributed to Chung-Tei Chou.

18 recordsLinked to original sources
PubMed2006

Association of acute anterior uveitis with disease activity, functional ability and physical mobility in patients with ankylosing spondylitis: a cross-sectional study of Chinese patients in Taiwan.

Acute anterior uveitis (AAU) is the most frequently extra-articular manifestation of ankylosing spondylitis (AS). To investigate whether AAU has an association with disease activity, functional ability and physical mobility in AS patients, 146 Chinese AS patients in Taiwan were enrolled in a cross-sectional study. These patients fulfilled the 1984 modified New York criteria and visited the Outpatient Department of the Veterans General Hospital-Taipei from April 2004 to July 2005. Patients completed questionnaires assessing disease activity [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)], functional ability [Bath Ankylosing Spondylitis Functional Index (BASFI)] and patient's global assessment [Bath Ankylosing Spondylitis Patient Global Score (BAS-G)]. Meanwhile, physical examinations were performed, including Schober test, finger-to-floor, lateral spinal flexion, occiput-to-wall and chest expansion. The history of AAU was accepted only if diagnosed by an ophthalmologist. The prevalence of AAU in this Chinese AS cohort was 15.8% (23/146). Patients with AAU had a significantly higher BASDAI than those without [absolute differences=0.96, 95% confidence intervals (CI): 0.35-1.88]. Additionally, patients with AAU had significantly increased BASFI than those without (absolute differences=1.46, 95% CI: 0.33-2.59). Moreover, there was advanced limitation of physical motility in patients with AAU, including finger-to-floor, occiput-to-wall distances and Schober test, (95% CI: 3.89-16.95 and p=0.046, respectively). Disease duration mildly correlated with BASFI (r=0.24, p=0.003) but not with BASDAI (p=0.838). There was no difference of disease duration between patients with and without AAU (p=0.343). These results suggested that the presence of AAU in AS patients may be associated with higher disease activity, poor functional ability and advanced physical impairment.

Activities of Daily Living↗
PubMed2006

An unusual case of Candida tropicalis and Candida krusei arthritis in a patient with acute myelogenous leukemia before chemotherapy.

A 79-year-old male with acute myelogenous leukemia developed acute right knee arthritis during admission, after the use of broad-spectrum antibiotics before chemotherapy. The initial synovial fluid sample appeared to be mildly inflammatory with a low white cell count. The fungal septic arthritis was not diagnosed until Candida tropicalis, a rare species of Candida, was isolated in the synovial fluid. Although fluconazole is effective in treating the microorganism, the untreated leukemia rendered the infection incurable and led to the growth of fluconazole-resistant Candida krusei. We reported the unusual case of fungal arthritis and reviewed the literature.

Aged↗
PubMed2006

The clinical application of etanercept in Chinese patients with rheumatic diseases.

Over a 2-year period, to evaluate the efficacy and safety of biologic agents, etanercept (25 mg twice per week, s.c.) was used to treat 57 rheumatoid arthritis (RA) patients, 9 ankylosing spondylitis (AS) patients, 6 psoriatic arthritis (PSA) patients, and 4 juvenile rheumatoid arthritis (JRA) patients. In addition to inflammatory arthritis, I have used this tumor necrosis factor (TNF) blocker in other rheumatic diseases including idiopathic thrombocytopenic purpura (ITP), Behçet's disease with intractable oral ulcer, fibromyalgia syndrome, and systemic lupus erythematosis with intractable pleural effusion and acute lumbar disc herniation. For RA, after 6 months of etanercept treatment, all the parameters including number of swollen joints, number of tender joints, disease activity score, erythrocyte sedimentation rate, C-reactive protein, and global health status were rapidly improved (P < 0.001 or P < 0.0001). The anticyclic citrullinated peptide (anti-CCP) antibody and rheumatoid factor also significantly declined. For spondyloarthropathy, it also gave a similar effect as to RA. Both Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index also improved. One of the two cases with Behçet's disease with intractable oral ulcer had a long-term remission after etanercept. The other Behçet's disease patient with oral ulcer and another with ITP obtained a good response temporarily. The short-term use of etanercept (<3 months) did not bring a significant effect for cases of fibromyalgia syndrome, pleural effusion, and lumbar disc herniation. In conclusion, a dramatic and rapid clinical response in different kinds of arthritis patients can be achieved by etanercept. Moreover, the TNF-alpha inhibitor also can treat other severe rheumatic-related symptoms. In general, except for a few cases with infection and two cases with malignancy, etanercept was safe in our arthritis patients. We need to study a larger number of patients in order to better understand the efficacy and safety of etanercept.

Adult↗
PubMed2006

Undifferentiated spondyloarthropathy in Chinese patients.

BACKGROUND: Undifferentiated spondyloarthropathy (USpA) is a unique group in spondyloarthropathy (SpA). This study will investigate the clinical and laboratory characteristics of USpA in the Chinese population. METHODS: Forty two patients with USpA were enrolled from our rheumatology outpatient facility in this retrospective study. SpA was diagnosed according to the European Spondyloarthropathy Study Group (ESSG) criteria. Patients were considered having USpA when they had SpA but did not meet the criteria for the diagnosis of ankylosing spondylitis (AS), Reiter's syndrome or reactive arthritis (ReA), psoriatic arthritis (PsA), and inflammatory bowel diseases (IBD)-related arthritis, etc. Laboratory tests included erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), immunoglobulin A (IgA), and human leukocyte antigen B27 (HLA-B27). RESULTS: Among the 42 USpA patients, the ratio of men to women was 1.47:1, and the age at onset was 32.33 +/- 10.83 years old. Approximately 61.9% of patients had peripheral arthritis, 30.95% had uveitis, and 64.29% had positive HLA-B27. Among these female USpA patients, compared to males, there is a trend of older age at disease onset, higher percentage of HLA-B27 positive, more peripheral arthritis and uveitis, longer disease duration, and higher level of ESR, and IgA and CRP in serum. The items reaching significant difference between males and females were longer disease duration (p < 0.001), higher level of ESR (p < 0.001), and serum IgA (p = 0.03). There was no significant difference in clinical and laboratory characteristics between HLA-B27-positive and -negative groups. CONCLUSIONS: Studies on USpA patients have not been reported in the Chinese population. In this study, we demonstrate the unique demographic characteristics, clinical and laboratory data of USpA in the Chinese population. These findings should be confirmed by analyzing larger number of patients and longer time for further follow-up. Such studies are crucial to understand the pathogenesis of USpA and evaluate its prognosis.

Adult↗
PubMed2006

Hepatitis, cholangitis, pulmonary hypertension, digital gangrene, and conjunctivitis sicca in a woman with anticentromere antibodies.

A 46-year-old woman presented with chronic fluctuated liver function impairment, Raynaud's phenomenon, digital gangrene, pulmonary hypertension, and intense pruritus within a period of 2 years. Laboratory investigations revealed antinuclear antibodies, anticentromere antibodies (ACA), hypergammaglobulinemia, lymphocytic infiltration of the liver parenchyma, and mild cholangitis. The associated symptoms included thyroiditis, conjunctivitis sicca, xerostomia, and polyarthralgia. There was no conspicuous sclerodactyly, calcinosis, or dysphagia. The symptoms were relieved with intravenous, as well as oral, methylprednisolone. This constellation of presentations, including chronic autoimmune hepatitis with mild cholangitis and pulmonary hypertension, suggested that the presence of serum ACA might indicate relentless visceral organ damage.

Journal Article↗
PubMed2006

Panniculitis: an unusual cutaneous manifestation of rheumatoid arthritis.

Specific and nonspecific panniculitis may occur during the course of connective tissue diseases. However, association of panniculitis and rheumatoid arthritis has only rarely been described, and with so few reports, it is difficult to know the significance of this unusual association. We describe 2 patients with rheumatoid arthritis and features of Sjögren syndrome in whom panniculitis developed during the course of the disease. Histologic confirmation of septal panniculitis was established in one case and the panniculitis in this case improved as the arthritis resolved.

Arthritis, Rheumatoid↗
PubMed2006

Pulmonary arterial hypertension in autoimmune diseases: an analysis of 19 cases from a medical center in northern Taiwan.

BACKGROUND AND PURPOSE: Pulmonary arterial hypertension (PAH), a serious complication of autoimmune diseases, has rarely been reported in Taiwan. METHODS: Nineteen patients with various autoimmune diseases diagnosed with PAH at Taipei Veterans General Hospital from 2002 to 2004 were enrolled; the underlying autoimmune diseases included systemic lupus erythematosus (n = 6), primary Sjögren's syndrome (n = 5), systemic sclerosis (n = 4), adult-onset Still's disease (n = 2), and mixed connective tissue disease (n = 2). The characteristic manifestations of underlying autoimmune diseases and the clinical features of PAH were analyzed. RESULTS: There were 16 female and 3 male patients. The median age at onset of PAH was 44 years and the mean right ventricular systolic pressure (RVSP) was 67.9 mm Hg. Patients without pneumonitis had a significantly higher RVSP value than those with pneumonitis (77.5 +/- 24.3 vs 54.8 +/- 18.4 mm Hg, p=0.041). Four out of 7 patients (57.1%) with RVSP >or=80 mm Hg and 1 out of 12 patients (8.3%) with RVSP <80 mm Hg died. In all of the 19 patients, the severity of RVSP was significantly correlated with serum uric acid (UA) level (r = 0.686, p=0.001). Among the PAH patients without pneumonitis, the severity of RVSP inversely correlated with the diffusion capacity of the lung for carbon monoxide (DLCO) [r = -0.856, p=0.003]. The characteristic manifestations of underlying autoimmune diseases included a high incidence of Raynaud's phenomenon (15/19, 78.9%), a high titer of antinuclear antibody (13/17, 76.5%), positive anti-ribonucleoprotein antibody (8/15, 53.3%), hypergammaglobulinemia (15/19, 78.9%), hyperuricemia (13/19, 68.4%), and less renal involvement. CONCLUSIONS: PAH in autoimmune diseases could be potentially fatal with characteristic manifestations. Moreover, RVSP correlated directly with serum UA level and inversely with DLCO.

Adult↗
PubMed2005

Laryngotracheal involvement as the initial manifestation of relapsing polychondritis.

Relapsing polychondritis (RP) is a rare multisystemic disease characterized by recurrent inflammation of cartilaginous and noncartilaginous tissues. When laryngotracheal or bronchial cartilages are involved, the disease can be life-threatening and needs aggressive treatment. Upper airway complaints are rare as initial presentations of RP. Here, however, we present a case of RP, with initial manifestations of cough and dyspnea that were treated as bronchial asthma for 6 months. Subglottic stenosis was found in April 2003, during a bronchoscopic examination, and emergency tracheostomy was performed. Auricular and nasal chondritis and bilateral scleritis developed 3 months after tracheostomy. High doses of methylprednisolone and immunosuppressive agents were used, and active inflammation in the eyes and ears was controlled, but the patient's upper airway was completely collapsed. This case is reported with the hope of increasing awareness about the potential for early upper airway involvement in RP.

Airway Obstruction↗
PubMed2005

Temporal arteritis.

Temporal arteritis, a chronic inflammatory vasculitis involving medium- and large-sized arteries, has rarely been reported in Asia. However, we report 2 cases, in which the patients initially presented with headache. Physical examination disclosed engorged, hard and palpable vessels in the temporal areas. Temporal-artery biopsy revealed 2 different types of arteritis: the multinucleated giant cell type and the panarteritis type without multinucleated giant cells. One patient was positive for immunoglobulin G anticardiolipin antibody. The pathologic findings of the different subsets of temporal arteritis, and the relationship between anticardiolipin antibody and the extent of vascular complications of temporal arteritis, are discussed.

Aged↗
PubMed2004

Relapsing polychondritis with encephalitis.

Central nervous system manifestations are rare in patients with relapsing polychondritis. We report a case of encephalitis associated with relapsing polychondritis. The patient presented with bilateral auricular chondritis first and then tracheal chondritis, and encephalitis developed. The symptoms and signs of encephalitis were felt mostly likely to be the result of vasculitis and improved dramatically after pulse corticosteroid therapy. We believe that early recognition of central nervous system involvement in relapsing polychondritis is extremely important. High-dose corticosteroids should be given to suspected cases as early as possible.

Journal Article↗
PubMedDate not supplied

Adequate nourishment through total parenteral nutrition treatment may augment immune function in patients with colon cancer.

BACKGROUND: Our objective was to evaluate immune function after total parenteral nutrition (TPN) treatment in colorectal cancer patients. METHODS: Data were collected from 11 patients with colorectal cancer who received total parenteral nutrition. Healthy medical staff volunteers were used as controls. Delay hypersensitivity skin test with eight agents tested was used before total parenteral nutrition (TPN) treatment. Phytohemagglutinin (PHA)-stimulated lymphocyte proliferation and mononuclear cytokine production (IL-1 beta, IL-2, IFN gamma), serum ICAM-1 and IL-6, and lymphocyte subpopulation including CD4, CD8, and CD4/CD8 ratio were measured before and after TPN treatment. RESULTS: Each patient had at least four of seven positive skin tests. After TPN treatment, lymphocyte proliferation increased remarkably (27,450 +/- 16,800 vs. 41,738 +/- 28,484, p=0.0168) and showed no significant difference to control group (p=0.0269). Levels of IL-1beta, IL-2, and IFN gamma after LPS-stimulation showed no significant difference before and after TPN treatment. Serum ICAM-1 showed a significant difference (388 +/- 158 vs. 481 +/- 210, p=0.0023) before and after TPN treatment. IL-6 was significantly different between patient and control groups but not different between patients before and after TPN treatment. CONCLUSIONS: This study showed a significant increase of mitogen-stimulated lymphocyte proliferation and intercellular adhesion molecular 1 (ICAM-1) level after TPN supply. Adequate nutrition through TPN may augment immune function.

Adult↗
PubMedDate not supplied

Serum anti-Yersinia antibody in Chinese patients with Kawasaki disease.

BACKGROUND: Many infectious agents have been implicated as an etiology to develop Kawasaki disease (KD). In Taiwan, studies on the relationship between Yersinia and KD have not been reported. METHODS: We measured sera for anti-Yersinia antibodies by using enzyme immunoassay (EIA) in 31 patients with KD and 60 healthy children (HC). Yersinia strains included Y. pseudotuberculosis I, II, III, IV, V, VI and Y. enterocolitica O3, O8 and O9. RESULTS: Data of 31 patients with KD showed that for the IgG antibody, serum anti-Y. pseudotuberculosis II, III, Y. O8 and O9 antibody were significantly higher when compared to the HC. Except for Y. pseudotuberculosis IV, all other Yersinia strains of either IgA or IgM antibodies increased significantly in patients with KD vs. the HC. If we compared the number of patients who had significant elevation of OD and those of HC, we found IgA anti-Yersinia antibodies (PST I, PST II, O3, O8, O9), IgM (PST VI, O8) and IgG (PST II, O8, O9) were significantly elevated in KD patients than in HC. A significant relationship was present between KD with myocarditis and increased anti-Yersinia antibody titer. CONCLUSIONS: The findings in this study suggest that preceding Yersinia infection may play a role in the pathogenesis of KD. Further study of the relationship between KD with myocarditis and increased anti-Yersinia antibody is needed.

Antibodies, Bacterial↗
PubMedDate not supplied

Binding of rheumatoid and lupus synovial fluids and sera-derived human IgG rheumatoid factor to degalactosylated IgG.

BACKGROUND: Altered glycosylation of immunoglobulin G (IgG) has been demonstrated in patients with rheumatoid arthritis (RA). Specificity of IgG rheumatoid factor (RF) in recognizing degalactosylated IgG (Fab)(2) and Fc was analyzed in the present study. METHODS: (Fab)(2) and Fc fragments were prepared from IgG of normal healthy subjects. Enzymes, including peptide-N-glycosidase (PNGase), neuraminidase, and beta-1,4-galactosidase, were used to digest (Fab)(2) and Fc fragments. Binding capacity of IgG RF from patients with RA, systemic lupus erythematosus (SLE), and from healthy subjects to (Fab)(2) and Fc treated with glycosidase, was measured with immunoassay. RESULTS: Treating (Fab)(2) and Fc with PNGase significantly diminished their binding capacity to IgG RFs. Degalactosylated (Fab)(2) revealed higher affinity to IgG RF in all tested groups. Fc lacking terminal galactose on oligosaccharide chains showed elevated binding with synovial IgG RF of RA patients. However, lesser binding was observed in sera of patients with RA and SLE. CONCLUSIONS: Our data suggest that IgG molecules containing less terminal galactose on their oligosaccharide moieties are preferentially recognized by IgG RF. Furthermore, IgG RF display alternative binding specificity to degalactosylated (Fab)(2) and Fc in synovial fluids and sera of RA patients.

Adult↗
PubMedDate not supplied

Decreased IL-12 production by polymorphonuclear leukocytes in patients with active systemic lupus erythematosus.

Polymorphonuclear leukocytes (PMN) play an important role in eradicating bacterial infections. To test if PMN of patients with systemic lupus erythematosus (SLE) have defective capacity to produce IL-12, IL-12 p35 gene transcription and p70 excretion by PMN were evaluated in SLE patients and normal subjects. Peripheral blood PMN from 25 patients with active SLE and 25 normal individuals were stimulated with lipopolysaccharide (LPS, 100ng/mL) in the presence or absence of recombinant interferon (IFN)-gamma (5-200IU/mL). The IL-12 p35 gene transcripts were analyzed by reverse transcription - polymerase chain reaction (RT-PCR) and the IL-12 p70 in culture supenatants was quantified by enzyme immunoassay (EIA). At the 6th hour of stimulation, IL-12 expression in PMN of SLE patients was less prominent than that of the normal controls. The IL-12 was produced by normal PMN on LPS stimulation in the absence of IFN-gamma. IFN-gamma enhanced the IL-12 production by normal PMN stimulated with LPS, but it inhibited the IL-12 production in PMN from active lupus patients in the presence of LPS. Analysis with PCR using the same primers on the chromosomal DNA showed that p35 gene was intact in SLE patients. These results have suggested that SLE-PMN may have defect in IL-12 expression and the defect may be exaggerated in the presence of IFN-gamma which normally stimulates IL-12 production. This may account for increased susceptibility to multiple infections in patients with active SLE.

Adolescent↗