PubMed Health⌕ Search

Biomedical subjects

D M Chang

Publications and source records attributed to D M Chang.

At least 55 records · Page 3Linked to original sources
PubMed1995

Lupus in Chinese male: a retrospective study of 61 patients.

BACKGROUND: Systemic lupus erythematosus (SLE) has traditionally been considered a disease of women, and is uncommon in men. In recent years, several large clinical series of male lupus patients have been reported. As no known data are available for lupus in males from Taiwan, a retrospective analysis of data from male lupus patients was done to determine whether these patients differed from other series of male or female SLE patients in the literature. METHODS: Sixty-one male lupus patients, diagnosed and followed in Tri-Service General Hospital, between 1983 and 1993, were studied and their data analyzed, retrospectively. RESULTS: The mean age of diagnosis was 30 +/- 17 (mean +/- SD, range: 13-81) years. The peak age of diagnosis was between 13 and 40 years. The mean duration of follow-up was 36 +/- 36 (range: 2-256) months. The 1-, 5- and 10-year survival rates were 84%, 76% and 75%, respectively. The frequency of clinical manifestations were renal disease, 75%; malar rash, 70%; arthritis, 60%; fever, 56%; photosensitivity, 48%; pleuritis, 39%; pericarditis, 31%; alopecia, 31%; mucosal ulcers, 29%; neuropsychiatric disease, 26%; discoid lupus, 21%; vasculitis, 15%; Raynaud's phenomenon, 10%; and lymphadenopathy, 2%. The frequency of abnormal laboratory findings were antinuclear antibodies (ANA), 95%; hypocomplementemia, 77%; antibodies to double-stranded DNA (anti-dsDNA), 57%; leukopenia, 44%; lupus erythematosus (LE) cells, 39%; anti-Ro, 39%; anti-Smith antibodies (anti-Sm), 19%; thrombocytopenia, 18%; rheumatoid factor, 17%; anti-ribonucleoprotein antibody (anti-RNP), 14%; autoimmune hemolytic anemia, 8%; false-positive venereal disease research laboratory test (VDRL), 6% and anti-La, 4%. CONCLUSIONS: In a review of the 61 ethnic Chinese male lupus patients, a higher frequency of renal disease, malar rash and photosensitivity, but a lower frequency of arthritis and lymphadenopathy, compared to previous reports of Caucasians. There were no significant immunological differences from other series of male lupus, except a lower frequency of anti-dsDNA. In general, poor prognosis was noted for male lupus patients here.

Adolescent↗
PubMed1995

X-linked agammaglobulinemia: a case report.

A 20-year-old male was admitted with fever and hemoptysis. Agammaglobulinemia was found, with bronchiectasis and sinusitis. Clinical and laboratory evidence included immunological examinations, bone marrow and small intestinal biopsies. Results suggested a diagnosis of X-linked agammaglobulinemia. After treatment with antibiotics and intravenous human immunoglobuline, the clinical symptoms demonstrated progressive improvement. The case is reported along with a review of the literature.

Adult↗
PubMed1994

Production of interleukin-1 (IL-1) and IL-1 inhibitor by human monocytes exposed to dengue virus.

Dengue hemorrhagic fever-dengue shock syndrome, the most severe manifestation of an acute dengue virus (DV) infection, is endemic in Southeast Asia. Antibody-dependent enhancement of DV growth in mononuclear phagocytes is thought to be the mechanism whereby preexisting dengue antibodies confer excess risk for this outcome. Interleukin-1 (IL-1) may play an important role in the pathogenetic mechanisms that cause dengue fever and shock. It was shown that both IL-1 and tumor necrosis factor-alpha are secreted from monocytes within 4 h after DV infection. However, there was no increase in IL-1 secretion by virus-stimulated monocytes from dengue fever patients compared with healthy controls. Significant amounts of IL-1 were secreted by DV-infected monocytes in the presence of aggregated immunoglobulin or immune complexes. In addition, a new 600-kDa IL-1 inhibitor from the supernatants of DV-infected monocytes was identified. This inhibitor may cause immunosuppression and influence the process of DV infection.

Asia, Southeastern↗
PubMed1994

Positive antinuclear antibody in peripheral T cell lymphoma: a case report.

The association of malignant lymphoma with positive antinuclear antibody is uncommon, and their relationship is not clear. Here a 35-year-old man is presented who initially had a high titer of antinuclear antibody; later, peripheral T cell lymphoma was found. It is suggested than an unexplained high antinuclear antibody titer may warrant searching for a malignancy.

Adult↗
PubMed1994

An experimental model of osteoarthritis in rabbit.

BACKGROUND: From both a microscopic and a metabolic view, experimental animal models are very important for study of the pathogenesis of osteoarthritis. A new, different operative procedure was used in rabbit models, and the pathologic findings were evaluated. METHODS: Twelve New Zealand white rabbits were divided into six groups; eight were used as animal models and four, for drug efficacy study. Transection of the anterior cruciate and medial collateral ligaments on the left knee joint, and sham-operation were performed on the right knee joint. Rabbits were sacrificed post surgery from 4, 6, 8 and 12 weeks. Eight parameters from gross to microscopic findings were used in order to evaluate osteoarthritic changes. Indomethacin and aspirin were chosen for the drug efficacy experiment; the two rabbits of each group were sacrificed at the end of the sixth week post-surgery. RESULTS: According to pathological findings, this operative procedure can produce osteoarthritic changes, visible both microscopically and macroscopically. There were osteoarthritic changes in the fourth week post-surgery group and, obviously, in the eighth week; these persisted until 12th weeks post-surgery. Neither indomethacin nor aspirin showed any effect in preventing osteoarthritis progression. CONCLUSIONS: Transection of the anterior cruciate and medial collateral ligament rabbit model can produce osteoarthritic lesions in the knee joint. This model can be used for further biochemical and metabolic studies.

Animals↗
PubMed1994

Intermittent intravenous treatment of lupus nephritis with cyclophosphamide: a four-year experience with twenty-four patients.

BACKGROUND: Renal involvement in systemic lupus erythematosus commonly leads to renal failure and death. We conducted a study to evaluate the efficacy and side effects of intermittent intravenous treatment with cyclophosphamide of patients with lupus nephritis. METHODS: Twenty-four patients with lupus nephritis were recruited at Tri-Service General Hospital from 1988 to 1992. Cyclophosphamide was administered intravenously monthly for three months, and then every three months. 24-hour urinary protein, creatinine clearance, serum creatinine, blood urea nitrogen, C3 and C4 levels, serum albumin, hemoglobin, and dosage of prednisolone were recorded before each treatment. During treatment, the side effects were monitored. RESULTS: Two patients progressed to renal failure within one year and one patient after three years. Fifteen patients completed therapy for one year. Among these 15 patients, the levels of hemoglobin, serum albumin, and C3 significantly increased at six months, then became stable; the level of C4 increased at 12 months. In contrast, the dosage of prednisolone decreased significantly at six months. There was no significant difference of creatinine clearance, 24-hour urinary protein, serum creatinine, and blood urea nitrogen before and after treatment. The most common side effects were nausea and vomiting. No severe side effect necessitated discontinuing therapy with cyclophosphamide. CONCLUSIONS: Intermittent intravenous therapy in lupus nephritis with cyclophosphamide can significantly increase levels of hemoglobin, serum albumin, C3 and C4, and keep renal function stable. Poor response was found in a subset of patients. The side effects were mild in the present study.

Adult↗
PubMed1994

Lupus nephritis: an analysis of 70 cases.

BACKGROUND: The influence of renal morphology and clinical factors at biopsy on the development of renal failure in patients with lupus nephritis remain controversial. We investigated the relation between renal histologic finding and clinical manifestations, and evaluated prognostic factors and short-term prognosis among patients with lupus nephritis. METHODS: Seventy patients with lupus nephritis were enrolled in the study from 1982 to 1992 at the Tri-Service General Hospital. Renal biopsy specimens from these patients were assessed according to the World Health Organization (WHO) classification, activity and chronicity indices, and clinical parameters. Survival was analyzed by using the day of renal biopsy as the starting point. The end point of renal survival was the date when patient started to receive regular hemodialysis. RESULTS: In pathological finding, one patient was grouped as Class I (1.4%); 14, as Class II (20%); 15, as Class III (21.4%); 29, as Class IV (41.4%); 9, as Class V (12.9%), and 2, as Class VI (2.9%). The scores of activity indices were highest in Class IV. The blood levels of C3 and C4 in Class V were significantly higher than Class IV. The values of BUN and 24-hour urine protein in Class II were significant lower than Class IV. Patients who progressed to renal failure had significantly higher numbers of death, higher serum creatinine and chronicity index, less creatinine clearance, and higher numbers of hypertension at the time of biopsy. Nephrotic syndrome was not associated with renal failure. Patient and renal survivals did not differ among WHO classifications. The patient and renal survivals were 84%, 60% and 85%, 72% at one and five years, respectively. Seventeen patients (24.2%) progressed to end-stage renal disease and 21 patients (30%) died during the study period. The leading causes of death were sepsis and renal failure. CONCLUSIONS: WHO classification had little correlation with clinical and renal information. At the time of biopsy the elevated serum creatinine and hypertension were good predictors for end-stage renal disease. Poor patient and renal survivals were found in this study.

Adolescent↗
PubMed1994

Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences.

OBJECTIVE: To determine the prevalence of symptomatic rheumatic disease in rural, urban and suburban areas of Taiwan by a 2-staged population survey. METHODS: Nine thousand subjects over 20 years old were sampled proportional to age and sex for the area from 3 administrative areas in Taiwan. A pretested questionnaire to screen for potential rheumatic disorders and/or disability was administered in the communities by health workers. Subjects who screened positive were examined by a rheumatologist who assigned a final diagnosis based on established criteria. RESULTS: A total of 8998 persons over age 20 residing in Hen-San (rural area), Sien-Dien (suburban), and Cu-Tien (urban) were studied. Twenty-five percent (2272) of the population indicated rheumatic problems: 1124 of 2271 were evaluated by a rheumatologist with serological and radiological testing. The response rates were 49.7% in Hen-San, 50.7% in Sien-Dien and 48.5% on Cu-Tien. After age and sex adjustment, the prevalence of rheumatic symptoms in Hen-San, Sien-Dien, and Cu-Tien was 24.3, 18.4 and 26.3% respectively. It was significantly higher in rural Hen-San and urban Cu-Tien than in Sien-Dien. The prevalence of rheumatoid arthritis (RA) in Hen-San, Sien-Dien, and Cu-Tien was 0.26, 0.78, and 0.93%, osteoarthritis (OA) was 6.3, 5.8, 5.1%, ankylosing spondylitis (AS) was 0.54, 0.19, 0.4%, gout was 0.16, 0.67, 0.67%, respectively. The prevalence of RA in Sien-Dien and Cu-Tien was significantly higher than in Hen-San (p < 0.05) but were not statistically different for OA, AS and gout among those 3 sites. Only one case of systemic lupus erythematosus (SLE) was found in urban Cu-Tien for a prevalence of 0.033%. CONCLUSION: Our results suggest that the prevalence of RA and AS is similar to that reported in Caucasians. We could not confirm anecdotal reports that SLE was common or that it is more common than RA in people of Chinese ancestry. The prevalence of OA of the hip is comparatively uncommon in our population. The difference in prevalence of rheumatism, RA, OA and gout in these areas suggests areas of further study.

Adult↗
PubMed1993

Efficacy and possible mechanisms of the Chinese herbs suching-huo-hsuei-tang in the treatment of adjuvant-induced arthritis in rats.

The Chinese herbal formula suching-huo-hsuei-tang (SHT) was studied to evaluate its efficacy and possible mechanism on adjuvant-induced arthritis (AIA) in rats. SHT was extracted with water, butanol and chloroform into 5 different layers. The top 3 layers of SHT showed a significant suppression of AIA and writhing reaction; the top 2 layers suppressed neutrophil chemotaxis and platelet aggregation. The results suggest that SHT is very promising in the treatment of rheumatoid arthritis (RA) by way of its anti-inflammatory and analgesic action. The possible mechanisms for arthritis are multifactorial.

Animals↗
PubMed1993

The role of cytokines in heat stroke.

Heat stroke is a disease characterized by high fever. Cytokines such as interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-delta) play a major role in fever production. In the current studies, eight patients with heat stroke were enrolled in a cytokine studies. Serum cytokine levels of these patients were determined by EIA methods, and in vitro IL-1 and IL-1 inhibitor production were determined by murine thymocyte proliferation assay and/or EIA. Significantly high levels of circulating IL-1, TNF-delta, and IL-6 were demonstrated. Positive correlations were demonstrated between the body temperature and the level of IL-1 beta, and the cooling time and level of serum IL-1 beta. In addition, monocytes from heat stroke patients after complete recovery, secreted a much higher amount of IL-1 than did normal volunteers. However, there was no difference in IL-1 inhibitor production. These results indicate that cytokines may play a major role in the pathogenesis of heat stroke, and the ability to make different amounts of IL-1 in response to exogenous stimulation appear to be risk factors for an attack of heat stroke.

Adult↗
PubMed1993

[The influence of Chinese traditional medicine on the production and activity of interleukin 1 (IL-1)].

Interleukin 1 (IL-1) is a cytokine closely related to the pathogenesis of inflammation and chronic destructive changes in rheumatoid arthritis (RA). Analysis of the effect of antirheumatic drugs on IL-1 production and activity is of great importance in exploring the therapeutic mechanism of RA. The purpose of the present study was to investigate the effect of Chinese herbs (10 prescription and 15 single drugs), which was often used in the treatment of RA, on the production and activity of IL-1. The production of IL-1 was tested through human monocytes stimulated with zymosan and measured by ELISA method; the activity of IL-1 was measured by its effect on the proliferation of murine thymocytes. The results showed that Tripterygium Wilfordii Hook, Tripterygil Hyhoglauci Tetrandrine significantly inhibited both of IL-1 production and IL-1 activity; while Aconiti Tuber, Ephedrae Herba, Atractyloidis Rhizoma, Atractyloidis Lanceae Rhizoma, Ledebouiellae Radix slightly inhibited IL-1 activity but not affecting IL-1 production. The ten prescriptions had no inhibitory effect on both of IL-1 production and IL-1 activity.

Animals↗
PubMed1992

Negative regulation of interleukin-1 in immune reactive cells.

Interleukin-1 (IL-1) is an immunological regulator with a multitude of effects. Recently, IL-1 inhibitors from urine, monocytes, or monocytic cell lines have been described. We previously demonstrated an IL-1 inhibitor from human monocytes under immune complex or immunoglobulin stimulation. The present studies were initiated to determine the production of IL-1 inhibitor from human polymorphonuclear cells (PMN), B and T lymphocytes in response to certain stimuli using a murine thymocyte system responsive to IL-1. My results indicated that the inhibitor is constitutively present in PMN because unstimulated PMN supernatants also show inhibitory activity. B and T lymphocytes can not produce IL-1 inhibitor under zymosan, immunoglobulin, or immune complex stimulation. The presence of this PMN inhibitor may also be important in the negative regulation of IL-1.

Animals↗
PubMed1992

The effects of methotrexate on interleukin 1 in patients with rheumatoid arthritis.

The effect of methotrexate (MTX) treatment on patients with rheumatoid arthritis on interleukin 1 (IL-1) was evaluated. Eight patients received a weekly MTX dose of 7.5 mg for 6 weeks; none received concomitant corticosteroids. Peripheral blood was obtained 1 day before and 1 day after their weekly MTX dose at Week 1 and 6, isolated monocytes stimulated ex vivo with 1 mg/ml zymosan for 18 h and IL-1 measured by bioassay. Serum and plasma IL-1 levels were measured by immunoassay. Four patients manifested a sharp decrease in IL-1 production 6 weeks after MTX administration associated with a decrease in the number of painful but not swollen joints. No effect on blood levels was observed. Our results suggest that MTX may affect IL-1 production and IL-1 mediated events in some patients.

Administration, Oral↗
PubMed1990

Human monocytes produce IL-1 and an inhibitor of IL-1 in response to two different signals.

Recently, IL-1 inhibitors from urine, monocytes, or monocyte lines have been described. The relationship of these inhibitors to the production, release, and immunological effects of IL-1 is unclear. The present studies were initiated to describe and quantitate the production of IL-1 and a 23 to 45-kDa IL-1 inhibitor from human monocytes in response to certain stimuli using a mouse thymocyte system responsive to IL-1. Zymosan stimulated monocytes to produce IL-1 but not IL-1 inhibitor. Adherent immune complexes, human IgG1-4, and Fc fragments, but not F(ab')2, stimulated monocyte production of IL-1 inhibitor and little if any IL-1. Fibronectin and three of its fragments had neither effect. These observations suggest that monocytes produce IL-1 or IL-1 inhibitor in response to two different signals, through "endotoxin or beta-glucan" and Fc receptors, respectively. The inhibitor decreases IL-1-induced CD-1, C3H/HeJ, and D10 G4.1 cells but not IL-2-induced CD-1, C3H/HeJ, or CTLL-2 proliferation. The inhibitor competitively blocked binding of radiolabeled rIL-1 to the IL-1 receptor on murine thymoma cells. Preincubation of thymocytes with the inhibitor prevented IL-1-induced proliferation; however, this effect was reversed by washing thymocytes and inhibitor activity was markedly reduced when added 24 hr after stimulation with IL-1. These observations suggest that the inhibitor acts on IL-1 receptors to prevent thymocyte proliferation. Monocytes from patients with systemic lupus erythematosus produced less IL-1 inhibitor than cells from normal volunteers. The decrease in IL-1 inhibitor production may play a role in disease states.

Adult↗
PubMed1990

The effect of antirheumatic drugs on interleukin 1 (IL-1) activity and IL-1 and IL-1 inhibitor production by human monocytes.

Interleukin 1 (IL-1) is an important mediator of immune regulation, inflammation and joint destruction in arthritis. The objective of our study was to investigate the effect of a number of representative antirheumatic agents on the activity of IL-1 and the production of both IL-1 and IL-1 inhibitor by human monocytes. IL-1 activity and production were measured by its effect on the proliferation of murine thymocytes; IL-1 inhibitor production was assayed by inhibition of IL-1 mediated thymocyte proliferation. Dexamethasone (10-100 nM) inhibited IL-1 production and IL-1 mediated thymocyte proliferation. High concentrations of indomethacin, aspirin, and 12 other nonsteroidal antiinflammatory drugs (NSAID) inhibited IL-1 activity, or production or both. Methotrexate inhibited IL-1 activity without affecting IL-1 production. D-penicillamine inhibited IL-1 activity and tended to inhibit IL-1 production. Gold compounds inhibited IL-1 activity, but only auranofin inhibited IL-1 production. Acetaminophen in high concentrations (1 mg/ml) inhibited IL-1 activity and production. Colchicine inhibited IL-1 activity but not IL-1 production. No drug tested induced, by itself, the production of IL-1 inhibitor or enhanced the production of IL-1 inhibitor.

Acetaminophen↗