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Biomedical subjects

I K Cheng

Publications and source records attributed to I K Cheng.

At least 91 records · Page 5Linked to original sources
PubMed1991

Aberrant T-regulation in rheumatoid arthritis and IgA nephropathy affects CD5+ and CD5- B lymphocytes equally.

T-suppressor function and T-helper function in healthy adults, elderly patients with non-immune diseases, and patients with rheumatoid arthritis (RA) and IgA nephropathy (IgAN) were titrated by adding graded concentrations of CD8+ cells to autologous CD8-depleted peripheral blood mononuclear cells (PBMC), or CD4+ cells to CD8- 4- PBMC, respectively. Following culture with pokeweed mitogen (PWM), numbers of CD5+ and CD5- immunoglobulin-secreting cells were determined using a combination of rosetting with anti-CD5-coated Dynabeads and reverse haemolytic plaque formation (Jones, 1990). Of 11 RA patients studied, eight had slightly reduced suppressor activity for CD5+ and CD5- IgM-secreting cells, and three with active disease and high serum levels of C-reactive protein, could not suppress IgG, IgA or IgM secretion by either B subset. Helper activity for both CD5+ and CD5- B cells was slightly but significantly increased in RA patients. One of eight patients with IgAN could not suppress IgG, IgA or IgM production by CD5+ or CD5- B cells, and all IgAN patients required strikingly fewer CD4+ cells for PWM-induced activation of CD5+ and CD5- B cells than controls. It was concluded that in two immunologically mediated diseases in which some patients have raised numbers of circulating CD5+ B cells, aberrant T-regulation affects CD5+ and conventional CD5- B cells equally.

Antibody Formation↗
PubMed1991

A multimodal neurophysiological assessment in terminal renal failure.

A prospective multimodal neurophysiological study was conducted on 36 patients with end-stage renal failure, 16 of whom subsequently underwent renal transplantation (TR). Nerve conduction study and somatosensory evoked potentials revealed that peripheral conduction deficit, often subclinical, was the commonest abnormality, and TR resulted in substantial improvement. Visual evoked potentials demonstrated subclinical impairment, which did not improve after TR. The brainstem auditory evoked potentials were essentially normal and unaffected by TR.

Brain Stem↗
PubMed1991

Crescentic IgA glomerulonephritis following interleukin-2 therapy for hepatocellular carcinoma of the liver.

A patient who developed crescentic IgA nephropathy following treatment with recombinant interleukin-2 (rIL2) and lymphokine-activated killer (LAK) cell therapy for hepatocellular carcinoma was reported. Cessation of rIL2 and LAK cell treatment plus plasmapheresis and steroid therapy was successful in achieving partial improvement and stabilization of renal function. This is the first case report of biopsy-documented glomerulonephritis developing after IL2 and LAK cell therapy. This provides indirect in vivo evidence for the role of IL2 in mediating glomerular injury in IgA nephropathy.

Biopsy↗
PubMed1991

A patient with focal segmental glomerulosclerosis and acute renal failure due to crescentic membranoproliferative glomerulonephritis.

We report a patient with relapsing nephrotic syndrome since the age of 4. Initial renal biopsy showed minimal change disease then focal segmental glomerulosclerosis. At the age of 21, he developed pulmonary tuberculosis, was treated with intermittent combination chemotherapy including rifampin and had oliguric acute or chronic renal failure 5 months later. Biopsy revealed crescentic membranoproliferative glomerulonephritis. The cause of the sequential glomerulonephritis is discussed.

Acute Kidney Injury↗
PubMed1991

Effect of phosphatidylcholine on ultrafiltration in patients on continuous ambulatory peritoneal dialysis.

Oral phosphatidylcholine at 900 mg/day was given to 4 patients with high lymph absorption for 8 weeks. Fluid and solute transfer before and after treatment were compared to 4 similar controls given placebo. None of the patients had overt ultrafiltration problems. After treatment, overnight peritoneal effluent phospholipid content did not change significantly. Ultrafiltration as well as solute and glucose transfer remained unchanged at the end of 8 weeks. A controlled trial on patients with overt ultrafiltration problems for a longer duration is required to further elucidate the role of phosphatidylcholine supplementation in patients on continuous ambulatory peritoneal dialysis.

Absorption↗
PubMed1991

Factors affecting lymphatic absorption in Chinese patients on continuous ambulatory peritoneal dialysis (CAPD).

The pathways and physiology of lymph absorption (LA) from the peritoneal cavity are well documented; however, much uncertainty still exists as to the various clinical and demographic factors affecting LA. We studied LA measured by the albumin instillation method, in adult Chinese CAPD patients, and showed that it was independent of age, sex, body surface area, duration of dialysis, intrinsic renal disease, use of intraperitoneal drugs (heparin/antibiotics/deferroxamine) and frequency of past bacterial peritonitis. High lymph absorbers had a relatively higher transcapillary cumulative ultrafiltration than low lymph absorbers. An enhanced LA was associated with a high initial intraperitoneal volume. Assessment of diaphragmatic strength by the decrement in vital capacity on changing from an erect to a supine position failed to distinguish patients with high and low LA.

Diaphragm↗
PubMed1991

Correction of anemia in patients on continuous ambulatory peritoneal dialysis with subcutaneous recombinant erythropoietin twice a week: a long-term study.

Subcutaneous recombinant human erythropoietin (rHuEPO) was given for 12 months twice weekly to 10 patients on continuous ambulatory peritoneal dialysis (CAPD) with anemia (hemoglobin less than 9.0 mg/dl). All patients responded to a median weekly dose of between 37.5 to 100 (mean 55 to 105) units/kg and reached a target hemoglobin of 10-12 mg/dl in a mean of 11.7 weeks (range 5-24). Serum iron, iron saturation and ferritin were significantly lower and serum potassium was significantly higher than the pre-treatment level from 1 month onwards. Five patients without pre-treatment iron overload required oral iron supplement and 3 required oral potassium-binding resin. No significant change in other serum biochemical parameters was observed. Blood pressure remained stable during the treatment period but additional or increased dosage of antihypertensive drugs was required in 5 patients. Peritoneal small solute clearance and ultrafiltration and residual renal clearance did not change significantly after correction of anemia. The incidence of peritonitis and exit site infection was similarly unaffected. One patient developed a severe headache which was not associated with hypertension and responded to withdrawal of rHuEPO treatment. Most of the remaining patients showed improvement in subjective well-being. It was concluded that the subcutaneous route twice a week is a safe, convenient and cost-effective way to administer rHuEPO to patients on CAPD.

Adult↗
PubMed1991

A randomised prospective comparison of oral ofloxacin and intraperitoneal vancomycin plus aztreonam in the treatment of bacterial peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD).

Forty six patients who developed 48 episodes of peritonitis while on CAPD were randomised to receive either oral ofloxacin or intraperitoneal (i.p.) vancomycin/aztreonam. Three patients were excluded from analysis: 2 were transferred to other hospitals and 1 was later found to have candida peritonitis. Of the remainder, 22 episodes were treated with oral ofloxacin and 23 with i.p. vancomycin/aztreonam. The primary cure rate in the oral ofloxacin and i.p. vancomycin/aztreonam group was 77.3% and 87.5% respectively. There were 3 primary failures and 2 relapses in the former and 1 failure and 2 relapses in the latter group. Two of the 4 primary failures were peritonitis episodes secondary to infection with pseudomonas species. The total number of days of hospital stay was 48 and 58 respectively in the two groups. Analysis of the cost of treatment revealed that i.p. vancomycin/aztreonam was 30 times more expensive than oral ofloxacin. Despite a slightly higher cure rate with i.p. vancomycin/aztreonam, oral ofloxacin is a more cost-effective primary treatment of bacterial peritonitis in patients on CAPD especially in countries with a limited health budget.

Administration, Oral↗
PubMed1990

Urinary tract infections in post-renal transplant patients.

The overall incidence of urinary tract infections (UTIs) in our renal transplant population was 30.9%, i.e. 0.15 episode per patient-year. UTIs occurred more often within the first 3 months (60%) of transplantation. Fifty per cent of UTIs were asymptomatic. Recurrences were common. Acute tubular necrosis and cellular rejections were important associations. UTIs had little effect on graft function and survival up to 3 years post-transplant.

Adolescent↗
PubMed1990

Haematological changes after renal transplantation: differences between cyclosporin-A and azathioprine therapy.

Haematological changes after renal transplantation in 76 patients were reviewed and the differences observed between patients treated with cyclosporin-A and prednisolone and those treated with azathioprine and prednisolone were compared. Erythrocytosis defined as haemoglobin concentration equal to or exceeding 17 g/dl occurred in 25% of patients treated with cyclosporin-A and in 11.4% of patients treated with azathioprine. Only one patient, who received cyclosporin-A, had clinical evidence of thrombosis. Eight patients treated with cyclosporin-A and five treated with azathioprine had therapeutic venesections. There was no difference in the incidence of putative risk factors for post-transplant erythrocytosis between the two groups.

Adolescent↗
PubMed1990

Comparison of captopril and enalapril in the treatment of hypertension in patients with non-insulin dependent diabetes mellitus and nephropathy.

Eighteen patients with non-insulin dependent diabetes mellitus (NIDDM), hypertension and nephropathy were randomized to receive captopril or enalapril for 6 months. Two patients with serum creatinine of greater than 400 mumol/l had to be excluded from the study because of rapidly deteriorating renal function after starting treatment. Of the remaining patients, 7 received captopril and 9 received enalapril. Blood pressure control was achieved in about 50% of patients with either drug alone. Serum creatinine and creatinine clearance were unchanged in both groups but there was a greater tendency for the former to increase in patients with higher pretreatment values. Proteinuria was reduced at 1 month only in the enalapril group which also showed a significant elevation of serum potassium after treatment. Captopril and enalapril have only a modest antihypertensive action in patients with NIDDM and nephropathy. Their use in patients with renal insufficiency must be balanced against the risk of further aggravating the deterioration of renal function.

Blood Pressure↗
PubMed1990

A randomized prospective trial of three different regimens of treatment of peritonitis in patients on continuous ambulatory peritoneal dialysis.

A randomized prospective study was undertaken in patients on continuous ambulatory peritoneal dialysis (CAPD) to evaluate the efficacy of three different antibiotic regimens for the treatment of peritonitis. There were 39 episodes in each treatment group. Patients were treated with intraperitoneal (IP) cephalothin (250 mg/L) and tobramycin (8 mg/L) in group 1, oral ofloxacin (400 mg loading followed by 300 mg daily) in group 2, and a combination of ofloxacin (400 mg followed by 300 mg daily) and rifampicin (300 mg daily). Treatment duration was 10 days. The average culture-positive rate was 75%. The overall cure rate was 80.6% with IP antibiotics, 78.4% with oral ofloxacin, and 81.1% with ofloxacin and rifampicin. After the exclusion of tunnel infections and episodes of peritonitis due to Pseudomonas and resistant organisms, the corresponding figures were 100%, 90.6%, and 93.7%, respectively. Side effects were minimal with IP treatment and with oral ofloxacin, but severe nausea and vomiting occurred in some cases with the combination of ofloxacin and rifampicin. It was concluded that oral ofloxacin is an acceptable first-line therapy for peritonitis in CAPD patients.

Administration, Oral↗
PubMed1990

The effect of fish-oil dietary supplement on the progression of mesangial IgA glomerulonephritis.

The effect of fish-oil dietary supplement on the rate of progression of renal failure in 11 patients with IgA nephropathy was investigated by comparing the slope of the plot of reciprocal serum creatinine versus time before and after supplement. After supplement, the slope significantly decreased in two patients, increased in two, and was not significantly altered in the remainder. Before supplement, serum IgA, IgA circulating immune complexes, and in-vitro Ig production were not significantly different from normal controls. After supplement, urinary protein transiently increased, serum IgA circulating immune complexes decreased, and serum triglyceride and in-vitro platelet aggregation tended to decrease. Only the change in serum IgG and spontaneous in-vitro IgG production correlated with the change in the rate of renal functional deterioration. No clinical or biochemical parameters before supplement predicted the subsequent response. In patients with IgA nephropathy, non-immune factors probably contribute to progression of renal failure, and in these patients fish-oil dietary supplement has either no demonstrable or an unpredictable effect.

Adult↗
PubMed1990

Oral neostigmine and lymphatic absorption in a myasthenia gravis patient on continuous ambulatory peritoneal dialysis (CAPD).

The effects of oral neostigmine on peritoneal lymph absorption and transcapillary and net ultrafiltration were studied in a myasthenia gravis patient on continuous ambulatory peritoneal dialysis (CAPD). Oral neostigmine decreased lymphatic absorption, but only up to a threshold dose. The effect on net ultrafiltration however was nullified to some extent by a concurrent decrease in cumulative transcapillary ultrafiltration.

Administration, Oral↗