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Biomedical subjects

J L Lan

Publications and source records attributed to J L Lan.

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

Effects of corticosteroid inhalation therapy on lung ventilation and alveolar permeability in asthma using TC-99M DTPA radioaerosol inhalation lung scintigraphy.

This study evaluates the effects of steroid inhalation on lung ventilation (LV) and alveolar permeability (AP) in 26 patients with asthma. The homogeneity of LV was evaluated as the inhalated Tc-99m diethylene triamine pentaacetic acid (DTPA) radioaerosol depositing ratios of the central 1/3 over peripheral 1/3 of the left lung. It is shown as a distribution factor (DF) in this study. The damage in AP was measured from the speed of Tc-99m DTPA radioaerosol clearance curves from the peripheral alveoli of the left lung and is represented as a slope in this study. The baseline LV and AP were calculated before an inhalation therapy of 0.05 mg beclomethasone dipropionate four times daily for one week, then the studies were repeated after treatment to evaluate the effects of inhalation therapies. The results revealed a significantly improved homogeneity of LV in 16/26 (62%) cases (DF: 0.79 +/- 0.32 vs 0.59 +/- 0.22, P = 0.0001), but no apparent change in AP (slope: 1.18 +/- 0.78 vs 1.25 +/- 0.88, P = 0.052) after the treatment. In conclusion, a corticosteroid inhalation therapy for asthma can improve the peripheral LV, but can not change the AP according to the findings of Tc-99m DTPA radioaerosol inhalation lung scintigraphy. We suggest that the widely available Tc-99m DTPA radioaerosol inhalation lung scintigraphy, coupled with the evaluation of LV and AP could contribute to any disorder involving both alveoli and airways.

Administration, Inhalation↗
PubMed1994

Lung inflammation in patients with systemic lupus erythematosus detected by quantitative 67Ga-citrate lung scanning.

The severity of lung inflammation in 34 patients with systemic lupus erythematosus (SLE) was measured by quantitative 67Ga-citrate lung scanning. The severity of lung inflammation in SLE was represented by the 67Ga uptake index (GUI). Quantitative 67Ga lung scanning was also performed on 20 normal controls for comparison with the SLE patients. The patients were divided into two subgroups according to the following two criteria: (a) stable or flare stage according to clinical features; or (b) positive or negative results of chest X-ray. The GUI values of the subgroups were also compared. The results revealed a trend towards higher values of GUI in SLE patients than in the normal controls. The GUI values were also higher for SLE cases with a flare stage or a negative chest X-ray than in SLE cases with a stable stage or a positive chest X-ray. The statistical results reveal that the differences in the GUI values are not significant. However, we found that (1) positive chest X-ray findings may be a later manifestation of a lung inflammation and (2) the values of GUI parallel clinical features in SLE patients.

Adult↗
PubMed1993

Crusted scabies in systematic lupus erythematosus: a case report.

Crusted scabies (Norwegian scabies) is uncommon in clinical practice and may present as papulosquamous dermatosis. A case of crusted scabies in systemic lupus erythematosus (SLE) is described. The skin lesions simulated those of subacute cutaneous lupus erythematosus of the papulosquamous type, and became the source of epidemic scabies in the hospital. The colonization with Staphylococcus aureus within crusted lesions may have contributed to the patient's sepsis. This case illustrates the pitfalls in recognition of crusted scabies and the importance of rapid diagnosis.

Humans↗
PubMed1993

Xe-133 muscle blood flow in polymyositis and dermatomyositis.

The histologic picture of polymyositis or dermatomyositis is characterized by muscle fiber degeneration, which is assumed to be caused by a circulatory abnormality. To verify this assumption, we measured the muscle blood flow in patients with polymyositis (or dermatomyositis) and in normal subjects using the inert gas Xe-133. Sixteen patients and 30 age-matched normal volunteers were studied. Muscle blood flow was measured with Xe-133 dissolved in isotonic saline as described by Lassen et al. (1964) and Pozderac et al. (1975). Data were acquired in the frame mode after intramuscular injection (anterior tibial muscle) of 0.3 mCi of Xe-133 in 0.2ml of saline for 20 min. A computer routine was used to calculate the clearance half time (T 1/2) in min and flow rate (Q) in ml/100 gm tissue/min. The student's t test was used to test statistical significance. Our preliminary results suggest: 1. The muscle blood flow in patients with polymyositis and dermatomyositis was significantly lower than the corresponding normal control levels. 2. This findings may be due to decreased in muscle capillary 3. Further studies are warranted to obtain a conclusive understanding of the pathogenesis of polymyositis and dermatomyositis.

Adult↗
PubMed1993

Juvenile and adult dermatomyositis among the Chinese: a comparative study.

Between 1983 and 1992, 11 children and 38 adults were seen at Taichung Veterans General Hospital with a definite diagnosis of dermatomyositis. Their clinical pictures, laboratory findings, courses and outcomes were compared. The mean age at diagnosis was 12 years and 50 years, respectively. Children had a higher female-to-male ratio (2.7:1 vs. 1.2:1) and a more acute onset, while adults had a higher incidence of malignancy and other connective tissue disease associations. Clinically, shawl sign was more common in the adults, whereas myalgia was more frequently seen in the children (0.05 < p < 0.1). Hemograms, serological parameters and immunological investigations showed no significant differences between the two groups. Elevated erythrocyte sedimentation rate and circulating immune complexes were found in over half of both groups of patients; however, their values bore no relationship to either disease activity or future outcome. Although no significant differences were demonstrated between the two groups of patients with regard to either clinical manifestations or laboratory findings, the disease entity seemed not to be the same because evidence of vasculopathy in muscle pathology was more prominent in the children, with endothelial swelling and necrosis the most common findings. Steroids had been used as the first choice of therapy in both groups of patients, followed by cytotoxic drugs and immunosuppressants. Children had a more favorable outcome compared to a 24% mortality rate in the adult group. Experience here recommends a complete cancer work-up in adults, especially for nasopharyngeal carcinoma among the Chinese. Various autoantibodies screenings may also be helpful for early detection of other associated connective tissue diseases.

Adolescent↗
PubMed1993

Solid phase radionuclide esophageal motility in polymyositis and dermatomyositis.

Polymyositis (PM) and dermatomyositis (DM) may be associated with motor dysfunction of the entire gastrointestinal tract. Abnormal esophageal motor function is a well-recognized complication of these diseases. In this study, we used a solid phase esophageal study to evaluate the motor function in patients with PM or DM. Twenty-three patients and 36 age-matched normal volunteers were studied. Each subject was placed in a supine position above a gamma camera linked to a computer and was given a 4-ml bolus of solid gelatin containing 1 mCi of Tc-99m phytate. Data were acquired in the list mode. A computer method modified from Kelim and Wald and Russell et al. was used to calculate the following: A) total mean transit time (MTT); B) residual fraction after the first swallow (RF); and C) retrograde index (RI). All values are presented as mean +/- standard deviation (SD). The Student's t-test was used to test statistical significance. Our preliminary results suggest: 1) delayed esophageal emptying is common (17/23) in PM/DM, indicating frequent malfunction of the smooth muscle of the upper gastrointestinal tract in PM/DM and 2) measurement of esophageal motility may monitor disease activity in PM/DM.

Adolescent↗
PubMed1992

Treatment of pigmented villonodular synovitis with yttrium-90: changes in immunologic features, Tc-99m uptake measurements, and MR imaging of one case.

Pigmented villonodular synovitis (PVNS) is an uncommon proliferative disease of synovium. We report a 35-year-old male with diffuse form of PVNS of left knee, treated with intraarticular injection of 5 mCi of yttrium-90 (Y-90) silicate colloid consisting of two doses with a 3-month interval between them. During follow-up, the affected knee showed clinical improvement and was accompanied by a decrease of the levels of soluble interleukin-2 receptor in sera and synovial fluids (SF). When compared to osteoarthritis subjects, SF lymphocyte subsets of this case before Y-90 therapy showed a lower CD4:CD8 cell ratio and absence of suppressor inducer cells (CD4+ 2H4+). The Tc-99m pertechnetate knee uptake indexes correlated well with clinical improvement. Serial magnetic resonance imaging revealed significant change one year after Y-90 therapy. The findings of immunological assessment suggested that immunoregulatory dysfunction may be related to the pathogenesis of PVNS.

Adult↗
PubMed1992

Detection of Mycobacterium tuberculosis antigen in synovial fluid of patients with rheumatoid arthritis.

By use of antimycobacterial saline extract antibodies, Mycobacterium tuberculosis (MT) antigens have been detected in synovial fluid (SF) of patients with rheumatoid arthritis (RA) by a highly specific and sensitive double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). Absorbance for 15 gout, 14 osteoarthritis (OA) patients, 12 patients with spondylarthropathies (SA) and eight patients with other inflammatory disorders (OID) ranged from 0.001 to 0.025 with the mean values of 0.0086 +/- 0.0078, 0.0077 +/- 0.0051, 0.0069 +/- 0.0059 and 0.0113 +/- 0.0059, respectively. Among 65 SF of patients with RA examined, 34 were found to be negative for MT antigen with absorbance ranging from 0.002 to 0.024 and a mean value of 0.0114 +/- 0.0070. For 31 (47.7%) MT antigen-positive specimens of RA, optical density ranged from 0.052 to 2.446 with a mean value of 0.5564 +/- 0.7354. Significant statistical difference (P less than 0.05) was found when MT antigen positives were compared with MT antigen negatives, gout, OA, SA and OID groups. Our results indicate that MT may be relevant to the pathogenesis of RA.

Analysis of Variance↗
PubMed1992

Chromosome studies in systemic sclerosis with consideration of antibodies to topoisomerase I.

Chromosome studies were performed on 11 patients with systemic sclerosis and on 35 control subjects. Nine patients with systemic sclerosis were positive for antibodies to topoisomerase I and two were negative. Of the 1100 metaphases from these 11 patients, 171 (15.5%) had chromosome breaks, compared with 61 of 3500 (1.7%) metaphases from normal control subjects. There were no statistically significant differences in the numbers of chromosome breaks between men and women. The most common fragile site in patients with systemic sclerosis was at 3p14. The karyotype of all patients was normal. Chromosome breaks did not correlate with the presence of antibodies to topoisomerase I.

Adult↗
PubMed1992

The influence on pregnancy of anti-SSA/Ro antibodies in systemic lupus erythematosus.

Excessive fetal morbidity and mortality have been noted in patients with systemic lupus erythematosus (SLE). The influence of anti-SSA/Ro antibodies on fetal outcome in SLE patients has rarely been reported, but its high association with congenital heart block or neonatal lupus syndrome is well known. In 430 pregnancies of the 154 SLE patients studied, there was an increased frequency of adverse fetal outcome compared with controls. There was no significant difference in the rates of adverse fetal outcome between anti-SSA/Ro positive and negative SLE patients, except that the incidence of intrauterine growth retardation increased in the positive patients. However, pregnant SLE patients with high titer of anti-SSA/Ro antibodies had more adverse fetal outcomes. All three infants who suffered congenital heart block/neonatal lupus syndrome were associated with maternal anti-SSA/Ro antibodies. The frequency of congenital heart block/neonatal lupus syndrome was 0.79% (3/379) in livebirths of all SLE patients and 1.17% (3/257) in live-births by anti-SSA/Ro positive SLE mothers.

Abortion, Spontaneous↗
PubMed1992

Anti-Jo-1 antibody in patients with polymyositis/dermatomyositis.

Interstitial lung disease (ILD) has been recognized as a manifestation of polymyositis or dermatomyositis (PM/DM). Patients with PM/DM with anti-Jo-1 antibody had a higher incidence of ILD. Thirty-five patients with PM/DM were studied the antibodies. Six (16.1%) were found to have them. ILD occurred in all 6 anti-Jo-1 positive patients, as opposed to 10 (34.5%) of 29 anti-Jo-1 negative patients. Only 2 cases of undifferentiated connective tissue disease among 1320 patients with various kinds of collagen vascular diseases other than PM/DM were positive for anti-Jo-1 antibody. These two patients also had lung involvement. Among six PM/DM patients with anti-Jo-1 antibody, dyspnea preceded proximal muscle weakness in three patients. In one case, the anti-Jo-1 antibody had been detected one month prior to the onset of myositis. Anti-Jo-1 antibody is a useful marker for PM/DM with ILD.

Adult↗
PubMed1992

Intestinal permeability test in systemic lupus erythematosus.

Using the Cr-51 labeled EDTA resorption test, intestinal permeability was measured in 23 patients with systemic lupus erythematosus and in 16 healthy volunteers. The Cr-51 EDTA intestinal permeability test was adopted from Bjarnason et al, (Gastroenterology 1983; 85:318). 87% (14/16) of the controls had an abnormal permeability test findings (more than 2.6% in 24h). No significant difference was demonstrated between the SLE patients and the controls (SLE = 3.51 +/- 1.66; controls = 4.20 +/- 1.56, P greater than 0.05). Our study indicated that Cr-51 EDTA permeability test failed to distinguish between SLE and normal groups, and that the elevated Cr-51 EDTA excretion in the controls challenged the validity of the test.

Adolescent↗
PubMed1992

[Personality characteristics of patients with fibromyalgia].

Fibromyalgia is a form of nonarticular rheumatism characterized by diffuse musculoskeletal pain. To investigate the personality characteristics of fibromyalgia, Ko's Mental Health Questionnaire was evaluated in 27 fibromyalgia patients and 23 normal controls. The fibromyalgia patients scored significantly higher than normal controls on hypochondriasis, depression, anxiety and compulsion, and significantly lower on independence. The fibromyalgia patients had 52% incidence of depression. Major depression occurred before onset of fibromyalgia at a mean of 5.5 years in 36% of the patients who experienced depression. The longer the duration of fibromyalgia, the higher the incidence of depression, and more numbers of tender points, indicating that the symptoms of fibromyalgia were more severe.

Adult↗
PubMed1991

Quantitative 99Tcm-HMPAO white blood cells and 67Ga scanning in rheumatoid arthritis.

This investigation assessed 99Tcm-HMPAO white blood cell (Tc-WBC) and 67Ga knee uptake indices before and after 90Y treatment in patients with intractable rheumatoid arthritis (RA) and correlated the uptake indices with the clinical score. Sixteen knee joints with RA were treated with intra-articular injection of 185 MBq of 90Y-silicate colloid (Amersham) flushed with 50 mg of hydrocortisone. Clinical score, quantitative 67Ga and Tc-WBC knee uptake indices were obtained before and three weeks after treatment. Our results showed that 9/16 (56%) had a good response and 7/16 (44%) had a poor response to 90Y injection. There was poor correlation between clinical improvement and changes in 67Ga and Tc-WBC knee uptake indices (r = 0.46 and 0.14, respectively). The correlation coefficient between changes in 67Ga and Tc-WBC knee uptake indices was 0.29.

Adult↗
PubMed1990

Production and characterization of monoclonal antibodies against major allergens of American cockroach.

From several fusion experiments between spleen cells obtained from BALB/c mice immunized with partially purified Cr-PI of American cockroach and NS-1 cells, growth was observed in many wells. Seven stable subclones secreting monoclonal antibodies (mAbs) against Cr-PI, as determined by enzyme-linked immunosorbent assay (ELISA) with high absorbance values and immunoblot analysis, were obtained. All seven mAbs were characterized as IgG1 subclass by immunodiffusion, and reacted strongly with 72 kilodaltons (kD) of Cr-PI which have been identified as a major allergen of American cockroach. Six mAbs were found to have similar epitope specificities against Cr-PI by ELISA. The remaining mAb was found to have different epitope specificities with others. Interestingly, all mAbs did not react with any components of crude extracts of Oriental and German cockroaches as determined by immunoblot analysis and ELISA. A mAb-based double-antibody sandwich ELISA was developed, and the ELISA was dose-dependent and capable of detecting as little as 140 ng of Cr-PI allergen.

Allergens↗
PubMed1990

Collagen autoimmunity to rheumatoid arthritis.

In this study, 26 patients with rheumatoid arthritis (RA), 10 with gout, 8 with scleroderma and 10 healthy volunteers were included. Antibodies to native and denatured human collagen types I, II and III were measured by an enzyme linked immunosorbent assay (ELISA). The frequencies of antibodies to native collagen type II were 19% in the sera of 26 patients with RA. These antibodies were also cross-reacted with collagen types I and III and generally, their activities to collagen in synovial fluids were higher than that in the serum. Only one in 8 patients with scleroderma showed high serum antibodies to these collagens. However, levels of collagen antibodies in patients with RA were not correlated with levels of rheumatoid factor, IgG, IgM and IgA. There was no different in the interleukin (IL)-1 production by synovial cells stimulated by collagens from patients with either RA or gout. The correlation between anti-collagen antibodies and HLA-DR4 antigen was poor, though the presence of DR4 was common in patients with RA. These evidences suggest that collagen antibodies were important to joint pathology only in some of the patients with RA. Thus, collagen autoimmunity warrants further investigation.

Arthritis, Rheumatoid↗