Biomedical subjects

R B Tang

Publications and source records attributed to R B Tang.

At least 37 records · Page 2Linked to original sources

PubMed1997

Interferon-gamma in cerebrospinal fluid of children with aseptic meningitis.

BACKGROUND: Certain cytokines may contribute to the sequence of events that lead to meningeal inflammation in bacterial meningitis. However, their role in viral meningitis is not so less well defined. We determined the cytokines levels in the cerebrospinal fluid (CSF) of children with aseptic meningitis and discussed their relationship with clinical and laboratory findings. METHODS: We determined the concentrations of interleukin-1 beta (IL-1 beta), interferon-gamma (IFN-gamma) and granulocyte-macrophage colony-stimulating factor (GM-CSF) in the CSF of 62 patients with aseptic meningitis including 17 patients with culture-proved enteroviral meningitis, and from 19 control acute febrile patients without meningitis. RESULTS: The GM-CSF in the cerebrospinal fluid was detected from one of the 62 patients with aseptic meningitis and none of the 19 controls. Fourteen (23%) of the 62 patients with aseptic meningitis and 2 (10.5%) of 19 controls had detectable IL-1 beta. There was no significant difference in IL-1 beta levels between patients with aseptic meningitis (4.4 +/- 11.4 pg/ml) and control group (2.4 +/- 7.7 pg/ml). The CSF IFN-gamma level was detectable in 40 (65%) of 62 patients and 6 (31.6%) of 19 controls. The mean CSF IFN-gamma concentration was significantly higher in patients with aseptic meningitis when compared with that in control group (37.9 +/- 48.8 pg/ml vs 17.5 +/- 29.7 pg/ml; p = 0.007). CONCLUSIONS: IFN-gamma was detectable in the CSF in 65% of patients with aseptic meningitis and the role of interferon-gamma remains to be determined.

Adolescent↗

PubMed1996

The clinical evaluation of an outbreak of aseptic meningitis in children.

BACKGROUND: Aseptic meningitis is a common disease in children; The present report describes the clinical and laboratory studies of 62 children involved in an outbreak of aseptic meningitis. METHODS: Sixty-two children with aseptic meningitis having been hospitalized from February to June 1993 were evaluated. The clinical data were obtained by review of the medical records. Initial cerebrospinal fluid (CSF) laboratory values were recorded, and CSF specimens were submitted to determine the viral etiology. RESULTS: Thirty-three percent of the cases were aged 2-5 years. Echovirus 30 was isolated from CSF specimens in 17 children, this is the only virus isolated from CSF during this period. The illness was characterized by transient fever, headache and vomiting. There was wide variation in the number of leukocyte from 14 to 2333 cell/mm3 in the spinal fluid. CSF protein ranged from 19 mg/dL to 114 mg/dL, and CSF sugar was normal in all specimens. Virus isolation was related to the cell count in CSF. There was no significant relationship between CSF cell count and protein content (r = 0.162, p = 0.2237). Hospital stay ranged from 1 to 14 days with an average of 3.9 days. CONCLUSIONS. The disease was mild and self-limiting without death or complication. Enterovirus isolation from CSF can substantially establish the diagnosis and the subsequent management, therefore, early discharge is expectable.

Adolescent↗

PubMed1996

Determination of the food specific IgE antibodies: comparison of MAST-CLA and CAP systems.

BACKGROUND: This study was carried out to compare two techniques used to determine the food specific IgE antibody. METHODS: Thirty-four allergic patients were evaluated for most common food IgE antibodies by multiple allergosorbent chemiluminescent assay (MAST-CLA). IgE antibodies to eight of these food allergens were also measured by Pharmacia CAP (CAP) test. RESULTS: The food specific IgE showed good agreement between MAST-CLA and CAP (kappa = 0.3-0.77). The sensitivity of MAST-CLA assay for food specific IgE antibody was variable comparing with that of CAP system. The accuracy ranged from 0.76 to 0.97. The agreement between the results of MAST-CLA and skin test was variable (kappa = 0.03-0.58). The agreement was poor in wheat, peanut and soybean (kappa = 0.03-0.12). Similar result between CAP and skin test was also obtained (kappa = 0.06-0.82). The agreement was poor in wheat (kappa = 0.06) and milk (kappa = 0.15). CONCLUSIONS: Different results might be related to quality of the extract, how they are performed in vitro test and difference of correspondent allergens employed in the tests.

Adolescent↗

PubMed1994

Fungal infection of ventriculoperitoneal shunts in children.

Infection is still the most common complication of shunt procedures in children. However, fungal infection is still considered to be rare. We found that fungi accounted for 17% of shunt infections (8 of 48) in a retrospective study. All of the patients were premature babies and had received a ventriculoperitoneal shunt because of hydrocephalus. The clinical manifestations were subtle and insidious. The time of onset of infection ranged from 1 month to 1 year after the insertion of the shunt. Examination of the cerebrospinal fluid of infected patients showed mild pleocytosis with an elevated protein concentration. Candida species (including Candida albicans, Candida parapsilosis, and Candida tropicalis) or Torulopsis glabrata were isolated. In all but one case, shunts were removed and systemic therapy with amphotericin B was administered. Amphotericin B was given intrathecally to two patients, who did not respond to systemic therapy. Treatment with fluconazole failed for one patient. We suggest performing fungal cultures in cases of shunt infection, especially those involving premature infants. Extraventricular drainage, systemic therapy with amphotericin B, and insertion of a new shunt remain the principal components of the treatment regimen for fungal shunt infections in children.

Amphotericin B↗

PubMed1994

Comparison between skin testing and in vitro testing for diagnosis of allergen in asthmatic children.

BACKGROUND: This study was designed to compare the skin testing and in vitro testing for the diagnosis of most common inhalant allergens in asthmatic children. METHODS: Sixty-two asthmatic children positive to most common allergens in the area of skin tests and multiple allergosorbent chemiluminescent assay (MAST-CLA) were subjected to another Pharmacia CAP test (CAP). RESULTS: The agreement between the results of MAST-CLA and CAP was variable. The correlation coefficient for CAP with MAST-CLA was significant for five allergens except candida, dog dander and Willow pollen when the diagnostic levels of MAST-CLA and CAP were compared with skin test reactions. For all the allergens tested, MAST-CLA showed a sensitivity of 51%, a specificity of 84% and an efficiency of 73%, compared with 57%, 80% and 74%, respectively, in the CAP analysis. CONCLUSIONS: MAST-CLA and CAP can be used as a screening test to measure allergen IgE level. Both MAST-CLA and CAP were comparable in their ability to diagnose of allergy to tested allergens.

Adolescent↗

PubMed1993

Continuous positive airway pressure by nasal prongs in bronchiolitis.

Ten infants with evidence of impending respiratory failure from severe bronchiolitis were successfully treated with continuous positive airway pressure (NCPAP) with double nasal prongs. Their mean (SD) age was 6.7 (3.8) months and mean (SD) body weight was 7.1 (2.1) kg. Respiratory assessments were made immediately before and 2 hours after application of NCPAP. Clinical symptoms, signs, and arterial blood gases improved in all patients, with a significant fall in mean (SD) respiratory rate [71 (6) vs. 54 (9) per minute], mean (SD) heart rate (178(9) vs. 154(15) per minute], and mean (SD) partial pressure of arterial carbon dioxide [Paco2; 48.0 (13.9) vs. 42.4 (12.9) mmHg]. There was a significant rise in mean (SD) arterial blood pH [7.33 (0.05) vs. 7.37 (0.05)] and mean (SD) oxygenation ratio [Fio2/Pao2, 155 (25) vs. 175 (22)]. We believe NCPAP is an effective method, with numerous advantages in the treatment of severe bronchiolitis. Early application of NCPAP is suggested to avoid the need for mechanical ventilation.

Bronchiolitis↗

PubMed1993

Preirradiation chemotherapy for very young children with brain tumors.

Standard management of malignant brain tumors includes either surgical resection alone or surgery followed by irradiation. However, neuroaxis irradiation administered to very young children for primary intracranial tumors is often associated with major late side effects. To delay irradiation and evaluate the efficacy of preirradiation chemotherapy, we treated 9 young children (aged less than 3 years), who had newly diagnosed brain tumors and underwent total or subtotal resection, with a combination of chemotherapy including vinblastine, cisplatin, and etoposide every 3-4 weeks for 6-14 courses between 1988 and 1992. There were malignant gliomas in four patients, medulloblastomas in three, and ependymomas in two. A response to preirradiation chemotherapy (complete remission or partial remission) occurred in seven out of nine cases. Only one patient had progressive disease during the chemotherapy period. Preirradiation chemotherapy with vinblastine, cisplatin, and etoposide might be a highly effective combination allowing delay of radiation therapy in very young children with brain tumors. Acute and subacute toxicity of chemotherapy in this study was mild.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1993

[Comparison of food specific IgE antibody test (RAST) and skin tests in children with atopic dermatitis].

Thirty children with atopic dermatitis were enrolled in our study to evaluate the food specific IgE antibody assay (RAST) and skin tests as a screening test for food hypersensitivity. Our results showed that eight food antigens (fish, shrimp, crab, soybean, milk, egg-white, peanut, wheat) frequently elicited positive hypersensitivity reactions. Twenty-four patients had at least a positive skin reaction to one of the foods tested. Of the 240 skin tests, 30% (72/240) yield positive reactions. Eighteen patients had at least a positive RAST reaction to one of the foods tested, 20.9% (50/240) yield positive reaction. The agreement between skin test and RAST was 79.6%. Crab and shrimp accounted for most frequent positive reaction in both tests. The skin tests produced more positive results in skin testing than RAST, but gave a higher frequency of false positive results. The diagnosis of food allergy may be suspected from the medical history or by food specific IgE antibodies together with skin test as a screening test. Furthermore, the double blind placebo controlled food challenge should be considered as standard for clinical investigations.

Adolescent↗

PubMed1992

Evaluation of a once-a-day theophylline preparation in asthmatic children.

We conducted a study to evaluate the serum theophylline concentrations and dose interval of Theolan preparation in asthmatic children. A series of serum theophylline levels were measured both in 10 asthmatic children taking Theolan once a day and 9 children twice a day. In the once-a-day group, the peak serum theophylline level was greater than 20 micrograms/ml; whereas, in the twice-a-day group, it was mostly between 10 and 20 micrograms/ml. The difference of the peak-to-trough was more fluctuant in the once-a-day group than in the twice-a-day group. These results suggest that Theolan given once a day in the evening can be useful in the management of nocturnal asthma; however, it was difficult for once-a-day administration of Theolan to sustain rigid therapeutic serum theophylline levels. Because of rapid metabolism in children, they may require a more frequent interval than once-a-day dosing to suppress the symptoms of chronic asthma.

Asthma↗

PubMed1991

Changes in the levels of house dust mite specific IgG4 during immunotherapy in asthmatic children.

Serum levels of IgG subclass and house dust mite (Dermatophagoides pteronyssinus, Dpt) specific IgG4 were evaluated during immunotherapy in asthmatic children. Asthmatic children undergoing long-term immunotherapy (more than 2 years) posed a mean value of total serum IgG4 or Dpt-specific IgG4 antibodies significantly higher than that of patients prior to receiving immunotherapy, asthmatic (placebo) controls, or patients undergoing short-term immunotherapy (less than 1 year) (P less than 0.05). The mean levels of serum Dpt-specific IgG4 in all asthmatic groups were also significantly higher than in the non-allergic controls (P less than 0.01). Moreover, the mean level of Dpt-specific IgG4 tended to increase during immunotherapy. A significant correlation between total serum IgG4 and Dpt-specific IgG4 antibodies was noted (r = 0.6243; P less than 0.001). Serial follow-up reveals that Dpt-specific IgG4 levels usually rose significantly with clinical improvement in asthmatic children during immunotherapy. These results suggest that the anti-mite-specific IgG4 antibody may serve as an indicator for clinical outcome of mite allergy during immunotherapy.

Animals↗

PubMed1990

The prevalence of allergic disease and IgE antibodies to house dust mite in schoolchildren in Taiwan.

The prevalence of positive specific IgE antibodies to house dust mites (Dermatophagoides pteronyssinus; D. farinae) was determined by enzyme-linked immunosorbent assay (ELISA) in 5097 (61%) volunteers of 8345 schoolchildren aged between 7 and 14 yr from two government schools. All of them filled out a questionnaire concerning allergic symptoms. Among them, 412 (8.1%) children showed a positive reaction to at least one of the two mite allergens, the range varying between 5.6 and 11.2% according to the child's age. Boys had higher prevalence of positive mite specific IgE than girls (9.8% vs. 6.4%, P less than 0.01), with the overall male to female ratio 1.5:1. The prevalence of bronchial asthma in boys and girls was 5.3% and 3.3% respectively. The positive mite specific IgE antibody in children with asthma and allergic rhinitis was 52% (103 of 198) and 28.7% (193 of 673) respectively. The mean levels of mite specific IgE were not significantly related to the age of onset and severity of asthmatic symptoms (P greater than 0.1), but were significantly different among subjects with current and past asthma (P less than 0.001). It is suggested that the mite-specific IgE may play a role in the pathogenesis of bronchial asthma in children.

Adolescent↗

PubMed1990

Changes of serum-specific IgE antibody titer during hyposensitization in mite-sensitive asthmatic children.

In this study, we used the enzyme-linked immunosorbent assay (ELISA) to evaluate the changes of IgE antibody titer against Dermatophagoides pteronyssinus (D. pteronyssinus) or Dermatophagoides farinae (D. farinae) in asthmatic children after immunotherapy. According to ELISA analysis, a significantly higher mean level of IgE antibody titer to D. pteronyssinus (or D. farinae) was found in nonhyposensitized asthmatic children than in the pediatric control group (p less than 0.001), but there was no significant difference between the group receiving short course (one year or less) immunotherapy and the group without immunotherapy (p greater than 0.05). We also noted the significant reduction of specific IgE antibody to D. farinae and D. pteronyssinus in the hyposensitized group after long-term immunotherapy; namely, 1.5 and 3 years, respectively, compared with the nontreated group (p less than 0.01). Although D. pteronyssinus-specific IgE antibody decreased less rapidly than D. farinae-specific IgE antibody, both kept decreasing throughout the period of immunotherapy. This study also indicates that the ELISA test may be helpful in screening specific IgE antibodies, diagnosing allergic disease, and evaluating therapeutic effects of hyposensitization.

Adolescent↗

PubMed1990

Expression of serum IL-2, IL-2R, and CD8 levels during hyposensitization in house-dust-sensitive asthmatics.

In this study, we used the enzyme-linked immunosorbent assay (ELISA) to evaluate the changes of serum interleukin-2 (IL-2), interleukin-2 receptor (IL-2R), and suppressor/cytotoxicity factor (CD8) in house dust-sensitive asthmatic children during hyposensitization. Patients before immunotherapy presented significantly higher serum levels of IL-2 and IL-2R than normal subjects (p less than 0.001), but these levels became normal after three years of hyposensitization. No significant difference of serum CD8 level was noted between pretreated patients and normal controls. Although the serum CD8 level in treated patients also decreased after three years of immunotherapy, this decrease was not significant compared with the pretreated patients (p greater than 0.05). This study suggests that serum IL-2 and IL-2R markers might be helpful in analyzing allergic states associated with immune activation and in evaluating the therapeutic effects of hyposensitization.

Adolescent↗

PubMed1990

A rapid cold agglutinin test in Mycoplasma pneumoniae infection.

A definite diagnosis of Mycoplasma pneumoniae infection is currently based on cultural method or complement fixation test which is usually retrospective. A rapid cold agglutinin test was developed to determine its value on the early diagnosis of M. Pneumoniae infection. One hundred and thirty patients with pneumonia aged between 5 and 14 years were studied. Blood specimens from all the patients were collected for rapid cold agglutinin test, cold hemagglutination test, and complement fixation test. Thirty patients showed positive, rapid cold agglutinin test. All the patients with positive rapid cold agglutinin test had higher (greater than or equal to 1:32) cold agglutinin titers which were simultaneously performed. The rapid cold agglutinin test had 100% sensitivity and 97% specificity when a cut-off criterion was set at cold agglutinin titer greater than or equal to 1:64. Twenty-five of the 130 cases were serologically proven to have M. pneumoniae infection using complement fixation test or/and cold agglutinin titer. M. pneumoniae was a major cause (21/28) in cold agglutinin-positive pneumonic patients. The positive predictive value of the rapid cold agglutinin test is 70% (21/30). Only 28% (7/25) of the patients with M. pneumoniae infection were diagnosed at acute stage with serological method. We conclude that the rapid cold agglutinin test is of much value in the early detection of M. pneumoniae infection in office or hospital practice in children with pneumonia.

Adolescent↗

PubMed1989

Study of restriction fragment length polymorphisms at the human phenylalanine hydroxylase locus and evaluation of its potential application in prenatal diagnosis of phenylketonuria in Chinese.

Using a human phenylalanine hydroxylase cDNA probe, the restriction fragment length polymorphisms at the human phenylalanine hydroxylase locus have been determined with the restriction enzymes BglII, PvuII, EcoRI + BamHI, MspI, XmnI, HindIII and EcoRV. The frequency of the observed heterozygosity of the restriction site polymorphisms at this locus in a Chinese population is approximately 54%, which is significantly lower than that in Caucasians. No DNA rearrangement or deletion of the phenylalanine hydroxylase locus was detected among mutant phenylalanine hydroxylase genes in seven Chinese classical phenylketonuria (PKU) families. Haplotype analysis of these seven families revealed that the mutant alleles belonged to five different haplotypes, i.e. haplotype 4, 11 and three unreported haplotypes. The majority of normal and mutant phenylalanine hydroxylase genes are confined to hyplotype 4. These results indicate that approximately 42% of Chinese PKU families are informative for prenatal diagnosis of PKU when eight restriction sites linked to the phenylalanine hydroxylase locus are examined.

Alleles↗

PubMed1989

Allergenic components of Candida albicans identified by immunoblot analysis.

Allergenic components of Candida albicans fractionated by SDS-polyacrylamide gel electrophoresis (PAGE) and transferred to nitrocellulose membranes were identified using sera from 30 asthmatic patients who showed positive skin test and RAST (radio-allergosorbent test) to C. albicans. The IgE-binding yeast components in the complex antigen preparation were then detected by reaction with enzyme-labelled anti-human IgE antibodies. They were confirmed by Coomassie blue R-250 staining of the membrane to visualize all protein bands after reaction with the enzyme substrate. The IgE-binding patterns of the sera tested were heterogeneous, displaying a total of 16 identifiable components with molecular weights ranging from 20 to 94 kD. A 40 kD component showed the highest IgE-binding frequency, being recognized by 23 (77%) of the 30 sera examined. The other 15 allergenic components identified were recognized by less than 25% of the sera tested. Only two of the 30 serum samples contained IgE antibodies reactive with seven to eight allergenic components. Ten of the 30 sera reacted with only one allergenic component, and the remaining serum samples recognized two to five of the 16 identified allergens. Results described in this study are applicable to allergen standardization work and provide a basis for further study on the role of C. albicans in clinical allergy.

Antigens, Fungal↗

PubMed1989

Total serum IgE, allergy skin testing, and the radioallergosorbent test for the diagnosis of allergy in asthmatic children.

Correlations of total serum IgE, skin test reactivity, and specific IgE antibodies to selected antigens were evaluated in asthmatic children. There was a significant difference in mean IgE level of each positive RAST score group compared with that of the RAST-negative score for dog epithelium, Candida, ragweed, and Bermuda grass allergen. The correlation coefficient between the total IgE and the RAST to D. farinae was 0.39 (P less than .05). There was no significant correlation between the total IgE and the RAST to D. pteronyssinus, Candida, dog epithelium, ragweed, Eucalyptus pollen, and Bermuda grass (P greater than .05). This indicates a low total serum IgE concentration does not exclude the possibility of significant elevation of specific IgE to a common allergen. Concordance for results of intradermal skin testing and RAST was high for most allergens. Lower efficiency for dog allergen and Candida suggests greater sensitivity of allergy skin testing for these allergens.

Adolescent↗

PubMed1988

Identification of allergens and antigens of Bermuda grass (Cynodon dactylon) pollen by immunoblot analysis.

Allergens and antigens of Bermuda grass pollen fractionated by SDS-polyacrylamide gel electrophoresis and transferred to nitrocellulose membranes were identified using twenty-one sera of Bermuda grass pollen-allergic patients. The IgE- and IgG-binding pollen components transferred to nitrocellulose were detected by reaction with enzyme-labelled anti-human IgE and anti-human IgG, respectively. There was heterogeneity in both IgE- and IgG-binding patterns of the allergic sera tested. Fourteen pollen components, ranging in molecular weight from 16,000 to 88,000 daltons, bound to IgE antibodies. Only two of the fourteen allergens identified reacted with IgE antibodies of more than 50% of the twenty-one allergic sera. The pollen component with a molecular weight of 32,000 daltons showed by far the highest frequency of IgE binding, being recognized by sixteen (76%) of the twenty-one sera examined. Fifteen (71%) of the twenty-one sera tested had IgE antibodies that reacted with more than one of the fourteen allergenic components identified. Pollen components recognized by IgE antibodies also reacted with IgG antibodies, and there were components only recognized by IgG antibodies. Results obtained from this study should be useful both clinically and in research.

Allergens↗