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Biomedical subjects

R Y Lin

Publications and source records attributed to R Y Lin.

At least 19 recordsLinked to original sources
PubMed1992

Malignant rhabdoid tumor arising from soft parts of the right thigh with unusual neurologic manifestation: report of a case.

A case of malignant rhabdoid tumor (MRT) arising from the soft tissue of the right thigh in a 49-year-old Chinese female with peripheral neuropathy is reported. The tumor, exhibiting the salient features of MRT, was composed of sheets and nests of polygonal cells with prominent nucleoli and characteristic paranuclear inclusion-like hyaline globules under light microscopy which corresponded to aggregates of intermediate filaments under electron microscopy. The results of immunohistochemical studies of the tumor cells were also characteristic: cytokeratin (+), vimentin (+), epithelial membrane antigen (EMA) (+), desmin (-), myoglobin (-), leukocyte common antigen (LCA) (-), kappa (-), lambda (-), IgG (-) and IgA (-). Serologic study revealed an M-component of IgA. The clinical evolution of the patient was highly aggressive and inevitably lethal. An adult malignant rhabdoid tumor is unusual, and its association with peripheral neuropathy and the coexistence of an M-component of IgA in this case appears to be unique. In this report, the differential diagnosis of histopathologic features, the association of peripheral neuropathy and the coexistence of an M-component of IgA are discussed.

Female↗
PubMed1992

Pattern of C3, iC3b, and C3d in patients hospitalized for acute asthma.

Twenty-three patients hospitalized for acute asthma were studied for a peripheral blood complement profile consisting of C3, C4, C3d, iC3b, C4d, and Bb concentrations. Compared with normals (n = 22) and patients (n = 10) with acute bacterial infections (ABI), asthmatic patients had significantly higher serum C3 concentrations (P less than .001). Plasma C3d levels and iC3b in asthmatic patients were both comparable to those observed in normal controls, whereas patients with ABI had significantly higher iC3b levels than both other groups. The ratio of iC3b to C3 concentrations were similar in asthmatic patients and controls, and iC3b levels were correlated with total serum C3 levels in asthmatic patients (r = .55, p less than .001) as well as in normal (r = .69, p less than .001). Both of these groups had significantly lower iC3b to C3 ratios compared with the ABI group (P less than .0001). Also observed in asthmatic patients were a significant correlation between serum C4 and C3 levels (r = .83, P less than .001) and a lower mean ratio of plasma C4d to C4 compared with normals (P less than .005). This profile of complement alterations is distinct from that observed in acute bacterial infection. These changes in asthmatic patients may relate to an acute phase reaction phenomenon affecting complement and/or complement regulatory proteins.

Acute Disease↗
PubMed1992

Zidovudine-induced leukocytoclastic vasculitis.

Cutaneous reactions, including acne, pruritus, urticaria, and nail dyschromia, have been associated with zidovudine use. Cutaneous leukocytoclastic vasculitis is characterized by distinctive patterns of dermal perivascular inflammation without visceral involvement. We treated two cases of cutaneous leukocytoclastic vasculitis associated with fever in patients with severe human immunodeficiency virus-related immunodeficiency in which symptoms resolved on withdrawal of zidovudine therapy and recurred after rechallenge with the drug. This unusual hypersensitivity reaction to zidovudine is probably related to the immune dysregulation and the propensity toward allergic phenomena found in human immunodeficiency virus infection.

Adult↗
PubMed1992

A perspective on penicillin allergy.

Clinical situations for which penicillin is indicated as the sole effective treatment are not infrequent and may be increasing in incidence. Penicillin allergy in these circumstances complicates their medical management. The proper evaluation of penicillin allergy is thus crucial to making decisions about alternative antibiotic therapy vs penicillin and the need for desensitization in allergic individuals. The combination of skin testing and assessment of the type of previous penicillin allergic reaction allows designation of patients into those at high risk and those at low risk for subsequent reactions. Penicillin allergy may also complicate the management of infections in which a cephalosporin is the preferred treatment. The available data on cross-reactivity and concurrent hypersensitivity involving these antibiotics and penicillin are incomplete. The current and past literature were reviewed in an attempt to develop practical treatment approaches and to identify clinical questions that need further investigation related to penicillin allergy.

Anti-Bacterial Agents↗
PubMed1991

[An assessment of patients hospitalized for burn injuries].

To study the causes of burn injuries and the nature of their medical treatment, we investigated the medical histories of hospitalized patients admitted to the burn center of Taipei City Ho-Ping Hospital from June 6, 1983 to June 6, 1987. Additionally, a phone interview follow-up on recovery conditions was made. Among the 300 patients admitted, the majority (53.7%) were burned by scalding water, while fire was the second most common cause of burns. The rate of incidence was highest for those aged 0-4 years, and 90% of this age group were victims of scalding. For all age groups, 78.9% of the burns resulted from negligence, with most accidents occurring in a kitchen, factory or workplace, or a bathroom. Men's burns were more severe than women's burns on average. Severe fire burns constituted half of the cases. The majority of the burns affected the front of the limbs, torso, head and neck. The degree of the burns was mixed, but second degree burns were most prominent (36%). Sixty percent of the patients were burned over less than 10% of their body surface. Seasonality was not evident, but most cases occurred between noon and eight o'clock in the evening. Patients with electric burns had the longest hospital stays, averaging 30.5 days, while those burned by scalding had the shortest (16 days). Those with severe burns average 26.5 days. Half (50.7%) of the patients recovered by the time they left the hospital. Examining the death rate by type of burn, we found that the death rate for chemical burns was the highest (10.34%), while the rate was lowest for scalding.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Population characteristics of tuberculosis in an HIV/AIDS registry from an East Harlem Hospital.

The recent increase of tuberculosis nationally and in New York City has been attributed in part to the progression of the acquired immunodeficiency syndrome (AIDS)/human immunodeficiency syndrome (HIV) epidemic. The East Harlem/South Bronx/Bushwick sections of New York City have an especially high incidence of tuberculosis. An HIV/AIDS registry (1986-1990) consisting of 1,312 patients from a community hospital serving East Harlem was examined for population characteristics associated with documented tuberculosis in the registrants. Tuberculosis affected males more commonly than females and was observed in comparable frequency in patients with AIDS-related complex (ARC) (12.9%) and AIDS (15.0%). The proportion of cases in blacks (18.3%) was significantly greater than that in Hispanics (10.4%, chi 2 = 15.196, p = 0.0003) or whites (8.7%, chi 2 = 5.62, p = 0.0171). Among intravenous (IV) drug users, the proportion of tuberculosis cases was also significantly higher in blacks than in Hispanics. These data could be consistent with a difference in exposure to tuberculosis and/or the purported racial susceptibility of blacks to tuberculosis infection. A review of new tuberculosis cases in East Harlem also suggests that blacks are at a greater risk for developing tuberculosis than Hispanics.

AIDS-Related Complex↗
PubMed1990

An improved scheme for the identification of antigens recognized by specific antibodies in two-dimensional gel electrophoresis and immunoblotting.

This paper describes an improved scheme for the identification of antigens in crude extracts recognized by specific antibodies when analyzed by a combination of two-dimensional gel electrophoresis and immunoblotting. First, protein components in gels are electrophoretically transferred to a polyvinylidene difluoride membrane which does not shrink or change dimensions in organic solvents. The efficiency of transfer and the localization of sample proteins on the membrane are checked and recorded by staining the blotting membrane with Fast Green FCF and recording the profile on a transparency. After blocking and the immunoassay, the results are recorded by photography. The sites of immune reaction are marked and the same membrane is restained briefly with Coomassie Brilliant Blue R-250 for the protein profile. Thus antigens in complex mixtures, recognized by antibodies of interest, can easily be identified from the restained membrane. If the whole protein profile is not well demonstrated, when used in combination with the profile recorded on the transparency, spots appearing on the restained membrane can still be used as useful landmarks in the final unequivocal antigenic identification. This improved scheme circumvents problems arising from membrane shrinkage and difficulties in accurately matching immunoreactive spots by conventional procedures and thus provides an accurate, simple and fast approach in the identification of antigens after immunoblotting.

Antibodies, Monoclonal↗
PubMed1990

Close relationships between neopterin and beta-2-microglobulin levels in intravenous drug abusers.

Serum from 36 intravenous drug abusers without acquired immunodeficiency syndrome (AIDS) or AIDS-related complex were tested for concentrations of neopterin and beta 2-microglobulin. The seroprevalence of human immunodeficiency virus (HIV) antibody in this group was 50%. Previous studies of this group showed that the HIV antibody positive patients had significant increases in HLA-DR expression on peripheral blood lymphocytes and increases in serum soluble CD8 antigen. Both neopterin and beta 2-microglobulin concentrations were significantly higher in the HIV antibody seropositive patients compared to the seronegative patients (p = 0.001 and p = 0.005, respectively). A highly significant positive correlation between neopterin and beta 2-microglobulin was found for the seropositive patients (r = 0.8879, p less than 0.0001) as well as for the entire group (r = 0.6054, p = 0.0002). Significant positive correlations were also found between neopterin or beta 2-microglobulin and the percent DR + T cells and CD8 antigen levels, although these correlations were not as significant as that observed between neopterin and beta 2-microglobulin. No relationships were found between neopterin or beta 2-microglobulin and total CD4 cell concentrations or CD4/CD8 ratios. These data demonstrate the significant interrelationships between various immune activation markers in a population at risk for developing AIDS.

Antibodies, Monoclonal↗
PubMed1990

Assessment of platelet antibody by flow cytometric and ELISA techniques: a comparison study.

Two different methods for evaluating platelet antibody were used to study 12 normal subjects and 24 patients consisting primarily of intravenous drug users (IVDUs) who were positive for human immunodeficiency virus (HIV). Total platelet-associated immunoglobulin G (IgG) and immunoglobulin M (IgM) were measured by enzyme-lined immunosorbent assay on platelet lysate, and platelet surface-associated IgG and IgM were measured by semiquantitative flow cytometry. IgG and IgM values showed significant correlations between the two measurement methods. Mean platelet surface IgG and total IgG were 3.6 and 4.3 times greater, respectively, in IVDUs than in controls, and platelet IgM was also significantly higher in IVDUs than in controls as measured by both techniques. Although mean platelet immunoglobulin levels were higher in the IVDUs with thrombocytopenia than in IVDUs with normal platelet counts, these differences did not achieve significance. These data show that platelet IgG and IgM levels are increased in IVDU-associated HIV infection and suggest that these increases are not confined to patients manifesting thrombocytopenia. The herein described platelet surface antibody and total platelet antibody measurements appear to be equally useful in studying this patient population. Specific details for generating platelet-associated immunofluorescence units are discussed.

Adult↗
PubMed1990

Desensitization in the management of vancomycin hypersensitivity.

Vancomycin is the preferred antimicrobial agent in the treatment of methicillin-resistant staphylococcal infections. One of the well-known hypersensitivity reactions to this agent is the "red-man syndrome," which is believed to involve drug-induced histamine release in certain individuals. Although rate and/or dose reductions may be effective in some cases, some hypersensitivity reactions necessitate the discontinuation of vancomycin. In this article one patient is described who developed vancomycin-associated reactions consistent with the red-man syndrome despite having tolerated vancomycin administration previously. This case was managed by sequential increments in vancomycin administration over several days that allowed for therapeutic doses of the drug to be administered. Prior to desensitization, vancomycin administration at a lowered rate and dose was unsuccessfully attempted, despite the presence of combination antihistamine therapy. A loss of skin prick test reactivity to vancomycin was demonstrated after successful desensitization. This desensitization method may be useful in managing certain refractory cases of vancomycin hypersensitivity.

Adult↗
PubMed1990

Skin prick test responses to codeine, histamine, and ragweed utilizing the Multitest device.

Epicutaneous skin testing is a useful diagnostic tool in evaluating allergic disorders. Utilizing the Multitest device, skin prick test responses to codeine phosphate, histamine phosphate, and ragweed were examined in 56 human subjects. Relationships between the two positive controls, codeine and histamine, and their use as a reference denominator for ragweed reactions were assessed. Ragweed elicited detectable wheals in 15/56. Histamine phosphate (2.75 mg/mL) elicited a positive wheal response in 52/56 subjects, while codeine phosphate elicited a positive wheal in 39/56 and 30/56 subjects at 30 and 3 mg/mL, respectively. Wheal sizes for codeine phosphate at both 30 and 3 mg/mL showed significantly concordant relationships with histamine phosphate-induced wheal sizes (Spearman rho, P = .0084 and .0155, respectively); however the intersubject coefficient of variation was lower for histamine-induced wheal sizes (44%) than for codeine-induced wheal sizes (64% and 65%, respectively for 30 and 3 mg/mL). When a ratio of allergen to positive control reaction size was used to grade ragweed reactions, different patterns were observed using codeine compared with histamine. These results have implications in utilizing codeine phosphate as a positive skin prick test control for allergy testing.

Adolescent↗
PubMed1989

Nuclear imaging and the assessment of human Fc receptor function: studies in systemic lupus erythematosus.

In vivo immune clearance of immunoglobulin G sensitized autologous erythrocytes (rbc) was studied in nine patients who fulfilled American Rheumatism Association (ARA) criteria for systemic lupus erythematosus (SLE). Opsonized rbc were radiolabelled with technetium 99. The rate of radioactive blood clearance was measured, as was organ-specific radioactive uptake utilizing area-of-interest (AOI) measurements in a computerized scintigraphic imaging system. It was shown that dynamic quantitation of an AOI corresponding to the heart generated time-activity curves which approximated blood-clearance curves. Calculation of first order clearance (min per 50% decrease in counts) showed a highly significant correlation between rates derived from heart AOI curves and those derived from blood-clearance curves (r = 0.9483, P = 0.0003). Clearance curves showed a monoexponential slope in most patients. Further exploration of organ-specific AOI curves showed that percent splenic uptake and the nature of the splenic uptake curves varied between patients. These studies point toward a variable splenic role in Fc receptor function for SLE patients and further demonstrate the utility of nuclear imaging in studying immune clearance.

Adult↗
PubMed1989

Levels of soluble CD8 antigen and circulating immune complexes in intravenous drug abusers: relationships to HIV antibody serology.

A total of 36 intravenous drug abusers (IVDA) were studied for circulating immune complexes (CIC) and serum soluble CD8 antigen (sCD8). None had symptoms or signs of AIDS-related complex or AIDS. sCD8 levels were significantly higher in 18 patients who had HIV antibody (Ab) compared with 18 patients who were HIV Ab negative (1640 +/- 578 virus 804 +/- 264 U/ml, p less than 0.0001). In HIV Ab+ patients but not in HIV Ab- patients, sCD8 levels significantly correlated with percentages and absolute numbers of activated CD3+DR+ peripheral blood mononuclear cells (p = 0.0024 and 0.0183, respectively). Also in HIV Ab+ patients, CIC levels were significantly greater for both anti-C3 binding (13.1 +/- 11.1 versus 2.9 +/- 3.4 micrograms/ml, p = 0.002) and C1q binding (23.5 +/- 20.2 versus 6.3 +/- 4.3 micrograms/ml, p = 0.001) CIC. Serum C4 concentrations were lower in the HIV Ab+ patient group (33.9 +/- 10.1 versus 41.6 +/- 12.4 mg/dL, p = 0.043). In the seropositive group, IgG levels were higher (2206 +/- 859 versus 1615 +/- 645 mg/dl) and total CD4 cell counts were lower (757 +/- 344 versus 1172 +/- 402 cells per mm3), but at a less significant level (p = 0.024 and 0.005, respectively), than that seen for sCD8 and C1q CIC differences. These results suggest that elevations of both the lymphocyte activation marker sCD8 and antigen nonspecific CIC characterize earlier stages of HIV infection in IVDA.

Adult↗
PubMed1989

Immunological abnormalities in autoimmune chronic active hepatitis.

Autoimmune chronic active hepatitis is often associated with clinical and laboratory features that resemble those observed in systemic lupus erythematosus (SLE). We describe a 24-year-old woman with autoimmune chronic active hepatitis who was studied for serologic markers of autoimmunity and for immune clearance in terms of in vivo Fc receptor function. A markedly depressed immune clearance and splenic uptake of radiolabelled and IgG coated autologous erythrocytes was observed. The magnitude of this defect equaled or exceeded the most severe defects seen in a group of patients with SLE. This phenomenon was associated with markedly depressed serum C4 levels, a variably positive Sm antibody, and normal circulating immune complex concentrations. In addition, many clinical extrahepatic manifestations meeting criteria for classifying SLE were present. These findings further support the concept of autoimmune chronic active hepatitis and SLE being part of spectrum of overlapping autoimmune diseases.

Adult↗
PubMed1988

Hypocomplementemia and human immunodeficiency virus infection. Clinical correlates and relationships to circulating immune complex and immunoglobulin G levels.

The levels of C4 and C3 were measured and related to other immunological and clinical parameters in 44 patients with the human immunodeficiency virus (HIV) infection. Circulating immune complexes (C1q-CIC) as measured by an enzyme-linked immunosorbent assay employing monoclonal antibody with specificity for bound Clq, and serum immunoglobulin G (IgG) concentrations were assessed simultaneously. Clinical parameters assessed included: (1) the presence of specific anti-infective medications; (2) the presence of hypotension and fluid administration, and (3) bacterial and specific opportunistic infections. Hypocomplementemia was observed in 25 of 46 sera for C3, and in 8 of 46 sera for C4. Clq-CIC increases were seen in 26 of 46 sera and hyper-IgG was present in 25 of 46 sera. Lower C3 concentrations were significantly associated with elevated Clq-CIC levels (p less than 0.001). There were significant correlations between Clq-CIC levels and C3 concentrations (p = 0.0065, negative) and IgG levels (p = 0.0075, positive). Clq-CIC were significantly higher with serum p-24 antigen levels of 50 pg/ml or greater. These data demonstrate that elevated Clq-CIC and hypocomplementemia are both common in HIV-infected patients and may have significant relationships.

Acquired Immunodeficiency Syndrome↗
PubMed1988

T cell immunophenotypes and DR antigen expression in intravenous drug users. Relationship to human immunodeficiency virus serology.

Thirty-six intravenous drug users were studied for peripheral blood mononuclear cell (PBMC) immunophenotypes and human immunodeficiency virus (HIV) serological profiles. This population has a high risk for developing HIV infection. Half (18/36) were HIV antibody (Ab) negative (-) and half were positive (+). Total T lymphocytes (CD3+ and CD2+) were not different between HIV Ab-negative and HIV-positive groups. Unactivated T(CD3+DR-) cells/mm3 were less (p = 0.003) in HIV Ab-positive patients (1,467 +/- 628) compared to HIV Ab-negative patients (2,190 +/- 695). T-helper (CD4+) cells/mm3 were also less in HIV Ab-positive patients (762 +/- 344 vs. 1,161 +/- 419, p = 0.005). The most significant difference was in activated T lymphocyte CD3+DR+) percentages where the mean was 9.6% in those HIV Ab-positive compared to 3.8% in seronegatives (p less than 0.001). Preliminary studies showed that in vitro naloxone treatment of PBMC had no effects on immunophenotypic expression except for CD3+DR+ lymphocytes, where a significant reduction was observed in the HIV Ab-positive group (p = 0.022) but not in the HIV ab-negative group. These findings suggest that in certain populations, activated T cells may be an early manifestation of HIV infection.

Adult↗
PubMed1988

Reiter's syndrome and human immunodeficiency virus infection.

A 35-year-old Black male with a long history of intravenous drug abuse developed clinical manifestations of Reiter's syndrome, with significant joint and psoriasiform skin involvement. In addition, he had signs and symptoms compatible with human immunodeficiency virus (HIV) infection and had a positive HIV antibody test confirmed with Western blot testing. Although many dermatologic manifestations of HIV infection have been described, this is the first time that an association with Reiter's syndrome has been reported. Recently, the development of psoriasis in other patients with HIV infection has been described. Taken together, these occurrences suggest that the purported retroviral relationship with psoriasis and related dermatoses may warrant further examination.

AIDS-Related Complex↗