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Biomedical subjects

T H Kwan

Publications and source records attributed to T H Kwan.

25 records · Page 2Linked to original sources
PubMed1986

Acid-fast bacilli with cytomegalovirus and herpesvirus inclusions in the skin of an AIDS patient.

A 66-year old acquired immunodeficiency syndrome (AIDS) patient presented with cutaneous lesions suspicious for Kaposi's sarcoma. Biopsies disclosed granulomatous infiltrates with acid-fast bacilli and cytomegalovirus inclusions within macrophages and endothelial cells in one biopsy. Herpesvirus vesicle, necrotizing folliculitis, and vasculitis were observed in a second biopsy taken concurrently. These findings emphasize the polymorphous presentation of infectious disorders in AIDS and the need for multiple biopsies and for work-up with special stains in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Alpha 1-antitrypsin and lysozyme in fibrous papules and angiofibromas.

The large stellate and polygonal cells observed in eleven fibrous papules and two angiofibromas were examined immunohistochemically for alpha 1-antitrypsin and lysozyme. The positive findings suggest that these cells are related to histiocytes rather than nevomelanocytes.

Histiocytes↗
PubMed1984

Dermal hypersensitivity reactions to imported fire ants.

A survey of suburban residents of New Orleans, La., revealed that 58% of the individuals who responded had been stung by imported fire ants (IFA) within the previous year. More than half of the patients stung had dermal reactions that were distinct from the previously reported reactions to IFA in that immediate wheal-and-flare reactions evolved into pruritic, edematous lesions that persisted about the developing pustule for 24 hr or more. Twenty-one volunteers were stung with live IFA, and the course of the reactions was observed. Nine developed persistent reactions after stings. These reactions could be reproduced by the intradermal injection of IFA--whole body extract in only four of these nine subjects. Biopsy specimens of sting reactions at 6 hr demonstrated the reactions to be "late phase reactions" characterized by dense fibrin deposits like those previously noted in dermal reactions to ragweed and insulin. Eosinophils were present in the sting-associated pustules only in individuals who developed late-phase reactions. These data demonstrate that late-phase reactions occur commonly to IFA stings and that this form of insect hypersensitivity may not always be diagnosed by skin testing with whole body extract.

Ants↗
PubMed1982

Bullous pemphigoid, an ultrastructural study of the inflammatory response: eosinophil, basophil and mast cell granule changes in multiple biopsies from one patient.

We have studied by electron and light microscopy the inflammatory reaction in lesions at various stages of clinical development from a patient with bullous pemphigoid. The evolution of clinical lesions was associated with a sequence of histopathologic events which began with alterations of mast cells and proceeded to infiltration, first with lymphocytes and later with eosinophils and basophils. Mast cells in the papillary and reticular dermis demonstrated a unique, focal, irregular loss of granule contents. Intact eosinophils demonstrated intracytoplasmic losses of granule contents and karyorrhectic and karyolytic eosinophils had released membranebound granules. Partially and completely degranulated basophils were present within a fibrin gel which formed in the dermis. Thus, the sequence of histopathologic events in the pathogenesis of bullous pemphigoid includes mast cell granule alterations and release of granule contents from eosinophils which are undergoing nuclear and cytoplasmic damage.

Basophils↗
PubMedDate not supplied

Relationship between adequacy of dialysis and nutritional status, and their impact on patient survival on CAPD in Hong Kong.

OBJECTIVE: Superior patient survival on continuous ambulatory peritoneal dialysis (CAPD) with 3 x 2-L exchanges has been reported from Hong Kong. This study examined the relationship between indices of dialysis adequacy and nutrition and patient survival on CAPD in Hong Kong. DESIGN: A cross-sectional study on prevalent CAPD patients. Patients were assessed for indices of dialysis adequacy and nutritional status with a composite nutritional index (CNI). Patients were then followed for 24 months. Survival data were analyzed according to adequacy indices and nutritional status. SETTING: All prevalent CAPD patients in nine dialysis centers in Hong Kong as of 1 April 1996. MAIN OUTCOME MEASURE: Mortality. RESULTS: 937 patients were assessed: 68.2% were using 3 x 2-L exchanges per day; mean age was 54.6 +/- 13 years. Mean total Kt/V was 1.83 +/- 0.42 and total creatinine clearance was 55.6 +/- 19.5 L/week/1.73 m2. 19% of patients were moderately to severely malnourished according to the CNI. There was no significant correlation between indices of adequacy and serum albumin or CNI. The 1- and 2-year patient survival from the time of assessment was 90.9% and 79.8%. There was a trend toward better survival in patients with Kt/V greater than 2.0, but it was not statistically significant. Peritoneal Kt/V did not impact survival in anuric patients. Malnourished patients had poorer survival than patients who were better nourished (p = 0.0259). After adjusting for age and diabetes, CNI was predictive of mortality but Kt/V and creatinine clearance were not. CONCLUSIONS: This study demonstrates the importance of nutritional status over adequacy indices in predicting patient survival. There was a lack of correlation between nutritional status and conventional indices of dialysis adequacy.

Adult↗