PubMed Health⌕ Search

Biomedical subjects

T P Huang

Publications and source records attributed to T P Huang.

At least 19 recordsLinked to original sources
PubMed1995

Renal function in gout patients.

Patients with gouty arthritis were examined at Veterans General Hospital to evaluate whether their renal function is impaired and to define the factor(s), if any, of renal function deterioration. A total of 152 cases were included in the study, and the patients were divided into two groups. One group (n = 80) exhibited pure gout without any associated medical problems or preexisting renal disorders. The second group (n = 72) included patients with gout and hypertension. The group with pure gout was further stratified into patients with tophi (n = 21) and those without (n = 59). Seventy-two sex- and age-matched normal adults served as the control group. We found (1) that the renal function was impaired in the pure-gout group when compared with sex- and age-matched normal individuals (serum creatinine 1.56 +/- 0.64 vs. 0.90 +/- 0.16 mg/dl, p = 0.0001; creatinine clearance 59.91 +/- 30.90 vs. 97.10 +/- 27.19 ml/min, p = 0.0001); (2) that the renal function was significantly more aggravated in patients with clinically visible tophi than in those without (gout with tophi vs. gout without tophi: serum creatinine 1.89 +/- 0.90 vs. 1.44 +/- 0.48 mg/dl, p = 0.040; creatinine clearance 47.27 +/- 31.90 vs. 64.40 +/- 29.53 ml/min, p = 0.030), and (3) that a further significant decline of the renal function was noted in gouty patients with an associated medical illness, i.e., hypertension (gout with hypertension vs. pure gout: serum creatinine 2.10 +/- 0.97 vs. 1.56 +/- 0.64 mg/dl, p = 0.0001; creatinine clearance 45.06 +/- 24.69 vs. 59.91 +/- 30.90 ml/min, p = 0.0029).(ABSTRACT TRUNCATED AT 250 WORDS)

Arthritis, Gouty↗
PubMed1995

Diabetes insipidus as an early sign of pineal tumor.

A 13-year-old boy's acute onset of diabetes insipidus was the first manifestation of a pineal tumor. One year after the physical symptoms of diabetes insipidus occurred, neurological examinations, tumor markers, and computed tomography brain scan were all normal. Three years later, rapid development of neurological changes was observed with the prevailing symptoms of increased intracranial pressure. The changes were related to a pineal germ cell tumor identified by a high level of beta-human chorionic gonadotropin in plasma and neuroradiological investigations, including computed tomography and magnetic resonance imaging. The clinical course of this case is unusual and we advocate the following: (1) the follow-up of children with diabetes insipidus is important for determining whether or not it is an idiopathic type and (2) elevation of plasma beta-human chorionic gonadotropin and development of neurological signs in patients with so-called idiopathic diabetes insipidus should arouse clinical suspicion of an intracranial germ cell tumor. It should be noted that the brain tumor is significant as the underlying pathology of childhood diabetes insipidus.

Administration, Intranasal↗
PubMed1995

Iron metabolism indices for early prediction of the response and resistance to erythropoietin therapy in maintenance hemodialysis patients.

A prospective study with 65 maintenance hemodialysis (MHD) patients on recombinant human erythropoietin (rHuEPO) therapy was conducted to assess the effect of iron balance on responsiveness. An attempt to define the predictors of erythropoietin (EPO) response and identify the specific causes of EPO resistance was undertaken in the present study. The treatment protocol consisted of two stages, the first was rHuEPO therapy for 6 months and the second was iron supplementation plus rHuEPO therapy in patients without response to EPO for the next 6 months. According to the hemoglobin (Hb) changes (increment exceeded 30% of baseline or did not exceed 15% of baseline for 3 consecutive months) and whether or not there was an achievement of target Hb level (>10.5 g/dl), all patients (n = 65) were divided into EPO-responsive (n = 20) and EPO-resistant (n = 45) groups. The EPO-resistant patients were then further stratified into iron-responsive (n = 29) and iron-irresponsive (n=16) groups. Iron metabolism and red cell indices were analyzed prior to and following rHuEPO therapy and iron supplementation.(ABSTRACT TRUNCATED AT 250 WORDS)

Anemia↗
PubMed1995

Intraperitoneal recombinant human erythropoietin therapy: influence of the duration of continuous ambulatory peritoneal dialysis treatment and peritonitis.

This study was performed to investigate the factors that influence intraperitoneal absorption of recombinant human erythropoietin (rHuEPO) and to evaluate the differences of the pharmacokinetics of intraperitoneally administered rHuEPO before peritonitis and after recovery. First, the pharmacokinetics in different groups of continuous ambulatory peritoneal dialysis (CAPD) patients was studied. Thirty-six CAPD patients were enrolled and divided into four groups. Group 1 included 20 patients who were either just placed on CAPD therapy or had been on CAPD for < 1 year, but with a low frequency of peritonitis episodes. Group 1 was divided into four subgroups by body weight (20-30, 31-45, 46-55, and > 55 kg). Group 2, patients who had received CAPD treatment for more than 1 year, was further divided into group 2a and group 2b according to a low or a high frequency of peritonitis episodes, respectively. rHuEPO (100 U/kg) was administered as a single bolus of intravenous, subcutaneous, or intraperitoneal injection. Intraperitoneal rHuEPO was retained for 10 h. The results showed no significant differences between subcutaneous and intraperitoneal administration in group 1 patients. However, peak concentration, time to reach peak serum level, area under the curves, and bioavailability were substantially lower after intraperitoneal than after subcutaneous administration in group 2a and group 2b patients. There was no influence of body size on peak concentration and area under the curve in group 1 patients. Second, comparison of the pharmacokinetics of intraperitoneal administration before and after recovery from peritonitis in group 1 patients revealed that the serum levels of rHuEPO became lower after the occurrence of peritonitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Anti-Nform antibody in hemodialysis patients.

The anti-Nform antibody is produced by dialysis patients following reuse of dialyzers sterilized with formaldehyde and it has been implicated as a cause of hemolytic anemia. Formaldehyde is one of the common disinfectants used for reprocessing capillary hemodialyzers. The safety of formaldehyde and the clinical significance of anti-Nform antibody need further evaluation. Amongst 45 patients practising dialyzer reuse, anti-Nform antibody was detected in 5 (11.1%), but not amongst 111 patients not reusing their dialyzer (p < 0.005). The presence of anti-Nform was not related to the sex, or duration of dialysis with positive anti-Nform antibody. Direct Coombs' test was positive amongst 80% of all tested patients with anti-Nform antibody, and in 38% of patients reusing dialyzers but without anti-Nform antibody. No tests of hemolysis (including direct Coombs' test) discriminated between anti-Nform antibody-positive and -negative patients, nor between anti-Nform antibody patients with and without overt hemolysis. The best diagnostic test for hemolysis in anti-Nform antibody-positive patients was hematocrit rise after cessation of dialyzer reuse. It appears that despite the induction of anti-Nform antibody, hemolysis is rarely a serious consequence of dialyzer reuse.

Adult↗
PubMed1995

Effect of long-term therapy with captopril on proteinuria and renal function in patients with non-insulin-dependent diabetes and with non-diabetic renal diseases.

Several studies have shown that long-term therapy with angiotensin-converting enzyme inhibitors may reduce urinary protein excretion and decrease the rate of progression of renal disease in patients with insulin-dependent diabetes mellitus more effectively than conventional antihypertensive drugs. Only few studies, however, have been performed in patients with non-insulin-dependent diabetes mellitus (NIDDM). To compare the effects of captopril with more conventional drugs on proteinuria and progression of renal disease, we conducted a prospective, 18-month study in 42 proteinuric (> 500 mg/day) NIDDM and, for comparison, in 31 nondiabetic patients with a variety of renal diseases (NDRD). Twenty-four NIDDM patients were treated with captopril and 18 with conventional drugs. Eighteen NDRD patients received captopril, and 13 received conventional drugs. Baseline proteinuria and glomerular filtration rate (GFR) were not different among groups. The blood pressure decreased equally in all group of patients, irrespective of whether they received captopril or conventional drugs. Urinary protein excretion, however, decreased significantly only in NIDDM and NDRD patients treated with captopril. The GFR decreased only in patients treated with conventional drugs, but not in those treated with captopril. The rate of decline in GFR in NIDDM patients treated with captopril was significantly lower than in patients treated with conventional drugs. However, in NDRD patients treated with captopril, the rate of decline in GFR was not different from that in patients treated with conventional drugs. The reduction of urinary protein excretion was poorly correlated with changes in blood pressure or with changes in renal function and renal hemodynamics. Serum potassium increased significantly in patients treated with captopril.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1994

The association of aldosterone-producing adrenal adenoma in a patient with autosomal dominant polycystic kidney disease.

We report a young female with autosomal dominant polycystic kidney disease associated with right adrenal adenoma. Refractory hypertension and hypokalemia were the findings that led to this diagnosis. The diagnostic approach included plasma potassium and aldosterone levels, plasma renin activity, captopril test, saline infusion test, NP-59 scintigraphy, computed tomography, and magnetic resonance imaging. Adrenalectomy completely normalized hypertension and hypokalemia in this patient.

Adenoma↗
PubMed1994

Hypokalemic effects of intravenous infusion or nebulization of salbutamol in patients with chronic renal failure: comparative study.

To examine and compare the efficacy and safety of different routes of administration of salbutamol in treating hyperkalemia, 15 patients with chronic renal failure (blood urea nitrogen > 80 mg/dL, serum creatinine > 8.0 mg/dL) were enrolled to sequentially receive either intravenous infusion (0.5 mg) or nebulization (10 mg) of salbutamol. Five of these patients (33.3%) did not respond to the intravenous salbutamol and were excluded from the study. Both treatments significantly decreased plasma potassium in 10 patients and the decrease was sustained for at least 3 hours. After infusion, the maximal reduction in plasma potassium levels was 0.92 +/- 0.10 mEq/L and occurred after 30 minutes. On the other hand, the maximal reduction in plasma potassium after nebulization (0.85 +/- 0.13 mEq/L) was similar to that after infusion, but it occurred after 90 minutes. Insulin and blood glucose increased, whereas blood pH, PCO2, sodium, osmolality, and blood pressure did not change after either treatment. Heart rate increased significantly after both treatments, but less after nebulization than after infusion. It is concluded that both infusion and nebulization are simple, effective, and safe therapeutic modalities for the treatment of hyperkalemia in patients with chronic renal failure. Infusion should be used in patients requiring a rapid decrease in plasma potassium; nebulization, on the other hand, should be used in patients with coronary artery diseases.

Administration, Inhalation↗
PubMed1994

Gene expression and release of interleukin-8 by peritoneal macrophages and polymorphonuclear leukocytes during peritonitis in uremic patients on continuous ambulatory peritoneal dialysis.

Interleukin-8 (IL-8) has been reported to be released by activated peritoneal macrophages (PMs) and a variety of other cell types, and it exhibits potent chemotactic activity for polymorphonuclear cells (PMNs). We have previously shown that IL-8 is detectable in the drain dialysate of uremic patients on continuous ambulatory peritoneal dialysis (CAPD) during peritonitis. The levels of IL-8 in infected drain dialysate caused by different microorganisms were variable. In this study, we evaluated the gene expression and release of IL-8 by PMs and PMNs during peritonitis caused by Staphylococcus aureus in uremic patients on CAPD. IL-8 levels were variable in the drain dialysate at the different episodes of peritonitis, even in the same patient. The IL-8 levels were highly correlated with PMN count in drain dialysate (r = 0.9919, p < 0.001). PMs and PMNs obtained from drain dialysate at the onset of peritonitis increased mRNA expression for IL-8 and the amount of IL-8 mRNA from drainage cells was also highly correlated with PMN count. In contrast, cells isolated from drain dialysate without peritonitis failed to express mRNA for IL-8. These data suggest that increased expression of IL-8 may be a feature of peritonitis. The levels of IL-8 during peritonitis were not only related to the etiological microorganism but also to other unknown factor(s).

Adult↗
PubMed1994

Comparative effect of oral or intravenous calcitriol on secondary hyperparathyroidism in chronic hemodialysis patients.

The suppressive effects of intravenous (IVC) and oral (ORC) 1,25(OH)2D3 (calcitriol) therapies on parathyroid hormone (PTH) secretion were compared in 10 hemodialysis (HD) patients with secondary hyperparathyroidism (SHPT). These patients were randomized to receive either IVC or ORC therapy for 12 weeks, both followed by a 12-week washout period. After the washout, the patients who received IVC then switched to ORC therapy for another 12 weeks, and the patients who received ORC switched to IVC therapy. The mean dose of IVC was 2.45 +/- 0.30 micrograms/dialysis session (approximately equal to 1.05 micrograms/day) and that of ORC was 0.69 +/- 0.07 micrograms/day. A significant reduction in serum levels of intact PTH was observed after 8 weeks and that of C-PTH after 10 weeks of ORC therapy, but both fell after 6 weeks of IVC treatment. There was a concomitant reduction in serum alkaline phosphatase (AP), but it became significant 4 weeks later than in intact PTH. The maximal reductions of serum levels of intact PTH, C-PTH and AP were 74.28, 64.91, 41.97%, respectively, after IVC, and 31.57, 24.39, 22.50%, respectively, after ORC therapy. Serum calcium rose faster during ORC treatment. There were no significant changes in serum levels of phosphorus, magnesium, and albumin throughout the treatment period. We conclude that both IVC or ORC treatments result in a significant decrement in blood levels of PTH in chronic HD patients with SHPT. However, this PTH-suppressive effect is more pronounced with IVC therapy, and cannot be totally explained by either the higher dose or elevated serum calcium.

Administration, Oral↗
PubMed1994

Ectopic ACTH syndrome with nocardiosis--a case report.

A 25-year-old man was admitted with chief complaints of multiple ecchymoses over face and both arms after a trivial trauma since one month before entry. Physically, he was thin without moon face, buffalo hump, or purple striae, while extensive fungus infection was present. Mild hyperglycemia, hypokalemic alkalosis were also found. Chest x-ray revealed multiple cavitary nodular lesions over bilateral lung fields. Needle biopsy from a rib lesion showed small cell carcinoma with strongly positive ACTH stain. The patient's basal cortisol level was greater than 62 micrograms/dl and failed to be suppressed by both low and high dose dexamethasone. The 24 hours urine free cortisol, 17 KS, and 17 OHCS were 8454 micrograms/24h, 49.8 mg/24h, and 50.8 mg/24h respectively. His plasma ACTH level was 725 pg/ml and remained high (1210 pg/ml) after high dose dexamethasone suppression. On the 10th day after admission, the patient's general condition got worse rapidly. Fever, dyspnea developed with progression of the lung lesions. Nocardia infection was proved. He expired three days later in spite of antibiotics and ketoconazole treatment.

ACTH Syndrome, Ectopic↗
PubMed1994

Intravenous infusion or nebulization of salbutamol for treatment of hyperkalemia in patients with chronic renal failure.

BACKGROUND: Hyperkalemia is one of the frequent medical emergencies in patients with chronic renal failure (CRF). We studied and compared the efficacy and safety of salbutamol either by intravenous infusion (i.v.) or nebulization (NB) in treating CRF patients with hyperkalemia. METHODS: Thirty-four patients (BUN > 80 mg/dl, serum creatinine > 8.0 mg/dl, and plasma potassium > 5.0 mEq/L) were randomly assigned to receive either i.v. (0.5 mg) or NB (10 mg) treatment of salbutamol. Plasma potassium, sodium, osmolarity, glucose, insulin, PCO2, blood pH, blood pressure and heart rate were monitored. RESULTS: One third of i.v. group and one fourth of NB group of patients were resistant to salbutamol treatment and were excluded from the study. All the baseline data were similar between 2 groups. After treatment, significant decrease in plasma potassium was found in both groups. The maximal reduction of plasma potassium was 0.95 +/- 0.14 mEq/L and occurred 30 minutes after i.v. treatment (n = 12) while it was 0.88 +/- 0.13 mEq/L and occurred 90 minutes after NB treatment (n = 12). During the first ninety minutes after treatments, the decrease of plasma potassium in IV group was faster and greater than in NB group. After that, the hypokalemic effect was more profound in NB group till the end of the study. The hypokalemic effects of both treatments sustained for at least 3 hours. Plasma insulin and glucose increased (p < 0.05) in both groups, whereas blood pH, PCO2, sodium, osmolarity and blood pressure did not change significantly. The reduction of potassium was significantly correlated with the elevation of insulin (i.v.: r = -0.56, p < 0.05; NB: r = -0.54, p < 0.05). Heart rate elevated significantly in both groups; nevertheless, this elevation was less marked in NB group. CONCLUSIONS: Both routes of administration of salbutamol resulted in a prompt and significant decrease of plasma potassium concentrations and both are considered as simple, effective and safe alternatives in treating hyperkalemia in patients with CRF. However, i.v. therapy might be preferred in CRF patients requiring a rapid lowering in plasma potassium; nebulization, on the other hand, should be preferred in CRF patients with coronary artery diseases.

Administration, Inhalation↗
PubMed1994

Effect of intravenous calcitriol on secondary hyperparathyroidism in chronic hemodialysis patients.

BACKGROUND: It has become evident that calcitriol can suppress parathyroid hormone (PTH) secretion by direct genomic actions. Intravenous calcitriol that bypasses gastrointestinal degradation might cause less degree of hypercalcemia and greater suppressive effect on PTH secretion. We investigated this PTH-suppressive effect of intravenous calcitriol in hemodialysis patients with secondary hyperparathyroidism. METHODS: Calcitriol was administered at the end of each dialysis session three times a week in 20 uremic patients, for 12 weeks. RESULTS: The mean dosage of calcitriol was 2.72 +/- 0.21 microgram per dialysis session. Serum intact PTH and C-PTH decreased (P < 0.05) after 6 weeks of treatment, while serum alkaline phosphatase (Alk-P) decreased 3 weeks later than PTH did. The individual maximal reduction of intact PTH, C-PTH and Alk-P were 77.80%, 67.36% and 45.98%. This PTH-suppression was dose-dependent. Despite the significant reduction of intact PTH by 58.17% after 6 weeks of treatment, no significant increase of serum calcium was found. An increase in serum calcium is not essential for this PTH-suppressive effect of calcitriol. Our observations thus provide another evidence to support the direct inhibitory effect of calcitriol on PTH secretion. Serum calcium, phosphorus, magnesium, albumin and osteocalcin levels did not change significantly. No side effect was found during treatment. CONCLUSIONS: Intravenous calcitriol is effective and safe in treating hemodialysis patients with secondary hyperparathyroidism. This treatment is more important in patients who are intolerant to oral vitamin D supply and who are candidates for surgical parathyroidectomy.

Adult↗
PubMed1993

The need for second-generation antihepatitis C virus testing in uremic patients on continuous ambulatory peritoneal dialysis.

OBJECTIVE: To assess the prevalence and clinical relevance of a hepatitis C virus (HCV) infection in continuous ambulatory peritoneal dialysis (CAPD) patients by first- (Ortho) and second-generation (Abbott and UBI) HCV antibody enzyme immunoassays. DESIGN: Thirty-two serum samples tested by first-generation HCV antibody enzyme immunoassays (EIA's) were reevaluated using two second-generation HCV antibody EIA's. Basic demographic data, history of blood transfusions, and duration of hemodialysis and CAPD were reviewed. Results were analyzed by chi square analysis, Wilcoxon rank sum, and the paired t-test. SETTING: The medical college's affiliated teaching hospital. RESULTS: The prevalence of the antibody anti-HCV increases with the duration of previous hemodialysis, but not with the duration of CAPD. The positive detection of anti-HCV by second-generation HCV antibody EIA's was higher than first-generation EIA's (25% and 34.4% vs 12.5%). CONCLUSION: The prevalence and clinical relevance of HCV infection can be more accurately studied using the second-generation assays in uremic patients.

Adolescent↗
PubMed1992

Spurious hyperchloremia and decreased anion gap in a patient with dextromethorphan bromide.

Although cold syrup containing dextromethorpan bromide is widely administered, the bromism due to cold syrup has not been reported. We report a patient who had negative anion gap with hyperchloremia and conscious loss because of daily intake of cold complex syrup (containing dextromethorphan bromide 0.4 mg/ml, acetaminophen 8.33 mg/ml) for headache for 4-5 years. The bromide content in cold complex syrup resulted in serum levels of bromide that interfered with the automated analyzers for chloride content. When conscious change is due to bromism, hemodialysis instead of forced hydration and diuresis should be performed immediately. Therefore, patients with a markedly negative anion gap with hyperchloremia should be considered as having halide intoxication.

Bromides↗
PubMed1992

[The long-term effects of cyclosporine on cultured rat mesangial cell].

In recent years, cyclosporine A(CSA) had been extensively used for anti-rejection in organ transplantation. In a high dosage, acute renal failure may occur. In this study, we cultured Sprague-Dawley rat mesangial cells in sandimmune (CSA 1 microgram/ml) and cremophor (13 micrograms/ml) for 2-4 weeks respectively, as the model for a CSA treated patient. A series of experiments were done that included PGE2/cAMP syntheses, mesangial cell proliferation and contraction. The mesangial cells were stimulated with: 1 microM ANGII, 1 microM AVP, 1 microM A23187, 1U/ml IL-1, 25ng/ml PDGF, 1mM IBMX, 10 microM forskolin and 5% fetal bovine serum (FBS). Experimental results were compared between the two groups with the Wilcoxon paired test. The only significant difference was in the cell proliferation study. In conclusion, cell proliferation was inhibited by CSA (p less than 0.05), but the influences of PGE2/cAMP synthesis and cell contraction were minimal on mesangial cells that had been cultured by a CSA contained medium for a relative long period.

Animals↗