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Chan MK. Protein loading test before and after kidney donation. AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE 1986; 16:691-4. [PMID: 3548685 DOI: 10.1111/j.1445-5994.1986.tb00014.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Renal response to a 60 g protein load was investigated in 33 normal subjects in terms of creatinine clearance and urinary protein excretion. The test was repeated in 10 of these subjects six months after donor nephrectomy. Creatinine clearance and urinary protein excretion increased significantly one and two hours after ingestion of the protein load (in the form of casein mixture); the change in urinary protein excretion correlated significantly with the change in creatinine clearance (p less than 0.0001). Plasma urea, calcium, and phosphate concentrations increased after protein ingestion, while plasma creatinine and uric acid decreased. Six months after donor nephrectomy the creatinine clearance had decreased but baseline protein excretion had increased. The pre-nephrectomy renal response to protein ingestion (i.e. increase in creatinine clearance and urinary protein excretion) did not predict creatinine clearance of the kidney after donor nephrectomy. After donor nephrectomy, the single kidney was able to increase creatinine clearance after a protein load, although qualitatively the response was different from that obtained with two kidneys in situ.
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152
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Lam KS, Chan MK, Yeung RT. High-density lipoprotein cholesterol, hepatic lipase and lipoprotein lipase activities in thyroid dysfunction--effects of treatment. THE QUARTERLY JOURNAL OF MEDICINE 1986; 59:513-21. [PMID: 3763814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We have investigated the effects of hyper- and hypothyroidism (clinical and subclinical) on lipid metabolism, with special emphasis on serum high-density lipoprotein cholesterol, post-heparin plasma hepatic lipase and lipoprotein lipase activities. In 16 patients with hyperthyroidism, increased post-heparin plasma hepatic lipase activity, decreased serum total cholesterol and serum high-density lipoprotein cholesterol were found while lipoprotein lipase activity and serum triglyceride were normal. In six patients with overt hypothyroidism serum total cholesterol and triglyceride were increased, post-heparin plasma hepatic lipase and lipoprotein lipase were decreased while serum high-density lipoprotein cholesterol was normal. In six patients with subclinical hypothyroidism, serum total cholesterol was increased, serum high-density lipoprotein cholesterol was decreased, while serum triglyceride, post-heparin plasma hepatic lipase and lipoprotein lipase were normal. When the three groups of patients became euthyroid, serum total cholesterol, serum triglyceride, post-heparin plasma hepatic lipase, lipoprotein lipase, and serum high-density lipoprotein cholesterol reverted to normal except for serum high-density lipoprotein cholesterol in the hyperthyroid group which showed no significant change with treatment. A positive correlation was found between serum T3 and post-heparin plasma hepatic lipase while negative correlations were found between serum total cholesterol and serum T3, post-heparin plasma hepatic lipase and serum total cholesterol, lipoprotein lipase and serum triglyceride respectively. Thus in these patients with thyroid dysfunction, significant reversible alterations in serum total cholesterol, triglyceride and high-density lipoprotein cholesterol were found and could be correlated with the observed changes in the activities of hepatic lipase and lipoprotein lipase.
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153
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Chan MK, Minta JO. Modulation of phospholipid methylation in rabbit leukocytes by indomethacin. Inflammation 1986; 10:67-77. [PMID: 3007356 DOI: 10.1007/bf00916042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Methylation of membrane phospholipids has been implicated as an early biochemical signal for the chemotactic migration of phagocytic cells into inflammatory sites. In this study, the ability of indomethacin to modulate phospholipid methylation as one of its mechanisms of antiinflammatory action was investigated. Nontoxic doses of indomethacin (10(-4) M and 10(-5) M) were found to retard the methylation of phosphatidylmonomethylethanolamine (PMME) to phosphatidyldimethylethanolamine (PDME) and phosphatidylcholine (PC) in rabbit leukocytes, suggesting inhibition of methyltransferase II activity. Indomethacin was, however, without effect on the uptake of L-[methyl 3H]methionine by rabbit leukocytes. It is suggested that the inhibition of membrane phospholipid methylation could result in the suppression of inflammatory responses such as prostaglandin and leukotriene synthesis, generation of reactive oxygen radicals, and chemotaxis.
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154
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Yin PD, Chan KW, Chan MK. Minimal change nephrotic syndrome presenting after acute decompression. BMJ : BRITISH MEDICAL JOURNAL 1986; 292:445-6. [PMID: 3081117 PMCID: PMC1339424 DOI: 10.1136/bmj.292.6518.445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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155
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Ng WL, Loke SL, Yeung CK, Kwan S, Chan KW, Chan MK. Clinical and histopathological predictors of progressive disease in IgA nephropathy. Pathology 1986; 18:29-34. [PMID: 3725430 DOI: 10.3109/00313028609090824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The clinical course and biopsy findings of twenty-one patients with IgA nephropathy, followed up for a mean period of 37.4 mth (range 24-54 mth) after diagnosis, were reviewed retrospectively to determine whether the clinical presentations, the laboratory findings or histopathologic changes have prognostic implications. An age of 24 yr or above and a serum creatinine of 0.18 mmol/l or above at diagnosis correlated significantly with renal insufficiency at the end of the follow-up (P = 0.023 & 0.03). Proteinuria of 1.5 g/d or more and hypertension (systolic greater than 150 mmHg or diastolic greater than 100 mmHg) when well controlled, were not found to be significant. Asymptomatic proteinuria and gross hematuria, on the other hand, correlated negatively with renal insufficiency at the end of the follow up (P = 0.034). With respect to histopathological changes, greater than 30% global glomerular sclerosis and moderate or marked tubular atrophy correlated significantly with renal insufficiency (P = 0.005 and 0.005). However, less than 10% glomerular crescents, small amounts of mesangial electron dense deposits or absent ultrastructural peripheral glomerular capillary wall abnormalities correlated negatively with renal insufficiency (P = 0.017, 0.03 & 0.03).
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156
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Kan SK, Singh N, Chan MK. Oliva vidua fulminans, a marine mollusc, responsible for five fatal cases of neurotoxic food poisoning in Sabah, Malaysia. Trans R Soc Trop Med Hyg 1986; 80:64-5. [PMID: 3727000 DOI: 10.1016/0035-9203(86)90197-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This is the first report in which a marine mollusc, Oliva vidua fulminans (olives), generally not known to be poisonous, was responsible for death in five children after consuming boiled olives with tamarind. The onset of symptoms was rapid 10 to 20 min after consumption of the olives. Signs and symptoms included nausea, vomiting, abdominal pain, tingling sensation around the lips, numbness around the mouth, drowsiness, lethargy and generalized weakness with paraesthesia in the limbs. The five deaths occurred within 3 to 4 hours after eating the poisoned olives and resulted from respiratory failure. Left-over olives from the affected household and freshly collected live olives had a toxicity of 14,200 mouse units (M.U.) and 15,000 M.U. per 100 g meat respectively. No other common chemical poison and organophosphorus insecticides were detected. The neurotoxic agent was acid and heat stable and was toxic at pH less than 4. Its action was similar to that of paralytic shellfish poisoning which was caused by toxins from certain dinoflagellates.
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157
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Pun KK, Yeung CK, Chan MK. Effects of nadolol and propranolol on renal function in hypertensive patients with moderately impaired renal function. Br J Clin Pharmacol 1985; 20:401-4. [PMID: 3907676 PMCID: PMC1400880 DOI: 10.1111/j.1365-2125.1985.tb05084.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Effects of oral administration of equipotent antihypertensive doses of propranolol and nadolol on renal function were examined in 20 hypertensive patients with moderately impaired renal function. Creatinine clearance increased, and serum beta 2-microglobulin concentrations decreased, when patients were switched from propranolol to nadolol therapy (creatinine clearance = 46.7 +/- 4.9 ml min-1 on propranolol and 52.7 +/- 5.9 on nadolol; beta 2-microglobulin = 6.14 +/- 0.66 mg l-1 on propranolol and 5.62 +/- 0.62 on nadolol). When patients were put back on propranolol, their creatinine clearances (45.9 +/- 5.0 ml min-1) and serum beta 2-microglobulin concentrations (6.51 +/- 0.67 mg l-1) returned to values comparable to those obtained before the change to nadolol was made. Serum beta 2-microglobulin concentrations correlated significantly with creatinine clearance (r = -0.819, P less than 0.001).
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158
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Chan MK, Minta JO. Effects of anti-inflammatory and anti-rheumatic drugs on the activities of purified and membrane-bound Na+/K+ adenosine triphosphatase. IMMUNOPHARMACOLOGY 1985; 10:61-7. [PMID: 2997083 DOI: 10.1016/0162-3109(85)90060-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We have examined the effects of anti-inflammatory and anti-rheumatic drugs on membrane-bound and purified Na+/K+-ATPase activity in vitro. Only the gold-containing compounds (gold sodium thiomalate and auranofin) were found to inhibit the enzyme activity in a dose-dependent manner. Sodium thiomalate and triethylphosphine, the ligand compounds for gold sodium thiomalate and auranofin, respectively, had no effect on ATPase activity. The antagonistic properties was abolished by preincubation of the gold compounds with dithiothreitol. Lineweaver-Burke analysis of the inhibitions of purified ATPase by the gold compounds was found to follow uncompetitive kinetics. Inhibition of ATPase by gold may cause disruption of transmembrane cation transport and thus result in impairment of several metabolic processes and cellular functions.
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159
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Yeung CK, Ng WL, Wong WS, Wong KL, Chan MK. Acute deterioration in renal function in systemic lupus erythematosus. THE QUARTERLY JOURNAL OF MEDICINE 1985; 56:393-402. [PMID: 4095251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In a retrospective study of 196 hospital admissions for systemic lupus erythematosus (SLE) over five years acute deterioration in renal function occurred in 36 admissions (18.4 per cent) and was the commonest mode of deterioration of renal function in SLE patients. Active lupus accounted for the majority of cases, with crescentic WHO IV lupus glomerulonephritis (greater than or equal to 50 per cent crescents) the commonest underlying pathology. In 19 per cent of these 36 admissions, it was most likely that concurrent infections at onset precipitated the episodes. Central nervous system lupus and infections were the major causes of death. Recovery of renal function was, however, achieved in 76 per cent using mainly pulse methylprednisolone and immunosuppressives as well as elimination of provoking factors especially infections.
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160
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Hii J, Kan S, Pereira M, Parmar SS, Campos RL, Chan MK. Bancroftian filariasis and malaria in island and hinterland populations in Sabah, Malaysia. TROPICAL AND GEOGRAPHICAL MEDICINE 1985; 37:93-101. [PMID: 3898498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
An epidemiological survey of filariasis and malaria in Banggi Island and Upper Kinabatangan, Sabah, revealed microfilarial rates of 7.2% and 8.6% respectively and malaria prevalence of 9.7% and 16.9% respectively. Wuchereria bancrofti was a rural nocturnally periodic type with a periodicity index of 137.2 and average peak hour at 01.32 hrs; 9.2% of microfilaremic carriers as compared to 2.4% amicrofilaremic subjects had clinical filariasis. The Plasmodium falciparum: P. vivax: P. malariae ratios were 1:1:0.17 and 1.4:1:0.12 for Banggi and Upper Kinabatangan respectively. Anopheles flavirostris was incriminated as a new malaria vector in Banggi where the well-known primary malaria vector is An. balabacensis. The latter was also found for the first time to be a vector of rural W. bancrofti in Upper Kinabatangan. Experimental feeding also showed that L3 larvae of W. bancrofti were recovered at low rates from An. balabacensis. Aedes togoi appeared to be a suitable laboratory vector for W. bancrofti.
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161
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Chan MK, Yeung CK. Captopril-induced natriuresis, polyuria, and acidification defect after renal transplantation. AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE 1985; 15:362-3. [PMID: 3904699 DOI: 10.1111/j.1445-5994.1985.tb04061.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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162
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Sham MK, Pun KK, Yeung CK, Ng WL, Chang WK, Chan MK. Hepatitis B induced glomerulonephritis, fact or fiction? AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE 1985; 15:356-8. [PMID: 3864431 DOI: 10.1111/j.1445-5994.1985.tb04057.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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163
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164
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Yeung CK, Wong KL, Wong WS, Chan MK, Ng WL. Unusual transformations of renal involvement in systemic lupus erythematosus. AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE 1985; 15:69-71. [PMID: 3859270 DOI: 10.1111/j.1445-5994.1985.tb02741.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The clinical course of a woman with systemic lupus erythematosus demonstrated that renal involvement in this disease can change, both in the predominant site of renal injury and in the pattern of glomerular lesions. Over 50 months she had first tubulo-interstitial lupus nephritis with no glomerular change, then a membranous nephropathy with disappearance of tubulo-interstitial inflammation, and finally crescentic glomerulonephritis. This case emphasizes the need for close follow-up of all lupus patients regardless of their initial renal manifestations and pathology.
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165
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Chan MK, Browning AK, Poole CJ, Matheson LA, Li CS, Baillod RA, Moorhead JF. Cefuroxime pharmacokinetics in continuous and intermittent peritoneal dialysis. Nephron Clin Pract 1985; 41:161-5. [PMID: 4047273 DOI: 10.1159/000183573] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Pharmacokinetics of cefuroxime was studied in patients on continuous ambulatory or intermittent peritoneal dialysis. A single intravenous bolus (15 mg/kg) of cefuroxime provided a mean serum concentration of 86 mg/litre 5 min, 40 mg/litre 1 h, 163 mg/litre 24 h after the injection. The peritoneal clearance of cefuroxime varied widely among different individuals, ranging from 1.45 to 6.17 ml/min with a mean of 3.59 ml/min during 4-hour exchanges, and from 0,52 to 11.3 ml/min during 2-hour exchanges. A single injection (15 mg/kg) of the antibiotic could not provide satisfactory antibiotic concentrations in peritoneal effluent during peritoneal lavage. When cefuroxime had been added to peritoneal dialysis solution before the solution was instilled into the peritoneal cavity, a significant decrease in cefuroxime concentration occurred in the peritoneal effluent even after a short equilibration time. Furthermore, cefuroxime concentrations measured in residual dialysis solutions in the plastic bags ranged from 44.3 to 1,351% of the concentration of cefuroxime calculated from the added doses, indicating that despite great care, mixing of the antibiotic with dialysis solutions in plastic bags was far from uniform.
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166
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Chan MK, Persaud JW, Varghese Z, Moorhead JF. Post-heparin hepatic and lipoprotein lipase activities in nephrotic syndrome. AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE 1984; 14:841-7. [PMID: 6598053 DOI: 10.1111/j.1445-5994.1984.tb03786.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Lipid metabolism was studied in 18 patients with nephrotic syndrome due to various glomerulonephritides. Nephrotic patients had hypercholesterolemia with or without hypertriglyceridemia. The mean serum high-density lipoprotein cholesterol concentration was not significantly reduced in nephrotic patients. Hepatic lipase and lipoprotein lipase activities were measured selectively in post-heparin plasma from all 18 patients using a substrate-specific method. The mean lipoprotein lipase activity in nephrotic patients was markedly reduced while the mean hepatic lipase activity was not significantly different from that of controls. Lipoprotein lipase activities correlated inversely with serum triglyceride concentrations, but positively with in vivo post-heparin fractional clearance rates of Intralipid and with serum high-density lipoprotein concentrations. Nephrotic serum inhibited lipoprotein lipase activity in normal subjects. The percentage inhibition, however, did not correlate with the degree of hypertriglyceridemia. A relatively weak inverse correlation was shown to exist between plasma albumin concentration and hepatic lipase activities.
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167
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Chan MK. Peritoneal dialysis--a review with consideration of the role of CAPD in renal replacement therapy in developing countries. Singapore Med J 1984; 25:212-5. [PMID: 6505720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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168
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169
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Chan MK, Persaud J, Varghese Z, Moorhead JF. Pathogenic roles of post-heparin lipases in lipid abnormalities in hemodialysis patients. Kidney Int 1984; 25:812-8. [PMID: 6471667 DOI: 10.1038/ki.1984.94] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The relative roles of hepatic lipase and lipoprotein lipase in the pathogenesis of uremic lipid abnormalities were studied in 92 hemodialysis patients. Fasting serum cholesterol, triglyceride, and HDL-cholesterol concentrations were measured. Plasma lipoprotein electrophoretic patterns were determined in all patients. Hepatic lipase and lipoprotein lipase activities were selectively measured in post-heparin plasma in 59 patients. Hemodialysis patients had higher serum triglyceride and lower HDL-cholesterol concentrations than did their age and sex-matched control subjects. Both hepatic and lipoprotein lipase activities were reduced in hemodialysis patients. An inverse relation between lipoprotein lipase activities and serum triglyceride concentrations emerged. Lipoprotein lipase activities correlated with in vivo post-heparin fractional clearance rates of Intralipid. A positive correlation between lipoprotein lipase activities and HDL-cholesterol concentrations probably reflected impaired catabolism of triglyceride-rich lipoproteins being responsible for the low HDL-cholesterol concentrations. Hemodialysis patients (41.3%) had an abnormal lipoprotein (the 'mid-band'). While hepatic lipase activities did not correlate with any parameters of lipid metabolism, patients with 'low' hepatic lipase activities had a significantly higher prevalence of 'mid-bands' than did those with 'normal' activities. No evidence was developed to prove that the 'mid-band' lipoproteins were remnant particles.
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170
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Pun KK, Yeung CK, Ho PW, Lin HJ, Chan MK, Yeung RT. Effects of propranolol and hemodialysis on the response of glucose, insulin, C-peptide and cyclic AMP to glucagon challenge. Clin Nephrol 1984; 21:235-40. [PMID: 6329569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Hypoglycemia is frequently reported in hemodialysis patients on propranolol. We studied the influence of propranolol on carbohydrate metabolism in sixteen hemodialysis patients (eight on propranolol and eight not) with pre-dialysis oral glucose tolerance tests (OGTT) and pre- and post-dialysis glucagon tests. Propranolol was shown to have significant suppressive effect on the insulin response during OGTT. With glucagon challenge pre- and post-dialysis, despite a similar cAMP response, patients on propranolol had significantly lower glucose response than those not receiving propranolol and it is postulated that this is due to post-receptor post-cAMP inhibition of hepatic glycogenolysis. Moreover, while the glucose response in patients not on propranolol significantly increased after dialysis, no significant change was found in patients on propranolol. The significantly higher C-peptide, insulin and cAMP responses to glucagon challenge in the hemodialysis patients as compared to normal controls may be due to delayed clearance of glucagon, and the further increased responses after dialysis may be due to the removal of a dialyzable factor suppressing these responses.
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171
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Chan MK, Sweny P, El Nahas AM, Farrington K, Fernando ON, Moorhead JF. Captopril in hypertension after renal transplantation. Postgrad Med J 1984; 60:132-4. [PMID: 6369287 PMCID: PMC2417707 DOI: 10.1136/pgmj.60.700.132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Eight hypertensive renal allograft recipients who had received captopril are presented. Captopril in a maximal daily dose of 250 mg enabled the withdrawal of large doses of beta-blocking agents and vasodilators. Blood pressure was satisfactorily controlled in all except one. No adverse side effects were observed other than the 'first dose' effect which resulted in transient anuria in one patient. Captopril appears to be a useful agent in the management of severe hypertension after renal transplantation.
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172
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Chan MK. Cyclophosphamide: a drug profile. JOURNAL OF THE ASSOCIATION OF PEDIATRIC ONCOLOGY NURSES 1984; 1:30-33. [PMID: 6565777 DOI: 10.1177/104345428400100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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173
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Hii JL, Kan S, Foh CK, Chan MK. Anopheles (Cellia) balabacensis Baisas is a vector of Wuchereria bancrofti in Sabah, Malaysia. Trans R Soc Trop Med Hyg 1984; 78:281-2. [PMID: 6380019 DOI: 10.1016/0035-9203(84)90302-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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174
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Chan MK. Asparaginase: a drug profile. JOURNAL OF THE ASSOCIATION OF PEDIATRIC ONCOLOGY NURSES 1984; 1:38-40. [PMID: 6563076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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175
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Moorhead JF, Chan MK, El-Malik F, Malik S, Raftery M, Baillod RA, Fernando ON, Varghese Z. Blood transfusion for renal transplantation: benefits and risks. KIDNEY INTERNATIONAL. SUPPLEMENT 1983:S-20-3. [PMID: 6224040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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176
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Moorhead JF, El-Nahas M, Harry D, Persaud JW, Mayne K, Chan MK, Varghese Z. Focal glomerular sclerosis and nephrotic syndrome with partial lecithin:cholesterol acetyltransferase deficiency and discoidal high density lipoprotein in plasma and urine. Lancet 1983; 1:936-7. [PMID: 6132255 DOI: 10.1016/s0140-6736(83)91368-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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177
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Moorhead JF, Chan MK, El-Nahas M, Varghese Z. Lipid nephrotoxicity in chronic progressive glomerular and tubulo-interstitial disease. Lancet 1982; 2:1309-11. [PMID: 6128601 DOI: 10.1016/s0140-6736(82)91513-6] [Citation(s) in RCA: 502] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
It is hypothesised that chronic progressive kidney disease may be mediated by abnormalities of lipid metabolism. A series of self-perpetuating secondary events follows an initial glomerular injury. Increased glomerular basement membrane permeability leads to loss of lipoprotein lipase activators, resulting in hyperlipidaemia. Circulating low-density lipoprotein binds with glycosaminoglycans in the glomerular basement membrane and increases its permeability. Filtered lipoprotein accumulates in mesangial cells and stimulates them to proliferate and produce excess basement membrane material. The proximal tubular cells metabolise some of the filtered lipoprotein and the remainder are altered on passage down the nephron. Luminal apoprotein precipitates, initiating or aggravating tubulo-interstitial disease, if the intraluminal pH is close to the isoelectric point of the apoprotein. The hypothesis offers new approaches to the study of chronic progressive kidney disease by proposing a major pathogenetic role for lipid abnormalities.
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178
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Chan MK, Lages W. Eosinophilic fasciitis: visceral involvement. ARCHIVES OF INTERNAL MEDICINE 1982; 142:2201-2. [PMID: 7138168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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179
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Chan MK, Ramdial L, Varghese Z, Persaud JW, Fernando ON, Moorhead JF. Plasma LCAT activities in renal allograft recipients. Clin Chim Acta 1982; 124:187-93. [PMID: 6754140 DOI: 10.1016/0009-8981(82)90386-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Plasma LCAT activities were measured in 51 renal allograft recipients as well in 18 patients before and after successful renal transplantation. The mean plasma LCAT activity of the 51 patients did not differ significantly from that of 27 normal subjects. When the patients were separated into two groups according to whether they had normal or impaired renal function, there was no significant difference in their mean LCAT activities. Plasma LCAT activities correlated significantly with total cholesterol and total triglyceride concentrations. The sequential study demonstrates that the low plasma LCAT activities in uraemic patients rose towards normal after successful transplantation. At the same time, total cholesterol and HDL-cholesterol concentrations also increased. The increase in LCAT activity after renal transplantation is due to increased concentrations of the enzyme and probably reflects increased turnover of triglyceride-rich lipoproteins.
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180
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Chan MK, Hendrickson CS, Taylor KE. Polyarthritis associated with breast carcinoma. West J Med 1982; 137:132-3. [PMID: 7135948 PMCID: PMC1274040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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181
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Chan MK, Kaye RL. Carpal tunnel syndrome as a precursor of polymyalgia rheumatica. ARIZONA MEDICINE 1982; 39:517-9. [PMID: 7138313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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182
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Boss M, Kingstone D, Chan MK, Varghese Z. Contradictory findings in the measurement of free thyroxin after administration of heparin. Clin Chem 1982; 28:1238-9. [PMID: 7074916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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183
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Boss M, Kingstone D, Chan MK, Varghese Z. Contradictory findings in the measurement of free thyroxin after administration of heparin. Clin Chem 1982. [DOI: 10.1093/clinchem/28.5.1238] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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184
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Chan MK, Varghese Z, Persaud JW, Baillod RA, Moorhead JF. Hyperlipidemia in patients on maintenance hemo- and peritoneal dialysis: the relative pathogenetic roles of triglyceride production and triglyceride removal. Clin Nephrol 1982; 17:183-90. [PMID: 7075035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
A study was undertaken in 76 patients on maintenance hemodialysis and 26 patients on maintenance peritoneal dialysis to elucidate the pathogenesis of hyperlipidemia in these patients. A high prevalence of hypertriglyceridemia and low concentrations of high density lipoprotein cholesterol was found. Hemodialysis patients had low or normal total cholesterol concentrations which were significantly lower than those on peritoneal dialysis. The length of treatment did not affect the prevalence of the lipid abnormalities. Both pre- and post-heparin fractional clearance rates of Intralipid were markedly reduced in both groups of dialysis patients and were correlated inversely with serum triglyceride concentrations. However, when compared with normal subjects with similar fractional clearance rates of Intralipid, both groups of dialysis patients had higher serum triglyceride concentrations, probably reflecting increased triglyceride production. Serum triglyceride concentrations in both groups of dialysis patients were positively correlated with plasma immunoreactive insulin levels. Furthermore, a significant inverse correlation was observed between plasma immunoreactive insulin levels and post-heparin fractional clearance rates of intralipid. It was concluded that insulin resistance probably caused the defective triglyceride removal, and that both decreased removal and increased production of triglycerides contributed to the hyperlipidemia in dialysis patients.
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185
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Chan MK, Ramdial L, Varghese Z, Persaud JW, Baillod RA, Moorhead JF. Plasma lecithin-cholesterol acyltransferase activities in uraemic patients. Clin Chim Acta 1982; 119:65-72. [PMID: 7060276 DOI: 10.1016/0009-8981(82)90405-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Plasma lecithin-cholesterol acyltransferase (LCAT) activity was measured in 43 haemodialysis and 15 peritoneal dialysis (CAPD) patients. LCAT activities in both groups of patients were significantly lower than those of normal subjects and did not correlate with any of the other biochemical parameters studied. The effect of intravenous administration of 100 U/kg of heparin on LCAT activity was examined in 21 haemodialysis patients and 19 normal subjects. Heparin inhibited LCAT activity by increasing plasma free fatty acid concentrations. LCAT remained inhibited throughout a dialysis session and returned towards pre-dialysis levels an hour after haemodialysis was discontinued. The cause of the low LCAT activities in the patients was not certain, but did not appear to be due to the presence of inhibitors in the uraemic plasma. The significance of these findings is discussed.
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186
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Chan MK, Persaud JW, Varghese Z, Baillod RA, Moorhead JF. Response patterns to DL-carnitine in patients on maintenance haemodialysis. Nephron Clin Pract 1982; 30:240-3. [PMID: 7099336 DOI: 10.1159/000182473] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
10 hypertriglyceridaemic hemodialysis patients were given dl-carnitine, 600 mg daily, for 8 weeks and then 1.2 g daily for 12 weeks. Serum total cholesterol, total triglyceride, high-density lipoprotein cholesterol and plasma free fatty acid (FFA), glucose, and immunoreactive insulin concentrations were measured at regular intervals during the treatment. Intravenous fat tolerance tests were performed in 9 patients. Plasma FFA concentrations fell and the post-heparin fractional clearance rate of Intralipid increased significantly after all-carnitine administration. While overall no clear-cut effect of dl-carnitine on serum lipids was found, two patterns of response to dl-carnitine could be distinguished: the 'paradoxic' response with a rise in serum triglyceride concentrations and the dual response to two different dosages of dl-carnitine.
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187
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Chan MK, Persaud JW, Ramdial L, Varghese Z, Sweny P, Moorhead JF. Hyperlipidaemia in untreated nephrotic syndrome, increased production or decreased removal? Clin Chim Acta 1981; 117:317-23. [PMID: 7318185 DOI: 10.1016/0009-8981(81)90119-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The relative importance of increased lipoprotein synthesis and decreased lipoprotein catabolism is examined in 13 patients with untreated nephrotic syndrome by the use of intravenous fat tolerance tests analysed in relation to other parameters of lipid metabolism. Increased lipoprotein synthesis in nephrotic patients was indicated by the fact that at a given fractional clearance rate of Intralipid (K2), nephrotic patients had higher serum TG concentrations than did control subjects. A defect in lipoprotein catabolism was also suggested by the frequent finding of intermediate density lipoproteins on electrophoresis and the marginally low (p = 0.05) mean K2 in nephrotic patients. A highly significant (p less than 0.001) positive correlation between HDL-cholesterol concentrations and postheparin fractional clearance rates (K'2) of Intralipid led to the speculation that in the severe nephrotic state (albumin less than 20 g/l) the loss of high density lipoproteins may contribute to the hyperlipidaemia.
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188
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Chan MK, Baillod RA, Tanner A, Raftery M, Sweny P, Fernando ON, Moorhead JF. Abdominal hernias in patients receiving continuous ambulatory peritoneal dialysis. BRITISH MEDICAL JOURNAL 1981; 283:826. [PMID: 6457662 PMCID: PMC1507083 DOI: 10.1136/bmj.283.6295.826] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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189
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Varghese Z, Chan MK, Fernando ON, Sweny P, Baillod RA, Moorhead JF, Hussain MA, Hoffbrand AV. Induction of immunological unresponsiveness by multiple blood transfusion in uraemic patients. Lancet 1981; 2:250-1. [PMID: 6114297 DOI: 10.1016/s0140-6736(81)90492-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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190
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Chan MK, Persaud JW, Varghese Z, Fernando ON, Moorhead JF. Fat clearances and hyperlipidaemia in renal allograft recipients--the role of insulin resistance. Clin Chim Acta 1981; 114:61-7. [PMID: 7018745 DOI: 10.1016/0009-8981(81)90228-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The mechanism of hyperlipidaemia in renal allograft recipients was investigated in 19 patients randomly selected from a cohort of 54 patients with functioning renal allografts. Serum cholesterol, triglyceride and high-density lipoprotein cholesterol concentrations as well as plasma immunoreactive insulin levels were measured in fasting blood samples. Intravenous fat tolerance tests were performed before and 15 min after heparin administration. Renal allograft recipients had reduced fractional clearance rates of Intralipid and a positive correlation was demonstrated between plasma immunoreactive insulin levels and serum triglyceride concentrations. Plasma immunoreactive insulins also correlated inversely with fractional clearance rates of Intralipid. It was concluded that both increased production and decreased removal of lipoproteins contribute to the hyperlipidaemia and that insulin resistance due to corticosteroids was the centre of the problem.
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191
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Chan MK, Baillod RA, Chuah P, Sweny P, Raftery MJ, Varghese Z, Moorhead JF. Three years' experience of continuous ambulatory peritoneal dialysis. Lancet 1981; 1:1409-12. [PMID: 6113364 DOI: 10.1016/s0140-6736(81)92582-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Patients on continuous ambulatory peritoneal dialysis (CAPD) were studied for three years. 29 of them who had been on CAPD for six months or more were compared with patients on intermittent peritoneal dialysis (IPD) and on haemodialysis (HD). CAPD patients had significantly higher levels of HDL-cholesterol than HD patients. Urea, potassium, phosphate, and urate levels were significantly lower, and haemoglobin levels significantly higher, than in the IPD and HD groups. 43 CAPD patients studied had a peritonitis rate of 2.22 episodes per patient-year. CAPD offers an alternative form of dialysis to those unsuitable for HD, but until peritonitis rates can be reduced CAPD cannot rival HD as a long-term treatment.
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192
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Chan MK, Varghese Z, Persaud JW, Fernando ON, Moorhead JF. The role of multiple pharmaco-therapy in the pathogenesis of hyperlipidemia after renal transplantation. Clin Nephrol 1981; 15:309-13. [PMID: 6113904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
A study was undertaken in 54 renal allograft recipients to evaluate the multiple factors contributing to the pathogenesis of hyperlipidemia after renal transplantation. Serum triglyceride concentrations were found to correlate positively with the cummulative prednisolone dose, and with abdominal skin fold thickness. Serum cholesterol concentrations correlated significantly with serum creatinine concentrations. Patients on beta adrenergic blocking agents had lower plasma free fatty acid concentrations and patients on diuretics had higher serum triglyceride concentrations. The implication of these findings are discussed.
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193
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Chan MK, Varghese Z, Moorhead JF. Lipid abnormalities in uremia, dialysis, and transplantation. Kidney Int 1981; 19:625-37. [PMID: 7026870 DOI: 10.1038/ki.1981.62] [Citation(s) in RCA: 183] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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194
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Miller P, Sweny P, Persaud JW, Varghese Z, Farrington K, Chan MK, Baillod RA, Moorhead JF. The effects of vitamin A toxicity on calcium and lipid metabolism in chronic renal failure. PROCEEDINGS OF THE EUROPEAN DIALYSIS AND TRANSPLANT ASSOCIATION. EUROPEAN DIALYSIS AND TRANSPLANT ASSOCIATION 1981; 18:573-578. [PMID: 7036172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Serum vitamin A levels were high in haemodialysis patients, and were found to correlate with plasma calcium, triglyceride, cholesterol and insulin levels. Vitamin A containing multivitamin supplements were found to contribute to increased serum vitamin A levels, and their withdrawal in seven patients caused a significant decrease in serum vitamin A and calcium levels, with no effect on lipid levels. Vitamin A containing preparations should therefore be prescribed with caution in these patients.
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195
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Chan MK, Moorhead JF. Hepatitis B and the dialysis and renal transplantation unit. Nephron Clin Pract 1981; 27:229-32. [PMID: 7022242 DOI: 10.1159/000182060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Different facets of hepatitis B infections are encountered in a renal unit. The viral antigens are implicated in the pathogenesis of some cases of glomerulonephritis. Hepatitis B surface (HBs) antigenaemia frequently persists in dialysis patients who contract the virus and presents a significant health hazard to the attendant staff. Persistent HBs antigenaemia does not jeopardise renal allograft survival. The effect of anti-HBs antibodies is not clear. Transplantation can reactivate latent hepatitis B infections and render patients HBs antigen (HBsAg)-positive. Hepatic malignancies have been observed and increased patient mortality reported in HBsAg-positive renal allograft recipients. The effect of immunosuppression and maternal viral infection on the fetus is open to speculation.
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196
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Chan MK, Varghese Z, Persaud JW, Baillod RA, Moorhead JF. Fat clearance before and after heparin in chronic renal failure--haemodialysis reduces post-heparin fractional clearance rates of intralipid. Clin Chim Acta 1980; 108:95-101. [PMID: 7449141 DOI: 10.1016/0009-8981(80)90297-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The effect of heparin on the kinetics of fat removal was studied in 15 subjects and it became apparent that the fat tolerance test could be performed after the administration of heparin. Therefore, fractional clearance rates of Intralipid were determined before and after heparin in three groups of patients: 18 in chronic renal failure, 11 on peritoneal dialysis and 17 on haemodialysis. Patients on peritoneal dialysis and on haemodialysis had similar serum triglyceride concentrations and comparable fractional clearance rates of Intralipid before heparin was given. However, the latter had significantly smaller increases in fractional rates of Intralipid clearance after the administration of heparin. Either gradual diminution of releasable releasable enzymes by regular heparinisation or activator concentrations becoming rate-limiting could be responsible for the low post-heparin fractional clearance rates observed in haemodialysis patients.
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197
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Chan MK, Britton M. Comparative clinical features in patients with myasthenia gravis with systemic lupus erythematosus. J Rheumatol Suppl 1980; 7:838-42. [PMID: 7205824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The occurrence of myasthenia gravis (MG) with systemic lupus erythematosus (SLE) seems to be more common than random association alone would predict. Moreover, both share immunologic aspects, tissue-directed antibodies and T and B cell abnormalities. To our knowledge, 7 cases of MG in association with SLE have been reported in the English literature in the last 15 yr; in 6 of the 7 cases, MG preceded the SLE; in only 1 reported case and in our case, SLE preceded the MG. The disease that develops later predominates in the prognosis for each patient.
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198
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Chan MK, Fernando ON, Moorhead JF. Hepatic malignancy after renal transplantation in an HBsAg positive patient. THE BRITISH JOURNAL OF CLINICAL PRACTICE 1980; 34:294-5. [PMID: 6257266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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199
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Kan SK, Chan MK. Annual and geographical distribution of Shigella serotypes in Sabah, Malaysia from 1974 to 1978. THE MEDICAL JOURNAL OF MALAYSIA 1980; 35:9-13. [PMID: 7254007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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200
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Fernando ON, Sweny P, Farrington K, Rogers H, Baillod RA, Chan MK, Varghese Z, Moorhead JF. Preliminary experience with cyclosporin A in human renal allografts. Transplant Proc 1980; 12:244-5. [PMID: 6994292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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