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Biomedical subjects

C C Fu

Publications and source records attributed to C C Fu.

At least 19 recordsLinked to original sources
PubMed2001

Abnormal glucose tolerance in transfusion-dependent beta-thalassemic patients.

OBJECTIVE: To study the prevalence of and risk factors for abnormal glucose tolerance in transfusion-dependent beta-thalassemic patients. RESEARCH DESIGN AND METHODS: A total of 89 transfusion-dependent beta-thalassemic patients were interviewed. Diabetes was previously diagnosed in 14 of them. In the remaining 75 patients, 68 participated in an oral glucose tolerance test. Potential risk factors were identified using the independent t test, chi2 test, and Fisher's exact test. Logistic regression analysis was used to select the independent risk factors that best predicted abnormal glucose tolerance A two-tailed P value of <0.05 was considered to be statistically significant. RESULTS: The prevalence of impaired glucose tolerance was 8.5% (7 of 82) and that of diabetes was 19.5% (16 of 82). Presentation with diabetic ketoacidosis was 31.1% (5 of 16). The risk factors for abnormal glucose tolerance found in transfusion-dependent beta-thalassemic patients were serum ferritin concentration and hepatitis C infection. CONCLUSIONS: The interaction of iron overload and hepatitis C infection worsened the prognosis of thalassemic patients. Aggressive iron-chelation therapy as well as prevention and treatment of hepatitis C infection should be mandatory in managing glucose homeostasis in transfusion-dependent beta-thalassemic patients in Taiwan.

Adolescent↗
PubMed1995

Incidence and progression of diabetic retinopathy among non-insulin-dependent diabetic subjects: a 4-year follow-up.

BACKGROUND: To assess the incidence and progression of diabetic retinopathy and explore risk factors associated with them among non-insulin-dependent diabetes mellitus (NIDDM) patients. METHODS: A total of 471 NIDDM subjects aged > or 40 were recruited from four primary health care centres of northern Taiwan in 1986 and followed up for 4 years. Their ocular fundi were clearly visible by ophthalmoscopy and the status of diabetic retinopathy could be graded. A structured questionnaire interview was conducted to collect basic data. Overnight fasting venous blood was collected every year to measure the levels of glucose, glycosylated haemoglobin (HbA1c), cholesterol and high density lipoprotein cholesterol. RESULTS: Among the 344 subjects who had no retinopathy initially, 66 subjects developed retinopathy 4 years later giving a 4-year cumulative incidence of 19.2%. Of the 120 subjects initially with background or preproliferative retinopathy, evidence of deterioration developed in 36 subjects. The cumulative incidence of progression was 30%. Seven subjects developed proliferative retinopathy giving a cumulative incidence of progression to proliferative retinopathy of 5.8%. The univariate analysis disclosed that the development of retinopathy was correlated with mean fasting blood glucose (MFBG) and HbA1c, diabetic duration, diabetic treatment and residential area. The progression of retinopathy correlated with MFBG and proteinuria, and the progression to proliferative retinopathy correlated with MFBG. Stepwise logistic regression analysis revealed that MFBG and HbA1c were the significant risk factors related to the development of retinopathy. CONCLUSIONS: Diabetic control assessed by MFBG or HbA1c was the significant risk factor correlated with the incidence and progression of retinopathy.

Adult↗
PubMed1994

Maternal role in type 2 diabetes mellitus: indirect evidence for a mitochondrial inheritance.

BACKGROUND: The role of mitochondrial inheritance in type 2 diabetes mellitus has received much attention recently. In this study, three existing datasets in Taiwan are analysed to examine this theory. METHODS: Two of the datasets were community surveys and one a hospital case series. Subjects who had information regarding their paternal or maternal diabetic status were selected for the present study. In the first dataset, 745 subjects had information about paternal diabetic status and 765 had information about maternal diabetic status. In the second dataset, 255 and 267 subjects had the paternal and maternal information, respectively. In the third, a total of 3625 subjects had information about both their paternal and maternal diabetic status. Diabetic status of the study subjects was determined by fasting plasma glucose levels and/or oral glucose tolerance test; their parental diabetic status was collected by interview. RESULTS: The three datasets consistently demonstrated a significantly elevated odds ratio (OR) for reporting maternal diabetes (OR = 2.64, 95% confidence interval: 1.12-5.71) in diabetic patients as compared to non-diabetic subjects. The reporting of paternal diabetes, however, was not significantly different between diabetics and non-diabetics. In addition, the OR for reporting paternal diabetes were not significantly different between groups of different age-at-onset. With respect to maternal history, the OR increased significantly when age-at-onset was younger (test-for-trend P < 0.001). CONCLUSIONS: Our findings support mitochondrial inheritance of type 2 diabetes mellitus in the human population. The age-modifying effect was also in accordance with the mitochondrial oxidative phosphorylation paradigm for degenerative diseases.

Adult↗
PubMed1994

[Retinal S-antigen and retinoblastoma--an immunohistochemical study].

A strain of monoclonal antibody, MabAgC6, which defines an epitope in S-antigen, was used to study S-antigen expression in 10 cases of retinoblastoma, where S-antigen immunoactivity was observed in different patterns: the "normal" photoreceptor elements incorporated in 3 cases of growing tumors, 3 of 4 fleurettes and E-W rosettes, and scattered tumor cells in 50% of the cases were stained positive. The results suggest that the expression of S-antigen in retinoblastoma may be used to assess the degree of tumor differentiation, as another of the tumor markers.

Antibodies, Monoclonal↗
PubMed1993

Development of macrovascular diseases in NIDDM patients in northern Taiwan. A 4-yr follow-up study.

OBJECTIVE: To assess the development of macrovascular diseases and explore major associative factors in NIDDM. RESEARCH DESIGN AND METHODS: A total of 479 NIDDM patients > or = 40 yr of age were recruited from four community primary care health centers of northern Taiwan in July 1986 for a cohort study with a 4-yr follow-up. No patient required insulin therapy within 1 yr of diagnosis nor had a history of diabetic ketoacidosis. All were able to participate independently in the activities of daily living. BP and ECG were measured, and a structured questionnaire was asked of each patient. Venous blood after overnight fasting was collected every year to measure cholesterol, HDL cholesterol, plasma glucose, and HbA1c. RESULTS: The duration of diabetes was associated with the development of stroke with a relative risk of 1.063 for every 1-yr increment (P = 0.07). As for HVDs, the significant risk factors were serum cholesterol and HbA1c. For every 1-mg/dl increase in mean total cholesterol level, the relative risk of developing HVD increased 1.016-fold (P = 0.04). For every 1% increase in HbA1c, the relative risk of developing HVD increased 1.170-fold (P = 0.01). With regard to leg VDs, sex and cigarette smoking were significant risk factors. Women diabetic subjects had a higher relative risk than men. Cigarette smoking was significantly associated with leg VD with a relative risk of 6.9 for smokers compared with nonsmokers. The most significant risk factor for LVD was the total cholesterol level. For every 1-mg/dl increase in mean serum cholesterol level, the relative risk of LVD increased 1.013-fold. CONCLUSIONS: In the prevention of macrovascular diseases, effective intervention of the nondiabetic cardiovascular risk factors may be as important as or even more important than the good control of diabetes.

Adult↗
PubMed1992

Prevalence and risk factors of diabetic retinopathy among noninsulin-dependent diabetic subjects.

In a population-based study in Taiwan, 11,478 subjects aged 40 years or older were screened for diabetes in one urban and five rural areas. Among the 715 subjects proven to have diabetes, 527 subjects underwent ophthalmoscopy. Diabetic retinopathy was present in 184 of the 527 subjects (35.0%), including background diabetic retinopathy in 157 subjects (30.0%), preproliferative diabetic retinopathy in 15 subjects (2.8%), and proliferative diabetic retinopathy in 12 subjects (2.2%). Diabetic retinopathy was correlated with the duration of diabetes and age at onset of diabetes, type of diabetes treatment, higher serum creatinine levels, and lower serum cholesterol levels. Several other factors, including gender, age, residential area, family income, educational level, control and family history of diabetes, body mass index, physical activity, exercise, cigarette smoking, stroke, ischemic heart disease, leg vessel disease, hypertension, and proteinuria, had no significant association with retinopathy. By multiple logistic regression analysis, duration of diabetes was the most important risk factor related to retinopathy. Diabetic subjects treated with insulin had a higher risk of developing retinopathy than those treated with dietary control (relative risk, 1.57; .05 < P < .10). The univariate analysis disclosed that proliferative diabetic retinopathy was related to older age at examination, older age at onset of diabetes, type of diabetes treatment, and presence of leg vessel disease. Insulin-treated diabetic subjects also had a higher risk of proliferative diabetic retinopathy than patients in whom diabetes was controlled by diet, with a relative risk of 2.51 (.05 < P < .10) in the multiple logistic regression analysis.

Adult↗
PubMed1992

Motor-evoked potentials in diabetes mellitus.

By using magnetic stimulation of the motor cortex and in the cervical region, conduction time in the central motor pathway was measured in 35 patients with diabetes mellitus (DM) and in 41 control subjects. Motor-evoked potentials (MEPs) were recorded from the contralateral thenar muscles. Central conduction time (CCT) was obtained by subtracting the latency of the spinal MEP from that of the scalp MEP. To compare central and peripheral nerve functions, the motor nerve conduction velocity (MCV) of the median nerve was also tested in patients with DM. In the 35 cases of DM, the mean latency of the cortical MEPs showed a significant increase, compared with normal controls; the mean CCT was also significantly prolonged in the patient group. There was a good correlation between central motor abnormalities and the duration of DM, as well as with impairment of the peripheral nervous system. Latencies of greater than two standard deviations were defined as abnormal. The abnormal rate in patients with DM was 29% for latency of the cortical MEP, 20% for latency of the cervical MEP and 37% for the CCT. In addition, there was a 35% abnormal rate for distal latency of the median MCV and a 40% abnormal rate for the median MCV. These findings support the theory that the metabolic disturbance in DM affects both the central and peripheral nervous systems in man. MEP studies provide objective measurements of central motor pathways.

Adult↗
PubMed1990

Vibratory perception threshold in diabetic neuropathy.

A total of 263 diabetic patients and 129 normal controls were enrolled in a study of vibratory perception threshold (VPT) using an electromagnetic vibrometer at two sites, the dorsum of the metacarpal bone of the index finger (IF) and the dorsomedial aspect of the metatarsal bone of the great toe (GT). The results showed that the mean values of VPT for both IF and GT were significantly higher in diabetics than in normal subjects. In both control and diabetic groups, the VPT values at GT only were elevated with increasing age. Furthermore, the mean VPTs at both IF and GT were related to the duration of illness and the severity of diabetes mellitus in the patient group. Eighty cases of diabetes mellitus received nerve stimulation tests including motor and sensory nerve conduction velocities of the upper and lower limbs. The results from these cases demonstrated good correlation between VPT and motor conduction velocity (MCV), but not between VPT and sensory conduction velocity (SCV). There was a negative correlation between VPT at IF and median MCV (p less than 0.0005) in the upper limbs, as well as VPT at GT and tibial MCV (p less than 0.0005) in the lower limbs. For clinical applications, VPT values seemed to be more sensitive than MCV in detecting neuropathic change in diabetic patients. Hence, impairment of vibratory perception can be taken as a subtle clinical sign of diabetic neuropathy, and measurement of VPT can be used as an index of a patient's current subclinical state.

Adolescent↗
PubMed1990

A comparison of newly and previously diagnosed diabetics in Taiwan.

Between 1985 and 1986, during a population survey of diabetes in 1 urban and 5 rural areas of Taiwan, a total of 11,478 adults aged 40 or older were screened. Capillary whole blood glucose was determined with a glucometer (Ames Co.) The diabetic criteria followed the WHO designations. From this survey, a comparison of 225 newly diagnosed and 383 previously diagnosed diabetics was conducted. Multiple regression analysis revealed a highly significant correlation for all diabetics with regard to age, body mass index, family history and hypertension, but no specific correlation to habitat. Mean fasting glucose levels in previously and newly diagnosed diabetics were 172 and 158 (males 158 vs 147 and females 184 vs 165) mg/dl, respectively, which suggest that treatment is apparently inadequate in this population. The prevalent rate (%) of retinopathy for previously and newly diagnosed diabetics was 45.2 and 28.3 (males 42.8 vs 33.3 and females 47.5 vs 24.8), respectively. The prevalence is as common as those reported in western countries. In conclusion, previously diagnosed diabetics had higher fasting glucose concentrations and prevalent rates of retinopathy than newly diagnosed diabetics, and these findings were particularly prominent in females.

Adult↗
PubMed1990

[Utilization and medical cost of patients with different insurance coverage among group practice centers].

In order to explore the utilization and medical cost of patients with different insurance coverage in group practice centers, we collected patient data in three centers from September 1, 1987 to February 28, 1988. We classified the payments as self-payment,partial-reimbursement and total-reimbursement. There were 42,234 visits by 8,111 patients. The average frequency of visits within 6 months was 6.1 in total-reimbursement patients, 5.2 in partial-reimbursement patients and 2.6 in self-payment patients. We found that the frequency of visits increased with age in patients with total-reimbursement and partial-reimbursement. On the other hand, the frequency decreased after the age of 65 in patients with self-payment; whether it was related to the economic problems of the elderly needs further study. The highest medical cost per visit was NT$. 343 in total reimbursement patients, followed by NT$. 281 in partial-reimbursement patients. The lowest cost was NT$. 208 in self-payment patients. Yet, the highest ratio of total drug cost by total medical cost per visit was 73.7% in partial-reimbursement patients followed by 63.6% in total-reimbursement patients. The lowest ratio was 56.7% in self-payment patients. Although the partial-reimbursement system could not decrease the ratio of total drug cost by total medical cost per visit, it would be beneficial in group practice centers to decrease the patients' visits and the medical cost per visit. Therefore, this system should be executed in the future.

Adolescent↗
PubMed1990

A comparison of diabetic control status between urban and rural diabetic patients in Taiwan.

Between 1985 and 1987, in two urban and five rural areas in Taiwan, a total of 16,636 subjects aged 40 or over were screened for diabetes mellitus according to the WHO criteria. Four hundred and fifty-two previously diagnosed patients and 274 newly diagnosed patients were found. All were non-insulin-dependent diabetics. The blood glucose control status was compared between the urban and rural previously diagnosed diabetics. Those living in the rural areas were found to have better control with a higher percentage under regular treatment. Stepwise multiple regression failed to discover a significant correlation between control status and any of the following factors: sex, age, body mass index (BMI), diabetic duration, treatment regularity, exercise, occupation, education, family income and the presence of hypertension or large vessel diseases. About 30% of the patients in rural areas and 40% in urban areas were poorly controlled. This indicates that our diabetic control program should be strengthened.

Aged↗
PubMed1990

Cutaneous thermal thresholds in normal subjects and diabetic patients without symptoms of peripheral neuropathy.

An automated system operating on the Peltier principle and using a two-alternative forced-choice testing technique was applied to measure the heat and cold thermal thresholds (HT and CT) in 63 normal subjects and 68 diabetic patients who had no clinical symptoms of peripheral neuropathy. To compare large and small nerve fiber functions, 34 of the diabetic group were also tested for vibration perception threshold (VPT) and nerve conduction velocity (NCV). The testing algorithm of the devices selected for used, including reference temperature and number of turns, was investigated for assessment of variability and reliability. The age effect on thermal thresholds was found in the normal group (p less than 0.001). There was a significant difference between HT and CT in an individual (p less than 0.01). CT was greater than HT in 68% of the subjects. The diabetic group had significantly higher thermal thresholds than the normal group (HT, 0.30 +/- 0.32 degree C vs 0.10 +/- 0.05 degree C, p less than 0.005; CT, 0.39 +/- 0.43 degree C vs 0.15 +/- 0.09 degree C, p less than 0.005). Thermal thresholds greater than the linear regression estimate for age plus three standard errors of estimate were defined as abnormal. The abnormality rate in diabetics was 33.8% for HT and 22.1% for CT. Of the 34 patients, 91.1% had abnormal results in at least one of the three tests: 47.1% abnormal for HT or CT, 67.6% for VPT, and 26.4% for NCV. No correlation existed between the thermal threshold and VPT (p greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Clinical use of differential lung ventilation in the treatment of asymmetric lung injury: report of a case.

Successful treatment of a 26-year-old male with asymmetric lung injury following a traffic accident is described. The patient was admitted with head injuries, right lung contusion, right pneumothorax, and multiple rib fractures (right 1-9). He developed a left pneumohemothorax and complete atelectasis of the lower lobe of the left lung two days later. Conventional mechanical ventilation with and without positive end-expiratory pressure (PEEP), supplemented by repeated therapeutic bronchoscopy, failed to reexpand the left lung. After 16 days of atelectasis, synchronized differential lung ventilation using a double lumen endobronchial tube connected to two ventilators (Siemens 900C) was instituted. Measurement of the tidal volume and static compliance of each lung showed marked inequality and 9 cm H2O of PEEP was applied selectively to the left lung (zero PEEP to the right) in an attempt to equalize tidal volumes. Evident improvement in blood gases and chest radiograph was obtained within 30 min but weaning back to a single lumen tube required 6 days, and was complicated by further episodes of atelectasis. Complete pulmonary and neurological recovery was obtained, and a normal chest radiograph was documented 3 months later. Differential ventilation proved simple to use, and highly effective in the management of this combination of lung problems.

Adult↗
PubMed1988

Paraquat intoxication during pregnancy: a report of 9 cases.

The details of nine patients who deliberately ingested paraquat (24% solution) while pregnant are presented. Two patients refused treatment. Paraquat levels in maternal, fetal and cord blood in 1 case shows that paraquat crosses the placenta and is concentrated to levels 4-6 times greater than the maternal blood. Amnioscopy in another case showed paraquat levels in amniotic fluid nearly twice that of maternal blood. All fetuses died, whether or not emergency cesarean operation was performed. The condition of the fetus worsened at delivery, or in utero if the gestational age was greater than 30 weeks. One of the 2 survivors has had a normal pregnancy since, with no evidence of teratogenicity from the earlier paraquat intoxication. This patient has shown a gradual return to normal spirometry values from the marked reduction that occurred at the time of paraquat intoxication.

Adolescent↗