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Biomedical subjects

Cheng-Chieh Lin

Publications and source records attributed to Cheng-Chieh Lin.

At least 55 records · Page 3Linked to original sources

Differentiating solitary pulmonary metastases in patients with renal cell carcinomas by 18F-fluoro-2-deoxyglucose positron emission tomography--a preliminary report.

OBJECTIVE: This preliminary study was to evaluate the characteristics of indeterminate solitary pulmonary lesions in patients with renal cell carcinomas (RCC) using (18)F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET). MATERIAL AND METHODS: Fifteen patients with RCC were found to have solitary pulmonary lesions with indeterminate chest X-ray and CT findings. Pulmonary metastases were suspected in all cases so whole body surveys with FDG-PET were performed. RESULTS: FDG-PET correctly identified 9 true-positive and 4 true-negative cases. However, FDG-PET failed to interpret 1 false-positive and 1 false-negative case. Standard uptake values (SUV) were used as parameters to differentiate the solitary pulmonary lesions. Using SUV >2.5 as the cutoff to diagnose malignancy, the sensitivity, specificity, and accuracy of FDG-PET were 90, 80, and 87%, respectively. CONCLUSION: We conclude that FDG-PET is an accurate modality to differentiate solitary pulmonary lesions in patients with RCC.

Adult↗

A higher prevalence of abnormal regional cerebral blood flow in patients with syndrome X and abnormal myocardial perfusion.

To test the hypothesis that syndrome X is a systemic vascular disorder, technetium-99m ethyl cysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) was used to detect abnormal regional cerebral blood flow (rCBF) in 30 patients with syndrome X. These patients were separated into group 1, 20 patients with definite myocardial perfusion defects diagnosed by thallium-201 (Tl-201) myocardial perfusion SPECT; and group 2, 10 patients without any myocardial perfusion defects. Tc-99m ECD brain SPECT demonstrated hypoperfusion brain lesions in 95% (19/20) and 20% (2/10) of patients in groups 1 and 2, respectively. This difference in the cidence between the two groups was significant. In group 1 and 2 patients, parietal lobes were the most common hypoperfusion areas, while the cerebellum was the least common hypoperfusion area of the brain. Syndrome X is a systemic vascular disorder with a high incidence of hypoperfusion lesions of the brain based on the findings of Tc-99m ECD brain SPECT, and is usually coincident with myocardial defects based on the Tl-201 myocardial perfusion SPECT findings.

Adult↗

The epidemiology of hyperuricemia in children of Taiwan aborigines.

OBJECTIVE: To explore the factors influencing serum uric acid concentrations and the prevalence of hyperuricemia in aboriginal children from an area in Taiwan with a high prevalence of gouty arthritis. METHODS: A cross sectional study of the Bunun tribe was conducted in central Taiwan from March to May 2001. Children aged 4-13 were requested to fill out a structured questionnaire with the assistance of their parents. A total of 414 children (mean age, 8.9 +/- 2.1 yrs) were recruited. Uric acid was determined by colorimetry using the uricase method. Since no previous study has investigated serum uric acid concentrations in these aboriginal children, hyperuricemia was defined as uric acid > 416.5 micromol/l (7 mg/dl) in boys and > 357 micromol/l (6 mg/dl) in girls. RESULTS: The mean concentration of serum uric acid was 368.9 +/- 83.3 micro mol/l. Ninety of 224 girls (40.2%) and 56 of 190 boys (29.5%) were hyperuricemic. Children with hyperuricemia had significantly higher body mass index (BMI), blood pressure, and triglyceride and creatinine concentrations than those with normal uric acid concentrations. After adjustment for age, sex, lipid profile, and blood pressure, hyperuricemia was found to be significantly associated with serum creatinine (OR 2.40, 95% CI 1.91-3.04), BMI (OR 1.24, 95% CI 1.11-1.40), and a family history of gouty arthritis in parents (OR 2.01, 95% CI 1.02-3.96). CONCLUSION: BMI, a positive family history of gouty arthritis in parents, and creatinine level correlated with hyperuricemia in aboriginal children in Taiwan.

Arthritis, Gouty↗

A clinical pathway for laparoscopically assisted vaginal hysterectomy. Impact on costs and clinical outcome.

OBJECTIVE: To evaluate the cost of and clinical outcome of implementing a clinical pathway for laparoscopically assisted vaginal hysterectomy. STUDY DESIGN: A retrospective study of the case records of patients who underwent laparoscopically assisted vaginal hysterectomy before (May-December 1997) and after (January 1998-March 1999) implementation of a clinical pathway. Data regarding resource consumption and clinical outcome represented by 10 clinical indicators were collected. Student's t test and the chi 2 test were used, as appropriate. Statistical significance was set at P = .05. RESULTS: After implementation of the laparoscopically assisted vaginal hysterectomy clinical pathway, the average total fee decreased significantly, by 8.1% (P = .03), the average inpatient drug fee decreased by 50.6% (P < .01), and the laboratory fee dropped by 56.2% (P < .01). Furthermore, the length of hospital stay significantly decreased, from 6.90 to 4.08 days (P < .01); the average operation time decreased by 24.8% (P < .01); and the average anesthesia time decreased by 21.6% (P < .01). The pre-clinical pathway and post-clinical pathway complication rate did not differ statistically, but the rate of initiating intravenous antibiotic injections > 48 hours following surgery decreased by 76.2% in the clinical pathway group (P = .02). CONCLUSION: Implementation of a clinical pathway for laparoscopically assisted vaginal hysterectomy can improve health care outcomes by decreasing length of hospital stay and admission fees and by maintaining quality of care. The clinical pathway is a good policy for maintaining cost containment and high-quality patient care.

Adult↗

Correlation between protein expression and epigenetic and mutation changes of Wnt pathway-related genes in oral cancer.

The components of the Wnt-signaling pathway are reported to be mutated in human cancer cells, but the relationship between the components and oral squamous carcinoma (SCC) is still unknown. In this study, we analyzed the epigenetic changes and expression patterns of four member proteins of the Wnt-signaling pathway and analyzed the mutations of beta-catenin and AXIN 1 genes, in order to explore the roles of the pathway in the development of oral cancer. The results showed that there are no beta-catenin and AXIN 1 gene mutations and no methylation of the CpG island of beta-catenin, AXIN I and GSK3beta genes in oral cancer cells; methylation of the CpG island of APC occurs in the precancerous stage and it is a dynamic change; the aberrant expressions or abnormal localization of the Wnt-signaling pathway proteins have no relationship with methylation status or mutation. From our results, we suggest that the Wnt pathway related genes play a very limited role in the development of oral SCC.

Adult↗

Association of an A allele for interleukin-10 -627 gene promoter polymorphism with higher susceptibility to endometriosis.

OBJECTIVE: To investigate whether interleukin-10 (IL-10) -627 gene promoter polymorphism could be used as a marker of susceptibility to endometriosis. STUDY DESIGN: Women were divided into 2 groups, endometriosis (n = 130) and nonendometriosis (n = 133). Polymorphisms for IL-10 -627 gene promoter were amplified by polymerase chain reaction and detected after restriction enzyme digestion. Genotypes and allelic frequencies in both groups were compared. RESULTS: Genotype proportions of different IL-10 gene polymorphisms in both groups were not significantly different. Proportions of A homozygote/heterozygote/T homozygote for IL-10 gene polymorphisms in both groups were 50%/40%/10% and 42.1%/38.4%/19.5%. In contrast, allele frequencies for IL-10 gene polymorphism between both groups were significantly different. Alleles A and C for IL-10 gene promoter polymorphism in the groups were 70%/30% and 61.3%/38.7%. A allele was associated with higher susceptibility to endometriosis. CONCLUSION: An association between endometriosis and IL-10 gene promoter polymorphism exists, and the IL-10 -627 A allele is related to a higher susceptibility to endometriosis.

Alleles↗

Risk factors for retinopathy of prematurity in very low birth-weight infants.

PURPOSE: To calculate incidence and evaluate the risk factors of the threshold retinopathy of prematurity (ROP) in very low birth-weight (VLBW, birth weight less than 1,251 gram) infants. We also compared the incidence of threshold ROP in Taiwan with those of Caucasians and Negros. Additionally, the post-conception age when threshold ROP happened was considered. METHODS: From February 1995 to February 2000, we enrolled 458 VLBW infants at the China Medical College Hospital. Patients with congenital anomalies and those who survived less than 6 months were excluded. The perinatal and neonatal data of enrolled infants were reviewed. Student's t test and chi-square test were used to evaluate the statistical significance of risk factors. We also used logistic regression test and correct classification rate to evaluate different risk factors. RESULTS: The incidence of threshold ROP in our study was 6.8%. The gestational age (GA), birth weight (BW), number of days in using ventilator, continuous positive airway pressure (CPAP) and oxygen supplements, the occurrence of broncopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC) and the length of hospitalization were statistically different between patients groups with and without threshold ROP (p < 0.05). However, small size for gestational age (SGA), sepsis status, intraventricular hemorrhage (IVH) status (Gr.III and Gr.IV) and type of delivery were not significantly different between patients with and without threshold ROP (p > 0.05). Threshold ROP was noted at an average post-conception age of 34.25 weeks. CONCLUSIONS: The incidence of threshold ROP (6.8%) in VLBW Taiwan babies is comparable with the incidence of Caucasian patients in Western countries. Risk factors including PVL, NEC, BPD and RDS should be avoided to prevent the occurrence of threshold ROP. Threshold ROP occurred at an average of 34.3 weeks of post-conception age; the premature baby around this age must be checked carefully.

Bronchopulmonary Dysplasia↗

The voltage-gated potassium channel KCNQ2 in Taiwanese children with febrile convulsions.

Mutations in the voltage-gated potassium channel genes KCNQ2 and KCNQ3 have been found to cause benign familial neonatal convulsions. Recent studies provided evidence that KCNQ2 and KCNQ3 contribute to the M-current, which regulates the subthreshold electrical excitability in the CNS. Febrile convulsions represent the majority of childhood seizures, and show a strong family history, suggesting a genetic predisposition. By performing an association study, we investigated whether KCNQ2 gene polymorphisms can be used as markers of susceptibility to febrile convulsions. These data suggest that the KCNQ2 gene might not be a useful marker for prediction of the susceptibility of febrile convulsions.

Child↗

Polymorphisms for interleukin 1 beta exon 5 and interleukin 1 receptor antagonist in Taiwanese children with febrile convulsions.

OBJECTIVE: To investigate whether interleukin 1 beta (IL-1 beta) exon 5 and IL-1 receptor antagonist (IL-1Ra) gene polymorphisms can be used as markers of susceptibility to febrile convulsions in children. METHODS: Children were divided into 2 groups: those with febrile convulsions (group 1; n = 51) and normal control subjects (group 2; n = 83). Polymorphisms for IL-1 beta exon 5 and IL-1Ra gene polymorphisms were detected by polymerase chain reaction. Genotypes and allelic frequencies for IL-1 beta exon 5 and IL-1Ra gene polymorphisms in both groups were compared. RESULTS: Genotype and allele frequencies for IL-1 beta exon 5 in both groups were not significantly different. Proportions of E1 homozygotes and E1/E2 heterozygotes for IL-1 beta exon 5 were 50 (98.1%) and 1 (1.9%), respectively, in group 1 and 82 (98.8%) and 1 (1.2%), respectively, in group 2. Frequencies of alleles E1 and E2 for IL-1 beta exon 5 were 101 (99.0%) and 1 (1.0%), respectively, in group 1 and 165 (99.4%) and 1 (0.6%), respectively, in group 2. Genotype proportions and allele frequencies for IL-1Ra between groups were significantly different. Proportions of genotypes I/I and I/II for IL-1Ra were 49 (96.1%) and 2 (3.9%) in group 1 and 69 (83.1%) and 14 (16.9%) in group 2. Frequencies of alleles I and II for IL-1Ra were 100 (98.0%) and 2 (2.0%) in group 1 and 152 (91.6%) and 14 (8.4%) in group 2. CONCLUSIONS: The IL-1Ra allele I is associated with a higher susceptibility to febrile convulsion, which may become a useful marker for predicting the development of febrile convulsions. The IL-1 beta exon 5 gene polymorphisms are not a useful marker for predicting the susceptibility to febrile convulsions.

Case-Control Studies↗

Urokinase gene 3'-UTR T/C polymorphism is associated with urolithiasis.

OBJECTIVES: To study single nucleotide polymorphisms to investigate the possibility that urokinase is involved in the formation of urolithiasis, which, although lacking in genetic evidence, has been previously proposed. METHODS: A total of 153 patients with recurrent calcium stones and 105 controls were studied. Polymerase chain reaction-based restriction analysis was used to identify the C/T polymorphism of the urokinase gene, which is mapped on the 3'-untranslated region (3'-UTR) on chromosome 10. RESULTS: A significant difference was found in the distribution of the urokinase gene 3'-UTR C/T polymorphism frequency between patients with stones and normal controls (P <0.05). The odds ratio for the risk of the "T" allele in patients with stones was 3.088 (95% confidence interval 1.06 to 8.99). CONCLUSIONS: The results of our study demonstrate that the urokinase gene 3'-UTR "T" allele is associated with calcium stone disease. Individuals possessing the "T" allele have a higher incidence of calcium oxalate stone disease. The results of this study provide genetic evidence that the urokinase gene may play a role in stone formation.

3' Untranslated Regions↗

Interleukin-4 intron 3 polymorphism is not related to susceptibility to febrile seizures.

Interleukin-4 (IL-4) is a cytokine with anti-inflammatory properties. This study was undertaken to investigate whether IL-4 intron 3 gene polymorphism could be used as markers of susceptibility to febrile seizures and epilepsy of children. Children were divided into three groups: group 1, febrile seizures (n = 51); group 2, epilepsy (n = 43); and group 3, normal control group (n = 83). Polymorphisms for IL-4 intron 3 were detected by polymerase chain reaction. Genotypes and allelic frequencies for IL-4 intron 3 gene polymorphism in three groups were compared. We found that proportions of different IL-4 intron 3 polymorphisms in three groups were nonsignificantly different. Proportions of RP1 homozygote/heterozygote/RP2 homozygote for IL-4 intron 3 in three groups were as follows: group 1, 56.9/41.2/1.9%; group 2, 62.8/32.6/4.6%; and group 3, 62.7/33.7/3.6%. The proportion of RP1/RP2 for IL-4 intron 3 in three groups were as follows: group 1, 77.5/22.5%, group 2, 79.1/20.9%, and group 3, 79.5/20.5%. We concluded that the association of IL-4 polymorphisms with febrile seizures and epilepsy of children does not exist. IL-4 intron 3 polymorphism is not a useful marker for prediction of the susceptibility of febrile seizure and epilepsy of children.

Chi-Square Distribution↗

Tubo-ovarian abscess presenting as pneumoperitoneum.

BACKGROUND: Tubo-ovarian abscess (TOA), a serious complication of pelvic inflammatory disease, often require the antibiotic administration, surgical resection or the transvaginal aspiration. Pneumoperitoneum is often associated with the bowel perforation. We reported one case with TOA and pneumoperitoneum that have been mistaken for a perforated bowel with concomitant adnexal mass. CASE: A 30-year-old diabetic Chinese woman was transferred for diffused abdominal pain, mild fever, nausea, and low-grade fever for 5 days. The sonography revealed a 5-cm adnexal mass. The chest X-rays revealed the pneumoperitoneum. Under the impression of bowel perforation and concomitant adnexal cyst, the emergent laparotomy was performed and the TOA was resected. No evidence of gastrointestinal perforation was present. Culture studies showed Escherichia coli without other bacteria flora. The postoperative course was uneventful. CONCLUSION: We concluded that, beside the bowel perforation, TOA should be considered when a diabetic woman presents with pneumoperitoneum and adnexal mass.

Abscess↗

Discordance between dipyridamole technetium-99m-sestamibi myocardial perfusion single photon emission computed tomography and two-dimensional echocardiography in Kawasaki disease--a preliminary report.

This study attempts to establish a noninvasive diagnostic method for early assessment of cardiac involvement in Kawasaki disease (KD), 36 children with KD were studied. The presence of abnormal coronary arteries (CA) with aneurysms was determined by experienced pediatric cardiologists using two-dimensional echocardiography (2D-Echo). Rest and dipyridamole-stress technetium-99m sestamibi (Tc-MIBI) single photon emission computed tomography (SPECT) was performed on the 36 children with KD for the assessment of myocardial perfusion and for comparison with 2D-Echo findings. The results showed that (1) 17/36 (47.2%) of the cases had no aneurysm and 19/36 (52.8%) had significant aneurysms; (2) 16/36 (44.4%) of the cases had normal myocardial perfusion and 20/36 (55.6%) had myocardial perfusion defects; (3) 9/36 (25.0%) cases showed both normal 2D-Echo and Tc-MIBI SPECT findings and 12/36 (33.3%) showed both abnormal 2D-Echo and Tc-MIBI SPECT findings; and (4) There was poor agreement between 2D-Echo and Tc-MIBI SPECT findings (kappa-value = 0.161, p = 0.332). We concluded that the most of the KD children had aneurysms or abnormal myocardial perfusion. However, poor agreement exists between 2D-Echo and Tc-MIBI SPECT findings with aneurysms and abnormal myocardial perfusion in patients with KD.

Adolescent↗

Detecting mediastinal lymph node metastases in non-small-cell lung cancer using a combination of technetium-99m tetrofosmin chest single photon emission computed tomography and chest computed tomography.

UNLABELLED: The staging of non-small-cell lung cancer (NSCLC) to detect mediastinal lymph node (MLN) metastases is very important for determining the therapeutic strategy. METHODS: Thirty-four patients with proven NSCLC were enrolled in this study. All patients underwent chest computed tomography (CT) and technetium-99m (Tc-99m) tetrofosmin chest single photon emission computed tomography (SPECT) preoperative staging. Mediastinal lymph node metastases were determined on the basis of postoperative pathologic findings to compare the diagnostic accuracy of chest CT with that of Tc-99m tetrofosmin chest SPECT. RESULTS: Tc-99m tetrofosmin chest SPECT showed a diagnostic accuracy rate of 85.3% in detecting MLN metastases. Chest CT had an accuracy rate of 73.5%. If either Tc-99m tetrofosmin chest SPECT or chest CT with positive findings was considered as positive findings, the sensitivity was 94.7%. If either Tc-99m tetrofosmin chest SPECT or chest CT with negative findings was considered as negative, the specificity was 93.3%. CONCLUSION: Tc-99m tetrofosmin chest SPECT was more accurate than chest CT in detecting MLN metastases in NSCLC patients. In addition, the combined use of Tc-99m tetrofosmin chest SPECT and chest CT could significantly increase the sensitivity and specificity compared with the single use of either Tc-99m tetrofosmin chest SPECT or chest CT.

Adult↗

Comparison of technetium-99m methoxyisobutylisonitrile scintimammography and ultrasonography in the diagnosis of breast cancer in patients with mammographically dense breast.

The main purpose of this study was to compare the utility of technetium-99m methoxyisobutylisonitrile (Tc-99m sestamibi) scintimammography with that of ultrasonography for diagnosis of breast cancer in 32 female patients with indeterminate mammographic probability of malignancy because of mammographically dense breast. All breast masses were removed and histopathological diagnosis was obtained in all cases. The results showed 20 of 24 cases of breast carcinoma detected on Tc-99m sestamibi scintimammography. Only one out of eight patients with benign breast lesion had abnormal scintimammographic finding. Ultrasonography diagnosed 22 of the 24 cases of breast carcinoma. However, five out of eight patients with benign breast lesion had positive ultrasonographic findings. In differentiating malignant and benign breast tumors in mammographically dense breast, the diagnostic sensitivities were 83 and 92%, specificities were 88 and 38%, and accuracies were 84 and 78% for Tc-99m sestamibi scintimammography and ultrasonography, respectively. Ultrasonography showed a nonsignificantly higher sensitivity (p < 0.05), but lower specificity, with more false-positive diagnoses made on ultrasonography. Due to its higher sensitivity, ultrasonography is more suitable for screening breast masses. However, Tc-99m sestamibi scintimammography exhibited significantly higher specificity (p < 0.05) and accuracy in detecting malignant breast tumors in the current study. We conclude that Tc-99m sestamibi scintimammography is a safe and useful diagnostic method for detection of breast cancer in patients with nondiagnostic mammogram because of mammographically dense breast.

Adult↗

Usefulness of technetium-99m tetrofosmin scintimammography to detect breast cancer in mammographically dense breasts.

The purpose of this study was to assess the usefulness of techentium-99m tetrofosmin (Tc-TF) scintimammography to detect breast cancer in 32 female Taiwanese patients with indeterminate mammograpic probability of malignancy because of mammographyically dense breasts. All breast masses were removed and final histopathological diagnoses were obtained in all cases. The results showed that Tc-TF scintimammography findings were true-positive in 20 cases, false-positive in 1 case, true-negative in seven cases, and false-negative in four cases. The diagnostic sensitivity, specificity, and accuracy were 83, 88, and 84%, respectively, for detecting breast cancer in mammographically dense breasts. In conclusion, Tc-TF scintimammography is a useful tool for detecting breast cancer in patients with indeterminate mammograms because of mammographically dense breasts.

Adult↗

Detecting breast cancer in mammographically dense breasts: comparing technetium-99m tetrofosmin mammoscintigraphy and ultrasonography.

The aim of our study was to compare the usefulness of technetium-99m tetrofosmin (Tc-TF) mammoscintigraphy and ultrasonography for detecting breast cancer in mammographically dense breasts. This study included 32 female Taiwanese patients with indeterminate mammographic probability of malignancy due to mammographically dense breasts. Both Tc-TF mammoscintigraphy and ultrasonography were performed on each patient. Then, all of the 32 breast masses underwent biopsies or operations to obtain final pathological diagnoses. Based on the final pathological diagnoses, 24 women had breast cancer and eight had benign breast tumors among the 32 patients. Twenty cancers and one benign tumor had positive Tc-TF mammoscintigraphic findings. The sensitivity, specificity, and accuracy were 83, 88, and 84%, respectively. Twenty-two cancers and five benign tumors had positive ultrasonographic findings. The sensitivity, specificity, and accuracy were 92, 38, and 78%, respectively. To detect breast cancer in patients with nondiagnostic mammograms because of mammographically dense breasts, ultrasonography with its higher sensitivity is more suitable for screening breast masses. However, due to its higher specificity, Tc-TF mammoscintigraphy is useful to confirm the ultrasonographic findings.

Adenocarcinoma↗

Differentiation of low-grade gastric MALT lymphoma and high-grade gastric MALT lymphoma: the clinical value of Ga-67 citrate scintigraphy--a pilot study.

Ga-67 citrate scintigraphy has been routinely and extensively used to evaluate non-Hodgkin's lymphoma (NHL) for more than 20 years. Gastric lymphoma of mucosa-associated lymphoid tissue (MALT) is by far the most common extranodal primary NHL. Gastric MALT lymphoma can be classified as low-grade (LG) or high-grade (HG). Low-grade gastric MALT lymphoma can be cured by eradication of Helicobacter pylori; but radiotherapy and/or chemotherapy and/or surgery are the major methods of treatment for the HG gastric MALT lymphoma. However, it is difficult to differentiate these two groups by clinical parameters and endoscopic findings. The purpose of this study was to determine whether Ga-67 citrate scintigraphy can distinguish the LG gastric MALT lymphoma from the HG gastric MALT lymphoma. Twenty-one patients (11 men and 10 women ranging in age from 38 to 83 years) with histologically confirmed gastric MALT lymphoma were enrolled. Twelve patients had LG and nine patients had HG. All 21 patients underwent Ga-67 citrate scintigraphy before treatment. The results of Ga-67 citrate scintigraphy were classified as positive or negative. In the LG group, nine patients had negative results and three patients had positive results. In the HG group of nine patients, all patients had positive results. Among the three patients who had positive results in the LG group, the uptake of gastric MALT lymphoma was lower than that of the liver. The Ga-67 citrate scintigraphy is of good clinical value for the differentiation of the LG gastric MALT lymphoma and the HG gastric MALT lymphoma. We think that the major value of Ga-67 citrate scintigraphy will be in following the patients with HG gastric MALT lymphoma after treatment to assess response of therapy and to detect possible recurrence and perhaps in determining transformation from the LG to HG gastric MALT lymphoma. However, further investigation is needed to understand the relationship between the uptake of Ga-67 citrate in gastric MALT lymphoma and transformation.

Adult↗