Biomedical subjects

Cheng-Chieh Lin

Publications and source records attributed to Cheng-Chieh Lin.

At least 73 records · Page 4Linked to original sources

PubMed2002

Prediction of asymptomatically poor muscle perfusion of lower extremities in patients with type II diabetes mellitus using an objective radionuclide method.

Foot problems are the most common cause of hospital admission in patients with type II diabetes mellitus (DM). Poor muscle perfusion of lower extremities is thought to be the major component in the pathogenesis of foot problems. We used a well-established and non-invasive radionuclide method to objectively evaluate the anterior tibial muscle perfusion of 120 type II DM patients without symptoms/signs of peripheral vascular disease (PVD) in the lower extremities. The patients were separated into groups according to the duration of the disease and condition of blood sugar control. Meanwhile, 60 normal control males with a matched age distribution were also included for comparison. The muscle perfusion were of significant difference between (1) 120 type II DM patients and 60 normal controls, (2) 72 patients with good sugar control and 48 patients with poor sugar control, as well as (3) 64 patients with short disease duration and 56 patient with long disease duration. Based on the objective radionuclide method, we concluded that the muscle perfusion in the lower extremities of type II DM patients without symptoms/signs of PVD is significantly decreased and related to the duration of the disease and condition of blood sugar control.

Aged↗

PubMed2002

Clinical impact of [(18)F]FDG-PET in patients with suspected recurrent breast cancer based on asymptomatically elevated tumor marker serum levels: a preliminary report.

OBJECTIVE: To evaluate retrospectively the impact of [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) on the detection of recurrent breast cancer based on asymptomatically elevated tumor markers levels. METHODS: Whole-body FDG-PET was performed in 30 patients with suspected recurrent breast cancer and asymptomatic tumor marker increase but negative or equivocal other imaging modality results. A blood sample was drawn in each case for marker assay (CA 15-3 and CEA) on the same day as the FDG-PET. All of these 30 asymptomatic patients had either CA l5-3 >32 U/ml or CEA >5 ng/ml. The final diagnosis of recurrent breast cancer was established by operation/biopsy histopathological findings or clinical follow-up for >1 year by additional morphological imaging techniques. RESULTS: Among the 30 patients, the final diagnosis of recurrent breast cancer was established in 38 sites in 28 patients. FDG-PET accurately detected 35/38 sites in 25/28 patients with recurrence. The diagnostic sensitivity and accuracy of FDG-PET in patients with suspected recurrent breast cancer and asymptomatically elevated tumor markers were 96 and 90%, respectively. CONCLUSIONS: FDG-PET is a useful technique for detecting recurrent breast cancer suspected from asymptomatically elevated tumor markers levels and has an important clinical impact on the management of these patients.

Adult↗

PubMed2002

Prospective study of decreased bone mineral density in patients with cervical cancer without bone metastases: a preliminary report.

BACKGROUND: In women, osteoporosis is a common chronic disease that induces spinal compression and femoral neck fractures, resulting in life-threatening complications. It is very important to identify risk factors in order to prevent this disorder. Bone destruction is a well-recognized complication in a variety of neoplasms without bone metastasis. Therefore, in the present study, we investigated the spinal bone mineral density (BMD) in patients with cervical cancer without bone metastases. METHODS: This was a prospective study. Before any treatment, the BMD in 50 patients with invasive cervical cancer without bone metastases was measured by dual-energy X-ray absorptiometry and compared with those in 50 control women with the same distribution of age, height, weight and body mass index. None of the patients and control women had reached menopause. RESULTS: The BMD in patients with cervical cancer was significantly lower (P < 0.05) than those of control women. However, serum levels of calcium and phosphate were not significantly different between the patients with cervical cancer and control women. CONCLUSION: Our preliminary results suggest that patients with invasive cervical cancer have a lower BMD, resulting in an increased risk of osteoporosis.

Absorptiometry, Photon↗

PubMed2002

Comparison of radionuclide imaging and ultrasonography in the differentiation of acute testicular torsion and inflammatory testicular disease.

PURPOSE: Torsion of the testis is a urologic emergency that requires early diagnosis and prompt surgical treatment for testicular survival. However, the early differential diagnosis of acute testicular torsion from epididymitis or orchitis is often difficult. The aim of this retrospective study was to evaluate and compare the value of Tc-99m pertechnetate radionuclide imaging and ultrasonography in the differentiation of acute testicular torsion and inflammatory testicular diseases. METHODS: Twenty patients (age range, 5 to 38 years) with possible acute testicular torsion from July 2000 to July 2001 were enrolled in this study. Ultrasonography was performed in all patients in the emergency room. Within 3 hours of ultrasonography, radionuclide imaging was also performed after intravenous injection of 5 to 15 mCi Tc-99m pertechnetate in the forearms. All of the patients with clinically suspected acute testicular torsion underwent surgery. The surgical findings and pathologic reports of these patients were reviewed and definite diagnoses were established. None of the other patients had surgery and were followed clinically for at least 1 month after ultrasonography and radionuclide imaging. RESULTS: Four patients with testicular torsion, 13 patients with inflammatory testicular disease, and three healthy persons had a final surgical and pathologic diagnosis or clinical follow-up, and all were accurately diagnosed by Tc-99m pertechnetate radionuclide imaging. In contrast, ultrasonography was less accurate in the diagnosis and differentiation of acute testicular torsion from inflammation. Only 1 of 4 patients with testicular torsion, 5 of 13 patients with inflammatory testicular disease, and 2 of 3 healthy persons were diagnosed by ultrasonography. CONCLUSIONS: The results indicate that Tc-99m pertechnetate radionuclide imaging is a more useful and accurate imaging method than ultrasonography in the detection and differentiation of acute testicular torsion from inflammatory testicular disease in patients with acute scrotal pain.

Acute Disease↗

PubMed2002

Predicting chemotherapy response to paclitaxel-based therapy in advanced non-small-cell lung cancer (stage IIIb or IV) with a higher T stage (> T2). Technetium-99m methoxyisobutylisonitrile chest single photon emission computed tomography and P-glycoprotein express ion.

OBJECTIVE: The aim of this study was to compare technetium-99m methoxyisobutylisonitrile (Tc-MIBI) chest single photon emission computed tomography (SPECT) results, immunohistochemical analyses of P-glycoprotein (Pgp) expression and response to paclitaxel in non-small-cell lung cancer (NSCLC). METHODS: Before chemotherapy with paclitaxel, 30 patients with stage IIIb or IV NSCLC were enrolled in this study. Early chest SPECT was performed 10 min after intravenous injection of Tc-MIBI. Tc-MIBI chest SPECT images were qualitatively interpreted. Early tumor-to-normal lung ratios (T/NL) were calculated quantitatively. Immunohistochemical analyses were performed on multiple nonconsecutive sections of the biopsy specimens to determine Pgp expression. Chemotherapy response was evaluated in the third month after completion of treatment by clinical and radiological methods. RESULTS: All 15 (100%) cases with good response and negative Pgp expression had positive results of early Tc-MIBI chest SPECT. Ten of 15 (67%) cases with poor response and positive Pgp expression had negative results of early Tc-MIBI chest SPECT. These early T/NL ratios (3.3 +/- 0.8 for the 15 patients with good response and 2.0 +/- 0.2 for the 5 patients with poor response) in lung cancer could be detected on early Tc-MIBI chest SPECT. The difference was significant (p < 0.05) by an independent Student t test. However, no significant differences were found for other prognostic factors (age, sex, body weight loss, performance status, tumor cell type, and tumor stage) between the good and poor response groups. CONCLUSION: Early Tc-MIBI chest SPECT can be used to understand the Pgp expression in NSCLC and to quickly predict chemotherapy response to paclitaxel.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed2002

Exercise and rest technetium-99m-tetrofosmin lung uptake: correlation with left ventricular ejection fraction in patients with coronary artery disease.

Increased lung uptake of thallium-201 (Tl-201) and technetium-99m (Tc-99m) MIBI in myocardial perfusion imaging is a reliable marker of left ventricular dysfunction. The goal of our study was to establish whether the lung-to-heart (L/H) uptake ratio with a newer cardiac imaging agent, Tc-99m tetrofosmin, can also provide valuable information about left ventricular function. We studied 60 patients with recent coronary artery diseases (CAD) undergoing first-pass radionuclide ventriculography to calculate left ventricular ejection fraction (LVEF) and myocardial perfusion imaging to calculate the L/H ratio. Group A consisting of 30 CAD patients with higher LVEF (> or =40%) had a significantly lower L/H ratio than group B consisting of 30 CAD patients with abnormal LVEF (<40%) during exercise and rest. In groups A and B, the exercise and rest L/H ratios did not differ significantly. However, a statistically significant inverse correlation was found between the L/H ratio and LVEF during exercise and rest among the 60 patients. L/H ratios, measured by 99mTc-tetrofosmin imaging, provide clinically useful information with which to predict left ventricular dysfunction in CAD patients.

Adult↗

PubMed2002

Sulfotransferase 1A2*2 is a risk factor for early-onset breast cancer.

The estrogen-signaling pathway plays an important role in the pathophysiology of breast cancer, and the sulfotransferase 1A (SULT1A) family has been found to be both downstream targets of tamoxifen and a risk factor of breast cancer. We have used PCR-RFLP and direct sequencing methods to determine SULT1A2 polymorphisms in 230 Taiwanese breast cancer patients. The results showed that the frequencies of SULT1A2*1 and SULT1A2*2 occurring were 94.8% and 5.2%, respectively. No SULT1A2*3 allele was found in these patients. In comparison with the frequency of healthy controls (96.0% and 4.0% for SULT1A2*1 and SULT1A2*2, respectively), the allelic frequencies of SULT1A2 polymorphisms in these patients were not statistically significant (p=0.398). However, the SULT1A2*2 allele seems to influence the age of onset among early-onset breast cancer patients (p=0.021, OR=2.74, 95%CI=1.13-6.65).

Adolescent↗

PubMedDate not supplied

Usefulness of techntium-99m hexamethylpropylene amine oxime lung scan to detect subclinical lung injury in patients with noninsulin-dependent diabetes mellitus.

In this study, we employed techntium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) lung scan to detect subclinical lung injury of patients with noninsulin-dependent diabetes mellitus (NIDDM) who had normal chest X-ray findings (CXR) and pulmonary function test (PFT). The degree of pulmonary vascular endothelium damage was represented as lung/liver uptake ratios (L/L ratios) calculated by Tc-99m HMPAO lung scan. The L/L ratios of the 20 male NIDDM patients with normal CXR and PFT were compared with those of the 20 male normal controls. The results show that the L/L ratios on Tc-99m HMPAO lung scan were significantly higher in NIDDM patients than those in normal controls. Using a cutoff value of 0.50, 17 of the 20 (85%) NIDDM patients had abnormally increased L/L ratios. Our findings concluded that the pulmonary vascular endothelium damage represented as significantly increased L/L ratios on Tc-99m HMPAO lung scan in NIDDM patients with normal CXR and PFT. In addition, Tc-99m HMPAO lung scan has the potential to be a sensitive, objective, and noninvasive method to detect subclinical lung injury of patients with NIDDN, which are different from the traditional studies such as CXR or CFT.

Adult↗

PubMedDate not supplied

Evidence of impaired gallbladder function in patients with non-insulin-dependent diabetes mellitus by quantitative cholescintigraphy.

Non-insulin-dependent diabetes mellitus (NIDDM) is considered to predispose impaired gallbladder function and an increased prevalence of gallbladder disease. The aim of this study was to evaluate the gallbladder function of patients with NIDDM by quantitative technetium-99m-labeled imino-diacetic acid analogue (Tc-99m DISIDA) cholescintigraphy. One hundred and forty-five NIDDM patients (100 males, 45 females; age: 58.7+/-9.5 years) with the absence of autonomic or peripheral neuropathy and without gallbladder or liver disorders were enrolled in this study. The patients were categorized by blood sugar control (HbA(1c)> or =10% as a poor blood sugar control group and HbA(1c)<10% as a good blood sugar control group) and disease duration (diabetic duration > or =10 years as a longer-duration group and diabetic duration <10 years as a shorter-duration group). In addition, 60 normal controls (38 males, 22 females; age: 59.1+/-10.2 years) were also studied for comparison. All NIDDM patients and normal controls underwent Tc-99m DISIDA cholescintigraphy, and the filling fraction (FF) and ejection fraction (EF) of gallbladder were calculated. The results showed significant difference between (1) NIDDM patients versus normal controls in FF and EF, (2) poor versus good blood sugar control of NIDDM patients in FF and EF, and (3) longer versus shorter disease duration of NIDDM patients in FF and EF. Our study, including a large number of subjects, showed that gallbladder function of patients with NIDDM is more impaired than the normal controls; and impaired gallbladder function in NIDDM patients is related to disease duration and blood sugar control.

Blood Glucose↗

PubMedDate not supplied

Improvement of esophageal and gastric motility after 2-week treatment of oral erythromycin in patients with non-insulin-dependent diabetes mellitus.

Forty-five patients with non-insulin-dependent diabetes mellitus (NIDDM) were enrolled in the study. Before and after the 2-week treatment course of oral erythromycin, esophageal (the mean transit time, MTT) and gastric motility (the halftime of gastric emptying, GETt1/2) were evaluated by radionuclide labeled liquid and solid meals. Meanwhile, the fasting blood sugar (FBS) levels were monitored. After a 2-week erythromycin treatment, MTT shortened from 9.32+/-1.12 to 6.28+/-0.91 s and GETt1/2 shortened from 210.2+/-24.3 to 128.3+/-30.1 min. Meanwhile, FBS decreased from 198.2+/-30.1 to 121.5+/-21.3 mg/dl (P value <.05). We conclude that a 2-week treatment course of oral erythromycin can significantly improve esophageal and gastric motility which results in a better control of blood sugar in patients with NIDDM.

Administration, Oral↗

PubMedDate not supplied

Usefulness of captopril renography to predict the benefits of renal artery revascularization or captopril treatment in hypertensive patients with diabetic nephropathy.

This retrospective study aimed to use captopril renography (CR) for predicting the benefits of captopril treatment in hypertensive patients with diabetic nephropathy. CR was utilized in 60 hypertensive patients with diabetic nephropathy for detecting the probability of renovascular hypertension (RVH) and predicting the benefits of renal artery revascularization or captopril treatment. Ten of the 60 patients showed a high probability of RVH with marked changes of the renogram curve after an oral intake of 50-mg captopril compared to baseline findings. All of the 10 patients confirmed significant main renal artery stenosis in all of them, bilaterally in four patients and unilaterally in the remaining six patients by renal angiographic findings. After successful revascularization, blood pressure was well controlled and renal function was preserved in all of the 10 patients. The other 50 patients showed a low or intermediate probability of RVH with normal findings or unchanged on CR after 50-mg captopril. Then, captopril alone or combination treatment started and continued on 50 patients. After monitoring for at least 6 months, blood pressure was well controlled and renal function was preserved in all the 50 patients on captopril treatment. We conclude that CR should be considered as the standard diagnostic criteria of RVH and may be helpful in predicting the beneficial impact of captopril treatment in hypertensive patients with diabetic nephropathy.

Age of Onset↗

PubMedDate not supplied

Using Tc-99m DMSA renal cortex scan to detect renal damage in women with type 2 diabetes.

Women with diabetes mellitus (DM) have urinary tract infection (UTI) more often than women without DM. It is unknown, however, what the prevalence and type of renal damage due to UTI is in these women. Therefore, in this study, we compared type 2 DM women with or without UTI history for the prevalence and type of renal damage by technetium-99m dimercapto-succinic acid (Tc-99m DMSA) renal scan. A total of 128 type 2 DM women with or without UTI history received Tc-99m DMSA renal scan were included in this study. The patients were separated into three groups: (1) 43 patients without UTI history, (2) 42 patients with only lower UTI (cystitis) history and (3) 43 patients with upper UTI (pyelonephritis) history. The renal scan findings were separated into three types: (A) normal, (B) inflammation and (C) scar. The 31.9% (50/128) of type 2 DM patients had renal damages. Group 1 patients had a significantly lower prevalence of renal damages including inflammation and scar as compared to Groups 2 and 3 patients. In addition, the prevalence of renal damage was significantly higher in Group 3 than in Group 2 patients. Renal scars only were visualized in Group 3 patients. However, other clinical data were not statistically different among the three group patients. Type 2 DM women with UTI history, especially if they had upper UTI have a significantly higher prevalence of renal damage than in those without UTI.

Biological Transport↗

PubMedDate not supplied

CYP17 gene promoter allelic variant is not associated with prostate cancer.

Prostate cancer is the most common urological malignancy in Taiwan. The formation of prostate cancer has been reported to be associated with androgen. Two key steps in the sex steroid synthesis are mediated by the enzyme cytochrome p450c17alpha which is encoded in the CYP17 gene. Our aim was to investigate whether a polymorphism of CYP17 gene could be used as a genetic marker for associating prostate cancer. In this study, we compared the frequency of the C/T polymorphism of CYP17 gene 5'-UTR promoter region between 93 patients with prostate cancer and 121 healthy male volunteers (age, >60 years). The result revealed no significant association between the CYP17 genotype and prostate cancer (P =.781). Therefore, CYP17 C/T polymorphism is not a valid genetic marker for prostate cancer. Although a possible interaction between CYP17 gene C/T polymorphism and SP-1 transcription factor has been reported in the literature, we did not find any evidence for this the difference among clinical staging, pathological grading, or responsiveness to hormonal therapy in prostate cancer.

3' Untranslated Regions↗

PubMedDate not supplied

Using technetium-99m-tetrofosmin scan to predict chemotherapy response of malignant lymphomas, compared with P-glycoprotein and multidrug resistance related protein expression.

The ability of technetium-99m tetrofosmin (Tc-TF) scan to predict chemotherapy response in malignant lymphomas (ML) was compared with the predictive ability of P-glycoprotein (Pgp) and multidrug resistance related protein (MRP) expression. Before chemotherapy, 25 ML patients were enrolled in this study. Scans were performed 10 min after intravenous injection of Tc-TF. Immunohistochemical analyses were performed on ML specimen sections to evaluate Pgp and MRP expression. Chemotherapy response was evaluated in the first 1-2 years after completion of chemotherapy. Based on Tc-TF scan results, the mean tumor-to-background (T/B) ratio of the 15 patients with good response (3.23 +/- 0.56) was significantly higher than that of the 10 patients with poor response (1.18 +/- 0.11). All 15 patients with good response had positive Tc-TF scan results but negative Pgp and MRP expression. All 10 patients with poor response had negative Tc-TF scan results but positive Pgp or MRP expression. No significant differences in the incidences of good and poor response results were found for patients with Hodgkin's disease versus non-Hodgkin's lymphoma, with stage I-II versus stage III-IV, with age > 40 versus age < or = 40 years, or with B symptoms versus without B symptoms. Tc-TF scan results, which may represent either Pgp or MRP expression, accurately predict chemotherapy response in patients with ML.

ATP Binding Cassette Transporter, Subfamily B↗

PubMedDate not supplied

Measurement of ear length in neonates, infants and preschool children in Taiwan.

Ear length is important in the evaluation of congenital anomaly syndrome, such as small ear in Down syndrome. In this research, 4,416 normal Chinese children in Taiwan were enrolled into our study. The sample of 284 full term neonates, 2,742 infants and children aged from one month to three years, and 1,420 preschool children were measured for ear length. We placed a ruler along the greatest vertical axis of the right ear We calculated the mean value and standard deviation of the ear length in normal Chinese neonates, infants and preschool children in Taiwan. No significant sex differences were observed. Twenty patients with Down syndrome were also measured. Compared with the previous study, there was no significant difference between the ear length of Chinese children and that of Caucasian children. The ear length of patients with Down syndrome was indeed smaller than that of the normal children. Due to the correlation of reduced ear length and congenital anomaly, we should set up our own data about the growth of the ear length. Thus we can provide an additional clue to diagnose the congenital anomaly syndromes.

Asian People↗

PubMedDate not supplied

Evaluation of gallbladder function in patients with non-diabetic chronic renal failure by quantitative radionuclide cholescintigraphy.

BACKGROUND/AIMS: We investigated quantitatively the motor function of the gallbladder in patients with non-diabetic chronic renal failure by the Tc-99m DISIDA cholescintigraphy. METHODOLOGY: Twenty-four patients (13 males, 11 females; aged 62.0 +/- 16.2 years) with non-diabetic chronic renal failure were included in this study. All cases had normal gallbladder diagnosed by ultrasonography and normal liver function without symptoms or signs of cholecystitis. Fifteen normal controls (12 males, 3 females; aged 60.7 +/- 6.3 years) were also included for comparison. Gallbladder function was represented as the filling fraction and the ejection fraction calculated using quantitative Tc-99m DISIDA cholescintigraphy and was compared in the groups. RESULTS: The results showed no significant difference (P > 0.05) between non-diabetic chronic renal failure and controls in filling fraction (64.3 +/- 31.0 vs. 74.9 +/- 9.5) and in ejection fraction (54.4 +/- 26.5 vs. 49.9 +/- 4.2) by the independent Student's t test. CONCLUSIONS: Non-diabetic chronic renal failure seems not to impair gallbladder function although non-diabetic chronic renal failure patients had a tendency toward a decreased filling fraction. The high variability of filling fraction and ejection fraction observed in our patients implies that the determinants of gallbladder functions in non-diabetic chronic renal failure patients may be multiple in nature.

Aged↗

PubMedDate not supplied

Detecting para-aortic lymph nodal metastasis by positron emission tomography of 18F-fluorodeoxyglucose in advanced cervical cancer with negative magnetic resonance imaging findings.

The patient's prognosis is significantly related to para-aortic lymph node metastasis in advanced cervical cancer. Magnetic resonance imaging (MRI) has been widely performed to detect lymph node metastasis with a variable sensitivity. Therefore, in this prospective study, we evaluated FDG-PET to detec para-aortic lymph nodal metastasis in locally advanced cervical carcinoma with negative MRI findings. Forty-two women with advanced cervical cancer and negative abdominal MRI findings were included in this study. Para-aortic lymph node metastases were confirmed according to para-aortic lymph-adenectomy findings. Para-aortic lymphadenectomy findings showed 12 patients with para-aortic lymph nodal metastasis. Two patients had false-negative and 1 patient had false-positive FDG-PET findings. The FDG-PET showed sensitivity of 83.3%, specificity of 96.7%, and accuracy of 92.9%. As assessment of para-aortic lymph node metastases may be essential for therapy planning, FDG-PET is an alternative tool to detect para-aortic lymph node metastases in advanced cervical cancer with negative MRI findings.

Adolescent↗

PubMedDate not supplied

Tissue polypeptide specific antigen (TPS) as a tumor marker in renal cell carcinoma.

Tissue polypeptide specific antigen (TPS) is a new tumor marker that indicates tumor proliferative rate rather than tumor burden. The purpose of this study was to assess the clinical value of TPS in patients with renal cell carcinoma (RCC). Serum levels of TPS were measured in 30 patients with locoregional and in 20 patients with advanced disease before and after therapy. The results showed that: (1) the detection sensitivity of TPS for RCC is 60.0%; (2) the detection sensitivity of TPS in advanced RCC (100.0%) was significantly higher than in locoregional RCC (33.3%); (3) the 10 locoregional RCC patients without recurrence had normal serum TPS levels during a follow-up period of 1 year; and (4) the 8 advanced RCC patients with good response during therapy had normal serum TPS levels, while 12 patients with poor disease had significantly elevated serum TPS levels during a follow-up period of 1 year. Our results suggest that TPS may have a potential clinical role as a valuable tumor marker for RCC, especially in advanced diseases and follow-up therapy response.

Adult↗