Biomedical subjects
Publications and source records attributed to Cheng-Chun Lee.
We report a new nonsense mutation in the human sedlin (SEDL) gene in a family with X-linked spondyloepiphyseal dysplasia tarda. A substitution of cytosine for adenine at nucleotide position 329 causing a nonsense mutation (S110X) in exon 6 was identified in the affected patient in the family.
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.
Explore the source record for details and available documents.
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.
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.
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.
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.
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.
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.
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.
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.
It is very important to establish a tumor marker combination with strong lead-time effects in early detection of recurrent ovarian cancer. This retrospective study included 32 patients with recurrent epithelial ovarian cancer after primary therapy. The serum levels of tissue polypeptide specific antigen (TPS) and carbohydrate antigen 125 (CA-125) were followed-up. Normal upper limits of serum levels of 78.5 U/l for TPS and 35 U/ml for CA-125 were selected according to the 95th percentile of serum concentrations measured in healthy control patients. When compared with other follow-up modalities, TPS and CA-125 appeared lead-time effective with early diagnosis of recurrent ovarian cancer in 18 and 16 patients, respectively. This difference was not statistically significant. The combination of TPS and CA-125 provided lead-time effects in 24 patients. Our data indicate that the combination of TPS and CA-125 is a potential tool in the early prediction of recurrent ovarian cancer.
BACKGROUND/AIMS: The aim of our study was to evaluate technetium-99m tetrofosmin SPECT (single photon emission computed tomography) of the chest as a potential non-invasive method to evaluate esophagitis among gastroesophageal reflux disease patients. METHODOLOGY: In this study, we used non-invasive radionuclide imaging technetium-99m tetrofosmin chest SPECT to detect and grade esophagitis in 60 patients with gastroesophageal reflux disease. RESULTS: Based on the endoscopic findings according to the Savary-Miller system, the sensitivity, specificity, and accuracy rates of technetium-99m tetrofosmin chest SPECT in detecting esophagitis were 95.2%, 72.2%, and 88.3%, respectively. The agreement between the endoscopic and technetium-99m tetrofosmin chest SPECT findings was evaluated and found to be good (kappa: 0.633, p < 0.001). CONCLUSIONS: Non-invasive technetium-99m tetrofosmin chest SPECT has excellent sensitivity and good accuracy as a screen for esophagitis among gastroesophageal reflux disease patients.
BACKGROUND/AIMS: Acute appendicitis is a clinically challenging surgical disease which is particularly difficult to diagnosis in women. An atypical presentation is a major obstacle to quickly diagnose acute appendicitis. METHODOLOGY: Fifty female patients with acute abdomen pain who were suspected of having appendicitis, but who had atypical findings were included in this study. After an intravenous injection of technetium-99m hexamethylpropyleneamineoxide (Tc-99m HMPAO) labeled white blood cells, serial anterior abdomen-pelvis images at 30 min, 60 min, 120 min and 240 min were obtained using a gamma camera. Meanwhile, at the point of maximal tenderness, abdominal sonography was performed with a graded compression technique for both longitudinal and transverse images. RESULTS: Thirty-two patients received a laparotomy for surgical and pathological diagnoses. The remaining 18 patients did not receive operations and showed no evidence of appendicitis after at least a one-month follow-up period. Two patients had false-positive white blood cell scan findings and 2 patients had false-negative white blood cell scan findings. The overall sensitivity, specificity, and accuracy for white blood cell scans in diagnosing appendicitis was 93.3%, 90.0%, 92.0%, respectively. One patient had false-positive abdominal sonographic finding and 5 patients had false-negative abdominal sonographic findings. The overall sensitivity, specificity, and accuracy for abdominal sonography scans in diagnosing appendicitis were 83.3%, 95.0%, and 88.0%, respectively. CONCLUSIONS: The Tc-99m HMPAO white blood cell scan provides a more sensitive and accurate method for the diagnosis of appendicitis in female patients with equivocal clinical presentation when compared with abdominal sonography.
BACKGROUND/AIMS: Early detection of post-surgical infection is important to decrease mortality in patients after operation. Both C-reactive protein test and gallium-67 scan (gallium scan) are sensitive examinations in the detection of infection. In this study, we compared the diagnostic accuracy of the two modalities in the detection of infection after abdominal surgery. METHODOLOGY: Forty-six patients undergoing abdominal surgery were enrolled in this study. All patients received blood examination for C-reactive protein test and were referred to our department for gallium scan because of unknown fever after surgery. RESULTS: Of the 46 patients with abdominal surgery, 22 (47.8%) were diagnosed to have infection including 6 intra-abdominal abscesses, 8 wound infection and 8 with both intra-abdominal abscesses and wound infection. To achieve better diagnostic results, C-reactive protein value of 2.8 mg/dL was chosen as cut-off value. The diagnostic sensitivities for both gallium scan and C-reactive protein test were 100%. The diagnostic specificity of gallium scan was superior to C-reactive protein test (83.3% vs. 54.2%). The overall diagnostic accuracy of gallium scan and C-reactive protein test were 92.6% and 76%, respectively. CONCLUSIONS: Both C-reactive protein test and gallium scan have good sensitivity in the detection of infection after abdominal surgery. Gallium scan has better diagnostic specificity than the C-reactive protein test.
Technetium-99m Tetrofosmin (Tc-TF) has been shown to be useful in identifying several types of tumors, such as breast, lung and thyroid cancers. However, there are no reports in the literature about the usefulness of Tc-TF liver imaging in detecting hepatocellular carcinoma (HCC). Twenty-two patients with HCC were enrolled in this study. Tc-TF liver single photon emission computed tomography (SPECT) images were performed 10 minutes after intravenous injection of 20mCi Tc-TF. All patients were pathologically investigated by liver biopsy or surgery within one week after Tc-TF liver SPECT imaging. Among the Tc-TF liver SPECT images, 20 out of 22 (90.9%) patients showed negative results without significant Tc-TF uptake in HCC, whereas only 2 (9.1%) patients showed positive results with significant Tc-TF uptake in HCC. No significant correlation between Tc-TF liver SPECT findings and sex, age, serum alpha feto-protein level, differentiation of the tumor, or status of hepatitis virus infection was found. In this preliminary report, Tc-TF liver SPECT imaging is not a sensitive method to detect HCC. However, further studies are necessary to analyze the correlation of Tc-TF liver imaging findings and the MDR gene Pgp expression in HCC.
We evaluated the clinical usefulness of dual phase 201Tl thyroid scan for 11 patients with false-negative fine-needle aspiration (FNA) cytological diagnoses to detect malignant non-functioning thyroid nodules. Benign FNA cytological diagnoses categorized by experienced pathologists were considered as false-negative diagnoses because the final diagnoses of surgical histopathology were malignant. Dual phase thyroid scan, including an early image and a delayed image, were acquired at 10 minutes and 3 hours, respectively, after 2 mCi (74 MBq) of 201Tl was injected intravenously. Dual phase 201Tl thyroid scan findings were visually interpreted as malignant or benign diagnoses. Dual phase 201Tl thyroid scan could accurately diagnose all of the 11 patients with false-negative FNA cytological diagnoses. We concluded that dual phase 201Tl thyroid scan was very useful in detecting malignant non-functioning thyroid nodules in 11 patients with false-negative FNA cytological diagnoses.