PubMed Health⌕ Search

Biomedical subjects

Chia-Hung Kao

Publications and source records attributed to Chia-Hung Kao.

At least 19 recordsLinked to original sources
PubMed2006

Effects of alendronate combined with hormone replacement therapy on osteoporotic postmenopausal Chinese women.

To evaluate the effect of alendronate combined with hormone replacement therapy (HRT) on postmenopausal osteoporotic Chinese women living in Taiwan, we treated 151 women (age range, 47-70 years; mean, 61 years) with conjugated equine estrogen (0.625 mg), medroxyprogesterone 5 mg, and elemental calcium 500 mg daily with either alendronate 10 mg (n = 79) or placebo (n = 72), and measured their bone mineral density (BMD) at the lumbar spine and hip every 6 months for 3 years. Urine N-telopeptide of type I collagen corrected by concentration of urine creatinine (NTx/Cr) and serum osteocalcin (OC) concentration was also measured at weeks 2, 4, and every 3 months from month 3 for 2 years. Significantly higher percentage increases in BMD at the lumbar spine (P < .0001, 2-way analysis of variance) throughout the 36-month treatment period were found in the alendronate plus HRT group than in the HRT-only group. However, there was no difference in BMD at the femoral neck and trochanter between these 2 groups. Treatment with alendronate plus HRT resulted in a 10.1% increase at the L-spine BMD and a 7.7% increase at the trochanter BMD at the end of the 3-year study period (P < .01, compared with baseline at both sites). A significant decline in urine NTx/Cr was observed at week 4 in the alendronate plus HRT group, whereas in the HRT-only group, a significant decline in urine NTx/Cr occurred at month 9. By the end of 24 months, urine NTx/Cr decreased by 49.7% in the alendronate plus HRT group (P = .001 compared with a 20.4% increase in the HRT group). A significant decline in serum OC level occurred at month 3 in the alendronate plus HRT group, whereas a similar decline was observed at month 6 in the HRT-only group. By the end of 24 months, serum OC decreased by 52.2% in the alendronate plus HRT group (P < .001 compared with a 1.5% increase in the HRT-only group). Subjects treated with alendronate plus HRT had a significantly greater percentage decrease in urine NTx/Cr (P = .0001) and serum OC (P = .0007) than subjects treated with HRT only throughout the 24-month treatment period by 2-way analysis of variance comparison. There was no difference in upper gastrointestinal or drug-related side effects between groups. In conclusion, our data suggest that the use of alendronate combined with HRT for 3 years was well tolerated and it significantly increased BMD at the L-spine and hip in postmenopausal Chinese women with osteoporosis. This regimen is safe and can be used in subjects who have no satisfactory response to a single agent or who have very low BMD with multiple risks. However, this study does not indicate whether HRT plus alendronate has any greater effect on BMD than alendronate alone.

Aged↗
PubMed2006

Positive correlation between standardized uptake values of FDG uptake in the stomach and the value of the C-13 urea breath test.

PURPOSE: The distribution of FDG uptake in the stomach is variable. Gastritis is one of the causes of elevated FDG uptake. Helicobacter pylori (HP) infection was found in approximately 80% of patients with peptic ulcer and 30% to 60% of symptomatic gastritis. The C-13 urea breath test (UBT) is one of the gold standard tools in diagnosis of HP infection. The aim of this study was to assess the correlation between standardized uptake values (SUVs) of FDG uptake in the stomach and the value of the C-13 urea breath test (UBT). METHODS: Sixteen patients, referred from the department of community medicine, for FDG PET for health examination were chronologically enrolled for detection of HP infection by using the C-13 UBT within 1 week. The maximal SUVs of FDG uptake in the gastric wall as well as the value of the C-13 UBT were measured. The correlation between maximal SUVs of FDG uptake in the stomach and the value of the C-13 UBT was observed. RESULTS: We took the results of C-13 UBT as the final diagnosis of HP infection. Of 16 patients, 5 were HP-infected and 11 were uninfected. Standardized uptake values of FDG uptake in the gastric wall were strong positively correlated with the value of the C-13 UBT in this retrospective study (P < 0.001). CONCLUSION: Except for gastric cancer, HP infection has to be concerned when high SUVs of FDG uptake in the stomach are noted.

Breath Tests↗
PubMed2005

Fusion images of Tl-201 SPECT and FDG PET with CT in detection of cervical carcinoma with bladder invasion.

Thallium-201 single-photon emission computed tomography (Tl-201 SPECT) and F-18 fluorodeoxyglucose positron emission tomography (FDG PET) are accurate and excellent methods for detecting malignant tumors and related metabolic abnormalities. However, there are still some limitations in clinical application. The major limitation of SPECT is poor image resolution. PET is less sensitive for detecting lesions of the urinary system adjacent to the bladder because of bladder radioactivity. Both T1-201 and F-18 FDG PET often provide less information than x-ray computed tomography (CT) about the anatomic landmarks needed to precisely locate lesions. Recent development of multimodality image registration and fusion has been shown to be an excellent tool to resolve these drawbacks. The authors present a rare case of residual cervical carcinoma with bladder invasion, which was detected by fusion imaging of Tl-201 SPECT and FDG PET with CT. This noninvasive image technique may become a valuable alternative to identify bladder invasion in cervical cancer.

Adenocarcinoma↗
PubMed2004

Usefulness of FDG-PET to detect recurrent cervical cancer based on asymptomatically elevated tumor marker serum levels--a preliminary report.

This study was to evaluate the clinical impact of whole body positron emission tomography (PET) with 18F-fluoro-2-deoxyglucose (FDG) to detect recurrent cervical cancer based on asymptomatically elevated tumor marker levels. Whole-body FDG-PET was performed in 20 patients with suspected recurrent squamous cell carcinoma (SCC) of the cervix and asymptomatic tumor marker of SCC antigen increased serum levels but negative or equivocal other imaging modality results. All of these 20 asymptomatic patients have serum levels of SCC antigen > 1.5 ng/mL. The final diagnosis of recurrent cervical cancer was established by operation/biopsy histopathological findings or clinical follow-up after more than 1 year by additional morphological imaging techniques. Among the 20 patients, the final diagnosis of recurrent cervical cancer was established in 81 lesions of 19 patients. The FDG-PET accurately detected 78/81 lesions. With asymptomatically elevated SCC antigen serum levels, the diagnostic sensitivity and accuracy of FDG-PET to detect recurrent cervical cancer lesions were 97.5% and 94.0%, respectively. The FDG-PET is a useful technique to detect recurrent cervical cancer for patients with asymptomatically elevated SCC antigen serum levels.

Adult↗
PubMed2004

The use of dual phase 201Tl SPECT for differentiating pulmonary malignancies from benign lesions.

BACKGROUND: This study examines the usefulness of thallium-201 single photon emission computed tomography ((201)Tl SPECT) in differentiating pulmonary malignancies from benign lesions by using dual phase (201)Tl scintigraphy. METHODS: One hundred and six patients with thoracic lesions and confirmed diagnoses were assessed by (201)Tl chest SPECT examinations; of these 106 enrolled thoracic lesions, 59 were malignancies and 47 were benign lesions. Dual phase (201)Tl SPECT was performed with an early image acquired at 10-20 min and a delayed image at 2-3 h after intravenous injection of 2-3 mCi of (201)Tl. The results of (201)Tl SPECT images were classified as either malignant or benign lesions by visual interpretation: the lesion was interpreted as positive for malignancy if the uptake of (201)Tl in the lung lesion in the delayed phase was increased or persistent as compared with that in the early phase image; otherwise, it was considered as a benign lesion. Simultaneously, the traditional method of retention index (RI) was also calculated to help in the differential diagnosis of pulmonary lesions. Then, both methods of dual phase (201)Tl SPECT, visual reading and traditional RI, were compared to differentiate pulmonary malignancies from benign lesions. RESULTS: Analyzing the image results, we found that dual phase (201)Tl SPECT could differentiate pulmonary malignancies from benign lesions with a sensitivity of 83%, a specificity of 91% and an accuracy of 87%. Moreover, by using the traditional RI method of (201)Tl SPECT, it could differentiate pulmonary malignancy from benign lesions with a sensitivity of 79.3%, a specificity of 80.8% and an accuracy of 80%. CONCLUSIONS: We conclude that using dual phase (201)Tl SPECT with visual interpretation is a simpler and potentially more effective method for differentiating pulmonary malignancies from benign lesions, with results compatible with the traditional RI method of (201)Tl SPECT.

Adenocarcinoma↗
PubMed2004

Elevated 18F-FDG uptake in skeletal muscles and thymus: a clue for the diagnosis of Graves' disease.

AIM: The aim of this study was to evaluate the appearance of Graves' disease in whole-body 2-[18F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) imaging. SUBJECTS: Twenty patients (three men, 17 women; mean age +/- SD, 37.2 +/- 12.1 years) with newly diagnosed Graves' disease without anti-thyroid drug treatment took part in the study. Secondly, a control group, 15 examinees (three men, 12 women; mean age +/- SD, 45.3 +/- 13 years) each with a history of Graves' disease and post-medical treatment were recruited. This group showed normal thyroid function. Finally, a normal group, 32 physical check-up examinees with non-specific medical histories and normal thyroid functions, were recruited. Whole-body FDG PET was performed on all subjects. The intensity of FDG uptake in the thyroid, thymus and muscles region was graded subjectively on a five-point scale. RESULTS: Among the 20 patients with Graves' disease, only six (30%) showed thyroid uptake of FDG, 15 (75%) showed thymus uptake of FDG, and up to 19 (95%) showed symmetrical increased uptake of FDG in skeletal muscles. In particular, the skeletal muscle uptake of FDG in the psoas and rectus abdominis muscles was 19/20 (95%) and 12/20 (60%), respectively. In the control group, three of the 15 examinees showed thyroid uptake of FDG. In the normal group, four of the 32 examinees had faintly visualized thyroid uptake of FDG. In thymus and skeletal muscles, there was no substantially increased FDG uptake in control and normal group examinees. CONCLUSIONS: In patients with Graves' disease, the thyroid uptake of FDG is not uniformly increased. Symmetrically increased uptake of FDG in the skeletal muscles and thymus is a clue for the diagnosis of Graves' disease. The uptake of FDG in skeletal muscles is more specific in the psoas and rectus abdominis muscles. An increment of muscle FDG uptake may be responsible for the high peripheral glucose utilization seen in Graves' disease.

Adult↗
PubMed2004

Single photon emission computed tomography (SPECT) for low back pain induced by extension with no root sign.

BACKGROUND: Low back pain (LBP) is very common in the general population. Most patients with LBP will receive an X-ray examination on lumbar spine; however, the results are likely to show a negative finding or degenerative joint disease, which are not truly pathological factors. Among various imaging diagnostic tools for active bony lesions of lumbar spine, planar bone scintigraphy has a higher sensitivity, but its ability to locate anatomic lesions is less satisfactory. The purpose of this study was to investigate the role of SPECT for evaluation of LBP. METHODS: Fifty-two consecutive patients who had low back pain induced by extension were studied. They had no evidence of malignant tumor, immune disease, spinal infection and neurological disorder by history-taking and physical examination. All patients received planar bone scintigraphy and SPECT exams following an X-ray examination. The results of X-ray finding were grouped into 3 categories: (A) normal; (B) degenerative joint arthritis; (C) spondylolysis. The data of test results and clinical evaluation were then used for analysis. RESULTS: Twenty (38.5%) out of 52 patients examined by planar scan had abnormality, with 29 increased uptake lesions, compared with 28 (53.8%) out of 52 patients with 60 increased uptake lesions by SPECT with planar scan; SPECT disclosed 1-2 more lesions with improved location in 15 patients (p < 0.05). Of the 52 patients, 21 (40.4%) presented in group A, 21 (40.4%) in group B, and 10 (19.2%) in group C according to the X-ray examination. In group A, 9 out of 21 (42.9%) patients had an abnormal SPECT result, compared to 5 of 10 (50%) in group B, and 14 out of 21 (66.7%) in group C, respectively (p > 0.05). The location of abnormal uptake on L-spine included vertebral body and arch (57.1%), vertebral arch (28.6%), and vertebral body (14.3%). Most of lesions (91.5%) were distributed at the 4th and 5th lumbar vertebral segments. CONCLUSIONS: SPECT was more sensitive and located more lesions than planar bone scintigraphy, especially when the lesions were located at posterior element of vertebrae. Most of the lesions were distributed at the 4 th and 5 th lumbar vertebral segments. There was no significant statistical difference of abnormal SPECT related to X-ray finding. The use of SPECT was the first choice among all image modalities when cause of low back pain was assumed to arise from bone and joint disorder at clinical evaluation.

Adult↗
PubMed2003

18-fluoro-2-deoxyglucose positron emission tomography in detecting residual/recurrent nasopharyngeal carcinomas and comparison with magnetic resonance imaging.

BACKGROUND: It is known that 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) is effective in the early detection of residual/recurrent nasopharyngeal carcinomas (NPC). To compare FDG-PET with the conventional magnetic resonance imaging (MRI) for the detection of residual/recurrent NPC, the authors studied 67 follow-up cases of patients with NPC using both FDG-PET and MRI. METHODS: From February 1997 to February 2001, 67 NPC patients (14 women, 53 men; age range, 16-67 years; mean age, 46.6 +/- 12.5 years) were recruited. Both FDG-PET and MRI of the head and neck area for each patient were performed at least 4 months (duration range, 4-70 months; mean, 14 +/- 13.5 months) after radiotherapy or radiotherapy with concurrent chemotherapy. The final diagnosis was confirmed by biopsy or clinical follow-up for at least 6 months. RESULTS: The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of FDG-PET images were 100%, 93.4%, 95.5%, 87.5%, and 100%, respectively. In contrast, the sensitivity, specificity, accuracy, PPV, and NPV of the MRI scans were 61.9%, 43.5%, 49.3%, 33.3%, and 70.0%, respectively. CONCLUSIONS: The results of the current study suggest that FDG-PET is much more effective than MRI in detecting residual/recurrent NPC.

Adolescent↗
PubMed2003

Decreased salivary gland function in patients with autoimmune thyroiditis.

BACKGROUND/AIMS: It has been speculated that impaired salivary flow contributes to autoimmune thyroiditis (chronic thyroiditis, Hashimoto's thyroiditis). To test this hypothesis, salivary function was measured by quantitative salivary scintigraphy in autoimmune thyroiditis patients, as well as in age- and gender-matched controls for comparison. METHODOLOGY: One hundred and twenty patients with an autoimmune thyroiditis history of more than 10 years each and 36 healthy controls were enrolled in the study. All the 120 autoimmune thyroiditis patients had good blood sugar control. None had autonomic neuropathy. These 120 autoimmune thyroiditis patients were separated into two subgroups: group 1, 60 patients with xerostomia; and group 2, 60 patients without xerostomia. After intravenous injection of 5 mCi Tc-99m pertechnetate, sequential images at 1 min/frame were acquired for 30 min. The first- and 15th-minute uptake ratios (UR) were calculated from the tracer uptakes in the four major salivary glands over the background regions of interest (ROIs). Saliva excretion was stimulated by 1 tablet of 200 mg ascorbic acid given orally 15 min after injection of the tracer. Then, the maximal excretion ratios (ER) of the four major salivary glands after sialagogue stimulation were calculated. RESULTS: Impaired salivary function, represented by significantly decreased UR and ER values, in autoimmune thyroiditis patients with xerostomia was demonstrated in this study. In addition, there was a significantly higher prevalence of salivary gland dysfunction in group 1 patients than in group 2 patients. CONCLUSIONS: Significantly poorer salivary function was found in autoimmune thyroiditis patients with xerostomia compared with autoimmune thyroiditis patients without xerostomia and healthy controls by means of objective and quantitative salivary scintigraphy.

Adult↗