Biomedical subjects

Shang-Ren Hsu

Publications and source records attributed to Shang-Ren Hsu.

4 recordsLinked to original sources

PubMed2006

Characteristics predicting dyslipidemia in drug-naïve type 2 diabetes patients.

BACKGROUND: Plasma lipid concentrations are related to a variety of attributes in obese subjects, but these relationships have not been extensively examined in type 2 diabetes patients. METHODS: A cross-sectional survey was conducted on type 2 diabetes patients who had never been treated with antihypertensives, lipid-lowering agents, and oral antidiabetic drugs other than sulfonylureas. Statistical analysis was performed to search for the correlation between lipid profiles and various parameters. RESULTS: Among diabetic men, the plasma triglyceride (TG) level was positively correlated with the waist-to-hip ratio (WHR) and alcohol consumption, whereas high-density lipoprotein cholesterol (HDL-C) was negatively correlated with age and body mass index (BMI). Obese persons and alcohol drinkers were more likely to need pharmacologic treatment for dyslipidemia. Among diabetic women, the plasma TG level was positively correlated with WHR and the duration of diabetes since diagnosis, while HDL-C was negatively correlated with WHR and BMI. The necessity of treatment for dyslipidemia increased with the duration of diabetes. CONCLUSION: We recommend a more intensive monitoring of lipid levels in drug-naive diabetic patients who possess the characteristics of alcohol consumption or older age (men), long duration of diabetes (women), and higher BMI or WHR (both genders).

Adult↗

PubMed2006

Association between serum uric acid level and components of the metabolic syndrome.

BACKGROUND: Serum uric acid (UA) level has been suggested to be associated with factors that contribute to the metabolic syndrome. However, the association between metabolic syndrome and UA has not been elucidated. We sought to determine the association between serum UA level and the number of components that contribute to the metabolic syndrome, and which component was associated most with higher serum UA level. METHODS: A consecutive sample was taken of the health examinations of all hospital staff who were assessed between January 2004 and December 2004 in a medical center. A total of 3,065 subjects aged 18 to 81 years (635 males, 2,430 females) participated. Blood tests and all physical variables were examined using standard methods. Subjects were divided into 5 groups according to their possession of 0, 1, 2, 3 or > or = 4 components of the metabolic syndrome. The differences in all variables between groups were analyzed by ANOVA. The relationship between serum UA level and the number of metabolic components was determined by linear regression analysis. The contribution to elevated UA of possessing different risk factors was determined by a multivariate linear regression model. RESULTS: Mean serum UA level increased as the number of metabolic factors increased. Serum UA level was higher in subjects with abnormal triglyceride (TG), waist circumference, high-density lipoprotein cholesterol (HDL-C) level and blood pressure (BP),with mean increases in UA level of 22.8, 21.4, 14.4 and 9.4 micromol/L, respectively (p < or = 0.001), compared to subjects with normal levels. After controlling for body mass index, abnormal TG, HDL-C and BP continued to account, in order of influence, for elevated UA. CONCLUSION: Serum UA level was elevated significantly as the number of metabolic components increased. Abnormal TG had the most influence on serum UA. A prospective study is warranted to determine if the prevention or treatment of hyperuricemia affects the development of metabolic syndrome.

Adult↗

PubMed2005

Synchronous parathyroid and papillary thyroid carcinoma.

Concomitant thyroid disease is not unusual among patients with primary hyperparathyroidism. However, the simultaneous occurrence of parathyroid and thyroid carcinoma is extremely rare. We report a 38-year-old man with primary hyperparathyroidism who presented with osteitis fibrosa cystica complicated with pathologic femoral neck fracture. Preoperative investigation for exclusion of multiple endocrine neoplasia did not find evidence of medullary thyroid carcinoma or pheochromocytoma, but imaging studies revealed the presence of nodules in the right lobe and a parathyroid lesion over the left inferior pole of the thyroid gland. Total thyroidectomy, left parathyroidectomy, and bipolar hemiarthroplasty of the left hip were then performed simultaneously. The resected specimens were pathologically identified as papillary thyroid carcinoma and parathyroid carcinoma, respectively. After the operation, 131I ablation therapy was administered at a dose of 120 mCi. Additional doses of 30 mCi were given yearly as serum thyroglobulin level became elevated. Serum calcium level remained normal during yearly follow-up. Although parathyroid carcinoma is an uncommon cause of parathyroid hormone-dependent hypercalcemia, it should nonetheless be given due consideration because its surgical approach differs from that of parathyroid adenoma. As the coexistence of parathyroid and non-medullary thyroid carcinoma has previously been reported, the possibility of both malignancies must also be considered in the setting of primary hyperparathyroidism with thyroid nodules. If confirmed with preoperative parathyroid scintigraphic and other laboratory studies, an optimal outcome may be achieved with complete resection of both tumors at the time of initial operation, followed by adjunctive therapy.

Adult↗

PubMed2005

Sheehan's syndrome presenting with early postpartum congestive heart failure.

We report the case of a young woman with Sheehan's syndrome who presented with ventricular arrhythmia and congestive heart failure. The patient was admitted because of postpartum hemorrhage and hypovolemic shock; a massive blood transfusion was required to restore blood volume. After initial stabilization, the patient developed acute respiratory distress and congestive heart failure accompanied by hemodynamic instability 2 weeks after delivery. Episodes of ventricular tachycardia of the torsade de pointes type and a prolonged QT interval were noted on baseline electrocardiogram. A low cortisol level was found incidentally, which led to the suspicion of hypopituitarism. The diagnosis was later supported by laboratory findings of multiple pituitary hormone deficiencies. After administration of corticosteroids and thyroxine, the patient's clinical condition improved dramatically. A pituitary magnetic resonance imaging scan 32 days after delivery revealed a diminished and flattened pituitary gland with prominent intrasellar cerebrospinal fluid loculation, which was compatible with the clinical diagnosis of empty sella with panhypopituitarism. The syndrome of acute anterior pituitary necrosis secondary to postpartum hemorrhage and shock was first described by Sheehan in 1939. Although the occurrence of Sheehan's syndrome is now rare, it should still be considered in any woman with a history of peripartum hemorrhage who develops manifestations of pituitary hormone deficiency. Appropriate hormone replacement therapy is essential and always results in dramatic clinical improvement.

Adult↗