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Biomedical subjects

Shih-Te Tu

Publications and source records attributed to Shih-Te Tu.

7 recordsLinked to original sources

Bisphosphonate pretreatment attenuates hungry bone syndrome postoperatively in subjects with primary hyperparathyroidism.

Primary hyperparathyroidism is characterized by hypercalcemia with loss of bone mass. After parathyroidectomy, hypocalcemia may develop in some patients due to unregulated bone mineralization. Preoperative administration of bisphosphonates, potent inhibitors of osteoclast activity, may prevent postoperative hypocalcemia after parathyroidectomy. We retrospectively reviewed medical records to investigate the effect of bisphosphonate pretreatment on serum calcium level changes after parathyroidectomy. Twenty-three patients with a diagnosis of primary hyperparathyroidism underwent parathyroidectomy between April 1997 and August 2002. Clinical and laboratory data were collected before and after the operation. These patients were divided into two groups; those showing hungry bone syndrome (n = 9) and those not (n = 14). None of the 9 patients with hungry bone syndrome had received bisphosphonate pretreatment. Of the 14 patients without hungry bone syndrome, 6 had received bisphosphonate pretreatment (P < 0.05). Furthermore, preoperative calcium concentration was not related to the occurrence of hypo-calcemia in those without bisphosphonate pretreatment. In conclusion, administration of bisphosphonates in primary hyperparathyroidism can prevent the occurrence of hungry bone syndrome after parathyroidectomy.

Adult↗

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↗

Anti-hyperglycemic activity of natural and fermented Cordyceps sinensis in rats with diabetes induced by nicotinamide and streptozotocin.

Our previous study demonstrated that the fruiting bodies of Cordyceps sinensis, a traditional Chinese medicine, attenuated diabetes-induced weight loss, polydipsia, and hyperglycemia in rats. In the present study, we further compared the anti-hyperglycemic activity of the fermented mycelia and broth of Cordyceps sinensis with that of the fruiting bodies. Male Wistar rats orally administered a placebo (STZ group), fruiting bodies (FB group, 1 g/day), fermented mycelia (MCS group, 1 g/day), fermented broth (BCS group, 1 g/day), or fermented mycelia plus broth (XCS group, 0.5 g/day of each) of Cordyceps sinensis (d1 to d28) were injected with nicotinamide (200 mg/kg) and streptozotocin (65 mg/kg) on d15. Rats fed with a placebo and injected with saline served as the control (CON) group. The amount of water and food consumption (d15 to d29), the 2-hour-postprandial blood glucose concentrations (d21 and d28), and the serum concentrations of fructosamine (d29) were significantly lower in the FB, MCS, BCS, and XCS groups than in the STZ group (one-way ANOVA, p < 0.05). The diabetic rats had significantly higher blood glucose concentrations as measured by the oral glucose tolerance test than the control rats; moreover, these changes were significantly reduced by ingesting the fruiting bodies, fermented mycelia and/or broth of Cordyceps sinensis. Our results revealed that the fermented mycelia and broth of Cordyceps sinensis have anti-hyperglycemic activities similar to those of the fruiting bodies. Therefore, the fermented products of Cordyceps sinensis could be developed as potential anti-diabetic agents or functional foods for persons with a high risk of diabetes mellitus.

Animals↗

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↗

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↗

The anti-hyperglycemic activity of the fruiting body of Cordyceps in diabetic rats induced by nicotinamide and streptozotocin.

Little scientific evidence exists to support the numerous herbs used to improve diabetes-related metabolic disorders. Cordyceps, a Chinese herbal medicine with fruiting body and carcass, has been proposed to have multiple medicinal activities. The objective of this study was to investigate the effects of fruiting body and carcass of Cordyceps on hyperglycemia. Male Wistar rats administered with placebo (STZ group), 1 g of fruiting body (FB group), 1 g of carcass (CC group), or 1g of fruiting body plus carcass (CF group) of Cordyceps for four weeks (d1 to d28) were injected with nicotinamide (200 mg/kg) and streptozotocin (65 mg/kg) on d15. Animals fed with placebo and injected with saline acted as the controls (CON group). The results showed that water intake (d15 to d29), changes in fasting blood glucose concentration (d15 to d26), and serum concentrations of fructosamine (d29) were significantly greater in the STZ, CC and CF groups than in the CON and FB groups (one-way ANOVA, P < 0.05). The diabetic rats had significantly lower weight gain and higher blood glucose response in oral glucose tolerance test than the control rats; and these changes were significantly reduced by administrating the fruiting body of Cordyceps. Our results revealed that fruiting body, not carcass, of Cordyceps attenuated the diabetes-induced weight loss, polydipsia and hyperglycemia, and these improvements suggest that fruiting body of Cordyceps has a potential to be the functional food for diabetes.

Administration, Oral↗

Comparison of the effectiveness between a single low dose and fractionated doses of radioiodine in ablation of post-operative thyroid remnants.

Due to the lack of radiation isolation wards in most hospitals in Taiwan, high-dose (exceeding 30 mCi) radioiodine therapy is usually performed in a fractionated manner (successively administering multiple low doses). This study compared the ablating efficacies of post-operative thyroid remnants using a single low dose (30 mCi) and fractionated doses (four doses of 30 mCi given at weekly intervals) in 59 patients with differentiated thyroid cancer who received total or near-total thyroidectomy. Successful ablation was obtained in 20 of 38 patients (52.6%) treated with a single low dose compared with 14 of 21 patients (66.7%) treated in a fractionated manner. There was no statistically significant difference between these two treatment protocols (P = 0.296). As the fractionated-dose protocol has the drawbacks of a much longer hypothyroid state and a higher total expense, we suggest that a single low dose is more feasible than fractionated doses for outpatient ablation therapy.

Adult↗