23 results on '"Feng-Hsuan Liu"'
Search Results
2. Outcomes of Patients With Metastatic Differentiated Thyroid Cancer After Excellent Response to Treatment
- Author
-
Chia-Jung, Hsu, Kun-Yu, Lai, Yu-Ling, Lu, Ming-Hsien, Wu, Feng-Hsuan, Liu, and Shu-Fu, Lin
- Subjects
Male ,Endocrinology, Diabetes and Metabolism ,Adenocarcinoma, Follicular ,Thyroidectomy ,Humans ,Female ,Thyroid Neoplasms ,Middle Aged ,Prognosis ,Carcinoma, Papillary - Abstract
BackgroundTo evaluate the outcomes in differentiated thyroid cancer (DTC) patients who achieved excellent response to initial treatment and developed distant metastasis during follow-up.MethodsThyroid cancer patients registered in Chang Gung Memorial Hospital thyroid cancer database between January 1979 and December 2019 were assessed.ResultsAmong 1053 DTC patients with excellent response to initial therapy, 14 (1.3%) patients developed metastatic disease during follow-up, including 6 males and 8 females with median age of 50.2 years [interquartile range (IQR), 39.9-53.7]. Nine (64.3%) patients had papillary cancer, four (28.6%) had follicular cancer, and one (7.1%) had Hürthle cell cancer. Most patients (92.9%) had stage I disease at diagnosis. The sites of metastasis were lung (71.4%), bone (7.1%), mediastinum (7.1%) and multiple sites (14.3%). With a median follow-up of 18.3 years (IQR, 14.8-23.8), 2 patients had disease-specific mortality. The 5- and 10-year disease-specific survival after the diagnosis of distant metastasis was 92% and 74%, respectively. Multiple sites of metastasis was associated with increased risk of mortality (P = 0.022).ConclusionsA small proportion of DTC patients with an excellence response to initial therapy developed distant metastasis during follow-up. Multiple organ distant metastases conferred a worse disease-specific survival.
- Published
- 2022
3. Successful Applications of Food-Assisted and -Simulated Training Model of Thyroid Radiofrequency Ablation
- Author
-
Yan-Rong Li, Wei-Yu Chou, Wai-Kin Chan, Kai-Lun Cheng, Jui-Hung Sun, Feng-Hsuan Liu, Szu-Tah Chen, and Miaw-Jene Liou
- Subjects
Radiofrequency Ablation ,Treatment Outcome ,surgical procedures, operative ,Endocrinology, Diabetes and Metabolism ,Catheter Ablation ,Humans ,Thyroid Nodule - Abstract
BackgroundRadiofrequency ablation (RFA) for benign thyroid nodules is one kind of scarless treatment for symptomatic or cosmetic benign thyroid nodules. However, how to train RFA-naive physicians to become qualified operators for thyroid RFA is an important issue. Our study aimed to introduce a successful training model of thyroid RFA.Materials and MethodsWe used a food-assisted and -simulated training model of thyroid RFA. Chicken hearts were simulated into thyroid nodules, three-layer pork meats were simulated into peri-thyroid structure, and gel bottles were simulated into trachea, respectively. Successful training ablations were defined as chicken hearts that were fully cooked. After repeating training ablations of chicken hearts at least 100 times with the nearly 100% success rates for three young trainees, they served as the first assistant for the real procedures of thyroid RFA and then were qualified to perform thyroid RFA on real patients under the supervision of one experienced interventional radiologist.Results23 real patients who received RFA and follow-up at least 6 months after treatment were included in Linkou Chang Gung Memorial Hospital from January 1, 2020 to October 1, 2021. Three young endocrinologists performed thyroid RFA independently. The outcomes were volume reduction rate (VRR), major complications and minor complications. The median VRR at 12 months was 82.00%, two major complications were transient hoarseness, and three minor complications were wound pain. All complications were completely recovered within three days.ConclusionsFor young and RFA-native physicians without any basic skills of echo-guided intervention, this food-assisted and -simulated training model of thyroid RFA was useful for medical training and education.
- Published
- 2022
4. Similar Cardiovascular Outcomes Between Insulin Detemir and Insulin Glargine In Type 2 Diabetic Patients With Extremely Atherosclerotic Cardiovascular Disease Risks
- Author
-
Feng-Hsuan Liu, Tien-Hsing Chen, Yan-Rong Li, Ching-Chung Hsiao, Szu-Tah Chen, Ming-Yun Ho, Chih-Ching Wang, and Chi-Hung Liu
- Subjects
medicine.medical_specialty ,Acute coronary syndrome ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Taiwan ,Insulin Glargine ,Brain Ischemia ,Cohort Studies ,Brain ischemia ,Percutaneous Coronary Intervention ,Endocrinology ,Insulin Detemir ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Retrospective Studies ,Insulin detemir ,Insulin glargine ,business.industry ,nutritional and metabolic diseases ,Type 2 Diabetes Mellitus ,Percutaneous coronary intervention ,Retrospective cohort study ,General Medicine ,medicine.disease ,Stroke ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Cardiology ,business ,medicine.drug - Abstract
The cardiovascular outcomes of insulin detemir in patients with type 2 diabetes mellitus (T2DM) after acute coronary syndrome (ACS) or acute ischemic stroke (AIS) are unclear. The aim of our real-life cohort study was to evaluate the cardiovascular outcomes of insulin detemir (IDet) versus insulin glargine (IGlar) in T2DM patients after ACS or AIS.A retrospective cohort study was conducted between June 1, 2005, and December 31, 2013, utilizing the Taiwan National Health Insurance Research Database. A total of 3,129 ACS or AIS patients were eligible for the analysis. Clinical outcomes were evaluated by comparing 1,043 subjects receiving IDet with 2,086 propensity score-matched subjects who received IGlar. The primary composite outcome included cardiovascular (CV) death, nonfatal myocardial infarction (MI) and nonfatal stroke.The primary composite outcome occurred in 322 patients (30.9%) in the IDet group and 604 patients (29.0%) in the IGlar group (hazard ratio [HR], 1.12; 95% confidence interval [CI], 0.95 to 1.32) with a mean follow-up of 2.4 years. No significant differences were observed for CV death (HR, 1.09; 95% CI, 0.86 to 1.38), nonfatal MI (HR, 0.88; 95% CI, 0.66 to 1.19), and nonfatal stroke (HR, 1.15; 95% CI, 0.97 to 1.35). There were similar risks of all-cause mortality, hospitalization for heart failure and revascularization between the IDet group and the IGlar group (P = .647, .115, and .390 respectively).Compared with IGlar, in T2DM patients after ACS or AIS, IDet was not associated with increased risks of CV death, nonfatal MI, or nonfatal stroke.ACS = acute coronary syndrome; AIS = acute ischemic stroke; ASCVD = atherosclerotic cardiovascular disease; CI = confidence interval; CV = cardiovascular; DKA = diabetic ketoacidosis; HHF = hospitalization for heart failure; HHS = hyperosmolar hyperglycemic state; HR = hazard ratio; IDet = insulin detemir; IGlar = insulin glargine; MI = myocardial infarction; NHIRD = National Health Insurance Research Database; PCI = percutaneous coronary intervention; PSM = propensity score matching; T2DM = type 2 diabetes mellitus.
- Published
- 2020
5. Using Deep Convolutional Neural Networks for Enhanced Ultrasonographic Image Diagnosis of Differentiated Thyroid Cancer
- Author
-
Szu-Tah Chen, Wai Kin Chan, Yan-Rong Li, Jui-Hung Sun, Feng-Hsuan Liu, Wei-Yu Chou, Miaw-Jene Liou, and Syu-Jyun Peng
- Subjects
medicine.medical_specialty ,endocrine system ,endocrine system diseases ,QH301-705.5 ,Medicine (miscellaneous) ,Convolutional neural network ,Article ,General Biochemistry, Genetics and Molecular Biology ,Thyroid carcinoma ,Follicular phase ,thyroid cancer ,Medicine ,Biology (General) ,Pathological ,Thyroid cancer ,business.industry ,Thyroid ,deep learning ,CNNs ,medicine.disease ,artificial intelligence ,Image diagnosis ,medicine.anatomical_structure ,Clinical diagnosis ,Radiology ,business - Abstract
Differentiated thyroid cancer (DTC) from follicular epithelial cells is the most common form of thyroid cancer. Beyond the common papillary thyroid carcinoma (PTC), there are a number of rare but difficult-to-diagnose pathological classifications, such as follicular thyroid carcinoma (FTC). We employed deep convolutional neural networks (CNNs) to facilitate the clinical diagnosis of differentiated thyroid cancers. An image dataset with thyroid ultrasound images of 421 DTCs and 391 benign patients was collected. Three CNNs (InceptionV3, ResNet101, and VGG19) were retrained and tested after undergoing transfer learning to classify malignant and benign thyroid tumors. The enrolled cases were classified as PTC, FTC, follicular variant of PTC (FVPTC), Hürthle cell carcinoma (HCC), or benign. The accuracy of the CNNs was as follows: InceptionV3 (76.5%), ResNet101 (77.6%), and VGG19 (76.1%). The sensitivity was as follows: InceptionV3 (83.7%), ResNet101 (72.5%), and VGG19 (66.2%). The specificity was as follows: InceptionV3 (83.7%), ResNet101 (81.4%), and VGG19 (76.9%). The area under the curve was as follows: Incep-tionV3 (0.82), ResNet101 (0.83), and VGG19 (0.83). A comparison between performance of physicians and CNNs was assessed and showed significantly better outcomes in the latter. Our results demonstrate that retrained deep CNNs can enhance diagnostic accuracy in most DTCs, including follicular cancers.
- Published
- 2021
6. The Risk of Bladder Cancer in Type 2 Diabetes Mellitus with Combination Therapy of SGLT-2 Inhibitors and Pioglitazone
- Author
-
Tien-Hsing Chen, Wei-Chiao Sun, Feng-Hsuan Liu, Victor Chien-Chia Wu, Yan-Rong Li, Chihung Lin, Chi-Hung Liu, Pei-Yi Fan, and Ching-Chung Hsiao
- Subjects
medicine.medical_specialty ,Bladder cancer ,Combination therapy ,business.industry ,type 2 diabetes mellitus ,Hazard ratio ,Medicine (miscellaneous) ,Type 2 Diabetes Mellitus ,medicine.disease ,mortality ,Confidence interval ,Article ,Internal medicine ,medicine ,Medicine ,bladder cancer ,pioglitazone ,business ,Database research ,Pioglitazone ,Reference group ,sodium glucose cotransporter-2 (SGLT-2) inhibitors ,medicine.drug - Abstract
Background: Either sodium-glucose cotransporter-2 (SGLT-2) inhibitors or pioglitazone (Pio) has doubtful issues of bladder cancer, especially for the combination therapy with these two drugs. Our study aimed to investigate the risk of bladder cancer under combination therapy of SGLT-2 inhibitors and Pio. Materials and Methods: We included 97,024 patients with type 2 diabetes mellitus (T2DM) in the Chang Gung Research Database in Taiwan from 1 January 2016 to 31 December 2019. The primary outcome was newly diagnosed bladder cancer after combination therapy with SGLT-2 inhibitors and Pio. Group 1 received both study drugs, group 2 received SGLT-2 inhibitors, group 3 received Pio, and group 4 received non-study drugs (the reference group). The secondary outcome in each group was all-cause mortality. Results: In group 1, no newly diagnosed bladder cancer was detected after a mean 2.8-year follow-up and all-cause mortality decreased significantly (adjusted hazard ratio (AHR), 0.70, 95% confidence interval (CI), 0.54–0.92) in comparison to the reference group (group 4). In group 2 and group 3, no trend of increased bladder cancer was observed (group 2: AHR 0.49, 95% CI 0.05–4.94, group 3: AHR 0.48, 95% CI 0.15–1.58) and it still reduced all-cause mortality (group 2: AHR 0.83, 95% CI 0.70–0.99, group 3: AHR 0.90, 95% CI 0.83–0.99). Conclusions: In T2DM patients without previous or active bladder cancer, the combination therapy of SGLT-2 inhibitors and Pio was not associated with newly diagnosed bladder cancer and had lower all-cause mortality.
- Published
- 2021
7. Diagnostic value of adrenal iodine-131 6-beta-iodomethyl-19-norcholesterol scintigraphy for primary aldosteronism: a retrospective study at a medical center in North Taiwan
- Author
-
Jui-Hung Sun, Feng-Hsuan Liu, Ming-Hsien Wu, Szu-Tah Chen, and Kun-Ju Lin
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,education ,Taiwan ,chemistry.chemical_element ,Secondary hypertension ,aldosterone-producing adenomas ,Iodine ,Scintigraphy ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Primary aldosteronism ,single-photon emission computed tomography/computed tomography scan ,mental disorders ,Adrenal Glands ,Hyperaldosteronism ,medicine ,NP-59 adrenal scintigraphy ,Humans ,Radiology, Nuclear Medicine and imaging ,Radionuclide imaging ,Radionuclide Imaging ,Aged ,Retrospective Studies ,Academic Medical Centers ,primary aldosteronism ,medicine.diagnostic_test ,business.industry ,19-Iodocholesterol ,Retrospective cohort study ,General Medicine ,Original Articles ,Hyperplasia ,Middle Aged ,medicine.disease ,6 beta-iodomethyl-19-norcholesterol ,chemistry ,030220 oncology & carcinogenesis ,Female ,business ,psychological phenomena and processes - Abstract
Background Primary aldosteronism (PA) is a common cause of secondary hypertension. Among the many leading causes of PA, the two most frequent are, bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenomas (APA). Since a solitary APA may be cured surgically, but BAH needs lifelong pharmacologic therapy, confirmation is mandatory before surgery. We herein sought to determine the diagnostic value of iodine-131 6-beta-iodomethyl-19-norcholesterol (NP-59) adrenal scintigraphy to distinguish BAH from APA. Patients and methods Patients clinically suspected of PA from March 2000 to October 2016 were retrospectively analyzed. A total of 145 patients, including 74 postunilateral adrenalectomy and seven postradiofrequency ablation for adrenal mass, were reviewed. All patients received NP-59 adrenal scintigraphy prior to surgery. The accuracy of the NP-59 adrenal scintigraphy was confirmed by the pathologic findings and postoperative outcomes. Results Among 81 patients receiving interventional procedures for adrenal mass, adenoma was eventually diagnosed in 72 patients according to their pathologic results, with 60 unilaterally and seven bilaterally localized lesions by NP-59 scintigraphy; nevertheless, there were five negative findings initially. The sensitivity, specificity, and positive predictive value of NP-59 scintigraphy for APA detection were therefore 83.3, 44.4, and 92.3%, respectively. Moreover, single-photon emission computed tomography/computed tomography scan increased the sensitivity and specificity, but not the positive predictive value (85.0, 60.0, and 89.5%) of NP-59 scintigraphy in this study. Conclusion NP-59 adrenal scintigraphy is a useful imaging test to detect APA. Lateralization by this modality prior to surgical intervention may reduce the need for such invasive procedures as adrenal venous sampling.
- Published
- 2019
8. The effect of suppressive thyroxine therapy in nodular goiter in postmenopausal women and 2 year’s bone mineral density change
- Author
-
Szu-Tah Chen, Bie-Yu Huang, Jen-Der Lin, Jawl-Shan Hwang, Chiung-Ya Chen, and Feng-Hsuan Liu
- Subjects
medicine.medical_specialty ,Goiter ,Endocrinology, Diabetes and Metabolism ,Urology ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Absorptiometry, Photon ,0302 clinical medicine ,Endocrinology ,Bone Density ,Multinodular goiter ,Humans ,Medicine ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Femoral neck ,Bone mineral ,Lumbar Vertebrae ,Postmenopausal women ,Femur Neck ,business.industry ,Therapeutic effect ,Nodule (medicine) ,Middle Aged ,medicine.disease ,Density change ,Postmenopause ,Thyroxine ,Treatment Outcome ,medicine.anatomical_structure ,Female ,medicine.symptom ,business ,Goiter, Nodular - Abstract
The efficacy of thyroxine suppressive therapy in reducing nodular growth and its effect to bone mineral density (BMD) in postmenopausal women is still debated. This study aimed to evaluate the therapeutic effect of thyroxine and its influence on BMD. Postmenopausal women with nodular or multinodular goiter during 2013-2015 at Chang Gung Memorial Hospital were enrolled and retrospectively traced back to the first date of visit or treatment. Ninety-four eligible patients were enrolled, of whom 45 were thyroxine-treated (LT-4 group) and 49 were treatment-naïve (control group). Data, including volume of nodules, were analyzed retrospectively. BMD was measured in each LT-4 group patient since the year of enrollment. Nodular volumes were reduced in both LT-4 (from 4.89 ± 4.46 to 4.10 ± 4.57 mL, p = 0.033) and control group (3.48 ± 4.36 to 3.09 ± 2.88 mL, p = 0.239) at initial 2-year follow-up. Nodular volume in LT-4 group increased insignificantly (from 4.89 ± 4.46 to 4.91 ± 5.40 mL, p = 0.711) at the end of 7-year follow-up. The best cut-off predictive nodular volume that may have responded to thyroxine is 2.6 mL (AUC, 0.740; sensitivity, 0.750; specificity, 0.733) during first 2 year. Lumbar spine, total hip and femoral neck BMD were not significantly changed during 2 year's thyroxine suppression therapy. In conclusion, thyroxine suppressive therapy in postmenopausal women had significant reduction in nodule volume at initial 2 years of treatment, especially in volume larger than 2.6 mL. Prolonged thyroxine treatment did not benefit nodular size reduction and may affect BMD minimally in postmenopausal women.
- Published
- 2018
9. Postoperative recurrence of papillary thyroid carcinoma with lymph node metastasis
- Author
-
Feng-Hsuan Liu, Sheng-Fong Kuo, Jen-Der Lin, Tzu-Chieh Chao, and Chuen Hsueh
- Subjects
Male ,Pathology ,endocrine system diseases ,medicine.medical_treatment ,radioactive iodine ,Soft Tissue Neoplasms ,Kaplan-Meier Estimate ,Lymph node metastasis ,thyroglobulin ,Cancer specific survival ,Metastasis ,Iodine Radioisotopes ,Risk Factors ,Medicine ,Postoperative Period ,Lymph node ,Research Articles ,Total thyroidectomy ,General Medicine ,Middle Aged ,humanities ,total thyroidectomy ,Treatment Outcome ,medicine.anatomical_structure ,Oncology ,Thyroid Cancer, Papillary ,Lymphatic Metastasis ,Thyroidectomy ,Neck Dissection ,Female ,Radioactive iodine ,Research Article ,Adult ,medicine.medical_specialty ,cancer specific survival ,lymph node dissection ,Disease-Free Survival ,Thyroid carcinoma ,Humans ,Neoplasm Invasiveness ,Thyroid Neoplasms ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Carcinoma ,medicine.disease ,Carcinoma, Papillary ,body regions ,Surgery ,Thyroglobulin ,Lymph Nodes ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Background and Objectives : The purpose of this study was to retrospectively analyze the features of patients with papillary thyroid carcinoma (PTC) presenting with neck lymph node (LN) metastasis. Methods : The study enrolled 909 patients with PTC who had undergone total thyroidectomy. After a median follow‐up of 14.6 years, 73 (8.0%) patients died of thyroid cancer. A total of 536 patients had the tumor confined to the thyroid (intra‐thyroid), 111 had lymph node (LN) metastasis, 225 showed soft tissue invasion, and 37 had distant metastasis. Results : Compared with the intra‐thyroid group, the group with LN metastases showed larger tumor size, higher postoperative thyroglobulin levels, advanced TNM stage, higher recurrence rates (5.2% vs. 31.5%), and higher disease‐specific mortality (1.3% vs. 12.6%). Of the 111 patients with PTC and LN metastases, 35 (31.5%) were diagnosed with recurrence during a mean follow‐up period of 16.9 ± 0.6 years. Among the 35 patients with recurrent PTC, 14 (40.0%) died of thyroid cancer. The mortality group was characterized by older, mostly male patients who presented with larger initial tumor size compared with survivors. Conclusions : In patients with PTC, the rates of recurrence and cancer mortality were higher in the group with LN metastasis than that in the intra‐thyroid tumor group. J. Surg. Oncol. 2015 111:149–154. © 2015 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.
- Published
- 2015
10. Higher body weight and distant metastasis are associated with higher radiation exposure to the household environment from patients with thyroid cancer after radioactive iodine therapy
- Author
-
Bie-Yui Huang, Hung-Yu Chang, Huang-Yang Chen, Ru-Chin Cheng, Sheng-Fong Kuo, Jen-Der Lin, Sheng-Chieh Chan, Sheng-Hwu Hsieh, Soh-Ching Ng, Tsung-Ying Ho, Kun-Ju Lin, Feng-Hsuan Liu, Kun-Chun Chiang, Miaw-Jene Liou, Chih-Lang Lin, and Ta-You Lo
- Subjects
Adult ,Male ,medicine.medical_specialty ,radioactive iodine ,Observational Study ,radiation exposure ,Body weight ,030218 nuclear medicine & medical imaging ,Iodine Radioisotopes ,03 medical and health sciences ,0302 clinical medicine ,Adenocarcinoma, Follicular ,thyroid cancer ,Medicine ,Humans ,Family ,Prospective Studies ,Thyroid Neoplasms ,Neoplasm Metastasis ,Thyroid cancer ,Aged ,business.industry ,Body Weight ,Distant metastasis ,General Medicine ,Middle Aged ,medicine.disease ,Carcinoma, Papillary ,Surgery ,rhTSH ,Radiation exposure ,Caregivers ,030220 oncology & carcinogenesis ,Female ,Thermoluminescent Dosimetry ,Radioactive iodine therapy ,Radiology ,Radioactive iodine ,business ,radiation protection ,Research Article - Abstract
There were insufficient data regarding radiation exposure to the household environment from patients with thyroid cancer who received radioactive iodine (RAI) therapy in Asia; we therefore performed the present study at the Chang Gung Memorial Hospital in Keelung, Taiwan. Patients with papillary or follicular thyroid cancer who received 3.7 GBq (100 mCi) RAI were enrolled in this prospective hospital-based study. The enrolled patients were asked to place a thermoluminescent dosimeter in the living room, bedroom, and bathroom of their houses for 4 weeks to measure radiation exposure to the household environment. A total of 43 patients (18 men and 25 women; mean age 51 ± 13 years) who received 3.7 GBq (100 mCi) RAI completed the study. The mean value of total radiation exposure over 4 weeks from the patients to the bedroom, bathroom, and living room (eliminating the background radiation factor) was 0.446 ± 0.304 (0.088–1.382) mSv. We divided the patients into 2 groups: those with more than and less than the mean value of total radiation exposure to the bedroom, bathroom, and living room. Factors associated with the higher amount of radiation exposure from the patients to the household environment were patient body weight (P = .025, univariate analysis; P = .037, multivariate analysis, odds ratio [95% confidence interval] 1.067 [1.004–1.134]) and distant metastases based on 131I post-therapy scanning (P = .041, univariate analysis; P = .058, multivariate analysis, odds ratio [95% confidence interval] 6.453 [0.938–44.369]); age, sex, body mass index, renal function, serum stimulated thyroglobulin level, and recombinant human thyroid-stimulating hormone use were not associated with the amount of radiation exposure from the patients to the household environment. Higher body weight and distant metastases may be the best predictors for higher radiation exposure to the household environment from patients with thyroid cancer after RAI therapy.
- Published
- 2017
11. Subclinical hypothyroidism and metabolic risk factors association: A health examination-based study in northern Taiwan
- Author
-
Feng-Hsuan Liu, Chang-Fu Kuo, Jawl-Shan Hwang, Jen-Der Lin, Yu-Shien Ko, and Szu-Tah Chen
- Subjects
Adult ,Male ,medicine.medical_specialty ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Hypothyroidism ,Risk Factors ,Internal medicine ,medicine ,Humans ,lcsh:QH301-705.5 ,Physical Examination ,Subclinical infection ,Aged ,Metabolic Syndrome ,lcsh:R5-920 ,Cholesterol ,business.industry ,Medical record ,Thyroid disease ,General Medicine ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,lcsh:Biology (General) ,chemistry ,Female ,Metabolic syndrome ,Thyroid function ,lcsh:Medicine (General) ,business ,Hormone ,Lipoprotein - Abstract
Background: Subclinical hypothyroidism (SCH) is defined as elevation in serum thyroid-stimulating hormone (TSH) levels despite normal serum levels of free thyroxine. It remains controversial whether people with SCH have higher total cholesterol and low-density lipoprotein cholesterol levels compared to normal-thyroid subjects. The aim of this study was to assess the metabolic risk factors for SCH. Methods: Subjects were recruited from the health examination center of Chang Gung Memorial Hospital, Linkou, from January 1, 2010 to December 31, 2011. This was a cross-sectional review of medical records. The subjects were ethnic Taiwanese residents without known thyroid disease at baseline. Results: A total of 22,324 subjects received annual health examination at Chang Gung Memorial Hospital from 2010 to 2011. Among them, 15,943 subjects were included as the normal thyroid group (NG), and 203 subjects (101 men and 102 women) met the criteria for SCH. The prevalence of metabolic syndrome (MetS) in the NG was 26.2% in men and 18.7% in women, whereas that in the SCH group was 39.6% in men and 29.4% in women. Women in the SCH group showed significantly higher cholesterol, triglyceride, non-high density lipoprotein (HDL) and cholesterol/HDL levels than those in the NG (p
- Published
- 2016
12. The efficacy and safety of concentrated herbal extract granules, YH1, as an add-on medication in poorly controlled type 2 diabetes: A randomized, double-blind, placebo-controlled pilot trial
- Author
-
Sheng-Hwu Hsieh, Miaw-Jene Liou, Chia-Hung Lin, Chung-Huei Huang, Ming-Chung Lee, Chih-Ching Wang, Lan-Yan Yang, Tzu-Yang Hsu, Szu-Tah Chen, Yueh-Hsiang Huang, Feng-Hsuan Liu, Jr-Rung Lin, Geng-Hao Liu, Chun-Teng Huang, and Yi-Hong Wu
- Subjects
Male ,Pilot Projects ,Type 2 diabetes ,Pathology and Laboratory Medicine ,Biochemistry ,law.invention ,chemistry.chemical_compound ,Endocrinology ,0302 clinical medicine ,Randomized controlled trial ,law ,Diabetes diagnosis and management ,Clinical endpoint ,Insulin ,Multidisciplinary ,Middle Aged ,Lipids ,Type 2 Diabetes ,Cholesterol ,Research Design ,030220 oncology & carcinogenesis ,Homeostatic model assessment ,Medicine ,Female ,Research Article ,Adult ,Diarrhea ,medicine.medical_specialty ,HbA1c ,Endocrine Disorders ,Clinical Research Design ,Science ,030209 endocrinology & metabolism ,Gastroenterology and Hepatology ,Research and Analysis Methods ,Placebo ,03 medical and health sciences ,Traditional Chinese medicine ,Signs and Symptoms ,Insulin resistance ,Double-Blind Method ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Araceae ,Humans ,Obesity ,Hemoglobin ,Aged ,Glycated Hemoglobin ,Medicine and health sciences ,Diabetic Endocrinology ,Plants, Medicinal ,Biology and life sciences ,Plant Extracts ,business.industry ,Proteins ,Traditional medicine ,medicine.disease ,Diagnostic medicine ,Hormones ,Diabetes Mellitus, Type 2 ,Complementary and alternative medicine ,chemistry ,Metabolic Disorders ,Adverse Events ,Glycated hemoglobin ,business ,Drugs, Chinese Herbal - Abstract
BackgroundIn Asian countries, many patients with type 2 diabetes fail to achieve controlled glycated hemoglobin (HbA1c) levels while taking several classes of oral hypoglycemic agents (OHAs). Traditional Chinese medicine could be an alternative therapeutic option for poorly controlled type 2 diabetes. YH1 is a concentrated Chinese herbal extract formula that combines Rhizoma Coptidis and Shen-Ling-Bai-Zhu-San. This randomized, double-blind, placebo-controlled pilot study evaluated YH1 as an add-on medication for poorly controlled type 2 diabetes.MethodsForty-six patients with poorly controlled type 2 diabetes were randomly assigned 1:1 to the YH1 or placebo group. Before the trial, all subjects had received three or more classes of OHAs with HbA1c > 7.0% (53 mmol/mol) and a body mass index ≥ 23 kg/m2. During the 12-week trial, participants continued to take OHAs without any dose or medication changes. The primary endpoint was the percentage change in HbA1c level. Per-protocol analysis was applied to the final evaluation.ResultsAt week 12, there was an 11.1% reduction in HbA1c from baseline and a 68.9% increase in homeostatic model assessment (HOMA) of β cell function in the YH1 group, which also exhibited significant reductions in two-hour postprandial glucose (-26.2%), triglycerides (-29.5%), total cholesterol (-21.6%), low-density lipoprotein cholesterol (-17.4%), body weight (-0.5%), and waist circumference (-1.1%). The changes in fasting plasma glucose, HOMA insulin resistance and symptom scores were not significantly different between the YH1 and placebo groups. No serious adverse events occurred during this clinical trial.ConclusionsThis pilot study indicates that YH1 together with OHAs can improve hypoglycemic action and β-cell function in overweight/obese patients with poorly controlled type 2 diabetes. YH1 is a safe add-on medication for OHAs and has beneficial effects on weight control and lipid metabolism. A larger study population with longer treatment and follow-up periods is required for further verification.
- Published
- 2019
13. Thyroid follicular neoplasm: Analysis by fine needle aspiration cytology, frozen section, and histopathology
- Author
-
Feng-Hsuan Liu, Tzu-Chieh Chao, Miaw-Jene Liou, Chuen Hsueh, and Jen-Der Lin
- Subjects
Thyroid nodules ,endocrine system ,Pathology ,medicine.medical_specialty ,Histology ,medicine.medical_treatment ,Biopsy, Fine-Needle ,Sensitivity and Specificity ,Pathology and Forensic Medicine ,Thyroid carcinoma ,Adenocarcinoma, Follicular ,Biopsy ,medicine ,Frozen Sections ,Humans ,Thyroid Neoplasms ,Retrospective Studies ,Frozen section procedure ,medicine.diagnostic_test ,business.industry ,Thyroid ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Adenocarcinoma ,Histopathology ,Thyroglobulin ,business - Abstract
We performed a retrospective analysis of follicular neoplasm data obtained from frozen section examinations of thyroid nodules. A total of 5,660 patients underwent preoperative neck ultrasonography and fine-needle aspiration cytology (FNAC), surgical treatment, and follow-up at a medical institute. Patients with papillary thyroid microcarcinoma were excluded from this study. In 971 cases, frozen section examination was performed during the surgical treatment of follicular neoplasm that was diagnosed via FNAC. Thyroid malignancies were histologically confirmed in 25.1% of cases (244/971). Among the patients with papillary thyroid carcinoma, 45 were diagnosed with the follicular variant of papillary thyroid carcinomas (27.4%). The diagnostic sensitivity of frozen section for the nonfollicular variant of papillary thyroid carcinoma was better than that for the follicular variant of papillary thyroid carcinoma (89.1% versus 78.9%; P = 0.1023). For 12 cases the diagnosis was atypical follicular adenomas. The diagnostic accuracy of frozen section in cases of follicular neoplasm was 76.9% with a sensitivity of 84.8% and a specificity of 98.9%. In conclusion, our analysis revealed high rates of accuracy when using frozen tissue sections for early diagnosis and treatment of follicular neoplasm; thus, an early decision to extent of surgery prevents a risky follow-up surgery.
- Published
- 2009
14. Sonography and fine-needle aspiration biopsy in the diagnosis of benign versus malignant nodules in patients with autoimmune thyroiditis
- Author
-
Hung-Yu Chang, Feng-hsuan Liu, Chuen Hsueh, Bie-Yu Huang, Miaw-Jene Liou, and Jen-Der Lin
- Subjects
Adult ,Male ,Thyroid nodules ,Pathology ,medicine.medical_specialty ,Adenoma ,Biopsy, Fine-Needle ,Autoimmune thyroiditis ,Neoplasms ,Biopsy ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Thyroid Neoplasms ,Halo sign ,Ultrasonography ,medicine.diagnostic_test ,business.industry ,Thyroiditis, Autoimmune ,Nodule (medicine) ,Middle Aged ,medicine.disease ,Fine-needle aspiration ,Female ,Radiology ,medicine.symptom ,business ,Lymphocytic Thyroiditis - Abstract
Purpose. To correlate sonographic (US) characteristics and results of fine-needle aspiration biopsy (FNAB) of thyroid nodules in autoimmune thyroiditis (AT) with surgical pathological findings. Method. Forty AT patients with 40 nodular lesions were analyzed retrospectively. Five sonographic characteristics were recorded for each nodule: diameter, echogenicity, microcalcification, halo sign, and margin. Preoperative sonograms and FNAB results were compared with postoperative histopathological findings. Result. Twenty-four of the 40 nodules were malignant, including 20 papillary carcinomas, 3 follicular carcinomas, and 1 medullary carcinoma. Of the 16 benign nodules, 8 were nodular hyperplasia, 6 lymphocytic thyroiditis, and 1 each follicular adenoma and Hurthle cell adenoma. The only US parameter that was significant in malignant vs. benign nodules was the presence of poorly defined margins. Based on preoperative cytology, 22 of the 23 malignant nodules were correctly diagnosed, and 10 of the 14 benign nodules were correctly identified. The positive predictive value was 78.6%, and the negative predictive value was 93.7%. Conclusion. No single US parameter can predict thyroid malignancy in patients with AT. A combination of US and FNAB provides the most sensitive and specific approach available preoperatively. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009
- Published
- 2009
15. Neck nodule and thyroid cancer in young without radiation exposure history
- Author
-
Chuen Hsueh, Jen-Der Lin, Tzu-Chieh Chao, and Feng-Hsuan Liu
- Subjects
Adenoma ,Male ,Thyroiditis ,medicine.medical_specialty ,Adolescent ,Lymphoma ,Biopsy, Fine-Needle ,medicine.disease_cause ,Sensitivity and Specificity ,Young Adult ,Predictive Value of Tests ,Humans ,Medicine ,Cyst ,Hemangioma, Capillary ,Child ,Atypical Adenoma ,Thyroid cancer ,Thyroid neoplasm ,Retrospective Studies ,Ultrasonography ,Neurofibroma ,Cysts ,business.industry ,Carcinoma ,Thyroid ,Infant ,Nodule (medicine) ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Head and Neck Neoplasms ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Surgery ,Radiology ,medicine.symptom ,business ,Neck - Abstract
The aim of this study was to analyze the results of histopathological studies in neck masses observed in young patients. The neck masses were detected using ultrasonography and fine-needle aspiration cytology (FNAC). In this retrospective study, we analyzed 234 young patients who were surgically treated for neck masses at Chang Gung Medical Center in Linkou. The mean age of the 234 young patients was 16.3 ± 4.0 years (range 1–20 years). Neck ultrasonography studies were conducted using a real-time ultrasonographic machine and a 10 MHz transducer. FNAC was performed for the suspected neck nodules. Of the 234 cases, 187 (79.9%) were surgically confirmed to be benign lesions, including four cases that were diagnosed as atypical adenoma. Malignant thyroid masses were identified in 47 patients. Surgery confirmed 22 cases to be lesions that were non-thyroid in origin, including those developing from a cyst, soft tissue, and with a lymphatic origin. Diagnostic accuracies of the FNAC and frozen section examination were found to be 91.1 and 97.7%, respectively. In the study population, 20.1% of the neck masses were malignant. Except in cases of follicular thyroid neoplasm, neck ultrasonography with FNAC could effectively identify the thyroid or non-thyroid origin of these masses with high-diagnostic accuracy.
- Published
- 2009
16. Modified vancomycin dosing protocol for treatment of diabetic foot infections
- Author
-
Ming-Hsun Lee, Hung-Yu Chang, Cheng Ho, Su-Chen Niu, Feng-Hsuan Liu, and Shin-Tarng Deng
- Subjects
Male ,Staphylococcus aureus ,medicine.medical_specialty ,Taiwan ,Renal function ,medicine.disease_cause ,Drug Administration Schedule ,chemistry.chemical_compound ,Vancomycin ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Dosing ,Prospective cohort study ,Pharmacology ,Creatinine ,Dose-Response Relationship, Drug ,business.industry ,Health Policy ,Middle Aged ,Staphylococcal Infections ,biochemical phenomena, metabolism, and nutrition ,Diabetic Foot ,Anti-Bacterial Agents ,Surgery ,Regimen ,chemistry ,Female ,Methicillin Resistance ,Gentamicin ,business ,medicine.drug - Abstract
Purpose. The clinical efficacy of a modified vancomycin dosing protocol with a conventional regimen for managing patients with diabetic foot infections caused by methicillin-resistant Staphylococcus aureus (MRSA) was evaluated. Methods. This prospective study was conducted from January 2002 to December 2004 at the diabetic ward of Chang Gung Memorial Hospital—Linkou in Taiwan. All diabetic patients with MRSA-related diabetic foot infections confirmed by wound cultures were enrolled in this study. Patients treated with the conventional protocol (from 2002 to 2003) received vancomycin 10–15 mg/kg (up to 1 g) over 60 minutes every 12 hours if their serum creatinine (SCr) concentration was 0.4–1.4 mg/dL according to the estimation of creatinine clearance (CLcr). Patients treated with the modified vancomycin dosing protocol (from 2003 to 2004) received vancomycin according to their SCr level, age, and concurrent gentamicin dosage. Data analyzed included patients’ age, sex, body weight, SCr level, CLcr, serum vancomycin peak and trough levels, vancomycin dosage, treatment period, and duration of hospital stay. Results. A total of 85 patients were enrolled in this study. The conventional protocol group achieved substantially higher serum vancomycin levels than those recommended by the British National Formulary ( BNF ). Although the vancomycin dosage in the modified protocol was lower than that in the conventional protocol, trough and peak vancomycin levels remained within the range recommended by the BNF . The duration of hospitalization and treatment did not significantly differ between the two groups. Conclusion. A modified vancomycin dosing protocol for treating diabetic foot infections caused by MRSA was superior to the conventional dosing regimen in achieving therapeutic serum levels of vancomycin.
- Published
- 2008
17. The impact of diabetes mellitus on the survival of patients with acromegaly
- Author
-
Chen-Nen Chang, Szu-Tah Chen, Ming-Hsu Wang, Wen-Ko Chiou, Jen-Der Lin, and Feng-Hsuan Liu
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,China ,business.industry ,Comorbidity ,Coronary Artery Disease ,Middle Aged ,medicine.disease ,Diabetes mellitus ,Neoplasms ,Acromegaly ,medicine ,Diabetes Mellitus ,Humans ,Female ,business ,Follow-Up Studies ,Retrospective Studies - Abstract
An increased risk of mortality in patients with uncontrolled acromegaly has been reported in several studies. We aimed to assess the impact of co-morbidities on the survival of patients with acromegaly after long-term treatment and follow-up.A retrospective analysis was performed for 285 patients with active acromegaly, who were admitted to the Chang Gung Memorial Hospital, Taiwan between 1978 and 2012. Of these patients, 106 (37.2%) were diagnosed with diabetes mellitus (DM). During the follow-up period, 21 cases of histological proved malignant in acromegalic patients, and DM with acromegaly had a higher incidence of malignancy (13.2% vs. 3.8%; p0.01). The 5-, 10-, and 20-year survival rates were 93.1%, 86.9%, and 84.7% for the DM group, respectively, and 96.5%, 96.5%, and 96.5% for the non-DM group, respectively. After a mean follow-up of 15.1 ± 0.6 years, age, DM, coronary heart disease, and malignancy were found to be significant factors of mortality. Control of growth hormone and IGF-1 levels also conferred a marginal survival benefit.DM and malignancy significantly influence the survival of patients with acromegaly; thus, these patients need close follow-up and appropriate therapy. (Endokrynol Pol 2016; 67 (5): 501-506).
- Published
- 2015
18. Protective Effect of Physical Activity Independent of Obesity on Metabolic Risk Factors
- Author
-
Jen-Der Lin, Feng-Hsuan Liu, and Chia-Lin Li
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Physical activity ,Medicine (miscellaneous) ,Physiology ,Body Mass Index ,Fasting glucose ,chemistry.chemical_compound ,Risk Factors ,Surveys and Questionnaires ,Internal medicine ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Obesity ,Prospective Studies ,Exercise physiology ,Prospective cohort study ,Exercise ,Triglycerides ,Nutrition and Dietetics ,business.industry ,Cholesterol ,Cholesterol, HDL ,Metabolic risk ,General Medicine ,medicine.disease ,Lipids ,Endocrinology ,chemistry ,Body Composition ,Female ,business ,Body mass index - Abstract
The purpose of this prospective study was to examine the effect of physical activity independent of obesity on metabolic risk factors. A total of 358 participants were recruited from the Department of Health Management of Chang Gung Medical Center. Physical activity was assessed using a 3-d activity record. Body-mass index (BMI) and metabolic risk factors were also assessed. Our findings demonstrate that an effect of obesity that was statistically independent of the levels of physical activity is associated with metabolic risk factors. Moreover, physical activity displayed inverse associations with triglycerides, and fasting plasma glucose and a positive association with HDL cholesterol. Those participants with time spent in moderate activity more than 0.5 h each day had significantly less risk of high fasting glucose. Significantly, these associations were independent of BMI.
- Published
- 2006
19. Human telomerase reverse transcriptase (hTERT) gene expression in FNA samples from thyroid neoplasms
- Author
-
Feng-Hsuan Liu, Err-Cheng Chan, Jen-Der Lin, Miaw-Jene Liou, and Tzu-Chieh Chao
- Subjects
Thyroid nodules ,endocrine system ,Cancer Research ,Pathology ,medicine.medical_specialty ,Goiter ,endocrine system diseases ,Thyroid Gland ,Malignancy ,Gene Expression Regulation, Enzymologic ,Thyroid carcinoma ,Predictive Value of Tests ,Adenocarcinoma, Follicular ,Biomarkers, Tumor ,medicine ,Humans ,Telomerase reverse transcriptase ,Prospective Studies ,RNA, Messenger ,RNA, Neoplasm ,Thyroid Neoplasms ,Thyroid Nodule ,Telomerase ,neoplasms ,DNA Primers ,Tumor marker ,Reverse Transcriptase Polymerase Chain Reaction ,business.industry ,Biopsy, Needle ,Thyroid ,medicine.disease ,Carcinoma, Papillary ,DNA-Binding Proteins ,Gene Expression Regulation, Neoplastic ,medicine.anatomical_structure ,Oncology ,RNA ,Adenocarcinoma ,business - Abstract
Identifying a tumor marker that can help distinguish benign from malignant thyroid tumors is crucial, because up to 30% of thyroid fine-needle aspirations (FNA) are diagnosed as 'suspicious' or follicular neoplasm for malignancy. Recently, the detection of human telomerase reverse transcriptase (hTERT) gene expression in thyroid FNA samples has been identified as a promising diagnostic marker in distinguishing benign and malignant thyroid tumors. Twenty-seven FNA samples from thyroid tumors that were suspected to be malignant were collected preoperatively, hTERT gene expression was examined by reverse transcriptase-polymerase chain reaction (RT-PCR), and the cytological and histological results were compared. The results demonstrated that 13 (92.8%) of 14 thyroid carcinomas, including eight of eight papillary, three of four follicular, and two of two Hürthle cell thyroid carcinomas have corresponding FNA samples that were positive for hTERT. Meanwhile, eight (61.5%) of 13 benign thyroid nodules, including three of six nodular goiter, two of two Graves' disease, two of two Hürthle cell adenomas, and one of three follicular adenomas were positive for hTERT. In conclusion, hTERT was more prevalent in malignant thyroid FNA samples than in the benign thyroid FNA samples. Notably, the extent of the differences in hTERT expression between benign and malignant follicular thyroid tumors require further investigation. Moreover, further information including semi-quantitative real-time RT-PCR, is required to verify whether hTERT mRNA expression could serve as an adjunctive molecular marker for the preoperative diagnosis of thyroid malignancies.
- Published
- 2003
20. Detection of mRNA of sodium iodide symporter in benign and malignant human thyroid tissues
- Author
-
Miaw-Jene Liou, Err-Cheng Chan, Feng-Hsuan Liu, Hsiao-Fen Weng, Jen-Der Lin, and Tzu-Chieh Chao
- Subjects
Adult ,Male ,Sodium-iodide symporter ,endocrine system ,Cancer Research ,Pathology ,medicine.medical_specialty ,Adolescent ,endocrine system diseases ,Adenoma ,Biology ,Papillary thyroid cancer ,Thyroid carcinoma ,Adenocarcinoma, Follicular ,Tumor Cells, Cultured ,medicine ,Humans ,RNA, Messenger ,Thyroid Neoplasms ,Aged ,Thyroid Epithelial Cells ,Symporters ,Reverse Transcriptase Polymerase Chain Reaction ,Thyroid ,Membrane Proteins ,Middle Aged ,Hyperplasia ,medicine.disease ,Carcinoma, Papillary ,medicine.anatomical_structure ,Oncology ,Symporter ,Female ,Carrier Proteins - Abstract
Human sodium iodide symporter (hNIS) is an intrinsic membrane protein with 12 transmembrane regions, which shows homology to other sodium-dependent transporters. There is controversy as to the amount of hNIS expression in different kinds of human thyroid cancer tissues and cell lines. In this study, reverse transcription-polymerase chain reaction (RT-PCR) was used to detect mRNA of hNIS in various fresh normal, benign tissues and malignant human thyroid tissues. The forward primer was nested hNIS-5' primer containing the sequences: ACCTGGAAATGCGCTTCAGC. The reverse primer was nested hNIS-3' primer containing the sequences: AAGCATGACACCGCGTGCCA. The results revealed three of three normal tissues, six of eight nodular hyperplasia, two of two hyperthyroidism, one of three follicular adenomas, five of ten papillary thyroid carcinomas, one of one follicular carcinoma and zero of one metastatic follicular tissues demonstrated positive results for hNIS in thyroid epithelial cells. A higher percentage of positive results of the symporter mRNA were found in normal benign thyroid tissues and the thyroid tissues of hyperthyroidism, and nodular hyperplasia (84.6%); however follicular adenoma, papillary and follicular thyroid carcinomas demonstrated a lower percentage of expression in the RT-PCR studies (46.7%). Serum thyrotropin levels and the degree of differentiated components presented in cancer tissues have been mentioned as important factors for hNIS expression in the cancer tissues. The discrepancies of the expression of hNIS in in vivo and in vitro studies need further investigation. In conclusion, hNIS was found in higher ratios in normal and benign thyroid tissues than in the malignant tissues. In addition, the RT-PCR technique hNIS did not detect the transporter in most papillary thyroid cancer tissues.
- Published
- 2000
21. Diagnostic and therapeutic strategies for minimally and widely invasive follicular thyroid carcinomas
- Author
-
Tzu-Chieh Chao, Chao-Chun Huang, Jen-Der Lin, Feng-Hsuan Liu, and Chuen Hsueh
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Taiwan ,Thyroid carcinoma ,Follicular phase ,Adenocarcinoma, Follicular ,medicine ,Frozen Sections ,Humans ,Thyroid Neoplasms ,Thyroid cancer ,Survival analysis ,Aged ,Retrospective Studies ,Ultrasonography ,Frozen section procedure ,business.industry ,General surgery ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Survival Analysis ,Thyroxine ,Treatment Outcome ,Oncology ,Adenocarcinoma ,Surgery ,Thyroglobulin ,Female ,Radiology ,business - Abstract
The purpose of this study is to investigate diagnostic and therapeutic strategies that will enable easy differentiation between minimally invasive follicular carcinoma (MIFC) and widely invasive follicular carcinoma (WIFC). We retrospectively reviewed 234 follicular thyroid carcinoma cases to compare the diagnostic and therapeutic characteristics between the minimally and the widely invasive types. Eighty-nine patients were diagnosed with MIFC (mean age, 39.2 ±14.9 years) and 145 were diagnosed with WIFC (mean age, 49.0 ± 17.7 years). Low diagnostic accuracy from preoperative cytology and frozen sections resulted in 60 patients undergoing subtotal thyroidectomies and 57 cases required a second operation for complete thyroidectomy. Patients in the MIFC group were younger, and had small-sized tumors, lower postoperative thyroglobulin levels, lower recurrent rates and lower cancer mortality rates than those in the WIFC group. Diagnostic accuracy from frozen sections in the WIFC group was relatively better. After a mean follow-up period of 9.0±0.4 years, 41 of the 234 (17.5%) patients with follicular thyroid carcinoma had died due to thyroid cancer. All MIFC patients remained disease-free or had a recurrence-free status. In conclusion, both WIFC and MIFC are difficult to diagnose on the basis of preoperative examinations and frozen sections. Patients diagnosed with MIFC had responded positively to the treatment; however, for patients diagnosed with WIFC to become disease-free, early diagnosis and aggressive surgical therapies in combination with (131)I therapy were required.
- Published
- 2009
22. Association of hematological factors with components of the metabolic syndrome in older and younger adults
- Author
-
Hung-Yu Chang, Jen-Der Lin, Feng-Hsuan Liu, Hsiao-Fen Weng, Wen-Ko Chiou, and Thu-Hua Liu
- Subjects
Adult ,Male ,medicine.medical_specialty ,Aging ,Waist ,Health Status ,Overweight ,Waist–hip ratio ,Internal medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,Metabolic Syndrome ,Anthropometry ,business.industry ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,Blood Cell Count ,Menopause ,Endocrinology ,Female ,Geriatrics and Gerontology ,medicine.symptom ,Metabolic syndrome ,business ,Dyslipidemia - Abstract
This study retrospectively examined the characteristics of metabolic syndrome in an aged population and assessed the risk factors for these subjects.A total of 1332 aged subjects (or =65 years; mean age 71.0+/-5.0 years) were enrolled from 6903 subjects recruited from the Department of Health Management at Chang Gung Medical Center. Of these 6903 subjects, 1665 (814 females and 851 males) were diagnosed with metabolic syndrome. Whole body three-dimensional (3- D) laser scanning was employed for anthropometric measurements. Furthermore, health index (HI) was derived by the following equation: HI = (body weight x 2 x waist area) / [body height2 x (breast area + hip area)].Among the 6903 subjects, no significant difference in gender was noted between groups with and without metabolic syndrome (p=0.142). For subjects64 years, the incidence of metabolic syndrome in females is higher than in males. Subjects are categorized into four groups based on age and whether they had metabolic syndrome. Group A (4402 cases) consists of subjects65 years old without metabolic syndrome. Group B (836 cases) comprises subjects64 years old and without metabolic syndrome. Group C (1169 cases) contains subjects65 years old with metabolic syndrome and group D (496 cases) is composed of subjects64 years old with metabolic syndrome. Of the aged 1332 subjects, 595 were females (mean age, 70.6+/-4.6 years) and 737 were males (mean age, 71.3+/-5.3years), 37.2% (496/1332) had metabolic syndrome, 19.9% had DM and 21.8% had hypertension. These subjects had decreased BMI with age. Additionally, WHR peaked at an age range of 75-79 years. Of the aged subjects, also overweight, 42.8% and 33.6% were diagnosed with hypertension and DM, respectively; both ratios higher than those for non-overweight subjects (25.3% and 26.2%, respectively). Of the four groups in this study, the ratios for DM, hypertension, and WHR, HI, and LDL levels progressively increased through groups A to D. WBC count differs statistically significantly between these groups. Statistical analysis of WBC count, RBC and hemoglobin (Hb) with different parameters demonstrates significant elevation of WBC counts with the components of metabolic syndrome in aged subjects.WBC count, RBC count and Hb are associated with metabolic syndrome components in younger and old adults of both genders. The incidence of metabolic syndrome marker increased after menopause onset in the female population in this study.
- Published
- 2007
23. Serum uric acid and leptin levels in metabolic syndrome: a quandary over the role of uric acid
- Author
-
Wen-Ko Chiou, Feng-Hsuan Liu, Hsiao-Fen Weng, Hung-Yu Chang, and Jen-Der Lin
- Subjects
Adult ,Leptin ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Body Mass Index ,chemistry.chemical_compound ,Endocrinology ,Waist–hip ratio ,Insulin resistance ,Risk Factors ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Hyperuricemia ,Aged ,Metabolic Syndrome ,business.industry ,Waist-Hip Ratio ,nutritional and metabolic diseases ,Middle Aged ,medicine.disease ,Obesity ,Uric Acid ,chemistry ,Uric acid ,Female ,Metabolic syndrome ,Insulin Resistance ,business ,Lipoproteins, HDL - Abstract
This study investigates the impact of uric acid (UA) on the risk factors associated with metabolic syndrome. In addition, this study explores the relationship between UA and insulin resistance and serum leptin levels in metabolic syndrome. A total of 470 subjects (252 women and 218 men) were recruited from the Department of Health Management at Chang Gung Medical Center (Linkou, Taiwan). Metabolic syndrome was defined using a modified Adult Treatment Panel III (ATP III) definition. The formula for the homeostasis model assessment of insulin resistance (HOMA-IR) is as follows: fasting serum insulin (microU/mL) x fasting plasma glucose (mmol/L)/22.5. Diabetes mellitus was diagnosed in 45 subjects (9.6%); 82 subjects (17.4%) had hypertension. Hyperuricemia was diagnosed in 144 subjects (30.6%). Of these subjects, 115 (63 females and 52 males) (24.5%) were diagnosed as having metabolic syndrome. Patients with hyperuricemia had increased body mass index, waist-to-hip ratio, and triglyceride (Tg) level. The subjects also had lower high-density lipoprotein and greater hypertension. Hormone assays showed an elevation of leptin, immunoreactive insulin (IRI), and HOMA-IR in the hyperuricemia group. Uric acid appeared to be better correlated with Tg, blood pressure (both systolic and diastolic), obesity, immunoreactive insulin, and HOMA-IR. Uric acid did not correlate with leptin or blood glucose levels. Metabolic syndrome and Tg/high-density lipoprotein ratio showed a statistically significant difference in HOMA-IR using 3.8 as a cutoff value. Otherwise, there was no difference in leptin value. In conclusion, serum UA is significantly related to risk factors of metabolic syndrome except for blood glucose. Waist-to-hip ratio and HOMA-IR were statistically different in subjects with and without metabolic syndrome.
- Published
- 2006
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.