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Biomedical subjects

B Y Huang

Publications and source records attributed to B Y Huang.

17 recordsLinked to original sources
PubMed1992

[Low dose radioiodine treatment of papillary thyroid carcinoma in a child--a case report].

The thyroid carcinoma is rare in children and the optimal management is rather controversial. We report a case of a 7-year-old boy who had right neck masses and proved to be papillary thyroid carcinoma after near-total thyroidectomy. Post-operative 20 mCi radioiodine-131 (I-131) ablation scan, lung metastasis was suspected but the chest X ray was normal. After being lost to follow up for 4 years, the patient returned with the complaints of cough; the chest X ray was still normal. He then received 5 treatment with low dose (30 mCi) I-131 therapy and continued thyroxine replacement. Progressive decrease both of the thyroglobulin level and the intensity of radioactivity of lung were noted. After a total doses of 193 mCi I-131 therapy, neither pulmonary fibrosis nor bone marrow suppression was seen. Although the low dose (< or = 30 mCi) I-131 therapy was recommended, it was limited for the ablation therapy of the remnant thyroid tissue. Upon consideration of economics and the convenience of not being admitted to the isolation room, the low dose I-131 therapy seems feasible for children with thyroid carcinoma with systemic disease. However, the long term efficacy needs further evaluation.

Carcinoma, Papillary↗
PubMed1992

[Pituitary apoplexy: a study of eighteen cases].

Pituitary Apoplexy is a rare but sometimes life threatening condition which requires prompt recognition and timely medical intervention to avoid catastrophic consequences. From January 1979 to June 1989 and total of one hundred and ninety eight pituitary tumor patients were operated on our hospital. Eighteen cases (9.1%) were diagnosed "pituitary apoplexy" according to histopathological findings. The group consisted of twelve men and six women ranging in age from twenty two to sixty one years with a mean of forty. There were three cases of prolactin-secreting adenomas (16.7%), four growth-hormone secreting adenomas (22.2%), and eleven nonfunctional adenomas (61.1%) with an incidence of 6.1%, 8.3%, and 11.4% respectively (P > 0.05). Clinical manifestation occurred acutely in 66.7% and nonacutely in 33.3%. The patients presented with headaches (100%), visual impairment (83.3%), visual field defects (66%), disturbed consciousness (22%), fever and meningismus (11%). Radiological examinations able to demonstrate abnormalities included plain skull films (84%), computed tomography (84.6%), and angiography (93.8%). Various investigations of endocrine function pre and post operatively showed a deficient gonad axis (53%, 62.5%), adrenal axis (26.7%, 56.2%), and thyroid axis (20%, 43.8%). Sixteen cases received a transsphenoid operation and three cases underwent a transfrontal craniotomy. No case of mortality was reported. Postoperative radiotherapy was given to nine cases and nine cases were followed up on a regular basis. Therefore, our retrospective study suggests that pituitary apoplexy is not uncommon and has an acute clinical presentation. No particular tumor type was prone to occur. Various radiological examinations could define perisellar abnormalities. With a decreasing order of hormone deficiency, gonad, adrenal and thyroid axis were observed during the course of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Apolipoprotein levels in normolipidemic non-insulin-dependent diabetes mellitus.

The purpose of this study was to examine the change in apolipoprotein and lipoprotein levels in patients with normolipidemic untreated non-insulin-dependent diabetes mellitus (NIDDM). Fifteen untreated, non-obese male NIDDM patients without hyperlipidemia were chosen, and 15 healthy subjects, matched for age, sex, body weight, alcohol consumption and cigarette smoking served as the control group. We observed that the concentrations of plasma total cholesterol (TC), triacylglycerol (TG) and very low density lipoprotein cholesterol (VLDL-C) were identical in both NIDDM and control groups. The levels of low-density lipoprotein cholesterol (LDL-C) were slightly increased in the diabetic group, but the difference did not reach statistical significance in our study. High-density lipoprotein cholesterol (HDL-C) was lower in the NIDDM group than in the controls. Significantly increased TC/HDL-C and LDL-C/HDL-C ratios were found in NIDDM patients compared with controls. The apolipoprotein A-I (apo A-I) and apolipoprotein A-II (apo A-II) levels were decreased in NIDDM patients, while the apolipoprotein B (apo B) level remained similar to that of the control subjects. The ratio of apo A-I/apo B was decreased significantly in the NIDDM group. Our results suggest that NIDDM patients are at higher risk of coronary heart disease, even if they remain normolipidemic.

Adult↗
PubMed1991

Agranulocytosis associated with anti-thyroid drug in patients with Graves' thyrotoxicosis--report of 11 cases.

Retrospective analysis of 11 Chinese patients with Graves' thyrotoxicosis developing agranulocytosis during anti-thyroid treatment was done. Seven of them received methimazole and 4 received carbimazole. None of the 11 patients had taken propylthiouracil. The major chief complaints were high fever (100%), chillness (91%), and sore throat (73%). The duration of drug treatment prior to the detection of agranulocytosis ranged from 13 to 63 days (mean +/- 1SE: 33.1 +/- 16.1). At the time of agranulocytosis detected, the peripheral leukocyte counts were 0.5 to 2.1 X 1000/mm3 (mean +/- 1SE: 1.05 +/- 0.47 X 1000/mm3), absolute neutrophil counts 0 to 450/mm3 (mean +/- 1SE: 54.27 +/- 132.12/mm3), and hemoglobin 8.2 to 15.9 g/dl (mean +/- 1SE: 11.85 +/- 2.24 gm/dl). Three of the 11 patients had positive bacterial blood cultures. The recovery time of absolute neutrophil counts above 500/mm3 ranged from 3 to 25 days (mean +/- 1SE: 10.5 +/- 6.6) after discontinuation of antithyroid drugs. Mortality was found in 2 of them (18%).

Adolescent↗
PubMed1991

Pre-operative localization of parathyroid tumor by ultrasonography.

From July 1984 to June 1989, 24 cases with hypercalcemia and surgical proof of parathyroid adenoma or carcinoma received preoperative parathyroid sonographic examination in Chang Gung Memorial Hospital. There were 10 male patients with mean age of 51.5 +/- 12.3, and 14 female patients with mean age of 49.4 +/- 12.6. Parathyroid enlargement was detected by sonography examination in 22 of the 24 cases. The maximal diameter of the enlarged parathyroid in this series ranged from 1 cm to 3 cm. The accuracy of case diagnosis with sonography is 83.3%. In 96 parathyroid glands examined by sonography, the sensitivity is 83.3%, the specificity is 95.8% and the positive predictive value is 87%. From the results, it suggests that parathyroid sonography can be used as the first line localization method to detect parathyroid enlargement in hypercalcemia patients.

Adenoma↗
PubMed1990

[Growth catch-up in the case of congenital hypothyroidism after delayed treatment--a case report].

We report a case of congenital hypothyroidism, presenting with growth and mental retardation since childhood, but in which the diagnosis was not made until he was 17 years old. Because of such an unusually long delay in treatment, we focussed on the growth catch-up. This included the change of skeletal growth, puberty and mentality after a 4-year treatment period. He was 114 cm in height (height age 5.5 years) with the upper segment measuring 60 cm and lower segment 54 cm (U/L ratio 1.1). His bone age was that of a six year old and he had no secondary sexual characteristics. IQ testing showed a full scale IQ of 68, verbal IQ 74 and performance IQ 64. After 4 years of treatment, his height caught up to 152 cm (height age 12.5 years), with the upper segment 77.2 cm, and that of lower segment 74.8 cm (U/L ratio 1.03). The bone age had advanced to that of a 17 year old. His pubic hair emerged after 18 months of therapy (at a chronologic age of 18.5 years), accompanied by a normalization of testosterone and a normal response to a GnRH test. His IQ test was rechecked after 2 years of treatment. His full scale IQ was 78, verbal IQ 77 and performance IQ 83. In the mean time, the patient got a job being more alert, active and self-confident following his growth catch-up.

Adolescent↗
PubMed1990

Insulin autoimmune syndrome as a cause of hypoglycemia--report of four cases.

Insulin autoimmune syndrome is a syndrome consisting of fasting hypoglycemia, hyperinsulinemia and detectable insulin-binding antibodies in patients who have never been exposed to exogenous insulin. Four cases who developed symptoms of hypoglycemic attack with self-limited duration and spontaneous remission were collected in our hospital from 1984 to 1988. The elevated serum total and free insulin and C-peptide levels, as well as the titer of insulin autoantibodies, decreased gradually; but insulin autoantibodies were still present in the serum for more than six months after the initial episodes of hypoglycemia. Three of four patients had Graves' disease and developed the syndrome after methimazole treatment. The fourth one had a history of hemorrhagic cystitis and denied history of specific drug exposure. The cause or stimulus for insulin autoantibody formation is still unknown, but drugs containing a sulfhydryl group like methimazole may play a role in the development of the syndrome. Extremely high insulin antibodies in patients with fasting hypoglycemia along with elevated serum levels of insulin and C-peptide suggest a diagnosis of insulin autoimmune syndrome and usually exclude the possibility of insulinoma or factitious hypoglycemia.

Adult↗
PubMed1990

Outcome following radioactive iodine therapy in Graves' disease.

One hundred and fifty three patients with Graves' hyperthyroidism treated with I-131 from March 1984 to September 1988 were analyzed. The dose of I-131 was given according to the formula: 100 microCi/gm x estimated thyroid size (gm) x 100/24 hr I-131 uptake (%) The mean dose was 5.41 mCi and the maximum dose was 7 mCi. After one year of follow up, 45 patients (29.4%) were euthyroid, 35 patients (22.9%) became hypothyroid, and 73 patients (47.7%) were persistently hyperthyroid. Discriminant analysis of pretreatment variables suggested that those patients who were still hyperthyroid at the end of the first year had significantly larger goiter size, and higher serum T4 and T3 levels. Men had greater incidence of relapse. Besides, those who had received antithyroid drug before I-131 therapy had a significantly higher incidence of failure. As compared with previous studies, our report had a significantly higher incidence (22.9%) of hypothyroidism one year after I-131 therapy, which may be due to recognition of subclinical hypothyroidism through TSH assay.

Adult↗
PubMed1990

Bone changes in hyperthyroidism--a preliminary study.

Thyrotoxicosis may cause osteopenia and lead to increased risk of fractures. From July 1988 to March 1989, 88 hyperthyroid patients and 65 age, sex matched normal controls were enrolled for lumbar spine bone mineral density (BMD) study. Significantly lower BMD values can be found in premenopausal hyperthyroid women (1.233 gm/cm2 vs 1.317 gm/cm2, p less than p less than 0.05). In the group of thyrotoxicosis, no linear correlation can be found between BMD and the degree of hyperthyroidism (N = 84, r = 0.01 and N = 74, r = 0.054 as comparing BMD to T4 and T3, respectively). After treatment with antithyroid drugs (ATD) for 3 months, BMD did not change significantly (1.258 gm/cm2 vs 1.242 gm/cm2, p = 0.02) in the hyperthyroid patients. Therefore, premenopausal hyperthyroid women have lower BMD than premenopausal euthyroid women. The treatment of hyperthyroidism after 3 months' course did not increase lumbar spine BMD.

Adult↗
PubMed1989

C-peptide response to glucagon in young diabetics.

Pancreatic beta cell function was measured in 15 nondiabetic controls, 10 insulin-dependent diabetics (IDD) and 19 non-insulin-dependent diabetics (NIDD), aged 18 to 45 years, by means of the peripheral serum C-peptide response to 1 mg of glucagon. The fasting serum C-peptide (FCP) in IDD was lower than in the controls and NIDD (p less than 0.01), but there was no significant difference between the controls and NIDD (p greater than 0.05). The maximal in crement of serum C-peptide (delta CP) after glucagon stimulation in the controls was higher than in IDD and NIDD (p less than 0.01), and there was a gap between IDD (less than or equal to 0.69 ng/ml) and NIDD (1.20 ng/ml). During the glucagon test, serum C-peptide concentrations were highest in the first 15 minutes unlike plasma glucose which reached its highest value between 20 and 40 minutes. NIDD, either obese or nonobese, had a lower mean delta CP value than did controls. In the controls, IDD and NIDD, the FCP was correlated well with delta CP (r = 0.61, 0.93 and 0.59) but not with fasting plasma glucose (r = 0.19, -0.08 and 0.23). During the glucagon test, the mean maximal increments of plasma glucose were between 52.5 and 62.5 mg/dl. Nausea was the main complaint in 19 (43%) of the subjects but it was mild and transient. In conclusion, measuring serum C-peptide response after glucagon stimulation is a simple and safe test which may be a discriminative method to establish insulin dependency in young diabetic patients.

Adolescent↗
PubMed1989

HLA-A,B,C and DR antigens in Chinese with non-insulin-dependent diabetes: comparison with goitrous diabetics.

To examine the relationship between HLA antigens and Type 2 non-insulin-dependent diabetes (NIDDM), 72 patients were studied and compared with 282 controls. Twenty of 72 patients had an associated non-toxic goiter. The clinical features of the goitrous diabetic patients were similar to those without goiter except that those with goiter were predominantly female (95%). Of the 46 antigens assayed, only A10 was increased in the 72 diabetics when compared with the controls (12.5 vs 5.7%, RR = 2.37, chi 2 = 4.07, p less than 0.05), but statistically this was not significant after p value correction. In the patients with goiter, antigens A2, A9, A10, B27, BW46, CW1, DR1, DR5, DR8, DRW9 showed 2 folds or greater differences in frequencies when compared to the non-goitrous diabetics. However, only A2 had a significant decrease in the former as compared with the latter (30.0 vs 59.6%, chi 2 = 5.07, p less than 0.05), but this was also statistically insignificant. The present study showed no significant HLA associations in Chinese NIDDM patients with or without non-toxic goiter, and the distribution of each antigen was not related to the presence or absence of goiter.

Adult↗
PubMed1988

Depressed natural killer activity in Graves' disease and during antithyroid medication.

To investigate the natural killer (NK) cell mediated immunity in Graves' disease (GD) and the effect of antithyroid drugs upon NK cell activity, 51Cr release assay for NK cytotoxicity against K562 cells was examined in patients with GD before and during antithyroid medication and after drug withdrawal. Fifty-eight patients were divided into three groups: the untreated thyrotoxic patients (n = 33), the euthyroid patients under antithyroid treatment (n = 19) and the euthyroid patients after drug withdrawal (n = 6). The results of the three groups were compared to 23, 15 and 5 sex- and age-matched controls, respectively. The data revealed a significant NK dysfunction in the untreated hyperthyroid patients, although the number of the NK cells was not decreased. NK function was normal when patients were no longer taking antithyroid medication and in euthyroid state. However, euthyroid patients under antithyroid medication had markedly depressed NK activity, suggesting an immunosuppressive effect of the antithyroid drugs. This study demonstrated that both the hyperthyroid state and the antithyroid drugs exerted immunosuppressive effects upon the NK cells. Since such an immunosuppressive effect on NK cells might be associated with a decreased immune surveillance against tumour growth, this study implies that a long-term follow up of GD patients treated with antithyroid drugs may be indicated to guard against a possible increased incidence of malignancy.

Adolescent↗