Fen-Yu Tseng

National Taiwan University Hospital, T’ai-pei, Taipei, Taiwan

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Publications (34)87.72 Total impact

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    ABSTRACT: Determining the visceral fat amount is important in the risk stratification for the prevention of type 2 diabetes and obesity-related disorders. The area-based measurement of visceral fat area (VFA) via magnetic resonance imaging (MRI) is an accurate but expensive and time-consuming method for estimating visceral fat amount. The aim of our study was to identify a practical predictive parameter for visceral obesity in clinical settings.In this cross-sectional study, we recruited 51 nondiabetic obese (body mass index [BMI] ≥ 27 kg/m) adults in Taiwan (21 men and 30 women, mean age 35.6 ± 9.2 years, mean BMI 33.3 ± 3.9 kg/m). VFA was quantified by a single-slice MRI image. Anthropometric indices and biochemical parameters including fasting plasma glucose, serum level of alanine aminotransferase, and lipid profiles were measured. The associations between different variables and VFA were analyzed by linear regression analysis.Increases in BMI, waist circumference, serum levels of alanine aminotransferase and triglycerides (TGs), and decreased serum levels of high-density lipoprotein cholesterol were correlated with larger VFA. After adjustment for age, sex, and anthropometric indices, only serum TG level remained as an independent correlate of VFA. Besides demographic and anthropometric indices, adding TG level may explain a greater variance of VFA. In stepwise multivariate regression analysis, male sex, age, waist circumference, and serum TG level remained significant predictors of VFA. In a subgroup analysis among subjects with BMI ≥30 kg/m, similar results were demonstrated and serum TG level remained as significant independent correlates of VFA in all of the predictive models.Among nondiabetic obese adults, serum TG level was positively associated with VFA. The combination of sex, age, anthropometric indices, and serum TG level may be used to estimate VFA in clinical settings.
    Medicine 06/2015; 94(23):e965. DOI:10.1097/MD.0000000000000965 · 4.87 Impact Factor
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    ABSTRACT: The association between subclinical hypothyroidism (SCH) and cancer mortality is seldom discussed. A total of 115,746 participants without thyroid disease history, aged 20 and above, were recruited from four nationwide health screening centers in Taiwan from 1998 to 1999. SCH was defined as a serum thyroid-stimulating hormone (TSH) level of 5.0-19.96 mIU/L with normal total thyroxine concentrations. Euthyroidism was defined as a serum TSH level of 0.47-4.9 mIU/L. Cox proportional hazards regression analyses were used to estimate the relative risks (RRs) of death from cancer for adults with SCH during a 10-year follow-up period. Among 115,746 adults, 1,841 had SCH (1.6%) and 113,905 (98.4%) had euthyroidism. There were 1,532 cancer deaths during the 1,034,082 person-years follow-up period. Adjusted for age, gender, body mass index, diabetes, hypertension, dyslipidemia, smoking, alcohol drinking, betel nut chewing, physical activity, income, and education level, the RRs (95% confidence interval) of cancer deaths among subjects with SCH versus euthyroid subjects were 1.51 (1.06 to 2.15). Cancer site analysis revealed a significant increased risk of bone, skin and breast cancer among SCH subjects (RR 2.79, (1.01, 7.70)). The risks of total cancer deaths were more prominent in the aged (RR 1.71, (1.02 to 2.87)), in females (RR 1.69 (1.08 to 2.65)), and in heavy smokers (RR 2.24, (1.19 to 4.21)). Subjects with SCH had a significantly increased risk for cancer mortality among adult Taiwanese. This is the first report to demonstrate the association between SCH and cancer mortality.
    PLoS ONE 04/2015; 10(4):e0122955. DOI:10.1371/journal.pone.0122955 · 3.53 Impact Factor
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    ABSTRACT: Background To identify the ranges of hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDL-C) levels which are associated with the lowest all-cause mortality. Methods A retrospective cohort of 12,643 type 2 diabetic patients (aged ≥18 years) were generated from 2002 to 2010, in Far-Eastern Memorial Hospital, New Taipei city, Taiwan. Patients were identified to include any outpatient diabetes diagnosis (ICD-9: 250), and drug prescriptions that included any oral hypoglycemic agents or insulin prescribed during the 6 months following their first outpatient visit for diabetes. HbA1c, SBP, and LDL-C levels were assessed by the mean value of all available data, from index date to death or censor date. Deaths were ascertained by matching patient records with the Taiwan National Register of Deaths. Results Our results showed general U-shaped associations, where the lowest hazard ratios occurred at HbA1c 7.0–8.0%, SBP 130–140 mmHg, and LDL-C 100–130 mg/dL. The risk of mortality gradually increases if the patient's mean HbA1c, SBP, or LDL-C during the follow-up period was higher or lower than these ranges. In comparison to the whole population, the adjusted hazard ratio (95% CI) for patients with HbA1c 7.0–8.0%, SBP 130–140 mmHg, and LDL-C 100–130 mg/dL were 0.69 (0.62–0.77), 0.80 (0.72–0.90), and 0.68 (0.61–0.75), respectively. Conclusions In our type 2 diabetic cohort, the patients with HbA1c 7.0–8.0%, SBP 130–140 mmHg, or LDL-C 100–130 mg/dL had the lowest all-cause mortality. Additional research is needed to confirm these associations and to further investigate their detailed mechanisms.
    PLoS ONE 10/2014; 9(10):e109501. DOI:10.1371/journal.pone.0109501 · 3.53 Impact Factor
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    ABSTRACT: Aims Myostatin is a negative regulator of skeletal muscle mass and may also modulate energy metabolism secondarily. We aim to investigate the relationship between serum myostatin and the metabolic variables in diabetic (DM) and non-diabetic subjects. Materials and Methods A cross-sectional study recruiting 246 consecutive DM patients and 82 age- and gender-matched non-diabetic individuals at a medical center was conducted. The variables of anthropometry and blood chemistry were obtained. Serum myostatin level was measured with enzyme immunoassay. Results DM group had lower serum myostatin compared with non-diabetics (7.82 versus 9.28 ng/ml, p<0.01). Sixty-two percent of the recruited individuals had metabolic syndrome (MetS). The patients with MetS had significantly lower serum myostatin than those without (7.39 versus 9.49 ng/ml, p<0.001). The serum myostatin level decreased with increasing numbers of the MetS components (p for trend<0.001). The patients with higher body mass index, larger abdominal girth, lower high-density lipoprotein cholesterol (HDL-C), and higher triglycerides had lower serum myostatin than those without. The serum myostatin level was independently negatively related to larger abdominal girth, higher triglycerides, and lower HDL-C after adjustment. The odds ratios for MetS, central obesity, low HDL-C, high triglycerides, and DM were 0.85, 0.88, 0.89, 0.85, and 0.92, respectively, when serum myostatin increased per 1 ng/mL, in the binary logistic regression models. Conclusions Lower serum myostatin independently associated with MetS, central obesity, low HDL-C, and high triglycerides after adjustment. Higher serum myostatin is associated with favorable metabolic profiles.
    PLoS ONE 09/2014; 9(9):e108230. DOI:10.1371/journal.pone.0108230 · 3.53 Impact Factor
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    ABSTRACT: Adiponectin might play a protective role in cardiometabolic and peripheral auditory disorders, but its role on central auditory function was still unclear. The aim of this study was to examine whether there is an association between plasma adiponectin levels and central auditory function in adults. We recruited 297 adults, with normal or symmetrical sensorineural hearing loss and normal cognitive functions. Multivariate linear regression was performed to assess the association between plasma adiponectin concentrations and pitch pattern sequence (PPS) score, which was one of central auditory tests. The results showed that there were 224 (75.4 %) women and 73 (24.6 %) men in this study. The mean age was 58.1 ± 8.4 years, the mean waist circumference (WC) was 81.1 ± 8.3 cm, and the mean body mass index (BMI) was 24.0 ± 3.0 kg/m(2). The mean PPS score was 71.5 ± 14.1 %, and plasma adiponectin concentration was 12.7 ± 5.5 g/mL. After adjusting for age, gender, WC, coronary artery disease, hypertension, diabetes mellitus, chronic kidney disease, smoking and drinking, plasma adiponectin concentrations (coefficient ± standard error, β ± SE = -0.09 ± 0.16, p = 0.563) were found to have no significant associations with PPS score. When WC was excluded from these variables in the multivariate linear regression model, plasma adiponectin concentrations (β ± SE = -0.03 ± 0.15, p = 0.855) were still not significantly associated with PPS score. In conclusion, plasma adiponectin levels were not significantly associated with PPS score, which was one of central auditory function tests. More studies should be conducted for the underlying mechanisms of obesity-related central auditory dysfunction.
    Metabolic Brain Disease 08/2014; 30(1). DOI:10.1007/s11011-014-9597-1 · 2.40 Impact Factor
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    ABSTRACT: Background and Aims Low vitamin D status has been linked to obesity, insulin resistance, and metabolic syndrome. In the present study, we aimed to explore the nature and strength of the relationship between vitamin D and metabolic syndrome among non-diabetic young adults. Methods This was a campus-based cross-sectional study of 355 non-diabetic young adult graduate students (233 males and 132 females; mean age, 23.5±2.4 years) in Northern Taiwan. We measured and tested the association of serum 25-hydroxyvitamin D levels with metabolic syndrome and cardio-metabolic parameters. Results A total of 24(6.8%) recruited young adults had metabolic syndrome. There were decreasing trends of body mass index (BMI), Homeostasis Model of Assessment - Insulin Resistance(HOMA-IR) and prevalence of metabolic syndrome across increasing tertiles of vitamin D levels irrespective of age and sex (P for trend <0.05). Without adjusting for BMI or HOMA-IR, the odds of having metabolic syndrome decreased across increasing tertiles of vitamin D levels (P for trend 0.021). The odds ratio of having metabolic syndrome was 0.26 (95% confidence interval: 0.08-0.85, P =0.025) for the highest vs. the lowest tertile of vitamin D levels. However, further adjustments for BMI and HOMA-IR largely removed the inverse association of vitamin D status with metabolic syndrome and its individual components. Conclusion Among non-diabetic young adults, the potential inverse relationship between vitamin D status and metabolic syndrome may be attributable to the conjunctive effects of individual obesity and insulin resistance.
    Clinical Nutrition 06/2014; 34(3). DOI:10.1016/j.clnu.2014.05.010 · 3.94 Impact Factor
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    ABSTRACT: This study sought to evaluate the relationship between subclinical hypothyroidism (SCH) and all-cause and cardiovascular disease (CVD) mortality. SCH may increase the risks of hypercholesterolemia and atherosclerosis. The associations between SCH and all-cause or CVD mortality are uncertain, on the basis of the results of previous studies. A baseline cohort of 115,746 participants without a history of thyroid disease, ≥20 years of age, was recruited in Taiwan. SCH was defined as a serum thyroid-stimulating hormone (TSH) level of 5.0 to 19.96 mIU/l with normal total thyroxine concentrations. Euthyroidism was defined as a serum TSH level of 0.47 to 4.9 mIU/l. Cox proportional hazards regression analysis was used to estimate the relative risks (RRs) of death from all-cause and CVD for adults with SCH during a 10-year follow-up period. There were 3,669 deaths during the follow-up period; 680 deaths were due to CVD. Compared with subjects with euthyroidism, after adjustment for age, sex, body mass index, diabetes, hypertension, dyslipidemia, smoking, alcohol consumption, betel nut chewing, physical activity, income, and education level, the RRs (95% confidence interval) of deaths from all-cause and CVD among subjects with SCH were 1.30 (1.02 to 1.66), and 1.68 (1.02 to 2.76), respectively. Adult Taiwanese with SCH had an increased risk for all-cause mortality and CVD death.
    Journal of the American College of Cardiology 06/2012; 60(8):730-7. DOI:10.1016/j.jacc.2012.03.047 · 15.34 Impact Factor
  • Fen-Yu Tseng
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    ABSTRACT: Non-attendance in outpatient clinics might disrupt medical care, interfere with outpatient clinic processing, and waste health service resources. This study was performed to identify predictive factors for non-attendance in endocrinology and metabolism (Endo/Meta) patients. Non-attendance was examined for a period of 6 months in Endo/Meta outpatient clinics in a medical center in Taiwan. Effects of physician, clinic, and patient characteristics, and appointment patterns in non-attendance were assessed by ξ(2) test and multivariate logistic regression. During the study period, a total of 13,584 patients booked appointments for 609 Endo/Meta clinics managed by 11 specialists. The mean number of appointments per patient was 2.3 ± 1.1. The total number of registered visits was 31,143. The total number of non-attendances was 2272. The overall proportion of non-attendance in Endo/Meta patients was 7.3%. The proportion of non-attendance varied with different physician teaching status and on different weekdays. In multivariate logistic regression, physician age (p = 0.0009), physician teaching status (p = 0.0013), number of physician shifts per week (p< 0.0001), patient age (p< 0.0001), first-time appointment (p< 0.0001) and registration order in the clinic (p < 0.0001) had significant effects on non-attendance, whereas physician and patient sex, weekdays and daytimes of clinics had no significant effect on non-attendance. Determinants of non-attendance in Endo/Meta patients include older physician age, lower physician teaching status, number of physician shifts per week, younger patient age, first-time appointment, and later registration order in the clinic. Research on non-attendance should be applied to improve quality of medical care. Optimal ways to ensure attendance deserve further investigation.
    Journal of the Formosan Medical Association 12/2010; 109(12):895-900. DOI:10.1016/S0929-6646(10)60136-2 · 1.70 Impact Factor
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    ABSTRACT: To analyze auditory brainstem response (ABR) data in patients with vestibular schwannomas (VS) in an effort to identify correlations between abnormal ABR parameters and tumor size. Cross-sectional study with chart review. Tertiary referral hospital. Retrospective chart review and analysis of bilateral ABR records in patients with VS. Interaural latency differences of interpeak I-V (ILD-I-V) and ILD-V longer than 0.2 ms were used as abnormal criteria. Thirty patients with a mean age of 50 +/- 14 years were included in this study. The most frequent changes in ABR parameters included those of ILD-I-V (100%), wave V latency (96.7%), ILD-V (93.3%), and interpeak I-V latency (90%). Average VS tumor size was 2.48 +/- 1.31 cm. For patients with VS greater than or equal to 2 cm, the prevalences of abnormal ipsilateral interpeak III-V latency, contralateral wave V latency, and interpeak III-V latency showed statically significant differences (P = 0.0035, P = 0.0267, and P = 0.0273, respectively) compared to those in patients with VS less than 2 cm. Tumor size was positively correlated with pure-tone average (P = 0.0106) and with the total number of bilateral abnormal ABR parameters (P = 0.004). We identified a correlation between ABR parameters and VS tumor size. An ipsilateral ILD-I-V greater than 0.2 ms was sensitive for detecting VS. Abnormal contralateral wave V and interpeak III-V latency indicated a tumor size potentially larger than 2 cm. Further studies are needed to confirm these findings.
    Otolaryngology Head and Neck Surgery 12/2009; 141(6):695-700. DOI:10.1016/j.otohns.2009.09.015 · 1.72 Impact Factor
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    ABSTRACT: The study attempted to highlight the differences of mechanical properties in microchambers and macrochambers between patients with type 2 diabetes mellitus and age-matched healthy volunteers. A total of 29 heels in 18 diabetic patients and 28 heels in 16 age-matched healthy participants were examined by a loading device consisting of a 10-MHz compact linear-array ultrasound transducer, a Plexiglas cylinder, and a load cell. Subjects in both groups were on average about 55 years old with a body mass index of approximately 25 kg/m(2). A stepping motor was used to progressively load the transducer on the tested heels at a velocity of 6mm/s from zero to the maximum stress of 78 kPa. Unloaded thickness, strain, and elastic modulus in microchambers, macrochambers and heel pads were measured. Microchambers strain in diabetic patients was significantly greater than that in healthy subjects (0.291 (SD 0.14) vs. 0.104 (SD 0.057); P<0.001). Macrochambers strain in diabetic patients was significantly less than that in healthy subjects (0.355 (SD 0.098) vs. 0.450 (SD 0.092); P=0.001). Microchambers stiffness in diabetic patients was significantly less than that in healthy persons (393 (SD 371)kPa vs. 1140 (SD 931)kPa; P<0.001). Macrochambers stiffness in diabetic patients was significantly greater than that in healthy persons (239 (SD 77)kPa vs. 181 (SD 42)kPa; P=0.001). Heel pad tissue properties are altered heterogeneously in people with diabetes. Increased macrochambers but decreased microchambers stiffness may cause diminished cushioning capacities in diabetic heels.
    Clinical biomechanics (Bristol, Avon) 08/2009; 24(8):682-6. DOI:10.1016/j.clinbiomech.2009.06.005 · 1.88 Impact Factor
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    ABSTRACT: In patients with malignant external otitis (MEO), mortality was not related to age, sex, degree of glucose tolerance, duration of diabetes mellitus (DM), microorganism, comorbid disease, or involvement of a single cranial nerve. Severe complications such as skull base osteomyelitis, intracranial extension, and involvement of multiple cranial nerves were correlated with mortality. To analyze the factors that affect the survival of patients with MEO in today's era of advanced antibiotics. Patients with a diagnosis of MEO from 1993 to 2005 were collected. A total 26 patients with a mean age of 63.7+/-10.2 years were included. All had a history of DM. Pseudomonas aeruginosa (26.9%), Klebsiella pneumoniae (19.2%), and fungus (15.4%) were most frequently found in pus cultures. Cranial nerves were involved in 11 patients: the facial nerve was most frequently (38.46%) involved. Complications such as osteomyelitis (11 patients) and intracranial involvement (3 patients) were noted in this series. Mastoidectomy was performed in 12 patients. A total of five patients died.
    Acta oto-laryngologica 06/2009; 130(1):89-94. DOI:10.3109/00016480902971247 · 0.99 Impact Factor
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    ABSTRACT: Facial palsy in children might be an alarming sign of serious underlying disease such as tumor, systemic disease or congenital anomalies and the recovery is poor in those cases. Therefore, careful investigation and differential diagnosis are essential in children. Prednisolone does not make a significant difference in the outcome in the treatment of children with Bell's palsy. The prognosis of Bell's palsy in the pediatric group is good; patients usually recover within 3 months. To review and analyze the etiology, management, and outcome of facial palsy in children. Using a retrospective chart review, patients under the age of 15 years with a diagnosis of facial palsy were collected from 1996 to 2002. A total of 56 cases (29 male, 27 female) with a mean age of 6.9±4.5 years were included in this analysis. Causes of facial palsy were Bell's palsy (44 patients, 78.6%), neoplastic (4 patients, 7.1%), head injury (3 patients, 5.4%), congenital (3 patients, 5.4%), or infectious (2 patients, 3.6%). In Bell's palsy there was no significant difference in the recovery rate between the groups with or without prednisolone treatment and between the groups that received medication within 1 week of syndrome onset or after more than 1 week.
    Acta oto-laryngologica 11/2008; 129(8):915-20. DOI:10.1080/00016480802468179 · 0.99 Impact Factor
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    ABSTRACT: To evaluate the prognostic factors of unknown primary head and neck squamous cell carcinoma (HNSCC). Retrospective study. Patients with unknown primary HNSCC from 1980 to 2000 were included. Forty-eight patients, predominantly male and with a mean age of 63.3+/-11.6 years, were recruited. The median survival time (MST) was 44 months. The overall survival rate was 60.4 percent at three years and 39.6 percent at five years. Forty-two patients receiving intervention regimens had a MST of 45 months, while six patients receiving palliative therapy had a MST of 8.5 months (log rank test, P=0.016). With multivariate Cox regression analysis, age (per year), higher nodal stage (N3 vs N1 or N2), and treatment (operation vs nonoperation) had a hazard ratio of 1.081 (P<0.0001), 5.852 (P=0.010), and 0.4 (P=0.042), respectively. Older age, higher nodal stage, and palliative treatment indicated poor prognosis. Survival time might be prolonged if surgical treatment is tolerable.
    Otolaryngology Head and Neck Surgery 10/2008; 139(3):429-35. DOI:10.1016/j.otohns.2008.05.015 · 1.72 Impact Factor
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    ABSTRACT: The objective of this study was to investigate the chronologic changes of nitric oxide (NO) concentration in the cochlear lateral wall and to explore its possible role in permanent threshold shift (PTS) after intense noise exposure. Seventeen guinea pigs were subjected to a single continuous exposure to broadband white noise at 105 +/- 2 dB sound pressure level (SPL) for 40 hours and were divided into four groups according to various postnoise recovery periods. Another 12 guinea pigs were not exposed to noise and served as controls. The hearing status of all animals was evaluated with auditory brainstem responses (ABR) evoked by condensation "click" sounds. ABR were recorded both prior to noise exposure and immediately before killing the animal. After death, NO concentration in the cochlear lateral wall was directly measured with an NO/ozone chemiluminescence technique. An approximately 1.7-fold increase in NO concentration was observed immediately postnoise exposure, which persisted for up to 28 days. The threshold of ABR elevation (mean, 30 dB SPL) peaked immediately after cessation of noise exposure and gradually resolved to a PTS (mean, 14.5 dB SPL) 56 days after noise exposure when NO concentration had returned to its prenoise exposure level. Noise-induced threshold shift, which resolved to a mild PTS, can be partially attributed to NO elevation in the cochlear lateral wall. Our results revealed a nonlinear correlation between ABR recovery and depletion of NO, indicating that the mechanisms of NO changes in the cochlear lateral wall may be more complicated than previously conceived and that other pathophysiologic mechanisms may also play important roles in noise-induced PTS.
    The Laryngoscope 06/2008; 118(5):832-6. DOI:10.1097/MLG.0b013e3181651c24 · 2.03 Impact Factor
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    ABSTRACT: The aims of this study were to evaluate the effect of a high dose (160 mg/kg) of methylprednisolone sodium succinate (MPSS) on the formation of endogenous nitric oxide (NO) in the brainstem after facial nerve transection and to explore whether this effect has relevance to the survival of facial motor neurons. Guinea pig facial nerves were transected at the tympanic segment, and half were administered with MPSS, while the other half were given a vehicle of saline solution. Post operation NO formation in the brainstem at different time points was directly measured with a NO/ozone chemiluminescence technique. The surviving motor neurons were counted in histological coronal frozen sections of facial motor nuclei. The present results revealed that facial nerve transection induced a significant increase in NO formation in the brainstem by 1 week in both MPSS and saline treated groups and lasted to the end of the study (4 weeks). Compared to the saline treated group, it appeared that MPSS administration could delay the increase of nitric oxide synthase (NOS) expression and NO formation during the first 1 approximately 2 weeks after facial nerve transection. The survival rate of facial motor neurons was significantly higher in the MPSS treated group than in the saline treated group when examined at 3 or 4 weeks after facial nerve transection. These results indicate that a high dose of MPSS elicited a delayed increase of NO formation and thus may concomitantly enhance the survival time of motor neurons after facial nerve transection.
    Brain Research 04/2008; 1197:23-31. DOI:10.1016/j.brainres.2007.12.046 · 2.83 Impact Factor
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    ABSTRACT: The purpose of the study was to evaluate the differences in the clinical characteristics of thyroglossal duct cysts (TGDC) between children and adults and to find a method for optimizing management of TGDC. This study consisted of a retrospective chart review of patients with a diagnosis of TGDC from 1997 to 2002. All records were reviewed for age and sex, season of first visit, diagnostic methods, sizes and locations of cysts, surgical management, and recurrences. Differences between children and adults were analyzed. A total of 84 patients (32 children, 52 adults) were recruited. There were no significant differences in sex in either group. Compared with children, more adult patients had left-sided and infrahyoid cyst locations. The cyst sizes were significantly larger in adults. In this review, 90.4% of adults and 75% of children underwent a Sistrunk operation, whereas the others underwent cyst excision. There was a total of 5 recurrences, 2 in children and 3 in adults. Although the recurrence rates between children and adults and between different surgical managements were not significantly different, a Sistrunk procedure is recommended as the main operation of choice, especially in adults in whom a more extended tract resection should be performed.
    American Journal of Otolaryngology 03/2008; 29(2):83-7. DOI:10.1016/j.amjoto.2007.02.003 · 1.08 Impact Factor
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    ABSTRACT: Hypernatremic myopathy was rarely reported in the literature and its clinical features have never been well-described. We present a 22-year-old man who had adipsic hypernatremia manifested with progressive proximal muscle weakness and remarkably high creatine kinase level that has never been reported in the cases of hypernatremic myopathy. His initial presentations were similar to that of polymyositis without the evidence of central nervous system dysfunction and hypopituitarism. The serum level of sodium at the beginning of myopathy is the lowest known in the literature. All the clinical presentations in this patient resulted from a hypothalamic mixed germ cell tumor with sub-acute intra-tumoral hemorrhage.
    Clinical Rheumatology 10/2007; 26(9):1591-4. DOI:10.1007/s10067-006-0481-1 · 1.77 Impact Factor
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    ABSTRACT: To evaluate risk factors for postoperative facial palsy in patients with parotid carcinoma. We conducted a retrospective chart review of patients with parotid carcinoma who underwent parotidectomy at National Taiwan University Hospital from 1980 to 2000. Eighty-eight patients with a mean age of 53 +/- 17 y were recruited. Sixty patients (68.2%) experienced postoperative facial palsy. Tumor size of larger than 4 cm was associated with an increased incidence of facial palsy (P = 0.0422). Facial palsy was noted in 95.5 percent of patients with facial nerve involvement and 51.3 percent of patients without facial nerve involvement (P = 0.0004). Of 42 patients with tumor over the deep lobe, 37 (88.1%) had facial palsy but only 50 percent (23 of 46) of those with tumor over the superficial lobe had facial palsy (P = 0.0001). There were no significant associations between histopathology and facial palsy. Increasing tumor size, deep lobe tumor location, and tumor invasion of facial nerve increased the incidence of postparotidectomy facial palsy. By paying attention to these risk factors a reduction of postoperative facial nerve palsy my be achieved.
    Otolaryngology Head and Neck Surgery 06/2007; 136(5):778-82. DOI:10.1016/j.otohns.2006.10.043 · 1.72 Impact Factor
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    Fen-Yu Tseng, Mei-Shu Lai
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    ABSTRACT: Physician characteristics might determine the quality of diabetes care. This study evaluated the effects of physician specialty on the use of antidiabetes drugs, process and outcomes of diabetes care. In 2002, 12,023 diabetes patients visited outpatient clinics more than four times at National Taiwan University Hospital. One-tenth of the patients were randomly sampled out. A retrospective chart review was conducted for those who were regularly cared for by endocrinologists (EN), other specialists in internal medicine (IM) and family medicine (FM) physicians. The use of antidiabetes drugs was assessed. Effects of physician specialty on the process or outcome indicators were analyzed by logistic or linear regression, accordingly. A total of 875 diabetes patients (477 men, 398 women) with a mean age of 62.3 +/- 12.7 years were recruited. EN patients had the highest rate of being prescribed insulin, metformin or nonsulfonylurea insulin secretagogues, and the lowest rate of being given sulfonylureas. EN patients showed a significantly better adherence to glucose checkup, glycosylated hemoglobin A1C measures and urinalysis than IM patients. EN patients also showed better adherence to glucose checkup and urinalysis than FM patients. EN patients had the lowest mean fasting plasma glucose (FPG) and lowest mean postprandial plasma glucose (PPG). The difference in PPG between EN and IM patients and the difference in FPG between EN and FM patients were persistently significant following adjustment by patient and physician characteristics. The use of antidiabetes drugs differed among patients cared for by EN, internists or generalists. Physician specialty had significant effects on the process and outcomes of diabetes care.
    Journal of the Formosan Medical Association 11/2006; 105(10):821-31. DOI:10.1016/S0929-6646(09)60269-2 · 1.70 Impact Factor
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    ABSTRACT: Broad-spectrum antibiotics are advocated for treating deep neck infection. Anaerobic coverage is necessary, especially in odontogenic cases. The presence of diabetes, infection of the parotid space and an obvious odontogenic source of infection can aid in determining the causative organisms. This study aimed to analyze the bacteriology in deep neck infections and identify the factors that influenced the causative pathogens. The records of 212 patients who were diagnosed as having deep neck infections at the National Taiwan University Hospital between 1997 and 2003 were reviewed; 128 patients with bacterial isolation from their pus cultures were enrolled. The cultures of 46 patients (35.9%) were polymicrobial. Viridans Streptococcus was the most commonly isolated organism (38.3%), followed by Klebsiella pneumoniae (32.0%) and Peptostreptococcus (17.2%). The most common organism in 44 diabetic patients was K. pneumoniae (54.5%), versus viridans streptococcus (48.8%) in 84 nondiabetic patients. In patients with dental sources of infections, the culture rate of anaerobes was 59.3%; in upper airway infections and other sources of infections they were 22.7% and 21.5%, respectively (Chi(2) test, p = 0.0008). The differences in age, sex, and climate did not show any significant changes in the common causative pathogens. Common pathogens in the infection of parapharyngeal, submandibular, and extended spaces were the same as viridans streptococcus, but in the parotid space K. pneumoniae was the most common pathogen.
    Acta Oto-Laryngologica 05/2006; 126(4):396-401. DOI:10.1080/00016480500395195 · 0.99 Impact Factor

Publication Stats

507 Citations
87.72 Total Impact Points

Institutions

  • 2002–2015
    • National Taiwan University Hospital
      • Department of Internal Medicine
      T’ai-pei, Taipei, Taiwan
  • 2002–2014
    • National Taiwan University
      • • College of Medicine
      • • Department of Otolaryngology
      T’ai-pei, Taipei, Taiwan
  • 2008
    • Taipei Medical University
      • Department of Internal Medicine
      T’ai-pei, Taipei, Taiwan
  • 2006
    • Far Eastern Memorial Hospital
      • Department of Internal Medicine
      T’ai-pei, Taipei, Taiwan