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Biomedical subjects

H S Kuo

Publications and source records attributed to H S Kuo.

At least 37 records · Page 2Linked to original sources
PubMed1994

A population survey on the prevalence of diabetes in Kin-Hu, Kinmen.

OBJECTIVE: To investigate the prevalence of non-insulin-dependent-diabetes mellitus in Kin-Hu, Kinmen. RESEARCH DESIGN AND METHODS: This is a community-based population survey. The target population are residents > or = 30 years of age in Kin-Hu, Kinmen, according to the official household registry in 1990. Face to face interviews were conducted by the Yang-Ming Crusade in 1991 using a structured questionnaire. Fasting blood samples were drawn by public health nurses, and a 75-g oral glucose tolerance test was performed for definite diagnosis of diabetes. RESULTS: There were 4,097 eligible subjects (2,026 men and 2,071 women), and 3,236 had complete fasting plasma glucose data (1,536 men and 1,700 women). The response rate was 79% (76% for men and 82% for women). The age-specific response rates were 81% for the 30- to 39-year and 50- to 59-year age-groups, 84% for the 40- to 49-year age-group, and 69% for the > or = 60-year age-group. The crude prevalence of diabetes in Kin-Hu was 6.5% (2.0% previous and 4.5% new). With the standard world population of Segi, the age-adjusted prevalence rate was 4.9% (4.5% for men and 5.4% for women). The prevalence rate of diabetes increased significantly with age. The prevalence of previously diagnosed diabetes accounted for less than one third of the total rate. CONCLUSIONS: The population survey in Kin-Hu, Kinmen, had a high response rate of 79%. The crude prevalence rate of diabetes was 6.5%, and the age-adjusted prevalence rate was 4.9%. The low ratio of previously diagnosed to newly diagnosed diabetic cases may be due to lack of public awareness and medical services in this community.

Adult↗
PubMed1993

Program description and preliminary health survey data in Kin-Hu, Kinmen.

The study subjects were those over 30 years of age in Kin-Hu, Kinmen. From January to February 1991, demographic data, physical data, life style and blood chemistry parameters were collected from 2929 respondents (1368 men and 1561 women) out of 4475 eligible subjects. The study, conducted by the Yang-Ming Crusade, used a structured questionnaire and venipuncture technique. After clarifying missing values, a total number of 2868 (64.1%; 1334 men and 1534 women) subjects had completed the data set. Of the total subjects, 32.3% were 30-39 years of age, 24.3% were 40-49 yrs, 22.4% were 50-59 yrs, and 21.0% were above 60 years old. Fifty-two percent of men and 2.8% of women, were current smokers. Most of the surveyed subjects described themselves as having infrequent physical activity (men vs. women, 66.4% vs. 81.0%, p < 0.001). Men had significantly lower body mass index (BMI) and higher waist-hip ratio (W/H) than women (BMI: 22.9 +/- 3.2 vs. 23.2 +/- 3.7, p < 0.01; W/H: 0.89 +/- 0.06 vs. 0.84 +/- 0.07, p < 0.01). Men also had higher fasting plasma glucose (FPG), systolic/diastolic blood pressure (SBP/DBP) than women (FPG: 99 +/- 25.3 vs. 95.7 +/- 25.3 mg/dl, p < 0.0001; SBP: 132.1 +/- 19 vs. 126.4 +/- 21.5 mmHg, p < 0.0001; DBP: 80.4 +/- 12.5 vs. 76.5 +/- 12.3 mmHg, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Colonoscopic surveillance after polypectomy: considerations of cost effectiveness.

OBJECTIVE: To assess the cost effectiveness of the current recommendation that persons who have had an adenomatous colon polyp removed have periodic colonoscopic surveillance at fixed and regular intervals. DESIGN: Cost-effectiveness analysis using data from the medical literature in a simulation model to estimate the costs of and the risk for perforation associated with periodic colonoscopic surveillance for a 50-year-old man followed for 30 years. MAIN RESULTS: A program of colonoscopy every 3 years would incur cumulatively a 1.4% risk for colon perforation, a 0.11% risk for perforation-related death, and direct physician costs of $2071 for colonoscopy (discounted at 5%). If a 50-year-old man's cumulative remaining risk for death from cancer is 2.5% after the removal of a single small adenoma and if effectiveness of colonoscopic surveillance every 3 years is 100%, then one death from cancer could be prevented by doing 283 colonoscopies, incurring 0.6 perforations, 0.04 perforation-related deaths, and direct physician costs of $82,000. If surveillance were 50% effective and the cumulative remaining risk for death from cancer were 1.25%--a plausible scenario--1131 colonoscopies would be required to prevent one death from cancer, incurring 2.3 perforations, 0.17 perforation-related deaths, and physician costs of $331,000. CONCLUSIONS: The cost effectiveness of colonoscopic surveillance is very sensitive to estimates of the cumulative remaining risk for death from cancer after polypectomy as well as to surveillance efficacy. For persons whose remaining risk for death from cancer may be low, such as persons with a single small adenoma, recommendations for colonoscopic surveillance at fixed and regular intervals may be excessively costly.

Aged↗
PubMed1991

Characterization of an endotoxemic baboon model of metabolic and organ dysfunction.

An anesthetized endotoxemic baboon model has been developed by infusing 2.0 mg E. coli endotoxin/kg i.v. over 1 hr (n = 7). Animals were monitored for 5-7 days with analyses of: cardiovascular, metabolic, and organ dysfunction; acid base, hemostatic, and hematological alterations; as well as tumor necrosis factor (TNF) and interleukin-6 (IL-6) levels. Pathophysiologies detected at 2 hr included transient decreases in vascular resistance and blood pressure, a 157% increase in blood lactate, and a 90% decrease in circulating neutrophils. Organ dysfunction was not observed until 24 hr and, although thrombocytopenia was prevalent (-72% at 48 hr), disseminated intravascular coagulation (DIC) was not a major pathology. Hematocrit fell 21% by 24 hr and was -41% at 5-7 days. Serum TNF peaked at 90 min (7.8 +/- 0.2 ng/mL) and was undetectable after 3 hr. IL-6 also increased early, peaked at 3 hr (3872 +/- 846 U/mL) and was still detectable at 24 hr. A low mortality primate model of gram-negative sepsis has been developed that is characterized by early cardiovascular and metabolic dysfunction (2-6 hr), late organ dysfunction (24-48 hr), sub-clinical DIC, a prolonged anemia, and a 29% mortality between 48 and 72 hr.

Acid-Base Equilibrium↗
PubMed1991

School-age mothers: predictors of long-term educational and economic outcomes.

The long-term effects of school-age pregnancy were investigated in a 20-year follow-up of a cohort of women who were pregnant adolescents in the late 1960s. Of the 149 living young black primiparas in the original cohort, 121 (81%) were located and interviewed. At follow-up the study population ranged in age from 32 to 38 years, 68% were unmarried, 71% had finished high school, 82% were completely self-supporting, and 27% reported living in public housing. Long-term success, defined as currently employed or supported by a spouse and a high school education (62%) or its equivalent, was associated with six features: having completed more school prior to becoming pregnant (odds ratio [OR] = 18; 95% confidence interval [CI] 2.3, 139.5); participating more actively in a program intervention offered to these pregnant teenagers 20 years ago (OR = 11.11; 95% CI 1.54, 79.87); being in school with no subsequent pregnancy at 26 months postpartum (OR = 10.1; 95% CI 1.64, 62.07); feeling in control of one's life (OR = 5.4; 95% CI 1.36, 21.54) and little social isolation (OR = 8.24; 95% CI 1.56, 43.50) at 26 months postpartum; and lifetime fertility control defined as one or two children after the index child (OR = 14.19; 95% CI 3.28, 61.29). It is concluded that most former teenage mothers complete a reasonable amount of education and are economically self-sufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Characterization of recombinant factor VIII and a recombinant factor VIII deletion mutant using a rabbit immunogenicity model system.

The use of factor VIII prepared genetically engineered cell lines (rFVIII) may avoid some of the problems inherently associated with administering plasma-derived factor VIII (pdFVIII) concentrates to hemophilia A patients. Although rFVIII may represent an improvement over traditional therapeutics, the chance exists that protein production in cell culture may result in the presence of novel epitopes that may enhance the formation of inhibitor antibodies capable of neutralizing either rFVIII or pdFVIII. To assess the differences between rFVIII and its plasma-derived homologue, a rabbit immunogenicity model system was developed. Antibodies raised to rFVIII in rabbits were tested for the presence of antibodies capable of binding rFVIII but not pdFVIII, the presence of which would suggest that novel epitope(s) were present. This analysis was performed using a competitive enzyme-linked immunosorbent assay, as well as immunoadsorption. For either technique, rFVIII-specific antibodies were not detected, indicating that differences between rFVIII and pdFVIII were not found. When a rFVIII B-region deletion mutant was similarly tested, antibodies specific for this protein were found. These specific antibodies appeared to bind in the vicinity of the deletion site and their binding was not affected by carbohydrate removal. These results indicate that the rabbit immunogenicity model system is sensitive to alterations in the factor VIII molecule and suggest that full-length rFVIII will not be any more immunogenic in human patients than pdFVIII.

Animals↗
PubMed1990

Infant feeding patterns during the first year of life in Denmark: factors associated with the discontinuation of breast-feeding.

We prospectively studied 500 infants born consecutively in a university-affiliated community hospital in Copenhagen, Denmark, over the first 12 months of life using a detailed monthly mailed questionnaire (overall response rate = 73%) which focused on feeding practices and illnesses. Seventy-seven percent of respondents breast-fed their infants at 1 month of life compared to 19% at 12 months of life. Analysis of breast-feeding behavior using survival analysis showed that 50% of the mothers who breast-fed since the first month of their infant's life were still breast-feeding at 7 months of life. Also, there was a greater than two-fold increase in the rate of discontinuation of breast-feeding for infants in daycare compared to infants not attending daycare (RR = 2.08, 95% CI = 1.43, 3.01). Discontinuation of breast-feeding was not significantly associated with the number of children in the family or with social class. These results give insight into infant feeding patterns in a developed country and suggest that: (1) breast-feeding is the dominant method of feeding during the infant's first year of life, and (2) the rate of discontinuation of breast-feeding is increased by the entry of these infants into daycare.

Age Factors↗
PubMed1990

Relationship between infant feeding and infectious illness: a prospective study of infants during the first year of life.

Prior studies investigating the relationship between infant feeding and infectious illnesses in developed countries have provided conflicting data about whether breast-feeding protects against common infectious illnesses early in life. These conflicts may in part be due to the failure to consider the following methodologic issues: (1) collecting data prospectively at frequent intervals for active surveillance of the detection of infections and of feeding practices, (2) specifying what is meant by infectious illnesses and breast-feeding, (3) controlling for confounding variables such as social class or presence of siblings in the household, and (4) applying appropriate analytical strategies to a population in which both feeding and exposure to illness change over time. A total of 500 infants born consecutively in a university-affiliated community hospital in Copenhagen, Denmark, were studied prospectively for the first 12 months of life by means of a detailed, monthly, mailed questionnaire that focused on feeding practices and illnesses (overall response rate, 73%). The percentage of infants who were completely or mostly breast-fed decreased from 88% at 1 month to 20% at 12 months of age. After adjustment for major covariates, no statistically significant relationship was found between the type of infant feeding and the incidence of four categories of infectious illnesses: gastroenteritis, upper respiratory illness, otitis media, and lower respiratory illness. The adjusted incidence density ratio for gastroenteritis was 1.067 (95% confidence interval = 0.982, 1.226) and for upper respiratory illnesses 0.984 (95% confidence interval = 0.883, 1.096).(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMed1980

The interaction of relaxin with the rat uterus. I. Effect on cyclic nucleotide levels and spontaneous contractile activity.

Three different preparations of relaxin elevated cAMP levels in isometrically suspended uterine strips obtained from estrogen-primed female rats in the presence of phosphodiesterase inhibitors. The effect was time and dose dependent, with maximal response at 20 min and 1 microgram/ml, respectively. No changes in cGMP levels were observed. No significant response was observed in ileum, vas deferens, epididymis, or testicular capsule. In the absence of phosphodiesterase inhibitors, relaxin markedly suppressed spontaneous contractile activity at doses of 0.36 and 0.96 microgram/ml but did not elevate cAMP in this dose range. While the beta-adrenergic antagonist propranolol suppressed both the relaxant action and cAMP stimulation promoted by isoproterenol, it did not interfere with the effect of relaxin on these same parameters. Relaxin is therefore capable of relaxing uterine muscle and elevating cAMP by mechanisms which probably do not require beta-adrenergic mediation. It is not clear at present whether the effects of relaxin on cAMP levels and contractile activity are causally related.

Animals↗