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Biomedical subjects

N H Cho

Publications and source records attributed to N H Cho.

At least 55 records · Page 3Linked to original sources
PubMed1995

Adverse pregnancy outcome after a false-positive screen for Down syndrome using multiple markers.

OBJECTIVE: To assess the relative risk of an adverse pregnancy outcome in women whose multiple-marker screening (maternal serum alpha-fetoprotein [MSAFP], unconjugated estriol [E3], and hCG levels, and age) indicating an increased risk for Down syndrome (more than 1:250) was not confirmed by amniocentesis. METHODS: Fifty-eight women with false-positive screens for Down syndrome were matched with a control group of 116 women whose screens indicated a risk for Down syndrome of less than 1:250. The risk for adverse pregnancy outcome was compared for the two groups, and the roles of MSAFP, unconjugated E3, and hCG as predictors of adverse pregnancy outcome were determined. RESULTS: Women with false-positive screens for Down syndrome were significantly different from their matched controls in the incidence of preterm delivery (20.6 versus 8.6%, respectively), preeclampsia (6.9 versus 0%), small for gestational age newborns (5.2 versus 0%), and fetal demise after 20 weeks' gestation (5.2 versus 0%). An adverse outcome occurred in 19 of 58 pregnancies (32.8%) in the study group and in 14 of 116 matched control pregnancies (12%) (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.6-7.8; P < .01). Unconjugated E3 of 0.75 multiples of the mean (MoM) or less was significantly associated with adverse pregnancy outcome after controlling for the effects of MSAFP and hCG (OR 2.5, 95% CI 1.13-5.55; P < .02). CONCLUSION: One in three women with a false-positive screen for Down syndrome may experience an adverse pregnancy outcome. In this study, unconjugated E3 of 0.75 MoM or less appeared to be a better predictor of adverse pregnancy outcome than were MSAFP and hCG levels.

Adult↗
PubMed1995

Impaired glucose tolerance in adolescent offspring of diabetic mothers. Relationship to fetal hyperinsulinism.

OBJECTIVE: To test the hypothesis that long-term postnatal development may be modified by metabolic experiences in utero. RESEARCH DESIGN AND METHODS: We enrolled offspring of women with pregestational diabetes (this included insulin-dependent diabetes mellitus [IDDM] and non-insulin-dependent diabetes mellitus [NIDDM]) and gestational diabetes in a prospective study from 1977 through 1983. Fetal beta-cell function was assessed by measurement of amniotic fluid insulin (AFI) at 32-38 weeks gestation. Postnatally, plasma glucose and insulin were measured yearly from 1.5 years of age after fasting and 2 h after 1.75 g/kg oral glucose. Control subjects had a single oral glucose challenge at 10-16 years. RESULTS: In offspring of diabetic mothers, the prevalence of impaired glucose tolerance (IGT) (2-h glucose concentration > 7.8 mmol/l) was: 1.2% at < 5 years, 5.4% at 5-9 years, and 19.3% at 10-16 years. The 88 offspring of diabetic mothers (12.3 +/- 1.7 years), when compared with 80 control subjects of the same age and pubertal stage, had higher 2-h glucose (6.8 +/- 1.4 vs. 5.7 +/- 0.9 mmol/l, P < 0.001) and insulin (660 +/- 720 vs. 455 +/- 285 pmol/l, P < 0.03) concentrations. The 17 subjects with IGT at > 10 years of age (9 boys and 8 girls) include one girl with NIDDM. IGT was not associated with the etiology of the mother's diabetes (gestational versus pregestational) or macrosomia at birth. IGT was found in only 3.7% (1 of 27) of adolescents whose AFI was normal ( < or = 100 pmol/l) and 33.3% (12 of 36) of those with elevated AFI (P < 0.001). Although most of the children with IGT are obese, AFI and obesity are independently associated with IGT by multiple logistic analysis. CONCLUSIONS: In confirmation of our original hypothesis, IGT in the offspring is a long-term complication of maternal diabetes. Excessive insulin secretion in utero, as assessed by AFI concentration, is a strong predictor of IGT in childhood.

Adolescent↗
PubMed1995

Analysis of nm23 expression as a prognostic parameter in renal cell carcinoma.

To identify the clinicopathological events including nm23 expression that underlies progression in renal cell carcinoma, a retrospective analysis of patients with renal cell carcinoma was performed. Ninety-eight cases of radical nephrectomies with extensive regional or para-aortic lymph node dissection were assessed for clinicopathological variables, and eighty-five cases underwent nm23/NDPK-A protein immunohistochemical staining. Significant parameters in survival were tumor size, histologic pattern, Fuhrman's nuclear grade, pathologic T(pT) stage, pathologic N stage, M stage, tumor thrombi, location of metastasis, and nm23 staining intensity. To assess the relationship with survival, the tumors with low and high nm23 expressions were compared. The fifty-nine patients with a high staining intensity had a significantly worse survival than did the twenty-six with a low staining intensity (p = 0.0015). Additionally nm23 staining intensity was correlated with tumor size, Fuhrman's nuclear grade, pT, and distant metastasis. Therefore, the immunostaining intensity of nm23 protein could be used as a prognostic parameter with an inverse correlation.

Adult↗
PubMed1995

Correlation between proliferating index and prognostic factors in papillary cystic tumors of the pancreas.

Fifteen cases of papillary cystic tumor of the pancreas (PCTP) were studied (14 female patients, one male patient; mean age: 23.5 years). Most tumors developed in the head of the pancreas as a well circumscribed large mass. The tumor had a mean diameter of 6.7 cm(range; 2 to 15 cm). Histopathologically abundant delicate papillary fragments, monomorphic tumor cells and degenerative changes of the solid area of the tumor were characteristic. All but two cases had completely circumscribed capsules. Two cases had duodenal invasion; one of all cases had cul de sac metastasis. Compared with 12 non-aggressive tumors, the aggressive cases had larger tumor size (more than 9 cm) with a thicker capsule (more than 2 mm). In studies to investigate the prognostic index using nucleolar organizing region (NOR), proliferating cell nuclear antigen (PCNA) and flow cytometry as well as nuclear grade and mitotic index, we could not find the useful parameter to detect the malignant potential of PCTP. In the flow cytometric analysis of cellular DNA contents, two invasive cases and the only one case of the male patient among the non-aggressive group were aneuploid. In conclusion, although it is hard to predict the prognosis by microscopic findings only, those with a thick capsule and aneuploidy tend to be related to malignant potential.

Adolescent↗
PubMed1994

Perinatal complications and cognitive development in 2- to 5-year-old children of diabetic mothers.

OBJECTIVE: Our purpose was to assess whether perinatal complications contribute to lower intellectual attainment in offspring of diabetic mothers, independent of antepartum metabolic disregulation. STUDY DESIGN: Subjects were 223 pregnant women and their singleton offspring. Eighty-nine women had pregestational diabetes mellitus, 99 had gestational diabetes mellitus, and 35 had normal gestational glucose metabolism. Perinatal complications were prospectively recorded on an examination checklist. The intelligence quotient of the child was assessed with the Bayley Scales of Infant Development at age 2 years and the Stanford-Binet Intelligence Scale at age 3 to 5 years. RESULTS: No significant correlations emerged between either measure of child's intelligence quotient and any prevalent perinatal complication, after statistical correction for socioeconomic status, race or ethnic origin, patient group, and antepartum metabolic control. CONCLUSIONS: Given prevailing practices in diabetes management and obstetric and neonatal care, the effects of prevalent perinatal complications on the intellectual development of offspring of diabetic mothers appear minimal.

Adult↗
PubMed1994

The incidence of IDDM in Seoul from 1985 to 1988.

OBJECTIVE: To determine insulin-dependent diabetes mellitus (IDDM) incidence rates for the first time in Seoul, Korea, from 1985 to 1988. RESEARCH DESIGN AND METHODS: A mail survey was conducted among all hospitals, a total of 136, with > 80 beds in the Seoul area. Of these, (15.4%) hospitals reported patients with newly diagnosed IDDM. RESULTS: The average incidence rate of IDDM from 1985 to 1988 was 0.70/100,000 (95% confidence interval [CI]: 0.55-0.89). When stratified by gender, the average incidence rate in boys was 0.58/100,000 (95% CI: 0.42-0.9), and in girls it was 0.78/100,000 (95% CI: 0.56-1.07). The age at onset was similar to that reported in other countries, i.e., more than 50% of the cases were diagnosed between the ages of 10 and 14. The incidence of IDDM increased in parallel with the age-group (0.4 < 5-9 < 10-14 years). Onset seasonality was also similar to that in other reported countries with the most cases occurring during the winter months and the least number of cases during the summer months. CONCLUSIONS: The incidence rate of IDDM in Seoul is the lowest reported in the world. This might be effectively considered a baseline incidence rate before exposure to environment or other risk factors. The similar pattern of onset characteristics in Korea to those in other countries suggests that the same etiological factors are operative.

Adolescent↗
PubMed1994

Clinicopathologic comparison of eroded polypoid hyperplasia and solitary rectal ulcer syndrome.

We experienced two unusual cases of tumor-like polypoid lesions involving the rectosigmoid colon. They could not be readily classified into any well known polypoid tumors of the rectosigmoid colon, but appeared to have some similarities to the previously documented "eroded polypoid hyperplasia (EPH)". A collective review of our seven cases of solitary rectal ulcer syndrome (SRUS), which proved to be due to paradoxically over-reactive muscle tone of the puborectalis, was performed, and clinicopathologic comparisons between EPH and SRUS were carried out. They shared histopathologic characteristics such as vascular congestion, crypt hyperplasia, and eroded surface, but they were different from each other in clinical symptoms, location of lesions and gross features. Furthermore, in one EPH case there was an altered much profile which was similar to that seen in SRUS and complete rectal prolapse. Conceivably, the pathological features of both EPH and SRUS were thought to have a possible connection with mucosal prolapse syndrome (MPS). Considering that MPS is a group of diseases encompassing SRUS and the related disorders of the colorectum and the anus, it is speculated that EPH of the rectosigmoid colon might be the proximal analogue of SRUS, a mucosal prolapse of the more distal colon.

Adult↗
PubMed1994

Effects of dimethyl methylphosphonate (DMMP) and trimethylphosphate (TMP) on spermatogenesis of rat testis.

Both dimethyl methylphosphonate (DMMP) and trimethylphosphate (TMP) are organophosphorous compounds that can evoke sterility in male rodents. The following studies examined the pathology of reproductive organ, especially on the testis, by light microscopy after treatment with both agents. Adult male rats were treated per oral with DMMP, 1,750 mg/Kg, for up to 12 weeks and per oral with TMP, 400 mg/Kg for up to 5 weeks. After 5 weeks of treatment with DMMP there were occasional multinucleated giant cells composed of late spermatids in stages X, XI, XII as well as cytoplasmic vacuolation of Sertoli cell. Anachronistic spermiations were seldom, if ever, seen throughout the experiment. After 7 weeks of DMMP those were markedly diminished. The overall changes after treatment with TMP are somewhat similar to those treated with DMMP. The major changes were composed of aggregate of multinucleated giant cells and maturation arrest at spermatid level, which appear immediately after administration of TMP. The peak frequency in the emergence of multinucleated giant cells in treatment with TMP was noted just a week after treatment, but afterwards declined. Maturation arrest was prominent after 3 weeks in the cases treated with TMP.

Animals↗
PubMed1993

Prepregnancy weight and antepartum insulin secretion predict glucose tolerance five years after gestational diabetes mellitus.

OBJECTIVE: To identify phenotypic, genotypic, and metabolic parameters measured at the time of antepartum diagnosis of gestational diabetes mellitus that can indicate the risk of diabetes mellitus at early postpartum (< or = 6 mo after delivery) and at a 5-yr follow-up. RESEARCH DESIGN AND METHODS: The recommendations from the National Diabetes Data Group and International Workshop Conferences on Gestational Diabetes Mellitus were used for screening, diagnosing, and subclassifying gestational diabetes mellitus. National Diabetes Data Group criteria were also used for classification of glucose tolerance postpartum. Plasma glucose, insulin, and free fatty acids were measured after an overnight fast. Plasma glucose and insulin were measured 15, 30, 60, 120, and 180 min after the 100-g oral glucose load. Postpartum glucose tolerance was evaluated at 3-6 mo (early), 1 yr, and annually thereafter. RESULTS: The 5-yr cumulative incidence of diabetes during follow-up after gestational diabetes mellitus was nearly 50%. Among those who had diabetes within 5 yr, a history of diabetes in only the mother was nearly threefold more common than a history of diabetes in only the father (30 vs. 11%, P < 0.01). Those who displayed diabetes at early postpartum (< or = 6 mo) testing had significantly higher antepartum glucose levels at 60, 120, and 180 min compared with those whose early postpartum results were normal. They were also relatively insulinopenic at antepartum testing. Their fasting, acutely stimulated (15 and 30 min), and integrated 3-h response to oral glucose were all significantly lower relative to women who remained normal or had impaired glucose tolerance at early postpartum testing. Women who developed diabetes between 6 mo and 5 yr postpartum were more obese before the index pregnancy, and they had lower fasting, acutely stimulated (15 and 30 min), and integrated (1-3 h) insulin levels compared with women who remained normal or displayed impaired glucose tolerance at 5 yr postpartum. A multiple logistic regression model showed that diabetes present at early postpartum testing was independently associated with higher 2-h glucose and lower basal and total integrated insulin level. Later (> or = 6 mo-5 yr postpartum) development of diabetes was independently associated with prepregnancy weight and impaired insulin secretion at diagnosis of gestational diabetes mellitus. CONCLUSIONS: Impaired beta-cell function and obesity at diagnosis of GDM were associated with the development of diabetes during a 5-yr, follow-up period. Studies designed to prevent diabetes in this high-risk group should examine strategies to maintain both optimal beta-cell function and maximum insulin sensitivity.

Adult↗
PubMed1993

Changes in the determinants of fertility in Korea: analyses of pregnancy intervals and outcomes.

Korea completed the whole process of what is called the demographic transition to a low fertility and mortality level with the successful implementation of the national family planning program in 1962, and this has been accompanied by rapid socioeconomic development. Most of the fertility decline was due to a rising age at marriage and to lower marital fertility. The national family planning program, combined with the widespread practice of induced abortion, has placed an important role in reducing marital fertility, particularly among older women. This paper aims, therefore, to examine the determinants of fertility and their changes over time in an effort to suggest future population policy directions for Korea. The analysis is divided into 2 parts-estimation of pregnancy intervals by applying the proportional hazards model, and estimation of the determinants of fertility by adopting the logistic regression model to find out whether a pregnancy terminates in a live birth or in an abortion. In both analyses, the sex was included as the main explanatory variable. A woman's education has been shown to have a significant effect on delaying the timing or on the wife's age at first pregnancy, but its effect on the pace of subsequent pregnancies is much smaller and often positive. On the other hand, the woman's education has a consistently positive effect on the probability of a pregnancy ending in an abortion although the effect shows a steady decline over time. Form first parity, the sex composition of previous children stands out consistently as the most important factor in deciding both the pace of pregnancy and its outcome. The pregnancy risks of the women with sons are reduced by almost 50% at the second and third parities. The probability of a pregnancy ending in an abortion also increases substantially when parents already have a son. The decline of the desired family size but the sustained strong son preference has made the sex of children a more important factor in the determination of Korean fertility. The woman's education, on the other hand, has become a less important factor.

Abortion, Induced↗
PubMed1992

Analysis of factors contributing to fertility decline in Korea.

With the successful Korean national family planning program and rapid socioeconomic advancement since 1962, the contraceptive prevalence rate has risen from 9% in 1964 to 79% in 1991, with the corresponding total fertility rate (TFR) going from 6.0 in 1960 to 1.6 in 1988, which is considerably below the replacement fertility rate. The main purpose of this study is, therefore, to identify the structural and causal factors that contributed to the fall in fertility over the last 3 decades, in an effort to formulate future population policy directions and strategies. The 2 methods used for the study were: the standardization approach to examine the structural factors on fertility decline, and the bongaarts model to measure the effects of the proximate variables in the fertility decline. The study indicated that the fall in the crude birth rate and the general fertility rate for the periods of 1960-70 and 1980-90 were largely influenced by the decline in marital fertility which was triggered by the national family planning program initiated in 1962. The analysis based on the bongaarts model revealed that the 3 principal factors which exercised a strong influence on the fertility decline were the rise in age at marriage, the increase in induced abortion, and the increase in contraceptive use, but the influence of induced abortion has been decreasing in recent years. In general, the study results suggest that the main concerns of the national family planning program should be shifted from the past quantitative approach with emphasis on fertility reduction to a qualitative approach which stresses maternal and child health and other public health programs.

Abortion, Induced↗
PubMed1991

Fine-needle aspiration cytology of pulmonary adenocarcinoma of fetal type: report of a case with immunohistochemical and ultrastructural studies.

This report describes the fine-needle aspiration (FNA) cytology of a case of adenocarcinoma resembling fetal lung in a 53-yr-old male, a very uncommon malignant tumor of the lung that is similar to an early stage of lung differentiation. FNA smears revealed relatively small, fairly uniform tumor cells appearing as cohesive cell groups and scattered, isolated cells, some of them showing a rosette or acinus pattern. In addition, clusters of larger cells with eosinophilic cytoplasm and prominent nucleoli existed contiguously with the small cells or separately. The possibilities of an unusual type of adenocarcinoma, carcinoid tumor, and pulmonary blastoma were suggested by the cytologic findings. Immunohistochemical studies performed on a resected tumor tissue showed immunoreactivity for alpha-fetoprotein, neuron-specific enolase, and somatostatin, and endocrine-type granules were found ultrastructurally. This type of adenocarcinoma is considered to have a histogenesis similar to that of pulmonary blastoma. To our knowledge this is the first reported case in the cytologic literature.

Adenocarcinoma↗
PubMed1991

Long-term prospective evaluation of offspring of diabetic mothers.

We have suggested that altered maternal metabolism may affect the subsequent anthropometric and neuropsychological development of children who were in utero during disturbances in maternal fuel economy. This study reports the physical growth through 8 yr of age and the neuropsychological development through 4 yr of age in offspring of diabetic mothers (ODM). At birth, 50% of infants had weights greater than 90th percentile for gestational age. By 12 mo, length and weight were similar to the general population. Height remained normal until 7 yr of age, when it became slightly greater than average. After 5 yr of age, relative weight increased dramatically, and by 8 yr of age, half of the ODM had weights greater than 90th percentile. This childhood obesity in ODM is correlated with maternal prepregnant weight and independently with amniotic fluid insulin at 32-38 wk gestation. The Brazelton Neonatal Behavioral Assessment Scale (BNBAS) was administered to 185 newborn ODM. Significant correlations were found between poorer second- and third-trimester glycemic regulation and lower scores in three of four newborn BNBAS dimensions. The Stanford-Binet Intelligence Scale was measured in 102 ODM at 4 yr of age. We found an inverse correlation between childhood IQ and second- and third-trimester maternal lipid metabolism (serum free fatty acids and beta-hydroxybutyrate). This correlation is not explained by adverse perinatal events, socioeconomic status, maternal IQ, ethnicity, or diabetes type. These long-range associations between altered maternal metabolism and childhood growth and development continue to support Freinkel's hypothesis of fuel-mediated teratogenesis.

Aging↗
PubMed1991

Gestational diabetes mellitus. Influence of race on disease prevalence and perinatal outcome in a U.S. population.

We explore whether racial differences in a United States population influence disease prevalence and perinatal outcome in gestational diabetes mellitus (GDM). The data presented are based on 3744 consecutive patients who underwent universal screening at 24-28 wk gestation; those with a 1-h plasma glucose greater than or equal to 7.2 mM underwent a 100-g 3-h oral glucose tolerance test (OGTT). The overall prevalence of GDM was 3.5 cases/100 with the standard O'Sullivan-Mahan diagnostic criteria derived for plasma, whereas use of the Carpenter-Coustan modification of the O'Sullivan-Mahan criteria yielded a prevalence of 5.5. The population was 39.1% white, 37.7% black, 19.8% Hispanic, and 3.4% Oriental/other. For those patients with a nondiagnostic test, mean plasma glucose at each time point of the OGTT was similar for all racial groups. Because of demographic and phenotypic heterogeneity between different racial groups, the influence of these different variables on the prevalence of GDM was tested by multiple logistic regression. Black and Hispanic race, maternal age, and percentage ideal body weight were found to have significant independent effects on the prevalence of GDM (P less than 0.05, 0.001, 0.001, and 0.001, respectively). The adjusted relative risk of GDM was significantly higher in black (1.81, 95% confidence interval [CI] 1.13-2.89, P less than 0.05) and Hispanic (2.45, 95% CI 1.48-4.04, P less than 0.001) patients compared with whites. The influence of race on infant birth weight was examined in the 92 patients with GDM controlled with diet.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Melanosis coli--histochemical and immunohistochemical comparison of the pigments of melanosis coli and Dubin-Johnson syndrome.

We compared the pigment of melanosis coli with the pigment of Dubin-Johnson syndrome, melanin, and lipofuscin. The pigment of melanosis coli appeared similar to lipofuscin in that it stained positively with periodic acid-Schiff, oil red-0 and Victoria blue stains and revealed negative reactions to the immunohistochemical stains for S-100 protein and neuron specific enolase, but had similarity to melanin as shown by the positive reaction to Fontana-Masson stain and negative autofluorescence. The pigment of Dubin-Johnson syndrome showed the same histochemical and immunohistochemical characteristics as that of melanosis coli. The results indicate that the pigments of melanosis coli and Dubin-Johnson syndrome are identical and are variants of lipofuscin.

Colonic Diseases↗
PubMed1990

Benign proliferative disorders of the breast.

Fibrocystic disease of the breast has been generally regarded as a disorder due to either excess hormonal stimulation or an exaggerated proliferative response by hypersensitive breast epithelium. The unique lobular lesion-adenosis- and its variants have been regarded as non-neoplastic and non-preneoplastic glandular hypertrophy and hyperplasia, and have different organoid patterns and origins. We have examined a total of 242 cases previously diagnosed as 'fibrocystic disease' at the Department of Pathology with the purpose of clarifying the variants of adenosis in detail and refining the infinitely large 'fibrocystic disease' classification as non-proliferative fibrocystic change and proliferative disorders, such as epitheliosis and atypical hyperplasia. In this study, 224 cases (92.5%) were nonproliferative disease, mostly adenosis (40.1%), and 18 cases (7.5%) were proliferative disease, which consisted of moderate to florid hyperplasia and epitheliosis.

Adult↗