Pathologic quiz case. Abdominal mass in a neonate.
Explore the source record for details and available documents.
Humans↗
Biomedical subjects
P Chou
Publications and source records attributed to P Chou.
Gender differences in the relationships of serum uric acid with fasting serum insulin and plasma glucose in patients without diabetes.
OBJECTIVE: To explore gender differences in the relationship of serum uric acid levels with fasting serum insulin and fasting plasma glucose concentrations among an adult Chinese nondiabetic population in Kinmen, Taiwan. METHODS: A total of 7,483 nondiabetic subjects (4,265 women, 3,218 men, aged 30 to 89 years) were involved in a community based epidemiologic study. Those with known or newly diagnosed diabetes were excluded. Overnight fasting blood samples were drawn for serum uric acid, glucose, insulin, lipid, and other biochemical measurements. Demographic and clinical variables including body mass index (weight/height2), waist-to-hip ratio, and blood pressure were measured and documented during face-to-face interviews with structured questionnaires. RESULTS: Stratified analyses revealed that (1) serum uric acid levels were positively associated with hyperinsulinemia and HOMA-insulin resistance in both men and women after adjusting for hypertriglyceridemia, hypertension, obesity, and plasma glucose levels; and (2) serum uric acid levels were more strongly associated with hyperinsulinemia and plasma glucose levels in women than in men. CONCLUSION; Hyperuricemia was positively associated with hyperinsulinemia among patients of both sexes without diabetes. Elevated levels of uric acid should alert physicians to the possibility of insulin resistance. The serum uric acid level was associated with insulin resistance and plasma glucose levels more strongly in females than in males in our study population.
Adult↗
Risk factors for low birth weight among first-time mothers in southern Taiwan.
BACKGROUND AND PURPOSE: Low birth weight (LBW) greatly affects infant development, the family, and health care financial systems. Nonetheless, the risk factors for LBW in Taiwan have not been investigated. The purpose of this study was to determine the risk factors for LBW in Kaohsiung County. METHODS: In this cross-sectional study, we recruited 1,147 first-time mothers, including all adolescent mothers (< 20 years old) who gave birth during the period from June 1994 through May 1995 and all adult mothers (> or = 20 years old) who gave birth in January and February 1995. The subjects were interviewed during home visits or by telephone by public health nurses in each township. Logistic regression analysis was used to identify the risk factors for LBW in adolescent and adult mothers. RESULTS: The prevalence of LBW in the study population was 6.2%, ranging from 7.6% in adolescent mothers to 4.9% in adult mothers. Univariate analysis showed that mothers who had low pregravid weight (< 45 kg), infrequent prenatal visits (< 10), anemia, low gestational weight gain (< 10 kg), or habits of alcohol consumption or cigarette smoking were more likely to give birth to LBW infants. In logistic regression analysis, after controlling for covariates, the significant risk factors for LBW were low gestational weight gain (< 10 kg) and low pregravid weight (< 45 kg) for adolescent mothers. Infrequent prenatal visits (< 10) was the only significant risk factor for adult mothers. CONCLUSIONS: In this study, the risk factors for LBW among adolescent and adult mothers were different. This suggests that programs for prevention of LBW should be tailored according to maternal age, begin before conception, and continue with enhanced surveillance during prenatal visits.
Adolescent↗
Factors related to utilization of traditional Chinese medicine in Taiwan.
Complementary and alternative medicine use is increasing worldwide. Expenses for complementary and alternative medicines are high, while the effectiveness of such medicines is still in debate. This paper reviewed the utilization of complementary and alternative medicines. Complementary and alternative therapies are used frequently and increasingly. Alternative therapies were used often for chronic conditions, including back problems, anxiety, depression and headaches in the United States. Musculoskeletal and respiratory complaints were the most frequent causes for complementary and alternative medicine consultation in Israel. In Taiwan, a systematic series of studies on factors related to utilization of traditional Chinese medicine (TCM) were conducted, including: (1) factors related to the choice of medical service (single or dual approach); (2) factors related to the choice of clinic type between TCM and western medicine among patients with single approach and among patients with dual approach; (3) factors related to patient choice of institute providing TCM (between TCM department in teaching hospital and regular TCM clinic) among patients using TCM only; and (4) knowledge, attitude and behavioral intention regarding TCM among patients using TCM only and among community residents over 30 years old. The findings of the above studies are summarized and presented accordingly.
Attitude↗
Evaluation of a population-based screening for type 2 diabetes: a community-based screening project in Puli, Taiwan.
BACKGROUND: A Markov method incorporating the relationships between prevalence, incidence, and mortality with respect to type 2 diabetes was used to assess a population-based screening for this disease. METHODS: Data from a population-based screening project for residents of Puli, Taiwan, over 30 years of age (n= 1,219) were used to estimate the annual incidence of asymptomatic type 2 diabetes, the prevalence to incidence (P/I) ratio, and the hazard rate of death due to type 2 diabetes. These parameters were employed to develop a Markov process to evaluate the effects of early detection of type 2 diabetes on the risk of death from this disease in a simulated population (n= 10,000) receiving biennial, 5-year interval, or no screening. RESULTS: The estimated annual incidence, average duration from asymptomatic to symptomatic type 2 diabetes (P/I ratio), and hazard rate for death from this disease were 0.86% (95% CI 0.50-1.48), 10 years (95% CI 7.69-14.01), and 1.1% per year, respectively. This yields an optimal screening interval of 5 years. Simulation of a 5-year interval screening regimen versus no screen ing yielded a relative risk reduction of 31% (95% CI 12-46%). A similar value was found for a biennial screening regime. CONCLUSIONS: The results suggest that early detection of type 2 diabetes via a community-based screening project in developing countries with high prevalence is worthwhile.
Adult↗
The prevalence of heavy proteinuria and progression risk factors in children undergoing urinary screening.
To evaluate the prevalence and incidence density of heavy proteinuria and chronic renal insufficiency (CRI) and the factors related to disease progression, 10,288,620 urinary screenings of elementary and junior high-school students from 1992 to 1996 were studied retrospectively. Urinary screening included pH, protein, occult blood, and glucose measurements. Blood sample analysis included total protein, albumin, A/G ratio, blood urea nitrogen, creatinine (Cr), antistreptolysin O titer, C3, cholesterol, hepatitis B virus surface antigen, IgA, and fasting blood sugar. The results showed that the 4-year prevalence of proteinuria was higher in girls than in boys (6.87x10(-4) vs. 4.83x10(-4) respectively). There were 189 cases with disease progression into CRI among the 10,288,620 students screened and followed continuously, with the prevalence of disease progression into CRI higher in boys than in girls (2.24x10(-5) vs. 1.41x10(-5) respectively). Of the 119 cases (63%) presenting with CRI since the first urine screening and blood sampling, only 14 had serum Cr levels higher than 6.0 mg/dl. There were 1,289 patients (10.5%) with proteinuria in 1992 and 705 patients (7.1%) in 1996. The absolute number of patients with heavy proteinuria decreased. The percentage of underlying glomerulonephritis in children on dialysis also decreased from 63.2% in 1992 to 47.0% in 1996. Logistic regression analysis showed that a persistent serum cholesterol level higher than 220 mg/dl, an albumin level lower than 3.5 g/dl, total protein less than 6 g/dl, and diastolic pressure higher than 90 mmHg were the significant risk factors for disease progression to CRI. We conclude that early detection of students with heavy proteinuria by mass urinary screening, early appropriate treatment, and monitoring of significant risk factors may help to decrease or delay the progression of renal disease, delay the introduction of dialysis in these predialysis CRI patients and maintain their growth and development.
Adolescent↗
Community-based epidemiological study of glucose tolerance in Kin-Chen, Kinmen: support for a new intermediate classification.
In this population-based survey, we investigated the prevalence of varying degrees of glucose tolerance among residents of Kin-Chen, Kinmen, as well as the association of glucose tolerance status with potential risk factors for type 2 diabetes and cardiovascular disease (CVD). We focused particularly on subjects with normal 2-h postload glucose level (<7.8 mmol/l) but persistent fasting hyperglycemia (PFH) (5.6-7.8 mmol/l), to examine whether PFH represents an intermediate state between normal glucose tolerance (NGT) and impaired glucose tolerance (IGT). The target population comprised 6346 residents aged 30 years and older. A total of 4354 subjects could be classified into categories of NGT, PFH, IGT, new diabetes, and known diabetes according to medical history, fasting plasma glucose levels, and the results of a 75-g oral glucose tolerance test (OGTT). The potential cardiovascular risk factors assessed included age, obesity (general and central), systolic blood pressure, and fasting levels of insulin, C-peptide, triglyceride, cholesterol, and high-density lipoprotein cholesterol (HDL-C). The age-standardized prevalences of PFH, IGT, new diabetes, and known diabetes were 2.9%, 3.5%, 4.0%, and 3.0%, respectively. Among nondiabetic subjects, the cardiovascular risk factor profiles worsened with decreasing glucose tolerance, with most values differing significantly among the NGT, PFH, and IGT groups. Subjects with PFH, who would be classified as having NGT according to conventional WHO criteria, had physical and biochemical features between those of the NGT and IGT groups. These findings support our previous observation that PFH may be a transition state between NGT and IGT in the progression toward type 2 diabetes.
Adult↗
Different association of hypertension and insulin-related metabolic syndrome between men and women in 8437 nondiabetic Chinese.
Insulin resistance may cause a metabolic syndrome but whether insulin resistance causes hypertension is very controversial. Furthermore, it remains unclear whether the link between the insulin-resistance-related metabolic syndrome and hypertension is different between men and women. We examined fasting insulin, glucose, triglyceride and high-density lipoprotein (HDL)-cholesterol levels, systolic blood pressure, body mass index, and waist-to-hip ratio in a dataset from 8437 nondiabetic residents (age range, 30 to 89 years) in Kinmen. Factor analysis, a multivariate correlation statistical technique, was used to investigate the clustering and interdependence of these risk variables. Factor analysis identified two factors for men (n = 3659) and three factors for women (n = 4778, respectively. In men, a cluster of insulin, triglyceride, HDL-cholesterol, body mass index, and waist-to-hip ratio (metabolic syndrome) accounted for 29.7%, and a cluster of systolic blood pressure and glucose (hyperglycemia plus hypertension) accounted for 18.1% of the total variance in all variables considered. In women, a cluster of insulin, triglyceride, body mass index, waist-to-hip ratio, and systolic blood pressure (metabolic syndrome plus hypertension) accounted for 29.4%, a cluster of systolic blood pressure, glucose, and triglyceride (hyperglycemia plus hypertension plus dyslipidemia) accounted for 14.0%, and a cluster of triglyceride and HDL-cholesterol (dyslipidemia) accounted for 16.2% of the total variance. In conclusion, a distinct insulin-resistance-related metabolic syndrome characterized by hyperinsulinemia, dyslipidemia, and obesity was observed for both men and women in this Chinese population. However, hypertension was linked to the metabolic syndrome in women only.
Adult↗
Bilateral superior cervical ganglionectomy increases choroidal blood flow in the rabbit.
In this study, we evaluate the effect of bilateral superior cervical ganglionectomy on albino rabbit choroidal blood flow (CBF) in changes of perfusion pressure (PP). Twenty albino rabbits of either sex weighing between 2.0 and 3.0 kg were randomly divided into two groups. The experimental group (group S) included 10 rabbits (20 eyes) that received bilateral superior cervical ganglionectomy one week prior to the study. The other 10 rabbits (20 eyes) served as a control (group N): each received the same procedure as group S except that the superior cervical ganglion was preserved. By means of a laser Doppler flowmeter (Perimed PF4001), blood cell flux (PF), velocity (V), and concentration of moving blood cells (CMBC) were recorded simultaneously while intraocular pressure was increased linearly by a syringe pump. Blood pressure and intraocular pressure were continuously monitored. The laser beam focused on the posterior pole away from major retinal vessels. When PP decreased from 75 to 0 mm Hg, in group N, PF, V and CMBC decreased from 100% to 6.94+/-0.91%, 8.41+/-0.87%, and 19.38+/-1.11%; in group S, it was 17.75+/-2.58%, 16.78+/-1.48%, and 34.58+/-4.42%, respectively. Group S poses higher PF, V, and CMBC than group N while PP decreased gradually. These results indicate that the superior cervical ganglion plays a role in CBF regulation. Bilateral sympathectomy led to a higher PF in the group S rabbits, indicating increased CBF. PF, V, and CMBC remained constant until PP <55 mm Hg demonstrated the existence of CBF autoregulation within a limited perfusion range in both groups. This autoregulation did not change after sympathectomy.
Animals↗
A 14-year-Old young woman with a five-week history of back pain.
Explore the source record for details and available documents.
Adolescent↗
Expression of a candidate gene for the gonadoblastoma locus in gonadoblastoma and testicular seminoma.
The gonadoblastoma locus on the Y chromosome (GBY) predisposes the dysgenetic gonads of XY females to develop in situ tumors. It has been mapped to a critical interval on the short arm and adjacent centromeric region on the Y chromosome. Currently there are five functional genes identified on the GBY critical region, thereby providing likely candidates for this cancer predisposition locus. To evaluate the candidacy of one of these five genes, testis-specific protein Y-encoded (TSPY), as the gene for GBY, expression patterns of TSPY in four gonadoblastoma from three patients were analyzed by immunohistochemistry using a TSPY specific antibody. Results from this study showed that TSPY was preferentially expressed in tumor germ cells of all gonadoblastoma specimens. Additional study on two cases of testicular seminoma demonstrated that TSPY was also abundantly expressed in all stages of these germ cell tumors. The present observations suggest that TSPY may either be involved in the oncogenesis of or be a useful marker for both types of germ cell tumors.
Cell Cycle Proteins↗
Flow cytometric immunophenotypic characterization of pediatric and adult minimally differentiated acute myeloid leukemia (AML-M0).
We reviewed the clinicopathologic and immunophenotypic profiles of 7 pediatric and 11 adult minimally differentiated acute myelogenous leukemias (AML-M0). We also compared and evaluated myeloperoxidase in leukemic blasts using standard cytochemical and polyclonal antibody immunohistochemical stains. No distinctive clinical findings were noted in either patient group; however, thrombocytopenia typically was more prominent in adults. Adult AML-M0 also was associated with an immature myeloid profile (CD34+, terminal deoxynucleotidyl transferase positive, CD13+, and CD33+), in contrast with pediatric AML-M0, which usually lacked terminal deoxynucleotidyl transferase or CD34 but expressed bright CD33 with weak or negative CD13. Coexpression of the T-cell-associated antigen CD7 was observed in both groups. Antibody immunohistochemical stains were more sensitive than cytochemical stains for detection of myeloperoxidase activity and a useful adjunct for establishing a diagnosis of myeloid leukemia in paraffin-embedded marrow tissues.
Adolescent↗
Sublingual enteric duplication cyst.
We describe a case of enteric duplication arising from the floor of the mouth and base of the tongue of a 7-year-old child. This mass was asymptomatic and was detected on routine dental examination. The unusual location, possible etiology, and a brief review of the literature are discussed.
Child↗
Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen.
OBJECTIVE: This is a population survey conducted in 1991-92 among residents aged > or =30 years in Kin-Hu, Kinmen, with a 77.7% response rate to study the prevalence of hyperuricemia and hyperuricemia associated gout. A stratified analysis based on sex and age was used to assess the interaction and analyze the associated risk factors for hyperuricemia and gout. METHODS: Hyperuricemia was defined as uric acid > or =7.0 mg/dl for men and > or =6.0 mg/dl for women. Gout was clinically diagnosed by a senior rheumatologist based on patient's history and examination according to the clinical criteria of Wallace. Basic demographic and lifestyle variables as well as biochemical data were collected. RESULTS: The prevalence of hyperuricemia was 25.8% (391/1515) in men and 15.0% (250/1670) in women. The prevalence of gout among hyperuricemic subjects was 11.5% for men and 3% for women. According to age spectrum, the risk factor for hyperuricemia was hyperlipidemia in young adults (30-39 yrs); lifestyle and some clinical syndromes played a significant role in middle aged persons (40-59 yrs). The different risk factors between the sexes in middle age were alcohol consumption effect in men and menopause effect in women. Impaired renal function and use of diuretics became the important factors in the elderly (> or =60 yrs). The risk factors for gout among either the general population or subjects with hyperuricemia were concentration of serum uric acid, alcohol consumption, and central obesity. CONCLUSION: Risk factors for hyperuricemia tended to be different with respect to sex and age. Alcohol consumption and central obesity were independent predictors of gout among hyperuricemic subjects irrespective of uric acid level.
Adult↗
Epidemiology of leprosy in Taiwan; its pattern in children.
OBJECTIVE: To study the epidemiology of leprosy in children in Taiwan. SETTING: Taiwan, with a population increase from 3.3 to 21.7 million, several tides of immigration and national leprosy control programs, from 1910 to 1997. DESIGN: To collect and analyze the documents of Taiwan leprosy surveys and charts of the National Leprosy Control Center. PATIENTS AND MEASUREMENTS: Cumulative and new number of all-age and pediatric-age patients, prevalence rates, new case detection rates, and results of skin bacterial smears. RESULTS AND CONCLUSIONS: The prevalence rates of all-age leprosy ranged between 1.54 and 3.22 per 10,000 population. The proportion of children among all-age patients reached the highest of 4.93% in 1966, dropping to 0% in 1984 and thereafter, until 1988 and 1991 when two and one pediatric-age patients appeared, respectively, following the influx of immigrants from leprosy-endemic countries. The rise and fall of new patients younger than 15 years and 15 years or older were slightly correlated (r = 0.935, p < 0.001). Detection and confirmation of leprosy in children are usually belated. Physicians should still be acquainted with the clinical diagnosis of leprosy since sporadic cases of leprosy can reappear, particularly among children coming from endemic countries.
Adolescent↗
The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study.
OBJECTIVE: To investigate the incidence of gout and the interaction between uric acid level and other risk factors in the development of gout. METHODS: Two hundred twenty-three asymptomatic hyperuricemic men initially studied in 1991-92 were reassessed in 1996-97. Gout was clinically diagnosed by a senior rheumatologist based on history and physical according to the clinical criteria of Wallace. Basic demographic and lifestyle variables as well as biochemical data were collected in both baseline and followup periods. Both the stability analysis and the analysis of repeated relationships were applied. RESULTS: The 5-year cumulative incidence of gout was 18.83% (42/223). The risk factors for gout based on the analysis of repeated relationships were uric acid level, alcohol consumption, use of diuretics, and obesity. The only predictor of gout at baseline was uric acid level. After adjusting for baseline uric acid level, followup uric acid increase, persistent alcohol consumption, use of diuretics in the followup period, and body mass index increase were independent predictors for gout among asymptomatic hyperuricemic men. Excessive alcohol consumption, particularly if occasional, was the most important factor in the development of gout, even when the concentration of uric acid level was below 8 mg/dl. CONCLUSION: Uric acid level is the key factor for prevention of gout and needs constant monitoring. Other contributing or possible etiologic factors such as alcohol consumption, diuretics use, and excess weight gain carry an increased risk of gout attack among patients with hyperuricemia.
Adult↗
Genotypic analysis of HCV infection in kinmen.
In this report, stratified random sampling of an epidemiological study population from the town of Kin-Hu in the Kinmen Islands was used to create a subpopulation of 832 individuals. Two enzyme immunoassays (EIA) were used for antibody testing including Abbott's hepatitis C virus (HCV) EIA 2nd Generation and a synthetic peptide-EIA, NANBASE C-96-EIA, based on the locally predominant strain of HCV. In addition to RIBA and DBL immunoblot assays, reverse transcription-polymerase chain reaction (RT-PCR) was employed to confirm HCV infection. Results showed that 20 of 832 (2.4%) adults in Kinmen had HCV infection. In terms of genotype distribution, 31.3% (5/16) were infected with both 1a and 1b genotypes, 25.0% (4/16) only with the 1b genotype, and 43.8% (7/16) with the 2a genotype. Through comparative analysis of RT-PCR, RIBA, and DBL results, we found that the sensitivities of RIBA and DBL could safely be increased by modifying the definition of a positive case. If the presence of a reactive band with > or = 2+ antibody reactivity to core protein is accepted as positive for overall RIBA or DBL testing, sensitivity is increased without adversely effecting specificity.
Adult↗
Correlation of fasting serum C-peptide and insulin with markers of metabolic syndrome-X in a homogenous Chinese population with normal glucose tolerance.
We surveyed 1447 men and 1800 women aged 30 years (mean 46.7 years) with normal glucose tolerance in Kin-Chen, Kinmen. Correlations of fasting serum insulin and C-peptide with various clinical and biochemical parameters were analyzed by multiple linear regression analysis. Women had significantly higher levels of insulin than men (98+/-43 vs. 91+/-43 pM, p<0.0001), yet they also had a more favorable cardiovascular risk profile. Insulin was positively associated with the female sex, height, body mass index, waist-to-hip ratio, serum triglyceride, total cholesterol, uric acid, and fasting plasma glucose, and was negatively associated with age, smoking, and high-density lipoprotein cholesterol. Independent correlates for C-peptide were similar to those of insulin, except for the addition of mean blood pressure and the exclusion of age and total cholesterol. Significant interaction of sex-body mass index (coefficient = -0.0051, p = 0.0232) was detected for C-peptide only. In conclusion, both fasting serum insulin and C-peptide are quantitatively associated with cardiovascular risk factors in this homogeneous Chinese population with normal glucose tolerance. The female sex is independently associated with higher insulin and C-peptide levels, and the strength of the positive association between the female sex and C-peptide reduces when the body mass index increases.
Adult↗