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Biomedical subjects

C K Shaw

Publications and source records attributed to C K Shaw.

At least 19 recordsLinked to original sources
PubMed2000

Effectiveness of an organ-sharing program in providing zero HLA-A,B,DR mismatched kidneys for transplantation in Taiwan.

PURPOSE: This study evaluated the effects of organ sharing on the allocation of kidneys from cadaveric donors to uremic patients from National Cheng Kung University Hospital (CKUH) and National Taiwan University Hospital (NTUH) who were waiting for kidney transplantation. METHODS: Standard complement-dependent microcytotoxicity assays were used. Human leukocyte antigen (HLA)-A,B,C typing was performed on nylon-wool-enriched T lymphocytes. HLA-DR typing was performed on either nylon-wool-separated B cells or Dynabeads. Isolation of class II-positive cells was performed with commercial typing trays. RESULTS: Organs were allocated from a total of 88 cadaveric donors to 320 patients treated at CKUH and 179 patients treated at NTUH. Cadaveric kidneys could be allocated with an A,B,DR mismatch to 6.9% of CKUH patients and to 4.7% of NTUH patients. When CKUH and NTUH patients were pooled, the total number of kidneys that could be allocated with 0-A,B,DR mismatch increased to 13.3% (p < 0.004). However, when allocation was assessed using 10,000 potential bone marrow donors instead of the 88 cadaveric donors, kidneys could have been allocated with 0-A,B,DR mismatch to 12% (p = 0.64) of patients. No significant benefit was found when allocation estimates from the 10,000 potential bone marrow donors were compared with those for the 88 cadaveric donors. Use of epitope matching resulted in a 0-A,B cross-reactive epitope group, and a 0-DR mismatch allocation rate of 36.4% in CKUH patients and 31.8% in NTUH patients. This rate increased to 54.6% (p < 0.001) when the patients from these hospitals were pooled. CONCLUSION: The results of this study demonstrate that the pooling of patients among regional transplant centers in Taiwan can significantly enhance the benefits of an organ donation program through better HLA matching.

HLA-A Antigens↗
PubMed2000

The DCC protein expression in breast carcinoma.

Inactivation of the gene "deleted in colon cancer" (DCC) on chromosome 18 is known to be associated with the tumorigenesis and metastasis of colorectal cancer. In the present study, we investigated the expression of DCC, P53 and HER-2/neu product in surgical specimens from 79 patients with invasive breast cancer by immunohistochemistry staining and found the expression of DCC to be decreased in 42 tumors (52%). Overexpression of HER-2/neu and P53 was detected in 29 (36.8%) and 26 (32.9%) of this 79 breast cancer specimens, respectively. To evaluate the outcomes of the 79 breast cancer patients, we followed up the patients during the period from May 1990 to August 1998. The average length of follow-up was 52 months (ranging from 4 to 94 months). Patients with tumors having a combination of DCC-negative and HER-2/neu overexpression showed a marginal influence on survival time of breast cancer (P = 0.06). However, patients with tumors having a combination of DCC-negative and P53 overexpression showed no influence of these on survival time of breast cancer (P = 0.36). These findings suggest that a decreased DCC expression and HER-2/neu overexpression may influence the prognosis of breast cancer.

Breast Neoplasms↗
PubMed1999

Distribution of HLA gene and haplotype frequencies in Taiwan: a comparative study among Min-nan, Hakka, Aborigines and Mainland Chinese.

A total of 8,497 blood samples were typed for HLA-A, B, DR and DQ. Of these, 7,137 Min-nan, 714 Hakka, 535 Mainland Chinese (152 from North China, 211 from Middle China, and 172 from South China) and 111 Aborigines were randomly selected from Tzu Chi Taiwan Marrow Donor Registry (TCTMDR). Differences in HLA gene and antigen frequencies have been observed between various ethnic groups of the Chinese population in Taiwan. The phylogenic tree shows Taiwan Aborigines and Javanese cluster together; Min-nan shares a common cluster with Hakka, Southern Hans and Thai; and Northern Hans shares a cluster with Middle Hans. The separation between Northern/Middle and Southern Chinese Hans support the idea that Northern and Southern Chinese have different genetic background. Aborigines appeared to be quite distinct in the distribution of a majority of the class I and class II antigens. High frequency of HLA-A24 (60.4%) and relatively restricted HLA polymorphisms are noted in Aborigines. The HLA haplotypes with high frequency in Aborigines included A24-B60-DRB1*04, A24-B60-DRB1*14, A24-B48-DRB1*04, and A24-B48-DRB1*14, which are different from the other ethnic groups. Although the phylogenic tree separates Aborigines and Han Chinese populations, 4 out of 20 most common HLA-A, -B, and -DR haplotypes presented in both Aborigines and Han Chinese may reflect an ancient common origin or intermixture between early settlers of Han Chinese and Taiwan Aborigines. The results in this study are essentially a summary of the observed gene/haplotype frequencies and differences among various ethnic groups in Taiwan.

Asian People↗
PubMed1999

Marrow donor registry and bone marrow transplantation from unrelated donors in Taiwan: initial experience of the Tzu Chi Taiwan Marrow Donor Registry (TCTMDR).

To evaluate the outcomes of unrelated bone marrow transplantation facilitated by TCTMDR, we focused on 48 marrow transplants performed in Taiwan during the period May 1994 to June 1997. Follow-up of these 48 cases was made up to 30 May 1998. The average length of follow-up was 328 days (range 7-1385 days). All the donor/recipient pairs were HLA-A, B and DR matched and were divided into two risk groups based on diagnosis and stage of disease. There were 24 standard risk and 24 high risk patients. Engraftment occurred in 40 patients (83.3%). Acute and chronic GVHD was observed in 80% of evaluable patients and accounts for 41% of deaths. The second leading cause of death was infection, accounting for 35% of deaths. The overall probability of survival for the 48 patients after BMT over 2 years was 33.3% (95% CI 19.67-46.32%). The probability of survival for standard risk and high risk groups was 54% and 8%, respectively. In multivariate analysis, patients who were younger, in the standard risk group, or with a shorter search interval showed a higher survival probability.

Acute Disease↗
PubMed1999

Genetic association study of a polymorphic CAG repeats array of calcium-activated potassium channel (KCNN3) gene and schizophrenia among the Chinese population from Taiwan.

Chandy et al suggested that a novel human neuronal small conductance, calcium-activated potassium channel gene, KCNN3, might be a candidate for schizophrenia. The KCNN3 cDNA sequences contain two stretches of CAG trinucleotide repeats encoding two separate polyglutamine segments near the N-terminus of this channel protein. The second CAG repeat was found to be highly polymorphic in the Caucasian population from both Europe and USA. Upon comparing the allelic frequency distribution between schizophrenic patients and ethnically matched controls, a significant excess of longer CAG repeats in schizophrenic patients was observed. A similar result was obtained in a recent replication study by Bowen et al, performed in Caucasians from UK or Eire. These results suggest an association between the longer CAG repeat allele of the KCNN3 gene and schizophrenia susceptibility. To verify if similar results can be observed in the Chinese population, we carried out a case-control study to compare the allelic frequency distribution of the CAG repeat of the KCNN3 gene between 92 Chinese schizophrenic patients and 100 normal controls from Taiwan. No significant difference of the allelic frequency distribution of the second CAG repeats was detected between the two groups (Wilcoxon Rank Sum test, P = 0.664). In addition, no over-representation of CAG repeats longer than the mode (19 repeats) was found in the patients' group (Fisher's exact test, P = 0.739). Thus, our data do not support that the second polymorphic CAG repeat of the KCNN3 gene may have an association with schizophrenia in our population.

Alleles↗
PubMed1999

High seroprevalence of Borna virus infection in schizophrenic patients, family members and mental health workers in Taiwan.

Borna disease virus (BDV), a negative-strand RNA virus, has been reported to be associated with severe psychiatric disorders. The association is mainly based on the findings that patients with schizophrenia and depression have a higher seroprevalence rate of BDV-specific antibodies than controls. In addition, psychiatric patients were also found to have a higher detection rate of BDV transcripts in their blood than controls. By using an improved Western blot analysis, we first demonstrated that Chinese schizophrenic patients from Taiwan also have a higher seroprevalence of BDV-specific antibodies than controls (12.1% vs 2.9%, P< 0.001), providing support to the positive association between BDV and psychiatric disorders in our population. Because of the contagious nature of viral infection, we further examined patients' family members and mental health workers, who have close contact with patients. We found that both groups also have a higher seroprevalence of BDV-specific antibodies, 12.1% and 9.8%, respectively, than controls. This finding provides some evidence for a possible human-to-human transmission of Borna disease virus. Our finding needs further independent verification from other research groups and the clinical relevance of this preliminary observation deserves further study.

Adult↗
PubMed1999

Detection of Borna disease virus RNA from peripheral blood cells in schizophrenic patients and mental health workers.

Accumulating evidence suggests that Borna disease virus (BDV), a neurotropic, negative-stranded RNA virus, might be associated with certain human mental disorders. Several research groups reported that psychiatric patients had a significantly higher prevalence of BDV serum antibodies than normal controls. In addition, a significantly higher presence of BDV RNA from peripheral blood cells was identified in mental patients than in controls. In our previous study, we first identified the presence of BDV serum antibodies in a cohort of Chinese schizophrenic patients from Taiwan, and we also demonstrated a significantly higher seroprevalence of BDV antibodies among schizophrenic patients than in non-psychiatric controls. Prompted by the positive seroepidemiological result, we set out to investigate the detection of BDV RNA from the peripheral blood cells of our schizophrenic patients. By using the reverse transcription-polymerase chain reaction (RT-PCR) method, 10 out of 74 Chinese schizophrenic patients from Taiwan were found to have BDV RNA in their blood cells, whereas only one out of 69 controls was positive. The BDV RNA detection rate among schizophrenic patients was significantly higher than that in controls (14% vs 1.4%, P < 0.01). Furthermore, we studied the BDV RNA detection rate among mental health workers, and seven out of 45 mental health workers were found to have positive results. The prevalence rate was significantly higher than that in normal controls (15% vs 1.4%, P < 0.001), which lends further support to our previous finding that mental health workers have a significantly higher presence of BDV serum antibodies. In summary, our data support the finding that BDV infection might be a contributory factor to the pathogenesis of schizophrenia in the Chinese population.

Adult↗
PubMed1999

Heterogeneity of HLA-DR2 haplotypes in Caucasoid Americans, African Americans, Chinese Americans, Native Americans and Xiamen Chinese.

HLA-DR, -DQ specificities were determined by PCR amplification with SSOP in 4560 individuals: Caucasoid Americans (CA), African Americans (AA), Chinese Americans (ChA), Native Americans (NA) and Xiamen Chinese (XC). DR2 subtypes were compared amongst the five ethnic populations. The DRB1*1501-DRB5*0101 haplotype was found to be the most frequent in all populations except African Americans, in which DRB1*1503-DRB5*0101 was the predominant haplotype, accounting for 65% of DR2 subtypes. In contrast to Caucasoid Americans, the DRB1*1602 is strongly associated with the DRB5*0101 allele in Chinese populations. The presence of DRB5*0203 and DRB1*1602-DRB5*0101 haplotypes in Chinese populations, especially in Xiamen Chinese, suggests that various DR2 haplotypes may be generated via multiple gene conversion events together with point mutations and reciprocal recombination. The strong DR and DQ associations are found in DRB1*1501/DQB1*0602 (66.22%) for CA, DRB1*1503/DQB1*0602 (56.58%) for AA, DRB1*1501/DQB1*0602 (30.20%) and DRB1*1602/DQB1*0502 (15.76%) for ChA, DRB1* 1501/DQB1*0602 (41.55%) and DRB1*1602/DQB1*0301 (40.25%) for NA, and DRB1*1501/DQB1*0602 (30.26%) and DRB1*1602/DQB1*0502 (25.81%) for XC.

Alleles↗
PubMed1999

Systematic mutation analysis of the catechol O-methyltransferase gene as a candidate gene for schizophrenia.

OBJECTIVE: Catechol O-methyltransferase (COMT) is involved in the degradation of catecholamine neurotransmitters. Recent linkage studies of schizophrenia and molecular studies of velocardiofacial syndrome suggest that the COMT gene might be a candidate gene for schizophrenia. METHOD: The authors systematically searched for mutations and microdeletion of the COMT gene in 177 Chinese schizophrenic patients from Taiwan; 99 comparison subjects were also studied. RESULTS: Five molecular variants were identified: c.186C > T at exon 3, c.408C > G at exon 4, c.472G > A at exon 4, c.597G > A at exon 5, and c.821-827insC at the 3' untranslated region. However, no differences in the genotype and haplotype frequencies of these molecular variants between the schizophrenic and comparison subjects were detected. Furthermore, no microdeletion was identified among the patients. CONCLUSIONS: These data suggest that the COMT gene does not play a major role in the pathogenesis of schizophrenia, and the genotypic overlap between schizophrenia and velocardiofacial syndrome was rare in this cohort.

Catechol O-Methyltransferase↗
PubMed1999

Gender differences in the presentation of adult obstructive hypertrophic cardiomyopathy with resting gradient: a study of 122 patients.

The present study investigated gender differences among adult patients with obstructive hypertrophic cardiomyopathy (OHCM) and resting gradient. Using outflow gradients >10 mmHg and the presence of asymmetrical septal hypertrophy of the left ventricle as inclusion criteria, 122 patients were identified among patients referred for echocardiographic examinations between May 1990 and October 1996. Clinical, echocardiographical and follow-up data were compared between male and female patients. The female patients were significantly older than male patients (mean age +/-SD 66.7+/-10.5 vs 54.8+/-12.5 years). The female patients had a smaller interventricular septal wall thickness, less frequent systolic anterior movement of the mitral valve, more frequent association with hypertension, and less frequent association with ischemic heart disease (IHD) and giant T wave inversion. In this study population, adult female patients presented with OHCM 12 years later than males. Whether this represents female patients' reluctance to seek medical attention early, a different disease process that affects predominantly elderly females, or a gender-specific end organ response to aging, hypertension, IHD and other processes, or the protective effects of estrogen remains to be determined.

Adolescent↗
PubMed1999

Climate, traffic-related air pollutants, and asthma prevalence in middle-school children in taiwan.

This study compared the prevalence of asthma with climate and air pollutant data to determine the relationship between asthma prevalence and these factors. We conducted a nationwide survey of respiratory illness and symptoms in middle-school students in Taiwan. Lifetime prevalences of physician-diagnosed asthma and of typical symptoms of asthma were compared to air monitoring station data for temperature, relative humidity, sulfur dioxide, nitrogen oxides, ozone, carbon monoxide, and particulate matter with aerodynamic diameter [less than/equal to] 10 microm (PM(10)). A total of 331,686 nonsmoking children attended schools located within 2 km of 55 stations. Asthma prevalence rates adjusted for age, history of atopic eczema, and parental education were associated with nonsummer (June-August) temperature, winter (January-March) humidity, and traffic-related air pollution, especially carbon monoxide and nitrogen oxides, for both girls and boys. Nonsummer temperature, winter humidity, and traffic-related air pollution, especially carbon monoxide and nitrogen oxides, were positively associated with the prevalence of asthma in middle-school students in Taiwan.

Adolescent↗
PubMed1999

Obstructive hypertrophic cardiomyopathy in Taiwanese adults.

The purpose of this study was to analyze the clinical profiles, echocardiographic findings, and mortality among adult Taiwanese patients with obstructive hypertrophic cardiomyopathy (HCM) at Chang Gung Memorial Hospital, a university-affiliated tertiary referral center in suburban Taipei. We reviewed the medical records of all adult (> 15 years of age) patients referred to our laboratory for echocardiographic examinations of cardiac diseases from May 1990 through December 1996. The diagnosis of obstructive HCM required an outflow gradient of above 10 mm Hg and the presence of asymmetric septal hypertrophy of the left ventricle. Follow-up information on was obtained from hospital records, questionnaires, interviews, or the National Death Certificate Registry. Of the 6.798 adults who underwent echocardiographic examinations during the study period 122 (1.79%) had obstructive HCM. The mean +/- standard deviation age of the patients was 62.2 +/- 12.6 years, and females predominated (n = 76, 62.3%). During the mean follow-up period of 3.2 years, the annual all-cause mortality rate was 4.7%. Most deaths were due to concurrent medical conditions. The annual cardiac mortality rate was 0.99%. Logistic regression analysis identified medication with calcium channel blockers as the only negative predictor (relative risk = 0.26, 95% confidence interval = 0.07-0.96) of all-cause mortality, and left atrial size as the only positive predictor (relative risk = 1.18, 95% confidence interval = 1.02-1.37) of cardiac mortality. Cox regression analysis confirmed the former association, but not the latter. Thus, in our institution, obstructive HCM had a low prevalence among adult patients referred for echocardiographic examination. These patients were elderly and often had other associated medical conditions. The high all-cause mortality rate was largely due to non-cardiac causes. These findings suggest that obstructive HCM tends to have a benign clinical course. Large atrial size could be an independent predictor of cardiac mortality, but this possibility requires further confirmation.

Aged↗
PubMed1998

Evaluation of the early stage of carotid atherosclerosis using the vascular response to nitroglycerin and high-resolution ultrasonography.

The purpose of this study was to determine whether the early stages of arterial atherosclerosis could be evaluated by the vascular response to nitroglycerin (NTG). The vascular elasticity of the common carotid artery (CCA) was evaluated at sites without atheromatous plaque using high-resolution ultrasonography before and after sublingular NTG administration. The vascular elasticity was expressed by vascular strain (VS) and pressure-strain elastic modulus (Ep). The study was performed in 9 normal young males (group N) and 52 patients who were suspected to have coronary artery disease (CAD). In group N, VS of the CCA increased from 9+/-2 to 13+/-4%, Ep decreased from 80+/-18 to 42+/-14 kPa (p<0.01) and systolic blood pressure (SBP) decreased from 116+/-8 to 109+/-8 mmHg (p<0.05) after NTG administration. Two different responses were observed in the patients. One group of patients (group A, n=27) showed similar responses to NTG as those of group N; that is, VS increased from 8+/-4 to 14+/-8%, Ep decreased from 115+/-64 to 57+/-31 kPa (p<0.01) and SBP decreased from 121+/-15 to 110+/-16 mmHg (p<0.05). In the other group (group B, n=25), in spite of SBP decreasing from 124+/-21 to 111+/-21 mmHg (p<0.05), VS decreased from 11+/-4 to 7+/-3% and Ep increased from 76+/-29 to 113+/-53 kPa (p<0.01). The prevalence and severity of CAD were lower in group A than in group B (33 vs 80%, 11 vs 60%, p<0.01, respectively). The prevalence of atheromatous plaque of the CCA was also lower in group A than in group B (4 vs 22%, p<0.01). These results revealed that the prevalence of carotid atheromatous plaque was highly correlated with that of CAD (p=0.001) and suggested that the vascular elasticity response of the CCA to NTG is highly associated with atherosclerotic changes of the artery and may be a useful method for detecting the early stages of atherosclerosis.

Administration, Sublingual↗
PubMed1997

Prevalence of diabetes mellitus and impaired glucose tolerance in Aborigines and Chinese in eastern Taiwan.

The aim of this study was to determine the prevalence of diabetes mellitus and impaired glucose tolerance (IGT) in three different ethnic groups in eastern Taiwan. The study was performed among Han Chinese, aboriginal Ami and aboriginal Atayal in six rural villages. Inhabitants aged 40 years and over were invited to participate. A 75-g oral glucose tolerance test (OGTT) was used as suggested by the World Health Organization (WHO) for population screening purposes. WHO criteria were used for determining the results. A total of 1013 adults (460 men and 553 women) were examined with a response rate of 62.1%. There were no significant differences in sex, age and history of diabetes between responders and non-responders. The age-adjusted prevalence of diabetes was 11.0% (9.8% in men and 12.3% in women) in the Chinese, 9.1% (12.1% in men and 7.4% in women) in the Amis, 10.8% (11.5% in men and 9.4% in women) in the Atayal and 9.9% (11.5% in men and 8.5% in women) for the two aboriginal groups together. Although sex differences in prevalence of diabetes were not statistically significant, it seems that diabetes was slightly more prevalent in Chinese women than in Chinese men (12.3 versus 9.8%). Nonetheless, the prevalence rate of diabetes was somewhat higher in the aboriginal males than in the aboriginal females (12.1 versus 9.8% for Ami and 11.5 versus 10.7% for Atayal). The prevalence of IGT was 7.2, 8.5, 10.8 and 9.7% for the Chinese, Amis, Atayal and the two aboriginal groups, respectively. There were no substantial differences in the prevalence of diabetes and IGT among these three ethnic groups. Environment, rather than ethnicity, was more likely the predominant factor. It was found that the prevalence of diabetes in this study was about twice as high as that reported in a 1987 survey in Taiwan. The discrepancy may be due to different screening methods and assessment periods.

Adult↗
PubMed1997

HLA polymorphism and probability of finding HLA-matched unrelated marrow donors for Chinese in Taiwan.

Tzu Chi Taiwan Marrow Donor Registry (TCTMDR) was established in 1993 to recruit and HLA-type volunteers who would be willing to donate bone marrow. TCTMDR is currently the largest marrow registry for Chinese in the world, with over 150,000 prospective donors registered as of July 1997. We present here the gene and haplotype frequencies based on 80,353 HLA class I-typed and 18,217 HLA class II-typed healthy Chinese in Taiwan. The resulting frequencies are used for estimating the probability of finding an HLA-matched donor for a patient. The common HLA class I antigens include A1 (gene frequency: 32.9%), A2 (29.7%), A24 (17.5%) and A33 (11.0%); B60 (18.1%), B46 (12.8%), B58 (9.8%) and B13 (7.8%); Cw3 (51.4%), Cw1 (11.6%) and Cw7 (8.6%). The common HLA class II antigens are DR4 (16.6%), DR9 (15.6%), and DR12 (14.0%); DQ7 (20.7%), DQ9 (12.7%), and DQ5 (12.1%). The common two-locus haplotypes observed with a P-value less than 0.001 are A2-B46 (haplotype frequency: 8.5%), A33-B58 (7.5%), A11-B60 (6.6%); B58-DR17 (7.0%), B46-DR9 (6.4%) and B60-DR4 (4.9%). The common three-locus haplotypes are A33-B58-DR17 (5.3%), A2-B46-DR9 (3.9%) and A11-B60-DR4 (2.0%). As expected, the gene frequency pattern of Taiwanese is more closely related to that of southern Hans than to the pattern of northern Hans, Japanese, Caucasians and African-Americans. Using our registry, 323 of 571 domestic patients (57%) successfully identified one or more matched donors. The empirical result correlated well with a mathematical simulation having an estimated 59% match when donor pool reaches 150,000.

Asian People↗
PubMed1997

Characteristics of malignant lymphoma in eastern Taiwan: comparison between aborigines and nonaborigines.

To study the characteristics of malignant lymphoma in aboriginal and nonaboriginal patients in eastern Taiwan, the records of 90 patients treated from July 1986 to September 1994 were reviewed. Immunohistologic staining with UCHL-1 and L-26 was used to determine immunophenotype. There were 20 aboriginal and 70 nonaboriginal patients (22% vs 78%). Among them, three had Hodgkin's diseases (HD) and 87 had non-Hodgkin's lymphomas (NHL). Comparing the histology of malignant lymphoma in aboriginal and nonaboriginal patients, there was no case of HD or follicular lymphoma in aborigines. Concerning primary extranodal lymphoma, no aboriginal patients were found to have gastric lymphoma, while eight nonaboriginal patients did. Among patients with intermediate and high-grade NHL, aboriginal patients had a higher rate of B symptoms (weight loss, fever, night sweats) than did nonaboriginal patients. In T cell lymphoma, three out of four (75%) aboriginal patients had angioimmunoblastic lymphadenopathy with dysproteinemia as compared with three out of 20 (15%) nonaboriginal patients. There were no significant differences in demographic data, stage or distribution of immunophenotype between the two groups. Several combination chemotherapy regimens were used and only 31 patients were considered evaluable, of which 12 were aboriginal and 19 were nonaboriginal patients. No distinct difference was found between aboriginal and nonaboriginal patients in overall response rate, complete response rate, disease-free survival or overall survival. Comparison of our results with other lymphoma studies in Taiwan revealed that the frequencies of HD and follicular lymphoma were higher in northern Taiwan studies than in southern and eastern Taiwan studies, and the frequency of primary extranodal lymphoma was much higher in eastern Taiwan than in other areas. While the rate of T cell lymphoma in NHL for nonaboriginal patients was similar to that of northern Taiwan studies, it was closer to that of southern Taiwan studies in aboriginal patients.

Adolescent↗
PubMed1995

[Health behavior in Hualien city high school students].

Chronic diseases and motor vehicle-related injuries are currently the major causes of death in Taiwan. Smoking, alcohol use and inappropriate driving behavior are important risk factors. Most health behavior develop during adolescence. Smoking and alcohol use always serve as "gateways" for other adverse health behavior. In this study, 1195 high school students from 27 classes were selected by a random systematic cluster sampling method, and a structured self-administered questionnaire was used to investigate their prevalent health behavior. The prevalence of current smoking was 9.9%, alcohol 18.7% and betel-nut chewing 5.4% among the academic high school students, whereas the prevalence among vocational school students was smoking 20.5%, alcohol 26.6% and betel-nut chewing 13.9%. Seventeen percent of vocational students reported that they often rode motorcycles after alcohol consumption. An aggregation of adverse health behavior, such as smoking, alcohol consumption and chewing betel-nuts was commonly observed. Designing comprehensive intervention programs to prevent and modify high school students adverse health behavior is an important task for school health-officials.

Adolescent↗