A charter to achieve health for all.
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Congresses as Topic↗
Biomedical subjects
K C Tang
Publications and source records attributed to K C Tang.
Motorcycle ownership and injury in China.
BACKGROUND: China has made tremendous progress in its economic development in the past two decades. Accompanying this economic development has been an evident shift in the modes of transport, from walking and cycling to the use of motorcycles and, increasingly, four-wheel vehicles. Such changes are likely to have also produced changes in the patterns and numbers of road traffic injuries, including increases in motorcycle injuries. However, such changes have not been well documented. The work described in this paper sought, therefore, to document the changes in motorcycle ownership, motorcyclist mortality and injury rates in China since 1987. METHODS: National traffic ownership and injury data from 1987 to 2001 were obtained from the National Bureau for Traffic Administration. Additionally, traffic ownership and injury records from 1997 to 2001 were collected from local police offices from 20 counties in Guangxi Region. Population data were obtained from the national and county statistics bureaus. Motorcycle ownership, fatality and injury trends over time were calculated. RESULTS: Nationally, motorcycles accounted for 23.4% of all registered motor vehicles in 1987, increasing to 63.2% in 2001. Motorcyclist fatalities and injuries increased 5.5-fold and 9.3-fold, respectively, between 1987 and 2001. In 1987, 7.5% of all traffic fatalities and 8.8% of all traffic injuries were sustained by motorcyclists, with the corresponding proportions increasing to 18.9% and 22.8%, respectively, in 2001. The changing proportions of both traffic fatalities and injuries sustained by motorcyclists were positively correlated with the change in the proportion of motorcycles among all motor vehicles. In the 20 counties in Guangxi, motorcyclist fatality and injury rates also increased between 1997 and 2001. Moreover, these rates were considerably higher than the national rates. CONCLUSIONS: Motorcyclist injury in China is a serious public health problem. Motorcyclist fatalities and injuries are likely to continue to increase unless appropriate intervention programmes are implemented.
Accidents, Traffic↗
A visual field abnormality: ocular or cerebral cause?
The visual field can be affected by disorders involving any part of the visual pathway, from the retina to the striate cortex. The pattern of visual field damage can indicate the location of the disorder. The case is presented here of an 8-year-old girl with congenital glaucoma. Initial perimetry appeared consistent with glaucomatous field loss; however, this evolved into a homonymous quadrantanopia, indicating the presence of a cerebral lesion as the cause. Computed tomography and magnetic resonance imaging scans detected a large middle cranial fossa arachnoid cyst. Postoperatively there was resolution of the visual field defects secondary to the arachnoid cyst. The pattern of field loss was pivotal in this patient's management. Attention must be paid when caring for the patient with a chronic disease to ensure that concurrent conditions are diagnosed.
Arachnoid Cysts↗
Involving the general public in priority setting: experiences from Australia.
The discussion over whether community preferences have a legitimate role to play in priority setting has been highly polarised. Skeptics warn of the risk of establishing a 'dictatorship of the uninformed', while advocates proclaim the legitimacy of the participatory process. The one group who appears not to be consulted in this debate is the citizens themselves. In this study, a convenience sample of 373 citizens attending two medical clinics in central Sydney were surveyed about whether the general public has a legitimate role to play in informing priority setting in health care. Respondents were presented with three different levels of priority setting: across health care programmes, across medical procedures, and at a global level. To assist respondents in understanding the choices and trade-offs involved, they were given information about current levels of funding and the cost-effectiveness of each alternative. Respondents were asked whether they felt the preferences of the general public should be used to inform priority setting at each level. Of particular interest was the question of whether their willingness to use public preferences depended on the level of priority setting. Respondents were also asked about who else's preferences should be used to inform priority setting at each level. The results suggest that the public overwhelmingly want their preferences to inform priority-setting decisions in health care. This was seen to be particularly important in informing decisions about how to prioritise across broad health care programmes and about the criteria to be used to allocate funds across different population groups. In contrast, the preferences of medical professionals and health service managers were rated most highly in relation to the prioritisation of different treatments and medical procedures. In most cases, however, respondents did not advocate the use of one particular group's preferences. Even when the preferences of the general public were considered most important, it was felt that any decision-making process needed to be informed by the preferences of a range of groups. The preferences of politicians were viewed as least important to processes of priority setting in health care.
Adolescent↗
Evidence based health promotion: recollections, reflections, and reconsiderations.
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Evidence-Based Medicine↗
Substance use in high school students in New South Wales, Australia, in relation to language spoken at home.
PURPOSE: To examine for the first time adolescent substance use by ethnicity, given the high proportion of migrants from non-English-speaking countries in New South Wales, (NSW), Australia. METHODS: Data from four surveys of NSW secondary school students in 1983, 1986, 1989, and 1992 were used for this analysis. The prevalence of substance use by whether English was spoken at home was stratified by sex and age using data from the most recent survey year. Adjusted odds ratios and 95% confidence intervals were produced by simultaneous logistic regression, adjusting for sex, age group, and the interaction term of sex and age for each of these substances, and for each survey year separately. Data from 1989 and 1992 were pooled together to examine rates of substance use by ethnic subgroups which reflect migration patterns. RESULTS: The prevalence of smoking and alcohol and illicit drug use was consistently lower among NSW adolescents speaking a language other than English at home, compared with those speaking English at home in all survey years. Only the prevalence of solvent sniffing was higher among younger adolescents speaking a language other than English at home. Students from Southeast Asia showed consistently lower rates of usage of all substances compared to all other groups. CONCLUSIONS: There may be different opportunities for the prevention of adolescent substance use among native English speakers to be gained from non-English-speaking cultures.
Adolescent↗
What constitutes treatment effectiveness? -- the differential judgements of Chinese Aaustralian patients and doctors.
Analysis of interviews and focus groups with users of traditional Chinese medicine (TCM) and ethnic Chinese general practitioners (GPs) in Sydney, Australia, demonstrated the concept of treatment effectiveness held by users had four aspects: diagnosis, intervention, outcome and prevention of recurrence. Respondents assessed orthodox medicine and TCM utilizing all four aspects. Orthodox medicine was considered effective for diagnosis and valued for the speed of its intervention. However, respondents regretted its failure to use food in treatment. Orthodox medicine was considered best for symptom relief but TCM was considered to be better at dealing with root causes of illness and was consequently better at preventing illness recurring. Respondents saw prevention as illness specific contrasting with the lifestyle prevention espoused by orthodox medicine. Respondents criticized TCM in Australia because of the perceived low expertise of practitioners and poor herb quality. GPs valued accurate diagnosis and symptom relief but were less concerned about root causes of illness and did not see food as a treatment intervention.
Adult↗
Role of pertussis toxin-sensitive G-proteins in synaptic transmission and plasticity at corticostriatal synapses.
The role of pertussis toxin (PTX)-sensitive G-proteins in corticostriatal synaptic transmission and long-term synaptic depression (LTD) was examined using extracellular field potential and whole cell voltage-clamp recordings in striatal slices. High-frequency stimulation (HFS) produced LTD, defined as long-lasting decreases both in synaptically driven population spikes (PSs) measured with field potential recording and in excitatory postsynaptic currents (EPSCs) measured with whole cell recording. Striatal LTD could not be induced in slices obtained from rats that had received a unilateral intrastriatal injection of PTX. However, LTD could be induced in slices obtained from paired control slices. Furthermore, striatal LTD was prevented by pretreatment with N-ethylmaleimide (NEM), another compound that disrupts the function of PTX-sensitive G-proteins. NEM, itself, also potentiated PS and EPSC amplitudes. In addition, NEM increased the frequency and amplitude of both spontaneous and miniature EPSCs and decreased the paired-pulse facilitation ratio, suggesting that it may act on both pre- and postsynaptic sites. The findings suggest that PTX-sensitive G-proteins have multiple roles at corticostriatal synapses, including regulation of synaptic transmission at both pre- and postsynaptic sites, and a key role in striatal LTD.
Animals↗
Regional and postnatal heterogeneity of activity-dependent long-term changes in synaptic efficacy in the dorsal striatum.
High-frequency activation of excitatory striatal synapses produces lasting changes in synaptic efficacy that may contribute to motor and cognitive functions. While some of the mechanisms responsible for the induction of long-term potentiation (LTP) and long-term depression (LTD) of excitatory synaptic responses at striatal synapses have been characterized, much less is known about the factors that govern the direction of synaptic plasticity in this brain region. Here we report heterogeneous activity-dependent changes in the direction of synaptic strength in subregions of the developing rat striatum. Neurons in the dorsolateral region of the anterior striatum tended to express LTD after high-frequency afferent stimulation (HFS) in slices from animals aged P15-P34. However, HFS in dorsolateral striatum from P12-P14 elicited an N-methyl-D-aspartate (NMDA) receptor-dependent form of LTP. Synapses in the dorsomedial anterior striatum exhibited a propensity to express an NMDA-receptor dependent form of LTP across the entire developmental time period examined. The NMDA receptor antagonist (+/-)-2-amino-5-phosphopentanoic acid (APV) inhibited evoked excitatory postsynaptic potentials recorded in striatum obtained from P12-P15 rats but had little effect in striatum from older animals. The expression of multiple forms of synaptic plasticity in the striatum suggests mechanisms by which this brain region plays pivotal roles in the acquisition or encoding of some forms of motor sequencing and stereotypical behaviors.
2-Amino-5-phosphonovalerate↗
Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration.
OBJECTIVE: To determine the nature and frequency of polypoidal choroidal vasculopathy (PCV) in a series of patients suspected of having neovascularized age-related macular degeneration (AMD). METHODS: A prospective analysis of 167 consecutive, newly diagnosed patients aged 55 years or older with presumed neovascularized AMD was performed. All patients were examined with fundus biomicroscopy as well as fluorescein and indocyanine green angiography. RESULTS: Choroidal neovascularization secondary to AMD was diagnosed in 154 (92.2%) of 167 patients; 13 (7.8%) patients had PCV. The patients affected by PCV were younger than those with AMD (P = .01). Peripapillary choroidal neovascularization was seen in 3 (1.9%) of 154 patients with AMD and 3 (23.1%) of 13 patients with PCV (P = .006). Significant drusen were present in 63 (70%) of 90 fellow eyes with unilateral AMD compared with only 1 (16.7%) of 6 eyes with PCV (P = .02). Only 5 patients with AMD (3.2%) were nonwhite compared with 3 patients with PCV (23.1%) (P = .02). CONCLUSIONS: A measurable number of elderly patients with findings suggestive of neovascularized AMD and serosanguineous macular manifestations will instead have PCV. Polypoidal choroidal vasculopathy can occur in any sex or race, but is more commonly seen in the peripapillary area, without associated drusen, and in nonwhite patients. It is important to differentiate AMD from PCV because there are significant differences in the demographic risk profile, natural course, visual prognosis, and management of these patients.
Aged↗
Nursing as a career choice: perceptions of school students speaking Arabic, Serbo-Croatian, Spanish, Turkish or Vietnamese at home.
Australia is a multicultural society and nowhere is this more evident than in Sydney where 25% of the population speaks a language other than English. In one of the largest area health services in New South Wales, the five most frequently spoken languages at home are Arabic, Serbo-Croatian, Spanish, Turkish or Vietnamese, with these language groups comprising 12% of Sydney's population. Yet nurses speaking one of these five languages comprise less than 1% of the nursing workforce. A cost-effective method of addressing the shortage of nurses speaking languages other than English is to recruit students who already speak another language into the profession. This study examined high school students' perceptions of nursing in order to determine appropriate methods of recruiting students speaking one of these languages. Implications for the design of recruitment campaigns are also discussed.
Attitude to Health↗
A longitudinal study of smoking in year 7 and 8 students speaking English or a language other than English at home in Sydney, Australia.
OBJECTIVE: To compare the rates and predictors of smoking uptake between adolescents speaking English and those speaking a language other than English (LOTE) at home. DESIGN: A cross-sectional survey of year 7 and 8 students (aged 12 and 13 years) was conducted in 1994 and repeated 12 months later. A cohort of students was identified with respondents at baseline matched at follow up. chi 2 and logistic regression were used for analysis. SETTING: 38 schools in southern, east, and northern Sydney, Australia. SUBJECTS: Year 7 and 8 students in the schools were included and examined on two occasions, with complete data for 5947 (80%) students at baseline and 6177 (98%) students at a 12-month follow up. Records were able to be matched perfectly for 3513 respondents (59%). MAIN OUTCOME MEASURES: Smoking rates and predictors of smoking uptake among students speaking English or a LOTE at home. RESULTS: At baseline, 6.1% of students surveyed were smokers. Twelve months later, 15.8% of student surveyed were smokers. There were significantly lower smoking rates among students speaking a LOTE at home compared with those speaking English at home at baseline and at 12 months. Using matched data, for students speaking English at home, five variables were significant predictors of smoking uptake: thinking it acceptable to smoke, perceived benefits of smoking, and having a brother, sister, or close friend who smokes. For students speaking a LOTE, the only predictor was the smoking status of close friends. CONCLUSIONS: Despite the higher smoking prevalence among men with a non-English-speaking background, and the reported strong association between fathers' smoking status and smoking onset of their children, adolescents speaking a LOTE at home were significantly less likely to be smokers than their English-speaking counterparts. Thus, there would seem to be a delay of smoking onset among students speaking a LOTE at home. The smoking rates among respondents speaking a LOTE at home in this study are lower than those obtained from the studies conducted in Europe and the United States. Effective smoking prevention interventions need to be implemented at an early stage of adolescence.
Adolescent↗
Elective neck dissection versus observation in the treatment of early oral tongue carcinoma.
BACKGROUND: The aim of the present review is to evaluate the results of elective neck dissection and "watchful waiting" in the surgical treatment of stages I and II squamous cell carcinoma of oral tongue. METHODS: This is a retrospective study of patients with surgical treatment between January 1980 and December 1994. RESULTS: There were 63 patients including those with 34 T1 and 29 T2 carcinoma. The first sites of tumor recurrence were 5 (8%) local, 17 (27%) regional, 2 (3%) distant, 1 (2%) locoregional, and 1 (2%) both regional and distant. Of the 30 NO neck patients who had no elective neck dissection, the regional recurrence rate was 47%, and eventually 23% died of tumor related to regional recurrence. Elective neck dissection significantly reduced the regional recurrence rate to 9% and also significantly reduced the regional recurrence related mortality to 3%. Elective neck dissection also increased the 5-year disease-free actuarial survival rate to 86% compared with 55% for "watchful waiting." CONCLUSIONS: Regional recurrence was the most common cause of failure after surgical treatment of oral tongue carcinoma. Elective neck dissection significantly reduced mortality due to regional recurrence and also increased the overall survival. There was no significant difference between elective radical neck dissection and selective I, II, and III neck dissection in the improvement of treatment results. This retrospective study suggests that elective selective I, II, III neck dissection is a treatment strategy of choice for stages I and II carcinoma of the oral tongue. A prospective randomized study is worthwhile to further evaluate the benefit of elective neck dissection in the treatment of early carcinoma of the tongue.
Adult↗
The liver biochemical tests and serological markers of hepatitis B virus in the very old-aged population in Taiwan.
BACKGROUND: Human liver alters with aging. Lower serum albumin with elevation in serum cholesterol and alkaline phosphatase (ALP) has been reported in the elders, but there was no further report on the very old people (i.e., >75 Y/O). We evaluated changes of liver biochemical tests and hepatitis B virus (HBV) serological markers in the very old-aged population. METHODS: From October 1993 to June 1994, 2,549 subjects attended our hospital for physical check-up. Of them 1,742 were healthy subjects (M/F = 1,058/648) and were enrolled for analysis of the normal range of liver biochemical tests in different age groups. They were divided into four groups; young-aged group (age between 18 and 40, n = 231), middle-aged group (age between 41 and 64, n = 991), old-aged group (age between 65 and 75, n = 424), and very old-aged group (age > or = 76, n = 96). The items of liver biochemical tests included albumin, total bilirubin, cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), ALP and gamma-glutamyl transpeptidase (GGT). The whole population, totally 2,549 subjects, were used for the analysis of the prevalence of HBV serological markers in different age groups. RESULTS: Serum albumin was the only biochemical parameter that persisted to decline after the age of 75 (p <0.05). Cholesterol began to elevate in the middle-age but decreased after 75 Y/O. The old-aged and very old-aged subjects had higher levels of serum bilirubin, AST, ALP, and GGT levels than the other two groups (p <0.05), however, the changes of ALT levels among these groups were not so remarkable. The HBV carrier rates in the young-aged, middle-aged, old-aged and the very old-aged groups were 16.8%, 12.3%, 6.8% and 7.0%, respectively (p <0.001). Furthermore, the very old-aged group had a significantly higher prevalence of negativity in both HBsAg and anti-HBs (p <0.001). CONCLUSIONS: Serum albumin is the only biochemical parameter that persists to decline after the age of 75. In contrast, elevation of cholesterol tends to reverse after that age. All the aging-related changes in biochemical tests are clinically nonsignificant though some of them are significant in statistical analysis. In addition, a low HBV carrier rate and a high prevalence of negativity in both HBsAg and anti-HBs are noted in the very old-aged people, possibly due to the progressive loss of HBV markers in the elders.
Adolescent↗
Translocational rearrangements of 11q23 in acute monoblastic leukemia.
We report the rearrangements of 11q23 in the form of t(6;11)(q27;q23) and t(11;16)(q23;q24) in three cases of acute monoblastic leukemia. The former translocation had only previously been reported in five cases of acute myeloid leukemia, while the latter is hitherto undescribed. In addition to describing a new chromosomal locus 16q24, which may participate in translocational exchanges with 11q23, this report also confirms the close association between 11q23 rearrangement and the involvement of the monocytic lineage in acute myeloid leukemia.
Adult↗
Biclonal acute monoblastic leukemia showing del(7q) and trisomies 9 and 22.
Cytogenetic biclonality is a rare phenomenon in acute myeloid leukemia. We report a case of acute monoblastic leukemia with biclonal cytogenetic abnormalities, showing an abnormal clone with an unusual occurrence of trisomy 9 and trisomy 22, in addition to a second clone with deletion of the long arm of chromosome 7 as the only abnormality. The significance of these findings in leukemogenesis is discussed.
Adult↗
B-cell small lymphocytic lymphoma with circulating granular prolymphocytes and a novel trisomy 15 anomaly.
A 53-year-old man presented with cervical lymphadenopathy and massive splenomegaly. Peripheral blood examination showed many prolymphocytes with cytoplasmic azurophilic granules, giving an initial impression of large granular lymphocytosis. The lymph node biopsy and immunohistochemical study findings, however, were more compatible with a diagnosis of B-cell small lymphocytic lymphoma. The circulating prolymphocytes showed restricted kappa light chain expression similar to the lymphoid infiltrate in the lymph node. Karyotypic analysis revealed trisomy 15, a chromosomal abnormality that has rarely been described in small lymphocytic lymphoma or chronic lymphocytic leukemia.
Bone Marrow↗
Differential effects of angiotensin II on the activities of suprachiasmatic neurons in rat brain slices.
The effects of angiotensin II (AII) on the firing rates of suprachiasmatic neurons were determined in rat brain slices. AII in pmol ranges stimulated 25% and inhibited another 25% of 52 irregular firing neurons, while it stimulated 23% and inhibited 4% of 30 regular firing neurons. Three "oscillating" neurons whose firing rates oscillated with rather constant amplitudes and periods were recorded. AII induced the occurrence of oscillation in one unit and modulated the oscillation amplitude of the other two. Pretreatment with saralasin, an AII antagonist, effectively blocked (100%) the actions of AII (n = 5). The present findings suggest that AII may act as an important mediator in the suprachiasmatic nucleus and its mode of action may be variable in different neurons.
Angiotensin II↗