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Biomedical subjects

C K Shaw

Publications and source records attributed to C K Shaw.

33 records · Page 2Linked to original sources

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↗

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↗

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↗

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↗

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↗

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↗

[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↗

An epidemiologic study of osteoporosis in Taiwan.

In 1989, a cross-sectional study was carried out in Taiwan to understand the distribution of bone mineral density (BMD) in the lumbar spine of Chinese people and to identify the risk factors associated with osteoporosis. BMD of the lumbar spine was measured by dual-photon absorptiometry in 404 healthy volunteers (266 women and 138 men, aged 15 to 83 years) living in Lin-Kou Township. The age-specific mean values of lumbar spine BMD were higher for men than for women after age 60. Furthermore, the BMD of women declined significantly after age 40. However, the BMD of men did not show a downward trend with age. In a multiple logistic regression analysis of fracture risk expressed as a categorical level of BMD, age, diabetes, and years since menopause were associated with lower BMD, while body mass index was associated with higher BMD. In a multiple linear regression analysis of BMD, significant variables were years since menopause, age, body mass index, and seaweed diet. Variables that were significant in bivariate analysis, but not multiple variable analysis were education, milk consumption, breast-feeding, frequency of pregnancy, and age at first menstruation. However, cigarette habits, alcohol consumption, and physical activity were not associated with the BMD level in any of these analyses.

Absorptiometry, Photon↗

Community-based study on the relationship between serum cholesterol/triglyceride and dietary habits/life styles in Pu-Li, Taiwan.

This is a community-based study on the relationship between serum cholesterol (CHO)/triglyceride (TG) and dietary habits/life styles of persons living in a central Taiwan Town. Door-to-door interviews were carried out by the Yang-Ming Crusade, and fasting blood for CHO and TG tests was drawn by public health nurses from Pu-Li Health Station. Univariate analysis found that significant variables correlated with CHO were age (+), locality, non-fish seafood (+) and pungent food (+). Significant variables correlated with TG were age (+), sex, locality, smoking (+), alcohol (+) and physical activity (-). Stratified by age (> or = 50 and < 50) and by sex respectively, only one significant interaction item--age x organ meat consumption--was found; those who consumed organ meat more frequently had higher TG, if they were less than 50 years of age. This was not true for those aged 50 and over. Multivariate analysis using logistic regression revealed that after controlling for all of the other covariates, significant variables correlated with CHO were age (OR = 1.92, 95% C.I. = 1.37-2.69), pungent food (OR = 1.91, 95% C.I. = 1.26-2.89); locality (OR = 0.53, 95% C.I. = 0.35-0.80 for sub urban area; and OR = 0.74, 95% C.I. = 0.50-1.08 for rural area); sea food consumption (OR = 1.50, 95% C.I. = 0.94-2.40); and smoking (OR = 0.69, 95% C.I. = 0.48-0.99).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Verbal versus tangible reward for children who stutter.

The results of several previous attempts to modify the speech of stuttering children suggest that tangible (as opposed to verbal) rewards are efficient forms of positive reinforcement. The purpose of this study was to investigate the relative effectiveness of these two forms of positive reinforcement with young stuttering subjects. Each of three stuttering children was seen for a base rate session, three experimental sessions, and a carry-over session. Experimental sessions were preceded by verbal instructions explaining the response contingency, and subjects selected their own verbal and tangible reinforcers. Results revealed that both verbal and tangible reinforcements were equally effective in modifying the speech of the three subjects. The possibility is discussed that the effectiveness of verbal and tangible rewards with young stuttering subjects can be explained by (1) selection of the rewards by the subjects; (2) reinforcement of easily identifiable behavior; and (3) subject awareness of the response contingency.

Behavior Therapy↗

Analysis of half-list scores on the PB-K 50 as a function of time compression and age.

Half-list speech discrimination measures have certain advantages in clinical measurement, particularly with children. In the present study, half-list and whole-list comparisons of the PB-K 50 measure under normal and time-compressed conditions were made on children's speech discrimination scores. Results indicated that half-lists of the PB-K 50 can be used effectively in the clinical setting, a practice which has clinical precedence.

Age Factors↗