Strategies for resolving aboriginal adolescent pregnancy in eastern Taiwan

BACKGROUND: Adolescent pregnancy has become a main issue in the health care system for aborigines in eastern Taiwan. Using aboriginal nurses to provide information on sexual behaviour may have potential as a means of promoting healthy sexual practices among aborigines. Aim. To explore aboriginal nurses' perspectives on strategies for resolving the high prevalence rate of Aboriginal adolescent motherhood in eastern Taiwan. DESIGN AND METHODS: A qualitative research design was employed and intensive individual interviews and focus groups were conducted among a convenience sample of aboriginal nursing staff in eastern Taiwan. Content analysis was used to analyse the data. RESULTS: Nine strategies were identified. They can be divided into family, school and society aspects. The family aspect included 'enhancing parents' sex education' and 'enhancing the understanding of older people about sex education in villages'. The school aspect included 'enhancing sex education in school', 'offering interrelationship courses for adolescents', 'offering gender issue courses for adolescents' and 'enhancing school teachers' sex education training'. The social aspect included 'advocating the sense of family in church', 'advocating social norms in church' and 'discussing appropriate sexual behaviour in adolescent church fellowships'. CONCLUSIONS: Health care providers can design intervention programmes to reinforce the ability of family, school and society to deliver sex education. In addition, training and cooperating with Aboriginal nurses to execute these programmes may also decrease teenage pregnancy rates in the future.     

Endoscopic banding ligation can effectively resect hyperplastic polyps of stomach

AIM: Bleeding and perforation are the major and serious complications associated with endoscopic polypectomy. To develop a safe and effective method to resect hyperplastic polyps of the stomach, we employed rubber bands to strangulate hyperplastic polyps and to determine the possibility of inducing avascular necrosis in these lesions. METHODS: Forty-seven patients with 72 hyperplastic polyps were treated with endoscopic banding ligation (EBL). On 14 days after endoscopic ligation, follow-up endoscopies were performed to assess the outcomes of the strangulated polyps. RESULTS: After being strangulated by the rubber bands, all of the polyps immediately became congested (100%), and then developed cyanotic changes (100%) approximately 4 minutes later. On follow-up endoscopy 2 weeks later, all the polyps except one had dropped off. The only one residual polyp shrank with a rubber band in its base, and it also dropped off spontaneously during subsequent follow-up. No complications occurred during or following the ligation procedures. CONCLUSION: Gastric polyps develop avascular necrosis following ligation by rubber bands. Employing suction equipment, EBL can easily capture sessile polyps. It is an easy, safe and effective method to eradicate hyperplastic polyps of the stomach.     

A composite graft material containing bone particles and collagen in osteoinduction in mouse.

Demineralized allogenic bone matrices (DABM) and demineralized freeze-dried bone allograft (DFDBA) have been successfully used as bone-graft materials in the treatment of acquired and congenital cranio-maxillofacial defects and in some orthopedic surgery. However, these bone-graft "powders" have many shortcomings. For example, placement of particulate graft material in a hemorrhaging site can result in inadequacies or inaccurate attachment as well as loss of the graft materials. To minimize the inadequacies of powderlike graft materials, xenogenic collagen isolated from human tendon, skin, or bone was added to the bone-graft particles to form a composite spongelike implant. This material is commercially available and consists of 60% collagen and 40% DFDBA (DynaGraft, GenSci Co., Irvine, CA). The goal of this study was to evaluate the characteristics of composite graft implants in the mineralization process in an animal model in comparison with DFDBA powder and pure collagen. Seventy-two Swiss Webster mice were divided into three groups: an experimental group implanted with DynaGraft, two comparison groups implanted with either DFDBA or collagen only. All the graft materials were surgically implanted and inserted into the left thigh muscle. Mice were humanely killed at 1, 2, 3, 4, 6, 8, and 12 weeks. Then the muscle tissues in the vicinity of the implants were excised and processed for histology. Paraffin sections were stained with hematoxylin and eosin (H&E), the Von Kossa method, and Masson's trichrome. Some selected specimens were processed for transmission electron microscopic observation. After 1 week of implantation, the DynaGraft group showed calcium deposition on the collagen material and on the periphery of the DFDBA particles. Increased calcification and bone-forming cells were observed at 4-6 weeks. After 8 weeks, the implant formed a calcified nodule and only heavily mineralized connective tissue was observed at the implanted site. The group implanted with DFDBA powder showed calcification around the particulates. The collagen-sponge control group revealed no calcification or bone formation during the period of implantation. The light microscopic findings were confirmed by electron microscopy. Quantitative radiographic density DynaGraft and DFDBA graft followed sequentially over a period 120 days. It was concluded that a higher rate of calcification and bone formation was produced in the composite graft implant compared to the DFDBA implant. The composite graft material (DynaGraft), which contains both collagen and DFDBA, proved to be more effective for bone formation than particle components alone.     

No association between the neuronal nitric oxide synthase gene polymorphism and Alzheimer Disease

Nitric oxide synthase (NOS) has been implicated in the pathogenesis of Alzheimer disease (AD). To examine the role of the neuronal NOS (nNOS) gene in AD, patients (n = 139) and control subjects (n = 101) were genotyped for the nNOS dinucleotide polymorphism. No association was demonstrated for AD and this particular nNOS polymorphism.     

Serotonin transporter genetic polymorphisms and harm avoidance in the Chinese

The association for the harm avoidance (HA) dimension, as assessed by the Tridimensional Personality Questionnaire (TPQ), and the serotonin-transporter genetic polymorphisms has been investigated with controversial results. The aim of the present study was to replicate this investigation and to establish the association for a Chinese population. Two polymorphisms of the serotonin transporter (5HTT-LPR, serotonin transporter-linked polymorphism region; 5HTT-VNTR, variable number tandem repeat polymorphism in intron 2 of the serotonin transporter gene) were determined for 192 healthy Han Chinese who had completed the TPQ. No significant differences were demonstrated for TPQ HA scores, including the sub-scales, for subjects with different 5HTT-LPR genotypes. A significantly higher HA2 sub-score was demonstrated for subjects carrying the 10-12 5HTT-VNTR genotype, however, compared with those from the 12-12 genotype group, for the male population (P = 0.007). Our findings suggest that the 5HTT genetic polymorphism may be associated with HA scores; however, the effect is influenced by ethnicity and gender.     

Left cervical aortic arch with aneurysm and obstruction: three-dimensional computed tomographic angiography and magnetic resonance angiographic appearance

Cervical arch is a rare congenital anomaly presumed to result from persistence of the third aortic arch and regression of the normal fourth arch. Rather rare is cervical aortic arch associated with aneurysm and obstruction, with eight known cases reported. Definitive diagnosis with a noninvasive imaging modality is desirable and very important to prevent the need for disaster intervention. We present two cases of a pulsatile mass in the left supraclavicular region. Three-dimensional computed tomographic angiography and magnetic resonance angiography clearly showed a left-sided cervical aortic arch (Haughton type D) with arch aneurysm and coarctation (pseudocoarctation).     

Acute myocardial infarction in the young— The University of Michigan experience

Background The purpose of this study was to assess frequency, risk factors, treatment, and complications of very young patients with acute myocardial infarction (MI) at the University of Michigan Medical Center (UMMC). Methods From a database of 976 consecutive patients admitted to the UMMC with acute MI between 1995 and 1998, we compared care and outcomes of patients divided into 3 age categories: <46 years, 46-54 years, and >54 years. Risk factors, presenting symptoms, type of MI, management, complications, and hospital outcomes of the 3 groups were evaluated. Results Young patients represented >10% of all patients with acute MI, and >25% of these individuals were women, a number considerably higher than seen in previous studies. This group of young patients was more likely to have Q-wave MI and risk factors such as family history and tobacco use and less likely to have a history of angina. Although all 3 groups received similar inpatient treatment, there was more attention paid to risk factor modification such as smoking cessation and referral to cardiac rehabilitation in younger individuals. Young patients had fewer in-hospital complications and a lower mortality rate. Conclusions At the University of Michigan, >1 in 10 with acute MI is <46 years old. Data suggest that current management and aggressive risk factor modification are quite good in this particular group, and overall the mortality rate is very low. (Am Heart J 2002;143:56-62.)