The features of head injury at Prince of Wales Hospital, Hong Kong, were determined by reviewing the medical records of head-injured patients admitted to its neurosurgical service during the period commencing January 1989 to December 1993. During this time, there was a decline in the total number of head injury admissions. This reduction was secondary to a decrease in admissions for minor head injuries. The number of severe head injuries remained constant during these years. Falls represented the leading cause of head injury and accounted for more than 50% of all head injury admissions. Fall from a height was mainly a paediatric problem and falling at ground level was most common in the elderly. In teenagers and young adults, the most common causes of head injury were bicycle- and traffic-related accidents. Traffic-related accidents accounted for more than 50% of all head injury fatalities. There was a direct relationship between age and the mortality rate.

The pathological lesions found in 68 successfully engrafted patients with human leucocyte antigen-matched sibling-related bone marrow transplants werereviewed retrospectively. Twenty-six (38%) patients had acute graft-versus-host disease, which was slightly less than that reported in Caucasians. Skin was a constant site of involvement (100%), followed by the gastrointestinal tract (74%) and liver (59%). There was a 74% correlation between the clinical and histological grading of cutaneous graft-versus-host disease, while that of the gastrointestinal tract was lower at 60%. Cytomegalovirus colitis was found on histological examination of two patients clinically thought to have graft-versus-host disease. Histological evidence of infection, which included viral hepatitis (n=5), disseminated cytomegalovirus infection (n=3), disseminated aspergillosis (n=2), systemic candidiasis (n=2), Pneumocystis carinii pneumonia (n=1), and bacterial pneumonia (n=1), was present in 14 patients. In addition to graft-versus-host disease and infections, there was a case of veno-occlusive disease of the liver. Histological examination is important in distinguishing graft-versus-host disease from infection and other complications in bone marrow transplantation.

An analysis was made of 51 Chinese patients who tested positive for antimyeloperoxidase antibody (anti-MPO) in the five-year period from 1989 to 1993 in Hong Kong. Nineteen could be clearly classified as having an identifiable vasculitic illness, while the features of the remainder were suggestive of vasculitic syndromes in most cases. Renal disease was present in 84% of all cases and was the commonest manifestation, followed by pulmonary diseases. Acute or acute-on-chronic renal failure developed in 20 patients (39%). Of those who had renal biopsy performed, over half had histologic evidence of crescentic glomerulonephritis. Anti-MPO associated disease carried a grave prognosis with significant morbidity and mortality. Steroid and immunosuppressive therapy was given to most of the patients and in those who responded to immunosuppressive therapy, anti-MPO was a useful marker for monitoring disease activity. Twenty patients died, either of complications or as a result of disease activity.

The prevalence of non-insulin-dependent diabetes mellitus in 1467 ambulatory elderly subjects aged from 60 to 90 years was determined using fasting plasma glucose as a screening test. A questionnaire survey on the history of diabetes and related complications was performed. The results showed that 10.7% had already been diagnosed as having diabetes mellitus. Screening revealed a further 5% who had diabetes mellitus but were asymptomatic. The prevalence of non-insulin-dependent diabetes mellitus was 15% (95% confidence interval 9-21) among the 60- to 80-year-old age group and 17% confidence interval (3 to 30) in those older than 80 years. Obesity and advancing age were adverse risk factors associated with diabetes. The diabetic subjects had significantly more coronary and cerebrovascular atherosclerosis, hypertension, and adverse lipid profiles. Even in the non-diabetic elderly subjects, fasting blood glucose was positively correlated with body weight and body mass index, confirming the importance in the aetiology of non-insulin-dependent diabetes mellitus. This is a common disease in the elderly and is associated with significant cardiovascular morbidity.

The objective of the study was to assess community attitudes to institutional care of the aged in Hong Kong. A random sample of 1,023 adult residents were telephone-interviewed. 22.7% and 57.5% of the respondents agreed or strongly agreed that non-disabled and disabled elderly be accommodated in institutions respectively. Social factors of the respondents and physical and behavioural factors of the elderly had significant effects on these attitudes. Furthermore, age, gender, educational level and experience in living or looking after elderly also had significant effects. This study provides important information on the community attitudes to institutionalization of the elderly in Hong Kong. These attitudes will have significant effects on the demand for institutional care for the elderly in the next decade. The findings should also help health care workers identify elderly at-risk of institutionalization. Hence, early intervention may help reduce some of these placements.