BACKGROUND: Taking Sauropus androgynus, a Malaysian food, to reduce weight began as a fad in Taiwan in 1994. Some advocates of this fad developed pulmonary dysfunction. The aim of this study is to report the lung injury in patients taking Sauropus androgynus.
METHODS: From July 1995 to November 1995, we investigated 104 nonsmoking patients (one male and 103 females) with chest roentgenography, pulmonary function, test, and Technetium 99m-labeled diethylene triamine penta-acetate (Tc-99m DTPA) radioaerosol inhalation lung scintigraphy.
RESULTS: Among the 90 patients receiving Tc-99m DTPA inhalation lung scan, 46 (51.1%) patients had increased clearance of Tc-99m DTPA from lung and 20 (22.2%) patients had inhomogeneous deposition of the submicronic radioaerosol. Eighteen (18/100) patients had obstructive ventilatory impairment in pulmonary function test. Analyzing the results, we found that the patients with respiratory symptoms (n = 42) took more vegetables (p = 0.016), had increased clearance of Tc-99m DTPA (p = 0.010) and had lower FEV1 (p = 0.001), FEV1/FVC (p < 0.001), FEF25-75 (p = 0.001), VC (p = 0.002) and DLCO (p = 0.009) than the patients without respiratory symptoms (n = 62). FEV1 and FEV1/FVC were significantly reduced in patients with severe impairment of alveolar permeability. The cumulative dosage and duration of exposure were significantly associated with the reduction of FEV1 and FEV1/FVC.
CONCLUSION: The lung injury after taking Sauropus androgynus involves alveoli and/or small airways and is manifest as obstructive ventilatory impairment with inhomogeneous aerosol distribution and increased lung epithelial permeability.
The Arg-to-Trp substitution at codon 3500 in the apolipoprotein (apo) B-100 gene is established as a cause of familial defective apo B-100 (FDB), a functional mutation, resulting in reduced LDL receptor binding and manifest hypercholesterolemia. In a search for similar mutations in 163 Malaysians, we screened the putative receptor-binding region (codons 3456-3553) of the apo B-100 gene by PCR amplification and denaturing gradient-gel electrophoresis. Four single-base mutations were detected and confirmed by DNA sequencing. Two females, a Chinese and a Malay, had the same CGG3500-->TGG mutation, resulting in an Arg3500-to-Trp substitution. This is the second published report of such an independent mutation involving the same codon as the established Arg3500-to-Gln mutation. The two other mutations detected, CTT3517-->CTG and GCC3527-->GCT, resulted in degenerate codons with no amino acid substitutions. All four mutations were associated with a unique apo B haplotype, different from those found in Caucasian FDB patients but concurring with that previously reported for two other Asians with FDB.
Molecular analysis has been performed on a Malaysian patient with a severe bleeding disorder due to factor XIII(A) subunit deficiency. Total mRNA was isolated from the patient's leucocytes and four overlapping segments corresponding to the entire coding region of the A subunit cDNA were amplified by RT-PCR. The cDNA segments amplified efficiently and were of expected size. Direct sequencing of the complete reading frame revealed a single homozygous base change (nt 1327G-T) in exon 10 corresponding to a missense mutation, Val414Phe, in the catalytic core domain of the A subunit monomer. The mutation eliminates a BsaJ1 restriction site and family screening showed that both parents were heterozygous for the defect. The base substitution was absent in 55 normal individuals. Val414 is a highly conserved residue in the calcium-dependent transglutaminase enzyme family. Computer modelling based on 3D crystallographic data predicts that the bulky aromatic side chain of the substituted phenylalanine residue distorts protein folding and destabilizes the molecule. In addition, conformation changes in the adjacent catalytic and calcium binding regions of the A subunit are likely to impair the enzymatic activity of any protein synthesized.
MeSH terms: Adult; Amino Acid Sequence; Base Sequence; DNA/genetics; Exons/genetics; Factor XIII/genetics*; Factor XIII/chemistry; Factor XIII Deficiency/genetics*; Humans; Male; Molecular Sequence Data; Mutation/genetics*; RNA/genetics; Polymerase Chain Reaction; Sequence Analysis, DNA
The incidence of road traffic injuries has increased over the last two decades. Of greater concern is the prediction that the problem is likely to increase further, given present trends in transportation. Injuries and not "accidents" need to be the focus of the health sector. Passive strategies, which are independent of human behaviour, are more likely to succeed in the prevention of injuries compared to "active" strategies. The health sector needs to play a bigger role in prevention through advocacy, research and education of target groups.
MeSH terms: Accidents, Traffic*; Humans; Malaysia; Primary Health Care; Transportation; Wounds and Injuries*; Incidence
The Patient's Charter tells about the rights and standard of service a patient can expect. However, little information is available to gauge the reality of the charter in real practice. This survey was performed to determine the validity of the charter to the services provided and to identify areas of improvement if the charter is to be revised. A questionnaire-based survey was used to seek information from 196 patients who attended the Outpatient Department in Banting District Hospital over a period of four days. The overall waiting time for registration, to be seen by a doctor and for medication were 17.4 ± 2.0 minutes, 25.3 ± 2.6 minutes and 15.8 ± 1.3 minutes respectively. The overall waiting time for the whole consultation was 61.4 ± 4.9 minutes. Only 30.8% respondents knew about the Patient's Charter. The Patient's Charter appears to be valid for the actual services provided. There have to be measures to increase the awareness of the charter to the public perhaps via pamphlets and to provide a multi-linguistic charter.
MeSH terms: Chin; Cross-Sectional Studies; Malaysia; Outpatients; Pamphlets; Primary Health Care