Browse publications by year: 2000

  1. A validation study of the Siriraj Stroke Score
    Kan CH, Lee SK, Low CS, Velusamy SS, Cheong I
    Int J Clin Pract, 2000 Dec;54(10):645-6.
    PMID: 11221275
    A cross-sectional study was conducted on 160 Malaysian patients to validate the usefulness of the Siriraj Stroke Score (SSS) for differentiating intracerebral haemorrhage and infarction following acute strokes. Our results indicate that the score lacks sensitivity and specificity. It should thus not be used in epidemiological studies to determine stroke types in a community. More importantly, in the absence of information from neuroimaging of the brain, it cannot be used safely by physicians to assess the need or otherwise of thrombolytic and/or anticoagulant therapy after an acute stroke.
    MeSH terms: Adult; Aged; Aged, 80 and over; Cerebral Hemorrhage/diagnosis*; Cerebral Infarction/diagnosis*; Cross-Sectional Studies; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Sensitivity and Specificity; Stroke/diagnosis*
  2. Sarcocystis levinei infection in Philippine water buffaloes (Bubalus bubalis)
    Claveria FG, Cruz MJ
    Parasitol Int, 2000 Jan;48(3):243-7.
    PMID: 11227764
    Ultrastructural studies of sarcocysts obtained from Philippine water buffaloes revealed the presence of the commonly reported macroscopic species, Sarcocystis fusiformis, and the microscopic species Sarcocystis levinei (Dissanaike A, Kan S. Studies on Sarcocystis in Malaysia. I: Sarcocystis levinei n.sp. from the water buffalo Bubalus bubalis. Z Parasitenkd 1978;55:127-38), (Huong L, Dubey J, Uggla A. Redescription of Sarcocystis levinei Dissanaike and Kan, 1978 (Protozoa: Sarcocystidae) of the water buffalo (Bubalus bubalis). J Parasitol 1997;83:1148-52). The globular to oval microscopic cysts commonly observed in the muscles of the diaphragm and neck exhibit compartmentalized arrangement of zoites with septal partitions and measure 13-48 microns in diameter. The parasitophorous vacuolar membrane of sarcocyst bears minute and hair-like villar protrusions measuring 2.3-2.75 microns long emanating at certain distances from the primary cyst wall and lack microfilaments. Villar protrusions have expanded to dome-shaped base measuring 0.33-1.6 microns long by 0.22-1.0 micron wide, and intermediate and tapering distal segments bent approximately 90 degrees and run parallel to the cyst surface. The distal segments at some areas join to form conical tufts. The primary cyst wall bears numerous prominent undulations that are arranged in small clusters. The ground substance is 0.42-0.57 micron thick. This paper documents the first report of S. levinei in Philippine water buffaloes possessing the type 7 cyst wall.
    MeSH terms: Animals; Buffaloes/parasitology*; Diaphragm/parasitology; Diaphragm/pathology; Esophagus/parasitology; Esophagus/pathology; Microscopy, Electron/veterinary; Philippines; Sarcocystis/classification; Sarcocystis/ultrastructure*; Sarcocystosis/parasitology; Sarcocystosis/pathology; Sarcocystosis/veterinary*; Muscle, Skeletal/parasitology; Muscle, Skeletal/pathology
  3. Multidrug-resistant strains of Salmonella enterica serotype typhi are genetically homogenous and coexist with antibiotic-sensitive strains as distinct, independent clones
    Thong KL, Bhutta ZA, Pang T
    Int J Infect Dis, 2000;4(4):194-7.
    PMID: 11231181
    OBJECTIVE: The goal of this study was to report the molecular analysis of antibiotic-sensitive and multidrug-resistant (MDR) strains of Salmonella typhi, using pulsed-field gel electrophoresis (PFGE), with a particular emphasis on the coexistence of these strains in a typhoid-endemic region of Karachi, Pakistan.

    METHODS: One hundred isolates of S. typhi in humans (50 MDR and 50 antibiotic-sensitive isolates) from sporadic cases of typhoid fever were analyzed by Vi-phage typing, antibiograms and PFGE.

    RESULTS: The MDR S. typhi strains were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. Analysis by PFGE showed that 50 MDR isolates of S. typhi had a single, homogenous PFGE profile, which was distinctly different from that of 50 antibiotic-sensitive isolates obtained in the same time frame from the same area. This latter group of isolates showed much greater diversity of PFGE profiles, as has been observed in other endemic regions.

    CONCLUSIONS: Multidrug-resistant and antibiotic-susceptible strains of S. typhi can coexist in endemic areas as epidemiologically independent pathogens and are not in competition for continued persistence and transmission.

    MeSH terms: Adolescent; Anti-Bacterial Agents/pharmacology*; Child; Child, Preschool; DNA, Bacterial/analysis; DNA, Bacterial/genetics; Drug Resistance, Microbial/genetics; Female; Humans; Infant; Male; Salmonella typhi/classification; Salmonella typhi/drug effects*; Salmonella typhi/genetics; Typhoid Fever/microbiology*; Bacterial Typing Techniques*; Electrophoresis, Gel, Pulsed-Field; Drug Resistance, Multiple/genetics
  4. Dealing with malaria in the last 60 years. A personal experience
    de Zulueta J
    Parassitologia, 2000 Jun;42(1-2):87-90.
    PMID: 11234335
    Dealing with malaria in the last 60 years is seen by the author in the perspective of his own experience. His malaria work, which began in 1941, covered the study of the habits of the mosquitoes dwelling in the savanna country of Eastern Colombia and the effect on malaria transmission of the newly introduced DDT residual spraying. The success of the campaign he later directed in Sarawak and Brunei contributed to the launching by WHO of its global malaria eradication campaign. Further successful work in Uganda showed the possibility of effective control and even eradication in highland country but left unsolved the problem of how to interrupt transmission of holoendemic malaria in Africa. The author's work with WHO in the Middle East showed to what extent social and economic conditions could influence the course of a malaria campaign. This was also the experience in America, both in Colombia in the author's early work and later in Mexico during an evaluation of the national malaria programme. Development of insecticide resistance was also encountered in his career and the refractoriness of the European vectors was also observed in his work as a malariologist.
    MeSH terms: Animals; DDT/history; Humans; Insecticides/history; Malaria/history*; Mosquito Control/history; World Health Organization/history; History, 20th Century
  5. Kimura's disease: a report of three cases with a brief review of literature
    Madhavan M, Othman NH, Singh MS, Indudharan R, Sharma HS, Shamsuddin AR
    Acta Otorhinolaryngol Ital, 2000 Aug;20(4):284-9.
    PMID: 11234448
    Kimura's disease (KD) is an uncommon chronic inflammatory condition of unknown aetiology involving subcutaneous tissue, presenting as a tumor like lesion with a predilection for the head and neck region. Clinically it is often confused with parotid tumor with lymph node metastasis. It is difficult to diagnose before tissue biopsy. Fine needle aspiration cytology has only limited value. Unless the pathologists are aware of this entity, it might be misdiagnosed. Surgery, radiotherapy and steroid therapy have been tried but none is proved best and recurrence is common. Three cases of KD seen in our hospital and the problems encountered in them are presented.
    MeSH terms: Adult; Angiolymphoid Hyperplasia with Eosinophilia/diagnosis*; Diagnosis, Differential; Humans; Male; Parotid Gland/pathology
  6. Fulltext Leptospirosis in Kuala Lumpur and the comparative evaluation of two rapid commercial diagnostic kits against the MAT test for the detection of antibodies to leptospira interrogans
    Sekhar WY, Soo EH, Gopalakrishnan V, Devi S
    Singapore Med J, 2000 Aug;41(8):370-5.
    PMID: 11256343
    The aim of the study was to look into the epidemiology of serodiagnosed cases of leptospirosis at the University Hospital and compare two commercial ELISA Assays to the Microscopic Agglutination Test (MAT). Demographic data for all serodiagnosed cases for the years 1991-1997 were collected. From this data, 104 sera (n = 104) were selected as samples for comparative evaluation of the commercial ELISAs (INDX Dip-S-Ticks and PanBio ELISA) to the MAT test. Thirty two (n = 32) negative control sera were selected from serodiagnosed cases of other differential diagnosis of leptospira infection. The MAT test is a standard test that detects agglutination antibodies to leptospira biflexa, while the INDX Dip-S-Ticks is an ELISA dot test assaying for total anti-leptospira antibodies. The PanBio ELISA is a colorometric assay in test well strips to detect anti-leptospira IgM. The sensitivity, specificity, and efficiency of tests were calculated at a MAT cut-off value of 1:320. Demographic data showed that leptospirosis peaks during March-May and Aug-Nov coinciding with the inter-monsoon period with more men being infected than women and more adults than children. The sensitivity, specificity, and efficiency of test for the INDX Dip-S-Ticks were 83.3%, 93.8% and 87.5% while the values for the PanBio ELISA were 54.2%, 96.9% and 71.3%. The suboptimal PanBio result could be related to the blocking effect of high IgG titres or could be related to the diagnostic MAT cut-off values used in this study. The data hence reflects a pattern of transmission that is related to "wet" occupational risk factors. The commercial assays evaluated, are easier to perform but interpretation of results should be based on level of endemicity. The INDX Dip-S-Ticks allows this flexibility and is a practical alternative to the MAT test.
    MeSH terms: Adult; Agglutination Tests/standards*; Antibodies, Bacterial/blood*; Child; Enzyme-Linked Immunosorbent Assay/standards*; Female; Humans; Immunoglobulin M/blood*; Leptospira interrogans/immunology*; Malaysia/epidemiology; Male; Middle Aged; Reagent Kits, Diagnostic/standards*; Seasons; Sensitivity and Specificity; Urban Health/statistics & numerical data; Weil Disease/blood; Weil Disease/diagnosis*; Weil Disease/immunology; Weil Disease/microbiology*; Weil Disease/epidemiology; Case-Control Studies; Age Distribution; Sex Distribution
  7. Fulltext Paediatric one lung anaesthesia by selective bronchial intubation
    Lew YS
    Singapore Med J, 2000 Aug;41(8):398-400.
    PMID: 11256348
    One lung anaesthesia in paediatric patients may not always be achievable by bronchial blockade or double lumen tube intubation due to inadequate experiences or facilities. We attempted to isolate right lung by selectively intubating the left bronchus with single lumen tube on a 10 kg child. Optimal surgical condition and satisfactory oxygenation achieved but complicated with severe respiratory acidosis. The possible causes for hypercapnea in this child were discussed.
    MeSH terms: Acidosis, Respiratory/blood; Acidosis, Respiratory/etiology*; Age Factors; Anesthesia, Inhalation/adverse effects*; Anesthesia, Inhalation/instrumentation; Anesthesia, Inhalation/methods*; Blood Gas Analysis; Body Weight; Empyema/radiography; Empyema/surgery; Female; Humans; Hypercapnia/blood; Hypercapnia/etiology*; Infant; Intubation, Intratracheal/adverse effects*; Intubation, Intratracheal/instrumentation; Intubation, Intratracheal/methods*; Monitoring, Intraoperative; Treatment Outcome
  8. An analysis of the teratagenic effects that could possibly be due to alcohol consumption by pregnant mothers
    Chaudhuri JD
    Indian J Med Sci, 2000 Oct;54(10):425-31.
    PMID: 11262858
    It can be concluded that alcohol is definitely harmful to the developing fetus. The effect can manifest in various ways, the most extreme of which is a condition called Fetal Alcohol Syndrome (FAS). The diagnosis of maternal alcoholism leading onto cases of FAS is difficult due to absence of accurate diagnostic tests. The diagnosis of FAS in a child is easier by a proper examination. There is no specific treatment of FAS in a child. The only management is by institution of corrective and rehabilitative measures. The exact mechanism of the teratogenic action of alcohol is not known. It is probably due to the harmful effect of alcohol on the epiblast layer of the bilaminar germ disc. In the absence of adequate knowledge regarding FAS, not much can be done to remedy the deleterious effects of alcohol. Hence, a word of advice to all pregnant women is to avoid drinking during pregnancy.
    MeSH terms: Alcohol Drinking*; Ethanol/adverse effects*; Alcoholism/complications; Alcoholism/diagnosis*; Child; Diagnosis, Differential; Female; Humans; India/epidemiology; Mothers*; Pregnancy; Prenatal Exposure Delayed Effects; Teratogens/toxicity*
  9. Enterovirus 71: the virus, its infections and outbreaks
    Ho M
    J Microbiol Immunol Infect, 2000 Dec;33(4):205-16.
    PMID: 11269363
    Enterovirus 71 (EV71) was first recognized in 1974. Since then it has been implicated in 13 small and large outbreaks world-wide. Large outbreaks of hand, foot and mouth disease (HFMD), mostly benign, occurred in Japan in 1973 and 1978. Four outbreaks with brain stem encephalitis and significant numbers of deaths occurred in Bulgaria and Hungary in the late 1970's and in Malaysia and Taiwan in 1997 and 1998 respectively. During the latter two epidemics, pulmonary edema and hemorrhage often leading to quick deaths in children aged from 0.5 to 3 years old was first recognized. In Taiwan 78 deaths and over 100,000 cases of HFMD occurred. Coxsackie A16 cocirculated with EV 71, without however, causing any severe illnesses. The transmission of EV 71 was related to number of siblings in a household, rural residence and contact with cases of HFMD. Genotype analyses show that genotypes have changed with time in the United States and Japan. Recent isolates from Japan are similar to the isolates from Malaysia and Taiwan in 1997 and 1998, respectively. Even though genotype analysis has not identified specific sequences responsible for neurovirulence, the strains causing brain stem encephalitis and pulmonary edema in the Far East are similar and have arisen since 1997. Seroepidemiological studies in Taiwan suggest that children aged from 0.5 to 4 years old are most susceptible while the rest of the population are over 50% immune. Theoretically there is a pool of such susceptible subjects every few years. In prevention for another major outbreak, a simple, inactivated Salk type vaccine should be immediately prepared and made available.
    MeSH terms: Disease Outbreaks*; Enterovirus Infections/complications*; Enterovirus Infections/epidemiology; Enterovirus Infections/virology; Enterovirus/classification*; Enterovirus/genetics; Genotype; Humans; Taiwan/epidemiology; Seroepidemiologic Studies
  10. Oral biopsy turnaround time: 20-year experience of the Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya
    Siar CH, Tan BH
    J Oral Sci, 2000 Dec;42(4):205-10.
    PMID: 11269378
    The turnaround time (TAT) for oral biopsies received for histological examination by the Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya, for the years 1978, 1988 and 1998 was evaluated. For the three years studied, TATs for 61, 233 and 463 specimens were retrospectively analysed. Testing intervals, that is, from the dates the surgeons procured the specimens, the laboratories accessioned them and until the pathologists signed off the diagnoses, were used to calculate TAT. The performance level of the respective pathologists, the growth of tissue diagnostic services and the possible variables that influence TAT were also evaluated. As prompt diagnosis means prompt treatment, which in turn has a bearing on prognosis, the TAT pertinent to oral malignant tumors was emphasized. The mean TAT, its mode and median fell significantly in 1998 compared with the previous 2 years; it was lower for soft tissue than for hard tissue specimens, and lower for malignant, than for non-malignant specimens. The progression of tissue diagnostic services is up to a satisfactory level, as 88.89 % of biopsies could render diagnoses within a fair period of time in 1998.
    MeSH terms: Biopsy*; Humans; Mouth Mucosa/pathology; Mouth Neoplasms/diagnosis; Mouth Neoplasms/pathology*; Retrospective Studies; Time and Motion Studies; Process Assessment (Health Care)
  11. Fulltext Acceptance of the Accuhaler, a multi-dose powder inhaler, among asthmatic patients: a comparison with the pressurized metered-dose inhaler
    Liam CK, Lim KH, Wong CM
    Asian Pac J Allergy Immunol, 2000 Sep;18(3):135-40.
    PMID: 11270467
    This study aimed to evaluate dry powder inhaler naive asthmatic patients' perception and preference of the Accuhaler, a multidose dry powder inhaler and the pressurized metered dose inhaler (pMDI). After the first instruction, 66.7% of 48 patients enrolled in the study could demonstrate the correct use of the Accuhaler. When the patients were asked to compare the pMDI and the Accuhaler after using the Accuhaler to administer salmeterol for 4 weeks, the Accuhaler scored significantly better than the pMDI for the following features: knowing how many doses are left, presence of an attached cover, taste, instruction for use, attractiveness, ease of use, ease of holding, shape, and comfortable mouthpiece. The pMDI scored better to the Accuhaler in terms of size. More patients preferred the Accuhaler than the pMDI; the presence of a dose counter and perceived ease of use were the main reasons cited for their preference for the Accuhaler.
    Study site: Asthma Clinic, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    MeSH terms: Salmeterol Xinafoate; Administration, Inhalation; Adolescent; Adult; Aerosols; Aged; Albuterol/administration & dosage*; Albuterol/analogs & derivatives*; Albuterol/therapeutic use; Asthma/drug therapy*; Bronchodilator Agents/administration & dosage*; Bronchodilator Agents/therapeutic use; Child; Equipment Design; Female; Hospitals, University; Humans; Malaysia; Male; Middle Aged; Nebulizers and Vaporizers*; Outpatient Clinics, Hospital; Powders; Time Factors; Patient Satisfaction; Anti-Asthmatic Agents/administration & dosage*; Anti-Asthmatic Agents/therapeutic use
  12. Histamine induced decrease of lecithin levels in broncho-alveolar lavage fluid of rats is mediated by H2 receptor
    Rao GJ
    Asian Pac J Allergy Immunol, 2000 Sep;18(3):169-71.
    PMID: 11270474
    Lecithin, a major surface active substance of the surfactant system of the lung, was estimated in broncho-alveolar lavage (BAL) fluid in four groups of healthy adult male albino rats. Rats from group I were not administered any drug and acted as controls. Group II were administered histamine diphosphate. Group III were given H1 blocker (pyrilamine maleate) followed by histamine diphosphate. Group IV received H2 blocker (ranitidine hydrochloride) followed by histamine diphosphate. Lecithin content of BAL fluid in the control group was compared with that in the other three groups. A significant decrease in lecithin content was observed in the rats that received either histamine diphosphate or H1 blocker followed by histamine diphosphate. However, compared to control rats no significant difference in lecithin content was seen in rats that received H2 blocker followed by histamine diphosphate. The results clearly indicate that the decrease in surface active lecithin content in BAL fluid following administration of histamine diphosphate was unaffected by prior administration of H1 blocker, but was blocked by prior administration of H2 blocker. It was concluded that histamine induced decrease in lecithin content of BAL fluid is mediated through H2 receptors. Since the predominant source of intra-alveolar lecithin are Type II cells of the alveolar epithelium, It is possible that Type II cells have H2 receptors, stimulation of which resulted in decreased intraalveolar lecithin.
    MeSH terms: Animals; Bronchoalveolar Lavage Fluid/chemistry*; Dose-Response Relationship, Drug; Histamine/administration & dosage; Histamine/pharmacology*; Histamine H1 Antagonists/pharmacology; Histamine H2 Antagonists/pharmacology; Lung/immunology; Lung/metabolism; Male; Phosphatidylcholines/analysis*; Phosphatidylcholines/metabolism; Phosphatidylcholines/secretion*; Pulmonary Alveoli/drug effects; Pulmonary Alveoli/secretion*; Receptors, Histamine H2/metabolism*; Respiratory Hypersensitivity/immunology; Respiratory Hypersensitivity/metabolism*; Rats, Wistar; Rats
  13. Dietary change, energy balance and body weight regulation among migrating students
    Reeves SL, Henry CJ
    Int J Food Sci Nutr, 2000 Nov;51(6):429-38.
    PMID: 11271846 DOI: 10.1080/09637480050208044
    This study was conducted to examine how subjects modulate their food intake and energy balance when they migrate from a low energy density food intake pattern to one of high energy density. It was hypothesised that an increase in the energy density of food consumed would result in increased body weight of the migrating subjects unless food intake and energy balance could be modulated. Food selection, food intake, basal metabolic rate (BMR) and anthropometric measurements were made on 53 female and 56 male newly arrived overseas students. All subjects were from Malaysia, but the data was collected at Oxford Brookes University where the subjects were studying. Food intake using 3-day food diaries and food frequency questionnaires (FFQs). BMR and anthropometric measurements including body weight were measured on arrival in the UK and after 3 and 6 months' stay. Student's t-tests and analysis of variance (ANOVA) were used to compare the data. A significant difference (P < 0.05) was found between the energy density of the foods consumed in Malaysia and after 3 and 6 months in the UK. There was also a significant decrease (P < 0.05) in protein consumed. However, there were no differences in total energy intake. From results of the FFQs, differences were found in food selection due mainly to the lack of availability of certain foods in UK supermarkets. No significant differences were found in the BMR and anthropometric measurements made at the start of the study and later assessments. It appears that Malaysian students are able to remain in energy balance and are weight stable at least during the first 6 months of residence in the UK, despite the wider choice of energy dense food available. This suggests that at least in the short term, subjects are able to modulate their food intake in response to changes in the energy densities and free choice of food.
    MeSH terms: Adult; Analysis of Variance; Basal Metabolism; Body Constitution; Body Weight/physiology*; Energy Metabolism*; Feeding Behavior/physiology*; Feeding Behavior/psychology; Female; Food Preferences; Great Britain/epidemiology; Humans; Malaysia/ethnology; Male; Transients and Migrants*; Diet Records; Body Mass Index
  14. Use of palm mid-fraction in dark chocolate as base filling centre at different storage temperatures
    Jinap S, Ali AA, Man YB, Suria AM
    Int J Food Sci Nutr, 2000 Nov;51(6):489-99.
    PMID: 11271851
    Dark chocolates filled with palm mid-fraction (PMF) were stored at different temperatures to evaluate the physical and chemical changes. Storage at low temperature (18 degrees C) reduces the PMF migration to negligible extent. Higher storage temperatures (30 and 35 degrees C) increased the PMF migration from the filling centre into the chocolate coating. As a consequence of fat migration, fatty acid composition, triglyceride composition, hardness, solid fat content, melting point and polymorphic structure changed, leading to bloom formation, which started by fat migration and was influenced by recrystallization tendency within the chocolate coating.
    MeSH terms: Cacao/chemistry*; Candy/analysis*; Crystallization; Fatty Acids/analysis; Hardness; Hot Temperature/adverse effects*; Plant Oils/chemistry*; Trees*; Triglycerides/analysis
  15. Effects of administration of alpha-tocopherol and tocotrienols on serum lipids and liver HMG CoA reductase activity
    Khor HT, Ng TT
    Int J Food Sci Nutr, 2000;51 Suppl:S3-11.
    PMID: 11271854
    Male hamsters were fed on semi-synthetic diets containing commercial corn oil (CO), isolated corn oil triglycerides (COTG), COTG supplemented with 30 ppm of alpha-tocopherol (COTGTL) and COTG supplemented with 81 ppm of alpha-tocopherol (COTGTH) as the dietary lipid for 45 days. Male albino guinea pigs were fed on commercial chow pellets and treated with different dosages of tocopherol and tocotrienols intra-peritoneally for 6 consecutive days. Serum and liver were taken for analysis. Our results show that stripping corn oil of its unsaponifiable components resulted in COTG which yielded lower serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and raised high-density lipoprotein cholesterol (HDL-C) and serum triglycerides (TG) levels. These results indicate that the COTG with its fatty acids are responsible for the hypocholesterolemic effect exhibited by corn oil. However, supplementing the COTG diet with alpha-tocopherol (alpha-T) at 30 ppm significantly raised the serum TC, LDL-C and TG levels, but did not alter the HDL-C level, indicating that alpha-T is hypercholesterolemic. Supplementing the COTG diet with alpha-T at 81 ppm raised the serum TC level but to a lesser extent as compared to that obtained with 30-ppm alpha-T supplementation. The increased TC, in this case, was reflected mainly by an increased in HDL-C level as the LDL-C level was unchanged. The TG level was also raised but to a lesser extent than that obtained with a lower alpha-T supplementation. The liver HMG CoA reductase (HMGCR) activity was exhibited (56%) by the COTG as compared to CO. Supplementation of alpha-T at 30 ppm to the COTG diet resulted in further inhibition (76%) of the liver HMGCR activity. On the contrary, supplementation of alpha-T at 81 ppm to COTG diet resulted in a highly stimulatory effect (131%) on the liver HMGCR activity. Short-term studies with guinea pigs treated intra-peritoneally with alpha-T showed that at low dosage (5 mg) the HMGCR activity was inhibited by 46% whereas increasing the dosage of alpha-T to 20 mg yielded lesser inhibition (18%) as compared to that of the control. Further increase in the dosage of alpha-T to 50 mg actually resulted in 90% stimulation of the liver HMGCR activity as compared to the control. These results clearly indicate that the effect of alpha-T on HMGCR activity was dose-dependent. Treatment of the guinea pigs with 10 mg of tocotrienols (T3) resulted in 48% inhibition of the liver HMGCR activity. However, treatment with a mixture of 5 mg of alpha-T with 10 mg of T3 resulted in lesser inhibition (13%) of the liver HMGCR activity as compared to that obtained with 10 mg of T3. The above results indicate that the alpha-T is hypercholesterolemic in the hamster and its effect on liver HMGCR is dose-dependent. T3 exhibited inhibitory effect on liver HMGCR and alpha-T attenuated the inhibitory effect of T3 on liver HMGCR.
    MeSH terms: Animals; Animal Feed/analysis; Corn Oil/chemistry; Guinea Pigs; Cricetinae; Hydroxymethylglutaryl CoA Reductases/metabolism*; Cholesterol, HDL/blood*; Cholesterol, LDL/blood*; Liver/metabolism*; Liver/chemistry; Male; Mesocricetus; Triglycerides/administration & dosage; Triglycerides/blood; Vitamin E/administration & dosage; Vitamin E/metabolism*
  16. Effect of palm vitamin E on the healing of ethanol-induced gastric injury in rats
    Jaarin K, Renuvathani M, Nafeeza MI, Gapor MT
    Int J Food Sci Nutr, 2000;51 Suppl:S31-41.
    PMID: 11271855
    The effect of palm vitamin E on the healing of ethanol-induced gastric lesions and various biochemical parameters were investigated. The study was divided into two phases. In the first phase of the study, 42 rats of Sprague Dawley species (200-250 gm weight) were randomly divided into two groups fed with a normal diet (control) or palm vitamin E enriched diet (150 mg/kg) for 3 weeks. The rats were killed after 3 weeks of feeding. Gastric tissue contents of malondialdehyde (MDA), prostaglandin E2 and acid were measured. In the second phase of the study 42 rats were divided into two groups. Group 1 was fed normal rat pellets (control) and group 2 was fed palm vitamin E enriched pellets (150 mg/kg food) for 3 weeks. After 3 weeks of feeding gastric mucosal injury was induced by an orogastric tube administration of 0.5 ml 100% ethanol. The rats were killed at 1 hour, 4 hours and 1 week after ethanol exposure for semiquantitative determination of ulcer index and gastric acid concentration. Gastric tissue MDA and mucus were measured only at 1 week after ethanol exposure. In the first phase of the study we found that palm vitamin E only caused a significant reduction in gastric MDA. However, it showed no significant effects on prostaglandin E2 and gastric acid concentration. In the second phase of the study, the mean ulcer index of palm vitamin E supplemented group killed after 1 week of ethanol exposure was significantly lower compared to the respective control. However, there was no significant difference in ulcer index in rats killed at 1 hour and 24 hours after ethanol exposure. The gastric acid concentration was significantly higher in the group treated with palm vitamin E killed 1 week after ethanol exposure compared to control. The gastric tissue MDA was significantly lower in the palm vitamin E supplemented group compared to control. There was no significant difference in gastric mucus content of the both groups. The ulcer healing which occurred in the presence of a high gastric acid suggests that the effect of palm vitamin E on the healing of gastric lesions was not mediated via a reduction in gastric acid nor was it mediated through increasing prostaglandin E2 or mucus production. The most probable mechanism is via reducing lipid peroxidation as reflected by a significant decreased in gastric tissue MDA content.
    MeSH terms: Ethanol/adverse effects; Animals; Animal Feed; Gastric Acid; Gastric Mucosa/drug effects; Gastric Mucosa/metabolism; Malondialdehyde/analysis; Prostaglandins E/analysis; Stomach Ulcer/chemically induced; Stomach Ulcer/drug therapy*; Stomach Ulcer/metabolism; Vitamin E/metabolism; Vitamin E/pharmacology; Vitamin E/therapeutic use*; Rats, Sprague-Dawley; Rats
  17. Vitamin E and factors affecting atherosclerosis in rabbits fed a cholesterol-rich diet
    Ismail NM, Abdul Ghafar N, Jaarin K, Khine JH, Top GM
    Int J Food Sci Nutr, 2000;51 Suppl:S79-94.
    PMID: 11271860
    The present study aims to examine the effects of a palm-oil-derived vitamin E mixture containing tocotrienol (approximately 70%) and tocopherol (approximately 30%) on plasma lipids and on the formation of atherosclerotic plaques in rabbits given a 2% cholesterol diet. Eighteen New Zealand White rabbits (2.2-2.8 kg) were divided into three groups; group 1 (control) was fed a normal diet, group 2 (AT) was fed a 2% cholesterol diet and group 3 (PV) was fed a 2% cholesterol diet with oral palm vitamin E (60 mg/kg body weight) given daily for 10 weeks. There were no differences in the total cholesterol and triacylglycerol levels between the AT and PV groups. The PV group had a significantly higher concentrations of HDL-c and a lower TC/HDL-c ratio compared to the AT group (P < 0.003). The aortic tissue content of cholesterol and atherosclerotic lesions were comparable in both the AT and PV groups. However, the PV group had a lower content of plasma and aortic tissue malondialdehyde (P < 0.005). Our findings suggest that despite a highly atherogenic diet, palm vitamin E improved some important plasma lipid parameters, reduced lipid peroxidation but did not have an effect on the atherosclerotic plaque formation.
    MeSH terms: Animals; Aorta, Thoracic/pathology; Aorta, Thoracic/chemistry; Arteriosclerosis/metabolism*; Arteriosclerosis/pathology; Cholesterol, Dietary/administration & dosage; Cholesterol, Dietary/metabolism*; Cholesterol, HDL/blood; Lipoproteins, LDL/blood; Lipoproteins, VLDL/blood; Male; Rabbits; Reagent Kits, Diagnostic; Triglycerides/blood; Vitamin E/administration & dosage; Vitamin E/metabolism*; Statistics, Nonparametric
  18. Tocotrienols inhibit growth of ZR-75-1 breast cancer cells
    Nesaretnam K, Dorasamy S, Darbre PD
    Int J Food Sci Nutr, 2000;51 Suppl:S95-103.
    PMID: 11271861
    The vitamin E component of palm oil provides a rich source of tocotrienols which have been shown previously to be growth inhibitory to two human breast cancer cell lines: responsive MCF7 cells and unresponsive MDA-MB-231 cells. Data presented here shows that the tocotrienol-rich fraction (TRF) of palm oil and individual fractions (alpha, gamma and delta) can also inhibit the growth of another responsive human breast cancer cell line, ZR-75-1. At low concentrations in the absence of oestrogen tocotrienols stimulated growth of the ZR-75-1 cells, but at higher concentrations in the presence as well as in the absence of oestradiol, tocotrienols inhibited cell growth strongly. As for MCF7 cells, alpha-tocopherol had no effect on growth of the ZR-75-1 cells in either the absence or presence of oestradiol. In studying the effects of tocotrienols in combination with antioestrogens, it was found that TRF could further inhibit growth of ZR-75-1 cells in the presence of tamoxifen (10(-7) M and 10(-8) M). Individual tocotrienol fractions (alpha, gamma, delta) could inhibit growth of ZR-75-1 cells in the presence of 10(-8) M oestradiol and 10(-8) M pure antioestrogen ICI 164,384. The immature mouse uterine weight bioassay confirmed that TRF could not exert oestrogen antagonist action in vivo. These results provide evidence of wider growth-inhibitory effects of tocotrienols beyond MCF7 and MDA-MB-231 cells, and with an oestrogen-independent mechanism of action, suggest a possible clinical advantage in combining administration of tocotrienols with antioestrogen therapy.
    MeSH terms: Animals; Antineoplastic Agents, Phytogenic/pharmacology; Antineoplastic Agents, Phytogenic/therapeutic use*; Breast Neoplasms/drug therapy*; Cell Division/drug effects; Estradiol/physiology; Estrogen Antagonists/pharmacology; Female; Humans; Tamoxifen/pharmacology; Tumor Cells, Cultured/drug effects; Uterus/drug effects; Vitamin E/pharmacology; Vitamin E/therapeutic use*; Mice
  19. Fulltext Lumbar puncture refusal in febrile convulsion
    Ling SG, Boey CC
    Singapore Med J, 2000 Oct;41(10):485-8.
    PMID: 11281439
    A descriptive study was carried out on patients admitted for febrile convulsion over a two-year period to determine rate of lumbar puncture (LP) refusal, factors associated with LP refusal and outcome of such patients. From 77 patients indicated and requested for LP, 19 (25%) patients refused the procedure. Refusal of LP was significantly more common among the Malay ethnic group (p = 0.01) but not significantly associated with age,gender or whether the patient was admitted for a first or recurrent febrile convulsion. Half of the patients who refused LP had to be started empirically on antibiotics for meningitis. Patients who refused LP were also 8.5 times more likely to discharge themselves "at own risk" (AOR), compared to other patients with febrile convulsion (p = 0.004). In conclusion, LP refusal is a common problem in the local setting and is a hindrance to the proper management of patients with fever and seizure. Appropriate measures must be carried out to educate the public, particularly those from the Malay ethnic group on the safety and usefulness of the procedure. Reasons for patients discharging AOR following LP refusal also need to be addressed and problems rectified.
    MeSH terms: Seizures, Febrile/therapy*; Culture; Female; Humans; Infant; Male; Meningitis/diagnosis; Meningitis/therapy; Parents; Singapore; Spinal Puncture*; Treatment Refusal*
  20. Fulltext A comparison of the maintenance and recovery charcateristic of sevoflurane-nitrous oxide against isoflurane-nitrous oxide anaesthesia
    Chiu CL, Chan YK, Ong GS, Delilkan AE
    Singapore Med J, 2000 Nov;41(11):530-3.
    PMID: 11284610
    To compare the maintenance and recovery characteristics of sevoflurane and isoflurane anaesthesia in Malaysian patients.
    MeSH terms: Adolescent; Adult; Anesthesia Recovery Period*; Blood Pressure/drug effects; Drug Therapy, Combination; Female; Heart Rate/drug effects; Humans; Isoflurane/pharmacology; Isoflurane/therapeutic use*; Malaysia; Methyl Ethers/pharmacology; Methyl Ethers/therapeutic use*; Middle Aged; Nitrous Oxide/pharmacology; Nitrous Oxide/therapeutic use*; Prospective Studies; Time Factors; Mastectomy, Segmental; Monitoring, Intraoperative; Anesthetics, Inhalation/pharmacology; Anesthetics, Inhalation/therapeutic use*
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