Oligostilbenoids are polyphenols that are widely distributed in nature with multifaceted biological activities. To achieve biomimetic synthesis of unnatural derivatives, we subjected three resveratrol analogues to oligomerization by means of one-electron oxidants. Upon varying the metal oxidant (AgOAc, CuBr(2), FeCl(3)6 H(2)O, FeCl(3)6 H(2)O/NaI, PbO(2), VOF(3)), the solvent (over the whole range of polarities), and the oxygenated substitution pattern of the starting material, stilbenoid oligomers with totally different carbon skeletons were obtained. Here we propose to explain the determinism of the type of skeleton produced with the aid of hard and soft acid/base concepts in conjunction with the solvating properties of the solvents and the preferred alignment by the effect of pi stacking.
OBJECTIVE: To assess bone mineral density (BMD) changes in patients with systemic lupus erythematosus (SLE) undergoing longterm therapy with corticosteroids (CS) while taking calcium, calcitriol, or alendronate. The primary endpoint was BMD changes at 2 years.
METHODS: Premenopausal SLE patients were randomized into 3 groups according to medication: calcium carbonate 500 mg bd (calcium alone), calcitriol 0.25 microg bd plus calcium carbonate 500 mg bd (calcitriol + calcium), and alendronate 70 mg/week plus calcium carbonate 500 mg bd (alendronate + calcium). BMD was measured at baseline and at the end of the first and second years.
RESULTS: Ninety-eight patients were recruited. There were 33 patients taking calcium alone, 33 calcitriol + calcium, and 32 alendronate + calcium. On randomization, median duration of CS use was 2.5 years (range 0-20 yrs). Seventy-seven patients (78.6%) completed the study (23 taking calcium alone, 27 calcitriol + calcium, 27 alendronate + calcium). There were no significant differences in mean CS dosages among the 3 groups at the time of BMD measurements. After 2 years, there were no significant changes in BMD in the calcium-alone and calcitriol + calcium groups, apart from a 0.93% (p < 0.001) reduction in total hip BMD in the calcium-alone group. In contrast, the alendronate + calcium group showed significant increases in BMD of 2.69% (p < 0.001) in the lumbar spine and 1.41% (p < 0.001) in total hip.
CONCLUSION: Both calcium alone and calcitriol + calcium preserved lumbar spine BMD in premenopausal patients with SLE taking longterm CS at 2 years, whereas alendronate + calcium led to increases in BMD in lumbar spine and total hip. Premenopausal women taking CS should be considered for osteoporosis prophylaxis.
Study site: Outpatient clinics in 2 teaching hospitals in Kuala Lumpur, Malaysia
Attitudes toward cervical cancer and participation in early detection and screening services are well known to be profoundly affected by cultural beliefs and norms.
MeSH terms: Adult; Anxiety/psychology; Uterine Cervical Neoplasms/ethnology*; Uterine Cervical Neoplasms/prevention & control*; Uterine Cervical Neoplasms/psychology; Cross-Cultural Comparison*; Culture; Female; Gender Identity; Health Education; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Mass Screening/psychology*; Middle Aged; Patient Acceptance of Health Care/psychology; Vaginal Smears/psychology*; Young Adult; Papanicolaou Test*
Sexually transmitted infections (STIs) are an increasingly common and important cause of a fever in a returning traveler. Systemic complications of STIs, human immunodeficiency virus seroconversion illness, and secondary syphilis are diagnoses that can easily be missed. We present a case of culture-negative disseminated gonococcal infection presenting with fever, malaise, polyarthralgia, arthritis, and a rash that developed following orogenital contact and was diagnosed using real-time polymerase chain reaction. This technology has major potential to improve the speed and sensitivity of diagnosis and consequent management of patients with this syndrome.
Study site: United Kingdom (patient had recent travel to Thailand and Malaysia)
Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm that occurs almost exclusively in the nasopharynx of adolescent males. Surgery remains the primary treatment of choice. JNA has always presented a management challenge to surgeons because of its vascular nature, site of occurrence, and local tissue destruction. The surgical approaches are either standard open method which include external or intraoral incisions, or the recent advanced approach, i.e. via using the endonasal endoscope. It is widely accepted that the use of preoperative angiographic embolization reduces the occurrence of intraoperative bleeding and facilitates tumour removal. However, angiographic embolization is not available at all centres. The purpose of this article is to present our experience with five patients diagnosed with JNA who were resected without embolization, using various surgical approaches. Two tumours were removed via endonasal endoscopic surgery. None of the tumours were embolized prior to surgery. We highlight the preoperative evaluation of tumour extent, using both computed tomography (CT) and magnetic resonance angiography, and the importance of temporary clamping of the external carotid artery intraoperatively. Our results suggest that the latter procedure is a safe and effective means of facilitating surgery and reducing intraoperative bleeding.
The prevalence of thyroid-associated ophthalmopathy (TAO) has been reported to be lower in several Asian populations than in Caucasians. The risk factors for TAO that have been demonstrated in Caucasians have not been studied in Asian populations. The aim of this study, therefore, was to determine the prevalence, risk factors, and clinical features of TAO in a cohort of multiethnic Malaysian patients with Graves' disease (GD).
The effects of inulin on the microbial composition and faecal characteristics in 36 healthy, formula-fed infants (average age 7.7 months) given 3 different daily dosages of native inulin (0.75 g/day, 1.00 g/day, and 1.25 g/day) were studied. At all levels of inulin consumption, a significant (p<0.05) reduction of potential pathogenic microorganisms such as clostridia was found. An intake of 1.25 g/day of inulin caused a significant (p<0.05) increase of Bifidobacterium spp. as well as a significant (p<0.05) decline in Gram-positive cocci and coliform bacteria. Inulin consumption resulted in a significant (p<0.05) decrease in faecal pH value and changes in faecal weight, faecal texture and colour, indicating improvement in healthy bile production and bacterial fermentation. It is concluded that inulin consumption in formula-fed infants after weaning positively affected the microbial composition of faeces and faecal properties.
Images of scanning electron microscope are usually in the monochrome mode. A simple and user-friendly approach is proposed to improve the mechanical contrast of the scanning electron microscope grey images. Also, most colourization techniques involve image segmentation or region tracking, which tend to degrade the image with fuzzy or complex region boundaries. A technique is proposed, which is a hybrid between the Canny edge detection technique and the optimization technique. Compared with existing methods, the new Canny optimization technique gives satisfactory results for scanning electron microscope images.
Evidence based on average patient data, which occupies most of our present day information databases, does not fulfil the needs of individual patient-centred health care. In spite of the unprecedented expansion in medical information we still do not have the types of information required to allow us to tailor optimal care for a given individual patient. As our current information is chiefly provided in disconnected silos, we need an information system that can seamlessly integrate different types of information to meet diverse user group needs. Groups of certain individual medical learners namely patients, medical students and health professionals share the patient's need to increasingly interact with and seek knowledge and solutions offered by others (individual medical learners) who have the lived experiences that they would benefit to access and learn from. A web-based user-driven learning solution may be a stepping-stone to address the present problem of information oversupply in medicine that mostly remains underutilized, as it doesn't meet the needs of the individual patient and health professional user. The key to its success would be to relax central control and make local trust and strategic health workers feel more engaged in the project such that it is truly user-driven.
MeSH terms: Biometry; Cooperative Behavior; Decision Support Techniques; Diffusion of Innovation; Female; Health Services Needs and Demand/organization & administration*; Humans; Patient Education as Topic/organization & administration*; Physician-Patient Relations; Random Allocation; Research Design; Purpura, Thrombocytopenic, Idiopathic/diagnosis; Purpura, Thrombocytopenic, Idiopathic/psychology; Purpura, Thrombocytopenic, Idiopathic/therapy; Models, Educational; Community Health Planning; Problem-Based Learning; Patient-Centered Care/organization & administration*; Observation; Internet/organization & administration*; Narration
The hypothesis in the conceptual model was that a user-driven innovation in presently available information and communication technology infrastructure would be able to meet patient and health professional users information needs and help them attain better health outcomes. An operational model was created to plan a trial on a sample diabetic population utilizing a randomized control trial design, assigning one randomly selected group of diabetics to receive electronic information intervention and analyse if it would improve their health outcomes in comparison with a matched diabetic population who would only receive regular medical intervention. Diabetes was chosen for this particular trial, as it is a major chronic illness in Malaysia as elsewhere in the world. It is in essence a position paper for how the study concept should be organized to stimulate wider discussion prior to beginning the study.
MeSH terms: Attitude of Health Personnel; Diabetes Mellitus, Type 2/metabolism; Diabetes Mellitus, Type 2/prevention & control; Diabetes Mellitus, Type 2/psychology; Health Services Needs and Demand/organization & administration*; Humans; Malaysia; Medical Record Linkage; Operations Research; Patient Education as Topic/organization & administration*; Patient Participation/methods; Patient Participation/psychology; Social Support; Medical Records Systems, Computerized/organization & administration; Outcome Assessment (Health Care); Models, Educational*; Models, Organizational; Patient-Centered Care/organization & administration*; Internet/organization & administration*; Qualitative Research; Cell Phones
Efficacy of Morinda citrifolia L. leaf (MLE) and fruit extracts (MFE) in inhibiting lipoprotein lipase (LPL) was determined in vitro. The result of the study showed that the highest inhibition on the LPL activity was exhibited by MLE (66%+/- 2.1%), which is significantly higher than that demonstrated by MFE (54.5%+/- 2.5%), green tea extract (GTE) (54.5%+/- 2.6%), and catechin (43.6%+/- 6.1%). Percent of LPL inhibition increase with concentration of the extracts. Quantitative analysis of the extracts revealed the presence of high levels of (+)-catechin at 63.5 +/- 17 and 53.7 +/- 5.7 mg/g in MLE and MFE, respectively, although not as high as that found in GTE (530.6 +/- 42 mg/g). Appreciable amount of epicatechin was found in all extracts tested, while rutin was only found in MLE and MFE. The study suggested that both leaf and fruit of M. citrifolia may be used as antiobesity agents in body weight management.
The conservative approach in the treatment of maxillofacial trauma in children has been widely adopted. The type of fracture and its presence within the growing facial skeleton along with the presence of tooth buds may result in different management strategies to that employed in adults. An understanding of conservative treatment options is essential to make informed choices which will best manage these injuries, and an example is presented in this paper. This case report describes a 14-year-old boy who sustained trauma to the chin as a result of a fall, causing a mandibular symphyseal fracture. He was successfully treated by the means of applying direct interdental wiring combined with an acrylic splint.
To examine the effects of short duration stress management training (SMT) on self-perceived depression, anxiety and stress in male automotive assembly workers, 118 male automotive workers from Pekan, Pahang (n = 60, mean age = 40.0 years, SD = 6.67) and Kota Bharu, Kelantan (n = 58, mean age = 38.1 years, SD = 5.86) were assigned to experimental and control group, respectively. A SMT program consisting of aerobic exercise, stress management manual, video session, lecture, question and answer session, and pamphlet and poster session were conducted in the experimental group. A validated short-form Malay version of the Depression Anxiety Stress Scales (DASS-21) were self-administered before and after the intervention program in the experimental and control group and their time and group interaction effects were examined using the repeated measure ANOVA test. Results indicated that the mean (SD) scores for DASS-Depression (p = 0.036) and DASS-Anxiety (p = 0.011) were significantly decreased, respectively, after the intervention program in the experimental group as compared to the control group (significant time-group interaction effects). No similar effect was observed for the mean (SD) scores for DASS-Stress (p = 0.104). However, the mean (SD) scores for subscales of DASS-Depression (Dysphoria, p = 0.01), DASS-Anxiety (Subjective Anxiety, p = 0.007, Situational Anxiety, p = 0.048), and DASS-Stress (Nervous Arousal, p = 0.018, Easily Upset, p = 0.047) showed significant time and group interaction effects. These findings suggest that short duration SMT is effective in reducing some aspects of self-perceived depression, anxiety and stress in male automotive workers.
PURPOSE: To investigate the level and distribution of stresses in endodontically treated maxillary premolar teeth restored using various cavity designs of bonded all-ceramic restorations. The hypothesis tested was that the various all-ceramic approaches, including incorporating a pulp chamber extension in the restoration, had no influence on the stresses in the restored tooth unit.
METHODS: Finite element packages Patran and Abaqus were used for the stress analysis. The cavity designs investigated include: (1) inlay (I); (2) inlay with palatal cusp coverage (IPC); (3) onlay (O); (4) inlay with pulp chamber extension (IPE); (5) inlay with palatal cusp coverage and pulp chamber extension (IPCPE); and (6) onlay with pulp chamber extension (OPE).
RESULTS: In each case, tensile stresses were found to be concentrated subjacent to the occlusal fossa. Peak tensile stress and peak shear stress values along the tooth/restoration interface for IPC, O IPCPE and OPE cavity designs were found to be associated with the axiogingival line angle. Overall, the order of the various forms of restoration investigated in terms of the maximum principal stress (from greatest to lowest) was as follows: IPE > IPCPE > OPE > I > IPC > O.
Embryonic stem cells (ESCs) can be an inexhaustible source of islet cells for transplantation. Previously published protocols have been characterized by low differentiation efficiency. In this study, we developed a scalable system for the growth and differentiation of hESCs towards pancreatic islets. Our results showed that hESCs can be grown on microcarriers to a larger scale and directed to differentiate into pancreatic progenitor endoderm cells. This culture system would represent an economical differentiation protocol that can be scaled-up to meet the demand in islet transplantation.
MeSH terms: Diabetes Mellitus/therapy*; Humans; Insulin/biosynthesis; Islets of Langerhans/cytology*; Pilot Projects; Stem Cells/cytology; Islets of Langerhans Transplantation/methods*; Insulin-Secreting Cells; Embryonic Stem Cells/cytology*; Embryonic Stem Cells/transplantation
Nerve stem cells have a unique characteristic in that they form spherical aggregates, also termed neurospheres, in vitro. The study demonstrated the successful derivation of these neurospheres from bone marrow culture. Their plasticity as nerve stem cells was confirmed. The findings further strengthens the pluripotency of cell populations within the bone marrow.
Human adipose-derived stem cells (HADSC) have demonstrated the capacity of differentiating into bone depending on the specific induction stimuli and growth factors. However, investigation on stem cell characteristic after osteogenic differentiation is still lacking. The goal of this study was to investigate the differential expression of sternness and osteogenic genes in non-induced HADSC compared with HADSC after osteogenic induction using quantitative Real Time RT-PCR. Our results showed that OCT-4, REX-1, FZD9, OSC, RUNX, and ALP were up regulated after osteogenic induction. This may indicated that HADSCs after osteogenic induction still possessed some stemness properties.
The objective of this study was to investigate the angiogenic potential of human chorion-derived stem cells (CDSC) cultured in medium containing bFGF and VEGF (EDM50). Total RNA was extracted from cells cultured in FD+10% FBS and EDM50. Quantitative RT-PCR was carried out to score the differential mRNA expression of genes involve in angiogenesis and endothelial differentiation. Our finding demonstrated that all angiogenic and endothelial associated genes were expressed higher in EDM50. Expression level of ANG-1, eNOS and VEGFR2 were significantly higher in EDM50 compared to FD+10% FBS. Our results suggested that human CDSC cultured in EDM50 can be used for angiogenesis purpose in regenerative medicine.