The L-amino acid oxidase (EC 1. 4. 3. 2) from King cobra (Ophiophagus hannah) venom was purified to electrophoretic homogeneity. The molecular weight of the enzyme was determined to be 140000 when examined by gel filtration and 68000 by SDS-polyacrylamide gel electrophoresis. The enzyme had an isoelectric point of 4.5 and an intravenous LD50 of 5 micrograms/g in mice. It is a glycoprotein and contains two moles of FAD per mole of enzyme. The enzyme exhibited unusual thermal stability and unlike most other venom L-amino acid oxidases, it was stable in alkaline solution and was not inactivated by freezing.
A female Malay patient with acute lymphoblastic leukemia in remission for one year developed bilateral visual loss. The ophthalmoscopic appearance showed infiltration of optic nerves and retinae by leukemic cells. At that time, her blood, bone marrow and cerebral spinal fluid remained normal. She had received prophylactic cranial irradiation and intrathecal methotrexate as part of the treatment programme. It was likely therefore she had a leukemic relapse from a pharmacologic sanctuary in the eyes. She responded to local irradiation but did not regain her sight. Three months later, she had a bone marrow relapse.
A report of 25 cases of neurosyphilis seen in University Hospital, Kuala Lumpur since 1970. Classical form of the disease still constitute the majority of the patients with often long delay before diagnosis.
Although most anatomical pathologists have encountered breast lesions with the composite histological features of fibroadenoma (FA) and fibrocystic change (FC), referred to as fibroadenomatosis or fibroadenomatoid mastopathy (FAM), little is known about its prevalence or clinico-pathological significance. In a retrospective histological review of 400 consecutive breast lesions, among both East and West Malaysians, coded either as FA or FC in the files of the Department of Pathology, University of Malaya, we found 45 (11.3%) cases of FAM. Typically, FAM lesions showed fibroadenomatoid foci in a background of fibrocystic change. The finding of FAM among lesions coded as FC was higher (18.5%) than among FA (4%). The mean age of patients with FAM (32.1 years) was similar to FC (35.1 years) but significantly older than that of FA (26.1 years). The notion that FA and FC are lesions at two ends of a spectrum of growth disorder of breast related to oestrogen-progesterone interplay, and that FAM occupies a position intermediate between the two, may explain its morphological and age patterns, but remains speculative. It is hoped that increasing awareness of this condition will lead to better understanding of breast pathophysiology. Nevertheless, until its biological nature, histogenesis and malignant potential are more clearly understood, defining FAM as a distinct form of breast disease may not be meaningful to patient management.
A retrospective study of 62 cases of myasthenia gravis in Malaysia is reviewed. It shows an apparent prevalence among the ethnic Chinese compared with the Malay and Indian. The incidence of male and female and their average age of onset are similar. Unlike the western figure, among those with age of onset less than 20 years. both sexes are equally affected. The symptomatology, morbidity and mortality and incidence of thymoma are the same as those
reported elsewhere.
An investigation of an outbreak of acute conjunctivitis in Kuala Lumpur from May to August 1978 was made. A total of 2,133 cases was involved, most of whom were adult Malay males of low income status from the surrounding villages and low-cost flats. The majority of cases had bilateral conjunctivitis with clear discharge. Pain and subconjunctival haemorrhage were not common and recovery, mostly without complications, occurred within 1 week. Eye scrapings and paired sera specimens were examined and the causal agent was found to be Coxsackievirus A24 (CA24).
1. Substrate specificity of purified king cobra (Ophiophagus hannah) venom L-amino acid oxidase was investigated. 2. The enzyme was highly specific for the L-enantiomer of amino acid. Effective oxidation of L-amino acid by the enzyme requires the presence of a free primary alpha-amino group but the alpha-carboxylate group is not as critical for the catalysis. 3. The enzyme was very active against L-Lys, L-Phe, L-Leu, L-Tyr, L-Tryp, L-Arg, L-Met, L-ornithine, L-norleucine and L-norvaline and moderately active against L-His, L-cystine and L-Ileu. Other L-amino acids were oxidized slowly or not oxidized. 4. The data suggest the presence of a side chain binding site in the enzyme, and that the binding site comprises at least five 'subsites': the hydrophobic subsites a, b and c; and the two 'amino' binding subsites d and e. Subsite b appears to be able to accommodate two methylene/methyl carbons.
A joint pilot project between the Ministry of Health and the Department of Social and Preventive Medicine, University of Malaya, to test the value of village aides in extending the health care system into isolated Iban communities was started in May 1979 in the Entabai District of Sarawak. A group of 15 village aides consisting of 11 traditional Iban manangs (medicine-men) and 4 youths were trained to provide primary health care including simple curative care, preventive care and to assist in the detection of malaria. Evaluation carried out 2 years later showed the following. In respect of curative care, the village aides were each, on the average, treating 70.6 patients per month, the most common illness being headaches (30.4 percent), which together with abdominal pain, constipation, bodyaches, diarrhoea, vomiting, fever, worm infestations, cough and sore throat, accounted for 89 percent of all illnesses seen by them. Subsequent to the introduction of village aides in the project area, the number ofseriously ill patients requiring admission to the rest beds of the klinik desa dropped by 43.8 percent and the number of emergency referrals to the back-up divisional hospitals fell by 46.1 percent showing that patients were coming to the klinik desa for treatment at an earlier stage. The 11 traditional Iban manangs, who had received training had, on their own accord, drastically reduced the use of traditional Iban modes of therapy in preference for "modern" medicine. During the 24 months immediately after the introduction of village aides into Entabai, 9 gravity feed water supply systems together with the related "health package" advocating general cleanliness, the use of latrines andfences were effected, whereas only 6 such systems were installed in the previous 24 months, indicating that it is likely that the village aides were of some assistance in mobilizing the community is respect of these self-help efforts. During the same period, the majority of longhouses in the area successfully established a number of vegetable gardens growing foods for home consumption, and continue to vigorously advocate breast feeding of infants in opposition to bottle feeding. During the 23 months after village aides were introduced, a total of 1,093 blood films were collected by the 15 village aides, the average number of blood films per village aide being 3.2 blood slides per month. Village aides are socially accepted by the Iban community who utilize their curative skills when mild illnesses disturb them, but who proceed directly to the klinik desa when more serious illnesses such as fevers strike them. The project has established clear lines of communication between the health team and the community, and has stimulated the community to organize itself to achieve an increasingly high level of health through community participation and self reliance. Plans have been approved in principle to train a further 2000 village aides in primary health care for the state of Sarawak.
The effect of oxytocin on testicular function was examined in the adult male long-tailed macaques (Macaca fascicularis). The monkeys were either infused with increasing concentrations of synthetic oxytocin (16-128 m.i.u./min for 3 h) or injected daily for a week with the same hormone (20 i.u., i.v.) and the plasma testosterone levels measured. The results of the present study show that acute infusion or chronic injection of oxytocin does not significantly affect the plasma testosterone levels, suggesting that systemic control of testicular endocrine function by oxytocin may be unimportant.
31 cases of ocular toxoplasmosis were seen at the Ophthalmology Clinic, Uniuersiti Kebangsaan Malaysia, Kuala Lumpur during a one-and-a-half year period. All these cases were diagnosed as congenital ocular toxoplasmosis. As this condition appears not to be uncommon in. Malaysia, greater effort should be made towards its prevention especially among pregnant women.
Study site: Ophthalmology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Male albino rats were chronically loaded with sodium by giving 1% NaCl solution as the sole source of drinking water. Daily fluid intake, daily urinary output and daily Na+ and K+ excretion rates were compared with control rats receiving tap water for six weeks. At the end ofsix weeks, sodium loaded animals were found to have raised plasma Na+ concentration, lowered plasma K+ concentration and lowered haematocrit value. Sodium loaded rats were also significantly more responsive to the pressor effect of submaximal doses of adrenaline, noradrenaline and angiotensin II given intravenously. It is concluded that the increase in sensitivity to adrenaline and noradrenaline may be due to changes in EGF and alterations of plasma electrolytes concentration. For angiotensin II, additionally, it may be due to low circulating endogenous angiotensin II, consequent of reduction in renin release attributed to chronic sodium loading.
1. The edema-inducing activity of 24 venoms from snakes of the subfamilies of Elapinae, Hydrophiini, Crotalinae and Viperinae was determined. 2. All snake venoms tested are very potent edema inducers. The minimum edema doses of the venoms ranged from 0.16 to 3.41 micrograms per mouse paw. 3. The venoms induced a rapid onset edema which peaked within 1 h of injection and declined thereafter; at low dose, however, some venoms induced a rapid onset edema that sustained over a longer duration.
Toxoplasmosis was found not to be an important cause of intrauterine infection in Malaysia as the rate of toxoplasma-specific IgM in 1,060 congenitally defective Malaysian children, 0 to 4 months old (0.4%) was lower than that in 405 normal children of the same age group (2.0%). A total of 8.2 intra-uterine toxoplasmic infections per 1,000 live births was detected of which one-third (2.7 per 1,000 live births) was overt, manifesting symptoms more of liver damage, than eye or brain damage. A comparison was made with the rates in U.S.A. and Europe. The role of toxoplasmosis in abortion needs to be studied.
Three hundred and ninety five cases in 358 consecutive patients (male-232, female-126) with renal and ureteric stones were treated with extracorporeal shockwave lithotripsy (ESWL) from March to November 1988. They either had ESWL alone, or in combination with stone manipulation or debulking percutaneous nephrolithotripsy (PCNL). Seventy five percent of the stones were found in the pelvicalyceal system and 25% in the ureter. Seventy-six percent of the stones were less than 25mm size. Two hundred and ninety (79%) cases were followed up to three months. Two hundred and forty nine (85.9%) cases were stone free and 36 (12.4%) had residual sand less than 3mm size. Five (1.7%) cases failed to fragment with ESWL monotherapy and were salvaged by either percutaneous or ureteroscopic intervention. None of the cases required any open surgery intervention.
Sixty eight consecutive cases of percutaneous renal surgery, percutaneous nephrolithotripsy (PCNL), were performed on 64 patients (male-41, female-23) at the Subang Jaya Medical Centre from April 1988 to July 1989. All the cases were done as a one stage procedure. Fifty eight stones were large renal or staghorn and ten were ureteric. Thirty cases (41%) were stone free after PCNL alone. Thirty eight cases had residual fragments needing extracorporeal shockwave lithotripsy (ESWL). Mean operating time was 109.6 +/- 36.0 minutes. Mean hospital stay was 4.5 +/- 1.8 days. At three months follow-up, 86% of the cases were stone free. The remaining had residual sand (less than 3mm). Minor complications occurred in six patients. None required major surgical intervention post PCNL.