MATERIALS AND METHODS: Tocotrienol-rich fraction was used to treat different stages of cellular aging of primary human diploid fibroblasts viz. young (passage 6), pre-senescent (passage 15) and senescent (passage 30). Several selected targets involved in the downstream of PI3K/AKT and RAF/MEK/ERK pathways were compared in total RNA and protein.
RESULTS: Different transcriptional profiles were observed in young, pre-senescent and senescent HDFs, in which cellular aging increased AKT, FOXO3, CDKN1A and RSK1 mRNA expression level, but decreased ELK1, FOS and SIRT1 mRNA expression level. With tocotrienol-rich fraction treatment, gene expression of AKT, FOXO3, ERK and RSK1 mRNA was decreased in senescent cells, but not in young cells. The three down-regulated mRNA in cellular aging, ELK1, FOS and SIRT1, were increased with tocotrienol-rich fraction treatment. Expression of FOXO3 and P21Cip1 proteins showed up-regulation in senescent cells but tocotrienol-rich fraction only decreased P21Cip1 protein expression in senescent cells.
CONCLUSIONS: Tocotrienol-rich fraction exerts gene modulating properties that might be responsible in promoting cell cycle progression during cellular aging.
MATERIALS AND METHODS: This is a prospective study performed from January 2010 until March 2011. All open hepatic resection were included. Dry white gauze is compressed onto the transected surface and observed for bile staining. The leaking duct is repaired immediately upon detection. The process is repeated until negative. Drain was removed on postoperative day-5. Post-operative bile leak is defined as: 1. Bilirubin concentration of the drain fluid is 3 times or higher than serum; 2. Presence of intra-abdominal bile collection on imaging and upon drainage; 3. Bile leak demonstrated on postoperative cholangiography.
RESULTS: 42 patients were recruited. Seven (16.7%) patients were cirrhotic with Child-Pugh A. White gauze test were positive for intra-operative bile leaks in 29 patients (70%), which were primarily repaired. As a result, there was no postoperative bile leak in this series. One mortality was detected in this series due to postoperative pancreatic fistula and multi organ failure.
CONCLUSIONS: The White Gauze Test is a useful method for the prevention of bile leakage after hepatic resection. It is safe, quick and cheap.
MATERIALS AND METHODS: This is questionnaire-based observational comparative study. Once the questionnaire is filled, the application of CP is tested on an airway model and competency level is documented. An education hand out is passed to all participants after the procedure. The improvement and knowledge retention were assess after 2 month.
RESULTS: A total of 81 completed surveys were returned comprises of of 34 medical officers, 23 staff nurses and 24 assistant medical officers. 75.3% subjects have work experience more than a year but only 59.3% of them were trained in CP application. A total of 69.1% participants passed the pre educational handout test and 100% passed the post educational handout test. However, for pre educational handout phase, 81.5% participants passed the theory part while only 42% passed the practical component. In post educational handout phase, the number of respondents who passed both components was 97.5% and 63% respectively. There are positive correlation between designation and working experience with overall passes in this study.
CONCLUSIONS: The theoretical knowledge of CP is satisfactory but clinical application is poor especially in the pre educational handout phase. The educational handout is proved to improve the knowledge transfer and retention with regards to CP.