Penilaian analisa enzim dan isoenzim dalam diagnosa penyakit infarksi miokardia

Reference ranges for the following 1 cardiac 1 enzymes and isoenzymes were established, using sera from 99 patients attending the USM outpatients departments: Creatine kinase (CK),lactate dehydrogenase (LD),aspartate aminotransferase (AST),creatine kinase-MB isoenzyme (CKMB) and 5 lactate dehydrogenase isoenzymes (LD1,LD2,LD4 and LD5).The reference ranges for LD1/LD2 ratio, LD1 expressed as percentage of total LD ( LD1%); and LD1 expressed as enzyme activity in International Units LD (IU) were also determined.67 patients who were admitted to the cardiac care unit with suspicion of myocardial infarction were analysed for the above "cardiac" enzymes and isoenzymes. Out of the 67 patients who were admitted to the cardiac care unit ·40 were diagnosed positive and 27 as negative for myocardial infarction. Using the established reference ranges and the diagnoses (positive or negative for myocardial infarction), we determined the sensitivities, specificities and efficiencies for each of the above enzyme/isoenzyme/isoenzyme ratios, at 0-12 hr, 13-24 hr,25-48 hr, and 49-92 hr after the onset of chest pain.For all the above enzymatic parameters the sensitivities were low (42.4 to 68.6) at the interval 0-12 hr, and progressively increased at 13-24 hr (58.7 to 87.1), 25-48 hr (81.1 to 96.9), and 49-92 hr (82.4 to 100) after onset of chest pain. The specificities were higher than sensitivities at 0-12 hr (74.1-100), and 13-24 hr (89.5-96.6). Beyond 25 hr after the onset of chest pain, the specificities were camparable to 13-24 hr except for LD and ID1 ( IU), which had lower specificities compared to earlier pericxis. In general, the best combinations of sensitivities and specificities was during 13-48 hr after onset of chest pain.Based on our data on sensitivities and specificies, it would appear that routine determination of CK-M8 or LD isoenzymes may not be necessary in the diagnosis of most cases of myocardial infarction

Barrett's Esophagus in an Area with an Exceptionally Low Prevalence of Helicobacter pylori Infection

Objective. This study was undertaken to gain an insight into the relationship between Helicobacter pylori (H. pylori) infection, Barrett's esophagus and reflux esophagitis in an area of exceptionally low prevalence of H. pylori infection. Methods. A total of 1895 consecutive upper endoscopies performed between January 2005 and July 2007 were reviewed. 120 cases of columnar-lined esophagus and endoscopic esophagitis were evaluated. H. pylori infection was determined using the urease test and/or histology. Results. The rate of endoscopic esophagitis was 5.49% (80 Malays, 24 non-Malays) while histological reflux esophagitis was found in 3.75% (56 Malays, 15 non-Malays). Barrett's esophagus was present in 0.79% (11 Malays, 4 non-Malays). H. pylori infection was present in 8/120 or 6.67% subjects. Conclusion. The low rate of Barrett's esophagus in this population does not support the hypothesis that the absence of H. pylori infection is more than a minor risk factor for Barrett's esophagus

Comparison of the gene expression profile of undifferentiated human embryonic stem cell lines and differentiating embryoid bodies

BACKGROUND: The identification of molecular pathways of differentiation of embryonic stem cells (hESC) is critical for the development of stem cell based medical therapies. In order to identify biomarkers and potential regulators of the process of differentiation, a high quality microarray containing 16,659 seventy base pair oligonucleotides was used to compare gene expression profiles of undifferentiated hESC lines and differentiating embryoid bodies. RESULTS: Previously identified "stemness" genes in undifferentiated hESC lines showed down modulation in differentiated cells while expression of several genes was induced as cells differentiated. In addition, a subset of 194 genes showed overexpression of greater than ≥ 3 folds in human embryoid bodies (hEB). These included 37 novel and 157 known genes. Gene expression was validated by a variety of techniques including another large scale array, reverse transcription polymerase chain reaction, focused cDNA microarrays, massively parallel signature sequencing (MPSS) analysis and immunocytochemisty. Several novel hEB specific expressed sequence tags (ESTs) were mapped to the human genome database and their expression profile characterized. A hierarchical clustering analysis clearly depicted a distinct difference in gene expression profile among undifferentiated and differentiated hESC and confirmed that microarray analysis could readily distinguish them. CONCLUSION: These results present a detailed characterization of a unique set of genes, which can be used to assess the hESC differentiation

A split-mouth randomized controlled trial to compare the rate of canine retraction after a soft tissue procedure compared against a corticotomy procedure for accelerated tooth movement

Background and Aim: Various methods to accelerate the orthodontic tooth movement have been used, among which corticotomy is considered to be the most common one. The suggested reasoning for such acceleration was the regional acceleratory phenomenon (RAP). Since the RAP is a property of both the hard and soft tissues, we designed a soft tissue flap procedure to compare the effects with the conventional corticotomy procedure. A split-mouth study was conducted where the two procedures were assessed in a single participant. Patients and Methods: The total sample size was calculated to be 40 with 20 participants in each group. The rate of tooth movement was the primary outcome measure, and the secondary outcomes were dentoalveolar changes, which were studied in both the conventional corticotomy and the flap-only procedure based on a cone-beam computed tomography (CBCT) wherein the alveolar bone density (BD) around canines, tipping, and rotational changes in canines, premolars, and molars were assessed. Results: Corticotomy resulted in greater canine angulation, lesser canine rotation and premolar rotation, and greater molar rotation compared with flap elevation, but these differences were statistically insignificant. Conclusion: Though the corticotomy resulted in higher BD, the differences were statistically insignificant. There was no significant difference in the rate of space closure assessed by the two techniques compared

The Anti-Inflammatory and Antibacterial Basis of Human Omental Defense: Selective Expression of Cytokines and Antimicrobial Peptides

BACKGROUND: The wound healing properties of the human omentum are well known and have extensively been exploited clinically. However, the underlying mechanisms of these effects are not well understood. We hypothesize that the omentum tissue promotes wound healing via modulation of anti-inflammatory pathways, and because the omentum is rich in adipocytes, the adipocytes may modulate the anti-inflammatory response. Factors released by human omentum may affect healing, inflammation and immune defense. METHODOLOGY: Six human omentum tissues (non obese, free from malignancy, and any other systemic disorder) were obtained during diagnostic laparoscopies having a negative outcome. Healthy oral mucosa (obtained from routine oral biopsies) was used as control. Cultured adipocytes derived from human omentum were exposed to lipopolysaccharide (LPS) (1-50 ng/mL) for 12-72 hours to identify the non-cytotoxic doses. Levels of expression (mRNA and protein) were carried out for genes associated with pro- and anti-inflammatory cytokine responses and antibacterial/antimicrobial activity using qRT-PCR, western blotting, and cell-based ELISA assays. RESULTS: The study shows significant higher levels of expression (mRNA and protein) of several specific cytokines, and antibacterial peptides in the omentum tissues when compared to oral sub-mucosal tissues. In the validation studies, primary cultures of adipocytes, derived from human omentum were exposed to LPS (5 and 10 ng/mL) for 24 and 48 h. The altered expressions were more pronounced in cultured adipocytes cells when exposed to LPS as compared to the omentum tissue. CONCLUSIONS/SIGNIFICANCE: Perhaps, this is the first report that provides evidence of expressional changes in pro- and anti-inflammatory cytokines and antibacterial peptides in the normal human omentum tissue as well as adipocytes cultured from this tissue. The study provides new insights on the molecular and cellular mechanisms of healing and defense by the omentum, and suggests the potential applicability of cultured adipocytes derived from the omentum for future therapeutic applications

ORIGINAL ARTICLE - THE PHARMACOKINETICS OF SINGLE DOSE VS STEADY-STATE DOSES OF PROPRANOLOL IN CIRRHOTIC MALAY PATIENTS

Pharmacokinetics of propranolol (PRN) given orally were studied in twelve cirrhotic Malay patients [10 males, 2 females], aged 33-62 years [49.83±9.17], body weight 39-72 kg [58.0±8.46] and height 142-168 cm [158.8±7.89] following single 20 mg and steady-state 20 mg tds for 7 days dosing of PRN. Blood samples were withdrawn hourly up to 48 hours. PRN concentrations in the plasma were assayed by HPLC with oxprenolol as the internal standard. Pharmacokinetic parameters were analysed using a non-linear regression program MultiForte. Area under the curve (AUC) as performed using the linear trapezoidal rule. Student' s t-test was used to test for statistical significance and AUC in Malay cirrhotic patients was found to be much bigger than that observed in Caucasians. Steady-state AUC was significantly increased following multiple dosing (961.31±7.47 vs 2954.19±1153.34 ng.hr/ml), however, the volume of distribution (Vd) declined (543.89±292.91 vs 224.14±1003.12 L) significantly compared to that of a single dose. The apparent systemic clearance (CL) was significantly reduced at steady-state (436.04±209.4 vs 129.51±48.42 ml/min) in comparison to single dose therapy. The peak plasma concentration (Cpmax) was greatly increased at steady-state (54.32±22.37 vs 136.10±38.63 ng/ml). Based on the AUC, PRN bioavailability was greater in cirrhotic Malay patients compared to Caucasians who took only 20 mg instead of 80 mg doses. The decline in drug clearance following steady-state was due to saturation of the metabolizing capacity of hepatic enzymes and a decreased portal blood flow. Reduced Vd was believed to be caused by increased drug-receptor interactions and decreased tissue/protein binding of PRN in these patients

ORIGINAL ARTICLE - THE EFFECT OF PROPRANOLOL IN MALAY PATIENTS WITH LIVER CIRRHOSIS – A PHARMACODYNAMIC EVALUATION

The pharmacodynamics of propranolol were studied in 12 cirrhotic Malay patients. Fifteen healthy Malay volunteers were selected and several clinical parameters were obtained. The effects of three doses of propranolol in reducing the heart rate (HR) of these patients were observed to be significantly different. These differences were seen at dosing of 10 mg vs 20 mg and 10 mg vs 30 mg (P<0.001 and P<0.01, respectively). However, no significant difference was seen for doses between 20 mg vs 30 mg. At 20 mg the reduction in HR is more pronounced than the effect seen with the other two doses. The effects of propranolol in reducing Vmax and Vmean of portal vein blood flow were found to be not significant at doses of 10 mg vs 30 mg, but between 10 mg vs 20 mg and 20 mg vs 30 mg there was significant difference (P<0.05 and P<0.01, respectively). Reduction of Vmax of more than 10% of baseline was achieved at doses of 10 mg and 20 mg. However, at a dose of 20 mg a more significant reduction was observed than at a dose of 10 mg. Dose-concentration-effect relationship was seen to be significantly different between HR reduction and propranolol concentration of the three steady-state levels (P<0.001). Similar results were obtained with Vmax and Vmean. The Vmax was found to be a reliable parameter for the assessment of therapeutic effect of the drugs in conferring changes in portal haemodynamics of liver cirrhotic patients. Further, Child-Pugh score is thought to be an important supporting factor in evaluating prognosis. The results of this pharmacodynamics studies suggest that the optimal dose of propranolol may be 20 mg propranolol thrice daily for cirrhotic Malay patients

Computer Aided Design of Centrifugal Pump

The design of centrihgal pump involves a large number of empirical data derived from experimental evaluation of pumps. For any small change in input details, it requires a complete rework of design procedure. Even after following this detailed, time consuming procedure, it was very difficult to explain the geometry of the pump elements. This paper discusses the optimisation and computerisation of the design procedure of single stage centrifUga1 pumps. The design procedure was developed using Graphical User Interface software with Visual Basic 5.0 and interfaced with a specially developed AutoLISP program in AutoCAD R13 environment. An algorithm for generating the Cartesian co-ordinates of the designed pump elements was evolved and incorporated in the program, which are used to show the geometrical shapes of the pump elements and also used as an input data for the Auto LISP program for generating three-dimensional views of the pump components. The options and utilities made available through a single program enables the user to design, view, redesign and optimize the pump geometry till it reaches a satisfactory value. The developed software is user-friendly and can be used as a design tool to configure an optimum pump geometry for a given duty like discharge and head

Not Available

Crop Residue ManagementCrop Residue ManagementNot Availabl