Immune modulation effect of porcine placenta extracts in weaned the pig.

In a previous study, we established a collection of appropriate porcine placental extracts using PBS at 80°C (PE-PBS80) as a food supplement to increase immune activities in a mice model. In this study, piglets were treated with 0.1%, 0.3%, and 0.5% PE-PBS80 for 3 wk after weaning. Experiments were performed at 2 separate farms using 2 different pig varieties. Composition of white blood cells, lymphocyte activation, and cytokine concentrations were analyzed to assess the immune modulation effect. In Exp. 1, the number of white blood cells increased significantly in the PE-PBS80 treatment and T- and B-cell activation increased as well (P < 0.01). Interestingly, piglets in all treatments in Exp. 2 were naturally infected by a rotavirus at the third day of the experiment but recovered after d 10. Increased lymphocyte activation was observed in the PE-PBS80 treatment (P < 0.01) regardless of viral infection. Additionally, unlike in Exp. 1, the percentage of granulocytes and concentrations of interferon-γ, IL-1ß, and IgG increased in the PE-PBS80 treatment (P < 0.01) and were more active in the 0.3% PE-PBS80 treatment compared with the control and the other treatment. In conclusion, 0.3% PE-PBS80 treatment modulated immune activities in antigen-infected piglets. Therefore, the PE-PBS80 pig placental extract, particularly the 0.3% supplement to the normal diet, could be useful as an alternative feed supplement to modulate immune activity during the early piglet period.

Physical properties of Gelidium corneum-gelatin blend films containing grapefruit seed extract or green tea extract and its application in the packaging of pork loins.

Edible Gelidium corneum-gelatin (GCG) blend films containing grapefruit seed extract (GFSE) or green tea extract (GTE) were manufactured, and the quality of pork loins packed with the film during storage was determined. Tensile strength (TS) and water vapor permeability (WVP) of the films containing GFSE or GTE were better than those of the control. The film's antimicrobial activity against Escherichia coli O157:H7 and Listeria monocytogenes increased with increasing antimicrobial concentration, resulting in a decrease in the populations of bacteria by 0.77 to 2.08 and 0.91 to 3.30 log CFU/g, respectively. Pork loin samples were inoculated with E. coli O157:H7 and L. monocytogenes. The samples packed with the GCG film containing GFSE (0.08%) or GTE (2.80%) had a decrease in the populations of E. coli O157:H7 and L. monocytogenes of 0.69 to 1.11 and 1.05 to 1.14 log CFU/g, respectively, compared to the control after 4 d of storage. The results showed that the quality of pork loins during storage could be improved by packaging them with the GCG film containing GFSE or GTE.

A preliminary evaluation of a disease management programme for patients with diabetes mellitus and hypertension in a primary healthcare setting.

INTRODUCTION: The Comprehensive Chronic Care Programme (CCCP) is an intensified programme designed to provide comprehensive care for the management of diabetes mellitus, hypertension and hyperlipidaemia at a primary healthcare setting. A formative study was done to evaluate the effectiveness of the CCCP compared to the normal polyclinic management of diabetes mellitus. MATERIALS AND METHODS: Control of diabetes (HbA1c) and hypertension (blood pressure) in 63 diabetic patients of a pilot CCCP was compared with 100 diabetic patients not on the programme (non-CCCP) after a 6-month follow-up. Paired t-tests were conducted for differences in mean HbA1c values between baseline and after 6 months. The H-rank test was applied to check for significant differences in change categories of hypertension control between CCCP and non-CCCP cases. RESULTS: In the CCCP group, there was a two-point decrease in HbA1c after 6 months and 65.1% of the patients showed improvement. The proportion of patients achieving optimal diabetic control increased from 9.5% to 36.5%. Conversely, there was deterioration in the non-CCCP group with decrease in the proportion of patients achieving optimal diabetic control from 31% to 21%. Of the hypertensive patients in the CCCP group, 54.5% showed an improvement in blood pressure (BP) control while 44% of the non-CCCP group showed improvement at 6 months. CONCLUSIONS: CCCP, a comprehensive chronic disease management programme, is effective for good diabetic control of patients with diabetes mellitus.

The curry spice curcumin reduces oxidative damage and amyloid pathology in an Alzheimer transgenic mouse.

Inflammation in Alzheimer's disease (AD) patients is characterized by increased cytokines and activated microglia. Epidemiological studies suggest reduced AD risk associates with long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Whereas chronic ibuprofen suppressed inflammation and plaque-related pathology in an Alzheimer transgenic APPSw mouse model (Tg2576), excessive use of NSAIDs targeting cyclooxygenase I can cause gastrointestinal, liver, and renal toxicity. One alternative NSAID is curcumin, derived from the curry spice turmeric. Curcumin has an extensive history as a food additive and herbal medicine in India and is also a potent polyphenolic antioxidant. To evaluate whether it could affect Alzheimer-like pathology in the APPSw mice, we tested a low (160 ppm) and a high dose of dietary curcumin (5000 ppm) on inflammation, oxidative damage, and plaque pathology. Low and high doses of curcumin significantly lowered oxidized proteins and interleukin-1beta, a proinflammatory cytokine elevated in the brains of these mice. With low-dose but not high-dose curcumin treatment, the astrocytic marker GFAP was reduced, and insoluble beta-amyloid (Abeta), soluble Abeta, and plaque burden were significantly decreased by 43-50%. However, levels of amyloid precursor (APP) in the membrane fraction were not reduced. Microgliosis was also suppressed in neuronal layers but not adjacent to plaques. In view of its efficacy and apparent low toxicity, this Indian spice component shows promise for the prevention of Alzheimer's disease.

Pyridoxine and pyridoxamine inhibits superoxide radicals and prevents lipid peroxidation, protein glycosylation, and (Na+ + K+)-ATPase activity reduction in high glucose-treated human erythrocytes.

Vitamin B(6) (pyridoxine) supplementation has been found beneficial in preventing diabetic neuropathy and retinopathy, and the glycosylation of proteins. Oxygen radicals and oxidative damage have been implicated in the cellular dysfunction and complications of diabetes. This study was undertaken to test the hypothesis that pyridoxine (P) and pyridoxamine (PM) inhibit superoxide radical production, reduce lipid peroxidation and glycosylation, and increase the (Na+ + K+)-ATPase activity in high glucose-exposed red blood cells (RBC). Superoxide radical production was assessed by the reduction of cytochrome C by glucose in the presence and absence of P or PM in a cell-free buffered solution. To examine cellular effects, washed normal human RBC were treated with control and high glucose concentrations with and without P or PM. Both P and PM significantly lowered lipid peroxidation and glycated hemoglobin (HbA(1)) formation in high glucose-exposed RBC. P and PM significantly prevented the reduction in (Na+ + K+)-ATPase activity in high glucose-treated RBC. Thus, P or PM can inhibit oxygen radical production, which in turn prevents the lipid peroxidation, protein glycosylation, and (Na+ + K+)-ATPase activity reduction induced by the hyperglycemia. This study describes a new biochemical mechanism by which P or PM supplementation may delay or inhibit the development of complications in diabetes.

Lipoic acid decreases lipid peroxidation and protein glycosylation and increases (Na(+) + K(+))- and Ca(++)-ATPase activities in high glucose-treated human erythrocytes.

Lipoic acid supplementation has been found to be beneficial in preventing neurovascular abnormalities in diabetic neuropathy. Insufficient (Na(+) + K(+))-ATPase activity has been suggested as a contributing factor in the development of diabetic neuropathy. This study was undertaken to test the hypothesis that lipoic acid reduces lipid peroxidation and glycosylation and can increase the (Na(+) + K(+))- and Ca(++)-ATPase activities in high glucose-exposed red blood cells (RBC). Washed normal human RBC were treated with normal (6 mM) and high glucose concentrations (45 mM) with 0-0.2 mM lipoic acid (mixture of S and R sterioisomers) in a shaking water bath at 37 degrees C for 24 h. There was a significant stimulation of glucose consumption by RBC in the presence of lipoic acid both in normal and high glucose-treated RBC. Lipoic acid significantly lowered the level of glycated hemoglobin (GHb) and lipid peroxidation in RBC exposed to high glucose concentrations. High glucose treatment significantly lowered the activities of (Na(+) + K(+))- and Ca(++)-ATPases of RBC membranes. Lipoic acid addition significantly blocked the reduction in activities of (Na(+) + K(+))- and Ca(++)-ATPases in high glucose- treated RBC. There were no differences in lipid peroxidation, GHb and (Na(+) + K(+))- and Ca(++)-ATPase activity levels in normal glucose-treated RBC with and without lipoic acid. Thus, lipoic acid can lower lipid peroxidation and protein glycosylation, and increase (Na(+) + K(+))- and Ca(++)-ATPase activities in high-glucose exposed RBC, which provides a potential mechanism by which lipoic acid may delay or inhibit the development of neuropathy in diabetes.

Adjuvant chemotherapy for colorectal cancer: a Malaysian experience.

This study aims to evaluate the practice of adjuvant chemotherapy in colorectal cancer at the Institute of Radiotherapy and Oncology, Hospital Kuala Lumpur. A retrospective analysis of 320 patients' records from 1986 to 1994 was carried out. Adjuvant chemotherapy was given to 98 patients. Cancers of the rectum and sigmoid colon constituted over 60% of the patients. All the regimes used were 5-fluorouracil-based. The oral route was the most commonly used (55.1%). Toxicity was seldom the reason for stopping treatment (2%). The adjuvant treatment employed has been tolerable while the survival was comparable with other centres.

Efficacy of phototherapy for hyperbilirubinaemia in infants with the respiratory distress syndrome.

OBJECTIVE: To evaluate the efficacy of phototherapy for hyperbilirubinaemia in preterm infants with and without the respiratory distress syndrome (RDS). METHODOLOGY: Prospective cohort study of preterm infants cared for at Kandang Kerbau Hospital, Singapore: 170 with RDS and 477 without RDS, sepsis or other complications (control group) presenting with non-haemolytic hyperbilirubinaemia at about the same time were exposed to daylight phototherapy when bilirubin concentrations exceeded 255 mumol/L or 222 mumol/L if < 48 h of age. Bilirubin values were monitored 6-hourly during exposure, and daily for at least 2 days post-phototherapy. RESULTS: The infants were comparable in birthweight, gestational age, postnatal age, haemoglobin, haematocrit and bilirubin values, at start. The response to phototherapy of the infants with RDS was comparable to that of the well preterm infants; the duration of exposure was 50.1 +/- 1.6 (mean +/- s.e.m.) versus 50.1 +/- 1.4 h, 24-hour decline rate 25.71 +/- 1.29% versus 26.32 +/- 0.65, and overall decline rate 0.96 +/- 0.03%/h versus 0.95 +/- 0.02%/h. CONCLUSION: The presence of RDS did not affect the efficacy of phototherapy for neonatal hyperbilirubinaemia in preterm infants.

Phototherapy for neonatal jaundice in infants with cephalhematomas.

The efficacy of phototherapy in a group of infants with nonhemolytic hyperbilirubinemia and no cephalhematomas was compared with a second group of infants with large cephalhematomas (> 7 cm across), but similar in all other aspects. The cephalhematoma group demonstrated significantly lower hemoglobin (Hb) and hematocrit (hct) values (P < .0001, P < .002 respectively) than the standard group, even after the latter group had been adjusted by stratification (P < .0001, P < .005) such that the starting bilirubin concentration, birth weight, and gestational age were highly comparable to the cephalhematoma group. The bilirubin concentrations of the cephalhematoma, original, and adjusted groups were 277.8 +/- 5.8 mumol/L (16.24 +/- 0.03 mg/dL), [mean +/- sem], 265.2 +/- 0.5 mumol/L (15.50 +/- 0.03 mg/dL), and 275.2 +/- 0.9 mumol/L (16.09 +/- 0.05 mg/dL), respectively. The postnatal age at the start of phototherapy in the cephalhematoma group was comparable with that of the standard group before and after adjustment. Phototherapy was equally effective in the cephalhematoma and standard (original and adjusted) groups of infants, in terms of duration, 24-hr decline, and overall decline/hr for the duration of exposure. The proportionate 24-hr decline was 24.02 +/- 1.90% vs 20.99 +/- 0.23% and 22.61 +/- 0.48% and overall decline/hr was 0.83 +/- 0.06% vs 0.74 +/- 0.01% and 0.78 +/- 0.01%. We conclude that the sequestrated blood in the cephalhematomas did not significantly interfere with the efficacy of phototherapy.

Efficacy of "high-intensity" blue-light and "standard" daylight phototherapy for non-haemolytic hyperbilirubinaemia.

We report our clinical experience with phototherapy in 3802 infants; 3629 were exposed to "standard" daylight phototherapy and 173 to "high-intensity" blue-light phototherapy. High-intensity blue-light phototherapy was twice as effective as standard daylight phototherapy in decreasing bilirubin concentrations. No failures occurred with high-intensity phototherapy compared with an overall failure rate of 1.84/1000 with daylight lamps; these cases were transferred to high-intensity phototherapy with prompt response. Rebound after cessation of phototherapy was greater in those exposed to high-intensity blue light with a significantly greater number requiring a second exposure. However, the incidence was still low. No third exposure was required in any infant. Nursing of infants under high-intensity blue light was more difficult and inconvenient as was clinical monitoring. The light also caused more stress on the nursing and medical personnel. However, the infants tolerated both types of phototherapy equally well. High-intensity blue-light phototherapy would seem to be the treatment of choice for infants with rapidly increasing or very high bilirubin levels, as well as in those not responding adequately to daylight phototherapy.

Phototherapy for ABO haemolytic hyperbilirubinaemia.

The efficacy of 'standard' daylight phototherapy and 'high intensity' blue light phototherapy for neonatal jaundice from ABO-HD, or of a non-haemolytic nature was evaluated. Altogether 77 full-term infants with ABO-HD and 3,020 with non-haemolytic jaundice were studied. Both groups of infants responded well to standard daylight phototherapy; the response in non-haemolytic hyperbilirubinaemia was significantly greater. High intensity blue light phototherapy was significantly more effective in reducing bilirubin levels than standard daylight phototherapy in both group of infants with no failure being encountered. Four infants with non-haemolytic jaundice did not respond adequately to white light (1.4/1,000); they needed high intensity blue light for adequate response. Bilirubin rebound was mild. Four infants in the blue light group needed a second exposure (28.3/1,000) compared with 20 in the white light group (6.9/1,000), a difference that was significant. Standard white light phototherapy is usually adequate for ABO-HD as well as non-haemolytic hyperbilirubinaemia. High intensity blue light would be preferable where a more rapid and greater response is desirable.

Postadrenalectomy pituitary adenoma (Nelson's syndrome) in childhood: clinical and roentgenologic detection.

Following total adrenalectomy in Cushing's syndrome associated with adrenal hyperplasia, but not with adrenal adenoma or malignancy, elements of the pituitary may be stimulated to grow rapidly and even aggressively. There is strong evidence to support the idea that there is a pre-existing tumor in many, if not all, of these cases. In some, the tumor may be too small to deform the sella turcica. After adrenalectomy, these patients should be observed carefully and frequently for hyperpigmentation, visual field defects, and sella turcica enlargement.