Health status of elderly in Hong Kong sheltered housing.
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Biomedical subjects
Publications and source records attributed to S C Ho.
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Daily intakes of protein and energy were estimated in a group of 417 apparently healthy elderly Chinese subjects aged 60 years and over, living independently in the community. The mean protein intake was 1.2 g/kg body weight, well above the WHO/FAO/UNU recommendation of 0.8 g/kg, and comparable to intakes of elderly Americans and Britons. Plasma total protein, albumin, prealbumin, retinol binding protein and transferrin concentrations were also measured. No age- or sex-related differences were found and the values were comparable to published values for elderly Caucasians. Plasma prealbumin and retinol binding protein concentrations correlated with protein intake and with arm muscle area. Protein nutritional status appears adequate for elderly Chinese living in the community.
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Dietary intakes of various nutrients, urinary electrolyte levels from a casual urine sample, and BP were determined in 425 active men and women aged 60 and above (mean age 70.6 years) living in the community. After exclusion of subjects taking Western or Chinese medicines, correlations were seen between body mass index and diastolic blood pressure (DBP, r = 0.15, P less than 0.01), between calcium intake and systolic blood pressure (SBP, r = 0.14, P less than 0.02) and retinol intake and SBP (r = -0.14, P less than 0.03). There was no significant correlation between BP and casual urinary Na/Cr, K/Cr, Na/K or Ca/Cr ratios. Fewer correlates were seen compared to younger age groups. These results suggest that dietary modification of BP based on studies in Caucasian communities of all ages may not apply to elderly Chinese populations.
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Dietary intakes of thiamine, riboflavin, nicotinic and ascorbic acid, together with the biochemical status of thiamine, riboflavin, pyridoxine and ascorbic acid, were determined in a cluster sample of 419 healthy active elderly subjects aged 60 years and above living in the community. Nicotinic acid intake per 1000 kcal (4.18 MJ) of food energy showed an age-related decrease in men, while women had higher ascorbic acid intakes than men. Between 38 and 98 per cent of this population have intakes of thiamine, riboflavin and nicotinic acid below the UK RDA values. Intakes of ascorbic acid were below the RDA for 17 per cent of men and 9 per cent of women. The prevalence of biochemical deficiency was 8, 14, 11.5 and 24 per cent for thiamine, riboflavin, pyridoxine and ascorbic acid respectively. A significant difference in intakes between groups with blood levels within and below the reference range was seen only for riboflavin, suggesting that factors other than low intake may be more important in contributing to low blood levels for thiamine and ascorbic acid. However, inaccuracies in dietary intake estimations may contribute to the poor correlation.
A lectin has been identified in the cell line, SB-1, originally derived from the roots of Glycine max. This lectin, which we shall refer to as SB-1 lectin, was isolated on the basis of its carbohydrate-binding activity (affinity chromatography on Sepharose column derivatized with N-caproyl-galactosamine) and its immunological cross-reactivity (immunoblotting with rabbit antibodies directed against seed soybean agglutinin (SBA]. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting analysis of SB-1 lectin revealed a major polypeptide (Mr approximately equal to 30,000) which co-migrated with seed SBA. This form of the lectin was observed in fractions purified from culture medium of SB-1 cells or supernatant fraction of SB-1 cell suspension after enzymatic removal of cell wall. Extracts of SB-1 cells under some other conditions yielded a major band (Mr approximately equal to 60,000) as revealed by SDS-PAGE and immunoblotting with rabbit anti-seed SBA; prolonged incubation of these samples in the presence of SDS resulted in the appearance of the 30-kDa polypeptide. It appears that the 60-kDa band represented a highly stable, even under SDS-PAGE conditions, dimeric form of the 30-kDa subunit. The SB-1 lectin derived from the culture medium was compared with seed SBA by gel filtration and by peptide mapping after limited proteolysis; no difference between the lectins from the two sources was found. Extracts of soybean roots fractionated on N-caproyl-galactosamine-Sepharose affinity columns yielded, upon elution with galactose, polypeptides of Mr 30,000 and 60,000. These results suggest that soybean roots contain a lectin whose polypeptide composition corresponds to that of seed SBA and SB-1 lectin.
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Incubation of Rhizobium japonicum with the cultured soybean cell line SB-1, originally derived from the roots of Glycine max, resulted in specific adhesion of the bacteria to the plant cells. This binding interaction appears to be mediated via carbohydrate recognition, since galactose can inhibit the heterotypic adhesion but glucose cannot. Affinity chromatography, on a Sepharose column derivatized with N-caproyl-galactosamine, of the supernatant fraction of a SB-1 cell suspension after enzymatic removal of cell wall yielded a single polypeptide (Mr approximately 30,000) on immunoblotting analysis with rabbit antibodies directed against seed soybean agglutinin. Fluorescently labeled rabbit anti-seed soybean agglutinin also yielded specific immunofluorescent staining on the cell wall and plasma membrane of the SB-1 cells. These results suggest that one likely candidate that may mediate the recognition between the Rhizobium and the soybean cells is the endogenously produced SB-1 lectin. This notion is supported by the observation that rabbit anti-seed soybean agglutinin blocked the Rhizobium-soybean cell adhesion, whereas control antibodies did not.
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A defect in the renin-angiotensin system has been shown in diabetic patients and experimental animals, in particular with nephropathy or autonomic neuropathy. The mechanism for this low plasma renin activity (PRA) is poorly understood. In order to clarify this defect, the renin-angiotensin system was studied in alloxan-induced diabetic and age-match control mice. In diabetic animals, kidney renin activity (KRA) was significantly lower than that of the controls, while plasma renin substrate (PRS) concentration was slightly higher and PRA was normal. The amount of injected radiolabeled renin extracted by the kidney was normal, but the amount extracted by the liver was significantly decreased in diabetic animals. On the other hand, the degradation of the extracted renin by both the kidney and the liver was elevated as compared to the controls. This high degradation rate was accompanied by a slight increase in lysosomal protease activity in the kidneys. In in vivo studies, isoproterenol-induced PRA was 20-fold in control animals. In diabetics, isoproterenol-induced PRA was attenuated and rose only four- to fivefold over basal level. The angiotensin converting enzyme (ACE) activity in the kidney was significantly decreased in the diabetic state. It is concluded that there were multiple defects in the renin-angiotensin system in this diabetic model, namely, a depletion of renin storage with subsequent loss of maximal responsiveness to the adrenergic agonist in renin release, an elevation of intrarenal renin degradation together with a deficiency in ACE which would possibly lead to a decrease in intrarenal formation of angiotensin II.
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Both the modern scientific and the Chinese traditional forms of health care are within easy geographical, economical and quantitative accessibility to the people in Singapore. The fourth component of accessibility, socio-cultural component encompasses the social milieu surrounding the individual, and the values and beliefs attached to diseases and health care services. This paper reveals the findings of a survey of a quota sample of patients in institutional clinics providing Chinese traditional medical consultations. The survey aimed to look at the types of illness conditions presented in these clinics, the multi-usage of both modern and traditional health care by these patients, and the inter-relationship between illness behaviour and differential preferences of treatment methods for various disease conditions.
Intravenous injection of 125I-radiolabeled submaxillary gland renin into mice resulted in rapid disappearance of this protein with a corresponding increase in its metabolites in the serum. The disappearance rate was substantially reduced after nephrectomy. Result from the in vitro incubation of the labeled renin with the whole blood excluded the possibility of any blood components participating in renin degradation. During the in vivo study, the kidneys were found to accumulate fivefold to sevenfold more radioactivity than the liver. The degradation of the labeled renin by the kidney and the liver was studied in vitro in slice preparations after preloading of the protein into organs in vivo for 15 min. Formation of metabolites was followed by the determination of the trichloroacetic acid-soluble radioactivity. Results from these in vitro experiments suggested that both tissues had about the same capacities to degrade the accumulated renin. A substantial amount of this renin-degradation activity could be inhibited by the metabolic energy inhibitors, sodium azide and 2,4-dinitrophenol, and the lysosomal inhibitor, chloroquine. The lysosomal localization of the organ-accumulated renin after subcellular fractionation further implied the active internalization of the protein into lysosomes. Although the efficiency for renin degradation by both types of tissue were about the same, the in vivo uptake of labeled renin by the kidneys surpassed the uptake by the liver by severalfold. It is concluded that the kidneys play a major role in the degradation of circulating submaxillary gland renin.
The effects of subcutaneous injection of compound 48/80 and histamine on the water intake, plasma renin activity (PRA) and plasma histamine levels were investigated in the rat. The results suggest that compound 48/80 and histamine stimulate water intake by different mechanisms. The compound 48/80-induced water intake seems to be mainly mediated by stimulation of the renin-angiotensin system. On the other hand, the histamine-induced water intake seems to be directly mediated by its action in the brain.
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