Unusual pure motor axonal neuropathy in a Burmese family with galactosialidosis.
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Adolescent↗
Biomedical subjects
Y L Lo
Publications and source records attributed to Y L Lo.
Electrophysiological features in the management of meralgia paraesthetica.
Meralgia paraesthetica is a condition which presents with pain and paresthesia over the anterolateral thigh, due to entrapment of the lateral femoral cutaneous nerve. Our local experience of 12 cases highlights the usefulness of antidromic sensory nerve conductions in the diagnostic and prognostic aspects of this condition. Follow-up studies suggest that patients with initial reduction rather than absent sensory amplitudes on the affected side more likely to experience symptomatic improvement over an 8 to 24 month period.
Action Potentials↗
Immunocytochemical localization of muscarinic m2 receptor in the rat spinal cord.
Muscarinic receptors have been implied in the regulation of spinal cord functions. The m2 subtype has been found to be one of the major muscarinic receptors expressed in the spinal cord. In order to determine the precise cellular localization of m2 receptor in the rat spinal cord, immunocytochemistry was performed using a commercially available specific antibody. In the dorsal horn, strong m2 immunoreactivity was detected in the substantia gelatinosa. In the ventral horn, m2 immunoreactivity was detected in patches that were associated with cell groups of motor neurons. At higher magnification, m2 immunoreactivity was detected in neuronal processes and many of them were seen in close apposition to m2-negative perikarya and proximal dendrites of motor neurons. These results indicate that m2 receptor immunoreactivity is localized in different neuronal elements of the spinal cord.
Animals↗
Comparison of two 1-week low-dose omeprazole triple therapies--optimal treatment for Helicobacter pylori infection?
OBJECTIVES: To determine and compare the efficacy and tolerability of two 1-week regimen comprising omeprazole, clarithromycin and amoxycillin or metronidazole in the eradication of Helicobacter pylori, and to determine the influence of bacterial resistance to metronidazole and clarithromycin on the outcome of treatment. PATIENTS AND METHODS: Patients with unequivocal evidence of H. pylori infection based on culture, histology and rapid urease test of both antrum and corpus biopsies were recruited for the study. The study was a randomized, investigator-blind, comparative study. Patients received either omeprazole 20 mg o.m., clarithromycin 250 mg b.d. and amoxycillin 500 mg b.d. (OAC) or omeprazole 20 mg o.m., metronidazole 400 mg b.d. and clarithromycin 250 mg b.d. (OMC) for 1 week. Patients were assessed for successful eradication, which was defined as absence of bacteria in all tests (culture, histology and urease test on both antral and corpus biopsies), at least 4 weeks after completion of therapy. RESULTS: Eighty-two patients were recruited for the study. Eradication rates on intention-to-treat analysis were--OAC: 36/41 (87.8%, 95% CI: 73.8, 95.9); OMC: 33/41 (80.5%, 95% CI: 65.1, 91.2). On per protocol analysis were--OAC: 36/40 (90%, 95% CI: 76.3, 97.2); OMC: 32/38 (84.2%, 95% CI: 68.7, 94.0). All side-effects encountered were mild and no patient discontinued treatment because of intolerance to medications. The most common side-effects were altered taste (OAC 31.7%, OMC 53.7%) and lethargy (OAC 14.6%, OMC 19.5%). Pre-treatment metronidazole resistance was encountered in 34/63 (54.0%) patients. No bacterial strains were found with primary resistance to clarithromycin. Metronidazole resistance did not significantly affect eradication rates. Emergence of resistance to clarithromycin was not seen post-therapy. CONCLUSIONS: Both the OAC and the OMC regimens were convenient and well-tolerated treatments for H. pylori. However, eradication rates were lower than anticipated.
Adult↗
Does Helicobacter pylori infection affect gastric emptying in patients with functional dyspepsia?
The objectives of the study were first, to determine if gastric emptying was altered in patients with functional dyspepsia with and without Helicobacter pylori infection compared with normal healthy volunteers; and second, to determine if there were further alterations in gastric emptying when the infection was eradicated. Gastric emptying was measured using a 99mtechnetium radiolabelled solid meal and gastric emptying time was measured as t1/2, viz. time taken for half the radiolabelled meal to be emptied from the stomach. The mean gastric emptying time for H. pylori-positive patients (n=20) was 56.4+/-24.8 min; H. pylori-negative patients (n=19) 67.8+/-31.8 min; and normal controls (n=20) 58.8+/-18.8min. No significant difference was obtained between the groups (ANOVA; P=0.348). Thirteen of 18 H. pylori-positive patients successfully eradicated the infection following treatment with omeprazole 40 mg o.m. and amoxycillin 500 mg t.d.s. for 2 weeks. The mean difference in the gastric emptying time before and after H. pylori eradication was 23.9+/-13.2 min (P= 0.556). There was no significant difference in the frequency of specific dyspeptic symptoms as well as the overall mean symptom score between the H. pylori-positive and -negative patients. Gastric emptying was not different between patients with functional dyspepsia and normal controls. Helicobacter pylori infection does not appear to affect gastric emptying in patients with functional dyspepsia.
Adolescent↗
Interaction between superoxide dismutase and dipalmitoylphosphotidylglycerol bilayers: a fourier transform infrared (FT-IR) spectroscopic study.
PURPOSE: Superoxide dismutase (SOD), an antioxidant enzyme, converts peroxide radicals into hydrogen peroxide. Liposomes have been used as carriers for SOD to enhance its antioxidant effect. Our previous DSC study has suggested that SOD binding to dipalmitoylphosphatidylglycerol (DPPG) may protect lipid membranes against oxygen-mediated injury. We now present FT-IR studies on the effect of DPPG binding on the temperature-induced SOD folding-unfolding process. METHODS: The FT-IR spectra of SOD in D2O or DPPG membranes are measured as temperatures increase from 28 degrees to 121 degrees C at a rate of 0.5 degrees C/min. From the quantitative determination of the changes in the amide I band components of the Fourier self-deconvoluted spectra, the DPPG-induced changes of SOD secondary structure could be detected as a function of temperature. RESULTS: We observe that the relative intensity of the SOD bands from 28 degrees C to 77 degrees C show graduate loss of beta-sheet "distorted" structure, loss of turns, and existence of an intermediate state around 50 degrees C. Beginning at 80 degrees C, changes are obtained in three temperature regions: (i) 80 degrees C, (ii) 92 degrees C, (iii) 109 degrees C. The result suggests that SOD folding/unfolding transition involves mostly the relative changes within the regions of helix-like hydrogen bonding pattern, turn, twisted beta-bend and irregular structures. When SOD is bound to DPPG, the conformational changes shift to lower temperatures, indicating a reduction of SOD thermal stability. In addition, the gel to liquid crystalline phase transition temperature of DPPG increases from 42 degrees C to 43.5 degrees C. CONCLUSIONS: These results suggest that the thermal stability of SOD is reduced by DPPG binding. However, DPPG bilayer is stabilized by the presence of SOD.
Cell Membrane↗
Helicobacter pylori eradication with short-term therapy leads to duodenal ulcer healing without the need for continued acid suppression therapy.
OBJECTIVE: To determine whether duodenal ulcers continue to heal following successful Helicobacter pylori eradication with short-term eradication therapy without further acid suppression therapy. METHODS: Patients with endoscopically proven duodenal ulcers who were H. pylori positive were randomized to receive omeprazole 40 mg each morning and clarithromycin 500 mg three times daily or famotidine 40 mg twice daily and clarithromycin 500 mg three times daily for 2 weeks. No acid-suppressing agents nor ulcerhealing drugs such as bismuth compounds or sucralfate were prescribed after that. Patients were re-examined endoscopically at week 2 at the end of treatment, and at week 6, 4 weeks after the completion of treatment. RESULTS: Thirty of 44 (68.2%) patients from both treatment arms, in whom the bacteria were subsequently noted to have been eradicated, had healed ulcers at week 2; at Week 6, 42 of 44 (95.5%) were noted to have healed ulcers without further acid-suppressing or ulcer-healing treatment. CONCLUSION: Although a short-term acid-suppressing treatment is insufficient to heal ulcers, where an important putative factor such as H. pylori is eliminated, the ulcer healing process continues without further need for acid-suppressing or ulcer-healing agents.
Adult↗
Protein location in liposomes, a drug carrier: a prediction by differential scanning calorimetry.
Location of protein drugs in lipid carriers often determines the stability, loading efficiency, and release rate of these drugs from the carriers following administration. On the basis of conventional differential scanning calorimetry (DSC) measurements, Papahadjopoulos et al. (Biochim. Biphys. Acta 1975, 401, 317-335) proposed that proteins can be classified into three categories depending on their effects on the thermotropic behavior of the lipids, e.g., transition temperature and enthalpy. Interactions are usually electrostatic, hydrophobic, or their combination. The nature of these interactions are reflected by changes in various thermotropic parameters. Our study aims to test the validity of Papahadjopoulos' classification. Hydrophilic ribonuclease A, cytochrome c, and superoxide dismutase (SOD), as well as hydrophobic cyclosporin A, are used as model proteins. Neutral lipids, e.g., dipalmitoylphosphatidylcholine, and/or negatively charged lipids, e.g., dipalmitoylphosphatidylglycerol (DPPG), are used to prepare liposomes. Results from conventional and high-sensitivity DSC are compared. High-sensitivity DSC gives significant, more reproducible results. We find that the classification of Papahadjopoulos et al. needs to be modified. No hydrophilic proteins bind to liposomes exclusively on the surface by electrostatic interactions, and some degree of penetration is observed in most cases. An unexpected binding between SOD and DPPG liposomes is observed. The binding of SOD to negatively charged lipids may account, at least in part, for its ability to protect lipid membranes against oxygen-mediated injury.
Cyclosporine↗
Omeprazole 40 mg o.m. combined with amoxycillin alone or with amoxycillin and metronidazole in the eradication of Helicobacter pylori.
OBJECTIVES: Our objectives were to determine the effect of dual therapy with omeprazole and amoxicillin and of triple therapy with omeprazole, amoxicillin, and metronidazole in the eradication of Helicobacter pylori (HP) and to study the long-term results of eradication in these patients. METHODS: A prospective, randomized, controlled trial was performed. Patients who were recruited had unequivocal evidence of HP infection based on culture, histology, rapid urease test, and Gram's stain of a tissue smear. Eradication was defined as the absence of bacteria in all tests performed on both corpus and antral biopsies. RESULTS: The infection was eradicated in 15 of 19 (78.9%) patients randomized to receive dual therapy and in 19 of 22 (86.4%) patients who received triple therapy. We followed the course of 30 patients in whom HP had been eradicated for a prolonged term (up to 12 months). All remained clear of HP. Twenty-five of 28 patients (89.3%) with duodenal ulcers in whom HP was successfully eradicated remained healed at 12 months. Fewer side effects were reported among patients who received the dual therapy. CONCLUSIONS: Combination therapy with omeprazole and amoxicillin with or without metronidazole is effective in the eradication of HP. In particular, the dual therapy regimen with amoxicillin is not only effective but is also well tolerated by patients.
Adult↗
Roxithromycin in the eradication of Helicobacter pylori.
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Anti-Ulcer Agents↗
Use of pressurised aerosol inhalers among patients attending the Chest Clinic and Primary Care Department of University Hospital, Kuala Lumpur.
Eighty consecutive patients who came to collect their prescriptions for pressurised aerosol inhalers at the Pharmacy of the University Hospital, Kuala Lumpur, were interviewed regarding their use of the pressurised inhaler. Their inhaler technique was also assessed. A significant proportion inhaled the steroid aerosol before the bronchodilator and 23.5% used the steroid inhaler for relief of acute dyspnoea. Only 28.8% of the 80 patients performed correctly all 6 steps necessary for the proper use of inhalers. The most common mistake was the failure to inhale slowly and deeply. Patients who had used the device for more than 5 years performed better, while correct inhaler technique was not dependent on the patient's sex, age or level of education.
Adolescent↗
Helicobacter pylori infection and non-ulcer dyspepsia: the effect of treatment with colloidal bismuth subcitrate.
A study was undertaken to determine the role of Helicobacter pylori in non-ulcer dyspepsia (NUD) and to determine the efficacy of colloidal bismuth subcitrate (CBS) in the treatment of NUD. Seventy-one patients were randomly allocated (double blind) to CBS or placebo, two tablets twice daily for 4 weeks. The severity of dyspepsia was scored and endoscopies performed before and after treatment, and antral biopsy specimens were taken for bacteriologic and histologic examination. Forty patients had H. pylori infection, and all had changes of chronic active gastritis. H. pylori was cleared from 17 to 21 patients (81%) treated with CBS, whereas none of the 19 patients treated with placebo cleared the bacteria. Improvement in histology was noted in 15 of 21 patients (71.4%) treated with CBS, whereas no improvement was noted in any of the placebo controls. Thirty-one patients were negative for H. pylori. All had either normal gastric histology or minor degrees of inflammation. Seventeen of these patients received CBS, and 14 received placebo. All groups reported improvement in the symptom score; however, the H. pylori-positive, CBS-treated group recorded a significantly higher improvement than the other groups (p less than 0.001). Relapse of H. pylori infection after initial clearance of the bacteria was high. Twelve of 16 patients evaluated relapsed 1 month after withdrawal of CBS.
Adult↗
Comparison of effects of natural or artificial rodent diet on etoposide absorption in rats.
The oral administration of etoposide has erratic absorption and low bioavailability. P-glycoprotein (Pgp) located in the intestinal brush-border membrane may pump out orally absorbed etoposide and thus decrease etoposide's absorption. Since flavonoids are abundant in food, we speculated that the common natural rodent diet may contain some flavonoid-related constituents which influence etoposide absorption. We therefore compared the absorption of etoposide's in the everted gut sacs of rats pretreated for 30 minutes with two different diets, natural rodent diet or artificial rodent diet. The effect of quercetin, one of the plant derived flavonoids with Pgp modulating activity, on etoposide's absorption was also compared. The addition of natural rodent diet or quercetin increased etoposide's absorption in everted sacs of jejunum or ileum, in comparison to those added with artificial rodent diet. The enhancing effect of quercetin was compatible with the effect of natural rodent diet in the jejunum and was higher in the ileum. These in vitro data supported the hypothesis that certain dietary components, possibly flavonoid-related compounds, may influence Pgp's function in intestine and thus increase etoposide's absorption. However, when fed with natural rodent diet for one week, a lower enhancing effect on absorption was observed. This may be due to the metabolism of the ingredients with modulating activity to their inactive forms, thus reducing the effect of natural rodent diet on etoposide absorption. The results proved that feeding rats with natural or artificial rodent diet had no obvious effect on etoposide absorption in vivo.
Absorption↗
Reversal of multidrug resistance to epirubicin by cyclosporin A in liposomes or intralipid.
Clinical applications of the first-generation multidrug resistance (MDR) modulators, such as cyclosporin A (CsA) have been hampered because of their severe side effects in vivo. In this study, we utilized liposomes and Intralipid to provide selective delivery of CsA to tumor cells as well as to circumvent toxicities associated with CsA by altering the pharmacodistribution properties of encapsulated CsA. The MDR reversing effect of CsA in free, liposomal or Intralipid formulations on the uptake and transport of epirubicin in Caco-2 cells and rat intestines was evaluated. The results showed that CsA in free or liposomal formulations significantly enhanced the intracellular accumulation of epirubicin in a dose-related fashion in Caco-2 cells, with the highest enhancement at 2 microM: These formulations substantially ameliorated the apical to basolateral absorption of epirubicin in Caco-2 cells and markedly increased mucosal to serosal absorption of epirubicin in rat jejunum and ileum. CsA in free, liposomal or Intralipid formulations all significantly reduced basolateral to apical efflux of epirubicin across Caco-2 monolayers. CsA encapsulated in liposomes showed greater enhancement than other formulations. In conclusion, liposomal preparations of CsA may circumvent MDR and have the advantage of diminishing side effects, thus providing a useful alternative dosage form for intravenous administration of CsA to be combined with cytotoxic agents for the treatment of resistant tumors.
Adenocarcinoma↗
Comparison of effects of surfactants with other MDR reversing agents on intracellular uptake of epirubicin in Caco-2 cell line.
P-glycoprotein (P-gp) actively pumps out a number of anticancer drugs, such as epirubicin, from tumor cells. P-gp is also expressed in the small intestine under normal physiological conditions. Inhibition of intestinal P-gp function using MDR reversing agents may enhance the oral bioavailability of some chemotherapeutic agents. Human colon adenocarcinoma (Caco-2) cell line expresses many characteristics of differentiated cells of the normal small intestine. Using Caco-2 as an in vitro intestinal model, the overall goal of the present study was to evaluate the MDR-reversing effects of some commonly used nonabsorptive pharmaceutical surfactants, such as Tween 20, Tween 80 and acacia on the intracellular accumulation of epirubicin by flow cytometry. Tween 20, Tween 80 or acacia all significantly increased intracellular accumulation of epirubicin with the highest enhancing effect for acacia and the lowest for Tween 20. Apart from progesterone, the enhancing effects of surfactants were better than those of non-surfactant MDR reversing agents such as verapamil, trifluoperazine and reserpine. In conclusion, our results demonstrate that progesterone, acacia, Tween 20 and Tween 80 are potent MDR modifiers of epirubicin in Caco-2 at concentrations that could be achieved in vivo. Use of surfactants in excipients may increase the intestinal absorption of some drugs through P-gp inhibition and thus improve drug bioavailability for P-gp substrate.
Antibiotics, Antineoplastic↗