Paraparesis can occur as a primary presentation of brain pathology at the motor strip along the parasagittal region. It could also occur as a neurological complication especially following resection of parasagittal meningioma with infiltration of the superior sagittal sinus (SSS). We report a case of a complete paraparesis immediately following resection of bilateral parasagittal meningioma with infiltration of the middle third of the SSS. A gradual improvement in neurological recovery and functional outcome was observed over a period of one year after undergoing an intensive neurorehabilitation program beginning from the acute inpatient phase post surgery.
In this study, the effect of the addition of different cryoprotectants on the freeze-thaw stability of duck surimi-like material (DSLM) was tested. A 6% (wt/wt) low-sweetness cryoprotectant (i.e., polydextrose, trehalose, lactitol, or palatinit) was added to a 3-kg portion of DSLM, and the mixture was subjected to freeze-thaw cycles during 4 mo of frozen storage. The DSLM with no cryoprotectant added (control) and with a 6% sucrose-sorbitol blend (high-sweetness cryoprotectant) added also were tested. The polydextrose-added sample had the highest water-holding capacity among the sample types tested (P < 0.05), and it retained its higher value during frozen storage. The protein solubility of the cryoprotectant-added samples decreased significantly (P < 0.05) from 58.99 to 59.60% at initial frozen storage (0 mo) to 48.60 to 54.61% at the end of the experiment (4 mo). The gel breaking force of all samples significantly decreased (P < 0.05) at 1 mo; this breaking force then stabilized after further frozen storage for the cryoprotectant-added samples, whereas it continued to decrease in the control samples. Gel deformation fluctuated during frozen storage and was significantly lower (P < 0.05) at the end of experiment than at the beginning. The presence of cryoprotectants reduced the whiteness of DSLM. Samples containing polydextrose, trehalose, lactitol, and palatinit were able to retain the protein solubility, gel breaking force, and deformation of DSLM better than control samples after 4 mo of frozen storage and exposure to freeze-thaw cycles. The effects of these low-sweetness cryoprotectants are comparable to those of sucrose-sorbitol, thus, these sugars could be used as alternatives in protecting surimi-like materials during frozen storage.
A single line flow injection analysis (FIA) method that incorporated a preconcentrator column packed with C(18) particles and capacitively coupled contactless conductivity detector (C(4)D) was developed for the determination of free fatty acid (FFA) in vegetable oils. The carrier stream was methanol/1.5 mM sodium acetate (pH 8) 80:20 (v/v) at a flow rate of 1.0 mL min(-1). Calibration curve was well correlated (r(2)=0.9995) within the range of 1-200 mg L(-1) FFA (expressed as palmitic acid). Sampling rate of 40-60 h(-1) was achieved. Good agreement was found between the standard non-aqueous titrimetry method and the proposed method when applied to the determination of FFA in palm (crude, olein, and refined, bleached and deodorised) and other vegetable (soybean, rice bran, walnut, corn and olive) oils. The proposed method offers distinct advantages over the official method, especially in terms of simplicity, high sampling rate, economy of solvents and sample, offering considerable promise as a low cost automated system that needs minimum human intervention over long periods of time.
The gelation properties of spent duck meat surimi-like material produced using acid solubilization (ACS) or alkaline solubilization (ALS) were studied and compared with conventionally processed (CON) surimi-like material. The ACS process yielded the highest protein recovery (P < 0.05). The ALS process generated the highest lipid reduction, and the CON process yielded the lowest reduction (P < 0.05). Surimi-like material produced by the CON process had the highest gel strength, salt extractable protein (SEP), and water holding capacity (WHC), followed by materials produced via the ALS and ACS processes and untreated duck meat (P < 0.05). The material produced by the CON process also had the highest cohesiveness, hardness, and gumminess values and the lowest springiness value. Material produced by the ACS and ALS processes had higher whiteness values than untreated duck meat gels and gels produced by the CON method (P < 0.05). Surimi-like material produced using the ACS and CON processes had significantly higher myoglobin removal (P < 0.05) than that produced by the ALS method and untreated duck meat. Among all surimi-like materials, the highest Ca(2+)-ATPase activity was found in conventionally produced gels (P < 0.05). This suggests that protein oxidation was induced by acid-alkaline solubilization. The gels produced by ALS had a significantly lower (P < 0.05) total SH content than the other samples. This result showed that the acid-alkaline solubilization clearly improved gelation and color properties of spent duck and possibly applied for other high fat raw material.
The physicochemical properties and sensory analysis of duck meatballs containing duck meat surimi-like material during frozen storage were evaluated. Properties of meatballs containing duck surimi-like material prepared by acid solubilization (ACDS), alkaline solubilization (ALDS), and conventional processing (CDS) as well as duck mince (as the control, CON) were compared. ACDS had significantly higher (P < 0.05) moisture and protein content and lower fat content compared with CON. The thiobarbituric acid-reactive substances (TBARS) value of all samples increased as the storage time increased up to week 8 (P < 0.05), but thereafter it decreased in most of the samples. ACDS and ALDS had significantly higher TBARS values (P < 0.05), and these values remained higher than those of the other samples throughout the frozen storage period. Addition of surimi-like material to the meatballs had significant effects (P < 0.05) on springiness, gumminess, and chewiness values of all samples. Ingredients and frozen storage affected most sensory attributes in samples significantly (P<0.05). No significant increase in growth of organisms occurred during 12-wk frozen storage The results indicate that acid-alkaline solubilization methods improve both physicochemical and sensory properties of duck meatballs containing duck surimi-like material. Thus, these techniques should be applicable to product development of duck surimi-like material.
Detoxifying enzymes are present in most epithelial cells of the human gastrointestinal tract where they protect against xenobiotics which may cause cancer. Induction of examples such as glutathione S-transferase (GST) and its thiol conjugate, glutathione (GSH) as well as NAD(P)H: quinoneoxidoreductase (NQO1) facilitate the excretion of carcinogens and thus preventing colon carcinogenesis. Pterostilbene, an analogue of resveratrol, has demonstrated numerous pharmacological activities linked with chemoprevention. This study was conducted to investigate the potential of pterostilbene as a chemopreventive agent using the HT-29 colon cancer cell line to study the modulation of GST and NQO1 activities as well as the GSH level. Initially, our group, established the optimum dose of 24 hours pterostilbene treatment using MTT assays. Then, effects of pterostilbene (0-50 μM) on GST and NQO1 activity and GSH levels were determined using GST, NQO1 and Ellman assays, respectively. MTT assay of pterostilbene (0-100 μM) showed no cytotoxicity toward the HT-29 cell line. Treatment increased GST activity in the cell line significantly (p<0.05) at 12.5 and 25.0 μM. In addition, treatment at 50 μM increased the GSH level significantly (p<0.05). Pterostilbene also enhanced NQO1 activity significantly (p<0.05) at 12.5 μM and 50 μM. Hence, pterostilbene is a potential chemopreventive agent capable of modulation of detoxifiying enzyme levels in HT-29 cells.
Cardiovascular disease (CVD) is responsible for the majority of deaths in chronic renal failure (CRF). Oxidative stress plays a key role in pathogenesis of atherosclerosis and CVD, which is promoted by the production of reactive oxygen species (ROS) and impaired antioxidant enzymes. These ROS react with nitric oxide (NO) to produce cytotoxic reactive nitrogen species that cause oxidative injury to the endothelium. This study evaluated biomarkers of oxidative stress, NOx (total NO(2) and NO(3)), and superoxide dismutase (SOD) enzyme in normal control and CRF patients as case group and correlated their association with CVD. This cross sectional study involved 173 CRF patients on different modes of treatment (hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), and predialysis). Of these, 74 had CVD. The control group consisted of 33 healthy subjects who had no history of CRF and CVD. Both NOx and SOD levels were significantly lower (P<0.05, P<0.001, respectively) in the case group. Comparing between CRF patients with and without CVD, SOD level was found to be significantly lower in CRF patients with CVD (P<0.05). Logistic regression analysis showed significant association of CVD event with age, male gender, diabetes, SOD level, and lipid profile in CRF patients. Oxidative stress occurs in the CRF patients with or without CVD. This study found that NOx and SOD levels were reduced in all CRF patients with or without CVD. However, it was noted that the levels of these biomarkers of oxidative stress were significantly lower in CRF patients with CVD compared with CRF patients without CVD. Therefore, these oxidative stress markers maybe contributing factors in the pathogenesis of CVD in patients with CRF.
Several organisms have been used as indicators, bio-monitoring agents or test organisms in ecotoxicological studies. A close relative of the well established Japanese medaka, the Java medaka (Oryzias javanicus), has the potential to be a test organism. The fish is native to the estuaries of the Malaysian Peninsula, Thailand, Indonesia and Singapore. In this study, newly fertilised eggs were exposed to different concentrations of Cd and Hg. Observations were done on the development of the embryos. Exposure to low levels of Cd and Hg (0.01-0.05 ppm) resulted in several developmental disorders that led to death. Exposure to ≥1.0 ppm Cd resulted in immediate developmental arrest. The embryos of Java medaka showed tolerance to a certain extent when exposed to ≥1.0 ppm Hg compared to Cd. Based on the sensitivity of the embryos, Java medaka is a suitable test organism for ecotoxicology in the tropical region.
Currently, of less than 50 cases of head and neck follicular dendritic cell (FDC) sarcoma reported in the literature, 5 have been found to occur in the background of Castleman disease. We report another case of head and neck FDC sarcoma with emphasise on its associated lesions and review the outcome of treatment from the existing cases in the literature.
The present study proposed the use of meranti sawdust in the removal of Cu(II), Cr(III), Ni(II) and Pb(II) ions from synthetic aqueous solutions. Batch adsorption studies showed that meranti sawdust was able to adsorb Cu(II), Cr(III), Ni(II) and Pb(II) ions from aqueous solutions in the concentration range 1-200mg/L. The adsorption was favoured with maximum adsorption at pH 6, whereas the adsorption starts at pH 1 for all metal ions. The effects of contact time, initial concentration of metal ions, adsorbent dosage and temperature have been reported. The applicability of Langmuir, Freundlich, and Dubinin-Radushkevich (D-R) isotherm was tried for the system to completely understand the adsorption isotherm processes. The adsorption kinetics tested with pseudo-first-order and pseudo-second-order models yielded high R(2) values from 0.850 to 0.932 and from 0.991 to 0.999, respectively. The meranti sawdust was found to be cost effective and has good efficiency to remove these toxic metal ions from aqueous solution.
BACKGROUND: Acute life threatening presentations of thyroid disease are uncommon. The aim of this study was to review our experience of emergency thyroid surgery with regard to the incidence, management and outcome to this approach.
METHODS: Forty patients who underwent emergency thyroid surgery from December 1998 to December 2007 were prospectively accrued in this study. There were 30 female and 10 male patients. The mean age was 63.8 years (range, 33-83 years). All patients had total thyroidectomy, except one patient who only had a right hemithyroidectomy for a dominant right multinodular goiter. Eight of the patients had been intubated before referring to our centre.
RESULTS: The mean weight of specimen was 219 g (range, 32-800 g). A histopathology report confirmed 16 patients had multinodular goiters, eight patients had papillary thyroid carcinomas, seven patients had anaplastic cancers, four patients had follicular thyroid carcinomas, two patients had thyroid lymphoma, one patient had medullary carcinoma, one patient had sarcoma and one patient had thyroid abscess. A total of 28 patients were discharged well postoperatively.
CONCLUSION: Acute life threatening presentations of thyroid disease are uncommon. However, early recognition of these problems is crucial and may life saving. Emergency thyroidectomy is important to release the critically obstructed airways. Nonetheless it is associated with higher risk of surgery and complication rate then any elective thyroid surgery.
Seawater may be contaminated by harmful substances, including toxic elements released by human activities. The present study evaluates the total mercury and methylmercury concentrations and their correlations to fish body size in longtail tuna and short-bodied mackerel from Chendring, Kuantan, at east coast and Kuala Perlis at west costs of Peninsular Malaysia during May to November 2007. Total mercury and methylmercury in muscle tissue of 69 samples of longtail tuna and short-bodied mackerel, ranged from 0.180 to 1.460 μg/g and 0.0.169-0.973 μg/g and 0.251-1.470 μg/g and 0.202-1.352, whereas the methylmercury to total mercury ratio ranged from 70% to 83%, respectively. Samples of both species from the east coast showed higher levels of mercury compared to those from west coast. In all of the locations, significant positive correlations were found between fish body weight and mercury content (R(2) > 0.470). The estimated weekly intake of total mercury and methylmercury from the consumption 66.33 g/week of short-bodied mackerel and 18.34 g/week of longtail tuna (based on local dietry survey) was found to be lower than the maximum limit of 5 and 1.5 μg/kg bodyweight established by FAO/WHO and codex, respectively.
Desmoid tumours are uncommon. They are locally invasive and incomplete excision leads to recurrence, which can pose a significant management challenge. Patients therefore require effective treatment, which essentially entails tumour excision with a clear surgical margin. The resulting wide defect may lead to difficulty in closure of the anterior abdominal wall. We report our experience in treating large desmoid tumours of the anterior abdominal wall. Between January 2000 and December 2001, three patients with large desmoid tumour of the anterior abdominal wall were treated with wide excision, which included a 3-cm margin of uninvolved tissues. This led to a considerable abdominal wall defect. The peritoneal defect was closed as a separate layer, though under considerable tension, while the abdominal wall musculature defect was closed with a polypropylene mesh. All three patients recovered well with no immediate or late postoperative morbidity. Follow-up until December 2006 has not revealed any tumour recurrence or hernia development. Wide excision of an anterior abdominal wall desmoid tumour with a clear margin of 3 cm including the peritoneum should be considered when managing such tumours. Closure under tension of the peritoneum did not seem to produce any morbidity.
An optical sensor for Hg(II) monitoring using a complex of zinc dithizonate immobilised on XAD 7 which is based on reflectance spectrophotometry has been developed in this study. Measurements were made using a kinetic approach whereby the reflectance signal is measured at a fixed time of 5 min. The sensor could be regenerated using a saturated solution of KCl in 1 M sulphuric acid. The sensor was found to have an optimum response at pH 3.0 with respective measurement repeatability and probe-to-probe reproducibility of 1.53% and 5.26%. A linear response was observed in the Hg(II) concentration range of 0.0-180.0 ppm with a calculated limit of detection (LOD) of 0.05 ppm. The results obtained for aqueous Hg(II) determination using this probe were found to be comparable with the well-established method of atomic absorption spectrometry.
A 5-month-old girl presented with a soft-tissue mass over the lateral aspect of her right eyebrow. Surgical resection revealed a diagnosis of infantile malignant hemangiopericytoma. The mass recurred after excision and reconstruction. The patient died 4 months later with brain and lung metastasis.
This is a study on 124 patients who were treated by the authors over a 19-year period. There were 48 male and 76 female patients. The age range of these patients at the time of treatment was between 4 months and 32 years. There was no family history of similar deformity. All of these patients come from a socially low-income group. Fourteen patients had accompanying congenital amputation of fingers, toes, or limbs. Two had oral cleft lip and palate. The surgical treatment was medial orbital wall osteotomy and excision of encephalocele. There were two mortalities and five patients who had complications that needed secondary surgical intervention. Thirty-eight patients are still under follow up without any complaints.
This study was carried out to evaluate the long-term effect on the donor side of the foot and ankle following vascularized fibular graft resection in children. Eight patients underwent resection of the fibula for the purpose of a vascularized fibular graft by a surgical team who practiced leaving at least 6 cm residual distal fibula. The age of these children at the time of surgery was between 3 and 12 years. They were reviewed between 3 and 12 years after surgery. Two patients who underwent resection of the middle shaft of the fibula at 3 and 5 years of age developed abnormal growth of the distal tibia, leading to ankle valgus. They were treated with growth modulation of the distal tibial physis and supramalleolar osteotomy with tibiofibular synostosis. Another patient who underwent the entire proximal fibula resection at the age of 6 years had developed hindfoot valgus because of weakness of the tibialis posterior muscle. He required talonavicular fusion and flexor hallucis to tibialis posterior muscle transfer. Patients operated at the age of older than 8 years neither had ankle nor hindfoot deformity. We concluded that resection of the middle shaft of the fibula for the purpose of a vascularized fibula graft, leaving a 6 cm distal fibular stump in children younger than 6 years old, may give rise to abnormal growth of the distal tibial physis, leading to valgus ankle. The entire proximal fibular resection for the similar purpose in a 6-year-old child may give rise to weakness of tibialis posterior and hindfoot valgus.
We analyzed the characteristics of patients presenting with acute pancreatitis to our unit. A total of 71 patients were admitted to the Surgical Department at University Kebangsaan Malaysia (UKM) over a period of seven years, between January 1990 to December 1996 with acute pancreatitis. There was a fourfold increase in incidence of acute pancreatitis in our hospital from January 1990 to December 1996. The commonest identifiable aetiology was gallstones followed by alcohol. There were two deaths. We conclude that acute pancreatitis is increasingly being diagnosed in our local population. This may be due to either greater awareness or changes in lifestyle of the population.
Intrahepatic stones remain a major source of morbidity and mortality. With improving techniques in hepatobiliary surgery, the management and the outcome of intrahepatic calculi is reviewed. Forty-nine cases referred from all over Malaysia between January 1993 to June 1996 were analyzed retrospectively. There were thirty-two females and seventeen males. The median age was 46 years. Biliary diseases encountered in association with intrahepatic calculi included benign strictures (n = 14), ascariasis (n = 3), cholangiocarcinoma (n = 1), Caroli's disease (n = 1), and thalassaemia, (n = 1), fifty-six percent of stones were located in both the intrahepatic ducts while 34% were found in the left intrahepatic duct. Thirty-one patients underwent common bile duct exploration either alone or in combination with liver resection or bilioenteric anastomosis. Despite the various combinations of surgical and non-surgical intervention 28 (57.1%) patients had residual stones. Despite the availability of newer techniques in hepatobiliary surgery, residual stones were common, resulting in higher treatment costs.