Introduction: The accuracy of image interpretations of CT and MRI studies is absolutely dependent on the quality of the images produced. Motion artifacts which result from the patients' movement during image acquisitions may lead to misinterpretation, wrong diagnosis or inconclusive examinations. In pediatric age groups, most of CT and MRI examinations require sedation or general anesthesia to achieve the degree of cooperation or immobilisation to complete the procedures successfully. Methods: The patients were randomly chosen among children, from newborn to 12 years of age who underwent sedation and general anesthesia for CT scan and and MRI in the University of Malaya Medical Centre between September 2001 and August 2003. The quality of MRI and CT images were evaluated by radiologists using a three-point scale: 1-no motion artifact; 2-minor motion artifacts and 3-major motion artifacts. Results: Among sedated children, 75.5% and 41% had good CT and MRI images respectively. In general, the anesthesia group, 100% had good CT images and 85.7% had good MRI images. Children who received sedation (33.5%) had severe motion artifacts whereas none of the anesthetised children had severe motion artifacts. Conclusion: General anesthesia is much better for good quality images in both MRI and CT examinations; however it is associated with a higher cost and longer hospital stay. Combination of oral chloral hydrate and intravenous midazolam was found to be the most effective sedative agent in terms of CT/MRI image quality.

Honey is a natural substance produced by honeybees, Apis mellifera, from the nectar of blossomed flowers or exudates of trees and plants producing nectar honeys or honeydews, respectively. It is a supersaturated solution of sugars, enriched with proteins, minerals, vitamins, organic acids and polyphenols. Honey possesses numerous nutritional, healing and prophylactic properties attributed by the rich components found in honey. Some of the health beneficial properties include wound healing, antimicrobial, antioxidant and anti-inflammatory potential. This review relates the nutritional composition, antioxidant and therapeutical effects of honey with emphasis on Malaysian honeys.

Chlorella vulgaris, a unicellular microalgae, produces many intracellular phytochemicals namely carotenoids, tocopherols, ubiquinone and protein. Skin ageing which is induced by oxidative stress involves decreased extracellular matrix synthesis and increased expression of enzymes that degrade the collagenous matrix. The objective of this study was to determine the effect of C. vulgaris on the expression of genes encoded for collagen (COL) and matrix metalloproteinases (MMPs) which are involved in skin ageing. Human diploid fibroblasts (HDFs) were obtained from circumcision foreskin of 8-12 year-old boys. HDFs were cultured into 3 groups: untreated control cells, cells with stress-induced premature senescence (SIPS; cells were induced with H2O2 at passage 6 for 2 weeks) and SIPS treated with C. vulgaris (prolonged C. vulgaris treatment started at passage 4 and combined treatment with H2O2 at passage 6 for 2 weeks). Senescence-associated ß-galactosidase (SA ß-gal) was determined using senescent cells histochemical staining kit (Sigma, USA). Expression of COLI, COLIII, COLIV, MMPI, MMPII and MMPIII genes was quantitatively analysed with real-time RT-PCR method (iScript™ One Step real-time PCR with SYBR® Green; Biorad). HDFs treated with H2O2 (SIPS) exhibited senescent morphological features of flattening and enlarged with increased expression of SA ß-gal (p<0.05). Gene expression analysis showed COLI was downregulated in SIPS and SIPS treated with C. vulgaris (p<0.05) while COLIII decreased in SIPS and increased in SIPS treated with C. vulgaris (p<0.05). Expression of MMPI was increased in SIPS and SIPS treated with C. vulgaris (p<0.05) indicating its synergistic effect with H2O2 treatment. In conclusion, in skin ageing, COLI and COLIII genes were downregulated while MMPI was upregulated. C. vulgaris modulated the expression of COL and MMP genes by downregulating COLI and upregulating COLIII and MMPI but it did not exert anti-ageing effect.

Ginger extract has been reported previously by our group to exhibit anticancer and antioxidant effects by reducing tumour burden and lipid peroxidation respectively in he-patocarcinogenesis induced rats. The current study examined the expression of pro-apoptotic protein caspase-8 and anti-apoptotic protein Bcl-2 in hepatocarcinogenesis treated rats. Thirty normal male Wistar rats were divided into 5 groups based on the diet given: i) control (normal rat chow), ii) olive oil, iii) ginger extract (100mg/kg body weight), iv) choline deficient diet + ethionine, CDE (to induce liver cancer) and v) CDE+ginger extract. Rats were killed at week 8, and liver tissues were excised for immuno-histochemical study to identify pro-apoptotic and anti-apoptotic proteins, caspase-8 and Bcl-2. The observation on H&E staining confirmed the CDE diet induced liver can-cer as indicated by the presence of numerous oval cells. Identification of Bcl-2 expres-sion showed that 91.6% (11/12) of the samples from the CDE group revealed positive staining while treatment with ginger extract however inhibited the expression with only 8.4% (1/12) samples showing positive staining for Bcl-2. As for caspase-8 protein, 41.7% (5/12) of the samples from CDE group showed positive staining, which in-creased to 100% (12/12) with ginger extract treatment. Our findings suggest that gin-ger extract has an anticancer effect by inducing apoptosis in liver cancer cells via up-regulation of the expression of pro-apoptotic protein, caspase-8 and down-regulation of the expression of anti-apoptotic protein Bcl-2.

A cross-sectional study was carried out to assess the physical activity levels among patients with type 2 diabetes mellitus (DM) at Cheras Health Clinic in Kuala Lumpur. A total of 132 subjects (62 men and 70 women) aged 30 years and above participated in this study. Data was collected using an interview based questionnaire to obtain socio-demographic and health profile information. Physical activity was assessed using a shortened version of the International Physical Activity Questionnaire (IPAQ). Anthropometric measurements and body fat were also taken. Glycaemic status, that is, HbA1c, fasting blood sugar (FBS) and 2 hours post-prandial (2-HPP) were obtained from medical records. Results showed that the mean age of the patients was 51.9 + 5.8 years. The majority of patients had poor glycaemic control based on HbA1c (70.7%), FBS (71.9%) and 2HPP (85.4%). Patients who were unmarried and aged(60 years and above had a lower physical activity level (p<0.05). In the older age group, low physical activity was associated with poor glycaemic control (p<0.05). Patients in the moderate and high physical activity level were motivated to perform physical activity so as to be healthy (68.1%). Low physical activity level among patients was due to lack of time (54.5%) and lack of energy (21.2%). In conclusion, physical activity levels of the patients were unsatisfactory and associated with poor glycaemic control, especially in the elderly. There is a need to encourage diabetic patients to undertake regular physical activity in order to achieve optimal glycaemic control.

Biomechanical abnormalities of pronated feet accompanied by functional leg length disparity may increase the risk of skeletal muscle injury. Objective of the study is to prove that correction of pronated feet by the foot orthoses will reduce the creatine kinase-MM (CK-MM) concentrations as the muscle injury indicator. The design study was double blind randomized clinical trials with control. Research subjects were divided into two groups, group 1 used the foot orthoses while group 2 did not used the foot orthoses. The whole subject examined the concentrations of the CK-MM enzyme before, and 24–72 hours after the walking test. The walking test was conducted 15 minutes with maximum speed. The concentration of the CK-MM enzyme before walking test on treatment group was 70.07±15.33 International Unit (IU), similar with the control group was 69.85±17.03 IU (P=0.971). The increased in CK-MM enzyme concentrations 45 hours after the walking test was lower in the treatment group (7.8±9 IU) than the control group (22.0±11.5 IU) (P=0.001). The CK-MM enzyme concentrations continued to decline in the treatment group after the second walking test (77.21±17.47 IU), and after the third walking test (69.86±11.88 IU) (P=0.018). The foot orthoses for correcting the pronated feet on the young women with biomechanical abnormalities is able to reduce the degree of the skeletal muscle injury after walking activity.
Creatine ; Female ; Foot Orthoses ; Foot* ; Humans ; Leg ; Muscle, Skeletal* ; Research Subjects ; Walking

BACKGROUNDThe main goals of flexor tendon surgery are to restore digital motion by providing tendon healing and to preserve tendon gliding. Our purpose was to investigate the effects of 5-fluorouracil (5-FU) on tendon adhesions in partially divided profundus flexor tendons (flexor digitorum profundus [FDPs]) following surgical repair and in partially divided FDPs without surgical repair, and to compare the results of the repair versus the nonrepair of zone two injuries via macroscopic and biomechanical evaluations of tendon adhesions.

METHODSWe used 32 adult male European rabbits (Oryctolagus cunniculus) weighing from 2.5 to 3.5 kg. The study was performed on the deep flexor tendons of the second and third digits of the right hind paws of the rabbits; thus, a total of 64 tendons were examined in this study.

RESULTSBased on the results achieved in our experimental study, the load (N) significantly increased in subgroup 1a in which the tendons were surgically repaired and were not treated with 5-FU compared with subgroup 2a in which tendons were surgically repaired and treated with 5-FU.

CONCLUSIONSThe load (N) significantly increased in subgroup 1a in which the tendons were surgically repaired and were not treated with 5-FU compared to subgroup 2a in which the tendons were surgically repaired and treated with 5-FU. Therefore, these results revealed a decrease in adhesion formation in the subgroup that was treated with 5-FU due to increased resistance to tendon adhesions during their excursion through the tendon sheath, which in this case required greater traction force.

Animals ; Fluorouracil ; therapeutic use ; Male ; Rabbits ; Tendon Injuries ; drug therapy ; physiopathology ; Tendons ; drug effects ; pathology ; Tissue Adhesions ; drug therapy ; physiopathology ; Wound Healing ; drug effects

Deposition of extracellular matrix (ECM) in the trabecular meshwork (TM) increases aqueous humour outflow resistance leading to elevation of intraocular pressure (IOP) in primary open-angle glaucoma, which remains the only modifiable risk factor. Resveratrol has been shown to counteract the steroid-induced increase in IOP and increase the TM expression of ECM proteolytic enzymes; however, its effects on the deposition of ECM components by TM and its associated pathways, such as TGF-β-SMAD signalling remain uncertain. This study, therefore, explored the effects of trans-resveratrol on the expression of ECM components, SMAD signalling molecules, plasminogen activator inhibitor-1 and tissue plasminogen activator in dexamethasone-treated human TM cells (HTMCs). We also studied the nature of molecular interaction of trans-resveratrol with SMAD4 domains using ensemble docking. Treatment of HTMCs with 12.5 µM trans-resveratrol downregulated the dexamethasone-induced increase in collagen, fibronectin and α-smooth muscle actin at gene and protein levels through downregulation of TGF-β1, SMAD4, and upregulation of SMAD7. Downregulation of TGF-β1 signalling by trans-resveratrol could be attributed to its effect on the transcriptional activity due to high affinity for the MH2 domain of SMAD4. These effects may contribute to resveratrol's IOP-lowering properties by reducing ECM deposition and enhancing aqueous humour outflow in the TM.