Prevalence and risk factors of anti-tuberculosis drug-induced hepatitis in Malaysia

INTRODUCTION: Tuberculosis (TB) affects one-third of the world's population. Anti-TB drugs with isoniazid, rifampicin and pyrazinamide are very effective but they can cause hepatotoxicity. Many risk factors have been recognised. Data on prevalence of anti-TB drug-induced hepatitis as well as the contributing risk factors are scarce in Malaysia. This observational case control study was designed to look at the prevalence and the risk factors of drug-induced hepatitis in our population. METHODS: We retrospectively examined all the case notes of anti-TB drug-induced hepatitis over a 30-month period from January 2003 to June 2005. They were compared with controls selected by simple random sampling. Both groups were compared in terms of demographical data and risk factors, such as age, gender, body mass index, hepatitis B carrier, human immunodeficiency virus (HIV) infection, sites of TB, and pretreatment liver biochemistries (serum albumin, globulin, aspartate aminotransferase, alanine aminotransferase and bilirubin). Data was evaluated by chi square, independent t-test (univariate) and binary logistic regression analysis (multivariate). RESULTS: Out of 473 TB patients, 46 developed hepatitis and 138 were selected as controls. The prevalence of drug-induced hepatitis was 9.7 percent. On univariate analysis, HIV infection (p-value is 0.005), extrapulmonary tuberculosis (p-value is 0.008), lower serum albumin (p-value is 0.023) and higher serum globulin (p-value is 0.025) were significant risk factors. On binary logistic regression, only HIV infection (p-value is 0.018) and extrapulmonary TB (p-value is 0.017) were significant. CONCLUSION: The prevalence of hepatitis was 9.7 percent. The presence of HIV infection and extrapulmonary TB were significant risk factors for the development of hepatitis.     

Transbronchial needle aspiration of mediastinal lymph node

In Malaysia, transbronchial needle aspiration (TBNA) is a relatively new procedure performed only in a handful of respiratory centres. We reviewed TBNA of mediastinal lymph node performed in Hospital Tengku Ampuan Afzan (HTAA) to determine the yield and its complications. Data was retrieved from endoscopy databases and patients' records, CT thorax images and all cytological and histological slides were reviewed. Twenty-five patients had TBNA performed. TBNA was positive in 15 patients (60%). Overall, 80% had confirmed malignancy after bronchoscopy. Only four patients had documented bleeding after TBNA and in two of them, bleeding stopped spontaneously and another two patients required diluted adrenaline to stop the bleed. No mortality was reported from this procedure. Hence, TBNA is a safe procedure.     

Human respiratory epithelial cells from nasal turbinate expressed stem cell genes even after serial passaging

Current development in the field of tissue engineering led to the idea of repairing and regenerating the respiratory airway through in vitro reconstruction using autologous respiratory epithelial (RE). To ensure the capability of proliferation, the stem cell property of RE cells from the nasal turbinate should be evaluated. Respiratory epithelial cells from six human nasal turbinates were harvested and cultured in vitro. The gene expression of FZD-9 and BST-1 were expressed in passage 2 (P2) and passage 4 (P4). The levels of expression were not significant between both passages. The RE cells exhibit the stem cell properties, which remains even after serial passaging.     

钝伤性前房出血118例回顾分析

目的：寻找因钝器损伤导致前房积血的原因、视力损伤等相关情况,并探讨治疗后的并发症及预后视力情况。方法：回顾性分析在马来亚大学医疗中心（马来西亚吉隆坡）治疗的因钝器损伤导致前房积血118例患者。从患者的病情记录获取患者的性别、年龄、种族、钝伤导致的积血原因、眼附属物、入院视力、相关眼科情况、并发症和视力结果等资料,并采用SPSS软件进行分析。结果：男性受累居多,占93．2％,有2／3患者（67．8％）年龄〈30岁。运动相关的伤害（38．1％）是最常见的前房积血原因。66．9％的患者5d内前房出血消失。虹膜损伤非常普遍,包括括约肌撕裂,虹膜根部断离等,而并发玻璃体出血患者约占11．9％。住院期间,二次观察出血的患者为3．4％。在最后的随访中视力≥6／18的最佳矫正视力占85．4％。这些患者随访不到位导致继发性青光眼的发病率无法确定。中度角膜血染患者约占0．8％。结论：在马来西亚,运动相关的损伤是前房出血最常见的原因。适当和及时的治疗能使钝伤性前房积血患者具有良好的视力,且无严重并发症发生。     

酪氨酸相关肽的合成及抗孕酮生成活性

利用固相法合成了二十个含羟基氨基酸的小肽。其中，以０．５ｍｏｌ·Ｌ－１二甲二氯硅烷／１．５ｍｏｌ·Ｌ－１苯酚／ＤＣＭ＊为脱除Ｂｏｃ试剂，以ＴＦＭＳＡ为切除树脂试剂。经Ｃ－１８反相柱纯化后，全部产物均通过氨基酸分析要求。体外黄体细胞分泌孕酮实验表明有八个肽化物ＧｌｙＴｙｒＡｌａＬｙｓ，（ＳａｒＳｅｒ）２Ｌｙｓ及其申酯，ＴｙｒＬｙｓ，ＨｉｓＴｙｒ－ＮＨ２，ＴｈｒＰｒｏＴｙｒＬｙｓ－ＮＨ２，ＴｙｒＴｈｒＰｒｏＡｒｇＬｙｓ，ＡｓｐＨｉｓＰｒｏＴｈｒ－ＰｈｅＬｙｓ显示较强的抑制ｈＣＧ致孕酮分泌的活性，而且前三个肽还能显著抑制基础孕酮的分泌，相反，ＧｌｙＳｅｒＴｙｒ能刺激基础孕酮的分泌。目前尚未建立合理的结构一活性关系。     

Birth-weight of Newborns to Chinese Women Subsequent to a Previous Abortion

The mean birth-weight of firstborns of women was significantly higher when there was a previous abortion. The increase was 73.5 and 119.4 g in newborns of women with an induced and a spontaneous abortion respectively. This trend of significant increased birth-weight among firstborns of women with either a previous induced or spontaneous abortion continued for male infants, in recent migrants, and in subjects aged 20-24 and 30-34 years. Stepwise logistic regression analyses showed that a history of an induced or a spontaneous abortion increased the birth-weight of the firstborns, while short maternal stature and female newborn were associated with decreased birth-weight. For low birth-weight, a previous abortion was not selected into the regression models but short maternal stature and female newborns continue to contribute to low birth-weight. Prematurity and mean gestation were found not to be associated with previous abortion using logistic regression analyses.     

N,N′-亚烷基双(取代苯酚)氨基乙酸的合成及对放射性核素钍-234的促排效果

本文报道合成的16个N,N′-亚烷基双(取代苯酚)氨基乙酸除化合物3,4外对放射性钍-234的加速排出均有较好的效果。其中有二个化合物促排效果达到70%以上,根据动物实验结果初步探讨了构效关系。     

黄花远志根中两个新■酮化合物的结构鉴定

从黄花远志（ＰｏｌｙｇａｌａａｒｉｌａｔａＢｕｃｈＨａｍ．）根中分离得到两个新的酮化合物，根据理化性质和光谱（ＵＶ，ＩＲ，ＭＳ，１ＨＮＭＲ，ＤＩＦＮＯＥ和１３ＣＮＭＲ）分析，分别鉴定为１，３二羟基２甲氧基酮（Ｉ）和７羟基１甲氧基２，３亚甲二氧基酮（Ｉ）。药理试验表明Ｉ，Ｉ均具有抑制醛糖酶的作用。