Isolation and structure elucidation of halymeniaol,a new antimalarial sterol derivative from the red alga Halymenia floresii

A new mono-hydroxy acetylated sterol derivative: 12β-hydroxy-3β, 15α, 16β-triacetoxy-cholest-5-en-7-one (halymeniaol) (1), and cholesterol (2) were isolated from the marine red alga Halymenia floresii. The structure of the compound 1 (halymeniaol) was established from its spectral data, derived from HRMS/MS and 2D NMR. Compound 1 exhibited growth inhibitory activity against chloroquine-resistant Plasmodium falciparum 3D7 strain with an IC₅₀ of 3.0 μM.     

抗磷脂综合征表现为视乳头水肿1例

目的:报告1例罕见抗磷脂综合征的患者,由于上矢状窦血栓形成而表现为双眼视乳头水肿及右眼第六颅神经麻痹,经抗凝和乙酰唑胺治疗后视乳头水肿恢复。方法:病例报告:一44岁中国男性,主诉为头痛、复视及轻度的视物模糊。临床检查发现右眼第6神经麻痹和双眼视乳头水肿,双眼视野盲点扩大和红绿色觉缺失,计算机断层摄影及核磁共振扫描显示上矢状窦血栓形成,血液学检查证实抗磷脂综合征是其潜在原因。结果:在联合应用抗凝和口服乙酰唑胺治疗3mo后,视乳头水肿恢复至正常的解剖,扩大的视野盲点降至正常水平,双眼红绿色觉恢复正常,伴随右眼视乳头水肿消退和视力改善表明这个患者视功能得以恢复。结论:抗磷脂综合征应与视乳头水肿鉴别诊断;对于顽固性的视乳头水肿,口服乙酰唑胺是抗凝治疗的重要辅助治疗,它可以保护视神经免受有可能导致失明后果的视神经损害。     

AntiPhosPholiPid syndrome manifesting as PaPill- edema

to rePort a rare caseof antiPhosPholiPid syndrome Presenting as PaPilledema and sixth nerve Palsy in right eye dueto suPerior sagittal sinusthrombosis, and regressionof PaPilledema following anticoagulation and acetazolamidetheraPy. ·METHODS: A 44-year-old Chinese gentleman Presented with headache, diPloPia and mild blurringof vision. Clinical examination revealedthe Presenceof sixth nerve Palsy in right eye and PaPilledema.there was enlargementof blind sPot inthe visual fields and red green deficiency in both eyes. ComPutedtomograPhy and magnetic resonance imaging showed suPerior sagittal sinusthrombosis. Hematological investigation confirmedthe Presenceof antiPhosPholiPid syndrome asthe underlying cause. ·RESULTS:the condition wastreated successfully inthree months withthe adjunctive useof anticoagulation and acetazolamide. Reversalof PaPilledema changes intheoPtic discto normal indicatesthe anatomical recovery, while reductionof enlargementof blind sPotto normal size, recoveryof red green deficienyto normal colour vision in both eyes and visual imProvement after regressionof PaPilledema in right eye indicate functional recovery inthis Patient. ·CONCLUSION: AntiPhosPholiPid syndrome should be consi- dered inthe differential diagnosisof PaPilledema, andoral acetazolamide is an imPortant adjuncttheraPyto anti- coagulation in casesof refractory PaPilledemato ProtecttheoPtic nerve from Potential damage which results in blindness.     

皮质类固醇治疗外伤性视神经病变的四天关键时期(英文)

目的:评估静脉注射甲基强的松龙(IVMP)对外伤性视神经病变患者的疗效。方法:回顾性分析2000-01至2007-06我院收治的16例外伤性视神经病变(TON)患者的临床资料。1g甲基强的松龙分3d静脉应用,然后口服泼尼松龙11d,并逐渐减量。记录从损伤开始到治疗开始的时间。视力变化是本研究结果的主要功能评价指标。在入院时,治疗后1,2,3d;1wk和1mo时,分别记录最佳矫正视力(BCVA)。结果:共有16例患者纳入本研究,平均年龄为30岁,其中男性14例、女性2例。引起TON的主要原因有摩托车事故(占69%),打架斗殴(占19%)和体育运动(占12%)。所有患者都表现有相对传入性瞳孔障碍。在损伤后4d内开始静脉注射甲基强的松龙,采用Snellen视力表检查视力,绝大部分(56%)患者视力提高超过3行或大于等于0.5(6/12)。在损伤后5d以上才开始用类固醇治疗,视力则没有任何进步。结论:治疗TON,静脉注射中等到大剂量甲基强的松龙仍将起到重要作用。静脉注射甲基强的松龙治疗TON可能存在伤后4d的关键时期,超过了这个时期,该治疗可能就毫无效果。但还需要有更多的研究来为我们提供有明显统计学意义的数据。     

Granulomas in acquired immunodeficiency syndrome‐associated cutaneous Kaposi sarcoma: evidence for a role for Mycobacterium tuberculosis

Background: Co‐lesional acquired immunodeficiency syndrome‐associated cutaneous Kaposi sarcoma (AIDS‐KS) and Mycobacterium tuberculosis‐associated granulomatous inflammation are undocumented. Method: Retrospective appraisal of skin biopsies with co‐lesional AIDS‐KS and microscopic tuberculosis (TB). Results: Sixteen biopsies from nine males and seven females form the study cohort. Histological assessment confirmed nodular and plaque KS in 12 and 4 cases each, respectively. Necrotizing, non‐necrotizing and a combination of necrotizing and non‐necrotizing granulomatous inflammation were present in nine, two and five biopsies each, respectively. The identification of acid fast bacilli on Ziehl‐Neelsen staining and M. tuberculosis on polymerase chain reaction confirmed co‐lesional TB in 15/16 biopsies. Co‐lesional AIDS‐KS and lichen scrofulosorum, hitherto undocumented, were confirmed in one biopsy. The histopathological findings served as a marker of human immunodeficiency virus (HIV) infection, visceral TB, therapeutic noncompliance and multidrug resistant pulmonary TB in nine, eight, five and one patient, respectively. M. tuberculosis was cultured from sputum or nodal tissue of all patients. Conclusion: Granulomatous inflammation in KS requires optimal histopathological and molecular investigation to confirm an M. tuberculosis origin. The cutaneous co‐lesional occurrence of AIDS‐KS and microscopic TB may serve as the sentinel clue to HIV infection, systemic TB, therapeutic noncompliance or multidrug resistant TB. Ramdial PK, Sing Y, Subrayan S, Calonje E, Aboobaker J, Sydney C, Sookdeo D, Ramburan A, Madiba TE. Granulomas in acquired immunodeficiency syndrome‐associated cutaneous Kaposi sarcoma: evidence for a role for Mycobacterium tuberculosis.     

Risk factors for clinically significant macular edema in a multi-ethnics population with type 2 diabetes

AIM: To determine the risk factors of clinically significant macular edema (CSME) in patients with non-proliferative diabetic retinopathy (NPDR) in a multi-ethnics Malaysian population. METHODS: We performed a case control study in which 150 patients with bilateral NPDR and CSME in either eye were compared to 150 patients with bilateral NPDR and no CSME in both eyes. CSME and NPDR were graded according to Early Treatment of Diabetic Retinopathy Study criteria. Student’s t-test, odds ratio and multiple logistic regression analysis were performed to analyze the duration of diabetes, body mass index (BMI), blood pressure(BP), total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG), fasting blood glucose (FBG), HbA1c, full blood count, serum creatinine and proteinuria between the two groups. RESULTS: Both groups were matched in terms of age, gender and ethnicity. Duration of diabetes, total serum cholesterol, serum LDL, FBG, HbA1c and serum creatinine were significantly higher in the CSME group (P<0.05). The hemoglobin, packed cell volume were significantly lower in the CSME group (p<0.05). There was no significant difference for serum HDL, TG, BMI, systolic and diastolic BP. Multiple logistic regression analysis showed that total serum cholesterol and HbA1c had significantly high odds of developing CSME. CONCLUSION: HbA1c and total cholesterol are the two most important risk factors associated with CSME in patients with NPDR.     

Childhood blindness and severe visual impairment in Malaysia: a nationwide study

Aim

To determine the causes of childhood blindness and severe visual impairment (BL/SVI) in schools for the blind in Malaysia.

Methods

All children ≤15years attending 24 schools for the blind throughout the country were examined using the WHO Prevention of Blindness Programme (WHO/PBL) eye examination record for children, and visual loss was classified according to the International Classification of Disease (ICD).

Results

In all, 469 children were examined, of whom 448 (95.6%) had BL/SVI. The major causes of visual loss were retinal disorders (n=148, 33% mainly retinopathy of prematurity (n=78, 17.4%)), cataract/pseudophakia/aphakia (n=77, 17.2%), and anomalies affecting the whole globe. (n=86, 19.2%). The major underlying etiology was undetermined (n=193, 43.1%), followed by hereditary factors, 21.7% (mainly retinal dystrophies), and perinatal factors, 20.5%. More than 34 (7.6%) cases were considered potentially preventable and 192 (42.9%) potentially treatable.

Conclusion

Diseases of the retina are the major cause of visual impairment, with retinopathy of prematurity being an important avoidable cause. This reflects expansion of neonatal services in Malaysia, and improved survival of very low birth weight and preterm babies. Lens-related causes of visual impairment reflect the need to further improve pediatric ophthalmology services in Malaysia.