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Hong CY, Goh LG, Lee HP. The advance directive--a review. Singapore Med J 1996; 37:411-8. [PMID: 8993145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The advance directive is a document that enables a competent individual to specify the form of health care he would like to have, in the event that he is unable to make such decisions in the future. This review paper traces the development of the advance directive from 1967, when it was first proposed by Luis Kutner. The Karen Ann Quinlan case and the Nancy Cruzan case are cited as examples of the case for the advance directive. The argument is that advance directives assist doctors, patients, family members and other carers with the increasingly complex health care decision making. Reservations have been expressed about the anticipatory nature of the decision, possible conflict with personal and religious ethics and the risk of cost containment considerations being over-riding concerns. The advance directive in America has undergone changes since the California Natural Death Act 1976 was passed. In the 1980s, "terminal" included permanent unconsciousness and advanced dementia. The declarant was also given a wider choice of treatment procedures that they wish to be withheld. Proxy directives were also introduced. In the 1990s, the declarant is even allowed to request the use of life-prolonging procedures. When appropriately implemented, the advance directive can perform its intended functions of clarifying the patient's perspective on life, death and medical care. When it is vague in terminology or applied to patients with uncertain prognoses, it can cause confusion to the patient's carers; and when improperly used, it can become an instrument not of patient's preferences, but of economic purpose, family bias, or physician's values.
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Hong CY, Huang SS, Tsai SK. Magnolol reduces infarct size and suppresses ventricular arrhythmia in rats subjected to coronary ligation. Clin Exp Pharmacol Physiol 1996; 23:660-4. [PMID: 8886485 DOI: 10.1111/j.1440-1681.1996.tb01753.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
1. Magnolol is an active component of Magnolia officinalis. It is 1000-times more potent than alpha-tocopherol in inhibiting lipid peroxidation in rat heart mitochondria. In the present study, the in vivo antiarrhythmic and anti-ischaemic effects of magnolol in coronary ligated rats were investigated. 2. Male Sprague-Dawley rats were anaesthetized with urethane. Magnolol, at dosages of 10(-7), 10(-8) and 10(-9) g/kg, was administered intravenously 15 min before ligation of the coronary artery. 3. The incidence and duration of ventricular tachycardia and ventricular fibrillation during 30 min coronary ligation were significantly reduced by magnolol. Ventricular arrhythmias during 10 min reperfusion after the relief of coronary ligation were also reduced. 4. In rats subjected to 4 h coronary ligation, 10(-7) and 10(-8) g/kg magnolol significantly reduced infarct size. 5. We conclude that magnolol may protect the myocardium against ischaemic injury and suppress ventricular arrhythmia during ischaemia and reperfusion.
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Oh JI, Paek KS, Ahn MJ, Kim MY, Hong CY, Kim IC, Kwak JH. In vitro and in vivo evaluations of LB20304, a new fluoronaphthyridone. Antimicrob Agents Chemother 1996; 40:1564-8. [PMID: 8726042 PMCID: PMC163372 DOI: 10.1128/aac.40.6.1564] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
In vitro activity of LB20304 against 1,231 clinical isolates was evaluated and compared with those of ciprofloxacin, sparfloxacin, lomefloxacin, and ofloxacin. LB20304 demonstrated the most potent activity against gram-positive bacteria. It was 32- to 64-fold more active than ciprofloxacin against methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus, methicillin-resistant Staphylococcus epidermidis, and Streptococcus pneumoniae (penicillin G resistant). LB20304 was also highly active against most members of the family Enterobacteriaceae. Its activity was more potent than those of sparfloxacin, ofloxacin, and lomefloxacin and comparable to that of ciprofloxacin. The protective activities of LB20304 against systemic infections caused by gram-positive bacteria in mice were superior to those of ciprofloxacin and sparfloxacin. Against infections by gram-negative bacteria, LB20304 was slightly less active than ciprofloxacin.
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Chan P, Niu CS, Cheng JT, Tsao CW, Tsai SK, Hong CY. Trilinolein preserves mitochondria ultrastructure in isolated rat heart subjected to global ischemia through antioxidant activity as measured by chemiluminescence. Pharmacology 1996; 52:216-25. [PMID: 8841084 DOI: 10.1159/000139386] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Oxygen-derived free radicals (OFR) have been proposed as the cause of myocardial damage through lipid peroxidation during ischemia and reperfusion. Antioxidants can effectively ameliorate the damage induced by lipid peroxidation. Trilinolein is a triacylglycerol recently purified from the well known traditional Chinese herb Panax pseudoginseng, which has been used in treating circulatory disorders among Chinese for hundreds of years; it has linoleate as the only fatty acid residue in all three esterified positions of glycerol. This chemical has recently been demonstrated to have antioxidant activity by enhanced chemiluminescence. The addition of phorbol myristic acetate (PMA) to medium containing leukocytes produces OFR; this phenomenon was measured by chemiluminescence. Addition of trilinolein to medium containing leukocytes preceding the addition of PMA suppressed the production of OFR. The control value of chemiluminescence of a medium containing leukocytes with addition of PMA was 9.23 +/- 1.19 x 10(3) mV. The most effective concentration of trilinolein was 10(-7) mol/l which decreased the signals to 4.59 +/- 0.02 x 10(3) mV (p < 0.001). The antioxidant effect had a concentration-response curve similar to alpha-tocopherol. After pretreatment for 15 min with trilinolein at a concentration of 10(-7) mol/l in isolated perfused rat heart which had been subjected to 60 min of global ischemia, the integrity of the rat heart mitochondria was preserved as examined under the electron microscope. No swelling of mitochondria occurred and there was good alignment of cristae and absence of amorphous density. Previous experiments have shown that trilinolein can also improve erythrocyte deformability in vitro. Infarct size reduction of about 50% was also demonstrated in in vivo rat heart subjected to 4 h coronary occlusion. The mechanism of myocardial protection, in addition to the antioxidant effect, is suggested as maintaining the membrane fluidity of cardiomyocytes.
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Huang YT, Wang GF, Chen CF, Chen CC, Hong CY, Yang MC. Fructus aurantii reduced portal pressure in portal hypertensive rats. Life Sci 1995; 57:2011-20. [PMID: 7475952 DOI: 10.1016/0024-3205(95)02195-o] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The purpose of this study was to investigate the effects of Fructus Aurantii (the unripe fruits of Citrus aurantium L.) on portal hypertensive rats. Portal hypertension was induced by partial portal vein ligation (PVL) in Sprague-Dawley rats. Sham-operated (Sham) rats served as controls. Hemodynamic and in vitro contractile studies were performed at 14 days after surgery. Both the aqueous extract of Fructus Aurantii and synephrine, one of its purified principles with pressor activity, were infused into the conscious PVL and Sham rats via a syringe pump. Fructus Aurantii (1.25, 2.5, & 5.0 mg/kg/min) dose-dependently reduced portal pressure in PVL and Sham rats, with the percentage change in portal pressure more pronounced in PVL rats. Mean arterial pressure was dose-dependently elevated by Fructus Aurantii. Synephrine (0.095, 0.19, & 0.38 mg/kg/min) also dose-dependently reduced portal pressure and elevated mean arterial pressure in PVL and Sham rats. Fructus Aurantii (2.8-280 micrograms/ml) induced dose-dependent contractile responses mainly in aorta and mesenteric artery, but little response in portal vein. The results showed that Fructus Aurantii infusion reduced portal pressure, possibly by way of arterial vasoconstriction.
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Shen YC, Hong CY. Effect of trilinolein on cyclic nucleotide formation in human platelets: relationship with its antiplatelet effect and nitric oxide synthesis. Br J Pharmacol 1995; 116:1644-8. [PMID: 8564231 PMCID: PMC1908908 DOI: 10.1111/j.1476-5381.1995.tb16385.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
1. Trilinolein, a triacylglycerol with linoleic acid as the only fatty acid residue in all three esterified positions of glycerol, was recently reported to have an inhibitory effect on adrenaline-induced platelet aggregation. In the present study, we found that trilinolein at concentrations ranging from 0.01 to 1 microM increased cyclic GMP formation and decreased cyclic AMP formation in washed human platelets. Both NG-nitro-L-arginine methyl ester (L-NAME) and methylene blue attenuated the trilinolein-induced increase in cyclic GMP. 2. Adrenaline decreased not only the production of cyclic AMP but also that of cyclic GMP. Trilinolein antagonized the inhibitory effect of adrenaline on cyclic GMP formation, but potentiated the inhibitory effect of adrenaline on cyclic AMP accumulation. 3. Both trilinolein and adrenaline enhanced intracellular calcium but the increment of intracellular calcium induced by them was much less than that produced by thrombin. 4. We propose that the anti-platelet effect of trilinolein is mediated through an increase in cyclic GMP, and that the change in cyclic GMP results from stimulation of nitric oxide synthesis in platelets. 5. We also propose that reduction of both cyclic AMP and cyclic GMP are involved in adrenaline-induced platelet aggregation.
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Huang SS, Yeh SF, Hong CY. Effect of anthraquinone derivatives on lipid peroxidation in rat heart mitochondria: structure-activity relationship. JOURNAL OF NATURAL PRODUCTS 1995; 58:1365-1371. [PMID: 7494143 DOI: 10.1021/np50123a005] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Lipid peroxidation was induced in rat heart mitochondria with FeSO4 and the inhibitory effects of various anthraquinone derivatives were compared. Oxygen consumption and malondialdehyde formation were used to quantitate the amount of lipid peroxidation. Emodin [2], alizarin [13], and alizarin complexone [14] significantly inhibited lipid peroxidation; their potency as inhibitors of lipid peroxidation was higher than that of alpha-tocopherol. Structure-activity analysis showed that two hydroxyl groups arranged in either the ortho- or meta-position in the C ring of the anthraquinone nucleus are required for such derivatives to inhibit lipid peroxidation. The diphenyl-p-picrylhydrazyl test showed that alizarin [13] and alizarin complexone [14] are free-radical scavengers while emodin [2] is not. The mechanism for emodin [2] to inhibit lipid peroxidation is most likely due to inhibition on the propagation of lipid peroxyl radicals in the mitochondrial membrane.
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Hong CY, Lai LJ, Huang YT. Endothelium-dependent vasorelaxant effect of trilinolein: mediated by nitric oxide and cyclic GMP. Life Sci 1995; 57:1309-15. [PMID: 7545773 DOI: 10.1016/0024-3205(95)02088-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
At concentrations ranged from 0.1 nM to 1 microM, trilinolein concentration-dependently relaxed the phenylephrine-induced constriction of isolated rat aorta. Concentration-response curves for the interaction between trilinolein and phenylephrine showed that trilinolein was unlikely a competitive antagonist of phenylephrine. The vasorelaxant effect of trilinolein was dependent on the presence of intact endothelium. Both NG-nitro-L-arginine methyl ester and methylene blue antagonized this vasorelaxant effect. L-arginine partially reversed the effect of L-NAME on trilinolein. Linoleic acid had no vasorelaxant effect. We concluded that trilinolein is an endothelium dependent vasorelaxant and the underlying mechanism could be a stimulation of the nitric oxide and cyclic GMP pathway.
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Chan P, Tsai SK, Chiang BN, Hong CY. Trilinolein reduces infarct size and suppresses ventricular arrhythmias in rats subjected to coronary ligation. Pharmacology 1995; 51:118-26. [PMID: 8584572 DOI: 10.1159/000139324] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Trilinolein, a triacylglycerol with linoleic acid as the only fatty acid residue in all esterified positions of glycerol, was previously found to improve erythrocyte deformability in vitro. In this study, the in vivo antiarrhythmic and anti-ischemic effects of trilinolein in coronary ligated rats were investigated. Male Sprague-Dawley rats were anaesthetized with urethane. Trilinolein, at dosages ranging from 10(-11) to 10(-7) g/kg, was administered intravenously 15 min before ligation of coronary artery. Also, the effect of trilinolein on arrhythmia was studied by ligating the coronary artery for 30 min, then reperfusing myocardium for 10 min. During the 30-min ischemia, trilinolein reduced not only the number of ectopic beats but also the incidence rate and duration of ventricular tachycardia. At 10(-7) g/kg, trilinolein completely suppressed all ventricular arrhythmias. Ventricular arrhythmias during 10 min reperfusion were also reduced by trilinolein at similar dosages. Furthermore, the effect of trilinolein on infarct size was evaluated by occluding the coronary artery for 4 h before the infarct zone was stained and weighed. In rats subjected to 4 h coronary ligation, pretreatment with 10(-7) g/kg trilinolein at 15 min prior to the coronary ligation significantly reduced infarct size. Trilinolein may protect myocardium against ischemic injury and suppress arrhythmia during ischemia and reperfusion.
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Strichartz GR, Hall S, Magnani B, Hong CY, Kishi Y, Debin JA. The potencies of synthetic analogues of saxitoxin and the absolute stereoselectivity of decarbamoyl saxitoxin. Toxicon 1995; 33:723-37. [PMID: 7676464 DOI: 10.1016/0041-0101(95)00031-g] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The potencies of synthetic saxitoxin (+/- STX) and six of its synthetic analogues, including the enantioselectively synthesized unnatural (-)enantiomer of decarbamoyl saxitoxin (dcSTX), were measured and compared to those of natural saxitoxin [(+)STX]. The analogues, all of which were racemic (+/-) mixtures except for dcSTX, varied in the substituents at the C6 position, the carbamoyl 'moeity', and the C12 position, the hydrated ketone. The ability of the toxins to inhibit the compound action potential (AP) and to displace radiolabeled natural saxitoxin (3H-STX) from nerve membranes at equilibrium were both used as potency assays. Biological activity of both (+)- and (-)dcSTX was analyzed by the kinetics of block of single Na+ channels reconstituted in planar lipid bilayer membranes, where it was demonstrated that only (+)dcSTX had biological activity. The potency of STX analogues fell markedly as the substituent at the C6 position became smaller; Ki values from the binding competition assay (at 4 degrees C) are: (+/-)6-methanolic-STX, 5 x 10(-10) M; (+/-)6-methyl-STX, 1 x 10(-6) M; (+/-)6-dihydro-STX, 3.5 x 10(-5) M. Replacement of the ketone at the C12 position by a methylene group was accomplished in two derivatives, although both also had substituents at the C6 position. The compound (+/-)6-methyl-12-deoxy-STX was about 0.03 as potent as (+/-)6-methyl-STX and only 10(-5) as potent as racemic (+/-)STX. In synthetic compounds where the benzyloxymethyl (-CH2OCH2C6H5) substituent occurred at the C6 position, the C12-methylene derivative still displayed some binding activity (Ki = 6 x 10(-4) M). However, when the same C6 derivatized compounds also contained a 6-membered heterocyclic group (-C3H8S2-) conjugated to carbon 12, the measured binding affinity was even further decreased (Ki = 2 x 10(-3) M). The findings show that substitutions on the carbon 6 position of STX have stronger effects on STX potency than previously believed, and that the toxin may form a hydrogen bond with the sodium channel at this site. Furthermore, the total removal of oxygen from the C12 position does not completely abolish the binding activity of the molecule.
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Lin MH, Chao HT, Hong CY. Magnolol protects human sperm motility against lipid peroxidation: a sperm head fixation method. ARCHIVES OF ANDROLOGY 1995; 34:151-6. [PMID: 7625878 DOI: 10.3109/01485019508987843] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
It was previously reported that magnolol, isolated from the Chinese medicinal herb Magnolia officinalis, had a potent inhibitory activity on lipid peroxidation. Since sperm motility could be suppressed by lipid peroxidation, this study examines the protective effect of magnolol on lipid peroxidation-suppressed sperm motility. FeSO4 was used to induced lipid peroxidation and sperm motility was expressed as tail beat frequency (TBF) measured with a sperm head fixation method. Magnolol at 10(-9) to 10(-7) M significantly reversed the FeSO4-suppressed TBF. Magnolol significantly inhibited the generation of malondialdehyde (MDA), the end product of lipid peroxidation, in sperm. Magnolol protected sperm motility by inhibiting lipid peroxidation in sperm.
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112
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Huang YT, Yu PC, Lee MF, Lin HC, Hong CY, Yang MC. Decreased vascular contractile and inositol phosphate responses in portal hypertensive rats. Can J Physiol Pharmacol 1995; 73:378-82. [PMID: 7648517 DOI: 10.1139/y95-048] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The purpose of this study was to investigate the vascular contractile and inositol phosphate responses in portal hypertensive rats. Portal hypertension was induced by partial portal vein ligation (PVL) in Sprague-Dawley rats. Sham-operated rats served as controls. Pressures, vasoconstrictor responses, and inositol phosphate responses were determined at 14 days after surgery. The portal venous pressure was significantly higher, while systemic arterial pressure and heart rate were lower, in PVL rats. Dose-dependent contractile responses were observed for both norepinephrine (1 x 10(-8) - 3 x 10(-6) M) and vasopressin (3 x 10(-10) - 3 x 10(-8) M) in the tail artery of both groups. The contractile response to norepinephrine was significantly decreased in PVL rats compared with controls at all doses. The contractile response to vasopressin was significantly decreased in PVL rats at higher doses. After myo-[3H]inositol incorporation in tail artery, the levels of 3H-labelled phosphatidylinositols (cpm/mg) were similar between the two groups. Norepinephrine (10(-7) - 10(-5) M) and vasopressin (10(-10) - 10(-8) M) dose dependently stimulated the 3H-labelled inositol phosphate production in the tail artery of both PVL and sham-operated rats. However, the response was significantly lower in PVL rats. The results suggested that the attenuation of vascular contractile responses in portal hypertension was reflected in the phosphoinositide messenger system.
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113
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Huang YT, Lo JW, Lin HC, Tsai YT, Hong CY, Yang MC. Change in vascular cAMP and cGMP contents in portal hypertensive rats. Pharmacology 1995; 50:86-91. [PMID: 7536331 DOI: 10.1159/000139270] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The purpose of this study was to investigate the possible changes of cyclic nucleotide contents in portal hypertensive rats. Portal hypertension was induced by partial portal vein ligation (PVL) in Sprague-Dawley rats. Sham-operated rats served as controls. Hemodynamic and cyclic nucleotide measurements were performed at 14 days after surgery. The portal venous pressure was significantly higher, while systemic arterial pressure and heart rate were lower in PVL rats than those in controls. Basal cAMP (PVL, 10.91 +/- 0.98, vs. sham, 8.08 +/- 0.81 pmol/mg protein) and cGMP (PVL, 0.91 +/- 0.12, vs. sham, 0.59 +/- 0.05 pmol/mg protein) contents in the tail artery were significantly higher in PVL rats. Isobutyryl methylxanthine (10(-5) M), a nonspecific phosphodiesterase inhibitor, exerted similarly stimulating effects on the tissue cGMP (PVL, 158 +/- 10, vs. sham, 178 +/- 20%) and cGMP (295 +/- 28 vs. 316 +/- 71%) levels in both PVL and control rats; so did forskolin (10(-6) M) on the cAMP (184 +/- 20 vs. 197 +/- 66%) content in both groups. Our results showed that the arterial cAMP and cGMP contents were higher in PVL rats, which may contribute to the reduction of peripheral resistance in portal hypertension.
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114
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Hong CY, Wang CP, Huang SS, Hsu FL. The inhibitory effect of tannins on lipid peroxidation of rat heart mitochondria. J Pharm Pharmacol 1995; 47:138-42. [PMID: 7602469 DOI: 10.1111/j.2042-7158.1995.tb05766.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We induced lipid peroxidation in rat heart mitochondria with ferrous sulphate (FeSO4) and compared the inhibitory effect of various tannins on the peroxidation. Oxygen consumption and malondialdehyde (MDA) formation were used to quantitate the amount of lipid peroxidation, and the free radical scavenger activity of tannins was measured with a diphenyl-p-picryl hydrazyl (DPPH) method. Of 25 tannins and related compounds tested, catechin benzylthioether and procyanidin B-2 benzylthioether were the most potent in inhibiting lipid peroxidation, with inhibitory effects stronger than that of trolox, a water soluble analogue of vitamin E. The concentrations (IC50) required for catechin benzylthioether and procyanidin B-2 benzylthioether to inhibit oxygen consumption to 50% of control values were 0.85 and 2.0 microM, respectively, while their IC50 values from the inhibition of MDA formation were 0.9 and 1.70 microM, respectively. The IC50 values for catechin, and procyanidin B-2 to inhibit oxygen consumption were 34.0 and 11.0 microM. Both compounds were less potent than their benzylthioether derivatives. However, the ability of catechin and procyanidin B-2 to scavenge DPPH were similar to that of their benzylthioether derivatives. We conclude that conjugation with a benzylthioether group enhances the inhibitor effect of tannins on lipid peroxidation, and that the mechanism is not an increase in its scavenger activity.
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Wong ML, Ng TP, Hong CY, Koh KT, Goh LG, Ling SL. Understanding asthma: patient survey. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 1994; 23:861-5. [PMID: 7741500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Eight hundred and two adult patients attending five randomly selected polyclinics in Singapore were interviewed to assess their understanding of asthma. Knowledge of asthma mechanism and its medications was poor with a mean score of 1.4 (median: 1) out of a total score of 6. About a third knew that asthma is due to narrowing of airways and a quarter knew the action of bronchodilators. Only 4.4% (27) knew that steroids decrease airway swelling or inflammation. The best knowledge score was associated with subjects who had the highest education, who had a family history and who had been exposed to pamphlets and books. Incorrect use of prophylaxis was also evident with only one-third (37%) using steroid inhalers regularly as prescribed. Only half (54.5%) of those with no schooling used the correct inhaler technique. Doctors were a source of information for only 49.9% (400) of the patients and it was those with the highest education who were most likely to get information from the doctors. Pamphlets were a source of information for less than one-fifth (16.2%) of the subjects. Greater emphasis should be given to patient education by doctors to help patients understand asthma and its treatment. Important target groups are the older, lesser educated and the moderate or severe patients on steroid inhalers.
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Abstract
At concentrations ranging from 10(-9) to 10(-6) M, trilinolein inhibited epinephrine-induced platelet aggregation. This inhibition was accompanied by reduced ATP release and thromboxane B2 formation. However, concentration-response curves for the interaction between trilinolein and epinephrine showed that trilinolein was unlikely a competitive antagonist of epinephrine. Platelet aggregation induced by collagen, thrombin, ADP or arachidonic acid was not inhibited. This study supported the theory that this type of triglyceride may have therapeutic potential but the definite mechanism for its effect remains to be answered.
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117
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Hong CY, Ng TP, Wong ML, Koh KT, Goh LG, Ling SL. Lifestyle and behavioural risk factors associated with asthma morbidity in adults. QJM 1994; 87:639-45. [PMID: 7987660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
We studied the association between morbidity and personal lifestyle/behavioural factors that predispose to exposure to known environmental precipitants of asthma, in a group of asthmatics (n = 787) in primary-care clinics. Clinical severity of asthma was determined by questions regarding the frequency of daytime or nocturnal attacks, the number of visits to primary care or hospital emergency departments for treatment of acute attacks, and the number of hospitalizations, as well as the amount of sick leave in the past year. Questions concerning risk factors included ethnicity, clinical atopic status (current rhinitis/eczema), smoking, occupation, keeping of pets, rugs and carpets, use of brooms, burning of mosquito coils or incense, and outdoor air pollution, as well as the patient's knowledge of asthma care. The most significant independent predictors of asthma morbidity, identified from multivariate logistic regression analyses, were current keeping of either pets or rugs/carpets (OR 1.49; 95% CI 1.12-1.99), and current high-risk occupations (OR 0.59, 95% CI 0.40-0.89). A multiplicity of interacting factors and behavioural responses appear to influence the effects of allergens and other environmental precipitants on asthma morbidity in patients.
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118
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Tsai SK, Chan P, Lee TY, Yung JM, Hong CY. Trilinolein improves erythrocyte deformability during cardiopulmonary bypass. Br J Clin Pharmacol 1994; 37:457-9. [PMID: 8054252 PMCID: PMC1364902 DOI: 10.1111/j.1365-2125.1994.tb05714.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The in vitro effect of trilinolein, a triglyceride with linoleic acid as the major fatty acid residue in the esterified positions of glycerol, on erythrocyte deformability was studied in blood samples collected from 12 patients before and after cardiopulmonary bypass (CPB). Erythrocyte deformability was measured with a filtration method and expressed as red cell filtration rate (RFR). RFR was reduced after CPB and the reduction was time dependent. Trilinolein at a concentration of 10(-7) M significantly reversed the CPB-induced reduction of RFR when it was mixed with blood samples collected 30, 60 and 90 min from the start of CPB. This study confirmed the effect of CPB on erythrocyte deformability and showed that this damage could be significantly improved by mixing blood with trilinolein.
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Ng TP, Hong CY, Goh LG, Wong ML, Koh KT, Ling SL. Risks of asthma associated with occupations in a community-based case-control study. Am J Ind Med 1994; 25:709-18. [PMID: 8030641 DOI: 10.1002/ajim.4700250510] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The aim of this study was to identify occupational risk groups which might usefully be targeted for occupational asthma surveillance and control, using a community-based case-control approach. Data on previous and current occupations held by subjects were analyzed for 787 adult patients with bronchial asthma and 1591 nonasthmatic patient controls, aged 20-54 years, belonging to the three major races (Chinese, Malays, and Indians) in five outpatient primary care polyclinics. Odds ratios (OR) and 95% confidence intervals (95% CI) of association were adjusted for sex, age, race, smoking, and clinical atopy. No associated risks of asthma were found for clerical or sales workers in general. Significantly reduced risks of association with asthma were found for professional, technical, administrative, and managerial occupations (OR, 0.62; 95% CI, 0.47-0.82). The associated risks of asthma were generally elevated for service workers (OR, 1.35; 95% CI, 1.04-1.74) and manufacturing production and related workers (OR, 1.49; 95% CI, 1.23-1.81). Among them, increased risks were observed for cleaners, particularly municipal cleaners and sweepers (OR, 1.91; 95% CI, 1.22-2.99), textile workers (OR, 5.83; 95% CI, 1.93-17.57), garment markers (OR, 1.61; 95% CI, 1.01-2.58), electrical and electronic production workers (OR, 1.36; 95% CI, 1.06-1.75), printers (OR, 2.24; 95% CI, 1.17-4.31), and construction/renovation workers (OR, 2.24; 95% CI, 1.30-3.85). The odds ratio of association of asthma with exposures in service and production-related occupations overall, relative to the "nonexposed" reference group of nonmanual professional/technical, administrative/managerial, clerical, and sales occupations, was estimated to be 1.72 (95% CI, 1.36-2.19); the estimated population attributable risk was 0.33 (95% CI, 0.22-0.44).
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Goh LG, Ng TP, Hong CY, Wong ML, Koh K, Ling SL. Outpatient adult bronchial asthma in Singapore. Singapore Med J 1994; 35:190-4. [PMID: 7939818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To describe the clinical pattern and drug use in adult bronchial asthma seen in Government polyclinics (primary health care centres). DESIGN A cross-sectional study using a structured questionnaire. SETTING The five largest Government polyclinics in Singapore. SUBJECTS Eight hundred and two subjects aged between 21-58 years drawn from the register of outpatient attendances. The response rate was 63%. RESULTS The mean age of the study subjects was 37.4 years and the mean age of onset was 19.2 years. Thirty-three percent had onset of asthma under 10 years old. The most commonly reported trigger factors were cold drinks (67%), a change of temperature or humidity (65%), influenza or colds (65%), house dust (58%) and cigarette smoke (37%). In 27%, the work environment was a provoking factor. One-fifth had attacks every night or every day. About half of the patients had FEV1 under 80% of predicted. In the past year, 10% had 4 or more acute attacks requiring emergency attendance, 18% had one or more hospital admissions and 21% had sickness absence from asthma for one week or more. Of the 186 subjects who needed bronchodilators/inhalers 3 times or more a day, only 19.3% were on inhaled steroids. CONCLUSIONS Considerable morbidity existed amongst outpatient asthmatics. Inhaled steroids appeared to be under-used.
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Abstract
The tail beat frequency (TBF) of sperm was measured with a sperm-head fixation method which was based on the tendency of sperm to attach its head to the surface of a glass slide. Ferrous sulphate, a promotor of lipid peroxidation, inhibited TBF within 5 min of mixing with sperm. This inhibition can be reversed dose-dependently by superoxide dismutase, catalase, glutathione, and albumin. It was concluded that TBF could be a new pharmacological model for studying the effect of lipid peroxidation and antioxidant on sperm motility. Both enzymatic and non-enzymatic antioxidants can be screened with this method.
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Lo YC, Teng CM, Chen CF, Chen CC, Hong CY. Magnolol and honokiol isolated from Magnolia officinalis protect rat heart mitochondria against lipid peroxidation. Biochem Pharmacol 1994; 47:549-53. [PMID: 8117323 DOI: 10.1016/0006-2952(94)90187-2] [Citation(s) in RCA: 181] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In isolated rat heart mitochondria lipid peroxidation was induced with ADP and ferrous sulfate (FeSO4). Oxygen consumption and malondialdehyde (MDA) production were measured to quantitate lipid peroxidation. The antioxidant effects of magnolol and honokiol purified from Magnolia officinalis were 1000 times higher than that of alpha-tocopherol. The IC50 values of magnolol and honokiol for inhibition of oxygen consumption were 8.0 x 10(-8) M and 1.0 x 10(-7) M, respectively, while that of alpha-tocopherol was 1.0 x 10(-4) M. Magnolol at 0.5 microM inhibited 71.4 +/- 9.4% of oxygen consumption and 59.3 +/- 4.6% MDA production. At the same concentration, honokiol inhibited 78.1 +/- 4.7% of oxygen consumption and 86.9 +/- 4.0% of MDA production. Of conjugated diene formation 48.4 +/- 4.6% and 53.1 +/- 3.4% were inhibited by 0.5 microM magnolol and honokiol, respectively. Also both magnolol and honokiol exhibited free radical scavenging activities as shown by the diphenyl-p-picrylhydrazyl assay, but they were less potent than alpha-tocopherol.
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Hong CY, Wang CP, Lo YC, Hsu FL. Effect of flavan-3-ol tannins purified from Camellia sinensis on lipid peroxidation of rat heart mitochondria. THE AMERICAN JOURNAL OF CHINESE MEDICINE 1994; 22:285-92. [PMID: 7872240 DOI: 10.1142/s0192415x94000346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We induced lipid peroxidation in rat heart mitochondria with FeSO4 and compared the inhibitory effect of various flavan-3-ol tannins on it. These tannins were purified from Chinese tea (Camellia sinensis). Oxygen consumption and malondialdehyde formation were used to quantitate the amount of lipid peroxidation. The free radical scavenger activity of tannins was then measured with a diphenyl-p-picrylhydrazyl method. These tannins significantly inhibited lipid peroxidation at micromolar concentration. Their potencies were higher than that of Trolox, a water soluble analogue of vitamin E. Since epicatechin-3-O-gallate, epigallocatechin-3-O-gallate and gallocatechin-3-O-gallate were more potent than other flavan-3-ol tannins in these assays, we considered that a galloyl group in 3-O-position increased the scavenger activity of flavan-3-ol tannins as well as their potency in inhibiting lipid peroxidation.
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Hong CY, Lo YC, Tan FC, Wei YH, Chen CF. Astragalus membranaceus and Polygonum multiflorum protect rat heart mitochondria against lipid peroxidation. THE AMERICAN JOURNAL OF CHINESE MEDICINE 1994; 22:63-70. [PMID: 8030620 DOI: 10.1142/s0192415x94000085] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We isolated rat heart mitochondria and induced lipid peroxidation with ADP and FeSO4. Oxygen consumption and MDA formation were measured for quantitating the amount of lipid peroxidation. Using these methods, we screened the water extracts of 14 Chinese medicinal herbs for their effect on lipid peroxidation. It was found that Astragalus membranaceus inhibited 42.1 +/- 3.4% of oxygen consumption and 39.8 +/- 3.2% of MDA production at concentration of 2 mg dried herb/ml mitochondrial suspension. At the same concentration, Polygonum multiflorum inhibited 52.1 +/- 7.3% of oxygen consumption and 50.9 +/- 5.3% of MDA production. Other herbs did not inhibit lipid peroxidation to 50% of control at concentration up to 6 mg dried herb/ml mitochondrial suspension. Purification and identification of the active component(s) in Astragalus membranaceus and Polygonum multiflorum as well as their clinical application await further studies.
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Lin SJ, Hong CY, Chang MS, Chiang BN, Chien S. Increased aortic endothelial death and enhanced transendothelial macromolecular transport in streptozotocin-diabetic rats. Diabetologia 1993; 36:926-30. [PMID: 8243871 DOI: 10.1007/bf02374474] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Hypertension, cigarette smoking and diabetes mellitus are well-known risk factors for atherosclerosis and coronary heart disease. Repeated endothelial cell injury and increased lipid entry have been suggested as initiating events in atherogenesis. Our previous studies have demonstrated that the frequency of endothelial cell death and associated endothelial permeability were significantly increased in the aorta of spontaneously hypertensive rats and chronic oral nicotine-treated rats. In the present investigation, we examined the hypothesis that diabetes also increases the frequency of arterial endothelial cell death and hence transendothelial macromolecular transport, which may have some implications in increasing lipid entry and thus accelerating atherogenesis. Diabetes was induced in 15 male Sprague-Dawley rats by intraperitoneal injection of 60 mg streptozotocin per kg body weight. The duration of diabetes was 6 weeks. A group of 15 age-matched rats, injected only with the buffer and maintained over the same time period, served as the controls. In en face preparations of the thoracic aorta, IgG-containing dead endothelial cells were identified by an indirect immunoperoxidase method, and endothelial leakage to Evans blue-albumin complexes was quantified by fluorescence microscopy. Diabetic rats, compared to control rats, had significantly higher values for the frequency of endothelial cell death (0.77 +/- 0.10% vs 0.38 +/- 0.04%; p < 0.005 by two-tailed, unpaired Student's t-test) and the number density of Evans blue-albumin leaky foci (4.33 +/- 0.48/mm2 vs 2.99 +/- 0.38/mm2; p < 0.05 by two-tailed, unpaired t-test) in the aorta.(ABSTRACT TRUNCATED AT 250 WORDS)
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