Effect of docosahexaenoic acid-enriched fish oil supplementation in pregnant women with Type 2 diabetes on membrane fatty acids and fetal body composition--double-blinded randomized placebo-controlled trial.

AIMS: To test if docosahexaenoic acid-enriched fish oil supplementation rectifies red cell membrane lipid anomaly in pregnant women with Type 2 diabetes and their neonates, and alters fetal body composition. METHODS: Women with Type 2 diabetes (n = 88; 41 fish oil, 47 placebo) and healthy women (n = 85; 45 fish oil, 40 placebo) were supplemented from the first trimester until delivery. Blood fatty acid composition, fetal biometric and neonatal anthropometric measurements were assessed. RESULTS: A total of 117 women completed the trial. The women with Type 2 diabetes who took fish oil compared with those who received placebo had higher percentage of docosahexaenoic acid in red cell phosphatidylethanolamine in the third trimester (12.0% vs. 8.9%, P = 0.000) and at delivery (10.7% vs. 7.4%, P = 0.001). Similarly, the neonates of the women with Type 2 diabetes supplemented with the fish oil had increased docosahexaenoic acid in the red cell phosphatidylethanolamine (9.2% vs. 7.7%, P = 0.027) and plasma phosphatidylcholine (6.1% vs. 4.7%, P = 0.020). Docosahexaenoic acid-rich fish oil had no effect on the body composition of the fetus and neonates of the women with Type 2 diabetes. CONCLUSIONS: A daily dose of 600 mg of docosahexaenoic acid was effective in ameliorating red cell membrane docosahexaenoic acid anomaly in pregnant women with Type 2 diabetes and neonates, and in preventing the decline of maternal docosahexaenoic acid during pregnancy. We suggest that the provision of docosahexaenoic acid supplement should be integrated in the antenatal care of pregnant women with Type 2 diabetes.

Electrooculogram detection of eye movements on gaze displacement.

Changes in potential are known to occur in the orbital area during saccades. The sign of these changes depends on the position of the electrode and the direction of eye rotation, while their amplitude depends on the rotation angle. The patterns of potentials can be used to resolve the reverse task, i.e., that of describing the gaze trajectory, such that the eye can be used to control a computer in an on-line regime. This requires a screen cursor to be placed at the calculated gaze fixation point, i.e., the point at which the observer is looking. Electrodes beneath the eyes were used to assess the vertical component of gaze displacement, while side electrodes at the corners of the orbit were used to assess the horizontal component. Sharp unipolar changes in potential occurring on saccades were apparent as steps which could be detected and measured. The signal was digitally filtered using a complex filter constructed by ourselves. The ratio of the amplitudes at the four points was then used to calculate the direction and angle of eye rotation. Characteristic changes in potential during spontaneous blinking were identified and ignored. Voluntary blinks of one eye were used to simulate mouse clicks. Subjects were initially told to make changes in gaze through specified angles in eight directions. This allowed calibration of standard saccades (in microV). Calibration curves were used to resolve the reverse task - changes in potential (in microV) were used to calculate the point on the screen (the pixel) to which the cursor was to be moved. Subjects were then trained to control the cursor using their eyes, and control of the computer was then completely handed over to the subject. The apparatus described here provides a brain-computer interface. Some interesting data on eye coordination were obtained during these studies: saccades were preceded by short negative electrooculogram (EOG) potentials lasting 10-15 msec. With age, the amplitude of saccade-related EOG potentials decreased. When gaze was shifted to the left, deviation of the eyes was more significant than when gaze was shifted to the right, while on shifting of gaze to the right, the lateral deviations of the eyes were similar. On diagonal right-down and left-up movements, right eye skew was greater than left eye skew, while on right-up and left-down movements, left eye skew was greater than right eye skew. Differences in eye coordination between genders were minor.

[Eye movement detection with the aid of the oculogram in shifting the gaze].

Eye saccades are accompanied by changes of ocular electric potential. The sign of these changes involves a function of electrode location and eye movement direction while an indicator of the rotation angle is the amplitude. Based on the spatial distribution of the ocular potential one can solve an inverse problem and recover eye movement trajectory to be used for on-line computer control. To achieve this a system has to be able to place a cursor to a point on a screen corresponding to the current gaze direction of the user. We used four electrodes, two inferior and two lateral around the ocular depths. Inferior electrodes were used for estimation of the vertical gaze shift component and the lateral electrodes for estimation of the horizontal component. We detected and processed saccadic unipolar potential changes whose morphology resembles that of the step function. Detection and processing was performed using our proprietary multistage filter applied to the 4-channel data. The output of this filter was used to compute eye rotation parameters. Characteristic potential changes during the spontaneous blinks were identified and excluded from processing. Voluntary winks were used to mimic mouse clicks. In the beginning, our subjects went through a calibration stage during which they had to follow the cursor in eight basic directions. Using the calibration results the inverse problem was solved, i. e. based on the spatial distribution of ocular potential we computed screen position coordinates corresponding to the gaze direction. The presented technique belongs to the class of brain-computer interfaces. In addition, this work led us to a set of interesting observations regarding the characteristic patterns of eye movements. For instance, we found that just prior to a saccade EOG demonstrates short negative potential of 10-15 ms duration. We have also observed that with age the saccade amplitude decreases. Interestingly, when the gaze is shifted to the left, the left eye deviation significantly exceeds that of the right eye but the right shift does not exhibit such an asymmetry. During the diagonal shifts (bottom-right, top-left) the right eye skew exceeds that of the left one and the situation reverses for the two complimentary directions. We have observed no significant differences in eye coordination due to the subject gender.

Use of natural gums and cellulose derivatives in production of sustained release metoprolol tablets.

Metoprolol tartrate sustained-release tablets (100 mg) were prepared using xanthan/guar gums and also hydroxypropyl methyl cellulose (HPMC) carboxymethyl-Cellulose (CMC) polymers by direct compression method. Physical characteristics of the tablets and water uptake in addition to their dissolution profiles were compared with standard (Lopressor SR) tablets. Dissolution test was performed in the phosphate buffer solution (pH 6.8) and the samples were analyzed spectrophotometerically in 275.7 nm. Dissolution studies showed that formulations containing 100 and 80% of HPMC, 100% of guar, and 20% of xanthan followed the Higuchi model, while those containing 60 and 40% HPMC and 100 and 80% xanthan followed a zero-order model. The tablets with 40% xanthen followed a Hixon-Crowell model. In cellulose derivatives the highest MDT and dissolution efficiency until 8 hr (DE8%) belonged to tablets with 40% HPMC, increasing the amount of CMC decreased the drug release rate, and formulations containing 60 and 40% of HPMC had the USP dissolution standards. While, in the gum formulations, the highest mean dissolution time and the lowest DE(8)% belonged to tablets with 100% xanthan, increasing the xanthan decreased the release rate of metoprolol, and formulations containing 80 and 100% xanthan had the USP dissolution standards. Results showed that natural gums are suitable for production of sustained-release tablets of metoprolol.

The IVS-II-1 (G-->a) beta0-thalassemia mutation in cis with HbA2-Troodos [delta116(G18)Arg-->Cys (CGC-->TGC)] causes a complex prenatal diagnosis in an Iranian family.

The beta-thalassemia (thal) minor phenotypes with normal Hb A2 levels and decreased MCV and MCH values are relatively rare beta-thal traits. Here, we describe a family with normal Hb A2 and decreased MCV and MCH levels. Amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) revealed the IVS-II-1 (G-->A) mutation in the beta-globin gene of the proband and her father. Direct sequencing of the gamma-globin gene of the proband and her father also revealed a previously reported variant called Hb A2-Troodos [gamma116(G18)Arg-->Cys] [in cis with the IVS-II-1 (G-->A) beta0-thal mutation]. This is the first case report of Hb A2-Troodos in association with the beta0 IVS-II-1 mutation. Reduced Hb A2 expression by a concomitant Hb A2 beta-thal in cis or trans, may cause problems in carrier diagnostics, and eventually in genetic counseling and prenatal diagnosis when insufficient molecular analyses are performed.

Epidemic dengue 3 in central Java, associated with low viremia in man.

An outbreak of dengue type 3 was studied in Central Java, Indonesia, in 1978. In contrast to previous dengue 3 epidemics in Central and East Java, this outbreak was less explosive, associated with mild illness, and low viremia. The dengue virus isolation rate from serologically confirmed patients was only 32% compared to 65% for an epidemic in Bantul a year earlier. Neither dengue hemagglutination-inhibition antibody titers nor day of illness on which specimens were collected accounted for this difference. These data suggest that some naturally occurring strains of dengue virus (endemic strains) are associated with low viremia and generally cause only mild illness in man.

Epidemic dengue hemorrhagic fever in rural Indonesia. I. Virological and epidemiological studies.

Virological studies were carried out during an epidemic of dengue hemorrhagic fever in Central Java, Indonesia in 1976. Dengue virus was isolated from the acute sera of 45 of 69 patients (65%). The isolation rate was higher in primary than secondary cases. Dengue 3 was the predominant serotype being transmitted (27 isolates), but both dengue 1 (8 isolates) and dengue 4 (10 isolates) were also being transmitted. A composite picture of magnitude and duration of viremia showed that many patients were circulating over 10(8) MID50 per milliliter dengue 3 virus for the first 3 days of illness and that viremia persisted for 5-6 days in some persons. If all shock cases were considered, there was no relationship between dengue serotype and severity of disease. All three confirmed fatal cases, however, were associated with dengue type 3 infections.

Epidemic dengue hemorrhagic fever in rural Indonesia. II. Clinical studies.

Clinical observations were made on 95 serologically or virologically confirmed dengue fever cases during an epidemic in a rural area of Indonesia in December 1976. The age distribution was similar to that observed in patients with dengue hemorrhagic fever in Jakarta, a highly endemic urban area. The observed disease ranged in severity from undifferentiated fever to shock and death. The majority of patients had acute onset of fever with nausea, vomiting, headache, and abdominal pain. Hepatomegaly was observed in only 19% of the patients. A positive tourniquet test was the most frequently observed hemorrhagic manifestation, but epistaxis was observed in 20% and hematemesis in 6% of the patients. Dengue shock syndrome was observed in 37% of the patients. There were four deaths, three of which were confirmed as due to dengue infection by virus isolation. The data suggest that one, and possibly two, of the fatal cases with virus isolation were primary infections, based on the results of hemagglutination-inhibition test using all four dengue antigens.

Epidemic dengue hemorrhagic fever in rural Indonesia. III. Entomological studies.

Entomological studies were carried out during a dengue hemorrhagic fever epidemic in Central Java in December 1976. Both Aedes aegypti and Aedes albopictus were widely distributed in Bantul, but the latter species was more abundant. Comparative studies on the vector competence of the two species showed that Ae. albopictus had a higher susceptibility than Ae. aegypti to oral infection with all four dengue serotypes. The two species were equally compentent in transmitting the Bantul strain of dengue 3 virus after parenteral infection. The data suggest that Ae. albopictus could have been an important vector in this epidemic, but no direct observations were obtained to define the respective contribution of either Ae. albopictus or Ae. aegypti.