The efficacy of methotrexate for intolerance to prednisolone therapy in cardiac sarcoidosis

Background and purpose Fluorine-18-flurodeoxyglucose positron emission tomography (18FDG-PET) is a useful examination assessing active inflammatory myocardium noninvasively in patients with cardiac sarcoidosis (CS). Though immunosuppression like prednisolone (PSL) and Methotrexate (MTX) as alternative therapy is used to suppress the inflammation, little is known about the rate of response and efficacy of MTX for intolerance to PSL therapy. Methods From Aug 2016, we prospectively enrolled CS with positively accumulated of FDG in the heart. The initial dose of PSL was 30mg/day, wherefrom the dose was tapered down 5mg/month until 6 months. After 6 months, follow-up 18FDG-PET was performed. Using 18FDG-PET images, we calculated total lesion glycolysis (TLG; SUVmeam x metabolic volume) and calculated the reduction rate of TLG. In order to estimate the response rate to PSL therapy, responder group (R-group) was defined as TLG reduction rate ≥70% and poor-responder group (PR-group) was defined as TLG reduction rate <70% after PSL therapy. After prescribed PSL, subjects with PR-group randomized to PSL (maximum dose 30mg daily and tapered down 5mg/month until 6 months) or to MTX (6mg weekly). Results In 64 CS patients, 55 patients had serial 18FDG-PET before and 6 months after PSL therapy. 18FDG-PET images were acquired following 7 day's carbohydrate limitation and after at least 18-h fasting (mean free fatty acid level right before 18FDG-PET acquisition was 1.05 mEq/L). The mean age was 63.4 years old and 42 (76.4%) patients were female. Because of 6 months PSL therapy, even though there were no significant difference in BNP (from 59.9 (26.2–137.6) to 60.4 (18.5–122.0) (P=0.593), LV-Dd (from 50.9 (44.5–59.5) to 49.7 (45.5–61.3) (P=0.666) and LV-EF (from 49.5 (34.4–62.5) to 49.9 (38.0–62.0) (P=0.792) at pre and post therapy, respectively, TLG were detected significant reduction from 216.4 (74.2–411.6) to 0.8 (0.0–8.2), (p<0.001). In response to PSL therapy, 47 (85.5%) CS patients were classified to R-group and 8 (14.5%) were classified to PR-group. Furthermore, when performed block randomization and divide 8 PR-group patients into MTX (n=3) and re-increased PSL (n=5) for more 6 months, MTX group is prone to high rate of TLG reduction than re-increased PSL-group (89.4% vs 59.9%) and one patient belonged to re-increased PSL group showed that the further elevation of TLG level at additional 6-months PSL therapy (349⇒483) (Figure). Conclusions 1) By immunosuppression therapy using PSL for CS, about 86% patients showed significant reduction of myocardial FDG accumulation. 2) When detected intolerance for PSL therapy, MTX might be effective for reduction of inflammation of sarcoidosis in the heart, which might be effective as an alternate therapy in CS. The TLG level after randomization Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Grant-in-aid for scientific research

Determination of Physicochemical and Functional Properties of Coconut Oil by Incorporating Bioactive Compounds in Selected Spices

Lipid oxidation has been identified as a major deterioration process of vegetable oils, which leads to the production of primary and secondary oxidative compounds that are harmful to human health. Oleoresins of ginger, garlic, nutmeg, pepper, cloves, and cinnamon were extracted and incorporated into coconut oil, and change occurrence on physicochemical properties, thermal stability, shelf life, and antioxidant activity was monitored against the same properties of pure coconut oil. Lipid oxidation was assessed in terms of the free fatty acid level and peroxide value. For the comparison purpose, another oil sample was prepared by incorporating vitamin E too. Results revealed that both peroxide value and FFA of pure and flavored coconut oil samples after a one-week storage period were 3.989±0.006 and 3.626±0.002 mEq/kg and 0.646±0.001 and 0.604±0.002 (%), respectively. Saponification value, iodine value, smoke point, and the flashpoint of flavored oil were decreased while increasing the viscosity during storage. The highest phenolic content and DPPH free radical scavenging activity were found in flavored coconut oil. Since spices containing antioxidants, the thermal stability of flavored oil was better than that of pure coconut oil. Both oleoresins and vitamin E-incorporated samples showed the same pattern of increment of FFA and peroxide value during storage; however, those increments were slower than those of pure coconut oil.

PENGARUH TINGKAT KEMATANGAN BUAH TERHADAP AKTIVITAS LARVASIDA DAN SIFAT FISIKO-KIMIA MINYAK KAMANDRAH (Croton tiglium L.)

<p>ABSTRAK</p><p>Indonesia terkenal kaya akan keanekaragaman hayati, termasukjenis tumbuhan yang mengandung bahan aktif insektisida. Tanamankamandrah (Croton tiglium L.) merupakan salah satu tanaman obat yangbanyak terdapat di wilayah Indonesia dan telah dimanfaatkan sebagaiinsektisida nabati. Penelitian ini bertujuan untuk mengetahui karakteristikfisiko-kimia minyak kamandrah pada berbagai tingkat kematangan sebagailarvasida nabati terhadap larva nyamuk demam berdarah dengue (A.aegypti). Penelitian dilakukan di Laboratorium Balai Penelitian TanamanRempah dan Aneka Tanaman Industri (Balittri) Sukabumi, Balai BesarLitbang Pascapanen Pertanian Bogor, Insektarium LaboratoriumParasitologi dan Entomologi Kesehatan FKH IPB Bogor, dan Biofarmaka-LPPM IPB Bogor, mulai bulan Februari sampai Desember 2010. Minyakkamandrah diperoleh dengan ekstraksi menggunakan pengempa hidrolikpada suhu 65 o C dan tekanan 7,9 MPa pada buah kamandrah dengan tigatingkat kematangan yang berbeda: warna kulit buah hijau kecokelatan,cokelat kehijauan, dan cokelat penuh. Minyak yang diperoleh selanjutnyadianalisis bilangan asam, kadar asam lemak bebas, bilangan peroksida,indeks bias, berat jenis, dan nilai warna minyak, serta uji larvasidaterhadap larva nyamuk A. aegypti instar III. Penentuan nilai lethalconcentration (LC) dilakukan dengan metode probit analisis (FinneyMethod). Hasil penelitian menunjukkan bahwa berdasarkan nilai LC,rendemen, dan mutu minyaknya, buah kamandrah yang berwarna kulitcokelat penuh lebih berpotensi sebagai larvasida nabati terhadap larva A.aegypti. Rendemen minyak kamandrah 20,42% dan nilai LC 50 adalah132,67 ppm (24 jam) dan 70,08 ppm (48 jam). Minyak tersebut memilikibilangan asam 8,76 mg KOH/g minyak; kadar asam lemak bebas 4,36 mgKOH/g minyak; bilangan peroksida 3,59 meq O/100g minyak; indeks bias1,4783; bobot jenis 0,9466 g/ml; dan warna meliputi nilai L* 73,03; a*3,26; dan b* 64,13. Minyak kamandrah berpotensi dapat dimanfaatkansebagai larvasida nabati dalam pengendalian vektor penyakit DBD.</p><p>Kata kunci : Croton tiglium L., kematangan buah, minyak kamandrah,larvasida</p><p>ABSTRACT</p><p>Effect of Maturity Level of Fruits on Larvicidal Activityand Physico-Chemical Properties of Kamandrah (Crotontiglium L.) Oil</p><p>Indonesia is famously rich in biodiversity, including species of plants thatcontain active ingredient for insecticide. Kamandrah plant (Croton tigliumL.) is one of many medicinal plants found in parts of Indonesia and it hasbeen used as an insecticidal plant. The objectives this research were todetermine the physico-chemical characteristics and larvasidal activities ofoil extracted from kamandrah seeds with varying levels of maturity asbotanical larvicide for mosquito dengue fever. The expreriments wereconducted in the Laboratory of Indonesian Spice and Industrial CropsResearch Institute (ISICRI) Sukabumi, Indonesian Center for AgriculturalPostharvest Research and Development (ICAPRD), InsectariumLaboratory of Health Parasitology and Entomology, Faculty of Veterinaryof Bogor Agricultural University (IPB), and Biopharmaca IPB Bogor,from February to December 2010. The oil was obtained through extractionusing hydraulic pressurer at 65 o C temperatures and 7.9 MPa pressures ofkamandrah fruits with three different maturity levels : brownish green,greenish brown, and fully brown color of fruit skins. Oil gained was thenanalyzed its acid number, free fatty acid content, peroxides number,refractive index, specific gravity, and oil color values, as well as the oillarvasida test against mosquito larvae A. aegypti instar III. Determinationthe oil lethal concentration (LC) values was tested using probit analysismethod (Finney Method). The results showed that based on the values ofLC, content, and quality of the oil, full-brown colored kamandrah fruits aremore potential as larvivida against A. aegypti larvae. Oil content of thekamandrah was 20.42% while LC 50 values were 132.67 ppm (at 24 hours)and 70.08 ppm (at 48 hours). The acid number of the oil was 8.76 mgKOH/g oil; free fatty acid level of 4.36 mg KOH/g oil; peroxide number of3.59 meq O/100 g oil, refractive index of 1.4783; density of 0.9466 g/ml;and the color values were 73.03, 3.26, and 64.13 for L*, a*, and b*,respectively. Therefore, kamandrah oil is very potential to be used aslarvicide for controling the vector of dengue disease.</p><p>Key words: Croton tiglium L., fruit maturity, kamandrah oil, larvicide</p>

Significance of plasma free fatty acid level for assessing and diagnosing acute myocardial infarction

Aim: To clarify the diagnostic value of the circulating free fatty acid (FFA) level for acute myocardial infarction (AMI) in coronary heart disease patients. Methods & results: A total of 1776 patients were screened by coronary angiography from October 2014 to February 2016. The plasma FFA level was significantly higher in coronary heart disease patients with lesions in three or more vessels than those with lesions in one or two vessels. Moreover, an elevated FFA level was identified as an independent risk factor for AMI on multivariate regression analysis and shown to be a sensitive and specific indicator for AMI diagnosis by receiver operating characteristic curve analysis. Conclusion: An elevated FFA level is an independent risk factor and independent diagnostic marker for AMI.

Proses Pembuatan Minyak Kelapa Murni dengan Menggunakan Rhizopus Oligosporus

Minyak kelapa murni merupakan bahan makanan yang banyak digunakan sebagai bahan konsumsi dan bahan tambahan untuk proses industri. Minyak kelapa murni diproduksi dari bahan baku krim santan yang merupakan hasil pelindihan antara air dengan buah kelapa. Pemecahan emulsi pada santan menggunakan teknik ekstraksi kering (dry extraction) dan teknik ekstraksi basah (wet extraction). Penelitian yang dilakukan menggunakan proses ekstraksi basah, yaitu secara fermentasi menggunakan inokulum padat berupa mikroba atau ragi yang dikembangkan pada media padat. Proses tersebut dipilih untuk menyesuaikan dengan situasi masyarakat daerah di Indonesia yang banyak menghasilkan kelapa serta menyesuaikan dengan keberadaan ragi tempe yang telah memasyarakat. Tujuan penelitian ini adalah untuk mendapatkan minyak kelapa dari bahan baku santan (coconut milk) dengan menggunakan inokulum ragi tempe yang mengandung Rhizopus oligosporus. Hasil minyak kelapa murni akan dianalisa parameternya berdasarkan Standar Nasional Indonesia. Dari data percobaan di peroleh hasil analisa produk minyak kelapa murni yang paling optimum sesuai dengan SNI adalah percobaan pada variasi jumlah ragi tempe 0.5 gram dengan jumlah minyak yang dihasilkan 91.35 gram dan nilai kekeruhan 1,8 NTU. Hasil analisis kimia dan fisik: Indeks bias: 1,451, Kadar air: 0,3%, Kadar kotoran: 0,023%, Kadar bebas asam lemak: 0,96%, Kadar minyak Pelikan: 1,82%, angka saponifikasi: 262,969 mgKOH / g lemak. Virgin coconut oil is a food ingredient that is widely used as a consumption material and as an additive for industrial processes. The oil produced from coconut milk cream which was the result of leaching between water and coconut. The emulsion in coconut milk then broken by dry extraction method and wet extraction method. In this research the method carried out by a wet extraction process, which used fermentation using microbes or yeast that was developed on solid media. This process was chosen to adapt to the Indonesian people who produced ton coconut each year and in the same time, the tempeh yeast that has been popular in Indonesia. The purpose of this study was to obtain virgin coconut oil from coconut milk using yeast inoculum containing Rhizopus oligosporus. The parameters of virgin coconut oil analyzed based on the Indonesian National Standard (SNI). The experimental data obtained from the results of the most optimal analysis of virgin coconut oil in accordance with SNI experiments on the variation of the amount of tempeh yeast 0.5 grams with the amount of oil produced 91.35 grams and turbidity value 1.8 NTU. Chemical and physical analysis results: Refractive index: 1,451, Air content: 0,3%, Dirt content: 0,023%, Free fatty acid level: 0,96%, Pelicans oil content: 1,82%, saponification rate: 262,969 mg KOH /g fat.

1172The increased serum level of troponin T after immunosuppression therapy reflects sustained myocardial FDG accumulation in cardiac sarcoidosis

Background and purpose Fluorine-18-flurodeoxyglucose positron emission computed tomography (18FDG-PET CT) is the sole but time-consuming and expensive examination assessing active inflammatory myocardium noninvasively in patients with cardiac sarcoidosis (CS). Though immunosuppression is used to treat CS, little is known about the cardiac biomarkers for determining therapeutic effect to immunosuppression therapy other than 18FDG-PET. Methods From Aug 2016, we prospectively enrolled 50 sarcoidosis patients with positively accumulated of FDG in the heart. The initial dose of prednisolone was 30mg/day, wherefrom the dose was tapered down 5mg/month until 6 months. After 6 months, follow-up 18FDG-PET was performed. Using 18FDG-PET images, we calculated total lesion glycolysis (TLG; SUVmeam x metabolic volume) and compared it to various cardiac markers. Non-responder was defined as TLG reduction rate <70% after immunosuppression therapy. Results In 50 CS patients, 41 patients had serial 18FDG-PET before and 6 months after immunosuppression therapy. 18FDG-PET images were acquired following 7 day's carbohydrate limitation and after at least 18-h fasting (mean free fatty acid level right before 18FDG-PET acquisition was 1.03 mEq/L). The mean age and plasma brain natriuretic peptide (BNP) level were 61.9 years old, 184 pg/mL at baseline, respectively. Because of immunosuppression therapy, TLG was significantly reduced from 195.3 (38.6–339.6) to 1.1 (0.01–7.37), p<0.001). Six (14.6%) patients were classified as NR group and the level of TnT at post therapy was significantly higher in NR group than responder-group (R-group) (0.021 (0.012–0.027) ng/ml vs 0.0095 (0.006–0.013) ng/ml, p=0.039) (Figure), while there were no significant differences between NR-group and R-group in the levels of ACE, sIL-2R, BNP, Dd, EF. Figure 1 Conclusions 1) By immunosuppression therapy using prednisolone for CS, about 85% patients showed significant reduction of increased myocardial FDG accumulation. 2) The sustained high level of serum TnT at post 6 months therapy indicates persistent inflammation of sarcoidosis in the heart, which could be an expedient marker for determining therapeutic effect.

THE QUALITY OF COCONUT OIL PREPARED USING HEATING TECHNIQUE WITH ADDITION OF CARROT POWDER (Daucus carrota L) AS NATURAL ANTIOXIDANT

Spoilage of coconut oil is indicated by rancidity caused by the oxidation and hydrolysis reactions. One of the efforts that can be carried out to inhibit the rancidity is by adding a natural antioxidant, such as carrot (Daucus carrota L) powder, into the coconut oil. This research aimed to find out the effect of the addition of carrot powder into the coconut oil on some parameters namely iodine number, peroxide number, FFA level, acid value and water content. The coconut oil was prepared by heating technique followed by the addition of carrot powder in the ratio of coconut oil:carrot of 100:1, 100:2, 100:3, 100:4, 100:5, and coconut oil:BHT (Butyl Hydroxy Toluene) of 100:1 as the positive control. The results were then compared to the Indonesian National Standard of SNI 01-2902-1992. It was found that the coconut oil added with carrot powder in the ratio of 100:4 showed the best quality with iodine number of 8.4092 ± 0.5761g iodine/100g, peroxide number of 3.2363 ± 1.9168mg O2/100g, Free Fatty Acid level (FFA) of 0.1676 ± 0.0037 %, acid value of 0.4656 ± 0.0119mg KOH/g and water content of 0.1038 ± 0.0068 %. The characterization using FTIR (Fourier-transform infrared spectroscopy) of such quality of coconut oil indicated some functional groups of OH, CH, CH3, C=O, CºC aliphatic and C=C aliphatic were contained.