rss_2.0Asian Biomedicine FeedSciendo RSS Feed for Asian Biomedicine Biomedicine 's Cover healing of the corneal epithelium: a review<abstract> <title style='display:none'>Abstract</title> <p>The corneal epithelium (CE) forms the outermost layer of the cornea. Despite its thickness of only 50 μm, the CE plays a key role as an initial barrier against any insults to the eye and contributes to the light refraction onto the retina required for clear vision. In the event of an injury, the cornea is equipped with many strategies contributing to competent wound healing, including angiogenic and immune privileges, and mechanotransduction. Various factors, including growth factors, keratin, cytokines, integrins, crystallins, basement membrane, and gap junction proteins are involved in CE wound healing and serve as markers in the healing process. Studies of CE wound healing are advancing rapidly in tandem with the rise of corneal bioengineering, which employs limbal epithelial stem cells as the primary source of cells utilizing various types of biomaterials as substrates.</p> </abstract>ARTICLE2021-10-29T00:00:00.000+00:00Assessing the burden of dengue among household members in Alaminos, Laguna, the Philippines: a prospective cohort study<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>The incidence of dengue is increasing rapidly and is a challenging health issue in the Philippines. Epidemiological data are largely based on a passive-surveillance reporting system, which leads to substantial under-reporting of cases.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To estimate dengue infection and disease incidence prospectively at the community level in an endemic area of the Philippines using an active surveillance strategy.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We implemented active surveillance in the highly endemic community of Alaminos, Laguna. The study consisted of a 1-year follow-up with 2 visits scheduled at the start and end of the study, as well as regular active surveillance in between and unscheduled visits for suspected cases. Blood samples were collected and analyzed to detect dengue during the first scheduled visit and all unscheduled visits, and clinical examination was performed at all visits (registered at NCT02766088).</p> </sec> <sec><title style='display:none'>Results</title> <p>We enrolled 500 participants, aged from 6 months to 50 years; 76.2% were found positive for immunoglobulin G (95% confidence interval [CI], 71.9–80.0), with 92.0% among those aged 9–17 years. Active (weekly) surveillance identified 4 virologically confirmed cases of dengue (incidence proportion 0.8; 95% CI 0.3–2.1); all in participants aged ≤14 years.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Routine surveillance programs such as sentinel sites are needed to characterize the entire clinical spectrum of symptomatic dengue, disease incidence, and transmission in the community.</p> </sec> </abstract>ARTICLE2021-10-29T00:00:00.000+00:00Anti-inflammatory and antioxidative effects of genistein in a model of spinal cord injury in rats<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Neurological damage from spinal cord injury (SCI) is a result of primary mechanical injury and secondary damage from oxidative stress and neuroinflammation. Although genistein has been shown to have potent antioxidant and anti-inflammatory effects in studies of brain injury, its effect on secondary damage in SCI has remained unknown.</p> </sec> <sec><title style='display:none'>Objective</title> <p>To determine effects of genistein in a model of SCI in rats.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We divided 21 rats evenly into 3 groups, a control group, in which only a laminectomy was performed; a trauma group in which SCI was induced; and a genistein group in which genistein was administered subcutaneously after SCI. The rats were assessed using a Basso–Beattie and Bresnahan functional score at the 12th hour and on the 1st, 3rd, 5th, and 7th days. Biochemical analyses were conducted at the same time points to determine the serum levels of catalase, ischemia-modified albumin (IMA), disulfide (SS), total thiol (TT), native thiol (NT), disulfide/total thiol (SS/TT), and native thiol/total thiol (NT/TT). Total oxidant and antioxidant capacity, and oxidative stress index were determined in spinal cord tissue obtained on the 7th day together with immunohistochemistry for cyclooxygenase-2 levels.</p> </sec> <sec><title style='display:none'>Result</title> <p>Catalase activity on the 7th day was significantly (<italic>P</italic> = 0.001) higher in the genistein-treated rats than in other groups, and IMA levels became stable earlier (3rd day) in the genistein group. SS values were significantly (<italic>P</italic> = 0.004) lower in the genistein group. NT/TT ratio were significantly (<italic>P</italic> = 0.049) higher in the genistein-treated rats on the 7th day.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Genistein has antioxidant, anti-inflammatory, and protective effects in a model of SCI in rats and warrants further study.</p> </sec> </abstract>ARTICLE2021-10-29T00:00:00.000+00:00Hydraulic expansion facilitates remodeling of arteriovenous fistulas without increasing venous intimal hyperplasia in rabbits<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>An arteriovenous fistula (AVF) is considered essential for chronic hemodialysis.</p> </sec> <sec><title style='display:none'>Objective</title> <p>To determine the effects of hydraulic expansion on the intimal hyperplasia of an AVF.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We divided 12 healthy male New Zealand white rabbits into a control group (vein without special handling and direct anastomosis with an artery, n = 6) and a hydraulic expansion group (vein dilated by hydraulic pressure before anastomosis, n = 6). Histopathomorphology was examined with hematoxylin and eosin staining and immunohistochemistry. Analysis of covariance (ANCOVA) was used to compare the data between the groups.</p> </sec> <sec><title style='display:none'>Results</title> <p>Immediately and 1 day after surgery, the diameter of the fistula vein in rabbits in the hydraulic expansion group was significantly larger than it was in the control group (<italic>P</italic> = 0.02 and 0.03 respectively), but not on subsequent days. After hydraulic expansion and before construction of the fistula, the wall of vein was noticeably thinner on macroscopic observation, and the anterior and posterior walls were indistinguishable. At 3 weeks after surgery in the hydraulic expansion group, cells in the vein wall were disordered, there were fewer elastic fibers, tissues from the endothelium to tunica externa were less dense, and there was less extracellular matrix than in the control group. Expression of connective tissue growth factor in the hydraulic expansion group was significantly less than that in the control group (<italic>P</italic> = 0.01). No differences were found in intimal thickness or immunohistochemistry scores for transforming growth factor-β1 between the groups.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Hydraulic expansion did not increase intimal hyperplasia of an AVF, but facilitates remodeling of AVFs in rabbits.</p> </sec> </abstract>ARTICLE2021-10-29T00:00:00.000+00:00Assessing the burden of dengue: an important step toward committing resources to address this global disease bone mineral density in Thai children with systemic lupus erythematosus: prevalence and risk factors<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Improvement of disease recognition and management has increased the survival of children with systemic lupus erythematosus (SLE), but has shifted the morbidity focus toward long-term complications, such as low bone mass and osteoporosis. Studies in adults with SLE show older age, chronic inflammation, and corticosteroid therapy are risk factors for low bone mineral density (BMD) and osteoporosis.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To determine the prevalence of and identify risk factors associated with low BMD in Thai children with SLE.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a retrospective review of demographic data and clinical variables for a cohort of 60 Thai children with SLE who underwent 2 dual-energy X-ray absorptiometry (DXA) at their initial examination and later follow-up. We considered a BMD <italic>z</italic> score ≤ −2.0 to indicate low BMD. Binary logistic regression was used to assess risk factors potentially associated with low BMD.</p> </sec> <sec><title style='display:none'>Results</title> <p>The prevalence of low BMD at the first visit was 40% and increased to 55% over follow-up. We found a significantly decreased hip BMD <italic>z</italic> score (median difference −0.25, 95% confidence interval [CI] −0.40 to −0.05; <italic>P</italic> = 0.016) and lumbar BMD <italic>z</italic> score (median difference −0.49, 95% CI −0.69 to −0.28; <italic>P</italic> &lt; 0.001) over time. The cumulative steroid dose tended to be higher for patients with low BMD (adjusted odds ratio [OR] = 1.08, 95% CI 1.00 to 1.17; <italic>P</italic> = 0.050).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Low BMD has a 40% prevalence in Thai children newly diagnosed with SLE and progresses significantly over time. Higher cumulative corticosteroid dose tended to be associated with a low BMD, but we did not find a significant risk in this small sample.</p> </sec> </abstract>ARTICLE2021-10-29T00:00:00.000+00:00In search of cost effective control of leptospirosis—a common zoonotic disease in developing countries of amentoflavone with antiviral properties in COVID-19 treatment<abstract> <title style='display:none'>Abstract</title> <p>Amentoflavone is one of the flavonoids that are known for their antiviral effects and many of them are predicted to have inhibitory effects against severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome Coronavirus (MERS-CoV) enzymes 3-chymotrypsin-like protease (3CLpro) and papain-like protease (PLpro). Amentoflavone is a biflavonoid found in the herbal extracts of St. John's wort (<italic>Hypericum perforatum</italic>), <italic>Gingko biloba</italic>, <italic>Selaginella tamariscina, Torreya nucifera</italic>, and many other plants. Its pharmacological actions have been listed as antiviral, antibacterial, antioxidant, anti-inflammatory, antidiabetic, antidepressant, and neuroprotective. Molecular docking studies have found that amentoflavone binds strongly to the active site of the main protease (M<sup>pro</sup>) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). As conventional antiviral medications are met with limited success against coronavirus disease-2019 (COVID-19) and vaccines are one of the only weapons against COVID-19 in the pharmaceutical armamentarium, traditional medicines are being considered for the forefront battle against COVID-19. Clinical studies with <italic>Hypericum</italic> and <italic>Gingko</italic> extract as additional or alternative drugs/supplements are registered. Here we review the potential of amentoflavone, an active agent in both <italic>Hypericum</italic> and <italic>Gingko</italic> extract as an adjunct therapy for COVID-19. Its anti-inflammatory, antioxidant, and sepsis preventive actions could provide protection against the “cytokine storm.” Compared with the herbal extracts, which induce cytochrome P450 (CYP) and uridine 5′-diphospho (UDP)-glucuronosyltransferases (UGT) activity producing a negative herb–drug interaction, amentoflavone is a potent inhibitor of CYP3A4, CYP2C9, and UGT. Further studies into the therapeutic potential of amentoflavone against the coronavirus infection are warranted.</p> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00A giant fourth-ventricular tuberculoma mimicking a primary posterior fossa tumor<abstract> <title style='display:none'>Abstract</title> <p>Typically, an intracranial tuberculoma occurs within the brain parenchyma. Intraventricular tuberculomas are rare in the absence of systemic tuberculosis (TB), and the differential diagnosis between tuberculoma and other lesions, such as primary brain tumors, can be difficult. We report an extremely unusual case of solitary fourth-ventricular tuberculoma, which occurred in a 3-year-old female patient, with no indication of TB. This lesion appeared as a primary intraventricular tumor in the fourth ventricle in both clinical and radiological examinations. In this scenario, a surgical treatment option was pursued. Histopathological testing supported the diagnosis of tuberculoma. The patient was subsequently treated with 18 months’ therapy for tuberculous, without adverse events.</p> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00Room-temperature stable loop-mediated isothermal amplification (LAMP) reagents to detect leptospiral DNA<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Loop-mediated isothermal amplification (LAMP) is one of the most promising tools for rapidly detecting <italic>Leptospira</italic> spp. However, LAMP is hampered by cold storage to maintain the enzymatic activity of <italic>Bst</italic> DNA polymerase.</p> </sec> <sec><title style='display:none'>Objective</title> <p>To overcome the drawback of cold storage requirement for LAMP reagents we modified the reagents by adding sucrose as stabilizer. We then sought to determine the stability at room temperature of the premixed LAMP reagents containing sucrose.</p> </sec> <sec><title style='display:none'>Method</title> <p>Premixed LAMP reagents with sucrose and without sucrose were prepared. The prepared mixtures were stored at room temperature for up to 60 days, and were subjected to LAMP reactions at various intervals using rat kidney samples to detect leptospiral DNA.</p> </sec> <sec><title style='display:none'>Results</title> <p>The premixed LAMP reagents with sucrose remained stable for 45 days while sucrose-free premixed LAMP reagents showed no amplification from day 1 of storage at room temperature up to day 14.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The LAMP reagent system can be refined by using sucrose as stabilizer, thus allowing their storage at room temperature without the need for cold storage. The modified method enables greater feasibility of LAMP for field surveillance and epidemiology in resource-limited settings.</p> </sec> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00Clinical characteristics and outcomes of Langerhans cell histiocytosis at a single institution in Thailand: a 20-year retrospective study<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Langerhans cell histiocytosis (LCH) is a rare disease characterized by the various systems involved and clinical manifestations with a wide range of symptoms.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To describe clinical characteristics, imaging, treatment, and outcomes of pediatric LCH at Phramongkutklao Hospital, Bangkok, Thailand.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a 20-year retrospective review of the medical records of patients diagnosed with LCH from birth to 21 years old from January 1, 1997, to December 31, 2016.</p> </sec> <sec><title style='display:none'>Results</title> <p>In all, 14 patients with median age of 2.5 years were studied. Six (43%) patients had single-system (SS) LCH. Five patients (63%) with multisystem (MS) LCH (n = 8. 57%) had risk-organ involvement (RO+). All patients had plain X-ray imaging of their skull with 11 (79%) showing abnormal findings. Tc-99m bone imaging and fluorodeoxyglucose F18 (FDG) positron emission tomography (PET)-computed tomography (CT) demonstrated abnormal findings in 8 (89%) and 4 (29%) patients, respectively. The 5-year event-free survival (EFS) for patients with RO+ MS-LCH was less than that for those without risk-organ involvement (RO−) MS-LCH and SS-LCH (20% vs. 100%, <italic>P</italic> = 0.005). Hematological dysfunction, hypoalbuminemia, and conjugated hyperbilirubinemia may be worse prognostic factors for RO+ MS-LCH.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>FDG-PET-CT might have a greater accuracy to detect LCH disease than conventional plain X-ray and Tc-99m bone imaging. RO+ MS-LCH has been encountered with relapse and poor outcomes. Hematopoietic involvement, hypoalbuminemia, and conjugated hyperbilirubinemia may be worse prognostic factors for RO+ MS-LCH.</p> </sec> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00 variation and the clinical characteristics of patients newly diagnosed with type 2 diabetes mellitus in Yogyakarta, Indonesia<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Adenosine monophosphate (AMP)-activated protein kinase (AMPK; EC enzymes play a pivotal role in cell metabolism. They are involved in type 2 diabetes mellitus (T2DM) pathogenesis. Genetic variation of <italic>PRKAA2</italic> coding for the AMPK α2 catalytic subunit (AMPKα2) is reported to be associated with susceptibility for T2DM.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To determine the association between <italic>PRKAA2</italic> genetic variations (rs2796498, rs9803799, and rs2746342) with clinical characteristics in patients newly diagnosed with T2DM.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We performed a cross-sectional study including 166 T2DM patients from 10 primary health care centers in Yogyakarta, Indonesia. We measured fasting plasma glucose, hemoglobin A1c, serum creatinine, glomerular filtration rate, blood pressure, and body mass index as clinical characteristics. <italic>PRKAA2</italic> genetic variations were determined by TaqMan SNP genotyping assay. Hardy–Weinberg equilibrium was calculated using χ<sup>2</sup> tests.</p> </sec> <sec><title style='display:none'>Results</title> <p>There was no difference in clinical characteristics for genotypes rs2796498, rs9803799, or rs2746342 (<italic>P</italic> &gt; 0.05). No significant association was found between <italic>PRKAA2</italic> genetic variations and any clinical feature observed. Further subgroup analysis adjusting for age, sex, and waist circumference did not detect any significant association of <italic>PRKAA2</italic> genetic variations with clinical characteristics (<italic>P</italic> &gt; 0.05).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p><italic>PRKAA2</italic> genetic variation is not associated with the clinical characteristics of Indonesian patients with newly diagnosed T2DM.</p> </sec> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00Identification of a mitochondrial 12S rRNA A1555G mutation causing aminoglycoside-induced deafness in a large Thai family<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.389_s_004_w2aab3b7c12b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e36609_w2aab3b7c12b1b6b1aab1c17b1aAa">Background</title><p>Hearing loss is among the most frequent sensory disorders. Preventable causes include medications given to genetically susceptible individuals. Several families around the world with an A1555G mitochondrial mutation who became profoundly deaf after receiving aminoglycosides have been described. However, none has been reported in Thailand.</p></sec><sec id="j_1905-7415.0902.389_s_005_w2aab3b7c12b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e36617_w2aab3b7c12b1b6b1aab1c17b2aAa">Objectives</title><p>To identify the cause of hearing loss of a large Thai family with 11 members who reportedly turned deaf after receiving antibiotics.</p></sec><sec id="j_1905-7415.0902.389_s_006_w2aab3b7c12b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e36625_w2aab3b7c12b1b6b1aab1c17b3aAa">Methods</title><p>We obtained blood samples from 5 members; 4 of whom had hearing loss. Mutation analyses were performed using molecular techniques including polymerase chain reaction, Sanger sequencing, and restriction fragment length polymorphism.</p></sec><sec id="j_1905-7415.0902.389_s_007_w2aab3b7c12b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e36633_w2aab3b7c12b1b6b1aab1c17b4aAa">Results</title><p>All 4 affected members were found to harbor the same A1555G mitochondrial mutation, while the unaffected had only the wild-type A.</p></sec><sec id="j_1905-7415.0902.389_s_008_w2aab3b7c12b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e36642_w2aab3b7c12b1b6b1aab1c17b5aAa">Conclusions</title><p>We have identified the mitochondrial mutation leading to aminoglycoside-induced hearing loss in a Thai population. Raising awareness for medical practitioners of this genetic susceptibility in Thailand is warranted. Avoidance of certain medications in these individuals would prevent this acquired permanent hearing loss.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Doppler waveform patterns and reference ranges of fetal renal artery blood flow indices in normal Thai fetuses during the second trimester<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.390_s_004_w2aab3b7c13b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e18235_w2aab3b7c13b1b6b1aab1c17b1aAa">Background</title><p>Fetal hemodynamics can be assessed by Doppler ultrasonography, but the normal Doppler waveform pattern and reference range of fetal renal artery blood flow indices in normal Thai fetuses during the second trimester have not been studied.</p></sec><sec id="j_1905-7415.0902.390_s_005_w2aab3b7c13b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e18243_w2aab3b7c13b1b6b1aab1c17b2aAa">Objectives</title><p>To study the pattern and establish the normal reference range of fetal renal artery blood flow indices in the normal Thai fetus during the second trimester.</p></sec><sec id="j_1905-7415.0902.390_s_006_w2aab3b7c13b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e18251_w2aab3b7c13b1b6b1aab1c17b3aAa">Materials and methods</title><p>This cross-sectional descriptive study included 512 normal singleton pregnant women, gestational age between 14<sup>(+0)</sup> and 28<sup>(+6)</sup> weeks. Ultrasonography was performed to assess the Doppler waveform pattern and estimate the normal reference range of fetal renal artery blood flow indices. All fetuses were delivered at term with normal outcomes at birth. The mean and 95<sup>th</sup> and 5<sup>th</sup> percentiles of the Doppler indices for each gestational week were estimated.</p></sec><sec id="j_1905-7415.0902.390_s_007_w2aab3b7c13b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e18271_w2aab3b7c13b1b6b1aab1c17b4aAa">Results</title><p>Doppler patterns with absence of diastolic flow in the entire cardiac cycle (type I), and absence of diastolic flow at the end of cardiac cycle (type II) were presented in about 10.4% of normal fetuses during the second trimester of pregnancy. Values for pulsatility index, peak systolic velocity, systolic-to-diastolic ratio, and resistance index (with absent end-diastolic velocity (AEDV) removed) each increased significantly with gestational age. The increase in end-diastolic velocity (with AEDV removed) with gestational age was not significant.</p></sec><sec id="j_1905-7415.0902.390_s_008_w2aab3b7c13b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e18280_w2aab3b7c13b1b6b1aab1c17b5aAa">Conclusion</title><p>These normative data could serve as a basis for evaluation of the fetal renal artery blood flow, which should be of benefit for pregnancy management, especially in situations that interfere with fetal renal perfusion.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Observational study of omeprazole for gastroesophageal reflux on pulmonary function in adult asthmatics<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.378_s_004_s_001_w2aab3b7b2b1b6b1aab1c16b1Aa"><title style='display:none' id="d1389236e14046_w2aab3b7b2b1b6b1aab1c16b1aAa">Background</title><p>Asthma is a chronic inflammatory disease of airways. Gastroesophageal reflux disease (GERD) is known to be associated with worsening asthma. We hypothesized that treatment of GERD in asthmatics will improve asthma control and quality of life. We reviewed our experience of treatment of GERD in asthmatics in Thailand.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_002_w2aab3b7b2b1b6b1aab1c16b2Aa"><title style='display:none' id="d1389236e14053_w2aab3b7b2b1b6b1aab1c16b2aAa">Objectives</title><p>To study the effects of omeprazole for treatment of GERD in patients with poorly controlled asthma on pulmonary function tests and asthma control test (ACT) scores.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_003_w2aab3b7b2b1b6b1aab1c16b3Aa"><title style='display:none' id="d1389236e14060_w2aab3b7b2b1b6b1aab1c16b3aAa">Methods</title><p>This study was conducted at King Chulalongkorn Memorial Hospital between August 2009 and December 2010. Patients with partly controlled and uncontrolled asthma who were found to have GERD by 24 hour esophageal pH monitoring were administered omeprazole 40 mg per day for 8 weeks. Pulmonary function tests and ACT scores before and after treatment were compared at 4-weeks and 8-weeks follow up.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_004_w2aab3b7b2b1b6b1aab1c16b4Aa"><title style='display:none' id="d1389236e14067_w2aab3b7b2b1b6b1aab1c16b4aAa">Results</title><p>Twenty four patients were included in this study. None of them had asthmatic attacks during the study. After 4 and 8 weeks of omeprazole treatment, the mean FEV1 (2.20 ± 0.64 L, 2.36 ± 0.58 L, respectively) and the mean ACT score (20.82 ± 3.30, 23.00 ± 1.69, respectively) were significantly higher than the pretreatment values (mean FEV1 1.99 ± 0.56 L and ACT score 16.36 ± 3.97) (<italic>P</italic> &lt; 0.05).</p></sec><sec id="j_1905-7415.0902.378_s_004_s_005_w2aab3b7b2b1b6b1aab1c16b5Aa"><title style='display:none' id="d1389236e14078_w2aab3b7b2b1b6b1aab1c16b5aAa">Conclusion</title><p>High-dose omeprazole may improve pulmonary function and the level of asthma control in Thai patients with partly controlled or uncontrolled asthma and coexisting GERD.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Stevens-Johnson Syndrome and toxic epidermal necrolysis in children: a retrospective study at Srinagarind Hospital, Khon Kaen, Thailand 1992–2012<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.386_s_005_w2aab3b7b9b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e7217_w2aab3b7b9b1b6b1aab1c17b1aAa">Background</title><p>Stevens–Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening skin conditions with an etiology of drug exposure or infections.</p></sec><sec id="j_1905-7415.0902.386_s_006_w2aab3b7b9b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e7225_w2aab3b7b9b1b6b1aab1c17b2aAa">Objectives</title><p>To determine the cause, treatments, complications, and outcomes of SJS/TEN in children admitted to Srinagrind Hospital during 1992–2012.</p></sec><sec id="j_1905-7415.0902.386_s_007_w2aab3b7b9b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e7233_w2aab3b7b9b1b6b1aab1c17b3aAa">Methods</title><p>Retrospective chart review. A diagnosis of SJS and TEN was confirmed by pediatric dermatologists.</p></sec><sec id="j_1905-7415.0902.386_s_008_w2aab3b7b9b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e7241_w2aab3b7b9b1b6b1aab1c17b4aAa">Results</title><p>A total of 38 patients was recorded. They consisted 31 (82%) SJS patients and 7 (18%) TEN patients. Mean age 6.6 years (range 1 to 14 years). Male to female was 1.1:1. Most cases (30 or 79%) were caused by drug exposure. Three cases (8%) by infection, and 5 cases (13%) were of unknown cause. The antiepileptic drug group was the most common cause. Systemic corticosteroids were used in 33 cases (87%). Intravenous immunoglobulin was used in one TEN patient (3%). There were 18 cases (47%) with acute complications. Ocular complications (7 cases, 39%), septicemia (4 cases, 22%), and secondary skin infections (3 cases, 17%) were the most common. Mean difference in length of hospital stay between those with and without acute complications was 12.3 days (<italic>P</italic> &lt; 0.01, 95% CI 5.9–18.6). Ocular complications were the only long-term complications at 1-year follow up, and included symblepharon, corneal pannus, and dry eyes. Two patients (5%), both having cases of TEN, died.</p></sec><sec id="j_1905-7415.0902.386_s_009_w2aab3b7b9b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e7253_w2aab3b7b9b1b6b1aab1c17b5aAa">Conclusions</title><p>Antiepileptic drugs were the most common causes of SJS/TEN in our study. Good ophthalmologic care of the prevalent acute eye complications in these patients is needed to prevent long-term ophthalmic complications.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Hepatic resection using ultrasonic surgical aspirator<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.384_s_004_w2aab3b7b7b1b6b1aab1c16b1Aa"><title style='display:none' id="d1389236e245_w2aab3b7b7b1b6b1aab1c16b1aAa">Background</title><p>Hepatic resections conducted for malignant tumors can be difficult because of the need to create cancer-free margins.</p></sec><sec id="j_1905-7415.0902.384_s_005_w2aab3b7b7b1b6b1aab1c16b2Aa"><title style='display:none' id="d1389236e253_w2aab3b7b7b1b6b1aab1c16b2aAa">Objectives</title><p>To examine the outcome of hepatic resections after the introduction of a Cavitron Ultrasonic Surgical Aspirator (CUSA).</p></sec><sec id="j_1905-7415.0902.384_s_006_w2aab3b7b7b1b6b1aab1c16b3Aa"><title style='display:none' id="d1389236e261_w2aab3b7b7b1b6b1aab1c16b3aAa">Methods</title><p>A retrospective study of patients who underwent hepatic resection by a single surgeon between April 1999 to March 2013.</p></sec><sec id="j_1905-7415.0902.384_s_007_w2aab3b7b7b1b6b1aab1c16b4Aa"><title style='display:none' id="d1389236e269_w2aab3b7b7b1b6b1aab1c16b4aAa">Results</title><p>We included 101 patients with 104 hepatectomies. Most hepatic parenchymal transections were performed using a CUSA under intermittent hepatic inflow occlusion (Pringle maneuver). Thirty-five patients underwent a right hepatectomy, 11 a left hepatectomy, 6 a right hepatectomy and segment I resection, 6 a right lobectomy, and 46 underwent segmentectomies, wedge resections, or other types of hepatic resections. Biliary-enteric reconstruction with a Roux-en-Y limb of the jejunum to a hepatic duct of the hepatic remnant was performed in 28 patients. Operative time was 90–720 min (median 300 min, mean 327 ± 149 min). Operative blood transfusion was 0–17 units (median 3 units, mean 3.9 ± 3.6 units). Twenty-one hepatectomies were conducted without blood transfusion. Thirty-four postoperative complications occurred in 30 patients with a 9% reoperation rate. Perioperative mortality was 6%. Age, operative time, operative blood transfusion, reoperation, and complications were significantly associated with mortality.</p></sec><sec id="j_1905-7415.0902.384_s_008_w2aab3b7b7b1b6b1aab1c16b5Aa"><title style='display:none' id="d1389236e278_w2aab3b7b7b1b6b1aab1c16b5aAa">Conclusion</title><p>Careful preoperative diagnosis and evaluation of patients, faultless surgical techniques, and excellent postoperative care are important to avoid potentially serious postoperative complications and mortality. The CUSA is an effective assisting device during hepatic parenchymal transection with a concomitant Pringle maneuver, apparently reducing operative blood loss.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Comprehensive care for thalassemia: not just the treatment of anemia function in patients with regular blood transfusion for thalassemia major<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.385_s_005_w2aab3b7b8b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e23217_w2aab3b7b8b1b6b1aab1c17b1aAa">Background</title><p>Regular blood transfusion and iron chelation therapy have improved the quality of life of patients with thalassemia and increased their longevity, but transfusion also increases the frequency of endocrine complications, possibly because of iron deposition in the pituitary gland or the gonads, or both.</p></sec><sec id="j_1905-7415.0902.385_s_006_w2aab3b7b8b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e23225_w2aab3b7b8b1b6b1aab1c17b2aAa">Objective</title><p>To evaluate testicular function in patients with thalassemia major by basal hormonal study, and identify risk factors for dysfunction.</p></sec><sec id="j_1905-7415.0902.385_s_007_w2aab3b7b8b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e23233_w2aab3b7b8b1b6b1aab1c17b3aAa">Methods</title><p>We performed a cross-sectional study of 28 patients with thalassemia major aged 11.7 ± 1.8 (8–14.9) years (15 in prepuberty, 13 in puberty with no delayed puberty) who had regular blood transfusions. A normal control group comprised 64 boys who were matched for age and Tanner genital stage.</p></sec><sec id="j_1905-7415.0902.385_s_008_w2aab3b7b8b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e23241_w2aab3b7b8b1b6b1aab1c17b4aAa">Results</title><p>The mean level of serum ferritin in the previous year was 1,575 ± 642 ng/mL, and the onset of blood transfusion was at 3.8 ± 2.3 years and iron chelation therapy was 6.6 ± 2.8 years. The trend for anti-Müllerian hormone levels in patients and controls was similar with age, and although higher in the patients, particularly at Tanner stage II, was not significantly different. Testosterone levels were lower in the patients compared with controls; particularly at Tanner stages IV–V (290.88 vs. 537.4 ng/dL, <italic>P</italic> &lt; 0.05). Serum follicle-stimulating hormone and luteinizing hormone levels were not significantly different between the groups at any Tanner stage.</p></sec><sec id="j_1905-7415.0902.385_s_009_w2aab3b7b8b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e23253_w2aab3b7b8b1b6b1aab1c17b5aAa">Conclusion</title><p>Patients who received regular blood transfusions had normal Sertoli cell function. Leydig cell dysfunction may occur, even though the patients had a normal pubertal onset.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Assessment of health-related quality of life in Thai patients after heart surgery<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.388_s_005_w2aab3b7c11b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e37824_w2aab3b7c11b1b6b1aab1c17b1aAa">Background</title><p>Little is known about health-related quality of life (HRQoL) of Thai patients after heart surgery. The Thai government initiated a cardiac surgery project to celebrate the 80<sup>th</sup> birthday anniversary of His Majesty The King.</p></sec><sec id="j_1905-7415.0902.388_s_006_w2aab3b7c11b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e37835_w2aab3b7c11b1b6b1aab1c17b2aAa">Objectives</title><p>To evaluate the HRQoL of Thai patients after heart surgery, as part of the Thai government’s cardiac surgery project, and to investigate the association of HRQoL instruments and patient characteristics.</p></sec><sec id="j_1905-7415.0902.388_s_007_w2aab3b7c11b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e37843_w2aab3b7c11b1b6b1aab1c17b3aAa">Methods</title><p>Of 7,863 patients in the project, 386 were randomly selected for a telephone interview by trained researchers during June–November 2008. The HRQoL of Thai patients was measured using 12-item Short Form version 2 and EuroQoL (EQ-5D) plus an EQ-5D visual analog scale (EQ-VAS).</p></sec><sec id="j_1905-7415.0902.388_s_008_w2aab3b7c11b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e37851_w2aab3b7c11b1b6b1aab1c17b4aAa">Results</title><p>The mean age of patient participants was 50.4 ± 13.7 years (range 17–82) and 49.5% were male. The Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were reported as 46.91 and 54.44, respectively, compared with the US norm scores of 50. The EQ-5D and EQ-VAS utility scores of 0.81 and 0.84 were comparable to those of Thai general population (0.77–0.84), but higher than those of Thai patients with heart disease (0.73–0.75). Patients with older age, female sex, unemployment, and presence of comorbidity rated a lower HRQoL. The multiple linear regression models showed that both EQ-5D and EQ-VAS were associated with PCS and MCS and could be predicted by 40%–50%.</p></sec><sec id="j_1905-7415.0902.388_s_009_w2aab3b7c11b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e37859_w2aab3b7c11b1b6b1aab1c17b5aAa">Conclusion</title><p>Overall, the HRQoL of patients after the heart surgery was satisfactory. The QoL in patients with a specific types of heart surgery warrants further study.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00en-us-1