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Zeitschriftendaten
Format
Zeitschrift
eISSN
1875-855X
Erstveröffentlichung
01 Jun 2007
Erscheinungsweise
6 Hefte pro Jahr
Sprachen
Englisch

Suche

Volumen 6 (2012): Heft 1 (February 2012)

Zeitschriftendaten
Format
Zeitschrift
eISSN
1875-855X
Erstveröffentlichung
01 Jun 2007
Erscheinungsweise
6 Hefte pro Jahr
Sprachen
Englisch

Suche

19 Artikel

Review article

Uneingeschränkter Zugang

Relationship between the 308GA polymorphism of the tumor necrosis factor alpha gene and acute or chronic pancreatitis: a meta-analysis

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 1 - 7

Zusammenfassung

Abstract

Background: Several studies have examined the association between G308A polymorphism of tumor necrosis factor alpha (TNF-α gene and acute or chronic pancreatitis, but the results are still controversial.

Objective: Assess whether a relationship exists between G308A polymorphism of TNF-α gene and acute or chronic pancreatitis using meta-analysis.

Methods: Relevant studies were identified from the electronic databases: MEDLINE, EMBASE, and Current Contents. This meta-analysis included 10 case-control studies, where 1,253 acute or chronic pancreatitis cases and 1,269 controls were included.

Results: The combined results based on all studies showed no relationship between the 308GA polymorphism of TNF-α gene and pancreatitis. When stratifying by types of disease, results were similar for both acute and chronic pancreatitis. Comparing severe with mild acute pancreatitis, we found no statistical association. When stratifying for race, results were similar among Asians and Caucasians.

Conclusion: There was no association between the 308GA polymorphism of TNF-α gene and acute or chronic pancreatitis.

Schlüsselwörter

  • Gene polymorphism
  • meta-analysis
  • pancreatitis
  • tumor necrosis factor alpha

Original article

Uneingeschränkter Zugang

Application of cell-sheet seeding to improve seeding efficiency of monolayer cells on the surface of biomaterials

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 9 - 18

Zusammenfassung

Abstract

Background: Cell seeding technique is a fundamental component of the tissue engineering construction. Effective cell seeding can not only shorten the construction time but also improve the final outcome of tissue engineered substitutes.

Objective: We improved the seeding efficiency of monolayer cells on the surface of biomaterials in tissue engineering. Cell sheet technology was applied to seed monolayer cell sheet instead of concentrated cell suspension, which was termed cell-sheet seeding.

Methods: Equal quantities of endothelial cells were seeded on the surface of equally sized acellular bovine pericardia by cell-sheet seeding and cell suspension seeding respectively. After culturing cell-seeded pericardia for 24 hours, the effects of these 2 cell seeding methods were evaluated and compared.

Results: As compared to cell suspension seeding, a larger quantity of loading cells, higher tissue-plasminogen activator (t-PA) and prostacyclin (PGI-2) content, and higher homogeneity of cells distribution on the surface of the pericardia was achieved with cell-sheet seeding. Furthermore, cell-sheet seeding did not affect metabolism or increase endothelial cells damage.

Conclusion: Cell-sheet seeding is an effective and time-saving method of seeding monolayer cells on the surface of biomaterials. This novel seeding method is particularly suitable for building tissue engineered substitutes with monolayered cells distribution and 2-dimensional structure.

Schlüsselwörter

  • Cell adhesion
  • cell seeding
  • cell sheet
  • extracellular matrix
  • tissue engineering
Uneingeschränkter Zugang

Serum vitamin E concentration in Iranian population with angiography defined coronary artery disease

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 19 - 25

Zusammenfassung

Abstract

Background: Oxidative modification of low-density lipoprotein (LDL) seems to play a role in the development of atherosclerosis and coronary artery disease (CAD). Although in many experiments a role for vitamin E in prevention of LDL oxidation and therefore CAD has been suggested, some clinical studies have failed to confirm these findings.

Objective: A case- control study was conducted to find out the association between serum vitamin E levels and coronary artery disease susceptibility in Iranian patients with CAD.

Methods: Ninety-one patients with angiographically confirmed CAD (defined as coronary obstruction >50%) and 39 age and sex matched controls that their atherosclerosis was not proven according to angiography were included. Serum vitamin E concentration was measured in plasma by high performance liquid chromatography (HPLC) for all patients.

Results: No significant difference in serum levels of vitamin E and standardized vitamin E [vitamin E/total cholesterol, and vitamin E/ (total cholesterol+triglycerides)] and lipid profile parameters was observed between patients and control groups. The association between vitamin E and CAD remained unchanged independent of age, sex, smoking habit, hypertension, hyperlipidemia and diabetes. Serum vitamin E levels were positively associated with waist/hip ratio, high-density lipoprotein cholesterol (HDL-C) and total cholesterol in the control group and inversely associated with HDL-C in the CAD group. Vitamin E/total cholesterol levels were inversely associated with HDL-C and low-density lipoprotein cholesterol (LDL-C).

Conclusion: Our data does not support the results of other studies which have shown an association between lower amounts of vitamin E and enhanced risk of coronary heart disease.

Schlüsselwörter

  • Coronary artery disease
  • HPLC
  • LDL-cholesterol
  • LDL oxidation
  • vitamin E
Uneingeschränkter Zugang

Molecular analysis of Malaysian Chinese D- donors: a single centre experience

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 27 - 33

Zusammenfassung

Abstract

Background: The Rh blood group system is highly polymorphic and next to the ABO system is the most clinically significant in transfusion medicine. The frequency of D- phenotypes and the underlying molecular genetics vary widely in different populations.

Objectives: We determined the prevalence of different D- phenotypes among Malaysian blood donors in a tertiary medical centre and identified the molecular basis of Chinese D- donors in this population.

Materials and methods: A total of 146 D- Chinese donors with various Rh phenotypes were identified from review of blood donor records between January 2003 and September 2008. Fresh blood samples from 36 of these donors were obtained and further characterized by PCR-SSP to determine the molecular basis of these D- individuals.

Results: A total of 86,620 blood donor records were reviewed. Of these 911 were D-, consisting of 483 Indians, 189 Malays and 146 Chinese. The ccee phenotype was the most common among D- individuals with a prevalence of 91.51% (442/483) in Indians, 74.60% (141/189) in Malays and 55.48% (81/146) in Chinese. D- phenotypes with C and/or E antigens were most common in Chinese {44.52% (65/146)}. In the molecular analysis of the 36 D- Chinese donor samples, 19 samples with ccee phenotype and 5/17 of samples with Ccee phenotype showed no detectable RHD gene. The remaining 12/17 Ccee samples had intact RHD genes with RHD (K409K) mutation.

Conclusion: In our donor population, we found a wide variation in the incidence of D- as well as the distribution of various D-phenotypes among the three major ethnic groups. A significant number of D- Chinese donors with Ccee phenotype were found to be DEL with RHD (K409K) mutation. DEL red cells are known to cause anti-D alloimmunization. Therefore, in clinical practice, it is important to exclude DEL RBCs from D- donor pools.

Schlüsselwörter

  • Chinese D- donors
  • DEL variant
  • Malaysian blood donors
  • molecular genotyping
  • RhD-negative phenotypes
Uneingeschränkter Zugang

Analysis of some of the epidemiological risk factors affecting the prevalence of tuberculosis in buffalo at seven livestock farms in Punjab Pakistan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 35 - 42

Zusammenfassung

Abstract

Background: Bovine tuberculosis is a disease of zoonotic importance. It is disease of high priority all over the world and needs to be investigated in each country.

Objective: This study was conducted to find out the prevalence of tuberculosis in buffaloes and associated risk factors.

Methods: The study was carried out at seven livestock experimental stations in Punjab, Pakistan. Buffaloes were studied by comparative cervical intradermal tuberculin test.

Result: The results of the study revealed an overall tuberculosis prevalence of 11.3% with 86% of farms having tuberculin positive animals. The frequency analysis revealed significant difference between different groups for age, calving, lactation length, average daily milk and live weight of the buffaloes. Data analysis by T-test also revealed significant difference between means for age, live weight, calving, lactation length and average daily milk between tuberculin positive and negative buffaloes. Bivariate and multivariate logistic analysis revealed significant association of age, live weight, calving, average daily milk and lactation length. Multivariate logistic regression analysis including all the variables in the model revealed significant association of tuberculosis with age, live weight, total milk produced, presence of cattle at the farm, lactation length, and total other animals at the farm.

Conclusion: The prevalence of tuberculosis in buffaloes increases with the increase in age, calving, live weight, milk production and presence of cattle at the farm, while the prevalence decreases with the increase in lactation length.

Schlüsselwörter

  • Buffaloes
  • Pakistan
  • prevalence
  • tuberculin test
  • tuberculosis
Uneingeschränkter Zugang

Impact of vitamin D receptor gene polymorphisms on blood lead levels in Thai lead exposed workers

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 43 - 50

Zusammenfassung

Schlüsselwörter

  • ApaI
  • BsmI
  • Cdx-2
  • FokI
  • lead level
  • lead poisoning
  • polymorphism
  • TaqI
  • vitamin D receptor
Uneingeschränkter Zugang

Anatomic variants of intrahepatic bile ducts in Thais

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 51 - 57

Zusammenfassung

Abstract

Background: The progress in development of hepatobiliary surgical procedure has made understanding of the normal and variations of bile ducts important.

Objective: We determined anatomical variation of intrahepatic bile ducts in detected on magnetic resonance cholangiopancreatography (MRCP) at King Chulalongkorn Memorial Hospital in Thai people in order to perform interventional procedures and/or hepatobiliary surgery safely.

Method: One hundred sixty three Thai subjects were examined by MRCP at KCMH between January 1, 2003 and November 30, 2008. Images of MRCP retrieved were reviewed and classified as type A, conventional pattern; type B, trifurcation; type C, right posterior segmental duct (RP) joining common hepatic duct (CHD); and type D, right posterior segmental duct (RP) joining left hepatic duct (LHD).

Results: The anatomy of the intrahepatic bile ducts was typical (type A) in 65% of cases (n=106). Variations from conventional intrahepatic bile duct anatomy were seen in the remaining 57 patients, showing trifurcation (type B) in 17.2% (n=28), anomalous drainage of RP into CHD (type C) in 5.5% (n=9) and drainage of RP into LHD (type D) in 9.2% (n=15). Other variations in 3.1% (n=5) included the presence of an accessory duct and drainage of RP into common bile duct.

Conclusion: The branching pattern of intrahepatic bile ducts was atypical in 35% of cases. The highest incidence of variation is type B or trifurcation. Our results confirm previous reports. Variant intrahepatic bile duct anatomy is relevant for the practice of safe and efficacious surgical and other hepatobiliary intervention.

Uneingeschränkter Zugang

The prevalence of fungal infections in unilateral abnormal sinus imaging

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 59 - 66

Zusammenfassung

Abstract

Background: Rhinosinusitis is a common disease which may involve paranasal sinuses unilaterally or bilaterally. Bilateral paranasal sinus infection is more prevalent, and mostly caused by viruses, bacteria and fungi respectively. Unilateral rhinosinusitis is found infrequently and is mostly caused by bacteria and fungi.

Objectives: We studied the prevalence and types of fungal infection, and types of rhinosinusitis, in patients with unilateral abnormal sinus imaging

Methodology: A descriptive study with prospective data collection from 44 patients with unilateral abnormal sinus imaging, who were diagnosed with rhinosinusitis in Srinagarind hospital, Khon Kaen University, Thailand between August 2005 and August 2007.

Results: The prevalence of fungal infection in unilateral rhinosinusitis was 16/41 (39.0 %, 95% CI 24.1-53.9). Bacterial infection was found in 25/41 (61%, 95% CI 46.1-75.9). Three patients were lost to follow-up. Most cases with fungal infection in our study had fungal balls which were removed by endoscopic surgery.

Conclusion: A high prevalence of fungal infection was found in patients with unilateral rhinosinusitis. This group of patients who do not respond to antibiotics require further investigations to evaluate fungal infection and early surgical intervention should be considered.

Schlüsselwörter

  • Fungi
  • magnetic resonance imaging
  • radiography
  • sinusitis
  • tomography
  • X-Ray computed

Brief communication (Original)

Uneingeschränkter Zugang

Variability of point-of-care testing blood glucometers versus the laboratory reference method in a tertiary teaching hospital

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 67 - 74

Zusammenfassung

Abstract

Background: Self-monitoring blood glucose (SMBG) has been established as a part of the point-of-care testing (POCT) in the management of patients diagnosed with diabetes mellitus. Various glucometers in the market have been used for this purpose but most are calibrated to whole blood. The recent recommendation by the International Federation of Clinical Chemistry (IFCC) is for glucose to be reported in plasma equivalent units which should correlate well with the clinical laboratory reference method. This is to minimize as much as possible the differences normally seen in the capillary whole blood glucose levels obtained during SMBG and routine plasma glucose levels reported by the laboratory.

Objective: We evaluated the accuracy of four commercial blood glucose strips currently available in the local hospital setting against the laboratory reference method. Methods: We analyzed 145 whole blood samples collected into plain tubes from the walk-in patients in the hospital. A simultaneously whole blood sample was collected in sodium fluoride tubes and analyzed by the routine laboratory hexokinase method (RxL, Siemens). The four different types of glucometer strips used were AccuChek Performa, AccuChek Advantage, Abbott Optium and Johnson & Johnson Surestep.

Results: The overall correlation coefficient for the four strips showed that the Accuchek Performa compared closest to the laboratory method which is R⃞=0.9761. This was followed by the Accuchek Advantage R⃞=0.9726. The Optium and Surestep systems showed R⃞=0.9376 and R⃞=0.9277 respectively. The coefficient variance (CV) for the Accuchek Performa is also <5% for both the control and sample precision. The ISO15197.2003 (E) acceptance criteria: percentage of individual results falling outside 0.8 mmol/L at glucose concentrations <4.1 mmol/L and outside 20% of the reference result at glucose concentrations >4.1 mmol/L will not be higher than 5% showed that the compliance for Performa is 100% compared to the rest (for percentage of results within 95% compliance limit).

Conclusion: The results showed that the Accuchek Performa system compared the closest to the laboratory method and complies to the ISO15197.2003 (E) with acceptable CV’s.

Schlüsselwörter

  • Glucometers
  • glucose
  • POCT
  • variation
Uneingeschränkter Zugang

Safety and efficacy of menatetrenone in children with osteogenesis imperfecta

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 75 - 79

Zusammenfassung

Abstract

Background: Osteogenesis imperfecta (OI) is an inherited connective tissue disorder with defective bone quality leading to increased bone fragility and low bone mass. Menatetrenone has been shown to reduce bone mineral density (BMD) loss as well as the incidence of fractures in patients with osteoporosis.

Objectives: We investigated the effects of menatetrenone in five prepubertal children with OI.

Methods: All patients had been treated with intravenous pamidronate for four to 42 months prior to enrollment in this study. Pamidronate was discontinued at least two months before starting 15 milligrams per day of oral menatetrenone. Menatetrenone was given for 12 months. BMD was measured at baseline and one year after menatetrenone treatment.

Results: During one year of menatetrenone treatment, the incidence of fractures was 1.0 (0.0-2.0) times/year, which was not significantly different from the fracture rate of 1.2 (0.0-1.5) times/year during pamidronate treatment. However, it significantly decreased compared with the fracture rate of 10.4 (2.7-47.6) times/year before pamidronate treatment (P=0.043). After one year of menatetrenone, BMD of lumbar spine and left hip significantly increased in three and two patients, respectively. However, one patient showed a significant decrease in BMD in both regions. Noteworthy, none of the patients developed adverse side effects during menatetrenone treatment.

Conclusions: One-year menatetrenone could maintain the decreased fracture rate of intravenous pamidronate in prepubertal OI patients. No adverse effects were observed. Larger and longer studies to determine the benefit of oral menatetrenone as adjunctive treatment in OI patients are warranted.

Schlüsselwörter

  • Fracture
  • menatetrenone
  • osteogenesis imperfecta
  • pamidronate
Uneingeschränkter Zugang

The relationship between dry eye and lactoferrin levels in tears

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 81 - 85

Zusammenfassung

Abstract

Background: Dry eye is a common ophthalmic problem and lactoferrin (LF) is one of the most important components of the immune system. Preliminary findings have suggested that LF concentration in tears may be linked to the risk of dry eye.

Objective: We investigated the relationship between dry eye and lactoferrin levels in tears.

Material and methods: LF levels in the tears of 40 patients with dry eye and 35 healthy controls were measured by radial immunodiffusion assay. Statistical analysis was used to study the correlation between LF levels and results of both Schirmer’s and tear film break-up time tests and the age of the subject.

Results: The concentration of LF was significantly decreased in the tears of dry eye subjects compared with control subjects (P<0.001). There is a positive relationship between LF in tears and results from Schirmer’s and tear film break-up time tests in non-Sj⃞gren’s syndrome (r=0.48 and 0.78 respectively P<0.001), while there is a negative relationship between LF and age (r= -0.74, P<0.005).

Conclusions: Decreased LF in tears is a factor in the pathology of dry eye. When treating non-Sj⃞gren’s syndrome, treatment with LF could be added to artificial tear treatment.

Schlüsselwörter

  • Dry eye
  • lactoferrin
  • non-Sj ⃞gren’s syndrome
  • radial immunodiffusion assay
Uneingeschränkter Zugang

Discrimination of Alzheimer’s disease using hippocampus texture features from MRI

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 87 - 94

Zusammenfassung

Abstract

Background: Alzheimer’s disease is the commonest cause of dementia and is fatal. Early detection of Alzheimer’s disease is important because treatment may be most useful if introduced early.

Objective: Analyse the utility of using the texture features of hippocampus MRI as the biomarker to identify Alzheimer’s disease.

Materials and methods: We chose the MRI of 146 normal controls and 133 Alzheimer’s disease patients from the Alzheimer’s disease neuroimaging initiative website. Sixty-nine texture features were extracted from the hippocampus region of interest as obtained from an automatic segmentation procedure. The best features were selected based on principal component analysis to decide which ones resulted in the highest rate of good classification. The proposed method is validated using a Support Vector Machine classifier.

Results: The accuracy of the proposed method on discrimination of Alzheimer’s disease patients is 93.6%.

Conclusion: The texture features taken only from hippocampus gives better discrimination between Alzheimer’s disease and normal controls. Therefore, the textures of hippocampus are much affected by Alzheimer’s disease.

Keyword

  • Alzheimer’s disease
  • hippocampus
  • principal component analysis
  • support vector machine
  • texture features
Uneingeschränkter Zugang

Restoration of renal perfusion and function in chronic kidney disease

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 95 - 98

Zusammenfassung

Abstract

Background: Present treatment with vasodilators usually initiated at the late stage of chronic kidney disease (CKD) fails to restore renal perfusion and function. This may be due to impaired mechanism of nitric oxide production, while the mechanism of vascular repair appears to be adequately functional in the early stage of CKD.

Objective: Investigate restoration of renal perfusion and function in CKD patients by implementing vasodilators treatment at the early stage of CKD.

Methods: Vasodilators treatment was implemented in 65 CKD patients (33 males and 32 females) at the early stage of CKD. The patients aged 28-71 years old, and were associated with mildly impaired renal function (mean creatinine clearance: 83±21 mL/min/1.73m2, fractional excretion of magnesium (FE Mg): 4±2% vs. normal 1.6±0.6%, total urinary protein: 85±12 mg/day, renal plasma flow (RPF): 459±59 mL/min/1.73m2, glomerlular filtration rate (GFR): 84±25 mL/min/1.73m2, peritubular capillary flow (PTCF): 332 mL/min/1.73m2). Treatment included vasodilators as follows, angiotensin converting enzyme inhibitor (ACEI) 5-20 mg/day, angiotensin II receptor blockers (ARB) 40-80 mg/day, and calcium channel blocker 5-10 mg/day for 12-24 months.

Results: Following the treatment, actual creatinine clearance rose to 101±23 mL/min/1.73m2, and FE Mg and total urinary protein declined to 3±2 % and 46±7 mg/day, respectively. RPF, GFR and PTCF significantly rose to 513±90 mL/min/1.73m2, 99±33 mL/min/1.73m2 and 413±73 mL/min/1.73m2, respectively.

Conclusion: Treatment with vasodilators at the early stage of CKD could restore renal perfusion and function.

Schlüsselwörter

  • Chronic kidney disease
  • creatinine clearance
  • FE Mg
  • vascular repair
  • vasodilators
  • renal hemodynamics
Uneingeschränkter Zugang

Basic fibroblast growth factor expression in hypertrophic ligamentum flavum of lumbar spinal stenosis

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 99 - 104

Zusammenfassung

Abstract

Background: Lumbar spinal canal stenosis is the most common spinal disorder in elderly patients. Canal narrowing is partly the result from hyperthrophy of ligamentum flavum (LF), which mechanically compresses nerve roots. Basic fibroblast growth factor (bFGF) is a potent regulator of many cellular functions including proliferation, differentiation, wound healing, and angiogenesis.

Objective: We examined the pattern of bFGF expression in the ligamentum flavum of lumbar spinal stenosis patients.

Methods: We quantified and localized bFGF expression in LF tissues obtained during surgery from nineteen patients with lumbar spinal stenosis. bFGF expression was determined using quantitative real-time polymerase chain reaction (real-time PCR). The concentration of bFGF was analyzed by enzyme-linked immunosorbent assay.

Results: The bFGF expression was significantly higher in hypertrophic LF of spinal stenosis than that in nonpathologic LF of controls. In real-time PCR, the expression of bFGF was substantially higher in the hypertrophic LF than in controls (P<0.001). The average concentration of bFGF in the hypertrophic LF (mean, 256.7 pg/mg protein) was markedly elevated compared with that of controls (mean, 75.7 pg/mg protein) (P=0.003). There was greater bFGF expression in lumbar spinal stenosis patients as quantified by real-time PCR and enzyme-linked immunosorbent assay.

Conclusion: Our study reveals that increased bFGF expression may be associated with degenerative changes of hypertrophic LF. This suggests that bFGF may contribute to pathogenesis of lumbar spinal stenosis.

Schlüsselwörter

  • Basic fibroblast growth factor
  • ligamentum flavum
  • lumbar spinal stenosis
Uneingeschränkter Zugang

Limit of sensitivity for melting curve screening for α-thalassemia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 105 - 109

Zusammenfassung

Abstract

Background: Thalassemia is a major inherited disease in Thailand, with a large number of people being either directly affected or carrying the trait. The Southeast Asian α-thalassemia 1 deletion (--SEA) is the most common α-thalassemia 1 type, with a high number of carriers in Thai population. Individuals who carry the deletion have the potential for having offspring with Hb Bart’s hydrops fetalis, the most severe thalassemia syndrome. Given the incidence of this disease, screening for thalassemia is an important tool in diagnosis and many methods have been developed.

Objectives: A single tube real-time PCR methodology with a melting curve analysis method has been recently developed, and this work sought to determine the limit of sensitivity of this technique to determine whether it is possible to optimize this methodology and apply it to the single cell level for application in preimplantation genetic diagnosis screening programs.

Methods: DNA was extracted from whole blood or isolated peripheral blood mononuclear cells of normal volunteers as well as α-thalassemia 1 (--SEA) carriers. Sensitivity of the melting curve analysis was established with serial dilutions of DNA down to the picogram (pg) level.

Results: The melting curve analysis as previously established was sensitive down to 2 ng of DNA. Further optimization increased sensitivity down to 200 pg, but discrimination of a normal allele from an α-thalassemia 1 (--SEA) allele below this level of DNA was not achieved.

Conclusion: While advantageous in routine screening programs, real time PCR coupled with a melting curve analysis is not currently suitable for adaptation to pre-implantation diagnosis for alpha thalassemia.

Schlüsselwörter

  • Hb Bart’s hydrops fetalis
  • PCR
  • PGD
  • thalassemia
Uneingeschränkter Zugang

Etiologies and treatment of acute pulmonary embolism at Srinagarind Hospital

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 111 - 116

Zusammenfassung

Abstract

Background: The incidence of acute pulmonary embolism has been increasing over the past few years. Prevention, early detection and appropriate treatment will decrease morbidity and mortality.

Objective: We identified the etiologies and treatment outcomes of acute pulmonary embolism.

Methods: We enrolled hospitalized patients diagnosed with acute pulmonary embolism at Srinagarind Hospital between January 1, 2002 and October 31, 2009.

Results: Over the eight-year period, 169 patients were diagnosed with acute pulmonary embolism; 95 (56.2%) females and 74 (43.8%) males. The mean age was 54.1 years (range, 18-85). 13% presented with massive pulmonary embolism. The most common presentation was dyspnea (65.1%). Arterial hypoxemia (88.8%) and sinus tachycardia (58.3%) were the common initial clinical findings. Twenty percent of chest radiograph were unremarkable. The most common etiology was cancer (62.1%), mostly solid malignancies (98/105) e.g., cholangiocarcinoma, gynecologic malignancy, and lung cancer. The second and the third common etiologies were immobilization/stasis (8.3%) and connective tissue disease (7.1%). After treatment, 58.6% of the patients improved while 21.3% died in hospital. The main therapeutic modality was anticoagulation. The treated group had better outcomes than those receiving only supportive care. Only one patient underwent thromboembolectomy but died. The complications during treatment were acute respiratory failure (34.9%), shock (18.3%), and bleeding (6.5%).

Conclusions: The most common etiology of acute pulmonary embolism was cancer, especially solid malignancies. Immobilization and connective tissue disease were the other common etiologies. The treatment group had a better prognosis than those with supportive care only.

Schlüsselwörter

  • Acute pulmonary embolism
  • etiology
  • outcome
Uneingeschränkter Zugang

Tibiofemoral joint reaction force during the stance phase of backward- and forward-walking at variable speeds

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 117 - 122

Zusammenfassung

Abstract

Background: The knee is the joint that often suffers from sport injury. Adequate post-injury rehabilitation helps the patients come back to the game earlier, and prevents re-injury. As part of the program, backward-walking is sometimes used, but information available for the knee-joint reaction force is limited.

Objective: Determine tibiofemoral joint reaction force (TFJRF) during the stance phase of backward- and forward-walking at variable speeds.

Methods: Fifty-four healthy Thai males (age 20 to 39 year old, body mass index <30) performed forward- and backward-walking on a split-belt treadmill to record the ground reaction force (GRF) on the force platform under each belt. The subjects were controlled to walk from the slowest to fastest speeds (0.8, 1.0, 1.2, 1.4, and 1.6 m/second). Kinematic data were recorded using six cameras, and analyzed by the motion analysis software. Based on the obtained kinematic and GRF data, TFJRF was calculated using an inverse dynamic model. Heart rates (HR) were also recorded using wireless electrocardiography.

Results: Backward-walking produced higher peak TFJRF during the stance phase than that of forward-walking in every speed. The subjects had higher HR in every speed during backward-walking, but the average TFJRF was lower in all test speeds except 0.8 m/second.

Conclusion: Peak TFJRF and HR during backward-walking were higher than those during forward-walking in every speed, but backward-walking showed a trend to lower the averaged TFJRF compared with forward-walking. In clinical practice, lower speed of backward-walking may be appropriate to prescribe as an exercise for those with tibiofemoral joint problems.

Schlüsselwörter

  • Backward walking
  • inverse dynamics
  • joint reaction force
  • split-belt treadmill
  • stance phase

Clinical report

Uneingeschränkter Zugang

Experiences with total femur replacement for malignant bone and soft tissue tumors

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 123 - 127

Zusammenfassung

Abstract

Background: Reasonable function can be restored after total femur replacement after massive resection of bone and soft tissue sarcomas of the thigh. The type of femoral prosthesis and surgical approach are tailored to the clinical characteristics of individual patients and to tumor anatomy. Though the complication rate is high, total femur replacement offers the patient limb salvage and a chance at functional ambulation.

Objective: We described the function and complications of total femur replacement performed at the institution as well as relevant literature reviews.

Methods: Seven patients underwent total femur replacement for the treatment of malignant bone and soft tissue tumors of the lower extremities between 1992 and 2010 at our institute. Ages ranged from 12 to 68 (mean=34) years. The tumor was pathologically diagnosed as osteosarcoma in two patients, Ewing’s sarcoma in two, chondrosarcoma (grade 3) in one, soft tissue malignant fibrous histiocytoma in one, and bone metastasis from renal cancer in one. Follow-up periods ranged from 1 to 17 years (mean = six years three months). All patients underwent wide resection, using the Howmedica Modular and Reconstruction System in five cases and the Kyocera Limb Salvage System in two cases. Function, complications and outcomes were evaluated in these patients, and the usefulness of the operative procedures is discussed herein.

Results: The mean functional score was 60%. X-ray examination revealed migration in only one case. Complications were infection (n=2), bipolar head dislocation (n=1) and patellar fracture (n=2). The outcomes were DOD (died of disease) in three cases, NED (no evidence of disease) in two, AWD (alive with disease) in one, and CDF (continuous disease free) in one.

Conclusion: The results suggest that total femur replacement is useful as a means of reconstructing affected limbs in patients with malignant bone and soft tissue tumors, but that latissimus dorsi muscle transplantation, as well as other procedures, must also be considered in cases requiring extensive soft tissue resection to prevent infection. Furthermore, early one-stage revision is advisable in cases showing signs of infection.

Schlüsselwörter

  • Femoral prosthesis
  • functional outcomes
  • malignant tumors
  • total femur replacement
Uneingeschränkter Zugang

Color Doppler sonography of pulmonary aspergillosis in infants with chronic granulomatous disease

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 129 - 133

Zusammenfassung

Abstract

Background: Pulmonary aspergillosis may be the first presentation of chronic granulomatous disease (CGD) and may occur during infancy. Imaging studies with plain chest radiographs and computed tomography may present a diagnostic challenge, and high index of suspicion is required for the diagnosis.

Objective: Report a six-week-old boy with chronic granulomatous disease and invasive pulmonary aspergillosis, in who color Doppler sonography of the chest showed systemic arterial supply to the pulmonary lesions.

Methods: Sonography of the chest using a high-frequency linear transducer was performed in a six-week-old infant with chronic granulomatous disease who presented with noisy breathing, cough, and low-grade fever, and his chest radiograph revealed multiple sites of pulmonary opacities.

Results: The peripheral pulmonary nodules had low-resistant arterial supply derived from a systemic artery of the chest wall. The pulmonary lesion was later proven to be fungal infection. Similar imaging was detected in another two infants with the same disease.

Conclusion: Systemic arterial supply could develop to feed peripheral pulmonary aspergillosis in an infant as young as six-week old who had underling CGD.

Schlüsselwörter

  • Aspergillosis
  • child
  • chronic granulomatous disease
  • lung
  • ultrasound
19 Artikel

Review article

Uneingeschränkter Zugang

Relationship between the 308GA polymorphism of the tumor necrosis factor alpha gene and acute or chronic pancreatitis: a meta-analysis

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 1 - 7

Zusammenfassung

Abstract

Background: Several studies have examined the association between G308A polymorphism of tumor necrosis factor alpha (TNF-α gene and acute or chronic pancreatitis, but the results are still controversial.

Objective: Assess whether a relationship exists between G308A polymorphism of TNF-α gene and acute or chronic pancreatitis using meta-analysis.

Methods: Relevant studies were identified from the electronic databases: MEDLINE, EMBASE, and Current Contents. This meta-analysis included 10 case-control studies, where 1,253 acute or chronic pancreatitis cases and 1,269 controls were included.

Results: The combined results based on all studies showed no relationship between the 308GA polymorphism of TNF-α gene and pancreatitis. When stratifying by types of disease, results were similar for both acute and chronic pancreatitis. Comparing severe with mild acute pancreatitis, we found no statistical association. When stratifying for race, results were similar among Asians and Caucasians.

Conclusion: There was no association between the 308GA polymorphism of TNF-α gene and acute or chronic pancreatitis.

Schlüsselwörter

  • Gene polymorphism
  • meta-analysis
  • pancreatitis
  • tumor necrosis factor alpha

Original article

Uneingeschränkter Zugang

Application of cell-sheet seeding to improve seeding efficiency of monolayer cells on the surface of biomaterials

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 9 - 18

Zusammenfassung

Abstract

Background: Cell seeding technique is a fundamental component of the tissue engineering construction. Effective cell seeding can not only shorten the construction time but also improve the final outcome of tissue engineered substitutes.

Objective: We improved the seeding efficiency of monolayer cells on the surface of biomaterials in tissue engineering. Cell sheet technology was applied to seed monolayer cell sheet instead of concentrated cell suspension, which was termed cell-sheet seeding.

Methods: Equal quantities of endothelial cells were seeded on the surface of equally sized acellular bovine pericardia by cell-sheet seeding and cell suspension seeding respectively. After culturing cell-seeded pericardia for 24 hours, the effects of these 2 cell seeding methods were evaluated and compared.

Results: As compared to cell suspension seeding, a larger quantity of loading cells, higher tissue-plasminogen activator (t-PA) and prostacyclin (PGI-2) content, and higher homogeneity of cells distribution on the surface of the pericardia was achieved with cell-sheet seeding. Furthermore, cell-sheet seeding did not affect metabolism or increase endothelial cells damage.

Conclusion: Cell-sheet seeding is an effective and time-saving method of seeding monolayer cells on the surface of biomaterials. This novel seeding method is particularly suitable for building tissue engineered substitutes with monolayered cells distribution and 2-dimensional structure.

Schlüsselwörter

  • Cell adhesion
  • cell seeding
  • cell sheet
  • extracellular matrix
  • tissue engineering
Uneingeschränkter Zugang

Serum vitamin E concentration in Iranian population with angiography defined coronary artery disease

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 19 - 25

Zusammenfassung

Abstract

Background: Oxidative modification of low-density lipoprotein (LDL) seems to play a role in the development of atherosclerosis and coronary artery disease (CAD). Although in many experiments a role for vitamin E in prevention of LDL oxidation and therefore CAD has been suggested, some clinical studies have failed to confirm these findings.

Objective: A case- control study was conducted to find out the association between serum vitamin E levels and coronary artery disease susceptibility in Iranian patients with CAD.

Methods: Ninety-one patients with angiographically confirmed CAD (defined as coronary obstruction >50%) and 39 age and sex matched controls that their atherosclerosis was not proven according to angiography were included. Serum vitamin E concentration was measured in plasma by high performance liquid chromatography (HPLC) for all patients.

Results: No significant difference in serum levels of vitamin E and standardized vitamin E [vitamin E/total cholesterol, and vitamin E/ (total cholesterol+triglycerides)] and lipid profile parameters was observed between patients and control groups. The association between vitamin E and CAD remained unchanged independent of age, sex, smoking habit, hypertension, hyperlipidemia and diabetes. Serum vitamin E levels were positively associated with waist/hip ratio, high-density lipoprotein cholesterol (HDL-C) and total cholesterol in the control group and inversely associated with HDL-C in the CAD group. Vitamin E/total cholesterol levels were inversely associated with HDL-C and low-density lipoprotein cholesterol (LDL-C).

Conclusion: Our data does not support the results of other studies which have shown an association between lower amounts of vitamin E and enhanced risk of coronary heart disease.

Schlüsselwörter

  • Coronary artery disease
  • HPLC
  • LDL-cholesterol
  • LDL oxidation
  • vitamin E
Uneingeschränkter Zugang

Molecular analysis of Malaysian Chinese D- donors: a single centre experience

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 27 - 33

Zusammenfassung

Abstract

Background: The Rh blood group system is highly polymorphic and next to the ABO system is the most clinically significant in transfusion medicine. The frequency of D- phenotypes and the underlying molecular genetics vary widely in different populations.

Objectives: We determined the prevalence of different D- phenotypes among Malaysian blood donors in a tertiary medical centre and identified the molecular basis of Chinese D- donors in this population.

Materials and methods: A total of 146 D- Chinese donors with various Rh phenotypes were identified from review of blood donor records between January 2003 and September 2008. Fresh blood samples from 36 of these donors were obtained and further characterized by PCR-SSP to determine the molecular basis of these D- individuals.

Results: A total of 86,620 blood donor records were reviewed. Of these 911 were D-, consisting of 483 Indians, 189 Malays and 146 Chinese. The ccee phenotype was the most common among D- individuals with a prevalence of 91.51% (442/483) in Indians, 74.60% (141/189) in Malays and 55.48% (81/146) in Chinese. D- phenotypes with C and/or E antigens were most common in Chinese {44.52% (65/146)}. In the molecular analysis of the 36 D- Chinese donor samples, 19 samples with ccee phenotype and 5/17 of samples with Ccee phenotype showed no detectable RHD gene. The remaining 12/17 Ccee samples had intact RHD genes with RHD (K409K) mutation.

Conclusion: In our donor population, we found a wide variation in the incidence of D- as well as the distribution of various D-phenotypes among the three major ethnic groups. A significant number of D- Chinese donors with Ccee phenotype were found to be DEL with RHD (K409K) mutation. DEL red cells are known to cause anti-D alloimmunization. Therefore, in clinical practice, it is important to exclude DEL RBCs from D- donor pools.

Schlüsselwörter

  • Chinese D- donors
  • DEL variant
  • Malaysian blood donors
  • molecular genotyping
  • RhD-negative phenotypes
Uneingeschränkter Zugang

Analysis of some of the epidemiological risk factors affecting the prevalence of tuberculosis in buffalo at seven livestock farms in Punjab Pakistan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 35 - 42

Zusammenfassung

Abstract

Background: Bovine tuberculosis is a disease of zoonotic importance. It is disease of high priority all over the world and needs to be investigated in each country.

Objective: This study was conducted to find out the prevalence of tuberculosis in buffaloes and associated risk factors.

Methods: The study was carried out at seven livestock experimental stations in Punjab, Pakistan. Buffaloes were studied by comparative cervical intradermal tuberculin test.

Result: The results of the study revealed an overall tuberculosis prevalence of 11.3% with 86% of farms having tuberculin positive animals. The frequency analysis revealed significant difference between different groups for age, calving, lactation length, average daily milk and live weight of the buffaloes. Data analysis by T-test also revealed significant difference between means for age, live weight, calving, lactation length and average daily milk between tuberculin positive and negative buffaloes. Bivariate and multivariate logistic analysis revealed significant association of age, live weight, calving, average daily milk and lactation length. Multivariate logistic regression analysis including all the variables in the model revealed significant association of tuberculosis with age, live weight, total milk produced, presence of cattle at the farm, lactation length, and total other animals at the farm.

Conclusion: The prevalence of tuberculosis in buffaloes increases with the increase in age, calving, live weight, milk production and presence of cattle at the farm, while the prevalence decreases with the increase in lactation length.

Schlüsselwörter

  • Buffaloes
  • Pakistan
  • prevalence
  • tuberculin test
  • tuberculosis
Uneingeschränkter Zugang

Impact of vitamin D receptor gene polymorphisms on blood lead levels in Thai lead exposed workers

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 43 - 50

Zusammenfassung

Schlüsselwörter

  • ApaI
  • BsmI
  • Cdx-2
  • FokI
  • lead level
  • lead poisoning
  • polymorphism
  • TaqI
  • vitamin D receptor
Uneingeschränkter Zugang

Anatomic variants of intrahepatic bile ducts in Thais

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 51 - 57

Zusammenfassung

Abstract

Background: The progress in development of hepatobiliary surgical procedure has made understanding of the normal and variations of bile ducts important.

Objective: We determined anatomical variation of intrahepatic bile ducts in detected on magnetic resonance cholangiopancreatography (MRCP) at King Chulalongkorn Memorial Hospital in Thai people in order to perform interventional procedures and/or hepatobiliary surgery safely.

Method: One hundred sixty three Thai subjects were examined by MRCP at KCMH between January 1, 2003 and November 30, 2008. Images of MRCP retrieved were reviewed and classified as type A, conventional pattern; type B, trifurcation; type C, right posterior segmental duct (RP) joining common hepatic duct (CHD); and type D, right posterior segmental duct (RP) joining left hepatic duct (LHD).

Results: The anatomy of the intrahepatic bile ducts was typical (type A) in 65% of cases (n=106). Variations from conventional intrahepatic bile duct anatomy were seen in the remaining 57 patients, showing trifurcation (type B) in 17.2% (n=28), anomalous drainage of RP into CHD (type C) in 5.5% (n=9) and drainage of RP into LHD (type D) in 9.2% (n=15). Other variations in 3.1% (n=5) included the presence of an accessory duct and drainage of RP into common bile duct.

Conclusion: The branching pattern of intrahepatic bile ducts was atypical in 35% of cases. The highest incidence of variation is type B or trifurcation. Our results confirm previous reports. Variant intrahepatic bile duct anatomy is relevant for the practice of safe and efficacious surgical and other hepatobiliary intervention.

Uneingeschränkter Zugang

The prevalence of fungal infections in unilateral abnormal sinus imaging

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 59 - 66

Zusammenfassung

Abstract

Background: Rhinosinusitis is a common disease which may involve paranasal sinuses unilaterally or bilaterally. Bilateral paranasal sinus infection is more prevalent, and mostly caused by viruses, bacteria and fungi respectively. Unilateral rhinosinusitis is found infrequently and is mostly caused by bacteria and fungi.

Objectives: We studied the prevalence and types of fungal infection, and types of rhinosinusitis, in patients with unilateral abnormal sinus imaging

Methodology: A descriptive study with prospective data collection from 44 patients with unilateral abnormal sinus imaging, who were diagnosed with rhinosinusitis in Srinagarind hospital, Khon Kaen University, Thailand between August 2005 and August 2007.

Results: The prevalence of fungal infection in unilateral rhinosinusitis was 16/41 (39.0 %, 95% CI 24.1-53.9). Bacterial infection was found in 25/41 (61%, 95% CI 46.1-75.9). Three patients were lost to follow-up. Most cases with fungal infection in our study had fungal balls which were removed by endoscopic surgery.

Conclusion: A high prevalence of fungal infection was found in patients with unilateral rhinosinusitis. This group of patients who do not respond to antibiotics require further investigations to evaluate fungal infection and early surgical intervention should be considered.

Schlüsselwörter

  • Fungi
  • magnetic resonance imaging
  • radiography
  • sinusitis
  • tomography
  • X-Ray computed

Brief communication (Original)

Uneingeschränkter Zugang

Variability of point-of-care testing blood glucometers versus the laboratory reference method in a tertiary teaching hospital

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 67 - 74

Zusammenfassung

Abstract

Background: Self-monitoring blood glucose (SMBG) has been established as a part of the point-of-care testing (POCT) in the management of patients diagnosed with diabetes mellitus. Various glucometers in the market have been used for this purpose but most are calibrated to whole blood. The recent recommendation by the International Federation of Clinical Chemistry (IFCC) is for glucose to be reported in plasma equivalent units which should correlate well with the clinical laboratory reference method. This is to minimize as much as possible the differences normally seen in the capillary whole blood glucose levels obtained during SMBG and routine plasma glucose levels reported by the laboratory.

Objective: We evaluated the accuracy of four commercial blood glucose strips currently available in the local hospital setting against the laboratory reference method. Methods: We analyzed 145 whole blood samples collected into plain tubes from the walk-in patients in the hospital. A simultaneously whole blood sample was collected in sodium fluoride tubes and analyzed by the routine laboratory hexokinase method (RxL, Siemens). The four different types of glucometer strips used were AccuChek Performa, AccuChek Advantage, Abbott Optium and Johnson & Johnson Surestep.

Results: The overall correlation coefficient for the four strips showed that the Accuchek Performa compared closest to the laboratory method which is R⃞=0.9761. This was followed by the Accuchek Advantage R⃞=0.9726. The Optium and Surestep systems showed R⃞=0.9376 and R⃞=0.9277 respectively. The coefficient variance (CV) for the Accuchek Performa is also <5% for both the control and sample precision. The ISO15197.2003 (E) acceptance criteria: percentage of individual results falling outside 0.8 mmol/L at glucose concentrations <4.1 mmol/L and outside 20% of the reference result at glucose concentrations >4.1 mmol/L will not be higher than 5% showed that the compliance for Performa is 100% compared to the rest (for percentage of results within 95% compliance limit).

Conclusion: The results showed that the Accuchek Performa system compared the closest to the laboratory method and complies to the ISO15197.2003 (E) with acceptable CV’s.

Schlüsselwörter

  • Glucometers
  • glucose
  • POCT
  • variation
Uneingeschränkter Zugang

Safety and efficacy of menatetrenone in children with osteogenesis imperfecta

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 75 - 79

Zusammenfassung

Abstract

Background: Osteogenesis imperfecta (OI) is an inherited connective tissue disorder with defective bone quality leading to increased bone fragility and low bone mass. Menatetrenone has been shown to reduce bone mineral density (BMD) loss as well as the incidence of fractures in patients with osteoporosis.

Objectives: We investigated the effects of menatetrenone in five prepubertal children with OI.

Methods: All patients had been treated with intravenous pamidronate for four to 42 months prior to enrollment in this study. Pamidronate was discontinued at least two months before starting 15 milligrams per day of oral menatetrenone. Menatetrenone was given for 12 months. BMD was measured at baseline and one year after menatetrenone treatment.

Results: During one year of menatetrenone treatment, the incidence of fractures was 1.0 (0.0-2.0) times/year, which was not significantly different from the fracture rate of 1.2 (0.0-1.5) times/year during pamidronate treatment. However, it significantly decreased compared with the fracture rate of 10.4 (2.7-47.6) times/year before pamidronate treatment (P=0.043). After one year of menatetrenone, BMD of lumbar spine and left hip significantly increased in three and two patients, respectively. However, one patient showed a significant decrease in BMD in both regions. Noteworthy, none of the patients developed adverse side effects during menatetrenone treatment.

Conclusions: One-year menatetrenone could maintain the decreased fracture rate of intravenous pamidronate in prepubertal OI patients. No adverse effects were observed. Larger and longer studies to determine the benefit of oral menatetrenone as adjunctive treatment in OI patients are warranted.

Schlüsselwörter

  • Fracture
  • menatetrenone
  • osteogenesis imperfecta
  • pamidronate
Uneingeschränkter Zugang

The relationship between dry eye and lactoferrin levels in tears

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 81 - 85

Zusammenfassung

Abstract

Background: Dry eye is a common ophthalmic problem and lactoferrin (LF) is one of the most important components of the immune system. Preliminary findings have suggested that LF concentration in tears may be linked to the risk of dry eye.

Objective: We investigated the relationship between dry eye and lactoferrin levels in tears.

Material and methods: LF levels in the tears of 40 patients with dry eye and 35 healthy controls were measured by radial immunodiffusion assay. Statistical analysis was used to study the correlation between LF levels and results of both Schirmer’s and tear film break-up time tests and the age of the subject.

Results: The concentration of LF was significantly decreased in the tears of dry eye subjects compared with control subjects (P<0.001). There is a positive relationship between LF in tears and results from Schirmer’s and tear film break-up time tests in non-Sj⃞gren’s syndrome (r=0.48 and 0.78 respectively P<0.001), while there is a negative relationship between LF and age (r= -0.74, P<0.005).

Conclusions: Decreased LF in tears is a factor in the pathology of dry eye. When treating non-Sj⃞gren’s syndrome, treatment with LF could be added to artificial tear treatment.

Schlüsselwörter

  • Dry eye
  • lactoferrin
  • non-Sj ⃞gren’s syndrome
  • radial immunodiffusion assay
Uneingeschränkter Zugang

Discrimination of Alzheimer’s disease using hippocampus texture features from MRI

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 87 - 94

Zusammenfassung

Abstract

Background: Alzheimer’s disease is the commonest cause of dementia and is fatal. Early detection of Alzheimer’s disease is important because treatment may be most useful if introduced early.

Objective: Analyse the utility of using the texture features of hippocampus MRI as the biomarker to identify Alzheimer’s disease.

Materials and methods: We chose the MRI of 146 normal controls and 133 Alzheimer’s disease patients from the Alzheimer’s disease neuroimaging initiative website. Sixty-nine texture features were extracted from the hippocampus region of interest as obtained from an automatic segmentation procedure. The best features were selected based on principal component analysis to decide which ones resulted in the highest rate of good classification. The proposed method is validated using a Support Vector Machine classifier.

Results: The accuracy of the proposed method on discrimination of Alzheimer’s disease patients is 93.6%.

Conclusion: The texture features taken only from hippocampus gives better discrimination between Alzheimer’s disease and normal controls. Therefore, the textures of hippocampus are much affected by Alzheimer’s disease.

Keyword

  • Alzheimer’s disease
  • hippocampus
  • principal component analysis
  • support vector machine
  • texture features
Uneingeschränkter Zugang

Restoration of renal perfusion and function in chronic kidney disease

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 95 - 98

Zusammenfassung

Abstract

Background: Present treatment with vasodilators usually initiated at the late stage of chronic kidney disease (CKD) fails to restore renal perfusion and function. This may be due to impaired mechanism of nitric oxide production, while the mechanism of vascular repair appears to be adequately functional in the early stage of CKD.

Objective: Investigate restoration of renal perfusion and function in CKD patients by implementing vasodilators treatment at the early stage of CKD.

Methods: Vasodilators treatment was implemented in 65 CKD patients (33 males and 32 females) at the early stage of CKD. The patients aged 28-71 years old, and were associated with mildly impaired renal function (mean creatinine clearance: 83±21 mL/min/1.73m2, fractional excretion of magnesium (FE Mg): 4±2% vs. normal 1.6±0.6%, total urinary protein: 85±12 mg/day, renal plasma flow (RPF): 459±59 mL/min/1.73m2, glomerlular filtration rate (GFR): 84±25 mL/min/1.73m2, peritubular capillary flow (PTCF): 332 mL/min/1.73m2). Treatment included vasodilators as follows, angiotensin converting enzyme inhibitor (ACEI) 5-20 mg/day, angiotensin II receptor blockers (ARB) 40-80 mg/day, and calcium channel blocker 5-10 mg/day for 12-24 months.

Results: Following the treatment, actual creatinine clearance rose to 101±23 mL/min/1.73m2, and FE Mg and total urinary protein declined to 3±2 % and 46±7 mg/day, respectively. RPF, GFR and PTCF significantly rose to 513±90 mL/min/1.73m2, 99±33 mL/min/1.73m2 and 413±73 mL/min/1.73m2, respectively.

Conclusion: Treatment with vasodilators at the early stage of CKD could restore renal perfusion and function.

Schlüsselwörter

  • Chronic kidney disease
  • creatinine clearance
  • FE Mg
  • vascular repair
  • vasodilators
  • renal hemodynamics
Uneingeschränkter Zugang

Basic fibroblast growth factor expression in hypertrophic ligamentum flavum of lumbar spinal stenosis

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 99 - 104

Zusammenfassung

Abstract

Background: Lumbar spinal canal stenosis is the most common spinal disorder in elderly patients. Canal narrowing is partly the result from hyperthrophy of ligamentum flavum (LF), which mechanically compresses nerve roots. Basic fibroblast growth factor (bFGF) is a potent regulator of many cellular functions including proliferation, differentiation, wound healing, and angiogenesis.

Objective: We examined the pattern of bFGF expression in the ligamentum flavum of lumbar spinal stenosis patients.

Methods: We quantified and localized bFGF expression in LF tissues obtained during surgery from nineteen patients with lumbar spinal stenosis. bFGF expression was determined using quantitative real-time polymerase chain reaction (real-time PCR). The concentration of bFGF was analyzed by enzyme-linked immunosorbent assay.

Results: The bFGF expression was significantly higher in hypertrophic LF of spinal stenosis than that in nonpathologic LF of controls. In real-time PCR, the expression of bFGF was substantially higher in the hypertrophic LF than in controls (P<0.001). The average concentration of bFGF in the hypertrophic LF (mean, 256.7 pg/mg protein) was markedly elevated compared with that of controls (mean, 75.7 pg/mg protein) (P=0.003). There was greater bFGF expression in lumbar spinal stenosis patients as quantified by real-time PCR and enzyme-linked immunosorbent assay.

Conclusion: Our study reveals that increased bFGF expression may be associated with degenerative changes of hypertrophic LF. This suggests that bFGF may contribute to pathogenesis of lumbar spinal stenosis.

Schlüsselwörter

  • Basic fibroblast growth factor
  • ligamentum flavum
  • lumbar spinal stenosis
Uneingeschränkter Zugang

Limit of sensitivity for melting curve screening for α-thalassemia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 105 - 109

Zusammenfassung

Abstract

Background: Thalassemia is a major inherited disease in Thailand, with a large number of people being either directly affected or carrying the trait. The Southeast Asian α-thalassemia 1 deletion (--SEA) is the most common α-thalassemia 1 type, with a high number of carriers in Thai population. Individuals who carry the deletion have the potential for having offspring with Hb Bart’s hydrops fetalis, the most severe thalassemia syndrome. Given the incidence of this disease, screening for thalassemia is an important tool in diagnosis and many methods have been developed.

Objectives: A single tube real-time PCR methodology with a melting curve analysis method has been recently developed, and this work sought to determine the limit of sensitivity of this technique to determine whether it is possible to optimize this methodology and apply it to the single cell level for application in preimplantation genetic diagnosis screening programs.

Methods: DNA was extracted from whole blood or isolated peripheral blood mononuclear cells of normal volunteers as well as α-thalassemia 1 (--SEA) carriers. Sensitivity of the melting curve analysis was established with serial dilutions of DNA down to the picogram (pg) level.

Results: The melting curve analysis as previously established was sensitive down to 2 ng of DNA. Further optimization increased sensitivity down to 200 pg, but discrimination of a normal allele from an α-thalassemia 1 (--SEA) allele below this level of DNA was not achieved.

Conclusion: While advantageous in routine screening programs, real time PCR coupled with a melting curve analysis is not currently suitable for adaptation to pre-implantation diagnosis for alpha thalassemia.

Schlüsselwörter

  • Hb Bart’s hydrops fetalis
  • PCR
  • PGD
  • thalassemia
Uneingeschränkter Zugang

Etiologies and treatment of acute pulmonary embolism at Srinagarind Hospital

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 111 - 116

Zusammenfassung

Abstract

Background: The incidence of acute pulmonary embolism has been increasing over the past few years. Prevention, early detection and appropriate treatment will decrease morbidity and mortality.

Objective: We identified the etiologies and treatment outcomes of acute pulmonary embolism.

Methods: We enrolled hospitalized patients diagnosed with acute pulmonary embolism at Srinagarind Hospital between January 1, 2002 and October 31, 2009.

Results: Over the eight-year period, 169 patients were diagnosed with acute pulmonary embolism; 95 (56.2%) females and 74 (43.8%) males. The mean age was 54.1 years (range, 18-85). 13% presented with massive pulmonary embolism. The most common presentation was dyspnea (65.1%). Arterial hypoxemia (88.8%) and sinus tachycardia (58.3%) were the common initial clinical findings. Twenty percent of chest radiograph were unremarkable. The most common etiology was cancer (62.1%), mostly solid malignancies (98/105) e.g., cholangiocarcinoma, gynecologic malignancy, and lung cancer. The second and the third common etiologies were immobilization/stasis (8.3%) and connective tissue disease (7.1%). After treatment, 58.6% of the patients improved while 21.3% died in hospital. The main therapeutic modality was anticoagulation. The treated group had better outcomes than those receiving only supportive care. Only one patient underwent thromboembolectomy but died. The complications during treatment were acute respiratory failure (34.9%), shock (18.3%), and bleeding (6.5%).

Conclusions: The most common etiology of acute pulmonary embolism was cancer, especially solid malignancies. Immobilization and connective tissue disease were the other common etiologies. The treatment group had a better prognosis than those with supportive care only.

Schlüsselwörter

  • Acute pulmonary embolism
  • etiology
  • outcome
Uneingeschränkter Zugang

Tibiofemoral joint reaction force during the stance phase of backward- and forward-walking at variable speeds

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 117 - 122

Zusammenfassung

Abstract

Background: The knee is the joint that often suffers from sport injury. Adequate post-injury rehabilitation helps the patients come back to the game earlier, and prevents re-injury. As part of the program, backward-walking is sometimes used, but information available for the knee-joint reaction force is limited.

Objective: Determine tibiofemoral joint reaction force (TFJRF) during the stance phase of backward- and forward-walking at variable speeds.

Methods: Fifty-four healthy Thai males (age 20 to 39 year old, body mass index <30) performed forward- and backward-walking on a split-belt treadmill to record the ground reaction force (GRF) on the force platform under each belt. The subjects were controlled to walk from the slowest to fastest speeds (0.8, 1.0, 1.2, 1.4, and 1.6 m/second). Kinematic data were recorded using six cameras, and analyzed by the motion analysis software. Based on the obtained kinematic and GRF data, TFJRF was calculated using an inverse dynamic model. Heart rates (HR) were also recorded using wireless electrocardiography.

Results: Backward-walking produced higher peak TFJRF during the stance phase than that of forward-walking in every speed. The subjects had higher HR in every speed during backward-walking, but the average TFJRF was lower in all test speeds except 0.8 m/second.

Conclusion: Peak TFJRF and HR during backward-walking were higher than those during forward-walking in every speed, but backward-walking showed a trend to lower the averaged TFJRF compared with forward-walking. In clinical practice, lower speed of backward-walking may be appropriate to prescribe as an exercise for those with tibiofemoral joint problems.

Schlüsselwörter

  • Backward walking
  • inverse dynamics
  • joint reaction force
  • split-belt treadmill
  • stance phase

Clinical report

Uneingeschränkter Zugang

Experiences with total femur replacement for malignant bone and soft tissue tumors

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 123 - 127

Zusammenfassung

Abstract

Background: Reasonable function can be restored after total femur replacement after massive resection of bone and soft tissue sarcomas of the thigh. The type of femoral prosthesis and surgical approach are tailored to the clinical characteristics of individual patients and to tumor anatomy. Though the complication rate is high, total femur replacement offers the patient limb salvage and a chance at functional ambulation.

Objective: We described the function and complications of total femur replacement performed at the institution as well as relevant literature reviews.

Methods: Seven patients underwent total femur replacement for the treatment of malignant bone and soft tissue tumors of the lower extremities between 1992 and 2010 at our institute. Ages ranged from 12 to 68 (mean=34) years. The tumor was pathologically diagnosed as osteosarcoma in two patients, Ewing’s sarcoma in two, chondrosarcoma (grade 3) in one, soft tissue malignant fibrous histiocytoma in one, and bone metastasis from renal cancer in one. Follow-up periods ranged from 1 to 17 years (mean = six years three months). All patients underwent wide resection, using the Howmedica Modular and Reconstruction System in five cases and the Kyocera Limb Salvage System in two cases. Function, complications and outcomes were evaluated in these patients, and the usefulness of the operative procedures is discussed herein.

Results: The mean functional score was 60%. X-ray examination revealed migration in only one case. Complications were infection (n=2), bipolar head dislocation (n=1) and patellar fracture (n=2). The outcomes were DOD (died of disease) in three cases, NED (no evidence of disease) in two, AWD (alive with disease) in one, and CDF (continuous disease free) in one.

Conclusion: The results suggest that total femur replacement is useful as a means of reconstructing affected limbs in patients with malignant bone and soft tissue tumors, but that latissimus dorsi muscle transplantation, as well as other procedures, must also be considered in cases requiring extensive soft tissue resection to prevent infection. Furthermore, early one-stage revision is advisable in cases showing signs of infection.

Schlüsselwörter

  • Femoral prosthesis
  • functional outcomes
  • malignant tumors
  • total femur replacement
Uneingeschränkter Zugang

Color Doppler sonography of pulmonary aspergillosis in infants with chronic granulomatous disease

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 129 - 133

Zusammenfassung

Abstract

Background: Pulmonary aspergillosis may be the first presentation of chronic granulomatous disease (CGD) and may occur during infancy. Imaging studies with plain chest radiographs and computed tomography may present a diagnostic challenge, and high index of suspicion is required for the diagnosis.

Objective: Report a six-week-old boy with chronic granulomatous disease and invasive pulmonary aspergillosis, in who color Doppler sonography of the chest showed systemic arterial supply to the pulmonary lesions.

Methods: Sonography of the chest using a high-frequency linear transducer was performed in a six-week-old infant with chronic granulomatous disease who presented with noisy breathing, cough, and low-grade fever, and his chest radiograph revealed multiple sites of pulmonary opacities.

Results: The peripheral pulmonary nodules had low-resistant arterial supply derived from a systemic artery of the chest wall. The pulmonary lesion was later proven to be fungal infection. Similar imaging was detected in another two infants with the same disease.

Conclusion: Systemic arterial supply could develop to feed peripheral pulmonary aspergillosis in an infant as young as six-week old who had underling CGD.

Schlüsselwörter

  • Aspergillosis
  • child
  • chronic granulomatous disease
  • lung
  • ultrasound

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