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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 4 (August 2012)

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

Suche

20 Artikel

Editorial

Uneingeschränkter Zugang

Ethics and the “Milwaukee protocol” for human rabies treatment

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 509 - 511

Zusammenfassung

Review article

Uneingeschränkter Zugang

Heat shock protein 60 and asthma treatment 10.5372/1905-7415.0604.084

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 513 - 518

Zusammenfassung

Abstract

Background: Asthma is a chronic and complex airway inflammatory disease characterized by airway hyperresponsiveness. Current asthma therapies are limited to specific disease manifestations, highlighting the importance of developing treatments with broader treatment applications. CD4+ T lymphocytes, which produce a characteristic repertoire of cytokines, play a critical role in the development of airway inflammation, mucus production, and airway hyper-responsiveness in asthma. Recently, it has been demonstrated that Heat Shock Protein 60 (HSP60) could mediate CD4+ T lymphocyte differentiation, suggesting that HSP60 can be targeted in the development of novel anti-asthma medications, especially for the treatment of severe disease or refractory patients.

Objective: This review summarizes the current knowledge regarding the relationship between HSP60 and asthma.

Method: We conducted a literature search using the MEDLINE (PubMed), SCOPUS and OVID/LWWW databases using the keywords “HSP”, “HSP60”, “HSP60 signaling pathway”, “TLR”, “TLR2 signaling pathway”, “asthma”, and “CD4+ T Lymphocytes”. Only articles published in English were included in the review.

Results: HSP60 was shown to either inhibit or exacerbate asthma through different mechanisms. However, the deleterious effects of HSP60 on asthma likely surpassed any beneficial inhibitory effects.

Conclusion: HSP60 can be expected to be developed into a new treatment target for asthma that may be of great interest to medical scientists and clinicians.

Schlüsselwörter

  • Asthma
  • CD4+ T Lymphocytes
  • HSP60

Original article

Uneingeschränkter Zugang

Inhibition of leptin receptors through plant-derived ligands for liver fibrosis drug development

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 519 - 526

Zusammenfassung

Abstract

Background: Liver fibrosis is a common health problem worldwide. Several drug-targets have been identified from the fibrosis pathway namely leptin, leptin receptors, adiponectin, and PPAR ã agonist. Suitable antifibrotic drugs are needed.

Objective: Present plant-derived ligands inhibiting the leptin receptor mediated pathway as antifibrotic drugs.

Methods: Bioinformatics was used to generate 3D-structure of leptin receptor to explore binding grooves of therapeutic targets. A molecular library with bioactive compounds from SE Asian medicinal plants was developed by using the bioactive compounds, docking with leptin receptor.

Results: The homology model of leptin receptor has showed similarities with crystal structures and folds reported previously for other cytokine family members. The Ramachandran plot shows that 89.1% of the residues are most favored region. Besides, 15 possible active sites were identified with active residues such as Ser180, Gln463, Pro477, IIe482, Leu519, Asn550, Pro564, Val600, Glu643, Lys665, Asp671, Ser675, Leu767, Pro803, and Glu834.

Conclusion: This study provides data on surface cavity, binding groove, and active sites of the leptin receptor, which will be useful for researchers to understand leptin receptor/complex. We hope that the strandline serve as a potential drug candidate for liver fibrosis in the near future.

Schlüsselwörter

  • Bioinformatics
  • drug target
  • hepatic fibrosis
  • leptin receptors
  • ligands
Uneingeschränkter Zugang

Thyroid-associated ophthalmopathy: linear regression analysis of single photon emission computed tomography

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 527 - 533

Zusammenfassung

Abstract

Background: At present, there is still no significant progress in the diagnosis and treatment of thyroidassociated ophthalmopathy.

Objective: We explored the role of 99mTc-octreotide single photon emission computed tomography (SPECT) in determination of the clinical activity of thyroid-associated ophthalmopathy (TAO).

Methods:A prospective study including 36 cases of TAO and 8 controls was conducted by intravenous injection of 99mTc-octreotide, followed by SPECT. The radioactive counting ratio was calculated for the orbital/occipital regions of interest (ROI), and the Spearman rank correlation between the average ratio and the corresponding clinical activity score (CAS) mean of ADHOC (Recommendation of the Ad Hoc Committee of The American Thyroid Association in 1992) was analyzed. A curve regression equation for the CAS to orbital/occipital radio counting ratio was determined to calculate the cutoff for TAO activity.

Results: The Spearman rank correlation between orbital/occipital uptake ratio and CAS was calculated (coefficient r = 0.972, p < 0.01). The curve regression equation for all patients with TAO (including the active group and resting group) was (Y) = -66.25 + 106.06 X-52.86 X2 + 8.94 X3. The transformational equation of the cubical CAS of exophthalmos (dependent variable Y) to the square root of the orbital/occipital uptake ratio (independent variable X) was (Y) = -752.67 + 676.74 (X). A cutoff of 1.48 was used to identify the active phase of exophthalmos. The sensitivity was 96.0% with a standard error of 3.92%, and the specificity was 94.73 with a standard error of 5.13%.

Conclusion: 99mTc-octreotide SPECT can objectively and accurately measure TAO activity. An orbital/occipital uptake ratio ≥1.48 is the recommended cutoff to determine the active phase of TAO. This may guide clinical treatment of TAO.

Schlüsselwörter

  • Clinical activity
  • SPECT
  • thyroid-associated ophthalmopathy
  • 99mTc-octreotide
Uneingeschränkter Zugang

Can job titles be predictors for recent onset latent tuberculosis in health care workers?

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 535 - 539

Zusammenfassung

Abstract

Background: Tuberculosis is a common health problem in developing countries including Thailand. The association between occupation and recent onset of tuberculosis is unclear.

Objective: We studied the association of job types and tuberculin conversion or recent onset latent tuberculosis in healthcare workers in an endemic area of tuberculosis.

Design and Sample: A case-control study was done at Srinagarind Hospital, Thailand. Cases were subjects with tuberculin conversion, while controls were subjects with negative results of tuberculin skin test (TST) in two consecutive years.

Results: One thousand twenty five subjects completed two consecutive TST between 2001 and 2009. The rate of tuberculin conversion was 19.8% or 203 subjects. In a multivariate model, the only three significant factors for tuberculin conversion were male gender, having a BCG scar, and job type. Only nurses, nurse assistants, and ward workers were significantly associated with tuberculin conversion with adjusted odds ratio [95% confidence interval] of 2.3 [1.3-4.1], 2.3 [1.3-4.7], and 3.0 [1.8-5.0], respectively.

Conclusion: Being male, having a BCG scar, and certain job types increase the risk of latent tuberculosis in healthcare workers. Tuberculosis infection control program should emphasize job types for healthcare workers who are at increased risk.

Schlüsselwörter

  • Healthcare workers
  • job title
  • latent tuberculosis
Uneingeschränkter Zugang

Drug errors from the Thai Anesthesia Incidents Monitoring Study: analysis of 1,996 incident reports

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 541 - 547

Zusammenfassung

Abstract

Background: The Royal College of Anesthesiologists of Thailand arranged the Thai Anesthesia Incidents Monitoring Study (Thai AIMS) to investigate the clinical course, outcome, contributing factors, and suggested preventive strategies for anesthesia related adverse events including drug errors.

Methods: As part of the Thai AIMS, perioperative anesthesia incident reports of adverse events were collected on an anonymous and voluntary basis from 51 participating hospitals across Thailand between January 1 and June 30, 2007. Three anesthesiologists reviewed relevant data of drug error incidents. A descriptive statistics was used.

Results: Among 1,996 incident reports of the Thai AIMS database, there were 82 incidents of drug errors (4.1%). Most of drug errors incidents occurred in maintenance phase (57.3%), general anesthesia (87.8%), and in the operation theatre (91.5%). One-fifth of incidents occurred under emergency condition (95%). Common anesthetic drugs involved were nondepolarizing neuromuscular blocking agent (23.1%), opioids (21.9%), antibiotics (17.1%), succinyl choline (7.3%), and induction agents (6.1%). Giving the wrong drug (35.4%), overdosage of drug (32.9%), problems with labeling (14.6%), and wrong concentration (9.8%) were the most common types of drug errors. Of the 25 substitutions with 14 syringe swap (17.1%) and six-ampule swap (7.3%), 60% involved a different pharmaceutical class of drug. Only 10.9% of incidents resulted in intubation, mechanical ventilation, or unplanned admission to intensive care unit. Seventy-nine point two percent were considered as preventable and 39% were due to system error. Haste (42.7%) was considered as the most common contributing factors while vigilance (72%) and having experience (30.5%) were considered as common factors minimizing medication errors.

Conclusion: Practice guidelines especially using of class specific color labeling, quality assurance activity, improvement of communication, and training were suggested preventive strategies.

Schlüsselwörter

  • Adverse event
  • anesthesia
  • complication
  • drug error
  • medication error
  • substitution
Uneingeschränkter Zugang

Polymorphism of COMT Val158Met is associated with inhalant use and dependence: a Thai substance dependence treatment cohort

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 549 - 556

Zusammenfassung

Abstract

Background: Inhalants are abused by adolescents worldwide, but genetic markers of inhalant use or dependence are poorly understood.

Objective: We assessed the frequency and association of a functional polymorphism in the gene encoding catechol-O-methyltransferase (COMT Val158Met) in inhalant-dependent (ID) subjects and inhalant users (IU).

Methods: Demographic and diagnostic data were collected by interviewing 456 Thai-speaking methamphetamine (MA) users by using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). COMT Val158Met (rs4680) genotyping was acquired by restriction fragment length polymorphism. Individuals with ID or IU were compared with non-ID or non-IU by using a χ2 test. After that, factors associated with ID or IU were analyzed by logistic regression. Blood samples from 217 healthy blood donors were used as controls for ID and IU in the allele frequency comparison. Deviation from Hardy-Weinberg Equilibrium Expectations (HWEE) was also tested.

Results: Out of 456 MA users, deviation from HWEE was observed in IU but not in ID, non-ID or from the total sample. The “Met” allele was significantly associated with ID (p = 0.02) and IU (p = 0.002) among MA users, but not in allele frequency comparisons when compared to the healthy control group (p > 0.1). With respect to logistic regression analysis, homo or heterozygosity for the “Met” allele, male sex, younger age, lower level of education, a major depressive episode (MDE), and alcohol dependence were associated with ID. Analyses of IU vs. non-IU yielded the same results except for age and MDE. In addition, individuals with MA-induced paranoia (MIP) were more likely to have used inhalants at least once in their lifetime compared to those without.

Conclusion: COMT 158Met, male sex, younger age, lower level of education, MDE, MIP, and alcohol dependence increased risk for inhalant use and/or dependence.

Schlüsselwörter

  • COMT
  • inhalant
  • methamphetamine
  • Thai
  • Val158Met
Uneingeschränkter Zugang

Fingerprints by pulsed-field gel electrophoresis of leptospires isolated from field rats and comparison with reference Leptospira serovars

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 557 - 564

Zusammenfassung

Abstract

Background: More than 260 leptospiral serovars by serology have been recorded. New genotypic methods have classified Leptospira into 20 species. Serovar identification is essential for epidemiological study of this disease.

Objective: We identified fingerprints from reference serovar strains of Leptospira spp. and representative serovars from field rat isolates by pulsed-field gel electrophoresis (PFGE).

Methods: Extract genomic DNA from 28 reference serovars of Leptospira spp. and 13 leptospiral isolates from field rats, selected as representative serovars Pyrogenes, Bataviae, Autumnalis, and Australis, using PFGE following NotI restriction digest.

Results: PFGE with NotI restriction enzyme successfully differentiated 28 reference serovars into 27 fingerprint patterns, with the exception of serovars Copenhageni and Icterohaemorrhagiae. The discriminatory power of these reference strains was 0.99. Isolates that yielded patterns identical to their corresponding serovars were serovars Pyrogenes strain Salinem and Bataviae. Patterns for isolates of serovars Autumnalis and Australis were different from reference serovar Autumnalis strain Akiyami A and serovar Australis strain Ballico used in this study.

Conclusion: PFGE can be useful for identifying serovars of leptospiral isolates from reservoirs and for identifying new serovars of Leptospira for epidemiological study.

Schlüsselwörter

  • Leptospira
  • leptospiral serovar
  • molecular typing
  • PFGE
  • pulsed-field gel electrophoresis
Uneingeschränkter Zugang

Radiation doses to patients in coronary interventions in a hospital in Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 565 - 571

Zusammenfassung

Abstract

Background: Radiation dose is best estimated by the Dose Area Product (DAP), the absorbed dose to air, multiplied by the X-ray beam cross-sectional area at the point of measurement. Interventional cardiologists should be made aware of the exposures to patients and how they compare to established norms.

Objective: We assessed patient doses during coronary diagnostic and interventions then compared doses between two angiocardiographic systems in our center and through these actions.

Methods and Results: In total, 308 (44.4%) diagnostic CAs, 229 (33.0%) one-vessel PCIs, 53 (7.6%) two or threevessel PCIs, and 15 (2.2%) PCIs to CTO were carried out. The mean DAP value for diagnostic CAs in room No. 1 (Siemens Axiom Artis dBC) was 45.2±28.7 Gy.cm2, compared with room No. 2 (Philips Allura Xper biplane FD 20/10) where mean DAP value was 78.6±58.4 Gy.cm2 (p < 0.001). The mean DAP value for one-vessel PCIs in room No. 1 was 97.8±67.5 Gy.cm2, compared with room No. 2, mean DAP value of 159.4±82.4 Gy.cm2 (p = 0.030). The mean DAP value for two or three-vessel PCIs in room No. 1 was 153.1±65.6 Gy.cm2, compared with room No. 2, mean DAP value of 168.0±94.7 Gy.cm2 (p = 0.070). DAP values per procedure in diagnostic CAs, one-vessel PCIs, and two or three-vessel PCIs in room No. 2 were higher than in room No. 1 after multivariable correction for weight and fluoroscopy time.

Conclusions: Regular measurement of patient doses is an essential step to optimize exposure. It makes operators aware their own performance and allows comparisons with generally accepted practice.

Schlüsselwörter

  • Coronary interventions
  • radiation dose

Brief communication (Original)

Uneingeschränkter Zugang

Clinicopathological and prognostic significance of phosphorylated PRAS40 (Thr246) in breast cancer

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 573 - 577

Zusammenfassung

Abstract

Background: Phosphorylation of proline-rich Akt substrate of 40 kilodaltons at Thr246 (p-PRAS40Thr246) is a novel identified specific and stable biomarker for predicting phosphatidylinositol 3-kinase (PI3K) pathway activation and AKT inhibitor sensitivity.

Objectives: We investigated the expression of p-PRAS40Thr246 in breast cancer, and their clinicopathological characteristics and prognostic significance.

Methods: The expression of p-PRAS40Thr246 was detected by immunohistochemistry in 117 invasive breast cancer tumors.

Results: p-PRAS40Thr246 was positive in 62 (53.0%) of 117 patients. p-PRAS40Thr246 expression was significantly associated with late tumor stages and shorter survival, but not with other clincopathological characteristics. Furthermore, p-PRAS40Thr246 was also an independent prognostic factor for invasive breast cancers.

Conclusion: High prevalence of p-PRAS40Thr246 overexpression and its clinical significance in breast cancer suggests that this subgroup might benefit from PI3K inhibitors. We proposed that the detection of p-PRAS40Thr246 in breast cancer tissues should be included in the future clinical practice to develop patient-tailored treatments.

Schlüsselwörter

  • Biomarker
  • PI3K pathway
  • PRAS40
  • phosphorylation
  • targeted therapy
Uneingeschränkter Zugang

P-glycoprotein expression in human cerebral malaria: a preliminary study

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 579 - 583

Zusammenfassung

Abstract

Background: P-glycoprotein is an efflux protein, which is expressed on several cell types, including vascular endothelial cells lining brain capillaries. The expression and activity of P-glycoprotein can be modulated under conditions, including inflammatory process. Cerebral malaria (CM), a complication caused by infections of Plasmodium falciparum, is considered an inflammatory disease.

Objective: We determined P-glycoprotein expression at protein levels in human CM brain capillaries.

Methods: Four brains, three CM and one control, were subjected to a postmortem study. The brain capillaries were isolated from cerebellum, cerebral cortex, striatum, and brainstem and analyzed for expression of P-glycoprotein using SDS-PAGE and western blot techniques. The expression levels in CM brain capillaries were assessed by comparing with that in control brain capillaries.

Results: P-glycoprotein decreased in all CM brain capillaries isolated from striatum, while two of three cerebellums showed the reduction, compared with the control. For cerebral cortex and brainstem brain capillaries, the expression decreased only in one of three CM subjects.

Conclusion: P-glycoprotein expression levels were modulated in CM brain capillaries, suggesting an involvement of P-glycoprotein in CM.

Schlüsselwörter

  • Brainstem
  • cerebellum
  • cerebral cortex
  • cerebral malaria: P-glycoprotein
  • Plasmodium falciparum
  • striatum
Uneingeschränkter Zugang

Downregulation in the mRNA expression of nuclear hormone receptor liver-X-receptor alpha (LXR-α) by TNF-α is abolished by the antioxidant kaempferol, but not ascorbic acid, in human hepatocarcinoma HepG2 cells

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 585 - 589

Zusammenfassung

Abstract

Background: Liver-X-Receptor alpha (LXR-α) plays an essential role in cholesterol metabolism, bile acids, and lipid synthesis. The proinflammatory cytokine TNF-α has been shown to downregulate the expression of LXR-α.

Objectives: We investigated the effects of antioxidants kaempferol and ascorbic acid on LXR-α mRNA expression in TNF-α stimulated HepG2 cells.

Methods: After the cells have reached 60% to 70% confluence, they were treated with 20 ng/ml of TNF-α for 24 hours prior to the stimulation with different concentrations of kaempferol (1 μM, 5 μM, 10 μM, and 20 μM) or ascorbic acid (15 μM, 150 μM, and 1500 μM) for another 24 hours. Total RNA was isolated using TRI Reagent LS (Molecular Research Centre). Reverse transcription quantitative real-time PCR was then conducted to determine the mRNA expression of LXR- α after their respective treatments.

Results: Kaempferol was able to relieve the downregulatory action of TNF-α on LXR-α in a dose-dependent manner. The highest dose of kaempferol (20 μM) almost abolished the action of TNF-α by restoring the levels of LXR-α to its basal levels in HepG2 cells. Twenty μM of kaempferol alone did not produce any significant effect on LXR-α mRNA expression. In contrast, ascorbic acid was unable to counteract the action of TNF-α. In contrast to kaempferol, the highest dose of ascorbic acid (1500 μM) suppressed the expression of LXR-α mRNA in TNF-α stimulated HepG2 cells to 0.571-fold compared with no treatment. In the presence of 1500 μM of ascorbic acid alone, LXR-α mRNA expression was also significantly suppressed to 0.320-fold.

Conclusion: This study demonstrated that kaempferol, but not ascorbic acid, was able to alleviate the TNF-α downregulatory effects on LXR-α mRNA in HepG2 cells. Kaempferol can be a better anti-inflammatory agent than ascorbic acid.

Schlüsselwörter

  • Antioxidants
  • ascorbic acid
  • cytokine
  • expression
  • kaempferol
  • LXR-α
  • TNF-α
Uneingeschränkter Zugang

A pilot study of four-dimensional visualization of mandibular and temporomandibular joint movement

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 591 - 596

Zusammenfassung

Abstract

Background: Mandibular movements are reliable indicators of mandibular system disease and changes in movements can be useful to estimate treatment effect. Detection of mandibular movement is important.

Objectives: We evaluated four-dimensional (4D) visualization of mandibular and temporomandibular joint movement using 320-row computed tomography (CT).

Methods: A stepwise mouth gag was placed between mandibular and maxillary incisors to control mouth opening (0.5-cm increments) in healthy volunteers and one temporomandibular disorder (TMD) patient. A 320-row CT Joint-Move and Shot sequence was used for scanning with an image taken after each increment. 4D reconstruction was used to establish volume data.

Results: 4D visualization of joint and dentition in a rest state and in a state of mandibular movement from multiple angles and in different planes demonstrated differences between healthy subjects and the subject with TMD. The effective dose per scan was approximately 17% of the 16-slice spiral CT.

Conclusion: 4D visualization of mandibular movement can be achieved through 320-row volume CT, which may provide a diagnosis of temporomandibular joint disorder and assessment of treatment effects.

Schlüsselwörter

  • Four-dimensional visualization
  • mandible
  • temporomandibular joint
  • 320 CT
Uneingeschränkter Zugang

The comparison of wound drainage after TKA between postoperative cast immobilization and nonimmobilization: a randomized controlled trial

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 597 - 600

Zusammenfassung

Abstract

Background: Many previous studies concluded that postoperative splint did not significantly decrease volume of blood loss in suction drainage. However, the splints in their studies were not rigid. We applied long leg cast, that was more rigid and subsequently may reduce blood loss in suction drainage.

Objectives: This study compared the blood from suction drainage after total knee arthroplasty between postoperative cast immobilization and non-immobilization.

Methods: A consecutive series of 142 knees in 142 osteoarthritis patients who required total knee arthroplasty were divided in long leg cast group and non-cast group (webril and elastic bandage wrapped) by close seal envelopes. Both groups removed their restrained at three days post operation. The volumes of blood from suction drainage in both groups were recorded for 24 hours after operation. Maximum knee flexion and wound complication were also evaluated.

Results: There were 69 knees in cast group and 73 knees in non-cast group. The mean±SD of blood loss in cast group was 324.7±129.3 ml and non-cast group was 546.8±122.2 ml. The mean difference in blood lost between cast and non-cast group were 222.1 ml (range from 180.4 to 263.8 ml.). Using unpaired t-test, there was a significant difference of wound drainage between both groups (p < 0.05). More maximum knee flexion at eight weeks postoperative was gain in cast group (p < 0.05). Wound complications were increase in non-cast group but not statistically significant (p = 0.497).

Conclusion: The immobilized knee with long leg cast after total knee arthroplasty can decrease blood loss from suction drainage. Therefore, we recommended using long leg cast after total knee arthroplasty as another technique that safely reduces blood loss without compromise to postoperative range of motion in patient who need blood saving as critical.

Schlüsselwörter

  • Blood loss
  • cast
  • immobilization
  • range of motion
  • total knee arthroplasty
  • wound complication
Uneingeschränkter Zugang

A flow cytometric urine analyzer for bacteria and white blood cell counts plus urine dipstick test for rapid screening of bacterial urinary tract infection

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 601 - 608

Zusammenfassung

Abstract

Background: Bacterial urinary tract infection (UTI) is one of the most common patient problems that have no reliably definite diagnosis. The gold standard urine culture is usually delayed and increases laboratory workload.

Objectives: To find a rapid method for the screening of bacterial urinary tract infection, the performance of four urinalysis parameters from automated urine dipstick test and flow cytometry were evaluated against the urine culture method.

Methods: Urine cultures were performed on 372 routine specimens of suspected UTI. Urine dipstick tests were performed using an automated reader. An automated urine particle analyzer was used for quantitative counting of bacteria and white blood cells.

Results: For screening of UTI, urinary bacteria count ≥14.2 cells/μL gave the highest sensitivity of 95.76% and 44.88% specificity.

Conclusion: We suggest using urinary bacteria count for screening of UTI. This method can reduce the laboratory workload for processing urine culture by 30.64%.

Schlüsselwörter

  • Flow cytometry
  • urinalysis
  • urine dipstick
  • UTI
Uneingeschränkter Zugang

Urinary leukotriene E4 in children with wheezing associated respiratory illness from influenza infection

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 609 - 614

Zusammenfassung

Abstract

Background: Influenza virus can cause bronchiolitis and recurrent wheezing in young children. Although the pathophysiology is unclear, leukotriene is thought to play an important role.

Objectives: We conducted a prospective case-control study to measure urinary leukotriene E4 (uLTE4) levels in children with wheezing associated respiratory illness (WARI) from influenza infection, compared to children without respiratory tract infection and to identify the association between clinical features and uLTE4 levels in influenza-infected children.

Methods: Nasopharygeal secretions from patients less than 6-years-old hospitalized due to WARI were tested for influenza virus by RT-PCR. The uLTE4 levels were measured in the patients with influenza infection and compared with normal controls. The correlation between clinical features and uLTE4 levels was also studied.

Results: The study included 10 patients with influenza infection (median age 23.5 months) and 10 children as control group (median age 23 months). The uLTE4 levels were not significantly different between influenza and control group; 191.63 ng/mM creatinine (IQR 162.57-244.25) vs. 132.32 ng/mM creatinine (IQR 93.79-215.65), respectively (p = 0.096). There was no significant correlation between uLTE4 levels and clinical features including pulmonary index, eosinophil count, and length of hospital stay.

Conclusion: The uLTE4 level does not increase in pediatric patients with wheezing associated influenza infection and does not correlate with clinical features during infection. Although there is a trend towards increased uLTE4 in influenza patients and a correlation to the pulmonary index, the small sample size may have altered the significance of these results.

Schlüsselwörter

  • Inflammatory mediator
  • influenza virus
  • leukotriene
  • lower airway obstruction
  • viral respiratory tract infection
Uneingeschränkter Zugang

Organisms and antibiotic sensitivity patterns in septicemic children of Lahore, Pakistan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 615 - 618

Zusammenfassung

Abstract

Background: The right understanding of antibiotic susceptibility patterns is important for cost effectiveness and outcome of care of septicemic patients.

Objectives: To determine antibacterial resistance patterns against commonly used therapeutic antibiotics in septicemic children of Lahore by isolating and analyzing the most frequently occurring bacterial pathogen from blood samples.

Methods: Twelve hundred blood samples from children with septicemia were processed at the Lahore Identification of Bacteria Laboratory following the Clinical Laboratory Standard Institute reference 2006. Antibiotic sensitivity was analyzed using the Kirby-Bauer disc diffusion method.

Results: The most effective antibiotics against the frequently isolated Klebsiella spp. were piperacillin- tazobactam (87.74%). High antimicrobial resistance was observed with cefuroxime (95.58%) and cefixime (93.38%).

Conclusion: Klebsiella are the most frequently occurring bacterial pathogens from blood samples of children with septicemia. Moreover, the antibiotics to which there was most resistance belong to the cephalosporins, which are among the foremost used antibiotics in Pakistan.

Schlüsselwörter

  • Antibiotic
  • Klebsiella species
  • septicemic children
  • Pakistan
Uneingeschränkter Zugang

Bioactivity of plant extracts against Burkholderia pseudomallei

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 619 - 623

Zusammenfassung

Abstract

Background: Burkholderia pseudomallei are causative agents of melioidosis, a disease found mostly in South- East Asia and Northern Australia. Recent reports of a reduced susceptibility of B. pseudomallei to antibiotics, especially ceftazidime, have indicated need for further research into new antimicrobial substances from plants.

Objectives: We tested antimicrobial activity of 10 plant extracts; Barringtonia acutangula (L.) Gaertn., Cleome gynandra Linn., Luffa acutangula (Linn.) Roxb., Limnophila geoffrayi Bonati, Centella asiatica (L.) Urban, Piper sarmentosum Roxb., Tamarindus indica, Cyperus rotundus Linn., Cassia fistula Linn., and Allium sativum Linn.

Materials and Methods: Crude extracts were tested for their antimicrobial activity by the standard disc diffusion assay and micro-dilution assay. Methanol, ethyl acetate, ethanol, hexane, and water were used as solvents for extraction.

Results: The methanolic extract of B. acutangula (L.) Gaertn. showed the best antimicrobial results against B. pseudomallei with an inhibition zone of 18 mm and minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of 4 mg/ml. The chemical structure of crude methanolic extracts of B. acutangula (L.) Gaertn. was primarily elucidated by nuclear magnetic resonance spectroscopy (NMR). The results showed that the chemical constituent was in the group of steroids.

Conclusions: It is concluded that Barringtonia acutangula (L.) Gaertn. may play an active part in the inhibition of the growth of B. pseudomallei.

Schlüsselwörter

  • Antimicrobial activity
  • B. pseudomallei
  • disc diffusion
  • plant extracts

Clinical report

Uneingeschränkter Zugang

Papillary muscle stump mimicking a left ventricular mass after mitral valve replacement with partial chordal preservation

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 625 - 628

Zusammenfassung

Abstract

Background: Maintaining continuity between the mitral valve and the subvalvular apparatus during mitral valve replacement (MVR) maximizes the left ventricular (LV) function and increases the survival rate. However, MVR potentially cause rupture of the papillary muscles, systemic embolization, or dehiscence of the mitral annulus from the transposed position.

Objective: We presented a case with severe rheumatic mitral valve disease treated with MVR and partial preservation of the posterior and anterior chordae tendineae.

Methods: Retrospectively review of medical records.

Results: Transthoracic echocardiography performed two weeks after surgery revealed a floating mass in the posterior inferior aspect of the left atrium and a lobulated mass joining the tip of the posterior papillary muscle in the left ventricle. Perioperative examination confirmed a large thrombus in the left atrium and the stump of the preserved posterior papillary muscle of the mitral valve.

Conclusion: Thus, the papillary muscle could present itself as an abnormal mass on echocardiography, resulting in misdiagnosing.

Schlüsselwörter

  • Intracardiac mass
  • mitral valve replacement
  • papillary muscle

History of Asian Biomedicine

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Einer Ammundsen, MD (1911-1999): Danish World War II hero and famous Bangkok family physician

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 629 - 630

Zusammenfassung

20 Artikel

Editorial

Uneingeschränkter Zugang

Ethics and the “Milwaukee protocol” for human rabies treatment

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 509 - 511

Zusammenfassung

Review article

Uneingeschränkter Zugang

Heat shock protein 60 and asthma treatment 10.5372/1905-7415.0604.084

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 513 - 518

Zusammenfassung

Abstract

Background: Asthma is a chronic and complex airway inflammatory disease characterized by airway hyperresponsiveness. Current asthma therapies are limited to specific disease manifestations, highlighting the importance of developing treatments with broader treatment applications. CD4+ T lymphocytes, which produce a characteristic repertoire of cytokines, play a critical role in the development of airway inflammation, mucus production, and airway hyper-responsiveness in asthma. Recently, it has been demonstrated that Heat Shock Protein 60 (HSP60) could mediate CD4+ T lymphocyte differentiation, suggesting that HSP60 can be targeted in the development of novel anti-asthma medications, especially for the treatment of severe disease or refractory patients.

Objective: This review summarizes the current knowledge regarding the relationship between HSP60 and asthma.

Method: We conducted a literature search using the MEDLINE (PubMed), SCOPUS and OVID/LWWW databases using the keywords “HSP”, “HSP60”, “HSP60 signaling pathway”, “TLR”, “TLR2 signaling pathway”, “asthma”, and “CD4+ T Lymphocytes”. Only articles published in English were included in the review.

Results: HSP60 was shown to either inhibit or exacerbate asthma through different mechanisms. However, the deleterious effects of HSP60 on asthma likely surpassed any beneficial inhibitory effects.

Conclusion: HSP60 can be expected to be developed into a new treatment target for asthma that may be of great interest to medical scientists and clinicians.

Schlüsselwörter

  • Asthma
  • CD4+ T Lymphocytes
  • HSP60

Original article

Uneingeschränkter Zugang

Inhibition of leptin receptors through plant-derived ligands for liver fibrosis drug development

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 519 - 526

Zusammenfassung

Abstract

Background: Liver fibrosis is a common health problem worldwide. Several drug-targets have been identified from the fibrosis pathway namely leptin, leptin receptors, adiponectin, and PPAR ã agonist. Suitable antifibrotic drugs are needed.

Objective: Present plant-derived ligands inhibiting the leptin receptor mediated pathway as antifibrotic drugs.

Methods: Bioinformatics was used to generate 3D-structure of leptin receptor to explore binding grooves of therapeutic targets. A molecular library with bioactive compounds from SE Asian medicinal plants was developed by using the bioactive compounds, docking with leptin receptor.

Results: The homology model of leptin receptor has showed similarities with crystal structures and folds reported previously for other cytokine family members. The Ramachandran plot shows that 89.1% of the residues are most favored region. Besides, 15 possible active sites were identified with active residues such as Ser180, Gln463, Pro477, IIe482, Leu519, Asn550, Pro564, Val600, Glu643, Lys665, Asp671, Ser675, Leu767, Pro803, and Glu834.

Conclusion: This study provides data on surface cavity, binding groove, and active sites of the leptin receptor, which will be useful for researchers to understand leptin receptor/complex. We hope that the strandline serve as a potential drug candidate for liver fibrosis in the near future.

Schlüsselwörter

  • Bioinformatics
  • drug target
  • hepatic fibrosis
  • leptin receptors
  • ligands
Uneingeschränkter Zugang

Thyroid-associated ophthalmopathy: linear regression analysis of single photon emission computed tomography

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 527 - 533

Zusammenfassung

Abstract

Background: At present, there is still no significant progress in the diagnosis and treatment of thyroidassociated ophthalmopathy.

Objective: We explored the role of 99mTc-octreotide single photon emission computed tomography (SPECT) in determination of the clinical activity of thyroid-associated ophthalmopathy (TAO).

Methods:A prospective study including 36 cases of TAO and 8 controls was conducted by intravenous injection of 99mTc-octreotide, followed by SPECT. The radioactive counting ratio was calculated for the orbital/occipital regions of interest (ROI), and the Spearman rank correlation between the average ratio and the corresponding clinical activity score (CAS) mean of ADHOC (Recommendation of the Ad Hoc Committee of The American Thyroid Association in 1992) was analyzed. A curve regression equation for the CAS to orbital/occipital radio counting ratio was determined to calculate the cutoff for TAO activity.

Results: The Spearman rank correlation between orbital/occipital uptake ratio and CAS was calculated (coefficient r = 0.972, p < 0.01). The curve regression equation for all patients with TAO (including the active group and resting group) was (Y) = -66.25 + 106.06 X-52.86 X2 + 8.94 X3. The transformational equation of the cubical CAS of exophthalmos (dependent variable Y) to the square root of the orbital/occipital uptake ratio (independent variable X) was (Y) = -752.67 + 676.74 (X). A cutoff of 1.48 was used to identify the active phase of exophthalmos. The sensitivity was 96.0% with a standard error of 3.92%, and the specificity was 94.73 with a standard error of 5.13%.

Conclusion: 99mTc-octreotide SPECT can objectively and accurately measure TAO activity. An orbital/occipital uptake ratio ≥1.48 is the recommended cutoff to determine the active phase of TAO. This may guide clinical treatment of TAO.

Schlüsselwörter

  • Clinical activity
  • SPECT
  • thyroid-associated ophthalmopathy
  • 99mTc-octreotide
Uneingeschränkter Zugang

Can job titles be predictors for recent onset latent tuberculosis in health care workers?

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 535 - 539

Zusammenfassung

Abstract

Background: Tuberculosis is a common health problem in developing countries including Thailand. The association between occupation and recent onset of tuberculosis is unclear.

Objective: We studied the association of job types and tuberculin conversion or recent onset latent tuberculosis in healthcare workers in an endemic area of tuberculosis.

Design and Sample: A case-control study was done at Srinagarind Hospital, Thailand. Cases were subjects with tuberculin conversion, while controls were subjects with negative results of tuberculin skin test (TST) in two consecutive years.

Results: One thousand twenty five subjects completed two consecutive TST between 2001 and 2009. The rate of tuberculin conversion was 19.8% or 203 subjects. In a multivariate model, the only three significant factors for tuberculin conversion were male gender, having a BCG scar, and job type. Only nurses, nurse assistants, and ward workers were significantly associated with tuberculin conversion with adjusted odds ratio [95% confidence interval] of 2.3 [1.3-4.1], 2.3 [1.3-4.7], and 3.0 [1.8-5.0], respectively.

Conclusion: Being male, having a BCG scar, and certain job types increase the risk of latent tuberculosis in healthcare workers. Tuberculosis infection control program should emphasize job types for healthcare workers who are at increased risk.

Schlüsselwörter

  • Healthcare workers
  • job title
  • latent tuberculosis
Uneingeschränkter Zugang

Drug errors from the Thai Anesthesia Incidents Monitoring Study: analysis of 1,996 incident reports

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 541 - 547

Zusammenfassung

Abstract

Background: The Royal College of Anesthesiologists of Thailand arranged the Thai Anesthesia Incidents Monitoring Study (Thai AIMS) to investigate the clinical course, outcome, contributing factors, and suggested preventive strategies for anesthesia related adverse events including drug errors.

Methods: As part of the Thai AIMS, perioperative anesthesia incident reports of adverse events were collected on an anonymous and voluntary basis from 51 participating hospitals across Thailand between January 1 and June 30, 2007. Three anesthesiologists reviewed relevant data of drug error incidents. A descriptive statistics was used.

Results: Among 1,996 incident reports of the Thai AIMS database, there were 82 incidents of drug errors (4.1%). Most of drug errors incidents occurred in maintenance phase (57.3%), general anesthesia (87.8%), and in the operation theatre (91.5%). One-fifth of incidents occurred under emergency condition (95%). Common anesthetic drugs involved were nondepolarizing neuromuscular blocking agent (23.1%), opioids (21.9%), antibiotics (17.1%), succinyl choline (7.3%), and induction agents (6.1%). Giving the wrong drug (35.4%), overdosage of drug (32.9%), problems with labeling (14.6%), and wrong concentration (9.8%) were the most common types of drug errors. Of the 25 substitutions with 14 syringe swap (17.1%) and six-ampule swap (7.3%), 60% involved a different pharmaceutical class of drug. Only 10.9% of incidents resulted in intubation, mechanical ventilation, or unplanned admission to intensive care unit. Seventy-nine point two percent were considered as preventable and 39% were due to system error. Haste (42.7%) was considered as the most common contributing factors while vigilance (72%) and having experience (30.5%) were considered as common factors minimizing medication errors.

Conclusion: Practice guidelines especially using of class specific color labeling, quality assurance activity, improvement of communication, and training were suggested preventive strategies.

Schlüsselwörter

  • Adverse event
  • anesthesia
  • complication
  • drug error
  • medication error
  • substitution
Uneingeschränkter Zugang

Polymorphism of COMT Val158Met is associated with inhalant use and dependence: a Thai substance dependence treatment cohort

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 549 - 556

Zusammenfassung

Abstract

Background: Inhalants are abused by adolescents worldwide, but genetic markers of inhalant use or dependence are poorly understood.

Objective: We assessed the frequency and association of a functional polymorphism in the gene encoding catechol-O-methyltransferase (COMT Val158Met) in inhalant-dependent (ID) subjects and inhalant users (IU).

Methods: Demographic and diagnostic data were collected by interviewing 456 Thai-speaking methamphetamine (MA) users by using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). COMT Val158Met (rs4680) genotyping was acquired by restriction fragment length polymorphism. Individuals with ID or IU were compared with non-ID or non-IU by using a χ2 test. After that, factors associated with ID or IU were analyzed by logistic regression. Blood samples from 217 healthy blood donors were used as controls for ID and IU in the allele frequency comparison. Deviation from Hardy-Weinberg Equilibrium Expectations (HWEE) was also tested.

Results: Out of 456 MA users, deviation from HWEE was observed in IU but not in ID, non-ID or from the total sample. The “Met” allele was significantly associated with ID (p = 0.02) and IU (p = 0.002) among MA users, but not in allele frequency comparisons when compared to the healthy control group (p > 0.1). With respect to logistic regression analysis, homo or heterozygosity for the “Met” allele, male sex, younger age, lower level of education, a major depressive episode (MDE), and alcohol dependence were associated with ID. Analyses of IU vs. non-IU yielded the same results except for age and MDE. In addition, individuals with MA-induced paranoia (MIP) were more likely to have used inhalants at least once in their lifetime compared to those without.

Conclusion: COMT 158Met, male sex, younger age, lower level of education, MDE, MIP, and alcohol dependence increased risk for inhalant use and/or dependence.

Schlüsselwörter

  • COMT
  • inhalant
  • methamphetamine
  • Thai
  • Val158Met
Uneingeschränkter Zugang

Fingerprints by pulsed-field gel electrophoresis of leptospires isolated from field rats and comparison with reference Leptospira serovars

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 557 - 564

Zusammenfassung

Abstract

Background: More than 260 leptospiral serovars by serology have been recorded. New genotypic methods have classified Leptospira into 20 species. Serovar identification is essential for epidemiological study of this disease.

Objective: We identified fingerprints from reference serovar strains of Leptospira spp. and representative serovars from field rat isolates by pulsed-field gel electrophoresis (PFGE).

Methods: Extract genomic DNA from 28 reference serovars of Leptospira spp. and 13 leptospiral isolates from field rats, selected as representative serovars Pyrogenes, Bataviae, Autumnalis, and Australis, using PFGE following NotI restriction digest.

Results: PFGE with NotI restriction enzyme successfully differentiated 28 reference serovars into 27 fingerprint patterns, with the exception of serovars Copenhageni and Icterohaemorrhagiae. The discriminatory power of these reference strains was 0.99. Isolates that yielded patterns identical to their corresponding serovars were serovars Pyrogenes strain Salinem and Bataviae. Patterns for isolates of serovars Autumnalis and Australis were different from reference serovar Autumnalis strain Akiyami A and serovar Australis strain Ballico used in this study.

Conclusion: PFGE can be useful for identifying serovars of leptospiral isolates from reservoirs and for identifying new serovars of Leptospira for epidemiological study.

Schlüsselwörter

  • Leptospira
  • leptospiral serovar
  • molecular typing
  • PFGE
  • pulsed-field gel electrophoresis
Uneingeschränkter Zugang

Radiation doses to patients in coronary interventions in a hospital in Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 565 - 571

Zusammenfassung

Abstract

Background: Radiation dose is best estimated by the Dose Area Product (DAP), the absorbed dose to air, multiplied by the X-ray beam cross-sectional area at the point of measurement. Interventional cardiologists should be made aware of the exposures to patients and how they compare to established norms.

Objective: We assessed patient doses during coronary diagnostic and interventions then compared doses between two angiocardiographic systems in our center and through these actions.

Methods and Results: In total, 308 (44.4%) diagnostic CAs, 229 (33.0%) one-vessel PCIs, 53 (7.6%) two or threevessel PCIs, and 15 (2.2%) PCIs to CTO were carried out. The mean DAP value for diagnostic CAs in room No. 1 (Siemens Axiom Artis dBC) was 45.2±28.7 Gy.cm2, compared with room No. 2 (Philips Allura Xper biplane FD 20/10) where mean DAP value was 78.6±58.4 Gy.cm2 (p < 0.001). The mean DAP value for one-vessel PCIs in room No. 1 was 97.8±67.5 Gy.cm2, compared with room No. 2, mean DAP value of 159.4±82.4 Gy.cm2 (p = 0.030). The mean DAP value for two or three-vessel PCIs in room No. 1 was 153.1±65.6 Gy.cm2, compared with room No. 2, mean DAP value of 168.0±94.7 Gy.cm2 (p = 0.070). DAP values per procedure in diagnostic CAs, one-vessel PCIs, and two or three-vessel PCIs in room No. 2 were higher than in room No. 1 after multivariable correction for weight and fluoroscopy time.

Conclusions: Regular measurement of patient doses is an essential step to optimize exposure. It makes operators aware their own performance and allows comparisons with generally accepted practice.

Schlüsselwörter

  • Coronary interventions
  • radiation dose

Brief communication (Original)

Uneingeschränkter Zugang

Clinicopathological and prognostic significance of phosphorylated PRAS40 (Thr246) in breast cancer

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 573 - 577

Zusammenfassung

Abstract

Background: Phosphorylation of proline-rich Akt substrate of 40 kilodaltons at Thr246 (p-PRAS40Thr246) is a novel identified specific and stable biomarker for predicting phosphatidylinositol 3-kinase (PI3K) pathway activation and AKT inhibitor sensitivity.

Objectives: We investigated the expression of p-PRAS40Thr246 in breast cancer, and their clinicopathological characteristics and prognostic significance.

Methods: The expression of p-PRAS40Thr246 was detected by immunohistochemistry in 117 invasive breast cancer tumors.

Results: p-PRAS40Thr246 was positive in 62 (53.0%) of 117 patients. p-PRAS40Thr246 expression was significantly associated with late tumor stages and shorter survival, but not with other clincopathological characteristics. Furthermore, p-PRAS40Thr246 was also an independent prognostic factor for invasive breast cancers.

Conclusion: High prevalence of p-PRAS40Thr246 overexpression and its clinical significance in breast cancer suggests that this subgroup might benefit from PI3K inhibitors. We proposed that the detection of p-PRAS40Thr246 in breast cancer tissues should be included in the future clinical practice to develop patient-tailored treatments.

Schlüsselwörter

  • Biomarker
  • PI3K pathway
  • PRAS40
  • phosphorylation
  • targeted therapy
Uneingeschränkter Zugang

P-glycoprotein expression in human cerebral malaria: a preliminary study

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 579 - 583

Zusammenfassung

Abstract

Background: P-glycoprotein is an efflux protein, which is expressed on several cell types, including vascular endothelial cells lining brain capillaries. The expression and activity of P-glycoprotein can be modulated under conditions, including inflammatory process. Cerebral malaria (CM), a complication caused by infections of Plasmodium falciparum, is considered an inflammatory disease.

Objective: We determined P-glycoprotein expression at protein levels in human CM brain capillaries.

Methods: Four brains, three CM and one control, were subjected to a postmortem study. The brain capillaries were isolated from cerebellum, cerebral cortex, striatum, and brainstem and analyzed for expression of P-glycoprotein using SDS-PAGE and western blot techniques. The expression levels in CM brain capillaries were assessed by comparing with that in control brain capillaries.

Results: P-glycoprotein decreased in all CM brain capillaries isolated from striatum, while two of three cerebellums showed the reduction, compared with the control. For cerebral cortex and brainstem brain capillaries, the expression decreased only in one of three CM subjects.

Conclusion: P-glycoprotein expression levels were modulated in CM brain capillaries, suggesting an involvement of P-glycoprotein in CM.

Schlüsselwörter

  • Brainstem
  • cerebellum
  • cerebral cortex
  • cerebral malaria: P-glycoprotein
  • Plasmodium falciparum
  • striatum
Uneingeschränkter Zugang

Downregulation in the mRNA expression of nuclear hormone receptor liver-X-receptor alpha (LXR-α) by TNF-α is abolished by the antioxidant kaempferol, but not ascorbic acid, in human hepatocarcinoma HepG2 cells

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 585 - 589

Zusammenfassung

Abstract

Background: Liver-X-Receptor alpha (LXR-α) plays an essential role in cholesterol metabolism, bile acids, and lipid synthesis. The proinflammatory cytokine TNF-α has been shown to downregulate the expression of LXR-α.

Objectives: We investigated the effects of antioxidants kaempferol and ascorbic acid on LXR-α mRNA expression in TNF-α stimulated HepG2 cells.

Methods: After the cells have reached 60% to 70% confluence, they were treated with 20 ng/ml of TNF-α for 24 hours prior to the stimulation with different concentrations of kaempferol (1 μM, 5 μM, 10 μM, and 20 μM) or ascorbic acid (15 μM, 150 μM, and 1500 μM) for another 24 hours. Total RNA was isolated using TRI Reagent LS (Molecular Research Centre). Reverse transcription quantitative real-time PCR was then conducted to determine the mRNA expression of LXR- α after their respective treatments.

Results: Kaempferol was able to relieve the downregulatory action of TNF-α on LXR-α in a dose-dependent manner. The highest dose of kaempferol (20 μM) almost abolished the action of TNF-α by restoring the levels of LXR-α to its basal levels in HepG2 cells. Twenty μM of kaempferol alone did not produce any significant effect on LXR-α mRNA expression. In contrast, ascorbic acid was unable to counteract the action of TNF-α. In contrast to kaempferol, the highest dose of ascorbic acid (1500 μM) suppressed the expression of LXR-α mRNA in TNF-α stimulated HepG2 cells to 0.571-fold compared with no treatment. In the presence of 1500 μM of ascorbic acid alone, LXR-α mRNA expression was also significantly suppressed to 0.320-fold.

Conclusion: This study demonstrated that kaempferol, but not ascorbic acid, was able to alleviate the TNF-α downregulatory effects on LXR-α mRNA in HepG2 cells. Kaempferol can be a better anti-inflammatory agent than ascorbic acid.

Schlüsselwörter

  • Antioxidants
  • ascorbic acid
  • cytokine
  • expression
  • kaempferol
  • LXR-α
  • TNF-α
Uneingeschränkter Zugang

A pilot study of four-dimensional visualization of mandibular and temporomandibular joint movement

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 591 - 596

Zusammenfassung

Abstract

Background: Mandibular movements are reliable indicators of mandibular system disease and changes in movements can be useful to estimate treatment effect. Detection of mandibular movement is important.

Objectives: We evaluated four-dimensional (4D) visualization of mandibular and temporomandibular joint movement using 320-row computed tomography (CT).

Methods: A stepwise mouth gag was placed between mandibular and maxillary incisors to control mouth opening (0.5-cm increments) in healthy volunteers and one temporomandibular disorder (TMD) patient. A 320-row CT Joint-Move and Shot sequence was used for scanning with an image taken after each increment. 4D reconstruction was used to establish volume data.

Results: 4D visualization of joint and dentition in a rest state and in a state of mandibular movement from multiple angles and in different planes demonstrated differences between healthy subjects and the subject with TMD. The effective dose per scan was approximately 17% of the 16-slice spiral CT.

Conclusion: 4D visualization of mandibular movement can be achieved through 320-row volume CT, which may provide a diagnosis of temporomandibular joint disorder and assessment of treatment effects.

Schlüsselwörter

  • Four-dimensional visualization
  • mandible
  • temporomandibular joint
  • 320 CT
Uneingeschränkter Zugang

The comparison of wound drainage after TKA between postoperative cast immobilization and nonimmobilization: a randomized controlled trial

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 597 - 600

Zusammenfassung

Abstract

Background: Many previous studies concluded that postoperative splint did not significantly decrease volume of blood loss in suction drainage. However, the splints in their studies were not rigid. We applied long leg cast, that was more rigid and subsequently may reduce blood loss in suction drainage.

Objectives: This study compared the blood from suction drainage after total knee arthroplasty between postoperative cast immobilization and non-immobilization.

Methods: A consecutive series of 142 knees in 142 osteoarthritis patients who required total knee arthroplasty were divided in long leg cast group and non-cast group (webril and elastic bandage wrapped) by close seal envelopes. Both groups removed their restrained at three days post operation. The volumes of blood from suction drainage in both groups were recorded for 24 hours after operation. Maximum knee flexion and wound complication were also evaluated.

Results: There were 69 knees in cast group and 73 knees in non-cast group. The mean±SD of blood loss in cast group was 324.7±129.3 ml and non-cast group was 546.8±122.2 ml. The mean difference in blood lost between cast and non-cast group were 222.1 ml (range from 180.4 to 263.8 ml.). Using unpaired t-test, there was a significant difference of wound drainage between both groups (p < 0.05). More maximum knee flexion at eight weeks postoperative was gain in cast group (p < 0.05). Wound complications were increase in non-cast group but not statistically significant (p = 0.497).

Conclusion: The immobilized knee with long leg cast after total knee arthroplasty can decrease blood loss from suction drainage. Therefore, we recommended using long leg cast after total knee arthroplasty as another technique that safely reduces blood loss without compromise to postoperative range of motion in patient who need blood saving as critical.

Schlüsselwörter

  • Blood loss
  • cast
  • immobilization
  • range of motion
  • total knee arthroplasty
  • wound complication
Uneingeschränkter Zugang

A flow cytometric urine analyzer for bacteria and white blood cell counts plus urine dipstick test for rapid screening of bacterial urinary tract infection

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 601 - 608

Zusammenfassung

Abstract

Background: Bacterial urinary tract infection (UTI) is one of the most common patient problems that have no reliably definite diagnosis. The gold standard urine culture is usually delayed and increases laboratory workload.

Objectives: To find a rapid method for the screening of bacterial urinary tract infection, the performance of four urinalysis parameters from automated urine dipstick test and flow cytometry were evaluated against the urine culture method.

Methods: Urine cultures were performed on 372 routine specimens of suspected UTI. Urine dipstick tests were performed using an automated reader. An automated urine particle analyzer was used for quantitative counting of bacteria and white blood cells.

Results: For screening of UTI, urinary bacteria count ≥14.2 cells/μL gave the highest sensitivity of 95.76% and 44.88% specificity.

Conclusion: We suggest using urinary bacteria count for screening of UTI. This method can reduce the laboratory workload for processing urine culture by 30.64%.

Schlüsselwörter

  • Flow cytometry
  • urinalysis
  • urine dipstick
  • UTI
Uneingeschränkter Zugang

Urinary leukotriene E4 in children with wheezing associated respiratory illness from influenza infection

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 609 - 614

Zusammenfassung

Abstract

Background: Influenza virus can cause bronchiolitis and recurrent wheezing in young children. Although the pathophysiology is unclear, leukotriene is thought to play an important role.

Objectives: We conducted a prospective case-control study to measure urinary leukotriene E4 (uLTE4) levels in children with wheezing associated respiratory illness (WARI) from influenza infection, compared to children without respiratory tract infection and to identify the association between clinical features and uLTE4 levels in influenza-infected children.

Methods: Nasopharygeal secretions from patients less than 6-years-old hospitalized due to WARI were tested for influenza virus by RT-PCR. The uLTE4 levels were measured in the patients with influenza infection and compared with normal controls. The correlation between clinical features and uLTE4 levels was also studied.

Results: The study included 10 patients with influenza infection (median age 23.5 months) and 10 children as control group (median age 23 months). The uLTE4 levels were not significantly different between influenza and control group; 191.63 ng/mM creatinine (IQR 162.57-244.25) vs. 132.32 ng/mM creatinine (IQR 93.79-215.65), respectively (p = 0.096). There was no significant correlation between uLTE4 levels and clinical features including pulmonary index, eosinophil count, and length of hospital stay.

Conclusion: The uLTE4 level does not increase in pediatric patients with wheezing associated influenza infection and does not correlate with clinical features during infection. Although there is a trend towards increased uLTE4 in influenza patients and a correlation to the pulmonary index, the small sample size may have altered the significance of these results.

Schlüsselwörter

  • Inflammatory mediator
  • influenza virus
  • leukotriene
  • lower airway obstruction
  • viral respiratory tract infection
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Organisms and antibiotic sensitivity patterns in septicemic children of Lahore, Pakistan

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 615 - 618

Zusammenfassung

Abstract

Background: The right understanding of antibiotic susceptibility patterns is important for cost effectiveness and outcome of care of septicemic patients.

Objectives: To determine antibacterial resistance patterns against commonly used therapeutic antibiotics in septicemic children of Lahore by isolating and analyzing the most frequently occurring bacterial pathogen from blood samples.

Methods: Twelve hundred blood samples from children with septicemia were processed at the Lahore Identification of Bacteria Laboratory following the Clinical Laboratory Standard Institute reference 2006. Antibiotic sensitivity was analyzed using the Kirby-Bauer disc diffusion method.

Results: The most effective antibiotics against the frequently isolated Klebsiella spp. were piperacillin- tazobactam (87.74%). High antimicrobial resistance was observed with cefuroxime (95.58%) and cefixime (93.38%).

Conclusion: Klebsiella are the most frequently occurring bacterial pathogens from blood samples of children with septicemia. Moreover, the antibiotics to which there was most resistance belong to the cephalosporins, which are among the foremost used antibiotics in Pakistan.

Schlüsselwörter

  • Antibiotic
  • Klebsiella species
  • septicemic children
  • Pakistan
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Bioactivity of plant extracts against Burkholderia pseudomallei

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 619 - 623

Zusammenfassung

Abstract

Background: Burkholderia pseudomallei are causative agents of melioidosis, a disease found mostly in South- East Asia and Northern Australia. Recent reports of a reduced susceptibility of B. pseudomallei to antibiotics, especially ceftazidime, have indicated need for further research into new antimicrobial substances from plants.

Objectives: We tested antimicrobial activity of 10 plant extracts; Barringtonia acutangula (L.) Gaertn., Cleome gynandra Linn., Luffa acutangula (Linn.) Roxb., Limnophila geoffrayi Bonati, Centella asiatica (L.) Urban, Piper sarmentosum Roxb., Tamarindus indica, Cyperus rotundus Linn., Cassia fistula Linn., and Allium sativum Linn.

Materials and Methods: Crude extracts were tested for their antimicrobial activity by the standard disc diffusion assay and micro-dilution assay. Methanol, ethyl acetate, ethanol, hexane, and water were used as solvents for extraction.

Results: The methanolic extract of B. acutangula (L.) Gaertn. showed the best antimicrobial results against B. pseudomallei with an inhibition zone of 18 mm and minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of 4 mg/ml. The chemical structure of crude methanolic extracts of B. acutangula (L.) Gaertn. was primarily elucidated by nuclear magnetic resonance spectroscopy (NMR). The results showed that the chemical constituent was in the group of steroids.

Conclusions: It is concluded that Barringtonia acutangula (L.) Gaertn. may play an active part in the inhibition of the growth of B. pseudomallei.

Schlüsselwörter

  • Antimicrobial activity
  • B. pseudomallei
  • disc diffusion
  • plant extracts

Clinical report

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Papillary muscle stump mimicking a left ventricular mass after mitral valve replacement with partial chordal preservation

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 625 - 628

Zusammenfassung

Abstract

Background: Maintaining continuity between the mitral valve and the subvalvular apparatus during mitral valve replacement (MVR) maximizes the left ventricular (LV) function and increases the survival rate. However, MVR potentially cause rupture of the papillary muscles, systemic embolization, or dehiscence of the mitral annulus from the transposed position.

Objective: We presented a case with severe rheumatic mitral valve disease treated with MVR and partial preservation of the posterior and anterior chordae tendineae.

Methods: Retrospectively review of medical records.

Results: Transthoracic echocardiography performed two weeks after surgery revealed a floating mass in the posterior inferior aspect of the left atrium and a lobulated mass joining the tip of the posterior papillary muscle in the left ventricle. Perioperative examination confirmed a large thrombus in the left atrium and the stump of the preserved posterior papillary muscle of the mitral valve.

Conclusion: Thus, the papillary muscle could present itself as an abnormal mass on echocardiography, resulting in misdiagnosing.

Schlüsselwörter

  • Intracardiac mass
  • mitral valve replacement
  • papillary muscle

History of Asian Biomedicine

Uneingeschränkter Zugang

Einer Ammundsen, MD (1911-1999): Danish World War II hero and famous Bangkok family physician

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 629 - 630

Zusammenfassung

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