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

Suche

Volumen 7 (2013): Heft 1 (February 2013)

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

Suche

17 Artikel

Editorial

Uneingeschränkter Zugang

A post-antibiotic world: the by-gone era of the future

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 1 - 2

Zusammenfassung

Review article

Uneingeschränkter Zugang

MicroRNAs: potential regulators of airway smooth muscle cell plasticity involved in asthma-induced airway remodeling

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 3 - 14

Zusammenfassung

Abstract

Background: Airway remodeling, which is fundamentally disordered in asthma, is related to the severity of asthma and poor response to current therapies. During airway remodeling, airway smooth muscle cells are not simply target cells, but participate actively in enhancing airway remodeling through changes induced by cellular plasticity.

Objective: We indicated that microRNAs, a class of regulatory non-coding RNAs, could regulate cellular plasticity at the posttranscriptional level. Here, we discuss the roles of microRNAs as regulators of plasticity in airway smooth muscle cells and possible mechanisms by which microRNAs modulate airway.

Methods: We conducted a literature search using the MEDLINE (PubMed) databases using the keywords “asthma”, “microRNAs”, “airway remodeling”, and “cellular plasticity”. Only articles published in English were included in the review.

Results: MicroRNAs, which regulated cellular plasticity in airway smooth muscle cells, was shown to modulate airway remodeling in asthma through different mechanisms.

Conclusion: MicroRNAs can be expected to be developed into a novel treatment strategy for reversing airway remodeling in patients with asthma.

Schlüsselwörter

  • Airway remodeling
  • asthma
  • cellular plasticity
  • gene regulation
  • MicroRNA

Original article

Uneingeschränkter Zugang

Antibiotic prescription for adults with upper respiratory tract infection and acute bronchitis at King Chulalongkorn Memorial Hospital, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 15 - 20

Zusammenfassung

Abstract

Background: Inappropriate use of antibiotics for upper respiratory tract infection (URI) and acute bronchitis frequently observed among patients in the outpatient department (OPD) can lead to increased rates of antibioticresistant bacteria and an unnecessary increase in cost of treatment. At the OPD of the King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand, the majority of antibiotics are prescribed by general practitioners and residents for patients with URI and acute bronchitis.

Objective: To determine physician practices in prescribing antibiotics for adult patients with URI and acute bronchitis attending a major urban OPD.

Material and Methods: This is a descriptive study of 379 cases involving adult patients with URI and acute bronchitis attending the OPD of KCMH from 1 October to 31 December 2010.

Results: Of the 379 study patients, 126 (33.2%) were males and 253 (66.8%) females; the mean age was 42.5±16.1 years. There were 339 (89.4%) and 40 (10.6%) patients with URI and acute bronchitis, respectively. Of 339 patients with URI, there were 171 (50.4%) URI of multiple and unspecified sites, 91 (26.8%) with pharyngitis, 32 (9.4%) with nasopharyngitis, 19 (5.6%) with sinusitis, 14 (4.13%) tonsillitis, and 12 (3.5%) patients with rhinitis. One hundred and sixty-seven (44.1%) patients were treated by residents and 212 (55.9%) by faculty staff. Antibiotics were prescribed for 81.3% of cases; the rates were 73.7% by residents and 87.7% by faculty staff. The most commonly prescribed antibiotic was amoxicillin (127 patients, 41.2%), followed by amoxicillin/clavulanic acid (86 patients, 27.9%), and roxithromycin (60 patients, 19.5%). According to the multivariate analysis, the factors contributing to antibiotic prescription included the presence of sore throat, abnormal lung signs, and examination and treatment by non-Medicine residents and staffs.

Conclusions: There is a very high rate of overuse of antibiotics for URI and acute bronchitis in our institute. Interventions to reduce the overuse of antibiotics are urgently needed.

Schlüsselwörter

  • Acute respiratory tract infection
  • acute bronchitis
  • antibiotic
  • antibiotic prescription
  • Thailand
Uneingeschränkter Zugang

The effect of diclofenac sodium on bladder detrusor contractility and its clinical implication

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 21 - 27

Zusammenfassung

Abstract

Background: Overactive bladder symptom (OAB) seriously influences a person’s life including mobility, workrelated activities, sleep, domestic, and sexual life. Many patients with OAB symptoms have insufficient improvement from usual treatment.

Objective: To investigate the effects of Diclofenac Sodium (DS) on bladder detrusor contractility and on the clinical symptoms associated with detrusor over-activity of patients following prostatectomy.

Methods: Bladders dissected from guinea pigs were used to study the effect of DS on uninhibited bladder contractions in vitro. Bladder detrusor contraction was evoked by histamine. The tension of bladder detrusor and the frequency and amplitude of bladder detrusor contraction were measured. In vivo efficacy of DS was then measured in patients after prostatectomy by using the symptom scoring system and by detecting the duration of the efficacy.

Results: DS significantly inhibited the contraction of detrusor evoked by histamine in a dose-dependent manner. The inhibition of bladder detrusor contraction by DS was statistically significantly stronger compared to that by normal saline (NS) and was analogous to that by verapamil in vitro. The total effective rates of DS were a little higher than intravenous verapamil in vivo. The complete remission rate and the mean effect-lasting time of rectal diclofenac were significantly higher than that of intravenous verapamil. No significant side effect was observed in patients with DS treatment.

Conclusion: DS significantly inhibited the contraction of bladder in vivo and in vitro. DS could act as a useful agent for the relief of overactive bladder symptom post-prostatectomy.

Schlüsselwörter

  • Bladder detrusor contraction
  • diclofenac sodium
  • guinea pig
  • overactive bladder symptom
  • patients following prostatectomy
Uneingeschränkter Zugang

Reduction in advanced glycation end products by ACE inhibitor in diabetic cardiomyopathy model

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 29 - 37

Zusammenfassung

Abstract

Background: Advanced glycation end-products (AGEs) due to hyperglycemia have been reported with diabetic complications. The effect of angiotensin converting enzyme (ACE) inhibition on the formation of AGEs and oxidative stress in the myocardium was explored.

Methods: Streptozocin-induced diabetic rats were randomized to three groups including untreated, treated with ACE inhibitor captopril, and treated with aminoguanidine for 24 weeks with non-diabetic rats as control.

Results: At study end, elevations of blood pressure, heart to body weight ratio, and brain natriuretic peptide levels were found in diabetic rats, indicating cardiac hypertrophy and dysfunction. Accumulation of myocardial AGEs/ receptor of AGEs (RAGEs), as determined by immunohistochemistry and Western blots were increased in diabetic animals, which were attenuated by both captopril and aminoguanidine. Staining of nitrotyrosine and 8-hydroxydeaminoguanosine, markers of oxidative stress, also increased in diabetic rats and was attenuated by both captopril and aminoguanidine treatment. The myocardial pentosidine, a marker of AGEs, increased in diabetic rats but was not significantly affected by either treatment.

Conclusion: This study has identified a relationship between the renin-angiotensin system and the accumulation of AGEs in experimental diabetic hearts that may be linked through oxidative stress.

Keyword

  • ACE inhibitor
  • advanced glycation end products
  • aminoguanidine
  • diabetic mellitus
  • oxidative stress
Uneingeschränkter Zugang

Enhanced antitumor effect of axitinib synergistic interaction with AG490 via VEGFR2/JAK2/STAT3 signaling mediated epithelial-mesenchymal transition in cervical cancer in vitro

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 39 - 49

Zusammenfassung

Abstract

Background: Epithelial to mesenchymal transition (EMT) not only confers tumor cells with a distinct advantage for metastatic dissemination, but also it provides tumor cells for proliferation and chemotherapy resistance. Thus, inhibiting this process using single or multiple agents, remains a field of intensive research. The development of EMT has been implicated in not only conferring cancer cells distant metastasis, but also providing tumor cells advantages for proliferation and chemotherapy resistance.

Objective: We investigated whether axitinib synergistic interaction with AG490 could effectively block the growth and EMT-mediated tumor metastasis in cervical cancer in vitro.

Methods: We addressed synergism effects on tumor growth, axitinib, AG490 alone and in any possible combinations on cell viability, apoptosis and cell cycle distribution were evaluated by XTT assay, Annexin V/propidium iodide staining and flow cytometric analysis. To assess how combination therapy affected chemotactic motility in tumor cells, wound-healing migration and the Boyden chamber invasion assays were applied in vitro. Further, using western blots, the key signaling molecules and pathways in response to axitinib and AG490 combination treatment in anti tumor growth and anti EMT-mediated tumor metastasis were analyzed in Hela cells.

Results: Therapy with axitinib and AG490 resulted in strong synergistic inhibition of proliferation, migration and cell cycle arrest without potently effect on apoptosis induction relative to AG490 monotherapy and control in vitro. Furthermore, phosphorylation of VEGFR2 (Tyr1175), JAK2 (Tyr1007/1008) and STAT3 (Tyr705) was completely blocked in parallel with significant reduction expressions of N-cadherin and obvious enhancement levels of E-cadherin through down-regulating Snail responding to combination treatment in cervical cancer cells.

Conclusion:We first provided evidences that combination therapy of axitinib and AG490 significantly enhances anti-tumor effect via VEGFR2/JAK2/STAT3 signaling mediated growth arrest and EMT-mediated tumor metastasis inhibition, holds promise for an efficacious treatment of these advanced patients.

Schlüsselwörter

  • AG490
  • axitinib
  • EMT
  • Hela cells
  • JAK2
  • STAT3
  • VEGFR2
Uneingeschränkter Zugang

Susceptibility of Aedes albopictus Skuse (Diptera: Culicidae) to permethrin in Kuala Lumpur, Malaysia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 51 - 62

Zusammenfassung

Abstract

Background: Insects control using insecticides is used extensively and intensively in vector control programs in many countries including Malaysia. Because of this, mosquito species have been found to develop various levels of resistance towards these insecticides, leading to failure in vector control activities.

Objectives: We determined permethrin resistance status in laboratory susceptible, permethrin-selected, and field strains of Aedes albopictus.

Methods: The susceptibility status of laboratory susceptible strain, permethrin-selected strain, and four field strains of Aedes albopictus collected from Kuala Lumpur were determined using three standard laboratory tests, WHO larval bioassay, WHO adult mosquito bioassay, and microassay of mixed function oxidases (MFOs).

Results: The LC50 values of permethrin-selected strain and field strains obtained from the WHO larval bioassay were almost two times higher (0.38-0.44 mg/L) than the LC50 value of the laboratory strain (0.20 mg/L). In the WHO adult bioassay, the susceptibility of permethrin-exposed of both permethrin-selected strain, and field strains (LT50 = 19.39 to 20.65 min) were reduced for 1.31 to 1.72 times after been exposed to the synergist, piperonyl butoxide (PBO) prior to permethrin. Complete mortalities were also recorded in both permethrin-exposed and PBO + permethrin-exposed Ae. albopictus of all strains, twenty-four hours post-exposure. For the MFOs enzyme microassay, a significant difference (p <0.05) in the mean absorbance of elevated oxidase activity at 630 nm was observed between all strains of both the non-exposed and PBO-exposed Ae. albopictus. Strong and significant positive correlations were also observed between LT50 values of permethrin-exposed and PBO + permethrinexposed with oxidase level in Ae. albopictus tested (r = 0.943; p <0.05).

Conclusion: These results indicate the association of oxidase activity with permethrin resistance development in Ae. albopictus.

Schlüsselwörter

  • Aedes albopictus
  • bioassay
  • Malaysia
  • mixed function oxidases
  • permethrin
Uneingeschränkter Zugang

Interleukin-4 and Prednisolone affect the matrix metalloproteinase-13 releasing from degenerative bovine nasal cartilage in vitro

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 63 - 72

Zusammenfassung

Abstract

Background: Proteolysis of the extracellular matrix (ECM) of articular cartilage by matrix metalloproteinases (MMPs) is a key characteristic of joint diseases. Thus, identification of MMPs expression mechanism in chondrocytes may lead to the development of new treatment for arthritis.

Objectives: Investigate the combination effects of interleukin-4 (IL-4) and Prednisolone on ECM alterations and production of matrix metalloproteinase-13 (MMP-13) induced by interleukin-1α (IL-1α) in bovine nasal cartilage (BNC) explants.

Materials and Methods: Ninety mg of BNC explants (10 slices in each well) were cultured in Dulbecco’s modified Eagle’s medium (DMEM) with IL-1α (10 ng/ml), IL-4 (50 ng/ml) and Prednisolone (1nM, 1000 nM) at the same time for 28 days. At days 3, 6,7,14, 21, and 28 media were removed and replaced with fresh media and the removed media were stored in -20°C. The alterations of ECM were assessed by using histology techniques. The combination effects of IL-4 and Prednisolone on MMP-13 production were analyzed by Western immunoblots. The cell viability was evaluated by using lactate dehydrogenase (LDH) assay kit.

Results: The results showed that after 28 days treated with IL-1α, matrix blue staining significantly disappeared. In addition, a clear band of MMP-13 was detected. In the presence of IL-1α and Prednisolone (1000 nM), matrix breakdown was partially decreased and MMP-13 production was significantly reduced. In combination of IL-4 with both low and high dose Prednisolone, proteogycan loss significantly reduced and synergistic inhibition of MMP-13 production were observed. LDH level was not significantly increased in the presence of cytokines and Prednisolone.

Conclusion: The combination of IL-4 and Prednisolone showed profound protective effects on cartilage matrix alterations. A better understanding of the mechanisms by this combination affects MMPs expression in human chondrocytes could provide valuable insight into new therapeutic strategies of cartilage destruction.

Schlüsselwörter

  • Chondrocytes
  • interleukin-1α
  • interleukin-4
  • matrix metalloproteinase-13 (MMP-13)
  • prednisolone
Uneingeschränkter Zugang

Effects of arterial carbon dioxide on recovery from rocuronium-induced neuromuscular blockade in anesthetized patients

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 73 - 79

Zusammenfassung

Abstract

Background: Respiratory function can be impaired during general anesthesia involving neuromuscular blockers such as rocuronium. However, the magnitude of the problems and the efficacy of their reversal with antagonistic drugs are not known.

Objective: To investigate the effects of arterial carbon dioxide (PaCO2) on recovery from rocuronium-induced neuromusuclar blockade with or without antagonism by neostigmine.

Methods: Ninety patients were randomly divided into six groups; group I and A, normal PaCO2 (35-45mmHg), group II and B, low PaCO2 (30-35mmHg), group III and C, high PaCO2 (45-50mmHg). The extent of neuromuscular blockade was evaluated by train-of-four (TOF) -watch accelerograph. Anesthesia was induced with intravenous propofol, fentanyl, and rocuronium 0.6mg/kg. Additional injection of rocuronium 0.15mg/kg per time was given whenever the first twitch of TOF (T1) recovered to 25%. The residual neuromuscular blockade was antagonized with neostigmine 0.02mg/kg in the groups I, II and III, when T1 reached 25%. The duration from T1 25% to 75% was recorded and defined as the recovery index and that from T1 25% to TOFR 0.9 was the recovery time.

Results: Both the recovery index and recovery time in group II were much shorter than in group I (p <0.05), while much longer in group III than in group I (p <0.05). No significant differences were found for the comparisons of those of values between groups B and A, or between groups C and A, although they were longer in group C than in group B. A linear relationship was found between the recovery index or recovery time and PaCO2.

Conclusion: Elevated PaCO2 prolongs the spontaneous recovery of neuromuscular blockade induced by rocuronium, as well as recovery after small doses of neostigmine, with a linear relationship.

Schlüsselwörter

  • Neuromuscular blockade
  • PaCO2
  • recovery
  • rocuronium
Uneingeschränkter Zugang

Expression of Annexin A1 and UCH-L1 in central nervous system neuroepithelial tumors

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 81 - 88

Zusammenfassung

Abstract

Background: Pathological diagnosis of CNS neuroepithelial tumors can be problematic due to morphological similarity, and many tumors in the group share immunohistochemical profile. New markers are needed to enhance histologic diagnosis.

Objective: We studied Annexin A1 and UCH-L1 expression in CNS neuroepithelial tumors, with regard to a possible application for practical usage.

Methods: Expression of Annexin A1 and UCH-L1 was evaluated in 224 various neuroepithelial tumors by immunohistochemistry using tissue microarrays.

Results: Annexin A1 was expressed by the majority of ependymoma (92%) but none of central neurocytoma (p = 0.0000002) and medulloblastoma (p <10-8). Absence of Annexin A1 and/or UCH-L1 was associated with low-grade astrocytoma rather than ependymoma (p = 0.0000009). Percentage of positive Annexin A1 and UCHL1 paralleled increasing histologic grades in diffuse astrocytomas.

Conclusion: Expression of Annexin A1 distinguishes ependymoma from central neurocytoma, and from medulloblastoma. Demonstration of Annexin A1 and/or UCH-L1 might be helpful to differentiate ependymoma from low-grade astrocytoma. Up-regulation of Annexin A1 and UCH-L1 in increasing histologic grade of diffuse astrocytomas suggests their roles in the malignant transformation.

Schlüsselwörter

  • Annexin A1
  • brain tumors
  • glioma
  • immunohistochemistry
  • UCH-L1
Uneingeschränkter Zugang

Inhibitory effect of Derris reticulata ethanol extract on LPS-induced macrophage activation

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 89 - 95

Zusammenfassung

Abstract

Background: Deiris reticulata Craib is a Thai medicinal plant in the Legiuninosae family. It has flavonoids as major active compounds similar to other plants in genus Denis. Several flavonoids have been identified to have anti-inflammatory activities. The anti-inflammatory mechanisms and potency of flavonoids from this medicinal plant is not known.

Objective: We investigated the effect of ethanolic extract fr om stem of D. reticulata on LPS-induced macrophage activation.

Methods: J774A.1 cells were treated with 6.25-100 g/ml the extract for 24 horns and then activated with 100 ng/ml lipopolysaccharide (LPS) for 24 horns. Tire extract inhibited nitric oxide production in LPS-activated J774A. 1 cells in concentration-dependent maimer with IC50 62.5 μg/ml. The effect of this extract on phagocytosis activity of LPS-activated J774A. 1 cells was also investigated.

Results: The extract at concentrations of 50 and 100 pg/ml significantly inhibited zymosan phagocytosis of LPS-activated cells in a concentration dependent maimer. It decreased the mRNA expression of the inducible nitric oxide synthase (iNOS) which plays a role in NO production and the cyclo-oxygenase 2 (COX-2) which is responsible for prostaglandins (PGs) production in LPS-activated J774A. 1 cells. This extract also inhibited the mRNA expression of pro-inflammatory cytokines. TNF-α. IL-β and IL-6 in the LPS-activated J774A. 1 cells.

Conclusion: The results hi this study reveal for the first time that the ethanolic extract of D. reticulata stem has potential anti-inflammatory activity. It inhibited production of several known inflammatory mediators in LPS-activated macrophages. These findings may be useful to study this plant further as a source of anti­inflammatory activity.

Schlüsselwörter

  • Activated macrophage
  • anti-inflammation
  • Derris reticulata
  • phagocytosis
  • pro-inflammatory cytokines
  • pro-inflammatory mediators
Uneingeschränkter Zugang

Occurrence and molecular identification of liver and minute intestinal flukes metacercariae in freshwater fish from Fang-Mae Ai Agricultural Basin, Chiang Mai province, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 97 - 104

Zusammenfassung

Abstract

Background: Fang-Mae Ai Agricultural Basin is located in Fang and Mae Ai districts, Chiang Mai province. There are many aquatic species distributed in this area, especially snails, crabs, and fish, which can serve as the first and second intermediate hosts of several trematodes. The roles of these intermediate hosts as related to parasitic infections in the area are not known.

Objective: We determined the occurrence of liver flukes and minute intestinal fluke metacercariae in freshwater fish from Fang-Mae Ai Agricultural Basin. We also identified of metacercariae by using HAT-RAPD PCR method comparing DNA profiles of parasites.

Materials and methods: Liver flukes and minute intestinal flukes were studied from the Fang-Mae Ai Agricultural Basin between October 2009 and September 2010. Fish specimens were seasonally collected and each fish was digested and filtered. The metacercariae were collected and counted under a stereo microscope and identified based on morphological characters. The genomic DNA of all parasites was extracted and purified from adult flukes and metacercariae. All extracted genomic DNA was detected by HAT-RAPD PCR using arbitrary primers to comparing DNA profiles between adult flukes and metacercariae.

Results: Five species of metacercariae were found. There were one species of liver fluke, Opisthorchis viverrini, and four species of minute intestinal flukes, viz. Haplorchis taichui, Haplorchoides sp., Centrocestus caninus, and Stellantchasmus falcatus. The prevalence of metacercarial infection was observed in the cool-dry season at 78.30%, followed by rainy and hot-dry seasons at 72.84% and 69.01%, respectively. The prevalence of trematodes were Haplorchoides sp. (37.43%), H. taichui (35.66%), C. caninus (3.80%), S. falcatus (1.40%), and O. viverrini (0.44%).

Conclusion: Minute intestinal flukes accounted for high infection rates while, liver fluke, O. viverrini was of low infection rate. DNA profiles among metacercariae in Fang-Mae Ai Agricultural Basin correctly identified adult stages.

Schlüsselwörter

  • Liver flukes
  • metacercaria
  • minute intestinal flukes
  • molecular identification
  • occurrence

Brief communication (Original)

Uneingeschränkter Zugang

Association study of the tryptophan hydroxylase 1 gene with major depressive disorder in three ethnic groups of the Malaysian population

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 105 - 112

Zusammenfassung

Abstract

Background: Alterations of the serotonergic neurotransmission system have been suspected to be involved in the pathogenesis of neuropsychiatric disorders including major depressive disorders (MDD). Tryptophan hydroxylase (TPH) 1 gene has been proposed as a candidate gene for MDD in Caucasian and Chinese populations from different countries. However, there is no comprehensive study of TPH1 gene in the MDD samples from Malaysia.

Objective:We examined the possible association between the two intronic polymorphisms, A218C (rs1800532) and A779C (rs1799913), and MDD in the three main ethnic groups of the Malaysian population.

Methods:We enrolled and genotyped 265 unrelated patients and 332 unrelated healthy subjects using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and amplification refractory mutation system-polymerase chain reaction (ARMS-PCR).

Results: We observed no significant association in the genotype and allele frequencies between the MDD patients and control subjects for either of the tested polymorphisms, whereas the linkage disequilibrium (LD) among the three ethnicities and combined samples were strong (D’ >0.8).

Conclusion: In summary, our preliminary study suggests that the TPH1 gene may be associated with the MDD in the Indian population. However, further studies using larger sample sizes are necessary in order to verify this result. The ability of obtaining the MDD patient’s genotypic data, in addition to the diagnosis of the myriad of symptoms, will most definitely be able to assist clinicians to better care, manage, and treat their patients.

Schlüsselwörter

  • Genetic polymorphism
  • Malaysia
  • MDD
  • PCR-RFLP
  • TPH1
Uneingeschränkter Zugang

Quality of life outcomes following knee arthrodesis in a resource poor setting

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 113 - 117

Zusammenfassung

Abstract

Background: For cases of chronic, intractable, knee pain in a resource poor setting such as Cambodia, knee arthrodesis may be an acceptable solution, offering pain relief, useful function and preservation of the limb.

Objectives: We studied the post-operative health related quality of life of patients following knee arthodesis in a resource poor setting.

Methods: The Children’s Surgical Centre, (CSC), providing free operations to disabled people, in Phnom Penh, Cambodia, performed 13 knee arthrodesis procedures in the period between January 2007 and February 2012. We were able to follow up 8 of these patients and used the Health Survey Short Form 36 version 2 (SF-36v2) (Quality Metric Incorporated and Medical Outcomes Trust) survey, to assess the impact of the procedure on their quality of life. We also asked patients whether they had been employed before and after undergoing knee arthrodesis.

Results: On SF-36v2, the post-op mean physical component score (PCS) was just below average at 47.6, indicating they had almost normal function and the mean mental component score (MCS) was low at 39.9, meaning their mental health was below normal (the average is 50 in a normal population). Five out of seven patients were continuing to work after undergoing arthrodesis, four of them in physically demanding occupations.

Conclusion: The results show that in this resource poor setting, knee arthrodesis gives good results. According to the SF-36v2, the mean post-operative bodily pain score was above average, indicating freedom from normal pain. (Knee pain is the primary indication for arthrodesis at CSC). Arthrodesis allows the maintenance of physical function at a level enabling patients to work in practical occupations such as farming. This study highlights some of the issues surrounding knee arthrodesis which should be explored further, such as possible effects on mental health and social functioning.

Schlüsselwörter

  • Cambodia
  • knee arthrodesis
  • poor setting
  • quality of life
Uneingeschränkter Zugang

Patient dose and image quality from the low kilovoltage dynamic liver computed tomography examinations

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 119 - 124

Zusammenfassung

Abstract

Background: In cases of patients with chronic liver disease, lesions were often detected in MRI replacing in computed tomography (CT) test because of the difference in X-ray attenuation that is likely to depend on constituent nodules. Therefore, the importance of pre enhancement study at liver dynamic CT scan is being emphasized.

Objective: To find optimal protocol and to reduce radiation dose without compromising image quality while taking low kilovoltage (kVp) liver dynamic CT examination using MDCT.

Subjects and Methods: Fifty patients under follow-up who were diagnosed of liver cancer have been examined using a 16-slice MDCT scanner, CT body dose phantom, and CT performance phantom for simulation. Contrast noise ratio and noise of water using phantom have been measured and Volume Computed Tomography Dose Index has been measured according to examination methods. Three points of liver parenchyma, aorta, and subcutaneous fat has been measured for CT attenuation value and compared with magnification picture archiving and communication system in 200% and region of interest for the same size.

Results: Scanning parameters were 120 kVp-140 mAs, 120 kVp-120mAs, and 80 kVp-280 mAs. The CNR was 6.87, 3.36, and 7.66 HU, respectively. Also, the noise of water was 6.83, 7.36, and 9.04 HU respectively. The CT attenuation value for the liver parenchyma, aorta, and fat is high about 15, 217, and 19 HU, respectively. Also, CTDIvol decreased to about 47.36%.

Conclusion: Four phase liver dynamic CT examination with low CT kVp setup is a useful tactic to reduce radiation dose and also can provide necessary images for clinical diagnosis when compared to the results from three phase liver dynamic CT.

Schlüsselwörter

  • Computed tomography (CT)
  • contrast to noise
  • dynamic liver CT patient dose
  • noise

Clinical repor

Uneingeschränkter Zugang

Severe acute fatty liver in pregnancy: a diagnostic dilemma in clinical practice

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 125 - 130

Zusammenfassung

Abstract

Background: Acute fatty liver of pregnancy (AFLP) is an uncommon complication in the third trimester of pregnancy. Differential diagnosis between severe cases of AFLP and others conditions remains challenging since there is no specific diagnostic test for this condition and the diagnosis is made by clinical and laboratory findings.

Objective: To evaluate the clinical presentation, laboratory findings, and clinical outcome in patients with acute fatty liver of pregnancy.

Material and Method: A retrospective study was carried out in all hospitalized pregnant patients who presented with hepatitis in the third trimester at King Chulalongkorn Memorial Hospital (KCMH), between January 2001 and March 2011. The diagnosis of AFLP had been made by clinical symptoms, laboratory evidence of acute hepatitis in the third trimester of pregnancy and by exclusion of other causes.

Results: Of 102,989 deliveries, there was five AFLP, giving an incidence of 1 in 20,598 pregnancies. The mean maternal age and gestational age was 33.6 years and 36 weeks, respectively. The mean length of stay in hospital was 12 days (range 8 to 20 days). Nausea and jaundice were the most common symptoms. It is of interest that one case of AFLP coexisted with the syndrome, which is a combined medical feature of “H” for hemolysis, “EL” for elevated liver enzymes, and “LP” for low platelet count (HELLP). Hypoglycemia was found in all patients requiring continuous infusion of dextrose solution. Acute renal failure was also found in all cases. Initial serum creatinine varied from 1.5 to 3.7 mg/dL. None of the patients required hemodialysis and renal function returned to normal at discharge. Two cases were associated with DIC, which caused postpartum hemorrhage. Liver function tests became normal within 7 to 43 days. There was one case of perinatal death of the fetus and no maternal deaths.

Conclusion: AFLP is an emergency. Multiple organ failures could develop even after delivery. In our experience, some cases of AFLP could overlap with HELLP syndrome or masquerade as TTP in the setting of pregnancy. Careful analysis of the clinical progression is important in the recognition of AFLP and prompt termination of the pregnancy is required to improve maternal and perinatal outcomes.

Schlüsselwörter

  • Acute fatty liver of pregnancy
  • acute renal failure
  • disseminated intravascular coagulopathy
Uneingeschränkter Zugang

Cultural considerations in family therapy: boys with conversion

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 131 - 136

Zusammenfassung

Abstract

Background: Conversion disorder is mostly reported in girls. One factor that makes girls vulnerable for emotional problems is the cultural practice of son preference, which is prevalent in many Asian countries including Thailand. However, other cultural factors make boys vulnerable to develop conversion disorders.

Objective: We reported clinical symptoms, family assessment, and important points in family therapy in two boys with conversion disorder.

Method: Two boys age 10 and 14 years old presented with seizures. Neurological tests were unremarkable and an organically-based seizure disorder was ruled out. The patients were diagnosed as having conversion disorder and were sent for psychiatric evaluation and treatment.

Result: Family assessment revealed some cultural practices that led to frustration and conversion. These factors included the culture of silence and the tendency to somatize; the cultural practice of mourning; and the parentification of children especially the first-born. In family therapy, therapeutic work included breaking the silence in the family and helping the family develop the ability to talk about feelings; helping the family deal with frustration more effectively, and dealing with somatic symptoms in an empathic manner. When the patients were able to reconnect with their families and to voice their needs, the body no longer needed to speak for them and the symptoms remitted.

Conclusion: The case vignettes illustrated the role culture plays in modifying the manifestations of both intrapsychic and interpersonal conflicts in boys. Understanding such a role will help therapists to treat conversion disorders in boys more effectively.

Schlüsselwörter

  • Boys
  • children
  • conversion disorder
  • culture
  • somatization
17 Artikel

Editorial

Uneingeschränkter Zugang

A post-antibiotic world: the by-gone era of the future

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 1 - 2

Zusammenfassung

Review article

Uneingeschränkter Zugang

MicroRNAs: potential regulators of airway smooth muscle cell plasticity involved in asthma-induced airway remodeling

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 3 - 14

Zusammenfassung

Abstract

Background: Airway remodeling, which is fundamentally disordered in asthma, is related to the severity of asthma and poor response to current therapies. During airway remodeling, airway smooth muscle cells are not simply target cells, but participate actively in enhancing airway remodeling through changes induced by cellular plasticity.

Objective: We indicated that microRNAs, a class of regulatory non-coding RNAs, could regulate cellular plasticity at the posttranscriptional level. Here, we discuss the roles of microRNAs as regulators of plasticity in airway smooth muscle cells and possible mechanisms by which microRNAs modulate airway.

Methods: We conducted a literature search using the MEDLINE (PubMed) databases using the keywords “asthma”, “microRNAs”, “airway remodeling”, and “cellular plasticity”. Only articles published in English were included in the review.

Results: MicroRNAs, which regulated cellular plasticity in airway smooth muscle cells, was shown to modulate airway remodeling in asthma through different mechanisms.

Conclusion: MicroRNAs can be expected to be developed into a novel treatment strategy for reversing airway remodeling in patients with asthma.

Schlüsselwörter

  • Airway remodeling
  • asthma
  • cellular plasticity
  • gene regulation
  • MicroRNA

Original article

Uneingeschränkter Zugang

Antibiotic prescription for adults with upper respiratory tract infection and acute bronchitis at King Chulalongkorn Memorial Hospital, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 15 - 20

Zusammenfassung

Abstract

Background: Inappropriate use of antibiotics for upper respiratory tract infection (URI) and acute bronchitis frequently observed among patients in the outpatient department (OPD) can lead to increased rates of antibioticresistant bacteria and an unnecessary increase in cost of treatment. At the OPD of the King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand, the majority of antibiotics are prescribed by general practitioners and residents for patients with URI and acute bronchitis.

Objective: To determine physician practices in prescribing antibiotics for adult patients with URI and acute bronchitis attending a major urban OPD.

Material and Methods: This is a descriptive study of 379 cases involving adult patients with URI and acute bronchitis attending the OPD of KCMH from 1 October to 31 December 2010.

Results: Of the 379 study patients, 126 (33.2%) were males and 253 (66.8%) females; the mean age was 42.5±16.1 years. There were 339 (89.4%) and 40 (10.6%) patients with URI and acute bronchitis, respectively. Of 339 patients with URI, there were 171 (50.4%) URI of multiple and unspecified sites, 91 (26.8%) with pharyngitis, 32 (9.4%) with nasopharyngitis, 19 (5.6%) with sinusitis, 14 (4.13%) tonsillitis, and 12 (3.5%) patients with rhinitis. One hundred and sixty-seven (44.1%) patients were treated by residents and 212 (55.9%) by faculty staff. Antibiotics were prescribed for 81.3% of cases; the rates were 73.7% by residents and 87.7% by faculty staff. The most commonly prescribed antibiotic was amoxicillin (127 patients, 41.2%), followed by amoxicillin/clavulanic acid (86 patients, 27.9%), and roxithromycin (60 patients, 19.5%). According to the multivariate analysis, the factors contributing to antibiotic prescription included the presence of sore throat, abnormal lung signs, and examination and treatment by non-Medicine residents and staffs.

Conclusions: There is a very high rate of overuse of antibiotics for URI and acute bronchitis in our institute. Interventions to reduce the overuse of antibiotics are urgently needed.

Schlüsselwörter

  • Acute respiratory tract infection
  • acute bronchitis
  • antibiotic
  • antibiotic prescription
  • Thailand
Uneingeschränkter Zugang

The effect of diclofenac sodium on bladder detrusor contractility and its clinical implication

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 21 - 27

Zusammenfassung

Abstract

Background: Overactive bladder symptom (OAB) seriously influences a person’s life including mobility, workrelated activities, sleep, domestic, and sexual life. Many patients with OAB symptoms have insufficient improvement from usual treatment.

Objective: To investigate the effects of Diclofenac Sodium (DS) on bladder detrusor contractility and on the clinical symptoms associated with detrusor over-activity of patients following prostatectomy.

Methods: Bladders dissected from guinea pigs were used to study the effect of DS on uninhibited bladder contractions in vitro. Bladder detrusor contraction was evoked by histamine. The tension of bladder detrusor and the frequency and amplitude of bladder detrusor contraction were measured. In vivo efficacy of DS was then measured in patients after prostatectomy by using the symptom scoring system and by detecting the duration of the efficacy.

Results: DS significantly inhibited the contraction of detrusor evoked by histamine in a dose-dependent manner. The inhibition of bladder detrusor contraction by DS was statistically significantly stronger compared to that by normal saline (NS) and was analogous to that by verapamil in vitro. The total effective rates of DS were a little higher than intravenous verapamil in vivo. The complete remission rate and the mean effect-lasting time of rectal diclofenac were significantly higher than that of intravenous verapamil. No significant side effect was observed in patients with DS treatment.

Conclusion: DS significantly inhibited the contraction of bladder in vivo and in vitro. DS could act as a useful agent for the relief of overactive bladder symptom post-prostatectomy.

Schlüsselwörter

  • Bladder detrusor contraction
  • diclofenac sodium
  • guinea pig
  • overactive bladder symptom
  • patients following prostatectomy
Uneingeschränkter Zugang

Reduction in advanced glycation end products by ACE inhibitor in diabetic cardiomyopathy model

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 29 - 37

Zusammenfassung

Abstract

Background: Advanced glycation end-products (AGEs) due to hyperglycemia have been reported with diabetic complications. The effect of angiotensin converting enzyme (ACE) inhibition on the formation of AGEs and oxidative stress in the myocardium was explored.

Methods: Streptozocin-induced diabetic rats were randomized to three groups including untreated, treated with ACE inhibitor captopril, and treated with aminoguanidine for 24 weeks with non-diabetic rats as control.

Results: At study end, elevations of blood pressure, heart to body weight ratio, and brain natriuretic peptide levels were found in diabetic rats, indicating cardiac hypertrophy and dysfunction. Accumulation of myocardial AGEs/ receptor of AGEs (RAGEs), as determined by immunohistochemistry and Western blots were increased in diabetic animals, which were attenuated by both captopril and aminoguanidine. Staining of nitrotyrosine and 8-hydroxydeaminoguanosine, markers of oxidative stress, also increased in diabetic rats and was attenuated by both captopril and aminoguanidine treatment. The myocardial pentosidine, a marker of AGEs, increased in diabetic rats but was not significantly affected by either treatment.

Conclusion: This study has identified a relationship between the renin-angiotensin system and the accumulation of AGEs in experimental diabetic hearts that may be linked through oxidative stress.

Keyword

  • ACE inhibitor
  • advanced glycation end products
  • aminoguanidine
  • diabetic mellitus
  • oxidative stress
Uneingeschränkter Zugang

Enhanced antitumor effect of axitinib synergistic interaction with AG490 via VEGFR2/JAK2/STAT3 signaling mediated epithelial-mesenchymal transition in cervical cancer in vitro

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 39 - 49

Zusammenfassung

Abstract

Background: Epithelial to mesenchymal transition (EMT) not only confers tumor cells with a distinct advantage for metastatic dissemination, but also it provides tumor cells for proliferation and chemotherapy resistance. Thus, inhibiting this process using single or multiple agents, remains a field of intensive research. The development of EMT has been implicated in not only conferring cancer cells distant metastasis, but also providing tumor cells advantages for proliferation and chemotherapy resistance.

Objective: We investigated whether axitinib synergistic interaction with AG490 could effectively block the growth and EMT-mediated tumor metastasis in cervical cancer in vitro.

Methods: We addressed synergism effects on tumor growth, axitinib, AG490 alone and in any possible combinations on cell viability, apoptosis and cell cycle distribution were evaluated by XTT assay, Annexin V/propidium iodide staining and flow cytometric analysis. To assess how combination therapy affected chemotactic motility in tumor cells, wound-healing migration and the Boyden chamber invasion assays were applied in vitro. Further, using western blots, the key signaling molecules and pathways in response to axitinib and AG490 combination treatment in anti tumor growth and anti EMT-mediated tumor metastasis were analyzed in Hela cells.

Results: Therapy with axitinib and AG490 resulted in strong synergistic inhibition of proliferation, migration and cell cycle arrest without potently effect on apoptosis induction relative to AG490 monotherapy and control in vitro. Furthermore, phosphorylation of VEGFR2 (Tyr1175), JAK2 (Tyr1007/1008) and STAT3 (Tyr705) was completely blocked in parallel with significant reduction expressions of N-cadherin and obvious enhancement levels of E-cadherin through down-regulating Snail responding to combination treatment in cervical cancer cells.

Conclusion:We first provided evidences that combination therapy of axitinib and AG490 significantly enhances anti-tumor effect via VEGFR2/JAK2/STAT3 signaling mediated growth arrest and EMT-mediated tumor metastasis inhibition, holds promise for an efficacious treatment of these advanced patients.

Schlüsselwörter

  • AG490
  • axitinib
  • EMT
  • Hela cells
  • JAK2
  • STAT3
  • VEGFR2
Uneingeschränkter Zugang

Susceptibility of Aedes albopictus Skuse (Diptera: Culicidae) to permethrin in Kuala Lumpur, Malaysia

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 51 - 62

Zusammenfassung

Abstract

Background: Insects control using insecticides is used extensively and intensively in vector control programs in many countries including Malaysia. Because of this, mosquito species have been found to develop various levels of resistance towards these insecticides, leading to failure in vector control activities.

Objectives: We determined permethrin resistance status in laboratory susceptible, permethrin-selected, and field strains of Aedes albopictus.

Methods: The susceptibility status of laboratory susceptible strain, permethrin-selected strain, and four field strains of Aedes albopictus collected from Kuala Lumpur were determined using three standard laboratory tests, WHO larval bioassay, WHO adult mosquito bioassay, and microassay of mixed function oxidases (MFOs).

Results: The LC50 values of permethrin-selected strain and field strains obtained from the WHO larval bioassay were almost two times higher (0.38-0.44 mg/L) than the LC50 value of the laboratory strain (0.20 mg/L). In the WHO adult bioassay, the susceptibility of permethrin-exposed of both permethrin-selected strain, and field strains (LT50 = 19.39 to 20.65 min) were reduced for 1.31 to 1.72 times after been exposed to the synergist, piperonyl butoxide (PBO) prior to permethrin. Complete mortalities were also recorded in both permethrin-exposed and PBO + permethrin-exposed Ae. albopictus of all strains, twenty-four hours post-exposure. For the MFOs enzyme microassay, a significant difference (p <0.05) in the mean absorbance of elevated oxidase activity at 630 nm was observed between all strains of both the non-exposed and PBO-exposed Ae. albopictus. Strong and significant positive correlations were also observed between LT50 values of permethrin-exposed and PBO + permethrinexposed with oxidase level in Ae. albopictus tested (r = 0.943; p <0.05).

Conclusion: These results indicate the association of oxidase activity with permethrin resistance development in Ae. albopictus.

Schlüsselwörter

  • Aedes albopictus
  • bioassay
  • Malaysia
  • mixed function oxidases
  • permethrin
Uneingeschränkter Zugang

Interleukin-4 and Prednisolone affect the matrix metalloproteinase-13 releasing from degenerative bovine nasal cartilage in vitro

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 63 - 72

Zusammenfassung

Abstract

Background: Proteolysis of the extracellular matrix (ECM) of articular cartilage by matrix metalloproteinases (MMPs) is a key characteristic of joint diseases. Thus, identification of MMPs expression mechanism in chondrocytes may lead to the development of new treatment for arthritis.

Objectives: Investigate the combination effects of interleukin-4 (IL-4) and Prednisolone on ECM alterations and production of matrix metalloproteinase-13 (MMP-13) induced by interleukin-1α (IL-1α) in bovine nasal cartilage (BNC) explants.

Materials and Methods: Ninety mg of BNC explants (10 slices in each well) were cultured in Dulbecco’s modified Eagle’s medium (DMEM) with IL-1α (10 ng/ml), IL-4 (50 ng/ml) and Prednisolone (1nM, 1000 nM) at the same time for 28 days. At days 3, 6,7,14, 21, and 28 media were removed and replaced with fresh media and the removed media were stored in -20°C. The alterations of ECM were assessed by using histology techniques. The combination effects of IL-4 and Prednisolone on MMP-13 production were analyzed by Western immunoblots. The cell viability was evaluated by using lactate dehydrogenase (LDH) assay kit.

Results: The results showed that after 28 days treated with IL-1α, matrix blue staining significantly disappeared. In addition, a clear band of MMP-13 was detected. In the presence of IL-1α and Prednisolone (1000 nM), matrix breakdown was partially decreased and MMP-13 production was significantly reduced. In combination of IL-4 with both low and high dose Prednisolone, proteogycan loss significantly reduced and synergistic inhibition of MMP-13 production were observed. LDH level was not significantly increased in the presence of cytokines and Prednisolone.

Conclusion: The combination of IL-4 and Prednisolone showed profound protective effects on cartilage matrix alterations. A better understanding of the mechanisms by this combination affects MMPs expression in human chondrocytes could provide valuable insight into new therapeutic strategies of cartilage destruction.

Schlüsselwörter

  • Chondrocytes
  • interleukin-1α
  • interleukin-4
  • matrix metalloproteinase-13 (MMP-13)
  • prednisolone
Uneingeschränkter Zugang

Effects of arterial carbon dioxide on recovery from rocuronium-induced neuromuscular blockade in anesthetized patients

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 73 - 79

Zusammenfassung

Abstract

Background: Respiratory function can be impaired during general anesthesia involving neuromuscular blockers such as rocuronium. However, the magnitude of the problems and the efficacy of their reversal with antagonistic drugs are not known.

Objective: To investigate the effects of arterial carbon dioxide (PaCO2) on recovery from rocuronium-induced neuromusuclar blockade with or without antagonism by neostigmine.

Methods: Ninety patients were randomly divided into six groups; group I and A, normal PaCO2 (35-45mmHg), group II and B, low PaCO2 (30-35mmHg), group III and C, high PaCO2 (45-50mmHg). The extent of neuromuscular blockade was evaluated by train-of-four (TOF) -watch accelerograph. Anesthesia was induced with intravenous propofol, fentanyl, and rocuronium 0.6mg/kg. Additional injection of rocuronium 0.15mg/kg per time was given whenever the first twitch of TOF (T1) recovered to 25%. The residual neuromuscular blockade was antagonized with neostigmine 0.02mg/kg in the groups I, II and III, when T1 reached 25%. The duration from T1 25% to 75% was recorded and defined as the recovery index and that from T1 25% to TOFR 0.9 was the recovery time.

Results: Both the recovery index and recovery time in group II were much shorter than in group I (p <0.05), while much longer in group III than in group I (p <0.05). No significant differences were found for the comparisons of those of values between groups B and A, or between groups C and A, although they were longer in group C than in group B. A linear relationship was found between the recovery index or recovery time and PaCO2.

Conclusion: Elevated PaCO2 prolongs the spontaneous recovery of neuromuscular blockade induced by rocuronium, as well as recovery after small doses of neostigmine, with a linear relationship.

Schlüsselwörter

  • Neuromuscular blockade
  • PaCO2
  • recovery
  • rocuronium
Uneingeschränkter Zugang

Expression of Annexin A1 and UCH-L1 in central nervous system neuroepithelial tumors

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 81 - 88

Zusammenfassung

Abstract

Background: Pathological diagnosis of CNS neuroepithelial tumors can be problematic due to morphological similarity, and many tumors in the group share immunohistochemical profile. New markers are needed to enhance histologic diagnosis.

Objective: We studied Annexin A1 and UCH-L1 expression in CNS neuroepithelial tumors, with regard to a possible application for practical usage.

Methods: Expression of Annexin A1 and UCH-L1 was evaluated in 224 various neuroepithelial tumors by immunohistochemistry using tissue microarrays.

Results: Annexin A1 was expressed by the majority of ependymoma (92%) but none of central neurocytoma (p = 0.0000002) and medulloblastoma (p <10-8). Absence of Annexin A1 and/or UCH-L1 was associated with low-grade astrocytoma rather than ependymoma (p = 0.0000009). Percentage of positive Annexin A1 and UCHL1 paralleled increasing histologic grades in diffuse astrocytomas.

Conclusion: Expression of Annexin A1 distinguishes ependymoma from central neurocytoma, and from medulloblastoma. Demonstration of Annexin A1 and/or UCH-L1 might be helpful to differentiate ependymoma from low-grade astrocytoma. Up-regulation of Annexin A1 and UCH-L1 in increasing histologic grade of diffuse astrocytomas suggests their roles in the malignant transformation.

Schlüsselwörter

  • Annexin A1
  • brain tumors
  • glioma
  • immunohistochemistry
  • UCH-L1
Uneingeschränkter Zugang

Inhibitory effect of Derris reticulata ethanol extract on LPS-induced macrophage activation

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 89 - 95

Zusammenfassung

Abstract

Background: Deiris reticulata Craib is a Thai medicinal plant in the Legiuninosae family. It has flavonoids as major active compounds similar to other plants in genus Denis. Several flavonoids have been identified to have anti-inflammatory activities. The anti-inflammatory mechanisms and potency of flavonoids from this medicinal plant is not known.

Objective: We investigated the effect of ethanolic extract fr om stem of D. reticulata on LPS-induced macrophage activation.

Methods: J774A.1 cells were treated with 6.25-100 g/ml the extract for 24 horns and then activated with 100 ng/ml lipopolysaccharide (LPS) for 24 horns. Tire extract inhibited nitric oxide production in LPS-activated J774A. 1 cells in concentration-dependent maimer with IC50 62.5 μg/ml. The effect of this extract on phagocytosis activity of LPS-activated J774A. 1 cells was also investigated.

Results: The extract at concentrations of 50 and 100 pg/ml significantly inhibited zymosan phagocytosis of LPS-activated cells in a concentration dependent maimer. It decreased the mRNA expression of the inducible nitric oxide synthase (iNOS) which plays a role in NO production and the cyclo-oxygenase 2 (COX-2) which is responsible for prostaglandins (PGs) production in LPS-activated J774A. 1 cells. This extract also inhibited the mRNA expression of pro-inflammatory cytokines. TNF-α. IL-β and IL-6 in the LPS-activated J774A. 1 cells.

Conclusion: The results hi this study reveal for the first time that the ethanolic extract of D. reticulata stem has potential anti-inflammatory activity. It inhibited production of several known inflammatory mediators in LPS-activated macrophages. These findings may be useful to study this plant further as a source of anti­inflammatory activity.

Schlüsselwörter

  • Activated macrophage
  • anti-inflammation
  • Derris reticulata
  • phagocytosis
  • pro-inflammatory cytokines
  • pro-inflammatory mediators
Uneingeschränkter Zugang

Occurrence and molecular identification of liver and minute intestinal flukes metacercariae in freshwater fish from Fang-Mae Ai Agricultural Basin, Chiang Mai province, Thailand

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 97 - 104

Zusammenfassung

Abstract

Background: Fang-Mae Ai Agricultural Basin is located in Fang and Mae Ai districts, Chiang Mai province. There are many aquatic species distributed in this area, especially snails, crabs, and fish, which can serve as the first and second intermediate hosts of several trematodes. The roles of these intermediate hosts as related to parasitic infections in the area are not known.

Objective: We determined the occurrence of liver flukes and minute intestinal fluke metacercariae in freshwater fish from Fang-Mae Ai Agricultural Basin. We also identified of metacercariae by using HAT-RAPD PCR method comparing DNA profiles of parasites.

Materials and methods: Liver flukes and minute intestinal flukes were studied from the Fang-Mae Ai Agricultural Basin between October 2009 and September 2010. Fish specimens were seasonally collected and each fish was digested and filtered. The metacercariae were collected and counted under a stereo microscope and identified based on morphological characters. The genomic DNA of all parasites was extracted and purified from adult flukes and metacercariae. All extracted genomic DNA was detected by HAT-RAPD PCR using arbitrary primers to comparing DNA profiles between adult flukes and metacercariae.

Results: Five species of metacercariae were found. There were one species of liver fluke, Opisthorchis viverrini, and four species of minute intestinal flukes, viz. Haplorchis taichui, Haplorchoides sp., Centrocestus caninus, and Stellantchasmus falcatus. The prevalence of metacercarial infection was observed in the cool-dry season at 78.30%, followed by rainy and hot-dry seasons at 72.84% and 69.01%, respectively. The prevalence of trematodes were Haplorchoides sp. (37.43%), H. taichui (35.66%), C. caninus (3.80%), S. falcatus (1.40%), and O. viverrini (0.44%).

Conclusion: Minute intestinal flukes accounted for high infection rates while, liver fluke, O. viverrini was of low infection rate. DNA profiles among metacercariae in Fang-Mae Ai Agricultural Basin correctly identified adult stages.

Schlüsselwörter

  • Liver flukes
  • metacercaria
  • minute intestinal flukes
  • molecular identification
  • occurrence

Brief communication (Original)

Uneingeschränkter Zugang

Association study of the tryptophan hydroxylase 1 gene with major depressive disorder in three ethnic groups of the Malaysian population

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 105 - 112

Zusammenfassung

Abstract

Background: Alterations of the serotonergic neurotransmission system have been suspected to be involved in the pathogenesis of neuropsychiatric disorders including major depressive disorders (MDD). Tryptophan hydroxylase (TPH) 1 gene has been proposed as a candidate gene for MDD in Caucasian and Chinese populations from different countries. However, there is no comprehensive study of TPH1 gene in the MDD samples from Malaysia.

Objective:We examined the possible association between the two intronic polymorphisms, A218C (rs1800532) and A779C (rs1799913), and MDD in the three main ethnic groups of the Malaysian population.

Methods:We enrolled and genotyped 265 unrelated patients and 332 unrelated healthy subjects using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and amplification refractory mutation system-polymerase chain reaction (ARMS-PCR).

Results: We observed no significant association in the genotype and allele frequencies between the MDD patients and control subjects for either of the tested polymorphisms, whereas the linkage disequilibrium (LD) among the three ethnicities and combined samples were strong (D’ >0.8).

Conclusion: In summary, our preliminary study suggests that the TPH1 gene may be associated with the MDD in the Indian population. However, further studies using larger sample sizes are necessary in order to verify this result. The ability of obtaining the MDD patient’s genotypic data, in addition to the diagnosis of the myriad of symptoms, will most definitely be able to assist clinicians to better care, manage, and treat their patients.

Schlüsselwörter

  • Genetic polymorphism
  • Malaysia
  • MDD
  • PCR-RFLP
  • TPH1
Uneingeschränkter Zugang

Quality of life outcomes following knee arthrodesis in a resource poor setting

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 113 - 117

Zusammenfassung

Abstract

Background: For cases of chronic, intractable, knee pain in a resource poor setting such as Cambodia, knee arthrodesis may be an acceptable solution, offering pain relief, useful function and preservation of the limb.

Objectives: We studied the post-operative health related quality of life of patients following knee arthodesis in a resource poor setting.

Methods: The Children’s Surgical Centre, (CSC), providing free operations to disabled people, in Phnom Penh, Cambodia, performed 13 knee arthrodesis procedures in the period between January 2007 and February 2012. We were able to follow up 8 of these patients and used the Health Survey Short Form 36 version 2 (SF-36v2) (Quality Metric Incorporated and Medical Outcomes Trust) survey, to assess the impact of the procedure on their quality of life. We also asked patients whether they had been employed before and after undergoing knee arthrodesis.

Results: On SF-36v2, the post-op mean physical component score (PCS) was just below average at 47.6, indicating they had almost normal function and the mean mental component score (MCS) was low at 39.9, meaning their mental health was below normal (the average is 50 in a normal population). Five out of seven patients were continuing to work after undergoing arthrodesis, four of them in physically demanding occupations.

Conclusion: The results show that in this resource poor setting, knee arthrodesis gives good results. According to the SF-36v2, the mean post-operative bodily pain score was above average, indicating freedom from normal pain. (Knee pain is the primary indication for arthrodesis at CSC). Arthrodesis allows the maintenance of physical function at a level enabling patients to work in practical occupations such as farming. This study highlights some of the issues surrounding knee arthrodesis which should be explored further, such as possible effects on mental health and social functioning.

Schlüsselwörter

  • Cambodia
  • knee arthrodesis
  • poor setting
  • quality of life
Uneingeschränkter Zugang

Patient dose and image quality from the low kilovoltage dynamic liver computed tomography examinations

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 119 - 124

Zusammenfassung

Abstract

Background: In cases of patients with chronic liver disease, lesions were often detected in MRI replacing in computed tomography (CT) test because of the difference in X-ray attenuation that is likely to depend on constituent nodules. Therefore, the importance of pre enhancement study at liver dynamic CT scan is being emphasized.

Objective: To find optimal protocol and to reduce radiation dose without compromising image quality while taking low kilovoltage (kVp) liver dynamic CT examination using MDCT.

Subjects and Methods: Fifty patients under follow-up who were diagnosed of liver cancer have been examined using a 16-slice MDCT scanner, CT body dose phantom, and CT performance phantom for simulation. Contrast noise ratio and noise of water using phantom have been measured and Volume Computed Tomography Dose Index has been measured according to examination methods. Three points of liver parenchyma, aorta, and subcutaneous fat has been measured for CT attenuation value and compared with magnification picture archiving and communication system in 200% and region of interest for the same size.

Results: Scanning parameters were 120 kVp-140 mAs, 120 kVp-120mAs, and 80 kVp-280 mAs. The CNR was 6.87, 3.36, and 7.66 HU, respectively. Also, the noise of water was 6.83, 7.36, and 9.04 HU respectively. The CT attenuation value for the liver parenchyma, aorta, and fat is high about 15, 217, and 19 HU, respectively. Also, CTDIvol decreased to about 47.36%.

Conclusion: Four phase liver dynamic CT examination with low CT kVp setup is a useful tactic to reduce radiation dose and also can provide necessary images for clinical diagnosis when compared to the results from three phase liver dynamic CT.

Schlüsselwörter

  • Computed tomography (CT)
  • contrast to noise
  • dynamic liver CT patient dose
  • noise

Clinical repor

Uneingeschränkter Zugang

Severe acute fatty liver in pregnancy: a diagnostic dilemma in clinical practice

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 125 - 130

Zusammenfassung

Abstract

Background: Acute fatty liver of pregnancy (AFLP) is an uncommon complication in the third trimester of pregnancy. Differential diagnosis between severe cases of AFLP and others conditions remains challenging since there is no specific diagnostic test for this condition and the diagnosis is made by clinical and laboratory findings.

Objective: To evaluate the clinical presentation, laboratory findings, and clinical outcome in patients with acute fatty liver of pregnancy.

Material and Method: A retrospective study was carried out in all hospitalized pregnant patients who presented with hepatitis in the third trimester at King Chulalongkorn Memorial Hospital (KCMH), between January 2001 and March 2011. The diagnosis of AFLP had been made by clinical symptoms, laboratory evidence of acute hepatitis in the third trimester of pregnancy and by exclusion of other causes.

Results: Of 102,989 deliveries, there was five AFLP, giving an incidence of 1 in 20,598 pregnancies. The mean maternal age and gestational age was 33.6 years and 36 weeks, respectively. The mean length of stay in hospital was 12 days (range 8 to 20 days). Nausea and jaundice were the most common symptoms. It is of interest that one case of AFLP coexisted with the syndrome, which is a combined medical feature of “H” for hemolysis, “EL” for elevated liver enzymes, and “LP” for low platelet count (HELLP). Hypoglycemia was found in all patients requiring continuous infusion of dextrose solution. Acute renal failure was also found in all cases. Initial serum creatinine varied from 1.5 to 3.7 mg/dL. None of the patients required hemodialysis and renal function returned to normal at discharge. Two cases were associated with DIC, which caused postpartum hemorrhage. Liver function tests became normal within 7 to 43 days. There was one case of perinatal death of the fetus and no maternal deaths.

Conclusion: AFLP is an emergency. Multiple organ failures could develop even after delivery. In our experience, some cases of AFLP could overlap with HELLP syndrome or masquerade as TTP in the setting of pregnancy. Careful analysis of the clinical progression is important in the recognition of AFLP and prompt termination of the pregnancy is required to improve maternal and perinatal outcomes.

Schlüsselwörter

  • Acute fatty liver of pregnancy
  • acute renal failure
  • disseminated intravascular coagulopathy
Uneingeschränkter Zugang

Cultural considerations in family therapy: boys with conversion

Online veröffentlicht: 04 Feb 2017
Seitenbereich: 131 - 136

Zusammenfassung

Abstract

Background: Conversion disorder is mostly reported in girls. One factor that makes girls vulnerable for emotional problems is the cultural practice of son preference, which is prevalent in many Asian countries including Thailand. However, other cultural factors make boys vulnerable to develop conversion disorders.

Objective: We reported clinical symptoms, family assessment, and important points in family therapy in two boys with conversion disorder.

Method: Two boys age 10 and 14 years old presented with seizures. Neurological tests were unremarkable and an organically-based seizure disorder was ruled out. The patients were diagnosed as having conversion disorder and were sent for psychiatric evaluation and treatment.

Result: Family assessment revealed some cultural practices that led to frustration and conversion. These factors included the culture of silence and the tendency to somatize; the cultural practice of mourning; and the parentification of children especially the first-born. In family therapy, therapeutic work included breaking the silence in the family and helping the family develop the ability to talk about feelings; helping the family deal with frustration more effectively, and dealing with somatic symptoms in an empathic manner. When the patients were able to reconnect with their families and to voice their needs, the body no longer needed to speak for them and the symptoms remitted.

Conclusion: The case vignettes illustrated the role culture plays in modifying the manifestations of both intrapsychic and interpersonal conflicts in boys. Understanding such a role will help therapists to treat conversion disorders in boys more effectively.

Schlüsselwörter

  • Boys
  • children
  • conversion disorder
  • culture
  • somatization

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