Showing papers by "Mahidol University published in 2001"
TL;DR: It is concluded that there is moderate variation in the incidence of hip fracture among Asian countries, and the rates were highest in urbanized countries.
Abstract: The Asian Osteoporosis Study (AOS) is the first multicenter study to document and compare the incidence of hip fracture in four Asian countries. Hospital discharge data for the year 1997 were obtained for the Hong Kong SAR, Singapore, Malaysia and Thailand (Chiang Mai). The number of patients who were 50 years of age and older and who were discharged with a diagnosis of hip fracture (ICD9 820) was enumerated. The age-specific incidence rates were deduced and were directly adjusted to the US white population in 1989. The age-adjusted rates for men and women (per 100 000) are as follows: Hong Kong, 180 and 459; Singapore, 164 and 442; Malaysia, 88 and 218; Thailand, 114 and 289; compared with US White rates of 187 in men and 535 in women, published in 1989. We conclude that there is moderate variation in the incidence of hip fracture among Asian countries. The rates were highest in urbanized countries. With rapid economic development in Asia, hip fracture will prove to be a major public health challenge.
300 citations
TL;DR: The higher the degree of deacetylation of chitosan the more brittle and the less moisture absorption the films became, and transmission infrared and 13C-NMR spectra supported that Chitosonium acetate films prepared by a casting technique using acetic acid as a dissolving vehicle were chitOSoniumacetate films.
Abstract: Chitosan films, varying in molecular weight and degree of deacetylation, were prepared by a casting technique using acetic acid as a dissolving vehicle. The physicochemical properties of the films were characterized. Both molecular weight and degree of deaceylation affected the film properties. Powder X-ray diffraction patterns and differential scanning calorimetry thermograms of all chitosan films indicated their amorphous state to partially crystalline state with thermal degradation temperature lower than 280-300 degrees C. The increase in molecular weight of chitosan would increase the tensile strength and elongation as well as moisture absorption of the films, whereas the increase in degree of deacetylation of chitosan would either increase or decrease the tensile strength of the films depending on its molecular weight. Moreover, the higher the degree of deacetylation of chitosan the more brittle and the less moisture absorption the films became. All chitosan films were soluble in HCl-KCl buffer (pH 1.2), normal saline, and distilled water. They swelled in phosphate buffer (pH 7.4), and cross-linking between chitosan and phosphate anions might occur Finally, transmission infrared and 13C-NMR spectra supported that chitosan films prepared by using acetic acid as a dissolving were chitosonium acetate films.
300 citations
TL;DR: The validated, simple, and inexpensive Fast Red TR dye technique will assist national malaria control authorities in urgently needed campaigns to stop this murderous trade.
224 citations
TL;DR: It was suggested that the swelling property, dissolution characteristics of the polymer films, pK(a) of drugs and especially drug-polymer interaction were important factors governing drug release patterns from chitosan films.
224 citations
TL;DR: Mutational analyses indicate that both ohrA and ohrB contribute to organic peroxide resistance in B. subtilis, with the OhrA protein playing the more important role in growing cells and at least three regulons that contribute to peroxide stress responses.
Abstract: Bacillus subtilis displays a complex adaptive response to the presence of reactive oxygen species. To date, most proteins that protect against reactive oxygen species are members of the peroxide-inducible PerR and sigma(B) regulons. We investigated the function of two B. subtilis homologs of the Xanthomonas campestris organic hydroperoxide resistance (ohr) gene. Mutational analyses indicate that both ohrA and ohrB contribute to organic peroxide resistance in B. subtilis, with the OhrA protein playing the more important role in growing cells. Expression of ohrA, but not ohrB, is strongly and specifically induced by organic peroxides. Regulation of ohrA requires the convergently transcribed gene, ohrR, which encodes a member of the MarR family of transcriptional repressors. In an ohrR mutant, ohrA expression is constitutive, whereas expression of the neighboring ohrB gene is unaffected. Selection for mutant strains that are derepressed for ohrA transcription identifies a perfect inverted repeat sequence that is required for OhrR-mediated regulation and likely defines an OhrR binding site. Thus, B. subtilis contains at least three regulons (sigma(B), PerR, and OhrR) that contribute to peroxide stress responses.
210 citations
TL;DR: In this article, structural characterization of naturally occurring polyisoprenes was carried out to solve the mystery of natural rubber (NR), such as the biosynthesis mechanism of rubber formation, the or...
Abstract: Structural characterization of naturally occurring polyisoprenes was carried out to solve the mystery of natural rubber (NR), such as the biosynthesis mechanism of rubber formation, the or...
194 citations
TL;DR: Amniotic membrane can successfully treat refractory corneal epithelial defect by promoting epithelial healing and thus prevent cornean perforation and can be used as a treatment for corneAL perforations by restoringCorneal stromal thickness so that emergency penetrating keratoplasty can be avoided.
Abstract: AIMS To evaluate the efficacy of amniotic membrane transplantation (AMT) in persistent corneal epithelial defect with or without stromal thinning and corneal perforation. METHODS 28 patients (28 eyes) with persistent corneal epithelial defect unresponsive to medical treatment were given preserved human amniotic membrane transplants. The patients were divided into three groups: group A, persistent corneal epithelial defect 10 eyes; group B, epithelial defect with stromal thinning 13 eyes; and group C, corneal perforation five eyes. AMT was performed using one layer in group A and multilayers in group B and C. The causes of persistent epithelial defect were neurotrophic keratopathy (24 eyes), limbal deficiency (six eyes), exposure keratopathy (four eyes), and Mooren9s ulcer (one eye). RESULTS Success was noted in 82.1% (23/28 eyes) in all groups, with 80% (8/10 eyes), 84.6% (11/13 eyes), and 80% (4/5 eyes) in groups A, B, and C respectively, with a mean follow up of 10.9 months (1–30 months). The mean epithelialisation time after AMT was 2.1 weeks. The healing times of groups B and C are also significantly shorter than group A (p=0.017 and 0.018, respectively). Corneal stromal thickness was significantly increased in all cases in groups B and C (p=0.006). Those with corneal perforation in group C were completely healed by multilayer AMT. There was no difference in the epithelialisation time between successful cases treated by a single operation (17 eyes) or repeated operation (six eyes). Vision improved in 18.9% (8/28 eyes) and worsened as a result of cataract formation in 2.3% (1/28 eyes). Failure was noted in 17.9% (5/28 eyes), because of corneal infection (two eyes), neurotrophic keratopathy with and without limbal deficiency (two eyes), and intractable corneal perforation (one eye). No patient developed major immediate postoperative complications or graft rejection. CONCLUSION Amniotic membrane can successfully treat refractory corneal epithelial defect by promoting epithelial healing and thus prevent corneal perforation. It can be used as a treatment for corneal perforation by restoring corneal stromal thickness so that emergency penetrating keratoplasty can be avoided.
173 citations
TL;DR: Artesunate or artemether was used to treat 539 episodes of acute P. falciparum malaria in 461 pregnant women, including 44 first-trimester episodes and the artemisinins were well tolerated with no evidence of adverse effects.
Abstract: The emergence and spread of multidrug-resistant Plasmodium falciparum compromises the treatment of malaria, especially during pregnancy, where the choice of antimalarials is already limited. Artesunate (n=528) or artemether (n=11) was used to treat 539 episodes of acute P. falciparum malaria in 461 pregnant women, including 44 first-trimester episodes. Most patients (310 [57.5%]) received re-treatments after earlier treatment with quinine or mefloquine. By use of survival analysis, the cumulative artemisinin failure rate for primary infections was 6.6% (95% confidence interval, 1.0-12.3), compared with the re-treatment failure rate of 21.7% (95% confidence interval, 15.4-28.0; P=.004). The artemisinins were well tolerated with no evidence of adverse effects. Birth outcomes did not differ significantly to community rates for abortion, stillbirth, congenital abnormality, and mean gestation at delivery. These results are reassuring, but further information about the safety of these valuable antimalarials in pregnancy is needed.
168 citations
TL;DR: A reorientation of priorities in drug development and health policy is needed as discussed by the authors, which requires political will, a strong commitment to prioritize health considerations over economic interests, and the enforcement of regulations and other mechanisms to stimulate essential drug development.
Abstract: Infectious diseases cause the suffering of hundreds of millions of people, especially in tropical and subtropical areas. Effective, affordable and easy-to-use medicines to fight these diseases are nearly absent. Although science and technology are sufficiently advanced to provide the necessary medicines, very few new drugs are being developed. However, drug discovery is not the major bottleneck. Today's R&D-based pharmaceutical industry is reluctant to invest in the development of drugs to treat the major diseases of the poor, because return on investment cannot be guaranteed. With national and international politics supporting a free market-based world order, financial opportunities rather than global health needs guide the direction of new drug development. Can we accept that the dearth of effective drugs for diseases that mainly affect the poor is simply the sad but inevitable consequence of a global market economy? Or is it a massive public health failure, and a failure to direct economic development for the benefit of society? An urgent reorientation of priorities in drug development and health policy is needed. The pharmaceutical industry must contribute to this effort, but national and international policies need to direct the global economy to address the true health needs of society. This requires political will, a strong commitment to prioritize health considerations over economic interests, and the enforcement of regulations and other mechanisms to stimulate essential drug development. New and creative strategies involving both the public and the private sector are needed to ensure that affordable medicines for today's neglected diseases are developed. Priority action areas include advocating an essential medicines R&D agenda, capacity-building in and technology transfer to developing countries, elaborating an adapted legal and regulatory framework, prioritizing funding for essential drug development and securing availability, accessibility, distribution and rational use of these drugs.
163 citations
TL;DR: The results suggest that the risk of DEET accumulating in the fetus is low and that DEET is safe to use in later pregnancy.
Abstract: The safety of daily application of N, N-diethyl-m-toluamide (DEET) (1.7 g of DEET/day) in the second and third trimesters of pregnancy was assessed as part of a double-blind, randomized, therapeutic trial of insect repellents for the prevention of malaria in pregnancy (n = 897). No adverse neurologic, gastrointestinal, or dermatologic effects were observed for women who applied a median total dose of 214.2 g of DEET per pregnancy (range = 0-345.1 g). DEET crossed the placenta and was detected in 8% (95% confidence interval = 2.6-18.2) of cord blood samples from a randomly selected subgroup of DEET users (n = 50). No adverse effects on survival, growth, or development at birth, or at one year, were found. This is the first study to document the safety of DEET applied regularly in the second and third trimesters of pregnancy. The results suggest that the risk of DEET accumulating in the fetus is low and that DEET is safe to use in later pregnancy.
158 citations
TL;DR: The PfHRP-2 dipstick test provides a useful indicator of recent severe malaria, but does not predict the therapeutic response.
Abstract: The potential for Plasmodium falciparum histidine-rich protein-2 (PfHRP-2) dipstick tests to predict antimalarial treatment failure was investigated in a prospective study in Thailand of 38 patients admitted with severe malaria and 54 hospitalized with uncomplicated P. falciparum infections. Of these, 40 had subsequent recrudescence of their infections. Overall, 89% of patients with severe malaria and 61% of patients with uncomplicated malaria had positive PfHRP-2 dipstick tests for > 2 weeks following the start of treatment. Persistence was correlated positively with admission parasite counts, PfHRP-2 intensity scores and disease severity. PfHRP-2 tests which remained positive for > 2 weeks and PfHRP-2 reactive intensity scores on admission, at day 7 and day 14 did not predict treatment failure independent of admission parasitaemia. Freezing and thawing the blood samples did not significantly affect PfHRP-2 results tested by the dipstick technique. The PfHRP-2 dipstick test provides a useful indicator of recent severe malaria, but does not predict the therapeutic response.
TL;DR: HIV-1 transmission risk remains high among Bangkok IDUs despite methadone treatment and other current prevention strategies, and this study led to the initiation in 1999 of a phase III HIV-1 vaccine efficacy trial in this population.
Abstract: A large epidemic of HIV-1 subtype B began among injection drug users (IDUs) in Bangkok in 1988. Despite on-going prevention efforts HIV-1 prevalence among IDUs remained at 30-50% through the 1990s. The objectives were to measure the incidence of HIV infection and related risk factors to guide prevention efforts and to evaluate the feasibility of conducting an HIV vaccine efficacy trial. A prospective cohort study was carried out in which IDUs attending methadone treatment programs in Bangkok were screened during 1995-96 for enrollment into the study. IDUs found to be HIV-seronegative on two occasions were offered enrollment with follow-up visits every 4 months. On each visit participants were evaluated with a questionnaire and serologic testing. A total of 1209 HIV-negative IDUs were enrolled. Through the end of 1998 the overall HIV-1 incidence rate was 5.8 (95% confidence interval 4.8-6.8) per 100 person-years of follow-up. HIV-1 subtypes E and B accounted for 79% and 21% of infections respectively. On multivariate analysis HIV-1 seroconversion was primarily associated with the frequency of heroin injection the sharing of injection equipment and incarceration especially with drug injection. Sexual behavior was not associated with increased risk for HIV-1. Risk factors for infection with HIV-1 subtypes E and B were similar. HIV-1 transmission risk remains high among Bangkok IDUs despite methadone treatment and other current prevention strategies. There is an urgent need to address this on-going epidemic especially in jails and prisons. This study led to the initiation in 1999 of a phase III HIV-1 vaccine efficacy trial in this population. (authors)
TL;DR: The isolates were later found to be facultative anaerobic, Gram‐positive, non‐spore‐forming, non-capsule‐forming and catalase‐negative bacilli, which could utilize casein but could not hydrolyse starch, and they produced hydrogen peroxide and bacteriocins.
Abstract: The aims of the present study were to screen and characterize the antimicrobial lactic acid bacteria which were isolated from healthy oral cavities of Thai volunteers, and to characterize their inhibiting substances. Among 3790 isolates (suspected to be lactic acid bacteria) from 130 volunteers, five showed an appreciable effect against Sarcina lutea ATCC 9341, Bacillus cereus ATCC 11778, Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 6538, Streptococcus mutans DTMU 1, Strep. salivarius DTMU 1, Strep. sanguis DTMU 1, Candida albicans ATCC 13803 and C. albicans DTMU 2, as well as the oral pathogens. These antimicrobial isolates included L17 and N14 which showed the antibacterial activity, D14 which showed the anticandidal activity, and D6 and N8 which showed both the antibacterial and anticandidal activities. The isolates were later found to be facultative anaerobic, Gram-positive, non-spore-forming, non-capsule-forming and catalase-negative bacilli. They could utilize casein but could not hydrolyse starch, and they produced hydrogen peroxide and bacteriocins. Their antimicrobial potentials were found to be affected by pH, catalase, proteolytic enzymes and temperature. The activity was partially inactivated after catalase treatment, significantly declined at pH > or =9.0 or after trypsin and pepsin treatments, and also reduced after heating at > or =100 degrees C. However, the antimicrobial activity of these five isolates was somewhat resistant to heat. When the isolates were tested for their antimicrobial sensitivity, they were shown to be sensitive to a number of antimicrobial agents. The final identification revealed that D6, D14 and N14 were Lactobacillus paracasei subsp. paracasei, and L17 and N8 were Lact. rhamnosus.
TL;DR: The estimated daily survival rate of older females (13–23 d old) was significantly greater than survival of younger ones (3–13 dOld) in Puerto Rico and Thailand, and nonlinear regression analysis is a sensitive approach for comparing patterns of mosquito survival based on mark, single release, multiple recapture data.
Abstract: It generally is assumed that the daily probability of survival of wild adult mosquitoes is independent of age. To test this assumption we conducted mark-release-recapture studies in Puerto Rico and Thailand to determine if estimated daily survival rates between two different age cohorts of the dengue vector Aedes aegypti (L.) were the same. Survivorship was estimated with nonlinear regression analysis using bootstrapping to obtain estimates of errors. Initial recapture success of the younger cohort was greater than the older cohort at both locations. Our analysis revealed a significantly greater survival rate for the younger cohort of females in Puerto Rico, and no significant differences between age cohorts in Thailand. For comparison, a traditional approach for analyzing these type of data, linear regression of log-transformed captures over time (exponential model), was used to calculate the probability of daily survival based on slopes of linear regression lines for recaptured mosquitoes. With this method, the estimated daily survival rate of older females (13-23 d old) was significantly greater than survival of younger ones (3-13 d old) in Puerto Rico and Thailand. In addition, short-range movement of mosquitoes was observed in Puerto Rico; maximum dispersal distance detected was 79 m. Survival rates of adult Ae. aegypti may be age-dependent and nonlinear regression analysis is a sensitive approach for comparing patterns of mosquito survival based on mark, single release, multiple recapture data.
TL;DR: Data indicated the spread ofblaVEB-1 in Bangkok due to frequent transfer of different plasmids and class 1 integrons and rarely to clonally related strains.
Abstract: Over a 21/2-month period in 1999, 37 ceftazidime-resistant nonrepetitive enterobacterial isolates were collected from 37 patients in a Bangkok hospital, Thailand. Eighty-one percent of these strains expressed a clavulanic acid-inhibited extended-cephalosporin resistance profile. An identical extended-spectrum beta-lactamase (ESBL), VEB-1, was found in 16 unrelated enterobacterial isolates (Escherichia coli, n = 10; Enterobacter cloacae, n = 2; Enterobacter sakazakii, n = 1; and Klebsiella pneumoniae, n = 3) and in two clonally related E. cloacae isolates. The bla(VEB-1) gene was located on mostly self-conjugative plasmids (ca. 24 to 200 kb) that conferred additional non-beta-lactam antibiotic resistance patterns. Additionally, the bla(VEB-1) gene cassette was part of class 1 integrons varying in size and structure. The bla(VEB-1)-containing integrons were mostly associated with bla(OXA-10)-like and arr-2-like gene cassettes, the latter conferring resistance to rifampin. These data indicated the spread of bla(VEB-1) in Bangkok due to frequent transfer of different plasmids and class 1 integrons and rarely to clonally related strains. Plasmid- and integron-mediated resistance to rifampin was also found in enterobacterial isolates.
TL;DR: In Thailand, climate is the main determinant of VZV seroprevalence and the delayed onset of natural immunity is more marked in warmer climate areas; population density is a secondary determinant; in the warmer areas, the pattern of adolescent and adult susceptibility was greater in rural than in urban areas.
Abstract: Blood samples were collected from healthy subjects, aged 9 months-29 years in urban and rural communities from 4 distinct regions in Thailand, to determine the seroprevalence rate of varicella-zoster virus (VZV) antibody and its relationship with demographic, climatic, and socioeconomic factors. The overall seroprevalence rate was 52.8% and increased from 15.5% in the 9-month to 4-year-old group to 75.9% in the 20-29 year-olds. The age-adjusted seroprevalence was significantly higher in the cooler than in the warmer regions. In the warmer regions only, the age-specific seroprevalence was significantly higher in the urban population than in the rural population. In Thailand, climate is the main determinant of VZV seroprevalence. The delayed onset of natural immunity is more marked in warmer climate areas. Population density is a secondary determinant; in the warmer areas, the pattern of adolescent and adult susceptibility was greater in rural than in urban areas.
TL;DR: The development of a continuous-flow sequential extraction method for soil As is described and assessed, having the benefits of simplicity, rapidity, less risk of contamination, and less vulnerability to changes in extraction conditions compared with traditional batch methods.
Abstract: Batch sequential extraction techniques for fractionating metals or metalloids in soils are time consuming and subject to several potential errors The development of a continuous-flow sequential extraction method for soil As is described and assessed, having the benefits of simplicity, rapidity, less risk of contamination, and less vulnerability to changes in extraction conditions compared with traditional batch methods The validated method was used to fractionate soil As using water, NaHCO3, NaOH, and HCl, followed by digestion of the residue with HNO3 and HF acids The extracts and digests were analyzed for As by graphite furnace atomic absorption spectrometry Good recoveries of total soil As (97-115%) were obtained and fractionation data generally comparable with those obtained using conventional batch techniques Soils from a tin-mining area in Thailand and soils from As-contaminated cattle (Bos taurus) dip sites in Australia were used to test the applicability of the method, and to demonstrate the usefulness of the extractogram obtained The ability to produce detailed extractograms for As and other elements (Al, Fe, and Ca) enabled an examination of elemental associations in individual fractions With the exception of As extracted with HCl, the extractograms generally support previous suggestions of the likely forms or associations of As present in the different soil fractions
TL;DR: Mutations in the Plasmodium falciparum gene (dhfr) encoding dihydrofolate reductase are associated with resistance to antifols in P. vivax and presumably arose from selection pressure.
Abstract: Mutations in the Plasmodium falciparum gene (dhfr) encoding dihydrofolate reductase are associated with resistance to antifols. Plasmodium vivax, the more prevalent malaria parasite in Asia and the Americas, is considered antifol resistant. Functional polymorphisms in the dhfr gene of P. vivax (pvdhfr) were assessed by PCR-restriction fragment length polymorphism using blood samples taken from 125 patients with acute vivax malaria from three widely separated locations, Thailand (n = 100), India (n = 16), and Madagascar and the Comoros Islands (n = 9). Upon evaluation of the three important codons (encoding residues 57, 58, and 117) of P. vivax dhfr (pvdhfr), double- or triple-mutation genotypes were found in all but one case from Thailand (99%), in only three cases from India (19%) and in no cases from Madagascar or the Comoros Islands (P < 0.0001). The dhfr PCR products of P. vivax from 32 Thai patients treated with the antifolate sulfadoxine-pyrimethamine (S-P) were investigated. All samples showed either double (53%) or triple (47%) mutations. Following treatment, 34% of the patients had early treatment failures and only 10 (31%) of the patients cleared their parasitemias for 28 days. There were no significant differences in cure rates, but parasite reduction ratios at 48 h were significantly lower for patients whose samples showed triple mutations than for those whose samples showed double mutations (P = 0.01). The three mutations at the pvdhfr codons for residues 57, 58, and 117 are associated with high levels of S-P resistance in P. vivax. These mutations presumably arose from selection pressure.
TL;DR: Northern blot analysis revealed that peroxinectin is constitutively expressed in shrimp haemocyte and was reduced significantly in shrimp injected with a beta-1,3-glucan, laminarin, to mimic an infection with a fungus.
Abstract: Upon activation of the prophenoloxidase activating system in the shrimp, Penaeus monodon, a cell adhesion activity in the haemolymph is generated. A cell adhesion assay showed that a high number of granular cells (60%) adhered to coverslips coated with a shrimp haemocyte lysate supernatant, whereas a very low number of cells adhered to coverslips coated with bovine serum albumin. Inhibition of adhesion by an antiserum against crayfish peroxinectin, a cell adhesion protein, revealed that the cell adhesion activity detected in shrimp haemocyte lysate supernatant might result from a peroxinectin-like molecule in shrimp. A cDNA clone encoding shrimp peroxinectin was isolated, which had an open reading frame of 2337 nucleotides, with a polyadenylation sequence and a poly A tail. It encodes a protein of 778 amino acids including a 20 amino acid signal peptide. The mature protein (758 amino acids) has a predicted molecular mass of 84.8kDa and an estimated pI of 9.0. Two putative integrin binding motifs, RGD (Arg-Gly-Asp) and KGD (Lys-Gly-Asp), were found in shrimp peroxinectin. Sequence comparison shows that the shrimp protein is similar to crayfish peroxinectin (69%) and to various peroxidases and putative peroxidases from invertebrates and vertebrates. The shrimp peroxinectin cDNA also shows similarity (51%) to both Drosophila peroxinectin-related protein (AAF78217) and peroxidasin (S46224), an extracellular matrix protein combining an active peroxidase domain as well as immunoglobulin domains, leucine rich repeats and procollagen-like motif. However, the sequence similarity to both Drosophila molecules are mostly within the peroxidase domain. Northern blot analysis, using a non-peroxidase region in peroxinectin as a probe, revealed that peroxinectin is constitutively expressed in shrimp haemocyte and was reduced significantly in shrimp injected with a beta-1,3-glucan, laminarin, to mimic an infection with a fungus.
TL;DR: Primary preventive programs for hip fracture could be planned in Asia based on findings of the AOS, which found relative risks of hip fracture in women and men by multiple logistic regression.
Abstract: The objectives of the Asian Osteoporosis Study (AOS) were to determine risk factors for hip fracture in men and women in four Asian countries, that is, Singapore, Malaysia, Thailand, and the Philippines. A total of 451 men and 725 women (aged 50 years and over) with hip fractures were compared with an equal number of community controls. A standardized questionnaire was administered by interview. The following relative risks (RRs) were found in women and men by multiple logistic regression: dietary calcium intake < 498 mg/day, 2.0 for women (95% CI, 1.5-2.8) and 1.5 for men (95% CI, 1.0-2.2); no load bearing activity in the immediate past, 2.0 for women (95% CI, 1.4-2.7) and 3.4 for men (95% CI, 2.3-5.1); no vigorous sport activities in young adulthood, 7.2 for women (95% CI, 4.0-13.0) and 2.4 for men (95% CI, 1.6-3.6); cigarette smoking, 1.5 for men (95% CI, 1.0-2.1); alcohol consumption 7 days a week, 2.9 for women (95% CI, 1.0-8.6) and 1.9 for men (95% CI, 1.1-3.2); fell twice or more in the last 12 months, 3.0 for women (95% CI, 1.8-4.8) and 3.4 for men (95% CI, 1.8-6.6); a history of fractures after 50 years of age, 1.8 for women (95% CI, 1.1-2.9) and 3.0 for men (95% CI, 1.6-5.6); a history of stroke, 3.8 for women (95% CI, 2.0-7.1) and 3.6 for men (95% CI, 1.8-7.1); use of sedatives, 2.5 for women (95% CI, 1.0-6.3) and 3.0 for men (95% CI, 1.0-9.7); and use of thyroid drugs, 7.1 for women (95% CI, 2.0-25.9) and 11.8 for men (95% CI, 1.3-106.0). Women who were 1.56 m or taller had an RR of 2.0 (95% CI, 1.3-3.0) for hip fracture and men who were 1.69 m or taller had an RR of 1.9 (95% CI, 1.2-3.1) for hip fracture. Based on these findings, primary preventive programs for hip fracture could be planned in Asia.
TL;DR: The study showed that protein-energy malnutrition is a common complication of liver cirrhosis, and nutritional disorders appeared to be related to the degree of liver injury and the etiology of nutritional disorders.
TL;DR: This retrospective study was performed to examine the effect of maternal hyperthyroidism during late pregnancy on neonatal birth weight (NBW).
Abstract: OBJECTIVE: Hyperthyroidism in pregnancy occurs with a prevalence of 0.05--0.2% and has been shown to affect neonatal outcomes. Fetal weight increases markedly during the third trimester of pregnancy. This retrospective study was performed to examine the effect of maternal hyperthyroidism during late pregnancy on neonatal birth weight (NBW). DESIGN: Medical and obstetric records of 293 pregnant women with present and past history of hyperthyroidism were retrospectively reviewed.
PATIENTS: There were 188 records of 181 patients with adequate data for inclusion in the analysis. The patients were divided into two groups according to the maternal thyroid function during the third trimester of pregnancy: hyperthyroidism (HT; 35 cases) and euthyroidism (ET; 153 cases).
MEASUREMENTS: Maternal thyroid function tests were periodically evaluated before and during the third trimester of pregnancy. Neonatal thyroid function tests and birth weight of the newborn infants were also assessed.
RESULTS: There was no significant difference of maternal age between HT and ET groups mean +/- SD (27.6 +/- 5.5 vs. 29.2 +/- 5.4 years). The NBW of the HT group was not significantly different from that of the ET group (2880 +/- 590 vs. 3019 +/- 426 g). However, the prevalence of infants with low birth weight (LBW) defined as NBW of lower than 2500 g in HT group was 22.9% which was significantly higher than the 9.8% in the ET group (P = 0.039, OR = 2.7, 95%CI = 1.1--7.1) and 9.7% of infants born to healthy mothers at Siriraj Hospital (control group) between 1991 and 1995 (P = 0.01, OR = 2.7, 95%CI = 1.3--6.1). The 90% CI for the true difference between the prevalence of LBW infants born to ET and HT mothers was 0.7--25.4. There was no significant difference in the prevalence of LBW infants in ET and control groups. Multiple logistic regression analyses showed that maternal hyperthyroidism during the third trimester of pregnancy was an independent factor associated with increased prevalence of LBW infants (P = 0.037, OR = 4.1, 95%CI = 1.1--15.0).
CONCLUSIONS: Maternal hyperthyroidism during the third trimester of pregnancy independently increases the risk of low birth weight by 4.1-fold. Appropriate management of hyperthyroidism throughout pregnancy is essential in the prevention of this undesirable neonatal outcome.
TL;DR: The Q-switched Nd:Y AG laser produced morphologic changes similar to, but lesser in degree, than those seen with both CO2 and Er:YAG laser resurfacing.
Abstract: Background. A variety of nonablative dermal remodeling techniques are currently available. The Q-switched Nd:YAG laser, in addition to its role in tattoo removal, hair removal, and vascular and pigmented lesion treatment, may also play a role in dermal remodeling for the treatment of wrinkles. The histologic changes seen in human skin after Q-switched Nd:YAG laser exposure have yet to be evaluated.
Objective. To study histologic changes after the use of a Q-switched Nd:YAG laser in the nonablative treatment of photoaged skin.
Methods. Sun-damaged infrauricular skin from six female subjects was exposed to a Q-switched Nd:YAG laser at fluences of 7 J/cm2 with two laser passes. Histologic examinations were performed before laser treatment and 3 months later.
Results. Biopsy specimens showed slight fibrosis in the superficial papillary dermis with unremarkable epidermal changes.
Conclusion. The Q-switched Nd:YAG laser produced morphologic changes similar to, but lesser in degree, than those seen with both CO2 and Er:YAG laser resurfacing.
TL;DR: This study was designed to cross-validate a composite measure of the pain scales CHEOPS, OPS, OPS (Objective Pain Scale, simplified for parent use by replacing blood pressure measurement with observation of body language or posture), TPPPS and FLACC in 167 Thai children aged 1-5.5 yr and recommendedCHEOPS as a valid, reliable and practical tool.
Abstract: This study was designed to cross-validate a composite measure of the pain scales CHEOPS (Children's Hospital of Eastern Ontario Pain Scale), OPS (Objective Pain Scale, simplified for parent use by replacing blood pressure measurement with observation of body language or posture), TPPPS (Toddler Preschool Postoperative Pain Scale) and FLACC (Face, Legs, Activity, Cry, Consolability) in 167 Thai children aged 1–5.5 yr. The pain scales were translated and tested for content, construct and concurrent validity, including inter-rater and intra-rater reliabilities. Discriminative validity in immediate and persistent pain for the age groups ≤3 and >3 yr were also studied. The children's behaviour was videotaped before and after surgery, before analgesia had been given in the post-anaesthesia care unit (PACU), and on the ward. Four observers then rated pain behaviour from rearranged videotapes. The decision to treat pain was based on routine practice and was made by a researcher unaware of the rating procedure. All tools had acceptable content validity and excellent inter-rater and intra-rater reliabilities (intraclass correlation >0.9 and >0.8 respectively). Construct validity was determined by the ability to differentiate the group with no pain before surgery and a high pain level after surgery, before analgesia (P
TL;DR: Comparison of the deduced amino acid sequence of the mature enzyme to other microbial chitinases shows a putative catalytic domain and a region with conserved amino acids similar to that of the type III module of fibronectin and a chit in-binding domain.
Abstract: The chitinase gene (chiA71) from Bacillus thuringiensis subsp. pakistani consists of an open reading frame of 1,905 nucleotides encoding 635 amino acid residues with an estimated molecular mass of 71 kDa. Comparison of the deduced amino acid sequence of the mature enzyme to other microbial chitinases shows a putative catalytic domain and a region with conserved amino acids similar to that of the type III module of fibronectin and a chitin-binding domain. By activity detection of chitinase on SDS-PAGE after renaturation, the molecular mass of protein bands with chitinase activity were 66, 60, 47, and 32 kDa. The N-terminal amino acid sequence of each chitinase activity band was the same (Asp-Ser-Pro-Lys-Gln), suggesting that the 60-, 47-, and 32-kDa chitinases were derived from the 66-kDa chitinase by processing step(s) at the C-terminus. The enzyme was identified as an exochitinase, since it generated N-acetylglucosamine from early stage of colloidal chitin hydrolysis. The crude protein (2.3-18.4 mg/ml), containing chitinase at final activities of 8, 16, 32, and 64 mU/ml, was toxic to Aedes aegypti larvae and caused mortalities of 7.5, 15.0, 51.3, and 70.0% respectively, but the same amount of crude protein from a B. thuringiensis subsp. pakistani mutant lacking chitinase was not toxic.
Journal Article•
TL;DR: The study examined patients who had symptoms indicating peptic ulcer and found that ulcers were absent in 48% or 12 cases, and blood chemistry and hematology of all 54 patients had no significant changes in hematological system, liver and renal functions both before and after treatment.
Abstract: The study examined patients who had symptoms indicating peptic ulcer. Forty-five patients, 24 males and 21 females, aged between 16-60 years were included in the study. Twenty-five patients, 18 males and 7 females, were endoscoped, their ulcers located in the duodenal bulb and gastric (angulus). The ulcer sizes varied between 0.5 to 1.5 cm in diameter. Capsule-filled turmeric was given orally in the dose of 2 capsules (300 mg each) five times daily, one half to an hour before meals, at 16.00 hours and at bedtime continuously. The result after 4 weeks of treatment showed that ulcers were absent in 48% or 12 cases (DU 9 and GU 3). Eighteen cases (DU 13 and GU 5) had absence of ulcer after 8 weeks of treatment. Nineteen cases (76%) (DU 14 and GU 5) did not have ulcers after 12 weeks of treatment. The rest, 20 cases were not found to have ulcers and some were not endoscoped. They appeared to have erosions, gastritis and dyspepsia. They received turmeric capsules for 4 weeks of treatment. The abdominal pain and discomfort satisfactorily subsided in the first and second week. They could take normal foods instead of soft meals. Blood chemistry and hematology of all 54 patients had no significant changes in hematological system, liver and renal functions both before and after treatment.
TL;DR: It is confirmed that two MRSA strains isolated from patients hospitalized between 1988 and 1999 in university hospitals in Thailand were heterogeneously resistant to vancomycin and were one of the common types of MRSA isolated in the hospital.
Abstract: To investigate whether there are methicillin-resistant Staphylococcus aureus (MRSA) strains with reduced susceptibility to vancomycin in Thailand, a total of 155 MRSA strains isolated from patients hospitalized between 1988 and 1999 in university hospitals in Thailand were tested for glycopeptide susceptibility. All the strains were classified as susceptible to vancomycin and teicoplanin when judged by NCCLS criteria for glycopeptide susceptibility using the agar dilution MIC determination. Vancomycin MICs at which 50 and 90% of the isolates tested were inhibited (MIC50 and MIC(90), respectively) were 0.5 and 1 microg/ml, respectively, with a range of 0.25 to 2 microg/ml. For teicoplanin, MIC50 and MIC90 were 2 microg/ml, with a range of 0.5 to 4 microg/ml. However, one-point population analysis identified three MRSA strains, MR135, MR187, and MR209, which contained subpopulations of cells that could grow in 4 microg of vancomycin per ml. The proportions of the subpopulations were 2 x 10(-4), 1.5 x 10(-6), and 4 x 10(-7), respectively. The subsequent performance of a complete population analysis and testing for the emergence of mutants with reduced susceptibility to vancomycin (MIC > or = 8 microg/ml) confirmed that these strains were heterogeneously resistant to vancomycin. Two of these strains caused infection that was refractory to vancomycin therapy. Pulsed-field gel electrophoresis showed that the two strains had identical SmaI macrorestriction patterns and that they were one of the common types of MRSA isolated in the hospital. This is the first report of heterogeneous resistance to vancomycin in Thailand and an early warning for the possible emergence of vancomycin resistance in S. aureus in Southeast Asia.
TL;DR: It is revealed that positive natural selection is an important factor in the maintenance of genetic diversity for AMA-1 and intragenic recombination is important in the generation of the AMA- 1 allelic diversity.
TL;DR: The results showed that spherical micro Capsules were obtained for all conditions except for 30 min of hardening time, which did not result in microcapsules.
Abstract: Microcapsules of vitamin A palmitate were prepared by gelatin-acacia complex coacervation The effects of colloid mixing ratio, core-to-wall ratio, hardening agent, concentration of core solution, and drying method on the coacervation process and the properties of the microcapsules were investigated The microcapsules of vitamin A palmitate were prepared using different weight ratios of gelatin and acacia, that is, 2:3, 1:1, and 3:2 under controlled conditions The other factors studied were 1:1, 1:2, and 1:3 core-to-wall ratios; 30, 60, and 120 min of hardening time; 2, 5, and 10 ml of formaldehyde per 280 g of coacervation system as a hardening agent; and 30%, 40%, and 50% w/w vitamin A palmitate in corn oil as a core material The drying methods used were air drying, hot air at 40 degrees C, and freeze-drying The results showed that spherical microcapsules were obtainedfor all conditions except for 30 min of hardening time, which did not result in microcapsules The optimum conditions for free-flowing microcapsules with a high percentage of entrapped drug were 1:1 gelatin-to-acacia ratio and 1:2 core-to-wall ratio when hardening with 2 ml formaldehyde for 60 min and using 40% w/w vitamin A palmitate in corn oil as the core concentration In addition, drying the microcapsules by freeze-drying provided microcapsules with excellent appearance
TL;DR: The conclusion drawn from this experiment was that epoxy resin root canal sealer was found to be more adaptable to the root canal wall and filling material than a calcium hydroxide sealer when bacterial coronal leakage was studied.