Alcohol and alkalosis enhance excystation of Opisthorchis viverrini metacercariae

The northeastern region of Thailand has long been known as an endemic area of the human liver fluke infection which is caused by Opisthorchis viverrini. Humans are infected by ingestion of uncooked cyprinoid fish in traditional dishes such as “koi-pla,” “pla-som,” “pla-jom,” and “pla-ra.” To date, the prevalence of this parasite infection remains high because of cultural behavior and local beliefs. The popular misunderstanding among people in this area is that alcohol, lemon juice, and fish sauce can kill the parasites. Thus, they believe that they can eat raw fish without the risk of infection. This study attempts to clarify the effects of ethyl alcohol and acidosis–alkalosis on O. viverrini metacercariae excystation. Metacercariae of O. viverrini were obtained from infected cyprinoid fish in a natural reservoir. Most metacercariae were obtained from small cyprinoid fish. Metacercariae were divided into three experimental groups and were treated with solutions containing four different concentrations of ethyl alcohol, four different concentrations of salt, and a range of acidic/basic pH. Metacercariae excystation was observed at the assigned times, and the data were then analyzed. Salt had no effect on excystation. Interestingly, the optimal conditions for O. viverrini excystation were pH 9 and 25 % ethyl alcohol. The present study suggests that raw fish should not be eaten while drinking alcohol or when consuming other ingredients with pH 9, because both alcohol and pH 9 could induce O. viverrini metacercariae excystation, leading to the early development of parasites in the hepatobiliary system.     

The effects of GnRH antagonist on the endometrium of normally menstruating women

Purpose

To study the effects of GnRH antagonist (ganirelix-Orgalutran®) on the endometrium of regularly menstruating women.

Materials and methods

Prospective, self-controlled study. The thirty-five volunteers were studied for two cycles: one as a control and the other, GnRH antagonist-treated cycles in which ganirelix 0.25 mg/d was given daily for 3 days, starting when the largest follicle reached 15 mm. In both cycles, serum estradiol, LH and endometrial thickness were measured when the largest follicle was ≥18 mm. Endometrial biopsy was performed on day 6 after ovulation for histological dating and morphometric study.

Results

No statistical differences between histological dating and the endometrial thickness in the control and GnRH antagonist-treated cycles. All morphometric parameters were also not different. Serum estradiol and LH levels were significantly lower in GnRH antagonist-treated cycles.

Conclusion

GnRH antagonist has no effect on the endometrium of regularly menstruating women as assessed by either histological dating or morphometric analysis.

     

Repeated infection with Opisthorchis viverrini induces accumulation of 8-nitroguanine and 8-oxo-7,8-dihydro-2'-deoxyguanine in the bile duct of hamsters via inducible nitric oxide synthase

Chronic inflammation induced by repeated infection with Opisthorchis viverrini has been postulated to be a risk factor for cholangiocarcinoma. To clarify the mechanism of carcinogenesis induced by repeated O.viverrini infection, we investigated the timecourse of 8-nitroguanine and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) formation, inducible nitric oxide synthase (iNOS) expression, nitric oxide production and pathological features in hamsters with two (2-IF) or three (3-IF) O.viverrini infections. Inflammatory cell infiltration triggered by repeated infection (3-IF > 2-IF > 1-IF) was earlier than by single infection (1-IF). HPLC coupled with an electrochemical detector revealed that 8-oxodG level in the liver was the highest on day 3 in 3-IF and day 7 in 2-IF, earlier than that on day 21 in 1-IF. Notably, a double immunofluorescence study revealed that formation of 8-nitroguanine and 8-oxodG appeared to increase in the epithelium of bile ducts in the order 3-IF > 2-IF > 1-IF after the decrease in inflammatory cells. This may be explained by the fact that repeated infection increased iNOS expression in the epithelium of bile ducts in the order 3-IF > 2-IF > 1-IF on day 90. Proliferating cell nuclear antigen accumulated in the epithelium of bile ducts on day 90 after repeated O.viverrini infection, supporting the hypothesis that cell proliferation was promoted by inflammation-mediated DNA damage. In conclusion, more frequent O.viverrini infection can induce the expression of iNOS not only in inflammatory cells but also in the epithelium of bile ducts and subsequently cause nitrosative and oxidative damage to nucleic acids, which may participate in the initiation and/or promotion steps of cholangiocarcinoma development.     

Results of direct current electrical activation of failed-to-fertilize oocytes after intracytoplasmic sperm injection

OBJECTIVE: To assess the embryo formation rate after electrical activation on failed-to-fertilize oocytes after intracytoplasmic sperm injection (ICSI). STUDY DESIGN: A prospective, randomized, experimental study was conducted in our research laboratory at the Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, between January and September 2004. One hundred failed-to-fertilize oocytes after ICSI were randomly assigned by stratified allocation according to oocyte grading before ICSI. Fifty unfertilized oocytes were activated with 3 consecutive 40-/microsec pulses of 1.5 kV/cm direct electrical current in buffer solution. The other 50 unfertilized oocytes, composing the control group, were treated in same way but without electrical activation. The embryo formation rates between the groups were compared. RESULTS: Embryo formation rates in the electrically activated group were 80% as compared with 16% in the control group (p < 0.001). CONCLUSION: Failed-to-fertilize oocytes after ICSI seem to be able to resume embryonic development after electrical activation.     

A Study Failing to Determine Significant Benefits from Assisted Hatching: Patients Selected for Advanced Age, Zonal Thickness of Embryos, and Previous Failed Attempts

Purpose: Pregnancy and implantation rates after mechanical assisted hatching (AH) in patients aged 38 years, with embryos 15 m in zonal thickness and two or more failed attempts, were assessed at two infertility centers using fresh and frozen embryo transfer (FET) cycles. Methods: AH was performed on 3-day-old embryos. Spare embryos cryopreserved at the two-pronucleus stage were subjected to AH after 2 days of culture and transferred to artificially prepared uteri. Results: In fresh cycles, no significant differences in pregnancy rates (clinical and ongoing) and implantation rates were observed between the AH and the controls for all three selected patient groups (Centers 1 and 2). In FET cycles, AH tended to give poor results for 38 year olds (clinical pregnancy rates of 0 and 5.0% with AH vs 13.3 and 16.7% for controls at Centers 1 and 2, respectively). With AH, embryos with thick zonae implanted to the same extent as those in the control group and achieved pregnancies for patients with multiple failures (four to six attempts for some) in both fresh and FET cycles. Conclusions: AH failed to show significant benefits in all three patient groups. A larger study group may confirm the effects of AH on frozen/thawed embryos and outcomes for multiple failure cases.     

Recurrent isosporiasis over a decade in an immunocompetent host successfully treated with pyrimethamine

Recurrent isosporiasis in an immunocompetent host is reported. The patient suffered from chronic intermittent diarrhea for over a decade. Multiple short-term administrations of trimethoprim-sulfamethoxazole followed by pyrimethamine, or albendazole combined with tinidazole could not control the relapses. However, treatment with pyrimethamine, 25 mg/d for 20 weeks, was successful.     

Dietary and socio-economic factors associated with beriberi in breastfed Lao infants

A case-control study was conducted to investigate the dietary and socio-economic factors associated with beriberi in infants attending three public hospitals in Vientiane, Lao PDR. Forty-three breast-feeding infants with a median (range) age of 3 (1-9) months were admitted with beriberi. This was defined as the presence of signs of congestive heart failure or shock in the absence of fever or other signs of sepsis, hypovolaemia or cardiac abnormalities, with rapid clinical improvement following parenteral thiamine. Subjects were matched by age and diet to 43 breast-feeding healthy control infants. Compared with control mothers, mothers of infants with beriberi had significantly less diet diversity (p <0.001), soaked glutinous rice for significantly longer or were more likely to pour off excess water from non-glutinous rice (p =0.006), had fewer years of schooling (p <0.05), were more likely to report that income was inadequate for basic needs (p <0.001), to perform hard physical labour (p <0.01) and to be married to farmers (p <0.01). Clinically significant thiamine deficiency in breastfed infants in Lao relates to methods of preparing rice, the food selected by lactating mothers and the family's socio-economic status.     

Road traffic injuries in Thailand: trends,selected underlying determinants and status of intervention

Injuries and deaths from traffic crashes have become a major public health and socio-economic problem in Thailand. Injuries, fatalities and economic losses due to traffic crashes have increased with the rising level of motorization. This study analyzes hospital-based data compiled by the Ministry of Public Health, data compiled by the National Police Office and data compiled by the traffic engineering division of the Department of Highways, Ministry of Transport and Communications. Analysis reveals that 70% of the people injured or killed in traffic crashes are aged 10-39. Men are at four to five times higher risk of death and injury due to traffic crashes than women. The number and rate of traffic injury in Thailand swung from a record low during the economic recovery in the 1980's to record a high during the bubble economy, then declined with the economic crisis in 1997. The economic costs were estimated at U.S.$1.6 billion in 1995. An urban-rural difference in traffic injuries has been recorded with a higher rural case-fatality rate. A number of known behavioral risk factors have been identified, i.e., drunk driving, speeding, substance abuse and failure to use helmets and seat belts. However, determinants of behavior need further investigation. Hazardous road locations have also been mapped. Trends of traffic injuries seem to follow trends of economic growth. Without effective policy and implementation programs to control the determinants, it is expected that traffic injuries will increase as the country recovers from economic crisis. A major pitfall to many current government programs is that they incorporate no systematic evaluation. The fragmented structure of road safety authorities further complicates collaboration and coordination. A broad coalition of stakeholders is needed to catalyze policy action.     

Properties of experimental copper-aluminium-nickel alloys for dental post-and-core applications

PURPOSE

This study aimed to develop a copper-aluminium-nickel alloy which has properties comparable to that of dental alloys used for dental post and core applications with the reasonable cost.

MATERIALS AND METHODS

Sixteen groups of experimental copper alloys with variants of 3, 6, 9, 12 wt% Al and 0, 2, 4, 6 wt% Ni were prepared and casted. Their properties were tested and evaluated. The data of thermal, physical, and mechanical properties were analyzed using the two-way ANOVA and Tukey''s test (α=0.05). The alloy toxicity was evaluated according to the ISO standard.

RESULTS

The solidus and liquidus points of experimental alloys ranged from 1023℃ to 1113℃ and increased as the nickel content increased. The highest ultimate tensile strength (595.9 ± 14.2 MPa) was shown in the Cu-12Al-4Ni alloy. The tensile strength was increased as the both elements increased. Alloys with 3-6 wt% Al exhibited a small amount of 0.2% proof strength. Accordingly, the Cu-9Al-2Ni and Cu-9Al-4Ni alloys not only demonstrated an appropriate modulus of elasticity (113.9 ± 8.0 and 122.8 ± 11.3 GPa, respectively), but also had a value of 0.2% proof strength (190.8 ± 4.8 and 198.2 ± 3.4 MPa, respectively), which complied with the ISO standard requirement (>180 MPa). Alloys with the highest contents of nickel (6 wt% Ni) revealed a widespread decolourisation zone (5.0-5.9 mm), which correspondingly produced the largest cell response, equating positive control.

CONCLUSION

The copper alloys fused with 9 wt% Al and 2-4 wt% Ni can be considered for a potential use as dental post and core applications.     

A randomized trial of the canalith repositioning procedure

OBJECTIVE: To compare the effectiveness and complications of our adaptation of the canalith repositioning procedure (CRP) with the expectation treatment for benign paroxysmal positional vertigo. STUDY DESIGN: A randomized, controlled trial in the setting of a neurotological clinic in Thailand. METHODS: Fifty-eight patients with posterior benign paroxysmal positional vertigo were randomly assigned to treatment and control groups using a block of four. The treatment group was treated with the modified CRP technique until the nystagmus disappeared. A mastoid oscillator was not used, nor were any instructions given for patients after the maneuver. Both groups recorded the daily grading of symptoms and the amount of anti-vertiginous drugs (cinnarizine) taken. Objective and subjective assessments were made weekly until the nystagmus disappeared or until 4 weeks had passed since treatment began. RESULTS: The rates of effectiveness of CRP treatment and the control treatment for benign paroxysmal positional vertigo were 75.9% and 48.2%, respectively. There was a significant difference in the treatment outcomes of the CRP and control groups (P =.03). The CRP group used significantly fewer drugs than the control group (P =.001). Complications in the CRP group, such as lateral canalithiasis and fainting, were observed in 13.8% of the patients. CONCLUSIONS: The CRP was more effective than the expectation treatment for benign paroxysmal positional vertigo insofar as it provided faster recovery and required less dependence on medication. Complications of CRP were limited to 13.8% of patients.