Tetrodotoxin poisoning following ingestion of the toxic eggs of the horseshoe crab Carcinoscorpius rotundicauda, a case series from 1994 through 2006

Between 1994 and 2006, a total of 280 cases of varying degrees of tetrodotoxin poisoning following ingestion of the toxic eggs of the horseshoe crab, Carcinoscorpius rotundicauda, were admitted to the medical service of Chon Buri Hospital. The severity of the poisoning was classified into four stages based on clinical signs and symptoms of human tetrodotoxication. Of 245 available medical records; 100 were in stage 1, 74 were in stage 2, 3 were in stage 3 and 68 were in stage 4. The frequencies of symptoms and signs included the following : circumoral and lingual numbness (98%), hands and feet numbness (94.7%), weakness (59.6%), dizziness and vertigo (54.3%), nausea and vomiting (52.6%), transient hypertension (39.6%), respiratory paralysis (27.7%), fixed dilated pupils (14.7%), ophthalmoplegia (12.2%), blood pressure lower than 90/60 mmHg (5.7%), and polyuria (0.4%). All patients received symptomatic and supportive treatment. Endotracheal intubation and mechanical ventilation were considered when paralysis was progressing rapidly. The results of treatment are as follows: 239 patients (97.5%) showed complete recovery, 5 patients (2%) died, and 1 patient (0.4%) suffered anoxic brain damage. Horseshoe crab poisoning occurs both sporadically and epidemically in Chon Buri. Seasonal variation in the number of cases of poisoning was observed with a peak from December through March.     

In silico and in vitro design of cordycepin encapsulation in liposomes for colon cancer treatment

Cordycepin or 3′-deoxyadenosine is an interesting anti-cancer drug candidate that is found in abundance in the fungus Cordyceps militaris. It inhibits cellular growth of many cancers including lung carcinoma, melanoma, bladder cancer, and colon cancer by inducing apoptosis, anti-proliferation, anti-metastasis and by arresting the cell cycle. Cordycepin has, however, poor stability and low solubility in water, resulting in loss of its bioactivity. Liposomes can be used to overcome these obstacles. Our aim is to improve cordycepin''s anti-colon cancer activity by liposome encapsulation. Cordycepin-encapsulated liposomes were designed and fabricated based on a combination of theoretical and experimental studies. Molecular dynamics (MD) simulations and free energy calculations suggest that phosphatidylcholine (PC) lipid environment is favorable for cordycepin adsorption. Cordycepin passively permeates into PC lipid bilayers without membrane damage and strongly binds to the lipids'' polar groups by flipping its deoxyribose sugar toward the bilayer center. Our fabricated liposomes containing 10 : 1 molar ratio of egg yolk PC : cholesterol showed encapsulation efficiency (%EE) of 99% using microfluidic hydrodynamic focusing (MHF) methods. In our in vitro study using the HT-29 colon cancer cell line, cordycepin was able to inhibit growth by induction of apoptosis. Cell viability was significantly decreased below 50% at 125 μg mL⁻¹ dosage after 48 h treatment with non-encapsulated and encapsulated cordycepin. Importantly, encapsulation provided (1) a 2-fold improvement in the inhibition of cancer cell growth at 125 μg mL⁻¹ dosage and (2) 4-fold increase in release time. These in silico and in vitro studies indicate that cordycepin-encapsulated liposomes could be a potent drug candidate for colon cancer therapy.

Cordycepin-encapsulated liposomes could be a potent drug candidate for cancer therapy.     

Relationship between male hydrocele and infection prevalences in clustered communities with uncertain transmission of Wuchereria bancrofti on the Thailand-Myanmar border

A cross-sectional community-based study was conducted in three clustered communities, belonging to a single small village in Mae Chan subdistrict, Umphang district, Tak Province, close to the Thailand-Myanmar border, where regular night blood survey have been discontinued since 1997 and no epidemiological study had been conducted. In order to understand prevalences of distribution of male hydrocele and infection in clinically diagnostic and epidemiologic implications in uncertain transmission of Wuchereria bancrofti, we analyzed the relationship between male hydrocele and community infection prevalences in 219 (90.5% coverage) subjects aged > or =1 year old, including 54.8% migratory and 45.2% local Karen inhabitants. Migratory inhabitants tended to have high prevalence of antigenemia (p < 0.05) and hydrocele. Overall rates of 23.7% antigenemia, 3.7% microfilaremia, and 4.6% male hydrocele were observed. Male hydrocele prevalence was significantly correlated (r = 0.348, p < 0.0001) with antigenemia prevalence, but not with microfilaremia prevalence (r = 0.065, p = 0.493). However, high antigenemia prevalence in local inhabitants was evident, particularly antigenemia prevalence in children suggesting that transmission in the village may have occurred in recent years.     

Bottle and biochemical assays on temephos resistance in Aedes aegypti in Thailand

The bottle bioassay measuring the time-mortality rate is a simplified procedure for detecting insecticide resistance. It can be used with a biochemical microplate assay to identify the mechanism involved. This integrated approach was used to detect temephos resistance in Aedes aegypti from Nonthaburi (lowest use) and Roi Et (highest use). Ae. aegypti BKK1 laboratory strain was used as the susceptible reference strain. The appropriate concentration of insecticide for bottle bioassay was determined empirically for Ae. aegypti BKK1 strain and found to be in the range of 800-1,050 microg/bottle. The time-mortality rate at 800 microg/bottle was 170 +/- 8.66 minutes, significantly different from the time-mortality rates in the 850, 900, 950, and 1,050 microg/bottle (p = 0.008) concentrations, which were 135 +/- 15.00, 140 +/- 8.66, 135 +/- 15.00, and 125 +/- 8.66 minutes, respectively. The cut-off concentration selected for resistance detection was 850 microg/bottle. The time-mortality rate for the Roi Et strain was 382 +/- 26.41 minutes, significantly higher than the Nonthaburi (150 +/- 25.10 minutes) and BKK1 strains (145 +/- 20.49 minutes) (p < 0.001). The temephos resistance ratio (RR100) for the Ae. aegypti Roi Et strain was 2.64-fold higher at lethal time (LT100) than for the reference Ae. aegypti BKK1 strain. The mean optical density (OD) value from the biochemical microplate assay for the non-specific esterase of the Roi Et strain was higher than the mean OD for the non-specific esterase of both the Nonthaburi and BKK1 strains. Insensitive acetylcholinesterase was not found to be responsible for the resistance in the field-collected mosquitos. This study suggests that esterase detoxification is the primary cause of resistance in the Ae. aegypti population from Roi Et. Both the bottle bioassay and the biochemical microplate assay were proven to be promising tools for initial detection and field surveillance for temephos resistance.     

Evaluation of a practical method to assess antiretroviral adherence in HIV-infected Thai children

The objective of this study was to evaluate a practical method to assess adherence to antiretroviral therapy by observing virological and immunological responses. We conducted a 12-month longitudinal cohort study of 162 HIV-infected Thai children. Adherence was assessed using 5 methods (self reporting calendar, records of missed doses, pill counts, physician assessment, and an interview questionnaire). CD4 count, percentage and viral load were performed at baseline and at 12 months. Mean adherence rates at 2, 6, and 12 months were 98, 100, and 99% by the calendar method; 98, 100, and 100% by recording missed doses; 96, 96, and 92% by pill count; and 90, 94, and 97% by physician assessment. Poor agreement (kappa < or = 0.1) was found among the methods. There was a statistically significant difference (p = 0.05) in virological response between participants with > or = 95% adherence (0.8 log10) and those with < 95% adherence (0.2 log10) when pill counts were used to assess adherence. In conclusion, despite poor agreement among these tools, a pill count appeared to be the only practical, validated method to differentiate the virological outcome between those who were fully and partially adhere to the treatment regimen.