Effectiveness of a back care pillow as an adjuvant physical therapy for chronic non-specific low back pain treatment: a randomized controlled trial

[Purpose] The aim of this study was to investigate the effect of a back care pillow (BCP) on pain, lumbar range of motion (LROM) and functional disability of patients with chronic non-specific low back pain (LBP). [Subjects and Methods] Fifty-two subjects who were aged between 20–69 years old, who presented with LBP of more than 3 months duration with a numerical rating scale (NRS) value of at least 4 were randomly assigned to treatment (BCP) and control (CON) groups. Participants in each group received six sessions of the 30 minutes treatment for two weeks. The BCP group was asked to wear the BCP during the daytime during the study period. Pain, lumbar ROM and functional disability were assessed before and after the 2-week treatment, and at the end of a 12-week follow up. [Results] After the 2-week treatment and 12-week follow up, all outcomes had improved in both groups; the BCP group had maintained the decrease in pain intensity and improved lumbar ROM in the extension position after the 12-week follow up, and showed better improvements in all outcomes at 2 weeks and after the 12-week follow up. [Conclusion] BCP combined with physical therapy had better pain, lumbar ROM and functional disability outcomes than physical therapy alone.Key words: Lower back support, Chronic low back pain, Numerical rating scale     

The platelet amyloid precursor protein ratio as a diagnostic marker for Alzheimer’s disease in Thai patients

The platelet amyloid precursor protein (APP) ratio has recently been shown to be a promising diagnostic marker for Alzheimer’s disease (AD). To evaluate its usefulness in Thai patients, platelet APP was analyzed by immunoblotting. The APP ratio was calculated as the ratio of the combined band density of the 120-kD and 130-kD isoforms compared to that of the 110-kD isoform. The mean ages (and ranges) of 27 normal and 13 AD-affected subjects were 68.3 (60–84) and 79.3 (70–97) years, respectively. The Thai Mental State Examination (TMSE) scores demonstrated that the AD patients had significantly poorer cognitive functions than the normal subjects, with mean TMSE scores of 20.3 and 27.6 (maximum score of 30 points), respectively (p < 0.05). The platelet APP ratios of the AD patients were significantly lower than those of normal subjects: values (mean ± standard deviation) were 7.32 ± 1.29 and 9.13 ± 3.00, respectively (p < 0.05) for AD patients and normal subjects. However, the ranges of the APP ratios from both groups markedly overlapped, which precluded the establishment of a cutoff level to differentiate between the AD and normal subjects. In addition, no significant correlations were observed between the platelet APP ratio and the TMSE score or between the APP ratio and the serum cholesterol in this study, in contrast to previous reports.     

A Peptide Inhibitor Derived from the Conserved Ectodomain Region of DENV Membrane (M) Protein with Activity Against Dengue Virus Infection

Dengue virus (DENV) infection is a public health problem worldwide; thus, the development of a vaccine and anti‐DENV drugs is urgently needed. It has been observed that low levels of viremia in DENV‐infected individuals are associated with mild disease outcomes; therefore, reduction of DENV load should offer therapeutic benefits. Disruption of protein–protein interactions on the surface of DENV by a peptide that mimics part of its structural protein may affect stability of the virion structure and inhibit viral entry into host cells. To test this hypothesis, we generated a novel peptide inhibitor that mimics the conserved ectodomain region of DENV membrane (M) protein, MLH40 peptide, for DENV inhibition assays. MLH40 inhibited all four serotypes of the virus (DENV1–4) at half maximal inhibition concentration of 24–31 μm . MLH40 at 100 μm blocked DENV2 attachment to cells by 80%. The inhibitory activity of MLH40 against DENV was consistently observed with different cell types, including Vero, A549, and Huh7 cells. Prediction of MLH40 binding by a molecular docking program indicated that its N‐terminal loop may interact with DENV envelope (E) proteins and alter their dimer conformation. Thus, MLH40 may serve as a lead‐peptide inhibitor for the development of an anti‐DENV drug.     

The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Validation Study of the Thai Version

The objective of this study was to assess the psychometric properties of the Thai version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) version 3.0. The questionnaire was completed by 310 cancer patients during their follow-up at 2 teaching hospital oncology clinics. About 70% of participants had advanced stage of cancer and 72% had been receiving chemotherapy. Cronbach’s α coefficients of the six scales were above 0.7, except for cognitive and social function scales. All test–retest reliability coefficients were high. Multitrait scaling analysis showed that all item-scale correlation coefficients met the standards of convergent and discriminant validity. Most scales and items could discriminate between subgroups of patients with different clinical status assessed with the Eastern Cooperative Oncology Group (ECOG) scale. The results suggested that the EORTC QLQ-C30 and the Functional Assessment of Cancer Therapy – General (FACT-G) measured different aspects of quality of life and should be independently used. Testing psychometric properties of the EORTC QLQ-C30 in heterogeneous diagnostic group yield similar results as found in homogeneous group. These results support that the EORTC QLQ-C30 (version 3.0) has proven to be a reliable and valid measure of the quality of life in Thai patients with various types of cancer.     

Production of a monoclonal antibody against a yeast secreted antigen of Penicillium marneffei

Monoclonal antibody against P. mameffei yeast secreted antigen was produced in order to develop a serological test for penicilliosis marneffei. The yeast form of P. marneffei was cultured in brain heart infusion broth at 37 degrees C for 7 days. A secreted antigen was prepared, partially purified from culture supernatant and subsequently immunized in a BALB/c mouse. Mouse monoclonal antibody was produced from immune spleen cells by a standard hybridoma technique. Specificity of the obtained monoclonal antibody was assessed with yeast secreted antigens for P. mameffei, C. alblicans, C. neoformans, and H. capsulatum by an indirect ELISA. Three of 46 hybrid clones (1 F1, 2G5, and 3G4) reacted positively with P mameffei secreted antigen. 1 F1 and 3G4 were cloned by two rounds of limiting dilution. Partially purified monoclonal antibody and rabbit polyclonal antibody against P. marneffei yeast secreted antigen were used to develop a double antibody sandwich ELISA to detect P. marneffei antigen in plasma or serum samples of 7 patients with penicilliosis marneffei and 5 healthy controls. The sandwich ELISA developed using monoclonal antibody as a capture antibody and rabbit polyclonal antibody as a detector was able to detect P. marneffei antigen in all the plasma and serum samples of penicilliosis marneffei patients, while negative in all the healthy controls. Thus, the monoclonal antibody produced in the present study appeared to be highly specific for P. marneffei and the double antibody sandwich ELISA developed using monoclonal and polyclonal antibodies against the yeast secreted antigen of P. marneffei showed a strong potential for the diagnosis of penicilliosis marneffei.     

Effectiveness of traditional Thai massage versus Swedish massage among patients with back pain associated with myofascial trigger points

The aim of this study was to verify the effectiveness of traditional Thai massage (TTM) among patients with back pain associated with myofascial trigger points (MTrPs). Swedish massage (SM) was selected as the treatment for the comparison group. One hundred and eighty patients were randomly allocated to receive either TTM or SM for 6 sessions during a 3–4 week period, with follow-up 1 month later. Results indicated that pain intensity, assessed using the visual analog scale (VAS), among patients in both groups was reduced by more than half after 3 weeks of treatment and for up to one month afterwards (P<0.05) with no significant difference in VAS between the groups. Similar improvements were found for most other outcome measures. We conclude that TTM and SM are effective in reducing back pain among patients with MTrPs. We therefore suggest that massage therapy, and in particular Thai massage, be considered as an alternative primary health care treatment for this disorder.     

Anti-cancer and anti-angiogenic effects of curcumin and tetrahydrocurcumin on implanted hepatocellular carcinoma in nude mice

AIM： To determine the effect of tetrahydrocurcumin （THC） on tumor angiogenesis compared with curcumin （CUR） by using both in vitro and in vivo models of human hepatocellular carcinoma cell line （HepG2）. METHODS： The 3-（4,5-dimethylthiazol-2-yl）-2, 5-diphenyl-tetrazolium bromide （MTT） assay was used for testing the anti-proliferating activities of CUR and THC. In male BALB/c nude mice, 2 ×10^6 human HepG2 cells were inoculated onto a dorsal skin-fold chamber. One day after HepG2 inoculation, the experimental groups were fed oral daily with CUR or THC （300 mg/kg or 3000 mg/kg）. On d 7, 14 and 21, the tumor microvasculature was observed using fluorescence videomicroscopy and capillary vascularity （CV） was measured. RESULTS： Pathological angiogenic features including microvascular dilatation, tortuosity, and hyper-permeability were observed. CUR and THC could attenuate these pathologic features. In HepG2-groups, the CV were significantly increased on d 7 （52.43%）, 14 （69.17%）, and 21 （74.08%）, as compared to controls （33.04%,P 〈 0.001）. Treatment with CUR and THC resulted in significant decrease in the CV （P 〈 0.005 and P 〈 0.001, respectively）. In particular, the anti-angiogenic effects of CUR and THC were dose-dependent manner. However, the beneficial effect of THC treatment than CUR was observed, in particular, from the 21 d CV （44.96% and 52.86%, P 〈 0.05）.CONCLUSION： THC expressed its anti-angiogenesis without any cytotoxic activities to HepG2 cells even at the highest doses. It is suggested that anti-angiogenic properties of CUR and THC represent a common potential mechanism for their anti-cancer actions.     

The Effects of Thoracic Manipulation Versus Mobilization for Chronic Neck Pain: a Randomized Controlled Trial Pilot Study

[Purpose] To investigate effects of thoracic manipulation versus mobilization on chronic neck pain. [Methods] Thirty-nine chronic neck pain subjects were randomly assigned to single level thoracic manipulation, single level thoracic mobilization, or a control group. The cervical range of motion (CROM) and pain ratings (using a visual analog scale: VAS) were measured before, immediately after and at a 24-hour follow-up. [Results] Thoracic manipulation significantly decreased VAS pain ratings and increased CROM in all directions in immediate and 24-hour follow-ups. The thoracic mobilization group significantly increased in CROM in most directions at immediate follow-up and right and left rotational directions at the 24-hour follow-up. Comparisons between groups revealed the CROM for the manipulation group to increase significantly more than for control subjects in most directions at immediate follow-up and flexion, left lateral flexion and left rotation at the 24-hour follow-up. The CROM for the thoracic mobilization group significantly increased in comparison to the control group in flexion at immediate follow-up and in flexion and left rotation at the 24-hour follow-up. [Conclusion] The study demonstrated reductions in VAS pain ratings and increases in CROM at immediate and 24-hour follow-ups from both single level thoracic spine manipulation and thoracic mobilization in chronic neck pain.Key words: Single level thoracic manipulation, Single level thoracic mobilization, Chronic neck pain     

A reduced curcuminoid analog as a novel inducer of fetal hemoglobin

Thalassemia is an inherited disorder of hemoglobin molecules that is characterized by an imbalance of α- and β-globin chain synthesis. Accumulation of unbound α-globin chains in erythroid cells is the major cause of pathology in β-thalassemia. Stimulation of γ-globin production can ameliorate disease severity as it combines with the α-globin to form fetal hemoglobin. We examined γ-globin-inducing effect of curcuminoids extracted from Curcuma longa L. and their metabolite reduced forms in erythroid leukemia K562 and human primary erythroid precursor cells. The results showed that curcuminoid compounds, especially bisdemethoxycurcumin are potential γ-globin enhancers. We also demonstrated that its reduced analog, hexahydrobisdemethoxycurcumin (HHBDMC), is most effective and leads to induction of γ-globin mRNA and HbF in primary erythroid precursor cells for 3.6?±?0.4- and 2.0?±?0.4-folds, respectively. This suggested that HHBDMC is the potential agent to be developed as a new therapeutic drug for β-thalassemia and related β-hemoglobinopathies.