Allergen sensitization to aeroallergens including Blomia tropicalis among adult and childhood asthmatics in Thailand.

To study prevalence of allergen sensitization among asthmatics in Thailand, skin prick tests (SPT) were performed in 84 pediatric, 71 adult asthmatics and 71 adult volunteers. Allergen extracts used for testing included common allergens in Thailand and in Singapore. The incidence of positive SPT to any allergen among the three groups (childhood, adult patients and adult controls) were 64.3%, 43.7% and 35.2%, respectively. Dermatophagoides were the most common allergens sensitized by both pediatric (58.3%) and adult asthmatics (40.8%). Twenty-four children (28.6%) and 8 adult patients (11.3%) were sensitized to storage mites (Blomia tropicalis and/or Austroglyciphagus malaysiensis). All patients sensitized to Blomia tropicalis were sensitized to Dermatophagoides. Twenty-seven percent and 15.5% of childhood and adult asthmatics were sensitized to cockroach allergens. The rates of sensitization to oil palm pollen in childhood and adult asthmatics were 8.3% and 5.6%, respectively. Sensitization to other pollens and spores were less than 5%. This study confirms the importance of Dermatophagoides among Thai asthmatics.

Differential cell analysis in bronchoalveolar lavage from various pulmonary diseases.

To obtain characteristics of cellular responses of the lung to various disease processes, we analyzed the cells in bronchoalveolar lavage fluid retrieved from various lung lesions. Patients affected with five groups of pulmonary diseases were included in this study. These were pulmonary tuberculosis (21), malignancy (7), interstitial lung disease (11), bacterial pneumonia (10), and invasive fungal infection (7). Diagnoses were made from histopathological or microbiological evidence and were followed by compatible clinical courses. We compared total cell counts, alveolar macrophages, neutrophils, and lymphocytes in both percentages and absolute numbers to the values in the normal population reported in previous studies. Comparisons within each disease were also made. Compared to the normal population reported in previous increased percentages of neutrophils and lymphocytes in nearly all groups. However, if the comparison was made among the five groups, only the bacterial pneumonia had a significantly higher total cell count, absolute count and percentage of neutrophils. A value of more than 50% neutrophils gave sensitivity and specificity as 80% and 89%, respectively, in differentiatind bacterial pneumonia from other diseases. No parameter was demonstrated as useful in distinguishing between nonbacterial conditions. In conclusion, increases in the percentage of neutrophils and lymphocytes were discovered in nearly all pulmonary diseases. The markedly increased percentage of neutrophils in bacterial pneumonia may be useful as adjunctive evidence in the diagnostic process in some special conditions.

Respiratory centre sensitivity and exercise tolerance in healthy Thais and in Thai COPD patients.

This study was conducted with the aim of determining the range of normal value of respiratory centre sensitivity and exercise tolerance in healthy Thais and any divergence from the normal range in those with COPD. Findings in healthy subjects disclosed that the end-tidal PCO2 and tidal volume response to CO2 were higher and exercise tolerance was lower among the elderly compared with younger subjects; only in young males was the ventilatory response to CO2 higher than in females. In the group of Thai COPD patients, all data were comparable to those of the match healthy subjects, with the exception that one-third of the patients experienced stronger ventilatory drive while breathing room air and a lower musculo-ventilation transfer index during room-air breathing as well as CO2 rebreathing.

Comparison of fenoterol, ipratropium bromide and their combination in asthma.

The present study was designed to determine the extent of additivity of response to combination therapy of ipratropium bromide (I) (40 meg; 2 puffs) and fenoterol hydrochloride (F) (100 ug; 2 puffs) in 16 adults asthmatic patients who are responsive to I. The study design was a randomized, double-blind cross-over trial. The trial was a double blind cross over deign employing placebo, I, F and combination. All test medications significantly improved both FEV1 and FVC than placebo. Analysis of improvements in pulmonary function tests using area under the curve estimations suggested that the order of the test medications by the patients and the physicians showed the significantly better ratings of the combination than all other test medications (p < 0.05). No significant changes in pulse rate, blood pressure and electrocardiogram were observer in all treatment groups. No side effects were reported by all patients during the whole trial period.

Lung cancer at Siriraj Hospital, Bangkok, 1974-1983.

This report is based on a retrospective analysis of 1,078 lung cancer patients treated at Siriraj Hospital during 1974-1983. Of the 565 histologically proven patients, 79.17 percent were men (M:F = 3.8:1). The sex ratio was conspicouous (M:F = 10.5:1) in cases with small-cell type. The highest tumor frequency for both sexes was in the age groups 51-60 years (35.93%) and 61-70 years (30.80%) respectively. The youngest patient was an 18 year-old girl with adenocarcinoma, and the oldest was an 82-year-old man with squamous-cell carcinoma. There was no statistical difference between the mean age of patients with various cell types. Adenocarcinoma was highly prevalent (32.39%) in the present series. Second and third in frequency were squamous-cell carcinoma (29.20%) and undifferentiated cell carcinoma (13.45%). The incidence of small-cell carcinoma was 8.14 percent, large-cell type was seen in one instance (0.17%); 7.08 percent remained unclassified. A history of cigarette smoking was noted in 86.73 percent. Among the 13.27 percent who were non-smokers, adenocarcinoma comprised the highest rate (30.77%) as compared to other cell types. Specific treatment was instituted in 63.81 percent of the cases, via: surgery 10.84 percent, radiotherapy 23.64 percent, chomothorapy 21.69 percent, and combined treatments 22.12 percent. Data on results of treatment were not available owing to the lack of follow-up records.