Erythrocyte sedimentation rate and plasma viscosity in pulmonary tuberculosis.

Erythrocyte sedimentation rate (ESR) and plasma viscosity (PV) are non-specific indices for screening, diagnosis and follow up to some disease. This prospective study of ESR and PV reports on 21 patients of pulmonary tuberculosis and 45 healthy. The mean and standard deviation of ESR in diseases and healthy were 80.1+35.4 and 11+7 mm/hr compared with PV 2.07+0.17 and 1.69+0.07 mPaS. After three months of complete treatment of pulmonary tuberculosis in six patients, the ESR returned from 69.2+25.9 to 21.3+16.8 mm/hr, the PV returned from 2.08+0.22 to 1.75+0.15 mPaS. Both tests gave good result in supporting diagnosis and follow up, however the PV is probably superior to ESR because of better quality control and precision, longer plasma reservation in room temperature. It is recommended that PV may have a role in clinical practice as well as ESR.

Fusion protein of Salmonella typhi flagellin as antigen for diagnosis of typhoid fever.

We previously established the specific 52 kDa antigen of Salmonella typhi, detected by our monoclonal antibodies, which was a flagellin protein. Comparison of the nucleotide sequences of phase-1 flagellin of Salmonella species available through GenBank database showed high homology at both ends of the genes with lower degree of homology in the middle portion which contained the antigenically variable regions. Thus, proteins from the central regions of flagellin genes should be species specific and could be used as specific antigens for the immunodiagnostic tests. In this report, recombinant protein derived from the central region of S. typhi flagellin was produced as a fusion protein with glutathione-S-transferase. This fusion protein was used as specific S. typhi antigen for the immunodiagnostic test to detect IgM antibodies in sera using enzyme-linked immunosorbent assay. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of this test were 53.5, 98.0, 91.5, 82.1 and 92.4%, respectively.

Plasma viscosity in healthy Thais.

Plasma viscosity estimation is the test which reflects the progress of various certain diseases. This test is more sensitive and more reliable than the erythrocyte sedimentation rate. In this study, plasma viscosity was determined in 175 health subjects with the ages ranging from 15 to 70 years. Ninety-two subjects were males and 83 females. The normal range of plasma viscosity was 1.51-1.79 mPa.S at 25 oC (mean = 1.65 mPa.S). The mean values of plasma viscosity in male and female were 1.64 and 1.67 mPa.S respectively. There was no statistical significant difference in plasma viscosity among both sex.

Comparison of culture and latex agglutination in the diagnosis of bacterial meningitis.

This preliminary study compared culture and latex agglutination in the diagnosis of bacterial meningitis. Only 23.08 per cent of meningitis patients were bacterial meningitis by culture. The causative organisms detected by culture and latex agglutination respectively were as follows: Streptococcus pneumoniae 7.69, 5.77 per cent: Haemophilus influenzae 1.92, 1.92 per cent: Neisseria meningitidis 1.92, 5.77 per cent: Salmonella species 5.77 per cent, -: Viridans streptococci 1.92 per cent, - and Nonfermentative gram-negative rod 3.85 per cent -. There was no latex reagent for the latter three organisms.

Detection of Salmonella typhi protein antigen in serum and urine: a value for diagnosis of typhoid fever in an endemic area.

Using haemoculture as the gold standard, a double antibody sandwich ELISA for the detection of Salmonella typhi Barber protein antigen (BP) was compared with the Widal test. Specimens used were serum and urine obtained from normal healthy individuals and from patients with typhoid fever, paratyphoid fever, pyrexia caused by other bacteria and pyrexia with negative haemoculture. The ELISA for antigenuria gave a significantly higher sensitivity, specificity, accuracy and positive predictive value than the Widal test (p less than 0.05). The ELISA for antigenaemia gave a significantly higher sensitivity and positive predictive value only. All other values were not significantly different. The timing of specimen collection was critical for sensitivity in the ELISA for antigenaemia and antigenuria, and the best results could be obtained by carrying out both assays simultaneously. The clearance of BP from serum into urine occurred around 16 days after the onset of fever in one patient. In two patients, BP could be detected in sera up to 3 weeks after the onset of fever. In two patients, serum BP could still be detected although haemoculture was negative.

Systemic and intestinal immunities after different typhoid vaccinations.

The comparative studies of systemic and intestinal immunities to S. typhi were performed in 29 healthy volunteers during 2 years after receiving oral vaccination with attenuated S. typhi Ty21a in gelatin capsule, parenteral vaccination with acetone inactivated or heat inactivated-phenol preserved S. typhi Ty2. The methods used were immunobead ELISA for total secretory IgA and indirect ELISA for specific secretory IgA in the intestinal lavage fluid. The specific systemic IgG, IgM and anti-O, anti-H agglutinins were measured by indirect ELISA and Widal test respectively. The leukocyte migration inhibition test was used for the measurement of systemic cell mediated immunity. The results indicate that the oral S. typhi Ty21a stimulated intestinal immunity better than both parenteral vaccines but evoked less systemic antibody response. The stimulation of systemic cell-mediated immunity by the live attenuated and acetone inactivated vaccine was comparable while stimulation by heat inactivated-phenol preserved vaccine was less pronounced. The same studies were performed in 26 healthy volunteers during 6 months following different doses of oral vaccination with S. typhi Ty21a in enteric-coated capsule. The results suggest that the stimulation of intestinal and systemic immunities by this vaccine is dosage dependent. Three doses of vaccine provide better stimulation than two doses and one dose, respectively.

Manual and automatic leucocyte counts.

A total of 2012 venous blood samples of healthy individuals were determined for leucocyte counts. The samples were taken between 9.00 to 12.00 a.m. Samples of 503 males and 504 females were examined by manual method, while another 502 males and 503 females were counted by electronic or automatic machine. The results were evaluated by Student’s t-test. The mean + standard deviation of ages in the manual group was 30.9 + 8.6 years for males and 27.4 + 7.7 years for females. They had a mean + standard deviation of total leucocyte counts 7003.78 + 785.76 cells per cu.mm. for males and 7028.83 + 778.09 cells per cu.mm. for females. There was no significant statistical difference (p=0.98981). The mean + standard deviation of ages in the automatic group was 29.5 + 7.4 years for males and 29.3 + 7 years for females. The mean + standard deviation of total leucocyte counts was 6482.68 + 1267.98 and 6819.89 + 1252.55 cells per cu.mm. for males and females respectively. the difference was not significant (p=0.98194). There was no significant statisfical difference in total leucocyte counts 1. between manual and automatic method 2. between males and females The average + standard deviation of total leucocyte counts of 2012 healthy individuals was 6924 + 1053 cells per cu.mm. The small variation of leucocyte counts among subjects aged 10 to 50 years was also observed.