Effect of aloe vera gel to healing of burn wound a clinical and histologic study.

In a study of twenty-seven patients with partial thickness burn wound, they were treated with aloe vera gel compared with vaseline gauze. It revealed the aloe vera gel treated lesion healed faster than the vaseline gauze area. The average time of healing in the aloe gel area was 11.89 days and 18.19 days for the vaseline gauze treated wound. Statistical analysis by using t-test and the value of P < 0.002 was statistically significant. In histologic study, it showed early epithelialization in the treated aloe vera gel area. Only some minor adverse effects, such as discomfort and pain were encountered in the 27 cases. This study showed the effectiveness of aloe vera gel on a partial thickness burn wound, and it might be beneficial to do further trials on burn wounds.

A study of simplified porcine skin preservation.

The study of preserved porcine skin was done by using split-thickness skin grafts of pigs weighing approximately 25 to 30 kg. The harvesting of split-thickness skin grafts was performed under aseptic and antiseptic conditions. The povidone-iodine solution and 0.25% acidified sodium hypochlorite solution were used before immersion of the skin in 90% glycerine solution. Prepared skin graft was stored in the freezer compartment of a home refrigerator. Serial studies of the bacteriology and the histology of specimens were performed monthly for 12 months. No bacterial organisms were found during the study. The integrity of the skin lasted up to 5 months, however, the property of the preserved skin was as good as the other biological dressing even after 6 months. This simple, low-cost procedure is useful for restoring allografts or even autografts in a hospital without conveniences or adequate facilities.

Wilms' tumor, male pseudohermaphroditism and glomerulonephritis: the Drash syndrome. First case report in Thailand and review the literatures.

The Drash syndrome, the first case in Thailand is reported. The patient had male pseudohermaphrodite, Wilms' tumor of the left kidney and mesangial proliferative glomerulonephritis. Metastasis of Wilms' tumor was noted in the liver, omentum, pelvic peritoneum and vertebral body. Chemotherapy (actinomycin D, vincristine and dexamethasone) and local irradiation were given. The patient developed pneumonia, diarrhea and ended up with Steven-Johnson syndrome from Cotrimoxazole hypersensitivity.

Immunological and immunopathological studies of patients with burn scar.

Sera obtained from 5 cases of burn scars (patients group 1) and cases of burn scars with squamous cell carcinoma (patients group 2) of the skin are analysed for anticollagen antibodies. Anticollagen type VI was demonstrable in the serum of one out of 5 cases in group 1 and 4 out of 6 cases in group 2. Collagen type VI was demonstrable in the scar without carcinoma of one patient whose serum contained anticollagen type VI. It is suggested that collagen type VI in the scar and their immunobiologic reaction may be related to the regulation of tumor development in scar tissue of the skin.

Heterogeneity of antibody response to glomerular basement membrane antigen in patients with different forms of glomerulonephritis.

Antibodies to collagenous and noncollagenous components of glomerular basement membrane (GBM) have been detected by immunoblotting in some sera from patients with various kinds of glomerulonephritis. A half proportion of patients with rapidly progressive glomerulonephritis (RPGN), chronic focal glomerulonephritis (CFGN), idiopathic membranous glomerulonephritis (MGN). IgA nephropathy and lupus nephritis (LE-GN) had IgG antibodies to heterogenous components in acid insoluble fraction of pepsin digested GBM. This acid insoluble fraction represented a complex of collagen and noncollagenous proteins of GBM. Following digestion of acid insoluble fraction with bacterial collagenase, the triple helical collagenous components of GBM were destroyed and released most likely of noncollagenous proteins. Antibodies to this noncollagenous proteins were found in only some patients with chronic glomerulonephritis (17.6%) and lupus nephritis (21.4%). Upon reaction with human placenta derived type IV collagen, different frequencies of antibody response were found in patients of different groups. However, all these reactive sera showed a similar immunoblotting pattern. The relationship between antibody response to antigenic components from human GBM or human placenta and pathogenesis of renal disease is unclear. However, the occurrence of spontaneous autoantibody response to some exposed GBM self antigens may mediate further renal destruction resulting in chronic ongoing stage of the disease.

Rapidly progressive glomerulonephritis in Thai children.

Sixteen children with extensive crescentic glomerulonephritis and rapid renal deterioration were selected from 476 patients with glomerulopathy for study. The patients (1-14 yr, M:F = 5:11) presented with edema, oligoanuria, hypertension, gross hematuria and uremic symptoms in 81, 62, 62, 56 and 50 per cent, respectively. The mean Scr was 804 (+/- 436) micromole/L and BUN 38 (+/- 13.4) mmole/L. Anemia was found in 100 per cent, hematuria in 100 per cent, heavy proteinuria 75 per cent, hypoalbuminemia 40 per cent, hypercholesterolemia 38 per cent and low C3 40 per cent. The underlying causes of RPGN included idiopathic 9, PSAGN 6 and LE 1. Eight patients recovered with normal or slightly elevated Scr while the diseases progressed to ESRD in 8 patients. Idiopathic RPGN and extensive (greater than 80%) crescentic glomerulonephritis correlated with a poor prognosis.

Development of immune-complex glomerulonephritis and amyloidosis in Syrian golden hamsters infected with Opisthorchis viverrini.

Renal disease associated with Opisthorchis viverrini infection was investigated in Syrian golden hamsters. On the fourth week after infection with 100 viable metacercariae; anti-tegumental membrane antibodies were detected in the sera by immunofluorescence antibody technic and by enzyme-linked immunosorbent assay. Six weeks after infection tegumental and anti-tegumental membrane immune-complex and amyloid fibrils were found in the glomeruli. Amyloid was characterized to be AA protein. Acute proliferative glomerulonephritis associated with the brightest immune-complex deposits developed in week 8 after infection. Intensity of immune-complexes in all glomeruli were reduce gradually thereafter and replaced by amyloid. Progressive obsolescence of the glomeruli, tubular atrophy, interstitial inflammation and fibrosis associated with massive proteinuria and deterioration of renal function appeared in week 10 after infection toward the end of the experiment in week 38 after infection.

Silicosis in ceramic-industry workers with particular reference to the diagnostic value of bronchoalveolar lavage.

We could identify, via bronchoalveolar lavage, crystals in the lavage fluid and in the alveolar macrophages. Thus, BAL could be another method for diagnosing silicosis patients.

Basement membrane antibodies in Alport's syndrome.

By the indirect immunofluorescent technique, sera from patients with Alport's syndrome showed a reaction with the basement membrane of the capillary wall of glomeruli and peritubular vessels and nearby interstitial tissue of normal monkey and mouse kidney as a substrate. It also revealed bright staining to the matrix surrounding the clusters of EHS tumor cells and stromal tissues. These reactions were caused by autoantibodies present in these sera. These findings were supported by the detection of antilaminin, nidogen and anti collagen type VI in the sera by ELISA method. These evidences suggest that the Alport's patients developed stage of autoimmunity. The exact causes were not so clear, but seemed to be due to multiple factors.

Urinary neopterin in patients with systemic lupus erythematosus.

Concentrations of neopterin were measured in urine specimens from 35 patients with active and eight with inactive systemic lupus erythematosus (SLE). Compared with those of apparently healthy controls, neopterin concentrations were higher in patients with active disease (P less than 0.001) and with inactive disease (P less than 0.01), those in patients with active disease being significantly higher than those in patients with inactive disease (P less than 0.001). The correlation between the neopterin concentration and evidence of disease activity was good. All of the patients with clinically active SLE had increased neopterin, but for only 37.5% (three of eight) did the neopterin concentration exceed the upper normal limit during clinical remission. The increase in neopterin concentration did not correlate with clinical courses or severity of renal function. Moreover, serial determinations of neopterin in active SLE patients showed a rapid decrease of initially high concentration, paralleling a decline of clinical activity after initiation of medical therapy. Thus, urinary neopterin may be a useful marker for monitoring disease activity in SLE patients.

An immunofluorescence study of cerebral malaria. A correlation with histopathology.

Histopathologic and immunopathologic features of cerebral malaria have been defined in a study of six autopsy cases with severe Plasmodium falciparum infection. In five cases, immunofluorescent studies demonstrated intense deposition of P falciparum antigen, IgG, and fibrin in cerebral vessels associated with the histopathologic finding of hemorrhage in the white matter of cerebrum and cerebellum regardless of the presence of parasitized erythrocytes in the cerebral vessels. Immunofluorescent study also demonstrated the extravascular deposits of P falciparum granular antigen associated with acute inflammatory lesion in cerebral tissue in one case. These findings suggested that the immunopathogenic mechanism may in some way play a role in the pathogenesis of cerebral malaria.

Increased ovalocytic red cells and their low parasitemia in malaria infected subjects.

Ovalocytic red blood cells were significantly increased in the peripheral blood films of patients infected with P. falciparum (mean +/- S.D. = 6.3 +/- 8.4%) and P. vivax (8.3 +/- 14.0%), whereas, there was only 0.6 +/- 0.4 per cent ovalocytes in normal individuals. Per cent parasitemia of ovalocytes counted at least 100 ovalocytes of the blood films of malaria infected individuals was significantly reduced when compared with that of discocytes which revealed at least 100 discocytes in the same blood smears. Relative increase in ovalocyte and their low parasitemia might be the response of malaria infected individuals to cope with malaria multiplication in their circulation.

The primary nephrotic syndrome in children at Ramathibodi Hospital: clinical and clinicopathological study.

Mesangial proliferative glomerulonephritis (MesPGN) is the most common histopathological finding of primary nephrotic syndrome in Thai children. Prediction of glomerular morphology is possible by the clinical characteristics: the age at onset older than 6 years old, occurring mostly in males, with or without hematuria, no hypertension, normal serum creatinine level, response to initial corticosteroid therapy but frequent relapses. Epidemiological study pertaining to associated environmental factors and immunological response of Thai children is needed.

Enhancement of DEN-induced hepatocellular nodule development by Opisthorchis viverrini infection in Syrian golden hamsters.

The influence of Opisthorchis viverrini liver fluke infection on development of diethylnitrosamine (DEN)-induced hepatocellular nodules was investigated in Syrian golden hamsters. Infection with 60 metacercariae, 4 weeks prior to administration of DEN for 12 weeks in the drinking water at dose levels of 10, 20 and 40 p.p.m., resulted in a significantly increased yield of nodular lesions as compared with the group receiving carcinogen treatment alone. The results indicate an importance for parasite-associated liver injury and compensatory regeneration in hepatocarcinogenesis and suggest a possible role for Opisthorchis infestation in the generation of hepatocellular tumours in man.

Asymptomatic bacteriuria in health and glomerulonephropathies.

In a comparative study of prevalence of asymptomatic bacteriuria in a Thai population, 1.4% of 955 apparently healthy adults (12 female and 1 male) were found to have positive urine culture. Of these, 6 individuals grew staphylococcal coagulase-negative, 3 grew E. coli, and the rest grew various other organisms. Among 176 patients with glomerulonephropathies (GNP), 20.5% (17 male and 16 female) yielded positive urine cultures. These included 18 positive for E. coli, 3 for staphylococcal coagulase-negative, 5 for Klebsiella and 3 for Enterobacter; the rest grew various other organisms. There was a higher overall prevalence of asymptomatic bacteriuria in GNP when compared to the controls. Heavy proteinuria is also a predisposing factor for an increase in the prevalence of asymptomatic bacteriuria in female GNP only.

Squamous carcinoma in scars: clinicopathological correlations.

Twelve cases of squamous cell carcinoma arising in scars of the skin are analyzed. Correlation of tumor aggressiveness, tumor differentiation, intensity of small lymphocyte infiltration, and nature of adjacent collagen tissue to tumor stroma was investigated. All tumors were predominantly well differentiated. Nine patients had no metastasis or recurrence after surgical treatment of the primary tumor. Three patients developed widespread metastases and died less than 2 years after operation. The tumors of these latter patients contained areas of pleomorphic and spindle cells and had minimal infiltrates of small lymphocytes. In contrast, the 9 patients who remained free of tumor had moderate infiltrates of small lymphocytes, and in just 1 of 9 was an area of pleomorphic tumor cells found. Prognosis in scar carcinoma, therefore, may be related to tumor differentiation and the degree of host response with small lymphocytes to the tumor, rather than to the universally poor prognosis recorded in the past.