Asian Pacific Journal of Allergy and Immunology
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Item The abnormalities of nailfold capillaries in scleroderma as assessed by video image analysis and photomicroscopy.(1996-12-01) Chandran, G; Simmons, L; Cheng, G; Yaakap, H; Nikoloutsopoulos, T; Roberts-Thomson, P JScleroderma is a systemic connective tissue disease in which the diagnosis in supported by morphological changes in nailfold capillary size and density. These changes are open to observer bias. In this paper we describe 2 objective methods that allow quantitative definition of capillary changes, video image analysis (VIA) and photomicroscopy. VIA was used to assess 15 healthy control subjects and 22 patients with scleroderma. Scleroderma patients had a significantly larger capillary diameter (43 microns versus 20 microns, p = 0.0001) and capillary density was reduced by a mean factor of 0.5. Image stored on computer will facilitate serial assessments of nailfold capillary changes and possibly provide information on disease progression.Item Acceptance of the Accuhaler, a multi-dose powder inhaler, among asthmatic patients: a comparison with the pressurized metered-dose inhaler.(2000-09-29) Liam, C K; Lim, K H; Wong, C MThis study aimed to evaluate dry powder inhaler naive asthmatic patients' perception and preference of the Accuhaler, a multidose dry powder inhaler and the pressurized metered dose inhaler (pMDI). After the first instruction, 66.7% of 48 patients enrolled in the study could demonstrate the correct use of the Accuhaler. When the patients were asked to compare the pMDI and the Accuhaler after using the Accuhaler to administer salmeterol for 4 weeks, the Accuhaler scored significantly better than the pMDI for the following features: knowing how many doses are left, presence of an attached cover, taste, instruction for use, attractiveness, ease of use, ease of holding, shape, and comfortable mouthpiece. The pMDI scored better to the Accuhaler in terms of size. More patients preferred the Accuhaler than the pMDI; the presence of a dose counter and perceived ease of use were the main reasons cited for their preference for the Accuhaler.Item The accumulation of dust mite allergens on mattresses made of different kinds of materials.(2010-06) Visitsunthorn, Nualanong; Chirdjirapong, Varakorn; Pootong, Visanu; Jirapongsananuruk, Orathai; Pacharn, Punchama; Weeravejsukit, Sirirat; Mahakittikun, Vanna; Vichyanond, PakitBackground: Different mattress materials may affect the accumulation of allergens. Objective: To compare the amount of group 1 dust mite allergens (Der p1 + Der f1) on mattresses made of different kinds of materials before and after use. Methods: Sixty new mattresses made of kapok, synthetic fiber, coconut fiber and sponge-like polyurethane, were placed in the house officers’ dormitory at Siriraj hospital, Thailand. The dust samples were collected before (0), 1, 2, 3, 6, 9 and 12 months after the mattresses were used. Group 1 dust mite allergens were analyzed using two-site monoclonal antibody ELISA. Results: Der f1 made up 86.7 % of group 1 allergens found in the matress dust. After the 2nd month, only the mean level in sponge-like polyurethane mattress was under 2 µg/g dust (sensitized level). At the 6th month, the mean levels were 13.1 in coconut, 21.7 in kapok and 17.3 µg/g dust in synthetic fiber, all of which were more than 10 µg/g dust (symptomatic level). At the 9th month, the level in sponge-like polyurethane mattress was increased to 11.2 µg/g. At 12th month the level in coconut fiber, sponge-like polyurethane synthetic fiber and kapok mattresses were 20.2, 22.4, 28.9 and 32.2 µg/g dust respectively. Conclusions: The accumulation rate in kapok and synthetic mattresses was significantly higher than coconut and sponge-like polyurethane mattresses. The mean level of group 1 mite allergens exceeded 10 µg/g dust after the 6th month of use in coconut fiber, kapok and synthetic fiber and at the 9th month in sponge-like polyurethane mattress.Item Acetylcholine receptor antibody in patients with myasthenia gravis.(1986-12-01) Xu, X H; Zhu, L P; Wu, J Y; Zhang, S Z; Yang, G Z; Ba, T; Tan, M X; Liu, S LThe determination of acetylcholine receptor antibody (AChR Ab) titer by an enzyme-linked immunosorbent assay (ELISA) in patients with myasthenia gravis was introduced. The optimal conditions were determined by chequerboard determination. The specificity was confirmed by inhibition tests. The sensitivity is 9 p mole. The comparison of AChR Ab titers among 49 myasthenic patients, 19 non-myasthenic neurological patients and 20 healthy blood donors has shown that it is a highly sensitive, specific, reproducible, rapid, simple and inexpensive method for determining AChR Ab and that it is highly valuable for the diagnosis of myasthenia gravis.Item Acquired immune deficiency syndrome in Thailand.(1985-06-01) Wilde, H; Locharenkul, C; Phanuphak, PItem Active pre-exposure immunisation against hepatitis B virus: immunogenicity of hepatitis B vaccine in healthy Thai adults and children.(1987-06-01) Pongpipat, D; Suvatte, V; Assateerawatts, A; Bhethraratt, SThe immunogenicity of plasma derived hepatitis B vaccine (Hevac B) was studied for active pre-exposure immunisation in 176 healthy volunteer adults and 162 randomised children who had no hepatitis B virus markers. All subjects received three injections of 5 micrograms of hepatitis B vaccine intramuscularly at one month intervals. Seroconversion at 2 months after the third dose of vaccine was 96.30 percent in the children and 92.00 percent in the adults with mean anti-HBs titres of 800 mlU/ml and 353 mlU/ml respectively. The difference of anti-HBs levels between these two groups was statistically significant (p less than 0.05). Female adults had exhibited higher immune response to HB vaccine than male adults but there was no seroconversion difference between boys and girls. There were no serious local or systemic side effects of hepatitis B vaccination. It was concluded that active immunisation with plasma derived hepatitis B vaccine in non-immune children and adults is highly effective without any serious side effects or complications. The prevention of horizontal transmission of hepatitis B virus should be done by vaccination in children since they have a much better immune response to hepatitis B vaccine than adults.Item Acute aortic valvulitis as an initial presentation of systemic lupus erythematosus.(1999-06-31) Louthrenoo, W; Kanjanavanit, R; Sukitawut, WValvular involvement in patients with systemic lupus erythematosus (SLE) is not uncommon but patients rarely present with it. The mitral valve is most commonly involved. We report a 36-year-old man who had an episode of acute fever, arthritis, and acute aortic insufficiency with a small vegetation at the tip of the aortic valve mimicking infective endocarditis, proven later to be due to SLE. SLE should be considered as one of the uncommon causes of acute aortic insufficiency.Item Acute urticaria: etiologies, clinical course and quality of life.(2008-03-04) Kulthanan, Kanokvalai; Chiawsirikajorn, Yodmanee; Jiamton, SukhumOne hundred patients with acute urticaria were prospectively studied over a 2-year period with respect to etiology, clinical features and outcome, including the patient's quality of life using a Thai version of the Dermatologic Life Quality Index (DLQI). Twenty-one patients (21%) turned out to have chronic and 79 acute urticaria. Itchy sensations had the highest mean DLQI score translating to the highest negative impact on the quality of life. In more than half of the patients, the cause of the acute urticaria could not be identified. The most common identified causes of acute urticaria were infections (36.7%), followed by drugs, foods and insect bite reactions. Among those with acute urticaria, sixteen percent had co-existing angioedema, and one fourth had systemic symptoms, the most common being dyspnea. Patients with extensive wheals tended to have co-existing angioedema and also a statistically significant higher percentage of systemic symptoms, higher mean pruritus and mean DLQI scores than those with less body surface area involvement. Fifty-six percent of the patients with acute urticaria had complete remissions within 1 week; 78.5%, within 2 weeks and 91.1%, within 3 weeks.Item Adult asthma prevalence, morbidity and mortality and their relationships with environmental and medical care factors in Singapore.(1999-09-04) Ng, T PWe have conducted a series of studies on adult asthma in Singapore that describe the prevalence, morbidity and mortality and their relationships with environmental and medical care factors. There was no evidence of a temporal increase of mortality from 1976 to 1995 for adults. The prevalence rate of asthma is 2.4% in men and 2.0% in women. There is considerable morbidity among asthmatics, corticosteroids are under-used, and patients' knowledge and self-management skills is poor. Increased morbidity is significantly associated with current keeping of pets, current smoking, and the patients' knowledge and self-management skills. Occupational exposure contributes up to a third of asthma morbidity. Malays and Indians have higher rates of asthma mortality and morbidity than Chinese. They have greater exposures to airborne allergens from keeping rugs or carpets, and pets. Malays experience the most morbidity from asthma, but make less use of health services, and receive less medical attention, than Indians or Chinese.Item Adult-onset atopic dermatitis: a cross-sectional study of natural history and clinical manifestation.(2007-12-12) Kulthanan, Kanokvalai; Samutrapong, Pailin; Jiamton, Sukhum; Tuchinda, PapapitThe previously reported prevalence of adult-onset atopic dermatitis (AD) varied from 13% to 47%. There were a few reports of clinical features of adult-onset AD. The purpose of this article was to study the clinical features of Thai patients with adult-onset AD. We recruited prospective patients from the outpatient Department of Dermatology, Siriraj hospital, Mahidol University in Bangkok, Thailand, from June, 2006 to May, 2007. The diagnosis of AD was made according to the criteria of Hanifin and Rajka and the severity of AD in each patient was assessed using the Rajka and Langeland score. Fifty nine patients were enrolled. The majority of the patients developed their dermatitis during their third decade. Typical lichenified/exudative lesions were found in all cases. Non-typical morphologic variants were found in 76.3%. The most common were nummular lesions. The main sites of involvement were the flexural area. The common sites of non-flexural involvement were the trunk, extensors and hands. The severity of AD was moderate in 64.4% of cases. A personal history of atopy was found in 84.7% of cases. Skin prick testing showed positive results (mostly to multiple allergens) in 25 of 29 patients (86.2%). Elevated serum total immunoglobulin E was detected in 6 of 10 patients (60%). It is concluded that adult-onset AD is not a rare but under-recognized eczematous condition.Item Aeroallergen sensitivity among Thai children with allergic respiratory diseases: a hospital-based study.(2004-12-30) Sritipsukho, PaskornOne hundred and twenty patients, aged 3-15 years, attending the Allergy Clinic, Thammasat University Hospital, with allergic rhinitis, asthma or both conditions were studied. Standardized skin prick tests were performed with 15 common aeroallergens. The subjects were 85 boys and 35 girls with the mean age of 8.1 years (SD = 3.4 years). There were 63 cases (53%), 22 cases (18%) and 35 cases (29%) diagnosed with allergic rhinitis only, asthma only and both conditions, respectively. The prevalence of asthma among the allergic rhinitis patients was 36 percent whereas the prevalence of allergic rhinitis among the asthmatic patients was 61 percent. The sensitization patterns for major aeroallergens among the three groups were similar with the most common sensitized allergens as D. pteronyssinus, followed by D. farinae, American cockroach, Kopok and German cockroach, respectively. Among the atopic patients, a greater number of allergen reactivity was significantly associated with the increased risk of having their coexistence of allergic rhinitis and asthma (p = 0.0046; score test for trend of odds ratio).Item Aeroallergen sensitivity of Thai patients with allergic rhinitis.(1997-12-14) Pumhirun, P; Towiwat, P; Mahakit, PThe aim of this study was to determine the aeroallergen sensitivity of allergic rhinitis patients. A total of 100 cases (female: 59, male: 41, aged between 10-59 years, mean age 27.9 years) who were diagnosed with allergic rhinitis by history and clinical presentation, underwent a prick skin test with 30 aeroallergens, and the important sensitizing allergens were assessed. Skin test reactivity showing > or = 3 mm wheal with erythema as the positive skin test, was recorded. The results of patients with positive skin tests follow. TREES: acacia 19%, mango 16%, coconut 12%. GRASSES: bermuda 17%, johnson 21%, timothy 16%, bahia 16% orchard 18%. WEEDS: pigweed 16%, kochia 14%. MOLDS: alternaria 11%, cladosporium 11%, aspergillus 12%, penicillium 16%, helminthosporium 16%, botrytis 15%, rhodotorula 20%, fusarium 26%, curvularia 26%, smut mix 11%, rust 9%. EPIDERMALS: cat 29%, dog 28%, feathers 37%. INDOOR ALLERGENS: house dust 72%, D. pteronyssinus 76%, D. farinae 79%, American cockroach 60%, German cockroach 41%, kapok 30%. Eighty-five percent of patients sensitive to house dust mites were positive to both D. pteronyssinus and D. farinae, indicating substantial cross-reactivity. The study shows that the house dust mite and the cockroach are important aeroallergen sensitizers among the Thai population, since more than half the patients were skin-test positive to the house dust mite and the cockroach.Item Aeroallergens in clinical practice of allergy in India- ARIA Asia Pacific Workshop report.(2008-12-26) Singh, Anand B; Shahi, ShipraAllergic diseases such as bronchial asthma, allergic rhinitis and atopic dermatitis are dramatically increasing all over the world including developing countries like India. Today, more than 30% of the population is known to suffer from one or other allergic ailment. Major causative agents implicated are pollen grains, fungal spores, dust mites, insect debris, animal epithelia, etc. Several aerobiological studies have been conducted in different parts of the country to ascertain aerial concentration and seasonality of pollen grains and fungi. Recently, an "All India Coordinated Project on Aeroallergens and Human Health" was undertaken by us to discover the quantitative and qualitative prevalence of aerosols at 18 different centers in the country. Allergenically important airborne pollen identified by clinico-immunologic evaluation are Alnus, Amaranthus, Argemone, Brassica, Cannabis, Cassia, Cedrus, Chenopodium, Cocos, Holoptelia, Mallotus, Morus, Parthenium, Prosopis juliflora, Quercus, Ricinus communis, and grasses such as Cenchrus, Cynodon, Imperata, Pennisetum etc. Cross-reactivity of the IgE antibodies is a common phenomenon among various pollen allergens. Ricinus communis pollen a commonly growing weed/shrub in India, cross-reacts with latex (Hevea brasiliensis), Mercurialis annua and also with seeds of Ricinus communis--all belonging to family Euphorbiaceae but geographically distantly located. Areca catechu cross-reacts with other members of Arecaceae such as Phoenix sylvestris, Cocos nucifera and Borassus flabelifer while pollen of Holoptelia integrifolia from India cross reacts with pollen of Parietaria judaica from Mediterranean Europe, both of which are members of family Urticaceae. Several reports on pollen and fruit syndrome have been analyzed. Experiments conducted by us revealed that pollutants (NO2 and SO2) not only affect pollen morphology but also changes its allergenic potency.Item Aerobiology of common environmental allergens: sizes of allergen carrying particles.(1993-06-01) Spieksma, F TItem Aerosol therapy of bronchial asthma.(1985-06-01) Newhouse, M T; Dolovich, MItem Affinity purified oval antigen for diagnosis of Opisthorchiasis viverrini.(2001-12-15) Wongsaroj, T; Sakolvaree, Y; Chaicumpa, W; Maleewong, W; Kitikoon, V; Tapchaisri, P; Chongsa-nguan, M; Cross, J HMonoclonal antibodies (MAb) were raised against an oval antigen of the liver fluke Opisthorchis viverrini which is the causative agent of a parasitosis, i.e. opisthorchiasis in Thailand. The antibodies were used in an affinity column to purify the O. viverrini oval antigen from a crude extract of adult parasites by chromatography. The oval antigen was then used in a membrane (dot) ELISA for detecting antibodies in serum samples of parasitologically confirmed Opisthorchis viverrini infected individuals (adult parasites were found in stools after praziquantel treatment and salt purgation), as well as of individuals infected with other parasites and parasite-free controls. The MAb-based dot-ELISA using the affinity purified O. viverrini oval antigen revealed 100% sensitivity, specificity and accuracy for detecting O. viverrini infection. The test is simple, rapid and highly reproducible. Several samples can be tested at the same time without the requirement for special equipment or much increase in testing time; thus it is suitable for mass screening for O. viverrini exposure, especially in new endemic areas. Furthermore using serum specimens could increase patient and community compliance compared to the conventional parasitological survey which uses stool samples for the detection of O. viverrini ova, without treatment and subsequent salt purgation, this conventional method shows a low sensitivity and is also unpleasant to both the sample donors and the laboratory technicians which has historically shown a further negative impact on the final outcome.Item Agar plating technique for enumeration of IL-2 producing cells in human peripheral blood mononuclear leukocytes.(1988-12-01) Hirunpetcharat, C; Kasinrerk, W; Makonkawkeyoon, SAn agar plating technique for detection and enumeration of IL-2 producing cells from human peripheral blood mononuclear leukocytes (PBML) has been developed. This method is based on the principle that PHA-stimulated PBML, as effector cells, secrete interleukin 2 (IL-2) into soft agar containing mouse 3-day Con A blasts as IL-2 dependent responder cells. The IL-2 dependent Con A blasts proliferating around the IL-2 producing cells form colonies or clusters of cells and are easily visualized under a dissecting microscope. The development of IL-2 producing cells was optimum when 1 X 10(6) cells/ml PBML were stimulated with 2 micrograms/ml PHA-P for 4 hours, and when 2.5 X 10(5) cells were co-cultured with 6 X 10(6) Con A blasts in soft agar for 5 days. The average number of IL-2 producing cells in 10 normal healthy controls were 754 +/- 94 (mean +/- S.E.M.) cells/10(6) PBML. The numbers of IL-2 producing cells and the levels of IL-2 produced were highly correlated (r = 0.929). The subpopulation of lymphocytes in the colonies was shown to be mostly murine T-cells, since they were mostly Thy 1.2 positive, CD3 negative and surface immunoglobulin negative. This technique is very simple to perform and provides an accurate and straightforward means to enumerate IL-2 producing cells from human PBML in a variety of human immunologic disorders.