Scopus 1991-2000
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Publication Metadata only Exchange transfusion in severe falciparum malaria(1999-04-20) S. Gulprasutdilog; P. Buranakitjaroen; V. Chongkolwatana; N. Jaroonvesama; Mahidol UniversityMalaria associated with complications or a fatal outcome is caused by Plasmodium falciparum. The mortality due to this disease is parallel to the degree of parasitemia. Successful use of exchange blood transfusion as a therapeutic adjunct for this infection was reported. The rationale for this form of therapy is based on (1) rapid reduction in parasite load by exchange transfusion, (2) removal of toxic substances and (3) reducing microcirculatory sludging. We describe here thirteen cases of severe falciparum malaria treated with infusion of quinine dihydrochloride and exchange transfusion 2,320 - 8,000 ml of whole blood. We observed that the greatest reduction in the average circulating infected red blood cells, from 20.7 per cent to 9.3 per cent, seemed to occur early in the first 2,000 ml of blood exchange and the parasitemia often reduced to 5.1 per cent in patients who had 4,000 ml of blood exchange. In order to reduce the initial parasitemia to 5 per cent by exchange transfusion, we suggest the volume of exchange transfusion should be 2,000 ml for average parasitemia 10 per cent, 4,000 ml for parasitemia > 20 per cent and 2,000 - 4,000 ml for parasitemia 10 - 20 per cent.Publication Metadata only Pharmacokinetics and bioequivalence evaluation of three commercial tablet formulations of mefloquine when given in combination with dihydroartemisinin in patients with acute uncomplicated falciparum malaria(2000-01-01) K. Na-Bangchang; J. Karbwang; P. A.C. Palacios; R. Ubalee; S. Saengtertsilapachai; W. H. Wernsdorfer; Mahidol University; The Hospital for Tropical Diseases, Bangkok; Universitat WienObjective: To assess the pharmacokinetics and relative bioavailability/bioequivalence of three commercial tablet formulations of mefloquine, i.e. Lariam (reference formulation), Mephaquin 100 Lactab and Eloquin-250, when given sequentially after dihydroartemisinin in Thai patients with acute uncomplicated falciparum malaria. Methods: Twenty-nine Thai patients with acute uncomplicated falciparum malaria were randomized to receive an initial dose of 300 mg dihydroartemisinin, followed by 1250 mg mefloquine (at 24 h and 30 h after dihydroartemisinin) given as either Lariam (n = 10 cases), Mephaquin (n = 9 cases) or Eloquin-250 (n = 10 cases). Serial blood samples were obtained up to day 42 after treatment with mefloquine. Mefloquine concentrations were determined in whole blood by means of ultraviolet high-performance liquid chromatography. The pharmacokinetic parameters of mefloquine were estimated using non-compartmental and compartmental analysis. Results: The three combination regimens were well tolerated. Patients in all treatment groups had a rapid initial response. However, nine patients (four and five cases in regimen containing Mephaquin 100 Lactab and Eloquin-250, respectively) had reappearance of parasitaemia during the follow-up period. Mefloquine from the three formulations showed significantly different pharmacokinetic and bioavailability metrics. Significantly lower peak plasma concentrations (C(max)) and areas under the plasma concentration-time curve (AUC; AUC(0-48h), AUC(0-7days), and total AUC) were observed with Mephaquin 100 Lactab than with the other two formulations. Mean values for relative bioavailability of the test to standard products were 49.1% (Mephaquin 100 Lactab) and 72.4% (Eloquine-250). Based on the criteria set, the bioavailability of the two test products (Mephaquin 100 Lactab and Eloquine-250) was considered non-equivalent to the reference product with respect to the rate (t(max), C(max)) and extent (AUC(0-48h), AUC(0-7days), total AUC) of mefloquine absorption.Publication Metadata only Possible thermogenesis with dexfenfluramine(1999-02-01) Chulaporn Roongpisuthipong; Orasa Panpakdee; Achara Boontawee; Swairin Kulapongse; Vichai Tanphaichitr; Mahidol UniversityFifty obese patients with a body mass index greater than 25 kg/m2 were randomized into 3 groups: control (C=19), placebo (P=18) and dexfenfluramine (D=18). A behavioral modification program which included eating habits, exercise, attitudes, social relationships and six steps to lifetime weight control was taught every week. All patients strictly followed the food manual and recorded their behavior, physical activity and food intake every day through 12 weeks. Placebo and dexfenfluramine 30 mg/day were given in a double blind placebo controlled study. The results showed that all 3 groups had significant decreases in rest times and increased activity times (p<0.05) and significant reductions of the average total daily energy, carbohydrate and fat intake (p<0.05). They all lost weight. Mean ± SEM cumulative weight loss was 8.3±0.7 kg in group D, 3.3±1 kg, in group P and 2.9±0.7 kg, in group C. The mean additional weight loss of 5 kg, and 5.4 kg seen with dexfenfluramine being highly significant (p<0.001) from group P and C most likely due to increased thermogenesis. Significant (p<0.05) and gradual reduction of biceps, triceps skinfold and percent body fat were constantly observed only in the dexfenfluramine group. There were no significant differences among the 3 groups regarding blood pressure, heart rate, hematologic, lipids and biochemical profiles.Publication Metadata only Persistent hyperinsulinemic hypoglycemia of infancy: Long-term outcome following subtotal pancreatectomy(2000-01-01) Pat Mahachoklertwattana; Chittiwat Suprasongsin; Sumate Teeraratkul; Chawalit Preeyasombat; Mahidol University; Faculty of Medicine, Ramathibodi Hospital, Mahidol UniversityBackground: Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is the most common cause of persistent hypoglycemia in infants. The current standard treatment is subtotal pancreatectomy (Px). However, the long-term outcome following surgery needs further attention. Methods: We analyzed 10 children (7M, 3F) with PHHI who underwent partial (65-80%) and subtotal (81- 95%) Px. Follow-up ranged from 2 to 9.4 yr (mean = 4.2 yr). We divided them into 2 groups based upon the age at onset of hypoglycemia: early (< 1 mo) and late (≥ 1 mo). Results: The seven patients in the early-onset group underwent 85-95% Px between ages of 18 d and 3 mo. Three of them initially treated by 85-90% Px had persistent hypoglycemia postoperatively. Two out of three required a 2(nd) operation with 95% Px for controlling hypoglycemia, though both still had persistent hypoglycemia and required medication to control blood glucose. The remaining four had 95% Px and had maintained euglycemia postoperatively. One patient developed diabetes 6 yr after surgery. Six of seven patients had delayed development and subnormal IQ. Three patients of the late-onset group (3 mo, 6 mo and 4 yr) underwent partial Px (80%, 65% and 65%, respectively) and maintained euglycemia postoperatively. Despite 65% Px, one developed diabetes 3 yr after surgery. Conclusions: These results suggest that children with early-onset hypoglycemia have more severe hyperinsulinism than those with late-onset hypoglycemia. The former require 95% Px for maintaining euglycemia, but long- term complications with diabetes may be common. In contrast, the latter require lower percentage Px which may reduce the incidence of diabetes in the future.Publication Metadata only Prevalences of human herpesvirus 6 and human herpesvirus 7 in normal Thai population(1999-06-01) Duanthanorm Thawaranantha; Kanittha Chimabutra; Kruavon Balachandra; Paijit Warachit; Somsak Pantuwatana; Reiko Inagi; Takeshi Kurata; Koichi Yamanishi; National Institutes of Health, Bethesda; Charoen Krung Pracharak Hospital; Mahidol University; National Institute of Infectious DiseasesPrevalences of human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7) DNA were investigated in normal Thai population. Peripheral blood mononuclear cells(PBMC) and saliva were collected from 238 healthy adults in five provinces which might be a representative of each part of the country, and 120 normal children in one province. Prevalences of HHV-6 DNA PBMC were 45.5-74.3% in adults and 78.3% in children, and in saliva, very low prevalences were detected; 5.7-8.6% in adults and 15.0% in children, respectively. Additionally, all HHV-6 DNA detected in this study were variant B. Comparingly to those of HHV-7 DNA, the prevalences were significantly higher than those of HHV-6, ie, 82.9-91.4% in PBMC of adults, 85% in PBMC of children, 84.8-89.0% in saliva of adults and 92.5% in saliva of children. HHV-6 and HHV-7 isolation from saliva specimens were also performed. No HHV-6 could be isolated from any samples, whereas, in the present study, HHV-7 could be isolated as 90.0% from children and as 20.0 -54.5% from adults.Publication Metadata only Malaria, multi-drug resistance and economic development in the greater Mekong subregion of Southeast Asia - Incorporating geographical information systems databases(1999-01-01) Pratap Singhasivanon; Mahidol UniversityThis monograph brings together national malaria databases for 1996, 1997 and 1998 from the 6 countries comprising the Greater Mekong Subregion of Southeast Asia: Cambodia, China (southern provinces), Lao People's Democratic Republic, Myanmar, Thailand, Viet Nam. The objective is to create a regional perspective in what is a global epicenter of drug resistant falciparum malaria, so to enhance the information flow required to improve malaria control on a regional basis in the context of economic and social change. Geographical Information Systems technology has been applied to the regional mapping of total reported malaria cases, malaria incidence, confirmed cases, parasite species distribution. There is great diversity in disease patterns in the 6 countries and at subnational administrative unit area level in each country, so that in the region as a whole there is marked asymmetry in disease distribution, with many areas of high endemicity. Focal expansion of maps in the vicinity of international border areas delineates the differential trans-border malaria distribution that presents a challenge for disease control. The malaria pattern is also depicted in environmental context against regional elevation and forest cover profiles, which affect mosquito breeding site distribution and agricultural activity. Data on resistance of falciparum malaria to a range of anti-malarial drugs summarise the historical and recent context of resistance development and spread in terms of geography and time frame. Data on population movement across international borders identify the magnitude of a major factor in the dispersal of malaria, including resistant parasite strains. Malaria control involves consideration of microeconomic capacity and operates in the broader context of macroeconomic policy: economic and social profiles of the region are included to provide this perspective. So too are maps depicting major economic development projects in the region, projects that have and will continue to have profound, dynamic impacts on malaria epidemiology. The geographic collation of regional malaria databases is thus placed in overall geographic, health, environmental and economic perspective. This beginning can form a basis for the development of an effective regional malaria surveillance system in the context of rapidly evolving social and infrastructural change, leading eventually to a multi-disease surveillance network.Publication Metadata only Cerebral blood flow velocity changes after bovine natural surfactant instillation(2000-01-01) Pracha Nuntnarumit; Henrietta S. Bada; Wenjian Yang; Sheldon B. Korones; University of Tennessee Health Science Center; Mahidol University; University of Memphis; Newborn CenterOBJECTIVE: To determine the effects of bovine natural surfactant (beractant) instillation on cerebral hemodynamics in preterin infants with respiratory distress syndrome (RDS). STUDY DESIGN: Preterm infants who required surfactant for RDS were enrolled Cerebral blood flow velocity (CBFV) waveforms from the pericallosal artery were analyzad by pulsed Doppler ultrasonography with the anterior fontanel serving as an acoustic window. CBFV was measured before and at 5,10,20, and 30 minutes after the first dose of a bolus instillation of surfactant in four aliquots. Simultaneously with CBFV measurements, mean blood pressure (MBP), heart rate, and ventilator settings were recorded pH, PACO2, and PAO2before and at 30 minutes after surfactant administration were also determined RESULTS: The 30 enrolled preterm infants had a mean birth weight of 973 gm (513 to 1996 gm) and a mean gestational age of 27 weeks (23 to 33 weeks). Mean postnatal age at surfactant administration was 4.7 ± 2.7 hours. There were no significant changes in pH and PACO2before and at 30 minutes after surfactant (before surfactant mean pH of 7.29 ± 0.07 and mean PACO2of 44.4 ± 7.1 torr; after surfactant mean pH of 7.31 ± 0.07 and mean PACO2of 42.7 ± 8.3 torr). PAO2increased significantly from a pre-surfactant mean of 83 torr to 130 torr at 30 minutes after surfactant (p < 0.05), with no significant changes in mean airway pressure. There were no significant changes in MBP, heart rate, mean CBFV, peak systolic flow velocity, and diastolic flow velocity before and after surfactant instillation regardless of gestational age. Individual changes in mean CBFV were related to MBP changes (p < 0.001, linear mixed models with random effects). CONCLUSION: In low birth weight infants with RDS, bovine surfactant instillation is not associated with a significant alteration in cerebral hemodynamics. However, the direct relationship between CBFV and MBP is consistent with the reported pressure-passive cerebral circulation in sick preterm infants.Publication Metadata only An exotic pulmonary infection in Thailand: Melioidosis(1999-12-01) K. Maneechotesuwan; Mahidol University;Melioidosis is an infectious disease from Burkholderia pseudomallei and is confined in specific geographic areas such as Southeast Asia. Its highest prevalence in Thailand is in the north-eastern part. Most infected patients had worked paddy fields or had underlying diseases such as diabetes mellitus. Melioidosis can manifest clinically, with either disseminated or localized features. In the disseminated form patients developed an acute and progressive course with septicaemia. In contrast, patients with the localized form usually presented with prolonged fever, and symptoms of one or more organ involvement, in particular the lung and the liver. Definite diagnosis of melioidosis is made by an isolation of Burkholderia pseudomallei from a variety of clinical specimens. Treatment of choice for the septicaemic patients is an initial combination of ceftrazidime and trimethoprime- sulfamethoxazole, followed by trimethoprime-sulfamethoxazole for up to 6-12 months depending on the result of clinical specimen culture. Treatment for the localized form requires simultaneous antibiotic therapy and surgical drainage. However, optimum duration of antibiotic therapy remains unknown so further research is required. Melioidosis is an important disease in terms of mortality rate and it requires rapid diagnosis and treatment. To prevent recurrence, it is necessary to continue oral doxycycline or trimethoprime- sulfamethoxazole for 6-12 months.Publication Metadata only A unique 3.5-kb deletion of the mitochondrial genome in Thai patients with Kearns-Sayre syndrome(1999-01-01) Patcharee Lertrit; Arisa Imsumran; Pongkiat Karnkirawattana; Voraphan Devahasdin; Tumtip Sangruchi; La Ongsri Atchaneeyasakul; Charoensri Mungkornkarn; Neelobol Neungton; Mahidol UniversityKearns-Sayre syndrome is one of the neurological diseases caused by a defect in the energy-producing system of mitochondria. Kearns-Sayre is known to be associated with a deletion in the mitochondrial genome and is usually detected in muscle biopsies of the patients. In this study, we report the molecular lesion of mitochondrial DNA (mtDNA) in four Thai patients admitted to hospital with encephalomyopathies. The 3.5-kb deletion of mtDNA was detected by Southern analysis, mapped by amplification with five primer pairs covering almost the total mitochondrial genome, and confirmed by PCR primer shift analysis. The deleted position was localized to nt 10208/13765 or nt 10204/13761 spanning the coding area of subunits 3 (ND3), 4L (ND4L), 4 (ND4), and 5 (ND5) of respiratory chain enzyme complex I and the tRNA genes for histidine, serine, leucine, and arginine. The sequence flanking the deletion was a 4-bp repeat of TCCC. All four patients have exactly the same 3558-bp mtDNA deletion; this is the only deleted position in their mtDNA but is different from those reported in the literature. The deletion seems to be found only in Thai patients, although they present with different clinical manifestations and none of them is not related.Publication Metadata only Heat treatments of Tanzania ruby as monitored by ESR spectroscopy(2000-06-30) P. Winotai; T. Wichan; I. M. Tang; J. Yaokulbode; Mahidol University; The Institute of Science and Technology for Research and Development, Mahidol UniversityThe main purpose of heat treatment is to find the optimum condition to either enchance or reduce the color in order to increase value of ruby. It was found that by heating a slightly bluish Tanzania ruby in oxygen gas atmosphere could lead to a more perfect ruby. While X-ray diffractometer found the maximum decrease in c/a ratio of the hexagonal structure after the heat treatment at 1200°C, the number of Fe2+ions converted to Fe3+was detected by electron spin resonance spectrometer and found to increase with heating temperatures. These were clearly two factors that reduced blue color in the Tanzania ruby. The best heat treating temperature to enhance the quality of the ruby was at 1300°C.Publication Metadata only Mefloquine concentration profiles during prophylactic dose regimens(2000-05-19) Herwig Kollaritsch; Juntra Karbwang; Gerhard Wiedermann; Andrea Mikolasek; Kesara Na-Bangchang; Walter H. Wernsdorfer; Mahidol University; Universitat WienA pharmacokinetic study with (malaria) prophylactic doses of mefloquine hydrochloride was conducted in 12 healthy adult subjects (Caucasians), 6 females and 6 males, mean age 29.2 ± 6.4 years, mean weight 70.6 ± 13.4 kg. Doses of 250 mg mefloquine were administered on days 0, 1, 7, 14, 21 and 28. Six subjects received a further 5 weekly doses of 250 mg mefloquine, the others 5 further weekly doses of 125 mg. After the third dose the protective threshold mefloquine concentration in blood plasma was achieved in all subjects. In female subjects, mean C(min ss), C(max) ss and AUC(d 0-35) were significantly higher than in males. After the fifth dose, mean Cmax in females reached 1692 ng/ml (4.48 μmol/l), equivalent to a high therapeutic concentration. This is apparently due to a generally lower body weight and a narrower volume of distribution in women. Adverse reactions were significantly more frequent in women than in men. Headache, anorexia, insomnia and vertigo were the most common side effects. The lesser tolerability of mefloquine in females may be due to the higher drug concentrations in this group. This may indicate the need for appropriate adjustment of the prophylactic dose regimen of mefloquine in females.Publication Metadata only Transarterial embolization of vein of galen aneurysmal malformations: 3 cases(2000-01-01) P. Jiarakongmun; S. Pongpech; S. Siriwimolmas; P. Lasjuanias; Mahidol UniversityPublication Metadata only Choleretic activity of phloracetophenone in rats: Structure-function studies using acetophenone analogues(2000-01-10) Pawinee Piyachaturawat; Nitjagan Chai-Ngam; Aporn Chuncharunee; Prayad Komaratat; Apichart Suksamrarn; Mahidol University; Faculty of Medicine, Siriraj Hospital, Mahidol University; Ramkhamhaeng UniversityThe relationship between the chemical structure and choleretic activity of phloracetophenone (2,4,6-trihydroxyacetophenone) was investigated in adult male rats. Fourteen acetophenone analogues, with different substituents on the benzene nucleus, were intraduodenally administered and bile samples were collected via a bile fistula. All of the compounds tested immediately induced choleresis. For the same number of substituents on the benzene ring, hydroxy analogues induced a greater choleresis. The number and position of hydroxy substituents on the benzene nucleus play an important role in determining choleretic activity and biliary secretion of bile acid, but had no relation to biliary excretion of cholesterol. The choleretic activity of the hydroxylated compounds was inversely related to hydrophobicity, as inferred by thin-layer chromatography (TLC). Among the hydroxylated acetophenone analogues, 2,4,6-trihydroxyacetophenone was identified as the most potent, with a choleretic activity of 231.8 ± 6.1 μl/mmol/min. It induced both a high bile flow rate and a high bile salt output and led to lower plasma cholesterol levels. This bile had a low lithogenic potential. The results suggest that a structural requirement for high choleretic activity of 2,4,6- trihydroxyacetophenone is a substituent hydroxy group at 4-position. Additional hydroxy groups at 2- and 6-positions are essential for the induction of higher an output of bile acid, and possibly, other solid materials. (C) 2000 Elsevier Science B.V.Publication Metadata only Interleukin-1β level in gingival crevicular fluid of patients with active periodontitis(2000-12-01) P. Suwatanapongched; P. Laohapand; R. Surarit; Y. Ohmoto; K. Ruxrungtham; Mahidol UniversityPrevious studies revealed that interleukin-1beta (IL-1β) was detectable in gingival crevicular fluid (GCF) of patients with periodontitis, and the level was increased in level in gingival tissue extracts of active periodontal disease sites (defined as attachment loss ≥ 2.5 mm over the preceding 2 months) compared to inactive sites or healthy sites. The present study evaluated the relationship of IL-1β level in GCF and periodontal disease status. GCF was collected with Periopaper strips from 34 disease-active and 45 disease-inactive teeth in 11 untreated periodontitis patients and from 60 teeth in 15 healthy control subjects. Disease activity was defined as attachment loss of ≥ 2.5 mm in at least one site of a tooth as determined by sequential probing. The absorbed GCF volume was determined using a Periotron 6000 and the crevicular IL-1β level was determined using IL-1β monoclonal antibody (Otsuka Pharmaceutical, Japan). IL-1β was below the detection level of the assay (6 pg/ml) in the healthy control group but was detected in most teeth of the periodontitis group. However, disease-active teeth had higher IL-1β level (Mann-Whitney U-test, p < 0.05) than disease-inactive teeth (mean total IL-1β of 5.89 ± 7.88 pg/tooth and 1.72 ± 2.28 pg/tooth; mean concentration of 1.6 ± 2.5 ng/ml and 0.6 ± 0.83 ng/ml, respectively). The level of IL-1β showed no correlation with probing depth, but had significant correlation (p < 0.05) with the extent of attachment loss. This study suggests that the level of IL-1β in GCF may have a predictive value for determining active and inactive periodontal status.Publication Metadata only Community-based programmes: Success factors for public nutrition derived from the experience of Thailand(1999-01-01) K. Tontisirin; P. Winichagoon; Mahidol UniversityThailand has faced the major nutritional problems of protein-energy malnutrition and micronutrient deficiencies, notably iron, iodine, and vitamin A deficiencies. For decades, the problem was addressed through the national health planning system. Its alleviation was embedded in a service-driven approach, which not only consumed a disproportionate share of the government budget, but also restricted participation by the people and depended heavily on centralized planning. This approach failed, resulting in a paradigm shift to community-driven programmes, which were seen as investments for the health of the Thai population. Nutrition was framed as part of the National Economic and Social Development Plan. A comprehensive situation analysis was undertaken and the results were used for community mobilizing, organizing, and financing, using basic minimum needs indicators to guide the process. Critical to the success of the community-based approach was the village-level volunteer system, which featured manageable ratios of mobilizers, facilitators, and households, interacting to define the needs of the communities and propose solutions.Publication Metadata only Prevalence of cytomegalovirus antibodies among various age groups of Thai population(1999-06-01) Surang Tantivanich; Varaporn Suphadtanaphongs; Chutatip Siripanth; Varunee Desakorn; Issaracha Suphanit; Suwanne Phromin; Salinee Panakitsuwan; Pornsawan Amarapand; Dept. of Microbiol. and Immunology; Mahidol UniversityThe prevalence of CMV antibody in various groups of Thai population was studied. Pregnant women and young children had been infected with CMV more than the other studied groups. Children of both sex had equal chance of getting CMV infection while the risk of CMV infection in adult between male and female was significantly difference (p < 0.001). Pregnant women had higher chance to get CMV infection than normal women. Prevalence of CMV antibody at present was similar to previous studies.Publication Metadata only Pharmacokinetics of levofloxacin in healthy Thai male volunteers(1999-12-01) S. Chulavatnatol; A. Vibhagool; C. Sriapha; B. Chindavijak; W. Wanabukul; C. Sirisangtragul; Mahidol UniversityThe pharmacokinetics of levofloxacin, a new fluoroquinolone, were investigated in 12 healthy Thai male volunteers with an average age (SD) of 22.92 (2.50) years. A single oral dose of 300 mg or 500 mg levofloxacin was given to subjects following an 8- hour overnight fast. The drug was given in a controlled, randomized, 2 x 2 crossover design with a 1 week washout period. Venous blood samples were drawn prior to and from 0.25 up to 48 hours after dosing. Plasma levofloxacin concentrations were determined by HPLC assay. The pharmacokinetics of levofloxacin were well described by a linear, 2-compartment open model with first-order adsorption with lag time and first- order elimination. Mean ± SEM of C(max) after 300 mg and 500 mg dose was 4.83 ± 0.33 and 7.75 ± 0.17 μg/mL, respectively. T(max) ranged from 0.7 to 0.8 hours for both doses. Mean ± SEM of AUC(0-(∞)) was 35.77 ± 2.06 μg x h/ml for 300 mg dose and 61.57 ± 2.84 μg x h/ml for 500 mg dose. High distribution with V(SS)/F value of approximately 1.5 L/kg was demonstrated after both doses. Mean ± SEM of CL/F value was 8.64 ± 0.41 L/H and 8.31 ± 0.37 L/h for a 300-mg and a 500-mg dose, respectively. Long t(1/2β) of 7 to 8 hours with the mean residence time of 10.43 ± 0.43 hours and 10.49 ± 0.38 hours after 300 mg and 500 mg dose, respectively, was observed. The results suggested that an oral 300 mg dose once daily provides sufficient C(max) to cover in mild to moderate respiratory tract infections or complicated urinary tract infections and Gram-positive bacteria (median MIC90 0.5 μg/mL) common in skin and soft tissue infections. For severe cases or Streptococcus pneumonia (MIC90 2 μg/mL) infection, a 500-mg dose should be recommended.Publication Metadata only Lipase-catalysed esterification reaction in an organic solvent: Comparison between free and immobilised biocatalysts(1999-03-01) Suphang Chulalaksananukul; Maria Asunción Longo; Warawut Chulalaksananukul; Jean Stéphane Condoret; Didier Combes; Laboratoire d'Ingenierie des Systemes Biologiques et des Procedes; Universidad de Vigo; Mahidol University; Chulalongkorn UniversityThe ability of Mucor miehei lipase to catalyse the esterification reaction between oleic acid and ethanol in a nearly anhydrous organic solvent has been investigated. First, a soluble lipase form was obtained by partial purification of a brute enzymatic solution. The esterification activity of the lipase and its stability in n-hexane were assayed, and the influence of water content on activity was studied. Optimal reaction conditions were obtained for 10 % weight of water/weight of purified enzyme. The reaction kinetics were determined and they were found to fit a Ping-Pong Bi Bi mechanism in which inhibition by excess of ethanol has been identified. The catalytic properties of the soluble form of the enzyme were compared to those previously obtained for the immobilised lipase. Both forms showed the same mechanism, although some differences were found, concerning the stability, values of the kinetic constants and influence of water content.Publication Metadata only Absence of knobs on parasitized red blood cells in a splenectomized patient in fatal falciparum malaria(2000-12-01) Emsri Pongponratn; Parnpen Viriyavejakul; Polrat Wilairatana; David Ferguson; Urai Chaisri; Gareth Turner; Sornchai Looareesuwan; Mahidol University; University of OxfordWe present a case report of fatal falciparum malaria of a splenectomized adult Thai patient. The patient developed high peripheral parasitemia and showed signs of severe malaria with multiorgans involvement. Ultrastructure of Plasmodium falciparum -infected red blood cells in a fatal splenectomized patient and pathological features are reported for the first time with special emphasis on the role of the spleen as a modulating cytoadherence phenotype of parasitized red blood cells (PRBC). In this patient, adherence of the PRBC to the vascular endothelium of brain, kidney and lung including blood circulating cells, was noted, despite the absence of knob on the surface of the PRBC.Publication Metadata only Prevalence of new coronary risk factors in Thai population(2000-11-01) Chunhakasem Chotinaiwattarakul; Nithi Mahanonda; Kiertijai Bhuripanyo; Wattana Leowattana; Charuwan Kangkagate; Rungroj Krittayaphong; Kanchana Wansanit; Chatchada Hongvisitkul; Sasikant Pokum; Mahidol UniversityMany new cardiovascular biomarkers of atherosclerosis have recently been emerging. However, there is a paucity of these data in the Thai population. This study aims to determine the prevalence of these biomarkers of atherosclerosis and the relationship between these new risk factors and other conventional risk factors for atherosclerosis in the healthy Thai population. As a yearly check-up program, we surveyed 3,615 normal healthy populations for their conventional risk factors and some new cardiovascular biomarkers for atherosclerosis. The authors found hyperhomocysteinemia and high level of Lp(a) in 27 per cent and 32 per cent of the cases respectively. Prevalence of recent and past chlamydial infection was found in 30 per cent and 51 per cent respectively.