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Publication Open Access Morphology and histology of the adult Paramphistomum gracile Fischoeder, 1901.(2013) Busaba Panyarachun; Arin Ngamniyom; Prasert Sobhon; Panat Anuracpreeda; Mahidol University. Kanchanaburi Campus. Agricultural Science; Mahidol University.Faculty of Science. Department of Anatomy; Mahidol University.Division of Agricultural Science.-sections were stained with hematoxylin and eosin, and examined. The body surface and longitudinal section of P. gracile were also assessed using scanning electron microscopy. In this species, the anterior sucker and posterior sucker (acetabulum) werePublication Open Access Mast cell activation in the skin of Plasmodium falciparum malaria patients.(2015-02-07) Panop Wilainam; ภานพ วิไลนาม; Rungrat Nintasen; Parnpen Viriyavejakul; พรรณเพ็ญ วิริยเวชกุล; Parnpen Viriyavejakul; Mahidol University. Faculty of Tropical Medicine. Department of Tropical Pathology.; Mahidol University. Faculty of Veterinary Science. Department of Preclinic and Applied Animal Science.cases. Normal skin tissues from 29 cases served as controls. Pre- and post-treatment tissues were included. Histopathological changes of the skin were evaluated using haematoxylin and eosin stain. MCs were investigated using toluidine blue stainingPublication Open Access Effect of L-cysteine on Chilled carp (Cyprinus carpio) semen qualities.(2013) Kan Kledmanee; Somrat Taweedet; Prawporn Thaijongruk; Panida Chanapiwat; Kampon Kaeoket; Mahidol University. Faculty of Veterinary Science. Department of Clinical Sciences and Public Health. Semen LaboratoryThe aim of the present study was to study the effects of L-cysteine on chilled carp (Cyprinus carpio) semen qualities. Pooled semen samples were prepared from eight fish, and divided into five groups according to the concentrations of L-cysteine as follows: 0 (T1), 0.5 (T2), 1.0 (T3), 1.5 (T4) and 2 (T5) mM. The sperm motility, duration of sperm motility and sperm viability were evaluated at 0, 12, 24, 48, 72 hours after chilled storage. Comparing between treatment and control groups, the percentage of sperm motility, duration of sperm motility and the percentage of sperm viability in the treatment groups were significantly higher than the control group (p < 0.05). Considering over a period of time after chilled storage, modified Kurokura’s extender plus L-cysteine groups were able to maintain carp semen qualities (motility, duration of motility and viability) up to 24 hour. Comparing all concentrations of L-cysteine, at 24 hour after chilled storage, the optimal concentration of L-cysteine was found at 1 mM. In conclusion, supplementation of L-cysteine at 1 mMol in modified Kurokura’s extender can be recommended for carp semen chilled storage.Publication Open Access Severe congenital nemaline myopathy with primary pulmonary lymphangiectasia: unusual clinical presentation and review of the literature(2015) Jariya Waisayarat; Chinnawut Suriyonplengsaeng; Chaiyos Khongkhatithum; Mana Rochanawutanon; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of PathologyIntroduction: Nemaline myopathy is a rare genetic muscle disorder defined by the presence of nemaline rods in the muscle fibre sarcoplasm. Congenital nemaline myopathy is the most serious form of the disease’s spectrum. Case presentation: The affected newborn has no spontaneous movement, fractures at birth and respiratory insufficiency. The present case was a Thai male, floppy at birth with fractures of both humeri and femurs and ventilator-dependent respiration. The patient developed bilateral chylothorax two weeks later and died at the age of 6 weeks. Whole-body postmortem examination with informed consent and genetic analysis of ACTA1 mutation were performed. A skeletal muscle biopsy examined by light and transmission electron microscopy showed the features of nemaline myopathy. ACTA 1 heterozygous missense mutation (c.1127G > C) was identified. Histological examination of both lungs revealed primary pulmonary lymphangiectasia. Conclusion: To the best of our knowledge, congenital nemaline myopathy with primary pulmonary lymphangiectasia causing bilateral chylothrax has never been previously reported. Considering chylothorax as a poor prognostic index and an unusual clinical presentation of severe congenital NM are proposed.Publication Open Access The effect of adding L-Cysteine in Modified Kenny's extender on the quality of chilled stallion semen at 5oC(2013) Panithi Sukho; Hiran Juwarahawong; Slitwan Sangiam; Kampon Kaeoket; Mahidol University. Faculty of Veterinary Science. Department of Clinical Sciences and Public Health. Semen LaboratoryThe aim of this study was to investigate the effect of supplementation of L-Cysteine in Modified Kenny's extender on chilled stallion semen quality at 5oC. Semen samples were collected from 3 stallions by artificial vagina and centrifugation to remove seminal plasma and diluted with Modified Kenny's extender to 50 x 106 sperm/ml. Semen samples (n=10 ejaculates) were divided into 3 portions, the first portion as the control (KE), the second portion was added with L-Cysteine 200 μmol/l (KEC200) and added L-Cysteine 400 μmol/l in the last portion (KEC400). In all samples, the percentage of progressive motility, viability and acrosome integrity were evaluated at 0, 24, 48 and 72 h after storage at 5oC. There were a significant (P < 0.05) lower percentage of dead spermatozoa in group KE200 than other groups at 24 h. There was a significantly lower percentage of progressive motility in KEC 400 compared toother groups at 48 h (P < 0.05). In addition, there was a tendency (P = 0.1) of lower percentage of dead spermatozoa in group KE200 than other groups at 48 h. At 72 h, comparing all groups, a higher percentage of viability in groups KEC200 and KEC400 was found, but not statistically significant. In conclusion, Addition of L-cysteine at a concentration of 200 μmol/l to the Modified Kenney's extender tend to improve the stallion chilled semen progressive motility, dead/alive, viability and acrosome integrity during chilled storage at 5oC for 48 h.Publication Open Access Severe falciparum malaria treated with artesunate complicated by delayed onset haemolysis and acute kidney injury(2015) Katherine Plewes; Haider, Md Shafiul; Kingston, Hugh W F; Yeo, Tsin W; Aniruddha Ghose; Hossain, Md Amir; Dondorp, Arjen M; Turner, Gareth D H; Anstey, Nicholas M; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research UnitBackground: Severe falciparum malaria may be complicated by haemolysis after parasite clearance, however the mechanisms remain unclear. Recent reports describe a pattern of delayed onset haemolysis among non-immune travellers with hyperparasitaemia treated with intravenous artesunate, termed post-artesunate delayed haemolysis (PADH). The occurrence and clinical impact of PADH following severe malaria infections in areas of unstable transmission are unknown. Case: A 45-year-old Bangladeshi male was initially admitted to a local hospital with severe falciparum malaria complicated by hyperparasitaemia and treated with intravenous artesunate. Twenty days from his first presentation he was readmitted with delayed onset haemolytic anaemia and acute kidney injury. Multiple blood transfusions and haemodialysis were required. Renal biopsy revealed acute tubular injury and haem pigment nephropathy. His haemoglobin and renal function recovered to baseline after 62 days from his second admission. Discussion: This case highlights the differential diagnosis of post-malaria delayed onset haemolysis, including the recently described syndrome of post-artemisinin delayed haemolysis. The pathophysiology contributing to acute kidney injury in this patient and the limited treatment options are discussed. Conclusions: This report describes PADH complicated by acute kidney injury in an adult patient living in a malaria hypoendemic region who subsequently required blood transfusions and haemodialysis. This case emphasizes the importance of routine follow up of haemoglobin and renal function in artesunate-treated patients who have recovered from severe malaria.Publication Open Access Interobserver variation in classifying lymphomas among hematopathologists(2014) Tawatchai Pongpruttipan; Sanya Sukpanichnant; Thamathorn Assanasen; Lertlakana Bhoopat; Kanita Kayasut; Wasana Kanoksil; Pongsak Wannakrairot; Mahidol University. Faculty of Medicine Siriraj Hospital. Department of PathologyBackground: Lymphomas are common malignancies that have various subtypes with many overlapping histologic, immunophenotypic and genetic features. Therefore, discordance in classifying lymphoma among pathologists may be encountered. But this issue is not well characterized. We conducted the present study to demonstrate discordances among Thai hematopathologists as well as to highlight common arguing points for classifying lymphomas. Methods: The 117 lymphoma cases were randomly retrieved and individually reviewed by 7 hematopathologists, members of the “Thai Hematopathologist Group,” without knowing the original diagnoses. The consensus diagnoses were given from a discussion by all members. In each case, the diagnosis from each participant was compared with the consensus diagnosis and classified into 4 categories as follow: 1) concordance, 2) minor discordance, 3) major discordance and 4) serious discordance. Results: There were approximately 11% discordances between original and consensus diagnoses. The average discordances among all pathologists according to minor, major and serious discordances were 10%, 3.5% and 0.3%, respectively. Diffuse large B-cell lymphoma had the least discordance (7%). Small biopsies had been found to increase discordances in some lymphoma subtypes. Conclusions: The present study reveals some degrees of interobserver variation in classifying of lymphoma by using the 2008 WHO classification among hematopathologists. Some types of lymphomas on small biopsies were found to have a significant higher discordance rate. This study also described some common diagnostic discordances regarded as potential pitfalls in classifying lymphomas. Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/ vs/13000_2014_162Publication Open Access Phenotypic characterizations and genetic study of progressive rod-cone degeneration in poodles in Thailand(2014) Metita Sussadee; Janjira Phavaphutanon; Chaiyan Kasorndorkbua; Areerat Kongcharoen; Preenun Jitasombuti; Sudtisa Laopiem; Aree Thayananuphat; Mahidol University. Faculty of Veterinary Science. Veterinary Teaching HospitalProgressive rod-cone degeneration (PRCD) is one of several groups of inherited progressive retinal atrophy in dogs. This study aims to describe the characterization of phenotypic appearance and demonstrate the responsible gene mutation, including analysis of the allele frequency of PRCD in Poodle dogs in Thailand. All 10 Poodles with clinical signs of PRCD were identified by a history of progressive vision loss, an abnormal obstacle test, and fundic appearance. Genetic testing of PRCD gene mutation using the Polymerase Chain Reaction and Restriction Fragment Length Polymorphism technique was performed in all dogs. The result confirmed that all 10 dogs were affected. The affected Poodles had presented age at first examination at 8.9 ± 2.33 years. Typical findings of retinal changes were bilateral retinal degeneration with tapetal hyperreflectivity, retinal vessel attenuation and optic disc atrophy. The electroretinogram from 7 affected dogs revealed non-detectable wave amplitude and implicit time in the session of rod responses in all dogs whereas small wave amplitude of cone response was recorded in 4 dogs. Histopathological examination of an affected eye revealed the collapse of the nuclear and photoreceptor layers. A prevalence of carriers in 50 Poodles was 12% while the allele frequency of mutant allele was 0.1. Genetic finding of PRCD in Poodles in Thailand corresponds to the previous report whereas the age onset of dogs presented from this disease and the age at complete blindness are much later than previously reported.Publication Open Access Reticulate hyperpigmentation in systemic sclerosis: a case report and review of the literature(2015) Mati Chuamanochan; Haws, Andrea L.; Penvadee Pattanaprichakul; Mahidol University. Faculty of Medicine Siriraj Hospital. Department of DermatologyIntroduction: Systemic sclerosis is a systemic connective tissue disease with variable cutaneous presentations. Although pigmentary disturbances have been described in systemic sclerosis, a reticulate hyperpigmentation has only been reported in one case of systemic sclerosis to date. Case presentation: We describe a previously healthy 51-year-old Thai woman who presented with a reticulate hyperpigmentation affecting her trunk and extremities, together with sclerodactyly and proximal sclerosis, resulting in a new diagnosis of systemic sclerosis. Conclusions: To date, the pathogenesis of reticulate hyperpigmentation in systemic sclerosis remains unclear. Increased melanin synthesis and altered thermoregulatory mechanism are proposed to be involved in the pathogenesis of this presentation. This case represents an unusual cutaneous feature of reticulate hyperpigmentation in the setting of systemic sclerosis.Publication Open Access Phenotypic alterations in human saphenous vein culture induced by tumor necrosis factor-alpha and lipoproteins: a preliminary development of an initial atherosclerotic plaque model(2013) Kriengchai Prasongsukarn; Urai Chaisri; Peenutchanee Chartburus; Kamolwan Wetchabut; Surachet Benjathummarak; Vasant Khachansaksumet; Yaowapa Maneerat; Mahidol University. Faculty of Tropical Medicine. Department of Tropical PathologyBackground: Atherosclerosis is a chronic progressive inflammatory disease of blood vessels particularly the arteries. The development of atherosclerotic plaques or atherogenesis is a complex process that is influenced by cardiovascular risk factors such as vascular inflammation and dyslipidemia. This study demonstrates the ability of tumor necrosis factor-alpha (TNF-α) and low density lipoproteins (LDL) to induce atherosclerotic plaque in human saphenous vein (HSV) organ culture. Methods: Normal HSV segments, from male patients who had coronary bypass graft, were cultured in DMEM containing 5% heat inactivated fetal bovine serum. TNF-α (5 ng/ml) was applied in combination with native LDL (nLDL) or oxidized LDL (oxLDL) at the dose of 50 μg/ml for 14 days. The phenotypic changes of the organ cultures characteristic of initial atherosclerotic plaques were evaluated. The effect of anti-atherogenic agent, 17-β estradiol (E2), was also determined. Results: Histologic, histomorphometric, and immunohistochemical examinations revealed that HSV rings stimulated with TNF-α + nLDL or TNF-α + oxLDL can exhibit the essential morphological features of atherogenesis, including fibrous cap formation, cholesterol clefts, evident thickening of the intimal layer, increased proliferation of smooth muscle cells (SMC) and migration to the subendothelial layer, significant SMC foam cell formation, and increased expression of adhesion molecules in the vascular wall. Addition of E2 (50 nM) to the culture significantly modulated the critical changes. Consistently, mRNA profiling of the HSV model revealed that 50 of 84 genes of atherosclerosis were up-regulated. Conclusions: Phenotypic changes characteristic of the initial development of atherosclerotic plaques can be induced in HSV organ culture.