Fever of unknown origin: a review of 25 cases in Ramathibodi Hospital.
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Biomedical subjects
Publications and source records attributed to A Limsuwan.
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Amoebocyte lysate from the horseshoe crabs (Tachypleus gigas) which abounds in the Gulf of Thailand was used to detect endotoxin in patients with Gram-negative bacteremia, in patients with Gram-positive bacterial infections as well as in the control. The Tachypleus lysate test (TLT) was positive in 94.4% of 36 patients with Gram-negative bacteremia before initiation of antibiotic therapy. Only 4% of 50 healthy individuals were positive and all 7 patients with Gram-positive bacterial infections were negative. The threshold sensitivity of TLT was 0.625 micrograms endotoxin per ml of the plasma. In comparison with the commercial Limulus lysate test (LLT), the TLT was slightly more sensitive in exhibiting higher grade of reaction, eventhough the threshold sensitivity was the same.
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Determination of diphtheria and tetanus antitoxin levels by an indirect haemagglutination method were conducted in 101 nonimmunized schoolchildren, 155 pediatric patients and 102 blood donors. Diphtheria and tetanus antitoxin levels were found mostly adequate among immunized children. Diphtheria antitoxin levels were found adequate in 68.3% of the non-immunized schoolchildren. Tetanus antitoxin levels were found inadequate for protection in the non-immunized children and adults. Immunization of children and adults with diphtheria and tetanus toxoid are highly recommended.
A total of 2,764 students were examined from five schools in Bang Pa-in, district, Ayutthaya Province, Thailand; 12 were found to have heart disease, a prevalence of 4.34 per thousand examined. Of these 4 cases were known by their parents to have heart disease prior to our study. The prevalence of congenital heart disease was 3.3 and of rheumatic heart disease 1 per thousand students. The incidence of functional heart murmur was 46%. The prevalence rate of heart disease in Thai school children was similar to rates in reports from Canada, America and Iran.
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We present a report on children with severe pulmonary hypertension secondary to congenital heart disease who received 6 months of beraprost therapy. The children had an increase in intracardiac left-to-right shunt and a reduction of the pulmonary-to-systemic vascular resistance ratio, whereas the pulmonary artery pressure was not significantly changed.
The safety and immunogenicity of REMUNE, an HIV-specific immune based therapy for HIV infection, was evaluated in a cohort of 30 HIV infected subjects in Thailand. This therapy utilizes a gp120 depleted inactivated virus (HZ321), which exhibits a high degree of conservation with the core antigens of both type B' and E strains of HIV, the predominant Thailand isolates. The treatment was well tolerated, with no serious adverse events reported over the course of the 4-month trial. Treatment in which four doses were administered with REMUNE appeared to boost HIV-specific immune responses, with approximately 75% of the treated subjects demonstrating an increase in either the repertoire or the intensity of the serological response to HIV as measured by Western blot. CD4%, viral load, and weight remained stable over the course of the 4-month study relative to baseline values. Viral subtyping of this cohort revealed a predominance of type 'E'. These data suggest that REMUNE is safe and immunogenic in seropositive Thai subjects and supports further study of the therapeutic potential of REMUNE to treat HIV-1 infection.
PURPOSE: Spontaneous resolution of myelofibrosis is extremely rare. A patient with myelofibrosis and pancytopenia that spontaneously resolved with subsequent development of acute myelomonocytic leukemia and an extramedullary mass of the ovary is described. PATIENT AND METHODS: A 2-year-old girl had severe pancytopenia and myelofibrosis without signs of myeloid metaplasia. The patient was transfused with packed red blood cells and platelets and monitored. RESULTS: The pancytopenia and myelofibrosis resolved spontaneously within 1 month after initial presentation and her blood counts normalized. The patient developed a chloroma of the ovary and acute myelomonocytic leukemia 13 months later and eventually died from disease. CONCLUSIONS: This patient initially had acute myelofibrosis which was most likely secondary to occult acute myelomonocytic leukemia. The transfusions may have been a contributing factor in the spontaneous remission.