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ELISA antibodies to cysticerci of Taenia solium in human populations in New Guinea, Oceania, and Southeast Asia.

The presence of ELISA antibodies to cysticerci of Taenia solium was surveyed in populations of New Guinea, Micronesia, and several areas of Southeast Asia. It is confirmed that cysticercosis in New Guinea remains limited to the primary Wissel Lakes focus in Irian Jaya, where the disease was introduced by the importation of infected pigs, and that it has not spread to populations east or south of the Wissel Lakes, or to Papua New Guinea. On the island of Bali, Indonesia, 21% of sera were positive from one village where pigs are especially numerous, whereas in Sumatra, Indonesia, only 3%-4% of sera were positive. In Singapore, there was a higher proportion of positive sera among the Chinese (13%) than among the Indian (5%) or Malay (3%) Moslems. From 3 to 13% of sera from populations in Micronesia, Burma, Vietnam, and the Philippines were also found to react with cysticercus antigen. However, the problem of incomplete ELISA specificity raises the possibility that in areas not known to be endemic for T. solium, seropositive results could represent either subclinical infection with cysticerci or crossreactivity to other parasitic infections.

Antibodies↗

[Liver cirrhosis in Asia and Africa].

Whereas in Europe and North America high alcohol consumption is a very frequent cause of cirrhosis of the liver, im many Asian and African countries hepatitis B virus is the most important etiologic agent. Own observations in 345 patients with liver cirrhosis serve to illustrate the etiologic factors, age, sex and causes of death of this disease in Japan. 25 of the patients also had primary hepatocellular carcinoma. Hepatitis B virus infection appears to be a frequent cause of cirrhosis of the liver and hepatocellular carcinoma in Asia and Africa.

Adult↗

Epidemiology and control of schistosomiasis in Southeast Asia.

Schistosomiasis in Southeast Asia, caused by Schistosoma japonicum, Schistosoma mekongi and Schistosoma japonicum-like, have been reported from six different countries. The S. japonicum infections are highly prevalent in the Philippines with Oncomelania hupensis quadrasi as the vector snail, and in localized areas in Indonesia with O.h. lindoensis as the snail vector. The S. mekongi infections are recent discovery in the Lower Mekong Basin in Laos and Kampuchea, with Tricula aperta as the vector snail. The S. japonicum-like infections are found as isolated cases diagnosed by the finding of S. japonicum-like eggs in the faeces, rectal biopsy, tissue biopsy or at necropsy in Thailand and Malaysia. The control measures of schistosomiasis have been implemented in the Philippines and Indonesia, while further research studies are being conducted in Thailand and Malaysia.

Adolescent↗

Anti-P1, allohemagglutinins associated with Clonorchis sinensis and opisthorchis viverrini infections in patients from Southeast Asia.

An automated assay of anti-P1 allohemagglutinins has been carried out on sera of 61 individuals from Southeast Asia : 28 with clonorchiasis, 18 with opisthorchiasis and 15 control subjects. Anti-P1 activity was detected in 61% of the opisthorchiasis sera, 57% of the clonorchiasis sera and in 26.6% of the control subjects. Their concentration, in the sera, was low in control subjects and exceptionally high in clonorchiasis and opisthorchiasis (up to 13 and 22 times the maximum concentration of the control subjects, respectively). In all cases the anti-P1 antibodies were of IgM class. The results suggested that Clonorchis and Opisthorchis were responsible for immunization of the patients, with P1 alloantigen.

Blood Group Antigens↗

Studies on the immune response of foot-and-mouth disease vaccine type Asia-1 in pregnant ewes, lambs and evaluation of type O vaccine by challenge.

Seven pregnant ewes at the 10th to 12th week of pregnancy were vaccinated with foot-and-mouth disease (FMD) vaccine type Asia-1. All pregnant animals responded well with antibody production without any adverse effects. The maximum antibody titer was noted 3 to 4 weeks after the vaccination. In the colostrum a high level of maternal antibodies persisted from 12 hrs to 6 weeks after birth. Irrespective of the presence of the maternal antibodies, the vaccinated lambs responded with antibody production within the first week of vaccination. The antibodies persisted up to the 12th week of vaccination. In another experiment five sheep were vaccinated with FMD type O vaccine and challenged with 10,000 TCID50 of virulent type O cell culture-adapted virus. The antibody titers in the vaccinated animals prior to challenge ranged between 1.26 to 1.65, while the four control sheep remained free from detectable antibody against virus type O. Pyrexia and viraemia developed present in all the control sheep but were absent in the vaccinated ones. Characteristic primary lesions on the dorsum of the tongue were observed after 48 hrs of virus challenge in the control sheep but were absent in the vaccinated ones.

Animals↗

[Restriction types of main noncoding segments of mitochondrial DNA in aboriginal and migrant inhabitants of Northeast Asia].

An analysis of data on the restriction fragment length polymorphism (RFLP) of the 16,081-16,545-bp locus of the major noncoding region of mitochondrial DNA (mtDNA) in samples of Asian Eskimos and coastal Chukchi of Chukotka and Slavs from Magadan is presented. By means of analysis of combinations of restriction pattern variants, the mitotypical structure of the studied population groups of the northeastern region of Russia was studied. A notable difference in mitotypical diversity was found: twelve types of the non-coding region were observed in Slvas (h = 0.916) and only two identical types each were found in Eskimos (h = 0.1) and Chukchi (h = 0.356). The results are compared with literature data on mtDNA polymorphism in various world populations. Possible reasons for the observed differences in mitotypical diversity in population groups of Northeast Asia differing in ethnic origin are discussed.

DNA, Mitochondrial↗

Odontometry and biological affinity in south Asia: analysis of three ethnic groups from northwest India.

Current knowledge of odontometric variation among the people of south Asia is limited, yet variation in tooth size has the potential to answer important questions regarding genetic relationships among contemporary social groups. Here, we report tooth crown diameters for 3 ethnic groups (Bhils, Garasias, Rajputs) from Gujarat State and contrast these data with 10 social groups from north, northwestern, northeastern, west-central, and south India. Univariate descriptive and inferential statistics are presented by group and by sex. Examination of crown diameters demonstrates that tooth size differs significantly between social groups in Gujarat. Cluster analysis of sex-standardized odontometric mean parameter values indicates that in apportionment of tooth size throughout the dentition low-status Garasias are slightly more similar to tribal Bhils than they are to high-status Rajputs. Principal components analysis by sex identifies three components that together account for 58.2% and 56.3% of the total variance among Gujarati females and males, respectively. These components are identified as overall size, a dimensional contrast between mesiodistal diameters and buccolingual diameters, and a dimensional contrast between mesiodistal diameters and buccolingual diameters among anterior teeth coupled with a contrast between anterior teeth (incisors, canines) and posterior teeth (premolars, molars). Ordination of group component scores indicates that (1) males and females of each social group exhibit a pattern of tooth size apportionment most similar to the opposite member of that same social group and (2) low-status Garasias exhibit a tooth size apportionment profile intermediate between tribal Bhils and high-status Rajputs. To place this pattern of odontometric variation among modern Gujaratis in larger perspective, data from Gujarati males were contrasted against males from 10 social groups from north, northwestern, northeastern, west-central, and south India. Cluster analysis of group-standardized odontometric mean parameter values indicates that (1) Gujarati social groups, regardless of social status or caste adherence, are more similar to one another than to any other group included in this analysis and (2) Gujarati social groups share closet affinities with geographically proximate social groups (Ahirs, Jats, Kunbis). Principal components analysis yields three components that combine to explain 64.0% of the total variance. These components are interpreted as a dimensional contrast among posterior teeth, a dimensional contrast among nonmolar teeth, and a contrast between anterior and posterior teeth. Ordination of group component scores indicates that tribal Bhils possess tooth size apportionment profiles that are different from other Indian tribal groups but are proximate to those found among Gujarati Hindu groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Extramural training of medical students: lessons from Southeast Asia.

Several medical schools in Southeast Asia have identified deficiencies in their undergraduate medical education that result in inappropriate training of students for the health-care problems that exist in their respective countries. Curriculum changes have been made that take students out of the laboratory and the subspecialty-oriented university hospital and place them in extramural programs in the community. Both the deficiencies identified and the solutions developed merit study by North American medical educators, especially those teaching primary care in family practice.

Community Health Services↗

Case report: locally acquired trichinosis in an immigrant from Southeast Asia.

The authors report a case of trichinosis acquired in Oklahoma City by an immigrant from Southeast Asia. The 49-year-old female reported having abdominal discomfort, nausea, and vomiting, and had purchased and eaten lightly cooked pork. She also complained of fatigue, anorexia, and muscle aches for several months. An immigrant from Laos, she stated that she regularly eats pork and prefers it rare or mildly cooked. The authors caution local physicians to be aware of the increased risk of trichinosis among Southeast Asian immigrants in the area, particularly those from Laos and Cambodia. Continued emphasis on the need to thoroughly cook all pork products is necessary if the incidence of trichinosis in the U.S. is to be controlled.

Animals↗

Frequency and characteristics of silent dementia among elderly Japanese-American men. The Honolulu-Asia Aging Study.

OBJECTIVE: To determine the frequency of unrecognized dementia in a group of men found to have dementia by population survey, and to identify factors associated with the failure of a family informant to recognize significant memory impairment. DESIGN AND SETTING: The Honolulu-Asia Aging Study, a population-based study of dementia among elderly Japanese-American men living on the island of Oahu, Hawaii. Data for this study were from the dementia prevalence survey, 1991-1993. STUDY PARTICIPANTS: A total of 191 noninstitutionalized men with dementia who had a reliable family informant. MAIN OUTCOME MEASURES: Failure of family informants to recognize a problem with thinking or memory in subjects with dementia. RESULTS: A total of 21% of family informants failed to recognize a problem with memory among subjects subsequently found to have dementia. Among subjects with very mild dementia, 52% of family informants failed to recognize a significant memory problem compared with 13% among more severely demented subjects. Of the subjects with dementia whose family informants did recognize a memory problem, 53% failed to receive a medical evaluation for this problem. For all family informants, increasing age, fewer years of education, less severe dementia, fewer behavioral complications, fewer functional disabilities, and better performance on certain tests of memory and language were significantly associated with the family informant's failure to recognize a problem with memory. When the family informants were wives living with husbands, less severe dementia, fewer behavioral complications, fewer functional disabilities, and intact remote memory were associated with unrecognized dementia. CONCLUSIONS: Unrecognized dementia was common in our population, especially among mild cases. Cognitive screening programs for the elderly and public education policies designed to increase awareness of early signs of dementia are needed if interventions for individuals with potentially treatable dementias are to be implemented.

Aged↗

Thoracoscopic major lung resection--indications, technique, and early results: experience from two centers in Asia.

The application of video-assisted thoracic surgery (VATS) to major lung resection is controversial. We reviewed our combined experience in this technique from two centers in Asia. From January 1993 to December 1995, 78 patients (44 male and 34 female patients with ages ranging from 16 to 85 years) successfully underwent VATS major lung resections. Selection criteria for this approach include (a) lesions < 5 cm in maximal diameter; (b) for primary lung carcinomas, clinical stage I status; (c) absence of chest wall involvement; (d) absence of pleural symphysis; and (e) complete or near complete interlobar fissures. Procedures included segmentectomy (1), lobectomy (69), bilobectomy (2), and pneumonectomy (6) together with mediastinal lymph node sampling in cases of primary malignancy. We emphasized not spreading ribs and using conventional thoracic instruments for dissection together with wound protection on specimen retrieval. There was one perioperative death and five nonfatal complications that included persistent air leak over 10 days in two patients, pneumonia in one, and persistent dysesthesia related to surgery in two. We conclude that VATS major lung resection is technically feasible. Stringent patient selection is important. Specific complications exist and special training is needed. The exact role of this approach in thoracic surgery remains to be defined by prospective randomized study compared with conventional thoracotomy with long-term follow-up.

Adolescent↗

[Pulmonary melioidosis in a German Southeast Asia tourist].

HISTORY AND CLINICAL FINDINGS: A patient who returned from a 3-year stay in Thailand and India one year ago, was admitted with fever of 38.5 degrees C and productive cough for the last four weeks. He remembered wounding his foot three years ago in India with contamination by soil. Subsequently, recurrent pustulae appeared on his feet. One such pustule was found on admittance. The clinical examination showed low body weight, without further abnormalities. INVESTIGATIONS: The blood examinations revealed high inflammation parameters and ruled out any immunodeficiency. Smouldering infiltrates in the upper lobes were found on the chest radiography. Sputum was free of acid fast bacilli and no mycobacterial DNA was detected by polymerase chain reaction. Bronchoscopy showed a normal endobronchal situation, Burkholderia pseudomallei were found to grow from specimens of bronchial mucus. TREATMENT AND COURSE: Under the empirical treatment with ampicillin/sulbactam, we could not find any response. After switching to Ceftazidime and trimethoprim/sulfamethoxazol (TMP/SMZ) we observed quick clinical improvement and normalisation of the inflammation parameters and notable radiological response over three weeks. We continued a five months TMP/SMZ therapy after discharge in order to prevent relapses. CONCLUSION: For travellers and immigrants from Southeast Asia presenting smouldering infiltrations of the upper lobes, one should include Melioidosis in the differential diagnosis.

Adult↗

[A molecular epidemiologic investigation of north Asia fever in scenic spots of Beijing suburb].

PCR/RFLP technique was used to detect spotted fever group rickettsiae (SFGR) in ticks and small mammals collected in eleven scenic spots of Beijing suburb. We not only detected Rickettsia sibirica in D. sinicus and hedgehog collected nearby the Museum of Aviation, but also isolated two strains of SFGR from them, named as BJ-95 strain and BJH-95 strain respectively. The two strains were identified as R. sibirica by SDS-PAGE, Western blot and PCR/RFLP. The results demonstrated the existence of horizontal transmission of R. sibirica between ticks and small mammals and showed the most scenic spots except the vicinity of Museum of Aviation being investigated were safe to North Asia Fever. This is the first report on the isolation of R. sibirica in hedgehogs.

Animals↗

[Tropical sprue as the cause of chronic diarrhea after travel to Southeast Asia].

A 43-year-old woman developed abdominal pain and diarrhea following a travel to Malaysia. Examinations in another hospital proved no evidence of infection, an empirical antibiotic therapy with ciprofloxacin yielded no benefit. One and a half year later, the patient was admitted to our department because of persistent diarrhea and wasting. Laboratory tests showed megaloblastic anemia, folate deficiency and steatorrhea. Stool specimens for bacterial pathogens and parasites were negative. Endoscopy and biopsy from the distal portion of the duodenum revealed broadening and shortening of the villi and an increased infiltration of the lamina propria by chronic inflammatory cells (plasma cells and lymphocytes). In conclusion, diagnosis of tropical sprue was established. The therapy comprised of tetracycline for six weeks and folic acid for six months. Subsequently, the diarrhea disappeared, the patient continuously gained weight and was free of any complaints. The complete remission following this regimen proved the suspected diagnosis. Differential diagnosis in any patient who recently returned from the tropics may be a challenge. Tropical sprue predominantly occurs during or after a longer stay in endemic areas. However, if chronic diarrhea and signs of malabsorption develop after a short journey to India, South-East Asia and parts of the Caribbean, tropical sprue has to be considered, too.

Adult↗

Female first marriage in East and Southeast Asia: a Kiefer-Neumann model.

Many studies have shown that schooling levels of husband and wife are important determinants of household behavior in developing countries. This article asks how the schooling levels of husband and wife come to be associated with each other through the marriage market. The Kiefer-Neumann model of labor market search is adapted to marital search, the aim being to explain both the positive sorting on educational levels for spouses, and the positive relationship between female schooling and age at 1st marriage. World Fertility Survey data for Indonesia, Korea, and Malaysia are employed in the analyses.

Asia↗