In vitro propagation and cryopreservation of Aerides odorata Lour. (Orchidaceae)

An efficient method for in vitro propagation and cryopreservation of Aerides odorata was established. Leaf segments were cultured on New Dogashima (ND) mediums supplemented with various concentrations of Benzyladenine (BA) (0-5 mg L(-1)) combined with Naphthaleneacetic Acid (NAA) (0-2 mg L(-1)). The optimal treatment for inducing Protocorm-like Bodies (PLBs) from leaf segments was obtained from the combination of 1 or 3 mg L(-1) BA and 0.5 or 1 mg L(-1) NAA; whereas, the addition of BA or NAA alone induced shoot and/or root initiation rather than PLB or callus formation. Shoots rapidly developed on ND mediums containing 5 mg L(-1) BA. Cryopreservation of leaf segment-derived PLBs was successful using the encapsulation-dehydration method. The maximum survival percentage of Cryopreserved (Cryp) PLBs was achieved by encapsulating PLBs with 2% Na-alginate combined with 2 M glycerol and 0.4 M sucrose. The encapsulated PLBs were then precultured in 0.75 M sucrose for 24 h and dehydrated for 6 h before plunging into liquid nitrogen. Genetic stability of Cryp PLBs after regrowth was assessed by flow cytometry. The findings showed no different patterns of ploidy levels and morphology between Cryp and non-cryopreserved (Ncryp) control plantlets.

Influence of nutrient composition and plant growth regulators on callus induction and plant regeneration in glutinous rice (Oryza sativa L.)

The potential for callus induction and regeneration depends on nutrient composition and plant growth regulators. The aim of the present study was to investigate the effect of nutrient composition and plant growth regulators on callus induction and plant regeneration in the glutinous rice cultivar Khunvang. The effect of 2,4-D concentrations (1, 2, 3, 4 and 5 mg L(-1)) on callus induction and growth were investigated. The results revealed that the highest percentage of callus induction (97%) was observed in MS medium supplemented with 5 mg L(-1) 2,4-D under 16 h Photoperiod. The effects of casein hydrolysate concentrations of casein hydrolysate (0, 300, 500, 700 and 900 mg L(-1)) and proline (0, 300, 500, 700 and 900 mg L(-1)) on callus induction and growth of Khunvang were also observed. The results indicated that the increasing casein hydrolysate and proline concentrations did not show a significant effect on callus growth. However, proline concentration of 900 mg L(-1) yielded 85.67% of callus growth.

Scoring total inflammation is superior to the current Banff inflammation score in predicting outcome and the degree of molecular disturbance in renal allografts

Emerging molecular analysis can be used as an objective and independent assessment of histopathological scoring systems. We compared the existing Banff i-score to the total inflammation (total i-) score for assessing the molecular phenotype in 129 renal allograft biopsies for cause. The total i-score showed stronger correlations with microarray-based gene sets representing major biological processes during allograft rejection. Receiver operating characteristic curves showed that total-i was superior (areas under the curves 0.85 vs. 0.73 for Banff i-score, p = 0.012) at assessing an abnormal cytotoxic T-cell burden, because it identified molecular disturbances in biopsies with advanced scarring. The total-i score was also a better predictor of graft survival than the Banff i-score and essentially all current diagnostic Banff categories. The exception was antibody-mediated rejection which is able to predict graft loss with greater specificity (96%) but at low sensitivity (38%) due to the fact that it only applies to cases with this diagnosis. The total i-score is able to achieve moderate sensitivities (60-80%) with losses in specificity (60-80%) across the whole population. Thus, the total i-score is superior to the current Banff i-score and most diagnostic Banff categories in predicting outcome and assessing the molecular phenotype of renal allografts.

Molecular correlates of scarring in kidney transplants: the emergence of mast cell transcripts

In the Banff consensus, infiltrates in areas of scarring are ignored. This study aimed to characterize the molecular correlates and clinical significance of scarring and inflammation in scarred areas. We assessed the extent of interstitial infiltrates, tubulitis and scarring in 129 clinically indicated renal allograft biopsies, and correlated the results with microarray expression data and allograft survival. Findings were validated in 50 additional biopsies. Transplants with scarring had a worse prognosis if the scarred area showed infiltrates. Infiltration in unscarred and scarred areas was associated with reduced death censored graft survival. In microarray analysis, infiltration in unscarred areas strongly (>r +/- 0.4) correlated with 484 transcripts associated with cytotoxic T cells, interferon-gamma, macrophages and injury. Scarring correlated with a distinct set of 172 transcripts associated with B cells, plasma cells, and others of unknown significance. The strongest correlation was with four mast cell transcripts. In biopsies with scarring, high expression of mast cell transcripts was associated with reduced graft survival and poor functional recovery. In renal allograft biopsies, infiltrates in scarred areas have implications for poor outcomes. Scarring is associated with a distinct pattern of inflammatory molecules, including B cell/immunoglobulin but particularly mast cell-associated transcripts, which correlated with poor outcomes.

FOXP3 expression in human kidney transplant biopsies is associated with rejection and time post transplant but not with favorable outcomes

Expression of the transcription factor forkhead box P3 (FOXP3) in transplant biopsies is of interest due to its role in a population of regulatory T cells. We analyzed FOXP3 mRNA expression using RT-PCR in 83 renal transplant biopsies for cause in relationship to histopathology, clinical findings and expression of pathogenesis-based transcript sets assessed by microarrays. FOXP3 mRNA was higher in rejection (T-cell and antibody-mediated) than nonrejection. Surprisingly, some native kidney controls also expressed FOXP3 mRNA. Immunostaining for FOXP3 was consistent with RT-PCR, showing interstitial FOXP3+ lymphocytes, even in some native kidney controls. FOXP3 expression correlated with interstitial inflammation, tubulitis, interstitial fibrosis, tubular atrophy, C4d positivity, longer time posttransplant, younger donors, class II panel reactive antibody >20% and transcript sets reflecting inflammation and injury, but unlike these features was time dependent. In multivariate analysis, higher FOXP3 mRNA was independently associated with rejection, T-cell-associated transcripts, younger donor age and longer time posttransplant. FOXP3 expression did not correlate with favorable graft outcomes, even when the analysis was restricted to biopsies with rejection. Thus FOXP3 mRNA expression is a time-dependent feature of inflammatory infiltrates in renal tissue. We hypothesize that time-dependent entry of FOXP3-positive cells represents a mechanism for stabilizing inflammatory sites.

Expression of B cell and immunoglobulin transcripts is a feature of inflammation in late allografts

To assess the significance of B-cell and plasma cell infiltrates in renal allografts, we compared expression of B-cell-associated transcripts (BATs) and immunoglobulin transcripts (IGTs) to histopathology and function in 177 renal allograft biopsies for clinical indications. BAT and IGT expression correlated with immunostaining for B cells and plasma cells and with expression of B-cell and plasma cell transcription factors. BATs and IGTs were increased in both T-cell-mediated and antibody-mediated rejection. BAT and IGT scores were strongly related to time posttransplant: biopsies <5 months expressed less BATs and did not express increased IGTs. In contrast, T-cell-associated transcripts were independent of time posttransplant. In biopsies > or =5 months, BAT and IGT scores correlated with interstitial inflammation, tubular atrophy and interstitial fibrosis. By regression tree analysis, the only variables independently correlated with BATs and IGTs were time and inflammation. Expression of BATs and IGTs correlated with renal function, but this relationship was due to differences in early versus late biopsies: BATs and IGTs were not related to function or future function after correcting for time.

Microarray analysis of rejection in human kidney transplants using pathogenesis-based transcript sets

Microarrays offer potential for objective diagnosis and insights into pathogenesis of allograft rejection. We used mouse transplants to annotate pathogenesis-based transcript sets (PBTs) that reflect major biologic events in allograft rejection-cytotoxic T-cell infiltration, interferon-gamma effects and parenchymal deterioration. We examined the relationship between PBT expression, histopathologic lesions and clinical diagnoses in 143 consecutive human kidney transplant biopsies for cause. PBTs correlated strongly with one another, indicating that transcriptome disturbances in renal transplants have a stereotyped internal structure. This disturbance was continuous, not dichotomous, across rejection and nonrejection. PBTs correlated with histopathologic lesions and were the highest in biopsies with clinically apparent rejection episodes. Surprisingly, antibody-mediated rejection had changes similar to T-cell mediated rejection. Biopsies lacking PBT disturbances did not have rejection. PBTs suggested that some current Banff histopathology criteria are unreliable, particularly at the cut-off between borderline and rejection. Results were validated in 51 additional biopsies. Thus many transcriptome changes previously described in rejection are features of a large-scale disturbance characteristic of rejection but occurring at lower levels in many forms of injury. PBTs represent a quantitative measure of the inflammatory disturbances in organ transplants, and a new window on the mechanisms of these changes.

Combined effects of curcumin and vitamin C to protect endothelial dysfunction in the iris tissue of STZ-induced diabetic rats

This study was aimed to evaluate the combined effect of curcumin with vitamin C supplementation on hyperglycemic and dyslipidemia conditions and endothelial cell dysfunction induced in diabetic rats. Wistar Furth rats were used and divided into four groups: control (single injection of 0.9% sterile saline), STZ (streptozotocin, Sigma, 55 mg/kg.BW, i.v.), STZ-vitC (1 g/l ascorbic acid mixed in drinking water), STZ-cur (daily oral treatment of 300 mg/kg.BW curcumin; Cayman Chemical Co., USA), and STZ-cur+vitC (1 g/l ascorbic acid mixed in drinking water and oral treatment of 300 mg/kg.BW curcumin). On 8th week after STZ-injection, the microcirculation in the iris tissue was observed using intravital fluorescence videomicroscopy, and also leukocyte adhesion in the venule was examined for each group. Blood glucose (BG), lipid profiles, glycosylated hemoglobin (HbA1c) were measured in blood samples collected at the end of each experiment. The contents of liver malondialdehyde (MDA) were also quantified for each group. Feeding curcumin (STZ-cur) could decrease BG, HbA1c, dyslipidemia, and MDA significantly, compared to STZ. In cases of feedings curcumin with vitamin C, these results were more effective in all aspects, including leukocyte adhesion. In conclusion, curcumin might increase the effect of vitamin C in protecting the function of endothelial cells through its anti-oxidant with hypoglycemic and hypolipidemic actions.

Attenuation of endothelial dysfunction by exercise training in STZ-induced diabetic rats

The protective effects of exercise training on the diabetic-induced endothelial cell (EC) dysfunction were determined using intravital fluorescent microscopy. Male Sprague-Dawley rats were divided into three groups of control (Con), diabetes (DM), and diabetes with exercise--training (DM+Ex). Diabetes was induced by single intravenous injection of streptozotocin (STZ; 50 mg/kg BW). The exercise training protocol consisted of treadmill running, 5 times/week with the velocity of 13-15 m/min, 30 min/day periods for 12 and 24 weeks (wks). 24 wks after the STZ injection, blood glucose (BG), glycosylated hemoglobin (HbA1C), mean arterial blood pressure (MAP) and heart weight (HW) were significantly higher in DM rats (p < 0.001). However, DM+Ex rats had reduced the abnormalities of MAP (p < 0.01) and HW (p < 0.05) compared with DM rats. Furthermore, there was a significant decrease in heart rate (HR) of DM+Ex rats (p < 0.05) relative to Con rats. To examine the influence of exercise training on EC dysfunction, leukocyte-EC interactions in mesenteric venules and vascular reactivity responses to vasodilators in mesenteric arterioles were monitored by using intravital fluorescence microscopy. The diabetic state enhanced leukocyte adhesion in mesenteric postcapillary venules (p < 0.001). Moreover, an impaired vasodilatory response to the EC-dependent vasodilator, acetylcholine (Ach), not to sodium nitroprusside (SNP), was found in 12- and 24-wk diabetic rats (p < 0.01). The leukocyte adhesion and the impairment of EC-dependent vasodilation to Ach were attenuated by exercise training (p < 0.05). In addition, exercise training was also shown to have favorable preventive effects on hyperglycemia induced oxidative stress, as lower malondialdehyde (MDA) levels were observed from both groups of 12 and 24 weeks DM+Ex compared with DM (p < 0.01). In conclusion, our findings indicate that the endothelial dysfunction of diabetic rats could be characterized by increased leukocyte adhesion and impaired endothelium-dependent relaxation. Regular low intensity exercise training could improve both indices of endothelial dysfunction through amelioration of diabetic-induced oxidant/antioxidant levels. These findings support the notion that regular exercise training could be a fundamental form of therapy in preventing diabetic cardiovascular complications potentiated by endothelial dysfunction.

A hemodynamically mediated mechanism of renal disease progression in severe glomerulonephritides or nephrosis

Glomerular endothelial cell (GEC) dysfunction due to oxidative stress and enhanced proinflammatory cytokines plays an important role in inducing proteinuria and procoagulant activity, namely blood hypercoagulability, hyperviscosity and local intravascular coagulation and altered hemorheology in NS. A dysfunctioning GEC releases fewer endothelium-dependent vasodilators but produces more vasoconstrictors. Severe intrarenal hemodynamic alteration associated with hemodynamic maladjustment with preferential constriction at the efferent arteriole has been uniquely implicated in severe GN and NS-FSGS. Such a constriction exerts three significant hemodynamic impacts. Proximal to the efferent arteriolar constriction, it induces (i) an overestimated GFR due to hyperfiltration and (ii) an elevated intraglomerular hydrostatic pressure. Distal to the efferent arteriolar constriction, it (iii) exaggeratedly reduces PTCF which correlates with the TIF.

Effectiveness and cost analysis of community-based rehabilitation service in Bangkok

This paper aimed to clarify the effectiveness and the cost of the community-based rehabilitation service in Klong Toey slum after a three year study period. One hundred and seventy eight patients used community-based rehabilitation during the three year period. One hundred and fifty-seven patients (86.5%) reported that their problems/conditions were cured or improved. Only nine patients (5.1%) reported that they stopped using community-based rehabilitation because their problems/conditions did not improve. A statistically significant improvement in pain level and walking velocity assessment, in 105 and 78 patients respectively, was demonstrated. Total cost and cost per patient-day of the community-based rehabilitation were Bt 559,920 and Bt 111.1 respectively. Cost per-patient-day of this community-based rehabilitation service was compared with an estimated cost per patient-day of using rehabilitation services at Chulalongkorn University Hospital and was found to be cheaper. This study supported the role of community-based rehabilitation in Thailand. The need for a health service study in rural areas was also noted.

Disability among Thai elderly living in Klong Toey slum

Forty three per cent of the elderly in Klong Toey slum had BAI score less than 20. One point six per cent were moderately severe or severely disabled and needed special care. Around one-third of them caused by stroke. Locomotion, reaching and stretching, dexterity, continence and seeing are common significant types of disability among this population study. Perceived health status, age and working status are independent factors related to disability level. The Barthel ADL index is suitable for using as a tool for a disability survey among Thai elderly. The ODS questionnaire may be applied after considerable modification of the questions concerning behavior and intelligence dimensions.

Health care for elderly people in developing countries: a case study of Thailand

The elderly populations of many developing countries are increasing rapidly. These demographic changes are a direct result of the success of socio-economic development that has led to declines in mortality rates at all ages and reductions in fertility. However, an aged population might be expected to suffer with the problems of dependency and disability leading to an increased burden of disease. Adequate disability and life expectancy data are essential for planning health and social policy but are currently insufficient. Making best use of the limited resources available for health care will require an emphasis on training of professional staff and carers, but with integration of health care for elderly people with established health services, particularly the existing primary health care systems. Strategies aimed at developing separate services for elderly people should be avoided because of the high likelihood of producing services of low quality with an inappropriate hospital emphasis.

Elderly bed-blockers in a Thai teaching hospital: is it a problem?

Elderly patients suffer from a wide range of chronic disabling diseases and social problems. These conditions often lead to increased lengths of hospital stay for acute medical and surgical problems--"bed-blocking". By means of a one-day census of all inpatients at Chulalongkorn Thai Red Cross Hospital the number and reasons for continued hospital stay of all patients, classified by age (less than 60, and 60+ years), were measured. Of 191 medical inpatients surveyed, 34 per cent were 60 years and over. More older than younger patients were still in hospital for non-medical reasons (35% vs 21%, Chi-square = 4.89, p < 0.01). Durations of hospital stay were longer for older patients: median stay 8 and 11 days respectively for those less than 60 and those 60+ years. Early discharge of disabled elderly people to their families was achieved by vigorous social work, thus reducing the extent to which elderly patients become bed-blockers. Further demographic trends, coupled with a breakdown of the extended family structure, will make bed-blocking a very likely problem. The present patterns of care may lead to poor long-term outcomes for the elderly.

The relationship between glucose and uric acid metabolism: influence of short term allopurinol on glucose metabolism

Many investigators suggest that insulin resistance of the peripheral tissues is the primary defect that results in non-insulin dependent diabetes mellitus (NIDDM). It is also generally accepted that multifactorial controls, playing in concert for gene expression trigger this disease. Previous research reports indicated that uric acid metabolism plays a role in the pathogenesis of NIDDM. To investigate this hypothesis, we studied 53 NIDDM patients by using a double blind cross over control study, of allopurinol and placebo administration. We found a statistically significant elevation in the level of hemoglobin A1c (HbA1c) after the allopurinol intervention period of 12 weeks compared with the placebo period of the same duration (p less than 0.003). The elevation was also found in a subgroup with Body Mass Index (BMI) less than 25 kg/m2 (p less than 0.001) and BMI more than or equal to 25 kg/m2 (p less than 0.05). No statistically significant differences between fasting plasma glucose, glucose tolerance test, serum insulin, total cholesterol, triglycerides, high density lipoprotein cholesterol, creatinine, prior to and after use of allopurinol were noted except for serum uric acid (p less than 0.001). No relationship between changes in HbA1c and changes in uric acid, analysed by linear regression analysis and correlation was demonstrated (r = 0.15, p = 0.29). We conclude that the changing of hemoglobin A1c may be a direct effect of allopurinol or support the role of uric acid in the pathogenesis of NIDDM.

Evaluation of diabetic control by using hemoglobin A1 and fructosamine

Evaluation of diabetic control was performed by using fasting plasma glucose, hemoglobin A1 and fructosamine in 139 patients with diabetes mellitus, and 36 normal controls. A linear correlation of fasting plasma glucose with fructosamine and hemoglobin A1 was found. Using fasting plasma glucose alone was found to be inadequate to define good control. HbA1 and fructosamine had an acceptable sensitivity and specificity in assessment of diabetic control, although fructosamine was slightly less sensitive than HbA1. In patients with thalassemia, hemoglobin A1 levels were elevated in 18 of 19 patients. Fructosamine levels also gave misleading results since 6 to 19 patients had an elevated level and one patient had a decreased level. Patients with hypoproteinemia had a decreased fructosamine and hemoglobin A1 level compared to normal control. HbA1 and fructosamine should be cautiously interpreted in patients with thalassemia and hypoproteinemic states. Using these methods in combination with other measure such as home monitoring of blood glucose would be more precise particularly in diabetic patients with hypoproteinemia, abnormal hemoglobin and other hemolytic disorders.

Effect of alloxan on the mouse pancreas during and after recovery from diabetes

Temporary diabetes was produced in mice by the intravenous injection of alloxan, 75 mg. per kilogram of body weight. The beta cells were degranulated within 6 hrs., but changes in microcirculation did not occur until 24 hrs., and did not appear to play arole in initiating damage to the beta cells. The total number of islets was decreased markedly within one week, but cellular proliferation of ducts and islets began as early as two weeks as indicated by in vivo study and radioautography. Improvement in the diabetic state, manifested by lowered blood glucose, coincided with restoration of a number of the islets. Although the total number of islets was not restored completely, the blood glucose values returned to normal, indicating that the new islets were functioning adequately. Replacement of the insular cells occurred solely by budding of new islets from the ducts,and no evidence of acino-insular transformation, or transformation of centro-acinar cellsinto beta cells, was found.

Effect of tolbutamide on postnatal neogenesis of the islet of Langerhans in mouse

Tolbutamide stimulates postnatal neogenesis of the islets of Langerhans as demonstrated by enumeration of the islets, in vivo studies and radioautography. This drug first causes transient dilatation of insular vessels and rapid blood flow, followed by de granulation of the beta cells. Reappearance of granules, proliferation of the small pancreatic ducts, formation of new islets and an increased number of small islets occur during chronic administration of tolbutamide. The implications of these findings for the management of juvenile diabetes are discussed.