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Since April 2022, the world has been witnessing a rapidly spreading outbreak of acute hepatitis of unknown origin in children < 16 years old that has affected several countries around the world. Most of the cases have presented with the clinical picture of severe hepatitis that has led to resorting to liver transplantation in several cases. Despite the numerous theories that have been suggested on the possible underlying etiologies of the outbreak, an association with hepatitis A-E viruses and a link to COVID-19 vaccines have been excluded. Adenovirus serotype 41 has been detected in numerous cases, which makes it the most likely underlying cause of the disease. Nevertheless, other hypotheses are being investigated to justify the severity of the clinical picture, which is not typical of this type of virus. This review aims to summarize the current knowledge about the outbreak, highlight the suggested working hypotheses, and report the public health measures undertaken to tackle the outbreak.
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COVID-19 , Hepatite A , Hepatite , Humanos , Criança , Adolescente , Vacinas contra COVID-19 , COVID-19/complicações , COVID-19/epidemiologia , Hepatite A/complicações , Hepatite A/epidemiologia , Saúde Pública , Surtos de Doenças , Doença AgudaRESUMO
BACKGROUND: As smartphone becomes increasingly prevalent and affordable, more youths today can own a smartphone device and download applications in various application stores. Smartphone applications have been proven to be useful for youths in various aspects. However, there has been a paucity of data looking into the preferences of Vietnamese youths and adolescents with regards to health-related applications and their receptiveness towards smartphone apps. Therefore, this study aimed to determine the receptiveness and preferences of health-related smartphone applications (mHealth apps) among online Vietnamese youths and adolescents. METHODS: An online cross-sectional study was conducted between the periods of August till October 2015 in Vietnam. Respondent-driven sampling technique (RDS) was utilized to recruit participants. Participants were asked questions about their history of downloading and using health-related smartphone applications and their receptiveness when using these applications. Moreover, socio-demographic characteristics and health status were also self-reported. Multivariate logistic regression was employed to determine associated factors. RESULTS: Among 1028 participants, 57.4% owned a smartphone and only 14.1% of smartphone users have used a health-related smartphone application, and most of these individuals downloaded the applications for disease prevention (66.3%). 66.4% of the participants who owned these applications reported that health applications were useful and 92.8% reported being satisfied with the functionalities of the applications which they owned. Among smartphone users, people who were employed (OR = 15.46; 95%CI = 4.93-48.47) were more likely to download mHealth apps. Meanwhile, youths with higher EQ-5D index had a lower likelihood of downloading healthcare-related smartphone applications (OR = 0.17; 95%CI = 0.04-0.81). CONCLUSIONS: This study highlighted a low rate of mHealth apps utilization among online Vietnamese youths and adolescents but a high acceptance of individuals who already used these apps. Developing mHealth apps or interventions towards the disease prevention and quality of life improvement could be feasible to proliferate the benefits of such applications in youths and adolescents in Vietnam. Further research should be conducted to optimize the contents and interfaces of mHealth apps that meet the needs of these populations.
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Atitude Frente a Saúde , Comportamento do Consumidor/estatística & dados numéricos , Aplicativos Móveis , Smartphone , Telemedicina , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Vietnã , Adulto JovemRESUMO
BACKGROUND: The members of the genus Muntiacus are of particular interest to evolutionary biologists due to their extreme chromosomal rearrangements and the ongoing discussions about the number of living species. Red muntjacs have the largest distribution of all muntjacs and were formerly considered as one species. Karyotype differences led to the provisional split between the Southern Red Muntjac (Muntiacus muntjak) and the Northern Red Muntjac (M. vaginalis), but uncertainties remain as, so far, no phylogenetic study has been conducted. Here, we analysed whole mitochondrial genomes of 59 archival and 16 contemporaneous samples to resolve uncertainties about their taxonomy and used red muntjacs as model for understanding the evolutionary history of other species in Southeast Asia. RESULTS: We found three distinct matrilineal groups of red muntjacs: Sri Lankan red muntjacs (including the Western Ghats) diverged first from other muntjacs about 1.5 Mya; later northern red muntjacs (including North India and Indochina) and southern red muntjacs (Sundaland) split around 1.12 Mya. The diversification of red muntjacs into these three main lineages was likely promoted by two Pleistocene barriers: one through the Indian subcontinent and one separating the Indochinese and Sundaic red muntjacs. Interestingly, we found a high level of gene flow within the populations of northern and southern red muntjacs, indicating gene flow between populations in Indochina and dispersal of red muntjacs over the exposed Sunda Shelf during the Last Glacial Maximum. CONCLUSIONS: Our results provide new insights into the evolution of species in South and Southeast Asia as we found clear genetic differentiation in a widespread and generalist species, corresponding to two known biogeographical barriers: The Isthmus of Kra and the central Indian dry zone. In addition, our molecular data support either the delineation of three monotypic species or three subspecies, but more importantly these data highlight the conservation importance of the Sri Lankan/South Indian red muntjac.
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Mitocôndrias/genética , Cervo Muntjac/classificação , Animais , Sudeste Asiático , DNA Mitocondrial , Evolução Molecular , Índia , Cariotipagem , Tipagem Molecular , Cervo Muntjac/genética , Filogenia , FilogeografiaRESUMO
Vietnam has a concentrated HIV epidemic, with the highest HIV prevalence being observed among people who inject drugs (PWID). Based on its experience scaling-up robust HIV interventions, Vietnam aims to further strengthen its response by harnessing the preventive benefits of antiretroviral therapy (ART). Mathematical modelling suggests that prioritizing key populations for earlier access to ART, combined with other prevention interventions, may have significant impact on the epidemic, cost-effectively reducing new HIV infections and deaths. Pilot studies are being conducted to assess feasibility and acceptability of expansion of HIV testing and counselling (HTC) and early ART among key populations and to demonstrate innovative service delivery models to address challenges in uptake of services across the care cascade. Earlier access of key populations to combination prevention interventions, combined with sustained political commitment and supportive environment for key populations, are essential for maximum impact of ART on the HIV epidemic in Vietnam.
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Antirretrovirais/uso terapêutico , Infecções por HIV/prevenção & controle , Antirretrovirais/economia , HIV/patogenicidade , Infecções por HIV/epidemiologia , Humanos , Modelos Teóricos , Vietnã/epidemiologiaRESUMO
Cardiac cysticercosis is rare in clinical practice and is usually accidentally identified during cardiac surgery or autopsies. Although mostly asymptomatic, cardiac cysticercosis could present with severe clinical conditions such as myocarditis, acute myocardial infarction, and arrhythmia. We present a 51-year-old female patient who accidentally discovered a solitary mass in the myocardium. The cardiac magnetic resonance imaging revealed a nonenhanced cyst in the interventricular septum protruding into the right ventricular chamber. Because of cardiac tamponade presenting during a right ventricular endomyocardial biopsy, an emergency open-heart surgery was performed to suture the ventricular wall perforation and remove the tumor. The histopathologic report demonstrated typical cysticercosis. Cardiac cysticercosis is an uncommon lesion and may present with atypical clinical and laboratory features. Therefore, this diagnosis should be considered single or multiple cardiac cystic lesions.
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In May 2022, the world witnessed the re-emergence of the zoonotic disease monkeypox. While this was not the first epidemic of this disease, what differentiated the outbreak was the rapid global spread and increase of cases, which led the WHO to declare monkeypox a global health emergency. Although the disease spreads mainly through inadequately cooked meat of various rodent species, this virus also shows droplet, respiratory, sexual, and even vertical transmission. Monkeypox further multiplies in lymphoproliferative organs and presents with a classical smallpox-like rash, fever, headache, and muscle aches. Diagnosis is confirmed with a polymerase-chain-reaction test and is managed largely supportively with possible usage of some antivirals and immunoglobulins. Moreover, some pre-exposure and postexposure prophylactic vaccines have been developed. This paper aims to conduct an in-depth review of the historical epidemics, transmission, pathophysiology, clinical presentation, and management of the monkeypox disease.
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Introduction: The 12-item Vietnamese smell identification test (VSIT) has been developed to evaluate the olfactory function of the Vietnamese population. This study aimed to investigate the normative value of the VSIT in different age groups and sexes. Methods: This cross-sectional study was conducted at Ho Chi Minh University Medical Center, Vietnam. All participants were evaluated for odor identification ability using the VSIT. We included healthy participants aged 18 years or older with no history of olfactory disturbances. Results: A total of 391 healthy volunteers were recruited with a mean age of 45.80 years (SD: 17.62; range: 18-86; female: 63.4 %). The tenth percentile of scores on the 0-12 VSIT scale was 8.3 in participants aged 18-29 years, 9.0 in 30-39 years, 8.0 in 40-49 years, 7.8 in 50-59 years, 7.9 in 60-69 years and 6.0 in over 70 years. Young adults (18-39 years old) had better olfactory identification ability than older adults (over 50 years), p < 0.001. There was a significant main effect of sex on VSIT score (p = 0.02), suggesting that females outperformed males. Sensitivity to 8 odors were negatively correlated with age: lemon, garlic, banana, coffee, mango, guava, apple and watermelon (p < 0.05 in all cases) whereas four odors were age-independent including orange, fish sauce, soy sauce, and fish. Conclusion: Normative data provide guidance for assessing individual olfactory function. However, there were significant sex and age effects on olfactory identification scores on the VSIT. Therefore, future studies should be conducted to better adjust for those confounders mentioned above.
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BACKGROUND: Correct olfactory identification requires familiarity with the odor stimuli and is culturally dependent. Existing smell identification tests (SIT) are not culturally specific and may not be reliable in detecting hyposmia in all populations. This study aimed to develop a smell identification test suitable for Vietnamese patients (VSIT). METHODS: The study included 4 phases: 1) survey-based evaluation of the familiarity of 68 odors to identify 18 odors for subsequent testing (N = 1050); 2) smell identification test of 18 odors in healthy patients (N = 50) to determine which 12 should be included in the VSIT; 3) comparison of VSIT scores on 12 odors in patients with hyposmia (N = 60; Brief smell identification test (BSIT) score <8 and those with normosmia (N = 120; BSIT score ≥8) to establish the validity of the newly developed test; and 4) retest of the VSIT in 60 normosmic patients from phase 3 (N = 60) to determine test-retest reliability. RESULTS: As expected, the mean (SD) VSIT score was significantly higher in the healthy participants than in the hyposmic patients [10.28 (1.34) vs 4.57 (1.76); P < 0.001]. Using a cut-off score at 8, the sensitivity and specificity of the instrument in detecting hyposmia were 93.3% and 97.5% respectively. The test-retest reliability using the intra-class correlation coefficient was at 0.72 (P < 0.001). CONCLUSION: The Vietnamese Smell Identification Test (VSIT) demonstrated favorable validity and reliability and will allow for assessment of olfactory function in Vietnamese patients.
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Transtornos do Olfato , Olfato , Humanos , Transtornos do Olfato/diagnóstico , Anosmia , Reprodutibilidade dos Testes , População do Sudeste Asiático , OdorantesRESUMO
Mosaicism, including alleles comprising both wild-type and mutant, is a serious problem for gene modification by gene editing using electroporation. One-step generation of F0 pigs with completely desired gene modifications saves cost and time, but the major obstacles have been mosaic mutations. We hypothesized that the timing of electroporation prior to in vitro fertilization (IVF) can increase the rates of biallelic mutation for multiple gene knockout as the permeability of mature oocytes is greater than that of zygotes. Hence, we determined whether the timing of electroporation during in vitro maturation (IVM) culture enhances triple gene editing in the resulting blastocysts. Three gRNAs targeting KDR, PDX1, and SALL1 were simultaneously introduced into the oocytes that had been incubated for 40, 42, and 44 h from the start of the IVM culture. Electroporation with three gRNAs at 40 h and 42 h during IVM culture decreased the blastocyst formation rates and did not improve the mutation rates and target number of biallelic mutations in the resulting blastocysts. The blastocyst formation rate, mutation rates, and target numbers in the resulting blastocysts from oocytes treated by electroporation at 44 h of IVM culture were similar to those of control zygotes electroporated at 13 h after the initiation of IVF. In conclusion, multiple gene editing efficiency in the resulting blastocysts was comparable between oocytes electroporated before and after the fertilization, indicating that oocytes with completed maturation time may allow better functioning of materials accepting gene editing application.
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In this paper, Ag-Au alloy nanoparticles (NPs) were fabricated by dewetting process to enhance the broadband antireflection performance of textured silicon surfaces. The alloy NPs presented a large range of shapes and sizes, which provided an average reflectance (AR) below 4% over the spectral range of 300~1200 nm, a decrease of ~50% and ~90% as compared to the corresponding monometallic NPs and the original flat Si surfaces, respectively. The superior broadband antireflection demonstrated by the alloy NPs are attributed to the enhanced light trapping by alloy nanoparticle plasmon resonance.
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Several articles have described arthroscopic fixation of coronal shear fractures of the distal humerus. However, not all of them have used purely arthroscopic techniques. In this Technical Note we describe another technique for intra-articular distal humeral fracture fixation using arthroscopy alone. Standard proximal anteromedial, proximal anterolateral, and posterolateral viewing portals are established with soft spot portal for reduction. During intra-articular examination, the fragment involving the capitellum and the trochlea as 1 piece is detected. Closed manipulative reduction under anesthesia is conducted with distraction, varus force, and gradual elbow extension. After closed reduction, reduction of the fragment more precisely under arthroscopic visualization using probe and elevator is performed. The fragment is temporarily fixed using 2 Kirschner wires from posterior direction. Anatomic reduction is confirmed with an image intensifier. Screw guide pin is inserted posteroanteriorly under image intensification, and a headless compression screw is placed over each wire. We describe a safe, reproducible, and minimal invasive technique for the arthroscopic treatment of coronal shear fractures of the distal humerus.
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BACKGROUND: Arthroscopic superior capsular reconstruction (ASCR) is a method for treating irreparable chronic rotator cuff tears. However, the extent to which ASCR can be performed with regard to the patient's age has yet to be determined. PURPOSE: To compare the surgical outcomes of ASCR for the treatment of irreparable rotator cuff tears (IRCTs) in patients aged <65 years versus patients aged ≥65 years. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Of 105 patients with IRCTs who underwent ASCR between March 2013 and June 2020, 73 patients were enrolled in this study based on the selection criteria. Polypropylene mesh augmentation to the graft was used in 18 of 36 patients in the younger adults group (age, <65 years) and 20 of 37 patients in the older adults group (age, ≥65 years). The clinical and radiological outcomes were evaluated preoperatively and at the final clinical follow-up. The graft integrity status was evaluated using serial magnetic resonance imaging and set as the primary endpoint. Furthermore, subgroup analysis was performed based on age group and graft type. RESULTS: The mean age of the patients was 59.2 ± 3.8 years in the younger adults group and 70.5 ± 4.1 years in the older adults group. Both groups showed improvement based on the clinical and radiological outcomes at the final follow-up. The mean American Shoulder and Elbow Surgeons scores improved from 52.3 ± 15.4 to 77.3 ± 13.5 in the younger adults group (P < .001) and from 45.7 ± 16.1 to 76.6 ± 11.4 in the older adults group (P < .001). The mean visual analog scale for pain scores improved from 5.5 ± 1.2 to 2.1 ± 0.9 in the younger adults group (P < .001) and from 5.5 ± 1.4 to 2.1 ± 1.2 in the older adults group (P < .001). The graft healing rate was significantly higher in the younger adults group (81%) than in the older adults group (65%) (P = .049). Subgroup analysis showed that after mesh augmentation, the healing rate in the younger adults group (84%) was similar to that in the older adults group (85%) (P = .299). CONCLUSION: ASCR resulted in a favorable surgical outcome for both younger and older adult patients with IRCT. The younger patients had lower graft failure rates and superior surgical outcomes. In older patients, ASCR using polypropylene mesh augmentation may reduce graft failure and result in surgical outcomes similar to those in younger patients.
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Lesões do Manguito Rotador , Articulação do Ombro , Idoso , Artroscopia , Estudos de Coortes , Humanos , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Lesões do Manguito Rotador/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Open Bankart repair provides surgeons and patients with an alternative solution for managing recurrent instability in young athletes with or without minimal bone loss. Despite many studies that have reported low recurrence rates and good functional outcomes after open Bankart repair, we have limited knowledge about the return to sport and work for high-demand populations. PURPOSE: To assess the return to sport and work for high-demand populations after open Bankart repair for recurrent anterior shoulder instability, outcomes of open Bankart repair with regard to recurrence, and development of osteoarthritic (OA) changes. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: We searched PubMed, EMBASE, Cochrane Library, Scopus, and Google Scholar databases using keywords as well as Medical Subject Headings terms and Emtree using "(Open Bankart OR Bankart surgery) (NOT arthroscopy NOT revision)" for English-language studies. We conducted a systematic review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS: In total, 11 articles (10 with level 4 and 1 with level 3 evidence) including 563 patients (566 shoulders) were identified. The majority of patients were male (82%), the average age at the time of surgery was 27.4 years, and the mean follow-up was 11.5 years (range, 2.5-29 years). The most common functional score used was the Rowe score (95%) for the reported outcome measures, which showed good to excellent results (mean, 88.5 points). The overall recurrent instability rate, including dislocation and subluxation as a postoperative complication, was 8.5%. A total of 87% of patients were able to return to sport and work postoperatively. Overall, OA changes were reported in 33% of the patients, and the overall revision rate was 1%. CONCLUSION: Open Bankart repair exhibited favorable results, with a low postoperative instability rate. It is a reliable surgical procedure that allows high-demand patients to return to sport and work.
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Camera trapping has been demonstrated to be an effective tool in surveying a suite of species, especially elusive mammals in rough terrains. The method has become increasingly common in primate surveys for both ground-dwelling and arboreal taxa in many tropical regions of the world. However, camera trapping has rarely been used to inventory primates in Vietnam, although many species are under severe threats and in critical need of surveying for improved conservation measures. In this study, we employed camera trapping to primarily investigate the possible continued presence of galliform species, but also to opportunistically record primate species, in Hue Saola Nature Reserve in central Vietnam. We documented five primate species, including the northern pig-tailed macaque Macaca leonina, the stump-tailed macaque Macaca arctoides, the rhesus macaque Macaca mulatta, the pygmy slow loris Nycticebus pygmaeus, and the red-shanked douc Pygathrix nemaeus, which represents a majority of primate diversity in the reserve. The results show that camera trapping may be an option for documenting primate diversity, and seasonal and daily activities of ground-dwelling taxa. Our data also suggest that although human disturbance is still rampant in the area, Hue Saola Nature Reserve appears to be reasonably well protected compared to other conservation areas in Indochina. In particular, it is home to several highly threatened primates, and it therefore plays a crucial role in primate conservation in Vietnam. However, these populations are in need of greater protection, such as more targeted patrols to remove snares and prevent other violations.
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Distribuição Animal , Conservação dos Recursos Naturais/métodos , Lorisidae , Macaca , Fotografação/instrumentação , Presbytini , Animais , VietnãRESUMO
BACKGROUND/AIM: Hirayama disease, a rare neurological disorder, is characterized by progressive, asymmetric muscle atrophy of the forearm and hand in young male patients. CASE REPORT: We noted two cases of Hirayama disease that appeared in the right upper limb and identified the cervical neutral and flexion position magnetic resonance imaging (MRI) characteristics. CONCLUSION: In the flexion posture, the cervical MRI allows early diagnosis of Hirayama disease and should be considered in patients with the typical clinical symptoms.
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Vértebras Cervicais , Atrofias Musculares Espinais da Infância , Povo Asiático , Humanos , Imageamento por Ressonância Magnética , Masculino , Atrofias Musculares Espinais da Infância/diagnóstico por imagemRESUMO
Bronchial asthma is one of the most common chronic inflammatory diseases. Complementary and alternative medicine is increasingly used for treating bronchial asthma. Ten electronic databases were searched to investigate whether honey alone or in combination with other ingredients can be considered as the potential treatment for bronchial asthma. Combinations of honey and Nigella sativa (NS) showed significant improvement in all pulmonary functions, including forced expiratory volume (FEV1) (MD = 0.52, P < .001), forced vital capacity (FVC) (MD = 0.55, P = .002), and peak expiratory flow rate (PEFR) (MD = 80.60, P < .001), in both moderate and severe, uncontrolled persistent asthma compared with baseline. Asthma control test scores also improved significantly (MD = 11.22, P < .001) in patients using combinations of honey and NS compared with baseline. Patients with a less severe grade of asthma showed a significant positive response in clinical parameters upon using honey. One study showed that using celery seeds and honey was associated with clinical improvement of both lung functions, FEV1 (MD = 18.09, P < .001) and FVC (MD = 24.23, P < .001), and respiratory parameters compared with baseline. In conclusion, honey alone has no strong evidence of being effective in controlling asthma. However, when used in combination with other substances, it showed a relatively high efficacy in patients with asthma. This finding may help in asthma control with lower cost alternatives and better outcomes.
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Asma/tratamento farmacológico , Mel/análise , Animais , Antiasmáticos/administração & dosagem , Asma/fisiopatologia , Volume Expiratório Forçado , HumanosRESUMO
BACKGROUND: Nowadays, there are few types of research held in Vietnam to investigate the anthropometric index of the nose as well as analysis the structure of nasal tip on ultrasound to identify the relationship between these parameters. AIM: To determine the relationship between the height and the width of the nasal tip and the structures constructed these areas by anthropometric and ultrasound measurement. METHODS: A descriptive study in Thanh Van Hospital from December 2017 to April 2019. RESULTS: There were 94 women (62.7%), and 56 men (37.3%) and the average age were 33.6 years old. The height and width of the nasal tip are 10.1 mm and 21.7 mm, respectively. Through the ultrasound, the thickness of the adipose tissues is 3 mm. The width of the interdomal fat pad is 6.5 mm and the distance between two tip point is 5.6 mm. There are the relationships between the distance of two tip points and the width of the tip (r = 0.341), and the width of the interdomal fat pad (r = 0.72). There is also the correlation between the width of the nasal tip with the distance of two tip points (r = 0.46) and the height of the tip with the thickness of the interdomal fat pad (r = 1.23). CONCLUSION: The thickness of the interdomal fat affects the height of the tip, and the distance of two tip points influences the width of the tip.
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BACKGROUND: There are recently many studies about the anatomy of lower lateral cartilage (LLC). However, the microanatomic studies to identify the segments of most LLC at the nasal tip in Vietnamese are very rare. AIM: Investigate the macroanatomic and microanatomic characteristics of the LLC and the structures of the nasal tip. METHODS: Descriptive study, 30 cadaver noses fixed by 10% formalin, 2 cadaver noses fixed by HE in 69 Institutes in Vietnam from December 2017 to April 2019. RESULTS: The average length of the medial crus is 12.3 mm on the right and 13.2 mm on the left. The maximum intercrural distance is 10.7 mm. The average length of the dome is 3.7 mm and 3.9 mm on the right and left side separately, with 2 subunits are the domal and lobular segment. The average thickness of the tip points is 1.0 mm. The width of the interdomal and intercrural ligaments are 0.5-fold the height and 2-fold the thickness. The thickness of the interdomal fat pad is 3mm and about 0.5-fold the wide. CONCLUSION: The LLC has 3 parts: intermediate, medial and lateral crus. The microanatomic structures of tip consist of the interdomal ligaments, intercrural ligaments, SMAS and interdomal fat pad.
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ETHNOPHARMACOLOGICAL RELEVANCE: In Vietnamese traditional herbalism, there are conflicting opinions about the effect of Artemisia vulgaris L. (AVL, English name: mugwort) on hypertension. Some ethnic doctors recommend the use of AVL for treatment of hypertension, whereas others advise against it. The purpose of this study was to clarify the pharmacological characteristics of AVL in isolated arteries to explain the conflicts surrounding the use of AVL for treatment of hypertension. MATERIALS AND METHODS: We initially performed a functional study using an organ bath system to investigate the effect of AVL extract on isolated porcine basilar artery. We then measured the change in intracellular free Ca(2+) concentration elicited by AVL using cultured smooth muscle cells loaded with the Ca(2+) indicator fluo-4. Finally, using HPLC, we determined the active components in AVL. RESULTS AND DISCUSSION: AVL induced vasoconstriction at resting tension, and endothelial removal enhanced this effect significantly. Pretreatment with PD123319 (an AT2 receptor antagonist), Nω-nitro-L-arginine (a nitric oxide synthase inhibitor), or both, also enhanced this effect. AVL-induced contraction was competitively inhibited by methiothepin (a 5-HT1 and 5-HT2 receptor antagonist) in the presence of ketanserin (a 5-HT2 receptor antagonist). Removal of extracellular calcium with nifedipine (an L-type Ca(2+) channel blocker) or ruthenium red (a ryanodine receptor blocker) significantly reduced AVL-induced contraction, whereas losartan (an AT1 receptor antagonist) and diphenhydramine (a H1 receptor antagonist) had no effect on this contraction. AVL increased the intracellular free Ca(2+) concentration in cultured cells, and this increment was inhibited by methiothepin. HPLC analysis revealed that the retention time of the first peak in the AVL profile was similar to that of the 5-HT standard, and that addition of 5-HT to the AVL sample enhanced this peak. On the other hand, AVL induced endothelium-independent relaxation under precontracted conditions with 60mM KCl. Captopril (an angiotensin converting enzyme inhibitor), atenolol (a ß1 receptor antagonist) and cimetidine (a H2 receptor antagonist) had no effect on this relaxation. In Ca(2+)-free 60mM KCl-containing solution, pretreatment with AVL significantly inhibited CaCl2-induced contraction. CONCLUSION: For the first time, the present study has demonstrated that AVL has two opposite effects, contraction and relaxation, on isolated artery, which may help to explain the conflicting indications for AVL in traditional herbalism. 5-HT is a significant factor affecting artery contraction in the presence of AVL.
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Artemisia , Artéria Basilar/efeitos dos fármacos , Extratos Vegetais/farmacologia , Animais , Artéria Basilar/metabolismo , Artéria Basilar/fisiologia , Feminino , Hipertensão/tratamento farmacológico , Técnicas In Vitro , Masculino , Medicina Tradicional , Metiotepina/farmacologia , Folhas de Planta , Cloreto de Potássio/farmacologia , Serotonina/metabolismo , Antagonistas da Serotonina/farmacologia , Suínos , Vasoconstrição/efeitos dos fármacos , VietnãRESUMO
BACKGROUND: The management of granulomatous mastitis depends on the causative factor, and accurate diagnosis in distinguishing between idiopathic granulomatous mastitis (IGM) and tuberculous mastitis (TBM) is indispensable. This is particularly problematic in the cases of granulomatous mastitis in which the microbiological studies are negative. In this study, in a large cohort, the histological features for IGM and TBM were compared. METHODS: The histopathology files from the two participating hospitals were searched for cases of granulomatous inflammation of the breast over an 8-year period. The parameters assessed included age of patient, lesional size, systemic and local symptoms, and histological findings of inflammatory cells, granulomas, necrosis, multinucleated giant cells, fibrosis and calcifications. RESULTS: 29 cases of IGM and 33 cases of TBM were included in this study. A significant difference was seen between the two groups with regard to patient age (t=2.52, p<0.05) and lesional size (t=-5.56, p<0.01). TBM occurred in a significantly younger population, and demonstrated larger lesional sizes than IGM. There was no difference between the number of cases showing mass, local and systemic symptoms. Comparing the different histological features, the TBM group showed significantly more fibrosis, eosinophils and necrosis, whereas the IGM group showed significantly more plasma cells. Taking all the cases together as one group to evaluate the relationship between the histological parameters, there was significant positive correlation between eosinophils and fibrosis (r(s)=0.39, p<0.01), and negative correlation between vague and well-formed granulomas (r(s)=-0.38, p<0.01). CONCLUSION: TBM was more likely to occur in younger patients, with a larger clinical mass at presentation. Histologically, TBM tends to show more eosinophils and necrosis, and IGM is associated with more plasma cells. The characteristics of the granulomas and giant cells were not distinguishing features.