Diaphragmatic Mobility and Chest Expansion in Patients with Scapulocostal Syndrome: A Cross-Sectional Study.

Scapulocostal syndrome (SCS) is a subset of myofascial pain syndrome affecting the posterior shoulder and upper back area. Some of the affected muscles are attached to the rib cage, which may affect diaphragmatic mobility and chest expansion. The purpose of this study was to investigate the characteristics of diaphragmatic mobility and chest expansion in patients with SCS. Twenty-nine patients with SCS and twenty-nine healthy participants of a similar age, gender, weight, and height were included in the study. All participants were evaluated for diaphragmatic mobility (DM) by real-time ultrasound (RTUS) and for chest expansion (CE) using a cloth tape measure. An independent t-test was used to compare the outcome variables between groups. The DM value in the SCS group was 46.24 ± 7.26 mm, whereas in the healthy group it was 54.18 ± 9.74 mm. The DM value was lower in the SCS group compared to in healthy participants (p < 0.05). Chest expansion at the axilla, the fourth intercostal space (4th ICS), and the xiphoid level in the SCS group was 7.26 ± 1.13, 6.83 ± 0.94, and 6.86 ± 1.25, respectively, while chest expansion at the axilla, 4th ICS, and xiphoid level in the healthy group was 7.92 ± 1.39, 7.54 ± 1.43, and 8.13 ± 1.32, respectively. Chest expansion at the 4th ICS and the xiphoid level in the SCS group was significantly lower than in the healthy group (p < 0.05). Patients with SCS presented a decrease in diaphragmatic mobility and chest expansion. Therefore, SCS treatment programs ought to add breathing exercises to improve lung expansion.

A diagnostic tool for people with lumbar instability: a criterion-related validity study.

BACKGROUND: Several clinical tests used to identify patients with lumbar instability have reported diagnostic accuracy in separate studies with conflicting results. To augment the diagnostic process, tests that are better able to identify lumbar instability suitable for use in the clinical setting are required. The aim of this study was to identify the probability to diagnose patients with lumbar instability, using x-ray imaging as the reference standard. METHODS: This study was a cross-sectional, diagnostic validity study. One hundred forty participants with chronic low back pain underwent an x-ray assessment and 14 clinical examinations. Data were analysed using multivariate regression methods to determine which clinical tests were most diagnostic for lumbar instability when they were applied together. RESULTS: Eighteen (12.85%) participants had radiological lumbar instability. Three clinical tests i) interspinous gap change during flexion-extension, ii) passive accessory intervertebral movement tests, iii) posterior shear test demonstrated an ability to diagnose lumbar instability of 67% when they were all positive. At this probability threshold, sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (-LR) were 5.56, 99.18%, 6.78, and 0.95. CONCLUSIONS: These 3 clinical tests could be useful in identifying patients with lumbar instability in the general community. These three tests are simple to perform by physical therapists, reliable to use in a clinical setting, and safe for patients. We recommend physical therapists use these three tests to assess patients who are suspected of having lumbar instability, in the absence of an x-ray assessment, to receive appropriate targeted intervention or referral for further investigation. TRIAL REGISTRATION: Thai Clinial Trial Registry (TCTR 20180820001; 19th August 2018).

Validity of a Screening Tool for Patients with a Sub-Threshold Level of Lumbar Instability: A Cross-Sectional Study.

Lumbar instability (LI) comprises one subgroup of those with chronic low back pain (CLBP); it indicates the impairment of at least one of the spinal stabilizing systems, and radiographic criteria of translation and rotation are used for its diagnosis. Previous studies have developed and tested a screening tool for LI where patients with sub-threshold lumbar instability (STLI) were detected in the initial stage of lumbar pathology using radiographs as a gold standard for diagnosis. The radiographic measurement in STLI lies between the range of translation and rotation of the LI and asymptomatic lumbar motion. However, there are no studies indicating the validity and cut-off points of the screening tool for STLI. The current study aimed to determine the validity of an LI screening tool to support the diagnostic process in patients with STLI. This study design was cross-sectional in nature. A total of 135 participants with CLBP, aged between 20 and 60 years, who had undergone flexion and extension radiographs, answered a screening tool with 14 questions. The cut-off score for identifying STLI using the screening tool was at least 6/14 positive responses to the LI questions. The findings suggested that the LI screening tool we tested is effective for the detection of STLI. The tool can be used in outpatient settings.

The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up.

Trunk stability exercises that focus on either deep or superficial muscles might produce different effects on lumbar segmental motion. This study compared outcomes in 34 lumbar instability patients in two exercises at 10 weeks and 12 months follow up. Participants were divided into either Core stabilization (deep) exercise, incorporating abdominal drawing-in maneuver technique (CSE with ADIM), or General strengthening (superficial) exercise (STE). Outcome measures were pain, muscle activation, and lumbar segmental motion. Participants in CSE with ADIM had significantly less pain than those in STE at 10 weeks. They showed significantly more improvement of abdominal muscle activity ratio than participants in STE at 10 weeks and 12 months follow-up. Participants in CSE with ADIM had significantly reduced sagittal translation at L4-L5 and L5-S1 compared with STE at 10 weeks. Participants in CSE with ADIM had significantly reduced sagittal translations at L4-L5 and L5-S1 compared with participants in STE at 10 weeks, whereas STE demonstrated significantly increased sagittal rotation at L4-L5. However, at 12 months follow-up, levels of lumbar sagittal translation were increased in both groups. CSE with ADIM which focuses on increasing deep trunk muscle activity can reduce lumbar segmental translation and should be recommended for lumbar instability.

Effectiveness of the manual diaphragmatic stretching technique on respiratory function in cerebral palsy: A randomised controlled trial.

BACKGROUND: Respiratory failure resulting from diaphragmatic muscle weakness is a major cause of long-term hospitalization in children with cerebral palsy (CP). Manual diaphragmatic stretching technique (MDST) can be directly applied to stretch diaphragmatic muscle and has been reported to improve respiratory function in patients with asthma and COPD. However, there have been no studies among CP. This study aimed to examine the effects of a six-week MDST course on respiratory function among CP. METHODS: Fifty-three children with spastic CP were randomly assigned to experimental (n = 27) and control (n = 26) groups. The experimental group received MDST on non-consecutive days, three days per week for six weeks alongside standard physiotherapy (SDPT), while the control group received only SDPT. The outcome variables were diaphragmatic mobility, pulmonary function and chest wall expansion. RESULTS: MDST significantly improved diaphragmatic mobility on both sides of the body, with a between-group difference of 0.97 cm (95% CI 0.55-1.39 cm, p < 0.001) for the right side and 0.82 cm (95% CI 0.35-1.29 cm, p = 0.001) for the left side. MDST significantly improved chest wall expansion at the xiphoid process and umbilical levels, with between-group differences of 0.57 cm (95% CI 0.12-1.20 cm, p = 0.013) and 0.87 cm (95% CI 0.31-1.43 cm, p = 0.003), respectively. There was no significant difference in pulmonary function testing between the groups. CONCLUSION: MDST could significantly improve diaphragmatic mobility, and lower and abdominal chest wall expansion, among children with CP. Therefore, MDST could be considered as an additional technique for physiotherapy programmes, to improve diaphragmatic function in spastic CP.

ADC cut points for chronic kidney disease in pathologically-proven cholangiocarcinoma.

PURPOSE: Apparent diffusion coefficient (ADC) has been shown to indicate renal function in various conditions. As cholangiocarcinoma may have renal involvement due to immune complex-mediated glomerulonephritis, this study aimed to determine whether or not there is any association between ADC values and renal function in these patients. METHODS: This was a retrospective, analytical study. The inclusion criteria were age over 18 years, pathologically proven cholangiocarcinoma diagnosis and having undergone either 1.5 T or 3.0 T diffusion-weighted MRI. Chronic kidney disease (CKD) was defined as eGFR less than 60 mL/min/1.73m2. Patients' ADC levels in the CKD and non-CKD groups were compared, and subgroup analysis was performed by MRI field strength and type of cholangiocarcinoma. RESULTS: One hundred fifty-eight patients participated in the study. Most were male (66.46 %), and the average age (SD) was 61.59 years (7.91). Average ADC levels in the CDK and non-CDK group differed significantly, regardless of MRI field strength or type of cholangiocarcinoma (2.11 mm/s2 in the ADC group vs 1.91 mm/s2 in the non-ADC group; P < 0.001). An ADC cut-point of 1.75 mm/s2 yielded sensitivities ranging from 66.67-90.00 in almost all study populations. The distal cholangiocarcinoma group had a perfect cut-point at 1.78 mm/s2 with 100 % sensitivity and area under the ROC curve. CONCLUSIONS: Radiologists can use ADC to detect CKD in cholangiocarcinoma patients regardless of MRI field strength or type of cholangiocarcinoma.

Diaphragmatic mobility in children with spastic cerebral palsy and differing motor performance levels.

The aim of this study was to compare diaphragmatic mobility (DM) and respiratory function between children with cerebral palsy (CP) and healthy controls (HC). CP was divided into non-ambulatory CP (NACP) and ambulatory CP (ACP). Eighteen children with NACP, 18 with ACP and 18 HC age between 8 and 18 years were recruited. Ultrasound was used to measure DM on both sides. Respiratory muscle strength (RMS), pulmonary function (PF) and chest expansion (CE) were also measured. The results showed that there was significantly lower right DM in CP than HC group. The NACP group had significantly lower DM than the ACP group. There were also significantly lower values of RMS, PF and CE in CP, compared to the HC group. There are significant impairments of diaphragmatic and respiratory function in CP, relative to HC. Thus, appropriate interventions to improve diaphragmatic muscle strength are necessary for children with CP, especially in the NACP.

Incidence of Clavicular Rhomboid Fossa in Northeastern Thais: An Anthropological Study.

The rhomboid fossa of clavicle is used to determine the age and sex in anthropology and forensic sciences. The variant types of rhomboid fossa on inferior surface have been reported in many races except in Thais. This study therefore was aimed at classifying the types of the rhomboid fossa in Northeastern Thais. The identified 476 Northeastern Thais dried clavicles (270 males and 206 females) were observed and recorded for the types of rhomboid fossa. The results showed that Thai-rhomboid fossa could be classified into 4 types: Type 1: smooth; Type 2: flat; Type 3: elevated; and Type 4: depressed, respectively. The incidences of rhomboid fossa were as follows: Type 1: 0.21%; Type 2: 19.75%; Type 3: 76.26%; and Type 4: 3.78%, respectively. Additionally, it was found that the percentage of Type 4 (11.84%) was much greater than that of female (1.94%) compared to other types. This incidence of rhomboid fossa types especially Type 4 may be a basic knowledge to be used in sex identification. The high incidence of rhomboid fossa in both sexes of Northeastern Thai clavicles was Type 3 (elevated type).

Pineal calcification is associated with pediatric primary brain tumor.

AIM: Melatonin has been associated with various tumors, including brain tumor, and shown to inhibit growth of neuroblastoma cells and gliomas in animal models. Likewise, patients with glioblastoma receiving melatonin reported better survival than controls. Pineal calcification may lead to a decreased production of melatonin by calcified glands. This study assessed association between pineal calcification and primary brain tumor in pediatric/adolescent patients. METHODS: Medical chart review was conducted in 181 patients <15 years old who had undergone brain computed tomography (CT) during 2008-2012. Pineal calcification was identified using brain CT scan by an experienced neurosurgeon. Primary brain tumor was confirmed by CT scan and histology, and association with pineal calcification was estimated using multiple logistic regression, adjusted for age and gender. RESULTS: Primary brain tumor was detected in 51 patients (mean age 9.0, standard deviation 4.0 years), with medulloblastoma being the most common (11 patients). Pineal calcification was detected in 12 patients (23.5%) with primary brain tumor, while only 11 patients (8.5%) without tumor had pineal calcification. Adjusted for patients' ages and genders, pineal calcification was associated with an increase in primary brain tumor of 2.82-fold (odds ratio 2.82; 95% confidence interval 1.12-7.08, P = 0.027). CONCLUSION: Pineal calcification appears to be associated with primary brain tumor. Further studies to explore this link are discussed and warranted.

Immediate Effects of Traditional Thai Massage on Psychological Stress as Indicated by Salivary Alpha-Amylase Levels in Healthy Persons.

BACKGROUND Stress can cause psychological and physiological changes. Many studies revealed that massage can decrease stress. However, traditional Thai massage has not been well researched in this regard. The purpose of this study was to investigate the immediate effects of traditional Thai massage (TTM) on salivary alpha-amylase levels (sAA), heart rate variability (HRV), autonomic nervous system (ANS) function, and plasma renin activity (PRA). MATERIAL AND METHODS Twenty-nine healthy participants were randomly allocated into either a traditional Thai massage (TTM) group or Control (C) group, after which they were switched to the other group with a 2-week wash-out period. Each of them was given a 10-minute mental arithmetic test to induce psychological stress before a 1-hour session of TTM or rest. RESULTS Within-groups comparison revealed that sAA was significantly decreased (p<0.05) in the TTM group but not in the C group. HRV and ANS function were significantly increased (p<0.05) and PRA was significantly decreased (p<0.05) in both groups. However, low frequency per high frequency ratio (LF/HF ratio) and ANS balance status were not changed. Only sAA was found to be significantly different between groups (p<0.05). CONCLUSIONS We conclude that both TTM and rest can reduce psychological stress, as indicated by decreased sAA levels, increased parasympathetic activity, decreased sympathetic activity, and decreased PRA. However, TTM may have a modest effect on stress reduction as indicated by a reduced sAA.

Psychological Stress Can Be Decreased by Traditional Thai Massage.

OBJECTIVE: The purpose of this study was to investigate the immediate effects of traditional Thai massage (TTM) on psychological stress and heart rate variability (HRV). MATERIAL AND METHOD: Thirty healthy participants were randomly allocated in two groups, a TTM group (n = 15) who received a 1-hour session with moderate pressure of whole body TTM or a control group (n=15) who rested on the bedfor 1 hour All ofthem were given a 10-minute mental arithmetic test to induce psychological stress after which they received a 1-hour session of TTM or bed rest. Psychological stress and HR V were measured at baseline and immediately after mental arithmetic test, and immediately after TTM or bed rest. RESULTS: The studyfound that psychological stress was signficantly increased (p<0.05) after mental arithmetic test in both groups. Comparison on these measures between immediately after mental arithmetic test and after TTM or bed rest revealed that psychological stress was significantly decreased (p<0.05) and HR Vwas significantly increased (p<0.05) in both groups. Root mean square of successive differences (RMSSD) and low frequency were significantly increased (p<0.05) only in the TTM group. However; all of these measures were found without significant difference when groups were compared. CONCLUSION: TTM and bed rest could decrease psychological stress and HRV

Pineal calcification is a novel risk factor for symptomatic intracerebral hemorrhage.

BACKGROUND: Pineal calcification is associated with symptomatic cerebral infarction in humans. However, there are limited data on the association of pineal calcification and intracerebral hemorrhage. We evaluated this association of symptomatic intracerebral hemorrhage and pineal calcification by computed tomography of the brain. METHODS: We reviewed all computed tomographic (CT) scans of the brains of patients over 15 years of age during the year 2011 at a university teaching hospital. Symptomatic intracerebral hemorrhage was identified by having clinical syndrome of stroke and acute intracerebral hemorrhage from brain CT scans. Pineal calcification was also evidenced by brain CT scans. Other stroke risk factors were recorded. The association of various risk factors including pineal calcification and intracerebral hemorrhage was calculated using logistic regression analysis. RESULTS: There were 2140 CT scans of the brains during the study period. Of those, 1071 scans (50.05%) met the study criteria. Intracerebral hemorrhage and pineal calcification were found in 77 (7.2%) and 689 (64.3%) patients, respectively. Pineal calcification was a significant risk factor for intracerebral hemorrhage with an adjusted odds ratio of 2.36 (95% confidence interval of 1.22-4.54). Other significant factors were age>50 years, hypertension, and diabetes. CONCLUSION: Pineal calcification is associated with symptomatic intracerebral hemorrhage.

Pineal calcification is associated with symptomatic cerebral infarction.

BACKGROUND: Pineal calcification and low melatonin have been shown to be risk factors for stroke in animal studies; however, there are limited clinical data on the association of pineal calcification and stroke in humans. METHODS: All computed tomographic (CT) scans of the brains of patients >15 years of age during the year 2011 at a university teaching hospital were retrospectively reviewed. Patient medical charts were used to obtain the risk factors for stroke, including diabetes, hypertension, dyslipidemia, age, and sex. Cerebral infarction was identified by having clinical syndromes of stroke and a positive CT scan. Patients with embolic or hemorrhagic stroke were excluded. Pineal calcification was evidenced by the CT scans. The association of various stroke risk factors and cerebral infarction were calculated using logistic regression analysis. RESULTS: A total of 1614 patients were included, and symptomatic cerebral infarction was identified in 620 patients (38.4%). Regarding stroke risk factors in symptomatic cerebral infarction patients, the majority of patients were male (356 [57.4%]), >50 years of age (525 [84.7%]), and had hypertension (361 [58.2%]); some had diabetes (199 [32.1%]) and dyslipidemia (174 [28.1%]). Pineal calcification was found in 1081 patients (67.0%), with a male:female ratio of 1.5:1. Significant factors related to cerebral infarction by univariate logistic regression were age >50 years, hypertension, diabetes, dyslipidemia, and pineal calcification. Pineal calcification as a risk factor for cerebral infarction had an adjusted odds ratio of 1.35 (95% confidence interval 1.05-1.72). CONCLUSIONS: Pineal calcification may be a potential new contributor to cerebral infarction.

Physical performance in recently aged adults after 6 weeks traditional Thai dance: a randomized controlled trial.

BACKGROUND: Exercise has been shown to be effective in cardiovascular endurance in the elderly. We studied the effect of Thai dancing on physical performance of Thai elderly. METHODS: This was an open-labeled, randomized intervention study. The Thai dancing group exercised for 40 minutes three times a week for 6 weeks. Physical performance ability was the primary outcome, including a 6-minute walk test (6MWT), five-times sit-to-stand (FTSST), and a sit-and-reach test measured before and after 6 weeks of intervention. RESULTS: There were 42 subjects enrolled in the study, and 38 female subjects completed (20 in Thai dance group, 18 controls), with an average age of 65.8 ± 5.1 years. The Thai dance group had significantly better physical performance in all measurements at the end of the study. The 6MWT was longer (416.7 ± 58.7 versus 345.7 ± 55.1 m; P = 0.011), FTSST was quicker (10.2 ± 1.5 versus 14.4 ± 3.3 seconds; P < 0.001), and flexibility was higher (14.9 ± 3.5 versus 11.1 ± 5.7 cm; P = 0.002) in the Thai dance group than the control group. CONCLUSION: Thai dance can improve physical performance in recently aged (elderly) female adults.

The effect of six-weeks of sauna on treatment autonomic nervous system, peak nasal inspiratory flow and lung functions of allergic rhinitis Thai patients.

BACKGROUND: Allergic rhinitis is a chronic respiratory disease. Sympathetic hypofunction has been identified in allergic rhinitis patients. OBJECTIVE: To investigate the effects of six weeks of repeated sauna treatment on the autonomic nervous system, peak nasal inspiratory flow (PNIF) and lung functions in Thai patients with allergic rhinitis. METHODS: Subjects were diagnosed with allergic rhinitis clinically by an attending physician based on history, physical examination and positive reactions to a skin prick test. Subjects were randomly assigned to two groups. Controlsubjects received education and maintained a normal life. The sauna group received sauna treatment over a six-week period, 3 days per week, with 6 sets of 5 minutes per set per day, totaling 30 minutes. Each 5 minute set alternated with a 5 minute period of rest. Heart rate variability (HRV), peak nasal inspiratory flow and lung function were measured at the beginning and after three and six weeks of sauna treatment. The HRV measurement is composed of three components, including low frequency (indicating sympathetic function in normal units or n.u.), high frequency (indicated parasympathetic function in n.u.), and the ratio of LF/HF (indicating the balance of the autonomic system). RESULTS: Twenty-six allergic rhinitis patients, 12 males and 14 females participated in this study, 13 in the control group and 13 in the sauna treatment group; there were 6 males in each group. Baseline characteristics for the control and sauna treatment groups were comparable. There were significant changes in the HRV after six weeks of sauna treatment. The high frequency component was significantly lower in sauna treatment group (51.8 vs 35.4), while the low frequency component and LF/HF ratio were significantly higher in sauna treatment group than in the control group (48.1 vs 64.5 and 0.9 vs 2.5, respectively). The PNIF and the forced expiratory volume in one second, or FEV1, were also significantly higher in sauna treatment group (103.0 vs 161.9 and 80.1 vs 95.6, respectively). CONCLUSION: The six weeks of repeated sauna treatment can increase sympathetic activity, PNIF, and FEV1 in Thai patients with allergic rhinitis.

A comparative study of neuroimaging features between human neuro-gnathostomiasis and angiostrongyliasis.

Gnathostoma spinigerum and Angiostrongylus cantonensis are human parasites that can cause neurological symptoms. The human diseases produced by these parasites can usually be differentiated by clinical symptoms. The aim of this study was to report neuroimaging abnormalities detected with computed tomography (CT) and MR in patients with gnathostomiasis and angiostrongyliasis. We enrolled 15 and 12 patients with serologically proven gnathostomiasis and angiostrongyliasis, respectively, who had brain or spinal imaging done. The neuro-gnathostomiasis group had significantly more patients with intracerebral hemorrhage and myelitis patterns. The angiostrongyliasis group had no specific findings and most patients had normal CT brain images. The variety of neuroimaging findings is shown here. This study emphasizes that neuroimaging studies may be useful to differentiate gnathostomiasis and angiostrongyliasis particularly in patients with indistinct clinical presentations.

Specificity of immunoblotting analyses in eosinophilic meningitis.

Angiostrongylus cantonensis and Gnathostoma spinigerum are the two most common causative parasites of eosinophilic meningitis (EOM). Serological tests are helpful tools for confirming the identity of the pathogen. Recent reports determined the specificity of such tests by using normal healthy controls. There have been limited studies done to rule out the cross-reactivity between these two causative parasites of EOM. This study aims to assess the specificity of the serological test in EOM by using each condition as a control for the other. Thirty-three patients with a diagnosis of EOM were enrolled. Sera from 22 patients with a positive 29-kDa antigenic diagnostic band of A. cantonensis were tested for the 21 and 24-kDa antigenic bands of G. spinigerum. Similarly, sera of 11 gnathostomiasis patients were tested for the 29-kDa diagnostic band for A. cantonensis. Only one patient in the angiostrongyliasis group had a positive result for the 21 and 24-kDa antigenic bands of G. spinigerum, while no gnathostomiasis patients showed a positive result for the 29-kDa antigenic band of A. cantonensis. The specificity of the 21 and 24-kDa antigenic bands for gnathostomiasis and the 29-kDa antigenic band for A. cantonensis was 95.5% and 100%, respectively. The antigenic bands for the diagnosis of gnathostomiasis and angiostrongyliasis in EOM were highly specific.

Molecular identification of a causative parasite species using formalin-fixed paraffin embedded (FFPE) tissues of a complicated human pulmonary sparganosis case without decisive clinical diagnosis.

PCR-based molecular diagnosis was made for the identification of causative agents of the clinically suspected pulmonary proliferative sparganosis case found in Thailand using formalin-fixed paraffin-embedded (FFPE) biopsy specimens. As a reference, FFPE biopsy specimen from a typical cutaneous sparganosis case was examined together. DNA samples were extracted from tissues and two partial fragments of cytochrome c oxidase subunit 1 (cox1) gene were amplified for the detection of Spirometra DNA. Two cox1 fragments were amplified successfully for both specimens. After alignment of nucleotide sequences of the PCR-amplicons, the causative agents of both cases were identified as Spirometra erinaceieuropaei.

Specificity of immunoblotting analyses in eosinophilic meningitis

Angiostrongylus cantonensis and Gnathostoma spinigerum are the two most common causative parasites of eosinophilic meningitis (EOM). Serological tests are helpful tools for confirming the identity of the pathogen. Recent reports determined the specificity of such tests by using normal healthy controls. There have been limited studies done to rule out the cross-reactivity between these two causative parasites of EOM. This study aims to assess the specificity of the serological test in EOM by using each condition as a control for the other. Thirty-three patients with a diagnosis of EOM were enrolled. Sera from 22 patients with a positive 29-kDa antigenic diagnostic band of A. cantonensis were tested for the 21 and 24-kDa antigenic bands of G. spinigerum. Similarly, sera of 11 gnathostomiasis patients were tested for the 29-kDa diagnostic band for A. cantonensis. Only one patient in the angiostrongyliasis group had a positive result for the 21 and 24-kDa antigenic bands of G. spinigerum, while no gnathostomiasis patients showed a positive result for the 29-kDa antigenic band of A. cantonensis. The specificity of the 21 and 24-kDa antigenic bands for gnathostomiasis and the 29-kDa antigenic band for A. cantonensis was 95.5 percent and 100 percent, respectively. The antigenic bands for the diagnosis of gnathostomiasis and angiostrongyliasis in EOM were highly specific.

Different chest radiographic findings of pulmonary paragonimiasis in two endemic countries.

We compared the chest radiographic findings of patients with pulmonary paragonimiasis in the Lao People's Democratic Republic (PDR) with a report from Korea. The clinical and radiological characteristics of 50 confirmed Laotian pleuropulmonary paragonimiasis patients were studied between March 2003 and June 2007. In 49 patients, the chest radiographs showed abnormal findings (98%). Pulmonary parenchymal abnormalities were found in all 49 patients, whereas pleural effusion was only found in 11 patients (22%). The three most common intraparenchymal findings were multiple small cysts (90%), irregular linear densities (68%), and nodular opacities (40%). The numbers of patients who had these three findings were significantly different from the Korean report (P < 0.001). In conclusion, radiographic findings of pulmonary paragonimiasis may vary among countries.