Serum Granulysin in Differentiation of Stevens-Johnson Syndrome/toxic Epidermal Necrolysis and Erythema Multiforme

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute, life-threatening drug reactions, which lead to massive epidermal necrolysis. Granulysin plays an important role as a key mediator for keratinocyte apoptosis in these conditions. Erythema multiforme (EM) may have skin manifestation similar to SJS/TEN. AIMS: The aim of the study was to compare serum granulysin levels in patients with SJS/TEN and EM as well as to investigate a possible association between serum granulysin levels and the severity of SJS/TEN. METHODS: In total, 48 patients with SJS/TEN, 43 patients with EM, and 20 health controls (HCs) were enrolled. We measured serum granulysin levels using enzyme-linked immunosorbent assay. RESULTS: The average level of serum granulysin in the SJS/TEN patients was 23.0 ng/ml (range 1.2–144.6 ng/ml), significantly higher than that of EM group (20.1 ng/ml; range 8.5–121 ng/ml, p < 0.05) and HCs group (20.8 ng/ml; range 10.1–46.7 ng/ml, p < 0.05). Of 48 SJS/TEN patients, the 25 samples collected <6 days after onset showed higher level of serum granulysin (27.7 ng/ml; range 2.5–144.6 ng/ml) than those collected ≥6 days after onset (17.9 ng/ml; range 1.2–59 ng/ml; p > 0.05). No significant correlation was found between serum granulysin levels and the body surface area affected and the modified-SCORTEN. At the day of re-epithelialization, serum granulysin levels were not different compared with those at the day of hospitalization. CONCLUSIONS: Serum granulysin levels are significantly higher in SJS/TEN group than in EM group. After the onset, serum granulysin levels in patients with SJS/TEN are not a good biomarker to evaluate the severity of the diseases

TÀI NGUYÊN VỊ THẾ ĐẢO CỒN CỎ

Being a basaltic volcano, Con Co island is an isometric hill 2.3 km2 wide and 63 m high, located far 24 km from the mainland, and guards the entrance to the Gulf of Tonkin. It is isolated, but unique in location, and relatively closed to mainland. Despite its small size, the characteristics of morphology and spatial structures, geological composition, area, height, ecological landscape, dynamics and stability of the island... create great values of geo-natural position resources and favorable environment for island residents. Regarding geo - economic position resources, the island is a district under the Quang Tri province, a priority location for development of the country’s marine and island economy, and the economic centre at the entrance of the Gulf of Tonkin. This is also a convenient site for the development of marine economic sectors such as fishery, natural conservation, services - tourism and some others. In terms of geo-political position resources, the island has tremendous advantages for the sovereignty, sovereign rights and national interests at sea. As an outpost at the highly sensitive geo-political area, the Con Co island has the great value of defense, as a solid military base in the entrance of the Gulf of Tonkin and the most important link in the line of defense from coastal islands in the North Centre. It possesses many valuable cultural heritages, especially the heroic relics during the war against the US.Đảo Cồn Cỏ nguồn gốc núi lửa bazan, dạng đồi đẳng thước rộng 2,3 km2, cao 63 m, nằm cách xa bờ 24 km. Đảo có vị trí lẻ loi ở cửa vịnh Bắc Bộ và khá gần bờ Việt Nam. Mặc dù diện tích đảo nhỏ, nhưng các đặc điểm về hình thể và cấu trúc không gian, cấu tạo địa chất; diện tích, độ cao và cảnh quan sinh thái; động lực và tính ổn định... đã tạo ra giá trị lớn cho đảo về tài nguyên địa - tự nhiên và môi trường sinh cư thuận lợi cho các loài sinh vật và con người. Về giá trị vị thế địa - kinh tế, Cồn Cỏ thuộc đơn vị hành chính cấp huyện thuộc tỉnh Quảng Trị, là vị trí ưu tiên đối với phát triển kinh tế biển - đảo của đất nước; là vị trí trung tâm của không gian kinh tế khu cửa vịnh Bắc Bộ. Đây là một địa bàn thuận lợi cho phát triển các lĩnh vực kinh tế biển như thủy sản, bảo tồn biển, dịch vụ - du lịch cùng với các loại hình dịch vụ khác. Về giá trị vị thế địa - chính trị, đảo Cồn Cỏ có giá trị to lớn đối với việc bảo vệ các quyền và lợi ích quốc gia của Việt Nam trên biển. Là đảo tiền tiêu nằm trong vùng địa - chính trị nhạy cảm cao, đảo có giá trị lớn về phòng thủ, là một cứ điểm quân sự vững chắc ở vùng cửa vịnh Bắc Bộ và mắt xích quan trọng nhất trong phòng tuyến các đảo ven bờ Bắc Trung Bộ. Cồn Cỏ có các giá trị di sản văn hoá biển đảo, đặc biệt là những chiến tích anh hùng trong thời chiến tranh chống Mỹ

The responsibility of C-terminal domain in the thermolabile haemolysin activity of Vibrio parahaemolyticus and inhibition treatments by Phellinus sp. extracts

The thermolabile haemolysin (tlh) of Vibrio parahaemolyticus (Vptlh) from V. parahaemolyticus is a multiple-function enzyme, initially describes as a haemolytic factor activated by lecithin and phospholipase A2 enzymatic activity (Shinoda, 1991; Vazquez-Morado, 2021; Yanagase et al., 1970). Until now, the tlh structure has hypothesized including N-terminal and C-terminal domain, but what domain of the Vptlh structure does the haemolytic activity has not been refined yet. In this study, a 450-bp VpTLH nucleotide sequence of the entire Vptlh gene encoded the C-terminal domain cloned firstly to examine its responsibility in the activity of the Vptlh. The C-terminal domain fused with a 6-His-tag named the His-tag-VpC-terminal domain was expressed successfully in soluble form in the BL21 (DE3) PlysS cell. Remarkably, both expression and purification results confirmed a high agreement in the molecular weight of the His-tag-VpC-terminal domain was 47 kDa. This work showed the His-tag-VpC-terminal domain lysed the erythrocyte membranes in the blood agar and the phosphate buffered saline (0.9%) media without adding the lecithin substrate of the phospholipase enzyme. Haemolysis occurred at all tested diluted concentrations of His-tag-VpC-terminal domain (p < 0.05), providing evidence for the independent haemolytic activity of the His-tag-VpC-terminal domain. The content of 100 μg of the His-tag-VpC-terminal domain brought the highest haemolytic activity of 80% compared to that in the three remaining contents. Significantly, the His-tag-VpC-terminal domain demonstrated not to involve the phospholipase activity in Luria-Bertani agar supplemented with 1% (vol/vol) egg yolk emulsion. All results proved the vital responsibility of the His-tag-VpC-terminal domain in causing the haemolytic activity without the required activation by the phospholipase enzyme. Raw extracts of Phellinus igniarus and Phellinus pipi at 10-1 mg/mL inhibited the haemolytic activity of the His-tag-VpC-terminal domain from 67.7% to 87.42%, respectively. Hence applying the His-tag-VpC-terminal domain as a simple biological material to evaluate quickly potential derivatives against the Vptlh in vivo conditions will accessible and more advantageous than using the whole of the Vptlh

The effect of different media and temperature conditions for Salmonella bacteriophage preservation

This research aimed to determine the optimal media and temperature conditions for the long-term storage of bacteriophages. In this study, the viability of Salmonella phages in 50% glycerol, 10% sodium chloride-magnesium sulfate (SM) buffer, and 5% dimethyl sulfoxide (DMSO) media at room temperature, 4oC, -20oC, and -80oC for 12 months was determined. In 50% glycerol, at the end of the experiment, no significant difference was found between four temperature conditions on phage density, ranging from 6.20-6.23 log10 PFU/mL (P>0.05). Under 10% SM medium, phage preservation at room temperature provided the optimum density at 6.31 log10 PFU/mL. In addition, phages preserved in a 5% DMSO medium were of similar density values across all temperature treatments. Still, their availability after 12 month-storage (88.0-88.5%) was significantly lower (P<0.05) than that of 50% glycerol and 10% SM. Moreover, for phage lysis capacity, low temperatures (4oC, -20oC, and -80oC) were superior to room temperature used for preservation. Considering the density, lysis capacity, and practical convenience, storing phages at 4°C in a 50% Glycerol medium is recommended

The Efficacy of a Two-Fold Increase of H1-Antihistamine in the Treatment of Chronic Urticaria - the Vietnamese Experience

BACKGROUND: Chronic urticaria, a mast cell-driven condition, is common, debilitating and hard to treat. H1-antihistamines are the first line treatment of chronic urticaria, but often patients do not get satisfactory relief with the recommended dose. European guidelines recommend increased antihistamine doses up to four-fold. AIM: We conducted this study to evaluate the efficacy of increased H1-antihistamine doses up to two-fold in Vietnamese chronic urticaria patients. METHODS: One hundred and two patients with chronic urticaria were recruited for treatment with levocetirizine (n = 52) or fexofenadine (n = 50). Treatment started at the conventional daily dose of 5 mg levocetirizine or 180 mg fexofenadine for 2 weeks and then increased to 10 mg levocetirizine or 360 mg fexofenadine for 2 weeks if patients did not have an improvement in symptoms. At week 0, week 2 and week 4 wheal, pruritus, size of the wheal, total symptom scores, and associated side-effects were assessed. RESULTS: With the conventional dose, the total symptom scores after week 2 decreased significantly in both groups compared to baseline figures, i.e. 7.4 vs 2.3 for levocetirizine group and 8.0 vs 2.6 for fexofenadine group (p &lt; 0.05). However, there were still 26 patients in each group who did not have improvements. Of these 26 patients, after having a two-fold increase of the conventional dose, 11.5% and 38.5% became symptom-free at week 4 in levocetirizine group and fexofenadine group, respectively. At week 4 in both groups, the total symptom scores had significantly decreased when compared with those at week 2 (2.8 ± 1.5 versus 4.7 ± 1.6 in levocetirizine group; 2.1 ± 1.9 versus 5.1 ± 1.4 in fexofenadine group). In both groups, there was no difference in the rate of negative side effects between the conventional dose and the double dose. CONCLUSION: This study showed that increasing the dosages of levocetirizine and fexofenadine by two-fold improved chronic urticaria symptoms without increasing the rate of negative side effects

Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Common Vulgaris Acne in Vietnamese Patients

AIM: To evaluate the efficacy of oral isotretinoin used alone and in combination with desloratadine in the treatment of moderate acne vulgaris. METHODS: A comparative clinical trial was undertaken to evaluate the efficacy of oral isotretinoin alone and in combination with desloratadine in the treatment of 62 moderate acne vulgaris patients. Patients were randomised into two groups with 31 patients in each group. Each studied group's patient took 20 mg isotretinoin and 5 mg desloratadine per day. In the control group, patients took only 20 mg isotretinoin per day. The treatment time was 16 weeks. The evaluation and follow-up were done at week 2, 4, 8, 12 and 16 of the treatment. RESULTS: The studied group had a better curative rate than the control group (45.2% versus 22.6%). The average number of inflammatory lesions in the studied group was significantly lower than the control group (0.19 versus 0.94). The mean GAGS score of the studied group was significantly lower than the control group (3.71 versus 6.52). Acne outbreaks rate of the studied group was lower than the control group (in week 2: 22.6% versus 45.2% and in week 4: 16.1% versus 38.7%, respectively). The rate of itchy was lower in the studied group. CONCLUSION: In the treatment of moderate acne vulgaris, oral isotretinoin in combination with desloratadine is more effective and has fewer side effects than using isotretinoin alone

Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Common Vulgaris Acne in Vietnamese Patients

AIM: To evaluate the efficacy of oral isotretinoin used alone and in combination with desloratadine in the treatment of moderate acne vulgaris. METHODS: A comparative clinical trial was undertaken to evaluate the efficacy of oral isotretinoin alone and in combination with desloratadine in the treatment of 62 moderate acne vulgaris patients. Patients were randomised into two groups with 31 patients in each group. Each studied group's patient took 20 mg isotretinoin and 5 mg desloratadine per day. In the control group, patients took only 20 mg isotretinoin per day. The treatment time was 16 weeks. The evaluation and follow-up were done at week 2, 4, 8, 12 and 16 of the treatment. RESULTS: The studied group had a better curative rate than the control group (45.2% versus 22.6%). The average number of inflammatory lesions in the studied group was significantly lower than the control group (0.19 versus 0.94). The mean GAGS score of the studied group was significantly lower than the control group (3.71 versus 6.52). Acne outbreaks rate of the studied group was lower than the control group (in week 2: 22.6% versus 45.2% and in week 4: 16.1% versus 38.7%, respectively). The rate of itchy was lower in the studied group. CONCLUSION: In the treatment of moderate acne vulgaris, oral isotretinoin in combination with desloratadine is more effective and has fewer side effects than using isotretinoin alone

The effectiveness of local surgical technique in treatment of axillary bromhidrosis

BACKGROUND: Up to now, surgical excision of apocrine glands still has been a method that yields high treatment results and low rate of odour recurrent for patients, but many people worry about some serious complications that have been observed postoperatively, such as hematoma and skin necrosis. These prolong wound healing, leading to unsightly scars in the axillary fossae. AIM: We conducted this research to investigate the effects and complications of our surgical technique for axillary bromhidrosis. METHODS: Forty-three patients with axillary bromhidrosis were treated. An elliptical incision was made at a central portion of the area marked, with both tips of the ellipse along the axillary crease. The elliptical skin with the subcutaneous tissue was removed en lock. The adjacent skin was undermined to the periphery of the hair-bearing area with straight scissors. The undermined subcutaneous tissue was removed with curved scissors, and the skin was defatted to become a full-thickness skin flap. Any suspected hemorrhagic spots were immediately coagulated electrosurgically. Appropriate drains were placed, and the treated area was covered with thick gauze to each axilla. Arm movement was strictly controlled in the first 3 days post-operatively. RESULTS: Thirty-one patients have been followed up and evaluated for 6 months. 56 out of 62 axillae (90.3%) showed good to excellent results for malodor elimination. All patients reported a reduction in axillary sweating. There were two axillae of skin necrosis and three axillae of hematoma, with one patient receiving an anticoagulant from a cardiologist after the first day of surgery, to treat heart valve disease. The Dermatology Life Quality Index (DLQI) score decreased significantly, and the quality of life improved after the operation. CONCLUSION: Our technique is a simple surgical procedure and easy to perform helping to achieve results for high malodor elimination, with almost no serious complications. Patient’s life quality improved significantly after the operation

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Deriving four generalizations about nominals in three classifier languages

This squib presents a set of facts concerning nominal structures in Bahnar, Mandarin, and Vietnamese. It proposes an account of these facts which reduces them to cross-linguistic differences with respect to the availability of particular syntactic configurations involving the bare noun and its extended projection. These differences, in turn, are derived from cross-linguistic variations with respect to the availability of items in the functional lexicon