Renal and systemic hemodynamics, plasma arginine vasopressin, plasma renin activity, plasma norep... more Renal and systemic hemodynamics, plasma arginine vasopressin, plasma renin activity, plasma norepinephrine, blood volume and water loading test were studied in 10 patients with falciparum malaria without renal failure. Six patients responded to water load normally, while 4 patients had a decreased response to water load. The patients with a normal water load response had normal renal and systemic hemodynamics and a normal hormonal profile. The patients with a decreased response to water load had hyponatremia, hypervolemia, high cardiac index, low systemic vascular resistance, high plasma arginine vasopressin, high plasma renin activity, high plasma norepinephrine, low creatinine and p-aminohippurate clearances, low urine sodium and high urine osmolality. They had a lower mean arterial pressure during the acute phase of the disease than during the recovery phase. The findings suggest that a decreased response to water load is due to peripheral vasodilatation which results in a decreased effective blood volume leading to the release of vasopressin and norepinephrine, increased renin activity and decreased renal hemodynamics.
The effects of Russell's viper venom on vasoactive mediators and renal hemodynamics were stud... more The effects of Russell's viper venom on vasoactive mediators and renal hemodynamics were studied in five mongrel dogs. Intravenous administration of Russell's viper venom to the dogs caused a reduction of mean arterial pressure, renal blood flow, and glomerular filtration rate. The filtration fraction was decreased. This was accompanied by a rise in plasma norepinephrine, endothelin, 6-keto-PGF1 alpha, a stable metabolite of PGI2, and TXB2, a metabolite of TXA2. Plasma levels of epinephrine and dopamine showed no significant changes. The increase of plasma levels of both vasodilatator and vasoconstrictor were critical to systemic and renal hemodynamics. While vasodilatation predominated in the systemic circulation and resulted in hypotension, vasoconstriction played a major role in decreasing renal hemodynamics. Decreased renal blood flow and decreased glomerular filtration rate were the result of renal vasoconstriction and hypotension.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2001
Hemodynamic alterations in Russell's viper envenomation are the result of interactions of var... more Hemodynamic alterations in Russell's viper envenomation are the result of interactions of various vasoactive mediators and perhaps proinflammatory cytokines. Since vascular endothelium is likely to be exposed to high concentrations of the venom and the endothelial cell itself not only plays an important role in the physiologic control of the circulation, but also play a role in inflammation with the synthesis and secretion of proinflammatory cytokines. It was therefore, the objective of this study to determine the effects of Russell's viper venom (RVV) on proinflammatory cytokine production by cultured human umbilical vein endothelial cells (HUVEC) and the release of endothelium-derived substances. Endothelial cells were isolated from freshly obtained human umbilical cord vein and grown in tissue culture to confluence as a homogeneous population. Cells were then incubated at 37 degrees C under 5 per cent CO2 with RVV (0.2, 1.0, 5.0, and 25.0 microg/ml) or lipopolysaccharide ...
Current Laboratory Techniques in Rabies Diagnosis, Research and Prevention, 2014
An immunochromatographic strip test is designed for fast and easy detection of rabies virus (RABV... more An immunochromatographic strip test is designed for fast and easy detection of rabies virus (RABV) antigens in clinical samples. In the field, saliva is a preferred clinical sample in the living patient because quick detection in such samples may be ideal for allowing management to be implemented in real time. Although the absolute RABV concentration in saliva samples is not known, the strip test in a lateral flow format performs well enough to be used for the detection of RABV in dog samples. The strip test has an advantage over many other field diagnostic techniques in that the test procedure is simple, rapid, and can be performed by public health professionals as well as veterinarians. However, a negative result with the test strip may indicate the absence of RABV antigens or that antigens are present below the level of detection. Thus, it must be understood that a negative test does not exclude a diagnosis of rabies.
Therapeutic antivenom against snakes was first produced by Albert Calmette in 1894. Since then an... more Therapeutic antivenom against snakes was first produced by Albert Calmette in 1894. Since then antivenoms have saved the life of countless snakebite victims. However, there are still many problems associated with antivenom production, for example variable percentage of responder horses, low neutralizing potency of antivenom, the large amount of snake venom needed for immunization and the difficulties encountered in producing potent polyvalent antivenoms. These problems have led to shortage and high cost of antivenom and, in some cases, failure of treatment. In 1997, a new immunization protocol for antivenom production was reported. It involves the injection of venom at low dose (approx. 2mg/horse) emulsified in Complete Freund's adjuvant in low volume (0.1-0.2 ml/site) in a total of 10 sites around the neck area of the horse. This immunization protocol has minimized the local reaction at the injection site thus allowing the use of the potent oil adjuvant. This, together with the increase in total surface area of the droplets, allow a more effective immune response to take place, e.g. enhancing the migration and activation of more antigen presenting cells and lymphocytes. The low dose, low volume multi-site immunization has resulted in dramatic improvements on the antivenom production in terms of amount of venom used for immunization, the time required to reach hyperimmune stage, the percent of responder horses and the potency of the antivenom. Furthermore, this protocol has made it possible to produce potent truly polyvalent antivenoms against several elapid and viperid snakes. This immunization protocol has alleviated various problems associated with antivenom production and has implications for immunization in general.
Changes in systemic and renal hemodynamics induced by Russell's viper venom are well establi... more Changes in systemic and renal hemodynamics induced by Russell's viper venom are well established. The component of the venom responsible for hemodynamic alteration has not been identified. By Sephadex column chromatography five fractions of Russell's viper (Daboia russellii siamensis) venom were isolated. Each venom fraction consisted of phospholipase A2, proteolytic enzyme, phosphomonoesterase, phosphodiesterase, arginine ester hydrolase and hyaluronidase of varying activities. Hemodynamic effects of each venom fraction including mean arterial pressure, cardiac output, systemic and renal vascular resistance, renal blood flow and glomerular filtration rate were studied in five groups of dogs; each group had four dogs. Minimal hemodynamic changes were observed in dogs receiving venom fraction I. Increased renal vascular resistance with diminution of renal blood flow and glomerular filtration rate was observed in dogs receiving venom fractions II, III, IV and V. A markedly i...
Background: The common complication in cases of poisoning by Russell’s viper (Daboia siamensis) v... more Background: The common complication in cases of poisoning by Russell’s viper (Daboia siamensis) venom (RVV) is acute renal failure, but the pathogenesis involved in the alteration of kidney function is still not well understood. Objective: To clarify the role of RVV in the pathogenesis of renal damage, the present study examines the functional short-term alterations acutely induced by RVV in isolated perfused rabbit kidney. Methods: Effects of RVV on renal tubular handling of sodium including mean perfusion pressure (PP), the renal vascular resistance (RVR), the glomerular filtration rate (GFR), the urinary flow (V) and osmolar clearance (Cosm) were studied in two groups of isolated perfused rabbit kidneys; each group had four isolated rabbit kidneys. RVV was added to the perfusion system to obtain the final concentration of 10 g/ml. Results: Immediate decreases in PP and RVR caused by the venom were significantly apparent (p < 0.05) in the first 15 min after RVV administration....
During an outbreak of leptospirosis in northeastern Thailand, 148 patients with sero- logically d... more During an outbreak of leptospirosis in northeastern Thailand, 148 patients with sero- logically diagnosed leptospirosis were seen in Loei Hospital. The clinical features were consistent with those described for the classic manifestation of the disease. However, hypotension was a common finding: noted in 94 patients (64%) upon admission or early in the course of the disease. Of these hypotensive patients,
Renal and systemic hemodynamics, plasma arginine vasopressin, plasma renin activity, plasma norep... more Renal and systemic hemodynamics, plasma arginine vasopressin, plasma renin activity, plasma norepinephrine, blood volume and water loading test were studied in 10 patients with falciparum malaria without renal failure. Six patients responded to water load normally, while 4 patients had a decreased response to water load. The patients with a normal water load response had normal renal and systemic hemodynamics and a normal hormonal profile. The patients with a decreased response to water load had hyponatremia, hypervolemia, high cardiac index, low systemic vascular resistance, high plasma arginine vasopressin, high plasma renin activity, high plasma norepinephrine, low creatinine and p-aminohippurate clearances, low urine sodium and high urine osmolality. They had a lower mean arterial pressure during the acute phase of the disease than during the recovery phase. The findings suggest that a decreased response to water load is due to peripheral vasodilatation which results in a decreased effective blood volume leading to the release of vasopressin and norepinephrine, increased renin activity and decreased renal hemodynamics.
The effects of Russell's viper venom on vasoactive mediators and renal hemodynamics were stud... more The effects of Russell's viper venom on vasoactive mediators and renal hemodynamics were studied in five mongrel dogs. Intravenous administration of Russell's viper venom to the dogs caused a reduction of mean arterial pressure, renal blood flow, and glomerular filtration rate. The filtration fraction was decreased. This was accompanied by a rise in plasma norepinephrine, endothelin, 6-keto-PGF1 alpha, a stable metabolite of PGI2, and TXB2, a metabolite of TXA2. Plasma levels of epinephrine and dopamine showed no significant changes. The increase of plasma levels of both vasodilatator and vasoconstrictor were critical to systemic and renal hemodynamics. While vasodilatation predominated in the systemic circulation and resulted in hypotension, vasoconstriction played a major role in decreasing renal hemodynamics. Decreased renal blood flow and decreased glomerular filtration rate were the result of renal vasoconstriction and hypotension.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2001
Hemodynamic alterations in Russell's viper envenomation are the result of interactions of var... more Hemodynamic alterations in Russell's viper envenomation are the result of interactions of various vasoactive mediators and perhaps proinflammatory cytokines. Since vascular endothelium is likely to be exposed to high concentrations of the venom and the endothelial cell itself not only plays an important role in the physiologic control of the circulation, but also play a role in inflammation with the synthesis and secretion of proinflammatory cytokines. It was therefore, the objective of this study to determine the effects of Russell's viper venom (RVV) on proinflammatory cytokine production by cultured human umbilical vein endothelial cells (HUVEC) and the release of endothelium-derived substances. Endothelial cells were isolated from freshly obtained human umbilical cord vein and grown in tissue culture to confluence as a homogeneous population. Cells were then incubated at 37 degrees C under 5 per cent CO2 with RVV (0.2, 1.0, 5.0, and 25.0 microg/ml) or lipopolysaccharide ...
Current Laboratory Techniques in Rabies Diagnosis, Research and Prevention, 2014
An immunochromatographic strip test is designed for fast and easy detection of rabies virus (RABV... more An immunochromatographic strip test is designed for fast and easy detection of rabies virus (RABV) antigens in clinical samples. In the field, saliva is a preferred clinical sample in the living patient because quick detection in such samples may be ideal for allowing management to be implemented in real time. Although the absolute RABV concentration in saliva samples is not known, the strip test in a lateral flow format performs well enough to be used for the detection of RABV in dog samples. The strip test has an advantage over many other field diagnostic techniques in that the test procedure is simple, rapid, and can be performed by public health professionals as well as veterinarians. However, a negative result with the test strip may indicate the absence of RABV antigens or that antigens are present below the level of detection. Thus, it must be understood that a negative test does not exclude a diagnosis of rabies.
Therapeutic antivenom against snakes was first produced by Albert Calmette in 1894. Since then an... more Therapeutic antivenom against snakes was first produced by Albert Calmette in 1894. Since then antivenoms have saved the life of countless snakebite victims. However, there are still many problems associated with antivenom production, for example variable percentage of responder horses, low neutralizing potency of antivenom, the large amount of snake venom needed for immunization and the difficulties encountered in producing potent polyvalent antivenoms. These problems have led to shortage and high cost of antivenom and, in some cases, failure of treatment. In 1997, a new immunization protocol for antivenom production was reported. It involves the injection of venom at low dose (approx. 2mg/horse) emulsified in Complete Freund&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s adjuvant in low volume (0.1-0.2 ml/site) in a total of 10 sites around the neck area of the horse. This immunization protocol has minimized the local reaction at the injection site thus allowing the use of the potent oil adjuvant. This, together with the increase in total surface area of the droplets, allow a more effective immune response to take place, e.g. enhancing the migration and activation of more antigen presenting cells and lymphocytes. The low dose, low volume multi-site immunization has resulted in dramatic improvements on the antivenom production in terms of amount of venom used for immunization, the time required to reach hyperimmune stage, the percent of responder horses and the potency of the antivenom. Furthermore, this protocol has made it possible to produce potent truly polyvalent antivenoms against several elapid and viperid snakes. This immunization protocol has alleviated various problems associated with antivenom production and has implications for immunization in general.
Changes in systemic and renal hemodynamics induced by Russell's viper venom are well establi... more Changes in systemic and renal hemodynamics induced by Russell's viper venom are well established. The component of the venom responsible for hemodynamic alteration has not been identified. By Sephadex column chromatography five fractions of Russell's viper (Daboia russellii siamensis) venom were isolated. Each venom fraction consisted of phospholipase A2, proteolytic enzyme, phosphomonoesterase, phosphodiesterase, arginine ester hydrolase and hyaluronidase of varying activities. Hemodynamic effects of each venom fraction including mean arterial pressure, cardiac output, systemic and renal vascular resistance, renal blood flow and glomerular filtration rate were studied in five groups of dogs; each group had four dogs. Minimal hemodynamic changes were observed in dogs receiving venom fraction I. Increased renal vascular resistance with diminution of renal blood flow and glomerular filtration rate was observed in dogs receiving venom fractions II, III, IV and V. A markedly i...
Background: The common complication in cases of poisoning by Russell’s viper (Daboia siamensis) v... more Background: The common complication in cases of poisoning by Russell’s viper (Daboia siamensis) venom (RVV) is acute renal failure, but the pathogenesis involved in the alteration of kidney function is still not well understood. Objective: To clarify the role of RVV in the pathogenesis of renal damage, the present study examines the functional short-term alterations acutely induced by RVV in isolated perfused rabbit kidney. Methods: Effects of RVV on renal tubular handling of sodium including mean perfusion pressure (PP), the renal vascular resistance (RVR), the glomerular filtration rate (GFR), the urinary flow (V) and osmolar clearance (Cosm) were studied in two groups of isolated perfused rabbit kidneys; each group had four isolated rabbit kidneys. RVV was added to the perfusion system to obtain the final concentration of 10 g/ml. Results: Immediate decreases in PP and RVR caused by the venom were significantly apparent (p < 0.05) in the first 15 min after RVV administration....
During an outbreak of leptospirosis in northeastern Thailand, 148 patients with sero- logically d... more During an outbreak of leptospirosis in northeastern Thailand, 148 patients with sero- logically diagnosed leptospirosis were seen in Loei Hospital. The clinical features were consistent with those described for the classic manifestation of the disease. However, hypotension was a common finding: noted in 94 patients (64%) upon admission or early in the course of the disease. Of these hypotensive patients,
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