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Biomedical subjects

A Chuansumrit

Publications and source records attributed to A Chuansumrit.

At least 55 records · Page 3Linked to original sources
PubMed1999

DNA extraction and amplification of 10-day, room-temperature blood samples.

DNA was serially studied in 20 samples of buffy coat stored at room temperature. Each sample was divided into 5 equal volumes, namely D0, D3, D5, D7 and D10. DNA extraction was performed on days 0, 3, 5, 7 and 10 after blood collection. The mean ratio of OD260/OD280 of the DNA obtained from D0 to D10 ranged from 1.77 to 1.79, and the mean amounts of the DNA obtained from D0 to D10 ranged from 602 to 740 ng/ul. There were no significant differences in the mean ratio and amounts of DNA obtained among these samples (p > 0.05). Subsequently, amplification was successfully performed from this template DNA to yield products of 1.4 kb and 142 bp at the sites associated with beta globin and factor VIII genes, respectively. These findings suggest the possibility of sending blood samples for DNA analysis by mail, or no ice is required during transportation.

Adult↗
PubMed1998

Management of haemophilia in the developing world.

The problems with management of haemophilia in developing countries are poor awareness, inadequate diagnostic facilities and scarce factor concentrates for therapy. The priorities in establishing services for haemophilia include training care providers, setting up care centres, initiating a registry, educating affected people and their families about the condition, providing low-cost factor concentrates, improving social awareness and developing a comprehensive care team. A coagulation laboratory capable of reliably performing clotting times with correction studies using normal pooled, FVIII and FIX deficient patient plasma and factor assay is most essential for diagnosis. More advanced centralized laboratories are also needed. Molecular biology techniques for mutation detection and gene tracking should be established in each country for accurate carrier detection and antenatal diagnosis. Different models of haemophilia care exists. In India, there is no support from the government. Services, including import of factor concentrates, are organized by the Haemophilia Federation of India, with support from other institutions. Haemophilia is managed with minimal replacement therapy (about 2000 i.u./PWH/year). In Malaysia, where the system is fully supported by the government, facilities are available at all public hospitals and moderate levels of factor concentrates are available 'on-demand' (about 11,000 i.u./PWH/year) at the hospitals. Haemophilia care in South Africa is provided through major public hospitals. Intermediate purity factor concentrates are locally produced (about 12,000 i.u./PWH/year) at low cost. The combined experience in the developing world in providing haemophilia services should be used to define standards for care and set achievable goals.

Developing Countries↗
PubMed1998

Use of an immunotherapeutic vaccine to treat a life-threatening human arteritic infection caused by Pythium insidiosum.

A 14-year-old Thai boy presented because of a history of headache, mandibular swelling, and facial nerve palsy. A microorganism identified as Pythium insidiosum was cultured from the mandibular abscesses. Despite treatment with amphotericin B, iodides, ketoconazole, and surgery, the infection progressed. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the neck revealed an aneurysm in the external carotid artery. The aneurysm was removed. MRA performed later showed stenosis of the internal carotid artery. Immunotherapy was recommended as a last resort. One hundred microliters of the P. insidiosum vaccine was subcutaneously injected into the patient's left shoulder, and 14 days later a similar dose was administered. Four weeks following the first vaccination, the patient's headache had disappeared, the facial swellings had dramatically diminished, the cervical lymph node had shrunk, and the proximal left internal carotid artery stenosis had significantly improved. One year after the vaccinations, the boy was considered clinically cured.

Arteries↗
PubMed1998

Allogeneic bone marrow transplantation in an osteopetrosis patient: first report in Thailand.

We described the successful allogeneic matched sibling bone marrow transplantation (BMT) in a 5-year-old Thai boy in whom osteopetrosis was diagnosed on the basis of anemia, thrombocytopenia, leukoerythroblastosis, sclerotic bone, hepatosplenomegaly, and visual deficit from an encroachment of cranial nerve foramina. The preparative regimen included 4 days of busulfan 4 mg/kg/day, and 4 days of cyclophosphamide 50 mg/kg/day. Complete hematopoietic engraftment and no evidence of graft versus host disease were shown after BMT. Complete hematologic findings were corrected. His hematopoietic chimerism was changed to that of his donor. Post BMT, he has no hepatosplenomegaly. His bone radiographic findings revealed normal after BMT. Bone marrow biopsy showed normalized bone and bone marrow matrix. However, his vision remained impaired. We believe that this is the first case of successful bone marrow transplantation in an osteopetrosis patient in Thailand.

Bone Marrow Transplantation↗
PubMed1998

Vitamin K deficiency bleeding in Thailand: a 32-year history.

Vitamin K deficiency bleeding cases in Thailand from 1963 to 1995 were extensively studied. From 1963 to 1987 there were 499 reported cases from 10 papers including 102 cases of the authors' series. From March 1994 to April 1996, two subsequent nationwide surveys were conducted where questionnaires were sent to 714 and 732 hospitals located throughout Thailand. The responding rate was 58.2% and 67% respectively. 331 cases were found during 1988 to 1995. The total number was 830 cases of which 799 were idiopathic vitamin K deficiency in infancy (IVKDI) and 31 were secondary types. IVKDI was found exclusively breast-fed infants (92%) who did not receive vitamin K prophylaxis at birth (90%). Bleeding and pallor were the common features. The occurrence of intracranial hemorrhage was strikingly high (82%); the fatality rates was 24%. However, the fatality rate among patients receiving either 1 mg of vitamin K, intramuscularly, (17%) or 2 mg, orally, (18%) were lower than those not receiving vitamin K prophylaxis (36%). The incidence of IVKDI significantly declined to 4.2-7.8 per 100,000 births between 1988 to 1995 which was in reverse proportion to the coverage of vitamin K prophylaxis (r = -0.94, p < 0.05).

Administration, Oral↗
PubMed1998

HLA class I antibodies in thalassemic patients.

This study was undertaken to demonstrate the prevalence of HLA class I antibodies among 62 polytransfused patients. The diagnosis included beta-thalassemia major, beta-thalassemia/Hb E disease and severe Hb H disease. Their ages ranged from 1 year to 23 years with the mean age of 10.7 years. The number of packed red cell transfusions ranged from 3 to 235 with the mean of 60 episodes per patient. The standard microlymphocytotoxicity test was performed using 50 panels of lymphocytes which specifically identified the majority of HLA class I antibodies. 31/62 cases (50%) were positive for HLA class I antibodies. The detection of single or multiple antibodies depended upon the number of blood transfusions and the patients' ages. These antibodies were induced by the leukocytes present in the transfused packed red cells. Therefore, leukocyte-reduced packed red cells prepared by either additional inverted centrifrugation or leukocyte filter is suggested for the routine blood bank service.

Adolescent↗
PubMed1997

Comparison between the conventional tube technique and the gel technique in direct antiglobulin tests.

OBJECTIVES: The direct antiglobulin test (DAT) is a diagnostic procedure demonstrating in-vivo antibody or complement coating on red cells. The gel technique (GT) for this test is sensitive and easier to do than the conventional tube technique (CTT). METHODS: We tested 52 newborns with hyperbilirubinemia and 6 children and 17 adults with autoimmune hemolytic anemia (AIHA) using the (DAT) in the form of the conventional tube technique (CTT) and the gel technique (GT) simultaneously. The gradings of the agglutination reactions of both techniques were scored as 12, 10, 8, 5, 3, 0 for 4+, 3+, 2+, 1+ and w+ and negative, respectively. RESULTS: The GT yielded higher scores than the CTT (p < 0.01). The overall sensitivity and specificity of the GT were 93.5 and 88.6%, respectively. The specificity of the DAT-positive results in newborns was determined by IgG only, while in AIHA, it was determined by IgG and/or C3d and, in only one sample, by IgM. CONCLUSION: The GT is equal to or better than the CTT. Since the GT is simple, the exposure of blood bank personnel to the blood sample is low. We highly recommend the GT, especially in areas where HIV infection is prevalent.

Adolescent↗
PubMed1997

Control cells for both electrical impedance and light scattering automated hematological analyzers: preparation from normal and thalassemic blood samples.

The study on quality control of automated blood cell analyzers, Technicon H*1 and Coulter MAXM by using three separately self-prepared control cells was extensively investigated. The three parts of control cells are pseudo-leukocyte and fixed platelets, which are fixed by glutaraldehyde, and control red cells from normal and thalassemic patients preserved and anticoagulated in CPD or CPDA-1. The Technicon H*1 system was based on the principle of light scattering but the Coulter MAXM was based on the principle of electrical impedance for cell counting and measurement. The self-prepared control cells can be satisfactorily utilized as control for each system with statistically significant difference (p < 0.05) for both systems. The expired dates for control cells are different in both systems and should be determined for each system specifically. The control red cells prepared from thalassemic patients were quite satisfactorily useful as an abnormal control for both systems during this study.

Blood Cell Count↗
PubMed1997

Eluding transfusion-transmitted HIV infection: report of two cases.

Two hemophilia A boys (FVIII: C < 1% and 2.2%), whose ages were 12 and 14 years. old, received fresh frozen plasma of 140 ml and 210 ml, respectively, in 1989. It was the 27th and 13th donation for each regular donor who was negative for anti-HIV testing. However, both donors had HIV seroconversion within 95 to 110 days after the last donation. They might have contracted HIV infection shortly after the last donation. Luckily, the two hemophiliac recipients are still in good health and negative for anti-HIV and HIV-antigen testings for 7 years.

Adolescent↗
PubMed1997

The benefit of the direct antiglobulin test using gel technique in ABO hemolytic disease of the newborn.

The direct antiglobulin test (DAT) using the gel technique was included in the investigation of infants with hyperbilirubinemia in the first week of life. Twelve cases were preterm and 48 cases were full term infants. The patients were divided into 2 groups: the study group comprised 22 cases of blood group A or B infants born to blood group O mothers; the control group comprised 38 cases of ABO blood groups compatible with those of their mothers. The mean +/- SD (39 +/- 26 hours) of the age at the onset of hyperbilirubinemia induced by ABO hemolytic disease of the newborn (HDN) was significantly earlier than that due to other causes. The positive rate of DAT in the ABO incompatible group was similar by both the conventional technique and the gel technique, 54.5% and 50% respectively. However, the scores by the gel technique were higher than those of the conventional technique. The gel technique is simple, reliable, involves less technical error and requires a small amount of blood sample. The grading system is clear-cut, especially grade 1 + or weak positive as compared to the conventional technique which requires examination under a microscope. Therefore, the DAT using the gel technique is beneficial to the diagnosis of ABO HDN. It should be included in the investigation of infants with hyperbilirubinemia especially in case of suspected ABO HDN.

ABO Blood-Group System↗
PubMed1997

Zinc and copper status of thalassemic children.

We investigated the amount of both zinc and copper in plasma, erythrocytes and hair in 11 patients with hemoglobin H disease, 59 patients with beta-thalassemia/HbE disease and 20 patients with homozygous beta-thalassemia. Plasma and hair zinc levels were found to be much lower, but erythrocyte zinc levels were higher, in thalassemic patients than in controls. The levels of copper in both plasma and erythrocytes were higher in the patients than in the controls. The mechanism with respect to the increase of the amount of both zinc and copper in erythrocytes was not clear; this result may reflect the impairment of zinc and copper utilization in tissues in the pathogenesis of these thalassemic patients.

Adolescent↗
PubMed1996

Investigation of the relative infectivity and pathogenicity of different hepatitis C virus genotypes in hemophiliacs.

To assess the relative infectivity and pathogenicity of variants of hepatitis C virus (HCV) genotypes, the distribution of genotypes in hemophilic patients who had been treated with nonvirally inactivated factor concentrates or cryoprecipitates prepared from local blood donors was compared with those found in the respective blood donor populations. Genotype frequencies differed markedly in the four countries investigated (Scotland, Hungary, South Africa, and Thailand) but in each, the HCV genotype distributions in hemophiliacs and blood donors were similar. In addition, HCV genotypes in recipients of commercially manufactured concentrates were similar to those found in the US general population. These findings provide no evidence that HCV genotypes differ significantly from each other in replication rate, transmissibility, or infectivity.

Hemophilia A↗
PubMed1996

Transfusion-transmitted AIDS with blood negative for anti-HIV and HIV-antigen.

A four-year-old boy who was diagnosed with Glanzmann's thrombasthenia received supportive treatment and desmopressin for his bleeding episodes. He seldom received blood components, except for platelet concentrates, due to severe bleeding. He was exposed to 18 routine donors and 2 plateletpheresis donors who were negative for human immunodeficiency virus (HIV) antigen and anti-HIV upon screening. At the age of 3 years and 9 months (4.5 months after the transfusion of platelet concentrate), he developed full-blown AIDS and died from circulatory failure 3 months later. The source of HIV transmission was identified as I donor who developed anti-HIV 3 months after the last donation. The rather short incubation time of AIDS in this case was attributed to a large inoculum of HIV virus in the 'window period' of infectivity of the newly infected donor. This case illustrates transfusion-transmitted HIV leading to AIDS, even though HIV antigen and anti-HIV screening tests were negative.

Acquired Immunodeficiency Syndrome↗
PubMed1996

A rapid and cost effective method for analysis of dinucleotide repeat polymorphisms in the factor VIII gene.

A simple, rapid and cheap method for the analysis of variable dinucleotide tandem polymorphisms in introns 13 and 22 of the factor VIII gene has been established. The protocol uses blood spots stored on filter paper (Guthrie spots) and other DNA containing materials as sources of DNA. Following DNA amplification using a thermostable DNA polymerase, products are size fractionated on native polyacrylamide gels and visualized by silver staining. This simplified protocol obviates the use of DNA extraction, reducing time and costs and in addition, reduces the requirement for gel documentation equipment (i.e., photography), as silver staining can be visualized readily without additional equipment and the gels themselves can be stored. These alterations to the analysis enhance the universal applicability of these polymorphisms, as was demonstrated by a comparative study in Caucasian and Thai females.

Cost-Benefit Analysis↗
PubMed1995

Prophylactic treatment for hemophilia A patients: a pilot study.

Prophylactic treatment with factor VIII concentrate was given to six hemophilia A boys whose factor VIII:C ranged from 1% to 3.5% at Ramathibodi Hospital. The age ranged from 11 to 16 years with the median age of 12 years old. Each patient received factor VIII concentrate twice a week in the dosage of 8-10 unit per kg for one year. During the prophylactic period, bleeding episodes seldom occurred. They did not need hospitalization. The absence from school was reduced. They became muscular from regular daily exercise. They could join the activity at school and lived a near normal life. The patients and family were very happy since they did not have to worry about bleeding. No adverse effect was found. The only constraint was the cost. It cost 180,000 baht (US$ 7,200) per year or 15,000 baht (US$ 600) per month for a 25 kg hemophiliac boy.

Adolescent↗
PubMed1995

DNA polymorphisms for carrier detection of hemophilia in Thailand.

The assessment of carrier state based on the pedigree and laboratory testing in 55 females from 34 Thai hemophilia families (24 affected by hemophilia A, 10 by hemophilia B) was studied. The laboratory testing included phenotypic analysis (FVIII:C/vWF: Ag ratio, FIX:C) and two types of DNA polymorphisms, restriction fragment length polymorphisms (RFLP) and variable number tandem repeats (VNTR) in/and close to the factor VIII genes (Bcl I, Xba I RFLP, St 14 VNTR) and factor IX genes (Mse I, Dde I RFLP). Fifteen out of seventeen (88%) obligate hemophilia A carriers and one out of five (20%) obligate hemophilia B carriers were diagnosed by phenotypic analysis. All hemophilia A carriers were informative for at least one polymorphism (Bcl I, Xba I or St 14) while 42% of hemophilia B carriers were informative for Mse I RFLP only. DNA polymorphism analysis has advantage over phenotypic analysis since it generally gives an absolute diagnosis when informative. Most DNA polymorphism analyses are performed by PCR technique which is a simple, inexpensive and quick procedure. However, it is limited by non-informativeness and high incidence of new mutations.

Factor IX↗