Biomedical subjects

Issarang Nuchprayoon

Publications and source records attributed to Issarang Nuchprayoon.

10 recordsLinked to original sources

PubMed2004

Noninvasive transcutaneous bilirubin as a screening test to identify the need for serum bilirubin assessment.

Hyperbilirubinemia is a common problem in the newborn infant. It can progress to develop kernicterus unless intervention is initiated. Severity and decision for management are usually based on serum bilirubin (TsB) which needs blood sampling. Transcutaneous bilirubin measurement is a noninvasive technique and the result correlates closely with TsB. A new transcutaneous bilirubinometer, Minolta AirShields Jaundice Meter, JM103, has been introduced The objectives of this study were: 1) To evaluate the accuracy of transcutaneous bilirubin (TcB) measured by JM 103, when compared to TsB, used clinically in a hospital setting (Leica Unistat Bilirubinometer) and 2) To develop a cut-off point of TcB level which indicated the need for serum bilirubin assessment. Three hundred and eighty eight term and near-term newborn infants with 460 paired TcB-TsB specimens were studied from August to November 2003. Birth weight was 3117.57 +/- 424.82 grams. TsB ranged from 4 to 19.6 mg/dL (x 10.5, SD 2.46). The correlation coefficient between TcB and TsB was significant (r 0.8, p < 0.001). TcB showed a tendency to underestimate TsB, with mean difference of 0.7 mg/dL, SD 1.6 mg/dL, and 95% confidence interval 0.85 and 0.55 mg/dL. TcB values of 8, 9, 10, 12 mg/dL were chosen as cut-off points that indicated the need for blood sampling for TsB (corresponded to hour-specific levels of 10, 12, 13 and 15 mg/dL, respectively when phototherapy should be initiated). In conclusion, noninvasive TcB assessment demonstrates significant accuracy, compared to TsB. It can be used as a screening test to identify the need for blood sampling for serum bilirubin level.

Bilirubin↗

PubMed2004

Endothelial injury and altered hemodynamics in thalassemia.

Increased activated circulating endothelial cells, enhanced von Willebrand factor (vWF:Ag) and adhesion molecules (sVCAM-1) are observed in patients with beta-thalassemia/hemoglobin E. Such evidences of endothelial cell injury are associated with altered intrarenal hemodynamics with a significant reduction in renal plasma flow. Altered renal functions (namely depleted creatinine clearance) and abnormal tubular function test, which is reflected by abnormally increased fractional excretion of magnesium (FE Mg), are also delineated. The increased FE Mg implies tubulointerstitial injury which may relate to the microvascular endothelial injury and chronic ischemia.

Case-Control Studies↗

PubMed2003

Study of specific IgG subclass antibodies for diagnosis of Gnathostoma spinigerum.

Gnathostoma spinigerum infection is endemic in Thailand and many Asian countries. Current diagnosis is the skin test and enzyme-linked immunosorbent assay (ELISA) for IgG antibody against the G. spinigerum third-stage larvae (L3), but cross-reactivity is common. We evaluated the sensitivity and specificity of anti-G. spinigerum L3 IgG subclass antibodies for diagnosis of 43 patients with gnathostomiasis. The majority of patients with gnathostomiasis (91%) had eosinophilia. While the anti-G. spinigerum L3 IgG1 antibody provided the highest sensitivity (98%), the anti-G. spinigerum L3 IgG2 antibody had the highest specificity (88%). The ELISA that detected anti-G. spinigerum L3 IgG1 antibody could be a reliable laboratory screening test, while anti-G. spinigerum L3 IgG2 antibody could be used to confirm the diagnosis.

Adolescent↗

PubMed2003

Expression of the FAT10 gene is highly upregulated in hepatocellular carcinoma and other gastrointestinal and gynecological cancers.

The ubiquitin-like modifier (UBL) family has recently generated much interest in the scientific community, as it is implicated to play important regulatory roles via novel protein-protein modification. FAT10 (diubiquitin) belongs to this family of proteins, comprising two ubiquitin-like moieties fused in tandem, and has been implicated to be involved in the maintenance of spindle integrity during mitosis. As FAT10 may play a role in the regulation of genomic stability, we examined if there is an association between FAT10 expression and hepatocellular carcinoma (HCC) or other cancers. Northern blot analyses revealed upregulation of FAT10 expression in the tumors of 90% of HCC patients. In situ hybridization as well as immunohistochemistry utilizing anti-FAT10 antibodies localized highest FAT10 expression in the nucleus of HCC hepatocytes rather than the surrounding immune and non-HCC cells. FAT10 expression was also found to be highly upregulated in other cancers of the gastrointestinal tract and female reproductive system. In conclusion, we demonstrated upregulation of FAT10 expression in various gastrointestinal and gynecological cancers. Its overexpression is unrelated to the general increase in protein synthesis or a general immune/inflammatory response to cancer. Rather, FAT10 may modulate tumorigenesis through its reported interaction with the MAD2 spindle-assembly checkpoint protein.

Carcinoma, Hepatocellular↗

PubMed2003

Red cell indices and therapeutic trial of iron in diagnostic work-up for anemic Thai females.

Anemia is common among Thai females. Thalassemia and iron deficiency are highly prevalent in the Thai population. A therapeutic trial of iron has been used to differentiate between the two conditions, however, no previous study on its usefulness in a Thai population has been reported. Otherwise healthy persons who had complete blood count (CBC) as routine 'check-up' and found to be anemic (Hb < 12 g/dl) at a preventive medicine clinic were tested for hemoglobin typing, serum ferritin, serum iron, and were given oral iron sulfate (120 mg elemental iron per day for at least 2 months) and a repeat CBC on a follow-up visit. Sixty-six individuals, all females, with pre-treatment hemoglobin (Hb) level of 9.5 +/- 1.7 g/dl (mean +/- SD), had complete data for analysis. Final diagnoses were isolated iron deficiency in 23 (34.8%), iron deficient thalassemia traits in 6 (9.1%) and iron-sufficient thalassemia syndromes in 29 (43.9%) anemic subjects. After a therapeutic trial of iron, Hb rose to 12.8 +/- 1.0 g/dl (n = 16, p = 2 x 10(-8)) among the iron deficient group, but not in thalassemia. The authors have identified that the most useful red cell indices that will discriminate between iron deficiency and thalassemia is a combination of red blood cell counts (RBC) > 4.4 x 10(6)/microl and mean corpuscular volume (MCV) < 69 fl. High RBC (> 4.4 x 10(6)/microl) and very low MCV (< 69 fl) is a sensitive (92.9%) and highly specific (100%) criteria for diagnosis of mild thalassemia diseases (Hemoglobin H (HbH), Hemoglobin H-Constant Spring (HbH-CS), and homozygous Hemoglobin E (HbEE)). Conversely, a low RBC (> 4.4 x 10(6)/microl) and/or low to normal MCV (69-85 fl) is highly sensitive (91.3%) but not specific (60%) for the diagnosis of iron deficiency. The authors conclude that a therapeutic trial of iron is useful as a diagnostic test in anemic females except those with high RBC (> 4.4 x 10(6)/microl) and very low MCV (< 69 fl), a subgroup which most likely has thalassemia and are least likely to benefit from iron treatment.

Adult↗

PubMed2003

Efficacy and safety of meropenem as an empirical treatment for febrile neutropenia in children with cancer.

Meropenem is a promising carbapenem antibiotic as an empirical monotherapy in patients with febrile neutropenia (FN). With the limited data of the therapy in pediatric patients, the authors conducted this study to evaluate the efficacy and safety of meropenem as empirical antibiotic therapy in 30 pediatric cancer patients with FN (mean age = 7.5 years), who were admitted to King Chulalongkorn Memorial Hospital from May 2000 to December 2001. Meropenem 60 mg/kg/day was given intravenously every 8 hours. The efficacy of meropenem was assessed as successful, inconclusive and failure on days 3 and 5 of the therapy and compared to that of other empirical antibiotics used from January 1997 to April 2000. The study showed that six blood culture specimens (20%) grew organisms, half of which were considered to be contaminants, and six urine culture specimens (20%) grew gram negative rod bacteria. On day 3 and 5 of the therapy, the success rate of meropenem was higher than that of comparatives (30.0% vs 17.6% on day 3, 50.0% vs 39.3% on day 5). The use of meropenem appeared safe, with minimal side effects. In conclusion, the present study showed that meropenem was safe and tolerable in children. The efficacy as an empirical monotherapy in pediatric cancer patients with FN was satisfactory, with a failure rate of 23.3 per cent on day 5 of treatment.

Adolescent↗

PubMed2003

Comparative study on serum iron determination by different methods.

Iron is an important trace element in humans. Depletion or overload iron status can result in a number of aberrant physiological functions. Determination of serum iron is one of the valuable test panels for iron status assessment. A comparative study was performed on 3 different methods of serum iron determination, nonprecipitating ferrozine colorimetric method, precipitating ferrozine colorimetric method, and iron liquicolor cleaning factor colorimetric agar-based (CAB) method (Human, Taunusstein, Germany). The correlation coefficients between nonprecipitating ferrozine colorimetric method and precipitating ferrozine colorimetric method, between nonprecipitating ferrozine colorimetric method and iron liquicolor cleaning factor CAB method, and between precipitating ferrozine colorimetric method and iron liquicolor cleaning factor CAB method were found to be 0.998 (P = .067), 0.999 (P = .067), and 0.951 (P = .934), respectively. For a setting with limited resources such as Thailand, use of the first analytical technique, nonprecipitating ferrozine colorimetric method, is recommended because of its low cost and ease of performance.

Colorimetry↗

PubMed2003

Prevalence of bancroftian filariasis on the Thai-Myanmar border.

To achieve the goal of eliminating lymphatic filariasis by the year 2020, close monitoring systems and effective control strategies need to be implemented and the real disease burden needs to be assessed. Bancroftian filariasis is endemic at the Thai-Myanmar border. However, there are only limited data on the prevalence of this disease in Thailand available. We employed microscopic examination, together with ELISA kits to detect W. bancrofti-specific Og4C3 circulating antigen and specific anti-filarial IgG4 antibodies to determine the burden of bancroftian filariasis in an endemic area at the Thai-Myanmar border in Umphang District, Tak province, Thailand. A total of 433 Thai-Karen blood samples were analyzed. The microfilarial rate determined by microscope was 6% and the W. bancrofti-specific Og4C3 antigenemia rate was 22%, while the specific anti-filarial IgG4 antibody rate was 54%. There were statistically significant higher levels of W. bancrofti-specific Og4C3 antigen in the microfilaremic-antigenemic group than in the amicrofilaremic-antigenemic group (unpaired Student's t-test; p < 0.001), similar to the specific anti-filarial IgG4 antibody results (unpaired Student's t-test; p < 0.001). A statistically significant correlation of moderate degree between the presence of W. bancrofti-specific Og4C3 antigen and of specific anti-filarial IgG4 antibody was found in the amicrofilaremic group (r = 0.474, p < 0.001), but not in the microfilaremic group (r = 0.291, p > 0.05). Our study revealed a very high prevalence of bancroftian filariasis in this endemic area and thus emphasized the importance of using highly sensitive and specific diagnostic tools to evaluate the true prevalence of the disease.

Adolescent↗

PubMed2002

Lyophilized cryoprecipitate for children with hemophilia A.

Cryoprecipitate is the most cost-effective treatment for bleeding events in hemophilia A children in Thailand. Lyophilized cryoprecipitate (LC), a freeze-dried heat-treated blood product from the National Blood Center, can be stored in a refrigerator. The objectives of this study were to assess the efficacy of LC in bleeding episodes of children with hemophilia A and to determine the pharmacokinetics of single dose LC infusion. Eight male children with congenital factor VIII deficiency, aged 1.2-13 years, with 12 active bleeding episodes were infused with reconsitituted LC (average factor VIII activity = 236 IU per bottle) at the dose of 1 bottle per 11 kg. All patients achieved clinical hemostasis by 12 hours post-infusion. The Factor VIII activity reached peak level within the first hour and declined slowly in the subsequent hours and retained in vivo Factor VIII activity at 27.3 +/- 5.6 per cent at 12 hours post-infusion. The incremental factor VIII activity was 2.37 +/- 1.05 per cent (mean +/- SD) per U infused per kilogram body weight. The half-life of infused factor VIII was 10.5 hours. The authors concluded that reconstituted LC infusion is efficacious in the treatment of bleeding episodes in children with hemophilia. Cost-effectiveness of this product and cryoprecipitate and other purified factor VIII should be evaluated.

Adolescent↗

PubMed2002

Prevalence of parasitic infections among Thai patients at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Parasitic diseases are still considered to be a major public health problem. Most patients with parasitic infections are asymptomatic and therefore remain undetected. Asymptomatic parasitic infections are usually discovered by routine parasite examination. To determine the result of parasite examination at the Parasitology Unit, Out Patient Department, King Chulalongkorn Memorial Hospital, Bangkok, Thailand, the authors collected the data of individuals examined for parasite infections from June to December 1997. A total of 6,231 Thais provided the data for analysis. Evidence of parasitic infections was found in 557 (8.94%) cases. The disease was most prevalent in males (57.3%), and in the age group >15-30 years old (11.13%). The population from the Northeast of Thailand was found to harbor parasites with the highest prevalence rate (17.03%), while it was 11.90 per cent in the northern group. The parasitic prevalence rates in the West, East, South and Central regions were 10.60 per cent, 8.90 per cent, 7.74 per cent, and 4.92 per cent, respectively. The parasite most commonly identified was Strongyloides stercoralis (33.39%), while giardiasis was the most common protozoan infection (14.36%). The highest infection rates of S. stercoralis, hookworms, Opisthorchis viverrini, and Gnathostoma spinigerum were found in northeasterners. People from the North of Thailand were infected mostly with G. lamblia. People of working-age from northeastern as well as northern regions harbored pathogenic parasites with high prevalence rates. To prevent parasitic infections, health education for these high risk groups should be provided.

Adolescent↗