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Biomedical subjects

K Chaichanwatanakul

Publications and source records attributed to K Chaichanwatanakul.

11 recordsLinked to original sources

Increasing prevalence of type 2 diabetes mellitus in Thai children and adolescents associated with increasing prevalence of obesity.

Type 2 diabetes mellitus (DM) is being diagnosed more frequently in children and adolescents. Thailand has a low incidence of childhood DM. This study reviewed patients with DM in the Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital compared to our previous study. The results demonstrate that type 2 DM in Thai children and adolescents has increased from 5% during 1986-1995 to 17.9% during 1996-1999. Mean age was 11.6 years. Mean BMI was 27.8 kg/m2. Fifty-six percent were diagnosed on routine examination. The period of increase in type 2 DM is associated with an increase of obesity prevalence from 5.8% in 1990 to 13.3% in 1996. This result emphasizes the importance of encouraging daily physical activity and healthy diet in our populations and also alerts our pediatricians and endocrinologists to the possibilities of type 2 DM in these age groups.

Adolescent↗

Measurement of serum free IGF-I in diagnosis of growth hormone deficiency.

Serum levels of total insulin-like growth factor-I (IGF-I) are growth hormone (GH) dependent and can be used as the screening tool for GH deficient status. However, most of them are bound to IGF-binding proteins, leaving less than 1 per cent in the free or unbound forms which represent the active biological fractions. Serum free IGF-I levels were measured by radioimmunoassay (IRMA) in 48 short children with various conditions. We found that the means +/- SEM of free IGF-I in children with panhypopituitarism (PAN) and complete growth hormone deficiencies (cGHD) were significantly lower than those in sex and age matched normal children (0.02 +/- 0.01 vs 2.01 +/- 0.7 ng/ml, p = 0.0006 and 0.42 +/- 0.18 vs 1.72 +/- 0.27 ng/ml, p = 0.0007 respectively) but not in children with partial growth hormone deficiencies (pGHD) (0.91 +/- 0.3 vs 1.97 +/- 0.4 ng/ml, p = 0.27) and idiopathic short stature (ISS) (0.94 +/- 0.3 vs 1.95 +/- 0.6 ng/ml, p = 0.13). However, when we classified the pGHD children into 2 groups according to IGFBP-3 SDS for normal Thai children, we found that the mean of free IGF-I levels in pGHD children with IGFBP-3 SDS < or = -1.3 was significantly lower than that of the controls. (0.68 +/- 0.55 vs 2.66 +/- 0.71 ng/ml, p = 0.04) In conclusion, the measurement of free IGF-I level can be used to evaluate the GH status of short children and might be used as a guide when starting treatment.

Child↗

Type 1 diabetes in Thai children aged 0-14 years.

Fifty-nine patients were diagnosed with diabetes in the ten years from 1987 to 1996 in the Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand. All patients were less than fifteen years old. Fifty-five patients (93.3%) were type 1 diabetes, three (5%) were type 2 diabetes and MODY, and one (1.7%) was diabetes secondary to beta thalassemia major. Patients with type 2 diabetes, MODY, and secondary diabetes were excluded from this study, and fifty-five patients with type 1 diabetes were analysed. The aims of this study were to determine some of the general characteristics of Thai childhood type 1 diabetes and to see whether a seasonal variation is present. The results showed a female to male ratio of 1.39:1. The peak age at diagnosis was from 9 to 12 years. Seventy-seven per cent had diabetic ketoacidosis at the time of diagnosis. The majority of patients (93.9%) had a BMI of less than 20 kg/m2. A family history of diabetes was reported in 38 per cent but only 2 per cent were type 1 diabetes. We found a high prevalence of patients in the summer and winter seasons (35-48% and 37-50% respectively) and a lower prevalence in the rainy season (14.8-15%). These results are different from a previously reported study in 1984-1985 which found no differences in summer, winter, and rainy seasons. Further research study into Thai childhood type 1 diabetes is needed, especially the influence of seasonal factors, the incidence of the disease, and the significance of family history.

Adolescent↗

Serum IGF-I and IGFBP-3 levels for normal Thai children and their usefulness in clinical practice.

Serum IGF-I and IGFBP-3 levels are growth hormone (GH) dependent and reflect the endogenous GH secretion. Two hundred and forty-four healthy children were evaluated for serum IGF-I and IGFBP-3 levels and then the age-defined normal values for Thai children were constructed. The results showed that the serum IGF-I and IGFBP-3 levels were age dependent, gradually increased from birth and reached the peak values around the age of 14-16 years. In addition, we studied the IGF-I and IGFBP-3 values in 28 GH deficient children and 26 normal variant short stature (NVSS) by using our normal constructed values as the reference. To minimize the influence of age, both IGF-I and IGFBP-3 values were transformed to standard deviation score (SDS). In clinical practice, we recommend using the IGF-I SDS and IGFBP-3 SDS of -1 and -1.3 respectively as a cut-off point to discriminate between GH deficiency and NVSS to avoid risky GH provocative tests and unnecessary GH replacement with the sensitivity of 71 per cent and the specificity of 92 per cent.

Adolescent↗

The correlation between osmolality and specific gravity of parenteral nutrition solution.

The correlation between osmolality and specific gravity of parenteral nutrition solutions containing various concentrations of amino acid and glucose were studied. There is good correlation between osmolality and specific gravity up to 1,000 mOsmol/kg H2O and 1.050, respectively. There are strong correlations between osmolality and amino acid concentration at each concentration of glucose. An equation which can be applied for quick calculation of osmolality of the solution from amino acid and glucose concentrations is: Osmolality (mOsmol/kg H2O) = 74.36 G + 163.91 A - 36.56. The results of this study can be adopted by all physicians for quick assessment of the osmolality of the PNS before administration to patients.

Osmolar Concentration↗

Gastric emptying pattern in Thai infants.

Gastric emptying of milk from the stomach of Thai infants shows a biphasic pattern. At 40 minutes the amount of stomach contents is more than at 20 minutes. At 100 minutes, only 16 per cent of the initial amount was recovered. The results of our study can be used as a standard reference for further study in infants with other diseases.

Female↗

Cytopathic effects of measles virus on the human intestinal mucosa.

We reported a case of measles with diarrhea in an infant. Capsule biopsy samples of intestinal mucosa taken 14 days after onset of fever was damaged and had low disaccharidase activities. Virus particles were found in the damaged villous cell. Second intestinal mucosa biopsy samples taken 28 days after onset of fever was found to be normal in structure, but lactase and sucrase activities were still low. Mucosal damage by virus particles was the cause of diarrhea in our infant.

Biopsy↗

Thyroxine effect on exocrine pancreatic development in rats.

Thyroxine and glucocorticoids both play important roles in regulating the development of mammalian tissues. The mechanisms by which they modulate the developmental process is not fully understood. Furthermore, the interaction between the effects of two hormones on the pancreas has not been studied in detail. To investigate these issues, we studied the effect of thyroxine and/or corticosterone on the development of the exocrine pancreas in normal and adrenalectomized rats. Daily injection of thyroxine (0.1 micrograms/g body wt) to pups starting at day 5 of age resulted in precocious increases of exocrine enzymes in the pancreata of these pups. Hypothyroid pups, induced by propylthiouracil, exhibited suppression of development of their pancreatic exocrine enzymes. Replacement of thyroxine or corticosterone alleviated the suppression of exocrine enzyme development in these pups. Rat pups, who underwent adrenalectomy at 5 days of age, had undetectable plasma corticosterone and exhibited similar suppression of pancreatic enzyme development. Injection of thyroxine or corticosterone alone to adrenalectomized pups led to normal development of exocrine pancreatic enzymes. When both thyroxine and corticosterone were given together to adrenalectomized pups, their pancreatic enzyme levels were found to increase to values above those of pups treated with thyroxine or corticosterone alone. We conclude that thyroxine has both direct and indirect modulatory roles in the development of the rat exocrine pancreas. Normal development of the exocrine pancreas depends on both intact adrenal and thyroid function in the rat.

Adrenalectomy↗