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Biomedical subjects

P Pacharee

Publications and source records attributed to P Pacharee.

At least 19 recordsLinked to original sources

Pathologic findings in 76 autopsy cases of thalassemia.

Pathologic findings in six beta-thal major, 58 beta-thal Hb E, and 12 Hb H patients were presented. The causes of death were mainly infection in the first and second decades and cardiac failure in older patients. There was accelerated intramedullary and extramedullary erythropoiesis, with a few cases showing focal fibrosis, some with decreased cellularity and occasional atypia. Iron deposition mirrored that of thal patients in the European and American literature, apart from minimal cardiac siderosis, and the correlation between the amount of iron deposited and dysfunction of the particular organ was not always apparent. Patients with Hb H disease showed a less extensive iron deposition and organ pathology than those with the other two types of thalassemia.

Adolescent↗

Cardiac pathology in 76 thalassemic patients.

Heart disease is a major cause of death in thal patients after the first decade of life. This study was carried out on autopsy material from 76 patients, six with beta-thal major, 58 with beta-thal/Hb E, and 12 with Hb H disease. Of the 58 patients with beta-thal/Hb E, which form the main group, all but one had cardiac hypertrophy, accompanied by dilatation in 17, five of ten patients with right ventricular and 14 of 25 patients with biventricular hypertrophy had chronic pulmonary thromboembolism. Iron deposition, while present in 18 patients, was very slight. Four patients had fibrinous pericarditis, two with diagnostic rheumatic heart disease; 15 patients had chronic pericarditis, with extensive fibrosis in half the cases. In comparison, the six patients with beta-thal major showed more severe cardiac changes, including more iron deposition. Of the 12 Hb H patients, two died of rheumatic heart disease, one had frank bilateral pulmonary embolism and striking right ventricular hypertrophy, while the remaining nine showed little cardiac pathology.

Adolescent↗

Immunoperoxidase study on paraffin sections of gastrointestinal lymphoreticular lesions.

Seventy-five cases of lymphoreticular lesions of the gastrointestinal tract were studied by the immunoperoxidase method on paraffin sections which demonstrated cytoplasmic markers, in particular immunoglobulin (Ig) in B-lymphocytes and alpha-1-antichymotrypsin in histiocytes. There were 4 cases of benign immunoproliferative disease (IPD), 1 in the stomach, 3 in the small intestine; their reactions were polyclonal. Large cell non-Hodgkin's lymphoma was subdivided into 21 cases with IPD ("Mediterranean Abdominal Lymphoma") and 29 cases without. Eight cases of lymphoma with IPD were gastric and 13 intestinal; 7 gastric and 12 intestinal lymphomas were of B-cell origin; 1 gastric tumour was histiocytic; 1 intestinal neoplasm had no detectable marker. Sixteen cases of lymphoma without IPD were gastric and 13 intestinal; 4 gastric and 4 intestinal lymphomas were of B-cell type; 3 gastric and 2 intestinal neoplasms were histiocytic; 1 intestinal tumour was a composite of B-cells and histiocytes, in separate but contiguous foci; 9 gastric and 4 intestinal lymphomas had no identifiable marker. One of 18 cases of mixed and small cell lymphoma was accompanied by IPD. In these types of lymphoma Ig was found only in 10-30% of cells, mainly with plasmacytoid differentiation.

Gastrointestinal Diseases↗

Cardiac pathology in 47 patients with beta thalassaemia/haemoglobin E.

Autopsy protocols and heart slides of 47 patients with beta thalassaemia/haemoglobin E disease were reviewed. All but 1 patient had cardiac hypertrophy, accompanied by dilatation in 17; 5 of 9 patients (56%) with right ventricular and 11 of 22 patients (50%) with biventricular hypertrophy had chronic pulmonary thromboembolism. Cardiac iron deposition while present in 15 patients (32%) was very slight, in contrast to the amount of iron in their liver and pancreas. Four patients had fibrinous pericarditis, 2 with rheumatic heart disease. Twelve patients had chronic pericardial changes, 7 with adhesive pericarditis. The effects of cardiac pathology on the morbidity and mortality of patients with beta thalassaemia/haemoglobin E disease were discussed.

Adolescent↗

Adenosquamous carcinoma and carcinoidal differentiation of the colon. Report of a case.

A case of colonic tumor demonstrating both adenosquamous carcinomatous and carcinoidal features is reported. Previous record of such an occurrence has not been encountered. The relationship between the three elements appears to be an intimate one. It is not regarded as purely coincidental, but supports the possibility of a close histogenetic relationship between the three components.

Adenocarcinoma↗

Burkitt's lymphoma in Thai children: an analysis of 25 cases.

Twenty five cases of Burkitt's lymphoma in Thai children were diagnosed at the Department of Pediatrics, Siriraj Hospital during the period of 13 years (January 1969 to April 1982). Males were more affected than females with the ratio of 1.7:1. The age ranged from 2 to 11 years with the median age of 4-5 years. The most common clinical manifestations were abdominal mass associated with nausea vomiting, abdominal pain, anorexia, weight loss and generalized lymphadenopathy which occurred in 50-60% of cases. Additional symptoms and signs included anemia, hepatosplenomegaly, edema and pleural effusion. Jaw tumor was found in only 37.5% of the patients. Definite diagnosis depended on the characteristic starry sky appearance of the lymph node biopsy or section of abdominal mass. In advance cases, the tumor cells could be discovered in bone marrow aspiration, ascitic fluid pleural fluid and cerebrospinal fluid. The typical blast cells were detected in the peripheral blood in 4 cases. Antibody to Epstein-Barr virus could be detected in almost all cases with high titers in some cases. Most patients responded very well to local irradiation and chemotherapy with prednisolone plus cyclophosphamide and vincristine or methotrexate. However, relapse occurred rapidly and 80% of the patients died within 3 months after diagnosis with the median survival of only 1 month. Five cases expired early before any specific treatment. The main causes of death were disease, sepsis, excessive bleeding and hyperkalemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Viral↗

A study of allergic factor in nasal polyp patients.

Various investigations for allergy were carried out on 57 nasal polyp patients. The majority of them (96.5%) showed positive responses to at least one of the methods used. The results suggest that allergy is a constant feature in the nasal polyp patients but that further investigation is needed before we can state that allergic manifestation contributes to polyp formation. It was also found in this study that 90% of the patients had definite pathological changes on their sinus x-rays. Sinus disease may be either predispose a patient to or result from nasal polyps.

Adolescent↗

An association between thalassaemia and autoimmune haemolytic anaemia (AIHA).

An association between thalassaemia and autoimmune haemolytic anaemia (AIHA) has not been previously recognized. 10 patients with thalassaemic diseases were found to give positive results to antiglobulin test with polyvalent antiserum. Tests with monovalent antisera revealed immunoglobulins on the red cells in all cases. From history of blood transfusion, auto-antibodies following alloimmunization were very unlikely. IgG, either alone or together with IgM or IgA, was the predominant antibody on the red cells. All cases had warm type AIHA and responded dramatically well with steroid treatment except 3 who eventually needed splenectomy which responded in 2 and failed in 1.

Adolescent↗

Pulmonary artery obstruction in thalassaemia.

A new feature has been encountered in review of a large species of autopsy materials of beta-thalassaemia/Hb E disease. Among 43 patients pulmonary arterial obstructive lesions were found in 19 (44%), of which 17 were splenectomised cases. The pulmonary arterial thromboembolism may have been due to circulating platelet aggregates. This newly discovered pathology may be an additional factor contributing toward dyspnoea and heart failure in thalassaemia besides anaemia and cardiac iron deposition. If it is proven that this pulmonary arterial thromboembolism is indeed due to circulating platelet aggregates, preventive measure by administration of drugs reducing platelet aggregation such as aspirin and Persantin may be indicated, especially after splenectomy.

Adolescent↗

Immunoproliferative disease of the gastrointestinal tract: a report of five cases.

Five patients with immunoproliferative disease of the gastrointestinal tract are presented. The main pathological feature was dense diffuse lymphoplasmacytic and immunoblastic infiltration of the mucosa and submucosa, of the proximal small bowel in 3 cases and the stomach in 2. Four of the five patients had concomitant immunoblastic sarcoma. The clinical presentation and pathological findings are compared and contrasted with those of "Mediterranean abdominal lymphoma" and alpha chain disease, and the possible role of ethnogeographical and environmental factors in the pathogenesis are discussed.

Adult↗