Pimol Chiewsilp

Prevention of hepatitis B infection in infants born to hepatitis B carrier mothers: low dosage vaccination

Two groups of newborn infants born to HBeAg positive carrier mothers were given HBIG (200 IU) immediately after birth. Subsequently, at age 2 days and at 1, 2 and 12 months, the first group received 5 μg and the second group 2 μg of HBV vaccines. There was no significant difference in the anti‐HBs seroconversion rate (SR), and the protective efficacy rate (PER) at the age of 13 months in either group. The SR and PER of group I were 91.7% and 90.18%, and group II were 92.9% and 91.01%, respectively. Although the significant differences were observed in the geometric mean titers of anti‐HBs in group I (526.3 mIU/ml) and group II (371.4 mIU/ml), both were above the protective level. The immune responses to the reduced dosage of HBV vaccines are satisfactory in preventing HBV in the newborn infants of HBeAg positive carrier mothers.

Red cell ABH antigens in leukaemias and lymphomas.

Abstract. The qualitative and quantitative determinations of A, B, and H antigens were studied in blood samples of 509 normal subjects and 114 patients. 11 of 53 (20.75%), 3 of 27 (11.11 %), and 4 of 34 (11.76%) of adults with leukaemia, children with leukaemia and adults with lymphomas, respectively, show significantly lower antigenic scores than normal controls. Since all A, B and H antigens were found to be independently affected, the destruction of well‐developed ABH antigens by a certain substance produced during the course of the disease was suspected.

HLA Class II Polymorphism in Thai Insulin-dependent Diabetes Mellitus

Fifty-seven Thai IDDM patients were studied for HLA class I by LCT and HLA class II by LCT and PCR-RFLP. It was found that DRB1*0301, DR3, DQB1*0201, DRB3*0202, DQA1*0501 and DQ2 were significantly increased with R.R. = 10.0, 6.6, 4.2, 3.7, 3.5 and 3.2 and Pc < 0.005, 0.001, 0.01, 0.005, 0.01 and 0.005, respectively. In contrast, DQA1*0101, DRB3*0301, DR5 and DQ1 were significantly decreased with R.R. = 0.2, 0.2, 0.3 and 0.5 and Pc < 0.01, 0.05, 0.01 and 0.05, respectively. The primary factor for IDDM susceptibility is probably DRB1. The homozygous Asp57/Asp57 DQB1 genotype appears to determine resistance to IDDM while Arg52-DQA1, non-Asp57-DQB1 haplotype confers susceptibility to IDDM. The common haplotypes in Thai IDDM cases were DRB1*0301, DRB3*0202, DQA1*0501, DQB1*0201, DPB1*0401 and DRB1*0405, DQA1*0301, DQB1*0402 (or 0401 or 0302), DPB1*0401 (or 0301 or 1501). The less common haplotypes were DRB1*0406, DQA1*0301, DPB1*0302, DPB1*0501 and DRB1*1202, DRB1*0301, DQA1*0601, DQB1*0301, DPB1*0501. DR3 was increased in both gender groups with early onset (< 10 years) regardless of a family history of DM. However, DR3/DR4 genotype was increased only in female patients with a family history of DM and early onset. In conclusion, DRB1, DRB3, DQA1 and DQB1, but not DPB1 are involved in the occurrence of IDDM. The cooperation of HLA class II and X-chromosome may contribute to the development of IDDM in addition to other factors such as other genetic (chromosomes 11, 19, 14, 7), immunologic and environmental factors which require further study.

Fresh dried plasma: A solution for the shortage of blood products in developing countries

SummaryThe availability of blood products for replacement therapy of hemophilia and allied disorders is still a formidable problem in most developing countries which consist of 80% of the world population. Fresh dried plasma (FDP) is a lyophilized form of fresh frozen plasma which can be stored at 4 °C, whereas fresh frozen plasma must be stored at −20 °C. A large-scale production of FDP from single units of fresh frozen plasma was achieved by the National Red Cross Blood Center in Thailand. This paper describes the method of preparation, biochemical and blood coagulation properties of FDP during one-year storage as well as its clinical usefulness. A batch of 179 bottles of FDP stored at 4 °C for one week, 3, 6, 9 and 12 months was studied in order to determine the biochemical and blood coagulation parameters. FDP has pH higher than that of fresh frozen plasma, but its value is within the safety range for infusion. Electrolyte and protein levels were comparable with those of fresh frozen plasma. Coagulant activities of factors I, II, V, VII, VIII, IX and X were about 10% lower than those of fresh frozen plasma; however, they are in the acceptable therapeutic range and all were stable during storage at 4 °C for up to one year. Over 4,000 bottles of FDP were used with good clinical and laboratory response and no serious side effects were observed in the treatment of bleeding in blood coagulation disorders and home care therapy of hemophilia.

The HL‐A System in Thais

Abstract. The HL‐A antigens were studied in 100 Thai subjects. HL‐A2, 11 and 9 of the first series and W15, HL‐A17, 5, and 13 of the second series were commonly found. HL‐A2‐11 and W15‐ were the commonest phenotypes observed in the first and the second series, respectively. The HL‐A2, X2, and 2, W15 were the most common haplotypes. However, there was no significant gametic association.

Fetal red cell in thai thalassemia trait patients

Suntaree Apibal, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok 10400 (Thailand) The presence of fetal red cells (F cells) in the maternal circulation is an indicator of a fetomaternal hemorrhage which may subsequently lead to hemo-lytic disease of the newborn [1]. However, a small amount of F cells were found in some normal adults [4] whereas the increase in hemoglobin F production might be increased in various conditions as thalassemia trait, unstable B chain variant and pregnancy [4]. In Thailand, thalassemia hemoglobin E-trait, ß-trait and α-trait were commonly found [2, 3]. The incidence of E-trait is 13% on average in the central region, 40% in the northeast, 8% in the north and 12% in the south [2]. The incidence of ß-trait is 3–9% and of α-trait is 20–30% [3]. So, the study for the percentage of F cells among these groups of subjects may be able to differentiate the false positive results of fetomaternal hemorrhage from F cells found in some normal persons and subjects with the thalassemia trait. F cells could be demonstrated in the maternal circulation by acid elution techniques. Our study revealed the presence of F cells in each group by the Saquan-sermsri acid elution technique as follows. The air-dried blood smear of not over 24 h was fixed in 80% ethanol for 3 min, then immersed in acid/alcohol/ami-do black solution for 3 min at room temperature (100 mg amido black B CI No. 20470, Merck’s Reagenzien, FRG, in 100 ml of 80% ethanol, pH adjusted to 2 with HC1). The smear was washed with tap water for 15 s and air dried. The stained smear was examined under an oil immersion microscope. The percentage of F cells (X ± SD) in 30 normal persons, 30 with E-trait, 30 with ß-trait and 30 with α-trait were 0.14 ± 0.18, 0.92 ± 0.78, 2.3 ± 1.87, and 0.5 ± 0.45, respectively. So, more investigations to exclude these conditions were needed before diagnosing fetomaternal hemorrhage. Thus, the diagnosis of fetomaternal hemorrhage is only valid in the presence of F cells in the maternal circulation if there are no such hemoglobinopathies in the mother. References Fanaroff AA, Martin RJ, Merleatz IR: Behrman’s Neonatal Perinatal Medicine, Disease of the Fetus and Infant, ed 3. St. Louis, Mosby, 1983. Na-Nakorn S, Minnich V, Chernoff A: Studies on hemoglobin E. II. The incidence of hemoglobin E in Thailand. J Lab Clin Med 1965;47:490. Wasi P, Na-Nakorn S, Pootrakul S, Sookanek M, Disthasong-chan P, Pornpatkul M, Panich V: Alpha and beta thalassemia in Thailand. Ann NY Acad Sci 1969;165:60.