Browsing by Author "Areekul, Suvit"
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Item Acetylcholinesterase activity in cord serum and human milk.(1987-12) Areekul, Suvit; Cheeramakara, Cheeraratanata; Churdchu, Korbkit; Watcharotayankul, WorawitAcetycholinesterase (AChE) and pseudocholinesterase (ChE) were determined on 44 cord serum and 72 human milk samples. The mean values of AChE were found to be 87 U/1 (rang 66-176 U/1 (range 1.1-6.6 U/1) in the cord serum and human milk respectively. There were no significant difference between the mean values of AChE in the milk samples collected on day 3 to day 12 after delivery. There was a tendency for increased AChE in the milk in the multi-gravidas more than in the first gravida. As the function of AChE in the milk is not exactly known at the neonatal gut because such systems required for the degradation of various amino acids are still not fully developed in the newborn. As AChE could not be detected in the neonatal serum aged 5 days, this indicatied that the enzyme in the milk. Cord serum contained a significantly lower ChE level than that of adult serum. As this low level rose in the first day and reached a double value within 3 weeks after delivery, this could not be due to the intake of the relatively low ChE in the human milk.Item Acetylcholinesterase activity in the amniotic fluid of normal Thai pregnant women.(1988-01) Watcharotayankul, Worawit; Churdchu, Korbkit; Cheeramakara, Cheeraratanata; Areekul, SuvitAcetylcholinesterase (AChE) activity was determined for 112 amniotic fluid samples obtained by amniocentesis from normal Thai pregnant women at gestational ages of 34 to 40 weeks. The method for estimation was based on inhibition the of non-specific cholinesterase (ChE) with ethoprorpazine and the expression of residual AChE activity as a percentage of total cholinesterase activity. The mean values of AChE and total ChE activities were found to be 3.65ฑ1.97 U/1 (range 1.10-7.72 U/1) and 7.61ฑ 2.55 U/1 (range 3.31-14.34 U/1) respectively. These values were in the same order of magnitude as results reported earlier in normal pregnant women. There were no relationships between gestational ages and amniotic fluid AChE, ChE or total ChE activities. As the concentration of AChE in the amniotic fluid is the index of the secreted AChE from neurons, it therefore increases considerably in fetus with open neural tube defect (NTD). The results for this pregnant women study is a base-line data for normal Thai pregnant women which will be useful in detecting the NTD in the fetus.Item Amniotic fluid folate level in normal pregnancy.(1990-12) Areekul, Suvit; Cheeramakara, Cheeraratana; Thanomsak, Wanyarat; Watcharotayankul, WorawitFolic acid level was determined in 175 amniotic fluid samples obtained by diagnostic amniocentesis from normal Thai pregnant women aged from 18 to 37 years. The mean value + one standard deviation was found to be 3.01+1.88 ng/ml, ranged from 0.5 ng/ml to 7.9 ng/ml. There were no difference of folic acid in amniotic fluid samples in different groups of gestational ages from 33 to 40 weeks and 1 to 4 gravida. The amniotic fluid folic acid also showed no correlation with the birthweight of the fetus or the foam test. The mechanism of the transfer of folic acid from mother to fetus and the significance of folic acid in the amniotic fluid is discussed in this paper.Item Assessment of optical density on amniotic fluid in predicting fetal lung maturity.(1990-01) Areekul, Suvit; Cheeramakara, Cheeraratana; Watcharotayankul, WorawitThe optical density (OD) of 107 amniotic fluids obtained by the amniocentesis after centrifugation at 450 x g or 2000 x g were measured at wave lengths varying from 500 to 650 nm. The OD was found to be lower at the centrifugation at 2000 x g than that at 450 x g and showed a reverse relationship to the wave lengths. In comparison with the foam test, OD measurements predicted the maturity of the fetal lung with less degree of accuracy and gave a higher false negative prediction was still relatively high. It was there fore concluded that OD measurements can not be used to replace the foam test because of their high degree of false negative prediction.Item A case with acute myelofibrosis and acute promyelocytic leukemia.(1995-02) Areekul, Suvit; Piankijagum, Anong; Churdchu, Korbkit; Thanomsak, WanyaratA 65-year-old man was admitted to a provincial hospital repeatedly over a period of years with a history of weakness, tiredness and progressive anemia. One occasion a bone marrow aspiration was found to contain normal marrow elements. On admission four months later, the patient was pale with pitting edema on both legs. His liver was barely palpable and the spleen was palpable 2 cm below the costal margin. He was anemic and peripheral blood showed anisopoikilocytosis, burr cells, ovalocytes and macrocytosis. The platelet level was very low, with some giant cells. The white blood cell count was normal, with some immature granulocytes. Bone marrow biopsy confirmed the diagnosis of acute myelofibrosis. The patient had very high levels of serum vitamin B12 and vitamin B12 binding proteins, especially transcobalamin I. After treatment with blood transfusion and prednisolone, his white cell count increased considerably. He died nine days after admission because of bronchopneumonia. This patient is an example of the simultaneous occurrence of acute myelofibrosis and acute promyelocytic leukemia that can terminate as acute myeloblastic or other stem – cell leukemia.Item A case with multiple myeloma, polycythemia vera and acute myelomonocytic leukemia.(1990-10) Areekul, Suvit; Srichaikul, Thanomsri; Leelasiri, Apichai; Cheeramakara, Cheeraratanata; Churdchu, KorbkitAn 83-year-old man with evidence of multiple myelome was admitted to the hospital with a history of weakness. His serum protein immunoelectrophoresis demonstrated monoclonal IgA lambda and bone marrow aspiration revealed plasma cells 20%. Two months alter, hematological examinations showed erythrocytosis, luecocytosis and thrombocytosis. The bone marrow showed hypercellular with increased plasma cells and monoblasts. Serum vitamin B12 and vitamin B12 binding proteins confirmed the diagnosis of polycythemia vera. After treatment with Busulfan, Prednisolone and Endoxan for 6 months, his blood examination revealed increased monocytes, metamyelocytes and myelocytes. Bone marrow examination confirmed the diagnosis of acute myelomonocytic leukemia with plasma cells. This patient is an example of the simultaneous occurrence of lympoproliferative and myeoproliferative disorder.Item Cholinesterase activity in serum and red cells of patients with retinoblastoma.(1986-11) Areekul, Suvit; Hathirat, Phongjan; Cheeramakara, CheeraratanataSerum cholinesterase (ChE) and erythrocyte acetylcholineaterase (AChE) activities were determined in 25 patients with retinoblastoma as well as in 80 normal subjects. There was no significant difference between the mean values of serum ChE in the group of patients and the normal group. These patients had a significantly lower mean value of red cell AChE activity than that of the normal subjects (P<0.01). Eleven out of 25 (44%) patients had red cell AChE activity lower than the normal limits. There was no relationship between erythrocyte AChE activities and Hb, Ht, red cell and white cell counts. Only 2 (8%) and 5 (20%) patients showed bone marrow and liver involvement, respectively, while 9 (36%) patients were anaemic. The cause and mechanism of reduced erythrocyte AChE activity in patients with retinoblastoma was not exactly known. One possibility was that the chromosome defect which predisposed to retinoblastoma may be the cause of intrinsic cellular defect of AChE synthesis.Item Cholinesterase and acetylcholineslinesterase activities in mice infected with plasmodium berghei.(1987-04) Areekul, Suvit; Cheeramakara, CheeraratanaCholinesterase (ChE) and acetylcholinesterase (AChE) activities were measured in serum, red cells, liver and spleen of normal and P. berghei – infected mice. Both serum ChE and red cell AChE activities in the infected group were found to be significantly higher than those of normal group. As only a negligible AChE activity was detected in the isolated P. berghei parasites and the parasitaemia showed no relationship to the erythrocyte AChE activity, this indicated that P. berghei possessed no AChE activity. The infected liver was significantly enlarged and contained elevated AChE and slightly but not significantly increased ChE and protein contents. The spleen was increased about 3 folds by weight which resulted in the slightly elevated ChE and AChE contents in the spleen of the infected mice. The elevated serum ChE and red cell AChE activities were therefore possibly due to the compensatory mechanism of the hepato-splenomegaly by having accelerated extramedullary erythropoiesis in the spleen and increased synthesis of ChE by the liver in mice infected with P. berghei.Item Differential diagnosis of myelofibrosis from polycythemia vera and chronic myelogenous leukemia by vitamin B12 determination.(1993-03) Areekul, Suvit; Piankijagum, Anong; Churdchu, KorbkitMyelofibrosis (MF) has a close pathogenic relationship to polycythemia vera (PV), chronic myelongenous leukemia (CML) and primary thrombocythemia (PT). Sometimes, clinical, hematological and radioisotopic studies in these patients cannot give a definite diagnosis. As serum vitamin B12 and vitamin B12 binding proteins in patients with PV and CML show their own specific pattern. It would be of interest to see whether these determinations could separate MF from PV and CML. Serum vitamin B12 and vitamin B12 binding proteins were determined on 6 patients with MF. It was found that serum vitamin B12, UBBC and TBBC levels were elevated. Both TCI and TCIII were increased while TCII decreased. A shift to the left of the increased granulocytes in MFR resulted in an increased TCI synthesized by the myelocytes and metamyelocytes while in PV, the increased number of granulocytes, most of which are mature granulocytes is characterized by increased serum TCII resulting in a reverse ratio of TCI/TCIII. In CML, serum vitamin B12, UBBC, TCI and TCII are much more sharply elevated than those of MF. Therefore determination of serum vitamin B12 and vitamin B12 binding proteins with other hematological, bone marrow and clinical studies could be used for a differential diagnosis of MF from PV or CML.Item Effect of chloroquine on serum vitamin B12 and its binding proteins in patients with plasmodium vivax.(1996-12) Areekul, Suvit; Churdchu, Korbkit; Thanomsak, Wanyarat; Cheeramakara, Cheeraratanata; Wilairatana, Polrat; Charoenlarp, PrichaChloroquine (CQ) is widely used as an antimalarial agent. It is accumulated in the lysosomes of various types of cells and inhibits the intralysosomal degradation of a wide range of proteins. CQ is found to interfere with vitamin B12 transportation in vitro and in the experimental animal. The present study was performed in order to determine such interference in humans receiving CQ. Serum vitamin B12 and vitamin B12 binding proteins were determined in 13 patients with P.vivax, both before and after receiving six tablets and 10 tablets of CQ. There were no significant differences between serum vitamin B12, UBBC, TBBC and TC values in patients before and after taking 6 tablets of CQ. A slight but not significant decrease in serum vitamin B12 and a significant increase in serum TCII were found after taking 10 tablets of CQ. The low serum vitamin B12 could be due to the effect of CQ on prevention of lysosomal degradation of intrinsic factor, leading to the accumulation of IF-B12 in the intestinal mucosa. As CQ also inhibits the intracellular degradation of TCII, therefore, more TCII levels are synthesized and secreted from various organs by the feedback mechanism. All these findings indicated the CQ had some effects on vitamin B12 absorption and transportation. However, these effects were relatively unsevere for the required dose of CQ in the treatment of P.vivax malaria.Item Elevated serum transcobalamin II levels in patients with prolonged fever.(1995-07) Areekul, Suvit; Churdchu, Korbkit; Paksanond, Suporn; Thanomsak, Wanyarat; Wilairatana, PolratSerum transcobalamin II levels were determined in 70 patients with prolonged fever. Twelve patients were found to have elevated serum TCII levels, i.e., 8 patients with salmonellosis, 3 patients with scrub typhus and 1 patient with pyrexia of unknown origin. There were no relationships between serum TCII levels and white blood cells, lymphocytes or monocytes. The possible mechanism producing increased serum TCIII levels in patients with salmonellosis and scrub typhus is the increased synthesis and release of TCII by the proliferative mononuclear phagocytic cells of the reticuloendothlial tissues such as spleen, liver, bone marrow and lymph nodes. This study gives the additional data that elevated serum TCII may occur not only in inflammatory disorders, autoimmune diseases, lymphoproliferative disorders, malignant histiocytosis and neoplasms, but also in infection with salmonellosis and scrub typhus.Item Elevation of serum transcobalamin II in patients with scrub typhus.(2005-01-24) Cheeramakara, Cheeraratana; Thanomsak, Wanyarat; Songmeang, Kriyaporn; Nontprasert, Apichart; Sanghirun, Charnnarong; Suthisai, Nopachai; Areekul, SuvitSerum transcobalamin II levels were measured in scrub typhus patients. Eighteen out of fifty-two patients admitted to Maharat Nakhon Ratchasima Hospital were diagnosed with scrub typhus infection. The serum unsaturated vitamin B12 binding protein (UBBC) and total vitamin B12 binding protein (TBBC) levels in these patients were significantly higher than in normal subjects (p < 0.001). The mean serum transcobalamin II level in the typhus patients was also significantly higher than in the normal subjects (p=0.004). There was a significant correlation between serum TCII levels and typhus IgM or IgG titers (p < 0.05), but not to total IgM levels. These findings indicate that patients with scrub typhus had stimulation of the recticuloendothelial system as a result of a considerable increase in transcobalamin II levels.Item Erythrocyte superoxide dismutase and catalase activities and serum uric acid in patients with malignant lymphoma.(1988-10) Areekul, Suvit; Tanthasawat, Veraporn; Patanamatum, Suporn; Hathirat, Phongjan; Piankijagum, AnongMany previous studies on superoxide dismutase (SOD) and catalase activities in red cells of patients with malignant lymphoma showed results. One possible factor may be the different oxidant stress in these patients. The objective of the present study was determine SOD and catalase activities in red cells of patients with untreated malignant lymphoma who had normal serum uric acid level. The studies were performed on 19 patients with Hodgkin's disease and 34 with non-Hodgkin's lymphoma (NHL) in comparison to 40 healthy normal subjects. The mean values of erythrocyte SOD activity in these patients were not significantly different from that of normal subjects. Serum uric acid levels were also within the normal ranges and only 4 out of 53 patients had serum uric acid over 7 mg/dl. There was no relationship between serum uric acid level would have red cell SOD within the normal limits. As hyperuricaemia may occur as a result of increased purine turnover from the increased destruction of tumor cells by therapy. The overproduction of uric acid would stimulate the generation of superoxide radicals. In such cases, red cell SOD would therefore be decreased during the hyperuicaemia. These findings may therefore explain why some previous authors found either increased or decreased SOD activity in red cell of patients with malignant lymphoma. No significant differentce of erythrocyte catalase activity between the groups of patients and the normal group was demonstrated in the present study.Item Erythrocyte superoxide dismutase and catalase activities in red cell infected with plasmodium vivax.(1988-12) Charoenyarp, Pricha; Thanomsak, Wanyarat; Churdchu, Korbkit; Areekul, Suvit; Phot, Tien PhoyIt has been shown that erythrocytes infected with asexual forms of malarial parasites are more sensitive to oxidant strees than normal red cells. Many studies reported a great alterations of SOD and catalase levels in red cells of subjects infected with different species of plasmodium indication the significant role of oxidant stress in the host defence mechanism against the parasites. In order to study these effects in patients with P.vivax, SOD and catalase activites were determined in red cells of 40 patients in comparison to 40 normal human subjects. Both mean erythrocyte SOD and catalase values in the patient group showed no significant difference from those of the normal group. There was a direct relationship between parasitemia and SOD cativity. AII these findings indicated that P.vivax parasites did not nave any effect on these enzymes of the host erythrocytes. It was therefore possible that the increased susceptibility of P.vivax infected red cells to oxidant damage was not a result of reduced functioning of the SOD and catalase. These findings could also explain the reasons why the symptoms of patients with P.vivax were less severe than those of patients with P.falciparum.Item Excessively high serum vitamin B12 level in patients with a provisional diagnosis of megaloblastic anemia.(1993-08) Areekul, Suvit; Churdchu, Korbkit; Thanomsak, Wanyarat; Viravan, ChaisinHigh serum vitamin B12 level has been reported in patients with liver diseases ad some hematological disorders. It has been observed that some patients diagnosed as megaloblastic anemia have high serum vitamin B12 with low serum unsaturated vitamin B12 binding capacity (UBBC). The objective of the present study was to investigate in these patients. A retrospective study in 9 patients with a provisional diagnosis of megaloblastic anemia showed extraordinarily high serum vitamin B12 with very low UBBC. Their past history showed that these patients were treated with 1,000 g vitamin B12 intramuscularly 10-24 hours before serum samples were taken for vitamin B12 determination. Study in another 3 patients showed that within 12 hours after a single injection of 1,000 g cyanocobalamin, their serum vitamin B12 raised considerably with an extremely low UBBC level. These findings indicated that the injected vitamin B12 saturated all transcobalamins and then exceeded to bind to other serum proteins such as albumin and gamma globulin. Serum vitamin B12 was maintained at a very high level with a very low unsaturated vitamin B12 binding capacity. Therefore the past history of receiving vitamin B12 must be exactly known in any patients who were taken blood sample for vitamin B12 determination.Item Folates and vitamin B12 status in patients with multiple myeloma.(1992-07) Areekul, Suvit; Cheeramakara, Cheeraratana; Churdchu, Korbkit; Hathirat, Phongjan; Piankijagum, AnongSerum and red cell folate, serum Vitamin B12 and Vitamin B12 binding proteins were multiple myeloma. Half of these patients were anaemic with a predominant macrocytic type. Altogether 17 and 33 percent had low serum and red cell folate levels, respectively. Low serum Vitamin B12 level was found in one third of these patients. Both TCI and TCIII increased while TCII decreased, while was different from the previous report of extremely elevated TCII in some patients with multiple myeloma. There was a direct relationship between serum Vitamin B12 and saturation of TCI. These finding indicated that folic acid and Vitamin B12 deficiency were relatively common in patients with multiple myeloma. The possible mechanisms of these vitamins deficiency were discussed in this paper.Item The hematological status, plasma vitamin B12 and folic acid levels, and intestinal pathology in rats infected with Giardia lamblia.(2004-12-27) Cheeramakara, Cheeraratana; Nontprasert, Apichart; Siripanth, Chutatip; Tanomsak, Wanyarat; Chularerk, Udomporn; Sucharit, Pramualmal; Areekul, SuvitThe purpose of our study was to investigate the hematological status, vitamin B12 and folic acid absorption and intestinal pathology after Giardia lamblia infection in a rat model. Adult Wistar rats were assigned randomly to receive human giardia cysts orally in the amount of 5 x 10(5) or 1.0 x 10(6) cysts, or none in the controls. The results showed that all the rats injected with giardia cysts became infected. The cyst output in the infected rats varied considerably. In rats infected with 5.0 x 10(5) giardia cysts, the incubation period until cyst output was 10 days compared with 4 days in rats infected with the higher amount of 1.0 x 106 giardia cysts. The highest peaks for cysts output in these 2 groups were on days 4-33, which decreased gradually to days 40-58. The hematocrit and hemoglobin levels in the infected rats were statistically significantly lower than in the controls on days 16, 22, 33, and 37 post-infection (p < 0.05). A reverse relationship between giardia cyst output and hemoglobin concentration was found in the infected rats (p = 0.05). There were no significant differences in plasma vitamin B12 and folic acid levels between the infected rats and the control rats. No pathological changes were found in the small intestine of infected rats. These findings suggest that giardiasis did not affect the absorption of plasma vitamin B12 and folic acid but caused anemia in a rat model.Item Hyperuricaemia and antioxidant enzymes in red cells of patients with malignacy of haematological origin.(1990-03) Areekul, Suvit; Tanthasawat, Veraporn; Patanamatum, Suporn; Hathirat, Phongjan; Piankijagum, AnongSerum uric acid, red cell SOD and catalase activities were determined in 117 patients acute lymphoblastic leukaemia, chronic myelocytic leukaemia, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, polycythemia vera and multiple myeloma in comparison to 40 healthy normal subjects. About 6-40 percent of these patients had serum uric acid level over 7 mg/dl. Altogether, 14 patients had hyperuricaemia, therefore they were grouped together. There was a reverse relationship between serum uric acid level and SOD activity in these patients. The hyperuricaemia is a result of increased proliferation and destruction of tumour cells which stimulates the generation of superoxide radicals. Therefore, red cell SOD will be decreased in patients with hyperuricaemia. In order to compensate for an elevated oxidant stress, SOD will therefore increase. These findings could explain the variable results of red cell SOD reported earlier in patients with malignancy of haematological origin. There was no relationship between serum uric acid and red cell catalase activity in these patients.Item Idiopathic hypereosinophilic syndrome: A case report.(1996-01) Areekul, Suvit; Wilairatana, Polrat; Viravan, ChaisinEosinophilia is quite common in Thailand due to the high prevalence of parasitic diseases. A study in 1993-1994 showed that 41% of patients with different parasitic infections had eosinophilia. We report herein a patient with idiopathic hypereosinophilic syndrome (HES). A 23-year-old man was admitted to the hospital with a 1.5 month history of chest pain and dyspnea on exertion. He had symptoms and signs of congestive heart failure. His peripheral blood revealed eosinophils 42% (8.4 x 109/1) with many hypogranulated and vacuolated eosinophils. Bone marrow aspiration showed a hypercellular marrow with eosinophils 10% and plasma cells 5-10%. Chest x-ray showed cardiomegaly and an echocardiography revealed pericardial effusion. As this patient had eosinophilia, signs and symptoms of cardiac involvement and lack of evidence for parasitic, allergic or other causes of eosinophilia, a diagnosis of idiopathic HES was made. Treatment with prednisolone resulted in the improvement of congestive heart failure and the eosinophil count returned to normal. A prompt diagnosis and treatment are needed in patents with this syndrome.Item Increased circulating levels of transcobalamin II in typhoid fever.(1996-10) Areekul, Suvit; Churdchu, Korbkit; Thanomsak, Wanyarat; Cheeramakara, Cheeraratanata; Sabcharoen, Arunee; Vongsthongsri, UsaneeMany previous studies have shown that serum transcobalamin II (TCII) is usually elevated in patients with a stimulated and proliferative reticuloendothelial system resulting from such diseases as multiple myeloma, systemic lupus erythrematosus, dermatomyositis, rheumatoid arthritis and Gaucher’s disease. As reactive macrophage hyperplasia with monocytosis also occurs in patients with typhoid fever, we therefore studied TCII in these patients. The mean value of serum TCII was significantly higher in the typhoid patients’ group, and 15 out of 35 patients had serum TCII values over 2,000 pg/ml. There was no relationship between serum TCII and white blood count, haemoglobin or haematocrit values. The increased serum TCII level in typhoid patients was possibly due to increased synthesis by the proliferative mononuclear cells derived from reticuloendothelial tissue in various organs such as the spleen, liver and mesenteric lymph nodes. This supposition is supported by a previous report that TCII is synthesized in part by mouse peritoneal macrophages, as well as by human monocytes and macrophages which produced and secreted considerable amounts of TCII into the medium. Findings of increased serum TCII in typhoid patients therefore add a new area of information which has never been studied before.
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