Browsing by Author "Suvatte, V"
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Item Abnormal hemostasis in dengue hemorrhagic fever.(1993-03-01) Hathirat, P; Isarangkura, P; Srichaikul, T; Suvatte, V; Mitrakul, CAbstract. Abnormal hemostasis in dengue hemorrhagic fever includes:- 1. Vasculopathy which occurs during the early febrile to pre-shock and shock phase. The evidences support are: 1.1 Increased anaphylatoxin, released by complement activation causing leakage of intravascular fluid in to serous space. 1.2 Positive tourniquet test, some of which occur preceeding thrombocytopenia in the acute phase of DHF. 1.3 Excessive increased in PGI2 which is the most potent vasodilator and platelet aggregation inhibitor. 2. Platelets: 2.1 Thrombocytopenia due to 2.1.1 The bone marrow hypocellularity with increased in all forms of megakaryocytes but the vacuolated and disintegrated ones. 2.1.2 Destruction by the liver and spleen. 2.1.3 Immune-mediated injury as demonstration of dengue antibody complexes on the platelet surface. 2.1.4 The in vitro spontaneous aggregation to vascular endothelial cell pre-infected by dengue virus inducing platelet aggregation, causing lysis and platelet destruction. 2.2 Dysfunction shown by 2.2.1 Increased release of betathromboglobulin (BTG), PF4 and PGI2. 2.2.2 In vitro hypoaggregation stimulated by ADP and defect in ADP-releasing ability. 3. Coagulopathy including: 3.1 Prothrombin complex deficiency due to liver damage. 3.2 Consumptive coagulopathy due to the activation by mononuclear phagocytes, PF3 released from platelet aggregation. DIC is seen in prolonged shock cases of DSS.Item Acquired platelet dysfunction with eosinophilia: study of platelet function in 62 cases.(1979-09-01) Suvatte, V; Mahasandana, C; Tanphaichitr, V; Tuchinda, SItem Active pre-exposure immunisation against hepatitis B virus: immunogenicity of hepatitis B vaccine in healthy Thai adults and children.(1987-06-01) Pongpipat, D; Suvatte, V; Assateerawatts, A; Bhethraratt, SThe immunogenicity of plasma derived hepatitis B vaccine (Hevac B) was studied for active pre-exposure immunisation in 176 healthy volunteer adults and 162 randomised children who had no hepatitis B virus markers. All subjects received three injections of 5 micrograms of hepatitis B vaccine intramuscularly at one month intervals. Seroconversion at 2 months after the third dose of vaccine was 96.30 percent in the children and 92.00 percent in the adults with mean anti-HBs titres of 800 mlU/ml and 353 mlU/ml respectively. The difference of anti-HBs levels between these two groups was statistically significant (p less than 0.05). Female adults had exhibited higher immune response to HB vaccine than male adults but there was no seroconversion difference between boys and girls. There were no serious local or systemic side effects of hepatitis B vaccination. It was concluded that active immunisation with plasma derived hepatitis B vaccine in non-immune children and adults is highly effective without any serious side effects or complications. The prevention of horizontal transmission of hepatitis B virus should be done by vaccination in children since they have a much better immune response to hepatitis B vaccine than adults.Item Aeromonas septicemia with shock in children with thalassemias.(1984-07-01) Tanphaichitr, V S; Suvatte, V; Mahasandana, C; Tuchinda, SItem Antibody against hepatitis associated antigen (H.A.A.) in children with thalassemia and the risk of posttransfusion hepatitis.(1973-06-01) Pongpipat, D; Suvatte, V; Ratanawong, AItem Bone-marrow transplantation for severe aplastic anemia: the first case report in Thailand.(1987-03-01) Issaragrisil, S; Chandanayingyong, D; Suvatte, V; Piankijagum, A; Lertakyamanee, N; Tepmongkol, P; Petchan, S; Wasi, C; Aswapokee, P; Danchaivijit, SItem Burkitt's lymphoma in Thai children: an analysis of 25 cases.(1983-09-01) Suvatte, V; Mahasandana, C; Tanphaichitr, V S; Tuchinda, S; Parichatikanond, P; Pacharee, PTwenty 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)Item Cell-mediated immunity in childhood malignancies.(1981-03-01) Suvatte, V; Tuchinda, MItem Combination of chemotherapy, radiotherapy and immunotherapy for acute lymphoblastic leukemia in children.(1981-04-01) Suvatte, V; Mahasandana, C; Tanphaichitr, V S; Tuchinda, S; Vootiprux, VItem Dengue hemorrhagic fever: a case report with acute hepatic failure, protracted hypocalcemia, hyperamylasemia and an enlargement of pancreas.(1988-09-01) Jirapinyo, P; Treetrakarn, A; Vajaradul, C; Suvatte, VItem Dengue hemorrhagic fever: hematological abnormalities and pathogenesis.(1978-12-01) Suvatte, VItem Detection of varicella-zoster antibody by immune adherence hemagglutination test.(1984-09-01) Kositanont, U; Suvatte, V; Wasi, C; Thongcharoen, PThe immune adherence hemagglutination (IAHA) is a more sensitive and specific test for evaluation of humoral immunity to varicella-zoster virus (VZV) than a conventional complement fixation (CF) test. The equipment, reagents, procedure used in the IAHA are basically the same as those employed in the CF test. After VZ vaccination, seroconversions detected by IAHA test were significantly greater than those by CF test (P less than 0.01, chi 2 test). Moreover, the IAHA titers were higher about 4 times (G.M. 30.9 vs 8.2) and persisted longer than CF titers. Although the IAHA antigen is not a commercial product, the IAHA is sensitive and suitable assay for VZ antibody determination in routine serological laboratory.Item The determination of Australia antigen and antibody by cross-over immunoelectrophoresis.(1971-08-01) Pongpipat, D; Suvatte, V; Ratanawong, AItem Diagnostic value of buffy coat preparation in dengue hemorrhagic fever.(1979-03-01) Suvatte, V; Longsaman, MExamination of the buffy coat preparation is a simple, rapid diagnostic aid for the early diagnosis of dengue hemorrhagic fever (DHF). The presence of many transformed lymphocytes, usually 20-50 per cent during the first few days of fever is a unique finding especially during a secondary infection. Similar findings are absent during the early phase of illness in other viral infections. The buffy coat appearance in DHF is also clearly different from those in patients with bacterial infections, which show many polymorphonuclear leukocytes containing toxic granules and vacuoles. The early buffy coat diagnosis in 320 cases of DHF correlated well with the later serologic diagnosis. The buffy coat diagnosis of secondary DHF was correct in 94.2% of cases as early as the third day of fever. This technique has proven to be clinically useful for early screening test of secondary DHF in Southeast Asian countries. The observation of many transformed lymphocytes in the peripheral blood of DHF patients also offer some insight into the pathogenesis of this condition.Item Efficacy of hepatitis B virus (HBV) vaccine in long term prevention of HBV infection.(1988-06-01) Pongpipat, D; Suvatte, V; Assatteerawats, AEfficacy of HBV vaccine in long term prevention of HBV infection was evaluated at 3 years after vaccination in 38 children and 61 adults. All vaccinees were negative for all HBV markers (HBsAg, anti-HBs and anti-HBc) before vaccination. Vaccines (Hevac B) were given for 3 doses, one month apart, to 38 children aged 1 month - 14 years and 61 adults aged 15-45 years. After 3 years of vaccination, blood specimens were collected for the determination of HBsAg, anti-HBs and anti-HBc. The results revealed that no HBsAg antigenemia was found in all 99 vaccinees. Anti-HBs could not be detected in 4 children and 11 adults and this occurred only in the group of subjects who had initial anti-HBs less than 100 mlU/ml at 2 months after the last dose of vaccination. At three years after the first course of vaccination, 89.4 percent of children and 83.4 percent of adults still have anti-HBs above protective level (more than 10 mlU/ml) with geometric mean titers of 101 and 35 mlU/ml in children and in adult groups, respectively. The anti-HBc was detected in 2 out of 38 children and 10 out of 61 adults, but none of them became chronic hepatitis B carriers or developed clinical disease. It is recommended that everyone with anti-HBs values below 100 mlU/ml two months after the last dose of vaccine should be revaccinated with a booster dose within 6 months. Those with anti-HBs levels higher than 100 mlU/ml, should be checked up at 3 years; if the anti-HBs is less than 10 mlU/ml, they should be revaccinated.Item Efficacy of hepatitis-B immunoglobulin and hepatitis-B vaccine in prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg.(1986-06-01) Pongpipat, D; Suvatte, V; Assateerawatts, ACombined prophylaxis of perinatal transmission of hepatitis B virus (HBV) with hepatitis-B immunoglobulin (HBIG) and hepatitis-B vaccine was investigated in 40 infants born to HBeAg positive carrier mothers. The efficacy of two combined prophylaxis schedules was compared to 78 similar infants in the control group receiving no treatment, by following the HBV markers at regular intervals up to one year of age. In both schedules, the HBIG and HBV vaccine were given at birth, followed by HBV vaccine given at 30 days and 60 days (group I) or 180 days (group II) of age. The incidence of persistent HBsAg carrier in infants born to HBeAg positive carrier mothers was significantly reduced from 92.6 percent at one year of age in the control group to zero percent (group I) and 11.5 percent (group II) in the treated groups. There was no statistical significant difference in the efficacy of these two combined prophylaxis schedules. HBIG given at birth did not interfere with infant immune response to the hepatitis B vaccine. At twelve months of age, anti-HBs could be detected in 77.8 percent of infants in group I and 89.5 percent in group II with mean titre of 621.4 and 1148.0 in group I and group II respectively. It was concluded that combined prophylaxis with HBIG and hepatitis-B vaccine immediately after birth is the best method for prevention of HBV perinatal transmission from HBeAg positive carrier mothers to their infants.Item Evidence of vitamin K deficiency in cord blood.(1993-03-01) Mahasandana, C; Pung-amritt, P; Yodthong, S; Suvatte, VThe prevalence of vitamin K deficiency in the newborns delivered at Siriraj Hospital was studied. The prolongation of one stage prothrombin time and the presence of PIVKA-II (non carboxylated prothrombin antigen) in cord blood were interpreted as the secondary change from vitamin K deficiency state. The most reliable method to diagnose vitamin K deficiency is the detection of vitamin K level in plasma which is not yet available in Thailand. Although the prevalence of vitamin K deficiency in the newborns from our data is not high, only 0.6%, it is shown that some of the apparently normal newborn infants may have bleeding problem from vitamin K deficiency in both newborn and early infancy periods. So, the correction of this deficiency by administration of vitamin K to all newborns is appropriate and reasonable decision.Item A first report of paediatric sarcoidosis in Thailand.(1984-06-01) Suvatte, V; Mahasandana, C; Tanphaichitr, V S; Tuchinda, M; Chantarakul, N; Bovornkitti, SItem Gaucher's disease;thirty-two years experience at Siriraj Hospital.(1999-12-13) Tanphaichitr, V S; Suvatte, V; Mahasandana, C; Sachapong, P; Veerakul, G; Kankirawatana, S; Wasant, PGaucher's disease, a lysosomal disorder, is not a common disease in Thailand. During the period 1966-1998 we saw 20 patients with Gaucher's disease at the Department of Pediatrics. Siriraj Hospital. The patients came from different regions of the country but mostly from the central part of Thailand. There were 8 males and 12 females from 13 families of Thai, Thai-Chinese, Thai-Laos and Chinese-Chinese in origin. A history of consanguinity was present in 2 families. The age of onset was 2 months-4 years and the age when they were diagnosed was 4 months-15 years. The most common clinical features included splenomegaly, hepatomegaly, growth retardation, pallor, bleeding disorders and neurological abnormalities. The diagnosis was made by the clinical manifestations, hematologic complications and demonstration of Gaucher cells in the bone marrow and/or other tissues. In one family, the diagnosis was confirmed by evaluation of glucocerebrosidase activities in skin fibroblasts. The management of these patients was symptomatic ie packed red cell and platelet transfusion, splenectomy and other supportive measures. Most patients died of bleeding or infection at an early age.Item Glucose-6-phosphate dehydrogenase deficiency in the newborn: its prevalence and relation to neonatal jaundice.(1995-03-01) Tanphaichitr, V S; Pung-amritt, P; Yodthong, S; Soongswang, J; Mahasandana, C; Suvatte, VGlucose-6-phosphate dehydrogenase (G6PD) deficiency is prevalent in Thailand. This condition can cause acute hemolysis during oxidative stress and also severe hyperbilirubinemia in the newborn in some populations. Our aim was to study the prevalence of G6PD deficiency in relation to neonatal jaundice. We performed quantitative red blood cell (RBC) G6PD assay in the cord blood of 505 male subjects. Observation of jaundice and determination of bilirubin level as well as work up for other causes of jaundice were made in the G6PD deficiency group compared to a G6PD normal group. Questionnaires were also sent for further follow up to both groups. The results of the study were as follows: Sixty-one of 505 male (12.08%) had RBC G6PD deficiency (Group I). The rest (444 cases) had normal G6PD (Group II). In Group I, 49.15% developed neonatal jaundice, of which 28.82% were physiologic and 20.33% were pathologic jaundice. In group II, 23.68% developed jaundice; 16.51% were physiologic and 7.17% were pathologic jaundice, respectively. Onset of jaundice, date of peak bilirubin and peak bilirubin level in Group I and Group II were not statistically different. ABO incompatibility was associated with Group I in 17.24% and with Group II in 9.09%. Hospitalization day in Groups I and II were not statistically different. Other associated diseases were found in both groups, ie infection, congenital malformation, respiratory distress syndrome, but there was no significant difference in terms of jaundice. Phototherapy was required in 18.64% and 10.28% in Group I and II with a duration of 3.91 +/- 1.24 and 3.21 +/- 1.75 days, respectively. One case in Group I who was also premature received one exchange blood transfusion due to severe sepsis but he did not survive. One case in Group II who had polycythemia was successfully treated by partial exchange transfusion with plasma.