Low serum vitamin B12 in alzheimer’s patients as detected by a solid phase radioimmunoassay.

Objective: To determine the relationship between serum levels of vitamin B12 and folate in AD and other types of dementia in Thai patients. Methods: One hundred and eleven Thai subjects were classified into 3 groups: 32 AD patients, 43 non-AD dementia patients and 36 age-matched controls. Serum concentrations of vitamin B12 and folate were measured using a solid phase radioimmunoassay. Results: Serum vitamin B12 levels were found to be significantly lower in AD and non-AD dementia patients than in age-matched controls. There is a significant relationship between Mini-Mental State Examination score and vitamin B12 level in AD and non-AD dementia groups. However, there is no significant difference in serum folate in AD and non-AD dementia groups when compared to age-matched controls. Conclusion: These findings suggest the need for vitamin B12 supplementation in AD and non-AD dementia patients.

Distribution of C14-labelled arteether in kidneys and livers of experimental mice after intramuscular injection.

To study the distribution and localization of oil-soluble arteether in experimental mice, we injected C14-labelled arteether (20 microCi/kg body weight) intramuscularly and measured radioactivity in the blood, kidney, and liver. The labelled arteether distributed and localized more to the kidney (819,180.4 +/- 34,134 dpm/cm3) than the liver (288,628.9 +/- 54,954 dpm/cm3) 4 hours post-injection. The main localization of labelled arteether was in the kidney cortex rather than the medulla (p < 0.05). However, the distribution of radioactivity was homogeneous in the liver. The terminal half-life of labelled arteether in the blood was 1.8 hours. The blood:kidney:liver ratio was 1:5:2. These findings show that labelled arteether was distributed quickly and localized in the cytoplasmic cortex of the kidney and homogeneously in the liver.

Food behavior and folate status of hill-tribe schoolchildren and women of childbearing age on the northern border of Thailand.

An insight into the folate nutritional status of the population is important from a public health perspective. The protective effect of folate against neural tube defects (NTDs) is widely recognized. To assess the health and nutritional status, especially folate status, of vulnerable hill-tribe groups, a cross-sectional study was conducted on 197 schoolchildren and 136 women of childbearing age in Chaloem Phra Kiat District, Nan Province, Thailand. The nutritional status of the study group was investigated by dietary survey, and blood samples were taken to determine hematocrit, protein, and serum and red blood cell folate. Anthropometric measurements were taken to assess body size, composition and nutritional indexes. The health and nutritional status of the hill-tribe schoolchildren and women of childbearing age were found to be unacceptable, particularly inregard to folate status, which was indicated by low folate levels found in the blood samples, and in the intake of this micronutrient.

Study on serum transcobalamin II in patients with murine typhus.

We measured the serum transcobalamin II in murine typhus- infected patients (n = 16) admitted to the Hospital for Tropical Diseases in 1996-1997, compared with healthy controls (n = 60). The results showed that the transcobalamin II (TCII) and total serum unsaturated vitaminB12 binding capacity (UBBC) in patients with murine typhus (2,126.5 pg/ml, range 1,262-4,568 and 3,771.5 pg/ml, range 1,576-6,763 pg/ml) were statistically significantly higher than normal subjects (987.5 pg/ml, range 678-2,000 pg/ml and 1,402 pg/ml, range 932-2,470 ml) (p<0.001). Serum TCII levels in patients (63%) were elevated during the febrile period and returned to normal post-treatment. These findings suggest that patients with murine typhus had stimulation of reticulo-endothelial system, spleen, mesenteric lymph nodes, liver and skin and then released TCII into the blood circulation. The elevation in TCII may be used for confirming a diagnosis of murine typhus.

Vitamin B12 status of Thai women with neoplasia of the cervix uteri.

The vitamin B12 statuses of Thai women with high- and low-grade cervical dysplasia were studied and compared with women with normal cytological smears. Serum vitamin B12 and vitamin B12 intakes were assessed, as well as demographic characteristics, sexual behavior, reproductive and menstrual history, exogenous hormone use, personal and familial medical history, smoking habit, and other risk factors. The presence or absence of genital HPV DNA was determined by polymerase chain reaction (PCR). Serum vitamin B12 levels in women with normal cytological smears were significantly higher than those with both high- and low-grade cervical dysplasia (p<0.001). Low vitamin B12 serum levels were significantly statistically associated with increased low-grade (OR = 4.08; 95% CI = 1.41-11.79; p < 0.05) and increased high-grade cervical dysplasia risk (OR = 3.53; 95% CI = 1.24-10.04; p< 0.05) for the highest vs lowest quartiles of serum vitamin B12. This study indicated a relationship between low vitamin B12 status and increased risk of cervical cancer.

Elevation of serum transcobalamin II in patients with scrub typhus.

Serum 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.

The hematological status, plasma vitamin B12 and folic acid levels, and intestinal pathology in rats infected with Giardia lamblia.

The 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.

Serum transcobalamin II level in a malarial patient with ceftriaxone-induced haemolyic anaemia.

Cephalosporins have rarely been reported as the cause of immune haemolytic anaemia (IHA). The case history of a patient who had elevated serum transcobalamin II (TCII) levels due to a ceftriaxone-induced haemloytic anaemia is presented in this study. The patient was admitted because of high fever due to P.falciparum. The fever subsided after treatment with anti-malarial drugs. However, two days later, the fever recurred and ceftriazone was given. On the next day, the patient had haemolysis with haemoglobinuria and renal insufficiency which resolved after withdrawal of the drug. Serum TCII levels were elevated during the haemolytic episode and the period of renal impairment. The mechanisms of increased serum TCII are probably due to the acute haemolysis and nephrotoxicityinduced by ceftriaxone, leading to the impaired catabolism and clearance of TCII. Therefore, intravascular THII survival is prolonged. Resulting in elevated serum TCIIlevels.

Serum folate and vitamin B12 levels in chronic alcoholics.

Anemia is common in alcoholics. Folate deficiency occurs commonly in association with the chronic use of alcohol. The incidence of folate deficiency in chronic alcoholic patients varies considerably from country to country. The purpose of the present study was to report the incidence of folate and vitamin B12 deficiencies in Thai chronic alcoholics. Serum folate and vitamin B12 levels were determined in 75 chronic alcoholics as well as in 80 apparently healthy Thai subjects. The mean Hb, Hct and serum folate levels were significantly lower in the alcoholics. Thirty-five percent and 84 percent had serum folate levels lower than 3 ng/ml and 6 ng/ml, respectively. On the other hand, the mean value of serum vitamin B12 in the alcoholic patients was significantly elevated, with 49 percent of them having serum vitamin B12 over 1,000 pg/ml. These findings indicated that the incidence of folic acid deficiency in the chronic alcoholics was quite high, which was probably due to dietary deficiency, folate malabsorption and interference by alcohol in folate metabolism. All these patients had a tendency to have a high serum vitamin B12 level, probably as a result of the increased release of vitamin B12 from storage in the injured liver.

Folates and vitamin B12 status in patients with multiple myeloma.

Serum 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.

Malabsorption syndrome and tropical sprue in a patient with capillaria infection.

A 52-year-old male complained of a four-year history of diarrhea. He had severe diarrhea and lost 10 kg of weight during the previous eight months. Physical examination revealed moderate wasting with mild eodema on both legs. His serum cholesterol, calcium, total protein, albumin, glodium and potassium levels were depressed. Both serum folate and vitamin B12 levels were within the normal limits. A G-I follow through study revealed irregularity of distal jejunum and mid-ileum. Intestinal biopsy showed shortening and widening of ileal villi, and that the submucosa was infiltrated with lymphocytes, eosinophils and plasma cells. Because of these findings coupled with the fact that no ova and parasites were detected in the stool, this patient was diagnosed as a case of tropical sprue. Tetracycline, flagyl and folic acid were given, but there was no clinical improvement. A segmental biopsy of the ileum showed C. philippinensis larvae in the crypts and surface mucosa. Mebendazole was given and the patient improved. Intestinal capillariasis is different from tropical sprue in that its pathology is usually in the jejunum while tropical sprue is in both the jejunum and ileum. Therefore, the serum vitamin B12 level is usually normal in the former while both serum folate and vitamin B12 levels are low in the latter.

Vitamin B12 deficiency in a patient with total gastrectomy.

A 31-year-old female was admitted to the hospital with a history of weight loss, weakness and exertional dyspnoea lasting for three months. Four years prior to admission, she had consumed half a glass of cleaning solution and had been admitted to hospital for a total gastrectomy. Physical examination showed markedly pale, cachexia and generalized muscle wasting. Oedema of both legs and hepatomegaly about 2 FB were noted. No abnormal neurologica,l findings were detected. Her blood picture and bone marrow showed megaloblastic changes. Serum vitamin B12 was low but serum and red-cell folate levels were within normal limits. Vitamin B12 (1 mg) was given intramuscularly and it produced a remarkable improvement in the clinical and haematological findings. The patient was discharged nine days after admission and attended the out-patient clinic where she received 1 mg of vitamin B12 intramuscularly once a month. The patient is now healthy with normal haematological findings, but she still receives vitamin B12 therapy monthly.

Serum zinc and copper levels in vegetarians.

Zine (Zn) and copper (Cu) are important trace elements that play a vital role in biochemical and physiological function in humans. However, vegetarians comprise a population at risk for Zn deficiency because of a marginal Zn intake and the low availability of Zn in vegetarian diets. The objective of the present study was to determine serum Zn, Cu and vitamin B12 levels in 35 vegetarians, and to correlate all these parameters. Results showed that serum Zn, Cu and Zn/Cu ratio in 120 control subjects were in the same order of magnitude as those in results reported previously. By contrast, the serum Zn levels in the 35 vegetarians was found to be significantly lower than that of the control subjects (p<0.01) The serum Cu level and Zn/Cu ratio in these vegetarians were within normal limits. No correlations between serum Zn and Cu, or between serum vitamin B12 level and serum Zn and Cu were demonstrated. The low serum Zn concentration in vegetarians was probably due to low dietary Zn intake and the depressed absorption of Zn from the vegetarians, diet which was high in phytate and/or fiber. Although serum vitamin B12 concentration was also decreased, there was no relationship between this vitamin and serum Zn level. Therefore, there was no connection between serum vitamin B12 and serum Zn or Cu in these vegetarians.

Amniotic fluid folate level in normal pregnancy.

Folic 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.

Vitamin B12 content in algae.

Algae are claimed to be a potentially important source of food for both man and animal because they contain amino acid, carbohydrate, minerals and vitamins. As algae are the only only plants that contain vitamin B12, they may, therefore, be the ideal food to provide this vitamin to vegetarians. The objective of the present study was to determine vitamin B12 in various marine and fresh water algae. A mean value of vitamin B12 of 56+35 µg/100g, ranging from 2.8 to 119.8 µg/100g, was found in 15 samples of marine algae bought from different markets. The fresh water algae contained a relative vitamin B12, i.e., 7.3 µg/100g, ranging from 0.02 to 31.5 µg/100g in 11 samples. A considerable amount of vitamin B12 were maintained after cooking for 5, 10 and 15 minutes, respectively. As marine algae contain a relatively high vitamin B12 content, it may serve as a good source of this vitamin for vegetarians. However, there may be some objections due to their high price, smell and taste.

Assessment of optical density on amniotic fluid in predicting fetal lung maturity.

The 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.

Serum and red cell folates in patients with leukaemia and lymphomas.

It has been suggested that leukaemia and lymphomas may cause folic acid depletion. The supporting evidence were obtained from urinary excretion of folic acid, rate of clearance of injected folic acid from the plasma and serum folic acid assays. However, no data red cell folate levels has been reported, the present study was there fore undertaken. Serum and red cell folate levels were determined in 144 patients with acute lymphocytic leukaemia, acute myeloblastic leukaemia, chronic myelocytic leukaemia, Hodgkin’s disease and non-Hodgkin’s lymphoma. The mean serum and red cell folate values in these patients were significantly lower than those of normal subjects. About 21.5% and 28.5% of these patients had serum folate levels lower than 3 ng/ml and red cell folate levels lower than 100 ng/ml, respectively. The elevated MCV and MCH values were also found in 42% and 30% of the patient’s groups. These findings indicated that some patients with leukaemia and lymphomas had macrocytiosis which was highly due to folic acid deficiency. The deficiency may be caused by various factors such as increased requirement due to an elevated production of leukaemic cells with higher folic acid content than normal leucocytes, poor dietary folic acid intake due to loss of appetite and intestinal malabsorption of lolic acid.

Cholinesterase and acetylcholineslinesterase activities in mice infected with plasmodium berghei.

Cholinesterase (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.