Prevalence of climacteric symptoms according to years after menopause.

OBJECTIVE: To study the prevalence of menopausal symptoms of women attending the menopause and gynecology clinics at Chulalongkorn Hospital. STUDY DESIGN: A descriptive study was conducted at the menopause and gynecology clinics at Chulalongkorn Hospital. After inclusion and exclusion were done, four hundred and twenty seven participants with premenopause, perimenopause and postmenopause were studied. All the women were classified into seven groups of premenopause, perimenopause and one, two, three, four and > or =five years after menopause. The interview was performed by well-trained social workers using standardized questionnaires. RESULTS: The average age at menopause of the postmenopausal women was 49.46 + 3.30 years. Prevalence of vasomotor symptoms eg. hot flushes in premenopause, perimenopause and one, two, three, four and > or =five years after menopause were 4.4 per cent, 25 per cent, 27.3 per cent, 38.8 per cent, 40 per cent, 11.1 per cent and 10.3 per cent, respectively. Prevalence of psychological symptoms eg. moodiness were 26.5 per cent, 25 per cent, 54.6 per cent, 38.7 per cent, 32.2 per cent, 11.2 per cent and 11.8 per cent, respectively. But the prevalence of headache in this category was 29.4 per cent, 23.3 per cent, 23.7 per cent, 22.6 per cent, 25.0 per cent, 11.1 per cent and 13.2 per cent, respectively. Prevalence of urinary symptoms seemed to increase continuously after menopause. Prevalence of genital symptoms eg. vaginal dryness were 5.9 per cent, 13.3 per cent, 25.5 per cent, 25.8 per cent, 15.0 per cent, 16.7 per cent and 20.6 per cent, respectively. Prevalence of other symptoms eg. muscle and joint pain were 22.1 per cent, 43.3 per cent, 56.4 per cent, 58.0 per cent, 45.0 per cent, 27.8 per cent and 28.0 per cent, respectively. CONCLUSION: The prevalence of menopausal symptoms in this postmenopausal group appeared to increase during the first and second years after menopause and tended to decrease afterwards. The prevalence of other symptoms eg. dry eyes and headache appeared to be unchanged after menopause.

Rosetting of Plasmodium falciparum required multiple components of the uninfected erythrocytes.

The mechanism of rosette formation of uninfected erythrocytes with Plasmodium falciparum-infected erythrocytes is rarely described. In this study, rosetting of uninfected normal erythrocytes with infected erythrocytes significantly reduced after treatment of the uninfected erythrocytes with neuraminidase. In contrast, the rosetting property of the infected erythrocytes was abolished by trypsinization but not by neuraminidase. The in vitro rosetting model showed that uninfected thalassemic erythrocytes poorly formed rosettes with infected normal erythrocytes when compared with normal erythrocytes of the same blood group. A rosetting parasite clone showed significant reduction in rosetting with thalassemic erythrocytes of all blood groups, however, this reduction was not obvious when the wild P. falciparum isolates were studied. These results suggest that while parasites from a single clone can rosette with uninfected erythrocytes via carbohydrate component, there is more than one type of receptor on uninfected erythrocytes involved in rosette formation with the heterogeneous populations of the wild P. falciparum isolates.

Population genetic data on loci LDLR, GYPA, HBGG, D7S8 and GC in the Bangkok population compared with rural Thais from Trat province.

Prior to the introduction of any DNA marker as a tool for person identification and paternity test in certain ethnic groups, a population genetic database should be constructed. Using multiplex primers in single tube polymerase chain amplification, 5 loci of unrelated genes in the PM Amplitype kit (Perkin Elmer) were studied in two Thai population groups: 228 DNA samples were extracted from blood collected at the Borai rural area in Trat province; another 123 DNA samples were collected at the outpatient clinic, Department of Forensic Medicine, King Chulalongkorn Memorial Hospital, Bangkok. Analysis of alleles and genotypes was performed after reversed dot blot hybridization of PCR products to allelic sequence specific probes immobilized on the membrane strip followed by nonradioisotopic detection according to the manufacturer's protocol. Population genetic statistic parameters including discrimination power (DP), the probability of matching (PM), power of exclusion for trio (PE trio) and typical paternity index (PI typical) were computed. Both Thai population groups showed no significant deviation from the Hardy Weinberg Expectation (HWE). The combined DP of all 5 loci in the PM Amplitype markers was 0.993636 for rural Thais and 0.994409 for Thais from Bangkok. The combined PM for rural Thais and those living in Bangkok was 0.006364 and 0.005591, respectively. The combined PE trio was 0.696825 and 0.698875 in both Thai population groups and the combined PI typical values were < 1.0. In conclusion, person identification using PM Amplitype DNA markers was efficient and satisfactory within certain limits. Hence, the application of PM Amplitype DNA markers for paternity tests should be cautiously considered and applied in combination with other parameters.

The variation of Pf155/RESA gene in field isolates of Plasmodium falciparum from Thailand.

Pf155/RESA, an antigen found on the surface of Plasmodium falciparum red blood cell membrane was once a proposed malarial vaccine candidate. The complete sequence of Pf155/RESA gene from one strain and partial sequence from two other isolates revealed that the gene is well conserved. But polymorphism of other antigenic encoded regions occurs with high frequency among isolates especially those collected from the field. Using solid phase sequencing technique, the nested PCR products of upstream 3' repeated region of exon 2 RESA gene were studied in 150 P. falciparum isolates. Of which 117 isolates were directly collected from the field and sequenced. Other samples studied include clones and cryopreserved of previously cultured isolates. The resulting sequences are compared with previously existing data of F32 (Tanzania) and FC27 (Papua New Guinea) designated as allelic type I and II respectively. Sequence analysis of the 150 P. falciparum showed that the amplified region of RESA gene was highly variable with substitution ranging from one to six bases and these allelic variables can be divided into 10 types. The frequency of type I(F32) occurrence is 70.86 percent, type III 13.38 per cent and 0.78 percent to 5.51 per cent for others. As a result of allelic polymorphism, the amino acid sequence is highly variable and this may cause Pf155/RESA to be an inefficient antigen.

Multiplex PCR to detect the dystrophin gene deletion in Thai patients.

We have demonstrated the usefulness of the multiplex PCR to directly detect the dystrophin gene mutation. Prenatal diagnosis and confirmation of clinical diagnosis of DMD/BMD via non invasive technique are now possible. Nine DMD and one BMD patients were tested. Five DMD patients demonstrated deletion. Thus, this multiplex PCR could detect deletion in approximately 50 per cent of DMD/BMD Thai patients. Eighty per cent of the deletions were in the distal part, whereas, 20 per cent were in the proximal part. We are planning to establish other molecular techniques such as linkage analysis, cDNA hybridization and immunostaining of dystrophin protein to improve a mode of diagnosis and management of DMD/BMD patients in the Thai community.