HLA class II allele frequencies in northern Thais (Kamphaeng Phet).

The polymorphism of HLA class II genes (HLA-DRB1, -DQA1, -DQB1 and -DPB1) was investigated in 97 normal Northern Thais (NT) from Kamphaeng Phet province using PCR-SSO typing. Allele frequencies (AF) have been determined. DRB1*1202 (17.5%), DRB1*1502 (16.5%), DQA1*0101 (25.8%), DQA1*0102 (21.7%), DQB1*0502 (22.7%), DPB1*0501 (23.2%) and DPB1*1301 (22.7%) showed the highest frequencies in each locus. These results were more similar to those observed in Present-day Thais (PDT) and Central Thais (CT) than Northern Thais from Chiang Mai (CM) and Dai Lue (DL). However, the data presented in this population study should be useful in many fields, such as anthropology, organ transplantation, disease susceptibility and evolutionary genetics.

HLA class I typing by one-dimensional isoelectric focusing and identification of the new variants in Thai population.

One-dimensional isoelectric focusing (1D-IEF) is the technique to define HLA class I antigens based on difference in isoelectric point of HLA molecules. Different IEF subtypes are shown in different populations. In this study, 1D-IEF was employed to study HLA-A and -B subtypes in Thai population. A panel of 117 samples including all serologically defined HLA-A and -B antigens in Thai population were typed by 1D-IEF. Serological specificities and subtypes correlated well with IEF results and some antigens with unclear serological specificities could be confirmed by IEF. In addition, more subtypes could be obtained by IEF than by serology. A total of 17 IEF subtypes from HLA-A and 31 IEF subtypes from HLA-B could be identified. The subtypes predominantly found in Thai population were A2.3, A24.2, A11.1, A33.2, B15.2, B7.1 and B13.1. In addition, new IEF variants were identified in HLA-B35, B5, B56 and B48. The band positions of these variants were different from those previously described. These IEF subtypes are HLA gene products which may be important in transplantation. The combination of IEF and serology for HLA typing can provide a better definition of each allelic product of HLA-A and -B.

Preoperative autologous blood collection and haemodilution with gelatin solution (gelifundol).

Autologous blood collection and haemodilution with gelatin solution had an effect on the decrease in red blood cells, haemoglobin, haemotocrit, fibrinogen and platelets; however, this technique had no effect on coagulograms, platelet function and haemostasis. In conclusion, this technique is suitable and possibly practical in obtaining sufficient blood for elective surgical patients and is without any undesirable side effects.

Factor VIII, factor IX and fibrinogen content in cryoprecipitate, fresh plasma and cryoprecipitate-removed plasma.

In order to provide accurate information for physicians, factor VIII, factor IX and fibrinogen content were determined in 40 bags of cryoprecipitate, fresh plasma and cryoprecipitate-removed plasma. A cryoprecipitate bag with a volume of 21.8 +/- 5.3 ml contained 139.5 +/- 42.9 units of factor VIII and 200.0 +/- 80.0 mg of fibrinogen. Fresh plasma with a volume of 208.0 +/- 22.5 ml contained 180.9 +/- 45.3 of factor IX, significantly higher than in cryoprecipitate-removed plasma. It was also found in this study that group O blood showed a significantly lower level of factor VIII.

Autologous blood and platelet-rich plasma reinfusion reduce post-operative blood and blood component therapy after cardiopulmonary bypass.

To study blood and blood component transfusion following reinfusion of platelet-rich plasma (PRP)/and autologous blood, 33 patients undergoing open-heart surgery were randomly divided into three groups. Group I comprised 13 patients as controls; group II, eight patients from whom were collected PRP 15-20 percent of plasma volume with Haemonetics; and group III, 12 patients from whom were collected PRP and whole blood (400-800 ml) before initiating standardized cardiopulmonary bypass. All of them had balanced anesthesia with thiopental, fentanyl, midazolam, atracurium and nitrous oxide in oxygen. After heparin reversal, PRP/PRP and autologous blood were reinfused in groups II and III, respectively. Recording of hematocrit, blood loss as well as the total number of transfusion was performed. In three groups, significant low levels of hematocrit were seen after cardiopulmonary bypass. Groups II and III has less blood loss after the operation as well as less banked blood and blood products transfusion (p<0.05). In conclusion, the reinfusion of PRP/PRP and autologous blood may serve as an effective method for reducing the amount of banked blood and blood products given in transfusion following cardiac operation.

HLA antigen and ventilatory drive in Thais with chronic obstructive pulmonary disease.

Studies of HLA antigens in 15 Thai patients with chronic obstructive pulmonary disease revealed a significant increase in HLA-Bw 60 frequency in the group with low ventilatory drive to carbondioxide using unstimulated airway pressure. The finding suggests an immunogenetic role of HLA-Bw 60 on the control of ventilation in COPD.

Massive chemotherapy and autologous bone marrow transplantation in Burkitt's lymphoma: the first two patients successfully treated in Thailand.

Massive chemotherapy and autologous bone marrow transplantation (ABMT) have been successfully used for the treatment of Burkitt's lymphoma. We report our first success with such treatment in two children with Burkitt's lymphoma in Thailand. Both patients had massive abdominal tumors with ascites and minimal bone marrow metastasis at the first presentation. They received induction chemotherapy and intensive treatment including central nervous system prophylaxis with cranial irradiation and intrathecal methotrexate until being in complete remission before starting massive chemotherapy, comprising the combination of BCNU, cytosine arabinoside, cyclophosphamide and 6-thioguanine followed by ABMT. Both patients recovered completely following intensive supportive treatments post ABMT and are still good health without evidence of the disease for 18 and 8 months after transplantation respectively. The role of massive chemotherapy and ABMT for the treatment of non-Hodgkin's lymphoma especially Burkitt's lymphoma was discussed.

HLA antigen profiles in Thai tuberculosis patients.

HLA antigens were studied in 35 Thai patients suffering from active pulmonary tuberculosis. An increase in the frequency of HLA-Bw46 and -DR4 and a decrease in the frequency of HLA-B12 were found when compared with the matched controls. These findings suggest that the pathogenetic role of HLA-B12 is to confer resistance and that HLA-Bw46 and -DR4 are associated with susceptibility. In addition it provided further information on HLA antigen profiles in pulmonary tuberculosis patients in another ethnic group (viz. Thais). Conclusions regarding genetic control over therapeutic efficacy must await further study.

Prevalence of cytomegalovirus antibodies in Thai blood donors.

Antibodies to cytomegalovirus (CMV) were determined in Thai blood donors using the complement fixation (CF) test and enzyme-linked immunosorbent assay (ELISA). A total of 203 voluntary blood donors, 181 males and 22 females, who came to the Blood Bank at Siriraj Hospital during February 1985, were investigated. Their ages ranged from 17 to 53 years (mean 24.3 +/- 6.9). Seventy-three out of 156 (46.8%) and 171 out of 203 (84.2%) sera were positive for CMV antibodies as detected by the CF test and ELISA respectively. The result of ELISA showed that 95.5 per cent of the female blood donors and 82.9 per cent of the males possessed CMV antibodies. No difference in the geometric mean titres of either sex was noted. The findings indicated that ELISA was more sensitive than the CF test for detecting CMV antibodies. The high percentage of CMV-seropositive blood donors indicates that CMV infection is common in this country. Therefore, it might be necessary to test blood donors for CMV antibodies when they are giving blood for use by certain patients, especially immunocompromised ones; the same observation applies with regard to organ donors before transplantation is carried out.

Further study of Rh, Kell, Duffy, P, MN, Lewis and Gerbiech blood groups of the Thais.

Blood and saliva from unselected blood donors at the Blood Bank, Siriraj Hospital were studied. Two Kell positive, two Rh negative and one Gerbiech negative were found, which could be considered as rare blood type in Thailand. The commonest Rh gene complex was CDe (R11 and the presence of CDE (Rz) in this study are the usual pattern of people in Southeast Asia. Fya is very common as in other people of Asia. In the Lewis system, the incidence of Le (a + b -) was 28.48% which agree well with our previous report 30.9%. There were 410 out of 1,668, (23.17%) who were found to be Lea non-secretor and 95 of them have Lewis antibodies in their sera. Aberrant secretion patterns were also found in this study, 5 people were found to secrete A or B substances according to their blood groups but no H substance was detectable. Further investigation of Lewis groups and secretion in Thailand are needed.

The HLA antibodies in Thai pregnant women at Siriraj Hospital.

The HLA antibodies in Thai pregnant women was determined. From 4,000 sera, only 577 cases (14.4%) showed positivity, and only 21% were monospecific antisera.

Unexpected red cell antibodies in donors and patients at Siriraj Hospital.

The incidence of unexpected red cell antibodies in patients and donors at Siriraj Hospital were found to be 4.91% and 4.33% respectively. Anti Lewis, anti P1 and anti Mia were the most common antibodies detected. Antibodies of Rh system were the next, in which anti E was more common than anti D. Anti Jka, Jkb, Fyb, Dia, S and rare antibodies such as anti K, Ge1, Mta and H were also detected in this study.