p53 gene mutations in non-small cell lung cancer from Thai patients.

Paraffin embedded tissues from twenty-two Thai patients with non-small cell lung cancer were studied for p53 gene mutations in exon 5 to 8 using polymerase chain reaction and single-stranded conformation polymorphism (PCR-SSCP) followed by thermal cycle sequencing. Results showed that point mutations in this region of p53 gene were present in 3 cases. One harboured the base change from GAC to AAC at codon 281, changing amino acid from aspartic acid to asparagine, whilst the other cases were transversion of AAA (lysine) to ACA (threonine) at codon 292. All subjects with p53 mutation had a past history of tobacco smoking.

K-ras oncogene and p53 gene mutations in cholangiocarcinoma from Thai patients.

Paraffin embedded tissues from twenty Thai patients with intrahepatic cholangiocarcinomas were studied for K-ras gene mutations at codon 12, 13 and 61 and for p53 gene mutations in exon 5 to 8 using polymerase chain reaction and thermal cycle sequencing. Results showed that point mutations at these regions in K-ras oncogene were not present in all the samples. One case harbored a p53 gene mutation in codon 282 in exon 8, CGG (arginine) to TGG (tryptophan), but the mutation was not found in other patient's tissues with similar histological features.

Flow rate and composition of whole saliva in children from rural and urban Thailand with different caries prevalence and dietary intake.

The aim of this study was to compare the prevalence of dental caries, dietary composition and whole salivary flow rates together with some of the components of saliva between two groups of children aged 12-16 years, one group from an urban area and the other from a rural area of Thailand. A stratified random samples were taken by class from one schools in each area. The children who had mixed dentition and/or who had migrated from other area of Bangkok and 138 students were selected from a school in a rural area of Khon Kaen in northeast Thailand. Results of completed 24-hour dietary recalls for three consecutive days examining the average nutrient intake were compared looking for differences, if any, between these two groups of children. Dental examinations and whole salivary sampling were also undertaken and possible relationships between some nutrients and certain salivary factors were explored. The prevalence of dental caries was found to be higher in the students living in the urban area. The children in the rural area consumed a higher load of carbohydrate, which came mainly from sticky rice. There was no difference in the protein consumption between the two groups, although the children in the rural area consumed more protein from vegetable sources. The salivary flow rate and the concentrations of fluoride, calcium and phosphate were significantly higher (p < 0.05) in the group from the rural area, while the salivary pH, buffer capacity, concentrations of total protein and urea were higher in the urban area. There was no correlation between nutrient intake and salivary composition in the children from these two areas, which may suggest that dietary nutrients may not have a direct effect on salivary compositions but it was noted that salivary flow rate correlated with salivary urea, albumin and buffer capacity in both areas.

alpha 1-antitrypsin phenotype PiMZ, a risk factor for liver cirrhosis but not for liver cancers in Thailand.

The risk of developing liver cirrhosis, hepatoma (HCC) and bile duct carcinoma (BDC) have been associated with homozygous alpha 1-antitrypsin (AT) deficiency especially linked to the Z allele. While the association between liver cancers and AT deficiency remains debatable, the risk of adult AT deficiency carriers to develop liver cirrhosis has not been assessed quantitatively. Liver cancers and liver diseases with subsequent liver cirrhosis are highly prevalent in tropical countries such as Thailand and heterozygous AT phenotypes are rather common in this country as well. The aim of this study was to assess the risk of developing liver cirrhosis, HCC and BDC by means of case-control studies with Thai patients and controls in connection with AT deficiency. For hepatitis, HCC and BDC to association with AT deficiency was detected. Carriers of PiMZ phenotype in Thailand have a high risk to develop liver cirrhosis (odds. ratio of 10.8, 95% confidence interval = 1.3-88.1). Patients with predisposing diseases should be screened for Pi phenotypes so that rigorous measures to combat the occurrence of liver cirrhosis can be implemented.

Vitamin B12, folic acid, ferritin and haematological variables among Thai construction site workers in urban Bangkok.

Serum vitamin B12, folic acid, ferritin and haematological variables were investigated in eighty-seven male and nineteen female construction site workers in Bangkok. Haemoglobin concentration, haematocrit and MCHC were found to be higher in male than in female workers. Serum ferritin was slightly higher in males than in females. Serum B12 was found to be higher in male than in female workers and serum folic acid level were significantly higher in female than in male workers. Vitamin B12 deficiency was found in 2.3 per cent and folic acid deficiency in 6.9 per cent of the male workers. Serum vitamin B12 and folic acid levels were normal for female workers. The adequate serum levels of vitamin B12 and folic acid might be the result of the habit of the workers to consume tonic drinks which contain glucose, caffeine, and vitamins especially vitamins B6, and B12.

Socio-demographic characteristics and health status of urban Thai elderly.

Socio-demographic and health status of 205 elderly aged 60-90 years who attended a special clinic for the elderly at Rajvithi Hospital were investigated. All of the subjects had no major complaints and seemed to be apparently healthy. Socio-economic situation, life-style pattern and other health related information was assessed. Nearly all of the elderly lived with their relatives. Quite a high number of the females had never attended school. Almost 60% of the elderly had no regular income. The health situation of the individuals under investigation seemed to be satisfactory. The majority did not smoke and did not drink alcohol. There are indications that in the future more of the elderly population will stay alone and will face economical problems because of the absence of general social security scheme for Thailand.

Parasitic infection and socio-demographic characteristics of urban construction site workers.

The socio-demographic characteristics and prevalence of parasitic infection of 117 (96 males and 21 females) construction site workers were investigated by means of questionnaires and stool examinations. The age characteristics of the individuals investigated varied widely from 15-60 years with a high percentage in the 21-30 years age range, no sex differences were discovered. Most of the workers received primary education even though some of them did not complete it. The percentage of illiteracy in females was quite high (9.5%) compared with males (2.1%). About 60% and 20% of these construction site workers migrated from the northeastern and northern regions of Thailand, respectively. 79.3% of male and 94.7% of female workers were found to be infected with parasites. Hookworm and Opisthorchis were predominant parasites.

Urine iodine concentration and prevalence of goiter among rural women of child bearing ages in Northeast Thailand.

Iodine deficiency was investigated in 575 women from 12 villages of Pupaman, Si Chomphu and Amphoe Chum Phae in Khon Kaen province in a project survey under Thai-German cooperation entitled "Promotion of Health and Nutrition Status of Rural Women in Northeast Thailand". The prevalence of goiter (grades 1A, 1B, 2 and 3) were 71.6 per cent in Pupaman, 58.4 per cent in Amphoe Si Chomphu and 35.1 per cent in Amphoe Chum Phae. However, the percentage of urine iodine deficiency of the women from these districts, is reversely with the palpation grading of thyroid gland. The high prevalence of goiter in Pupaman might occur due to goitrogenic effects, although the urine iodine concentration was lower than other districts. Further study about the determination of thiocyanate should be suggested in the high prevalence of goiter.

Nutritional health and parasitic infection of rural Thai women of the child bearing age.

The nutritional and health status of non-pregnant women of child bearing age from 20 villages of two districts in Maha Sarakham Province, approximately 500 km northeast of Bangkok, were investigated in April 1987. About 12 per cent of the studied women had a body mass index below 18.7 which is used as a cut-off point of being undernourished. Fat stores and muscle mass were smaller when compared to western females. Only two per cent of the women investigated had low serum albumin, indicating a severe deprivation in the nutritional status. A relatively high prevalence of anaemia was also found. Iron deficiency and haemoglobinopathy are common causes of anaemia. In addition, vitamin B2 depletion also contributes to the high rate of anaemia. Gastrointestinal parasitic infection rates were high with liver fluke, hookworm and echinostomiasis. Hookworm infection had no effect on the rate of anaemic, most probably the worm load in the women infected was rather low. It is recommended that the nutritional health of rural adolescents and young women should be enhanced by generally improving dietary habits and the quality of nutrient intake especially through protein, vitamins and micronutrient. Public health programmes focused on preventive activities should be aimed at this group in order to reduce the prevalent rate of undernutrition, anaemia and parasitic infection.

Vitamin B12, folic acid and haematological status in elderly Thais.

Serum vitamin B12, folic acid and haematological data from 147 elderly people (55 males and 92 females) who visited the special clinic for the elderly at Rajvithi Hospital, Bangkok between July and November 1989 were investigated. The individuals studied came from a health-conscious group of the middle socio-economic class in Bangkok. All of them were fairly well except for minor ailments and typical diseases of elderly people such as hypertension, mild to moderate degree coronary heart diseases and non-insulin dependent diabetes mellitus. There was a statistically significant difference in haemoglobin concentrations between males and females. According to the standard haemoglobin cut-off point values of 13 g/dl for males and 12 g/dl for females, anaemia was detected in 22 (15%) of the 147 subjects. The percentage of folic acid deficiency was found to be 20.6 per cent (30 of the 147 cases). Vitamin B12 insufficiency was found in only 6.9 per cent (10 of the 147 cases). No statistically significant correlation between haemoglobin, folic acid and vitamin B12 was found. However, when the data were grouped according to different intervals of increasing haemoglobin concentrations, for females there was a tendency for serum vitamin B12 to decrease, and serum folic acid to increase in both males and females. The results of this study suggest that folate deficiency may play a role in the occurrence of anaemia in elderly people, and therefore, dietary counselling and supplementation of folic acid are recommended.

Vitamin B12, folic acid and haematological status of 132 Thai vegetarians.

Serum vitamin B12, folic acid and haematological variables of 132 Thai vegetarians (64 males and 68 females) were investigated. Forty-seven healthy omnivorous individuals served as controls. No statistical differences in haemoglobin concentration, packed red cell volume and mean corpuscular haemoglobin concentration between the vegetarians and controls had been detected. In the female vegetarians, the haemoglobin concentration and packed red cell volume were, however, statistically lower. No significant differences in the white cell counts and platelet counts were observed in both groups. A significant increase of basophilic stippling and reticulocytes was observed in the vegetarians. Serum vitamin B12 decreased and serum folic acid levels increased according to the duration of vegetarianism in the vegetarians. In the females practicing vegetarianism for 6-10 years or more, the proportion of serum vitamin B12 deficiencies was particularly high. The high percentage of vitamin B12 deficiency in the vegetarians might be related to megaloblastic anaemia. This form of anaemia is commonly associated with the presence of basophilic stippling. Therefore, the increased presence of basophilic stippling and reticulocytes might indicate a mild stage of this type of anaemia among the vegetarians.

Lipid profile, anthropometry and dietary intake of 132 Thai vegetarians.

The anthropometric measurements, lipid pattern and dietary intake of 64 male and 68 female Thai vegetarians (mostly lacto-vegetarians) were investigated. 32 males and 36 females on an ordinary Thai diet served as controls. Nutritional anthropometric variables and serum lipid concentrations, which the exception of triglycerides, were found to be lower in the vegetarian group than in the control group. The vegetarians consumed more energy than the controls. No difference in the protein intake was observed in both groups. Fat intake was, however, lower and carbohydrate intake higher in the vegetarian group. Also in the vegetarian group, HDL-cholesterol fraction correlated negatively with anthropometric measurements. Other fractions show only a weak correlation, if at all, in this group. A good correlation to all serum lipid variables determined to anthropometric measurement was observed in the control group.

Nutrition and the environmental situation in Bangkok.

Bangkok, the capital of Thailand, is a large city of about six million people. According to the rapid growth of economy, Bangkok faces to the problems of urbanization and industrialization. Non-communicable disease such as cardiovascular diseases, cancers are the leading causes of death. There is a trend of increasing air pollution in the congested areas and industrialized zones, with the increase over the ambient air quality standard involving suspended particulate matter. Other public health problems include the sanitation of restaurants, the quality of drinking water and coloring agents in food, drug addiction especially in young males. Poor hygiene in drug injection is one of the major causes of HIV transmission. AIDS, originally our imported disease, needs urgent prevention by health education and counseling. Improvements in government and non-government health care resources are still needed. A good cooperative city health plan serves a practical purpose, especially for the solution of the air and water pollution in Bangkok. However, pilot operational research on nutrition, health and environment in relation to city health planning needs to be discussed further for more effective implementation.

Vitamin B1, B2 and B6 status of vegetarians.

The vitamin B1, B2 and B6 status was determined in 132 healthy vegetarians, age range 25-57 years who have been practising vegetarianism for 1-22 years. Sixty-eight healthy non-vegetarians were chosen as controls. The conventional methods to measure the activation coefficient alpha ETK, alpha EGR and alpha EAST were applied to assess the vitamin status of B1, B2 and B6 respectively. The value of 1.25 alpha ETK, 1.5 alpha EGR and 2.0 alpha EAST and above indicate a deficiency in the vitamin status. The results showed significantly poorer vitamin B1 and B6 status in vegetarians than in non-vegetarians, whereas, no significant difference in vitamin B2 status was found. None of the non-vegetarians were deficient in vitamin B1 but 3 of them (4.4%) were deficient in vitamin B6. On the other hand, 10 of vegetarians (7.6%) were deficient in vitamin B1; 38 (28.8%) in vitamin B6. A high prevalence of riboflavin deficiency was found in 32 (24.2%) of the vegetarians; as well as in 15 (22.2%) of the non-vegetarians. Only riboflavin status was significantly related with the duration of vegetarianism practiced. Vegetarians should be considered as the vulnerable group for vitamin B2 and vitamin B6 deficiencies. B-vitamins status should be checked and efforts should be made to improve through dietary counselling and nutritional education should be included and stress in the health education program in order to improve nutritional deficiencies.

B vitamins status: effect of prolonged heroin addiction and methadone treatment.

Vitamin B1, B2 and B6 status were determined in 90 male heroin addicts admitted to Pramongkutklao Army Hospital. Their age (Mean +/- S.D.) was 25.5 +/- 7.8 years. Their activation coefficients of the enzyme transketolase, glutathione oxidoreductase and aspartate aminotransferase (ETK AC, EGR AC and EAST AC respectively) were significantly increased for addicts who were on drugs for a long time which indicated a biochemical deficiency. In addition, 26 follow-up cases treated with methadone for a period of one and two weeks were compared before and after treatment and it was found that ETK AC, EGR AC, and EAST AC were significantly decreased. This means that improvement in the vitamin B1, B2 and B6 status was obtained during admission.

Anthropometry, lipid- and vitamin status of 215 health-conscious Thai elderly.

A survey was carried out on 59 males and 146 females aged 60 years and above from a special clinic for the elderly in Bangkok. All of these subjects had no major complaints of ill health and, judging by their appearance, they seemed to be apparently healthy. 6.8% of the males and 11% of the females were found to be over-nourished. Less than 15% of all the individuals under investigation were suffering from hypertension, hyperglycaemia and hyperuricaemia. 35% of the males but only 13% of the females were anemic. The lipid status of the females was generally worse with statistically higher median values for total cholesterol, LDL-cholesterol and triglycerides than the males. There was no significant difference in the variation of HDL-cholesterol between the sexes. High vitamin C, B2 and B6 deficiency rates were observed in both the males and the females.

Aspects of community-based nutritional intervention.

A number of aspects are discussed in relation to community-based nutrition intervention projects. This includes the application of different intervention measures, the used of anthropometric indicators, and the methods of immediate and final data evaluation.

PIP: A nutritional intervention program in 4 villages, with 3 control villages, in Khon Kaen Province, Northeast Thailand, in 1982-1985, is evaluated in terms of the nutritional status of children. In these villages where no severe poverty existed, 37% of children under 5 were underweight, 8-15% were wasted and 35-40% were stunted. Common causes of wasting are infections, neglect, improper feeding, prolonged exclusive breast feeding, and family crises. Results were evaluated by median and standard deviations of percentages of wasted children, of stunted and underweight children, using -2.0 S.D. as they cut-off value for each village. There were marked seasonal variations, with more underweight in the rainy (planting) and dry (harvesting) seasons than in the cold season, which was correlated with fewer infections and better appetites in children. Decrements in rates of underweight and wasting were observed in both index and control villages (n.s.). Best results were observed in villages where there was good cooperation from the villagers and their health workers. This compromised the findings of the study, since there was one very cooperative village among the controls, and one less cooperative village in the intervention group. Days of illness per child fell from 22.5 to 7.2 in cooperative villages, and rose from 16.5 to 20.2 in the less cooperative villages. Best results were obtained with regular home visits and regular growth monitoring, combined with nutritional and health advice.

Serum unconjugated primary and secondary bile acids in patients with cholangiocarcinoma and hepatocellular carcinoma.

Serum unconjugated primary bile acids (cholic acid, chenodeoxycholic acid), secondary bile acids (lithocholic acid, deoxycholic acid), conjugated primary bile acids (glycocholic acid, glycohenodeoxycholic acid, taurocholic acid, taurochenodeoxycholic acid) and total bile acids were measured in 25 and 75 male patients with cholangiocarcinoma and hepatocellular carcinoma respectively. Twenty-one healthy male volunteers served as controls. Other biochemical parameters, i.e. bilirubin, transaminases, albumin, globulin and cholesterol were also studied. Conjugated bile acids and total bile acids were elevated in both patient groups when compared with those of controls. The presence of unconjugated primary bile acids and secondary bile acids was noted in the patient groups, whereas, they were not detectable in controls. The appearance of these serum bile acids may be useful as a marker for early diagnosis of cholangiocarcinoma and hepatocellular carcinoma in people at-risk such as those who have chronic infection with Opisthorchis viverrini. Differentiation between the two types of tumor may be possible by using other parameters such as alpha-fetoprotein or other tumor markers newly discovered. An increase of the trihydroxy bile acids: dihydroxy bile acids and glycine conjugated bile acids: taurine conjugated bile acids ratios was shown in the patient groups. The latter may be due to the proportion of the increase of taurine conjugates being greater than the increase of glycine conjugates. The other biochemical parameters were significantly elevated in the patient groups except for albumin which was significantly decreased. The sensitivity of the tests for cholic acid, chenodeoxycholic acid, alkaline phosphatase and gamma glutamyl transferase was high.

Vitamin B1, B2 and B6 in relation to anthropometry, hemoglobin and albumin of newborns and their mothers from northeast Thailand.

The weight and height measurements of fifty-three mothers and their newborns residing in the northeast of Thailand were recorded. Hemoglobin, albumin and cord blood samples were taken immediately after delivery. The vitamin B1, B2 and B6 status of the women and their newborns was assessed through functional tests. Vitamin B1 and B2 status of the newborns was found to be generally better than those of their mothers. This is not so, however, for vitamin B6. The rate of deficiency in the mothers was highest for vitamin B2 (54.7%). The mothers' height, hemoglobin and albumin concentrations and their vitamin B2 status correlated with those of their children at birth. 50% of low birth weight deliveries (2500 g and below) were included in this study. The risk of a low birth weight delivery cannot, however, be explained by any of the biochemical variables. Although the rate of low birth weight is used commonly to determine mother and child health care, this paper shows that for Hb, albumin, Vitamins B1, B2 and B6, it is not an effective indicator used to determine nutritional deficiencies in mothers.