Hemoglobin typing in cholangiocarcinoma.

Prevalence of thalassemias and/or hemoglobinopathies, particularly hemoglobin E, and cholangiocarcinoma were found more prominently in the lower part of the Northeast of Thailand as compared with the upper part of this region or any other area of the country. The aim of this study was to evaluate if there was coincident distribution or some relationship. Hemoglobin typing by the cellulose acetate method was performed in 111 cases of cholangiocarcinoma, mainly diagnosed by ultrasonography, compared with 146 normal controls. It was found that hemoglobin E trait and beta-thalassemia trait were significantly higher in the former group.

Low dose cytosine arabinoside in the treatment of acute non-lymphoblastic leukemia.

Low-dose ARA-C (10 mg/m2 subcutaneous injection twice/day for 20 days with 10 days rest) was prescribed in 8 cases of newly diagnosed ANLL. Only one case attained complete remission in 2 courses and lasted for one and a half years without maintenance therapy. She was 63 years of age. The drug could be tolerated well and no serious side effect was observed.

Danazol for thrombocytopenia in pregnancy with underlying systemic lupus erythematosus.

A case of full blown systemic lupus erythematosus (SLE) was treated with steroid. The patient was in remission with low dose of prednisolone for a year. When she became pregnant, there was no relapse of SLE activities in any organ. However, she developed gum bleeding and petechiae due to thrombocytopenia in the second half of the pregnancy. With a normal amount of megakaryocyte in the bone marrow, it was supposed to be due to SLE which no longer responded to even a full dose of steroid. Therefore, danazol 600 mg/day was given orally and she made a complete recovery within one week. She delivered vaginally a normal female newborn without fetal thrombocytopenia or bleeding.

Prevalences of thalassemia/hemoglobinopathies and G-6-PD deficiency in malaria patients.

It seems that thalassemia and/or hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency (G-6-PD) have some protective effects against malaria infection. To verify this, hemoglobin typing and methehoglobin reduction test were performed on 115 malaria patients and compared with controls. It was found that the number of thalassemia/hemoglobinopathies in the malaria group and in the control group were not significantly different and also occurrence of G-6-PD deficiency in the malaria group was not different from that of the controls. Clinical manifestations of malaria in any group are quite similar. It is concluded that there is no protective effect against malaria in thalassemia/hemoglobinopathies or G-6-PD deficiency.

Hereditary coproporphyria: a case report.

A case of hereditary coproporphyria was reported, he was a 21-year-old farmer, presenting with abdominal pain and fever. His manifestations were composed of all classical symptoms of acute hepatic porphyrias i.e. convulsions, psychosis, hypertension and respiratory failure as well as dark red urine with positive Watson-Schwartz test. Because of lack of cutaneous photosensitivity and strikingly increased urinary coproporphyrin, diagnosis of hereditary coproporphyria was most likely. Precipitating factor could not be identified. He responded well to glucose and other symptomatic treatment during the first admission but not in the second. He died from respiratory failure.

Liver cancer in Thailand. I. A case-control study of cholangiocarcinoma.

Potential risk factors for cholangiocarcinoma were investigated in a case-control study among inhabitants of north-east Thailand, which included 103 cases from 3 hospitals, with age- and sex-matched controls. A clear association with past or present infection with Opisthorchis viverrini, as indicated by raised serum antibodies, was found (o.r. 5.0), and at least two-thirds of cases can be attributed to this cause. The results suggest that males may be at higher risk than females. There was no association with hepatitis B infection, with aflatoxin intake as estimated from albumin adducts in serum or with any particular dietary patterns. Alcohol consumption was very low in the population, and the risk associated with regular drinking was non-significant. Regular users of betel nut-predominantly female-had a high risk (o.r. 6.4), a possible mechanism being through their increased exposure to nitrosamines.

Liver cancer in Thailand. II. A case-control study of hepatocellular carcinoma.

Potential risk factors for hepatocellular carcinoma were investigated in a case-control study among inhabitants of north east Thailand. Sixty-five cases from 3 hospitals, with matched controls, were included. Infection with hepatitis-B virus was the major risk factor-chronic carriers of HB surface antigen had an estimated relative risk of 15.2. Infection with hepatitis-C virus appeared to be rare. No increase in risk was found with recent aflatoxin intake, as estimated by consumption of possibly contaminated foods, or by measuring aflatoxin-albumin adducts in serum. Regular use of alcohol (2 or more glasses of spirits per week) was associated with a non-significant elevation in risk (o.r. = 3.4, 95% c.i. 0.8-14.6), but the number of regular drinkers in the population was small. The meaning of an apparent protection conferred by certain food items is uncertain, but a possible role of betel nut in the aetiology deserves further investigation.