Sasivimol Rattanasiri

Ramathibodi Hospital, Siayuthia, Bangkok, Thailand

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Publications (55)124.22 Total impact

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    ABSTRACT: To determine the association between angiotensin-converting enzyme (ACE) I/D polymorphism and the presence of systemic lupus erythematosus (SLE) disease and lupus nephritis (LN), including the association with disease severity in a Thai population. In this retrospective study, 187 SLE patients followed up for (at least) 7 years in a rheumatology clinic of an academic hospital were enrolled. Disease severity and damage score at diagnosis and every 6 months, including treatment outcome of the first episode of LN were retrieved from medical records. The ACE genotype of SLE patients were determined by polymerase chain reaction and compared with ACE genotype in 687 controls from a database of a Thai surveillance cohort. There was an association between ACE I/D polymorphism and the presence of SLE disease and LN (P < 0.001). Unexpectedly, the prevalence of DD genotype in SLE patients was lower than controls (OR 0.44 [95% CI 0.23-0.84], P = 0.013). The prevalence of ID genotype was not different between SLE patients and controls (OR 1.44 [95%CI 0.93-2.24], P = 0.102), but was higher in LN patients compared to controls (OR 1.77 [95% CI 1.14-2.72], P = 0.01). However, the ACE I/D polymorphism is not associated with SLE disease severity, either in patients with or without nephritis. The DD genotype could not be used as a poor prognostic marker for SLE and LN susceptibility in a Thai population. However, ID genotype may be associated with risk to develop LN. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
    No preview · Article · Jul 2015 · International Journal of Rheumatic Diseases
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    ABSTRACT: This study aimed to determine the utility and a cut-off level of serum squamous cell carcinoma antigen (SCC-Ag) to predict lymph node metastasis in locally advanced cervical cancer cases. We also investigated the correlation between SCC-Ag level and lymph node status. From June 2009 to June 2014, 232 patients with cervical cancer stage IB2-IVA, who were treated at Ramathibodi Hospital, were recruited. Receiver operating characteristic (ROC) curves were used to identify the best cut-off point of SCC-Ag level to predict lymph node metastasis. Quantile regression was performed to evaluate the correlation between SCC-Ag levels and pelvic lymph node metastasis, paraaortic lymph node metastasis, and parametrial involvement as well as tumor size. Pelvic lymph node metastasis and paraaortic lymph node metastasis were diagnosed in 46.6% and 20.1% of the patients, respectively. The median SCC-Ag level was 6 ng/mL (range, 0.5 to 464.6 ng/ mL). The areas under ROC curves between SCC-Ag level and pelvic lymph node metastasis, paraaotic lymph node metastasis, parametrial involvements were low. SCC-Ag level was significantly correlated with paraaortic lymph node status (p=0.045) but not with pelvic lymph node status and parametrial involvement. SCC-Ag level was also related to the tumor diameter (p<0.05). SCC-Ag level is not a good predictor for pelvic and paraaortic lymph node metastasis. However, it is still beneficial to assess the tumor burden of squamous cell carcinoma of the cervix.
    No preview · Article · Jun 2015 · Asian Pacific journal of cancer prevention: APJCP
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    ABSTRACT: Human leukocyte antigen (HLA)-G is a nonclassical HLA class I molecule that displays strong immune-inhibitory properties and has been associated with allograft acceptance. However, there are conflicting data on the correlation of soluble HLA-G (sHLA-G) and acute rejection and no data on the correlation with acute tubular necrosis in kidney transplantation. To evaluate the association of sHLA-G level in early post-transplant period and allograft rejection/ and acute tubular necrosis (ATN) in kidney transplant recipients. The sera procured before transplantation and serially on day 3 and day 7 after transplantation from 76 kidney transplant recipients were analyzed for the level of sHLA-G by enzyme-linked immunosorbent assay. The levels of sHLA-G from three serial sera did not differ between patients with acute rejection and patients without rejection. However, the sHLA-G levels on day 3 post-transplant and day 7 post-transplant in patients with ATN were significantly higher than that in patients without ATN (16.3 vs 9.85 U/ml, p = 0.018, for day 3 post-transplant and 12.47 vs 5.42 U/ml, p = 0.044, for day 7 post-transplant). In addition, the ROC analysis of sHLA-G for identifying patients with ATN showed that the area under curve was 0.67 (95% confidence interval 0.54-0.80). There was no significant difference for sHLA-G levels between patients with acute rejection and without rejection. Interestingly, high levels of sHLA-G in day 3 and day 7 after transplantation were associated with acute tubular necrosis. Our findings raise the question whether the increased levels of sHLA-G in patients with acute tubular necrosis after transplantation might be a result of ischemia and reperfusion injury.
    No preview · Article · Jun 2015 · Asian Pacific journal of allergy and immunology / launched by the Allergy and Immunology Society of Thailand
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    ABSTRACT: Background. The renin-angiotensin system (RAS) and transforming growth factor beta(1) (TGF-beta(1)) may play a role in the pathogenesis of fibrosis in kidney allografts. Experimental hyperuricemia shows activation of intrarenal RAS. However, the association between uric acid (UA), RAS, and TGF-beta(1) in allograft recipients has not been demonstrated. Therefore we investigated the association between serum UA levels, RAS, and TGF-beta(1) in kidney transplant recipients during the 1st year after transplantation. Methods. Sixty-two transplant recipients were included in the study. Serum UA level, plasma renin activity (PRA), and urine TGF-beta(1) concentration were studied at 3, 6, and 12 months after transplantation. Statistical correlation was demonstrated with the use of Spearman rank correlation coefficient. Receiver operating characteristic curve analysis and area under the curve were performed to assess the diagnostic performance to discriminate between estimated glomerular filtration rate (eGFR) <60 and >= 60 mL/min/1.73 m(2). Results. For all 62 patients, urine TGF-beta(1) and serum UA had a tendency to increase during the 1-year follow-up period, despite no statistically significant change in eGFR. We found that increased urine TGF-beta(1) was correlated with rising serum UA levels and a decrease of the eGFR (r = 0.27 [P =.01]; r = -0.38 [P =.0003]). In contrast, there was no significant change in PRA and it was not correlated with eGFR or TGF-beta(1) (r = -0.01; P =.93). Conclusions. Increased urine TGF-beta(1) and serum UA level during the 1st year after transplantation correlated with a decline in eGFR. The evaluation of these parameters in the early post-transplantation period may identify patients at risk of allograft dysfunction.
    No preview · Article · Mar 2015 · Transplantation Proceedings
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    ABSTRACT: AimTo compare the effects of ethinyl estradiol (EE) 30 mcg/desogestrel 150 mcg plus spironolactone 25 mg/day (group A) versus EE 35 mcg/cyproterone acetate 2 mg (group B) on hyperandrogenism and metabolism in PCOS.Methods This was a randomized clinical study. Eighteen women in groups A and B received medications for three cycles. Acne score, androgens and metabolic parameters were assessed before and after treatment.ResultsOne and two women in groups A and B, respectively, were excluded from the study. Both groups had significantly decreased acne score and free androgen index, and increased sex hormone-binding globulin levels. Cholesterol and high-density lipoprotein were significantly increased in group B, and androstenedione was significantly decreased in group A. The regular withdrawal bleeding was obtained in both groups.Conclusion Both regimens had quite similar efficacy on hyperandrogenism after three cycles of therapy and without any changes in metabolic parameters.
    No preview · Article · Nov 2014 · Journal of Obstetrics and Gynaecology Research
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    ABSTRACT: Background: Since some retrospective studies have given inconsistent findings about innervation in adenomyosis, its role in the pain mechanism is still inconclusive. Objective: Define the nerve fiber density in adenomyotic tissue as it correlated to pain symptoms. Material and method: A cross-sectional study was performed in twenty-five uterine samples from reproductive age women with adenomyosis who underwent either laparotomy or laparoscopic surgery. The nerve fiber density from hysterectomized specimens as measured by immunohistochemistry staining for Protein gene product (PGP) 9.5 and Neurofilament (NF) were compared with the level of pain in the patients as defined by a visual analogue scale and a verbal rating scale. Results: Nerve fibers as detected by PGP9.5 and NF staining in the myometrium were significantly increased in the group of women with adenomyosis experiencing moderate and severe pain as compared to the group experiencing less pain (4 (0, 7) vs. 1.55 (0, 7)/mm2, p-value <0.001, and 6 (3, 10) vs. 0 (0, 4)/mm2, p-value <0.001 respectively). At both phases of the menstrual cycle, the densities of nerve fibers stained with PGP9.5 and NF showed no significant difference. Conclusion: These results suggested that the increased of nerve fibers shown in the more severe pain group might play a role in the pathogenesis or symptoms of adenomyosis.
    No preview · Article · Aug 2014 · Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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    ABSTRACT: IntroductionThe aim of this study was to conduct a systematic review and meta-analysis for determining the effects of prehospital adrenaline administration on return of spontaneous circulation, hospital admission, survival to discharge and discharge with cerebral performance category 1 or 2 in out-of-hospital cardiac arrest patients.MethodsMEDLINE and Scopus databases were searched to identify studies reported to March 2014. Study selection and data extraction were independently completed by two reviewers (PA and SR). The baseline characteristics of each study and number of events were extracted. Risk ratios were pooled. Heterogeneity and publication bias were also explored.ResultsIn total 15 studies were eligible and included in the study. Of 13 adult observational studies, 4 to 8 studies were pooled for each outcome. These yielded a total sample size that ranged from 2381 to 421,459. A random effects model suggested that patients receiving prehospital adrenaline were 2.89 times (95% CI: 2.36, 3.54) more likely to achieve prehospital return of spontaneous circulation than those not administered adrenaline. However, there were no significant effects on overall return of spontaneous circulation (RR¿=¿0.93, 95% CI: 0.5, 1.74), admission (RR¿=¿1.05, 95% CI: 0.80, 1.38) and survival to discharge (RR¿=¿0.69, 95% CI: 0.48, 1.00).Conclusions Prehospital adrenaline administration may increase prehospital return of spontaneous circulation, but it does not improve overall rates of return of spontaneous circulation, hospital admission and survival to discharge.
    Full-text · Article · Jul 2014 · Critical care (London, England)
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    ABSTRACT: Objectives De novo donor-specific HLA antibodies (DSA) are associated with allograft rejection and allograft loss. However, not all DSA are equally detrimental to allograft function. The ability to activate complement may be an important factor differentiating clinically relevant DSA from nonrelevant DSA. The C1q assay detects a subset of HLA antibodies that can fix complement. This study aimed to investigate the correlation between C1q-fixing de novo DSA (dnDSA) and clinical outcomes posttransplant. Methods This retrospective study included 193 sera from kidney transplant recipients who underwent posttransplant DSA testing and/or kidney biopsy for clinical causes. Thirty-five of the 193 (18.1%) had immunoglobulin G DSA. Seventeen of the 35 patients were excluded owing to the presence of pretransplant HLA antibodies. We then analyzed C1q DSA at the time of biopsy in 18 recipients who developed dnDSA. The clinical outcomes of patients with C1q-positive DSA and C1q-negative DSA were compared. Results C1q-positive DSA were detected in 10 of 18 patients (55.6%). The incidences of transplant glomerulopathy were significantly higher among patients with C1q-positive DSA than patients with C1q-negative DSA (80% vs 0%; P = .001). Although patients with C1q-positive DSA experienced more chronic antibody-mediated rejection and graft loss (80% vs 37.5% [P = .145]; 60% vs 25% [P = .188]), the differences were not significant. The receiver operating characteristic curve analysis showed that the C1q assay was an excellent predictor of transplant glomerulopathy with area under the curve of 0.9 (95% CI, 0.769–1.000). Conclusion The presence of C1q-positive dnDSA was associated with an increased risk of transplant glomerulopathy. The C1q assay is potentially a powerful method for identifying patients at risk for transplant glomerulopathy.
    Full-text · Article · Mar 2014 · Transplantation Proceedings
  • Matchuporn Sukprasert · Sasivimol Rattanasiri · Kungpu Xu
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    ABSTRACT: Whole genome amplification (WGA) is a very important step in providing sufficient DNA templates for many high-throughput genetic analyzes. WGA approaches can be subdivided into PCR- or non-PCR-based methods. The PCR amplification category includes PEP-PCR, DOP-PCR and linker-adapter PCR, but only the linker-adapter PCR is suitable for application in preimplantation genetic diagnostic screening because it provides the necessary rapid turnaround time. Evaluate the ability of linker-adapter WGA commercial kits by using half volume compare with full volume of the reagent amplified DNA extracted from single cell fibroblast. Single cell fibroblast was used based on known genetic profiles. The authors reduced the volume of the reagent and compared the DNA yields and fragmented DNA products with yields and products using the original protocol. Our result did not show a significant difference between the amount of DNA products between full and half volume method (4.72 vs. 4.89 microg, p-value = 0.56). We achieve a slightly different of fragmented length of WGA products, full volume of reagent received slightly longer length than half volume (502.83 vs. 478.30 bp, p-value = 0.19). In this study we have shown that the half volume of the reagent of linker-adapter WGA method amplified DNA extracted from single cell fibroblast was comparable DNA yield and DNA fragmented length with the original method. We need further study extrapolate to evaluate the outcome.
    No preview · Article · Nov 2013 · Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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    ABSTRACT: We performed a systematic review and meta-analysis with the aim of assessing the association between cytokine gene polymorphisms and graft rejection in heart transplantation. We identified relevant studies from Medline and Embase using PubMed and Ovid search engines, respectively. Allele frequencies and allele and genotypic effects were pooled. Heterogeneity and publication bias were explored. Four to 5 studies were included in pooling of 3 gene polymorphisms. The prevalences of the minor alleles for TNF α -308, TGF β 1-c10, and TGF β 1-c25 were 0.166 (95% CI: 0.129, 0.203), 0.413 (95% CI: 0.363, 0.462), and 0.082 (95% CI: 0.054, 0.111) in the control groups, respectively. Carrying the A allele for the TNF α -308 had 18% (95% CI of OR: 0.46, 3.01) increased risk, but this was not significant for developing graft rejection than the G allele. Conversely, carrying the minor alleles for both TGF β 1-c10 and c25 had nonsignificantly lower odds of graft rejection than major alleles, with the pooled ORs of 0.87 (95% CI: 0.65, 1.18) and 0.70 (95% CI: 0.40, 1.23), respectively. There was no evidence of publication bias for all poolings. An updated meta-analysis is required when more studies are published to increase the power of detection for the association between these polymorphisms and allograft rejection.
    Full-text · Article · Aug 2013
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    ABSTRACT: The aim of this study was to examine the effects of estradiol valerate (EV) on the thickness of clomiphene citrate (CC)-stimulated endometrium. Thirty-four normal ovulatory women were randomized double-blindly into two groups to receive CC 100 mg/day on day 2-6 of the treatment cycle, and either vitamin B (placebo) or EV 6 mg/day on day 10-14 of the cycle. The endometrial thickness, endometrial pattern, numbers of mature follicles, and maximal diameters of preovulatory follicles were evaluated by transvaginal sonographic examination. Thirty women completed both treatment cycles. Two other participants dropped out during the treatment due to side-effects (headache). The average endometrial thickness of the group treated with CC + placebo became slightly thinner when compared to the thickness at the baseline (9.04 vs 9.52 mm; P = 0.24). The CC + placebo and the CC + EV resulted in similar endometrial pattern, ovulation day, numbers of mature follicles, and sizes of the leading follicles before ovulation. However, an addition of EV into the CC cycle significantly increased the average endometrial thickness (10.7 mm vs 9.04 mm; P < 0.001). We concluded that the addition of 6 mg/day EV following the CC treatment can prevent the endometrial thinning without perturbing folliculogenesis and ovulation.
    Full-text · Article · Aug 2013 · Journal of Obstetrics and Gynaecology Research
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    ABSTRACT: Introduction: Kidney retransplantation is a high-risk procedure that is increasingly performed because of previous graft failure. The aim of this study was to determine the long-term outcomes of kidney retransplantations compared with first kidney transplantations under the current era of immunosuppression. Methods: Since the first retransplantation in Thailand was performed in 1993, this study included all consecutive cases registered in the Thai Transplantation Registry database from January 1993 to December 2011. A total of 3337 kidney transplantations were available for the analysis. Graft loss was defined as a return to dialysis or graft removal. Death with a functioning graft was censored. Results: Of 3337 kidney transplantations during the study period, 113 were second and 3 were third transplantations. Among these 116 retransplantations, the most common identified causes of end-stage renal disease were chronic glomerulonephritis (38.8%), followed by hypertensive nephropathy (13.0%), diabetic nephropathy (6.0%), and lupus nephritis (1.7%). The retransplantation recipients were older (mean age, 46.2 ± 12.8 years) than the first transplantation group (mean age, 42.2 ± 12.8 years). The proportion of living-related kidney transplantations and male sex were similar between first and retransplantation recipients. Fourteen percent of retransplantation recipients showed high immunologic risk as defined by current panel reactive antibodies ≥30% compared with 3% of those in the first transplantation group (P < .001). The percentages of induction therapy with antithymocyte globulin and anti-interleukin-2 antibody in the retransplantation and first transplantation groups were 18.3% versus 4.3% and 60.0% versus 32.6%, respectively. The graft survival rates (95% confidence interval [CI]) at 1, 5, and 10 years were 88.6% (80.7-93.3), 87.3% (79.1-92.5), and 74.4% (53.7-86.9) among retransplantation, versus 95.0% (94.1-95.7), 87.0% (85.5-88.5), and 70.7% (67.4-73.8) among first transplantation groups, respectively (P = .63). Patient survival rates were not different between first and retransplantation groups (P = .42). The leading cause of graft loss in the retransplantation group was chronic allograft nephropathy (22%), whereas infection (57%) was the major cause of death in this group. Conclusion: The 10-year patient and graft survival rates of kidney retransplantation were acceptable. The combination of induction therapy with a calcineurin inhibitor and a mycophenolate mofetil/mychophenolic acid-based regimen lead to outcomes comparable to first kidney transplantations among our cohort of 3337 patients.
    No preview · Article · May 2013 · Transplantation Proceedings
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    ABSTRACT: Retrograde ejaculation, a common type of anejaculation, is attributable to many causes, some of which can be treated with medication and some of which cannot. For infertility treatment, sperm must be collected from the urine of the patients. Our study attempts to ascertain the effects of different g-forces on sperm motility, morphology and DNA integrity in sperm preparation by the Sil-Select™ density gradient method of isolating sperm from urine specimens. Forty-seven semen samples with normal semen analyses according to World Health Organisation (WHO) 1999 criteria were included in this study. Semen samples of 1 ml were mixed with 20 ml alkalinised normal urine and then divided equally into tubes A and B. The two samples were prepared by the Sil-Select™ density gradient centrifugation method at 350 g (tube A) and at 700 g (tube B). Total motile sperm after centrifugation at 700 g was significantly higher than after centrifugation at 350 g [6.7 (0.4-23.0) million versus 3.1 (0.1-13.7) million] (P < 0.001). There was no significant difference between the either the percentage of sperm with normal morphology or with DNA damage between centrifugation at 350 g and 700 g (P > 0.05), although centrifugation at 700 g achieves a higher number of total motile sperm compared with Sil-Select™ sperm preparation at 350 g centrifugation.
    No preview · Article · Apr 2013 · Andrologia
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    ABSTRACT: Objective: The aim of our study was to investigate the natural course of silicosis in terms of radiographic progression among Japanese tunnel workers. Methods: Tunnel workers with silicosis were included in our study between January 2008 and June 2011. We retrospectively assessed workers' radiographs from their first through last visits to see whether there was progression. All films were interpreted by two physicians, who had been specially trained in using the ILO (2000) International Classification of Radiographs of Pneumoconioses (ILO/ICRP). We classified the radiographic findings according to the ILO/ICRP. Survival analysis was performed and then presented as time to progression. Subgroup analysis among the progressed group was performed to demonstrate duration of progression. Results: A total of 65 patients, who were no longer exposed to silica for the duration of the study, were included. The mean age at the first visit was 58.60 ± 7.10 years. The incidence rate of progression was 42 per 1,000 person-years with a median time to progression of 17 years. Progression was demonstrated among 33 cases (51%). The mean durations of progression from category 1 to category 4 and category 2 to category 4 were 14.55 and 10.65 years, respectively. Most patients (86%) had radiographic change from category 1 or 2 directly to category 4. Conclusion: Silicosis progressed at a relatively high rate among tunnel workers without further silica exposure. The high probability of progression directly from category 1 to category 4 may lead to further investigation for the improvement of disease prevention.
    Full-text · Article · Mar 2013 · Journal of Occupational Health
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    ABSTRACT: Objective: The aim of our study was to investigate the natural course of silicosis in terms of radiographic progression among Japanese tunnel workers. Methods: Tunnel workers with silicosis were included in our study between January 2008 and June 2011. We retrospectively assessed workers&apos; radiographs from their first through last visits to see whether there was progression. All films were interpreted by two physicians, who had been specially trained in using the ILO (2000) International Classification of Radiographs of Pneumoconioses (ILO/ICRP). We classified the radiographic findings according to the ILO/ICRP. Survival analysis was performed and then presented as time to progression. Subgroup analysis among the progressed group was performed to demonstrate duration of progression. Results: A total of 65 patients, who were no longer exposed to silica for the duration of the study, were included. The mean age at the first visit was 58.60 ± 7.10 years. The incidence rate of progression was 42 per 1,000 person-years with a median time to progression of 17 years. Progression was demonstrated among 33 cases (51%). The mean durations of progression from category 1 to category 4 and category 2 to category 4 were 14.55 and 10.65 years, respectively. Most patients (86%) had radiographic change from category 1 or 2 directly to category 4. Conclusion: Silicosis progressed at a relatively high rate among tunnel workers without further silica exposure. The high probability of progression directly from category 1 to category 4 may lead to further investigation for the improvement of disease prevention.(J Occup Health 2013; 55: 142–148)
    Full-text · Article · Mar 2013 · Journal of Occupational Health
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    ABSTRACT: We investigated the contribution of polymorphisms in cytokine genes (TNFa-308, IL10-1082 & -592, TGFb1-c10 & c25, and IFNg+874) on the risk of graft rejection in liver transplantation. We performed a systematic review by identifying relevant studies and applied meta-analysis to pool gene effects. In total, 12 studies were eligible and included in the study. Data extraction and assessments for risk of bias were independently performed by two reviewers. Data for allele frequencies, allelic, and genotypic effects were pooled. Heterogeneity and publication bias were assessed. Pooled minor allele frequencies for TNFa-308, IL10-1082, TGFb1-c10, TGFb1-c25, IFNg+874, and IL10-592 were 0.140 (95% CI: 0.083, 0.198), 0.432 (95% CI: 0.392, 0.472), 0.387 (95% CI: 0.307, 0.467), 0.090 (95% CI: 0.056, 0.123), 0.460 (95% CI: 0.392, 0.528), and 0.224 (95% CI: 0.178, 0.269), respectively. OnlyTNFa-308, IL10-1082 polymorphisms were significantly associated with graft rejection. Patients who carried minor homozygous genotypes for these two polymorphisms were at 3.5 and 1.69 times higher risk of graft rejections than patients who carried major homozygous genotypes. The estimated lambdas were 0.41 and 0.47, suggesting an additive mode of effect was most likely. However, we could not detect the associations of TGFb1at c10 and c25, INFg+874, and IL10-592 polymorphisms and graft rejection. In summary, our systematic review has demonstrated that TNFa-308 and IL10-1082 are potential risk factors of poor outcomes in liver transplantation. Future updated meta-analysis studies to confirm the power of these genotypes in association with allograft rejection is needed.
    Full-text · Article · Oct 2012 · Transplant Immunology
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    ABSTRACT: Malignant glioma is a rare but fatal tumour. High expression of O6-methylguanine-DNA-methyltransferase (MGMT) has been linked to poor outcome. We investigated the frequency of MGMT expression and its correlation with outcome and response to treatment in Thai patients.Methods In a retrospective cohort study of adult patients with histologically confirmed WHO grade III and IV malignant glioma diagnosed at Ramathibodi Hospital between January 1997 and December 2009, tumour tissue was assayed for MGMT immunohistochemistry status using MT 3.1 antibody with normal brain as the internal control. Data for clinical characteristics, treatment details, and outcome were collected. The main objective was the frequency of MGMT overexpression. Secondary outcomes were the correlation of MGMT expression with survival and treatment response.FindingsOne hundred thirty-five patients were eligible for analysis. The median age was 47 years. The most common histology was glioblastoma multiforme (WHO grade IV, 54.8%). Only 97 specimens were available for MGMT analysis and overexpression was detected in 31%. Median overall survival (OS) was 11.9 months and 1-year, 2-year, and 5-year OS was 50% (95% confidence interval (CI), 0.41–0.58), 34% (95% CI, 0.26–0.42), and 21% (95% CI, 0.14–0.29), respectively. Four significant adverse prognostic factors for survival that were identified in a multivariate analysis were diabetes mellitus, neurological deficit at diagnosis, histology of glioblastoma multiforme, and receipt of only single treatment modality. MGMT expression did not have prognostic value in the univariate and multivariate analyses. There was no difference in overall survival or response to treatment with temozolamide/BCNU in the subgroup with low MGMT compared with high MGMT.InterpretationThe prevalence of MGMT expression in Thai patients with malignant glioma was not different from that reported elsewhere. MGMT expression did not affect outcome in this study cohort. Therefore, considering MGMT as a relevant factor in selection for treatment with temozolamide might be premature.FundingFaculty research grant from Ramathibodi Hospital.The authors declared no conflicts of interest.
    No preview · Article · Apr 2012 · European Journal of Cancer
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    ABSTRACT: The traditional method for assessing HLA antibodies in recipient serum samples is the complement-dependent cytotoxicity testing (CDC). Recently, the highly sensitive microbead-based Luminex assay was introduced and can detect low levels of anti-HLA Abs. To determine the impact of pretransplant donor-specific HLA antibodies (DSA) detectable by Luminex, despite a negative CDC crossmatch, on the outcomes of kidney transplantation. The correlation and cut-off value of panel reactive antibody (PRA) and DSA was also evaluated. Pre-transplant sera from 116 kidney transplant recipients with a negative CDC crossmatch were assessed for donor-specific HLA antibodies by using Luminex single antigen beads. The patients received kidney transplants at Ramathibodi Hospital between January 2003 and December 2007. The results were correlated with kidney graft outcomes. DSA were found in 24.1% (28/116) of all recipients. Of the twenty-eight DSA positive patients, four developed antibody-mediated rejection (AMR) (4/28 = 14.3%). All these 4 patients had positive C4d staining in their biopsies. Of the eighty-eight DSA negative patients, two developed AMR (2/88 = 2.3%). The AMR occurred more frequently in the DSA positive group than in the DSA negative group (14.3% versus 2.3%. The patient and graft survival were similar in both groups. The strength of pre-transplant DSA was not associated with the incidence of rejection episodes. There was a higher incidence of AMR in patients with pre-transplant DSA despite a negative CDC crossmatch. However, pre-transplant DSA detected by Luminex had no statistically significant impact on delayed graft function, patient survival and graft survival.
    Full-text · Article · Mar 2012 · Asian Pacific journal of allergy and immunology / launched by the Allergy and Immunology Society of Thailand
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    ABSTRACT: Solid surface vitrificaition (SSV) is a cryoperservative method that has been used in the cryopreservation of oocytes, and embryos. Here, we report an application of the SSV in the cryopreservation of human spermatozoa. We compared the SSV with a standard freezing method in terms of sperm motility, morphology, vitality and DNA integrity. Sperm motility was determined by computer assisted semen analysis, morphology and vitality were determined by eosin-methylene blue staining, and DNA integrity was determined by a TUNEL assay. We found that while both cryopreservative methods produced spermatozoa with comparable vitality and motility, the SSV gave slightly, but significantly fewer sperm with DNA damage, and loose tail. We concluded that, a cryopreservation of human spermatozoa by SSV is feasible and provides a quick and practical way to preserve human spermatozoa with a comparable, if not better, quality of the preserved spermatozoa to the standard freezing method.
    No preview · Article · Dec 2011 · Andrologia
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    ABSTRACT: Background: Bacteria need to be eliminated for skin preparation in minor hand surgery. The standard method of skin preparation uses an antiseptic scrub and antiseptic solution, which is expensive and time-consuming. Objective: Design a "double-painted antiseptic application method", and compare the effectiveness of eliminating bacteria at the area around the hand and wrist between the standard method and the double-painted antiseptic application method. Methods: This cross-over designed experimental study was performed on seven volunteers. The standard and the double-painted antiseptic application method were alternately used for skin preparation around the hand, wrist, and half of the forearm. The bacterial colony counts were collected before, immediately after, and at 45 minutes after skin preparation by using the modified glove-juice technique. The primary outcomes were the eradication rate and the number of bacterial colonies. Results: There was no statistical difference in bacterial colonies between either method before skin preparation. The median of bacterial colony counts immediately after and at 45 minutes after skin preparation were zero colony forming units per milliliter in both methods. The eradication rate was 61.5% and 76.9% in the standard and double-painted antiseptic application method, respectively, for a risk difference of -15.4. There was no statistically significant difference (p=0.67). Conclusion: The number of bacterial colonies and eradication rate were not significantly different between either method. The double-painted antiseptic application method can be used instead of the standard method for the skin preparation in minor hand surgery, which has an expected duration of about 45 minutes or less.
    Preview · Article · Oct 2011

Publication Stats

498 Citations
124.22 Total Impact Points

Institutions

  • 2004-2015
    • Ramathibodi Hospital
      • Department of Diagnostic and Therapeutic Radiology
      Siayuthia, Bangkok, Thailand
  • 2002-2015
    • Mahidol University
      • • Faculty of Medicine Ramathibodi Hospital
      • • Department of Biostatistics
      Siayuthia, Bangkok, Thailand