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Year 2007

JN : Angiology. 2007 Oct-Nov;58(5):572-8.
TI : Prevalence and risk factors of peripheral arterial disease in a selected Thai population.
AU : Sritara P, Sritara C, Woodward M, Wangsuphachart S, Barzi F, Hengprasith B, Yipintsoi T.
EN-AB: Peripheral arterial disease (PAD) is a condition with high mortality, but it is amenable to secondary prevention. Data on its prevalence in Thailand are scarce. To study the prevalence of PAD in a middle-class, urban Thai population, a cross-sectional study was conducted at the Electric Generating Authority of Thailand's head plant, Nonthaburi, in 2002 and 2003 on all surviving and contactable employees and former employees who had participated in the first cardiovascular risk factors survey in 1985. Participants completed a structured questionnaire detailing their medical history, and they underwent a physical examination. A diagnosis of PAD was made when the ankle-brachial index (ABI) was < 0.9. Ankle-brachial index data were available for 98% of participants in the survey; 75% were men, and participants' ages ranged from 52 to 73 years. The overall prevalence of PAD was 5.2%. The age-standardized prevalence of PAD was 4% in men and 9% in women. Multiple logistic regression analysis found hypertension (OR = 1.7), female gender (OR = 1.9), current smoking (OR = 3.0), current alcohol drinking (OR = 0.41), and overweight (body mass index [BMI] > 25 kg/m( 2), OR = 0.54) to be significant (P < .05) predictors of PAD. The prevalence of PAD in urban, middle-class Thais was similar to that in the population in developed countries. (NO 18024940)

JN : J Med Assoc Thai. 2007 Aug;90(8):1573-80.
TI : Detection of coronary stenoses in chronic stable angina by multi-detector CT coronary angiography.
AU : Panmethis M, Wangsuphachart S, Rerkpattanapipat P, Srimahachota S, Buddhari W, Kitsukjit W.
EN-AB: OBJECTIVE: To assess the accuracy for detection of coronary stenoses in chronic stable angina patients. MATERIAL AND METHOD: Twenty-four chronic stable angina patients, referred for conventional coronary angiography by the indication of positive stress tests or clinical highly suspicion of coronary artery disease were enrolled. MDCT coronary angiography (MDCTCA) and conventional coronary angiography (144 coronary vessels) were performed within one month. Accuracy of MDCTCA for predicting significant coronary artery stenoses was analyzed. RESULTS: Five patients were excluded due to the total Agaston calcium score more than 500. Therefore, 114 vessels or 209 segments from 19 patients (9 males and 10 females) were available for analysis, and 186 segments were assessable (89%). Of all assessable segments, 13 from 20 significant lesions (65%) and 158 from 167 normal or non-significant lesions (95%) were correctly detected by MDCTCA. The sensitivity, specificity, positive and negative predictive values to detect significant coronary artery stenoses in terms of vessel are 82%, 96%, 79%, and 97% respectively. CONCLUSION: Coronary CT angiography provides accurate assessment of coronary luminal artery narrowing and shows the ability to exclude significant coronary artery stenoses in patients with chronic stable angina. (NO 17926987)

JN : J Med Assoc Thai. 2007 Mar;90(3):532-8.
TI : Reliability of the evaluation for left ventricular ejection fraction by ECG-gated multi-detector CT (MDCT): comparison with biplane cine left ventriculography.
AU : Chaosuwannakit N, Rerkpattanapipat P, Wangsuphachart S, Srimahachota S.
EN-AB: OBJECTIVE: To evaluate the reliability of measurement for left ventricular ejection fraction (LVEF) by ECG-gated multi-detector CT (MDCT) comparing with biplane cine left ventriculography that is current gold standard. MATERIAL AND METHOD: The authors reviewed the data from 15 patients who were referred for coronary CT angiography for clinical indications and underwent cardiac catheterization within 14 days. Coronary CTA studies were performed on MDCT Somatom Sensation 16, Siemens, Germany, Slice thickness 1 mm, Slice collimation 0. 75 mm, and Pitch 0. 3. L VEF were measured with MDCTby Simpson s method and compared with values measured by biplane area length method from cardiac catheterization. The L VEF from both techniques were compared using intraclass correlation power analysis (SPSS analysis software). RESULTS: The study population consisted with six men and nine women with a mean age of 54+/-10 years. The LVEF measured from MDCT and cine ventriculography were 54.7 +/-10% and 56. 3+/-10%, respectively. LVEF measured with MDCT by interpreter I and interpreter 2 was significantly correlated with L VEF measured with biplane cine ventriculography (ICC= 0.99 and 0.98, respectively). The interobserver reliability was excellent with ICC = 0.9. CONCLUSION: LVEF measurement with MDCT during coronary CT angiography can be performed easily, very accurately, and compare well with measures taken from biplane cine left ventriculography. (NO 17427532)

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Year 2006

JN : J Infect Dis. 2006 Sep 1;194(5):642-50. Epub 2006 Jul 18.
TI : Changes in body composition and mitochondrial nucleic acid content in patients switched from failed nucleoside analogue therapy to ritonavir-boosted indinavir and efavirenz.
AU : Boyd MA, Carr A, Ruxrungtham K, Srasuebkul P, Bien D, Law M, Wangsuphachart S, Krisanachinda A, Lerdlum S, Lange JM, Phanuphak P, Cooper DA, Reiss P.
EN-AB: BACKGROUND: Body composition changes complicate antiretroviral therapy. Improvements in lipoatrophy after a switch in nucleoside reverse-transcriptase inhibitors (NRTIs) have been demonstrated. We investigated 60 patients switching from failed NRTIs to ritonavir-boosted indinavir and efavirenz. METHODS: Body composition (assessed by dual-energy x-ray absorptiometry scan and by single-slice computed tomography of the abdomen through the level of the fourth lumbar vertebra [L4] and the mid-right thigh) and fasted metabolics were measured at the baseline time-point at switch and at weeks 48 and 96 thereafter. Mitochondrial DNA and RNA were extracted from right-thigh subcutaneous fat and peripheral-blood mononuclear cells (PBMCs) at weeks 0 and 48. The primary end point was the change in mean limb fat over 48 weeks. RESULTS: At week 96, we observed increases in mean (standard deviation [SD]) limb fat (+620 [974] g; P=.003), L4 subcutaneous adipose tissue (+20 [35] cm(2); P<.001), mid-thigh subcutaneous adipose tissue (+5 [10] cm(2); P<.001), and L4 visceral adipose tissue (+11 [34] cm(2); P=.01), but we also observed reduced lean limb mass (-831 [1,100] g; P=.3). Mean (SD) mtDNA content in subcutaneous fat and in PBMCs increased (+109 [274] and +45 [100] copies/cell, respectively). Improved virological control or immune recovery did not explain the results. Triglyceride, total cholesterol, estimated low-density lipoprotein cholesterol, ratio of total cholesterol to high-density lipoprotein cholesterol, and blood glucose levels deteriorated (i.e., had increased by 206%, 67%, 58%, 19%, and 6%, respectively, at week 96). CONCLUSIONS: This regimen was associated with statistically significant but clinically modest increases in peripheral fat, visceral fat, and mitochondrial nucleic acid content. A predominantly adverse metabolic profile developed. (NO 16897663)

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Year 2002

AU : Piyavisetpat N, Mahayosnand A, Wangsuphachart S.
TI : Hysterosalpingographic accuracy of peritubal adhesion.
JN : J Med Assoc Thai 2002 Jun ; 85 (Suppl 1) : S210-S216 (NO 07669)

AU : Tepmongkol S, Wangsuphachart S, Lerdlum S, Sittipunt C, Udayachalerm W.
TI : Comparison of TC-99m apcitide scintigraphy with CT angiography in intermediate probability of pulmonary emboli by pioped criteria using pulmonary angiography as a gold standard.
JN : ASEAN J Radiol 2002 Sep-Dec ; 8 (3) : 185-192 (NO 08154)

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Year 2001

AU : Wangsuphachart S, Kingpetch K.
TI : Endocrine tumor imaging.
JN : Chula Med J 2001 Sep ; 45 (9) : 741-754 (NO 06827)

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Year 2000

AU : Suwanwela N, Phanuphak P, Phanthumchinda K, Suwanwela NC, Tantivatana J, Ruxrungtham K, Suttipan J, Wangsuphachart S, Hanvanich M.
TI : Magnetic resonance spectroscopy of the brain in neurologically asymptomatic HIV-infected patients.
JN : Magn Reson Imaging 2000 Sep ; 18 (7) : 859-865 (NO 07010)

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Year 1999

AU : สมใจ หวังศุภชาติ.
TI : การวิจัยเพื่อศึกษาคุณสมบัติเฉพาะของเครื่องมือการตรวจวินิจฉัย
BK : หลักการทำวิจัยให้สำเร็จ คณะแพทยศาสตร์ จุฬาลงกรณ์มหาวิทยาลัย 1999 : 53-60
TH-AB: โดยทั่วไปการส่งตรวจเพื่อวินิจฉัยนั้นจะทำเมื่อประวัติการตรวจร่างกาย หรือผลการตรวจ วินิจฉัยที่มีมาก่อนนั้นให้ข้อมูลที่ไม่เพียงพอที่จะบอกว่าผู้ป่วยเป็นอะไร เพื่อการรักษาที่ถูกต้อง การตัดสินใจเลือกประเภทหรือวิธีการของการตรวจใหม่ก็จะต้องให้แน่ใจว่าผลของการตรวจ นั้นจะต้องสมารถลดความไม่แน่ใจของแพทย์ลงจากก่อนการตรวจได้ ซึ่งแพทย์ควรจะมีข้อมูล ในใจก่อนที่จะส่งตรวจว่าก่อนการส่งตรวจนั้น ผู้ป่วยมีโอกาสที่จะเป็นโรคที่นึกถึงอยู่เท่าใด เรียกว่า prevalence หรือ pretest probability เครื่องมือหรือวิธีการตรวจที่เหมาะสม สำหรับโรคใดโรคหนึ่งจะต้องมีคุณสมบัติหรือคุณสมบัติซึ่งสามารถเพิ่มโอกาสที่จะวินิจฉัยโรคได้ เมื่อเทียบกับตอนก่อนส่งตรวจ ถ้าผลการตรวจให้ผลบวก ทั้งนี้หมายความว่า Posttest probability จะต้องสูงกว่า pretest probability การตรวจหรือ test นั้น จึงมีคุณค่าช่วยในการวินิจฉัย. (NO 05627)

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Year 1998

AU : Kasantikul V, Tontiranon P, Wangsuphachart S, Panichabhongse V.
TI : Chordoma in a child presenting as unilateral proptosis and high serum alpha-fetoprotein.
JN : Neuropathology 1998 ; 18 : 73-76 (NO 04776)

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Year 1997

AU : สมใจ หวังศุภชาติ.
TI : Widened mediastinum in trauma patients.
BK : ศัลยศาสตร์อุบัติเหตุ 8 1997 : 131-149 (NO 03595)

AU : Pataramontree J, Wangsuphachart S, Apaiphonlacharn J, Chaichan P.
TI : Patients' surface dose reduction in general diagnostic x-rays in Bangkok, Thailand.
CONF : Proceedings of Chulalongkorn University 80th anniversary research conference 1997 : 563-570 (NO 03908)

AU : Pataramontree J, Wangsuphachart S, Apaiphonlacharn J, Chaichan P.
TI : Patients' surface dose reduction in general diagnostic x-rays in Bangkok, Thailand.
JN : Medical & Biological Engineering & Computing 1997 ; 35 (Suppl part2) : 1120 (NO 04918)

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Year 1996

AU : สมใจ หวังศุภชาติ.
TI : เทคโนโลยีในการตรวจวินิจฉัยด้วยภาพในประเทศไทย : สถานการณ์ปัจจุบันปัญหาและแนวทางแก้ไข
JN : ว.การวิจัยระบบสาธารณสุข = Health Systems Research Journal 1996 ; 4 (2) : 124-130 (NO 04926)

AU : Wangsupachart S.
TI : เทคโนโลยีในการตรวจวินิจฉัยด้วยภาพในประเทศไทย : สถานการณ์ปัจจุบัน ปัญหา และแนวทางแก้ไข
JN : ว.การวิจัยระบบสาธารณสุข = Health Systems Research Journal (Thai) 1996 ; 4 (2) : 124-130 (NO 07349)

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Year 1995

AU : Shuangshoti S, Wangsuphachart S.
TI : Angiolipoma of suprasellar region.
JN : J Med Assoc Thai 1995 ; 78 (11) : 631-634
EN-AB: An angiolipoma of the suprasellar region occurred in an 8-year-old boy. Review of 5 intracranial ngiolipomas, including the current case, revealed that four were in the sellar region of one man and the women. One was in the thalamus of a man. The average age of the patients was 49 years, and average size of the tumors was 2.5 cm across. The angiolipomas associated with the sellar region often created abnormalities of the eye viz exophthalmos, decreased vision, and palsy of the oculomotor nerve. Sudden onset has ensured in a massively hemorrhagic thalamic angiolipoma. The characteristic low density with negative Hounsfield unit values in CT scan and hyperdensity in MRI of the brain suggested adipose tissue component of the angiolipoma. The angiography has depicted the angiomatous component of the latter. The combined characteristic CT scan, MRI, and angiographic features should demonstrate both vascular and adipose tissue elements of the angiolipomas before pathologic examination. (NO 02593)

AU : Sirichindakul B, Sriussadaporn S, Wangsupachart S.
TI : Successful transcatheter embolization of traumatic hepatic artery false aneurysm : case report.
JN : Chulalongkorn Medical Journal 1995 ; 39 (7) : 537-542
EN-AB: A case of traumatic hepatic artery false aneurysm is presented. A 45-year-old female patient had a gunshot wound of theliver which was treated by suturing the entrance and exit of the bullet tract 3 months before this admission. She was referred to Chulalongkorn Hospital because of false aneurysm of the right hepatic artery detected by ultrasonography on routine follow-up. A CT scan of the abdomen with arterial enhancement revealed a 4 x 3 x 3 cm3 intrahepatic hematoma in the right lobe of the liver. Angiography via the right common femoral artery was performed and a false aneurysm arising from the segmental branch of the right hepatic artery was demonstrated. Embolization of the right hepatic artery with Gelfoam was subsequently performed successfully. The patient was well and discharged 2 days later. Follow-up CT scans at 1 and 3 months postembolization revealed a near complete resolution of the intrahepatic hematoma with no arterial enhancement. Percutaneous transcatheter embolization is an effective and safe procedure for management of post traumatic hepatic artery false aneurysm. The procedure is simple and may spare the patients from potentially dangerous major hepatic surgery. (NO 02623)

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Year 1994

AU : Virutamasen P, Wangsuphachart S, Reinprayoon D, Kriengsinyot R, Leepipatpaiboon S, Gua C.
TI : Trabecular bone in long-term depot-medroxyprogesterone acetate users.
JN : Asia-Oceania Journal of Obstetrics & Gynaecology 1994 Sep ; 20 (3) : 269-74
EN-AB: A cross-sectional study was designed to determine trabecular bone density in 75 long-term depot-medroxyprogesterone acetate (DMPA) users ( 3 yr) matched with non-DMPA users by age, body mass index (18-25), limitation of age ( 45 yr), and body weight ( 60 kg). The long-term DMPA cases were divided into 3 groups according to duration of injectable contraceptive use. Neither cases nor controls had a smoking or chronic alcohol consumption history. Cases and controls were matched by age. Trabecular bone of the femoral neck were assessed by X-ray and interpreted by a single-blinded radiologist. Trabecular bone patterns were graded according to Singh's Index. Blood collection for determination of estradiol, prolactin, calcium, phosphorus, and medroxyprogesterone acetate were performed in cases and controls. Venous blood was taken at twelfth week of injection of DMPA and within 5 days after menstrual bleeding cessation in the controls. Mean trabecular bone in the cases was 5.5 +/- 0.6 (range 4-6). It was not statistically different from that in the controls (mean 5.5 +/- 0.6, range 2-6). No statistically significant difference of serum, calcium, phosphorus, prolactin, and estradiol was seen in the cases when compared to controls at mid follicular phase of normal menstrual cycle. Serum MPA of individual case at twelfth week of injection was 4.1 +/- 1.1 nmol/l. In conclusion, trabecular bone density in long-term DMPA users were not statistically different from normal menstruating women who have not received injectable DMPA. (NO 02875)

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Year 1993

AU : Rojpornpradit P, Lertsanguansinchai P, Thitathan S, Rajatapiti P, Wangsupachat S.
TI : Adjuvant chemotherapy for non-metastatic osteosarcoma of the extremity a preliminary report.
JN : Chulalongkorn Medical Journal 1993 ; 37 (12) : 735-741
EN-AB: Nine cases seven males and two females of non-metastatic osteosarcoma of the extremity were treated with chemotherapy in an adjuvant fashion. The primary lesion was in the distal femur in five patients, the proximal tibia in two, and one each in the distal tibia and proximal femur. Pre-operative chemotherapy with intra-arterial cisplatin (100 mglm2) and intravenous dexorubicin (60 mglm2) was administered in two patients. Post-operatively, cisplatin (100 mglm2) and dexorubicin (60 mglm2) were given intravenously for one year. Doxorubicin was given until the dose reached a total of 450 mglm'. Surgery consisted of limb-sparing surgery in four of the cases, above-knee amputation in three, and one each of hip-disarticulation and below-knee-amputation. Four of the nine patients were disease-free past 24 months. The two-year disease-free survival rate was 50.1 per cent and overall survival was 87.5 per cent. Refinements in treatment and more thorough pre-treatment investigations are discussed. (NO 02806)

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Year 1992

AU : Arjhansiri K, Wangsuphachart S.
TI : Orbital varix.
JN : Chulalongkorn Medical Journal 1992 ; 36 (11) : 869-876
EN-AB: A case report of orbital varix diagnosed by plain skull radiograph, orbital venography and computerized tomography with a classical radiological findings was presented. The patho-physiology, classical clinical features, various diagnostic imaging modalities, differential diagnosis and treatment of this unusual entity are discussed. (NO 02739)

AU : Phanthumchinda K, Wangsuphachart S, Sridama V, Shuangshoti S, Apiratanakasem P.
TI : A case presenting with fever, coma and right hemiparesis with multiple cerebral enhanced and calcified nodules.
JN : Chulalongkorn Medical Journal 1992 ; 36 (1) : 59-68
EN-AB: A 50-year-old Thai male farmer was admitted to the hospital for 8-day-unconsciousness. He had severe back pain for 23 days prior to admission. Thirteen days prior to admission, he developed severe headache, alteration of consciousness, fever and right hemiparesis. Computerized axial tomographic scan of the brain revealed multiple nodular lesions with ring enhancement and calcification, and communicating hydrocephalus. Lumbosacral spine roentgenography demonstrated degenerative change. Chronic fibrotic infiltration of both lungs with compensatory emphysema was seen on chest X-ray. Cerebrospinal fluid from a ventriculostomy revealed an increment in the lymphocytes and a low glucose profile. During hospitalization, he developed polyuria and urine output of 7,900-11,645 ml per day. Antituberculous drugs and desmopressin were prescribed. He expired on the eighth day of admission. Clinical diagnosis was multifocal lesions of the supratentorial level caused by chronic infections, most likely tuberculosis, pulmonary tuberculosis and degenerative disease of the lumbar spine. Pathological diagnosis included caseous granuloma containing acid-fast bacilli of the upper lobe of both lungs, hilar lymph nodes, left clavicle and left kidney, caseous granulomatous meningitis of the base of the brain, tuberculomas of the brain right parietal lobe and left internal capusule, and caseous granuloma of the hypothalamus. (NO 02753)

AU : Sriussadaporn S, Tanprayoon T, Kosolbhand P, Wangsuphachart S.
TI : Emergency embolization of post-traumatic hemobilia.
JN : Chulalongkorn Medical Journal 1992 ; 37 (9) : 577-581
EN-AB: A case of post-traumatic hemobilia in a 18-year-old patient is reported. The patient had a motorcycle accident and underwent exploratory laparotomy at a rural hospital. A deep laceration of the right lobe of the liver was found and treated by suture repair. One week later he underwent another exploratory laparotomy because of massive upper gastrointestinal bleeding and the diagnosis of hemobilia was made by the observation of blood coming out of the ampulla of Vater when a duodenotomy was done. The bleeding stopped spontaneously. One month later he had another episode of upper gastrointestinal bleeding and was transferred to Chulalongkorn Hospital. The diagnosis of hemobilia was subsequently confirmed by angiography which revealed a false aneurysm arising from the segmental branch of the right hepatic artery and the extravasation of contrast media into the biliary tract. Transcatheter embolization with Gelfoam resulted in immediate cessation of bleeding. Repeat angiography 10 days later showed complete disappearance of the false aneurysm. The patient made an unevenfful recovery. (NO 02793)

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Year 1991

AU : Wangsuphachart S.
TI : Low osmolar (non-ionic) contrast media versus high osmolar (ionic) contrast media in intravenous urography and enhanced computerized tomography. a cost-effectiveness analysis.
JN : Southeast Asian Journal of Tropical Medicine & Public Health 1991 Dec ; 22 (4) : 664-76
EN-AB: The cost-effectiveness of three alternative policies for the use of intravenous contrast media for urography and enhanced computerized tomography (CT) are analyzed. Alternative :1 is to use high osmolar contrast media (HOCM) in all patients, the historical policy. Alternative :2 is to replace it with low osmolar contrast media (LOCM) in all patients. Alternative :3 is to use LOCM only in the high risk patients. Data on the 6,242 patients who underwent intravenous urography and enhanced CT at the Department of Radiology, Chulalongkorn Hospital in 1989 were used. Both societal and hospital viewpoints were analyzed. The incremental cost-effectiveness (ICE) between :2 and :1 was 26,739 Baht (US$1,070) per healthy day saved (HDS), while the ICE between :3 and :1 was 12,057 Baht (US$482) per HDS. For fatal cases only, ICE between :2 and :1 was 35,111 Baht (US$1,404) per HDS, while the ICE between :3 and :1 was 18,266 Baht (US$731) per HDS. The incremental cost (IC) per patient was 2,341 Baht (US$94) and 681 Baht (US$27) respectively. For the hospital viewpoint the ICE between :2 and :1 was 13,744 (US$550) and between :3 and :1 was 6,127 Baht (US$245) per HDS. The IC per patient was 1,203 Baht (US$48) and 346 Baht (US$14), respectively. From the sensitivity analysis, :3 should be used if the LOCM price is reduced more than 75 (equal to 626 Baht or less) and more than 80 of the patients are able to pay for the contrast media. (NO 02286)

AU : Wangsuphachart S.
TI : Low osmolar (non-ionic) contrast media versus high osmolar (ionic) contrast media in intravenous urography and enhanced computerized tomography : a cost-effectiveness analysis.
JN : Southeast Asian J Trop Med Public Health 1991 Dec ; 22 (4) : 664-676
EN-AB: The cost-effectiveness of three alternative policies for the use of intravenous contrast media for urography and enhanced computerized tomography (CT) are analyzed. Alternative no. 1 is to use high osmolar contrast media (HOCM) in all patients, the historical polity. Alternative no. 2 is to replace it with low osmolar contrast media (LOCM) in all patients. Alternative no. 3 is to use LOCM only in the high risk patients. Data on the 6,242 patients who underwent intravenous urography and enhanced CT at the Department of Radiology, Chulalongkorn Hospital in 1989 were used. Both societal and hospital viewpoints were analyzed. The incremental cost-effectiveness (ICE) between no. 2 and no. 1 was 26,739 Baht (US$1,070) per healthly day saved (HDS), while the ICE between no. 3 and no. 1 was 12,057 Baht (US$482) per HDS. For fatal cases only, ICE between no. 2 and no. 1 was 35,111 Baht (US$1,404) per HDS, while the ICE between no. 3 and no. 1 was 18,266 Baht (US$731) per HDS. The incremental cost (IC) per patient was 2,341 Baht (US$94) and 681 Baht (US$27) respectively. For the hospital viewpoint the ICE between no. 2 and no. 1 was 13,744 (US$550) and between no. 3 and no. 1 was 6,127 Baht (US$245) per HDS. The IC per patient was 1,203 Baht (US$48) and 346 Baht (US$14), respectively. From the sensitivity analysis, no. 3 should be used if the LOCM price is reduced more than 75 per cent (equal to 626 Baht of less) and more than 80 per cent of the patients are able to pay for the contrast media. (NO 02501)

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Year 1989

AU : Shuangshoti S, Kasantikul V, Taecholarn C, Wangsuphachart S.
TI : Symptomatic intraspinal genuine endodermal epithelial cyst.
JN : J Med Assoc Thai 1989 May ; 72 (5) : 295-301
EN-AB: An intraspinal cervicodorsal endodermal epithelial cyst occurred in a 20-year-old man who experienced sudden paraparesis at the age of 6 years and subsequently developed progressive sensory disturbances. The patient underwent repeated surgical explorations indicating that the lesion may be difficult to identify. The cyst wall consisted of the outer smooth muscle and connective tissue and the inner epithelium that produced mucin and mucopolysaccharide. The intimate association between the epithelium and smooth muscle makes the cyst wall strikingly like the wall of the digestive tract or the respiratory passage and supports the endodermal origin of the cyst which must be distinguished from the neuroepithelial cyst. The pathogenesis of the endodermal epithelial cyst is suggested to be related to congenital maldevelopment of the notochord and the primitive gut (NO 01770)

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Year 1987

AU : Wangsuphachart S, Kaewtubtim J, Jaratkulangkoon C.
TI : Roentgenographic features of cholangiocarcinoma in percutaneous transhepatic cholangiography.
CONF : Annual Scientific Meeting of Faculty of Medicine, Chulalongkorn University. 27th, 1986 May 26-30, Bangkok, Thailand
JN : Chula Med J 1987 Jan ; 31 (1) : 21-28
EN-AB: Forty two cases of right-sided percutaneous transhepatic cholangiograms of histologically proven cholangiocarcinoma were analysed from the aspect of roentgenographic features. Twenty two cases of complete biliary obstruction revealed 2 round blind pouches, 5 blind pouches with dimple, 10 rat tail defects, 5 left and right bifurcated narrowing, and 1 concave meniscus defect (2 obstructive lesion in one case). Of the 20 cases of partial biliary obstruction, there were 15 portal trifurcated narrowings, 4 apple-core defects, 1 smooth narrowing and 1 intraluminal defect (also 2 obstructive lesions in one case). For the obstructed site, 10 were intrahepatic, 23 at porta-hepatic trifurcation, 5 at trifurcation of CHD-cystic duct- CBD, and 6 at proximal CBD. Common obstructed site was porta-hepatic trifurcation (54 per cent). The most common finding for the complete obstructive lesions was the rat tail-defect (45 per cent) while portal trifurcated narrowing was the most common pattern for the partial obstructive lesions and the total of cases (71 per cent) and 34 per cent respectively). Each roentgenographic feature is showned and reviewed for the possible differential diagnoses. (NO 00876)

AU : Kasantikul V, Shuangshoti S, Preechayudh P, Wangsuphachart S.
TI : A combined neurilemmoma and angioma of the parasellar region : case report.
JN : J Neurosurg 1987 Aug ; 67 (2) : 307-311
EN-AB: A combined neurilemmoma and angioma of the parasellar region is presented that clinically simulated a pituitary tumor. The lesion produced increased intracranial pressure and subarachnoid hemorrhage (SAH). This neoplasm is believed to have originated from the leptomeninges or the perivascular neural elements, or both. The angiomatous network within the tumor could have been the source of SAH. (NO 01044)

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Year 1986

AU : Wangsuphachart S, Kaewtubtim J, Jaratkulangkoon C.
TI : การประเมินผลอัลตราซาวด์และ P.T.C. ในการวินิจฉัยโรคดีซ่านจากมะเร็งในโรงพยาบาลจุฬาลงกรณ์
JN : Chula Med J 1986 ; 30 (Suppl) : S-20
EN-AB: As the 82 per cent prevalence of malignant obstructive jaundice in 50 surgical proved obsturctive jaundice cases, ultrasonography had the sensitivity of 85 per cent and specificity of 33 per cent in prediction of malignant obstructive nature; while percutaneous transhepatic cholangiography (PTC) showed 90 per cent of sensitivity and 88 per cent of specificity. Both positive predictive value (97 per cent) and negative predictive value (66 per cent) of PTC are higher than of ultrasonography, 85 per cent and 33 per cent respectively. The accuracy of obstructive site was 68 per cent in ultrasonography and 96 per cent in PTC. Ultrasonography is probably sufficient to adequate evaluate malignant obstructive jaundice prior to surgery but PTC should be proceeded in negative study of ultrasonography as weell as undetermined or non-malignant nature of clinically suspected obstructive jaundice patients. (NO 00878)

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Year 1985

AU : Cutchavaree A, Wangsuphachart S, Hanvong Y.
TI : Penetrating neck wound with tracheoesophageal fistula.
JN : J Med Assoc Thai 1985 Jan ; 68 (1) : 33-38
EN-AB: Tracheoesophageal fistulas due to penetrating wounds are relatively rare. A case of laryngotracheal injury with associated laryngotracheo-esophageal fistula caused by bullet wound is presented. It was successfully treated by two layered closure of the esophagus and positioning of regional muscle pedicled flaps between the airway and esophagus without further reconstruction of the larynx and trachea. (NO 00009)

AU : Suwanwela N, Lerdlum S, Ukachoke J, Wangsuphachart S, Khaoroptham S.
TI : Computed tomography of spinal cord arteriovenous malformations.
JN : Chula Med J 1985 Dec ; 29 (12) : 1291-1304
EN-AB: Computed tomography of the spine has been used in the evaluation of five patients with surgically proved arteriovenous malformation of the spinal cord. In plain CT scans, focal hyperdense areas were found in all cases. In one case, an area of higher attenuation value was demonstrated and proved to be a hematoma at operation. In all four enhanced scans, enhanced patches and dots were visualized which corresponded to enlarged vessels. Metrizamide CT scans performed in three preoperative cases showed widened cords with irregular or tortuous filling defects. One post first operative metrizamide CT scan also demonstrated a filling defect which disappeared in the following scan after the second operation. CT scan especially with intravenous contrast enhancement and post intrathecal metrizamide should be a useful screening and follow-up method for AVM of the spinal cord, and a safe procedure for assessing therapeutic results. (NO 00221)

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Year 1984

AU : Suwanwela N, Wangsuphachart S, Tanpairoj S.
TI : Computed tomography of the eye and orbit : experiences with 70 cases.
JN : Chula Med J 1984 Sep ; 28 (9) : 1001-1030
EN-AB: Seventy patients who had orbital abnormalities in late-generation CT examination of the eye and orbit were analyzed. CT scan could demonstrate location, extension of the orbital lesions as well as their relationships to globe, optic nerve, extraocular muscles, vascular structures, intraorbital fat or periorbital structures. Of the 70 patients, 30 cases had tumors (31 tumors), 16 cases were primary and 14 cases extended from periorbital tumors and metastasis. Other categories were frontoethmoidal encephalomeningocele 9, inflammation (abscess, mucocele, pseudotumor, optic neuritis, old eye infection) 8, thyroid ophthalmopathy 6, fibrous dysplasia 7, carotid-cavernous fistula 3, orbital fracture 2, organized hematoma 1, chronic glaucoma 1, chronic retinal detachment 1, artificial eye 1 and amyloidosis 1. Some specific diseases could be verified by CT scan such as thyroid ophthalmopathy, carotid-cavernous fistula, fracture, frontoethmoidal encephalomeningocele, fibrous dysplasia and mucocele. Axial CT scan with direct coronal scan or coronal and sagittal reformations are the present most non-invasive useful procedures in diagnosis of orbital lesions. Details of CT finding in different diseases were discussed. (NO 00875)

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Year 1983

AU : Poovorawan Y, Chandrakamol B, Luang-Aroon B, Wangsuphachart S, Thisyakorn C, Borirakchanyavat V, Suwangool P.
TI : Idiopathic portal hypertension in children. 1983 : 44-45
TH-AB: Idiopathic portal hypertension หรือ noncirrhotic portal fibrosis เป็นสาเหตุของ portal hypertension ที่พบได้ในประเทศเขตร้อน เช่น ในอินเดีย และประ เทศในอัฟริกา ส่วนใหญ่เป็นรายงานในผู้ป่วยผู้ใหญ่ ในประเทศไทยผู้ป่วย portal hypertension ที่ไม่ได้เป็นโรคตับแข็งพบได้น้อย ในเด็กที่พบได้แก่ extrahepatic portal vein obstruction และ congenital hepatic fibrosis ส่วน idiopathic portal hypertension ในผู้ป่วยเด็กอาจให้การวินิจฉัยผิดเป็น extrahepatic portal vein obstruction ได้ ถ้าไม่ได4 ราย ที่ได้รับการวินิจฉัยเป็น idiopathic portal hypertension ผู้ป่วยเป็นเด็กชายทั้งหมด อายุระหว่าง 1 ถึง 14 ปี มีภูมิลำเนาอยู่จังหวัดสุรินทร์ ชัยนาท นครปฐม และกรุงเทพฯ อย่างละ 1 ราย ทุกรายมาด้วยอาการอาเจียนเป็นเลือดจำนวนมาก เพราะ esophageal varices แตก ทุกรายตรวจร่างกายคลำตับได้ขนาดปกติ คลำม้ามได้โตมาก ผลการตรวจทางห้องปฎิบัติการพบว่าซีด (Hb ระหว่าง 5.6-9 gm เปอร์เซนต์) ไม่พบมาลาเรีย ตรวจการทำงานตับรวมทั้ง albumin globulin และ prothrombin time อยู่ในเกณฑ์ปกติ การศึกษาทางรังสี upper GI 3 ราย พบ esophageal varices ทั้ง 3 ราย splenoportogram ทั้ง 4 ราย พบ collateral circulation จำนวนมาก เห็น portal vein เพียง 2 ราย ส่วนอีก 2 ราย เห็น portal vein จาก operative portogram portal pressure จากการวัด 3 ราย สูง 250, 410, และ 460 มม. น้ำ hepatic wedge pressure วัดได้ 9 มม.ปรอท 2 ราย พยาธิสภาพตับที่พบมี fibrosis เล็กน้อยถึงปานกลางบริเวณ portal ผู้ป่วยได้รับการรักษาโดยการตัดม้ามออก และทำ splenorenal shunt หลังทำผู้ป่วยสบายดีจนถึงปัจจุบัน (2 เดือน - 2 / 1/2 ปี) โรค idiopathic portal hypertension เป็นโรคที่พบได้ในเขตร้อน สาเหตุของโรคในปัจจุบันยังไม่ทราบ อาจจะเกี่ยวข้องกับโรคในเขตร้อน เช่น มาลาเรีย พยาธิ สารพิษ ท็อกซิน ต่าง ๆ ที่ยังไม่สามารถตรวจพบได้ในปัจจุบัน การตรวจ operative portogram จะช่วยในการวินิจฉัยแยกโรคจาก extrahepatic portal vein obstruction ได้โดยเฉพาะในผู้ป่วยเด็ก (NO 01131)

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Year 1980

AU : Suwanwela N, Wangsuphachart S, Suwanwela C.
TI : Clivus chordoma.
JN : Thai J Radiol 1980 ; 17 (1) : 13-25
TH-AB: Chordoma เป็นเนื้องอกที่พบได้น้อย การศึกษาทางรังสีวิทยาอาจช่วยในการวินิจฉัย โดยพบการเปลี่ยนแปลงต่างๆ กันในภาพรังสีธรรมดา, tomogram, angiogram, pneumoencephalogram, ventriculogram, cisternogram, การศึกษาโดยสารราดิโอไอโซโทปและเครื่องเอกซเรย์คอมพิวเตอร์ ได้รายงานลักษณะการเปลี่ยนแปลงทางภาพรังสีของผู้ป่วยโรคเนื้องอก chordoma ที่พบในโรงพยาบาลจุฬาลงกรณ์ จำนวน 3 ราย และได้วิเคราะห์วารสารที่มีรายงานโรคนี้ (NO 00005)

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