visitor # 1 since May 2003
JN : Thyroid. 2008 Jul;18(7):697-704.
TI : Rosiglitazone effect on radioiodine uptake in thyroid carcinoma patients with high thyroglobulin but negative total body scan: a correlation with the expression of peroxisome proliferator-activated receptor-gamma.
AU : Tepmongkol S, Keelawat S, Honsawek S, Ruangvejvorachai P.
EN-AB: BACKGROUND: Thyroid carcinoma patients with high thyroglobulin (Tg) level but negative total body scan (TBS) are difficult to treat with radioiodine (RAI). The objective of this study was to determine if treatment with rosiglitazone (RZ), a peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonist, was associated with an increase in RAI uptake in thyroid carcinoma patients with high serum Tg and negative TBSs. We also determined if there was a correspondence between the effect of RZ and the degree of staining for PPAR-gamma within thyroid cancer tissues. METHODS: We prescribed 8 mg of RZ daily for 6 weeks in 23 patients with epithelial cell thyroid carcinoma who previously had negative posttherapeutic I-131 total body scans (post Rx TBSs) with high serum Tg concentrations. Diagnostic total body scans (Dx TBSs) before and 6 weeks after RZ treatment were compared. An ablative dose of I-131 was then given to all patients, and post Rx TBS was performed to evaluate RAI uptake. Immunohistochemical staining of PPAR-gamma expression in thyroid cancer biopsies was done to correlate this with possible effects of RZ on RAI uptake. RESULTS: Seven patients had strong PPAR-gamma-positive staining in thyroid biopsies, nine patients had weakly positive staining, and seven patients had negative staining. Five of seven patients with strong staining had either positive post Rx TBS, or both Dx TBS and post Rx TBS. One of nine patients with weak staining had positive Dx TBS and post Rx TBS. In contrast, none of the seven patients with negative staining had positive TBS. CONCLUSIONS: RZ can increase RAI uptake in thyroid tissue in the majority of patients with epithelial cell thyroid carcinoma whose previous posttherapeutic I-131 scans were negative provided they have high intensity and extent of PPAR-gamma expression in thyroid tissue. Few, if any, patients with weak or no PPAR-gamma expression in thyroid cancer tissue increase RAI uptake after RZ treatment. (NO 18630997)
JN : Eur J Nucl Med Mol Imaging. 2008 Jan;35(1):107-15. Epub 2007 Sep 26.
TI : Comparative analysis of MR imaging, ictal SPECT and EEG in temporal lobe epilepsy: a prospective IAEA multi-center study.
AU : Zaknun JJ, Bal C, Maes A, Tepmongkol S, Vazquez S, Dupont P, Dondi M.
EN-AB: BACKGROUND AND PURPOSE: MR imaging, ictal single-photon emission CT (SPECT) and ictal EEG play important roles in the presurgical localization of epileptic foci. This multi-center study was established to investigate whether the complementary role of perfusion SPECT, MRI and EEG for presurgical localization of temporal lobe epilepsy could be confirmed in a prospective setting involving centers from India, Thailand, Italy and Argentina. METHODS: We studied 74 patients who underwent interictal and ictal EEG, interictal and ictal SPECT and MRI before surgery of the temporal lobe. In all but three patients, histology was reported. The clinical outcome was assessed using Engel's classification. Sensitivity values of all imaging modalities were calculated, and the add-on value of SPECT was assessed. RESULTS: Outcome (Engel's classification) in 74 patients was class I, 89%; class II, 7%; class III, 3%; and IV, 1%. Regarding the localization of seizure origin, sensitivity was 84% for ictal SPECT, 70% for ictal EEG, 86% for MRI, 55% for interictal SPECT and 40% for interictal EEG. Add-on value of ictal SPECT was shown by its ability to correctly localize 17/22 (77%) of the seizure foci missed by ictal EEG and 8/10 (80%) of the seizure foci not detected by MRI. CONCLUSIONS: This prospective multi-center trial, involving centers from different parts of the world, confirms that ictal perfusion SPECT is an effective diagnostic modality for correctly identifying seizure origin in temporal lobe epilepsy, providing complementary information to ictal EEG and MRI. (NO 17899076)
JN : J Craniofac Surg. 2007 Sep;18(5):1236-41.
TI : Quantitative study of new bone formation in distraction osteogenesis of craniofacial bones by bone scintigraphy.
AU : Rojvachiranonda N, Tepmongkol S, Mahatumarat C.
EN-AB: Although distraction osteogenesis is widely accepted as a technique to augment the craniofacial skeleton, timing to start distraction after an osteotomy or to remove distractors is basically based on studies on long bones. Because bone scintigraphy is well known to be the gold standard for quantitative measurement of bone formation, we conducted this pilot study to evaluate its feasibility as a tool for assessing new bone formation by distraction osteogenesis. Five patients with midface hypoplasia and four with mandibular hypoplasia were studied. Each patient had five bone scans: before surgery, 3 and 30 days after stopping distraction, and 3 days before and 3 months after distractor removal. Radiotracer uptake values at distraction sites were measured at 1 and 3 hours. Each uptake value was compared with preoperative study as uptake ratio. A typical pattern of radiotracer uptake ratio was observed in all cases with successful distraction. Uptake rose to the maximum during the consolidation period and remained at or above the preoperative level until the study end point. In one patient who had mandibular distraction and nonunion of the right ramus, there was no uptake peak during early consolidation as seen in the successfully distracted body and in the other cases. Bone scintigraphy was found to be a useful investigation in craniofacial distraction. It showed the dynamic of new bone formation by demonstrating the osteoblastic activity, which is important objective information for determining distraction rate and consolidation duration in each case. It may also be a tool that can predict the outcome of distraction osteogenesis. (NO 17912120)
JN : J Med Assoc Thai. 2006 Aug;89(8):1269-76.
TI : Successful resection of Hypothalamic Hamartoma with intractable gelastic seizures--by transcallosal subchoroidal approach.
AU : Bunyaratavej K, Locharernkul C, Tepmongkol S, Lerdlum S, Shuangshoti S, Khaoroptham S.
EN-AB: A 19-year old female with intractable gelastic seizures was found to have 0.7 x 1.8 x 1.8 cm elliptical mass on the floor of the third ventricle. The signal intensity on the Magnetic Resonance Imaging (MRI) was consistent with the Hypothalamic Hamartoma (HH). Ictal EEG demonstrated rhythmic 7 Hz waves over Fp2, F4, and C4 with spreading to the right temporal region and then bilaterally. Ictal Single Photon Emission Computerized Tomography (SPECT) showed hyperperfusion at hypothalamic and medial frontopolar regions. The patient underwent surgical resection using Trans Callosal Subchoroidal Approach (TCSA) to the third ventricle. Pathological finding confirmed the diagnosis of hypothalamic hamartoma. Following the operation, she has been seizure free up to 12 months. Thereafter, provoked seizures seldom occurred and there has been improvement in her memory, emotional control and independence. This appears to be the first report of this surgical approach for HH, which is less likely to disturb memory function compared to previously described interfoniceal approach. (NO 17048440)
JN : J Med Assoc Thai. 2006 Apr;89(4):527-32.
TI : The first invasive EEG monitoring for surgical treatment of epilepsy in Thailand.
AU : Srikijvilaikul T, Locharernkul C, Deesudchit T, Tuchinda L, Lerdlum S, Tepmongkol S, Shoungshotti S.
EN-AB: The authors report the first invasive electroencephalography (EEG) monitoring in Thailand in a patient who had intractable left temporal lobe epilepsy. The seizure origin and functioning cortices were identified The corresponding epileptogenic zone was resected without functional deficit. The patient has become seizure free 1 year since surgery. Subdural EEG monitoring with cortical stimulation have been developed at this tertiary epilepsy center The technique provides essential evidence for the surgical decision so that the best post operative outcome can be achieved. (NO 16696401)
JN : J Med Assoc Thai. 2005 Sep;88 Suppl 4:S235-41.
TI : The difference among stress and rest normal reference databases using non-corrected, scatter corrected, and scatter with attenuation corrected Bull's eye myocardial perfusion scintigraphy in both genders.
AU : Tepmongkol S, Pasawang P, Krisanachinda A, Srimahachota S.
EN-AB: OBJECTIVES: To compare 3 types of Bull's eye normal reference maps; non-corrected, scatter corrected, and scatter with attenuation corrected Bull's eye in both genders. MATERIAL AND METHOD: Sixty-seven normal healthy males and females volunteered for the present study. After screening tests to identify low post-test (exercise EKG) likelihood of coronary artery disease, 41 subjects (20 males and 21 females) had stress and rest myocardial perfusion scintigraphy (99mTc-sestamibi). The data were reconstructed by filtered back projection reconstruction in three ways as follows; (1) non-correction (NoC), (2) scatter elimination only (SC), (3) scatter elimination and attenuation correction (SC+AC). Three sets of reconstructed data of both stress and resting studies were added into 6 sets of Bull's eye. The data of each Bull's eve were normalized to 100% of the maximum count. Percentage of uptake in each area was compared by t-test statistics. RESULTS: Stress and rest count distribution of NoC and SC sets were lowest at the inferior wall, followed by the septal wall, anterior wall, and lateral wall in both genders. In the SC+AC sets; septum and lateral walls showed more uptake than anterior and inferior walls. A significant difference of percentage uptake between stress and rest images at septum in NoC and SC images in male and in SC image in female was observed. No difference was seen in the SC+AC groups. CONCLUSION: There was similarity of count distribution between NoC and SC images. SC+AC caused more uniform image. However; some non-uniformity was observed. The use of sex-independent SC+AC bull's eye is possible. Stress study can be omitted for bull's eye collection of normal files. (NO 16623035)
JN : J Med Assoc Thai. 2005 Sep;88 Suppl 4:S207-13.
TI : Quality of life after successful epilepsy surgery: evaluation by occupational achievement and income acquisition.
AU : Locharernkul C, Kanchanatawan B, Bunyaratavej K, Srikijvilaikul T, Deesudchit T, Tepmongkol S, Lertlum S, Tuchinda L, Shoungshotti C, Ounpak P.
EN-AB: OBJECTIVES: A comprehensive epilepsy surgery program has been developed at Chulalongkorn University Hospital, Thailand to reach an international standard level, rendering patients good surgical outcomes comparable to developed countries. After successful operation, seizure free patients have become independent, self earning or employed. However, quality of life (QOL) in terms of occupational achievement and income acquisition after epilepsy surgery has never been studied. These indicators reflect the ultimate QOL in the aspects of actual independency, intact brain functions, mental health and psycho-social interactions. The authors therefore conduct the study on improvement of QOL after successful epilepsy surgery using these parameters. MATERIAL AND METHOD: One hundred and eleven intractable epilepsy who have become seizure free to worthwhile improved (Engel class I to III) after standard presurgical evaluation and epilepsy surgery from January 2002 to December 2004 were evaluated. The patients were followed up for 3 years. The occupational status and incomes were categorized according to the ranking of the patients' functioning levels. The pre and post surgery work abilities, employment and incomes were interviewed and compared. Mc Nemar test and paired t-test were used for statistical analyses. RESULTS: The average age of the 111 adults (54 males and 57 females) was 33.7 +/- 9.2 years. Eighty two percent of the patients had temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) and underwent standard anterior temporal lobectomy. The rest had tumors, cortical dysplasia or scar and received lesionectomy or cortical resection assisted by intra-operative or intra-cranial EEG. The overall seizure free rate is 83.8%. The occupational status of the subjects was shown to improve significantly after surgery from unemployed to higher categories of professional achievement (p < 0.001). The number of unemployed and no income individuals decreased from 66 to 25 cases (62.1% reduction rate) after surgery (p < 0. 001). Reciprocally, the number of persons who achieved professional jobs with regular incomes or salaries increase from 30 to 53 cases (43.4% increasing rate) (p < 0.001). The patients who have not acquired any income increment showed improvement in working ability after epilepsy surgery. The average annual incomes per capita shows the increasing rate of 45.08%, from 55,657.85 Baht (approximately U.S. dollars 1390) to 80,748.15 Baht (approximately U.S. dollars 2018), with strong statistical significance (p < 0.001). The improvement is best seen in seizure free than in non-seizure free subjects. CONCLUSION: The present study, to the authors 'knowledge, is the first to use work abilities, professional achievement and income acquisition to assess the ultimate QOL after epilepsy surgery. Most subjects have been shown to significantly improve their postoperative lives in terms of occupational accomplishment and income increment, especially in seizure free individuals. The need for expansion of epilepsy surgery is emphasized. (NO 16623030)
JN : J Med Assoc Thai. 2003 Jun;86 Suppl 2:S189-94.
TI : The effect of phenobarbital on the accuracy of technetium-99m diisopropyl iminodiacetic acid hepatobiliary scintigraphy in differentiating biliary atresia from neonatal hepatitis syndrome.
AU : Charearnrad P, Chongsrisawat V, Tepmongkol S, Poovorawan Y.
EN-AB: Biliary atresia (BA) and neonatal hepatitis syndrome (NHS) are major causes of cholestatic jaundice in infancy. Technetium-99m diisopropyl iminodiacetic acid hepatobiliary scintigraphy (99mTc-DISIDA scan) is widely used in the differentiation of these two entities. The objective of this study was to evaluate the effect of phenobarbital premedication on the accuracy of 99mTc-DISIDA scan. Ninety-five cholestatic infants (38 females and 57 males) with an age range of 2 weeks to 4 months (mean 2.1 mo) who underwent 99mTc-DISIDA scan testing were retrospectively reviewed. The patients were divided into 3 groups according to the history of phenobarbital administration prior to 99mTc-DISIDA scan examination. Group 1 (n = 48), group 2 (n = 29), and group 3 (n = 18) received phenobarbital at the dosage of 5 mg/kg/day for at least 5 days, less than 5 mg/kg/day or less than 5 days, and no premedication, respectively. The accuracy of 99mTc-DISIDA scan in differentiating BA from NHS in group 1, 2, and 3 was 72.92 per cent, 89.66 per cent, and 100 per cent, respectively. No significant difference was seen between the patients who received and did not receive phenobarbital in terms of age at presentation, age at onset of jaundice, and liver function tests. In conclusion, phenobarbital therapy may not be necessary prior to 99mTc-DISIDA scan examination in the evaluation of cholestatic infants and thus a delay in diagnosis and surgical therapy of BA can be avoided. (NO 12929988)
AU : Tepmongkol S, Chotipanich C, Sirisalipoch S, Chaiwatanarat T, Vilaichon A, Wattana D.
TI : Relationship between vesicoureteral reflux and renal cortical scar development in Thai children: The significance of renal cortical scintigraphy and direct radionuclide cystography.
JN : J Med Assoc Thai 2002 Jun ; 85 (Suppl 1) : S203-S209 (NO 07637)
AU : Tepmongkol S, Udayachalerm W.
TI : Potential role of trimetazidine enhanced myocardial perfusion uptake in the evaluation of coronary collaterals.
JN : World Journal of Nuclear Medicine 2002 May (Suppl 1) : S94 (NO 07638)
AU : Tepmongkol S.
TI : Detection of acute cerebral ischemia with Tc-99m apcitide scintigraphy.
JN : Asean J Radiol 2002 Jan-Apr ; 8 (1) : 73-76 (NO 07639)
AU : Tepmongkol S.
TI : Detection of acute cerebral ischaemia with Tc-99m apcitide scintigraphy.
JN : Neuroradiology 2002 Oct ; 44 (10) : 819-821 (NO 08091)
AU : Tepmongkol S.
TI : Enhancement of radioiodine uptake in hyperthyroidism with hydrochlorothiazide: a prospective randomised control study.
JN : Eur J Nucl Med Mol Imaging 2002 Oct ; 29 (10) : 1307-1310 (NO 08092)
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)
AU : Srimahachota S, Limpijankit T, Boonyaratavej S, Tepmongkol S, Udayachalerm W, Suithichaiyakul T, Ngarmukos P.
TI : Detection of restenosis after percutaneous transluminal coronary angioplasty using the exercise treadmill test and technetium 99m-sestamibi scintigraphy.
JN : J Med Assoc Thai 2001 Mar ; 84 (3) : 307-313 (NO 06942)
AU : Tepmongkol S.
TI : Enhancement of radioiodine uptake in hyperthyroid patients with hydrochlorothiazide : preliminary result of a prospective randomized control study.
JN : Eur J Nucl Med 2001 Aug ; 28 (8) : 1006 (NO 07640)
AU : Tepmongkol S.
TI : Recent advances in nuclear cardiology.
JN : Chula Med J 2001 Jun ; 45 (6) : 551 (NO 07641)
AU : Tepmongkol S.
TI : Efficacy comparison between filtered back projection reconstruction without correction and iterative reconstruction with scatter and attenuation corrections for myocardial perfusion SPECT.
JN : Proceedings of continuous quality improvement in medical imaging and radiotherapy 2001 Apr : 23-24 (NO 07642)
AU : Tepmongkol S.
TI : Radionuclide Therapy : Radiation Synovectomy.
BK : Proceeding of 41st Annual Scientific Meeting, Faculty of Medicine, Chulalongkorn 2000 March
CONF : 41st; Annual Scientific Meeting, Faculty of Medicine, Chulalongkorn, March 2000 : 261-270 (NO 07643)
AU : Tepmongkol S, Heyman S.
TI : A comparison of Meckel's scintigraphy in children : premedication with pentagastrin versus pentagastrin plus H2-receptor blocker (ranitidine).
JN : ASEAN J Radiol 1999 Sep-Dec ; 5 (3) : 215-226
EN-AB: wait (NO 06131)
AU : Tepmongkol S, Kingpetch K, Boonvisut S.
TI : The advantage of double phase 99M TC-MIBI scintigraphy over dual-tracer subtraction method in tertiary hyperparathyroidism with sick euthyroid syndrome.
JN : ASEAN J Radiol 1999 May-Aug ; 5 (2) : 199-203
EN-AB: wait (NO 06132)
AU : Tepmongkol S, Heyman S.
TI : 131I MIBG therapy in neuroblastoma : mechanisms, rationale, and current status.
JN : Med Pediatr Oncol 1999 Jun ; 32 (6) : 427-431
EN-AB: wait (NO 06133)
AU : Tepmongkol S, Heyman S.
TI : Tc-99m pertechnetate scintigraphy to diagnose rectal duplication.
JN : Clin Nuclear Med 1999 Apr ; 24 (4) : 289 (NO 06134)
AU : Limpijankit T, Srimahachota S, Boonyaratavej S, Tepmongkol S, Udayachalerm W, Ngarmukos P.
TI : Early detection of restenosis after successful coronary angioplasty by Tc-99m MIBI scintigraphy. 1997 (NO 05450)
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