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Year 2006

JN : J Med Assoc Thai. 2006 Feb;89(2):236-41.
TI : Integrated criteria of fine-needle aspiration cytology and radiological imaging for verification of breast cancer in nonpalpable lesions.
AU : Sampatanukul P, Boonjunwetwat D, Thanakit V, Pak-Art P.
EN-AB: OBJECTIVES: To evaluate the accuracy of using radiologic, cytologic and integrated radiologic and cytologic criteria in diagnosis of nonpalpable breast lesions. MATERIAL AND METHOD: From January 2003 to May 2004, a prospective study of performing fine-needle aspiration biopsy (FNAB) was carried out at King Chulalongkorn Memorial Hospital on female patients with nonpalpable or vaguely palpable lumps that needed ultrasound localization for the direction and depth. RESULTS: There were 162 lesions from 150 patients, consisting of 29 malignant neoplasms (17.9%) and 133 benign lesions (82.1%). Of the 107 classified as subcentimeter focal lesions (< 1 x 1 cm2 in size), two of radiological malignancy were false and two others were falsely negative by cytology. While the 23 large/ill-defined lesions (> 1.5 x 1.5 cm2 in size), one hiding malignant lesion adjacent to a prominent intraduct papilloma was missed. Two others had falsely negative cytologic diagnosis. The integrated criteria achieved accuracy and sensitivity of 97.5% and 93% compared with the cytology, 96.3% and 82.8% and the better scenario of radiology, 95.7% and 82.8% respectively. CONCLUSION: The integrated criteria provide the most accuracy rate and sensitivity rate for detection of malignancy in nonpalpable breast lesions. (NO 16579012)

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Year 2005

JN : J Med Assoc Thai. 2005 Oct;88(10):1367-72.
TI : Does color Doppler ultrasound vascularity predict the response to neoadjuvant chemotherapy in breast cancer?
AU : Boonjunwetwat D, Prueksadee J, Sampatanukul P, Chatamra K.
EN-AB: OBJECTIVES: To assess the proportions of response to neoadjuvant chemotherapy of breast cancer according to color Doppler ultrasound vascularity patterns. MATERIAL AND METHOD: Prospective evaluation using gray scale and color Doppler ultrasound for number of vessels and feeding appearances of tumors as well as the changes in tumor sizes at before and after chemotherapy in 69 breast cancer patients. RESULTS: The overall response rate in 70 breast cancers was 20%. Twenty-nine lesions (41%) showed hypervascularity and 41 lesions (59%) revealed hypovascularity. There were 5 vascularity patterns and each pattern had the proportion of responders as follows; 33.3% for hypovascularity with single-vessel feeding into the tumor, 25% for hypovascularity with single-vessel feeding at periphery of the tumor, 25% for no vascular feeding to the tumor, 16.7% for hypervascularity with vascular feeding at the periphery of the tumor and 13% for hypervascularity with vascular feeding into the tumor. The highest percentage of responsive group was the pattern of hypovascularity with single-vessel feeding into the tumor (33.3%). CONCLUSION: There is a trend that tumor vascularity and patterns of vascular feeding by color Doppler ultrasound can predict the responsiveness of breast cancer to neoadjuvant chemotherapy. (NO 16519381)

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Year 2003

JN : J Med Assoc Thai. 2003 Jun;86 Suppl 2:S284-90.
TI : Role of combined fine needle aspiration and ultrasonography in the diagnosis of impalpable lesions of the breast.
AU : Sampatanukul P, Boonjunwetwat D, Pak-art P.
EN-AB: OBJECTIVE: To evaluate the efficacy of combined fine needle aspiration (FNA) and ultrasonography in the diagnosis of impalpable breast lesions. METHOD: To analyze the diagnostic performance of the FNA cytology and ultrasound among female patients with impalpable breast lesions that were referred to the FNA clinic at King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University in Bangkok, Thailand during the period of July 2001 to June 2002. The final diagnoses employed surgical pathology and 6-month follow-up of the patients. RESULT: In a-year-period of the studied frame, there were 57 studied cases (18.3% of the total FNA breast cases). To diagnose malignant lesions, FNA cytology achieved the sensitivity of 61 per cent and the specificity of 100 per cent, whereas, diagnostic radiology had a sensitivity of 100 per cent and specificity of 56.1 per cent. The FNA cytology was superior to ultrasound in the determination of inflammatory lesions while imaging was dominant in the hard-to-aspirate malignant lesions. Therefore, the combined cyto-radiology criteria could correctly diagnose malignancy in all cases (100% accuracy). CONCLUSION: The efficacy of combined FNA and ultrasonography in the diagnosis of impalpable breast lesions was highly satisfactory. The accuracy of each technique enhanced each other and gave the correct diagnosis in all cases. (NO 12930001)

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Year 2002

AU : Lertsanguansinchai P, Chottetanaprasith T, Chatamra K, Sampatanukul P, Wannakrairot P, Rojpornpradit P, Shotelersuk K, Lertbutsayanukul C, Boonjunwetwat D, Vajragupta L.
TI : Estrogen and progesterone receptors status in Thai female breast cancer patients : an analysis of 399 cases at King Chulalongkorn Memorial Hospital.
JN : J Med Assoc Thai 2002 Jun ; 85 (Suppl 1) : S193-S202
EN-AB: A retrospective review was performed on 576 patients who have been diagnosed breast cancer and referred to Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between January 1995-September 2001. There were three hundred ninety nine cases of invasive breast cancer that available for estrogen (ER) and/or progesterone (PR) receptor status. The mean and median age in our study were 49.6 year and 49.0 year respectively. About 60.9 per cent of the patients were pre and peri-menopause and 37.8 per cent were post-menopause. Most of the histological cell type were invasive ductal carcinoma which comprised of 92.7 per cent. Histologic grading were nearly equal for moderately and poorly differentiated grade: 43.66 per cent and 40.66 per cent. The results of our study showed 53.4 per cent of 399 patients had ER positive and 42.1 per cent of 380 patients had PR positive. The proportion of ER+PR+, ER+PR-, ER-PR+, and ER-PR- were 36.31 per cent, 15.53 per cent, 5.79 per cent and 42.37 per cent respectively. Older age and post-menopause women had higher ER+. While patients with increase tumor size, poorly differentiated grading, increase positivity of axillary lymph nodes and higher stage have more chance of ER negative and PR negative. (NO 07577)

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Year 2001

AU : Boonjunwetwat D, Sungtong P, Rojanasakul A.
TI : Defecography in patients with anorectal disorders : a study in 27 cases.
JN : J Med Assoc Thai 2001 Aug ; 84 (8) : 1097-1102 (NO 07138)

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Year 2000

AU : Boonjunwetwat D, SaetiewD, Sampatanukul P.
TI : Mixed invasive lobular carcinoma/invasive ductal carcinoma (ILC/IDC) of the breast.
JN : Chula Med J 2000 พ.ค. ; 44 (5) : 363-370
EN-AB: A case of breast carcinoma with mixed histologic subtypes composed of invasive lobular carcinoma and invasive ductal carcinoma is reported. The incidence is rare, about 2 per cent of breast cancers. In many published series these two histologic subtypes had different mammographic features. The imaging of this case, including mammography and ultra-sonography, were evaluated corresponding with the histopathology. The mammography showed a bilobed mass, one pole was invasive ductal carcinoma with a rounded hyperdense mass, the other pole was invasive lobular carcinoma with an isodense mass with a spiculated border. The ultrasonography showed an ill defined, lobulated low echoic mass with an irregular echogenic rim and posterior shadows suggestive of malignancy. There is no specific ultrasonographic feature of these two subtypes.,
TH-AB: รายงานผู้ป่วยมะเร็งเต้านม 1 ราย ที่เกิดจากเซลล์มะเร็ง 2 ชนิดร่วมกัน ได้แก่ Invasive lobular carcinoma และ Invasive ductal carcinoma: ซึ่งเป็นภาวะที่พบน้อย มีอัตราการเกิดร่วมกันประมาณ 2 เปอร์เซ็นต์ ของมะเร็งเต้านม ในรายงานนี้ได้เสนอลักษณะภาพแมมโมแกรม และอุลตราซาวด์ร่วมกับลักษณะทางพยาธิ ภาพแมมโมแกรมของก้อนมะเร็งมีลักษณะเป็นก้อนที่มี 2 ขั้ว ขั้วหนึ่งเป็นก้อนกลมมีพยาธิพบเป็น invasive ductal carcinoma อีกขั้วหนึ่งของก้อน มีลักษณะเป็นก้อนที่มีขอบเขตไม่เรียบ (spiculated) มีพยาธิพบเป็น invasive lobular carcinoma ลักษณะที่พบนี้แสดงให้เห็นว่ามะเร็งชนิด invasive ductal carcinoma และ invasive lubular carcinoma จะให้ลักษณะภาพแมมโมแกรมที่ต่างกัน ซึ่งสอดคล้องกับรายงานอื่นๆ ส่วนภาพอุลตราซาวด์ของก้อนมะเร็งนี้พบมีลักษณะเป็นก้อนเนื้อที่มี echo ต่ำ (hypoechogeni-city) มีขอบเขตไม่เรียบ ขอบหนาไม่ชัดเจน มีแถบดำบริเวณด้านหลังก้อน (posterior shadows) ลักษณะเหล่านี้ชี้บ่งว่าเป็นมะเร็ง แต่ภาพอุลตราซาวด์ไม่สามารถแสดงถึงความแตกต่างของมะเร็งทั้ง 2 ชนิดนี้. (NO 06380)

AU : Boonjunwetwat D, Prathombutr A.
TI : Imaging of benign papillary neoplasm of the breast : mammographic, galactographic and sonographic findings.
JN : J Med Assoc Thai 2000 Aug ; 83 (8) : 832-838 (NO 07018)

AU : Chaiwatanarat T, Apinyanurak C, Boonjunwetwat D, Chatamra K, Poshyachinda M.
TI : Breast cancer detection with 99mTc MIBI imaging and mammography.
JN : Asean Journal of Radiology 2000 ; 6 : 73-82 (NO 07644)

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Year 1999

AU : Boonjunwetwat D, Mookdadilok O.
TI : Peripheral aneurysms with a review of the literature.
JN : The Asian Journal of Radiology 1999 Jan-Apr ; 1 : 9-17 (NO 05629)

AU : Boonjunwetwat D, Vajarapongse K, Keeratikasikorn W, Sampatanukul P.
TI : Occult breast carcinoma presenting with axillary metastases (A case report with literature reviews).
JN : The Asian Journal of Radiology 1999 Jan-Apr ; 1 : 19-26 (NO 05630)

AU : Boonjunwetwat D, Isarankura P, Sampatanukul P.
TI : Radial scar with microcalcification Mammographic-pathologic correlation : case report.
JN : J Med Assoc Thai 1999 Apr ; 82 (4) : 405-409 (NO 05631)

AU : Boonjunwetwat D, Thaiarte N.
TI : A report of four cases of Hemophiliac Bone Pseudotumors.
JN : Journal of the Medical Association of Thailand 1999 Jan ; 82 (1) : 89-95
EN-AB: Four cases of proved hemophiliac pseudotumors caused by intraosseous bleeding are reported. Five lesions were found at the uncommon locations involving the cranial vault, mandible, phalanx, distal femur and distal tibia. The conventional radiographic and computed tomographic findings are expansile osteolytic destruction, cortical thinning, partial breaking cortex or pathological fracture, and sometimes associated soft tissue mass. Ultrasonographic feature of one case at the phalanx shows cortical expansion and thinning contained mixed echogenicity in the medullary canal with soft tissue extension. T99m DTPA of one case at the distal femur shows increased vascular flow and uptake at right distal tibia and left distal femur. (NO 05632)

AU : Boonjunwetwat D.
TI : Mammographic parenchymal patterns in thai woman.
BK : RST'99 36th Annual Scientific Meeting 1999 : 39-42 (NO 05633)

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Year 1998

AU : Boonjunwetawat D, Phunchana L.
TI : MRI of pyogenic spondylitis : cases reports.
JN : จุฬาลงกรณ์เวชสาร = Chulalongkorn Medical Jouranl 1998 Mar ; 42 (3) : 198-206
EN-AB: We report the MRI features of four cases of proven pyogenic spondylitis. Several studies have shown that the sensitivity of MRI for detection of osteomyelitis is equal to, or exceeds, 3-phase technitium-99m methylene diphosponate (99mTc-MDP) and galium-67 citrate (67 Ga) scintigraphy. MRI has been found to be better than CT scans for imaging spondylitis and vertebral osteomyelitis because of its ability to depict the anatomy, including the disc space, the spinal canal and its contents, and the paraspinal regions. (1) Early diagnosis and prompt treatment are essential to prevent permanent neurologic deficit and/or spinal deformity. (NO 05616)

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Year 1997

AU : Boonjunwetwat D, Hojan O.
TI : Heperechoic dots and small fat densities US and CT signs of xanthogranulomatous cholecystitis : a case report.
JN : Asean Journal of Radiology 1997 Jan-Apr ; 3 (1) : 125-129 (NO 04936)

AU : Boonjunwetawat D.
TI : MRI of hepatobiliary system.
JN : Chula Med J = จุฬาลงกรณ์เวชสารChulalongkorn Medical Journal 1997 Sep ; 41 (9) : 679-693
EN-AB: MRI has been accepted to be an effective imaging tool in evaluation of the hepatobiliary disease. MRI helps to detect the small or early lesion. The most useful ability is to clarify the nature of the liver lesion presenting with mass, consequently the hepatoce11ular carcinoma and hemagioma can be differentiated. The evolution of the advanced technology by setting up a variety of the new pulse suquences provides more capability in distinguishing the pathology. A great beneft was gained by the development of MR angiography (MRA) and MR cholangio pancreatography (MRCP) for evaluation of the vascular and biliary diseases. Owing to their noninvasive procedures and easy performances give a promising for the routine screening use. In the future trend, the more aggressive investigations including PTC, ERCP and angiography would be reduced. On the otherhand, there are some 1imitations for MRI. Besides its expensive cost, the quality of the images is quite depended on the palient's status as well as the scanning techniques. The motion would create a lot of artifact shadows which is the big prob1em for interpretation. (NO 05095)

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Year 1996

AU : Boonjunwetawat D.
TI : Recent advances in GI imaging.
JN : จุฬาลงกรณ์เวชสาร = Chulalongkorn Medical Journal 1996 Dec ; 40 (12) : 973-977
EN-AB: The imaging methods for investigation of the abdominal organs have been evoluted with high technology of the instruments. Basically, the conventional methods including fluorocopy, US, CT and angiography still pay important roles for the diagnostic work up. Now a days, the new imaging methods are introduced leading to the expansion of the field of investigation. The development of the anvanced machines which would promise to be dispensible in the future trend are digital fluoroscopy, color doppler and power doppler, spiral CT and advanced MRI. The benifits that these machines provide are easy to perform, noninvasive procedures, decreased risks of radiation exposure and contrast injection, as well as the great values for the diagnosis, consequently, the invasive procedures such as PTC, ERCP and angiography would be avoided or less necessary. On the other hand, the high technology would bring the high expense that the patients deserve to pay. (NO 03116)

AU : Boonjunwetwat D.
TI : A case report : splenic epidermoid cyst.
JN : Asean Journal of Radiology 1996 May-Aug ; 2 (2) : 61-64 (NO 04935)

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Year 1995

AU : Boonjunwetwat D.
TI : Guest editor of the radiology, editorial.
JN : Chulalongkorn Medical Journal 1995 ; 39 (1) : 1-2 (NO 02123)

AU : Futrakul P, Boonjunwetwat D, Pochanugool C, Sitprija V, Futrakul N, Trakarnvanich T.
TI : Renal vein thrombosis in a severe form of renal disease [letter].
JN : Am J NephrolAmerican Journal of Nephrology 1995 ; 15 (4) : 364-6 (NO 03331)

AU : Futrakul P, Futrakul N, Pochanugool C, Sitprija V, Boonjunwetwat D.
TI : Renal vein thrombosis in chronic glomerulonephritides.
CONF : Abstracts, Themes & Topic Sessions XIIIth ICN, Madrid, July 2-6, 1995 1995 : 262 (NO 03930)

AU : Boonjunwetwat D, Stapatayawong V.
TI : Conventional contrast study in demonstration of branchial cleft fistula : a report of three cases with review of the literature.
JN : Asean Journal of Radiology 1995 Jan-Apr ; 1 (1) : 73-82 (NO 04937)

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Year 1994

AU : Boonjunwetwat D, Kengsurakarn S, Vajragupta L, Buachum V.
TI : Imaging of Caroli's disease : case report with review of literative.
JN : Chulalongkorn Medical Journal 1994 ; 38 (4) : 219-228
EN-AB: The diagnosis of Caroli's disease of an eight-month female infant was established by computer tomogram, ultrasound and hepatobiliar7 scintigraphy. The imaging clues were specifically demonstrated. CT, with strong contrast enhancement, showed the central dot sign within the saccular dilated intrahepatic bile ducts or multiple cyst-like structures. US showed muliple cysts with central tubular and dot echoes representing protrusion and bridge formation in the dilated intrahepatic bile ducts. The Tc-99m-IODIDA hepathobiliary scan confirmed through excretion of the radiotracer into the cystic structures that the muliple cysts in the liver were non-obstructive cystic dilatation of the bile ducts. (NO 02144)

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Year 1993

AU : Kasantikul V, Boonjunwetwat D, Suwangool P.
TI : Prolactin cell carcinoma of the pituitary.
JN : Journal of the Medical Association of Thailand 1993 ; 76 (4) : 230-237
EN-AB: Two patients with malignant prolactinoma are reported. The diagnosis of malignancy depends on the demonstration of invasion of brainstem and subarachnoid space and on the presence of marked cellular pleomorphism and mitotic activity Review of the literature revealed that such malignant tumors were more common in men than in women. The most frequency intracranial sites of metastases were frontal and occipital lobes, and cerebellum. The possibility of radiation-induced carcinomatous transformation is discussed. (NO 02016)

AU : Vajragupta L, Vasuratna B, Vajarapongse K, Boonjunwetwat D.
TI : Ultrasonographic findings of pancreatic carcinoma.
JN : Chulalongkorn Medical Journal 1993 ; 37 (10) : 609-618
EN-AB: The ultrasound examinations of 43 patients with proven adenocarcinoma of pancreas were reviewed. Pancreatic masses were detected in 33 patients. Pancreatic duct and biliary tract obstruction were seen in 20 and 33 patients respectively. Liver metastasis were identified in 10 patients and missed in10, while regional lymphadenopathy were detected in 14 and missed in 12. Each of portal vein involvement, psoas muscle metastasis and ascites were seen. There was one patient whose ultrasound study was normal. The accuracy rate was 76.7 per cent. The usefulness of ultrasonography as the primary and effective method of investigation is discussed. (NO 02795)

AU : Boonjunwetwat D, Sathaphytayavongs V, Kosolbhand P.
TI : Conventional contrast study in demonstrating branchial cleft fistula : a report of three cases with review literature.
CONF : Proceedings in Annual Scientific Meeting of Radiological Society of Thailand 1993 1993 (NO 03913)

AU : ดรุณี บุญยืนเวทวัฒน์.
TI : ก้าวใหม่ของการตรวจด้านการเห็นภาพในออร์โทปิดิกส์ (บทบรรณาธิการ).
JN : Chula Med J = จุฬาลงกรณ์เวชสารChulalongkorn Medical Journal 1993 Oct ; 37 (10) : 599-600 (NO 04209)

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Year 1992

AU : Kladchareon N, Chusil S, Boonjunwetwat D, Pongsabutra S.
TI : Clinicopathological conference middle-aged woman with hepatic and renal failure.
JN : จุฬาลงกรณ์เวชสาร = Chulalongkorn Medical Journal 1992 ; 36 (2) : 143-154
EN-AB: A 49-year-old non-alcoholic woman presented with progressive hepatic disease of one-year duration. The final clinical course was marked with complications of advanced liver disease and progressive renal failure. Clinical differential diagnosis was discussed and patholo-gical findings at autopsy were presented. (NO 02704)

AU : Shuangshoti S, Boonjunwetwat D, Kaoroptham S.
TI : Association of primary intraspinal meningiomas and subcutaneous meningioma of the cervical region: case report and review of literature..
JN : Surgical Neurology 1992 Aug ; 38 (2) : 129-34
EN-AB: A report is made of a unique combination of occurrences of primary intraspinal epidural and subdural meningiomas and primary subcutaneous meningioma in the cervical region of a 15-year-old boy. The subcutaneous meningioma was detected at birth. Review of 92 recorded cases of primary dermal meningiomas revealed that they tended to occur in young patients, with an average age of 34 years for both sexes. The female-to-male ratio was 4:5. Most cutaneous meningiomas occurred in the head and neck, and the scalp was the most common site. (NO 02895)

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Year 1991

AU : Vajarpongse K, Bunjunwetwat D, Kaengsurakran S, Vajragupta L.
TI : CT scan and ultrasonic characteristie imaging of renal cell carcinoma.
JN : จุฬาลงกรณ์เวชสาร = Chulalongkorn Medical Journal 1991 ; 35 (10) : 651-661
EN-AB: The computerized tomographic (CT) and ultrasonographic (US) findings of 10 cases of renal cell carcinoma were reviewed. US was performed in nine patients (1O tumors); most of the findings (6 out of 10) were of a mass with complex echoes of mixed solid and cystic components. Three tumors were cystic in form, showing the characteristic appearance of a thick-walled cyst with echoic septation and growth projection containing internal bright echoes. Only one case showed multiple hyperechoic masses in the same kidney. CT was performed in eight patients (9 tumors). Characteristic findings were well-defined masses of mixed density. Six out of the nine tumors were mainly slightly more hyperdense than normal renal parenchyma on plain CT, showing patchy enhancement of a less than normally enhanced renal cortex. The other three cases were well-defined, thick- walled cysts, with septation and peripheral rim enhancement. All tumors were intrarenal masses, except one retroperitoneal mass which occurred following a previous nephrectomy for renal cell carcinoma of the left kidney. All involved kidneys preserved their excretory function. Only one case showed calcification in both the US and CT images. (NO 02693)

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Year 1990

AU : Suvichanvorasin M, Kasantikul V, Boonjunwetwat D, Leewongcharoen C.
TI : Abdominal actinomycosis : report of two case.
JN : Chula Med J 1990 Sep ; 34 (9) : 705-711
EN-AB: Two cases of abdomina actinomycosis are reported. Both patients presented with abdominal masses which were mistaken for malignancy on clinical ground. Pathologically the lesions consisted of dense fibrous connective tissue and granulation tissue mingled with abscesses. Indentification of bacterial colonies was essential to establish the diagnosis. (NO 02441)

AU : Boonjunwetwat D.
TI : Ultrasound diagnosis of biliary system.
JN : Chula Surg Proc = ว.ศัลยศาสตร์จุฬาChula Surgical Proceedings 1990 Jan-Feb ; 6 (1) : 5-9 (NO 04938)

AU : Boonjunwetwat D.
TI : Ultrasound diagnosis of liver diseases.
JN : Chula Surg Proc = ว.ศัลยศาสตร์จุฬาChula Surgical Proceedings 1990 Mar-Apr ; 6 (2) : 35-44 (NO 04939)

AU : Vajragupta L, Vajarapongse R, Pipatchaisiri S, Boonjunwetwat D.
TI : Imaging of renal abscesses.
JN : Chula Med J = จุฬาลงกรณ์เวชสารChulalongkorn Medical Journal 1990 Aug ; 34 (8) : 587-599
EN-AB: We retrospectively reviewed sonographic, excretory urographic and computed tomographic appearances of renal abscesses in 17 patients during January 1984 to June 1989. Each patient had sonography; 11 had excretory urography and 8 computed tomography. The most common sonographicfindings were an inhomogeneous hypoechoic well-defined mass with through transmission (12/17). The remaining soriographic patterns were thick-walled cysts with internal echo in 4, diffuse enlarged kidney with inhomogeneous parenchymal echo in 2, perinephric collection in 2, subcapsular collection in 1 and splenic extension in l. The excretory urography showed mass effect upon the pelvicalyceal system in 9 patients and faint excretion with enlarged kidney in 2 patients. 1he computed tomography revealed low-density mass with rim enhancement in 5 and without rim enhancement in 2 patients, thick-walled cyst with septation in 1, thickening of the Gerota's fascia in 5, edematous perirenal fat in 3, subcapsular collection in 2, perinephric collection in 2 and splenic extension in 1. Excretory urography is not a sensitive and specific method for visualizing small abscesses of the kidney. The number of positive excretory urogram increases as the mass becomes larger and more defined. Sonography is the fastest, least expensive and accurate method that can be used to identify and follow up renal abscess. The examination is not affected by poor renal function or allergy to contrast material. Percutaneous diagnostic needle aspiration and drainage by sonographic guidance can provide specific cytologic or bacteriologic proof of infection. Computed tomography is an expensive modality but it provides the most precise anatomic localization of the lesion. Computed tomography is help l in acutely or critically ill patients with high suspicions of renal abscess and uncertain sonographic findings. (NO 04940)

AU : Pungrassami P, Boonjunwetwat D, Arjhansiri K, Sampatanukul P.
TI : Pedunculated hepatocellular carcinoma : a report of three cases in Thailand.
JN : Chula Med J = จุฬาลงกรณ์เวชสารChulalongkorn Medical Journal 1990 Aug ; 34 (8) : 613-624
EN-AB: Pedunculated hepatocellular carcinoma is an unusual entity with its extrahepatic growth, high resectability and good prognosis. Three cases are reportedpom Thailand with review of available literatures. The 76, 73 and 56 year-old male patients presented with abdominal mass, anorexia and weight loss of at least I year-duration. The US and CT of the 3 cases showed protrusion of the mass from inferior surface of the liver. Hepatic angiogmms of case No. and No.3 revealed arterial supply mainly from left and right hepatic arteries respectively. Awareness of this condition is necessary for early diagnosis and selection of surgical procedure. Presence of pedicle invasion, hepatic or portal vein thrombosis are determining factors for prognosis and adjuvant therapy. (NO 04941)

AU : Boonjunwetwat D, Treretanakulwongs J, Chomdej S, Vajarapongse K, Vajragupta L.
TI : The sonographic features of the retroperitoneal masses in infants and children.
JN : Chula Med J = จุฬาลงกรณ์เวชสารChulalongkorn Medical Journal 1990 Sep ; 34 (9) : 691-704
EN-AB: Sonograms of 23 infants and children with retroperitoneal mass were re rospectively reviewed, including 14 Wilms' tumors, 4 neuroblastomas, 3 teratomas and 2 lymphomas. The following sonographic criteria : size, location, internal echo pattern, anechoic areas, margination and the presence of hepatic metastasis were evaluated separately in each entity of disease. Most of the sonographic features of Wilms' tumor were large-sized, sharply marginated and echogenically heterogeneous with anechoic areas located at the kidney. In all cases of neuroblastomas, the mass was an inhomogeneously echoic solid mass of extra-renal origin; the presence of tumor calcification and hepatic metastases were presented in three of four cases. Three cases of teratomas showed the sonographic characteristics as a large, well-defined complex mass containing solid and cystic components with calcification. In two cases of non-Hodgkin's lymphoma; one with mass at the paraaortic area showed multiple, lobulated, low echoic masses representing lymph node enlargement. The other mass primarily arising from the cecum showed a target lesion. The spectrum of sonographic features of these retroperitoneal masses and the diagnostic value of sonography are discussed. (NO 04942)

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Year 1987

AU : Vajarapongse K, Boonjunwetwat D, Taecholarn C, Khaoroptham S, Vajragupta L, Chayapum P.
TI : Value of ultrasonography in the evaluation of spinal dysraphism.
JN : Chula Med J 1987 Jan ; 31 (1) : 35-46
EN-AB: Ultrasonograms of eleven children with the clinical diagnosis of spinal dysraphism were retrospectively analysed. The study was correlated with clincal, operative and pathological findings. The spinal abnormalities demonstrated by ultrasound included spina bifida in 10 cases, lipomyelomeningocele in 6, myelomeningocele in 2, meningocele in one, dermoid in one, and epidermoid cyst with hydromyelia in one. The case of dermoid tumor was misdiagnosed by ultrasound to be lipoma and the case of epidermoid cyst with hydromyelia was misdiagnosed as lipomyelomeningocele. in addition, the other abnormalities demonstrated by ultrasound were neurogenic bladder with bilateral hydronephrosis in two cases and severe hydrocephalus in one. it is concluded that ultrasound examination should be used as an initial diagnostic modality for the evaluation of infants and children with minimal cutaneous stigmata or clinical signs of spinal dysraphism. However ultrasonography has a limited use, and computed tomography is generally accepted as the preferable method of examination in older children with intact bony spinal canal and in doubtful cases. (NO 00426)

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Year 1986

AU : Vajarapongse K, Boonjunwetwat D, Vajragupta L, Tanphiphat C.
TI : Ultrasonographic evaluation of the single thyroid nodule.
JN : J Otolaryngol Head Neck Surg (Thai) 1986 Jul ; 1 (2) : 67-81
EN-AB: Ninety four patients with single thyroid nodule were examined by ultrasound at Chulalongkorn Hospital from January 1981 to December 1983. Ultrasonographic characteristics of the thyroid nodules were correlated with the pathology after excisional surgery. Of the 94 nodules, there were 55 adenomas, 23 adenomatous goiters, 12 carcinomas and four cysts. The ultrasonographic patterns of the 55 adenomas showed 32 (58.2 per cent) solid, six (30.9 per cent) complex nodules. The presence of peripheral sonolucent zone(halo) surrounding the thyroid mass was observed in 39 (70.9 per cent) adenomas. Of the 23 adenomatous goiters, ultrasound showed five (21.7 per cent) solid, four (17.4 per cent) cystic, eight (34.8 per cent) multinodular goiters and six (26.1 per cent) complex nodules. One complex nodule was partially calcified. The halo sign was found in 11 (47.8 per cent) nodules. The ultrasonographic patterns of 12 carcinomas were five (41.7 per cent) solid, six (50 per cent) complex and one (8.3 per cent) thick walled cystic nodule. The halo sign was present in three (25 per cent) nodules. (NO 00150)

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Year 1985

AU : Boonjunwetwat D, Vajarapongse K, Vajragupta L.
TI : Ultrasonic and computed tomographic appearances of hepatic melioidosis.
JN : Chula Med J 1985 Dec ; 29 (12) : 1341-1348
EN-AB: Five cases of hepatic melioidosis were evaluated by ultrasonography which showed difference appearances. Two cases showed numerous small rounded low or anechoic lesions in the liver. One case showed multiple low and high echoic lesions. One case showed a complex mass and the last case showed no detectable abnormality. CT was performed only in one case and showed diffused small rounded low density areas in the liver. (NO 01239)

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Year 1969

AU : Suwanwela C, Boonyunwetwat D, Suwanwela N, Intakorn E, Kongmebhol V, Boonruxa U, Loharnchun Y.
TI : ประสบการณ์ทางการแพทย์ที่ตำบลหนองรี จังหวัดกาญจนบุรี
JN : Chula Med J 1969 Jan ; 14 (1) : 22-34
TH-AB: การส่งแพทย์เคลื่อนที่ออกไปปฏิบัติงานในท้องถิ่นทุรกันดารนั้น, นอกจากจะได้ประโยชน์ตามวัตถุประสงค์ในการบำบัดโรคให้แก่ประชาชนแล้ว ยังมีผลพลอยได้คือประสบการณ์ของแพทย์ที่ออกปฏิบัติการด้วย ทำให้ทราบถึงความต้องการด้านการแพทย์ของประชาชนในท้องถิ่นนั้น ๆ. ทั้งนี้ย่อมเป็นประโยชน์ในการพิจารณาการพัฒนา การพัฒนาการแพทย์และการศึกษาแพทย์ให้เหมาะสมกับความต้องการของประเทศ คณะแพทย์ที่ออกปฏิบัติงานในหน่วยของคณะกรรมการกลางรักษาความปลอดภัยแห่งชาติชุดที่ 30 มีความเห็นว่า. น่าจะบันทึกประสบการณ์ไว้ เพราะอาจจะเกิดประโยชน์ได้บ้างแม้จะเป็นการสำรวจทางการแพทย์อย่างตื้น ๆ ก็ตาม (NO 01395)

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