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Year 2006

JN : Biol Reprod. 2006 Mar;74(3):577-84. Epub 2005 Dec 7.
TI : Bovine NALP5, NALP8, and NALP9 genes: assignment to a QTL region and the expression in adult tissues, oocytes, and preimplantation embryos.
AU : Ponsuksili S, Brunner RM, Goldammer T, Kรผhn C, Walz C, Chomdej S, Tesfaye D, Schellander K, Wimmers K, Schwerin M.
EN-AB: A 3204-bp full-length cDNA of bovine NALP9 was cloned and its genomic organization was analyzed. The 2988-bp open reading frame covers 9 exons and encodes a deduced protein of 996 amino acids containing Pyrin, Nacht and leucine-rich repeat domains like the human NALP gene family members. Mapping with the WGRH5000 panel and fluorescence in situ hybridization assigned NALP9 in close vicinity to BM2078 (LOD score 25.71; distance 0.0 cR5000) on bovine chromosome 18, BTA18q25-q26, within a previously identified QTL region for reproductive traits flanked by the bovine marker BM2078 and TGLA227. BAC contig analysis revealed that NALP9, NALP8, and NALP5 map in this QTL region. Temporospatial expression of these members of the NALP gene family was monitored. Among the adult tissues examined, transcripts of NALP8 and NALP9 were detected exclusively in testis and ovary, whereas transcripts of the NALP5 gene are limited to the ovary. The transcripts of NALP9, NALP8, and NALP5 were detected in oocytes before and after in vitro maturation and with a gradual decline from 2-cell to 8-cell stage, suggesting no reactivation at the time of bovine maternal to embryonic transition. Assignment to a QTL region for reproductive traits and preferential expression of NALP9, NALP8, and NALP5 in oocyte, germinal lineage, and gonad cells may suggest their functional relevance to reproduction and possible contribution to phenotypic variation. (NO 16339045)

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Year 2005

JN : Anim Genet. 2005 Dec;36(6):477-83.
TI : SNP detection and genetic mapping of porcine genes encoding enzymes in hepatic metabolic pathways and evaluation of linkage with carcass traits.
AU : Ponsuksili S, Chomdej S, Murani E, Blรคser U, Schreinemachers HJ, Schellander K, Wimmers K.
EN-AB: We have previously identified and mapped porcine expressed sequence tags (ESTs) derived from genes that are preferentially expressed in liver. The aim of the present study was to identify single nucleotide polymorphisms (SNPs) in porcine genes encoding enzymes in hepatic metabolic pathways and use the SNPs for mapping. Furthermore, these genes, which are involved in utilization and partitioning of nutrients, were examined for their effects on carcass and meat quality traits by linkage analyses. In total, 100 ESTs were screened for SNPs by single strand conformation polymorphism analyses across a diverse panel of animals with a 36% success rate. Twelve of 36 polymorphic loci segregated in a three-generation Duroc x Berlin Miniature Pig (F2) resource population, the DUMI resource population, and were genetically mapped. Interval mapping of the corresponding chromosomes was performed to verify mapping of the genes within quantitative trait loci (QTL) regions detected in this resource population. QTL with genome-wide significance were detected in the vicinity of GNMT, ESTL147 and HGD. These loci therefore are positional candidate genes. (NO 16293120)

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Year 2004

JN : Anim Genet. 2004 Dec;35(6):469-70.
TI : Detection of SNPs and linkage and radiation hybrid mapping of the porcine C-reactive protein (CRP ) gene.
AU : Chomdej S, Ponsuksili S, Schellander K, Wimmers K. (NO 15566474)

JN : Anim Genet. 2004 Apr;35(2):151-2.
TI : Sequencing, SNP identification and mapping of the porcine PTHLH gene to chromosome 5.
AU : Chomdej S, Ponsuksili S, Schellander K, Wimmers K. (NO 15025584)

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Year 2001

AU : อัจฉรา มหายศนันท์, สุดี ชมเดช.
TI : Pediatric chest x-ray.
BK : Pediatric pulmonary & respiratory care : a current practice เล่ม 1โดย: อรุณวรรณ พฤทธิพันธุ์: ชมรมโรคระบบหายใจและเวชบำบัดวิกฤตเด็กแห่งประเทศไทย, 2001 : 76-90 (NO 07576)

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Year 1999

AU : Keelawat S, Chongsrisawat V, Poovorawan Y, RungruxsirivornS, Suwangool P, Karnsawai S, Chomdej S, Nivatvongs S.
TI : Pulmonary calcification after liver transplantation.
JN : Chula Med J 1999 ส.ค. ; 43 (8) : 569-576
EN-AB: We report here the case of a 5 11/12 year-old girl with extrahepatic biliary atresia who developed pulmonary calcification after orthotopic liver transplantation. She required multiple intra and post-operative blood transfusions. Previous reports of soft tissue calcification following liver transplantation were reviewed. The potential pathogenesis of pulmonary calcification in this patient was metastatic calcification whereas the cause issuing from dystrophic calcification could not be concluded because there was no firm evidence that this patient had pneumonia or any kind of lung injuries prior to the development of this pulmonary abnormality. Pulmonary calcification is usually benign and may not require specific treatment. However, this condition may be potentially progressive and cause fatal respiratory failure. Therefore, preventing its development is crucial.,
TH-AB: รายงานผู้ป่วยเด็กผู้หญิง อายุ 5 ปี 11 เดือน ซึ่งเป็นโรค extrahepatic biliary atresia ผู้ป่วยรายนี้ได้รับการปลูกถ่ายตับแล้ว ต่อมาภายหลังมีหินปูนมาเกาะในเนื้อปอด ผู้ป่วยได้รับการถ่ายเลือดหลายครั้งระหว่าง และหลังจากการผ่าตัดปลูกถ่ายตับ คณะผู้รายงานได้ทบทวนวรรณกรรมเรื่องภาวะหินปูนจับในเนื้อเยื่อในที่ต่าง ๆ ของร่างกายภายหลังได้รับการปลูกถ่ายตับ สำหรับภาวะหินปูนเกาะในเนื้อปอดของผู้ป่วยรายนี้ ผู้รายงานเชื่อว่าสาเหตุมาจาก metastatic calcification ส่วนสาเหตุจาก dystrophic calcification ไม่สามารถสรุปได้เพราะว่าไม่มีหลักฐานเพียงพอที่จะชี้ว่าผู้ป่วยเคยมีปอดอักเสบหรือภาวะอื่น ๆ ที่ทำให้มีการบาดเจ็บต่อเนื้อเยื่อปอดมาก่อนที่จะเกิดรอยโรคนี้ขึ้น โดยทั่วไปภาวะหินปูนเกาะในเนื้อปอดนี้มักไม่ก่อให้เกิดอันตรายต่อผู้ป่วย และอาจไม่ต้องทำการรักษาใด ๆ อย่างไรก็ตาม ในบางรายอาจทำให้เกิดอาการรุนแรงจนถึงขั้นเกิดอาการหายใจล้มเหลวได้ ดังนั้นการป้องกันการเกิดภาวะนี้จึงเป็นสิ่งสำคัญ. (NO 06478)

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Year 1992

AU : Taechakraichana N, Tannirandorn Y, Phaosavasdi S, Thaithumyanon P, Chomdej S.
TI : Antenatal sonographic diagnosis of lethal skeletal dysplasia. a case report.
JN : จุฬาลงกรณ์เวชสาร = Chulalongkorn Medical Journal 1992 Feb ; 36 (2) : 123-130
EN-AB: Fetal extremity abnormalities, especially lethal skeletal dysplasias, are rare. Antenatal sonography accurately depicts the fetal musculoskeletal system. Measurement of the fetal long bones permits detection of many skeletal dysplasias. Observation of the characteristic features of these may enable differentiation of many syndromes, thus making it possible for the sonographer to render an accurate antenatal diagnosis and prognosis. Such information will alert parents, obstetricians and pediatricians to potential perinatal problems and facilitate optimum management. We report a case of achondrogenesis, diagnosed in the early third trimester of pregnancy on the basis of sonographic visualizatinn of striking micromelia, poor vertebral body and sacral ossification but normal calvarial ossification. The diagnosis was confirmed after birth by post-mortem radiograph.
TH-AB: ภาวะ lethal skeletal dysplasias เป็นความพิการทางกระดูกของทารกที่พบได้น้อยมาก การตรวจวิน ิจฉัยทารกในครรภ์ด้วยคลื่นเสียงความถี่สูง สามารถบ่งบอกความผิดปกติขอ งโครงกระดูกทารก การวัดความยาวของกระดูกทารกในส่วนต่าง ๆ จะช่วยในการ วินิจฉัยโรค skeletal dysplasias ได้หลายชนิด ซึ่งจะช่วยให้แพทย์ผู้ดูแลทราบถึงความผิดปกติ  และสามารถพิจารณาดูแลรักษาที่เหมาะสม รวมทั้งให้คำปรึกษาแก่บิดามารด าได้ดียิ่งขึ้น ผู้รายงานนำเสนอกรณีตัวอย่างการตรวจทารกในครรภ์ด้วยคล ื่นเสียงความถี่สูง ในระยะต้นของไตรมาสที่สาม พบว่ามีกระดูกแขนขาสั้น มาก กระดูกส่วน vertebral body และ sacrum มี ossification ที่ลดลงอย่างผิดปกติ ในขณะที่ส่วนของกะโหลกศีรษะมี ossification ที่เป็นปกติ และได้ให้การวินิจฉัยในระยะก่อนคลอดว่าเป็น lethal skeletal dysplasias ชนิด achondrogenesis ซึ่งได้รับการตรวจวินิจฉัยยืนยันภายหลังคลอดทางรังสี วิทยา. (NO 02957)

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Year 1991

AU : Prapphal N, Limudomporn S, Watana D, Yenrudi S, Viravaidya D, Chomdej S, Cutchavaree A.
TI : Lymphomatoid granulomatosis with upper airway obstruction : a case report.
JN : J Med Assoc Thaiจดหมายเหตุทางแพทย์ 1991 Nov ; 74 (11) : 526-530
EN-AB: A case of lymphomatoid granulomatosis in a previously healthy 13-year-old Thai girl presenting with right sixth cranial nerve palsy and severe upper airway obstruction was reported. Cranial nerve palsy later disappeared spontaneously but the patient developed multiple pulmonary nodules and cavity leading to pulmonary insufficiency. Her course was complicated with septicemia which limited the use of corticosteroid and cytotoxic drugs. She finally expired with pseudomonas sepsis in addition to pulmonary and liver involvement. This is the first case of lymphomatoid granulomatosis in a child ever reported in Thailand. Lymphomatoid granulomatosis should be included in the differential diagnosis of upper airway obstruction with pulmonary nodules and cavity and multi-organ involvement in children. (NO 04649)

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Year 1990

AU : Chittmittrapap S, Chatwiriyacharoen W, Chere W, Chomdej S.
TI : Intestinal pseudo-obstruction caused by visceral myopathy.
JN : จุฬาลงกรณ์เวชสาร = Chula Med J 1990 Dec ; 34 (12) : 975-983
EN-AB: Intestinal pseudo-obstruction is a condition of intestinal dysmotility with apparent intestinal obstruction, but without any mechanical cause. It has been described in association with a wide variety of both systemic and gastrointestinal disorders in adult but more commonly it is the primary dysfunction of the intestine in children. Visceral myopathy is a rare entity with the abnormalities in the smooth muscle which may involve either gastrointestinal or genitourinary system or both. Successful treatment in intestinal pseudo-obstruction caused by visceral myopathy has been limited but the understanding of the pathophysiology, the diagnosis and the management are still challenging. (NO 02448)

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 1989

AU : Limudomporn S, Prapphal N, Nunthapisud P, Chomdej S.
TI : Afebrile pneumonia associated with chlamydial infection in infants less than 6 months of age : initial results of a three year prospective study.
JN : Southeast Asian J Trop Med Public Health 1989 Jun ; 20 (2) : 285-290
EN-AB: During the year 1986-1988, 112 infants younger than 6 months of age with the diagnosis of afebrile pneumonia were studied at Chulalongkorn Hospital, Bangkok, Thailand. Thirty cases (26.78 per cent) were caused by Chlamydia trachomatis. The clinical and laboratory findings which differed significantly from pneumonia caused by other organisms included longer duration of symptoms (greater than 1 week), younger age of onset (less than 12 weeks), history of conjunctivitis after birth, no wheezing detected, white blood cell count greater than or equal 10,000 cell/ul with eosinophilic count greater than or equal 300 cells/ul and reticulonodular infiltration on the chest X-ray. (NO 01697)

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Year 1988

AU : Suwanwela N, Lertlum S, Phanuphak P, Hanvanich M, Jimarkorn P, Vajarapongse K, Chomdej S, Vajaragupta L, Hemachudha T, Locharernkul C.
TI : Radiologic aspects of AIDS in Thailand.
JN : Chula Med J 1988 Jan ; 32 (1) : 43-58
EN-AB: An increasing number of patients with acquired immunodeficiency syndrome (AIDS) has been reported in Thailand. Radiologic findings including CT scan and ultrasonographic findings were studied in 7 out of a total of 11 AIDS patients from November 1984 to August 1987. Chest x-ray films were abnormal in all cases of which 4 were proven to be pneumocystis carinii pneumonia, 2 to be tuberculosis and one of no definite diagnosis. Radiologic features of pneumocystis carinii pneumonia were bilateral perihilar, basilar, diffuse reticulonodular infiltration, consolidation and atypical upper lobe infiltration. In tuberculosis, upper lobe infiltration and mediastinal node enlargement were seen. Diffuse mucosal plaques, irregular enlarged folds and ulceration were demonstrated in upper gastro-intertinal tract studies in three patients with Candida esophagitis. Evidences of cholecystitis in both CT scan and ultrasonography were seen in a patient with jaundice. He also had hypoechoice lesions in the liver, spleen and kidneys which later disappeared. On CT scan, two patients had evidences of mild degrees of cerebral atrophy. Another patient with AIDS-related complex (ARC) showed evidences of retroperitoneal node enlargements on CT scan and ultrasonography. Inhomogeneous density of cervical spinal cord and evidences of brain atrophy in this patient were also demonstrated on CT scan. (NO 01551)

AU : Chittmittrapap S, Chandrakamol B, Chomdej S.
TI : Intramural haematoma of the alimentary tract in children.
CONF : Biennial Congress of the Association of Surgeons of Southeast Asia. 6th, 1987 Feb, Bangkok, Thailand
JN : Br J Surg 1988 Aug ; 75 (8) : 754-757
EN-AB: Thirteen children with intramural haematoma of the alimentary tract were treated in Chulalongkorn University Hospital during an 8-year period (1978-1986). A history of trauma was obtained in 11 cases, 1 case presented as a result of a coagulation defect secondary to a haematotoxic snake bite and no causative factor was apparent in 1 patient. Profound vomitting with abdominal pain is the typical presentation. Upper gastrointestinal contrast study is usually characteristic and diagnostic. Conservative treatment was successful in 12 of the cases with no morbidity and mortality. (NO 01563)

AU : Chomdej S.
TI : Giant cardiothymic shadow in neonate with pectus excavatum.
JN : Journal of the Paediatric Society of Thailand 1988 ; 27 (1) : 71-76
EN-AB: Thoracic cage deformity presented as the pectus excavatum (funnel chest, straight back syndrome) is not uncommonly found and mostly is the incidental finding on physical check-up. On routine chest radiograph of frontal projection usually found as the cardiomegaly with clear demonstration of body of the lower thoracic spine. Since its narrowing of the anteroposterior diameter of the chest, this accentuated the size of the mediastinum mass and the cardiac shadow which often leading to the false interpretation as the mediastinal mass and cardiomegaly. The neonate in this presentation was suffering from the respiratory distress since birth. The frontal chest radiograph at six hours of age showed and huge mediastinal mass fully occupied the thoracic cavity. At two days of age, large pneumothorax was noted but the size of cardiac shadow was normal and the mediastinal mass disappeared. Follow-up chest radiograph at the age of 4 months, both frontal and true lateral views revealed a huge cardiothymic shadow resembling the first radiograph taken after birth. Anterio-posterior depression of the sternal bone with marked narrowing of the A-P diameter of the chest were also noted, combined with straightened thoracic spine which is compatible with " Pectus excavatum ". (NO 02076)

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Year 1987

AU : Chomdej S.
TI : Roentgenographic detection of bone changes in lead poisoning.
JN : Chula Med J 1987 Jan ; 31 (1) : 5-13
EN-AB: A roentgenographic survey for bone changes was carried out on 62 children who lived in an area contaminated by lead from batteries discarded 3 years ago on a dirty mud-road. The radiographic study of lead line was obtained by frontal projection of the knee. Children aged 3 months - 9 years were found to have had definite lead line in 36/62 cases but only 3/19 cases in older children (10-16 year of age). One young child presentd with underconstriction as the severe bone change. Blood lead were from 10-13,000 microgram per cent and did not correlate with the current lead line density nor with the basophilic stippling. Eosinophilia were found but their causes were not determined in this study. The sensitivity of lead line in bone radiograph was found to be reliable in young children under ten years. (NO 00154)

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Year 1986

AU : Chittmittrapap S, Chandrakamol B, Chomdej S, Poovorawan Y.
TI : Intramural hematoma of duodenum.
JN : Chula Med J 1986 Oct ; 30 (10) : 1037-1050
EN-AB: Intramural hematoma of the alimentary tract is a condition which has been sporadically commented upon in the world literature. This localized collection of blood, extravasated into the subserosal and interstitial tissues of the intestine is more commonly found in children. Most cases has occurred as a result of trauma. Correct diagnosis is based on the history, physical examination and radiological study, especially an upper gastrointestinal contrast study. This condition can be successfully treated by a conservative method. Two cases with different clinical presentations were discussed. (NO 00601)

AU : Chittmittrapap S, Chandrakamol B, Chomdej S, Parkpian V, Phisitbutr M, Poovorawan Y.
TI : Psoas abscess presenting as abdominal mass.
JN : Chula Med J 1986 Jul ; 30 (7) : 687-701
EN-AB: A seven-year-old boy came to the hospital with a complaint of abdominal and flank pain. Abnormal mass was found in his lower abdomen and a psoas abscess was diagnosed by means of physical examination and radiological study. The etiology was definitely established to be tuberculous, resulting from tuberculosis of the lumbar spine. An understanding of the anatomy of the psoas muscle with its fascial covering and relations to the nearby structures is essential for the successful diagnosis and operation, the details of which are discussed. (NO 00606)

AU : Chittmittrapap S, Poovorawan Y, Chandrakamol B, Suwangool P, Chomdej S.
TI : Neuroblastoma with normal urinary catecholamine excretion.
JN : Chula Med J 1986 Aug ; 30 (8) : 787-799
EN-AB: This paper describes an unusual finding in a case of metastatic neuroblastoma to the liver in a two month-old infant. He presented with a severe abdominal enlargement and the clinical presentation was suggestive of hepatoblastoma. The alpha fetoprotein was negative although the liver scan and ultrasonogram suggested a tumor of the liver. Intravenous pyelogram reported an intrarenal mass. The urinary excretion of 3-methoxy-4-hydroxy vanillyl mandelic acid (VMA) was normal. Metastatic neuroblastoma was diagnosed histologically from the liver tissue and was later confirmed by autopsy. Normal VMA and severely enlarged liver do not rule out neuroblastoma and should always be one of the differential diagnoses in young infants. (NO 00607)

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Year 1985

AU : Poovorawan Y, Tatiyakavee K, Luang-Aroon B, Chomdej S, Chandrakamol B.
TI : Chronic pancreatitis in children.
JN : Chula Med J 1985 Mar ; 29 (3) : 391-404
EN-AB: Chronic pancreatitis is a progressive, irreversible destructive condition of the pancreas. It is uncommon in the paediatric age group and its causes are somewhat different from those in the adult. The diagnosis of chronic pancreatitis is based on clinical manifestations, radiologic evidence and changing exocrine or endocrine functions of the pancreas. The finding of calcification in the pancreas is the pathognomonic evidence of chronic pancreatitis. This article is to present 3 children with chronic calcifying pancreatitis. The guidelines for the diagnosis and management are reviewed. (NO 00828)

AU : พรศักดิ์ ดิสนีเวทย์, สุดี ชมเดช, เทวี วัฒนา, ประสิทธิ์ ฟูตระกูล, รัชนี เซ็นศิริวัฒนา.
TI : Evaluation of genito-urinary tract abnormalities in children with UTI : clinical aspects and radiological studies (Abstract). 1985 : s-5
TH-AB: ได้ศึกษาบันทึกผู้ป่วยย้อนหลังของเด็กที่มีการติดเชื้อของทางเดินปัสสาวะที่มาตรวจกับหน่วยโรคไตและท างเดินปัสสาวะ ภาควิชากุมารเวชศาสตร์ โรงพยาบาลจุฬาลงกรณ์ เป็นเวลา 5 ปี ตั้งแต่เดือนมกราคม 2522 ถึงเดือนธันวาคม 2526 โดยเลือกผู้ป่วยที่ได้ทำ Intravenous Pyelography (IVP) และ Voiding Cystourethrography (VCUG) และทำการตรวจทางศัลยกรรมยูโร เมื่อมีข้อบ่งชี้ในบางราย วัตถุประสงค์การศึกษา เพื่อดูความผิดปกติของทางเดินปัสสาวะในผู้ป่วยที่มีการติดเชื้อของทางเดินปัสสาวะ และเปรียบเทียบกลุ่มที่มีความผิดปกติกับกลุ่มที่ไม่มีความผิดปกติ พร้อมกับหาอาการและสิ่งตรวจพบทางคลินิค ซึ่งแนะว่าน่าจะมีความผิดปกติของทางเดินปัสสาวะ จากการศึกษานี้พบว่า มีผู้ป่วยจำนวน 46 คน เพศชาย 26 เพศหญิง 20 อายุตั้งแต่ 1 เดือน ถึง 13 ปี ประมาณครึ่งของผู้ป่วย (21 ราย) อายุต่ำกว่า 3 ปี 28 ราย (60.9 เปอร์เซ็นต์) มีการถ่ายปัสสาวะผิดปกติเป็นอาการสำคัญ 15 ราย (32.6 เปอร์เซ็นต์) มีไข้ 12 ราย (26 เปอร์เซ็นต์) น้ำหนักตัวน้อยกว่าปกติ และ 14 ราย (30 เปอร์เซ็นต์) ตรวจร่างกายไม่พบความผิดปกติใด ๆ เชื้อที่พบบ่อยที่สุดคือ E. Coli 30 ราย (65 เปอร์เซ็นต์) จากการประเมินผล IVP, VCUG และการตรวจทางศัลยกรรมยูโรพบเด็ก 23 ราย (50 เปอร์เซ็นต์) มีความผิดปกติที่ไต (Major Abnormalities) และ 15 ราย (32.6 เปอร์เซ็นต์) มีความผิดปกติในทางเดินปัสสาวะที่ไม่ใช่ไต (Minor Abnormalities) 18 ราย (39.1 เปอร์เซ็นต์) มี Vesico-Ureteral Reflux ในกลุ่ม Major Abnormalities จะพบว่ามีค่า Urine Sp.gr. น้อยกว่าหรือเท่ากับ 1.010, serum bicarbonate น้อยกว่าหรือเท่ากับ 15 mEq/L, BUN มากกว่า 18 mg เปอร์เซ็นต์ แตกต่างกับกลุ่ม Minor Abnormalities และกลุ่มที่ไม่พบความผิดปกติอย่างมีนัยสำคัญทางสถิติ (p น้อยกว่า 0.05) ดังนั้นในเด็กที่มีการติดเชื้อของทางเดินปัสสาวะ และตรวจพบ Urine Sp.gr. น้อยกว่าหรือเท่ากับ 1.010, serum bicarbonate น้อยกว่าหรือเท่ากับ 15 mEq/L, BUN มากกว่า 18 mg เปอร์เซ็นต์ ควรได้รับการตรวจหาความผิดปกติของทางเดินปัสสาวะ. (NO 02036)

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Year 1984

AU : Chomdej S.
TI : Radiologic examination of conjoined twins, ischiopagus tetrapus.
JN : Thai J Radiol 1984 Oct ; 21 (2) : 117-123
EN-AB: Presentation of the radiological investigation of Thai conjoined twins, ischiopagus type. Radiological examination commented at aged 7 days. The examination based on the emergency work up for separation and revealed 1, conjoined twins with fusion of soft tissue part at the bottom as sitting position on each other 2, total separation of normal formed skeletal structure of coccyx 3, occasional cardiomegaly of the first partner as clinically suggested of heart failure 4, by venous angiocardiogram via the peripheral vein of the foot presented the total separation of the great vessels, inferior vena cava, aorta 5, anastomosis of vessels via the lateral femoral circumflex vein from first partner into the ileo femoral vein and inferior vena cava of second partner. Anastomosis of middle sacral vein of each other partner 6, separation and normal formed urogram of calyceal system, ureters but common urinary bladder 7, separation and normal gastrointestinal tract and rectum 8, female genitalia with openings on both side of the joined perineum of which the fistulograms revealed the opening of urinary bladder as very near to the rectum of the inner structure. The surgical separation had been performed at aged 6 months, when the twins were in good health, and well clinical prepared including the anaesthetic work up operative thearter preparation the surgical separation was successful and findings were the same as the radiological examination. Except the ureteric openings which were normal but opened at the trigone on (NO 00363)

AU : Poovorawan Y, Chomdej S, Mongkolkumnuanket P, Chandrakamol B, Sukantanaya C.
TI : Acute segmental necrotizing enteritis in children.
JN : Chula Med J 1984 Mar ; 28 (3) : 327-336
EN-AB: This paper is to report 3 cases of acute segmental necrotizing enteritis seen at Pediatric Department, Chulalongkorn Hospital during 1981 to 1983. The disease occurs mostly in children in the rural area of the Northern and North-Eastern part of Thailand and this report cases are from the Central part of Thailand. The etiology and pathogenesis are not known. Clostridium toxin and diet containing trypsin inhibitor might be the influencing factors. It is more frequently found in children between 6 to 9 years old. Symptoms and signs include:- high fever, abdominal cramp, watery to bloody mucous diarrhea, abdominal distension and shock in one case. Laboratory findings reveal high hematocrit, leukocytosis and shift to the left. Widening and thickening loop of small bowel are seen on the films of abdomen. The sites of intestinal involvement are jejunum, ileum, and jejunum and ileum. The mortality rate is about 20-70 per cent but in this report all are survived. The collective reports of the acute segmental necrotizing enteritis in Thai children are also reviewed as guidelines of diagnosis. Awareness of the disease, early diagnosis and prompt treatment can reduce the mortality rate. (NO 00826)

AU : Pathmanand C, Poovorawan Y, Chomdej S, Rungruxsirivorn S, Rungruxsirivorn S, Kanjanapipatkul P.
TI : Acute iron poisoning.
JN : Chula Med J 1984 Jun ; 28 (6) : 639-656
EN-AB: Acute iron poisioning is a relatively common and sometimes fatal intoxication in childhood, due to a widespread use of iron preparations as a hematinic and in combination with vitamins. Apart from the access availability, its external appearance and flavor, which is similar to sugar coated candy, together with the innocence of the public for its potential hazard, play the important roles among the contributing factors of overdosage ingestion. The clinical manifestations described can range from vomiting, bloody diarrhea, shock to acute hepatic failure. Peritonitis, pneumatosis cystoides intestinalis, coagulation defect, stenosis of stomach and intestine and severe mental retardation were listed among the complications and sequelae. Seven patients admitted with overdosage of iron ingestion to the Pediatric Department, Chulalongkorn Hospital during January 1979 to December 1982 were analysed. 7 manifested with gastrointestinal symptoms-vomiting and tarry stools. In all, there were neither signs nor symptoms of shock. 6 had leukocytosis. 4 had positive abdominal roentgenogram. 4 exhibited abnormal liver function test and 5 manifested positive brownish-red urine after testing with deferoxamine. All had received deferoxamine as an antidote and other symptomatic management. 2 died of acute periportal necrosis of the liver, constituting 28 per cent mortality rate. The prevention and public education of iron toxicity are far more important than the management of the patient. (NO 00829)

AU : Su-ampun U, Poovorawan Y, Chomdej S.
TI : Childhood aerophagia.
JN : Chula Med J 1984 Mar ; 28 (3) : 291-302
EN-AB: Childhood aerophagia is a rarely recognized and often poorly treated entity which has remained almost undescribed in either the surgical or pediatric literature. Two cases of childhood aerophagia were reported and discussed about their psychopathogenesis and treatment. The clinical characteristics were previous normal stooling pattern, visible and often audible air swallowing and excessive flatus. Physical examination often demonstrated a markedly or intermittently distended and tympanitic abdomen. Roentgenographic evaluation showed massively distended loops of intestine throughout without associated air-fluid levels. Treatment could be difficult and frustrating but was based essentially on recognition of the entity. Psychotherapy was successful. (NO 00845)

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Year 1983

AU : Kosolbhand P, Chomdej S.
TI : Pulmonary spreading of juvenile laryngeal papilloma.
JN : Songkla Med J 1983 Apr ; 1 (2) : 71-76
EN-AB: Thirty-two cases of juvenile laryngeal papilloma were analyzed. Four cases had pulmonary nodules, sized ranged from 5-15 mm. The time interval from diagnosis of laryngeal papilloma until the occuring of pulmonary nodules ranged from 16-66 months. Cavitation appeared in every cases with pulmonary involvement within 12-18 months. (NO 00156)

AU : Luang-Aroon B, Suwangool P, Poovorawan Y, Chomdej S.
TI : Jejunal biopsy in children with malabsorption.
CONF : Annual Scientific Meeting of Faculty of Medicine, Chulalongkorn University. 24 th, 1983 Mar 14-18, Bangkok, Thailand
JN : Chula Med J 1983 Mar ; 27 (2) : A-34
EN-AB: Intestinal biopsy plays an important role to diagnose cause of malabsorption. During July-November 1982, intestinal biopsies were done in 9 malnourished children. Two cases of tropical sprue were recognized, in one case intestinal biopsy prior and after treatment with tetracycline and folic acid were performed. Astonishing improvement of intestinal morphology was well correlated with clinical appearance. One case of kwashiorkor developed within 2 months demonstrated mild villous atrophy and crypt hyperplasia. The others were to exclude G.I. diseases : intestinal lymphangiectasia, hypoglycemia due to malabsorption and Giardiasis. In every biopsy, eosinophils and plasma cells remarkedly infitrated in lamina propria even without evidence of parasitic infestation. (NO 01128)

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Year 1980

AU : Srivuthana S, Shuangshoti S, Chomdej S, Dhamkrong-at A.
TI : Histiocytosis X : Hand-Schuller-Christian disease.
JN : J Med Assoc Thai 1980 Oct ; 63 (10) : 582-590
EN-AB: A case is reported of a 3-year-old boy who had histiocytosis X with the classic Hand-Schuller-Christian triad of defect in membranous bone, exophthalmos, and diabetes insipidus. The postmortem findings demonstrated disseminated involvement of lymph nodes, gallbaldder, cranial bone, bone morrow, lungs, pituitary gland especially the neurohypophysis and hypophysial stalk. The presenting symptom of jaundice was related to compression of the extrahepatic bliliary passage by the enlarged lymph nodes and biliary cirrhosis of the liver. Hyperglycemia is suggested to be associated with a decrease in function of the cirrhotic liver utilizing the circulating glucose for glycogen synthesis. The patient died with massive gastro-intestinal hemorrhage from rupture of esophageal varices. Correct diagnosis and proper treatment were regrettably delayed for about 8 months, chiefly because the X-ray pictures of the lungs resembled pulmonary miliary tuberculosis. Histiocytosis X should be one of the differential diagnoses for any patient having pulmonary roentgenographic findings of miliary tuberculosis, but does not respond to the antituberculous therapy (NO 01007)

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Year 1979

AU : Poovorawan Y, Chomdej S, Sensirivatana R, Benjavongkulchai S.
TI : Intestinal lymphangiectasia.A case report.
JN : J Paediatr Soc Thai 1979 Jul-Dec ; 22 (2) : 179-186
EN-AB: Intestinal lymphangiectasia is a disease characterized by dilated intestinal lymphatics, protein losing enteropathy, hypoproteinemia and edema. This paper is to report a child with history of recurrent episodes of diarrhea and edema from hypoproteinemia, laboratory and radiological findings suggested intestinal lymphangiectasia. At 2 years of age, his right leg was swollen from lymphangiomatosis malformation. The patient failed to thrive from uncontrollable protein losing enteropathy and expired at age 6 year. The diagnosis was confirmed at postmortem. The pathology of intestine showed generalized severe dilatation of lymphatic vessels on gross as well as microscopic specimens. (NO 00832)

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Year 1978

AU : Poovorawan Y, Chomdej S, Lekakul P.
TI : Acute necrotizing enterocolitis in infant.
JN : Chula Med J 1978 Jul ; 22 (3) : 201-210
TH-AB: Acute Necrotizing Enterocolitis ยังเป็นสาเหตุสำคัญที่ทำให้ทารกถึงแก่ชีวิตนอกเหนือไปจาก respiratory distress syndromeโรคติดเชื้อและความพิการแต่กำเนิด ทั้งนี้เนื่องจาก Acute Necrotizing Enterocolitis มีปัญหาในด้านการวินิจฉัยและการรักษาที่แน่นอนนัก ดังนั้นผู้รายงานจึงได้ค้นคว้าและรวบรวมรายงานจากวารสารต่าง ๆ มาเสนอ พร้อมทั้งรวบรวมวิเคราะห์ข้อมูลของผู้ป่วยจากแผนกกุมารเวชศาสตร์ โรงพยาบาลจุฬาลงกรณ์ ตั้งแต่ ม.ค. 2519 - ธ.ค. 2519 เพื่อเป็นแนวทางในการวินิจฉัยผู้ป่วย Acute Necrotizing Enterocolitis ได้รวดเร็วขึ้น และเพื่อให้การรักษาได้ทันท่วงทีซึ่งจะช่วยลดอัตราการตายของทารกได้ตายของทารกได้ (NO 00839)

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