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Biomedical subjects

A Kanjanapitak

Publications and source records attributed to A Kanjanapitak.

10 recordsLinked to original sources
PubMed2000

Gigantic hepatocellular carcinoma, treated by transcatheter oily chemoembolization (TOCE) and wedge hepatic resection.

Four cases of gigantic hepatocellular carcinoma, considered by surgeons to be inoperable, were treated with repeated transcatheter chemoembolization (TOCE) until the serum alfafetoprotein reduced to normal or less than half of the original level or until the tumor reduced to less than half of the original size documented by CT scan and angiogram. Wedge hepatic resection was performed using ultrasonic dissector. Histologic section of the resected tumor mass revealed tumor necrosis. The extent of tumor necrosis was related to tumor size and corresponded inversely to the thickness of the tumor capsule. The survival periods were 48 to 108 months with only one to two episodes of recurrence during follow-up. Repeated wedge hepatic resection was performed successfully for recurrent cases. Serum alfafetoprotein (AFP) is a very sensitive and reliable tumor marker for follow-up results and appears to be a sensitive indicator for tumor recurrence.

Adult↗
PubMed2000

Hepatocellular carcinoma : treated with hepatic arterial embolization, an analysis of prognostic features in 150 cases.

From July 1989 to July 1999, 120 male and 30 female patients with hepatocellular carcinoma (HCC), whose ages ranged from 18 to 71 years, were treated by different modalities. The patients were divided into 3 groups according to treatment modalities: group 1 consisted of 35 cases treated by transarterial embolization (TAE) using gelatin sponge permeated with mitomycin-c 20 mg, group 2 - 100 cases treated by transcatheter oily chemoembolization (TOCE) using lipiodol 10 cc with mitomycin-c 20 mg together with gelatin sponge for hepatic embolization, and group 3 - 15 cases treated by TOCE followed by surgical wedge hepatic resection. The prognostic features following treatments were retrospectively analysed in relation to therapeutic modalities. The results revealed that TOCE was superior to TAE and that TOCE plus adjunct wedge hepatic resection was the best treatment modality with the best cumulative surgical rate (median survival 46.69 months). Analysis of the life-table methods of group 2 patients revealed that the stage of tumors and serum biochemistry on entry, both of which corresponded well with hepatic reserve function were statistically significant prognostic factors for treatment result and long-term outcomes. Further analysis of all the patients also revealed that tumor size and stage of tumors were significant prognostic factors for the treatment of hepatocellular carcinomas.

Adolescent↗
PubMed1994

Routine or selective intraoperative cholangiography.

IOC is definitely indicated in patients with clinical indications. It avoided unnecessary exploration of the common bile duct in 32.7 per cent. Of all the clinical indications, palpable common bile duct stone was the most accurate. Dilated common bile duct, dilated cystic duct, elevated serum alkaline phosphatase, multiple small stones and positive imaging investigations were a statistically significant prediction of common bile duct stones. IOC is not justified in patients without clinical indications because of the low incidence of unsuspected common bile duct stone (0.66%) and on the basis of cost-effectiveness. The results support the view that IOC is invaluable and should be used selectively.

Adolescent↗
PubMed1985

Opisthorchis viverrini infection and cholangiocarcinoma. A prospective, case-controlled study.

During a prospective, 24-mo case-controlled study, 551 patients from northeastern Thailand were independently evaluated for Opisthorchis viverrini infection, hepatobiliary tract disease, and hepatic carcinoma to determine whether there was any association between hepatic carcinoma and O. viverrini infection. Stool examination by the formalin-ether concentration method revealed O. viverrini ova in 389 (70.6%) patients. Of the 551 patients, 72 (13.1%) had both clinical and laboratory evidence of hepatobiliary tract disease, chronic liver disease, or hepatic carcinoma, alone or in combination. Of these 72 patients, 28 (38.9%) had a liver biopsy that revealed cholangiocarcinoma in 7 patients with O. viverrini ova in their stools, and in 4 patients without. In another patient with ova in the stool combined hepatocellular carcinoma and cholangiocarcinoma was found. In the 4 patients with cholangiocarcinoma who had no O. viverrini ova in their stools, ova were detected in the bile fluid aspirated from the intrahepatic biliary tree during exploratory laparotomy. An additional patient with clinically suspected cholangiocarcinoma and O. viverrini ova in stool had a left supraclavicular lymph node biopsy specimen taken that revealed metastatic adenocarcinoma; this adenocarcinoma was interpreted as compatible with cholangiocarcinoma. Cholangiocarcinoma, therefore, was found only in patients with O. viverrini ova in stool or in the intrahepatic biliary tree. Statistical analysis revealed that patients with known O. viverrini infection had a higher incidence of cholangiocarcinoma than did patients without such infection (X2 test, p less than 0.05).

Adenoma, Bile Duct↗
PubMed1984

Consistency of fecal egg output in patients with Opisthochiasis viverrini.

Counts of Opisthorchis eggs in two samples of feces arbitrarily taken 0-21 days apart from each of 209 patients from northeastern Thailand were carried out by Stoll's dilution technique. Based on the number of eggs/mg feces, each patient was classified as uninfected, lightly infected (less than 1 egg/mg), moderately infected (1-10/mg), heavily infected (greater than 10-50/mg), or very heavily infected (greater than 50/mg). The intensity of infection for each of the 209 individuals as shown by first and second counts was compared. Of the 209 individuals, 150 (71.8%) remained within the same egg excretion category, with all but five (2.4%) of the remainder being in an adjacent category. Statistical analysis showed no effect of variation in interval between stool counts on the accuracy or consistency of replicate counts.

Feces↗
PubMedDate not supplied

Detection of colorectal carcinoma by anti-CEA monoclonal antibody (IOR-CEA1) labeled with 99mTc scintigraphy.

BACKGROUND/AIMS: This study shows that a new monoclonal antibody (IOR-CEA1) labeled with technetium-99m has high diagnostic efficacy for colorectal adenocarcinoma. This immunoscintigraphy is helpful in clinical management especially for patients whose serum carcinoembryonic antigen and computed tomography are questionable for recurrent diseases. The study aims to evaluate the efficiency of a new monoclonal antibody (IOR-CEA1) labeled with technetium-99m in the detection of colorectal carcinoma. METHODOLOGY: Forty colorectal carcinoma patients were examined. They were divided into 2 groups: Group I (9 patients) with untreated primary tumor; and Group II (31 patients) who were suspected of recurrent or residual diseases from 1) equivocal computed tomography or magnetic resonance imaging, or 2) rising serum carcinoembryonic antigen but normal imaging or clinical findings. One milligram of the antibody labeled with 25mCi of technetium-99m was slowly infused intravenously and images were obtained by nuclear medicine techniques. Sensitivity, specificity, accuracy, positive and negative predictive values were determined. RESULTS: 99mTc-IOR-CEA1 had 86% sensitivity, 71% specificity, 83% accuracy, 94% positive predictive value and 50% negative predictive value for the detection of colorectal cancer in 42 studies (2 patients had repeated studies). Serum carcinoembryonic antigen had only 33% sensitivity for detection of the primary cancer and 58% sensitivity in detection of recurrent diseases. Carcinoembryonic antigen had 100% positive predictive value but only 31.3% negative predictive value for diagnosis of the recurrence of tumor. Fifty-two percent of the antibody scans provided more information than computed tomography scans with clinical impact on further management in group II patients. CONCLUSIONS: The 99mTc-IOR-CEA1 scintigraphy is a promising investigative method which is safe and has high accuracy in the detection of recurrent colorectal carcinoma, especially in the patients whose serum carcinoembryonic antigen and computed tomography findings are equivocal for recurrent diseases.

Adenocarcinoma↗