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Kittipan Rerkasem

Publications and source records attributed to Kittipan Rerkasem.

5 recordsLinked to original sources
PubMed2005

Decrease in the incidence of Buerger's disease recurrence in northern Thailand.

PURPOSE: Buerger's disease is a peripheral arterial occlusive disease (PAOD), which occurs mainly in young male smokers. It is common in Asia, the Middle East, and Eastern European countries, but rare in North America and Western European countries. We investigated the changes in the prevalence and recurrence of Buerger's disease at a referral hospital in northern Thailand. METHODS: We conducted a retrospective study of patients with Buerger's disease admitted to Chiang Mai University Hospital between January 1988 and December 2002. Buerger's disease was diagnosed according to Shionoya's clinical criteria. RESULTS: We evaluated 78 patients with Buerger's disease, with a collective total of 108 admissions. Forty-one patients were admitted for initial treatment, and 37 patients had a history of treatment and were admitted for worsening of Buerger's disease. Between 1988 and 1995, 23 patients were admitted with newly diagnosed Buerger's disease, 52 were admitted because of Buerger's disease exacerbation, and 372 were admitted for a PAOD; whereas between 1996 and 2002, the respective numbers were 18, 15, and 632 (2.9 +/- 1.9/year vs 2.6 +/- 1.3/year, P = 0.25; 6.5 +/- 1.1/year vs 2.1 +/- 1.1/year, P = 0.001; 54.1 +/- 6.7/year vs 81.6 +/- 5.2/year, P < 0.0001). Of the 78 patients with Buerger's disease, 76 were men and 2 were women, with a mean age at onset of 34.1 +/- 5 years. The predominant symptom on admission was burning pain in the feet and hands in 75%, digital gangrene in 74%, and a digital ulcer in 43.5%. CONCLUSIONS: The incidence of recurrence of Buerger's disease seems to be decreasing in our institution, whereas the incidence of this disease and its recurrence both seem to be decreasing in Western countries and Japan.

Adult↗
PubMed2005

Left retroperitoneal versus midline transperitoneal approach for abdominal aortic aneurysms (AAAs) repair.

OBJECTIVE: The purpose of this prospective randomized study was to compare the left retroperitoneal approach (RPA) with the midline transperitoneal approach (TPA) for infrarenal abdominal aortic aneurysms (AAAs) repair with operative details, postoperative complications, and total cost comparision. MATERIAL AND METHOD: Between January 2000 and December 2003, 36 patients undergoing elective surgery for infrarenal AAAs were included in the prospective comparison of transperitoneal approach (TPA) with retroperitoneal approach (RPA). Thirty-six patients were analyzed, with 18 in group 2 (TPA) and 18 in group I (PRA). There was no significant differences between the groups in patient demographics. (p value > 0.05) RESULTS: There was no significant differences in the aortic cross clamp time, operative time, estimated blood loss and intraoperative blood transfusion between the two groups (p value > 0.05); however, significantly more intraoperative fluid needs and bowel function onset had a statistically longer return in group 11 (TPA) than in group I (RPA). Statistically reduction in postoperative ileus (>4 days) and total length of hospital stay was observed in group I (RPA) (p value < 0.05). Postoperative cardiopulmonary complications were statistically significantly more increased in group II (TPA) than in group I (RPA). Wound complications were more in group I (RPA) (1 hematoma, 4 abdominal wall hernia, and 4 chronic wound pain) than in group II (TPA) (2 chronic wound pain). Total cost payment was not significantly different in both groups. CONCLUSION: The left retroperitoneal approach for infrarenal AAAs repair, with fewer cardiopulmonary complications and shorter hospital stay has more unsatisfactory postoperative wound complications than the midline transperitoneal approach.

Aged↗
PubMed2004

Differences in matrix metalloproteinase-1 and matrix metalloproteinase-12 transcript levels among carotid atherosclerotic plaques with different histopathological characteristics.

BACKGROUND AND PURPOSE: Previous studies have shown that atherosclerotic lesions express a number of matrix metalloproteinases (MMPs). Here we investigated whether transcript levels of MMP-1, -3, -7, -9, and -12 in carotid atherosclerotic plaques were correlated with histological features and clinical manifestations. METHODS: Atherosclerotic plaques (n=50) removed from patients undergoing carotid endarterectomy were classified histologically using a system proposed by Virmani et al, and MMP-1, -3, -7, -9, and -12 transcript levels in these tissues were quantified by real-time reverse-transcriptase polymerase chain reaction. RESULTS: Compared to plaques with a thick fibrous cap, those with a thin cap had a 7.8-fold higher MMP-1 transcript level (P=0.006). MMP-3, -7, and -12 were 1.5-fold, 1.8-fold, and 2.1-fold, respectively, higher in thin cap plaques, but the differences did not reach statistical significance. MMP-12 transcript levels were significantly increased in ruptured plaques compared with lesions without cap disruption (P=0.001). MMP-9 transcript levels were similar among the different types of lesion. MMP-1 and -12 transcript levels were significantly higher in plaques from patients with amaurosis fugax, than in those from asymptomatic patients (P=0.029 and P=0.008 for MMP-1 and MMP-12, respectively), than in those from patients with stroke (P=0.027 and P=0.001, respectively), and than in those from patients with transient ischemic attack (P=0.046 and P=0.008, respectively). CONCLUSIONS: These data support a role of MMP-1 and -12 in determining atherosclerotic plaque stability.

Aged↗
PubMed2003

Association of n-3 polyunsaturated fatty acids with stability of atherosclerotic plaques: a randomised controlled trial.

BACKGROUND: N-3 polyunsaturated fatty acids (PUFAs) from oily fish protect against death from cardiovascular disease. We aimed to assess the hypothesis that incorporation of n-3 and n-6 PUFAs into advanced atherosclerotic plaques increases and decreases plaque stability, respectively. METHODS: We did a randomised controlled trial of patients awaiting carotid endarterectomy. We randomly allocated patients control, sunflower oil (n-6), or fish-oil (n-3) capsules until surgery. Primary outcome was plaque morphology indicative of stability or instability, and outcome measures were concentrations of EPA, DHA, and linoleic acid in carotid plaques; plaque morphology; and presence of macrophages in plaques. Analysis was per protocol. FINDINGS: 188 patients were enrolled and randomised; 18 withdrew and eight were excluded. Duration of oil treatment was 7-189 days (median 42) and did not differ between groups. The proportions of EPA and DHA were higher in carotid plaque fractions in patients receiving fish oil compared with those receiving control (absolute difference 0.5 [95% CI 0.3-0.7], 0.4 [0.1-0.6], and 0.2 [0.1-0.4] g/100 g total fatty acids for EPA; and 0.3 [0.0-0.8], 0.4 [0.1-0.7], and 0.3 [0.1-0.6] g/100 g total fatty acids for DHA; in plaque phospholipids, cholesteryl esters, and triacylglycerols, respectively). Sunflower oil had little effect on the fatty acid composition of lipid fractions. Fewer plaques from patients being treated with fish oil had thin fibrous caps and signs of inflammation and more plaques had thick fibrous caps and no signs of inflammation, compared with plaques in patients in the control and sunflower oil groups (odds ratio 0.52 [95% CI 0.24-0.89] and 1.19 [1.02-1.57] vs control; 0.49 [0.23-0.90] and 1.16 [1.01-1.53] vs sunflower oil). The number of macrophages in plaques from patients receiving fish oil was lower than in the other two groups. Carotid plaque morphology and infiltration by macrophages did not differ between control and sunflower oil groups. INTERPRETATION: Atherosclerotic plaques readily incorporate n-3 PUFAs from fish-oil supplementation, inducing changes that can enhance stability of atherosclerotic plaques. By contrast, increased consumption of n-6 PUFAs does not affect carotid plaque fatty-acid composition or stability over the time course studied here. Stability of plaques could explain reductions in non-fatal and fatal cardiovascular events associated with increased n-3 PUFA intake.

Aged↗