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Biomedical subjects

P Chiowanich

Publications and source records attributed to P Chiowanich.

14 recordsLinked to original sources

Arterial pseudostenosis on first-pass gadolinium-enhanced three-dimensional MR angiography: new observation of a potential pitfall.

OBJECTIVE: The purpose of this study was to determine the frequency of apparent stenosis of normal aortic branches in patients on first-pass gadolinium-enhanced three-dimensional (3D) MR angiography and to reproduce the same phenomenon in a pulsatile flow phantom model. CONCLUSION: Apparent stenosis of normal vessels on gadolinium-enhanced 3D MR angiography seen on the first-pass acquisition was observed in only a small proportion (approximately 2%) of our patients. The pseudostenosis was reproducible in the phantom model using rapid injection. A stenosis on first-pass images should be interpreted with caution. Confirmation of the findings on other sequences, such as the second-pass gadolinium-enhanced 3D MR angiography or 3D phase-contrast MR angiography, prevented overdiagnosis of significant stenoses.

Aortic Valve Stenosis↗

Serial CT and MR imaging of carmustine wafers.

BACKGROUND AND PURPOSE: A new option in the treatment of recurrent malignant glioma is surgical placement of chemotherapy-laden biodegradable wafers. We describe the CT and MR appearance of chemotherapy wafers in patients after surgery for recurrent malignant glioma METHODS: Eighteen patients had carmustine (BCNU) wafers implanted during reoperation for malignant glioma; three patients had empty, placebo wafers placed. The 21 patients had a total of 22 CT and 57 MR imaging studies. Repeat CT studies were conducted for up to 6 months, the MR studies for up to 1 year. Examinations were evaluated for attenuation on CT scans, signal abnormalities on MR images, and changing appearance during the follow-up period. Enhancement characteristics were also assessed. RESULTS: On CT scans, 13 of 16 acute (<7 days) cases showed linear high-attenuation wafers, with three showing low attenuation. On MR images, all T1 and T2 studies performed in the acute stage showed decreased signal of the wafers. Eight of 15 studies showed a transient increase in T1 only at about 2 months. Wafers decreased in conspicuity on both CT and MR studies after 2 months. The wafers did not enhance. One postoperative tumor showed a transient increase in edema and increased enhancement at 5 weeks. The presence or absence of BCNU within the wafers did not change their appearance. CONCLUSION: BCNU wafers have a characteristic appearance: in the first 7 days after implantation they are linear, usually of increased attenuation on CT scans, and always show decreased signal on MR images; they do not enhance, and become less conspicuous after 2 months.

Antineoplastic Agents, Alkylating↗

Effects of parity on breastfeeding: a study in the rural setting in northern Thailand.

UNLABELLED: This analysis was undertaken to see whether or not previous successful breastfeeding has any influence on subsequent breastfeeding behavior. Lactational outcomes were compared between those with and without breastfeeding experience. METHODS: Amount of breast milk transferred, frequency of breastfeeding, and time spent on the breast, as well as infant's weight, were recorded on days 15, 45, 90, 180, 270, and 360 postpartum in 30 primiparae and 30 multiparae. Outcomes of the primiparae were found to be similar to those of the more experienced breastfeeding multiparous mothers with respect to infant growth, amount of breast milk transferred, and the frequency of breastfeeding or number of attachments to the breast. Though primiparae took somewhat longer to transfer similar amounts of breast milk to their infants during the initial 45 to 90 days postpartum, feed duration after 90 days was similar to that of the multiparae. Lactation performance of the rural northern Thai mothers in our sample was highly successful with or without previous breastfeeding experience. It may be that a cultural pattern of breastfeeding on demand, strong family support, and traditional practices that encourage close contact between mother and her newborn compensate for the absence of lactational experience. Unlike reports from Western countries, previous breastfeeding does not appear to be an important predictor of successful and prolonged breastfeeding in our population.

Adult↗

Ovarian Brenner tumors: MR imaging characteristics.

This study describes the appearance of Brenner tumors on MR imaging and compares quantitative signal intensity measurements of Brenner tumors with that of other ovarian tumors. A search of pathologic and MR records disclosed patients who had MRIs showing Brenner tumors prior to surgical excision. Patients (21) with other surgically proven ovarian masses were randomly selected for comparison. MR imaging was performed at 1.5 T with phased array multicoils and fast spin echo T2-weighted images. Region-of-interest measurements of signal intensity (SI) were made to calculate signal intensity ratios (SIR = mass SI/muscle SI). Brenner tumors showed significantly lower SIR than other tumors on T2-weighted images (p = 0.004) and similar SIR on T1-weighted images. Brenner tumors show lower signal intensity on T2-weighted images than other non-fibrous ovarian tumors. This lower signal intensity may result from the extensive fibrous content of these tumors.

Adult↗

Dilated fallopian tubes: MR imaging characteristics.

PURPOSE: To determine the magnetic resonance (MR) imaging characteristics of hydrosalpinx and the accuracy of MR imaging for distinguishing hydrosalpinx from other adnexal masses. MATERIALS AND METHODS: Cross-referencing of pathologic records and MR studies from two institutions disclosed 41 study patients with surgically proved dilated fallopian tubes. A set of 38 patients with surgically evaluated adnexal masses, but no hydrosalpinx, were randomly chosen as control subjects. All MR examinations included T1-weighted spin-echo and T2-weighted fast spin-echo imaging in multiple planes with a phased-array multicoil. Two blinded readers scored each adnexa for the presence of a dilated fallopian tube or thickened tubal wall and mucosal folds and the signal intensity of the intratubal fluid. Blinded readings were compared with surgical findings of dilated fallopian tube, endometriosis, and salpingitis. Radiologic-pathologic correlation was performed with adnexal specimens imaged in vitro in three study patients. RESULTS: On a per patient basis, the blinded readers correctly identified dilated fallopian tubes in 31 of 41 study patients and correctly excluded dilated tubes in a mean 34 of 38 control subjects. On T1-weighted images, hyperintense tubal fluid was significantly correlated with the presence of endometriosis in the pelvis at surgery (P < .002, chi 2). CONCLUSION: MR imaging can depict most dilated fallopian tubes and differentiate them from other adnexal masses on the basis of morphologic features. On T1-weighted images, high signal intensity is correlated with the presence of endometriosis affecting the tube.

Adult↗

Case report 758. Reflex sympathetic dystrophy syndrome (RSDS).

We report the angiographic and venographic findings in a case of reflex sympathetic dystrophy syndrome (RSDS) of the lower extremity. The hypervascular intraosseous lesion which initially simulated an arteriovenous malformation provides important information about the vascular nature of this lesion.

Foot Diseases↗

Successful sustained lactation following postpartum tubal ligation.

This study was undertaken to see whether tubal ligation performed within days postpartum, and associated with a delay in the initiation of breastfeeding, exerts a disruptive influence on successfully establishing lactation among the rural population of northern Thailand. Lactational performance of 12 rural northern Thai mothers was not affected by the delay in reunion of mothers with their babies as a result of postpartum tubal sterilization procedure when compared with a group of 8 other healthy mothers and babies. The volume of breast milk transferred, frequency of breastfeeding and the total feeding time spent on the breast were similar on days 15, 45, 90, 180 and 360 postpartum. This finding suggests that the pattern of intense breastfeeding activity as practiced by this group of mothers has a stronger influence on prolonged and successful lactation than early contact in the immediate postpartum period.

Adult↗

The Chiang Mai lactation project: study design and implementation.

The Chiang Mai lactation project is a longitudinal field study of human lactation carried out among northern Thai women living in the Sanpatong area of Chiang Mai Province. Its aim was to measure the volume and composition of breast milk transferred from mothers to their infants in the first year postpartum, and to relate it to predictors of milk production, and to the growth of the child. Breast milk and supplementary food intake, and nursing patterns, were recorded over two consecutive 24-hour periods six times during the first year. Samples of breast milk and of supplementary foods were analysed for energy and protein. Supplementary foods were also analysed for bacterial contamination. The growth of the child was measured, and health assessed using a combination of health diaries and examination by a physician. Recruitment to the study was excellent. After recruitment, two subjects left the study area, but otherwise only two dropped out, so complete sets of data covering these variables are available for 58 of the 62 recruited subjects.

Body Weight↗

Relationships between nursing patterns, supplementary food intake and breast-milk intake in a rural Thai population.

Relationships between nursing patterns, supplementary food intake and breast-milk intake were examined in a group of 52 Thai babies under 1 year of age. All data were collected over two consecutive days, 24 h/day. Total sucking time (min/day) and supplementary food intake (kcal/day) were significant predictors of breast-milk intake after allowing for the age of the baby: R-squared is 0.32 for sucking time and 0.39 for supplementary food intake. The two variables were themselves correlated (r is -0.47). The number of breastfeeds per day and their mean duration was determined for each case, counting each episode of attachment to the breast as a separate feed. Number and mean duration of breastfeeds were then evaluated as predictor variables. The duration of feeds had no predictive power. Number of feeds was linearly related to milk intake and combined with age was as good a predictor of milk intake as total sucking time (with R-squared 0.34). These results suggest that a simple count of breastfeeds is as valuable as more complex measures of sucking duration in predicting to breast-milk intake.

Breast Feeding↗

Predictors of breast milk intake in rural northern Thailand.

A random sample of 52 mothers and infants from a rural area of Northern Thailand were studied in their homes for 48 h. Infants were breast fed on demand. Daytime feeds were test weighed with electronic averaging balances and nighttime intake estimated using a new method, Indirect Test Weighing. All feeds, both day and night, were timed to the nearest minute. Other variables measured by direct observation were infant weight, and supplementary food and water intake. Mean 24-h breast milk intake was 579 g (range 78-1,011 g) with a median between day coefficient of variation of 8.8%. The proportion of 24-h breast milk intake consumed at night ranged from 8 to 91%, and increased with increasing infant age. Significant positive associations were found between breast milk intake, and sucking time and infant weight. There were significant negative associations between breast milk intake and age, and supplementary food and water intake.

Body Weight↗

Infant weight in relation to nutritional intake and morbidity in northern Thailand.

A cross-sectional study of 58 infants (age range 2-53 weeks) was carried out in a rural area of northern Thailand. Total dietary intake (energy and protein from breastmilk and supplementary food) was measured directly during continuous observation over 48 h of randomly selected study subjects in their homes. Associations between infant weight and total energy intake, total protein intake and morbidity were analysed by multiple regression analysis. Up to 6 months of age, heavier infants had larger energy intakes, when age and birthweight were taken into account. In the 7-12 months age group, heavier infants consumed more protein and had fewer respiratory infections. Weaned infants older than 6 months were significantly heavier and consumed more protein than infants of similar age who were still receiving breastmilk. The lower protein intakes of the latter infants were due to the low protein concentration of breastmilk compared with supplementary food.

Body Weight↗

Flavivirus infections in Chiang Mai area, Thailand, in 1982.

Infection by JE virus still constitutes major cause of encephalitis in Chiang Mai Area, although some cases of possible dengue encephalopathy were observed. In spite of many apparent encephalitis cases, infection of vector mosquitoes by JE virus was not demonstrated. Virus isolation from hospitalized patients showed that the principal type of dengue virus circulating in Chiang Mai in 1982 was type 1 virus. Seroepidemiological survey on healthy humans indicated that the northern part of Chiang Mai Province in the region of the Maekong Valley has not yet been invaded so much by dengue viruses, compared with the Chiang Mai Valley, where dengue infection apparently became more prevalent than 12 years ago. The survey also indicated that the spread of JE virus in the study area was not uniform. Survey on vertebrates showed that anti-JE antibodies were highly prevalent among swine, horses, mules, sheep, and dogs. On the other hand, antibody prevalence was low in monkeys, ducks, and sparrows, and was negative among chickens and lizards. IgM-ELISA appeared to help differential diagnosis on JE from dengue even when the HI test did not give positive results.

Adolescent↗

Free MRA of the abdomen: postprocessing dynamic gadolinium-enhanced 3D axial MR images.

Dynamic contrast-enhanced whole-abdomen axial images were obtained by using a fat-suppressed, three-dimensional, breath-hold enhanced fast spoiled gradient-echo technique, configured for optimal evaluation for detection and characterization of liver lesions. We then evaluated the feasibility of using these images to reconstruct "free" abdominal magnetic resonance angiography, without additional cost or acquisition time, in 32 randomly chosen patients. The aorta, celiac trunk, superior mesenteric, hepatic, splenic, and renal arteries were clearly depicted.

Abdomen↗