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Biomedical subjects

S Wilailak

Publications and source records attributed to S Wilailak.

13 recordsLinked to original sources
PubMed1999

Recent management of malignant ovarian germ cell tumors: a study of 34 cases.

OBJECTIVE: To review the outcome of the treatment in patients with malignant ovarian Germ cell tumors with respect to survival and surgical management at a single institution during 1990-1996. METHODS: Thirty-four patients with malignant ovarian Germ cell tumors were studied retrospectively for their surgical management. Fourteen patients had pure dysgerminoma, 11 endodermal sinus tumor, 6 immature teratoma, and 3 mixed Germ cell tumors. Nine patients had stage IA, 8 stage IC, 2 stage IIC, 8 stage III, 3 stage IV, and 4 referred patients with recurrent diseases. RESULTS: Nineteen patients underwent primary conservative surgery, 11 had primary nonconservative surgery. Twenty-two patients were treated with chemotherapy (BEP or EP or PVB regimen). Five patients with pure dysgerminoma received adjuvant radiotherapy. Persistent remission was achieved in 26 patients. Two patients (7.4%) had recurrence after remission. Seven patients had died of the diseases. Patients with complete clinical remission did not undergo second-look surgery. The overall survival was 78.8%, 100% for immature teratoma, 84.6% for pure dysgerminoma, 72.8% for endodermal sinus tumor, and 33.3% for mixed Germ cell tumors, with median follow-up time 31 (3-93) months. CONCLUSION: Patients with limited diseases regardless of histologic types can be safely managed by unilateral salpingo-oophorectomy followed by, if indicated, 3-4 courses of cisplatin-based chemotherapy. For advanced diseases, conservative surgery is advisable in patients with endodermal sinus tumor.

Adolescent↗
PubMed1999

Malignant ascites in female patients: a seven-year review.

Malignant ascites is common in various types of advanced cancer. Our objective was to determine the primary site and the clinical characteristics of female patients presenting with malignant ascites as well as evaluating the outcome. The authors carried out a retrospective study of 118 cases of malignant ascites diagnosed from January 1986 to December 1992 in female patients. Of the 118 cases, the primary site of the neoplasms was gynecologic in 65 cases (cervix 4, endometrium 6, ovary 52, fallopian tube 3) = 55.1 per cent, non-gynecologic 29 cases (GI 18, lymphoma 8, breast 2, kidney 1) = 24.6 per cent, and unknown 24 cases = 20.3 per cent. The mean age of patients in the gynecologic, non-gynecologic and unknown primary site was 50.4, 45.5 and 59.3 years respectively. Surgery combined with chemotherapy was the main treatment in the gynecologic group, whereas, supportive and symptomatic management was the main treatment in the unknown primary group. Treatments in non-gynecologic group were supportive and symptomatic, surgery and chemotherapy. Survival was longer in gynecologic than in the nongynecologic and the unknown primary groups. The most common primary site of malignant ascites in females was ovarian cancer. In malignant ascites in females caused by gynecologic neoplasms, the prognosis as measured by survival was better than in the non-gynecologic and the unknown primary groups.

Adult↗
PubMed1998

An HIV-infected woman with choriocarcinoma presenting with a nasal mass.

Gestational choriocarcinoma metastasized to the nasal mucosa is extremely rare. An HIV-infected woman with choriocarcinoma presenting with a nasal mass is reported. The clinical findings are compared with a previous reported case. She responded to multiagent chemotherapy and has obtained complete remission. The role of HIV infection is also discussed.

Adult↗
PubMed1998

Epithelial ovarian cancer treated by platinum or platinum analogue with cyclophosphamide: experience in Ramathibodi Hospital.

This study presented the outcome of 92 EOC patients treated by platinum or platinum analogue with cyclophosphamide from January 1, 1993 to December 31, 1995. There were 77 evaluable patients. The follow-up ranged from 4-42 months (median 14 months). The over all 3-year survival was 64 per cent and the median progression-free interval was 16 months for the whole group. There was no significant difference in survival between patients who received cisplatin and those who received carboplatin (P = 0.093). Patients who underwent optimal debulking surgery had significantly longer progression-free interval (P = 0.001) than those who had sub-optimal surgery. Fifty four per cent of patients with clear cell carcinoma died of the disease. Patients who received cisplatin had a drop out rate while on therapy more often (24% vs 5.3%) than that of carboplatin. Toxicities from chemotherapy were moderate but manageable.

Adenocarcinoma↗
PubMed1995

A randomized study comparing suture with non-suture cold-knife conization.

OBJECTIVE: To compare the short-term outcome of cold-knife conization between suture and non-suture (with Monsel's solution pack) methods. METHODS: Between February, 1990 and March, 1992, 142 patients underwent cold-knife conization were randomly allocated into 2 groups. The hemostasis was done by suture in one group and by Monsel's solution pack without suture in the other group. The patients' and cone specimens' characteristics as well as short-term outcome were recorded and compared using Chi-square test, Fisher exact test and t-test where appropriate. RESULTS: The patients' characteristics, cone size, and histologic diagnosis of both groups were comparable. The non-suture group had shorter operative time (10.69 +/- 7.86 vs. 20.04 +/- 6.99 minutes) and lesser late hemorrhage (2.9 vs. 15.9%) than the suture group (p < 0.05). There was no statistical difference in the operative blood loss. CONCLUSION: The non-suture method of conization should replace the traditional suture method.

Adult↗
PubMed1995

Peritoneal papillary serous carcinoma: response to Taxol in platinum resistant disease.

A case of peritoneal papillary serous carcinoma which developed after total abdominal hysterectomy and bilateral salpingo-oophorectomy for a benign condition is presented. The patient was treated with platinum-based chemotherapy to which she initially responded, but then the tumor progressed. High dose paclitaxel (250 mg/m2) was given. The patient tolerated this treatment well, achieving a rapid partial response with good palliation of symptoms. Paclitaxel should be considered for patients with a platinum resistant peritoneal papillary serous carcinoma.

Carboplatin↗
PubMed1994

Malignant Brenner tumor: a case of aggressive clinical course and cutaneous metastases.

Malignant Brenner tumor is a very rare ovarian tumor of which the definition of this entity and its biologic behavior remain controversial to this day. In this case report a 30-year-old patient with malignant Brenner tumor was presented with an aggressive clinical course and cutaneous metastases. The disease progressed from apparently unilateral ovarian involvement to intraabdominal, lung and cutaneous metastases. She expired within two months of diagnosis of disease. The histopathology of the ovarian tumor and the metastatic skin lesion are illustrated. In the authors' opinion this case should be categorized as a transitional cell carcinoma of the ovary.

Adult↗
PubMed1993

Elective induction of labor: Ramathibodi Hospital (Jan-Jun, 1990).

To assess the outcome of elective induction of labor, 262 deliveries were studied retrospectively and compared with 249 controlled cases whose labor began spontaneously. Elective induction accounted for 61 per cent of all patients induced with the overall induction rate of 11 per cent. Sixty-two per cent of the private cases as opposed to 24 per cent of the nonprivate cases were induced before the expected date of confinement. Among private cases, the cesarean section rate was similar whether the patients were induced or admitted in spontaneous labor. However, when considering the nonprivate cases the cesarean section rate was twice as high if the patients were induced. Mean maternal height and fetal birth weight were similar in both the study and control groups but there were more cases of low birth weight infants in the study group. The fetal outcome as indicated by 5-minute Apgar score was not less than five in both groups.

Adult↗
PubMed1993

Recurrence of cervical carcinoma following radical hysterectomy and pelvic node dissection.

The aim of this report is to review the clinical pattern of the recurrent cases. From May 1969 to December 1988, 200 patients with cervical carcinoma stage IB were treated with radical hysterectomy and pelvic node dissection at the Department of Obstetrics and Gynaecology, Ramathibodi Hospital, Mahidol University. One hundred and eighty-two patients were included in this study. Twenty-one patients (11.5%) developed recurrent cervical carcinoma. Most of the recurrence were diagnosed within 3 years after surgery. The most common recurrent site was pelvic sidewall. Patients' complaint and abnormal physical findings accounted for 81 percent of the first evidence. Treatment of recurrences was radiation in 15, chemotherapy in 3 and symptomatic treatment in the remaining three. Nine patients died of the recurrent tumor. The median time from recurrence to death was 24 months (range 12-65). The majority of the deaths occurred in the first three years after detection of recurrence. Radiation may be beneficial in treatment of recurrent tumor and in regional control of tumor after surgery.

Adult↗
PubMed1993

Prognostic factors associated with recurrence in stage IB cervical carcinoma after radical hysterectomy and pelvic lymphadenectomy.

Radical hysterectomy with pelvic lymphadenectomy is the treatment of choice for stage IB cervical carcinoma. Recurrence of disease usually results in poor prognosis. The prognostic factors associated with recurrence were analyzed in 182 patients with stage IB cervical carcinoma treated with radical hysterectomy with pelvic lymphadenectomy at Department of Obstetrics and Gynaecology, Ramathibodi Hospital from May 1969 to December 1988. Twenty-one patients (11.5%) developed recurrent cervical cancer. Factors which were found to have statistical significance associated with recurrence were positive lymph node, positive surgical margin and cervical lesion size of 3 cm or more. The application of these factors was discussed.

Adult↗
PubMed1993

Hospital charge of gynecological in-patients at Ramathibodi Hospital.

There have been few studies of hospital charge done in Thailand and that led us to be aware of health economics. In this cross sectional study, 182 gynecological in-patients admitted between July 1 and 31, 1990 were recruited. Mean hospital charge was 3,258.50 baht. The patients's employers bore the main financial burden (48%). The hospital bore 9 per cent of this total financial burden, and the rest (44%) was self paid. The amount of hospital charge may depend on some factors. Further study of this subject should be conducted.

Adolescent↗
PubMed1992

Assessment of fetal well-being: fetal movement count versus non stress test.

In this prospective study, comparisons were made between the results of fetal movement count as performed by either the attending staff or by the patients using the non stress test (NST). A total of 283 NSTs were performed in 200 patients who had singleton pregnancy of at least 32 weeks gestation with indications for assessment of fetal well-being. Fetal movement counts performed by the attending staff and by the patients were recorded on 241 and 170 occasions, respectively. The results showed that the best correlation between fetal movement count by the attending staff with NST was when the criteria of three or more fetal movements within 10 min was used. Likewise, the best correlation between fetal movement count by patients with NST was found when ten fetal movements within 2 h was used as a cut off point. The result of this study suggests the usefulness of fetal movement count performed either by attending staff or patients as a cheap and effective method of screening for good fetal well-being in places where NST is not readily available and may also be used as a screening for patients prior to further evaluation.

Female↗