Biomedical subjects

Saranatra Waikakul

Publications and source records attributed to Saranatra Waikakul.

3 recordsLinked to original sources

PubMed2006

Neuropathic arthropathy of the elbow: a report of two cases.

BACKGROUND: Neuropathic arthropathy (charcot joint) of the elbow is a rare condition. It is among the least frequently reported charcot pathology of the joint. The clinical symptoms are characterized by a painless and unstable joint. Infection in the neuropathic joint is rare. Only a limited number of cases have been reported in the literature. The authors present two cases of neuropathic arthropathy of the elbow. One of them was diagnosed as Septic neuropathic arthropathy. MATERIAL AND METHOD: Two patients with neuropathic arthropathy of the elbow (an infected and a noninfected case) were treated at our department. Both patients were over 60 years old. The underlying conditions associated with the arthropathy included combined median and ulnar neuropathy in the infected case and idiopathic in the non-infected case. Both of the patients had a history of specific trauma at the affected elbows. The radiographs of the elbows revealed dislocation, fracture fragmentation and some bony sclerosis. The management in the non-infected case aimed to maintain the function of the elbow with a short period of immobilization and physical therapy. For the infected case, the patient was treated successfully with systemic antibiotic, surgical debridement and a period of immobilization with an external fixator RESULTS: The patients were followed-up for approximately 9 months for the non-infected and 2 years for the infected case. Both of them had painless and functional range of motion of the elbows in the most recent follow-up examination. For the infected case, the surgical incision healed well and there was no recurrent discharge from that affected elbow. CONCLUSION: In the first case, with neuropathic arthropathy of the elbow, the investigations were made to find the underlying disease. The second case with septic neuropathic joint, systemic antibiotic, surgical debridement and appropriate immobilization were needed. With gross instability and marked distortion of the joint, the elbow of both patients functioned remarkably well.

Aged↗

PubMed2005

Effective osteosarcoma cytolysis using cytokine-induced killer cells pre-inoculated with tumor RNA-pulsed dendritic cells.

Osteosarcoma with distant metastases at late stage has posed a challenge for novel therapeutic modalities. The application of cytokine-induced killer (CIK) cells to osteosarcoma constitutes a promising strategy. This approach had been studied in multiple myeloma and breast cancers, where CIK cells exhibited specific cytotoxicity toward malignant cells while sparing wild-type tissues. However, the consistency of CIK cell-induced anti-tumor cytotoxicity has not been thoroughly examined. We investigated whether autologous CIK cells could effectively induce cytolysis of cultured osteosarcoma cells. In addition to the observed CIK cell-induced osteosarcoma cytolysis, the pre-incubation of CIK cells with autologous dendritic cells pulsed with tumor's total RNA further enhanced the tumor cytolysis to greater than 6-fold. The anti-tumor cytolysis was optimized in complete autologous setting, and was attenuated with allogeneic components. The advantage of the co-culture with RNA-pulsed DC was lost when high CIK cell density was employed for anti-tumor cytotoxic assay, but was maintained in purified CD3(+)CD56(+) cells isolated from the CIK cells. This finding implied that CIK cells at limited cell density could induce effective osteosarcoma cytolysis with an aid from tumor antigen presentation on dendritic cell surface.

Bone Neoplasms↗

PubMed2003

A knee model for arthrocentesis simulation.

OBJECTIVES: To produce a knee model for medical students and residents to practice knee aspiration and intra-articular injection. MATERIAL AND METHOD: The model was made of plastic, rubber and silicone that included the lower third of the femur, the upper third of the tibia and the patella. They were fixed on 2 plastic boxes in the anatomical position and the boxes were connected together with 2 small hinge joints. A rubber bag was made in the pattern of synovial space of the knee. Quadriceps, anterior muscles of the leg and patellar tendon were also presented. The model was covered with silicon sheet, representing the skin. Water was used to fill up the synovial bag to simulate joint aspiration via supero-lateral approach with the knee in extension. The model was appraised by 30 medical students, 26 orthopedic residents and 10 orthopedic staff in terms of size, anatomy, physical examination, feeling during aspiration, need of the model in education and commercial use. RESULTS: Most of the medical students, residents and staff (80-90%) were satisfied with the model and rated it as good to very good teaching media. However, the model should come out in different sizes and the synovial bag should be modified to improve the ballotment test. Mass production of the model should be done. CONCLUSION: The knee model is an acceptable teaching model for arthrocentesis simulation with affordable cost.

Adult↗