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Biomedical subjects

A Rojanasakul

Publications and source records attributed to A Rojanasakul.

At least 19 recordsLinked to original sources
PubMed1995

Determinants of multiple pregnancies in in vitro fertilization other than number of transferred embryos.

The aim of this study is to assess the many different parameters involved in the incidence of multiple pregnancies, such as maternal age, stimulation, endometrium, receptivity and the quality of the transferred embryos. During a 3.5 year period, 86 pregnancies were recorded in our IVF unit. A single gestational sac was identified by early ultrasonography in 67 patients, while in 19 others, multiple sacs were noted. Patient characteristics, treatment cycles and embryology results were similar in the two groups. When the number of transferred embryos was kept similar in both groups, EIR was found to be a valuable prognostic determinant for multiple pregnancies in IVF.

Abortion, Spontaneous↗
PubMed1994

Carcinoma of the rectum. Profiles of intraoperative and early postoperative complications.

PURPOSE: The aim of this study was to determine the incidence and risk factors that were significant in contributing the intraoperative and early postoperative complications for operations of carcinoma of the rectum. METHODS: Between 1984 and 1986 inclusive, 426 patients underwent surgery for primary adenocarcinoma of the rectum. Cases of local excision were excluded. The relationship between each complication and nominal risk factors were studied. The types of surgery included an abdominoperineal resection, low anterior resection, low anterior resection with coloanal anastomosis, anterior resection, colostomy, and Hartmann's procedure. RESULTS: There were two (0.5 percent) deaths. Intraoperative complications occurred in 34 (8 percent) patients. The most common intraoperative complication was presacral bleeding which occurred in 14 patients. Postoperative complications occurred in 214 (50 percent) patients. The two most common complications were urinary retention and urinary tract infection. Abdominoperineal resection had the highest early postoperative complication rate (59 percent). There were 17 clinical anastomotic leaks (7 percent in 221 patients with unprotected anastomoses). The development of complications reached statistical significance with increasing age (P = 0.003), male sex (P = 0.003), increasing weight (P = 0.006), and types of operative procedure (P = 0.001). CONCLUSIONS: Operations for carcinoma of the rectum can be performed with low mortality. Although the overall early postoperative complications were high, the majority was not life-threatening and usually resolved with time and proper management.

Adenocarcinoma↗
PubMed1994

Chemiluminescence immunoassay versus radioimmunoassay for the measurement of reproductive hormones.

OBJECTIVES: To compare the hormonal values determined by chemiluminescence immunoassay (CIA) and radioimmunoassay (RIA). METHODS: Blood samples, drawn from eight volunteers during one menstrual cycle, were assayed for estradiol, progesterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin by CIA and RIA methods. The values obtained from these two assay techniques were compared. Statistical analysis were performed using the t-test, Pearson correlation coefficient and simple linear regression analysis. RESULTS: CIA yielded lower mean values of LH, FSH, progesterone, but higher mean values of prolactin than RIA. Mean estradiol levels assayed by the two methods were similar. There was a good correlation between the hormonal values performed by the two methods. By calculation, the CIA hormonal value could accurately predict the RIA value by 96.6, 93.9, 89.9 and 66.0% for progesterone, LH, FSH and prolactin, respectively. CONCLUSIONS: The disparity in the hormonal values obtained from different assay methods warrants clinicians to be aware of their clinical interpretation. Using the same reference range for different assay methods is not appropriate. A comparative study between the new and standard assays is essential.

Adult↗
PubMed1994

"Simplified IVF": program for developing countries.

The aim of this study is to assess the results of the "Simplified IVF" program at Ramathibodi Hospital. Ramathibodi IVF program has been in operation since October, 1991. Some steps of the conventional IVF procedures have been modified due to the limitation of resources. The embryo laboratory is a simple, clean room situated in a different building from the oocyte recovery room. Short protocol of GnRHa/HMG is used for ovarian stimulation. Monitoring of the follicular development is performed by ultrasound alone with limited number of scans (2-3 times/cycle). Oocyte retrieval is carried out under transvaginal ultrasound guidance and the aspirate transported to the embryo laboratory in a simple insulated box. Luteal phase is supported by giving micronized progesterone. Eighty five couples have undergone 105 ovarian stimulation cycles. OR was done in 100 cycles from 80 couples. Total oocytes collected is 1091. The fertilization rate is 75 per cent. Embryos were transferred in 97 cycles. Clinical pregnancy occurred in 25 cycles. Pregnancy rate per OR and ET is 25 and 25.8 per cent respectively. Nineteen patients have delivered (6 twins, 13 singletons). Simplification of procedures has enabled the IVF service to be available in a center with limited resources without compromising the results. Other advantages are improvement of the patient's convenience, cost savings and less time consumed as well as being less stressful.

Adult↗
PubMed1993

Two years' experience of intrauterine insemination for the treatment of infertility.

The result of a two year (1990-1991) trial of IUI is presented. Discontinuous Percoll-gradient centrifugation technic was used for motile sperm separation. In 174 couples with 610 treatment cycles, there were 49 clinical pregnancies. The pregnancy per patient was 28 per cent and the pregnancy per cycle was 8 per cent. Cycle fecundity by various factors which possibly influence the outcome were assessed. The success rate appeared to be higher in the young female age group, short duration of infertility, secondary infertility, unexplained infertility, a higher number of motile sperm inseminated and dual insemination in a cycle.

Adult↗
PubMed1993

Early experience with gamete intrafallopian transfer at Ramathibodi Hospital.

This report summarises the result of the GIFT program at Ramathibodi Hospital during 1990-1991. There were 35 treatment cycles in 34 infertile couples. The age of the females varied from 29 to 41 years. Duration of infertility was 3 to 10 years. GIFT was performed during diagnostic laparoscopy in 26 cycles (78%). Other indications were endometriosis (5 cycles), concurrent with myomectomy (3 cycles) and unexplained infertility (1 cycle). Two cases received CC+HMG for superovulation, the others had GnRHa+HMG. Transvaginal ultrasound guided oocyte pick up yielded 2 to 10 oocytes (mean 5.8 oocytes per cycle). Two to 8 oocytes were transferred. All patients received progesterone or HCG for luteal support. In cases of diagnostic laparoscopy, the findings were normal (10 cases), endometriosis (7 cases), pelvic adhesion (6 cases) and myoma uteri 3 cases). No pregnancy was achieved among 18 GIFT cycles performed in 1990. In 1991, after changing some instruments and methods, there were 5 pregnancies out of 17 GIFT cycles (29%). The factors that influenced the outcome were good selection of instruments and method, maturity of oocytes and semen parameters.

Adult↗
PubMed1992

The fate of patients following polypectomy alone for polyps containing invasive carcinoma.

Eighty-two patients with colon and rectal polyps containing invasive adenocarcinoma treated by polypectomy alone were studied. Seven of 34 patients (21 percent) with sessile lesions had an adverse outcome, including five local recurrences and two distant metastases. They occurred from 4 to 68 months after the polypectomy. Forty-seven pedunculated polyps with invasion to the head (Level 1) or to the stalk (Level 3) and one polyp to the base of the stalk (Level 4) had no evidence of local recurrence or signs of metastasis. Twenty-eight percent of patients were found to have adenomatous polyps, and 4 percent had malignant polyps during the follow-up examinations (range, 3-119 months; mean, 53 months). The findings suggested that pedunculated polyps with invasion to the head (Level 1), neck (Level 2), or stalk (Level 3) can be safely treated with a complete polypectomy provided that the carcinoma is not undifferentiated. Sessile lesions as well as Level 4 pedunculated lesions should be treated aggressively. If resection is not performed, a long-term follow-up in these patients is essential.

Adenocarcinoma↗
PubMed1991

The risk of lymph node metastasis in colorectal polyps with invasive adenocarcinoma.

One hundred fifty-one patients with colorectal polyps containing invasive adenocarcinoma treated by resection were studied to determine the incidence of lymph node metastasis and whether lymph node metastasis was related to the depth of invasion. Other variables evaluated included size and configuration of the polyp, grade of adenocarcinoma, presence or absence of lymphovascular invasion, and degree of differentiation. In patients with sessile polyps, the incidence of lymph node metastasis was 10 percent. Eighty percent of these lesions had lymphovascular invasion. For pedunculated polyps, the overall incidence of lymph node metastasis was 6 percent. However, there was no incidence of lymph node metastasis when the depth of invasion was limited to the head, neck, and stalk of the polyp (Levels 1, 2, and 3). Only when the depth of invasion reached to the base of the stalk (Level 4) was the risk of lymph node metastasis high (27 percent). The other risk factors were not associated with lymph node metastasis. We concluded that the most significant risk factor for lymph node metastasis in patients with invasive carcinoma in a polyp was invasion into the submucosa of the bowel wall (Level 4).

Adenocarcinoma↗
PubMed1990

Treatment of endometriosis with gonadotropin releasing hormone agonist (buserelin).

The results of treatment of endometriosis with intranasal buserelin is convincing. The drug effectively suppresses serum estradiol to the menopausal level. Clinical improvement and regression of endometriotic lesions were observed during treatment. Thus, buserelin offers an alternative medical treatment of endometriosis. Further studies of the effects of GnRH agonist on bone mass are needed.

Adult↗
PubMed1990

The efficacy of lisuride in the treatment of hyperprolactinemic amenorrhea.

Thirteen women with hyperprolactinemic amenorrhea were treated with lisuride (Dopergin, Schering AG, Germany). The dosage of lisuride was started with 0.1 mg per day and increased to 0.2 mg per day after one week of treatment. Further increment of the drug depended on clinical and laboratory responses of the patients. One patient dropped out from the study due to marked nausea and dizziness. In ten out of twelve patients serum prolactin decreased to normal. Most patients received lisuride 0.2-0.4 mg per day. Only one got more than 0.4 mg per day. Two patients whose serum prolactin levels did not decrease to normal range had uterine bleeding, quite regularly. Menstrual cycle resumed within 23 to 141 days. All galactorrhea disappeared during treatment. Two of five patients who desired pregnancy became pregnant during the treatment. The course and outcome of pregnancies were normal. Common side effects of lisuride treatment were nausea and dizziness. In conclusion, this study demonstrated that lisuride is another effective prolactin inhibiting agent even at low dose. This drug provides an alternative treatment to bromocriptine.

Adult↗
PubMed1989

Clinical presentation, hormonal profiles and ultrasonic ovarian morphology in women with suspected polycystic ovarian disease.

The aim of this study is to determine the clinical presentation, hormonal profiles and ultrasonic ovarian morphology in a group of Thai women with polycystic ovarian disease. The patients consisted of 54 women who had abnormal menstruation, androgenic symptoms, LH to FSH ratio of at least 3 and normal serum prolactin. The clinical and hormonal profiles of the patients were similar to the previous reports from developed countries. The typical ultrasonic cystic appearance of the ovaries was observed in about two-thirds of the patients. The patients with cystic ovaries had lower mean body weight but higher mean serum LH and FSH than the control group.

Adolescent↗
PubMed1988

Serum lipids and lipoproteins in women with polycystic ovarian disease with different body mass index.

A study to determine serum lipids and lipoproteins in 54 women with polycystic ovarian disease (PCOD) who had varying body mass index (BMI) compared to the normal regular menstruating women was carried out. All patients had similar hormonal profiles of PCOD and differed from the control group. The significant observations were high level of triglyceride and low percentage of alpha lipoprotein in obese PCOD. The BMI was positively correlated with serum triglyceride level, beta and prebeta lipoproteins but inversely correlated with high density lipoprotein (HDL) cholesterol, the low density lipoprotein (LDL) cholesterol/HDL cholesterol ratio and alpha lipoprotein. No significant correlation between lipids, lipoproteins and testosterone levels was observed. It appeared that the alteration of serum lipids and lipoproteins in PCOD is due to the effect of obesity.

Adult↗