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Biomedical subjects

P Kullavanijaya

Publications and source records attributed to P Kullavanijaya.

At least 19 recordsLinked to original sources
PubMed1998

Natural history of untreated primary hepatocellular carcinoma: a retrospective study of 157 patients.

Primary hepatocellular carcinoma (HCC) is a common malignancy with a dismal prognosis; new modalities of treatment as alternatives to surgery have been developed for unresectable patients. The authors obtain baseline data for the natural history of HCC so that the efficacy of new treatments may be evaluated. A retrospective study of 157 untreated patients with tissue-proven or serodiagnosed HCC was conducted. Clinical characteristics including laboratory investigation, treatment received, survival from the time of diagnosis, and prognostic factors were evaluated. There were 129 men and 28 women (ratio, 4.6:1). Median age was 50.9 years (range, 14.1-85.3 years). The most common symptoms and signs were weight loss (68.2%), abdominal fullness (62.5%), abdominal pain (51.6%), hepatomegaly (73.7%), ascites (45.2%), and jaundice (40.6%). Eighteen percent had extrahepatic metastases of which the lungs were the most common site. Seventy percent were hepatitis B virus related. Overall median survival was 8.7 weeks after the time of diagnosis. Survivals by stages were: TNM II, 16.6 weeks; TNM III, 7.3 weeks; TNM IVA, 9.7 weeks; TNM IVB, 7.6 weeks; Okuda II, 10.7 weeks; and Okuda III, 7.3 weeks. Multivariate analysis revealed serum total bilirubin and albumin as independent prognostic factors of survival. Common causes of death were upper gastrointestinal hemorrhage (34.1%), cancer-related causes (cachexia, HCC rupture, metastatic disease, 31.8%), and hepatic failure (25.0%). Patients with HCC were diagnosed at late stages of their disease and the advanced nature of the tumor precluded effective therapy. Earlier tumor detection at a time when patients are better candidates for treatment may be aided by an active surveillance program of high risk groups.

Adolescent↗
PubMed1998

Topical PUVA therapy for chronic hand eczema.

Seventeen patients with persistent chronic hand eczema were treated with topical 0.1% 8-methoxypsoralen and UVA (PUVA) for 8 weeks. Significant improvement was achieved in 5 cases (29%), moderate improvement in 9 (53%), and little improvement in 3 (18%). The mean number of PUVA treatments was 22.2, and the mean total UVA dose was 63.5 J/cm2. There was no association between clinical response and duration of hand eczema, positive patch test reaction, or atopic status. Since topical PUVA has no risk of systemic side effects, it should be considered as an alternative treatment for patients with chronic hand eczema who are resistant to other topical medications.

Adolescent↗
PubMed1997

A study of dermatitis in the lacquerware industry.

Contact dermatitis from lacquer has been documented. The causative agent is a resin from a lacquer tree that can induce either irritation or sensitization. Thai and Japanese lacquer trees are 2 distinct species but are both members of the Anacardiaceae family. We report 3 cases of contact dermatitis from Thai lacquer resin. Observation and study of the lacquer plantation and working process at the factory were made to elucidate the aetiology of the dermatitis.

Adolescent↗
PubMed1997

Primary cutaneous infection with Mycobacterium avium intracellulare complex resembling lupus vulgaris.

We describe a 56-year-old woman with Mycobacterium avium complex infection of the skin. She presented with a granulomatous plaque studded with pustules and crusts on the cheeks and bridge of the nose. The appearance resembled lupus vulgaris. The lesion responded well to antituberculous treatment within 9 months. An association of Mycobacterium avium complex with squamous cell carcinoma of the cervix is emphasized.

Carcinoma, Squamous Cell↗
PubMed1996

Chronic discoid lupus erythematosus in Thailand: direct immunofluorescence study.

BACKGROUND: Studies of chronic discoid lupus erythematosus (DLE) lesions by direct immunofluorescence (DIF) were heterogeneous with respect to classes of immunoglobulins and sites where these were deposited. Most of the studies were done in the USA and European countries. MATERIALS AND METHODS: To obtain representative data from Asiatic countries, we analyzed the direct immunofluorescent abnormalities of 100 DLE lesions in Thai patients who were diagnosed on the basis of clinical and histologic criteria. RESULTS: Granular deposits at the dermoepidermal junction (DEJ) were detected in 90% of cases. The common immunoreactants at the DEJ were IgG (63%) and IgM (47%). The deposits were usually combinations of various classes of immunoglobulins, mostly IgG (53%) and IgM (41%). Deposits of IgG and IgM alone at the DEJ were observed in 12% and 8%, respectively. Deposits at colloid bodies, dermal blood vessel walls, and epidermal nuclei were sometimes also seen. CONCLUSIONS: The DIF test of skin biopsy specimens is diagnostically significant in chronic DLE. Our study in Thai patients showed that the most common deposit was a combination of various classes of immunoglobulins, mostly IgG and often IgM as well as C3, and occurred at the DEJ of the involved area.

Adolescent↗
PubMed1995

Successful treatment of chromoblastomycosis due to Fonsecaea pedrosoi by the combination of itraconazole and cryotherapy.

BACKGROUND: Many methods and medications had been tried for the treatment of chromoblastomycosis with unsatisfactory results. Recently, there were several reports showing a good response of chromoblastomycosis to itraconazole, but it took as long as 18-30 months for lesions to heal. METHODS: Itraconazole, 200 to 400 mg/day alone or in combination with monthly liquid nitrogen cryotherapy, was tried on 10 cases of chromoblastomycosis, caused by Fonsecaea pedrosoi in order to increase the potency of the drug and shorten the duration of treatment. RESULTS: The 10 cases included five newly diagnosed and five recalcitrant cases. Two patients were cured by 200 mg/day alone within 3 months. Seven patients required itraconazole, 400 mg/day, with combined cryotherapy to cure the lesions within 5 to 10 months. One case showed marked improvement but no cure. After the period of 1-year follow-up, only one case had a recurrent infection. CONCLUSIONS: Itraconazole was highly effective and may be useful in the treatment of chromoblastomycosis. A high dose is indicated in chronic fibrotic lesions in combination with liquid nitrogen cryotherapy, with higher efficacy and quicker healing than with medication alone.

Adult↗
PubMed1995

Cutaneous carcinoma and PUVA lentigines in Thai patients treated with oral PUVA.

A total of 113 Thai patients who were treated with oral PUVA from 1979 to 1992 were examined for long-term cutaneous side effects of PUVA. Two psoriatic patients developed PUVA keratosis on non-sun-exposed areas. Both were skin type IV and had had phototherapy with UVB and sunlight previously. The total doses of UVA were 909 J/cm2 and 242 J/cm2 respectively. One psoriatic patient developed Bowen's disease. He had had a cumulative dose of UVA 2207 J/cm2. He also had a past history of arsenic intake and phototherapy with UVB and sunlight. PUVA lentigines were seen in 58 patients (51.4%). It was associated with older age at starting PUVA, higher cumulative UVA dose and greater number of PUVA treatment. This study suggests that previous exposure to other risk factors is important for inducing skin cancer in populations with skin phototype III, IV and V treated with oral PUVA.

Administration, Oral↗
PubMed1994

Basal cell carcinoma: seven years' experience at the Institute of Dermatology in Bangkok.

Sixty-seven patients with basal cell carcinoma (BCC) were observed at the Institute of Dermatology, Bangkok, Thailand between 1982 and 1989. The male:female ratio was 1:2. The average age of the patients at first examination was 60.6 years. Lesions in sun-exposed areas were three times more frequent than lesions in covered areas. The principal location was the face, including the cheek, nose, periorbital area, ears, and forehead. The remainder were on the scalp, breast, abdomen, back, thigh, and knee. Ulceration was the most frequent symptom, followed by a mass. Histopathologically, pigmented BCC was the most frequent, followed by solid BCC, superficial BCC, adenoid BCC, morphoeic BCC, cystic BCC, basosquamous BCC, mixed carcinoma, keratotic BCC, and fibroepitheliomatous BCC. In patients younger than 50 years of age, solid or pigmented tumors were frequent. The morphoeic type was present only on the face and scalp. In females, solid BCC or adenoid BCC predominated. Only 4 of our 67 patients had histories of ingestion of herbal medicine with arsenic as one of the ingredients. Sixty-one patients were treated surgically. There was only one case of tumor recurrence after surgery. The remaining patients were treated by electric cautery, liquid nitrogen, or irradiation. No patients developed distant metastasis.

Adolescent↗
PubMed1993

Clinical efficacy and side effects of acitretin on the disorders of keratinization: a one-year study.

Acitretin, Ro 10-1670, the principal and free acid metabolite of etretinate, was used to treat twenty patients with disorders of keratinization. An open, prospective study of clinical efficacy, tolerability, and the effects of acitretin on lipid metabolism, hepatic function, and the osteoarticular system was performed over a one year period. Each patient was initially treated with 30 mg/day of acitretin or approximately 0.6 mg/kg/day. Doses were adjusted according to the clinical efficacy and maintained for one year. There were no statistically significant changes in liver function tests or lipid profile. Twelve of eighteen evaluated patients developed asymptomatic skeletal changes; the most common change was disc space narrowing, especially at thoracic-spine level (7 of 18 patients). The earliest bone change was detected 9 months after treatment. Acitretin is effective in improving the disorders of keratinization with mild mucocutaneous side effects and asymptomatic osteoarticular changes.

Acitretin↗
PubMed1993

Outbreak of cercarial dermatitis in Thailand.

BACKGROUND: An epidemic of cercarial dermatitis caused by Schistosoma spindale cercaria occurred in November 1988 in a district called Chaiya, Surajthani province, in Southern Thailand. CASE REPORTS: Fifty-eight Thai farmers in Chaiya, Surajthani gave a history of itch following immersion in water while planting rice. The area of rice field was flooded for 10 days before farmers started working. The duration of the disease ranged from 2 days to 1 month. Forty-one patients had the disease for the first time, seventeen had a history of previous manifestations. CONCLUSIONS: This epidemic was caused by S. spindale cercaria, which developed in the Indoplanorbis exustus snail, associated with flooding.

Adult↗