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Biomedical subjects

Vorapong Phupong

Publications and source records attributed to Vorapong Phupong.

At least 19 recordsLinked to original sources
PubMed2005

Serum calcium and serum magnesium in normal and preeclamptic pregnancy.

OBJECTIVE: The aims of this study were to measure serum levels of calcium and magnesium in preeclamptic pregnancies and to compare them with those in normal pregnancies. MATERIALS AND METHODS: We collected venous serum samples from 40 preeclamptic pregnant women and 40 normal pregnant women. The blood samples were analyzed for calcium and magnesium, using a colorimetric analyzer. The data were analyzed using the Student's t-test, chi2-test or Fisher exact tests when appropriate. RESULTS: The serum calcium concentration in preeclamptic pregnant women is significantly lower than that in normal pregnant women (9.0 +/- 0.4 mg/dl vs. 9.7 +/- 0.7 mg/dl, p < 0.0001). Like serum calcium, serum magnesium concentration in preeclamptic women is significantly lower than that in normal pregnant women (0.77 +/- 0.08 mmol/l vs. 0.85 +/- 0.09 mmol/l, p = 0.001). CONCLUSION: This study shows that both serum calcium and serum magnesium levels in preeclamptic pregnant women are lower than in normal pregnant women. These findings support the hypothesis that hypocalcemia and hypomagnesemia are possible etiologies of preeclampsia.

Adult↗
PubMed2005

Prospective randomized, double-blinded, placebo-controlled trial of preoperative rofecoxib for pain relief in uterine curettage.

OBJECTIVE: To evaluate the analgesic efficacy of preoperative rofecoxib in patients who underwent uterine curettage. MATERIALS AND METHODS: This double-blinded, randomized, placebo-controlled trial included 80 women who underwent uterine curettage. Forty women were randomly assigned to rofecoxib 50 mg and 40 women to the placebo. The main outcome measure was the intensity of pain measured by the visual analog scale and categorical pain scores during and after the procedure. Chi-squared, Fisher exact, Student t test, and Mann-Whitney U tests were used for statistical analysis. RESULTS: The intensity of pain was not found to be different between groups over the course of procedure (P>0.05). There were no serious adverse effects in this study. CONCLUSION: The preoperative administration of rofecoxib was not effective in reducing pain in uterine curettage.

Adult↗
PubMed2005

First trimester diagnosis of partial mole.

BACKGROUND: Partial mole is one of the two distinctive subtypes of hydatidiform mole. It is usually paternally derived triploid conceptions in which embryonal development occurs in association with trophoblastic hyperplasia. The definite diagnosis is confirmed by pathological and cytogenetic studies. Ultrasound might be helpful to diagnose partial mole in the first trimester. CASE: A 25-year-old woman, gravida 2, para 0-0-1-0, was initially seen for antenatal care at 6 weeks' pregnant. Ultrasound was undertaken at 13 weeks' pregnancy due to her first fetal anomaly, which demonstrated partial mole and embryonic death. The serum beta hCG was 190,900 mIU/ml. Suction curettage was performed without complication. Histopathological study confirmed partial mole and cytogenetic study of the placenta revealed an uncommon karyotype, mosaicism of triploid (69,XXX/69,XXY). Serum beta hCG was declined and negative at 8 weeks. The patient was well and serum beta hCG remained normal throughout 6 months of follow-up. CONCLUSION: Although the majority of partial mole pregnancies cannot be detected by routine first trimester ultrasound examination, first trimester ultrasound can be helpful in some cases, such as this one. If partial mole is sonographically suspected, it should be confirmed with histopathology and cytogenetic studies. The management is similar to complete mole including prompt evacuation and careful monitoring of beta hCG.

Adult↗
PubMed2004

Bilateral pheochromocytoma during pregnancy.

BACKGROUND: Pheochromocytoma is a rare disease of the chromaffin cells that secrete catecholamines. It may occur during pregnancy. Bilateral pheochromocytoma in pregnancy is even rarer. CASE: A 26-year-old woman, gravida 2, para 0-0-1-0, 18 weeks' pregnancy, was initially seen with elevated blood pressure (170/100 mmHg) and mild headache. The cause of hypertension was conventionally investigated and bilateral pheochromocytoma was finally searched for and found. Bilateral adrenalectomy was undertaken at 23 weeks' gestation and Cesarean section was performed at 31 weeks' gestation due to intrauterine growth retardation (IUGR) and compromised fetal well-being. The maternal outcome was uneventful and the baby was physiologically complicated only by neonatal jaundice. CONCLUSION: Pheochromocytoma should be searched for in the conventionally differential diagnosis in hypertension during pregnancy, especially in the young. Early diagnosis and proper management with medical treatment followed by surgical removal of the tumor usually result in good maternal and fetal outcomes.

Adrenal Gland Neoplasms↗
PubMed2004

Prenatal diagnosis of Pompe disease by electron microscopy.

INTRODUCTION: Pompe disease is one of the lysosomal storage disorders caused by alpha-glucosidase deficiency. The disease is characterized by accumulation of glycogen in the lysosome. The accumulation has unique ultrastructural features, which enable a prenatal diagnosis possible by electron microscopy. MATERIALS AND METHODS: A prenatal diagnosis of Pompe disease by electron microscopic study of chorionic villus biopsies is described in a fetus of a mother whose previous child had died of the disease. RESULTS: Electron microscopy revealed fibrocytes with typical vacuoles filled with glycogen. A prenatal diagnosis of Pompe disease was made and subsequently confirmed by the autopsy study of the abortus. CONCLUSION: We report the usefulness of electron microscopy for prenatal diagnosis in the first trimester of Pompe disease.

Abortion, Induced↗
PubMed2004

Comparative study between single dose 600 microg and repeated dose of oral misoprostol for treatment of incomplete abortion.

OBJECTIVE: To evaluate and compare the effectiveness and side effects of two regimens of oral misoprostol, single dose (600 microg) and repeated dose (1200 microg), in the treatment of incomplete abortion. METHODS: A prospective randomized controlled trial was conducted. One-hundred women who had incomplete abortion (gestational age < 20 weeks) and consented to randomization by computer-generated randomization model prior to treatment. A single oral 600-microg dose or repeated oral dose after 4 h (total 1200 microg) was given to the randomized women. RESULTS: The overall incidence of complete abortion was 86.9%. This incidence was not statistically different between the single-dose and repeated-dose groups (81.6% vs. 92%, p > 0.05). However, there was a significantly decreased incidence of diarrhea (18.4% vs. 40%, p < 0.05) with the use of single-dose treatment. Overall rate of acceptability and tolerable side effects were 88.9% and 97.9%, respectively. These rates were similar in both groups (87.8% vs. 90% and 98% vs. 98%, p > 0.05). CONCLUSIONS: Oral misoprostol may be a practical alternative in the management of incomplete abortion. Oral misoprostol is acceptable and tolerable to women. Single-dose regimen is as effective as repeated-dose regimen, with a reduction in the incidence of diarrhea.

Abortifacient Agents, Nonsteroidal↗
PubMed2004

First trimester umbilical cord and vessel diameters of Thai fetuses.

OBJECTIVE: To establish the reference ranges for first trimester umbilical cord and vessel diameters of Thai fetuses. MATERIAL AND METHOD: A prospective study was performed on normal pregnant women between 10(+0) and 13(+6) weeks of gestation who underwent ultrasound examination. The diameter measurements were obtained by a 7.5 MHz vaginal--or a 3.75 MHz abdominal transducer. Statistics were analyzed using SPSS computer program. RESULTS: Records of 184 pregnancies were analyzed and the outcome demonstrated a strong correlation between umbilical cord diameter and gestational age (r = 0.90; p < 0.001). Umbilical vessel diameters were also correlated with gestational age. CONCLUSION: First trimester umbilical cord and vessel diameters of Thai fetuses are related to gestational age. The presented reference ranges might be useful for further studies, such as prediction of adverse pregnancy outcome or combination with biochemical or other ultrasound markers for fetal aneuploidy screening.

Adult↗
PubMed2004

Authorship.

Explore the source record for details and available documents.

Authorship↗
PubMed2004

Oral salbutamol for treatment of preterm labor.

OBJECTIVE: The aim of this study was to assess the value of oral salbutamol for the inhibition of preterm labor. MATERIAL AND METHOD: Medical records of the department from January 1, 1991 to December 31, 1999 were reviewed for all idiopathic preterm labors that were inhibited by oral salbutamol and statistically analyzed. RESULTS: Of 132 pregnancies, 81.1% (95%CI, 74.4, 87.7) were prolonged for more than 24 hours, 59.8% (95%CI, 51.5, 68.2) for more than 2 days, 32.6% (95%CI, 24.6, 40.6) for more than 1 week, and 8.3% (95%CI, 4.2, 14.4) for more than 4 weeks. Tachycardia (pulse rate > 100 beats/min) occurred in 85.6% of the patients, but those with a pulse rate higher than 140 beats/min occurred in only 3%. Hypotension occurred in only 0.8%. Neonatal complications occurred in 28%, while respiratory distress syndrome occurred in 22.7% of the babies. Perinatal mortality in the present study was 7.6 per 1,000 births. When comparing the pregnancy outcome between groups regarding the prolongation time, the pregnancy outcome was significantly better in the group that had a prolongation time of at least 48 hours. CONCLUSION: Oral salbutamol proved to be another effective method that inhibits preterm labor and consequently prolongs pregnancy. Because it requires no intensive medical nursing care and observations, and no discomfort of an intravenous line, oral salbutamol may be an alternative drug in the management of preterm labor.

Administration, Oral↗
PubMed2004

High level of CA 125 due to large endometrioma.

BACKGROUND: CA 125 is a tumor-associated antigen. Its high levels are usually associated with ovarian malignancies, whereas smaller increases in the levels were associated with benign gynecologic conditions. The authors report a high level of CA 125 in a case of large ovarian endometrioma. CASE REPORT: A 45-year-old nulliparous Thai woman, presented with an increase of her abdominal girth for 7 months. Transabdominal ultrasonogram demonstrated a large ovarian cyst and multiple small leiomyoma uteri, and serum CA 125 level was 1,006 U/ml. The preoperative diagnosis was ovarian cancer with leiomyoma uteri. Exploratory laparotomy was performed. There were a large right ovarian endometrioma, small left ovarian endometrioma and multiple small leiomyoma. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed and histopathology confirmed the diagnosis of endometrioma and leiomyoma. The serum CA 125 level declined to non-detectable at the 4th week. She was well at discharge and throughout her 4th week follow-up period CONCLUSION: Although a very high level of CA 125 is associated with a malignant process, it can also be found in benign conditions such as a large endometrioma. The case emphasizes the association of high levels of CA 125 with benign gynecologic conditions.

CA-125 Antigen↗
PubMed2004

Scrub typhus during pregnancy: a case report and review of the literature.

Scrub typhus is a rickettsial disease that is uncommon during pregnancy. We report a case of a 33-year-old woman, G1P0, 29 weeks pregnancy who presented to hospital with high fever, chill and headache for two weeks. Her diagnosis of scrub typhus was confirmed by serum immunofluorescent assay. She was successfully treated with chloramphenicol, but preterm delivery occurred. Her infant died from respiratory distress syndrome. No vertical transmission was demonstrated in this case. Scrub typhus should be listed in the differential diagnosis of acute febrile illness in pregnant women, who either live in, or return from, endemic areas. Chloramphenicol can be used safely during pregnancy if it is not circulating at the time of delivery.

Adult↗
PubMed2004

Prenatal exclusion of Crouzon syndrome by mutation analysis of FGFR2.

Crouzon Syndrome is an autosomal dominant syndromic craniosynostosis characterized by premature closure of cranial sutures, exophthalmos, and midface hypoplasia. It is caused by multiple mutations in the fibroblast growth factor receptor 2 (FGFR2). We describe prenatal genetic testing of FGFR2 in a fetus of a mother whose previous child had Crouzon Syndrome due to an apparently de novo mutation, S351C. Sequence electropherograms of the exon 10 of FGFR2 encompassing the codon 351 revealed only the normal sequence, thus predicting a very high likelihood of an unaffected fetus. The study was confirmed by the birth of a normal neonate. We report the use of molecular genetic testing to exclude Crouzon Syndrome due to FGFR2 mutation prenatally. Prenatal diagnostic testing for a known mutation is a reasonable option for couples at risk for having a child with Crouzon Syndrome due to germline mosaicism. Molecular testing is more accurate and reliable than ultrasonography and provides families with reassurance.

Adult↗
PubMed2003

Infected endometrioma in pregnancy masquerading as acute appendicitis.

BACKGROUND: A pregnancy complicated by ovarian endometrioma is rare. Other complications of ovarian endometrioma in pregnancy, i.e., rupture and infection are also rare. CASE: A 35-year-old woman, gravida 2, para 0-0-1-0, at 35 weeks' pregnancy, came to the hospital with a right abdominal pain. She also had a history of diarrhea. She had history of infertility and preexisting right endometrioma. The investigations revealed leukocytosis with neutrophils predominant. The preoperative diagnosis was acute appendicitis. Infected right ovarian endometrioma was demonstrated during exploratory laparotomy, opened and drainage of the right endometrioma and appendectomy were performed. The final diagnosis was infected ovarian endometrioma in pregnancy, later confirmed by a pathological report. CONCLUSION: Although complication of ovarian endometrioma such as infected endometrioma during pregnancy is rare, it should be included in the differential diagnosis of pelvic pain during pregnancy, especially in the patient who has history of ovarian endometrioma.

Abdominal Pain↗
PubMed2003

Simultaneous tubal pregnancy and twisted ovarian cyst.

BACKGROUND: Simultaneous or concomitant bilateral adnexal pathology is rare. But simultaneous tubal pregnancy and twisted ovarian cyst is even rarer. CASE: A 25-year-old woman, gravida 2, parity 0, presented with acute abdomen after 12 weeks of amenorrhea. Simultaneous right tubal pregnancy and twisted left ovarian cyst were intraoperatively diagnosed. Right salpingostomy and left salpingo-oophorectomy were performed. The follow-up serum beta-hCG was negative at the nineteenth postoperative day. She was well at discharge and throughout the 4-week follow-up period. CONCLUSION: Although simultaneous or concomitant bilateral adnexal pathology is uncommon, a careful assessment of both adnexa is mandatory especially in the cases with inconsistent site of symptom and pathology in order to avoid undiagnosed simultaneous pathologies that may be missed.

Adult↗
PubMed2003

Ovarian teratoma with diffused peritoneal reactions mimicking advanced ovarian malignancy.

BACKGROUND: Benign cystic teratomas are one of the most common benign ovarian neoplasms. Although its rupture is rare, once occurred it can cause complications such as granulomatous peritonitis, mimicking metastatic ovarian malignancy. CASE: A 39-year-old woman, Para 0-0-0-0, presented to the hospital with rapid abdominal distention for 3 months. Her physical examination and ultrasonographic findings led to a diagnosis of advanced stage ovarian carcinoma. An exploratory laparotomy was performed and the operative impression was that of stage III ovarian carcinoma. Total hysterectomy with bilateral salpingo-oophorectomy and surgical staging were done. The postoperative pathology revealed a benign cystic teratoma of right ovary with chronic granulomatous peritonitis. She was well at discharge and at her 1-year follow-up. CONCLUSION: Although ruptured a benign cystic teratoma is rare, it can cause granulomatous peritonitis, the clinical findings of which mimic advanced stage ovarian carcinoma. This warrants physicians to be aware of and intraoperative frozen section should be used, its correct management will provide a good outcome with less complication.

Adult↗
PubMed2003

Fatal maternal outcome of a parturient with Eisenmenger's syndrome and severe preeclampsia.

Eisenmenger's syndrome in pregnancy is associated with a high maternal and fetal morbidity and mortality. When it occurs with severe preeclampsia, the morbidity and mortality are higher. We report the case of a 30 weeks' pregnant woman with Eisenmenger's syndrome and severe preeclampsia. Cesarean section was performed due to severe preeclampsia and an unfavorable cervix under general anesthesia. The intraoperative period was uneventful and a healthy 1300 g male infant was delivered, but the patient died on the second postoperative day due to a pulmonary embolism. This case confirms the frequently fatal maternal outcome of Eisenmenger's syndrome in pregnancy. Early termination of pregnancy is the treatment of choice.

Adult↗