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Biomedical subjects

Yuen Tannirandorn

Publications and source records attributed to Yuen Tannirandorn.

11 recordsLinked to original sources
PubMed2002

Value of humerus length shortening for prenatal detection of Down syndrome in a Thai population.

OBJECTIVE: To assess the value of humerus length shortening for prenatal detection of Down syndrome in a Thai population. METHODS: A prospective study was performed on 3053 women undergoing second-trimester amniocentesis, between 16 and 24 weeks gestation, for the indications of advanced maternal age and a past history of chromosomal abnormality. Biparietal diameter (BPD) and humerus length measurements were obtained before the procedures. Regression equations relating BPD to humerus length were used to calculate observed humerus length/expected humerus length ratio in chromosomally normal and Down syndrome fetuses. Sensitivity, specificity, false-positive rate and likelihood ratio of a positive test result at various observed humerus length/expected humerus length ratios for detection of Down syndrome were calculated. A receiver-operator characteristic curve was used to determine the threshold screening ratio. RESULTS: There were 3003 chromosomally normal pregnancies and 24 fetuses with Down syndrome. The relationship between humerus length and BPD was: expected humerus length = 0.7403BPD - 5.1057, R2= 0.77, P < 0.001. Humerus length in Down syndrome fetuses was significantly shorter than in normal fetuses (P < 0.001). A ratio of 0.91 for observed humerus length/expected humerus length yielded a sensitivity of 41.7%, specificity of 88.3%, a false-positive rate of 11.7% and likelihood ratio of a positive test result of 3.63 (95% confidence interval 2.24-5.88) for detection of Down syndrome. CONCLUSIONS: Humerus length shortening in the second trimester appears to be a useful adjunctive screening parameter for fetal Down syndrome in a Thai population.

Amniocentesis↗
PubMed2002

Informed consent.

Information to make patients fully aware of all the details of treatments is an important part of the medical practice before obtaining patient's signature in the consent form. Explanation may be detailed enough to make patients understand the process of treatment. However, sometime it may not be inclusive enough to cover all major statements that give pros and cons of the treatment. Perhaps detailed explanation may reveal too much information that may discourage patients to receive treatments and cause fear, anxiety, and hopelessness. If health care personnels do not mention all the risks involved in medical treatments, they may be subjected to an accusation of concealing the truth that should be made known to patients. This is one of many ways of looking at the problems. There is no easy answer to the problem of what 'appropriate' explanation should be. Most of our patients are from all walks of life which are not medical profession, and they do not have knowledge to understand technical terms. How should we approach patients in order to be safe from an accusation of that we are not over supporting, not giving the patients false hope? Therefore, we would like to present a guideline for informing and explaining to the patients under the following headings (15): 1. Diseases or major symptoms which are diagnosed. 2. The necessity to receive treatments for the benefits of patients or fetus. 3. If possible, determine the duration of treatments. 4. Methods of treatment, evaluation, and schedule for next appointment. 5. Inform about necessary investigations. 6. Inform about complications of risks, and cost of investigations 7. Usefulness and results of investigations. 8. If options of treatments are available, they should be explained in details, the pros and cons, the risks, and the costs, etc. 9. Maintaining medical confidentiality and the use of patient chart by medical personnel and other related health care providers, for instance, hospital staffs from all levels, medical students, technical medical students, and social workers, etc.

Humans↗
PubMed2002

Reference ranges for Doppler indices of uterine arteries in pregnant women during 22-28 weeks' gestation: a study at King Chulalongkorn Memorial Hospital.

Color pulsed Doppler ultrasound was used to examine the uterine arteries of a total of 265 normal pregnant women during 22-28 weeks' gestation at the Division of Maternal-Fetal Medicine, King Chulalongkorn Memorial Hospital. Reference ranges for pulsatility index (PI) were determined and throughout this gestational range, the mean values were nearly constant and lower than 0.9 and the upper limit of 95 per cent confidence interval (CI) for the PI values were lower than 1.0. In conclusion, the authors have established the reference ranges for PI of uterine arteries in the late second to early third trimester of pregnancy in Thai pregnant women. This could be beneficial for the baseline data in the evaluation of pregnant women complicated with preeclampsia and fetal growth restriction.

Adolescent↗