http://imsear.hellis.org:80 The IMSEAR Digital Repository digital repository system captures, stores, indexes, preserves, and distributes digital research material. 2012-02-23T02:04:32Z http://imsear.hellis.org/handle/123456789/137248 Title: Value of computed tomography in T-stage assessment and therapy of nasopharyngeal carcinoma. Authors: Chiewwit, Pipat; Thapemongkol, Kullatorn; Churojana, Anchalee; Chawalparit, Orasa; Suthipongchai, Suthisak Abstract: The accurate evaluation of tumor size, localization and spread of nasopharyngeal carcinoma help optimal treatment planning. The purpose of our retrospective study is to compare the T-stage of nasopharyngeal carcinoma between evaluated by physical examination and CT scan and to compare the response to treatment in the group also underwent CT (147 patients) and the group without CT staging (40 patients). The sex ratio, and the mean age of the patients in both groups was not significantly different. Radiological study showed Stage 1 the tumor confined in nasopharyngeal region. Stage II showed tumor spreading with lateral extension to the parapharyngeal region. Stage III and stage IV, the tumor spread in a superior direction to the paranasal sinus and the base of the skull. CT staging resulted in upgrading the T stage in 88/147 cases ( 59.9%). A Complete response was higher in the CT than the non CT Group at the T2 and T4 stage. CT imaging is better than clinical examination and conventional imaging in detecting the involvement of more than one wall, base of skull involvement, differentiating tumor from sinusitis, detecting intracranial invasion and neck node involvement. In Conclusion, a CT scan is require in nasopharyngeal carcinoma patients for accurate staging, modified radiation treatment and improved treatment results. 2002-01-01T00:00:00Z http://imsear.hellis.org/handle/123456789/137247 Title: Effect of coaching and reflective learning on competency and satisfaction towards the teaching and learning process of nursing students. Authors: Sangkapong, Tipapan; Pichitpornchai, Wanpen; Tupairoh, Pranee; Kongkar, Ruttanaporn; Musikthong, Jongkonwan; Sornsong, Talearngsri; Wungsri, Somong; Thanomklang, Suleeporn; Olarnrutmanee, Tassanee; Pukcharoon, Benjawan; Srivirojn, Jariya Abstract: The aim of this quasi-experimental research was to examine the of coaching and reflective learning on competency and satisfaction of nursing students studying clinical nursing management practicum. The sample was purposively selected and consisted of 16 fourth year students in a major teaching hospital under the Ministry of University Affairs. Data were collected using a set of research instrument developed by the researchers. The instruments include 3 parts : 1) competency assessment questionnaire ; 2) satisfaction questionnaire ; and 3) clinical log. Data were then analyzed using mean, standard deviation, and independent t - test. The findings revealed that the students who participated in the coaching and reflective learning activities had a high level of clinical competency and a high level of satisfaction with the teaching and learning process. Meanwhile, the student who participated in usual teaching and learning activities had a moderate level of clinical competency and a level of satisfaction. When comparing the two groups, the means scores of clinical competency of the student who participated in the coaching and reflective learning activities were significantly higher than those in the usual teaching and learning activities (P < 0.05), whereas the mean scores of satisfaction of both groups were not statistically different (P > 0.05). Based on these finding, nurse educators as well as clinical nurse might consider coaching and reflective learning activities as a strategy for fostering effective teaching process as well as improving competency of the nursing students. 2003-12-01T00:00:00Z http://imsear.hellis.org/handle/123456789/137246 Title: Imaging findings and prevalence of central precocious puberty at Siriraj Hospital. Authors: Pongpornsup, Sopa; Chawalparit, Orasa; Pacharn, Preeyacha Abstract: Central precocious puberty occurs as a result of premature pituitary stimulation and increased secretion of gonadotropins. The differential diagnosis of true precocious puberty includes cerebral and idiopathic categories. This differentiation, which cannot be made endocrinologically due to similarities in pituitary gonadotropin and sex steroid levels, may facilitatic by Magnetic Resonance Imaging (MRI) of the brain. Objective: To analyze MR imaging findings and incidence of each pathology in central precocious puberty, and to compare pituitary height in patients with central precocious puberty with patients in a control group. Materials and methods: A retrospective study of central precocious puberty in 22 patients was performed from March 2002 to July 2003. The control group consisted of 54 boys and 46 girls. Analyzed parameter included pituitary height, shape and posterior bright spot. The shape was assessed by a pituitary grading system which was based on the concavity of the upper pituitary surface (grade 1 = marked concavity, grade 2 = mild concavity, grade 3 = flat, grade 4 = mild convexity, grade 5 = marked convexity). Bone age, and pelvic ultrasonography were evaluated in the study group. Results: Twenty two children with central precocious puberty (4 boys and 18 girls) were divided into two subgroup according to MRI findings as follows : idiopathic 15 patients (68.18%) and noidiopathic 7 patients (3 patients had nodule at pituitary stalk, 2 had microadenoma, 1 had germ cell tumour at pinealgland, and 1 had hypothalamic harmatoma). The mean pituitary height in the study group was 5.59 mm (SD 1.7). The mean height of the control group was 5.25 mm. There was significant difference among the two groups (p < 0.005). Conclusion: The most common cause in central precocious puberty is idiopathic. However the MRI is necessary to necessary to excluding the surgical cause as tumor. Pituitary height of more than 5.25 mm may be a helpful variable for follow up the result of medical treatment in precocious children. 2003-12-01T00:00:00Z http://imsear.hellis.org/handle/123456789/137245 Title: Anatomic variations of the lumbar plexus in Thais. Authors: Chandraphak, Supichya; Sangvichien, Sanjai; Chuncharunee, Aporn Abstract: The aim of this study was to examine the variation of the lumbar plexus in Thais in terms of its origin, branches, and variation of each branch. Anatomical dissections were conducted in 150 halves of formalin-embalmed cadavers. All preserved cadavers were Thais, ranging the age from 35 to 85 years old, 86 males and 64 females. The lumbar plexus was markedly composed of the first to fourth lumbar ventral rami (L1-L4) in 81.33% of the plexuses (or 122 cases), but its origin varied, as it was derived from the ventral rami of the twelfth thoracic to fifth lumbar ventral rami (T12-L5) in 18.67% of the cases. Eight branches of the plexus were found, including seven typical branches and an additional branch. The seven typical branches occured in 100% of cases, and they were the iliohypogastric, ilioinguinal, genitofemoral, lateral cutaneous nerve of the thigh, femoral, obturator nerve and lumbosacral trunk. The additional branch, the accessory obturator nerve occurred in only 3.33% of the cases. In conclusion, the variation pattern of the plexuses occurred on both sides. However, the anatomic variability of the plexuses was not statistically different with regard to either side or gender. The result from this study provided additional information different with regard to either side or gender. The results from this study provided additional information and new insights into the lumbar plexus in terms of its origins, branches, and variations of each branch that might be useful in medicine, anesthesia, surgery and physical therapy. 2003-12-01T00:00:00Z http://imsear.hellis.org/handle/123456789/137244 Title: Results of cervical cancer patients treated according to clinical practice guideline in Siriraj Hospital. Authors: Ieumwananonthachai, Nantakan; Pattaranutapon, Pittayapoom; Chansilpa, Yaowalak; Sangruchi, Supatra; Verasan, Vattisiri; Suntornpong, Nan; Petchsuksiri, Janjira; Vutipruk, Raweewan; Kietikajornthada, Chatchapol; Samasanti, Nataya; Noumtong, Nuchapong Abstract: Patients with cervical cancer stage Ib-IVa treated with curative intent at Siriraj Hospital between January and December 2002 were included in the study. There were 362 patients with an age range of 26-86 years old. We found that 65.3% of the patients were treaded according to Siriraj Hospital’s clinical practice guideline (CPG) and 34.7% were not treated according to the CPG. Early results of the treatment showed that 70.4% of the patients treated according to the CPG had complete response at 3 months. After further follow up and salvage treatments, five more patients treated according to CPG accomplished complete responses. The overall results of CPG treatment were comparable to the result of cervical cancer treatment in the literature. 2003-12-01T00:00:00Z http://imsear.hellis.org/handle/123456789/137243 Title: Microvascularization of the midbrain in lylei’s flying fox (Pteropus lylei). Authors: Sricharoenvej, Sirinush; Uthaichotiwan, Paowana; Sangvichien, Sanjai Abstract: Midbrain vascular casts of the Lylei’s flying foxes (Pteropus lylei) were prepared by infusion of Batson’s No.17 plastic mixture into the blood vessels and examined by stereomicroscopy and scanning electron microscopy. Histological study of the midbrain was also performed. It was found that the midbrain of Lylei’s flying fox was supplied by the branches of the vertebrobasilar system. These branches gave off the penetrating arteries, which coursed radially into the internal part of the midbrain to ward the cerebral aqueduct. These arteries, which could be divided into anteromedial, anterolateral, posterolateral and posteromedial groups, according to the points of entry and supplying areas. The arteries ramified into arterioles and capillaries, respectively. The density of the capillary network in the midbrain was closely related to the density of the nerve cells in midbrain nuclei. Less vascularity was found in the areas occupied by nerve fibers. The arterial anastomoses could be observed on the surface of the midbrain. The venous drainage in the midbrain could be divided into three major groups according to the areas of drainage. Firstly, anterior or petrosal group drained the blood from the areas ventral to cerebral aqueduct into the superior petrosal sinus. Secondly, the superior or galenic group emptied the venous blood from the thalamocollicular and dorsal aqueductal veins into the great cerebral vein of Galen and rectus sinus, respectively. Thirdly, the posterior group collected blood from the collicular veins into the rectus sinus. Finally, both rectus and superior petrosal sinuses drained into the external jugular vein and partially into the internal jugular vein. 2003-11-01T00:00:00Z