Browsing by Author "Sansanee Wongwaisayawan"
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Publication Metadata only Breast cancer cells in the afferent lymphatic tracts of sentinel lymph nodes(2012-07-01) Prakasit Chirappapha; Kampol Ratchaworapong; Sansanee Wongwaisayawan; Panuwat Lertsithichai; Ronnarat Suvikapakornkul; Yodying Wasuthit; Youwanush Kongdan; Mahidol UniversityBackground: To identify breast cancer cells in the afferent lymphatic tracts of axillary sentinel lymph nodes (SLNs). Material and Method: The authors performed a prospective study of 100 breast cancer patients who underwent SLN biopsy between June 2009 and January 2010. The afferent lymphatic tracts of SLNs were identified by isosulfan blue or radiocolloid or both and were examined histologically. Results: One hundred three SLNs and afferent lymphatic tracts were examined. The mean age of the patients was 53.2 years (range, 24 to 78 years). The median number of SLNs was 2 (range, 1 to 7). Twenty-four (24%) patients had positive SLNs. Most patients had stage I breast cancer (67%). Three patients with positive SLNs (13%) and stages IIB-IIIC breast cancers had tumor cells in the afferent tract tissue. There were no tumor cells in the afferent tracts of negative SLNs. Conclusion: Only a small proportion of operable breast cancer patients have tumor cells in the afferent lymphatic tract tissue of SLNs. There was a probable trend for more advanced stage breast cancer to harbor tumor cells in the afferent lymphatic tract tissue.Publication Metadata only Breast cancer underestimation rate of atypical ductal hyperplasia diagnosed by core-needle biopsy under imaging guidance(2005-04-01) Cholatip Wiratkapun; Bussanee Wibulpholprasert; Panuwat Lertsithichai; Kamolthum Pulpinyo; Sansanee Wongwaisayawan; Mahidol UniversityObjective: To evaluate breast cancer underestimation rate of atypical ductal hyperplasia (ADH) diagnosed by core-needle biopsy (CNB) under imaging guidance in Ramathibodi Hospital and to determine the difference between the malignant and benign groups in terms of clinical and imaging characteristics. Material and Method: The pathological records of 1,521 patients who underwent CNB under imaging guidance were reviewed. Thirty-nine patients diagnosed with ADH were enrolled into the present study. Clinical data, imaging features, biopsy technique and result of excisional biopsy as well as follow-up data were retrospectively reviewed. Results: Of 39 ADH cases, eight (20.5%) were found to have malignancy on subsequent excisional biopsy. The majority of these were ductal carcinoma in situ (DCIS) (62.5%). Lesion categorized as category 5 according to BI-RADS (Breast imaging reporting and data system) was the only feature which was statistically different between the benign and malignant groups. No statistically significant difference was found between the benign and malignant groups in terms of age, personal and family history of breast cancer, clinical finding, mammographic lesion type, size of lesion, image-guided technique and percentage of lesion removal. Conclusion: The underestimation rate of ADH in the present study was comparable to other studies. The finding of BI-RADS category 5 in patients with ADH diagnosed from CNB is a strong indication for subsequent excisional biopsy.Publication Metadata only Coexisting vulvar paget's disease and mucinous carcinoma of the breast: A case report and review of the literature(2012-06-01) Rangsima Aroonroch; Yingluck Visetsiri; Sansanee Wongwaisayawan; Chuenkamon Charakorn; Siroj Kanchanapanjapol; Mana Rochanawutanon; Mahidol UniversityVulvar Paget' disease is the most common site of extramammary Paget's disease (EMPD). The disease frequently associated with the underlying invasive skin adnexal carcinoma or representing the migration of underlying internal malignancy, especially anorectal and genitourinary cancer, but the coexisting with primary breast cancer is rare. Herein, the authors report a case of a 46-year-old Thai woman who had vulvar Paget's disease with subsequent development of mucinous carcinoma of the breast. Interestingly, the overexpression of HER-2/neu in vulvar Paget's disease raises the additional option of anti-HER-2/neu antibody therapy in highly aggressive or recurrent disease. In conclusion, primary breast cancer should be of concern in patients with vulva Paget's disease, even though it is an uncommon association.Publication Metadata only Determination of irinotecan, SN-38 and SN-38 glucuronide using HPLC/MS/MS: Application in a clinical pharmacokinetic and personalized medicine in colorectal cancer patients(2018-01-01) Chalirmporn Atasilp; Pichai Chansriwong; Ekapob Sirachainan; Thanyanan Reungwetwattana; Apichaya Puangpetch; Santirhat Prommas; Suwannee Sirilerttrakul; Budsaba Rerkarmnuaychoke; Sansanee Wongwaisayawan; Chonlaphat Sukasem; Faculty of Medicine, Ramathibodi Hospital, Mahidol University© 2017 Wiley Periodicals, Inc. Background: Irinotecan (CPT-11) is chemotherapy used mainly in the metastatic colorectal cancer. The purpose of this study was to develop and validate the LC-MS/MS for the simultaneous determination of CPT-11, SN-38, and SN-38G. Methods: A 100 μL of plasma was prepared after protein precipitation and analyzed on a C18 column using 0.1% acetic acid in water and 0.1% acetic acid in acetonitrile as mobile phases. The mass spectrometer worked with multiple reaction monitoring (MRM) in positive scan mode. The standard curves were linear on a concentration range of 5-10 000 ng/mL for CPT-11, 5-1000 ng/mL for SN-38, and 8-1000 ng/mL for SN-38G. Results: In this assay, the intra and interday precision consisted of ≤9.11% and ≤11.29% for CPT-11, ≤8.70% and 8.31% for SN-38, and ≤9.90 and 9.64% for SN-38G. Conclusion: This method was successfully used to quantify CPT-11, SN-38, and SN-38G and applied to a pharmacokinetic study.Publication Metadata only Development and validation of a breast cancer risk prediction model for thai women: A cross-sectional study(2014-01-01) Thunyarat Anothaisintawee; Yot Teerawattananon; Cholatip Wiratkapun; Jiraporn Srinakarin; Piyanoot Woodtichartpreecha; Siriporn Hirunpat; Sansanee Wongwaisayawan; Panuwat Lertsithichai; Vijj Kasamesup; Ammarin Thakkinstian; Mahidol University; Thailand Ministry of Public Health; Khon Kaen University; Prince of Songkla UniversityBackground: Breast cancer risk prediction models are widely used in clinical practice. They should be useful in identifying high risk women for screening in limited-resource countries. However, previous models showed poor performance in derived and validated settings. Therefore, we aimed to develop and validate a breast cancer risk prediction model for Thai women. Materials and Methods: This cross-sectional study consisted of derived and validation phases. Data collected at Ramathibodi and other two hospitals were used for deriving and externally validating models, respectively. Multiple logistic regression was applied to construct the model. Calibration and discrimination performances were assessed using the observed/expected ratio and concordance statistic (C-statistic), respectively. A bootstrap with 200 repetitions was applied for internal validation. Results: Age, menopausal status, body mass index, and use of oral contraceptives were significantly associated with breast cancer and were included in the model. Observed/expected ratio and C-statistic were 1.00 (95% CI: 0.82, 1.21) and 0.651 (95% CI: 0.595, 0.707), respectively. Internal validation showed good performance with a bias of 0.010 (95% CI: 0.002, 0.018) and C-statistic of 0.646(95% CI: 0.642, 0.650). The observed/expected ratio and C-statistic from external validation were 0.97 (95% CI: 0.68, 1.35) and 0.609 (95% CI: 0.511, 0.706), respectively. Risk scores were created and was stratified as low (0-0.86), low-intermediate (0.87-1.14), intermediate-high (1.15-1.52), and high-risk (1.53-3.40) groups. Conclusions: A Thai breast cancer risk prediction model was created with good calibration and fair discrimination performance. Risk stratification should aid to prioritize high risk women to receive an organized breast cancer screening program in Thailand and other limited-resource countries.Publication Metadata only Double check up of malignancy biopsy specimens for patient safety(2010-11-01) Pattana Sornmayura; Yingluck Visessiri; Mana Rochanawutanon; Vorachai Sirikulchayanonta; Rangsima Aroonroch; Wasana Kanoksil; Noppadol Larbcharoensub; Sansanee Wongwaisayawan; Juvady Leopairut; Panas Chalermsanyakorn; Suchin Worawichawong; Niramol Chanplakorn; Paisan Leelachaikul; Atcharaporn Pongtippan; Mahidol UniversityBackground: The diagnostic of malignancy in biopsy specimens is very important because it guides to selected treatment option and prognostic prediction. However, biopsy specimens usually have small pieces leading to variations of the interpretation by anatomical pathologists. Objective: To detect and correct the errors or the significant discrepancies in the diagnosis of biopsy specimens before signout and to determine the frequency of anatomic pathology significant discrepancies. Design: The application of the mutually agreed work instructions (record) for the detection of errors or the significant discrepancies and their process of sign-out. The record of biopsy specimen that received a secondary check (1,959 cases, 2005-2007) was analyzed. Results: After a secondary check, 53 cases of non-malignancy for any reason by a second pathologist were included. However, when using our definition on significant discrepancies, only 37 cases were considered. Another seven cases with the opinions with malignancy that were of different cell types that do harm to the patients were added. Therefore, 44 cases (2.25%) had truly significant discrepancies. Conclusion: The truly significant discrepancy frequency was 2.25% during the process of pre-sign-out secondary check of malignancy of biopsy specimens. The project has been applied as a routine daily work. It can be an innovative safety program for patient in Thailand.Publication Metadata only Droplet digital PCR using HER2/EIF2C1 ratio for detection of HER2 amplification in breast cancer tissues(2018-12-01) Anchalee Tantiwetrueangdet; Ravat Panvichian; Sansanee Wongwaisayawan; Natthaporn Sueangoen; Panuwat Lertsithichai; Faculty of Medicine, Ramathibodi Hospital, Mahidol University© 2018, The Author(s). Breast cancers with amplification and overexpression of human epithelial growth factor receptor 2 (HER2) are associated with poor prognosis, and targeted for anti-HER2 therapy. Immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) are currently the recommended methods to asses HER2 overexpression/amplification. Droplet digital PCR (ddPCR), a highly accurate method to quantify DNA copy number, is potentially a robust alternative for HER2 diagnostics. In the FISH assay and most of previous ddPCR reports, chromosome 17 centromere (CEP17) has been used as the reference control to determine HER2/CEP17 ratio. Nevertheless, miss-classification could occur when HER2 is co-amplified with CEP17. To avoid this inherent defect, in the present study, we employed ddPCR assay using the human eukaryotic translation initiation factor 2C1 (EIF2C1) gene located at chromosome 1p34.3 as the reference control to quantify HER2 copy number in 31 frozen breast cancer tissues. HER2 status of these samples had been determined by FISH and classified as HER2-amplified and HER2-non-amplified breast cancers. The results showed that HER2 determined by ddPCR using HER2/EIF2C1 ratio was in good concordance with HER2 determined by FISH using HER2/CEP17 ratio, the concordance rate 87.1% (27/31), Kappa = 0.719. The sensitivity and specificity of ddPCR assay was 90% (9/10) and 85.7% (18/21), respectively. The median HER2/EIF2C1 copy number ratio in HER2-amplified cancers (6.55, range 1.3–17.3) was significantly higher than in HER2-non-amplified cancers (1.05, range 0.6–3.6, p < 0.001). This study demonstrated that ddPCR using HER2/EIF2C1 ratio could accurately assess HER2 status in frozen breast cancer tissues. Thus, our findings warrant further studies into breast cancer with HER2-equivocal by IHC/FISH.Publication Metadata only An effective treatment of dark lip by frequency-doubled Q-switched Nd:YAG laser(2001-02-10) Somyos Kunachak; Somsak Kunachakr; Suntharee Kunachakr; Panadda Leelaudomlipi; Sansanee Wongwaisayawan; Mahidol University; Piyamin Hospital, Samutprakarn; Charoen Krung Pracharak Hospital; Thammasat UniversityBACKGROUND. Dark lip is a common cosmetic problem in Southeast Asia. There is no known effective treatment. OBJECTIVE. To propose an effective method for treating dark lips of varying causes with frequency-doubled Q-switched Nd: YAG laser. METHODS. Seventy patients with dark lip, of which 22 were congenital, 24 acquired, and 24 of uncertain cause, were treated by frequency-doubled Q-switched Nd:YAG laser at a fluence of 2-3.5 J/cm2 (mode 2.5 J/cm2) after application of topical anesthesia. The endpoint of treatment was complete clearance of the pigment. Follow-up time was 24-36 months (mean 29 months). RESULTS. All patients attained complete clearance of the lesion after an average of 2.5 treatments in the congenital group, 2.2 treatments in the acquired group, and 1.8 treatments in the group with uncertain etiology. The mean (±SD) number of treatments required by the whole group was 2.1 ± 1.4. Recurrence was observed in one case of congenital origin 3 months after the last treatment. In the remaining cases, results persisted up to the time of follow-up. Herpes simplex reactivation was noted in one case 3 days after treatment. There was no dyschromia, scar formation, or change of skin texture. CONCLUSION. Dark lip can be effectively treated by frequency-doubled Q-switched Nd:YAG laser without major adverse effects.Publication Metadata only Genetic Variations and Frequencies of the Two Functional Single Nucleotide Polymorphisms of SLCO1B1 in the Thai Population(2020-06-05) Chalitpon Na nakorn; Jariya Waisayarat; Charungthai Dejthevaporn; Pornpen Srisawasdi; Sansanee Wongwaisayawan; Chonlaphat Sukasem; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Prince of Songkla University© Copyright © 2020 Na nakorn, Waisayarat, Dejthevaporn, Srisawasdi, Wongwaisayawan and Sukasem. Aim: To investigate the variations and the frequencies of the SLCO1B1 gene in the Thai population. Methods: Collected samples were categorized into five regions of Thailand. DNA samples were genotyped for two variants, c.388A>G and c.521T>C of the SLCO1B1, using TaqMan® real-time PCR. Results: The minor allele frequencies (MAFs) of two single nucleotide polymorphisms (SNPs) were not significantly different among the five regions. The most frequent haplotype was SLCO1B1*1b (frequency: 0.654), followed by *1a (frequency: 0.217), *15 (frequency: 0.128), and *5 (frequency: 0.001). We observed a similar frequency of OATP1B1 transporter phenotypes compared to other populations. 75.85% of the Thai subjects showed normal OATP1B1 activity, 22.5% showed intermediate OATP1B1 activity, and 1.58% showed low OATP1B1 activity. Conclusion: This study reported the frequencies of the SLCO1B1 variants and the subsequent OATP1B1 activity in a large cohort of Thais that can provide important information for the guidance of personalized drug therapy.Publication Metadata only Glioblastoma multiforme at the corpus callosum with spinal leptomeningeal metastasis(2011-06-01) Pirada Witoonpanich; Krittika Bamrungrak; Artit Jinawath; Sansanee Wongwaisayawan; Suchart Phudhichareonrat; Rawiphan Witoonpanich; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Mahidol UniversityGlioblastoma multiforme (GBM) often occurs in the supratentorial white matter including corpus callosum. However, spinal leptomeningeal metastasis in cases of supratentorial GBM has been reported to be rare and there is usually a long interval between the cerebral lesion and the spinal seeding. We report here a case of GBM at the corpus callosum and other parts of the brain with simultaneous manifestation of spinal leptomeningeal seeding. The patient exhibited an abnormal motor behavior of the left hand as mirror movement when the right hand was performing a unimanual task (diagonistic dyspraxia) which is a sign of lesion of the posterior part and splenium of the corpus callosum. There were also signs of peripheral nerve or nerve root involvement suggestive of spinal metastasis without any sensory symptoms. He died 3 months after the onset of the symptoms confirming the poor prognosis and short survival time in cases with spinal leptomeningeal metastasis reported previously. The cerebral GBM with spinal seeding was disclosed at autopsy. © 2010 Elsevier B.V. All rights reserved.Publication Metadata only HER2 expression in breast cancer with nonamplified HER2 and gains of chromosome 17 centromere(2012-07-01) Ravat Panvichian; Anchalee Tantiwetrueangdet; Sansanee Wongwaisayawan; Amporn Nampoon; Panuwat Lertsithichai; Surasak Leelaudomlipi; Mahidol University; Research Center; Division of General SurgeryGains of chromosome 17 centromere (CEP17) may be accompanied by gains of chromosome 17q. To evaluate the effect of CEP17 gains (CEP17 > 3 copies per tumor nucleus) on the expression of the HER2 gene, which is located on chromosome 17q12-21.32, we analyzed HER2 amplification and expression in breast carcinomas with and without CEP17 gains. We isolated tumor nuclei from frozen tissues of 37 breast carcinomas for analysis of the HER2 gene and CEP17 by fluorescence in situ hybridization. HER2 expression was detected by immunohistochemistry (IHC) performed on formalin-fixed, paraffin-embedded sections of the corresponding tumors. Tumors with amplified HER2 as determined by both HER2 copy number and HER2/CEP17 ratio were detected in 29.7% (11/37). CEP17 gains were significantly associated with HER2 amplification (P=0.005) but not associated with estrogen receptor status, tumor grade, and lymph node status (P > 0.05). In contrast, HER2 amplification was significantly associated with estrogen receptor negativity (P=0.020) but not with tumor grade and lymph node status (P > 0.05). IHC analysis was performed in 7 HER2-amplified tumors and all of these were IHC 3+, which were used as positive controls. Among HER2-non-amplified tumors with CEP17 gains, only 1 tumor (1/8, 12.5%) was IHC 3+. However, none of the HER2-non-amplified tumors without CEP17 gains was IHC 3+. In HER2-non-amplified tumors, there was no significant association between HER2 protein expression as detected by IHC and CEP17 or HER2 copy number (P=0.999, P=0.785, respectively). These findings indicate that in the absence of HER2 amplification, CEP17 gains do not have a significant effect on HER2 protein expression. Copyright © 2012 by Lippincott Williams & Wilkins.Publication Metadata only Hydroxyurea and colonic ulcers: A case report(2014-07-31) Kochawan Boonyawat; Sansanee Wongwaisayawan; Prawat Nitiyanant; Vichai Atichartakarn; Mahidol University© 2014 Boonyawat et al.; licensee BioMed Central Ltd. Background: Hydroxyurea at a relatively low dose is frequently prescribed to induce hemoglobin F production in patients with sickle cell and β-thalassemia diseases because of its good efficacy and safety profiles. However, a potentially fatal gastrointestinal ulceration was recently found and herein reported.Case presentation: A thirty-seven-year-old man with transfusion dependent hemoglobin E/β-thalassemia disease was treated with hydroxyurea to induce hemoglobin F production since 2007 without incident. From 2008 to April 2010, episodes of hematochezia, mucous diarrhea and epigastric pain intermittently manifested. Four colonoscopies done during the period repeatedly showed ulcerative lesions from the terminal ileum to the ascending colon with a non-specific histo-pathologic finding. Subsequently, ulcerative lesions also developed at the pharynx, histo-pathologic findings of which were not different from those in the colon. These ulcerative lesions resolved within a month after discontinuing hydroxyurea in April 2010 and have not recurred since.Conclusion: The findings suggested role of hydroxyurea in the pathogenesis of these ulcers, and that it must be immediately discontinued to prevent further damage to the digestive mucosa.Publication Open Access Hydroxyurea and colonic ulcers: a case report(2014) Kochawan Boonyawat; Sansanee Wongwaisayawan; Prawat Nitiyanant; Vichai Atichartakarn; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of PathologyBackground: Hydroxyurea at a relatively low dose is frequently prescribed to induce hemoglobin F production in patients with sickle cell and β-thalassemia diseases because of its good efficacy and safety profiles. However, a potentially fatal gastrointestinal ulceration was recently found and herein reported. Case presentation: A thirty-seven-year-old man with transfusion dependent hemoglobin E/β-thalassemia disease was treated with hydroxyurea to induce hemoglobin F production since 2007 without incident. From 2008 to April 2010, episodes of hematochezia, mucous diarrhea and epigastric pain intermittently manifested. Four colonoscopies done during the period repeatedly showed ulcerative lesions from the terminal ileum to the ascending colon with a non-specific histo-pathologic finding. Subsequently, ulcerative lesions also developed at the pharynx, histo-pathologic findings of which were not different from those in the colon. These ulcerative lesions resolved within a month after discontinuing hydroxyurea in April 2010 and have not recurred since. Conclusion: The findings suggested role of hydroxyurea in the pathogenesis of these ulcers, and that it must be immediately discontinued to prevent further damage to the digestive mucosa.Item Metadata only Laser-induced fluorescence spectrum of normal and cancer breast tissues(Mahidol University. Mahidol University Library and Knowledge Center, 2000) Jiraporn Kiewteang; Kwan Arayathanitkul; Sansanee Wongwaisayawan; Sunanta ChariyalertsakIn this study, fluorescence spectra are used to distinguish normal and cancer breast tissues. Two different techniques are used to measure the fluorescence spectra. The first, the arc lamp-induced fluorescence spectra were obtained from cancer and normal breast tissues using commercial fluorescence spectrometer. The second, the laser-induced fluorescence spectra were obtained by the second harmonic of 90 nanosecond pulse from Nd:YAG laser. The spectral profiles from the cancer and normal breast tissues from the first method are the same, whereas the spectral profiles from the second method are substantially different. We used the difference of fluorescence intensity in wavelength range 630-690 nm to distinguish the spectra from both tissues. This difference is attributed to the native porphyrins fluorophors. The result shows the needs for a laser-induced method in order to distinguish the spectra from cancer and normal breast tissues. The statistics of the fluorescence results are given. The results were found to indicate cancer tissue with 85 % of confident level. Further clinical studies will make this method a diagnosis tool for breast cancer as well as other diseases.Publication Open Access MicroRNA Expression of Primary and Metastatic Colorectal and Breast Carcinoma(2022) Thaniya Sricharunrat; Artit Jinawath; Pattana Sornmayura; Sansanee Wongwaisayawan; Budsaba Rerkamnuaychoke; ธนิยะ ศรีจรุณรัตน์; อาทิตย์ จินาวัฒน์; พัฒนา ศรมยุรา; ศันสนีย์ วงศ์ไวศยวรรณ; บุษบา ฤกษ์อำนวยโชค; Chulabhorn Hospital, Chulabhorn Royal Academy. Pathology and Forensic Science Department; Mahidol University. Faculty of Medicine Ramathibodi Hospital.Department of Pathology; Rangsit University. Department of Medical Science, Faculty of ScienceBackground: Colorectal and breast carcinoma are frequently diagnosed cancers. At advanced stages, cancers metastasize to certain organs resulting in loss of function of these organs, and eventually death. Therefore, there is a specific need for the prognosis of these cancers. Currently, microRNAs (miRNAs), have emerged as a new target of cancer-specific biomarker. Objective: To examine the expression of miRNA in primary and metastatic breast and colorectal cancers. Methods: This study investigated the expression of 6 miRNAs (miR-10b, miR-21, miR-145, miR-155, miR-200c, and miR-373) in formalin fixed paraffin embed tissues from pairs of normal tissues with primary and metastatic tumor samples of breast and colorectal carcinoma cases in Ramathibodi Hospital, Thailand by real-time RT-PCR. Results: Among 6 miRNAs, miR-145 decreased significantly in all samples of primary and metastatic colorectal and breast carcinoma. There was significantly decreased expression of miR-145 in metastatic colorectal carcinoma compared to their primary colorectal carcinoma (P < .05). Whereas miR-10b, miR-155, and miR-200c showed a decreased expression; miR-21, and miR-373 showed an increased expression in the majority of cases. Unlike miR-145, other miRNAs showed no significant difference of expression (P > .05). Conclusions: This finding indicates that miR-145 may be the potential metastatic biomarker. Decrease of miR-145 could be applied to the prognosis and target for therapy of breast and colorectal carcinoma.Publication Metadata only Nondiagnostic core needle biopsy of the breast under imaging guidance: Result of rebiopsy(2005-03-01) Cholatip Wiratkapun; Bussanee Wibulpholprasert; Sansanee Wongwaisayawan; Kamoltum Pulpinyo; Mahidol UniversityObjective: To determine the rate and the clinical application of recommendation for repeat biopsy after core needle biopsy (CNB) under imaging guidance and to determine the result of rebiopsy. Material and Method: A retrospective review was performed in 1,306 consecutive women who underwent core needle biopsy under imaging guidance at the breast diagnostic center, the Faculty of Medicine, Ramathibodi Hospital from October 1997 to March 2004. Results: Among 1,306 patients, there were 44 patients (3.37%) who had undergone rebiopsy. The three most common reasons for recommendation of rebiopsy were discordant imaging and pathology, atypical ductal hyperplasia and inadequate specimen. The authors found 12 malignancies subsequently found in rebiopsy (27.3%). The most common reason for rebiopsy in this group was inadequate specimen. Conclusion: Core needle biopsy under imaging guidance is a minimally invasive diagnostic tool and promises high accuracy and reliability. However, some patients need rebiopsy to exclude hidden malignancy. The cooperation between the radiologists, surgeons and pathologists are prudent for giving the best care to the patients.Publication Metadata only Noninvasive treatment of bromidrosis by frequency-doubled Q-switched Nd:YAG laser(2000-05-01) Somyos Kunachak; Sansanee Wongwaisayawan; Panadda Leelaudomlipi; Mahidol UniversityAxillary bromidrosis (osmidrosis) is a common and disgusting disorder in Asian communities. Current treatments are basically invasive resulting in varying degrees of success and complications. The objective of this study was to investigate the efficacy of frequency-doubled Q-switched Nd:YAG laser as a possible noninvasive technique for treating axillary bromidrosis. Sixty-four axillae of 32 patients were lased by a single session of green light energy at the fluence of 3.5 joules at a 4-mm spot size. The follow-up time was 6-18 months (mean 15). Twenty-six patients (81.2%) showed good to excellent results, 4 patients (12.5%) had fair results, and 2 (6.2%) patients had poor results. The only side effect was a temporary hyperpigmentation at the periphery of the treated area in a few patients with dark skin color. In conclusion, frequency-doubled Q-switched Nd:YAG laser is an effective noninvasive treatment for axillary bromidrosis.Publication Open Access Occult Metastases in Negative Sentinel Lymph Node of Invasive Breast Cancer Discovered by Serial Section in Ramathibodi Hospital(2009) Orathai Thangnapakorn; Sansanee Wongwaisayawan; Panuwat Lertsithichai; Sasivimol Rattanasiri; อรทัย ตั้งนภากร; ศันสนีย์ วงศ์ไวศยวรรณ; ภาณุวัฒน์ เลิศสิทธิชัย; ศศิวิมล รัตนสิริ; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Pathology; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Surgery; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Section for Clinical Epidemiology and BiostatisticsBackground: Sentinel lymph node (SLN) biopsy is an established method for evaluating axillary metastases in breast cancer. This study was designed to ascertain whether serial sections with haematoxylin and eosin stain could significant improve the detection of occult metastases in sentinel lymph nodes. Method: Sentinel lymph nodes negative for cancer metastases by routine histology were received from 50 patients with invasive breast cancer in Ramathibodi Hospital between 2006-2007. The lymph nodes were examined by serial sections at 25 microns intervals at each level with haematoxylin and eosin stain. Result: Occult metastases were detected by serial sectioning in 4 (8%) out of 50 breast cancer patients. One patient had macrometastasis, two patients had micrometastases and one patient had isolated cell metastasis. No clinical or pathological characteristics (age, mammography, tumor size, tumor grading, TNM staging, and number of SLNs) were associated with occult metastases (P- value > 0.05). Conclusion: The prevalence of occult metastases in negative sentinel lymph nodes of breast cancer patients was quite low in the present study. Serial sectioning sentinel lymph nodes for all patients might not be cost-effective. However, the clinician should be aware of occult metastases in node-negative cases.Publication Metadata only Ocular pythiosis: Is it under-diagnosed?(2004-01-01) Theerapong Krajaejun; Rungnapa Pracharktam; Sansanee Wongwaisayawan; Mana Rochanawutinon; Mongkol Kunakorn; Skowrat Kunavisarut; Mahidol UniversityPURPOSE: To increase awareness of ocular pythiosis by presenting a typical case and summarizing clinical data of 11 ocular pythiosis cases in Ramathibodi Hospital. DESIGN: Interventional case report. METHODS: A 48-year-old healthy woman with a history of 3-week painful corneal ulcer of left eye was treated with enucleation. RESULTS: The histopathology of enucleated eye revealed endophthalmitis and ulcerative keratitis with numerous hyphae in full-thickness of corneal stroma. The culture identification of the causative organism was Pythium insidiosum. The final diagnosis was ocular pythiosis. CONCLUSIONS: Pythium insidiosum is a causative agent of pythiosis and is distributed worldwide. Ocular pythiosis may not be uncommon, as it may be underdiagnosed due to unfamiliarity among clinicians and microbiologists. Diagnosis of pythiosis is difficult. The disease has high morbidity, as evidenced by nearly evisceration or enucleation among all patients at Ramathibodi Hospital. Early detection and effective treatment are needed for possible cure. © 2004 by Elsevier Inc. All rights reserved.Item Metadata only P53 expression and steroid receptor status in breast cancer(Mahidol University. Mahidol University Library and Knowledge Center, 1998) Oranan Preechanont; Suntaree Apibal; Sansanee Wongwaisayawan; Budsaba Rerkamnuaychoke; Pongsak Wannakrairot; Sunanta Chariyalertsak
