Sensitivity and Specificity of Pronto Dry® for Diagnosis of Helicobacter Pylori Infection

Abstract Sensitivity and Specificity of Pronto Dry® for Diagnosis of Helicobacter Pylori Infection Suphakan         Techapongsatorn         MD.* Anan                 Manomaipiboon             MD., MSc (Clinical Epidemiology)* Supot                Kaitwanidwilai                MD.* General Surgery unit. Department of Surgery, Bangkok Metropolitan Administration Medical College and Vajira Hospital Objective: To study sensitivity and specificity of urease test for Helicobacter pylori infection comparing with pathological finding. Study design: Diagnostic test. Setting: Division of General Surgery, Department of Surgery, Bangkok Metropolitan Administration Medical College and Vajira Hospital. Subjects: Seventy six patients, older than 15 years old, with clinical symptoms of dyspepsia underwent gastroduodenoscopy between December 2002 to September 2003 Intervention: The mucosa of gastric antrum was biopsied for pathological examination and urease test (Pronto Dry®) to detect Helicobacter pylori infection Main outcome measure: Helicobacter pylori infection. Results: Among 76 patients, positive Helicobacter pylori from histopathological study was identifies in 25 patients (32.89%). In positive urease test, the color of the test was changes from yellow to red magenda. At 180 minutes, positive urease test was identifies in 29 patients (38.16%), Sensitivity and specificity of this urease test was 76% and 80.6% respectively with 95% CI was 76 + 9.8. Conclusion: The urease test can be diagnostic test for Helicobacter pylori infection and the most appropriate time for urease test in this study to detect Helicobacter pylori infection was 180 minutes. Key Words: Urease test, Helicobacter pylori infection Vajira Med J 2005 ; 49 : 53 - 58

A Comparative Study Measuring Surface Pressure Among Variation of Adhesive Dressing Methods.

Abstract A Comparative Study Measuring Surface Pressure Among Variation of Adhesive Dressing Methods.   Suphakan      Techapongsatorn      MD.,* Anan               Manomaipiboon         MD., MSc (Clinical Epidemiology)* Cherdchai      Kittipovanon               MD.,* Satit                Srimontayamas         MD.,* Pong               Kanchanasuttirak      MD.*   *Department of Surgery, Bangkok Metropolitan Administration Medical College and Vajira Hospital   Objective: To compare the surface pressure of various adhesive dressing after mastectomy. Study design: Experimental study in thoracic and breast model. Intervention: Four types of adhesive dressing, including 1)         adhesive dressing with fixumull® 2)         adhesive dressing with OCL elastic bandage BPC 3)         adhesive dressing with tensoplast®  EAB 4)         adhesive dressing with compressive brassiere, were applies to the model. Surface pressure was measures at 0, 1, 6, 24 hours. The experiment was repeated for 6 times. Data were analysed by using ANCOVA and repeated measure analysis. Results: The surface pressure of adhesive dressing with fixumull®, OCL elastic bandage BPC®  , tensoplast®  EAB and compressive brassiere were not different. The surface pressure of adhesive dressing from compressive brassiere was the most sustainable during the first 24 hours. Conclusion: Each kinds of adhesive dressing produced different pressure. the adhesive dressing from compressive brassiere was the most sustainable of the surface pressure than others. Vajira Med J 2005 ; 49 : 117 - 122

Abstract Endoscopic Finding in Corrosive Ingestion

Abstract Endoscopic Finding in Corrosive Ingestion Suphakan Techapongsatorn          MD  Pong          Kanjanasuthirak           MD  Satit           Srimantayamas            MD  Objective: To review the endoscopic finding within 48 hours after corrosive agent ingestion.  Study design: Descriptive study. Subjects: One hundred and seventy-one patients were admitted in Department of Surgery, Bangkok Metropolitan  Administration Medical College and Vajira Hospital during January 2001 to December 2005, from corrosive ingestion.  Methods: Hospital records and endoscopic records were collected and analyzed.  Main outcome measure: Endoscopic finding which were classified into 4 groups: no injury, 1st degree injury,  2nd degree injury and 3rd degree injury. The sites of injuries were divided into proximal esophagus, distal  esophagus, proximal stomach (cardia, fundus and body), distal stomach (antrum and pylorus) and 1st part  duodenum.  Results: Demographic data showed that 124 patients (72.5%) were female and the average age was 26.2 years. Intentional ingestion was the cause in 166 patients (97.1%). Hydrochloric acid existing in hard surfaces  Cleaner  especially toilet and bowl cleaners was the most common corrosive agent in 126 patients (73.7%).  The prevalence of injury in upper esophagus, lower esophagus, proximal stomach, distal stomach  A and duodenum were 35.0%, 69.4%, 64.9%, 33.1% and 17.2% consecutively.  Conclusion: These findings were different from the developed countries. In those countries, the most common  corrosive agents were sodium hydroxide and potassium hydroxide that were strong bases in drain or pipe  cleaner. Furthermore, lower esophagus especially esophagogastric junction and proximal stomach were  the most susceptible sites of injuries. Then, management and teaching should be conversely from the  developed countries as mentioned in many textbooks and journals.  Key Words: endoscopic finding, corrosive ingestion  Vajira Med J 2006 ; 50 : 33 - 38

Solid Pseudopapillary Tumor of the Pancreas: A Case Report

Abstract Solid Pseudopapillary Tumor of the Pancreas: A Case Report Suphakan         Techapongsatorn            MD, FICS Waigoon           Stapanavatr                     MD, FICS Satit                  Srimantayamas               MD Wisit                  Kasetsermwiriya            MD Department of Surgery, BMA Medical College and Vajira Hospital                 Solid pseudopapillary tumor is an uncommon low-graded malignant tumor of the pancreas. Definite diagnosis usually comes from pathological study of the surgical specimens. The prognosis is good whenever the tumor is completely removed. We herein present a case report of 19-year-old Myanmese woman suffered from intra-abdominal mass for 7 years. The computed tomography showed huge solid and cystic mass at body and tail of pancreas. She underwent enbloc resection included distal pancreatectomy and splenectomy. The pathological finding revealed solid pseudopapillary tumor. The patient was follow-up for 24 months with an uneventful post-operative course. She was free from tumor recurrence. Key words: pseudopapapillary tumor, pancreas Vajira Med J 2006 ; 50 : 193 - 197

A Comparative Study between Compressible Brassiere and Conventional Pressure Dressing for Seroma Prevention after Mastectomy in Breast Cancer

Abstract A Comparative Study between Compressible Brassiere and Conventional Pressure Dressing for Seroma Prevention after Mastectomy in Breast Cancer Suphakan   Techapongsatorn          MD, FICS Wisit           Kasetsermviriya            MD Satit           Srimantayamas              MD Vasin          Chotivanich                     MD Anan         Manomaipiboon               MD, MSc, FICS Department of Surgery, BMA Medical College and Vajira Hospital Objective: To evaluate the effectiveness between compressible brassiere without axillary compression and conventional pressure dressing for seroma prevention after mastectomy in breast cancer. Study design: Prospective, randomized controlled trial. Subjects: A total of 56 female patients with breast cancer managed by modified radical mastectomy in BMA Medical College and Vajira Hospital during December 2004 to October 2005 were enrolled. They were divided into two groups. First, conventional dressing was applied in 29 patients as control group. Second, compressible brassiere without axillary compression was applied in 27 patients as study group. Methods: All subjects were randomly assigned into two groups after surgical wound closing. Surgeons and the patients never knew the dressing techniques until finishing the operation. Patients' characteristics, clinical data, intra-operative data and outcomes were collected and analysed. Main outcome measures: Occurrence of seroma, amount of drainage serum, length of hospital stay after operation and other post-operative wound complications. Results: Patients' characteristics, clinical data and intra-operative data were not different significantly between two groups. Amount of drainage serum, length of hospital stay and occurrence of seroma in control group and study group were 725.0 ± 511.6 ml vs 774.3 ± 535.6, 9.3 ± 5.4 days vs 11.1 ± 4.9 days and 4/29 vs 6/27 patients (p-value \> 0.05). These final outcomes were not different significantly too. Conclusion: Pressure dressing with compressible brassiere without axillary compression after modified radical mastectomy in breast cancer could not reduce seroma, drainage serum and length of hospital stay. Vajira Med J 2007 ; 51 : 87 - 94

Quality of Life in Breast Cancer Patients

Abstract Quality of Life in Breast Cancer Patients Suphakan   Techapongsatorn          MD, FICS* Supada       Techapongsatorn           MD** Wisit           Kasetsermviriya            MD* Satit           Srimantayamas              MD* Vasin          Chotivanich                      MD* *Department of Surgery, BMA Medical College and Vajira Hospital **Department of Preventive Medicine, BMA Medical College and Vajira Hospital Objectives: To study the quality of life in patients with stage 1-3 breast cancer and affecting factors in BMA Medical College and Vajira Hospital. Study design: Descriptive study. Subjects: One hundred and five patients with stage 1-3 breast cancer attending breast cancer clinic, BMA Medical College and Vajira Hospital during December 2004 to November 2005 were enrolled. Methods: Quality of life was assessed by using self-administered questionnaire (WHOQOL- BREF, Thai version). The socioeconomic and status of treatment were collected and analyzed. Main outcome measures: Quality of life score and affecting factors. Results: The mean quality of life score were 87.8 ± 8.6 with classified to medium level. The incomes and educational status affected with the quality of life score significantly (p-value \< 0.05). Conclusion: The quality of life in breast cancer patient stage 1-3 was in medium level. Incomes and educational status were the affecting factors to the quality of life. Vajira Med J 2007 ; 51 : 33 - 40

A Randomized Controlled Trial Comparing 2-Octylcyanoacrylate and Absorbable Subcuticular Suture in Small Surgical Incision Wound Closure

Abstract A Randomized Controlled Trial Comparing 2-Octylcyanoacrylate and Absorbable Subcuticular Suture in Small Surgical Incision Wound Closure Suphakan  Techapongsatorn MD, MSc (Clinical Epidemiology), FICS Department of Surgery, BMA Medical College and Vajira Hospital Objective: To compare the efficacy of 2-octylcyanoacrylate with absorbable subcuticular suture for surgical incision wound closure. Study design: Randomized controlled trial. Subjects: A total of 88 patients, who were indicated for surgical removal of benign skin or subcutaneous lesions in the Department of Surgery, BMA Medical College and Vajira Hospital during March and July 2007 were enrolled. Methods: All patients were randomly assigned into two groups: 2-octylcyanoacrylate for wound closure (n= 44) and absorbable subcuticular suture for wound closure (n=44). The closure wound was evaluated on day 7 postoperatively. Main outcome measures: Wound closure evaluation score. Results: The wound closure evaluation score in the 2-octylcyanoacrylate group was statistically significant better than absorbable subcuticular suture group, particularly in terms of wound approximation, wound inflammation and wound epithelization. Conclusion: 2-octylcyanoacrylate has higher wound closure evaluation score than absorbable subcuticular suture for closure of small surgical incision wound. Vajira Med J 2008 ; 52 : 93 - 100