• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2599-2605
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• 2013

The study aimed to evaluate immune-stimulating effects of a well-known Thai folkloric remedy when used for adjuvant therapy with conventional chemotherapeutics for treatment of breast cancer. Immunostimulating influence of the remedy (215 mg/kg body weight per day) on NK cell activity and TNF-${\alpha}$ release from the monocytes/macrophages were investigated in a total of 15 healthy women and 13 female patients with breast cancer (Group 1). The effect of breast tumor surgery on NK cell activity was further investigated in 18 female patients with breast cancer (Group 2). NK cell cytotoxic activity was determined by chromium release cytotoxic assay using K562, an erythroleukemic cell line. TNF-${\alpha}$ release from monocytes/macrophages separated from blood samples was determined through a biological assay using actinomycin D-treated L929 mouse fibroblast cells in the presence and absence of LPS. Baseline NK cell activity of the monocytes/macrophages separated from Group 2 patients expressed as %cytotoxicity was significantly lower than in the healthy subjects at E:T ratios of 100:1 and 25:1. In healthy subjects, there was no change in NK cell cytotoxic activity (%cytotoxicity or LU) following 1 and 2 weeks of treatment with the remedy compared with the baseline at various E:T ratios but the binding activity (%binding) was significantly increased after 2 weeks of treatment. The addition of one or two conventional chemotherapeutic regimens did not significantly reduce the NK cytotoxic activity but did affect release of TNF-${\alpha}$ in both unstimulated and LPS-stimulated samples. Surgery produced a significant suppressive effect on NK cell activity. The use of the remedy as an adjunct therapy may improve therapeutic efficacy and safety profiles of conventional chemotherapeutic regimens through stimulation of the immune system in cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2039-2043
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• 2012

Objectives: Depression is common in cancer patients. However, only limited evidence is available for Asian populations. The authors therefore examine the prevalence of depression in Thai patients with cancer. In addition, associated factors were determined. Methods: This cross-sectional study was conducted in cancer patients admitted to a university hospital during December 2006 - December 2007. The Patient Health Questionnaire (PHQ-9) was used to assess all cancer patients. Suicidal risk was assessed by using the Mini-International Neuropsychiatric Interview (MINI) in the module of suicidal risk assessment. Results: Of 108 cancer patients, 29.6 % were diagnosed with a depressive disorder (mild, 14.8 %; moderate, 5.6 %; severe, 9.3 %). However, only 25.0 % of these were recognized as being depressed by the primary physician. According to the MINI., 28.1 % of these depressed cancer patients had a moderate to severe level of suicidal risk. In addition, the findings suggest that increased risk of depression is significantly associated with increased pain score, lower number of cancer treatments (< 2 methods), increased educational duration (>13 years), increased age (> 50 years old) and being female. Conclusions: The prevalence of depression is high in Thai cancer patients. However, depressive disorder in those patients is frequently undiagnosed. It is associated with several factors including pain, a number of cancer treatments, education duration, age and sex. To improve quality of life, increase compliance with treatments and prevent of suicide, screening for depressive disorders in this patient group is strongly recommended.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10887-10891
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• 2015

Background: Helicobacter pylori (H. pylori) is a well known major cause of gastric cancer and even when asymptomatic infected patients are at elevated risk. Functional dyspepsia (FD) is also one of the most common gastrointestinal diseases, which greatly impacts the quality of life. H. pylori infection and psychosocial stress are frequently associated with FD but limited studies have confirmed the relationships, especially in Southeast Asian countries. Here we aimed to investigate the prevalence and impact of H. pylori infection, anxiety and depression on Thai FD patients. Materials and Methods: This cross-sectional study was conducted in a tertiary care center in Thailand, during February 2013-January 2014. All FD patients were diagnosed and categorized by Rome III criteria into epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) groups. The Hospital Anxiety and Depression Scale was used to evaluate psychological status. The presence of H. pylori was defined as positive with H. pylori culture, positive rapid urease test or positive histology. Results: Three hundred FD patients were included, 174 (58%) female. Overall mean age was 54.8+15.1 years. There were 192 (64%) patients with PDS and 108 (36%) with EPS. H. pylori infection was demonstrated in 70 (23.3%) patients. Anxiety and depression were documented in 69 (23%) and 22 (7.3%), respectively. H. pylori infection, anxiety and depression were significantly higher in PDS than EPS patients (27.1% vs 16.7%; p=0.04; OR=1.86; 95%CI=1.01-3.53 and 29.7% vs 11.1%; p=0.0002; OR=3.4; 95%CI=1.7-7.1 and 10.4% vs 1.9%; p=0.006; OR=6.2; 95%CI=1.4-38.9, respectively). Conclusions: H. pylori infection, anxiety and depression were commonly found in Thai FD patients and more prevalent in PDS than EPS. H. pylori eradication might be the key to success for the treatment of Thai FD patients and prevent the development of gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5945-5950
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• 2015

A 6-year retrospective cohort study was conducted among Thai hematologic malignancy (HM) patients receiving intensive chemotherapy. Of the 145 eligible patients receiving 893 chemotherapy sessions, 46.9% were female, median age was 52 years, and the most common HM diagnosis was diffuse large B-cell lymphoma (46.2%). Febrile neutropenia (FN) occurred in 14.9% of chemotherapy sessions with an incidence of 24.8 per 1,000 chemotherapy cycles per year. Independent factors associated with FN were receiving the first chemotherapy cycle [adjusted hazard ratio (aHR) 4.1], having hemoglobin ${\leq}100g/L$ (aHR 3.7) and platelet ${\leq}140,000/{\mu}L$ (aHR 2.7) on chemotherapy day and receiving acute myeloid leukemia regimens (aHR 20.8). Granulocyte colony stimulating factor was significantly associated with reduced rate of FN when given in those receiving CHOP regimen. With the median follow-up time of 16 months, the overall survival time was significantly longer in patients without FN than those with FN (61.7 vs. 20.8 months; p<0.001).

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1177-1180
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• 2014

Background: Anogenital warts (AGWs) are common results of sexually transmitted infection (STI). Human papillomavirus (HPV) types 6 and 11, which are non-oncogenic types, account for 90% of the clinical manifestations. Although the quadrivalent HPV vaccine has been launched, AGW remains prevalent in some countries and shows association with abnormal cervical cytology. Objectives: To study the prevalence of abnormal cervical cytology (low grade squamous intraepithelial lesions or worse; LSIL+) in immunocompetent Thai women newly presenting with external AGWs. Materials and Methods: Medical charts of all women attending Siriraj STI clinic during 2007-2011 were reviewed. Only women presenting with external AGWs who were not immunocompromised (pregnant, human immunodeficiency virus positive or being on immunosuppressant drugs) and had not been diagnosed with cervical cancer were included into the study. Multivariate analysis was used to determine the association between the characteristics of the patients and those of AGWs and LSIL+. Results: A total of 191 women were eligible, with a mean age of $27.0{\pm}8.9$ years; and a mean body mass index of $20.6{\pm}8.9kg/m^2$. Half of them finished university. The most common type of AGWs was exophytic (80.1%). The posterior fourchette appeared to be the most common affected site of the warts (31.9%), followed by labia minora (26.6%) and mons pubis (19.9%). The median number of lesions was 3 (range 1-20). Around 40% of them had recurrent warts within 6 months after completing the treatment. The prevalence of LSIL+ at the first visit was 16.3% (LSIL 12.6%, ASC-H 1.1%, HSIL 2.6%). After adjusting for age, parity and miscarriage, number of warts ${\geq}5$ was the only factor associated with LSIL+(aOR 2.65, 95%CI 1.11-6.29, p 0.027). Conclusions: LSIL+ is prevalent among immunocompetent Thai women presenting with external AGWs, especially those with multiple lesions.

• Imaging Science in Dentistry
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• v.43 no.4
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• pp.289-293
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• 2013

Purpose: This study was performed to determine the relationship between the stage of tooth eruption (both vertical and mesio-angular) and chronological age. Materials and Methods: Indirect digital panoramic radiographs were used to measure the distances from the dentinoenamel junction (DEJ) of the second molars to the occlusal plane of the second molar teeth and of the adjacent third molars in 264 Thai males and 437 Thai females using ImageJ software. The ratio of those distances was calculated by patient age, and the correlation coefficient of the ratio of the third molar length to the second molar length was calculated. Results: The correlation between the height of the vertically erupted upper third molar teeth and age was at the intermediate level. The age range of ${\geq}15$ to <16 years was noted to be the range in which the correlation between the chronological age determined from the eruptional height and actual chronological age was statistically significant. The mean age of the female subjects, in which the position of the right upper third molar teeth was at or above the DEJ of the adjacent second molar but below one half of its coronal height was $19.9{\pm}2.6$ years. That for the left side was $20.2{\pm}2.7$ years. The mean ages of the male subjects were $20.1{\pm}3.3$ years and $19.8{\pm}2.7$ years for the right and left sides, respectively. Conclusion: It might be possible to predict chronological age from the eruption height of the wisdom teeth.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2853-2856
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• 2016

Background: Many studies have pointed to strategies to cope with patient anxiety in colposcopy. Evidence shows that patients experienced considerable distress with the large loop excision of transformation zone (LLETZ) procedure and suitable interventions should be introduced to reduce anxiety. This study aimed to investigate the effects of music therapy in patients undergoing LLETZ. Materials and Methods: A randomized controlled trial was conducted with patients undergoing LLETZ performed under local anesthesia in an out patient setting at Ramathibodi Hospital, Bangkok, Thailand, from February 2015 to January 2016. After informed consent and demographic data were obtained, we assessed the anxiety level using State Anxiety Inventory pre and post procedures. Music group patients listened to classical songs through headphones, while the control group received the standard care. Pain score was evaluated with a visual analog scale (VAS). Statistical analysis was conducted using Pearson Chi-square, Fisher's Exact test and T-Test and p-values less than 0.05 were considered statistically significant. Results: A total of 73 patients were enrolled and randomized, resulting in 36 women in the music group and 37 women in the non-music control group. The preoperative mean anxiety score was higher in the music group (46.8 VS 45.8 points). The postoperative mean anxiety scores in the music and the non-music groups were 38.7 and 41.3 points, respectively. VAS was lower in music group (2.55 VS 3.33). The percent change of anxiety was greater in the music group, although there was no significant difference between two groups. Conclusions: Music therapy did not significantly reduce anxiety in patients undergoing the LLETZ procedure. However, different interventions should be developed to ease the patients' apprehension during this procedure.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1361-1364
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• 2012

Background: Results of screening colonoscopy from Western countries reported adenoma detection rates (ADRs) of 30-40% while those from Asia had ADR as low as 10%. There have been limited data regarding screening colonoscopy in Thailand. The objectives of this study were therefore to determine polyp and adenoma detection rates in Thai people, to evaluate the incidence of colorectal cancer detected during screening colonoscopy and to determine the endoscopic findings of the polyps which might have some impact on endoscopists to perform polypectomy. Materials & Methods: This study was a retrospective electronic chart review of asymptomatic Thai adults who underwent screening colonoscopy in our endoscopic center from June 2007 to October 2010.Results: A total of 1,594 cases were reviewed. The patients had an average age of $58.3{\pm}10.5$ years (range 27-82) and 55.5% were female. Most of the cases (83.8%) were handled by staff who were endoscopists. A total of 488 patients (30.6%) were reported to have colonic polyps. Left-sided colon was the most common site (45.1%), followed by right-sided colon (36.5%) and the rectum (18%). Those polyps were removed in 97.5% of cases and 88.5 % of the polyps were sent for histopathology (data lost 11.5%). Two hundred and sixty three cases had adenomatous polyps, accounting for 16.5 % ADR. Advanced adenomas were detected in 43 cases (2.6%). Hyperplastic polyps were mainly located distal to the splenic flexure of the colon whereas adenomas were found throughout the large intestine. Ten cases (0.6%) were found to have colorectal cancer. Four advanced adenomas and two malignant polyps were reported in lesions ${\leq}$ 5 mm. Conclusion: The polyp detection rate, adenoma detection rate, advanced adenoma detection rate and colorectal cancer detection rate in the screening colonoscopy of Thai adults were 30.9%, 16.5%, 2.6% and 0.6% respectively. Malignant transformation was detected regardless of the size and location of the polyps. Therefore, new technology would play an important role indistinguishing polyps.

• Imaging Science in Dentistry
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• v.53 no.4
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• pp.291-302
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• 2023

Purpose: Early detection of carotid stenosis can reduce cardiovascular risk. In this study, the maximum-carotid intima-media thickness (CIMT), the mean-CIMT, and the presence of plaque were examined in healthy young Thai adults. Additionally, correlations between CIMT and cardiovascular risk factors were assessed. Materials and Methods: Left and right carotid arteries of 302 participants(15-45 years old) were scanned, with CIMT measured at the far walls of the common carotid artery, carotid bulb, and internal carotid artery. Demographics and risk factors were assessed using a questionnaire. Ten random participants were re-scanned after 4 weeks. Results: The study included 123 (40.70%) male and 179 (59.30%) female participants. The max-CIMT, mean-CIMT, and plaque thickness were 0.400±0.100, 0.403±0.095 and 1.520±0.814 mm, respectively. Male participants had significantly higher CIMT values for nearly all locations and age groups. The right-sided CIMT values were higher for all locations. The carotid bulb had the greatest CIMT values(0.437±0.178 mm), followed by the common (0.403±0.095 mm) and internal(0.361±0.099 mm) carotid arteries. Plaque was present in 18 locations (1.00%), affecting 15 participants (4.97%). These plaques were found in the right carotid bulb (n=9; 0.50%), left carotid bulb (n=7; 0.39%), and right internal carotid artery (n=2; 0.11%). Adjusted multivariable regression revealed significant positive associations between CIMT and male, increased age and "other" occupation (P<0.05). Conclusion: Both max-CIMT and mean-CIMT were approximately 0.4 mm. Plaque was observed in 4.97% of patients, with an average thickness of 1.5 mm. The most influential risk factors for increased CIMT were sex, age, and occupation.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2055-2060
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• 2016

Background: Colorectal cancer (CRC) is one of the most common causes of death worldwide and in Thailand. The X-ray repair cross-complementary protein 1 (XRCC1) is required for efficient DNA repair. The effects of this gene on survival in colorectal cancer remain controversial and have not been reported in Thailand. The aim of this study was to investigate the association of the XRCC1 gene with survival of colorectal cancer patients in a Thai population. Materials and Methods: Data and blood samples were collected from 255 newly diagnosed and pathologically confirmed CRC patients who were recruited during the period 2002 to 2006 and whose vital status was followed up until 31 October, 2014. Real-time PCR-HRM was used for genotype identification. The Kaplan-Meier method, the log-rank test, and Cox proportional hazard regression were used to estimate cumulative survival curves and compare various survival distributions and adjusted hazard ratios. Results: Most of the cases were males, and the median age was 55 years. The median survival time was 2.43 years. The cumulative 1-, 3-, 5-, 7-, and 10 year survival rates were 76.70%, 39.25%, 26.50%, 16.60% and 3.56%, respectively. After adjustment, female gender, ages 50-59 and ${\geq}60years$, tumour stage III+IV, a signet-ring cell carcinoma, and poor differentiation had significant associations with increased risk of CRC death. While the XRCC1 Arg/Arg homozygote appeared to be a risk factor for CRC death, the association was not significant. Conclusions: The genetic variant in the XRCC1 may not be associated with the survival of CRC patients in Thailand. Further studies are needed to verify our findings.