Siriraj Medical Journal

114-121

Authors: atsanee Soontrapirom,Suriyadeo Tripathi,M.D.,Pattarawalai Talungchit,M.D.,Ph.D., Suporn Apinuntavech,M.D.

Background: Teenage pregnancy is an evolving global public health problem. Level of life assets could predict behaviors and take e ect to less sexual risk behaviors in teenagers. Objective: To compare life assets between pregnant and non-pregnant teenagers and to evaluate the relationship between basic factors and teenage pregnancy. Methods: A total of 172 female teenagers aged 12-19 years were included. e control group was matched with the case group by age with mean age of 17.07 years old. e case group consisted of 86 pregnant teenagers who attended the Teenage Antenatal Care Unit at Siriraj Hospital. e control group consisted of 86 teenagers who were not pregnant and who had never been pregnant. e research instruments were general information and life assets inventory questionnaires developed by Suriyadeo Tripathi with Cronbach’s Alpha coe cient at 0.890. Results: Mean life assets scores were signi cantly higher in the control group than in the case group (T-test analysis: Mean = 94.70/87.65, SD = 17.45/22.68, p-value =.024, respectively). e control group scored more favorably than the case group on 16 items. In addition, the case group could not meet the minimum assessment criteria on 21 items, which indicated their status as an at risk group. A total of 12 factors were found to be statistically signi cantly associated with teenage pregnancy. Conclusion: Overall life assets were signi cantly higher among teenagers who had not experienced pregnancy. e risk factors included level of education, GPA, family income, mothers or family members of teenagers having experience of teenage pregnancy, main guardians, father education, mother occupation, parental relationship, family warmth and smoking were found to be signi cantly associated with risk of teenage pregnancy in this study. ese results will help to facilitate preventive interventions and the development of policies and guidelines to control and perhaps reverse current trends in teenage pregnancy.

128-136

Authors: Jantima Roongruangchai, D.D.S., Ph.D.*, Yadaridee Viravud, D.D.S.,M.Sc.*, Vasana Plakornkul, D.V.M., M.Sc., Kesorn Sripaoraya, M.Sc., Sakultra Muangwatana, M.Sc., Kosol Roongruangchai, M.Sc., M.D.

Background: Anti-epileptic drugs are known to be the risk of teratogenicity. Topiramate (TPM) is a new kind of such drug, for which no research has con rmed the incidence of producing congenital abnormalities. Objective: is study was conducted to study the teratogenic e ects of TPM by using chick embryos as an animal model and the results can be compared to the human embryo of the same stage. Methods: Fertilized Leghorn hen eggs were injected in ovo with two concentrations of TPM, which were 10mg, and 20mg, in NSS at a volume of 0.1 ml into the yolk sac at 21 hrs of incubation and repeated injections at 72 hrs at a volume of 0.05 ml. e chick embryos on day 3, 6 and 11 of incubation were sacri ced and all living embryos were processed for total mount and serial section. Results: e mortality rate increased corresponding to the concentrations of TPM, and the embryonic stage. e total mount of day 3 showed major abnormalities of the eye and heart, such as microphthalmia and looser of heart looping. e serial section of day 3 showed opening of the anterior neuropore, ectopia viscerae and multiple malformations of the eye and heart. Day 6 chick embryos showed ectopia cordis and ectopia viscerae. Moreover, there were retardation and abnormalities of several organs such as eye, heart, liver, mesonephros and gonads. Day 11 chick embryos showed ectopia viscerae and several growth retardations, retardation of ossi cation of both limb bones and skull bones. Conclusion: is study showed that TPM might cause embryonic death, growth retardation and abnormalities of the eye, heart, an opening of the anterior neuropore and ectopia viscerae. is might indicate abnormalities to the baby born from mother with gestational epilepsy who was taking this drug continuously, and it might lead to spontaneous abortion or congenital anomalies of the fetus.

143-146

Authors: Warissara Rongthong, M.D.

Data supporting the role of radiotherapy in secondary trigeminal nerve lymphoma is scarce. Here, I report the case of 64-year-old ai male diagnosed as gastric di use large B cell lymphoma with secondary trigeminal nerve lymphoma. He had previously received one cycle of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), followed by ve cycles of rituximab plus CHOP (R-CHOP) with intrathecal methotrexate (MTX) and cytarabine (Ara-C). One month a er the last cycle of R-CHOP, he developed a headache and numbness on the le side of his face. MRI revealed thickening of the le trigeminal nerve. He received one intrathecal injection of MTX and Ara-C, followed by systemic chemotherapy. A er receiving intrathecal chemotherapy, his symptoms disappeared. Clinical response and MRI studies suggested secondary trigeminal nerve lymphoma. Two months later, our patient’s secondary trigeminal nerve lymphoma had progressed. Salvage whole brain irradiation (36 Gy) with boost dose (50 Gy) along the le trigeminal nerve was given. Unfortunately, our patient developed heart failure and expired during the radiotherapy session. In conclusion and speci c to secondary central nervous system lymphoma (SCNSL), radiotherapy may bene t patients who fail to respond to systemic chemotherapy and palliative treatment. e results this report fail to support the role of radiotherapy in secondary trigeminal nerve lymphoma.

151-155

Authors: Asawin Sudcharoen, M.D., Panitpong Marungroj, M.D., Wanaporn Burivong, M.D., Piyakorn Poonyam, M.D., Piyanant Chonmaitree, M.D.

e authors report a case of colorectal liver metastasis which is one of the uncommon causes of liver tumor with central scar in a young female. Our patient presented with right upper abdominal discomfort and palpable liver mass for about 2 months. She did not have underlying disease. She had used oral contraceptive pills for 14 years. Physical examination revealed only liver span 16 centimeters (cm). Multidetector-row computed tomography demonstrated 3 masses and the largest one measured 10.7x 8.3x 7 cm in diameter with lobulated contour, hypodensity enhancing pattern, and a central scar at segment II and IVa of liver. Magnetic resonance imaging (MRI) of the largest mass showed hyposignal intensity on T1-weighted and slightly hypersignal intensity in T2-weighted MRI. is mass also had a large central scar which was hyposignal intensity on T1-weighted and hypersignal intensity in T2-weighted MRI. Liver biopsy showed scattered in ltration of atypical epithelium with glandular formation. Immunohistochemical analysis was compatible with colorectal cancer. Colonoscopy was performed and revealed large mass at distal part of sigmoid colon. e patient was scheduled to undergo surgical operation and receive chemotherapy. To our knowledge, colorectal metastasis of liver should be considered as a cause of liver tumor with central scar.