Kimaporn Khamanarong

Occipitalization of the atlas: its incidence and clinical implications

OBJECTIVE The aim of the present study was to investigate the incidence of occipitalization of the atlas among Thai dried skulls, in order to contribute to baseline awareness of this condition. MATERIALS AND METHODS The skulls of 633 adult Thais from the collection maintained in the Department of Anatomy, Faculty of Medicine, Khon Kaen University, Thailand, were examined for evidence of occipitalization of the atlas. The skulls were well-preserved and did not show any traits of craniofacial deformation. The skulls for which the age and sex were unknown were excluded from the analysis. From the cadaveric records on each individual, we learned that the skulls belonged to 373 men (age of decease between 25 and 90 years), and 260 women (age of decease between 28 and 92 years). RESULTS Occipitalization of the atlas was detected in 2 skulls (0.32%). The first case was a male skull (54 years of age at decease), where the atlas was partially fused to the occipital bone. The second case was also a male skull (59 years of age at decease) showing complete fusion of the anterior arch of the atlas. CONCLUSION The incidence of occipitalization of the atlas is low; however, if present this abnormality may cause a wide range of neurological problems. Knowledge of occipitalization of the atlas may be of substantial importance to orthopedists, neurosurgeons, physiotherapists and radiologists dealing with abnormalities of the cervical spine. Mistaken diagnoses have led to delayed treatment and at times adverse results.

Duplicated axillary arch muscles arising from the latissimus dorsi

Many origins and insertions of an axillary muscular slip (also known as Langers or axillary arch muscles) have been documented previously. In this report, we found duplicated axillary arch muscles (two variant muscular slips) originating from the inferolateral border of the right side latissimus dorsi muscle. Obviously, these axillary arch muscles can be distinguished as short and long muscular strips. While the origin was the same, the short muscular slip inserts into the fascia covering on the pectoralis minor, whereas the longer one inserts on/into the aponeurosis of pectoralis major. For the surgery in the axillary region, this rare variation should be considered a cause of surgical interventions.

A rare variation of posterior cord brachial plexus branching coexisting with the intercalated ectopic muscle

During a dissection of the brachial plexus we found a rare variation of left posterior cord branching coexisting with an unusual intercalated ectopic muscle. This muscle originated from the shoulder joint capsule at the lesser tubercle on insertion of the subscapularis then pierced between the brachial plexus, enclosed by two roots of the radial nerve, and inserted into the upper part of the latissimus dorsi muscle. The variant posterior cord divided into two roots; a thin lateral and thick medial root. The lateral root gave off the thoracodorsal nerve that penetrated and also innervated the ectopic muscle. The medial root gave off five nerve branches; two upper subscapular, one lower subscapular, one axillary and one terminal branch. A terminal branch fused with the lateral root to form a loop enclosing the ectopic muscle then continued as the radial nerve. This type of variation may be useful to interpret unexplained clinical signs and symptoms and provided additional knowledge to surgeons who perform brachial plexus surgery.

Version of Femoral Neck: A Cadaveric Dried Bone Study

El objetivo fue medir el cuello femoral en femures humanos de tailandeses adultos. La version del cuello femoral es muy variable. Es importante conocer la version de cuello femoral en una poblacion en particular para llevar a cabo con exito una cirugia reconstructiva. Se utilizaron 216 femures secos de adultos tailandeses obtenidos de la coleccion del Departamento de Anatomia de la Facultad de Medicina de la Universidad de Khon Kaen, Tailandia. La anteversion femoral (AFM) media+DE fue de 16,21±5,24. El intervalo de confianza del 95% de la AFM fue entre 15,48 a 16,94. El promedio de intervalos de confianza del 95% en hombres y mujeres fue desde 14,75 a 16,90 y 15,59 a 17,59, respectivamente. No hubo diferencia significativa entre hombres y mujeres en ambos grupos de anteversion y retroversion. La AFM promedio en hombres no mostro diferencia significativa con la anteversion media de las mujeres. Se observo un promedio de -8,22 a -4,80 y -7,71 a -4,47 en el 95% de los intervalos de confianza entre hombres y mujeres, respectivamente. La retroversion promedio en hombres no mostro ninguna diferencia significativa con la retroversion media en las mujeres. Estos grados de AFM deben ser considerados en la planificacion de una cirugia reconstructiva del cuello femoral.

Incidencia de la Formación Inusual del Nervio Mediano en Cadáveres Embalsamados del Noreste de Tailandia

This study aimed to investigate the incidence of unusual formation of the median nerve in Thai cadavers. Two hundred and ninety-two upper limbs were dissected and observed. The results showed that 5 out of 292 (1.71 %) arms had unusual splitting of median nerve that supplied the flexor arm muscles. Concomitantly, the musculocutaneous nerve was absent. In 4 out of 5 variant arms (80 % or 1.37 % of total upper limbs), each median nerve was unusually formed by 3 roots; the first and second roo t were from lateral cord and the third one from medial cord. The union of the second lateral and medial roots to become a median nerve distantly extended in the arm. The second lateral roots gave off small muscular branches to the upper part of flexor arm muscles. Knowled ge of such anatomical variations is helpful for surgeons in performing of brachial plexus surgery.

Classification and Incidence of Pterion Patterns of Thai Skulls

The pterion, a landmark for neurosurgery, is the weakest part of the skull owing to relatively thin bone. Variant patterns of pterion can confuse the clinicians during diagnosis of the lateral skull fractures in emergency situations. Thediff erent pterion types of many races have been reported but not of Thais. In this study; therefore, we investigated the incidence of sutural pte rion patterns on of Thai skulls. The infratemporal fossa of 110 sides from 55 dried skulls identified as Thais were observed and classified for indivi ual pterion types. The results showed that the pterion patterns can be classified into 4 types; spheno-parietal (87.27 %), fronto-t emporal (4.55 %), uni-epipteric (6.36 %), and multi-epipteric (1.82 %) types. It was found that the spheno-parietal type was dominant in males (61.81 %) than in females (25.45 %). The majority of the skulls showed bilateral symmetry (85.45 %) in all types and the unilateral ones were far less (14.55 %). In bilateral pterion incidence, the spheno-parietal type was approximately 93.61 % while the uni-epipteric type was not found. Moreover, the bilateral multi-epipteric type was found only in one female skull (2.13 %). These findings will be useful for the radiologists and the neurosurgeons concerning lateral skull fractures in emergency diagnosis

Double inferior vena cava with three shunts: a rare anomaly with important implications for surgeons

Inferior vena cava (IVC) is the largest single vein that collects systemic venous blood from the lower part of the body except the gut and drains into the right atrium. Double IVC is a rare anomaly in humans and usually is discovered incidentally during the interventional radiological procedures or routine cadaveric dissection. Here we report a rare case of unusual observations in an adult female Thai cadaver with a duplicated left IVC with three short venous shunts and a variant pattern of the hemiazygos vein. Also included in this case was the presence of unilateral double renal vein on the right kidney. This type of anatomic variation of the great vein has never been reported before. A detailed description of these variations is useful and essential for the surgeons during approaching the retroperitoneal region.

Predictive Equation Model for Decision-Making of Industries Outsourcing to Rural Area in Northeast Thailand

Outsourcing is a critical issue facing industrial management. However, the discussion concerning ways to outsource industrial production remains in the conceptual stage. Currently, It has not exist model to help a practitioner determine which methods would be most effective in implementing an outsourcing program. The purpose of this research was to study influence factors for decision-making of rural industries outsourcing in Northeast Thailand. This study points to the entrepreneurs in smalland medium-sized enterprises in the manufacturing sector in Northeast Thailand. In the study, a multiple regression method was used as a tool to analyze the influence factors for decisions to outsource rural industries. According to the analysis, It was found three factors were proned to affect the decision for rural * π—°»÷°...“ À≈—° Ÿμ√»‘≈a»“ μ√¥ÿ...Æ’∫—≥±‘μ “¢“«‘TM“æ—≤π»“ μ√å §≥–¡πÿ...¬»“ μ√å·≈– —ߧ¡»“ μ√å ¡À“«‘∑¬“≈—¬¢Õπ·°àπ ** √Õß»“ μ√“®“√¬å “¢“°“√∫√‘À“√Õÿμ “À°√√¡·≈–«‘ “À°‘® §≥–¡πÿ...¬»“ μ√å·≈– —ߧ¡»“ μ√å ¡À“«‘∑¬“≈—¬¢Õπ·°àπ *** √Õß»“ μ√“®“√¬å ¿“§«‘TM“°“¬«‘¿“§»“ μ√å §≥–·æ∑¬å»“ μ√å ¡À“«‘∑¬“≈—¬¢Õπ·°àπ **** √Õß»“ μ√“®“√¬å ¿“§«‘TM“«‘»«°√√¡‰øøÑ“ §≥–«‘»«°√√¡»“ μ√å ¡À“«‘∑¬“≈—¬¢Õπ·°àπ 84 «“√ “√«‘®—¬ ¡¢. (∫».) 8 (3) : °.§. °.¬. 2551