Pasuk Mahakkanukrauh

Incidence of a septum in the first dorsal compartment and its effects on therapy of de Quervain's disease.

Because there has been no study of the presence of a septum in the first dorsal compartment of the wrist in Asians and there is no method of conservative treatment of de Quervains disease based on the presence of this septum, the authors have evaluated this septum in a large Asian population. Two‐hundred wrists in 100 Asian cadavers were dissected.. The presence of the septum was documented by removing the abductor pollicis longus (APL) tendon from its tunnel in the first dorsal compartment and observing through the same tunnel if there was a septum to prevent immediate access to the extensor pollicis brevis (EPB) tendor. A septum was present in 77.5% of wrists. When the septum was present, the resultant subcompartment for the EPB was quite narrow. Given the high incidence of the septum, therapy of de Quervains disease could reasonably be modified accordingly. For instance, to improve the success rate for local steroid injection, the solution of steroid should aim at reaching both subjcompartments by redirecting the course of the injecting needle. As for surgical release, adequacy could be enhanced by the realization by the surgeon of the possible presence of the septum. Clin. Anat. 13:195–198, 2000.

Anatomic Variations of the Lateral Intercondylar Ridge Relationship to the Anterior Margin of the Anterior Cruciate Ligament

Background: The lateral intercondylar ridge (LIR) has been recognized as an important landmark to create an appropriate femoral tunnel in single-bundle anterior cruciate ligament (ACL) reconstruction. However, because of variations in the distal part of the LIR or because the relationship between the LIR and the anterior margin of the ACL attachment has not been sufficiently clarified, the utility of the LIR for anatomic single- and double-bundle reconstruction remains controversial. Hypotheses: (1) There is a large degree of positional and dimensional variation in the LIR, specifically concerning the distal part. (2) There may be significant differences between sexes in the LIR. (3) The anterior margin of the ACL attachment may be located anterior to the distal part of the LIR. Study Design: Descriptive laboratory study. Methods: A total of 318 femora, which were collected with the donors’ demographic data, were examined to determine anatomic variations of the LIR. In addition, 20 cadaveric knees, in which the anterior margin was marked by radiopaque silicon markers, were examined with micro–computed tomography to evaluate the positional relationship between the LIR and the anterior margin of the ACL attachment. Results: Although the LIR was identified in 94.0% of the 318 femora, the distal half of the LIR was not visible in 18.4% of these femora. Moreover, the LIR was located in an extremely anterior part of the lateral condyle surface in 8.8% in comparison with the common location, and in an extremely posterior part in 8.5%. The length–height ratio (69.9% in men, 63.6% in women) and the length between the inlet of the notch roof and the proximal part of the LIR (19.9 mm in men, 17.9 mm in women) were significantly greater in males than in females (P = .0028 and P < .0001, respectively). The anterior margin of the ACL attachment was commonly located anterior to the middle and distal part of the LIR, having the mean marker-ridge distance of 4.2 mm. Conclusion: There were large positional and dimensional variations in the LIR, specifically concerning the distal part. There are slight but significant differences between the male and female femora. The anterior margin of the ACL attachment is commonly located anterior to the middle and distal parts of the LIR. Clinical Relevance: Utility of the LIR as an osseous landmark for femoral tunnel creation is limited in anatomic reconstruction of the posterolateral bundle and anatomic single-bundle reconstruction.

Femoral neck-shaft angle in humans: variation relating to climate, clothing, lifestyle, sex, age and side

The femoral neck‐shaft angle (NSA) varies among modern humans but measurement problems and sampling limitations have precluded the identification of factors contributing to its variation at the population level. Potential sources of variation include sex, age, side (left or right), regional differences in body shape due to climatic adaptation, and the effects of habitual activity patterns (e.g. mobile and sedentary lifestyles and foraging, agricultural, and urban economies). In this study we addressed these issues, using consistent methods to assemble a global NSA database comprising over 8000 femora representing 100 human groups. Results from the analyses show an average NSA for modern humans of 127° (markedly lower than the accepted value of 135°); there is no sex difference, no age‐related change in adults, but possibly a small lateral difference which could be due to right leg dominance. Climatic trends consistent with principles based on Bergmanns rule are evident at the global and continental levels, with the NSA varying in relation to other body shape indices: median NSA, for instance, is higher in warmer regions, notably in the Pacific (130°), whereas lower values (associated with a more stocky body build) are found in regions where ancestral populations were exposed to colder conditions, in Europe (126°) and the Americas (125°). There is a modest trend towards increasing NSA with the economic transitions from forager to agricultural and urban lifestyles and, to a lesser extent, from a mobile to a sedentary existence. However, the main trend associated with these transitions is a progressive narrowing in the range of variation in the NSA, which may be attributable to thermal insulation provided by improved cultural buffering from climate, particularly clothing.

Simultaneous accumulation of magnesium with calcium and phosphorus in aorta and iliac arteries of Thai.

To elucidate compositional changes of arteries with aging, the authors previously investigated age-related changes of mineral contents in the various arteries of Japanese and Japanese monkey. To examine whether there were differences between races in regard to age-related changes of mineral contents and the relationships among element contents in the arteries, the authors investigated the arteries of Thai. The subjects consisted of 13 men and 3 women, ranging in age from 39 to 84 yr. After the ordinary dissection at Chiang Mai University was finished, abdominal aortas, common iliac, internal iliac, and external iliac arteries were resected and the element contents were determined by inductively coupled plasma-atomic emission spectrometry. The contents of calcium, phosphorus, and magnesium became the highest in the fifties in the abdominal aorta, common iliac, and external iliac arteries, whereas the contents of calcium and magnesium became the highest in the sixties in the internal iliac artery, and decreased thereafter. In regard to relationships among element contents, it was found that there were high correlations between calcium and phosphorus contents, between calcium and magnesium contents, and between phosphorus and magnesium in all of the abdominal aortas and three iliac arteries. The mass ratios of magnesium to calcium and phosphorus were each similar in the abdominal aorta, common iliac, and internal iliac arteries, except for the external iliac artery, in which it was slightly high. These revealed that as calcium and phosphorus increased in the arteries with aging, magnesium increased in the arteries as well. The differences between the arteries of Thai and Japanese were discussed in the present article.

Determination of sex from the metacarpals in a Thai population

Determination of sex using metacarpals was carried out on a sample of 249 skeletons from a Thai population (154 males and 95 females), ranging in age from 19 to 93 years. Six measurements were taken on each metacarpal, namely maximum length, medio-lateral base width, antero-posterior base height, medio-lateral head width, antero-posterior head height and mid-shaft diameter. Binary logistic regression equations were calculated for determining sex from these measurements. All metacarpals from both sides produced at least one equation that correctly allocated the skeletons with 80% or greater accuracy. In a comparative test using only individuals with no missing measurements (n=196), the most accurate equations for each metacarpal on the right side had pooled allocation accuracies ranging from 85.2% to 89.3%, with the best equation based on three measurements from the 5th metacarpal. On the left side, the most accurate equations for each metacarpal ranged from 83.2% to 89.8% correct allocation, with the best equation based on three measurements of the 2nd metacarpal. When the allocation accuracy for each sex is considered in addition to the pooled accuracy, the best equations involve the same three measurements of the 5th metacarpal on the right side, but shift to three measurements of the first metacarpal on the left side, with a pooled accuracy of 88.3%. The results of this study suggest that metacarpals can be used quite reliably for sexing in forensic contexts in Thailand.

Sex estimation from the talus in a Thai population

Previous research on sex estimation from the tarsals has shown that the talus is the most sexually dimorphic tarsal bone in most populations. In order to assess the sexing potential of the talus in a Thai population, 252 skeletons (126 male, 126 female) from the Chiang Mai University Skeletal Collection were measured. The sample represents Thai people who come from the local Chiang Mai area and who died within the past ten years. Ten measurements were taken on the left and right tali from each skeleton. Seven of these measurements are similar, or identical, to measurements used by other researchers. Three experimental measurements were also taken. Logistic regression equations were calculated for each measurement, and for pairs of measurements. The individual measurements were also examined using ROC analysis. Averaging the results from both sides, the individual measurements with the highest correct allocation accuracies based on logistic regression analysis were trochlear length (88.2%), trochlear breadth (87.3%), talar length (85.5%), and inferior articular surface length (84.5%). The ROC results followed a similar pattern, with Area Under the Curve values as follows: trochlear length (0.952), inferior articular surface length (0.937), trochlear breadth (0.935), and talar length (0.914). When pairs of measurements were considered by means of logistic regression, four equations produced predicted allocation accuracies greater than 90% - three from the right talus, and one from the left. The highest accuracy on both sides resulted from a combination of the two most sexually dimorphic individual measurements of trochlear length and trochlear breadth. Together, they produced predicted allocation accuracies of 91.3% on the right side, and 91.4% on the left side. Unlike many past studies that have found talar length to be the most sexually dimorphic measurement of the talus, our study found trochlear length and breadth to be the most accurate measurements for distinguishing the sexes. Researchers developing sexing equations for use with other populations should consider including trochlear length and breadth in their analyses.

Accumulation of Elements in the Arteries and Cardiac Valves of Thai with Aging

To elucidate whether the extent of element accumulation in the arteries and cardiac valves with aging was different between different races, the authors investigated the accumulation of elements in the arteries and cardiac valves of the Thai with aging and the relationships among elements in the cardiac valves. After ordinary dissection at Chiang Mai University was finished, 16 arteries and 4 cardiac valves were resected and element contents were determined by inductively coupled plasma-atomic emission spectrometry.In the 16 arteries, the average content of calcium was the highest in the site of the abdominal aorta ramifying into the common iliac arteries, and it decreased in the order internal iliac, coronary, abdominal aorta, common iliac, external iliac, superior mesenteric, inferior mesenteric, thoracic aorta, brachial, radial, common carotid, subclavian, ulnar, axillary, renal, and internal thoracic arteries. The average contents of phosphorus and magnesium in respective arteries were parallel with the average contents of calcium, except for the coronary artery. In comparison with the arteries of the Japanese, the trend of calcium accumulation in the arteries of the Thai was almost similar to that in the arteries of the Japanese, except for the coronary artery and thoracic aorta. The calcium accumulation in the coronary artery was much higher in the Thai than in the Japanese, whereas that in the thoracic aorta was lower in the Thai than in the Japanese.Regarding elements in the cardiac valves, the calcium content increased remarkably in the seventies in the aortic valve and in the nineties in the pulmonary valve, but it hardly increased in both the mitral and tricuspid valves with aging. The average content of calcium was the highest in the aortic valve, and it decreased in the order pulmonary, tricuspid, and mitral valves. Regarding the relationship among elements in the aortic valves, it was found that there were extremely significant direct correlations among the contents of calcium, phosphorus, and magnesium, whereas there were significant direct correlations between zinc and either calcium or phosphorus contents. Although significant correlations were found between sulfur and the other element contents in the aortic valves of the Japanese, no significant correlations were found between them in the aortic valves of the Thai. In the mitral valves, extremely or very significant direct correlations were found among the contents of calcium, phosphorus, magnesium, and sulfur, with some exceptions that there were no significant correlations between phosphorus and either magnesium or sulfur contents.In addition, no significant correlation was found in the calcium content between the aortic valve and coronary artery in the same individuals.

Earlier accumulation of calcium, phosphorus, and magnesium in the coronary artery in comparison with the ascending aorta, aortic valve, and mitral valve

To explore reasons for a high accumulation of Ca and P occurring in the coronary artery of Thai with aging, the authors investigated age-related changes of elements in the coronary artery, ascending aorta near the heart, and cardiac valves in single individuals, and the relationships in the elements between the coronary artery and either the ascending aorta or cardiac valves. After an ordinary dissection by medical students at Chiang Mai University was finished, the anterior descending arteries of the left coronary artery, ascending aortas, mitral valves, and aortic valves were resected from the subjects. The subjects consisted of 17 men and 9 women, ranging in age from 46 to 76 yr. The element content was analyzed by inductively coupled plasma-atomic emission spectrometry. The average content of Ca and P was the highest in the coronary artery and decreased in the order aortic valve, ascending aorta, and mitral valve. The Ca, P, and Mg content increased in the coronary artery in the fifties and in the ascending aorta, aortic valve, and mitral valve in the sixties. It should be noted that the accumulation of Ca, P, and Mg occurred earlier in the coronary artery than in the ascending aorta, aortic valve, and mitral valve. It was found that with respect to the Ca, P, Mg, and Na contents, the coronary artery correlated well with both the aortic valve and ascending aorta, especially with the aortic valve, but it did not correlate with the mitral valves. This finding suggests that the accumulation of Ca, P, Mg, and Na occurs in the coronary artery together with the aortic valve and ascending aorta, but not together with the mitral valve. Because regarding the accumulation of Ca, P, and Mg, the ascending aorta and aortic valve are preceded by the coronary artery, it is unlikely that the accumulation of Ca, P, and Mg spreads from the ascending aorta or aortic valve to the coronary artery.

Different accumulation of elements in the rami of the coronary arteries of Thai

To analyze the accumulation of elements in the rami of the coronary arteries, the authors determined element contents in both the coronary arteries and their rami of the Thai by inductively coupled plasma-atomic emission spectrometry. The subjects consisted of 13 men and 6 women, ranging in age from 34 to 83 yr. It was found that a higher accumulation of calcium and phosphorus occurred in the proximal sites of coronary arteries such as the anterior descending, right coronary, left coronary, and circumflex arteries than the distal sites such as the diagonal, lateral, conus, acute marginal, and posterior descending arteries. The accumulation of calcium and phosphorus in the anterior descending and right coronary arteries of the Thai increased remarkably in the fifties, thereafter decreased, and increased again in the eighties. It should be noted that a very high accumulation of calcium and phosphorus in the coronary arteries occurred in the fifties. In regard to relationships among the average contents of elements in the coronary arteries and their rami, it was found that there were very significant direct correlations between calcium and phosphorus contents, between calcium and magnesium contents, and between phosphorus and magnesium contents. These results suggested that as calcium and phosphorus increased in the coronary arteries and their rami, magnesium increased simultaneously in all of the coronary arteries and their rami.

High accumulation of calcium and phosphorus in the coronary artery of the Thai in comparison with the Japanese

To examine whether there were differences between races in regard to age-related changes of mineral contents and the relationships among element contents in the arteries, the authors investigated the coronary arteries of Thai and Japanese. The Thai subjects consisted of 13 men and 3 women, ranging in age from 39 to 84 yr, whereas the Japanese subjects consisted of 17 men and 9 women, ranging in age from 55 to 92 yr. After the ordinary dissections at Chiang Mai University and Nara Medical University were finished, the coronary arteries were resected and the element contents were determined by inductively coupled plasma-atomic emission spectrometry. In the Thai, an accumulation of calcium and phosphorus began to occur in the forties and increased markedly in the fifties, whereas in the Japanese, an accumulation of calcium and phosphorus began to occur in the seventies and increased markedly in the nineties. The result revealed that an accumulation of calcium and phosphorus occurred earlier in the Thai than in the Japanese. Regarding the relationships among element contents, extremely significant correlations were found between calcium and phosphorus contents, between calcium and magnesium contents, and between phosphorus and magnesium contents in both the coronary arteries of the Thai and the Japanese. As far as the coronary arteries with a very high accumulation of calcium and phosphorus, the mass ratios of magnesium to calcium and phosphorus were lower in the coronary arteries of the Thai in comparison with the Japanese.