Siriraj Medical Journal

147-150

Authors: Songkiat Panyachare, M.D., Pacharapol Udomkiat, M.D.

Objective: To determine the angulation of the distal femoral axis - femoral mechanical axis and the coronal femoral bowing in varus OA knees. This information is necessar, because the routine distal femoral valgus cut can potentially lead to error in post-operative alignment. Methods: Hip to ankle standing radiographs were ordered in 160 varus OA patients (200 limbs). The mean age of the patients was 63.8 years. In addition, 50 limbs of young volunteers with an average age of 28.8 years, were also studied for comparison. The distal femoral axis-femoral mechanical axis angle, femoral bow, and other angles were determined and compared between two groups. Results: Mean distal femoral axis-mechanical axis angle was 7.0o ± 1.5o and mean femoral bow was 2.4o ± 2.6o in patients compared to 5.7o ± 0.5o and 0.3o ± 0.5o respectively, in controls. The varus deformity significantly correlated with femoral bowing. Thirty-five (17.5 percent) of OA limbs showed a distal femoral axis-mechanical axis angle of more than 9o and there were 42 OA limbs (21%) that had significant (> 3o) femoral bowing. Conclusion: These findings have implications in deciding the optimum valgus angle at which to perform distal femoral resection during TKA in varus OA knee.

157-162

Authors: Natthawut Somboonsap, M.D., Wish Banhiran, M.D., Choakchai Metheetrairut, M.D., Pipat Chiewvit, M.D.

Objective: To obtain referent normative values of lateral cephalometric parameters of the upper airway in Thai people without clinical features of obstructive sleep apnea syndrome (OSAS). Methods: A total of 105 healthy subjects (80 males and 25 females) were recruited. Inclusion criteria were healthy people age ≥ 18 years with body mass index (BMI) of < 30 kg/m2, normal visual harmony of facial profile, no history of snoring or witnessed apnea, and no excessive daytime sleepiness (Epworth Sleepiness Scale ≤ 8). All subjects must have a regular sleep pattern with total sleep duration of 7-9 hours and must have no complaint of difficulty sleeping. Exclusion criteria were pregnant women, patients with previous orthodontic treatment, corrective jaw surgery, upper airway surgery, neoplasm, irradiation in head and neck, and patients who had underlying illnesses using medication or substance which affected the sleep-wake cycle. All subjects had lateral cephalometric radiographs taken with a standardized technique. Every data was measured twice on separate occasions. Results: The reliability of repeated measurements was excellent shown by intraclass correlation coefficients ranging from 0.95 to 0.99. The baseline data were presented in mean ± SD. SNA, SNB, PAS, MPH and PNS-P in males were 84.3 ± 4.0, 81.5 ± 4.1, 14.2 ± 3.4, 16.1 ± 5.3, and 34.8 ± 6.1, respectively. SNA, SNB, PAS, MPH and PNS-P in females were 84.4 ± 3.1, 80.7 ± 3.2, 11.1 ± 3.3, 10.8 ± 4.9, and 32.3 ± 3.1, respectively. The parameters that were different between both genders included N-ANS, GN-GO, H-PP, MPH, PAS, and TL. (p < 0.05) Conclusion: To date, this study has possibly represented the largest local database of lateral cephalometric measurements focusing on Thai people without clinical features of OSAS. It may be another useful reference for future research and clinical practice.

168-170

Authors: Niphon Poungvarin, M.D., FRCP, FRI.

No abstract available.

174-176

Authors: Sith Sathornsumetee, M.D.

Not Available.

185-186

Authors: Niphon Chirapapaisan, M.D., Wanicha Chuenkongkaew, M.D.

A 50-year-old man with high altitude illness had bilateral lateral rectus palsies when he went to the Himalaya at 5,000 meters. He had no other neurological signs, except headache. He received acetazolamide, prednisone, and spent time in a hyperbaric chamber; but unfortunately he showed no improvement. Two months later, his diplopia completely resolved itself without any treatment, after his descent to a lower altitude.