The dorsalis pedis artery (DPA) is a vital artery that supplies the foot and ankle area which is clinically important for palpating when taking the pulse. This research was performed on fresh cadaveric dissection of 40 legs by injecting paint into popliteal artery for tracking the dorsalis pedis artery and its branches. The present research revealed that the Thai population has an anatomical variation and different location of the DPA and exact location of DPA for estimating the location of the DPA and may have clinical implications. The statistically descriptive analysis elucidated the distances of the DPA to the lateral malleolus and medial malleolus which were 51.48 ± 7.27 mm and 42.62 ± 11.40 mm, respectively. The distance of the extensor hallucis longus (EHL) to the DPA was 14.29 ± 4.11 mm. The length of the dorsalis pedis artery which measured from artery on intermalleolar line to its dipping in 1st intermetatarsal space to be 122.03 ± 21.07 mm. The arcuate loop which is anastomosis U-loop of lateral tarsal arteries of the DPA was found 55 % in Thais population. There were no statistically significant differences of all parameters between the side and sex in DPA consideration. An understanding of the variations of the anatomical vasculature of DPA is essential for precise clinical assessment because exact anatomical knowledge and location can contribute to the pulse taking and be applied in surgical procedure.
The individualized prediction of breast cancer survival (IPBS) model was recently developed. Although the model showed acceptable performance during derivation, its external performance remained unknown. This study aimed to validate the IPBS model using the data of breast cancer patients in Northern Thailand. An external validation study was conducted based on female patients with breast cancer who underwent surgery at Maharaj Nakorn Chiang Mai hospital from 2005 to 2015. Data on IPBS predictors were collected. The endpoints were 5-year overall survival (OS) and disease-free survival (DFS). The model performance was evaluated in terms of discrimination and calibration. Missing data were handled with multiple imputation. Of all 3581 eligible patients, 1868 were included. The 5-year OS and DFS were 85.2% and 81.9%. The IPBS model showed acceptable discrimination: C-statistics 0.706 to 0.728 for OS and 0.675 to 0.689 for DFS at 5 years. However, the IPBS model minimally overestimated both OS and DFS predictions. These overestimations were corrected after model recalibration. In this external validation study, the IPBS model exhibited good discriminative ability. Although it may provide minimal overestimation, recalibrating the model to the local context is a practical solution to improve the model calibration.
Supratrochlear foramen (STF) is a perforation of bony wall that separates the olecranon fossa and the coronoid fossa. Its incidence varies among different races. The aim of this study was to investigate the prevalence and morphometry of supratrochlear foramen among Thai population. A total of 640 dry humeri from 320 skeletons, 160 paired humeri of each sex, and known age were collected to study the prevalence of STF. The prevalence is reported categorized by sex and the side of humerus to identify whether there is a correlation. STF is categorized by shape and their metrics measured with digital vernier calipers. The ratio of transverse diameter (TD) and distance from the medial epicondyle to the lateral epicondyle (DMLE) were calculated to represent the size of STF. From 640 humeri, 404 cases were translucent septum, 133 cases were opaque septum, and 103 cases were recorded as foramen. In this study, the majority of supratrochlear foramen were oval-shaped, followed by irregular-shaped and round-shaped foramen. The ratio between TD and DMLE was 0.09±0.44 mm on the right and 0.08±0.41 mm on the left which was not significantly different. The findings can be used to understand the variation and location of supratrochlear foramen to help radiologists and orthopedic surgeons to avoid misdiagnosis of cystic lesion at the distal humerus.
Background Long‐term high‐fat diet consumption causes prediabetic conditions with brain pathology, as indicated by peripheral and brain insulin resistance, neuroinflammation, neuronal necroptosis, microglial and astrocyte hyperactivation and increased Alzheimer’s disease‐related proteins including amyloid precursor protein (APP). Although pioglitazone, a peroxisome proliferator‐activated receptor (PPAR)‐γ agonist clinically used to treat type 2 diabetes mellitus, has been shown to improve the metabolic and brain functions in prediabetic condition, this drug can lead to several adverse effects. Recently, an in vitro study showed that Cyclosorus terminans extract, which acts as a natural PPAR‐γ agonist, possessed anti‐diabetic and anti‐obesity properties in adipose‐derived stem cells. However, the comparative efficacy of Cyclosorus terminans extract and pioglitazone on metabolic and brain functions in the prediabetic model has not been elucidated. Method Thirty male rats were fed with either a normal diet (ND) or a high‐fat diet (HFD) for 14 weeks. At week 13, ND‐fed rats received vehicle (NDV; n = 6) for additional 2 weeks. HFD‐fed rats were divided into four subgroups to receive either vehicle (HFV; n = 6), 100 mg/kg/day of Cyclosorus terminans extract (I‐100; n = 6), 200 mg/kg/day of Cyclosorus terminans extract (I‐200; n = 6); or 20 mg/kg/day of pioglitazone (Pio; n = 6) for additional 2 weeks. At the end of experimental period, blood and brains were collected to determine metabolic and brain functions. Result HFD‐fed rats exhibited a prediabetic condition as characterized by obesity with peripheral insulin resistance. In addition, neuroinflammation, neuronal necroptosis, microglial and astrocyte hyperactivation, and APP expression significantly increased in HFD‐induced prediabetic rats. Cyclosorus terminans extract (100 mg/kg/day) did not attenuate the metabolic disturbance and brain pathologies in HFD‐induced prediabetic rats. Interestingly, 200 mg/kg/day of Cyclosorus terminans extract and pioglitazone equally attenuated peripheral insulin resistance, neuroinflammation, neuronal necroptosis, microglial and astrocyte hyperactivation, and APP expression in HFD‐induced prediabetic rats (P < 0.05, Figure 1). Conclusion These findings suggest that Cyclosorus terminans extract may be another therapeutic approach for improving metabolic and brain functions in prediabetic patients who have contraindications to pioglitazone therapy.
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