Valproic acid induces histologic changes and decreases androgen receptor levels of testis and epididymis in rats

Background: valproic acid [VPA], an anti-epileptic drug, can cause male subfertility. However, the degree to which testicular and epididymal histopathologies and androgen receptor [AR] expression are changed under VPA treatment has never been reported

Objective: to investigate the histopathological changes and AR protein levels of testis and epididymis in VPA-treated rats for every single day

Materials and Methods: sixty-four adult male Wistar rats were divided into control and VPA-treated groups [n=8/ each]. Treated rats were injected with 500 mg/ kgBW, intraperitoneally, VPA for 10 consecutive days. At the end of every experimental day, all reproductive parameters including histology by hematoxylin and eosin staining and protein expression of AR by Immuno-Western blot in testis and epididymis were examined

Results: VPA-treated rats showed dramatically changes in testicular and epididymal histopathologies compared to control group. The multinucleated giant cells and sloughing of germ cells were observed on day 6. The germ cell disintegration and increased intercellular spaces of seminiferous tubular epithelium appeared in days 7-10 of VPA treatment. Additionally, extensive multinucleated giant cells and complete exfoliation were clearly found from days 8-10. Such exfoliated germ cells were clearly seen in its epididymal lumen at day 10. The increasing rate of sperm concentration was approximately 32.31% of that in control group at day 10 [p=0.03]. Moreover, the protein expressions of testicular and epididymal AR [% intensity/ 80 ?g protein lysate] was decreased in VPA-treated rats compared with control

Conclusion: VPA treatment induces histologic changes of germ cell epithelium in seminiferous tubules and decreases the expression of testicular and epididymal androgen receptors

Variant insertion of the teres major muscle / 대한해부학회지

The teres major (TerMa) muscle has a clinical significance for tendon transfer procedures in patients with massive rotator cuff tears. Individually, it originates from the dorsum of the inferior angle of scapula and inserts into the medial lip of bicepital groove of the humerus. Functionally, TerMa in cooperation with latissimus dorsi (LD) adducts arm, medially rotates arm, and assists in arm extension. The variation of TerMa insertion is very rare. In the shoulder and axillary regions of a 33-year-old Thai male cadaver, the variant insertion of the right TerMa was found. The muscle fibers of TerMa are directly attached at the supero-medial border of LD tendon. Notably, there was no terminal tendon of TerMa. To explain an unusual movement of the arm, this rare variation of the TerMa insertion is necessary to be recognized. This case report is very important for surgeons to preoperatively consider using the terminal tendon of TerMa for tendon transfer in treating patients with irreparable cuff tears.

Duplicated axillary arch muscles arising from the latissimus dorsi / 대한해부학회지

Many origins and insertions of an axillary muscular slip (also known as Langer's 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.

Achievement in Personality and Ethics Development 2nd year medical student, 1994 Academic year.

Objective1. To establish and develop personality in order  to promote good leadership and  remember the essential merit and that correlate to the social needs of students.2. To build up and create appropriate values in Thai society among the students themselves especially in terms of unity, affection and a sense of belonging to each other and to the Academic Institute.3. To develop the student in terms of Social, Emotional \& Moral behaviour so that they can adapt to the new society.4. Build up the sensitivity and responsibility of students to society and to the country after graduation5. To promote in Medical students and supervisors a better relationship which will lead to trust and consultationMethods: The students were asked to attend the camp and advisers encouraged to understand their role so that they had ability to extend group relations. After this the students attended a 2 day and 2 night camp with various activities. Each group had 1-2 supervisors for group relationship activities using games as a medium by which to present social situations and human behavioral analysis. There was a video show about development, community life, leadership and human relations. There were group planning conferences, project planning activities, self and family development group presentations and other activities. Assessment by collective observation and the use of questionnaires showed that the target objectives were achieved. As a result of the course students personalities were developed to produce good leaders as well as producing good team member of society. Good ethical beliefs were fostered as was the aim of  being a worthy member of society. The right values of affection, good person to person relations a pride in the institute, adaptation to the school environment and to colleagues were achieved. A feeling of responsibility to society and to the Nation together with the promotion of relationships both to students and supervisors was established. The recommendation from students and participating supervisors is that it should be extended from 2 days and 2 nights to be 3 says and 2 nights by using a weekday and weekend or only the former which means doing the course after the students finish their exam. The location should be nor too far away from University. It should have a wide-enough conference room that suits various activities, a yard or sports ground that is suitable for physical or moral exercise of the students and nearby accommodation with an adequate restroom. Food should be arranged for everyone. This could be used by 3 rd year medical students so that they could prepare themselves for the clinical year. The assessment should be carries out regularly so as to improve weak points and become Faculty’s policy in the following academic year by training the 1st or 3rs year medical student and applying the formula that has been practiced by the 2 nd year medical student for the 2 st year medical student. Furthermore, the formula arranged for clinical year students to be demonstrates in the 3 rd year to medical students before they start their 4 th year. Subsequently it should be distributes so as to be part of the University plan.

The pattern of talar articular facets in Northeastern Thai calcanei

 The variations of the talar articular facets in 230 Northeastern Thai calcanei were studied and classified.  The specimens were 100 wet calcanei and 130 dry calcanei.  Three types were considered: type A (calcanei with two articular facets for the talar head, with four subtypes); type B (calcanei with the anterior and middle talar articular facets coalescing into a common articular facet for the talar head, with two subypes); type C (calcanei with the anterior, middle and posterior talar articular facets coalescing into a sigle facet for the talus).  It is interesting that our studies of the two groups of specimens yielded similar percentages of calcaneal types, 40% of type A, 59% of type B, and 0-1% of type C.  Therefore, the overall results reflect the type distribution of both wet and dry groups.  In 230 calcanei we found 40% (93 cases) of type A calcanei, 59% (136 cases) of type B calcanei and 0.43% (1 case) of type C calcaneus.  The incidence of type B was significantly higher than type A (P

The Position of the Mandibular Foramen in the Adult Mandibles of Northeastern Thai

 Locating the mandibular foramen is important clinically when mandibular nerve block is required.  However, there is still no concrete assesment of the position of the mandibular forament inThai people.  This study was designed to determine the exact position of the mandibular foramen in relation to surrounding bony landmarks as one of the standard references for Thai people.  Forty-nine adult human mandibles of Northeastern Thai were examined to measure the location of the mandibular foramen.  Measurements and observations were based on the following : the distance from the mandibular foramen to the internal oblique ridge (LI), the distance from the mandibular foramen to the anterior border of the mandibular ramus (La) and the distance from the mandibular foramen to the posterior border of the mandibular ramus (LP).  Our study showed that the mean lengths of the LI of the left and right mandibular rami are 13.00 + 1.82 mm and 13.15 + 1.87 mm, respectively.  The mean lengths of the LA of the left and right mandibular rami are 20.17 + 1.86 mm and 20.09 + 1.77 mm. The mean lengths of the LP of the left and right mandibular rami are 20.74 + 1.79 mm and 20.46 + 2.05 mm.  Therefore, the mandibular foramen is located halfway between the anterior and posterior borders of the ramus.  The width of the mandibular ramus is approximately 40 mm. There is no significant difference between the lengths of the left and right mandibular rami measured no matter whether the third molar erupts or not.

Development of Appropriate Personality and Ethics in Medical Students.

Background:  The objective of this research was to evaluate the progressive behavior development of fourth and fifth year medical students based on their first to third year attendance at the seminars, “How to develop good personality qualities and ethics.”  The research focused on: 1. Behavioral differences between trained versus previous groups of students who had not been trained. 2. Whether and how the training actually affected student behavior. 3. Development of recommendations for future course.Method:   This was prospective cohort behavioral study.  The data were elicited from fourth and fifth year medical students using questionnaires, direct observations, and informal interviews.  They were compared with the collective subjective judgement of faculty members regarding former students who did not undergo the same training.Results:  Students who passed all of the training sessions had good relationships with teachers, colleagues patients, and family.  The tone of their conversation was positive.  Their behavior (manners and responsiveness to patients) and ethics (capacity to use appropriate medical techniques) were judged to be better than those students who had not been trained. We concluded that since the first three years of training are formative (with eagerness and newness), training in behavior and ethics at this time is well-received; allowing students to prepare themselves for the following more interactive clinical phase of medical education. Notwithstanding, the wholly subjective nature of the comparison of trained versus untrained students, all (100%) of the department heads and head nurses agreed that medical students should attend training in ethics and personal behavior development.  Similarly, 92% of the fourth and fifth year students were of the opinion that behavior and ethics training, both in class and at camp, should continue because they learned about economizing, psychology, manners, appropriate attire, public conduct, and respectfulness toward teachers, colleagues, seniors and juniorsKey words: Medical Students, Personality, Ethics

The Prevalence of Kinking of the External iliac Artery

Background and Objective: The aim of this study is to find the prevalence of kinking of the external iliac artery (EIA) in cadavers and related symptoms of lower limbs and illness before death.Methods: The 128 halves of pelvis  from 64 cadavers (  age = 72.5 years) were dissected and identified the kinking of the EIA. A retrospective study of symptom of lower limbs and illness before death were inspected by interviewing their relatives of 6 cases.  The inguinal ligament and femoral ring edge were also observed for possible causes of abnormality of the artery.Results:  Kinking of the external iliac artery was found  in 10 cases (  age = 77.1 years, men = 9, woman = 1). The kinking was classified  into 2 types : type I (3 right and 1 left sides)  and type II (5 bilateral and 2 right sides)   respectively.  A retrospective history revealed that the symptoms of lower limb and illness before death were related to the kinking of the external iliac artery.Conclusion: Aging persons who showed symptoms of fatigue, edema, pain, weakness or claudication in lower limbs could be  caused by  kinking or coiling of blood vessels in the pelvis.  The high degree of kinking or coiling may lead to ischemia of lower limbs or vascular complication during surgery. Therefore meticulous investigation should be performed to rule out external iliac artery kinking along with any treatment of pelvis and hip regions.Keywords: Kinking, Prevalence, External iliac artery

A Case of Multiple Aneurysms in Northeast Thailand Embalmed Cadaver

Background: Aneurysms left in the cadaver has been difficult to find in our experiences, during 34 years from the establishment of Khon Kaen University Medical School. We witnessed the first case of multiple aneurysms in 2007 in the male cadaver out of 843 of both gender specimens. We always have diagnosed and treated the patients now and then in our teaching hospital, Srinagarind.Purpose: 1) To record the basic data for clinical management of aneurysm. 2) To stimulate the interests of the medical students to make them pay more attention to gross anatomy as it is the basis for tackling the aneurysm problem early in the medical career.Materials \& Methods: We redissected 843 cadavers after the standard procedure. They were 371 females aged between 21-92 years and 472 males between 38-88 years old at the time of death. The work was accomplished in the KKU Dept. Anat. dissecting room and from 1973-2007.Results: We found 3 aneurysms in one male cadaver aged 65 years, They were, 1) right popliteal aneurysm, 2) right internal iliac aneurysm, and 3) left common iliac aneurysmConclusion: The gross lesion of aneurysm seen in the dissecting room is very exciting for the medical students and the anatomists which lead to the stimulation of the students’ interests. This leads further to the thoughts for the application in the patients. This also enhances the teaching and learning process. The other morbid anatomy in the cadaver will surely serve the same objective. The etiology was discussed.Key words: aneurysm, Northeast Thailand, etiology

Cleidohyoid Muscle in Human: A Case Report

Background and Objective: The surgical approaches of the neck region are very frequent. The examples are thyroidectomy, tracheotomy, and removal masses including lymph nodes. Therefore, the surgeons have to be aware of anatomical variations in the neck including the unseen and unreported ones. The present study was to report the cleidohyoid muscle in Thai cadavers as a first case in the Northeast Thailand.Methods: Re-dissection surveys had been performed on the embalmed, legally donated cadavers to Department of Anatomy, Faculty of Medicine, Khon Kaen University from 1974 to 2008.Results: The cleidohyoid muscle was observed in one male out off 939 cadavers. This muscle is present in birds and disappears somewhere along the course of evolution. The muscle helps in the process of feeding. It connects the pectoral girdle, specifically the clavicle, to the tongue skeleton especially the hyoid bone, so that the swallowing of food is possible. The incidence of this variation is very rare. It is 0.01% in this study. The developmental history and the surgical aspect of the muscle were presented. Conclusion: The occurrence of the cleidohyoid muscle in the densely packed region as in the neck requires an extremely careful procedure of the surgeons.Keywords: Gross anatomy variation, cleidohyoid muscle, mechanism of feeding, developmental history, evolution