Sakkadech Limmahakhun

Chiang Mai University, Amphoe Muang Chiang Mai, Chiang Mai, Thailand

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Publications (3)2.54 Total impact

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    ABSTRACT: To perform total knee arthroplasty, some surgeons prefer to use a fixed valgus angle, for example 5° or 6°, for the distal femoral cut with every patient. This angle may be appropriate for some patients, but may not be for all. To determine the proper angle of the distal femoral cut during total knee arthroplasty (TKA) in Thai patients with osteoarthritis of the knee. A cross-sectional study was conducted of 80 osteoarthritic knees of 50 Thai patients with a mean age of 69 years (range 52-82, SD 7.64) who had received total knee arthroplasty at Chiang Mai University Hospital between January 2011 and March 2013. The femoral mechanical-anatomical (FMA) angle, femorotibial (FT) angle, mechanical femorotibial (MFT) angle, femoral bowing angle, femoral length, hip offset, gender, and age of the patients were analysed using multivariate regression analysis. Average FMA angle was 6.46° (range 4°-10°, SD 1.26°). The FMA angle was 6.85° and 5.28° in patients with varus and valgus deformity, respectively. Fifteen percent of all patients showed a FMA angle either less than 5° or greater than 7°. The average FMA angle of patients with gonarthrosis was 6.46°. If it is not possible to measure the FMA angle in Thai patients, 7° valgus cut angle is recommended for patients with varus deformity. Variation in this angle was high. Pre-operative measurement of FMA angle is beneficial for precise TKA.
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    ABSTRACT: Thailand has been greatly affected by the tuberculosis (TB) and HIV syndemic. This study aimed to determine treatment outcomes among HIV/TB co-infected patients. A retrospective cohort study was conducted at Chiang Mai University Hospital from 1 January 2000 to 31 December 2009. Of 171 patients, 100 patients were male (58.5%) and the mean age was 36.8 ± 8.0 years. Seventy-two patients (42.1%) had pulmonary tuberculosis. Median CD4+ count before TB treatment was 69 cells/mm(3) (interquartile range [IQR] 33, 151). The overall mortality was 3.5% (6 patients). Immune reconstitution inflammatory syndrome (IRIS) occurred in eight patients (6.0%). Disseminated TB infections increased risk of death (odds ratio [OR] = 2.55, 95% confidence interval [CI] 1.25, 5.18) and IRIS (OR = 9.16, 95% CI 1.67, 50.07). Initiating combination antiretroviral therapy (cART) within two months after TB treatment increased risk of IRIS (OR = 6.57, 95% CI 1.61-26.86) and physicians caring for HIV/TB co-infected patients should be aware of this condition.
    International Journal of STD & AIDS 06/2012; 23(6):414-8. DOI:10.1258/ijsa.2012.011291 · 1.04 Impact Factor
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    ABSTRACT: Currently, serum biomarkers play an important role as sensitive tools for monitoring the cancer development and progression. Each biomarker represents a specific pathogenesis and has different predictive capability. In order to identify their characteristics in human osteosarcoma, multiple potential biomarkers were analyzed simultaneously with clinical presentations. Blood samples were collected from 28 osteosarcoma patients and 30 healthy matched controls. Specific clinical presentations were recorded, including: tumor volume, estimated based on three-dimensional MRI volumetric measurement; metastasis status; and histological cell types. Serum biomarkers analyzed by ELISA-based assays were bone-specific alkaline phosphatase (BALP), vascular endothelial growth factor (VEGF), hyaluronic acid (HA) and chondroitin sulfate WF6 (WF6). Serum lactate dehydrogenase (LDH) was analyzed by a photometric-based system. Serum BALP, LDH and WF6 levels of osteosarcoma patients were significantly higher than those of healthy controls, whereas HA and VEGF levels were not significantly different between the two groups. Serum BALP and LDH were positively correlated with tumor volume, (correlation coefficients 0.5 and 0.4, respectively). Serum BALP from metastasis and osteoblastic subtype group had a significantly higher level than that found in non-metastasis and non-osteoblastic subtypes group, respectively. Upon multivariate analysis, tumor volume was the only factor which correlated with BALP levels. Of the biomarkers analyzed in this study, serum BALP was the most reliable and sensitive for estimating tumor volume. A high level of serum WF6 reflects alteration of the extracellular matrix component of tumors. Both serum biomarkers can be expected to be further explored for use in specific clinical monitoring.
    Asian Pacific journal of cancer prevention: APJCP 01/2011; 12(7):1717-22. · 1.50 Impact Factor