No abstract available.
Anesthesia ; Rubinstein-Taybi Syndrome

Heterotopic ossification is defined as a reactive disease with mature lamellar bone formation in soft tissue. We experienced a case of heterotopicc ossification occurred on the thenar eminence and the thumb without trauma. We report this rare case with a review of the relevant literature.
Ossification, Heterotopic ; Osteogenesis ; Thumb

PURPOSE: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. METHODS: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I(n=92), Merocel(R) was used for nasal packing, for Group II(n=152) vaseline gauze was used, and Rolled silastic sheet(RSS) with vaseline gauze packing(VGP) was used for Group III(n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. RESULTS: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased(p<0.05) and the postoperative complication(deviation) were decreased comparing to vaseline gauze packing and Merocel(R) packing, however, these differences were not statistically significant(p>0.05). CONCLUSION: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.
Anesthesia, General ; Dimethylpolysiloxanes ; Facial Bones ; Humans ; Nasal Bone ; Nasal Septum ; Nose ; Petrolatum ; Sensation

BACKGROUND AND PURPOSE: Exercise is recommended for every patient with Parkinson's disease (PD). The effectiveness of two different forms of exercise for PD, Tai Chi and combined stretching-strengthening exercise, was compared. METHODS: Patients with mild-to-moderate PD were recruited to join either the combined stretching-strengthening exercise group (n=7), the Tai Chi group (n=9), or the control (nonintervention) group (n=7). Exercise was performed three times a week over a period of 8 weeks. The Tai Chi exercise was led by certified instructors based on a Tai-Chi-for-arthritis program. The combined stretching-strengthening exercise comprised folk dancing, stepping, and elastic-band exercises. The subjects' functional fitness, parkinsonian symptoms, quality of life (QoL), and depression were evaluated. RESULTS: Both exercise groups yielded better results in their overall functional fitness after the intervention. However, no improvement with exercise was found for parkinsonian symptoms, as evaluated using the Unified Parkinson's Disease Rating Scale. With respect to the domains of QoL, the combined stretching-strengthening exercise group fared better in the social domain of QoL, and the Tai Chi group fared better in the emotional domain, while QoL and depression worsened in the control group. The postintervention QoL was improved relative to the control condition only for the Tai Chi group. Although the exercise interventions did not have any effect on depression, the control group was associated with a significant deterioration. CONCLUSIONS: Exercise improved the functional fitness and QoL of PD patients, with Tai Chi yielding better results in QoL and favorable results in functional fitness. These findings suggest that Tai Chi could be a good exercise strategy for patients with PD.
Dancing ; Depression ; Exercise ; Humans ; Parkinson Disease* ; Quality of Life ; Tai Ji*

Inverted nipples have shortened lactiferous ducts and less fibrous and collagenous muscular tissue and less connective tissue present, thus giving less bulk and less tissue for nipple projection. Until now, many authors suggested various methods of correction of inverted nipple, but it shows that perfect method does not exist. From July 2008 to December 2010, 41 nipples in 21 patients were treated. 20 patients had bilateral inverted nipples. Under the local anesthesia with sedation, the nipple was everted. A small incision was made on both lateral side at the nipple-areola junction. After nipple traction, the lactiferous ducts and surrounding connective tissues were divided by sharp dissection only through vertical direction. Upper and lower purse-string sutures using Nylon 4-0 were performed for the maintenance of corrected nipple. The small incision was closed by the simple suture. The operation time averaged 15minutes for each nipple. The mean follow-up period was 6 months. There were no complications associated with surgery, such as recurrence, infection, hematoma, nipple necrosis and sensory loss. We applied modified purse-string sutures to mild and moderate inverted nipple patients, and acquired good results. So we report our experience with a review of literature.
Anesthesia, Local ; Breast Diseases ; Collagen ; Connective Tissue ; Follow-Up Studies ; Hematoma ; Humans ; Necrosis ; Nipples ; Nylons ; Recurrence ; Suture Techniques ; Sutures ; Traction

BACKGROUND: The physician's hands are close to the X-ray field in C-arm fluoroscopy-guided pain interventions. We prospectively investigated the radiation attenuation of Proguard RR-2 gloves. METHODS: In 100 cases, the effective doses (EDs) of two dosimeters without a radiation-reducing glove were collected. EDs from the two dosimeters-one dosimeter wrapped with a glove and the other dosimeter without a glove- were also measured at the side of the table (Group 1, 140 cases) and at a location 20 cm away from the side of the table (Group 2, 120 cases). Mean differences such as age, height, weight, radiation absorbed dose (RAD), exposure time, ED, and ratio of EDs were analyzed. RESULTS: In the EDs of two dosimeters without gloves, there were no significant differences (39.0 +/- 36.3 microSv vs. 38.8 +/- 36.4 microSv) (P = 0.578). The RAD (192.0 +/- 182.0 radcm2) in Group 2 was higher than that (132.3 +/- 103.5 radcm2) in Group 1 (P = 0.002). The ED (33.3 +/- 30.9 microSv) of the dosimeter without a glove in Group 1 was higher than that (12.3 +/- 8.8 microSv) in Group 2 (P < 0.001). The ED (24.4 +/- 22.4 microSv) of the dosimeter wrapped with a glove in Group 1 was higher than that (9.2 +/- 6.8 microSv) in Group 2 (P < 0.001). No significant differences were noted in the ratio of EDs (73.5 +/- 6.7% vs. 74.2 +/- 9.3%, P = 0.469) between Group 1 and Group 2. CONCLUSIONS: Proguard RR-2 gloves have a radiation attenuation effect of 25.8-26.5%. The radiation attenuation is not significantly different by intensity of scatter radiation or the different RADs of C-arm fluoroscopy.
Fluoroscopy ; Hand ; Prospective Studies

PURPOSE: To find out the clinical usefulness of carpal tunnel release with open minimal incision MATERIALS AND METHODS: We studied 149 patients (152 carpal tunnel) who were able to follow up for more than 6 months after being treated with carpal tunnel release with open minimal incision from January 2000 to January 2006. We compared the clinical results of this procedure using recovery time, the disappearance of symptoms, the presence of the kelloid and the scar tenderness and analyzed preoperative and postoperative VAS score of tingling sensation, dull sensation, inappropriate hand movement, muscle weakness, edema, palmar pain as subjective satisfaction. We used the independent t-test for the statistical significance. RESULTS: All cases had complete disappearance or marked improvement in symptoms, and there was no kelloid formation. Residual symptoms and tenderness of the scar was found in 8 cases (5.4%), but gradually disappeared. In last follow up, tingling sensation decreased from 7.8 to 1.0 and dull sensation from 7.0 to 1.5, inappropriate hand movement from 4.8 to 1.1, muscle weakness from 5.9 to 0.8, edema from 2.0 to 0.5, palmar pain from 2.1 to 0.2 in preoperative and postoperative VAS score, all were significantly improved statistically (P<0.05). CONCLUSIONS: We think that carpal tunnel release with open minimal incision has little complication and is a safe and effective operation method having similar effect with endoscopic surgery or conventional open surgery.
Carpal Tunnel Syndrome ; Cicatrix ; Edema ; Follow-Up Studies ; Hand ; Humans ; Muscle Weakness ; Sensation

PURPOSE: To investigate the clinical usefulness of hematoma distraction arthroplasty to treat advanced trapeoziometacarpal osteoarthritis of the thumb. MATERIALS AND METHODS: We studied 12 cases (1 male, 11 females) with osteoarthritis of the thumb that was managed with hematoma distraction arthroplasty using K-wire fixation. Of the 12 cases, 7 were Littler-Eaton stage III and 5 were Littler-Eaton stage IV. We investigated operation time, preoperative and postoperative visual analogue scale (VAS) score, preoperative and postoperative range of motion, grip power and radiologic changes. RESULTS: The mean patient age was 53.2 (39-61) years and the mean duration of follow-up was 19.5 (14-27) months. The average operation time was 52 minutes. The mean VAS scores at 6 and 12 months after the operation were 1.3 and 0.7, respectively. The range of motion and grip power of the finger improved postoperatively (15% in abduction, 18% in adduction, 25% in flexion, 14% in extension, 66% in grip power of the finger). On a simple 12-month postoperative radiologic exam, the interval between the scaphoid and first metacarpal bone had decreased 6.5 mm compared with the preoperative interval. CONCLUSION: The surgical treatment using hematoma distraction arthroplasty for trapeziometacarpal osteoarthritis is an effective method for pain relief, improvement of motion range and finger-grip power.
Arthroplasty ; Fingers ; Follow-Up Studies ; Hand Strength ; Hematoma ; Humans ; Joints ; Male ; Osteoarthritis ; Range of Motion, Articular ; Thumb

A benign periosteal reaction, which can occur after trauma or stress, has a solid and uninterrupted appearance on radiography. In contrast, an aggressive periosteal reaction, which may indicate a malignancy, appears as a Codman's triangle or with a spiculated and sunburst pattern. In the present case, an 11-year-old boy with a previous injury to the distal radial growth plate presented with diffuse osteolysis on the distal radial metaphysis and decreased opacity of the lateral side cortex on plain radiograph. A Codman's triangle-like lesion was seen on the lateral side of the distal radius, and a few spicules were observed on the medial side of the distal radius. A T2-weighted coronal magnetic resonance image revealed a mass that had stripped the periosteum; the mass had heterogeneous signal intensity and a fl uid-fluid level on axial views. The margins of the mass were unclear, but enhanced. Suspecting a primary malignancy, we performed a biopsy. The pathology revealed that the mass was a simple hematoma.
Biopsy ; Child ; Growth Plate ; Hematoma ; Humans ; Magnetic Resonance Spectroscopy ; Osteolysis ; Periosteum ; Radius

PURPOSE: To analyze the clinical result of a contoured plate fixation using a bicortical screw and a double plate fixation in the surgical treatment of an adult's comminuted olecranon fracture. MATERIALS AND METHODS: A total of 22 patients were classified by Mayo classification as Type IIB (17) and Type IIIB (5). All patients enrolled in the study were treated between July 2002 and September 2009. Twelve patients were operated on using the contoured plate internal fixation using a bicortical screw procedure classified as group 'A'. The 10 patients operated on by a double plate fixation were classified as group 'B'. The Mayo elbow performance score was used to compare postoperative clinical results based on total points in 4 categories: pain, range of motion, articular stability, and articular function. RESULTS: The clinical results of using the Mayo elbow performance score of group 'A' were that 10 scored in the 'excellent' range and 2 scored in the 'good' range the following: in group 'B' were in the excellent range and 3 were in the good range. Both groups showed satisfactory results. Postoperative elbow exercises in group 'A' commenced 7.8 (5-14) days on average, postoperatively. For 'B' group, post-operative elbow exercises began 4.5 (3-7) days following the operation. With regard to the exercise and the range of elbow motion, group 'A' averaged 113.5 degrees and group 'B' averaged 112 degrees. After surgery, the average durations until the bone union were 3.8 (2.4-5.6) months for group 'A' and 4 (2.5-5) months for group 'B', respectively. CONCLUSION: There was no significant difference in the clinical results between patients treated with the contoured plate internal fixation using a bicortical screw or the internal fixation using a double plate in the surgical treatment of adults with comminuted olecranon fracture or dislocation. Therefore, both types of operative approach are acceptable.
Adult ; Dislocations ; Elbow ; Exercise ; Humans ; Olecranon Process ; Range of Motion, Articular ; Retrospective Studies