Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Nails ; pathology ; surgery ; Nails, Ingrown ; pathology ; prevention & control ; surgery ; Recurrence

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nails ; pathology ; surgery ; Nails, Ingrown ; pathology ; surgery ; Reconstructive Surgical Procedures ; methods

Docetaxel is a commonly-used anti-cancer chemotherapeutic agent given its efficacy in a large variety of solid tumors. It is associated with various adverse effects one of which is nail toxicity. We report a case of severe onycholysis as a result of treatment with docetaxel in a patient who suffered from metastatic nasopharyngeal carcinoma. The case report will be followed by a discussion on the possible mechanism and preventive strategies for taxane-induced nail toxicity.
Adult ; Female ; Humans ; Nails ; drug effects ; pathology ; Onycholysis ; chemically induced ; Taxoids ; adverse effects

OBJECTIVE: To investigate the feasibility of the new method of combining freeze grinding with ultrasonic technique for the pretreatment of the nail for toxicological and pharmaceutical analysis and to compare the advantages and disadvantages of this method with other traditional methods. METHODS: Five pretreatment methods were examined. Scanning electron microscope (SEM) was used to observe the microstructural changes of the nail. RESULTS: The microscopic structure of nail totally destroyed after alkali treatment. The hierarchy mode of the internal structure became obvious and tight after acid hydrolysis, which became indistinct after methanol infiltration. The structure of nail broke to pieces after ultrasonic technique. After freeze grinding combined ultrasonic technique, the particle structure kept original shape, and its size was one hundred times smaller than which after manual way. CONCLUSION The freeze grinding combined ultrasonic technique can improve the release efficiency, and ensure the stability of the toxicant or drug during the pretreatment process. It is appropriate for toxicological and pharmaceutical analysis in the nail.
Forensic Pathology ; Freeze Drying/methods* ; Humans ; Microscopy, Electron, Scanning ; Nails/chemistry* ; Particle Size ; Ultrasonics

Subungual metastasis resulting from internal malignancies is an extremely rare event. A few cases of subungual metastasis from lung cancer have been reported. However, subungual metastasis arising from lung cancer without any other form of distant metastases has not been reported. The misdiagnosis of a solitary subungual metastases as a benign inflammatory lesion is an important problem as it may cause the misdiagnosis of a lower stage of lung cancer. We may be reporting the first case of a subungual metastasis from lung cancer without any other distant metastases.
Carcinoma, Squamous Cell/secondary* ; Carcinoma, Squamous Cell/radiography ; Carcinoma, Squamous Cell/pathology ; Case Report ; Human ; Lung Neoplasms/radiography ; Lung Neoplasms/pathology* ; Male ; Middle Age ; Nails*/pathology ; Radiography, Thoracic ; Skin Neoplasms/secondary* ; Skin Neoplasms/pathology ; Tomography, X-Ray Computed

OBJECTIVETo study the quantitative measurement of the extent of malrotation after interlocking intramedullary nailing of femoral shaft fracture.

METHODCT scan ("routine method") applied in 36 femoral shaft fractures that had been treated with close reduction and interlocking intramedullary nailing. For the judgement of the extent of malrotation, the anteversion of both fracture side and contralateral side were measured and the difference between the 2 sides was evaluated. The increase of anteversion represented internal rotation of the distal fragment, whereas the decrease of anteversion represented external rotation.

RESULTSThe maximum anteversion of the fracture sides, whereas 48 degrees, the minimum anteversion -10 degrees, the mean value, 15.04 degrees, and the standard error is 11.34 degrees. The maximum anteversion of the contralateral side, whereas 31.3 degrees, minimum -4.8 degrees, the mean value was 13.96 degrees and the standard error was 10.20 degrees (P < 0.001). Compared with the contralateral side, half of the 36 cases showed increased anteversion and the other half decreased anteversion. The mean value of internal rotation is 11.56 degrees, and external rotation 9.39 degrees. The maximum internal rotation was 37 degrees, the minimum 0.9 degrees. Eight cases had internal rotation less than 8 degrees, 6 between 10 degrees - 15 degrees, and 4 over 15 degrees. The maximum external rotation was 24.3 degrees, and the minimum 1.8 degrees. Eleven cases had external rotation less than 10 degrees, 4 between 10 degrees - 15 degrees and 3 over 15 degrees. The incidence of malrotation more than 10 degrees was 47% (17/36), and more than 15 degrees 19.4% (7/36).

CONCLUSIONThe incidence of malrotation after femoral shaft fracture treated with close reduction and interlocking intramedullary nailing is high. Attention should be paid to clinical management and strict control for rotational reduction intra-operatively.

Adolescent ; Adult ; Bone Nails ; Female ; Femoral Fractures ; diagnostic imaging ; pathology ; surgery ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Rotation ; Tomography, X-Ray Computed

OBJECTIVETo investigate the surgical treatment of mid-distal humeral shaft fractures associated with radial nerve palsysis with minimal invasive screwed nails osteosynthesis technique.

METHODSThirty-six patients treated mid-distal humeral shaft fractures associated with radial nerve palsysis from January 2004 to January 2008. There were 28 males and 8 females whose age ranged from 20- to 58-years-old with an average of 36.5-years-old. Injury reasons: mechanical injury 18 cases, traffic injury 8 cases, accidents injury 10 cases, all cases were closed fracture. According to AO/ASIF classification, type A1 5 cases, type A2 7 cases, type B1 8 cases, type B2 7 cases, type B3 5 cases, type C3 4 cases. The small lateral incision was performed located to the fracture. After exploration of the radial nerve, the fractures were reduced. By acromion small lateral incision, the deltoid was separated. In the posterior macronodular slotted antegrade reamed bored with medullary cavity drill and selected a suitable screwed nail screwed into the medullary cavity distal. Along the slot, the locking pieces were inserted to complete the fixation. The postoperative complication, fracture healing time, radial nerve function recovery time, the motion of shoulder and elbow were recorded.

RESULTSThe incision of all cases healed with stage I . The patients were followed up for 9-36 weeks with an average of 18.5 weeks. The X-ray examination showed fractures healing in 12-16 weeks (average of 15.6 weeks). Radial nerve function recovered fully at 12-36 weeks after operation (average of 17.8 weeks). Shoulder abduction is 150 degrees-170 degrees with an average of 160 degrees; elbow motion of activities was 130 degrees-140 degrees with an average of 135 degrees. The ASES method was used to assess the shoulder joint function, 20 cases gained the excellent result, 12 good and 4 poor. And according to HSS method, 36 cases of elbow joint function gained the excellent result.

CONCLUSIONThe surgical treatment of mid-distal humeral shaft fractures associated with radial nerve palsysis with minimal invasive screwed nails osteosynthesis technique is effective.

Adult ; Bone Nails ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Humeral Fractures ; surgery ; Humerus ; injuries ; innervation ; surgery ; Internal Fixators ; Male ; Paralysis ; surgery ; Radial Nerve ; pathology ; Young Adult

OBJECTIVETo explore the method and effect of inter-locking intramedullary nail and tripus in closed reduction for treating tibial fracture.

METHODSOne hundred and twenty-six patients of tibial fractures were treated by inter-locking intramedullary nail and tripus in closed reduction. There were 76 males and 50 females aged from 25 to 68, the mean age was 38; There were 86 close fractures and 40 open fractures (Gustilo I and II type). AO classification system was used for all cases, fracture type A in 49 cases, type B in 41 cases, type C in 36 cases.

RESULTSAll patients were followed up for 10 to 16 months. Fratures were cured, according to the criteria of Johner-Wruhs, the results were excellent in 103 cases, good in 18 cases, fair in 5 cases.

CONCLUSIONInter-locking intramedullary nail is the optimal operation method in treating tibial fracture. Static locking should be a routine way, and closed reduction, no stripping periosteum, infectious rate and complications are reduced. Through tripus work intensity are reduced and reduction easily during operation.

Adult ; Aged ; Bone Nails ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; Humans ; Male ; Middle Aged ; Tibial Fractures ; pathology ; physiopathology ; surgery ; therapy ; Treatment Outcome

Systemic sclerosis is a connective tissue disease characterized by alterations in microvascular structure and function. In these patients, numerous studies have demonstrated a relationship between capillary morphology and peripheral blood perfusion. Nailfold videocapillaroscopy reveals the peripheral microvascular morphology and thus allows classification and scoring of capillary abnormalities with respect to different microangiopathy patterns (early, active, and late). Laser Doppler flowmetry and laser speckle contrast analysis can be used to estimate cutaneous blood flow through microvessels and to assess and quantify blood perfusion at peripheral sites. These two methods are also used to identify changes in digital blood perfusion after the infusion of vasodilators.
Blood Flow Velocity ; Humans ; *Laser-Doppler Flowmetry ; *Microcirculation ; Microscopic Angioscopy/*methods ; Microvessels/*pathology/*physiopathology ; Nails ; Predictive Value of Tests ; Regional Blood Flow ; Scleroderma, Systemic/*diagnosis/pathology/physiopathology ; Skin/*blood supply ; Vasodilator Agents/diagnostic use ; *Video Recording

BACKGROUND/AIMS: Nailfold capillaroscopy (NFC) has been used to examine morphological and functional microcirculation changes in connective tissue diseases. It has been demonstrated that NFC patterns reflect abnormal microvascular dynamics, which may play a role in fibromyalgia (FM) syndrome. The aim of this study was to determine NFC patterns in FM, and their association with clinical features of FM. METHODS: A total of 67 patients with FM, and 30 age- and sex-matched healthy controls, were included. Nailfold capillary patterns were quantitatively analyzed using computerized NFC. The parameters of interest were as follows: number of capillaries within the central 3 mm, deletion score, apical limb width, capillary width, and capillary dimension. Capillary dimension was determined by calculating the number of capillaries using the Adobe Photoshop version 7.0. RESULTS: FM patients had a lower number of capillaries and higher deletion scores on NFC compared to healthy controls (17.3 +/- 1.7 vs. 21.8 +/- 2.9, p < 0.05; 2.2 +/- 0.9 vs. 0.7 +/- 0.6, p < 0.05, respectively). Both apical limb width (microm) and capillary width (microm) were significantly decreased in FM patients (1.1 +/- 0.2 vs. 3.7 +/- 0.6; 5.4 +/- 0.5 vs. 7.5 +/- 1.4, respectively), indicating that FM patients have abnormally decreased digital capillary diameter and density. Interestingly, there was no difference in capillary dimension between the two groups, suggesting that the length or tortuosity of capillaries in FM patients is increased to compensate for diminished microcirculation. CONCLUSIONS: FM patients had altered capillary density and diameter in the digits. Diminished microcirculation on NFC may alter capillary density and increase tortuosity.
Adult ; Capillaries/*pathology/physiopathology ; Case-Control Studies ; Female ; Fibromyalgia/*diagnosis/pathology/physiopathology ; Humans ; Image Interpretation, Computer-Assisted ; Male ; Microcirculation ; *Microscopic Angioscopy ; Nails/*blood supply ; Predictive Value of Tests ; Regional Blood Flow