Hand fractures are the second most common fracture in the upper extremities after the distal radius, and patients with these injuries may be experienced in hand surgery clinics. On the other hand, during the treatment of hand fractures, complications can occur due to complex functions of the hand and small-sized injuries to the bone and soft tissues. This review focused on the principles of management of these fractures, including injury mechanism, evaluations and recent treatment options. Minimally invasive surgery in various types of hand fractures, including the phalanx and metacarpal bone, is preferred because early mobilization after surgery has been emphasized to reduce complications, such as stiffness.
Early Ambulation ; Finger Phalanges ; Hand ; Humans ; Metacarpal Bones ; Minimally Invasive Surgical Procedures ; Radius ; Upper Extremity

OBJECTIVES: Purpose of this study is investigation the influence of intravenous and oral bisphosphonate to bone union and clinical results in patient treated with plate fixation in an osteoporotic distal radius fracture. MATERIALS AND METHODS: The medical records of 160 patients with an osteoporotic distal radius fracture treated with plate fixation in our hospital between January 2008 and April 2012 were reviewed retrospectively. The patients were classified by 3 groups; who did not administrate bisphosphonate after surgery as Group I (n=69), administrated oral bisphosphonate after surgery as Group II (n=44), and administrated intravenous bisphosphonate as Group III (n=47). After surgery, bone union, radiologic parameters, disabilities of the DASH score and range of motion of wrist were assessed. RESULTS: Mean time of bone union was 6.7 weeks in Group I, 6.8 weeks in Group II, and 7.1 weeks in Group III. There was no significant difference between three groups (P=0.571). Bone union rate on 6weeks shows no significant differences between three groups (P=0.16). Three groups also have no significant differences in all radiologic and clinical parameters. CONCLUSION: This study shows that early initiation of oral and Intravenous bisphosphonate did not affect bone union and clinical results compared to group who did not administrate bisphosphonate result in patient treated with plate fixation in an osteoporotic distal radius fracture.
Humans ; Medical Records ; Osteoporosis ; Radius Fractures ; Radius ; Range of Motion, Articular ; Retrospective Studies ; Wrist

Background: Non-invasive painless signaling therapy (NPST) is an electro-cutaneous treatment that converts endogenous pain information into synthetic non-pain information. This study explored whether pain improvement by NPST in failed back surgery syndrome (FBSS) patients is related to cerebral modulation. Methods: Electroencephalography (EEG) analysis was performed in 11 patients with FBSS. Subjects received daily NPST for 5 days. Before the first treatment, patients completed the Brief Pain Inventory (BPI) and Beck Depression Inventory and underwent baseline EEG. After the final treatment, they responded again to the BPI, reported the percent pain improvement (PPI), and then underwent post-treatment EEG. If the PPI grade was zero, they were assigned to the ineffective group, while all others were assigned to the effective group. We used standardized low-resolution brain electromagnetic tomography (sLORETA) to explore the EEG current-source distribution (CSD) associated with pain improvement by NPST. Results: The 11 participants had a median age of 67.0 years, and 63.6% were female. The sLORETA images revealed a beta-2 CSD increment in 12 voxels of the right anterior cingulate gyrus (ACG) and the right medial frontal area. The point of maximal CSD changes was in the right ACG. The alpha band CSD increased in 2 voxels of the left transverse gyrus. Conclusions Pain improvement by NPST in FBSS patients was associated with increased cerebral activity, mainly in the right ACG. The change in afferent information induced by NPST seems to be associated with cerebral pain perception.

Background: Non-invasive painless signaling therapy (NPST) is an electro-cutaneous treatment that converts endogenous pain information into synthetic non-pain information. This study explored whether pain improvement by NPST in failed back surgery syndrome (FBSS) patients is related to cerebral modulation. Methods: Electroencephalography (EEG) analysis was performed in 11 patients with FBSS. Subjects received daily NPST for 5 days. Before the first treatment, patients completed the Brief Pain Inventory (BPI) and Beck Depression Inventory and underwent baseline EEG. After the final treatment, they responded again to the BPI, reported the percent pain improvement (PPI), and then underwent post-treatment EEG. If the PPI grade was zero, they were assigned to the ineffective group, while all others were assigned to the effective group. We used standardized low-resolution brain electromagnetic tomography (sLORETA) to explore the EEG current-source distribution (CSD) associated with pain improvement by NPST. Results: The 11 participants had a median age of 67.0 years, and 63.6% were female. The sLORETA images revealed a beta-2 CSD increment in 12 voxels of the right anterior cingulate gyrus (ACG) and the right medial frontal area. The point of maximal CSD changes was in the right ACG. The alpha band CSD increased in 2 voxels of the left transverse gyrus. Conclusions Pain improvement by NPST in FBSS patients was associated with increased cerebral activity, mainly in the right ACG. The change in afferent information induced by NPST seems to be associated with cerebral pain perception.

Purpose: This study aimed to compare the clinical outcomes of laparoscopic appendectomy (LA) according to the method of appendiceal stump closure. Methods: Patients who underwent LA for appendicitis between 2010 and 2020 were retrospectively reviewed. Patients were classified into locking polymeric clip (LPC) and loop ligature (LL) groups. Clinical outcomes were compared between the groups. Results: LPC and LL were used in 188 (56.6%) and 144 patients (43.4%), respectively for appendiceal stump closure. No significant differences were observed in sex, age, comorbidities, and the severity of appendicitis between the groups. The median operative time was shorter in the LPC group than in the LL group (64.5 minutes vs. 71.5 minutes, P=0.027). The median hospital stay was longer in the LL group than in the LPC group (4 days vs. 3 days, P=0.020). Postoperative incidences of intraabdominal abscess and ileus were higher in the LL group than in the LPC group (4.2% vs. 1.1%, P=0.082 and 2.8% vs. 0%, P=0.035; respectively). The readmission rate was higher in the LL group than that in the LPC group (6.3% vs. 1.1%, P=0.012). Conclusion Using LPC for appendiceal stump closure during LA for appendicitis was associated with lower postoperative complication rate, shorter operative time, and shorter hospital stay compared to the use of LL. Operative time above 60 minutes and the use of LL were identified as independent risk factors for postoperative complications in LA. Therefore, LPC could be considered a more favorable closure method than LL during LA for appendicitis.

Purpose: As we enter an aging society, the number of elderly patients with breast cancer is increasing. We assessed the prognostic factors for breast cancer recurrence or metastasis in patients over the age of 65 years by analyzing tumor characteristics and long-term clinical outcomes. Methods: In this retrospective study, the data of 286 breast cancer patients aged 65 years and older, who underwent treatment at the Pusan National University Hospital and Pusan National University Yangsan Hospital from 2008 to 2014, were analyzed. The patients were divided into two groups: those with recurrence or metastasis and those without. Cox-regression model was used to analyze the risk factors for recurrence or metastasis. Kaplan-Meier method was used to analyze survival rates by the log-rank test. Results: Among the 286 patients with invasive breast cancer, 43 patients (15.0%) had recurrence or distant metastasis during a median follow-up period of 61 months. Advanced stages of breast cancer and patients who are not adapted to endocrine therapy were associated with poor prognosis. Conclusion In this study, advanced stages of breast cancer and endocrine therapy were the prognostic factors for breast cancer recurrences or metastases. Early detection of elderly breast cancer generally increases the possibility of diagnosis at an earlier stage, which can lead to a better prognosis. Moreover, endocrine therapy should be administered to elderly patients who manifest favorable intrinsic subtypes of breast cancer.

PURPOSE: Idiopathic scoliosis is a structural lateral curvature of the spine of unknown etiology. The relationship between degree of spine curvature and cardiopulmonary function has not yet been investigated. The purpose of this study was to determine the association between scoliosis and cardiopulmonary characteristics. METHODS: Ninety children who underwent preoperative pulmonary or cardiac evaluation at a single spine institution over 41 months were included. They were divided into the thoracic-dominant scoliosis (group A, n=78) and lumbar-dominant scoliosis (group B, n=12) groups. Scoliosis severity was evaluated using the Cobb method. In each group, relationships between Cobb angles and cardiopulmonary markers such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, left ventricular ejection fraction, pulmonary artery flow velocity, and tissue Doppler velocities (E/E', E'/A') were analyzed by correlation analysis linear regression. RESULTS: In group A, 72 patients (92.3%) underwent pulmonary function tests (PFTs), and 41 (52.6%) underwent echocardiography. In group B, 9 patients (75.0%) underwent PFT and 8 (66.7%) underwent echocardiography. Cobb angles showed a significant negative correlation with FVC and FEV1 in group A (both P<0.05), but no such correlation in group B, and a significant negative correlation with mitral E/A ratio (P<0.05) and tissue Doppler E'/A' (P<0.05) in group A, with a positive correlation with mitral E/A ratio (P<0.05) in group B. CONCLUSION: Pulmonary and cardiac function was significantly correlated with the degree of scoliosis in patients with thoracic-dominant scoliosis. Myocardial diastolic function might be impaired in patients with the most severe scoliosis.
Child* ; Echocardiography ; Forced Expiratory Volume ; Humans ; Linear Models ; Pulmonary Artery ; Respiratory Function Tests ; Scoliosis* ; Spine ; Stroke Volume ; Vital Capacity

Ictal crying has been associated with ictal activities in the medial frontal or medial temporal area of the nondominant hemisphere. We applied current-source analysis to the interictal spikes of a patient with episodes of ictal crying without sad feelings, but fear sensation. The current sources were in the medial frontal area of both cerebral hemispheres, the temporal area and the posterior cingulate gyrus of the right hemisphere.
Cerebrum ; Crying ; Gyrus Cinguli ; Humans ; Sensation

BACKGROUND: The voltage topography of temporal spikes has two distinct patterns, designated type I and type II; the orientation of the current-dipole source (O-CDS) of type I spikes tends to be oblique, while that of type II spikes tends to be horizontal. The purpose of this study was to identify the effects of the O-CDS of anterior temporal spikes on clinical factors including onset age, seizure frequency, secondary generalization, disease duration, intractability, polytherapy, febrile seizure, hippocampal sclerosis, and neocortical-temporal aura. METHODS: We examined the scalp electroencephalograms of 24 patients with temporal lobe epilepsy (TLE) and anterior temporal spikes. A spatiotemporal dipole model was applied to determine the O-CDS of the averaged spikes in each patient. We performed current-source analysis of multiple spatiotemporal dipole models using Brain Electrical Source Analysis software. The patients were divided into two subgroups according to their O-CDS pattern: oblique and horizontal. Clinical factors were compared between the two groups. RESULTS: Sixteen patients were classified into the oblique group, and 8 patients into the horizontal group. A neocortical-temporal aura was more commonly observed in the horizontal group (p<0.05), while drug-resistance tendencies were more commonly observed in the oblique group (p<0.1). CONCLUSIONS: The horizontal O-CDS of anterior temporal spikes may be more frequently associated with a neocortical-temporal aura than the oblique O-CDS in TLE. In addition, the oblique O-CDS pattern suggests a tendency toward drug resistance. The findings of this study imply that the oblique O-CDS pattern of anterior temporal spikes may provide additional electrophysiologic information regarding drug-resistant mesial TLE.
Age of Onset ; Brain ; Drug Resistance ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe ; Generalization (Psychology) ; Humans ; Orientation ; Scalp ; Sclerosis ; Seizures ; Seizures, Febrile

Alpha coma is a coma state with predominant alpha activities in electroencephalography. There are two different patterns of alpha coma, depending upon the distribution of alpha activity. The causes may vary with the distribution pattern. To clarify the difference in alpha-activity distribution, we conducted current-source analysis of the alpha-frequency band in two patients with alpha-coma caused by drug intoxication and pontine infarction, respectively. The current-source analysis of alpha-frequency bands may make it easier to distinguish the distribution patterns.
Coma ; Electroencephalography ; Humans ; Infarction