Injury of the sagittal band, a crucial component of the extensor hood, can occur in various situations, including spontaneous events, trauma, and rheumatic diseases. This case presents a rupture of the sagittal band resulting from chronic irritation caused by a metacarpal head osteoma. A 22-year-old female presented with ulnar subluxation of the extensor tendon at the left third metacarpophalangeal joint, without any history of trauma or pain. Ultrasonography and computed tomography revealed a 1.7 mm-sized bony lesion on the radial side of the metacarpal head, accompanied by a partial tear of the radial sagittal band. Our hypothesis that chronic irritation of the sagittal band by the adjacent bony lesion led to the partial tear was confirmed by intraoperative findings. The lesion was excised, and the radial sagittal band was reconstructed. Histopathological examination confirmed a diagnosis of osteoma. To our knowledge, this is the first reported case of sagittal band rupture caused by an osteoma of the metacarpal head. This case underscores the importance of considering an underlying metacarpal head osteoma in patients with non-rheumatoid joints presenting, in the absence of a traumatic history, with a sagittal band rupture due to chronic irritation.

Full-thickness nail bed defects with exposure of the distal phalanx are difficult to reconstruct with limited options for bone coverage. A subcutaneous flap can effectively cover bone exposure, followed by a nail bed graft. We report a case of successful nail bed reconstruction using this approach, incorporating a split-thickness nail bed graft. A 59-year-old woman sustained injuries to the nail bed of the right middle finger from a blender blade. The defect, measuring 1.2 × 0.6 cm, was located in the center of the nail bed with associated bone exposure. Both lateral nail folds remained intact and our aim was to reconstruct the defect without disrupting these structures. A subcutaneous flap incorporating the digital artery was elevated. The flap was then transposed beneath the lateral nail fold and uninjured nail bed to provide coverage for the defect. This technique allowed for the reconstruction of the damaged area while preserving the vascular supply and ensuring adequate soft-tissue coverage. Three weeks post-surgery, the flap survived, and the eponychial folds were all preserved, allowing for a subsequent split-thickness nail bed graft. At 12 months post-surgery, the outcome was evaluated as “very good” according to Zook’s criteria.

Lecanemab (product name Leqembi ® ) is an anti-amyloid monoclonal antibody treatment approved for use in Korea for patients with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease. The Korean Dementia Association has created recommendations for the appropriate use of lecanemab to assist clinicians. These recommendations include selecting patients for administration, necessary pre-administration tests and preparations,administration methods, monitoring for amyloid related imaging abnormalities (ARIA), and communication with patients and caregivers. Lecanemab is recommended for patients with MCI or mild dementia who confirmed positive amyloid biomarkers, and should not be administered to patients with severe hypersensitivity to lecanemab or those unable to undergo magnetic resonance imaging (MRI) evaluation. To predict the risk of ARIA before administration, apolipoprotein E genotyping is conducted, and regular brain MRI evaluations are recommended to monitor for ARIA during treatment. The most common adverse reactions are infusion-related reactions, which require appropriate management upon occurrence. Additional caution is needed when co-administering with anticoagulants or tissue plasminogen activator due to the risk of macrohemorrhage. Clinicians should consider the efficacy and necessary conditions for administration, as well as the safety of lecanemab, to make a comprehensive decision regarding its use.

Anterior interosseous nerve syndrome (AINS) is typically characterized by dysfunction of the pure motor branch of the median nerve, primarily affecting the flexor pollicis longus and the flexor digitorum profundus (FDP) of the index finger, and occasionally involving the FDP of the middle finger and the pronator quadratus. Although various etiologies such as compressive neuropathy and isolated neuritis have been proposed, the most recent review describes AINS as a form of neuralgic amyotrophy. Its treatment remains a matter of debate; the most frequently discussed approach is conservative treatment followed by surgical intervention above the medial epicondyle level if recovery is not achieved. In the case described herein, a hematoma resulting from blunt trauma at the forearm level compressed the anterior interosseous nerve (AIN), with clinical features and diagnostic findings very similar to those of typical AINS. Early surgical removal of the hematoma led to complete recovery without complications. Despite the current understanding of AINS pathophysiology and treatment, this case emphasizes the need to consider the possibility of AIN palsy due to forearm lesions. We report on the clinical course and successful treatment of this case to highlight this important consideration.

We investigated whether endurance exercise training (EXT) ameliorates circadian rhythm (CR)-induced risk factors by improving skeletal muscle (SKM) mitochondrial biogenesis, reducing oxidative stress, and modulating apoptotic protein expression. We distinguished between regular and shift workers using the National Health and Nutrition Examination Survey (NHANES) and investigated the health problems caused by shift work (CR disturbance) and the potential therapeutic effects of exercise. In our animal study, 36 rats underwent 12 weeks of CR disturbance, divided into regular and irregular CR groups. These groups were further split into EXT (n = 12) and sedentary (n = 12) for an additional 8 weeks. We analyzed SKM tissue to understand the molecular changes induced by CR and EXT. NHANES data were analyzed using SAS 9.4 and Prism 8 software, while experimental animal data were analyzed using Prism 8 software. The statistical procedures used in each experiment are indicated in the figure legends. Our studies showed that CR disturbance increases dyslipidemia, alters circadian clock proteins (BMAL1, PER2), raises apoptotic protein levels, and reduces mitochondrial biogenesis in SKM. EXT improved LDL-C and HDLC levels without affecting muscle BMAL1 expression. It also enhanced mitochondrial biogenesis (AMPK, PGC-1α, Tfam, NADH-UO, COX-I), antioxidant levels (Catalase, SOD1, SOD2), and apoptotic protein (p53, Bax/Bcl2) expression or activity in SKM. We demonstrated that shift work-induced CR disturbance leads to dyslipidemia, diminished mitochondrial biogenesis, and reduced antioxidant capacity in SKM. However, EXT can counteract dyslipidemia under CR disturbance, potentially lowering the risk of cardiovascular disorders.

We investigated whether endurance exercise training (EXT) ameliorates circadian rhythm (CR)-induced risk factors by improving skeletal muscle (SKM) mitochondrial biogenesis, reducing oxidative stress, and modulating apoptotic protein expression. We distinguished between regular and shift workers using the National Health and Nutrition Examination Survey (NHANES) and investigated the health problems caused by shift work (CR disturbance) and the potential therapeutic effects of exercise. In our animal study, 36 rats underwent 12 weeks of CR disturbance, divided into regular and irregular CR groups. These groups were further split into EXT (n = 12) and sedentary (n = 12) for an additional 8 weeks. We analyzed SKM tissue to understand the molecular changes induced by CR and EXT. NHANES data were analyzed using SAS 9.4 and Prism 8 software, while experimental animal data were analyzed using Prism 8 software. The statistical procedures used in each experiment are indicated in the figure legends. Our studies showed that CR disturbance increases dyslipidemia, alters circadian clock proteins (BMAL1, PER2), raises apoptotic protein levels, and reduces mitochondrial biogenesis in SKM. EXT improved LDL-C and HDLC levels without affecting muscle BMAL1 expression. It also enhanced mitochondrial biogenesis (AMPK, PGC-1α, Tfam, NADH-UO, COX-I), antioxidant levels (Catalase, SOD1, SOD2), and apoptotic protein (p53, Bax/Bcl2) expression or activity in SKM. We demonstrated that shift work-induced CR disturbance leads to dyslipidemia, diminished mitochondrial biogenesis, and reduced antioxidant capacity in SKM. However, EXT can counteract dyslipidemia under CR disturbance, potentially lowering the risk of cardiovascular disorders.

Purpose: Cystoscopy is a diagnostic test performed frequently in urology outpatient clinics. Despite the large number of inspections, the associated pain, discomfort, or anxiety can markedly affect patient compliance and adherence to subsequent surveillance protocols. This study conducted a prospective, randomized study to investigate the potential efficacy of music and pyuria on pain or anxiety during outpatient cystoscopy. Materials and Methods: In this single-institution, randomized study, the participants were assigned to a music-intervention or non-music control group. The music-intervention group underwent an identical procedure with the addition of Johann Sebastian Bach’s “Air on the G String” from Suite No. 3 in D major, BWV 1068. Urinalysis was performed to determine if pyuria affects pain during the procedure. Results: The patient-reported outcomes, encompassing the changes in the STAI-X-1 (State-Trait Anxiety Inventory-X-1) scores, subjective levels of discomfort, embarrassment, satisfaction, and pain, were similar in the two groups. In contrast, the surgeons reported statistically significant differences in their evaluations of the same items as patient-reported outcomes of the two groups. The patient-reported pain showed no significant differences between the pyuria-negative group (0-2 and 3-5 WBC/HPF) and pyuria-positive group (>5 WBC/HPF). Conclusions The data from this study do not support the hypothesis that musical intervention during cystoscopy alleviates pain or anxiety to any significant extent.In addition, pyuria did not affect the patient’s reported pain. Nevertheless, a notable impact was observed in the surgeons’ assessments, suggesting that the musical accompaniment may alter the surgeons’ perception of patient pain and anxiety levels throughout the procedure.

Purpose: The aim of this study was to investigate the prognostic impact of time to percutaneous nephrostomy (PCN) insertion on obstructive ureteral stones with sepsis. Materials and Methods: Data were collected on patients who presented at our Emergency Department between 2017 and 2021 with obstructive uropathy due to urinary stones and underwent PCN insertion. Patients were stratified into 4 groups in accordance with the quick sepsis-related organ failure (qSOFA) score at presentation (<2 or ≥2) and time to PCN insertion (<4 hours or ≥4 hours) as follows: group 1, qSOFA < 2 and time to PCN insertion < 4 hours; group 2, qSOFA < 2 and time to PCN insertion ≥ 4 hours; group 3, qSOFA ≥ 2 and time to PCN insertion < 4 hours; group 4, qSOFA ≥ 2 and time to PCN insertion ≥ 4 hours. The prognostic impacts of the time to PCN insertion were compared between these groups Results: The total cohort consisted of 96 patients, of whom 70 were classified as either group 1 or 2 (qSOFA < 2). Overall, 37 patients had a positive urine culture. The median time to PCN insertion was 218 minutes, and the median length of stay was 14 days. The hospitalization period was significantly shorter in group 3 than in group 4 (p=0.041). Conclusions A shorter length of stay was associated with more rapid PCN insertion in patients with obstructive uropathy and a high risk of sepsis.

We investigated whether endurance exercise training (EXT) ameliorates circadian rhythm (CR)-induced risk factors by improving skeletal muscle (SKM) mitochondrial biogenesis, reducing oxidative stress, and modulating apoptotic protein expression. We distinguished between regular and shift workers using the National Health and Nutrition Examination Survey (NHANES) and investigated the health problems caused by shift work (CR disturbance) and the potential therapeutic effects of exercise. In our animal study, 36 rats underwent 12 weeks of CR disturbance, divided into regular and irregular CR groups. These groups were further split into EXT (n = 12) and sedentary (n = 12) for an additional 8 weeks. We analyzed SKM tissue to understand the molecular changes induced by CR and EXT. NHANES data were analyzed using SAS 9.4 and Prism 8 software, while experimental animal data were analyzed using Prism 8 software. The statistical procedures used in each experiment are indicated in the figure legends. Our studies showed that CR disturbance increases dyslipidemia, alters circadian clock proteins (BMAL1, PER2), raises apoptotic protein levels, and reduces mitochondrial biogenesis in SKM. EXT improved LDL-C and HDLC levels without affecting muscle BMAL1 expression. It also enhanced mitochondrial biogenesis (AMPK, PGC-1α, Tfam, NADH-UO, COX-I), antioxidant levels (Catalase, SOD1, SOD2), and apoptotic protein (p53, Bax/Bcl2) expression or activity in SKM. We demonstrated that shift work-induced CR disturbance leads to dyslipidemia, diminished mitochondrial biogenesis, and reduced antioxidant capacity in SKM. However, EXT can counteract dyslipidemia under CR disturbance, potentially lowering the risk of cardiovascular disorders.

Purpose: Cystoscopy is a diagnostic test performed frequently in urology outpatient clinics. Despite the large number of inspections, the associated pain, discomfort, or anxiety can markedly affect patient compliance and adherence to subsequent surveillance protocols. This study conducted a prospective, randomized study to investigate the potential efficacy of music and pyuria on pain or anxiety during outpatient cystoscopy. Materials and Methods: In this single-institution, randomized study, the participants were assigned to a music-intervention or non-music control group. The music-intervention group underwent an identical procedure with the addition of Johann Sebastian Bach’s “Air on the G String” from Suite No. 3 in D major, BWV 1068. Urinalysis was performed to determine if pyuria affects pain during the procedure. Results: The patient-reported outcomes, encompassing the changes in the STAI-X-1 (State-Trait Anxiety Inventory-X-1) scores, subjective levels of discomfort, embarrassment, satisfaction, and pain, were similar in the two groups. In contrast, the surgeons reported statistically significant differences in their evaluations of the same items as patient-reported outcomes of the two groups. The patient-reported pain showed no significant differences between the pyuria-negative group (0-2 and 3-5 WBC/HPF) and pyuria-positive group (>5 WBC/HPF). Conclusions The data from this study do not support the hypothesis that musical intervention during cystoscopy alleviates pain or anxiety to any significant extent.In addition, pyuria did not affect the patient’s reported pain. Nevertheless, a notable impact was observed in the surgeons’ assessments, suggesting that the musical accompaniment may alter the surgeons’ perception of patient pain and anxiety levels throughout the procedure.