Search

Background: The aim of this study was to compare the functional outcomes and direct costs of Stack splints and aluminum finger splints when used in the conservative management of patients with acute Doyle type IVb bony mallet finger., Methods: We retrospectively analyzed demographic and clinical characteristics, functional outcomes (using the Crawford classification, DIP flexion angles, and extension lag measurements), time to confirmation of union, and splint costs of 24 patients treated with aluminum finger splints (Group 1) and 20 patients treated with Stack splints (Group 2)., Results: Of 44 patients, the median age was 38 (range, 20-59) years, 14 (32%) were smokers, 23 (52%) had fourth digit injuries, 32 (70%) had injuries to the dominant hand, 30 (68%) had a mechanism of injury of a fall, and median follow-up was 15 (range, 12-18) months; none of these differed significantly between Group 1 and Group 2 (all p > 0.05). In Group 1, functional outcomes were excellent and good in 14 (58%) and 10 (42%) patients, respectively; in Group 2 functional outcomes were excellent and good in 13 (62%) and 7 (35%) patients, respectively; and there was no significant difference between the groups. Median extension lag was 3.2° (range, 3.0°-3.5°) in group 1 and 3.4° (range, 3.2°-3.8°) in group 2, indicating no significant difference between groups. Complete union was confirmed radiographically in all patients. Per-patient cost was significantly lower for aluminum finger splints (0.208 TRY [US $0.03]) than for Stack splints (25 TRY [US $3.60])., Conclusions: Good functional outcomes are possible with the use of either Stack or aluminum finger splints in patients with acute Doyle type IVb mallet finger, confirming that conservative management may be appropriate for these injuries. Direct costs of Stack splints are many times greater than those of aluminum splints, though the costs for both are relatively low., Level of Evidence: Therapeutic, Level III., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)

Introduction: Immunotherapy has been determined as an important choice in breast carcinomas, especially in tumors with markedly inflammatory response. About this promising subject, tumor-infiltrating lymphocytes (TIL) and the expression of immune control point receptors on TIL have gained importance., Materials and Methods: In this study, stromal TIL and tertiary lymphoid structures (TLS) were determined in tumor tissues of 312 invasive and 68 in situ breast cancer patients. Expression rates of PD-1, LAG-3, and TIM-3 on intratumoral and stromal TIL were immunohistochemically evaluated., Results: In invasive breast carcinomas, stromal TIL was found to be significantly associated with lymph node metastasis, HR and HER2 expression, and basal-like phenotype, as the presence of TLS with neoadjuvant therapy, recurrence, death, and expression of HR and HER2. PD-1, LAG-3, and TIM-3 expressions were found to be associated with HR and HER2 status, stromal TIL rates, and TLS. In multivariate analysis, high stromal TIL and PD-1 expression in intratumoral TIL were found to be independent prognostic factors in terms of overall survival and disease-free survival., Conclusion: Evaluation of TIL and immune control point receptor expressions in breast cancer is particularly important in terms of planning the therapeutic approaches based on immunotherapy protocols., Competing Interests: Disclosure The authors declare that they have no conflict of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Loss of the radius with open fractures of the forearm is rarely reported in pediatric cases and to the authors' knowledge, cases of segmental loss of the distal half of the ulna have not been previously reported. A 6-year-old girl was admitted with a Gustilo-Anderson type IIIB open forearm fracture and loss of the distal half of the ulna after a motor vehicle accident. Serial debridement was performed and a Kirschner wire was inserted into the distal half of the ulna. Unexpectedly, the ulna regenerated and the defect healed 4 weeks later. Soft tissue coverage was achieved with a skin graft and uneventful healing ensued. Eight weeks later, the bone was spontaneously and completely reconstituted. This case report demonstrates that substantial defects of the ulna may be spontaneously reconstituted over time., (Copyright © 2021 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

3D image reconstruction with electron tomography holds problems due to the severely limited range of projection angles and low signal to noise ratio of the acquired projection images. The maximum a posteriori (MAP) reconstruction methods have been successful in compensating for the missing information and suppressing noise with their intrinsic regularization techniques. There are two major problems in MAP reconstruction methods: (1) selection of the regularization parameter that controls the balance between the data fidelity and the prior information, and (2) long computation time. One aim of this study is to provide an adaptive solution to the regularization parameter selection problem without having additional knowledge about the imaging environment and the sample. The other aim is to realize the reconstruction using sequences of resolution levels to shorten the computation time. The reconstructions were analyzed in terms of accuracy and computational efficiency using a simulated biological phantom and publically available experimental datasets of electron tomography. The numerical and visual evaluations of the experiments show that the adaptive multiresolution method can provide more accurate results than the weighted back projection (WBP), simultaneous iterative reconstruction technique (SIRT), and sequential MAP expectation maximization (sMAPEM) method. The method is superior to sMAPEM also in terms of computation time and usability since it can reconstruct 3D images significantly faster without requiring any parameter to be set by the user., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Stroke is the leading cause of serious disability. Estimating severity of the disease and early risk assessment is crucial. Several studies have been carried on and several biomarkers have been proposed in the literature for risk assessment and to estimate the stroke prognosis. In this study we assessed the association of predictors such as patient age, gender, stroke volume and NIHS scores on prognosis of stroke event. We investigated whether the serum pentraxin-3 levels are linked with stroke prognosis., Methods: Forty-four stroke patients without cardiovascular risk factors were included in this study. Initial NIHS scores, stroke volumes, serum pentraxin-3 levels and the data regarding the risk factors were collected in the first and seventh days of event. Association of predictors with final NIHS scores were investigated using multivariate regression model., Results: Initial NIHS score, initial and final stroke volumes were independently associated with final NIHS score whereas serum pentraxin-3 levels, whether acquired at the first or seventh day of stroke, were not associated with final NIHS score., Conclusions: In stroke patients without cardiovascular, cardiopulmonary and infectious diseases, serum pentraxin-3 levels are not associated with stroke prognosis., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Background: sE-selectin has recently been suggested as a surrogate marker for prediction of ROP development., Aims: The possible role of serial plasma sE-selectin measurements in early prediction and diagnosis of ROP was evaluated., Study Design: Prospective observational study, Subjects: Forty six preterm infants aged <34weeks of gestation and weighing <1500 g were enrolled. Of these, 26 constituted the ROP group and 20 constituted the no-ROP group. sE-selectin levels were measured serially in blood samples on the 1st day and on 14th and 28th postnatal days., Outcome Measures: The primary outcome measure was to evaluate the role of sE-selectin concentrations in prediction of ROP., Results: The mean gestational age and birth weight were significantly lower in the ROP group. The mean sE-selectin concentrations in ROP group were significantly greater than those in no-ROP group at each time point (1st, 14th and 28th days of postnatal life). A receiver operating characteristic (ROC) analysis showed that at a plasma concentration of ≥86ng/mL on the 1st postnatal day, sE-selectin had a sensitivity of 100% and a specificity of 94.1% with a positive predictive value of 96.3% and a negative predictive value of 100%. Plasma sE-selectin concentrations were significantly greater in infants who developed ROP in three different time points., Conclusions: This study shows for the first time that measurement of plasma sE-selectin concentrations as early as the first day of life might help identify preterm infants at risk of ROP., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: Emerging evidence indicates the prognostic importance of cystatin C (Cys-C) in patients with coronary artery disease. However, whether Cys-C concentrations are associated with adverse clinical events among patients with acute coronary syndromes (ACS) have not been studied extensively. We compared the long-term prognostic efficacy of Cys-C with other markers of renal dysfunction, inflammation and systolic dysfunction in patients with ACS., Methods and Results: Serum levels of Cys-C, high sensitive C-reactive protein (hs-CRP), brain natriuretic peptide (BNP) and creatinine were measured in 160 patients with ACS (112 males, 48 females, mean age 60+/-10 years) on admission. Primary end point of the study was major adverse cardiac events (MACE) defined as the combination of cardiac death, non-fatal myocardial infarction and recurrent rest angina that required hospitalization within 12 months of follow-up. During the follow-up period, 42 (26%) patients met the MACE criteria. The occurrence of MACE was significantly higher among patients with higher Cys-C levels. In multivariate analysis, Cys-C was the most important parameter associated with the occurrence of MACE (OR=9.62, 95% CI=2.3-40.5, p<0.001). ROC curve analysis showed that the predictive cut-off value of Cys-C for MACE was 1051ng/ml. In the Cox regression analysis adjusted for multiple risk factors, Cys-C was found as the most powerful predictor for MACE (RR=9.43, 95% CI=4.0-21.8, p<0.001)., Conclusion: The results of the present study indicate that admission levels of Cys-C may be a good prognostic indicator of recurrent cardiovascular events in patients with ACS. Further studies are needed to confirm these results.