1
|
Lin CY, Shao YC, Chen WL, Chen SN. Melanoma-associated retinopathy with presentation of transient multiple hyper-autofluorescent dots. Kaohsiung J Med Sci 2024; 40:198-200. [PMID: 38062921 DOI: 10.1002/kjm2.12792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/16/2023] [Accepted: 10/31/2023] [Indexed: 02/03/2024] Open
Affiliation(s)
- Chih-Ying Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye center, China Medical University Hospital, Taichung City, Taiwan
| | - Yi-Ching Shao
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye center, China Medical University Hospital, Taichung City, Taiwan
| | - Wen-Lu Chen
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye center, China Medical University Hospital, Taichung City, Taiwan
| | - San-Ni Chen
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye center, China Medical University Hospital, Taichung City, Taiwan
| |
Collapse
|
2
|
Chu C, Jiang SK, Shao YC, Yeh SP. Case report: Sudden onset optic neuritis shortly after SARS-CoV-2 vaccination in an allogeneic hematopoietic stem cell transplant recipient with chronic graft-vs.-host disease. Front Med (Lausanne) 2023; 10:1177610. [PMID: 37409268 PMCID: PMC10318169 DOI: 10.3389/fmed.2023.1177610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/08/2023] [Indexed: 07/07/2023] Open
Abstract
Hematopoietic stem cell transplantation (HSCT) recipients affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have a high mortality rate. The American Society of Transplantation and Cellular Therapy (ASTCT) and the European Society for Blood and Marrow Transplantation (EBMT) recommend vaccination for these vulnerable populations. However, emerging data suggested that vaccination might elicit immunological adverse events, including an exacerbation of graft-vs.-host disease (GVHD). Herein, we report a case of severe optic neuritis developed shortly after AstraZeneca COVID-19 vaccination in an allogeneic HSCT recipient with underlying chronic GVHD. The patient had a headache 5 days after vaccination, and the disease progressed rapidly to complete blindness 17 days after the vaccination. The diagnosis of optic neuritis was well-confirmed by the presence of an anti-myelin oligodendrocyte glycoprotein antibody and the typical features of MRI image and Ophthalmoscopy. Other differential diagnoses, such as infection or leukemia relapse in the central nervous system (CNS), were carefully excluded. A timely high-dose corticosteroid was administered, and her visual acuity improved rapidly. She returned to her baseline status 1 month later. With more than 1 year of follow-up, no optic neuritis or leukemia relapse was observed. In summary, allogeneic transplant recipients can develop severe optic neuritis after vaccination. Optic neuritis can be an exacerbation of GVHD or rarely a sporadic adverse event of vaccination. Furthermore, our experience indicates that a prompt diagnosis and early steroid treatment are vital for a good recovery.
Collapse
Affiliation(s)
- Chiang Chu
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shin-Kuang Jiang
- Division of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Ching Shao
- Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - Su-Peng Yeh
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- China Medical University, Taichung, Taiwan
| |
Collapse
|
3
|
Shao YC, Karki B, Huang W, Feng X, Sumanasekera G, Guo JH, Chuang YD, Freelon B. Spectroscopic Determination of Key Energy Scales for the Base Hamiltonian of Chromium Trihalides. J Phys Chem Lett 2021; 12:724-731. [PMID: 33400873 DOI: 10.1021/acs.jpclett.0c03476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The van der Waals (vdW) chromium trihalides (CrX3) exhibit field-tunable, two-dimensional magnetic orders that vary with the halogen species and the number of layers. Their magnetic ground states with proximity in energies are sensitive to the degree of ligand-metal (p-d) hybridization and relevant modulations in the Cr d-orbital interactions. We use soft X-ray absorption (XAS) and resonant inelastic X-ray scattering (RIXS) spectroscopy at Cr L-edge along with the atomic multiplet simulations to determine the key energy scales such as the crystal field 10 Dq and interorbital Coulomb interactions under different ligand metal charge transfer (LMCT) in CrX3 (X= Cl, Br, and I). Through this systematic study, we show that our approach compared to the literature has yielded a set of more reliably determined parameters for establishing a base Hamiltonian for CrX3.
Collapse
Affiliation(s)
- Y C Shao
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
- Department of Physics, University of Houston, Houston, Texas 77204, United States
| | - B Karki
- Department of Physics and Astronomy, University of Louisville, Louisville, Kentucky 40292, United States
| | - W Huang
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
- State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and InformationTechnology, Chinese Academy of Sciences, Shanghai 200050, China
| | - X Feng
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - G Sumanasekera
- Department of Physics and Astronomy, University of Louisville, Louisville, Kentucky 40292, United States
| | - J-H Guo
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - Y-D Chuang
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - B Freelon
- Department of Physics, University of Houston, Houston, Texas 77204, United States
- Texas Center for Superconductivity, University of Houston, Houston Texas 77204, United States
| |
Collapse
|
4
|
Lu H, Gauthier A, Hepting M, Tremsin AS, Reid AH, Kirchmann PS, Shen ZX, Devereaux TP, Shao YC, Feng X, Coslovich G, Hussain Z, Dakovski GL, Chuang YD, Lee WS. Time-resolved RIXS experiment with pulse-by-pulse parallel readout data collection using X-ray free electron laser. Sci Rep 2020; 10:22226. [PMID: 33335197 PMCID: PMC7746750 DOI: 10.1038/s41598-020-79210-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/30/2020] [Indexed: 11/21/2022] Open
Abstract
Time-resolved resonant inelastic X-ray scattering (RIXS) is one of the developing techniques enabled by the advent of X-ray free electron laser (FEL). It is important to evaluate how the FEL jitter, which is inherent in the self-amplified spontaneous emission process, influences the RIXS measurement. Here, we use a microchannel plate (MCP) based Timepix soft X-ray detector to conduct a time-resolved RIXS measurement at the Ti L3-edge on a charge-density-wave material TiSe2. The fast parallel Timepix readout and single photon sensitivity enable pulse-by-pulse data acquisition and analysis. Due to the FEL jitter, low detection efficiency of spectrometer, and low quantum yield of RIXS process, we find that less than 2% of the X-ray FEL pulses produce signals, preventing acquiring sufficient data statistics while maintaining temporal and energy resolution in this measurement. These limitations can be mitigated by using future X-ray FELs with high repetition rates, approaching MHz such as the European XFEL in Germany and LCLS-II in the USA, as well as by utilizing advanced detectors, such as the prototype used in this study.
Collapse
Affiliation(s)
- H Lu
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Stanford University, 2575 Sand Hill Road, Menlo Park, CA, 94025, USA
| | - A Gauthier
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Stanford University, 2575 Sand Hill Road, Menlo Park, CA, 94025, USA
| | - M Hepting
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Stanford University, 2575 Sand Hill Road, Menlo Park, CA, 94025, USA
| | - A S Tremsin
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, 94720, USA
| | - A H Reid
- Linac Coherent Light Source (LCLS), SLAC National Accelerator Laboratory, Menlo Park, CA, 94025, USA
| | - P S Kirchmann
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Stanford University, 2575 Sand Hill Road, Menlo Park, CA, 94025, USA.,Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, CA, 94305, USA
| | - Z X Shen
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Stanford University, 2575 Sand Hill Road, Menlo Park, CA, 94025, USA.,Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, CA, 94305, USA
| | - T P Devereaux
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Stanford University, 2575 Sand Hill Road, Menlo Park, CA, 94025, USA.,Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, CA, 94305, USA.,Department of Materials Science and Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Y C Shao
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - X Feng
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - G Coslovich
- Linac Coherent Light Source (LCLS), SLAC National Accelerator Laboratory, Menlo Park, CA, 94025, USA
| | - Z Hussain
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - G L Dakovski
- Linac Coherent Light Source (LCLS), SLAC National Accelerator Laboratory, Menlo Park, CA, 94025, USA
| | - Y D Chuang
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - W S Lee
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Stanford University, 2575 Sand Hill Road, Menlo Park, CA, 94025, USA.
| |
Collapse
|
5
|
Srivastava MK, Qiu XS, Chin YY, Hsieh SH, Shao YC, Liang YH, Lai CH, Du CH, Wang HT, Chiou JW, Lai YC, Tsai HM, Pao CW, Lin HJ, Lee JF, Asokan K, Pong WF. The effect of orbital-lattice coupling on the electrical resistivity of YBaCuFeO 5 investigated by X-ray absorption. Sci Rep 2019; 9:18586. [PMID: 31819082 PMCID: PMC6901513 DOI: 10.1038/s41598-019-54772-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 11/14/2019] [Indexed: 11/25/2022] Open
Abstract
Temperature-dependent X-ray absorption near-edge structures, X-ray linear dichroism (XLD) and extended X-ray absorption fine structure (EXAFS) spectroscopic techniques were used to investigate the valence state, preferred orbital and local atomic structure that significantly affect the electrical and magnetic properties of a single crystal of YBaCuFeO5 (YBCFO). An onset of increase of resistivity at ~180 K, followed by a rapid increase at/below 125 K, is observed. An antiferromagnetic (AFM)-like transition is close to the temperature at which the resistivity starts to increase in the ab-plane and is also observed with strong anisotropy between the ab-plane and the c-axis. The XLD spectra at the Fe L3,2-edge revealed a change in Fe 3d eg holes from the preferential [Formula: see text] orbital at high temperature (300-150 K) to the [Formula: see text] orbital at/below 125 K. The analysis of the Fe K-edge EXAFS data of YBCFO further revealed an unusual increase in the Debye-Waller factor of the nearest-neighbor Fe-O bond length at/below 125 K, suggesting phonon-softening behavior, resulting in the breaking of lattice symmetry, particularly in the ab-plane of Fe-related square pyramids. These findings demonstrate a close correlation between electrical resistivity and coupling of the preferred Fe 3d orbital with lattice distortion of a single crystal of YBCFO.
Collapse
Affiliation(s)
- M K Srivastava
- Department of Physics, Tamkang University, Tamsui, 251, Taiwan
- Department of Physics, Banasthali Vidyapith, Rajasthan, 304022, India
| | - X-S Qiu
- Department of Physics, Tamkang University, Tamsui, 251, Taiwan
| | - Y Y Chin
- Department of Physics, National Chung Cheng University, Chiayi, 621, Taiwan
| | - S H Hsieh
- Department of Physics, Tamkang University, Tamsui, 251, Taiwan
- National Synchrotron Radiation Research Center, Hsinchu, 300, Taiwan
| | - Y C Shao
- Department of Physics, Tamkang University, Tamsui, 251, Taiwan
| | - Y-H Liang
- Department of Physics, Tamkang University, Tamsui, 251, Taiwan
| | - C-H Lai
- Department of Physics, Tamkang University, Tamsui, 251, Taiwan
| | - C H Du
- Department of Physics, Tamkang University, Tamsui, 251, Taiwan
| | - H T Wang
- Department of Physics, Tamkang University, Tamsui, 251, Taiwan
- Department of Physics, National Tsinghua University, Hsinchu, 300, Taiwan
| | - J W Chiou
- Department of Applied Physics, National University of Kaohsiung, Kaohsiung, 811, Taiwan
| | - Y C Lai
- National Synchrotron Radiation Research Center, Hsinchu, 300, Taiwan
| | - H M Tsai
- National Synchrotron Radiation Research Center, Hsinchu, 300, Taiwan
| | - C W Pao
- National Synchrotron Radiation Research Center, Hsinchu, 300, Taiwan
| | - H J Lin
- National Synchrotron Radiation Research Center, Hsinchu, 300, Taiwan
| | - J F Lee
- National Synchrotron Radiation Research Center, Hsinchu, 300, Taiwan
| | - K Asokan
- Inter-University Accelerator Center, Aruna Asaf Ali Marg, New Delhi, 110 067, India
| | - W F Pong
- Department of Physics, Tamkang University, Tamsui, 251, Taiwan.
| |
Collapse
|
6
|
Shao YC, Liou JC, Kuo CY, Tsai YS, Lin EC, Hsieh CJ, Lin SP, Chen BY. UVB promotes the initiation of uveitic inflammatory injury in vivo and is attenuated by UV-blocking protection. Mol Vis 2017; 23:219-227. [PMID: 28446860 PMCID: PMC5390783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 04/10/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Uveitic inflammatory injury can cause irreversible visual loss; however, no single animal model recapitulates all the characteristics of human uveitis. Ultraviolet radiation (UVR) is one of the risk factors for uveitis, but the role of UVR in the pathogenesis of uveitic injury is unclear. The aim of this study was to elucidate whether UVB promotes the initiation of, and subsequently contributes to, uveitic inflammatory injury. METHODS Mice were assigned to either a blank control group or one of three UVB treatment groups: no protection, protection with Nelfilcon A contact lens (Food and Drug Administration [FDA] class II, about 46.8% UVB transmittance), or protection with Etafilcon A contact lens (FDA class IV, about 0.55% UVB transmittance). The contact lenses acted as blocking barriers against UVR. After the application of UVR, pathologic injuries were determined with slit-lamp microscopy and histologic examination. RESULTS Compared with the intact status of the controls, the anterior eyes of the UVB groups showed pathologic alterations in physiologic properties and tissue integrity. UVR promoted anterior uveitic inflammatory injury, with expansion of the hyperemic iris vessels, over-production of aqueous humor protein, disruption of the blood-aqueous barrier, and embedding of infiltrative leukocytes inside the iridocorneal angle. However, blockage of UVR in vivo retarded the progression of uveitic inflammatory injury. The highest level of UV protection in the Etafilcon A group resulted in greater inhibition of uveitic inflammatory injury than that in the Nelfilcon A group. CONCLUSIONS This study demonstrates that UVB initiated and promoted uveitic inflammatory injury. UV protection is needed for the clinical management of anterior uveitis. The Etafilcon A lenses provide better protection of the anterior segment of the eye against UVB damage compared with the Nelfilcon A lenses.
Collapse
Affiliation(s)
- Yi-Ching Shao
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan,Department of Optometry, Chung Shan Medical University, Taichung, Taiwan
| | - Jyh-Cheng Liou
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan,Department of Optometry, Chung Shan Medical University, Taichung, Taiwan,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chan-Yen Kuo
- Institute of Systems Biology and Bioinformatics, National Central University, Jhongli, Taiwan
| | - Yun-Shan Tsai
- Department of Optometry, Chung Shan Medical University, Taichung, Taiwan,Institute of Optometry, Chung Shan Medical University, Taichung, Taiwan
| | - En-Chieh Lin
- Institute of Optometry, Chung Shan Medical University, Taichung, Taiwan,Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
| | - Ching-Ju Hsieh
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan,Department of Optometry, University of Kang Ning, Taipei, Taiwan
| | - Si-Ping Lin
- Department of Optometry, Chung Shan Medical University, Taichung, Taiwan,Institute of Optometry, Chung Shan Medical University, Taichung, Taiwan
| | - Bo-Yie Chen
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan,Department of Optometry, Chung Shan Medical University, Taichung, Taiwan,Institute of Optometry, Chung Shan Medical University, Taichung, Taiwan
| |
Collapse
|
7
|
Wang YF, Singh SB, Limaye MV, Shao YC, Hsieh SH, Chen LY, Hsueh HC, Wang HT, Chiou JW, Yeh YC, Chen CW, Chen CH, Ray SC, Wang J, Pong WF, Takagi Y, Ohigashi T, Yokoyama T, Kosugi N. Visualizing chemical states and defects induced magnetism of graphene oxide by spatially-resolved-X-ray microscopy and spectroscopy. Sci Rep 2015; 5:15439. [PMID: 26481557 PMCID: PMC4612711 DOI: 10.1038/srep15439] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/02/2015] [Indexed: 11/23/2022] Open
Abstract
This investigation studies the various magnetic behaviors of graphene oxide (GO) and reduced graphene oxides (rGOs) and elucidates the relationship between the chemical states that involve defects therein and their magnetic behaviors in GO sheets. Magnetic hysteresis loop reveals that the GO is ferromagnetic whereas photo-thermal moderately reduced graphene oxide (M-rGO) and heavily reduced graphene oxide (H-rGO) gradually become paramagnetic behavior at room temperature. Scanning transmission X-ray microscopy and corresponding X-ray absorption near-edge structure spectroscopy were utilized to investigate thoroughly the variation of the C 2p(π*) states that are bound with oxygen-containing and hydroxyl groups, as well as the C 2p(σ*)-derived states in flat and wrinkle regions to clarify the relationship between the spatially-resolved chemical states and the magnetism of GO, M-rGO and H-rGO. The results of X-ray magnetic circular dichroism further support the finding that C 2p(σ*)-derived states are the main origin of the magnetism of GO. Based on experimental results and first-principles calculations, the variation in magnetic behavior from GO to M-rGO and to H-rGO is interpreted, and the origin of ferromagnetism is identified as the C 2p(σ*)-derived states that involve defects/vacancies rather than the C 2p(π*) states that are bound with oxygen-containing and hydroxyl groups on GO sheets.
Collapse
Affiliation(s)
- Y F Wang
- Department of Physics, Tamkang University, Tamsui 251, Taiwan.,Institute for Molecular Science, Okazaki 444-8585, Japan
| | - Shashi B Singh
- Department of Physics, Tamkang University, Tamsui 251, Taiwan.,Department of Physics, Indian Institute of Science Education and Research, Bhopal 462066, India
| | - Mukta V Limaye
- Department of Physics, Tamkang University, Tamsui 251, Taiwan.,Department of Physics, Indian Institute of Science Education and Research, Bhopal 462066, India
| | - Y C Shao
- Department of Physics, Tamkang University, Tamsui 251, Taiwan
| | - S H Hsieh
- Department of Physics, Tamkang University, Tamsui 251, Taiwan
| | - L Y Chen
- Department of Physics, Tamkang University, Tamsui 251, Taiwan
| | - H C Hsueh
- Department of Physics, Tamkang University, Tamsui 251, Taiwan
| | - H T Wang
- Department of Physics, National Tsinghua University, Hsinchu 300, Taiwan
| | - J W Chiou
- Department of Applied Physics, National University of Kaohsiung, Kaohsiung 811, Taiwan
| | - Y C Yeh
- Department of Materials Science and Engineering, National Taiwan University, Taipei 106, Taiwan
| | - C W Chen
- Department of Materials Science and Engineering, National Taiwan University, Taipei 106, Taiwan
| | - C H Chen
- National Synchrotron Radiation Research Center, Hsinchu 300, Taiwan
| | - Sekhar C Ray
- Department of Physics, University of South Africa, Johannesburg 1710, South Africa
| | - J Wang
- Canadian Light Source Inc., University of Saskatchewan, Saskatoon S7N 2V3, Canada
| | - W F Pong
- Department of Physics, Tamkang University, Tamsui 251, Taiwan
| | - Y Takagi
- Institute for Molecular Science, Okazaki 444-8585, Japan
| | - T Ohigashi
- Institute for Molecular Science, Okazaki 444-8585, Japan
| | - T Yokoyama
- Institute for Molecular Science, Okazaki 444-8585, Japan
| | - N Kosugi
- Institute for Molecular Science, Okazaki 444-8585, Japan
| |
Collapse
|
8
|
Abstract
The management of radial nerve palsy associated with fractures of the shaft of the humerus has been disputed for several decades. This study has systematically reviewed the published evidence and developed an algorithm to guide management. We searched web-based databases for studies published in the past 40 years and identified further pages through manual searches of the bibliography in papers identified electronically. Of 391 papers identified initially, encompassing a total of 1045 patients with radial nerve palsy, 35 papers met all our criteria for eligibility. Meticulous extraction of the data was carried out according to a preset protocol. The overall prevalence of radial nerve palsy after fracture of the shaft of the humerus in 21 papers was 11.8% (532 palsies in 4517 fractures). Fractures of the middle and middle-distal parts of the shaft had a significantly higher association with radial nerve palsy than those in other parts. Transverse and spiral fractures were more likely to be associated with radial nerve palsy than oblique and comminuted patterns of fracture (p < 0.001). The overall rate of recovery was 88.1% (921 of 1045), with spontaneous recovery reaching 70.7% (411 of 581) in patients treated conservatively. There was no significant difference in the final results when comparing groups which were initially managed expectantly with those explored early, suggesting that the initial expectant treatment did not affect the extent of nerve recovery adversely and would avoid many unnecessary operations. A treatment algorithm for the management of radial nerve palsy associated with fracture of the shaft of the humerus is recommended by the authors.
Collapse
Affiliation(s)
- Y C Shao
- Department of Trauma & Orthopaedic Surgery School of Medicine, St James's University Hospital, Leeds, UK
| | | | | | | | | |
Collapse
|