Relapsing polychondritis is a rare multisystem rheumatic disease,characterized by recurrent and potentially destructive inflammatory lesions of cartilaginous structures.All types of cartilage & other proteoglycan-rich structures may be involved,resulting in auricular chondritis,laryngotracheal chondritis,ocular symptoms,vasculitis,cardiac abnormalities,skin lesions and glomerulonephritis. The disease may be associated with another connective tissue and autoimmune diseases such as rheumatoid arthritis,systemic lupus erythematosus,Sjogren's syndrome and systemic vasculitis. We experienced a 69-year-old female patient who had been previously diagnosed as Sjogren's syndrome,presenting respiratory tract involvement,episcleritis,auricular chondritis and vestibular dysfunction.
Aged ; Autoimmune Diseases ; Cartilage ; Connective Tissue ; Female ; Glomerulonephritis ; Humans ; Polychondritis, Relapsing* ; Respiratory System ; Sjogren's Syndrome* ; Systemic Vasculitis

Keloids are benign fibrcus growths which extend beyond the original wound and rarely regress. Available methods of treatment include surgical excision, radiotherapy, intralesional steroid injection, cryotherapy, systemie. chemotherapy, zinc tape strapping, pressure, silicon gel and combined therapy. Postoperative irradiation is a useful and effective method of eradication or prevent.ion of keloid. We describe two cases of the prevention of keloids associated with postoperative irradiation.
Cryotherapy ; Drug Therapy ; Keloid* ; Radiotherapy ; Silicone Gels ; Wounds and Injuries ; Zinc

A hand-arm vibration syndrome, local vibration illness, occurs in some workers who use hand held vibration tools. It consists of white fingers, diffusely distributed finger neuropathy, pain in the hand and arm, and a small excess risk of osteoarthritis. This study is aimed to identify effective methods to confirm local vibration illness among various health exams, which are mentioned in worker's special health exam regulation. In addition, this study is aimed to quantitatively assess the daily vibration exposure level as a major determinant of vibration illness. The subjects, 46 vibration workers, were selected according to the results of the first special health exam about vibration hazards at shipbuilding industry in 1997. They all had experiences of work related blanching of fingers. Fifteen controls, who had no vibration exposure at all, were also recruited to compare their test results with the results of vibration workers. We adopted 1 subjective and 6 objective tests to evaluate the effectiveness and feasibility for confirming local vibration illness. These tests were history taking of subjective symptoms according to the Stockholm classification, checking blood pressure of finger, checking grasp power, checking finger skin temperature, nail-bed pressing test, vibration perceptional threshold test, and skin prick test for pain perception. Among these, checking skin temperature, nail-bed pressing test, and vibration perception test included cold water provocations. We also estimated some vibration exposure levels of hand held vibration tools by using previously published data from one automobile company. In conclusion, history taking of subjective symptoms according to the Stockholm classification, nail-bed pressing test, and vibration perceptional threshold test were discovered to be effective to diagnose local vibration illness. Furthermore, vibration perceptional threshold on right fingers showed a dose-response relationship to daily vibration exposure levels. The parameter beta was 0.0005(+/-0.0002), and statistically significant by REM (random effects model).
Arm ; Automobiles ; Blood Pressure ; Classification ; Fingers ; Hand ; Hand Strength ; Hand-Arm Vibration Syndrome ; Osteoarthritis ; Pain Perception ; Skin ; Skin Temperature ; Vibration* ; Water

OBJECTIVES: This study was conducted to estimate the incidence rate, and to identify the risk factors for the occupational low back pain among shipyard workers. METHODS: The study subjects consisted of 9,784 workers who were employed in a ship-building industry(excluded workers who had a history of low pack pain before 1995 or did not take periodic health examination in 1995). The cases were 220 people who experienced back pain from January 1, 1996 to December 31, 1998. To assess risk factors for occupational low back pain, Cox propotional hazard model was used. RESULTS: During the recent three years from 1996 to 1998, the incidence rate per 1,000 persons was 7. 8 in 1996, 8. 8 in 1997, and 3. 1 in 1998. The main causes of work-related low back pain were sprain, strain and disc herniation. Lifting was the most common cause of back pain(35. 3%), and carrying(10.2%) and pulling(8.0%) were followed. In Cox proportional harzard model, independent risk factors for back pain were body mass index(R.R.; 1.54, 959o C.I.: 1.06-2.25), shift work(R.R.; 1.65, 95% C.I.: 1.19-2.28), and lifting heavy material(R.R. ; 3.95, 95% C.I: 2.29-6.82). CONCLUSIONS: This study suggests that the risk factors of back pain in shipyard workers were body mass index, shift work and lifting.
Back Pain ; Body Mass Index ; Humans ; Incidence* ; Lifting ; Low Back Pain* ; Proportional Hazards Models ; Risk Factors* ; Sprains and Strains

Traumatic arteriovenous fistulas (AVFs) involving the external carotid artery are exceedingly rare in young adults. Since an AVF is the most common life-threatening cause for pulsatile tinnitus (PT), meticulous evaluation and treatment of patients with PT is crucial. Here, we present two traumatic AVF cases treated with coil embolization leading to no residual fistulous connections followed by an immediate and complete resolution of PT. A 20-year-old man developed left ear tinnitus three months after a traumatic brain injury involving the right temporal bone fracture. Cerebral angiography demonstrated an enlarged left middle meningeal artery (MMA) and a fistular point at the posterior branch of the MMA draining to the middle meningeal vein (MMV) and the left pterygoid plexus, suggesting an AVF. Another 18-year-old girl developed left tinnitus, left exophthalmos, and conjunctival injection 6 months after a traffic accident involving no demonstrable abnormal findings in the radiologic exam. Magnetic resonance angiography demonstrated a markedly dilated left MMA draining to the MMV, left cavernous sinus, and left superior ophthalmic vein. In both cases, coil embolization was performed with total obliteration of the fistular point.

OBJECTIVES: The purpose of this study was to assess the relationship between job strains and absenteeism from work. METHODS: The study design was cross-sectional, and the study subjects consisted of 1,166 workers who were employed in the small-sized industries. A self administered questionnaire was used to measure the general characteristics, job characteristics(job demand, job control), and social support(coworker support, supervisor support) at work. The Job Content Questionnaire(JCQ) was used to assess job demand(2 items) and decision lattitude(10 items). Social support at work (10 items) was measured using JCQ. Sick absence was collected using self-report and were rechecked by the attendance record of their company. Odds ratios and 95% confidence intervals for the association between job strain and sick absence were estimated. The modifying effect of social support was evaluated by stratification. Logistic regression was used to estimate the relationship between job strain and sick absence. RESULTS: In the bivariate analysis, the variables related to sick absence were age, marital status, occupation, job demand. Four distinctly different kinds of level of job strain were generated by the combination of job demand and job control: low strain group, high strain group, active group, and passive group. The crude odds ratio of high job strain was 1.78(95% CI: 1.26-2.53), and those of active group and passive group were 1.33(95% CI: 1.07-1.66) and 1.13 (95% CI: 0.88-1.47), respectively. The odds ratio of high job strain after adjusting for age and occupation were still significant. The odds ratio of high job strain in low social support was 5.96(95% CI: 2.45-14.51), but that in high social support was 0.73(95% CI: 0.26-2.01). CONCLUSIONS: Job strain was associated with increased risk of absenteeism from work, and social support at work modified the association between job strain and sick absence.
Absenteeism* ; Logistic Models ; Marital Status ; Occupations ; Odds Ratio ; Surveys and Questionnaires

Colorectal varix (CRV) is a rare cause of lower gastrointestinal bleeding and usually associated with portal hypertension from liver cirrhosis or portal venous obstruction. Idiopathic CRV have no identifiable underlying cause and can only be diagnosed after the cause of portal or mesenteric vein circulation have been excluded. We report a case of idioipathic CRV presented with rectal bleeding for a week. Colonoscopy revealed markedly dilatated tortuous, and bluish veins in the rectum as well as coexistent adenomatous polyp and internal hemorrhoid. Despite extensive investigation, there was no evidence of portal hypertension or any other cause. Family history was also negative. Although blood transfusions were required, the patient remained asymptomatic without further rectal bleeding.
Adenomatous Polyps ; Blood Transfusion ; Colonoscopy ; Hemorrhage ; Hemorrhoids ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Mesenteric Veins ; Rectum ; Varicose Veins* ; Veins

PURPOSE: To apply a distributed circuit theory, to develop a head-size transverse electromagnetic(TEM) resonator coil for a home-built 3T whole-body MRI system and to report an efficiency of the coil. MATERIALS AND METHODS: The dimension of TEM resonator with 16 cavity element, the diameter of copper rod was 0.63cm and its length was 13.75cm. As raw materials, the purity of copper rod was 98% and the dielectric constant of teflon was 2.08. RESULTS: The TEM head-size resonator with 16cavity elements exhibiting 9-mode resonances was robust to the surrounding influences owing to the self-shielding structure. The isolation of quadrature with a human brain was 364 and the ratio of Q(unloaded/Q(loaded) was 2.9. CONCLUSION: It was successfully demonstrated that the TEM head-size resonator with high Q factor can provide high quality MR images at 3T MRI system. Also, the TEM resonator coil has an advantage for a fine tune with length adjustment of each cavity elements. Thus, it is expected that the TEM resonator at 3T, even higher field could be used in the clinical and research studies in near future.
Brain ; Copper ; Head* ; Humans ; Magnetic Resonance Imaging* ; Polytetrafluoroethylene

PURPOSE: Insistence that total regression of primary tumor would not represent long-term oncologic outcomes has been raised. Therefore, this study aimed to evaluate the outcomes of these patients after preoperative chemoradiotherapy (PCRT) and radical surgery and to evaluate the associated risk factors. METHODS: We included 189 patients with rectal cancer who showed total regression of the primary tumor after PCRT, followed by radical resection, between 2001 and 2012. Recurrence-free survival (RFS) was calculated using the Kaplan-Meier method, and the results were compared with 77 patients with Tis rectal cancer who received only radical resection. Factors associated with RFS were evaluated using Cox regression analysis. RESULTS: Sphincter-saving resection was performed for 146 patients (77.2%). Adjuvant chemotherapy was administered to 168 patients (88.9%). During the follow-up period, recurrence occurred in 17 patients (9%). The 5-year RFS was 91.3%, which was significantly lower than that of patients with Tis rectal cancer without PCRT (P = 0.005). In univariate analysis, preoperative CEA and histologic differentiation were associated with RFS. However, no factors were found to be associated with RFS. CONCLUSION: RFS was lower in patients with total regression of primary rectal cancer after PCRT than in those with Tis rectal cancer without PCRT, and it would not be considered as the same entity with early rectal cancer or “disappeared tumor” status.
Chemoradiotherapy ; Chemotherapy, Adjuvant ; Follow-Up Studies ; Humans ; Methods ; Rectal Neoplasms ; Recurrence ; Risk Factors

PURPOSE: We wanted to compare the insufficiency stress fractures of the femoral neck (group I) with the traumatic femoral neck fractures (group II) in patients who were 70 years of age and older. MATERIALS AND METHODS: Between January 2000 and October 2006, we evaluated 10 insufficiency stress fractures among 191 femoral neck fractures in patients who were 70 years of age and older. We compared these fractures with the traumatic femoral neck fractures by using the bone mineral density (BMD), neck-shaft angle, the hip axis length (HAL) and the ratio of the HAL to the femoral neck width. RESULTS: The incidence of insufficiency stress fracture was 5.2%. There were 6 cases of displaced fractures and 4 cases of non-displaced fractures. All of non-displaced fractures revealed the tension (transverse) type. The mean neck-shaft angle was 130.45 degrees in group I and this was 131.94 degrees in group II. The mean HAL was 117.6 mm in group I and 115.3 mm in group II, and the ratio of the HAL to the femoral neck width was 0.30 in each group. The BMD (T-score) was -3.73 in group I and -3.4 in group II. CONCLUSION: The BMD of the insufficiency fracture group was significantly lower than that of the traumatic femoral neck fracture group. However, there were no significant differences in the neck-shaft angle, the HAL and the ratio of the HAL to femoral the neck width between the 2 groups.
Aged ; Axis, Cervical Vertebra ; Bone Density ; Femoral Neck Fractures ; Femur Neck ; Fractures, Stress ; Hip ; Humans ; Incidence ; Neck