Although acute traumatic fractures of the clavicle are relatively common, stress fractures of the proximal clavicle are extremely rare. Stress fractures of the clavicle have often been reported after a radical neck dissection or radiation but rarely occur during excessive repetitive exercise in professional athletes. The authors report a case of a stress fracture of the proximal clavicle during exercise in a young man with no specific preceding factors, which has not been reported in the Korean literature.
Athletes ; Clavicle ; Fractures, Stress ; Humans ; Male ; Neck Dissection

Retinal detachment is a rare disease in children but cases of serous retinal detachment due to use of systemic corticosteroids have been reported in and out country. Rhematogenous retinal detachment has developed in a child with oral and steroid pulse therapy due to nephrotic syndrome. He was treated with laser and buckling in right and left eye respectively. Currently he is under observation through the out patient department.
Adrenal Cortex Hormones ; Child* ; Humans ; Nephrotic Syndrome* ; Rare Diseases ; Retinal Detachment* ; Retinaldehyde*

Occupational asthma (OA) can improve after cessation of exposure; however, some patients suffer from persistence or aggravation of their asthmatic symptoms. Here we report a case of a new sensitization to house dust mites during the follow-up period in a 37-year-old female patient with OA induced by cefteram pivoxil powder (cefteram powder). She was previously diagnosed with OA caused by inhalation of cefteram powder. Consequently, she left her job and had been well for 9 subsequent years. She began to experience aggravation of her rhinitis and asthmatic symptoms again several months prior to presentation. Her skin-prick test results had converted to strongly positive responses to two types of house dust mites. The serum levels of eosinophil cationic protein (ECP) and the total and specific immunoglobulin (Ig)E levels against the two types of house dust mites were elevated. An inhalation challenge test with Dermatophagoides farinae was performed, and significant bronchoconstriction (21.1% reduction in the forced expiratory volume in the first second) with asthma symptoms was observed at 10 minutes. To our knowledge, this is the first case demonstrating a new sensitization to house dust mites in a patient with OA caused by cefteram powder. Regular monitoring, including skin-prick tests and measurement of specific serum IgE/ECP levels, may help to screen potential cases.
Adult ; Asthma ; Asthma, Occupational ; Bronchoconstriction ; Cefmenoxime ; Dermatophagoides farinae ; Dust ; Eosinophil Cationic Protein ; Female ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Immunoglobulins ; Inhalation ; Occupations ; Pyroglyphidae ; Rhinitis

Various reactive dyes can elicit occupational asthma in exposed textile industry workers. To date, there has been no report of occupational asthma caused by the red dye Synozol Red-K 3BS (Red-K). Here, we report a 38-year-old male textile worker with occupational asthma and rhinitis induced by inhalation of Red-K. He showed positive responses to Red-K extract on skin-prick testing and serum specific IgE antibodies to Red-K-human serum albumin conjugate were detected using an enzyme-linked immunosorbent assay. A bronchoprovocation test with Red-K extract resulted in significant bronchoconstriction. These findings suggest that the inhalation of the reactive dye Red-K can induce IgE-mediated occupational asthma and rhinitis in exposed workers.
Adult ; Antibodies ; Asthma ; Asthma, Occupational ; Bronchoconstriction ; Coloring Agents ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Inhalation ; Male ; Occupations ; Rhinitis ; Serum Albumin ; Textile Industry ; Textiles

PURPOSE: Although the mechanism of virus-induced, aspirin-exacerbated respiratory disease (AERD) is not known fully, direct activation of viral components through Toll-like receptor 3 (TLR3) has been suggested. TLR3 recognizes double-stranded RNA (dsRNA), and activates nuclear factor-kappaB and increases interferon-gamma, which signals other cells to induce airway inflammation in asthma. Considering the association of TLR3 in viral infections and AERD, we investigated whether promoter and non-synonymous variants of TLR3 were associated with AERD. METHODS: The three study groups, 203 with AERD, 254 with aspirin-tolerant asthma (ATA), and 274 normal healthy controls (NC) were recruited from Ajou University Hospital, Korea. Two polymorphisms, -299698G>T and 293391G>A [Leu412Phe], were genotyped using primer extension methods. RESULTS: Genetic associations were examined between two genetic polymorphisms of TLR3 (-299698G>T and 293391G>A [Leu412Phe]) in the three study groups. AERD patients that carried the GG genotype of 293391G>A showed a significantly lower frequency compared with ATA in both co-dominant (P=0.025) and dominant models (P=0.036). Similarly, in the minor allele frequency, the A allele was significantly higher (P=0.023) in AERD compared with ATA for this polymorphism. AERD patients who carried HT2 [GA] showed a significantly higher frequency than other haplotypes in co-dominant (P=0.02) and recessive (P=0.026) models. CONCLUSIONS: Our findings suggest that the -299698G>T and 293391G>A [Leu412Phe] polymorphisms of the TLR3 gene are associated with the AERD phenotype.
Alleles ; Asthma ; Gene Frequency ; Genotype ; Haplotypes ; Humans ; Inflammation ; Interferon-gamma ; Korea ; Phenotype ; Polymorphism, Genetic ; RNA, Double-Stranded ; Toll-Like Receptor 3 ; Toll-Like Receptors ; Viral Structures

Multiple autoimmune syndrome (MAS) is a rare condition, in which at least three well-defined autoimmune diseases co-occur in a single patient. Although the pathogenesis of MAS remains poorly understood, genetic, immunological, hormonal, and environmental factors may all play a role. Although three classic subtypes of MAS are well known, several cases that could not be placed into any of these three categories have recently been reported. To the best of our knowledge, the co-existence of psoriasis, vitiligo, and Crohn's disease has been reported in only one patient, who had a total of five autoimmune diseases (alopecia areata and oral lichen planus in addition to the three conditions mentioned). We herein describe a rare case of MAS presenting with psoriasis, vitiligo, and Crohn's disease, and suggest that tumor necrosis factor-α may be associated with the pathogenesis of all three conditions.
Autoimmune Diseases ; Crohn Disease* ; Humans ; Lichen Planus, Oral ; Necrosis ; Psoriasis* ; Vitiligo*

STUDY DESIGN: This study is a retrospective evaluation of the surgical outcome by the patient satisfaction and Oswestry low back pain questionnaire. OBJECTIVE: The goal of this study was to evaluate the clinical correlations of various factors with the patient's satisfaction and with the surgical results in degenerative spinal stenosis. SUMMARY OF LITERATURE REVIEW: The patients satisfaction and surgical outcome of the degenerative spinal stenosis by the objective method have not been well described in the literature. MATERIAL AND METHODS: Mean follow-up period was 4.8 years after surgery in 114 patients. Outcome was based on subjective disability using Oswestry low back pain questionnaire. Patient satisfaction degree was rated to 'very satisfied(1)', 'somewhat satisfied(2)', 'somewhat dissatisfied(3)' and 'very dissatisfied(4)'. Several factors that might be associated with patient satisfac-tion and outcome were investigated. RESULTS: Of the one hundred and fourteen patients, 84(73.9%) were satisfied to the surgery and mean satisfaction degree was 1.94. Ninety two patients(80.7%) had excellent-to-good results with the mean Oswestry disability score 26.9. There were 7 complications including dural tear in 3 cases, pseudarthrosis in 1 case, dissociation between rod and screw in 1 case, pedicle screw breakage in 1 case and termination of operatin due to massive bleeding during operation in 1 case. CONCLUSION: Clinical results and patient satisfaction were better in the cases with short segments fusion than long segments fusion and the patients with preoperative leg symptom as major symptom had significantly lower Oswestry disability score.
Follow-Up Studies ; Hemorrhage ; Humans ; Leg ; Low Back Pain ; Patient Satisfaction* ; Pseudarthrosis ; Surveys and Questionnaires ; Retrospective Studies ; Spinal Stenosis*

PURPOSE: The purpose of this study was to investigate the reosseointegration periods when the rough surface implants, which had complete bone-implant ankylosis, suddenly losed the osseointegration. MATERIALS AND METHODS: The implants with RBM surface treatment were inserted into both tibias of 23 rabbits. Two implants were submerged into each side. After six weeks, the primary removal torque was measured by Digital torque gauge, and then the implants were replaced and submerged to estimate the level of reosseointegration. After assigned healing periods for each group, the removal torque was measured again. BIC (Bone-Implant contact, %) ratio was measured through histomorphometric analysis.Paired t-test was processed by SPSS 14.0. One-way ANOVA and Tukey's post-hoc test was processed to analyze statistically significant differences among the groups. RESULTS: In comparison with the primary removal torque, the secondary removal torque was increased after 11 days and significantly increased from 2 weeks. In fluorochrome labeling, the origin of mineralization was observed after 7 days, which showed as fluorescent bands around the boneimplant interfaces. After 11 days, the bone formation was apparent, and it is increased continuously with the passage of the time. CONCLUSION: In 11 days after the implant replacement, the secondary removal torque was almost as same as the primary value, and was significantly higher from 2 weeks. The mineralized shapes were observed in 7 days after the implant replacement, and then thebone formation appeared visibly in 11 days.
Ankylosis ; Osseointegration ; Osteogenesis ; Rabbits ; Tibia ; Torque

Thymic carcinoma is a rare malignant neoplasm of the thymic epithelium, distinguished from benign or invasive thymoma by the presence of malignant cytology and a greater incidence of local invasion and embolic metastases. The true incidence of this neoplasm is unknown. Nearly three fourth of their patients had symptoms of an anterior mediastinal mass, including cough, chest pain, and superior vena cava syndrome. These patients rarely have myasthenia gravis or other thymoma-associated paraneoplastic syndromes. The treatment of thymic carcinoma remains a controversial matter. We report eight cases of thymic carcinoma treated in our institution from 1990 to 1997.
Chest Pain ; Cough ; Epithelium ; Humans ; Incidence ; Mediastinum ; Myasthenia Gravis ; Neoplasm Metastasis ; Paraneoplastic Syndromes ; Superior Vena Cava Syndrome ; Thymoma*

The aim of this study was to analyze long-term survivals in patients with stage IB to IIA cervical cancer treated by neoadjuvant chemotherapy setting. Between February 1989 and January 1998, 94 women with previously untreated stage IB to IIA carcinoma of the uterine cervix who received cisplatin based neoadjuvant chemotherapy were enrolled in this study. All of patients with chemoresponse (complete response, n=15; partial response, n=47) and 16 patients with chemoresistance received radical surgery (RS group). The other 16 patients with chemoresistance received radiotherapy for definite treatment (RT group). In the RS group, the 10 yr survival estimation in patients with bulky tumors (diameter > or =4 cm, n=26) was similar to that with non-bulky tumors (83.3% vs. 89.3%, p=NS). In selected patients with chemoresistance, those treated by radiotherapy (n=16) showed significantly poorer survivals than those treated by radical surgery (n=16) [10 yr survival rates of RT (25%) vs. RS (76.4%), p=0.0111]. Our results support that a possible therapeutic benefit of neoadjuvant chemotherapy plus radical surgery is only in patients with bulky stage IB to IIA cervical cancer. In cases of chemoresistance, radical surgery might be a better definite treatment option.
Uterine Cervical Neoplasms/drug therapy/*radiotherapy/*surgery ; Treatment Outcome ; Survival Analysis ; Retrospective Studies ; Prognosis ; Neoplasm Staging ; Multivariate Analysis ; Middle Aged ; Humans ; Follow-Up Studies ; Fluorouracil/administration & dosage ; Female ; Drug Resistance, Neoplasm ; Combined Modality Therapy ; Cisplatin/administration & dosage ; Chemotherapy, Adjuvant ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Adult