Osteoporosis due to the rheumatoid arthritis and the glucocorticoid therapy predisposes patients to insufficiency fractures. Insufficiency fractures or periprosthetic fractures of the lower extremity in the rheumatoid arthritis have been frequently reported. But those of the upper extremity were rarely reported. We report three cases of the insufficiency fracture of the olecranon after total elbow replacement arthroplasty in patients with the rheumatoid arthritis. All the cases were successfully treated by immobilization for 3 weeks. At the last follow-up, there were no functional impairments or residual symptoms caused by the fractures.
Arthritis, Rheumatoid* ; Arthroplasty* ; Arthroplasty, Replacement, Elbow* ; Follow-Up Studies ; Fractures, Stress* ; Humans ; Immobilization ; Lower Extremity ; Olecranon Process* ; Osteoporosis ; Periprosthetic Fractures ; Upper Extremity

Congenital adrenal hyperplasia, which is caused by the disorder of the enzyme for synthesizingadrenal hormones, results in hypertropy of the clitoris due to overporduction of adrenalandrogen. Diagnosis of the congenital adrenal hyperplasia can be obtained by the study ofsteroid levels in blood and urine. The blood levels of ACTH, testosterone and 17-hydroxyprogesteronewere increased and the concentration of 17-ketosteroid were decreased after the dexamethasonesuppression test. The internal genital organ was normal appearance on the pelvic CTscan. Clitoromegaly due to congenital adrenal byperplasia was corrected previously by the variousoperational procedures in which the clitoris was removed entirely for only physial appearance.However the sensitive function of the clitoris after the operative correction throughpuberty is to be preserved by the method "clitoroplasty" for preserving neurovascular supply tothe clitoris. The writer experienced a case of a 5-year-old girl with congenital adrenalhyperplasia and tried this clitoroplasty for surgical treatment of clitoromegly for preservation ofpostoperative sensitivity of the clitoris.
Adrenal Hyperplasia, Congenital* ; Adrenocorticotropic Hormone ; Child, Preschool ; Clitoris* ; Diagnosis ; Female ; Genitalia ; Humans ; Testosterone

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.
Absorption ; Biological Availability ; Fasting ; Gastric Acid ; Hospitals, General ; Humans ; Itraconazole* ; Korea ; Outpatients ; Tablets ; Tinea Pedis* ; Tinea* ; Treatment Failure