Entrapment of the extensor pollicis longus tendon is reported rarely on Smith's fractures in children. In our case, a 15 year old boy with Smith's fracture received treatment of closed reduction at another hospital. When he visited our hospital, a wide gap at the fracture site was detected on radiograph and the thumb movement was limited. We have doubt the entrapment of the soft tissue, especially the tendon. We decided on open reduction. In the operation field, entrapment of the extensor pollicis longus tendon at the gap of the fracture site was found through dorsal approach. In addition, fracture treatment with K-wire fixation after reduction of extensonr pollicis longus tendon reduction was done. Therefore, we report this case with a review of the literatures.
Child ; Humans ; Tendons ; Thumb

PURPOSE: We investigated the prognostic impact of discordance between the receptor status of primary breast cancers and corresponding metastases. METHODS: A total 144 patients with breast cancer and distant metastasis were investigated. The estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status of primary tumor and corresponding metastases were assessed. Tumor phenotype according to receptor status was classified as triple-negative phenotype (TNP) or non-TNP. Concordance and discordance was determined by whether there was a change in receptor status or phenotype between primary and metastatic lesions. RESULTS: The rates of discordance between primary breast cancer and metastatic lesions were 18.1%, 25.0%, and 10.3% for ER, PR, and HER2, respectively. The rates of concordant non-TNP, concordant TNP and discordant TNP were 65.9%, 20.9%, and 13.2%, respectively. Patients with concordant ER/PR-negative status had worse postrecurrence survival (PRS) than patients with concordant ER/PR-positive and discordant ER/PR status (p=0.001 and p=0.021, respectively). Patients who converted from HER2-positive to negative after distant metastasis had worst PRS (p=0.040). Multivariate analysis showed that concordant TNP was statistically significant factor for worse PRS (p<0.001). CONCLUSION: Discordance in receptor status and tumor phenotype between primary breast cancer and corresponding metastatic lesions was observed. Patients with concordant TNP had worse long-term outcomes than patients with concordant non-TNP and discordant TNP between primary and metastatic breast cancer. Identifying the receptor status of metastatic lesions may lead to improvements in patient management and survival.
Breast Neoplasms ; Breast* ; Estrogens ; Humans ; Multivariate Analysis ; Neoplasm Metastasis* ; Phenotype* ; Prognosis* ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone

Breast cancer ranks second to stomach cancer as a primary cancer site. An increasing trend in mortality and morbidity of breast cancet has been shown since 1980s. Studies on migrant populations, in which higher incidences were shown than population in their motherlands, indicated the importance of environmental factors on breast cancer development. Older age, family history of breast cancer, early menarche, late menopause, late full-term pregnancy, never-having had a breast-fed child, and postmenopausal obesity were idenrified as risk factors in Korea. These are not different from risk factors detected in western countries. Nevertheless, a ^-shape age-specific incidences surve is shown in Korea shose incidence is relatively low. In western countries, where incidence rates are high, the incidences increase with age in a straight line. This difference may be explained by the "Estrogen-Augmented-:rogesterone Hypothesis" that is relevant to sex hormones. In fact, a nuch lower estradiol levels was reported in Korean women compared to those in American. On the other hand, genetic polymorphism is expected for future research on breast cancer etiology. Only preventive strategies based on epidemiology of breast cancer in Korea may effective to counter this malignancy in Korean women.
Breast Neoplasms* ; Breast* ; Child ; Epidemiology ; Estradiol ; Female ; Gonadal Steroid Hormones ; Hand ; Humans ; Incidence* ; Korea* ; Menarche ; Menopause ; Mortality ; Obesity ; Polymorphism, Genetic ; Pregnancy ; Risk Factors ; Stomach Neoplasms ; Transients and Migrants

PURPOSE: We evaluated the efficacy of breast magnetic resonance imaging (MRI) for detecting additional malignancies in breast cancer patients newly diagnosed by breast ultrasonography and mammography. METHODS: We retrospectively reviewed the records of 1,038 breast cancer patients who underwent preoperative mammography, bilateral breast ultrasonography, and subsequent breast MRI between August 2007 and December 2010 at single institution in Korea. MRI-detected additional lesions were defined as those lesions detected by breast MRI that were previously undetected by mammography and ultrasonography and which would otherwise have not been identified. RESULTS: Among the 1,038 cases, 228 additional lesions (22.0%) and 30 additional malignancies (2.9%) were detected by breast MRI. Of these 228 lesions, 109 were suspected to be malignant (Breast Imaging-Reporting and Data System category 4 or 5) on breast MRI and second-look ultrasonography and 30 were pathologically confirmed to be malignant (13.2%). Of these 30 lesions, 21 were ipsilateral to the main lesion and nine were contralateral. Fourteen lesions were in situ carcinomas and 16 were invasive carcinomas. The positive predictive value of breast MRI was 27.5% (30/109). No clinicopathological factors were significantly associated with additional malignant foci. CONCLUSION: Breast MRI was useful in detecting additional malignancy in a small number of patients who underwent ultrasonography and mammography.
Breast ; Breast Neoplasms* ; Humans ; Information Systems ; Korea ; Limit of Detection ; Magnetic Resonance Imaging* ; Mammography* ; Retrospective Studies ; Ultrasonography* ; Ultrasonography, Mammary

BACKGROUND: Differentiation of atypical pathogens is important for community-acquired pneumonia (CAP). In this study, we compared sputum and nasopharyngeal swabs (NPS) for use in detection of Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), and Legionella pneumophila (LP), using Seeplex PneumoBacter ACE Detection Assay (PneumoBacter; Seegene). METHODS: Sputum and NPS specimens were collected from patients in 15 hospitals. DNA was extracted from sputum using QIAamp DNA Stool Mini Kit (Qiagen) and from NPS using easyMAG (bioMerieux). Both types of specimens were evaluated by multiplex PCR using PneumoBacter. To determine the diagnostic performance of this assay, sputum samples were also tested using BD ProbeTec ET Atypical Pneumonia Assay (APA; Becton Dickinson). RESULTS: Among 217 sputum and NPS, 20 (9.2%), 2 (0.9%), and 0 sputum were positive for MP, LP, and CP, respectively, whereas 8 (3.7%) NPS were positive for MP. The sputum APA test yielded 186, 206, and 204 interpretable results for MP, LP, and CP, respectively. Of these, 21 (11.3%) were positive for MP, 2 (1.0%) were positive for LP, and 0 samples were positive for CP. Compared to APA, the sensitivity and specificity of the sputum assay for MP were 95.2% and 100.0%, respectively, whereas for the NPS assay, these were 38.1% and 93.9%. Sputum testing was more sensitive than NPS testing (P=0.002). For LP and CP diagnosis, PneumoBacter and APA tests agreed 100%. CONCLUSIONS: Specimen type is crucial and sputum is preferred over NPS for simultaneous detection of MP, LP, and CP using multiplex PCR in CAP.
Chlamydophila Infections/diagnosis ; Chlamydophila pneumoniae/*genetics/isolation & purification ; Community-Acquired Infections/*diagnosis ; DNA, Bacterial/analysis/isolation & purification ; Humans ; Legionella pneumophila/*genetics/isolation & purification ; Legionnaires' Disease/diagnosis ; Multiplex Polymerase Chain Reaction ; Mycoplasma pneumoniae/*genetics/isolation & purification ; Nasopharynx/*microbiology ; Pneumonia, Mycoplasma/diagnosis ; Reagent Kits, Diagnostic ; Sputum/*microbiology

BACKGROUND: Obesity increases the risk of cardiovascular disease, hypertension, diabetes, and other disorders. Several studies have shown that excess weight or weight gain was related to the decline of pulmonary function. This study is to find out whether pilot's age, height, body weight, body mass index(BMI) and smoking are related to the baseline measurement of pulmonary function in order to promote the healthy behavior of pilots. METHOD: The analysis was based on data from the annual physical examination of pilots which was conducted in one airlines company of Korea. This study compared the data obtained from 73 pilots in 1996 with the data in 2002. Pulmonary function(forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximal mid expiratory flow (MMEF), peak expiratory flow (PEF)), age, height, body weight and body mass index were measured in both surveys. Multivariate analysis of variance (MANOVA) was used to examine the relationship weight gain, smoking and pulmonary function. RESULTS: According to the data from 2002, mean age, mean height, mean body weight and mean BMI of pilots were examined: 47.62 years, 171.60 cm, 70.6 Kg and 24.03 Kg/m(2). Age was significantly related to FVC, FEV1 and MMEF. Height was significantly related to FVC and FEV1. However, body weight was significantly related to PEF and MMEF. The effect of smoking on pulmonary function was not significant. Pilots who gained body weight and BMI after 7 years were not related significantly to the pulmonary function. CONCLUSION: This study shows that age, height, weight are significantly related to pulmonary function. And other studies show that weight gain is significantly related to the decline of pulmonary function, but the relationship from this study is not significant because the number of sample is not enough and healthy behaviors of most pilots are relatively well.
Body Height ; Body Mass Index ; Body Weight* ; Cardiovascular Diseases ; Forced Expiratory Volume ; Hypertension ; Korea ; Multivariate Analysis ; Obesity ; Physical Examination ; Smoke ; Smoking ; Vital Capacity ; Weight Gain

BACKGROUND: The pilots with cardiovascular events have a possibility for a risk of suffering from sudden incapacitation which is closely related to flying safety. The coagulation factors such as fibrinogen, factor VII, and factor VIII are possibly related to cardiovascular events. Several studies for general population have shown that an increase of those coagulation factors with age, a correlation of Factor VII and fibrinogen with BMI, and of fibrinogen with smoking. However, this study is to find out whether pilots' age, body weight, body mass index (BMI) and smoking are related to the baseline measurement of coagulation factor VII, factor VIII and fibrinogen. METHOD: Samples were taken from 21 pilots from Asiana Airlines: 11 smokers and 10 non-smokers. In order to measure the relationship between age, body weight, BMI, and the coagulation factors, Pearson correlation was used in this analysis. Independent two sampled t-test was used to analyze the correlation between smoking and the coagulation factors. RESULTS: Mean age, mean height, mean body weight and mean BMI of pilots were examined: 38 years, 171.81 cm, 70.67 Kg and 23.94 Kg/m(2). Mean fibrinogen, mean factor VII, and mean factor VIII were also obtained: 236.0 mg/dl, 92.93%, and 60.16%. The coagulation factor VII, factor VIII and fibrinogen were not significant related to age, body weight, BMI, smoking of pilots. CONCLUSION: This study has no correlation between age, body weight, BMI, smoking and the coagulation factors because the age of this study does not have pilots with over 60 years old and healthy behaviors (e.g., exercise, smoking, drinking, etc.) of most pilots are relatively well.
Blood Coagulation Factors* ; Body Height* ; Body Mass Index ; Body Weight* ; Cardiovascular Diseases ; Diptera ; Drinking ; Factor VII* ; Factor VIII ; Fibrinogen* ; Humans ; Middle Aged ; Smoke* ; Smoking*

OBJECTIVE: To investigate the efficacy of core strengthening on trunk balance in patients with subacute stroke. METHOD: Fifty-nine subacute hemiparetic stroke in-patients participated in this study. All patients were randomly assigned to one of two groups: the control group and the experimental group. Both groups received the same conventional physical therapies for 4 weeks. The experimental group received an additional core strengthening program (CSP). Korean mini-mental state examination (K-MMSE) and Korean Modified Barthel Index (K-MBI) were performed on admission. CSP was performed for 30 minutes a day, 3 days per week for 4 weeks. We selected nine exercises available for stroke patients, and divided them as three steps according to the degree of difficulty. Because of the muscle weakness in stroke patients, a physical therapist often helped them during exercise. Outcome measurement included trunk control test (TCT), trunk impairment scale (TIS), and Berg balance scale (BBS) and we compared both groups before and after the period of training. RESULTS: There were no significant differences in baseline general characteristics and initial values between the two groups. After rehabilitation therapy, both groups showed significant improvements in BBS, TIS, and TCT (p<0.05). Following 4 weeks of therapy, changes of BBS, TIS score in the experimental group were significantly higher than those of the control group (p<0.05). However, the change of TCT score was not significantly different. CONCLUSION: Analysis of different clinical parameters showed that better outcomes in BBS, TIS scores were achieved from CSP. This study suggests that CSP conducted for 4 weeks may be beneficial as a therapeutic technique for use in improvement of trunk balance in patients with subacute hemiparetic stroke.
Exercise ; Humans ; Muscle Weakness ; Physical Therapists ; Stroke

Purpose: Optimal treatment for stage IIIA/N2 non–small cell lung cancer (NSCLC) is controversial. We aimed to assess the efficacy and safety of adjuvant pembrolizumab for stage IIIA/N2 NSCLC completely resected after neoadjuvant concurrent chemoradiation therapy (CCRT). Materials and Methods: In this open-label, single-center, single-arm phase 2 trial, patients with stage IIIA/N2 NSCLC received adjuvant pembrolizumab for up to 2 years after complete resection following neoadjuvant CCRT. The primary endpoint was disease-free survival (DFS). Secondary endpoints included overall survival (OS) and safety. As an exploratory biomarker analysis, we evaluated the proliferative response of blood CD39+PD-1+CD8+ T cells using fold changes in the percentage of proliferating Ki-67+ cells from days 1 to 7 of cycle 1 (Ki-67D7/D1). Results: Between October 2017 and October 2018, 37 patients were enrolled. Twelve (32%) and three (8%) patients harbored EGFR and ALK alterations, respectively. Of 34 patients with programmed cell death ligand 1 assessment, 21 (62%), nine (26%), and four (12%) had a tumor proportion score of < 1%, 1%-50%, and ≥ 50%, respectively. The median follow-up was 71 months. The median DFS was 22.4 months in the overall population, with a 5-year DFS rate of 29%. The OS rate was 86% at 2 years and 76% at 5 years. Patients with tumor recurrence within 6 months had a significantly lower Ki-67D7/D1 among CD39+PD-1+CD8+ T cells than those without (p=0.036). No new safety signals were identified. Conclusion Adjuvant pembrolizumab may offer durable disease control in a subset of stage IIIA/N2 NSCLC patients after neoadjuvant CCRT and surgery.

Purpose: Optimal treatment for stage IIIA/N2 non–small cell lung cancer (NSCLC) is controversial. We aimed to assess the efficacy and safety of adjuvant pembrolizumab for stage IIIA/N2 NSCLC completely resected after neoadjuvant concurrent chemoradiation therapy (CCRT). Materials and Methods: In this open-label, single-center, single-arm phase 2 trial, patients with stage IIIA/N2 NSCLC received adjuvant pembrolizumab for up to 2 years after complete resection following neoadjuvant CCRT. The primary endpoint was disease-free survival (DFS). Secondary endpoints included overall survival (OS) and safety. As an exploratory biomarker analysis, we evaluated the proliferative response of blood CD39+PD-1+CD8+ T cells using fold changes in the percentage of proliferating Ki-67+ cells from days 1 to 7 of cycle 1 (Ki-67D7/D1). Results: Between October 2017 and October 2018, 37 patients were enrolled. Twelve (32%) and three (8%) patients harbored EGFR and ALK alterations, respectively. Of 34 patients with programmed cell death ligand 1 assessment, 21 (62%), nine (26%), and four (12%) had a tumor proportion score of < 1%, 1%-50%, and ≥ 50%, respectively. The median follow-up was 71 months. The median DFS was 22.4 months in the overall population, with a 5-year DFS rate of 29%. The OS rate was 86% at 2 years and 76% at 5 years. Patients with tumor recurrence within 6 months had a significantly lower Ki-67D7/D1 among CD39+PD-1+CD8+ T cells than those without (p=0.036). No new safety signals were identified. Conclusion Adjuvant pembrolizumab may offer durable disease control in a subset of stage IIIA/N2 NSCLC patients after neoadjuvant CCRT and surgery.