After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Head* ; Humeral Fractures ; Humerus* ; Incidence ; Intra-Articular Fractures ; Surgeons ; Ulnar Nerve*

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Head ; Humeral Fractures ; Humerus ; Incidence ; Intra-Articular Fractures ; Surgeons ; Ulnar Nerve

To date, there are still very few reports on benign-tumor cases based on East Asian skeletal series, even though other regions and continents have been well represented. In our study on the Joseon Human Skeletal Series, we identified benign bone tumors in two skeletons (cases Nos. 75 and 96). Our radiological analyses showed both cases to be homogeneous sclerotic bone masses aligned with the cranial vault suture. In a subsequent series of differential diagnoses, we determined both cases to be osteoma, the most common bone-tumor type reported for archaeological samples. Our study is the osteoarchaeological basis for this, the first-ever report on benign bone neoplasm in a pre-modern East Asian population.
Asian Continental Ancestry Group ; Bone Neoplasms ; Diagnosis, Differential ; Humans* ; Korea ; Osteoma ; Paleopathology ; Skeleton ; Skull* ; Sutures

The author's name and the institutional affiliation of the authors were published incorrectly.
Cemeteries* ; Seoul ; Skeleton*

Stable carbon and nitrogen isotope analysis reveals the diets of different human populations in history. In this study, we performed stable isotope analysis on human skeletons from Joseon-period cemeteries discovered around Old Seoul City (Hansung). Our data clearly showed that Joseon individuals consumed more C3-based than C4-based foods as the main staples, and that the proteins they ate were mainly of terrestrial, but not of marine origin. Stable isotope values exhibited unique patterns in each of our sample subgroups. Whereas the delta13C values did not show any statistical differences among the subgroups, significantly higher values of delta15N were found in males than in females, which might reflect dietary differences between the sexes. For a fuller understanding of the dietary patterns of pre-industrial (pre-20th century) Koreans, additional studies on Joseon samples from Korean archaeological sites will be necessary.
Carbon ; Cemeteries* ; Diet ; Female ; Humans ; Male ; Nitrogen ; Seoul ; Skeleton*

Perilla is an Asian grain that consumed for food ingredient, oil crops, medicinal materials through the process of roasting. A 49-year-old male has been roasting grains for 10 years, who met with shortness of breath during the roasting perilla seeds, but not in other situations. Serum total immunoglobulin E (IgE) level, serum eosinophil count and skin prick test didn't showed significant results. Methacholine bronchial provocation test was positive (PC20 0.31 mg/mL). Specific bronchial provocation test with inhaling smoke from roasting perilla seeds showed a dual asthmatic response. Measured peak expiratory flow rate on his work place showed the result of 37% decrease at the end of work and full recovery at 6 hours after the end of work. Skin prick test to row perilla showed positive response with late symptoms. We diagnosed that the patient had an occupational asthma caused by inhaling smoke from roasting perilla seeds with IgE mediated mechanism.
Asian Continental Ancestry Group ; Asthma, Occupational ; Bronchial Provocation Tests ; Edible Grain ; Dyspnea ; Eosinophils ; Humans ; Hypogonadism ; Immunoglobulin E ; Immunoglobulins ; Inhalation ; Male ; Methacholine Chloride ; Mitochondrial Diseases ; Ophthalmoplegia ; Peak Expiratory Flow Rate ; Perilla ; Seeds ; Skin ; Smoke ; Workplace

Levofloxacin, a fluoroquinolone and L-isomer of the racemate ofloxacin, has been approved for the treatment of acute and chronic bacterial infections. Gastrointestinal complaints are the most frequently reported adverse drug reactions to fluoroquinolones. Other adverse events include headache, dizziness, increased liver enzyme levels, photosensitivity, tachycardia, QT prolongation, and eruptions. Anaphylaxis has been documented as a rare adverse drug reaction to levofloxacin; however, diagnostic tests are needed to evaluate whether these reactions are the result of levofloxacin treatment. While the results of skin tests are considered unreliable due to false-positive responses, the oral provocation test is currently considered to be the most reliable test. Tryptase, a neutral protease, is the dominant protein component of secretory granules in human mast cells, and an increased serum concentration of tryptase is a highly sensitive indicator of anaphylaxis. Herein, we report a case of levofloxacin-induced anaphylaxis in which the patient exhibited elevated serum tryptase levels and a positive oral levofloxacin challenge test result. As anaphylaxis is potentially life-threatening, the administration of fluoroquinolones to patients who have experienced a prior reaction to this type of agent should be avoided.
Anaphylaxis ; Bacterial Infections ; Diagnostic Tests, Routine ; Dizziness ; Drug Hypersensitivity ; Drug Toxicity ; Fluoroquinolones ; Headache ; Humans ; Liver ; Mast Cells ; Ofloxacin ; Secretory Vesicles ; Skin Tests ; Tachycardia ; Tryptases

BACKGROUND: Local adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients. METHODS: The study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months. RESULTS: The mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly. CONCLUSION: The immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.
Androstadienes ; Candidiasis, Oral ; Diet ; Dietary Sucrose ; Diethylpropion ; Drug Toxicity ; Dysphonia ; Follow-Up Studies ; Humans ; Meals ; Mouth ; Nebulizers and Vaporizers ; Pharyngitis ; Pilot Projects ; Steroids ; Fluticasone

Synchronous esophageal and gastric cancers with the pathologic features of a squamous cell carcinoma are extremely rare. A 57-year-old male visited our hospital with a history of hematemesis and was diagnosed with a synchronous cancer. He underwent a staging work-up, and the resectable lesion in the stomach was operated on following radiologic and endoscopic evaluations. The pathologic examination revealed a synchronous cancer consisting of squamous cell carcinoma in the distal esophagus and the cardia of the stomach. We report a case of a synchronous cancer that was successfully treated by surgical resection followed by concurrent chemoradiotherapy. We also discuss the hypothesis regarding the origin and presentation of the synchronous cancer and highlight the importance of careful surveillance by physicians at the time of diagnosis.
Carcinoma, Squamous Cell ; Cardia ; Chemoradiotherapy ; Esophageal Neoplasms ; Esophagus ; Hematemesis ; Humans ; Male ; Middle Aged ; Stomach ; Stomach Neoplasms

BACKGROUND: The prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB. METHODS: From December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females). RESULTS: Mortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis. CONCLUSION: In our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.
Adult ; C-Reactive Protein ; Cholesterol ; Creatinine ; Drug Resistance ; Emergencies ; Hemoglobins ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Leukocytes ; Lung ; Lymphocytes ; Male ; Medical Records ; Nitrogen ; Nutritional Status ; Prevalence ; Republic of Korea ; Risk Factors ; Sodium ; Tertiary Care Centers ; Tuberculosis ; Tuberculosis, Pulmonary