Pseudo-Bartter syndrome is a rare medical disease of the kidney characterized by normal blood pressure, hypokalemic metabolic alkalosis, hyperreninemia and hyperaldosteronism with drug history of diuretics. We report US, CT and MRI findings of a patient with clinically proved pseudo-Bartter syndrome. The patient was a 37-year-old woman with a history of long term ingestion of the diuretics(furosemide) for 20 years. Renal US revealed hyperechoic renal medulla at both kidneys. The resistive index(RI), calculated from the duplex doppler waveform is 0.61. Unenhanced CT revealed faint high attenuation along the medulla. Tl-weighted MRI revealed indistinct corticomedullary differentiation.
Adult ; Alkalosis ; Blood Pressure ; Diuretics ; Eating ; Female ; Humans ; Hyperaldosteronism ; Kidney ; Magnetic Resonance Imaging

Traumatic spondylolisthesis of the axis is the fracture of both pedicles and is called commonly as hangman' s fracture. The fractures with the anterior displacement more than 3mm and the angulation, more than 11 degrees were classified as unstable and the surgical methods were recommended for the treatment of the fractures. As for the surgical methods, anterior C2-3 fusion with plate fixation or transpedicular screw fixation were used. However, the differences between the clinical results of both methods were not reported in the literatures. In order to clarisy the clinical results of both methods, the authors evaluated the clinical results of 11 patients treated by anterior plate fixation and 7 patients treated by transpedicular fixation who were operated on between Mar. 1987 and,Jan: 1992. Minimum follow-up period was 12 months. 1. As the surgical complications, two cases of transient dysphagia in anterior fixation group and three cases of malinserted screw in transpedicular fixation group were observed. 2. Limitation of rotatory neck motion, less than 20 degrees in one direction was observed in four cases of transpedicular fixation group. 3. Anterior angulation, more than 10 degrees was noted in three cases of transpedicular group. 4. Mild intermittent neck pain was observed in two cases of anterior fixation group and two cases of transpedicular fixation group. Constant neck pain was present in three cases of transpedicular fixation group. 5. Over-all clinical results were excellent or good in all of anterior fixation group, and in four of seven transpedicular group. Although the clinical materials were limited in number, method of anterior plate fixation was recommended by the authors in the management of traumatic spondylolisthesis of axis, because of the easier technique and the better clinical results than the transpedicular screw fixation.
Deglutition Disorders ; Follow-Up Studies ; Humans ; Methods ; Neck ; Neck Pain ; Spine ; Spondylolisthesis

No abstract available.
Lung* ; Neoplasm Metastasis* ; Uterus*

The accuracy of fine needle aspiration cytology (FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases (43.6%) were diagnosed as tuberculosis, 4 (10.3%) as granulomatous lymphadenitis, 3 (7.7%) as necrotizing lymphadenitis, and 15 (38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Flow Cytometry ; Hyperplasia ; Inflammation ; Lymph Nodes ; Lymphadenitis ; Lymphoma ; Lymphoma, T-Cell, Peripheral ; Polymerase Chain Reaction ; Receptors, Antigen ; Sensitivity and Specificity ; Tuberculosis

Epidemiologic investigation was conducted on January, 1993 in Seoul to identify the cause of an infant methemoglobinemia. Field investigation of the area of outbreak, survey of household and family members, analysis of ground water, and blood tests of involved family members were performed. Following results were obtained. On analyzing the quality of the ground water on patients's household high levels of nitrate was found indicating contamination of water as the cause of a methemoglobinemia outbreak. On analyzing the quality of the ground waters on seven other places within the neighborhood five were contaminated by nitrate in concentration that exceeded the permissible limit implying presence nearby source of contamination. Sources of contamination were thought to be originating from human waste in conventional bathroom facilities, chicken manure used in nearby orchards and plant fields or fertilizers. But the results of water analysis with presence of bacteria or E.coli, concentration of potassium, phosphate and the past history of diarrhea among family members, chicken manure suggested the most possible source of contamination. To evaluate the health status of members in the neighborhood past history was reviewed revealing no prior existence of patient with cyanosis and 65 people in the neighborhood had normal levels of methemoglobin concentration in their blood. Conclusively, the ground water on patient's household was contaminated with nitrate and despite provision of adequate water supply, family members of the patient along with distrust in the water supply system had used ground water as their source of drinking water resulting of methemoglobinemia. Many suburban area of Seoul and country side thought to be having similar problems concerning contaminated ground water supply and dormant outbreak of patients as a result of the drinking of the contaminated water. Epidemiologic investigation and water analysis of ground waters are advised.
Bacteria ; Chickens ; Cyanosis ; Diarrhea ; Drinking ; Drinking Water ; Family Characteristics ; Fertilizers ; Groundwater ; Hematologic Tests ; Humans ; Infant* ; Manure ; Methemoglobin ; Methemoglobinemia* ; Plants ; Potassium ; Residence Characteristics ; Seoul ; Water ; Water Supply

PURPOSE: To evaluate the radiologic characteristics of axillary lymph nodes which are found on mediolateral oblique(MLO) view of mammography and to assess their clinical significance. MATERIALS AND METHODS: We retrospectively evaluated 119 cases axillary lymph nodes on MLO view of 410 cases of mammography in 205 patients regarding the size, bilaterality, number, grade of density, presence of central lucency, calcification of lymph nodes and presence of associated parenchymal pathologic lesions in breast. RESULTS: Axillary lymph nodes on MLO view were demonstrated in 119 (29%) among 410 cases. Axillary lymph nodes(112 cases) in cases without breast parenchymal lesions or with benign breast lesions showed; unilaterality in 68 cases(61%), smaller than 1.5cm in 100 cases(89%), lower density than breast parenchyma in 99 cases(88%), presence of central lucency in 99 cases(88%) and calcification in 3 cases(2.7%). Axillary lymph nodes(7 cases)in cases with breast cancer showed small size of less than 1.5cm in 4 cases(57%), absence of central lucency in 7 cases(100%) and iso-to higher density than breast parenchyma in 7 c&ses(100%). CONCLUSION: Axillary lymph nodes noted on MLO view of mammography, more than 1.5cm in diameter, absence of central lucency and iso to higher density than breast parenchyma could be suggested as clinically significant.
Breast ; Breast Neoplasms ; Humans ; Lymph Nodes* ; Mammography ; Retrospective Studies

PURPOSE: To evaluate the radiologic characteristics of axillary lymph nodes which are found on mediolateral oblique(MLO) view of mammography and to assess their clinical significance. MATERIALS AND METHODS: We retrospectively evaluated 119 cases axillary lymph nodes on MLO view of 410 cases of mammography in 205 patients regarding the size, bilaterality, number, grade of density, presence of central lucency, calcification of lymph nodes and presence of associated parenchymal pathologic lesions in breast. RESULTS: Axillary lymph nodes on MLO view were demonstrated in 119 (29%) among 410 cases. Axillary lymph nodes(112 cases) in cases without breast parenchymal lesions or with benign breast lesions showed; unilaterality in 68 cases(61%), smaller than 1.5cm in 100 cases(89%), lower density than breast parenchyma in 99 cases(88%), presence of central lucency in 99 cases(88%) and calcification in 3 cases(2.7%). Axillary lymph nodes(7 cases)in cases with breast cancer showed small size of less than 1.5cm in 4 cases(57%), absence of central lucency in 7 cases(100%) and iso-to higher density than breast parenchyma in 7 c&ses(100%). CONCLUSION: Axillary lymph nodes noted on MLO view of mammography, more than 1.5cm in diameter, absence of central lucency and iso to higher density than breast parenchyma could be suggested as clinically significant.
Breast ; Breast Neoplasms ; Humans ; Lymph Nodes* ; Mammography ; Retrospective Studies

Background : It is not easy to diagnose sporadic medullary thyroid carcinoma(MTC) before surgery and this might lead the patient reoperation and/or lowered chance of definite cure. Methods : The prevalence of sporadic MTC in Korean was studied in patients with thyroid nodules. A prospective study of 1048 consecutive patients with thyroid nodules was performed. In all patients, measurements of basal serum calcitonin, thyroid hormones, TSH, anti-thyroglobulin antibody and anti-thyroperoxidase antibody were undertaken along with technetium-99m thyroid scintigraphy and fine needle aspiration cytology. In patients with elevated basal calcitonin levels, calcium stimulated calcitonin level was determined. Results: Two patient had markedly elevated calcitonin levels(over 3,200 pg/mL and 1,763 pg/ mL) and another one slightly elevated calcitoni#n(71.9 pg/mL). Fine needle aspiration cytology was suggestive of MTC in one and nodular hyperplasia in the other two. They underwent surgery and histological examination revealed MTC in those two with markedly elevated calcitonin levels. The patient with slightly elevated calcitonin, who was on the maintenance hemodialysis due to chronic renal failure, had nodular hyperplasia. Conclusion: MTC was found in 0.19% of patients with thyroid nodules, which was not different with the previously reported prevalence in Europe. Routine measurements of serum calcitonin might be of value to detect sporadic MTC; however, the cost-effectiveness of routine measurement of serum calcitonin is not clear, considering the relatively low prevalence of MTC in Koreans.
Biopsy, Fine-Needle ; Calcitonin ; Calcium ; Carcinoma, Medullary ; Europe ; Humans ; Hyperplasia ; Kidney Failure, Chronic ; Mass Screening ; Prevalence ; Prospective Studies ; Radionuclide Imaging ; Renal Dialysis ; Reoperation ; Thyroid Gland ; Thyroid Hormones ; Thyroid Nodule

In 1941 Wiberg discribed morphologic classification of patella in axial plane and the correlationship between its shape and dysfunction. Here the authors reviewed 120 cases and divided them into four groups. Group I is the one with no knee joint pain or patella dysfunction, group II is the patients with meniscus injury, gruop III is the patients with chondromalacia of patella and group IV is the patients with osteoarthritis of knee joint. We analysed them according to the ratio between the length of the patella and the articular surface in lateral X-ray films of patella. The results were as follows:1. The ratio between the length of the patella and the articular surface is 1.45±0.13(mean±SD) in group I, 1.47±0.18 in group II, 1.56±0.12 in group lll and 1.57±0.15 in group IV. 2. Statistically(P<0.05), no significant difference between group I and group II, but group III and group IV is significantly different from the group I. 3. The ratio between the length of the patella and the articular surface is thought to be helpful for diagnosing the patient with vague knee joint pain.
Cartilage Diseases ; Classification ; Humans ; Joints ; Knee Joint ; Osteoarthritis, Knee ; Patella ; X-Ray Film

The purpose of this study was to investigate not only quality characteristics such as overrun, meltdown and sensory evaluation of oligosaccharide-supplemented soy ice cream but also physiological effects of ice cream with soy and/or oligosaccharide on blood sugar and lipid profile in streptozotocin-induced diabetic rats. Powder of parched soybean was added at 7.6% replacing skimmed milk and cream, soybean oil at 7.6% replacing milk oil in cream, and fructooligosaccharide at 9.5% replacing sucrose on weight basis. Five kinds of ice cream were prepared: MMS (skimmed milk, milk oil, sucrose), MMO (skimmed milk, milk oil, oligosaccharide), SSS (soybean, soybean oil, sucrose), SSO (soybean, soybean oil, oligosaccharide), and BSO (black soybean, soybean oil, oligosaccharide). Overrun and meltdown of soy ice cream were significantly lower than those of milk ice cream. Scores of sensory evaluation especially in mouth feel and melting feel in mouth were lower in soy ice cream. Freeze-dried ice cream was supplemented to AIN93-based diets at 30% (w/w). Sprague-Dawley male rats with diabetes induced by injecting streptozotocin were fed experimental diets for 4 weeks. Plasma glucose level was significantly lowered in SSO group compared with MMS group. Plasma insulin levels of MMO and SSO groups were not significantly different from that of normal group, while those of MMS and SSS group were significantly lower than normal group. Plasma cholesterol was decreased in groups fed ice cream supplemented either soybean or fructooligosaccharide compared to MMS group. HDL-cholesterol level was elevated and triglyceride was decreased significantly in MMO group compared to MMS group. LDL-cholesterol levels of SSS and BSO groups and liver triglyceride level of SSO group were significantly lower compared to MMS group. In conclusion, oligosaccharide-supplemented soy ice cream lowered blood sugar, and ice cream supplemented with soybean and/or oligosaccharide improved lipid profile in diabetic rats.
Animals ; Blood Glucose* ; Cholesterol ; Diet ; Freezing ; Humans ; Ice Cream* ; Ice* ; Insulin ; Liver ; Male ; Milk ; Mouth ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Soybean Oil ; Soybeans ; Streptozocin ; Sucrose ; Triglycerides