Over the past three decades, radionuclide myocardial perfusion scintigraphy (MPS) has become established as the main functional cardiac imaging technique for ischemic heart disease. It is currently appropriate for all aspects of detecting and managing ischemic heart disease, including diagnosis, risk assessment and stratification, assessment of myocardial viability, and evaluation of left ventricular function. The purpose of this article was to review recent trends in nuclear cardiology practice, excluding positron emission tomography. The past few years have brought several rapid developments that have increased photon sensitivity in nuclear cardiology scanner hardware. Additionally, software applying new methods of single photon emission tomography (SPECT) reconstruction on conventional and dedicated systems has preserved or even improved SPECT image quality with lower count statistics. On the other hand, much interest has been shown in lowering the radiation dose by the stakeholders of MPS.
Cardiac Imaging Techniques ; Cardiology ; Hand ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging ; Positron-Emission Tomography ; Risk Assessment ; Tomography, Emission-Computed, Single-Photon ; Ventricular Function, Left

A low iodine diet (LID) is the recommended preparation for radioactive iodine treatment. However, the recommended duration and stringency of LID are different among each recommendation. More stringent LID is expected in Korea because Korea is a iodine-rich region. We investigated the decrement of urine iodine excretion by two-week stringent LID for remnant thyroid ablation with radioactive iodine in Korean patients with thyroid cancer, prospectively. MATERIAL AND METHOD: From November 2006, patients who referred to our hospital for remnant ablation after total thyroidectomy were included in this study. To decrease total body iodine, our protocol included three strategies. First, we checked medication which could inhibit the radioactive iodine uptake. Second, the date of I-131 treatment was scheduled at least 3 months later if contrast agent had been used. The last strategy was two-week stringent LID education by specialized nutritionist. Before and after two-week stringent LID, 24hr-urine iodine was analyzed respectively. 24hr-urine creatinine was also analyzed for determining more valid 24hr urine sampling subgroup. RESULTS: Total 51 patients were finally enrolled. Average of 24hr-urine iodine excretion was significantly lowered (787+/-2242 -> 85+/-85 microgram/d, p=0.03) after LID and 74.4% of patients reached below the recommended urine iodine excretion level (<100 microgram/d). In subgroup (n=14), similar results was showed (505+/-666 -> 99+/-116 microgram/d, p=0.05) and 78.6% of patients met the criteria. CONCLUSION: Most patients could reach below the recommended urine iodine level after two-week stringent LID. Therefore, in our opinion, at least two-week stringent LID should be recommended in Korea.
Creatinine ; Diet ; Humans ; Iodine ; Korea ; Prospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

Carpal tunnel syndrome, compression of the median nerve in the carpal tunnel at the wrist, is the most common entrapment syndrome of peripheral nerve. It is characterized by sensory and motor symptoms and signs in the distribution of the median nerve. Radiofrequency thermocoagulation is a neuroablative treatment for various chronic pain disorders, but is associated with neural injury, neuritis, and occasional neuroma. Unlike RF, pulsed radiofrequency, the use of the high current intensity and electrical fields, has been proposed for the modulation of the excited nervous system pathway of pain without neuro-destruction and other potential complications. We report a case of bilateral carpal tunnel syndrome that was relieved after PRF lesioning of both median nerves.
Carpal Tunnel Syndrome ; Chronic Pain ; Electrocoagulation ; Humans ; Median Nerve ; Nervous System ; Neuritis ; Neuroma ; Peripheral Nerves ; Wrist

Chronic constrictive pericarditis is an uncommon disease, but an importanat one because of its potential curability. It usually begins with an initial episode of acute pericarditis often with a pericardial effusion which may not be detected clinically. This then progresses to resorption of the effusion followed by obliteration of pericardial abity with formation of fibrotic tissue, which results in symmetrical scarring that produce uniform restriction. In general, there are no specific problems due to remained pericardial effusion in the clinically manifestated case of constrictive pericarditis. We report a case of chronic constrictive pericarditis with localized pericardial effusion, which caused to hemodynamic compromise due to local compression of the right ventricle.
Cicatrix ; Heart Ventricles ; Hemodynamics ; Pericardial Effusion* ; Pericarditis ; Pericarditis, Constrictive*

BACKGROUND: Although used for obtund pain, bupivacaine may itself initially produce pain on injection. This study was designed to evaluate the effect of diluting bupivacaine with normal saline, lactated Ringer's solution, 5% dextrous in water and distilled water on perception of pain associated with intramuscular injection. METHODS: Twenty-five healthy volunteers were involved in this study. Each subject received 4 injections in random order: 0.25% bupivacaine in normal saline, lactated Ringer's solution, 5% dextrous in water and distilled water. Both upper trapezius muscles were used for the intramuscular injection site. Needle size (25-gauge), injection depth (1.5-2 cm), injection volume (2.5 ml), administration speed (0.5 ml/sec), and temperature (room) were controlled for each of the four injections. The intensity of pain was rated on a 0 to 10 visual analogue scale (VAS) score at the point of needle insertion and injecting solutions. RESULTS: There was no statistical difference among each solution in VAS score. However, the VAS scores of drug administration were higher than those of needle insertion in all diluting solutions (P<0.05). CONCLUSIONS: There was no difference in the intensity of pain of an intramuscular injection of bupivacaine between four different kinds of solutions. However, it might be suggested that more effort and investigation will be needed to reduce pain with an intramuscular injection.
Bupivacaine* ; Healthy Volunteers ; Injections, Intramuscular* ; Needles ; Superficial Back Muscles ; Water

OBJECTIVE: Chlamydia trachomatis is one of the most common causative microorganisms in pelvic inflammatory disease. The symptom of Chlamydia infection is nearly absent or weak in many cases, but its complication is clinically very important because of tubal obstruction, infertility, tubal pregnancy, and recurrent pelvic inflammatory disease. This study was performed to investigate the prevalence rate and clinical characteristics of Chlamydia trachomatis. METHODS: From May, 2001 to April, 2002, in Daerim St. Mary's Hospital, OB-Gyn department, the 68 inpatients of pelvic inflammatory diseases and 607 outpatients of routine gynecologic examination were studied on history taking, physical examination, laboratory test, and polymerase chain reaction for the detection of Chlamydia trachomatis. RESULTS: The prevalence rate of Chlamydia trachomatis was 20.6% (14/68) in pelvic inflammatory disease and 8.6% (51/593) in routine gynecologic examination. As regarding the age distribution of Chlamydia trachomatis positive group was the largest portion in the twenties, and symptom-free group was about 40%. Chlamydia infection was related to the history of artificial abortion, and showed no significant difference in parity. Most common site of infection was uterine cervix, and mixed infection rate with other bacteria was 43.1%. The treatments were given medically in 58 cases, surgically in 6 cases, and laparoscopy in 1 case were performed. CONCLUSION: Although the prevalence rate of Chlamydia infection is high in sexually active age group and Chlamydia infection has a serious bad effect on reproduction, the disease detection is difficult because symptom is weak or absent, but it reveals good cure rate. Therefore the screening and treatment of Chlamydia trachomatis are necessary to decrease the prevalence and prevention of complication.
Age Distribution ; Bacteria ; Cervix Uteri ; Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Coinfection ; Fallopian Tube Diseases ; Female ; Humans ; Infertility ; Inpatients ; Laparoscopy ; Mass Screening ; Outpatients ; Parity ; Pelvic Inflammatory Disease ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Prevalence ; Reproduction

PURPOSE: To construct new Korean reference curves for birth weight by sex and gestational age using contemporary Korean birth weight data and to compare them with the Lubchenco and the 2010 United States (US) intrauterine growth curves. METHODS: Data of 2,336,727 newborns by the Korean Statistical Information Service (2008-2012) were used. Smoothed percentile curves were created by the Lambda Mu Sigma method using subsample of singleton. The new Korean reference curves were compared with the Lubchenco and the 2010 US intrauterine growth curves. RESULTS: Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles birth weight by gestational age were made using 2,249,804 (male, 1,159,070) singleton newborns with gestational age 23-43 weeks. Separate birth weight curves were constructed for male and female. The Korean reference curves are similar to the 2010 US intrauterine growth curves. However, the cutoff values for small for gestational age (<10th percentile) of the new Korean curves differed from those of the Lubchenco curves for each gestational age. The Lubchenco curves underestimated the percentage of infants who were born small for gestational age. CONCLUSION: The new Korean reference curves for birth weight show a different pattern from the Lubchenco curves, which were made from white neonates more than 60 years ago. Further research on short-term and long-term health outcomes of small for gestational age babies based on the new Korean reference data is needed.
Asian Continental Ancestry Group ; Birth Weight* ; Female ; Gestational Age* ; Growth Charts ; Humans ; Infant ; Infant, Newborn ; Information Services* ; Male ; United States

BACKGROUND: Dermatitis occurring after ingestion of the urushiol chicken is quite common in Korea. Although many cases of the systemic contact dermatitis due to urushiol chicken have already been reported, systemic study on its epidemiology is not done yet. OBJECTIVE: To elucidate the demography of the eaters of the urushiol chicken with its general understandings in society and the incidence of the resultant systemic dermatitis. METHODS: By the help of the patients who developed the dermatitis, all the persons who ate it together with the patients were interviewed. RESULTS AND CONCLUSION: l. 171 eaters of the urushiol chicken(125 male and 46 female) were enrolled in this study(M:F= 3.1:1). The age group in 4th decade was the most common in male, the 5th decade in female. The age prevalence of the systemic contact dermatitis corresponded to the age prevalence of the eater. 2. Incidence rate of systemic contact dermatitis among the eaters was 32.2% (55/171). Incidence rate according to each age group were as follows : 0% in 2nd decade, 33.3% in the 3rd decade, 32.4% in 4th decade, 32.8% in 5th decade, 33.3% in 6th decade, 25% in the 7th decade. 3. One third (57/171) of the eaters ate the urushiol chicken to strengthen their internal organs, especially stomach, which they believed to be weak 70 persons (40.9%) ate it at home, 101 persons (59.1%) ate it at a restaurant. 4. Out of 67 persons having past history of allergic contact dermatitis to Rhus tree, 28 persons (41.8%) showed systemic contact dermatitis. Out of 104 persons without past history of allergy to Rhus, 27 persons (26.0%) showed systemic contact dermatitis.
Chickens ; Demography ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Eating* ; Epidemiologic Studies* ; Epidemiology ; Female ; Humans ; Hypersensitivity ; Incidence ; Korea ; Male ; Prevalence ; Restaurants ; Rhus* ; Stomach ; Trees

PURPOSE: The advantages of air reduction are the ease of performing the procedure, reduced radiation time and lower morbidity rate if perforation occurs. But, patients who fail air reduction undergo a laparotomy at which 10% have spontaneously reduced. The first enema decreases the edema and venous congestion of bowel wall, thus repeated reduction may succeed. The aim of this study is to evaluate the efficacy of delayed repeated pneumatic reduction of intussusception in patients with failure of an initial attempt. METHODS: Between January 1998 and December 1999, 21 patients with proven intussusception received repeated delayed reduction 1 to 3 hours following the first failed attempt. These patients were in stable condition and did not have peritonitis, shock or toxic sign. RESULTS: Before reduction, the patients had symptoms and signs for 6 to 48 hours (median 24 hr). The interval from the first reduction to the repeated was 1 to 3 hours (median 2.2 hr). The success rate of repeated reductions was 76.2% (16 of 21 patients), and 23.8% (5 of 21 patients) required surgery. Four of 5 patients requiring surgery were manually reduced and 1 spontaneously reduced in the operating room. CONCLUSION: We recommended a repeated reduction in patients with intussusception who are in stable clinical condition after an unsuccessful initial reduction attempt.
Edema ; Enema ; Humans ; Hyperemia ; Intussusception* ; Laparotomy ; Operating Rooms ; Peritonitis ; Shock

BACKGROUND: Direct puncture by a needle is a risk factor for nerve damage. This study was designed to demonstrate nerve damage caused by a needle using the synchrotron small-angle X-ray scattering (SAXS) technique. METHODS: A 15 mm section of rat (Male Spargue-Dawley, about 250 grams) sciatic nerves were involved in this study. The nerve specimen for the experiment (N = 5) was punctured 5 times by a needle (25 G, 100 beveled) under general anesthesia with enflurane. The needle was placed perpendicular to the nerve and the needle bevel was placed parallel to the nerve. The SAXS patterns of the punctured nerves, extracted about 15 min prior to the experiment, were acquired after 1 week. The SAXS patterns of a normal sciatic nerve (N = 5), extracted about 15 min prior to the experiment, were measured in order to provide a comparison. Experiments were carried out at 4C1 beamline at Pohang Accelerator Laboratory in Korea. Incoming X-rays were monochromatized at 11 keV using a double multilayer (WB4C) monochromator; the beam size was around 0.5 (V) x 0.8 (H) mm2. The exposure time was 60 sec, and 8 to 12 images were acquired per sample with a 0.5 mm interval. RESULTS: In the punctured group, the periodic peaks of myelin sheath and collagen fiber were not changed. However, the periodic peaks of interfibrillar distance of collagen were greatly changed. CONCLUSIONS: Direct needle-nerve impalement did not cause damages in myelin sheath and collagen fibers when the needle was placed perpendicular and the needle bevel paralleled to the nerve fiber. This result can imply that the needle slipped into the interfibrillar packing of collagen fibrils.
Anesthesia, General ; Animals ; Collagen ; Enflurane ; Gyeongsangbuk-do ; Korea ; Myelin Sheath ; Needles* ; Nerve Fibers ; Peripheral Nerve Injuries* ; Punctures ; Rats* ; Risk Factors ; Sciatic Nerve* ; Synchrotrons*