PURPOSE: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). MATERIALS AND METHODS: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: 49.1+/-10.8). RESULTS: Eighteen lesions of primary HPT consisted of 13 adenomas and 5 hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). CONCLUSION: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.
Adenoma ; Diagnosis ; Humans ; Hyperparathyroidism, Primary ; Hyperparathyroidism, Secondary* ; Hyperplasia ; Parathyroid Glands ; Radionuclide Imaging* ; Retrospective Studies ; Sensitivity and Specificity

To investigate the occurrence and distribution of serotype, specific virulence genes, and pulse field gel electrophoresis (PFGE) patterns in Vibrio parahaemolyticus isolates from Jeonnam, Korea, we tested 87 strains which were identified with V. parahaemolyticus from diarrheal episode patients in 2005. In this study, 16 different O:K serotype combinations of V. parahaemolyticus were determined. The distributions of O and K serotypes were O4:K68 (51.72%), O1:K70 (18.39%), O3:K6 (5.74%), O1:K68 (4.60%) and O3:K57 (4.60%) respectively. Serotype O4:K68 was the regional dominant specific serotype of V. parahaemolyticus in Sinan of Jeonnam, Korea. For the detection of thermostable direct hemolysin (tdh) and TDH-related hemolysin (trh) gene of V. parahaemolyticus, PCR was performed. The tdh gene was detected in all of the V. parahaemolyticus isolates from diarrheal patients, but trh gene was not detected. Analysis of PFGE patterns of 30 V. parahaemolyticus isolates showed 3 groups and 20 types. Among 14 O4:K68 serotypes which were isolated in Sinan, PFGE patterns of 12 strains were closely related (100%), but 2 strains were related by 58.3% and 45.4%, respectively. Also two strains of O1:K4 serotype in Gurye and two strains of O3:K6 serotype in Yeosu were closely related (100%), respectively. Although serotypes (O1:K4, O1:K70, O3:K6 and O4:K68) were different, PFGE patterns were related for more than 80.9%. Therefore, the epidemiological surveillance of V. parahaemolyticus is required by PFGE typing scheme as a further diagnostic tool.
Bacterial Toxins ; Electrophoresis ; Hemolysin Proteins ; Humans ; Korea ; Polymerase Chain Reaction ; Serotyping ; Vibrio ; Vibrio parahaemolyticus

Vitreous surgery has become a widly practiced procedure for use in the variety of pathological conditions in the anterior and posterior semgment of the eye. The goal of the vitreous 'surgery is to clear the optic pathway and restore the anatomy and function of the eye. Vitreous surgery was performed in 28 eyes using the O'malley ocutome from April, 1980 to October, 1980. Among the 28 eyes, 14 eyes received anterior segment surgery and the other 14 eyes received posterior segment surgery. The follow up period after surgery ranged from 3 weeks to 7 months and the average period was 4 months. The conditions requiring surgery were as follows: 9 eyes had Reconstruction of anterior segment after trauma; 4, removal of pupillary membrane due to chronic uveitis and after cataract; and 1, anterior vitrectomy with removal of subluxated lens. As for the causes of posterior segment surgery, 5 eyes had trauma of eyeballs; 3, hypertensive retinopathies; 2, vitreous opacity with retinal detachment; 1, diabetic retinopathy; 1, central retinal vein occlusion; 1, nonmagnetic intraocular foreignbody; and 1, lost lens nucleus into the vitreous. The improvement of visual acuity after surgery was seen in 14 eyes (50%), 9 eyes in anterior segment surgery and 5 eyes in posterior segment surgery. The complications during operation were vitreous hemorrhage (1 eye; 3.5%), retinal detachment (2 eye; 7%), and traumatic cataract (1 eye; 3.5%). Postoperative complications were phthisis bulbi (1 eye; 3.5%), and cataract (1 ; 3.5%). We found that vitreous surgery is not only useful to removal of the various pathologic conditions of vitreous through the pars plana approach but in anterior segment as an emergency procedure at the time of trauma and vitreous loss during anterior segment surgery.
Cataract ; Diabetic Retinopathy ; Emergencies ; Follow-Up Studies ; Hypertensive Retinopathy ; Membranes ; Postoperative Complications ; Retinal Detachment ; Retinal Vein ; Uveitis ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

No abstract available.
Dysentery, Bacillary*

Purpose: This study aimed to evaluate the effectiveness of exercise in patients with hemophilia. Methods: We carried out a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. A literature search was conducted of published randomized controlled trials for exercise interventions from January 1, 2014 to March 15, 2023. To estimate the size of the effects of exercise, a meta-analysis was performed using the R package “meta.” Results: Five databases were searched to obtain articles published in Korean or English. Of 1,150 articles reviewed, 13 were included in the systematic review and 9 in the meta-analysis. The risk of bias was assessed using RoB 2.0. Results: The overall effect sizes of exercise interventions, calculated as the standardized mean difference, were -0.11 (95% confidence interval [CI] = -1.41 to –1.20) for pain, -2.13 (95% CI = -3.33 to -0.93) for joint health, 9.96 (95% CI = 7.51 to 12.28) for physical activity, and 0.59 (95% CI = -0.39 to -1.56) for quality of life. Conclusion These findings suggest that exercise is useful for improving the joint health and physical activity of patients with hemophilia. Thus, it is necessary to develop and apply exercise interventions for patients with hemophilia to reduce their pain and improve their quality of life.

Although we managed a patient with traumatic endophthalmitis with potent antibiotics for 7 days topically and systemically, her clinical symtoms and signs did not improved and her visual activity decreased from hand motion to light perception. So, we performed pars plana vitrectomy and lensectomy using the Ocutome(R) and Frognatome(TM) and achieved a successful result with final visual acuity of 50 cm finger count or better without evidence of phthisis bulbi in this case.
Anti-Bacterial Agents ; Endophthalmitis* ; Fingers ; Hand ; Humans ; Visual Acuity ; Vitrectomy*

BACKGROUNDS: In the absence of distant metastasis, small cell lung cancer (SCLC) patients presenting with supraclavicular lymph node (SCLN) involvement and pleural effusion can benefit from thoracic radiotherapy. But there are some debate as to the prognostic significance of both SCLN involvement and pleural effusion. The purpose of this study was to determine the prognostic significance of SCLN involvement and pleural effusion in SCLC. METHODS: Two Hundred and fifteen patients with histologically confirmed small cell lung cancer, who were treated either at the Keimyung university Dongsan hospital and Kyungpook national university hospital from January 1994 to June 1998, were evaluated retrospectively. The patients were classified as having either limited or extensive stage using the Veterans Administration staging system. RESULTS: SCLN was presented in 10.5% of patients(n=21). The median survival was 247 days for patients with SCLN(n=21) and 264 days for patients without(n=194) (p=0.52). After treatment, the median survival was 298 days for patients with SCLN(n=13) and 348 days for patients without(n=115) (p=0.52). SCLN involvement was not correlated with the presence of distant metastases. Medican survival was 459 days for patients with a limited stage without SCLN(n=66), 650 days for those with a limited stage with SCLN (n=7) (p=0.96). Pleural effusion was presented in 24.7% of patients(n=52). The median survival was 198 days for patients with pleural effusion(n=52) and 275 days for patients without(n=163) (p<0.05). After treatment, the median survival was 294 days for patients with a pleural effusion(n=25) and 286 days for patients without(n=103) (p=0.39). The presence of pleural effusion was not correlated with that of distant metastases. The median survival was 395 days for patients with a limited stage without a pleural effusion(n=63), 451 days for those with a limited stage with pleural effusion(n=10) (p=0.92). CONCLUSIONS: In this study, SCLN involvement does not explain the poor survival rate and the relevance to extensive staged disease. Furthermore, the existence of a pleural effusion did not correlated with the presence of distant metastases. However, the presence of a pleural effusion appears to be a minor prognostic factor in our study. Therefore supraclavicular lymph node justify any amendment to the staging system currently used.
Gyeongsangbuk-do ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Pleural Effusion* ; Radiotherapy ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Survival Rate ; United States Department of Veterans Affairs

BACKGROUNDS: Assessment of the presence and degree of reversibility of airflow obstruction is clinically important in patients with asthma or chronic obstructive pulmonary disease. The measurement of peak expiratory flow(PEF) is a simple, fast, and cheap method to assess the severity of obstruction and its degree of reversibility. Assessing the reversibility of airflow obstruction by peak expiratory flow(PEF) measurements would be is practicable in general practice, but its usefulness has not been well investigated. We compared PEF and FEV1 in assessing reversibility of airflow obstruction in patients with chronic obstructive pulmonary disease or asthma and developed a practical criterion for assessing the presence of reversibility in general practice. METHODS: PEF measurements were performed (Spirometry) in 80 patients(aged 24-78) with a history of asthma or chronic obstructive lung disease before and after the inhalation of 200 mg salbutamol. The change in PEF was compared with the change in forced expiratory volume in one second(FEV1). Reversible airflow obstruction was analysed analyzed according to American Thoracic Society(ATS) criteria. RESULTS: When defined as a 12% A 12% increase above the prebronchodilator value and a 200ml increase in either FVC or FEV1 reversibility was were observed in 45%(36) of the patients. Relative operating characteristic(ROC) analysis showed that an absolute improvement in PEF of 30l/min gave optimal discrimination between patients with reversible and irreversible airflow obstruction(the sensitivity and specificity of an increase of 30l/min in detecting a 12% increase above the prebronchodilator value and a 200ml increase in either FVC or FEV1 were 72.2% and 72.7% respectively, with a positive predictive value of 68.4%) CONCLUSIONS: Absolute changes in PEF can be used to diagnose reversible airflow obstruction.
Albuterol ; Asthma ; Discrimination (Psychology) ; Forced Expiratory Volume ; General Practice ; Humans ; Inhalation ; Pulmonary Disease, Chronic Obstructive

Generally, osteoporosis is caused by the age-related physiologic bone loss. In cases of severe osteoporosis, the reduced bone mass and increaed skeletal fragility make the risk of fracture high. Recently, the relationship between the mandible and the condition of the skeletal bone, the molphometric data about the quality and quantity of the mandible are very important in the diagnosis and treatment of osteoporosis. This study was undertaken to clarify the correlations of the mineral density between mandible and other bones, to predict the bone mineral density (BMD) of the mandible. Cervical (2nd~5th) and lumbar (1st~4th) vertebrae, the bones of forearm and proximal femurs, mandibles from 42-embalmed cadavers (22/M, 20/F, mean age: 66.95 years) were examined. The BMD was measured by dual energy X-ray absorptiometry. The data were analysed with SPSS 12.0 program according to age, gender, to verify the statistical significance. 1. The BMD in the mandibular areas were variable. The BMD in the angle of the mandible (mean 0.40 g/cm2) was similar with that of ultra-distal part of the forearm (mean 0.34 g/cm2). 2. The BMD in the mandible was highly correlated with that of around the forearm. The correlation coefficient between density in the angle, the part between 1st and 2nd molar, the part between 1st molar and 2nd premolar and incisor portion of the mandible and density in the 1/3-distal part of the forearm was high (r=0.742, 0.697, 0.618, 0.652). The correlation coefficient between density in the part between 1st and 2nd premolar and density in the total femur was high (r=0.542). 3. The BMD in the mandible was correlated with that of around the femur neck (r=0.607). 4. The correlation coefficient between the BMD in the 1st and 2nd molar of the mandible and the BMD in the 5th cervical vertebra was high (r=0.543). And also, the correlation coefficient between the BMD in the incisor area of the mandible and the BMD in the 3rd lumbar vertebra was high (r=0.561). 5. Bony status of the mandible was classified into normal, osteopenia, osteoporosis by BMD of WHO criteria. The data represented that BMD of the mandible was decreased as BMD of the skeletal bones decreased. It is concluded that it could be possible to predict BMD of the mandible by the measurement of BMD in the forearm.
Absorptiometry, Photon ; Bicuspid ; Bone Density ; Bone Diseases, Metabolic ; Cadaver ; Femur ; Femur Neck ; Forearm ; Incisor ; Mandible ; Molar ; Osteoporosis ; Spine

BACKGROUND AND OBJECTIVES: The etiology of Idiopathic sudden sensorineural hearing loss (ISSHL) is uncertain, but viral infection and disturbance of blood circulation in the inner ear are suspected as the causes of the disease, and a stellate ganglion block (SGB) and antiviral agent (Acyclovir) have been used in its treatment. The purpose of this study was to find out the effect of SGB and antiviral agent in the treatment of ISSHL and to find out appropriate patients to evaluate the therapeutic effect. MATERIALS AND METHODS: We reviewed the records of 193 patients (202 ears) who were admitted to the Presbyterian Medical Center from January 1994 to August 2000. Fifty-eight ears were treated with acyclovir and sixty nine ears were treated with SGB and seventy five ears were treated as a control group. RESULTS: The therapeutic result of SGB was better than that of control group and acyclovir had more effect on the subgroups when the initial hearing loss was 41dB~70dB. In the patients with initial hearing level worse than 71dB, the recovery rates were constant regardless of the group. And the patients who were treated after 8 days from the onset had analogic recovery rate to each remedy. CONCLUSION: The patients with the initial hearing level of worse than 71dB and who visited the clinic within 7days of the onset were found to be appropriate candidates for the evaluation of therapeutic effects of ISSHL and SGB. SGB was recommended for the treatment of ISSHL and antiviral agents for patients between the hearing levels of 410dB-70dB.
Acyclovir ; Antiviral Agents ; Blood Circulation ; Ear ; Ear, Inner ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural* ; Humans ; Protestantism ; Stellate Ganglion*