OBJECTIVE: Serologic support is important for the diagnosis of rheumatoid arthritis (RA). Anti-cyclic citrullinated peptide (anti-CCP) has relatively low sensitivity despite of high specificity for the diagnosis of RA. Anti-mutated citrullinated vimentin (anti-MCV) is an indirect solid phase enzyme immunoassay for the quantitative measeurement of IgG class autoantibodies against MCV, a novel serologic marker for an aid in the diagnosis of RA. We investigated a diagnostic value of anti-MCV in comparison with those of anti-CCP, and rheumatoid factors (IgM, IgG, and IgA RFs) in RA patients. METHODS: Cohorts of 48 patients with RA and 50 patients with osteoarthritis (OA) were enrolled. All patients underwent standard examinations, including anti-MCV, anti-CCP, IgM RF, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). We measured IgG RF and IgA RF titers in 21 RA and 50 OA patients. The sensitivities and specificities of anti-MCV, anti-CCP, RFs were determined. Correlations with these markers, ESR and CRP were analyzed. RESULTS: The sensitivity of anti-MCV, anti-CCP, and IgM RF were 89.6%, 89.6%, and 77.1%, respectively. The specificities of them were 96.0%, 96.0%, and 88%, respectively. Combination of two tests such as anti-MCV or anti-CCP positivity increased the sensitivity up to 93.8%. None of these markers showed significant correlation with ESR and CRP. Anti-MCV correlated with anti-CCP (r=0.596, p<0.01) and IgM RF (r=0.301, p=0.038). CONCLUSION: Anti-MCV and anti-CCP showed high sensitivity and specificity for the diagnosis of RA. Combination of these markers increased the sensitivity without significant decrease in the specificity, suggesting they may be promising serologic markers for RA.
Arthritis, Rheumatoid* ; Autoantibodies ; Blood Sedimentation ; C-Reactive Protein ; Cohort Studies ; Diagnosis ; Humans ; Immunoenzyme Techniques ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Osteoarthritis ; Rheumatoid Factor* ; Sensitivity and Specificity ; Vimentin*

PURPOSE: To compare the diagnostic accuracy of proximal caries detection between Kodak Insight film and the Biomedisys CDX2000HQ digital (CCD) sensor. MATERIALS AND METHODS: 156 proximal surfaces of extracted teeth, 78 of which had chemical artificial caries, were used in this study. Four observers interpreted the radiographs using a five-point confidence rating scale to record their diagnoses. The results were analyzed by receiver operating characteristic curves, ANOVA and Kappa values. RESULT: Analysis using receiver operating characteristic curves revealed the areas under each curve which indicated a diagnostic accuracy of 0.951 in Insight and 0.952 in CDX2000HQ digital sensor. ANOVA revealed no significant differences between the two images with respect to caries detection. Kappa values indicated that the mean intra-observer agreement was 0.85 and inter-observer agreement 0.71 in conventional radiography. In digital radiography, the mean intraobserver agreement was 0.84 and inter-observer agreement 0.72. CONCLUSION: The results suggest that no significant difference exists between the two modalities for artificial caries detection and that CDX2000HQ was as good as Insight film for this purpose.
Dental Caries ; Diagnosis ; Radiographic Image Enhancement ; Radiography ; ROC Curve ; Tooth ; X-Ray Film

No abstract available.
Pneumonia*

PURPOSE: We compared the reproducibility of 201Tl and 99mTc-sestamibi (MIBI) gated SPECT measurement of myocardial function using the Germano algorithm. MATERIALS AND METHODS: Gated SPECT acquisition was repeated in the same position in 30 patients who received 201Tl and in 26 who received 99mTc-MIBI. The quantification of end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) on 201Tl and 99mTc-MIBI gated SPECT was processed independently using Cedars quantitative gated SPECT software. The reproducibility of the assessment of myocardial function on 201Tl gated SPECT was compared with that of 99mTc-MIBI gated SPECT. RESULTS: Correlation between the two measurements for volumes and EF was excellent by the repeated gated SPECT studies of 201Tl (r=0.928 to 0.986; p<0.05) and 99mTc-MIBI (r=0.979 to 0.997; p<0.05). However, Bland Altman analysis revealed the 95% limits of agreement (2 SD) for volumes and EF were tighter by repeated 99mTc-MIBI gated SPECT (EDV: 14.1 ml, ESV: 9.4 ml and EF: 5.5%) than by repeated 201Tl gated SPECT (EDV: 24.1 ml, ESV: 18.6 ml and EF: 10.3%). The root mean square (RMS) values of the coefficient of variation (CV) for volumes and EFs were smaller by repeated 99mTc-MIBI gated SPECT (EDV: 2.1 ml, ESV: 2.7 ml and EF: 2.3%) than by repeated 201Tl gated SPECT (EDV: 3.2 ml, ESV: 3.5 ml and EF: 5.2%). CONCLUSION: 99mTc-MIBI provides more reproducible volumes and EF than 201Tl on repeated acquisition gated SPECT. 99mTc-MIBI gated SPECT is the preferable method for the clinical monitoring of myocardial function.
Humans ; Perfusion* ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed, Single-Photon*

An 8 year-old boy was presented with typical symptoms of neuromyelitis optica. Hematologic data revealed leucocytosis and elevated erythrocyte sedimentation rate(ESR). CSF analysis showed elevated protein and lymphocyte dominant leucocytosis. Treatment with high dose steroid was administered. He recovered fully within a few weeks after the onset or paraparesis. Neuromyelitis optica is a clinical syndrome. Pathophysiologically, it is a autoimmune process involving the optic nerve and the spinal cord. It is characterized by rapid progressive paraparesis and bilateral visual disturbance. There are no definitive laboratory clues for diagnosis. Treatments including the use of steroid, ACTH, antiviral agent and immunosuppresant, all result in variable effect. Prognosis is very variable ranging from full recovery to death. The most common cause of death is respiratory failure with the cord lesions. Neuromyelitis optica is very rare in Korea. We report the case with review of the literature.
Adrenocorticotropic Hormone ; Blood Sedimentation ; Cause of Death ; Child ; Diagnosis ; Humans ; Korea ; Lymphocytes ; Male ; Neuromyelitis Optica ; Optic Nerve ; Paraparesis ; Prognosis ; Respiratory Insufficiency ; Spinal Cord

Orofacial pain can be caused by intracranial disorders or can be musculoskeletal, vascular, internal derangemental, and neurologic in origin. The neurologic pain is derived from structural and functional disorders of nerve, and the trigeminal neuralgia is the typical manifestation. Trigeminal neuralgia is known from centuries ago, and is one of the most common pains in human. We present our experience with three patients who have trigeminal neuralgia. The first case is a 50-year-old female who had no specific evidence radiographically. Second is a 50-year-old male with microvascular compression on right trigeminal nerve. The third case is a 60-year-old female who had a neoplasm in cerebellopontine angle with associated mass effect.
Cerebellopontine Angle ; Facial Pain ; Female ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Trigeminal Nerve ; Trigeminal Neuralgia*

The odontogenic myxoma is an infiltrative benign tumor of bone that occurs almost exclusively in the jaw bones and comprises 3% to 6% of odontogenic tumors. This neoplasm is thought to arise from the primitive mesenchymal structures of a developing tooth, including the dental follicle, dental papilla, or periodontal ligament. Radiographically the odontogenic myxoma may produce several patterns: unicystic, multilocular, pericoronal, and radiolucent-radiopaque, making the differential diagnosis difficult. In this report, two cases of the odontogenic myxoma in the jaw bones are presented. The first case involved only the mandible, while the second case involved the maxilla. Both cases presented extensive multilocular radiolucencies characteristic of odontogenic myxoma.
Dental Papilla ; Dental Sac ; Diagnosis, Differential ; Jaw ; Jaw Neoplasms ; Magnetic Resonance Imaging ; Mandible ; Maxilla ; Myxoma* ; Odontogenic Tumors ; Periodontal Ligament ; Tooth

Deteriorated mental status and new neurological deficits after head trauma signify the formation of intracranial hematoma or brain edema. In a case of head trauma accompanied by basal skull fracture, even if without intracranial hematoma formation or edema, we should be alert to the possibility of injury of the petrosal carotid artery which needs prompt diagnostic evaluation and management. We report a case of traumatic cerebral infarction due to injury of the petrosal internal carotid artery and review the literatures.
Brain Edema ; Carotid Arteries ; Carotid Artery, Internal* ; Cerebral Infarction* ; Craniocerebral Trauma* ; Edema ; Head* ; Hematoma ; Skull Fractures

Enteritis cystica profunda is a very rare disease in which a mucin-filled cystic space is surrounded partially with nonneoplastic columnar epithelium in the submucosa of the small intestine. Most of the cases are accompanied by intestinal diseases, and the disease usually occurs in the jejunum and the ileum and there has been no report of a case that occurred in the ampulla of Vater. A 58-year-old healthy female patient without any particular symptom visited the hospital to get additional examination for a mass found on the ampulla of Vater by accident. In esophagogastroduodenoscopy, a cystic mass showing a positive pillow sign was found on the ampulla of Vater. Endoscopic retrogradecholangiopancreatography was conducted as choledochocele was suspected, but no abnormality was found in the biliary system. In endoscopic ultrasonography, multiseptated cystic structures were detected in the submucosal layer of the duodenum. The lesion was resected completely through endoscopic snare polypectomy and the case was histologically diagnosed as enteritis cystica profunda.
Ampulla of Vater ; Biliary Tract ; Choledochal Cyst ; Duodenum ; Endoscopy, Digestive System ; Endosonography ; Enteritis ; Epithelium ; Female ; Humans ; Ileum ; Intestinal Diseases ; Intestine, Small ; Jejunum ; Rare Diseases ; SNARE Proteins

BACKGROUND: Apolipoprotein E has been one of the most thoroughly studied genetic polymorphisms, particularly for its effects on lipid profiles and coronary heart disease risk. This study investigated the relationship between the apolipoprotein E polymorphism and essential hypertension in a Korean population. METHODS: The subjects (n=1,243) were participants in a population-based study in Incheon metropolitan City, Korea. The apolipoprotein E polymorphism was determined using a polymerase chain reaction method. RESULTS: The frequencies of the genotypes did not differ significantly between the hypertensive groups (60.0% epsilon2/epsilon2, 30.8% epsilon2/epsilon3, 44.4% epsilon2/epsilon4, 33.3% epsilon3/epsilon3, 32.3% epsilon3/epsilon4, and 15.4% epsilon4/epsilon4; p=0.498). After adjusting for other risk factors, genotypes were not associated with hypertension(OR 5.74, 95% CI 0.81-40.76, epsilon2/epsilon2 vs. epsilon3/epsilon3; OR 0.94, 95% CI 0.60-1.47, epsilon2/epsilon3 vs. epsilon3/epsilon3; OR 1.21, 95% CI 0.30-4.89, epsilon2/epsilon4 vs. epsilon3/epsilon3; OR 0.79, 95% CI 0.56-1.13, epsilon3/epsilon4 vs. epsilon3/epsilon3; OR 0.29, 95% CI 0.06-1.45, epsilon4/epsilon4 vs. epsilon3/epsilon3). CONCLUSIONS: These findings suggest that the apolipoprotein E polymorphism is not associated with hypertension.
Adult* ; Apolipoproteins* ; Coronary Disease ; Genotype ; Humans ; Hypertension* ; Incheon ; Korea ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Risk Factors