Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age 53+/-12 years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% per year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary a disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of cardiac event rates between patients with normal and abnormal coronary angiograms.
Chest Pain* ; Coronary Artery Disease ; Coronary Vessels ; Death ; Female ; Follow-Up Studies ; Humans ; Male ; Myocardial Infarction ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Prognosis ; Thorax* ; Tomography, Emission-Computed, Single-Photon

It has been shown that both rest and stress myocardial perfusion imagings with technetium agents can be performed on the same day using two different doses injected within few hours. The purpose of this study was to compare the two protocols (stress-rest and rest-stress) in detecting coronary artery diseases. One hundred and sixty patients (101 males, 59 females, mean age 57+/-9 years) and 120 patients (79 males, 41 females, mean age 59+/-10 years) underwent stress-rest myocardial perfusion SPECT and rest-stress myocardial perfusion SPECT, respectively All of them underwent both myocardial perfusion SPECT and coronary angiography within 1 month. A coronary stenosis was considered significant when it compromised the luminal diameter by> or =50%. The chi square test was used to compare differences in sensitivity, specificity and accuracy between the two groups. The overall sensitivity, specificity and accuracy of stress-rest protocol were 99%, 35%and 68%, respectively. Those of rest-stress protocol were 96%, 47%, and 78%, respectively. There was no difference between the two protocols in identifying individual diseased coronary artery branches. Therefore, one day stress-rest and rest-stress myocardial SPECT using Tc-99m agents were comparable and were very sensitive tests in detecting coronary artery diseases.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Female ; Humans ; Male ; Perfusion Imaging ; Perfusion* ; Phenobarbital ; Sensitivity and Specificity ; Technetium ; Tomography, Emission-Computed, Single-Photon

PURPOSE: Tc-99m-tetrofosmin(TF) is a recently proposed myocardial imaging agent which has similar biokinetic characteristics to Tc-99m-sestamibi(MIBI). The aim of this study was to compare TF and MIBI myocardial perfusion SPECTs in detecting coronary artery disease. MATERIALS AND METHODS: One hundred and sixty patients(l0l males, 59 females, mean age 57+/-9 yr) who had undergone both myocardial perfusion SPECT (M- SPECT) and coronary angiography within 1 month were studied. M-SPECT was performed using TF in 115 patients and MIBI in 45 patients. Stress-rest one day protocol was used in all patients A coronary stenosis was considered significant when the luminal diameter > or =50% was compromised. The chi square test was used to compare, differences in sensitivity and specificity between the two groups. RESULTS: There was no difference in age and diseased coronary artery branches between the two groups. There were more male patients in TF group: Male-to-female ratios of TF and MIBI groups were 78:37 and 23:22, respectively (p<0.05). The overall sensitivity of TF study was 92% and specificity 36%. The overall, sensitivity and specificity of MIBI study were 93% and 30% respectively. There was no difference between TF and MIBI groups in identifying individual diseased coronary artery branches. CONCLUSION: One day stress-rest myocardial SPECT using either TF or MIBI was comparable and was a very sensitive test in detecting coronary artery disease.
Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels* ; Female ; Humans ; Male ; Perfusion* ; Phenobarbital ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: Myocardial SPECT is an effective test for detecting coronary artery disease in the general population. But the diagnostic accuracy between sexes is not defined. The purpose of this study is to compare the diagnostic accuracy between males and females. MATERIALS AND METHODS: One hundred and seventy seven male and 98 female patients who underwent myocardial SPECT within 1 month of coronary angiography were studied. Myocardial SPECTs were considered abnormal if fixed or reversible perfusion defects were detected. Stenosis severity of > or = 50% luminal diameter reduction of any artery defined coronary artery disease (CAD). RESULTS: Overall sensitivity for detection of CAD was 98% in men and 97% in women (p=not significant). However, specificities, accuracies, and positive predictive values (PPV) in men and women were 49% vs 31% (p<0.05), 81% vs 57% (p<0.01), 78% vs 48% (P<0.01), respectively Diagnostic accuracies for detection of right coronary artery disease were not different in both sexes, however, accuracies for detection of left anterior descending artery disease and left circumflex artery disease were significantly lower in female (p<0.05). CONCLUSION: A significant difference of diagnostic accuracy between sexes, especially in LAD and LCx disease, was noted. Artifacts from breast attenuation might be a cause for the lower diagnostic accuracy in female.
Arteries ; Artifacts ; Breast ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Humans ; Male ; Perfusion* ; Phenobarbital ; Tomography, Emission-Computed, Single-Photon*

It is well known that involvement of the cranial nerves is a relatively common manifestation of tuberculous meningitis because tuberculous exudate is most likely to be located at the base of brain and in the basal cisterns. We reviewed 73 adult patients under the diagnosis of tuberculous meningitis at Hanyang University Hospital during last three and a half years from March, 1986. Patients were classified into two groups according to the presence or absence of cranial nerve palsies. Cranial nerve palsies were noted in 22 patients (30.1%) at the time of admission or in the early period of antituberculous therapy. The oculomotor and abdcens nerves were most commonly involved, followed by the optic nerve. In 10 cases with oculomotor nerve palsy, 7 cases were noted to have involvement of both pupils and extraocular movements, 2 had involvement of one pupil only and one remaining case involved extraocular movements only (spared pupil). Cranial nerve palsies developed 7 to 89 days (median, 21.5) after initial symptoms, and in 10 cases their palsies disappeared within 15 to 65 days (median, 40.9). The incidence of SIADH and basal meningeal involvement were much higher in the cranial nerve palsy group. Increase of total protein and decrease of sugar in initial CSF examination were significant (p<0.05) in the cranial nerve palsy group.
Adult* ; Brain ; Cranial Nerve Diseases* ; Cranial Nerves* ; Diagnosis ; Exudates and Transudates ; Humans ; Inappropriate ADH Syndrome ; Incidence ; Oculomotor Nerve Diseases ; Optic Nerve ; Paralysis ; Pupil ; Tuberculosis, Meningeal*

We report a false positive case of I-131 scan due to a sialolithiasis in right submandibular gland. I-131 images showed not only remnant thyroid tissues and functional metastases in the anterior neck but also a hot uptake near right submandibular gland. We confirmed the sialolithiasis by radiologic studies. Sialolithiasis should be regarded as a false positive cause when I-131 scan shows a hot spot near salivary bed.
Neck ; Neoplasm Metastasis ; Salivary Gland Calculi* ; Submandibular Gland ; Thyroid Gland* ; Thyroid Neoplasms*

OBJECTIVES: Previous studies reported that attention-deficit hyperactivity disorder (ADHD) resulted from a deficit of selective attention and sustained attention. In this study, we assessed the result of methylphenidate-induced changes of the cerebral frontal executive functions in patients with ADHD. METHODS: The subjects in this study consisted of 16 ADHD patients whose age ranged from 7 to 12. We used ADHD Diagnostic System (ADS) for the attention improvement, and the Stroop Test for the executive function response to pharmacotherapy with MPH. RESULTS: After pharmacotherapy with methylphenidate for 12 weeks, the study group showed improvement in the clinical aspects through Clinical Global Impression-Severity, ADHD-rating scale and Inattention/Overactivity With Aggression Conner's Parents Rating Scale. In the ADS test, only in auditory task there was a decrease of both the response time and the standard deviation of the response time significantly. In the Stroop Test, there was a decrease in the word task, color task and color-word task significantly. CONCLUSION: Our results show that psychostimulant medication improves neuropsychological function, including the cerebral frontal executive function. This study implies that we have to consider the improvement of executive function, as well as attention when evaluating the efficacy of treatment.
Adolescent* ; Aggression ; Child* ; Drug Therapy ; Executive Function ; Humans ; Methylphenidate ; Parents ; Reaction Time ; Stroop Test

OBJECTIVES: This study aimed to investigate the 3-year mean periods aftermath of child sexual abuse and to compare the sexual violence victims regard to the treatment. METHODS: 682 sexual violence victims were recruited by Seoul Sunflower Children Center, a nation-funded sexual violence victim protection center for children age 13, from 2004 to 2008. Data from 49 victims among 116 consented a follow-up, were analyzed. The victims were assessed by psychological test. Data was analyzed by SPSS ver. 15.0 (SPSS Inc.). RESULTS: The average time elapsed from the last presumed sexual abuse was 39.7 months [standard deviation (SD) 26.02]. Overall, Children's Depression Inventory (CDI) was significantly decreased from 15.8 (SD 9.33) to 10.4 (SD 9.98), and several subscales (depression, anxiety, anger, posttraumatic stress, and dissociation) of Trauma Symptom Checklist for Children (TSCC) were also significantly decreased. CDI and TSCC scores showed no statistical difference between treatment-given and not-given groups, but Revised Children's Manifest Anxiety Scale (RCMAS) was decreased in treatment-given group, whereas it was increased in treatment-not-given group. The difference of RCMAS scores between the two groups was statistically significant [F(1,28)=4.54, p < 0.05]. CONCLUSION: Sexually abused children showed overall symptom decreases over time, but anxiety was not decreased in treatment not-given group.
Anger ; Anxiety ; Checklist ; Child ; Child Abuse, Sexual* ; Child* ; Depression ; Follow-Up Studies ; Helianthus ; Humans ; Korea* ; Manifest Anxiety Scale ; Psychological Tests ; Seoul ; Sex Offenses*

OBJECTIVES: The goals of the study are how to establish the cohort systems for the children and adolescents victims with sexual abuse in Korea and to identify the risk and protective factors that influence mental health in child sexual abuse (CSA). This is initial assessment data based on the analysis of cohort variables for baseline evaluation of subjects. METHODS: We constructed the cohort systems for CSA victims recruited by Seoul Sunflower Children Center, CSA victims protection center. The initial assessment data which consisted of demographic and psychological inventories of CSA victims and their parents/families, psychiatric diagnoses were the results of statistical analysis of 65 subjects under 19 years old for 3 years 7 months. RESULTS: The initial data were followings : female participants, N=56; mean age, 11.6 (SD=4.5); the most sexual assault, molestation 71.8%; victims, family and acquaintance 87.1%; 61.5% of the subjects diagnosed with psychiatric disorder; 29.2% diagnosed with PTSD and 23.1% diagnosed with depression. Mean duration for abuse to report is 1.5 years. Mean score of IES-R-K, TSCYC-avoidant and CBCL-problematic behavior were increased above clinical cut-off. CONCLUSIONS: CSA victims tend to have high risks in mental health problem. The cohort study could provide the risk and protective factors of CSA in mental health, and construct the predictive model for mental illness in Korea.
Adolescent ; Child Abuse, Sexual ; Child ; Cohort Studies ; Depression ; Diagnosis ; Equipment and Supplies ; Female ; Helianthus ; Humans ; Korea ; Mental Health ; Protective Factors ; Seoul ; Sex Offenses ; Stress Disorders, Post-Traumatic

BACKGROUND: Tc-99m myocardial perfusion imaging agents have recently found wide spread use as detecting agents of coronary diseases. Unfortunately, false positive results are not infrequent. METHODS: We analyzed Tc-99m myocardial perfusion SPECT (Tc-SPECT) findings in angina patients showing normal coronary angiography. Seventy patients who underwent myocardial SPECT wihin one month of coronary angiography which revealed no significant stenosis were studied. RESULTS: Forty six (65.7%) patients showed perfusion defects on Tc-SPECT. Eighteen were due to soft tissue attenuation, thirteen were due to technical problems such as low count rate, six were associated with intraventricular conduction abnormalities, four with coronary spasms, three with old infarctions, and one with slow coronary flow. CONCLUSION: Photon attenuation and inadequate count rates were the main causes of false positive results on myocardial SPECT imaging with Tc-99m agents. However, pathological conditions such as conduction disturbance, coronary spasm or slow coronary flow were also associated with positive SPECT findings in patients with normal coronary angiograms.
Constriction, Pathologic ; Coronary Angiography* ; Coronary Disease ; Humans ; Infarction ; Myocardial Perfusion Imaging ; Perfusion* ; Spasm ; Tomography, Emission-Computed, Single-Photon*