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*

No abstract available.
Biopsy* ; Breast Neoplasms* ; Breast*

One hundred and fifty two patients presenting with palpable primary breast cancer were studied to evaluate accuracy of clinical assessment, mammography, and ultrasonography in measuring tumor size. The clinical, mammographic, and ultasonographic diameter of tumor size was compared to histological diameters. The histological diameter of tumors was 27.9+/-12.7mm. The average diameter of tumor on clinical assessment was 33.8+/-13.1mm and its correlation coefficient to the histological size was 0.73. The average size on the mammography was 21.4+/-9.0m and its correlation coefficient to the histological size is 0.71. The tumor size on the ultrasonography in 22 patients was is 22.3+/-10.4mm. The sonographic measurement dimonstrated the highest correlation coefficient (0.83). The clinical assessment overstimated the tumor size, but the mammogaphic and sonographic measurement understimated it compared with histological size. The combined measurement with clinical and ultrasonography could be useful method to estimate tumor size preoperatively. And when it is combined with clinical assessment, it is the most reliable and accurate technique.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Ultrasonography

Apocrine carcinoma is an uncommon, poorly characterized type of breast tumor. The histologic characteristics of apocrine epithelium in malignant breast lesion were first noted by Krompecher(1916), while the first detailed description of an apocrine carcinoma is credited to Ewing in 1928. The reported incidence of apocrine carcinoma is approximately 0.4% of breast cancers. Apocrine carcinoma has distinct histologic and ultrastructural features that distinguish it as a specialized form of infiltrating ductal carcinoma. The finding of a uniform pattern of apocrine differentiation with dense granularity typifying the majority of cells characterizes this variant. We experienced two cases of invasive apocrine carcinoma of the breast and report with a review of the related literature.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Epithelium ; Incidence

Leprosy is disease of skin and peripheral nerve especially. Sequale and disability of musculoskeletal system, especially peripheral extremities (hands and foots) can be developed due to severe and irreversible peripheral nerve damage in leprosy. In leprosy, Skin ulcers can relapse very often and progress to deformity and amputation of hands or foot. We need methods to treat skin ulcer effectively. We have used various therapies such as antibiotics in infectious state, disinfectant, variable wet dressing materials(transparent film, foams, gels&hydrogels, hydrocolloids, calcium alignate), silver dressing, Vacuum Assisted Closure unit, debridement, curettage, surgery to treat skin ulcer in leprosy patients. Sometimes we can treat skin ulcer successfully but, we often encounter ulcer resistant to treat. We need to find and develop methods to treat ulcer successfully. Several researches have reported articles to treat wound successfully using light emitting diode(LED). We tried to treat ulcer in old leprosy patients using LED. We divided ulcers patients into case group(conventional dressing therapy + LED therapy) and control group (only conventional dressing therapy) randomly in out patient department and in ward. This research was carried out from February 2012 to September 2012. Case group and control group have composed of 30 patients respectively. Average age of patients was 74 years old in case group and 69 years old in control group. We have used LED device composed of 700 pieces of diodes emitting 635nm and 500 pieces of diodes emitting 830nm, totally 1200 pieces of diodes. We have observed the size of wounds twice per week in control group and case group. Before treatment average size of wounds was 8509.76mm3 in case group and 8625.33mm3 in control group. P-vale was 0.49. There was no significant difference in case and control group. After treatment average size of wounds was 787.83mm3 in case group and 8074.63mm3 in control group. P-vale was 0.02. There was significant difference in case and control group. After treatment average reduction of size per time was 338.02mm3/day in case group and 26.55mm3/day in control group. P-vale was 0.002. There was significant difference in case and control group. Therefore we have concluded that LED device was effective in wound treatment. Some articles have reported that LED Device have helped to treat wounds in DM ulcer, third degree burn, oral ulcer, skin ulcer in Klippel-Trenaunay syndrome patient, some retinopathy etc. We have concluded that LED of infrared or long visible wavelength light can be used effectively in treatment of wound along with conventional treatment concurrently.
Amputation ; Anti-Bacterial Agents ; Bandages ; Burns ; Calcium ; Colloids ; Congenital Abnormalities ; Curettage ; Debridement ; Enzyme Multiplied Immunoassay Technique ; Extremities ; Foot ; Foot Ulcer ; Hand ; Humans ; Klippel-Trenaunay-Weber Syndrome ; Leprosy ; Light ; Musculoskeletal System ; Negative-Pressure Wound Therapy ; Oral Ulcer ; Peripheral Nerves ; Recurrence ; Silver ; Skin ; Skin Ulcer ; Ulcer

BACKGROUND: Survival time of patients with multiple myeloma has been reported to be closely related to the cytology of bone marrow smears and the histologic features of bone marrow biopsies. However, there have been many differences in morphological criteria applied by various authors. In this study, we evaluated the prognostic relevance of bone marrow features in patients with multple myeloma by investigation of the cytologic feature and the histologic patterns. MATERIALS AND METHODS: One hundred and seven previously untreated patients with multiple myeloma, admitted to Asan Medical Center, between 1989 and 1997, were studied. Bone marrow aspirations and biopsies were analyzed according to the criteria such as cytologic differentiation, volume of infiltration, pattern of infiltration, degree of hematopoiesis, and presence of fibrosis. RESULTS: 64 cases (59.8%) of 107 patients with multiple myeloma were plasmacytic type and 43 cases (40.2%) were plasmablastic type. Each median survival time was 35.0 months and 18.0 months (P<0.05). The patients with more than 25% of plasmablasts showed shorter median survival time than those with 1ess than 25% (18 months vs 38.9 months, P<0.05). The patients with nodular or packed marrow pattern revealed poorer prognosis than those with interstitial or interstitial/nodular pattern (P<0.05). The patients of plasmablastic type disclosed larger volume of myeloma cell infiltration and more packed marow pattern than those of plasmacytic type. CONCLUSIONS: The cytologic differentiation, the volume of infiltration and the patterns of infiltration were reliable predictors of survival in myeloma patients. Thus, for the prognostic evaluation and therapeutic plans, the descriptions for cytologic differentiation (especially percentage of plasmablasts), volume of infiltration and pattern of infiltration should be included in the bone marrow interpretation of multiple myeloma.
Aspirations (Psychology) ; Biopsy ; Bone Marrow* ; Chungcheongnam-do ; Fibrosis ; Hematopoiesis ; Humans ; Multiple Myeloma* ; Prognosis

BACKGROUND: Nm23 gene was identified by the hybridization between two murine melanoma cell lines which had low or high metastatic potential and was located in chromosome 17q22. A number of tumor cohort studies have shown an inverse relationship between the levels of expression of nm23 protein and disease aggressiveness and tumor metastatic potential. METHODS: In order to determine the significance of overexpression of the antimetastatic gene nm23 protein in human-lymph node-negative breast cancer and to compare it with established clinicopathologic prognostic factors such as the tumor size, histologic grades, TNM stages, and hormonal receptor status, we analyzed the nm23 protein expressions by immunohistochemical staining in 53 lymph-node-negative breast-cancer tissue specimens. RESULTS: The nm23 protein expression was positive in 35 cases (66%). There was no relationship between nm23 protein overexpression and menopause status, tumor size, histologic grade, and hormonal receptor status, but tumor stage correlated with nm23 protein overexpression. Also, overexpression of the nm23 protein was significantly correlated with a longer disease-free survival rate. CONCLUSION: Expression of nm23 protein may be of value for predicting the long-term disease-free survival rate in lymph-node-negative breast-cancer patients.
Breast Neoplasms ; Breast* ; Cell Line ; Cohort Studies ; Disease-Free Survival ; Female ; Humans ; Lymph Nodes* ; Melanoma ; Menopause ; Staphylococcal Protein A*

Axial mesodermal dysplasia complex (AMDC) arises in variable combinations of craniocaudal anomalies such as musculoskeletal deformities, neuroschisis, or rhombencephalic developmental disorders. To the best of our knowledge, the co-existence of AMDC with associated musculoskeletal anomalies, medullary neuroschisis with mirror movements, and cranial nerve anomalies has not yet been reported. Here, we report the case of a 4-year-old boy whose clinical features were suggestive of Goldenhar syndrome and Poland syndrome with Sprengel deformity. Moreover, he showed mirror movements in his hands suspected of rhombencephalic malformation, and infranuclear-type facial nerve palsy of the left side of his face, the opposite side to the facial anomalies of Goldenhar syndrome. After conducting radiological studies, he was diagnosed with medullary neuroschisis without pontine malformations and Klippel-Feil syndrome with rib anomalies. Based on these findings, we propose that clinical AMDC can be accompanied by a wide variety of musculoskeletal defects and variable degrees of central nervous system malformations. Therefore, in addition to detailed physical and neurological examinations, imaging studies should be considered in AMDC.
Central Nervous System ; Child, Preschool ; Congenital Abnormalities ; Cranial Nerves ; Facial Nerve ; Goldenhar Syndrome ; Hand ; Humans ; Klippel-Feil Syndrome ; Male ; Medulla Oblongata ; Mesoderm* ; Neurologic Examination ; Paralysis ; Poland Syndrome ; Rhombencephalon ; Ribs

This study was carried out to evaluate the factors influencing the outcome of an operation for adrenal hypertension. 35 patients with adrenal hypertension who were operated on between Jan. 1989 and Dec. 1996 at the Department of surgery, Korea University Hospital, underwent an adrenalectomy for pheochromocytoma, Cushing's syndrome and primary aldosteronism. Out of 20 clinicopathologic factors, only 3 were showen through univariate analysis to be associated with postoperative persistent hypertension. Fifteen of the 16 patients with pheochromocytoma (93.8%), 4 of the 7 patients with Cushing's syndrome (57.8%), and 5 of the 12 patients with primary aldosteronism became normotensive following surgery. Persistent hypertension correlated with a kind of adrenal hypertension, especially Cushing's syndrome or primary aldosteronism (p=0.012). In primary aldosteronism, none of the patients with fundoscopic arterial grade of more than III were in the complete response group but 5 of the 7 patients in the incomplete response group (p=0.004). For primary aldosteronism the mean serum renin level for the complete response group was 0.058+/-0.025 ng/ml/hr and that of incomplete response group was 0.51+/-0.87 ng/ml/hr (p=0.03). This study suggests that or adrenalectomy for hypertension with Cushing's syndrome or primary aldosteronism results in a more unfavorable outcome than one for hypertension with pheochromocytoma. The presence of fundoscopic arterial grade of more than III or a depressed serum renin level in primary aldosteronism was a cautious predictor of persistent hypertension after the adrenalectomy.
Adrenal Glands ; Adrenalectomy ; Cushing Syndrome ; Humans ; Hyperaldosteronism ; Hypertension ; Korea ; Pheochromocytoma ; Renin

BACKGROUND: As surgical techniques and postoperative care are improving, a pneumonectomy is a relatively popular surgical method in disease which is not treated completely with other types of pulmonary resection. However, a postpneumonectomy complication is a serious life-threatening problem if it occurrs. The purpose of this study is to evaluate determinants for postoperative mortality after pneumonectomy. METHODS: Patients were divided for study as follows: the Dead group versus the Alive group. To determine whether age, operation site, operation time, intraoperative fiuid intake, urine output, blood loss, complications, preoperative and intraoperative arterial blood gas analyses, and preoperative pulmonary function tests influence the determinants for postoperative mortality after pneumonectomy, a rettospecive analysis was performed on 71 patients who had undergone pneumonectomy from 1990to 1994 in Kosin Medical COLLEGE hOSPITAL. RESULTS: Operation time and blood loss were longer and greater respectively in the Dead group. The intraoperative PaO2 was lower and incidence of complications was more frequent in the Dead group.Otherwise there were no significant differences between two groups. CONCLUSION: We concluded that operation time, blood loss, incidence of complications and intra-operative PaO2 were closely related with postoperative mortality.
Blood Gas Analysis ; Humans ; Incidence ; Mortality* ; Pneumonectomy* ; Postoperative Care ; Respiratory Function Tests