No abstract available.
Agammaglobulinemia*

Accessory breast is an ectopic breast tissue from developemental remnants. It sometimes begins to make symptoms, pain and swelling, during premenstrual period or pregnancy. For it has been known as a rere condition, it has occasionally misdiagnosed as a abnormal mass, such as lymphadenitis or hidradenitis. We have analyzed 52 accessory breast tissues prospectively, to document the characteristic findings of accessory breast. In summary, the characteristic sonographic findings of accessory breast were the presence of breast tissue superficial to the axillary fascia or underlying fascia if not in axilla, resembling the patient's own breast pattern, the presence of converging appearance of dilated ducts, presence of nipple and/or areola, the obliteration of inner wall of dermis, the obliteration of sucutaneous fat layer, and the downward displacement of axillary fascia or underlying fascia if not in axilla wighout interruption.
Axilla ; Breast* ; Dermis ; Fascia ; Hidradenitis ; Lymphadenitis ; Nipples ; Pregnancy ; Prospective Studies ; Ultrasonography

BACKGROUND: Cardiac troponin T (cTnT) is a new serological marker for use as a diagnostic toots for acute myocardial infarction (AMI). This study was designed to evaluate tee diagnostic efficiency of troponin T in AMI. METHODS: We determined the reference range of troponin T in 20 healthy adults without previous cardiovascular diseases and chest pain. We evaluated troponin-T, CK, LD, AST and CK-MB in serum of 13 AMI and 5 angina pectoris patients. The patients were arrived at the hospital within 3 hours after onset of (most recent) acute symptoms. Samples were drawn individually at the times of 0, 1, 3, 7, 18 and 24 hours after admission and continued at 6-h intervals for 2 days and 24-h intervals fort 2 weeks. Troponin T was determined by an enzyme-linked immuno-sorbent assay (one step sandwich assay) on an ES-300 analyzer. RESULTS: We found that serum troponin-T concentrations in healthy control adults were below 0.07microgram/L. The peak level of troponin-T concentration of patients with AMI was 22.0microgram/L, mean value, at 7 hours after admission and showed 110 times its discrimination limit value (0.2microgram/L). CK-MB value was normalized within 3 days after admission, but cTnT value remained high above its discrimination limit value until 2 weeks after admission during this study. CONCLUSIONS: The data indicate that the measurement of serum cTnT improves efficiency of serological testings of AMI as compared with conventionally used cardiac enzymes.
Adult ; Angina Pectoris ; Cardiovascular Diseases ; Chest Pain ; Discrimination (Psychology) ; Humans ; Myocardial Infarction* ; Reference Values ; Serologic Tests ; Troponin T* ; Troponin*

PURPOSE: Algorithms to get cross-sectional bone density pattern(transverse histogram) to predict the loosening of hip prosthesis using DXA(Dual X-ray Absorptiometry) have been developed. We performed this study to analyze the correlation between radiologic findings and densitometric pattern of the THRA(Total Hip Replacement Arthroplasty) patients. MATERIALS AND METHODS: Thirty-six hips of 32 THRA patients were evaluated. The duration between THRA and DXA was from 1 year 7 months to 15 years. On transverse histogram, the periprosthetic bone density patterns were classified as 3 types;type I, rigid fixation in 17, type II, definite loosening in 8, and type III, partial loosening in 11 cases. Surgical findings, plain X-ray findnings and transverse histogram using DXA were correlated. RESULTS: Among 14 cases performing revision for acetabular prosthesis loosening, 5 cases revealed loosening of fernoral stems while 9 cases revealed rigid fixation of femoral stems. Sensitivity was 100% for either plain X-ray or DXA. Specificity was 88%, 77% for plain X-ray and DXA respectively. CONCLUSION: This preliminary study reveals that periprosthetic bone density pattern on transverse histogram on DXA may be useful in the evaluation of the loosening. However, further study will be needed for clinical application.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Bone Density ; Hip ; Hip Prosthesis ; Humans ; Prosthesis Failure ; Sensitivity and Specificity

PURPOSE: To assess the spinal canal and neural foraminal stenosis associated with spondylolisthesis on MR imaging. MATERIALS AND METHODS: We retrospectively analysed MR findings of 63 cases of spondylolisthesis(degenerative type:23 cases, isthmic type:40 cases) regarding the type and grade of spondylolisthesis, prensence or absence of associated spinal canal stenosis, and the severity of associated neural foraminal stenosis. RESULTS: Central canal stenosis were more frequent in degenerative type(91%) than isthmic type(33%), and more frequent in grade II spondylolisthesis of degenerative type(100%) and isthmic type(89%) than in grade spondylolisthesis of degenerative type(45%) and isthmic type(20%). There was positive correlation between the severity of neural foraminal stenosis and the grade of spondylolisthesis, whereas there was no significant difference between degenerative and isthmic types. CONCLUSION: Degenerative spondylolisthesis were frequently associated with central canal stenosis more than isthmic type. When the grade of spondylolisthesis was higher, it was more frequently associated with central canal stenosis and severe neural foraminal stenosis.
Constriction, Pathologic* ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Canal ; Spondylolisthesis*

PURPOSE: To evaluate the ultrasonomammographic findings of breast fibroadenoma. METHODS AND MATERIALS:We evaluated the ultrasonographic findings of histopathologically proved 135 fibroadenomas in 103 patients from January 1986 to September 1990, retrospectively. The ultrasonographic examinations were performed with a hand held linear array 5MHz transducer(Acuson 128(USA). Aloka 650, 280(Japan)). A sonopad was also used during the examinations. RESULTS: The common ultrasonographic findings of fibroadenomas usually showed smooth contour in 120 lesions(88.9% ), oval or round shape in 114 lesions(84.4%), uniform homogeneous echogenecity in 106 lesions(78.5% ), intermediate hypoechoic internal echo pattern in 105 lesions(77.8%), thin boundary echo in 117 lesions(86.7%), lateral shadowings in 97 lesions(72%), and posterior acoustic enhancement in 56 lesions(41%). The longitudinal/transverse ratio of fibroadenoma was revealed between 0.2 and 1.14 (mean 0.58) and usually under 1.0 (68.9%). CONCLUSION: Finally, most of fibroadenomas are easily diagnosed by ultrasonography but if differential diagnosis from malignant breast mass is difficult due to atypical appearance, other combined modalities such as filmmammography, fine needle aspiration biopsy and MRI are necessary.
Acoustics ; Biopsy ; Biopsy, Fine-Needle ; Breast* ; Diagnosis, Differential ; Fibroadenoma* ; Hand ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Shadowing (Histology) ; Ultrasonography

To evaluate the usefulness of MR in the osteomyelitis, we reviewed MR examinations of 14 patients with pyogenic osteomyelitis of the long bone. All 14 patients were confirmed to have osteomyelitis either surgically (13/14) or by aspiration (1/14). MRI was performed with 0.5R (n=8) or 2.0T (n=6) SE technique, and Gd-DTPA enhanced T1WI was obtained in 10 examinations. Anatomic location of lesions were femur (8/14), tibia (5/14),m and fibula (1/14). The marrow cavity and soft tissue were involved in 13/14, 12/14 respectively. The signals of both intraosseous and extraosseous infected area were iso to low signal intensity to muscles on T1WI and high signal intensity on PDWI & T2WI. Rim or diffuse enhancement of the marrow cavity and soft tissue were seen in all (10/10) cases. Sequestra, periosteal reaction. And cortical defect were found in 12/14, 10/14, 9/14. MR provided more accurate and detailed anatomic information including extent of disease and possible activity than bone scintigraphy, CT, or conventional radiography. We conclude that MR might be the choice of modality in the diagnosis of osteomyelitis of the long bone.
Bone Marrow ; Diagnosis ; Femur ; Fibula ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Muscles ; Osteomyelitis* ; Radiography ; Radionuclide Imaging ; Tibia

Orbital tuberculosis is a rare form of extrapulmonary tuberculosis, even in endemic areas. It may involve the soft tissue, lacrimal gland, periosteum, or bones of the orbital wall. We present a case of orbital tuberculosis on the lower eyelid. An 18-year-old woman with no underlying disease visited our clinic for evaluation of an oval nodule (1.5× 1.2 cm) on the right lower eyelid. Incision and drainage without biopsy was performed 2 months ago in ophthalmology department, but the periorbital mass had deteriorated, as the patient had erythematous swelling, tenderness, and cervical lymphadenopathy. Visual acuity was normal; there were no signs of proptosis, diplopia, or ophthalmoplegia. Computed tomography revealed a small abscess cavity without bony involvement. We performed an excision and biopsy through a percutaneous incision under local anesthesia. Histological examination revealed a granuloma and was diagnosed as orbital tuberculosis. The patient was additionally treated with anti-tuberculosis therapy for 6 months and recovered without complication or recurrence by 7 months. Orbital tuberculosis occurs in patients with or without associated pulmonary tuberculosis, and should be considered as a differential diagnosis in patients with inflammatory orbital disease and an orbital mass. If recurrence occurs despite adequate initial treatment, we recommend an additional examination and excisional biopsy.
Abscess ; Adolescent ; Anesthesia, Local ; Biopsy ; Diagnosis, Differential ; Diplopia ; Drainage ; Exophthalmos ; Eyelids ; Female ; Granuloma ; Humans ; Lacrimal Apparatus ; Lymphatic Diseases ; Ophthalmology ; Ophthalmoplegia ; Orbit ; Orbital Diseases ; Periosteum ; Recurrence ; Tuberculosis ; Tuberculosis, Pulmonary ; Visual Acuity

OBJECTIVE: To estimate the motor unit numbers in normal adult hand muscles using manual incremental technique and F-wave technique. METHOD: We estimated the motor unit numbers in abductor pollicis brevis muscles of twenty normal adults. In manual incremental technique, we estimated the motor unit numbers using motor unit count program setted in electrodiagnostic equipment (Dantec, Keypoint). In F-wave technique, we estimated the motor unit numbers dividing maximal M-potential amplitude by mean amplitude of surface motor unit action potential. RESULTS: There was no significant difference of motor unit numbers between right and left abductor pollicis brevis in both manual incremental and F-wave technique. Motor unit numbers using F-wave technique were significantly greater than motor unit numbers using manual incremental technique. CONCLUSION: The difference of motor unit numbers using manual incremental technique and F-wave technique was considered as a difference of functional electrical stimulation. F-wave technique was more physiologic and functional method of motor unit numbers estimation than manual incremental technique.
Action Potentials ; Adult* ; Electric Stimulation ; Hand ; Humans ; Muscles

OBJECTIVES: The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. METHODS: A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudocontrol group. RESULTS: The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. CONCLUSIONS: The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.
Child, Preschool ; Cost Sharing/*legislation & jurisprudence ; *Health Policy ; Health Services/*utilization ; Hospitalization ; Humans ; Insurance Claim Review ; Korea ; Length of Stay