PURPOSE: It is difficult to determine the activity of tuberculosis radiologically. Therefore there have been efforts to assess the activity using radiopharmaceuticals such as 67Ga, 99mTc-tetrofosmin, and 99mTc-MIBI. But there may be some discrepancy in defining the term 'activity' between clinicians and nuclear physicians. While negative conversion of sputum acid fast bacilli (AFB) is defined as 'disappearance of activity' by clinicians, a loss of uptake in previously positive lesion is accepted as 'disappearance of activity' by nuclear physicians. We designed a prospective study to see if the negative conversion of sputum AFB could directly match the disappearance of radioactivity of the lesion. MATERALS AND METHODS: Fifteen patients with bacteriologically confirmed active localized pulmonary tuberculosis were scanned 10 and 60 min after intravenous injection of 550 MBq 99mTc-MIBI. In 6 patients, who showed negative conversion of sputum AFB after 3-7 months of chemotherapy, 99mTc-MIBI scan was repeated. For the purpose of comparison, target/nontarget ratios of the lesions were determined. RESULTS: 12/15 (80%) patients with active pulmonary tuberculosis showed increased uptake of 99mTc-MIBI in tuberculous lesion. After negative conversion of sputum AFB, 5/6 (83%) patients still showed increased uptake, although the intensity of uptake decreased. CONCLUSION: Uptake of radioactivity decreased but did not disappear after negative conversion of sputum AFB. 99mTc-MIBI scan may be useful to address the degree of inflammation of pulmonary tuberculous lesion, but the uptake did not directly match the activity defined by positivity of sputum AFB. We nuclear physicians might have used the term 'activity' somewhat differently from clinicians who treat patients with tuberculosis.
Drug Therapy ; Humans ; Inflammation ; Injections, Intravenous ; Prospective Studies ; Radioactivity ; Radiopharmaceuticals ; Sputum ; Tuberculosis* ; Tuberculosis, Pulmonary*

PURPOSE: To evaluate dysphagia objectively and quantitatively, and ta clarify the effect of neck position and viscosity changes in patients with aspiration and laryngeal penetration. MATERIALS AND METHODS: We studied 35 patients with dysphagia and 21 normal controls using videofluoroscopy and scintigraphy. Videofluoroscopy was performed with barium with three different viscosity, and scintigraphy was done, with water, yogurt, and steamed egg mixed with Tc-99m tin colloid. 1f aspiration was found during videofluoroscopic examination, patients neck position was changed and study repeated. Videofluoroscopy was analyzed qualitatively. We calculated 7 quantitative parameters from scintigraphy. According to the videofluoroscopic findings, we divided patients into 3 subgroups; aspiration, laryngeal penetration, and no-aspiration group. RESULTS: The result of videofluoroscopy revealed that the most cornmon finding was the delay in triggering pharyngeal swallow. Pharyrigeal transit time (PTT) and pharyngeal swallowing efficiency(PSE) in patients with aspiration were significantly different from other groups. After neck position change, aspiration could be reduced in all of 7 patients, and laryngeal penetration reduced hy about 82%. PTT ancl PSE were also improved after position change. Aspiration and laryngeal penetration occurred more frequently in thin liquid swallowing than in thick liquid and solid swallowing. CONCLUSION: PTT and PSE were useful for the evaluation of dysphagia. Aspiration and laryngeal penetration could be reduced when appropriate position assumed, We could decrease the chance of aspiration by changing the patient diet consisIency. Scintigraphy might be useful tool to quantitate and follow up these changes.
Barium ; Colloids ; Deglutition ; Deglutition Disorders* ; Diet ; Evaluation Studies as Topic* ; Follow-Up Studies ; Humans ; Neck ; Ovum ; Radionuclide Imaging* ; Steam ; Tin ; Viscosity ; Water ; Yogurt

Although cerebrospinal fluid leakage is suggested as one of the causes of spontaneous intracranial hypotension, on]y a few cases with direct evidence of cerebrospinal fluid leakage on radionuclide cisternography have been reported in the literature Indirect evidences of cerebrospinal fluid leakage such as early visualization of the soft tissue and bladder or delayed migration of radiotracer have been observed in most patients with spontaneous intracranial hypotension. We report a case of spontaneous intracranial hypotension in which cerebrospinal fluid leakage was directly demonstrated by early dynamic imaging of spine on radionuclide cisternography. We suggest that early dynamic imaging of spine is an important adjunctive procedure in detecting cerebrospinal fluid leakage in patients with spontaneous intracranial hypotension.
Cerebrospinal Fluid* ; Humans ; Intracranial Hypotension* ; Spine ; Urinary Bladder

No Abstract Available.
Keratitis* ; Keratomileusis, Laser In Situ*

No abstract available.
Chylothorax*

OBJECTIVE: To evaluate the effects of strengthening exercise for isolated lumbar extensor muscles on chronic low back pain patients. METHOD: 28 patients with chronic low back pain in back school program participated in this study. Initially, isometric lumbar extensor strength, 10 point of Visual analog scale (VAS) and questionnaires related to self-experienced symptoms and daily activity (ADL) were checked. Isometric lumbar extensor strength test and strengthening exercise were performed with MedXTM lumbar extensor machine, which was designed to stabilize the pelvis. After 8 weeks of training program, isometric lumbar extensor strength & other pain related variables were checked again in the same way. RESULTS: The results were as follows: 1) After 8 weeks of lumbar extensor strengthening program, isometric lumbar extensor strength was increased at all the measured points significantly (p<0.01). 2) VAS and ADL were improved from 6.7 to 3.7, and from 6.9 to 9.1 respectively (p<0.05). CONCLUSION: 8 weeks of lumbar extensor strengthening program with pelvic stabilization was effective therapeutic tools for patients with chronic low back pain.
Activities of Daily Living ; Education ; Humans ; Low Back Pain* ; Muscles ; Pelvis ; Surveys and Questionnaires ; Visual Analog Scale

Background: The goal of this study was to investigate the incidence and type of seizurerelated injuries (SRIs) in patients presenting with seizures to the emergency department (ED) and to determine the risk factors of SRIs. Methods: In this retrospective cross-sectional study, we surveyed all seizure patients aged 18 years and older who visited the ED of Yeungnam University Hospital between October 2017 and September 2019. We excluded patients who developed seizures secondary to cardiac arrest or acute head trauma. Results: A total of 165 patients were enrolled and SRIs occurred in 33 patients (20.0%). The most common SRI was head injury (35.3%), followed by soft tissue injury (29.4%) and orolingual injury (17.6%). Most injuries were single, minor injury and required little or no treatment. Death occurred in one patient (3.0%) with SRIs due to intracranial hemorrhage. On univariate analysis, young age (p<0.001), history of alcohol use disorder (p=0.005), hypertension (p=0.022) and stroke (p=0.032), falling during seizure (p<0.001), seizure cluster (p=0.001), convulsive status epilepticus (p=0.034), generalized tonic-clonic seizure (p=0.010), initial blood ammonia level (p=0.007), and alcohol-related seizure (p=0.032) predicted the occurrence of SRIs. All patients with SRIs were independent in daily activities. On multiple logistic regression analysis, five variables remained significant: young age (p=0.037), history of alcohol use disorder (p=0.040), falling during seizure (p<0.001), seizure cluster (p=0.013), and convulsive status epilepticus (p=0.032). Conclusions Young age, history of alcohol use disorder, falling during seizure, seizure cluster, and convulsive status epilepticus predicted SRIs in people presenting with seizure.

Osteoporosis is the most common generalized skeletal disease, which lays a significant socioeconomic burden to Korea. The early diagnosis and treatment of osteoporosis are of the great interest to minimize the economic co nsequence. We have studied vertebral BMD and bone scan of 30 patients with osteoporotic compression fractures. The purpose of this study was to investigate the effect of osteoporotic compression fracture on bone mineral density(BMD). We have measured the vertebral heights, vertebral bone mineral density, and bone scan counts of vertebral bodies on osteoporotic patients. Vertebral BMD was measured from T12 to L4 using dual photon absorptiometry. Anterior(Ha), middle(Hm), and posterior(Hp) height of vertebrae were measured from T12 to L4, and the spinal deformity indices(Ha/Hp, Hm/Hp, and Hp/Hi ratios) were calculated. The bone scan counts were measured from T12 to L4, and bone scan ratios were calculated. The BMD of fractured vertebrae was significantly higher than that of non-fractured vertebrae The spinal deformity indices were not correlated to the BMD of fractured vertebrae. The bone scan ratio was correlated to the BMD of fractured vertebrae. This study suggests that the increased BMD observed in fractured vertebrae is related to metabolic effect of compression fractures rather than mechanical effect.
Absorptiometry, Photon ; Bone Density* ; Congenital Abnormalities ; Early Diagnosis ; Fractures, Compression* ; Humans ; Korea ; Osteoporosis ; Spine

Intermittent Exotropia has been treated by various surgical methods such as bilateral medial rectus resection, lateral rectus recession and medial rectus resection of deviating eye, and bilateral lateral rectus recession. However, the outcomes of such operations are unsatisfactory because of high incidence of postoperative undercorrection and overcorrection. Authors have performed a surgical method which is the medial rectus muscle resection of dominant eye and lateral rectus muscle recession of non-dominant eye in 68 patients. Authors considered the outcome successful if patients achieve deviation between 10 PD of exophoria and 5 PD of esophoria, good stereopsis, no suppression and no manifest deviation. The success rate was 83.8% (57/68) and there was no overcorrection over 6 months follow-up. As postoperative complications, 5 cases of temporary turning of face and 3 cases of asymmetric palpebral fissure were seen. Therefore, these results suggest that medial rectus resection of dominant eye and lateral rectus recession of non-dominant eye in intermittent exotropia may be an alternative surgical method for intermittent exotropia. However, further studies are necessary to determine the exact surgical amounts and mechanism of this surgical method.
Depth Perception ; Esotropia ; Exotropia* ; Follow-Up Studies ; Humans ; Incidence ; Postoperative Complications

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels*