PURPOSE : 99mTc DMSA renal scan have been widely used not only for the evaluation of renal scars but also for the diagnosis of acute pyelonephritis. Recent studies have shown SPECT images have higher accuracy than the planar images with some controversy. We evaluated the availability of the SPECT images adding to planar images for the diagnosis of acute pyelonephritis(APN) and renal scar in children with urinary tract infection (UTI). METHODS : 130 children with UTI (260 kidney units) and 22 follow-up children (44 kidney units) were included between January 1, 1997 and July 31, 1999 at Ewha University Mokdong Hospital. Planar Anterior and posterior images and SPECT axial and coronal images of 99mTc DMSA renal scan were obtained with Starcam 4000-i U.S.A. GE at 3 hours after 99mTc DMSA I.V. injection. The data were analyzed by Chi square test after Yates's correction. RESULTS : The detection rate of the acute pyelonephritis by SPECT images was 12.3% higher than that of planar images (47.7% vs 35.4%) by the patient and 6.9% higher also (31.9% vs 25.4%) by the kidney unit. 18 kidney units with negative planar images had focal defect in 10 kidney units (3.8%) and multifocal defect in 8 kidney units (3.1%) on SPECT images, but 1 kidney unit with positive planar image had negative SPECT image. SPECT images were superior to the planar images in 17.3%, identical in 82.3% and inferior in 0.4% to planar image. The detection rate of the renal scars by SPECT images was 13.7% higher than planar images by the patient (68.2% vs 54.5%) and 6.8% higher also (43.2% vs 36.4%) by the kidney unit. SPECT images were superior to the planar images in 17.3% and identical in 82.3% to planar image. CONCLUSION : SPECT images had shown higher detection rate and better image than planar images for the diagnosis of the acute pyelonephritis and the evaluation of the renal scars.
Child* ; Cicatrix ; Diagnosis ; Follow-Up Studies ; Humans ; Kidney ; Pyelonephritis ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: This study was preformed to demonstrate the improvement of respiratory symptoms and pulmonary function parameters after albuterol inhalation in asthmatic bronchitis using pneumotachography. METHODS: Fifteen asthmatic bronchitis patients admitted to Ewha Womans University Hospital from September in 1998 to July in 1999 were enrolled in this study. Clinical symptoms and pulmonary function parameters including respiratory rate, heart rate, inspiratory tidal volume(Vi), expiratory tidal volume(Ve), peak tidal expiratory flow(PTEF), tidal expiratory flow at 25% of tidal volume(TEF25), mid-expiratory flow(MEF) and mid-inspiratory flow(MIF), compliance, and pulmonary resistance were evaluated by clinical symptom score and pneumotachography before and after albuterol inhalation treatment. RESULTS: The clinical score was decreased significantly after treatment, but heart rate did not show a significant difference. By flow-volume curve, Ve were 7.39+/-2.11 mL/kg, 9.39+/-3.20 mL/kg, and Vi were 7.44+/-2.08 mL/kg, 9.46+/-3.26 mL/kg, and PTEF were 130.1+/-82.1 mL/kg, 123.1+/-64.8 mL/kg before and after treatment, respectively. All the pulmonary function parameters showed no significant differences before and after treatment. CONCLUSIONS: Clinical symptoms were improved after albuterol inhalation treatment in asthmatic bronchitis, but pulmonary function was not recovered after a short-term treatment.
Albuterol ; Bronchitis* ; Compliance ; Female ; Heart Rate ; Humans ; Inhalation ; Respiratory Function Tests* ; Respiratory Rate

We evaluated the clinical effects of amlodipine in 10 patients(7 male and 3 female) with angina pectoris in terms of the effect on the anginal pain, hemodynamic changes and side effects. The results obtained were as follows; 1) The clinical improvement was obsebed in 8(80.8%) of 10 and 9(88.9%) of 9 patients at 2 and 10 weeks after oral amlodipine. 2) The systolic and diastolic blood pressure was decreased significantly(136.0+/-16.5mmHg vs 117.0+/-10.6mmHg, p<0.01 and 85.0+/-9.7mmHg vs 75.0+/-5.3mmHg, p<0.01 respectively) but the heart rate was indepentent of amlodipine administration. 3) The adverse effects of amlodipine were as headache in 3, facial flushing in 3, palpitation, dizziness, urinary difficulty in 1 respectively and one of them discontinued amlodipine due to severe palpitation and facial flushing.
Amlodipine* ; Angina Pectoris* ; Blood Pressure ; Dizziness ; Flushing ; Headache ; Heart Rate ; Hemodynamics ; Humans ; Male

PURPOSE: To evaluate a role as over 35 years, maternal serum markers, and a false positive screen for Down syndrome were the predictor of adverse pregnancy outcome. Materials and METHODS: From Mar.1994, through Feb.1996, 5284 women were screened triple test to detect Down syndrome in the second trimester and were delivered Samsung Cheil hospital. The values of each maternal serum markers were measured with radioimmunoassay. And then, the screen positive of Down syndrome was calculated using alpha-software Version 4.0. The adverse outcome of the fetus and the mother included low birth weight(LBW) ( <2500gm), prematurity( <37 gestational weeks), placenta previa, preterm premature rupture of membranes(PPROM), pregnancy induced hypertension(PIH),abruptio placenta, and intrauterine fetal death(IUFD). The predictor markers included over 35years, elevated alpha-fetoprotein (AFP), elevated human chorionic gonadotropin(hCG), lowered unconjugated estriol (uE3), and a false positive screen for Down syndrome. RESULTS: Mean age and mean gestational weeks in the study were 30+/-4.8 years and 17.1 weeks respectively. The adverse pregnancy outcomes were 357 LBW(6.8%), 253 prematurity(4.8%), 108 placenta previa(2.0%), 68 PPROM(1.3%), 66 PIH(1.3%), 24 abruptio placenta(0.5%), and 20 IUFD(0.4%). In univariate analysis, over 35 years was significantly associated with abruptio placenta, prematurity, and placenta previa, elevated MS-AFP( >2.0 MoM) associated with IUFD, LBW, PIH, prematurity, and PPROM , elevated MS-hCG (>3.0 MoM) associated with IUFD, LBW, PIH, prematurity, and placenta previa, lowered uE3 (<0.75) associated with IUFD, abruptio placenta, LBW, and prematurity.(P <0.05). In multivariate logistic regression analysis, IUFD was significantly associated with only elevated MS-AFP, LBW associated with elevated MS-AFP, elevated MS-hCG, and lowered uE3, PIH associated with only elevated MS-AFP, PPROM only elevated MS-AFP, prematurity only elevated MS-AFP, and placenta previa over 35 years, elevated MS-hCG.(P <0.05). However, abruptio placenta was not significantly associated with predictor markers.(P >0.05) CONCLUSIONS: Some predictors such as over 35 year, elevated hCG, lowered uE3, a false positive screen for Down syndrome were significantly associated with adverse pregnancy outcome. Also in multivariate analysis, we identified especially elevated AFP to be the most reliable predictor for adverse pregnancy outcome.
alpha-Fetoproteins ; Biomarkers ; Chorion ; Down Syndrome ; Estriol ; Female ; Fetus ; Humans ; Logistic Models ; Mothers ; Multivariate Analysis* ; Parturition ; Placenta ; Placenta Previa ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, Second ; Pregnancy* ; Radioimmunoassay ; Rupture

No abstract available.
Facial Paralysis ; Paresis

Albright's hereditary osteodystrophy is an inherited syndrome that encompasses endocrinologic anomaly of pseudohypoparathyroidim or less commonly, pseudo-pseudohypoparathyroidism and various physical stigmata such as mental retardation, short stature, skeletal anomaly of the hands, abnormal dentition, round facies, and osteoma cutis. Primary osteoma cutis in this syndrome presents at birth or in early infancy, preceding most of the other manifestations. This case is a typical presentation with osteoma cutis as the sole initial manifestation. Rather unfamiliar to dermatologists, Albright's hereditary osteodystrophy still deserves to be included in the differentials when an isolated case of osteoma cutis presents in a young child.
Child ; Christianity ; Dentition ; Facies ; Hand ; Humans ; Intellectual Disability ; Osteoma* ; Parturition ; Pseudopseudohypoparathyroidism

Purpose: This study evaluated the effectiveness of bipolar hemiarthroplasty with a cementless femoral stem for hip fractures in patients older than 70 years with osteoporosis. Materials and Methods: This study examined 84 hips with osteoporosis that are available to follow up of more than 2 years, between July 1997 and May 2006. The clinical evaluation was carried out using the Koval classification before the fracture and at the last follow-up, and the Harris hip score at the last follow up. The radiological evaluation was carried out using the plain radiographs. Results: The average follow up period was 31.4 months. The Koval classification was as follows: recovery to the condition before the fracture in 25 cases (30.1%), degradation by 1 class in 56 cases (67.5%) and degradation by 2 classes in 2 cases (2.4%). The Harris hip score was 82.7 points at the last follow-up. One case (1.2%) showed cortical hypertrophy and all cases showed stable insertion of the femoral stem. Conclusion: Bipolar hemiarthroplasty with a cementless femoral stem is effective and satisfactory, both clinically and radiologically, for the treatment of elderly patients with fractures around the hip.
Aged ; Femur ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Hip Fractures ; Humans ; Hypertrophy ; Neck ; Osteoporosis

OBJECTIVE: Recently, carotid artery stenting (CAS) has become as the first choice of treatment for carotid artery stenosis. Although there are many differences in the outcomes of patients receiving stents among many different study groups, some reports suggest that stenting can be performed with periprocedural complication rates similar to those of a carotid endarterectomy (CEA). In this study, we investigated 39 cases of CAS. METHODS: From May 2003 to March 2007, 39 patients undergoing CAS were reviewed. We analyzed the 30-day morbidity/mortality rate. A minor stroke was defined as a new neurological deficit that either resolved completely within 30 days or increased the NIH Stroke Scale by< or =3. A major stroke was defined as a new neurological deficit that persisted for 30 days and increased the NIH Stroke Scale by> or =4. RESULTS: Among 39 patients, a minor stroke was noted in three patients (7.7%), and there were no major strokes and deaths. The overall 30-day stroke and death rate was 7.7% (n = 3). CONCLUSION: With the evolution and maturation of equipment and technique, carotid angioplasty and stenting (CAS) is increasingly being used for the treatment of carotid artery disease.
Angioplasty ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Stenosis* ; Endarterectomy, Carotid ; Humans ; Mortality ; Stents* ; Stroke

Churg-Strauss syndrome (CSS) or allergic granulomatous angiitis is a rare syndrome that is characterized by hypereosinophilic systemic necrotizing vasculitis affecting small- to medium-sized arteries and veins. In general, it occurs in individuals with pre-existing allergic asthma. When CSS appears in patients, it has the following characteristics: eosinophilia of more than 10% in peripheral blood, paranasal sinusitis, pulmonary infiltrates, histological proof of vasculitis with extravascular eosinophils, and mononeuritis multiplex or polyneuropathy. Therapeutic trials dedicated to Churg-Strauss syndrome have been limited due to the rarity of this disorder and the difficulty in making a histological diagnosis. Proper treatment of patients with CSS is not widely known. In this case study, we report on our experience with an unusual patient case, characterized by purpura and a perforation of the small intestine after inadequate steroid therapy.
Arteries ; Asthma ; Churg-Strauss Syndrome ; Eosinophilia ; Eosinophils ; Humans ; Intestinal Perforation ; Intestine, Small ; Mononeuropathies ; Polyneuropathies ; Purpura ; Sinusitis ; Vasculitis ; Veins

Secondary esophageal carcinoma usually originates from a primary site in either the lung or breast. Only one case of metastatic esophageal cancer with a radiologic evidence that it was originated from the rectal cancer had been reported. We report an unusual case of a 80-year-old man with secondary esophageal carcinoma originated from the rectal cancer. It was diagnosed by histopathologic confirmation using immunohistochemical staining including CK20 and CK7 by comparing the histopathologic findings of surgical specimen of rectal cancer and endoscopic biopsy tissue from the esophagus. To the best of our knowledge, this is the first case of secondary esophageal cancer arising from rectum in Korea.
Aged, 80 and over ; Biopsy ; Breast ; Esophageal Neoplasms* ; Esophagus ; Humans ; Korea ; Lung ; Rectal Neoplasms* ; Rectum