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.
Cholecystectomy*

Otocephaly is a rare malformations comprising hypoplasia or absence of the mandible (agnathia), ventromedial displacement and often fusion of external ears (synotia or otocephaly), and hypoplasia of the oral cavity (microstomia) and tongue (hypoglassia). This developmental complex represents a malformation of the first and second branchial arches and occurs sometimes with holoprosencephaly. We present the ultrasound detection of otocephaly and holoprosencephaly with cyclopia in a fetus of 27 gestational weeks 6 days. The use of three-dimensional (3-D) ultrasound made additional diagnostic ultrasound tomograms possible, and the volume reconstructions improved the imaging and the understanding of the condition.
Branchial Region ; Diagnosis* ; Ear, External ; Fetus ; Holoprosencephaly ; Mandible ; Mouth ; Tongue ; Ultrasonography

No abstract available.
Melanoma* ; Mycobacterium bovis*

Hyperplastic anterior choroidal artery (AchA) is an extremely rare congenital vascular variant that can be mistaken for other cerebral arteries. This case report presents a 38-year-old man who presented with a severe sudden-onset headache and was diagnosed with a ruptured aneurysm originating from a hyperplastic AchA. The aneurysm was successfully treated with coil embolization, but recurrence was detected after eight months, leading to additional surgical intervention. The discussion highlights the classification of hyperplastic AchA and emphasizes the importance of recognizing this anatomical variant to avoid complications during treatment. This case report underscores the need for awareness and understanding of hyperplastic AchA in the management of cerebral aneurysms.

Acute generalized exanthematous pustulosis (AGEP) is characterized by acute nonfollicular sterile pustules on a background of edematous erythema. Hydroxychloroquine (HCQ), an antimalarial drug, widely used to treat rheumatic and dermatologic diseases. HCQ has been reported to be an uncommon cause of AGEP. We report a 60-year-old woman with rheumatoid arthritis requiring the use of HCQ presented fever and erythematous eruption on the trunk with sterile pustules. Leukocytosis and elevated erythrocyte sedimention rate noted on laboratory examination. On the histopathological examination of the skin biopsy specimen showed neutrophilic infiltration and scattered eosinohpils. The lesions were resolved with removal of HCQ. The clinical course was consistent with the diagnosis of AGEP associated with HCQ. We reported a case of typical AGEP associated with HCQ in a patient with Rheumatoid arthritis. The patient presented resolution from cutaneous lesions with withdrawal of culprit drug, without the need of systemic steroid.
Acute Generalized Exanthematous Pustulosis ; Arthritis, Rheumatoid ; Biopsy ; Erythema ; Erythrocytes ; Female ; Fever ; Humans ; Hydroxychloroquine ; Leukocytosis ; Neutrophils ; Skin

Acute interstitial pneumonia is a fulminant disease of unknown etiology that usually occurs in a previously healthy person and produces the histologic findings of the organizing phase of diffuse alveolar damage. We experienced an autopsy case of acute interstitial pneumonia of unknown etiology. The patient was a 48 year old man who had been healthy and had not been exposed to organic dusts or other toxic materials. The chief complaints represented were dyspnea and a dry cough for several weeks before hospitalization, and the chest radiographs showed bilateral interstitial infiltrates. Patchy consolidation of air space was also identified and ground-glass attenuation similar to those described in ARDS was detected on high-resolution computed tomography. Steroid pulse therapy, mechanical ventilation, and antibiotics for superimposed bacterial infection were performed, but the symptoms did not improve and the patient died of generalized respiratory insufficiency and severe hypoxemia 2 1/2 months after hospitalization. At autopsy the macroscopic and microscopic findings were confined mainly to the lungs. On the whole, both lungs were firm in consistency and the external surface showed a cobblestone appearance. The cut surface showed almost complete replacement of the normal lung parenchyma with gray to yellow fibrous tissue with a little residual functional area remaining. The pathology of both open lung biopsy and autopsy tissue showed marked hyperplasia of type II pneumocytes, hyaline membrane formation, thickening of the alveolar wall due to extensive fibroblast proliferation, and relatively abundant young collagen deposition in the interstitium. An immunohistochemical stain for cytokeratin revealed epithelial hyperplasia and showed that the alveolar spaces were markedly shrunken by fibrous tissue.
Anoxia ; Anti-Bacterial Agents ; Autopsy* ; Bacterial Infections ; Biopsy ; Collagen ; Cough ; Dust ; Dyspnea ; Fibroblasts ; Hospitalization ; Humans ; Hyalin ; Hyperplasia ; Keratins ; Lung ; Lung Diseases, Interstitial* ; Membranes ; Middle Aged ; Pathology ; Pneumocytes ; Pulmonary Fibrosis ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Insufficiency

OBJECTIVE: The study shows that the DFS is a questionnaire that almost effortlessly can be completed within 60-90 seconds during any moment of labor and delivery. The aim of the present study was to test the validity and reliability of the DFS, to identify its factor structure in Korea. METHODS: Review of the medical records from the department of obstetrics and gynecology from January to April 2005, a confirmed 51 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. 22 primiparous and 29 multiparous women answered the Delivery Fear Scale (DFS) once during active labor, and the STAI (State-Trait Anxiety Inventory) after delivery. Reliability test to calculate Chronbach alpha and validity test to measure correlation between DFS and STAI was done. Then factor analysis was applied with the method of principal component analysis and varimax rotation. RESULTS: Korean version of DFS proved to be a reliable and valid scale statistically: Cronbach's alpha was 0.7182 in study. CONCLUSION: Women's psychological experiences during the actual process of labor and delivery are essential part of obstetrical care. Nevertheless, studies examining psychological variables concerning childbirth, are mostly performed before or after labor. The DFS measures fear during labor and delivery in an effortless and fast away. The development of the Korean version of DFS which is reliable and valid, and consists of three sub-factors may facilitate future research in the field.
Anxiety ; Diagnosis ; Female ; Gynecology ; Humans ; Korea ; Medical Records ; Obstetrics ; Parturition* ; Pregnancy ; Principal Component Analysis ; Surveys and Questionnaire ; Reproducibility of Results

Ectopic pregnancies accout for 1% of all pregnancies and abdominal pregnancies account for almost 1% of ectopic pregnancies. The causes of abdominal pregnancy are two. First is primaries implantation of gestational sac in the abdomen, second is migration of the embryo through a fistulous tract of the tube or uterus. Their early symptom is absent and diagnosis by ultrasonography is difficult. Thus the mortality is very high because of complications such as hemorrhage and infection due to delayed diagnosis. The accurate diagnosis mostly made by laparoscopy or laparotomy is usual. Nowadays the treatment of choice must be laparoscopy according to the development of efficient laparoscopic instrumentation and accumulating experience and skill of laparoscopic surgeon. Here we report a case of uterine serosal pregnancy at 8(+1) weeks with both ovarian cysts which was undergone pelviscopy at the impression of right tubal pregnancy. At local gynecologic clinic, they guessed the patient's lower abdominal pain was due to the torsion of both ovarian masses and transferred the patient for an operation. beta-hCG was 52,509 mIU/mL. By ultrasonographic finding both ovarian cysts and 2 cm sized gestational sac with fetal pole and fetal heart tone were found nearby right fallopian tube. Under the impression of right tubal pregnancy she underwent the emergent pelviscopic operation. Mass consisted with the gestational sac and placenta was attatched to the posterior surface of uterus and minimal amount of fresh blood in the posterior cul de sac was observed. Both tubes and the uterus were intact, and both ovarian cysts were not torted or ruptured. The mass was detached and the bed of implantation was biopsyed. Gestational sac contained the intact embryo within.
Abdomen ; Abdominal Pain ; Delayed Diagnosis ; Diagnosis ; Embryonic Structures ; Fallopian Tubes ; Female ; Fetal Heart ; Gestational Sac ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Liability, Legal ; Mortality ; Ovarian Cysts* ; Placenta ; Pregnancy* ; Pregnancy, Abdominal ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Ultrasonography ; Uterus

The Ziehl-Neelson's AFB staining method was mainly used for the AFB observation of the diagnosis of leprosy. However, the fluorescent stain performs better and allows the detection of more positive smears. The limitation for its widespread use has been the high cost for fluorescent microscopes. Novel light-emitting diodes (LED) are inexpensive solutions for fluorescent microscopes, and thus fluorescent stain may be a cost-effective step to improve the diagnosis of leprosy in resource-poor countries. And the comparison of auramine and acridine orange for staining of acid-fast bacteria was showed significantly more acid-fast rods after using acridine orange and the number of "false positive" results was somewhat higher on auramine staining. So acridine orange offers a good alternative to auramine which is considered carcinogenic. This study evaluated the comparison of the Ziehl-Neelson's AFB stain and the acridine orange stain in the skin smear based on PCR. As PCR results were taken as gold standard, results of the study revealed that the sensitivity of Ziehl-Neelson's AFB stain was 50% and that of acridine orange stain was 92.2%. This study confirmed that the fluorescence stain method is more sensitive than the Ziehl-Neelsen's staining method. It is suggested that the training of laboratory technicians on fluorescence microscopy should be scaled up for increased disease control.
Acridine Orange* ; Bacteria ; Benzophenoneidum ; Diagnosis ; Fluorescence ; Humans ; Laboratory Personnel ; Leprosy ; Microscopy, Fluorescence ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction ; Skin