PURPOSE: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). MATERIALS AND METHODS: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: 49.1+/-10.8). RESULTS: Eighteen lesions of primary HPT consisted of 13 adenomas and 5 hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). CONCLUSION: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.
Adenoma ; Diagnosis ; Humans ; Hyperparathyroidism, Primary ; Hyperparathyroidism, Secondary* ; Hyperplasia ; Parathyroid Glands ; Radionuclide Imaging* ; Retrospective Studies ; Sensitivity and Specificity

Acquired port-wine stain is rare. It mimics a congenital port-wine stain morphologically but the pattern of onset is acquired after birth. It represents a progressive ectasia of vessels located in the superficial vascular plexus. The exact mechanism is unknown but some reported cases have occurred after trauma. We herein report five cases of acquired port-wine stains and they were idiopathic in nature.
Dilatation, Pathologic ; Parturition ; Port-Wine Stain*

Venous hemangioma is a vascular tumor that has been reported by such diverse names as; "cirsoid aneurysm", "arteriovenous hemangioma", "acral arteriovenous tumor" according to the author's opinions of its origin and histopathologic classification. It is benign and rarely biopsied, and it is also rarely reported in dermatology literature. We present two cases of venous hemangioma. The first case was a 64-year-old man who was presented with an elliptical dark-red plaque with overlying several grouped papules on the left periorbital area which had been present for 7 years. The second case was a 56-year-old man who was presented with a single red papule on the right postauricular area which had been present for 4 months. Histopathologically, there were a well-circumscribed proliferation of thick-walled muscle-containing blood vessels in the dermis. Intermingled with the thick-walled blood vessels, there were also thin-walled dilated blood vessels. In both cases, the thick-walled blood vessels resembled arteries, but they lacked elastic fibers on the Verhoeff van Gieson stain.
Arteries ; Blood Vessels ; Classification ; Dermatology ; Dermis ; Elastic Tissue ; Hemangioma* ; Humans ; Middle Aged

The persistent left superior vena cava (LSVC) is not rare cardiovascular developmental anomaly occurring both in association with congenital heart disease and as an isolated anomaly of no hemodynamic importance. We have studied 73 cases of the LSCV out of 1,060 cases of congenital heart disease catheterized at Yonsei Cardiovascular Center. We conducted the study with a view point of position of the heart and abdominal organs and segmental analysis of the underlying congenital heart disease. We also analysed the associated extracardiac vascular anomalies. The following results were obtained: 1) The incidence of this anomaly among congenital heart disease was 6.9% and 41 cases(56.2%) had cyanosis. 2) We observed 20 cases(27.3%) with the malposition of the heart and 17 cases(23.3%) with malposition of the abdominal organs. The ventricular loops revealed D-loop in 60 cases, L-loop in 7 cases and in the remaining 6 cases, it was uncertain. 3) With a view point of type of LSVC by Lucas & Krabill, type A was in 50 cases(68.5%), type D in 14 cases(19.2%), type B in 5 cases(6.8%) and type C in 4 cases(5.5%). 4) Associated cardiovascular anomalies were as follows: ventricular septal defect; 42 cases(57.5%), atrial septal defect; 33 cases(45.2%), patent ductus arteriosus; 27 cases(36.9%), and tetralogy of Fallot; 18 cases(24.7%). In conclusion, LSVC usually has no hemodynamic importance, but this cardiac anomaly is frequently combined with complex intracardiac anomalies. Therefore, it is important to making accurate diagnosis and successful management for preventing the risk of it.
Catheters ; Classification* ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hemodynamics ; Incidence ; Tetralogy of Fallot ; Vena Cava, Superior*

Currently, although LASIK has proved to be effective for correcting the high myopia, it is increasingly being favored for correcting the moderate myopia. We compared the clinical results after excimer laser photorefractive keratectomy(PRK)and laser associated in situ keratomileusis(LASIK)for the correction of moderate myopia from -4.00 diopter to -6.25 diopter. 31patients(40 eyes)who underwent LASIK with microkeratome(SCMD, USA) and STAR laser(VISX, USA)and 29 patients(38 eyes)who underwent PRK with the same laser were examined retrospectively. Mean uncorrective visual acuity(UCVA)was 0.64+/-0.24 7 days after surgery which was 63%of that at postoperation 6 months in the PRK, while that was 0.73+/-0.21 7 days after surgery which was 85%of that at postoperation 6 months in the LASIK(p<0.05). However, at 2 and 6 months postoperatively, the mean UCVA was similar between two procedures(0.93+/-0.15, 0.96+/-0.14 for PRK and 0.85+/-0.22, 0.82+/-0.22 for LASIK, respectively (p>0.05)). At 7 days, the mean spherical equivalent for PRK was +1. 81+/-0.82 D, which was significantly more overcorrected than that for LASIK(+0.47+/-1.07 D(p<0.05)). In addition, the overall refractive regression from 7 days to 6 months was 1. 58D in the PRK compared with regression of 0.96D over the same period in the LASIK, while the mean refractive regression from 2 months to 6months was similar between two procedures(0.27 D for PRK and 0.39 D for LASIK). Cylindrical error within 1D was increased from 0.48 +/-0.36D before operation to 0.69+/-0.31 D of 6 months after operation in LASIK(p>0.05), whereas it was decreased from 0.39+/-0.31 D to 0.07+/-0.31D in PRK (p<0.05). Conclusively, although improvement in UCVA and mean spherical equivalent is more rapid in LASIK than in PRK, the increased propensity of cylindrical error and undercorrection in LASIK requires further investigation.
Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia* ; Retrospective Studies

From January 2007 to June 2012, 55 autopsy cases were reviewed, in which death occurred outside the hospital and the patients were declared dead on arrival at the emergency departments, in order to compare the clinical and postmortem examination diagnoses of death-on-arrival patients in tertiary hospitals in Busan, Yangsan and Ulsan city. Of 22 non-traumatic deaths, 21 occurred from natural causes and 1 from unknown cause (sudden infant death syndrome, SIDS). Clinical diagnoses were cardiovascular diseases or "non-traumatic" / "unknown" while autopsy diagnoses were majorly cardiovascular diseases, especially coronary artery diseases (72.7%). Of 33 unnatural deaths, the cause of death was blunt trauma in 4 patients, sharp-force injury in 6, falling in 10, gunshot injury in 1, traffic accidents in 3, asphyxia in 2, drowning in 2, fire-related death in 1, and intoxication in 4. There were no definite discrepancies between clinical and autopsy diagnoses, except for 5 non-traumatic deaths and 2 unnatural deaths. These results suggest that the role of the emergency department may be crucial in postmortem investigations.
Accidents, Traffic ; Asphyxia ; Autopsy ; Cardiovascular Diseases ; Cause of Death ; Coronary Artery Disease ; Drowning ; Emergencies ; Humans ; Infant ; Tertiary Care Centers

No abstract available.
Lymphangioma*

OBJECTIVE: Fetal heart rate in embryos(6-8 gestational weeks) have been significantly related to fetal outcome, but have rarely been studied. We attempted to identify fetal heart rate during 6-8 gestational weeks. Our purpose was to determine the lower limit of the heart rate associated with a favorable outcome and to evaluate the prognosis for those embryos with slow heart rates in early period. METHODS: We prospectively studied 798 singleton pregnancies between Jul. 1997-Dec. 1999 visiting our hospital. Gestational age was calculated from the beginning of the last menstrual period in the case of regular cycle and was confirmed by the crown-rump length. Other cases were measured by crown-rump length or mean gestational sac diameter. Color doppler sonography was used to calculate the fetal heart rate in beats per minute as the mean of 3 waves. RESULTS: Mean fetal heart rate (+/-SD) were 114.08+/-15.40 bpm for group 1, 126.49+/-18.78 for group 2, 139.83+/-19.92 for group 3, and 149.58+/-23.34 for group 4(p<0.001). Prognosis in the first trimester improved as heart rate increased to 100 bpm in group 1 and 120 bpm in group 2. In group 3 and 4, most of fetus with heart rates below 110 bpm died. CONCLUSIONS: The fetal heart rate during 6-8 gestational weeks is associated with fetal outcome at the end of the first trimester and we can identify the fetuses that are in risk.
Crown-Rump Length ; Embryonic Structures ; Female ; Fetal Heart* ; Fetus ; Gestational Age ; Gestational Sac ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy* ; Prognosis ; Prospective Studies ; Ultrasonography*

Kaposis sarcoma is well recognized in patient,s with imrnunodef cienicy states such as organ trans plantation, malignancy, and acquired irnmunodeficiency syndrome(tILS). Kaposis sarcorna associated with organ transplantation is, however relatively uncomrnon in Konea. We report a case of Kaposi's sarcorna in a 23 year old male kidney recipient., who was on cyclosporine and prednisolone. The tumor involved the larynx and long as well as the skin. He was treated with radiation therapy and chemotherapy, and the dosage of immunosupressants were reduced.
Cyclosporine ; Drug Therapy ; Humans ; Kidney Transplantation* ; Kidney* ; Larynx ; Male ; Organ Transplantation ; Prednisolone ; Sarcoma, Kaposi* ; Skin ; Transplants ; Young Adult

Animals ; Bone Marrow ; Bone Regeneration ; Calcium Phosphates ; Fibrin ; Humans ; Osteogenesis ; Platelet-Rich Plasma ; Rabbits ; Skull ; Transplants