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*

PURPOSE: Myocardial SPECT is an effective test for detecting coronary artery disease in the general population. But the diagnostic accuracy between sexes is not defined. The purpose of this study is to compare the diagnostic accuracy between males and females. MATERIALS AND METHODS: One hundred and seventy seven male and 98 female patients who underwent myocardial SPECT within 1 month of coronary angiography were studied. Myocardial SPECTs were considered abnormal if fixed or reversible perfusion defects were detected. Stenosis severity of > or = 50% luminal diameter reduction of any artery defined coronary artery disease (CAD). RESULTS: Overall sensitivity for detection of CAD was 98% in men and 97% in women (p=not significant). However, specificities, accuracies, and positive predictive values (PPV) in men and women were 49% vs 31% (p<0.05), 81% vs 57% (p<0.01), 78% vs 48% (P<0.01), respectively Diagnostic accuracies for detection of right coronary artery disease were not different in both sexes, however, accuracies for detection of left anterior descending artery disease and left circumflex artery disease were significantly lower in female (p<0.05). CONCLUSION: A significant difference of diagnostic accuracy between sexes, especially in LAD and LCx disease, was noted. Artifacts from breast attenuation might be a cause for the lower diagnostic accuracy in female.
Arteries ; Artifacts ; Breast ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Humans ; Male ; Perfusion* ; Phenobarbital ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Humans ; Infant* ; Infant, Very Low Birth Weight*

No abstract available.
Dermoid Cyst*

PURPOSE: To assess the MR findings of Tolosa-Hunt syndrome and to evaluat differential point of cavernous sinus lesions. MATERIALS AND METHODS: Eleven cases of Tolosa-Hunt syndrome were evaluated by MRI with specific regard to the shape of cavernous sinus, signal intensity, and pattern of enhancement. Other associated findings were also anlaysed. RESULTS: Two patients had normal MR features of the cavernous sinus. When compared with the contralateral normal cavernous sinus, the involved cavernous sinus was enlarged in six of the nine patients. The outer dural margin was convex and bulged laterally in 6 cases, flat in 2 cases, and concave in 1 case. Of the nine patients, five had iso-signal intensity and four had low signal intensity relative to gray matter on short TR/short TE. Three had isosignal intensity and 6 were not detectale on long TR/short and long TE pulse sequence. Contrast enhancement was seen in 8 cases ;7 cases showed homogeneous enhancement, 1 case heterogeneous enhancement. CONCLUSION: In the appropriate clinical setting of painful ophthalmoplegia, MR findings of cavernous sinus abnormality that consist of iso to low signal intensity on short TR/short TE images and isointense or undetectale mass on long TR/short TE or long TR/Iong TE images may suggest the dignosis of Tolosa-Hunt syndrome.
Cavernous Sinus ; Humans ; Magnetic Resonance Imaging ; Ophthalmoplegia ; Tolosa-Hunt Syndrome*

OBJECTIVES: This study investigated lung function in workers exposed to dusts, fumes and noxious gases at small foundries. METHODS: Lung function was measured in 148 male workers from 12 small foundries and 202 unexposed male workers. Pulmonary function tests performed included: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), percent of FEV1/FVC (FEV1/FVC%), maximum mid-expiratory flow (MMEF), peak expiratory flow (PEF), and forced expiratory flow at 25, 50, and 75% of expired FVC (FEF25, 50, 75). RESULTS: Mean values of all ventilatory indices except FEF25 of foundry workers were significantly lower than those of controls. Specifically, following stratification by smoking habits, all ventilatory indices except FEF25 of foundry workers were significantly lower than those of controls who smoked; however, there were no significant differences observed in any ventilatory indices between nonsmoking exposed workers and controls. The results of multiple linear regression analysis indicated work duration as a significant predictor of a decrease in FVC%. CONCLUSIONS: This research indicates that combined occupational exposure to dust, fumes, and gases in small foundries is associated with a reduction in lung function. Smoking may also contribute to respiratory abnormalities. These results suggested that foundry workers should be required to undergo periodic lung function tests and-in addition to not smoking, efficient use of personal protection equipment while at work is recommended.
Dust ; Forced Expiratory Volume ; Gases ; Humans ; Linear Models ; Lung ; Male ; Occupational Exposure ; Respiratory Function Tests ; Smoke ; Smoking ; Vital Capacity

PURPOSE: The usual technique of temporomandibular joint (TMJ) reduction, recommended by most emergency medicine textbooks, consists of downward forces applied to the mandible. However, it has been the authors' experience that conscious sedation and significant force is required to achieve reduction. For that reason, we designed a new method of TMJ reduction. The purpose of our study is to introduce the new method of TMJ reduction and to compare the traditional method with the new method. METHODS: We performed a prospective, randomized trial with 52 patients who were diagnosed as having a TMJ dislocation. The patients were divided into two groups: the group treated with the traditional method (25 cases) and treated with the new method (27cases). Patients with histories of trauma or inflammatory signs were excluded from this study. The new method is an extraoral approach in which the operator applies the coronoid process on the face in the posteroinferior direction. RESULTS: Age, sex, and history of TMJ dislocation showed no statistical differences between the two groups. Reduction of the TMJ dislocation was achieved in 15 (60.0%) of the traditional method group and in 25 (92.6%) of the new method group (p=0.005). The means of the reduction time were 11.8+/-6.2 sec in the traditional method group and 6.6 +/- 3.3 sec in the new method group (p=0.007). CONCLUSION: The new method was an effective treatment for TMJ dislocation without any sedations. I had a higher success rate and a shorter reduction time than traditional method.
Conscious Sedation ; Dislocations ; Emergency Medicine ; Humans ; Mandible ; Prospective Studies* ; Temporomandibular Joint*

To investigate the risk factors and clinical characteristics of postrenal transplant diabetes mellitus (PTDM), we reviewed the records of 177 renal allograft recipients in Maryknoll Hospiatal whose allografts had functioned longer than 6 months. Nineteen patients (10.7%) developed PTDM at 5.0+/-7.8 (1-52) months; 9 (47%) of these within 1 month. PTDM patients were older than nondiabetic renal transplants (42+/-2 vs 37+/-1 years, P<0.05). Body mass index tended to be higher in PTDM (23.5+/-1.0 vs 21.8+/-0.3kg/m2, P=0.09). Number of acute rejections (0.6+/-0.2 vs 0.5+/-0.1) and serum creatinine at 1 year after transplantation (1.2+/-0.8 vs 1.3+/-0.3mg/dL) were not different. Fasting (103.6+/-10.4 vs 84.4+/-1.6mg/dL, P<0.05) and postprandial (189.2+/-24.8 vs 118.6+/-2.3 mg/dL, P<0.01) blood sugars, measured before transplantation, were higher in PTDM. CsA blood level at 1 month posttransplantation was higher in PTDM (350+/-34 vs 279+/-8ng/mL, P<0.05). Fasting serum insulin was significantly higher (28.2+/-12.2 vs 7.3+/-2.0 microunit/dL, P<0.05) and serum C-peptide tended to be higher in PTDM patients compared with euglycemic renal recipients (6.3+/-1.6 vs 3.8+/-0.9ng/dL, P=0.08). All the PTDM patients were treated by either insulin or oral agent; 15 of 19 required no treatment after 4.7+/-6.9 months. In conclusion, prevalence of PTDM was 10.7%. PTDM patients were older. Body mass index was tended to be higher. Fasting and postprandial blood sugars, measured before transplantation, were higher in PTDM. Faslting serum insulin was higher and C-peptide tended to be higher in diabetics. These results suggested that increased insulin resistance plays a major role in the pathogenesis of PTDM.
Allografts ; Blood Glucose ; Body Mass Index ; C-Peptide ; Creatinine ; Cyclosporine ; Diabetes Mellitus* ; Fasting ; Humans ; Insulin ; Insulin Resistance ; Prevalence ; Risk Factors*

No abstract available.
Ureteral Obstruction* ; Uterine Prolapse*

We report a case of a patient with cystic subdural hygroma who underwent pre-operative Tc-99m DTPA cistrenoscintigraphy to determine the course of operation. A 68-year-old female was admitted to the department of neurosurgery because of acute subarachnoid hemorrhage. After emergency ventricular drainage, the hydrocephalus and cystic subdural hygroma in the right fronto-temporal area developed. She underwent Tc-99m DTPA cisternoscintigraphy to evaluate the type of hydrocephalus, which revealed obstructive communicating hydrocephalus and the communication between the subdural hygroma and the subarachnoid space. As a result of these findings, she underwent the ventriculo-peritoneal shunt operation without removal of the subdural hygroma. Post-operative brain CT showed nearly normalized shape and size of the right ventricle and disappearance of subdural hygroma. We recommend the pre-operative cisternoscintigraphy in patients with complex hygroma to evaluate the communication between subdural hygroma and the subarachnoid space.
Aged ; Brain ; Decision Making* ; Drainage ; Emergencies ; Female ; Heart Ventricles ; Humans ; Hydrocephalus ; Lymphangioma, Cystic ; Neurosurgery ; Pentetic Acid ; Subarachnoid Hemorrhage ; Subarachnoid Space ; Subdural Effusion* ; Ventriculoperitoneal Shunt