The authors reviewed the clinical findings and treatment results of 12 cases of spinal meningeal cysts which were detected in MRI of low back patients. In these lesions, large cysts without CSF communication can compressed the nerve roots within spinal canal and it is difficult to confirm the cause of symptom whether it is originated from cysts or from associated spinal disorders. The terms and classifications of spinal meningeal cysts were very confusing. Among 12 cases, we excised 3 cases of large cysts with gluteal and perianal pains that were caused by compressed sacral nerve roots. All three cases were type 2 cyst (classified by Nabors) and located in sacral canal. In one case associated with isthmic spondylolisthesis, posterolateral fusion and pedicle screw fixations were combined with cyst excision. In other two cases, there were not any spinal pathologic findings that compressed sacral nerve roots except mild degenerative changes and intervertebral disc herniation in lower lumbar and sacral levels All 3 excised cases showed good prognosis in more than one year follow up. The other cases were treated conservatively for the associated spinal disorders.
Classification ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Prognosis ; Radiculopathy ; Spinal Canal ; Spondylolisthesis

No abstract available.
Pregnancy*

PURPOSE: Tc-99m-MIBI (MIBI) and Tc-99m-Tetrofosmin (TF) are commonly used for scintimammography (SMM). We compared the diagnostic ability of SMM using Tc-99m-MIBI and Tc-99m-TF for the differential diagnosis of breast mass. MATERIALS AND METHODS: The study subjects were comprised of 123 breast lesions and 86 normal breasts of 114 patients who underwent SMM. Bilateral prone images and anterior supine images were obtained at 5 minutes and 1 or 3 hours after intravenous injection of 740 MBq of either MIBI or TF. Sizes of tumors were not significantly different between the MIBI and TF groups. First, two observers independently read the SMM without clinical information (1st interpretation), then read again with information about mass location (2nd interpretation). Sensitivity and specificity of each radiopharmaceutical for the diagnosis of breast cancer were evaluated in terms of image acquisition time, tumor size, and location. RESULTS: The SMM showed a good agreement between two observers for 1st and 2nd interpretation, except for TF SMM at 3 hr. For the first interpretation, the sensitivities at 5 min, 1 hr, and 3 hr were not significantly different between MIBI and TF SMM (81.6%, 80.0%, 60.9% in MIBI vs. 88.9%, 80.6%, 42.9% in TF), although the senstivities of 3 hr images were significantly lower than 5 min images in both MIBI and TF SMM. The specificity of TF at 5 min was superior to that of MIBI (81.5%, 90.0%, 82.9% in MIBI vs. 96.7%, 100%, 90.0% in TF, p<0.01 MIBI vs. TF at 5 min). For the second interpretation with information of mass location, the sensitivities at 3 hr images were significantly lower than 5 min images (86.8%, 86.7%, 78.3% in MIBI vs. 88.9%, 93.5%, 57.1% in TF) between MIBI and TF SMM. However, there was no significant difference in the specificity (60.0%, 53.8%, 75.0% for MIBI vs. 86.7%, 100%, 100% for TF). MIBI and TF SMM showed lower sensitivities for the tumors with less than 1 cm than tumors with more than 1 cm. However, the location of tumors did not influence the sensitivity and specificity between MIBI and TF SMM. CONCLUSION: The ability for the differential diagnosis of breast tumor is similar between MIBI and TF SMM, and delayed image is not necessary. TF may be better than MIBI considering the specificity of SMM without clinical information and labeling convenience.
Breast Neoplasms ; Breast* ; Diagnosis ; Diagnosis, Differential* ; Humans ; Injections, Intravenous ; Sensitivity and Specificity

OBJECTIVE: To report three cases of monozygotic twinning after IVF-ET transfer. METHODS: Private practice in two different assisted reproductive technology clinics. RESULTS: Three intrauterine monozygotic twin pregnancies occurred after IVF-ET. One of them was complicated by cord entanglement, another is progressing normal pregnancy without complication and the other was had a normal pregnancy without complication and delivered twin by cesarean section. CONCLUSION: The reported prevalence of multiple gestations in IVF-ET is a approximately 30%, and it is only 2.7% to be monozygotic twinning in IVF-ET. We report three cases of monozygotic twining after IVF-ET.
Cesarean Section ; Female ; Humans ; Pregnancy* ; Prevalence ; Private Practice ; Reproductive Techniques, Assisted ; Twinning, Monozygotic ; Twins, Monozygotic*

No abstract available.
Lymphangioma, Cystic* ; Turner Syndrome* ; Ultrasonography*

BACKGROUND: Thyroid cancer is the most common tumor with a endocrine gland origin, and it has a gradually increasing incidence rate. An operative procedure is useful to obtain good results for this disease. Howevers, the selection of operation method remains controversial. Thus, we reviewed the variable prognostic factors which influence thyroid cancer recurrence in order to determine the treatment methods which reduce the recurrence rate. METHODS: We retrospectively reviewed the cases of 383 thyroid cancer patients who had received operations from January 1988 to December 1993. The review looked at age, sex, operation methods, lymph-node metastasis, histologic types, mass size and capsular invasions, and the correlations between these factors and recurrence were analyzed by using Chi-square and SAS trend tests. Complications which developed after various operation methods were also reviewed. RESULTS: Thyroid cancer recurred in 33 (8.6%) patients. Age, sex, lymph-node metastasis, histologic types and capsular invasions did not influence the cancer recurrence rate significantly. However, mass size and operation method were potential factors for recurrence. CONCLUSIONS: If thyroid cancer is diagnosed, a total thyroidectomy with lymph-node dissection is the best method for reducing the cancer recurrence rate. By careful management, complications can be prevented after a total thyroidectomy.
Endocrine Glands ; Humans ; Incidence ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

Speckled lentiginous nevus is circumscribed patch of hyperpigmentation with smaller, darker pigmented macules or papules within the patch. The background shows histologic features of lentigo simplex. The speckled areas show junctional or compound nevus. Association of speckled lentiginous nevus with multiple spitz nevi was rarely reported. We report a case of multiple spitz nevi arising in a giant speckled lentiginous nevus.
Hyperpigmentation ; Lentigo ; Nevus* ; Nevus, Epithelioid and Spindle Cell*

BACKGROUND: Patients with mitral regurgitation (MR) in the setting of coronary artery disease have a dismal long-term prognosis whether treated medically or surgically. Moreover, the optimal management of moderate ischemic MR at the time of coronary artery bypass grafting (CABG) remains the subjects of controversy. Thus, the present retrospective study was undertaken to determine whether mitral valve surgery for moderate ischemic MR at the time of CABG would be preferable to CABG alone in terms of clinical outcome. MATERIALS AND METHOD: Between January 1997 and December 2003, 34 patients with moderate (Gr 3/4) ischemic MR underwent CABG alone (Group I, n=23) or CABG plus mitral valve surgery (Group II, n=11). Operative mortality, long-term survival and echocardiographic parameters were used to evaluate the efficacy of mitral valve surgery in patients with moderate ischemic MR. The mean follow-up durations of each group were 69.3+/-4.3 months and 53.1+/-4.9 months respectively. RESULT: There was no hospital mortality in both groups. There was one case of late mortality in Group I. The mean number of bypass graft was similar (3.8+/-1.2 vs 3.7+/-1.3 respectively). Cardiopulmonary bypass time was longer in group II (p=0.014). In group II, all of the patients received mitral annuloplasty using ring. On immediate postoperative echocardiogram, mitral regurgitation was reduced more in group II (p=0.002). Echocardiogram performed at last follow-up state showed no difference except the grade of MR between the two groups. Actuarial survival of both groups at 5 years was similar (95.5% vs 100%, p=0.48). CONCLUSION: This study shows that in selected patients with moderate ischemic MR, CABG without mitral valve surgery might be sufficient. However, patients with low EF and NYHA functional class pre-operatively had tendency of significant residual MR, so mitral valve surgery should be necessary in these patients, and moreover, MR severity and left ventricle volume decreased more in mitral valve surgery group. Therefore, more large-scale studies are necessary to determine these effects on the ventricular function and long-term survival.
Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Disease ; Echocardiography ; Follow-Up Studies ; Heart Ventricles ; Hospital Mortality ; Humans ; Mitral Valve Annuloplasty ; Mitral Valve Insufficiency* ; Mitral Valve* ; Mortality ; Myocardial Ischemia ; Prognosis ; Retrospective Studies ; Transplants ; Ventricular Function

No abstract available.
Cryptococcosis*

In this study, we are to produce the single chain variable fragment (scFv) antibodies against surface protein of hepatitis B virus (HBV) using antibody phage display technique. Balb/c mice were immunized with preS1 and cDNAs of heavy and light chains of splenic B cells from immunized mice were prepared using RT-PCR. Two cDNAs were linked with (64S) linker DNA under recombination PCR to produce single chain Fv DNA. After digestion of scFv DNA with Sp 1 and Not 1, the digested DNA was ligated into pCANTAB 5E and electroporated into E. coli XL1-Blue to prepare scFv-library. The size of library was 1 * 10' pfu/ml. Phage antibodies (phabs) against preS1 were rescued with M13K07 helper phages, and preS1-binders were selected through 3 times of panning using 96 well microtitre plates. Phage antibody clones were assayed directly for the ability to bind preS1 by ELISA. And then 7 phage antibody clones had high ELISA signals against preS1. Phabs from preS1-specific pMsc-17 had the strongest ELISA signal to preS1. Phabs from pMsc-17 were used for Western blot to preS1 and the results revealed that it was specific to preS1. To prepare the soluble scFv antibody, phabs from pMsc-17 were transfected into non-suppressor E. coli HB2151, and grown under 1 mM IPTG. Soluble scFv antibody was mainly accumulated in the periplasmic space, but small amount of antibody was secreted into culture media.
Animals ; Antibodies ; B-Lymphocytes ; Bacteriophages* ; Blotting, Western ; Cell Surface Display Techniques ; Clone Cells ; Culture Media ; Digestion ; DNA ; DNA, Complementary ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Isopropyl Thiogalactoside ; Mice* ; Periplasm ; Polymerase Chain Reaction ; Recombination, Genetic ; Single-Chain Antibodies*