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

Myocarditis is defined as the myocardial inflammation caused by various infectious agents (such as virus, rickettsia , bacteria, protozoa, fungus and parasites). The clinical manifestations of myocarditis ranges from the asymptomatic state due to focal inflammation to fulminant fatal congestive heart failure secondary to diffuse myocardial involvement. Clinically, in some cases, it may simulate an acute myocardial infarction. We experienced a case of acute fulminant myocarditis that presented as acute myocardial infarction initially, and then progressed into and recovered from congestive heart failure and multiorgan failure.
Asymptomatic Diseases ; Bacteria ; Estrogens, Conjugated (USP)* ; Fungi ; Heart Failure* ; Inflammation ; Myocardial Infarction ; Myocarditis* ; Rickettsia

No abstract available.
Child* ; Humans ; Hypercalciuria*

This study was undertaken to observe the histologic changes of surrounding maxillary sutures to the widening of midpalatal suture, using two adult dogs, weighing about 10 kg, for experimental, and one for control group. After widening of the midpalatal suture with expansion screw for ten days was performed, and followed by sacrifice of experimental animals. Tissues were excised from 5 surrounding maxillary suture portions such as, internasal, interfrontal, midsagittal, zygomatrco-temporal, and midpalatal sutures. After that, the specimens were fixed and d calcified in 10% formalin sol. and 5% nitric acid. Embedding in paraffin end, serial sections at a thickness of 5 micron was done, After Hema toxylin Eosin staining and light microscopic examination, Following results were obtained 1. in midpalatal suture area, which showed most prominent histologic change, High degree of fibronlastic and osteoblastic proliferation lining the bony trabeculae with osteoid tissue projection into the fibrous connective tissue were observed. 2. In interfrontal suture area, moderate degree of fibroblastic and osteoblastic proliferation was observed. 3. In internasal suture area, active osteoblastic and osteoclastic proliferation lining the bony trabeculae was observed, and separation of fibrous connective tissue was also observed. 4. In midsagittal and zygomatico-temporal suture areas, no histologic changes can be observed.
Adult ; Animals ; Connective Tissue ; Dogs* ; Eosine Yellowish-(YS) ; Fibroblasts ; Formaldehyde ; Humans ; Nitric Acid ; Osteoblasts ; Osteoclasts ; Paraffin ; Sutures*

PURPOSE: Radionuclide cisternography may be helpful in understanding pathophysiology of postural headache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. MATERIALS AND METHODS: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 1/2 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. RESULTS: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30 min (6/10) and 2 hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30 min. Epidural blood patch was done in 11 patients and headache was improved in all cases. CONCLUSION: The characterstic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.
Absorption ; Blood Patch, Epidural ; Diagnosis ; Headache ; Humans ; Intracranial Hypotension* ; Pentetic Acid ; Radioactivity ; Spinal Puncture ; Subarachnoid Space ; Urinary Bladder

A case of 42-year-oldI kidney transplant patient who developed invasive carcinama of the cervix after immunoauppresawe therepy is reported and the literature related to this diease is revuewed. The iatmgenic immunosuppresaionn renal transplantation recipients has been associated with increased incidence of malignancy in these patients. In particular, immunosuppressed women are al greater risk of developing cervical intraepithelial neoplasia and buman papillomavirus type 16 or 18 infection. So, all such individuals are required to receive periodic gynecologic examination before renal transplantation and at regular intervals thereafter so that the development of CIN may be diagnosed at an early Stage and treated effestively.
Allografts* ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Female ; Humans ; Incidence ; Kidney ; Kidney Transplantation

Polycystic ovary syndrome is characterized by symptoms of oligomenorrhea, amenorrhea, infertility, hirsutism and obesity. It is known that the women with such diseases would have higher risks to coronary heart diseases, hypertension, DM and endometrial cancer later on, Known risk factors of endometrial cancer are nullipara, late menopause, obesity, DM, unopposed estrogen, tamoxifen treatment, and atypical endometrial hyperplasia ect. 75% of endometrial cancer occurs in age over 50 and 4% of endometrial cancer occurs in age under 40. Particulary endometrial cancer concurrent polycystic ovary syndrome occurs usually in people under age 40 and is commonly well differentiated cell type and is related to good prognosis. We experienced a case of endometrial cancer with polycystic ovary syndrome, who was early dignosed, presented with infertility and got an operation in our hospital, and report this case with a brief review of literature.
Amenorrhea ; Coronary Disease ; Endometrial Hyperplasia ; Endometrial Neoplasms* ; Estrogens ; Female ; Hirsutism ; Humans ; Hypertension ; Infertility ; Menopause ; Obesity ; Oligomenorrhea ; Polycystic Ovary Syndrome* ; Prognosis ; Risk Factors ; Tamoxifen

OBJECTIVE: This study aimed to evaluate psychometric properties of the Munich ChronoType Questionnaire (MCTQ) in a sample of Korean older adults. METHODS: One-hundred ninety two participants aged 65 and over completed interview-based questionnaires about chronotype, insomnia, depression, and anxiety. Additionally, a small subset of subjects completed a 7-day sleep diary and actigraphy measurements. RESULTS: Morningness-Eveningness Questionnaire (MEQ) scores were significantly negatively correlated with Midpoint of sleep on free days corrected for sleep debt accumulated through weekdays (MSFsc) (r=-0.45, p < 0.01) assessed by the MCTQ. MSFsc using the MCTQ was significantly positively correlated with MSFsc assessed by both the sleep diary (r=0.74, p < 0.05) and actigraphy (r=0.76, p < 0.05). Additionally, MSFsc assessed by the MCTQ was significantly positively correlated with insomnia (r=0.26, p < 0.01), depression (r=0.25, p < 0.01), and anxiety (r=0.18, p < 0.05). Finally, based on MEQ scores, we derived a cut-off score for the MCTQ that distinguishes morning type and other types (intermediate/evening types) in older adults. CONCLUSION: The results of these studies supported the validity of the MCTQ in Korean older adults. Additionally, while sleep rhythms in elder adults may be more advanced, eveningness tendency may be still important and indicative of sleep and psychological disturbance.
Actigraphy ; Adult* ; Anxiety ; Circadian Rhythm ; Depression ; Geriatric Assessment ; Geriatric Psychiatry ; Humans ; Psychometrics ; Sleep Initiation and Maintenance Disorders ; Sleep Wake Disorders

BACKGROUND/AIMS: The aims of this study were to examine the expressions of endothelium specific VE-cadherin, intestine specific LI-cadherin, and vascular endothelial growth factor (VEGF), and to determine their relationships with the clinicopathological parameters of gastric cancer. METHODS: A total 47 patients with gastric cancer who underwent surgery were enrolled. Endoscopic biopsies were obtained from the cancer and normal mucosa, respectively. Using semiquantitative RT-PCR, the mRNA expression levels of VE-cadherin, LI-cadherin and VEGF were measured by tumor/normal (T/N) ratios. The protein expressions of VE-cadherin, LI-cadherin and VEGF were examined by Western blot and immunohistochemical stain in surgically resected tissues. The clinicopathological variables were reviewed and analyzed, retrospectively. RESULTS: Twenty two cases (46.8%) of VE-cadherin, 25 cases (53.2%) of LI-cadherin and 27 cases (51.1%) of VEGF mRNA expressions were overexpressed in gastric cancer compared to normal tissue. There was a tendency for T/N ratio of VE-cadherin mRNA to correlate with the lymphatic invasion (p=0.07) and the lymph node metastasis (p=0.099) in advanced gastric cancer. The T/N ratio of LI-cadherin mRNA showed significant association with distant metastasis (p=0.031) and lymphatic invasion especially in advanced gastric cancer (p=0.023). There was a tendency for the T/N ratio of VEGF mRNA to correlate with the distant metastasis (p=0.073) in advanced gastric cancer. CONCLUSIONS: As increased mRNA expression of LI-cadherin was associated with distant metastasis and lymphatic invasion especially in the biopsy specimen of advanced gastric cancer before surgery, it may provide useful preoperative information on tumor aggressiveness.
Adult ; Aged ; Aged, 80 and over ; Antigens, CD/genetics/*metabolism ; Cadherins/genetics/*metabolism ; Female ; Gastroscopy ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms/*metabolism/pathology/surgery ; Vascular Endothelial Growth Factor A/genetics/*metabolism

Humans ; Incisor ; Lip ; Osteotomy ; Tooth