Lichen nitidus(LN) is an unaommon chronic eruption of numerou tiny, discrete, usually flesh colored, shiny papules most cornmonly located on the penis, arms, for arms, and abdomen. It was described by Pinkus, first in 1901. The distribution of LN is most often locaized, but in some cases it may become generalized. A 10-year-old healthy boy was seen by our department because of many flesh colored, discrete, shiny papules on the whole body. The papules are skin colored, pinhcad sized, round, and flat-topped. The lesions appeared first at the age of 9 on the forehead and then neased in the number and extended downward to the neck, trunk, abdornen and both extremities. This case was successfully treated with topical corticosteroid.
Abdomen ; Arm ; Child ; Extremities ; Forehead ; Humans ; Lichen Nitidus* ; Lichens* ; Male ; Neck ; Penis ; Skin

PURPOSE: F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been proven to be useful in the differential diagnosis of breast mass and staging of breast cancer. This study assessed the diagnostic accuracy of F-18-FDG PET in the differentiation of breast mass and staging of breast cancer. MATERIALS AND METHODS: Total 42 patients who had breast mass underwent F-18-FDG PET (all female, 40+/-10 year old). We compared F-18 FDG PET results with pathologic findings in 24 patients RESULTS: In the differentiation of breast mass, sensitivity and specificity were 95% (19/20) and 77% (7/9) respectively. Three false positive cases were due to inflammation and one false negative patient had small tumor less than 1 cm. In the assessment of axillary lymph node status, sensitivity and specificity were 73% (8/11) and 100% (7/7) respectively. We found distant metastasis that were not suspected before F-18-FDG PET in 2 patients. CONCLUSION: F-18-FDG PET shows good diagnostic performance in differentiation of breast mass and staging of breast cancer.
Breast Neoplasms* ; Breast* ; Diagnosis, Differential* ; Female ; Humans ; Inflammation ; Lymph Nodes ; Neoplasm Metastasis ; Positron-Emission Tomography ; Sensitivity and Specificity

PURPOSE: Cost-effectiveness of myocardial SPECT f'or the diagniosis of coronary artery disease was investigated considering the present and amended costs of myocardial SPECT and exercise ECG in Korea. MATERIALS AND METHODS: Four diagnostic tactics such as 1) coronary angiography (CAG) after exercise ECG, 2) CAG after myocardial SPECT, 3) direct CAG, and 4) CAG after myocardial SPECT following exercise ECG were chosen. Costs were calculated using the present costs of various tests and effects represented by Quality Adjusted Life Year (QALY) were estimated. Difference of QALY (deltaQALY) was calculated by subtracting QALY of diagnosed/treated cases from QALY of undiagnosed cases, Cost/delta QALY was calculated and compared between four different tactics according to pre-test probability, RESULTS: When pre-test probability was equal to or larger than 0.6, direct CAG was the most cost-effective. When pre-test probability was between 0.2 and 0.6, CAG after myocardial SPECT following exercise ECG was the most cost-effective. CAG after myocardial SPECT was the second most cost-effective. Cost-effectiveness was similar when the costs of exercise ECG were doubled or quadrupled. CAG after exercise ECG was always the least cost-effective, CONCLUSION: Myocardial SPECT with or without preceding exercise ECG was the most cost-effective method to diagnose coronary artery disease in the present or expected amended cost system.
Coronary Angiography* ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Electrocardiography* ; Korea* ; Perfusion* ; Quality-Adjusted Life Years ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Wilms tumor, the most common primary malignant renal tumor of childhood, has relatively good prognosis among solid tumors occurring in childhood because of the improved operation skill, proper selection of chemotherapeutic agents, and combined radiotherapy on the primary and distant metastatic sites after nephrectomy. However, successful therapy has been associated with long-term toxicity occurring years or decades later. So it is important to identify and understand the possible late effects of treatment for Wilms tumor. METHODS: We reviewed 73 cases of Wilms tumor who were diagnosed and treated from Mar., 1983 to Nov., 1996 and calculated the survival rate. In addition, 42 cases were investigated to see the late effects of treatment for Wilms tumor since Feb., 1993, especially with predesigned indices such as blood pressure, blood urea nitrogen(BUN), serum creatinine(S-Cr), 24 hour urine protein/creatinine(24 HU Pr/Cr), 24 hour urine microalbumin(24 HU MA), 24 hour urine beta2-microglobulin/creatinine(24 HU beta2-MG/Cr). RESULTS: Overall survival rate of Wilms tumor was 86% in 5 years. There was significant difference in survival between stage I, II, III group and stage IV, V group(90% vs 72%, P=0.032), and survival rate of favorable histology group was higher than that of unfavorable histology group(92% vs 73%, P=0.043). Of the 42 cases in our study of late effects, no patient has presented significant late sequelae causing morbidity, and there were one case of transient hypertension, three cases of microalbuminuria, three cases of proteinuria, one case of asymptomatic microscopic hematuria, one case of radiation hepatitis and two cases of nut-cracker syndrome. No abnormality was noted in BUN, S-Cr, or 24 HU beta2-MG/Cr. CONCLUSION: Wilms tumor in our center have an excellent prognosis and no significant late sequelae that might affect long-term morbidity were found. But thorough and further longer follow-up is mandatory to understand the possible late effects fully, so that cope with properly and improve the quality of life.
Blood Pressure ; Follow-Up Studies ; Hematuria ; Hepatitis ; Humans ; Hypertension ; Nephrectomy ; Prognosis ; Proteinuria ; Quality of Life ; Radiotherapy ; Survival Rate* ; Urea ; Wilms Tumor*

PURPOSE: This study was designed to compare the follow up results with clinical and laboratory findings in patients with seizures in the neonatal period. Also, it was aimed to evaluate the usefulness of scoring prognostic factors and its efficacy as a prognostic index. METHODS: The subjects are 67 neonates who were admitted to Chungnam National University Hospital from January 1999 to April 2005 for seizures which occurred within 28 days of birth. These patients were investigated retrospectively from the hospital records. We scored clinical manifestations including gestational age, birth weight, Apgar score at 5 min, etiology, type, onset, duration, and frequency of seizures, neurologic examination results, EEG background activities, and treatment responses. Follow-up examinations were done to analyze the presence of epilepsy and neurologic deficits. A sum of the factors associated with outcomes regarded as a prognostic index, were studied. RESULTS: 50 cases(74.6%) showed normal outcomes, while 7 cases(10.4%) had unfavorable neurologic outcomes and 4 cases(6.0%) favorable neurologic outcomes with epilepsy. 6 cases(9.0%) showed unfavorable neurologic outcomes with epilepsy. All of the data including gestational age, Apgar score at 5 min, etiology, type, duration, and frequency of seizures, neurologic examination results, EEG background activities, and treatment responses were used as a prognostic index by a scoring system. When the cut-off point was 7, sensitivity, specificity, positive predictive value and negative predictive value were 76.5%, 78.0%, 54.2%, and 90.7% respectively. CONCLUSION: A scoring system for neonatal seizures earned high scores in sensitivity, specificity and negative predictive value, so that it seems to be useful as a predicitive prognostic index.
Apgar Score ; Birth Weight ; Chungcheongnam-do ; Electroencephalography ; Epilepsy ; Follow-Up Studies ; Gestational Age ; Hospital Records ; Humans ; Infant, Newborn ; Neurologic Examination ; Neurologic Manifestations ; Parturition ; Retrospective Studies ; Seizures* ; Sensitivity and Specificity

PURPOSE: For quantitative estimation of cerebrovascular reserve (CVR), we estimated the cerebral blood flow (CBF) using Lassen's nonlinearity correction algorithm and Tc-99m HMPAO brain SPECT images acquired with consecutive acquisition protocol. Using the values of CBF in basal and acetazolamide (ACZ) stress states, CBF increase was calculated. MATERALS AND METHODS: In 9 normal subjects (age: 72+/-4 years), brain SPECT was performed at basal and ACZ stress states consecutively after injection of 555 MBq and 1,110 MBq of Tc-99m HMPAO, respectively. Cerebellum was automatically extracted as reference region on basal SPECT image using threshold method. Assuming basal CBF of cerebellum as 55 ml/100 g/min, CBF was calculated for every pixel at basal states using Lassen's algorithm. Cerebellar blood flow at stress was estimated comparing counts of cerebellum at rest and ACZ stress and Lassen's algorithm. CBF of every pixel at ACZ stress state was calculated using Lassen's algorithm and ACZ cerebellar count. CVR was calculated by subtracting basal CBF from ACZ stress CBF for every pixel. The percent CVR was calculated by dividing CVR by basal CBF. The CBF and percentage CVR parametric images were generated. RESULTS: The CBF and percentage CVR parametric images were obtained successfully in all the subjects. Global mean CBF were 49.6+/-5.5 ml/100g/min and 64.4+/-10.2 ml/100g/min at basal and ACZ stress states, respectively. The increase of CBF at ACZ stress state was 14.7+/-9.6 ml/100g/min. The global mean percent CVR was 30.7% and was higher than the 13.8% calculated using count images. CONCLUSION: The blood flow at basal and ACZ stress states and cerebrovascular reserve were estimated using basal/ACZ Tc-99m-HMPAO SPECT images and Lassen's algorithm. Using these values, parametric images for blood flow and cerebrovascular reserve were generated.
Acetazolamide ; Brain* ; Cerebellum ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Dipyridamole* ; Perfusion*

PCR is a rapid and sensitive method for detection of viruses from clinical samples and good primers are essential for successful PCR. However, high mutation rate of viral genomes often results in failure in detecting viruses, and there have been attempts to develop primers from multiple viral sequences. Thus, we developed a program called Universal Primers Score Ranking (UPSR) which generates primers from multiple sequences and ranks the quality of primers automatically. The feasibility of the UPSR program was tested using hepatitis B viruses (HBV) isolated from Korean patients. UPSR generated primer candidates with quality score ranks according to two T(m) values. We found that T(m2) values calculated based on the thermodynamics of nearest neighboring bases were better correlated with actual detection rate of HBV from patients' sera. The primer with number 1 rank by T(m2) values detected more samples than any other primers designed by UPSR, commercial primer, or other reference primers suggested by previous literatures. Thus, UPSR proved to be easy and useful to design primers from multiples sequences in detecting viruses.
Collodion ; Genome, Viral ; Hepatitis B virus ; Humans ; Mutation Rate ; Polymerase Chain Reaction ; Thermodynamics

PURPOSE: As our society ages, a disease like benign prostatic hyperplasia (BPH) are increasing and needs consequent management. Recently, through the expansion of the communication infrastructure and terminals, a network services can be provided. However, the concern about distant medical management is increasing. We introduce here the Personal BPH Control Program (PBCP) and its application to clinical patients. MATERIALS AND METHODS: We have asked BPH patients to input the variable elements on the digital survey through the Personal Digital Assistant (PDA) once a week. We used the International Prostate Symptom Score (IPSS) and the average flow rate as the variable elements. We have used an algorithm to determine the patients condition. With this, we have developed a program that helps patients to adjust their visits to the hospital. RESULTS: According to the input elements, we have determined that the patients' condition was good (visit the hospital every 3 months) when the IPSS decreased, compared with the baseline and when the average flow rate was up above 2ml/sec. The patients' condition was a warning (visit the hospital every 2 months) when the IPSS was increased to below 3 and the average flow rate was down below +/- 2ml/sec, and the patients' condition was urgent when the IPSS increased to above 4 and the average flow rate was down above 3ml/sec. CONCLUSIONS: We expect that the PBCP has great socioeconomic utility when applying it to patients. A portable personal apparatus for measuring the flow rate is now being developed. When sufficient examples of applying the symptom algorithm have accumulated, we are going to report afterward the prospects of using the PBCP in the future.
Computers, Handheld ; Humans ; Prostate ; Prostatic Hyperplasia ; Telecommunications

The incidence of bilateral temporal bone fractures are reported in 9% to 20%. Otic capsule violating temporal bone fractures are highly related to sensorineural hearing loss, when compared with otic capsule sparing fractures. Patients with bilateral temporal bone fractures and profound bilateral sensorineural hearing loss may benefit from cochlear implantation. We present the case of a 44-year-old male with bilateral profound sensorineural hearing loss caused by bilateral temporal bone fractures who achieved successful auditory rehabilitation after a cochlear implantation.
Adult ; Cochlear Implantation ; Cochlear Implants ; Hearing Loss, Sensorineural ; Humans ; Incidence ; Male ; Temporal Bone