PURPOSE: Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of 99mTc-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of 99mTc-DMSA in predicting early diabetic nephropathy. MATERIALS AND METHODS: 99mTc-DMSA scan was performed and a total renal uptake of 99mTc-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases), Group II (microalbuminuria, 39 cases), and Group III (overt proteinuria, 32 cases). The differences of 99mTc-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of 99mTc-DMSA and other clinical parameters were analyzed. RESULTS: The total renal uptake of 99mTc-DMSA of Group II (40.8+/-11.0%) was significantly lower than that of Group I (54.4+/-6.3%, p<0.001). The uptake of Group III (27.7+/-12.0%) was significantly lower than those of both GroupI and Group II (p<0.001). 99mTc-DMSA total renal uptakes correlated negatively with serum creatinine level (r=-0.629, p<0.001) and positively correlated with creatinine clearance rate (r=0.702, p<0.001). CONCLUSION: 99mTc-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, 99mTc-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy.
Creatinine ; Diabetic Nephropathies ; Humans ; Incidence ; Kidney Failure, Chronic ; Proteinuria ; Technetium Tc 99m Dimercaptosuccinic Acid*

No abstract available.
Succimer* ; Thymoma*

No abstract available.
Child* ; Humans ; Immunotherapy*

Pseudoaneurysm is uncommon but a life threatening complication of chronic pancreatitis. Angiography has been the standard definitive imaging modality in the diagnosis of pseudoaneurysm. However, over the past 5 years duplux US and Dynamic CT have been proven to be valuable. The authors report a case of gastroduodenal pseudoaneurysm in chronic pancreatitis, which could be diagnosed by duplux US and Dynamic CT. Furthermore this case proved to be a pseudocyst which converted into a pseudoaneurysm by vessel rupture.
Aneurysm, False* ; Angiography ; Arteries* ; Diagnosis* ; Pancreatitis, Chronic* ; Rupture

No abstract available.
Child* ; Humans ; Immunoglobulin G*

Hantaviruses are distributed in rodent population world-widely even in geographical areas where hemorrhagic fever with renal syndrome (HFRS) has not been reported. Va.ictus species of Family Muridae and Arvicolidae serve as the natural reservoirs of hantaviruses. Hantaan virus, Seoul virus, Puumala virus, Prospect Hll virus, Sin Hombre virus and New York virus are members of genus Hantavirus and isolated from lungs of A. agrarius, C glareolus, M. pennsylvanicus, P. maniculatus and P. leucopus respectively. This experiment was intended to find the distribution of hantavirus infection among wild rodents and isolate the hantavirus from lung tissue of seropositve Apodemus peninsulae, and compared the nucleotide and amino acid sequences with prototype of hantaan virus 76-118 strain. Hantaviral sequences were amplified from lung tissues of A. peninsulae by reverse-transcriptase polymerase chain reaction. Alignment and comparison of the 324 nucleotide of G2 region of M-genomic segment diverged 4.6% and 0% at the nucleotide and amino acid levels, and complete N protein-coding region of S-genomic segment diverged 3.7% and 1.4% nucleotide and amino acid levels, respectively. This is the report to spill-over on the hantaan virus from A. peninsulae to A. peninsulae in Korea.
Amino Acid Sequence ; Animals ; Gyeonggi-do* ; Hantaan virus ; Hantavirus Infections ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea ; Lung ; Muridae ; Murinae* ; Polymerase Chain Reaction ; Puumala virus ; Rodentia ; Seoul virus

PURPOSE: We measured pulmonary epithelial permeability by Tc-DTPA radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate Tc-DTPA radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. MATERIALS AND METHODS: We performed ' Tc-DTPA radioaerosol scan in 10 normal subjects, 10 asym-ptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). Tc-DTPA clearance half-time (T1/2) was calculated, then compared with the result of chest radiography and pulmonary function test. RESULTS: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with micraangiopathy were significantly older (p<0.05). The T1/2of normal subjects and asyrnptomatic smokers were significantly different (65.2+23.7min vs 39.6+9.8min, p<0.05). For diabetic patients with microangiopathy, the T, was 90 5+46.5min and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the T1/2of diabetic patients without microangiopathy, 70.0+12.7 min, was not significantly different from those of normals or asyrnptomatic smokers (p>0.05). No significant correlation was found between the T1/2and spirometric parameters including DLcc>, FVC, FEV>, FEV(/FVC (%) and FEF)5-75g in all subjects, and between the T1/2 and duration of diabetes in diabetic patients. CONCLUSION: Eventhough the influence of age cant be excluded, delayed Tc-DTPA clearance half-time (T1/2)in diabetic patients with microangiopathy indicates decreased pulmonary cspillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.
Diabetes Mellitus ; Diagnostic Tests, Routine ; Humans ; Permeability ; Radiography ; Respiratory Function Tests ; Smoke ; Smoking ; Technetium Tc 99m Pentetate ; Thorax

No abstract available.

PURPOSE: We performed this study to evaluate the changes of gallbladder ejection fraction (GBEF) in diabetic patients with or without autonomic neuropathy. MATERIALS AND METHODS: This study included 37 diabetic patients (25 women, 12 men, mean age 51 years) and 24 normal controls (10 women, 14 men, mean age 38 years). After intravenous injection of 185 MBq of 99mTc-DISIDA, serial anterior abdominal images were acquired before and after fatty meal. Regions of interest were applied on gallbladder and right hepatic lobe on 60 and 90 minute images to calculate GBEF. RESULTS: GBEF was significantly reduced in diabetes with autonomic neuropathy (43+/-12.3%) and without autonomic neuropathy (57.5+/-13.2%) compared with normal controls (68+/-11.6%, p <0.05). And also, GBEF was significantly reduced in diabetes with autonomic neuropathy compared with diabetes without autonomic neuropathy (p <0.05). Fasting blood glucose level, age, sex, hemoglobin A1c, body mass index, serum lipid level were not different in these two diabetic patient groups (p>0.05). When 50.2% of GBEF was used as the criteria for diabetic autonomic neuropathy, the sensitivity and specificity were 80%, 76.5%, respectively. The area under receiver operating characteristic curve was 0.846. CONCLUSION: GBEF of diabetic patients with autonomic neuropathy was significantly reduced than that of diabetic patients without autonomic neuropathy.
Blood Glucose ; Body Mass Index ; Diabetic Neuropathies* ; Fasting ; Female ; Gallbladder* ; Humans ; Injections, Intravenous ; Male ; Meals ; ROC Curve ; Sensitivity and Specificity ; Technetium Tc 99m Disofenin*

We experienced a case of congenital tuberculosis infected in utero, who had been found to have massive ascites and pleural effusion on routine ultrasonography at the 39 weeks' gestation. The emergency C-section delivered a male neonate weighing 2,050 g with poor condition and in severe respiratory distress. He was the first child born of a 27-year-old woman, who was diagnosed as having tuberculous pleurisy after delivery. Detection of acidfast bacilli in gastric aspirates obtained from the newborn as well as the clinical features and maternal history confirmed the diagnosis of congenital tuberculosis. Though rare, congenital tuberculosis requires early detection and treatment because of its severity and high mortality. A brief review of the relevant literature was made.
Adult ; Ascites* ; Child ; Diagnosis ; Emergencies ; Female ; Humans ; Infant, Newborn ; Male ; Mortality ; Pleural Effusion* ; Pregnancy ; Tuberculosis* ; Tuberculosis, Pleural ; Ultrasonography