PURPOSE:It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. MATERIALS AND METHODS: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. RESULTS: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). CONCLUSION: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.
Bone Transplantation ; Female ; Follow-Up Studies ; Head* ; Hip Joint ; Humans ; Male ; Necrosis* ; Prognosis* ; Radionuclide Imaging* ; Technetium Tc 99m Medronate ; Transplants*

Gastritis is a common but a serious disease with a potential risk of developing carcinoma. Helicobacter pylori infection is reported as the most common cause of gastritis, but other genetic and genomic factors exist, especially single-nucleotide polymorphisms (SNPs). Association studies between SNPs and gastritis disease are important, but results on epistatic interactions from multiple SNPs are rarely found in previous genome-wide association (GWA) studies. In this study, we performed computational GWA case-control studies for gastritis in Korea Associated Resource (KARE) data. By transforming the resulting SNP epistasis network into a gene-gene epistasis network, we also identified potential gene-gene interaction factors that affect the susceptibility to gastritis.
Case-Control Studies ; Cohort Studies* ; Gastritis* ; Genome-Wide Association Study ; Helicobacter pylori ; Korea ; Polymorphism, Single Nucleotide

Pneumatosis cystoides intestinalis is a rare condition which is characterized by multiple gas-filled cysts of varying sizes in the wall of the gastrointestinal tract. In 85% of the cases, it is associated with gastrointestinal, pulmonary, and connective tissue diseases or with other conditions. In about 15% of the cases, the etiology remains obscure. In most cases, the prognosis is poor, so early diagnosis and treatment are required. We report two cases of primary pneumatosis cystoides intestinalis with portal venous gas which were associated with alcoholism and diabetes mellites and which were complicated by pneumoperitoneum and panperitonitis.
Alcoholism ; Connective Tissue Diseases ; Early Diagnosis ; Gastrointestinal Tract ; Pneumatosis Cystoides Intestinalis* ; Pneumoperitoneum ; Portal Vein ; Prognosis

PURPOSE: Diagnosis of acute abdomen in infants and children is difficult. The aim of this study is to evaluate the usefulness of sonography in the children suffering from acute abdominal pain. METHODS: From January 2001 through July 2002, abdominal sonography was carried out in 265 children who had abdominal pain, vomiting, or irritability. The suspected diagnosis were acute appendicitis, intussusception, congenital pyloric obstruction, inguinal hernia, and illeocolitis. Medical records were reviewed retrospectively for age, sex, sonographic diagnosis, and the impact of the sonography in the treatment was evaluated by comparing the sonographic diagnosis with the final diagnosis (guidance for treatment). RESULTS: Among 265 patiens, the sex ratio (male:female) was 1.7:1. According to the findings of sonographic studies, mesenteric lymphadenitis (40.8%) was the most common diagnosis and was followed by acute appendicitis (21.9%), normal abdomen (19.2%), intussusception (14.3%), ileus (3.4%), and epididymitis (0.4%). In 259 of the 265 patients, sonography helped guideline for treatment (97.7%). CONCLUSION: Sonography is very useful in the diagnosis and establishing the treatment guideline of pediatric patients with acute abdomen.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Appendicitis ; Child ; Diagnosis ; Emergencies* ; Epididymitis ; Hernia, Inguinal ; Humans ; Ileus ; Infant ; Intussusception ; Male ; Medical Records ; Mesenteric Lymphadenitis ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Vomiting

Background: Sedentary behavior (SB) has emerged as a new risk factor for cardiovascular accidents. We investigated whether physical activity levels or SB were related to percent body fat (%BF) in type 2 diabetes mellitus (T2DM). Methods: In this cross sectional study, we measured the duration of SB, light physical activity (LPA), moderate to vigorous physical activity (MVPA), total energy expenditure, and step counts using a wireless activity tracker (Fitbit HR; FB) for 7 days in freeliving conditions, along with %BF using a bio impedance analyzer (Inbody; Biospace) in 120 smartphone users with T2DM. Subjects were divided into exercise (Exe, n=68) and non-exercise (nonExe, n=52) groups based on self-reports of whether the recommended exercises (30 min/day, 3 days/week for 3 months) were performed. SBt, LPAt, MVPAt were transformed from SB, LPA, MVPA for normally distributed variables. Results: Participants were: female, 59.2%; age, 59.3±8.4 years; body mass index, 25.5±3.4 kg/m2; glycosylated hemoglobin (HbA1c), 7.6%±1.2%; %BF, 30.4%±7.1%. They performed SB for 15.7±3.7 hr/day, LPA for 4.4±1.7 hr/day, and MVPA for 0.9±0.8 hr/day. The %BF was related to SBt and LPAt, but not to MVPA after adjustments for age, gender, and HbA1c. VPA was significantly higher in the Exe group than in the nonExe group, but SB, LPA, and moderate physical activity were not different. Predicted %BF was 89.494 to 0.105 (age), –13.047 (gender), –0.507 (HbA1c), –7.655 (LPAt) (F[4, 64]=62.929, P<0.001), with an R2 of 0.785 in multiple linear regression analysis. Conclusion Reduced body fat in elderly diabetic patients might be associated with reduced inactivity and increased LPA.

The global incidence of breast cancer is on the rise, a trend also observed in South Korea.However, thanks to the rapid advancements in anticancer therapies, survival rates are improving. Consequently, post-treatment health and quality of life for breast cancer survivors are emerging as significant concerns, particularly regarding treatment-related cardiotoxicity. In this review, we delve into the cardiovascular complications associated with breast cancer treatment, explore surveillance protocols for early detection and diagnosis of late complications, and discuss protective strategies against cardiotoxicity in breast cancer patients undergoing anticancer therapy, drawing from multiple guidelines.

We experienced a case of cerebral hypoperfusion due to cyclosporine neurotoxocity confirmed only by Tc-99m ECD brain SPECT. A 53-year-old female had received allogenic peripheral blood stem cell transplantation due to refractory plasmacytoid lymphoma. Cyclosporine and steroid had been administrated to prevent graft versus host disease. Twenty days after transplantation, she became delirious and suffered from generalized tonic-clonic seizure. Immediately, brain MRI and MR angiography were performed and these studies did not show any abnormal findings. However, Tc-99m ECD brain SPECT showed diffuse hypoperfusion in the left cerebral hemisphere and blood cyclosporine level was 962.6 ng/ml. Cyclosporine administration was stopped and discontinuation of cyclosporine resulted in disappearance of all neurological symptoms. The same neurological symptoms recurred with cyclosporine re-administration for management of exacerbated graft versus host disease. In this case, Tc-99m ECD brain SPECT proved very helpful in the diagnosis of cycloporine neurotoxicity.
Angiography ; Brain ; Cerebrum ; Cyclosporine* ; Diagnosis ; Female ; Graft vs Host Disease ; Humans ; Lymphoma ; Magnetic Resonance Imaging ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Seizures ; Tomography, Emission-Computed, Single-Photon

OBJECTIVE: To evaluate the effectiveness of hysteroscopy and the incidence of endometrial polyps in women with endometriosis. METHODS: A total of 99 patients determined to be with infertility by laparoscopic procedure from March 1999 to February 2000 were prospectively analyzed at Ajou University Hospital, Suwon, Korea. The study group was 63 patients with endometriosis and the control group consisted of 36 patients without endometriosis. The presence of endometriosis was documented laparoscopically and scored according to The American Fertility Society Classification. We confirmed the presence of endometrial polyps by pathologic examination after polypectomy. We compared the results of the operation to that of the hysterosalpingogram(HSG) and transvaginal sonogram(TVS) before the procedure. RESULTS: Among the 99 patients with infertility, endometrial polyps were found in 40 of 63 women(63.5%) with endometriosis but in only 10 of 36 women(38.5%) without endometriosis. The greater the degree of endometriosis was accompanied by increased incidence of endometrial polyps, and in particular, women with stage three endomeriosis or higher all showed the presence of endometrial polyps. The sensitivity and specificity of the HSG detecting the presence of an endometrial polyp is 55.3%, 87.2%, and that of the TVS is 78.9%, 95.7%. DISCUSSION: The presence of endometrial polyps is significantly associated with the presence of endometriosis, and therefore hysteroscopy should be performed in patients with endometriosis who have not been confirmed with endometrial pathology by HSG or TVS.
Classification ; Endometriosis* ; Female ; Fertility ; Gyeonggi-do ; Humans ; Hysteroscopy* ; Incidence ; Infertility ; Korea ; Laparoscopy ; Pathology ; Polyps* ; Prospective Studies ; Sensitivity and Specificity

PURPOSE: To determine whether Tc-99mMIBI is recognized by the multidrug resistant P-glycoprotein (Pgp), we have measured quantitatively Tc-99mMIBI uptake in cancer cells. The effects of various Pgp reversing agents on cellular Tc-99m-MIBI uptake were also investigated in the presence of multidrug resistance gene-1 (mdr1 gene) overexpression. MATERIALS AND METHODS: We measured percentage uptake of Tc-99m-MIBI at different incubation temperatures both in mdr1 positive and negative cells. The effects of verapamil, cyclosporin, and dipyridamole on cellular uptake of Tc-99m-MIBI were also evaluated with or without overexpression of mdr1 gene in cultured murine leukemia L1210 cells. RESULTS: The mdr1 gene expressing cell lines were effectively induced in in vitro with continuous application of low-dose adriamycin or vincristine. Cellular uptake of Tc-99m-MIBI was higher in mdr1 negative L1210 cells than those of mdr1 positive cells, and higher when incubated in 37 degree C than 4 degree C. In the presence of verapamil, cyclosporin or dipyridamole, Tc-99m-MIBI uptake was increased upto 604% in mdr1 positive cells. CONCLUSION: Cellular uptake of Tc-99m-MIBI is lower in leukemia cells over-expressing mdr1 gene, and MDR-reversing agents increase cellular uptake. These results suggest that Tc-99m-MIBI can be used for characterizing Pgp expression and developing MDR-reversing agents In vitro.
Animals ; Cell Line ; Cyclosporine ; Dipyridamole ; Doxorubicin ; Drug Resistance, Multiple* ; Leukemia L1210 ; Leukemia* ; P-Glycoprotein ; Technetium Tc 99m Sestamibi* ; Verapamil ; Vincristine

Emergence and spread of low-level mupirocin resistance in staphylococci have been increasingly reported in recent years. The aim of this study was to characterize missense mutations within the chromosomal isoleucyl-tRNA synthetase gene (ileS) among clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) with low-level mupirocin resistance. A total of 20 isolates of MRSA with low-level mupirocin resistance (minimal inhibitory concentration, 16-64 microgram/mL) were collected from 79 patients in intensive care units for six months. The isolates were analyzed for isoleucyl-tRNA synthetase (IleS) mutations that might affect the binding of mupirocin to the three-dimensional structure of the S. aureus IleS enzyme. All isolates with low-level mupirocin resistance contained the known V588F mutation affecting the Rossman fold, and some of them additionally had previously unidentified mutations such as P187F, K226T, F227L, Q612H, or V767D. Interestingly, Q612H was a novel mutation that was involved in stabilizing the conformation of the catalytic loop containing the KMSKS motif. In conclusion, this study confirms that molecular heterogeneity in ileS gene is common among clinical MRSA isolates with low-level mupirocin resistance, and further study on clinical mutants is needed to understand the structural basis of low-level mupirocin resistance.
Staphylococcus aureus/drug effects/*genetics ; *Mutation, Missense ; Mupirocin/*pharmacology ; Methicillin Resistance ; Isoleucine-tRNA Ligase/*genetics ; Intensive Care Units ; Humans ; Electrophoresis, Gel, Pulsed-Field ; Drug Resistance, Bacterial