PURPOSE: Complete fibrovascular ingrowth within the hydroxyapatite ocular implant is necessary for peg drilling which is performed to prevent infection and to provide motility to the ocular prosthesis. We compared planar bone scintigraphy and SPECT for the evaluation of the vascularization within hydroxyapatite ocular implants. MATERIALS AND METHODS: Seventeen patients (M:F=12:5, mean age: 50.4+/-17.5 years) who had received a coralline hydroxyapatite ocular implant after enucleation surgery were enrolled. Patients underwent Tc-99m MDP planar bone and SPECT imaging by dual head gamma camera after their implant surgery (interval: 197+/-81 days). Uptake on planar and SPECT images was graded visually as less than (grade 1), equal to (grade 2), and greater than (grade 3) nasal bridge activity. Quantitative ratio of implanted to non-implanted intraorbital activity was also measured. Vascularization within hydroxyapatite implants was confirmed by slit lamp examination and ocular movement. RESULTS: All but three patients were considered to be vascularized within hydroxyapatite implants. In visual analysis of planar image and SPECT, grade 1 was noted in 9/18 (50%) and 6/18 (33%), respectively. Grade 2 pattern was 7/18 (39%) and 4/18 (22%), and grade 3 pattern was 2/18 (11%) and 8/18 (44%) respectively. When grade 2 or 3 was considered to be positive for vascularization, the sensitivity of planar and SPECT imaging were 60% (9/15) and 80% (12/15), respectively. In 3 patients with incomplete vascularization, both planar and SPECT showed grade 1 uptake. The orbital activity ratios on planar imaging were not significantly different between complete and incomplete vascularization (1.96+/-0.87 vs 1.17+/-0.08, p>0.05), however, it was significantly higher on SPECT in patients with complete vascularization (8.44+/-5.45 vs 2.20+/-0.87, p<0.05). CONCLUSION: In the assessment of fibrovascular ingrowth within ocular implants by Tc-99m MDP bone scintigraphy, SPECT image appears to be more effective than planar scintigraphy.
Durapatite* ; Eye, Artificial ; Gamma Cameras ; Head ; Humans ; Orbit ; Radionuclide Imaging* ; Technetium Tc 99m Medronate ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: Cortical dysplasia (CD) designates a diverse group of malformations resulting from one or more abnormalities in the development of the cerebral cortex. We investigated the findings of interictal SPECT and the diagnostic usefulness of interical and ictal SPECT according to pathological grading (PG) in comparison with MRI. MATERIALS AND METHODS: This study included 16 patients (M:F=9:7, age: 19.9+/-11.8 yrs) with pathologically proven CD. Tc-99m ECD SPECT was performed in all patients: interictal 11, interictal and ictal 3, ictal 2. MRI were obtained in all patients and image analysis was done blindly as to the result of SPECT. Pathologic findings of CD were classified into grade 1 (G1, dyslamination), grade 2 (G2, dysplastic neurons) and grade 3 (G3, balloon cells). We compared SPECT with MRI in lesions-to-lesions and analyzed the result according to PG. RESULTS: In SPECT and MRI, 38 and 27 lesions were visually recognized. In 14 interictal SPECT, variable findings in 35 lesions were demonstrated: 26 were hypoperfusion, 7 hyperperfusion, 2 heterotopic perfusion in the white matter. By comparison between two studies, missed lesions were founded: SPECT were 1 lesion, MRI 12. Review of missed 12 lesions of MRI were followed according to PG; G1 patients were 16.7% (4/19), G2 40.0% (6/15), and G3 50% (2/4). CONCLUSION: Interictal SPECT in CD showed variable findings such as hypoperfusion, hyperperfusion or heterotopic perfusion. However, for detection of missed CD on MRI, SPECT may help to detect a functional abnormality of the lesion with high PG.
Cerebral Cortex ; Humans ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. MATERALS AND METHODS: We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4+/-7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class I , II). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6+/-19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propagation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis RESULTS: CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=0.01) and age (p=0.02) were related to the development of CCH. CONCLUSION: Crossed cerebellar hyperperfusio ictal brain SPECT did not help differentiate mesial from lateral temporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.
Brain* ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Logistic Models ; Retrospective Studies ; Technetium Tc 99m Exametazime* ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: MOPP/ABV hybrid regimen incorporates MOPP and ABVD into a single regimen on the tenets of the Goldie-Coldman hypothesis. This study was performed to determine the efficacy of COPP/ABV hybrid regimen, in which cyclophosphamide was substituted for mechlorethamine, in patients with advanced Hodgkin's disease. MATERIALS AND METHODS: Patients with advanced Hodgkin's disease were treated with cyclophosphamide(600 mg/m2 iv, Dl), vincristine(1.4 mg/m2 iv, D1), procarbazine(100 mg/m2/d po, D1-7), prednisolone(40 mg/m2/d po D1-14), doxorubicin(35 mg/m2 iv, D8), bleomycin(10 mg/m2 iv, D8) and vinblastine(6 mg/m2 iv, D8). The treatment was repeated every 4 weeks. RESULTS: Between Aug. 1989 and Aug. 1996, 28 patients were enrolled. The median age was 33 years. Twenty one(75%) were previously untreated, newly diagnosed patients and 7(25%) were those who had relapsed after previous radiotherapy(RT). The common histologic types were nodular sclerosis(46%) and mixed cellularity(36%). Twenty three (82%) patients achieved complete remission(CR), three(11%) with the assistance of involved-field RT. Only one patient was primary treatment failure. The median follow-up duration was 56 months. Of the 23 patients achieving CR, three(13%) relapsed. Five-year relapse-free survival was 84.4%. Eight patients died. Five-year overall survival rate was 66.6% and 5-year failure-free survival rate was 66.3%. The survival rate of those who had relapsed after previous RT was significantly lower than that of newly diagnosed patients(P=0.03). The hematologic toxicities were common, but nonhernatologic toxicities were uncommon. Five patients died of treatment-related pneumonia or sepsis. Among them, four were those who had relapsed after previous RT. CONCLUSION: COPP/ABV hybrid regimen could cure significant proportion of patients with advanced Hodgkin's disease but the treatment-related mortality was high, especially in those who had relapsed after previous RT. Another regimen should be considered for those who received previous RT.
Cyclophosphamide ; Drug Therapy* ; Follow-Up Studies ; Hodgkin Disease* ; Humans ; Mechlorethamine ; Mortality ; Pneumonia ; Radiotherapy ; Sepsis ; Survival Rate ; Treatment Failure

Hyperphosphatemia develops when there is impaired renal phosphate excretion or massive extracellular fluid phosphate load. For example, renal insufficiency, hypoparathyroidism, exogenous phosphate administration, and extensive cellular injury induce a hyperphosphatemic state. In patients with multiple myeloma, renal insufficiency occurs as a result of hypercalcemia, light chain tubulopathy, urate nephropathy or infection, and hyperphosphatemia usually results from renal failure. We report here a case of a patient with multiple myeloma who had an elevated serum phosphate level measured by the phosphomolybdate UV method without significant renal insufficiency and was finally diagnosed with pseudohyperphosphatemia.
Extracellular Fluid ; Humans ; Hypercalcemia ; Hyperphosphatemia ; Hypoparathyroidism ; Light ; Molybdenum ; Multiple Myeloma ; Phosphoric Acids ; Renal Insufficiency ; Uric Acid

Miyoshi myopathy (MM) is a type of distal myopathy that is characterized by an early adult onset and a prominent involvement of the gastrocnemius muscles. Weakness usually appears between 15 and 30 years of age starting in the posterior compartment of the legs. Creatine kinase (CK) values are characteristically elevated to levels 10 to 100 fold above normal range. Here we report one patient who was diagnosed as MM. She developed a motor weakness in her early thirties. There was an early and predominant involvement of the gastrocnemius muscles. Creatine kinase activity was elevated 10 to 15 fold above normal range. Electromyography revealed fibrillations, positive sharp waves, and a myopathic pattern of motor unit potentials, particularly in the distal muscles of the lower limbs. Myopathic features without vacuoles were seen in the vastus lateralis muscle. This is the first case report of MM in Korea, which should be considered in the differential diagnosis of slowly progressive weakness of distal legs.
Adult ; Creatine Kinase ; Diagnosis, Differential ; Distal Myopathies* ; Electromyography ; Humans ; Korea ; Leg ; Lower Extremity ; Muscles ; Muscular Diseases ; Quadriceps Muscle ; Reference Values ; Vacuoles

Miyoshi myopathy (MM) is a type of distal myopathy that is characterized by an early adult onset and a prominent involvement of the gastrocnemius muscles. Weakness usually appears between 15 and 30 years of age starting in the posterior compartment of the legs. Creatine kinase (CK) values are characteristically elevated to levels 10 to 100 fold above normal range. Here we report one patient who was diagnosed as MM. She developed a motor weakness in her early thirties. There was an early and predominant involvement of the gastrocnemius muscles. Creatine kinase activity was elevated 10 to 15 fold above normal range. Electromyography revealed fibrillations, positive sharp waves, and a myopathic pattern of motor unit potentials, particularly in the distal muscles of the lower limbs. Myopathic features without vacuoles were seen in the vastus lateralis muscle. This is the first case report of MM in Korea, which should be considered in the differential diagnosis of slowly progressive weakness of distal legs.
Adult ; Creatine Kinase ; Diagnosis, Differential ; Distal Myopathies* ; Electromyography ; Humans ; Korea ; Leg ; Lower Extremity ; Muscles ; Muscular Diseases ; Quadriceps Muscle ; Reference Values ; Vacuoles

Neurilemmoma is a benign and slowly growing neurogenic tumor. Intrathoracic neurilemmoma often develops in the chest wall and posterior mediastinum, but endobronchial neurilemmoma is extremely rare. The diagnosis of endobronchial neurilemmoma with preoperative imaging findings is challenging and is usually made via postoperative pathological examination. These authors encountered a case of primary endobronchial neurilemmoma in a 52-year-old woman who had no symptoms. A 3.0 x 2.6 cm mass in the right lower lobe projecting into the mediobasal segmental bronchus was shown in the results of the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the chest. Benign neurilemmoma was confirmed via bronchoscopic biopsy, and surgical resection (sleeve bronchial excision and end-to-end anastomosis) was performed.
Biopsy ; Bronchi ; Female ; Humans ; Magnetic Resonance Imaging ; Mediastinum ; Middle Aged ; Neurilemmoma ; Pulmonary Surgical Procedures ; Thoracic Wall ; Thorax

Various biological approaches to the promotion of periodontal regeneration have been used. These can be divided into the use of growth and differentiation factors, application of extracellular matrix proteins and attachment factors and use of mediators of bone metabolism. The purpose of this study was to evaluate the effect of enamel matrix protein and platelet-rich plasma on the treatment of intrabony defect, with bovine-derived bone powder in humans by digital subtraction radiography. 12 teeth(experimental I group) were treated with enamel matrix protein combined with bovine-derived bone powder and 12 teeth(experimental II group) were treated with platelet-rich plasma combined with bovine-derived bone powder. The change of bone density was assessed by digital subtraction radiography in this study. The change of mineral content was assessed in the method that two radiographs were put into computer program to be overlapped and the previous image was subtracted by the later one. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-whitney Test using SPSS program for windows(5% significance level). The results were as follows: 1. The radiolucency in 3 months after surgery was significantly increased than 1 month after surgery in both groups(experimental I and II groups)(p<0.05). 2. The radiopacity in 6 months after surgery was significantly increased than 3 months after surgery in both groups(experimental I and II groups)(p<0.05). 3. In experimental I group, there was no significant difference between 1 month and 6 months after surgery. 4. In experimental II group, the radiopacity in 6 months after surgery was significantly increased than 1 month after surgery(p<0.05). 5. There was no significant difference between experimental I and II group at 1 month and 3 months after surgery, but the radiopacity in experimental II group was significantly increased at 6 months after surgery(p<0.05). In conclusion, platelet-rich plasma can enhance bone density than enamel matrix protein until 6 months after surgery.
Bone Density ; Dental Enamel* ; Extracellular Matrix Proteins ; Heterografts* ; Humans* ; Metabolism ; Platelet-Rich Plasma* ; Radiography* ; Regeneration

The purpose of this study was to evaluate the effect of acid-treatment conditions on the surface properties of the RBM (Resorbable Blast Media) treated titanium. Disk typed cp-titanium specimens were prepared and RBM treatments was performed with calcium phosphate ceramic powder. Acid solution was mixed using HCl, H2SO4 and deionized water with 4 different volume fraction. The RBM treated titanium was acid treated with different acid solutions at 3 different temperatures and for 3 different periods. After acid-treatments, samples were cleaned with 1 % Solujet solution for 30 min and deionized water for 30 min using ultrasonic cleanser, then dried in the electrical oven (37℃). Weight of samples before and after acid-treatment were measured using electric balance. Surface roughness was estimated using a confocal laser scanning microscopy, crystal phase in the surface of sample was analyzed using X-ray diffractometer. Surface morphology and components were evaluated using Scanning Electron Microscope (SEM) with Energy Dispersive X-ray spectroscopy (EDX) and X-ray Photoemission Spectroscopy (XPS). Values of the weight changes and surface roughness were statistically analyzed using Tukey-multiple comparison test (p=0.05). Weight change after acid treatments were significantly increased with increasing the concentration of H₂SO₄ and temperature of acid-solution. Acid-treatment conditions (concentration of H₂SO₄, temperature and time) did not produce consistent effects on the surface roughness, it showed the scattered results. From XRD analysis, formation of titanium hydrides in the titanium surface were observed in all specimens treated with acid-solutions. From XPS analysis, thin titanium oxide layer in the acid-treated specimens could be evaluated. Acid solution with 90℃ showed the strong effect on the titanium surface, it should be treated with caution to avoid the over-etching process.
Calcium ; Ceramics ; Microscopy, Confocal ; Photoelectron Spectroscopy ; Spectrometry, X-Ray Emission ; Surface Properties ; Titanium ; Ultrasonics ; Water