PURPOSE: We evaluated the importance of redistribution and 24 hour reinjection images in Tl-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). MATERIALS AND METHODS: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection Tl-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or l (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assess-ment in stress-redistribution and stress-reinjection images. RESULTS: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. CONCLUSION: The 24 hour reinjection imaging is useful in the assessment of rnyocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.
Complement System Proteins ; Dipyridamole ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon

Hydrochlorothiazide is a diuretic drug used in the treatement of edema and hypertension. We report a case of hydrochlorothiazide induced photosensitivity in a 54 year old woman who had taken hydrochlorothiazide for 3 years for hypertension. She complained of itching and burning sensation with erythematous papules and lichenified plaques on light-exposed areas. Fhototest showed marked decrease of the minimal erythema dose(MED) for UVA. The symptoms subsided after the use of topical steroid and the substitution atenolol for hydrochlorothiazide.
Atenolol ; Burns ; Edema ; Erythema ; Female ; Humans ; Hydrochlorothiazide* ; Hypertension ; Middle Aged ; Pruritus ; Sensation

Eczema herpeticum is a herpes simplex virus infection with disseminated skin involvement superimposed on a pre-existing dermatosis. Dariers disease has been reported to be among the dermatoses susceptible to the sudden onset of a widespread vesicular eruption accompanied by high fever known as Kaposis varicelliform eruption. We report a case of eczema herpeticum in a 46-year-old woman associated with Dariers disease.
Darier Disease* ; Eczema* ; Female ; Fever ; Humans ; Kaposi Varicelliform Eruption* ; Middle Aged ; Simplexvirus ; Skin ; Skin Diseases

PURPOSE: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system (MUTARS(R)) used in patients with a malignant bone tumor. MATERIALS AND METHODS: Thirty one cases which used MUTARS(R) tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. RESULTS: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. CONCLUSION: Our results suggest limb salvage with the MUTARS(R) endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.
Extremities ; Femoral Fractures ; Femur ; Follow-Up Studies ; Humans ; Humerus ; Leg ; Limb Salvage ; Neoplasm Metastasis ; Prostheses and Implants ; Recurrence ; Retrospective Studies ; Tibia

Authors experienced a case of human infection with Anisakis sp. in left tonsil. The case was 27 year Korean female who visited Department of Otolaryngology, Severance Hospital with the chief complaints of swollowing difficulty, and the sensation of a foreign body in the throat, on November 20th 1968. Physical examination of the oral cavity revealed that both palatin tonsil were chronically enlarged. A larval worm was found in crypt of the upper portion of the left palatin tonsil. Chief complaints of the patient was improved after removal of it by forceps. The greyish white living worm was fixed in lactophenol solution for morphological study. The worm measured 36 mm in length by 0.6 mm in width, 2.4 mm in esophageal length, 1.4 mm in ventricule, 0.1 mm in tail length, and 0.025 mm in caudal spine length, respectively and histological study was carried out from the serial section of the larva which was stained with hematoxylin eosin. Authors identified that the larva was Anisakis species.
parasitology-helminth-nematoda-Anisakis sp. ; case report ; tonsil ; swollowing difficulty

Prediction of acetabular development after reduction in treatment of developmental dysplasia of thc hip (DDH) is earlier, the hetter results because it would help ensure optimal timing of additional procedure if necessary. In this respect, authors reviewed retrospectively the radiographs of the hips of 35 children with DDH who had unilateral involvement and treated hy senior author (S.H.Lee) from the heginning with single successful attempt of reduction. The radiographs which were made at the time of initial diagnosis, one, two year nfter reduction und final follow up were assessed of teardrop figures. The results of treatment were classified as satisfactory group(CE > 10degrees ) and unsatisfactory group(CE < 10degrees) judged hy center-edge angle(CE degrees) at final follow-ups. 1. The teardrop figures were classifiable into 4 distinct groups as i)absent. ii)V-shaped, iii)Ushaped, iv) inverted D-shaped. 2. The teardrop figures in normal sides of hip were all U-shaped. 3. In dislocated but with satisfactory result group(24 cases), absent at 2 cases(8%), U-shaped teardrop was seen at 13 cases(54%), V-shaped in 9 cases(38%), and inverted 2-shaped in 0 case at I year after reduction. 4. In dislocated but with unsatisfactory result group( 11 cases), they were mostly of V-shaped(7 cases, 64%). The rest were of ahsent in 4 cases(36%) . hut none of U-shaped and inverted 2-shaped. In conclusions, teardrop figures appeared as significant predictor of future development of hip joint. Teardrop figure which stay as V-shaped at one year after reduction seems suggestive of insufficient reduction of DDH, therehy calls for early additional procedure.
Acetabulum ; Child ; Diagnosis ; Dislocations* ; Dronabinol ; Follow-Up Studies ; Hip Joint ; Hip* ; Humans ; Retrospective Studies

Renal artery aneurysm is a rare disease and a uniommon cause of renovascular hypertension. The estimated incidence of renal artery aneurysm in the normal population varies from 0.09% to 0.3%. Eight renal artery aneurysms that we experienced between February 1986 and January 1998 were reviewed. All were saccular including one iatrogenic pseudoaneurysm after balloon angioplasty for fibromuscular renal artery stenosis. The ages ranged from 20 through 66 years with the mean age of 42 years and there was no difference in sex distribution. Of the 8 patients, 6 were diagnosed on the basis of arteriography, 1 on the basis of computed tomography, and 1 at a urologic surgery. There was no aneurysm ruptured spontaneously. The aneurysm size ranged from 1.5 cm through 12.5 cm with the mean size of 4.1 cm, but 7 aneurysms were not greater than 5 cm in size. In 4 patients (50%) the aneurysm were calcified. Only four had symptoms such as pain or discomfort on trunk. 2 patients had associated renovascular hypertension. 5 patients (63%) underwent operation i.e. 3 arterial reconstruction and 2 nephrectomy that was inevitable due to complicated location or surrounding adhesion enough to unappreciable of vascular reconstruction. One associated hypertension was cured with operation, another renovascular hypertention was not resolved by operation. There was no operative mortality. This study reveals that the saccular type is predominant and spontaneous rupture is uncommon feature in renal artery aneurysm.
Aneurysm ; Aneurysm, False ; Angiography ; Angioplasty, Balloon ; Humans ; Hypertension ; Hypertension, Renovascular ; Incidence ; Mortality ; Nephrectomy ; Rare Diseases ; Renal Artery Obstruction ; Renal Artery ; Rupture, Spontaneous ; Sex Distribution

Hemangiopericytoma is a rare mesenchymal neoplasm, accounting for about 1% of vascular tumor. Hemangiopericytoma is known to be derived from the vascular pericyte and occurs most commonly lower extremities, pelvis and retroperitoneum. Surgical radical excision is the treatment of choice. Because of malignant features of hemangiopericytoma, long term and close follow-up is important. We report a case of successfully resected retroperitoneal hemangiopericytoma.
Accounting ; Follow-Up Studies ; Hemangiopericytoma ; Lower Extremity ; Pelvis ; Pericytes

Objectives: . Endoscopic tympanoplasty (ET) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility for the treatment of tympanic membrane (TM) perforations. However, the literature on surgical outcomes for large TM perforations is lacking and limited to small series. This study aimed to evaluate the clinical benefits of ET for large TM perforations. Methods: . This retrospective cohort study was conducted at nine tertiary referral hospitals in South Korea, where 252 patients who underwent ET as primary surgery from September 2019 to August 2021 were included. The outcome measures included the graft success rate and pre- and postoperative audiometric data. Results: . In 239 patients, the graft success rate of ET for large or subtotal perforations was 86.2% (206 patients), while the graft failure rate was 13.8% (33 patients). The graft failure rate was directly correlated with surgical techniques, including overlay and medial or lateral underlay tympanoplasty (P=0.027). Lateral underlay tympanoplasty showed the most favorable results. Sex, laterality, etiology, site and size of perforation, operation time, and graft materials did not vary significantly between the graft success and failure groups (P>0.05). The mean air-bone gap (ABG) improved significantly in both groups (graft success group: 10.0±0.6 dB and graft failure group: 7.7±0.3 dB; P<0.001). However, the ABG improvement did not significantly differ between the groups. Analysis of covariance revealed that the postoperative 500-Hz bone conduction threshold improved after successful ET (adjusted coefficient, –11.351; 95% confidence interval, –21.491 to –1.212; P=0.028). Conclusion . This study involved the largest population to date of large TM perforations treated by ET. The study findings suggest that ET is feasible and effective in treating large TM perforations.

High incidence of deep venous thrombosis after radical pelvic surgery is well known. Among gynecologic malignancies, ovarian cancer, especially clear cell adenocarcinoma is likely to develop thromboembolism. We report 2 cases of pulmonary thromboembolism and deep vein thrombosis in ovarian clear cell carcinoma with endometriosis and history of IVF-ET during cislatin-irinotecan chemotherapy following the surgery.
Adenocarcinoma ; Adenocarcinoma, Clear Cell ; Endometriosis ; Female ; Incidence ; Ovarian Neoplasms ; Pulmonary Embolism ; Thromboembolism ; Venous Thrombosis