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*

This study was to find out whether the rendering screen difference affect to measuring distance in a CAD program according to three types of CAD programs. Materials and methods: The model presented in ISO 12836 for dental scanner evaluation was reduced by 70%. This model was repeatedly scanned 15times using Trios II (3Shape, Denmark). Using the output STL file, 3Shape CAD, inLab 15, and ExoCAD programs were used to measure the horizontal distance (H) and vertical distance (V) between adjacent point angle, and for each experiment, three groups were set according to the CAD program type. Statistical analysis was performed using One-way ANOVA test and post hoc was performed using Dunnett T3 test. Results: In the horizontal and vertical distance measurement, there was no difference in the average of the measured values between the three groups according to the CAD program (P>.05). Conclusion: There were no effect of the difference in the rendering screen in the horizontal and vertical linear distance measurements of the inlay model on the dental CAD program.

A 54-year-old man presented to the emergency department with a chief complaint of suprapubic pain and inability to void for 1 day after self insertion of urethral foreign bodies. These foreign bodies were two beans self inserted compulsively into the urethra by the patient. On physical examination, two materials of oval shape in the bulbous urethra were palpable. Retrograde urethrogram showed a complete obstruction in the bulbous urethra. When possible, endoscopic removal should be used for urethral foreign bodies. However the beans of our case required surgical retrieval. We present a case of foreign bodies in the urethra with brief review of literature. To our knowledge, this is the first case of acute urinary retention due to beans in Korean literature.
Emergency Service, Hospital ; Fabaceae ; Foreign Bodies* ; Humans ; Middle Aged ; Physical Examination ; Urethra ; Urinary Retention*

Decompression sickness is a disease caused by nitrogen bubbles in the tissues of divers who move too rapidly from environments of higher to those of lower atmospheric pressures. Nitrogen breathed in air under pressure dissolves in tissue fluids. When ambient pressure is reduced too rapidly, nitrogen goes out of solution faster than it can be circulated to the lungs for expiration. Gaseous nitrogen then accumulates in the joint spaces and peripheral circulation, impairing tissue oxygenation. We report a case of patient who experiencedneurogenic bladder and erectile dysfunction after decompression sickness. To our knowledge, this is the first case of neurogenic bladder and erectile dysfunction due to decompression sickness in the Korean literature.
Atmospheric Pressure ; Decompression Sickness* ; Decompression* ; Erectile Dysfunction* ; Humans ; Joints ; Lung ; Male ; Nitrogen ; Oxygen ; Urinary Bladder ; Urinary Bladder, Neurogenic*

Single coronary artery is a rare congenital anomaly occurring in approximately 0.04% of the population. This entity can be diagnosed during life only by coronary angiography. Typical angina does not occur with single coronary artery in the absence of coexisting coronary artery disease or aortic stenosis. Among 874 patients who underwent diagnostic coronary angiography at Asan Medical Center. we have experienced a case of single coronary artery with significant atherosclerotic coronary artery disease which has been managed succesfully coronary angioplasty. We report this case of single coronary artery with a review of literature.
Angioplasty ; Aortic Valve Stenosis ; Chungcheongnam-do ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Humans

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

PURPOSE: To report a case of acquired lacrimal fistula caused by silicone tube remnant. CASE SUMMARY: A 56-years-old female who suffered from purulent discharge in inner skin of the right lower eyelid visited our clinic. Lacrimal fistula was found in the skin at the medial side of the right lower eyelid. The patient reported that she had a silicone tube intubation operation 3 years prior due to a nasolacrimal obstruction of right eye. On syringing test, saline solution and purulent discharge were drained from the fistula skin opening and there was no nasolacrimal obstruction. After admission, antibiotic treatment and potadine soaking dressing were performed to facilitate spontaneous closing of the lacrimal fistula. However, the lacrimal fistula relapsed and lacrimal fistulectomy and bicanalicular silicone tube intubation were performed. During surgery, silicone tube remnant material not totally extubated at the lacrimal sac was found which we removed. Postoperatively, systemic antibiotic therapy was administered and the chronic inflammation improved. CONCLUSIONS: We report a case of lacrimal fistula caused by silicone tube remnant in the lacrimal sac. Acquired lacrimal fistula caused by a silicone tube remnant can be treated by fistulectomy and silicone tube remnant removal.
Bandages ; Eyelids ; Female ; Fistula* ; Humans ; Inflammation ; Intubation ; Silicones* ; Skin ; Sodium Chloride

PURPOSE: To report a case of acquired lacrimal fistula caused by silicone tube remnant. CASE SUMMARY: A 56-years-old female who suffered from purulent discharge in inner skin of the right lower eyelid visited our clinic. Lacrimal fistula was found in the skin at the medial side of the right lower eyelid. The patient reported that she had a silicone tube intubation operation 3 years prior due to a nasolacrimal obstruction of right eye. On syringing test, saline solution and purulent discharge were drained from the fistula skin opening and there was no nasolacrimal obstruction. After admission, antibiotic treatment and potadine soaking dressing were performed to facilitate spontaneous closing of the lacrimal fistula. However, the lacrimal fistula relapsed and lacrimal fistulectomy and bicanalicular silicone tube intubation were performed. During surgery, silicone tube remnant material not totally extubated at the lacrimal sac was found which we removed. Postoperatively, systemic antibiotic therapy was administered and the chronic inflammation improved. CONCLUSIONS: We report a case of lacrimal fistula caused by silicone tube remnant in the lacrimal sac. Acquired lacrimal fistula caused by a silicone tube remnant can be treated by fistulectomy and silicone tube remnant removal.
Bandages ; Eyelids ; Female ; Fistula* ; Humans ; Inflammation ; Intubation ; Silicones* ; Skin ; Sodium Chloride

PURPOSE: Tc-99m MIBI scintimammography has been validated as an useful non-invasive diagnostic tool for the primary breast cancer. But most studies have included small population of patients. We have experienced a large study population and investigated the diagnostie usefulness of Tc-99m MIBI scintimammography in detection of primary breast cancer and axillary Iymph node metastasis. MATERIALS AND METHODS: This study included 30S patients who underwent scintimammography for palpable breast masses or abnormal radiologic findings. Tc-99m MIRI scintirnammography was performed 10 minutes after intravenous injection of 925 MBq of Tc-99m MIBI. If the early image revealed abnormal finding, 3 hour delayed image was also acquired. We calculated early and delayed lesion to non-lesion ratios (L/N). The pathologic diagnosis was obtained from surgical operation or F.4AB and compared with the results of Tc-99m MIBI scintimammography. RESULTS: Malignant breast diseases were 155 and benign ones were 150. Tc-99m MIBI scintimammography revealed 132 true positive, 23 false negative, 10 false positive, and 140 true negative cases. The sensitivity, specificity, positive predictive value and negative predictive value for the primary breast cancer detection were 85.2%, 93.4%, 92.9%, and 85.9%, respectively. The sensitivity, specificity, positive predictive and negative predictive values of Tc-99m MIBI scintimammography in detecting metastatic axillary lymph node involvement were 22%, 90.4%, 61.9% and 62.3%, respectively. Early L/N of malignant breast disease was significantly higher than that of benign one (2,44+/-0.97 vs 1.94+/-0.78, p=0.01). Delayed L/N had no significant difference between malignant an Breast Diseases ; Breast Neoplasms* ; Breast* ; Diagnosis ; Humans ; Injections, Intravenous ; Lymph Nodes ; Neoplasm Metastasis ; Sensitivity and Specificity