No abstract available.
Animals ; Iproniazid* ; Monoamine Oxidase* ; Rats* ; Tyramine*

Although the pregnancy period has typically been viewed as a time of emotional well-being, recent data do not substantiate this optimistic view for women with prior histories of depression. This paper will review the natural history of depression in pregnancy. The potential risks to the mother and the fetus when the psychiatric illness goes untreated will be reviewed. Also to be discussed are: the potential teratogenicity of each class of psychotropic medication, the treatment dilemmas, the possible alternatives when prescribing psychotropic medications and the decision-making guidelines regarding the discontinuation of medications. The risk of major depression in the postpartum period in the overall population and the likelihood of recurrence will be reviewed, and prophylactic strategies will be covered also.
Depression ; Female ; Fetus ; Humans ; Lactation* ; Mothers ; Natural History ; Postpartum Period ; Pregnancy* ; Recurrence

PURPOSE: We performed this study to compare T1-201 and Tc-99m MIBI scans for the differentiation of malignant from benign breast mass. MATERIALS AND METHODS: Thirty-eight female patients underwent T1-201 breast scan and thirty-two of them also underwent Tc-99m MIBI scan of the breast. After intravenous injection of 74-111 MBq of T1-201, early (10 minutes) and delayed (3 hours) images were obtained. Then, 555-740 MBq of Tc-99m MIBI was injected and images after 30 minutes were obtained. We compared T1-201 and Tc-99m MIBI scans with pathologic RESULTS. RESULTS: Twenty-three patients were confirmed to have infiltrating duct carcinoma and fifteen patients to have benign breast mass by excisonal biopsy. The sensitivity of early and delayed T1-201 scan and Tc-99m MIBI scan in the detection of malignant breast lesion were 100% (23/23), 82% (18/22), and 90% (18/20), respectively. The specificity of early T1-201 scan was significantly higher than that of delayed T1-201 scan (p<0.05). The specificity of early and delayed T1-201 scan and Tc-99m MIBI scan were 73% (11/15), 73% (11/15) and 83% (10/12), respectively (p:not significant). Three patients out of nine with fibroadenoma and one patient with atypical duct hyperplasia were false positive in both early and delayed T1-201 scans. The size of fibroadenoma with false positvie in early and delayed T1-201 scan (4 cases) was larger than that of 11 fibradenoma with true negative scan (p<0.01). Metastatic axillary lymph node involvement was present in fifteen patients. The sensitive to detect metastatic nodes was 38% (5/13) for early T1-201 images, 15% (2/13) for delayed T1-201 images, 58% (7/12) for Tc-99m MIBI planar images and 67% (4/6) for Tc-99m MIBI SPECT. The sensitive of Tc-99m MIBI planar or SPECT was significantly higher than that of delayed T1-201 images (p<0.05). CONCLUSION: Early T1-201 and Tc-99m MIBI scan are useful noninvasive methods to differentiate malignant form benign mass of breast. Tc-99m MIBI scan was sensitive in detecting axillary lymph node metastasis in patients with brease cancer.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis, Differential* ; Female ; Fibroadenoma ; Humans ; Hyperplasia ; Injections, Intravenous ; Lymph Nodes ; Neoplasm Metastasis ; Radionuclide Imaging ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon

The authors conducted a clinical observation of 55 cases of solitary pulmonary nodules at Yeungnam University Hospital from June 1986 to October 1990, and the following results were obtained: 1. The age distribution was ranged from 18 to 77 years, and the male-to female ratio was 1.8:1. 2. Among 55 cases of nodules, 28 cases were benign and 27 cases were malignant nodules, and of malignant nodules, the primary lung cancer was 23 cases and of benign nodules, 18 cases were tuberculoma. 3. 23 cases (41.8%) was asymptomatic and the other 32 cases were symptomatic; chest pain 12 cases, hemoptysis; 8 cases, cough; 8 cases and dyspnea; 4 cases. 4. The non-smoker-to-smoker ratio was 1:1.04, but among 23 smoker over 20 pack years, 14 cases were malignant nodules. 5. According to nodular size, there is no striking differences between benign and malignant nodules except 3-4 cm sized nodules. 6. The lobar distribution of nodules, 35 cases were in the right lung (upper lobe; 14 cases, middle lobe; 11 cases, and lower lobe; 10 cases) and 23 cases were in the left lung (upper lobe; 9 cases, lower lobe; 11 cases), and the malignant nodules were most commonly observed in the right upper lung.
Age Distribution ; Chest Pain ; Cough ; Dyspnea ; Female ; Hemoptysis ; Humans ; Lung ; Lung Neoplasms ; Solitary Pulmonary Nodule* ; Strikes, Employee ; Tuberculoma

PURPOSE: MR is the most useful imaging method in evaluating the anatomic changes of the optic chiasm (OC). The purpose of this study is to investigate the relationship between the OC displacement and visual manifestations. MATERIALS AND METHODS: We retrospectively reviewed 44 patients who showed displacement of OC on brain MR. The pattern of OC displacement was classified into 3 groups according to following criteria: group A included the patients with OC displacement only due to empty sella;group B represented the patients with OC displacement by a lesion and the border between the lesion and OC was distinct;and group C was the patients with OC displacement by a lesion and had a indistinct border or thinning of the OC. RESULTS: Visual symptoms and signs were noted in 12 patients and the most common sign was bitemporal hemianopsia. In group A(7 patients), the visual symptoms and signs were seen in only one patient(14%), in whom contracted visual fields persisted since previous pituitary apoplexy had developed. In group B(30 patients), the visual symptoms and signs were seen in 4 patients(13%) who had tumorous conditions except one case of cysticercosis. In group C(7 patients), the visual symptoms and signs were seen in all patients (100%). CONCLUSION: The more OC is compressed, the more the prevalence of visual symptoms and signs increases. However, there was no correlation between the occurrence of visual symptoms and the presence of OC displacement only without compression.
Brain ; Cysticercosis ; Hemianopsia ; Humans ; Optic Chiasm* ; Pituitary Apoplexy ; Prevalence ; Retrospective Studies ; Visual Fields

Levator function test is one of the most useful methods of diagnosis and evaluation of blepharoptosis. Because levator function test is more difficult to measure and unreliable in children or uncooperated patients, new method evaluating blepharoptosis is needed in these patients. Therefore, we measured lid movement velocity and the correlation between levator palpe-bral muscle function and lid motility velocity was evaluated. We videotaped the eyelid movements using videocamera in 66 eyes, 33 patients before operation, and analyzed the eyelid movement velocity and com-pared the eyelid movement velocity with levator palpebral muscle function. Levator palpebral muscle function was directly related to the mean velocity of eye opening, correlation coefficiency being 0.687(p<0.05). Therefore, we conclude that the mean velocity of eye opening using video camera can be useful for evaluation of blepharoptosis in uncooperated patients.
Blepharoptosis* ; Child ; Diagnosis ; Eyelids* ; Humans

PURPOSE: To give a help in the interpretation of cardiac cine-MR examination, the extent, shape, and timing of appearance of signal void regions near atrioventricular(A-V) valve prospectively evaluated in the healthy population. MATERIALS AND METHODS: Using an axial gradient-echo technique with small flip angle, repetition time(TR) of 36 msec and echo time(TE) of 22 msec, 20 volunteers without known valvular abnormalities undertook cardiac cine-MR imaging including atrioventricualr valve areas. RESULTS: Transient signal void was observed within the atrium near the tricuspid(13/20 = 65%) and mitral valves(9/20 = 45%), respectively, which is so called "physiologic atrioventricular valvular insufficiency". Eight subjects revealed the signal void areas near both tricuspid and mitral valves but, 5 subjects didnot show any evidences of physiologic insufficiency. This physiologic condition does not extend more than lcm proximal to A-V valve plane and is generally observed only during early systole. Its morphology is semilunar or triangular configuration with the base to the valve plane in most cases of normal tricuspid insufficiency and small globular appearance in most cases of normal mitral insufficiency. CONCLUSION: Awareness of normal signal void areas near the A-V valve and their characteristics is critical in the interpretation of cardiac cine MR examinations and maybe helpfal in the study of the normal cardiac physiology.
Magnetic Resonance Imaging* ; Mitral Valve ; Mitral Valve Insufficiency ; Physiology ; Prospective Studies ; Systole ; Volunteers

BACKGROUND: The aim of this study was to determine the prognostic value and optimal sampling time of serum S-100B protein for the prediction of poor neurological outcomes in post-cardiac arrest (CA) patients treated with therapeutic hypothermia (TH). METHODS: We prospectively measured serum S100 calcium binding protein beta subunit (S-100B protein) levels 12 times (0-96 hours) after the return of spontaneous circulation (ROSC). The patients were classified into two groups based on cerebral performance category (CPC): the good neurological outcome group (CPC 1-2 at 6 months) and the poor neurological outcome group (CPC 3-5). We compared serial changes and serum S-100B protein levels at each time point between the two groups and performed receiver operating characteristic curve analysis for the prediction of poor neurological outcomes. RESULTS: A total of 40 patients were enrolled in the study. S-100B protein levels peaked at ROSC (0 hour), decreased rapidly to 6 hours and maintained a similar level thereafter. Serum S-100B protein levels in the poor CPC group (n = 22) were significantly higher than in the good CPC group (n = 18) at all time points after ROSC except at 4 hours. The time points with highest area under curve were 24 (0.829) and 36 (0.837) hours. The cut-off value, the sensitivity (24/36 hours) and specificity (24/36 hours) for the prediction of poor CPC at 24 and 48 hours were 0.221/0.249 ug/L, 75/65% and 82.4/94.1%, respectively. CONCLUSIONS: Serum S-100B protein was an early and useful marker for the prediction of poor neurological outcomes in post-CA patients treated with TH and the optimal sampling times were 24 and 36 hours after ROSC.
Area Under Curve ; Heart Arrest* ; Humans ; Hypothermia* ; Prospective Studies ; ROC Curve ; S100 Calcium Binding Protein beta Subunit* ; Sensitivity and Specificity

Objective: To demonstrate the effects of chin-down maneuver on swallowing by using high-resolution manometry (HRM). Methods: HRM data of 20 healthy subjects and 64 dysphagic patients were analyzed. Participants swallowed 5 mL of thin and honey-like liquids in neutral and chin-down positions. HRM was used to evaluate maximal velopharyngeal pressure/area, maximal tongue base pressure/area, maximal pharyngeal constrictor pressure, pre-/post-swallow upper esophageal sphincter (UES) peak pressure, minimal UES pressure, UES activity time, and nadir duration. Results: Compared to the neutral position, the chin-down maneuver significantly increased tongue base pressure in both normal and dysphagic groups as well as for both honey-like and thin viscosities, although the honey-like liquid did not reach statistical significance in the dysphagic group. Regarding pharyngeal constrictors and pre-swallow peak UES pressure, the healthy group showed a significant decrease in thin liquid swallowing and decreasing tendency in honeylike liquid swallowing. UES nadir duration was significantly decreased for honey-like liquid swallowing in the dysphagic group and for both thin and honey-like liquids in the healthy group. UES nadir duration of honey-like and thin flow swallowing in the dysphagia group was 0.26 seconds after the chin-down maneuver, which was severely limited. Conclusion This study showed a different kinetic effect of the chin-down maneuver between the healthy and dysphagic groups, as well as between thin and honey-like viscosities. The chin-down maneuver increased tongue base pressure and decreased UES nadir duration, which the latter was severely limited in dysphagic patients. Therefore, appropriate application of the chin-down maneuver in clinical practice is required.

The use of digital technology in fixed prosthetic treatment using implants enables predictive treatment through diagnosis and virtual surgery by integrating clinical and radiological information of patients. Existing digital scanning methods require several components to be removed, such as removing the healing abutment and connecting the scan body. In the scannable healing abutment developed in consideration of this point, scanning is performed directly on the healing abutment, maintaining soft tissue sealing and simplifying scanning. Digital technology can also be used when obtaining the intermaxillary relationship. Recently, various digital technologies have been reported to acquire the intermaxillary relationship of edentulous patients using surgical guides, patient-specific scanning devices, or scans of the inside of temporary dentures. In this case, the implant-supported fixed prosthesis treatment was performed through scanning the scannable healing abutment and the inner side of the temporary denture to obtain the intermaxillary relationship, thereby simplifying the treatment process and obtaining aesthetically and functionally excellent clinical results.