PURPOSE: Piccolo et al. advocated the usefulness of Tc-99m-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied Tc-99m-MDP uptake pattern and lesions/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of Tc-99m-MDP scan. MATERIALS AND METHODS: Total 34 patients were studied with physical examination, mammogram and Tc-99m-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq Tc-99m-MDP. Breast uptake pattern of Tc-99m-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammo-grain. RESULTS: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of Tc-99m-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 2/7, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. CONCLUSION: Tc-99m-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.
Biopsy ; Biopsy, Needle ; Breast Neoplasms ; Breast* ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Mammography ; Physical Examination ; Prospective Studies ; Technetium Tc 99m Medronate*

General epidemiological data regarding herpes zoster (HZ) are necessary for treatment and prevention of this disease. In addition, epidemiological data can play an important role in evaluating the efficacy and impact of vaccination. Though several epidemiological studies of HZ in Korea have been conducted, they usually depend on hospital-based data and may not be representative of HZ characteristics all over Korea. The purpose of this study was to evaluate the incidence and other epidemiological features of HZ in the general Korean population. We used population-based medical records from the Health Insurance Review & Assessment Service, which includes 50,908,646 medical insurance subscribers, to calculate the incidence of HZ. Also, we analyzed an age-stratified random sample of 1,375,842 individuals to study descriptive epidemiologic characteristics of HZ in Korea in 2011. We observed that the incidence of HZ was 10.4 per 1,000 person-years and was strongly correlated with age. Sex had a major influence on HZ incidence; overall, there were 12.6 cases per 1,000 person years in women and 8.3 cases per 1,000 person years in men. There was no difference in incidence according to the locality and season.
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Herpes Zoster/*diagnosis/*epidemiology ; Hospitalization/*statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Seasons ; Sex Distribution ; Young Adult

There is no therapy currently available that influences the natural history of disease progression in patients with chronic obstructive pulmonary disease (COPD). Although stem cell therapy is considered a potential therapeutic option in COPD, there are no clinical trials proving definitive therapeutic effects in patients with COPD. Recently, it was reported that pioglitazone might potentiate the therapeutic effects of stem cells in patients with heart or liver disease. To test the capacity of pioglitazone pretreatment of stem cells for emphysema repair, we evaluated the therapeutic effects of pioglitazone-pretreated human adipose-derived mesenchymal stem cells (ASCs) on elastase-induced or cigarette smoke-induced emphysema in mice. We also investigated the mechanisms of action of pioglitazone-pretreated ASCs. Pioglitazone-pretreated ASCs had a more potent therapeutic effect than non-pretreated ASCs in the repair of both elastase-induced and smoke-induced emphysema models (mean linear intercept, 78.1±2.5 μm vs 83.2±2.6 μm in elastase models and 75.6±1.4 μm vs 80.5±3.2 μm in smoke models, P<0.05). Furthermore, we showed that pioglitazone-pretreated ASCs increased vascular endothelial growth factor (VEGF) production both in vitro and in mouse lungs in the smoke-induced emphysema model. Pioglitazone-pretreated ASCs may have more potent therapeutic effects than non-pretreated ASCs in emphysema mouse models.
Animals ; Disease Progression ; Emphysema* ; Heart ; Humans ; In Vitro Techniques ; Liver Diseases ; Lung ; Mesenchymal Stromal Cells ; Mice* ; Natural History ; Pancreatic Elastase ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Stem Cells* ; Therapeutic Uses* ; Tobacco Products ; Vascular Endothelial Growth Factor A

Background: Isotretinoin is a gold standard treatment for moderate to severe acne vulgaris but is associated with cheilitis. Though moisturizing agents or petrolatum have been suggested, uncomfortable isotretinoin-induced cheilitis can disrupt treatment of acne patients. Topical tacrolimus has been used in atopic dermatitis with good safety and efficacy; however, there is no study of application of topical tacrolimus in cheilitis induced by isotretinoin. Objective: In this study, we aimed to describe the efficacy of topical tacrolimus 0.1% ointment on cheilitis associated with isotretinoin therapy using isotretinoin cheilitis grading scale (ICGS), investigator global assessment (IGA), and patient global assessment (PGA). We also observed the side effects of topical tacrolimus ointment. Methods: Fifty acne vulgaris patients with isotretinoin-induced cheilitis were randomly allocated to either topical tacrolimus or petrolatum treatment using permuted-block randomization. Patients were followed-up at 4 and 8 weeks, at which cheilitis lesions were photographed and evaluated with ICGS, IGA, and PGA. Results: Compared to petrolatum group, tacrolimus group had greater responses to treatment as measured by mean values of ICGS, IGA, PGA at follow-up visits. Also, the ICGS decrease was larger in the tacrolimus group compared with the petrolatum group even according to isotretinoin dose. Conclusion Topical tacrolimus ointment had superior efficacy in treating cheilitis induced by isotretinoin compared to petrolatum. Erythema, fissures, scales, and commissures all showed better response to tacrolimus ointment. Topical tacrolimus ointment can be administered as an effective strategy in treatment of cheilitis as a complication of isotretinoin therapy and can improve compliance of acne patients.

Background: Isotretinoin is a gold standard treatment for moderate to severe acne vulgaris but is associated with cheilitis. Though moisturizing agents or petrolatum have been suggested, uncomfortable isotretinoin-induced cheilitis can disrupt treatment of acne patients. Topical tacrolimus has been used in atopic dermatitis with good safety and efficacy; however, there is no study of application of topical tacrolimus in cheilitis induced by isotretinoin. Objective: In this study, we aimed to describe the efficacy of topical tacrolimus 0.1% ointment on cheilitis associated with isotretinoin therapy using isotretinoin cheilitis grading scale (ICGS), investigator global assessment (IGA), and patient global assessment (PGA). We also observed the side effects of topical tacrolimus ointment. Methods: Fifty acne vulgaris patients with isotretinoin-induced cheilitis were randomly allocated to either topical tacrolimus or petrolatum treatment using permuted-block randomization. Patients were followed-up at 4 and 8 weeks, at which cheilitis lesions were photographed and evaluated with ICGS, IGA, and PGA. Results: Compared to petrolatum group, tacrolimus group had greater responses to treatment as measured by mean values of ICGS, IGA, PGA at follow-up visits. Also, the ICGS decrease was larger in the tacrolimus group compared with the petrolatum group even according to isotretinoin dose. Conclusion Topical tacrolimus ointment had superior efficacy in treating cheilitis induced by isotretinoin compared to petrolatum. Erythema, fissures, scales, and commissures all showed better response to tacrolimus ointment. Topical tacrolimus ointment can be administered as an effective strategy in treatment of cheilitis as a complication of isotretinoin therapy and can improve compliance of acne patients.

BACKGROUND/AIMS: Pyloric exclusion has been recommended in patients with severe injury to the pancreas and duodenum. METHODS: A retrospective case review of 8 patients treated with pyloric exclusion following pancreaticoduodenal injury from March 1994 to May 2002 in Department of Surgery, the Catholic University of Korea, Daejeon St. Mary's Hospital. RESULTS: The age range of the patients was from 8 to 31 years. Most of the etiolgy (n=7) was the blunt abdominal trauma and one case due to the iatrogenic injury from the therapeutic endoscopic retrograde cholangiopancretography. The time interval between the injury and the operation varied from 3 to 48 hours. The most common postoperative complication was wound infection (n=8). We found the other complications such as intraabdominal abscess (n=3), pneumonia (n=3), but the complications were treated successfully with conservative measures. There was no mortality cases in these patients. The duration of admission was delayed in the cases of concomitant injury (64 vs 46 days). All patients above 16 years old (n=7) were supported with parenteral nutritional fluid via central intravenous route (mean 32 days). We could not find the spontaneous opening of the pyloric closure at least 4 patients in postoperative 3 months but there was no major complication according to the sustained gastrojejunostomy. CONCLUSION: Pyloric exclusion appears to offer a satisfactory option for the treatment of the severe pancreaticoduodenal injury with minor complication. Do you have any comments about the spontaneous opening of the pyloric closure?
Abscess ; Adolescent ; Duodenum ; Gastric Bypass ; Humans ; Korea ; Mortality ; Pancreas ; Pneumonia ; Postoperative Complications ; Retrospective Studies ; Wound Infection

Organophosphate (OP) pesticides are the most common source of human toxicity globally, causing high mortality and morbidity despite the availability of atropine as a specific antidote and oximes to reactivate acetylcholinesterase. The primary toxicity mechanism is inhibition of acetylcholinesterase (AchE), resulting in accumulation of the neurotransmitter, acetylcholine, and abnormal stimulation of acetylcholine receptors. Thus, the symptoms (muscarinic, nicotinic, and central nervous system) result from cholinergic overactivity because of AchE inhibition. OP can also cause rhabdomyolysis, pancreatitis, parotitis, and hepatitis. OP therapy includes decontamination, supportive therapy, and the use of specific antidotes such as atropine and oximes. However, there has been a paucity of controlled trials in humans. Here we evaluated the literature for advances in therapeutic strategies for acute OP poisoning over the last 10 years.
Acetylcholine ; Acetylcholinesterase ; Antidotes ; Atropine ; Decontamination ; Hepatitis ; Humans ; Neurotransmitter Agents ; Oximes ; Pancreatitis ; Parotitis ; Pesticides ; Receptors, Cholinergic ; Rhabdomyolysis

Pneumolabyrinth is an uncommon condition in which air is present in the vestibule or cochlear. It is rarely found, even in otic capsule violating fractures or in transverse fracture of the temporal bone. So far, there is no consensus on management of pneumolabyrinth. We describe 2 new cases of pneumolabyrinth by penetrating injury with traumatic tympanic membrane perforation. They presented whirling vertigo with moderate conductive hearing loss. Temporal bone computed tomography clearly demonstrated the presence of air in the vestibule and cochlear.
Consensus ; Hearing Loss, Conductive ; Temporal Bone ; Tympanic Membrane Perforation ; Tympanic Membrane ; Vertigo

We experienced a case of infective endocarditis, which unusual has symptoms and microcytic hypochromic anemia. Anemia associated with infective endocarditis is a common manifestation, but is generally normocytic nor-mochromic. However, microcytic hypochromic anemia is an uncommon manifestation of infective endo-carditis, and has only been noted in a few previous reports. We systematically evaluated anemia, and diagnosed fatal underlying diseases, such as infective endocarditis.
Anemia ; Anemia, Hypochromic* ; Endocarditis*