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*

BACKGROUND AND OBJECTIVES: A precise osteotomy is a requirement for successful rhinoplasty. Osteotomy in rhinoplasty is frequently performed via intranasal route through vestibular incision or can be performed by percutaneous approach. The latter has never been reported in the domestic journal. Thus, we aimed to evaluate in this study the usefulness of rhinoplasty using percutaneous osteotomy. MATERIALS AND METHODS: The pateints age ranged from 19 to 38 years. Surgeries were performed on 6 cases who underwent rhinoplasty during the period of October 1999 to February 2000. Osteotomy via external approach was used with the aid of a sharp, straight 2 mm osteotome. RESULT: Irregularity, scoliosis, and broadness of nasal bony pyramid in the study subjects were successfully corrected using percutaneous osteotomy. During the procedure, hemomhage was minimal. Postoperatively, ecchymosis and edema was negligible and scarring was barely perceptible. However, one female patient who have fair complexion complained of osteotomy scar. CONCLUSION: Our results indicate that the percutaneous osteotomy may be used as a good alternative for the osteotomy approach but must used in judicious manner because of osteotomy scar.
Cicatrix ; Ecchymosis ; Edema ; Female ; Humans ; Osteotomy* ; Rhinoplasty* ; Scoliosis

No abstract available.
Succimer* ; Thymoma*

BACKGROUND AND OBJECTIVES: Subjects with nasal septal deviation (NSD) are commonly confronted with mucosal hypertrophy of the concave side of nasal cavity. Previous studies have characterized response to exercise in healthy subjects and in subjects with rhinitis, but such studies are not yet done in subjects with NSD. In this research, by using acoustic rhinometry, we aimed to investigate the nasal response to exercise in subjects with nasal septal deviation. MATERIALS AND METHODS: Acoustic rhinometric measurements of the cross sectional areas (CSA) at 3.3, 4.0, and 6.4 cm from the nostril, and nasal volume were taken in 10 subjects with NSD. The consecutive acoustic rhinometric measurements were undertaken just before and immediately after, and 10, 20, and 30 minutes after treadmill exercise. RESULTS: In nasal cavities showing compensatory hypertrophy, nasal volume and CSA at 3.3 cm and 6.4 cm from the nostril showed significant increase in immediate post- exercises and 10-minute post-exercise measurements when compared with baseline measurements. At 4.0 cm from the nostril, the increase in CSA was significant until the 20-minute post-exercise measurement in the hypertrophied side. However, in contralateral nasal cavities, exercise did not result in significant changes when compared with the base line measurement, except for the immediate post-exercise measurement at the point of 4 cm from the nostril. CONCLUSION: The results of this study indicated that the mucosal response to exercise was pronounced in concave nasal cavities in subjects with NSD. By contrast, in the convex nasal cavities, the mucosal response was very weak in terms of nasal patency.
Acoustics ; Exercise ; Hypertrophy ; Nasal Cavity ; Nasal Septum ; Rhinitis ; Rhinometry, Acoustic

No abstract available.
Adolescent* ; Humans ; Male* ; Psoriasis*

PURPOSE: We performed this study to evaluate the changes of gallbladder ejection fraction (GBEF) in diabetic patients with or without autonomic neuropathy. MATERIALS AND METHODS: This study included 37 diabetic patients (25 women, 12 men, mean age 51 years) and 24 normal controls (10 women, 14 men, mean age 38 years). After intravenous injection of 185 MBq of 99mTc-DISIDA, serial anterior abdominal images were acquired before and after fatty meal. Regions of interest were applied on gallbladder and right hepatic lobe on 60 and 90 minute images to calculate GBEF. RESULTS: GBEF was significantly reduced in diabetes with autonomic neuropathy (43+/-12.3%) and without autonomic neuropathy (57.5+/-13.2%) compared with normal controls (68+/-11.6%, p <0.05). And also, GBEF was significantly reduced in diabetes with autonomic neuropathy compared with diabetes without autonomic neuropathy (p <0.05). Fasting blood glucose level, age, sex, hemoglobin A1c, body mass index, serum lipid level were not different in these two diabetic patient groups (p>0.05). When 50.2% of GBEF was used as the criteria for diabetic autonomic neuropathy, the sensitivity and specificity were 80%, 76.5%, respectively. The area under receiver operating characteristic curve was 0.846. CONCLUSION: GBEF of diabetic patients with autonomic neuropathy was significantly reduced than that of diabetic patients without autonomic neuropathy.
Blood Glucose ; Body Mass Index ; Diabetic Neuropathies* ; Fasting ; Female ; Gallbladder* ; Humans ; Injections, Intravenous ; Male ; Meals ; ROC Curve ; Sensitivity and Specificity ; Technetium Tc 99m Disofenin*

PURPOSE: The aim of this study was to investigate the diagnostic role of 99mTc-Tetrofosmin in detection of breast cancer and compared with that of 99mTc-MIBI. MATERAL AND METHODS: Forty-eight patients with a clinically palpable mass or abnormal mammographic or ultrasonographic findings had 99mTc-MIBI and 99mTc-Tetrofosmin scintimammographies after intravenous injection of 925 MBq of radiopharmaceuticals. The scintimammographs were correlated with histopathologic findings. RESULTS: Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The numbers of true positive, true negative, false positive, and false negative cases of 99mTc-MIBI scintimammography were 29, 10, 5, and 4 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of 99mTc-MIBI scintimammographies were 87.8%, 66.7%, 85.3%, and 71.4% respectively. The numbers of true positive, true negative, false positive, and false negative cases of 99mTc-Tetrofosmin were 31,10, 5, and 2 respectively. The sensitivity, specificity, positive predictive value, negative predictive value of 99mTc-Tetrofosmin were 93.9%, 66.7%, 86.1%, and 73.3% respectively. One patient was false negative in both 99mTc-MIBI and 99mTc-Tetrofosmin scintimammographies and its size was 0.5cm. CONCLUSION: 99mTc-Tetrofosmin and 99mTc-MIBI were non-invasive and useful in detection of breast cancer and 99mTc-Tetrofosmin was comparable to the 99mTc-MIBI in detection of primary breast cancer.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Humans ; Injections, Intravenous ; Radiopharmaceuticals ; Sensitivity and Specificity

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

No abstract available.
Carcinoma, Non-Small-Cell Lung* ; Fingers*

The aim of this study was to evaluate the effect of topical methacholine on the nasal mucosa in allergic rhinitis and nonallergic control group, particularly in terms of nasal patency. The study population consisted of 32 adults with no nasal disorders and 22 patients with nasal allergy, and their age ranged from 18 to 42. Increasing concentrations of methacholine ranging from 0.125% to 25% were sprayed on both nasal cavities of the study subjects. The minimal cross sectional area and the nasal cavity volume at each concentration were measured using acoustic rhinometry. The overall incidence of methacholine responsiveness was 56%. The allergic group did not show a significantly higher incidence of methacholine responsiveness compared to the control group. The incidence and the pattern of methacholine responsiveness was not bilaterally symmetric on both sides of the nasal cavities. The results of this study indicate that, both in allergic and control group, topical methacholine stimulation resulted in decreased nasal patency only in a subset of the population.
Acoustics* ; Adult ; Humans ; Hypersensitivity ; Incidence ; Methacholine Chloride* ; Nasal Cavity ; Nasal Mucosa ; Nose Diseases ; Rhinitis ; Rhinometry, Acoustic*