Though exercise T1-201 myocardial perfusion-scintigraphy is an important test in the diagnosis and evaluation of coronary artery disease, this test is limited in cases with poor physical conditions and unstable angina and the physical characteristics of thallium are not ideal for nuclear imaging of the myocardium. Recently, technetium-99m-labelled agent(99mTc-MIBI) has been developed to improved the quality of imaging and for easy usage in myocardial perfusion scan. Therefore, we performed dipyridamole 99mTc-MIBI myocardial scintigraphy and coronary angiography on 25 subjects who were suspeced to have coronary artery disease and the results obtanined were as follows ; 1) The overall diagnostic sensitivity of dipyridamole 99mTc-MIBI perfusion scintigraphy was 73.4%, while specificity was 66.7%. 2) Per vessel sensitivity for coronary artery disease diagnosis by the test was 71.4% and a per vessel specificity for coronary artery disease was 95.7%. 3) In all 75 coronary arteries, LAD had a sensitivity of 66.7%(10/15) and a specificity of 100%(10/10); RCA had a sensitivity of 75%(6/8) and a specificity of 82.4%(14/17); LCX had a sensitivity of 60%(3/5) and a specificity of 100%(20/20). 4) After infusion of dipyridamole, the most frequent adverse effect was chest pain which was seen in 8 cases(32%). The headache was seen in 7 cases(28%). Most of the symptoms were mild in severity and subsided spontaneously but 3 subjects were severe enough to require intravenous administration of aminophylline. In conclusion, dipyridamole 99m2011-06-17Tc-MIBI myocardial perfusion scintigraphy is a useful and safe test for diagnosis of coronary artery disease.
Administration, Intravenous ; Aminophylline ; Angina, Unstable ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Dipyridamole* ; Headache ; Myocardial Perfusion Imaging* ; Myocardium ; Perfusion ; Perfusion Imaging ; Sensitivity and Specificity ; Thallium

BACKGROUND: In South Korea, indigenous malaria has been reappeared since 1993 and more than 350 cases diagnosed in 1996. For the diagnosis of malaria the classic methods such as thin and thick blood smears with Giemsa or Wright stain has been routinely used. Since recently fluorochrome staining has been shown to be more sensitive, easy to do, and less time-consuming, we applied the new method, Acridine orange stain, for diagnosis of clinically suspected cases. METHODS: Thin and thick blood smears were prepared from civilian patients of Kyunggi Province (n=20) and Republic Of Korea army patients pre- (n=67) and post-treatment (n=13) of malaria. The slides were fixed by methanol and stained by either Giemsa or Acridine orange solution (10-50 g/mL). For comparison, an expert on malaria diagnosis examined them by light and fluorescent microscope, respectively. RESULT: Acridine orange stain was found to be a rapid technique, and as sensitive (83%) as thick smears (83%) for diagnosis of malaria. The detection limit of acridine orange stain was 23.5 parasites/ul of blood. The staining time was much shorter (30 sec) than that of Giemsa stain (30-60min). CONCLUSION: Acridine orange stain is evaluated as a simple, rapid, and sensitive method for malaria diagnosis compared with Giemsa stain.
Acridine Orange* ; Azure Stains ; Diagnosis* ; Gyeonggi-do ; Humans ; Korea ; Limit of Detection ; Malaria* ; Methanol ; Republic of Korea

PURPOSE: The main purpose of this study is to develop new payment rates for services of Radiation Oncology, considering costs of treating patients. MATERIAL AND METHODS: A survey of forty hospitals has been conducted in order to analyze the costs of treating patients. Before conducting the survey, we evaluated and reclassified the individual service items currently using as payments units on the fee-for-service reimbursement system. This study embodies the analysis of replies received from the twenty four hospitals. The survey contains informations about the hospitals' costs of 1995 for the reclassified service items on Radiation Oncology. After we adjust the hospital costs by the operating rate of medical equipment, we compare the adjusted costs with the current payment rates of individual services. RESULTS: The current payment rates were 5.05-6.58 times lower than the adjusted costs in treatment planning services, 2.22 times lower in block making service, 1.57-2.86 times lower in external beam irradiation services, 3.82-5.01 times lower in intracavitary and interstitial irradiation and 1.12- 2.55 times lower in total body irradiation. CONCLUSION: We could conclude that the current payment system on Radiation Oncology does not only reflect the costs of treating patients appropriately but also classify the service items correctly. For an example, when the appropriate costs and classification are applied to TBI, the payment rates of TBI should be increased five times more than current level.
Classification* ; Fee-for-Service Plans ; Hospital Costs ; Humans ; Radiation Oncology* ; Whole-Body Irradiation

PURPOSE: This retrospective study is conducted to evaluate the local response rate, survival rate, median survival times and complication of hyperthermic treatment combined with radiotherapy/chemotherapy in locally advanced inoperable gastric cancer. MATERIALS AND METHODS: One hundred and twenty-seven patients treated with hyperthermia from April, 1992 to December, 1994 were enrolled. Among 127 patients, 13(10.2%) were treated with thermo-radiotherapy(Group I), 4(3.1%) were treated with thermo-radio-chemotherapy(Group II) and 110(86.6%) were treated with thermo-chemotherapy (Group III). Hyperfractionated radiotherapy(135 cGy/fr., 2 times/day) using 6-MV X-ray Linac was delivered with total doses of 40.5~67.5 Gy(median: 45 Gy). Chemotherapy by FI(5-FU+ Interferon) or EAP(Etoposide+ Adriamycin+ Cisplatin) regimens was administered. Hyperthermia using 8-MHz RF(radiofrequency) capacitive heating eqiupment (CANCERMIA GHT-8) was applied with interval of 2 times/week, 40~60 minutes /session within 10~15 minutes following radiation, and was simultaneously done with chemotherapy. The estimation of local response was used computed tomography and endoscopy, and was divided into complete response(CR), partial response(PR), and no response(NR). The survival rate was calculated by Kaplan-Meier method. RESULTS: Overall local response rate(CR+ PR) was 68.5% with 6.3% in CR and 62.2% in PR. The local response rates by treatment modality were 92.3% (CR: 15.4%, PR: 76.9%) in Group I, 100%(CR: 75.0%, PR: 25.0%) in Group II and 64.5%(CR: 2.7%, PR: 61.8%) in Group III. There was statistically significant difference(p=0.0001). The overall 1 and 2 years survival rates with median survival time(MST) were 20.5%, 7.1% with 9 months, respectively. The overall 1 and 2 years survival rates(with MST) by treatment modality were 7.7%, 0%(7 months) in Group I, 50.0%, 0%(9 months) in Group II and 20.9%, 8.2%(6 months) in Group III. There was no statistically significant difference. The incidence of side effect by heating was 3.1%(4 patients) and the most serious side effect was subcutaneous fat necrosis in anterior abdominal wall. CONCLUSION: From this study we concluded that hyperthermic treatment combined with radiotherapy/chemotherapy may increase the local response rate in locally advanced inoperable gastric cancer.
Abdominal Wall ; Drug Therapy ; Endoscopy ; Fever ; Heating ; Hot Temperature ; Humans ; Incidence ; Necrosis ; Retrospective Studies ; Stomach Neoplasms* ; Subcutaneous Fat ; Survival Rate

OBJECTIVES: To determine the relationship between stress Factors and work-related musculoskeletal symptoms of assembly line workers in the automobile industry. METHODS: A cross-sectional study was conducted in two Factories of automobile manufacturing companies where inappropriate posture and repetitive motions were required. The total number of subjects was 636, and consisted entirely of men. The Age, length of work duration, marital status, education level, smoking status, drinking status, sleeping time and stress scores were investigated according to subgroups of general characteristics. We divided the subjects into a Reference group and a Stress risk group to compare the frequency of the variables between them. The stress scores of the Positive symptom group were compared with the Symptom free group by the t-test. To measure the stress level, the PWI(Psychosocial Well being Index) which consists of 4 Factors, totaling 45 items, was used. A standardized self-reported questionnaire was used to assess the symptoms in workers. The criteria for positive symptoms were based on Operational Definition of Work-related Musculoskeletal Disorders of the NIOSH. RESULTS: 1) The subgroups of Age, Work duration, Marital status, Education level, Smoking status, Drinking status and Sleeping time revealed no differences in frequencies in musculoskeletal symptoms. 2) Higher PWI(p<0.05), Factor 3(p<0.05) and Factor 4(p<0.01) scores were observed in younger workers compared with older workers. 3) The workers who had work durations between 11-15 years showed higher PWI(p<0.01), Factor 2(p<0.01), Factor 3(p<0.01), and Factor 4(p<0.01), compared with other work duration subgroups. 4) Singles had higher Factor 4 scores(p<0.01). 5) The sleeping time of less than 6 hours a day expressed a higher PWI(p<0.01), Factor 2(p<0.05), and Factor 3(p<0.01), Factor 4(p<0.05). 6) There was no difference in the prevalence of musculoskeletal symptoms between the Reference group and Stress risk group. 7) The subjects who had Positive musculoskeletal symptoms showed a significant difference in Factor 2 scores compared with the Symptom free groups. 8) According to a univariate logistic regression analysis, Factor 2(OR: 1.02, 95% CI: 1.00-1.04, p-value: 0.0291) expressed significant but mild effects on the musculoskeletal symptoms and a multivariate logistic regression showed a statistically significant effect on musculoskeletal symptoms(OR:1.04, 95% CI: 1.01-1.07, p-value: 0.0170). CONCLUSION: Psychosocial stress scores were not higher in symptomatic subjects compared with those who had no symptoms. Sleeping longer showed a protective effect on symptoms but this was not statistically significant. There was no relationship between the stress scores and musculoskeletal symptoms in social performance and self-confidence, general well-being and vitality. Factor 2(Depression) was statistically significant though its effect was mild. Limited to this study, We could find partial relationship between psychosocial stress(Depression) and musculoskeletal symptoms. So it could therefore be suspected that ergonomic or other unknown factors may be more significant causes of musculoskeletal symptoms but we did not investigate these.
Automobiles* ; Cross-Sectional Studies ; Depression ; Drinking ; Education ; Humans ; Logistic Models ; Male ; Marital Status ; National Institute for Occupational Safety and Health (U.S.) ; Posture ; Prevalence ; Questionnaires ; Smoke ; Smoking

Most submucosal tumors of the stomach are of mesenchymal origin. Gastric schwannoma, which is a subset of mesenchymal tumors, is a rare tumor taking origin from Schwann's cells. A 61-year-old woman whose endoscopy showed a well circumscribed submucosal mass measuring 2.5 cm on the midbody of the stomach. Endosonographically, the tumor was well circumscribed, low echoic submucosal mass with cystic lesion in the 4th layer of the gastric wall. The patient underwent wedge resection. Microscopically, the cells were made up of irregular fasciculating bundles of spindle cells featured with benign nuclear atypia and peripheral lymphoid cell cuffing, involving muscularis propria. Immunohistochemical staining showed positivity for S-100 protein and the neuron-specific enolase, but were negative to CD 34, desmin and smooth muscle actin. From these findings, this tumor was diagnosed as a schwannoma.
Actins ; Desmin ; Endoscopy ; Female ; Humans ; Lymphocytes ; Middle Aged ; Muscle, Smooth ; Neurilemmoma* ; Phosphopyruvate Hydratase ; S100 Proteins ; Stomach

BACKGROUND/AIMS: The aim of this study was to assess the diagnostic use of endoscopic ultrasonograpy (EUS) in detecting the cause of common bile duct (CBD) dilatation in patients in whom abdominal ultrasonography or abdominal CT scan could not identify the cause of dilatation. METHODS: Thirty-seven patients (23 men, 14 women, mean age 62.2 years) with uncertain causes of CBD dilatation on abdominal sonogram and CT scan between October 1999 and November 2003 were enrolled. All patients were evaluated by EUS and endoscopic retrograde cholangiopancreatography (ERCP). Final diagnosis were determined by ERCP, surgical exploration and clinical follow-up. RESULTS: The following diagnosis were made by EUS: choledocholithiasis in 11 patients, CBD dilatation only in 12, benign stricture of distal CBD in 8, periampullary tumor in 6. The definitive diagnosis of choledocholithiasis (n=11), benign stricture of distal CBD (n=10), ampullary tumor (n= 5) were determined by ERCP with or without sphincterotomy and surgical exploration. EUS provided the accurate explanation for CBD dilatation in 32 of the 37 patients (86%). CONCLUSIONS: When the diagnosis of biliary obstruction remains obscure on abdominal sonography or CT scan, EUS may be useful.
Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct* ; Constriction, Pathologic ; Diagnosis ; Dilatation* ; Endosonography* ; Female ; Follow-Up Studies ; Humans ; Male ; Tomography, X-Ray Computed ; Ultrasonography

Nutcracker esophagus is thought to be a common cause of noncardiac chest pain although has not been clearly established, and the effective treatment is lacking. The usual forms of therapy for noncardiac chest pain by nutcracker esophagus have been directed traditionally toward reducing esophageal hypermotility and muscle tone such as nitrate and calcium channel blocker. However, the results of this treatment in the long term care of patient with esophageal symptoms have been generally disappointing and often unsatisfactory. Recently, psychosomatic aspect of esophageal motility disorder including antidepressant treatment has been accepted in the treatment of noncardiac chest pain. We report a 48 year old female with nutcracker esophagus associated chest pain by ambulatory 24 hour esophageal manometry who failed diagnosis by conventional manometry. The symptoms of chest pain, quality of life, and depression of the patient were improved after antidepressant medication.
Calcium Channels ; Chest Pain* ; Depression ; Diagnosis ; Esophageal Motility Disorders* ; Female ; Humans ; Long-Term Care ; Manometry ; Middle Aged ; Quality of Life ; Thorax*

BACKGROUND: Screening of donor blood for malaria has not been activated in Korea yet in spite of the recent resurgence of tertian malaria among Korean army soldiers in Delimited Militarized Zone areas. Prospective donors (travelers, immigrants, refugees, citizens or residents) following a visit to or coming from an endemic area who have had malaria or taken antimalarial prophylaxis should be deferred for 3 years after cessation of therapy or after departure from malarial area. We studied the risk of the transmission of malaria, especially through army blood donation which comprised up to 57.8% of whole blood donation in Korea. METHODS: The data were collected by personal interview and review of donation records of Korea Red Cross Center and medical records from 174 army soldiers with malaria who admitted to Army Hospital from May 1995 to October 1996. We analyzed the time interval between onset of illness and blood donation, and geographic distribution of the patients. RESULTS: About 70.7% (123/174) of the patients donated blood before the onset of illness, and the interval between blood donation and onset of illness ranged from 2 days to 2,750 days (mean 377, standard deviation 488). Patients who donated blood within 3 years before onset of illness were 87.8%(n=108) of the total blood donation. All donation (n=18) after treatment were within 3 years from 46 days to 342 days (mean 138, standard deviation 80.7). The frequent of blood donations were from the prevalent areas of malaria such as Pajoo City (40%), Younchon Kun (29%), Cholwon Kun (15.5%) and others(15.5%). CONCLUSION: We showed that donated army blood a risk of malaria transmission. Therefore the blood bank needs to set strict guidelines for blood donation especially from Korean army soldiers to control malaria transmission.
Blood Banks ; Blood Donors* ; Emigrants and Immigrants ; Hospitals, Military ; Humans ; Korea* ; Malaria* ; Mass Screening ; Medical Records ; Military Personnel* ; Red Cross ; Refugees ; Tissue Donors

OBJECTIVES: Genomic function of vitamin D receptor (VDR) indicates spermatogenesis that is important for in male reproductive organ authors evaluated the VDR expression in seminal vesicles with high cholesterol (HC) formula diet rat, because there is no report about relationship or difference in VDR in seminal vesicles between HC and control. METHODS: Male C57BL/6 mice aged 5 weeks were raised for 13 weeks. After one week of adaptation-period, they were fed different diet on normal AIN-93G diet, or HC diet containing 2% cholesterol for 12 weeks. The antibodies used were rabbit anti-VDR primary polyclonal. RESULTS: There was no significant difference in VDR reactivity in seminal vesicles, body weight of rat and weight of seminal vesicles between HC group and normal control group. CONCLUSION: Our data give the no difference in expression of VDR of seminal vesicles rat between HC formula diet and normal AIN-93G diet. But we confirmed the VDR expression in seminal vesicles.
Animals ; Antibodies ; Body Weight ; Cholesterol* ; Diet ; Humans ; Male ; Mice* ; Rats ; Receptors, Calcitriol* ; Seminal Vesicles* ; Spermatogenesis ; Vitamin D* ; Vitamins*