OBJECTIVE: We investigated the usefulness of the scintigraphic swallowing study in selecting the patients with low risk of aspiration pneumonia among those who showed small amount of laryngeal aspiration in videofluoroscopy. METHOD: Scintigraphic swallowing study was performed in 22 patients with brain injury who showed small amount of laryngeal aspiration in videofluoroscopy. Oral feeding was tried in the patients who showed airway clearing function or no aspiration in scintigraphic swallowing study, and they were followed up for possible aspiration pneumonia. RESULTS: Total of sixteen patients showed no aspiration in scintigraphic swallowing study. Five patients showed laryngeal aspiration, but preserved airway clearing function. One patient showed impairment of airway clearing function. Oral feeding was tried in 21 patients. Oral feeding was successful in 18 of 21 patients but not in 3 patients because of dysphagia or cough. Only 1 patient developed pneumonia after 246 days of follow up. CONCLUSION: Scintigraphic swallowing study is useful to select the patients with low risk of aspiration pneumonia among the patients who showed small amount of laryngeal aspiration in videofluoroscopy.
Brain Injuries* ; Brain* ; Cough ; Deglutition Disorders ; Deglutition* ; Follow-Up Studies ; Humans ; Pneumonia ; Pneumonia, Aspiration ; Radionuclide Imaging

OBJECTIVE: Using [123I]IPT-SPECT, we compared between the dopamine transporter (DAT) density of the basal ganglia in first-episode, patients with schizophrenia and DAT density in normal control subjects. We investigated the change between DAT density before and after taking olanzapine during 4weeks in patients with schizophrenia. We studied correlations between the clinical symptoms of schizophrenia and DAT density. METHODS: Ten patients with schizophrenia and ten healthy control subjects were included in this study. Brief Psychiatric Rating Scale (BPRS) and Montgomery-Asberg Depression Rating Scale (MADRS) were obtained before and after 4-week treatment with olanzapine in schizophrenic group. Nuclear imaging using [123I]IPT-SPECT was obtained in normal control subjects and schizophrenic group before taking olanzapine. After 4-week treatment with olanzapine, Nuclear imaging was obtained in schizophrenic group. RESULTS: There is significant negative correlation between BPRS total score, withdrawal subscale score after treatment and DAT density before treatment. There is significant positive correlation between the age of onset and DAT density after treatment and there is significant negative correlation between the duration of illness and DAT density after treatment. CONCLUSION: The data of this study suggest that DAT density in basal ganglia in patients with schizophrenia would be a predicting factor in treatment response.
Age of Onset ; Basal Ganglia ; Brief Psychiatric Rating Scale ; Depression ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Psychopathology* ; Schizophrenia*

OBJECTIVE: Using [123I]IPT-SPECT, we compared between the dopamine transporter (DAT) density of the basal ganglia in first-episode, patients with schizophrenia and DAT density in normal control subjects. We investigated the change between DAT density before and after taking olanzapine during 4weeks in patients with schizophrenia. We studied correlations between the clinical symptoms of schizophrenia and DAT density. METHODS: Ten patients with schizophrenia and ten healthy control subjects were included in this study. Brief Psychiatric Rating Scale (BPRS) and Montgomery-Asberg Depression Rating Scale (MADRS) were obtained before and after 4-week treatment with olanzapine in schizophrenic group. Nuclear imaging using [123I]IPT-SPECT was obtained in normal control subjects and schizophrenic group before taking olanzapine. After 4-week treatment with olanzapine, Nuclear imaging was obtained in schizophrenic group. RESULTS: There is significant negative correlation between BPRS total score, withdrawal subscale score after treatment and DAT density before treatment. There is significant positive correlation between the age of onset and DAT density after treatment and there is significant negative correlation between the duration of illness and DAT density after treatment. CONCLUSION: The data of this study suggest that DAT density in basal ganglia in patients with schizophrenia would be a predicting factor in treatment response.
Age of Onset ; Basal Ganglia ; Brief Psychiatric Rating Scale ; Depression ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Psychopathology* ; Schizophrenia*

Wegener's granulomatosis (WG) is a syndrome characterized by necrotizing granulomatosis lesions in the upper and lower respiratory tracts, glomerulonephritis, and generalized vasculitis involving both arteries and veins. This syndrome usually affects the upper and lower respiratory tract and the kidneys. Some patients with WG have cardiac involvement such as pericarditis, myocarditis, valvulitis, arrhthymia, coronary arteritis, and rarely cardiomyopathy. Ocular manifestations include keratitis, conjuntivitis, scleritis, retro-orbital granuloma with proptosis. Uncommonly, blindness may occur due to retinal vasculitis and optic neuritis. We report a 45-year-old female patient with WG who had sinusitis and lung nodules. She complained of sudden chest pain. Electocardiography and nuclear myocardial perfusion study suggested transient myocardial ischemia. During the active course of the disease, she complained of severe pain in the right eye-ball with decreased visual acuity. Subsequently, she developed monocular blindness probably due to retinal vasculitis.
Arteries ; Arteritis ; Arthritis, Rheumatoid* ; Blindness ; Cardiomyopathies ; Chest Pain ; Eosinophilia* ; Exophthalmos ; Female ; Glomerulonephritis ; Granuloma ; Humans ; Keratitis ; Kidney ; Lung ; Middle Aged ; Myocardial Ischemia ; Myocarditis ; Optic Neuritis ; Perfusion ; Pericarditis ; Respiratory System ; Retinal Vasculitis ; Scleritis ; Sinusitis ; Vasculitis ; Veins ; Visual Acuity ; Wegener Granulomatosis

No abstract available.
Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Pilot Projects* ; Tomography, Emission-Computed, Single-Photon*

Systemic lupus erythematosus (SLE) is a multisystemic inflammatory autoimmune disease caused by various autoantibodies and immune complexes. Splenic involvement in SLE includes hypersplenism, splenic atrophy, and splenic infarction, which has rarely been reported. We report a case of SLE with isolated splenic infarction. A 20-year-old female patient was admitted complaining of general weakness, malar rash, and easy fatigue. She was diagnosed as having SLE with thrombocytopenia and received steroid treatment. On the 7th hospital day, she complained of severe left upper abdominal pain with sudden-onset. While abdominal ultrasonography showed only mild splenomegaly, abdominal CT and 99mTc-RBC splenic scintigraphy revealed segmental splenic infarction. She had no evidence of additional thrombotic event or hemorrhage. After administration of high dose steroid, abdominal pain subsided and splenic infarction was resolved.
Abdominal Pain ; Antigen-Antibody Complex ; Atrophy ; Autoantibodies ; Autoimmune Diseases ; Exanthema ; Fatigue ; Female ; Hemorrhage ; Humans ; Hypersplenism ; Lupus Erythematosus, Systemic* ; Radionuclide Imaging ; Splenic Infarction* ; Splenomegaly ; Thrombocytopenia ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult

Clinically detectable metastatic follicular thyroid carcinoma to the thymus is very rare in the literature and sometimes confused with false positive uptake of Iodine
Adenocarcinoma, Follicular/*secondary ; Adult ; Case Report ; Female ; Human ; Iodine Radioisotopes/diagnostic use ; Thymus Neoplasms/*secondary ; Thyroid Neoplasms/*pathology/radionuclide imaging/surgery ; Tomography, Emission-Computed

BACKGROUND: The detection of residual stenosis of infarct related artery (IRA) at early stage after acute myocardial infarction (AMI) is crucial in clinical decision making for interventional revascularization. The aim of this study was to evaluate the relevancy of early dipyridamole stress myocardial SPECT to detect functionally and luminologically significant residual stenosis of IRA after AMI. METHOD: Twenty five consecutive patients (M:F=19:6, age: 56+/-13yrs) with AMI underwent SPECT and coronary angiography within 5 days of the attack. Infarct related arteries with FFR < 0.75 and diameter stenosis (DST) >70% were regarded to have functionally and morphologically significant residual stenosis. Reversible perfusion defect was defined if there was improvement of the perfusion score more than one grade in infarct segments on rest images of SPECT compared with stress images. RESULTS: Mean FFR and DST were 0.76+/-0.14 and 74+/-15%. SPECT showed no significant correlation with both FFR and DST with Kendall's coefficiency of 0.28 (p=0.05) and 0.13 (p=0.35). The sensitivity and specificity of SPECT to detect functionally and morphologically significant residual stenosis were 92%, 31% and 83%, 29%. CONCLUSION: The early dipyridamole stress myocardial SPECT after AMI does not seem to be a useful non-invasive test for the detection of functionally and luminologically significant residual stenosis of IRA.
Adult ; Aged ; Blood Flow Velocity ; Comparative Study ; *Coronary Angiography ; Coronary Circulation ; Coronary Stenosis/physiopathology/radiography/*radionuclide imaging ; Dipyridamole/diagnostic use ; *Exercise Test ; Female ; Human ; Male ; Middle Age ; Myocardial Infarction/physiopathology/radiography/*radionuclide imaging ; Sensitivity and Specificity ; Severity of Illness Index ; *Tomography, Emission-Computed, Single-Photon

PURPOSE: An increased incidence of gallstones has been widely reported in patients who had undergone a gastrectomy. But, there has been little information about the pathophysiologic mechanism for the occurrence of gallstones after gastric surgery. Many investigators have considered the cause to be decreased gallbladder motility due to vagal denervation. We observed higher increase in the incidence of gallbladder stones in patients who underwent a Billroth II gastrojejunostomy than in those who underwent a Billroth I gastrojejunostomy after radical subtotal gastrectomy. METHODS: We prospectively studied the change in the motility of the gallbladder after a gastrectomy. The gallbladder ejection fraction (EF) was compared pre- and postoperatively by using gallbladder scintigraphy with 2,6-diisopropyl-iminodiacetic acid (DISIDA). RESULTS: Twenty patients underwent a Billroth(B) I anastomosis and twelve patients underwent a B-II anastmosis after the gastrectomy. The means of the EF of the B-I group were 75.9%, 46.4%, 68.1% at the preoperative period, at 1 month and 6 months after the gastrectomy respectively. Those of B-II group were 78.2%, 45.3%, 56.3%, respectively. There was no statistically significant difference of EF between the two groups at postoperative 1 month, but the difference at postoperative 6months was statistically significant. The differences of EF between preoperative period and postoperative 1 month, 6 months were significant in the B-I group andthe B-II group. CONCLUSION: At 6 months postoperative period, there was more recovered gallbladder motility after a gastrectomy with B-I anastomosis than with B-II anastomosis.
Denervation ; Gallbladder* ; Gallstones ; Gastrectomy* ; Gastric Bypass ; Gastroenterostomy ; Humans ; Incidence ; Postoperative Period ; Preoperative Period ; Prospective Studies ; Radionuclide Imaging ; Research Personnel

No abstract available.
Pericarditis, Tuberculous* ; Tomography, Emission-Computed, Single-Photon*