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Biomedical subjects

S M Kim

Publications and source records attributed to S M Kim.

At least 19 recordsLinked to original sources
PubMed1992

Diabetic nephropathy: duplex Doppler ultrasound findings.

To evaluate the correlations among Doppler sonographic findings, morphologic sonographic findings, and laboratory findings representing renal functional status, duplex Doppler sonography of the kidney was performed in 32 patients with diabetes mellitus. Resistive indices obtained in the region of the arcuate or the interlobar arteries in patients with elevated serum creatinine levels were significantly higher than those in patients with normal serum creatinine levels (P < 0.05). Also, there was a significant correlation between the resistive indices and creatinine clearance levels (correlation coefficient, -0.828). There was a significant difference between the serum creatinine levels of patients with normal renal cortical echogenicity and those with increased cortical echogenicity (P < 0.05). Analysis of the Doppler spectrum of the intrarenal arteries in conjunction with careful evaluation of the renal cortical echogenicity may be helpful in sonographic prediction of the renal functional status in patients with diabetes mellitus.

Albuminuria↗
PubMed1992

Nonpustular psoriatic lesions detected by Tc-99m HMPAO labeled granulocytes.

A patient with a fever of unknown origin was evaluated by abdominal SPECT using Tc-99m HMPAO labeled granulocytes and a triple detector camera. Although no abscesses were located, nonpustular psoriatic skin lesions were demonstrated incidentally on the reprojectional images. Psoriatic scales contain a chemotactic factor for leukocytes, and this is a likely explanation for the increased uptake of the radiotracer by psoriatic lesions.

Fever of Unknown Origin↗
PubMed1992

Dual isotope SPECT in the evaluation of recurrent brain tumor.

Dual isotope brain SPECT was performed in a patient with recurrent brain tumor (grade II astrocytoma). In this case, a good coregistration of brain perfusion and tumor images was obtained because Tc-99m HMPAO and the Tl-201 chloride imaging were done simultaneously using a Triad SPECT unit. This method might play an important clinical role in the evaluation of patients with recurrent brain tumors.

Adult↗
PubMed1992

Reverse crossed cerebellar diaschisis in partial complex seizures related to herpes simplex encephalitis.

Tc-99m HMPAO brain SPECT was performed in a patient who had partial complex seizures for 1 year after successful acyclovir treatment of biopsy-proven herpes simplex encephalitis 2 years earlier. In spite of antiepileptic medications, her seizures were intractable and occurred daily. Tc-99m HMPAO was administered intravenously while she was having subclinical seizures, and brain SPECT demonstrated an area of hyperperfusion in the right temporal lobe medially and in the contralateral cerebellum. This reverse of the crossed cerebellar diaschisis phenomenon in epileptic disorders has not previously been documented.

Adult↗
PubMed1992

Tc-99m DTPA diffuse pulmonary uptake in patients with coronary artery disease and renal insufficiency.

Diffuse bilateral lung uptake was observed in 10 patients undergoing Tc-99m DTPA renal scanning, referred for the evaluation of rising serum creatinine levels. All 10 patients demonstrated renal insufficiency (RI) as shown by both decreased bilateral renal tracer concentration and elevated background activity. Nine of the patients were known to have coronary artery disease (CAD) and six of these nine patients were in congestive heart failure (CHF), at or around the time of scanning. However, Tc-99m DTPA lung uptake was not observed in five other patients whose scans demonstrated RI, in whom there was no CAD or other cardiac disease. Diffuse lung uptake of Tc-99m DTPA in patients with RI therefore is highly suggestive of cardiac dysfunction (i.e. CAD and/or CHF).

Aged↗
PubMed1992

Surgical treatment of periampullary cancer--review of 766 surgical experiences of 8 hospitals.

The incidence of periampullary cancer has been steadily rising in Korea. In the present study, we have reviewed 766 cases of surgically treated periampullary cancers, including 122 cases of our own, which were published in the Korean literature from 1984 to 1992. The 6th decade was the most prevalent age group, occupying 38% of the patients. The ratio of male of female was 1.7 to 1. Approximately 60% of lesion located at the head of the pancreas. Computed tomography which had 85% sensitivity was the most commonly employed modality for a diagnosis. The diagnostic sensitivity of percutaneous transhepatic cholangiography was 72%, of endoscopic retrograde cholangiopancreatography was 71%, and of ultrasonography was 54% in order of frequency. Tumor markers such as CA-19, CEA, and CA-125 were also studied in pancreatic cancer. The combinations of these markers recorded a higher positivity than using solely. The resection rate for lesions at the head of the pancreas was 21%, and that of distal common bile duct, ampulla of vater, and duodenum were 37%, 85%, and 50%, respectively. The morbidity and mortality rates after pancreatoduodenectomy were 44% and 12%, respectively. TNM staging revealed 66% of patients were in stage III, 26% in stage I, and 8% in stage II. The actual 5-year survival rates for cancer of the head of the pancreas was 11%, and that of duodenal cancer, distal choledochal cancer, and ampullary cancer were 21%, 18%, and 15%, respectively. In nonresected group, none survived over 18 months after treatment. Relatively high portion of lymph node metastatic patients may explain the poor survival observed in our series.

Ampulla of Vater↗
PubMed1992

Present status of periampullary cancer treatment in Korea.

The incidence of periampullary cancer has been steadily risen in Korea. In the present study, we have reviewed 766 cases of surgically treated periampullary cancers, including 122 cases of our own, that were published in the Korean literatures in last ten years. The 6th decade was the most common age group, occupying 37.9% of the patients. Male to female, ratio was 1.7 to 1. C-T scan was the principal modality available for diagnosis and preoperative staging, and recorded 84% of diagnostic accuracy. The accuracy rate of PTC was 72%, ERCP of 68%, and USG of 51%, in order of frequency. For the screening of pancreatic cancer, diagnostic serologic test using serum markers such as CA 19-9, CEA, CA 125, and various combinations were studied. The combinations of these markers recorded higher positivity. Overall resectability was 36.2%. Preoperative C-T scan with antigraphy correlated with better discrimination of the resectable lesion preoperatively than C-T scan alone was performed (63% VS 46%). The morbidity and mortality after pancreaticoduodenectomy were 46% and 13.2%, and 1, 3, and 5-year survival rates after the resection were 68, 25, and 15%, respectively. In non-resected group, none survived at 18 months after treatment. To improve resectability; early detection, precise preoperative staging, and improved surgical approach are imperative. Future studies will be necessary to find a better multimodality therapy.

Ampulla of Vater↗
PubMed1991

Evaluation of plantar fasciitis by three-phase bone scintigraphy.

Fifteen patients complaining of chronic heel pain underwent three-phase Tc-99m MDP bone scintigraphy. Ten patients demonstrated abnormal scan findings consistent with plantar fasciitis (PF) and had responded to conventional therapy. Two patients were found to have calcaneal stress fractures, and one patient demonstrated a calcaneal spur that required no treatment. The remaining two patients had normal scans and did not appear clinically to have PF. The three-phase bone scan is therefore very useful in diagnosing PF and in distinguishing it from other etiologies of the painful heel syndrome.

Adult↗
PubMed1991

Scintigraphic diagnosis of right ventricular ischemia.

We present a patient with exercise induced right ventricular ischemia demonstrated on stress TI-201 myocardial scintiscan. The patient underwent cardiac catheterization, and subtotal occlusion was found at the proximal right coronary artery. Repeat stress TI-201 scan became normal following the successful percutaneous transluminal coronary angioplasty.

Cardiac Catheterization↗
PubMed1991

Malignant glomus tumor originating in the superior mediastinum--an immunohistochemical and ultrastructural study.

An extremely rare case of malignant glomus tumor originating in the superior mediastinum was evaluated immunohistochemically and ultrastructurally. A 78-year-old woman who had been suffering from dysphagia and dyspnea had poorly-defined soft tissue mass, 4.5 x 2.5cm, in the superior mediastinum with direct invasion into the esophagus, trachea, and bilateral thyroid glands. This case is believed to be unique in several respects. There were neither recognizable findings of benign glomus tumor nor sarcomatous areas, in contrast to the previously reported cases. A definite direct invasion into the surrounding organs was identified. We therefore interpreted this case as primary malignant glomus tumor, not as glomangiosarcoma arising in a benign glomus tumor.

Actins↗
PubMed1991

Solitary myeloma with massive extracellular crystalline structures--a case report.

We describe a case of solitary myeloma showing cystic change filled with massive crystalline structures in a 54-year-old woman. A bone X-ray showed a solitary cystic osteolytic lesion in the right iliac bone. Serum and urine protein electrophoresis showed no demonstrable M-protein, and bone-marrow aspirates did not show any myeloma cells. Histologic examination of the tumor revealed aggregation of plasma cells with massive extracellular infiltration of the rhomboid-shaped crystalline structures. In immunoperoxidase staining, both these crystalline structures and the cytoplasms of the myeloma cells demonstrated a positive reaction for lambda light chain. By electron microscope, the large extracellular crystalline structures were observed, and we found unique rhomboid or rectangular-shaped crystalline structures in the cytoplasms of the myeloma cells.

Bone Neoplasms↗
PubMed1991

Benign brainstem hemorrhage simulating transient ischemic attack.

A 48-year-old hypertensive man had sudden onset of symptoms suggesting vertebrobasilar insufficiency, which were transient in nature lasted for only 4 hours. Brain computed tomography revealed a small hematoma in the pontomedullary junction. This is an uncommon presentation of benign brainstem hemorrhage simulating transient ischemic attack. We propose that computed tomographic scan using thin slices of 3mm to 5mm thickness at the level of brainstem is required before starting anticoagulation therapy for vertebrobasilar transient ischemic attack.

Brain Stem↗
PubMed1991

Two cases of mitochondrial myopathy with predominant respiratory dysfunction.

Although it is well known that the respiratory failure is a major cause of death in most patients with chronic neuromuscular disease, predominant respiratory dysfunction without severe involvement of limb muscles is an unusual complication of mitochondrial myopathy in adult age. We experienced two cases of mitochondrial myopathy with severe involvement of respiratory function and only mild involvement of limb muscles. One is a 16 year old female and another is a 22 year old male. The diagnosis is based on morphologic characteristics of "ragged red fibers" under the light microscope and abnormal mitochondrias on the electron microscope in the muscle biopsy.

Adolescent↗
PubMed1991

Gallium uptake in tryptophan-related pulmonary disease.

We describe a patient who developed fever, fatigue, muscle weakness, dyspnea, skin rash, and eosinophilia after taking "high doses" of tryptophan for insomnia for two years. A gallium-67 scan revealed diffuse increased uptake in the lung and no abnormal uptake in the muscular distribution. Bronchoscopy and biopsy confirmed inflammatory reactions with infiltration by eosinophils, mast cells, and lymphocytes. CT scan showed an interstitial alveolar pattern without fibrosis. EMG demonstrated diffuse myopathy. Muscle biopsy from the right thigh showed an inflammatory myositis with eosinophilic and lymphocytic infiltrations.

Female↗
PubMed1989

Scintigraphic evaluation of regional migratory osteoporosis.

Three patients with regional migratory osteoporosis (RMO) of the lower extremity were observed over a period of time with clinical and scintigraphic follow-up. The diagnosis of RMO is clinically and radiographically difficult, but a three-phase bone image is very helpful in diagnosing patients with RMO.

Aged↗