Combined effect of bisphosphonate and recombinant human bone morphogenetic protein 2 on bone healing of rat calvarial defects / 대한악안면성형재건외과학회지

PURPOSE: This study aimed to investigate new bone formation using recombinant human bone morphogenetic protein 2 (rhBMP-2) and locally applied bisphosphonate in rat calvarial defects. METHODS: Thirty-six rats were studied. Two circular 5 mm diameter bony defect were formed in the calvaria using a trephine bur. The bony defect were grafted with Bio-Oss(R) only (group 1, n = 9), Bio-Oss(R) wetted with rhBMP-2 (group 2, n = 9), Bio-Oss(R) wetted with rhBMP-2 and 1 mM alendronate (group 3, n = 9) and Bio-Oss(R) wetted with rhBMP-2 and 10 mM alendronate (group 4, n = 9). In each group, three animals were euthanized at 2, 4 and 8 weeks after surgery, respectively. The specimens were then analyzed by histology, histomorphometry and immunohistochemistry analysis. RESULTS: There were significant decrease of bone formation area (p < 0.05) between group 4 and group 2, 3. Group 3 showed increase of new bone formation compared to group 2. In immunohistochemistry, collagen type I and osteoprotegerin (OPG) didn't show any difference. However, receptor activator of nuclear factor kappaB ligand (RANKL) decreased with time dependent except group 4. CONCLUSION: Low concentration bisphosphonate and rhBMP-2 have synergic effect on bone regeneration and this is result from the decreased activity of RANKL of osteoblast.

Effects of Aerobic Exercise on Abdominal Fat, Thigh Muscle Mass and Muscle Strength in Type 2 Diabetic Subject / 당뇨병

BACKGROUND: Aerobic exercise can effectively reduce visceral fat. However, few studies have examined the effect of daily physical activity on obesity and cardiopulmonary function in the subjects with diabetes. We examined the effect of moderate intensity of walking in obese diabetes patients by monitoring of daily activity and measuring the change in abdominal fat area, muscle are and maximal muscle strength. METHODS: We randomly assigned 27 obese women with type 2 diabetes to an aerobic exercise group (AG, n = 13) and control group (CG, n = 14). The AG performed moderate intensity walking for 60 minutes per exercise, 5 times per week, and for 12 weeks. The activity energy expenditure was monitored by a multi-record accelerometer. The CG maintained routine daily activities. At the time of the initiation of the study and after 12 weeks of exercise, the aerobic exercise capacity was assessed using oxygen consumption rate at anaerobic threshold (VO2-AT). The abdominal fat area and the quadriceps muscle area were measured by computed tomography, and the maximum muscle strength of the upper and lower limbs was measured by a chest press and a leg press, respectively. RESULTS: The mean age of the study subjects was 56.6 +/- 8.0 years, the mean duration of diabetes was 6.3 +/- 6.0 years, and the body weight index (BMI) was 27.3 +/- 2.7 kg/m2. The BMI of the AG was significantly decreased (P = 0.003). In the AG, the visceral fat area and subcutaneous fat area were also significantly decreased (P = 0.018 and P < 0.001, respectively) but not in CG. VO2-AT of the AG was significantly improved, while that of the CG did not change (P = 0.009 and P = 0.115, respectively). The quadriceps muscle mass and the maximal muscle strength of the AG did not change, however, the CG showed a significant decrease. Duration of moderate intensity exercise was correlated with the decrease in total abdominal fat area (r = -0.484; P = 0.011) and that of high intensity exercise was correlated with improvement of cardiopulmonary function (r = 0.414; P = 0.032). CONCLUSION: Daily moderate intensity aerobic exercise is effective at reducing abdominal fat mass, while high intensity exercise improves cardiopulmonary function.

Effects of Aerobic Exercise on Abdominal Fat, Thigh Muscle Mass and Muscle Strength in Type 2 Diabetic Subject / 당뇨병

BACKGROUND: Aerobic exercise can effectively reduce visceral fat. However, few studies have examined the effect of daily physical activity on obesity and cardiopulmonary function in the subjects with diabetes. We examined the effect of moderate intensity of walking in obese diabetes patients by monitoring of daily activity and measuring the change in abdominal fat area, muscle are and maximal muscle strength. METHODS: We randomly assigned 27 obese women with type 2 diabetes to an aerobic exercise group (AG, n = 13) and control group (CG, n = 14). The AG performed moderate intensity walking for 60 minutes per exercise, 5 times per week, and for 12 weeks. The activity energy expenditure was monitored by a multi-record accelerometer. The CG maintained routine daily activities. At the time of the initiation of the study and after 12 weeks of exercise, the aerobic exercise capacity was assessed using oxygen consumption rate at anaerobic threshold (VO2-AT). The abdominal fat area and the quadriceps muscle area were measured by computed tomography, and the maximum muscle strength of the upper and lower limbs was measured by a chest press and a leg press, respectively. RESULTS: The mean age of the study subjects was 56.6 +/- 8.0 years, the mean duration of diabetes was 6.3 +/- 6.0 years, and the body weight index (BMI) was 27.3 +/- 2.7 kg/m2. The BMI of the AG was significantly decreased (P = 0.003). In the AG, the visceral fat area and subcutaneous fat area were also significantly decreased (P = 0.018 and P < 0.001, respectively) but not in CG. VO2-AT of the AG was significantly improved, while that of the CG did not change (P = 0.009 and P = 0.115, respectively). The quadriceps muscle mass and the maximal muscle strength of the AG did not change, however, the CG showed a significant decrease. Duration of moderate intensity exercise was correlated with the decrease in total abdominal fat area (r = -0.484; P = 0.011) and that of high intensity exercise was correlated with improvement of cardiopulmonary function (r = 0.414; P = 0.032). CONCLUSION: Daily moderate intensity aerobic exercise is effective at reducing abdominal fat mass, while high intensity exercise improves cardiopulmonary function.

The Effects of Resistance Training on Muscle and Body Fat Mass and Muscle Strength in Type 2 Diabetic Women / 당뇨병

BACKGROUND: Our goal was to investigate the effects of low intensity resistance training on body fat, muscle mass and strength, cardiovascular fitness, and insulin sensitivity in type 2 diabetes. METHODS: Twenty-eight overweight women with type 2 diabetes were randomly assigned to a resistance training group (RG, n = 13) or a control group (CG, n = 15). RG performed resistance training using elastic bands, of which strength was equal to 40 to 50% of one repetition maximum (1RM), for three days per week. Each exercise consisted of three sets for 60 minutes. We assessed abdominal fat using computed tomography, muscle mass using dual-energy X-ray absorptiometry, and muscle strength using Keiser's chest and leg press. Insulin sensitivity was measured using the insulin tolerance test, and aerobic capacity was expressed as oxygen uptake at the anaerobic threshold (AT-VO2) before and after the 12-week exercise program. RESULTS: The age of participants was 56.4 +/- 7.1 years, duration of diabetes was 5.9 +/- 5.5 years, and BMI was 27.4 +/- 2.5 kg/m2, without significant differences between two groups. During intervention, a greater increase in muscle mass and greater decreases in both total fat mass and abdominal fat were observed in RG compared to those of CG (P = 0.015, P = 0.011, P = 0.010, respectively). Increase in 1RM of upper and lower extremities was observed in the RG (P = 0.004, P = 0.040, respectively), without changes in AT-VO2 and insulin resistance in either group. CONCLUSION: In conclusion, the low intensity resistance training was effective in increasing muscle mass and strength and reducing total fat mass without change of insulin sensitivity in type 2 diabetic patients.

Effects of Aerobic Exercise Intensity on Insulin Resistance in Patients with Type 2 Diabetes Mellitus / 당뇨병

BACKGROUND: Exercise offers protection against atherosclerosis and insulin resistance. We evaluated the benefits of exercise at different levels of intensity for ameliorating inflammation, endothelial dysfunction, and insulin resistance in a sample of type 2 diabetic subjects. METHODS: Fifty-nine overweight women with type 2 diabetes were randomly assigned to control (CG, N = 18), moderate-intensity exercise (MEG, N = 17), and vigorous-intensity exercise (VEG, N = 14) groups. Patients in the two experimental groups completed a 12-week exercise program, with their exercise activities monitored by accelerometers. We assessed the patients' body weights, total abdominal fat (TF), subcutaneous fat (SF) and visceral fat (VF) via computed tomography, measurements of plasma levels of hs-C-reactive protein (hs-CRP) and interleukin-6 (IL-6), assessment of endothelial function by brachial artery flow-mediated dilation (FMD), and evaluation of insulin sensitivity by insulin tolerance tests, at baseline, at the end of the 12-week interventions, and one year after initiation of the study. RESULTS: At baseline, the average age of all subjects was 54 +/- 7 years, and average body mass index (BMI) was 26.9 +/- 2.5 kg/m2. During the intervention, patients in the MEG and VEG groups expended comparable amounts of activity-related calories (488.6 +/- 111.9 kcal/day, 518.8 +/- 104.1 kcal/day, respectively). Although BMI, TF, and SF decreased similarly in the MEG and VEG groups (deltaBMI: -1.1 +/- 0.7, -0.8 +/- 0.5, deltaTF: -4,647 +/- 3,613 mm2, -2,577 +/- 2,872 mm2, deltaSF: -2,057 +/- 2,021 mm2, -1,141 +/- 1,825 mm2, respectively), compared to control (P<0.01), hs-CRP, IL-6, and FMD remained constant in both exercise groups even after completion of the 12-week exercise intervention. Insulin sensitivity improved only in patients subjected to vigorous exercise (VEG). Visceral fat loss was observed only in patients subjected to moderate exercise (MEG). At one-year follow up, these values had all returned to baseline. CONCLUSION: Exercise vigorous enough to result in significant weight and fat reduction did not ameliorate inflammation and endothelial dysfunction as measured at the end of a 12-week exercise intervention, nor did it result in sustained improvements in insulin sensitivity in type 2 diabetic subjects.

Clinical Features in Patients with Amylase-Rich Pleural Effusion / 결핵

BACKGROUND: Pleural effusions with high amylase levels are reported frequently in patients with pancreatic diseases, a rupture of the esophagus and a malignancy. However, there is no data available on the clinical features of an amylase-rich pleural effusion in Korea. This report describes the causes of the high amylase levels in a pleural effusion and analyzes its association with malignancy. METHODS: The records of patients with an amylase-rich pleural effusion who were assessed at the Gyeongsang National University Hospital from January 1998 to August 2002 were examined retrospectively, and the distribution of amylase levels in those patients, the causative diseases, and the histological type in the case of a malignancy were analyzed. Among the 532 patients whose pleural effusion was evident on a chest X-ray, there were 36 cases with an amylase-rich pleural effusion. The amylase levels were determined by an enzyme method (Hitach 747 autoanalyzer). RESULTS: Of the 36 patients with an amylase-rich pleural effusion, there were 18 patients(50%) associated with a malignancy, 8 patients(22%) with a parapneumonic effusion, 7 patients(19%) with pancreatic disease, and 3 patients with other causes. The amylase level in a pleural effusion due to pancreatic disease was much higher than that due to other causes(p<0.01). Among the malignant pleural effusions with high amylase levels, the origin of the malignancy was a primary lung cancer in 13 cases and metastatic lung cancer in 5 cases. The histological types of malignant causes were adenocarcinoma in 10 cases(56%), squamous cell carcinoma in 2 cases(11%) and unknown type of carcinoma in 6 cases. The amylase level in the adenocarcinoma cases was much higher than that in the other cell type carcinomas(p<0.01). There was no significant association between the amylase level and the glucose level among the malignant cases with amylase-rich pleural effusion(p=0.21). CONCLUSION: The most frequent cause of an amylase-rich pleural effusion was a malignancy. Primary lung cancer and adenocarcinoma were the most common malignancies and histological types associated with a malignant pleural effusion with high amylase levels. The amylase level in a pleural effusion secondary to pancreatic disease was much higher than from any other causes.

Intussusception due to Inverted Meckel Diverticulum with Ectopic Pancreas: A Case Report

Meckel diverticulum is the most common congenital abnormality of the small intestine. The condition occasionally involves invagination of the bowel lumen, leading to intussusception. We report a case in which intussusception secondary to an inverted Meckel diverticulum, together with an ectopic pancreas, occurred in an adult, and describe the associated radiologic, clinical and pathologic findings.

Native Ureterotransplant Ureterostomy for Ureteral Obstruction after Simultaneous Pancreas Kidney Transplantation

Significant surgical complications occur in about half of patients after simultaneous pancreas kidney transplantation (SPK) with bladder drainage. Urologic complications are very common in bladder-drained pancreas transplants. Urinary obstruction occurs in either the early or the late period following transplantation. Predictors of urological complications after transplantation have not been well established. Early obstruction is usually diagnosed by an increment of serum creatinine or through imaging studies, such as ultrasound and antegrade pyelogram. Surgical management is inevitable when conservative managements fails. If the length of the donor ureter is sufficient, it is possible to redo the ureteroneocystostomy. However, if this is not the case or the stricture is at a high level, a native ureterotransplant ureterostomy may be the procedure of choice. SPK was performed on a 36 year old male patient with insulin dependent diabetes mellitus and diabetic nephropathy. The pancreatic exocrine secretion was drained by duodenocystostomy. The patient developed an obstruction in upper ureter on the postoperative 16th day. On the postoperative 32nd day, a native ureterotransplant ureterostomy with a double J stent was performed. The postoperative course was uneventful. The double J stent was removed on postoperative 112nd day by cystoscope. A subsequent follow up showed excellent pancreatic and renal function.

A Case of Kartagener's Syndrome with Various Ultrastructural Defects / 결핵

Kartagener's syndrome is an inherited condition characterized by triad of chronic paranasal sinusitis, situs inversus, and bronchiectasis. Since 1976, Afzelius found a lack of dynein arm in immotile spermatozoa by electron microscopy, numerous recent studies have focused on the ultrastructural defect in the cilia and reported that the variety type of ultrastructural defect in immotile cilia syndrome. We report a female patient who had the Kartagener's triad with rare multiple ultrastructural defect of cilia in one patient. The electron microscopic examination showed partial dynein arm defect, loss of radial spoke, microtubular transposition, and giant cilia.

Usefulness of Unenhanced Helical CT in Patients with Suspected Ureteral Colic

PURPOSE: To determine the usefulness of unenhanced helical CT in patients with suspected renal colic. MATERIALS AND METHODS: One hundred and fourteen patients with suspected ureteral colic, referred by physicians, underwent unenhanced helical CT. Two radiologists prospectively interpreted the results, determining the presence or absence of ureter stone and other diseases that arise outside the urinary tract. In cases of ureteral stone, we retrospectively sought secondary signs of hydronephrosis, perinephric fat stranding, thickening of renal fascia, renal enlargement, and the tissue rim sign. RESULTS: Among the 114 patients, 57 were confirmed as having ureter stones. Unenhanced helical CT depicted 57 of 58 stones in 57 patients, producing one false-negative and one false-positive result. Overall, the results showed 98% sensitivity, 95% specificity, 98% positive predictive value, 95% negative predictive value, and 97% accuracy. The frequencies of secondary signs were as follows: hydronephrosis, 95% (54/57); perinephric fat stranding, 81% (46/57); thickening of renal fascia, 77% (44/57); renal enlargement, 65% (37/57); and the tissue rim sign 72% (21/29). In 20 patients, the diagnoses were not related to stone disease and included one falsenegative diagnosis of pyonephrosis. CONCLUSION: Unenhanced helical CT provides information which is valuable in the accurate diagnosis of ureteral stone as well as other diseases that arise outside the urinary tract in patients with suspected renal colic.

Sarcomatoid Carcinoma of the Stomach: Report of Three Cases

Sarcomatoid carcinoma is a rare neoplasm of epithelial origin but consists partly of variable differentiated tumor cells of mesenchymal origin. Accurate diagnosis, including differentiation from adenocarcinoma or gastrointestinal stromal tumor, is difficult. We experienced three cases of sarcomatoid carcinoma of the stomach, and describe the radiological and pathologic findings. One case involved a polypoid mass in the antrum, another a mass with a large ulcer mimicking a Bormann type-II adenocarcinoma in the body, while in the third case, an intraluminal bulky mass arising from the cardia of the stomach was present. This was not differentiated from cancer or stromal tumor.

Complete Invagination of Vermiform Appendix with Adenocarcinoma

Appendiceal intussusception is a very rare pathological condition, an incidence, as revealed by appendectomy specimens, of only 0.01 percent. There are various types among which complete invagination of the appendix is very rare. We encountered a case of intussusception of the appendix with complete invagination induced by appendiceal adenocarcinoma. A preoperative diagnosis of appendiceal adenocarcinoma and intussusception was not possible, but a final pathological report confirmed these conditions and retrospective analysis of a barium enema showed a finger-like filling defect of the cecum, a relatively specific finding in such cases. We describe a case involving a 39-year old man who one month earlier had noted the onset of pain in the right lower abdomen.

Dual Phase CT Hepatic Arteriography in the Evaluation of Hypervascular Hepatocellular Carcinoma

PURPOSE: To assess the diagnostic accuracy of dual-phase computed tomography during hepaticarteriography(CTHA) in depicting hypervascular hepatocellular carcinoma. MATERIALS AND METHODS: Forty patientswith hepatocellular carcinoma underwent dual-phase CTHA. First-phase data was obtained 6 seconds after contrastmedia was injected into the common hepatic artery, while second-phase data was obtained 35-40 seconds later.Lipiodol CT was performed 10-17 days after 2mL of lipiodol was injected into the proper hepatic artery. As agold-standard of 172 lipiodol-uptaken nodules seen on lipiodol CT, the detectability and positive predictive valueof the first and second phases, and the simultaneous interpretation of both phases, were analysed. RESULTS: Allnodules were detected by first-phase CTHA, 162 (94%) by second-phase CTHA, and 170 (99%) by simultaneousinterpretation of both phases. The detection sensitivities of first-phase CTHA and simultaneous interpretation ofboth phases were statistically superior to that of second-phase CTHA. Positive predictive values were 87% withfirst-phase CTHA, 96% with second-phase CTHA, and 97% with simultaneous interpretation of both phases. CONCLUSION: Dual-phase CTHA was useful for increasing detectability and accuracy in the diagnosis of hypervascularhepatocellular carcinoma.

Two Cases of Post-Traumatic Arterial High-Flow Priapism / 대한남성과학회지

type presents as a prolonged painful erection and is characterized by ischemia and pooling of blood within the corpora cavernosa. The less common form, high-flow priapism, is characterized by absence of pain and ischemia. We report two cases of high-flow priapism caused by rupture of the cavernosal artery following blunt perineal trauma. The patients complained of painless and persistent penile erection. By trauma history, cavernosal blood gas analysis, and color Doppler sonography, arterial high-flow priapism was confirmed, In both cases, left cavernosal artery leakage was revealed by internal pudendal selective angiography. The cavernosal artery was embolized with coils in both patients, and penile detumescence was achieved.

Two Cases of Post-Traumatic Arterial High-Flow Priapism / 대한남성과학회지

type presents as a prolonged painful erection and is characterized by ischemia and pooling of blood within the corpora cavernosa. The less common form, high-flow priapism, is characterized by absence of pain and ischemia. We report two cases of high-flow priapism caused by rupture of the cavernosal artery following blunt perineal trauma. The patients complained of painless and persistent penile erection. By trauma history, cavernosal blood gas analysis, and color Doppler sonography, arterial high-flow priapism was confirmed, In both cases, left cavernosal artery leakage was revealed by internal pudendal selective angiography. The cavernosal artery was embolized with coils in both patients, and penile detumescence was achieved.

A Case of Liver Transplantation using a Jump Graft in a Patient with Portal Vein Thrombosis and Postoperative Chylous Ascites

Venous anomalies, including portal vein thrombosis (PVT) and prior portosystemic shunts, are not uncommon in orthotopic liver transplantation (OLT) and require vascular reconstruction. PVT has been considered as a contraindication to OLT because of surgical complexity and increased postoperative morbidity and mortailty rates. Postoperative chylous ascites occur following disruption of abdominal lymphatics after retroperitoneal dissection. Chyloperitoeum after OLT is very rare. We report a case of piggyback OLT in a cirrhotic patient with portal vein thrombosis. A thromboendarterectomy was attempted first, and a venous jump graft was required between the donor portal vein and the infrapancreatic superior mesenteric vein. An aortic conduit was used for the hepatic arterial reconstruction. Retroperitoneal dissection was inevitable. Chylous ascites developed after the operation and were managed successfully with a low-at diet. In conclusion, we suggest that the presence of PVT is not a contraindication for OLT. Chylous ascites are rare after OLT, and the treatment of choice is a conservative one based on diet control.

Polyarteritis Nodosa in Superior Mesenteric Artery: A Case Report

Polyarteritis nodosa(PAN) is a multisystem disease characterized by necrotizing vasculitis of small andmedium-sized arteries, and in 50% of all cases there is gastrointestinal involvement. We describe a patient withPAN involving the gastrointestinal tract. A small bowel series showed nodular fold thickening, submucosal fillingdefects, shallow ulcerations, segmental luminal narrowing, and decreased peristalsis at the duodenum, jejunum, andileum; superior mesenteric arteriography showed hypervascularity and microaneurysm. Segmental resection of thesmall bowel indicated the presence of PAN.

CT Angiography in Patients with Spontaneous Intracerebral Hematoma

PURPOSE: The purpose of this study was to assess the usefulness of CT angiography(CTA) in patients withintracerebral hematoma. MATERIALS AND METHODS: Eighteen patients with spontaneous intracerebral hematoma underwentCTA ; 20-30 seconds after the onset of an injection of contrast media(100mL, with the use of a power injector, ata rate of 3 mL/sec), Scanning(30-second continuous exposure and 60-90mm length) was performed with a table speedof 2-3 mm/sec and section thickness of 2mm. The starting point selected was the floor of the sella turcica. Theresulting data were reformatted by maximum intensity projection(MIP) after reconstruction at 1-mm intervals, andCTA findings were compared with those of conventional angiography(n=17), surgery(n=6), and postcontrast CT(n=10). RESULTS: The diagnostic findings of CTA included five arteriovenous malformations, two aneurysms, one venousangioma, and one venous sinus occlusion, while the remaining nine patients had no vascular lesion. In all cases,CTA findings correlated well with those of conventional angiography and surgery ; in four cases, they weresuperior to those of postcontrast CT. In one cases of arteriovenous malformation, however, the feeding artery anddraining vein were not definite on CTA, and in one case of sinus occlusion, the full length of the superiorsagittal sinus could not be delineated. CONCLUSION: In patients with spontaneous intracerebral hematoma, CTA is avaluable screening method.

Collateral Vessels in Moyamoya Disease: Comparison of MR and MRA with Conventional Angiography

PURPOSE: To determine the value of magnetic resonance imaging(MR) and magnetic resonance angiography(MRA) inassessing collateral vessels of moyamoya disease. MATERIALS AND METHODS: Twenty-four patients with moyamoyadisease who underwent MR, 3D TOF MRA, and conventional angiography participated in this study. Two radiologistsworking independently and with no knowledge of the angiographic findings, interpreted the MR and MRA images. Todetermine the presence of parenchymal and leptomeningeal collaterals(48 hemispheres) and transdural collaterals(38hemispheres in 19 patients were depicted by angiography of the external carotid), the findings were compared withthose of angiography. RESULTS: Parenchymal, leptomeningeal, and transdural collaterals were depicted byconventional angiography in 34(71%), 32(67%), and 11(29%) hemispheres respectively. The sensitivity andspecificity of MR/MRA for collateral vessels were 79.1/ 88.1% for parenchymal collaterals, 72.1/ 88.1% forleptomeningeal collaterals, and 0.1/18.1% for transdural collaterals, respectively. Respective sensitivity andspecificity of MR/MRA were 88.94/94.1% for leptomeningeal collaterals, and 18.93/55.1% for transdural collaterals,when the prominent posterior cerebral and external carotid artery were regarded as secondary signs ofleptomeningeal and transdural collateral vessels. CONCLUSION: In moyamoya disease, MR and MRA are useful imagingmodalities for the assessment of collateral vessels. The prominent posterior cerebral artery and external carotidartery can be useful secondary signs of leptomeningeal and transdural collateral vessels.

Comparison between Mammography and Ultrasonography for Palpable Breast Mass: Focusing Fibroadenoma and Breast Cancer

PURPOSE: The purpose of our study was to compare the diagnostic accuracy of mammography and breast ultrasonography between fibroadenoma and palpable breast cancer and to evaluate the feasibility of ultrasonography as a primary diagnostic modality to differentiate between these two tumor types. MATERIALS AND METHODS: In 36 cases of fibroadenoma and 35 of breast cancer, all palpable and pathologically-proven, the diagnostic accuracy of mammography and ultrasonography was retrospectively analysed. RESULTS: In fibroadenoma cases, the diagnostic accuracy of mammography and ultrasonography was 53% and 80%, respectively, and the difference was statistically significant (p=0.0162). In cases of breast cancer, the corresponding figures were 74% and 82%, respectively ; the difference was not statistically significant (p=0.55). Overall, the diagnostic accuracy of mammography and ultrasonography was 63% and 82%, respectively, and this difference was statistically significant (p=0.0164). The total diagnostic accuracy of both studies was 90%, and this was significantly different (p=0.044) from that of ultrasonography (82%). CONCLUSION: In patients who have clinically palpable breast masses, ultrasonography can be recommended as the primary diagnostic modality, though for other breast lesions, mammography is the recommended primary modality.