MR Imaging of Diabetic Mastopathy: A Case Report / 한국유방암학회지

Diabetic mastopathy is a rare disease that occurs in long-term insulin-dependent diabetic patient. It manifests as a hard palpable breast mass that may be clinically indistinguishable from a breast carcinoma. Mammography shows a non-specific, dense, heterogenous glandular opacity in both breasts. Sonography shows a markedly hypoechoic, ill-marginated mass with a posterior acoustic shadowing. We present the mammography, ultrasonography and MRI findings of a 54-year-old woman with diabetic mastopathy.

Quantitative Evaluation of Dysphagia Using Scintigraphy

OBJECTIVE: To investigate the clinical usefulness of scintigraphy for the evaluation of dysphagia in patients with brain lesion and to clarify the most useful quantitative parameter for detection of aspiration using scintigraphy. METHOD: For 42 patients with dysphagia, swallowing evaluations were done by videofluoroscopy and scintigraphy. According to videofluoroscopic findings these patients were grouped into three; aspiration, laryngeal penetration and no penetration group. Quantitative parameters from scintigraphy were measured and compared among three patients groups and normal control; these parameters were oral discharge time (ODT), pharyngeal transit time (PTT), oral residue (OR), pharyngeal residue (PR), pharyngeal swallowing efficiency (PSE) and oro-pharyngeal swallowing efficiency (OPSE). Sensitivity and specificity of these parameters detecting aspiration were also evaluated according to the videofluoroscopic findings. RESULTS: In aspiration group ODT, PTT, PSE and OPSE were 1.18+/-1.14 sec, 1.80+/-1.49 sec, 86.05+/-61.42%/sec and 38.21+/- 28.65%/sec respectively, all of which were significantly different from the other groups, but OR and PR were not different statistically. According to the ROC (Relative Operating Characteristic) table, sensitivity and specificity of OPSE were 72.7 and 80.7% respectively, which were the highest among the parameters. CONCLUSION: Scintigraphy was useful to quantitative dysphagia in patients with brain lesion. Sensitivity and specificity of swallowing efficiency was higher than time and residue parameters. OPSE was considered to be the most useful quantitative parameter for detecting aspiration.

The Assessment of Spasticity Using Isokinetic Eccentric Torque Measurement

OBJECTIVE: To observe changes in reflex threshold and gain in spastic muscles and to find useful parameters in biomechanical assessment of spasticity. METHOD: Ankle plantar flexor muscles of twenty two hemiplegic patients were stretched by isokinetic dynamometer. Stretching was done at the velocities of 10degrees/sec, 300degrees/sec, and at the threshold velocity (e.g. lowest velocity at which electromyographic evidence of stretch reflex was recorded). Peak eccentric torque, torque at joint angle of 20degrees, torque threshold angle, and stiffness index were measured. RESULTS: Peak eccentric torque and stiffness index were increased and torque threshold angle was decreased in hemiplegic side. Peak eccentric torque and stiffness index were increased at 300degrees/sec compared to 10degrees/sec. Stiffness index showed significant correlation with modified Ashworth scale at 300degrees/sec and threshold velocity. CONCLUSION: Both reflex threshold and reflex gain were changed in spastic muscles. Stiffness index was thought to be one of useful parameters in biomechanical assessment of spasticity.

Bone Mineral Density in Patients with Osteoporotic Compression Fractures

Osteoporosis is the most common generalized skeletal disease, which lays a significant socioeconomic burden to Korea. The early diagnosis and treatment of osteoporosis are of the great interest to minimize the economic co nsequence. We have studied vertebral BMD and bone scan of 30 patients with osteoporotic compression fractures. The purpose of this study was to investigate the effect of osteoporotic compression fracture on bone mineral density(BMD). We have measured the vertebral heights, vertebral bone mineral density, and bone scan counts of vertebral bodies on osteoporotic patients. Vertebral BMD was measured from T12 to L4 using dual photon absorptiometry. Anterior(Ha), middle(Hm), and posterior(Hp) height of vertebrae were measured from T12 to L4, and the spinal deformity indices(Ha/Hp, Hm/Hp, and Hp/Hi ratios) were calculated. The bone scan counts were measured from T12 to L4, and bone scan ratios were calculated. The BMD of fractured vertebrae was significantly higher than that of non-fractured vertebrae The spinal deformity indices were not correlated to the BMD of fractured vertebrae. The bone scan ratio was correlated to the BMD of fractured vertebrae. This study suggests that the increased BMD observed in fractured vertebrae is related to metabolic effect of compression fractures rather than mechanical effect.