Hyperinsulinemic hypoglycemia is a relatively rare disease in childhood period except neonate, but hypoglycemia due to delicate imbalance between glucose production & consumption is evoked easily and left permanent damage to brain at these period. The definition is that serum insulin level is above 10microU/ml when blood sugar level is below the 40mg/dl and so I/G ratio is higher than 0.4. The clinical manifestations are irrtability, frequent feeding and seizures etc. and there is no specific pancreatic pathology in most cases. We experienced 2 cases of hyperinsulinemic hypoglycemia with pancreatic hyperplasia and pancreatic adenoma each other. The diagnosis was made on clinical manifestations, laboratory results, radiologic and pathologic findings. We reported these cases with brief review of literature.
Adenoma ; Blood Glucose ; Brain ; Diagnosis ; Glucose ; Humans ; Hyperplasia ; Hypoglycemia* ; Infant, Newborn ; Insulin ; Pathology ; Rare Diseases ; Seizures

No abstract available.
Follow-Up Studies*

We have reserched the relationship of their clinical pictures and factors related to the risk of recurrence of 75 patients with simple or complex febrile convulsions, who were admitted to the Departmenrt of Pediatrics, Chungnam National University Hospital from January 1987 to July 199. The 75patient were followed up and consisted of the 55 patients with initial or non-recurrent febrile convulsions and the othere 20 patients with recurrent febrile convulsions. The results were of follows; 1) The age of first episodes was under the 6 years in 94.6% and the first episode under the 12 months was 14.6% in initial cases and 55% in recurrent cases. 2) There were family history of convulsive disorder in 40% of recurrent cases, compared to 10.9% of initial cases. 3) In gestational age, there was no significant difference between initial and recurrent cases. 4) In sex distribution, the boys (66.7%) outnumbered the girls(33.7%) and the ratios was 2:1. Among the recurrent cases of 20 patients, the boys(90%) were much more than the girls(10%). 5) The patients of low birth weight had more febrile convulsions than large birth weight in both initial and recurrent cases. 6) There was no significant difference between initial and recurrent cases in the causes of febrile convulsion. 7) In abnormal EEG findings, recurrent cases were 30% more than 7.3% of initial cases. 8) There was no significant difference of number of seizure during a day in both initial and recurrent cases 9) In episodes of duration over 15 minutes, recurrent cases were 40% more than 23.7% of initial cases. 10) The resident of urban was 78.6% and of rural was 21.4%. 11) The types of convulsion were generalized in 92% of total cases and focalized in 8%. In the focal types, recurrent cases (15%) were much more than initial cases (5.5%). 12) In occurrence of seizures in body temperature above 40 degrees C, it was 5.5% in initial cases, whereas it was 20% in recurrent cases. 13) 13) There was no significant difference between initial and recurrent cases on fever duration before seizure.
Birth Weight ; Body Temperature ; Chungcheongnam-do ; Electroencephalography ; Fever ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Pediatrics ; Recurrence* ; Seizures ; Seizures, Febrile* ; Sex Distribution

Sea urchin granuloma is a rare skin disorder, considered to be allergic or foreign body reaction caused by stick of spines of sea urchin. However, detection of the spine in the granuloma is quite difficult. A 27 year-old marine was seen with several asymptomatic hard nodules on the dorsum of hands, fingers, forearrns and knees at the injured site of the spines after a latent period of 6 rnonths. Histolagical examination revealed dermal granulomatous inflamation with hyperkeratotic and acanthotic epidermis. On examination with polarized microscopy, sea urchin spines in the granuloma were seen as bright white fragments in the dark field. Those nodules were regressed with intralesional injection of triamcinoIone.
Adult ; Epidermis ; Fingers ; Foreign-Body Reaction ; Granuloma* ; Hand ; Humans ; Injections, Intralesional ; Knee ; Microscopy ; Sea Urchins* ; Skin ; Spine

This study examined the expression of the bcl-2 protein in 59 cases of transitional cell carcinomas (TCCs) of the bladder and evaluated the relationship of bcl-2 and p53 with apoptosis. The cases were divided into 41 low-grade TCCs, 18 high-grade TCCs, 32 superficial TCCs, and 27 invasive TCCs. p53 and bcl-2 protein were detected by the immunohistochemical method and apoptosis was analysed by using hematoxylin-eosin stained slide. The results were as follows: bcl-2 protein was detected in 8 (14%) TCCs and all of these cases were low grade TCCs. Expression of bcl-2 protein was not correlated with clinical stage. There was no correlation between bcl-2 and p53 protein. According to the immunohistochemical results of bcl-2 and p53 protein, the cases were divided 4 groups. Apoptotic index (AI) was higher in p53 positive/ bcl-2 negative group than other groups but the significance was recognized only between p53 positive/bcl-2 negative group and p53 negative/bcl-2 negative group (p<0.05). p53 protein was detected in 20 (36%) TCCs and its expression was correlated positively with histologic grade and clinical stage (p<0.05). AI correlated positively with histologic grade and clinical stage (p<0.01). These data indicate that overexpression of bcl-2 protein is rare in TCC of the bladder and associated with low grade TCCs. Overexpression of p53 is associated with the tumor progression in the TCCs. AI correlates with p53 positivity but does not correlate with bcl-2 positivity.
Apoptosis* ; Carcinoma, Transitional Cell* ; Urinary Bladder*

Purpose: The purposes of this study were to compare the magnitude and phase between the RR interval and QT interval variability in the frequency domain. METHODS: Twenty four, 12-13 year old healthy males were randomly selected. At resting state and for 5 minutes, ECGs were obtained, and they were digitized to 1000Hz. After measurement of RR interval, QT interval variability was measured using template matching strategy. After normalization of the RR and QT interval time series, power spectral and cross spectral analysis were performed. From each of the time series, low- (0.04-0.15 hertz) and high- (0.15-0.4 hertz) frequency power were measured. From the phase spectrum, the phases and time lags between the two time series at each of the two frequency range were calculated. RESULTS: The average of RR interval and QT interval was 616.0+/-71.0, 364.0+/-47.0 msec, respectively. Their normalized low- and high- frequency power was 4.4+/-7.9 NU(normalized unit), 0.1+/-0.1 NU(p<0.005), and 11.0+/-30.0 NU, 0.3+/-0.3(NU, p<0.005), respectively. The phase differences and resulting time lags between the two interval were -0.5+/-0.4 pi radian(-0.9 seconds) and -0.2+/-0.3 pi radian(-0.4 seconds) in the low- and high-frequency range, respectively. CONCLUSION: During resting state, when compared to RR interval, QT interval oscillates in significantly lower amplitude in both low- and high- frequency ranges. However, the oscillations precede those of the RR interval 0.9 seconds and 0.4 seconds, respectively.
Electrocardiography ; Humans ; Male

No abstract available.
Hypopituitarism* ; Hypothyroidism*

The purpose of this study is to observe histopathologic changes in the bilateral craniomandibular joints after allowing 6 weeks of consolidation by varying the amount of distraction in rabbit mandible. Eight rabbits weighing about 2 to 3kg were used. After corticotomy was performed on the left mandibular body between the first premolar and the second premolar region, a unilateral fixation device was placed. Then, a 7-day period was allowed without distraction of the device. The mandible was lengthened 0.5mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 6-week-consolidation period was allowed. Then, the rabbits were sacrificed, and histologic examination of the craniomandibular joints was performed. Proliferative changes were observed in the craniomandibular joints in all groups. With the increasing amount of distraction, hypertrophy of the cartilage layer became more severe, bone formed was dense and enchondral ossification was clearly shown in subchondral bone. Hypertrophy of the cartilage layer was also seen in the non-distracted side as the distracted side in the experimental group. These results indicate that when physical force is applied constantly to joints, the proliferation of articular cartilage and bone formation are present. When more than 6 weeks of consolidation period is allowed at the time of performing distraction for more than 5mm, articular changes, especially, in the contralateral side should also be noted.
Bicuspid ; Cartilage ; Cartilage, Articular ; Hypertrophy ; Joints* ; Mandible ; Osteogenesis ; Osteogenesis, Distraction* ; Rabbits*

BACKGROUND: Nitric Oxide (NO) has been discovered to be an important endothelium-derived relaxing factor. The exogenous inhaled NO may diffuse from the alveoli to pulmonary vascular smooth muscle and produce pulmonary vasodilation, but any NO that diffuses into blood will be inactivated before it can produce systemic effects. To examine the effects of NO on pulmonary and systemic hemodynamics, NO was inhaled by experimental dogs in an attempt to reduce the increase in pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) induced by hypoxia in dogs. METHODS: Eight mongrel dogs were studied while inhaling 1)50% O2 (baseline), 2)12% O2 in N2 (hypoxia), 3)followed by the same hypoxic gas mixture of O2 and N2 containing 20, 40 and 80 ppm of NO, respectively. RESULTS: Breathing at FIO2 0.12 nearly doubled the pulmonary vascular resistance from 173 56dyn sec cm-5 to 407 139dyn sec cm-5 and significantly increased the mean pulmonary artery pressure from 16 3mmHg to 22 4mmHg. After adding 20~80 ppm NO to the inspired gas while maintaining the FIO2 at 0.12, the mean pulmonary artery pressure decreased (p<0.05) to the level when breathing oxygen at FIO2 0.5 while the PaO2 and PaCO2 were unchanged. The pulmonary vascular resistance decreased significantly and the right ventricular stroke work index returned to a level similar to breathing at FIO2 0.5 by addition of NO into the breathing circuit. Pulmonary hypertension resumed within 3~5 minutes of ceasing NO inhalation. In none of our studies did inhaling NO produce systemic hypotension and elevate methemoglobin levels. CONCLUSIONS: Inhalation of 20~80 ppm NO selectively induced pulmonary vasodilation and reversed hypoxic pulmonary vasoconstriction without causing systemic vasodilation and bronchodilation. Methemoglobin and NO2 were within normal limit during the study.
Animals ; Anoxia ; Dogs ; Endothelium-Dependent Relaxing Factors ; Hemodynamics* ; Hypertension, Pulmonary ; Hypotension ; Inhalation* ; Methemoglobin ; Muscle, Smooth, Vascular ; Nitric Oxide* ; Oxygen ; Pulmonary Artery ; Respiration ; Stroke ; Vascular Resistance ; Vasoconstriction* ; Vasodilation

We present a case of acquired tracheoesophageal fistula (TEF) which was found during induction of general anesthesia for clipping of aneurysm. The patient had been intubated with endotracheal tube for 10 days and then done tracheotomy for 45 days. Thereafter, TEF was confirmed by MRI and treated with fistula repair and tracheal fenestration. Acquired TEF can occur under the condition of prolonged tracheal intubation with high cuff pressure (>30 mmHg) and can also result from intratracheal neoplasm, mediastinitis, and other tracheal or esophageal damages. If unrecognized during anesthetic induction, TEF can cause gastric dilatation and rupture, pulmonary aspiration and respiratory failure. So early diagnosis and proper management is very important whenever TEF is suspected during anesthetic induction.
Anesthesia, General ; Aneurysm ; Early Diagnosis ; Fistula ; Gastric Dilatation ; Humans ; Intubation ; Magnetic Resonance Imaging ; Mediastinitis ; Respiratory Insufficiency ; Rupture ; Tracheoesophageal Fistula* ; Tracheotomy