BACKGROUND: Insulin resistance syndrome shows extreme insulin resistance and is associated with acanthosis nigricans. We can differentiate it into type A insulin resistance that has insulin receptor defect, and type B insulin resistance due to insulin receptor autoantibody. Type B insulin resistance was firstly described by Kahn in 1976. It was often found in adult female and showed autoimmune characteristics. As clinical characteristics, there are hyperglycemia, hypoglycemia, hyperinsulinemia, extreme insulin resistance and acanthosis nigricans. METHODS: We investigated 17 insulin receptor autoantibody positive cases and 8 cases of normal control who had visited Wonju Christian Hospital from October 1994 to December 1995. Among insulin receptor autoantibody positive subject, male was 4 cases and female 13 cases. Their mean age was 42.2. We compared patients who had insulin receptor antibody positive acanthosis nigricans(IRA) with normal controls. IRA patients were 6 cases(35.3%) of nomal glucose tolerance, 11 cases(64.7%) of abnormal glucose tolerance including overt diabetes mellitus. RESULTS: The 11 cases(64.7%) among IRA patrents were obese and 13 cases(76.5%) had hyperininsulinemia. In IRA patients, mean serum insulin concentration during oral glucose tolerance test was 202.1mU/mL and it was greater than 46.3 of normal controls. Insulin sensitivity in 1.79mg/L * mM * xmU * min normal controls was higher than 0.74mg/L * mM * min of IRA patients. CONCLUSION: IRA patients showed abnormal glucose tolerance including overt diabetes millitus, severe insulin resistance, hyperinsulinemia and obesity.
Acanthosis Nigricans* ; Adult ; Diabetes Mellitus ; Female ; Gangwon-do ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Hyperinsulinism ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Male ; Obesity ; Receptor, Insulin*

No abstract available.
Mucocele* ; Sphenoid Sinus*

No abstract available.
Carcinoma, Squamous Cell* ; Head* ; Neck* ; Neoplasm Metastasis*

No abstract available.
Magnetic Resonance Imaging*

Contrast arteriography and phlebography remain the standard diagnostic techniques for evaluation of peripheral arterial and venous diseases. However, invasive angiographic techniques involve expense, time, discomfort, and potential risks to the patient which preclude their use as routine screening and followup procedures. In order to obtain accurate, objective information to complement the clinical diagnosis of peripheral vascular diseases, many noninvasive diagnostic techniques have recently become available to the clinican. Among these techniques, photoplethysmograph (PPG), strain gauge plethysmograph (SPG), and doppler ultrasound were adopted for our study. Fourty young volunteers were studied as a control group, and twenty peripheral vascular disease patients were studied as a patient group. We obtained average values of PPGa, blood flow, maximum PRT venous reflux folw (MVRF), maximum venous outflow (MVOF), pulse reappearance time (PRT), PRT/2 and pulsatility idex(PI) for control group. Results for patient group were analysed and compared with those of control group. 1. Normal PPGa wave has a steep upslope, a relatively narrow peak, and a dicrotic wave on the downslope which is concave toward the baseline. PPGa reflected skin blood flow sensitively than any other technique. 2. Average forearm blood flow by means of SPG was 5.7±2.0, and that of calf was 3.7±1.4ml/min/100cc tissue. MVOF of forearm was 32.9±10.4, and that of calf was 18.0±7.0ml/min/100cc tissue. Blood flow measurement was not useful for detection of arterial occlusive disease, but MV OF was useful for diagnosis of deep vein thrombosis. 3. PRT, PRT/2, over shooting reaction time by means of SPG have low diagnostic value and PI by means of doppler ultrasound was useful for localization of arterial narrowing or obstruction. 4. Noninvasive diagnostic techniques including PPG, SPG and doppler ultrasound are useful for screening and follow-up procedures in diagnosis of peripheral vascular disease. They are also valuable to supplement angiographic or physical findings.
Angiography ; Arterial Occlusive Diseases ; Complement System Proteins ; Diagnosis ; Follow-Up Studies ; Forearm ; Humans ; Mass Screening ; Peripheral Vascular Diseases ; Phlebography ; Reaction Time ; Skin ; Ultrasonography ; Vascular Diseases ; Venous Thrombosis ; Volunteers

No abstract available.
Ultrasonography*

As craniopharyngioma is histologically benign, recent trend of managing this tumor has been complete surgical removal without adding any adjuvant therapy. But because of its close relation with surrounding vital structures, total removal sometimes results in unacceptable neurologic sequelae. To avoid these serious complications various management options have been suggested. Among these, bleomycin injections into the cystic cavity have been sporadically reported with satisfactory results. The authors report a 50-year-old woman presented with visual symptoms, who was found to have a largely cystic craniopharyngioma. Because the boarder between the tumor and hypothalamus was ill defined, intracystic bleomycin injection followed by delayed surgery was scheduled. A total of 80mg bleomycin was given over the 8 days. After the treatment high fever, skin rash and mental change developed but these symptoms were gradually subsided and the cysts were shrunken with surrounding infarction. During the follow-up period, visual symptoms became rapidly worse for which surgery was undertaken. Optic nerve was severely compressed by the underlying solid tumor and overlying A1 portion of the anterior cerebral artery. The tumor was near totally removed without any vascular insult. After the operation, the patient remained drowsy and lapsed into coma 6 days later and died. CT scan just before her death showed an infarct in the right ACA and MCA territories suggesting ICA occlusion. The cause of ICA occlusion remained to be unsolved.
Anterior Cerebral Artery ; Bleomycin* ; Coma ; Craniopharyngioma* ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Humans ; Hypothalamus ; Infarction ; Middle Aged ; Optic Nerve ; Tomography, X-Ray Computed

Aplastic anemia is characterized by a failure of blood cell production resulting in varying degrees of pancytopenia with a markedly hypocellular bone marrow. Most cases of aplastic anemia are acquired, but the disease may also occur as the result of inherited abnormalities. In 50-65% of cases, however, the etiology is unknown. For acquired forms of aplastic anemia, a variety of causative factors, including radiation, viruses, chemicals and drugs, have been implicated. Antithyroid drugs(Carbimazole, Methimazole, Propylthiouracil) are usually listed among agents associated with the development of agranulocytosis, but aplastic anemia rarely follows their use. The first case of aplastic anemia followmg propylthiouracil was reported by Marte~lo et al. in 1967 and the second case was by Aksoy and Erdem in 1968. Recently, we experienced two cases of aplastic anemia following propylthiouracil therapy due to Graves disease, so we report here these cases with literature review.
Agranulocytosis ; Anemia, Aplastic* ; Blood Cells ; Bone Marrow ; Graves Disease ; Methimazole ; Pancytopenia ; Propylthiouracil*

No abstract available.
Brain* ; Nitrogen* ; Oxygen*

BACKGROUND: Recently authentic human growth hormone(hGH) has produced in the E coli K-12, W3110 by recombinant DNA tecbnology in Korea In this paper, the clinical efficacy and immunogenicity of this GH was shdied in 38 children with growth hormone deficiency during therapy of 1 year. METHODS: The subjects of this study were aged 4.9-13.9 years, diagnosed by failure of plasma GH to respond to insulin-induced hypoglycemia, arginine and/or L-dopa loading and height below -2 standard deviation of mean for their chronological age. Each patient received GH 0.5-0.7IU/kg/week subcutaneously in 6-7 divided doses. During treatment, vital signs, height, body weight and bone age were checked every 3 months. Complete blood count, urinalysis, blood chemistry and thyroid hormone were checked before and every 6 months. The measurement of serum IGF-1 level and antibody against hGH were performed before and every 6 months during therapy of I year. RESULT: The height velocities significantly increased from 3.3 +/- 1.5cm/year to 10.1 +/- 2.5 and 9.0 +/- 1.8cm/year at 6 and 12 months of therapy, respectively. The height standard deviation score for chronological age were significantly improved from -2.141.50 to -1.74 +/- 1.43 and -1.54 +/- 1.38 at 6 and 12 months of therapy with increasing ratio of bone age to chronological age from 0.72 +/- 0.15 at pretreatment to 0.76 +/- 0.15 at 6 month, 0.79 +/- 0.16 at 12 month of therapy. The plasma IGF-1 level significantly increased during treatment. One of 36 patients(2.8%) showed positive antibody against hGH after 1 year of treatment. During therapy of 1 year, unwanted and remarkable clinical side effect were not observed in all subjects. CONCLUSION: These results indicate that this E. coli derived authentic recombinant growth hormone is very effective in stimulating linear growth in children with growth hormone deficiency.
Arginine ; Blood Cell Count ; Body Height ; Chemistry ; Child* ; DNA, Recombinant ; Escherichia coli ; Growth Hormone* ; Human Growth Hormone ; Humans* ; Hypoglycemia ; Insulin-Like Growth Factor I ; Korea ; Levodopa ; Plasma ; Thyroid Gland ; Urinalysis ; Vital Signs