No abstract available.
Thioctic Acid*

Neonatal diabetes mellitus (NDM) is defined as hyperglycemia that presents clinical symptoms within the first month of life and requires insulin therapy to maintain euglycemia. The diabetic condition may be transient, permanent, or transient with recurrence later in life. NDM is a rare clinical disorder. Three cases of NDM have been reported in Korea so far. We experienced two cases of NDM in twin brothers who were born with small for gestational ages. Their HLA typings were DR9 and DR14, and insulin autoantibody, islet cell antibody, GAD-reactive autoantibody, and insulin receptor antibody were not found. The genetic analysis with polymorphic DNA markers for chromosome 6 indicated paternal uniparental isodisomy.
Chromosomes, Human, Pair 6 ; Diabetes Mellitus* ; Genetic Markers ; Gestational Age ; Histocompatibility Testing ; Humans ; Hyperglycemia ; Insulin ; Islets of Langerhans ; Korea ; Receptor, Insulin ; Recurrence ; Siblings* ; Twins* ; Uniparental Disomy

Purpose: To evaluate the timing of the improvement in surgical skills of the direct anterior approach for hip arthroplasty through an analysis of the clinical features and learning curve in 58 cases. Materials and Methods: From November 2016 to November 2018, 58 patients, who were divided into an early half and late half, and underwent hip arthroplasty by the direct anterior approach, were enrolled in this retrospective study. The operation time and complications (fracture, lateral femoral cutaneous nerve injury, heterotopic ossification, infection, and dislocation) were assessed using a chi-square test, paired t-test, and cumulative sum (CUSUM) test. Results: The mean operation times in total hip arthroplasty (26 cases) and bipolar hemi-arthroplasty were 132.1 minutes and 79.7 minutes, respectively, demonstrating a significant difference between the two groups. CUSUM analysis based on the results revealed breakthrough points of the operation time, decreasing to less than the mean operation time because of the 16th case in total hip arthroplasty and 14th case in bipolar hemiarthroplasty. Complications were encountered in the early phase and late phase: five cases of fractures in the early phase, no case in the late phase; eight and two cases of lateral femoral cutaneous nerve injury, respectively; three and two cases of heterotopic ossification, respectively; and one case of dislocation, one case of infection and three cases of others in the early phase. The CUSUM chart for the fracture rate during operation in the early phase revealed the following: five cases fracture (17.2%) in the early phase and no case in the late phase (0%). This highlights the learning curve and the need for monitoring the inadequacy of operation based on the complications. Conclusion Hip arthroplasty performed by the direct anterior approach based on an anatomical understanding makes it difficult to observe the surgical field and requires a learning curve of at least 30 cases.

The risk of malignancy after transplantation is higher than that of general population. Laparoscopic surgery has become a standard treatment of gastric cancer. However, there are no case reports evaluating totally laparoscopic gastrectomy in patients with previous liver transplantation. Herein we report our experience with a liver transplant recipient who underwent totally laparoscopic distal gastrectomy (TLDG) for gastric cancer. A 63 year-old man underwent orthotopic liver transplantation (OLT) for cryptogenic liver cirrhosis. 8 years later, gastric cancer was diagnosed during the follow-up. Endoscopic submucosal dissection was performed and additional surgical resection was needed. TLDG and D1+ lymph node dissection was performed, and the patient was discharged on the 8th post-operative day without any complications. To the best of our knowledge, this is the first case of de novo gastric cancer treated with TLDG after OLT. This suggests that TLDG is a feasible for patients after OLT.
Follow-Up Studies ; Gastrectomy ; Humans ; Laparoscopy ; Liver Cirrhosis ; Liver Transplantation ; Liver ; Lymph Node Excision ; Stomach Neoplasms ; Transplant Recipients

Traditional adipose tissue transplantation has unpredictable viability and poor absorption rates. Recent studies have reported that treatment with platelet-rich plasma (PRP), adipose-derived stem cells (ASCs), and stromal vascular fraction (SVF) are related to increased survival of grafted adipose tissue. This study was the first simultaneous comparison of graft survival in combination with PRP, ASCs, and SVF. Adipose tissues were mixed with each other, injected subcutaneously into the back of nude mice, and evaluated at 4, 8, and 12 weeks. Human adipocytes were grossly maintained in the ASCs and SVF mixtures. Survival of the adipose tissues with PRP was observed at 4 weeks and with SVF at 8 and 12 weeks. At 12 weeks, volume reduction in the ASCs and SVF mixtures were 36.9% and 32.1%, respectively, which were significantly different from that of the control group without adjuvant treatment, 51.0%. Neovascular structures were rarely observed in any of the groups. Our results suggest that the technique of adding ASCs or SVF to transplanted adipose tissue might be more effective than the conventional grafting method. An autologous adipose tissue graft in combination with ASCs or SVF may potentially contribute to stabilization of engraftment.
Adipocytes/*transplantation ; Adipose Tissue/cytology/*transplantation ; Adult ; Animals ; Female ; *Graft Survival ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; *Platelet-Rich Plasma ; Stem Cells ; Stromal Cells/*transplantation ; Transplantation, Heterologous

OBJECTIVES: To explore the relationship of white matter changes (WMC) on magnetic resornance imaging (MRI) with plasma homocysteine and folate levels in Alzheimer's disease (AD) patients. METHODS: Forty-one patients with probable AD were evaluated on WMC on brain MRI, plasma homocysteine and folate levels, and cerebrovascular risk factors. Subjects were divided into two groups according to WMC scores (lower group with < 5 and higher group with > or = 5). WMC were assessed by a scale of the European Task Force on Age-Related WMC. RESULTS: Plasma homocysteine levels were correlated with right frontal WMC and have a tendency of correlation with left frontal WMC. When subjects were divided into two groups: higher plasma homocysteine group (> or = 14 micronmol/L) and lower plasma homocysteine group (< 14 micronmol/L), the former was significantly higher than the latter in both frontal WMC. In a logistic regression analysis, higher plasma homocysteine were not a significant risk factor for higher WMC. Increasing age was a only significant risk factor for higher WMC and correlated with both frontal WMC. There was no relationship folate with any WMC. CONCLUSION: It is possible that plasma homocysteine levels have a region-specific correlation with frontal WMC in AD. However, it is important that effect of age on the relationship should be considered.
Advisory Committees ; Alzheimer Disease ; Brain ; Folic Acid ; Homocysteine ; Humans ; Logistic Models ; Magnetics ; Magnets ; Plasma ; Risk Factors

Fibrous dysplasia is a developmental disease of bone in which the normal substance of the interior of the bone is replaced by fibro-osseous connective tissue. It exhibits varying degrees of osseous metaplasia histologically. Craniofacial fibrous dysplasia frequently affects the maxilla, frontal bone, and mandible. The nasal septum is rarely affected. There is only one reported case of fibrous dysplasia arising in the septum internationally. Hence, we report a case of fibrous dysplasia of the nasal septum with a review of literature.
Connective Tissue ; Frontal Bone ; Mandible ; Maxilla ; Metaplasia ; Nasal Septum

PURPOSE: The aim of this study was to investigate the clinical characteristics of primary spontaneous pneumothorax (PSP) in adolescents and identify risk factors for the recurrence of PSP. METHODS: A total of 292 patients diagnosed with PSP from January 1998 to December 2011 were retrospectively studied. Clinical data on demographics, diagnostic imaging, therapies, and risk factors of recurrence were collected and analyzed. RESULTS: The sex ratio of 292 patients was 19.8:1 (male:female), and the average age of the patients was 17.0 years. The average body mass index of the patients was 18.8 kg/m2. The most common presenting symptom was chest pain. There was no seasonal variation in the incidence of PSP. Thirty patients (10.2%) had a history of smoking. The most common location of PSP was the left side. Out of 249 patients, 169 (67.9%) had cysts (blebs/bullae). Fifty-four patients (18.5%) received oxygen therapy, 3 patients (1%) needle aspiration, 119 patients (40.8%) closed tube drainage, and 116 patients (39.7%) surgery. The recurrence rate was 38.6%. Smoking was associated with the size of pneumothorax (P=0.002). Also, the size of pneumothorax and surgery was associated with recurrence (P=0.040 and P=0.004). However, previously reported risk factors for recurrence were not identified in our patients. CONCLUSION: Pediatric PSP occurred mainly in males in late adolescence with normal body mass index. No significant risk factors were related to recurrence of PSP in our study.
Adolescent* ; Body Mass Index ; Chest Pain ; Demography ; Diagnostic Imaging ; Drainage ; Humans ; Incidence ; Male ; Needles ; Oxygen ; Pneumothorax* ; Recurrence* ; Retrospective Studies ; Risk Factors ; Seasons ; Sex Ratio ; Smoke ; Smoking

It already has been known that various ions were participated in phototransduction mechanism of the vertebrate photoreceptor during the visual adaptation. The vitreous humor(VH)contains certain amount of Na+, K+ and Ca++ as well. However, the roles of these ions are unknown except functioning of metabolic process. Our preliminary electroretinogram(ERG) experiments suggested that the permeability of these ions has light dependent activity during the light illumination. We have supported this suggestion more tangibly by trying out various experiments with bullfrog eyes as a reference of visual adaptation. The results are summarized as follows: 1)According to our atomic absorption spectroscopic measurements, the concentration of Na+, K+ and Ca++ in light adapted VH was higher than that of dark adapted VH. This result indicated that the light-dependention transport systems which affect the ionic movements might be in internal limiting membrane(ILM). 2)The amplitude of ERG b-wave was reduced by concentration decrement of Na+ and concentration increment of K+ respectively. On the other hand, the elimination of Ca++ within ringer solution resulted in b-wave amplitude increment. 3)Treatment of Na+ hannel blockers(TTX, STX)and K+ channel blockers(Ba++, Cd++, Cs+, 4-AP and TEA)in the vitreous humor side induced the increment and the decrement of b-wave response respectively. Taken together, these results suggest that the light dependent Na+ K+ channels exist in the ILM of vertebrate retina which participates visual adaptation.
Absorption ; Hand ; Ions ; Light Signal Transduction ; Lighting ; Membranes* ; Metabolism ; Permeability ; Photoreceptor Cells, Vertebrate ; Rana catesbeiana ; Retina ; Vertebrates* ; Vitreous Body

Neurologic complications such as mental status changes, incontinence, gait disturbances, extrapyramidal symptoms may be delayed days or weeks after exposure to carbon monoxide but hyperkinesia such as choreoballism and athetosis rarely occurs as symptoms of delayed neurologic complication of carbon monoxide intoxication. Neuroleptic malignant syandrome (NMS) is a rare, potentially fatal drug-induced disorder associated with hyperthermia, muscle rigidity, autonomic instability, mental dysfunction and various dyskinesia. Various major neuroleptic drugs seem to be its culprits. We describe a 24-year-old female patient who presented with NMS following administration of haloperidol for choreoballism, a symptom of delayed neurologic sequelas after carbon monoxide intoxication, with a review of the literature.
Antipsychotic Agents ; Athetosis ; Carbon Monoxide* ; Carbon* ; Dyskinesias ; Female ; Fever ; Gait ; Haloperidol ; Humans ; Hyperkinesis ; Muscle Rigidity ; Neuroleptic Malignant Syndrome* ; Young Adult