Nesidioblastosis, also known as persistent hyperinsulinemic hypoglycemia of infancy(PHHI) or familial hyperinsulinsm, is the most common cause of recurrent severe hypoglycemia in infancy. It is an autosomal recessive disorder characterized by irregular insulin secretion leading to inappropriately raised plasma insulin concentration compared to blood glucose levels. Recently, mutations in the sulfonylurea receptor(SUR) have been described in association with PHHI. The mainstay of medical treatment is glucose infusion and diazoxide or long acting somatostatin. If medical treatment fails in preventing hypoglycemia, near total pancreatectomy is recommended. We report one case of nesidioblastosis cured by near total pancreatectomy with brief review of literatures.
Blood Glucose ; Congenital Hyperinsulinism* ; Diazoxide ; Glucose ; Humans ; Hypoglycemia ; Infant, Newborn* ; Insulin ; Nesidioblastosis* ; Pancreatectomy ; Plasma ; Somatostatin

Present study describes two rare spermatic cord sarcomas. The first case is leiomyosarcoma of a 56-year-old man with 3-years' history of slowly growing hard mass in the right inguinal area, measuring 8x6x5 cm. The second case is fibrosarcoma of a 39-year-old man with 3x2 cm painless right inguinal mass. Both cases underwent radical excision of mass and orchiectomy. Clinico-pathologic characteristics of spermatic cord sarcoma are discussed with literature review.
Adult ; Fibrosarcoma ; Humans ; Leiomyosarcoma ; Middle Aged ; Orchiectomy ; Sarcoma* ; Spermatic Cord*

No abstract available.
Appendicitis* ; Humans

No abstract available.
DNA* ; Female* ; Humans* ; Prevalence* ; Uterine Cervical Neoplasms*

The authors present 31 patient with acute epidural hematoma who had been admitted from January, 1987 to June. 1989 managed by consevative treatment. The results were as follows ; 1) The age of patients was distributed evenly, most patients were male (26 cases) and the most common mechanism of injury was traffic accidents(14 cases). 2) Sites of hematoma were mostly the temporal and parietal area and the maximum thickness of hematoma was not different from each site. 3) On admission, all patients presented GCS score above 13 except 2 cases. 4) All patients did not undergo delayed up, due to the enlargement of the hematoma or neurological deterioration. 5) The maximum thickness of hematoma was under 20 mm in all patients. 6) The hematoma was resolved within 30 days in all cases. This was confirmed with brain CT scan.
Brain ; Hematoma* ; Humans ; Male ; Rabeprazole ; Tomography, X-Ray Computed

The authors compared the changes of morphology, blood brain barrier alteration, pathology, arterial blood lactate content and cerebrospinal fluid lactate content between an intermittent brain retraction group and a continuous brain retraction group in 56 mongrel cats. The results were as follows ; 1) Microscopically, hemorrhages were punctate in 15 cases among 25 cases in the intermittent retraction group. However, there were multiple or large hemorrhages in 13 cases among the 25 cases in the continuous brain retraction group. 2) All cases of the intermittent retraction group showed 0~25% Evans blue staining of the coronal section crossing the retraction site. However, 8 cases among the 25 cases of the continuous retraction group showed 51~75% Evans blue staining and 4 cases of this group showed 76~100% staining. 3) With photomicroscopy, the authors noted small hemorrhage and cellular swelling in the intermittent retraction group instead of pyknosis, hemorrhagic necrosis, vacuolation in the continuous retraction group. 4) The change of arterial blood lactate content was from 1.22+/-0.24mmol/L at preretraction time to 1.42+/-0.26mmol/L at 90 minutes after release of retractor in the intermittent retraction group(p<0.01). In the continuous retraction group, the authors noted a change in the lactate content from 1.20+/-0.38mmol/L to 3.15+/-0.97mmol/L for the same time as above(p<0.001). 5) The change of CSF lactate content in the intermittent retraction group was from 1.39+/-0.29mmol/L at preretraction time to 1.43+/-0.23mmol/L at 90 minutes after release of retractor(p>0.05). In the continuous retraction group, this author noted change in the lactate content from 1.37+/-0.28mmol/L to 2.11+/-0.52mmol/L for the same time as described above(p<0.01). From the above results, the superiority of the intermittent brain retraction was demonstrated as compared with the continuous brain retraction. Also the possible utilization of this experimental method was discussed for other wxperimental studies on ischemia.
Animals ; Blood-Brain Barrier ; Brain* ; Cats* ; Cerebrospinal Fluid ; Evans Blue ; Hemorrhage ; Ischemia ; Lactic Acid ; Necrosis ; Pathology

Liquid crystal thermography is a new diagnostic imaging method detecting the temperature change by the physiologic disturbance as compared with the radilogic method detecting the anatomical distortion. We have used liquid crystal thermography in 54 patients with complaining low back pain during the period form 2nd. March 1989 to 30th. April 1989. Of these 54 patients, 35 had myelography and C-T scan, 23 had EMG, and 13 were operated upon. 1. There were 35 clinically positive patients on whom concomitant myelography and C-T scan was performed; 32 patients(91%) had a positive myelography and C-T scan, and 30 patients (86%) had a positive thermography. Of these 35 patients, 23 had EMG concomitantly; 17 patients(74%) had a positive EMG and 18 patients(78%) had a positive thermography. 2. Liquid crystal thermography correlated with myelography and C-T scan in 31 patients(89%), EMG in 18 patients(78%). 3. Concomitant thermography, myelography and C-T scan, and surgery were performed on 13 patients among them EMG was added on 5 patients; Myelography and C-T scan had 100% accuracy, thermography had 92% accuracy, and EMG had 80 % accuracy. 4. Liquid crystal thermography is non-invasive method, dose not involve the use of ionizing radiation, and correlates well with clinical and surgical findings and other diagnostic methods, and costs relatively low. So, liquid crystal thermography is useful and reliable diagnostic method in patients with low back pain.
Diagnostic Imaging ; Humans ; Liquid Crystals ; Low Back Pain ; Methods ; Myelography ; Radiation, Ionizing ; Thermography

No abstract available.
Krukenberg Tumor*

PURPOSE: To compare standard laparoscopy-assisted Billroth I gastrectomies including standard lymph node dissection (LABIG) with hand-assisted laparoscopic surgery with the HandPort system (HALS) for the removal of early gastric cancers (EGC). METHODS: A prospective study was performed on 26 patients of EGC at Ewha Womans University Mok-Dong Hospital from July 1999 to August 2001. Seventeen patients (Group L) received LABIG using conventional laparoscopy-assisted methods and 9 patients received LABIG using HALS (Group H). We used staplers for the anastomosis, and a standard D2 lymph node dissection was done with ultrasonic shears or electrocautery. RESULTS: In group L, pathologic reports revealed 14 EGC (stage IA 14 cases), and 3 pm cancers (stage IB 1 case, II 2 cases). In group H, there were 9 early gastric cancers (stage IA 8 cases, IB 1 case). Significant differences (P<0.05) were present between group L and H in regards to the number of harvested lymph nodes (30.8 vs 18.9), estimated blood loss (462.1 vs 286.7 ml) and postoperative transfusion amounts (0.59 vs 0 unit). There were no differences in the mean operating time, distance from the lesion to the resection margin, postoperative leukocyte count, frequencies for pain control, wound size, time to diet, weight loss, serum protein, and postoperative hospital stay. Complications were present in 1 case in group L (enterocutaneous fistula) and 1 case in group H (gastric atony). There was one conversion to open surgery in group H. CONCLUSION: LABIG including standard lymph node dissections with both standard laparoscopic surgery and HALS were performed with equal outcome. The choice of surgical method depends on the characteristics of the lesion and the patient's physical factors.
Conversion to Open Surgery ; Diet, Reducing ; Electrocoagulation ; Female ; Gastrectomy* ; Gastroenterostomy* ; Hand-Assisted Laparoscopy* ; Humans ; Laparoscopy ; Length of Stay ; Leukocyte Count ; Lymph Node Excision ; Lymph Nodes ; Prospective Studies* ; Stomach Neoplasms* ; Ultrasonics ; Wounds and Injuries

This treatise summarizes the medical facts about the persistent vegetative state(PVS) and the associated issues. In August 1998, the opinions of the 380 neurologists and the 1007 neurosurgeons are inquired about the diagnostic criteria of PVS, the degree and the withdrawal of treatment on PVS patients. The response rate is 18.8%. The diagnostic criteria of PVS is determined by the items approved above 5007o of responses. (1) no evidence of cerebral function and an inability to interact with visual, auditory stimuli and follow commands. (2) maintaining the respiratory function with spontaneous respiration and normal respiratory pattern. (3) spontaneous eye opening and eye ball movements without sustained tracking. (4) variably preserved brain stem reflexes. (5) presence of sleep-wake cycles. (6) (1)-(5) symptoms should be persist for 6 months after the development of vegetative state. (7) the diagnostic criteria of PVS should be applied more than 3 times during the minimum observation period. (8) this diagnostic criteria of PVS could be applied to adults over 7 ages. As to the degree of treatment, nasogastric tube feeding and air-way keeping through the tracheostomy are approved over 9007b. Also antibiotics can be used in infection. As to the withdrawal of treatment, do not resuscitate order of patient s family is accepted by 46.1% in an emergency condition like cardiac arrest. But discharge against medical advice by the patient s family is accepted by 73.107o in non-emergency condition. In the case of neonates, parents decision is more determinative than any other thing.
Adult ; Anti-Bacterial Agents ; Brain Stem ; Emergencies ; Enteral Nutrition ; Heart Arrest ; Humans ; Infant, Newborn ; Korea* ; Parents ; Persistent Vegetative State* ; Reflex ; Respiration ; Tracheostomy