Insulinoma is rare functioning islet cell tumor of pancreas and its main feature is frequent attacks of hypoglycemia. Because of frequent seizure, the disease is occasionally mistook as epilepy. We experienced a case of insulinoma with dilantin toxicity in a 45 year old patient who had been treated with dilantin for 7 years. Selective splenic arteriogram showed 0.8cm mass in the tail of pancreas which was proven insulin secreting tumor on histiopathological examination. After operation no more seizure attack was detected and her blood sugar level was well maintained within normal range. This case might provide an insight that the possibility of insulinoma should be considered in patient with episodic neurobehavioral dysfunction such as epilepsy.
Adenoma, Islet Cell ; Blood Glucose ; Epilepsy ; Humans ; Hypoglycemia ; Insulin ; Insulinoma ; Pancreas ; Phenytoin ; Reference Values ; Seizures ; Tail

No abstract available.
Female ; Gynecologic Surgical Procedures* ; Humans ; Nutrition Assessment* ; Postoperative Complications*

No abstract available.
Induction Chemotherapy* ; Ovarian Neoplasms*

OBJECTIVES: Posttraumatic stress disorder(PTSD) has devastating effects on multiple aspects of the quality of life(QoL). Therefore, the purpose of this study is to compare the QoL between PTSD group and non-PTSD group, and identify the variables affecting the QoL of the Vietnam War veterans. METHODS: We recruited 39 veterans with PTSD and 43 veterans without PTSD, all of whom had deployed to the Vietnam War. We used the Korean version of Mini International Neuropsychiatric Interview-Plus, the Korean version of Clinician-Administered PTSD Scale, Combat Exposure Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument abbreviated version. We used independent samples t-test to identify the differences between PTSD and non-PTSD group in each domains of the quality of life. We also used stepwise multiple linear regression analysis to figure out the variables affecting the QoL of the Vietnam War veterans. RESULTS: In the PTSD group, all domains of the QoL and the QoL total score(p<0.01) were significantly lower than those in the non-PTSD group. In the Vietnam War veterans, PTSD, major depressive disorder and education levels were the variables affecting the QoL. Among these, PTSD uniquely explained the QoL of the overall and general health(beta=-1.411, R2=0.180), the physical health domain(beta=-2.806, R2=0.089) and the total score (beta=-11.479, R2=0.104). CONCLUSIONS: These results suggest that among the Vietnam War veterans, the QoL of the PTSD group is significantly lower than that of the non-PTSD group. Among the combat exposed veterans, PTSD may be one of the main reasons that affect the multiple domains of the QoL.
Depressive Disorder, Major ; Humans ; Linear Models ; Quality of Life ; Stress Disorders, Post-Traumatic ; Veterans ; Vietnam ; World Health Organization

PURPOSE: To determine the clinical efficacy of SS-cream, the topical agent made from the extracts of natural products for treating premature ejaculation(PE), a double blind, randomized placebo controlled phase III study on the patients with primary PE was performed in three medical centers. MATERIALS AND METHODS: Mean age of patient with primary PE was 38.7+/-0.6 years and duration of suffer from PE was 15.8+/-0.4 years. We investigated the ejaculatory latency calculated by stop watch and sexual satisfaction rate after the treatment(1 placebo and 5 SS-cream 0.2gm). Patients were instructed to apply the cream on the glans penis 1 hour before sexual intercourse in double blind randomized fashion. Clinical efficacy was compared with the prolongation of ejaculatory latency and improvement of sexual satisfaction rate. RESULTS: 106 patients with primary premature ejaculation completed this study. Mean ejaculatory latency tested at screening period was 1.37+/-0.1 min and both of patient and partner were not satisfied with their sexual lives. The mean ejaculatory latency was significantly prolonged as 10.92+/-1.0 min with SS-cream, while 2.45+/-0.3 min with placebo. In 79.8%, there was prolongation of ejaculatory latency longer than 2 minutes with SS-cream, while in 15.1% with placebo. The sexual satisfaction rate was also significantly improved as 82.2% with SS-cream, while 12.6% with placebo. 103 (16.2%) out of 636 trials of SS-cream showed mild local irritation including 82 mild burning senses and 21 mild pain, which disappeared in less than 1 hour. No adverse effect on sexual function and partner and no systemic side effects were observed. CONCLUSIONS: With these results, SS-cream is effective and safe in the treatment PE with mild local side effect.
Biological Products ; Burns ; Coitus ; Humans ; Male ; Mass Screening ; Penis ; Premature Ejaculation*

PURPOSE AND METHODS: Urinary tract infection(UTI) is one of the most important diseases of childhood, especially for young infants. To characterize the patients diagnosed with febrile UTI in their first 6 months of life and to explore the risk factors of recurrent UTI, a retrospective study was performed. RESULTS: Among the 90 patients studied, 77 were boys(86%). First episodes of UTI were diagnosed at the age of 2.5+/-1.4 months. These patients underwent ultrasonographic evaluation of urinary tract(n=90) and voiding cystourethrography(n=81) where 53 and 35 studies showed abnormal findings respectively, and a total of 45 cases of urinary tract anomaly including vesicoureteral reflux(VUR, n=35) were diagnosed. Normal findings on ultrasonography indicated decreased risk of VUR in boys of 1-3 months of age(n=30). 53 patients were followed up more than 6 months and 45 episodes of subsequent UTI developed in 29 patients during the first 6-month period. Patients with relapse were older than patients without relapse at the diagnosis of first UTI, but other clinical parameters including abnormal findings on the imaging studies and prophylactic antibiotics prescription were not different between the two groups. CONCLUSION: UTI in early infancy occurred mainly in male infants and half of the patients had structural anomalies. USG was of clinical value in detecting anomalies requiring surgical intervention, and to rule out high grade VUR in 1-3 months old boys. Results of the imaging study or prophylactic antibiotics could not modify the risk of recurrent UTI.
Anti-Bacterial Agents ; Diagnosis ; Humans ; Infant ; Male ; Prescriptions ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Ultrasonography ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: This study was aimed to investigate the relationship between the mandibular asymmetry and the internal derangement of temporomandibular joint. MATERIALS AND METHODS: One hundred and sixty eight patients had been assessed through clinical examinations, panoramic radi-ographs and magnetic resonance imagings (MRIs), were selected. The samples were classified into three subgroups according to the severity of the mandibular asymmetries in the panoramic radiographs and the status of TMJ discs on the MRI were compared among each groups. RESULTS: In an apparent asymmetry group, there was a significant difference in the number of temporomandibular disk displacement without reduction between the long and short side (66.7%, 18/27 joints on the short side) when the ratio of condylar process and coro-noid process was used (P<0.05), but there was no statistically significant difference when the ratio of condyle and ramus was used. CONCLUSION: The probability of the disc displacement without reduction was higher at the side with relatively shorter condylar process on the panoramic radiograph, and also it might be more effective to use ratio of condylar process and coronoid process in the assessment of mandibular asymmetry. Therefore, a careful assessment on the temporomandibular disorders is necessary to diagnose and establish the treatment plans for the patients with a mandibular asymmetry and the panoramic radiograph can be used effectively on that way.
Humans ; Joints ; Magnetic Resonance Imaging* ; Temporomandibular Joint Disc* ; Temporomandibular Joint Disorders ; Temporomandibular Joint*

OBJECTIVE: Dopamine transporter is member of family of Na/Cl dependent neurotransmitter transporter, 12 transmembrane domain that has high substrate specificity, affinity. It is related with dopamine reuptake in presynaptic vesicle. DAT has a VNTR in its 3'-untranslated region(UTR), 3'-UTR VNTR polymorphism is related with modification of dopamine transmission. The association between with VNTR polymorphism and neuropsychiatric disorders such as alcohol dependence, and low activity ALDH has been studied but their relationship is unclear. We study about association of 3'-UTR VNTR of DAT gene and G2319A and alcohol dependence. METHOD: Group of Korea subjects were studied with alcohol dependence(n=49 male) compared to mentally healthy controls(n=53 male). The peripheral blood sample was acquired. and Polymerase Chain Reaction(PCR) amplification, Mspl procedure was done. RESULT: There was a significant difference between alcohol dependence group and normal control(genotype frequency p<0.05 allele frequency p<0.05) Allele A frequency and genotype(GG,GA) frequency was a significant difference between alcohol dependence group and normal control(p<0.05) CONCLUSION: Our study showed that genetic polymorphism of DAT1 G2319A had relation with alcohol dependence.
Alcoholism* ; Alleles ; Dopamine Plasma Membrane Transport Proteins ; Dopamine* ; Gene Frequency ; Humans ; Korea ; Neurotransmitter Agents ; Polymorphism, Genetic* ; Substrate Specificity

BACKGROUND: Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. METHODS: We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital. RESULTS: Among the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05). CONCLUSIONS: Instruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management.
Anesthesia, Conduction ; Anonyms and Pseudonyms ; Education* ; Fellowships and Scholarships* ; Korea* ; Lumbosacral Plexus ; Nerve Block ; Neuronavigation ; Organization and Administration ; Pain Management ; Spinal Nerve Roots ; Spine ; Stellate Ganglion ; Surveys and Questionnaires ; Ultrasonography

OBJECTIVES: Obstructive sleep apnea (OSA) is classified as positional sleep apnea (POSA) and non-positional sleep apnea (NPOSA) according to apnea-hypopnea index (AHI) changed by sleep position. The aim of this study was to compare neurocognitive functions between two groups in the elderly Korean population. METHODS: Forty-four subjects in OSA patients with total AHI> or =5 participated as criteria for POSA (n=25) with 1) supine position AHI/non-supine position AHI> or =2 and 2) total AHI> or =5 or not (NPOSA, n=19). All participants completed clinical interview by physician and neurocognitive function assessments. Mann-Whitney U and chi-square test were performed for comparison of neurocognitive functions and sleep characteristics with polysomnography between two groups. RESULTS: No significant difference in demographic and clinical characteristics was observed between the two groups. However the NPOSA group showed more decline than the POSA group on the Boston naming test (p=0.034), digit span test (p=0.001), go-no-go test (p=0.042), and fist-edge-palm test (p=0.007). CONCLUSION: In this study NPOSA patients were found to have lower cognitive functions compared to POSA patients. A larger sample and long term follow-up study might be needed.
Aged* ; Follow-Up Studies ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Supine Position