To elucidate the significance of the nesidiodysplasia of pancreas, histological re-evaluation and immunohistochemical studies for insulin, glucagon and somatostatin were done on 16 consecutive cases (5 premature babies, 2 stillborns, 5 infants and 3 adults) in which paraffin blocks of the pancreas were available. Only one infant was hypoglycemic. All 16 pancreases showed changes of nesidiodysplasia which appeared immunohistochemically to have isulin, glucagon and /or somatostatin. The histologic patterns of nesidiodysplasia included ductoendocrine proliferation, endocrine cell dysplasia, adenomatosis, septal islet, islket cell hypertrophy and islet hypertrophy. All the patterns of nesidiodysplasia except for the adenomatosis were seen in premature babies, infants, stillborns and adults with or without hypoglycemia. The adenomatosis was found only in the hypoglycemic infant. The result suggests that all patterns of nesidiodysplasia of other than the adenomatosis does not imply the pathologic basis of hypoglycemia.
Infant ; Adult ; Male ; Female ; Humans

Astrocytes are the most numerous cellular elements in the cerebrum, and they normally have a very slow turnover rate. But during regeneration after injury, they proliferate markedly resulting in astrogliosis. The extracellular matrix in the central nervous system is present in the vessel walls and in the external glia limitans as a basal lamina. The presence of an intact extracellular matrix framework is important in regeneration after injury. Understanding the properties of astrocytic proliferation will be helpful to find out new treatment for functional recovery in the central nervous system. In this study, after cryogenic injury was performed on the cerebral cortex in rats, changes in astrocytes and the extracellular matrix were observed using light microscopy, immunohistochemical stain for glial fibrillary acidic protein(GFAP), proliferating cell nuclear antigen(PCNA), fibronectin, laminin, and type IV collagen, autoradiography and electron microscopy. The results were as follows; 1) The coagulative necrosis, which followed cryogenic injury on the cerebral cortex was healed, forming a new pia mater above the lesion. 2) Some of the PCNA positive cells were astrocytes and some of the GFAP positive cells showed a positive reaction to PCNA. 3) Proliferating astrocytes labelled by autoradiography or immunohistochemical stain for PCNA reached maximal numbers 3days after the injury and they were no longer found 2 weeks after injury. 4) In autoradiography with immunohistochemical stain for GFAP, about 1% of GFAP positive astrocytes were labelled by autoradiography and in double immunohistochemical stain for PCNA and GFAP, about 8-16% of GFAP positive astrocytes were also stained by PCNA. 5) In immunohistochemical stain for fibronectin, laminin and type IV collagen, laminin and type IV collagen were present in the newly formed blood vessel walls and fibronectin showed a diffuse positive reaction within the lesion. The new pia mater was formed within 2 weeks after the injury. 6) On electron microscopic examination, basal lamina material was found in the vessel wall 1 week after the injury and at 2 weeks, a nearly complete and continuous basal lamina was formed although the thickness was uneven. According to these findings, astrocytes in the cerebral cortex of adult rats proliferate very early in the regenerative period after cryogenic injury. At 2 weeks after the injury, this regeneration ceases and the damaged basal lamina of pia mater and vessel wall were reconstituted.
Adult ; Male ; Female ; Humans ; Rats ; Animals

OBJECTIVE: In the pediatric population the skull has not yet undergone ossification and it is assumed that the diagnostic rate of skull fractures by simple X-rays are lower than that of adults. It has been recently proposed that the diagnostic rates of skull fractures by 3-dimensional computer tomography (3D-CT) are higher than simple X-rays. The authors therefore attempted to compare the diagnostic rates of pediatric skull fractures by simple X-rays and 3D-CTs with respect to the type of fracture. METHODS: One-hundred patients aged less than 12 years who visited the Emergency Center for cranial injury were subject to simple X-rays and 3D-CTs. The type and location of the fractures were compared and Kappa statistical analysis and the t-test were conducted. RESULTS: Among the 100 pediatric patients, 65 were male and 35 were female. The mean age was 50+/-45 months. 63 patients had simple skull fractures and 22 had complex fractures, and the types of fractures were linear fractures in 74, diastatic fractures 15, depressed fractures in 10, penetrating fracture in 1, and greenstick fractures in 3 patients. Statistical difference was observed for the predictive value of simple skull fractures' diagnostic rate depending on the method for diagnosis. A significant difference of the Kappa value was noted in the diagnosis of depressed skull fractures and diastatic skull fractures. CONCLUSION: In the majority of pediatric skull fractures, 3D-CT showed superior diagnosis rates compared to simple skull X-rays and therefore 3D-CT is recommended whenever skull fractures are suspected. This is especially true for depressed skull fractures and diastatic skull fractures.
Adult ; Aged ; Child ; Emergencies ; Female ; Humans ; Male ; Skull ; Skull Fracture, Depressed ; Skull Fractures

Inappropriate sinus bradycardia associated with degenerative changes in the sinoatrial node has been designated as the sick sinus syndrome. Patients can be asymptomatic but often complain of palpitations and syncopal episodes. A 30 year old parturient, whose pulse rate was about 45-55 beats/min, underwent cesarean section under neuroleptanesthesia. Authors report this case with the review of the relevant literatures.
Adult ; Bradycardia ; Cesarean Section ; Female ; Heart Rate ; Humans ; Pregnancy ; Sick Sinus Syndrome* ; Sinoatrial Node ; Syncope

We report a case of a 44 year old femele with unilateral aldosterone-proudcing adrenal adenoma characterized by hypertension, plasma aldosterone excess, and low plasma renin, commonly but not invariably with hypokalemia. She also had asymmetric septal hypertrophy of left ventricle established with two-dimensional echocardiography. The electrocardiogram showed inverted T wave and prominent U wave with high QRS voltage on precordial leads. In the case of this patient, we are not sure whether asymmetric septal hypertrophy was caused by secondary hypertension and chronic aldosterone excess of primary aldosteronism, or hypertrophic cardiomyopathy per se, so further long=term follow-up is required to determine it. Following the successful unilateral adrenalectomy, however, the systemic pressure fell down to the normal level and electrolyte abnormalities were corrected immediaterly within a few days and the modest regression in septal hypertrophy was noted in one year, suggesting that the promary aldosteronism contributes to the development or porgression of asymmetric septal hepertrophy.
Adenoma ; Adrenalectomy ; Adult ; Aldosterone ; Cardiomyopathy, Hypertrophic* ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Humans ; Hyperaldosteronism* ; Hypertension ; Hypertrophy ; Hypokalemia ; Plasma ; Renin

The index on myocardial contractility of pure mitral regurgitation(MR) after mitral valve replacement is believed to be useful in determining proper operation time before irreversible myocardial damage by volume overload. Thus the authors examined pre and post-operative echocardiographic results of 20 cases of pure MR patients who had been admitted to Pusan National University hospital and compared the usefulness of each index. Pre and post-operative echocardiographic results were as follows respectively ; 1) Left ventricular internal dimension in diastole(LVIDd) were 6.49+/-0.19cm and 5.51+/-0.17cm. 2) Left ventricular internal dimension in systole(LVIDs) were 4.26+/-0.12 and 3.79+/-0.18cm. 3) Ejection fraction were 71.28+/-1.57% and 59.24+/-3.05%. 4) Fractional shortening(FS) were 34.09+/-1.18% and 27.21+/-1.84%. 5) Mean Vcf were 1.53+/-0.08cm/sec and 1.18+/-0.09cm/sec. 6) Left ventricular end-diastolic volume index(EDVI) were 196.35+/-18.33cc/m2 and 98.46+/-9.96cc/m2. 7) Left ventricular end-systolic volume index(ESVI) were 55.28+/-5.12cc/m2 and 41.88+/-6.07cc/m2. 8) Left ventricular end-systolic wall stress/ESVI(ESS/ESVI) were 2.3+/-0.21 and 3.91+/-0.83. ESS/ESVI showed significantly(p<0.05) elevated postoperative change, LVIDd, LVIDs, EF, FS, EDVI, ESVI revealed significantly(p<0.05) reduced postoperative change whereas Mean Vcf had no postoperative change. After examining correlation between preoperative and postoperative results of each index, it is believed that LVIDd, LVIDs, and ESS/ESVI were useful prognostic indices but were unrelated to postoperative ejection phase indices such as EF, FS, and MEan Vcf. Especially in case of LVIDd>6cm, LVIDs>4cm, and ESS/ESVI<2, the prognosis was poor due to myocardial damage by mitral regurgitation.
Busan ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Prognosis ; Stroke Volume

PURPOSE: To compare the results of mitomycin C trabeculectomy and Ahmed valve implant surgery for neovascular glaucoma (NVG). METHODS: We reviewed the medical records of 58 patients (66 eyes) with NVG who had undergone mitomycin C trabeculectomy or Ahmed valve implant surgery in the previous 5 years. Trabeculectomy (A group) was performed in 27 eyes of 24 patients and valve implant surgery (B group) in 39 eyes of 34 patients. Intraocular pressure (IOP), visual acuity, complications and the rate of surgical success of the two groups were compared. IOP under 21 mmHg without medication was considered as complete success (CS), under 21 mmHg with medication as qualified success (QS), and IOP over 22 mmHg despite medication as failure (F). RESULTS: IOP at postoperative 2 months was lower in the trabeculectomy group than in the drainage implant surgery group (16.4 +/- 11.3 mmHg, 20.9 +/- 8.7 mmHg, P=.087), but at 12 months, there was no statistically significant difference (18.4 +/- 11.5 mmHg, 17.0 +/- 6.4 mmHg, P=.608). Visual acuity also showed no significant difference. The respective rate of success between A and B groups was 66.7% and 38.5% (CS), 25.9% and 33.3% (QS), and 7.4% and 28.2% (F), at postoperative 2 months, and 47.8% and 42.3% (CS), 30.4% and 46.2% (QS), and 21.7% and 11.5% (F), at 12 months. The most common postoperative complication was hyphema in both groups, while other complications were shallow anterior chamber, valve problems, etc. CONCLUSIONS: The type of surgery had no significant effect on the success rate of neovascular glaucoma treatment at postoperative 12 months.
Anterior Chamber ; Drainage ; Glaucoma, Neovascular* ; Humans ; Hyphema ; Intraocular Pressure ; Medical Records ; Mitomycin* ; Postoperative Complications ; Trabeculectomy* ; Visual Acuity

Purpose: This study aimed to describe clinical nurses’ lived experiences of workplace verbal violence through qualitative research using descriptive phenomenology. Methods: Six female Korean nurses who had less than 5 years of clinical experience and had experienced verbal violence in the workplace within the past year participated in the study. Data were collected through one-on-one in-depth interviews with the participants and analyzed using Colaizzi’s phenomenological method. Results: A total of 27 codes, eight themes, and four theme clusters were derived from the participants’ statements. The four theme clusters of the clinical nurses’ experiences of verbal violence in the workplace were as follows: “tip of the iceberg,” “beyond me and my control,” “fear and resignation,” and “personal burden.” The participants recognized that nurses experienced verbal violence daily, and that the causes of and responses to verbal violence were determined by external situational factors rather than nurses’ individual problems. This suggests that nurses felt that they had no choice but to personally cope with verbal violence and bear the consequences due to systematic indifference and silence about verbal violence experienced by clinical nurses. Conclusion The findings show that verbal violence was pervasive and unmerited, yet often endured at the cost of a personal burden to nurses. A clear definition of verbal violence and education for employees are needed, and a reporting system should be established to report all forms of violence regardless of the severity of the incident.

Bicuspid ; Biopsy ; Dentistry ; Female ; Humans ; Incidence ; Male ; Mandible ; Maxilla ; Molar ; Periapical Abscess ; Periapical Granuloma ; Radicular Cyst ; Tooth