PURPOSE: The purpose of this study was to describe the clinical outcome after pancreatcetmy and its relationship with pathological appearances and clinical features in patients with persistent hyperinsulinemic hypoglycemia of infancy(PHHI). METHODS: Medical records of 10 patients(9 males and 1 female, mean age:40.4+/-1.5 months) who were diagnosed as PHHI and underwent pancreatectomy from 1988 to 2000 were reviewed. Clincal and biochemical data were recorded. Subjects were classified arbitrarily into early-onset or late-onset group according to age of onset. Pathologic appearance of pancreas was divided into 2 forms:diffuse or focal. The former had a focal pancreatic adenomatous hyperplasia and the latter was characterized by increased number of betacells with similar distribution seen in normal neonates. RESULTS: One patient had focal, and nine had diffuse lesions. After near-total pancreatectomy, 4 patients(40.0%) showed complete response, 4(40.0%) had persistent hypoglycemia, and 2(20.0%) developed diabetes mellitus. As neurological sequelae, 6 patients(60.0%) had persistent seizures, and 6(60.0%) had delayed motor and speech development. No clinical or biochemical factors related to postoperative outcome were found. CONCLUSION: This data indicate that early diagnosis of patients who present with hypoglycemic symptoms in infancy, especially early in life, and development of more effective therapy are warranted, because there is no clinical or biochemical factor predicting final outcome after near-total pancreatectomy and only 40% of patients with PHHI remained euglycemic after surgery with possible severe neurological sequelae.
Age of Onset ; Congenital Hyperinsulinism* ; Diabetes Mellitus ; Early Diagnosis ; Female ; Humans ; Hyperplasia ; Hypoglycemia ; Infant, Newborn ; Male ; Medical Records ; Pancreas ; Pancreatectomy* ; Seizures

PURPOSE: To compare central keratometric values (K-values) measured at the pupillary center by Orbscan II (R) topography (Orbtek, Bausch & Lomb, USA) with preexisting methods for K-values in patients who have been treated with laser in situ keratomileusis (LASIK). METHODS: A total of 36 consecutive eyes of 25 patients who were treated with LASIK for myopia have been followed up for more than 1 year. Central K-values measured by Orbscan II(R) topography, K-values measured with autorefractokeratometer, and refraction-derived K-values were compared . RESULTS: The mean central keratometric K-value measured by Orbscan II (R) topography was 39.65+/-1.94 (35.82 to 43.45) diopter (D), and was not statistically significantly different from the mean refraction derived K-value which was 39.63+/-1.95 D (35.95 to 43.41) (p>0.05), but was statistically lower than the mean K-value measured with autorefractokeratometer which was 40.23+/-1.76 D (36.56 to 43.69) (P<0.05). CONCLUSIONS: In patients who have been treated with LASIK for myopia, central keratometric K-value measured with Orbscan II R topography is not statistically significantly different from refraction derived K-value, but is lower than K-value measured with autorefractokeratometer.
Humans ; Keratomileusis, Laser In Situ* ; Myopia

This study was designed to examine the effect of polyP on the periodontal ligament fibroblasts. The cells were incubated for 24 and 48 hours with various concentrations (0.001%, 0.002%, 0.005%, 0.010%, 0.020%, 0.040%) of polyP. Cell activity, alkaline phosphatase activity, and protein synthesis activity of the cells were examined. The results were as follows: 1. Twenty four hours after incubation with polyP, the cell activity of the periodontal ligament fibroblasts was increased. Forty eight hours after polyP application, the activity of the cells was similar to that of control group. 2. Twenty four or forty eight hours after incubation with polyP, the alkaline phosphatase activity of the periodontal ligament fibroblasts was increased. 3. The protein synthesis of the periodontal ligament fibroblasts was not changed after polyP application. These results suggest that, polyP may increase the cell activity and alkaline phosphatase activity of periodotal ligament fibroblasts and polyP may not affect the protein synthesis of the cells.
Alkaline Phosphatase ; Fibroblasts ; Ligaments ; Periodontal Ligament* ; Polyps

PURPOSE: To report a previously unreported secondary Mooren's ulcer associated with simultaneous sur-gery for cataract and pterygium. METHODS: Case report. Five days after simultaneous surgery for cataract and pterygium, an 86-year-old woman developed severe pain and a superior and inferior peripheral corneal ulcer that had the characteristic clinical appearance of Mooren's ulcer. RESULTS: Peripheral corneal ulcer is rapidly progressive, painful, beginning at the limbus with a gray, overhanging, infiltrated edge at its central border. She had no history of collagen-vascular disease, negative serologic test result, and negative culture for pathogen. Surgical trauma may have been the inciting factor in development of the ulcer. She was treated with topical and systemic steroids. After complete control of the inflammation, the patient remained in remission.
Aged, 80 and over ; Cataract* ; Corneal Ulcer* ; Female ; Humans ; Inflammation ; Pterygium* ; Serologic Tests ; Steroids ; Ulcer*

A 48 year-old male with back pain and foot drop had been treated. Studies for myelomatosis were all negative. A plain lumbar spin X-ray showed an erosion of the left pedicle of the first lumbar vertebra. A myelography via lumbar and cisternal routes revealed total block with feather appearance at the upper level of the L2 and the lower level of the T12 vertebra. Pathologic evaluation confirmed the diagnosis of solitary myeloma of the bone. After undergoing almost total excision, followed by radiation, the patient was still doing well.
Animals ; Back Pain ; Diagnosis ; Feathers ; Foot ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; Myelography ; Spine*

Porphyromonas gingivalis is strongly implicated in the pathogenesis of adult periodontitis, the major cause of tooth loss in adults. Use of an antibacterial agent controlling P. gingivalis as a periodontal therapeutic agent has been rationalized. The present study was performed to observe the antibacterial effect of inorganic polyphosphates (polyP) on P. gingivalis. P. gingivalis 2561 was grown in half-strength brain-heart infusion broth containing hemin and vitamin K with or without polyP. Minimal inhibitory concentration (MIC) of polyP with various chain lengths was determined by measuring the absorbance of the grown cells at 540 nm. MIC of polyP for the bacterium was determined to be 0.05%. The effect of polyP with a chain length of 75 (polyP 75) was further examined. PolyP 75 added to the growing culture of P. gingivalis at its exponential phase was as effective in inhibiting the growth of P. gingivalis as polyP 75 added at the very beginning of the culture. More than 99% of the cells lost their viability determined by viable cell count when polyP 75 was added to the culture of growing P. gingivalis at the concentration of 0.06%, suggesting that polyP 75 has a bactericidal effect on the bacterium. Intracellular nucleotide release from the cells was increased by approx. 20% in the presence of polyP 75 but was not reversed by the addition of divalent cations like Ca++ and Mg++. Under the transmission electron microscope, only a small number of the growing P. gingivalis cells were actually lysed. However, the majority of the cells appeared to be atypical in their shape, demonstrating accumulation of highly electron-dense granules and bodies of condensed nucleic acid-like material in the cytoplasm. In the presence of polyP 75, the protein profile of P. gingivalis was changed as determined by SDS-polyacrylamide gel electrophoresis and immunoblot, and the proteolytic activity of the bacterium demostrated on the zymograms was decreased. The overall results suggest that polyP have a strong bactericidal activity against P. gingivalis in which lysis in relation to chelation may not play the major role but unknown mechanism that possibly affects the viability of the bacterium may be involved. PolyP may be used as an agent for prevention and treatment of periodontitis.
Adult ; Cations, Divalent ; Cell Count ; Chronic Periodontitis ; Cytoplasm ; Electrophoresis ; Hemin ; Humans ; Periodontitis ; Polyphosphates* ; Polyps ; Porphyromonas gingivalis* ; Porphyromonas* ; Tooth Loss ; Vitamin K

Arthralgia ; Humans ; Jaw ; Magnetic Resonance Imaging ; Splints ; Temporomandibular Joint Disc ; Temporomandibular Joint Disorders ; Temporomandibular Joint

OBJECTIVE: The intracranial pathologies after head trauma should be usually progressed. It is clearly visualized in the non-invasive brain CT. The invasive monitor such as intracranial pressure (ICP) monitoring may be accompanied with the complications. This study aims whether the patients with severe head injury could be managed with serial CT scans. METHODS: The medical records of 113 patients with severe head injury in the prospectively enrolled trauma bank were retrospectively analyzed. After the emergency care, all the patients were admitted to the intensive care unit for the aggressive medical managements. Repeat brain CT scans were routinely taken at 6 hours and 48 hours after the trauma. ICP monitoring was restrictively applied for the uncertain intracranial pressure based on the CT. The surgical intervention and the mortality rate were analyzed. RESULTS: Immediate surgical intervention after the initial CT scan was done in 47 patients. Among the initially non-surgical patients, 59 patients were managed with the serial CT scans and 7 with the ICP monitoring. Surgical interventions underwent eventually for 10 patients in the initially non-surgical patients; 1 in the ICP monitoring and 9 in the serial CT. The mortality rate was 23.7% in the serial brain CT and 28.6% in the ICP monitoring. There was no statistical difference between two groups in the aspect of mortality (p=0.33). CONCLUSION: Serial CT scans in time could be a good way to monitor the intracranial progression in the severe head injury and reduce the implantation of an invasive ICP probe.
Brain* ; Craniocerebral Trauma* ; Emergency Medical Services ; Humans ; Intensive Care Units ; Intracranial Pressure* ; Medical Records ; Mortality ; Pathology ; Prospective Studies ; Retrospective Studies ; Tomography, X-Ray Computed*

From October 1991 to April 1996, 27 patients underwent aortocoronary bypass graft. There were 17 men, 10 women. The mean age was 65 years(range 45 to 76). The preoperative clinical status were chronic stable angina in 11 cases, unstable angina in 13 cases and postinfarction angina in 3 cases. The involved risk factors were as follows: Hypertension in 7 cases, Diabetes Mellitus in 5 cases and any other diseases in 3 cases. We divided these patients into two groups in this survey: The A group was 15 patients who were managed with cardioplegia from 1991 to 1994. The B group of 12 patients was done with intermittent aortic clamping without cardioplegia from 1995 to 1996. The mean numbers of graft per patient was 2.0 in A group and 2.83 in B group. The ischemic time per graft was 27.3 minute in A group and 18.5 minute in B group respectively. The morbidity was occlusion of grafted vessel in one patient and one of postoperative angina in A group. The total mortality was 14.8%(4/27), but mortality of B group was 8.3%(1/12).
Angina, Stable ; Angina, Unstable ; Constriction ; Coronary Artery Bypass* ; Coronary Vessels* ; Diabetes Mellitus ; Female ; Heart Arrest, Induced ; Humans ; Hypertension ; Male ; Mortality ; Risk Factors ; Transplants

As a part of plan to construct a multifunctional hospital information system, We planned to develop a chemotherapy order system. First, a software developing team was established which is composed of hematooncology staffs, special pharmacists and programmer who are responsible for OCS. We set up an outline of this system after collecting various kinds of sources such as foreign examples, gathered protocol that are used for chemotherapy, and organized these protocol in programming the chemotherapy order system. This project is expected to provide accurate prescription, to shorten the time to prepare prescription, to standardize the protocol of chemotherapy within the medical center, to manage an effective dispensing schedule and to be used as a source for education and research.
Appointments and Schedules ; Drug Therapy* ; Education ; Hospital Information Systems ; Humans ; Pharmacists ; Prescriptions