The morphologic abnormalities of the endocrine pancreas that underlie persistent neonatal hyperinsulinemic hypoglycemia and are included under the heading "nesidioblastosis" appears to be heterogeneous. This characteristic morphologic finding is ductuloinsular complexes showing endocrine cells budding off the ductoepithelium and merging with adjacent endocrine cell clusters. A case of nesidioblastosis associated with hyperinsulinemic hypoglycemia occurred in a 6/365 year-old male neonate. Microscopic finding of near totally resected pancreas revealed irregular sized islets and ductuloinsular complexes, both of which contained hypertrophied B cells with a few mitosis. Because of persistent hypoglycemia after first operation, he received second operation 8 days after. This histologic finding was more severe comparative to that of first operation. According to these findings, the pathogenesis of nesidioblastosis may be congenital or developmental defect of a kind of compensatory mechanism by unknown stimuli to acquire persistent hypoglycemia.
Male ; Infant, Newborn ; Humans

No abstract available.
Asphyxia* ; Brain Stem*

No abstract available.
Cardiomyopathy, Hypertrophic* ; Humans ; Infant* ; Mothers*

PURPOSE: In this study we analyzed and compared the orbital anatomy in Korean and Caucasian subjects using computed tomography (CT) measurements. METHODS: Two observers performed a cross-sectional, retrospective analysis of 44 CT scans of subjects (22 Koreans, 22 Caucasians) with no appreciable orbital or globe disease. Ten length measurements and 3 angle measurements of various orbital aspects were obtained. Analysis was performed to determine if changes in these parameters were associated with race. RESULTS: Anterior medial interorbital length was 24.05 +/- 2.00 mm in Korean and 21.96 +/- 1.96 mm in Caucasian subjects. Anterior vertical orbital length was 34.19 +/- 1.67 mm in Korean and 35.03 +/- 1.18 mm in Caucasian subjects. The anterior medial interorbital length and anterior vertical orbital length (p < 0.05) were significantly different. Interorbital angle was 47.69degrees +/- 1.49degrees in Korean and 46.15degrees +/- 2.19degrees in Caucasian subjects; the difference was statistically significant (p < 0.05). CONCLUSIONS: Compared with Caucasians, the orbit of Korean subjects has a narrower orbital opening and longer interorbital distance. The present study regarding the anatomy of Korean and Caucasian orbits will assist physicians with the evaluation and treatment of orbital diseases.
Continental Population Groups ; Humans ; Orbit* ; Orbital Diseases ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Child* ; Evoked Potentials, Auditory, Brain Stem* ; Humans

No abstract available.
Osteoblastoma* ; Spine*

Purpose: In hormone receptor-positive, human epidermal growth factor receptor 2–negative metastatic breast cancer (HR+ HER2–MBC), the mainstay treatment options include cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) and everolimus (EVE) in combination with endocrine treatment. This study aims to compare the outcomes of the following treatment sequences: CDK4/6i followed by EVE and EVE followed by CDK4/6i. Materials and Methods: Data from HR+ HER2– MBC patients treated between January 2014 and November 2020 with both CDK4/6i and EVE were retrospectively analyzed. Results: Among the 88 patients included in the study, 51 received CDK4/6i before EVE (C→E group), and 37 received EVE before CDK4/6i (E→C group) with endocrine treatment. More patients in the E→C group had endocrine resistance (13.7% vs. 40.5%), experienced palliative chemotherapy (7.8% vs. 40.5%), and were heavily treated (treated as ≥ 3rd line, 5.9% vs. 40.5%). Median overall survival was 46.8 months in the C→E group and 38.9 months in the E→C group (p=0.151). Median composite progression-free survival (PFS), defined as the time from the start of the preceding regimen to disease progression on the following regimen or death, was 24.8 months in the C→E group vs. 21.8 months in the E→C group (p=0.681). Median PFS2/PFS1 ratio did not differ significantly between groups (0.5 in the C→E group, 0.6 in the E→C group; p=0.775). Ten patients (11.4%) discontinued EVE, and two patients (2.3%) discontinued CDK4/6i during treatment. Conclusion Although the CDK4/6i-based regimen should be considered as an earlier line of treatment, CDK4/6i- and EVE-based treatments can be valid options in circumstances where the other treatment had been already given.

It has been well known that variable complications oecur in multiple organs in chronic renal failure patients. Of them gastrointestinal complications are also variable including nausea, vomiting, gastritis, peptic ulcer, gastrointestinal bleeding, hepatitis, pancreatitis, telangiectasia, angiody- splasia etc. Of such complications the incidence of peptic ulcer had been known to be high, but after endoscopic study, the incidence of nonulcer mueosal lesion has been more common. So we evaluated tbe upper gastrointestinal mucosal lesion in chronic renal failure patients by endoscopic examination. 129 subjects(mean age, 42 years, creatinine clearance ratio<10 ml/min) participated in this study. After overnight fasting the subjects were premedicated with simethicon and benoxinate. The mucosal lesion was diagnosed by two endoscopists with observing the TV monitor of electronic endoscope Fujinon EVG-FP. Of the 129 patients, 78 patients(76%) were revealed to abnormal endoscopic finding. Of the abnormal findings, the incidence of gastritis was most common in 34.9%, and then gastic erosion, duodenal erosion, gastric petechiae, gastric telangiectasia, duodenitis, gastric ulcer, gastric xanthoma, esophageal erosion, duodenal ulcer, esophageal uicer in orders. There was no difference in abnormal finding according to therapeutic type. From our study, we conclude that the incidence of nonulcer mucosal lesion is higher than ulcer disease in chronic renal failure patient, moreover those lesion can be diagnosed only by endoseopy. So we think that upper gastrointestinal endoscopy is necessory for evaluation of upper gastrointestinal tract in chronic renal failure patient.
Creatinine ; Duodenal Ulcer ; Duodenitis ; Endoscopes ; Endoscopy, Gastrointestinal ; Fasting ; Gastritis ; Hemorrhage ; Hepatitis ; Humans ; Incidence ; Kidney Failure, Chronic* ; Nausea ; Pancreatitis ; Peptic Ulcer ; Purpura ; Stomach Ulcer ; Telangiectasis ; Ulcer ; Upper Gastrointestinal Tract ; Vomiting ; Xanthomatosis

PURPOSE: To introduce the minimal skin and orbicularis oculi muscle resection with the full thickness rotating suture technique for lower lid epiblepharon and to assess its surgical outcome. METHODS: A retrospective review of medical records was performed on lower lid epiblepharon patients who were followed for more than 6 months after surgical correction performed between January 2004 and December 2015. All surgeries were performed by one surgeon using minimal skin and orbicularis oculi muscle resection and the full thickness rotating suture technique for lower lid epiblepharon correction. RESULTS: A total of 943 lower lid epiblepharon patients (403 male, 540 female) were included in the analysis. The mean patient age was 6.7 ± 2.4 years, and the mean postoperative follow-up was 12.9 ± 7.2 months. Eyelid shape and function were well maintained in 904 patients (95.9%), with no recurrence during follow-up. Among the recurrent cases (39 patients [4.1%]), 19 patients (2%) underwent a second correction surgery. CONCLUSIONS: Minimal skin and orbicularis oculi muscle resection with the full thickness rotating suture technique for lower lid epiblepharon showed good surgical outcome with few complications and high success rate.
Eyelids ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Skin ; Suture Techniques* ; Sutures*

Traumatic injury to the lower legs has been increasing in Korea and often leads to skin and soft tissue loss, exposing blood vessels, nerves, tendons or bones. Salvaging these legs often requires free flaps. Over the past two decades, the use of free tissue transfer has produced an increasing salvage rate for severely injured lower leg. Between April. 1988 to July, 1997, 47 cases of lower soft tissue defects were reconstructed with free flaps, and retrospective analysis was performed to determine more about the factors associated with free flap failure or immediate vascular complications. We evaluated wound status before operation, operation time after injury, vascular status of recipient site, use of vein graft, use of reverse flow, salvage protocol in compromised anastomosis, survival rate and complications. There were 9 cases of venous thrombosis and 2 cases of arterial insufficiency while 7 out of 9 cases of venous thrombosis were reexplorated. However, 2 cases of partial flap necrosis and 1 case of total necrosis. Two cases of arterial insufficiency were necrotized, so the overall free flap failure rate was 9.6%. The results were analyzed to determine the factors promoting either failure or vascular complication, Many factors which are often blamed for failure (trauma cause, preoperative general condition, preoperative infection status, intraoperative ischemic time) were not significant in this study, but prolonged time after injury correlated with free flap failure, We concluded the adequate debridement and infection control, adequate selection of recipient vessel, accurate vascular anastomosis and most of all, early free flap transfer after injury, will improve the success rate.
Blood Vessels ; Debridement ; Free Tissue Flaps* ; Infection Control ; Korea ; Leg* ; Necrosis ; Retrospective Studies ; Skin ; Survival Rate ; Tendons ; Transplants ; Vascular System Injuries ; Veins ; Venous Thrombosis ; Wounds and Injuries