No abstract available.
Dermoscopy* ; Diagnosis

PURPOSE:Idiopathic ketotic hypoglycemia (IKH) is an important cause of hypoglycemia in children. The purpose of this study was to determine the prevalence of ketotic hypoglycemia and to describe the clinical manifestation. METHODS:We conducted a retrospective chart review of children presenting hypoglycemia to the emergency department (ED) of Ewha Womans University Hospital between January 1995 and June 2004. Information recorded for subject included age, gender, weight, time of presentation, presenting symptoms, and laboratory data. RESULTS:Eighty two children were identified for hypoglycemia during the study period. IKH was the ultimate diagnosis for 66 patients (80.5%). Other diagnoses included hyperinsulinism (2.4%), drug adverse event (1.2%), sepsis (1.2%), and other disorder. The mean age for presentation of IKH was 37.9+/-18.6 months. Thirty eight boys and twenty eight girls were identified. The median time of presentation was 9:48 a.m. Of the 66 subjects, body weight of 46.9% patients was below 25th percentile for age. The average blood glucose was 41.4+/-14.2 mg/dL. Symptoms at presentation included lethargy (24.2%), mental change (16.7%) and vomiting (16.7%). 49 patients (74.2%) were described as having a concomitant illness. CONCLUSION: IKH was responsible for 80.4% of cases of hypoglycemia in pediatric ED and it had usually concomitant intercurrent illness which resulting in poor oral intake. Awareness of IKH, and its presenting characteristics, will be helpful in the ED when taking care of hypoglycemic children.
Blood Glucose ; Body Weight ; Child ; Diagnosis ; Emergency Service, Hospital ; Female ; Humans ; Hyperinsulinism ; Hypoglycemia* ; Lethargy ; Prevalence* ; Retrospective Studies ; Sepsis ; Vomiting

Purpose: This report describes a case of recurrent ophthalmoplegia associated with hyperhomocysteinemia due to methylenetetrahydrofolate reductase (MTHFR) gene polymorphism.Case summary: A 40‐year‐old healthy man presented with acute diplopia. He had a history of diplopia due to left sixth nerve palsy 2 years ago. Prism and alternate cover tests revealed left hypertropia in the primary position. Examination of ductions and versions showed mild elevation of the left eye on adduction. Brain and orbit magnetic resonance imaging were normal. Laboratory studies revealed an elevated level of erythrocyte sedimentation rate (ESR) and homocysteine. A diagnosis of left fourth nerve palsy associated with hyperhomocysteinemia was made. Symptoms were completely resolved within 2 weeks. Two years later, the patient again had diplopia associated with esotropia and limited abduction of the right eye. ESR and homocysteine level were normal. Analysis for MTHFR gene polymorphisms, which contribute to variable hyperhomocysteinemia, revealed 677TT homozygote variant. A diagnosis of recurrent paralytic strabismus associated with hyperhomocysteinemia, caused by MTHFR gene polymorphism, was made. Symptoms resolved within 1 month, and the patient did not have any further recurrence in 6 months. Conclusions Patients with hyperhomocysteinemia may present with ophthalmoplegia. An analysis for MTHFR gene polymorphisms is needed to diagnose hyperhomocysteinemia.

Recently refractive corneal surgery has been increasing and intraocular lens implantation is a routine procedure during cataract surgery. Many people have various activities in the evening such as night driving, thus it may be very important measuring the pupil size in the dark in determining the size of the optical zone. We measured pupil size of sixty normal adult candidates in darkness of 0, 20, 60, 100 lux and also in the bright illumination of 200 lux for comparison using near lens camera and slide film. The pupils became larger with younger age and increased darkness. Pupil Size(log mm) = 4.57 - 0.0388 X Age(year) - 0.005 X Luminance(lux). The average pupil size of all age groups were 7.0mm, 6.56mm, 5.97mm, 5.4mm sequencially in darkness and 4.77mm in brightness(200 lux). The average pupil size of 20~30 year old group who are socially active even at night was 7.18mm and 8.4mm in maximum. This has significant meaning clinically. Additionally the size of pupil became larger with increased corneal diameter and the amount of anisocoria tended to be greater with the increase of the darkness.
Adult* ; Anisocoria ; Cataract ; Darkness ; Humans ; Lens Implantation, Intraocular ; Lighting ; Pupil*

Gastritis cystica superficialis (GCS) is a rare lesion which is characterized by glandular hyperplasia with regeneration and degeneration in the mucosa and muscularis mucosa. Recently, GCS is revealed as precancerous lesion, but most report has been associated with those found at the site of a gastroenterostomy. So, we report two cases with GCS who had not previous gastric surgery. A 45-year-old woman visited for epigastric discomfort and another 4Q-year-old woman for epigastric pain. They had not undergone any gastric surgery. The gastroscopy discovered one polyp on anterior wall of greater curvature, upper body and another polyp in the center of the fold of greater curvature, lower body. We removed it by snare polypectomy and the histologic finding showed the character of GCS.
Female ; Gastritis* ; Gastroenterostomy ; Gastroscopy ; Humans ; Hyperplasia ; Middle Aged ; Mucous Membrane ; Polyps ; Regeneration ; SNARE Proteins

Trypsin and DNase digestion technique has become a retinal digestion technique for studying diabetic retinopathy. We tried osmotic digestion method with DNase and compared the quality of preparation of retina and microvascular change with trypsin digestion in normal and diabetic rats. Streptozotocin-induced diabetic rats were sacrificed at 9, 18, 27weeks in 6 rats. Right retinas were digested with 3% trypsin while left wer digested with 0.1% DNase. For control, 18 normal rats were sacrificed at the same time. DNase was superior to trypsin for retinal preparation on the stainability, the degree of separating nonvascular fissue from vascular net, the degree of preservation of vascular net in normal & diabetic rats. In diabetic rats, the number of pericyte decreased significantly with age, which not in normal rats(p=0.0023) We suggest DNase digestion technique as an new alternative for trypsin digestion technique in the study of microvascular change of diabetic retinopathy.
Animals ; Deoxyribonucleases* ; Diabetes Mellitus ; Diabetic Retinopathy ; Digestion* ; Endothelial Cells ; Microvessels* ; Pericytes ; Rats* ; Retina ; Retinaldehyde* ; Trypsin*

No abstract available.
Bowen's Disease*

BACKGROUND: Skin thickness for parameter of skin aging has been analysed with various methods. Skin thickness variations between the young and the old has been studied with various methods such as biopsies, calipers, micrometers, computer tomography, ultrsonography. But none of these methods evaluates skin thickness exactly. OBJECTIVE: For the evaluation of age-dependent skin thickness changes, we compared the skin thickness of an old-aged group and a young group with 20MHz-ultrasonography. METHODS: In order to identify the skin thickness variation between different age groups, 60 subjects, 30 aged 23-33, and 30 over 60, were studied with 20MHz-high frequency ultrasonogrphy (Dermascan C, Cortex Technology, Hadsund, Denmark) on fourteen skin sites. This machine was designed to measure the thickness from the top of the epidermis to the bottom of the dermis. After storage of cross-sectional skin imaging, skin thickness was calculated with a computer assisted image-analysis program. Skin thickness of the old was analysed by age, sex, height and weight.
Biopsy ; Dermis ; Epidermis ; Humans ; Skin Aging ; Skin* ; Ultrasonography*

No abstract available.
Cesarean Section* ; Cicatrix* ; Endometriosis* ; Female ; Pregnancy

No abstract available.
Carcinoma, Basal Cell* ; Nevus*