We report a case of hepatocellular carcinoma presented with severe hypoglycemia. Computerized tomography and ultrasonography revealed a massive bilateral tumor with portal vein thrombosis. The levels of IGF-I (113 ng/mL) and IGFBP- (815 ng/mL) measured in the plasma, were lower than normal range. There was strong immunoreactivity of IGF- and IGF-I in immunohistochemical stain of tumor cells.
Carcinoma, Hepatocellular* ; Carrier Proteins* ; Fibrinogen* ; Hypoglycemia* ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Plasma ; Reference Values ; Ultrasonography ; Venous Thrombosis

No abstract available.
Cesarean Section* ; Female ; Pregnancy

Fanconi syndrome is a complex of renal tubular dysfunction defined by glycosuria without diabetes, generalized aminoaciduria, phosphaturia, bicarbonaturia, uric aciduria, and renal tubular acidosis. It is often associated with hypokalemia, hypophosphatemia, rickets and osteomalacia. We have experienced one case of Fanconi syndrome with chronic tubulointerstitial nephritis. The patient was a 4 year old and his chief complaints were polyuria, polydipsia, and poor weight gain. There were hyperchloremic metabolic acidosis, hypokalemia, glycosuria, generalized aminoaciduria and phosphaturia. We report a case of Fanconi syndrome with brief review of the literatures.
Acidosis ; Acidosis, Renal Tubular ; Child, Preschool ; Fanconi Syndrome* ; Glycosuria ; Humans ; Hypokalemia ; Hypophosphatemia ; Hypophosphatemia, Familial ; Nephritis, Interstitial ; Osteomalacia ; Polydipsia ; Polyuria ; Rickets ; Weight Gain

No abstract available.

The mandibular contour determines the shape of the lower part of face and thus influences the appearance of head and neck. A prominent mandibular angle produce characteristic quadriangular, coarse and muscular appearance. To correct this facial contour to oval shape, the prominent angle can be contoured. the cutaneous approach has been used, but it leaves noticeble scar and has risk of facial nerve injury. Thus the intraoral approach has been used commonly. But because of restricition of operation field, the intraoral approach disadvantages of long operation time, high risk of complications. So, we have performed mandibular contouring procedure by new approach which uses reciprocating saw through stab incision under the mandibular body to correct the 9 patients of mandibular angle protrusion who visited our clinics recently. And we found that mandibular angle contouring by this new approach is easy, and makes the operation and recovery time shorter. There were no complications and cosmetic results were quite satisfactory.
Cicatrix ; Facial Nerve Injuries ; Head ; Humans ; Neck

No abstract available.
Chromosome Aberrations*

OBJECTIVE: To investigate the response of hyperplastic endometrium to Medroxyprogesterone acetate according to the histologic types such as simple typical, complex typical and atypical hyperplasia. METHODS: A total of 79 patients with histologically proved endometrial hyperplasia were enrolled into this prospective study between March 1996 and May 1998. Patients without atypia were placed on a regimen of cyclic therapy with 10mg MPA orally, each day for 14days per month for 3 months. In the cases in which hyperplasia did not regress , MPA was increased to 20mg. Patients with atypical hyperplasia received continuous MPA therapy, 20mg orally each day for 3 month. All patients were followed up for a minimum of 3 months and a maximum of 1 year(mean 7 months). RESULTS: In patients with simple typical hyperplasia, 45 patients(80.4%) had regression, 11 patients(19.6%) had persistence and none had progression. In patients with complex typical hyperplasia, 10 patients(83.3%) had regression, 2 patients(16.7%) had persistence and none had progression. But, in patients with atypical hyperplasia 5 patients(45.4%) had regression, 4 patients(36.4%) had persistence and 2(18.2%) patients had well differentiated endometrial adenocarcinoma. There was no recurrence during the follow up. CONCLUSION: This data suggest that most women with typical hyperplasia respond to progestin therapy, but there is high failure rate of response to progestin therapy and risk of endometrial cancer in patients with atypical hyperplasia. If the young patient desires to preserve her fertility, then progestin therapy may be considered as primary treatment in patients with atypical hyperplasia. But older patients in whom fertility is not an issue, hysterectomy should be selected as treatment of choice for atypical lesion.
Adenocarcinoma ; Endometrial Hyperplasia* ; Endometrial Neoplasms ; Endometrium ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hyperplasia ; Hysterectomy ; Medroxyprogesterone Acetate ; Medroxyprogesterone* ; Prospective Studies ; Recurrence

Ganglion cyst of the spinal facet joint is rare. It is believed that ganglion cysts on the dorsal aspect of the facet joints are asymptomatic and therefore are not clinically appreciated. But we have experienced a patient who had severe low-back and buttock pain and diagnosed as ganglion cyst located on the dorsal aspect of the right side facet joint between the fourth and fifth lumbar vertebrae. The treatment was surgical excision of the cyst and resulted in a satisfactory recovery. The differential diagnosis involving herniated lumbar intervertebral disc should not exclude ganglion cyst of the dorsal aspect of the lumbar facet joint.
Buttocks ; Diagnosis, Differential ; Ganglion Cysts* ; Humans ; Intervertebral Disc ; Lumbar Vertebrae ; Zygapophyseal Joint*

Generally alloplastic matrials such as collagen compound and liquid silicone injection, or autologous fat injection have been used for correction of surface irregularity. But, except for autologous fat injection, the other methods have been proved to be not effective or even dangerous. Then with the explosion in the popularity of liposuction, the autologous fat injection has been applied to variable clinical uses for contouring of the soft tissue irregularities. The author performed main operations with fat injections as ancillary procedure in 16 patients from 1993 to 1996, and long term follow-ups were reported. The lesions treated most frequently were cheeks, and others were thighs, legs, nasolabial folds and upper eyelids in order of frequency. The donor sites were lower abdomen, thigh, buttock and cheek. Our method of fat injection was used as an ancillary procedure for improving post-operative results in variable cases (craniofacial microsomia, fibrous dysplasia, asymmetry of leg, etc). And the important technical points in our method for reducing the absorption of fat after injection were atraumatic liposuction, multilayered dispersed injection, and 20% overcorrection. We obtained satisfactory aethetic results without major complications.
Abdomen ; Absorption ; Buttocks ; Cheek ; Collagen ; Explosions ; Eyelids ; Follow-Up Studies ; Humans ; Leg ; Lipectomy ; Nasolabial Fold ; Silicones ; Thigh ; Tissue Donors ; Transplants*

In the past years skin grafts, local flaps and free flaps have been used in reconstructing skin of soft tissue defects and deformities of the face where primary closure is not feasible. A number of local flaps have been used for reconstruction of facial defects and deformities, but the size of a defect that could be treated in such a way was restricted and the donor site deformity was another problem of local flaps. Introduction of the tissue expansion technique has made it possible to cover even wider defects with neighboring skin and advantageous in facial reconstruction in that such defects can be resurfaced with skin of similar color, texture and thickness, a match superior to that of skin obtained elsewhere. We used tissue expanders in reconstructing defects and deformities of the face(post-burn scar ; 17cases, post-traumatic scar ; 7cases, congenital nevus ; 3cases, total 27cases) from Mar. 1990 to Sep. 1996. We used expanders of various size and shape according to the site and size of the defects. We prefered to use round or croissant type tissue expander for the reconstruction of small-sized scar on medial cheek and to use rectangular type expander for large-sized scar on lateral cheek. Ports are placed under the scar or scalp. Expansion period ranged from 28days to 97days (mean 7weeks) and overinflation (mean 170%) was done. And various methods are used for prevention of complication. We have made anchoring sutures of the remained capsule to the underlying periosteum for prevention of ectropion. We have got satisfactory results from that aesthetically and functionally, so report the results with a review of the current literature.
Cheek ; Cicatrix ; Congenital Abnormalities ; Ectropion ; Free Tissue Flaps ; Humans ; Nevus ; Periosteum ; Scalp ; Skin* ; Sutures ; Tissue Donors ; Tissue Expansion Devices ; Tissue Expansion* ; Transplants