No abstract available.

BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

PURPOSE: The purpose of this study is to evaluate the findings of magnetic resonance imaging(MRI) of posterior fossa hemangioblastoma and usefulness of contrast enhancement with Gd-DTPA. MATERIALS AND METHODS: Seven patients with posterior fossa hemangioblastoma were studied with both pre- and post-enhanced MRI. The MR images were reviewed regarding the location, size, signal intensities of cysts and mural nodules, and their contrast enhancement pattern. RESULTS: Five tumors were located in cerebellar hemisphere, one in vermis, and one in posterior part of medulla. One patient with von HippeI-Lindau disease had a medullary hemangioblastoma with multiple pancreatic cysts. In 6 cases, the major portion of the tumor was cysts and had small mulkal nodules. The solid portion was relatiely lange in one case, cemprising half of the tumor Cysts were oval shaped and their sizes were 3--6.7cm in diameter. In five cases(71%), septations were noted within the cysts. Cysts were isointense or slightly hyperintense on Tl-weighted image and hyperintense on T2-weighted image compared with cerebrospinal fluid. Mural nodules were oval or rounded appearance in five cases and flattened appearance in two, and their size was 0.5--2.5cm in diameter. Mural nodules were isointense to gray matter. They were detected in five cases on Tl-weighted images and one case on T2-weighted images. In two cases, vascular signal void area was noted in mural nodules. On contrast-enhanced Tl-weighted images, all mural nodules were intensely enhanced. CONCLUSION: MRI proved to be a good diagnostic method to detect and characterize posterior fossa hemangioblastoma. The most common finding is Cystic posterior fossa lesion with enhancing mural nodule. Contrast enhancement is essential for specific diagnosis.
Cerebrospinal Fluid ; Diagnosis ; Gadolinium DTPA ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Pancreatic Cyst

No abstract available.
Humans

We report a case of a 6-month-old female who had had verrucous hemangioma since birth. The lesions were dark red, verrucous surfaced, hyperkeratotic papules on the right sole. A histopathological examination showed hyperkeratosis, papillomatosis, irregular acanthosis, lobular proliferation and dilatation of blood vessels in the deep dermis with a gap devoid of vessel proliferation in the mid dermis.
Blood Vessels ; Dermis ; Dilatation ; Female ; Hemangioma* ; Humans ; Infant ; Papilloma ; Parturition

The intra-articular tibial plateau fracture can induce many complications of the knee joint after conservative treatment or operative treatment. Recent experience could decrease the complications with accurate anatomical reduction, stable internal fixation and early knee ROM exercise, but still unsatisfactory results were reported from 20% to 40%. The authors analyzed the 30 cases that could be follow-up from 1 year to 6 years and were treated with operative methods, and the following results were obtained. 1. The most common cause of injury was traffic accident (14 cases-46.4%). 2. The most common fracture type by Hohls classification was type VI (13 cases-43.1%). 3. According to Blokker's criteria, 26 cases (86.7%) among 30 cases had satisfactory results. 4. The one of the most important factor influencing end results was thught to be the anatomical reduction of the articular margin.
Accidents, Traffic ; Classification ; Follow-Up Studies ; Knee ; Knee Joint

PURPOSE: The aim of the study was to evaluate the long-term safety profile and efficacy of Alfuzosin 10 mg once daily in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), under daily practice conditions in Korea. MATERIALS AND METHODS: In this 6-months, open-label, multicenter, noncomparative, observational study, 511 men were enrolled. International Prostate Symptom Score (IPSS), IPSS 8th question (bother score), maximum flow rate (Qmax), Danish Prostate Symptom Score (DAN-PSS) were evaluated at baseline and after 3, 6 months of treatment. Safety was analyzed in all patients exposed to alfuzosin (n=480). Analysis was performed at end-point in the intent to treat population (n=368). RESULTS: Of the 511 enrolled patients in the study, 218 patients (42.7%) dropped out. With alfuzosin, IPSS and bother score significantly improved from baseline by -6.7+/-6.4 (-31.9%, p<0.001) and -1.2+/-1.2 (-29.3%, p<0.001), respectively. Nocturia also significantly improved from 2.3+/-1.3 at baseline to 1.8+/-1.0 at end-point (-0.6+/-1.1, p<0.001). In the subgroup of patients likely to be obstructed (Qmax <10 ml/sec at baseline), Qmax improved from 8.3+/-1.2 at baseline to 13.7+/-6.1 at end-point (+5.4+/-5.8, p=0.001). In patients with pain/discomfort on ejaculation, weighted score significantly improved from 2.4+/-2.2 at baseline to 1.5+/-1.9 at end-point (-31%, p=0.002). There were no clinically relevant changes in sitting systolic BP and diastolic BP at endpoint. CONCLUSIONS: Alfuzosin 10 mg once daily administered for 6-months is effective in improving LUTS and quality of life, and is well tolerated from a sexual and cardiovascular perspective, including in elderly men and those receiving anti-hypertensive co-medication.
Aged ; Ejaculation ; Humans ; Korea ; Lower Urinary Tract Symptoms ; Male ; Nocturia ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Quinazolines

BACKGROUND: Cut-off values for visceral fat area (VFA) measured by computed tomography (CT) for identifying individuals at risk of metabolic syndrome (MetS) have not been clearly established in Korean adults, particularly for large populations. We aimed to identify optimal VFA and waist circumference (WC) cut-off values and compare the ability of VFA and WC to predict the presence of ≥2 metabolic risk factors. METHODS: We included 36,783 subjects aged 19–79 years undergoing abdominal fat CT during regular health checkups between January 2007 and February 2015 in Seoul. The risk factors for MetS except WC were based on the International Diabetes Federation criteria. Receiver operating characteristic curve analyses were used to determine the appropriate VFA and WC cut-off values for MetS. RESULTS: VFA was a more significant predictor of metabolic risk factors than WC and body mass index (BMI). The optimal cut-off values for VFA and WC were 134.6 cm2 and 88 cm for men and 91.1 cm2 and 81 cm for women, respectively. We estimated age-specific cut-off values for VFA, WC, and BMI. VFA cut-off values increased with age, particularly among women. CONCLUSION: This large population study proposed the cut-off values for VFA and WC for identifying subjects at risk of MetS among Korean adults. For more accurate diagnosis, different age-specific cut-off values for VFA and WC may be considered.
Abdominal Fat ; Adult* ; Body Mass Index ; Diagnosis ; Female ; Humans ; Intra-Abdominal Fat* ; Male ; Obesity, Abdominal ; Risk Factors ; ROC Curve ; Seoul ; Waist Circumference

PURPOSE: In Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists. RESULTS: For the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms. CONCLUSION: The results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.
Adrenergic alpha-Antagonists/therapeutic use ; Cholestenone 5 alpha-Reductase/antagonists & inhibitors ; Data Collection ; Humans ; Korea ; Male ; Prostatic Hyperplasia/*diagnosis/*drug therapy ; Urology/statistics & numerical data

BACKGROUND: Video assisted thoracic sympathectomy or sympathicotomy is a safe and effective therapy for the treatment of palmar hyperhidrosis with immediate symptomatic imporvement. However the degree of satisfaction may diminish with time due to cmpensatory sweating or excessive hand dryness. Therefore by comparing and assessing the degree of symptomatic improvement or compensatory sweating following sympathectomy or sympathicotomy at various levels we aim to determine the optimal level of sympathetic nerve block which will result in minimal side effects and maximal benefit. MATERIAL AND METHOD: Among 194 patients having undergone video assisted thoracic sympathectomy or sympathicotomy between January 1996 and June 1999, 137 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into three groups. Group I(n=61) ; patients having undergone T2,3,4 sympathectomy group II(35) ; patients having undergone T2 sympathicotomy and group III(41) ; patients having undergone limited T2 sympathicotomy which consist of block of interganglionic neuronal fiber on the third rib. The parameters studied comprised of pre- and post-operative palmar temperature change treatment satisfaction the degree of compensatory sweating or discomfort from palmar dryness postoperative complication and changes in plantar sweating. RESULT: There was no difference in age and sex among the groups and the mean postoperative elevation in palmar temperature was 21.59degrees C without any differences among the groups. Patients expressing satisfaction were 65.6%, 62.9% and 90.24% in groups I, II and III, respectively(p<0.05) Moderate to severe compensatory sweating was present in 65.6% 51.4%, and 24.39%, in group I, II, and III, respectively (p<0.05) Slight but comfortable amount of palmar humidness was expressed in decreasing order group III(41.6%) group I(24.6%) and group II(5.7%) (p<0.05) Ineffectiveness or recurrence was present in 5patients in group I(8.2%) 1 patient in group II(2.9%) and none in group III. With regards to plantar sweating decrease in sweating was expressed in 43 patients(31.4%) while similar degree of sweating in 61 patients(44.5%) and increase in sweating in another 33 patinets(24.1%). CONCLUSION: Limited T2 sympathicotomy resection of the lower interganglionic neuronal fiber of the second sympathetic ganglion on the third rib showed immediate effect in palmar hyperhidrosis and caused lesser compensatory sweating and hand dryness.
Autonomic Nerve Block ; Ganglia, Sympathetic ; Hand ; Humans ; Hyperhidrosis* ; Interviews as Topic ; Neurons ; Postoperative Complications ; Surveys and Questionnaires ; Recurrence ; Ribs ; Sweat ; Sweating ; Sympathectomy