Insulinoma is the most frequent endocrine tumor of the pancreas and the first of the endocrine-secreting tumor of the gut to be recognized by Nicholls in 1902. Recurrent episodes of hypoglycemia is the main cause of the symptoms and signs which were sweating, pallor, dizziness, habitual change, convulsion and coma. In 1935, Whipple and Frants were described so-called “Whipple's triad”: the patient's symptoms occur with fasting or exercise; at the time of symptoms, the serum glucose in 50mg/dl or less; and the symptoms are relieved by the administration of glucose. While these criteria were timely, they proved to be rather nonspecific and may be found in other conditions that result in fasting hypoglycemia. We experienced a 44-year-old female patient who had repeated attacks of convulsion, unconsciousness and coma for 3 years. Although she has been treated with anticonvulsant, the symptoms and signs were not disappeared. At the time of administration, she was a full coma state due to hypoglycemia and was dramatically reversed by intravenous administration of the glucose solution. The preoperative test such as provocative test, abdominal CT and celiac angiography revealed insulinoma and after enucleation the pathologic diagnosis was the same. We like to report an adult female patient with insulinoma and the review of literatures briefly.
Administration, Intravenous ; Adult ; Angiography ; Blood Glucose ; Coma ; Diagnosis ; Dizziness ; Fasting ; Female ; Glucose ; Humans ; Hypoglycemia ; Insulinoma* ; Pallor ; Pancreas ; Seizures ; Sweat ; Sweating ; Tomography, X-Ray Computed ; Unconsciousness

No abstract available.
Animals ; Rats* ; Reperfusion*

PURPOSE:It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. MATERIALS AND METHODS: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. RESULTS: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). CONCLUSION: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.
Bone Transplantation ; Female ; Follow-Up Studies ; Head* ; Hip Joint ; Humans ; Male ; Necrosis* ; Prognosis* ; Radionuclide Imaging* ; Technetium Tc 99m Medronate ; Transplants*

Hemangiopericytoma is a rare vascular tumor arising from pericytes. The tumor usually develops in the skin or subcutaneous tissue, particularly in the extremities.4 pulmonary origin of hemangiopericytoma is known to be quite rare. It has the potential to become a highly malignant lesion, so wide excision is the treatment of choice. We present a case of primary malignant hemangiopericytoma of the lung and discuss the clinical symptoms, diagnosis, therapy and prognosis within the context of a brief review.
Diagnosis ; Hemangiopericytoma* ; Lung* ; Pericytes ; Prognosis ; Skin ; Subcutaneous Tissue

Local control is the important prognostic factor in cancer treatment because local control decrease the relative risk of metastatic spread and increse distant metastasis free survival. IORT is the modality which could increase local control without incressing complication, combined with curative operation. Eventhough we could achieve significant deacreased local failure by IORT and curative resection, it should not be committed as a main treatment modality without proving acceptable complications. Therapeutic Radiology Department of Yeungnam University Medical Center have tried 58 IORT from June 15, 1988, and performed 53 IORT in patients with gastric cancer. No local failure has been reporte? by regular follow up so far. Nine cases(17%) of treatment related complifaiton were reported including intestinal obstrution, hemorrhage, sepsis, and bone marrow depression. These complications could be comparable to Jo's 25.2% (chemotherapy + operation), Kim's 18% (chemotherapy only in inoperable patients), because our treatment regimen is consisted of IORT (1500 cGy), external irradiation(--4500 cGy) and extensive chemotherapy (FAM, 5FU+MMC, BACOP). Our data encouraged us to re-inforce further IORT in stomach cancer treatment.
Academic Medical Centers ; Bone Marrow ; Depression ; Drug Therapy ; Follow-Up Studies ; Hemorrhage ; Humans ; Neoplasm Metastasis ; Radiation Oncology ; Sepsis ; Stomach Neoplasms*

Total 28 patients with respectable, locally advanced gastric cancer were entered in our prospective randomized study from June 15, 1988 to Sep. 15, 1990 in Yeungnam University Hospital. This study consisted of curative resection, IORT, external irradiation and combination of chemotherapy. Twenty-four of 28 patients were treated with single dose of 1500 cGy per fraction, 5 days per week was started within 4th weeks postoperative days. Various chemotherapy with or without external irradiation were added for reducing hematogenous and/or peritoneal dissemination and determination of complication of each arm. Duration of follow up was 4~31 months. No serious complication related with radiation were reported compare to resection and chemotherapy only group. Although our follow up period is too short to draw any conclusion, IORT appears to improve local control, hopely further survival. Continuous follow up should be needed for evaluation of real therapeutic gain such as complication vs. improved survival.
Arm ; Drug Therapy ; Follow-Up Studies ; Hope ; Humans ; Prospective Studies ; Stomach Neoplasms*

Necrotizing pneumonia causes necrosis of pulmonary parenchyma and may lead to pulmonary gangrene. Prior to theantibiotic era, extensive pulmonary involvement was potentially fatal, but the incidence of necrotizing pneumoniais now less common. On contrast-enhanced CT scans, consolidation with contrast enhancement containing necroticfoci with low attenuation and cavities is characteristic. Radiologic findings do not differ according to thecausative organism and in most of cases, specific diagnosis may be impossible. Clinical findings and certaincharacteristic radiologic findings may be helpful for narrowing the differential diagnosis. We illustrate theclinical and radiologic characteristics of necrotizing pneumonia according to causative bacterial organisms.
Diagnosis ; Diagnosis, Differential ; Gangrene ; Incidence ; Necrosis ; Pneumonia* ; Tomography, X-Ray Computed

No abstract available.
Humans ; Pericardial Effusion*

Pulmonary epithelioid hemangioendothelioma (PEH), originally termed an intravacular bronchioloalveolar tumor, is a rare pulmonary neoplasm with a vascular origin and slow rate of malignancy. It affects various organs such as the liver, the central nervous system, lung, etc. Clinically, pulmonary epithelioid hemangioendothelioma has been considered to be a borderline malignancy, a generally indolent and nonaggressive tumor that displaes the pulomonary parenchyma over a number of years by slowly enlarging the tumor nodule. The clinical course of PEH is known to be usually benign. Here we report an unusual case of PEH that was highly malignant and was eventually fatal. The PEH was confirmed by microscopic analysis and hmmunohistochemical staining of CD31+(a membrane receptor and a sensitive and specific marker for vascular lesions) from an open lung biopsy specimen.
Biopsy ; Central Nervous System ; Hemangioendothelioma, Epithelioid* ; Liver ; Lung ; Lung Neoplasms ; Membranes

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks' gestation by ultra- sonography, so present the case and the review with literature briefly.
Congenital Abnormalities ; Ectopia Cordis* ; Heart ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Thorax