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*

No abstract available.

PURPOSE: This study evaluated the efficacy for preventing venous thromboembolism (VTE) and adverse effects of low-molecular-weight heparin (LMWH) in order to launch a prospective clinical trial in Korea. METHODS: We reviewed the medical records of 108 consecutive patients who underwent gastric cancer surgery. These patients were divided into 2 groups according to the type of thromboprophylaxis: group A, LMWH combined with intermittent pneumatic compression (IPC); group B, IPC alone. The postoperative outcomes of the two groups were compared. RESULTS: Symptomatic VTE was observed in only 1 patient (0.9%) from group B. Postoperative bleeding was more common in group A than in group B (10.9% vs. 7.5%), although the difference was not significant (P = 0.055). Most bleeding episodes were minor and managed conservatively without intervention. Only a high body mass index was associated with a significantly increased risk of postoperative bleeding (odds ratio, 1.45; 95% confidence interval, 1.12-2.43; P = 0.051). CONCLUSION: A 40 mg of enoxaparin sodium is a safe and feasible dose for prevention of VTE. With the results of this study, we are planning a prospective randomized clinical trial to investigate the clinical efficacy of LMWH thromboprophylaxis in gastric cancer patients in Korea.
Body Mass Index ; Enoxaparin ; Hemorrhage ; Heparin* ; Heparin, Low-Molecular-Weight ; Humans ; Korea ; Medical Records ; Prospective Studies ; Sodium ; Stomach Neoplasms* ; Thromboembolism ; Venous Thromboembolism

No abstract available.
Colorectal Neoplasms*

PURPOSE: Although many studies on the clinicopathological characteristics of signet ring cell (SRC) carcinoma of the stomach have been made, there is no consistent report of the characteristics and prognosis of this condition. In this study, the clinicopathological features and prognosis of patients with SRC and non-SRC gastric cancer were compared. METHODS: Between 1990 and 2002, 1,884 patients, who underwent a curative resection for gastric cancer in our hospital, were analyzed retrospectively. Among them, 185 (9.8%) patients with SRC were compared with 1,699 (90.2%) patients with non-SRC. RESULTS: SRC in gastric cancer was found more commonly in younger patients and women. The depth of the invasion in the SRC patients was less invasive and a lymph node metastasis is less frequent. A higher frequency of the depressed gross type and middle third tumor location in SRC are similar characteristics of the undifferentiated type of gastric cancer. However, SRC in EGC have similar characteristics to the differentiated type of gastric cancer such as a higher rate of mucosa-confined tumors and less frequent lymph node metastasis. The five-year survival rate of SRC in AGC was similar to that of other pathologic types, and the pathologic type does not influence the survival rate. CONCLUSION: SRC patient in EGC should be considered as a differentiated type. Therefore, the mucosa confined tumor and less frequent lymph node metastases are expected.
Carcinoma, Signet Ring Cell* ; Female ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Pathology ; Prognosis ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate