Nesidioblastosis, also known as persistent hyperinsulinemic hypoglycemia of infancy(PHHI) or familial hyperinsulinsm, is the most common cause of recurrent severe hypoglycemia in infancy. It is an autosomal recessive disorder characterized by irregular insulin secretion leading to inappropriately raised plasma insulin concentration compared to blood glucose levels. Recently, mutations in the sulfonylurea receptor(SUR) have been described in association with PHHI. The mainstay of medical treatment is glucose infusion and diazoxide or long acting somatostatin. If medical treatment fails in preventing hypoglycemia, near total pancreatectomy is recommended. We report one case of nesidioblastosis cured by near total pancreatectomy with brief review of literatures.
Blood Glucose ; Congenital Hyperinsulinism* ; Diazoxide ; Glucose ; Humans ; Hypoglycemia ; Infant, Newborn* ; Insulin ; Nesidioblastosis* ; Pancreatectomy ; Plasma ; Somatostatin

PURPOSE: To determine the significance of anomalous position of the gallbladder. MATERIALS AND METHODS: Sixteen patients with anomalous position of the gallbladder were evaluated for analysis. The diagnosis was confirmed by ultrasonography(15 patients) and oral cholecystography(1patient). Among those, six patients underwent CT scan and a patient had 99mTc-DISIDA scan. The images were analysed with respect to the location of the GB and configuration and associated abnormality of the liver and hepatobiliary systems. Medical records of each patient were also reviewed. RESULTS: Among 16 patients having an anomalous position of the gallbladder, nine had retrodisplaced gallbladder, four had left-sided gallbaldder, two had suprahepatic gallbladder, and one had floating gallbladder. Except for one patient, fifteen had abnormality in the liver such as focal atrophic or hypoplastic change and liver cirrhosis. Intrahepatic stones were demonstrated in 6 patients. CONCLUSION: Our results showed that anomalous position of the gallbladder was commonly associated with atrophy or hypoplasia of the liver rather than congenital in origin. The possiblity of an anomalous location of gallbladder should be kept in mind when GB is not in its normal location.
Atrophy ; Diagnosis ; Gallbladder* ; Humans ; Liver ; Liver Cirrhosis ; Medical Records ; Technetium Tc 99m Disofenin ; Tomography, X-Ray Computed

BACKGROUND: Human hair usually emerges from the scalp in groups of 2 or 3-hair units. Hair densities and grouping patterns in androgenetic alopecia (AGA) patients are known to be different from those in normal adults, but no comparative study has ever before been made in Korea. Therefore we have developed some technical improvements on phototrichogram methodology to evaluate the differences between these two groups. BACKGROUND: Objectives: This study was performed to quantify Koreans' hair characteristics at each site (vertex, occipital, temporal) of the scalp according to the age and to compare the differences of hair characteristics of AGA and normal adults using phototrichogram. METHODS: Hairs in the precisely defined circle at each (vertex, temporal, occipital) site of the scalp in 37 AGA male patients and 15 healthy male volunteers were evaluated according to age. Each circumscribed area of the scalp, centered with a dot tattoo to ensure reproducibility, was photographed just after shaving, and named 'primary image'. Two days later, the same area was again photographed, and named 'secondary image', from which the hair density and the grouping pattern of hair follicular units were determined by the image analyzer program. RESULTS: The results can be summarized as follows: 1. In normal adult males, the range of hair density was 117~13/cm2~140~16/cm2, with the hair density of the occiput being significantly higher than that of the temple. No significant differences in hair density were shown between vertex and occiput. 2. In AGA male patients, the range of hair density was 102~23/cm2-137~17/cm2, and the differences of the hair density between vertex and occiput were statistically significant. 3. The numbers of grouped hair units per square centimeter in the non-bald adult male group ranged from 59~11/cm2 to 73~14/cm2. The most common grouped hair unit was a 2-hair unit, followed by a 1-hair unit and a 3-hair unit group. 4. In the AGA group, the numbers of grouped hair units per square centimeter ranged from 57~6/cm2 to 72~12/cm2, showing no significance with the control group. The most common grouped hair unit was a 1-hair unit, followed by a 2-hair unit and a 3-hair unit group. CONCLUSIONS: The AGA group compared remarkably with the normal adult male group, showing a lower hair density with a larger proportion of 1-grouped hair units. Based on the data about hair density and hair grouping patterns in AGA patients, surgeons can estimate the area of donor scalp with the most probable number of follicular units in hair trans-plantation procedures.
Adult ; Alopecia* ; Hair* ; Humans ; Korea ; Male ; Scalp* ; Tissue Donors ; Volunteers

No abstract available.
Female ; Laparoscopy* ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

Bromidrosis is a disorder characterized by rancid body odor which influences a patient's social life and mental health. The therapeutic modalities and the mechanism of bromidrosis have been carefully studied, however, there have been few reports about the genetic inheritance of bromidrosis. We investigated the family history of 42 patients who were operated on for bromidrosis and followed up to the third generation in 10 cases. The results were as follows: Results of investigation which were followed up the second generation. The fathers of five patients and the mothers of 11 patients had bromidrosis in 18 male patients. The fathers of six patients and the mothers of 12 patients had bromidrosis in 24 female patients. Thirty-four patient (81.0%) among a total of 42 have a single parent with bromidrosis. Result of investigation which were followed up to the third generation Bromidrosis was occurred in 17 of 42 patients (40.5%) in the second generation, and 18 of 27 patients (66.7%) in the third generation. In one case, a father transmitted bromidrosis to his three sons, and as a result, X-linked inheritance could be ruled out Bromidrosis was not skipped in every generation of all families. We on conclude that bromidrosis is an autosomal dominant inherited disorder.
Fathers ; Female ; Genes, X-Linked ; Humans ; Male ; Mental Health ; Mothers ; Odors ; Single Parent ; Wills*

The purpose of this study is to evaluate the stress distribution in the bone around dental implants supporting mandibular overdenture according to the number of implant and the type of attachment. Two or four implants were placed in an edentulous mandibular model and three dimensional photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure and also to calculate principle stress components at cervical area of each implant. The attachments tested were rigid and resilient type of Dolder bar, Round bar, Hader bar and Dal-Ro attachment. The results were as follows; 1. In 2-implant supported overdenture using Round bar, Hader bar, and Dal-Ro attachment, compressive stress pattern was observed on the supporting structure of implant on loaded side, while tensile stress pattern in unloaded side. 2. In 2-implant supported overdenture using Dolder bar, the rigid Dolder bar shared the occlusal loads between 2 implants in a more favorable manner than was exhibited by the resilient type, while the resilient type placed a more stress on the distocervical area of the implant on the loaded side. But compressive stress pattern was observed in both the loaded and unloaded sides in either case. 3. In 2-implant supported overdenture, rigid and resilient type of Dolder bar exhibited more cross arch involvement than the Round bar, Hader bar, or Dal-Ro attachment. 4. In 4-implant supported overdenture using resilient Dolder bar and Hader bar, stress turned out to be distributed evenly among the implants between loaded and unloaded side, but ther was no reduction in the magnitude of the stress in the surrounding structure of implant contratry to 2-implant supported overdenture.. 5. The stress pattern at cervical area of implant was different with the number of implant or the type of attachment but the overload, harmful to surrounding structure of implant, was not observed.
Dental Implants ; Denture, Overlay*

We treated a case of extramammary Paget's disease that affected the scalp of a 45-year-old female. It is extremely rare that the disease arises in areas other than the anogenital region and the axillae. The lesion was a round erythematous oozing crusted hairless patch. Histopathologically, many pagetoid cells were found within the epidermis and dermis. The cytoplasms of these cells stained with alcian blue at pH 2.5, CEA, EMA and low-molecular-weight-cytokeratin. The patient underwent a wide local excision. We used a mapping technique to reveal the distribution of microscopically involved lesions.
Alcian Blue ; Axilla ; Cytoplasm ; Dermis ; Epidermis ; Female ; Humans ; Hydrogen-Ion Concentration ; Middle Aged ; Paget Disease, Extramammary* ; Scalp*

BACKGROUND: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. METHODS: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged > or =40 years. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. RESULTS: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. CONCLUSIONS: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.
Arthrography ; Arthroscopy ; California ; Elbow ; Follow-Up Studies ; Humans ; Patient Selection ; Range of Motion, Articular ; Shoulder ; Visual Analog Scale

A 28-year-old female devei,oped five rice-sized erythematous telaniectatic solid papules of her left side of cheek and numerous light brownish flat papules of her face two years before visiting our department of dermatology. Biopsy results of the erythematous papule vere dermal infiltration by well-differentiated, however, somewhat atypical and varying sized plasma cells involving epidermis, and the flat papule was that of verwca plana. Bone marrow aspirate was essentially normal. Primary cutaneous plasmacytoma is a rare disease. A significant proportion of patients with this ent on to develop systemic disease with a poor prognosis. Our patient was not treatead, bit only excised partially for biopsy. All skin lesions involuted two years later spontaneously and rema ns well until now six years later without recurring.
Adult ; Biopsy ; Bone Marrow ; Cheek ; Dermatology ; Epidermis ; Female ; Humans ; Plasma Cells ; Plasmacytoma* ; Prognosis ; Rare Diseases ; Skin