Infantile onset diabetes mellitus(especially, neonatal diabetes) is rare disorder and may be transient or permanent. Most patients are full-term but small-for-date infants and typical symptoms occur within the first 4-6 weeks of life, requiring insulin therapy. Neonatal diabetes differs from type 1 diabetes in many aspects and seems to form a distinct entity of inborn pancreatic malfunction. The transient cases often develop type 2 diabetes mellitus later in life. In recent reports, transient neonatal diabetes is associated with paternal uniparental isodisomy and unbalanced duplication of chromosome 6q22-23. In our study, clinical course of case 1 was compatible with transient neonatal diabetes, but chromosomal abnormalities such as above was not shown in DNA analysis. In case 2 and 3, we could not decide exactly on genetic basis.
Chromosome Aberrations ; Diabetes Mellitus, Type 1* ; Diabetes Mellitus, Type 2 ; DNA ; Genomic Imprinting* ; Humans ; Infant ; Insulin ; Uniparental Disomy

OBJECTIVE: The objective of this study was to determine the relationship between the fetal doppler flow velocimetry and birth weight in low risk pregnancy population. METHODS: From December 1995 to May 1996, We prospectively performed doppler study in 254 uncomplicated, term pregnant women, who visited Pohang Hospital, Dongguk University. Using pulsed color doppler, we measured umbilical artery RI, middle cerebral artery RI and middle cerebral-umbilical artery RI ratio within one week before delivery. RESULTS: The result was that low birth weight group (below 2500gm) had very significant lationship with umbilical artery RI(P<0.01), middle cerebral artery RI(P<0.05) and middle cerebral-umbilical artery RI ratio(P<0.05), but there was no significant relationship in these blood flow indices between normal birth weight group (2501gm- 3999gm) and macrosomia group (above 4000gm). CONCLUSIONS: We concluded that application of doppler ultrasonopaphy in the assessment of fetal weight is somewhat helpful for identification of low birth weight, not for macrosomia.
Arteries ; Birth Weight ; Female ; Fetal Weight* ; Gyeongsangbuk-do ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Middle Cerebral Artery ; Pregnancy ; Pregnant Women ; Prospective Studies ; Rheology ; Ultrasonography* ; Umbilical Arteries

OBJECTIVE: This study is to analyze the direct effects of hyperprolactinemia, cause of anovulation and infertility, on ovarian function. METHODS: The prepubertal female Sprague-Dawley (SD) rats were obtained and ovulation was induced with PMSG and hCG s.c.. The rats were divided into four groups, which received the following treatments IP : saline 0.2 ml, 150 ug PRL, 300 ug PRL, 300 ug PRL plus 300 ug naloxone. The animals were killed and the oviducts were evaluated for the presence of ova. The ovary were then removed and evaluated under light microscopy. For changes of follicular t-PA and PGE2 concentration after PRL, immature female SD rats were stimulated as described above. At four hours after the hCG injection the rats were killed and the ovaried were removed. Each isolated ovaries were incubated in culture plate containing incubation medium or 300 ng PRL to be tested. And PRL plus gonadotropin in incubation medium was tested because of change of PGE2 concentration. After incubation period, t-PA and PGE2 were measured by EIA. Differences between groups were assessed by two-way ANOVA of variance followed Mann-Whitney U test or Kruskal-Wallis test for multiple comparisons. p<0.05 was considered statistically significant. RESULTS: As result, prolactin transiently suppresses ovulation, especially with its increased concentration not by altering the ovarian morphology. But ovulation inhibition was reversed by naloxone injection. The level of t-PA in control and prolactin-treated group increased steadily in response to human chorionic gonadotropin administration, yet lower in prolactin-treated group. But PGE2 concentration was increased in gonadotropin mixed groups but not affected in prolactin-treated group despite a significant blockade of ovulation. CONCLUSION: Thus, further studies on the effect of high level prolactin on ovulatory function would significantly contribute toward the patient with hyperprolactinemia for managing infertility and maintaining appropriate female reproductive function.
Animals ; Anovulation ; Chorionic Gonadotropin ; Dinoprostone* ; Female ; Gonadotropins ; Humans ; Hyperprolactinemia ; Infertility ; Microscopy ; Naloxone ; Ovary ; Oviducts ; Ovulation ; Ovulation Inhibition ; Ovum ; Prolactin* ; Rats* ; Rats, Sprague-Dawley

We have used mivacurium in two myasthenic patients, a generalized myasthenia gravis (MG) patient presenting for thymectomy and a Lambert-Eaton myasthenic (LEM) patient for mediastinoscopic lymph node biopsy. Both of them received nitrous oxide/oxygen (1:1)-narcotic-enflurane anesthesia with mivacurium as a muscle relaxant and the neuromuscular blocking effect of mivacurium was monitored continuously through the operation as well as before the induction of anesthesia. The dose of mivacurium for MG patient was 5.5 mg and LEM patient was 12 mg, because MG patient showed more severe clinical symptoms. The response to train-of-four (TOF) ulnar nerve stimulation was recorded using accelography. The onset times to maximal block in MG and LEM patients were 30 and 120 sec, respectively after injection and the recovery times to 25% from maximal block were 117 and 76 min, respectively. Mivacrium would be safe and appropriate for use in myasthenic patients, with relatively small dose under the neuromuscular monitoring.
Anesthesia ; Biopsy ; Humans ; Kinetocardiography ; Lymph Nodes ; Myasthenia Gravis ; Neuromuscular Blockade ; Neuromuscular Monitoring ; Thymectomy ; Ulnar Nerve

OBJECTIVE: The current understanding reveals that chronic subdural hematoma (CSDH) is mostly the results of direct or indirect head trauma. Other factors such as alcoholism, medication (such as anticoagulants or antiplatelet agents), liver cirrhosis, chronic renal failure and hematologic disease are also well known as causes of CSDH. Of them, the authors attempted to identify the risk factors of CSDH by focusing on the age with a view point of recent increase in the elderly population. METHODS: We retrospectively reviewed 216 consecutive CSDH patients who underwent surgery at our institute between 2002 and 2011. We classified them into two groups according to the patients' age (Group A: <65 years old, Group B: > or =65 years old). Various factors were investigated for risk factor of CSDH, such as head trauma, chronic alcoholism, epilepsy, previous shunt surgery, underlying disease having bleeding tendency or medication affecting blood coagulation. And these factors were compared between the two groups for statistical significance. RESULTS: Among the 216 patients, group A included 81 patients (37.5%), group B included 135 patients (62.5%). The medication of group B had significantly more proportion than group A, comparing to the result that group B had relatively less proportion of head trauma and alcoholism (p<0.05). And medication was more associated with non-traumatic CSDH, especially in group B. CONCLUSION: As previously reported, head trauma or alcoholism are also most important causes as a risk factor of CSDH of all ages in our study. But medication is more closely related to the incidence of CSDH in group A, than group B.
Aged ; Alcoholism ; Anticoagulants ; Blood Coagulation ; Craniocerebral Trauma ; Epilepsy ; Hematologic Diseases ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Incidence ; Kidney Failure, Chronic ; Liver Cirrhosis ; Retrospective Studies ; Risk Factors

Mayer-Rokitansky-Kster-Hauser Syndrome is characterized by the absence of the vagina and uterus, the presence of apparently normal tubes and ovaries, feminine appeara-nce, normal female secondary sexual characteristics, a normal 46,XX karyotype, and a fem-inine psychosexual orientation. Various methods of surgical treatment have been introduced, but the ideal method is still not found. The two cases reviewed in this paper were all treated with McIndoe operation using full thickness skin graft. Both women were satisfied with vaginal depth and excellent result was achieved. We report two vaginoplasties in patients of Mayer-Rokitansky-Kster-Hauser Syndr- ome including a brief review of literature.
Female ; Humans ; Karyotype ; Ovary ; Skin ; Transplants ; Uterus ; Vagina

PURPOSE: The aim of this study was to investigate the effects of grooved abutments on abutment screw loosening. MATERIALS AND METHODS: This study was conducted to evaluate the abutment screw loosening after 6 months for 50 patients (51 implants) treated at the department of Prosthodontics in Yonsei University Dental Hospital from March, 2015 to July, 2015. A control group with non-grooved abutment consists of 30 implants, and an experimental group with grooved abutment consists of 21 implants. Astra, Straumann, Implantium, Osstem system were used in the study. The abutments with loose screws cases after a period of 6 months has been investigated, with two kinds of measurements: 1) measuring the additional rotational angle on abutment during placement with the same force, 2) measuring the PTV on bucco-cervical area of implant crown. All data collected has been analyzed by normality test followed by Mann-Whitney test using SPSS program. RESULTS: No complications were reported after 6 months for the 51 implants. Abutment screw loose and crown fracture have not been seen in the study groups. The data collected from the two measurements showed no significant differences between the two groups with P-value 0.576 (average= control group: 7.35°, experimental group: 4.75°) for the additional rotational angle measurement and with P-value 0.767 for PTV. CONCLUSION: There are no significant differences between the grooved and non-grooved abutment in screw stability. However, further studies with long-term follow-ups and larger group of patients is needed in order to investigate the effects of grooved abutment on screw stability.
Crowns ; Follow-Up Studies ; Humans ; Prosthodontics

We report a rare case of Williams syndrome accompanying moyamoya disease in whom postoperative global cerebral infarction occurred unpredictably. Williams syndrome is an uncommon hereditary disorder associated with the connective tissue abnormalities and cardiovascular disease. To our knowledge, our case report is the second case of Williams syndrome accompanying moyamoya disease. A 9-year-old boy was presented with right hemiparesis after second operation for coarctation of aorta. He was diagnosed as having Williams syndrome at the age of 1 year. Brain MRI showed left cerebral cortical infarction, and angiography showed severe stenosis of bilateral internal carotid arteries and moyamoya vessels. To reduce the risk of furthermore cerebral infarction, we performed indirect anastomosis successfully. Postoperatively, the patient recovered well, but at postoperative third day, without any unusual predictive abnormal findings the patient's pupils were suddenly dilated. Brain CT showed the global cerebral infarction. Despite of vigorous treatment, the patient was not recovered and fell in brain death one week later. We suggest that in this kind of labile patient with Williams syndrome accompanying moyamoya disease, postoperative sedation should be done with more thorough strict patient monitoring than usual moyamoya patients. Also, we should decide the revascularization surgery more cautiously than usual moyamoya disease. The possibility of unpredictable postoperative ischemic complication should be kept in mind.
Angiography ; Aortic Coarctation ; Brain ; Brain Death ; Cardiovascular Diseases ; Carotid Artery, Internal ; Cerebral Infarction* ; Child ; Connective Tissue ; Constriction, Pathologic ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Monitoring, Physiologic ; Moyamoya Disease* ; Paresis ; Pupil ; Williams Syndrome*

A case of gonadoblastoma with dysgerminoma and choriocarcinoma in the right ovary of a 23-year-old woman is reported. A case of gonadoblastoma without a Y chromosome is very rare. She had a 46XX chromosomes, normal genitalia, no history of menstrual irregularities, thereby differing from the other reproted case. The patient had a normal term pregnancy 2 years after surgery and chemotherapy. It is suggested that gonadoblastoma may occur in functionally and morphologically normal gonads. There have been no signs of recurrence or metastasis for 3 years after the first operation.
Choriocarcinoma* ; Drug Therapy ; Dysgerminoma* ; Female ; Genitalia ; Gonadoblastoma* ; Gonads ; Humans ; Karyotype* ; Neoplasm Metastasis ; Ovary* ; Pregnancy ; Recurrence ; Y Chromosome ; Young Adult

OBJECTIVE: Chronic subdural hematoma (CSDH) is a typical disease that is encountered frequently in neurosurgical practice. The medications which could cause coagulopathies were known as one of the risk factors of CSDH, such as anticoagulants (ACs) and antiplatelet agents (APs). Recently, the number of patients who are treated with ACs/APs is increasing, especially in the elderly population. With widespread use of these drugs, there is a need to study the changes in risk factors of CSDH patients. METHODS: We retrospectively reviewed 290 CSDH patients who underwent surgery at our institute between 1996 and 2010. We classified them into three groups according to the time of presentation (Group A : the remote period group, 1996-2000, Group B : the past period group, 2001-2005, and Group C : the recent period group, 2006-2010). Also, we performed the comparative analysis of independent risk factors between three groups. RESULTS: Among the 290 patients, Group A included 71 patients (24.5%), Group B included 98 patients (33.8%) and Group C included 121 patients (41.7%). Three patients (4.2%) in Group A had a history of receiving ACs/APs, 8 patients (8.2%) in Group B, and 19 patients (15.7%) in Group C. Other factors such as head trauma, alcoholism, epilepsy, previous neurosurgery and underlying disease having bleeding tendency were also evaluated. In ACs/APs related cause of CSDH in Group C, significantly less proportion of the patients are associated with trauma or alcohol compared to the non-medication group. CONCLUSION: In this study, the authors concluded that ACs/APs have more importance as a risk factor of CSDH in the recent period compared to the past. Therefore, doctors should prescribe these medications carefully balancing the potential risk and benefit.
Aged ; Alcoholism ; Anticoagulants ; Craniocerebral Trauma ; Epilepsy ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Neurosurgery ; Platelet Aggregation Inhibitors ; Retrospective Studies ; Risk Factors