We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

The most common cause of chronic cutaneous sinus tract in the face and neck is chronically draining dental infection. The diagnosis is easily confirmed by dental examination and dental roentgenogram of the involved area, but this disease is frequently misdiagnosed and incorrectly treated in dermatologic department. We report four cases of cutaneous sinus tract of dental origin. First patient had a painful nodule with chronically draining pus and a dimple on the left cheek. Second patient had a dimple with draining bloody fluid on the right chin. Third patient had a pea-sized papule with draining serous fluid on the left chin. Fourth patient had a fluctuant erythematous plaque with draining pus and a dimple on the left buccal area. In all four patients radiologic examination of the maxillary and mandibular regions demonstrated radioluency at the apex of tooth consistent with periapical abscess.
Cheek ; Chin ; Diagnosis ; Humans ; Neck ; Periapical Abscess ; Suppuration ; Tooth

Purpura is discoloration of the skin and mucous membranes due to extravasation of red blood cells and may be due to a variety of factors, but it is sometimes difficult to identify the exact cause. Some forms of purpura can frighten the patient and puzzle the physician. Mask phenomenon is an unusual purpura of the relatively loose tissues of the face and neck occuring after prolonged coughing, vigorous vomiting, valsalva's maneuver, parturition, or any other exertion that raises intrathoracic or abdominal pressure. This occurs with acute onset and fades within twenty-four to seventy-two hours spontaneously. A work-up for a coagulation or platelet defect is usually not required. We herein describe five cases of mask phenomenon(unusual facial purpura).
Blood Platelets ; Cough ; Erythrocytes ; Humans ; Masks* ; Mucous Membrane ; Neck ; Parturition ; Purpura* ; Skin ; Valsalva Maneuver ; Vomiting

Purpura is discoloration of the skin and mucous membranes due to extravasation of red blood cells and may be due to a variety of factors, but it is sometimes difficult to identify the exact cause. Some forms of purpura can frighten the patient and puzzle the physician. Mask phenomenon is an unusual purpura of the relatively loose tissues of the face and neck occuring after prolonged coughing, vigorous vomiting, valsalva's maneuver, parturition, or any other exertion that raises intrathoracic or abdominal pressure. This occurs with acute onset and fades within twenty-four to seventy-two hours spontaneously. A work-up for a coagulation or platelet defect is usually not required. We herein describe five cases of mask phenomenon(unusual facial purpura).
Blood Platelets ; Cough ; Erythrocytes ; Humans ; Masks* ; Mucous Membrane ; Neck ; Parturition ; Purpura* ; Skin ; Valsalva Maneuver ; Vomiting

Intrahepatic sarcomatoid cholangiocarcinomais is a very rare disease with a poor prognosis due to its biologically aggressive tumor behavior. We report a patient who presented with subcapsular hemorrhage and a rapidly growing liver mass. A 57 year-old man was admitted with severe abdominal pain. CT and MRI images showed the presence of a 10 cm-sized subcapsular hemorrhage connected with a multi-lobulated mass with hemorrhage and necrotic foci in the right liver. The patients underwent right hemihepatectomy with caudate lobectomy and lymphadenectomy. The operation findings revealed metastatic nodules to the diaphragm and omentum. Detailed histopathological analysis through immunohistochemistry confirmed the diagnosis of sarcomatoid cholangiocarcinoma with a poorly undifferentiated sarcomatous component. The patient underwent chemotherapy. To date, the patient is doing well for 8 months after initial diagnosis.
Abdominal Pain ; Benzeneacetamides ; Cholangiocarcinoma ; Diaphragm ; Hematoma ; Hemorrhage ; Humans ; Immunohistochemistry ; Liver ; Lymph Node Excision ; Omentum ; Piperidones ; Prognosis ; Rare Diseases

PURPOSE: Attention Deficit Hyperactivity Disorder (ADHD) is known to be more common in children with epilepsy than in the general population. Thirty one to forty percent of ADHD is accompanied with epilepsy. Few studies regarding this matter have been reported in Korea. This study was aimed to evaluate the comorbidity of ADHD in children with epilepsy. METHODS: This is a two center based, retrospective and controlled study. Thirty four ADHD children with epilepsy from Chungbuk National University hospital and 38 ADHD children without epilepsy from Cheonju St. Mary's hospital were recruited from January 2005 to June 2010. RESULTS: In ADHD children with epilepsy, twelve (35.2%) had partial seizures, 11 (32.2%) did generalized seizures and 11 (32.2%) were unclassified. EEG abnormalities were found in the frontal lobe (15 cases), in the central lobe (7 cases), in the temporal lobe (6 cases), and in the occipital lobe (3 cases). In ADHD children with epilepsy, the combined type was major (76.4%) and in ADHD children without epilepsy, the inattentive type was major (50.5%) (P=0.004). Learning disability was mor common in ADHD with epilepsy than in ADHD without epilepsy (P=0.01). CONCLUSION: This study showed that ADHD children with epilepsy are more likely to have combined type (76.4%) and learning disability as compared with ADHD without epilepsy.
Attention Deficit Disorder with Hyperactivity ; Child ; Comorbidity ; Electroencephalography ; Epilepsy ; Frontal Lobe ; Humans ; Korea ; Learning Disorders ; Occipital Lobe ; Retrospective Studies ; Seizures ; Temporal Lobe

PURPOSE: The selection of systemic therapy for breast cancer is based on the expression pattern of biological prognostic markers. Neoadjuvant chemotherapy has been considered the standard care for locally advanced breast cancer. However, its effect on the expression of biological prognostic markers is controversial. The aim of this study was to determine whether neoadjuvant chemotherapy may alter these expression patterns in patients suffering with breast cancer. METHODS: We determined the protein expression levels of estrogen receptor (ER), progesterone receptor (PR), p53 and HER-2/neu in the preoperative core needle biopsies and the final surgical specimens from 15 patients who received neoadjuvant chemotherapy between January 2002 and June 2007. As a control group, we analyzed the samples from patients who did not receive neoadjuvant chemotherapy. RESULTS: The pathologic complete tumor response rate (pCR) of the neoadjuvant chemotherapy group was 6.7% (1/15). Of those patients who did not achieve a pCR (n=14), no significant differences in the biological prognostic markers expression were observed between the two groups. Alteration of the ER or PR status occurred in 42.8% (6/14) of the patients after neoadjuvant chemotherapy and in 14.3% (2/14) of the control patients, showing there was no significant difference between the two groups (P=0.210). The hormonal receptor status was changed in 3 cases (21.4%) after neoadjuvant chemotherapy. CONCLUSION: There were no significant differences for the changes in the expression of ER, PR, p53 and HER-2/neu from the preoperative core needle biopsy to the final surgical specimens between those patients who had received neoadjuvant chemotherapy and those patients who didn't. However, changes of the ER or PR status and the hormonal receptor status occurred in 42.8% and 21.4%, respectively, of the patients who underwent neoadjuvant chemotherapy. As these changes may impact treatment, we suggest that immunohistochemical assay is necessary before and after neoadjuvant chemotherapy in patients with breast cancer.
Biopsy, Large-Core Needle ; Breast ; Breast Neoplasms ; Estrogens ; Humans ; Polymerase Chain Reaction ; Receptors, Progesterone ; Stress, Psychological

PURPOSE: The selection of systemic therapy for breast cancer is based on the expression pattern of biological prognostic markers. Neoadjuvant chemotherapy has been considered the standard care for locally advanced breast cancer. However, its effect on the expression of biological prognostic markers is controversial. The aim of this study was to determine whether neoadjuvant chemotherapy may alter these expression patterns in patients suffering with breast cancer. METHODS: We determined the protein expression levels of estrogen receptor (ER), progesterone receptor (PR), p53 and HER-2/neu in the preoperative core needle biopsies and the final surgical specimens from 15 patients who received neoadjuvant chemotherapy between January 2002 and June 2007. As a control group, we analyzed the samples from patients who did not receive neoadjuvant chemotherapy. RESULTS: The pathologic complete tumor response rate (pCR) of the neoadjuvant chemotherapy group was 6.7% (1/15). Of those patients who did not achieve a pCR (n=14), no significant differences in the biological prognostic markers expression were observed between the two groups. Alteration of the ER or PR status occurred in 42.8% (6/14) of the patients after neoadjuvant chemotherapy and in 14.3% (2/14) of the control patients, showing there was no significant difference between the two groups (P=0.210). The hormonal receptor status was changed in 3 cases (21.4%) after neoadjuvant chemotherapy. CONCLUSION: There were no significant differences for the changes in the expression of ER, PR, p53 and HER-2/neu from the preoperative core needle biopsy to the final surgical specimens between those patients who had received neoadjuvant chemotherapy and those patients who didn't. However, changes of the ER or PR status and the hormonal receptor status occurred in 42.8% and 21.4%, respectively, of the patients who underwent neoadjuvant chemotherapy. As these changes may impact treatment, we suggest that immunohistochemical assay is necessary before and after neoadjuvant chemotherapy in patients with breast cancer.
Biopsy, Large-Core Needle ; Breast ; Breast Neoplasms ; Estrogens ; Humans ; Polymerase Chain Reaction ; Receptors, Progesterone ; Stress, Psychological

The developmental changes of the lingual salivary glands in the postnatal rats were examined by lectin histochemical methods. For the morphological changes, H-E and PAS staining were used. The biotinylated lectins used in the study were DBA, SBA, PNA, BSL-1, sWGA, RCA-1, UEA-1, Con A and LCA. The promordia and undifferentiated acini of the lingual glands were found in the mucous glands at 0 day suckling rat and the von Ebner's glands at 3 day suckling rat, respectively. The differentiation and maturation of the lingual glands were faster than those of the von Ebner's gland. The differentiation and proliferation of both glands were occurred remarkably at suckling periods rather than weaning periods. The lectin binding pattern of glandular promordia and undifferentiated serous acini in von Ebner's gland was weak in BSL-1 and weak to moderate in RCA-1. DBA and sWGA showed tendency to increase in 1 week suckling rat, but The binding reactivity of other lectins was disappeared except BSL-1 that was reacted tracely in 2 and 3 weak suckling and 4 week weaning rat. RCA-1, PNA, sWGA, BSL-1 and SBA of the differentiated serous acini were appeared in the 2 week suckling rat and SBA and sWGA was more intense. Especially, the reactivity of these lectins of suckling periods was showed more tendency to increase than that of weaning periods. The increase of PNA, SBA and BSL-1 was prominent during suckling and weaning periods. RCA-1 and sWGA were decreased in 5 week rat, increased in 6 week rat, and then decreased in adult rat. UEA-1 which was not shown from 0 day to 2 week was showed trace to moderate reactivity in some serous acini. Con A and PNA of glandular promordia and undifferentiated mucous acini were appeared trace or weak, and absent at 0 day suckling rat, but PNA reactivity was showed tendency to incerase at 3 day suckling rat. Other lectins of these promordia and acini were not showed reactivity. In the differentiated mucous acini at 0 day suckling rat, all mucous acini were weak to moderate with DBA, and some of mucous acini also were weak to moderate with BSL-1. Most mucous acini showed weak reactivity with SBA, but some mucous acini showed trace or weak reactivity with RCA, PNA, sWGA and BSL-1. The reactivity of BSL-1 and sWGA was increased from birth to 2 week and then decreased, and absent at 5 week. But it increased at 6 week. RCA-1 and PNA also increased in the acini up to 1 week. However, PNA reactivity was absent at 5 and 6 week. With RCA-1, the intensity of reactivity was increased. Differentiated mucous acini was reacted to increase with SBA from birth, the intensity was strong in weaning periods rather than suckling period. UEA-1 reactivity was showed to decrease from 1 week to 2 week and moderately increased from 3 week to 5 week, and thereafter decreased. DBA binding pattern was somewhat changed throughout the observation periods but it was predominent.
Adult ; Animals ; Glycoconjugates* ; Humans ; Lectins ; Parturition ; Rats* ; Salivary Glands* ; von Ebner Glands ; Weaning

The diagnosis of acute pancreatitis occurred in CAPD patients is quite difficult due to its clinical similarity with acute peritonitis. Delayed diagnosis and treatment of acute pancreatitis in CAPD patients may result in fatal complication. We experienced a case of acute pancreatitis in a CAPD patient. A 62 years old female visited the hospital with acute abdominal pain and cloudy effluent for 3 days. She has been on CAPD for 3 years and had two episodes of peritonitis at 6 months and 1 year before the admission. The causative organism was Streptococcus viridans in each episode. The peritonitis symptoms and peritoneal leukocyte count incresed despite of using Vancomycin(R) and Netilmicin(R). Causative organism was not isolated from dialysis. Serum amylase concentrations increased from 105mg/dL at the admission to 1,052mg/dL on day 10 of admission. Abdominal ultrasonography and abdominal computerized tomogram revealed fat infiltration, focal necrosis and multiple cyst formation at pancreas area. Computerized tomogram guided aspiration cytology revealed acute inflammation and necrosis. Bacteria were not found in the aspirate. Clinical symptoms were improved after discontinuation of CAPD and intraperitoneal use of antibiotics. The patient restarted CAPD on the day 18 and remained without complications. We report this case with a brief review of literatures.
Abdominal Pain ; Amylases ; Anti-Bacterial Agents ; Bacteria ; Delayed Diagnosis ; Diagnosis ; Dialysis ; Female ; Humans ; Inflammation ; Leukocyte Count ; Middle Aged ; Necrosis ; Pancreas ; Pancreatitis* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Renal Dialysis ; Ultrasonography ; Viridans Streptococci