Atopic dermatitis (AD) is believed to be associated with the intake of antioxidant nutrients and fatty acids due to its immunological dysfunction. The purpose of this study was to examine the effects of nutrition education promoting vegetable, fruit, and fish intake on the severity of AD in children. Children with AD aged 6 months to 5 years were randomly assigned into education and control groups, and followed for 1 year. Seventy-six children completed the study (38 for control, 38 for education). The education group received education promoting the intakes of antioxidant-rich foods (vegetables, fruits) and n-3 fatty acid foods (fish). A 24-hour food recall was collected for the diet information. After education, all vegetables (p < 0.001), fruits (p < 0.01), and fish (p < 0.05) intakes per 1000 kcal increased significantly in the education group, whereas only vegetable intake increased in the control group (p < 0.001). The SCORAD index, the severity of atopic dermatitis, decreased significantly in the education group (p < 0.05). Increased consumption of dietary vitamin E was significantly associated with reduction in the SCORAD index, after adjusting for age and gender (p < 0.05). A nutritional education program to increase vegetable, fruit, and fish intake may be effective in reducing the severity of AD, and vitamin E intake may be associated with the decreased severity of AD. More controlled studies on the relationship between these intakes and severity of AD, with intensive diet and/or supplement intervention programs, are needed to obtain conclusive results.
Child* ; Dermatitis, Atopic* ; Diet ; Education* ; Fatty Acids ; Follow-Up Studies* ; Fruit* ; Humans ; Vegetables* ; Vitamin E ; Vitamins

OBJECTIVES: Due to the complex anatomy and function of the head and neck region, the reconstruction of ablative defects in this area is challenging. In addition, an increasing interest in improving the quality of life of patients and achieving good functional results has highlighted the importance of free flaps. The aim of this study was to summarize the results of free flap reconstruction and salvage of free flaps in a single institute, and to analyze differences in the results by the flap donor site, recipient site, and learning curve. METHODS: The medical records of patients who underwent free flap reconstruction from 2004-2012 were reviewed retrospectively. One hundred and fifty free flaps were used in 134 patients, who had an average age of 57.7 years. The types of flaps applied, primary defect sites, success rates, results of salvage operations for compromised flap, and the learning curve were analyzed. RESULTS: The anterolateral thigh flap was preferred for the reconstruction of head and neck defects. The overall success rate was 90.7%, with 14 cases of failure. A total of 19 salvage operations (12.7%) for compromised flap were performed, and 12 flaps (63.2%) were salvaged successfully. Dependency on the facial vessels as recipient vessels was statistically different when oral and oropharyngeal defects were compared to hypopharyngeal and laryngeal defects. The learning curve for microvascular surgery showed decrease in the failure rate after 50 cases. CONCLUSION: The free flap technique is safe but involves a significant learning period and requires careful postoperative monitoring of the patient. Early intervention is important for the salvage of free flaps and for lowering the failure rate.
Early Intervention (Education) ; Free Tissue Flaps* ; Head and Neck Neoplasms ; Head* ; Humans ; Learning ; Learning Curve ; Medical Records ; Neck* ; Quality of Life ; Reoperation ; Retrospective Studies ; Thigh ; Tissue Donors

The prevalence of atopic dermatitis (AD), chronic cutaneous disease, has increased rapidly worldwide. Since AD is the most common disease affecting infants, maternal food intake during pregnancy as well as lactation is important. The purpose of this research was to examine the difference in maternal food intake during pregnancy between mothers having children with or without AD. One hundred forty-eight mothers with children aged under 2 years with AD (AD group, n=74) or without AD (non-AD group, n=74) were included in the study. Diet during pregnancy was examined using a food frequency questionnaire. There were no differences in the status of mothers' food consumption during pregnancy between the AD and non-AD groups. Mothers in the AD group consumed significantly less white fish (P<0.05), carrot & pumpkin (P<0.01), walnut & pine nut (P<0.05), mandarin & orange (P<0.05), and peach (P<0.05) than those in the non-AD group. As food frequencies were categorized according to <1/month, 1~3/month, 1~6/week, and 1~3/day, lower consumption of carrot & pumpkin (Odds Ratio (OR)=6.67, 95% Confidence Interval (CI)=1.98~22.44), tomato (OR=5.11, 95% CI=1.62~16.08), mandarin & orange (OR=8.64, 95% CI=1.59~46.81), and walnut & pine nut (OR=3.85, 95% CI=1.26~11.77) increased the risk of childhood AD. According to the results, maternal food intakes during pregnancy were significantly different between the AD and non-AD groups. Therefore, further studies are necessary to examine the causal relationship between maternal food intake and prevalence of AD in children.
Aged ; Child ; Citrus sinensis ; Cucurbita ; Daucus carota ; Dermatitis, Atopic ; Diet ; Eating ; Female ; Humans ; Infant ; Juglans ; Lactation ; Lycopersicon esculentum ; Mothers ; Nuts ; Pregnancy ; Prevalence ; Prunus persica ; Surveys and Questionnaires

Multiple myeloma is a clonal B-cell tumor of slowly proliferating plasma cells within the bone marrow. It is a relatively well known disease, but temporal bone involvements have rarely been reported. It is not easy to diagnose multiple myeloma of the temporal bone in the early stage, since it presents with general, nonspecific otologic symptoms and pathologic confirmation in the temporal bone is difficult. Multiple myeloma involving the temporal bone area is considered to be in its terminal stage, but the treatment strategy is the same as that for conventional multiple myeloma involving other organs. We experienced a case of facial palsy had suddenly developed and was later diagnosed with multiple myeloma after a pathologic review and systemic evaluation. Herein we report this rare case with a review of literature.
B-Lymphocytes ; Bone Marrow ; Facial Nerve ; Facial Paralysis ; Multiple Myeloma ; Paralysis ; Plasma Cells ; Temporal Bone

The prevalence of Atopic Dermatitis (AD), a non-infective chronic inflammatory skin disease, is increasing worldwide. Avoiding the allergen is the basic principle in the treatment of AD. However, when the allergen is food, excessive restriction can lead to nutrition deficiency. The objective of the study was to examine the status of the dietary restriction and compare the caregiver's restriction practice with doctor's recommendation in Korean children with AD. A total of 158 children diagnosed with Atopic Dermatitis were recruited for this study. Information about foods that aggravate AD symptoms and food restriction were collected from the mothers of 158 children aged 6 month-5 year with AD using questionnaires. Food restriction recommendation by doctor was collected through medical chart. McNemar and Margianl homogeneity tests were used to detect a relationship between food restriction recommended by doctor and current practice by mother. There were significant proportion differences of food restriction for each food between by doctor and mother. We found 75.9% of children were avoiding eggs although only 61.4% were recommended for egg restriction by a doctor. Children with restriction of more than 4 kinds of food were 53.2% compared to 13.3% by doctor. Excessive restrictors tended to be younger and diagnosed at younger age. The caregivers of excessive restrictors had trends of "being older" and "having higher income". Avoidance of common foods in children without food allergy could result in malnutrition or impaired growth. Nutrition education is needed for sound practice and nutrition care in children with Atopic Dermatitis as well as interactive communication between caregivers and experts.
Aged ; Caregivers ; Child ; Dermatitis, Atopic ; Eggs ; Food Hypersensitivity ; Humans ; Malnutrition ; Mothers ; Ovum ; Prevalence ; Surveys and Questionnaires ; Skin Diseases

PURPOSE: Extraosseous Ewing's sarcoma (EOE) of the rectum is extremely rare: only three cases have been reported in the literature and none of these reports described their imaging findings in detail. Herein, we describe the tumor imaging and pathological features in detail. MATERIALS AND METHODS: We report a case of rectal EOE in a 72-year-old female who received local excision and was provisionally diagnosed with a rectal submucosal spindle cell tumor. We used immunohistochemistry, histopathology, and fluorescence in situ hybridization to characterize the tumor and provide a definitive diagnosis of EOE. RESULTS: MRI revealed a well-demarcated submucosal tumor with heterogeneous enhancement and hemorrhagic foci in rectum. EOE was diagnosed by positive staining of tumor cells for CD99 and Fli-1 by immunohistochemistry and the presence of the EWSR1 gene translocation by fluorescence in situ hybridization. Although the patient underwent radiation treatment and surgery, the tumor recurred after 4 months as revealed by computed tomography and magnetic resonance imaging. CONCLUSION: Rectal EOE may present as a rectal submucosal tumor. The understanding of imaging and histological characteristics of this tumor are critical for accurate diagnosis and appropriate aggressive treatment.
Aged ; Diagnosis ; Female ; Fluorescence ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Magnetic Resonance Imaging ; Rectum ; Sarcoma, Ewing*

BACKGROUND: The diseases that cause neonatal cholestasis display several overlapping clinical feature. Making the differential diagnosis using liver biopsy specimens from infants with neonatal cholestasis is important for delivering the proper treatment. METHODS: We assessed the clinical manifestations, laboratory data, and histopathologic features of the pretreatment liver biopsy specimens from patients suffering with biliary atresia (n=66), intrahepatic bile duct paucity (n=15), and neonatal hepatitis (n=21). RESULTS: The gender distribution was nearly equal for the patients with biliary atresia and intrahepatic bile duct paucity, whereas males predominated for the cases of neonatal hepatitis. Only the gamma-glutamyl transferase level differed significantly amongst the groups. The diagnostic features for making the differential diagnosis of bile duct lesions included marked bile ductular proliferation, severe fibrosis, and bile duct loss. The difference of the average percentage of portal tracts with bile duct loss was statistically significant between the patients with intrahepatic bile duct paucity (73.9%) and those patients with neonatal hepatitis (39.1%) (p<0.001). CONCLUSIONS: Bile ductular proliferation, bile duct loss, and advanced fibrosis are useful for the differential diagnosis of neonatal cholestasis. Moreover, stricter diagnostic criteria for bile duct loss (more than 2/3 of bile ducts) should be applied for the definitive diagnosis of intrahepatic bile duct paucity, because bile duct loss also frequently occurs in infants suffering with neonatal hepatitis.
Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Atresia ; Biopsy ; Cholestasis ; Diagnosis, Differential ; Fibrosis ; Hepatitis ; Humans ; Infant ; Infant, Newborn ; Liver ; Male ; Stress, Psychological ; Transferases

OBJECTIVES: Somatostatin inhibits lymph production and reduces lymph flow into the lymphatic duct. We hypothesized that octreotide, a long-acting somatostatin analog, would reduce drainage after neck dissection (ND) by reducing the overall lymphatic flow in the neck as well as thoracic duct flow. METHODS: From 2012 to 2014, total 123 patients who had undergone left-sided comprehensive ND, were divided into an octreotide group (49 patients) and a control group (74 patients). Seventeen patients from the octreotide group and 17 from the control group were individually matched by age (±10 years), sex, body mass index (±1 kg/m2), type of cancer, surgeon, and the extent of surgery. These 34 patients were finally included in the study. RESULTS: The total fluid drainage volume (540.9 mL vs. 707.9 mL) and drainage volume during the period of octreotide use (the first 5 postoperative days) (461.1 mL vs. 676.4 mL) were significantly lower in the octreotide group. The duration of drain placement (6.3 days vs. 9.4 days) was also shorter in the octreotide group. In the octreotide group, the mean triglyceride concentration in the drainage fluid was significantly lower than that in the control group (43.1 mg/dL vs. 88.8 mg/dL). There was no complication associated with the use of octreotide. CONCLUSION: Our study has shown that postoperative octreotide injections reduce postoperative drainage and the duration of drain placement. Further studies with larger patient populations are warranted to confirm these results and to evaluate the clinical benefits for patients.
Body Mass Index ; Case-Control Studies* ; Chyle ; Drainage* ; Humans ; Neck Dissection* ; Neck* ; Octreotide* ; Prospective Studies* ; Somatostatin ; Thoracic Duct ; Triglycerides

PURPOSE: To describe the imaging findings at susceptibility weighted imaging (SWI) at 3T in patients with occlusion of middle cerebral artery, and to correlate the absence or presence of arterial bright foci in sylvian fissure, as one of their finding at SWI, with the diffusion weighted imaging (DWI) scores. MATERIALS AND METHODS: We included 12 patients with symptomatic unilateral occlusion of middle cerebral artery. Retrospective review of SWI and DWI was done. On DWI, size of infarction was analyzed according to the ASPECTS grading system. On SWI, presence of hemorrhage, dark blooming of intravascular clot, distension of medullary or cortical vein, and absence or presence of bright arterial foci in sylvian fissure were evaluated. RESULTS: Of 12 patients with symptomatic unilateral MCA occlusion, SWI showed dark blooming of intravascular clot in 8 patients (66.7%), distended medullary or cortical vein in 7 patients (58.3%), nonvisualization of arterial bright signal intensity in sylvian fissure in 7 patients (58.3%), and hemorrhage in one patient (8.3%). In comparison with DWI, patients with sylvian arterial bright signal intensity showed better ASPECTS score (6.4+/-4.1) than patients without arterial bright signal intensity (4.4+/-1.1), yet it was not statistically significant (p=0.267, t-test). CONCLUSION: SWI at 3T provides added diagnostic information including site of occlusion, collateral flow by arterial bright signal intensity in sylvian fissure and early hemorrhagic transformation in patients with symptomatic MCA occlusion.
Diffusion ; Hemorrhage ; Humans ; Infarction ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery ; Retrospective Studies ; Stroke ; Veins

BACKGROUND AND OBJECTIVES: Occult multifocal diseases are often identified after hemithyroidectomy in patients with papillary thyroid microcarcinoma (PTMC). There has been considerable debate with regard to whether multifocal diseases actually behave more aggressively compared with unifocal diseases, particularly PTMC. The present study aimed at evaluating the clinical impact of occult multifocal diseases on the recurrence of PTMC treated with hemithyroidectomy. SUBJECTS AND METHOD: We compared the clinicopathological characteristics and 5-year outcomes for 319 patients with unifocal PTMC patients and 29 patients with occult multifocal PTMC, all of whom were treated with hemithyroidectomy between January 2004 and December 2010. RESULTS: The incidence of occult multifocal disease was 8.4%, with a mean size of 0.28 cm. Although microscopic extrathyroidal extension (ETE) was more frequent in patients with occult multifocal PTMC as compared with that of unifocal diseases (41.4% vs. 23.2%, p=0.030), multifocality was not associated with age, primary tumor size, and concurrent Hashimoto's thyroiditis. With respect to recurrence, there was no difference between the unifocal and multifocal groups during the mean 55.8-month follow-up period (4.4% vs. 10.3%, p=0.160). In addition, univariate and multivariate analyses revealed no meaningful association between recurrence and presence of occult multifocal diseases in patients with PTMC treated with hemithyroidectomy. CONCLUSION: Although presence of occult multifocal diseases was associated with microscopic ETE, its clinical impact on disease recurrence was not significant in PTMC patients treated with hemithyroidectomy. Therefore, multifocality identified after hemithyroidectomy would not be an absolute indication for the completion of thyroidectomy in patients with PTMC.
Follow-Up Studies ; Humans ; Incidence ; Multivariate Analysis ; Recurrence ; Thyroid Gland* ; Thyroidectomy ; Thyroiditis