This study was performed in order to investigate the relationship between attention deficit hyperactivity disorder (ADHD), dietary habit and caffeine intake in upper-grade elementary school children. The total number of the study subjects was 237 students (111 boys and 126 girls), where 30 students (12.7%) were diagnosed as ADHD. The dietary habit score of the ADHD group was significantly lower than that of the normal group. In particular, the ADHD group had lower dietary scores in consuming daily breakfast, diverse foods, fruit and milk than those in the normal group. Meanwhile, the daily intake frequency of instant noodle (ramyeon) was significantly higher in the ADHD group than that in the normal group. The mean caffeine intake of the students was 42.95 mg and the proportion of students consuming more than the ADI (acceptable daily intake) was 11.8%. The caffeine intake of ADHD group (63.63 mg) tended to be higher than that of the normal group (39.95 mg); however, it was not significantly different. The ADHD score of the students was negatively related with the dietary habit score (r = -0.279, p < 0.01) but positively related with caffeine intake (r = 0.164, p < 0.05). The dietary habit score had a negative relationship with caffeine intake (r = -0.180, p < 0.01) and a positive relationship with height (r = 0.195, p < 0.01). Caffeine intake had a negative relationship with the height of the students (r = -0.171, p < 0.05). In conclusion, ADHD in children was related to poor dietary habit and high caffeine intake.
Attention Deficit Disorder with Hyperactivity ; Breakfast ; Caffeine ; Child ; Food Habits ; Fruit ; Humans ; Milk

Alveolar soft part sarcoma (ASPS) is a rare and potentially aggressive soft tissue malignancy that primarily affects teenagers and young adults. It is generally associated with a high incidence of metastasis early in the disease course, with brain metastases occurring more frequently than in other high-grade sarcomas. ASPS most commonly arises in the extremities, particularly the lower limbs, while approximately one-fourth of cases occur in the head and neck region, with typical sites including the tongue and orbit, although involvement of the larynx is very rare. In this case report, we present a rare case of ASPS located in the larynx, accompanied by a review of the literature. This case emphasizes that ASPS should be considered in the differential diagnosis when evaluating solid and/or vascular laryngeal masses in the young population, and underscores the necessity of early surgical intervention.

Alveolar soft part sarcoma (ASPS) is a rare and potentially aggressive soft tissue malignancy that primarily affects teenagers and young adults. It is generally associated with a high incidence of metastasis early in the disease course, with brain metastases occurring more frequently than in other high-grade sarcomas. ASPS most commonly arises in the extremities, particularly the lower limbs, while approximately one-fourth of cases occur in the head and neck region, with typical sites including the tongue and orbit, although involvement of the larynx is very rare. In this case report, we present a rare case of ASPS located in the larynx, accompanied by a review of the literature. This case emphasizes that ASPS should be considered in the differential diagnosis when evaluating solid and/or vascular laryngeal masses in the young population, and underscores the necessity of early surgical intervention.

Alveolar soft part sarcoma (ASPS) is a rare and potentially aggressive soft tissue malignancy that primarily affects teenagers and young adults. It is generally associated with a high incidence of metastasis early in the disease course, with brain metastases occurring more frequently than in other high-grade sarcomas. ASPS most commonly arises in the extremities, particularly the lower limbs, while approximately one-fourth of cases occur in the head and neck region, with typical sites including the tongue and orbit, although involvement of the larynx is very rare. In this case report, we present a rare case of ASPS located in the larynx, accompanied by a review of the literature. This case emphasizes that ASPS should be considered in the differential diagnosis when evaluating solid and/or vascular laryngeal masses in the young population, and underscores the necessity of early surgical intervention.

Alveolar soft part sarcoma (ASPS) is a rare and potentially aggressive soft tissue malignancy that primarily affects teenagers and young adults. It is generally associated with a high incidence of metastasis early in the disease course, with brain metastases occurring more frequently than in other high-grade sarcomas. ASPS most commonly arises in the extremities, particularly the lower limbs, while approximately one-fourth of cases occur in the head and neck region, with typical sites including the tongue and orbit, although involvement of the larynx is very rare. In this case report, we present a rare case of ASPS located in the larynx, accompanied by a review of the literature. This case emphasizes that ASPS should be considered in the differential diagnosis when evaluating solid and/or vascular laryngeal masses in the young population, and underscores the necessity of early surgical intervention.

Pharyngocutaneous fistula occurring after total laryngectomy is a bothersome complication as it can even cause a massive bleeding due to carotid artery rupture. Preoperative radiation, extensive diseases which need flap reconstruction, low albumin or hemoglobin level, history of smoking, or underlying diseases have been domestically reported to have a relationship with the condition. To reduce this complication, simultaneous coverage for the pharyngeal closure has been developed using flaps, such as the pectoralis major muscle, the radial forearm or the anterolateral thigh, which are distant from the radiation field. However, these methods need additional surgical techniques and times. Another method advocated is pharyngeal reinforcement using flaps that can be easily obtained from the same surgical field, such as the sternocleidomastoid or the infrahyoid muscle or the acellular dermal graft with relative significances. Here we suggest reinforcement of pharyngeal closure after total laryngectomy using the sternohyoid and omohyoid muscle flaps.

Juvenile xanthogranuloma (JXG) is a rare benign histiocytic tumor, which was first described by Adamson in 1905. JXG typically presents as solitary or multiple yellow-brown skin nodules in infants, most often on the head, neck or upper trunk. Extracutaneous forms are rare and there are only several cases reported in the nasal cavity up to date. Previous cases were presented with the mass effect such as nasal obstruction. We recently experienced a pediatric patient with epistaxis and the nasal endoscopy suggested pyogenic granuloma. However, biopsy of the mass revealed JXG. Herein, we report a case of disseminated juvenile xanthoma misdiagnosed as pyogenic granuloma.

Extramammary Paget disease (EMPD) is an uncommon malignancy that occurs in apocrine gland-rich areas of the body. EMPD of the axilla is rare, but a few cases have been reported. Some cases of EMPD have been reported with underlying apocrine adenocarcinoma; rarely, mammary-type ductal carcinoma can accompany EMPD. Here, we report a very rare case of EMPD with apocrine adenocarcinoma and invasive mammary-type ductal carcinoma. A 55-year-old woman was referred with a brownish pigmented plaque accompanying an area of ulceration in the left axilla. A preoperative biopsy indicated Paget disease, and an additional evaluation was performed to determine whether it was of primary or secondary origin. A wide excision was made, and the axilla was reconstructed using a thoracodorsal artery perforator flap. The biopsy showed apocrine adenocarcinoma and invasive mammary-type ductal carcinoma with pagetoid spreading. The patient had no evidence of recurrence or other postoperative complications.

Tracheocutaneous fistula (TCF) formation is a complication of long-term tracheostomy use. Surgical closure is necessary for a persistent TCF because this can lead to various complications. Herein, we describe our use of an island deltopectoral (DP) flap to treat a large TCF. A 62-year-old male, who had previously undergone supraglottic partial laryngectomy with laser and radiation therapy, presented with a second recurrence of supraglottic cancer. Supracricoid partial laryngectomy and cricohyoidoepiglottopexy (CHEP) were performed. Afterward, a large TCF measuring about 2.0×2.5 cm developed. The island DP flap facilitated successful TCF closure. There have been no recurrences or complications, and both the reconstruction site and donor site are well-maintained after 25 months of follow-up. The island DP flap can be a useful option for large TCF closure, even for patients who have had previous radiation therapy.

Tracheocutaneous fistula (TCF) formation is a complication of long-term tracheostomy use. Surgical closure is necessary for a persistent TCF because this can lead to various complications. Herein, we describe our use of an island deltopectoral (DP) flap to treat a large TCF. A 62-year-old male, who had previously undergone supraglottic partial laryngectomy with laser and radiation therapy, presented with a second recurrence of supraglottic cancer. Supracricoid partial laryngectomy and cricohyoidoepiglottopexy (CHEP) were performed. Afterward, a large TCF measuring about 2.0×2.5 cm developed. The island DP flap facilitated successful TCF closure. There have been no recurrences or complications, and both the reconstruction site and donor site are well-maintained after 25 months of follow-up. The island DP flap can be a useful option for large TCF closure, even for patients who have had previous radiation therapy.