No abstract available.
Child ; Male ; Female ; Humans

Authors retrospectively analyzed ultrasonographic findings of 12 cases of breast carcinomas which were proven pathologically at Yeungnam University Hospital from March 1992 to August 1992. Classically, breast carcinomas were described as irregular and lobulated hypoechoic solid masses with inhomogeneous internal echoes and frequent attenuation of the sound beam. And other additional ultrasonographic findings were echogenic rim, disruptions of superficial layer, microcalcification, skin thickening and so on. In our studies, not all of these findings of breast carcinomas were found in each case, but most of these findings were noted. However, several studies have demonstrated considerable overlap in the ultrasonographic appearance of benign lesions and carcinoma. Thus, accurate sonographic determination of the type of solid mass is not possible with current ultrasonographic imaging techniques and criteria. For more accurate diagnosis of breast lesions, sonographic and other imaging techniques are interpreted together.
Breast Neoplasms* ; Breast* ; Diagnosis ; Retrospective Studies ; Skin ; Ultrasonography

PURPOSE: To make objective standards of small intestinal mucosal changes in cow's milk-sensitive enteropathy (CMSE) we analyzed histological changes of endoscopic duodenal mucosa biopsy specimens from normal children and patients of CMSE. METHODS: We review the medical records of patients who had been admitted and diagnosed as CMSE by means of gastrofiberscopic duodenal mucosal biopsy following cow's milk challenge and withdrawal. Thirteen babies with CMSE, ranging from 14 days to 56 days of age, were studied. Five non-CMSE patients were used as control, ranging from 22 days to 72 days of age. The morphometric parameters under study were villous height, crypt zone depth, ratio of villous height to crypt zone depth, total mucosal thickness and length of surface epithelium by using H & E stained specimens under the drawing apparatus attached microscope. In addition, the numbers of lymphocytes in the epithelium and eosinophil cells in the lamina propria and epithelium were measured. RESULTS: In the duodenal mucosal biopsy specimens in CMSE we found partial and subtotal villous atrophy with an increased number of interepithelial lymphocytes. The mean villous height(135+/-59 micrometer), ratio of villous height to crypt zone depth (0.46+/-0.28), total mucosal thickness (499+/-56 micrometer), length of surface epithelium of small intestinal mucosa (889+/-231 micrometer) in CMSE was significantly decreased compared with the control (p<0.05). The mean crypt zone depth (311+/-65 micrometer) was significantly greater than the control (188+/-24 micrometer)(p<0.05). Infiltration of interepithelial lymphocytes (34.1+/-10.5) were significantly greater than the control (13.6+/-3.6)(p<0.05). The number of eosinophil cells in both lamina propria and epithelium was no significant differences between groups (p>0.05). The small intestinal mucosa in treated CMSE showed much improved enteropathy of villous height, crypt zone depth, interepithelial lymphocytes compared with the control as well as untreated CMSE. CONCLUSION: Quantitation of mucosal dimensions confirmed the presence of CMSE. It seems to be a limitation in the capacity of crypt cells to compensate for the loss of villous epithelium in CMSE. Specimens obtained by gastrofiberscopic duodenal mucosal biopsy were suitable for morphometric diagnosis of CMSE. Improvement of CMSE also can be confirmed histologically after the therapy of protein hydrolysate.
Atrophy ; Biopsy ; Child ; Diagnosis ; Eosinophils ; Epithelium ; Humans ; Intestinal Mucosa* ; Lymphocytes ; Medical Records ; Milk ; Mucous Membrane

Among infants and toddlers with chronic frequent loose stool, normal frequent and loose stool (NFLS) is more common than diarrheal illness with dehydration and nutritional deficiency (DIDN). To identify more objective factors for differentiating between NFLS and DIDN is important. The frequency, mucus content, and microbiological findings of stools, as well as diaper dermatitis are not important factors to significantly differentiate the groups. Instead, a failure to gain weight, fever, colic/abdominal pain, gross blood in stool (except allergic proctocolitis), nocturnal stool, and the score of the stool quantity are important factors to significantly differentiate the groups. A failure to gain weight is also observed even in NFLS, which may come from iatrogenic diet manipulation with nutritionally deficient food. The most objective differential factors are nocturnal stool and the score of stool amount (> or =7 points/day). The use of these objective factors could lessen parental anxiety and distress, iatrogenic undernutrition of patients, and socioeconomic loss due to improper medical investigations or inappropriate management of NFLS.
Anxiety ; Chronic Disease ; Dehydration ; Dermatitis ; Diagnosis, Differential ; Diarrhea ; Diet ; Fever ; Humans ; Infant ; Malnutrition ; Mucus ; Parents

In the process of medical care of acute diarrhea in children, two pathophysiologic aspects should be considered: dehydration associated with electrolyte imbalance, and nutritional disorder. It is important to continue to provide foods easy to digest with appropriate recipes from the early stage after a remedy of dehydration using oral rehydration solution or intravenous fluid therapy according to patients' condition. Nil per os or diluted diet can slow the recovery of an intestinal function and lengthen the diarrheal period. Although the damage on the intestinal mucosa occurs from various causes, the gastrointestinal mucosa maximizes absorbing capacity by expanding the area of a surface. Early oral-feeding contributes to restoring mucosa favorably and thus facilitates a rapid improvement of symptoms. Breast-feeding should continue to be performed in the midst of rehydration, and lactose-containing regular cow's milk formula is recommended for cow's milk-fed patients after rehydration. In mild or severe acute diarrhea, administering probiotics in conjunction with feeding is expected to shorten the diarrheal period.
Child ; Dehydration ; Diarrhea ; Diet ; Fluid Therapy ; Humans ; Intestinal Mucosa ; Milk ; Mucous Membrane ; Nutrition Disorders ; Probiotics

No abstract available.
Diarrhea

BACKGROUND/AIMS: Foreign body (FB) removal is a common indication of therapeutic endoscopy in children. The trend is becoming wider and more rational in application. The spectrum of upper gastrointestinal FB's in children during a recent 2 year period was reviewed in Taegu, Kyungbook Province in order to obtain a the consensus of recent trend of indications and techniques of endoscopic FB removal in children. METHODS: Esophagogastroscopy was performed on 78 children who had been referred to 3 University Hospitals in Taegu for FB ingestion from Oct. 1996 to Sep. 1998. RESULTS: Age between 1~2 year was the peak age group; 22 cases (28%). Male to female ratio was 1.9:1. Thirty four cases (44%) were in the esophagus, 44 cases (56%) in the stomach. The majority (49%) of the FB's were coins, 26 of 34 esophageal FB's and 12 of 44 gastric FB's. Others were 14 sharp/pointed objects, 12 big/long objects, 7 toxic objects, etc. In 67 children (86%) the FB was successfully removed and spontaneous passage through the pylorus was observed in 9 children. CONCLUSIONS: Endoscopic FB removal can be performed safely and effectively in children with minimal or no complications by an experienced endoscopist. Proper arrangement should be conducted with consideration to the property of FB's, expected complication, and the possibility of an emergency situation.
Child* ; Consensus ; Daegu* ; Eating ; Emergencies ; Endoscopy ; Esophagus ; Female ; Foreign Bodies* ; Hospitals, University ; Humans ; Korea* ; Male ; Numismatics ; Pylorus ; Stomach ; Upper Gastrointestinal Tract*

Food protein-induced enterocolitis syndrome (FPIES) is an under-recognized non-IgE-mediated gastrointestinal food allergy. The diagnosis of FPIES is based on clinical history, sequential symptoms and the timing, after excluding other possible causes. It is definitively diagnosed by an oral food challenge test. Unfortunately, the diagnosis of FPIES is frequently delayed because of non-specific symptoms and insufficient definitive diagnostic biomarkers. FPIES is not well recognized by clinicians; the affected infants are often mismanaged as having viral gastroenteritis, food poisoning, sepsis, or a surgical disease. Familiarity with the clinical features of FPIES and awareness of the indexes of suspicion for FPIES are important to diagnose FPIES. Understanding the recently defined clinical terms and types of FPIES is mandatory to suspect and correctly diagnose FPIES. The aim of this review is to provide a case-driven presentation as a guide of how to recognize the clinical features of FPIES to improve diagnosis and management of patients with FPIES.
Biomarkers ; Classification ; Diagnosis ; Enterocolitis* ; Food Hypersensitivity* ; Foodborne Diseases ; Gastroenteritis ; Humans ; Infant ; Recognition (Psychology) ; Sepsis

Non-traumatic acute abdominal pain in children presents a diagnostic dilemma. Numerous disorders can cause abdominal pain. Although many etiologies are benign, some require a rapid diagnosis and treatment in order to minimize morbidity. This review concentrates on the clinical office evaluation of acute abdominal pain in infants and children and details the clinical guideline for the diagnostic approach to imaging and the salient clinical features of some of the conditions. The clinical outcomes of children presenting with acute abdominal pain and the risk factors of the high risk underlying diseases would be provided for the diagnostic algorithm.
Abdominal Pain* ; Child* ; Diagnosis ; Humans ; Infant ; Risk Factors*

Failure to thrive is a term used to describe growth failure in infants and young children that may be accompanied by retarded social and motor achievements. The three categories of failure to thrive is based on anthropometric measurements of weight, length, and head circumference for age. Type 1 category, inadequate growth or loss of body weight with relatively normal height and head circumference, is the failure to gain weight due mainly to malnutrition. Most of time, the failure to gain weight is detected in a routine visit to the pediatrician. Many parents do not seem to notice the situation until it is brought to their attention. In most instances, the failure to gain weight is insidious and gradual. If malnutrition becomes severe and chronic during the first year of life, the child's neurologic development may be permanently affected, making early recognition and prompt intervention critical. This review may introduce a clinical approach to failure to gain weight in infants visiting out-patients clinic.
Anthropometry ; Body Weight ; Child ; Failure to Thrive ; Head ; Humans ; Infant* ; Malnutrition ; Outpatients ; Parents