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

The etiology of small and fresh rectal bleeding in neonates who are not sick is usually unknown; the only known cause is food protein-induced proctocolitis (FPIPC). It has been recently reported that FPIPC is a rare cause of rectal bleeding in newborns, and most cases have been proved to be due to idiopathic neonatal transient colitis. A recommended strategy for diagnosing suspected FPIPC in neonates is as follows. During the early stage, the etiology of small and fresh rectal bleeding in an otherwise healthy newborn need not be studied through extensive investigations. In patients showing continued bleeding even after 4 days, sigmoidoscopy and rectal mucosal biopsy may be performed. Even if mucosal histological findings indicate a diagnosis of FPIPC, further oral food elimination and challenge tests must be performed sequentially to confirm FPIPC. Food elimination and challenge tests should be included in the diagnostic criteria of FPIPC.
Biopsy ; Colitis ; Diagnosis ; Dietary Proteins ; Food Hypersensitivity ; Hemorrhage ; Humans ; Infant, Newborn* ; Proctocolitis* ; Sigmoidoscopy

No abstract available.
Plasma Exchange* ; Plasma*

Failure to thrive (FTT) is a term used to describe growth failure in infants and toddlers. The three categories of FTT are based on anthropometric measurements of weight, length, and head circumference for age. Type 1 FTT is the failure to gain weight due mainly to inadequate nutrition. Type 2 FTT is a clinical condition associated with short stature induced by endocrine or genetic factors. Type 3 FTT results from chromosome anomalies or central nervous system abnormalities. Pediatric endocrinologists may be involved in treating patients with short stature of type 2 FTT. Pediatric gastroenterologists may be interested in patients with malnutrition of type 1 FTT, and pediatric psychologists may play a major roll in treating those with non-organic FTT or feeding disorders. This review introduces a new paradigm of clinical approaches to FTT in infants and toddlers to emphasize the importance of multidisciplinary clinical approaches to FTT.
Central Nervous System ; Failure to Thrive ; Head ; Humans ; Infant ; Malnutrition

Chronic abdominal pain (CAP) in children and adolescents remains one of the pathogenetically ambiguous disorders and a great trouble to their caretakers as well as patients. Although the symptom does not usually lead to a crucial problem, the parents may be terribly worried, the child may be in distress, and the practitioner may be concerned about ordering tests to confirm a serious occult disease. Systemized diagnostic approaches are needed to overcome this unique difficulty. The presence of red flag symptoms or signs is a general indication to pursue diagnostic testing for organic etiologies of CAP on the basis of specific symptoms in an individual case. Functional abdominal pain can be normally diagnosed when there are no red flag symptoms or signs. According to the Rome III criteria for pediatric functional gastrointestinal disorders, functional disorders of CAP can be classified into functional dyspepsia, irritable bowel syndrome, abdominal migraine, and chronic functional abdominal pain syndrome. Cyclic vomiting syndrome and pathologic aerophagia are also major functional causes of CAP. Modern concepts of the pathogenesis of functional abdominal pain include brain-gut interaction, visceral hypersensitivity, autonomic dysfunction, and psychosocial factors. In addition, psychiatric disorders, presented with red flag symptoms or signs, may induce the CAP in children and adolescents. We introduce practical and systemized diagnostic approaches by illustrating clinical cases of CAP in children and adolescents.
Abdominal Pain ; Adolescent ; Child ; Diagnostic Tests, Routine ; Dyspepsia ; Gastrointestinal Diseases ; Humans ; Hypersensitivity ; Irritable Bowel Syndrome ; Migraine Disorders ; Parents ; Rome ; Vomiting

No abstract available.
Infant, Newborn ; Jaundice, Neonatal* ; Radionuclide Imaging* ; Technetium Tc 99m Disofenin*

This paper aims to provide an introduction to junior authors on how to write a medical paper in a clearer and more scientific manner. One important thing to be always remembered is that the reviewer and the reader will be reading your paper for the first time, and thus, you should make it as lucid as possible. You should pay attention to consistency in every regard in your paper. Use of the active voice usually makes the sentences shorter and clearer in meaning. Organize your content carefully and present it logically, avoiding unnecessary repetition in different sections. Give a diligent thought to every aspect; research is a work of the mind, not of the hands. Write technically, using powerful language. Most importantly, fulfill the exact submission requirements of the journal.
Hand ; Logic ; Voice ; Writing

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated hypersensitivity disorder, which is associated with mainly gastrointestinal symptoms and has a delayed onset. The vomiting and/or diarrheal symptoms of FPIES typically begin in the first month of life in association with a failure to thrive, metabolic acidosis, and shock. Therefore, the differential diagnosis of FPIES and neonatal or infantile sepsis-like illnesses or gastroenteritis is difficult. The early recognition of indexes of suspicion for FPIES may help in the diagnosis and treatment of this disorder. The diagnosis of FPIES is generally made through clinical practice and food-specific IgE test findings are typically negative in this condition. Therefore, oral cow's milk challenge (OCC) remains the valid diagnostic standard for FPIES. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in FPIES. Moreover, it has not been clearly determined in infantile FPIES when 1st follow up-oral food challenge (FU-OFC) should be performed, with what kind of food protein (e.g., cow's milk, soy), and how much protein should be administered. Hence, to prevent the risk of inappropriate FU-OFC or accidental exposure and achieve appropriate dietary management, it is necessary to identify tolerance rates to major foods under the careful follow up of infantile FPIES patients. On the other hand, small intestinal enteropathy with villous atrophy is observed in FPIES and this enteropathy seems to be in part induced by both of epithelial apoptosis and intercellular junctional complex breakdown. The purpose of this report is to introduce an update on diagnostic and therapeutic approaches in FPIES and suggest the possible histopathological evidences in this disorder.
Acidosis ; Apoptosis ; Atrophy ; Diagnosis ; Diagnosis, Differential ; Enterocolitis* ; Failure to Thrive ; Follow-Up Studies ; Food Hypersensitivity ; Gastroenteritis ; Hand ; Humans ; Hypersensitivity ; Immunoglobulin E ; Milk ; Shock ; Vomiting