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 goal of therapy in patients with traumatic carotid-cavernous fistulas is to occlude the fistula preferably while maintaining the carotid blood flow. Since the introduction of the concepts of detachable balloon technique to occlude arteriovenous fistulas, the technique has become the treatment of choice in the management of traumatic carotid-cavernous fistulas. The major symptoms of traumatic CCFs are (1) pulsating exophthalmos, (2) orbital and cephalic bruit and murmur, (3) headache, (4) chemosis, (5) extraocular palsies, and (6) visual failure. Traumatic CCFs are combined with multiple associated lesion. We tried the occlusion of fistulas using Goldvalve balloons in 8 consecutive cases of traumatic CCF and the result of our experience is reported. Transarterial approach with manually-tied latex balloons is tried in all cases and the fistulas was successfully occluded in all cases. In 5 cases, the internal carotid artery was preserved and the arterial lumen was occluded along with fistula opening in cases. In one case, surgical ligation was done because of symptoms recurred and incomplete occlusion of fistula. We experienced hemiparesis as a major complication in one case during occlusion tolerance test, which was remitted spontaneously. The results of Debrun balloon treatment were relatively excellent. We consider that the first choice of treatment of traumatic CCF is occlusion of the fistula by a detachable balloons.
Arteriovenous Fistula ; Carotid Artery, Internal ; Exophthalmos ; Fistula* ; Headache ; Humans ; Latex ; Ligation ; Orbit ; Paralysis ; Paresis

Food protein induced proctocolitis (FPIPC) is a non-IgE mediated food allergy. FPIPC occurs exclusively among breast-fed infants within the first months of life. FPIPC is often diagnosed clinically in normal-conditioned infants with rectal bleeding. But FPIPC among infancy with rectal bleeding is less general than conceived. The endoscopic findings reveal an edematous and erythematous mucosa with superficial erosions or ulcerations, bleeding and lymphoid nodular hyperplasia. The prominent eosinophilic infiltrates in the rectosigmoid mucosa are important for the histopathologic diagnosis of FPIPC. However, in explaining eosinophilic infiltration within the lamina propria of the mucosa, it is necessary to differentiate whether it is a part of normal findings or occurs due to inflammatory reactions. Oral food challenge and elimination test is performed to identify the same clinical reaction as the symptom of FPIPC by the administration of a specific type of food to infants. The most common causal food is cow's milk. Thus oral food challenge and elimination test can be the effective way of confirming FPIPC, reducing the possibility of misdiagnosis. The purpose of this report is to identify the characteristics of FPIPC, to introduce its diagnostic methods, and to suggest the future direction of research.
Diagnostic Errors ; Eosinophils ; Food Hypersensitivity ; Hemorrhage ; Humans ; Hyperplasia ; Infant ; Milk ; Mucous Membrane ; Proctocolitis ; Ulcer

Food allergies affect 7~8% of infants and young children, and their prevalence appears to have increased in recent years. Food allergy refers to an abnormal immunological reaction to a specific food. These reactions can be recurrent each time the food is ingested. Food allergy manifests itself with a wide spectrum of clinical characteristics including IgE-mediated diseases as immediate reactions, non-IgE-mediated disorders as delayed reactions, and mixed hypersensitivities. As a consequence, the clinical picture of a food allergy is pleomorphic. A well-designed oral food challenge is the most reliable diagnostic test for infants and young children whose clinical history and physical examination point towards a specific food allergy. Food specific IgE antibody tests (RAST, MAST, skin prick test, Uni-CAP, etc) are an alternative tool to determine oral food challenge for IgE-mediated disorders, but not for non-IgE-mediated allergies. Moreover, parents often impose their children on unnecessary diets without adequate medical supervision. These inappropriate dietary restrictions may cause nutritional deficiencies. This review aims to introduce clinical perspectives of food allergy in infants and young children and to orient clinicians towards different strains of diagnostic approaches, dietary management, and follow-up assessment of tolerance development.
Child ; Diagnostic Tests, Routine ; Diet ; Follow-Up Studies ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Malnutrition ; Organization and Administration ; Parents ; Physical Examination ; Prevalence ; Skin

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

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

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

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