PURPOSE: To analyse unusual radiologic manifestations of colonic adenocarcinoma, and to correlate these with pathologic findings. MATERIALS AND METHODS: Radiologic findings of ten patients with atypical adenocarcinoma ofthe colon were retrospectively evaluated. The unusual radiologic findings were difined as terminal ileal involvement of the cecal mass, long segmental involvement of over 9cm, and exophytic tumor growth. radiologic and sonographic findings were compared with pathologic specimens obtained from surgical resection. RESULTS: Involvement of the terminal ileum was noted in three cases, long segmental involvement of over 11cm in five cases, and exophytic mass in two. Of three cases with thickening of the terminal ileum, two revealed the infiltration of cancer into the terminal ileum through the ileocecal valve, and the other revealed vascular congestion and edemaon microscopic examination. Five cases with long segmental involvement of over 11cm comprised one of cancer totally infiltrated through the submucosal and proper muscle layer, one of inflammatory thickening distal to thecancer, two of inflammatory change of pericolic fat and serosal adhesion and one of a large intraluminal fungatingmass. In the cases of exophytic mass, one with a larger extraluminal and a smaller intraluminal component revealed necrosis and abscess on pathologic examination, accounting for low attenuation on CT, whereas the other, with exophytic growth, disclosed abundant pools of mucin, resulting in low attenuation on CT. These two cases could notbe differentiated from submucosal tumors. CONCLUSION: Atypical colon cancer may have various manifestations, suchas thickening of the terminal ileum, involvement of a long segment, and an exophytically growing mass. An appreciation of the radiologic findings of this cancer may therefore help in differential diagnosis in cases simulating colitis or submucosal tumors of the colon, such as lymphoma or leiomyoma.
Abscess ; Adenocarcinoma* ; Colitis ; Colon* ; Colonic Neoplasms ; Diagnosis, Differential ; Estrogens, Conjugated (USP) ; Humans ; Ileocecal Valve ; Ileum ; Leiomyoma ; Lymphoma ; Mucins ; Retrospective Studies

OBJECTIVES: The purpose of this study was to investigate the differences between adolescents and adults, in the perspective-taking ability, as well as the brain activation patterns during the perspective-taking situation.METHODS: We recruited healthy adolescents aged 13 years to 15 years (n = 20) and adults aged 19 years to 29 years (n = 20). All the subjects were scanned while performing the perspective-taking task, in which an emotional situation was presented in the form of statements comprising first person, as well as third person perspectives. Differences in brain activation between groups were assessed by contrasting neural activity during the tasks.RESULTS: In the between-group analysis, while performing the third-person perspective-taking task, the adolescent group showed greater neural activities in the middle frontal gyrus and precentral gyrus as compared to the adult group. Positive correlation was observed between the activity in the frontal areas (Brodmann area 6/9) and the score of scales related to perspective-taking and social cognition in the adolescent group.CONCLUSIONS: This study suggests that several frontal brain areas of adolescents needs to be overactivated in order to compensate for low perspective-taking ability when they ought to take another person's point of view.
Adolescent ; Adult ; Brain ; Cognition ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Weights and Measures

Bartter syndrome is a rare disorder characterized by the association of hypokalemic hypochloremic metabolic alkalosis, hyperreninemia, hyperaldosteronemia, short stature and nephrocalcinosis. This disorder presents with hyperplasia of juxtaglomerular apparatus on renal biopsy. We experienced a case of late-onset Bartter syndrome with nephrocalcinosis in a 9-year-old boy, whose chief pictures were muscle weakness, short stature, persistent sterile pyuria and microscopic hematuria. We report this case with a brief review of related literatures.
Alkalosis ; Bartter Syndrome* ; Biopsy ; Child ; Hematuria ; Humans ; Hyperplasia ; Juxtaglomerular Apparatus ; Male ; Muscle Weakness* ; Nephrocalcinosis ; Pyuria

BACKGROUND: The cell-mediated immune response plays an important role in tuberculosis. After being activated by mycobacterial antigens, T lymphocytes express a high affinity receptor (IL-2R) for interleukin-2 (IL-2) on their own surface and release a soluble fraction of the IL-2 receptor (sIL-2R) from the cell membrane into the circulation. Neopterin is a metabolite of guanosine-triphosphate, which is produced by stimulated macrophages under the influence of IFN-gamma with a T lymphocyte origin. Therefore, the utility of sIL-2R, IFN-gamma and the neopterin levels as immunologic indices of the cell-mediated immune response and severity of disease in patients with pulmonary tuberculosis was assessed. METHOD: The serum sIL-2R, IFN-gamma and neopterin levels were measured in 39 patients with pulmonary tuberculosis, 6 patients with tuberculous lymphadenitis prior to treatment and 10 healthy subjects. The serum and pleural sIL-2R, neopterin and ADA levels were measured in 22 patients with tuberculous pleurisy. The patients with pulmonary tuberculosis were divided into a mild, moderate and severe group according to the severity by ATS guidelines. To compare the results from these patients with those of the pretreatment levels, the sIL-2R, IFN-gamma and neopterin levels were measured in 36 of the 39 patients(1 patient, expired; 2 patients were referred to a sanitarium) with pulmonary tuberculosis after 2 months of treatment. RESULTS: 1) The serum sIL-2R and IFN-gamma levels were elevated in patients with tuberculosis when compared to those of healthy subjects (0.05). The neopterin concentration in the serum was significantly lower in patients with pulmonary tuberculosis(2967+/-2132.8 pg/ml) than in healthy controls(4949+/-1242.1 pg/ml)(p<0.05). 2) In the pulmonary tuberculosis group, the serum sIL-2R and IFN-gamma levels were higher in patients with severe disease than those in patients with mild and moderate disease. However, the neopterin levels declined as the pulmonary tuberculosis became more severe (p<0.01). 3) The mean serum sIL-2R and IFN-gamma levels declined from 1071+/-1139.4 U/ml to 1023+/-1920.9 U/ml(p>0.05), 41 52.8 pg/ml to 22+/-23.9 pg/ml(p<0.05), respectively, after 2 month of treatment. The mean serum neopterin levels increased from 3158+/-2272.6 pg/ml to 3737+/-2307.5 pg/ml(0.05) after a 2 month of treatment. These findings were remarkable in the severe group of pulmonary tuberculosis with a clinical correlation. 4) In the patients with tuberculous pleurisy, the serum sIL-2R and ADA were significantly higher than those in the pleural fluid, However, the neopterin levels in the sera and pleural effusion were similar. CONCLUSION: On the basis of this study, sIL-2R, IFN-gamma and neopterin measurements may not only provide an insight into the present state of the cell-mediated immune response, but also serve as parameters monitoring of the prognosis of the disease, particularly in patients with severe pulmonary tuberculosis. In addition, an assay of the pleural sIL-2R levels might signal a stimulated local immunity including T cell activation in the tuberculous pleural effusion.

Objectives: We investigated the differences in cognitive and emotional empathic ability between adolescents and adults, and the differences of the brain activation during cognitive and emotional empathy tasks. Methods: Adolescents (aged 13–15 years, n=14) and adults (aged 19–29 years, n=17) completed a range of empathic ability questionnaires and were scanned functional magnetic resonance imaging (fMRI) during both cognitive and emotional empathy task. Differences in empathic ability and brain activation between the groups were analyzed. Results: Both cognitive and emotional empathic ability were significantly lower in the adolescent compared to the adult group. Comparing the adolescent to the adult group showed that brain activation was significantly greater in the right transverse temporal gyrus (BA 41), right insula (BA 13), right superior parietal lobule (BA 7), right precentral gyrus (BA 4), and right thalamus whilst performing emotional empathy tasks. No brain regions showed significantly greater activation in the adolescent compared to the adult group while performing cognitive empathy task. In the adolescent group, scores of the Fantasy Subscale in the Interpersonal Reactivity Index, which reflects cognitive empathic ability, negatively correlated with activity of right superior parietal lobule during emotional empathic situations (r=-0.739, p=0.006). Conclusion These results strongly suggest that adolescents possess lower cognitive and emotional empathic abilities than adults do and require compensatory hyperactivation of the brain regions associated with emotional empathy or embodiment in emotional empathic situation. Compensatory hyperactivation in the emotional empathy-related brain areas among adolescents are likely associated with their lower cognitive empathic ability.

OBJECTIVES: Individuals with autism spectrum disorder (ASD) are considered to have problems with empathy. It has recently been suggested that there are two systems for empathy; cognitive and emotional. We aimed to investigate the neural response to cognitive and emotional empathy and elucidate the neurobiological aspects of empathy in patients with ASD. METHODS: We recruited patients with ASD (N=17, ASD group) and healthy controls (HC) (N=22, HC group) for an functional magnetic resonance imaging study. All of the subjects were scanned while performing cognitive and emotional empathy tasks. The differences in brain activation between the groups were assessed by contrasting their neural activity during the tasks. RESULTS: During both tasks, the ASD group showed greater neural activities in the bilateral occipital area compared to the HC group. The ASD group showed more activation in the bilateral precunei only during the emotional empathy task. No brain regions were more activated in the HC group than in the ASD group during the cognitive empathy task. While performing the emotional empathy task, the HC group exhibited greater neural activities in the left middle frontal gyrus and right anterior cingulate gyrus than the ASD group. CONCLUSION: This study showed that the brain regions associated with cognitive and emotional empathy in ASD patients differed from those in healthy individuals. The results of this study suggest that individuals with ASD might have defects both in cognitive empathy and in emotional empathy.
Autism Spectrum Disorder* ; Autistic Disorder* ; Brain ; Empathy* ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging

This study investigated elementary, middle, and high school teachers' satisfaction, nutrition education, workload changes, and demands in school foodservice programs (SFPs). The subjects were 630 teachers at 12 elementary, 9 middle, and 9 high school within the nation. Ninety five percent of the teachers felt that there was a necessity for SFPs. Middle school teachers (MTs) and high school teachers (HTs) thought that it was necessary in order to reduce the students'burden of carrying lunch boxes. The teachers were relatively satisfied with their school's foodservice management types, food distribution types, meal quality, and sanitation. Elementary teachers (ETs) and HTs had a higher satisfaction than MTs. Teachers thought that SFPs had positive effects on their students' nutrition and health, enhancing desirable eating habits, and socialization. ETs had more positive opinions than MTs or HTs. ETs and MTs thought that their workload had been increased by SFPs more than HTs, but they had relatively positive opinions on the workload change. ETs taught nutrition and health through SFPs more frequently than MTs or HTs. Many teachers thought that there was a lack of appropriate teaching materials. Some teachers thought that the problems in the present SFPs were: a lack of cafeteria facilities, poor quality of meals, and management of leftovers. Their demands for SFPs were a improvement of meal quality and the establishment of cafeterias. In conclusion, MTs had more negative opinions than ETs or HTs. ETs perceived that SFPs had a function as an important educational activity as well as the supply of nutritional meals. MTs or HTs tended to consider only a meal. It is suggested that teachers, especially MTs and HTs, should modify their attitudes and recognize the educational functions of SFPs. Training programs should be developed under government auspices.
Eating ; Education ; Humans ; Lunch ; Meals ; Sanitation ; Socialization ; Teaching Materials

This study on satisfaction with school food service (FS) programs was conducted with 485 middle school students and 515 high school students based on FS management type. There were four types of FS management: independent-conventional (IC), independent-commissary (ICM), contract-conventional (CC), and contract-delivery (CD). About seventy percent of the students expressed satisfaction with the food quantity of the school lunches. But one third of the students, who felt the quantity was insufficient, cited the small size of the rice serving. Many high school students cited the small size of the side dishes as well as the rice serving. It is suggested that the meal quantity should be determined in consideration of the students' physical development. The satisfaction with FS sanitation was lower than that with the meal quality, eating environment, and environment of dining room with respect to all four types of FS management, and was lowest in the CD. It is suggested that FS sanitation should be managed more thoroughly for the students' safety, and that the school FS Committee should carefully monitor the sanitary management of the contract FS companies by means of a well-designed and monitored management system. Most of middle and high school students expected good taste and a diversity of foods in their school lunches. Food taste should be improved, and various food materials and cooking methods should be used for balanced nutrition and greater student satisfaction, particularly in contract FS types (CC and CD).
Cooking ; Eating ; Food Services* ; Humans ; Lunch ; Meals ; Sanitation

OBJECTIVES: Total intracranial volume (TIV) is a major nuisance of neuroimaging research for interindividual differences of brain structure and function. Authors intended to prove the reliability of the atlas scaling factor (ASF) method for TIV estimation in FreeSurfer by comparing it with the results of manual tracing as reference method. METHODS: The TIVs of 26 normal children and 26 children with attention-deficit hyperactivity disorder (ADHD) were obtained by using FreeSurfer reconstruction and manual tracing with T1-weighted images. Manual tracing performed in every 10th slice of MRI dataset from midline of sagittal plane by one researcher who was blinded from clinical data. Another reseacher performed manual tracing independently for randomly selected 20 dataset to verify interrater reliability. RESULTS: The interrater reliability was excellent (intraclass coefficient = 0.91, p < 7.1e-07). There were no significant differences of age and gender distribution between normal and ADHD groups. No significant differences were found between TIVs from ASF method and manual tracing. Strong correlation between TIVs from 2 different methods were shown (r = 0.90, p < 2.2e-16). CONCLUSIONS: The ASF method for TIV estimation by using FreeSurfer showed good agreement with the reference method. We can use the TIV from ASF method for correction in analysis of structural and functional neuroimaging studies with not only elderly subjects but also children, even with ADHD.

Objectives: To investigate the relationship between brain structure and empathy in early adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods: Nineteen early adolescents with ADHD and 20 healthy controls underwent 3T MRI. All the participants were assessed for different aspects of empathy using measures including the Interpersonal Reactivity Index and Empathy Quotient. Cortical thickness and subcortical structural volume based on T1-weighted scans were analyzed using FreeSurfer. Results: Cognitive empathy (t=-2.52, p=0.016) and perspective taking (t=-2.10, p=0.043) were impaired in the ADHD group compared with the control group. The cluster encompassing the left posterior insular, supramarginal, and transverse temporal cortices [cluster-wise p-value (CWP)=0.001], which are associated with emotional empathy, was significantly smaller in the ADHD group, and the volume of the left nucleus accumbens was greater than that of the control group (F=10.12, p=0.003, effect size=0.22). In the control group, the left superior temporal (CWP=0.002) and lingual cortical (CWP=0.035) thicknesses were positively associated with cognitive empathy, while the right amygdala volume was positively associated with empathic concern (Coef=14.26, t=3.92, p=0.001). However, there was no significant correlation between empathy and brain structure in the ADHD group. Conclusion The ADHD group had a smaller volume of the cortical area associated with emotional empathy than the control group, and there was no brain region showing significant correlation with empathy, unlike in the control group.