No abstract available.
Zygoma*

We experienced a case of arteriovenous hemangioma showing Dariers sign on the forehead of a 43-year-old man. He presented with a single, 1 * 1.5cm sized, violaceous, asymptomatic nodule with a history of an intermittent wheal at the lesional site. This skin lesion showed Dariers sign clinically and proliferation of mast cells histopathologically with the punch biopsy specirnen suggesting urticaria pig- mentosa. Howerer, we could diagnose it as a arteriovenous hemangioma on complete excision, as the specimen showed arteriovenous proliferation with increased mast cells in a perivascular pattern. This case showed confusing clinical signs and showed the importance of complete excision for the diagnosis of a small skin tumor especially when a vascular proliferating tumor is suspected.
Adult ; Biopsy ; Diagnosis ; Forehead ; Hemangioma* ; Humans ; Mast Cells ; Skin ; Urticaria

Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by the presence of intramural gas-filled cysts in the gastrointestinal wall. This disease has been documented in patients with various medical conditions such as gastrointestinal disease, chronic obstructive lung disease, sepsis, and autoimmune disorders. A 49-year-old woman, who was undergoing immumosuppressant therapy due to polymyositis, developed PCI. She experienced a gradual onset of abdominal distension. A simple abdominal radiograph revealed small, round air shadows involving the small bowel, and abdominal computed tomography showed intraluminal air bubbles at the jejunal loop with free air in the peritoneum. Treatment with doxycycline effectively relieved the clinical symptoms and reduced the intramural gas.
Doxycycline ; Female ; Gastrointestinal Diseases ; Humans ; Intestinal Obstruction ; Middle Aged ; Peritoneum ; Pneumatosis Cystoides Intestinalis ; Polymyositis ; Pulmonary Disease, Chronic Obstructive ; Rare Diseases ; Sepsis

BACKGROUND: The expansion and strengthening of primary care is approved as the only method to revise the ineffective health care system in Korea. In such a system, we intended to analyze the functional and regianal distribution of specialists by investigating and classifying the hospitals where residents who completed their training in a university hospital located in Seoul for seven years are working and by acquiring the distribution of the subjects who are practicing as primary care physicians by year, specialties and location. METHODS: We selected 384 specialists, all of whom were trained as residents at a university hospital located in Seoul from 1987 to 1993. The hospitals they worked at were classified as primary, secondary and tertiary care hospitals according to the classification in the health care administration. The location of primary care hcspitals among them was plotted an two maps; one of Seoul, the other of Korea. RESULTS: The number of females in the subjects was 68(17.7%) and that of males 316(82.3%). The number of practitianers was 156(40.6%) and that of specialists working at the secondary care hospitals was 55(14.3%), and 147 specialists were working at the tertiary care hospitals(38.3%). With regard to the pereentage of practitioners, dermatologic specialists presented with 60%, and relatively high group included obstetrics and gynecology(59.2%), family medicine(54.5%), plastic surgery(52.6%), otolaryngology (52.0%), pediatrics(51.7%), and orthopedics(48.6%).In tertiary care hospital, chest surgery showed 72.7% as highest. Radiologic ancology presented with 66.7% and anatamical pathology with 66.7%. As to the location of primary care hospitals, 41.0% were in Seoul and 38.5% in Kyungkido. And the rest of the 20. 5% were located in other areas of Korea. CONCLUSIONS: Considering the results of the study that show a great number of specialists are actually practicing as primary care physicians after their specialists training, the present training system of specialists needs to be revised and cantrolled in structure.
Classification ; Delivery of Health Care ; Female ; Gyeonggi-do ; Humans ; Korea ; Male ; Obstetrics ; Otolaryngology ; Pathology ; Physicians, Primary Care ; Primary Health Care ; Secondary Care ; Seoul ; Specialization ; Tertiary Healthcare ; Thorax

Avellis syndrome is a clinical disorder characterized by ipsilateral paralysis of palate, larynx, and vocal cord paralysis and contralateral hemianesthesia. The syndrome is usually due to lesion of medulla oblongata. Involeved structures are nucleus ambiguus, lateral spinothalamic tract, and descending sympathetic fibers. We present 2 cases of Avellis syndrome with MRI findings, which showed infarction of right-sided upper medulla oblongata.
Adrenergic Fibers ; Infarction ; Larynx ; Magnetic Resonance Imaging ; Medulla Oblongata ; Palate ; Paralysis ; Spinothalamic Tracts ; Vocal Cord Paralysis

OBJECTIVES: An association between dietary patterns and mental health in children has been suggested in a series of studies, yet detailed analyses of dietary patterns and their effects on ADHD (attention deficit hyperactivity disorder) are limited. METHODS: We included 4569 children who had dietary intake data as part of the CHEER (Children's Health and Environmental Research) study conducted nationwide from 2005 to 2010. We assessed ADHD (Attention Deficit Hyperactivity Disorder) by the DuPaul's ADHD Rating Scales and dietary intake by a semi-quantitative food frequency questionnaire. Using intake data, we constructed five dietary patterns: “Plant foods & fish,” “Sweets,” “Meat & fish,” “Fruits & dairy products,” and “Wheat based.” RESULTS: The overall proportion of ADHD was 12.3%. Boys (17.8%) showed a higher rate of ADHD than girls (6.5%). The total intake of calories (85 kcal) and plant fat (2g) in the ADHD group was significantly higher than that of the normal group. ADHD was significantly negatively associated with dietary habits such as having breakfast and meal frequency, and positively associated with eating speed, unbalanced diet, overeating, and rice consumption. Regarding dietary patterns, the “Sweets” category was relevant to high ADHD risk (OR 1.59, 95% CI: 1.18, 2.15 for Q5 vs. Q1) in a linear relationship. An inverse, non-linear association was found between “Fruits & dairy products” and ADHD (OR 0.55, 95% CI: 0.39, 0.76 for Q4 vs. Q1). CONCLUSIONS: Our study confirms both positive and negative associations between diet and ADHD in elementary school age children. Moreover, linear or nonlinear associations between diet and ADHD draw attention to the possible threshold role of nutrients. Further studies may consider characteristics of diet in more detail to develop better intervention or management in terms of diet and health.
Attention Deficit Disorder with Hyperactivity ; Breakfast ; Child ; Diet ; Eating ; Female ; Food Habits ; Humans ; Hyperphagia ; Meals ; Mental Health ; Plants ; Weights and Measures

OBJECTIVES: An association between dietary patterns and mental health in children has been suggested in a series of studies, yet detailed analyses of dietary patterns and their effects on ADHD (attention deficit hyperactivity disorder) are limited. METHODS: We included 4569 children who had dietary intake data as part of the CHEER (Children's Health and Environmental Research) study conducted nationwide from 2005 to 2010. We assessed ADHD (Attention Deficit Hyperactivity Disorder) by the DuPaul's ADHD Rating Scales and dietary intake by a semi-quantitative food frequency questionnaire. Using intake data, we constructed five dietary patterns: “Plant foods & fish,” “Sweets,” “Meat & fish,” “Fruits & dairy products,” and “Wheat based.” RESULTS: The overall proportion of ADHD was 12.3%. Boys (17.8%) showed a higher rate of ADHD than girls (6.5%). The total intake of calories (85 kcal) and plant fat (2g) in the ADHD group was significantly higher than that of the normal group. ADHD was significantly negatively associated with dietary habits such as having breakfast and meal frequency, and positively associated with eating speed, unbalanced diet, overeating, and rice consumption. Regarding dietary patterns, the “Sweets” category was relevant to high ADHD risk (OR 1.59, 95% CI: 1.18, 2.15 for Q5 vs. Q1) in a linear relationship. An inverse, non-linear association was found between “Fruits & dairy products” and ADHD (OR 0.55, 95% CI: 0.39, 0.76 for Q4 vs. Q1). CONCLUSIONS: Our study confirms both positive and negative associations between diet and ADHD in elementary school age children. Moreover, linear or nonlinear associations between diet and ADHD draw attention to the possible threshold role of nutrients. Further studies may consider characteristics of diet in more detail to develop better intervention or management in terms of diet and health.
Attention Deficit Disorder with Hyperactivity ; Breakfast ; Child ; Diet ; Eating ; Female ; Food Habits ; Humans ; Hyperphagia ; Meals ; Mental Health ; Plants ; Weights and Measures

Objectives: Clozapine is the most effective atypical antipsychotic agent for the treatment-resistant schizophrenia (TRS), however, only 40%–70% of TRS patients respond to clozapine. Moreover, TRS encompasses various symptom dimensions. Therefore, augmentation with other medications for clozapine is frequently applied. However, the prescription pattern of clozapine and combined medications in Korea is yet to be examined. This study aims to investigate the maintenance treatment pattern of clozapine and augmentation agents in one Korean tertiary hospital. Methods: The patients with schizophrenia spectrum disorders under clozapine maintenance, defined as one-year clozapine continuation, were subjected for analysis. Medication data at one-year time-point after clozapine initiation was extracted and analyzed. Results: Among total 2897 patients having clozapine prescription experience from January 2000 to December 2018, 1011 patients were on clozapine maintenance. The mean age of clozapine initiation was 30.2 ± 11.3 years, and the maintenance dose of clozapine was 217.8 ± 124.3 mg/day. Combination rate of antipsychotics, mood stabilizers, and antidepressants were 43.5%, 25.3%, 38.6%, respectively. Most frequently prescribed drugs in each category were aripiprazole, valproate, and sertraline. Olanzapine equivalent dose of combined antipsychotics was 10.4 ± 7.7 mg/day. Male patients were prescribed higher dose of combined antipsychotics and higher rate of antidepressants. Female patients had later onset of clozapine prescription. Patients with two or more combined antipsychotics were prescribed higher dose of clozapine and higher rate of antidepressants compared to patients with one combined antipsychotic. Conclusions Taken together, among the patients taking clozapine, a substantial rate of patients were under polypharmacy. The present findings based on the real-world prescription pattern could provide the valuable clinical information on the treatment of TRSrelated conditions.

BACKGROUND: Idiopathic pulmonary fibrosis involves irreversible alveolar destruction. Although alveolar epithelial type II cells are key functional participants within the lung parenchyma, how epithelial cells are affected upon bleomycin (BLM) exposure remains unknown. In this study, we determined whether BLM could induce cell cycle arrest via regulation of Schlafen (SLFN) family genes, a group of cell cycle regulators known to mediate growth-inhibitory responses and apoptosis in alveolar epithelial type II cells. METHODS: Mouse AE II cell line MLE-12 were exposed to 1–10 µg/mL BLM and 0.01–100 µM baicalein (Bai), a G1/G2 cell cycle inhibitor, for 24 hours. Cell viability and levels of pro-inflammatory cytokines were analyzed by MTT and enzyme-linked immunosorbent assay, respectively. Apoptosis-related gene expression was evaluated by quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR). Cellular morphology was determined after DAPI and Hoechst 33258 staining. To verify cell cycle arrest, propidium iodide (PI) staining was performed for MLE-12 after exposure to BLM. RESULTS: BLM decreased the proliferation of MLE-12 cells. However, it significantly increased expression levels of interleukin 6, tumor necrosis factor α, and transforming growth factor β1. Based on Hoechst 33258 staining, BLM induced condensation of nuclear and fragmentation. Based on DAPI and PI staining, BLM significantly increased the size of nuclei and induced G2/M phase cell cycle arrest. Results of qRT-PCR analysis revealed that BLM increased mRNA levels of BAX but decreased those of Bcl2. In addition, BLM/Bai increased mRNA levels of p53, p21, SLFN1, 2, 4 of Schlafen family. CONCLUSION: BLM exposure affects pulmonary epithelial type II cells, resulting in decreased proliferation possibly through apoptotic and cell cycle arrest associated signaling.
Animals ; Apoptosis ; Bisbenzimidazole ; Bleomycin ; Cell Cycle Checkpoints ; Cell Cycle ; Cell Line ; Cell Survival ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Gene Expression ; Genes, vif ; Humans ; Idiopathic Pulmonary Fibrosis ; Interleukin-6 ; Lung ; Mice ; Propidium ; RNA, Messenger ; Transforming Growth Factors ; Tumor Necrosis Factor-alpha