This study was conducted to compare the eating habits of disabled and non-disabled children in Seoul and Gangneung, Korea. Questionnaires about eating habits were answered by the children's parents and their teachers. The subjects of this study consisted of 146 disabled children (108 boys and 38 girls) from two special education schools and 241 nondisabled children (control group, 120 boys and 121 girls) from two elementary schools in Seoul and Gangneung, respectively. The percentage of the children who required more than 30 minutes to eat was 11.3% in the disabled group and 2.5% in the non-disabled group. In the disabled group, 44.0% ate excessive amounts of food or could not control their intake. The percentage of the children whose frequency of eating breakfast was less than 1 to 2 times per week was 21.0% in the disabled group and 9.7% in the non-disabled group. Also, 7.6% of the disabled group and 13.9% of the nondisabled group had snacks more than three times per day. The percentage of children who were able to eat by themselves was lower in the disabled group (47.9%) than in the non-disabled group (87.8%). Of the remainder of the disabled group, 28.6% spilled food, and 14.3% needed the aid of others when picking up side dishes. The percentage of parents who worried about their children's eating an unbalanced diet was 48.5% in the disabled group and 41.8% in the non-disabled group. In addition, there were problems with eating behaviors in 22.7% in the disabled group ; and with under-eating (15.9%) and with excessive intake of instant foods (16.8%) in the non-disabled group. These results suggest that the eating habits and eating behaviors of disabled children are different from those of non-disabled children. Thus, nutritional educational programs and educational materials for disabled children and their parents should be developed.
Breakfast ; Child* ; Diet ; Disabled Children ; Eating* ; Education, Special ; Feeding Behavior* ; Gangwon-do ; Humans ; Korea ; Parents ; Seoul ; Snacks ; Surveys and Questionnaires

Milia are benign primary or secondary keratinous cysts. Multiple eruptive milia (MEM) and milia en plaque (MEP) are rarely reported. A 21-year-old male presented with multiple skin-colored papules on the abdomen and both acral regions, and erythematous plaques featuring similar papules on the wrist and the dorsa of the feet. A biopsy confirmed MEP and he was diagnosed with both MEM and MEP. We thus report a rare case of simultaneous MEM and MEP.
Abdomen ; Biopsy ; Foot ; Humans ; Keratosis ; Male ; Skin Diseases ; Wrist ; Young Adult*

PURPOSE: The etiology of acute gastroenteritis (AGE) has changed since the introduction of the rotavirus vaccination. The aim of this study was to clarify which common pathogens, both bacterial and viral, are currently causing AGE in infants. METHODS: Infants with acute diarrhea were enrolled. We tested for 10 bacterial pathogens and five viral pathogens in stool specimens collected from infants with AGE. The clinical symptoms such as vomiting, mucoid or bloody diarrhea, dehydration, irritability, and poor oral intake were recorded, and laboratory data such as white blood cell count and C-reactive protein were collected. The clinical and laboratory data for the cases with bacterial pathogens and the cases with viral pathogens were compared. RESULTS: Of 41 total infants, 21 (51.2%) were positive for at least one pathogen. Seventeen cases (41.5%) were positive for bacterial pathogens and seven cases (17.1%) were positive for viral pathogens. Staphylococcus aureus (13 cases, 31.7%) and Clostridium perfringens (four cases, 9.8%) were common bacterial pathogens. Norovirus (five cases, 12.2%) was the most common viral pathogen. Fever and respiratory symptoms were common in the isolated viral infection group (p=0.023 and 0.044, respectively), whereas other clinical and laboratory data were indistinguishable between the groups. CONCLUSION: In our study, S. aureus (41.5%) and norovirus (12.2%) were the most common bacterial and viral pathogens, respectively, among infants with AGE.
C-Reactive Protein ; Clostridium perfringens ; Dehydration ; Diarrhea ; Epidemiology ; Fever ; Gastroenteritis* ; Humans ; Incidence* ; Infant ; Korea ; Leukocyte Count ; Norovirus* ; Rotavirus ; Staphylococcus aureus* ; Vaccination ; Vomiting

Angioleiomyoma is a rare disease that is histologically characterized by smooth muscle cells arranged around vascular spaces. Although angioleiomyomas occur rarely in the head and neck region, they can cause various symptoms according the site involved. Here, we present a 44-year-old male patient with a 15-year history of asthma, who presented with recent onset of chest discomfort, globus sensation and throat pain. Medication was not effective in relieving his symptoms, and further evaluation revealed a polypoid ovoid mass, almost obstructing the airway at the border of the larynx and upper trachea on chest computed tomography. The mass was completely resected via a rigid bronchoscopy procedure. Histopathologic examination revealed that the excised mass was angioleiomyoma, which was immunohistochemically positive for smooth muscle actin and negative for desmin.
Actins ; Adult ; Angiomyoma* ; Asthma* ; Bronchoscopy ; Desmin ; Head ; Humans ; Larynx ; Male ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Neck ; Pharynx ; Rare Diseases ; Sensation ; Thorax ; Trachea*

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis and multisystem disease. First described in 1930, there are no more than 750 cases reported. The etiology remains unknown, but a majority of cases of ECD and Langerhans cell histiocytosis were found to have clonal mutations involving genes of the mitogen-activated protein kinase pathway. We recently encountered a 53-year-old male patient with extensive ECD involving the systemic lymph nodes, pleura, liver, and long bones clinically mimicking malignant lymphoma. Biopsies were performed at multiple sites, including a pleural mass, an external iliac lymph node, bone marrow, and the liver. Based on histopathological and immunohistochemical findings of positivity for CD68 and negativity for CD1a and S-100, the patient was diagnosed with ECD. Interferon-α was administered as the first-line treatment, but the patient rapidly progressed to hepatic failure after 2 months of treatment. We report this rare case of ECD clinically mimicking malignant lymphoma and diagnosed by careful pathological review.
Biopsy ; Bone Marrow ; Erdheim-Chester Disease ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Liver Failure ; Liver ; Lymph Nodes ; Lymphoma ; Male ; Middle Aged ; Pleura ; Protein Kinases ; Spine

Background: Squamous cell carcinomas (SqCCs) of the lung are known to arise more often in a central area but reports of peripheral SqCCs have increased, with a pathogenesis that is obscured. In this study, the clinicopathologic characteristics of peripheral lung SqCCs were studied and compared with those of the central type. Methods: This study included 63 peripheral lung SqCCs and 48 randomly selected central cases; hematoxylin and eosin-stained slides of surgically resected specimens were reviewed in conjunction with radiologic images and clinical history. Cytokeratin-7 immunohistochemical staining of key slides and epidermal growth factor receptor (EGFR)/KRAS mutations tested by DNA sequencing were also included. Results: Stages of peripheral SqCCs were significantly lower than central SqCCs (p=.016). Cystic change of the mass (p=.007), presence of interstitial fibrosis (p=0.007), and anthracosis (p=.049) in the background lung were significantly associated with the peripheral type. Cytokeratin-7 positivity was also higher in peripheral SqCCs with cutoffs of both 10% and 50% (p=.011). Pathogenic mutations in EGFR and KRAS were observed in only one case out of the 72 evaluated. The Cox proportional hazard model indicated a significantly better disease-free survival (p=.009) and the tendency of better overall survival (p=.106) in the peripheral type. Conclusions In peripheral type, lower stage is a favorable factor for survival but more frequent interstitial fibrosis and older age are unfavorable factors. Multivariate Cox analysis revealed that peripheral type is associated with better disease-free survival. The pathogenesis of peripheral lung SqCCs needs further investigation, together with consideration of the background lung conditions.

Background: The metastatic brain tumor is the most common brain tumor. The aim of this study was to demonstrate the clinicopathological and molecular pathologic features of brain metastases (BM). Methods: A total of 269 patients were diagnosed with BM through surgical resection at Seoul St. Mary’s Hospital from January 2010 to March 2020. We reviewed the clinicopathological features and molecular status of primary and metastatic brain tissues using immunohistochemistry and molecular pathology results. Results: Among 269 patients, 139 males and 130 females were included. The median age of primary tumor was 58 years (range, 13 to 87 years) and 86 patients (32.0%) had BM at initial presentation. Median BM free interval was 28.0 months (range, 1 to 286 months). The most frequent primary site was lung 46.5% (125/269), and followed by breast 15.6% (42/269), colorectum 10.0% (27/269). Epidermal growth factor receptor (EGFR) mutation was found in 50.8% (32/63) and 58.0% (40/69) of lung primary and BM, respectively. In both breast primary and breast cancer with BM, luminal B was the most frequent subtype at 37.9% (11/29) and 42.9% (18/42), respectively, followed by human epidermal growth factor receptor 2 with 31.0% (9/29) and 33.3% (14/42). Triple-negative was 20.7% (6/29) and 16.7% (7/42), and luminal A was 10.3% (3/29) and 7.1% (3/42) of breast primary and BM, respectively. In colorectal primary and colorectal cancer with BM, KRAS mutation was found in 76.9% (10/13) and 66.7% (2/3), respectively. Conclusions We report the clinicopathological and molecular pathologic features of BM that can provide useful information for understanding the pathogenesis of metastasis and for clinical trials based on the tumor’s molecular pathology.

OBJECTIVE: Infection with high-risk genotypes of human papillomavirus (HR-HPV) is the major cause of invasive cervical cancers. HPV-16 and HPV-18 are known to be responsible for two-thirds of all invasive cervical carcinomas, followed by HPV-45, -31, and -33. Current guidelines only differentiate HPV-16/18 (+) by recommending direct colposcopy for treatment. We tried to evaluate whether there are differences in risk among 12 non-16/18 HR-HPV genotypes in this study. METHODS: The pathology archive database records of 1,102 consecutive gynecologic patients, who had results for cervical cytology and histology and for HPV testing, as determined by HPV 9G DNA chip, were reviewed. RESULTS: Among the 1,102 patients, 346 were non-16/18 HR-HPV (+) and 231 were HPV-16/18 (+). We calculated the odds ratios for ≥cervical intraepithelial neoplasia 2 (CIN 2) of 14 groups of each HR-HPV genotype compared with a group of HR-HPV (–) patients. Based on the odds ratio of each genotype, we divided patients with non-16/18 HR-HPV genotypes (+) into two groups: HPV-31/33/35/45/52/58 (+) and HPV-39/51/56/59/66/68 (+). The age-adjusted odds ratios for ≥CIN 2 of the HPV-31/33/35/45/52/58 (+) and HPV-39/51/56/59/66/68 (+) groups compared with a HR-HPV (–) group were 11.9 (95% CI, 7.6 to 18.8; p<0.001) and 2.4 (95% CI, 1.4 to 4.3; p<0.001), respectively, while that of the HPV-16/18 (+) group was 18.1 (95% CI, 11.6 to 28.3; p=0.003). CONCLUSION: The 12 non-16/18 HR-HPV genotypes can be further categorized (HPV-31/33/35/45/52/58 vs. HPV-39/51/56/59/66/68) by risk stratification. The HPV-31/33/35/45/52/58 genotypes might need more aggressive action. Large scale clinical trials or cohort studies are necessary to confirm our suggestion.
Adult ; Cervical Intraepithelial Neoplasia/*virology ; Colposcopy ; DNA, Viral/analysis ; Female ; *Genotype ; Human papillomavirus 16/genetics ; Human papillomavirus 18/genetics ; Humans ; Middle Aged ; Papanicolaou Test ; Papillomaviridae/*genetics ; Papillomavirus Infections/*virology ; Risk Factors ; Uterine Cervical Neoplasms/virology ; Vaginal Smears