The trichofolliculoma is a rare tumor of the hair follicle occuring most often on the head and neck. We have experienced a case of 24-year-old female who had a small, dome-shaped, tan brown firm nodule on the nose. Under the clinical impression of a granuloma, an excisional biopsy of the nodule was done. Microscopically the lesion was composed of a large central cystic hair follicle with many srhall but well differenciated secondary hair follicles branching from the wall. Well developed secondary hair follicles were often grouped and were surrounded by a prominent stroma.
Female ; Humans ; Biopsy

No abstract available.
Anemia, Megaloblastic* ; Humans ; Megaloblasts* ; Methotrexate*

This study was carried out to investigate foodservice management practices of 100 child care centers nationwide, and to provide background information for developing foodservice management policies at child care centers. Approximately 20% of the child care centers had a separate dining room; most of the centers were vulnerable to sanitation or safety problems. The percentage of the centers that planned menus was about 60% and 10% established standardized recipes. Fourteen percent of the centers kept records for distribution and menu evaluation and 33% kept sanitation management records. Since only 7% of the centers employed a dietitian, foodservice in most centers were not managed by professionals. The results of menu assessment revealed that 56.5% of the national/public child care centers received 19 points or higher out of 21 points, whereas 5.6% of the private child care centers received the same scores. Proper usage and storage of raw food, sanitary management of equipment and facilities, waste management/leftover food treatment, and basic facility of cooking zones were performed well by many centers. The overall scores of foodservice performance were only 31.2 out of 60 points, representing relatively poor safety management, food procurement management, and facilities and equipment management. These results indicate that the foodservice management of the child care centers are in a relatively poor state. Since nutrition management of the most centers was performed by non-professionals, it may not be possible to provide proper nutrition for health and normal growth of preschool children and to perform efficient nutrition education programs. The following suggestions are strongly recommended in order to improve foodservice performance at child care centers. First, foodservice administration should be performed by a dietitian, and second, efforts should be focused on strengthening nutrition and sanitation management.
Child ; Child Care* ; Child* ; Child, Preschool ; Cooking ; Education ; Humans ; Nutritionists ; Safety Management ; Sanitation

PURPOSE: The purpose of this study was to analyze the characteristic MR findings of childhood metachromatic leukodystrophy. MATERIALS AND METHODS: Five female patients (10--29 months old;mean age, 21.8 months) of biochemically confirmed metachromatic leukodystrophy were included in this study. We evaluated the extent of white matter degeneration, which was shown as high signal intensity on T2-weighted image, and the presence or absence of the enhancement. Result.' All 5 cases showed high signal intensity in periventricular deep white matter and centrum semiovale which were bilateral, symmetric and confluent. Posterior predominace, sparing of subcortical U fibers and immediate periventricular white matter, and the involvement of splenium of corpus callosum were also noted in all cases. There were other manifestations, such as 'tigroid pattern' in centrum semiovale (n=4), the involvement of genu of corpus callosum(n=4), posterior limb of internal capsule(n=4), descending pyramidal tracts (n=3), deep cerebellar white matter(n=1), claustrum(n=2), and diffuse brain atrophy(n=1). In three cases with Gd-infusion, contrast enhancement of the lesion was not seen. CONCLUSION: In childhood metachromatic leukodystrophy, MRI can clearly demonstrate the chracteristic extent of the white matter lesion and other associated findings, facilitating the differential diagnosis from other similar leukodystrophies.
Brain ; Corpus Callosum ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Leukodystrophy, Metachromatic* ; Magnetic Resonance Imaging* ; Pyramidal Tracts

Background: This study aimed to examine international students’ perceptions, characteristics, use of public medical services, and satisfaction with the National Health Insurance System, and compared the results with the Health Insurance System Perception Survey conducted on Korean population to understand the differences between the two groups’ perceptions of the health insurance system and their use of medical services. Methods: A survey was conducted from May 23, 2022 to June 21, 2022 to measure various data of international students related to the National Health Insurance System and analyzed the results. Results: Most international students were in their 20s (the average age was 23±2.06 years), which showed that they were less likely to use medical services compared to Korean population in their 20s. Both Korean population and international students viewed their subjective health as generally good. Regarding the perceptions of the National Health Insurance System, 75.6% of the Korean population responded positively, while only 16% of international students responded positively. The biggest reason for the negative responses was the higher contributions compared to private health insurance, showing that financial hardship played a large role in the negative perceptions. The insurance contribution calculation methods by the Government showed differences.International students receive the same insurance contributions regardless of their nationality, age, income, or assets. Conclusions Through this study, it has been confirmed that further research and examination are needed regarding the application of Korean health insurance to foreign residents and the appropriate calculation of insurance contributions.

Angiomyofibroblastoma is a rare, benign mesenchymal tumor of the vulva. Since it was described in 1992 by Fletcher, 15 cases have been reported in literature. We recently experienced a recurred angiomyofibroblastoma of the vulva. A 45-year-old woman was presented initially in 1991 with a mass of labium major and local excision of tumor mass had been performed. A histologic diagnosis was made of angiomyxoma, but this diagnosis was revised to angiomyofibroblastoma by the authors. The recurred mass was well circumscribed, measuring 2.5x1.6x1.5cm in dimensions. Microscopically the tumor was characterized by high cellularity, numerous blood vessels(which lack prominent hyalinization), and plump stromal cells. Immunohistochemically, the stromal cells were reactive for vimentin and desmin, but not alpha-smooth muscle actin, or S-100 protein. We thought that this case was a recurred angiomyofibrblastoma of the vulva due to incomplete surgical excision.
Female ; Humans

No abstract available.

Obstetrical hemorrhage is one of the deadly triad, along with hypertensive disorder in pregnancy and infection. Postpartum hemorrhage is the major cause of obstetrical hemorrhage. Uterine atony is the most common cause of postpartum hemorrhage, and resulted from poor uterine contraction after delivery of the fetus and placenta. Initial management to control postpartum uterine atonic bleeding is based on the use of uterotonics such as well known oxytocin and ergot preparations together with uterine massage. Prostaglandin E2 analogue, sulprostone can be used next when these agents are failed to produce uterine contraction. The woman unresponsive to non-surgical managements requires surgical interventions including emergency hysterectomy. Recently prostaglandin E1 analogue, misoprostol, has been known to elicit potent uterine contraction and cervical ripening after oral, vaginal or rectal administration. We have experienced two cases of postpartum uterine atonic bleedings which were unresponsive to oxytocin, ergot, or prostaglandin E2, but were successfully controlled by rectal administration of misoprostols.
Administration, Rectal ; Alprostadil ; Cervical Ripening ; Dinoprostone ; Emergencies ; Female ; Fetus ; Hemorrhage* ; Humans ; Hysterectomy ; Massage ; Misoprostol* ; Oxytocin ; Placenta ; Postpartum Hemorrhage ; Postpartum Period* ; Pregnancy ; Uterine Contraction ; Uterine Inertia

The Prototheca species is achlorophyllic algae and rarely causes human infection. Human protothecosis presents clinically as a cutaneous infection, olecranon bursitis, and disseminated systemic disease. We report a case of human cutaneous protothecosis involving the left wrist. A 68-year-old man presented with an ill-defined erythematous lesion with crust at the dorsal aspect of his left wrist. A punch biopsy was performed to reveal the histologic features of granulomatous inflammation with necrosis at the upper dermis, containing Prototheca organisms, of which, the characteristic features were highlighted by special staining. Through a molecular study, the Prototheca zopfii species was identified.
Aged ; Biopsy ; Bursitis ; Dermis ; Humans* ; Inflammation ; Necrosis ; Olecranon Process ; Prototheca ; Wrist

BACKGROUND: There were several studies for the incidence of gastroesophageal reflux associated with the laryngeal mask airway (LMA), but the results of those studies were much different from one another. This conflicting results may be due to the time of the removal of LMA, which has been usually after the arousal (when the patient can open the mouth on command). So, the authors investigated the incidence of the gastroesophageal reflux and the regurgitation of gastric contents above the upper esophageal sphincter associated with the difference of the time of the removal of LMA. METHODS: Sixty three patients scheduled for elective orthopedic surgery with a standardized general anesthetic technique were allocated randomly to Group A (n=34, LMA was removed when the rejection signs such as struggle, restlessness, swallowing and cough came out.) or Group B (n=29, LMA was removed after arousal). For the detection of reflux and regurgitation episodes during anesthesia, a pH monitoring probe was positioned in the lower esophagus and a methylene blue (50 mg) gelatine capsule was swallowed just before induction. At the end of anesthesia, the episodes of reflux and regurgitation of gastric contents were analyzed according to the pharyngeal blue staining or pH< or = 4. RESULTS: The incidence of reflux (pH< or = 4) from the time of the rejection signs to the removal of LMA and the total incidence of reflux in Group B were significantly higher than that of Group A. No patient in both group showed pharyngeal staining of methylene blue. There was no clinical evidence of aspiration of gastric contents in either group. CONCLUSION: Maintenance of LMA until the patient can open the mouth on command seems to increase the incidence of the gastroesophageal reflux.
Anesthesia ; Arousal ; Cough ; Deglutition ; Esophageal Sphincter, Upper ; Esophagus ; Gastroesophageal Reflux ; Gelatin ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Laryngeal Masks* ; Methylene Blue ; Mouth ; Orthopedics ; Psychomotor Agitation