Gastric trichobezoars are commonly observed in young women with trichotillomania and trichophagia. We encountered an 8-year-old girl who had trichotillomania and trichophagia with abdominal pain and a mass, which was diagnosed as a large gastric trichobezoar. On physical examination, a huge, firm nontender mobile mass was palpated in her epigastrium. An upper gastrointestinal series and abdominal computed tomography (CT) scan showed a large mass in the stomach. Endoscopic removal was tried but failed. Laparoscopic removal was therefore performed. The trichobezoar was successfully retrieved through a gastrotomy and removed through an extended umbilical trocar incision. This case demonstrates that laparoscopic removal of large gastric trichobezoars is feasible and safe without a large abdominal incision.
Abdominal Pain ; Bezoars ; Child ; Female ; Humans ; Physical Examination ; Stomach ; Surgical Instruments ; Trichotillomania

BACKGROUND: The claudins are a family of transmembrane proteins associated with tight junctions and they are critical for maintaining cell-to-cell adhesion in sheets of epithelial cells. However, their role in the progression of cancer remains largely unexplored. The aims of this study were to evaluate the expression patterns of claudin-1 and -4 in benign lesions and invasive ductal carcinomas (IDC) of the breast, and relationships between the expression of these markers and the clinicopathological characteristics in IDC patients. METHODS: We examined the claudin-1 and -4 protein expressions by performing immunohistochemical stainings in 54 benign lesions and 120 IDCs via the tissue microarray method. We evaluated the correlation between the expression of these markers and the clinicopathological characteristics of IDC. RESULTS: The expressions of claudin-1 (p=0.099) and -4 (p=0.000) were up-regulated in IDCs as compared with benign lesions. The claudin-1 expression correlated with the loss of estrogen receptor (p=0.036) and progesterone receptor (p=0.011). The claudin-4 expression correlated with lymph node metastasis (p=0.043), the nuclear grade (p=0.030), the histologic grade (p=0.007), and the loss of estrogen receptor (p=0.001) and progesterone receptor (p= 0.029). CONCLUSIONS: These results suggest that claudin-1 and -4 may play a significant role in the carcinogenesis of IDC of the breast and these may represent novel markers for this disease.
Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Claudin-1* ; Claudin-4 ; Claudins ; Epithelial Cells ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Receptors, Progesterone ; Tight Junctions

A 3-year-old boy with purulent otitis media received a chest radiograph as the part of a routine work up. The patient was normal appearing, in no acute distress. The patient's lung and heart sounds were clear and normal. The patient's abdomen was soft, non-distended, and non-tender. An anterior cardiophrenic mass was incidentally identified on the lateral chest radiograph. A computed tomography scan demonstrated a diaphragmatic hernia with bowel loops in the retrosternal space. An exploratory operation revealed a diaphragmatic defect (4 cm in diameter) on the left side of the falciform ligament, through which transverse colon was protruded. There was no hernia sac, and the defect was closed with interrupted No. 2 silk sutures. The child was discharged on the 8th postoperative day without any complications. During 6 months of follow-up period, recurrence was not noticed.
Abdomen ; Child ; Child, Preschool* ; Colon, Transverse ; Follow-Up Studies ; Heart Sounds ; Hernia* ; Hernia, Diaphragmatic ; Humans ; Ligaments ; Lung ; Male* ; Otitis Media, Suppurative ; Radiography, Thoracic ; Recurrence ; Silk ; Sutures

Benign lymph node inclusions are rare, and can be mistaken for metastasis. We report, herein, a case of a 50-year-old woman who underwent a hysterectomy, with a lymphadenectomy, for an endometrial carcinoma. There was no lymph node metastasis; however, the left external and common iliac lymph nodes demonstrated a few glands, consistent with M llerian-type inclusions (endosalpingiosis). Awareness of these lesions is important to avoid either unnecessary therapy or any delay in treatment. Furthermore, pelvic and aortic lymphadenectomies may be warranted, as neoplastic transformation of preexisting metaplastic tubal-type epithelium is strongly suggested. This paper presents a case of intranodal endosalpingiosis mimicking metastasis.
Endometrial Neoplasms ; Epithelium ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes* ; Middle Aged ; Neoplasm Metastasis*

No abstract available.
Anemia, Hemolytic, Autoimmune*

No abstract available.
Anemia, Hemolytic, Autoimmune*

Takayasu's arteritis (TA), a granulomatous vasculitis, affects the aorta and its major branches. Glucocorticoids are an effective treatment for patients with active TA, but some patients fail to achieve or maintain remission with the conventional therapy, and side effects resulting from long-term glucocorticoid therapy are potentially serious. Anti-tumor necrosis factor-alpha agents, such as infliximab, may be efficient in patients with refractory TA. We report on a 24-year-old female patient with refractory TA who was treated successfully with infliximab. Clinical remission was induced as determined by repeated 18F-fluoro-2-deoxy-D-glucose positron emission tomography scans combined with assay of serological inflammatory markers.
Antibodies, Monoclonal ; Aorta ; Female ; Glucocorticoids ; Humans ; Necrosis ; Positron-Emission Tomography ; Takayasu Arteritis* ; Vasculitis ; Young Adult ; Infliximab

The purpose of this study was to investigate the current status of food service management in the restaurants participating in the government-funded children's meal program during summer vacation. A mail survey was conducted with individuals who worked in the restaurants participating in the government-funded children's meal program in Seoul during the summer vacation in 2010. A total of 600 questionnaires were distributed to 274 Chinese, 235 Bunsik and 91 Korean restaurants, which were selected using proportionate stratified sampling by regions and types of operations. A total of 138 usable questionnaires (23.0%) were returned and analyzed. The results showed that over half (57.2%) of the restaurants did not employ any certified cooks. Most of the restaurants (97.8%) provided side dishes; among them, only 42% planned menus for side dishes in advance and only a half changed side dish menus periodically. The suggested reasonable reimbursement rate per meal for children using restaurants differed by types of restaurants; the percentage of restaurants having responded 5,000 won or higher was the highest in Chinese restaurants. This study revealed that food service in the restaurants participating in the government-funded children's meal program was not properly managed during summer vacation, especially in terms of menu and food production. This study also showed that the suggested reasonable reimbursement rate of meals for children using restaurants differed by types of restaurants, implying that adjusting the reimbursement rate according to types of restaurants should be considered in the government-funded children's meal program.
Asian Continental Ancestry Group ; Child ; Food Services ; Humans ; Korea ; Meals ; Postal Service ; Surveys and Questionnaires ; Restaurants

Hypopharyngeal mass is an uncommon condition in the aerodigestive tract. There were only a few cases have been published in the medical literature. We experienced a case of incidentally detected hypopharyngeal mass during endotracheal intubation. Hypopharyngeal mass was located at the right posterior pharyngeal wall. The hypopharyngeal mass was small and not obstruct the glottis, and endotracheal intubation was performed successfully. We have also briefly discussed symptoms, diagnosis, and related problems during general anesthesia of hypopharyngeal mass.

PURPOSE: The first aim of this study was to retrospectively survey sports injuries among 608 athletes participating in 26 sport events. The second aim was to compare the characteristics of sports injuries depending on the occurrences during the high school and university periods.METHODS: The data were collected based on the daily injury report form proposed by the International Olympic Committee from March to June 2019.RESULTS: Four hundred and thirty-nine athletes (313 men) of 608 participated athletes experienced a total of 747 sports injuries, indicating 0.7 injuries per 1,000 athlete exposures (AEs). The incidence rate during the university period was 6.1 injuries/1,000 AEs, which was approximately two-fold higher than that during the high school period (2.8 injuries/1,000 AEs). The reported frequency of injuries was the highest among long distance athletics (n=60, 8.0%), and in each subgroup as well.CONCLUSION: Many more injuries were incurred during practice wherein injuries in long-distance athletics were the most common than in competition athletics; handball injuries and taekwondo injuries were the most common during high school and university, respectively. The most contact injuries occurred in taekwondo and most noncontact injuries occurred in gymnastics during high school and in badminton during university. The most commonly affected body parts were the knee, shoulder, and ankle. Severe injuries were the most frequent in long distance athletics, and emergent situations were the most common in taekwondo.
Ankle ; Athletes ; Athletic Injuries ; Gymnastics ; Human Body ; Humans ; Incidence ; Knee ; Racquet Sports ; Retrospective Studies ; Shoulder ; Sports