This report describes a rare case of primary rectal mature teratoma in a 56-year-old woman. She was referred to the outpatient clinic with a large pedunculated rectal mass, which was found during a regular health check-up. Polypectomy was performed and microscopic findings showed various structures derived from all three germ cell layers. Epidermis, hair follicles, sebaceous glands, eccrine glands, and apocrine sweat glands, with some scattered melanophages and lymphocytes were present as ectodermal derivatives. Smooth muscle fibers, blood vessels, and fibrous and adipose tissues were found as mesodermal derivatives. In addition, thyroid follicles, mucinous glands, and bronchial respiratory epithelium with peribronchial glands were detected as endodermal derivatives. She is healthy and has shown no evidence of recurrence or distant metastasis for 25 months post-surgical resection. Primary rectal teratomas are generally benign and primarily affect women. Therefore, minimally invasive surgical procedures, such as endoscopic polypectomy for a pedunculated polyp and segmentectomy for a larger mass, are satisfactory in most cases. Induction of primary rectal teratomas has been suggested to occur mainly by errors in a single germ cell after the end of meiosis I; in addition, it has also been suggested that the difference in gender incidence may be associated with differences in sex chromosomes between males and females rather than with anatomical proximity between ovary and rectum.

Clear cell adenocarcinoma (CCA) is a rare malignant neoplasm of salivary gland that represents only 1% of all salivary gland tumors. CCA is histopathologically characterized by monotonous, glycogen-rich, round to ovoid clear cells intermixed with hyalinized stroma. However, other salivary gland tumors such as mucoepidermoid carcinoma, acinic cell adenocarcinoma, oncocytoma, epithelial-myoepithelial carcinoma, and myoepithelial carcinoma should be ruled out to diagnosis CCA. We herein report a case of CCA involving the soft palate in a 56-year-old female. It is essential to consider CCA in the differential diagnoses of clear cell tumors.

복막 가성점액종은 원발병소에 관계없이 복막표면과 대망 등에 점액성 물질이 침착되면서 점액성 복수가 복강 내에 축적되는 상태를 말하는 임상적 질환이다. 원인질환으로 매우 드물지만 췌관내 유두상 점액종양이 보고되고 있으며, 시술과 관련된 점액의 누출, IPMN 파열 및 샛길 형성에 의한 복강내 점액누출 등이 유발기전으로 제시되고있다. 저자들은 췌장의 악성 IPMN 점액누출에 의해 발생한 복막 가성점액종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

감염성 췌장괴사의 고전적인 치료는 개복 수술이었다. 하지만 개복 수술 후 합병증, 사망률의 유의한 증가가 보고되면서 항생제와 보존적 치료가 일차적 치료로서 우선적으로 선택되고 있다. 보존 치료에 반응이 없는 경우에는 다양한 경로를 통한 배액법 및 괴사제거술 등의 최소 침습시술이 대두되고 있으며, 이러한 최소 침습 시술의 선택은 환자의 임상 양상, 보존적 치료에 대한 치료 반응, 괴사 조직과 위장관의 해부학적 위치 관계에 대한 정확한 평가 및 그에 따른 시술 방법의 선택이 이루어져야 한다. 저자들은 급성 감염성 췌장 괴사에서 항생제 등의 보존적 치료와 경피적 배액술을 시행하였으나 치료반응이 없는 환자에서 경피적 내시경적 괴사 제거술을 통한 성공적인 괴사 치료1예를 경험하였기에 보고하는 바이다.

A Warthin’s tumor of major salivary glands, in particular of parotid glands, is a common benign tumor that may occur synchronously or metachronously in the same or contralateral gland. Moreover, epithelial malignance associated with a Warthin’s tumor is extremely rare, and exists in three forms; epidermoid carcinoma, adenocarcinoma, and undifferentiated carcinoma. The reports, related with a case of squamous cell carcinoma arising in a Warthin’s tumor at the parotid gland were reported only additional 3 cases from 1999 to 2010; 30 cases reported up to 1999.[2,4,7] This case report was a extremely rare case where both a primary squamous cell carcinoma and a Warthin's tumor were coexisting in the same

Small cell osteosarcoma of bone, which was first described in 1979, is an unusual variant of osteosarcoma. Osteoid production by tumor cells is frequently focal or minimal, making the differential diagnosis with other small round cell tumors of bone difficult. Here, we present a rare case of small cell osteosarcoma of the mandible appearing as bony bulging mass in 31-year-old male who has neither tenderness nor paresthesia. Histologically, the tumor contains hypercellular cartilage and abnormal osteoid associated with small round to ovoid malignant cells. Awareness of small cell osteosarcoma should be emphasized because it has worse prognosis than both other small round cell tumor and conventional osteosarcoma.

◉ 목적 : 본 연구는 컴퓨터 보조 인지 재활프로그램으로 사용되는 Rehacom을 이용하여 학령기 아동을 대상으로 한 치료효과를 알아보고자 하였다. ◉ 연구방법 : 본 연구는 2011년 10월부터 2011년 12월까지 총 3명을 대상으로, 15인치 노트북과 컴퓨터 보조 인지 재활프로그램의 전용패널을 사용하여 실시하였다. 1회기 치료시간은 30분이며, 10분씩 정해진 3가지 컴퓨터 보조 인지 재활프로그램(위치기억, 지속적 집중력, 공간적 조작 능력)을 6주간, 주 2회 시행하였다. ◉ 결과 : 대상자 A를 제외한 B와 C는 공간적 조작 능력에서 향상된 결과를 보였으며, 위치기억력, 지속적 주의력은 3명 모두 향상된 결과를 보였다. 또한 일상생활에서도 Rehacom 치료 프로그램 적용 후 향상된 기능수준을 나타냈다. ◉ 결론 : 3명의 지적장애 학생을 대상으로 컴퓨터 보조 인지 재활프로그램을 실시한 결과 위치적 기억과 지속적 집중력이 점차 향상되었으며, 일상생활이 이전에 비해 향상된 것으로 나타났다.

Whereas calcium deposition in soft tissues is not uncommon, highly-structured, identified as mature cancellous bone within soft tissues is not frequent. Here, we report an usual case of mature cancellous bone in cheek subcutaneous tissue in 15-year-old Korean male. Microscopically the cancellous bone was encompassed by epithelial cells, which was confirmed by immunohistochemical staining with cytokeratin AE1/3. The present mature cancellous bone in subcutaneous tissue could be originated from oral epithelium.

A tissue sample of a laryngopharyngeal mass from a 9-year-old male Dachshund dog was submitted to the Animal, Plant and Fisheries Quarantine and Inspection Agency for histopathologic evaluation. The mass measured was 3.1×3.0× 5.0 ㎝ in diameter and was first detected by computed tomography. Histopathologically, the nodules consisted of large round and polygonal cells with abundant eosinophilic cytoplasm. The mitotic index was 1～3 per view under a high power field (400×). Immunohistochemically, tumor cells were positive for vimentin and desmin, but negative for cytokeratin, S-100, and α-Smooth Muscle Actin (α-SMA). Based on these findings, the tumor was confirmed as Laryngopharyngeal Rhabdomyosarcoma. To the best of our knowledge, this is the first case report in Korea.

Malignant tumor of the paranasal sinus is a rare, occurring most frequently in the maxillary sinus. Carcinomas of the maxillary sinus are usually diagnosed at the advanced stage because most tumors have no symptom or nonspecific symptoms such as pain, nasal obstruction, rhinorrhea, and epistaxis. In addition to these features, it is difficult to distinguish carcinoma from inflammatory or cystic lesion on imaging study until the carcinoma destroys the surrounding structures. Therefore, the diagnosis is prone to be delayed. Here, we report a case of an 83‐year‐old male with nonkeratinizing carcinoma on the maxillary sinus, which was initially misdiagnosed as a cystic lesion. The aim of this study is to emphasize the effort for early diagnosis in order to improve prognosis and avoid inadequate treatment

The ossifying fibroma (OF), with the microscopic features of trabuclae or spherules of bone or cementum-like material in a cellular fibrous connective tissue stroma, is one of the most common benign fibro-osseous lesions in the jaw bones. The OF often occurs in patients from 20 to 40 years of age, which is a definite female predilection. The mandibles are involved far more often than the maxillas, especially the pre-molar and molar regions. It is slow-growing, bone producing, asymptomatic and well-demarcated. The OF is a disorder of odontogenesis or osteogenesis ascribed to bone marrow stroma cells (BMSCs) abnormality. However, the detailed mechanisms of OF’s oncogenesis, cytodifferentiation, and tumor progression remain unknown. In this article, we reported a huge central OF on the anterior mandible. The lesion was enucleated and peripheral ostectomy was done via intraoral approach and reconstructed with vascularized iliac block bone graft. After 25 months of follow up, the tumor had not recurred. This case shows that OF may be successfully treated by conservative surgical enucleation and peripheral ostectomy.

Nodular fasciitis is defined by the World Health Organization as a benign proliferative fibroblastic lesion. It was first described in 1955 by Konwaler et al. and also known as “nodular pseudosarcomatous fasciitis” and “infiltrative fasciitis”, which reflect the lesion’s rapid growth, dense cellularity, alarming mitotoic activity and lack of circumscription. Here, we report a case of nodular fasciitis, which appeared as subcutaneous mass of right perizygoma area in 40-year-old Korean female. She had no history of trauma or cosmetic surgery related with the lesion. She disclosed that the mass grew rapidly for last 2 months. Computed tomography showed relatively well-defined spherical mass with 1.2 cm in diameter. Under local anesthesia the mass was resected by intraoral approach. The histological examination revealed a relatively poor-dermacated mass with high cellularity, which was composed with infiltrative spindle-shaped cells without accompanying inflammatory reactions. The tumor cells were partially positive for α-smooth muscle actin and β-catenin, but negative for cytokeratin AE1/3, S-100, desmin, and CD34. Therefore, the lesion was pathologically diagnosed as nodular fasciitis. Although nodular fasciitis is known to pseudosarcomatous benign reactive lesion, the clinician need to follow up the patient periodically. The reasons are as follows; Nodular fasciitis may accompany nuclear accumulation of β-catenin, which imply neoplastic process rather than reactive process of the lesion. Moreover, it has many histological similarities with inflammatory myofibroblastic tumor which have malignant transformation tendency. Further research for mesenchymal tumor could help our understanding for the disease entity of nodular fasciitis

The osteoblastic activity of carcinoma is restricted in osteoblastic metastasis, common in the patients with prostate cancer, whereas its mechanism and the factors involved are unknown. Here, we present a case of central adenocarcinoma showing the osteoblastic activity in the mandible of the 80-year-old Korean male who had suffered from the paresthesia of lower lip during four mouths. Clinically the overlying oral epithelium was intact, but the radiologic images revealed the ill-defined radiolucent intraosseous lesions in left ascending ramus. Microscopically, the mandibular lesion was composed with carcinoma of ductal or glandular differentiation but lack typical features of any epithelial salivary gland malignancies. Intriguingly abundant new bone formation was found in the stroma, but the tumor cells expressed no reactivity for prostate-specific antigen(PSA). The patient had low ionized calcium level, normal serum alkaline phosphatase and PSA level. Positron emission tomography-computed tomopraphy scan revealed the benign prostatic hyperplasia, but failed to trace the primary site of tumor other than mandible. Therefore, pathologically diagnosis for the lesion was informed as adenocarcinoma, not otherwise specified(NOS). Because occult primary tumor associated with osteoblastic metastasis cannot be completely ruled out, periodic and careful check-ups for the patient should be performed.

목적 : 사례연구를 통해 근거중심의 컴퓨터-보조 인지 프로그램 중 전산화 인지재활프로그램(COMCOG)을 이용하여 치매환자의 기억력 감퇴에 어떠한 영향을 미치는가를 알아봄으로써 전산화 신경 인지재활 치료에 기여할 수 있는 기초 자료를 제공 하고자 한다. 연구방법 : 본 연구 대상자는 알츠하이머 진단을 받은 77세 노인 환자이다. 대상자의 인지치료는 COMCOG를 사용하였으며, 대상자의 인지기능은 CARDS, MMSE-K, COPM, ACLS를 사용하여 평가하였다. 치료 기간은 2010년 11월 20일부터 동년 12 월 21일까지 주 5회 4주간 총 20회기였다. 결과 : 컴퓨터-보조 인지 프로그램을 이용한 인지치료 훈련은 실험 전보다 실험 후 지남력(시간, 장소, 사람), 단어지연회상(10개 단어, 물건), 재인지(10개 단어, 물건), 최근기억, 과거기억에서 의미 있게 향상된 결과를 보였다. 또한 컴퓨터-보조 인지 프로그램을 이용한 인지치료 훈련은 MMSE-K와 ACLS, COPM에서 향상된 결과를 나타내었다. 결론 : 본 연구에서 컴퓨터-보조 인지 프로그램 사용이 치매환자의 기억력에 영향을 미친다고 볼 수 있으며, 조기에 컴퓨터- 보조 인지 치료적 접근방법을 사용한다면 환자들의 삶의 질은 크게 향상시킬 수 있을 것이며, 임상에서 유용하게 사용될 것으로 생각되어진다.

In this case report, we investigated the effects of robot-assisted gait therapy in a chronic stroke patient using motor assessment and gait analysis. A patient who suffered from the right hemiparesis following the left corona radiata and basal ganglia infarction received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks. Outcome was measured using Motoricity index(MI), Fugl-Meyer assessment(FMA), modified motor assessment scale(MMAS), isometric torque, body tissue composition, 10-meter gait speed and gait analysis. After robot-assisted gait therapy, the patient showed improvement in motor functions measured by MI, FMA, MMAS, isometric torque, skeletal muscle mass, 10-meter gait speed. In gait analysis, cadence, single support time, double support time, step length, walking speed improvement in after robot-assisted gait therapy. The results of this study showed that robot-assisted gait therapy is considered to facilitate locomotor recovery of the chronic hemiparetic stroke patient.

Osteogenic sarcoma is primary malignant bone tumor. It can arise de novo or from the benign precursors lesions, like Paget’s disease, giant cell tumor, chronic osteomyelitis, osteoblastoma, and fibrous dysplasia. Here, we present a case of osteogenic sarcoma arising from florid osseous dysplasia appearing as a rapidly growing bony bulging mass in 44‐year‐old Korean female who had at first been non‐symptomatic, but later suffered from the numbness of chin and lower lip. The radiologic images revealed the mixed radiopaque‐ radiolucent intraosseous lesions throughout the mandible, which were diagnosed as florid osseous dysplasia pathologically. But only after 6 months, the lesions were substituted by the radiological ill‐defined diffuse bony sclerotic lesion with bone destruction, accompanying the interrupted periosteal bone formation, which were pathologically diagnosed as osteogenic sarcomas. These serial clinicopathologic changes imply the malignant progression of florid osseous dysplasia rather than the collision of benign condition, florid osseous dysplasia and malignant tumor, osteogenic sarcoma. The possibility for fibro‐osseous lesion of the jaw as premalignant lesion should not be overlooked; therefore, periodic check‐ups for the lesions are necessary. Proper evaluation and interpretation for clinical neural symptom and radiologic change of bone density may lead to the correct differential diagnosis and therapeutic intervention.

This infection includes an allergic bronchial reaction, an aspergilloma, and an invasive aspergillosis, which is more common in immunosuppressed patients and presents as multiorgan disease. The maxillary sinus is a relatively common site for formation of an aspergilloma where it forms around a nexus of foreign body. It has been indicated that the foreign body containing zinc extruded into the maxillary sinus has the potential to become infected and form an aspergilloma. The treatment of this disease is radical surgery and adjunctive systemic antifungal therapy. This is a case report of solitary aspergillosis of the right maxillary sinus. We experienced a case of right maxillary sinus aspergillosis in a 37 years old male who has dull pain on right temporal and zygoma area. We reported a case with review of literature

The present case study highlights the effects of a novel Comprehensive Hand Repetitive Intensive Strengthening Training (CHRIST) on morphological changes and associated upper extremity (UE) muscle strength and motor performance in a child with spastic quadriplegic cerebral palsy (CP). The Child, a 10-year-old girl with spastic quadriplegic CP, was treated with CHRIST for 60 minutes a day, five times a week, for 5 weeks. The CHRIST was designed to improve motor function and strength. Clinical tests including the modified Wolf Test, Jebsen-Taylor Hand Function Test, and Pediatric Motor Activity Log questionnaire were used to determine motor function. Ultrasound imaging was performed to determine the changes in the cross-section area (CSA) of the extensor carpi radialis (ECR) and triceps brachii (TRI). Muscle strength was measured with a dynamometer at pretest, and post-test, and 3-month follow-up. Ultrasound imaging data showed that the CSAs of both ECR and TRI muscles were enhanced as a function of the intervention. These changes were associated with muscle strength and motor performance and their effects remained even at a 3-month follow-up test. Our results suggest that the CHRIST was effective at treating muscle atrophy, weakness and motor dysfunction in a child with spastic quadriplegic CP.