유두주위게실은 담석의 발생 및 재발에 영향을 주는 위험인자로 보고된 바 있다. 하지만 유두주위게실이 내 시 경 역 행 담 췌 관 조 영 술 ( e n d o s c o p i c r e t r o g r a d e cholangiopancreatography) 시행 중 선택적 담관 삽관의 성공률에 영향을 주는지에 대해서는 논란의 여지가 있다. 다만, 실제 임상에서는 유두주위게실로 인해 선택적 담관 삽관이 어려운 경우가 분명히 존재하며, 이를 해결하기 위한 다양한 방법이 보고되었다. 본고에서는 생검겸자를 이용해 선택적 담관 삽관에 성공한 증례를 보고하고자 한다.

Dystocia, a challenging condition in obstetrics, can arise from various causes, including fetal monsters with structural abnormalities. This case report presents a unique case of dystocia due to a fetal monster known as Perosomus Elumbis in a beetal breed goat from Pakistan. The 4-years-old pregnant doe presented with prolonged straining and failure to deliver the fetus after 8 hours of labor. Upon examination, the cervix was dilated, and only the forelimbs of the fetus were visible in the birth canal. The subsequent delivery involved the application of manual traction by using a dystocia kit, and the removal of edematous fluid from the legs. The monster fetus exhibited absence of hair growth, along with the absence of thoracic vertebrae. Two other fetuses were present, with one found dead and the other alive. Posttreatment involved fluid therapy, antibiotics, and supportive care for the doe. This case report sheds light on the occurrence of Perosomus Elumbis fetal monsters and their impact on dystocia in goat breeding. Understanding the underlying causes and implementing appropriate management strategies are crucial for successful outcomes in similar cases.

Cemento-ossifying fibroma (COF) is classified as a fibro-osseous lesion and usually presents as a progressively growing lesion that can reach a large size if left untreated. Fibrous dysplasia (FD) is a non-neoplastic development that affects the craniofacial bones and is characterized by painless hypertrophy due to the replacement of bone by abnormal fibrous tissue. Herein, a case of concurrent occurrence of COF and FD involving the right mandible is described in a 14-year-old male patient. In this review, the current knowledge of FD and COF is summarized, emphasizing the importance of integrating the understanding of clinical, radiographic, and histopathological features. In addition, the relevant aspects associated with differential diagnosis and patient care are evaluated.

Cat-scratch disease (CSD) is a bacterial infection which primarily transmitted to humans through scratches, bites, or licks from infected cats. Even though CSD is generally a mild condition, atypical symptoms may appear and must be distinguished from other diseases. We encountered a 57-year-old woman who presented with intermittent pain in the right upper quadrant and epigastric part of the abdomen, and had lost 11 kg within a few months. She never had a cat and did not recall being scratched by a cat. Radiologic examinations strongly suggest a malignant bile duct tumor, thus liver resection was done. However, the result of histopathology was a CSD. At follow-up, the patient was stable and also showed improvement in her general condition. Hence, proper preoperative examinations of the patients are crucial in order to avoid excessive or inadequate treatment.

케타민은 진단을 위한 시술과 수술에 사용하는 마취제이다. 하지만 해리성 마취를 일으키고 환각을 유발할 수 있어 유희적인 목적으로 남용되는 경향이 있다. 만성적인 케타민 사용은 케타민 유발 담관병증, 궤양성 방광염 등 많은 부작용을 일으킬 수 있다. 케타민 유발 담관병증은 1980년대부터 보고되었으며 대부분의 증례는 서구 국가와 남아시아에서 보고되었다. 이에 저자들은 국내에서 케타민 유발 담관병증이 발생한 증례를 처음으로 보고하고자 한다. 국내에서 유희적인 목적의 약물 남용이 증가하고 있는 점을 감안하여 젊은 환자에서 원인을 알 수 없는 담관염이 발생한다면 케타민 유발 담관병증을 감별 진단으로 고려해야 한다.

Background: Cerebral palsy presents significant challenges in motor function for affected children. While conventional bottom-up approaches are common in physical therapy, there is increasing interest in the efficacy of the top-down approach. Objectives: To investigated the impact of applying the top-down approach in physical therapy for a child diagnosed with cerebral palsy, focusing on functional improvement and quality of life. Design: A single-case study. Methods: The patient was a 15-year-old boy with spastic diplegic cerebral palsy who was entering middle school. Cerebral palsy treatment approach of the top-down method (jumping rope) was used to guide and direct physical therapy. Results: The child improved in muscle strength of lower extremity, gross motor function, participation and self-esteem, but the pattern of his gait seemed to be more severe on tiptoe. When the child participated in a jumping rope class, he was able to do more than 10 jumps. Conclusion: The effectiveness of the top-down approach in enhancing functional outcomes and quality of life in children with cerebral palsy. It highlights the potential of this approach in pediatric physical therapy, warranting further research validation.

순간증모제는 산화철, 이산화 타이타늄 등의 다양한 금속을 함유하고 있으며 이들은 대체로 금속 인공물을 발생시키 는 원인이 된다. 본원에서 발생한 순간증모제에 의한 자화율 인공물 사례를 공유함으로써 뇌 자기공명영상 검사 전 순간증모제의 사용 여부 확인 및 제거의 필요성을 강조하고자 하였다. 본원의 사례에서 주 자장 세기에 따라 3.0T에 서 검사한 영상에 비해 1.5T에서 검사한 영상에서 자화율 인공물의 강도가 적음을 확인하였다. 시퀀스에 따라서 스핀 에코 기법 영상보다 경사 에코 시퀀스와 EPI에서 큰 자화율 인공물을 발견할 수 있었다. 또한, 순간증모제는 인공물의 원인이 될 뿐만 아니라 영상의 진단적 가치에 영향을 미쳐 뇌 질환을 진단하는데 오진을 초래할 가능성이 있음을 확인하였다. 따라서 자화율 인공물의 발생을 감소시키기 위해서 뇌 자기공명영상 검사 전 순간증모제 사용 여부를 확인하고 되도록 제거한 후 검사를 시행할 것을 권고한다.

In addition to its effectiveness in resolving apical periodontitis, regenerative endodontic treatment (RET) has advantages of inducing root maturation and restoring innate immunity or sensory function through revascularization. However, its adoption in mature teeth in adults has been scarce due to limited stem cell sources and constricted apical size. In recent years, there have been instances of studies performing RET in mature permanent teeth. The present case report describes the treatment of apical periodontitis in a previously treated mature permanent tooth using RET with a 3-year follow up. In the present case, a 34-year-old female patient presented with previously treated maxillary lateral incisor with a large radiolucency. After removal of previous gutta percha within the root canal, bleeding was induced by passing hand file beyond root apex and calcium hydroxide was applied over the blood clot. During the 9-month follow-up, a reduction in periapical radiolucency was observed. Subsequently, after removing calcium hydroxide, apical bleeding was induced again and mineral trioxide silicate was placed up to 3mm beneath cemento-enamel junction, above the blood clot. The tooth was later restored with glass-ionomer cement and composite resin. After 3 years, the tooth was asymptomatic and radiographic evaluations showed complete resolution of periapical radiolucency with presence of normal lamina dura and periodontal ligament space. In conclusion, modified RET with long-term calcium hydroxide application is a potentially viable treatment option for previously treated mature permanent teeth with apical periodontitis. However, further clinical studies with larger number of cases are recommended to verify its effect.

Purpose: This case aims to present basic data needed to improve cognitive function and quality of care for aged with dementia. Methods: A total of ten sessions were organized and operated once a week for 12 aged with dementia using the center. Data collection was conducted from July 27 to September 30, 2022. Data analysis was conducted through observational evaluation of participation, satisfaction, and performance of each individual and in-depth interviews at the end of the program. Results: Among the 12 subjects who participated in the quality improvement program, an average of 8.4 subjects in each session showed high levels of participation and satisfaction. On the other hand, the performance level was low, with an average of 6.9 subjects per session. In the in-depth interview, two concepts were confirmed: ‘regrets about the past’ and ‘satisfaction with present life.’ Conclusions: We hope that the results of this case report will be useful in developing a multifaceted cognitive therapy program to improve the cognitive function of aged with dementia in the future.

호산구성 장염에 의한 급성 췌장염은 매우 드문 질환으로 증상 및 검사실 소견이 특별하지 않아 진단이 어렵다. 급성 췌장염의 원인이 명확하지 않은 경우, 가능한 원인으로 매우 드물지만 호산구성 위장염이 있을 수 있으며, 본 저자들은 호산구성 위십이지장염에 의해 발생한 재발성 급성 췌장염을 진단하고 류코트리엔 수용체 길항제로 치료하였던 증례를 문헌고찰과 함께 보고한다.

파골세포양 거대세포형 미분화 암종은 췌장암의 1%만을 차지하는 흔치 않은 암종으로 알려져 있다. 저자들은 39세 남자에게서 진단된, 수술 및 항암치료를 시행한 1예를 소개하고자 한다.

Langerhans cell histiocytosis (LCH) is a rare disease that arises from an abnormal increase in histiocytes. Due to its rare occurrence, the diagnosis of LCH is often delayed or missed. This report presents a case of LCH in a 16-month-old girl. After biopsy, the patient’s previous medical records were obtained. The records described the presence of a yellowish plaque on the forehead since birth, a characteristic feature of LCH. Earlier knowledge of this medical history would have helped facilitate the diagnosis of LCH. This report aims to inform clinicians of the clinical and histopathological features of LCH in order to aid in the early diagnosis of this disease, which can occur in infancy.

Mucoepidermoid carcinoma (MEC) is the most prevalent malignant tumor originating from the salivary gland. The gradation of MEC is determined histologically based on cellular composition, with high-grade MEC presenting with distinct characteristics and clinical implications. A 56-year-old male presented with a 3-month history of right facial swelling and a recent onset of pain. A subsequent biopsy confirmed a malignant epithelial tumor, with further imaging assisting in determining the surgical approach. Comprehensive surgery, involving the removal of the right submandibular gland and reconstructive procedures, was undertaken. Histopathological evaluation post-surgery confirmed a high-grade MEC. The differentiation between inflammatory conditions and neoplastic lesions in the orofacial region can be challenging. The gradation of MEC is important in guiding therapeutic decisions. Among various classification systems, the Brandwein system offers detailed histopathological criteria that correlate reliably with clinical features. High-grade MECs, although less frequent, are aggressive and have a lower 5-year survival rate. Accurate histopathological diagnosis is crucial in devising an effective treatment plan. The presented case underlines the importance of a meticulous yet periodic follow-up, considering the aggressive nature of high-grade MECs.

이번에 제시할 화상 사례 보고는 환자와 검사를 시행하는 방사선사의 부주의로 인한 화상 안전사고가 아니라 환자 가운 의 치수 구별을 하기 위하여 사용한 녹색 염료가 착색된 파이핑 라인에서 발생한 복부 부위 화상 안전사고에 대한 MRI 인공물 영상과 사례를 보고하고자 함이다. 화학 착색염료는 다양한 금속을 사용하여 만들어지고 주로 금속 염화물로 이루 어져 있으며 이번에 화상 사례로 발생한 녹색 염료는 열 전도성이 높은 구리와 크롬, 철 성분이 많이 함유된 염화물이 주로 사용되고 있다. 이러한 화상 안전사고를 막기 위해서는 염료의 성분에 대해서 알아보고 열 전도성이 없는 스펀지나 면으로 된 포 등을 피부와 환자 가운 사이에 끼워 간격을 두어야 할 것이다. 이번 화상 사례는 철저한 검사 전 선별 절차에도 불구 하고 화상 안전사고가 발생할 수 있음을 보여 주고 있으며 MRI 인공물 영상을 확인하여 조치하면 화상 안전사고를 미리 예방할 수 있는 정보로 가치가 있을 것으로 생각된다.

Synovial cysts of the temporomandibular joint are rare. They commonly occur in the wrist, knee and feet. The main symptoms of synovial cysts occurring in the temporomandibular joint include preauricular pain and swelling, and surgical removal is the gold-standard treatment. A 54-year-old woman who presented with swelling of the right temporomandibular joint visited Kyungpook National University Dental Hospital. She had undergone enhanced computed tomography from another hospital, which showed a 1.1 × 0.8 × 1 cm well-defined rounded cystic lesion on the lateral area of the right temporomandibular joint. A synovial or ganglion cyst was suspected. The cystic lesion was surgically removed under general anesthesia and was histopathologically diagnosed as a synovial cyst. Histopathological findings show a lumen surrounded by loose fibrous tissue, and the lining is in a folded form and is composed of synovial cells.

Cellular myxoma is an uncommon type of myxoid benign tumor, predominantly occurring in adult female patients aged >40 years. This report aims to document a case of cellular myxoma that occurred in the buccal mucosa. Compared to intramuscular myxomas, cellular myxoma demonstrates hypercellularity and vascularity. Its manifestation in the soft tissue of the head and neck area is exceptionally rare. Generally, cellular myxoma manifests as a firm and immovable mass covered with normal oral mucosa, with no associated clinical symptoms. Homogenous low signal intensity on T1-weighted scans and high-signal intensity on T2-weighted magnetic resonance scans reveal cellular myxoma, as most lesions show well-defined margins and heterogeneous contrast enhancement. The significant histologic features include a focal or diffuse increase in cellularity with fibroblast-like cells and vascularity with an abundant collagenous matrix. Our presented case reflects these facts examinations, based on which a final diagnosis of cellular myxoma was made. Immunohistochemistry revealed locally and diffusely positive SMA and CD34. The clinical tendency of cellular myxoma with hypercellularity may affect the production of myxoid and collagenous substrates, and if complete resection is not performed, the possibility of local recurrence in the primarily affected region remains. Hence, complete surgical excision was performed under general anesthesia, and follow-up until a year after treatment revealed no observed recurrence. To achieve precise diagnosis and complete treatment without local recurrence, several diagnostic examinations should be considered.