Localized juvenile spongiotic gingival hyperplasia (LJSGH) is an exceedingly rare gingival disease. Most LJSGH occur in children, predominantly on the labial gingiva of the maxilla, and exhibit clinical manifestations similar to pyogenic granuloma or puberty gingivitis. This report presents a case of LJSGH. A 15-year-old male referred for evaluation of red lesions on the labial gingiva of the maxillary anterior teeth. Clinical examination revealed redness and swelling of the labial marginal gingiva, with no associated pain. After an incisional biopsy, the lesion was histopathologically diagnosed as LJSGH. We present this case to suggest that LJSGH should be considered in the differential diagnosis of patients presenting with painless gingival redness and swelling. We also report that we have obtained satisfactory aesthetic results by applying CO2 laser to LJSGH.

Paradental cysts characteristically develop adjacent to the cervical margin on the lateral aspect of a tooth root and result from inflammatory processes within the periodontal pocket. Standard management usually involves cyst enucleation while striving to retain the affected tooth. Recurrence rates are infrequent following complete removal of the lesion. However, intentional replantation becomes necessary in cases with anatomical constraints or accessibility issues. We present the case of a 13-year-old female patient exhibiting delayed eruption of the mandibular left second molar, attributed to a cystic lesion located on the lingual-coronal aspect of the tooth.

Parotid gland ancient schwannoma is an extremely rare entity, with only 6 cases reported to date. Ancient schwannoma present degenerative alteration, including cystic changes, hyalinizing stroma, hemorrhages, infiltration of macrophages, and cellular atypia with hyperchromatic nuclei. These factors have the potential to mimic malignant tumors, resulting in an overestimation of diagnosis and subsequent inappropriate management. In the present case, we report a case of parotid gland ancient schwannoma, which developed relatively fast degenerative alteration without a large-sized mass. We reviewed all the cases of parotid ancient schwannoma, and suggest that the character of parotid gland tissue can deceive the change of tumor growth size. We also suspect that pre-surgical manipulation, such as FNAB or CNB, can cause degenerative changes in a relative short period. It is important to consider reactive degenerative alteration of schwannoma, and not to misinterpret as a malignant entities, notably when needle biopsy history is present.

The purpose of this study was to introduce and evaluate a nursing ethics seminar course designed for senior nursing students at a university to address the ethical challenges they faced during clinical practice. The course was offered as an elective and 22 students who had completed various clinical practicums over four semesters participated. The participants led discussions on ethical issues they encountered during their clinical practice. To evaluate the effectiveness of the course, an open-ended survey was conducted at the end of the course. The findings were categorized into three main themes: Individual Growth, Collaborative Opportunities, Suggestions for Improvement. The first category is comprised of ‘Experienced emotional acceptance and relaxation’, ‘Felt comforted and encouraged’, ‘Gained clarity’, and ‘Experienced personal growth’. The second category consists of ‘Self-reflection within a group’, ‘Diverse learning opportunities’, ‘Pleasures of discussion-based learning.’ Third category is comprised of ‘Modifying the lesson structure’ and ‘Optimizing the learning space.’

자가면역췌장염은 혈중 IgG4의 증가와 췌장 조직에서 IgG4 양성 플라즈마세포의 침윤을 보이는 질환이다. 제1형 자가면역췌장염의 경우 담관, 타액선, 신장, 후 복강 등을 포함한 다른 장기의 침범도 가능하다. 췌장 종괴 형태로 발현한 자가면역췌장염은 췌장얌과 감별하기 쉽지 않을 수 있다. 60세 남자 환자가 상복부 불편감으로 본원을 방문하였다. 복부전산화단층촬영 및 자기공명영상에서 4.8 cm 크기의 췌장두부 종괴가 있었고 이는 총담관를 침범하고 있었다. 내시경초음파 유도하 세침조직검사 및 내시경역행담 췌관조영술 유도하 담관내조직검사에서 악성세포는 보이지 않았다. 그러나 IgG4 양성 세포가 고배율시야에서 20개 이상 관찰되었다. 총 3주 동안의 스테로이드 치료 후 환자의 증상이 호전되었고 추적 영상검사에서 췌장두부 종괴의 크기가 3 cm로 감소하였다. 이상으로 췌장암과 감별이 어려웠던 췌장 종괴 형태로 발현한 자가면역췌장염 1예를 보고한다.

악성 간문부 담관 폐쇄(malignant hilar biliary obstruction, MHBO) 치료를 위해 시행되는 내시경 담관배액술은 후속 치료, 생존율 및 환자 삶의 질 향상에 필수적이다. 그러나 간문부 담관의 복잡한 해부학적 특징으로 인해 시술의 난이도가 높고 시술 관련 우발증의 위험이 있다. 본 고에서는 완전 피막형 자가팽창성 금속 스텐트(fully covered self-expandable metal stent, fcSEMS)를 이용한 나란한 양측 삽입 담관배액술을 시행 후 근위부 담관내 이탈(proximal stent migration)이 발생한 증례를 보고한다. 현재까지 MHBO에 대해서는 어떤 종류의 스텐트를 어떠한 방법으로 시술할지에 대하여 충분한 근거가 정립되어 있지는 않다. 그렇지만 본 증례와 같이 fcSEMS를 사용할 경우 스텐트 이탈 위험성이 ucSEMS보다 높다는 것은 인지하고 있어야 하겠으며, 환자 진료 시 이러한 사항을 고려하여 적절한 대비가 필요하겠다. 향후 이러한 스텐트 이탈을 줄일 수 있는 다양한 예방법이 고안된다면 많은 도움이 될 것으로 기대 된다.

고주파 흡수제(Accusorb MRI)를 이용한 자기공명영상 검사 중 화재가 발생했다. 다행히 환자는 화상을 입지는 않았 지만 스트랩과 4채널 코일의 케이블, Accusorb MRI가 녹아서 탄 흔적이 발견되었다. 자기공명영상 검사에 사용되 는 도구의 안전 지침을 준수해야 하지만 이를 지키지 않으면 화상, 열상, 장비 손상의 위험이 있다. 사고를 방지하기 위해서는 철저한 사전 점검을 해야 하고 모든 기기, 물품들이 자기공명영상 검사 시 사용 가능한 제품인지 확인하고 사용법을 정확하게 숙지하여야 한다.

Orthokeratinized odontogenic cysts are developmental cysts that occur in the jaw that account for approximately 7%–17% of all cysts in the jaws. Studies have shown that malignant transformation of odontogenic cysts most often occurs in inflammatory cysts, such as periapical cysts, but malignant transformation of orthokeratinized odontogenic cysts has also been reported. In this report, we present an uncommon case of squamous cell carcinoma arising from an orthokeratinized odontogenic cyst.

Purpose: This case report aimed to provide basic data to improve instrumental activities of daily living and quality of care for elderly with dementia. Methods: A total of ten sessions were organized and operated once a week for 16 elderly with dementia. Data analysis was conducted through observational evaluation of participation, concentration, and satisfaction, and pre and post test for each individual. In-depth interviews were performed at the end of each session. Results: Participants were 16.0% in their 70s, 68.7% in their 80s, and 6.3% in their 90s. Their average instrumental activities daily living (I-ADL) score was 20.12±4.93. Post test scores increased in 78% of the elderly. Participation, concentration, and satisfaction were the highest in the 8th session, which was operated under the theme of ‘A good day to go to the hospital,’ and the lowest participation, concentration, and satisfaction were in the 5th session, which was operated under the theme of ‘A good day to go out.’ Conclusion: In the case of elderly with mild or early dementia, performance of instrumental activities of daily living can be improved through repetitive learning. Thus, there is a need to continuously provide such program as a regular program for elderly people in the early stages of dementia.

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.