Pseudolipoma of Glisson’s capsule is a rare benign fatty mass that develops in the subcapsular space of the liver, typically at the interface between the diaphragm and the liver. Histologically, it resembles an epiploic appendage. This report describes a case in which a newly formed hepatic pseudolipoma migrated during follow-up. Positional changes in pseudolipomas are exceedingly rare, with only one other case documented in the literature. This case supports the hypothesis that a lipomatous mass originating from an epiploic appendage can migrate between the serosa of the liver and Glisson’s capsule, eventually forming a pseudolipoma. We present this case to provide valuable insights into the limited literature on this rare phenomenon.

Vertebral artery dissection (VAD) is a rare but serious safety concern associated with spinal manipulative therapy. This report highlights the occurrence of such condition in a 35-year-old male without predisposing risk factors. The patient has had dizziness and occipital pain of new onset following chirotherapy for the neck spines. On admission, magnetic resonance angiography depicted a dissecting dilatation at the intracranial portion of the right vertebral artery. He was placed on antithrombotic therapy and fluid supplementation. His presenting symptoms completely remitted without recurrence. Follow-up images 4 months later showed resolution of the arterial dissection without progression to rupture. The study with featured images facilitates the physicians better understand VAD in those with neurologic complaints following chiropractic manipulation of the cervical vertebra.

Frailty poses a complex challenge to the health and well-being of aging populations, particularly in South Korea, where its prevalence is substantial and increasing. This review explores the landscape of frailty assessment and management in Korea, emphasizing the transition from a disease-centric approach to one focused on maintaining functional abilities and promoting healthy aging. This review covers various frailty screening tools, comprehensive geriatric assessment methods, and targeted interventions across domains such as polypharmacy, physical activity, nutrition, oral health, vitamin D supplementation, cognitive function, falls, and social frailty. The integration of these strategies aims to address the multifaceted nature of frailty and improve health outcomes for older adults. Furthermore, the importance of regular monitoring and reassessment is highlighted to guide personalized interventions and optimize outcomes, particularly for older adults with chronic illnesses. Through a multifaceted approach encompassing medical, social, and functional dimensions, this review advocates for effective frailty management to enhance the health and well-being of elderly in Korea and globally.

Telomere shortening has been suggested as an indicator of aging and psychiatric disorders. However, few studies have explored the relationship between telomere length (TL) and irritable bowel syndrome (IBS). We investigated the association between TL and IBS in 43 IBS patients using quantitative polymerase chain reaction. The clinical characteristics and severity of IBS, assessed by the visual analogue scale, were also analyzed. The average TL was 4.40 ± 3.87, with TL shortening tending to be associated with female sex and smoking. However, these associations did not reach statistical significance. Correlation analysis showed a negative correlation between IBS severity and TL (r = –0.285, p = 0.083), although this was not statistically significant. No other clinical characteristics were significantly associated with TL. This is the first study to examine the relationship between TL and IBS. Our findings suggest that TL may have potential as a predictor for IBS diagnosis.

Pediatric inguinal hernia is the most prevalent surgical condition in children and accounts for nearly half of all pediatric surgical procedures performed. The primary cause of pediatric inguinal hernia is a patent processus vaginalis (PPV), which often requires surgery. Traditionally, the standard treatment involved high ligation of the PPV through a small incision combined with laparoscopic methods. These minimally invasive techniques offer improved cosmetic outcomes and are increasingly favored in clinical practice. This review aimed to present the current surgical techniques for pediatric inguinal hernia treatment, with a focus on various laparoscopic approaches. Additionally, it discusses the optimal timing for treating hernias in neonates and preterm infants as well as specialized surgical strategies for adolescent patients. This review highlights advancements in surgical methods that accommodate the specific needs of different age groups within the pediatric population.

Chiropractic care, known for its non-invasive and hands-on approach to healthcare, can occasionally lead to adverse reactions. This case report details an unusual occurrence of intracranial hypotension (IH) in a 30-year-old female who received chiropractic care for neck pain. The patient experienced a throbbing positional headache five days after mobilization and adjustment of the cervical spine. Upon admission, lumbar puncture performed in the lateral position revealed an opening pressure of 55 mm H2O. Magnetic resonance imaging showed subdural fluid collection and diffuse pachymeningeal enhancement in the cerebral hemispheres. Radioisotope cisternography revealed dural leakage at the upper cervical level. Following unsuccessful supportive measures, the patient underwent treatment with an epidural blood patch. After the treatment, her postural headaches completely subsided without recurrence. This report underscores that IH syndrome is a rare yet clinically significant complication that may be associated with manipulation of the upper spine.

The importance of medical ethics education is increasingly emphasized in medical schools. To improve students’ problem-solving skills, various medical ethics cases are developed and discussed in medical ethics. In this study, based on actual cases of telemedicine and doctors’ strikes, we aim to reflect on medical students’ narratives and identify changes in shared thoughts. The study included 83 students, with responses from 75 students, excluding insincere responses, analyzed. Changes in opinion during discussions were examined using Giorgi’s phenomenological analysis. There was a significant difference in the pros and cons of telemedicine and doctors’ strikes before and after the discussion. The pros of telemedicine were analyzed as ‘expanding healthcare coverage,’ ‘preparing for emerging infectious diseases like coronavirus disease 2019,’ and ‘efficiency of care for certain conditions.’ The cons included ‘high likelihood of misdiagnosis,’ ‘premature implementation and possible abuse of the system,’ ‘risk of healthcare system collapse,’ ‘issues with rural internet and medical devices, and privacy leaks.’ The pros of the doctors’ strike included ‘the need for policies with expert inputs,’ ‘telemedicine may not benefit patients,’ and ‘Korean Medical Association endorsement.’ The cons focused on ‘lack of legitimacy, even if the system is flawed,’ ‘negative image,’ and ‘ignoring doctors’ personal opinions.’ As future doctors, today’s medical students will encounter more complex ethical issues. Medical ethics cases help determine whether they can effectively persuade others with evidence when faced with ethical dilemmas in actual practice.

Severe fever with thrombocytopenia syndrome (SFTS) is a viral hemorrhagic disease prevalent in Asian countries with a fatality rate of approximately 10% to 30%. However, there are currently no definitive treatments for reducing mortality. Variable management strategies have been attempted to reduce the mortality rate associated with SFTS. Tocilizumab is an inhibitor of interleukin-6 and is used to treat rheumatologic and viral infectious diseases. This article presents two cases of SFTS in older patients with neurological symptoms and explores the potential use of tocilizumab, as a treatment option. The patient showed improved consciousness and clinical outcomes after tocilizumab administration. This report describes this condition and reviews related literature.

The number of physicians in Japan has been and will continue to be lower than that in other the Organization for Economic Co-operative and Development (OECD) countries. The admission capacity of medical schools, which has the greatest impact on the number of physicians, has been determined through discussions among the Ministry of Health, Labour and Welfare, medical associations, medical organizations, universities, and academics, depending on the medical supply-demand status on that era. In recent years, the maldistribution of medical specialties and regions has become an issue. For the involving this issue, Japanese government takes from multiple perspectives to address this problem, including “regional quotas” in admission quotas for university medical school and, setting a ceiling on the number of residency positions available in each prefecture as well as on recruitment capacity in the specialist physician system. The implementation of “work style reform” for physicians, focuses on shortening physicians’ working hours and has raised concerns regarding a shortage and regional maldistribution of physicians. The government’s policy is based on a key concern: rising healthcare costs could seriously threaten the country’s financial health. Therefore, the government has limited the increase in the number of physicians. Conversely, this year, the government has begun to argue that a regulatory approach is necessary to address the uneven distribution of physicians. Our proposition is to achieve a number of physicians comparable to that of other OECD countries and to create an environment that enables physicians to voluntarily address their regional and departmental maldistribution.