A Complex Cortical Malformation Caused by a Mutation in the Tubulin-Encoding TUBB3 Gene

Tubulinopathy commonly refers to complex congenital and non-progressive brain malformations caused by mutations in the tubulin genes. Among tubulin-encoding genes, TUBB3 has rarely been reported as a cause of complex cortical malformations. Herein, we report a case of tubulinopathy in a 21-month-old boy who presented with delayed development. He could not walk on his own and was not able to speak more than five words. Physical examination revealed right esotropia and hypotonia of the lower extremities. MRI showed dysmorphic brainstem and dysmorphic and hypertrophic basal ganglia. The right thalamus was relatively smaller than the left one. The cerebellum showed disorganization of the cerebellar folia. DNA sequencing revealed a missense mutation of the TUBB3 gene.

Omental Torsion and Infarction Secondary to Omental Hernia in the Right Inguinal Canal

Omental torsion secondary to inguinal hernia has rarely been reported as a cause of acute abdominalpain. However, in our case, omental infarction due to prolonged inguinal hernia-associatedomental torsion led to the formation of a large omental mass with marginal fibrosis, andthe patient presented with chronic abdominal pain. A 74-year-old man presented with complaintsof lower abdominal pain for 1 month; subsequently, bilateral inguinal hernias wereidentified through inguinal ultrasonography. CT scans revealed that the greater omentum wastrapped within the right inguinal canal, leading to omental torsion. The greater omentum, distalto the pedicle, appeared as a 30 cm-sized oblong fibrofatty mass in the right lower abdomenand pelvic cavity. Laparoscopic omentectomy with hernia repair was successfully performed.

Giant Intramyocardial Aneurysm in a Patient with Intercoronary Communication between the Left Circumflex Artery and Right Coronary Artery: A Case Report

Coronary artery aneurysm is a rare disease. It occurs in the epicardial space, mostly along the course of major coronary arteries. Here, we report a case of a giant incidental aneurysm embedded in the basal posterior wall of the left ventricle. A 43-year-old woman was referred to our institution for the evaluation of cardiac palpitations that had been present from the previous 2 months. She reported no medical history (such as Kawasaki's disease or hypertension) or previous operative history. Echocardiogram and subsequent cardiac CT revealed a giant aneurysm in the left ventricle, with a direct fistulous connection to a dilated and tortuous left circumflex artery, which showed direct communication with the straight right coronary artery.

The Role of 18F-FDG PET/CT for Evaluation of Cervical Metastatic Lymph Nodes in a Patient with Metallic Artifacts from Dental Prosthesis: a Case Report / 대한핵의학회잡지

Cervical metastasis of squamous cell carcinoma from an unknown primary site occurs in approximately 2–4% of head and neck tumor cases. Without identification of the primary site, proper management cannot be achieved, resulting in significant morbidity and a lower cure rate. For the primary site assessment, positron emission tomography/computed tomography (PET/CT) using the radiotracer 18F-fluorodeoxyglucose (FDG) is the imaging modality of choice and has been shown to be superior to CT alone. Here, we report a case of cervical metastasis of squamous cell carcinoma in an 82-year-old man. 18F-FDG PET/CT revealed a tongue-base lesion, although neck CT detected no lesions because of artifacts from dental prosthesis, which was suspected as the primary site. The final diagnosis was confirmed as tongue-base cancer with neck lymph node metastases through biopsy. These results suggest that 18F-FDG PET/CT is a valuable diagnostic tool in patients with cervical metastatic lymph nodes because it can demonstrate primary tumors in patients with dental prosthesis.

Embolotherapy of Ruptured Gastroepiploico-Colic Communicating Artery with Median Arcuate Ligament Syndrome: A Case Report

Aneurysm of collateral vessels in celiac axis stenosis has seldom been reported. We report a case of hemoperitoneum due to spontaneous aneurysmal rupture of a previously unreported collateral vessel in a patient with median arcuate ligament syndrome. A 37-year-old man without any history of illness or trauma exhibited hemoperitoneum with an aneurysm in the right subhepatic area on CT. CT findings also included celiac stenosis due to median arcuate ligament thickening. Celiac and superior mesenteric artery angiography revealed an abnormal communicating artery aneurysm between the right gastroepiploic and right colic arteries. We named this aberrant anastomosis “gastroepiploico-colic communicating artery.” This rare collateral channel may cause spontaneous aneurysmal rupture in the presence of celiac stenosis. We successfully treated the aneurysmal rupture by transcatheter arterial embolization.

A Case of Incidentally Discovered Subclinical Cushing Syndrome in a Patient with Chronic Fatigue and Anxiety / 가정의학회지

Subclinical Cushing syndrome (SCS) is a hypothalamic-pituitary-adrenal axis abnormality characterized by autonomous cortisol secretion in patients with no typical signs or symptoms of Cushing syndrome. SCS patients may have adverse metabolic and cardiovascular effects due to slight, but continuous glucocorticoid secretion. Glucocorticoids also affect behavior, mood, neural activity, and a number of specific biochemical processes in the central nervous system. Here, we report a case of SCS due to an adrenal incidentaloma in a hypertensive diabetic patient who presented with chronic fatigue and anxiety that disappeared after the removal of the adrenal adenoma.

Changes in Skin Color after Smoking Cessation / 가정의학회지

This study was performed to assess changes in skin color over 1 month after smoking cessation. The study population consisted of 49 men who participated in a smoking cessation program from March 2010 to June 2010 at a public health centre in Yangsan, South Korea. Thirty-four men who stop smoking completely were included in our study. Instrumental evaluations of skin color were performed using Mexameter (MX 18; Courage and Khazaka Electronic GmbH) at the beginning of the study and at 1-week and 4-week follow-up visits. Skin color was evaluated by measurement of 2 main color bases-melanin and haemoglobin-with the results expressed as melanin index (MI) and erythema index (EI). Both MI and EI were significantly reduced at the 4-week follow-up visit on all 7 sites measured. We anticipate that desirable effects on skin color after smoking cessation will play a positive role in maintaining smoking abstinence in routine clinical practice.

A Case of Scrub Typhus Complicated by Acute Calculous Cholecystitis / 가정의학회지

We report a case of acute calculous cholecystitis through scrub typhus. A 69-year-old woman presented with a history of general myalgia, fever, and right abdominal pain. She referred to our hospital for surgical treatment of clinically suspected acute cholecystitis. Physicians concluded the cause of cholecystitis as gall bladder (GB) stone and proper antibiotics treatment of scrub typhus was started later. The patient developed acute respiratory distress syndrome and multi organ failure through scrub typhus. Five days after admission, the patient was treated with proper antibiotics and discharged on the 13th day after starting doxycycline treatment without any sequelae. In areas endemic for tsutsugamushi disease, even though a patient with GB stone presents with symptoms of acute cholecystitis, careful history and physical examination are required to reveal the existence of eschars or skin eruptions.

A Case of Wilson's Disease in Patient with Mildly Elevated Liver Enzymes / 가정의학회지

Wilson's disease is an autosomal recessive disorder affecting copper transport; it results in the accumulation of copper in the liver, brain, and other organs. Wilson's disease is the most common inherited liver disease with more than 500 cases reported in Korea. An impairment in biliary excretion process leads to copper accumulation in the liver, which progressively damages the liver, leading to cirrhosis. Since effective treatment is available for this disease, early and correct diagnosis is very important. Here, we report a case of Wilson's disease with mildly elevated liver enzyme levels in a 29-year-old breast-feeding woman with weight loss.

Comparison of transition temperature range and phase transformation behavior of nickel-titanium wires / 대한치과교정학회지

OBJECTIVE: The aim of this research was to evaluate the mechanical properties (MP) and degree of the phase transformation (PT) of martensitic (M-NiTi), austenitic (A-NiTi) and thermodynamic nickel-titanium wire (T-NiTi). METHODS: The samples consisted of 0.016 x 0.022 inch M-NiTi (Nitinol Classic, NC), A-NiTi (Optimalloy, OPTI) and T-NiTi (Neo-Sentalloy, NEO). Differential scanning calorimetry (DSC), three-point bending test, X-ray diffraction (XRD), and microstructure examination were used. Statistical evaluation was undertaken using ANOVA test. RESULTS: In DSC analysis, OPTI and NEO showed two peaks in the heating curves and one peak in the cooling curves. However, NC revealed one single broad and weak peak in the heating and cooling curves. Austenite finishing (Af) temperatures were 19.7degrees C for OPTI, 24.6degrees C for NEO and 52.4degrees C for NC. In the three-point bending test, residual deflection was observed for NC, OPTI and NEO. The load ranges of NC and OPTI were broader and higher than NEO. XRD and microstructure analyses showed that OPTI and NEO had a mixture of martensite and austenite at temperatures below Martensite finishing (Mf). NEO and OPTI showed improved MP and PT behavior than NC. CONCLUSIONS: The mechanical and thermal behaviors of NiTi wire cannot be completely explained by the expected degree of PT because of complicated martensite variants and independent PT induced by heat and stress.

A Case of Co-infection of Salmonella typhi and Viral Hepatitis A after Traveling Abroad / 가정의학회지

Infectious diseases imported from other countries have increased. Feco-oral route is the most common mode of transmission for both typhoid fever and hepatitis A, and thus infection by these agents have an association with poor sanitation. A 30-year-old male was visited to the hospital because of high fever after traveling in Thailand. The level of hepatic transaminases were mildly elevated and viral serological marker for hepatitis was negative. The blood culture was reported positive for Salmonella typhi. After a few days, the level of hepatic transaminases rapidly increased and viral serological marker for hepatitis became positive with anti-hepatitis A viral IgM at follow-up. Therefore we report a case of co-infection of S. typhi and viral hepatitis A after traveling abroad.

Delayed Ventricular Septal Rupture after Percutaneous Coronary Intervention in Acute Myocardial Infarction

In the era before reperfusion therapy, ventricular septal rupture complicated 1~3% of acute myocardial infarctions (AMI) usually 3-5 days after onset. Studies have reported a positive correlation between the incidence of septal perforation and total occlusion of the coronary arteries. A 70-year old female patient was referred to the emergency room with the diagnosis of acute anterior myocardial infarction (MI) and recent cerebral infarction. The coronary angiogram showed a 90% stenosis at the mid-portion of the left anterior descending artery (LAD), and the lesion was successfully treated by percutaneous coronary intervention (PCI) with stent implantation. After PCI, the anterior wall motion improved on the follow-up echocardiogram. However, on the 20th hospital day, the patient condition deteriorated suddenly with pulmonary congestion. The echocardiography revealed a 1.3 cm ventricular septal defect at the apical septum with a left-to-right shunt. We report this rare case of delayed septal rupture in a patient with patent LAD after PCI and recovery of wall motion.

Two treatment approach to skeletal Class III : A case report on sisters / 대한치과교정학회지

Patients with skeletal class III can be successfully treated by either orthognathic surgery or orthodontic treatment owing to unavoidable circumstances. Sisters were treated, elder sister by orthognathic surgery and younger one by compromised treatment. For the ideal treatment goal, orthognathic surgery will be inevitable in skeletal problem case, but by the patient`s private situations orthodontist cannot help doing compromised treatment. It could be another option if correct biomechanical approach is used.

A study on the psychosocial implications of malocclusion in korean males of their earely twenties

It is very important for oral and maxillofacial surgeon to understand the attitude of maxillofacial deformity patients toward their deformity. The patients' expectations from surgery, motivations, and the psychological meanings of maxillofacial deformity are considerd by surgeon. The patient's satisfaction and self-assessment on his or her apperance and malocclusion are influenced by realistic condition more and less. There are some differences in points of view on malocclusion between specialist and lay-persons. Some differences from social and cultural base may exist as well. The study of psychological implications of malocclusion with general public will be a foundation in understanding of malocclusion patients. The authers studied the relation between malocclusion and body image, self-perception of malocclusion, social meanings of malocclusion with Korean men around early twenties The results were as follows: 1. The malocclusion played important role in body image. 2. There was difference in the weight of teeth in body image distortion according to the malocclusion. 3. Dissatisfaction aginst his malocclusion was salient in the groups of mandibular prognathism, anterior both crowding, deep overjet . The gruops of deep overjet, anterior both crowding weresusceptibe to the teasing in adolescence period.

A Case Report of Fatal Mediastinal Abscess Secondary to Odontogenic Infection

Modern antibiotic therapy and rapid surgical intervention have greately reduced the complication from the spread of odontogenic infections. Nevertheless, fatalities from dental infections continue to occur. One of the most threaded, and probably lethal form is the mediastinal abscess. This is a case of Ludwig's angina dissected along deep cervical planes into the mediastinum caused a virulent mediastinitis and abscess, computed tomography precisely delineated the extent of the infection. Incomplete debridement resulted in a residual abscess and persistent systemic sepsis that culminated in the patient's death. Aggressive antibiotic treatment of the orofacial cellulitis along with complete mediastinal drainage are recommended for optimal outcome.

Dentofacial changes in Class I protrusion patients treated with premolar extractions / 대한치과교정학회지

The purpose of this study was to evaluate the dentofacial characteristics and the post-treatment dentofacial changes of those treated by four premolar extractions and to investigate the factors affecting extraction decision. The sample consisted of 35 patients ( 27 females, and 8 males ) with no more than 7.0mm crowding, diagnosed as Class I protrusion. Pre-treatment and post-treatment lateral cephalograms were evaluated. Computerized statistical analysis was carried out using SPSS/PC+ program. The results were as follows. 1. There was no significant change in skeletal pattern after treatment while there was significant change in dentoalveolar and soft tissue pattern. 2. In pre-treatment skeletal pattern, a tendency toward vertical discrepancy was found. 3. In pre-treatment dental pattern, interincisal angle was 113.11degrees, Ul to FH was 117.78degrees and Ll to A-Pog was 7.94mm. Pre-treatment upper and lower lip position was 2.88mm and 5.43mm to E line. 4. After treatment, interincisal angle increased 14.46degrees and upper and lower lip moved back 2.45mm and 12mm to Eline. (p<0.001) 5. The EI was 138.71 before treatment and 148.2 after treatment.