Various anomalous origins of the vertebral arteries (VAs) have been reported. However, anomalous origins of the bilateral VAs arising directly from the aortic arch are extremely rare. We encountered a 60-year-old male who developed sudden-onset right hemiparesis with an incidentally discovered rare origins of the bilateral VAs from aortic arch. CT angiography demonstrated the right VA originating from the aortic arch distal to the left subclavian artery and left VA originating from the aortic arch between the left common carotid artery and the left subclavian artery. The possible embryological mechanism of this variant was also reviewed. If the VA can not be found in the usual position during the procedure, a rare variant of the VA with anomalous origin should be considered. Understanding these variations is important to avoid unexpected events during endovascular procedures or surgery.

Various anomalous origins of the vertebral arteries (VAs) have been reported. However, anomalous origins of the bilateral VAs arising directly from the aortic arch are extremely rare. We encountered a 60-year-old male who developed sudden-onset right hemiparesis with an incidentally discovered rare origins of the bilateral VAs from aortic arch. CT angiography demonstrated the right VA originating from the aortic arch distal to the left subclavian artery and left VA originating from the aortic arch between the left common carotid artery and the left subclavian artery. The possible embryological mechanism of this variant was also reviewed. If the VA can not be found in the usual position during the procedure, a rare variant of the VA with anomalous origin should be considered. Understanding these variations is important to avoid unexpected events during endovascular procedures or surgery.

The coronoid process of the ulna surrounds the distal humerus and plays a vital role in posterior dislocation and posterolateral rotational instability. Elbow stability may not be possible if there is a more than 50% loss. Anteromedial facet fractures can lead to instability, radioulnar synostosis. ulnohumeral arthrosis, severe stiffness. Therefore, surgical fixation is required to ensure adequate elbow stability and decrease the risk of posttraumatic ulnohumeral arthrosis. There are several approaches for the repair of coronoid process fractures.In most cases, the posterior approach was used to make a transosseous tunnel connecting the posterior aspect of the olecranon to fix the fracture site. During surgery, the additional dissection required to repair the coronoid might increase the infection risk, nerve injury, heterotopic ossification, and elbow stiffness. The author performed a modified suture lasso and plate fixation with good outcomes. This paper reports this case with a review of the relevant literature.

Recently, sedation is routinely used in children who lacked cooperation in pediatric dental clinics. The purpose of this study is to analyze dental treatment cases in department of pediatric dentistry at Dankook University Dental Hospital associating with sedation during 5 years.From January 2011 to December 2015, information about dental treatment cases in department of pediatric dentistry was collected and reviewed. The information gathered included patient gender, age, sedation type, sedative agents, date of operation, and type of procedure.The proportion of treatment cases with conscious sedation for total treatment cases continued to decline until 2014. On the other hand, the incidence of general anesthesia increased gradually. The frequency of midazolam administration and nitrous oxide inhalation sedation increased recently. The use of conscious sedation was significantly decreased when the age of patient was 3 years or older. The frequency of general anesthesia was similar in all age groups. There was a tendency to perform treatment with deeper sedation when the patient was male than female, and when the pulp treatment was performed together with the restorative treatment than not performed. The frequency of re-treatment within 90 days after restoration treatment decreased as the depth of sedation increased.
Anesthesia, General ; Child ; Conscious Sedation ; Dental Clinics ; Female ; Hand ; Humans ; Incidence ; Inhalation ; Male ; Midazolam ; Nitrous Oxide ; Pediatric Dentistry ; Retrospective Studies ; Statistics as Topic

Langerhans cell histiocytosis (LCH) is a rare condition that usually occurs in children and commonly affects the skeletal system. It is extremely rare in adults, especially in the clavicles. In this report, we describe a pathologically confirmed case of LCH in the clavicle of a 50-year-old male. We report various radiological findings, such as plain radiography, CT, MR, and PET-CT, along with a review of the literature.

Langerhans cell histiocytosis (LCH) is a rare condition that usually occurs in children and commonly affects the skeletal system. It is extremely rare in adults, especially in the clavicles. In this report, we describe a pathologically confirmed case of LCH in the clavicle of a 50-year-old male. We report various radiological findings, such as plain radiography, CT, MR, and PET-CT, along with a review of the literature.

No abstract available.
Biopsy* ; Hemoglobinuria, Paroxysmal* ; Kidney* ; Magnetic Resonance Imaging*

Dapagliflozin is a recently developed oral anti-diabetic drug and SGLT2 inhibitor with well-known cardioprotective and renoprotective effects. Although a reduction of the glomerular filtration rate is induced by volume depletion and tubule-glomerular feedback during the early period after administering a SGLT2 inhibitor, the renal prognosis improves more with a decrease of proteinuria. However, the risk of acute kidney injury increases in heart failure and hypovolemia patients, and in those taking certain drugs, such as non-steroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitor/angiotensin II receptor blockers, or diuretics. We report acute kidney injury after dapagliflozin administration in a diabetic patient with acute cerebral infarction accompanied by right hemiplegia, motor aphasia, and dysphagia.

Dapagliflozin is a recently developed oral anti-diabetic drug and SGLT2 inhibitor with well-known cardioprotective and renoprotective effects. Although a reduction of the glomerular filtration rate is induced by volume depletion and tubule-glomerular feedback during the early period after administering a SGLT2 inhibitor, the renal prognosis improves more with a decrease of proteinuria. However, the risk of acute kidney injury increases in heart failure and hypovolemia patients, and in those taking certain drugs, such as non-steroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitor/angiotensin II receptor blockers, or diuretics. We report acute kidney injury after dapagliflozin administration in a diabetic patient with acute cerebral infarction accompanied by right hemiplegia, motor aphasia, and dysphagia.

Background/Aims: The SAMe-TT2R2 score is used for assessing anticoagulation control (AC) quality with warfarin. However, it is hard to apply SAMe-TT2R2 score in Asian patients with atrial fibrillation (AF), because it has not been proven in those populations. This study aimed to validate the SAMe-TT2R2 score in Asian patients with AF and suggest a modified SAMe- TT2R2 score for this population. Methods: We analyzed 710 Korean patients with AF who were using warfarin. The AC quality was assessed as the mean time in therapeutic range (TTR). Each component of SAMe-TT2R2 score was evaluated for the relationship with AC. Further clinical factors that predict AC were analyzed. Identified factors were re-assorted and constructed as SA2Me-TTR scoring system. Results: Of the components of the SAMe-TT2R2 score, female, age, and rhythm control were associated with AC. Heart failure and renal insufficiency were newly identified factors associated with AC. The modified SA2Me-TTR score was reconstructed with the relevant risk factors (S, female gender, 1 point; A, age < 60 yr, 2 points; Me, medical history of heart failure, 1 point; T, treatment for rhythm control, 1 point; T, history of stroke or transient ischemic attack, 1 point; R, renal insufficiency, 1 point). The modified SA2Me-TTR score demonstrated an excellent relationship with the grading of AC. The modified SA2Me-TTR score ≤ 1 identified patients with good AC (hazard ratio 2.46, 95% CI 1.75–3.47). Conclusions The modified SA2Me-TTR score was useful for guiding oral anticoagulants selection in Asian patients with AF.