Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and restricted, repetitive patterns of behavior and interest. Sleep problems are not uncommon in children with autism spectrum disorders. Symptoms of insomnia are the most frequent sleep problems in individuals with ASD. Sleep problems can cause significant difficulties in the daily life of children with ASD and their families. Genetic factor, deregulations of melatonin synthesis, extraneous environmental stimuli and psychiatric and medical conditions may cause sleep problems. The first line treatment of sleep problems in ASD includes managements for potential contributing factors and parent education about sleep hygiene care for child and behavioral therapy. Supplementation with melatonin may be effective before considering other medications, such as risperidone, clonidine, and mirtazapine.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Clonidine ; Education ; Genetics ; Humans ; Hygiene ; Melatonin ; Parents ; Risperidone ; Sleep Initiation and Maintenance Disorders

We report a case of subclavian artery laceration caused by the removal of a pigtail pleural drainage catheter in a patient with a pneumothorax. The patient was successfully resuscitated through diagnostic angiography with subsequent balloon occlusion and primary repair of the injured subclavian artery. Although pigtail drainage of a pneumothorax is known to be safe and effective, proper insertion and removal techniques should be emphasized to reduce the risk of complications.
Angiography ; Balloon Occlusion ; Catheters* ; Drainage ; Hemothorax ; Humans ; Lacerations* ; Pneumothorax* ; Subclavian Artery* ; Thoracostomy

Parenchymal pulmonary endometriosis has unique symptoms such as hemoptysis, dyspnea and chest pain in associated with menstruation. We experienced a case of parenchymal pulmonary endometriosis with the complaints of catamenial hemoptysis. Bronchoalveolar lavage(BAL) was performed when catamenial hemoptysis occurred. The BAL fluid showed many erythrocytes, hemosiderin-laden macrophages, and sheets of endometrial stromal cells.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Chest Pain ; Dyspnea ; Endometriosis* ; Erythrocytes ; Female ; Hemoptysis ; Macrophages ; Menstruation ; Stromal Cells

Gestational trophoblastic tumor is one of the curable disease, but metastatic trophoblastic tumor still shows high mortality rate because of resistance to the chemotherapy. Choriocarcinoma may occur after an any type of human pregnancy. The incidence of choriocarcinoma following term pregnancy is very uncommon, and such tumor appears to follow a more aggressive course with more extensive metastatic spread and is less responsive to chemotherapy resulting in a poorer prognosis. Choriocarcinoma presenting as postpartum hemorrhage, and spontaneous tumor perforation with intra-abdominal hemorrhage is even rarer, requiring emergency laparotomy. We had experienced one case of metastatic choriocarcinoma following term pregnancy that required emergency total abdominal hysterectomy due to uterine perforation and hemorrhage. So, we report this case with brief review of literatures.
Choriocarcinoma* ; Drug Therapy ; Emergencies ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Laparotomy ; Mortality ; Postpartum Hemorrhage ; Pregnancy ; Pregnancy* ; Prognosis ; Trophoblastic Neoplasms ; Uterine Perforation*

A patient (Hellman dental age IIIA) who had anterior cross bite due to functional factor was treated with activator. Following results were obtained: 1) Anterior cross bite was crorrected 3 months after the initial application of the appliance. 2) Comparing pretreatment records with posttreatment, the main effects were labioversion of upper incisors, increase of upper arch length and downward-backward rotation of the mandible. 3) There was no damage on teeth and periodontal tissues and the patient had normal occlusion 1 year after the treatment.
Humans ; Incisor ; Malocclusion ; Mandible ; Prognathism* ; Tooth

No abstract available.
Cheek* ; Ultrasonography*

Purpose: The results of a more than 10-year follow-up after total hip arthroplasties with circumferential and proximal porous-coated femoral stems were evaluated. Materials and Methods: Seventy-six patients (80 hips), who were operated on between Aug. 1991 and July 1994, were followed for more than 10 years after primary total hip arthroplasties using Multilock stems. The mean age at the time of the operations was 47.3 years old and the mean duration of follow-up was 12.3 years. The clinical results and radiological findings were evaluated. Results: The mean Harris hip scores improved from 54.7 points to 88.5 points at the time of the 10-year follow up. On the last follow-up radiograph, endosteal bone formation was observed in 70 hips (90%) and all femoral stems were biologically stable. Femoral osteolysis, which was linear in Gruen zone I and VII and mostly restricted to the proximal zones, was observed in 67 hips (84%), and no hip had distal osteolysis in the femur. There was no loosening, migration, or revisions of the stems. Conclusion: Total hip arthroplasties using circumferential and proximal porous coated Multilock femoral stems demonstrated stable osseous fixation and no distal osteolysis for a minimum 10-year follow-up; therefore, all stems were reported to have satisfactory outcomes. With improvement of cup design and liner wear, circumferential and proximal porous coating designs of femoral stems can be an alternative answer to mechanical failure due to aseptic loosening.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Femur ; Follow-Up Studies* ; Hip ; Humans ; Osteogenesis ; Osteolysis

PURPOSE: This study was performed to evaluate MR signal intensity(SI) of calcification and to assess the capability of MRI in detection of various intracranial calcifications. MATERIALS AND METHODS: The MR findings and ROI value of experimental model of calcium carbonate suspension according to each concentration (20, 35, 50%) and diameter (1-10 mm) and hydroxyapatite suspension according to each concentration (10, 20, 30, 40, 50%) were analyzed. A specimen of calcification in cranio-pharyngioma was analyzed for its composition by XRD(X-ray diffractometer) and ICP(inductively coupled plasma) methods. MRI of 34 patients with intracranial calcifications were retrospectively analyzed for signal intensity of the calcification and its capability to detect calcifications according to size, location, and contrast with adjacent lesion. RESULTS: The calcium carbonate phantom with larger diameter and low concentration showed lower signal intensity on T2 than TlWl. Hydroxyapatite phantom showed high signal intensity in 10-30% concentration and low signal intensity in 40-50% concentration on T1 weighted image. The 5 cases of 34 intracranial calcifications showed high signal intensity on T1 weighted image. The capability of MRI in the detection of intracranial calcifications decreased in the circumstances such as small size(<2.5mm) and intraventricular location. Although the size of calcification was small, the detection was easy in the good contrast with adjacent lesion. However, the detection of the small sized calcification was easy if the contrast with adjacent lesion was good. CONCLUSION: lntracranial calcification shows generally low signal intensity on T1 and T2 weighted image with the exception of occasional high SI on TlWl. Detection of intracranial calcification in MRI is affected by its composition, size, location, and contrast with adjcent lesion.
Calcium Carbonate ; Durapatite ; Humans ; Magnetic Resonance Imaging* ; Models, Theoretical ; Retrospective Studies

BACKGROUND: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. METHODS: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. RESULTS: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at 90o abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). CONCLUSIONS: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.
Adrenal Cortex Hormones* ; Compliance ; Elbow ; Follow-Up Studies ; Humans ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation ; Shoulder Joint* ; Shoulder* ; Triamcinolone ; Ultrasonography*

PURPOSE:There are some cases of false positive in neonatal screening for congenital adrenal hyperplasia. To understand its significance of the increased 17 alpha-hydroxyprogesterone(17 alpha-OHP) levels in the cases of positive result, we followed its levels during infancy. METHODS:From July 1997 to June 1998, totally 1,730 babies were screened for congenital adrenal hyperplasia(CAH) measuring 17 alpha-hydroxyprogesterone(17 alpha- OHP) using an enzyme immunoassay(EIA) on dried blood spots. In infants of positive result, the radioimmunoassay(RIA) was used measuring 17 alpha-OHP in serum. And we followed up the levels of 17 alpha-OHP during infancy. Cortisol and ACTH were also measured and followed up in the morning simultaneously. RESULTS:No CAH was detected during the study period. With the 13 ng/mL cutoff limit for 17 alpha-OHP before March 1998, the recall rate was 3.09%. With the 20 ng/mL cutoff limit after March 1998, the recall rate was decreased to 1.58%. Follow-up of the high levels of 17 alpha-OHP in positive cases showed a sharply decreased curve according to age. CONCLUSION: In clinically normal neonates, the high levels of 17 alpha-OHP at screening decreased continuously during infancy.
17-alpha-Hydroxyprogesterone* ; Adrenal Hyperplasia, Congenital ; Adrenocorticotropic Hormone ; Follow-Up Studies ; Humans ; Hydrocortisone ; Infant ; Infant, Newborn ; Mass Screening ; Neonatal Screening*