At the finishing stage, the use of asymmetric elastics to treat mild skeletal and dental midline discrepancies often creates several side effects such as canted occlusal plane, tipped incisors and anesthetic results. This report presents the clinical cases with midline discrepancies, following a differential diagnosis, optimal mechanics, and considerations in treatment. Differential diagnosis and treatment mechanics with three-piece basal archwire can obtain predictable midline correction with minimal side effects.
Dental Occlusion ; Diagnosis, Differential ; Humans ; Incisor ; Mechanics

An ABO discrepancy was observed in a 37-year-old patient with duodenal ulcer bleeding and B subgroup was suspected. The results of adsorption-elution test, saliva and serum inhibition test and family study suggested Bx phenotype that is not a usual phenotype and is the second case to be reported in Korea.
Adult ; Duodenal Ulcer ; Hemorrhage ; Humans ; Korea ; Phenotype ; Saliva

Paraffinoma is a well known complication of previous paraffin injection into the subcutaneous layer that presents as various conditions including firm mass formation, edema, induration, ulceration, and skin necrosis. Paraffinoma can mimic neoplasm on physical examination and imaging studies and may complicate ultrasonographic diagnoses due to typical posterior shadowing and high echogenicity. When paraffinomas involve around the thyroid gland, the diagnosis of thyroid tumors is very difficult. We present a case of thyroid cancer, the evaluation of which was complicated by the presence of cervical paraffinoma.
Edema ; Hydrazines ; Necrosis ; Paraffin ; Physical Examination ; Shadowing (Histology) ; Skin ; Thyroid Gland ; Thyroid Neoplasms ; Ulcer

Interventions for targeted symptoms are important when setting treatment strategies for individuals with autism spectrum disorder (ASD) and developmental disabilities. Especially, the goal should be to achieve individual “niche construction” by allowing them to select and adjust an environment where they can demonstrate their special characteristics and strengths. In addition, these choices should vary depending on the stage of development of each person with ASD and developmental disabilities. It is necessary to establish a detailed and systematic plan for diagnosis and treatment necessary for infants and toddlers, school placement in school age, and employment or self-reliance in adult transition period to establish customized treatment strategies that fit the individual level of people with ASD and developmental disabilities.

Opacification of the cornea due to the deposition of lipids may be primary without evidence of previous corneal vascularization, or secondary to either preexisting corneal disease or systemic disturbances of lipid metabolism. If the deterioration of vision continues, penetrating keratoplasty may be needed. We evaluated a 19 year-old female patient referred to our department due to progressive corneal opacity in the left eye. She did not have significant past or family histories of corneal diseases. Ocular examinations revealed the whitish corneal deposits with deep stromal vascularization in her left eye. For confirmation of the diagnosis, lamellar keratectomy with amniotic membrane transplantation was performed and deep stromal vessels were photocoagulated using an argon laser. Histologic findings were compatible with lipid degeneration. The corneal opacities reduced markedly and did not show any evidence of recurrence during the follow up period of six months. Therefore, we report this case with the review of the literature.
Amnion* ; Argon ; Cornea ; Corneal Diseases ; Corneal Opacity ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Keratoplasty, Penetrating ; Light Coagulation* ; Lipid Metabolism ; Recurrence ; Young Adult

A choledochal cyst is a relatively common lesion of the biliary tract in pediatric patients and usually presents abdominal pain, jaundice, and abdominal mass. Its etiology is unknown, but the theory of pancreatobiliary reflux through anomalous pancreatobiliary duct union is widely accepted. A mucinous cystadenoma of the pancreas is very rare in children. To our knowledge, there is no literature reporting a case of a choledochal cyst with a mucinous cystadenoma of the pancreas. We report a case of a choledochal cyst combined with a mucinous cystadenoma of borderline malignancy at the head of the pancreas in a 5-year-old girl and review the literature.
Abdominal Pain ; Biliary Tract ; Child ; Child, Preschool ; Choledochal Cyst* ; Cystadenocarcinoma ; Cystadenoma, Mucinous* ; Female ; Head ; Humans ; Jaundice ; Mucins* ; Pancreas*

The majority of the cysts developed in pancreas are inflammatory pseudocyst but neoplastic cysts are rarely encountered Especially, mucinous cystadenoma which was begun and originated from epithelial cell of pancreatic duct is difficult to differentiate from pseudocysts by preoperative clinical, laboratory and radiologic findings. Mucinous cystadenoma has a malignant potentiality, so complete excision of cystadenoma is the treatment of choice. Recently, we experienced one case of mucionus cystadenoma in 37 year-old female, we report it with a review of the literature.
Adult ; Cystadenoma ; Cystadenoma, Mucinous* ; Epithelial Cells ; Female ; Humans ; Mucins* ; Pancreas* ; Pancreatic Ducts

A persistent left superior vena cava is the most common anomaly of the superior caval system. Usually the persistent left superior vena cava is connected with the right atrium via the coronary sinus, resulting in no physiologic derangement : however in 7 to 8 percents of the patietns with a persistent left superior vena cava, the anomalous vessel communicates with the left atrim. In the absence of obstruction to the flow from the left atrium to the left ventricle. this anatomic situation usually results in right to left shunting of varying degress. We recently experienced a case of persistent left superior vena cava in a 52-year-old female who complained of chest discomfort, epigastric pain and dyspnea(NYHA functional class II). Cine-angiography showed that the contrast passed from the left SVC through the dilated coronary sinus into right atrium. And right sided SVC was not seen. The patient was treated with conservative measures and discharged with improved condition.
Coronary Sinus ; Female ; Heart Atria ; Heart Ventricles ; Humans ; Middle Aged ; Thorax ; Tricuspid Valve Insufficiency* ; Vena Cava, Superior

BACKGROUND: The etiology of choledochal cysts is unknown, but the theory of pancreatobiliary reflux through an anomalous pancreatobiliary ductal union (APBDU) is widely accepted. The aim of this study was to evaluate the correlation between choledochal cysts and APBDUs in children. METHODS: We retrospectively analyzed 33 pediatric patients with choledochal cyst who had undergone excision of the whole extrahepatic bile duct along with hepaticoenterostomy at the Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine, from 1993 to 1998. RESULTS: The mean age of the patients was 51 months, and the ratio of males to females was 1:2.3. Anatomical types were Ia (n=17, 52%), Ic (n=11, 33%), III (n=1, 3%), and IVa (n=4, 12%) in the Todani classification of biliary cysts. We performed endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, or intraoperative cholangiopancreatography in all cases. An APBDU was identified in 24 patients (73%): right angle union (n=11, 33%), acute angle union (n=11, 33%), or a complex union (n=2, 6%) in the Todani classification of APBDUs. Type Ia cystic lesions correlated with right angle unions whereas Type Ic cylindrical lesions correlated with acute angle unions. The mean age of patients with a Type Ic, acute angle union was older than that of patients with a Type Ia, right angle union. In Type Ic, the amylase levels in serum and bile were elevated, but in Type Ia, they were not. CONCLUSIONS: APBDUs correlated highly with the shape of the extrahepatic dilatation, the age at onset, and the reflux of pancreatic juice. We think the excision of the entire extrahepatic duct along with a hepaticoenterostomy and appropriate evaluation of the APBDU are essential for the treatment of choledochal cysts in children.
Amylases ; Bile ; Bile Ducts, Extrahepatic ; Child* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst* ; Classification ; Dilatation ; Female ; Humans ; Male ; Pancreatic Juice ; Retrospective Studies

BACKGROUND: Metabolic syndrome is a major risk factor for cardiovascular disease. The combination of an aging population with a chronic diseased population is leading to an increase in the mortality rate due to cardiovascular diseases. The purpose of this study was to assess the prevalence of metabolic syndrome in the Korean population and to evaluate its related factors for sex differences. METHODS: From April 2007 to December 2008, a total of 2,729 volunteers aged 40-69 years living in Changwon city underwent a clinical examination at a hospital in Changwon, Korea. Metabolic syndrome was diagnosed following the criteria defined in Circulation 2009. The clinical examination included measuring anthropometric variables and cardiovascular risk factors, while lifestyle factors were assessed through a questionnaire. RESULTS: The prevalence of metabolic syndrome in our sampling pool was 25.2% with a break down by sex showing a rate of 30.2% in men and 22.2% in women. Related factors associated with metabolic syndrome common to both sex were age, self-health assessment, and alcohol consumption. Sleep duration seemed to be a related factor in men, while income, education, and menstruation status played significant roles in women. CONCLUSIONS: To better manage metabolic syndrome, men need to be educated on alcohol use and women of low socioeconomic status require particular attention as do the aging population and postmenopausal women.
Adult ; Aged ; Aging ; Alcohol Drinking ; Cardiovascular Diseases ; Female ; Humans ; Korea ; Life Style ; Male ; Menstruation ; Prevalence ; Risk Factors ; Sex Characteristics ; Social Class