To describe treatment using aligners in an adult female patient with dental class II malocclusion associated with crowding. Treatment objectives were achieved in 10 months with patient satisfaction. Combining aligners with appropriate attachment location, geometry and staging are efficacious means of resolving class II malocclusion.

Hepatic arteriovenous malformation mostly occurs as a manifestation of hereditary hemorrhagic telangiectasia. Clinical symptoms include hyperpulsatile heart failure, hepatic encephalopathy, and ascites. We present a case of hepatic arteriovenous malformation and atrial septal defect causing heart failure.

Nodular melanoma (NM) is the third most common subtype of melanoma among African Americans (AA) behind acral lentiginous melanoma (ALM) and superficial spreading melanoma (SSM) (1, 2). This case of NM in an African American Japanese male was selected due the rare occurrence of NM in skin of color patients.

Laryngeal venous malformations rarely but do cause airway obstruction resulting in life-threatening events. The perioperative airway management for the patients with them have not been well established. We suggest a strategy for laryngeal venous malformations management in the patients who undergo surgery in addition to planning for airway management.

We report two cases of previously healthy young men with COVID-19 infection who developed acute ischemic stroke due to large vessel occlusion followed by secondary events concerning for a further thromboembolic event. We hypothesize that the hypercoagulable state related to COVID-19 exacerbated the underlying hereditary thrombophilia due to MTHFR-gene mutation.

Gastroenteritis can be associated with life-threatening complications like myocarditis. A 16-year-old male presented with acute myocarditis mimicking STEMI after gastroenteritis. He made an uneventful recovery after appropriate treatment. This case report highlights that clinicians should be aware of this rare, but serious, cardiac complication when treating patients with gastroenteritis.

Basal ganglia calcifications have been linked to a wide range of causes. Mostly it is an idiopathic finding, especially in elderly. Endocrinological and neurological disorders are major causatives. Hyperthyroidism was not related to this finding. We present a case of incidental basal ganglia calcification in man with Grave's disease.

Masked polycythemia vera due to iron deficiency anemiaKoma Hotta, MD1, Ryotaro Niwa, MD21Department of General Internal Medicine, Takatsuki Hospital, Osaka, Japan2Department of Hematology, Japanese Red Cross Takatsuki Hospital, Osaka, Japan

The case is a 67-year-old female with autosomal dominant polycystic kidney disease who was followed up regularly. CT scan showed a mural nodule growing over the past 4 years inside the hypodense region surrounded by hepatic cysts. Surgery was performed and the pathological diagnosis was StageⅠ gallbladder cancer.

Moebius Syndrome is a rare multifactorial condition defined by congenital complete or partial VII and VIth cranial nerves palsy and other physical abnormalities. We present the case of a 3 months old infant with Moebius sequence and breathing and eating difficulties, managed by tracheostomy and laryngoplasty.

Streptococcus intermedius is a commensal bacterium reported in few cases as the causative agent of brain and lung abscesses, pneumonia, and endocarditis. Lung abscesses due to Streptococcus intermedius are rare, especially in pregnancy. We describe the first case of lung abscess due to streptococcus intermedius in a pregnant woman.

We present the case of a 65 years old patient who developed a complete, sensorineural hearing loss on the right side due to an intravestibular schwannoma. Our video shows a transcanal, endoscopic approach with complete schwannoma removal on the right side, subsequent e-BERA recordings, and cochlear implantation.

Herein we report the intriguing case of a 42-year-old woman presenting with grade three hypertension, severe hypokalemia and primary amenorrhea, which revealed to be the complete form of 17 alpha-hydroxylase deficiency. We also discuss the challenging therapeutic approach as well as the outcomes and the follow-up of this patient.

Methemoglobinemia is a rare but fatal disorder of the oxygen-carrying capacity of hemoglobin. Here is a case representing high-dose Sulfamethoxazole/ Trimethoprim ( SMX/TMP ) induced Methemoglobinemia in a boy treated for Ventilator-associated pneumonia (VAP), which was resolved successfully after administration of methylene blue and discontinuation of SMX/TMP

Retroperitoneal sarcoma is relatively uncommon. We share our experience in encountering retroperitoneal sarcoma with vascular and urethral adhesion in a 46-year-old woman. Given the rarity of these tumors, evaluation and management should ideally be performed in a center equipped with multidisciplinary expertise in treating sarcomas.

A 55-year-old female patient presented with generalized tonic-clonic seizures. Laboratory evaluation showe low calcium (4.9 mg/dL), low PTH (0.9 pg/mL), & positive activating CaSR antibodies. The condition was diagnosed as autoimmune hypoparathyroidism. Vitamin supplements did not correct the patient’s hypocalcemia and steroids were added to the treatment.

Here we discuss a diabetic 54 years old female presented with malignant otitis externa and bilateral facial paresis followed by cervical spondylitis and C1-C2 instability. Skull base osteomyelitis confirmed by clinical presentation, imaging, and lab data. Fortunately, she responded well to anti-bacterial and antifungal therapy.

The use of Dynamic Movement Orthoses® is examined in a young woman with hypermobile Ehlers-Danlos syndrome (hEDS) referred for physiotherapy with hip dysplasia, prior to a right peri-acetabular osteotomy. Dynamic Movement Orthoses® plus rigorous subjective examination, therapists’ listening skills and patient-centred goals was useful for this hEDS patient.