No abstract available.
Eosinophilic Granuloma* ; Eosinophils* ; Meningitis, Bacterial*

As times go by, the objects and subjects of researches have changed. Forensic medicine and science can not be escaped. To overview the international changes and trend of forensic medicine and science, we gathered abstracts of 3,354 articles from 5 outstanding international journals, those are (1) Forensic Science International, (2) Journal of Forensic Science, (3) American Journal of Forensic Medicine and Pathology, (4) Medicine, Science and the Law, (5) International Journal of Legal Medicine. There were 1,226 articles (36.6%) on forensic pathology, followed by forensic genetics (902 articles, 26.9%), toxicology (549 articles, 16.4%), forensic sciences (445 articles, 13.3%) and medical law & criminal psychology (232 articles, 6.9%). Corresponding authors from 4 countries (USA, Great Britain, Germany and Japan) took more than half of total corresponding authors. And there were 27 articles (0.8%) from Korea. This article will introduce us an overview of international trend of forensic researches.
Criminal Psychology ; Forensic Genetics ; Forensic Medicine ; Forensic Pathology ; Forensic Sciences ; Germany ; Great Britain ; Jurisprudence ; Korea ; Pathology ; Toxicology ; United Nations

No abstract available.
Acoustic Stimulation* ; Acoustics* ; Female ; Fetal Heart* ; Fetus* ; Heart Rate, Fetal* ; Pregnancy

BACKGROUND: Microcirculatory derangement in sepsis plays a crucial role in the impairment of tissue oxygenation that can lead to multi-organ failure and death. The change of RBC rheology in sepsis has been known to be important factors in microcirculatory derangement. Several studies have demonstrated that RBCs have decreased deformability in sepsis. We investigated the relationship between multi-organ failure and spherical index of RBC estimated by flow cytometer in critically ill patients with or without sepsis compared with the relationship in healthy volunteers. METHODS: Fourteen non-septic critically ill patients, 18 septic patients and 10 healthy volunteers were evaluated. We obtained peripheral venous blood from each patient and analyzed the change of RBC shape using flow cytometer (Becton Dickinson FACSCalibur) within 90 minute. The change of RBC shape was accessed with spherical index (M2/M1). A decrease in M2/M1 was correlated with the sphericity of the RBC and considered to have a lower capacity to alter their shape when placed in microcirculation. Multi-organ failure was accessed with sequential organ failure assessment (SOFA) score. RESULTS: The M2/M1 ratio of healthy volunteers, non-septic patients and septic patients were 2.25+/-0.08, 2.16+/-0.39 and 2.05+/-0.53, respectively. But, there was no significant difference between each group (p>0.05). And, there was no significant correlation between M2/M1 ratio of septic and non- septic patients and SOFA score (p>0.05, r2= -0.13). CONCLUSIONS: In our study, the spherical index of RBC was not associated with multi-organ failure in sepsis. But, further studies may be needed to evaluate the role of RBC rheology in sepsis.
Critical Illness ; Healthy Volunteers ; Humans ; Microcirculation ; Oxygen ; Rheology ; Sepsis*

BACKGROUND: Pulmonary Kaposi's sarcoma (PKS) directly affects the life expectancy of those infected and yet the clinical and radiographic features of Kaposi's sarcoma (KS) with pulmonary involvement are nonspecific, which makes diagnosis difficult. In Uganda, pulmonary tuberculosis, which has clinical features that closely resemble those of PKS, also occurs commonly and thus confusion is bound to arise. Bronchoscopy is a recognized diagnostic investigatory modality for PKS. The aim of present study was to identify unique or useful points for the differential diagnosis of PKS and other opportunistic infections. METHODS: The clinical, radiologic, and bronchoscopic findings in thirty-five Ugandan patients (age 20-50, median 32) with PKS were analyzed. RESULTS: Cough and weight loss were most common and occurred in 97.1%, whereas fever occurred in 62.9%, and breathlessness in 57.1%. Thirty-four patients (97.1%) showed mucocutaneous KS, and palatal KS was most frequent and was observed in 74.3%. In addition, 25 patients (71.4%) showed the characteristic endobronchial plaques of KS. The most frequently observed radiographic abnormality was bilateral reticulonodular density. Histological examinations of bronchoscopic biopsies revealed KS in 7 (36.6%) cases. Five PFS patients (25%) also had co-existent tuberculosis. CONCLUSIONS: The majority of patients with PKS showed no specific findings on physical examination, apart from mucocutaneous KS. Our findings indicate that palatal KS may be a strong predictor of PKS. In Uganda, pulmonary tuberculosis may be the most common concomitant pulmonary infection in PKS patients.
Uganda ; Tuberculosis, Pulmonary/diagnosis ; Sarcoma, Kaposi/*diagnosis ; Middle Aged ; Male ; Lung Neoplasms/*diagnosis ; Humans ; Female ; Diagnosis, Differential ; *Bronchoscopy ; Adult

OBJECTIVE: To assess the pre-pregnancy and pregnancy factors influencing pregnancy outcome in renal transplanted women Materials and METHODS: This retrospective study included all pregnancies in renal transplanted women in Asan Medical Center between June 1996 and February 1998. We collected data from the medical records of allograft recipients. Pre-pregnant status and pregnancy outcome were described. RESULTS: Seventeen pregnancies in 13 allograft recipients resulted in 7 term deliveries, 4 preterm births, 2 spontaneous abortions, and 4 therapeutic abortions. All but one patient received immunosuppressive therapy with cyclosporin A, azathioprine, and prednisolone during pregnancy. The mean interval from the time of transplantation to conception was 28.8+/-14.3 months(range 6-60 months). In live birth group, the mean gestational age at delivery was 37.7+/-1.2 weeks and the mean birth weight of their offspring was 2.85+/-0.37 kilogram. Apgar scores at 5 minutes were 8 or more in all of them. The obstetric complications were distributed as follows: pregnancy induced hypertension in 6 cases(55%), pregnancy aggravated hypertension in 2 cases(18%), fetal growth restriction in 1 case(9%), prematurity in 4 cases(36%). Cesarean sections were done in 4 cases(36%) because of previous Cesarean section(3 cases) and uncontrolled hypertension(1 case). Neonatal complication, transient tachypnea of the newborn, was found in one case. Graft rejection after transplantation occurred in 4 cases: 3 cases in preterm births and 1 case in therapeutic abortions. Maternal renal functions were normal during pregnancy and postpartum period whose pre-pregnant renal functions had been normal. No patient experienced any rejection episode or graft loss during pregnancy. CONCLUSION: Successful pregnancy can be expected in women with a renal transplant, although there was high incidence of pregnancy-related complications, especially hypertensive disorders. Pregnancy can be encouraged to these allograft recipients if they have good renal function.
Abortion, Spontaneous ; Abortion, Therapeutic ; Allografts* ; Azathioprine ; Birth Weight ; Cesarean Section ; Chungcheongnam-do ; Cyclosporine ; Female ; Fertilization ; Fetal Development ; Gestational Age ; Graft Rejection ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Incidence ; Kidney Transplantation ; Live Birth ; Medical Records ; Postpartum Period ; Prednisolone ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Retrospective Studies ; Transient Tachypnea of the Newborn ; Transplants

It is well known that immunologic factors like rejection episode and HLA missmatch influence allograft loss and prognosis. However, non-immu- nologic factors such as glomerular hyperfiltration may also have an effect on the survival of the allograft. We measured relative kidney function(dkRF) by DMSA scan, GFR(dGFR) using EDTA and CCr dCCr) by 24-hour urine collection in donors of 70 adult living-related renal allografts engrafted at a single center between December 1992 and January 1994 as a donor work-up before transplantation, and calculated donated kidney GFR(dkGFR=dGFRxdkRF) and CCr(dkCCr=dkCCrxdkRF). We observed graft function for 5 years and analyzed the prognostic factors for the graft. Graft dysfunction was defined as the increase of serum creatinine 5 years after transplantation more than 1.5 times of stabilized serum creatinine at 3 months after transplantation. 1) Sixty patients were followed up for 5 years. Graft dysfunction was observed in 22 patients(37%) and maintenance renal replacement therapy was required in 9(15%) of them. 2) Of the non-immunologic factors, donor age was older in patients with graft dysfunction(51 +/- 12 years) than those without it(34 +/- 11 years, p<0.01), but dkGFR(54.1 +/- 12.2ml/min vs. 58.5 +/- 11.9mVmin), dkCCr(44.8 +/- 14.3mVmin vs. 50.74 13.4ml/min) and the ratio of body surface area(recipient/donor, 0.964 0.14 vs. 0.990.12) were not different in the two groups. Age of recipients and occurrence of graft glomerulopathy also were not different in the two groups. The episode of acute rejection was more frequent in patients with graft dysfunction(32%, 7/ 22) than those without it(3%, 1/38, p<0.01), but the degree of HLA missmatch was not different. In multivariate analysis, donor age(p<0.01) and the episode of acute rejection(p<0.05) were independent factors affecting graft dysfunction. 3) Donor age was older(52 +/- 12 vs. 3814 years, p<0.01) and the episode of acute rejection was more frequent(56%, 5/9 vs. 696, 3/51, p<0.01) in 9 patients with graft loss than those without it. However, dkGFR, dkCCr, body surface area ratio, recipient age, occurrence of glomerulopathy and HLA missmatch were not different. In multivariate analysis, donor age(p<0.05) and the experience of acute rejection(p<0.01) were independent factors affecting graft loss. We therefore conclude that donor age is more important as non-immunologic prognostic factors in graft dysfunction than GFR of the donated kidney and the difference in body mass between recipient and donor.
Adult ; Allografts* ; Body Surface Area ; Creatinine ; Edetic Acid ; Humans ; Immunologic Factors ; Kidney ; Kidney Transplantation ; Multivariate Analysis ; Prognosis ; Renal Replacement Therapy ; Succimer ; Tissue Donors ; Transplants ; Urine Specimen Collection

Adefovir dipivoxil (ADV) effectively inhibits lamivudine-resistant hepatitis B virus replication. Hypophosphatemia and elevated serum creatinine are ADV-related nephrotoxicity caused by high-dose ADV. Hypophosphatemic osteomalacia is very rare and is induced by low-dose ADV. A 61-year-old man suffering from chronic hepatitis B manifested with generalized myalgia and bone pain, especially in both ankles and knees. He had been administered ADV for 56 months, since lamivudine-resistant HBV was detected. He developed severe hypophosphatemia and elevated serum alkaline phosphatase levels with a high bone fraction. Bone densitometry and a whole-body bone scan revealed osteoporosis and multiple hot uptake lesions. Blood chemistry and clinical symptoms improved after discontinuing the ADV.
Adenine ; Alkaline Phosphatase ; Animals ; Ankle ; Creatinine ; Densitometry ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Hypophosphatemia ; Knee ; Middle Aged ; Organophosphonates ; Osteomalacia ; Osteoporosis ; Stress, Psychological

A young male patient diagnosed with Klinefelter syndrome was admitted to our hospital via the emergency room with chief complaints of acute chest pain and dyspnea. Pulmonary thromboembolism was diagnosed from his chest CT images. His symptoms improved after he underwent thrombolysis and anticoagulation treatment. Klinefelter syndrome has a tendency towards hypercoagulability due to hormonal imbalance and one or more inherited thromophilic factors. Thus, Klinefelter syndrome patients with a past medical history of venous thromboembolism require continuous oral anticoagulation therapy for a period of at least six months.
Chest Pain ; Dyspnea ; Emergencies ; Humans ; Klinefelter Syndrome ; Male ; Pulmonary Embolism ; Thorax ; Thrombophilia ; Venous Thromboembolism ; Venous Thrombosis

Occipital nerve blockade is a widely used procedure in the treatment of primary and secondary headache disorders. The procedure is generally well tolerated, although local side effects such as cutaneous atrophy, hyperpigmentation, and alopecia can occur. The present study describes a case of alopecia following occipital nerve blockade with triamcinolone. This complication can be avoided by precautions such as local injection and the use of alternative steroid preparations.
Alopecia ; Atrophy ; Headache Disorders, Secondary ; Hyperpigmentation ; Nerve Block ; Triamcinolone