Fisting is an uncommon sexual activity, and death due to fisting is very rare. In the present report, we describe a case of a woman who died from fisting by her male partner. A 38-year-old woman went to a motel with a man after consuming alcohol, and there they kissed each other. As desired by woman, the man inserted his fingers into her vagina and anus, and later inserted his fist and forearm into her vagina and anus. After 20-30 minutes of fisting, the woman became unconscious and died. The autopsy confirmed the presence of perineal and vaginal lacerations with massive internal pelvic soft tissue injury with uterine artery rupture. A partial tear was noted at the rectosigmoid junction. The cause of death was hypovolemic shock due to uterine artery rupture. Following court trials, the assailant was sentenced to 4 years of imprisonment for the felony of inflicting bodily injury resulting in death.
Anal Canal ; Autopsy ; Cause of Death ; Female ; Fingers ; Forearm ; Humans ; Lacerations ; Male ; Rupture ; Sexual Behavior ; Shock ; Soft Tissue Injuries ; Unconscious (Psychology) ; Uterine Artery ; Vagina

We report a case of anosacral cutaneous amyloidosis in a 74 year-old-man. The skin finding is a patch of the size of a childs palm on the sacral area, consisting of brownish macular lines that radiate frorn the anus. Histopathology revealed defiosits of homogenous eosinophilic mateial s in the papillary dermis. Congo red staining and dylon staining was positive. Immuohistochemical staining using anti SAP antibodies and anti-keratin antibodies showed positive reactions.
Amyloidosis* ; Anal Canal ; Antibodies ; Child ; Congo Red ; Dermis ; Eosinophils ; Humans ; Skin

BACKGROUND: Although palmoplantar epidermal cysts have long been associated with develop ment following implantation of an epidermal fragment as a result of a penetrating or blunt injury, the pathogenic mechanism is still not fully understood. Since 1987, many cases have been reported in which human papillomavirus(HPV) could be associated with palmoplantar epidermal cysts. OBJECTIVE: In this study, we evaluated the clinicopathological findings of palmoplantar epidermal cysts and investigated them for the presence of HPV in order to examine the role of HPV in the pathogenesis of this disorder in Korea. METHODS: The clinical, histological, immunohistochemical studies were performed on seven cases of plantar cysts, and two cases of palmar cysts. RESULTS: No previous trauma history was seen. Histopathologically, parakeratotic nuclei, or vacuolar strutures within the keratinous mass in the cyst cavity were found. However, we could not find intracytoplasirnic eosinophilic bodies in the wall, the cyst content, or the overlying epidermis. The dyskeratotic keratinocytes were observed in 3 cases. Papillomavirus common antigens were not detected by immunohissochemical staining. CONCLUSIONS: Palmoplantar epidermal cysts in Korea have some different histological features compared to those of HPV 60-associated cases in Japan and we could not detect the immunohistochemical evidence of HPV infection in our cases.
Eosinophils ; Epidermal Cyst* ; Epidermis ; Humans ; Japan ; Keratinocytes ; Korea ; Wounds, Nonpenetrating

The affiliations were published incorrectly.

We report three cases of rat mite dermatitis caused by Ornithonysus bacoti(Hirst, 1913), commonly referred to it as the tropicalrat mite. The first case, a 26-year old female had multiple pinhead sized vesicles with peripheral erythematous macule on the upper arms. The second case, a 34-year-old femal had multiple variable sized vesicles with erythematous base on the extremeties. The third case, a 43-year old male had multiple erythematous macules and papules with central punctum on the trunl: and extremities. Histopathologic sections from lesions of the first and second patient showed moderate perivascular lymphahistiocytic infiltration intermingled with some eosinophils. Causative mites, Ornithonyssus bacoti, female were collected around the skin lesion in rase 1, from the house dust in case 2 and furniture in case 3.
Adult ; Animals ; Arm ; Dermatitis* ; Dust ; Eosinophils ; Extremities ; Female ; Humans ; Interior Design and Furnishings ; Male ; Mites* ; Rats* ; Skin

No abstract available.
Neurons*

BACKGROUND: Basal cell carcinoma(BCC) is the commonest type of skin malignacy, and its incidence is increasing. As a result, the number of cases requiring treatment by dermatologists may also be increasing. OBJECTIVE: The aim of this study was to clarify the presentation pattern of BCC and to assessce the surgical treatment used in the dermatological surgery clinics in Seoul National University Hospital and Seoul City Boramae Hosptial between 1994 to 1998. METHOD: We reviewed the medical records and checked clinical aspects and surgical treatment methods. RESULTS: The Total number of patients was 33. There were 21 Females and 12 males. The Mean age was 63.1. The most common anatomical site was the face and scalp(30 cases, 91%). The mean size of the tumor was 12.2 by 9.6 mm. BCCs were removed by complete surgical excision with a normal skin margin of 2 to 4 mm. The local flap was most commonly used to repair surgical wounds (55%) and primary closure was used in 39% of patients. A Pedicle flap and full thickness skin graft were also used in surgical defect reconstruction. CONCLUSION: With increasing public awareness and earlier presentation there may be a reduction in tumor size at the time of diagnosis. As most BCCs are found on the head and neck and are usually more or less than 1cm in diameter, it is thought that appropriate education of surgical skills should be needed and offered.
Carcinoma, Basal Cell* ; Diagnosis ; Education ; Female ; Head ; Humans ; Incidence ; Male ; Medical Records ; Neck ; Seoul ; Skin ; Transplants ; Wounds and Injuries*

Intrathecal administration of methotrexate(IT-MTX) has constituted the standard approach to prophylaxis and treatment of central nevous system(CNS) leukemia. We experienced a quadriplegia and motor aphasia in a 14-year-old boy following repeated IT-MTX for the prophylaxis of meningeal leukemia. He was diagnosed as ALL without CNS involvement and treated by CCG- 1882 protocol. IT-MTX was administered for CNS prophylaxis. The patient began complaining of urinary incontinence, motor aphasia and weakness in his right leg from 12 days after the 5th dose of the IT-MTX therapy. Even though the IT-MTX was discontinued, loss of muscle power progressed upward resulting in quadriplegia. The patient showed slow and partial recovery on right extremities over 3 months. We report this case with brief review of literature.
Adolescent ; Aphasia, Broca* ; Extremities ; Humans ; Leg ; Leukemia ; Male ; Methotrexate* ; Quadriplegia* ; Urinary Incontinence

Diffuse interstitial lung disease(DILD) is a large group of heterogeneous diseases that diffusely involve the pulmonary connective tissues, principally subpleural, interlobular and alveolar wall portions. Terminology and classification of these diseases are not uniform, and the cause and the pathogenesis are unknown in many entities. It is generally accepted that the response to therapy is related to the relative degree of cellularity and fibrosis present, therefore a histologic evaluation of the relative extent and severity of these changes is required. We reviewed 52 cases of DILD from January 1990 to May 1995 diagnosed by open lung biopsy to reappraise classification and quantitative assessment of the histopathologic features. Differential histopathologic features between usual interstitial pneumonia(UIP) and nonspecific interstitial pneumonia(NIP) were examined with a correlation of HRCT findings and clinical findings. Among 52 cases of DILD, 18 cases(34.6%) were UIP, 6 cases(11.5%) were hypersensitivity pneumonia was NIP was 5 cases(9.6%), interstitial lung diseases associated with the connective tissue diseases were 5 cases(9.6%), inorganic dusts were 4 cases(7.7%), infections were 4 cases(7.7%), durgs were 2 cases(3.8%), acute interstitial pneumonia was 1 case(1.9%), sarcoidosis was 1 case(1.9%) in order of frequency plus 6 other cases(11.5%). UIP was the most frequent DILD in this study which seemed to be a criteria bias of patient selection on open lung biopsy. Quantitative assessment of histopathologic features was useful in the differential diagnosis of DILD and differentiation of UIP from NIP was possible based on histopathologic features and supported by HRCT. UIP disclosed a significantly high score of fibrotic changes, especially in the interstitial fibrosis, smooth muscle proliferation and honeycombing, otherwise NIP appeared relatively high score in inflammatory changes. Correlation between histopathologic scores and the clinical outcome after steroid therapy or no therapy in UIP was not evident.
Diagnosis, Differential ; Biopsy

Hypertensive left ventricular hypertrophy(LVH) was considered to be a physiologic adaptation to the increased afterload of left ventricle, but recent studies revealed that LVH was one of the most important target organ damage in essential hypertensive patients & cardiovascular morbidity was increased in patients with hypertensive LVH. Hypertensive LVH could be classified into three types : concentric LVH, disproportionate septal thickening(DST), and left ventricular dilatation. Relatively high incidence of DST in hypertension has bee reported after clinical introduction of echocardiogram. But, the mechanisms for the development of DST and its clinical significance have not been elucidated exactly. In order to assess left ventricular diastolic function in hypertensives with DST, the authors performed phonocardiogram, M-mode, and pulsed Doppler echocardiogram in 15 normotensive control(group A : 5 male, 10 female, 44.4+/-7.7 years), 15 hypertensives without LVH(group B : 5 male, 10 female, 45.5+/-8.6 years), 85 hypertensives with DST(group C : 9 male, 16 female, 47.5+/-8.6 years) and 15 hypertensives with concentric LVH(group D : 8 male, 7 female, 47.7+/-6.1 years). The obtained results were as follows : 1) Left ventricular ejection fraction was 71.6+/-6.3% in group A, 71.9+/-7.5% in group B, 731+/-7.0% in group C, and 70.3+/-10.3% in group D. Ejection fraction was not significantly different in each other group. 2) Left ventricular mass index(LVMI) by echocardiogram was 87.8+/-20.6g/m
Adaptation, Physiological ; Bees ; Deceleration ; Dilatation ; Female ; Heart Ventricles ; Humans ; Hypertension ; Hypertrophy ; Incidence ; Male ; Relaxation ; Stroke Volume