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

Sixty one cases of gastric adenocarcinoma were studied immunohistochemically for expression of HLA-DR and secretory component(SC) in order to analyze the relationship between expression of these in gastric cancer cells and the adjacent mucosa. Immunostaining was detected within the cytoplasm and on the cell memgrane. The rate of HLA-DR and SC expressions in cancer cells were 59.0% and 49.2%, respectively, and 52.5%/52.5% and 31.2%/50.8% the mucosa in adjacent/remote from the site of to cancer. The SC expression in the adjacent mucosa was lower than that of the remote mucosa(p=0.027). The HLA-DR expression in the cancer cells in the intestinal type of gastric adenocarcinoma(73.9%) was higher than that of the diffuse type(14.3%) and it was statistically significant(p=0.02). The presence of an increased amount of lymphoid infiltration in the gastric mucosa was closely related to the expression of HLA-DR and SC. Decreased or absent expression of SC at the transitional mucosal cells was possibly a result of exposure to genotoxic agents due to the lack of protective function of SC-IgA. From these results, one can postulate that the expression of HLA-DR and SC may play an important role in atleration in microenvironment with lymphoid infiltration.
Adenocarcinoma ; Stomach Neoplasms

The affiliations were published incorrectly.

BACKGROUNDS: To examine the effects of seizure laterality and stimulus type on Wada memory performance in patients with temporal lobe epilepsy(TLE). METHODS: The subjects were 43 patients with medically intractable TLE (left TLE 26, Right TLE 17) who had no or rare seizures after surgery. The memory stimuli were concrete figures for some subjects and abstract figures for the other subjects. RESULTS: A clinical criterion of at least 2-points difference between left and right injections correctly classified 31(72%) patients into left and right TLE groups, with 4(9%) patients falsely classified. A discriminant function analysis(DFA) based on left and right injection scores allowed for a correct classification of 37(86%) patients into left and right TLE groups. When the memory stimuli were concrete figures, the correct classification rate was greater for right than left TLE patients. In contrast, with abstract figures, the correct classification rate was greater for left than right TLE patients. CONCLUSIONS: The Wada memory test is a valuable diagnostic aid in lateralizing temporal epileptogenic foci. Stimulus type as well as seizure lateralization is a major determinant of Wada memory asymmetries.
Amobarbital* ; Classification ; Epilepsy, Temporal Lobe ; Humans ; Memory* ; Seizures ; Temporal Lobe*

BACKGROUND: There is concem about the rising incidence of skin cancer. However, few articles have reported the change in the clinical and epidemiological aspects of skin cancer. OBJECTIVE: We performed this study in order to clarifiy the recent changes in cutaneous premalignant and malignant lesions. METHODS: A statistical analysis was made using 101 cases of cutaneous premalignant lesions and 205 cases of ma]ignant tumors out of a total number of 20,175 new outpatients that visited the Department of Dermatology at the Seoul National University Hospital during a 6 year period(1990-1995). RESULTS: The frequency of premalignant lesions was 0.50% and that of malignant tumors was 1.02%. The frequency showed an increasing tendency compared to previous reports. In the premalignant lesion cases, actinic keratosis was most common and represented a figure of 82.2%. Among the malignant tumors, basal cell carcinoma was most frequent at 24.4%. Age, sex and anatomical site distribution of basal cell carcinoma, malignant melanoma was no different. The mean age of squamous cell carcinoma was greater than in previous reports and main preceding lesions were actinic keratosis and cheilitis. The frequency of lymphoma was markedly increased but the reason for this remains to be determined. CONCLUSION: Our findings showed the continous increasing incidence of skin cancers and emphasize the need for public eduacation, early diagnosis and proper treatment.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheilitis ; Dermatology ; Early Diagnosis ; Humans ; Incidence ; Keratosis, Actinic ; Lymphoma ; Melanoma ; Outpatients ; Seoul ; Skin Neoplasms ; Statistics as Topic*

OBJECTIVES: This study was aimed to examine the prevalence of neuroleptic-induced irregular menstruation and its related factors as well as the possible relationship of irregular menstruation with psychopathology and extrapyramidal symptoms in schizophrenic patients. METHODS: Thirty five schizophrenic inpatients at Naju National Mental Hospital who satisfied the diagnostic criteria of DSM-IV were selected. They had drug-free periods for more than 1 month before admission and had been taking neuroleptics for more than 3 months after admission. From all patients, reliable information regarding the sociodemographic characteristics, the menstrual histories before and after admission and clinical characteristics, including previous and current medications were investigated. The following were also evaluated: Serum prolactin level(by radioimmunoassay), psychopathology(by positive and negative syndrome scale: PANSS), and extrapyramidal symptoms(by extrapyramidal symptom rating scale: ESRS). RESULTS: Twelve patients(34%) showed regular menstruation and 23 patients(66%) were suffering from irregular menstruation. Of those with irregular menstruation, 13 patients(37%) had oligomenorrhea and 10 patients(29%) had amenorrhea. There were no differences in sociodemographic characteristics and menstrual histories before admission between the regular and irregular menstruation groups. But, the significant differences between the two were found in the following variables: The irregular menstruation group had shorter durations of illness, higher daily doses of current neuroleptics, higher serum prolactin levels, higher scores on the general psychopathology scale of PANSS, and higher scores on the parkinsonian symptom scale, hypokinetic symptom factor and clinical global impression of ESRS. CONCLUSION: The high prevalence of the irregular menstruation in schizophrenic patients reflects a state of hyperprolactinemia due to the interference of dopamine activity by high doses of neuroleptics.
Amenorrhea ; Antipsychotic Agents ; Diagnostic and Statistical Manual of Mental Disorders ; Dopamine ; Female ; Hospitals, Psychiatric ; Humans ; Hyperprolactinemia ; Inpatients ; Jeollanam-do ; Menstruation* ; Oligomenorrhea ; Prevalence ; Prolactin ; Psychopathology ; Schizophrenia

PURPOSE: The objective of augmentation mammoplasty includes reconstruction and cosmesis after breast surgery Increasing frequency of the procedure has been related with increased complications. Authors evaluated the value of breast MRI in the diagnosis of complications after augmentation mammoplasty. MATERIALS AND METHODS: Authors studied 42 breasts of 24 patients, who had undertaken augmentation mammoplasty. We evaluated findings of mammography, ultrasonography, and breast MRI in all patients. We used variable MRI sequences for better evaluation of implant status. The results were compared with the findings in surgical field. RESULTS: In all imaging studies, nodule or mass was indentifiable in the cases of interstitial paraffine injection(8 breasts), interstitial silicon injection(7 breasts), and herb medication(2 breasts). However, the differentitation between malignant and benign nodule was only possible at dynamic breast MRI. Mammogram was not helpful in the evaluation of extracapsular rupture in the cases of silastic bag insertion. In sonogram, identification of echogenic material was possible, although, false negative and false positive rate were high. MRI was able to visualize contour of entire implant and it was able to easily recognize low signal internal structure. CONCLUSION: MRI was the most accurate diagnostic tool in the evaluation of the character of the palpable mass after augmentation mammoplasty and early detection of breast implant rupture.
Breast ; Breast Implants ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging* ; Mammaplasty* ; Mammography ; Paraffin ; Rupture ; Silicones ; Ultrasonography

PURPOSE: The objective of augmentation mammoplasty includes reconstruction and cosmesis after breast surgery Increasing frequency of the procedure has been related with increased complications. Authors evaluated the value of breast MRI in the diagnosis of complications after augmentation mammoplasty. MATERIALS AND METHODS: Authors studied 42 breasts of 24 patients, who had undertaken augmentation mammoplasty. We evaluated findings of mammography, ultrasonography, and breast MRI in all patients. We used variable MRI sequences for better evaluation of implant status. The results were compared with the findings in surgical field. RESULTS: In all imaging studies, nodule or mass was indentifiable in the cases of interstitial paraffine injection(8 breasts), interstitial silicon injection(7 breasts), and herb medication(2 breasts). However, the differentitation between malignant and benign nodule was only possible at dynamic breast MRI. Mammogram was not helpful in the evaluation of extracapsular rupture in the cases of silastic bag insertion. In sonogram, identification of echogenic material was possible, although, false negative and false positive rate were high. MRI was able to visualize contour of entire implant and it was able to easily recognize low signal internal structure. CONCLUSION: MRI was the most accurate diagnostic tool in the evaluation of the character of the palpable mass after augmentation mammoplasty and early detection of breast implant rupture.
Breast ; Breast Implants ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging* ; Mammaplasty* ; Mammography ; Paraffin ; Rupture ; Silicones ; Ultrasonography

Harlequin ichthyosis is a most severe form of lamellar ichthyosis, which is one of congenital ichthyosis, and X- linked inherited, very rare, fatal congenital dermatologic disorder. At second trimaster in utero, skin deformity is occurred. We experienced a case of Harlequin baby in female neonate who showed typical skin appearance at birth. The nose and were flattened. The chemosis and severe ectropion obscured the orbit, and her lips were everted. The all joints were flexed due to inelastic skin, and hands and feets were fixed and ischemic. Diagnosis was established by clinical features and histopathological studies. A brief review of literature was made.
Congenital Abnormalities ; Diagnosis ; Ectropion ; Female ; Foot ; Hand ; Humans ; Ichthyosis ; Ichthyosis, Lamellar* ; Infant, Newborn ; Joints ; Lip ; Nose ; Orbit ; Parturition ; Skin

We report Descemet's membrane detachment during 360 degrees trabeculotomy using 6-0 polypropylene suture fragment. Using 6-0 polypropylene suture fragment 360 degrees trabeculotomy was performed on a 24-year-old male patient with juvenile glaucoma showing iris inserting anteriorly. Soon after pulling the suture fragment, anterior chamber became shallow abruptly and massive bleeding developed into anterior chamber. Corneal edema and large blood clot in anterior chamber were noted postoperatively.Rolled Descemet's membrane was attached to superior cornea.Seven and 14 days after trabeculotomy, viscoelastic was injected into anterior chamber and flattened the rolled Descemet's membrane.At 25 days after trabeculotomy, Descemet's membrane was reattached to central cornea, which became clear. Extensive Descemet's membrane detachment during 360 degrees trabeculotomy can be prevented by cautious pulling of suture fragments and injection of viscoelastic into anterior chamber just before pulling.When detached Descemet's membrane was rolled too tightly to be reattached by conventional procedure such as mattress suture or gas injection, the reattachment of the Descemet's membrane can be achieved by unrolling the membrane using viscoelastic
Anterior Chamber ; Cornea ; Corneal Edema ; Descemet Membrane* ; Glaucoma ; Hemorrhage ; Humans ; Iris ; Male ; Membranes ; Polypropylenes ; Sutures ; Trabeculectomy ; Young Adult