PURPOSE: The purpose of this study was to investigate screw joint stability and sagittal fit between internal connection implant fixtures of two different manufacturers and customized abutments. MATERIALS AND METHODS: Internal connection implant systems from two different manufacturers (Biomet 3i system, Astra Tech system) were selected for this study (n=24 for each implant system, total n=48). For 3i implant system, half of the implants were connected with Ti ready-made abutments and the other half implants were connected with Ti CAD-CAM custom ones of domestic-make (Myplant, Raphabio Co., Seoul, Korea) and were classified into Group 1 and Group 2 respectively. Astra implants were divided into Group 3 and Group 4 in the same way. Micro-CT sagittal imaging was performed for fit analysis of interfaces and preloading reverse torque values (RTV) were measured. RESULTS: In the contact length of fixture-abutment interface, there were no significant differences not only between Group 1 and Group 2 but also between Group 3 and Group 4 (Mann-Whitney test, P>.05). However, Group 2 and Group 4 showed higher contact length significantly than Group 1 and Group 3 in abutmentscrew interface as well as fixture-screw one (Mann-Whitney test, P<.05). In addition, RTV was lower in CAD-CAM custom abutments compared to ready-made ones (Student t-test, P<.05). CONCLUSION: It is considered that domestically manufactured CAD-CAM custom abutments have similar fit at the fixture abutment interface and it could be used clinically. However, RTV of CAD-CAM custom abutments should be improved for the increase of clinical application.
Computer-Aided Design* ; Joints ; Seoul ; Torque

Mirizzi's syndrome (MS) caused by the retention of a stone in the cystic duct stump after cholecystectomy is rare. Most cases of MS are treated by surgical intervention. However, developments of endoscopic accessories and techniques have resulted in the recent introduction of endoscopic treatments for MS. Furthermore, in view of the postoperative morbidity caused by post-operative scarring, the endoscopic approach should be preferred to the surgical approach. In the described case, the authors were able to remove a remnant cystic duct stone endoscopically because the cystic duct stump was wide and non-tortuous. This case shows endoscopic retrograde cholangiopancreatography with mechanical lithotripsy can be utilized in suitable cases of type I MS development after cholecystectomy.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cicatrix ; Cystic Duct ; Lithotripsy ; Mirizzi Syndrome*

Traumatic subarachnoid hemorrhage (tSAH) can be almost immediately fatal. However, sudden death due to tSAH caused by delayed aneurysmal rupture is very rare sequela of mild head trauma. We experienced a death case of a 47-year-old woman who had subarachnoid hemorrhage and intraventricular hemorrhage 3 days after head trauma. Delayed death after any kinds of trauma is important to forensic and legal aspects. Herein we report a case of fatal subarachnoid hemorrhage caused by delayed rupture of traumatic aneurysm.
Aneurysm ; Craniocerebral Trauma ; Death, Sudden ; Female ; Head ; Hemorrhage ; Humans ; Jurisprudence ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage ; Subarachnoid Hemorrhage, Traumatic

The overall data associated with the causes and the manners of death of individuals are necessary to make policies for the public health or judicial system in the society. To obtain basic data of the causes and the manners of death, the 206 autopsy cases performed at the Department of Forensic Medicine of Chonnam National University Medical School in 2007 and 2008 were statistically analyzed according to the cause of death and the manner of death. The results are as follows ; 1. The total number of forensic-legal autopsy was 206 (139 males and 67 females). The number of the 5th decade (58 cases) and the 6th decade (54 cases) occupied over 50 percent (54.4%) of total cases. 2. Unnatural deaths were 127 cases (61.7%), and natural deaths were 79 cases (38.3%). Of 127 cases of unnatural deaths, suicides were 33 cases (26.0%), homicides were 46 cases (36.2%), accidental deaths were 37 cases (29.1%), and undetermined deaths were 11 cases (8.7%). 3. Among 79 natural deaths, deaths of cardiac origin were 46 cases (58.2%) and it was a leading cause of death in natural deaths. Deaths due to disease of vascular system were 10 cases (12.7%), deaths due to respiratory system were 8 cases (10.1%), deaths due to digestive system were 6 cases (7.6%), and other causes were 10 cases (12.4%). 4. Child deaths under the age of 10 were 8 cases (3.9%). Three cases were homicide, 3 cases were accident, and 2 cases were natural deaths.
Autopsy ; Cause of Death ; Child ; Digestive System ; Forensic Medicine ; Homicide ; Humans ; Korea ; Male ; Public Health ; Respiratory System ; Schools, Medical ; Suicide

BACKGROUND: The Postmortem examination certificate and death certificate prove deaths of human and supply important data used to establish health statistics. However, not only the format of the form itself, but the accuracy of postmortem examination certificate and death certificate has errors which needs further study such as comparing with the postmortem study such as autopsy. METHODS: We reviewed 206 autopsies which were performed in the Department of Forensic Medicine of Chonnam National University Medical School from January 1, 2007 to December 31, 2008 and compared with their postmortem examination certificates and death certificates for analysis. RESULTS: Of the 174 cases submitted with death certifications, total 67 cases accorded with cause of death on the autopsy report. Eighty six cases had clear descriptions of cause of death. Of those 86 cases, 46 were from postmortem examination, 40 were from death certificates and 23 were natural deaths, 63 were unnatural deaths. Each of them, the accordant rates were 63.0% (29 cases/46cases), 77.5% (31 cases/40 cases), 43.5% (10 cases/23 cases), and 79.4% (50 cases/63 cases). From these results, we found various erroneous types in postmortem examination certificates and death certificates. CONCLUSIONS: This study brings into realization there is a high rate of discrepancy between causes of death on the death certificates and postmortem examination certificates. And also, there are a few useful death certificate and postmortem examination certificate. Therefore, we want to propose several remedies to increase the accuracy of death certificate and postmortem death certificate.
Autopsy ; Cause of Death ; Certification ; Death Certificates ; Forensic Medicine ; Humans ; Schools, Medical

A 48 years old man was sent to hospital through emergency room immediately after head injuries. He was arrived at hospital being dead and autopsy was done sixty hours later after insult. Multiple skull fractures and brain parenchymal contusions, subarachnoid hemorrhage, stem hemorrhage were noted, and these injuries were considering as a cause of death. Interestingly, blood alcohol concentration (BAC) using cardiac blood was very high (0.738%) in this case. Here in, we report abnormally high BAC in heart blood which is not a cause of death and we review the general aspects about alcohol concentration interpretation.
Male ; Humans

A pulmonary thromboembolism (PTE), which is a sudden blockage in a pulmonary artery, usually due to a blood clot, is rare in children. The clinical presentation is often subtle or masked by the underlying clinical condition and the condition must be suspected during clinical testing. Although the choice of treatment depends on the clinical presentation, anticoagulation is the mainstay of therapy for children with PTE. We report the case of a healthy 1-month-old boy who presented with hemoptysis without hemodynamic instability. He was diagnosed based on chest computed tomography with angiography and 99mTc macroaggregated albumin lung perfusion scintigraphy and treated with low-molecular-weight heparin.
Angiography ; Child ; Hemodynamics ; Hemoptysis ; Heparin, Low-Molecular-Weight ; Humans ; Infant* ; Infant, Newborn ; Lung ; Male ; Masks ; Perfusion Imaging ; Pulmonary Artery ; Pulmonary Embolism* ; Thorax

The present study was designed to examine the effect of d-amphetamine on CA release from the isolated perfused model of the rat adrenal gland, and to establish its mechanism of action. D- amphetamine (10~100microM), when perfused into an adrenal vein of the rat adrenal gland for 60 min, enhanced the CA secretory responses evoked by ACh (5.32x10-3 M), excess K+ (5.6x10-2 M, a membrane depolarizer), DMPP (10-4 M, a selective neuronal nicotinic Nn-receptor agonist) and McN-A-343 (10-4 M, a selective M1-muscarinic agonist) only for the first period (4 min), although it alone has weak effect on CA secretion. Moreover, d-amphetamine (30microM) in to an adrenal vein for 60 min also augmented the CA release evoked by BAY-K-8644, an activator of the dihydropyridine L-type Ca2+ channels, and cyclopiazonic acid, an inhibitor of cytoplasmic Ca2+ ATPase only for the first period (4 min). However, in the presence of high concentration (500microM), d-amphetamine rather inhibited the CA secretory responses evoked by the above all of secretagogues. Collectively, these experimental results suggest that d-amphetamine at low concentrations enhances the CA secretion from the rat adrenal medulla evoked by cholinergic stimulation (both nicotininc and muscarinic receptors) as well as by membrane depolarization, but at high concentration it rather inhibits them. It seems that d-amphetamine has dual effects as both agonist and antagonist at nicotinic receptors of the isolated perfused rat adrenal medulla, which might be dependent on the concentration. It is also thought that these actions of d-amphetamine are probably relevant to the Ca2+ mobilization through the dihydropyridine L-type Ca2+ channels located on the rat adrenomedullary chromaffin cell membrane and the release of Ca2+ from the cytoplasmic store.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Glands ; Adrenal Medulla* ; Amphetamine ; Animals ; Calcium-Transporting ATPases ; Chromaffin Cells ; Cytoplasm ; Dextroamphetamine* ; Dimethylphenylpiperazinium Iodide ; Membranes ; Neurons ; Rats* ; Receptors, Nicotinic ; Veins

Gastrocolocutaneous fistula is a rare complication of the percutaneous endoscopic gastrostomy (PEG) procedure. Typical symptoms usually occur in the first few months. We recently encountered 2 patients with 8- and 33-month asymptomatic periods. A 74-year-old man presented with watery diarrhea for 1 month. He had undergone PEG 9 months earlier. During workup, an upper endoscopy and abdominal CT scan revealed the migration of the feeding tube into the transverse colon. He was discharged with a nasogastric tube after treatment. A 77-year-old man presented with sudden loosening of his PEG tube with a duration over 3 days. He had undergone PEG procedure three times until that time. During workup, a gastrocolocutaneous fistula was diagnosed. However, when previous studies were reviewed, an abdominal CT scan, which was done 6 months ago before the third PEG, showed the fistula already existed at that time, suggesting that it was created about 33 months earlier when he underwent the second PEG procedure. The patient died of pneumonia aggravation despite conservative treatment. Both a high index of suspicion and the careful inspection of the upper endoscopy are very important for early diagnosis regardless of symptoms.
Aged ; Colon, Transverse ; Diarrhea ; Early Diagnosis ; Endoscopy ; Fistula* ; Gastrostomy* ; Humans ; Pneumonia ; Tomography, X-Ray Computed