Erratum agreed to by all authors, editor in chief, publisher, and scientific society.

No accepted standard currently exists to classify asphyxia and define its subtypes. Sauvageau and Boghossian proposed an asphyxia classification system in 2010 that divided asphyxia into suffocation, strangulation, mechanical asphyxia, and drowning. Here, we present a modification of this classification system. We propose to classify asphyxia into four main categories: suffocation, strangulation, mechanical asphyxia, and complicated asphyxia. Suffocation includes smothering and choking as well as confined spaces, entrapment, and vitiated atmosphere. Strangulation is subdivided into hanging, ligature strangulation, manual strangulation, and other unspecified strangulation. Mechanical asphyxia includes positional and traumatic asphyxia. Finally, complicated asphyxia is defined as cases with two or more identifiable mechanisms of asphyxia. In this study, we review autopsy cases from 2012 diagnosed as asphyxia and classify them according to our proposed asphyxia classification system. In 24.7% of cases, the age range was 40-49 years, and 51.9% were men. The most common method of asphyxia was hanging (245 cases, 55.1%), followed by ligature or manual strangulation (53 cases, 11.9%). Most hangings were suicides; smothering, ligature, and manual strangulation were usually homicides. Eighteen cases were complicated asphyxia. This classification provides a simplified, unified, and useful tool to classify and understand deaths due to asphyxia.
Airway Obstruction ; Asphyxia* ; Atmosphere ; Autopsy* ; Classification* ; Confined Spaces ; Drowning ; Homicide ; Humans ; Korea* ; Ligation ; Male ; Suicide

No abstract available.
Alcoholics* ; Erythrocyte Indices* ; Humans

BACKGROUND: Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus (HAV). The purpose of this study was to investigate the HAV vaccination status and related factors among college students. METHODS: The study subjects were 503 students conveniently sampled from C university located in one district of Jeollanamdo. General characteristics and HAV vaccination related factors were collected by a self-reported questionnaire in October 2013. Chi-square tests and multiple logistic regression analyses were used to evaluate related factors with HAV vaccination. RESULTS: Of the 503 subjects without a history of HAV infection, 65 subjects (12.9%) reported that they were vaccinated. In multiple analyses, subjects who have had health screening (adjusted odds ratio, aOR=2.44 and 95% confidence interval, 95% CI=1.26-4.73) and those who were aware of HAV infection (aOR=6.00, 95% CI=1.81-19.91) or who perceived the benefits of HAV vaccine (aOR=2.05, 95% CI=1.07-3.93) were more likely to be vaccinated than those not involved in these factors. With regard to intention for HAV vaccine, 314 subjects (71.9%) reported that they have the intention to be vaccinated against HAV. In multiple analyses, higher grade level, high monthly allowance, awareness of HAV vaccine, perceived susceptibility of HAV, perceived seriousness of HAV and perceived benefits of HAV vaccine were significantly associated with the intention for HAV vaccination. CONCLUSIONS: The vaccination rate for HAV was found to be low in our sample of college students. To reduce health risks related with HAV, prevention efforts should consider these results.
Communicable Diseases ; Hepatitis A ; Hepatitis A virus* ; Humans ; Intention ; Jeollanam-do ; Liver ; Logistic Models ; Mass Screening ; Odds Ratio ; Risk Factors ; Vaccination* ; Surveys and Questionnaires

In the case of crush injury, the failure rate of replantation of free tissue transfer is high. Recently, the freezing of intact and repaired microarteries has been known to relieve spasm without inducing thrombosis in vivo. Therefore, the author thought that the vascular freezing of crushed vein showing only unrecognized endothelial damage after adequate debridement of a damaged vessel can also relieve spasm without inducing thrombosis and improve the patency rate of microvascular anastomosis. In this study, the process of vascular freezing was investigated in veins with acutely damaged endothelium using ethly chloride in a rat model. Two experiments were performed in 30 Sprague-Dawley rats, weighing about 250 gm. In the first experiment, a new crush model was established on the femoral vein of the rats. The degree of vessel injury was evaluated as crush energy. The proper crush energy was determined only by the endothelial damage without inducing thrombosis(0.037 J). In the second experiment, femoral veins were crushed with the energy of 0.037 J on the left side and then frozen after inflicted crush injury with the same energy on the right side. The gross and pathologic findings and patency rates were observed at postoperative day 2, 10 and 30. Patency in both the crushed and crush-freezing group was 100%. Pathlolgic findings in the crush-freezing group were more severe loss of the intima and most parts of the media, as well as cellular depopulation of the media when compared to the crushed group. Microthrombi adherent to the wall were demonstrated in several crush-freezing specimens, but the crush-freezing group showed relief of crush-induced vasopasm and endothelial regeneration. In conclusion, the freezing of microveins with acute endothelial damage relieves spasm without inducing thrombosis. Therefore, this study presents the posslbility of clinical application of vascular freezing in a case of crush injury requiring microvascualr anastomosis.
Animals ; Debridement ; Endothelium* ; Femoral Vein* ; Freezing* ; Models, Animal ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Replantation ; Spasm ; Thrombosis ; Veins

No abstract available.
Humans ; Physicians, Family*

No abstract available.
Temporal Bone*

The presence of epicanthal folds in Asian eyelids is one of their unique features, in combination with the lack of supratarsal folds. Western culture has influenced many people to prefer to eliminate the prominent epicanthal fold. A number of surgical techniques have been suggested for their correction. However, difficulty with design, excessive and prominent scarring of medial canthal and nasal area, recurrence, and rigidity of application are potential problems associated with many procedures. This paper describes a epicanthoplasty with three-dimensional Z-plasty. Through epicanthal fold incision, the medial canthal tecdon is medially advanced and sutured to the periosteum of nasal bone. After the transposition of the flaps, trimming of the flap is usually required. Three-dimensional Z-plasty crates the attactive eyes. From March, 1995 to March, 1997, the technique was applied to 37 patients with epicanthal fold and was performed with or without double-fold operation. There were 34 females and 3 males with ages ranging from 17 to 30 years. Through 2 years follow-up, this techniques has delivered esthetically good results with minimal postoperative scar and could made the reduction of ICD from 40 +/- 2.13mm to 34 +/- 1.98mm. The advantages of epicanthoplasty procedure using three-dimensional Z-plasty(Yoon's method) are as follows; 1) simple in design 2) minimal postoperative scar in the medial canthal area 3) versatile in its application 4) no recurrence 5) no hypertrophic scar 6) preserving ethnic identity.
Asian Continental Ancestry Group ; Cicatrix ; Cicatrix, Hypertrophic ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Male ; Nasal Bone ; Periosteum ; Recurrence

OBJECTIVE: The purpose of this study was to compare cognitive flexibility abilities, stress, and anxiety between starters and non-starter athletes. METHODS: A total of 30 male professional-soccer and 40 professional-baseball athletes were recruited. Wisconsin Card Sorting Test (WCST) and Trail Making Test A & B (TMT A & B) were administered to assess cognitive flexibility during competition. The Korean version of the STAI form Y (STAI-KY) and Visual analogue scale for anxiety and stress were used to assess the anxiety and stress. RESULTS: The starter group had better cognitive function (fewer perseverative errors and rapid TMTB times) (Z=3.32, p<0.01; Z=2.20, p=0.03, respectively) and lower stress and anxiety (F=4.34, p=0.01; F=6.61, p<0.01, respectively) during competition than the non-starter group. CONCLUSION: The better cognitive performances were negatively correlated with stress and anxiety. Current results suggested that cognitive flexibility would enhance human performance by modulation of the anxiety and stress during competition.
Anxiety ; Athletes ; Humans ; Male ; Pliability ; Trail Making Test ; Wisconsin

Chronic lymphedema of the penis and scrotum is a rare disease in Korea. Lymphedema can be defined as an accumulation of excessive lymph, proteins, chronic inflammation, edema and fibrosis, secondary to the impairment of the lymph vessels, which can be classified into primary, which is the result of inadequate drainage of lymph caused by agenesis and hypogenesis of lymph vessels, and secondary, which could be due to an obstruction or interruption of the lymphatic system, caused by malignancies, post-operative, post-radiation fibrosis, infection, trauma or excision. The treatment method for a lymphedema of the genitalia is determined by cause, which is crucial to the natural course of the disease. In contrast to a primary lymphedema without soft tissue changes and injury, which could be treated conservatively, surgical excision is the best method to treat a chronic lymphedema with soft tissue changes. In this article, a case of penile and scrotal chronic lymphedema of unknown cause, treated with surgical methods, is reported.
Drainage ; Edema ; Fibrosis ; Genitalia ; Inflammation ; Korea ; Lymphatic System ; Lymphedema* ; Male ; Penis* ; Rare Diseases ; Scrotum* ; Surgical Procedures, Operative