There has been an increase in the incidence of elevator-related accidents in the Republic of Korea. Every year, approximately 10~20 elevator-related fatalities are reported in the Republic of Korea. According to research from the United States, 'falls' were the most common cause of death, followed by 'caught in/between'. In such investigations, it is important to distinguish between the manners of death. Herein, we report an elevator-related fatality, which required careful forensic investigation to determine the cause of death. A thorough forensic autopsy and reinvestigation of the death scene by medical examiners were required to determine if the death was caused as a result of the deceased falling from from a height or being caught in between the elevator and the wall of building.
Autopsy ; Cause of Death ; Coroners and Medical Examiners ; Elevators and Escalators ; Humans ; Incidence ; Republic of Korea ; United States

Wilms' tumor is the most common urinary tract neoplasm and one of the most frequent solid abdominal malignant tumors of childhood, usually diagnosed between the ages of 2 and 5 years. Typically, it is manifested as an asymptomatic unilateral or upper abdominal mass. Abdimonal pain after some traumatic incident, fever, anemia, hematuria and hypertension are other patterns of presentation. In a considerable number of these patients, pulmonary metastases are present at the time of primary diagnosis. But, the initial presentation of acute pulmonary tumor emboli without surgical manipulation is very rare. We describe a sudden unexpected infantile death case diagnosed as pulmonary tumor embolism preexisting Wilms tumor. To our knowledge, this is the initial autopsy presentation of Wilms tumor with tumor embolism as sudden and unexpected death in Korea.
Anemia ; Autopsy ; Death, Sudden* ; Diagnosis ; Fever ; Hematuria ; Humans ; Hypertension ; Korea ; Neoplasm Metastasis ; Neoplastic Cells, Circulating* ; Urologic Neoplasms ; Wilms Tumor*

The tricuspid valve is not a simple but a complex structure, tricuspid valve complex. This complex is composed of tricuspid orifice, annulus, valve leaflet, chordae tendineae and papillary muscles. There are flew articles about these structures. The authors studied tricuspid valve complex in 53 cases of normal korean adults, such as circumference of tricuspid annulus, the maximum diameter of the tricuspid orifice, height and breadth of the cusps, including commissures, the ratio of rough to clear zone, the number of scallops of posterior cusp, the number, length and pattern of arrangement of the several types of chordae, the number and morphological characteristics of papillary muscles.
Adult* ; Chordae Tendineae ; Heart* ; Humans ; Papillary Muscles ; Pectinidae ; Tricuspid Valve*

Hepatocellular carcinoma (HCC) is one of the leading causes of death in Korea. Chronic hepatitis, alcoholic liver disease and liver cirrhosis are predisposing factor of HCC. Bleeding tendency and hemorrhage resulting from reduced production of coagulation factors or portal hypertension are not uncommon in HCC, moreover spontaneous hemoperitoneum also can occur. Spontaneous hemoperitoneum is a complication of HCC, that is caused by the rupture of HCC mass which abuts on the hepatic capsule. However hemoperitoneum also occurs due to the rupture of vasculature of the mass. Emergency laparotomy is the recommended treatment, however these patients exhibit poor prognosis because of hemodynamic instability followed by combined liver disease. Herein, we report a case of spontaneous hemoperitoneum due to the rupture of subcapsular vessels with invasion of HCC in a 39-years-old man, whose tumor was left undetected.
Blood Coagulation Factors ; Carcinoma, Hepatocellular ; Cause of Death ; Emergencies ; Hemodynamics ; Hemoperitoneum ; Hemorrhage ; Hepatitis, Chronic ; Humans ; Hypertension, Portal ; Korea ; Laparotomy ; Liver Cirrhosis ; Liver Diseases ; Liver Diseases, Alcoholic ; Prognosis ; Rupture

To provide the information necessary for the insurance medicine management plan, price discount rates among the insurance medicines were studied. A total of 2,107 items of insurance medicine of which prices were discounted via government inspections of real transactional process of insurance medicine were analysed. The conclusions are as follows; 1. Among the variables relevant to the characteristics of manufacturers, price discount rates of insurance medicines were statistically significant with production rankings of manufacturers, incorporation year, existence of investments by foreign corporation, existence of a research institute, and enrollment in the exchange. And among the variables relevant to the properties of medicines, the number of enrolled items which have the same components, classification, the date of new enrollment, the sales of items, and the number of raw materials in the items were statistically significant. 2. Stepwide multiple regression was done to identify the factors which affect the price discount rates of insurance medicines. The number of enrolled items which have the same components, production rankings of manufactures, classification number (medicines for function of tissue cells), incorporation year (1940-1949), existence of investments by foreign corporations, classification number (anti-germ medicines), number of raw materials in the items, the sales of items, and medicines whose major objective is not treatment were significant variables and the R2-value for these variables was 21.2%. Considering all of the above results, for management of insurance medicines, it seems important that the real transactional prices of insurance medicines should be identified systematically, focusing on the properties which affect the price discount rates of insurance medicines.
Academies and Institutes ; Classification ; Commerce ; Insurance* ; Investments

OBJECTIVE: In recent years, the neurosurgeon's role in managing cerebrovascular diseases (CVD) has becomes rapidly challenged and overlapped with other specialists. Furthermore, the patterns of CVD and patient recruitment have also changed. We conducted a retrospective study regarding the practical trends of CVD with reference to the management paradigms at our institute. METHOD: We reviewed all the available data, including the annual reports, the daily department records, the medical records and the radiographic films of the CVD patients who had been admitted to our Neurosurgery Department during the five years between Jan. 2004 and Dec. 2008. RESULTS: The total numbers of CVD operations showed a slight initial increase, but then they remained steady for the latter 3 years. The number of cases of non-angiomatous hemorrhage has been relatively steady, regardless of surgery. The total numbers of treated aneurysms increased, but the main body of this increment was attributed to the initiation of endovascular treatment and increased identification of unruptured vascular lesions. Vascular malformations were sustained with a small number of cases due to referring them to other institutes for radiosurgery, except for the cases that required urgent hemorrhagic evacuation. CONCLUSION: Hemorrhagic CVDs tended to decrease either due to increasing identification before rupture or shifting such patients into a large volume hospital. The increasing awareness of ischemic CVD, the early detection of unruptured aneurysms, and the separation of medical responsibilities from neurologists have all pushed neurosurgeons to make treatment plans in a more cooperative fashion, instead of a competitive way. Neurosurgeons should be furnished with several revolutionary surgical options to widen their scope of managing patients with CVD.
Academies and Institutes ; Aneurysm ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm ; Medical Records ; Neurosurgery ; Patient Selection ; Radiosurgery ; Retrospective Studies ; Rupture ; Specialization ; Subarachnoid Hemorrhage ; Vascular Malformations ; X-Ray Film

We reports a woman's death caused by massive intraabdominal hemorrhage, who was in chronic alcoholic state with advanced liver cirrhosis and found dead in her room. No macroscopic source for the bleeding was found in her intraabdomen and there was no circumstances of traumatic forces to the individual's body around the death. The presenting unsuspected death could be consistent with the forensic pathological cases described as sudden, unexpected death due to massive nontraumatic intraabdominal hemorrhage in association with liver cirrhosis by DiMaio in 1987.
Alcoholics ; Hemorrhage* ; Humans ; Liver Cirrhosis* ; Liver*

A 60-year-old man presented with electrocardiographic abnormalities after treatment for oral squamous cell carcinoma with surgical resection and radiation therapy 7 months ago. The patient died within 2 h without response to CPR after sudden arrest. Electrocardiographic changes 9 h before death included low QRS voltage and sinus tachycardia. Autopsy revealed cardiac metastasis with chronic active fibrinoid pericarditis accompanied by tumor cell infiltration. Although the frequency of cardiac metastasis in patients with oral cancer is reportedly low, clinicians should be aware that cardiac metastasis may exist if there are electrocardiographic changes in patients receiving follow-up care for primary malignancy. We report a rare medicolegal case of cardiac metastasis-related sudden death.
Autopsy ; Carcinoma, Squamous Cell ; Cardiopulmonary Resuscitation ; Death, Sudden ; Electrocardiography ; Follow-Up Studies ; Humans ; Middle Aged ; Mouth Neoplasms ; Neoplasm Metastasis ; Pericarditis ; Tachycardia, Sinus

The E-cadherin, alpha-catenin, and beta-catenin expressions were immunohistochemically investigated in paraffin-embedded materials of 80 cases of colorectal adenocarcinomas. The staining similar to normal colorectal mucosa with preserved strong membranous staining pattern was considered normal or preserved expression. The X2 test was used to analyse the statistical correlation of cadherin/catenin expression with clinicopathologic parameters and the Breslow test for the correlation with survival length. Normal colorectal mucosa showed strong membranous expression of cadherin/catenin complex. The reduced E-cadherin, alpha-catenin, and beta-catenin expression were found in 53/80 (66.3%), 46/80 (57.5%), and 44/80 (55.5%) cases of colorectal cancers examined, respectively. There were significant correlations between E- cadherin and alpha -catenin (p=0.035), and between alpha-catenin and beta-catenin (p=0.013). The reduced E-cadherin expression was associated with histologic dedifferentiation, tumor depth, lymph node metastasis, clinical stage (p<0.05), poor clinical outcome in stage II (p=0.016) and the reduced alpha-catenin expression with lymph node metastasis and clinical stage (p<0.05). Reduced expression of two or more proteins was correlated with lymph node matastasis, histologic dedifferentiation, clinical stage, and survival (p<0.05). The present study demonstrates a significant down-regulation of E-cadherin and alpha-catenin expression in colorectal cancer is associated with tumor invasiveness, histologic dedifferentiation, lymph node metastasis, and clinical stage. These results suggest that E-cadherin and alpha-catenin may be useful markers of invasiveness, lymph node metastatic potential, and clinical stage and of value as prognostic markers in the earlier stage. Further studies are needed to confirm the prognostic value of these cadherin/catenin complex.
Adenocarcinoma* ; alpha Catenin* ; beta Catenin* ; Cadherins* ; Colorectal Neoplasms ; Down-Regulation ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis

BACKGROUND: Chrome has been known to be a toxic and poten sensitizer and is contained in materials with which we are in frequent contact. But we have few reports detailing chrome contact dermatitis by clothes or the chrome content of materials in out use. OBJECTIVES: Our purpose was to evaluate the chrome content in rassieres. METHODS: We analyzed chrome in brassieres by using atomied absorption spectrophotometer, quantitatively and diphenylcarbazide method, qualitatively. RESULTS: The content of chrome in a 24 hour saline extracted g roup, a 48 hour saline extracted group and a pure nitric acid extracted group in the black was more abundant than in the reds or in the whites. But there was no aignificant difference in the different fabrics of the blacks. CONCLUSION: Although, in reality, it is hard to change chrome to an other substrate as the mordant of dyes, a limitation needed to prevent diseases induced by chrome during the process of dyeing. If someone has a sensitivity to chrome, it is necessary to wash new clothes before waring and to avoid black colored underwear.
Absorption ; African Continental Ancestry Group ; Coloring Agents ; Dermatitis, Contact ; Diphenylcarbazide ; Humans ; Keratinocytes ; Melanocytes ; Nitric Acid