Since the book "Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying" was published in 1991, there has been a worldwide increase in the number of cases of suicidal asphyxiation using helium gas. However, no domestic reports have been published thus far. Recently, we encountered a case of asphyxial suicide by inhalation of helium from inside a plastic bag. Subsequently, we reviewed the records of the Scientific Crime Analysis System of National Police Agency of Korea. There were 17 cases of helium-associated asphyxial suicides between January 1, 2000 and June 30, 2012. The average age of the deceased was 30.6 years with a male to female ratio of approximately 5:1. Thirteen of 17 such deaths occurred in the victims'houses. In all cases, the method of death involved placing a plastic bag over the head with a hose attached to helium tanks. In 6 of 17 cases, the decedents had psychiatric disorders such as depression. As neither characteristic signs of death nor conventional methods for detecting helium gas exist, a thorough investigation of the death scene and the decedents'environment is extremely vital for confirming death due to helium asphyxiation.
Crime ; Depression ; Female ; Head ; Helium ; Humans ; Inhalation ; Korea ; Male ; Plastics ; Police ; Suicide ; Suicide, Assisted

BACKGROUND: Intracoronary stent with various designs have been developed to treat dissections or acute closure after angioplasty. The efficacy of flexible coil stent as a bail-out device has been reported. However, the restenosis after stenting still remained as a main limitation like other devices. This study reports on the angiographic follow-up after successful intracoronary stenting with flexible coil stent. METHOD: From April 1993 through July 1994, coronary stenting was tried in 21 patients by a single operator for various indications(acute or threatened closure, suboptimal result after balloon angioplasty). The nineteen(95%) out of 20 patients in whom stent was successfully deployed underwent follow-up coronary angiography 7.6+/-3.0 months after coronary stenting. RESULT: Mean age was 54.7+/-11.3(33-73) years and 16 parients were men. Clinical diagnosis of patients were as follows : stable angina 7, unstable angina 6, old myocardial infarction with stable angina 6 and acute myocardial infarction in 1 patient, respectively. Stents were implanted at left anterior descending artery in 9, left circumflex artery in 5 and right coronary artery in 8. Ten out of 21 stents(47.6%) were found to be renarrowed more than 50% at follow-up coronary angiography. There was no significant difference in clinical and angiographic variables between restenosis group and no-restenosis group. Coronary artery bypass graft surgery was performed in 1 patient for the treatment of restenosis after stenting. Repeat PTCA was performed in 3 patients and remaining 5 patients were followed medically. CONCLUSION: Flexible coil(Gianturco-Roubin) coronary stent is a useful adjunct percutaneous intervention to prevent or minimize complicatioms associated with dissections. Despite favorable initial angiographic and clinical results, 47.6% of stents were found to be renarrowed significantly at follow-up coronary angiography. New techniques or more optimal characters of stents would be desired.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Arteries ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Diagnosis ; Follow-Up Studies* ; Humans ; Male ; Myocardial Infarction ; Stents* ; Transplants

BACKGROUND: Intracoronary stent with various designs have been developed to treat dissections or acute closure after angioplasty. The efficacy of flexible coil stent as a bail-out device has been reported. However, the restenosis after stenting still remained as a main limitation like other devices. This study reports on the angiographic follow-up after successful intracoronary stenting with flexible coil stent. METHOD: From April 1993 through July 1994, coronary stenting was tried in 21 patients by a single operator for various indications(acute or threatened closure, suboptimal result after balloon angioplasty). The nineteen(95%) out of 20 patients in whom stent was successfully deployed underwent follow-up coronary angiography 7.6+/-3.0 months after coronary stenting. RESULT: Mean age was 54.7+/-11.3(33-73) years and 16 parients were men. Clinical diagnosis of patients were as follows : stable angina 7, unstable angina 6, old myocardial infarction with stable angina 6 and acute myocardial infarction in 1 patient, respectively. Stents were implanted at left anterior descending artery in 9, left circumflex artery in 5 and right coronary artery in 8. Ten out of 21 stents(47.6%) were found to be renarrowed more than 50% at follow-up coronary angiography. There was no significant difference in clinical and angiographic variables between restenosis group and no-restenosis group. Coronary artery bypass graft surgery was performed in 1 patient for the treatment of restenosis after stenting. Repeat PTCA was performed in 3 patients and remaining 5 patients were followed medically. CONCLUSION: Flexible coil(Gianturco-Roubin) coronary stent is a useful adjunct percutaneous intervention to prevent or minimize complicatioms associated with dissections. Despite favorable initial angiographic and clinical results, 47.6% of stents were found to be renarrowed significantly at follow-up coronary angiography. New techniques or more optimal characters of stents would be desired.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Arteries ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Diagnosis ; Follow-Up Studies* ; Humans ; Male ; Myocardial Infarction ; Stents* ; Transplants

PURPOSE: The colonoscopic polypectomy has become a valuable procedure for removing precursors of colorectal cancer, but some complications can be occurred. The most common complication after colonoscopic polypectomy is bleeding, which is reported to range from 1% to 6% and which can be immediate or delayed. Because the management of delayed postpolypectomy bleeding could be difficult, the use of preventive technique and reductions of risk factors are essential. METHODS: From January 2007 to December 2008, delayed hemorrhage occurred in 18 of the 1,841 polypectomy patients examined by one endoscopist. These cases were reviewed retrospectively for risk factors, pathologic findings, and treatment methods. RESULTS: Delayed bleeding occurred in 18/1,841 patients (0.95%). The mean age was 55.9 +/- 10.9 years, and the male-to-female ratio was 8:1. The most common site was the right colon (11 cases, 61.1%), and the average polyp size was 9.2 +/- 2.8 mm. Delayed bleeding was identified from 1 to 5 days after resection (mean, 1.6 +/- 1.2 days). The most common macroscopic type of polyp was a sessile polyp (10 cases, 55.6%), and histologic finding was a tubular adenoma in 13 cases (72.2%). Seventeen cases were treated with clipping for hemostasis and 1 case with epinephrine injection. CONCLUSION: The right colon and a sessile polyp were associated with an increase in delayed postpolypectomy bleeding. Reducing risk factors and close observation were essential in high risk patients, and prompt management with hemoclips was effective.
Adenoma ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Epinephrine ; Hemorrhage ; Hemostasis ; Humans ; Polyps ; Retrospective Studies ; Risk Factors

PURPOSE: The anal verge is the border of the lowest part of the anal canal. However, grossly, it may be difficult to identify. Therefore, to assess the precise position of the anal verge, we performed this study. METHODS: From August 1 to 31, 2006, 40 patients having anal surgery under spinal anesthesia were selected randomly. Prior to surgery, the anal verge was marked with the patient in the Sims's position. After marking, the anus was pulled bilaterally to both sides using bandages, and the lengths of the four areas were measured with the patient in the jackknife position. RESULTS: With the patient in the jackknife position, the anal verge was moved laterally by an average of 1.09+/-0.36 cm. The shift distance of the anal verge relative to the anal area was measured; the shift distance in the posterior direction was 1.1+/-0.30 cm, that in the anterior direction was 0.85+/-0.25 cm, that in the right lateral direction was 1.22+/-0.41 cm, and that in the left lateral direction was 1.20+/-0.34 cm. The shifted distance to the posterior area was significantly longer than that to the anterior area (P<0.05). CONCLUSION: When performing anal surgery with the patient in the jackknife position, the anal verge is shifted to the lateral side of the anus compared to its position when the patient is in the normal position. Notably, the shift distance to the posterior area was significantly longer than that to the anterior area. By assessing the precise position of the anal verge, the surgeon can reduce the resection range of the anoderm and create an appropriate drainage wound.
Anal Canal ; Anesthesia, Spinal ; Bandages ; Drainage ; Humans

No abstract available.
Spinal Stenosis*

No abstract available.

PURPOSE: This study examined the effects of a spiral elastic band for the walking function on patients with chronic stroke. METHODS: Twenty one chronic stroke patients were recruited and divided randomly into the experimental group and control group. Both groups performed mat exercises and gait training three times a week for four weeks, and gait training was applied to the experimental group with additional spinal elastic bands. RESULTS: The results of this research were as follows. The 10MWT measurements showed that the velocities within and between the groups decreased significantly, and the results of TUG showed significant decreases in velocities after the interventions in both the control group and experimental group. On the other hand, there were no significant differences between the control and experimental group. The FRT measurements showed significantly increased stride lengths within and between the groups. The measurements of the stride length, stride velocity, cadence, and step length showed significant improvement within the groups, but there was no significant difference between the groups. The measurement of stance showed that the non-paralytic patients had a significant increase in the rates within the groups and a significant difference was observed between the groups. CONCLUSION: Spiral elastic bands are an effective intervention method for rehabilitation programs to enhance the walking function in the clinical field. A treatment needs to be developed for patients with walking problems due to various disorders by investigating the action mechanism of spiral elastic bands.
Exercise ; Gait ; Hand ; Humans ; Methods ; Rehabilitation ; Stroke ; Walking

Most athletes with anterior cruciate ligament (ACL) ruptures undergo a surgical ACL reconstruction (ACLR) and rehabilitation. On the other hand, controversy still exists because neither a reconstruction nor rehabilitation have been proven to be superior in the management of ACL injury. This study reviewed the success rates of interventions to provide recommendations for the optimal management after an ACL injury. One of the most important considerations after an ACL injury is the timing and type of intervention. At the early stages, which involve the loss of volume and strength of quadriceps femoral muscle, weight bearing (closed kinetic chain) exercises with pain management followed by high velocity resistance exercises in an open kinetic chain environment are recommended to improve the quadriceps function. After that, it is important to apply intensive isokinetic exercise with a lower extension rate. In this case, it is important to apply overload to the muscles and to simultaneously lead the co-contraction of the hamstrings. Standards are essential because the timing and type of interventions are crucial to prevent re-injury and complications, such as osteoarthritis, as well as to confirm the successful outcome of the treatment. Different interventions recommended for ACL damage have yet to reach consensus. Further studies will be needed to observe the effects of the intervention through multidisciplinary approaches.
Anterior Cruciate Ligament ; Athletes ; Consensus ; Exercise ; Hand ; Humans ; Muscle Strength ; Muscles ; Osteoarthritis ; Pain Management ; Rehabilitation ; Rupture ; Weight-Bearing

Purpose: The mass of facial muscles can be increased through exercise, as is also the case for muscles in the extremities. This systematic review was conducted to investigate the effect of facial exercises on facial muscle strengthening and facial rejuvenation, focusing on recent studies. Methods: A literature search was performed using the PubMed, ScienceDirect, and Web of Science databases. The quality of the trials was evaluated according to the PEDro scale. In total, 11 studies were included in this review: four studies on facial exercise for facial rejuvenation and seven studies on strengthening the muscles of the face. Results: Facial exercises for facial rejuvenation increased the mechanical properties and elasticity of the skin of the face and neck, the thickness and cross-sectional area of the facial muscles, and the fullness of the upper and lower cheeks. Conclusion A study aimed at strengthening facial muscles showed improvements in labial closure strength and tongue elevation strength. Despite the positive results for facial rejuvenation and muscle strengthening, the level of evidence was low. Therefore, in future research, it will be necessary to investigate the effects of facial exercise in a thoroughly controlled experiment with a sufficient sample size to increase the level of evidence.