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

PURPOSE: To investigate the Doppler ultrasonographic parameters of a carotid ultrasound (CUS) for the stenosis of the intracranial internal carotid artery (IICA). MATERIALS AND METHODS: The authors evaluated 15 patients with normal extracranial ICA, the common carotid artery (CCA), and stenosis of IICA (patient group). The control group consisted of 22 patients with normal findings on a magnetic resonance angiography (control group). All subjects were subjected to a CUS, whereas subjects from the patient group underwent a cerebral angiography. The following parameters were investigated: peak systolic velocity (PSV) and end diastolic velocity (EDV) in ICA, PSV in CCA, resistive index (RI) in ICA, and PSV ratio. Stenosis was measured following an angiography and was graded as follows: normal (0-24%), mild (25-49%), moderate (50-69%), and severe (70-99%). Next, the CUS findings, which reflected the IICA stenosis, were investigated. RESULTS: Of the 74 ICAs, 52 were normal (44 ICAs in the normal group and 8 ICAs in the patient group), 10 had mild stenosis, 8 had moderate stenosis, and severe 4 had severe stenosis. As the stenosis grade increased, PSV and EDV in ICA as well as PSV in CCA, decreased (p value < 0.05); however, the PSV ratio and RI remained unchanged. CONCLUSION: As stenosis of IICA increases, PSV and EDV of ICA and PSV of CCA decreases following a CUS.
Angiography ; Atherosclerosis ; Carotid Artery, Common ; Carotid Artery, Internal ; Carotid Stenosis ; Cerebral Angiography ; Constriction, Pathologic ; Copper ; Humans ; Magnetic Resonance Angiography ; Ultrasonography, Doppler

PURPOSE: Since children under two years with suspected urinary tract infections (UTIs) cannot control urination, urine cultures in such children are usually performed via urine bags. This method is noninvasive but has a high contamination rate. We studied the contamination rate of bag urine culture in diagnosing UTIs in infants under two years and the factors responsible for contamination. METHODS: We examined patients under 2 years in whom urine culture through the urine bag method yielded over 105 colonies of a single pathogen. We defined UTIs by referring to the guidelines of The Korean Society of Pediatric Nephrology, 2005. We examined the factors responsible for contamination according to sex, duration of urine collection, and whether diarrhea took place with contamination rate. RESULTS: We examined 717 patients (412 males and 305 females). The contamination rate of one bag urine culture was 37.9%. Gender was not related to the contamination rate (P>0.05). Duration of urine collection showed an association with the contamination rate. The longer the duration of collecting urine, the higher was the contamination rate. Duration of urine collection was divided into three groups: first group, <2 hours; second group, 2-4 hours; and third group, > or =4 hours. The contamination rates were 30.0%, 42.2%, and 43.7% for the first, second, and third groups, respectively, with statistical significance (P=0 .001). Diarrhea at admission had no impact on the contamination rate (P>0.05). CONCLUSION: The contamination rate of urine culture in the examined patients was 37.9%. Gender and diarrhea symptoms were not responsible for contamination. In infants with a suspected UTIs, urine should be collected within 2 hours through the urine bag method. If urine collection takes over 2 hours, the urine bag should be resterilized and reattached to the patient.
Child ; Diarrhea ; Humans ; Hypogonadism ; Infant ; Male ; Mitochondrial Diseases ; Nephrology ; Ophthalmoplegia ; Urinary Tract Infections ; Urination ; Urine Specimen Collection

BACKGROUND: The dipyridamole and dobutamine stress echocardiography have been studied as a non-invasive diagnostic test in coronary artery disease. Recently, some authors have extended the usefulness of these tests to predicting the prognosis of myocardial infarction patients. But as far as we know, there was no literature which tried boh tests to the same infarcted patients group. So, we performed both tests in the 23 infarcted patients to compare and evaluate both tests as predicting the prognosis in myocardial infarction. METHODS: Patients underwent (1) two-dimensional echocardiography under basal condition and after dipyridamole infusion for 4 minites at the dose of 0.14mg/kg/min, (2) another two dimensional echocardiography under basal and during dobutamine infusion at each dose of 5 to a maximum of 20microg/kg/min at 1 or 2 days after dipyridamole stress echocardiography, and (3) coronary and left ventricular angiography. Preinfusion and peak infusion images were analyzed independently by two different observers using Nova Micro Sonic soft were(DataVueII and ColorVue II analysis system). The segmental wall motions were scored as follows ; hyperkinetic : 1, normal : 2, hypokinetic : 3, akinetic : 4. THe test response was considered positive if abnormal wall motion and reduced myocardial thickening were observed during drug infusion at the vascular distributions except the akinetic infarcted segment identified during basal condition. The coronary angiography was analyzed by measuring the maximal luminal diameter stenosis with caliper and 50% or greater diameter narrowing was considered significant. The sensitivity and specificity were calculated by comparing echocardiographic prediction and angiographic findings. RESULTS: 1) Among 22 patients with sufficient image in dipyridamole stress echocardiography, 13 patients have myltivessel coronary disease without resting akinesia of non-infarcted segments. Only 5 patients showed positive findings in dipyridamole stress echocardiography(sensitivity, 38.4%). Among 9 patients who has single or minimal disease, 9 patients were negative finding(specificity, 100%). 2) Among 21 patients with sufficient image in dobutamine stress echocardiography, 12 patients have multivessel coronary disease without resting akinesia of non-infarcted segments. 7 patients showed positive finding in dobutamine stress echocardiography(sensitivity, 58.3%). Among 9 patients who has single or minimal disease, 8 patients showed negative finding(specificity, 88.8%). 3) In hemodynamic changes, dipyridamole stress echocardiography showed significant changes in heart rates and double products and dobutamine stress echocardiography showed significant changes in heart rates, systolic blood pressure and double products. 4) There was no significant side effect during both stress tests inacute and old myocardial infarction patients. CONCLUSION: 1) The dobutamine and dipyridamole stress echocardiography are safe and easy test for myocardial infarction patients. 2) The dobutamine stress echocardiography has higher sensitivity than dipyrdamole stress echocardiography for identifying multivessel coronary disease in myocardial infarction patients but the dose of both drugs were relatively small to get the adequate results. So the high dose of drugs must be tried in feature study.
Angiography ; Blood Pressure ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Diagnostic Tests, Routine ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Exercise Test ; Heart Rate ; Hemodynamics ; Humans ; Myocardial Infarction* ; Phenobarbital ; Prognosis ; Sensitivity and Specificity

No abstract available.
Asthma* ; Theophylline*

In complication of infective endocaditis splenomegaly and splenic infarction are not uncommon but splenic rupture is very rare. We report a case of splenic rupture complicated by infective endocarditis in 1 71-yr-old man who had been suffered from rheumatic heart disease (aortic regurgitation and stenosis and mitral regurgitation). The patient was admitted to mild fever and generalized weakness for 20 days. Diagnosis of infective endocarditis due to Staphylococcus epidermidis was made by clinical manifestaions and blood culture study.On 34th day of admissionthe patient suddenly displayed the symptoms and signs of massive intraperitoneal hemorrhage. Splenic rupture was revealed by paracentesis and radiologic studies. Rupture of spleen is an uncommon and usually fatal complication of infective endocarditis. Therefore early diagnosis and prompt treatment must be performed.
Constriction, Pathologic ; Diagnosis ; Early Diagnosis ; Endocarditis* ; Fever ; Hemorrhage ; Humans ; Paracentesis ; Rheumatic Heart Disease ; Rupture ; Spleen ; Splenic Infarction ; Splenic Rupture* ; Splenomegaly ; Staphylococcus epidermidis

Between 1989 and 1993, 31 patients who had undergone ACL reconstruction using autogenous patellar bone-tendon-bone were studied to evaluate the effects on knee joint function. After having harvested the central one third of the patellar tendon, it was positioned isometrically through tunnels of tibia and femur and also central defect of the patellar ligament was sutured loosely. Clinically Hospital for special surgery(HSS) knee socre by Marshall 1997, manual knee test, knee extention and flexion angles, Cybex test, KT-2000 measurments and radiological study were performed for subjective and objective symptoms at the average follow-up 33 months (range 18-72 months). Quadriceps weakness of strength less than 80% of the normal side was present in 61% of patients, patellofemoral joint pain in 15%, AP translation more than 3mm in 23%, flexion contracture of 5 degree or more in 29%. Hospital for special surgery(HSS) knee score was improved from 35 to 46 in average during follow-up period. The height of the patella was increased in 2 cases and decreased in 6 cases within normal variation which was not significant statistically. The above results indicate that importance of postoperative rehabilitation program and extension position of knee joint after surgery place a major emphasis on the avoidance of flexion contracture and on the improvement of joint function.
Contracture ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Patella ; Patellar Ligament ; Patellofemoral Joint ; Rehabilitation ; Tibia ; Transplants

This study investigated the utilization of clinical information on cancer to establish a basic paln for construction of systematic and efficient Cancer Clinical Information System (CCIS) in Korea. A mail survey was conducted among 141 clinical oncologists from 10 hospitals. Their utilization of the information system, capabilities in managing the information, and opinions on establishing a nationalized CCIS were surveyed and analyzed. By descriptive statistical methods, a Chi-square test, a Kruskal-Wallis test, a t-test and ANOVA. The most popular way to obtain the clinical information on cancer was through paper charts. All the respondents stated that the cancer clinical information procured from the current information system was insufficient due to the lack of standardized clinical information, the absence of coded data and applicable information, and the inefficiency of the information system. Over 90% of respondents indicated the need to develop a well organized and specifically planned CCIS. Information on diagnosis, surgery and pathology were three most useful and accessible item in clinical research on cancer. Information on side effects of cancer treatment and survival rates of cancer patient were necessary, but not available in the current CCIS. In conclusion, the existing information system has not been used effectively in extracting the requested information on clinical oncology. In order to develop a database, a higher priority should be placed on standardizing and continuously updating the contents, diversifying the search subjects and improving the security of the database system. The government needs to get involved in planning this CCIS to connect all the health care facilities across the country. Moreover, there must be some administrative support for the construction of a CCIS in order to achieve some technical advancement in hardware and software development and to regulate the clinical information.
Surveys and Questionnaires ; Delivery of Health Care ; Diagnosis ; Humans ; Information Systems* ; Korea* ; Medical Oncology ; Pathology ; Postal Service ; Survival Rate

PURPOSE: To evaluate the value of dacryoscintigraphy in the assessment of patients with a clinical diagnosis of functional nasolacrimal duct obstruction. MATERIALS AND METHODS: Dacryoscintigraphy was performed in symptomatic 35 lacrimal drainage systems in 18 patients (age range: 37~76, 8 males, 10 females) that were patent on syringing. RESULTS: Abnormalities were detected with dacryoscintigraphy in 75.8% of systems. The positive scintigrams were subdivided into those demonstrating prelacrimal sac delay (31.8%), delay at the lacrimal sac/junction (40.9%), or delay within the duct (27%). CONCLUSION: Dacryoscintigraphy is noninvasive useful technique in the assessment of the functional nasolacrimal duct obstruction and very sensitive at detecting abnormalities in patients with lid laxity caused by senile change and facial nerve palsy.
Diagnosis* ; Drainage ; Facial Nerve ; Humans ; Male ; Nasolacrimal Duct* ; Paralysis

No abstract available.
Prevalence* ; Ulsan*