Hypertrophic cardiomyopathy (HCMP) is characterized myofiber hypertrophy and structural remodeling with changes in the proportion of the muscular, vascular, and interstitial compartments. A study was done to determine the structural remodeling patterns and the role of microvasculature of hearts in HCMP. Forty-two postmortem hearts were analyzed including 14 from patients who died of HCMP (group 1), 8 patients with HCMP but who died from extracardiac causes (group 2), 10 patients with ischemic heart disease (group 3), and 10 normal adult hearts (group 4). Macro- and microscopic examination, immunohistochemical study using CD34 antibody, and morphometric studies using image analyzer were performed. Mean cardiac weight and wall thickness were significantly higher in the HCMP group. Myocardial hypertrophy, and a variety of myocardial disarray and fibrosis involved the whole area of the left ventricles with HCMP. The percentage areas of microvessels were 6.40 0.7 in group 1, 5.90 0.6 in group 2, 4.98 0.3 in group 3, 4.85 0.4 in group 4, respectively, and the numbers of microvessels were 198.0 20.7 in group 1, 230.0 22.3 in group 2, 211.7 11.2 in group 3, and 236.4 11.4 in group 4, respectively (mean SE). The percentage area of microvessels was significantly higher in group 1 than in other groups. However, the number of microvessels in that group was lower than in the other groups, although it was statistically insignificant. Since flow-dependent vasodilation is preserved in HCMP, we considered flow-dependent vasodilation the cause of the discrepancy between the area and the number of microvessels. Ischemic changes observed in chronic HCMP and related heart failure were considesed to be due to the relative deficiency of the coronary flow compared to the increasing cardiac mass.
Adult ; Cardiomyopathy, Hypertrophic* ; Fibrosis ; Heart ; Heart Failure ; Heart Ventricles ; Humans ; Hypertrophy ; Microvessels ; Myocardial Ischemia ; Vasodilation

PURPOSE: The purpose of this study is to compare the postoperative results of surgery for 60 patients with intermittent exotropia (20-30PD). METHODS: They were classified into two groups: one group with bilateral lateral rectus recession (n=34) and another group with unilateral medial rectus resection and lateral rectus recession (n=26). We assessed the postoperative results by comparing the deviation at postoperative 1 year to those at 1day, 1week, 1month, and 6months after surgery. RESULTS: The stisfactory result defined as orthophoria and deviation between 10PD esodeviation and 10PD exodeviation. The postoperative success rates are as follows: 65% in the bilateral rectus recession group and 62% in the unilateral lateral rectus muscle recession and medial rectus resection group. In the bilateral lateral rectus recession group, postoperative 1 day alignment of 11-15PD esodeviation showed the success rate of 83%. In the unilateral medial rectus resection and lateral rectus recession group, postoperative 1 day alignment of 1-5PD esodeviation resulted in the success rate of 80%. CONCLUSIONS: The initial postoperative esodevation of 11-15PD in bilateral lateral rectus recession and esodeviation of 1-5PD in unilateral medial rectus resection and lateral rectus recession can lead to good results. Postoperative 1 year surgical results for exotropia of moderate degree could be predicted from angle of deviation at postoperative 6 months, regardless of the type of surgery.
Esotropia ; Exotropia* ; Humans

PURPOSE: We conducted this study to evaluate the clinical efficacy of simplified single suture aponeurotic tuck technique and examine its long-term results in ptosis patients with levator function of over 7 mm. METHODS: For twenty patients (22 eyes) were noted to have ptosis from September 2000 to December 2001, we performed simplified single suture levator tuck technique to repair ptosis using a single 5-0 prolene suture. We performed tucking 1-2 mm higher than the contralateral side in patients with unilateral ptosis and same height in those with bilateral ptosis. Mean post-operative follow-up observation period was 6.8 months. 7 patients (7 eyes) had congenital ptosis and 13 patients (15 eyes) had acquired ptosis. Pre-operative and post-operative marginal reflex distance [MRD1] at week 1, month 1 and month 3 were measured to evaluate surgical outcome and post-operative complications. RESULTS: All the cases with congenital ptosis showed satisfactory surgical outcomes. On the contrary, 3 eyes with acquired ptosis who had shown unsatisfactory surgical outcomes received re-operation and showed satisfactory outcomes. 1 case with acquired ptosis had eyelid peaking, but was resolved with no further complications. The postoperative MRD1 was stabilized after the 1-month follow-up. CONCLUSIONS: It was possible to predict post-operative outcome by performing simplified single stitch levator tuck for ptosis patients under local infiltrative anesthesia if the patients are cooperative. Simplified single stitch levator tuck had such advantages as short surgical time, convenient technique, minimal postoperative anatomical change in upper eyelid, and easiness to perform to re-operation.
Anesthesia ; Eyelids ; Follow-Up Studies ; Humans ; Operative Time ; Polypropylenes ; Reflex ; Sutures*

14 supratentorial and 6 infratentorial arachnoid cysts, diagnosed and treated at Kangnam St Mary's Hospital from 1983 to 1988, are reported. The most common presenting symptoms in children were craniomegaly, delayed development, increased ICP and neurological focal signs. Neuroradiological examination included plain skull X-ray, brain CT and metrizamide CT or isotope study. Therapeutic criteria according to the clinical and radiological findings were reviewed. The results were as follows; 1) The patient below age of 2 yrs who's brain had a potent ability of growth should be operated in any cases for reducing mass effect. 2) In sylvian lesion, Type II and III according to the classification of Galassi were well treated with C-P snunt. 3) In infratentorial lesion, all patients had hydrocephalus and the patient who had communicated with subarachnoid space in metrizamide CT were well treated with V-P shunt and who not communicated with subarachnoid space was well treated with Y-shunt. 4) We had good results by fenestration above the age of 3 yrs and by C-P shunt under the age of 2 yrs in supratentorial lesion.
Arachnoid Cysts* ; Brain ; Child* ; Classification ; Humans ; Hydrocephalus ; Metrizamide ; Skull ; Subarachnoid Space

Background: Corrective osteotomy is an effective surgery for correcting posture in patients with ankylosing spondylitis (AS). Despite satisfactory correction, some patients experience re-stooping during follow-up. However, there have been no studies on restooping in AS. We aimed to analyze the factors that affect re-stooping. Methods: Fifty patients (50 cases) who underwent thoracolumbar corrective osteotomy for AS from March 2006 to April 2018 were analyzed. We defined re-stooping as global kyphosis that recurs after corrective osteotomy. The patients were divided into two groups based on the ratio of correction loss: non-re-stooping group (N group) and re-stooping group (R group). We analyzed the demographic data and radiological parameters, such as modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), sagittal vertical axis, and various angles. We also investigated the factors affecting re-stooping by analyzing the correlation between the ratio of correction loss and various factors. Results: A significant difference was seen in the change in the mSASSS from before surgery to the last follow-up between the N group (2.87 ± 3.08) and the R group (9.20 ± 5.44). In multivariate analysis, only the change in the mSASSS from before surgery to the last follow-up was significantly correlated with the ratio of correction loss. Conclusions Thoracolumbar corrective osteotomy seems to provide high satisfaction among patients with AS but can lead to re-stooping during follow-up. The change in mSASSS was related with re-stooping in the current study. We recommend active rehabilitative exercises and appropriate medication depending on the patient’s condition, which may help delay the postoperative progression of AS.

A case of neurenteric cyst within the cervical canal is reported. He has been suffered from gradual aggravated quardriparesis since 4 months. On spine C-T scan and cervical myelographic examination, intradural extramedullary mass was detected. And so total laminectomy of C4, C5 and C6 was performed. We could diagnose by the pathological findings.
Laminectomy ; Neural Tube Defects* ; Spinal Canal* ; Spine

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

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

PURPOSE: We designed this study to evaluate the interobserver reliability of magnetic resonance imaging (MRI), post-myelographic computed tomography (CT-myelogram) and myelography for the diagnosis of lumbar spinal stenosis. MATERIALS AND METHODS: Thirty two patients with lumbar spinal stenosis were evaluated preoperatively by MRI, CT-myelography, and myelography by four observers. For each set of scans, the examiners assessed the presence or absence of; 1) intervertebral disk protrusion, 2) facet arthrosis, 3) ligamentum flavum hypertrophy, and 4) nerve root impingement. The severities of 1) central, 2) lateral, 3) foraminal and 4) entire spinal stenosis were graded using a four-point scale range from 1 (no stenosis) to 4 (severe stenosis). RESULTS: Kappa statistical analysis revealed moderate interobserver agreement in terms of disk protrusion (0.49), nerve root impingement (0.42) and lateral stenosis grade based on MRI. Low levels of agreement were found for facet arthrosis and ligamentum flavum hypertrophy. Relatively higher levels of agreement were found for nerve root impingement, lateral stenosis and entire stenosis, graded by MRI and for central stenosis graded by myelography. CONCLUSION: The results of this study reflect that MRI showed relatively higher levels of interobserver reliability than the other diagnostic modalities in the evaluation of patients with lumbar spinal stenosis.
Constriction, Pathologic ; Diagnosis ; Humans ; Hypertrophy ; Intervertebral Disc ; Ligamentum Flavum ; Magnetic Resonance Imaging* ; Myelography ; Spinal Stenosis*