Cardiovascular disease is the most important cause of unexpected sudden death. Although ischemic heart disease by coronary atherosclerosis is the most common cause of sudden cardiac death, other diseases such as cardiomyopathy, congenital heart disease, valvular heart disease and rarely myocarditis can produce sudden cardiac death. Myocarditis is an inflammatory process of the myocardium characterized by an interstitial inflammatory infiltrate and an injury to myocytes adjacent to the inflammatory cells. The clinical expression of myocarditis ranges from the asymptomatic state to fulminant fatal congestive heart failure. Because myocardial involvement is subclinical in most acute infectious disease, the majority of patients have no specific complaints referable to the cardiovascular system. It is possible that it causes a medicolegal problems in case of sudden death. Therefore, author reviewed the clinical and pathological findings of 18 myocarditis autopsy cases. The victims 'age was varied 4-month-59-year olds. 5 (28%) were male and 13 (72%) were female. 15 cases received medical treatment due to clinical symptoms(URI symptoms: 2 cases, tonsillitis and tonsillar abcess: 3 cases, GI symptoms: 5 cases, URI & GI symptoms: 3 cases, pneumonia: 1 case, operation due to ovarian tumor: 1 case) and were associated with medicolegal problem. By the results of this study, important gross findings were pericardial effusions, characteristic cardiomegaly, and pulmonary edema.
Asymptomatic Diseases ; Autopsy ; Cardiomegaly ; Cardiomyopathies ; Cardiovascular Diseases ; Cardiovascular System ; Communicable Diseases ; Coronary Artery Disease ; Death, Sudden ; Death, Sudden, Cardiac ; Female ; Heart Defects, Congenital ; Heart Failure ; Heart Valve Diseases ; Humans ; Male ; Muscle Cells ; Myocardial Ischemia ; Myocarditis* ; Myocardium ; Palatine Tonsil ; Pericardial Effusion ; Pneumonia ; Pulmonary Edema ; Tonsillitis

Retinal prosthesis is regarded as the most feasible method for the blind caused by retinal diseases such as retinitis pigmentosa or age-related macular degeneration. One of the prerequisites for the success of retinal prosthesis is the optimization of the electrical stimuli applied through the prosthesis. Since electrical characteristics of degenerate retina are expected to differ from those of normal retina, we investigated differences of the retinal waveforms in normal and degenerate retina to provide a guideline for the optimization of electrical stimulation for the upcoming prosthesis. After isolation of retina, retinal patch was attached with the ganglion cell side facing the surface of microelectrode arrays (MEA). 8x8 grid layout MEA (electrode diameter: 30micrometer, electrode spacing: 200micrometer, and impedance: 50 k omega at 1 kHz) was used to record in-vitro retinal ganglion cell activity. In normal mice (C57BL/6J strain) of postnatal day 28, only short duration (<2 ms) retinal spikes were recorded. In rd/rd mice (C3H/HeJ strain), besides normal spikes, waveform with longer duration (~100 ms), the slow wave component was recorded. We attempted to understand the mechanism of this slow wave component in degenerate retina using various synaptic blockers. We suggest that stronger glutamatergic input from bipolar cell to the ganglion cell in rd/rd mouse than normal mouse contributes the most to this slow wave component. Out of many degenerative changes, we favor elimination of the inhibitory horizontal input to bipolar cells as a main contributor for a relatively stronger input from bipolar cell to ganglion cell in rd/rd mouse.
Animals ; Electric Stimulation ; Electrodes ; Ganglion Cysts ; Macular Degeneration ; Mice ; Microelectrodes ; Prostheses and Implants ; Retina ; Retinal Diseases ; Retinal Ganglion Cells ; Retinaldehyde ; Retinitis Pigmentosa ; Visual Prosthesis

OBJECTIVE: To compare the scar formation and hand function between moist exposed burn ointment (MEBO) treatment and conventional skin graft in full thickness hand burns. METHOD: Prospective comparative study was done between MEBO treatment group and conventional skin graft group. Full thickness burn wound scars on dorsal hand were compared. Scars were assessed with the Vancouver scar scale and other objective measurement tools such as pigmentation, erythema, pliability, transepideramal water loss, thickness and perfusion. Hand function was evaluated by the Jebsen hand function test and Michigan Hand Function Questionnaire. RESULTS: Vancouver Scar scale showed significantly better scores in the MEBO group than in the conventional skin graft group. Scar thickness and transepidermal water loss were greater in the MEBO treatment group whereas pigmentation value was greater in the conventional skin graft group. There was no significant difference in the hand function between the two groups. CONCLUSION: MEBO application could be an alternative treatment to conventional skin graft treatment in full thickness hand burn wounds. In the future, more studies are yet to come how MEBO treatment may affect the skin condition of the burn injuries.
Burns* ; Cicatrix* ; Erythema ; Hand* ; Michigan ; Perfusion ; Pigmentation ; Pliability ; Prospective Studies ; Surveys and Questionnaires ; Skin* ; Transplants* ; Wounds and Injuries

Although the management of fractures of the calcaneus still remains controversial, open reduction and internal fixation is gaining in popularity as the method of choice for the treatment of displaced intraarticular calcaneal fractures. However, open methods can make several complications such as neurovascular injury and infection. Thus we have performed the new technique of arthroscopic reduction and minimal internal fixation for displaced intraarticular calcaneal fractures in 5 cases. The results were evaluated between 12 and 16 months after surgery. A Bohler angle was restored to 25degrees-40degrees in all cases. Anatomical reduction of articular surface were obtained from 4 cases out of 5. No complications were found except 1 peroneal tendinitis. The clinical results by Creighton-Nebraska health foundation assessment for fractures of the calcaneus were 3 excellent, 1 good and 1 fair. Even though this was a few case and a short term follow-up study, the arthroscopic assisted management of displaced intraarticular calcaneal fracture induced a little complications and satisfactory results.
Calcaneus ; Follow-Up Studies ; Tendinopathy

Objectives: . To determine the appropriate anatomical borders of implantation on the temporal bone in a cadaver study, and to develop a simplified surgical technique for Baha Attract implantation through a small incision along the hairline using anatomical evidence and a navigation system. Methods: . In a cadaver study, 20 human adult dry skulls were used to find flat areas of the temporal bone for Baha Attract magnet implantation. Four borders of the “optimal surgical site” were defined: Asterion line, occipitomastoid suture line, sigmoid sinus line, and digastric groove line. In three patients, we implanted the Baha Attract according to the newly developed surgical procedure and validated the feasibility of this technique with a navigation system. Results: . We identified the appropriate position of the implant on the temporal bone, suggesting a simplified surgical technique for Baha Attract with a small incision. We determined the spot of implantation, and the implants were inserted through a small surgical incision (<2.5 cm) under local anesthesia; the procedure lasted approximately 30 minutes. Conclusion . The optimal surgical site of the temporal bone is a safe and easily accessible location for implantation of the Baha Attract.

STUDY DESIGN: Retrospective study. PURPOSE: To estimate the usefulness of bone scan and magnetic resonance imaging (MRI) for the diagnosis of new fracture in osteoporotic vertebral fractures. OVERVIEW OF LITERATURE: The diagnosis of new fractrure in osteoporotic vertebral fractures requires simple X-ray and supplementary studies. METHODS: We analyzed 87 vertebrae in 44 patients, who diagnosed with osteoporotic vertebral fractures using bone scan and MRI within 2 months interval between August 2001 and July 2008. We compared hot uptakes in bone scan with MRI findings such as new fractures, old fractures and degenerative lesions. RESULTS: Hot uptakes in bone scan was matched to 48 new fractures, 26 old fractures and 13 degenerative lesions in MRI findings. It was 55% of concordance between hot uptakes in bone scan and new fractures in MRI. The rate of new vertebral fractures confirmed by MRI according to 1 level hot uptakes in bone scan was 96%, 2 levels was 50% and 3 more levels was 36%. CONCLUSIONS: The diagnosis of new fracture in osteoporotic vertebral fractures requires simple X-ray and supplementary studies such as bone scan and MRI. We recommend more careful interpretation in multiple osteoporotic vertebral fracture patients about hot uptake lesions of bone scan.
Fractures, Compression ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine

Flowable resins can be used as a base material during the restoration of deep tooth cavity. The purpose of the present study was to evaluate the mechanical properties of the layered specimens which have flowable resin as a base material. For the study, two composite resins and five flowable resins were chosen for the overlying and base materials, respectively. Flexural and compressive properties of each bulk and ten layered specimens were measured. Layered specimens showed high flexural strength (FS) and flexural modulus (FM) if bulk state FS and FM of the base flowable resin are high. However, compressive strength (CS) was not that case. CS of the layered specimen was not high (251.4~295.3 MPa) whether CS of the bulk state is high or not (259.8~439.8 MPa). FM showed high linear correlation with CM. After all mechanical properties of the layered specimens were not consistently influenced by the mechanical properties of the base flowable resins regardless of the overlying composite resins.
Composite Resins ; Compressive Strength ; Tooth

Electrocutions are relatively rare. However, the electrocutions are gradually increasing as the increases of the use of electricity. In this study, we diagnosed 46 cases as electrocutions among author's autopsy cases from 1991 to 2002 year and reviewed in aspects of forensic medicine. The results were as follows : 1. All cases were males and average age was 35.6 years. 2. Electrocutions occur most frequently in July and August, which are particularly hot and humid. 3. 38 victims were the worker and 44 cases were accident in the manner of death. Only two cases were suicide. 4. 28 cases showed the typical current mark, especially in the fingers and hands(15 cases). 5. The scene investigation by specialists or policemen were made in 36 cases. 6. Forensic pathologists should consider the thorough investigation of the scene for exact diagnosis, if the victims were suspected of accidental electrocution.
Autopsy ; Diagnosis ; Electric Injuries ; Electricity ; Fingers ; Forensic Medicine ; Humans ; Male ; Specialization ; Suicide

BACKGROUND: Skin Biopsy is a equently used diagnostic tool in dermatology and clinical impressions before biopsy may be different with pathologic diagnosis. OBJECTIVES: The purpose of this study was to investigate the concordance rate of clinical impression and pathologic diagnosis. METHODS: Clinical and Pathological studies were done on 559 biopsied skin diseases among 16, 944 out-patients in Dermatologic department of Chungnam University Hospital during the period of 1 year from March, 2002 to February, 2003. RESULTS AND CONCLUSION: The study results are summarized as follows: 1. The most frequently biopsied skin disease group was non-tumor, noninfectious disease (40.8%), followed by benign tumor (37.4%), infectious disease (11.8%), malignant tumor (10.0%). 2. The concordance rate between clinical impression and pathologic diagnosis showed 68.9% in complete agreement and 79.6% in complete and partial agreement. 3. The concordance rate of professor committed cases was 68.8% and that of residents committed cases was 69.1%. 4. The concordance rates among disease groups were highest in malignant tumor (74.6%), then benign tumor (70.8%), non-tumor infectious disease (67.4%) and non-tumor noninfectious disease (65.2%).
Biopsy* ; Chungcheongnam-do ; Communicable Diseases ; Dermatology ; Diagnosis* ; Humans ; Outpatients ; Skin Diseases ; Skin*

Blue nevi are usually solitary, but they may be multiple and form a plaque composed of multiple papules or nodules with an intervening flat area of blue coloration. It looks like a benign and asymptomatic lesion. However, because of its rarity, no definitive prognosis can be given. An 18-year-old male presented with a 5 x 4 cm-sized, speckled blue-black tumor on his posterior neck, which had existed since birth. Histopathologic examination showed clumps of melanocytes intermingled with irregularly arranged collagen bundles in the mid and lower dermis, with some extending to the subcutaneous tissue. We diagnosed the lesion as a plaque-type blue nevus, based on histopathologic findings of common blue nevus.
Adolescent ; Collagen ; Dermis ; Humans ; Male ; Melanocytes ; Neck ; Nevus, Blue* ; Parturition ; Prognosis ; Subcutaneous Tissue