In the following report, we describe the case of a rapidly skeletonized corpse discovered in late summer. On the first day of September, a 57-year-old man was found almost completely skeletonized on a hill behind his house. His body lay prone, accompanied by a brush cutter at the entrance to the graveyard where his friend's parents were buried. His cap, clothes, and rubber boots were all intact and undamaged. Upon autopsy, no definite abnormalities were identified except for an old linear fracture on the frontoparietal bone. According to his friends and neighbors, he had likely died 8 or 9 days prior to the discovery of his body.
Autopsy ; Cadaver ; Friends ; Humans ; Middle Aged ; Parents ; Postmortem Changes ; Rubber ; Skeleton*

INTRODUCTION: Excessive daytime sleepiness and cataplexy are key features of narcolepsy. Modafinil is psychostimulant used in the treatment of narcolepsy. In this study, we evaluated effects of modafinil on nocturnal sleep structure and sleep latency in multiple sleep latency test and clinical features. METHODS: Twelve narcoleptic patients (7 male, age: 22.9 +/- 2.6 yrs) were participated in the study. All of them had done nocturnal polysomnography (nPSG), multiple sleep latency test (MSLT), clinical symptoms scales and have repeated same procedure after taking 200 mg of modafinil. We have done linear mixed model analysis to describe effects of group, medication and nap time on these measures. RESULTS: Modafinil did not affect clinical scales except PSQI which had been reduced after medication. In this study, Modafinil reduced total sleep time, sleep efficiency and increased wake after sleep onset and percent of arousal during sleep in nocturnal polysomnography and prolonged mean sleep latency in multiple sleep latency tests in both group. DISCUSSION: Modafinil has stimulant effect of central nervous system but its effect on night sleep is less than other psychostimulants such as methylphenidate. We ascertained that modafinil affected total sleep time, sleep efficiency and percent of wake during sleep but did not effect on sleep structure. Modafinil was effective in the management of day time sleepiness. Modafinil can enhance alertness of control group without day time sleepiness.
Arousal ; Cataplexy ; Central Nervous System ; Humans ; Male ; Methylphenidate ; Narcolepsy* ; Polysomnography ; Weights and Measures

INTRODUCTION: Detrended fluctuation analysis (DFA) is used as a way of studying nonlinearity of EEG. In this study, DFA is applied on sleep EEG of normal subjects to look into its nonlinearity in terms of EEG channels and sleep stages. METHOD: Twelve healthy young subjects (age: 23.8+/-2.5 years old, male:female=7:5) have undergone nocturnal polysomnography (nPSG). EEG from nPSG was classified in terms of its channels and sleep stages and was analyzed by DFA. Scaling exponents (SEs) yielded by DFA were compared using linear mixed model analysis. RESULTS: Scaling exponents (SEs) of sleep EEG were distributed around 1 showing long term temporal correlation and self-similarity. SE of C3 channel was bigger than that of O1 channel. As sleep stage progressed from stage 1 to slow wave sleep, SE increased accordingly. SE of stage REM sleep did not show significant difference when compared with that of stage 1 sleep. CONCLUSION: SEs of Normal sleep EEG showed nonlinear characteristic with scale-free fluctuation, long-range temporal correlation, self-similarity and self-organized criticality. SE from DFA differentiated sleep stages and EEG channels. It can be a useful tool in the research with sleep EEG.
Electroencephalography* ; Polysomnography ; Sleep Stages ; Sleep, REM

An epidemiological investigation was conducted on Metagonimus yokogawai infection in Hadong Gun (County), Gyeongsang Nam Do, Korea, and following findings were obtained. Overall prevalence rate of Metagonimus yokogawai infection was 29.1 percent from a total of 1,163 inhabitants examined. By area of river and stream, Seomjin-gang R.: 9.5 percent (out of 95 inhabitants examined) in Jeondo Ri in the lower river, 19.9 percent (156) at Dugog Ri near Hadong town, and 90.8 percent (65) in Tab Ri of Hwagae Myeon where Hwagae-cheon Stream joins; Hwagae-Cheon Stream: 42.2 percent (45) in Yonggang Ri of the middle stream and 27.5 percent (72) in Daeseong Ri of the upper stream; Hoengcheon-gang R.: 54.7 percent (161) in Gojeol Ri of the lower river, 40.6 percent (128) in Hoengcheon Ri of the middle stream, and 5.4 percent (93) in Jungi Ri of the upper stream, and 43.8 percent (89) in Uge Ri located along a tributary of the Hoengcheon-gang R. and 4.0 percent (101) in Jangam Ri which is located about 4 km away from the river; Deogcheon-gang R.: 18.5 percent (54) in Munam Ri; Gwangog-cheon Stream: 2.8 percent (107) in Gwangog Ri. The difference in prevalence rate of the infection by area was correlated with the opportunity and amount of raw eating of sweetfish by the inhabitants in the respective areas. By age and sex, the overall prevalence rate increased from young age group and reached a peak at 20-29 age group and then the rate decreased gradually. In high endemic areas, however, a peak level of the rate lasted up to 40-49 age group in male. On the other hand, in low endemic areas, the rate was significantly lower in female, though moderate level of the infection was seen in male. The overall prevalence rate was higher in male than in female and the difference was greater in middle age groups. The most significant mode of infection by the inhabitants was the raw eating of sweetfish which commonly harbour metacercariae of M. yokogawai during summer through autumn. Besides, it was noted that the infection can be acquired through contamination with the metacercariae on food of various side-dish and kitchen utensils as well as on hands of a cook when such fish are prepared or handled. The inhabitants usually begin to acquire infection from early June of a year when fishing of sweetfish opens and acquire infection more frequently in July and August when fish are caught more productively and favored for raw consumption by inhabitants. From September, sweetfish are no more favored for raw consumption and accordingly are dried and cooked in this season. The infection in the sweetfish Plecoglossus altivelis as the second intermediate host was first observed from May with low level of infection and the intensity of infection in a fish rapidly increased until reaching a peak in October when sweetfish season normally ends. The first intermediate host snail of M. yokogawai in this area was Semisulcospira coreana (Martens) which is widely distributed in the streams and rivers in this locality.
parasitology-helminth-trematoda ; Metagonimus yokogawai ; metacercaria ; Plecoglossus altivelis ; epidemiology

OBJECTIVE: Cervical carcinoma can be adequately treated when diagnosed in early stage. However, the progsnosis of recurrent cervical carcinoma remains poor. The objective of this study is to analyze the prognostic factors affecting survial of recurrent cervical carcinoma patients. METHODS: The clinical characteristics of eighty-three patients who were diagnosed as recurrent cervical carcinoma from Jan 1988 to Apr 1999 were retrospecively analyzed, The initial FIGO stage of II (67.5%) was the most predominant. There were 9.6% of adenocarcinoma, 9.6% of adenosquamous carcinoma, and 1.2% of small cell carcinoma other than squamous cell carcinoma (77.1%). Diagnosis of recurrence was made by histopathologic examination, CT/MRI, Chest X-ray, intravenous pyelography. The recurrence was detected on routine follow-up in 41.0%. Comparison of Kaplan-Meyer survival curve was made with log-rank test, P-value less than 0.05 was regarded as statistically significant. RESULTS: Overall 2-year survival rate was 37.3% and median survival was 17 [13-21, 95%CI] months. Four patients survived more than 5 years. There was no significant difference among survival rates of histopathologic types, Survival rates of patients with central recurrence were significantly higher than those of lateral and distant recurrence (P= 0.009). 13 patients who did not receive any treatment after recurrence survived only for 9 [7-11] months and the survival of those were significantly lower than the survival of patients who received treatment of any kind (P<0.001). The treatment modalities after recurrence did not affect survival. CONCLUSION: We conclude that regular follow-up of cervical carcinoma patients is very important in detecting recurrence and that treatment after recurrence does affect survival of patients.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Recurrence ; Survival Rate ; Thorax ; Urography

The case reported here, concerns a spontaneous low-flow fistula between the carotid arterial network and the cavernous sinus, with ophthalmological symptoms such as conjunctival congestion and diplopia in a 41-year-old woman. The patient has suffered from diabetes without trauma history. Patient's ocular symptoms and signs were only present in the left eye with best-corrected visual acuity 0.04 at the time of presentation. Other ophthalmic findings were exophthalmos, elevated intraocular pressure, and visual field defects. Enlarged extraocular muscles and proptosis were found on orbital computed tomography leading to the misdiagnosis of orbial pseudotumor or thyroid rbitopathy. Carotid angiography showed dural carotid-cavernous sinus fistula, which involved left-side internal and external carotid arterial network and right-side internal carotid arterial network. Orbital color Doppler imaging showed a flow reversal with a systolic component in the enlarged superior ophthalmic vein. We were able to diagnose dural carotid-cavernous sinus fistula. Dural carotid-cavernous sinus fistula was closed successfully by embolization via the vein without omplication. The visual acuity, proptosis, and dilated and tortuous vessels of the conjunctiva improved.
Adult ; Angiography ; Carotid-Cavernous Sinus Fistula ; Cavernous Sinus ; Conjunctiva ; Diagnostic Errors ; Diplopia ; Estrogens, Conjugated (USP) ; Exophthalmos ; Female ; Fistula* ; Humans ; Intraocular Pressure ; Muscles ; Orbit ; Thyroid Gland ; Veins ; Visual Acuity ; Visual Fields

PURPOSE: The BTA stat test is a one-step immunochromatographic assay to detect bladder tumor antigen in the urine. We evaluated the efficacy of the BTA stat test and bladder wash cytology(BWC) in the detection and follow-up of bladder cancer. MATERIALS AND METHODS: A voided urine sample for BTA stat test and bladder washing urine for cytology were obtained. The BTA stat test with or without BWC was performed in normal volunteers(n=20), patients with hematuria of unknown origin(n=29), patients with benign genitourinary(GU) disease(n=17), patients with other GU cancer(n=12), patients with bladder cancer(n=46) and patients with a history of bladder cancer(n=54). RESULTS: The overall sensitivities of the BTA stat and BWC in bladder cancer were 69.6% and 41.3%, respectively(p<0.01). For T2 or higher stage tumors, sensitivity was 94.1% for BTA stat and 64.7% for BWC(p<0.05). Grade II tumors were detected at 64.3% with BTA stat and 35.7% with BWC(p<0.05). The sensitivities of the BTA stat and BWC in the follow-up of patients after transurethral resection of bladder tumor were 45.5%(5/11) and 27.3% (3/11), respectively. The specificities of the BTA stat and BWC in the same patients were 88.4%(38/43) and 100%(43/43), respectively(p<0.05). The specificity in patients with hematuria but without disease was 69% for BTA stat and 100% for BWC. The specificities of the BTA stat in healthy volunteers, benign GU disease and other GU cancer were 95%, 82.4% and 75%, respectively. CONCLUSIONS: Our results demonstrate that BTA stat test is a simple, noninvasive test that is superior to bladder wash cytology for detection of bladder cancer in its sensitivity and a useful adjunct of cystoscopy in surveillance and diagnosis of bladder cancer. However, the BTA stat test can not replace cystoscopy due to low specificity.
Cystoscopy ; Diagnosis* ; Follow-Up Studies* ; Healthy Volunteers ; Hematuria ; Humans ; Immunochromatography ; Sensitivity and Specificity ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Perfluorocarbon liquids have been shown to be a useful intraoperative adjunct in managing complicated retinal detachment. To prove the effectiveness of intraoperative use of perfluorocarbon liquid and the improvement of surgical and functional outcomes, we retrospcetively evaluated the clinical results of the patients[13 eyes]who had retinal detachment complicated with proliferative vitreoretinopathy [over PVR Grade C4, C4 :7 eyes, C5 :6 eyes]. We performed standard 3-port pars plana vitrectomy in all eyes included in this study.Perfluorodecalin[DK-line]was used as a shortterm vitreous substitute intraoperatively and removed before the end of the surgery. The mean follow-up period was 15 months.Anatomical success rate was 86%[6 eyes]in Grade C4, 67%[4 eyes]in Grade C5, Visual acuity was over 5/200 in one eye[8%]and there was improvement in 5 eyes[40%] although it was below 5/200. Consequently, we could easily manage the retinal detachment with PVR with help of intraoperative perfluorocarbon liquid and could improve the postoperative surgical and visual outcomes.
Follow-Up Studies ; Retinal Detachment ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative*

The purpose of the study is to describe the cases with prepapillary or peripapillary vascular malformation who have experienced mild vitreous hemorrhage. Five patients [5 eyes], 1 male and 4 females, were included in the study.The vascular malformation was unilaterally present in all patients.Vitreous hemorrhage occurred from the area of retinal vascular malformation near or on the optic nerve, and cleared without further complications. Fluorescein angiographic feature of each eye was normal. Arteriovenous communication, secondary retinal exudation, or vascular leakage from vascular malformation was not observed. Each patient showed improvement in visual acuity of 2 lines or more. This benign, congenital vascular malformation may be non-progressive and infrequently cause mild vitreous hemorrhage.Therapeutic intervention was not necessary in these cases.
Female ; Fluorescein ; Hemorrhage ; Humans ; Male ; Optic Nerve ; Retinaldehyde ; Vascular Malformations* ; Visual Acuity ; Vitreous Hemorrhage

Pilomatricoma, known as calcifying epithelioma of Malherbe, is a deep dermal or subcutaneous tumor showing slow growth. There are some reports showing rapid enlargement of the tumors as a result of variable amounts of bleeding into the intratumoral cystic space and into the superficial dermis. We report an uncommon case of a rapidly enlarged pilomatricoma due to simultaneous in tratumoral and intradermal hemorrhage.
Dermis ; Hemorrhage* ; Pilomatrixoma*