1.A Case Report of Fatal Vaginal and Anal Fisting.
Ji Eun KIM ; Young Ran CHO ; Sang Han LEE
Korean Journal of Legal Medicine 2013;37(3):157-160
Fisting is an uncommon sexual activity, and death due to fisting is very rare. In the present report, we describe a case of a woman who died from fisting by her male partner. A 38-year-old woman went to a motel with a man after consuming alcohol, and there they kissed each other. As desired by woman, the man inserted his fingers into her vagina and anus, and later inserted his fist and forearm into her vagina and anus. After 20-30 minutes of fisting, the woman became unconscious and died. The autopsy confirmed the presence of perineal and vaginal lacerations with massive internal pelvic soft tissue injury with uterine artery rupture. A partial tear was noted at the rectosigmoid junction. The cause of death was hypovolemic shock due to uterine artery rupture. Following court trials, the assailant was sentenced to 4 years of imprisonment for the felony of inflicting bodily injury resulting in death.
Anal Canal
;
Autopsy
;
Cause of Death
;
Female
;
Fingers
;
Forearm
;
Humans
;
Lacerations
;
Male
;
Rupture
;
Sexual Behavior
;
Shock
;
Soft Tissue Injuries
;
Unconscious (Psychology)
;
Uterine Artery
;
Vagina
2.Rapid Diagnosis of Isoniazid Resistance by Detection of Mutations in katG and inhA of Mycobacterium tuberculosis from Korea.
Sang Jae KIM ; Seok Yong KIM ; Ji Youn LEE ; Sang Ryeol RYU ; Gil Han BAI
Journal of the Korean Society for Microbiology 1997;32(5):569-576
29 isoniazid (INH) resistant isolated strains and INH sensitive reference strain (H37Rv) of Mycobacterium tuberculosis were analysed by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and NciI restriction mapping for the detection of mutations in katG gene and inhA gene. The katG gene was divided into 3 parts (Akat, Bkat, Ckat; each part is about 800 bp) and amplified, inhA gene was amplified as a whole. Each of the amplified 800 bp DNA was digested into small fragments of less than 400 bp with restriction enzymes for the direct PCR-SSCP analysis. Firstly, 10 strains were analysed. All the 10 isolates showed clearly distinct SSCP patterns in Bkat from that of the reference strain, but only two isolates showed distinct SSCP patterns in Akat, and no isolated strain showed any distinct SSCP patterns in Ckat. 10 isolates also showed distinct SSCP patterns in inhA. NciI restriction mapping of Bkat showed mutation in codon 463 in 7 strains among 10 isolated strains. With these results an early detection strategy for the INH resistant M. tuberculosis was applied to the rest of 19 isolated INH resistant strains. Firstly, isolates were screened by Ncsl mapping in Bkat, and 13 strains showed mutations in codon 463. Secondly, the rest of 6 INH resistant isolates were analysed by PCR-SSCP with restriction enzyme digestion (PCR-SSCP-RE) in Bkat, and all the strains showed distinct SSCP patterns from that of the INH sensitive reference strain. This proved our strategy as effective and economic and time saving method in early detection of INH resistant M. tuberculosis.
Codon
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Diagnosis*
;
Digestion
;
DNA
;
Isoniazid*
;
Korea*
;
Mycobacterium tuberculosis*
;
Mycobacterium*
;
Polymorphism, Single-Stranded Conformational
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Restriction Mapping
;
Tuberculosis
3.Current Status of Children Born from Renal Transplanted Mother .
Ji Hyung YOO ; Jin Won YOOK ; Ji Hong KIM ; Pyung Kil KIM ; Sang Won HAN ; Myoung Jun KIM
Journal of the Korean Society of Pediatric Nephrology 2000;4(1):77-83
Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently, the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively, Their cytoiogic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows ; 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2, Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans' type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found. 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.
Biopsy, Fine-Needle
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Breast
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Breast Diseases
;
Child*
;
Diagnosis, Differential
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Dilatation, Pathologic
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Epithelial Cells
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Epithelioid Cells
;
Fat Necrosis
;
Female
;
Giant Cells
;
Granuloma
;
Granulomatous Mastitis
;
Histiocytes
;
Humans
;
Leukocytes, Mononuclear
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Mastitis
;
Mothers*
;
Neutrophils
;
Salivary Glands
4.Analysis of Children with Unilateral Multicystic Dysplastic Kidney ( MCDK ).
Ji Hyung YOO ; Jin Won YOOK ; Ji Hong KIM ; Pyung Kil KIM ; Sang Won HAN ; Myoung Jun KIM
Journal of the Korean Society of Pediatric Nephrology 2000;4(1):63-68
In a six-year period(1988. 5-1994. 4), fine needle aspiration cytology(FNAC) of 322 pulmonary lesions from 296 patients were performed at Soonchunhyang University Hospital. Of these 322, malignancy was diagnosed cytologically in 139(43.2%), suspicious malignancy in 7(2.2%), negative in 164(50.8%), and insufficient material in 12(3.8%). Malignant lesions consisted of 54 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 18 cases of small cell carcinoma. They were verified by histologic examination in 70 cases. There were 2(0.6%) false positive cases due to florid bronchoalveolar hyperplasia and atypical bronchial epithelial cells associated with granulomatous lesion. The overall accuracy rate was 90%, the sensitivity 84.3% and the specificity 94.7%.
Adenocarcinoma
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Biopsy, Fine-Needle
;
Carcinoma, Small Cell
;
Carcinoma, Squamous Cell
;
Child*
;
Epithelial Cells
;
Humans
;
Hyperplasia
;
Multicystic Dysplastic Kidney*
;
Sensitivity and Specificity
;
Tuberculosis, Pulmonary
5.The Treatment of Cutaneous T-cell Lymphoma with Triple Combination of Interferon alfa, Retinoid, and Photochemotherapy.
Jeong Deuk LEE ; Ji Sun LEE ; Sang Hyun CHO ; Chi Hwa HAN
Annals of Dermatology 2004;16(1):39-41
Cutaneous T-cell lymphoma(CTCL) is a rare cutaneous malignant disease and is typically a disease of older adults. There is no optimal treatment for CTCL, which ranges from topical steroid to systemic chemotherapy. Hence until curative therapy is found, therapies that keep CTCL in check and prevent progression to more advanced lymphoma may be desirable alternatives and may presetve quality of life. Herein we report our experience in treating a stage 11B CTCL patient with triple combination of interferon alfa, oral retinoid, and psoralen plus WA(PWA) therapy.
Adult
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Drug Therapy
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Ficusin
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Humans
;
Interferon-alpha*
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Interferons*
;
Lymphoma
;
Lymphoma, T-Cell, Cutaneous*
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Photochemotherapy*
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Quality of Life
;
T-Lymphocytes
6.Sedation and Hemodynamic Stability during Fiberoptic Awake Nasotracheal Intubation: Comparison between Propofol Infusion and Intravenous Boluses of Fentanyl and Midazolam.
Ji Hee LEE ; Sang Wook HAN ; Yu Young KIM ; Kwang Won YUM
Korean Journal of Anesthesiology 1997;33(4):741-749
BACKGROUND: Crucial to the success of fiberoptic awake tracheal intubation is proper preparation of the patient; this technique will work well in most patients when they are quiet and cooperative and have a larynx nonreactive to physical stimuli. We have attempted to ascertain how well these conditions are achieved with a low-dose infusion of propofol, because of its pharmacological profile. METHODS: Thirty patients, physical status by American Society of Anesthesiologists (A. S. A.) I-II, scheduled for oral and maxillofacial surgery, were randomly assigned to receive either propofol infusion 1 mg kg-1 h-1 preceded by a 1 mg kg-1 bolus (Group P) or intravenous fentanyl 1ug kg-1 and midazolam 0.05 mg kg-1 (Group F). These two groups were compared in terms of hemodynamic profile, sedation score, condition for intubation, coughing and swallowing. RESULTS: There were no statistically significant differences in mean arterial blood pressures according to time between two groups. But in Group F, heart rates were significantly increased in immediately after transtracheal injection of lidocaine, immediately before the fiberoscopy was started, 1, 2 minutes after start of fiberoscopy, compared to Group P (p<0.05). The patients in Group P were more sedated than those in Group F (p<0.05) but there were no significant differences in condition for intubation, reflex of coughing and swallowing, duration of fiberoptic intubation. CONCLUSIONS: We conclude that propofol is useful sedative agent in fiberoptic awake intubation with similar efficacy to midazolam and fentanyl but with more profound sedation and stable hemodynamic profile. These represent significant advantages for severe anxious or hypertensive patients and prolonged procedure of intubation.
Arterial Pressure
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Cough
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Deglutition
;
Fentanyl*
;
Heart Rate
;
Hemodynamics*
;
Humans
;
Intubation*
;
Larynx
;
Lidocaine
;
Midazolam*
;
Propofol*
;
Reflex
;
Surgery, Oral
7.Clinical Findings and Therapy of Ureteral Duplication in 61 Children.
Pyung Kil KIM ; Sang Won HAN ; Ji Hong KIM ; Jin Won YOOK
Journal of the Korean Society of Pediatric Nephrology 1998;2(2):169-177
Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked giant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46- year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like giant cells and mononuclear cells.
Child
;
Male
;
Female
;
Humans
;
Biopsy
8.IgG4-Related Sclerosing Sialadenitis: Report of Three Cases.
Ji Seon BAE ; Joo Young KIM ; Sang Hak HAN ; Seung Ho CHOI ; Kyung Ja CHO
Korean Journal of Pathology 2011;45(Suppl 1):S36-S40
Chronic sclerosing sialadenitis, Mikulicz disease or Kuttner tumor has been recently recognized as a spectrum of IgG4-related sclerosing disease. IgG4-related disease is characterized by a high serum IgG4 level and tissue infiltration of IgG4-positive plasmacytes. We report three cases of chronic sclerosing sialadenitis with variably associated systemic involvement. All patients presented with a submandibular mass or swelling, and all the resected submandibular glands showed diffuse lymphocytic infiltration, lymphoid follicles, and septal fibrosis. Two of the specimens revealed numerous IgG-positive plasma cells, most of which were IgG4-positive on immunohistochemical staining. One of them was associated with dacryoadenitis and hypophysitis. The other patient had ureterorenal lesions. Immunohistochemical study was unavailable in remaining one case, but the histologic features along with elevated IgG level and associated pancreatitis supported the diagnosis. All patients received steroid therapy postoperatively and are doing well. Salivary gland involvement in IgG4-related fibrosclerosis should be recognized in systemic medical pathology.
Dacryocystitis
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Fibrosis
;
Humans
;
Immunoglobulin G
;
Mikulicz' Disease
;
Pancreatitis
;
Plasma Cells
;
Salivary Glands
;
Sialadenitis
;
Submandibular Gland
9.Paraganglioma of Cauda Equina: A case report.
Ji Hwa KIM ; Sang Han LEE ; Yoon Kyung SHON ; Jyung Sik KWAK ; Tae Joong SHON
Korean Journal of Pathology 1994;28(5):528-532
The clinical and pathological features of a paraganglioma arising in the cauda equina is described and compared with previous reports. The right microscopic fetures were similar to those of paragangliomas from other sites, with a 'Zellballen' pattern of cells containing arzyrophil granules. Immunohistocytochemical stains for neurone specific enolase, S-100 protein, cytokeratin were positive, but stains for glial fibrillary acidic protein were negative. Electron microscopy showed densely staining membrane-bound granules, cilia like structures and fibros bodies in the cytoplasm. The last two features only occur in paragangliomas from this site. The pathological findings suggest that paragangliomas in this site arise from pre-existing paraganglia, possibly of the visceral autonomic group.
10.The Effect on Onset Time of Warming Local Anesthetic for Caudal Block.
Ji Ah LEE ; Soo Jin CHUNG ; Sang Bo HAN ; Tae Ho CHUNG ; Chung Hwan PARK
Korean Journal of Anesthesiology 1997;33(6):1098-1102
BACKGROUND: One of the main disadvantages of caudal block is the long latent period before a satisfactory blockade is obtained. Many investigators have used various preparations of local anesthetic solutions to improve the speed of onset. This study was performed to evaluate the effectiveness of prewarming of lidocaine HCl for caudal block. METHODS: Fifty healthy young patients (ASA I) were allocated into two groups, A and B. In group A, the local anesthetic solution were injected at room temperature (25 degrees C), while in group B, they were injected at 37oC. All the caudal block were performed using 2% lidocaine HCl 20 ml with fentanyl 100ug and epinephrine 1:200,000. The onset time was defined as the period from completion of injection until the patient first noticed loss of sensation to pin-prick on perianal region. Assessment of sensory loss was made at 15 seconds interval. We have compared the onset of sensory blockade between groups. The duration of analgesia and any significant side effects were also recorded. RESULTS: The onset of sensory blockade was significantly faster in group B (3.5 +/- 0.5 minutes) than group A (6.2 +/- 0.9 minutes). The duration of analgesia were not significantly changed between groups. Side effects of urinary retention, pruritus and nausea were noted between both groups but the difference was not significant. CONCLUSIONS: We have found that the onset time was 44% faster with warm lidocaine-fentanyl mixture (37 degrees C) than with the room temperature (25 degrees C). The improved clinical usefulness was achieved with no increase in side effects. The technique is a safe and effective method to reduce the latency of onset.
Analgesia
;
Epinephrine
;
Fentanyl
;
Humans
;
Lidocaine
;
Nausea
;
Pruritus
;
Research Personnel
;
Sensation
;
Urinary Retention