Chronic expanding hematoma (CEH) is a hematoma that increases in size, usually occurring after trauma or surgery, more than a month after initial bleeding. Thighs and upper limbs are the most common sites of CEH. Only a few cases of CEH have been reported in the amputation stump site since CEH itself is a rare disease.We experienced a case of a 59-year-old man who underwent transtibial amputation and suffered from recurrent non-infectious hematoma. For the treatment of CEH, the patient underwent an open bursectomy, followed by bony spur removal surgery. However, CEH recurred, and the pain was only managed by intermittent aspiration and compression. We report a long journey of managing painful CEH of the transtibial amputation stump.

The death caused by a hand grenade detonation is extremely uncommon and specialized event in Korea cause that it used in military fields, and these cases are only investigated by CIC (Criminal Investigation Command) of ROK Army. The hand grenade is small, light weighted anti-human explosive, so it uses widely than other explosive objects. The morphological characteristics seeing in victim by hand grenade detonation are very variable according to position, distance of explosion, type of grenade, environmental effects, and so many others. We performed retrospective analysis of 23 cases of death by hand grenade in ROK Army from 1990 to 2008. These cases are classified by direction and position of wounds, injuries of external and internal organs. Most of all are contact or near contact range detonation, and the focus of detonation is suggested anterior chest wall mostly. Amputations or critical wounds are mostly located on hand, arm, anterior chest, but wounds of dorsal portion is relatively rare. Most of all are suggested to detonate grenade in standing or straightened-arm position. Internal organ damages, such as hemothorax, hemoperitoneum, hemopericardium by detonation pressure or penetration by fragments, are seen in 75% cases of all, and the organs are mostly heart, lung and other hollow organs. External examination may fail to show fatal external damage or wound. The data of this analysis would be used as adjunctive and objective examples of investigation of death by hand grenade in Korea.
Amputation ; Arm ; Explosions ; Hand ; Heart ; Hemoperitoneum ; Hemothorax ; Homicide ; Humans ; Korea ; Light ; Lung ; Military Personnel ; Pericardial Effusion ; Retrospective Studies ; Suicide ; Thoracic Wall ; Thorax

Deaths caused by grenades hardly occur except for during wartime, and can be seen as a particular incident that can be observed only within the military or by acts of terrorism. However, there has never been any data which tried to analyze the damage patterns through mock grenade explosions. So far, the processes leading to deaths were merely inferred by reconstructing the situation with limited intelligence after the incidents have already occurred. Therefore, the authors believe that having mock grenade explosions in order to compare and study the observances with those of the actual incident will be helpful for a more precise and objective medical jurisprudence, and thus have summarized the damage patterned obtained on 8 butchered pigs, that were 6~8 months old, about 100 cm in length and 70~100 kg in weight by photographing with radioactive rays and running autopsies after detonating grenades on them. In conclusion, if there was extensive loss of body parts, the grenade probably exploded when in contact with the lost body parts. If fractures were found the grenade is likely to have detonated contacting or within 25 cm of distance with the body, and if there were no lacerations or loss of body parts the grenade probably exploded at a distance of at least 50 cm. If soot was prevalent on the deceased's body, the grenade is likely to have exploded within a distance of 25 cm from the body at a free floating state, in which it was not in contact with the ground or the body. Lastly, if no soot was found, the grenade most probably detonated at a distance of 50 cm or more. The posture or the direction of the body cannot give precise clues of the victim's state before theexplosion, and a hasty presupposition could be very dangerous in case of contact explosions especially.
Autopsy ; Bombs ; Explosions ; Hand ; Homicide ; Human Body ; Humans ; Intelligence ; Jurisprudence ; Lacerations ; Military Personnel ; Posture ; Running ; Soot ; Suicide ; Swine ; Terrorism

The authors investigated the death days of 246 people who committed suicide and converted them into their respective days in lunar calendar in order to see if there are any correlations with the cycle of months. The cycle of the months was divided into the first quarter, full moon, last quarter, and the new moon. The death days were investigated by daily statistics each, and they were investigated in relation with the cycle of the months regarding the occurrence of suicide, holidays, and weekends. There were twice as many people committing suicide when the moon is dark than when it is full moon, but there weren't much significance when judging from the big context. There were three times as many people committing suicide in a short period of time when the moon is dark than when it is full moon, but there wasn't much significance when judging from the big context. There wasn't anything special about suicide in daily basis. There wasn't a big inclination in the number of people committing suicide over holidays or weekends despite common belief. If we find the correlation between the psychological factors and the actions of those who commit suicide in the military, we could contribute to adjusting to some extent the actions of those who have the potential of committing a suicide. Out of such expectation was proceeded this research.
Holidays ; Humans ; Military Personnel ; Moon ; Suicide

Herein, we describe a bacteremia caused by Neisseria gonorrhoeae that presented as liver abscesses. The patient had no risk factors for disseminated gonococcal infection. Periodic fever, skin rashes, and papules were present and the results of an abdominal computed tomography scan indicated the presence of small liver abscesses. The results of blood culture and 16S rRNA sequencing of the bacterial isolates confirmed the presence of N. gonorrhoeae. The patient improved with antibiotic therapy.
Adult* ; Bacteremia* ; Exanthema ; Fever ; Humans ; Liver Abscess* ; Neisseria gonorrhoeae ; Risk Factors

This study was conducted to investigate relationships and gender differences in dietary supplement (DS) and oriental supplement (OS) prevalence as well as anti-doping awareness during training and the game period. Korea National Sport University athletes (343 male and 136 female) participated in this study and completed DS and OS practice and anti-doping awareness questionnaires. Forty-six percent of athletes used DS during the training period, and there was significantly higher DS use in females (53%) compared to males (43%) (P < 0.05). Twenty-eight percent of athletes used OS, and there was significantly higher OS use in females (35%) than males (26%) (P < 0.05) during the training period. The primary reason of DS use was to supply energy both in males (36%) and females (28%). The main reason for male athletes' OS use was to supply energy (41%). Meanwhile, the reasons for female athletes' OS use were to supply energy (23%), to maintain health (19%), and to improve recovery ability (20%), which showed a significant gender difference (P < 0.05). Athletes rated their perceived degree of satisfaction, perceived importance, and beliefs in efficacy of DS and OS use all over 50% during the training period, and no gender differences were detected. In a comparison between athletes educated about anti-doping (at least more than one time) and non-received athletes, DS and OS use during the training period was 2.30 (1.47-3.60) and 1.71 (1.03-2.82), respectively. DS and OS use immediately before the game period was 2.38 (1.50-3.80) and 3.99 (1.20-13.28), respectively. Elite athletes' anti-doping education was highly related to increased DS use during the training period and immediately before the game. Although elite athletes use various DS and OS during the training period and before the game period, doping education for elite athletes is related with DS and OS use during the training period and before the game.
Athletes ; Dietary Supplements ; Female ; Humans ; Korea ; Male ; Prevalence ; Surveys and Questionnaires ; Sports

Forensic interpretation of whether the manner of death is suicide or homicide is very important in death cases due to multiple gunshot wounds. We analyzed 18 death cases from multiple gunshot wounds with Korean military rifles (K-1 and K-2) in the Republic of Korea Army from 2000 to 2011. In cases of the suicide, distance of gun from the body was all contact or near-contact range, except for 1 case of near range. When the selector was set to single shot, the initial entrance wounds were formed on the typical suicidal areas. The bullet tracks, however, did not involve the anatomical regions that would cause immediate incapacitation. The following entrance wounds also were sustained on the typical suicidal areas while the bullet tracks were made in the immediate incapacitation regions. When the selector was set to precision shot or multiple shot, the initial entrance wounds were located on typical suicidal areas, and the entrance wounds resulting from following bullets were gradually moving away form the initial entrance wound due to pop-up effect of the rifle. In cases of the homicide, distance of gun from the body was all distant range and the location of entrance wounds were not significantly related to typical suicidal areas.
Firearms ; Homicide ; Humans ; Military Personnel ; Republic of Korea ; Suicide ; Track and Field ; Wounds, Gunshot

OBJECTIVE: The aim of this study was to investigate the efficacy of globus pallidus interna deep brain stimulation (GPi-DBS) for treating dystonia due to the GNAL mutation. METHODS: We provide the first report of a dystonia patient with a genetically confirmed GNAL mutation in the Korean population and reviewed the literature on patients with the GNAL mutation who underwent GPi-DBS. We compared the effectiveness of DBS in patients with the GNAL mutation compared to that in patients with DYT1 and DYT6 in a previous study. RESULTS: Patients with the GNAL mutation and those with DYT1 had higher early responder rates (GNAL, 5/5, 100%; DYT1, 7/7, 100%) than did patients with DYT6 (p = 0.047). The responder rates at late follow-up did not differ statistically among the three groups (p = 0.278). The decrease in the dystonia motor scale score in the GNAL group was 46.9% at early follow-up and 63.4% at late follow-up. CONCLUSION: GPi-DBS would be an effective treatment option for dystonia patients with the GNAL mutation who are resistant to medication or botulinum toxin treatment.
Botulinum Toxins ; Deep Brain Stimulation ; Dystonia ; Follow-Up Studies ; Globus Pallidus ; Humans

OBJECTIVE: Neurodegeneration with brain iron accumulation (NBIA) represents a group of inherited movement disorders characterized by iron accumulation in the basal ganglia. Recent advances have included the identification of new causative genes and highlighted the wide phenotypic variation between and within the specific NBIA subtypes. This study aimed to investigate the current status of NBIA in Korea. METHODS: We collected genetically confirmed NBIA patients from twelve nationwide referral hospitals and from a review of the literature. We conducted a study to describe the phenotypic and genotypic characteristics of Korean adults with atypical pantothenate kinase-associated neurodegeneration (PKAN). RESULTS: Four subtypes of NBIA including PKAN (n = 30), PLA2G6-related neurodegeneration (n = 2), beta-propeller protein-associated neurodegeneration (n = 1), and aceruloplasminemia (n = 1) have been identified in the Korean population. The clinical features of fifteen adults with atypical PKAN included early focal limb dystonia, parkinsonism-predominant feature, oromandibular dystonia, and isolated freezing of gait (FOG). Patients with a higher age of onset tended to present with parkinsonism and FOG. The p.R440P and p.D378G mutations are two major mutations that represent approximately 50% of the mutated alleles. Although there were no specific genotype-phenotype correlations, most patients carrying the p.D378G mutation had a late-onset, atypical form of PKAN. CONCLUSIONS: We found considerable phenotypic heterogeneity in Korean adults with atypical PKAN. The age of onset may influence the presentation of extrapyramidal symptoms.
Adult ; Age of Onset ; Alleles ; Basal Ganglia ; Brain ; Dystonia ; Freezing ; Gait ; Gene Frequency ; Genetic Association Studies ; Humans ; Iron ; Korea ; Movement Disorders ; Neurodegenerative Diseases ; Pantothenate Kinase-Associated Neurodegeneration* ; Parkinsonian Disorders ; Phenotype ; Population Characteristics* ; Referral and Consultation ; Weather