The diagnosis of death by drowning is one of the hardest challenges in forensic pathology. Circumstantial factors and physical evidence such as autopsy findings are both important in drowning. However, drowning findings are not specific and no laboratory tests can specifically detect drowning. It has been suggested that fluid in the paranasal sinuses, especially the sphenoid sinuses, is a sign of drowning, in conjunction with other autopsy findings. This study aimed to determine the frequency of detection of fluid in the sphenoid sinuses in cases of death by drowning. From 2003 to 2012, 54 autopsied cases of drowning were selected and reviewed in the Department of Forensic Medicine, Kyungpook National University School of Medicine, Daegu. The most common autopsy findings were foaming at the mouth and nostrils (13%), frothy fluid in the airways (28%), pulmonary edema with overexpansion of lungs (87%), drowning liquid in the stomach and duodenum (52%) and hemorrhages in the petromastoid part of the temporal bone (93%). Fluid in the sphenoid sinuses was detected in 45/54 cases (83%). The plankton test was positive in 33/54 cases (87%), however, in 26 of these cases, plankton was found only in the lung tissue. In conclusion, detection of fluid in the sphenoid sinuses could be a diagnostic sign for death by drowning. The sphenoid sinuses are easily accessible on autopsy, so it is highly recommended to look for fluid in the sphenoid sinuses when performing an autopsy on bodies recovered from water.
Autopsy ; Cause of Death ; Drowning ; Duodenum ; Forensic Medicine ; Forensic Pathology ; Hemorrhage ; Humans ; Lung ; Mouth ; Paranasal Sinuses ; Plankton ; Pulmonary Edema ; Sphenoid Sinus ; Stomach ; Temporal Bone

A case of chondromyxoid fibroma, which was experienced at Seoul National University Hospital, is presented with a brief review of the literature, because of its relative rarity in incidence, its unusual location and its huze size in demension which seems to be largest in reported series in literatures.
Fibroma ; Incidence ; Seoul

No abstract available.
Adipose Tissue* ; Apoptosis ; Lipodystrophy*

BACKGROUND: Recently, the molecular pathologic investigation for clonality in lymphomas has been introduced and has gained a role in the diagnosis of lymphomas. In fact, the clonality test using TCRGR phenomenon has been done by Southern blot analysis (SBA) and polymerase chain reaction (PCR) for molecular pathologic diagnosis of T cell lymphomas. However, it is difficult to perform SBA with paraffin embedded specimens or with samples of small skin biopsies. OBJECTIVE: We investigated the efficacy of PCR amplification of TCR gene in paraffin em-bedded cutaneous T cell lymphomas. METHODS: Iii this study, the clonality was assessed by polymerase chain reaction (PCR) analysis of T cell receptor gamma (TCR) gene from the DNA extracts obtained from paraffin em-bedded tissues (PET) of malignant T cells, B cell lymphomas, and benign cutaneous T cell proliferative disorders. Heteroduple-x-analyses were also performed to rule out the false positives. RESULTS: Among the total of 62 cases analyzed, monoclonality was observed in 4 out of 10 mycosis fungoides, 7 out of 9 cutaneous T cell lymphomas excluding mycosis fungoides, 1 out of 3 angiocentric lymphomas, 2 out of 2 lymphomatosis papulosis, 1 out of 7 large plaque parapsoriasis, and 1 out of 2 T cell lymphomas in other organs. No monoclonality was observed in 9 inflammatory cutaneous diseases, 5 small plaque parapsoriasis, 4 cutaneous B cell lymphomas, and 11 B cell lymphomas in lymph nodes. CONCLUSION: The results suggest that the PCR method and heteroduplex analysis used in this study were not only practical but also efficacious for the diagnosis of cutaneous T cell lymphomas using tissues embedded in paraffins.
Biopsy ; Blotting, Southern ; Diagnosis ; DNA ; Gene Rearrangement* ; Genes, T-Cell Receptor ; Heteroduplex Analysis* ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides ; Paraffin ; Parapsoriasis ; Polymerase Chain Reaction* ; Receptors, Antigen, T-Cell* ; Skin ; T-Lymphocytes

BACKGROUND: In the skin, it is often difficult to differentiate lymphomas from reactive lymphoid lesions by light microscopic examination. OBJECTIVE: Our purpose was to determine whether immunologic data obtained from mutine-processed specimens could be used to further objective morphologic interpretations. METHODS: We conducted an immunohistochcmical staining in 44 cases of benign and malignant cutaneous lymphoproliferative lesions using nine antibodies, including anti-CD3, UCHL1, MT1, MT2, L26, MB2, BerH2, 123C3, and MIB1. RESULTS: 1. Immunophenotyping with anti-CD3, UCHL1, MT1, L26, and MB2 was useful for the diagnosis of T cell or B cell lymphoma. However, these antibodies showed a lack of specificity for neoplastic cells, 2. Antibody to CD56, 123C3 showed positivity in 4 cases of angiocentric lymphoma, but negativity in 8 cases showing angiocentric lymphoma-like pathology. 3. Antibody to CD30, BerH2 showed positivity in all 6 cases of CD30 positive large cell lymphoma, but negativity in 6 cases showing diffuse lymphoma-like pathology. 4. Antibody to Ki-67, MIB1 showed positivity in more than 30% of infiltrating cells in 6 cases of angiocentric lymphoma, 4 cases of diffuse B cell lymphoma, and in more than 60% of infiltrating cells in 6 cases of CD30 positive large cell lymphoma. CONCLUSION: These observations suggest that immunostaining may provide useful adjunctive information in distinguishing benign from malignant cutaneous lymphoproliferations in paraffin sections.
Antibodies ; Diagnosis ; Immunophenotyping ; Lymphoma ; Lymphoma, B-Cell ; Paraffin ; Pathology ; Pseudolymphoma* ; Sensitivity and Specificity ; Skin

No abstract available.
Brain Stem* ; Hepatolenticular Degeneration*

It is well known that there is close relation of the left atrial pathology to atrial fibrillation(AF) in patients with mitral valvular disease. To evaluate such relation is existed or not in the right atrium, the right atrial wall biopsy was performed in 31 patients with mitral valvular disease during valve surgery. The specimens obtained were interpretated by the pathologist who had no information about the patients. The specimens were graded according to severity of morphological change. In Grade I, the atrial myocardium is degenerated and has moderate fibrosis in it. Grade II shows the atrial myocardial layer of the atrium and severe degenerated with pre and postoperative heart rhythm. Four patients had Grade I change and 3 patients among them had pre and postoperative AF. Eleven patients had Grade III changes and 9 among them had pre and postoperative AF. The results show there is strong tendency that the patients with pre and postopeative AF had Grade III change in the right atrium and the relation of the right atrial pathology to AF is same as that of the left atrium.
Atrial Fibrillation* ; Biopsy ; Fibrosis ; Heart ; Heart Atria ; Humans ; Myocardium ; Pathology*

No abstract available.
Adenomatous Polyposis Coli* ; Colectomy* ; Humans ; Polyps*

BACKGROUND & OBJECTIVES: Subacute combined degeneration (SCD) is a disease of spinal cord involving the posterior and lateral column due to vitamin B12 deficiency. The clinical and electrophysiologic findings of SCD are various. METHODS: From 1989 to 1996, 7 patients were diagnosed with SCD in our hospitals. The diagnosis was made by the neurologic and laboratory findings and electrophysiolgic studies such as nerve conduction studies(NCS) and evoked potential(EP). RESULT: Four patients received gastrectomy. Two had chronic atrophic, gastritis; one of them was assumed to have food-cobalamin malabsorrtion. The remaining one was a heavy drinker. The mean duration of neurologic symptoms was 35.7 months. The most common initial complaint was paresthesia (in 4) and impairment of cutaneous sensation was the most common neurologic sign At the time of diagnosis, 5 patients had myelopathy with was supported by EP in 3(60%). There were abnormal NCS findings in 5 f 6 patients with peripheral neuropathy. In one patient, there was no symptom and sign compatible with myelopathy but median nerve SEP showed bilateral central conduction delay. No one had visual symptoms but prolongation of P 100 was detected in 2 patients. Sural nerve biopsy was done in 2 case, which revealed chronic nonspecific neuropatby in one and chronic axonopathy in the other. Megaloblastic anemia was found in 4 cases and improved by cobalamin therapy in all the parents, in which the follow up hematologic data were available. There as a tendency that nonanemic patients had more severe neurologic symptoms than anemic ones. We could not find any relationship between the duration and severity of neurologic menifestations was best in the patients with the shortest duration of neurologic manifestations and hematologic feature festations. CONCLUSIONS: The authors suggest that early detection and treatment is very important for the improvement of symptoms in SCD.
Anemia, Megaloblastic ; Biopsy ; Diagnosis ; Follow-Up Studies ; Gastrectomy ; Gastritis ; Humans ; Median Nerve ; Neural Conduction ; Neurologic Manifestations ; Parents ; Paresthesia ; Peripheral Nervous System Diseases ; Sensation ; Spinal Cord ; Spinal Cord Diseases ; Subacute Combined Degeneration* ; Sural Nerve ; Vitamin B 12 ; Vitamin B 12 Deficiency

BACKGROUND: In gastric cancer surgery, a splenectomy might enhance the radicality of the operation, but, on the other hand, it can alter the immune status of the patients. In the immunological aspect, many studies suggest that a splenectomy is therapeutically effective for stage IV gastric cancer and that the spleen must be preserved for stage I or II disease. However, a splenectomy for stage III gastric cancer is controversial. The purpose of this study was to evaluate the effect of splenectomy on the immune status of stage III gastric cancer patients. METHODS: From 1989 to 1995, a splenectomy was done in 76 patients with stage III gastric cancer at the Department of Surgery, College of Medicine, Seoul National University. From the patients treated during this period, we selected 18 patients for a splenectomy group and 18 patients for a non-splenectomy group. T-lymphocyte subset studies were performed pre-and post-operatively in all of these patients. Postoperative PHA stimulation lymphocyte cultures were performed in 10 patients of the splenectomy group and all of the patients in the non-splenectomy group. The postoperative studies were performed at around 2 years after the operations. RESULTS: In the splenectomy group, the ratio of T4 (helper cell)/T8 (suppressor cell) was significantly decreased after the operation; this may be due to a decrease in the proportion of T4. In the non-splenectomy group, the proportion of T3 was increased significantly after the operation; this may be due to an increase in the proportion of T8. The results of the PHA stimulation lymphocyte cultures did not show significant differences between the 2 groups. CONCLUSIONS: In stage III gastric cancer, a splenectomy may be detrimental because the effect of the reduction in the proportion of T4 can be somewhat higher than that of T8. Thus, a splenectomy in stage III gastric cancer might lower the patient's postoperative immune status.
Hand ; Humans ; Lymphocytes ; Seoul ; Spleen ; Splenectomy ; Stomach Neoplasms* ; T-Lymphocyte Subsets* ; T-Lymphocytes*