No accepted standard currently exists to classify asphyxia and define its subtypes. Sauvageau and Boghossian proposed an asphyxia classification system in 2010 that divided asphyxia into suffocation, strangulation, mechanical asphyxia, and drowning. Here, we present a modification of this classification system. We propose to classify asphyxia into four main categories: suffocation, strangulation, mechanical asphyxia, and complicated asphyxia. Suffocation includes smothering and choking as well as confined spaces, entrapment, and vitiated atmosphere. Strangulation is subdivided into hanging, ligature strangulation, manual strangulation, and other unspecified strangulation. Mechanical asphyxia includes positional and traumatic asphyxia. Finally, complicated asphyxia is defined as cases with two or more identifiable mechanisms of asphyxia. In this study, we review autopsy cases from 2012 diagnosed as asphyxia and classify them according to our proposed asphyxia classification system. In 24.7% of cases, the age range was 40-49 years, and 51.9% were men. The most common method of asphyxia was hanging (245 cases, 55.1%), followed by ligature or manual strangulation (53 cases, 11.9%). Most hangings were suicides; smothering, ligature, and manual strangulation were usually homicides. Eighteen cases were complicated asphyxia. This classification provides a simplified, unified, and useful tool to classify and understand deaths due to asphyxia.
Airway Obstruction ; Asphyxia* ; Atmosphere ; Autopsy* ; Classification* ; Confined Spaces ; Drowning ; Homicide ; Humans ; Korea* ; Ligation ; Male ; Suicide

The Ross operation, a procedure of replacement of the diseased aortic valve with an autologous pulmonary valve, has many advantages such as no need for anticoagulation therapy and similar valve function and growth potential as native valves. However secondary aortic disease has emerged as a significant complication and indication for reoperation. We report a 48-year-old woman who had Ross operation in 1997 for a damaged bicuspid aortic valve and severe aortic regurgitation due to subacute bacterial endocarditis complicated by aortic root abscess. In 2009, 12 years later, progressive severe aortic regurgitation with incomplete coaptation and mild dilatation of the aortic root was shown on echocardiography and contrasted CT, while the pulmonary homograft retained normal function. She subsequently underwent aortic valve replacement. Histopathological examination of the explanted neo-aortic valve and neo-arterial wall revealed pannus formation at the nodulus Arantii area of the three valve cusps, ventricularis, and arterialis. The amount of elastic fibres in the neo-aorta media was less than usual for an aorta of this patient's age but was similar to a pulmonary artery. The pathological findings were not different from other studies of specimens removed between 7 to 12 years after Ross operation. However, the pathophysiology and long-term implications of these findings remain debatable. Considering the anatomical and physiological changes induced by the procedure, separate mechanisms for aortic dilatation and regurgitation are worthy of consideration.
Aorta/*pathology ; Aortic Valve/*surgery ; Aortic Valve Insufficiency/*etiology ; Cardiovascular Surgical Procedures/*adverse effects ; Dilatation, Pathologic ; Heart Valve Diseases/*surgery ; Prostheses and Implants ; Pulmonary Valve/*transplantation

Variable methods have been using for reconstruction of soft tissue defect of feet and legs. Skin graft, local flap, and free flap have been using for this purpose. But, skin graft produced secondary contracture of recipient site and increased in donor site scarring. Local flap was limited its donor site and remained severe deformities of recipient site. Free flap was required prolonged operation time and secondary operation. Acelluar human dermal allograft, AlloDerm, was removed cellular elements of the epidermis and dermis. It was relatively immunologically inert. From August 1997 to April 1998, we have grafted acellular human dermal allograft with thin split-thickness skin graft on soft tissue defect of feet and legs in 7 cases. We concluded that cryopreserved acelluar human dermal allograft has been proposed as the solution to problems of skin graft, local flap, and free flap.
Allografts ; Cicatrix ; Congenital Abnormalities ; Contracture ; Dermis ; Epidermis ; Foot* ; Free Tissue Flaps ; Humans ; Leg* ; Skin ; Tissue Donors ; Transplants

No abstract available.
Fistula*

Mucinous adenocarcinoma of the renal pelvis is a extremely rare disease and reported less than 50 cases in literature. This tumor is known to be commonly associated with renal stone, hydronephrosis and pyelonephritis. We report a case of mucinous adenocarcinoma of the renal pelvis in hydronephrotic kidney with multiple renal stones.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Hydronephrosis ; Kidney ; Kidney Pelvis* ; Mucins* ; Pyelonephritis ; Rare Diseases

This study was made to evaluate the effect of oral atenolol, a cardioselective beta-adrenergic blocking agent without intrinsic sympathomimetic activity, on left ventricular function in patient with essential hypertension. Atenolol, 100mg/day, was given to 11 hypertensive patients for 4 weeks, and its effects on arterial pressure, pulse rate, left ventricular dimensions and ejection phase indices of myocardial performance were examined by echocardiography. Echocardiographic studies were performed before treatment and after 4 weeks of atenolol therapy. Arterial pressure fell form 145/90 mmHg to 138/84mmHg after 4 weeks. Pulse rate fell significantly from 69/min to 58/min(p<0.05). Left ventricular end-diastolic and end-systolic dimensions and mean rate of circumferential fiber shortening(mVcf) did not change significantly. Ejection fraction increased significantly from 0.66 to 0.72(p=0.01). This results indicate that atenolol in the resting state has no depressant effect on left ventricular function in patients with essential hypertension.
Arterial Pressure ; Atenolol* ; Echocardiography ; Heart Rate ; Humans ; Hypertension* ; Ventricular Function, Left*

PURPOSE: We have experienced a mucoepidermoid carcinoma of the lacrimal gland. METHODS: 39-year-old male patient complaint of proptosis and upper eyelid swelling of the left eye for 4 months. Orbit radiographs showed a 2 cm sized inhomogenous density mass in upper lateral aspect of the left orbit. Excisional biopsy was performed. RESULTS: Histopathologically, the mass was proved as an intermediate grade mucoepidermoid carcinoma of the lacrimal gland. Postoperative radiopraphs showed no metastasis. Additional operation was performed to eliminate the remnant tumor near the lacrimal gland. The patient underwent a concurrent chemoradiotherapy and no recurrence or metastasis was found. CONCLUSIONS: We report a mucoepidermoid carcinoma which occurs rarely in lacrimal gland.
Adult ; Biopsy ; Carcinoma, Mucoepidermoid* ; Chemoradiotherapy ; Exophthalmos ; Eyelids ; Humans ; Lacrimal Apparatus* ; Male ; Neoplasm Metastasis ; Orbit ; Recurrence

Infection with invasive Shigella species results in intestinal inflammation in humans but no symptoms in adult mice. To investigate why adult mice are resistant to invasive shigellae, 6~8-week-old mice were infected orally with S. flexneri 5a. Shigellae successfully colonized the small and large intestines. Mild cell death was seen but no inflammation. The infected bacteria were cleared 24 hours later. Microarray analysis of infected intestinal tissue showed that several genes that are involved with the sphingosine-1-phosphate (S1P) signaling pathway, a lipid mediator which mediates immune responses, were altered significantly. Shigella infection of a human intestinal cell line modulated host S1P-related genes to reduce S1P levels. In addition, co-administration of S1P with shigellae could induce inflammatory responses in the gut. Here we propose that Shigella species have evasion mechanisms that dampen host inflammatory responses by lowering host S1P levels in the gut of adult mice.
Adult ; Animals ; Bacteria ; Cell Death ; Cell Line ; Colon ; Humans ; Inflammation* ; Intestines ; Mice* ; Microarray Analysis ; Shigella ; Shigella flexneri*

The renal agenesis and ectopic ureter were relatively rare congenital disease, but their combined form was more extremely rare condition. We report a case of ectopic ureteral opening associated with ipsilateral renal agenesisthat noted recurrent epididymitis in 18 month old children with review of literatures.
Child ; Epididymitis ; Humans ; Infant ; Male ; Ureter*

PURPOSES: To evaluate the effect of cycloplegia on the visual acuity and stereopsis according to the refraction and age. METHODS: This study included 112 eyes of 56 patients, which were divided into three groups according to the refraction. The best corrected visual acuity and stereopsis were compared between without and with cycloplegia in all groups according to age. RESULTS: After cycloplegia, at near, naked visual acuity decreased in 0.53 logMAR, average and stereopsis also deceased from 93 seconds to 343 seconds. At far, the naked and best corrected visual acuity had less decreased than near visual acuity. At near, there was no significant difference on the degree of decreased visual acuity and stereopsis according to refraction, but in emmetropic patients, the visual acuity at near significantly decreased. Patients younger than ten years old had more decreased visual acuity at near compared with older than forty-five years old. CONCLUSIONS: After pupil dilatation, there significant decreased near visual acuity and stereopsis, there was little change at far. The degree of decreased vision was different according to the refraction and age, therefore it would be helpful to explain the anticipating result.
Depth Perception* ; Dilatation ; Humans ; Pupil ; Visual Acuity