The role of forensic anthropology is to reconstruct the process of individual death by predicting the cause and manner of death as well as to find out biological profiles of unknown skeletal remains based on the data of physical anthropology. The purpose of this study is to suggest the data of decision-making process for cranial fractures and its related weapons of skeletal remains from the forensic fields. A hammer (31.7%) and baseball bat (16.7%) represented almost half of the blunt type of weapon used in the cranial fracture. The linear fracture was caused by most of weapons, the spider's web and depressed fracture by the hammer, and the comminuted fracture by the heavy tools such as maul, wrench, etc as well as the hammer. By the chi-square test, there were significant differences between fracture patterns and types of weapon that it was helpful to estimate the weapon of cranial fracture for forensic anthropological decisions. Conclusively, we could prepare the priority order of estimating cause and manner of death in the case of cranial fracture for the forensic context and suggest research design of physical anthropology about osteological biomechanics and taphonomy relating cranial fractures.
Anthropology, Physical ; Baseball ; Biomechanics ; Forensic Anthropology ; Fractures, Comminuted ; Research Design ; Skull ; Weapons

No abstract available.
Ectromelia*

Acellular pertussis vaccine has been used widely in Korea since 1984. However, because many of the former generations were not inoculated with pertussis vaccine, they may infect infants with pertussis. With this background, we investigated the prevalence of pertussis antibodies in all age groups. Enzyme-linked immunosorbent assay (ELISA) to assess IgG antibodies to pertussis toxin (PT) and filamentous hemagglutinin (FHA) and bacterial agglutination (BA) to assess antibodies to agglutinogen were compared on 842 serum samples which were donated from 11 hospitals in Seoul area. In comparison with age groups under 20 years, antibodies of adults against PT and FHA were maintained. But antibodies against agglutinogen showed no pattem in all age groups. Antibodies to PT were correlated with antibodies to FHA. There was no significant difference in antibody levels between male and female (p<0.05).
Adult ; Agglutination ; Antibodies ; Bordetella pertussis ; Enzyme-Linked Immunosorbent Assay ; Family Characteristics ; Female ; Hemagglutinins ; Humans ; Immunoglobulin G ; Infant ; Korea* ; Male ; Pertussis Toxin ; Pertussis Vaccine ; Prevalence ; Seoul ; Whooping Cough*

Background: Deltoid function critically influences the results of reverse total shoulder arthroplasty (RTSA), and spontaneous deltoid attrition tears are frequently detected in cuff tear arthropathy (CTA) patients; however, the clinical impacts of these tears on RTSA outcomes are undetermined. Our aim was to determine the effect of spontaneous deltoid attrition tears on postoperative outcomes after RTSA without an additional deltoid procedure. Methods: Seventy-two patients who underwent RTSA for CTA with preoperative magnetic resonance imaging (MRI) and a minimum clinical follow-up of 1 year (mean, 32 months) were retrospectively reviewed in the study. Patients with a history of previous shoulder surgery or injury were excluded. The presence and location of deltoid attrition tears were determined in preoperative MRI. Propensity score matching (1:1) was performed to construct tear and no-tear groups. Finally, 21 patients, matched with respect to age, sex, hand dominance, symptom duration, medical comorbidity (obesity, diabetes mellitus, and coronary artery disease), Hamada grade, and implant type, were assigned to each group. Clinical outcomes (functional scores, isometric power, and range of motion) in the two groups were compared. Results: Deltoid attrition tears were detected in 21 of the 72 enrolled cases (29.1%). Anterolateral deltoid was the most frequent location and no tear was detected in the posterior deltoid. The tear rate increased with disease severity (Hamada G2, 4.8%; G3, 23.8%; > G4, 71.4%). No pre- or postoperative clinical variables differed significantly between the tear and no tear groups. Conclusions Deltoid attrition tears were detected in 29% of CTA patients who underwent RTSA. The most common site was the anterolateral region and tear prevalence tended to increase with CTA progression. However, RTSA was found to provide satisfactory outcomes regardless of the presence of a deltoid attrition tear.

OBJECTIVES: Tumor markers have been clinically used to diagnose and monitor the progression of various tumor or to assess their response to therapy. This study focuses on the evaluation of tumor markers in Chronic renal failure patients, compared with normal controls. METHODS: The following 9 kinds of serum tumor markers, such as carcinoembryonic antigen(CEA), squamaus cell carcinoma-related antigen(SCC), CYFRA 21-1, CA(carbohydrate antigen) 125, CA 19-9, alpha-fetoprotein(AFP), prostate specific antigen(PSA), human chorionic gonadotropin(hCG) and CA 72-4 were measured in 56 persons without chronic renal failure(CRF) as controls, in 132 patients with chronic renal failure(56 patients on conservative management, 41 patients on chronic hemodialysis, and 35 patients on CAPD) who did not present any evidences of neoplasia. RESULTS: 1) The mean level of CEA in CRF patients was significantly higher than that of controls(p<0.001), and that of CRF patients on hemodialysis was significantly higher than that of patients on conservative management(p<0.05). 2) The mean level of SCC in CRF patients was significantly higher than that of controls(p<0.001), and the mean levels of SCC did not differ significantly among three groups of CRF patients. 3) The mean level of CYFRA in CI4F patients was significantly higher than that of controls(p<0.001), and that of CRF patients on hemodialysis was significantly higher than those of patients on conservative management and on CAPD respectively (p<0.05). 4) The mean level of CA 125 in CRF patients was significantly higher than that of controls (p<0.001), and that of CRF patients on CAPD was significantly lower than that of controls(p<0.05). 5) Positive percent for CYFRA 21-1 in all CRF patients was 89.7%, and SCC 82.9%, CEA 60.3%, CA 125 48%, CA 19-9 22.4%, PSA 7.9%, CA 72-4 6.1%, hCG 4.7% and AFV 3.2% respectively. CONCLUSION: The present study shows that tumor markers such as CEA, SCC, CYFRA 21-1, CA 19-9 and CA 125 are elevated above reference values in a substantial number of patients according to the reference values commonly used in normal persons, making them unreliable for monitoring malignancies in uremic patients. While the other tumor markers such as AFP, PSA, hCG and CA 72-4 are reliable for the same purpose. These results must be taken into account when serum levels of tumor markers are measured in CRF patients
Chorion ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory ; Prostate ; Reference Values ; Renal Dialysis ; Biomarkers, Tumor*

Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment: do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications (syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after 1~2 weeks. The final prognosis was comfortable without common complications.
Appointments and Schedules ; Dentists ; Drainage ; Follow-Up Studies ; Hemorrhage ; Humans ; Prognosis ; Telephone ; Tooth* ; Vital Signs ; Wounds and Injuries

PURPOSE: The purpose of this study was to analyze the results for clinical outcome and radiologic assessment of ceramic on ceramic cementless total hip arthroplasty using a 36 mm diameter femoral head. MATERIALS AND METHODS: This study included a group of 40 patients of 43 cases who underwent ceramic on ceramic cementless total hip arthroplasty using a 36 mm diameter femoral head. The age range of this group was 28 to 82(mean 56); we monitored them over a period of 5.3 years(3-7.5 years). This clinical evaluation process included monitoring the degree of pain, range of motion, and the Harris hip score after three years since the surgery was performed. Radiographic evaluation and complication were confirmed as well. RESULTS: The preoperative Harris hip score increased from 43.4(21-57) to 88.1(81-95) after the surgery. The average motion range of hip was 113degrees flexion, 30degrees abduction, 24degrees adduction, 36degrees external rotation, and 12degrees internal rotation. Subjective pain was zero or minimal in all cases. Among the complications, dislocation occurred in only one case by a fall from a height and was reduced by closed reduction. There was no occurrence of ceramic fracture, even though infection occurred in one hip. CONCLUSION: The clinical outcome and radiologic assessment of the ceramic on ceramic cementless total hip arthroplasty using a 36 mm diameter femoral head showed a satisfactory result at three-year follow-up. Longer-term follow up is needed for further assessment.
Arthroplasty ; Ceramics ; Dislocations ; Follow-Up Studies ; Head ; Hip ; Humans ; Range of Motion, Articular

No abstract available.
Glomerular Filtration Rate* ; Kidney*

Essential thrombocytosis (ET) is a clonal myeloproliferative disorder, characterized predominantly by a markedly elevated platelet count without known cause. We report a case of essential thrombocytosis, the only clinical manifestation of which consisted of neurologic symptoms, including headache, dysarthria, right hemiparesis with a relatively benign and slowly progressive clinical course. Neuroradiologic examination (Brain CT and MRI) disclosed a multiple infarction in the both basal ganglia and left parietal region. These findings are discussed in relation to the possible pathogenetic mechanisms of the vascular occlusion due to abnormal platelet function in ET.
Basal Ganglia ; Blood Platelets ; Cerebral Infarction* ; Dysarthria ; Headache ; Infarction ; Myeloproliferative Disorders ; Neurologic Manifestations ; Paresis ; Platelet Count ; Rabeprazole ; Thrombocytosis*

Spontaneous cervical epidural hematoma is an infrequent entity that usually requires emergency decompression on account of impending neurologic deficit. We present a case of a 36-year-old man who visited our emergency room complainng of severe neck pain with progressive weakness of both upper extrmities. On cervical MRI, fusiform epidural hematoma was found extending from the fifth to the seventh cervical vertebrae. Emergency surgical evacuation was performed. The patient was fully recovered and discharged uneventfully.
Adult ; Cervical Vertebrae ; Decompression ; Emergencies ; Emergency Service, Hospital ; Female ; Hematoma* ; Humans ; Magnetic Resonance Imaging ; Neck Pain ; Neurologic Manifestations