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

In order to observe the complement fixation test and immuno-diffusion test of paragonimiasis, the sera taken at 10 days intervals up to 150 days from cats infected with Paragonimus westermani were examined by the above two immunological methods. The resultant findings were as follows: The complement fixation test showed positive reaction 20 days after the infection with 20 metacercariae, and 40-50 days after the infection with 10 metacercariae. The highest titer was observed 110 days later following the acceleration at 80 days later. In immuno-diffusion test, one are appeared 30 days after the infection with 20 metacercariae, but 60 days after the infection with 10 metacercariae. However, more than two arcs were observed since 70 days after infection. A relatively wide band appeared by the antigens of Fresh worm material and Somatic material. But relatively clear precipitin lines were observed in the diffusion test with V.B.S. antigen, increasing to 3-4 arcs after 110days. In general, complement fixation test showed earlier and higher sensitive reaction than immuno-diffusion test, and was considered to be more valuable method forr immunological diagnosis.
parasitology-helminth-trematoda ; Paragonimus westermani ; immunology ; cat ; complement fixation test ; immuno-diffusion test

Dementia is defined as a syndrome which is characterized by various impairments in cognitive functions, especially memory function, Most of the diagnostic criteria for dementia include memory impairment as no essential feature. Memory decline can be present as a consequence of the aging process, But it does not cause significant distress or impairment in social and occupational functionings while dementiadoes. Depression may also be associated with memory impairment. funcitionings while dementiadoes. Depression may also be associated with memory impairment. However, unlike dementia, depression dose not cause decrease in delayed verbal learning and recognition memory. In dementia, different features of memory impairment may be present depending on the involved area. Memory impairment in cortical dementia is affected by the disturbance of encoding of information and memory consolidation, while memory imparnene in subcrotical denentiy is affected y the disturbance of retrieval in subcortial dementia.
Aging ; Dementia ; Depression ; Humans ; Memory* ; Verbal Learning

No abstract available.
Child* ; Humans ; Shigella* ; Vaginitis*

No abstract available.
Humans ; Keratoderma, Palmoplantar ; Pityriasis Rubra Pilaris ; Pityriasis ; Siblings

No abstract available.
Child* ; Fever* ; Humans ; Infant*

The chest wall and breast asymmetry varies from severe pectus deformities to an isolated breast hypoplasia. In addition to the chest abnormality, a natural-looking breast is the aesthetic challenge in women. Considering that the most common indication of operations is an aesthetic one, any procedures leaving much scars and deformities at the donor site aren't preferred by patients. A 31-year-old female had a 4 x 10 x 2.5 cm sized pectus-excavatum deformity on her right chest, and a slightly hypoplastic breast compared with the left one. The nipple of her right breast was located supero-medially and pectoralis muscles were preserved to some degree at the right side. Through a bilateral submammary and subxiphoid incision, the deformed cartilage was resected from 3th to 7th rib bilaterally and chondrotomy was done at the sternum partially. After this modified Ravitch's technique, two-metal pins were fixated between right 4th~5th ribs and left 4th rib, and the depressed sternum was elevated over the metal pins. The deficient volume of her right breast was corrected by inserting a siliconegel breast implant (120 cc) submuscularly to restore a adequately projected breast. The results of twelve months' follow-up demonstrated a symmetric and well- projected breast. There were no significant chest wall depression or capsular contracture. Restoring a fundamental bony structure would decrease the amount of augmentation needed in the soft tissues. And a silicone-gel breast implant may be used as an the alternative material for whose axillary fold is preserved to some degree.
Adult ; Breast Implants ; Breast* ; Cartilage ; Cicatrix ; Congenital Abnormalities* ; Contracture ; Depression ; Female ; Follow-Up Studies ; Humans ; Nipples ; Pectoralis Muscles ; Ribs ; Sternum ; Thoracic Wall* ; Thorax* ; Tissue Donors

BACKGROUND: To determine the advantage of laparoscopic splenectomy techniques in immune thrombocytopenic purpura (ITP), we compared it with an open splenectomy. METHODS: The cases of all patients who had undergone (52) a splenectomy for ITP at St. Mary's Hospital from January 1993 to December 1997 were reviewed. From the 52 cases, 21 cases were managed with a laparoscopic technique only and 31 cases were managed with an open technique. RESULTS: Blood and platelet transfusion requirements were reduced in the laparoscopic group. Although the mean operating time was slightly longer in the laparoscopic group (110 versus 184 minutes, p<0.001), the mean hospital stay (9.7 versus 5.9 days, p<0.001) was slightly shorter and the postoperative analgesic requirement (p<0.001) and the incidence of post operative complications (9.5 versus 48.4%) were greatly reduced. The detection rates of accessory spleens was low in the laparoscopic group. CONCLUSIONS: The laparoscopic splenectomy produced better clinical outcomes than an elective splenectomy for ITP. Also, such laparoscopic methods reduced costs.
Humans ; Incidence ; Laparoscopy ; Length of Stay ; Platelet Transfusion ; Purpura, Thrombocytopenic, Idiopathic* ; Spleen ; Splenectomy*

PURPOSE: To evaluate the surgical results and efficacy of laser refractive cataract surgery with a femtosecond laser compared with conventional phacoemulsification. METHODS: Thirty-one eyes from 31 patients underwent laser refractive cataract surgery (femtosecond laser group), and conventional cataract surgery with phacoemulsification was performed in 30 eyes from 30 patients (conventional group). Best corrected visual acuity, spherical equivalent, surgical induced astigmatism, corneal and ocular astigmatism, total high order aberration, Strehl ratio, objective scatter index, diameter of continuous curvilinear capsulorrhexis (CCC), distance from visual axis to the center of CCC, intraocular lens (IOL) tilt, mean absolute error, effective phaco time, average phaco power and operation time were measured to compare the 2 groups. RESULTS: No significant differences were found between best corrected visual acuity, spherical equivalent, surgical induced astigmatism, corneal and ocular astigmatism, total high order aberration, Strehl ratio, objective scatter index, mean absolute error, effective phaco time, average phaco power or operation time. Significant differences were found in the diameter of CCC, distance from visual axis to the center of CCC, and IOL tilt. CONCLUSIONS: Results of laser refractive cataract surgery with a femtosecond laser showed more precise CCC, and more stable IOL position than conventional cataract surgery.
Astigmatism ; Axis, Cervical Vertebra ; Capsulorhexis ; Cataract ; Chlormequat ; Eye ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Visual Acuity

BACKGROUND: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. METHODS: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. RESULTS: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was 127.5°. CONCLUSIONS: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.