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

No abstract available.
Pregnancy*

No abstract available.
Humans

The duodenal lipoma is infrequent and few reports deseribed its endoscopic features, We recently encountered one case of duodenal lipoma which was large polypoid one in the descending portion of the duodenum. The patient had been suffred from epigastric dull pain and bloating sensatio for 5 months. We did endoscopic polypectomy of the lipoma successfully.
Duodenum ; Humans ; Lipoma*

No abstract available.
Mediastinitis*

No abstract available.
Mediastinitis*

PURPOSE: A number of drugs are capable of changing body weight as a side effect. A number of neurotransmitter systems acting in several hypothalamic nuclei are pivotal to the storage regulation of body fat. Leptin is a protein encoded by the ob gene that is expressed in adipocyte. It regulates eating behavior by activating the action to the satiety center in the hypothalmus. The purpose of this study is to investigate the changes of serum leptin in children with epilepsy. METHODS: Serum leptin levels were measured in 43 epileptic patients (30 males, 13 females) receiving valproate or carbamazepine by radioimmunoassay. Thirty patients (19 males, 11 females, 10.0+/-5.0 years of age) were treated with valproate (VPA group) and 13 patients (11 males, 2 females, 9.1+/-4.0 years of age) were treated with carbamazepine (CBZ group). Obesity index and body mass index were calculated before and during anticonvulsant medications. RESULTS: 1) Body mass indices were significantly increased after VPA or CBZ medication; from 17.24+/-2.74 to 18.47+/-2.60 in VPA group, from 16.77+/-1.69 to 17.43+/-3.01 in CBZ group. 2) Obesity indices were increased without statistical significance after medication in both group. 3) Serum leptin levels were significantly higher in VPA group (4.54+/-4.77ng/ml) than CBZ group (2.47+/-2.26ng/ml). CONCLUSION: Body weight gain after VPA medication in susceptible individual might be related to a certain mechanism that elevates serum leptin level.
Adipocytes ; Adipose Tissue ; Body Mass Index ; Body Weight ; Carbamazepine ; Child* ; Epilepsy ; Feeding Behavior ; Female ; Humans ; Leptin* ; Male ; Neurotransmitter Agents ; Obesity ; Radioimmunoassay ; Valproic Acid ; Weight Gain

We evaluated MR imaging of spondylolytic spondylolisthesis degenerative spondylolisthesis and retrolisthesis in 14, 9 and 20 patients respectively. Sagittal and axial spin echo and gradient echo images were obtained with 25-30cm FOV and 5mm/0.5mm thickness/gap by using spine surface coil. Sagittal images showed defects of pars interarticularis just inside of the pedicles of spines in all the cases of spondylolytic spondylolisthesis with relatively variable signal intensity. Displaced vertebrae were commonly observed at L5 (8/14) in spondylolytic spondylolisthesis, at L4 (5/9) in degenerative spondylolisthesis and at variable locations in retrolisthesis. The mean length of displacement of vertebrae in spondylolytic spondylolisthesis was about 7mm and less displacement was onserved in degenerative spondylolisthesis and retrolisthesis. Seven, four and six cases of pseudobulging of disk at displaced level were observed in cases of spondylolytic spondylolisthesis, degenerative spondylolisthesis and retrolisthesis respectively. Seven, five and 14 cases of true disk lesions were onserved in cases of spondylolytic spondylolisthesis, degenertive spondylolisthesis and retrolisthesis respectively. Grade II neural foraminal stenoses (obliteration of one half epidural fat of neural foramen) were commonly (8/14) seen in spondylolytic spondylolisthesis, however the other two types showed less severe neural foraminal stenosis. In conclusion, MR imaging is a highly accurate method for the diagnosis and evaluation of spondylolisthesis and associated lesions of spine and disks.
Constriction, Pathologic ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Methods ; Spine ; Spondylolisthesis*

High Mobility Group I(HMG-I) proteins are nuclear proteins that are required for induction of the human IFN-beta gene by virus and for the regulation of the tumor necrosis-beta factor and rRNA genes. Proteins I and Y result from alternative splicing of a single functional gene named HMGI(Y). In several studies, elevated expressions of the HMGI proteins (HMGI, HMGY, and HMGI-C) have been used as markers in thyroid cancer, but not in adenomas, goiters, and normal thyroid tissues and cells. Here, we try to demonstrate the elevated expression of the HMGI(Y) proteins in thyroid carcinomas by using semi-quantified RT-PCR (Reverse Transcription and Polymerase Chain Reaction). In cases of thyroid carcinomas 4 of 5(80%) were positive, in 10 cases of adenomas, goiters, and normal thyroid tissues, 1(10%) was positive. These results suggest that the semi-quantified RT-PCR is useful preoperative diagnostic tool for differentiating thyroid tumors.
Adenoma ; Alternative Splicing ; Genes, rRNA ; Goiter ; HMGA1a Protein ; Humans ; Nuclear Proteins ; Thyroid Gland* ; Thyroid Neoplasms*

OBJECTIVE: Thyroid nodule is frequent and occurs in about 5+ACU- of the general population. In contrast, thyroid cancer is much less frequent and occurs in about 5-10+ACU- of thyroid nodules. Distinguishing between benign and malignant lesions is an important task that is best accomplished by fine needle aspiration. Recently, Chiappetta et al. reported that the expression of the high mobility group (HMG) I(Y) proteins correlates with the malignant phenotype of human thyroid neoplasia, and suggested that the detection of the HMG I(Y) proteins might be a valid tool for an easy and sensitive discrimination assay between benign and malignant neoplastic thyroid disease. METHODS: We evaluated the expression of the HMG I(Y) mRNA in 39 frozen thyroid tissues from patients with thyroid nodule by semiquantitative RT-PCR. RESULTS: The expression of the HMG I(Y) mRNA was low in all of 10 normal thyroid tissues. In all of 3 adenomatous goiters, 6 follicular adenomas and 2 Hurthle cell adenomas, the HMG I(Y) mRNA expression level was low. In 11 of 13 papillary carcinomas and all of 5 follicular carcinomas, the HMG I(Y) mRNA expression level was high. CONCLUSION: These results indicate that there is a correlation between the expression of HMG I(Y) and the malignant phenotype of thyroid cancer, suggesting that these proteins may be useful as a marker in thyroid cancer.
Biopsy, Needle ; Comparative Study ; Diagnosis, Differential ; Female ; Gene Expression Regulation, Neoplastic ; High Mobility Group Proteins/analysis+ACo- ; Human ; Male ; Probability ; RNA, Messenger/analysis+ACo- ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity ; Thyroid Neoplasms/genetics+ACo- ; Thyroid Neoplasms/diagnosis+ACo- ; Thyroid Nodule/genetics+ACo- ; Thyroid Nodule/diagnosis+ACo- ; Tumor Markers, Biological/analysis+ACo-