No abstract available.
Carcinoma, Adenosquamous* ; Lung*

Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is characterized histologically by massive infilteration of right ventricular wall by fat tissue with surviving strands of cardiomyocytes bordered by or embedded in fibrosis. ARVC has been recognized as a cause of sudden death, especially in the young. We report an autopy case of ARVD/C in a 35-year-old female. She was found dead in her house under apparently natural circumstances. The autopsy revealed a dilated 340-gram heart with a fibrofatty replacement of the right ventricular myocardium. On the review of her past medical history, she had taken medical examination for prolonged general weakness about 1 year prior to death. At that time the echocardiogram revealed dilatation of right ventricular cavity size and moderately decreased left ventricular systolic function, the electrocardiogram revealed R>S at V1 lead and T-wave inversion at V1-V3 leads. To the best of our knowledge, this is the second autopsy case of ARVD/C, reported in the literature of Korea.
Adult ; Autopsy* ; Death, Sudden ; Dilatation ; Electrocardiography ; Female ; Fibrosis ; Heart ; Humans ; Korea ; Myocardium ; Myocytes, Cardiac

No abstract available.
Adenocarcinoma* ; Scrotum* ; Stomach Neoplasms*

PURPOSE: We evaluated the rate of prostate cancer detection according to the region and number of biopsies in patients with an elevated level of serum prostate-specific antigen (PSA). MATERIALS AND METHODS: Transrectal ultrasound (TRUS) guided prostate biopsies were performed at 12 regions, using the standard sextant, with an additional 6 cores far lateral peripheral zone, in 178 men with an elevated PSA level, and with no suspicious lesions of prostate cancer on digital rectal examination (DRE) and TRUS. We analyzed the rate prostate cancer detection according to the region, number of biopsies, the PSA level, prostate volume and PSA density (PSAD). RESULTS: The rates of cancer detection were 12.9, 11.8 and 7.4% in the 12 core, lateral 6 core and medial 6 core (standard sextant) biopsies, respectively (p<0.05). There were no differences in overall cancer detection rates between 12 core and lateral 6 core plus apex medial 2 core biopsies (12.9%). In men with a PSA level greater than 20ng/ml, no difference in cancer detection was found with the 12 core or either of the 6 core biopsies (positive rate 33.3%). In men with a PSA level over 10ng/ml, a prostate volume less than 49cc or a PSAD greater than 0.15, a lateral 6 core biopsy made no difference to the diagnosis of prostate cancer compared to a 12 core biopsy. CONCLUSIONS: A lateral 6 core biopsy, combined with an apex medial 2 core biopsy, is a more efficient method for the detection of prostate cancer than the standard sextant biopsy in men with an elevated serum PSA level without a suspicious lesion on DRE and TRUS.
Biopsy* ; Diagnosis ; Digital Rectal Examination ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Ultrasonography

Kaposis sarcoma is well recognized in patient,s with imrnunodef cienicy states such as organ trans plantation, malignancy, and acquired irnmunodeficiency syndrome(tILS). Kaposis sarcorna associated with organ transplantation is, however relatively uncomrnon in Konea. We report a case of Kaposi's sarcorna in a 23 year old male kidney recipient., who was on cyclosporine and prednisolone. The tumor involved the larynx and long as well as the skin. He was treated with radiation therapy and chemotherapy, and the dosage of immunosupressants were reduced.
Cyclosporine ; Drug Therapy ; Humans ; Kidney Transplantation* ; Kidney* ; Larynx ; Male ; Organ Transplantation ; Prednisolone ; Sarcoma, Kaposi* ; Skin ; Transplants ; Young Adult

This statistical analysis of 4,709 legal autopsies performed in Korea in 2012 was conducted to obtain primary data about and related variables. The analysis revealed the following: 1. Of the total number of deaths, men accounted for and women, 26.8%. Evidently, the number of deaths among men was more than twice that among women. 2. With respect to mode of death, 54.8% were recorded as unnatural deaths, 39.2% were natural deaths, and 6.0% had unknown causes. Of the 2,581 unnatural deaths, 44.8% were accidental deaths; 27.2%, suicidal; 17.5%, homicidal; and 10.3%, undetermined. 3. Of the total number of unnatural deaths, 43.0% were trauma-related deaths, for which falling down was the leading cause, accounting for 33.5% cases. Asphyxiation was accounted for 17.2%, among which the predominant cause was hanging (55.3%). Moreover, 12.5% of deaths were due to drowning; 11.5%, poisoning; 11.2%, thermal injuries; 2.7%, complications in medical procedures; and 0.3%, electrocution, starvation, or neglect. 4. Among 1,847 natural deaths, heart diseases accounted for 50.2% and vascular diseases accounted for 16.7%. 5. There were 207 cases of deaths among children under the age of 10, of which 94 were unnatural and 49 were homicidal deaths. Of all cases, 9.2% had an unknown cause of death, and of these 67.6%, were putrefied or skeletonized bodies.
Autopsy* ; Cause of Death ; Child ; Drowning ; Female ; Heart Diseases ; Humans ; Korea* ; Male ; Poisoning ; Skeleton ; Starvation ; Vascular Diseases

No abstract available.
Biopsy*

BACKGROUND: Spontaneous echo contrast (SEC) of the left atrium (LA) is associated with increased risk of thromboembolism in patients with mitral stenosis(MS). The determination of the presence and severity of LA spontaneous echo contrast(SEC) is of prognostic importance in these patients. Harmonic imaging(HI), a novel echocardiographic technique that differs from conventional fundamental imaging(FI) by transmitting ultrasound at one frequency and receiving at twice the transmitted frequency, produces better endocardial border definition and myocardial opacification. However, there are no data about its value on the detection of LA SEC. The purpose of this study was to investigate the utility of transthoracic noncontrast HI in the detection of LA SEC in patients with. METHODS: Seventy-four consecutive patients with MS (49 female, mean age 51) underwent standard transthoracic echocardiograms (TTE) in both HI and FI and transesophageal echocardiography (TEE) to determine the presence and severity of LA SEC. LA SEC was graded by TEE; mild if only seen at high gain, severe if visible in the entire LA at normal gain control of the equipment. Control subjects comprised of 30 patients randomly selected from patients who did not have LA SEC at TEE examination. RESULTS: Atrial fibrillation was found in 46 patients (62.2%). The mean mitral valve area and mean mitral gradient were 1.0+/-0.3cm2 and 8.2+/-4.1mmHg, respectively. Nine patients (12.2%) had episodes of systemic embolism; stroke in 8 and peripheral embolism in 1. LA thrombus was found in 11 patients (14.9%) by TEE. LA SEC was present in all but one patient by TEE (mild in 35, severe in 38 patients). FI of TTE, however, revealed LA SEC in only 5 (6.8%) of the 73 patients. In contrast, in HI, LA SEC could be detected in 63 (86.3%) of the 73 patients. In the detection of severe LA SEC, the sensitivity of FI and HI were 13.2% (5/38) and 100% (38/38), respectively. LA SEC was not observed in control subjects either by FI or HI. CONCLUSION: Transthoracic HI significantly enhances the detection of LA SEC in patients with MS.
Atrial Fibrillation ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Female ; Heart Atria ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Stroke ; Thromboembolism ; Thrombosis ; Ultrasonography

PURPOSE: Emergency medical service (EMS) providers often care for pregnant women at risk for out-of-hospital delivery and born-before-arrival neonates. As the increase in mortality and morbidity from out-of-hospital delivery is well established, this study sought to determine whether a delivery and neonatal care education program could impact the knowledge and practice of EMS providers. METHODS: EMS providers working in the southeast Gyeonggi province in South Korea received an education program for out-of-hospital delivery and neonatal care. The program consisted of a pretest, didactic, mannequin training, and posttest. Six months after the education program a follow-up survey was administered. A paired t-test was then used to compare pretest and posttest scores. Overall, 56 EMS providers completed the study. RESULTS: The pretest average score was 80.4 and the posttest average score was 92.9 (p<0.001). The percentage of correct answers on each question was relatively and equally elevated in the posttest, regardless of the participant's certification. Participants expressed their satisfaction with the education program and this appraisal was maintained in the 6-month follow-up survey. CONCLUSION: These results suggest that EMS providers can benefit from a didactic and training session regarding out-of-hospital delivery and neonatal care. Further studies are needed, however, to develop the reliability and validity of the test and to determine its clinical applications.
Certification ; Delivery, Obstetric ; Education* ; Emergencies* ; Emergency Medical Services* ; Female ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Infant, Newborn ; Manikins ; Mortality ; Pregnant Women ; Reproducibility of Results ; Republic of Korea

PURPOSE: Lymph node metastasis is one of the most important prognostic factors in breast cancer. Survival of patients with axillary node positive breast cancer is worse than that of patients with axillary lymph node negative breast cancer. Recently, some authors suggest that axillary dissection may be avoidable if sentinel nodes of the breast cancer do not harbour metastasis. However, 15-20 % of patients with lymph node negative breast cancer recurs within 10 years. Micrometastasis, which was missed or not detected in routine histologic examination, is thought to be one of the reasons for recurrence of axillary node negative breast cancer patients. METHODS: We investigated the frequency of micrometastasis and any clinical significance of micrometastasis in the breast cancer by immunohistochemical staining with anti-cytokeratin antibody from July, 1996 to November, 1990. 70 patients who underwent curative resection for axillary node negative breast cancer were studied retrospectively. We used paraffin blocks of lymph nodes which did not show metastasis by conventional pathological examination. After preparation of tissue blocks with a serial sectioning technique, specimens were stained by an immunohistochemical method using anti-cytokeratin antibody. Hematoxylin-eosin stainings were also repeated. We define metastasis less than 2mm as a micrometastasis. RESULTS: The results showed that micrometastasis were found in 8 of 70 cases(11.4%). There was a significant relationship between the micrometastasis and tumor size. With median follow-up of 20 months, we found 3 recurrences in 70 patients. : 2 recurrences(3.2%) in the 62 axillary node negative breast cancer patients and 1 recurrences(12.5%) in 8 micrometastasis patients. CONCLUSIONSThe results showed that micrometastasis of lymph node in breast cancer might increase the rick for development of breast cancer recurrence. But, there was no significant relationship between the micrometastasis and recurrence of breast cancer because of small numbers of recurrences and relatively short follow-up period. Long tern follow-up will be needed for further evaluation.
Animals ; Breast Neoplasms* ; Breast* ; Charadriiformes ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Paraffin ; Recurrence ; Retrospective Studies