The purpose of this study was to review the tendency of the Supreme Court's test for death from overwork (so called 'Karoshi'). Using inner-network of court, we analyzed judicial tests from 2000 to 2010, associated with claimed death from overwork and/or psychological stress. Judicial tests were classified according to the clarification of cause of death and preexisting diseases. Through analyzing relevantly the tests for death from overwork, the authors found that many tests have emphasized the necessity of forensic autopsy to elucidate the proper casual relationship between death and overexertion. This study also shows recent changes in judicial tests based on the latest medical knowledge. Therefore, it is suggested that social issue on forensic autopsy system need to recall Korean society to establish the clarification of the proper casual relationship associated with death from work as well as social justice.
Autopsy ; Cause of Death ; Death, Sudden ; Social Justice ; Stress, Psychological

Thymic cyst is relatively rare tumor which usually occurs in the neck or mediastinum. Cervical thymic cyst is usually situated laterally and deep to the anterior border of the sternocleidomastoid muscle, simulating a branchial cyst. Thymic cyst of the mediastinum is usually detected incidentally and differential diagnoses include cystic degeneration of thymoma, and cystic teratoma. Two case of a cervical and a mediastinal thymic cysts were reported. The one was a cervical thymic cyst developed slowly growing mass in a 53-year-old male a for 10 years. The cyst was unilocular and measures 5.4x2.9x2.8 cm with columnar or squamous cell linings. The other is a mediastinal thymic cyst developed in a 37-year-old female with chest discomfort for 7 months. The cyst was uniocular and measures 2.8x2.2x2.0 cm. The epithelial lining of the cyst was largely desquamated and covered by macrophages with cholesterol granuloma. Involutional thymic stissue in their walls were noted in both cysts. In both cases presence of thymic tissue in the wall of the cyst thought to be the most important diagnostic feature.
Female ; Male ; Humans ; Diagnosis, Differential ; Cysts

Primary chondrosarcoma of the lung is an extremely rare tumor, and classified into two types, tracheobronchial & lung variety. The tracheobronchial variety is usually localized and lacked lymph nodal or distant spread with good prognosis. The lung variety tends to be more invasive associated with mediastinal lymph node involvement and thoracic metastasis. Authors experienced a case of primary chondrosarcoma, lung variety, of the lung involving left lower lobe with thoracic metastasis, not yet reported in Korean literatures. The patient was 55-year-old Korean female and chief complaints were cough, dyspnea & chest pain. Pathologically, it was confused with the metastatic adenocarcinoma in the first pleural fluid cytology. But bronchoscopic biopsy revealed typical morphology of chondrosarcoma with concentric growth encircling the bronchial tree and partial destruction of the bronchiols, suggesting its primary origin. Later pleural biopsy and aspiration materials during ches tube insertion revealed also metastatic chondrosarcoma. Radiologic studies were also campatible findings to chondrosarcoma. After admision, the patient underwent progressively downhill course & expired at 31st hospital day.
Female ; Humans ; Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

BACKGROUND: Acromioclavicular (AC) stability is maintained through a complex combination of soft-tissue restraints that include coracoclavicular (CC), AC ligament and overlying muscles. Among these structures, the role of the CC ligament has continued to be studied because of its importance on shoulder kinematics, especially after AC injury. This study was designed to determine the geometric change of conoid and trapezoid ligaments and resulting stresses on these ligaments according to various scapular motions. METHODS: The scapuloclavicular (SC) complex was isolated from a fresh-frozen cadaver by removing all soft tissues except the AC and CC ligaments. The anatomically aligned SC complex was then scanned with a high-resolution computed tomography scanner into 0.6-mm slices. The Finite element model of the SC complex was obtained and used for calculating the stress on different parts of the CC ligaments with simulated movements of the scapula. RESULTS: Average stress on the conoid ligament during anterior tilt, internal rotation, and scapular protraction was higher, whereas the stress on the trapezoid ligament was more prominent during posterior tilt, external rotation, and retraction. CONCLUSIONS: We conclude that CC ligament plays an integral role in regulating horizontal SC motion as well as complex motions indicated by increased stress over the ligament with an incremental scapular position change. The conoid ligament is the key structure restraining scapular protraction that might occur in high-grade AC dislocation. Hence in CC ligament reconstructions involving only single bundle, every attempt must be made to reconstruct conoid part of CC ligament as anatomically as possible.
Biomechanical Phenomena ; Cadaver* ; Dislocations ; Ligaments* ; Muscles ; Scapula ; Shoulder

PURPOSE: To investigate the changes of the dopaminergic system in rat striatum after visual deprivation during a critical period of postnatal development. METHODS: The changes of dopamine D1 and D2 receptor (Rc) mRNA were investigated by using Northern blot analysis, in situ hybridization in the rat striatum. The right eyelid of visually deprivated rat was sutured at 10 postnatal days. After visual deprivation for 4 weeks, rats were sacrificed and striatum tissues were removed for analysis. RESULTS: By Northern blot analysis and in situ hybridization, decreased expression of D1 and D2 Rc mRNA was noted in the ipsilateral striatum to the deprivated eye. CONCLUSIONS: These results have shown that visual deprivation during a critical period of postnatal development influences the dopaminergic system in the striatum.
Animals ; Blotting, Northern ; Critical Period (Psychology) ; Dopamine* ; Eyelids ; In Situ Hybridization ; Rats* ; Receptors, Dopamine* ; RNA, Messenger*

Myasthenia gravis(MG) is an autoimmune disorder characterized by the presence of anti-acetylcholine receptor antibody and weakness of voluntary muscles. The pathogenesis of MG is decreased numbers of acetylcholine receptors at postsynaptic membranes of neuromuscular junctions. It has been reported that MG often coexists with other autoimmune disorders. This is a case report of systemic lupus erythematosus coexisting with MG in a 23 year old female patient presenting with dysarthria, dysphagia, and limb weakness. We report the case with relevant literature review.
Deglutition Disorders ; Dysarthria ; Extremities ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Membranes ; Muscle, Skeletal ; Myasthenia Gravis* ; Neuromuscular Junction ; Receptors, Cholinergic ; Young Adult

STUDY DESIGN: A retrospective study of the effectiveness of traction thoracolumbosacral orthosis (TLSO) in idiopathic scoliosis. OBJECTIVE: To compare the results of traction TLSO and conventional TLSO. SUMMARY OF LITERATURE REVIEW : No report has been published about longitudinal traction and lateral force before cast molding in the nonoperative treatment of idiopathic scoliosis. MATERIALS AND METHODS: Twenty-one cases of traction TLSO (group I) and 17 cases of conventional TLSO (group II) were studied. Traction TLSO was made as follows: 1. Cervical traction was applied to the patient standing under the frame with application of lateral force with compression pad. 2. Cast molding. 3. Fabrication of plastic jacket and application of pads. The mean age of group I was 12 years and of group II, 13 years. We evaluated the effectiveness of traction TLSO with Cobb`s angle reduction, trunk pain and dyspnea. Statistical analysis was made with SPSS. RESULTS: In group I, mean pre-brace Cobb`s angle was 31.1 degrees and in group II, 29.6 degrees. Flexibility of the curves was 78% and 75%, respectively. Mean reduction rate of Cobb`s angle after 3 days of brace application was 59.5% and 15.4%, respectively. One year later, reduction of Cobb`s angle was 15.4 degrees in group I and 2.7 degrees in group II. Reduction rate of Cobb`s angle after 1 year of brace application was 54.2% and 7.9%, respectively. Post-brace pain and dyspnea were similar in both groups. CONCLUSION: Traction TLSO was superior to conventional TLSO in terms of angle reduction, but was similar in subjective symptoms.
Braces ; Dyspnea ; Fungi ; Humans ; Orthotic Devices* ; Plastics ; Pliability ; Retrospective Studies ; Scoliosis* ; Traction*

PURPOSE: To compare the two transscleral fixation (TSF) techniques of intrascleral pocket and conventional scleral flap with conjunctival division techniques in terms of short-term clinical effects. METHODS: This retrospective cohort study included all consecutive patients with aphakia in Gyeongsang National University Hospital in Jinju, Korea, who underwent TSF between January 2012 and December 2014. The medical records of all patients were retrospectively reviewed, and the endothelial cell count (ECC), refraction, best-corrected visual acuity (BCVA), intraocular pressure, slit lamp, and fundus examination results before and 1 day and 6 months after surgery were recorded. The postoperative complications and visual outcomes were also recorded. RESULTS: The intrascleral pocket and conventional-flap groups did not differ significantly in terms of demographics, presurgical BCVA, or ECC. However, the intrascleral pocket group had a significantly lower BCVA at 1 day and 6 months after surgery compared to the conventional-flap group. The two groups did not differ in terms of ECC 6 months after surgery. The intrascleral pocket group had no postoperative complications, but five patients in the conventional-flap group complained of irritation. In both groups, the intraocular lens was well positioned without tilting or subluxation, and astigmatism was significantly reduced at 1 day and 6 months after surgery. CONCLUSIONS: The intrascleral pocket technique of TSF does not involve conjunctival dissection and is a successful method of sulcus fixation. It stably corrects the intraocular lens and is easy to perform, which helps to reduce operation time. It also reliably yields rapid visual acuity recovery without complications.
Aphakia ; Astigmatism ; Cohort Studies* ; Demography ; Endothelial Cells ; Gyeongsangnam-do ; Humans ; Intraocular Pressure ; Korea ; Lenses, Intraocular ; Medical Records ; Postoperative Complications ; Retrospective Studies* ; Visual Acuity

PURPOSE: To investigate the change of the Beta adrenergic system in the rat visual cortex and superior colliculus after visual deprivation during a critical period of postnatal development. METHODS: The changes of beta 1 and beta 2 adrenergic receptor mRNA were investigated by using northern blot analysis in the rat visual cortex and superior colliculus. The right eyelid of visually deprived rat was sutured at the 10th postnatal days. After visual deprivation for 4 weeks, the rat were sacrificed and the visual cortex and superior colliculus tissues were removed for analysis. RESULTS: Beta 1 and beta 2 adrenergic receptor mRNA expression was decreased in the contralateral visual cortex to the deprived eye. In the superior colliculus, beta 2 adrenergic receptor mRNA expression increased in both sides, but a much greater increase was shown in the ipsilateral superior colliculus than the contralateral side. CONCLUSIONS: These results suggests that visual deprivation during a critical period of postnatal development influences the beta adrenergic system in the rat visual cortex and superior colliculus.
Animals ; Blotting, Northern ; Critical Period (Psychology) ; Eyelids ; Rats* ; Receptors, Adrenergic ; RNA, Messenger* ; Superior Colliculi* ; Visual Cortex*

The search for a less traumatic method of cataract removal through a small incision, is on going. One of the advantages of phacoemulsification is that it permits the removal of a cataract through a small incision than otherwise possible. The small incision allows the refractive error to be stabilized sooner and reduces the amount of induced postoperative astigmatism. But it may be traumatic to the endothelium, especially in cases with hard nucleus. There is a method using the Nd:YAG laser to preoperatively soften the nucleus of the cataract intracapsularly and thereby simplyfing the technique of phacoemulsification. The aim of this study is to evaluate the safety of softening lens nucleus by Nd:YAG laser application for cataract operation, and we observed the change of corneal endothleium and IOP and corneal thickness according to varied intensity, and time of laser application. The authors attempted to soften the nucleus using the Q-switched Nd:YAG laser without opening the anterior capsule. The laser was focused into the center of the nucleus and 100, 150 and 200 laser shots were made with the power of 5 mJ, 7 mJ, 10 mJ and 15 mJ. The results were as follows: 1. The corneal thickness was increased to the peak 24 hours after Nd:YAG laser application in cases of 150 and 200 laser shots with 15 mJ (P<0.05). 2. Intraocular pressure was not changed in any group after Nd:YAG laser application. 3. In morphological study with scanning electron microscope, the cases of 200 laser shots with 10 mJ and 150 laser shots with 15 mJ showed moderatly decreased the number of microvilli and partial seperation of the intercellular junctions. The cases of 200 laser shots with 15 mJ showed markedly decreased the number of microvilli and partial seperation of the intercellular junctions.
Astigmatism ; Cataract ; Endothelial Cells* ; Endothelium ; Intercellular Junctions ; Intraocular Pressure* ; Microvilli ; Phacoemulsification ; Refractive Errors