Death by drowning is a major cause of unnatural death worldwide. It is therefore important to conduct forensic examination of immersed bodies following drowning, in order to determine the diagnosis of drowning, because no specific methods have been established thus far. Therefore, we performed a series of rat experiments to compare autopsy findings between seawater and fresh water drowning cases, which included the presence of pleural effusion and histologic findings of the lung. The results showed that the volume of pleural effusion increased in the seawater drowning group compared to the fresh water drowning group, and the total weight of lung was affected by the type of drowning medium and postmortem interval. However, histologic findings of the lung showed no significant difference between the 2 types of drowning mediums.
Animals ; Autopsy ; Drowning ; Fresh Water ; Lung ; Pleural Effusion ; Rats ; Seawater

PURPOSE:There is a clear sexual dimorphism in circulating concentration of leptin in adulthood. However, we don' know when such dimorphism begins and how much pubertal development influences on it. So we examined body composition and circulating concentrations of leptin according to Tanner stage(TS). METHODS:We examined 112 children(M; 56, F; 56, Age; 8.5-17 yr) to evaluate the relationship of leptin and body composition. Body composition was determined by bioelectric impedence measurements(BIA) and by anthropometry. Leptin was measured by human specific RIA. Leptin level was analysed according to TS, body mass index(BMI), fat mass(FM), and lean body mass. RESULTS:BMI and free FM was correlated with TS in both sexes. FM was closely correlated with TS in girls but not in boys(M; r=0.08, P=0.54. F; r=0.73, P>0.001). Leptin levels increased in girls with advanced TS(r=0.355, P<0.01), but decreased in boys(r=-0.339, P<0.01). A strong exponential relationship was observed for leptin levels with BMI, FM, and percentage body fat as determined by BIA. There was significant sexual dimorphism of leptin level at TS VI/V. Because leptin level was significantly related FM, leptin level was normalized to FM(Leptin/FM). Leptin/FM of females(0.67+/-.27 ng/mL/kg) was also significantly higher then that of males(0.31+/-.15 ng/mL/kg)(P<0.001). CONCLUSION: These data suggest that plasma leptin levels increase in girls and decrease in boys after TS II as pubertal development proceeds; they show a significant gender difference, especially late puberty, even after adjustment for FM. Sexual dimorphism in leptin during puberty reflects not only differential changes in body composition but also different leptin resistance; reference ranges of leptin could be modified by TS and gender.
Adipose Tissue ; Adolescent* ; Anthropometry ; Body Composition* ; Child* ; Female ; Humans ; Leptin* ; Plasma ; Puberty ; Reference Values

PURPOSE:There is a clear sexual dimorphism in circulating concentration of leptin in adulthood. However, we don' know when such dimorphism begins and how much pubertal development influences on it. So we examined body composition and circulating concentrations of leptin according to Tanner stage(TS). METHODS:We examined 112 children(M; 56, F; 56, Age; 8.5-17 yr) to evaluate the relationship of leptin and body composition. Body composition was determined by bioelectric impedence measurements(BIA) and by anthropometry. Leptin was measured by human specific RIA. Leptin level was analysed according to TS, body mass index(BMI), fat mass(FM), and lean body mass. RESULTS:BMI and free FM was correlated with TS in both sexes. FM was closely correlated with TS in girls but not in boys(M; r=0.08, P=0.54. F; r=0.73, P>0.001). Leptin levels increased in girls with advanced TS(r=0.355, P<0.01), but decreased in boys(r=-0.339, P<0.01). A strong exponential relationship was observed for leptin levels with BMI, FM, and percentage body fat as determined by BIA. There was significant sexual dimorphism of leptin level at TS VI/V. Because leptin level was significantly related FM, leptin level was normalized to FM(Leptin/FM). Leptin/FM of females(0.67+/-.27 ng/mL/kg) was also significantly higher then that of males(0.31+/-.15 ng/mL/kg)(P<0.001). CONCLUSION: These data suggest that plasma leptin levels increase in girls and decrease in boys after TS II as pubertal development proceeds; they show a significant gender difference, especially late puberty, even after adjustment for FM. Sexual dimorphism in leptin during puberty reflects not only differential changes in body composition but also different leptin resistance; reference ranges of leptin could be modified by TS and gender.
Adipose Tissue ; Adolescent* ; Anthropometry ; Body Composition* ; Child* ; Female ; Humans ; Leptin* ; Plasma ; Puberty ; Reference Values

BACKGROUND: beta-lactam antibiotics are one of the most frequently used antimicrobial agents. However, with the increase of beta-lactamase-producing bacteria, penicillins arid 1 st generation cephalosporins have become less useful. Cefatrizine and clavulanic acid combination (CTCA) was developed to restore the activity. The aim of this study was to determine the activities of CTCA against major recent clinical isolates. METHODS: Aerobic and anaerobic bacteria tested were isolated from clinical specimens in Severance Hospital during 1996 to 1999. Antimicrobial susceptibility was determined by the NCCLS agar dilution methods. RESULTS: MICs of cefatrizine (CT) and CTCA were similar for methicillin-susceptible Staphylococcus aureus, Streptococcus pyogenes and S. pneumoniae. For Moraxella (Branhamella) catarrhalis, MIC90 CTCA was 1 microgram/mL, which was 1/8-fold lower than that of cefatrizine. MIC90S of CTCA for Escherichia coli and Klebsiella pneumoniae were 4 microgram/mL and 8 microgram/mL, respectively, which were 1/4- to 1/16-fold lower than those of CT. However, it was less active against Citrobacter freundii, Enterobacter cloacae and Serratia marcescens. Against Bacteroides fragilis group organisms, it showed good activities similar to those of other beta-lactam and beta-lactamase inhibitor combinations. CONCLUSIONS: CTCA showed good antimicrobial activities against M. (B.) catarrhalis, Haemophilus influenzae, Neisseria gonorrhoeae, extended spectrum beta-lactamase-producing E. coli and K. pneumoniae, Proteus vulgaris and B. fragilis. In conclusion, it would be useful for the treatment of infections due to those organisms, and for the empirical treatment of respiratory and urinary tract infections.
Agar ; Anti-Bacterial Agents ; Anti-Infective Agents ; Bacteria* ; Bacteria, Anaerobic ; Bacteroides fragilis ; beta-Lactamases ; Cefatrizine ; Cephalosporins ; Citrobacter freundii ; Clavulanic Acid ; Enterobacter cloacae ; Escherichia coli ; Haemophilus influenzae ; Klebsiella pneumoniae ; Moraxella (Branhamella) catarrhalis ; Neisseria gonorrhoeae ; Penicillins ; Pneumonia ; Proteus vulgaris ; Serratia marcescens ; Staphylococcus aureus ; Streptococcus pyogenes ; Urinary Tract Infections

Indirect composite resin are used as an popular effective esthetic material in prosthetic dentistry, often with metallic substructure that provides support for restorations. Recently, new indirect composite resins as a substitute of ceramic have been developed. These resins provide good esthetics, with a wide range of hue and chroma. And the flexural strength of those is in the range of 120-150MPa, which is higher than that of feldspathic ceramic, and similar tot hat of Dicor. Although it has many merits, one of the major clinical problems of composite resins is the bond failure between metal and resin due to insufficient interfacial bond strength. The purpose of this study was to evaluate shear bond strength of the reinforced indirect composite resin to dental alloys. Three different composite resin systems(Artglass . Sculpture , Targis ) as test groups and ceramic(VMK 68 ) as control group were bonded to Ni-Cr-Be alloy(Rexillium III ) and gold alloy(Dave 4). All specimens were stored at 37degrees C distilled water for 24 hours and the half of specimens were thermocycled 2000 times at temperature from 5degrees C to 60degrees C. The shear bond strengths of reinforced indirect composite resins to dental alloys were measured by using the universal testing machine, and modes of debonding were observed by stereoscope and scanning electron microscope. The results were as follows : 1. The shear bond strengths of reinforced indirect composit resins to dental alloys were approximately half those of ceramic to dental alloys(P<0.01). 2. There was no significant difference between the shear bond strength of several reinforced indirect composite resins to metal. 3. Alloy type did not affect on the shear bond strengths of resin to metal, but the shear bond strengths of ceramic to gold alloys were higher than those of ceramic to Ni-Cr alloys(P<0.05). 4. The shear bond strenghts of Artglass and Targis to gold alloys were significantly decreased after thermocycling treatment(P<0.01). 5. Sculpture showed cohesive, adhesive, and mixed failure modes, but Artglass and Targis showed adhesive or mixed failures. And ceramic showed cohesive and mixed failures.
Adhesives ; Alloys ; Ceramics ; Composite Resins* ; Dental Alloys* ; Dentistry ; Esthetics ; Gold Alloys ; Sculpture ; Water

Backgroud: To evaluate the appropriateness of the requests of the emergency transfusions, 3 year experiences in the use of the immediate-spin crossmatched blood(ISMB) for emergency transfusions in tertiary hospital were reviewed. METHODS: Low-isotonic salt solution was used as a cell suspension and crossmatchings were continued including antiglobulin phase after issuing of the ISMB. The number of cases, the issuing time, sex, age, reasons for emergency transfusions and vital signs of the patients were retrospectively reviewed. Only cases of massive transfusions and classes III and IV according to the Advanced Trauma Life Support(ATLS) classification were considered appropriate. RESULTS: 1. The total number of emergency transfusions were 614 and 0.53 cases per day. The average age of the patients was 44.7+/-17.8 and male to female ratio was 2:1. And 357 cases(58.2%) were performed during off hours when the hospital was not fully staffed. 2. Six hundred thirteen cases(99.8%) were transfused with compatible blood. However, one case(0.2%) was found to have anti-E antibody during the emergency transfusion. 3. Massive transfusion was performed only in 32% of the total cases and the reasons of emergency transfusions in remaining cases were upper gastrointestinal bleeding(53%), trauma(19.2%) and obstetrical problems(16.8%). 4. Of the total 519 cases reviewed, 392 cases(75.5%) were considered appropriately, and 127 cases(24.5%) were considered inappropriately selected for emergency transfusions. CONCLUSIONS: One fourth of emergency transfusions was found to be inappropriate. We believe that the use of ISMB for emergency transfusions should be carefully requested by physicians and educational programs for the use of ISMB is clearly indicated for emergency transfusion management.
Classification ; Emergencies* ; Female ; Humans ; Male ; Retrospective Studies ; Tertiary Care Centers ; Vital Signs

Pressure sores are common complications in patients with spinal injuries or cerebrovascular accidents. The management of pressure sores requires prolonged hospitalization and repeated surgical interventions with a high recurrence rate. Particularly osteomyelitis following initial pressure sores persistently complicates wound healing and recovery. Furthermore, it may also ultimately result in serious sepsis; thus an early diagnosis of osteomyelitis in pressure sore patients is crucial along with appropriate surgical and antibiotic therapy. Although many diagnostic methods were reported, there is no single 'gold' standard for early diagnosis of pressure sore-associated osteomyelitis. Authors reviewed pre-operative CBC, plain X-ray, Tc-99m bone scan, and post-operative biopsy results in 37 patients who had received surgical treatment for pressure sores in a 5-year period from September 1991 to August 1996. Based on these reviews, authors compared and analyzed the sensitivity and specificity in diagnosing osteomyelitis.The results were as follows: 1. Of 37 patients studied, 25 cases were confirmed histologically as osteomyelitis. Ischial region revealed the highest incidence of pressure sore-related osteomyelitis(78%, 14 out of 18 cases) while the regional incidence was as following in descending order : ischial, sacral, and greater trochanteric area. 2. Tc-99m bone scan had superior sensitivity(100%) and specificity(83%) to other pre-operative studies in diagnosing osteomyelitis.In conclusion, authors suggest that Tc-99m bone scan is the best diagnostic method because of its high sensitivity and specificity if osteomyelitis is clinically suspected in pressure sore patients. And in case the test result is positive, agressive surgical bone resection and appropriate antibiotic therapy based on bacterial culture from deep bone specimen should be combined to prevent complications or recurrences.
Biopsy ; Early Diagnosis ; Femur ; Hospitalization ; Humans ; Incidence ; Osteomyelitis ; Pressure Ulcer* ; Recurrence ; Sensitivity and Specificity ; Sepsis ; Spinal Injuries ; Stroke ; Wound Healing

Fiber-reinforced composite(FRC) was developed as a structural component for dental appliances such as prosthodontic framework. FRC provides the potential for fabrication of a metal-free, excellent esthetic prostheses. It has demonstrated success as a result of its simple fabrication, natural colour, and marginal integrity, and fracture resistance of veneering composite resin and the FRC material. Although it has lots of merits, clinical and objective data are insufficient. The purpose of this study was to evaluate the fracture strength and marginal fitness of fiber-reinforced composite bridge in the posterior region for clinical application. Sixteen bridges of each group, Targis/Vectris(R), Sculpture-fibrekor(R)and In-Ceram, were fabricated. All specimens were cemented with Panavia 21 to the master dies. Strength evaluation was accomplished by a universal testing machine (Instron). The marginal fitness was measured by using the stereoscope (X50). The results were as follows. : 1.The fracture strength according to the materials was significantly decreaed in order In-Ceram(238.81+/-82). Targis Vectris(176.25+/-18.93), Sculpture-Fibrekor(120.35 +/-20.08) bridges. 2.FRC resin bridges were not completely fractured, while In-Ceram bridges were completely fractured in the pontic joint. 3.The marginal accuracy was significantly decreased in order Targis/Vectris (60.71micrometer), Sculpture-Fibrekor(73.10micrometer). In-Cream Bridge(83.81micrometer). 4.The fitness of occlusal sites had a lower value than the marginal sites(P<0.001), and the marginal gaps of inner site of the pontic were greater than that of outer sites of the pontic. Fiber reinforced composite bridges are new, esthetic prosthesis and can be clinically used in anterior regions and short span bridges. However, caution must be exercised when extrapolating laboratory data to the clinical situation because there are no long term clinical data regarding the overall success of the FRC.
Denture, Partial, Fixed ; Joints ; Prostheses and Implants ; Prosthodontics

No abstract available.
Fetal Blood* ; Growth Hormone* ; Humans ; Infant, Newborn* ; Insulin-Like Growth Factor I* ; Somatomedins* ; Umbilical Cord*

PURPOSE: Pseudohypoparathyroidism(PHP) is caused by a defect of G protein and receptor despite of normal parathyroid hormone(PTH) secretion. It is a rare disorder characterized by hypocalcemia, hyperphophatemia, elevated PTH levels and albright hereditory osteodystrophy(AHO). We retrospectively reviewed the clinical characteristics of PHP. METHODS: We reviewed clinical features, laboratory findings, and outcome to treatment of 8 PHP patients, diagnosed at Seoul National University Hospital from 1988 to rool. RESULTS: Male to Female ratio was 1.7:1 and mean age at diagnosis was 11.8 years old. The initial average height SDS was 0.13+/-.08 and the average weight SDS was 0.43+/-.31. The most common symptom was seizure. Only one patient had typical AHO, three patients had mental retardation. Brain MRI or CT showed basal ganglia calcification in 3 patients. All patients treated with vitamin D and calcium supplementation could maintained normal serum levels of calcium and phophorus. CONCLUSION: PHP should be suspected in patient with seizure of unknown origin, aged above 5 year-old. AHO and mental retardation could be adjuvant signs to the diagnosis of PHP. But definite diagnosis could be made by laboratory work up.
Basal Ganglia ; Brain ; Calcium ; Child, Preschool ; Diagnosis ; Female ; GTP-Binding Proteins ; Humans ; Hypocalcemia ; Intellectual Disability ; Magnetic Resonance Imaging ; Male ; Pseudohypoparathyroidism* ; Retrospective Studies ; Seizures ; Seoul ; Vitamin D