Drowning is a leading cause of accidental deaths worldwide, but its pathological diagnosis remains a challenge for forensic pathologists owing to a lack of pathognomonic findings in drowning deaths and inconclusive autopsy findings caused by postmortem changes. The aim of the present study was to investigate the pathway taken by inhaled drowning medium through the airway after death in a variety of experimental conditions, including underwater pressurization. We used methylene blue dye to monitor the spread of drowning medium to the lungs. Results of theses experiments demonstrated that it is possible for a significant amount of downing medium to enter the airway during immersion after death. Our results suggest that autopsies of immersed bodies and interpretation of these findings should be performed with special care.
Animal Experimentation* ; Animals* ; Autopsy ; Diagnosis ; Drowning* ; Immersion ; Inhalation* ; Lung ; Methylene Blue* ; Postmortem Changes

BACKGROUND: The positive reactions of carcinoembryonic antigen(CEA) show varying degrees in the tissue of all sweat gland neoplasms by immunohistochemistry. The CEA secreted from sweat glands presents a high value, compared with that of serum. OBJECTIVE: The study was to evaluate the sweat CEA value in relation to serum CEA value by sex, smoking status and blood type in healthy subjects. METHOD: Fifty-two healthy subjects(M : 43, F :9) aged 21-30, participated in the study. 2ml sweat was collected from the face and chest after intense exercises and 3ml blood was collected from their antecubital veins. Roche Core CEA enzyme immunoassay was used for the measurement of sweat and serum CEA. RESULTS: Sweat CEA values were 102.0+4100.5ng/ml in males and 70.6+458.5ng/ml in females, with their mean valueof 96.6+/-94.9ng/ml. Sweat CEA values were 108.3+/-103.5ng/ml in 27 smokers and 83.9+/-84.8ng/ml in 25 nonsmokers(p>0.05, t-test). Sweat CEA values were higher among the males and the smokers. Serum CEA values were 2.5+/-1.7ng/ml in males and 1.6+/-0.8ng/ml in females, with its mean value of 2.4+/-1.6ng/ml. There was no difference between serum values of smokers and nonsmokers. Sweat CEA values were about 40 times higher than those of serum, with no correlation of sweat and serum CEA(correlation coefficient=-0.16, P>0.05). In the blood type study, sweat CEA values were 123.1+/-131.8ng/ml in A type and 66.1+/-55.0ng/ml in B type(P>0.05), whereas serum CEA values were higher in AB type and lower in O type(P<0.05, ANOVA). CONCLUSION: Sweat CEA values are extraordinarily high in contradistinction to serum. Sweat CEA values are not affected by sex, smoking status and blood type. There seems to be no association between CEA values of sweat and serum.
Carcinoembryonic Antigen* ; Exercise ; Female ; Humans ; Immunoenzyme Techniques ; Immunohistochemistry ; Male ; Smoke ; Smoking ; Sweat Gland Neoplasms ; Sweat Glands ; Sweat* ; Thorax ; Veins

There have been many epidemiological and clinical researches on chronic fatigue (CF) and chronic fatigue syndrome (CFS) since the 1990s, but such studies have been quite limited in Korea. The aim of this study was to investigate the point prevalence of CF and CFS in patients who visited community-based eight primary care clinics in Korea. The study subjects were 1,648 patients aged 18 yr and over who visited one of eight primary care clinics in Korea between the 7th and 17th of May 2001. The physicians determined the status of the subjects through fatigue-related questionnaires, medical history, physical examination, and laboratory tests. The subjects were categorized into no fatigue, prolonged fatigue, CF and then CF were further classified to medically explained CF (Physical CF and Psychological CF) and medically unexplained CF (CFS and idiopathic chronic fatigue). The point prevalence of CF and CFS were 8.4% (95% CI 7.1-9.7%) and 0.6% (95% CI 0.2-1.0%). Medically explained CF was 80.5% of CF, of which 57.1% had psychological causes. The clinical characteristics of CFS were distinguished from explained CF. CF was common but CFS was rare in community-based primary care settings in Korea.
Adolescent ; Adult ; Age Distribution ; Chronic Disease ; Community Health Services/statistics & numerical data ; Comparative Study ; Fatigue/*epidemiology ; Fatigue Syndrome, Chronic/*epidemiology ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Sex Distribution

Endometriosis is an enigmatic disease of menstruating females affecting the reproductive life. We report herein a case of perineal endometriosis in a 33-year-old woman. The patient presented two rounded, thickened plaques bilaterally on the perineum for about four year. The plaque on the right side was located mainly at the episiotomy scar. Histologic examination showed confirmative feature of glandular structures embedded in the cellular stroma and predecidual changes of late secretory phase of endometrium. Radical operation of total hysterectomy with bilateral oophorectomy and partial excision of perineal lesions were performed. There was complete resolution with no relapse by the 6-month follow-up. This is of a very rare occurrence and three cases have been reported in the Korean literatures up to date.
Adult ; Cicatrix ; Endometriosis* ; Endometrium ; Episiotomy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Ovariectomy ; Perineum ; Recurrence

No abstract available.
Actinomycosis*

A healthy 12-year-old girl had noted over 2 years a gradual-growing painless nodule on the area below the right axilla. The lesion measuring approxima:;ely 1.2 x 1.2 x 0.4cm in size, had a reddish-blue colored ulcerative papule raised on its cente with mucous discharge to compression. Histopathelogically, a circumscribed solid tumor located in the deep dermis, revealed the predominnntly epidermoid features of polyhedral cells, with the mucous cells within and at the peripiiery of the tumor. The mucous cells exhibited diastase-resistant PAS -positive, alcian-blue reactive at pH 2.5 and mucicarmine-positive reactions. Results of irnmunoperoxidase staining for cytokeratin and carcinoernbryonic antigen were focally cytoplasmic-positive, while negative for S-100 protein and epithlial membrane antigen. She has remained free of disease one year following excision.
Acrospiroma* ; Axilla ; Child ; Dermis ; Female ; Humans ; Hydrogen-Ion Concentration ; Keratins ; Membranes ; S100 Proteins ; Ulcer

Normal lymphocyte transfer (NLT) test is composed of two peaks of delaycd. hypersensitivity reaction of erythema and/or induration developed at the site of intradermal inoculatioa of allogenic lymphocyte. It has been suggested that NLT test is a px.siblc homograft raaction, how var tlv exact mecha.nism is remained to be resolved. In leprosy, there has been accumulating evidenc. indicating defective cell mediated. immunity detected by varioua immunological tests. The present study was undertaken to evaluate the immune capability of patients with leprosy using NLT test. A total of 20 hea,lthy volunteers, 20 lepromatous and 22 tuberculoid leprosy patients who were under antileprosy chemotherapy with DDS for varying periods, entered this study. Lymphocytes from hepatitis associati antigen (HAA) negative donor were isolated with Ficoll- Hypaque density gradient method and the cell concentration was adjusted by normal saline so as to give 2, 5 million cells per 0. 1 ml. Each recipient was given 0. 1 ml lymphocyte suspension on the flexor surface of th right forearm intrad.ermally using 1 ml tuberculi n syringe with a 26 gauge needle. The appearance and the size of induration was checked daily for 2 weeks. In this atudy, the NLT reaction pattem was classified as follows: a. normal pattem showing the first peak and second peak of reaction. b. first peak only showing the first peak, but no second peak, of reaction. c. flat pattem showing neitger the first peak nor the second peak of reaction The results were as follows: 1. There were normal pattem in sixteen persons(80%) and first peak only in 4 persons(20%) among twenty healthy human volunteers. 2. There were normal pattem in four patients(20%), first peak only in six patients(30%) and flat pattem in ten patients(50%) among twenty letromatous leprosy patients. 3. There were normal pattem in twelve patients(54.5%), first peak only in eight patients(36.4%) and flat pattem in two patients(9.1%) among twenty-two tuberouloid leprosy patients. These findings suggest that NLT test may be useful in evaluating the immune capability in leprosy and host factor in belived to be important in the development of both first and second peaks of NLT test.
Allografts ; Diatrizoate ; Drug Therapy ; Erythema ; Forearm ; Healthy Volunteers ; Hepatitis ; Humans ; Hypersensitivity ; Immunologic Tests ; Leprosy* ; Leprosy, Tuberculoid ; Lymphocytes* ; Needles ; Syringes ; Tissue Donors ; Volunteers

Authors report herein a case of a 27-year-old male patient who had been suffering from chronic ulcerative dermatitis with scar-like changes and successive involvement of the ankles, limb folds, nape and abdomen, and no tendency to heal from age 4. At the age 14, an immunologic study showed a selective IgA deficiency with partial T-lymphocyte inactivation. Ten years later, at age 24, he showed a severe form of morphea over a generalized area and disabling joint contractures, and was diagnosed as disabling pansclerotic morphea with an IgA value that returned to a near normal level. At the age 27, an adult-fist, 7×6×4cm sized, squamous cell carcinoma with an easy bleeding tendency like an overgrowing granulation tissue vascular tumor had developed on the chronic ulcerative lesion on the posterior aspect of the right ankle for 2 months. Aggressive metastatic lesion occurred on the right popliteal area 3 months later. He died 1 month thereafter.
Abdomen ; Adult ; Ankle ; Carcinoma, Squamous Cell* ; Contracture ; Dermatitis ; Epithelial Cells* ; Extremities ; Granulation Tissue ; Hemorrhage ; Humans ; IgA Deficiency ; Immunoglobulin A ; Joints ; Male ; Scleroderma, Localized* ; T-Lymphocytes ; Ulcer*

Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life, but it is rare in the pleura. We recently experienced a case of cytology of malignant fibrous histiocytoma in pleural fluid. The smear revealed histiocytic malignant cells, spindle malignant cells and inflammatory cells. The histiocytic cells showed abundant, pale cytoplasm and ovoid, irregular, eccentrically-placed nuclei. The spindle cells showed elongated nuclei. Intercellular collagen was also present.
Adult ; Child* ; Collagen ; Cytoplasm ; Diagnostic Errors ; Follow-Up Studies* ; Histiocytoma, Malignant Fibrous ; Humans ; Hypercalciuria* ; Pilomatrixoma ; Pleura ; Sarcoma

We reported herein a rare case of a 65-year-old female who lead intestinal tuberculosis of about 2 months duration, with little late development of metastatit berculosis abscess of the skin. The lesions were egg tow wolnut-sized abscesses or nodules occu in, on the back, right flank and lower abdomen with no pain or mild tenderness. Physical exami saion was unremarkable on dissemination of other sites. The tuberculin test was negative. The skin esions were diagnosed by clinical, histopathologic features, and positive results for Mycobactc iuntuberculosis in smear.; and cultures in the pus discharge: as well as polymerase chain reaction nethod on the nodular lesion. A barium enema showed the findings of intestinal tuberculosis, with positive culture in the stool. A combined treatment was intituted. During the initial 4 month, utaneous lesions did not respond and in some cases worsened with the multidrug of isoniazicr fampin, pyrazinamide and streptomycin, all of which were surgically excised. Thereafter, the drugs of isoniazid and rifampin were further administered for ahout 14 months, with the complete resecution of both lesions and the systemic symptomatolo. There was no relapse at follow-up after 6 months.
Abdomen ; Abscess* ; Aged ; Barium ; Enema ; Female ; Follow-Up Studies ; Humans ; Isoniazid ; Ovum ; Polymerase Chain Reaction ; Pyrazinamide ; Recurrence ; Rifampin ; Skin* ; Streptomycin ; Suppuration ; Tuberculin Test ; Tuberculosis*