Drowning is one of the most common causes accidental death worldwide, but its diagnosis remains a challenging task in forensic pathology. Several authors have suggested that diatom analysis be conducted via an enzymatic digestion method that uses proteinase K to provide objective evidence for drowning; we employed this method in our study because of its superior applicability as compared to the conventional disorganization methods. The purpose of this study was to examine the reclaiming ratio of diatoms from experimentally drowned animal organs, which could be influenced by diatom morphology. The authors injected 3 diatoms species (Cyclotella striata, Navicula incerta, and Pleurosigma angulatum) into a rat's airway and compared the detection rate to investigate the factors that influence the sensitivity of diatom analysis. The results are as follows: (1) Average reclaiming ratio in the lungs was 81.07 for Navicula incerta, 48.26 for Cyclotella striata, and 5.35 for Pleurosigma angulatum. (2) The detection rates from the closed organs in 15 experimental animals were highest in the kidney (73%, 11/15), followed by the heart (67%, 10/15), brain (60%, 9/15), and liver (53%, 8/15). (3) Two Cyclotella striata was detected in the kidney of postmortem control group which suggest the possibility of contamination during laboratory procedure. In conclusion, the authors propose that diatom size could be a significant influencing factor for diatom extraction from the organs of drowned bodies; therefore, the results of diatom analysis must be interpreted after considering the diatom population of the drowning medium at the scene and the possibility of contamination during the laboratory procedure.
Animal Structures ; Animals ; Brain ; Diatoms ; Digestion ; Drowning ; Endopeptidase K ; Forensic Pathology ; Heart ; Kidney ; Liver ; Lung

This study is statistical investigation on the relationship of atopic dermatitis to molluscum contagiosum. The study was included 1,215 cases of atopic dermatitis and. 354 cases with mollescum contagiosum during the period of 1974 to 1977. According to our clinical experiences it was not uncommon to develop the combined cases with atopic dermatitis and mollucum contagiosum. On the immunological point of view the association of defective cell-mediated immunity and increased susceptibility to viral and fungaI infections in some cases with atopic dermatitis has been reported by many authors. The results are as follows: 1) The order of combined diseases in atopic dermatitis was rnolluscum contagiosum (8. 9 %), impetigo (6. 8 %), contact dermatitis (5. 1%), insect bite (3. 5 %) and urticaria (2. 0 %). The highest combined rate was seen in molluscum contagiosum. (p<0. 05) 2) The order of combined diseases in molluscum contagiosum was atopic dermatitis. (30.5%), impetigo (6.0%), contact dermatitis (5.7%) and insect bite (2.4%). The highest combined rate was seen in atopic dermatitis(p<0. 01). 3) Atopic dermatitis was more frequent in male than in female(p<0. 01) but in the age group above 11, female was more prevalent(p<0. 01). There was no sex difference for developing molluscum contagiosum in all our studied cases, but the frequency was higher in male below 5 year of age(p<0. 01%) and in female above 11 year old (p<0. 01). 4) Atopic dermatitis was frequently seen in the age group below 5 year old(72. 0%), and also moIluscum contagiosum was common in the same age group(60. 5 %). There were two peaks in incidence, below 10 year old(78. O%) and the age group of 21 to 3O(12. 4%). in molluscum contagiosum. The incidence was significantly higher in woman(10. 2%) than that of man(2. 3%) in the later group. The combined cases with atopic dermatitis and molluscurn contagiosum were more frequently seen in the age group below 5(84. 3%)but no case was found in more than 15 year old. 5) Atopic dermatitis was more frequent in winter and spring (62. 7%) than in summer and autumn(37. 3%), (p<0. 01). The combined cases with atopic dermatitis and moIluscum contagiosum were most frequent in spring(85. 2 %),(p<0. 05).
Adolescent ; Child ; Dermatitis, Atopic* ; Dermatitis, Contact ; Female ; Humans ; Immunity, Cellular ; Impetigo ; Incidence ; Insect Bites and Stings ; Male ; Molluscum Contagiosum* ; Sex Characteristics ; Urticaria

Dissecting aortic aneurysm is an emergency condition which requires prompt diagnosis and management. From January 1992 to December 1996, 54 patients were admitted to our department. Patients were categorized according to the Stanford classification of aortic dissection and investigation of the clinical records utilized the retrospective method. Male constituted the majority, according for 38(70.4%) of the total number of patients, whereas females accounted for 16(29.6%). Mean age was 52.1+/-2.2 years old (range:25~82). Clinical findings included chest pain in 46 cases(85.2%), renal failure in 11(20.4%), aortic insufficiency in 10(18.5%) and stroke in 9(16.7%). Predisposing factors were hypertension in 48 cases(88.9%), Marfan's syndrome in 5(9.3%) and diabetes mellitus in 1(1.8%). 21 patients(type A:12, type B:9) underwent surgical treatment. There were three(2 in type A and 1 in type B) deaths in the surgical treatment group and nine(5 in type A and 4 in type B) deaths in the medical treatment group. These results reflect our current policy in the management of dissecting aortic aneurysm.
Aortic Aneurysm* ; Causality ; Chest Pain ; Classification ; Diabetes Mellitus ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Hypertension ; Male ; Marfan Syndrome ; Renal Insufficiency ; Retrospective Studies ; Stroke

Several immunosuppressive agents were used to prolong the survival of full-thickries skin homografts in albino rats. The grafts were squares in size of 2.0cm. The results were as follows. 1. The mean survival time of skin homografts in control group was 6.0 days. 2. Total body X-irradiation (500r) to the recipients 24 hours before grafting resulted in prolongation of survival of the grafts. (Mean, 12.5 days) 3. Administration of Imuran(azathioprine) to the recipients in a does of 5mg/kg/day for 7 days. before grafting resulted in prolongation of survival of the grafts. (Mean, 9. 6 days) 4. Spleneetomized homografted rats showed no prolongation of survival of the grafts. (Mean, 6.1days) 5. Administration of prednisolone to the recipients in a does of 2mg/kg/day for 7 days before grafting resulted in no prolongation of survival of the grafts. (Mean, 6.3 days) 6. Above results were discussed and compared with those of others.
Allografts* ; Animals ; Azathioprine* ; Immunosuppressive Agents* ; Prednisolone* ; Rats* ; Skin* ; Splenectomy* ; Survival Rate ; Transplants ; Whole-Body Irradiation*

Authors analysed the corpus callosum of Korean(27 male & 14 female) anthrolopologically by the method of Kappers and Ban, and obtained the following results ; 1. The mean height of corpus callosum of the Korean male was about 25.9mm and that of the female was about 25.6mm. 2. The mean length of corpus callosum of the Korean male was about 69.1mm and that of the female was about 69.9mm. 3. According to the callosum horizontal index, the length of the cerebral hemisphere of the Korean male was about 2.22 times longer than that of the corpus callosum, and that of the female was about 2.27 times longer. 4. According to the callosum parietal index, the height of parietal lobe of the Korean male and female was about 2.8 times higher than that of corpus callosum. 5. The mean value of the callosum index of Korean was about 0.374, which was greater than that of the Japanese and Chinese, but lesser than that of Battak. 6. The most common type of corpus callosum of the Korean was the type III and VI, but the type I and X were not appeared. 7. According to the type distribution in relation to the callosum horizontal index, the type VI at callosum horizontal index 0.44 was the most common types.
Asian Continental Ancestry Group ; Cerebrum ; Corpus Callosum* ; Female ; Humans ; Male ; Methods ; Parietal Lobe ; Rabeprazole

Deliberate hypotension reduces bleeding in a wound, there by providing the surgeon with both better visibility and technical freedom for a more definitive dissection and minimizes the need for blood replacement, thereby reducing the risks of transfusion reactions, hepatitis, and acquired immune deficiency syndrome (AlDS). anesthesia With major development in surgery for spine problems in this century there are many reports and studies about the pathophysiology of spine, cord hemodynamics and functional monitoring about spinal cord activity during induced hypotension. Although by the comparative studies of vasodilator deliberate hypotension with nitroprusside was found to induce a reliable and rapid drop in blood pressure, we have found some different responses to the chosen vasodilators between the older, less active groups and the healthy, robust, and physically active groups. In this study we evaluated the hypotensive anesthesia for 42 cases of spinal surgery-posterior stabilization, spinal fusion, laminectomy, osteotomies, and discectomy-performed at Kwangju Christian Hoispital from May 1987 to May 1988. The result of our study was as follows: 1) Halothane and enflurane were used as primary anesthetics in 31 and ll cases respectively. Nitroprusside, hydralazine and both of this two vasodilatora were supplementarily used for inducing hypotensin in 14, 16 and 5 cases, respectively. 2) Although in many paient particularly in the older and less active groups, the combination of halogenated anesthetics and hydralazine are sufficient to produce appropriate operating conditions, in healthy, robust and physicaly active groups nitroprusside or even the combination of two vasodilators are required. 3) The mean arterial pressure of the lowest blood pressure in the induced hypotension was 60.5+/-11.6 mmHg. 4)The mean blood loss and blood replacement was 1242.2+/-769 ml and 925.4+/-854 ml respectively. 5) In the intraoperative period gas analysis arterial CO2 tension was 34.2+/-6.6mmHg and other values was within normal limit. 6) There was no significant perioperative and postoperative complication due to induced hypotension itself. In conclusion, the technique of using induced hypotension with inhalation anesthetics supplemented by nitroprusside, hydralazine, or both is safe and useful one to use in performing surgery for spinal problems.
Acquired Immunodeficiency Syndrome ; Anesthesia* ; Anesthetics ; Anesthetics, Inhalation ; Arterial Pressure ; Blood Group Incompatibility ; Blood Pressure ; Enflurane ; Freedom ; Gwangju ; Halothane ; Hemodynamics ; Hemorrhage ; Hepatitis ; Hydralazine ; Hypotension ; Intraoperative Period ; Laminectomy ; Nitroprusside ; Osteotomy ; Postoperative Complications ; Spinal Cord ; Spinal Fusion ; Spine ; Vasodilator Agents ; Wounds and Injuries

Mercury had been an important constituent of the remedial drugs for last few centuries, but substantially replaced by more specific and effective mordern medicines. However, metalic mercury, tbe vestige of the last decades, has still been employed for the patients of scabies by the herbal doctors in Korea. Therefore, we have often experienced patients with such complications as exfoliative dermatitis following topical applications of metalic mercury or inhalation of the vapor. There are three major toxic chernical forms of mercury, such as metalic (ele- mental) mercury vapor, salts of the mercury, and organic mercur.'als. Metailc mercury is the most volatile of the inorganic forms of the metal, Inhalation of the vapor of the metalic mercury is very toxic, but ingestion of the globular forms is rarely harmful. Acute mercury poison.ng due to topical mercurials is very rare. This case was a such patient who showed the mercury poisoning can result from the percutaneous absorption of topically applied mercury. The patient was an 11 year-old schoolboy with scabies. Three days after topical applications on the whole body with the mixture of rneta,lic rnercury, phosphorus and perilla oil, as prescribed by a herbal doctor, he was suffered from headache, fever, facial flushing, sore throat, a,nd stomatitis for a few days, and then followed by exfoliative dermatitis, renal and bone marrow fa'.lures. However, bone marrow failure due to mercury was very rarely described in the literatures. Virtually, the whole body was covered by thick scales on the dirty greyish pigmented or erytheinatoas Cohfluent payules. It whs oozing on the external genital area, and all nails were spontaneously extracted. Tbe findings of renal failures included puffy face, ascites, BUN 92. 8 mg/dl, serum creatinine 7. 3 mg/dl. creat.nine clearance 12rnl/min., proteinuria, rnicro and gross hematuria, and non or poor visualizations of IVP. The peak in severity was at about 50 days after onset and bacame normal except mild proteinuria at about 70 days after onset. The findings of aplastic anemia were shown by pancytopenia(Hb 7. 6g/dl, WBC 1, 700, seg. neutro. 18%, lympho. 40% mono. 26%, eosino. 16%, Hct25%, thrombocytes 40, 000, RBC 3, 000, 000, reticulocytes 0. 1%) and about 20 per cent of the cellularity in bone marrow aspiration from about 70 to 90 days after onset. In fact, the aplastic anemia was coincided with nasal bleeding, staphylococcal septisema, and staphylococcal pustulation at the site of IM injection. However, the levels of onset 80 day-urine and blood rnercury were high: 208 ug/1. (norm.alless than 100 ug/l)in urine, and 126. 3 ug/100g (normal less than 5 ug/100g) in blood.
Anemia, Aplastic ; Ascites ; Blood Platelets ; Bone Marrow* ; Child ; Creatinine ; Dermatitis, Exfoliative* ; Eating ; Epistaxis ; Fever ; Flushing ; Headache ; Hematuria ; Humans ; Inhalation ; Korea ; Mercury Poisoning ; Perilla ; Pharyngitis ; Phosphorus ; Proteinuria ; Renal Insufficiency ; Reticulocytes ; Salts ; Scabies ; Skin Absorption ; Stomatitis ; Weights and Measures

Acid ingestion causes a coagulative necrosis of the surface epithelium of the upper gastromtestinal tract. Its late sequence is luminal stenosis which frequently requires surgical repair. Nevertherless, in many cases, non-operative dilatation of luminal stenosis have been applicated, such as bouginations, balloon dilatations, endoscopic laser therapy, endoscopic electrocoagulation, endescopic microwave coagulation. These methods may give some considerable benefits in unoperable cases. Recently, we experienced a case of a 60-year-old man who had severe corrosive esophageal and gastric angular strictures by accidentally ingested hydrochloric acid and after many tiems of application of non-operative dilatation was able to have normal diet without dysphagia. So, we report this case with a review of literatures.
Constriction, Pathologic* ; Deglutition Disorders ; Diet ; Dilatation* ; Eating ; Electrocoagulation ; Epithelium ; Humans ; Hydrochloric Acid ; Laser Therapy ; Microwaves ; Middle Aged ; Necrosis ; Phenobarbital

Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked giant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46- year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like giant cells and mononuclear cells.
Child ; Male ; Female ; Humans ; Biopsy

Recently the syndrome of mitral valve prolapse with associated auscultatory and other clinical findings has generated considerable interest. Although this syndrome was originally described as benign, more recent observations have demonstrated that the patients are subject to sudden death, life threatening arrhythmias, bacterial endocarditis or hemodynamically significant mitral regurgitation. It is therefore important to identify such patients so that appropriate antibiotic prophylaxis and antiarrhythmic therapy may be instituted. Since earlier reports of this syndrome by Barlow et al. in 1963, various names or descriptions have been applied to the condition based upon pathologic findings, on cinical investigators has stressed different aspects of the entity. Now it is well known that the syndrome is no longer a benign condition. We have recently had the opportunity to study 15 cases of mitral valve prolapse, which was confirmed by left ventricular cineangiography. Among them 9 cases had associated other cardiac anomalies, most frequently secundum type of atrial septal defect. Among 15 cases 8 were female and the ages ranged from 20 to 52. Selective cine-coronary arteriography was also performed in 2 cases who complained of severe chest pain. We discussed generally the clinical features including hemodynamic and angiocardiographic findings, and pertinent literature published until recently were reviewed.
Female ; Humans