Recreational diving is an exciting and adventurous sport, but is also potentially hazardous. Despite its inherent hazards, an increasing number of people enjoy SCUBA (self-contained underwater breathing apparatus) diving; the number of diving-related accidents is therefore also likely to increase. Divers might face physical or psychological stresses from the unfamiliar or hostile underwater environment, which can lead to fatal accidents. To investigate deaths related to SCUBA diving, a forensic pathologist should understand the types and mechanisms of injuries and illnesses unique to SCUBA diving. Postmortem examination of diving fatalities is therefore a formidable task for most forensic pathologists because cases are sparse and the process requires an understanding of diving physiology, diving equipment, and the underwater environment. The primary aim of autopsies in SCUBA diving fatalities is to detect evidence of pulmonary barotrauma, intravascular gas, or pre-existing illnesses. Standard autopsy protocol for SCUBA diving-related deaths should include methods to detect intravascular gas and gas accumulation in the tissue or body cavity through plain radiographs or Computerized Tomography (CT) scans. Analysis of the gas components is also helpful for determining the origin of the gas. Here, the author proposes a practical method for performing an autopsy on a person who died while SCUBA diving.
Autopsy* ; Barotrauma ; Diving* ; Humans ; Methods ; Physiology ; Preexisting Condition Coverage ; Respiration ; Sports ; Stress, Psychological

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

Simple congenital lymphedema is a congenital form of chronic lymphedema of unknown etiology which affects a part or all of the one extremity, especially the lower extremities, at or immediately after birth. A clinical classification of lymphedema was offered by Allen and Ghormley in 1935, based on a study of 300 cases of lymphedema of which 12 cases are simple congenital lymphedema. They classified the cases of lymphedema into two divisions: noninflammatory and inflammatory, with a tabulation of primary and secondary causes. One caes I reporting is classified as being of congenital origin and naturally comes under the noninflammatory group. On May 1960, a 3 year old girl entered to the Department of Orthopaedic Surgery, Kyungpook National University Hospital because of lymphedema of right leg. Since at birth, there were no history of skin infection, cellulitis and lymphangitis etc. Gross appearance of the skin of the affecte leg revealed leather like consistency and thickening. One week of preoperative preparation of the patient was sustained absolute bed rest with elevation of affected limb to ease drainage of lymphatic fluid. The two staged operation of Homans procedure were performed under general anesthesia, first to medical half and second to remaining lateral half of the affected leg. The end result was relatively good in decreasing the circumfence of affected leg but it was not quite acceptable in its cosmetic effect. The literature on primary lymphedema is reviewed.
Anesthesia, General ; Bed Rest ; Cellulitis ; Classification ; Drainage ; Extremities ; Female ; Gyeongsangbuk-do ; Humans ; Leg ; Lower Extremity ; Lymphangitis ; Lymphedema ; Parturition ; Skin

OBJECTIVES: This study was designed to evaluate the problems of pre-hospital Emergency medical care system (EMS) in workplace. We analysed 25 fatal work-place injuries during the recent 4 years and the work-place EMS of 8 enterprises located in Masan-city, Changwon-city and Kuje-island. METHODS: The safety managers and the members of Dept. of safety in the labor unions were interviewed about the work-place EMS. And we investigated on the injury reports, the work-place medical-room records and the medical records of emergency center for fatal 25 cases. RESULTS: The enterprises had the at-risk machines and processes, volatile materials and high-altitude working processes. There were duty doctors in only 3 enterprises but a few duty nurses or health-care providers in the others. The time spent for the education to the workers on safety was 24hrs/yr in 3 enterprises in 1998 but less than Bhrs in the others. There were medical service center in all enterprises but the ambulances in three. The time for activation of the ambulance was ranging from 5 minutes to 10 minutes in 6 enterprises, and from 10 minutes to 30 minutes in two. The patient transportation to the emergency center was possible within 30 minutes in all enterprises but there were no equipments for airway maintenance and shock management in all enterprises. The 15 (60%) fatal injuries were occurred at one enterprise. The 64% of casualties had the duration of job-employment more than 10yrs and the 68% were suffered the typical type of work-place injury as descending injuries, collisions and falls. Most of all primary calls for rescue were concentrated on the fire-service agencies. But in 85% of fatal injtories, the tome for the activation of ambulance was more than 10 minutes and no emergency care was taken in the field in 48 percent of casualtles. The transportation time to the emergency center was more than 30 minutes in 50 percent. It toolk from injury to death was less than one hour in the 40 percent of all cases, and from one hour to four in the 50 percent. The causes of death in the 68 percent were the head-and-neck injuries or thoracic injuries. CONCLUSIONS: We found that there was Insufficiency of the education associated with work-place injury for workers, manpower and facilities, equipments related to the work-place EMS, the problems of the delay in transportation system.
Ambulances ; Cause of Death ; Education ; Emergencies* ; Emergency Medical Services* ; Humans ; Labor Unions ; Medical Records ; Shock ; Thoracic Injuries ; Transportation

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

We experienced a case of purpura pigmentosa chronica in a 9-year-old girl whose skin lesions are widespread, so that face is also involved in addition to the lower extremi ties, trunk, and upper extremities.
Child ; Female ; Humans ; Purpura* ; Skin ; Upper Extremity

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

Our study was performed to evaluate the efficacy of anthralin-UVB therapy on patients with psoriasis. We studied twenty two patients suffering from plaque-type psoriasis of varying degrees of severity. The results can be summarized as follows. l. 2p patients(90.9%) out of the total 22 patients showed grade 4 improvement. The rernaining 2 patients failed to respond to treatment, 2. Arnong the improved 2Q patients, 2 patients who were treated more than 3p times for grade 4 improvement were excluded, so cleared patients were 18(81.8%). 3. Arnong the 18 cleared patients, the mean nurnber of therapy wasg. 6 for grade 3 and 12. 5 for grade 4 in the cases of trunk lesiona, and 13. 2 for grade 3 and 17. 8 for grade 4 in the cases of extrernities lesions. With above results, anth-ralin-UVB therapy was rnore effective in lesions of the trunk than in those of extremi.ties. 4. Notable side effects were pruritus in 6 patients(27.3pg), staining in 4 patients (18,2%), and 1ITltatioB in 2 patients(9.1%)
Anthralin* ; Humans ; Phototherapy* ; Pruritus ; Psoriasis*

Tinea pedis is frequently found in people with poor personal hygiene and in hot, humid environments. The authors investigated the clinical, epidemiological, and mycological characteristics of tinea pedis in 170 garbage workers(166 males and 4 females) employed in a garbage plant in Seoul, Korea. 40 were clerical workers and 130 were field workers. Tinea pedis was found in 134 with a prevalence rate of 78.8%. Of those 134, 61(45.5%) also had onychomycosis. The prevalence of tinea pedis increased with age and the period working in garbage plant. However, there was no difference in the prevalence of tinea pedis between clerical workers and field workers, mitigating against the conclusion that their tinea pedis may be of occupational origin. Clinically tinea pedis was classified into 4 types ; interdigital (41.8%), vesicular(23.1%), dry squamous(22.4%), and mixed(12.7%). KOH smear positivity and culture positivity was related to clinical types of the lesion the lowest in the interdigital type. In the interdigital type, the etiology of nonmycotic lesions could not be identified. Negative fungal cultures could have been due to secondary bacterial infections. 63 strains of dermatophytes were isolated; 54 strains of Trichophyton rubrem(85.7%), 8 strains of Trichophyton mentagrophytes(12.7%) and 1 mixed infection of T. rubrum and T. mentagrophytes. T. mentagrophytes was isolated only from the vesicular lesions. 8 strains of yeast forms, positive in KOH smears and yielding pure colonies, were also isolated, and repeated mycologic examination yielded the same results. Among them, at least 4 cases of Trichosporon beigelii, and 1 case of Candida parapsilosis were considered to be of pathogenic significance.
Arthrodermataceae ; Bacterial Infections ; Candida ; Coinfection ; Garbage* ; Health Personnel ; Humans ; Hygiene ; Korea ; Male ; Onychomycosis ; Plants ; Prevalence ; Seoul ; Tinea Pedis* ; Tinea* ; Trichophyton ; Trichosporon ; Yeasts

We performed anthralin comparative study(0.01% vs 0.1%) to assess the effectiveness of low-strengh anthralin therapy in 34 psoriatic patients and the resu1ts can be summarized as follows. 1. In the case of 13 patients using Burdick UVB larnp, in 1 patient the effect of 0.1% anthralin was superior to that of 0.01% anthralin from the start to the end of treatment, in 5 patients(38.5%) initially the effect of 0.1% anthralin was superior but in time became equal to that of 0.01% anthralin, and in 7 patients (53.8%) the effect of either side was same throughout the courae of the treatment. In the case of 21 patients using Waldmann UVB cabinet, there were 2(9.5 %), 3(14.3%) and 16 patients(76.2%) in the order named above. 2. The side effect of 0.1% anthralin was more severe than or at least the same as that of 0.01% anthralin in every patient who complained about side effects. So low-strengh anthalin-UVB phototherapy was thought to be the effective and alternative method of treatment particularly for the purpose of lessening the side effects.
Anthralin* ; Humans ; Phototherapy ; Psoriasis*