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Neck*

No accepted standard currently exists to classify asphyxia and define its subtypes. Sauvageau and Boghossian proposed an asphyxia classification system in 2010 that divided asphyxia into suffocation, strangulation, mechanical asphyxia, and drowning. Here, we present a modification of this classification system. We propose to classify asphyxia into four main categories: suffocation, strangulation, mechanical asphyxia, and complicated asphyxia. Suffocation includes smothering and choking as well as confined spaces, entrapment, and vitiated atmosphere. Strangulation is subdivided into hanging, ligature strangulation, manual strangulation, and other unspecified strangulation. Mechanical asphyxia includes positional and traumatic asphyxia. Finally, complicated asphyxia is defined as cases with two or more identifiable mechanisms of asphyxia. In this study, we review autopsy cases from 2012 diagnosed as asphyxia and classify them according to our proposed asphyxia classification system. In 24.7% of cases, the age range was 40-49 years, and 51.9% were men. The most common method of asphyxia was hanging (245 cases, 55.1%), followed by ligature or manual strangulation (53 cases, 11.9%). Most hangings were suicides; smothering, ligature, and manual strangulation were usually homicides. Eighteen cases were complicated asphyxia. This classification provides a simplified, unified, and useful tool to classify and understand deaths due to asphyxia.
Airway Obstruction ; Asphyxia* ; Atmosphere ; Autopsy* ; Classification* ; Confined Spaces ; Drowning ; Homicide ; Humans ; Korea* ; Ligation ; Male ; Suicide

The purposes of this study were to measure the service mind and customer orientation of employees and to identify the effect of service mind on customer orientation in elementary school foodservices. The questionnaires were distributed to foodservice employees of the 19 elementary schools, but collected from 12 schools in Gwangju, Gyeonggi. The statistical data analysis was completed using SPSS (ver. 18.0) for the independent sample t-test, ANOVA, Cronbach's alpha, principal component analysis, hierarchical & K-means cluster analysis, Pearson' correlation analysis, and multiple regression analysis. Foodservice employees highly rated their service mind (3.94 out of 5 points), especially their perceptions on the importance of service (4.13 points). The effort to provide service was significantly different depending on the serving place (P<0.05). Employees had a high level of customer orientation (4.02 points), which was significantly influenced by age, position, or career (P<0.05), and cook license (P<0.01). As a result of cluster analysis for service mind, employees were divided into two groups: a low-service mind group (cluster 1) and a high-service mind group (cluster 2). Cluster 2 had a significantly higher overall customer orientation than cluster 1 (P<0.001). The pride in providing services (beta=0.390, P<0.01) and the perception of the importance of services (beta=0.297, P<0.05) showed a significant and positive effect on customer orientation.
Data Interpretation, Statistical ; Humans ; Hypogonadism ; Licensure ; Mitochondrial Diseases ; Ophthalmoplegia ; Orientation ; Principal Component Analysis ; Surveys and Questionnaires

Rhinoscleroma is a chronic, granulomatous infectious lesion most frequently affecting the respiratory tract mucosa. This disease is endemic to Africa, Central and South America, South Central and Eastern Europe, the Middle East, and China. We report an extremely rare disease of nasal rhinoscleroma in Korea. The patient was a 63-yr-old man, who suffered from chronic nasal obstruction and septal deviation. Characteristic histology from a nasal biopsy was proven and special stains for bacteria were employed: periodic acid-Schiff, Warthin-Starry silver, Giemsa, and Gram stains. Isolation of Klebsiella rhinoscleromatis from a culture of nasal discharge was failed, but ultrastructural examination of numerous phagocyzed bacilli in the Mikulicz cells confirmed the diagnosis. The histiocytic nature of the Mikulicz cells was confirmed, using CD 68 and alpha-1 antitrypsin, and by the ultrastructural features of Mikulicz cells. Here, we emphasize the recognition of this rare entity in nonendemic regions, frequently leading to delayed diagnosis.
Endemic Diseases ; Fibrosis ; Human ; Klebsiella pneumoniae/*isolation & purification ; Korea ; Male ; Microscopy, Electron ; Middle Aged ; Nasal Mucosa/*microbiology/pathology/ultrastructure ; Rhinoscleroma/*pathology

Delayed cerebral necrosis is a well-known complication of radiation therapy (RT). Because of its irreversible nature, it should be avoided if possible, but avoidance occurs at the expense of potentially compromised tumor control, despite the use of the modern advanced technique of conformal RT that minimizes radiation to normal brain tissue. Risk factors for radiation-induced cerebral necrosis include a higher dose per fraction, larger treatment volume, higher cumulative dose, and shorter time interval (for re-irradiation). The same principle can be applied to proton beam therapy (PBT) to avoid delayed cerebral necrosis. However, conversion of PBT radiation energy into conventional RT is still short of clinical support, compared to conventional RT. Herein, we describe two patients with excessively delayed cerebral necrosis after PBT, in whom follow-up MRI showed no RT-induced changes prior to 3 years after treatment. One patient developed radiation necrosis at 4 years after PBT to the resection cavity of an astroblastoma, and the other developed brainstem necrosis that became symptomatic 6 months after its first appearance on the 3-year follow-up brain MRI. We also discuss possible differences between radiation changes after PBT versus conventional RT.

The renal agenesis and ectopic ureter were relatively rare congenital disease, but their combined form was more extremely rare condition. We report a case of ectopic ureteral opening associated with ipsilateral renal agenesisthat noted recurrent epididymitis in 18 month old children with review of literatures.
Child ; Epididymitis ; Humans ; Infant ; Male ; Ureter*

PURPOSE: Many investigators suggested that changes in hormonal environment in the postmenopausal women functionally or histologically effect the clitoris and vagina. We investigated the mechanism of female se xual dysfunction occurring in the decreased hormonal status, and aimed to establish and experimental base for the hormone replacement in postmenopausal women to correct sexual dysfunction. MATERIALS AND METHODS: Twenty mature female New Zealand white rabbits were randomly divided into three groups; control group, oophorectomy group, estrogen replacement group after oophorectomy. Nitric oxide synthase (NOS) activity and the degree of expression of neuronal NOS (nNOS) and endothelial NOS (eNOS), collagen content in clitoral tissues were analysed. RESULTS: nNOS and eNOS were significantly increased in the oohporectomized group while decreased in the estrogen replacement group (p<0.01). NOS activity showed the similar pattern of change (p<0.05). Oophorectomy induced a significant increase in collagen content, while the ratio of smooth muscle content was increased significantly after the estrogen replacement (p<0.01). CONCLUSIONS: Estrogen deficiency induces collagen synthesis and decreases the content of smooth muscle in clitoris, resulting in a structural relaxation difficulty. We believe that NOS becomes more active to improve the relaxation difficulty and that hormone replacement helps to restore the normal state of smooth muscle relaxation. Considering these findings, we suggest that estrogen down-regulates NOS and its activity.
Clitoris* ; Collagen ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Muscle, Smooth ; Neurons ; Nitric Oxide Synthase ; Ovariectomy ; Rabbits ; Relaxation ; Research Personnel ; Vagina

OBJECTIVE: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. METHOD: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were sub-classified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. RESULTS: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). CONCLUSION: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.
Bronchopneumonia ; Child* ; Codeine* ; Cytochrome P-450 CYP2D6 ; Diagnosis ; Drug Utilization Review ; Humans ; Inappropriate Prescribing ; Inpatients ; Insurance, Health ; Korea* ; Outpatients ; Prescriptions ; Primary Health Care ; Respiratory Insufficiency ; Rhinitis, Vasomotor

The purpose of the study was to investigate the influences of contract foodservice managers' personal characteristics, foodservice characteristics and organizational characteristics on job satisfaction, including interpersonal relationships, self-actualization and promotion opportunity categories. A survey was administered to four hundred contract foodservice managers of five large companies and five small/medium companies in the Seoul and Kyungin areas. The final response rate was 66% (N = 265), and the data were analyzed using SPSS Windows (ver. 12.0). The respondents were 76.1% female, average age 28.8 years, and 73.0% were regular workers. Contract foodservices have profit and loss contracts (69.1%), single menu types (59.6%) and buffet serving styles (37.7%). There are significant differences of job satisfaction by some personal characteristic variables (gender, martial status, age, education, position, work hours, period of working for the present company, and payroll per year) and foodservice characteristic variables (type of contract and charge of food costs). In three job satisfaction categories, foodservice managers reported the highest interpersonal relationship satisfaction, following self-actualization satisfaction and promotion opportunity satisfaction in both large companies and small/medium companies. However, foodservice managers of large companies tended to be more satisfied regarding their promotion opportunities than foodservice managers of small/medium companies (P < 0.05). Work hours, number of meals served/day, male, workload, communication with the clients, relationship with co-workers, obvious role and autonomy were significant factors to increase the job satisfaction in contract foodservices of large companies. On the other hand, relationships with co-workers and males were significant factors to increase the job satisfaction in contract foodservices of small/medium companies. This research suggests that contract foodservice companies need to understand the characteristics of their managers, foodservices and organizations to enhance the job satisfaction of foodservice managers and to develop specified human resource management strategies that can be applied to each company scale.
Contracts ; Surveys and Questionnaires ; Fees and Charges ; Female ; Hand ; Humans ; Job Satisfaction ; Male ; Meals