Gua Sha is a traditional Asian medicine with different names in many Asian countries. It is a treatment to scrape the petechiae of the skin with ointment. It has generally been administered to patients with upper respiratory infections, heat syndrome, and pain. Herein, we report the case of a 31-year-old Cambodian man who was found dead at a farm accommodation. During the autopsy, multiple linear intradermal hemorrhages without subcutaneous damage were observed in the upper chest and both shoulders. The cause of death was sudden unexpected nocturnal death syndrome because he was a young Asian man who died while sleeping without specific findings. Since it is an unfamiliar traditional medicine in Korea compared to other Asian countries, forensic officers without background knowledge about Gua Sha initially suspected that he was severely assaulted or pressed against a particular object enough to cause crush asphyxia. Because of the difficulty of going to the hospital during the coronavirus disease 2019 pandemic, Gua Sha was used to treat headaches and mild fever. Therefore, this case shows that understanding the culture of other countries could be helpful for investigations especially with the increase of multicultural families in Korea.

OBJECTIVES: To evaluate the effect of obstructive sleep apnea (OSA) surgery on long-term (5-year) subjective outcomes, including sleep disordered breathing (SDB) symptoms and other complications, in patients with OSA. METHODS: We enrolled patients who underwent diagnostic polysomnography for OSA between January 2006 and December 2006 in ten hospitals. Patients either were treated for OSA or were not treated for OSA. All patients completed a brief telephone survey regarding their SDB signs and symptoms (e.g., snoring, apnea, nocturnal arousals, and daytime sleepiness), positive airway pressure (PAP) compliance, and any adverse effects of either the surgery or PAP. A positive subjective outcome for either surgery or no treatment was taken to be the alleviation of apnea, defined as a > or =50% increase in score. A positive subjective outcome (compliance) for PAP was defined as a PAP usage of > or =4 hours per night and > or =5 days per week. RESULTS: A total of 229 patients were included in this study. Patients were divided into three groups: a surgery group (n=87), a PAP group (n=68), and a control (untreated) group (n=74). The surgery group exhibited significant improvement in all SDB symptoms compared with the control group. The long-term subjective outcomes of the surgery (52.9%) and PAP (54.4%) groups were significantly better than those of the control group (25.0%). The subjective outcome of the surgery group was not significantly different from that of the PAP group. The overall surgical complication rate was 23.0% (20 of 87) in the surgery group, and 55.0% (22 of 40) of all patients with PAP experienced adverse effects. CONCLUSION: The extent of SDB symptoms was consistently improved in patients with OSA at 5 years postsurgery. Information about the potential long-term subjective outcomes should be provided to patients when considering surgery.
Apnea ; Arousal ; Compliance ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Telephone ; Treatment Outcome

0.05). Regenerated bone volume (mm3) of 1% TC-loaded SFM, SFM, and control were 36.56+/-8.50, 25.86+/-8.17, and 19.09+/-5.07 at 8 weeks postoperatively, respectively (P<0.05).CONCLUSION: The 1% TC-loaded SFM showed more bone regeneration than the SFM and the uncovered control, in guided bone regeneration.]]>
Animals ; Bone Regeneration ; Eosine Yellowish-(YS) ; Fibroins ; Hematoxylin ; Humans ; Membranes ; Parietal Bone ; Rabbits ; Silk ; Tetracycline

BACKGROUND: There have been several reports describing the capability of ginseng extracts as an adjuvant. In this study, we tested if ginsan, a polysaccharide extracted from Panax ginseng, was effective in enhancing antibody response to orally delivered Salmonella antigen. METHODS: Ginsan was treated before oral salmonella antigen administration. Salmonella specific antibody was determined by ELISA. mRNA expression was determined by RT-PCR. Cell migration was determined by confocal microscopy and flow cytometry. COX expression was detected by western blot. RESULTS: Ginsan treatment before oral Salmonella antigen delivery significantly increased both secretory and serum antibody production. Ginsan increased the expression of COX in the Peyer's patches. Various genes were screened and we found that CCL3 mRNA expression was increased in the Peyer's patch. Ginsan increased dendritic cells in the Peyer's patch and newly migrated dendritic cells were mostly found in the subepithelial dome region. When COX inhibitors were treated, the expression of CCL3 was reduced. COX inhibitor also antagonized both the migration of dendritic cells and the humoral immune response against oral Salmonella antigen. CONCLUSION: Ginsan effectively enhances the humoral immune response to orally delivered antigen, mediated by CCL3 via COX. Ginsan may serve as a potent vaccine suppliment for oral immunization.
Antibody Formation ; Blotting, Western ; Cell Movement ; Dendritic Cells ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Immunity, Humoral ; Immunization ; Microscopy, Confocal ; Panax ; Peyer's Patches ; Polysaccharides ; Prostaglandin-Endoperoxide Synthases ; RNA, Messenger ; Salmonella

BACKGROUND/AIMS: An intrahepatic cholangiocarcinoma, which has been defined as a primary adenocarcinoma from the intrahepatic bile duct to the second-order branch of the main hepatic duct, has a poor prognosis due to late diagnosis and low resectability. The purpose of this study is to define the prognostic factors that affected the survival of patients. METHODS: To evaluate the clinical manifestation and pathologic characteristics and the value of surgical management in relation to survival, we retrospectively reviewed the clinical records of 37 patients with an intrahepatic cholangiocarcinoma who had been underwent hepatic resection at the department of surgery, Hanyang University Hospital from April 1986 to April 2001. Cumulative survival rate and clinicopa-thologic factors that may influence the prognosis were analyzed statistically. Statistical significance was calculated by the Kaplan-Meier and compared by log rank test with statistical significance defined as p<0.05. RESULTS: The median survival time of the patients was 24.6 months (mean, 23.97 months), with 2 and 3-year survival rates of 33.3% and 27.3%, respectively. Univariate analysis showed that TMN stage and gross type correlated significantly with prognosis. Age, sex, tumor marker, Clonorchis Sinensis, intrahepatic duct stone and cell differentiation were not significantly correlated with prognosis. CONCLUSION: In case of the intrahepatic cholangiocarcinoma, without surgical treatment, survival time is not longer than mean 6 months from the first diagnosis. According to this study, we strongly recommend to early diagnosis and proper hepatic resection with lymph node dissection, be recommended to raise the long-term survival rate and improve the quality of life.
Adenocarcinoma ; Bile Ducts, Intrahepatic ; Cell Differentiation ; Cholangiocarcinoma* ; Clonorchis sinensis ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis ; Hepatic Duct, Common ; Humans ; Lymph Node Excision ; Prognosis ; Quality of Life ; Retrospective Studies ; Survival Rate

Idiopathic hypoparathyroidism is activating mutation of the calcium sensor receptor lead to inhibition of parathyroid hormone (PTH) secertion at inappropriately low serum ionized calcium levels and are a cause of autosomal dominant hypoparathyroidism. This disease often show slight mental retardation and associated endocrine abnormalities, most commonly hypothyroidism (without goiter) and hypogonadism. We diagnosed this in 20 year old male who presented with left foot pain with rigidity during he was treated for idiopathic epilepsy and had goiter. We report this case with a review of the literature.
Calcium ; Epilepsy* ; Foot ; Goiter ; Humans ; Hypogonadism ; Hypoparathyroidism* ; Hypothyroidism* ; Intellectual Disability ; Male ; Parathyroid Hormone ; Tetany ; Young Adult

Idiopathic hypoparathyroidism is activating mutation of the calcium sensor receptor lead to inhibition of parathyroid hormone (PTH) secertion at inappropriately low serum ionized calcium levels and are a cause of autosomal dominant hypoparathyroidism. This disease often show slight mental retardation and associated endocrine abnormalities, most commonly hypothyroidism (without goiter) and hypogonadism. We diagnosed this in 20 year old male who presented with left foot pain with rigidity during he was treated for idiopathic epilepsy and had goiter. We report this case with a review of the literature.
Calcium ; Epilepsy* ; Foot ; Goiter ; Humans ; Hypogonadism ; Hypoparathyroidism* ; Hypothyroidism* ; Intellectual Disability ; Male ; Parathyroid Hormone ; Tetany ; Young Adult

OBJECTIVES: A study was to assess the prognostic significance of ascitic anti-p53 autoantibodies in patients with advanced ovarian carcinoma. METHODS: Retrospective study was peformed in 43 ovarian carcinoma patients who presented with a significant amount of ascites at the Department of Obstetrics and Gynecology in Hanyang University Hospital between 1991 to 2000. p53 autoantibodies were determined by highly specific enzyme-linked immunosorbant assay (p53-Autoantibody ELISAplus, CAT QI A53, A CN Bioscience Company, Boston). The 'positive' and 'negative' group were categorized on the basis of the presence of anti-p53 autoantibodies. The clinicopathologic characteristics, disease free survival and overall survival rate in each groups were compared. Statistical analysis was performed by X2 and independent sample t-test. RESULT: Ascitic anti-p53 autoantibodies were found in 16% (7/43) of the study patients. The positive rates were revealed as follows : serous 15% (2/13), mucinous 11% (2/17), undifferentiated, 42% (3/7) in histologic type ; stage I/II5% (1/21), III/IV 27% (6/16); grade I/II12% (3/26), III 24% (4/17). There was no correlation between clinicopathologic characteristics and the presence of ascitic anti-p53 autoantibodies except the stage of disease. The overall survival rate revealed no significant statistical meaning (20.0 vs 35.7 months, p=0.492). In contrast, disease free survival rate was decreased in positive group. (10.0 vs 24.7 months, p=0.032). A significance association was observed between presence of ascitic anti-p53 autoantibody and response to chemotherapy. Ascitic anti-p53 autoantibodies were detected in only 3 (16%) of 18 patients who achieved pathological partial and complete response, but it was detected in 3 (75%) of 4 patients who did not respond to chemotherapy (p=0.046). CONCLUSION: The presence of p53 autoantibodies in ascites is tend to be associated with advanced stage and poorly differentiated group. A significant correlation was observed between presence of ascitic p53 autoantibodies and decrease in disease free survival rate suggesting that it is related to poor prognosis. Moreover, presence of ascitic p53 autoantibodies was also related to chemoresistance. But since this study is retrospective and based on very limited case, further study is warranted to be performed prospectively and based on larger number of study group.
Animals ; Ascites ; Autoantibodies* ; Cats ; Disease-Free Survival ; Drug Therapy ; Gynecology ; Humans ; Mucins ; Obstetrics ; Prognosis ; Qi ; Retrospective Studies ; Survival Rate

PURPOSE: This study is to evaluate the effectiveness on patency rates of two silicone tube intubation comparing with one silicone tube intubation in endonasal dacryorhinostomy. METHODS: The 99 patients' charts were reviewed on patency rate and the cause of failure in patients with nasolacrimal duct obstruction, who had undergone endonasal DCR with two sets of silicone tube intubation. Another 100 patients who underwent endoscopic DCR with single silicone tube intubation, were enrolled in this study as the control group to compare the patency rates and the causes of failure between the two groups. RESULTS: Double silicone tube intubation group showed much higher lacrimal patency rates (89.9%) than that (84.0%) of single silicone intubation group. It seems to be due to less membrane formation (4%) at the site of internal ostium by sufficient bougination in two silicone tube intubation group compared with one silicone tube intubation group (16%). Two silicone tube intubation in endonasal DCR was more effective in preserving the lacrimal patency and avoidance of membranous obstruction at newly created nasal ostium (P=0.03). There were no significant differences in the size of nasal cavity, sex and age distributions, and postoperative cares between the two groups. CONCLUSIONS: Two silicone tube intubation can be considered to be a method of improving success rate in endonasal DCR.
Age Distribution ; Dacryocystorhinostomy* ; Humans ; Intubation* ; Membranes ; Nasal Cavity ; Nasolacrimal Duct ; Silicones*

OBJECTIVES: It is now conventional practice to use human chorionic gonadotropin (hCG) as the marker of tumor activity in gestational trophoblastic disease (GTD). The interpretation of serial serum beta-hCG regression patterns is important in monitoring the course of the disease. The purpose of this study was to establish a regression time and pattern of the serum beta-hCG in which GTD is divided into hydatidiform mole and malignant trophoblastic disease. MATERIALS & METHODS: During the period from January 1990 through December 2000, 46 patients with GTD were histopathologically diagnosed and treated at the department of Obstetrics and Gynecology in Hanyang University Hospital. For the purpose of analysis and comparison, patients were divided into 19 cases of hydatidiform mole and 27 cases of malignant trophoblastic disease which was subdivided into nonmetastatic (17) and metastatic (10). Patients were followed clinically and by weekly estimations of quantitative serum beta-hCG until negative (<3 mIU/ml). After three consecutive negative beta-hCG, serum beta-hCG were drawn monthly in all patients for one year. The level of serum beta-hCG was detected by two-site sandwich immunoassay (Chiron Diagnostics Automated Chemiluminescence System 180). The obtained data were analyzed using t test and ANOVA test by SPSS. RESULTS: The incidence of the GTD compared with delivery was one per 182.7 deliveries. The mean value of serum beta-hCG regression time in hydatidiform mole was 12.8+/-1.1 (SEM) weeks (7.0-26.0 weeks) and 17.9+/-1.4 (SEM) weeks (8.0-34.0 weeks) in malignant trophoblastic disease. The regression time was significantly shorter in hydatidiform mole than that of malignant trophoblastic disease (P<0.01). The differences of mean value of serum beta-hCG regression time between the groups with nonmetastatic (18.0 weeks) and metastatic (17.8 weeks) were not statistically significant(P =0.946). The mean values of serum beta-hCG in both hydatidiform mole and malignant trophoblastic disease declined following a log-normal distribution. CONCLUSIONS: The regression pattern of serum beta-hCG in present study was similar to that of which in Western and also similar to that of which in Korea in 1980s. The present study supports the continued use of individual patients serum beta-hCG regression curve to make treatment decision and to recognize malignant trophoblastic disease promptly.
Chorionic Gonadotropin ; Female ; Gestational Trophoblastic Disease* ; Gynecology ; Humans ; Hydatidiform Mole ; Immunoassay ; Incidence ; Korea ; Luminescence ; Obstetrics ; Pregnancy ; Trophoblasts