Significance of Knife Tip Injuries as Hesitation Marks / 대한법의학회지

Hesitation wounds are tentative, superficial incised wounds around the fatal wound(s). This study aimed to investigate the frequency and characteristic features of hesitation wounds including ordinary incised wounds and knife tip injuries as hesitation marks from the autopsy cases of suicides using sharp force instruments. The subjects were 478 cases out of 3,131 suicide cases autopsied at the Department of Forensic Medicine, School of Medicine, Kyungpook National University in Daegu, from August, 2001 to 2013. 48 cases (approximately 10%) were suicides using sharp force instruments. In 27 cases (56.3%), the sharp force was successfully applied causing suicide; 17 cases (35.4%) were so called complex suicide cases, in which two or more different methods including sharp force injury were used; and the 4 remaining cases were suicides caused by other reasons. Overall hesitation wounds had a high frequency of 33/48 cases (68.8%). The frequency of cases in which knife tip injuries were found was lower, appearing in 13/33 cases (39.3%). The most preferred sites of knife tip injuries were the abdomen (9 cases), neck (4 cases), chest (3 cases), and face (1 case) in these 13 cases, including several overlapped cases. The average number of knife tip injuries was 14.6. A total of 88.2% of knife tip injuries was found near the incised hesitation wounds or fatal wounds. In conclusion, knife tip injuries may be a significant factor in identifying hesitation wounds, and they should be precisely examined and evaluated during autopsies to determine the manner of death.

Significance of Knife Tip Injuries as Hesitation Marks / 대한법의학회지

Hesitation wounds are tentative, superficial incised wounds around the fatal wound(s). This study aimed to investigate the frequency and characteristic features of hesitation wounds including ordinary incised wounds and knife tip injuries as hesitation marks from the autopsy cases of suicides using sharp force instruments. The subjects were 478 cases out of 3,131 suicide cases autopsied at the Department of Forensic Medicine, School of Medicine, Kyungpook National University in Daegu, from August, 2001 to 2013. 48 cases (approximately 10%) were suicides using sharp force instruments. In 27 cases (56.3%), the sharp force was successfully applied causing suicide; 17 cases (35.4%) were so called complex suicide cases, in which two or more different methods including sharp force injury were used; and the 4 remaining cases were suicides caused by other reasons. Overall hesitation wounds had a high frequency of 33/48 cases (68.8%). The frequency of cases in which knife tip injuries were found was lower, appearing in 13/33 cases (39.3%). The most preferred sites of knife tip injuries were the abdomen (9 cases), neck (4 cases), chest (3 cases), and face (1 case) in these 13 cases, including several overlapped cases. The average number of knife tip injuries was 14.6. A total of 88.2% of knife tip injuries was found near the incised hesitation wounds or fatal wounds. In conclusion, knife tip injuries may be a significant factor in identifying hesitation wounds, and they should be precisely examined and evaluated during autopsies to determine the manner of death.

Articulation error of children with adenoid hypertrophy / 소아과

PURPOSE: Adenoid hypertrophy is a physical alteration that may affect speech, and a speech disorder can have other negative effects on a child's life. Airway obstruction leads to constricted oral breathing and causes postural alterations of several oro-facial structures, including the mouth, tongue, and hyoid bone. The postural modifications may affect several aspects of speech production. METHODS: In this study, we compared articulation errors in 19 children with adenoid hypertrophy (subject group) to those of 33 children with functional articulation disorders independent of anatomical problems (control group). RESULTS: The mean age of the subject group was significantly higher (P=0.016). Substitution was more frequent in the subject group (P=0.003; odds ratio [OR], 1.80; 95% confidence interval [CI], 1.23-2.62), while omission was less frequent (P<0.001; OR, 0.43; 95% CI, 0.27-0.67). Articulation errors were significantly less frequent in the palatal affricative in the subject group (P=0.047; OR, 0.25; 95% CI, 0.07-0.92). The number of articulation errors in other consonants was not different between the two groups. Nasalization and aspiration were significantly more frequent in the subject group (P=0.007 and 0.014; OR, 14.77 and 0.014; 95% CI, [1.62-135.04] and NA, respectively). Otherwise, there were no differences between the two groups. CONCLUSION: We identified the characteristics of articulation errors in children with adenoid hypertrophy, but our data did not show the relationship between adenoid hypertrophy and oral motor function that has been observed in previous studies. The association between adenoid hypertrophy and oral motor function remains doubtful.

Articulation Patterns of Children who Developed Articulation Disorders Associated with Ankyloglossia

PURPOSE: We investigated articulation patterns in children with ankyloglossia who developed articulation disorders in order to determine the relationship between ankyloglossia and articulation disorders, and to clinically detect children who have articulation disorders associated with ankyloglossia. METHODS: The participants of this study were 23 children with articulation disorders that accompanied ankyloglossia and 55 controls with functional articulation disorders independent of anatomical problems, who were admitted to our hospital from January 1, 2002 to December 31, 2012. All children underwent speech-language pathologic evaluation using the Picture Consonant Articulation Test (PCAT; Young-Tae Kim, 1994). We retrospectively compared collected data between the subject and control groups using Fisher's exact test and odds ratio tests with a 95% confidential interval for categorical variables and the independent Mann-Whitney U-test for continuous variables. RESULTS: The number of patients with articulation errors in the velar nasal was lower significantly only in the subject group (P=0.038). The total numbers of articulation errors in the bilabial plosive, velar plosive and velar nasal also were lower (P=0.007, P<0.001, and P=0.034, respectively). There were no differences in the numbers of patients with articulation errors according to phonological changes between the two groups. However, the total numbers of fronting and frication were lower in the subject group (both P<0.001), but the total numbers of plosivation and tensing were higher (P=0.002 and P=0.008, respectively). CONCLUSION: This study showed that the relationship between an articulation disorder and ankyloglossia is doubtful, although some results suggest that ankyloglossia may cause articulation errors only in certain individuals. Therefore, clinicians should be careful when determining the relationship between ankyloglossia and articulation disorders and use caution when making a treatment decision.

The Effect of the Cancer Genetic Education Program for Nurses / 종양간호학회지

PURPOSE: Advancing genetic knowledge for oncology nurses is especially important in Korea because physicians have launched to incorporate genetic risk assessment and genetic testing into their practice. The purpose of this paper was to identify the effect of the first academic cancer genetic risk assessment and counseling course for Korean nurses. METHODS: Thirty-five nurses were recruited and educated from June 8 to 14, 2006 in Seoul, Korea. Two measurement tools were used: 'knowledge about the hereditary breast and ovarian cancer (HBOC)' and 'knowledge about the cancer genetics'. RESULTS: Students' score of knowledge about HBOC at pre-education was 12.22+/-2.23, and after education, it increased to 13.62+/-1.76. This change was statistically significant (t=-3.253, p=.003). The score of knowledge about cancer genetics at pre-education was 11.31+/-3.44, and after education it has increased to 16.17+/-1.94. It also was statistically significant (t=-6.92, p=.000). CONCLUSION: This program was effective to be a starting point for establishing genetic educational planning for the oncology nurses in Korea. This academically-based course is recognized as valuable by oncology nurses. With this new knowledge, nurses can begin to expand their role in delivering comprehensive cancer care services in Korea.

A Study of the Curriculum of Genetics Nursing Education / 종양간호학회지

PURPOSE: This study was undertaken to establish the framework for development of the curriculum of genetics in Nursing Education. METHODS: The Internet search, literature review of the US system of genetic nurses, genetic graduate nursing education programs and curricula for nurse in Korea were reviewed and analyzed. RESULTS: American Nurses genetic system consists of APNG and the GCS and all the APNG credential provided by the GNCC of ISONG. The curriculums of genetic nursing education in the US are mainly conducted in of master's program and genetically related subjects consists of basic genetics subjects, basic applied genetics subjects, genetics in nursing subjects and practical training subjects. Lastly a genetic nursing education program in Korea 44 hr of lectures and practical training of 4 hr is composed of basic genetics, genetic cancer, genetics in nursing and practicum in the computer lab and online include family history assessment, pedigree construction, breast and colorectal cancer risk calculations, and ELSI discussions. CONCLUSION: This study suggested that genetic nursing education course needs in master's program as detailed subjects. Also the establishment of the genetic nurse system is an urgent needed.

Clinical Aspects of Functional Articulation Disorder

PURPOSE: Speech and language development is an useful indicator of the overall development of children. Since speech and language delay can lead to emotional, social, and learning problems, the early intervention is very important. We examined 137 children with speech or language problems including 22 children of functional articulation disorders of their clinical features. METHODS: 137 children with speech or language problems in the Department of Pediatrics, Uijeongbu St. Mary's Hospital from January 2004 to December 2007 were reviewed for sex, age, developmental and language test findings retrospectively. Especially, in 22 children diagnosed with functional articulation disorders, articulation test findings were analyzed. RESULTS: 1) The mean age of 137 children was 46.8 months, the ratio of male to female was 2.5:1, and the most frequent age group was 24-35 months. The chief complaints included language delay(67.2%), mispronouncing speech sound(27%), stuttering(3.6%), learning disability(2.2%). The diagnoses of them were developmental language disorder(70.8%), functional articulation disorders(16.1%), mental retardation(5.8%), stuttering(2.9%), tongue tie(0.7%), normal language pattern(3.6%). 2) The mean age of 22 patients with functional articulation disorders was 63 months, the ratio of male to female was 1.4:1, and the most frequent age group was 60-71 months. The mean percentage of consonant correct of Picture Consonant Articulation Test was higher in older age group. In the types of phonetic errors substitutions were most common. Distortions, omissions, and additions were followed in the order of frequency. Substitutions and distortions were common in word initial and medial but omissions in word final. It is appeared that the patients had the difficulties in pronouncing alveolar fricative, palatal affricate, liquid, and velar plosive which mature lately in older children. Mainly palatal affricate, alveolar fricative, and velar plosive were substituted for alveolar plosive and the liquid and alveolar fricative were distorted as gliding. CONCLUSION: Categorizing the cause of language and speech delay is essential to make an adequate treatment plans and decrease the late complications. The future studies for the early screening, more suitable tests in Korean, treatment guidelines or prognosis are needed.