Exploring the Relationship between Psychosocial Risk Factors and Sudden Unexplained Infant Death: A Study of Autopsy Cases from a Perspective of Child Welfare / 대한법의학회지

Infants who are born between 24 hours and 1 year of age require extreme caution in their care due to their fragility. However, if there are multiple risk factors associated with the infant, caretaker, household, and surrounding circumstances, providing proper and appropriate care becomes problematic. This difficulty in caring for infants can contribute to abuse, neglect, or even death. This study investigates unexplained infant deaths that occur in the presence of multiple psychosocial risk factors. This study aimed to explore the relationship between various psychosocial risk factors and sudden, unexplained infant deaths. We examined nine cases from the autopsy archive of the National Forensic Service using a statistical approach. Among these cases, three were subject to legal action, while six were closed without further legal process. Although it was difficult to establish a clear relationship between death and abuse or neglect in the six cases, all were found to have experienced a harsh environment that was similar to abuse or neglect. We discuss the implications of our findings for understanding infant deaths and legal outcomes and propose a new framework to understand the deaths of infants.

Two Cases of the Postmortem Testing of Ethyl Glucuronide and Beta-hydroxybutyrate for Chronic Alcoholism / 대한법의학회지

To determine chronic alcoholism (or alcohol abuse) in postmortem cases, investigating the evidence in incident (or medical) reports is important, but it may not be certain. The indicator of alcohol abuse over long time periods was analyzed from hair as ethyl glucuronide (EtG). Beta-hydroxybutyrate (BHB) was analyzed from blood as a representative indicator of ketosis. Moreover, the blood was analyzed for ethanol (ethyl alcohol, EtOH) and EtG before death to determine drinking. Case 1 had chronic alcoholism and a history of diabetic disease. EtG concentration was 1,244 pg/mg in hair, and BHB in the blood was 276 mg/L. EtOH was less than 0.010% in the blood, however EtG was 0.38 mg/ L as drinking positive. Case 2 had a habit of drinking well, with EtG in hair of 54 pg/mg, BHB in the blood of 371 mg/L, EtOH of < 0.010%, and EtG of 0.81 mg/L.Although the EtOH was not detected in the blood, it was evaluated that alcohol was consumed before death, due to the EtG detected. In conclusion, forensic information from simultaneous analysis of EtG and BHB in biological samples (hair or blood) could be more cause of death effective assistant in chronic alcoholism (or alcohol abuse).

The Estrogen and Progesterone Receptor Expressions in Thyroid Nodules / 대한내분비외과학회지

PURPOSE: Thyroid cancer is the most common malignancy affecting the endocrine glands. The incidence of his malady has conspicuously increased during the recent years. Thyroid diseases affect women approximately 3 times more often than men, and this incidence decreases after menopause. This gender difference has suggested that the female sex steroids stimulate the growth of the thyroid, the same as for the breast. In the present study, we investigated the expressions of estrogen receptor (ER) and progesterone receptor (PR) in thyroid lesions. METHODS: The tissues from 193 human thyroid glands (136 thyroid cancers and 57 adenomatous hyperplasias) were used for the present immunohistochemical assessment of the ER and PR expressions. RESULTS: The incidences of the estrogen and progesterone receptor positive cases were 19.7 and 41.5%, respectively. The incidence of the progesterone receptor positive cases was higher for females (46.5%) than for males (19.4%) however, the expression of estrogen receptor was not different significantly between the females and males. Higher expressions of estrogen and progesterone receptors were detected in the thyroid cancers than in the adenomatous hyperplasias. The PR expression seemed to correlate with the tumor size: a higher PR expression was found in the T3 cancers than in the T2 cancers. CONCLUSION: Our findings provide new insight that the ER and PR expressions may be related to the pathogenesis and progression of thyroid cancer.

Clinical Review and Operative Management in Patients of Symptomatic Hepatic Cysts / 한국간담췌외과학회지

BACKGROUND/AIMS: Hepatic cysts are incidentally found at laparotomy or through abdominal imaging studies. When they become symptomatic, treatment is indicated. The aim of this study is to evaluate many options of their management, especially about surgical methods. METHODS: Data were retrospectively analyzed from the clinical charts of 21 patients undergoing surgery for symptomatic hepatic cysts from January, 1995, through December, 2002 in department of Surgery, Pusan University Hosipital. Charts were obtained from the original hosipital referral. We considered the following variables for analysis: age, sex, symptoms, hepatic cyst location, size, operative methods, histological confirm, postoperative morbidity and mortality, length of postoperative hosipital stay, and follow-up outcome. RESULTS: Mean age of the 21 patients was 53 years. The ratio of male and female was 1:4.3. Their main symptoms were right upper quadrant pain or discomfort, epigastric pain, and abdominal distension. Rarely, palpable mass, dyspepsia, mild jaundice, and acute abdominal pain from ruptured hepatic cyst were observed. Preoperative abdominal ultrasound and computed tomographic scannig were done in all patients. The mean size of hepatic cysts was 9.04 cm in computed tomographic scanning. The 61.9% of patients had the location in right lobe. Simple cyst was characterized by homogeneous, low attenuated and unilocular mass in computed tomographic scanning: in difference, biliary cystadenoma, internal intervening septation and papillary infoldings with cyst itself. Fifteen patients underwent partial cystectomy and 4, complete cystectomy and 1, non-anatomical hepatic resection and 1, left lateral segmentectomy. Hepatic cysts were consisting of 15 cases of simple cyst, 4 cases of biliary cystadenoma, 1 case of Caroli's disease and 1 case of polycystic liver disease. Postoperative complication was bile leakage in one case. No symptomatic recurrence occured during a mean follow-up period of 42.5 months. CONCLUSION: According to the characteristics of symptomatic hepatic cyst, proper operative methods of management were considered. More long-term follow-up is necessary but in simple cyst in histological type, partial cystectomy can be the acceptable technique, complete cystectomy or hepatic resection should be perfomed in biliary cystadenoma for recurrence and malignant potential.