Usefulness of Dipstick Test for Vitreous Glucose in Autopsy Practice / 대한법의학회지

The concentration of glucose in the vitreous humor serves as an important diagnostic marker for diabetic mellitus in post-mortem examinations, as the vitreous humor can be easily collected and the glucose test using vitreous humor is not significantly affected by cell autolysis and hemolysis. For a quick and effective glucose test, we suggest a dipstick test of the vitreous humor during autopsy. The results were evaluated and compared with other methods for significance testing. In this study, vitreous humor was analyzed from 257 autopsy cases. Qualitative concordance rate of the dipstick test for glucose and the hexokinase test was 98.7%, positive prediction rate was 89.6%, and negative prediction rate was 100%. However, there was no significant correlation between the dipstick glucose test and the hexokinase test. We conclude that the dipstick glucose test is effective and useful for post-mortem glucose screening testing and for additional post-mortem diabetes testing. Recently, the importance of post-mortem glucose testing has increased with the increase in deaths from diabetes complications. The use of the dipstick glucose test in autopsy practice can improve forensic medicine in Korea.

Current Approaches for Carpal Tunnel Syndrome

With advancement in biomechanical and biological research on idiopathic carpal tunnel syndrome, the insight on the pathophysiology of carpal tunnel syndrome has gained much clinical relevance. Open carpal tunnel release is still a gold standard procedure for carpal tunnel syndrome, which has evolved into mini-open procedure with development of new devices. Endoscopic carpal tunnel release has become popular in recent practice of hand surgery with an advantage of early recovery of hand function with minimal morbidity. However, endoscopic carpal tunnel release has its own limitation such as long learning curve with obvious surgical risk reported in the literature. In this review article, various treatment protocols for idiopathic carpal tunnel syndrome are presented with special highlight on endoscopic carpal tunnel release, which is gaining popularity in current practice.

Sudden Unexpected Death Due to Medulloblastoma / 대한법의학회지

The majority of deaths due to intracranial tumors are preceded by long periods of symptoms, resulting in diagnosis of the tumors. And introduction of CT and MRI have led to increased early detection of intracranial tumors. Nonetheless, sudden unexpected deaths from intracranial tumors are rarely encountered at autopsy. We report an autopsy case of 2-year-old boy who died from medulloblastoma.

A Self-inflicted Pneumatic Nail Gun Head Injury / 대한법의학회지

A nail gun is a type of a tool used to drive nails into some kinds of hard materials. In this paper, an unusual case of intracranial penetrating nail gun injury is presented. The body of a badly charred man was found following a house fire. Autopsy revealed four intracranial nails in the occipital area. Also, tears of the stomach and diaphragm were found. Carbon monoxide saturation of a blood sample was a 5.2% and a small amount of soot was present in larynx and trachea. Subsequent investigation of the circumstance and autopsy findings strongly suggest that the deceased had shot himself in the head with a pneumatic nail gun and had died by self immolation.

Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture

PURPOSE: To compare retrospectively the antegrade and retrograde nailing in the management of ipsilateral femoral neck and shaft fractures. MATERIALS AND METHODS: Thirty-two patients (thirty-three injuries) were included in this study. Mean age of patients was 38 years-old in the antegrade nailing group (16 injuries) and 44 years-old in the retrograde nailing group (17 injuries). We compared the union of fractures and complications between two groups, and investigated the influencing factors. RESULTS: Femoral shaft fracture was united in 10 cases (63%) of antegrade group and 12 cases (71%) of retrograde group, at 28.2 and 27.3 weeks respectively. Nonunion was more prevalent in Winquist-Hansen III and IV (5 in antegrade nailing, 3 in retrograde nailing) than I and II. Femoral neck fracture was united with 1 case of nonunion in each group. Nonunion developed from Garden stage IV, but fractures of Garden stage I and II united regardless of methods. CONCLUSION: In ipsilateral femoral neck and shaft fractures, the kinds of methods did not affect the results of shaft fractures. Minimally displaced neck fractures also were not influenced by kinds of methods, but retrograde nailing may have a benefit in fixing the displaced neck fractures

Retrograde Intramedullary Nailing for the Treatment of Ipsilateral Femoral Shaft and Neck Fracture / 대한정형외과학회잡지

PURPOSE: To evaluate the results of the operative method for ipsilateral femoral shaft and neck fractures using retrograde nailing technique. MATERIALS AND METHODS: Seventeen fractures (sixteen patients), followed-up more than 1 year, were included in this study. There were 14 men and 2 women, and the mean age was 44 years-old. According to the Winquist-Hansen classification, type II was most common with 11 cases. In femoral neck fractures, type B was most common with 13 cases according to AO-OTA classification and 6 of them were type II in Garden stage. After retrograde nailing of femoral shaft fractures, neck fractures were fixed by cannulated screw or dynamic hip screw. RESULTS: The average time for union of shaft fractures was 27.3 (14-60) weeks. Nonunion occurred in five patients, who required bone grafts or changes of fixation. The average time for union of neck fractures was 11 (8-12) weeks. All united, except for one case of nonunion with avascuar necrosis, which was a Garden stage IV fracture. Functional results using Friedman-Wyman criteria were good in 16 cases, and fair in one. The only fair result was nonunion of the femoral neck, which had the joint arthroplasty. CONCLUSION: Although the union rate of femoral shaft must be improved, retrograde nailing can provide an easy fixation and a favorable result for ipsilateral femoral neck fractures.

Histopathological Findings of Cardiac Conduction System of Korean / 대한법의학회지

One hundred and thirty three heart specimens were collected from the cases submitted fo autopsy in the Department of Forensic Medicine in the Central District Office of National Institute of Scientific Investigation in January 2003-March 2004 and April-November 2005. The cardiac conduction system(CCS) of these heart were examined in order to find out histopathological changes in the CCS of Korean people and their forensic pathological significance. There were 98 males and 35 females. Almost all age groups were included. The results revealed that in the most of the people the fibrosis and fatty infiltration in the CCS increased with aging. The pathologic findings that may be causing arrhythmia, include 10 cases of severe narrowing of the sinoatrial(SA) or atrioventricular(AV) artery by fibromuscular hyperplasia(FMH), 9 cases of anomalous conduction fibers arising from atrioventriular node or His bundle, 5 cases of focal myocarditis of CCS were identified in this study. The authors concluded that routine examination of the CCS is helpful for revealing disease of the CCS and improving the quality of forensic pathologic diagnosis.