Transfusion support in hematopoietic stem cell transplantation

Transfusion support for hematopoietic stem cell transplantation (HSCT) is an essential part of supportive care, and compatible blood should be transfused into recipients. As leukocyte antigen (HLA) matching is considered first and as the blood group does not impede HSCT, major, minor, bidirectional, and RhD incompatibilities occur that might hinder transfusion and cause adverse events. Leukocyte reduction in blood products is frequently used, and irradiation should be performed for blood products, except for plasma. To mitigate incompatibility and adverse events, local transfusion guidelines, hospital transfusion committees, and patient management should be considered.

The Role of Medical Examiners in Organ or Tissue Procurement of the Brain Dead People / 대한법의학회지

In the western countries, forensic pathologists under their rational postmortem investigation system do their appropriate role before or during all process of transplantation. As it is ongoing remarkable development in the transplantation medicine and it is more and more increased the number of would-be transplant patients, organ procurement from the brain dead will expand than ever. Considering the major causes of brain death which are cerebrovascular diseases, traffic accidents, and head injuries, the role of forensic doctors has to be more important in transplantation. Reviewing literatures and reporting our case which was requested for forensic consultation before the organ procurement because this case was related with violence and the cause of death was obscure, we would like to discuss and develop the systematic and organizational approach about the role of forensic pathologists in transplantation medicine in Korea.

Alteration of Ventricular Repolarization by Intracoronary Infusion of Normal Saline in Patients With Variant Angina

BACKGROUND AND OBJECTIVES: During coronary angiography and interventional procedures, catheters that are engaged in a coronary ostium are routinely flushed, typically with normal saline, to expel blood from the catheter or to inject a pharmacologic agent. Saline contains sodium and chloride ions. Such injections may affect the electrophysiologic properties of the myocardium; however, the effect of normal saline on ventricular repolarization has not been established in patients with variant angina. SUBJECTS AND METHODS: We studied 51 consecutive patients with variant angina. Five mL of normal saline (NS) or 5% dextrose solution (DW) were infused into the left coronary artery in random order. We measured the heart rate, QT interval, and T-wave amplitude using Mac-Lac 5.2. RESULTS: The baseline clinical characteristics were not different between the NS {n=30 (14 males); mean age, 56+/-10 years} and the 5% DW groups {n=21 (7 males); mean age, 59+/-10 years}. The changes in the mean corrected QT (QTc) interval were significantly increased at the time of infusion of NS compared to 5% DW (45.1+/-30.3 vs. 20.9+/-23.3 ms, p=0.004). There was a T-wave amplitude change >0.2 mV in at least one-lead in 27 patients (90.0%) during NS infusion compared to 7 patients (33.3%) during 5% DW infusions (p=0.001). No significant changes in heart rate and blood pressure were noted during of the infusions. CONCLUSION: NS was associated with prolongation of ventricular repolarization in patients with variant angina.

The Statistical Analysis on Legal Autopsy in 2006 (The Headquarters of National Institute of Scientific Investigation) / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2006. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,515 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 1,788 cases(71.1%) and that of female 727(28.9%). Male was over twice more than female. The forties were 709 cases(28.2%), the fifties 496(19.7%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,437 cases(57.1%), natural 955(38.0%), and the unknown 123(4.9%). Among 1,437 unnatural deaths, suicide was 366(25.5%), homicide 387(26.9%), accident 392(27.3%), and the unclear 292(20.3%). Homicide occupied 40.4% of trauma, 51.9% of blunt force injury excluding traffic and fall-down injury, and 91.2% of sharp force injury. The homicide rate in asphyxia was 33.2%, but it went up to 71.4% excluding hanging. It showed only 1.3% percent of homicide in poisoning. 3. Traumatic deaths were 681 cases, occupying 47.4% of 1,437 unnatural deaths, followed by drowning deaths(199 cases). Blunt trauma was 206 cases(30.2%) and the leading cause of death in traumatic death. Poisoning was 158 cases, among which the cyanides were dominant(37cases). Thermal injuries were 144 cases, electrocution 14 cases, and starvation/neglect 21 cases. and 17 cases were directly due to medical procedures. 4. Among 955 natural deaths, heart diseases were 495 cases(51.8%), and vascular diseases 165(17.3%), and these two categories were added up to 660(69.1%). 5. Child deaths under the age of 10 were 118 cases. Homicide was 35 cases(57.4%) out of 61 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 45 cases(38.1%)

Post-traumatic primary bacterial peritonitis / 대한법의학회지

Spontaneous bacterial peritonitis (SBP) is a bacterial infection of ascites arising from liver cirrhosis, nephrotic syndrome and so on. Primary bacterial peritonitis (PBP) is a rare intraabdomial infection in the absence of underlying diseases or rupture of the viscus. The authors report an autopsy case of posttraumatic primary bacterial peritonitis in the otherwise physically healthy young female. She was beaten repeatedly around the abdomen with human physical instruments for a prolonged time.

Sudden death due to epiglottic abscess / 대한법의학회지

Acute epiglottitis is a local bacterial infection of the supraglottic area. Epiglottitis is generally caused by organisms which invoke an inflammatory response that develops rapid obstructive edema. The disease rarely progresses to abscess stage, either because medical intervention is sought or death by asphyxiation ensues. A 38-year-old, mentally ill but physically healthy woman died of airway obstruction caused by acute epiglottitis forming an abscess. She died unexpectedly and suddenly showing only minor nonspecific symptoms.

A Statistical Analysis on Legal Autopsy in 2005 (The Headquarters of National Institute of Scientific Investigation) / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation (NISI), requested by every kind of law enforcement agencies during the year of 2005. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,851 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,007 cases (70.4%) and that of female 844 (29.6%). Male was over twice more than female. The forties were 807 cases (28.3%), the thirties 573 (20.1%), and these two decades occupied 48.4%. 2. Unnatural deaths were 1,716 cases (60.2%), natural 1011 (35.5%), and the unknown 124 (4.3%). Among 1,716 unnatural deaths, suicide was 497 (29.0%), homicide 426 (24.9%), accident 510 (29.6%), and the unclear 283 (16.5%). Homicide occupied 42.0% of trauma, 75.6% of blunt force injury excluding traffic and fall-down injury, and 85.5% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 60.1% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 716 cases, occupying 41.7% of 1,716 unnatural deaths, followed by asphyxial deaths(296 cases). Blunt trauma was 205 cases (28.6%) and the leading cause of death in traumatic death. Poisoning was 229 cases, among which the ethanols were dominant (58cases). Thermal injuries were 198 cases, electrocution 20 cases, and starvation/neglect 14 cases. and 18 cases were directly due to medical procedures. 4. Among 1,011 natural deaths, heart diseases were 481 cases (47.6%), and vascular diseases 193 (19.1%), and these two categories were added up to 674 (66.7%). 5. Child deaths under the age of 10 were 129 cases. Homicide was 40 cases (62.5%) out of 64 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 41 cases(31.8%)

The Statistical Analysis on Legal Autopsy in 2004 (The Headquarters of National Institute of Scientific Investigation) / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2004. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 3,051 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,214 cases(73%) and that of female 837(27%). Male was over twice more than female. The forties were 899 cases(29.5%), the thirties 561(18.4%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,816 cases(59.5%), natural 1,104(36.2%), and the unknown 131(4.3%). Among 1,816 unnatural deaths, suicide was 513(28.2%), homicide 414(22.8%), accident 505(27.8%), and the unclear 384(21.2%). Homicide occupied 38.4% of trauma, 62.9% of blunt force injury excluding traffic and fall-down injury, and 82.7% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 67.7% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 779 cases, occupying 42.9% of 1,816 unnatural deaths, followed by poisoning deaths(286 cases) and asphyxial deaths(283 cases). Blunt trauma was 240 cases(30.8%) and the leading cause of death in traumatic death. Poisoning was 286 cases, among which the ethanols were dominant( 76cases). Thermal injuries were 162 cases, electrocution 27 cases, and starvation/neglect 7 cases and 17 cases were directly due to medical procedures. 4. Among 1,104 natural deaths, heart diseases were 522 cases(47.3%), and vascular diseases 182(16.5%), and these two categories were added up to 704(63.8%). 5. Child deaths under the age of 10 were 147 cases. Homicide was 31 cases(51.7%) out of 60 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 48 cases(32.7%).

The Statistical Analysis on Legal Autopsy in 2003: The Headquarters of National Institute of Scientific Investigation / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation (NISI), requested by every kind of law enforcement agencies during the year of 2003. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 3,167 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,311 cases (73%) and that of female 856 (27%). Male was over twice more than female. The forties were 838 cases (26.5%), the thirties 700 (22.1%), and these two decades occupied 48.6%. 2. Unnatural deaths were 1,941 cases (61.3%), natural 1,133 (35.8%), and the unknown 93 (2.9%). Among 1,941 unnatural deaths, suicide was 522 (26.9%), homicide 457 (23.5%), accident 576 (29.7%), and the unclear 386 (19.9%). Homicide occupied 37.1% of trauma, 57.4% of blunt force injury excluding traffic and fall-down injury, and 81.9% of sharp force injury. The homicide rate in asphyxia was 35.5%, but it went up to 69.6% excluding hanging. It showed only 1.0% percent of homicide in poisoning. 3. Traumatic deaths were 902 cases, occupying 46.5% of 1,941 unnatural deaths, followed by poisoning deaths (289 cases) and asphyxial deaths (286 cases). Blunt trauma was 324 cases (35.9%) and the leading cause of death in traumatic death. Poisoning was 289 cases, among which the ethanols were dominant (99cases). Thermal injuries were 192 cases, electrocution 24 cases, and starvation/neglect 11 cases. and 15 cases were directly due to medical procedures.4. Among 1,133 natural deaths, heart diseases were 490 cases (43.2%), and vascular diseases 210 (18.5%), and these two categories were added up to 700 (61.7%). 5. Child deaths under the age of 10 were 135 cases. Homicide was 42 cases (63.6%) out of 60 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 52 cases (38.5%).

The Statistical Analysis on Legal Autopsy in 2002: The Headquarters of National Institute of Scientific Investigation / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2002. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 3,045 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,199 cases (72.2%) and that of female 846 (27.8%). Male was over twice more than female. The forties were 766 cases (25.2%), the thirties 692 (22.7%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,810 cases (59.5%), natural 1082 (35.5%), and the unknown 153 (5.0%). Among 1,810 unnatural deaths, suicide was 416 (23.0%), homicide 394 (21.8%), accident 592 (32.7%), and the unclear 408 (22.5%). Homicide occupied 33.3% of trauma, 49.3% of blunt force injury excluding traffic and fall-down injury, and 88.2% of sharp force injury. The homicide rate in asphyxia was 31.7%,but it went up to 59.2% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 867 cases, occupying 47,9% of 1,810 unnatural deaths, followed by poisoning deaths (269 cases). Blunt trauma was 284 cases (32.8%) and the leading cause of death in traumatic death. Poisoning was 269 cases, among which the agrochemicals were dominant (64cases). Thermal injuries were 193 cases, electrocution 16 cases, and starvation/neglect 9 cases. and 17 cases were directly due to medical procedures.4. Among 1,082 natural deaths, heart diseases were 450 cases (41.6%), and vascular diseases 186 (17.2%), and these two categories were added up to 636 (58.8%). 5. Child deaths under the age of 10 were 179 cases. Homicide was 35 cases (37.2%) out of 94 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 48 cases (26.8%)

An Analysis on Legal Autopsy Under 1Year of Age / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies under 1 year of age performed at the Headquarters of the National Institute Scientific Investigation, requested from law enforcement agencies from 1996 to 2000. This report aims to analyse various aspects of 530 unusual deaths under 1 year of age in Korea, chiefly Seoul and its surrounding area. Male was 55.8% and female was 44.2%. Unnatural deaths were 39.6%, natural 53.4%, and the unknown 7.0%. Homicide occupied 66.7% in unnatural death and asphyxia was 41.4%, starvation and neglect 35.0%, and trauma 20.7% in homicide. Smothering was the leading cause of asphyxial homicide and accidental death. Natural death including perinatal disorders, sudden infant death syndrome and congenital malformations was the main cause of death in this age group.

Pulmonary Thromboembolsm in Legal Autopsy / 대한법의학회지

Pulmonary thromboembolism (PTE) is a significant cause of death in the hospitalized patient in the western and developed countries. The development of PTE and venous thrombi is associated with many and various factors, including that physicians fail to provide adequate prophylaxis to the high risk patients. The authors studied 74 legal autopsy cases performed from 1996 to 2000 at the Headquarters of National Institute of Scientific Investigation, Seoul, Korea. We learned that ceasarian section was the most common precedong trauma in PTE death in legal cases. Excluding Ceasarian section cases, major mechanical injuries, male gender and aging were common factors associated with PTE. Obesity was a common factor in all kinds of trauma. Deep vein thrombi were documented in majority cases and ambulation was a critical triggering cause for the thrombi making PTE. Clinical diagnosis was not so satisfactory.

The Statistical Analysis on Legal Autopsy in 2001: The Headquarters of National Institute of Scientific Investigation / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2001. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City, and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,807 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,043 cases (72.8%) and that of female 764 (27.2%). Male was over twice more than female. The forties were 723 cases (25.8%), the thirties 641 (22.8%), and these two decades occupied 48.6%. 2. Unnatural deaths were 1,690 cases (60.2%), natural 1020 (36.3%), and the unknown 97 (3.5%). Among 1,690 unnatural deaths, suicide was 415 (24.6%), homicide 418 (24.7%), accident 505 (29.9%), and the unclear 352 (20.8%). Homicide occupied 37.1% of trauma, 44.1% of blunt force injury excluding traffic and fall-down injury, and 83.5% of sharp force injury. The homicide rate in asphyxia was 32.5%, but it went up to 62.7% excluding hanging. It showed only 1.0% of homicide in poisoning. 3. Traumatic deaths were 825 cases, occupying 48,8% of 1,690 unnatural deaths, followed by asphyxial death (249 cases). Blunt trauma was 295 cases (35.8%) and the leading cause of death in traumatic death. Poisoning was 213 cases, among which the agrochemicals were dominant (68 cases). Thermal injuries were 193 cases, electrocution 31 cases, and starvation/neglect 10 cases. 36 cases were direct- 4. Among 1,020 natural deaths, heart diseases were 398 cases (39.0%), and vascular diseases 145 (14.2%), and these two categories were added up to 543 (53.2%). 5. Child deaths under the age of 10 were 194 cases. Homicide was 43 cases (48.9%) out of 88 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 64 cases(33.0%).

Comparison between the Presumed and the Most Possible Cause of Death in Unusual Cases: Legal Autopsy performed by The Headquarters of National Institute of Scientific Investigation in 2000 / 대한법의학회지

This is a comparative study based on the data of legal autopsies performed at the National Institute of Scientific Investigation, Seoul, during the year of 2000. In South Korea, the pathologists usually do not attend the death scene, and the scene investigation is performed only by the law enforcement agency. The latter collects the information needed for clarifying the cause and manner of death. The authors tried to estimate the efficiency of the death investigation through the discrepancy between the presumed and the most possible cause of death. We presumed the cause of death on the ground of police investigation and external examination by the general physicians, The most possible cause of death means the best diagnosis after autopsy by pathologists, with the consideration of police information. Followings are the summary of the results. The coincidence rate with the most possible death are over 90% in presumed trauma, asphyxia, thermal injuries, electrocution, starvation/neglect, and over 80% in drowning and natural deaths. The rate was low in medical injuries(26.6%) and poisoning(67.2%). 7.3 to 8.2% were natural in presumed blunt trauma, traffic injury and fall down injuries. Among 48 cases of presumed ligature strangulation, 6 were other type of asphyxia or other injuries, and 2 unknown. The coincidence rate was only 30.8% in acute alcohol poisoning. 5.9% of presumed fire death was proved other type of violent injuries. In the field of medical practices, only 6.3% of accused general medical procedures were proved dead due to themselves. But the rate was increased up to 49.0% in presumed surgery/anesthetic deaths. 12.9% were violent death in presumed natural death, and 64.6% were dead due to violent causes in the cases of no presumable cause of death.

A case of Delayed Renavascular Hypertension in Stab Injury Induced Renal Artery-IVC Fistula and Its Renal Artery Aneurysm / 대한신장학회잡지

Renovascular hypertension is the most common cause of curable hypertension. The exact prevalence of renovascular hypertension is not known, and the diagnosis is probably missed in many patients. It is important to recognize this condition in clinical practice, first, because it is a correctable form of secondary hypertension, and second, it is a reversible cause of renal failure in some patients. The Basic lesion of renovascular hypertension is stenosis of the renal artery caused usually by either one of the two most common etiologies, atherosclerosis or fibromuscular dysplasia. Other known causes of renovascular hypertension include aneurysm, embolism, arterio venous fistula, neurofibromatosis, tumor, hematoma, foreign body induced compression, and trauma. Its treatment can be divided into surgical intervention, percutaneous transluminal balloon angioplasty, and medical therapy. Recently, selective embolization has been introduced as a useful alter native therapeutic modality in the management of arterio venous fistula and aneurysm. We report a case of delayed renovascular hyper-tension in stab injury induced renal artery-IVC fistula and its renal artery aneurysm in a 20 year-old man. Embolization of the renal arterio venous fistula was achieved by inserting a detachable balloon, and embolization of the renal aneurysm and lumbar artery pseudoaneurysm was performed using micro-eo-ils. Arteriogram immediately after embolization con- firmed complete occlusion of the ancurysm and closure of the arterio venous fistula. After the procedure, improvement of blood pressure was noted in the patient who is currently being followed-up on an out-patient basis.

Diagnostic Significance of ECG Ergonovine Provocation Test in Patients with Vasospastic Angina

BACKGROUND: The diagnostic significance of ECG ergonovine test and the incidence of vasospastic angina in patients with chest pain are still uncertain. METHODS: From May 1998 to June 1999, 133 consecutive patients with chest pain were admitted for diagnostic coronary angiography. ECG ergonovine provocation tests were performed in 64 patients who have a clinical history suggesting vasospatic angina, including 27 of 28 patients with vasospastic angina documented electrocardiographically, or who's coronary angiographic findings could not be explained by their clinical history. Ergonovine was administered intravenously in incremental dose of 0.05, 0.1, 0.2, 0.3, 0.4 mg up to total cumulative dosage of 1.0mg during coronary angiography(41 cases), in the exercise laboratory(21 cases) or both(2 cases). RESULTS: Of 133 patients with chest pain, vasospastic angina was documented in 32(24%), unstable angina in 52(34%), stable angina in 10(8%), and others in 39(29%). Angiography demonstrated coronary spasm in 4 additional patients as well as 22 patients with vasospastic angina documented electrocardiographically, but ergonovine tests in the exercise laboratory showed positive response in 5 of 6 patients with vasospastic angina documented. Among the 25 patients with coronary spasm proved angiographically during ergonovine test, ECG findings at the time of coronary spasm were ST segment elevation in 21(84%), depression in 1(4%) and no change in 3(12%) patients, who had branch vessel spasm, 3 vessel spasm or incomplete spasm on coronary angiogram. Of the 31 patients with vasospastic angina who underwent ergonovine tests, positive response occurred in 24(77%) after a cumulative dose of 0.4mg. However the other 4(13%) had no ECG changes even after the higher dose(>0.4mg) of ergonovine. CONCLUSION: This results suggest that vasospastic angina appear to be a common cause of chest pain, and ECG ergonovine test with high dose can improve diagnostic sensitivity but cannot detect some patients with vasospastic angina.

A Case of Meckel's Enterolith / 대한소화기내시경학회지

The term enterolith refers to concretions formed within the gastrointestinal tract. Enteroliths are thought to result from stasis and are usually found proximal to an area of stricture or within diverticulum. Meckel's diverticulum occurs in 1% to 3% of the population at autopsy and is the most common congenital anomaly of the gastrointestinal tract. Common complications of Meckel's diverticulum include hemorrhage, infection, inflammation, and intussusception. However, enterolith formation in a Meckel's diverticulum, which referred to as Meckel's enterolith, is rare. A 58-year-old female who experienced constipation and low abdominal pain for 20 years, was admitted due to severe low abdominal pain for 3 days. A 3 2 cm sized, lozenge-shaped radiopaque stone with peripheral dense calcification and radiolucent center, located between two areas of stricture in the distal ileum, was observed in abdominal radiograph, abdominal sonogram, small bowel study, and CT scan. Pathologic findings after surgery reveal an enterolith in Meckel's diverticulum without ectopic gastric mucosa. The case of Meckel's enterolith is herein reported.

A Case of Hydrogen Peroxide Induced Colitis / 대한소화기내시경학회지

Hydrogen peroxide has been used for various medical purposes and also recommended in the disinfection process for endoscopes. However, hydrogen peroxide as a cause of chemical colitis or disinfectant colitis has been infrequently reported. The endoscopic findings of hydrogen peroxide induced colitis revealed pseudomembranous-like enteritis such as white plaques, erythema, foamy liquid, patchy, granularity, and ulcerations, resulting from effervescence caused by the release of oxygen from the breakdown of hydrogen peroxide. A 36 year-old single male, who had 30 ml of 3% hydrogen peroxide inserted into his anus the day before due to sexual reasons, was hospitalized as a result of suffering from hematochezia, tenesmus, and lower abdominal pain. Colonoscopy revealed discrete or confluent white plaques adherent to the colonic mucosa, severe erythema on the surrounding mucosa, patchy granularity, and scattered ulcerations up to 28 cm from the anal verge. Pathologic finding revealed inflammatory cells infiltration, variable sized vacuoles, vascular congestion, hemorrhage, fibrin deposition and ulcerations with regenerating epithelium in the lamina propria, consistent with acute mucosal injury caused by hydrogen peroxide. A case of hydrogen peroxide induced colitis is herein reported.

Endoscopic Ligation Therapy for Gastric Angiodysplasia / 대한소화기내시경학회지

Gastric angiodysplasia may be responsible for up to 2% to 6% of upper gastrointestinal bleeding. Moreover, gastric angiodysplasia may be particularly difficult to treat and is usually associated with a high rebleeding rate. Bleeding due to gastric angiodypsplasia is usually treated by various endoscopic approaches, including argon and Nd:YAG laser photocoagulation, monopolar or biopolar electrocoagulation, heater probe, or injection. Associated complications of these methods, however, such as perforation, acute bleeding during the procedure, or delayed massive hemorrhage have been reported. Recently a few reports have been suggested that endoscopic ligation therapy is a safe, effective treatment for gastric angiodysplasia. A 70-year-old man, who had undergone subtotal gastrectomy for perforation of a duodenal ulcer for 20 years, was admitted due to melena and dizziness persisting for 1 week. A gastroscopy revealed a single angiodysplasia with active bleeding just above the anastomotic site of the remnant stomach. Endoscopic ligation therapy was performed successfully and the bleeding stopped immediately after endoscopic ligation. Since then, no recurrence of bleeding has been reported to date.

Studies on Sickness in Rural Residents / 예방의학회지

A study on the sickness distribution and mode of treatment in rural area was conducted during the period from July '75 to Aug. '75 using 1,225 households, 7,918 population (4,017 male, 3,901 female) and 343 cases that found during the period of survey who had been lived in nammyon, Hwasoongun, Chonnam. The summarized results were as follows : 1. Average family number per household was 6.5 and prevalence rate was 43.3 (21.2 for male, 22.1 for female). 2. General sickness distribution by classification of disease according to W.H.O. was highest in disease of the nervous system and sense organs (21.3%), and important others were disease of the digestive system (16.9%) and disease of the respiratory system (14.8%). In male, distribution was in order of downward disease of digestive system, disease of nervous system and sense organs, disease of skin, cellular tissue, bones and organs of movement , and disease of respiratory system. In female, distribution was in order of downward disease of nervous system and sense organs, disease of respiratory system, disease of digestive system, and disease of skin, cellular tissue, bones and organs of movement. 3. Types of treatment in both sexes were showed that home and folkmedicine (41.1%), pharmacy (24.5%), admission to hospital or clinic (16.9%), out-patient clinic (10.8%) ad herbmedicine (6.7%) in downward order. Hospital and clinic utility rate was 27.8% (31.5 for male, 24.0 for female) and it was highest in 0-4 age groups and lowest in 40-49 year age groups. 4. Hospital and clinic utility rate was highest in neoplasms, and the other hands, disease of the nervous system and sense organs and disease of the digestive system were the highest groups in the all types of treatment other than hospital and clinic. 5. On the results of treatment not, exactly replied answer was the highest (41.7%) and only 16.0% said complete recovery, In completely recovered cases, hospital and clinic using group was predominant (58.2%) and in aggravated cases home and folkmedicine using group was highest.