A Fatal Intracerebral Hemorrhage due to Chronic Methamphetamine Use / 대한법의학회지

The authors report a case of an otherwise healthy 33-year-old man who presented with intracerebral hemorrhage in the right frontal lobe following chronic methamphetamine use. An autopsy was performed within 2 days after death. The postmortem examination revealed cerebral edema and intracerebral and intraventricular hemorrhage. Microscopic examination revealed endovasculitis in the systemic vessels including the aorta and carotid and coronary arteries, but no aneurysm or arterio-venous malformation. Acute toxicity and chronic methamphetamine use was verified using blood and segmental hair analysis, respectively. Cerebrovascular accidents including stroke and intracerebral and subarachnoid hemorrhage are rare in young persons, but methamphetamine use is a risk factor for cerebrovascular accidents in young adults. Therefore, forensic pathologists should be aware of the acute and chronic harmful effects of methamphetamine. Detailed history taking and toxic screening tests for illicit drug use, especially methamphetamine, as well as a meticulous postmortem examination should be conducted in young patients who died due to cerebrovascular accident.

A Fatal Intracerebral Hemorrhage due to Chronic Methamphetamine Use / 대한법의학회지

The authors report a case of an otherwise healthy 33-year-old man who presented with intracerebral hemorrhage in the right frontal lobe following chronic methamphetamine use. An autopsy was performed within 2 days after death. The postmortem examination revealed cerebral edema and intracerebral and intraventricular hemorrhage. Microscopic examination revealed endovasculitis in the systemic vessels including the aorta and carotid and coronary arteries, but no aneurysm or arterio-venous malformation. Acute toxicity and chronic methamphetamine use was verified using blood and segmental hair analysis, respectively. Cerebrovascular accidents including stroke and intracerebral and subarachnoid hemorrhage are rare in young persons, but methamphetamine use is a risk factor for cerebrovascular accidents in young adults. Therefore, forensic pathologists should be aware of the acute and chronic harmful effects of methamphetamine. Detailed history taking and toxic screening tests for illicit drug use, especially methamphetamine, as well as a meticulous postmortem examination should be conducted in young patients who died due to cerebrovascular accident.

A Clinical Study of Borderline Malignant Tumors of the Ovary / 대한산부인과학회잡지

OBJECTIVE: To evaluate the clinical and histopathological features, treatment and prognosis of borderline ovarian tumors (BOT). METHODS: Thirty nine cases of BOT were treated between January 1985 and December 2001 at Maryknoll Hospital. All of BOT were classified in accordance with the WHO criteria for histological typing and clinical staging according to the FIGO system. The clinical records of all patients were reviewed retrospectively. RESULTS: The incidence of BOT was 21.0% (39/186) of epithelial ovarian malignancies and patients with these tumors tended to present at younger age (36.6 years old) than those with invasive carcinoma (53.6 years old). Fourteen patients (35.9%) were nullipara. The most common chief complaint was palpable mass (28.2%). Serous type (17.9%) occurred less frequently than mucinous type (76.9%). The positive ratio of CA 125 was 45%. Stage I was 37 cases (94.8%), stage II, 1 case (2.6%), and stage III, 1 case (2.6%). The mean size of mucinous tumors was larger than that of serous types (18.7 cm vs 10.0 cm). Twenty three (59%) cases were managed by conservative surgery (unilateral salpingo-oophorectomy) and sixteen cases (41%) by extirpative operation. Post-operative adjuvant chemotherapy was given to seven patients (17.9%). Median follow-up period was 30 months. One patient expired in case of mucinous tumor and seven cases lost during follow-up. Overall survival rate was 96.9%. CONCLUSION: Borderline ovarian tumors constitute approximately 21.0% of epithelial ovarian malignancy and occur in younger patients than those with invasive cancer. It is mostly seen serous and mucinous types and most of them are diagnosed at early stage making definite treatment possible.

Complications in Pediatric Tracheotomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Improvements in the fields of neonatology and surgical subspecialities make tracheotomy possible to the younger population. But complication rates for pediatric tracheotomy are significantly higher than that for adult tracheotomy. This study was designed to present our 14-year experiences of pediatric tracheotomy and to evaluate the effect of several factors of complications. MATERIALS AND METHODS: From 1986 through 1999, 188 tracheotomies were performed on 162 children. The charts were reviewed retrospectively and the results were analyzed. RESULTS: There was no tracheotomy-related mortality. Intraoperative complications were not developed either. Early and late postoperative complication rates were 7.4% and 44.6% respectively. Wound infection and granulation tissue formation were common complications. Granulation tissue formation was related to the duration of the tracheotomised state, dysfunction of vocal fold and pulmonary infection during tracheotomised state. CONCLUSIONS: Pediatric tracheotomy had significant morbidities, especially late complications. Granulation tissue formation was related to the duration of the tracheotomised state, dysfunction of vocal fold and pulmonary infection during the tracheotomised state. Our experience of 14 years will be helpful in the management of tracheostoma and the airways in pediatric patients.

Videostrobokymographic Analysis of Reinke's Edema / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Videostrobokymography (VSK) has been recently developed in our institute. VSK can select multiple regions of interest and analyze vibratory patterns of vocal folds using video data recorded by the conventional videostroboscopy. But the efficacy of VSK in clinical application needs to be proven. MATERIALS AND METHODS: We compared the preoperative and postoperative VSK patterns of Reinke's edema in 15 cases with some other parameters. RESULTS: Most of the patients showed improvement of voice quality by self-assessment, however, the fundamental frequency and subglottic pressure did not return to the normal range after operation. Preoperative videostroboscopy for Reinke's edema patients revealed greatly irregular patterns of mucosal wave so that kymogram could be obtained only in 3 of the 8 preoperative examinations. However, postoperative vibration of the vocal folds returned to the regular pattern on VSK. CONCLUSION: VSK could serve as one of the effective tools to document the vocal fold vibration objectively in various kinds of benign mucosal diseases of the vocal folds.

Expression of Human b-Defensin-1 mRNA in Human Nasal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES:Antimicrobial peptides are cationic proteins that are found in a wide range of organisms. Recent reports suggest that human beta-defensin-1 (hBD-1), a prominent group of antimicrobial peptides, is an important component of the innate immune response, particularly at mucosal surfaces that are vulnerable to colonization by potential pathogens. Therefore, hBD-1 may participate in providing intrinsic nasal mucosal defense against microbial infections. The present study aimed to look for hBD-1 mRNA in apparently normal human nasal mucosa. MATERIALS AND METHODS: The expression of hBD-1 mRNA was investigated in the inferior turbinate tissues using reverse transcription-polymerase chain reaction (RT-PCR) and in situ hybridization. RESULTS: The expression of hBD-1 mRNA was detected in these tissues. By in situ hybridization, hBD-1 mRNA was predominantly localized in superficial epithelial cells and submucosal glandular epithelium. CONCLUSION: These data suggest that nasal epithelia and submucosal glands may secrete hBD-1 and thus contribute to the mucosal defense of the nose.