• Title/Summary/Keyword: forensic medicine

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Clinically Correlated Anatomical Basis of Cricothyrotomy and Tracheostomy

  • Gulsen, Salih;Unal, Melih;Dinc, Ahmet Hakan;Altinors, Nur
    • Journal of Korean Neurosurgical Society
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    • v.47 no.3
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    • pp.174-179
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    • 2010
  • Objective : Cricothyrotomy and tracheostomy are performed by physicians in various disciplines. It is important to know the comprehensive anatomy of the laryngotracheal region. Hemorrhage, esophageal injury, recurrent laryngeal nerve injury, pneumothorax, hemothorax, false passage of the tube and tracheal stenosis after decannulation are well known complications of the cricothyrotomy and tracheostomy. Cricothyrotomy and tracheostomy should be performed without complications and as quickly as possible with regards the patients' clinical condition. Methods : A total of 40 cadaver necks were dissected in this study. The trachea and larynx and the relationship between the trachea and larynx and the surrounding structures was investigated. The tracheal cartilages and annular ligaments were counted and the relationship between tracheal cartilages and the thyroid gland and vascular structures was investigated. We performed cricothyrotomy and tracheostomy in eleven cadavers while simulating intensive care unit conditions to determine the duration of those procedures. Results : There were 11 tracheal cartilages and 10 annular ligaments between the cricoid cartilage and sternal notch. The average length of trachea between the cricoid cartilage and the suprasternal notch was 6.9 to 8.2 cm. The cricothyroid muscle and cricothyroid ligament were observed and dissected and no vital anatomic structure detected. The average length and width of the cricothyroid ligament was 8 to 12 mm and 8 to 10 mm, respectively. There was a statistically significant difference between the surgical time required for cricothyrotomy and tracheostomy (p < 0.0001). Conclusion : Tracheostomy and cricothyrotomy have a low complication rate if the person performing the procedure has thorough knowledge of the neck anatomy. The choice of tracheostomy or cricothyrotomy to establish an airway depends on the patients' clinical condition, for instance; cricothyrotomy should be preferred in patients with cervicothoracal injury or dislocation who suffer from respiratory dysfunction. Furthermore; if a patient is under risk of hypoxia or anoxia due to a difficult airway, cricothyrotomy should be preferred rather than tracheostomy.

Artificial neural network model for predicting sex using dental and orthodontic measurements

  • Sandra Anic-Milosevic;Natasa Medancic;Martina Calusic-Sarac;Jelena Dumancic;Hrvoje Brkic
    • The korean journal of orthodontics
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    • v.53 no.3
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    • pp.194-204
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    • 2023
  • Objective: To investigate sex-specific correlations between the dimensions of permanent canines and the anterior Bolton ratio and to construct a statistical model capable of identifying the sex of an unknown subject. Methods: Odontometric data were collected from 121 plaster study models derived from Caucasian orthodontic patients aged 12-17 years at the pretreatment stage by measuring the dimensions of the permanent canines and Bolton's anterior ratio. Sixteen variables were collected for each subject: 12 dimensions of the permanent canines, sex, age, anterior Bolton ratio, and Angle's classification. Data were analyzed using inferential statistics, principal component analysis, and artificial neural network modeling. Results: Sex-specific differences were identified in all odontometric variables, and an artificial neural network model was prepared that used odontometric variables for predicting the sex of the participants with an accuracy of > 80%. This model can be applied for forensic purposes, and its accuracy can be further improved by adding data collected from new subjects or adding new variables for existing subjects. The improvement in the accuracy of the model was demonstrated by an increase in the percentage of accurate predictions from 72.0-78.1% to 77.8-85.7% after the anterior Bolton ratio and age were added. Conclusions: The described artificial neural network model combines forensic dentistry and orthodontics to improve subject recognition by expanding the initial space of odontometric variables and adding orthodontic parameters.

Arthroscopic evaluation of the rotator cuff vasculature: inferences into the pathogenesis of cuff tear and re-tear

  • Steafano Gumina;Hyun Seok Song;Hyungsuk Kim;Vittorio Candela
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.203-211
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    • 2024
  • Background: Little is known about alterations of the rotator cuff (RC) macroscopic vasculature associated with medical conditions and/or habits that predispose a person to diseases of the peripheral microcirculation. The high frequency of cuff tear and re-tear in patients with diabetes, hypercholesterolemia, uncontrolled arterial hypertension, or metabolic syndrome may be due to tissue hypovascularity. Methods: The macroscopic vasculature of both the articular and bursal sides of the posterosuperior RC was evaluated arthroscopically in 107 patients (mean age, 58.2 years) with no RC tear. Patients were divided into three groups according to medical comorbidities and lifestyle factors (group I, none; group II, smokers and/or drinkers and one comorbidity; and group III, two or more comorbidities). Pulsating vessels originating from both the myotendinous and osteotendinous junctions were assessed as "clearly evident," "poorly evident," or "not evident." Results: Groups I, II, and III comprised 36, 45, and 26 patients, respectively. Within the myotendinous junction, vessels were visualized in 22 group I patients (61%), 25 group II patients (55%), and 6 group III patients (23%) (P=0.007). Pulsating arterial vessels originating from the osteotendinous junction were seen in 42%, 36%, and 0% of patients, respectively (P<0.001). Within the bursal side of the RC, a dense anastomotic network was visualized (either clearly or poorly) in 94% (34), 80% (36), and 35% (9) of patients, respectively (P<0.001). Conclusions: The macroscopic vasculature of the RC is influenced by pre-existing diseases and lifestyle factors, which may impair peripheral microcirculation.

Simultaneous analysis of ethylene glycol and glycolic acid in bio-specimens by GC/MS (생체시료에서 GC/MS에 의한 에틸렌글리콜 및 대사체인 글리콜산 동시분석)

  • Lee, Joon-Bae;Park, Mee-Jung;Sung, Tae-Myung;Choi, Byung-Ha;You, Jae-Hoon;Shon, Shung-Kun;Paeng, Ki-Jung
    • Analytical Science and Technology
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    • v.23 no.6
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    • pp.544-550
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    • 2010
  • Mistaking pink colored thermal oil for grape wine, a victim drank the oil to death which was analyzed to contain 39% of ethylene glycol. Thermal oil could be used for heat transfer to prevent the malfunction due to the high pressure in the boiler operated at high temperature when using water. Main component of thermal oil is known to be mineral oil or ethylene glycol. From the blood and other tissue of the victim from autopsy, ethylene glycol and its metabolite were simultaneously analyzed by GC/MS after extraction under acidic condition with acetonitrile followed by derivatization with BSTFA. About 0.2 g of the specimens were pretreated with 50 uL of 0.5 M HCl solution to keep acidic condition, then dehydrated with anhydrous sodium sulfate followed by concentration under nitrogen stream. Ethylene glycol and glycolic acid concentration in blood was measured to be $2,755\;{\mu}g/mL$ and $174\;{\mu}g/mL$ respectively. In other specimen, the concentration of ethylene glycol and glycolic acid was $860\;{\mu}g/g\sim1,290\;{\mu}g/g$ and $93\;{\mu}g/g\sim134\;{\mu}g/g$. Especially, crystal appeared in kidney which was supposed xalate from the metabolite of ethylene glycol.

Enhancing CT Image Quality Using Conditional Generative Adversarial Networks for Applying Post-mortem Computed Tomography in Forensic Pathology: A Phantom Study (사후전산화단층촬영의 법의병리학 분야 활용을 위한 조건부 적대적 생성 신경망을 이용한 CT 영상의 해상도 개선: 팬텀 연구)

  • Yebin Yoon;Jinhaeng Heo;Yeji Kim;Hyejin Jo;Yongsu Yoon
    • Journal of radiological science and technology
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    • v.46 no.4
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    • pp.315-323
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    • 2023
  • Post-mortem computed tomography (PMCT) is commonly employed in the field of forensic pathology. PMCT was mainly performed using a whole-body scan with a wide field of view (FOV), which lead to a decrease in spatial resolution due to the increased pixel size. This study aims to evaluate the potential for developing a super-resolution model based on conditional generative adversarial networks (CGAN) to enhance the image quality of CT. 1761 low-resolution images were obtained using a whole-body scan with a wide FOV of the head phantom, and 341 high-resolution images were obtained using the appropriate FOV for the head phantom. Of the 150 paired images in the total dataset, which were divided into training set (96 paired images) and validation set (54 paired images). Data augmentation was perform to improve the effectiveness of training by implementing rotations and flips. To evaluate the performance of the proposed model, we used the Peak Signal-to-Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM) and Deep Image Structure and Texture Similarity (DISTS). Obtained the PSNR, SSIM, and DISTS values of the entire image and the Medial orbital wall, the zygomatic arch, and the temporal bone, where fractures often occur during head trauma. The proposed method demonstrated improvements in values of PSNR by 13.14%, SSIM by 13.10% and DISTS by 45.45% when compared to low-resolution images. The image quality of the three areas where fractures commonly occur during head trauma has also improved compared to low-resolution images.

OEM Pre-Medical Education ('OEM' 방식의 의예과 교육은 개선되어야 한다)

  • Lee, Sung Nak
    • Korean Medical Education Review
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    • v.12 no.2
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    • pp.3-4
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    • 2010
  • Purpose: Education provided in many Korean medical colleges still isn't free from the contents of the "2+4 year program." Korean medical colleges especially holds onto the belief that humanities must be taught to the lower grades. Methods: I introduced the six-year integrated program and reversed the order of the existing education program. The new program assigned anatomy, physiology, and biochemistry to the 1st years, and humanities subjects such as forensic medicine and medical ethics to the 4th, 5th, and 6th years. Results: Increased participation and interests among students. Conclusion: Occupational and Environmental Medicine (OEM) at the level of pre-medicine brings harm rather than good.

A Roentgenographic Study on the Growth and Development of Mandibular Permanent Teeth (하악영구치 발육에 대한 방사선학적 연구)

  • Woo-Cheon Kee;Kwang-Woo Lee;Byung-Kook Kim
    • Journal of Oral Medicine and Pain
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    • v.13 no.1
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    • pp.53-60
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    • 1988
  • The authors have studied the growth and development of mandibular permanent teeth in order to the make basic data that are necessary to determine the forensic age. The 631 subjects whose ages range from 3 years to 18 years were selected to analyze calcification degree of mandibular teeth. The results were as follows: 1. There were significant differences between adjacent ages, except 14-15 years and 17-18 years. 2. In each tooth, these were differences between adjacent ages from 3 years to 10 years, except central incisor and third molars. 3. All teeth were almost completely developed at the age of about 14 years, except second and third molars. 4. In each tooth, there were the widest significances between adjacent ages in premolars.

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Discovery of Taeniid Eggs from A 17th Century Tomb in Korea

  • Lee, Hye-Jung;Shin, Dong-Hoon;Seo, Min
    • Parasites, Hosts and Diseases
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    • v.49 no.3
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    • pp.327-329
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    • 2011
  • Even though Taenia spp. eggs are occasionally discovered from archeological remains around the world, these eggs have never been discovered in ancient samples from Korea. When we attempted to re-examine the archeological samples maintained in our collection, the eggs of Taenia spp., 5 in total number, were recovered from a tomb of Gongju-si. The eggs had radially striated embryophore, and $37.5-40.0\;{\mu}m{\times}37.5\;{\mu}m$ in size. This is the first report on taeniid eggs from ancient samples of Korea, and it is suggested that intensive examination of voluminous archeological samples should be needed for identification of Taenia spp.

Proteomic Analysis of a Rat Cerebral Ischemic Injury Model after Human Cerebral Endothelial Cell Transplantation

  • Choi, Tae-Min;Yun, Misun;Lee, Jung-Kil;Park, Jong-Tae;Park, Man-Seok;Kim, Hyung-Seok
    • Journal of Korean Neurosurgical Society
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    • v.59 no.6
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    • pp.544-550
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    • 2016
  • Objective : Cerebral endothelial cells have unique biological features and are fascinating candidate cells for stroke therapy. Methods : In order to understand the molecular mechanisms of human cerebral endothelial cell (hCMEC/D3) transplantation in a rat stroke model, we performed proteomic analysis using 2-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Protein expression was confirmed by quantitative real-time PCR and Western blot. Results : Several protein spots were identified by gel electrophoresis in the sham, cerebral ischemia (CI), and CI with hCMEC/D3 treatment cerebral ischemia with cell transplantation (CT) groups, and we identified 14 differentially expressed proteins in the CT group. Proteins involved in mitochondrial dysfunction (paraplegin matrix AAA peptidase subunit, SPG7), neuroinflammation (peroxiredoxin 6, PRDX6), and neuronal death (zinc finger protein 90, ZFP90) were markedly reduced in the CT group compared with the CI group. The expression of chloride intracellular channel 4 proteins involved in post-ischemic vasculogenesis was significantly decreased in the CI group but comparable to sham in the CT group. Conclusion : These results contribute to our understanding of the early phase processes that follow cerebral endothelial cell treatment in CI. Moreover, some of the identified proteins may present promising new targets for stroke therapy.

The 765G>C Polymorphism in the Cyclooxygenase-2 Gene and Gastric Cancer Risk: an Update by Meta-analysis

  • Zhao, Fen;Zhu, Hong;Huang, Min;Yi, Cheng;Huang, Ying
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2863-2868
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    • 2014
  • Background: The 765G>C polymorphism in cyclooxygenase-2 (COX-2) gene has been extensively investigated for association with gastric cancer (GC). However, the results of different studies have been inconsistent. The aim of this study is to comprehensively evaluate the genetic risk of -765G>C polymorphism in the COX-2 gene for GC. Materials and Methods: We searched Pubmed, Embase, Medline, CNKI database, Wanfang database, Weipu database, and Chinese Biomedical database, covering all publications (last search been performed on Jan 10, 2014). Statistical analyses were performed using Revman 5.2 and STATA 10.0 software. Results: A total of 1,874 cases and 3,005 controls in 10 case-control studies were included in this meta-analysis. The results indicated that the variant C allele carriers (GC+CC) had a 69% increased risk of GC when compared with the homozygote GG (odds ratio (OR)=1.69, 95% confidence interval (CI), 1.10-2.61 for GC+CC vs GG). In the subgroup analysis by ethnicity, significant elevated risks were associated with C allele carriers in Asians (OR=1.75, 95%CI=1.40-2.18, and p<0.00001) and in Indians (OR=8.38, 95%CI=4.34-16.16, and p<0.00001) but not in Caucasians (OR=1.07, 95%CI=0.81-1.42, and p=0.62) or in Dutch (OR=0.53, 95%CI= 0.33-0.87, and p= 0.01).In the subgroup analysis by Helicobacter pylori (H. pylori) status, a significantly increased risk was identified among H. pylori (+) (OR=3.58, 95%CI=2.33-3.50, and p<0.00001) and H. pylori (-) (OR=2.32, 95%CI=1.46-3.69, and p=0.0004). Conclusions: This meta-analysis suggested that the -765G>C polymorphism in the COX-2 gene could be a risk factor for GC in Asians and Indians.