Pontomedullary lacerations in unhelmeted motorcyclists and bicyclists: a retrospective autopsy study

ABSTRACT: Pontomedullary lacerations (PMLs) have often been reported in car occupants and pedestrians, are less frequently described in motorcyclists, and are very rarely described in bicyclists. The aim of this study was to determine the frequency of brainstem PMLs among fatally injured motorcyclists and bicyclists as well as the frequency of concomitant cranial, facial, and cervical spine injuries in such cases. A possible underlying mechanism of PML in fatally injured motorcyclists and bicyclists might thus be established. Of 443 cases of fatally injured motorcyclists and bicyclists, a sample of 381 cases of fatally injured motorcyclists and bicyclists with head injury of Abbreviated Injury Scale score of 3 or greater was formed and further analyzed. This group was composed of 345 men and 36 women. The average age was 48.8 ± 20.8 years (range, 15-99 years). In the analyzed sample group, there were 158 motorcyclists and 223 bicyclists. Partial PMLs were present in 44 cases (12%) within the sample of 381 head injuries, which breaks down to 40 men and 4 women. In our study, the impact area on the head and the specific skull base fracture type were good predictors of either PML occurrence or absence (B = -2.036, Wald = 161.312, P < 0.01, for the whole model). Impact to the chin, with or without a skull base fracture, most often led to this fatal injury due to impact force transmission, either through jawbone or vertebral column. Also, lateral head impact, the most frequent in bicyclists, with subsequent hinge fracture, PML, and frontoposterior hyperextension of the head that is associated with upper spine fracture, could be possible mechanisms of brainstem injury in fatally injured motorcyclists or bicyclists. Our study showed that the jawbone, as well as other facial bones, could act as shock absorbers, and their fracture could diminish energy transfer toward the skull and protect the brain and brainstem from injury.     

Social Darwinism as History and Reality: “Competition” and “The Weak” in Early Twentieth-Century Korea

ABSTRACT

By the time of Korea’s forced integration into the Japanese Empire in 1910, Social Darwinism was established as the main reference frame for the modernizing intellectual elite. The weak had only themselves to blame for their misfortune, and Korea, if it wished to succeed in collective survival in the modern world’s Darwinist jungles, had to strengthen itself. This mode of thinking was inherited by the right-wing nationalists in the 1920s–1930s; their programs of “national reconstruction” (minjok kaejo) aimed at remaking weak Korea into a “fitter” nation, thus preparing for the eventual independence from the Japanese. At the same time, in the 1920s and 1930s some nationalists appropriated the slogan of solidarity and protection of the weak, nationally and internationally, in the course of their competition against the Left. After liberation from Japanese colonialism in 1945, “competition” mostly referred to inter-state competition in South Korean right-wing discourse. However, the neo-liberal age after the 1997 Asian financial crisis witnessed a new discursive shift, competition-driven society being now the core of the mainstream agenda.