No abstract available.

Both death certificates and postmortem examination certificates are used as proof of death. These certificates sometimes contain erroneous information but how frequently they do so is unknown. In particular, only a few studies have measured the accuracy of the cause and manner of death on Korea death documents. In this study, we compared the cause and manner of death on both kinds of certificates with those on autopsy reports to determine the frequency of errors, and to identify way to improve the accuracy of these certificates. In 2012, 528 autopsies were requested of out institute, and certificates were submitted in 241 of the cases. The manner of death was classified as natural, unnatural, or unknown. The cause of death in the autopsy report matched that on the death certificate in 37 of 63 cases (58.7%), and the manner of death matched in 40 of 63 cases (63.5%). The cause of death in the autopsy report matched that on the postmortem examination certificate in 62 of 178 cases (34.8%), and the manner of death matched in 74 of 178 cases (41.6%). Death certificates and postmortem examination certificates are important documents. We identified many incorrect reports of causes and manners of death on both kinds of documents, especially the postmortem death certificates. These inaccuracies are presumably due to a lack of forensic information and education, as well as lack of interest on the part of medical doctors.
Autopsy* ; Cause of Death ; Death Certificates* ; Education ; Korea

OBJECTIVES: Recently, Korean psychiatrists have noticed the complaints from probands and family members that private health insurance companies do not pay for most psychiatric disorders. Furthermore, probands cannot even apply for insurance because of their medical record of psychiatric disorders. Authors investigated and reviewed contracts of Korean private insurance companies to find reasons for banning psychiatric disorders from insurance policies. METHODS: Authors reviewed more than 800 contracts from 48 insurance companies. RESULTS: Among all the psychiatric diagnoses, few of them-dementia and some other organic mental disorders-are guaranteed to be paid from insurance companies. Less then 10 contracts say they pay for psychiatric illnesses. Most insurance companies have contracts prohibiting F codes ; however, there are not enough reasons in these contracts. CONCLUSIONS: In the private health insurance system, psychiatric illnesses have almost no rooms. It is very urgent to add space for patients with psychiatric illnesses and psychiatrists in the insurance policies.
Diagnosis ; Humans ; Insurance* ; Insurance, Health ; Korea* ; Medical Records ; Psychiatry

Chronic myelogenous leukemia (CML) is characterized by the presence of the Philadelphia chromosome, which is generated by a reciprocal t(9;22)(q34;q11) translocation. Variant Philadelphia chromosomes, found in 5-10% of CML cases, are a result of translocations involving other chromosomes, in addition to 9 and 22. These four-way Philadelphia chromosome translocations are very rare; only about 60 patients with such chromosomes have been described. Here, we report a CML case with a novel four-way variant Philadelphia chromosome. A conventional chromosome analysis of bone marrow cells revealed a 46,XY,t(5;9;22;18)(q31;q34;q11.2;q21) karyotype, which was confirmed by multicolor fluorescence in situ hybridization. The major BCR-ABL1 fusion gene was detected by reverse transcription-nested PCR. The patient was treated with imatinib. Twelve months after treatment, he demonstrated a complete hematologic response and chromosome analysis showed that he had a normal karyotype.
Bone Marrow Cells ; Fluorescence ; Humans ; In Situ Hybridization ; Karyotype ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Philadelphia Chromosome ; Polymerase Chain Reaction ; Imatinib Mesylate

Chronic myelogenous leukemia (CML) is characterized by the presence of the Philadelphia chromosome, which is generated by a reciprocal t(9;22)(q34;q11) translocation. Variant Philadelphia chromosomes, found in 5-10% of CML cases, are a result of translocations involving other chromosomes, in addition to 9 and 22. These four-way Philadelphia chromosome translocations are very rare; only about 60 patients with such chromosomes have been described. Here, we report a CML case with a novel four-way variant Philadelphia chromosome. A conventional chromosome analysis of bone marrow cells revealed a 46,XY,t(5;9;22;18)(q31;q34;q11.2;q21) karyotype, which was confirmed by multicolor fluorescence in situ hybridization. The major BCR-ABL1 fusion gene was detected by reverse transcription-nested PCR. The patient was treated with imatinib. Twelve months after treatment, he demonstrated a complete hematologic response and chromosome analysis showed that he had a normal karyotype.
Bone Marrow Cells ; Fluorescence ; Humans ; In Situ Hybridization ; Karyotype ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Philadelphia Chromosome ; Polymerase Chain Reaction ; Imatinib Mesylate

We experienced 3 cases of Candida esophagitis in infancy which were diagnosed by esophageal endoscopy. First case, 10 month-old boy with combined immune deficiency had suffered from oral thrush and poor feeding for more than 4 months. Esophageal endoscopy revealed multiple whitish creamy patches on the friable erythematous and necrotic mucosa of the esophagus. He was firstly treated with amphotericin-B but in vain. Then he was treated with fluconazole (5 mg/kg/day) and in a few days oral thrush nearly disappeared and endoscopy after 2 weeks revealed complete healing of the esophagitis. Second case, 6 month-old boy with some cellular immue defect also suffered from oral thrush, poor feeding and intermittent fever. He was treated with fluconazole and oral thrush was imporved. He was discharged without follow up endoscopy. Third case, 4 month-old girl with liver cirrhosis due to infantile cholestasis had Candida sepsis. Esophagitis was found incidentally during the endoscopic examination of esophageal varix. First 2 cases showed multiple small filling defects and decreased motility on esophagography. Candida antigen was not detected in the sera of all 3 cases of candidiasis. We conclude that Candidia esophagitis should be suspected when an infant has been suffering from long-term treatmet-resistant oral thrush and poor feeding and that esophageal endoscopy can be easily performed in infants also and useful in diagnosing esophagitis and assessing the outcome of treatment.
Candida* ; Candidiasis ; Candidiasis, Oral ; Cholestasis ; Endoscopy ; Esophageal and Gastric Varices ; Esophagitis* ; Esophagus ; Female ; Fever ; Fluconazole ; Humans ; Infant ; Liver Cirrhosis ; Male ; Mucous Membrane ; Sepsis

This study analyzes the role of the Sorting Hat in structuring the identity of the characters in the Harry Potter series written by J. K. Rowling. In the different stages of adolescence, one explores and re-establishes one's identity. One's sense of identity is determined by the commitments made regarding personal and social traits. However, it is difficult to establish a concrete identity formation process theory that is communicable to adolescents. In Harry Potter, the characters' identities are reflected upon the Sorting Hat and are continuously molded throughout the book. The Sorting Hat provides nurturing experiences based on temperament. Based primarily on their temperament, it sorts the students into four houses, each with their own distinct characteristics. Once sorted, the houses become the living and learning communities in which the students share the same dormitory and classes until their graduation. Within the community, the students seek connections, supportive relationships, and understanding within the group. The taking on of the group identity is an explanatory variable in the formation of individual identity. The Sorting Hat provides the students with stability and a safe boundary. After being sorted based on their temperament, the inexperienced and immature adolescents can explore different options under the guidance of the Hat before making a definite commitment. By presenting them with an appropriate environment (such as a mentor, friend, or family member), the Hat further shapes their identity and integrates the identity elements ascribed in the beginning. By providing experiences and interactions based on their unique temperament and environment, the Sorting Hat plays a crucial role in establishing the students' identities. The Sorting Hat can be an ideal model for finding one's identity during adolescence.
Adolescent* ; Friends ; Fungi ; Humans ; Learning ; Mentors ; Sociological Factors ; Temperament

OBJECTIVE: To evaluate the inter-vendor and inter-session reliability of diffusion tensor imaging (DTI) and relevant parameters. MATERIALS AND METHODS: This prospective study included 10 healthy subjects (5 women and 5 men; age range, 25–33 years). Each subject was scanned twice using 3T magnetic resonance scanners from three different vendors at two different sites. A voxel-wise statistical analysis of diffusion data was performed using Tract-Based Spatial Statistics. Fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) values were calculated for each brain voxel using FMRIB's Diffusion Toolbox. RESULTS: A repeated measures analysis of variance revealed that there were no significant differences in FA values across the vendors or between sessions; however, there were significant differences in MD values between the vendors (p = 0.020). Although there were no significant differences in inter-session MD and inter-session/inter-vendor RD values, a significant group × factor interaction revealed differences in MD and RD values between the 1st and 2nd sessions conducted by the vendors (p = 0.004 and 0.006, respectively). CONCLUSION: Although FA values exhibited good inter-vendor and inter-session reliability, MD and RD values did not show consistent results. Researchers using DTI should be aware of these limitations, especially when implementing DTI in multicenter studies.
Anisotropy ; Brain ; Commerce ; Diffusion Tensor Imaging* ; Diffusion* ; Female ; Healthy Volunteers ; Humans ; Male ; Prospective Studies

Arm ; Free Tissue Flaps ; Humans ; Osteotomy ; Pliability ; Transplants

Stress-induced cardiomyopathy, known as Takotsubo cardiomyopathy, is a newly described clinical entity characterized by transient left ventricular apical ballooning and left ventricular apical dyskinesis, with no significant stenosis on the coronary angiogram. We describe a patient who had transient cardiomyopathy with akinesia of the basal portions of the left ventricle and hyperkinesia of the apex. This is the first case of stress-induced cardiomyopathy with an "inverted Takotsubo" contractile pattern triggered by emotional stress in Korea. The cause of stress-induced cardiomyopathy is unclear, but catecholamines probably play a role in this syndrome. This entity could provide clues to the pathophysiology underlying stress-induced cardiomyopathy.
Cardiomyopathies ; Catecholamines ; Constriction, Pathologic ; Heart Ventricles ; Humans ; Hyperkinesis ; Korea ; Stress, Psychological ; Takotsubo Cardiomyopathy