Narcissistic personality is an ego centric personality characterized by obsession with oneself, disregard for others, and lack of empathy. It forms a spectrum from normal to pathological levels. A narcissistic person unconsciously fears death because he/she pursues immortality and omnipotence. A narcissistic person does not consider others important. Thus, he/she does not mourn separation or loss. It might be a characteristic defense of narcissistic personality. The authors selected by Japanese author Yoko Sano as a text. Many people loved the cat and cried and mourned when the cat died. However, he was reborn immediately a million times. The cat loved only itself. The cat then met a white cat and fell in love for the first time. They lived to-gether. As time passed, the white cat died. For the first time, the cat cried out loud in sadness. After crying and crying, he stoppedmoving and dying. He was not reborn again. The authors viewed the cat as a narcissistic personality and interpreted its active avoidance and denial of separation, death, and mourning as a narcissistic defense. Repeating this only strengthened his narcissistic traits.However, the momentum of change was falling in love. Losing a loved one and going through the process of mourning the eternalseparation of death for the first time became the trigger for the change in narcissistic personality.

Background and Objectives: It is necessary to understand the variations of the paranasal sinuses (PNS) and other anatomical structures during an endoscopic sinus surgery (ESS). The purpose of this study was to investigate any association between the degree of frontal sinus (FS) pneumatization and the development of the PNS structures. Subjects and Method We analyzed 311 PNS computed tomography (CT) scans (622 sinuses, including the left and right sides). We classified FS into type I (aplasia), type II (hypoplasia), and type III (control). We assessed and compared the middle turbinate pneumatization (MTP), superior turbinate pneumatization (STP), agger nasi cell (ANC), infraorbital cell (IOC), optic nerve (ON) type, and vidian nerve (VN) type with the pneumatization of the FS. We further studied for any association between the degree of pneumatization of the FS, maxillary sinus (MS), and sphenoid sinus (SS) and the lateral lamella length (LLL). Results: MTP, ANC, and IOC rates according to the FS types were not significant (p>0.05). Both type II and III showed more frequent occurrences of STP than type I (p=0.005). The ON type III and IV were significantly frequent in the FS type III (p<0.001). The occurrence of VN type III in the FS type I was significant (p<0.001). When comparing the pneumatizations of FS with MS or SS, there were no significant correlations between them (p>0.05). In the FS type II and III, the LLL was significantly greater than in type I (p<0.001). Conclusion Increased FS pneumatization shows greater indentation of ON and VN into the SS, as well as increased LLL. During ESS, it is important to recognize the possibility of structural damage of ON, VN, and LLL according to FS pneumatization.

Molecular imaging in gastroenterology has become more feasible with recent advances in imaging technology, molecular genetics, and next-generation biochemistry, in addition to advances in endoscopic imaging techniques including magnified high-resolution endoscopy, narrow band imaging or autofluorescence imaging, flexible spectral imaging color enhancement, and confocal laser endomicroscopy. These developments have the potential to serve as "red flag" techniques enabling the earlier and accurate detection of mucosal abnormalities (such as precancerous lesions) beyond biomarkers, virtual histology of detected lesions, and molecular targeted therapy-the strategy of "one stone to kill two or three birds"; however, more effort should be done to be "blue ocean" benefit. This review deals with the introduction of Raman spectroscopy endoscopy, imaging mass spectroscopy, and nanomolecule development for theranostics. Imaging of molecular pathological changes in cells/tissues/organs might open the "royal road" to either convincing diagnosis of diseases that otherwise would only be detected in the advanced stages or novel therapeutic methods targeted to personalized medicine.
Biochemistry ; Birds* ; Diagnosis ; Endoscopy ; Gastroenterology* ; Mass Spectrometry ; Molecular Biology ; Molecular Imaging* ; Narrow Band Imaging ; Optical Imaging ; Spectrum Analysis, Raman ; Biomarkers ; Precision Medicine

OBJECTIVES: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. METHODS: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. RESULTS: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092–1.183) for diagnosis of diabetes, 1.278 (1.278–1.386) for diagnosis of dyslipidemia, 0.940 (0.904–0.977) for diagnosis of arthritis, 0.785(0.736–0.837) for treatment of arthritis, 1.159 (1.116–1.203) for diagnosis of cataracts, and 1.285(1.200–1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p<0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p<0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. CONCLUSION Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.