Mushroom poisoning widely reported in Oriental and Western literature, is typically caused by accidental ingestion of toxic mushrooms that resemble edible mushrooms. Reports about poisoning due to species of Omphalotus, Amanita, Clitocybe, and other toxic mushroom species have been reported; toxicity depends on the mushroom species and the amount of toxin, which varies according to the climatic and environmental conditions. Symptoms of poisoning, such as unspecific nausea, vomiting, and diarrhea, as well as intestinal, hepatic and renal toxicities, also vary according to the mushroom species. Most patients recover with anti-muscarinic therapy and supportive care for nonspecific symptoms; however some cases of poisoning are fatal in children and elderly people. We report a case of sudden death due to mushroom poisoning in a 74-year-old woman, with hemorrhagic enteritis.
Agaricales* ; Aged ; Amanita ; Child ; Death, Sudden ; Diarrhea ; Eating ; Enteritis* ; Female ; Humans ; Mushroom Poisoning* ; Nausea ; Poisoning ; Vomiting

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2 autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.
Anaphylaxis ; Autopsy ; Forensic Medicine ; Korea ; Mast Cells ; Tryptases

The primary tumor of the heart is rare and the myxoma is the most common primary cardiac tumor. Sudden death due to cardiac myxoma is mainly with atrial myxoma, tumor embolization, or obstruction of blood flow at the mitral or tricuspid valve. Thus it appears that histologically benign but potentially lethal. This report describes an unusual cause of sudden unexpected death and the autopsy findings for a 51-years-old woman with left atrial myxoma. She complained fatigue and weight loss during 1 year, without dyspnea or other systemic symptoms. On autopsy, the left atrium is slightly enlarged as ball-shaped. Opening it, a smooth surfaced pale, round and lobulated mass is found, attached on left atrial septum. On cut section, it is dark brown to dark red colored with gelatinous appearance, and shows focal interstitial fibrosis, calcification and hemorrhage. We present a case diagnosed at post-mortem of an left atrial myxoma without any informations of clinical symptoms. The cardiac myxoma must considered for cause of sudden death to cardiac problem.
Atrial Septum ; Autopsy ; Death, Sudden ; Dyspnea ; Fatigue ; Female ; Fibrosis ; Gelatin ; Heart ; Heart Atria ; Heart Neoplasms ; Hemorrhage ; Humans ; Myxoma ; Tricuspid Valve ; Weight Loss

Hydrothorax is an uncommon but a well-recognized complication of peritoneal dialysis, and is estimated at 1.6-10%. It is not a life-threatening condition, but massive hydrothorax (so called 'tension hydrothorax') has been documented rarely. We report an autopsy case showing the right-sided hydrothorax associated with peritoneal dialysis. A 27-year-old man who had suffered chronic renal failure and peritoneal dialysis, was found dead in his room. At autopsy, there were about 3 liters of clear transudate in the right pleural cavity and the right lung was collapsed. The biochemical study of the pleural fluid showed 266 mg/dL of glucose.
Adult ; Autopsy ; Exudates and Transudates ; Glucose ; Humans ; Hydrothorax ; Kidney Failure, Chronic ; Lung ; Peritoneal Dialysis ; Pleural Cavity

OBJECTIVES: This study was conducted to examine the relationships between muscle mass and hand strength in elderly people. METHODS: The study subjects were 659 volunteers aged older than 65 in Jejudo, south Korea. The anthropometric information such as weight, body mass index (BMI) and muscular mass was collected by the body composition analyzer. The hand strength was obtained by the digital grip dynamometer. The fasting blood sugar index called as potential diabetes mellitus (DM) was defined as the condition over 120 mg/dL of the blood sugar. The BMI was classified into under 23, 23-25 and over 25 to analyze the relationships of BMI and muscle mass, hand strength. RESULTS: The factors affecting muscle mass were sex (p<0.001), age (p<0.001) and BMI (p<0.001). The factors affecting hand strength were sex (p<0.001), age (p<0.001) and BMI (p=0.003). And there was a weak association between muscle mass and hand strength after controlling with the affected factors (r2=0.15, p<0.001). CONCLUSIONS: The hand strength is weekly correlated with the muscle mass. So we recommend to use digital grip dynamometer combining with other measurements for diagnosis the sarcopenia in epidemiologic study.
Aged* ; Blood Glucose ; Body Composition ; Body Weight ; Diabetes Mellitus ; Diagnosis ; Epidemiologic Studies ; Fasting ; Hand Strength* ; Humans ; Jeju-do* ; Korea ; Muscle, Skeletal ; Sarcopenia ; Statistics as Topic ; Volunteers

Inclusion body myositis is a rare condition of idiopathic inflammatory myopathy. Prior criteria for the diagnosis of inclusion body myositis essentially required pathological features of rimmed vacuoles, tubulofilamentous inclusions, and amyloid deposits. However, recently developed new diagnostic criteria emphasize clinical characteristics including weakness of finger flexors and knee extensors. In addition, a serological evaluation of anti-cN1A antibody is helpful for the diagnosis. We report a case of inclusion body myositis with clinical, pathological, and serological consideration.

In 2019, the Seoul metropolitan government established its own ‘Seoul-type paid sick leave project’. Although the central government had to introduce such a system, which is also called sickness benefits, it was not implemented. In order to understand the process by which the Seoul government has implemented such a policy, this study used Kingdon’s multiple streams framework. As a result, in the problem stream, it was found that the economic burden of sickness has been considered only in terms of medical expenses in the past of Korea. Then Songpa’s three women and Middle East respiratory syndrome incidents raised awareness of the necessity of the sickness benefit system in 2014 and 2015. In the political stream, several social affairs such as national health insurance huge surpluses and the 2017 presidential election opened policy window. At that time, Seoul Mayor actively promoted sickness benefits as a policy entrepreneur. In the policy stream, the sickness benefit system has gained new attention through political events. To summary, these three streams flowed separately and then they assembled around huge political affairs. As a result, it was confirmed that Kingdon’s model is the most effective theory than any other models in analyzing the health care policy decision process in Korea.

Background: and Purpose Advances in serological tests are transforming the classification of idiopathic inflammatory myopathy (IIM). The new criteria suggested by the 119th European Neuromuscular Center international workshop divide IIM cases into four main diseases according to clinical and pathological findings, adding immune-mediated necrotizing myositis and nonspecific myositis to the classic categories of polymyositis and dermatomyositis. Methods: Seventy one cases of IIM with sufficient available clinical and pathological data were reviewed to be reclassified according to the new criteria. Results: Most of the cases previously classified as polymyositis (77.8%, 35/45) were reclassified as immune-mediated necrotizing myopathy. The results of myositis-specific antibodies matched well with the new clinicopathological classification. Conclusions This new clinicopathological classification for IIM in combination with serological test results could be applied to our previous case series. Adoption of the new criteria will lead to a better understanding of the disease and hence new therapeutic insights.

We report the case of a 42-year-old woman who died in hospital from severe respiratory failure, 10 days after the onset of symptoms. Autopsy and microscopic examination identified features of diffuse alveolar damage in both lungs including hyaline membranes and intra-alveolar exudate. Gomori's methenamine silver stain of pink frothy materials in these exudates revealed thin-walled and cup-shaped microorganisms and a diagnosis of Pneumocystis jirovecii pneumonia was made. There were small granulomas in the pulmonary interstitium and hepatic lobules representing an unusual inflammatory reaction against Pneumocystis jirovecii. Extrapulmonary involvement with pneumocystis infection is a rare event occurring in 1% to 2% of all pneumocystis cases. Screening and confirmatory tests for human immunodeficiency virus (HIV) detection were positive. There was no information available regarding the patient's medical history or the possibility of HIV infection prior to the autopsy, because the patient was a foreign worker who arrived in Korea 2 months before her death. Medical examiners often perform autopsies with limited information regarding the deceased person, even when person is a Korean national. Therefore, an awareness of protection protocols during autopsy, as well as of the atypical patterns of critical diseases, is crucial.
Adult ; Autopsy* ; Coroners and Medical Examiners ; Diagnosis ; Exudates and Transudates ; Female ; Granuloma ; HIV ; HIV Infections ; Humans ; Hyalin ; Korea ; Liver* ; Lung* ; Mass Screening ; Membranes ; Methenamine ; Pneumocystis Infections ; Pneumocystis jirovecii* ; Pneumocystis* ; Pneumonia* ; Pneumonia, Pneumocystis ; Respiratory Insufficiency