Medicolegal autopsy is a vital tool for obtaining reliable injury mortality data. This study statistically analyzed data obtained from medicolegal autopsies performed in Korea in 2013. The aim of this study was to analyze various aspects of the 4,861 deaths that were categorized as unusual in Korea in 2013. A total of 4,861 deaths were analyzed by gender, age, manner of death, and cause of death. Of the 4,861 deaths, 3,542 (73.3%) were of men and 1,302 (26.7%) were of women. With respect to the manner of death, 54.4% were recorded as unnatural deaths, 38.8% were natural deaths, and 6.9% had unknown causes. Of the 2,642 unnatural deaths, 45.0% were determined to be accidental deaths, 26.3% suicidal, 16.9% homicidal, and 11.8% undetermined. Of the total number of unnatural deaths, 42.1% were trauma-related deaths, for which falling down accounted for 33.8%. Asphyxiation accounted for 16.0% of unnatural deaths, and of these, the predominant cause was hanging (58.8%). In addition, 14.4% of deaths were due to drowning, 12.9% poisoning, 11.0% thermal injuries, 1.8% complications arising from medical procedures, and 0.8% electrocution, starvation, or neglect. Among the 1,886 natural deaths, heart diseases accounted for 52.0% and vascular diseases accounted for 16.9%. Of the 196 deaths among children under the age of 10 years, 41.8% were recorded as unnatural deaths, 45.1% were natural deaths, and 1.5% had unknown causes.
Autopsy* ; Cause of Death ; Child ; Data Interpretation, Statistical ; Drowning ; Female ; Heart Diseases ; Humans ; Korea ; Male ; Mortality ; Poisoning ; Starvation ; Vascular Diseases

Congenital lobar emphysema has the clinical features of an air block' syndrome with- out the evidence of pulmonary infection or intrabronchial foreign body. The hyperinflated lung causes a compression of uninvolved lobes creating respiratory distress, cyanosis within the first weeks of life. We experienced a case of congenital lobar emphysema diagnosed incidentally by chest reontgenogram in an infant with frequent upper respiratory infection within a few weeks of life. Chest X-ray revealed extensive emphysematous changes in the left upper lobe, shifting of heart and medistinum to the right and compression of the right lung. Respiratory distress, cyanosis and chest wall retraction ensued and left upper lobe Lobectomy was performed successfully.
Cyanosis ; Emphysema* ; Foreign Bodies ; Heart ; Humans ; Infant ; Lung ; Thoracic Wall ; Thorax

Background: The purpose of this study was to assess the reliability and validity of the 3-item version of the Work Engagement Scale (WES-3), which is based on the Job DemandsResources (JD-R) model and was used in the 5 th Korean Working Conditions Survey (KWCS). Methods: This study used data from the 5th KWCS (n = 50,205), which was conducted in 2017 with a sample of the Korean working population. The survey gathered comprehensive information on working conditions to define workforce changes and the quality of work and life. The reliability and internal consistency of the WES-3 were assessed using the corrected item-total correlation and Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was used to test the construct validity of work engagement. The convergent validity was assessed using the correlation with the WHO-5 well-being index. Correlations between work engagement and JD-R factors were also calculated. Results: The Cronbach's alpha for work engagement was 0.776, indicating acceptable internal consistency. The model comprising 3 work engagement and 2 burnout items showed an excellent fit (χ2 : 382.05, Tucker-Lewis index: 0.984, comparative fit index: 0.994, root mean square error of approximation: 0.043). The convergent validity was significant (correlation coefficient: 0.42). Correlations with burnout and job demands were negligible, whereas correlations with job resources and job satisfaction were weakly positive. Conclusions The results of our study confirm that the WES-3 has acceptable reliability and validity.

Background: The purpose of this study was to assess the reliability and validity of the 3-item version of the Work Engagement Scale (WES-3), which is based on the Job DemandsResources (JD-R) model and was used in the 5 th Korean Working Conditions Survey (KWCS). Methods: This study used data from the 5th KWCS (n = 50,205), which was conducted in 2017 with a sample of the Korean working population. The survey gathered comprehensive information on working conditions to define workforce changes and the quality of work and life. The reliability and internal consistency of the WES-3 were assessed using the corrected item-total correlation and Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was used to test the construct validity of work engagement. The convergent validity was assessed using the correlation with the WHO-5 well-being index. Correlations between work engagement and JD-R factors were also calculated. Results: The Cronbach's alpha for work engagement was 0.776, indicating acceptable internal consistency. The model comprising 3 work engagement and 2 burnout items showed an excellent fit (χ2 : 382.05, Tucker-Lewis index: 0.984, comparative fit index: 0.994, root mean square error of approximation: 0.043). The convergent validity was significant (correlation coefficient: 0.42). Correlations with burnout and job demands were negligible, whereas correlations with job resources and job satisfaction were weakly positive. Conclusions The results of our study confirm that the WES-3 has acceptable reliability and validity.

This study was performed to investigate the anatomical features of vertebral artery between the atlas and the axis. For this, we examined four angles (angle I, angle II, angle III and angle IV) to identify tortuosity of vertebral artery and diameter between the atlas and the axis. Materials used in this study were 93 vertebral arteries obtained from 48 adult Korean cadavers (34 males, 14 females) ranging from 18 to 90 years in age. On the anterior view, the vertebral artery relatively ascended vertically from C6 to the axis and then laterally passed through the foramen transversarium (FT) of the axis. The average of this angle I was 83.3 degree. The average of the right and left sides of this angle I were 84.7 degree and 82.0 degree, respectively. The average of angle I (95.4 degree) in female was larger than that (80.5 degree) of male. The artery passed through the FT of the axis turned to the superior direction. The average of this angle II was 95.9 degree. The right and left sides of the angle II were 97.8 degree and 93.8 degree, respectively. As the angle I, the average of angle II (110.6 degree) in female was larger than that of angle II (93.1 degree) in male. On the lateral view, the vertebral artery relatively ascended vertically from C6 to the axis and then posteriorly passed through the FT of the axis. The average of this angle III was 71.3 degree. The artery passed through the FT of the axis turned to the superior direction. The average of this angle IV was 87.3 degree. In angle III and angle IV, the average of angle in female were larger than that of male. These results show that female has greater tortuosity than male. The average diameter of the vertebral artery was 3.7 mm and the average diameter of right and left are 3.5 mm and 4.0 mm, respectively. In 76% of the total, left vertebral artery diameter was larger than that of the right.
Adult ; Arteries ; Axis, Cervical Vertebra* ; Cadaver ; Female ; Humans ; Male ; Vertebral Artery*

PURPOSE: To report a case of Chrysosporium parvum endophthalmitis after trauma. METHODS: A 42-year-old healthy woman visited our hospital complaining of ocular pain after trauma sustained with a wire used to tie grapes. She showed corneal laceration and iris prolapse of the right eye on slit lamp examination. She underwent primary suture of the corneal laceration. Two days later, she presented with hypopyon of the anterior chamber. She was treated with topical antibiotics and a topical steroid. On follow-up examination, she again presented with hypopyon of the anterior chamber. She was admitted for microbiologic examination and was again treated with topical antibiotics and a topical steroid. Unfortunately, no organisms were identified by culture. Later, she reported a recurrent history of the inflammation. After 9 months, she presented with increased hypopyon of the anterior chamber and was treated with anterior chamber irrigation and intracameral antibiotics injection on two different occasions. But, still no organisams were identified. After one year, the patient visited our clinic with ocular pain and decreased visual acuity. Her intraocular pressure was 72 mmHg and there was whitish infiltration and hypopyon around 360 degrees of the anterior chamber and angle. At the same time, the intraocular pressure and inflammation were uncontrolled. Ultimately, microscopic examination of specimens obtained directly from tissue after enucleation identified the organism as Chrysosporium parvum. CONCLUSIONS: We experienced a case of Chrysosporium parvum endophthalmitis after trauma. To our knowledge, this was the first report of a case of Chrysosporium parvum endophthalmitis in the world.
Adult ; Anterior Chamber ; Anti-Bacterial Agents ; Chrysosporium* ; Endophthalmitis* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Intraocular Pressure ; Iris ; Lacerations ; Prolapse ; Sutures ; Visual Acuity ; Vitis

PURPOSE: For tachycardic patients not in need of immediate cardioversion, the International Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care emphasize specific rhythm diagnosis and avoidance of simplistic overuse of adenosine. The purpose of this study was to identify the rhythms for which adenosine was inappropriately prescribed at the emergency department after the International Guidelines 2000 had been adopted. METHODS: We retrospectively investigated 128 tachycardic patients who had been prescribed adenosine at the emergency department from September 2000 to March 2003. Patients were divided into two groups. The Appropriate Use Group was comprised of patients for whom had been prescribed for narrow QRS-complex tachycardia on the initial ECG. The Inappropriate Use Group was comprised of patients for whom adenosine had been prescribed for atrial fibrillation, atrial flutter, atrial tachycardia, sinus tachycardia, and wide QRS-complex tachycardia of unknown origin on the initial ECG. RESULTS: Of the 128 patients, 31 (24.2%) were in the Inappropriate Use Group. Among them, atrial fibrillation was involved in 15, atrial flutter in 3, atrial tachycardia in 2, sinus tachycardia in 8, and wide QRS-complex tachycardia of unknown origin in 3. CONCLUSION: Approximately 24% of the emergency department patients who were treated with adenosine received the medication unnecessarily for atrial fibrillation, atrial flutter, atrial tachycardia, sinus tachycardia, and wide QRS-complex tachycardia of unknown origin. Additional education on electrocardiographic recognition of tachyarrhythmias, and the Tachycardia Algorithms of Guidelines 2000 may be necessary for residents of emergency department.
Adenosine* ; Atrial Fibrillation ; Atrial Flutter ; Cardiopulmonary Resuscitation ; Diagnosis ; Education ; Electric Countershock ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Retrospective Studies ; Tachycardia ; Tachycardia, Sinus

The authors report a case of esthesioneuroblastoma with intracranial extension treated by craniofacial resection. The tumor was resected by transbasal approach and repaired the dural defect using pericranial flap. The defect of floor of anterior cranial fossa was repaired with splitted calvarium and pericranial flap. Otorhinolaryngologist removed the residual tumor mass located at paranasal sinuses using lateral rhinotomy. Using cranifacial resection, the authors could remove the mass completely. The patient was referred to hemato-oncologist for chemotherapy.
Cranial Fossa, Anterior ; Drug Therapy ; Esthesioneuroblastoma, Olfactory* ; Humans ; Neoplasm, Residual ; Paranasal Sinuses ; Skull

A 39-year-old hairdresser developed sodium bromate poisoning after drinking a cup of hair neutralizer in a suicide attempt. This is the first case of visual loss afteringestion of sodium bromate. Only few cases are as a cause of acute renal failure reported in medical literature. She presented 1 day later with anuria, required hemodialysis. Sensorineural hearing loss, often a characteristic finding, was developed.
Acute Kidney Injury* ; Adult ; Anuria ; Deafness* ; Drinking ; Hair ; Hearing Loss, Sensorineural ; Humans ; Poisoning* ; Renal Dialysis ; Sodium* ; Suicide

We experienced two cases of Boerhaave syndrome (spontaneous esophageal rupture). The first patient was a 62-year-old male who presented epigastric pain after several violent vomitings associated with alcohol ingestion. Diagnosis was done early and promptly in our emergency center and then definitive treatment was done only after 12hrs from onset of his symptom and he was discharged in relatively good condition 256ays after his admission. The second patient was a 44-year-old male who was transfered to our emergency center with chest pain, dyspnea and fever after vomitings associated with autobicycle accident. Diagnosis was delayed due to initial trauma oriented evaluation and incidious develpement of typical clinical findings and then he was managed conservatively but he died of multiple organ failure due to sepsis. We report these cases with literature review.
Adult ; Chest Pain ; Diagnosis ; Dyspnea ; Eating ; Emergencies ; Esophageal Perforation* ; Fever ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; Sepsis