Application of 3D Surface Scanners in Forensic Science and Medicine ( I ): Digital Storage of Human Skeletons and Development of Appraisal Methods for Incident Scenes / 대한법의학회지

The aim of this project was to use 3D scanning data collected at incident scenes and various evidence to 1) develop surveying methods based on 3D data consisting of overall and detailed scene evidence, captured by long-range and micros-canner, which can be shared by personnel working in different fields such as forensic medicine, video analysis, physical analysis, traffic engineering, and fire investigation; 2) create digital storage for human skeletons and set the foundation for virtual anthropology; and 3) improve the credibility of 3D evidence by virtual remodeling and simulation of incident scenes and evidence to provide a basis for advanced and high-tech scientific investigation. Two complete skeletons of male and female were scanned using 3D micro-scanner. Each bone was successfully reproduced and assembled in virtual space. In addition, recreating evidence scheduled for invasive examination by creating RP (rapid prototype) was possible. These outcomes could play an important role in setting up the new field of virtual anthropology. Case-specific surveying methods were developed through analysis of 3D scanning data collected by long-range surface scanners at the scenes of vehicular accidents, falls, shootings, and violent crimes. A technique and recording method was also developed for detecting forged seals by micro-scanning the pressure exerted on the seal. Appraisal methods developed in this project could be utilized to secure 3D data of human skeletal remains and incident scenes, create a standard for application, and increase objectivity, reproducibility, and accuracy of scanning methods. We plan to develop case-specific 3D data analysis techniques to improve the credibility of analysis at the NFS and to establish a 3D data collection and analysis team.

Physical Anthropological Study of Excavated Bones from Siheung Cultural Remains / 체질인류학회지

GyeongGi Cultural Foundation was requested the identification of eight excavated human skeletons from Neunggok residential development district within Siheung-si. Those were measured for distinguishing sex, stature, and age at death using metric and non-metric methods. The identification of eight human remains was not easy because the excavated bones were destroyed partly and totally. Six skeletons were excavated from the limed-soiled mixture tomb; five remains among 8 were buried in same grave and 2 skeletons were excavated from the earthen tomb. Four remains were determined female skeletons. One skeleton was assumed adolescence, three skeletons were estimated 40's~50's years old and others couldn't be done. Four among eight remain skeletons, the stature of female remains was around 150~157 cm and male's stature was around 165 cm. Most bones were damaged and destroyed, and the remaining teeth on the maxilla and mandible were not enough for identification. We couldn't identify through metric and non-metric methods. If the human skeletal remains were not found with artifact, those couldn't determine the period. So we couldn't know the relationship between the period of burial and condition of bones. For this reason, we will study the identification using the small and damaged bones. Anthropologists and archeaologists need to work together to make database to determine identification and period.

Corrective Rhinoplasty for Deviated Nose a New Osteotomy Technique

PURPOSE: Posttraumatic nasal deformities might not be corrected adequately by conventional osteotomy techniques when the configuration of the nasal bone has been changed due to malunion. To consistently obtain good aesthetic and functional results, the anatomic reduction of malunion sites of the nasal bone is important. The purpose of this study is to present an osteotomy technique, including refracture along malunion sites and anatomical reduction of a malformed nasal bone, for the correction of a posttraumatic deviated nose. METHODS: From March of 2003 to May of 2004, 27 patients, who underwent corrective rhinoplasty for the correction of bony pyramid deviation, were included in this study. Postoperative results of the technique were evaluated objectively at 1 year after surgery regarding nasal midline location, nose symmetry, and nasal contour. Results were rated as excellent, good, fair, or poor. All patients were also evaluated subjectively for cosmetic improvement, changes in breathing, and overall satisfaction. RESULTS: Objective analysis of the outcomes revealed an excellent result in 17 patients(63%), good in 9(33%), and fair in 1 patient(4%). No case evaluated had a poor result. Regarding subjective analysis, 19 patients(70%) evaluated the cosmetic outcome as perfect. Among the 21 patients with preoperative airway problems, 19 patients(90%) reported improved breathing post-operatively. Patients' overall satisfaction levels were also very positive. No postoperative complications occurred during the 14 month mean follow-up period. CONCLUSION: The osteotomy technique presented in this study is simple, effective, and safe for correcting posttraumatic nasal deviation, and also produces consistent results.

The Removal of Plates after Craniomaxillofacial Surgery: A Retrospective Study

PURPOSE: Plate systems have been used for osteosynthesis of cranial and oromaxillofacial fracture. However, there is no consensus on the need for routine removal of plate and the question about indications of removal. Therefore, we present the retrospective study to clarify the indications and consensus of removal. METHODS: The medical records of patients who were treated with rigid internal fixation using plates after craniofacial trauma were reviewed. Study variables included age, gender, type of fracture, type of plate, seniority of the operator, causes of removal, and time between insertion and removal. All results amendable to statistics were analyzed using SPSS 10.0 to determine which set of variables might affect the fate of the plates. RESULTS: For a period of 10 years (March 1, 1994 through July 31, 2004), total of 41 plates(6.7%) were removed among 609 plates inserted into 419 patients; 27 plates were removed from 15 patients for infection, which is the most common cause of removal accounting for 65.8%. Mean time between insertion and removal is 35.2 months and mean age is 41.4 years. Most plates were removed from combined fracture(14.92%) and facial fracture(8.47%) and these were statistically significant. The age, gender, seniority of the operator and other variables were not statistically associated with plate removal. CONCLUSION: This retrospective study shows that routine removal does not appear to be clinically indicated due to respectively low removal rate and that the commonest indications for removal were infection.

"Recovery Only" ST-Segment Depressions in an Exercise Treadmill Test and the Prediction of Coronary Artery Disease

BACKGROUND AND OBJECTIVES: "Recovery only" ST-segment depressions are sometimes detected during an exercise treadmill test. We undertook this study in order to clarify the predictive value of exercise-induced ST-segment depression occurring in recovery only. SUBJECTS AND METHODS: The study included 931 patients who had both a sign or symptom -limited treadmill test. Of the 66 patients who demonstrated abnormal ST-segment responses, 43 experienced ST-segment depressions during exercise (Group A) and 23 displayed such responses only during recovery (Group B). RESULTS: The positive predictive value of an exercise treadmill test for significant angiographic disease in group A (81.3%) was statistically different from the predictive value in group B (30.4%). Horizontal ST-segment depression in recovery periods and female sex were statistically significant factors favoring negative coronary angiographic results. CONCLUSION: The occurrence of horizontal mild ST-segment depression during only the recovery periodgenerally represents a "false positive" response, particularly in female patients.

The Optimal Timing to Measure C-Reactive Protein to Predict Cardiac Events in Patients with Unstable Angina

BACKGROUNDS AND OBJECTIVES: C-Reactive protein (CRP) levels are powerful predictors of cardiac complications and death in patients with unstable angina unrelated with myocardial cell damage or myocardial ischemia. This study was performed to determine the optimal timing to measure CRP to predict cardiac events in patients with unstable angina. MATERIALS AND METHOD: The study was comprised 50 patients with unstable angina (Braunwald Class IIIb). We randomized the study subjects by the time of CRP elevation (> 8mg/L): Group A (on admission, 15 patients), Group B (during hospitalization, 19 patients), and Group C (at discharge, 19 patients). RESULTS: 1) CRP levels (median and range) of Group A, B, and C were 10.6 (8.2-24.2), 12.8 (8.1-33.7), and 10.3 (8.1-18.7) mg/L, respectively (p=S). 2) During clinical follow-up at a mean duration of 12 months, there were 1 death, 1 myocardial infarction, 6 revascularization therapy (PTCA or CABG) and 11 recurrent angina. 3) In Group A, 10 cardiac events (1 myocardial infarction, 4 revascularization therapy, and 5 recurrent angina) occurred. The elevated levels of CRP predicted cardiac events during clinical follow-up with sensitivity of 53%(10/19), positive predictive value of 67%(10/15), and negative predictive value of 74%(26/35). In Group C, 13 cardiac events were occurred. Sensitivity, positive and negative predictive value to predict cardiac events of elevated levels of CRP were 68%(13/19), 68%(13/19) and 81%(25/31), respectively. 4) Elevated levels of CRP (>8mg/L) were predictors for cardiac events in patients with unstable angina (Group A; p 8mg/L at discharge were only predictive of cardiac events with odd ratio of 6.01 (95% CI 1.50-44.3, p 8mg/L) was elevated in 38% of patients at discharge and elevated levels of CRP at discharge were only predictive of cardiac events in patients with unstable angina.

TnI, cTnT, and CK-MB in patients with chronic renal failure / 대한내과학회지

BACKGROUND: Nonspecific elevations of CK-MB, cTnT have been well known in patients with chronic renal failure(CRF) on maintenance hemodialysis. It has been suggested that recently developed cTnI seldom shows nonspecific elevations in these patients. Status of CRF patients can be divided into three groups: predialysis group, hemodialysis group and peritoneal dialysis group. Until now, most researchers have studied CK-MB, cTnT and cTnI only in CRF patients receiving maintenance hemodialysis. No previous studies have ever compared the differences of the nonspecific positivity of CK-MB, cTnT and cTnI according to the different status of CRF patients. METHODS: Nonspecific positive ratios of cTnI, cTnT, & CK-MB in were evaluated 20 predialysis patients, 13 CAPD patients and 20 hemodialysis patients. No one had had any evidence of myocardial ischemia during the previous 3 months before the study entry. The predialysis group was again divided into two groups according to the cut off level of serum creatinine of 3.0 mg/dl. Authors also compared the nonspecific positive ratios of cTnI, cTnT, CK-MB between diabetic CRF group and non diabetic CRF group. The sensitivity, specificity and false positive ratios of each enzymes were examined on and 6 hours after arrival in 21 CRF patients who visited the emergency room with the complaint of chest pain. RESULTS: 1) There were no nonspecific significant elevations of cTnI in CRF patients regardless of the status of CRF. But there were significant nonspecific elevations of CK-MB, cTnT in them. It was more marked in cTnT especially with the cut-off value of 0.1 ng/ml. 2) Nonspecific positive ratios of cTnT was significantly increased in diabetic CRF patients. 3) The sensitivity and specificity of cTnI were 100% and 93.3% each, which were significantly higher than those of CK-MB(83.3%, 66.7%) & cTnT(66.7%, 53.3%). CONCLUSION: In CRF patients, the nonspecific positive ratios of CK-MB, cTnT were higher than that of cTnI, and only cTnI did show significant specific elevations in all the CRF patients with acute myocardial infarction. It is likely that the status of CRF patients, dialysis mode, the sampling time point would not give significant changes in the nonspecific positive ratios of CK-MB, cTnT and cTnI.