Postmortem Diagnosis of Diabetic Ketoacidosis: An Autopsy Case / 대한법의학회지

Diabetic ketoacidosis is an acute complication of type 1 diabetes mellitus, which is observed frequently in routine autopsies. However, there are limitations of postmortem diagnosis of diabetic ketoacidosis. Clinical diagnostic criteria of the disease are not applicable to postmortem diagnosis because of the postmortem changes of the body; hence, diagnostic morphological changes cannot be observed. We report the case of a 47-year-old man that was diagnosed with diabetic ketoacidosis via routine autopsy and laboratory tests without information regarding his medical history. Additionally, we present a brief literature review.

Cheese-like Material in the Heart: An Autopsy Case Report of Severe Hypertriglyceridemia in Diabetic Ketoacidosis Patient / 대한법의학회지

Here we report an autopsy case of diabetic ketoacidosis (DKA) with severe hypertriglyceridemia (12,900 mg/dl). A 29-year-old woman with a history of type 1 diabetes was found dead at a motel. There was no injury on external inspection, but a lump of cheese-like material was noted in the heart at autopsy and peripheral blood plasma had a creamy appearance. After postmortem biochemical analysis, we made a diagnosis of DKA with severe hypertriglyceridemia and concluded that these unusual autopsy findings were caused by DKA and postmortem change. Uncontrolled diabetes often causes DKA and hypertriglyceridemia. To the best of our knowledge, this is the first report in Korea of DKA with severe hypertriglyceridemia diagnosed by autopsy.

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.

A Statistical Analysis on Forensic Odontological Examination at the NFS from 2007 to 2010 / 대한법의학회지

Analysis of the cases registered for the Forensic Odontology Lab of the National Forensic Service (NFS) from April 6th, 2007 to December 2010 was performed to observe the trend and pattern of the cases, in order to propose measures for improvement in future cases both in quantity as well as quality. High rate of cases were observed from the capital area, especially in ground and mountains during warmer season from June to October. Most of the cases were of human remains requested and examined for the estimation of age, sex, stature and identification. However, some of the requested criteria were applied forensic methods such as postmortem interval, cause of death, and facial reconstruction which could not be conducted. To better fulfill the needs of the society, reform of the current registration-examination system by introducing a multi-disciplinary team for processing the scene, education of the law enforcement personnel, research and acquiring funds for the relevant areas, developing antemortem dental record database are recommended for improvement in quantity and quality of the information produced by odontology lab.

A Study of Weight Ratio of Lung to the Spleen for the Diagnostic Index of Drowning / 대한법의학회지

The diagnosis of drowning is one of the most difficult in forensic pathology. One of the most common autopsy findings in drowning cases is a heavy, edematous lung as the result of water that is aspirated into the lungs before death. There are several controversial findings and arguments about the lung weight as a marker of drowning. The aim of the present study is to examine the difference in the lungs to the spleen weight ratio between seawater and freshwater drowning, compared with asphyxiation and acute cardiac death. This study compared the weight ratio of the lungs to the spleen for 29 cases of drowning (24 males, 5 females), 30 cases of mechanical asphyxiation (16 males, 14 females), and 37 cases of acute cardiac death (30 males, 7 females). This study presented significant differences in the lungs to the spleen weight ratio between drowning and the other causes of death . Therefore, these findings suggest that the ratio may be a useful index for accurate diagnosis of death by drowning.

Preparation of Bone Slide for Histomorphometry in Forensic Anthropology / 대한법의학회지

Microscopic analysis of bone is very useful method for estimating age at death of individual identification, diagnosing metabolic disorder or dietary deficiency in bone tissue, and differentiating human bone or not when applied to fragmentary skeletal remains. The purpose of this study was to establish a systematic method for preparing bone tissues by manual grinding method and offer help in application of related histomorphometric field such as estimating age at death. For this, human bone tissues of rib and femur from cadavers were prepared and considered histomorphological variations of osteon with light microscope. As results of this study, Type II osteons, smaller versions of Intact osteons (Type I) that form by radial remodeling of a preexisting Haversian canal, were distinguished from double-zonal osteons, one of the osteons that exhibit hypercalcified ring within their concentric lamellae, by the lack of an internal reversal line and the parallel contours of lamellae, and it is possible to suggest metric basis for drifting osteons as counting one osteon with the exception of size measurement. By applying this method of present study, one could easily make a bone tissue all oneself that would be helpful for establishing basic data in physical and forensic anthropology.

A Case of Crush Syndrome after Physical Assaults / 대한법의학회지

The crush syndrome was first defined as a clinical entity in 1941. The term myorenal syndrome is preferred to the term crush injury or crush syndrome. The syndrome occurs in sjambok, deep burns and crush injuries. Crush injury is caused by continuous prolonged pressure on the limb. The main injury is to muscles of the limbs. Crush syndrome, which is the general manifestation of crush injury, has been accompainment of crushing injuries following disaster situations and war. However, we report a case of crush syndrome after physical assaults.

PMI (PostMortem Interval) Estimation Through Forensic Entomology Method: A Case study of Whasung Woman University Student Dead Affair / 대한법의학회지

It is difficult to estimate PMI of whom died long times ago, because corpse goes by many decomposition stages. So it makes investigation more difficult. Nowadays many studies about PMI estimation have been performed. In other countries, forensic entomology studies which is possible to estimate not characteristic of death site but also exact death time are actively advanced. So forensic entomology has been more important related not PMI estimation but also many lawsuits in other countries. In Korea, the necessity of Forensic entomology has increased after occuring of the case 'Gaeguri Sonyeon(missing boys who went to catch a flog)'. In this case, regional characteristic is known by insects found on the corpse or clothes. We suggest possibility of applying forensic entomology, consideration, some limitations and the direction of the future study through the analysis, comparison with true facts, and PMI estimation using collected fly larvae in "Hwaseong Case".

The Study on the Association between Smoking and Coronary Artery Stenosis in Some Autopsy Cases / 한국역학회지

Coronary artery disease(CAD), such as atherosclerosis, myocardial infarction and sudden death has been considered the major cause of death for decades and their incidence and prevalence are still increasing. Numerous studies have been done on the risk factor analysis of CAD. But, they were usually based on the clinical and epidemiologic studies of the living patients. The purpose of this study was to evaluate the risk factors for the cardiovascular diseases in autopsy cases from Korean men. The author analysed 81 cases of heart who underwent legal autopsy from Aug. to Dec. 1998. The author measured percent stenosis of coronary artery, site of stenosis, perimeter of aorta, heart weight, body weight, and height and checked the past history including smoking, drinking and age. The results were as follows: 1) Coronary artery stenosis had a positive correlation with age, perimeter of aorta and smoking, but had no correlation with body weight, height, body mass index, heart weight, and drinking. 2) According to the logistic regression analysis, smoking amount and age were significantly associated with coronary artery stenosis. In conclusion, smoking was the most significant independent variable for coronary artery stenosis of some Korean men.

Paraquat Poisoning by Injection: 3 autopsy cases / 대한법의학회지

Paraquat is a bipyridilium nonselective contact herbicide and well-known pulmonary toxicants. Concentrated solution of paraquat may causes severe corrosive injury and multiple system organ failure. It is poorly absorbed from GI tract, but is extremely toxic and so one swallowed mouthful of Gramoxone(about 5ml) will be fatal. We experienced 3 cases of paraquat poisoning through injection and examined pathologic findings, medical records and concentration of paraquat in blood and tissues. We reviewed the mechanism of action of paraquat, pathologic changes of organ system, concentration of compound in the various organ and cause of death in autopsy cases.