Sudden Infant Death Syndrome in Korea: A Retrospective Analysis of Autopsy-Diagnosed Cases

This study aimed to elucidate the demographic and sleeping environmental factors associated with sudden infant death syndrome (SIDS) in Korea. The autopsy reports of all SIDS cases reported to the National Forensic Service and Seoul National University College of Medicine between 1996 and 2008 were reviewed for data collection and analysis to identify the risk factors for SIDS. Analysis of the 355 SIDS cases reported within the study period revealed that of the 168 (47.3%) cases for which sleeping position before death had been reported, 75 (44.7%) cases had occurred after placement in prone or side position. Of the 204 (57.5%) cases for which bed-sharing situation had been reported, 121 (59.3%) deaths had occurred during bed-sharing, of which 54 (44.6%) infants were under 3 months of age, a significantly younger age than that of the non-bed-sharing cases (P = 0.0279). Analysis of the results indicated no tendency toward an increase or decrease in the use of a prone or side position. Rather, there was a statistically significant increasing trend for bed-sharing over the study period (OR, 1.087; 95% CI, 1.004-1.177; P = 0.04). These findings indicate the need for nationwide educational programs promoting a safe sleeping environment to enhance SIDS prevention.

The Role of Medical Examiners in Organ or Tissue Procurement of the Brain Dead People / 대한법의학회지

In the western countries, forensic pathologists under their rational postmortem investigation system do their appropriate role before or during all process of transplantation. As it is ongoing remarkable development in the transplantation medicine and it is more and more increased the number of would-be transplant patients, organ procurement from the brain dead will expand than ever. Considering the major causes of brain death which are cerebrovascular diseases, traffic accidents, and head injuries, the role of forensic doctors has to be more important in transplantation. Reviewing literatures and reporting our case which was requested for forensic consultation before the organ procurement because this case was related with violence and the cause of death was obscure, we would like to discuss and develop the systematic and organizational approach about the role of forensic pathologists in transplantation medicine in Korea.

The Statistical Analysis on Legal Autopsy in 2006 (The Headquarters of National Institute of Scientific Investigation) / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2006. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,515 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 1,788 cases(71.1%) and that of female 727(28.9%). Male was over twice more than female. The forties were 709 cases(28.2%), the fifties 496(19.7%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,437 cases(57.1%), natural 955(38.0%), and the unknown 123(4.9%). Among 1,437 unnatural deaths, suicide was 366(25.5%), homicide 387(26.9%), accident 392(27.3%), and the unclear 292(20.3%). Homicide occupied 40.4% of trauma, 51.9% of blunt force injury excluding traffic and fall-down injury, and 91.2% of sharp force injury. The homicide rate in asphyxia was 33.2%, but it went up to 71.4% excluding hanging. It showed only 1.3% percent of homicide in poisoning. 3. Traumatic deaths were 681 cases, occupying 47.4% of 1,437 unnatural deaths, followed by drowning deaths(199 cases). Blunt trauma was 206 cases(30.2%) and the leading cause of death in traumatic death. Poisoning was 158 cases, among which the cyanides were dominant(37cases). Thermal injuries were 144 cases, electrocution 14 cases, and starvation/neglect 21 cases. and 17 cases were directly due to medical procedures. 4. Among 955 natural deaths, heart diseases were 495 cases(51.8%), and vascular diseases 165(17.3%), and these two categories were added up to 660(69.1%). 5. Child deaths under the age of 10 were 118 cases. Homicide was 35 cases(57.4%) out of 61 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 45 cases(38.1%)

Post-traumatic primary bacterial peritonitis / 대한법의학회지

Spontaneous bacterial peritonitis (SBP) is a bacterial infection of ascites arising from liver cirrhosis, nephrotic syndrome and so on. Primary bacterial peritonitis (PBP) is a rare intraabdomial infection in the absence of underlying diseases or rupture of the viscus. The authors report an autopsy case of posttraumatic primary bacterial peritonitis in the otherwise physically healthy young female. She was beaten repeatedly around the abdomen with human physical instruments for a prolonged time.

The plausible practicality of modern high-tech medical imaging devices to forensic medicine and scientific crime investigation / 대한법의학회지

CT and MRI are high-tech devices for medical diagnosis. Their electromechanical function has leaped forward such a fast step, so that their image quality is improved and the time for a whole body scanning is shortened as little as only several minutes. These essential diagnostic tools are tried to apply for the field of forensic medicine in favor of their noninvasiveness and great resolution. These merits could make our postmortem investigation system improve in the aspect of practicality. This presenting study was done for the purpose of expecting what the field of forensic medicine could get or lose, what is needed technically, and what kind of supports are required. In our preliminary study, we gave injuries to the pigs' heads with weapons, scanned the wounds with high-tech devices, and embodied the injuries and the weapons three-dimensionally. These high-tech methods would be expected to play a role in forensic medicine and scientific crime investigation as a new and powerful testimony.

Sudden death due to epiglottic abscess / 대한법의학회지

Acute epiglottitis is a local bacterial infection of the supraglottic area. Epiglottitis is generally caused by organisms which invoke an inflammatory response that develops rapid obstructive edema. The disease rarely progresses to abscess stage, either because medical intervention is sought or death by asphyxiation ensues. A 38-year-old, mentally ill but physically healthy woman died of airway obstruction caused by acute epiglottitis forming an abscess. She died unexpectedly and suddenly showing only minor nonspecific symptoms.

A Case of Tension Pneumoperitoneum as a Fatal Complication of Colonoscopy / 대한법의학회지

Tension pneumoperitoneum (TP) is a rare fatal complication of colonoscopy. In a forensic point of view, this complication is hard to be diagnosed as a cause of death simply considering the result of autopsy findings without clinical information. We experienced an autopsy case expired by TP resulting from colonic perforation during colonoscopy. A 51-year-old woman was performed a colonoscopy under the sedation with propofol. The physician could not find any pathologic lesions throughout the whole colonic mucosa and noticed a perforation at sigmoid colon when he was about to wrap up his procedure. The patient was immediately transferred to the emergency department and showed distended abdomen with unstable vital signs. Although she was taken emergency exploratory laparotomy and simple closure of the perforated site, she died at 3 days after operation due to multiple organ failure. At autopsy, we could not find any other pathologic abnormality except for a wellsutured perforated site. However, the clinical findings and course enabled us to come to conclusion that the cause of death was TP. In conclusion, when conducting an autopsy on the death after colonoscopy, we should consider the possibility of TP by leakage of large amount of air during colonoscopy.

A Statistical Analysis on Legal Autopsy in 2005 (The Headquarters of National Institute of Scientific Investigation) / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation (NISI), requested by every kind of law enforcement agencies during the year of 2005. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,851 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,007 cases (70.4%) and that of female 844 (29.6%). Male was over twice more than female. The forties were 807 cases (28.3%), the thirties 573 (20.1%), and these two decades occupied 48.4%. 2. Unnatural deaths were 1,716 cases (60.2%), natural 1011 (35.5%), and the unknown 124 (4.3%). Among 1,716 unnatural deaths, suicide was 497 (29.0%), homicide 426 (24.9%), accident 510 (29.6%), and the unclear 283 (16.5%). Homicide occupied 42.0% of trauma, 75.6% of blunt force injury excluding traffic and fall-down injury, and 85.5% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 60.1% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 716 cases, occupying 41.7% of 1,716 unnatural deaths, followed by asphyxial deaths(296 cases). Blunt trauma was 205 cases (28.6%) and the leading cause of death in traumatic death. Poisoning was 229 cases, among which the ethanols were dominant (58cases). Thermal injuries were 198 cases, electrocution 20 cases, and starvation/neglect 14 cases. and 18 cases were directly due to medical procedures. 4. Among 1,011 natural deaths, heart diseases were 481 cases (47.6%), and vascular diseases 193 (19.1%), and these two categories were added up to 674 (66.7%). 5. Child deaths under the age of 10 were 129 cases. Homicide was 40 cases (62.5%) out of 64 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 41 cases(31.8%)

A Case of Natural Death Misinterpreted as Electrocution / 대한법의학회지

When the circumstance of a death seems to be related with electric shock, most of the forensic pathologists tend to diagnose the cause of death as electrocution if they see the electric mark(s) with the notincompatible histology, and find no other definite causes of death at autopsy. But admittedly forensic pathologists know that the so-called electric mark(s) and its histology is not pathognomonic to diagnose electrocution, so the diagnosis should be confirmed by the appropriate investigation of the death scene and the electric devices. We present a case of a man who had a likely current mark that could be diagnosed as natural by ruling out the possibility of electrocution with the examination of the electric lamp which had been under the dead body at the scene. This case gives us the importance of appropriate probe about scene evidences supplied by forensic science in diagnosing and ruling out the electrocution.

Mechanical Asphyxia Caused by Thymoma / 대한법의학회지

A 65 year-old female was suddenly expired soon after arriving in emergency room. Before arriving, she complained chest discomfort. Her neck mass was diagnosed as thyroid tumor about 11 years ago. She was recommended operation, but not taken due to arrhythmia. The neck mass was originally diagnosed as thyroid mass(goiter) by radiologic studies. The mass (10.5 x 9.5 x 7.0 cm, 319 gm) is mainly located in the lower neck and partly in the anterior superior mediastinum. The trachea is compressed by the mass and its tubal structure is flattened. The cause of death is mechanical asphyxia by thymoma(type B1 according to the WHO classification of thymoma, and stage I according to Masaoka's classification). On review of her past history, paraneoplastic syndrome including myasthenia gravis is not present. Generally, the patient with large thymic mass shows symptoms including chest pain, respiratory difficulty, hemoptysis, cough, superior vena cava syndrome. Although the symptoms related with its mass effect are common, but the death from mechanical asphyxia by thymoma is very rare in recent days.

The Statistical Analysis on Legal Autopsy in 2004 (The Headquarters of National Institute of Scientific Investigation) / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2004. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 3,051 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,214 cases(73%) and that of female 837(27%). Male was over twice more than female. The forties were 899 cases(29.5%), the thirties 561(18.4%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,816 cases(59.5%), natural 1,104(36.2%), and the unknown 131(4.3%). Among 1,816 unnatural deaths, suicide was 513(28.2%), homicide 414(22.8%), accident 505(27.8%), and the unclear 384(21.2%). Homicide occupied 38.4% of trauma, 62.9% of blunt force injury excluding traffic and fall-down injury, and 82.7% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 67.7% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 779 cases, occupying 42.9% of 1,816 unnatural deaths, followed by poisoning deaths(286 cases) and asphyxial deaths(283 cases). Blunt trauma was 240 cases(30.8%) and the leading cause of death in traumatic death. Poisoning was 286 cases, among which the ethanols were dominant( 76cases). Thermal injuries were 162 cases, electrocution 27 cases, and starvation/neglect 7 cases and 17 cases were directly due to medical procedures. 4. Among 1,104 natural deaths, heart diseases were 522 cases(47.3%), and vascular diseases 182(16.5%), and these two categories were added up to 704(63.8%). 5. Child deaths under the age of 10 were 147 cases. Homicide was 31 cases(51.7%) out of 60 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 48 cases(32.7%).

A Positional Asphyxia in an Unusual Place (a Laundry) / 대한법의학회지

Authors had experienced an unusual case of asphyxial death. A healthy woman was found dead in a laundry nakedly with her forearms being firmly fitted between inner tub and outer case of laundry. It was very difficult to explain why the woman was found in a narrow and small laundry tub nakedly. The autopsy findings were as following : Only small external bruises and excoriations were on trunk, arms and knees. On internal examinations there were no particular diseases and traumas. So to determine the manner and cause of death, it was essential to examine the place and the laundry. After investigation of the death scene and the laundry, we concluded that the woman was dead because of asphyxiation due to mechanical interference with pulmonary ventilation resulting from the unusual body position in the small laundry. Drunken state might be a crucial factor to death.

The Statistical Analysis on Legal Autopsy in 2003: The Headquarters of National Institute of Scientific Investigation / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation (NISI), requested by every kind of law enforcement agencies during the year of 2003. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 3,167 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,311 cases (73%) and that of female 856 (27%). Male was over twice more than female. The forties were 838 cases (26.5%), the thirties 700 (22.1%), and these two decades occupied 48.6%. 2. Unnatural deaths were 1,941 cases (61.3%), natural 1,133 (35.8%), and the unknown 93 (2.9%). Among 1,941 unnatural deaths, suicide was 522 (26.9%), homicide 457 (23.5%), accident 576 (29.7%), and the unclear 386 (19.9%). Homicide occupied 37.1% of trauma, 57.4% of blunt force injury excluding traffic and fall-down injury, and 81.9% of sharp force injury. The homicide rate in asphyxia was 35.5%, but it went up to 69.6% excluding hanging. It showed only 1.0% percent of homicide in poisoning. 3. Traumatic deaths were 902 cases, occupying 46.5% of 1,941 unnatural deaths, followed by poisoning deaths (289 cases) and asphyxial deaths (286 cases). Blunt trauma was 324 cases (35.9%) and the leading cause of death in traumatic death. Poisoning was 289 cases, among which the ethanols were dominant (99cases). Thermal injuries were 192 cases, electrocution 24 cases, and starvation/neglect 11 cases. and 15 cases were directly due to medical procedures.4. Among 1,133 natural deaths, heart diseases were 490 cases (43.2%), and vascular diseases 210 (18.5%), and these two categories were added up to 700 (61.7%). 5. Child deaths under the age of 10 were 135 cases. Homicide was 42 cases (63.6%) out of 60 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 52 cases (38.5%).

A Case Study of Death by Bullet with Fired Blank Cartridge / 대한법의학회지

An university student passed away by an unidentified bullet in a reserve force exercise. An X-ray could not find any bullet from the thorax. The post-mortem examination revealed that the victim had been killed by a 5.56 mm (diameter) bullet. The striation mark of the fatal bullet was coincided with a test fired bullet of a suspect's machine gun. However only blank cartridges had been fired according to the firing range records. Also, the examiner found that the mouth diameter of the fatal blank cartridge case is narrower than the others. In order to explain the strange happening, various situation of blank cartridge firing was considered. The examiner group noticed that the diameter of a blank cartridge mouth fired from an unexpelled bullet including gun may change. The authors test fired a blank cartridge case with a gun including an unexpelled bullet, and compared the shape of the mouth with the fatal blank cartridge case. The mouth shapes of two blank cartridges were coincided. The authors could conclude that the an unidentified suspect charged a bullet in the muzzle of the suspect's gun, and the bullet expelled by the gas pressure of the fatal blank cartridge case.

The Statistical Analysis on Legal Autopsy in 2002: The Headquarters of National Institute of Scientific Investigation / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2002. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 3,045 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,199 cases (72.2%) and that of female 846 (27.8%). Male was over twice more than female. The forties were 766 cases (25.2%), the thirties 692 (22.7%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,810 cases (59.5%), natural 1082 (35.5%), and the unknown 153 (5.0%). Among 1,810 unnatural deaths, suicide was 416 (23.0%), homicide 394 (21.8%), accident 592 (32.7%), and the unclear 408 (22.5%). Homicide occupied 33.3% of trauma, 49.3% of blunt force injury excluding traffic and fall-down injury, and 88.2% of sharp force injury. The homicide rate in asphyxia was 31.7%,but it went up to 59.2% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 867 cases, occupying 47,9% of 1,810 unnatural deaths, followed by poisoning deaths (269 cases). Blunt trauma was 284 cases (32.8%) and the leading cause of death in traumatic death. Poisoning was 269 cases, among which the agrochemicals were dominant (64cases). Thermal injuries were 193 cases, electrocution 16 cases, and starvation/neglect 9 cases. and 17 cases were directly due to medical procedures.4. Among 1,082 natural deaths, heart diseases were 450 cases (41.6%), and vascular diseases 186 (17.2%), and these two categories were added up to 636 (58.8%). 5. Child deaths under the age of 10 were 179 cases. Homicide was 35 cases (37.2%) out of 94 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 48 cases (26.8%)

An Analysis on Legal Autopsy Under 1Year of Age / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies under 1 year of age performed at the Headquarters of the National Institute Scientific Investigation, requested from law enforcement agencies from 1996 to 2000. This report aims to analyse various aspects of 530 unusual deaths under 1 year of age in Korea, chiefly Seoul and its surrounding area. Male was 55.8% and female was 44.2%. Unnatural deaths were 39.6%, natural 53.4%, and the unknown 7.0%. Homicide occupied 66.7% in unnatural death and asphyxia was 41.4%, starvation and neglect 35.0%, and trauma 20.7% in homicide. Smothering was the leading cause of asphyxial homicide and accidental death. Natural death including perinatal disorders, sudden infant death syndrome and congenital malformations was the main cause of death in this age group.

Pulmonary Thromboembolsm in Legal Autopsy / 대한법의학회지

Pulmonary thromboembolism (PTE) is a significant cause of death in the hospitalized patient in the western and developed countries. The development of PTE and venous thrombi is associated with many and various factors, including that physicians fail to provide adequate prophylaxis to the high risk patients. The authors studied 74 legal autopsy cases performed from 1996 to 2000 at the Headquarters of National Institute of Scientific Investigation, Seoul, Korea. We learned that ceasarian section was the most common precedong trauma in PTE death in legal cases. Excluding Ceasarian section cases, major mechanical injuries, male gender and aging were common factors associated with PTE. Obesity was a common factor in all kinds of trauma. Deep vein thrombi were documented in majority cases and ambulation was a critical triggering cause for the thrombi making PTE. Clinical diagnosis was not so satisfactory.

Sudden Infant Death Syndrome and Sudden Child Death Syndrome / 대한법의학회지

In 1969, the International Conference proposed a definition of sudden infant death syndrome (SIDS): the sudden death of any infant or young child which is unexpected by history and in whom a thorough necropsy fails to demonstrate an adequate cause of death. The National Institute of Child Health and Human Development redefined SIDS in 1989, requiring death scene investigation with age restriction under 12 months. These definitions, however, are not adequate for the countries having under-organized medico-legal system. In South Korea, no mandatory or customary complete medico-legal investigation is not performed in the sudden child death cases, including autopsy. As a consequence, SIDS can be diagnosed as 'unknown 'by non-pathologists. Even in autopsy cases, the pathologists can not collect proper medical history by themselves. Furthermore, scene investigation is just performed by police or omitted. Age in SIDS is a controversial problem in both upper and lower limit. So the authors concluded that the above two definitions of SIDS are not agreeable with the country such as South Korea. We proposed a new concept of sudden child death syndrome (SCDS), which means 'the sudden death of any infant including neonate with good condition after birth, or young child which reveals no definite cause of death by inspection or autopsy ', for the purpose of not unreasonable diagnosis and adequate research in the countries having under-developed postmortem investigation system.

Report of Newborn deaths at Post-delivery care facilities in 2001 and 2002 / 대한법의학회지

The increase in number of nuclear families and double-income families contributed to the birth of many post-delivery care facilities, and this trend also bolstered such facilities that are not registered as a medical institution to provide post-delivery care to group of infants and new mothers. The fear of anthrax that hit America after the September 11 Attack has attributed to aggravation of the fear of virus in Korea, and the cause of infant deaths at post-delivery care facilities drew unprecedented public attention. In this context, it would be worth to note the cause of infant deaths in six cases that took place in October and November of 2001, March of 2002 at post-delivery care facilities. The age of the victims were 11 days(twin boys), 17 days(girl), 21 days(girl), 15 days(girl), 14 days(girl) and 14 days(boy). The circumstances under which those infants died were varied, but with a exception of one infant, all were presumed to have suffered from diarrhea at the facilities, and were brought to hospitals after suffering from respiratory difficulties only after care providers suspected more serious medical problems than initial thought. The first two autopsies indicated positive for rotavirus test. Autopsies of all cases except one reveal no specific findings that are noteworthy. One case shows global ischemic myocardial necrosis and pneumonia. In five cases where the amount of feeding was tracked down, the less than normal amount of feeding and the slower than normal body-weight increase were noted that lasted for several days before deaths. It is our opinion that even healthy infants in a group care facility require a higher standard of sanitation to prevent various infection and that the use of measurement that easily indicates the correlation between the amount of feeding and the body-weight increase will be helpful to prevent deaths from virus infection at group care type of post-delivery facilities.

The Statistical Analysis on Legal Autopsy in 2001: The Headquarters of National Institute of Scientific Investigation / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2001. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City, and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,807 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,043 cases (72.8%) and that of female 764 (27.2%). Male was over twice more than female. The forties were 723 cases (25.8%), the thirties 641 (22.8%), and these two decades occupied 48.6%. 2. Unnatural deaths were 1,690 cases (60.2%), natural 1020 (36.3%), and the unknown 97 (3.5%). Among 1,690 unnatural deaths, suicide was 415 (24.6%), homicide 418 (24.7%), accident 505 (29.9%), and the unclear 352 (20.8%). Homicide occupied 37.1% of trauma, 44.1% of blunt force injury excluding traffic and fall-down injury, and 83.5% of sharp force injury. The homicide rate in asphyxia was 32.5%, but it went up to 62.7% excluding hanging. It showed only 1.0% of homicide in poisoning. 3. Traumatic deaths were 825 cases, occupying 48,8% of 1,690 unnatural deaths, followed by asphyxial death (249 cases). Blunt trauma was 295 cases (35.8%) and the leading cause of death in traumatic death. Poisoning was 213 cases, among which the agrochemicals were dominant (68 cases). Thermal injuries were 193 cases, electrocution 31 cases, and starvation/neglect 10 cases. 36 cases were direct- 4. Among 1,020 natural deaths, heart diseases were 398 cases (39.0%), and vascular diseases 145 (14.2%), and these two categories were added up to 543 (53.2%). 5. Child deaths under the age of 10 were 194 cases. Homicide was 43 cases (48.9%) out of 88 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 64 cases(33.0%).