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.

Treatment Outcome of Langerhans Cell Histocytosis / 대한골관절종양학회지

PURPOSE: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. MATERIALS AND METHODS: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. RESULTS: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. CONCLUSION: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

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.

The Analysis of Post Operative Treatment of Malignant Melanoma Using High Dose Interferon-alpha2b Immunotherapy: Preliminary Report / 대한골관절종양학회지

PURPOSE: Interferon-alpha2b using immunotherapy of malignant melanoma is known to increase the microscopic enemies that remain after surgical resection of the tumor to prevent recurrence, disease-free survival and overall survival. Authors in patients with malignant melanoma after surgical resection and high-dose interferon-alpha immunotherapy treated group of disease-free survival and overall survival compared with the results of the treatment of immune therapy to a preliminary report. MATERIALS AND METHODS: From February 2010 to October 2012 at our institution between being diagnosed with malignant melanoma after surgical immunotherapy treated patients were analyzed. Patients was evaluated using the stage AJCC stage IIA 3 cases, IIB 1 cases, IV 1 were as follows. Follow-up period of at least 7 months, and a maximum of 32 months. As maintenance therapy after the first induction therapy group underwent immunotherapy interferon-alpha of body-surface area per 200,000 IU five times in a week for 4 weeks sedentary and body surface area a total of 48 weeks per week to 100,000 IU three times subcutaneously. These patients for local recurrence and metastases, and distant metastasis were investigated disease-free survival was investigated. RESULTS: Interferon-evaluation through follow-up chest computed tomography (CT) and positron emission computed tomography (PET CT) in patients who underwent the alpha immunotherapy results above both local recurrence and metastases without evidence of distant metastases. CONCLUSION: The high-dose alpha2b immunotherapy performed in patients to prevent the local recurrence of the tumor and metastasis to the current or future ultimate survival and disease-free survival improvement achieved is additional study and follow-up will be needed.

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.

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 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.

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.

Cyclosporin Modulates DNCB Contact Hypersensitivity Reaction in Guinea Pigs / 대한피부과학회지

CsA per os during the early sensitization period caused potentiation of 14-day shin response and this response was enhanced in group D, CsA given on days 3 7 Thereafter, suppression of CHS began in group E, CsA was given on days 6- 1G, and this tendency continue to the time of full sensitization of guinea pigs (group G). 27701173 We report herein a case of alopecia mucinosa in a 46-year-old male. He had a coin-sized erythematous hairless plaque on the parietal area. Histopathologic examinations, including much stains, showed typical findings of alopecia mucinosa. Thc present case, appeared on the scalp, might be an acute benign type of the disease.

A Case of Sparganosis Developedin Penile Shaft / 대한피부과학회지

We experienced a case of sparganosis developed in the dorsum of penile shaft where, we think, is the very rare site of sparganosis reported in Korea. The patient, a 23 year-old Korean soldier, had slight tender thread-like linear subcutaneous mass on the dorsal aspect of penile shaft for 1 month prior to coming to us. The skin lesion was not palpated when the penis was erect. He had experience of intaking raw-snakes intermittently(5 times) since 2 years ago.

Avian Mite Dermatitis: Observation of the Causative Mites and Clinical Findings / 대한피부과학회지

It has been well known that prutic skin diseases are very common among the chicken raisers. Authors visited three paultry farming area in Kyung Ki Province to observe the avian mite dermatitis among the workers and to collect the causative paultry mites during the period from March to September, 1982. At every paultry farming area, we chose two families to investigate every family member and to check the dermatitis correlated with the mite that we had collected from the samples of each house dust and hen-house dust. The result were summarized as follows; 1. Ornithonyssus sylviarum (Canestrini and Fanzago, 1877) was found in dust samples from two houses and two hen-houses. And Dermatophagoides species and Acarus siro (Linnaeus, 1758) were also collected from the other house and henhouse samples. 2. Three cases of avian mite dermatitis were found in one family, where O. syiviarum was collected in the dust samples from their house and hen-house.

A Case of Hair Follicle Nevus / 대한피부과학회지

Hair follicle nevus is one of several nevi, in which hair and hair follicle are involved. Crowding of numerous tiny but mature hair follicles with thick fibrous root sheath are the characteristie histologic finding of the nevus. The patient was one month old male infant with pedunculated. mass l cm in size on the left preauricular area. Histologically the skin of the lesion is covered by acanthotic epidermis. In the corium are numerous small mature hair follicles with thick fibrous sheath and a few small Iobules of sebaceous gland embedded in a fibrovascular stroma. There are, however, no central plate of cartilage and adipose tissue.

Two Cases of Unusual Scabies / 대한피부과학회지

Recently tnere have been many reports about scabies aggravated during treatment with topical fluorinated st roid. We describe bere two cases of scabies showing unusual clinical features associated. with topical steroid a.nd morphology of different s.zges of 5arcoptes scabiei coliected from the patient. In first case who was 20 year-old riiale patient treated with topical betamethasone cream and antihistaminics per os for 2 months, we collected 62 mites from 130 burrows: 45 adult females, 5 adult males, 6 deutonymphs, 4 protonymphs and 2 larvae. In second case who was 29 year old male patient treated with topical steroid (Esperson), for one month, we rollected 9 adult female itch mites and two (male & female) Dermatophagoides pteronyssnus from 48 burrows.