Statistical Analysis of Postmortem Inspection Cases of the National Forensic Service Seoul Institute in 2017 / 대한법의학회지

This study provides a statistical analysis of 1,226 cases of death occurring in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro Police Stations) from January 1 to December 31, 2017. There were 427 postmortem inspection cases in Gangseo, 393 in Yangcheon, 377 in Guro, and 29 in other areas. The number of autopsy cases was 69 in Gangseo, 70 in Yangcheon, 86 in Guro, and seven in other areas. According to the postmortem inspection reports, there were 593 cases of natural death and 336 cases of unnatural death, while in 297 cases the cause of death was unknown. Of the 297 unknown cases, autopsy rates from each police station were as follows: 54 of 99 cases (54.5%) in Gangseo, 60 of 101 cases (59.4%) in Yangcheon, 67 of 93 cases (72.0%) in Guro, and in all four cases (100%) from other areas. Unnatural deaths included 215 cases of suicide, nine cases of homicide, and 64 accidental death, while 48 cases were undetermined. Among the unnatural deaths, the cause of death included 138 cases of hanging, 72 cases of falls from a height, and 32 cases of poisoning. Since this statistical study is based on actual postmortem inspection data for 1,226 cases of death in the eight areas of Seoul (excluding deaths from traffic accidents), it raises issues relating to the current postmortem inspection system, and can be used as reference material for a comprehensive overview of causes of death.

Statistical Analysis of Postmortem Inspection Cases of the National Forensic Service Seoul Institute in 2017 / 대한법의학회지

This study provides a statistical analysis of 1,226 cases of death occurring in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro Police Stations) from January 1 to December 31, 2017. There were 427 postmortem inspection cases in Gangseo, 393 in Yangcheon, 377 in Guro, and 29 in other areas. The number of autopsy cases was 69 in Gangseo, 70 in Yangcheon, 86 in Guro, and seven in other areas. According to the postmortem inspection reports, there were 593 cases of natural death and 336 cases of unnatural death, while in 297 cases the cause of death was unknown. Of the 297 unknown cases, autopsy rates from each police station were as follows: 54 of 99 cases (54.5%) in Gangseo, 60 of 101 cases (59.4%) in Yangcheon, 67 of 93 cases (72.0%) in Guro, and in all four cases (100%) from other areas. Unnatural deaths included 215 cases of suicide, nine cases of homicide, and 64 accidental death, while 48 cases were undetermined. Among the unnatural deaths, the cause of death included 138 cases of hanging, 72 cases of falls from a height, and 32 cases of poisoning. Since this statistical study is based on actual postmortem inspection data for 1,226 cases of death in the eight areas of Seoul (excluding deaths from traffic accidents), it raises issues relating to the current postmortem inspection system, and can be used as reference material for a comprehensive overview of causes of death.

The Statistical Analysis on the Postmortem Inspection Cases of National Forensic Service Seoul Institute in 2016 / 대한법의학회지

From January 1, 2016 to December 31, 2016, a total of 1147 postmortem inspection cases in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro police stations) were statistically analyzed. Autopsies were performed in 205 cases (17.9%), and the autopsy rates were 17.6% (75/426 cases) in the Gangseo police station, 9.5% (34/357 cases) in the Yangcheon police station, and 24.3% (82/337 cases) in the Guro police station. For 288 cases with an unknown cause of death, the autopsy rates were 70.0% (60/87 cases) in the Gangseo police station, 28.6% (26/91 cases) in the Yangcheon police station, and 63.1% (65/103 cases) in the Guro police station. For 65 cases due to fall from height, the autopsy rate was 7.7% (n=5). Of the 187 cases due to hanging, 155 cases were classified as suicide at the scene with a 4.5% (n=7) autopsy rate and 32 cases were classified as an undetermined manner of death at the scene with a 15.6% (n=5) autopsy rate. The distribution of the “manner of death” was natural death, 45% (n=516); unnatural death, 29.9% (n=343); and other and undetermined, 25.1% (n=288). Proportions of dispatch times were 50.9% (584 cases) during work hours (09:00–18:00), 13.8% (n=158) during evening hours (18:00–21:00), 13.4% (n=154) at night (21:00–00:00), 11% (n=126) at dawn (00:00–06:00), and 10.9% (n=125) during morning hours (06:00–09:00). The male-to-female ratio was 1.86:1 (746:401). These statistics are valuable for the evaluation of postmortem inspections by experts.

Therapeutic potentials occurring during the early differentiation process of mesenchymal stem cells in a rats model with thioacetamide-induced liver fibrosis

BACKGROUNDS/AIMS: Mesenchymal stem cells (MSCs) have the capacity to differentiate into hepatocytes, The purpose of this study is to investigate the MSCs' differentiation process and therapeutic potentials by comparing isolated MSCs with HGF-treated MSCs in rat's model with thiacetamide (TAA)-induced cirrhosis. METHODS: Male Sprague-Dawley (SD) rats, weighing 100-150 g were used in this study. To induce liver fibrosis, recipient rats were taken with 0.04% thioacetamide (TAA) in the drinking water (400 mg TAA/L) for 8 weeks. The rats underlying liver cirrhosis were divided into 3 groups according to the transplanted materials, compared to normal saline as control (I) and isolated MSCs (II) HGF-treated MSCs. RESULTS: Severe hepatic fibrosis and hepatocyte destruction were detected in the control group. Less hepatic cirrhosis and collagen formation, more hepatocyte regeneration and glycogen storage were detected in isolated MSCs compared to HGF-treated MSCs group, Distribution of red autofluorescence is mainly localized near the sinusoids in isolated MSCs, scattered away the sinusoids in HGF-treated MSCs group. MSCs transdifferentiated into CK-19 postive Oval cells and then to albulmin-producing hepatocytes, HGF treated MSCs differentiated into hepatocyte without the intermediate oval cells phase. HGF treated MSCs became the CK18-positive, MSCs became CD 90-positive. CONCLUSIONS: Significant hepatocyte differentiation occurred in not HGF-treated MSCs but isolated MSCs group unexpectedly. These results suggest that the beneficial effect of MSCs on in rat's model with TAA-induced cirrhosis may occur during early differentiation course of MSCs. Mature hepatocyte itself has a little effect on the accelerated differentiation and functional capacity of hepatic lineage cell-line.

Unexpected Sudden Death of a 19-Year-Old Female with Congenital Single Coronary Artery Ostium during Exertion

Coronary artery anomalies are associated often with myocardial ischemia or sudden cardiac death. A 19-year-old woman who participated in an exertive game lost consciousness upon one such exertion. She was taken to a hospital where she died on the same day. An autopsy revealed that she had bifurcated coronary arteries, which arose from one coronary ostium in the left sinus of Valsalva. The right coronary artery arose from the left sinus and traveled between the aorta and the pulmonary trunk. The heart as well as the cardiac conduction system depended exclusively on the single coronary artery ostium for oxygenated blood supply, and the unbalanced blood distribution on her exertion probably led to sudden cardiac death. The case highlights the medicolegal importance of unexpected sudden cardiac death related to an anomalous origin of the coronary arteries.

Gastric Necrosis after Gastric Dilatation in a Patient with Bulimia / 대한법의학회지

Acute gastric dilatation leading to gastric necrosis is rare but potentially fatal condition that can occur in patients with bulimia. It usually develops after a bulimic episode and it is not diagnosed with sufficient rapidity it may lead to gastric perforation followed by peritonitis, sepsis, shock, and death. Because of the rarity of this condition and the patients in whom it occurs, the clinician must maintain a high degree of suspicion when treating patients with eating disorders who present with abdominal pain after a binge. This case report describes a 24-year old woman with acute gastric dilatation due to binge eating, who had the gastrotomy and died of complications such as gastric necrosis and disseminated intravascular coagulation.

The Feasibility of Recovered Warm Ischemic Injury on Non-heart-beating Donor Liver by Hepatocyte Growth Factor in Animal Model / 대한이식학회지

PURPOSE: Liver transplantation is the therapy of choice for patients with acute and acute-on-chronic severe liver failure or hepatocellular carcinoma. But a suitable liver is not always available for transplantation due to limited donor numbers. To increase the number of available liver for transplantation, a non-heart-beating donor (NHBD) liver transplant program is started. In NHBD liver transplantation, warm ischemic injury of liver occurs. The duration of warm ischemia is thought to be the most important risk factor for postoperative complications such as primary nonfunction or severe hepatic dysfunction. Recent evidence indicates that hepatocyte growth factor (HGF) plays an important role as a cytoprotector against hepatic injury by anti-apoptotic effect and mitogen in liver regeneration. Therefore studies also were performed to examine whether HGF influenced the viability and regeneration of hepatocytes from rats, subjected to prolonged warm ischemic injury. METHODS: Male Sprague- Dawley rats were subjected to non-heart-beating death by cervical spine fracture. Rats left in room temperature directly after, 30-minutes, 1-hours before surgery and perfusion was performed for isolating hepatocyte. Among three groups, hepatocyte viability was compared by trypan blue stain. And isolated hepatocytes from 30-minutes warm ischemic group were cultured for 24-hours, which were treated with no HGF and addition of various doses (5 ng/mL, 10 ng/mL, 20 ng/ mL, 40 ng/mL, 100 ng/mL) of HGF. Anti-apoptosis and regeneration of hepatocyte were compared by LDH assay, MTS assay, western blot, and immunocyto-chemistry after a 24-hours culture. RESULTS: The results of hepatocyte viability along the prolonged warm ischemic groups in isolated hepatocytes decreased sequentially 74.8+/-12.6%, 45.0+/-5.4%, 37.8+/-10.4% along directly after, 30-minutes, 1-hours in trypan blue stain (P<0.01). And 24-hour-cultured hepatocytes from 30-minutes warm ischemic group were treated with HGF. The results of LDH assay, MTS assay did not have relation with HGF addition. But the results of western blot and immunocytochemistry shown that HGF doses dependent anti-apoptosis and regeneration of hepatocyte increased. That indicates HGF presumably inhibites apoptotic pathway by phosphorylation. And HGF also makes hepatocyte hypertrophy and albumin synthesis. CONCLUSION: HGF was a potent cytoprotector against hepatic injury by anti- apoptotic effect and mitogen of liver regeneration in NHBD liver animal model. HGF facilitates recovery of the liver from prolong warm ischemic injury. If the more clinical studies and large animal studies are performed, NHBD using liver transplantation will be available with more chances by HGF.

Hypothermic Death with Paradoxical Undressing : Mimicking Rape-related Homicide : Case Report / 대한법의학회지

Paradoxical undressing is a well-known but uncommon phenomenon in hypothermic deaths. If an individual is found unusually undressed in cold weather and its autopsy finding is not related to any homicidal circumstance, the undressing is considered the victim s perimortem act accompanied in the hypothermic death. But unexperienced police staffs and scene investigators who are unaware of this perimortem phenomenon could take especially female death cases with paradoxical undressing for rape related homicides. The presenting case was initially considered a rape homicide but ruled a hypothermic death with the manner an accident through complete postmortem examinations including meticulous autopsy. We think this case is a good example for understanding the hypothermic death with pardoxical undressing and how to come to rule out homicide from it.

Alterations of the Cerebellar Inhibitory Interneurons and Inhibitory Synapse Following KA-induced Seizures / 대한해부학회지

Most epileptic patients have commonly suffered from recurrent seizures for many years. These seizures are usually associated with inhibitory synaptic reorganization of the hippocampal region, but it is not known whether cerebellar inhibitory synaptic changes can be induced by seizure activity. We sought to determine the pattern of cerebellar alterations in the cerebellar inhibitory interneurons (basket and stellate cells) and then tested if the alterations are associated with their synaptic transmission at the cerebellar GABAergic synapses between inhibitory interneurons and Purkinje cells after systemic kainic acid administration by immunohistochemistry, western blot analysis, dot blot analysis and confocal microscopy. A dramatic increase of the intensity of GAP-43 immunostaining was obvious in the pinceau structures following KA-induced seizures and the intense GAP-43 immunoreaction involved in high expression of PKC-sigma. The activation of the presynaptic terminal at the cerebellar inhibitory synapse is accompanied with strong GABA immunoreactivity in pinceau region (especially 48 h) after KA-seizures. These results suggest a possibility that KA-seizures increase the release of GABA at the cerebellar inhibitory presynaptic terminal and it would be contribute to the depression of Purkinje cell activity, disinhibition, during the epileptogenesis.

Roles of Stem Cell Factor and c-kit Receptor in the Development of Cerebellar GABAergic Neurons / 대한해부학회지

Evidence that Stem cell factor (SCF) and c-Kit receptor tyrosine kinase are expressed in the cerebellum during postnatal development, suggests a possible contribution of the SCF/Kit signaling pathway in the cerebellar development. In the present study, we prepared cerebellar cultures from C57Bl/6J mouse at postnatal day 1and 7 to investigate the role of c-kit receptor and SCF in regulation of growth and differentiation in the postnatal cerebellar GABAergic cells. SCF increased the number of survival cerebellar cells and density of glutamic acid decarboxylase 65/67 (GAD65/67) and calbindin D-28K expression in the immunoblot analysis. SCF also improved the neurite extension of the interneuron neuritis and dendritogenesis of Purkinje cells. Treatment with c-Kit antibody accelerated cellular loss in serum-free media and decreased the growth ability and dendritogenesis of Purkinje cells and cerebellar inhibitory interneurons. Our data suggest that SCF and c-kit receptor are required for the normal growth of postnatal cerebellum and a possible involvement of functional regulation through the SCF/c-kit receptor pathways in the postnatal cerebellar development.