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 2015 / 대한법의학회지

Since March 1, 2015, the National Forensic Service Seoul Institute has commenced postmortem inspections at the death scene in agreement with the Korean National Police Agency. Included regions were mainly Seoul Metropolitan Police Agency Wide Area 8 (Gangseo, Yangcheon, Guro police stations), and several other areas. In total, 837 postmortem inspection cases from March 1 to December 31, 2015, were analyzed statistically. Of these, 168 were autopsy cases, and the rates were 20% (67 cases) in Gangseo Police, 14.5% (30 cases) in Yangcheon Police, and 22% (57 cases) in Guro Police stations. For 269 cases of “unknown cause of death”, the autopsy rates were 44% in Gangseo Police, 36% in Yangcheon Police, and 47% in Guro Police stations. For 82 cases of fall from height, autopsy rates were 17% (n=14). Of the 133 cases of hanging, 121 cases were classified as suicide at the scene with a 2.5% (n=3) autopsy rate. Twelve cases were classified as an undetermined manner of death at the scene with a 33% (n=4) autopsy rate. The distribution of the “manner of death” was natural death for 29% (n=250), unnatural death for 38% (n=318), and other and undetermined manner of death for 32% (n=269) of cases. Proportions of dispatch times were 49.2% (412 cases) during work hours (09:00-18:00), 15.7% (n=131) during evening hours (18:00-21:00), 13% (n=110) at night (21:00-24:00), 10% (n=88) at dawn (24:00-06:00), and 11% (n=96) during morning hours (06:00-09:00). The male to female sex ratio was 1.96:1 (556:281). These statistics are valuable for evaluation of postmortem inspections by experts.

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.

The Predictive Ratios of Intoxicated Deaths by Police's Death Scene Investigation and Doctor's Death Certificates in South Korea / 대한법의학회지

Forensic autopsies were performed on 1,821 cases in 2014 and 2,024 cases in 2015 at the National Forensic Service Seoul Institute. Based on the autopsy reports, 103 cases (5.7%) in 2014 and 130 cases (6.4%) in 2015 were selected as unnatural deaths caused by fatal intoxication. The cases were divided into five groups. The first group had ethanol intoxication, the second had drug intoxication, the third had agrochemical intoxication, the fourth had cyanide intoxication, and the fifth had miscellaneous intoxications. Of the 233 cases, 202 had death certificates. Of these 202 cases, 169 (83.7%) had an undetermined manner of death (MOD); 17 (8.4%) had an unnatrual MOD and intoxication was the cause of death (COD); nine (4.5%) had an unnatural MOD, but the COD was not intoxication; seven (3.5%) had a natural MOD and disease as a COD. The predictive ratios of intoxication as a COD were compared with the death certificates and the police death scene investigation results. The death certificates and the police investigation results showed predictive ratios of 8.4% and 55.2%, respectively, for intoxication as a COD. The discrepance in these predictive ratios and relatively low predictive ratio of police investigation results mean that intoxicated deaths have been underevaluated; thus, some homicides or intentional deaths were probably missed under South Korea's death investigation system. Doctors who specialize in forensic medicine need to supervise the entire postmortem examination process and emergency blood toxicological analysis should be performed in South Korea.

A Case of Concurrent Acute Viral Myocarditis and Intussusceptions in a 3-Year-Old Child / 대한법의학회지

Chickenpox is an acute disease caused by the varicella-zoster virus (VZV), a herpesvirus that causes human infection worldwide. Primary VZV infection routinely occurs during childhood and is usually a self-limiting illness in immunocompetent children. However, chickenpox can be a severe disease in adolescents, adults, and immunosuppressed or immunocompromised patients. Although vaccination substantially attenuates disease manifestations, significant complications such as secondary soft tissue infection, encephalitis, and pneumonia can occur. We present a rare autopsy case of concurrent acute myocarditis and intussusceptions in a 3-year-old female child who presented with chickenpox followed by abdominal pain and sudden death. The present case emphasizes the potential for fatal complications of viral infections, which should be considered in cases of sudden unexpected infectious death in children.

A Case of Dyadic Death Associated with Helium Gas: An Autopsy Case Report / 대한법의학회지

A 39-year-old man, his 35-year-old wife, and their 13-year-old daughter were found dead in their home. The man and his daughter were found lying in her bedroom, with his head wrapped in a plastic bag connected to four helium gas cylinders by green polypropylene tubes. Fragments of the burnt ignition briquette were found in the bucket located at her feet. His wife was found in a decomposed state lying on her right side in her bedroom. Autopsy findings for the man were unremarkable except for cherry pink lividity; the blood carboxyhemoglobin concentration was 73%. Autopsy findings were unremarkable for the woman as well, except for a few petechial hemorrhages and conjunctival congestion. The daughter showed no definite abnormalities; however, her blood and lung contained helium gas. The deceased man's suicide note, evidence gathered at the scene, and postmortem examination revealed that this was a case of dyadic death.

The Statistical Analysis of Legal Autopsies in 2011 (The Headquarters of National Forensic Service) / 대한법의학회지

This is a statistical analysis of the data obtained from legal autopsies performed at the headquarters of the National Forensic Service during 2011. This report aims to analyze 2,723 cases. 1. There were 1,995 (73.3%) cases involving mortalities among men and 707 (26.7%) among women; evidently, the number of deaths that occurred among men were twice as many as that among women. With respect to age, 694 (24.4%) deaths occurred in individuals aged in their forties and 658 (22.8%) among those in their fifties. 2. There were 1,437 (52.8%) cases of unnatural deaths, 1,159 (42.5%) cases of natural deaths, and 127 (4.7%) deaths from unknown causes. Among the 1,437 unnatural deaths, 483 (33.6%) were suicidal, 255 (17.7%) homicidal, 546 (38.0%) accidental, and 153 (10.6%) were of undetermined causes. 3. There were 618 cases of trauma-related death, accounting for 43.0% of the 1,437 unnatural deaths. Blunt trauma was the leading cause of trauma-related deaths, accounting for 174 (28.2%) cases. Deaths due to asphyxiation, among which hanging (187 cases, 64.7%) was the predominant cause, accounted for 289 cases. There were 192 (13.4%) deaths from poisoning, 151 (10.5%) from drowning, 139 (9.7%) from thermal injuries, 31 (2.2%) as a complication of medical procedures, and 14 (1.0%) from electrocutions. 4. Among the 1,159 natural deaths, heart diseases accounted for 600 (51.8%) deaths and vascular diseases accounted for 160 (13.8%) deaths. 5. There were 83 cases of death among children aged under 10; out of 33 unnatural deaths, 20 (24.1%) cases were homicidal.

The Statistical Analysis on Legal Autopsy in 2010 (The headquarters of National Forensic Service) / 대한법의학회지

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Forensic Service (NFS), requested by every kind of law enforcement agencies during the year of 2010. NFS is located in Seoul, Korea and has four branches throughout the country. The Seoul NFS covers all legal autopsies in Seoul, Incheon City and Gyeonggi Province and some cases referred from other regions. This report aims to analyze various aspects of 2,425 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 1,777 cases (73.3%) and that of female 648 (26.7%). Male was over twice more than female. The forties were 592 cases (24.4%), the fifties 552 (22.8%), and these two decades occupied 47.2%. 2. Unnatural deaths were 1,377 cases (56.8%), natural 875 (36.1%), and the unknown 173 (7.1%). Among 1,377 unnatural deaths, suicide was 411 (29.8%), homicide 260 (18.9%, accident 417 (30.3%), and the undetermined 289 (21.0%). Homicide occupied 34.7% of trauma, 61.2% of blunt force injury excluding traffic and fall-down injury, and 81.4% of sharp force injury. The homicide rate in asphyxia was 23.9%, but it went up to 60.9% excluding hanging. It showed only 1.3% of homicide in poisoning. 3. Traumatic deaths were 536 cases, occupying 38.9% of 1,377 unnatural deaths, followed by poisoning. Blunt trauma was 138 cases (25.0%) and the leading cause of death in traumatic death. Poisoning was 245 cases, among which the alcohols were dominant (54 cases). Thermal injuries were 119 cases, electrocution 10 cases, and starvation/neglect 2 cases. and 48 cases were directly due to medical procedures. 4. Among 875 natural deaths, heart diseases were 583 cases (66.6%), and vascular diseases 64 (7.3%), and these two categories were added up to 647 (73.9%). 5. Child deaths under the age of 10 were 102 cases. Homicide was 25 cases (65.8%) out of 38 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 73 cases (71.6%).

Stercoral Colitis Leading to Fatal Peritonitis and Systemic Inflammatory Response Syndrome / 대한법의학회지

The stercoral colitis is an inflammatory process involving the colonic wall related to fecal impaction. This rare condition usually has a poor prognosis. We experienced a death case where an 84 years old woman died of stercoral colitis complications after total knee arthroplasty surgery. The fatal complications were peritonitis with systemic inflammatory response syndrome, not accompanying bowel perforations. We would like to show the autopsy case of stercoral colitis and suggest the importance of early suspicion and treatment.

A Sudden Unexpected Death in an Epileptic with Cerebral Cavernous Angioma / 대한법의학회지

Cerebral cavernous angioma is a rare form of vascular malformations which is histologically composed of closely-packed, thin-walled blood vessels without neural tissue intervened. One of the most common symptoms is seizure, which is usually well-controlled by medication or surgery and known to be rarely intractable or fatal. Because sudden, unexpected death in epilepsy patients reveals generally its unclear death mechanism and negative autopsy finding in forensic pathology practice, particular attention should be paid. We recently experienced an autopsy case of 32-year-old woman who had suffered from epilepsy and showed cerebral cavernous angioma on autopsy. We report this case with literature review.

A Suicide with Multiple Deep Throat Cuts / 대한법의학회지

A 46-year-old man was found dead at the foot of a mountain, with a bloody knife aside of his neck. A horizontal throat cut wound with multiple vertebral incisions was observed, with damages of neck vessels and pharynx. There were also three stab wounds in the abdomen and a horizontal cut in the anterior side of left proximal arm. He had suffered from depression. Scene circumstances and autopsy findings pointed toward a suicidal etiology.

Ruptured Subvalvular Aortic Aneurysm of a Person Who Has Bicuspid Aortic Valve / 대한법의학회지

Subvalvular aortic aneurysms are rare but can be a cause of sudden death. This case report involves a 36-year-old male who died suddenly from rupture of a subvalvular aortic aneurysm with resultant hemopericardium with tamponade. He had a bicuspid aortic valve with acute infective endocarditis. A review of the literature enlightens the association between bicuspid aortic valve and subvalvular aortic aneurysm. The pathogenesis of the diseases of the aortic root will be discussed.

Analysis of Clavicular Periosteal Hemorrhages at the Sternocleidomastoid Muscle Origin in Hanging / 대한법의학회지

To evaluate the significance of clavicular periosteal hemorrhage at the sternocleidomastoid muscle origin in hangings, we performed prospective analysis on 62 hanging cases. Periosteal hemorrhages were observed in 40 of 62 (64.5%) hanging cases. Periosteal hemorrhages were found in only one or both at the origin site of the sternocleidomastoid muscle; 4, left; 14, right; 22 both clavicles. The analysis based on the hanging types showed that 13 cases were typical/complete hangings and 15, typical/incomplete, 12, atypical/complete, and 22, atypical/incomplete. Of 40 hemorrhage-cases, 19 cases had the hyoid bone and/or thyroid cartilage fractures. Although no statistical significance was observed between the periosteal hemorrhages and the knot locations, or the types of hanging, or the type of knot, hyoid bone and/or thyroid cartilage fractures was significantly correlated with the hemorrhage. We also analyzed 10 cases of manual and ligature strangulation. In only one of 10 cases, periosteal hemorrhage at both clavicles was observed. Compared with other inner cervical injuries in hangings, periosteal hemorrhage is the most common findings of inner neck lesion. Therefore, clavicular periosteal hemorrhage could be auxiliary feature in diagnosis and interpretation of hanging cases.

Unexpected Death due to Massive Nontraumatic Intraabdominal Hemorrhage in association with Liver Cirrhosis / 대한법의학회지

We reports a woman's death caused by massive intraabdominal hemorrhage, who was in chronic alcoholic state with advanced liver cirrhosis and found dead in her room. No macroscopic source for the bleeding was found in her intraabdomen and there was no circumstances of traumatic forces to the individual's body around the death. The presenting unsuspected death could be consistent with the forensic pathological cases described as sudden, unexpected death due to massive nontraumatic intraabdominal hemorrhage in association with liver cirrhosis by DiMaio in 1987.

Fatal Pulmonary Thromboembolism Associated with Prolonged Sitting at Computer / 대한법의학회지

A newly reported, variant form of venous thromboembolism (VTE), named as "eThrombosis"1), occurred to a patient who was a prolonged sitting position at computer. The patient fortunately recovered from the disease through the early diagnosis and treatment. Recently, the author experienced a new case of a 24-year-old Korean man who died due to "eThrombosis"after playing an internet computer game continuously for about 85 hours. Therefore, the author would like to warn heavy computer users of the risk of the "eThrombosis", as they might also have high risk factors based upon this case, and inform this at-risk group that sitting for a long time at the computer results in an immobility that is a new greater risk factor of life-threatening VTE.

Forensic Review of Poisoning of Cyanide And Agrochemical Substances: The Gross Appearances of Gastric Mucosa And Its Content / 대한법의학회지

In forensic autopsies, some cases of poisoning of cyanide and agrochemical substances are noted. In these cases, the appearance of gastric mucosa and its content is essential and important to determine the cause of death because the appearance of them is usually specific to kinds of cyanide and agrochemical substances. So, full awareness of the appearance of gastric mucosa and its content is very important to forensic pathologist in these cases. The 134 autopsy cases are reviewed and the photographs of gastric mucosa and its content are collected. After the choose of good and typical photographs, the illustrations of these cases are displayed. The purpose of this study is offering the guidelines of appearance of gastric mucosa and its contents in cases of poisoning.

Death due to glyphosate intoxication / 대한법의학회지

Glyphosate containing herbicides, such as 'Touchdown' or 'Roundup', have been known relatively safe. They have been introduced as substitute for highly toxic paraquat. Till now few researchers have paid their attention for this material, and few data are available concerning this. Recently we experienced seven cases of glyphosate intoxication during past three years. Most of the cases could be regarded as intentional ingestion and accidental intoxication seemed to be quite less compared to paraquat. As there exist technical difficulties for the clarification of the material quantitatively, some cases were disputable concerning the circumstances in which ingestion of the material or death have occurred. Cases were reviewed and several points about this material were discussed.

Inadequacies of Death Certification: The Role of Forensic Pathologist / 대한법의학회지

Death certification is a public health surveillance tool and a valuable source of information at the national and local levels. Among activities that benefit from the availability of cause-of-death statistics obtained from death certificates are the monitoring of the health of populations, the setting of priorities and the targeting of intervention. Such statistics are also the keystone of much epidemiological study. So adequate writing cause-of-death statements for death is very important. The present study was undertaken to evaluate death certification in Seoul and Kyung-in area of Korea. The available 203 death certificates were obtained from the 1026 autopsy files of National Institute of Scientific Investigation(june, 2002-september, 2002). The summary of the results were: 1. Cases that writing the phenomenon such as cardiac or respiratory arrest, heart failure in the box of cause-of-death were 64 cases(31.5%). Cases that writing the immediate cause of death in the second or third line of box were 50 cases(24.6%). Cases that writing two or more immediate cause-of-death in one line of box were 36 cases(17.7%). 2. Cases that the statement of cause-of-death not correlated with the statement of manner-of-death were 18 cases(8.4%). 3. Cases that the immediate cause-of-death and manner-of-death is changed after autopsy were 179 cases(88.2%). The results of this study showed inadequacies of death certification in Seoul, Kyung-in area of Korea. We thought the reasons for this inadequacies of death certification were mainly insufficient education and campaign for physicians about accurate understanding of cause of death, manner of death. The forensic pathologists certified a number of deaths and have responsibility for education about cause of death, manner of death. So we emphasized need for forensic pathologists to be involved in works related with death certification forms and policies.

Dismembered Corpse : medicolegal implications / 대한법의학회지

Disposal of a homicide victim by dismemberment is rare, but individual cases are on record in most major medicolegal departments. Recognition of postmortem mutilation may be of importance in the interpretation of certain murders committed by sexual perverts and other mentally deranged individuals and sometimes performed for the sole reason of easier disposal of the body. Postmortem dismemberment is usually readily recognizable as such; The edges of the injuries are dry and lack evidence of bleeding. The joints may be disarticulated without fracture, or the use of an axe or saw may be evident from examination of bones. Parallel horizontal or oblique furrows in the bone surface are caused by skipping of the saw prior to establishing depth. Such patterns on the bone may assist in identifying the particular saw involved. So we report 25 dismembered corpses that autopsied in National Institute of Scientific Investigation. This paper can help in attempting to establish not only the first criminal investigation steps but also the medicolegal approach methods in unidentified and dismembered deaths.