Analysis of Diatom Detection Result for Immersed Bodies in Honam Area in 2008 / 대한법의학회지

Death by drowning is one of the most common cause of death worldwide, and the diagnosis of fatal drowning through postmortem examination is not always confirmative. Although many autopsy findings of drowning have been described so far, all these macroscopical signs are non-specific and moreover disappear quite rapidly in the process of decomposition. The combination of autopsy findings and diatom test can provide useful indication for the tentative diagnosis of drowning, but the value of the diatom analysis is still argued. The aim of the present study is to investigate the diagnostic usefulness of diatom test for the drowning death in Korea. The authors reviewed the result of 87 cases of diatom test in the autopsy file and analyzed it by parameters of the common diatom species, monthly frequency, the difference between sea and land water, and the correlation between the test result and the decision of cause of death. The result revealed no definite seasonal variation of diatom detection or no species difference between sea water cases and fresh water cases. The detection rate of diatoms in systemic organs of all cases was 11.49% and that of drowning cases was 9.43%.

Analysis of 12 Autopsy Cases related with Insurance Money / 대한법의학회지

Life insurance has been developed in means of providing economic compensation for unexpected accidental losses. As the insurance industry of Korea grows along with improvement of economic state, the life insurance crime has now appeared as an increasing social issue. The studies on the life insurance crime in Korea have been barely done with the viewpoint of forensic medicine and science. An understanding of insurance crime cases may be fundamental to develop the system to uncover or prevent it. The authors examined the definition of life insurance crime and twelve cases of insurance money related death investigated by postmortem examination through autopsy file of WDO, NISI in Korea. This article analyzes twelve autopsy cases related with insurance money, even though some cases have no proven investigative evidence or court ruling. A feature found in the cases is that it has the tendency of occurring among family members. Other characteristic is that automobiles are exploited with elaborately planned crime plots. To achieve an efficient prevention method for cutting down these insurance crimes, active government's engagement, assiduous operation of investigation authorities, insurance company's co-effort, and good information exchange system should be worked cooperatively.

Defect in Post-mortem Examination System Reviewed by the Realities of Death Certificate Issuing / 대한법의학회지

Death certificate is one of the most important medical documents for public health surveillance and it serves a tool for national health statistics. The authors analyzed 125 cases of death certificate for suspicious death from 276 medico-legal autopsy cases. When compared to autopsy results, almost all death certificates were inaccurate and inadequate for estimation of cause of death and manner of death. To decide a man's cause of death or manner of death is not easy job, even though for forensic pathologist after completing dissection and toxicological analysis. The authors think that inadequate death certificate is originated from insufficient medical education system and imperfect postmortem examination system. It may cause covering up the serious crime. The authors assert to reform the issuing system of death certificate, especially separation of death certification by attending physician and certification for death on arrival cases. The summary of present study is as follows ; 1. 52 cases (41.6%) did not follow the new form of death certificate ruled by law. 2. 66 cases (52.8%) were undetermined on the manner of death in death certificate, 3. Matching rate of cause of death and manner of death between death certificate and autopsy result was 56.8% (71 cases) and 36.8% (46 cases), respectively. 4. There were many critical or trivial faults in writing of death certificate, for example omission of direct cause of death or manner of death determination or serial number, etc.

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.

A Forensic Pathologic Study of Diffuse Axonal Injury of Brain / 대한법의학회지

Axonal swellings or retraction balls are the major histologic hallmark of diffuse axonal injury in craniocerebral trauma. However, traditional histologic methods have proven of limited use in identifying reactive axonal change early in the posttraumatic course. In the present study, we try to compare conventional histologic and immunohistochemical methods, and transmission electron microscopy for demonstrating axonal swellings in 18 cases of head trauma. Brain regions such as corpus callosum, cerebral cortex, and brain stem were examined with immunohistochemical markers for beta-Amyloid precursor protein (beta-APP), neurofilament, ubiquitin, and CD68. The result was as follows: In 2 out of 18 cases, eosiniophilic spheroid axon balls were demonstrated with hematoxylineosin stain. Ultrastructurally, the axon balls exhibited misalignment, clumping or loss of neurofilaments, and accumulation of organelles. The organelles consisted of mitochondria, dense membranous bodies, and SER. The overlying thin myelin sheath was distended. In 6 cases with no axonal swellings at the histologic section, electron microscopic examination revealed axonopathy as evidenced by disintegration of neurofilaments and aggregated organelles. Immunostaining with an antibody to beta-APP disclosed varying positive reaction in axonal swellings and axon balls, suggestive for injured axons. However, the axons which did not appear obviously swollen at short survival times disclosed beta-APP negativity. Our findings suggest that transmission electron microscopy was very useful to identify the early axonal events in the posttraumatic course, while the immunostain was of limited value. The pathogenesis of axonal swellings in injured axons was discussed.