We report the case of a 42-year-old woman who died in hospital from severe respiratory failure, 10 days after the onset of symptoms. Autopsy and microscopic examination identified features of diffuse alveolar damage in both lungs including hyaline membranes and intra-alveolar exudate. Gomori's methenamine silver stain of pink frothy materials in these exudates revealed thin-walled and cup-shaped microorganisms and a diagnosis of Pneumocystis jirovecii pneumonia was made. There were small granulomas in the pulmonary interstitium and hepatic lobules representing an unusual inflammatory reaction against Pneumocystis jirovecii. Extrapulmonary involvement with pneumocystis infection is a rare event occurring in 1% to 2% of all pneumocystis cases. Screening and confirmatory tests for human immunodeficiency virus (HIV) detection were positive. There was no information available regarding the patient's medical history or the possibility of HIV infection prior to the autopsy, because the patient was a foreign worker who arrived in Korea 2 months before her death. Medical examiners often perform autopsies with limited information regarding the deceased person, even when person is a Korean national. Therefore, an awareness of protection protocols during autopsy, as well as of the atypical patterns of critical diseases, is crucial.
Adult ; Autopsy* ; Coroners and Medical Examiners ; Diagnosis ; Exudates and Transudates ; Female ; Granuloma ; HIV ; HIV Infections ; Humans ; Hyalin ; Korea ; Liver* ; Lung* ; Mass Screening ; Membranes ; Methenamine ; Pneumocystis Infections ; Pneumocystis jirovecii* ; Pneumocystis* ; Pneumonia* ; Pneumonia, Pneumocystis ; Respiratory Insufficiency

PURPOSE: This study was conducted to describe and compare how emergency room (ER) nurses and coroners perceive good death and their attitudes toward death. METHODS: A survey was performed with 51 ER nurses in P city and 44 coroners nationwide. Data were collected from October 1, 2010 through February 28, 2011. Data were analyzed with descriptive statistics, t-test, ANCOVA, Scheffe's test using the IBM SPSS statistics 21.0 program. RESULTS: For the perception of good death and attitudes toward death, coroners scored higher (3.01+/-0.43 and 2.87+/-0.35, respectively) than ER nurses group (2.95+/-0.40 and 2.61+/-0.33, respectively), but the differences were not significant. The results of perception of good death and attitudes toward death were not statistically significant between ER nurses and coroners. CONCLUSION: The study showed no difference between ER nurses' perception of good death and attitudes toward death and those held by coroners. The findings of the study show that it is necessary to offer steady education on death to nurses and coroners to help them build a proper understanding of good death and grow positive attitudes toward death.
Coroners and Medical Examiners* ; Education ; Emergency Service, Hospital ; Humans

This paper reviewed structure and current status of laws related to patient safety using patient safety law matrix to promote systematic approach in legal system of patient safety. Laws related to patient safety can be divided into three areas: laws for preventing; laws for knowing about; and laws for responding. In the case of Korea, gaps are especially prominent in the areas of laws for knowing about and responding. Patient safety law which will be enacted in July 2016 will fill the gap in the area of laws for knowing about. This law will be comprehensive law, covering the full spectrum of laws related to patient safety. However, after reviewing current patient safety law in Korea, the following drawbacks were identified: absence of code for grasping the current patient safety level; absence of code for mandatory reporting in patient safety reporting system; and absence of code for privilege about patient safety work product. Furthermore we need wider discussions about covering issues of open disclosure, apology law, coroners system, and complaint management system in patient safety law.
Coroners and Medical Examiners ; Disclosure ; Hand Strength ; Humans ; Jurisprudence ; Korea* ; Mandatory Reporting ; Patient Safety* ; Risk Management

There has been an increase in the incidence of elevator-related accidents in the Republic of Korea. Every year, approximately 10~20 elevator-related fatalities are reported in the Republic of Korea. According to research from the United States, 'falls' were the most common cause of death, followed by 'caught in/between'. In such investigations, it is important to distinguish between the manners of death. Herein, we report an elevator-related fatality, which required careful forensic investigation to determine the cause of death. A thorough forensic autopsy and reinvestigation of the death scene by medical examiners were required to determine if the death was caused as a result of the deceased falling from from a height or being caught in between the elevator and the wall of building.
Autopsy ; Cause of Death ; Coroners and Medical Examiners ; Elevators and Escalators ; Humans ; Incidence ; Republic of Korea ; United States

Medicolegal death investigations in the U.S. have become a critical part of crime investigations over the past several decades. additionally, the roles of medical examiners (MEs) and coroners have expanded beyond the field of criminal justice in recent years. despite the fact that these roles are becoming increasingly more important a systematic and comprehensive study of this complicated system is yet to be conducted. Since there is no national standard or federal system, medicolegal death investigations vary across states, districts, and counties in the U.S. In this paper, we attempted to classify the systems into three categories. We also examined the roles and work procedures that MEs and coroners commonly share across the country as well as the problems and challenges that the medicolegal death investigation system is facing today. In addition, we have also provided a brief summary of the Korean system in order to add a comparative perspective, since the Korean legal system differs substantially that of the U.S.
Americas ; Coroners and Medical Examiners ; Crime ; Criminal Law ; Humans

Recent reports show that over 2 billion people are travelling via air every year, and the number of countries involved in space exploration is growing. Aerospace medicine, one of the specialty areas in preventive medicine, focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles. Flight surgeons are military medical officers who play an important role in these tasks. The civilian equivalent of the flight surgeon is the aviation medical examiner (AME). Among the challenges that we encounter at high altitudes are a change in pressure, noise, spa-tial disorientation, and acceleration. We should also overcome microgravity and radiation in space. The common in-flight medical emergencies are abdominal pain, diarrhea, chest pain, coll-apse, asthma, diabetes, and allergic reactions. There is only one aerospace medical institute, the Aerospace Medical Center, in the Republic of Korea. The Aerospace Medical Association of Korea, established in 1989, continues to grow. In the near future, aerospace medicine will be an important part of preventive medicine in the Republic of Korea.
Abdominal Pain ; Acceleration ; Aerospace Medicine ; Altitude ; Asthma ; Aviation ; Chest Pain ; Coroners and Medical Examiners ; Diarrhea ; Emergencies ; Humans ; Hypersensitivity ; Korea ; Military Personnel ; Noise ; Preventive Medicine ; Republic of Korea ; Space Flight ; Weightlessness

While forensic pathology has become a vital tool in solving crime over recent years, it remains a vague term to many criminal justice practitioners. Chronicling the development of autopsy and forensic pathology in the United States will introduce this modern field. An examination of forensic pathology will also explain how its role has evolved to accommodate legal and civil issues. The utility of forensic pathology extends well beyond the medical realm by affecting the core of the medicolegal investigative system in the United States.
Autopsy ; Coroners and Medical Examiners ; Crime ; Criminal Law ; Forensic Pathology ; Humans ; United States

Medicolegal autopsy is divided into judicial autopsy and administrative autopsy in Korea and Japan. Recently a new concept of "consented autopsy" has been developed in Japan. Consented autopsy is a kind of administrative autopsy which performed by informed consent of the bereaved of the dead. In Japan, all medicolegal autopsies are strictly divided into judicial autopsy and administrative autopsy. The latter is called to consented autopsy in the most prefectures of Japan except the five cities that have Japanese medical examiner system. Consented autopsy is a procedure that enhances people's recognition of legal medicine in the society and universities. Author introduce the peculiar procedures of consented autopsy in the Department of Legal Medicine, Kitasato University and Kyushu University in Japan. We can expect that the universities and other organs in Korea will establish our own methods of medicolegal activities in the future referring to the Japan's consented autopsy system.
Asian Continental Ancestry Group ; Autopsy ; Coroners and Medical Examiners ; Forensic Medicine ; Humans ; Informed Consent ; Japan ; Korea

The issues concerning the disability evaluating system in Korea are controversial to say the least. Evaluating systems are so complicated that they continually cause confusion to medical examiners even though they must evaluate patient's medical status accurately, objectively and reasonably to provide adequate compensation for patients. However, controlling associations or educating curricula for disability evaluation are not in place. This study investigates the impending problems of disability evaluation in Korea and discussed what should be done to improve the situations. Social environments, evaluating standards, examiners' capability and education are reviewed in an effort to present an adequate proposals to Korean medical examiners.
Compensation and Redress ; Coroners and Medical Examiners ; Curriculum ; Disability Evaluation ; Humans ; Hypogonadism ; Korea ; Mitochondrial Diseases ; Ophthalmoplegia ; Social Environment

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.
Accidents, Traffic ; Brain ; Brain Death ; Cause of Death ; Coroners and Medical Examiners ; Craniocerebral Trauma ; Humans ; Korea ; Tissue and Organ Procurement ; Transplants ; Violence