We present here a brief literature review and a case study of postpartum pulmonary arterial hypertension, a rare and progressive disease with a high maternal mortality rate. The patient, a 32-year-old woman, presented with dyspnea and shivering immediately following an uncomplicated vaginal delivery. The patient had no remarkable individual or familial history. She died 4 hours after her delivery, and an autopsy revealed atherosclerosis of the main pulmonary arteries and characteristic plexiform lesions on the lung. The remaining organs showed no remarkable pathology. We reported pulmonary arterial hypertension associated with pregnancy as the cause of death.
Adult ; Atherosclerosis ; Autopsy ; Cause of Death ; Death, Sudden ; Dyspnea ; Female ; Humans ; Hypertension* ; Lung ; Maternal Mortality ; Pathology ; Postpartum Period* ; Pregnancy ; Pulmonary Artery ; Shivering

In the following report, we describe the case of a rapidly skeletonized corpse discovered in late summer. On the first day of September, a 57-year-old man was found almost completely skeletonized on a hill behind his house. His body lay prone, accompanied by a brush cutter at the entrance to the graveyard where his friend's parents were buried. His cap, clothes, and rubber boots were all intact and undamaged. Upon autopsy, no definite abnormalities were identified except for an old linear fracture on the frontoparietal bone. According to his friends and neighbors, he had likely died 8 or 9 days prior to the discovery of his body.
Autopsy ; Cadaver ; Friends ; Humans ; Middle Aged ; Parents ; Postmortem Changes ; Rubber ; Skeleton*

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.
Adolescent ; Adult ; Asphyxia ; Autopsy* ; Carboxyhemoglobin ; Deception ; Estrogens, Conjugated (USP) ; Female ; Foot ; Head ; Helium* ; Hemorrhage ; Humans ; Lung ; Nuclear Family ; Plastics ; Polypropylenes ; Prunus ; Spouses ; Suicide

The Y-chromosome, as with other chromosomes in the cell, is subject to mutations. However, unlike autosomal genes, the Y chromosome does not undergo recombination, and therefore individuals from different geographical regions may have differing distribution patterns with respect to Y-chromosome mutations. More detailed knowledge and information regarding Y-chromosome mutations might therefore provide insights into phylogenetic history and personal identification. Here, we describe a case study involving genotype-phenotype discrepancy in an Indian male individual. We found that the mistyping in sex determination was caused by a deletion in the amelogenin Y (AMEL Y) gene. Furthermore, on examining the short tandem repeat (Y-STR) loci using the PowerPlex(R) Y23 System, we found four more deleted loci on Yp11.2 (DYS576, DYS481, DYS570, and DYS458) in this sample. We performed deletion mapping for this sample, and we propose that the microdeletion on the Yp11.2 locus occurred approximately in the 6.44 Mb to 9.75 Mb region. Previous studies have reported that the AMEL Y deletion is a common mutation in the Indian population. Taking into account regional differences, we also analyzed several area-specific Y-chromosome mutations.
Amelogenin ; DNA* ; Humans ; Male ; Microsatellite Repeats ; Recombination, Genetic ; Y Chromosome*

Dieulafoy's lesion is a rare condition that may cause intermittent or massive gastrointestinal bleeding. It is characterized by the exteriorization of an arterial vessel into the lumen of the affected organ, generally the upper digestive tract, through an apparently normal mucosa or a small tear or erosion. We report two patients with Dieulafoy's lesions, one in whom the lesion was misdiagnosed as a submucosal tumor and endoscopic biopsy resulted in fatal bleeding.
Autopsy ; Biopsy ; Endoscopy ; Gastrointestinal Hemorrhage* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Mucous Membrane

Despite being a very new field, forensic imaging is rapidly being used in forensic medical practices around the world. Computed tomography images are being produced and used for many reasons. Forensic imaging is being used for preliminary examination of serious findings before a routine autopsy, as it might help to give positive proof in some cases. Some major preliminary findings, such as brain hemorrhage, cardiac tamponade, or aortic dissection, can then be substantiated with the results of the physical autopsy. Forensic imaging techniques may also provide additive evidence about the cause of death such as pneumothorax, ileus, gas embolism, and aspiration that are difficult to detect with the traditional surgical autopsy techniques. Forensic imaging is also proving useful outside the autopsy room; forensic anthropologists and odontologists are using images to help them determine the age, sex, and even lifestyle of human specimens. Finally, forensic images have also begun to function as a form of record keeping in complex cases.
Autopsy* ; Cardiac Tamponade ; Cause of Death ; Embolism, Air ; Humans ; Ileus ; Intracranial Hemorrhages ; Life Style ; Pneumothorax

This statistical analysis was based on the cause and manner of death on 149 cases of legal autopsy performed at the Department of Forensic Medicine, Jeonbuk National University Medical School, referred by law enforcement agencies in Jeonbuk in 2009. Among the total 149 cases, male was 93 cases (62.4%), and female 56 cases (37.6%). The age of forties were 52 cases (34.9%), the fifties 22 cases (14.8%) and sixties 22 cases (14.8%), and these three decades occupied 96 cases (64.5%) more than half. By the manner of death, there were 105 cases of unnatural deaths (70.5%), 37 natural deaths (24.8%), and 7 unknown (4.7%). Among unnatural deaths, there were 30 cases of suicide (28.6%), 21 homicide (20.0%), 43 accident (41.0%), and 11 undetermined (10.5%). By the case of death, unnatural deaths was classified as 48 cases of traumatic deaths (45.7%), 19 asphyxia (18.1%), 15 thermal injuries (14.3%), 15 drowning (14.3%), 8 poisoning (7.6%). Among 37 natural deaths, there were 14 cases of cardiac diseases (37.8%), 10 diseases involving vascular system (27.0%), and 3 diseases involving digestive system (8.1%).
Asphyxia ; Autopsy ; Digestive System ; Drowning ; Female ; Forensic Medicine ; Heart Diseases ; Homicide ; Humans ; Law Enforcement ; Male ; Schools, Medical ; Suicide

Alcohol is very popular and readily available among the population but is also known to be a toxic substance. Excessive alcohol ingestion can lead to death induced by acute intoxication. In addition, chronic alcohol ingestion can cause many diseases such as alcoholic liver disease and cardiomyopathy. Alcohol consumption is associated with many social incidents. For example, traffic accidents, murders, incendiary crimes and so on. Hence, alcohol should be considered as a significant and socially relevant substance. However, there is currently no statistical analysis about deaths associated with alcohol consumption in forensic autopsy cases. We analyzed forensic autopsy cases involving alcohol during 2007 to 2009 in Gwangju city and Jeollanamdo province, Korea. The following is the summary of the results. 1. The number of total cases in our department from 2007 to 2009 was 329. 2. Among the 329 cases, 314 cases were checked to have alcohol concentration levels. Alcohol related deaths were 118 cases (35.9%). 3. Among 118 cases, natural deaths were 27 (22.9%) and unnatural deaths were 91 cases (77.1%). 4. Deaths caused by alcohol intoxication were 9 cases (7.6%). The remaining 82 cases of unnatural deaths were as follows: suicides (18 cases, 22.0%), homicides (32 cases, 39.0%), accidents (24 cases, 29.3%), and undetermined (8 cases, 9.8%).
Accidents, Traffic ; Alcohol Drinking ; Autopsy ; Cardiomyopathies ; Crime ; Eating ; Homicide ; Korea ; Liver Diseases, Alcoholic ; Suicide

BACKGROUND: Aconitium species have been used for a material of oriental herb medicine for analgesic and anti-inflammatory effects. But Aconitium species were known to have the potent poisons like aconitine, mesaconitine and hypaconitine which are of C19 diterpenoid alkaloids. The intoxication symptoms are nausea, vomiting, discomfort and cardiac arrhythmias which are well known as a main cause of death. METHOD AND MATERIALS: We obtained the specimens from the five poisoned cases and analyzed those specimens by GC/MS-SIM for 2002-2004. These cases were divided into two groups. The first group was the victims who ingested raw Aconitium roots and leaves and were all dead. The second was those who ingested processed Aconitium roots. One of them drank Aconitium root-submersed alcohol (root wine) and died. Another victim had ingested some liquid extract of herb medicine for three months but the person's symptom was manifested by jaundice and hematuria without fatality. RESULTS: Autopsy pathology on the cases of raw Aconitium ingestion and root wine drinking revealed similar gross and microscopic feature. The benzoylaconine analogues were detected in root wine (dead case) and hypaconitine, benzoylmesaconine and benzoylhypaconine were detected in herb liquid (living case). The aconitine analogues are hydrolyzed to make less toxic benzoylaconine analogues but the toxicity of hydrolyzed products and the methods of detoxification are still in controversy. CONCLUSION: We could conclude that benzoylaconine is relatively more toxic than benzoylmesaconine and benzoylhypaconitine. And the hypaconitine is relatively less toxic than aconitine and mesaconitine.
Aconitine ; Alkaloids ; Arrhythmias, Cardiac ; Autopsy ; Cause of Death ; Chromatography, Gas ; Drinking ; Eating ; Hematuria ; Jaundice ; Mass Spectrometry ; Nausea ; Poisons ; Vomiting ; Wine

To check expert opinion about the investigation system of medicine-related death, model for "Death Investigation Center" was suggested and related questionnaire were requested. Between 15 December 2009 and 5 April 2010, we sent e-mails of the questionnaire which asked the opinion for the new postmortem investigation system. We sent the questionnaire to 3,289 lawyers and 4,523 doctors (total 7812), and received 100 replies out of the total. All the lawyers and doctors interviewed knew the importance of the postmortem investigation system. Most of them (87%) agreed to the introduction of the new postmortem investigation system. Some of them thought that protector's agreement was necessary for the postmortem investigation (21%), and more doctors were likely to participate with legal protocol (23%). If the postmortem investigation could not be performed due to the protector's disagreement, another specialized medical investigation should be needed to figure out the cause of death (85%). The new postmortem investigation system should be performed by the specific institution, and supported by the government (44%). In many expert's opinion, nonmedical experts such as lawyers and priests should be included for the institution of investigation for objectivity and neutrality (72%). This sample study finds that the postmortem investigation performed by specialized institution is necessary to determine the cause of death in the hospital. For the operation of the system, neutrality and the operating core would be the most important.
Cause of Death ; Electronic Mail ; Expert Testimony ; Humans ; Lawyers ; Surveys and Questionnaires