Infectious mononucleosis(IM) is a benign self-limiting disease and result from a polyclonal B cell proliferation secondary to Epstein-Barr virus (EBV) infections. The infection is controlled by cytotoxic T cells triggered by EBV infected B cells. However, rare cases develop severe or fatal IM accompanied by hemophagocytic syndrome. We report a case of a 4-year-old girl who presented with high fever, hepatosplenomegaly, hepatic failure, pancytopenia and coagulopathy. Despite intensive treatment, the patient's condition deteriorated rapidly and died 3 days after admission. At autopsy, there was prominent infiltration of atypical lymphocytes with hemophagocytosis in multiple organs, especially liver, spleen and lymph nodes. Atypical lymphocytes were immunopositive for T cell markers and showed positive signal in EBV in situ hybridization.
Autopsy ; B-Lymphocytes ; Cell Proliferation ; Child, Preschool ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Infectious Mononucleosis* ; Liver ; Liver Failure ; Lymph Nodes ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic ; Pancytopenia ; Spleen ; T-Lymphocytes

Spontaneous bacterial peritonitis (SBP) is a bacterial infection of ascites arising from liver cirrhosis, nephrotic syndrome and so on. Primary bacterial peritonitis (PBP) is a rare intraabdomial infection in the absence of underlying diseases or rupture of the viscus. The authors report an autopsy case of posttraumatic primary bacterial peritonitis in the otherwise physically healthy young female. She was beaten repeatedly around the abdomen with human physical instruments for a prolonged time.
Abdomen ; Ascites ; Autopsy ; Bacterial Infections ; Female ; Humans ; Liver Cirrhosis ; Nephrotic Syndrome ; Peritonitis* ; Rupture

This study reviews the various types of medical accidents that have emerged over the past two years in hospitals where an agency specializing in medical disputes has been established, as well as the process through which medical accidents are resolved and the results thereof. In addition, the role of these specialized agencies in resolving medical disputes is also analyzed herein. The effective resolution of medical disputes through either judicial or non-judicial means requires that the organization overseeing the resolution of the relevant issue be objective and fair, able to forge independent decisions, and possess specialized knowledge of the issue at hand. The most significant advantage possessed by medicolegal offices since their inception has been the fact that they have featured specialists in the relevant fields who have been able in many cases to correctly perceive the central issues at play in a medical dispute from early onwards, and that these have promoted the establishment of reasonable means through which to resolve such medical disputes based on medical reviews and legal analyses. These medicolegal offices have been designed to create an opportunity to directly discuss the medical complaints raised by the plaintiffs with the medical staff, and for the plaintiffs to receive firsthand explanations with regards to their medical questions and suspicions. This process has helped to resolve numerous medical disputes. To this end, medicolegal offices are encouraged to play the role of objective mediators helping those involved in medical disputes reach settlements acceptable to all parties, and to shy away from the extreme method known as medical litigation that seeks resolutions which favor only one of the concerned parties.
Dissent and Disputes* ; Hand ; Humans ; Jurisprudence* ; Medical Staff ; Specialization

Neck fracture is a major cause of death in traffic accidents and this injury pattern occurred normally in a frontal collision or overturn process. This study investigates a case of neck fracture from a low speed collision. In this case examined, the passenger in the front seat of the car was pulled back and did not have the seat belt on. As the vehicle slipped on a frozen road surface in a downward hill and crashed into the shoulder of the road at low speed. But strangely, even though his neck is fracture there were not any collision marks on interior of the car. This study applied computer simulation to analyze this case and we found out that the upper part of the person was rotated and raised at the time of collision and his neck was fully bent by interference with roof and we also know that the seat belt did not resist the passenger who pulled back his seat.
Accidents, Traffic ; Cause of Death ; Computer Simulation ; Humans ; Neck Injuries ; Neck* ; Seat Belts ; Shoulder

The fifteen persons from In-jae, Kang-won do, were missing by floods on July 2006. In relation to the this case, the two unidentified corpses were found nearby So-yang lake on June and September 2007, respectively. In these cases, autosome short tandem repeats (STR) and Y-STR were used for identification. The AmpFlSTR Identifiler kit (amelogenin and 15 STRs) and the AmpFlSTR Yfiler kit (16 Y-STRs) are analysed by multiplex-PCR and automated fluorescent detection using Perkin Elmer Prism 310 DNA sequencer. Finally we could found identify the two missing persons.
Cadaver ; DNA ; Floods* ; Forensic Anthropology ; Gangwon-do ; Humans ; Lakes ; Microsatellite Repeats

To construct a Korean Y-chromosomal STR database for 22 Y-STRs (DYS19, DYS385, DYS388, DYS389I/II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439, DYS446, DYS447, DYS448, DYS449, DYS456, DYS458, DYS464, DYS635, and GATA H4.1), 708 DNA samples from unrelated Korean males were analyzed using three multiplex PCR systems. During analysis, thirty two microvariant alleles were observed at DYS449, DYS458, and DYS464, and duplicated alleles were occurred once each for DYS19, DYS390, and DYS447. In haplotype analysis for the 22 Y-STRs, a total of 693 different haplotypes were observed with overall haplotype diversity of 0.9999, and of these, 680 haplotypes were unique. By combining each marker for the extended SWGDAM haplotype, DYS458 was the most informative marker. In addition, the diversity of combined haplotypes of DYS447, DYS458, DYS635, GATA H4.1, and the SWGDAM Y-STR loci was comparable to haplotypes of 17 loci in the AmpFlSTR(R) Yfiler(TM) kit.
Alleles ; Asian Continental Ancestry Group ; DNA ; Haplotypes ; Humans ; Male ; Multiplex Polymerase Chain Reaction ; Y Chromosome

The PMT-air airplane crash accident occurred in June 25, 2007 in Sihanoukville, Cambodia. All 22 passengers and crew, including 13 Korean victims, were found dead. Human identification was done at the Cambodian-Russian Soviet friendship hospital. All of Korean victims were identified with fingerprint comparison, age estimation, comparison of belongings and examination of past medical history. In this identification process, the examination of antemortem data source with searching personal blog of internet had been proved efficient in human identification. The antemortem data collection with internet access may be useful and should be combined with classical antemortem data collection process because it is beyond spatial and time limitation.
Aircraft* ; Blogging ; Cambodia ; Information Storage and Retrieval ; Dermatoglyphics ; Forensic Anthropology ; Friends ; Humans ; Internet

Microscopic analysis of bone is very useful method for estimating age at death of individual identification, diagnosing metabolic disorder or dietary deficiency in bone tissue, and differentiating human bone or not when applied to fragmentary skeletal remains. The purpose of this study was to establish a systematic method for preparing bone tissues by manual grinding method and offer help in application of related histomorphometric field such as estimating age at death. For this, human bone tissues of rib and femur from cadavers were prepared and considered histomorphological variations of osteon with light microscope. As results of this study, Type II osteons, smaller versions of Intact osteons (Type I) that form by radial remodeling of a preexisting Haversian canal, were distinguished from double-zonal osteons, one of the osteons that exhibit hypercalcified ring within their concentric lamellae, by the lack of an internal reversal line and the parallel contours of lamellae, and it is possible to suggest metric basis for drifting osteons as counting one osteon with the exception of size measurement. By applying this method of present study, one could easily make a bone tissue all oneself that would be helpful for establishing basic data in physical and forensic anthropology.
Bone and Bones ; Cadaver ; Femur ; Forensic Anthropology* ; Haversian System ; Humans ; Ribs

AIMS: The left colon receives its arterial supply from the inferior mesenteric artery (IMA). The detailed anatomical understanding of IMA is important for sigmoid colon or rectal cancer surgery. The aim of this study is to investigate the vascular anatomy of the IMA by measuring the distance from the aortic bifurcation and the length of the IMA in autopsy cases. METHODS: 41 consecutive autopsy cases were enrolled prospectively. 29 cases were males and 12 females. Mean age was 47.7+/-15.6 with a range of 12 to 82 years. The distance from the aortic bifurcation is measured between the angle of abdominal aortic bifurcation and the inferior margin of the IMA. The length of the IMA is measured between the root of the IMA and the proximal border of the first branch of the IMA. Mann-Whitney U test, Pearson's correlation coefficient, and Spearman's rho were used for statistical analysis. RESULTS: The distance from the aortic bifurcation ranged from 3 to 6.3 cm with a mean of 4.4+/-0.71 cm. The length of the IMA ranged from 2.5 to 7 cm with a mean of 4+/-0.8 cm. The distance from the aortic bifurcation and the length of the IMA had no correlations with subject's height and weight. CONCLUSIONS: The vascular anatomy of the IMA in the general population is an important information for colorectal surgeon. Clear anatomical understanding of IMA may help perform oncologically safe colorectal surgery.
Autopsy* ; Colon ; Colon, Sigmoid ; Colorectal Surgery ; Female ; Humans ; Male ; Mesenteric Artery, Inferior* ; Prospective Studies ; Rectal Neoplasms ; Rectum ; Statistics, Nonparametric

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2006. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,515 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 1,788 cases(71.1%) and that of female 727(28.9%). Male was over twice more than female. The forties were 709 cases(28.2%), the fifties 496(19.7%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,437 cases(57.1%), natural 955(38.0%), and the unknown 123(4.9%). Among 1,437 unnatural deaths, suicide was 366(25.5%), homicide 387(26.9%), accident 392(27.3%), and the unclear 292(20.3%). Homicide occupied 40.4% of trauma, 51.9% of blunt force injury excluding traffic and fall-down injury, and 91.2% of sharp force injury. The homicide rate in asphyxia was 33.2%, but it went up to 71.4% excluding hanging. It showed only 1.3% percent of homicide in poisoning. 3. Traumatic deaths were 681 cases, occupying 47.4% of 1,437 unnatural deaths, followed by drowning deaths(199 cases). Blunt trauma was 206 cases(30.2%) and the leading cause of death in traumatic death. Poisoning was 158 cases, among which the cyanides were dominant(37cases). Thermal injuries were 144 cases, electrocution 14 cases, and starvation/neglect 21 cases. and 17 cases were directly due to medical procedures. 4. Among 955 natural deaths, heart diseases were 495 cases(51.8%), and vascular diseases 165(17.3%), and these two categories were added up to 660(69.1%). 5. Child deaths under the age of 10 were 118 cases. Homicide was 35 cases(57.4%) out of 61 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 45 cases(38.1%)
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Cyanides ; Drowning ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases