In recent years, the increase in the number of cases of postural asphyxia has gradually attracted the attention and discussion of forensic scientists domestically and internationally, but a systematic, comprehensive and recognized expert consensus and identification standard has not been established at home and abroad. This paper reviews the case characteristics, occurrence, mechanism of death, and identification criteria of postural asphyxia, to provide reference for future research.
Asphyxia/etiology* ; Forensic Medicine ; Forensic Pathology ; Humans

Mitochondria are the special organelle in eukaryotic cells. Their main functions are to synthesize energy required for cell activity by oxidative phosphorylation. Most of the oxygen absorbed by the body is consumed in the mitochondria. The precise diagnosis of mechanical asphyxia is one of the difficulties in forensic pathology practice. Forensic pathologists have been trying to find a reliable and sensitive marker for the diagnosis of mechanical asphyxia. Mitochondria are very sensitive to hypoxic environments, and the markers of mitochondrion damage can be used as a basis for the diagnosis of mechanical asphyxia. The purpose of this paper is to review the research progress on mitochondrial damage in hypoxic environments and to explore the possibility of using markers of mitochondrion damage in forensic pathological practice.
Asphyxia ; Forensic Pathology ; Humans ; Hypoxia ; Mitochondria ; Oxygen

Lung is the largest organ of the respiratory system. During hypoxia, pulmonary cells undergo rapid damage changes and activate the self-rescue pathways, thus leading to complex biomacromolecule modification. Death from mechanical asphyxia refers to death due to acute respiratory disorder caused by mechanical violence. Because of the absence of characteristic signs in corpse, the accurate identification of mechanical asphyxia has always been the difficulty in forensic pathology. This paper reviews the biomacromolecule changes under the pulmonary hypoxia condition and discusses the possibility of application of these changes to accurate identification of death from mechanical asphyxia, aiming to provide new ideas for related research.
Humans ; Asphyxia/pathology* ; Cause of Death ; Hypoxia/pathology* ; Lung/pathology* ; Forensic Pathology

Investigating neonatal deaths in the toilets is challenging for forensic pathologists. During the postmortem examination, they should evaluate whether the baby was alive or a stillbirth and determine any causes of death, such as prenatal cause, infection, anatomical abnormalities, birth or other blunt force injury, drowning, and asphyxia. We retrieved two cases of neonatal deaths in the toilets and reviewed their autopsy findings and circumstances. However, findings from the postmortem examination were insignificant. Their lung examinations revealed non-expanded alveoli, and hydrostatic tests were negative. However, the cases cannot be confirmed as stillbirths because of the possibility that they might be alive for a short period of time after birth and then exposed into the water in the toilet or to accidental or non-accidental asphyxia or that they might have died because of neglect. These cases illustrate that the death scene and the associated circumstances should be meticulously and carefully investigated.
Asphyxia ; Autopsy ; Cause of Death ; Drowning ; Forensic Pathology ; Humans ; Infant, Newborn* ; Lung ; Parturition ; Perinatal Death ; Stillbirth ; Water

Despite improvement in perinatal practice during the past several decades, the incidence of cerebral palsy has remained essentially unchanged. The cause of cerebral palsy is thought to be multifactorial, including prematurity, inflammation, genetic cause and environmental factors. Although evidences suggest that 70-80% of cerebral palsy is due to prenatal factors and birth asphyxia plays a relatively minor role (<10%), development of cerebral palsy is frequently attributed to the obstetric misstep. Therefore, it is of critical importance to keeping in touch with recent trend and advances regarding cerebral palsy. In this background, this review was mainly focused on the articles published from Jan 2006 to June 2007, excluding the orthopedic and rehabilitational aspects. The subjects are arbitrary divided into the following four categories; 1) recent epidemiologic studies of cerebral palsy, 2) recent evidences of antenatal risk factors, 3) cerebral palsy and placental pathology, 4) role of MRI in diagnosis of cerebral palsy.
Asphyxia ; Cerebral Palsy* ; Diagnosis ; Epidemiology ; Incidence ; Inflammation ; Magnetic Resonance Imaging ; Orthopedics ; Parturition ; Pathology ; Risk Factors

Abnormalities, Multiple ; diagnosis ; therapy ; Asphyxia ; pathology ; Female ; Humans ; Infant ; Musculoskeletal Abnormalities ; diagnosis ; therapy ; Syndrome ; Thorax ; abnormalities

Airway Obstruction ; complications ; etiology ; physiopathology ; Asphyxia ; etiology ; physiopathology ; Fibroma ; complications ; pathology ; Humans ; Infant, Newborn ; Oropharyngeal Neoplasms ; complications ; pathology ; Rare Diseases

BACKGROUNDThe two most prevalent causes of sudden cardiac death are ventricular fibrillation cardiac arrest (VFCA) and asphyxiation cardiac arrest (ACA). Profound postresuscitation myocardial dysfunction has been demonstrated in both VFCA and ACA animal models. Our study aimed to characterize the two porcine models of cardiac arrest and postresuscitation myocardial metabolism dysfunction.

METHODSThirty-two pigs were randomized into two groups. The VFCA group (n = 16) were subject to programmed electrical stimulation and the ACA group (n = 16) underwent endotracheal tube clamping to induce cardiac arrest (CA). Once induced, CA remained untreated for a period of 8 minutes. Two minutes following initiation of cardiopulmonary resuscitation (CPR), defibrillation was attempted until return of spontaneous circulation (ROSC) was achieved or animals died. To assess myocardial metabolism, (18)F-FluoroDeoxyGlucose Positron Emission Tomography was performed at baseline and 4 hours after ROSC.

RESULTSROSC was 100% successful in VFCA and 50% successful in ACA. VFCA had better mean arterial pressure and cardiac output after ROSC than ACA. Arterial blood gas analysis indicated more detrimental metabolic disturbances in ACA compared with VFCA after ROSC (ROSC 0.5 hours, pH: 7.01 ± 0.06 vs. 7.21 ± 0.03, P < 0.01; HCO3(-): (15.83 ± 2.31 vs. 20.11 ± 1.83) mmol/L, P < 0.01; lactate: (16.22 ± 1.76 vs. 5.84 ± 1.44) mmol/L, P < 0.01). Myocardial metabolism imaging using Positron Emission Tomography demonstrated that myocardial injuries after ACA were more severe and widespread than after VFCA at 4 hours after ROSC (the maximum standardized uptake value of the whole left ventricular: 1.00 ± 0.17 vs. 1.93 ± 0.27, P < 0.01). Lower contents of myocardial energy metabolism enzymes (Na(+)-K(+)-ATPase enzyme activity, Ca(2+)- ATPase enzyme activity, superoxide dismutase and phosphodiesterase) were found in ACA relative to VFCA.

CONCLUSIONSCompared with VFCA, ACA causes more severe myocardium injury and metabolism hindrance, therefore they should be treated as different pathological entities.

Animals ; Asphyxia ; pathology ; Cardiomyopathies ; pathology ; Cardiopulmonary Resuscitation ; Disease Models, Animal ; Female ; Heart Arrest ; pathology ; Heart Injuries ; pathology ; Male ; Swine ; Ventricular Fibrillation ; pathology

This is the statistical analysis about the medicolegal autopsy cases performed by the Department of Forensic Medicine, Seoul National University Medical College during the last 5 years. 1. The total number of cases was 330, among which male took 256(77.5%) cases, female 74(22.5%) cases. The natural death took 134(40.6%) cases, unnatural death 177(53.6%) cases. For remaining 19(5.8%) cases the cause of death was known, although thorough analyses including microscopic examination, toxicology study were done. The thirties were most as 25.4% of the total cases, and the forties followed the second. 2. The number of autopsy showed severe variation annually or monthly in a year. 3. Among unnatural death, death by violent injury took 87(49.2%) cases, asphyxia 48(27.1%) cases, intoxication 17(9.6%) cases and death by thermal injuries or electric injuries 25(14.1%) cases. 4. Among natural death the abnormality in cardiovascular system were the most as 73(54.5%) cases, gastrointestinal system 38(28.4%) cases and central nervous system 12(8.9%) cases. 5. There were some differences between these and the data from other institute in the ratio of male to female, ratio of natural death to unnatural death and the ratio of specific cause of death among natural and unnatural death. 6. During this work, there were some difficulties in the aspect the irregularity of the work, in requesting toxicology and in the expense needed for the process. Considering the educational aspect for the students and the residents in pathology, performing medicolegal autopsy in medical college should be encouraged. The small number of autopsy and the closeness of the scene made the scene investigation possible in several cases, which is the ideal form that we must consider when we set up our system for the postmortem investigation.
Asphyxia ; Autopsy* ; Cardiovascular System ; Cause of Death ; Central Nervous System ; Electric Injuries ; Female ; Forensic Medicine ; Humans ; Male ; Pathology ; Seoul* ; Toxicology

Periventricular leukomalacia is a major cause of neuro-developmental delay in premature infant. Although it develops in only a small percentage of preterm infants, the condition poses a major problem. The pathogenesis of periventricular leukomalacia is not well established. Because of the topography of the lesion, a decreased cerebral perfusion occurred before delivery is thought to be a critical pathogenetic factor. Therefore, hypoxic brain damage is thought to be a major cause of periventricular leukomalacia. The importance of neurochemically mediated injury to the white matter has been stressed. Recently, high incidence of placental chorioamnionitis with periventricular leukomalacia. We experienced a case of periventricular leukomalacia related to chorioamnionitis. The pathology of placenta was chorioamniontis, and it was thought to be a cause of periventricular leukomalacia. So, we report our case with a short literature review to ensuring that chorioamionitis without perinatal asphyxia cause a periventricular leukomalacia.
Asphyxia ; Chorioamnionitis* ; Female ; Humans ; Hypoxia, Brain ; Incidence ; Infant, Newborn ; Infant, Premature ; Leukomalacia, Periventricular* ; Pathology ; Perfusion ; Placenta ; Pregnancy