Maternal mental illness is a significant public health concern, with established adverse outcomes on both mother and infant, such as impaired mother-infant bonding and infant cognitive and emotional development. In severe cases, maternal mortality and infanticide can tragically occur. This is a report on the suicide of a mother who jumped to her death at three months postpartum. She suffered from puerperal psychosis with bipolar features, with onset at six weeks postpartum. The case highlights the burden of maternal mental illness in our community as well as the need for resources and services to care well for mothers. With a better understanding of its presentation and risk factors, early identification and intervention can reduce morbidity and mortality.
Adult ; Autopsy ; Fatal Outcome ; Female ; Humans ; Maternal Death ; Mental Disorders ; pathology ; psychology ; Mothers ; psychology ; Postpartum Period ; psychology ; Psychiatry ; methods ; Suicide ; psychology

Primary aldosteronism due to unilateral adenoma is a rare cause of surgically curable hypertension. Bilateral adrenal mass has occasionally been reported in this syndrome, and bilateral aldosterone-producing adenoma (APA), or bilateral adrenal nodular hyperplasia have been demonstrated in some cases. However, another possibility is the coexistence of a unilateral APA with a contralateral benign or metastatic nonfunctioning mass, because adrenal tumors are frequently found at autopsy or incidentally detected during abdominal morphological evaluation in patients without adrenal dysfunction. A 39 year-old woman presented with hyperaldosteronism, suppressed renin levels, and bilateral adrenal mass on adrenal CT scanning. Selective adrenal venous sampling was unsuccessful in demonstrating concentration gradient of aldosterone. Postoperative measurement of hormone content in the tumor extract revealed unilateral aldosteron-producing adenoma with contralateral nonfunctioning black adenoma, Determination of hormone content in the tumor extract could be useful for the discrimination of functioning and nonfunctioning endocrine tumors, particularly in case of multiple tumors.
Adenoma* ; Adult ; Aldosterone ; Autopsy ; Discrimination (Psychology) ; Female ; Humans ; Hyperaldosteronism ; Hyperplasia ; Hypertension ; Renin ; Tomography, X-Ray Computed

Suicide, the fourth leading cause of death in Korea, is a serious national problem. The Korea National Suicide Survey (KNSS) is the result of the first legislation to address this issue, "Article 11 of THE ACT FOR THE PREVENTION OF SUICIDE AND THE CREATION OF A CULTURE OF RESPECT FOR LIFE" (the "Act for the Prevention of Suicide"). To overcome the limitations of previous studies, the KNSS was designed by collaborators from a variety of fields : psychology, epidemiology, social welfare, and psychiatry. The KNSS was composed of four substudies that addressed the multifaceted process involved in suicide-related behavior over time, exploring general attitudes toward suicide and suicidal ideation, suicide planning, suicide attempts, and completed suicides. Study 1 examined the risk factors for suicide based on data regarding completed suicides ; Study 2 adopted the approach of a psychological autopsy ; Study 3 focused on suicide attempters ; and Study 4 explored attitudes toward suicide in the general population. The KNSS was designed to provide a comprehensive understanding of suicide from a longitudinal, multifaceted perspective to serve as a basis for policies aimed at suicide prevention.
Autopsy ; Cause of Death ; Epidemiology ; Korea ; Psychology ; Risk Factors ; Social Welfare ; Suicidal Ideation ; Suicide*

A seaman died after a jet of compressed air directed to his anus while working with his colleagues in deck of the ship. He suffered from abdominal pain and distension, and died 5 hours later in the ship. Autopsy was performed and revealed rupture of the splenic flexure of the colon and partial seromuscular tearing in the rectosigmoidal region. We concluded that the cause of death was tension pneumoperitoneum by the pneumatic colonic rupture. The need for education of the workers handling compressed air appliances is emphasized.
Abdominal Pain ; Anal Canal ; Autopsy ; Cause of Death ; Colon ; Colon, Transverse ; Compressed Air ; Handling (Psychology) ; Pneumoperitoneum ; Rupture ; Ships

OBJECTIVE: The aim of the study was to develop the Korean Psychological Autopsy Checklist for Adolescent (K-PAC-A) and conduct a pilot study. METHODS: A number of steps were undertaken in the development of the K-PAC-A including literature reviews, consultations, and a pilot study. The Korean psychology autopsy checklist 2.0 (K-PAC 2.0) was carefully reviewed to adopt some domains and questions which can be applied to adolescents. RESULTS: In addition to the adoption of some domains and questions from the K-PAC 2.0, some items were developed by considering the risk factors shown in the previous studies and cultural factors including family-based and school-based problems. A pilot study was conducted in collaboration with Eulji hospital, and Suicide and School Mental Health Institute of Hallym University and 5 cases of adolescent suicide victims were recruited. A final version of the K-PAC-A consists of three domains; a bereaved family (informants), a decedent, and psychological assessments. CONCLUSION: An adolescent psychological autopsy study using the K-PAC-A is expected to provide useful evidence for suicide prevention policies and intervention plans for Korean youths in the future.
Adolescent* ; Autopsy* ; Checklist* ; Child ; Cooperative Behavior ; Humans ; Mental Health ; Pilot Projects ; Psychology ; Referral and Consultation ; Risk Factors ; Suicide

Fisting is an uncommon sexual activity, and death due to fisting is very rare. In the present report, we describe a case of a woman who died from fisting by her male partner. A 38-year-old woman went to a motel with a man after consuming alcohol, and there they kissed each other. As desired by woman, the man inserted his fingers into her vagina and anus, and later inserted his fist and forearm into her vagina and anus. After 20-30 minutes of fisting, the woman became unconscious and died. The autopsy confirmed the presence of perineal and vaginal lacerations with massive internal pelvic soft tissue injury with uterine artery rupture. A partial tear was noted at the rectosigmoid junction. The cause of death was hypovolemic shock due to uterine artery rupture. Following court trials, the assailant was sentenced to 4 years of imprisonment for the felony of inflicting bodily injury resulting in death.
Anal Canal ; Autopsy ; Cause of Death ; Female ; Fingers ; Forearm ; Humans ; Lacerations ; Male ; Rupture ; Sexual Behavior ; Shock ; Soft Tissue Injuries ; Unconscious (Psychology) ; Uterine Artery ; Vagina

The suicide were analyzed depending only on the death scene and cadaver features but not on the psychological autopsy (PA) that also enables the determination of the manner of death in China for a long time. There are significant differences between PA and the traditional risk assessment of suicide. The goals of PA are to find out the features of individuality, the patterns of behavior and the possible motives of suicide. The methods of PA involve investigating, collecting and analyzing all related information of the deceased. There are many limitations of PA in application mainly due to the lack of the standard procedures. Although an improved procedure has recently developed by Berman, many problems need to be solved before the actual application of PA in China.
Autopsy/psychology* ; Cause of Death ; Data Collection/statistics & numerical data* ; Forensic Psychiatry/methods* ; Humans ; Life Change Events ; Retrospective Studies ; Risk Factors ; Suicide/statistics & numerical data* ; Suicide Prevention

OBJECTIVETo compare the characteristics of suicides in the four main demographic groups: urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China.

METHODSA detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country.

RESULTSPesticide ingestion accounted for 58% (519) of all suicides and 61% (318/519) of deaths were due to unsuccessful medical resuscitation. A substantial proportion (37%) of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% (76/563) received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion (79%), the lowest prevalence of mental illness (39%), and the highest acute stress from precipitating life events just prior to the suicide.

CONCLUSIONMany suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autopsy ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Mental Disorders ; epidemiology ; psychology ; Middle Aged ; Rural Population ; Suicide ; psychology ; statistics & numerical data ; trends ; Urban Population

OBJECTIVES: To analyze the relationship between the suicide method and the sex, age, education background and cause of suicide to provide reference for the forensic identification of suicide. METHODS: After scene investigation, external body examination, autopsy and case investigation, 124 identified suicide cases which happened in recent three years in Wuhua district in Kunming were collected. Analytical methods as chi-square test and descriptive statistics were performed by SPSS 22.0. RESULTS: In all the suicide cases, male to female ratio was 1.53∶1. The suicide methods were mainly fatal fall, hanging and drowning. The ratio of local to non-native residents was 1∶1. The suicide rate in the people with primary school or junior middle school education level was highest. The group of >10-50 years tended to choose fatal fall suicide and people over 60 years were more likely to choose hanging. People with different academic background tended to choose fatal fall suicide. The suicide methods as fatal fall and hanging were chosen because of mental and physical diseases and economic problems, while the suicides with emotional problems were more likely to choose fatal fall and poisoning. CONCLUSIONS Suicide belongs to a kind of complex cases. For the cases of suspected suicide, complete exploration and overall consideration should be done to determine the nature of cases based on comprehensive analysis of all the influence factors.
Adolescent ; Adult ; Age Distribution ; Aged ; Autopsy ; Cause of Death ; Child ; China/epidemiology* ; Drowning/psychology* ; Female ; Humans ; Incidence ; Male ; Mental Disorders/psychology* ; Middle Aged ; Sex Distribution ; Suicide/statistics & numerical data* ; Young Adult

The Tuskegee Study of Untreated Syphilis in the Negro Male was an observational study on African-American males in Tuskegee, Alabama between 1932 and 1972. The U. S. Public Health Service ran this study on more than 300 people without notifying the participants about their disease nor treating them even after the introduction of penicillin. The study included recording the progress of disease and performing an autopsy on the deaths. This paper explores historical backgrounds enabled this infamous study, and discusses three driving forces behind the Tuskegee Study. First, it is important to understand that the Public Health Service was established in the U. S. Surgeon General's office and was operated as a military organization. Amidst the development of an imperial agenda of the U.S. in the late 19th and early 20th centuries, the PHS was responsible for protecting hygiene and the superiority of “the American race” against infectious foreign elements from the borders. The U.S. Army's experience of medical experiments in colonies and abroad was imported back to the country and formed a crucial part of the attitude and philosophy on public health. Secondly, the growing influence of eugenics and racial pathology at the time reinforced discriminative views on minorities. Progressivism was realized in the form of domestic reform and imperial pursuit at the same time. Major medical journals argued that blacks were inclined to have certain defects, especially sexually transmitted diseases like syphilis, because of their prodigal behavior and lack of hygiene. This kind of racial ideas were shared by the PHS officials who were in charge of the Tuskegee Study. Lastly, the PHS officials believed in continuing the experiment regardless of various social changes. They considered that black participants were not only poor but also ignorant of and even unwilling to undergo the treatment. When the exposure of the experiment led to the Senate investigation in 1973, the participating doctors of the PHS maintained that their study offered valuable contribution to the medical research. This paper argues that the combination of the efficiency of military medicine, progressive and imperial racial ideology, and discrimination on African-Americans resulted in the Tuskegee Syphilis Experiment.
African Continental Ancestry Group ; Alabama ; Autopsy ; Discrimination (Psychology) ; Eugenics ; Humans ; Hydrogen-Ion Concentration ; Hygiene ; Male ; Military Medicine ; Military Personnel ; Observational Study ; Pathology ; Penicillins ; Philosophy ; Public Health* ; Sexually Transmitted Diseases ; Social Change ; Syphilis ; United States Public Health Service ; United States*