Both death certificates and postmortem examination certificates are used as proof of death. These certificates sometimes contain erroneous information but how frequently they do so is unknown. In particular, only a few studies have measured the accuracy of the cause and manner of death on Korea death documents. In this study, we compared the cause and manner of death on both kinds of certificates with those on autopsy reports to determine the frequency of errors, and to identify way to improve the accuracy of these certificates. In 2012, 528 autopsies were requested of out institute, and certificates were submitted in 241 of the cases. The manner of death was classified as natural, unnatural, or unknown. The cause of death in the autopsy report matched that on the death certificate in 37 of 63 cases (58.7%), and the manner of death matched in 40 of 63 cases (63.5%). The cause of death in the autopsy report matched that on the postmortem examination certificate in 62 of 178 cases (34.8%), and the manner of death matched in 74 of 178 cases (41.6%). Death certificates and postmortem examination certificates are important documents. We identified many incorrect reports of causes and manners of death on both kinds of documents, especially the postmortem death certificates. These inaccuracies are presumably due to a lack of forensic information and education, as well as lack of interest on the part of medical doctors.
Autopsy* ; Cause of Death ; Death Certificates* ; Education ; Korea

The Korean Society for Legal Medicine (KSLM) was founded in 1976 and launched its official journal, the Korean Journal of Legal Medicine (KJLM), in 1977. They have played an important role in Korea's forensic medicine and science, the demand for which has increased in Korean society over the years. A historical review is important and has a significant value in the advancement of forensic medicine and science in Korea. Accordingly, this study reviews and analyzes all papers published in KJLM for 39 years, from Volume 1, Issue No. 1 in 1977 to Volume 39, Issue No. 4 in 2015. There are 891 published papers, which are categorized into 318 review articles, 339 original articles, and 234 case reports. Of the total 891 papers, 377 (42.3%) are related to forensic pathology, whereas 111 (12.5%) concern forensic genetics. The major submitting institutes are forensic medicine departments of universities and the National Forensic Service. KJLM's history can be divided into two phases. The first phase is from the 1970s to the 1990s, and the second, from the 2000s to the present. Many review articles were published in the first phase; approximately 10% of these articles concern clinical forensic medicine and law. Articles on forensic genetics, identification, and entomology also started to be published in the first phase. In the next phase, many case reports from the National Forensic Service were published, and the number of articles on forensic pathology and forensic genetics multiplied. The results of this study provide KSLM and KJLM with direction toward sustainable development. This study is part of the organization's 40th anniversary celebration, and in commemoration of its contribution to advancing human rights and social stability in Korea.
Academies and Institutes ; Anniversaries and Special Events* ; Conservation of Natural Resources ; Entomology ; Forensic Genetics ; Forensic Medicine* ; Forensic Pathology ; Human Rights ; Jurisprudence ; Korea

Currently in the Republic of Korea, most postmortem investigations occur within the context of a death scene investigation and are restricted to a postmortem inspection without a subsequent autopsy. In this study, we analyzed the discrepancies between the results of postmortem inspection and autopsy to investigate the limits of postmortem inspection. The conclusions about the cause and manner of death stated in the two reports were compared. A retrospective study was carried out on 6,126 autopsy cases performed in the Republic of Korea in 2015. Of these autopsy cases, 2,263 included postmortem inspection reports. The stated cause and manner of death conflicted with the autopsy report in 55.1% and 32.9% of the postmortem inspection reports, respectively. Among these conflicted reports, the cause and manner of death was undetermined in 66.6% and 70.3% of the postmortem inspection reports, respectively. Furthermore, different types of discrepancies were found between the causes and manner of death that were stated in the reports by police investigators and those by forensic pathologists. This study revealed that postmortem inspection is not sufficient in the postmortem investigation and forensic autopsies need to be performed.
Autopsy* ; Cause of Death ; Humans ; Police ; Republic of Korea ; Research Personnel ; Retrospective Studies

PURPOSE: To assess the efficacy of unilateral use of a blood reinfusion device in one-stage bilateral total knee arthroplasty (TKA). MATERIALS AND METHODS: We carried out a retrospective cohort study on 100 patients having one-stage bilateral TKA. In 50 of these patients (study group), a blood reinfusion device was applied on one knee and a standard suction drain on the other, and they were compared with 50 matched controls who received bilateral suction drains (control group). The hemoglobin (Hb) level, the hematocrit (Hct) and the platelet count were checked preoperatively, immediately postoperatively, and the third and seventh days postoperatively. The total drain output and the amount of allogeneic blood transfusion were also compared. RESULTS: There were no significant differences in the total drain output and required amount of allogeneic blood transfusions between groups (p>0.05). However, the study group had significantly lower Hb and Hct values by the first day postoperatively and significantly lower platelet count values by the third day postoperatively than the control group (p<0.05). CONCLUSIONS: Compared with use of bilateral suction drains, unilateral use of reinfusion device was not advantageous in reducing allogeneic transfusion in one-stage bilateral TKA.
Arthroplasty ; Blood Transfusion ; Cohort Studies ; Hematocrit ; Humans ; Knee ; Platelet Count ; Retrospective Studies ; Suction

Background: Peripheral nerve injury is a complication that can occur after general anesthesia. It significantly impairs the patient’s quality of life and may lead to permanent disability. Nerves in several areas can be damaged during the perioperative period, but it is very rare that numbness of the lower lip is caused after general anesthesia. Case: A 73-year-old man with diabetes mellitus underwent urological surgery under general anesthesia. The day after surgery, he complained of numbness on the right lower lip caused by a mental nerve injury. Diabetic mononeuropathy or neurapraxia related to mechanical compression was considered a possible cause. The symptoms resolved spontaneously after six weeks. Conclusions Mental nerve injury is a rare perioperative complication in surgical patients under general anesthesia. In this case, patients should be reassured and advised to avoid injuries to the mouth and lips. However, specific treatment is not required.

Background: Peripheral nerve injury is a complication that can occur after general anesthesia. It significantly impairs the patient’s quality of life and may lead to permanent disability. Nerves in several areas can be damaged during the perioperative period, but it is very rare that numbness of the lower lip is caused after general anesthesia. Case: A 73-year-old man with diabetes mellitus underwent urological surgery under general anesthesia. The day after surgery, he complained of numbness on the right lower lip caused by a mental nerve injury. Diabetic mononeuropathy or neurapraxia related to mechanical compression was considered a possible cause. The symptoms resolved spontaneously after six weeks. Conclusions Mental nerve injury is a rare perioperative complication in surgical patients under general anesthesia. In this case, patients should be reassured and advised to avoid injuries to the mouth and lips. However, specific treatment is not required.

STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to clarify the association between the position of the atlantoaxial fusion angle and the change of the subaxial cervical spine alignment (SCA) and the reduction loss after atlantoaxial fusion (AAF) using the posterior wiring technique (PWT), transarticular screw fixation (TAF) and posterior screw-rod fixation (PSR) for treating atlantoaxial instability (AAI). SUMMARY OF LITERATURE REVIEW: There are not many studies on the change of the SCA and the reduction loss after AAF. MATERIALS AND METHODS: Thirty five patients underwent AAF for AAI from 1986 to 2008. The mean follow-up period was 59.5 months. The surgical techniques were divided into three groups, that is, PWT: 17 patients, TAS: 10 and PSR: 8. The causes of instability were transverse ligament rupture in 12 patients, rheumatoid arthritis in 11, Os odontoideum in 6 and nonunion of an odontoid fracture in 6. Plain radiographs were used to assess the atlanto-dental interval, the posterior arch-lamina angle, the change of the SCA and the time of fusion. RESULTS: Fusion was achieved in all the patients within 3.5 months (range: 3-5 months). The radiologic findings in the 5 PWT patients showed a reduction loss and 3 patients showed subaxial cervical kyphosis (SCK). The TAS group had no reduction loss or SCK. The PSR group had no reduction loss and one patient showed SCK. A statistically significant reduction loss and SCK occurred in the group in which there was a posterior arch-laminar angle greater than 10 degrees before and after surgery. CONCLUSIONS: For the treatment of AAI, the position of the AAF is associated with the change of the postoperative SCA. The preoperative lodortic position of C1-2 should be maintained to prevent the change of the SCA.
Arthritis, Rheumatoid ; Atlanto-Axial Joint ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Ligaments ; Retrospective Studies ; Rupture ; Spine

Spontaneous hepatic rupture, which is a complication of hypertension in pregnancy, is extremely rare. However, high maternal and perinatal mortality rates are observed. Several factors, namely, age over 30 years, multiparity, severe preeclampsia, or HELLP syndrome (a group of symptoms which include hemolytic anemia, hepatic enzyme increase, and thrombocytopenia), are associated with this condition. An autopsy case of a woman with twin pregnancy was studied. She was at 36 weeks of gestational age and suffered from the sudden development and rapid progression of hypertension. Moreover, she died because of spontaneous hepatic rupture despite an emergency operation. Autopsy revealed a capsular rupture of the right lobe of the liver with numerous blood clots and hypovolemic signs, such as weak postmortem lividity and palor of the skin and conjunctiva. A close examination of the trunk and liver for the classification of the cause of rupture and an assessment of medical history, such as preeclampsia, are needed during postmortem examination of pregnant women with hepatic rupture or her fetus. To the best of our knowledge, this fatal complication in pregnant women is not yet presented in postmortem examinations in Korea. Thus, we report the findings of this case to share the knowledge.
Anemia, Hemolytic ; Autopsy* ; Classification ; Conjunctiva ; Emergencies ; Female ; Fetus ; Gestational Age ; HELLP Syndrome ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Hypovolemia ; Korea ; Liver ; Parity ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Pregnancy, Twin ; Pregnant Women* ; Rupture* ; Rupture, Spontaneous ; Skin

Pulmonary artery aneurysms (PAAs) are rare, and massive hemoptysis can lead to death if appropriate diagnosis and treatment is not provided. PAAs can be of congenital, acquired, or idiopathic origin, and the clinical symptoms are various. Among all reported cases, one-third of the patients died due to rupture. Optimal treatment or guidelines for PAAs remain uncertain. Herein, we report autopsy findings from a woman with PAA. The patient was taking medication for tuberculosis. On bronchoscopy, a polypoid lesion was found, suspected to be an inflammatory polyp. Biopsy was performed and massive bleeding into the airway occurred. The bleeding could not be controlled by bronchoscopic suction, and cardiac arrest occurred 30 minutes after biopsy; the patient subsequently died. Autopsy revealed a round, calcified PAA in the bronchus of the right middle lobe; the end of the PAA was torn. Hypovolemic signs, including weak postmortem lividity and pallor of the skin and conjunctivae, were observed. Visual inspection and histopathological examination of the right lung revealed tuberculosis and congestion. Cases related PAA are not uncommon, but autopsy cases of death occurring after biopsy of PAA mimicking bronchial polyps are rarely reported.
Aneurysm* ; Autopsy ; Biopsy* ; Bronchi ; Bronchoscopy ; Conjunctiva ; Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Heart Arrest ; Hemoptysis ; Hemorrhage ; Humans ; Hypovolemia ; Lung ; Pallor ; Polyps* ; Pulmonary Artery* ; Rupture ; Skin ; Suction ; Tuberculosis