A 65 year-old female was suddenly expired soon after arriving in emergency room. Before arriving, she complained chest discomfort. Her neck mass was diagnosed as thyroid tumor about 11 years ago. She was recommended operation, but not taken due to arrhythmia. The neck mass was originally diagnosed as thyroid mass(goiter) by radiologic studies. The mass (10.5 x 9.5 x 7.0 cm, 319 gm) is mainly located in the lower neck and partly in the anterior superior mediastinum. The trachea is compressed by the mass and its tubal structure is flattened. The cause of death is mechanical asphyxia by thymoma(type B1 according to the WHO classification of thymoma, and stage I according to Masaoka's classification). On review of her past history, paraneoplastic syndrome including myasthenia gravis is not present. Generally, the patient with large thymic mass shows symptoms including chest pain, respiratory difficulty, hemoptysis, cough, superior vena cava syndrome. Although the symptoms related with its mass effect are common, but the death from mechanical asphyxia by thymoma is very rare in recent days.
Aged ; Arrhythmias, Cardiac ; Asphyxia* ; Cause of Death ; Chest Pain ; Classification ; Cough ; Emergency Service, Hospital ; Female ; Hemoptysis ; Humans ; Mediastinum ; Myasthenia Gravis ; Neck ; Paraneoplastic Syndromes ; Superior Vena Cava Syndrome ; Thorax ; Thymoma* ; Thyroid Gland ; Trachea

No abstract available.

Neurofibromatosis type1(von Recklinghausen's disease) is characterized by multiple skin tumors and abnormal cutaneous pigmentation(cafe au lait spots). Unlikely the solitary neurofibroma, those encountered in von Recklinghausen's disease may cause significant morbidity. The vasculopathy, although poorly recognized manifestation of von Recklinghausen's neurofibromatosis is a major cause of fatal cases. One of its most dramatic presentation is the spontaneous hemothorax. We report a case of Von Recklinghausen's disease with multiple neurofibromatosis accompanying intrathoracic hemorrhage due to vascular rupture, which is the first legal autopsy case in korea.
Autopsy ; Death, Sudden* ; Hemorrhage ; Hemothorax ; Humans ; Korea ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Rupture ; Skin

Paraquat is a bipyridilium nonselective contact herbicide and well-known pulmonary toxicants. Concentrated solution of paraquat may causes severe corrosive injury and multiple system organ failure. It is poorly absorbed from GI tract, but is extremely toxic and so one swallowed mouthful of Gramoxone(about 5ml) will be fatal. We experienced 3 cases of paraquat poisoning through injection and examined pathologic findings, medical records and concentration of paraquat in blood and tissues. We reviewed the mechanism of action of paraquat, pathologic changes of organ system, concentration of compound in the various organ and cause of death in autopsy cases.
Autopsy* ; Cause of Death ; Gastrointestinal Tract ; Medical Records ; Mouth ; Paraquat* ; Poisoning*

Chronic rheumatic heart disease is the most important consequence of rheumatic fever and characterized principally by deforming fibrotic valvular disease(particularly mitral stenosis), which can produce permanent dysfunction and severe, sometimes fatal, cardiac dysfunction decades later. So the operation should be carried out in symptomatic patients with moderate to severe mitral or aortic stenosis or regurgitation. Postoperative mortality rate is low. But some postoperative complications including thromboembolism and prosthetic valve endocarditis are associated with high mortality. We report a autopsy case diagnosed as cerebral infarction due to thromboembolic complication of rheumatic heart disease patient with mechanical mitral and aortic prostheses. To our knowledge, this is the initial autopsy presentation of cerebral infarction due to thromboembolic complication of mechanical prosthetic valve in the patient with rheumatic heart disease in Korea.
Aortic Valve Stenosis ; Autopsy ; Cerebral Infarction* ; Endocarditis ; Heart Valve Prosthesis ; Humans ; Korea ; Mortality ; Postoperative Complications ; Prostheses and Implants* ; Rheumatic Fever ; Rheumatic Heart Disease* ; Thromboembolism

Two autopsied cases of dissecting aneurysms of intracranial vertebral artery are reported and the appropriate literature is reviewed to investigate the pathological characteristics and pathogenesis. The location and pathological features of the aneurysms are similar in the two cases. The aneurysms in both cases are confined to the intracranial vertebral artery and massive subarachnoid hemorrhage in basal cistern develop caused by the rupture of the arterial wall. And the aneurysms show mainly subadventitial dissection and display intimal thickening, disruption of internal elastic lamina, and degeneration of the media. Based on their pathological investigation of these two cases and a review of reported cases, the authors propose that weakness of internal elastic lamina may be responsible for initiating dissection in susceptible individuals and hypertention is one of contributing factors that result in weakness of internal elastic lamina.
Aneurysm ; Aneurysm, Dissecting* ; Autopsy* ; Rupture ; Subarachnoid Hemorrhage ; Vertebral Artery*

Carbon monoxide which is an odorless, colorless, non-irritating gas causes asphyxia by blocking the hemoglobin of the RBC from carrying oxygen to the tissues and from returning carbon dioxide to the lungs. The clinical symptoms of CO poisoning depend on the blood CO saturation level and in a healthy middle-aged individual a blood CO saturation greater than 50% is considered fatal. In forensic science, the investigation of the scene in cases of CO poisoning is imperative to determine the manner of death or the source of CO production, while postmortem diagnosis of CO poisoning is not difficult. The author reported four cases of CO poisoning in the unusual or atypical circumstances, which were not recognized in the scene.
Asphyxia ; Carbon Dioxide ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Diagnosis ; Forensic Sciences ; Lung ; Oxygen ; Poisoning

The principal manifestation of poisoning induced by the alkaline substance is a corrosive effects in tissues. The alkalies combine with protein and fat of the tissue, causing deep penetrating injury and liquefactive necrosis of the organs. Liquid lye is the most frequently ingested form of corrosive agents and causes most of the deaths associated with corrosive agent ingestion. We have experienced 5 fatal cases which were accidentally administered liquid lye as soap-saline enema in the hospital during 30 days. the 3 cases of them were autopsied at this institute. At autopsy, the digestive tract including rectum, colon and small intestine revealed hemorrhagic necrosis with multiple area of perforation. Because these were the first proved cases that the liquid lye was used as enema solution, we report here.
Alkalies ; Autopsy ; Colon ; Corrosion ; Eating ; Enema* ; Gastrointestinal Tract ; Intestine, Small ; Lye* ; Necrosis ; Poisoning ; Rectum

The validation study for two STR loci on X-chromosome, DXS7132 and GATA31D10, was done including allelic distribution and frequency of each allele to use these results for individual identification and paternity testing. For 496 unrelated Koreans, above two STR loci were amplified simultaneously using duplex PCR amplification method. The amplified products were analyzed by polyacrylamide gel electrophoresis followed by silver staining. In male DXS7132 locus revealed 7 different alleles ranging from 276bp to 300bp. The largest allele was consisted of 14 repetition of [TCTA] unit and took 0.3417. The allele 15 followed next as 0.3165 and allele 13 as 0.1726. In female general distribution was same except one allele, allele 18 was found additionally. The heterozygosity was 0.7706 and 23 different genotypes were found. Polymorphism information content(PIC) was 0.727. Two cases of mutation were noted in DXS7132 locusIn both male and female 7 different alleles were noted in GATA31D10 locus and the alleles ranged from 195bp to 231bp. The allele 15(199bp) took the majority of all as 0.825. The other alleles showed rather relatively low frequency. The heterozygosity was 0.2385 and 11 different genotypes were found. PIC was 0.2521, and no mutation was noted in GATA31D10 locus. Considering these two loci together, 22 different halpotype were noted.
Alleles ; Electrophoresis, Polyacrylamide Gel ; Female ; Genotype ; Haplotypes ; Humans ; Male ; Paternity ; Polymerase Chain Reaction ; Silver Staining

The aim of this study was to validate the sex typing based on amplification of X-Y homologous Amelogenin locus in Korean including mutation rate in this locus. It was found that there was no case with reported mutation that may hinder the exact sex typing among 240 Koreans, and the sex typing was successful even with subnanogram quantities of male and female DNA. There was no difference in the sensitivity of reaction among male and female. Differential amplification between X and Y amelogenin bands in some samples was noted, and dilution study revealed that this phenomenon was more frequent when the quantity of sample was low, usually less than 10 ng. That phenomenon was variable between amplification reactions, and was also dependent on different Taq enzyme used for the amplification. When there was differential amplification, the intensity ratio (Y band/X band) ranged about 0.68 - 0.87.
Amelogenin* ; DNA ; Female ; Humans ; Male ; Mutation Rate