Medico-legal investigations in Korea depend mostly on postmortem inspection without autopsy. Both untrained physicians and experienced forensic pathologists may not be able to determine the cause and manner of death only by postmortem inspection. The aim of our study was to show the limitations of postmortem inspection by evaluating the discrepancy between the results of postmortem inspection and autopsy after natural death. The manner of death by postmortem inspection changed to unnatural death in 9.4% of the cases (12 cases/127 cases) after autopsy. The cause of death in most cases was consumption of alcohol, agricultural chemicals, and antipsychotic intoxication. The cause of death by postmortem inspection changed in 24.3% of the cases (26 cases/107 cases) among cases of confirmed natural death after autopsy. The positive predictive value of cause of death by postmortem inspection was higher for cardiovascular disease (79.0%) and lower for chronic alcoholism and/or chronic liver disease (28.6%). This study shows that forensic pathologists could make considerable errors in determining the cause and manner of death without autopsy and emphasizes the necessity to refine medico-legal investigations in Korea by introducing the limited autopsy with toxicologic study and supportive postmortem imaging.
Agrochemicals ; Alcoholism ; Autopsy ; Cardiovascular Diseases ; Cause of Death ; Korea ; Liver Diseases

Cerebral infarction caused by Carotid injury after blunt trauma to the head and neck is rare, but these injuries have high mortality. Recently we experienced a case of carotid artery occlusion probably related to the traffic accident. A 38-year-old man was motorcycling and was struck on the front of his motorcycle by a car. He sustained rib fractures and sprain of the neck, but there was no disturbance of consciousness or paresis of extremities. 16 days later, he developed right hemiparesis. CT scan revealed infarction in the distribution of the left middle cerebral artery territories, angiography revealed total thrombotic occlusion of the left internal carotid artery just distal to the bifurcation. He died 21 days after the accident, and the postmortem exam findings were concordant with clinical findings.
Accidents, Traffic ; Adult ; Angiography ; Autopsy* ; Carotid Arteries* ; Carotid Artery Thrombosis* ; Carotid Artery, Internal ; Cerebral Infarction ; Consciousness ; Extremities ; Head ; Humans ; Infarction ; Middle Cerebral Artery ; Mortality ; Motorcycles ; Neck ; Paresis ; Rib Fractures ; Sprains and Strains ; Thrombosis ; Tomography, X-Ray Computed

Transsexualism is a variety and complexity of conditions to the desire for sex change and may require medical treatments over psychological evaluations in some patients. Consequently, there is a potential confusion in the determination of anatomical sex in transsexuals arising from administration of hormone and/or sex reassignment surgery. In this article, we represent a case of a 52-year-old "woman"found dead on the road-side. "She"was naked on the scene and supposed to be murdered by strangulation of he neck. Surprisingly, autopsy findings as well as DNA typing revealed that "she"was transsexual once a man. We discuss medicolegal problems posed by medico-surgical treatment in transsexuals.
Autopsy* ; DNA Fingerprinting ; Female ; Homicide ; Humans ; Middle Aged ; Neck ; Sex Reassignment Surgery ; Transsexualism

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

Hypopharyngeal perforation associated with traffic accident is a rare occurrence, which can cause serious morbidity and mortality if not diagnosed and treated early. We report an autopsy case of hypopharyngeal perforation following a traffic accident. A 32-year-old man hits his chin when his car hits highway guardrail. He complained continuous neck pain and died 5 days after the accident. Autopsy was performed, and death was due to undiagnosed retropharyngeal abscess with sepsis.
Accidents, Traffic ; Adult ; Autopsy ; Chin ; Humans ; Hypopharynx ; Neck Pain ; Retropharyngeal Abscess ; Sepsis

The incidence of sudden death due to undiagnosed primary intracranial tumor is very low in forensic autopsy practice. The ganglioglioma is a well differentiated, slow growing primary brain tumor that is encountered predominantly in childhood. We report a sudden, unexpected death in a 6-year-old girl from a ganglioglioma. On autopsy, there was an intraventricular tumor with recent hemorrhage, occupying the anterior aspect of the lateral ventricle and resulting in hydrocephalus. Acute intratumoral hemorrhage appears to be the mechanism of sudden death.
Autopsy ; Brain Neoplasms ; Child ; Death, Sudden ; Ganglioglioma ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Lateral Ventricles

Congenital pneumonia is defined as pneumonia acquired transplacentally or perinatally. It is frequently associated with prolonged rupture of the membranes, chorioamnionitis, prolonged labor, premature labor, fetal distress, prematurity and meconium staining. It is one of the important causes of neonatal death. We report a case of congenital pneumonia of a full-term, female neonate who was born by cesarian section and died at 10th hours of her life. There were no maternal signs and symptoms of infection and amniotic fluid was not stained with meconium at birth. We insist that full physical examination and routine laboratory examinations including simple chest X ray are required even in grossly normal neonate without specific risk factors and that possibility of neonatal pneumonia should always be considered when the cause of death cannot be explained immediately by gross autopsy findings.
Amniotic Fluid ; Autopsy ; Cause of Death ; Chorioamnionitis ; Death, Sudden* ; Female ; Fetal Distress ; Humans ; Infant, Newborn ; Meconium ; Membranes ; Obstetric Labor, Premature ; Parturition* ; Physical Examination ; Pneumonia* ; Pregnancy ; Risk Factors ; Rupture ; Sudden Infant Death ; Thorax

Autoerotic death is an accident occurring during individual, usually solitary sexual activity in which a device or apparatus used to enhance the sexual stimulation. Although it is a well-known phenomenon described in many forensic medicine reports, cases are rare in Korea because of conservative tradition of the society and embarrassment of the victim 's family members. It may be far more common than realized. We present a case of the autoerotic accident involving a plastic bag asphyxia in a 67-year-old man. The death scene investigation and findings at autopsy will provide police officers and physicians with adequate knowledge about this phenomenon to make an accurate diagnosis.
Aged ; Asphyxia ; Autopsy ; Diagnosis ; Forensic Medicine ; Humans ; Korea ; Plastics ; Police ; Sexual Behavior

Since patients with intracranial neoplasms usually represent their neurological symptoms rather early in the course of the disease, sudden unexpected death due to intracranial neoplasms is an uncommon event seen only exceptionally in medicolegal autopsy practice. Although meningiom is one of the most common primary intracranial neoplasms, sudden death due to the tumor is an uncommon event. We report a sudden, unexpected death of a 56-year-old female with an undiagnosed olfactory groove meningioma. It is assumed that peritumoral edema is related to the sudden death among the several mechanisms.
Female ; Humans

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