1.Positional Asphyxia: Remains Hard to Diagnose?
Hongil HA ; Nahyun AUM ; Han Na KIM
Korean Journal of Legal Medicine 2024;48(2):27-34
Positional asphyxia is a type of asphyxia where the position of an individual compromises the ability to breathe. It is commonly caused by accidents due to alcohol or drug intoxication, diseases, and/or being in a confined space. In this study, the authors reviewed autopsy cases at their institute over the past 5 years where positional asphyxia is suspected as a contributing factor or cause of death. The autopsy cases (n=24) were divided into three groups: positional asphyxia was the cause of death (n=15); unknown cause of death but positional asphyxia was considered (n=4); and positional asphyxia was suspected to be a contributing factor (n=5). All cases of group A included postures that could interfere with breathing, but the typical jackknife or head-down postures were seen in approximately half of the cases; “classic signs of asphyxia” were also observed in approximately half of the cases. They shared features such as high blood alcohol concentration, therapeutic levels of drugs, various disease, minor head trauma, and morbid obesity; however, no definite diagnostic criteria have been established for forensic practice. Positional asphyxia is a form of mechanical asphyxia which must be differentiated from traumatic asphyxia. In addition to a complete autopsy, thorough laboratory tests and understanding of the circumstances of the case and the situation at the death scene are required for diagnosis. Special attention is required for the diagnosis of special types of positional asphyxia such as death during institutional restraint or prone restraint.
2.Sex Estimation Using Humerus Volume of CT Images in Korean Population: A Metric Study
Yun Taek SHIM ; Nahyun AUM ; Young Man LEE ; Seongho KIM ; Jin Young HYUN ; Kyung-mi LEE
Korean Journal of Legal Medicine 2023;47(4):146-152
This study aimed to explore the use of three-dimensional reconstructed computed tomography images of the adult humerus for forensic anthropological sex estimation in the Korean population. In forensic anthropology, the skull and pelvic bone show high accuracy in sex estimation; however, when they are impaired, other bones should be available for sex estimation. Six hundred images of the right and left humerus pair were used. A logistic regression analysis was performed by measuring the volumes of 500 images and the remaining 100 images were used in the metric sex estimation. Both the logistic regression and metric measurements were performed separately on three regions of the right and left humerus: the head, mid-shaft, and digital regions, The accuracy of sex estimation in the right humerus was 93% (91% for men and 96% for women), 92% (93% for men and 91% for women), and 87% (85% for men and 89% for women) for the head, mid-shaft, and digital regions, respectively. Sex estimation accuracy in the left humerus was 92% (89% for men and 96% for women), 93% (96% for men and 89% for women), and 91% (91% for men and 91% for women) for the head, mid-shaft, and digital regions, respectively. These results contribute to high accuracy and reliability in sex estimation using three-dimensional images of the humerus in Koreans, whereas the two-dimensional metric method provided limited information on bone measurements.
3.Estimation of Forensic Sex Based on Three-Dimensional Reconstruction of Skull in Korean: Non-metric Study
Yun Taek SHIM ; Ye Hwon JEONG ; Yi-Suk KIM ; Nahyun AUM ; Seung Gyu CHOI ; Se-Min OH ; Ji Hwan PARK ; Dong Yeong KIM ; Hyung Nam KOO
Korean Journal of Legal Medicine 2021;45(3):79-86
This study performed the forensic anthropological sex estimation of Koreans in a non-metric way by reconstructing three-dimensional (3D) computed tomography (CT) images of skulls. The skull CT images used in this study were 100 (51 males, 49 females), and all CT images were taken with a slice thickness of 0.75 mm and then reconstructed into 3D images using the MIMICS 23.0 program. Using the reconstructed 3D image, measurements were repeated twice. The sex determination was male if the 4 point to 5 point was relatively more in five landmarks, and female if the points of 1 to 2 were relatively more. Results of the study show that, 88 of the 100 cases matched the actual sex. Among the 12 discrepant cases, ten cases were mismatched with the actual sex even though the estimation and repeated estimation readout of sexestimating were the same. Two cases, were “unknown,” showing different sexes in the first and repeated estimations. In conclusion, this study indicated that a forensic anthropological analysis from 3D images provided accurate point information on the landmarks of skulls, showing as high an accuracy as the sex estimation method using real bones. The ten cases of sex mismatch, except the two “Unknown” cases, are considered to be errors that did not consider differences in population groups. In further studies, further establishing a nonmetric, specifically Korean methods to increase the accuracy and reliability of sex estimation is need.
4.Usefulness of Dipstick Test for Vitreous Glucose in Autopsy Practice.
Kyunghong LEE ; Hyung Nam KOO ; Tae Gong KIM ; Jeong Yeol PARK ; Kang Hyun BAEK ; Seung Gyu CHOI ; Cheol Ho CHOI ; Nahyun AUM ; Nak Won LEE ; Byung Ha CHOI
Korean Journal of Legal Medicine 2016;40(4):99-103
The concentration of glucose in the vitreous humor serves as an important diagnostic marker for diabetic mellitus in post-mortem examinations, as the vitreous humor can be easily collected and the glucose test using vitreous humor is not significantly affected by cell autolysis and hemolysis. For a quick and effective glucose test, we suggest a dipstick test of the vitreous humor during autopsy. The results were evaluated and compared with other methods for significance testing. In this study, vitreous humor was analyzed from 257 autopsy cases. Qualitative concordance rate of the dipstick test for glucose and the hexokinase test was 98.7%, positive prediction rate was 89.6%, and negative prediction rate was 100%. However, there was no significant correlation between the dipstick glucose test and the hexokinase test. We conclude that the dipstick glucose test is effective and useful for post-mortem glucose screening testing and for additional post-mortem diabetes testing. Recently, the importance of post-mortem glucose testing has increased with the increase in deaths from diabetes complications. The use of the dipstick glucose test in autopsy practice can improve forensic medicine in Korea.
Autolysis
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Autopsy*
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Diabetes Complications
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Forensic Medicine
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Glucose*
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Hemolysis
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Hexokinase
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Korea
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Mass Screening
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Vitreous Body
5.Statistical Analysis of Postmortem Inspection Cases of the National Forensic Service Seoul Institute in 2017
Young Man LEE ; Minsung CHOI ; You jin WON ; Jong pil PARK ; Cheol Ho CHOI ; Insoo SEO ; Duk Hoon KIM ; Seung gyu CHOI ; Bonggu KANG ; Nahyun AUM ; Dong yeong KIM ; Seong Ho KIM ; Yu hoon KIM ; Jeong woo PARK ; Kyung moo YANG ; Young Shik CHOI
Korean Journal of Legal Medicine 2019;43(2):64-70
This study provides a statistical analysis of 1,226 cases of death occurring in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro Police Stations) from January 1 to December 31, 2017. There were 427 postmortem inspection cases in Gangseo, 393 in Yangcheon, 377 in Guro, and 29 in other areas. The number of autopsy cases was 69 in Gangseo, 70 in Yangcheon, 86 in Guro, and seven in other areas. According to the postmortem inspection reports, there were 593 cases of natural death and 336 cases of unnatural death, while in 297 cases the cause of death was unknown. Of the 297 unknown cases, autopsy rates from each police station were as follows: 54 of 99 cases (54.5%) in Gangseo, 60 of 101 cases (59.4%) in Yangcheon, 67 of 93 cases (72.0%) in Guro, and in all four cases (100%) from other areas. Unnatural deaths included 215 cases of suicide, nine cases of homicide, and 64 accidental death, while 48 cases were undetermined. Among the unnatural deaths, the cause of death included 138 cases of hanging, 72 cases of falls from a height, and 32 cases of poisoning. Since this statistical study is based on actual postmortem inspection data for 1,226 cases of death in the eight areas of Seoul (excluding deaths from traffic accidents), it raises issues relating to the current postmortem inspection system, and can be used as reference material for a comprehensive overview of causes of death.
Accidental Falls
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Autopsy
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Cause of Death
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Homicide
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Humans
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Poisoning
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Police
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Seoul
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Statistics as Topic
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Suicide
6.Statistical Analysis of Postmortem Inspection Cases of the National Forensic Service Seoul Institute in 2017
Young Man LEE ; Minsung CHOI ; You jin WON ; Jong pil PARK ; Cheol Ho CHOI ; Insoo SEO ; Duk Hoon KIM ; Seung gyu CHOI ; Bonggu KANG ; Nahyun AUM ; Dong yeong KIM ; Seong Ho KIM ; Yu hoon KIM ; Jeong woo PARK ; Kyung moo YANG ; Young Shik CHOI
Korean Journal of Legal Medicine 2019;43(2):64-70
This study provides a statistical analysis of 1,226 cases of death occurring in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro Police Stations) from January 1 to December 31, 2017. There were 427 postmortem inspection cases in Gangseo, 393 in Yangcheon, 377 in Guro, and 29 in other areas. The number of autopsy cases was 69 in Gangseo, 70 in Yangcheon, 86 in Guro, and seven in other areas. According to the postmortem inspection reports, there were 593 cases of natural death and 336 cases of unnatural death, while in 297 cases the cause of death was unknown. Of the 297 unknown cases, autopsy rates from each police station were as follows: 54 of 99 cases (54.5%) in Gangseo, 60 of 101 cases (59.4%) in Yangcheon, 67 of 93 cases (72.0%) in Guro, and in all four cases (100%) from other areas. Unnatural deaths included 215 cases of suicide, nine cases of homicide, and 64 accidental death, while 48 cases were undetermined. Among the unnatural deaths, the cause of death included 138 cases of hanging, 72 cases of falls from a height, and 32 cases of poisoning. Since this statistical study is based on actual postmortem inspection data for 1,226 cases of death in the eight areas of Seoul (excluding deaths from traffic accidents), it raises issues relating to the current postmortem inspection system, and can be used as reference material for a comprehensive overview of causes of death.
7.The Statistical Analysis on the Postmortem Inspection Cases of National Forensic Service Seoul Institute in 2016.
You Jin WON ; Jeong Woo PARK ; Seung Gyu CHOI ; Nahyun AUM ; Dong Yeong KIM ; Won Jun SEO ; Seung Woo CHOI ; Min Je LEE ; Mi Young YU ; Jong Pil PARK ; Minsung CHOI ; Seong Ho KIM ; Soo Kyung LEE ; Woong Jae YUN ; Yu Hoon KIM ; Yi Suk KIM ; Seong Hwan PARK ; Jang Han KIM ; Seong Ho YOO ; Soong Deok LEE ; Jae Yong GIM ; Kyung Moo YANG ; Han Young LEE ; Young Shik CHOI
Korean Journal of Legal Medicine 2017;41(3):67-72
From January 1, 2016 to December 31, 2016, a total of 1147 postmortem inspection cases in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro police stations) were statistically analyzed. Autopsies were performed in 205 cases (17.9%), and the autopsy rates were 17.6% (75/426 cases) in the Gangseo police station, 9.5% (34/357 cases) in the Yangcheon police station, and 24.3% (82/337 cases) in the Guro police station. For 288 cases with an unknown cause of death, the autopsy rates were 70.0% (60/87 cases) in the Gangseo police station, 28.6% (26/91 cases) in the Yangcheon police station, and 63.1% (65/103 cases) in the Guro police station. For 65 cases due to fall from height, the autopsy rate was 7.7% (n=5). Of the 187 cases due to hanging, 155 cases were classified as suicide at the scene with a 4.5% (n=7) autopsy rate and 32 cases were classified as an undetermined manner of death at the scene with a 15.6% (n=5) autopsy rate. The distribution of the “manner of death” was natural death, 45% (n=516); unnatural death, 29.9% (n=343); and other and undetermined, 25.1% (n=288). Proportions of dispatch times were 50.9% (584 cases) during work hours (09:00–18:00), 13.8% (n=158) during evening hours (18:00–21:00), 13.4% (n=154) at night (21:00–00:00), 11% (n=126) at dawn (00:00–06:00), and 10.9% (n=125) during morning hours (06:00–09:00). The male-to-female ratio was 1.86:1 (746:401). These statistics are valuable for the evaluation of postmortem inspections by experts.
Autopsy
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Cause of Death
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Humans
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Police
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Seoul*
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Suicide