Because the postmortem changes rapidly distort values of many constituents in the body fluids, the determination of postmortem chemical changes and relation among body fluids is very important in medicolegal community. A laboratory result is not useful if appropriate data for comparison are lacking. The aim of this paper is to determine the reference ranges and the postmortem changes for chemical constituents in postmortem specimen. We examined 17 clinical laboratory parameters in cadaveric blood and vitreous humor obtained from 51 autopsy cases. The mean, standard error, standard deviation and confidence interval of all measured constituents were shown in Table 2 & Figure 1. The postmortem blood level of amylase, phosporus, LDH, ALT, AST and CPK are very higher than those of antemortem blood. The postmortem vitreous level of total bilirubin, triglyceride, GGT, alkaline phosphatase, albumin, total protein and cholesterol are very low and is not reliable. The ratio of vitreous/blood in calcium, BUN, creatine and uric acid are 0.74, 0.68, 0.29 and 0.23 in decreasing orders(Table 3,4). For the medical examiner or pathologist, routine chemical examinations of the vitreous humor can provide evidence of abnormality not apparent in gross or microscopic examination of the tissue. A more extensive study will be required, using a larger number of subjects, to establish the full range of variability.
Alkaline Phosphatase ; Amylases ; Autopsy ; Bilirubin ; Body Fluids ; Cadaver ; Calcium ; Cholesterol ; Confidence Intervals ; Coroners and Medical Examiners ; Creatine ; Humans ; Postmortem Changes ; Reference Values ; Triglycerides ; Uric Acid ; Vitreous Body

Here we report an autopsy case of diabetic ketoacidosis (DKA) with severe hypertriglyceridemia (12,900 mg/dl). A 29-year-old woman with a history of type 1 diabetes was found dead at a motel. There was no injury on external inspection, but a lump of cheese-like material was noted in the heart at autopsy and peripheral blood plasma had a creamy appearance. After postmortem biochemical analysis, we made a diagnosis of DKA with severe hypertriglyceridemia and concluded that these unusual autopsy findings were caused by DKA and postmortem change. Uncontrolled diabetes often causes DKA and hypertriglyceridemia. To the best of our knowledge, this is the first report in Korea of DKA with severe hypertriglyceridemia diagnosed by autopsy.
Adult ; Autopsy* ; Diabetic Ketoacidosis* ; Diagnosis ; Female ; Heart* ; Humans ; Hypertriglyceridemia* ; Korea ; Plasma ; Postmortem Changes

BACKGROUND: A two-dose measles vaccination schedule is recommended routinely for either school entry or 11 to 13 years of age in America since 1989. But, several studies were performed on measles antibody in Korea and it remains controversial whether a second dose measles vaccine after 15 months is necessary. To generate baseline data, measles antibody prevalence and its levels according to different age groups in children and young adults in Taejon area were studied. METHODS: A total of 261 subjects at 3 to 21 years of age, who had received a single dose of measles vaccine, were tested for measles antibody by quantitative alpha enzyme immunoassay. The subjects were divided into five age-groups based on the educational system (preschool, elementary school, middle school, high school, young-adult). RESULTS: The seropositivity rates were 97.7% and not significantly different among groups. The expected tendency of declining antibody levels with advancing age, as reported by other studies, was not observed in this study. Except for between Group I and Group II, no significant difference was noted in the antibody levels among the five age groups. Group II showed significantly higher antibody levels than those of Group I (P=0.0025). CONCLUSIONS: No declining tendency of measles antibody levels with advancing age is different from many other studies and contradicts the current recommendations for supplementary vaccinations after 15 months. These might reflect the regional characteristics of the study population in Taejon area and current vaccination rate. Therefore, futher studies with larger population in different geographic regions by quantitative EIA would be needed.
Americas ; Appointments and Schedules ; Child ; Daejeon ; Humans ; Immunoenzyme Techniques ; Korea ; Measles Vaccine ; Measles* ; Prevalence ; Vaccination* ; Young Adult

High-protein anti-D reagents prepared from pools of human serum have been used for routine RhD typing but, low-protein, saline reactive anti-D reagents formulated predominantly with monoclonal antibodies are in current use. Because some of the high-protein reagents contain macromolecular additives that may cause red cells coated with immunoglobulin to aggregate spontaneously, antisera with these additives may produce a false-positive reaction. A four-day old male was admitted due to severe jaundice. Initially, the RhD type of the newborn using a high-protein reagent was D-positive and then, using two low-protein reagents, it was D-negative. The blood type of the mother was B, CDe, and that of the newborn was B, CcdEe. The direct antiglobulin test on the newborn's RBC was positive. Anti-E and anti-c were identified in the mother's serum and anti-E only was identified in the newborn's serum. The newborn was treated with phototherapy for 10 days and discharged as recovered. We present a case of hemolytic disease of the D negative newborn, which showed a discrepancy between high protein anti-D and low protein anti-D. With a review of literature, the newborn was possibly misinterpreted as D positive.
Antibodies, Monoclonal ; Coombs Test ; Humans ; Immune Sera ; Immunoglobulins ; Indicators and Reagents ; Infant, Newborn* ; Jaundice ; Male ; Mothers ; Phototherapy

Medicolegal autopsy is a vital tool for obtaining reliable injury mortality data. This study statistically analyzed data obtained from medicolegal autopsies performed in Korea in 2013. The aim of this study was to analyze various aspects of the 4,861 deaths that were categorized as unusual in Korea in 2013. A total of 4,861 deaths were analyzed by gender, age, manner of death, and cause of death. Of the 4,861 deaths, 3,542 (73.3%) were of men and 1,302 (26.7%) were of women. With respect to the manner of death, 54.4% were recorded as unnatural deaths, 38.8% were natural deaths, and 6.9% had unknown causes. Of the 2,642 unnatural deaths, 45.0% were determined to be accidental deaths, 26.3% suicidal, 16.9% homicidal, and 11.8% undetermined. Of the total number of unnatural deaths, 42.1% were trauma-related deaths, for which falling down accounted for 33.8%. Asphyxiation accounted for 16.0% of unnatural deaths, and of these, the predominant cause was hanging (58.8%). In addition, 14.4% of deaths were due to drowning, 12.9% poisoning, 11.0% thermal injuries, 1.8% complications arising from medical procedures, and 0.8% electrocution, starvation, or neglect. Among the 1,886 natural deaths, heart diseases accounted for 52.0% and vascular diseases accounted for 16.9%. Of the 196 deaths among children under the age of 10 years, 41.8% were recorded as unnatural deaths, 45.1% were natural deaths, and 1.5% had unknown causes.
Autopsy* ; Cause of Death ; Child ; Data Interpretation, Statistical ; Drowning ; Female ; Heart Diseases ; Humans ; Korea ; Male ; Mortality ; Poisoning ; Starvation ; Vascular Diseases

The potential of tivozanib as a treatment for oral squamous cell carcinoma (OSCC) was explored in this study. We investigated the effects of tivozanib on OSCC using the Ca9-22 and CAL27 cell lines. OSCC is a highly prevalent cancer type with a significant risk of lymphatic metastasis and recurrence, which necessitates the development of innovative treatment approaches. Tivozanib, a vascular endothelial growth factor receptor inhibitor, has shown efficacy in inhibiting neovascularization in various cancer types but has not been thoroughly studied in OSCC. Our comprehensive assessment revealed that tivozanib effectively inhibited OSCC cells. This was accompanied by the suppression of Bcl-2, a reduction in matrix metalloproteinase levels, and the induction of intrinsic pathway-mediated apoptosis. Furthermore, tivozanib contributed to epithelial-to-mesenchymal transition (EMT) inhibition by increasing E-cadherin levels while decreasing N-cadherin levels. These findings highlight the substantial anticancer potential of tivozanib in OSCC and thus its promise as a therapeutic option. Beyond reducing cell viability and inducing apoptosis, the capacity of tivozanib to inhibit EMT and modulate key proteins presents the possibility of a paradigm shift in OSCC treatment.

Acute necrotizing esophagitis (AEN), also called "black esophagus," is a rare disorder with an unknown pathogenesis. Endoscopic findings generally show black pigmentation throughout the esophagus. This case also offered rare views of the gross anatomy of this disorder. Histological examination revealed that the mucosal and submucosal layers of the esophagus were involved in the severe necrotizing inflammation. The chief manifestation of this disease is hematemesis from hemorrhage of the upper gastrointestinal tract with a typically multifactorial etiology. AEN is also characterized by a clear boundary at the gastroesophageal junction where the necrosis stops. In this study, we report an autopsy case of a 61-year-old man with necrotizing inflammation throughout the esophagus and esophageal necrosis from the laryngopharynx to the gastroesophageal junction. The patient was a disabled person with a history of alcohol abuse who was also diagnosed with mild coronary arteriosclerosis and fatty liver on the basis of the underlying diseases. In this case, the main etiology for poor perfusion from the distal esophageal area was likely underlying illness, history of alcoholism, and malnutrition.
Alcoholism ; Autopsy* ; Coronary Artery Disease ; Disabled Persons ; Esophagitis* ; Esophagogastric Junction ; Esophagus ; Fatty Liver ; Hematemesis ; Hemorrhage ; Humans ; Hypopharynx ; Inflammation ; Malnutrition ; Middle Aged ; Necrosis ; Perfusion ; Pigmentation ; Upper Gastrointestinal Tract

Coronary artery fistula (CAF) is a rare congenital malformation, comprising less than 1% of all congenital heart disease. Most fistulas drain into the right-sided heart chambers or pulmonary artery, and termination in left heart chambers is an uncommon finding. Clinical presentation mainly depends on the severity of the left-to-right shunt, and adult patients usually do not develop any symptom. There are few case reports relating CAF manifested as an exceptional form of sudden unexpected death. We experienced a case of a 62-year-old male with a single CAF arising from left main coronary artery which drains into the left ventricle, and reported with review of the related articles.
Adult ; Cardiomegaly ; Coronary Vessels ; Death, Sudden ; Fistula ; Heart ; Heart Diseases ; Heart Ventricles ; Humans ; Male ; Middle Aged ; Pulmonary Artery

Peri-implantitis appears in almost 20% of patients who received implant treatment, and increase in its number is inevitable as time goes by. Although it can be treated by both non-surgical and surgical procedures, in cases which include severe bone loss, explantation and rehabilitation may be necessary. Careful treatment planning and considerations to prevent recurrent peri-implantitis should be taken into account. In the following case presented, a patient with chronic periodontitis and peri-implantitis was successfully rehabilitated after removal of several implants. Extraction and explantation of multiple teeth and implants were followed by full mouth reconstruction with fixed implant prostheses on the mandible and implant retained overdenture on the maxilla. Surgical and prosthetic measures to prevent recurrent peri-implantitis were taken into consideration.
Chronic Periodontitis ; Denture, Overlay ; Humans ; Mandible ; Maxilla ; Mouth Rehabilitation ; Mouth ; Peri-Implantitis ; Prostheses and Implants ; Rehabilitation ; Tooth

Medicolegal autopsies are a vital tool for obtaining reliable injury mortality data. This study statistically analyzed the data obtained from medicolegal autopsies performed in Korea in 2014. A total of 5,324 deaths were analyzed by sex, age, manner of death, and cause of death. With respect to the manner of death, 56.3% were recorded as unnatural deaths, 38.4% were natural deaths, and 5.3% had unknown causes. Of the 2,998 unnatural deaths, 41.0% were determined to be accidental deaths; 28.1%, suicidal; 16.1%, homicidal; and 14.8%, undetermined. Of the total number of unnatural deaths, 38.8% were trauma-related, wherein falls accounted for 32.7%. Asphyxiation accounted for 16.3% of unnatural deaths; of these, the predominant cause was hanging (59.4%). In addition, 15.0% of the unnatural deaths were due to drowning; 14.8%, poisoning; 11.3%, thermal injuries; 2.5%, complications arising from medical procedures; and 0.4%, electrocution, starvation, or neglect. Among the 2,042 natural deaths, heart diseases accounted for 49.0% and vascular diseases accounted for 17.3%. Of the 170 deaths among children under the age of 10, 38.8% were recorded as unnatural deaths, 54.1% were natural deaths, and 7.1% had unknown causes.
Autopsy* ; Cause of Death ; Child ; Data Interpretation, Statistical ; Drowning ; Heart Diseases ; Humans ; Korea* ; Mortality ; Poisoning ; Starvation ; Vascular Diseases