PURPOSE: This study examined the patterns of drugs, poisons, and chemicals detected in autopsy samples performed in the Seoul Institute and other regional forensic offices of the National Forensic Service (NFS) between 2014 and 2016. METHODS: The investigation carried out using the laboratory information management system. Forensic toxicological identification and quantitation were performed in autopsy samples, including heart blood, peripheral blood, liver, kidney, vitreous humor and etc. Gas chromatography/mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) were used to analyze the drugs and poisons. RESULTS: Forensic autopsies were performed on 9,674 cases in this period. Based on the autopsy reports, 699 cases (7.2%) were considered as unnatural deaths caused by fatal intoxication. The number of male deaths was higher than that of female deaths, with the age of 50-59 being the most common age group. CONCLUSION: Drugs comprised the largest number of deaths due to poison, followed by alcohol, agrochemicals, drug with alcohol, carbon monoxide, and cyanide, in that order. Zolpidem was the most frequently used drug in all drug-related intoxication cases.
Agrochemicals ; Autopsy ; Carbon Monoxide ; Female ; Heart ; Humans ; Information Management ; Kidney ; Liver ; Male ; Mass Spectrometry ; Poisoning* ; Poisons ; Seoul ; Spectrum Analysis ; Vitreous Body

Mammary tuberculosis is a rare entity. The incidence of the disease varies from 0.025% to 4.5% of all surgically treated breast diseases. The surgical resection is required for diagnosis of mammary tuberculosis, since the clinician may confuse tuberculosis mastitis with either carcinoma or breast abscess. Treatment is the combination of resection and chemotherapy. We report a case of mammary tuberculosis diagnosed by fine-needle aspiration and biopsy (FNAB), along with a review of literature.
Abscess ; Biopsy ; Biopsy, Fine-Needle ; Breast ; Breast Diseases ; Diagnosis ; Drug Therapy ; Female ; Incidence ; Mastitis ; Tuberculosis*

Lynch syndrome is also called Hereditary nonpolyposis colorectal cancer (HNPCC). It is characterized by a risk of colorectal cancer and other cancers of the endometrium, ovary, stomach, small intestine etc. The increased risk is due to inherited mutations that impaired DNA mismatch repair. Two to three percentage of colon cancer is caused by Lynch syndrome. A family history of colon cancer occurs at a young age. We experienced one case of Lynch syndrome who had had stomach cancer, endometrial cancer and colon cancer recently. Hence we report this case with a brief review of literature.
Colonic Neoplasms ; Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Intestine, Small ; Ovary ; Stomach ; Stomach Neoplasms

Giant pulmonary bulla (GPB) is a rare manifestation of emphysema and usually enlarges gradually over time, occasionally resulting in complications. Hence, more often than not, the surgical intervention of a Bullectomy is the standard method of treatment for GPB. However, there are case reports that show the complete resolution of GPB after its inflammation process even without surgical intervention. A 51-year-old man was admitted to our clinic due to pleuritic pain. After a chest X-ray and CT scan, a new air-fluid level within the GPB was revealed in the right upper lobe of his lung. His clinical status had improved promptly with intravenous antibiotics. A one-year follow-up study showed the GPB was completely resolved.
Anti-Bacterial Agents ; Emphysema ; Follow-Up Studies ; Humans ; Inflammation ; Lung ; Methods ; Middle Aged ; Thorax ; Tomography, X-Ray Computed

A mixed infection of Mycobacterium abscessus subsp. abscessus (Mab) and Mycobacterium tuberculosis (MTB) in the lung is an unusual clinical manifestation and has not yet been reported. A 61-year-old woman had been treated for Mab lung disease and concomitant pneumonia, and was diagnosed with pulmonary tuberculosis (PTB). Despite both anti-PTB and anti-Mab therapy, her entire left lung was destroyed and collapsed. She underwent left pneumonectomy and received medical therapy. We were able to successfully treat her mixed infection by pneumonectomy followed by inhaled amikacin therapy. To the best of our knowledge, thus far, this is the first description of a mixed Mab and MTB lung infection.
Amikacin ; Coinfection* ; Female ; Humans ; Lung Diseases ; Lung* ; Middle Aged ; Mycobacterium tuberculosis* ; Mycobacterium* ; Pneumonectomy ; Pneumonia ; Tuberculosis, Pulmonary

Congenital cardiovascular anomalies, such as dextrocardia, persistent left superior vena cava (SVC), and pulmonary artery (PA) sling, are rare disorders. These congenital anomalies can occur alone, or coincide with other congenital malformations. In the majority of cases, congenital anomalies are detected early in life by certain signs and symptoms. A 56-year-old man with no previous medical history was admitted due to recurrent wide QRS complex tachycardia with hemodynamic collapse. A chest radiograph showed dextrocardia. After synchronized cardioversion, an electrocardiogram revealed Wolff-Parkinson-White (WPW) syndrome. Persistent left SVC, PA sling, and right tracheal bronchus were also detected by a chest computed tomography (CT) scan. He was diagnosed with paroxysmal supraventricular tachycardia (PSVT) associated with WPW syndrome, and underwent radiofrequency ablation. We reported the first case of situs solitus dextrocardia coexisting with persistent left SVC, PA sling and right tracheal bronchus presented with WPW and PSVT in a middle-aged adult. In patients with a cardiovascular anomaly, clinicians should consider thorough evaluation of possibly combined cardiovascular and airway malformations and cardiac dysrhythmia.
Adult* ; Arrhythmias, Cardiac ; Bronchi ; Catheter Ablation ; Dextrocardia ; Electric Countershock ; Electrocardiography ; Hemodynamics ; Humans ; Middle Aged ; Pulmonary Artery ; Radiography, Thoracic ; Tachycardia ; Tachycardia, Supraventricular ; Thorax ; Vena Cava, Superior ; Wolff-Parkinson-White Syndrome*

Flare phenomenon refers to increased radiotracer uptake in bones despite clinical findings showing a positive response to treatment. Flare phenomena are most often observed in patients with breast or prostate cancer. Here, we present a case of bone flare in a 54-year-old male who had advanced gastric cancer with bone metastases. After three cycles of chemotherapy, a bone scan showed increased intensity, but the patient's bone pain was alleviated and abdominal computed tomography revealed a decrease in the size of the primary mass and metastatic lymph nodes. We therefore continued chemotherapy using the same regimen, and a follow-up bone scan revealed decreased intensity. A flare phenomenon after treatment is rare in cases of gastric cancer with bone metastasis. Although flare phenomena are not common, they should be considered in patients with gastric cancer when the clinical results are inconsistent with bone-scan findings.
Breast ; Diagnostic Imaging ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis* ; Prostatic Neoplasms ; Stomach Neoplasms*

Pulmonary vein thrombosis is a rare disease related to a lung malignancy or complication after lung surgery. Generally, it is caused by tumor invasion or localized stenosis of a vein anastomosis site after an operation. Here we report a case of pulmonary vein thrombosis that occurred in a patient with local thrombophlebitis due to lobar pneumonia.
Constriction, Pathologic ; Humans ; Lung ; Pneumonia* ; Pulmonary Veins* ; Rare Diseases ; Thrombophlebitis ; Thrombosis* ; Veins