Sexual activity (SA), combined with organic heart disease, may cause sudden death (SD). However, the causes of SD related to SA are not known well. The aim of this study was to assess the causes of SD related to SA. From August 2001 to November 2005, all autopsies (n=1,379) performed at Kyungpook National University were prospectively searched for SD cases related to SA. Fourteen cases (46+/-11 yr old, 9 males) of SD related to SA were found. All were heterosexual. The toxicologic study was negative in all. Ten cases were witnessed; during SA in 4 cases, just after SA in another 4 cases, 2 and 5 hr after in 1 each case. In 4 unwitnessed cases the victims were found dead less than 12 hr from the end of their SA. The partners were steady extramarital partners (n=8), prostitutes (n=2), marital partner (n=1) and unknown (n=3). The causes of the SD were as follows; coronary artery disease in 6, subarachnoid hemorrhage with ruptured berry aneurysm in 4, fibromuscular dysplasia of the atrioventricular nodal artery in 2, and unknown in 2. Coronary artery disease and subarachnoid hemorrhage with ruptured berry aneurysm were important as causes of SD related to SA.
Sexual Behavior/*statistics & numerical data ; Risk Assessment/*methods ; Prevalence ; Middle Aged ; Male ; Korea/epidemiology ; Humans ; Heart Diseases/*mortality ; Female ; Death, Sudden/*epidemiology ; Comorbidity ; Cause of Death ; Autopsy ; Adult

Sexual activity (SA), combined with organic heart disease, may cause sudden death (SD). However, the causes of SD related to SA are not known well. The aim of this study was to assess the causes of SD related to SA. From August 2001 to November 2005, all autopsies (n=1,379) performed at Kyungpook National University were prospectively searched for SD cases related to SA. Fourteen cases (46+/-11 yr old, 9 males) of SD related to SA were found. All were heterosexual. The toxicologic study was negative in all. Ten cases were witnessed; during SA in 4 cases, just after SA in another 4 cases, 2 and 5 hr after in 1 each case. In 4 unwitnessed cases the victims were found dead less than 12 hr from the end of their SA. The partners were steady extramarital partners (n=8), prostitutes (n=2), marital partner (n=1) and unknown (n=3). The causes of the SD were as follows; coronary artery disease in 6, subarachnoid hemorrhage with ruptured berry aneurysm in 4, fibromuscular dysplasia of the atrioventricular nodal artery in 2, and unknown in 2. Coronary artery disease and subarachnoid hemorrhage with ruptured berry aneurysm were important as causes of SD related to SA.
Sexual Behavior/*statistics & numerical data ; Risk Assessment/*methods ; Prevalence ; Middle Aged ; Male ; Korea/epidemiology ; Humans ; Heart Diseases/*mortality ; Female ; Death, Sudden/*epidemiology ; Comorbidity ; Cause of Death ; Autopsy ; Adult

One of the most common methods of suicide is hanging, and suicide by ligature strangulation is quite rare. Vehicles have a confined space, making them an unusual place for committing suicide by hanging or ligature strangulation, because they are more typically the location of suicide by carbon monoxide intoxication by briquette or drug intoxication. Here, we present three cases of unusual suicide by ligature strangulation, discuss the mechanism of asphyxia in each case, and review the literature. In case 1, the victim used a backpack to perform reverse hanging by wrapping the shoulder strap of the backpack around his neck and then tossing the backpack behind the backrest of the driver's seat. In case 2, the victim did not use the internal structures of the vehicle, but pulled down on a ligature wrapped around both his knees and neck. In case 3, the victim hanged himself using a package line fixed to the roof handle grab of the back passenger seat.

Many people end their lives by committing suicide every year. Most of these people inflict their own death using a method that is considered least painful such as hanging, gun shots, and drug overdose. Some choose to use their surroundings and jump off high buildings. We here present two cases of extremely rare suicide methods compared to the typically observed self-inflicted deaths. In the first case, a woman amputated her foot above the ankle with a kitchen knife, and in the second case, a man used an abrasive saw to cut his neck. Both victims had a psychiatric problem consistent with schizophrenia. Examination of these extraordinary death cases warrants a thorough scene investigation and an autopsy to determine past and present psychiatric illnesses and drug prescriptions.
Ankle ; Autopsy ; Drug Overdose ; Drug Prescriptions ; Female ; Foot ; Humans ; Methods ; Neck ; Schizophrenia ; Suicide

Wischnewski spots (WS) are multiple black spots observed in the gastric mucosa at autopsy that are considered a reliable and important feature of hypothermia. Nonetheless, the frequency of WS varies widely. WS were discovered in 20 cases out of 3,493 autopsies (0.57%) conducted between 2001 and 2017 in the Department of Forensic Medicine of the School of Medicine, Kyungpook National University in Korea. This study aimed to investigate the distribution and size of WS in these cases and analyze the respective causes of death. Nine cases that occurred in winter were the same as the nine cases with hypothermia as the cause of death or contributory cause. The post-mortem blood alcohol test was positive in eight cases, with acute or chronic alcoholism determined as the cause of death in two of these cases. There were two cases of acute poisoning by pesticides. Putrefaction was noted in six cases (30%). WS presented in various sizes ranging from pinpoint to more than 5 mm in diameter, and the number of WS varied from 5 to 100. WS distribution was diffuse in four cases (20%) and localized in 13 cases (65%). Microscopic examination showed brown to black pigmentation but no neutrophil infiltration or vital reactions in the WS. Thus, WS are associated with hypothermia and are considered post-mortem alterations with variable appearance, size, and distribution. Hypothermia is an exclusive diagnosis at autopsy that should result from a combined assessment of toxicological tests, circumstance of death, and autopsy findings.
Alcoholism ; Autopsy ; Cause of Death ; Diagnosis ; Forensic Medicine ; Gastric Mucosa ; Gyeongsangbuk-do ; Humans ; Hypothermia ; Korea ; Neutrophil Infiltration ; Pesticides ; Pigmentation ; Poisoning

Hesitation wounds are tentative, superficial incised wounds around the fatal wound(s). This study aimed to investigate the frequency and characteristic features of hesitation wounds including ordinary incised wounds and knife tip injuries as hesitation marks from the autopsy cases of suicides using sharp force instruments. The subjects were 478 cases out of 3,131 suicide cases autopsied at the Department of Forensic Medicine, School of Medicine, Kyungpook National University in Daegu, from August, 2001 to 2013. 48 cases (approximately 10%) were suicides using sharp force instruments. In 27 cases (56.3%), the sharp force was successfully applied causing suicide; 17 cases (35.4%) were so called complex suicide cases, in which two or more different methods including sharp force injury were used; and the 4 remaining cases were suicides caused by other reasons. Overall hesitation wounds had a high frequency of 33/48 cases (68.8%). The frequency of cases in which knife tip injuries were found was lower, appearing in 13/33 cases (39.3%). The most preferred sites of knife tip injuries were the abdomen (9 cases), neck (4 cases), chest (3 cases), and face (1 case) in these 13 cases, including several overlapped cases. The average number of knife tip injuries was 14.6. A total of 88.2% of knife tip injuries was found near the incised hesitation wounds or fatal wounds. In conclusion, knife tip injuries may be a significant factor in identifying hesitation wounds, and they should be precisely examined and evaluated during autopsies to determine the manner of death.
Abdomen ; Autopsy ; Daegu ; Forensic Medicine ; Gyeongsangbuk-do ; Humans ; Neck ; Suicide ; Thorax ; Wounds and Injuries

No abstract available.
Aneurysm ; Autopsy ; Child ; Coronary Vessels ; Humans ; Mucocutaneous Lymph Node Syndrome

Proximal pulmonary artery aneurysms and dissection are rare and life-threatening conditions, which are usually detected only during autopsy examination in cases of sudden death. These pathological entities often occur as complications of chronic pulmonary hypertension and most commonly result from pulmonary arterial hypertension associated with various congenital cardiac lesions involving left-to-right shunting. This study describes an autopsy case of a 38-year-old man who was diagnosed with Eisenmenger syndrome 5 years prior to sudden death secondary to cardiac tamponade following a ruptured pulmonary trunk aneurysm.
Adult ; Aneurysm ; Autopsy ; Cardiac Tamponade ; Death, Sudden ; Eisenmenger Complex ; Humans ; Hypertension ; Hypertension, Pulmonary ; Pulmonary Artery ; Rupture

The death certificate is a medical document that proves the death of a person and forms the basis of an administrative death report. It is a source of statistics on the cause of a person's death and the basic tool used in national health policy and health promotion activities. This study reviews the major categories of historical changes made to the Korean death certificate form over the years. During the Japanese colonial period, the death certificate form was first introduced under the Koii (public doctor) system. However, the first structurally organized form of the death certificate was based on the “National Medical Service Act” (June 26, 1955.); it was structurally very similar to the current form. Since the enactment of the “Enforcement Decree of the Medical Service Act”, the death certificate form has undergone structural changes 13 times. The changes made to the contents or format of the death certificate during its 98 revisions can be classified into eight categories: death certificate title, form language, personal information, place of death, cause of death, manner of death, information on unnatural death, and other changes (chart number, serial number, confirmation seal, etc.). The authors hope that future revisions to the Korean death certificate would make it easier to write.
Asian Continental Ancestry Group ; Cause of Death ; Death Certificates ; Health Policy ; Health Promotion ; Hope ; Humans ; Korea

Most cases of ligature strangulation are generally homicides, and deaths due to suicide or accident are rare. We present a very rare case of a man using a recliner sofa as an aid for strangulation. The deceased, a man in his 50s, cut his wrists using an industrial cutter several times and placed his hands into a bathtub containing warm water, which, however, did not lead to death. His suicide attempt through self-ligature strangulation using a recliner in the living room finally resulted in his death. After considering the results of the scene investigation, testimony of the witnesses, and the autopsy findings, the cause of death was determined to be self-ligature strangulation, and wrist incisions were found to be a contributory cause of death.
Asphyxia ; Autopsy ; Cause of Death ; Hand ; Homicide ; Ligation ; Suicide ; Water ; Wrist