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Congenitally Corrected Transposition of the Great Arteries.

Youn Shin KIM ; Gil Ro HAN ; Jeong Wook SEO ; Juck Joon HWANG

Korean Journal of Legal Medicine.1998;22(1):79-82.

The corrected transposition of the great arteries is a rare congenital heart anomaly consisting of the discordant connections of both the atria to ventricles and the ventricles to the great arteries. But its circulation is physiologically corrected and therefore it is compatible with life unless there are associated lesions. Our case was associated with VSD, COA, and PDA. He was slightly cyanotic and irritable. Despite of oxygen supply, his symptoms were not improved and he eventually died in 52 hours after delivery. Medical record revealed severe respiratory and metabolic acidosis.
Acidosis ; Arteries* ; Heart ; Medical Records ; Oxygen

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Death by Spontaneous Hemoperitoneum due to the Rupture of Capsular Vasculature in Hepatocellular Carcinoma Patient: A Case Report.

Minsung CHOI ; Byung Ha CHOI ; Hyoung Joong KIM

Korean Journal of Legal Medicine.2013;37(1):42-45. doi:10.7580/kjlm.2013.37.1.42

Hepatocellular carcinoma (HCC) is one of the leading causes of death in Korea. Chronic hepatitis, alcoholic liver disease and liver cirrhosis are predisposing factor of HCC. Bleeding tendency and hemorrhage resulting from reduced production of coagulation factors or portal hypertension are not uncommon in HCC, moreover spontaneous hemoperitoneum also can occur. Spontaneous hemoperitoneum is a complication of HCC, that is caused by the rupture of HCC mass which abuts on the hepatic capsule. However hemoperitoneum also occurs due to the rupture of vasculature of the mass. Emergency laparotomy is the recommended treatment, however these patients exhibit poor prognosis because of hemodynamic instability followed by combined liver disease. Herein, we report a case of spontaneous hemoperitoneum due to the rupture of subcapsular vessels with invasion of HCC in a 39-years-old man, whose tumor was left undetected.
Blood Coagulation Factors ; Carcinoma, Hepatocellular ; Cause of Death ; Emergencies ; Hemodynamics ; Hemoperitoneum ; Hemorrhage ; Hepatitis, Chronic ; Humans ; Hypertension, Portal ; Korea ; Laparotomy ; Liver Cirrhosis ; Liver Diseases ; Liver Diseases, Alcoholic ; Prognosis ; Rupture

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A Case of Molecular Analysis of XX Male Syndrome.

Hye Young LEE ; Sung Hee LYOO ; Choon Hong HWANG ; Soong Deok LEE

Korean Journal of Legal Medicine.2013;37(1):38-41. doi:10.7580/kjlm.2013.37.1.38

Sex typing may become the start point in investigations that are usually performed through amelogenin typing. In cases involving genotype-phenotype discrepancy, amelogenin typing could yield misleading results. The rare XX male syndrome is characterized by a phenotypic male with a 46, XX female karyotype. In this point, this case report would help understand the importance of genotype-phenotype discrepancy.
Amelogenin ; Female ; Genes, sry ; Humans ; Karyotype ; Klinefelter Syndrome ; Male ; Y Chromosome

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Aneurysmal Rupture of the Internal Carotid Artery in a Presumed Neurofibromatosis Type I Patient.

Joo Young NA ; Jong Pil PARK ; Dal Won KIM ; Yu Jin WON ; Hyoung Joong KIM

Korean Journal of Legal Medicine.2013;37(1):34-37. doi:10.7580/kjlm.2013.37.1.34

Aneurysm of the internal carotid artery is a rare disease and is known to be associated with congenital arterial anomalies such as neurofibromatosis type I (NF-I). NF-I is an autosomal dominant neurocutaneous disorder characterized by a variety of manifestations that involve the central and peripheral nervous systems, skin, vascular system, and skeleton. In particular, the involvement of vascular abnormalities in NF-I is well known. Any vessel may be affected by this condition, although the renal artery is most frequently involved. The vascular abnormality can be occlusive or an aneurysmal degenerative change. Therefore, symptomatic presentations might assume an indolent pathophysiologic course such as hypertension, or manifest as a catastrophic event such as arterial rupture that could result in sudden death. We report a rare autopsy case of an aneurysmal rupture of the internal carotid artery in a woman with suspected NF-I, who collapsed in her home.
Aneurysm ; Autopsy ; Carotid Artery, Internal ; Death, Sudden ; Female ; Glycosaminoglycans ; Humans ; Hypertension ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Peripheral Nervous System ; Rare Diseases ; Renal Artery ; Rupture ; Skeleton ; Skin

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Psychiatric Diagnosis and Hypersexual Behavior Inventory, Sexual Addiction Screening Test, and Beck Depression Inventory/Beck Anxiety Inventory of the Sexual Offenders.

Jun Hyung LEE ; Hyun Sic KIM ; Jae Woo LEE ; Woo Sung PARK ; Myung Ho LIM

Korean Journal of Legal Medicine.2013;37(1):27-33. doi:10.7580/kjlm.2013.37.1.27

The current study evaluated DSM-IV psychiatric diagnoses and investigated the psychological characteristics of sexual offenders by using the Hypersexual Behavior Inventory(HBI), Sexual Addiction Screening Test (SAST), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Fifty male sexual offenders and 36 male healthy controls completed the psychiatric diagnosis and 30 of the 50 male sexual offenders completed the psychological tests listed above. Thirty-two of the 50 sexual offenders were patients with paraphilias, these sexual offenders had been admitted by the Ministry of Justice to the Institute for Forensic Psychiatry in Gongjui-si due to sexual violence. Participants displayed high lifetime rates of psychiatric disorders: 32 (64%) had paraphilias, 16 (32%) had depressive disorders, 10 (20%) had anxiety disorders, 9 (18%) had impulse control disorders, 6 (12%) had schizophrenia, 2 (4%) had bipolar disorders, and 16 (32%) had personality disorders or some other Axis II disorder. Scores for the sexual offenders were significantly higher both on the HBI and the SAST than the comparison group. Scores for the sexual offenders were also higher for the BDI and the BAI as compared to the control group, but this difference was not statistically significant. Results indicate that sexual offenders may have sexual addictions and be hypersexual. In addition to depressive and anxious psychopathologies, they also seem to have sexual psychopathologies. These results suggested that the psychopathology of sexual offenders may be different than that of a control group.
Anxiety ; Anxiety Disorders ; Axis, Cervical Vertebra ; Bipolar Disorder ; Criminals ; Depression ; Depressive Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Forensic Psychiatry ; Humans ; Disruptive, Impulse Control, and Conduct Disorders ; Male ; Mass Screening ; Mental Disorders ; Paraphilic Disorders ; Personality Disorders ; Psychological Tests ; Psychopathology ; Schizophrenia ; Sex Offenses ; Social Justice

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The Analysis of Reclaiming Ratio for 3 Diatom Species from Experimentally Drowned Animal Organs.

Jeong Won HONG ; Youn Shin KIM

Korean Journal of Legal Medicine.2013;37(1):19-26. doi:10.7580/kjlm.2013.37.1.19

Drowning is one of the most common causes accidental death worldwide, but its diagnosis remains a challenging task in forensic pathology. Several authors have suggested that diatom analysis be conducted via an enzymatic digestion method that uses proteinase K to provide objective evidence for drowning; we employed this method in our study because of its superior applicability as compared to the conventional disorganization methods. The purpose of this study was to examine the reclaiming ratio of diatoms from experimentally drowned animal organs, which could be influenced by diatom morphology. The authors injected 3 diatoms species (Cyclotella striata, Navicula incerta, and Pleurosigma angulatum) into a rat's airway and compared the detection rate to investigate the factors that influence the sensitivity of diatom analysis. The results are as follows: (1) Average reclaiming ratio in the lungs was 81.07 for Navicula incerta, 48.26 for Cyclotella striata, and 5.35 for Pleurosigma angulatum. (2) The detection rates from the closed organs in 15 experimental animals were highest in the kidney (73%, 11/15), followed by the heart (67%, 10/15), brain (60%, 9/15), and liver (53%, 8/15). (3) Two Cyclotella striata was detected in the kidney of postmortem control group which suggest the possibility of contamination during laboratory procedure. In conclusion, the authors propose that diatom size could be a significant influencing factor for diatom extraction from the organs of drowned bodies; therefore, the results of diatom analysis must be interpreted after considering the diatom population of the drowning medium at the scene and the possibility of contamination during the laboratory procedure.
Animal Structures ; Animals ; Brain ; Diatoms ; Digestion ; Drowning ; Endopeptidase K ; Forensic Pathology ; Heart ; Kidney ; Liver ; Lung

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Forensic Analysis of the Cause of Death and Death on Arrival of Patients at the Emergency Room.

Jong Hyeok PARK ; Young Joo KIM ; Suk Hoon HAM ; Seok Ran YEOM ; Ryeok AHN ; Hongil HA

Korean Journal of Legal Medicine.2013;37(1):14-18. doi:10.7580/kjlm.2013.37.1.14

From January 2007 to June 2012, 55 autopsy cases were reviewed, in which death occurred outside the hospital and the patients were declared dead on arrival at the emergency departments, in order to compare the clinical and postmortem examination diagnoses of death-on-arrival patients in tertiary hospitals in Busan, Yangsan and Ulsan city. Of 22 non-traumatic deaths, 21 occurred from natural causes and 1 from unknown cause (sudden infant death syndrome, SIDS). Clinical diagnoses were cardiovascular diseases or "non-traumatic" / "unknown" while autopsy diagnoses were majorly cardiovascular diseases, especially coronary artery diseases (72.7%). Of 33 unnatural deaths, the cause of death was blunt trauma in 4 patients, sharp-force injury in 6, falling in 10, gunshot injury in 1, traffic accidents in 3, asphyxia in 2, drowning in 2, fire-related death in 1, and intoxication in 4. There were no definite discrepancies between clinical and autopsy diagnoses, except for 5 non-traumatic deaths and 2 unnatural deaths. These results suggest that the role of the emergency department may be crucial in postmortem investigations.
Accidents, Traffic ; Asphyxia ; Autopsy ; Cardiovascular Diseases ; Cause of Death ; Coronary Artery Disease ; Drowning ; Emergencies ; Humans ; Infant ; Tertiary Care Centers

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Differences in the Determination of Cause and Manner of 127 Natural Death Cases by Postmortem Inspection and Autopsy.

Gi Yeong HUH ; Kwang Hoon KIM ; Gam Rae JO ; Sang Yong LEE

Korean Journal of Legal Medicine.2013;37(1):9-13. doi:10.7580/kjlm.2013.37.1.9

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

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DNA Methylation-Based Age Estimation in the Forensic Field.

Ja Hyun AN ; Kyoung Jin SHIN ; Ajin CHOI ; Woo Ick YANG ; Hwan Young LEE

Korean Journal of Legal Medicine.2013;37(1):1-8. doi:10.7580/kjlm.2013.37.1.1

The estimation of age is an important issue in forensic science, and the forensic community has attempted many times to establish methods for solving this issue. Aging leads to alterations in tissues and organs at the molecular level. These alterations at the molecular level may aid forensic scientists to estimate the age of a living person or a dead body. Initially, the focus was on the genetic components of aging, but recently, epigenetic mechanisms have emerged as the key contributors to the alterations in genome structure and function that accompany aging. In particular, DNA methylation is one of the best-understood mechanisms, and it has been suggested as a promising biomarker for age estimation in many studies. In this review, we summarize the recent studies on age-associated DNA methylation changes in different tissues and discuss its possible and practical applications in forensics.
Aging ; DNA ; DNA Methylation ; Epigenomics ; Forensic Sciences ; Genome ; Humans

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Death by Homicidal Smothering Using Hot Steam Towel: A Case Report.

Seon Jung JANG ; Jong Hyeok PARK ; Young Joo KIM ; Suk Hoon HAM ; Na Young JO ; Hongil HA

Korean Journal of Legal Medicine.2013;37(2):90-92. doi:10.7580/kjlm.2013.37.2.90

An unusual case of homicide of a 21-year-old man who was smothered with a hot steam towel by his mother and a pastoress in the name of exorcism. Homicidal smothering in adults is rare, but does occur when the victims are not capable of defending themselves in situations such as chronic illness, old age, drug intoxication or when restrained by other people. In this case, distinct facial scalding was a clue to smothering with a hot steam towel.
Adult ; Chronic Disease ; Homicide ; Humans ; Mothers ; Steam

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