Purpose: Recently, deep learning techniques have been introduced for age estimation, with automated methods based on radiographic analysis demonstrating high accuracy. In this study, we applied convolutional neural network (CNN) techniques to the lower dentition area on orthopantomograms (OPGs) of children to develop an automated age estimation model and evaluate its accuracy for use in forensic dentistry. Methods: In this study, OPGs of 2,856 subjects aged 3-14 years were analyzed. The You Only Look Once (YOLO) V8 object detection technique was applied to extract the mandibular dentition area on OPGs, designating it as the region of interest (ROI). First, 200 radiographs were randomly selected, and were used to train a model for extracting the ROI. The trained model was then applied to the entire dataset. For the CNN image classification task, 80% of OPGs were allocated to the training set, while the remaining 20% were used as the test set. A transfer learning approach was employed using the ResNet50 and VGG19 backbone models, with an ensemble technique combining these models to improve performance. The mean absolute error (MAE) on the test set was used as the validation metric, and the model with the lowest MAE was selected. Results: In this study, the age estimation model developed using mandibular dentition region from OPGs achieved MAE and root mean squared error (RMSE) values of 0.501 and 0.742, respectively, on the test set, and MAE and RMSE values of 0.273 and 0.354, respectively, on the training set. Conclusions The automated age estimation model developed in this study demonstrated accuracy comparable to that of previous research and shows potential for applications in forensic investigations. Increasing the sample size and incorporating diverse deep learning techniques are expected to further enhance the accuracy of future age estimation models.

The aim of this study was to elucidate the diatomological investigation and the forensic role of spleen tissue in cases of drowning or non-drowning. Specimens of spleen tissue and other organ tissue from 136 drowning cases, as well as 21 cases where death resulted from causes other than drowning (acting as controls), were examined for the presence of diatoms. The diatom test was performed on all cases using the acid digestion method, involving fumed nitric acid on a hot sand bath. The presence of diatoms in spleen tissue was observed in drowning cases but not in non-drowning cases. Diatoms in spleen tissue showed a positive association with drowning (P=0.011). Among the 136 drowning cases, diatoms were most frequently found in lung tissue (n=134, 99%), followed by spleen (n=33, 24%), kidney (n=28, 21%), liver (n=27, 20%), and heart (n=22, 16%) tissues. Moreover, in 95 cases where putrefaction did not progress, diatoms were detected in spleen tissues in 14 cases, indicating that the highest detection rate among other enclosed organ tissues, excluding lung tissues. Furthermore, a significant correlation was observed between the presence of diatoms in spleen tissue and those in enclosed organs, including the liver, kidney, and heart, but not in lung tissues. Our results revealed a significant correlation between the presence of diatoms in spleen tissue and drowning. Thus, the present study provides evidence that the presence of diatoms in spleen tissue may be a reliable indicator of death by drowning.

Duchenne muscular dystrophy (DMD) is a degenerative muscle disease characterized by a progressive decline in muscular function, with cardiomyopathy in the later stages. We report the autopsy findings of a 29-year-old man with DMD. He had been stable with the assistance of mechanical ventilation until he was found unconscious, without known cause. External examination confirmed generalized muscular atrophy and contracture consistent with his clinical history. Histopathology revealed varying degrees of fibrofatty changes in the muscles, with the calf muscles being the most extensively affected, followed by the diaphragm and heart. The cardiac muscle showed the least involvement and the pathology was confined to the left ventricular wall and the interventricular septum, exhibiting a unique morphology of fibrosis resembling stretched springs. The cause of death was attributed to cardiac failure due to DMD progression. This case highlights the clinical course of DMD, emphasizing the need for thorough examination of both skeletal and non-skeletal muscles, including the cardiac muscles, to obtain a better understanding of the disease.

BACKGROUND: Headache/eyestrain symptoms are common health problems that people experience in daily life. Various studies have examined risk factors contributing to headache/eyestrains, and physicochemical exposure was found to be a leading risk factor in causing such symptoms. The purpose of this study was to examine the relationship of headache/eyestrain symptoms with physicochemical exposure among Korean construction workers depended on worksite.METHODS: This study used data from the 4th Korean Workers Conditions Survey and selected 1,945 Korean construction workers as participants. Multivariable logistic regression analysis was used to determine the relationship.RESULTS: Exposure to vibrations among all construction workers affected the moderate exposure group [odds ratio (OR) 1.53, 95% confidence interval (CI) 1.01–2.32], the high exposure group (OR 1.77 95%CI 1.17–2.67), and the indoor high exposure group (OR 1.61, 95%CI 1.02-2.55) and among outdoor construction workers, the moderate group (OR 6.61, 95%CI 15.4–28.48) and the high group (OR 6.61, 95%CI 1.56–27.98). When exposed to mist, dust, and fumes, the indoor high exposure group was significantly affected (OR 1.63, 95%CI 1.07–2.47). All construction workers exposed to organic solvents were affected, high exposure group (OR 1.69, 95%CI 1.15–2.49) and indoor high exposure group (OR 1.77, 95%CI 1.08–2.89). The high exposure group in all construction worker (OR 1.70, 95%CI 1.20–2.42) and the indoor high exposure group (OR 1.83, 95%CI 1.17–2.89) also were affected by secondhand smoking exposure.CONCLUSION: Many physicochemical exposure factors affect headache/eyestrain symptoms among construction workers, especially indoor construction workers, suggesting a deficiency in occupational hygiene and health environments at indoor construction worksites.
Dust ; Headache ; Hygiene ; Logistic Models ; Risk Factors ; Solvents ; Tobacco Smoke Pollution ; Vibration ; Workplace

Ehlers-Danlos syndrome type IV (EDS IV) is a hereditary disorder of the connective tissue, characterized by easy bruising, thin skin with visible veins, and spontaneous rupture of the large arteries, uterus, or bowel. EDS IV is caused by mutations of the gene for type III procollagen (COL3A1), resulting in insufficient collagen production or a defect in the structure of collagen. EDS IV can have fatal complications such as the rupture of great vessels or organs, which can cause hemorrhaging and sudden unexpected death. Here, we report a case of a 43-year-old female who collapsed after a struggle with a neighbor. In this patient, the bifurcation of the bilateral common iliac artery ruptured, with no evidence of trauma, inflammation, or atherosclerosis. Genetic analysis of COL3A1 showed the presence of a c.2771G>A (p.Gly924Arg) mutation, which may be associated with EDS IV. The forensic pathologist should consider the possibility that the spontaneous visceral or arterial rupture was caused by EDS IV. Genetic analysis is not currently a routine procedure during autopsy. However, in this case, we suggest that the patient possibly had an underlying EDS IV condition, and we recommended family members of the deceased to seek genetic analysis and counseling.
Adult ; Aortic Rupture* ; Arteries ; Atherosclerosis ; Autopsy ; Collagen ; Collagen Type III ; Connective Tissue ; Counseling ; Ehlers-Danlos Syndrome* ; Female ; Humans ; Iliac Artery ; Inflammation ; Rupture ; Rupture, Spontaneous ; Skin ; Uterus ; Veins

OBJECTIVES: The aim of this study is to find the association between mothers' working hours and obesity of their children according to children's age and gender. METHODS: This study used data from the second and third year of KNHANES IV and the first year in KNHANES V (2008-2010). We calculate odds ratio (OR) and 95% confidence interval (CI) by using survey logistic regression to assess association of mother's working hours with overweight or obesity of her children. The model was adjusted with household income, mothers' education and obesity and mothers' job characteristics. RESULTS: 13-18 aged boys whose mothers worked under 40 hours per week were higher risk for obesity and overweight (including obesity) than 13-18 aged boys whose mothers worked 40-48 hours. 6-12 aged girls whose mothers worked 49-60 hours per week were more overweight (including obesity) than girls whose mothers worked 40-48 hours per week. 13-18 aged girls whose mothers worked over 60 hours were more overweight (including obesity) than the reference. CONCLUSION: This study showed that girls' obesity was associated with mothers' long working hours. Long working hours can influence health of workers' family.
Child ; Education ; Family Characteristics ; Female ; Humans ; Logistic Models ; Mothers ; Nutrition Surveys* ; Obesity* ; Odds Ratio ; Overweight

Pulmonary interstitial glycogenosis (PIG) is a very rare interstitial lung disease in infants. It is poorly understood, but its pathological features are distinct; they include uniform alveolar septal thickening, caused by a group of oval to spindle-shaped cells containing abundant glycogen, without apparent inflammation or fibrosis. PIG is usually associated with a good prognosis. However, in the present report, we describe the case of a 5-month-old male infant who died due to PIG; he was severely underweight and not administered proper treatment or care. The pathology of PIG was determined following a medico-legal autopsy.
Autopsy ; Fibrosis ; Glycogen ; Glycogen Storage Disease ; Humans ; Infant ; Inflammation ; Lung Diseases, Interstitial ; Male ; Prognosis ; Thinness

Large cell neuroendocrine carcinomas of the colon are rare and represent only a small percentage of all colonic endocrine tumors. Here, we report a case of a colonic large cell neuroendocrine carcinomas concurrent with a colonic adenocarcinoma. A 70-year-old man presented with acute abdominal pain. A spiral computed tomography scan of the abdomen revealed eccentric wall thickening on the ascending colon. An explorative laparotomy and a right hemicolectomy were performed. Grossly, two separated masses were observed in the proximal ascending colon. One was a 7.4 x 5.1 cm ulcerative fungating lesion, and the other was a 2.8 x 1.9 cm polypoid lesion. Microscopically, the ulcerative fungating lesion showed a well-differentiated neuroendocrine morphology with necrosis and increased mitosis. Most of the tumor cells had large, vesicular nuclei with eosinophilic nucleoli, variable amounts of eosinophilic cytoplasm, and immunoreactivity for chromogranin A and synaptophysin. The polypoid lesion was a well-differentiated adenocarcinoma that had invaded the submucosa. We diagnosed these lesions as a concurrent large cell neuroendocrine carcinoma and an adenocarcinoma of the ascending colon.
Abdomen ; Abdominal Pain ; Adenocarcinoma ; Aged ; Carcinoma, Neuroendocrine ; Chromogranin A ; Colon ; Colon, Ascending ; Colonic Neoplasms ; Cytoplasm ; Eosinophils ; Humans ; Laparotomy ; Mitosis ; Necrosis ; Synaptophysin ; Tomography, Spiral Computed ; Ulcer

OBJECTIVES: A growing body of research has documented that job stress has a pivotal role in developing adverse health outcomes. However, little is known about the relationship between farmers' job stress and health outcomes. This study was undertaken to identify the relationship between job stress and self-perceived fatigue in Korean farmers. METHODS: A total of 526 Korean farmers were asked to participate in this study. A self-administered questionnaire was used to assess the participants' general characteristics, job stress and self-perceived fatigue. Job stress was measured using a forty-eight item Farm Stressor Inventory (FSI), and the self-perceived fatigue was estimated by Multidimensional Fatigue Scale (MFS). Binary logistic regression analysis was conducted to examine the relationship between job stress and self-perceived fatigue. RESULTS: The result showed that job stress was associated with self-perceived fatigue. For the farmers with high job stress, the risk of self-perceived fatigue was more likely to increase compared to those with low job stress. For males, labor intensity (OR, 3.88; 95% CI, 1.91~7.89), job environment (OR, 2.45; 95% CI, 1.22~4.93), social support (OR, 2.10; 95% CI, 1.07~4.13), social isolation (OR, 2.45; 95% CI, 1.15~5.60), financial problems (OR, 3.25; 95% CI, 1.53~6.91), uncertainty (OR, 2.48; 95% CI, 1.30~4.75) and health problems (OR, 5.77; 95% CI, 2.46~13.53) were associated with self-perceived fatigue. For females, job environment (OR, 2.23; 95% CI, 1.22~4.08), social isolation (OR, 2.08; 95% CI, 1.05-4.15), physical environment & weather condition (OR, 2.61; 95% CI, 1.33~5.12), financial problems (OR, 2.87; 95% CI, 1.55~5.32), uncertainty (OR, 3.65; 95% CI, 1.95~6.83) and health problems (OR, 3.38; 95% CI, 1.57~7.27) were associated with self-perceived fatigue. CONCLUSIONS: This result suggests that farmers' job stress plays a role in the development of fatigue, and job stressors related to fatigue are slightly different according to gender.
Agriculture ; Fatigue ; Female ; Humans ; Logistic Models ; Male ; Questionnaires ; Social Isolation ; Uncertainty ; Weather

A teenaged female was found dead in front of a three story building. Blunt force injuries were found mainly in the right upper-posterior part of the body. Autopsy findings revealed basal skull fracture, multiple rib fractures of the right thoracic cage, both scapular fractures and right iliac bone fracture. Additionally, typical so-called 'tramline'bruises were bilaterally noted at buttocks. The hymen was intact, but showed mucosal hemorrhage. After the personal identity was revealed, the police could find a witness who heard the detailed description of the criminal acts from one of the suspects. According to the witness, the deceased was pushed by two other teenaged girls from the concrete fence of the roof floor after the suspects molested the genitalia of the deceased and beat on the buttocks with a wooden stick. Mathematical estimation of the height of fall based on the severity of injuries correlates with that of the three story building. Authors suggest that a careful examination of injury patterns is required to differentiate homicidal falls from suicidal or accidental ones. Furthermore, application of mathematical model might be helpful to estimate the height of falls or correlate the assumed height of fall with severity of injuries.
Accidental Falls ; Autopsy ; Buttocks ; Contusions ; Criminals ; Female ; Floors and Floorcoverings ; Forensic Pathology ; Fractures, Bone ; Genitalia ; Hemorrhage ; Homicide ; Humans ; Hymen ; Models, Theoretical ; Police ; Rib Fractures ; Skull Fractures ; Wit and Humor as Topic