1.A Statistical Analysis of Forensic Autopsies Performed in the Jungbu Province of Korea in 2022
JeongHwan KIM ; Donghyun KIM ; Minjung KIM ; Min Jee PARK ; Yujin WON ; Nak-won LEE ; Soo Kyung LEE ; Jooyeon LEE ; Hyelim YI ; Inseok CHOI ; Ji Hye PARK
Korean Journal of Legal Medicine 2024;48(4):153-164
We analyzed the manner and cause of death in 1,193 forensic autopsies from the Jungbu province (central part of South Korea) conducted by the National Forensic Service Daejeon Institute in 2022. Analysis of the manner of deaths revealed that 43.1% (514/1,193 cases) were natural deaths; 42.8% (511/1,193 cases) were unnatural deaths; and 14.1% (168/1,193 cases) were unknown. Among the unnatural deaths, the major manner of death was 44.6% (228/511 cases) by accidents, 34.1% (174/511 cases) by suicide, 13.5% (69/511 cases) undetermined, and 7.8% (40/511 cases) by homicide. Among the unnatural deaths, the major causes of death was 38.4% (196/511 cases) by trauma, 20.4% (104/511 cases) by poisoning, and 17.6% (90/511 cases) by asphyxia. Falling was the major cause of death by trauma (58.7%, 115/196 cases), and strangulation was the major cause of death by asphyxia (75.6%, 68/90 cases). Among the natural deaths, heart disease was the major cause (46.7%, 240/514 cases), followed by endocrine, nutritional and metabolic diseases (14.0%, 72/514 cases). A time-series statistical analysis and comparison of the manner and cause of deaths in this province may facilitate more advanced interpretations relating to both public safety and healthcare in the future.
2.A Statistical Analysis of Forensic Autopsies Performed in the Jungbu Province of Korea in 2022
JeongHwan KIM ; Donghyun KIM ; Minjung KIM ; Min Jee PARK ; Yujin WON ; Nak-won LEE ; Soo Kyung LEE ; Jooyeon LEE ; Hyelim YI ; Inseok CHOI ; Ji Hye PARK
Korean Journal of Legal Medicine 2024;48(4):153-164
We analyzed the manner and cause of death in 1,193 forensic autopsies from the Jungbu province (central part of South Korea) conducted by the National Forensic Service Daejeon Institute in 2022. Analysis of the manner of deaths revealed that 43.1% (514/1,193 cases) were natural deaths; 42.8% (511/1,193 cases) were unnatural deaths; and 14.1% (168/1,193 cases) were unknown. Among the unnatural deaths, the major manner of death was 44.6% (228/511 cases) by accidents, 34.1% (174/511 cases) by suicide, 13.5% (69/511 cases) undetermined, and 7.8% (40/511 cases) by homicide. Among the unnatural deaths, the major causes of death was 38.4% (196/511 cases) by trauma, 20.4% (104/511 cases) by poisoning, and 17.6% (90/511 cases) by asphyxia. Falling was the major cause of death by trauma (58.7%, 115/196 cases), and strangulation was the major cause of death by asphyxia (75.6%, 68/90 cases). Among the natural deaths, heart disease was the major cause (46.7%, 240/514 cases), followed by endocrine, nutritional and metabolic diseases (14.0%, 72/514 cases). A time-series statistical analysis and comparison of the manner and cause of deaths in this province may facilitate more advanced interpretations relating to both public safety and healthcare in the future.
3.A Statistical Analysis of Forensic Autopsies Performed in the Jungbu Province of Korea in 2022
JeongHwan KIM ; Donghyun KIM ; Minjung KIM ; Min Jee PARK ; Yujin WON ; Nak-won LEE ; Soo Kyung LEE ; Jooyeon LEE ; Hyelim YI ; Inseok CHOI ; Ji Hye PARK
Korean Journal of Legal Medicine 2024;48(4):153-164
We analyzed the manner and cause of death in 1,193 forensic autopsies from the Jungbu province (central part of South Korea) conducted by the National Forensic Service Daejeon Institute in 2022. Analysis of the manner of deaths revealed that 43.1% (514/1,193 cases) were natural deaths; 42.8% (511/1,193 cases) were unnatural deaths; and 14.1% (168/1,193 cases) were unknown. Among the unnatural deaths, the major manner of death was 44.6% (228/511 cases) by accidents, 34.1% (174/511 cases) by suicide, 13.5% (69/511 cases) undetermined, and 7.8% (40/511 cases) by homicide. Among the unnatural deaths, the major causes of death was 38.4% (196/511 cases) by trauma, 20.4% (104/511 cases) by poisoning, and 17.6% (90/511 cases) by asphyxia. Falling was the major cause of death by trauma (58.7%, 115/196 cases), and strangulation was the major cause of death by asphyxia (75.6%, 68/90 cases). Among the natural deaths, heart disease was the major cause (46.7%, 240/514 cases), followed by endocrine, nutritional and metabolic diseases (14.0%, 72/514 cases). A time-series statistical analysis and comparison of the manner and cause of deaths in this province may facilitate more advanced interpretations relating to both public safety and healthcare in the future.
4.A Statistical Analysis of Forensic Autopsies Performed in the Jungbu Province of Korea in 2022
JeongHwan KIM ; Donghyun KIM ; Minjung KIM ; Min Jee PARK ; Yujin WON ; Nak-won LEE ; Soo Kyung LEE ; Jooyeon LEE ; Hyelim YI ; Inseok CHOI ; Ji Hye PARK
Korean Journal of Legal Medicine 2024;48(4):153-164
We analyzed the manner and cause of death in 1,193 forensic autopsies from the Jungbu province (central part of South Korea) conducted by the National Forensic Service Daejeon Institute in 2022. Analysis of the manner of deaths revealed that 43.1% (514/1,193 cases) were natural deaths; 42.8% (511/1,193 cases) were unnatural deaths; and 14.1% (168/1,193 cases) were unknown. Among the unnatural deaths, the major manner of death was 44.6% (228/511 cases) by accidents, 34.1% (174/511 cases) by suicide, 13.5% (69/511 cases) undetermined, and 7.8% (40/511 cases) by homicide. Among the unnatural deaths, the major causes of death was 38.4% (196/511 cases) by trauma, 20.4% (104/511 cases) by poisoning, and 17.6% (90/511 cases) by asphyxia. Falling was the major cause of death by trauma (58.7%, 115/196 cases), and strangulation was the major cause of death by asphyxia (75.6%, 68/90 cases). Among the natural deaths, heart disease was the major cause (46.7%, 240/514 cases), followed by endocrine, nutritional and metabolic diseases (14.0%, 72/514 cases). A time-series statistical analysis and comparison of the manner and cause of deaths in this province may facilitate more advanced interpretations relating to both public safety and healthcare in the future.
5.Post-Traumatic Stress Symptoms and Related Factors in Patients Admitted and Discharged From COVID-19 Isolation Ward
Minjung KIM ; Jihye KIM ; Se Hyun KWAK ; Eun Hye LEE ; Jin Young PARK ; Deokjong LEE
Journal of Korean Neuropsychiatric Association 2024;63(3):167-176
Objectives:
Pandemic diseases like COVID-19 could affect people even after they are cured. In this study, we asked COVID-19 survivors whether they showed post-traumatic stress disorder (PTSD) symptoms, and tried to figure out what factors can affect their symptoms.
Methods:
Approximately 3 months after their discharge, a psychological survey was conducted with 83 adults (38 men and 45 women, mean age 38.6±11.3 years) who had been hospitalized with COVID-19 in an isolation ward. The group was divided according to the presence or absence of PTSD symptoms, and differences in demographic, psychological, and hospitalizationrelated factors between the groups were analyzed using the independent t-test. We conducted hierarchical multiple regression analysis exploring variables affecting PTSD symptoms.
Results:
Fourteen of the survey respondents (15.8%) reported experiencing PTSD symptoms, including partial PTSD symptoms. The group with PTSD symptoms appeared to have more pain upon admission to hospital, compared to the group without PTSD symptoms. The group with PTSD symptoms showed higher anxiety and depression than the group without PTSD symptoms, and their physical quality of life was found to be low. The presence of PTSD symptoms seemed to be influenced by anxiety sensitivity.
Conclusion
Our findings suggest that hospitalization in an isolation ward due to COVID-19 may be associated with the development of PTSD symptoms. Anxiety sensitivity could influence the level of PTSD symptoms after discharge. The results of this study suggest the need to monitor and care for the mental health of patients admitted to and discharged from isolation wards due to infection.
6.Comparison of cardiovascular event predictability between the 2009 and 2021 Chronic Kidney Disease Epidemiology Collaboration equations in a Korean chronic kidney disease cohort: the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease
Ji Hye KIM ; Minjung KANG ; Eunjeong KANG ; Hyunjin RYU ; Yujin JEONG ; Jayoun KIM ; Sue K. PARK ; Jong Cheol JEONG ; Tae-Hyun YOO ; Yaeni KIM ; Yong Chul KIM ; Seung Seok HAN ; Hajeong LEE ; Kook-Hwan OH
Kidney Research and Clinical Practice 2023;42(6):700-711
The 2009 Chronic Kidney Disease Epidemiology Collaboration creatinine-based estimated glomerular filtration rate (eGFRcr) equation contains a race component that is not based on biology and may cause a bias in results. Therefore, the 2021 eGFRcr and creatinine-cystatin C–based eGFR (eGFRcr-cysC) equations were developed with no consideration of race. This study compared the cardiovascular event (CVE) and all-cause mortality and CVE combined predictability among the three eGFR equations in Korean chronic kidney disease (CKD) patients. Methods: This study included 2,207 patients from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease. Receiver operating characteristic (ROC) and net reclassification improvement (NRI) index were used to compare the predictability of the study outcomes according to the 2009 eGFRcr, 2021 eGFRcr, and 2021 eGFRcr-cysC equations. Results: The overall prevalence of CVE and all-cause mortality were 9% and 7%, respectively. There was no difference in area under the curve of ROC for CVE and mortality and CVE combined among all three equations. Compared to the 2009 eGFRcr, both the 2021 eGFRcr (NRI, 0.013; 95% confidence interval [CI], – 0.002 to 0.028) and the eGFRcr-cysC (NRI, –0.001; 95% CI, –0.031 to 0.029) equations did not show improved CVE predictability. Similar findings were observed for mortality and CVE combined predictability with both the 2021 eGFRcr (NRI, –0.019; 95% CI, –0.039–0.000) and the eGFRcr-cysC (NRI, –0.002; 95% CI, –0.023 to 0.018). Conclusion: The 2009 eGFRcr equation was not inferior to either the 2021 eGFRcr or eGFRcr-cysC equation in predicting CVE and the composite of mortality and CVE in Korean CKD patients.
7.Clinical Course of Suspected Diagnosis of Pulmonary Tumor Thrombotic Microangiopathy: A 10-Year Experience of Rapid Progressive Right Ventricular Failure Syndrome in Advanced Cancer Patients
Minjung BAK ; Minyeong KIM ; Boram LEE ; Eun Kyoung KIM ; Taek Kyu PARK ; Jeong Hoon YANG ; Duk-Kyung KIM ; Sung-A CHANG
Korean Circulation Journal 2023;53(3):170-184
Background and Objectives:
Several cases involving severe right ventricular (RV) failure in advanced cancer patients have been found to be pulmonary tumor thrombotic microangiopathies (PTTMs). This study aimed to discover the nature of rapid RV failure syndrome with a suspected diagnosis of PTTM for better diagnosis, treatment, and prognosis prediction in clinical practice.
Methods:
From 2011 to 2021, all patients with clinically suspected PTTM were derived from the one tertiary cancer hospital with more than 2000 in-hospital bed.
Results:
A total of 28 cases of clinically suspected PTTM with one biopsy confirmed case were included. The most common cancer types were breast (9/28, 32%) and the most common tissue type was adenocarcinoma (22/26, 85%). The time interval from dyspnea New York Heart Association (NYHA) Grade 2, 3, 4 to death, thrombocytopenia to death, desaturation to death, admission to death, RV failure to death, cardiogenic shock to death were 33.5 days, 14.5 days, 7.4 days, 6.4 days, 6.1 days, 6.0 days, 3.8 days and 1.2 days, respectively. The NYHA Grade 4 to death time was 7 days longer in those who received chemotherapy (7.1 days vs.13.8 days, p value=0.030). However, anticoagulation, vasopressors or intensive care could not change clinical course.
Conclusions
Rapid RV failure syndrome with a suspected diagnosis of PTTM showed a rapid progressive course from symptom onset to death. Although chemotherapy was effective, increased life survival was negligible, and treatments other than chemotherapy did not help to improve the patient’s prognosis.
8.Statistical Analysis of Medicolegal Autopsy of Migrant Workers in Korea
Kiha KIM ; Minsung CHOI ; Minjung KIM ; Junmo KIM ; HyeJeong KIM ; Sookyoung LEE ; Seon Jung JANG ; Yujin WON ; Jong-Pil PARK
Korean Journal of Legal Medicine 2023;47(4):163-170
The number of migrant workers is increasing worldwide every year, and their number and role in Korean society is also increasing. However, the poor conditions faced by migrant workers often become a social issue, and it is not uncommon for them to be the subject of forensic autopsies. This study aimed to investigate the current status of medicolegal autopsy on migrant workers in Korea. We collected data of medicolegal autopsies on migrant workers conducted in Korea from 2016 to 2020 by requesting data from the institutions performing medicolegal autopsy. We calculated the autopsy rate and analyzed manner of death and cause of death. The medicolegal autopsy rate for foreign deaths was 16.4%, which was more than five times higher than the autopsy rate for Korean deaths. By manner of death, 43.7% were natural death, 6.4% were homicides, 8.5% were suicides, 23.6% were accidental deaths, 2.7% were undetermined unnatural deaths and 15.0% were unknown. These results showed a high rate of homicide, accidental death, and unknown death compared to Korean. And the proportion of industrial accident deaths and sudden manhood death syndrome were high. Through this study, it was confirmed that medicolegal autopsies are performed at a relatively high frequency when migrant workers die, and the characteristics related to the deaths of migrant workers were identified.
9.A Statistical Analysis of Forensic Autopsies Performed in the Jungbu Province of Korea in 2021
JeongHwan KIM ; Eun Kyoung KIM ; Min Jee PARK ; Ji Hye PARK ; Se-min OH ; Yujin WON ; Nak-won LEE ; Soo Kyung LEE ; Hyelim YI ; Minjung KIM
Korean Journal of Legal Medicine 2023;47(4):110-121
We analyzed 1,079 forensic autopsies conducted in 2021 by the National Forensic Service Daejeon Institute from the Jungbu province in the central part of South Korea, for their manner and cause of death. Among the manner of death (n=1,079), 45.3% (n=489) were categorised as unnatural, 39.5% (n=426) as natural, and 15.2% (n=164) were unknown. Among the unnatural deaths (n=489), 40.7% (n=199) were accidents, 36.8% (n=180) were suicides, 14.1% (n=69) were undetermined, and 8.4% (n=41) were homicides. The major causes of unnatural deaths (n=489) were by trauma, causing 34.4% (n=168), poisoning causing 26.8% (n=131), and asphyxia causing 17.2% (n=84). The major cause of death by trauma (n=168) was falling at 46.4% (n=78), and by asphyxia (n=84) was strangulation at 76.2% (n=64). Among natural deaths (n=426), heart disease was the major cause at 49.8% (n=212) followed by vascular disease at 16.7% (n=71). In future, a time-series statistical analysis on the manner and causes of death in Jungbu province may provide insight and allow for more advanced interpretations about both healthcare and public safety.
10.Improvement of Severe Colon Stricture after Rituximab Therapy for Concomitant Mucosa-associated Lymphoid Tissue Lymphoma in a Patient with Ulcerative Colitis
Hyun Joon PARK ; Won MOON ; Seun Ja PARK ; Moo In PARK ; Sung Eun KIM ; Jae Hyun KIM ; Kyoungwon JUNG ; Kwang Il SEO ; Eun Mi LEE ; Minjung JUNG
The Korean Journal of Gastroenterology 2023;82(5):254-260
Colorectal strictures are uncommon in patients with ulcerative colitis (UC). An extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma is rarely involved in the colon but may be associated with inflammatory bowel diseases. A 41-year-old female with a six-year history of UC presented with a severe stricture of the sigmoid colon that prevented the passage of a colonoscope. A histological examination revealed non-specific inflammation and fibrosis without dysplasia or cancer.Despite conventional treatment, including mesalazine and azathioprine for one year after that visit, the stricture persisted. In addition, diffuse, edematous exudative inflammation and multiple shallow ulcers were observed in the distal rectum, revealing a MALT lymphoma testing positive for CD20, CD43, CD5, and Bcl-2, but negative for CD3, CD10, CD23, and cyclin-D1. Four weekly doses of rituximab were administered. Follow-up colonoscopy performed one month after treatment revealed slight improvement in the rectal lesion without remnant histological evidence of a MALT lymphoma. In addition, the stricture showed marked improvement, and the colonoscope could pass easily through the stricture site. This is the first case report on an improvement of a severe sigmoid colon stricture in a patient with UC after rituximab treatment for a concomitant rectal MALT lymphoma.

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