1.Postmortem Computed Tomography – Based Body Weight Estimation in Korean Infants Using Volume and Multiplication Factors
Jin-Haeng HEO ; Seon Jung JANG ; Jeong-hwa KWON ; Sang-Beom IM ; Joo-Young NA ; Yongsu YOON ; Young San KO ; Minju LEE ; Se-Min OH ; Sung Wook CHOI ; Sookyoung LEE
Korean Journal of Legal Medicine 2024;48(3):55-60
Postmortem computed tomography (PMCT) is used in forensic medicine worldwide due to its ability to non-invasively visualize injuries, hemorrhage, and estimate volume. In the autopsy of infants, assessing nutritional conditions such as weight is crucial for identifying neglect. This study aims to evaluate the usefulness of retrospectively estimating the weight of Korean infants using PMCT-based volume and multiplication factors, even when the body has been cremated. A total of 44 cases of infant death (under 12 months) were analyzed. PMCT images were obtained before autopsy. Autopsy records and documentation provided by the police at the time of autopsy were reviewed to determine the weight (g) of the infant. PMCT-based infant volumes (mL) were estimated using a three-dimensional semi-automatic segmentation method. Multiplication factors (g/mL) were calculated by dividing the weight recorded at autopsy by the PMCT-based volume, yielding a mean of 1.047 g/mL, ranging from 1.014 g/mL to 1.085 g/mL. The mean absolute error compared to weights recorded at autopsy was 95 g. Significant discrepancies were observed between weights recorded at the scene or medical center and those measured at autopsy. This study demonstrates that PMCT-based weight estimation for Korean infants is a reliable method and has the potential for retrospectively validating incorrect weight measurements and addressing inconsistencies in recorded weight data.
2.Methyl Salicylate Poisoning Due to Suicidal Ingestion: A Case Report and Literature Review
Tae Young YU ; Jeong-hwa KWON ; Suk Hoon HAM ; Sang-Beom IM ; Young-Il PARK ; Young San KO ; Jin-Haeng HEO ; Sin Eun KIM ; Seon Jung JANG
Korean Journal of Legal Medicine 2024;48(1):23-25
Methyl salicylate is widely used in various topical products, including sports creams, ointments, patches, and oral hygiene products. These products are mainly used for localized treatment of musculoskeletal pain. Given their intended topical application, their ingestion can result in salicylic acid poisoning due to their high concentrations of methyl salicylate. Symptoms of salicylic acid poisoning may include dizziness, vomiting, hallucinations, seizures, and, in severe cases, unconsciousness, respiratory failure, and circulatory disorders. We report a case of a 71-year-old male who ingested Mensolatum Lotion to commit suicide and died.
3.The Significance of Detecting Diatoms in Spleen Tissue for the Postmortem Diagnosis of Drowning
Young San KO ; Suk Hoon HAM ; Jin-Haeng HEO ; Sang-Beom IM ; Young-Il PARK ; Jeong-hwa KWON ; Kyung Ryoul KIM ; Ho Suk SONG ; Seon Jung JANG
Korean Journal of Legal Medicine 2024;48(1):1-6
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.
4.U-Net-Based Automatic Segmentation of Sphenoid Sinus Fluid in Drowning Cases Using Postmortem CT Images:A Feasibility Study
Jin-Haeng HEO ; Seon Jung JANG ; Jeong-hwa KWON ; Young San KO ; Sang-Beom IM ; Sookyoung LEE ; In-Soo SEO ; Joo-Young NA ; Yeji KIM ; Yongsu YOON
Korean Journal of Legal Medicine 2024;48(1):7-13
Detecting sphenoid sinus fluid (SSF) is an additional finding in autopsies for diagnosing drowning. SSF can provide additional forensic evidence through laboratory tests such as diatom and electrolyte analyses. If drowning is suspected, accurately assessing the presence and volume of SSF during an autopsy is crucial. Utilizing postmortem computed tomography (PMCT) images could aid in accurately sampling SSF. Accurately segmenting the region of interest is essential for volume analysis using computed tomography images. However, manual segmentation techniques are labor-intensive and time-consuming, and their success depends on the experience of the observer. Therefore, this study aimed to develop a U-Net–based deep learning model for the automatic segmentation of SSF in drowning cases using PMCT images and to evaluate the performance of the model. We retrospectively reviewed 34 drowning cases in which both PMCT scans and forensic autopsies were performed at our institution. The U-Net architecture of deep learning was used for automatic segmentation. The proposed model achieved the Dice similarity coefficient (DSC) and Intersection over Union (IoU) of a maximum of 95.85% and 92.03%, a minimum of 0% and 0%, and an average of 77.15% and 67.18%, respectively. Although the average DSC and IoU did not show high similarity, this study showed that PMCT images can be used for automatic segmentation of SSF in drowning cases, which could improve the performance with sufficient dataset acquisition and further model training.
5.Introduction of the Korea BioData Station (K-BDS) for sharing biological data
Byungwook LEE ; Seungwoo HWANG ; Pan-Gyu KIM ; Gunwhan KO ; Kiwon JANG ; Sangok KIM ; Jong-Hwan KIM ; Jongbum JEON ; Hyerin KIM ; Jaeeun JUNG ; Byoung-Ha YOON ; Iksu BYEON ; Insu JANG ; Wangho SONG ; Jinhyuk CHOI ; Seon-Young KIM
Genomics & Informatics 2023;21(1):e12-
A wave of new technologies has created opportunities for the cost-effective generation of high-throughput profiles of biological systems, foreshadowing a "data-driven science" era. The large variety of data available from biological research is also a rich resource that can be used for innovative endeavors. However, we are facing considerable challenges in big data deposition, integration, and translation due to the complexity of biological data and its production at unprecedented exponential rates. To address these problems, in 2020, the Korean government officially announced a national strategy to collect and manage the biological data produced through national R&D fund allocations and provide the collected data to researchers. To this end, the Korea Bioinformation Center (KOBIC) developed a new biological data repository, the Korea BioData Station (K-BDS), for sharing data from individual researchers and research programs to create a data-driven biological study environment. The K-BDS is dedicated to providing free open access to a suite of featured data resources in support of worldwide activities in both academia and industry.
6.Chronic Hypoxemia Triggers a Neuropathic Process in Chronic Obstructive Pulmonary Disease:Insight From In Vivo Neurophysiological Assessments
Seon Min YOON ; Young Bum PARK ; Yousang KO ; Jong Seok BAE
Journal of Clinical Neurology 2023;19(2):186-194
Background:
and PurposePeripheral neuropathies (PNs) are a common but poorly understood complication of chronic obstructive pulmonary disease (COPD). To clarify the initial trigger of a PN in COPD, we investigated the excitability of peripheral nerves in patients with COPD.
Methods:
The automated nerve excitability test (NET) using the threshold-tracking paradigm was applied to 20 COPD patients. The recording protocol calculated the strength–duration time constant, threshold electrotonus (TE), current–threshold relationship, and recovery cycle (RC). Each NET parameter was compared with two control groups: normal controls group (NC group) and smokers without COPD group (smoker group).
Results:
In the motor NETs, the change in the threshold in the mid-depolarizing phase of TE (40–60 ms) was smaller in the COPD group (50.7%±1.2%, mean±SEM; n=20) than in the NC group (54.5%±0.7%, n=25; p<0.01), as was the prominence of superexcitability in the RC (-22.6%±1.5% and -26.4%±1.1%, respectively; p=0.04). There were no significant differences in the sensory NETs. Comparisons between the COPD and smoker groups (n=25) also showed no differences in either the motor or sensory NETs.
Conclusions
The pattern of excitability in COPD revealed a membrane depolarization attributable to Na+–K+–ATPase failure in the axolemma of distal motor nerves. This finding suggests that chronic hypoxemia and adaptative process can alter axonal excitability and trigger a resultant neuropathic process that is antecedent to PN in COPD.
8.Transcriptomic Analysis of Papillary Thyroid Cancer: A Focus on Immune-Subtyping, Oncogenic Fusion, and Recurrence
Seung-Jin PARK ; Yea Eun KANG ; Jeong-Hwan KIM ; Jong-Lyul PARK ; Seon-Kyu KIM ; Seung-Woo BAEK ; In Sun CHU ; Shinae YI ; Seong Eun LEE ; Young Joo PARK ; Eun-Jae CHUNG ; Jin Man KIM ; Hye Mi KO ; Je-Ryong KIM ; Seung-Nam JUNG ; Ho-Ryun WON ; Jae Won CHANG ; Bon Seok KOO ; Seon-Young KIM
Clinical and Experimental Otorhinolaryngology 2022;15(2):183-193
Objectives:
. Thyroid cancer is the most common endocrine tumor, with rapidly increasing incidence worldwide. However, its transcriptomic characteristics associated with immunological signatures, driver fusions, and recurrence markers remain unclear. We aimed to investigate the transcriptomic characteristics of advanced papillary thyroid cancer.
Methods:
. This study included 282 papillary thyroid cancer tumor samples and 155 normal samples from Chungnam National University Hospital and Seoul National University Hospital. Transcriptomic quantification was determined by high-throughput RNA sequencing. We investigated the associations of clinical parameters and molecular signatures using RNA sequencing. We validated predictive biomarkers using the Cancer Genome Atlas database.
Results:
. Through a comparison of differentially expressed genes, gene sets, and pathways in papillary thyroid cancer compared to normal tumor-adjacent tissue, we found increased immune signaling associated with cytokines or T cells and decreased thyroid hormone synthetic pathways. In addition, patients with recurrence presented increased CD8+ T-cell and Th1-cell signatures. Interestingly, we found differentially overexpressed genes related to immune-escape signaling such as CTLA4, IDO1, LAG3, and PDCD1 in advanced papillary thyroid cancer with a low thyroid differentiation score. Fusion analysis showed that the PI3K and mitogen-activated protein kinase (MAPK) signaling pathways were regulated differently according to the RET fusion partner genes (CCDC6 or NCOA4). Finally, we identified HOXD9 as a novel molecular biomarker that predicts the recurrence of thyroid cancer in addition to known risk factors (tumor size, lymph node metastasis, and extrathyroidal extension).
Conclusion
. We identified a high association with immune-escape signaling in the immune-hot group with aggressive clinical characteristics among Korean thyroid cancer patients. Moreover, RET fusion differentially regulated PI3K and MAPK signaling depending on the partner gene of RET, and HOXD9 was found to be a recurrence marker for advanced papillary thyroid cancer.
9.Obesity Exacerbates Coxsackievirus Infection via Lipid-Induced Mitochondrial Reactive Oxygen Species Generation
Seong-Ryeol KIM ; Jae-Hyoung SONG ; Jae-Hee AHN ; Myeong Seon JEONG ; Yoon Mee YANG ; Jaewon CHO ; Jae-Hyeon JEONG ; Younggil CHA ; Kil-Nam KIM ; Hong Pyo KIM ; Sun-Young CHANG ; Hyun-Jeong KO
Immune Network 2022;22(2):e19-
Coxsackievirus B3 (CVB3) infection causes acute pancreatitis and myocarditis. However, its pathophysiological mechanism is unclear. Here, we investigated how lipid metabolism is associated with exacerbation of CVB3 pathology using high-fat diet (HFD)-induced obese mice. Mice were intraperitoneally inoculated with 1×10 6 pfu/mouse of CVB3 after being fed a control or HFD to induce obesity. Mice were treated with mitoquinone (MitoQ) to reduce the level of mitochondrial ROS (mtROS). In obese mice, lipotoxicity of white adipose tissue-induced inflammation caused increased replication of CVB3 and mortality.The coxsackievirus adenovirus receptor increased under obese conditions, facilitating CVB3 replication in vitro. However, lipid-treated cells with receptor-specific inhibitors did not reduce CVB3 replication. In addition, lipid treatment increased mitochondria-derived vesicle formation and the number of multivesicular bodies. Alternatively, we found that inhibition of lipid-induced mtROS decreased viral replication. Notably, HFD-fed mice were more susceptible to CVB3-induced mortality in association with increased levels of CVB3 replication in adipose tissue, which was ameliorated by administration of the mtROS inhibitor, MitoQ. These results suggest that mtROS inhibitors can be used as potential treatments for CVB3 infection.
10.Efficacy and safety of rapid intermittent bolus compared with slow continuous infusion in patients with severe hypernatremia (SALSA II trial): a study protocol for a randomized controlled trial
Ji Young RYU ; Songuk YOON ; Jeonghwan LEE ; Sumin BAEK ; You Hwan JO ; Kwang-Pil KO ; Jin-ah SIM ; Junhee HAN ; Sejoong KIM ; Seon Ha BAEK
Kidney Research and Clinical Practice 2022;41(4):508-520
Hypernatremia is a common electrolyte disorder in children and elderly people and has high short-term mortality. However, no high-quality studies have examined the correction rate of hypernatremia and the amount of fluid required for correction. Therefore, in this study, we will compare the efficacy and safety of rapid intermittent bolus (RIB) and slow continuous infusion (SCI) of electrolyte-free solution in hypernatremia treatment. Methods: This is a prospective, investigator-initiated, multicenter, open-label, randomized controlled study with two experimental groups. A total of 166 participants with severe hypernatremia will be enrolled and divided into two randomized groups; both the RIB and SCI groups will be managed with electrolyte-free water. We plan to infuse the same amount of fluid to both groups, for 1 hour in the RIB group and continuously in the SCI group. The primary outcome is a rapid decrease in serum sodium levels within 24 hours. The secondary outcomes will further compare the efficacy and safety of the two treatment protocols. Conclusion: This is the first randomized controlled trial to evaluate the efficacy and safety of RIB correction compared with SCI in adult patients with severe hypernatremia.

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