This study aimed to elucidate the demographic and sleeping environmental factors associated with sudden infant death syndrome (SIDS) in Korea. The autopsy reports of all SIDS cases reported to the National Forensic Service and Seoul National University College of Medicine between 1996 and 2008 were reviewed for data collection and analysis to identify the risk factors for SIDS. Analysis of the 355 SIDS cases reported within the study period revealed that of the 168 (47.3%) cases for which sleeping position before death had been reported, 75 (44.7%) cases had occurred after placement in prone or side position. Of the 204 (57.5%) cases for which bed-sharing situation had been reported, 121 (59.3%) deaths had occurred during bed-sharing, of which 54 (44.6%) infants were under 3 months of age, a significantly younger age than that of the non-bed-sharing cases (P = 0.0279). Analysis of the results indicated no tendency toward an increase or decrease in the use of a prone or side position. Rather, there was a statistically significant increasing trend for bed-sharing over the study period (OR, 1.087; 95% CI, 1.004-1.177; P = 0.04). These findings indicate the need for nationwide educational programs promoting a safe sleeping environment to enhance SIDS prevention.
Asian Continental Ancestry Group ; Autopsy ; Beds ; Demography ; Female ; Forensic Sciences ; Humans ; Infant ; Infant, Newborn ; Male ; Odds Ratio ; Prone Position ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Seasons ; Sudden Infant Death/*pathology/prevention & control

In the western countries, forensic pathologists under their rational postmortem investigation system do their appropriate role before or during all process of transplantation. As it is ongoing remarkable development in the transplantation medicine and it is more and more increased the number of would-be transplant patients, organ procurement from the brain dead will expand than ever. Considering the major causes of brain death which are cerebrovascular diseases, traffic accidents, and head injuries, the role of forensic doctors has to be more important in transplantation. Reviewing literatures and reporting our case which was requested for forensic consultation before the organ procurement because this case was related with violence and the cause of death was obscure, we would like to discuss and develop the systematic and organizational approach about the role of forensic pathologists in transplantation medicine in Korea.
Accidents, Traffic ; Brain ; Brain Death ; Cause of Death ; Coroners and Medical Examiners ; Craniocerebral Trauma ; Humans ; Korea ; Tissue and Organ Procurement ; Transplants ; Violence

Spontaneous bacterial peritonitis (SBP) is a bacterial infection of ascites arising from liver cirrhosis, nephrotic syndrome and so on. Primary bacterial peritonitis (PBP) is a rare intraabdomial infection in the absence of underlying diseases or rupture of the viscus. The authors report an autopsy case of posttraumatic primary bacterial peritonitis in the otherwise physically healthy young female. She was beaten repeatedly around the abdomen with human physical instruments for a prolonged time.
Abdomen ; Ascites ; Autopsy ; Bacterial Infections ; Female ; Humans ; Liver Cirrhosis ; Nephrotic Syndrome ; Peritonitis* ; Rupture

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation(NISI), requested by every kind of law enforcement agencies during the year of 2006. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,515 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 1,788 cases(71.1%) and that of female 727(28.9%). Male was over twice more than female. The forties were 709 cases(28.2%), the fifties 496(19.7%), and these two decades occupied 47.9%. 2. Unnatural deaths were 1,437 cases(57.1%), natural 955(38.0%), and the unknown 123(4.9%). Among 1,437 unnatural deaths, suicide was 366(25.5%), homicide 387(26.9%), accident 392(27.3%), and the unclear 292(20.3%). Homicide occupied 40.4% of trauma, 51.9% of blunt force injury excluding traffic and fall-down injury, and 91.2% of sharp force injury. The homicide rate in asphyxia was 33.2%, but it went up to 71.4% excluding hanging. It showed only 1.3% percent of homicide in poisoning. 3. Traumatic deaths were 681 cases, occupying 47.4% of 1,437 unnatural deaths, followed by drowning deaths(199 cases). Blunt trauma was 206 cases(30.2%) and the leading cause of death in traumatic death. Poisoning was 158 cases, among which the cyanides were dominant(37cases). Thermal injuries were 144 cases, electrocution 14 cases, and starvation/neglect 21 cases. and 17 cases were directly due to medical procedures. 4. Among 955 natural deaths, heart diseases were 495 cases(51.8%), and vascular diseases 165(17.3%), and these two categories were added up to 660(69.1%). 5. Child deaths under the age of 10 were 118 cases. Homicide was 35 cases(57.4%) out of 61 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 45 cases(38.1%)
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Cyanides ; Drowning ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases

Tension pneumoperitoneum (TP) is a rare fatal complication of colonoscopy. In a forensic point of view, this complication is hard to be diagnosed as a cause of death simply considering the result of autopsy findings without clinical information. We experienced an autopsy case expired by TP resulting from colonic perforation during colonoscopy. A 51-year-old woman was performed a colonoscopy under the sedation with propofol. The physician could not find any pathologic lesions throughout the whole colonic mucosa and noticed a perforation at sigmoid colon when he was about to wrap up his procedure. The patient was immediately transferred to the emergency department and showed distended abdomen with unstable vital signs. Although she was taken emergency exploratory laparotomy and simple closure of the perforated site, she died at 3 days after operation due to multiple organ failure. At autopsy, we could not find any other pathologic abnormality except for a wellsutured perforated site. However, the clinical findings and course enabled us to come to conclusion that the cause of death was TP. In conclusion, when conducting an autopsy on the death after colonoscopy, we should consider the possibility of TP by leakage of large amount of air during colonoscopy.
Abdomen ; Autopsy ; Cause of Death ; Colon ; Colon, Sigmoid ; Colonoscopy* ; Emergencies ; Emergency Service, Hospital ; Female ; Humans ; Laparotomy ; Middle Aged ; Mucous Membrane ; Multiple Organ Failure ; Pneumoperitoneum* ; Propofol ; Vital Signs

Acute epiglottitis is a local bacterial infection of the supraglottic area. Epiglottitis is generally caused by organisms which invoke an inflammatory response that develops rapid obstructive edema. The disease rarely progresses to abscess stage, either because medical intervention is sought or death by asphyxiation ensues. A 38-year-old, mentally ill but physically healthy woman died of airway obstruction caused by acute epiglottitis forming an abscess. She died unexpectedly and suddenly showing only minor nonspecific symptoms.
Abscess* ; Adult ; Airway Obstruction ; Bacterial Infections ; Death, Sudden* ; Edema ; Epiglottitis ; Female ; Humans ; Mentally Ill Persons

CT and MRI are high-tech devices for medical diagnosis. Their electromechanical function has leaped forward such a fast step, so that their image quality is improved and the time for a whole body scanning is shortened as little as only several minutes. These essential diagnostic tools are tried to apply for the field of forensic medicine in favor of their noninvasiveness and great resolution. These merits could make our postmortem investigation system improve in the aspect of practicality. This presenting study was done for the purpose of expecting what the field of forensic medicine could get or lose, what is needed technically, and what kind of supports are required. In our preliminary study, we gave injuries to the pigs' heads with weapons, scanned the wounds with high-tech devices, and embodied the injuries and the weapons three-dimensionally. These high-tech methods would be expected to play a role in forensic medicine and scientific crime investigation as a new and powerful testimony.
Autopsy ; Crime* ; Diagnosis ; Diagnostic Imaging* ; Forensic Medicine* ; Head ; Magnetic Resonance Imaging ; Weapons ; Whole Body Imaging ; Wounds and Injuries

A 65 year-old female was suddenly expired soon after arriving in emergency room. Before arriving, she complained chest discomfort. Her neck mass was diagnosed as thyroid tumor about 11 years ago. She was recommended operation, but not taken due to arrhythmia. The neck mass was originally diagnosed as thyroid mass(goiter) by radiologic studies. The mass (10.5 x 9.5 x 7.0 cm, 319 gm) is mainly located in the lower neck and partly in the anterior superior mediastinum. The trachea is compressed by the mass and its tubal structure is flattened. The cause of death is mechanical asphyxia by thymoma(type B1 according to the WHO classification of thymoma, and stage I according to Masaoka's classification). On review of her past history, paraneoplastic syndrome including myasthenia gravis is not present. Generally, the patient with large thymic mass shows symptoms including chest pain, respiratory difficulty, hemoptysis, cough, superior vena cava syndrome. Although the symptoms related with its mass effect are common, but the death from mechanical asphyxia by thymoma is very rare in recent days.
Aged ; Arrhythmias, Cardiac ; Asphyxia* ; Cause of Death ; Chest Pain ; Classification ; Cough ; Emergency Service, Hospital ; Female ; Hemoptysis ; Humans ; Mediastinum ; Myasthenia Gravis ; Neck ; Paraneoplastic Syndromes ; Superior Vena Cava Syndrome ; Thorax ; Thymoma* ; Thyroid Gland ; Trachea

When the circumstance of a death seems to be related with electric shock, most of the forensic pathologists tend to diagnose the cause of death as electrocution if they see the electric mark(s) with the notincompatible histology, and find no other definite causes of death at autopsy. But admittedly forensic pathologists know that the so-called electric mark(s) and its histology is not pathognomonic to diagnose electrocution, so the diagnosis should be confirmed by the appropriate investigation of the death scene and the electric devices. We present a case of a man who had a likely current mark that could be diagnosed as natural by ruling out the possibility of electrocution with the examination of the electric lamp which had been under the dead body at the scene. This case gives us the importance of appropriate probe about scene evidences supplied by forensic science in diagnosing and ruling out the electrocution.
Autopsy ; Cause of Death ; Diagnosis ; Forensic Sciences ; Shock

This is a statistical analysis based on the data of legal autopsies performed at the Headquarters of the National Institute Scientific Investigation (NISI), requested by every kind of law enforcement agencies during the year of 2005. NISI is located in Seoul, Korea and has three branches throughout the country. The Seoul NISI covers all legal autopsies in Seoul City, Incheon City and Kyunggi Province and some cases referred from other regions. This report aims to analyse various aspects of 2,851 unusual deaths in Korea, chiefly Seoul and its surrounding area. Followings are the summary of the results. 1. The number of male was 2,007 cases (70.4%) and that of female 844 (29.6%). Male was over twice more than female. The forties were 807 cases (28.3%), the thirties 573 (20.1%), and these two decades occupied 48.4%. 2. Unnatural deaths were 1,716 cases (60.2%), natural 1011 (35.5%), and the unknown 124 (4.3%). Among 1,716 unnatural deaths, suicide was 497 (29.0%), homicide 426 (24.9%), accident 510 (29.6%), and the unclear 283 (16.5%). Homicide occupied 42.0% of trauma, 75.6% of blunt force injury excluding traffic and fall-down injury, and 85.5% of sharp force injury. The homicide rate in asphyxia was 31.1%, but it went up to 60.1% excluding hanging. It showed only 0.4% percent of homicide in poisoning. 3. Traumatic deaths were 716 cases, occupying 41.7% of 1,716 unnatural deaths, followed by asphyxial deaths(296 cases). Blunt trauma was 205 cases (28.6%) and the leading cause of death in traumatic death. Poisoning was 229 cases, among which the ethanols were dominant (58cases). Thermal injuries were 198 cases, electrocution 20 cases, and starvation/neglect 14 cases. and 18 cases were directly due to medical procedures. 4. Among 1,011 natural deaths, heart diseases were 481 cases (47.6%), and vascular diseases 193 (19.1%), and these two categories were added up to 674 (66.7%). 5. Child deaths under the age of 10 were 129 cases. Homicide was 40 cases (62.5%) out of 64 unnatural deaths. Neonates including still births were the leading period of age in unnatural death, counting 41 cases(31.8%)
Asphyxia ; Autopsy* ; Cause of Death ; Child ; Ethanol ; Female ; Gyeonggi-do ; Heart Diseases ; Homicide ; Humans ; Incheon ; Infant, Newborn ; Korea ; Law Enforcement ; Male ; Parturition ; Poisoning ; Seoul ; Suicide ; Vascular Diseases