事故死의 法醫剖檢 統計

黃迪駿 中央醫學社 1987 中央醫學 Vol.52 No.11

In order to evaluate the death structures of the accidental death in legal autopsy, a total of 1,751 cases out of 6,256 legal autopsies performed in National. Institute of Scienti-fic Investigation, during 1982-1986 were analyzed with. emphasis on types and causes of accidental death. The results obtained were as follows: 1. The annual death of accidental cases was 28.0% and the male to female sex ratio in the legal autopsy cases of accident was 1.78. 2. In age distribution, the most prevalent group was 20's (37.6% followed by 30's (18.6%, 10's (18.3%) and 40's (11.5%). 3. Pneumonia was the leading cause of death below 9, while carbon monoxide poisoning in other age groups. 4. In accidents the major types of death were poisoning (42.6%), asphyxia (17.6%), medical accidents (14.6%). traffic .accidents (8.0%) and fall from height (6.3%). 5. In. death related to medical care, the major causes of death were pneumonia (16.9%), atonic uterine bleeding (10.6%), coronary atherosclerosis (8.6%) and congestive heart failure (7.0%).

外傷과 脂肪栓塞症

黃迪駿 大韓法醫學會 1988 대한법의학회지 Vol.12 No.2

The topic of fat embolism forms a clearly defined area of discussion within the field of the pathology of trauma. Natural fat embolism was first described by Zenker in 1862 and a connexion between pulmonary fat embolism and injury involving bone marrow was demonstrated by Bush shortly afterwards. This blockage of capillaries and arteriols by fat gloubles has given rise to conflicting opinions since its initial description, and to this day there is widespread lack of agreement as to its frequency, etiology, pathogenesis, and clinical significance. The purpose of this paper is to give a brief review of the subject with an attempt to put it inot a relevant perspective.

檢屍와 無所見剖檢

黃迪駿 大韓法醫學會 1989 대한법의학회지 Vol.13 No.2

The forensic pathologists or medical examiners involved in the investigation of medicolegal cases can expect to come across cases of negative autopsy. One may consider that when no cause of death is found at the postmortem table the autopsy is negative. An autopsy is considered to be negative when all efforts, including gross and microscopic studies and toxicological analyses, fail to reveal a cause of death. Theoretically speaking, there must be a cause of death, but in practice it is not possible to establish the true cause of death in every case. A negative autopsy may result from one of the following factors. 1. Autopsy carried out without adequate history. 2. Lapses in external examination 3. Inadequate or improper internal examination. 4. Insufficient histological examination 5. Lack of toxicological and other investigations. 6. Pathologist's training. In the following paragraphs, several of the conditions that can be missed at autopsy or those that can create difficulty in interpretation are described. 1. Deaths from fright or shock 2. Concealed or apparently insignificant trauma. 3. Lesions of the nervous system 1) Concussion 2) Atlanto-occipital joint dislocation with spinal cord injury 3) Epilepsy 4) Chronic encephalitis 5) Fat or air embolism 6) Delirium tremens 4. Lesions in the neck 5. Lesions of cardiovascular system 1) Distal coronary artery occlusion 2) Coronary spasm 3) Pathology of the SA and AV nodes and bundle of His 4) Asymmetrical obstructive hypertrophy of the heart 5) Myocarditis 6) Periarteritis nodosa 7) Brown atrophy of the heart 8) Sarcoidosis 6. Lesions of the adrenal glands 7. Sickle cell disease 8. Decomposition

우리나라 法醫學의 現況 : 법의학 교육과 검시제도에 대해 Medicolegal Education and Postmortem Investigation System

황적준 大韓法醫學會 1992 대한법의학회지 Vol.16 No.1

In Korea, nothing had been written on legal medicine nor was it a subject of instruction or the modern medicolegal system up till the middle of this century. This is understandable as in political and social chaos, and economical indigence being experienced under the way that our country had been going through many stages of the social modernization. With each passing year, however, the legal medicine and forensic scineces in our contry are called upon to play roles of ever-increasing importance in the civil and criminal justice systems. There also seems to be a greater awareness on the part of medical and law school eductors as well as the whole people of our country. Though many difficulties may remain in the path of the medicolegal progress, there be a steady advance occuring that cannot be stopped and that will be continue until every pary of our contry is served by an efficient medicolegal service, a service which can be only rejected if it is willig to pay the price of justice in its stead. To reach this goal, a turnover of the mdicolegal education and the present postortem investigation system should be required.

創傷의 經過時間

黃迪駿,李羲碩,南容碩 大韓法醫學會 1994 대한법의학회지 Vol.18 No.2

When examining a victim of viloence, no forensic pathologist is fulfilling his role when one confines the report to merely a numbered lists of wounds found on the corpse. Of course, the nature, exact position, and dimensios of every injury should be described, and it should e photographed. However, the distinction between antemortem and postmortem injuries and their proper timing is one of the cardinal problems of froensic medicine. It help not only to convict guilty but also to acquit persons who are suspect but in factnot guilty. The cause of death is sometimes of less importance than the recsotruction of events, which may become possible with careful examination of the wounds and their proper timing. As with time of death, it can be a very dificult matter in forensic medical investigations to determine whether a wound found at autopsy was inflicted before or after death, and if ante-mortem, how long before death was it sustained? Unfortunately, as with so many problems, biological variability introduces a wide range of uncertainty about the time of wound, so that a range of probabilities can be offered, but never a definite time interval. Therefore, the purpose of this paper is to discuss pros and cons about various dating methods of ante-mortem wound that have been published.

심장의 물리적손상

황적준 大韓法醫學會 1995 대한법의학회지 Vol.19 No.2

Numerous physical agents may impart energy in harmful form to body tissues or may create an injurious environment so that, under proper circumstances, some are capable, directly or indirectly, of damaging the various kinds of body tissue including cardiovascular structures as environmental disorders. However, it is impossible to consider all the disorders encompassed within even our limited interpretation of the term environmental pathology. Here our consideration is restricted to the legally significant causes of heart disorder. : The physical agents most commonly alleged as possibly injurious to the heart are 1) ultraviolet, infrared, and microwave radiation, 2) the ionizing radiation, 3) abnormal temperature and humidity, 4) abnormal barometric pressures, 5) vibrations, unpleasant sounds and noises, and 6) electric currents.

事故死의 法醫剖檢 統計

黃迪駿 大韓法醫學會 1987 대한법의학회지 Vol.11 No.2

In order to evaluate the death structures of the accidental death in legal autopsy, a total of 1,751 cases out of 6,256 legal autopsies performed in National Institute of Scientific Investigation during 1982-1986 were analysed with emphasis on types and causes of accidental death. The results obtained were as follows: 1. The annual death of accidental cases was 28.0% and the male to female sex ratio in the legal autopsy cases of accident was 1.78. 2. In age distribution, the most prevalent group was 20's (37.6%) followed by 30's(18.6%), 10's(18.3%) and 40's(11.5%). 3. Pneumonia was the leading cause of death below 9, while carbon monoxide poisonining in other age groups. 4. In accidents the major types of death were poisoning (42.6%), asphyxia(17.6%), medical accidents(14.6%) traffic accidents(8.0%) and fall from heigh(6.3%). 5. In death related to medical care, the major causes of death were pneumonia(16.9%), atonic uterine bleeding(10.6%), coronary atherosclerosis(8.6%) and congestive heart failure(7.0%).

螢光像 測定法으로 分析한 HUMACTBP2 遺傳座位에 대한 韓國人의 遺傳的 多樣性과 法醫學的 有用性

황적준,남용석,최하주,이혜린,한길로 大韓法醫學會 1997 대한법의학회지 Vol.21 No.1

The HUMACTBP2 locus was investigated to collect population genetic data in the Korean population and to evaluate the applicability for the forensic field. An Automatic fluorescent-based sequencer (377 automatic DNA sequencer, ABI) was used to detect amplified fragments of the HUMACTBP2 locus electrophoresed on 4% denaturing polyacrylamide sequencing gels. ACTBP2 allelic ladder consisting of different sizes of 18 alleles was constructed and employed as an internal size standard in combination with a GS-350 size standard for precision of allele-band sizing. By utilizing different fluorescent dyes, both the allelic ladders and samples were able to be analyzed in the same lane by 99% precision of allele-band sizing. Among the Korean population (n=224), 26 alleles in the range of 239-313 bp are determined. Allele No. 6 is found 45 times (0.100) which is mostly frequent, and the rest of allele is distributed with their relative frequency of 0.112-0.100. The comparison between observed and expected numbers of homozygous and heterozygous individuals confirms that ACTBP2 locus is in the state of Hardy-Weinberg equilibrium among the Korean population. The heterozygosity is 0.9389±0.0034(93.89%), and the power of discrimination)PD) and power of exclusion(PEX) are calculated to be 0.991(99.1%) and 0.890(89.0%), respectively, showing the high informativeness for individual identification. Thus, these results mean that the HUMACTBP2 locus can effectively be used for the forensic application.

韓國人에서 미토콘드리아 DVA 轉寫調節 部位의 鹽基存列 多樣性과 法醫學的 活用性

黃迪駿,李奭秀 大韓法醫學會 1995 대한법의학회지 Vol.19 No.2

In addition to the nuclear genome, the rapidly evolving noncoding region containing the D-loop in the mitochondrial genome is another DNA sequence that appears suitable for ascertaining genetic individuality. The maternal inheritance of the mitochondrial DNA makes it possible to analyse nucleotide sequence of the mtDNA hypervariable region via polymerase chain reaction(PCR) whether individuals are maternally related, or not. However, no significant population data in Korean have been available to assess the potential of the mtDNA hypervariable region. By direct sequencing of each amplified DNA product, about 440 bp-long segment of the hypervariable control region I of mitochondrial DNA (mtDNA) from 100 Korean individuals have been studied. The data are analysed to get an information of genetic characteristics of the mtDNA hypervariable control region I in Korean Population. Among these sequences 74 nucleotide sites are polymorphic, 69 nucleotides of which is substituted by transition(88.5%) and 9 nucleotides by transversion(11.5%). From one hundred Korean individuals 83 mtDNA lineage types are found ; 26 individuals are represented by nine different mtDNA types and the rest have each mtDNA type. Twenty-six individuals grouped by nine mtDNA types are confrmed to be the different one by the DNA typing of VNTR alleles of DIS80. In Korean population(n=100), nucleotide diversity of mtDNA hypervariable control region I is 0.95% on average, and gene diversity 0.982. The probability that two unrelated are genetically identical for this section of mtDNA is 0.018, resulting in 98.2% of power of discrimination(PD). These results suggest that more sequence analysis of the mtDNA hypervariable region containing control regionⅡ would be needed to distinguish one from other, who are not maternal relatives.

부검에 대한 일반 대학생과 의과 대학생의 인식도

황적준,김정아,한길로 大韓法醫學會 1999 대한법의학회지 Vol.23 No.1

The attitude toward the use of autopsies affects the incidence of performance of th procedure. In foreign countries, many studies on this subjects have been conducted. However, in Korea, no study has been reported. We hypothesized that the general university students may be negative, whereas the medical college students may have positive attitude toward the use of autopsies. In contrary to our hypothesis, there existed only a little difference for the attitude toward conducting an autopsy between the general university students and the medical students. Both groups had positive attitudes toward autopsy. When the medical students become medical doctors, the main reason for not requesting patients to be conducted an autopsy is that their family members may feel offended. These results show that the low incidence of autopsy cases in Korea is caused not by the attitude of the general population, but by the attitude of medical doctors. Thus, we should make every effort to increase the incidence of autopsy by educational programs and discussions about autopsy and death.