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익사 사례에서 Postmortem CT 영상을 활용한 U-Net 기반 나비굴 내 액체 자동 분할: 타당성 연구
허진행,장선정,권정화,고영산,임상범,이수경,서인수,나주영,김예지,윤용수 대한법의학회 2024 대한법의학회지 Vol.48 No.1
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.
허진행,임상범,장선정,권정화,나주영 대한법의학회 2023 대한법의학회지 Vol.47 No.4
Intracranial hemorrhage is a major cause of sudden unexpected death and its identification is important for death investigations. Cisternal puncture of the cerebellomedullary cistern (CMC) can be used to identify intracranial hemorrhage during postmortem examination. Intracranial hemorrhage comprises various types of hemorrhage, and the possibility of hemorrhage identification by cisternal puncture can differ according to the type of intracranial hemorrhage. Postmortem computed tomography (PMCT) is non-invasive and can be performed before autopsy. In this study, we aimed to identify the hemorrhage in the CMC using PMCT in cases of various intracranial hemorrhage. PMCT was performed before the autopsy. Autopsy reports and PMCT were retrospectively reviewed for 108 cases of intracranial hemorrhage confirmed by conventional autopsy. Hemorrhagic regions showed ≥60 Hounsfield units on PMCT. Hemorrhage in the CMC was identified in 42.6% (46/108) by PMCT and was frequently identified in the cases of basal subarachnoid hemorrhage (SAH) (19/21). Hemorrhage in the CMC was identified in approximately 50% of patients with non-basal SAH and intracerebral hemorrhage. Detection of hemorrhage in the CMC by PMCT is hindered by several factors, such as dental artifacts. This study does not guarantee the usefulness of postmortem cisternal puncture. However, this study verified hemorrhage in the CMC according to the various types of intracranial hemorrhages using PMCT and showed its possibilities and limitations.
허진행,나주영,박영일,고영산,함석훈,권훈 대한법의학회 2022 대한법의학회지 Vol.46 No.3
The coronavirus disease 2019 (COVID-19) pandemic resulted from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Variants of SARSCoV-2 have caused distinct COVID-19 surges worldwide. The Omicron variant has replaced other variants as a cause of COVID-19 in the Republic of Korea. Fortunately, COVID-19 patients infected with Omicron have a decreased disease severity. Tuberculosis (TB) remains a major public health threat worldwide, and the incidence of TB is still high in the Republic of Korea. We report the case of a deceased illegal migrant who died at home. An autopsy revealed fatal pneumonia with pulmonary TB caused by the Omicron subvariant BA.2 of SARSCoV-2. We assumed that a superimposed SARS-CoV-2 infection caused this fatal pneumonia with a previous TB infection. After a comprehensive postmortem (PM) examination, including gross dissection, microscopic studies, PM computed tomography, and PM laboratory tests, the cause of death was determined to be pneumonia, and the death manner was natural. We present this case with a comprehensive PM examination from the perspective of forensic pathology and the public healthcare system.
방사선 치료 시 EPID와 OBI의 유용성에 관한 연구
허진행(Jinhang Heo),신재봉(Jaebong Shin),구효근(Hyogeun Koo),송재흥(Jaeheung Song),구재흥(Jaeheung Koo) 한국방사선학회 2014 한국방사선학회 학술대회 논문집 Vol.2014 No.춘계
선형가속기를 이용한 방사선 치료가 증가되면서 치료의 정확성 및 재현성 향상을 위한 치료부위 확인 장치도 많은 발전 을 거듭해 왔다. 본 연구는 방사선 치료 전 치료부위 확인 영상장치인 EPID와 OBI를 이용하여 치료부위의 영상을 획득하 였다. 모의치료 시 팬톰 자세 및 위치 영상과 치료부위 확인 영상을 비교하여 두 장치의 유용성을 평가하고자 한다. 팬톰이 위치한 치료테이블을 측면으로 2 cm, 5 cm, 10 cm씩 각각 이동하여 두 장치의 오차를 확인하였다. 테이블을 측면으 로 10 cm 이동한 결과 0.4∼0.6 cm의 오차가 나타났지만, 테이블의 2 cm, 5 cm의 거리 이동에서는 두 영상에서 오차가 작게 나타났다. 즉, 두 장치모두 치료부위의 이동은 오차가 발생하지만 OBI를 이용한 영상이 EPID에 비해 환자의 치료 부위를 확인하기에 높은 화질의 영상을 제공하므로 보다 객관적이고 정확한 치료부위의 보정이 가능하며, 임상에 근무하 는 방사선사의 업무 효율 또한 증가 될 것으로 사료된다. With increased radiotherapy using a linear accelerator, there has been continuous progress in devices locating treatment sites to improve the accuracy and repeatability of treatment. The study acquired the images of treatment sites using EPID and OBI which are image equipment to identify treatment sites prior to radiation therapy. It attempts to evaluate the usefulness of the two devices by comparing the image of the postures and locations of a phantom with those of locating treatment sites. The error in the images from the devices was identified by moving the treatment table where the phantom was located 2 cm, 5 cm, 10 cm laterally. The error range in the images was 0.4∼0.6 cm when the table was moved 10cm, while it was smaller when the table was moved 2 cm and 5 cm. In other words, while moving treatment sitescaused errors in both devices, since OBI provides higher quality images than EPID, enable more objectiveand accurate locating of treatment sites, it is considered to increase work efficiency of radiological technologists in clinics.
형광 Peptide를 이용한 Streptomyces griseus IFO 13350의 인산화 단백질 동정
허진행 ( Jin Haeng Her ),정용훈 ( Yong Hoon Choeng ),김종희 ( Jong Hee Kim ),신수경 ( Soo Kyung Sin ),현창구 ( Chang Gu Hyun ),강상순 ( Sang Soon Kang ),천재순 ( Jae Sun Chun ),강대경 ( Dae Kyung Kang ),홍순광 ( Soon Kwang Hong 한국미생물생명공학회 2002 한국미생물·생명공학회지 Vol.30 No.3
The Significance of Detecting Diatoms in Spleen Tissue for the Postmortem Diagnosis of Drowning
고영산,함석훈,허진행,임상범,박영일,권정화,김경열,송호석,장선정 대한법의학회 2024 대한법의학회지 Vol.48 No.1
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.
나주영,권희주,허진행,박영일,임상범 대한법의학회 2021 대한법의학회지 Vol.45 No.3
A malignancy is a fatal condition that could occur through various mechanisms. Forensic pathologists sometimes find unexpected findings during autopsy and post-mortem (PM) tests. Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. The deceased was a 64-year-old man with a medical history of right hemicolectomy due to colon cancer approximately two years earlier. He was found dead at his home. He was admitted to the hospital due to subdural hemorrhage (SDH) two days prior to his demise and was discharged without the permission of the doctor after one day of hospitalization. An autopsy was performed within two days of his death. After gross dissection, the cause and manner of death were assumed to be SDH and unnatural death, respectively. Microscopic examination revealed fresh SDH and dural metastasis of signet-ring cell carcinoma. Furthermore, metastasis was identified in the heart, stomach, and peritoneum. Immunohistochemical examination revealed cancer cells to originate from the colon. After meticulous PM examination, including gross dissection, microscopic examination, PM computed tomography, and PM laboratory tests, the cause and manner of death were determined as SDH and natural death, respectively. This case report highlights the importance of comprehensive PM evaluation for investigating death.
황청수,나주영,고영산,박영일,허진행,송호석 대한법의학회 2022 대한법의학회지 Vol.46 No.4
Coronavirus disease 2019 (COVID-19) is a manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and its major symptoms include pulmonary complications, such as pneumonia. However, it also involves the cardiovascular system and the developed myocarditis can lead to sudden unexpected death. Herein, we present a case in which a patient died four days after release from isolation due to SARS-CoV-2 infection. SARS-CoV-2 was confirmed again during postmortem (PM) inspection at the scene of death. Autopsy revealed myocarditis and evidence of pulmonary involvement with SARS-CoV-2. Pathological examination revealed myocardial perivascular infiltration of lymphocytes and macrophages with multifocally injured cardiomyocytes. The pathological findings of COVID-19–induced myocarditis differ from those of other viral myocarditis, and we assume that different pathophysiological mechanisms could have been responsible for this manifestation. After a comprehensive PM examination, including gross dissection, microscopic examination, PM computed tomography, and PM laboratory tests, the cause and manner of death were determined to be myocarditis caused by COVID-19 and naturally, respectively. This case highlights the significance of autopsy and comprehensive PM examinations in both forensic and public healthcare systems.