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%).

생물학적 증거물의 채취

황적준 大韓法醫學會 2000 대한법의학회지 Vol.24 No.2

As physical evidence can prove that a crime has been committed or establish key elements of a crime, police investigators deal with evidence on a daily basis. When its collection is performed with a selectivity governed by the collector's thorough knowledge of the crime laboratory's techniques, capabilities, and limitations, physical evidence can only achieve its optimum balue in criminal investigations. Also, their ability to recognize, collect, and use evidence effectively in criminal investigations determines to a large degree their success as the crime investigators. If the investigator cannot recognize physical evidence or cannot preserve it for laboratory examination, no mount of sophisticated laboratory instrumentation or technical expertise can salvage the situation. The know-how for conducting a proper crime-scene search for physical evidence is not beyond the grasp of any police department and forensic practitioners. With proper training, the techniques of crime-scene investigation including collection and preservation of physical evidence are not difficult to master and certainly lie within the bounds of comprehension of the average police officer.

醫療事故와 剖檢의 必要性

尹重鎭,黃迪駿 大韓法醫學會 1987 대한법의학회지 Vol.11 No.1

Insofar as the work of medicolegal investigators is concerned, the investigation of medical accidents associated with deaths constitues one of the most perplexing, challenging, and frustrating categories of cases. In many instances it is immediately clear why a patient has died during the performance of medical or surgical cares. However, even allowing for these categories, there remains a large number of deaths that are not readily or easily explained. These are the cases that present the greatest challenge to skilled forensic pathologist. Detailed postmortem analyses will provide the greatest chances for successful determination of the specific etiology of the pathophysiological processes that produced the patient's death and will there by best serve the legitimate interests of all concerned parties.

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

미토콘드리아 DNA 염기서열 분석법에 의한 가족관계의 규명

남용석,이희석,김희선,이혜린,황적준 大韓法醫學會 1995 대한법의학회지 Vol.19 No.1

The human mitochondrial DNA has two characteristics that make it possible to identify individuals and establish family relationships. First, it is haploid, being exhibited only maternal inheritance. Second, it is highly variable on the hypervariable control region of mitochondrial DNA. Taking advantage of two characteristics of mitochondrial DNA, individual relationships in dispute were identified by combining PCR amplification with direct mitochondrial DNA sequencing. Two persons who alleged the same maternal lineage were identical on the mitochondrial DNA sequences from 15,960 to 16,569 and from 1 to 533. Other two persons were identical on the mitochondrial DNA sequences from 16221 to 16390 each other. However, seven bases are different on the sequences from 16221 to 16390 between two groups,. Even though four persons are kinship, these results suggest that they should come from two different maternal lineage.

pV47-2 多座位 探針을 利用한 親生子鑑定

李卿,明賢君,鄭宰安,黃迪駿 大韓法醫學會 1993 대한법의학회지 Vol.17 No.1

DNA fingerprinting prepared using multi-locus DNA probe can provide valuable testing system in cases of disputed parentage. Because DNA-based testing takes the advantage of limitless numbers of VNTRs loci and the highly informative character of these markers. A simple approach based on Bayesian Theorem is described to the interpretation of the DNA fingerprints in disputed paternity cases that are detected by pV47-2 multilocus probe, including a Korean woman who has sought her biological father to a family consisting of a father and his two child. This paper then outline the analysis of each paternity case and give a numerical example as following results ; 1. From band-sharing coefficient(X=0.18) of DNA fingerprints detected by pV47-2 multilocus probe, the probability(r) that a parent will pass on a given DNA fingerprint to an offspring is 0.525. 2. As the biological mother(M), child(C), and alleged father(AF), or random man(RM) exhibit a given DNA fingerprint, paternity index(PI) is 1.298. 3. As alleged father or random man and Child share a given DNA fingerprint, but not M, PI is 5.526. 4. As the biological mother and child share a given DNA fingerprint, but not alleged father of random man, PI is 0.885. 5. As alleged father or random man only shares a given DNA fingerprint, PI is 0.525, whereas the biological mother only has one, PI is 1.1. 6. As the biological mother and alleged father or random man share a given DNA fingerprint, but not child, PI is 0.526. 7. When the biological mother, child and alleged father or random man do not share a given DNA fingerprint, PI is 1.1. 8. From the above paternity indices, likelihood ratio(LR) in case 1 is 99.994%, LR for child 1 and 2 in case 2 is 99.97% and 99.999%, respectively, but LR for unknown female in case 3 is 62,589% whereas LR for child 1 and 2 is 99.996% and 99.928%, respectively.

氣管切開術後 合倂症으로 發生된 溺死 1例

黃迪駿 大韓法醫學會 1987 대한법의학회지 Vol.11 No.1

The case of a 30-year-old male who died suddenly and unexpectedly of asphyxia due to intrabronchial bleeding is presented and the pathomechanism of hemorrhage following tracheostomy is breiefly reviewed. It is suggested that the intrabronchial bleeding occured as a late complication of tracheotomy results in asphyxia by drowning even through no more than a few ounce of blood are lost. It is hoped that the comment may help in diminishing the number of post-tracheotomy bleeding especially of hemorrhage due to erosion.

任婦傷害의 剖檢統計分析

尹重鎭,黃迪駿 大韓法醫學會 1986 대한법의학회지 Vol.10 No.2

In order to evaluate the death structures of the pregnant women autopsied, a total of 267 cases out of 10,650 legal autopsies in the Department of Legal medicine, National Institute of Scientific Investigation during 1976-1985 were analyzed with emphasis on Cause and Manner of Death. The results obtained were as follows: 1. The annual death of the pregnant women autopsied was 2.5% and its trend was downward slowly. 2. In age distribution, the most prevalent grop was the first half of 20's (35.6%), followed by the latter half of 20's (25.1%), of 10's (13.5%)and the first half of 30's (13.1%). 3. In manner of death, natural death was 55.4%, comparing with 40.1% of violent death which includes 22.8% of accident, 9.0% suicide and 8.2% homicide. 4. Hemorrhage (39.3%) was the leading cause of death in the pregnant women autopsied and some others such as poisoning (15.0%), infection (7.9%), congestive heary failure (7.5%), toxemia (6.0%) and asphyxia (5.2%) ranked in that order. 5. Among 105 cases of hemorrhage, 75.3% was found to be obstetric, while 24.7% to be non-obstetric. 6. In accidents, the major cause of death was carbon monoxide poisoning (34.4%) and hemorrhage (29.5%) and infection (24.6) occured by medical interventions. 7. In suicides, poisoning (79.2%) was found to be a major cause of death and the major agents used were cyanide(37.5%) and agricultural chemicals (16.7%). 8. In homicides, asphyxia such as manual and ligature strangulation was the leading cause of death. 9. In the pregnant women autopsied, 39.0% were died in the full term of pregnancy, followed by the first trimester (22.8%), the second trimester (17.2%) and the third trimester (10.9%) of pregnancy. 10. It could be inferred that most of the violent death were frequently occured in the first trimester of pregnancy, while the natural death predominantly being in the full term of pregnancy. However, hemorrhage and infection caused by medical intervention had a tendency to be occured in the second trimester and full term of pregnancy.

한국인에서 다변성 D12S391 유전좌의 집단유전학적 연구

이용욱,김성민,구태완,이혜린,강일호,한길로,이혜승,황적준 大韓法醫學會 1999 대한법의학회지 Vol.23 No.1

The hypervariable short tandem repeat(STR) locus D12S391 was investigated in a Korean population. A total of 14 alleles were detected by size under denaturing conditions in 517 unrelated individuals. To confirm all of the alleles detected in a Korean population, a total of 34 fragments were sequenced. Prior to allele designation, we constructed the allelic ladders containing 11 alleles sequenced in this study. Allele 18 is the most common with a frequency of 0.281 in Koreans, and one variant allele 19.3 which have been confirmed by sequencing, was detected. The observed heterozygosity, the power of discrimination (PD), and the mean exclusion chance (MEC) for the locus D12S392 is 0.781, 0.946 and 0.652 , respectively. No deviation from Hardy-Weinberg equilibrium was observed in a Korean population (p=0.557). In the 424 meioses in 105 Korean families confirmed using other 17 STR loci, no mutation was detected in locus D12S391. The STR locus D12S391system is useful both for the analysis identification and parternity.

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.