한국인 콩팥문 및 콩팥동맥, 정맥, 요관의 관계

최병영(CHOI Byoung Young),김광진(KIM Kwang Jin¹),이혜연(LEE Hye Yeon),서원석(SIR Won Seok),정인혁(CHUNG In Hyuk),이한영(LEE Han Young²),서재관(SUH Jai Kwan²) 대한체질인류학회 1992 해부·생물인류학 (Anat Biol Anthropol) Vol.5 No.1

한국인 콩팥과 콩팥문의 형태학적 변이를 조사하여 임상적 응용에 도움을 주고 체질인류학적으로 다른 종족과 비교하여 차이가 있는지를 밝히고자 한국 성인 콩팥 204개(신선한 것 81개 포함)를 해부하여 콩팥의 크기와 모양, 콩팥문의 형태, 콩팥문 바깥에서 콩팥동맥, 정맥, 요관의 위치관계, 콩팥동맥이 나뉘는 모양, 콩팥문에서 형관의 가지와 요관의 위치 관계를 관찰하였다. 1.콩팥의 크기를 신선한 것 81개에서 측정하였다. 콩팥크기의 평균은 세로길이 10.0±0.9㎝ , 가로길이 5.8±0.6㎝, 두께 3.8±0.5㎝였고, 양쪽 콩팥의 차이는 없었다. 2.콩팥을 가로길이에 대한 세로길이의 비를 기준으로 세가지 유형으로 분류하였고 이즁 강낭콩 모양을 한 것이 73%였다. 3.콩팥문의 모양은 뷸규칙했으며, 문의 방향은 내측을 향한 것이 58.5%였다. 4.콩팥 내측면에 접하는 면보다 근위쪽 1㎝부의에서 콩팥동맥과 정맥 그리고 욕관이 이루는 관계에 따라 5유형으로 뷴류하는데, 동맥이 위쪽에 있고 그 아래에 정맥, 정맥 뒤에 요관이 있는 형이 68.1㎝였다. 5.콩팥 내측면에 접하는 면에서 콩팥동맥이 나뉘어져 있는 상태를 4유형으로 분류하였으며 가지가 나위어져 있지 않는 것이 42.2%였다. 6.콩팥문 안에서 요관과 콩팥동맥과 공팥정맥 가지들의 배열상태는 콩팥동맥의 가지가 요곤을 둘러싸듯 고리처럼 원형으로 배열되어 있는 경우가 91.2%였다.

法醫剖檢鑑定

徐在冠 大韓法醫學會 1992 대한법의학회지 Vol.16 No.2

Ⅰ. A Statistical Observation This report aims to reveal facts on various causes of death in Korea in an attempt to analyse 2,107 cases which were performed medicolegal autopsy in National Institute of Scientific Investigation during the year of 1991. The following are the summary of results ; 1. The total numbers of autopsy were 2,017 cases, of these 1,523 (75.5%) cases were males and 494(22.9%) cases were females. 2. Violent deaths were 1,291(64.0%) cases, natural deaths were 661(32.8%) cases, negative autopsy were 34(1.7%) cases and unknown cases due to severe decomposition were 31(1.5%). 3. In violent deaths : deaths due to injury were 629(31.2%), asphyxial deaths were 284 (14.1%), deaths due to abnormal temperature were 104(5.2%) and deaths due to intoxication were 274(13.6%). 4. In natural deaths : deaths due to disease of the cardiovascular system were 403(20..0%), the central nervous system were 81(4.0%), the gastrointestinal system were 75(3.7%), the respiratory system were 59(2.9%), the genitourinary system were 10(0.5%) and miscellaneous cases were33(1.6%). Ⅱ. Case Reviews ·Case A : Hemoperitoneum due to liver needle biopsy ·Case B : Rupture of the right internal iliac artery aneurysm ·Case C : Asphyxial deaths (a male and a female) due to stab of the trachea

1994년도 法醫剖檢 통계분석

서재관,김종열 大韓法醫學會 1995 대한법의학회지 Vol.19 No.2

This is a statistical observation by authors based on the data of so called unusual death brought to this institute for medicolegal autopsy by all of law enforcement agencies in Korea in the year of 1994. This report aims to reveal the facts on various causes of unusual death in Korea. The following are the summary of results, 1. The total numbers of autopsy made for the unusual deaths were 2,123 cases, of these 1,576 cases were males and 547 cases were females. 2. Violent deaths were 1,380 cases (65.0%), natural deaths were 657 cases (30.9%), and unknown cases were 86(4.1%). 3. For deaths due to injuries, blunt object injuries were the leading ahead. 4. Asphyxial deaths were 340 cases, 16.0 percents of the total and drowning were 139 cases showing the biggest number among the asphyxial deaths. 5. Deaths from abnormal temperature and electricity were death due to fire, burning, hypothermia, heatstroke and electrocution. 6. There were 5 cases for starvation 7. Infanticides were 8 cases, 0.4 percent of the total number. 8. For the death due to intoxication, 236 cases (11.1%) were recorded and the biggest number among these was CO intoxication. 9. For the natural death, 657 cases, 30.9 percents of the total were recorded and the death due to the disease of the cardiovascular system was taking the most of the total number with 323 cases. 10. Cause of death unknown due to negative autopsy and to the severe decomposition of the body were 86 cases, 4.1 percents of the total number

主要 法醫剖檢 鑑定例(1993)

徐在冠 大韓法醫學會 1994 대한법의학회지 Vol.18 No.2

?? Case Ⅰ : Silicon embolism (46-year-old woman) Silicon(ploy-dimethyl-siloxane) is a polymer with a minimal tissue reaction and a high degree of thermal stability. So it is widely used for medical purpose, especially in the correction of minor contour defects. Illegal injections of silicon in human beings, however, have been associated with many adverse effects, including migration of the silicone, skin hypopigmentation, granulomatous hepatitis, sclerosis, and human autoimmune diseases. Silicon may migrate through the subcutaneous tissue to areas as far away as the parenchymal organs such as lungs. Now, a lung embolism is reported in a case involving death following repeated injections of liquid silicone for vaginal wall reconstruction(vaginoplasty). ?? Case Ⅱ : Choking by hen egg (17-year-old girl) Choking is suffocation due to obstruction of the air passages by a foreign body which is not unusual for a large piece of food hastily swallowed, often in drunkenness, to lodge in the upper pharynx, there become impacted, compressing the epiglottis and the entracne of the larynx. This condition is referred to as "cafe-coronary" because it mimicks a heart attack. Food aspiration following suppression of the gag reflex by tranquilizing drugs is a common phenomenon in mental institutions. A 17-year-old girl inhaled the piece of hen egg during her breakfast time in mental hospital. She lapsed into unconsciousness and became cyanosis in front of nurse. At autopsy her blood alcohol level was negative, and she was not under the influence of medication. ?? Case Ⅲ : Venom intoxication (55-year-old woman) Snake venoms are slightly viscid fluids, usaually pale yellow to amber. Numerous enzymes have been identified in snake venoms. Hyaluronidases which present in most venoms, Proteases which cause local inflammation, necrosis and damage to vascular epithelium, Phospholipase A, which is most toxic, alters membrane permeability and releases histamine, thus contributing to hemorrhage and shock, Phosphodiesterase which may be responsible for some of the hypotensive effect of venoms and Esterases which liberate bradykinin. Clinically, anticoagulant activity of venoms is more important and may result from destruction of fibrinogen or prothrombin, or in vivo defibrination with formation of minute fibrin emboli. The clinical symptoms are severe local pain, edema spreading from the bite, painful lymphadenopathy, and local ecchymosis. Systemic manifestations include nausea and vomiting, thirst, sweating and fever. Therapy in snakebite has five aims : ①retarding absorption of venom and removing as much as possible by mechanical means, ②neutralizationof venom by immune serum, ③counteractiong specific pharmacologic activities of the venom, ④relief of symptoms, and ⑤prevention of complications. This case represents the death due to venom intoxication who is bited by snake while working in her peanut field.

法醫副檢 鑑定例 : 自絞死의 2例 Two Cases of Suicidal Ligature Strangulation

徐在冠 大韓法醫學會 1990 대한법의학회지 Vol.14 No.2

Suicidal ligature strangulation deaths are uncommon tragedies. Normally, self-ligature strangulation is prevented as the individual becomes unconscious as the venous circulation is obstructed, leading to relaxation of the ligature tension. The hallmark of self-strangulation is usually accepted, when a cord may be firmly applied with multiple turns without knotting of the free ends, and when a ligature is firmly applied with one or more turns and a final tying of the free ends with a half-knot or half hitch. The following case report describes two interesting cases of suicidal self-strangulation. One victim (Case 1) was a women aged 30 whose body was found in her own room. The cord was firmly applied with three turns. The first turn was tight, but the second and the third, although close to the first were easily released and the ligature round her neck was left in a half-knot. The second victim (Case 2) was a women aged 36 whose body was found in old ruined house. The cord was applied with one-half turns and extended to her both feet. The neck and waist were extended while both hip joint were fully abducted with both knee joint were fully flexed.

法醫剖檢統計 (1990)

徐在冠 大韓法醫學會 1991 대한법의학회지 Vol.15 No.2

This is a statistical observation by the author based on data of deaths brought to National Institute of Scientific Investigation for medicolegal autopsy by all of law enforcement agencies in Korea during the year of 1990. The report aims to reveal facts on various causes of death in Korea in an attempt to analyse 2,177 cases statistically. The following are the summary of results; 1. The total numbers of autopsy were 2,177 cases, of these 1,679 cases (77.1%) were males and 498 cases (22.9%) were females. 2. Violent deaths were 1,342 cases (61.6%) and natural deaths were 763 cases (35.0%) and unknown cases were 72 (3.3%). 3. In violent deaths; The percentage of autopsied cases with 20's age group was 30.1% (the most), 30's was 26.8%, 40's was 17.5%, 10's was 10.3%... in male and 20's was 29.3%, 30's was 24.0%, 10's was 11.8%, 0's was 9.8% ... in female. In natural deaths; The percentage of autopsied cases of 30's was 29.3%(the most), 40's was 25.7%, 20's and 50's were 14.3% ...in male and 3-'s was 23.5%, 20's was 22.7%, 40's was 15.9%, 0's was 13.6% ... in female. 4. For deaths due to injuries, head traumas were the leading ahead (191 cases, 60.5) cause of death. 5. Asphyxial deaths were 322 cases, 14.8% of the total and drownings were the biggest number among the asphyxial death. 6. For the death due to the intoxication, carbon-monoxide intoxication was the most prevalent (154 case, 7.1% of the total) ethanol and butane intoxication were increased yearly. 7. For the (sudden) natural death, 763 cases 35.0% of the total were recorded and the death due to the disease of the cardiovascular system was taking the most of the total number with 434 cases in all.

燒死 및 爆發死의 檢屍

徐在冠 中央醫學社 1988 中央醫學 Vol.53 No.5

The mechanism of death in conflagrations is a complex one of burning, toxic gas (carbon monoxide, cyanic gas, etc.) intoxication and oxygen deficiency, and in explosions is also a complex one of mechanical injury, heat damage and carbon monoxide intoxication. In these cases, the body has to be identified and the cause of death has to be established and also it has to be decided if the death was due to burns, at what time death occurred, if it was the result of an accident, homicide, or suicide. The most important signs of vital conflagrations (or sometimes explosions) are : Carbon monoxide hemoglobin formation in the blood, The aspiration or swallowing of carbon particles, Secondary reactions in damaged areas of skin, pharynx, and respiratory tract, and Toxic changes of parenchymatous organ.

燒死 및 爆發死의 檢屍

徐在冠 大韓法醫學會 1987 대한법의학회지 Vol.11 No.2

The mechanism of death in conflagrations is a complex one of burning, toxic gas(carbon monoxide, cyanic gas, etc.) intoxication and oxygen deficiency, and in explosions is also a complex one of mechanical injury, heat damage and carbon monoxide intoxication. In these cases, the body has to be identified and the cause of death has to be established and also it has to be decided if the death was due to burns, at what time death occurred, if it was the result of an accident, homicide, or suicide. The most important signs of vital conflagrations(or sometimes explosions)are : Carbon monoxide hemoglobin formation in the blood, The aspiration or swallowing of carbon particles, Secondary reactions in damaged areas of skin, pharynx, and respiratory tract, and Toxic changes of parenchymatous organ.

영兒殺(Infanticide)

徐在冠 大韓法醫學會 1993 대한법의학회지 Vol.17 No.2

Child murder is infrequent and committed in most instances by the parencts. Most attention has been directed to the universal phenomenon of child abuse. Infanticide was identified as being clinically different from other forms of child murder by parents because the crime is usually committed by young, single, immature, unmarried and not mentally ill women. The apparent motive of the infanticide was that child was unwanted. Hominides of children by their parents have been discussed in medical, psychiatric aspects. Especially infanticidal behaviour in parents may mostly be associated with common forms of psychiatric disorders. So the major contributions to the classification of child murder have been based mostly on the motives or the source of the impulse to kill. It is extremely important for the scene investigator to personally interview the individual who was caring for the infant at the time be died and also to interview the first person who discovered the child.

窒息死의 檢屍

徐在冠 大韓法醫學會 1989 대한법의학회지 Vol.13 No.2

Asphyxia is applied to those circumstances in which mechanical interference either 1) impedes access of air to the lungs 2) interferes with the cerebral blood supply 3) interferes with the vagal nerve supply which results in arrest of the heart and coincident cessation of breathing. For practical purpose, mechanical asphyxia falls into one of the following categoris: 1. Compression of the neck a. Hanging b. Ligature strangulation c. Manual strangulation (throttling) 2. Suffocation a. smothering b. Choking c. Traumatic or crush asphyxia d. Overlying 3. Drowning a. Wet drowning b. Dry drowning