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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.
부검 실무에서 사후 검체를 이용한 C-반응단백질 검사에 대한 연구
오연호,함석훈,박정우,김형석,박종태,나주영 대한법의학회 2016 대한법의학회지 Vol.40 No.1
C-Reactive protein (CRP) is an acute phase response protein synthesized in the liver as a response to various inflammation. CRP is extensively used as a general marker for inflammation in clinical medicine. A forensic applications of the CRP using postmortem samples have been studied in oversea. We have compared CRP in the between antemortem and postmortem samples and studied stability of postmortem blood samples for CRP test. In 69 consecutive autopsy cases, we have analysed heart blood samples (69 cases), peripheral blood samples (33 cases), and vitreous humor samples (60 cases). Postmortem CRP was elevated in 25 cases (36.2%) and possible causes of CRP elevation were inflammatory disease except one case (unknown). Postmortem CRP test shows sensitivity 86.7%, specificity 80%, positive predictive value 92.9%, and negative predictive value 66.7% for inflammation based on 20 cases with antemortem CRP results. The postmortem CRP levels were similar in the heart blood samples and peripheral blood samples. Vitreous humor samples are not useful in postmortem CRP testing. And both whole blood and serum samples are stable in room temperature until 31 days. We conclude that serum from heart blood is best suitable sample for postmortem CRP test and postmortem CRP test is useful in routine autopsy practice to detect inflammatory disease such as sepsis. From the view of postmortem point, we desire that this valuable test should be used in routine autopsy practice in Korea.
나주영,함석훈,오연호,이성수,김형석,박종태 대한법의학회 2015 대한법의학회지 Vol.39 No.4
Ludwig’s angina is a progressive gangrenous cellulitis and edema of the soft tissues of the neck and floor of the mouth. Ludwig’s angina can be fatal as a result of progressive swelling of the soft tissues of the neck and elevation and posterior displacement of the tongue, resulting in airway obstruction. We report the case of a 77-yearold man who was admitted to the dental hospital with a toothache and headache. He was diagnosed with left submandibular space abscess. Four days post-admission, the submandibular and submental abscess was incised and drained. After the operation, the patient suddenly developed dyspnea and suffered cardiopulmonary arrest and died. An autopsy was performed, and exploration of the neck revealed a submental and submandibular abscess with massive inflammation, edema, and an abscess in multiple layers of the cervical subcutaneous tissue. After autopsy, the cause of death was confirmed as Ludwig’s angina with a deep neck abscess. Ludwig’s angina is a rapidly progressive cellulitis that often results in death by asphyxia or sepsis and is rarely seen in a forensic autopsy practice. Here in we report a case of Ludwig’s angina and present a review of the literature.
A Comparative Study of Postmortem Bacterial Culture and Identification Methods
나주영,박지혜,함석훈,김형석,박종태 대한법의학회 2016 대한법의학회지 Vol.40 No.2
Postmortem bacterial culture can be valuable for investigating deaths and determining the cause of death. However, there are many concerns regarding postmortem bacterial culture such as postmortem transmigration and agonal spread of bacteria. The two main methods for identification of the bacteria are biochemical and genetic methods. In Korea, the genetic method has been used for postmortem bacterial culture and identification in forensic medicine. However, there is a lack of consensus on the method to be used for postmortem bacterial culture and identification. Herein, we compared the genetic and biochemical methods of postmortem bacterial culture in autopsy practice. Both analyses were performed on the same samples. Bacteria were identified in 28 of the 34 cases (82.4%). Of the 74 comparable samples, only 28 (37.8%) showed consistent results by both methods. In addition, the biochemical method had a shorter reporting time and was more sensitive. In conclusion, we analyzed the causes of the inconsistency between the two methods and provided appropriate conditions and protocols for postmortem bacterial culture and identification.
살리실산메틸 음용으로 인한 자살 사망: 사례보고 및 문헌고찰
유태영,권정화,함석훈,임상범,박영일,고영산,허진행,김신은,장선정 대한법의학회 2024 대한법의학회지 Vol.48 No.1
Methyl salicylate is widely used in various topical products, including sports creams, ointments, patches, and oral hygiene products. These products are mainly used for localized treatment of musculoskeletal pain. Given their intended topical application, their ingestion can result in salicylic acid poisoning due to their high concentrations of methyl salicylate. Symptoms of salicylic acid poisoning may include dizziness, vomiting, hallucinations, seizures, and, in severe cases, unconsciousness, respiratory failure, and circulatory disorders. We report a case of a 71-year-old male who ingested Mensolatum Lotion to commit suicide and died.