• Title/Summary/Keyword: Medical Examiner

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Improve the Administrative Death Investigation System (행정검시제도 개선방안)

  • Kim, Heon-Jin
    • The Journal of the Korea Contents Association
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    • v.12 no.2
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    • pp.276-283
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    • 2012
  • Current Administrative Death investigation system is have many problems. Almost local governor don't exercise about administrative death investigation authority. Thus, prosecutors have to many decisions about judicial death investigation authority. Consequently, these vicious cycle is repeated. There is not clear regulations about scope for judicial death investigation. Discussed in this paper improve the Administrative Death investigation system are as follows : First, the uniform act of death investigation is have to legislated. Second, the scope for death investigation is clearly legalized. Medical examiner is must administrative death investigation according to the law. Also prosecutor can order to judicial autopsy to medic examiner. Third, Administrative Death investigation rules should be clarified. Introduce a Medical Examiner System Korean Administrative Death Investigation system centered on prosecutor and judicature who are not a specialist in pathology or forensic medicine. Lacking in professional understanding cause less accuracy of Administrative Death Investigation. To overcome limitations and problems of our Administrative Death Investigation system is suggested to introduce a Medical Examiner system.

Death due to Aspergillus Tracheobronchitis: An Autopsy Case (아스페르길루스 기관기관지염에 의한 사망: 부검 1예)

  • You, Tack Kune;Choi, Byung Ha;Lee, Bong Woo;Choi, Young Shik
    • The Korean Journal of Legal Medicine
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    • v.42 no.4
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    • pp.164-167
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    • 2018
  • Aspergillus infection is the most common cause of death due to fungi in immunocompromised hosts. Aspergillus tracheobronchitis is an uncommon but severe form of invasive pulmonary aspergillosis, which is limited entirely or mainly to the tracheobronchial tree and can often be life-threatening. We report a case of a 54-year-old man who died from Aspergillus tracheobronchitis without an underlying disease. Autopsy revealed an extensive yellowish plaque adhering to the trachea and bronchial wall. The microscopic examination of the trachea and bronchus revealed septate branching hyphae of Aspergillus.

[Secondary publication] Sudden Aortic Rupture in Ehlers-Danlos Syndrome Type IV (엘러스-단로스 제4형 증후군 환자에서 발생한 대동맥 파열)

  • Baek, Taehwa;Kim, Minjung;Ki, Chang-Seok;Park, Seong Hwan;Lee, Heon;Kim, Kyung Ryoul;Choi, Byung-Ha
    • The Korean Journal of Legal Medicine
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    • v.40 no.2
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    • pp.61-64
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    • 2016
  • Ehlers-Danlos syndrome type IV (EDS IV) is a hereditary disorder of the connective tissue, characterized by easy bruising, thin skin with visible veins, and spontaneous rupture of the large arteries, uterus, or bowel. EDS IV is caused by mutations of the gene for type III procollagen (COL3A1), resulting in insufficient collagen production or a defect in the structure of collagen. EDS IV can have fatal complications such as the rupture of great vessels or organs, which can cause hemorrhaging and sudden unexpected death. Here, we report a case of a 43-year-old female who collapsed after a struggle with a neighbor. In this patient, the bifurcation of the bilateral common iliac artery ruptured, with no evidence of trauma, inflammation, or atherosclerosis. Genetic analysis of COL3A1 showed the presence of a c.2771G>A (p.Gly924Arg) mutation, which may be associated with EDS IV. The forensic pathologist should consider the possibility that the spontaneous visceral or arterial rupture was caused by EDS IV. Genetic analysis is not currently a routine procedure during autopsy. However, in this case, we suggest that the patient possibly had an underlying EDS IV condition, and we recommended family members of the deceased to seek genetic analysis and counseling.

The Application of Paewinsky et al.'s Age Estimation Method to Periapical Radiographs (치근단 방사선 사진에서 Paewinsky 연령추정법 적용에 대한 연구)

  • Roh, Byung-Yoon;Seo, Jeong-Uk;Kim, Chang-Gyum;Choi, Chang-Un;Lee, Won-Joon;Lee, Sang-Seob
    • The Korean Journal of Legal Medicine
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    • v.42 no.4
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    • pp.141-145
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    • 2018
  • There have been many radiographic studies on age estimation that evaluate reduction in size of dental pulp cavity with secondary dentin formation. The Paewinsky method reported high accuracy in estimating ages by measuring the width of the pulp cavity in panoramic radiographs. The aim of this study was to evaluate the application of the Paewinsky method to digital periapical radiographs. This study was conducted on 103 cases that reported to the Section of Human Identification of the National Forensic Service. The age was calculated by applying the Paewinsky method that measures the root and pulp canal width at three points in a tooth. The estimation results were compared with those calculated by the Johanson method. When the Paewinsky models were applied to digital periapical radiographs, the errors were significantly greater as compared to the original study. The errors of the maxillary second premolar and mandibular lateral incisor were greater than those of the maxillary central incisor, lateral incisor, mandibular canine, and first premolar. Furthermore, errors of the age estimation models in level C were greater than those in levels A and B. This study could be a reference for the application of the Paewinsky method to digital periapical radiographs.

Accuracy of posteroanterior cephalogram landmarks and measurements identification using a cascaded convolutional neural network algorithm: A multicenter study

  • Sung-Hoon Han;Jisup Lim;Jun-Sik Kim;Jin-Hyoung Cho;Mihee Hong;Minji Kim;Su-Jung Kim;Yoon-Ji Kim;Young Ho Kim;Sung-Hoon Lim;Sang Jin Sung;Kyung-Hwa Kang;Seung-Hak Baek;Sung-Kwon Choi;Namkug Kim
    • The korean journal of orthodontics
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    • v.54 no.1
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    • pp.48-58
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    • 2024
  • Objective: To quantify the effects of midline-related landmark identification on midline deviation measurements in posteroanterior (PA) cephalograms using a cascaded convolutional neural network (CNN). Methods: A total of 2,903 PA cephalogram images obtained from 9 university hospitals were divided into training, internal validation, and test sets (n = 2,150, 376, and 377). As the gold standard, 2 orthodontic professors marked the bilateral landmarks, including the frontozygomatic suture point and latero-orbitale (LO), and the midline landmarks, including the crista galli, anterior nasal spine (ANS), upper dental midpoint (UDM), lower dental midpoint (LDM), and menton (Me). For the test, Examiner-1 and Examiner-2 (3-year and 1-year orthodontic residents) and the Cascaded-CNN models marked the landmarks. After point-to-point errors of landmark identification, the successful detection rate (SDR) and distance and direction of the midline landmark deviation from the midsagittal line (ANS-mid, UDM-mid, LDM-mid, and Me-mid) were measured, and statistical analysis was performed. Results: The cascaded-CNN algorithm showed a clinically acceptable level of point-to-point error (1.26 mm vs. 1.57 mm in Examiner-1 and 1.75 mm in Examiner-2). The average SDR within the 2 mm range was 83.2%, with high accuracy at the LO (right, 96.9%; left, 97.1%), and UDM (96.9%). The absolute measurement errors were less than 1 mm for ANS-mid, UDM-mid, and LDM-mid compared with the gold standard. Conclusions: The cascaded-CNN model may be considered an effective tool for the auto-identification of midline landmarks and quantification of midline deviation in PA cephalograms of adult patients, regardless of variations in the image acquisition method.

Scotopic Pupil Size in Myopes (근시안에서 암순응상태의 동공크기)

  • Jeong, Woo-Jae;Jeon, In-Chul;Kang, Ji-Hun
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.2
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    • pp.197-202
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    • 2013
  • Purpose: This research was performed to measure and analyze scotopic pupil size in myopes and to figure out the factors that influence it. Methods: The pupil size of 191 healthy myopic subjects were measured with the pupillometer (Colvard pupillometer, OASIS medical, USA) in scotopic and analyzed with the age, corneal size, spherical equivalent refractive error, corneal curvature. In addition, it was compared with the measurements of intra-examiner and inter-examiner to verify reproducibility of pupillometer. Results: The mean (${\pm}$SD) scotopic pupil size was $6.64{\pm}0.68$ mm (range, 5.00~8.00 mm), the lower age and the larger corneal size, The bigger the pupil size. The lower spherical equivalent refractive error and steepper corneal curvature tends to be smaller. The reproducibility of intra-examiner and inter-examiner in pupillometer showed the reliability highly (Guttman splithalf point > 0.91). Conclusions: The pupil size associated with age, corneal size, spherical equivalent refractive error and corneal curvature in scotopic condition. It can refer to prevent inconvenience that may occur RGP contact lenses, cataract surgery and refractive surgery.

Inter-Examiner Reliability of the Korean Version of the Pediatric Balance Scale (한글판 아동 균형척도(Pediatric Balance Scale)의 측정자간 신뢰도)

  • Ko, Myung-Sook;Lee, Nam-Hyun;Lee, Jung-Ah;Jeon, Hye-Seon
    • Physical Therapy Korea
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    • v.15 no.1
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    • pp.86-95
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    • 2008
  • The Pediatric Balance Scale (PBS) is a modified Berg's Balance Scale developed as a balance measure for school-aged children with mild to moderate motor impairments. The purpose of this study was to determine the inter-examiner reliability of the Korean version of PBS when applied to children with developmental delays. In this study, PBS was administrated to a total of 79 children with developmental delays (17 with global developmental delay, 31 with cerebral palsy, and 31 with mental retardation) in the Seoul Community Rehabilitation Center. Two pediatric trained physical therapists with longer than 13 year of clinical experience scored the children's performance blind, while replaying videotaped data. The inter-examiner reliability was statistically determined by intraclass correlation coefficients (ICCs). The results of this study revealed that the Korean version of PBS seems to have high inter-examiner reliability when applied to children with movement disorders such as global developmental delay (ICC=.96) and cerebral palsy (ICC=.97); however, it has relatively lower inter-examiner reliability (ICC=.78) for children with developmental delay secondary to mental retardation. therefore, the results support that the Korean version of the PBS could be a useful clinical measurement to assess the balance skills for children with developmental delay who have an adequate level of cognition to enable them to fol1ow the verbal instructions to complete the test.

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Inter- and Intra-Observer Variability of the Volume of Cervical Ossification of the Posterior Longitudinal Ligament Using Medical Image Processing Software

  • Shin, Dong Ah;Ji, Gyu Yeul;Oh, Chang Hyun;Kim, Keung Nyun;Yoon, Do Heum;Shin, Hyunchul
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.441-447
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    • 2017
  • Objective : Computed tomography (CT)-based method of three dimensional (3D) analysis ($MIMICS^{(R)}$, Materialise, Leuven, Belgium) is reported as very useful software for evaluation of OPLL, but its reliability and reproducibility are obscure. This study was conducted to evaluate the accuracy of $MIMICS^{(R)}$ system, and inter- and intra-observer reliability in the measurement of OPLL. Methods : Three neurosurgeons independently analyzed the randomly selected 10 OPLL cases with medical image processing software ($MIMICS^{(R)}$) which create 3D model with Digital Imaging and Communication in Medicine (DICOM) data from CT images after brief explanation was given to examiners before the image construction steps. To assess the reliability of inter- and intra-examiner intraclass correlation coefficient (ICC), 3 examiners measured 4 parameters (volume, length, width, and length) in 10 cases 2 times with 1-week interval. Results : The inter-examiner ICCs among 3 examiners were 0.996 (95% confidence interval [CI], 0.987-0.999) for volume measurement, 0.973 (95% CI, 0.907-0.978) for thickness, 0.969 (95% CI, 0.895-0.993) for width, and 0.995 (95% CI, 0.983-0.999) for length. The intra-examiner ICCs were 0.994 (range, 0.991-0.996) for volume, 0.996 (range, 0.944-0.998) for length, 0.930 (range, 0.873-0.947) for width, and 0.987 (range, 0.985-0.995) for length. Conclusion : The medical image processing software ($MIMICS^{(R)}$) provided detailed quantification OPLL volume with minimal error of inter- and intra-observer reliability in the measurement of OPLL.

An Effective Transcranial Electric Motor-Evoked Potentials Method in Spinal Dural Arteriovenous Fistula Ligation Surgery (척수경막동정맥루 결찰술에서의 효과적인 경두개운동유발전위 검사방법)

  • Jang, Min Hwan;Lee, In Seok;Lim, Sung Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.193-198
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    • 2021
  • The purpose of spinal dural arteriovenous fistula (SDAVF) ligation is to prevent neurological injury and the poor blood supply through ligation of arteriovenous fistula. Therefore, intraoperative neurophysiological monitoring (INM) is required via multimodal neurological examination for minimizing the side effects after surgery based on the patient's symptoms. Transcranial electric motor-evoked potentials (TceMEP) help to check the condition of the corticospinal tract. Whenever ligation is performed, TceMEP should be performed every minute to check for abnormalities. However, an examiner's lack of knowledge about the operation procedure and examination and also poor communication between the examiner and surgeon can cause incorrect timing of the stimulation of TceMEP that interferes with the procedure and causes side effects such as paralysis and motor weakness. As a result of this SDAVF ligation survey, it is believed that for proper INM, case reports will be needed along with further research and the examiner will also have to work closely with the surgeon to minimize neurological damage to patients.

Diagnosis of Anterior Cruciate Ligament Injury (전방십자인대 손상의 진단)

  • Ahn, Jin-Whan
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.26-30
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    • 1997
  • Recently, the incidence of anterior cruciate ligament injury is rapidly increasing because many young Korean are actively participating in sports activities including basketball, skiing and soccer. Sometimes acute ACL injuries arc misdiagnosed as sprain because of pain and muscle spasm. An accurate physical examination and careful history taking are very important to diagnose the ACL injuries. Therefore author described the skill of history taking and the technique of physical examination to diagnose ACL injuries. The most sensitive test is the Lachman's test, which is performed with the knee in 200 of flexion, the femur stabilized with full flexed examiner's knee placed behind patient's distal thigh and one hand of examiner, and the proximal tibia grasped with the other. The pivot shift test is a passive motion test that attempts to subluxate the tibia anteriorly, then have it reduce rapidly. The pivot shift test is very sensitive test to diagnose the chronic ACL injuries.

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