태평양 참다랑어의 동해 북상 원인 분석과 어획량 제한의 문제점

나주영,이지민,손예선,이충일 한국수산과학회 양식분과 2023 한국수산과학회 양식분과 학술대회 Vol.2023 No.6

Sudden Unexpected Deaths due to Multiple Metastasis of Colon Cancer: With a Focus on Cardiac and Dural Metastasis

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.

패혈증비브리오균에 의한 패혈증: 부검 증례

나주영,허기영,박종태,김형석,박정우,오연호,안으리 대한법의학회 2015 대한법의학회지 Vol.39 No.2

Vibrio vulnificus infection can lead to the rapid expansion of cellulitis or sepsis and can be lethal. Vibrio vulnificus is transmitted through seawater or ingestion of raw or undercooked shellfish. We experienced an uncommon case of death due to Vibrio sepsis, which was confirmed by autopsy. A 56-year-old man who was a sailor was found dead in a fishing boat. Autopsy was performed 3 days later. External examination revealed a few blisters and erythematous lesions on both legs. Internal examination revealed a fatty liver and edema of the legs. The skin lesions on the legs showed blisters that extended from the epidermis to the dermis, accompanied by massive acute inflammation in the dermis and subcutaneous tissue with multinuclear giant cells, as noted on the histologic examination. Vibrio vulnificus was isolated from postmortem blood and subcutaneous tissue of the leg. To the best of our knowledge, this is the first autopsy case in Korea in which Vibrio vulnificus was isolated from postmortem blood. Herein, we present a case of sepsis due to Vibrio vulnificus which was confirmed by autopsy, pathological findings, and postmortem microbiological culture.

대뇌정맥혈전증 환자에서 폐 혈전색전증에 의한 사망

나주영,박정우,오연호,강경욱,나종인,김형석,박종태 대한법의학회 2015 대한법의학회지 Vol.39 No.1

Cerebral venous thrombosis is an uncommon cause of cerebral infarction. A 31-yearoldman complained of headache, weakness, and numbness of the left leg a daybefore being admitted to the hospital. After admission, brain computed tomographyand brain magnetic resonance imaging revealed superior sagittal sinus thrombosiswith cerebral infarction in the right hemisphere. He had no significant medical history. On the fourth hospital day, he suddenly collapsed and died. Medicolegal autopsy wasperformed 3 days later; medical malpractice was suspected. External examinationrevealed a few conjunctival petechiae. Internal examination revealed thrombi in thesuperior sagittal sinus and superficial cortical veins. Thrombi were noted in the pulmonarytrunk and both pulmonary arteries. Upon dissection of the left leg, we foundthrombi in the posterior tibial vein. A microscopic examination revealed vasculitis ofthe same cortical veins, and we therefore assumed that vasculitis of the cortical veinsgave rise to thrombosis. In typical autopsy practice, an examination of the dura materis often overlooked, but careful examination of this region should be performed incases of cerebral infarction in young adults, such as this one.

대한법의학회지 40년에 대한 역사적 고찰: 대한법의학회 40주년에 즈음하여

나주영,김형건,김형석,이호 대한법의학회 2016 대한법의학회지 Vol.40 No.4

The Korean Society for Legal Medicine (KSLM) was founded in 1976 and launched its official journal, the Korean Journal of Legal Medicine (KJLM), in 1977. They have played an important role in Korea’s forensic medicine and science, the demand for which has increased in Korean society over the years. A historical review is important and has a significant value in the advancement of forensic medicine and science in Korea. Accordingly, this study reviews and analyzes all papers published in KJLM for 39 years, from Volume 1, Issue No. 1 in 1977 to Volume 39, Issue No. 4 in 2015. There are 891 published papers, which are categorized into 318 review articles, 339 original articles, and 234 case reports. Of the total 891 papers, 377 (42.3%) are related to forensic pathology, whereas 111 (12.5%) concern forensic genetics. The major submitting institutes are forensic medicine departments of universities and the National Forensic Service. KJLM’s history can be divided into two phases. The first phase is from the 1970s to the 1990s, and the second, from the 2000s to the present. Many review articles were published in the first phase; approximately 10% of these articles concern clinical forensic medicine and law. Articles on forensic genetics, identification, and entomology also started to be published in the first phase. In the next phase, many case reports from the National Forensic Service were published, and the number of articles on forensic pathology and forensic genetics multiplied. The results of this study provide KSLM and KJLM with direction toward sustainable development. This study is part of the organization’s 40th anniversary celebration, and in commemoration of its contribution to advancing human rights and social stability in Korea.

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.

루드비히 앙기나 부검 증례

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.

사후 혈액에서 흡광도 분석의 유용성에 관한 연구

나주영,박종태 대한법의학회 2018 대한법의학회지 Vol.42 No.4

The diagnosis of cause of death (COD) or estimation of postmortem interval (PMI) is hard to perform using postmortem blood or other bodily fluids due to various biochemical changes that occur during the agonal phase or after death. To solve these problems, new paradigms and new analytical methods are needed. In this study, postmortem blood was fractionated with specific gravity 1.021, 1.029, 1.038, and 1.045, and the absorbance patterns of each sample of the 131 total cases (12 kinds of COD) were analyzed using a spectrometer. The absorbance was grouped into 9 patterns (ABS pattern 1 to 9) according to the wave length and the signal intensity. These patterns of postmortem blood were found to be distinctly different from the absorbance pattern of fresh blood. The analysis of ABS patterns is useful for the diagnosis of deaths due to acute or rapid bleeding, fire death, drowning and, in some cases, poisoning, but is not useful for the estimation of PMI.

Analysis of Cisternal Puncture Results during a Postmortem Examination

나주영,박지혜,오연호,오세민,김형석,박종태 대한법의학회 2016 대한법의학회지 Vol.40 No.2

Examination of cerebrospinal fluid (CSF) samples is important in postmortem examinations. CSF samples can be collected by performing lumbar or cisternal punctures. Additionally, if bloody fluid is aspirated during a spinal puncture, intracranial hemorrhage could be diagnosed. However, vascular injury and hemorrhage can occur during these procedures. The authors performed cisternal punctures during routine autopsies; further, to evaluate the usefulness of the former, the results were analyzed. Out of 50 cases, bloody fluid was aspirated in CSF samples of 20, while CSF samples of the other 30 were clear. Cases in which bloody fluid was aspirated were divided into blood-tinged and blood aspiration groups according to hemoglobin levels in the aspirated fluids. Cisternal punctures were characterized by high specificity and sensitivity; further, positive and negative predictive values were obtained that enabled detection of head and neck injuries including non-traumatic basal subarachnoid hemorrhage. Main head and neck injuries in blood aspiration group were skull base fracture, cervical fracture, and dislocation.

광주, 전남 일부 지역에서 이루어진 법의부검 중 알코올과 관련된 사망의 통계적 분석

나주영,민병우,이영직,김형석,박종태 대한법의학회 2010 대한법의학회지 Vol.34 No.1

Alcohol is very popular and readily available among the population but is also known to be a toxic substance. Excessive alcohol ingestion can lead to death induced by acute intoxication. In addition, chronic alcohol ingestion can cause many diseases such as alcoholic liver disease and cardiomyopathy. Alcohol consumption is associated with many social incidents. For example, traffic accidents, murders, incendiary crimes and so on. Hence, alcohol should be considered as a significant and socially relevant substance. However, there is currently no statistical analysis about deaths associated with alcohol consumption in forensic autopsy cases. We analyzed forensic autopsy cases involving alcohol during 2007 to 2009 in Gwangju city and Jeollanamdo province, Korea. The following is the summary of the results. 1. The number of total cases in our department from 2007 to 2009 was 329. 2. Among the 329 cases, 314 cases were checked to have alcohol concentration levels. Alcohol related deaths were 118 cases (35.9%). 3. Among 118 cases, natural deaths were 27 (22.9%) and unnatural deaths were 91 cases (77.1%). 4. Deaths caused by alcohol intoxication were 9 cases (7.6%). The remaining 82cases of unnatural deaths were as follows: suicides (18 cases, 22.0%), homicides (32 cases, 39.0%), accidents (24 cases, 29.3%), and undetermined (8cases, 9.8%). 2007-2009년 동안 본 기관에서 시행한 부검은 329예이었으며, 이 중 부패로 인해 알코올이 검출된 2예를 제외하고 알코올 농도가 측정된 312예 중에서 알코올 농도가 0.05% 이상 측정된 경우는 93예(29.8%)로 약 30%에 해당되었고, 40대와50대에서 가장 많았다. 알코올과 관련된 사망 중 내인사는 27예로 전체 329예 중에서 8.2%였고, 외인사는 91예로 27.7%였다. 과거 통계와 비교할 때, 본 기관에서 이루어진 사법 부검 중 자연사의 약 1/5, 외인사의 약 1/2는 알코올과 관련된 사망으로 판단되었다. 알코올과 관련된 사망은 주정 중독에 의한 사망(Code A.),알코올 섭취와 관련된 내인사(Code B.), 알코올과 관련된 자살, 타살, 사고사, 불상 등 외인사(Code C.)로 각각 코드화 하여 분석한 결과 알코올과 관련된 사망은 전체 329예 중에서118예로 35.9%였으며, 이 중 주정중독에 의한 사망은 9예로7.6%였다. 내인사 27예 중에서는 남성이 24명으로 많았으며,이 중 40대 남성이 13명(48.1%)으로 가장 많았다. 사인은 주로 심혈관 질환이 많았으며, 이러한 결과는 심혈관계 질환으로 인한 사망 중 많은 부분은 알코올에 의한 사망의 가능성이 있으며, 알코올에 의한 사망이 저 평가 되어 있을 가능성이 있다는 과거의 보고와 일치하는 결과로 판단되었다. 알코올과 관련된 자살은 18예이었으며, 특히 20대의 경우 여성이 남성보다많다는 점과 20대 여성의 자살의 경우 알코올과 관련성이 높다는 것이 특징적이었다. 알코올과 관련된 타살의 경우 32예가있었으나, 이러한 결과는 피해자 뿐 아니라 가해자에 대한 자료 조사가 부족하였다는 점에서 실제보다 적게 계수되었을 가능성이 있는 것으로 판단되었다. 알코올과 관련된 사고사는 24예 있었고, 다른 연령에 비하여 고령이 많았다는 점이 특징적이었다. 기타 불상은 8예가 있었으며, 불상 중에서는 화재사가4예로 가장 많았다. 본 연구는 몇 가지 제한 점이 있으나, 알코올 섭취와 관련된사망을 전반적으로 포함하여 분석하였다는 점과, 법의 부검이시행된 사망에서 알코올과 관련된 사망을 처음으로 통계적 고찰하여 그 특징을 분석하였다는 점에서 의의가 있다고 생각된다.