Factors Influencing Postmortem Catecholamine Level and Its Correlations With Agony Time and Cause of Death in Medicolegal Autopsy

Background@#Catecholamines consisting of epinephrine (EP), norepinephrine (NE), and dopamine (DA) are known as a class of chemical neurotransmitters and hormones essential for regulation of physiological processes including stress responses. Many researchers have tried to establish a relationship between postmortem catecholamine level and agony time or underlying cause of death. However, relevant studies have yielded debatable results.This study was performed to determine characteristics of catecholamine distribution in postmortem specimens with various influencing factors and to assess relationships of postmortem catecholamine levels with agony time and cause of death. @*Methods@#A total of 114 autopsy cases were analyzed for catecholamine levels and EP/NE ratios in femoral blood, heart blood, and urine specimens. Postmortem catecholamine levels according to sex, age, medical treatments (cardiopulmonary resuscitation [CPR] and EP injection), postmortem interval (PMI), agonal period, manner of death, and cause of death were evaluated. @*Results@#Close mutual relationships were noted among femoral and heart blood catecholamine levels. There was no correlation between blood and urine catecholamine levels. Catecholamine levels showed no significant differences according to sex, age, or manner of death. Heart EP and heart EP/NE ratio were significantly higher in the group with CPR. Femoral DA, heart EP, heart NE, heart DA, and urine DA were significantly increased in the group with EP injection. Urine NE and urine DA showed significant differences among PMI groups, with both increased over PMI. In correlation analysis, femoral DA and urine NE displayed weak correlations with PMI. Regarding agony time, femoral and heart DA were significantly increased in long agony group compared to those in the short agony group. With regard to the cause of death, multiple comparison analysis for major categories (natural death, injury, intoxication, asphyxia, drowning, and fire death) revealed a significant increase of femoral NE in asphyxia in comparison with injury. In subgroup analysis for the group without EP injection, femoral NE (P = 0.048), femoral DA (P = 0.039), and heart EP (P = 0.021) showed significant differences between PMI groups. @*Conclusion@#Results of this study have important implications for understanding postmortem catecholamine distribution and their mutual associations, influences of clinical and demographic factors, and relationships with agony time and cause of death in Korean population. Although comprehensive demonstration of catecholamine level as stress index was not possible in the present study, the assessment of postmortem catecholamine levels could be used as a supportive tool in classification of agonal status and differential diagnosis of the cause of death in particular cases. Further investigation is needed on this issue.

Assessment of Bacterial Communities Within the Biofilm of Bladder Calculi in the Neurogenic Bladder Rat Model Following Spinal Cord Injury / 대한배뇨장애요실금학회지

Purpose@#To develop a rat model of bladder calculi in the neurogenic bladder following spinal cord injury (SCI) and assess bacterial communities within the biofilm of bladder calculi using denaturing gradient gel electrophoresis (DGGE). @*Methods@#The silk tied to a small segment of the Teflon IV catheter was implanted through the urethra into the bladder of rats with SCI induced by T9 laminectomy. After 6 months, the rats were sacrificed and their bladder calculi were collected by opening the bladders through the low-midline incision. Genomic DNA was extracted from the biofilm of bladder calculi followed by DGGE to obtain bacterial DNA. The DNA sequences were compared and analyzed using BLAST (Basic Local Alignment Search Tool) to identify bacteria. @*Results@#After placing silk nidus in the bladder for 6 months, all 6 rats developed bladder calculi. According to DGGE analysis, Pseudomonas aeruginosa was the most dominant strain, while Clostridium sp. and Lactobacillus sp. were relatively dominant strains within the biofilm of bladder calculi in the rats with SCI. @*Conclusions@#DGGE analysis showed various microorganisms in the biofilm of calculi arising from a neurogenic bladder rat model. This research design can be the basis for clinical studies and may be applied to calculi in patients with neurogenic bladder following SCI.

The Application of Paewinsky et al.'s Age Estimation Method to Periapical Radiographs / 대한법의학회지

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.

Radiocarbon Dating of Skeletal Remains: Case Report / 대한법의학회지

While radioactive isotope analysis has proved to be a useful method in disciplines such as archaeology and forensic anthropology, more recently, radiocarbon dating has allowed for a more nuanced biological profile of human skeletal remains. Radiocarbon dating has been made possible by the above ground nuclear bomb test conducted in 1963, which raised the level of atmospheric radiocarbon concentration to almost twice the natural level. Because the annually measured tropospheric ¹⁴C concentrations are integrated into the bomb peak curve, the time of birth and death of an individual can be estimated by comparing the radiocarbon content of a skeletal sample to the bomb-curve value. In July 2017, about 1,000 skeletal remains were excavated at the construction site of Sokcho. For medico-legal purposes, we conducted anthropological and odontological examinations of all the human remains. We then conducted the radiocarbon analysis on seven femora (head and body portions), five mandibular teeth, and soil from the site through a request to the Korea Institute of Geoscience and Mineral Resources. The results demonstrated that the estimated year of birth or death was prior to the 1950s. Due to the diverse distribution of results, we deduced that the human remains were from the local mass grave. This study supports and suggests the use of radiocarbon dating more frequently in the analysis of human skeletal remains.

The Application of Paewinsky et al.'s Age Estimation Method to Periapical Radiographs / 대한법의학회지

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.

Radiocarbon Dating of Skeletal Remains: Case Report / 대한법의학회지

While radioactive isotope analysis has proved to be a useful method in disciplines such as archaeology and forensic anthropology, more recently, radiocarbon dating has allowed for a more nuanced biological profile of human skeletal remains. Radiocarbon dating has been made possible by the above ground nuclear bomb test conducted in 1963, which raised the level of atmospheric radiocarbon concentration to almost twice the natural level. Because the annually measured tropospheric ¹⁴C concentrations are integrated into the bomb peak curve, the time of birth and death of an individual can be estimated by comparing the radiocarbon content of a skeletal sample to the bomb-curve value. In July 2017, about 1,000 skeletal remains were excavated at the construction site of Sokcho. For medico-legal purposes, we conducted anthropological and odontological examinations of all the human remains. We then conducted the radiocarbon analysis on seven femora (head and body portions), five mandibular teeth, and soil from the site through a request to the Korea Institute of Geoscience and Mineral Resources. The results demonstrated that the estimated year of birth or death was prior to the 1950s. Due to the diverse distribution of results, we deduced that the human remains were from the local mass grave. This study supports and suggests the use of radiocarbon dating more frequently in the analysis of human skeletal remains.

Monitoring of Noxious Protozoa for Management of Natural Water Resources

Waterborne parasitic protozoa, particularly Giardia lamblia and Cryptosporidium spp., are common causes of diarrhea and gastroenteritis worldwide. The most frequently identified source of infestation is water, and exposure involves either drinking water or recreation in swimming pools or natural bodies of water. In practice, studies on Cryptosporidium oocysts and Giardia cysts in surface water are challenging owing to the low concentrations of these microorganisms because of dilution. In this study, a 3-year monitoring of Cryptosporidium parvum, Giardia lamblia, and Naegleria fowleri was conducted from August 2014 to June 2016 at 5 surface water sites including 2 lakes, 1 river, and 2 water intake plants. A total of 50 water samples of 40 L were examined. Cryptosporidium oocysts were detected in 22% of samples and Giardia cysts in 32%. Water at the 5 sampling sites was all contaminated with Cryptosporidium oocysts (0–36/L), Giardia cysts (0–39/L), or both. The geometric mean concentrations of Cryptosporidium and Giardia were 1.14 oocysts/L and 4.62 cysts/L, respectively. Thus, effective monitoring plans must take into account the spatial and temporal parameters of contamination because they affect the prevalence and distribution of these protozoan cysts in local water resources.

Ossification of the Medial Clavicular Epiphysis on Chest Radiographs: Utility and Diagnostic Accuracy in Identifying Korean Adolescents and Young Adults under the Age of Majority

The aim of our study was to evaluate the utility and diagnostic accuracy of the ossification grade of medial clavicular epiphysis on chest radiographs for identifying Korean adolescents and young adults under the age of majority. Overall, 1,151 patients (age, 16-30) without any systemic disease and who underwent chest radiography were included for ossification grading. Two radiologists independently classified the ossification of the medial clavicular epiphysis from chest radiographs into five grades. The age distribution and inter-observer agreement on the ossification grade were assessed. The diagnostic accuracy of the averaged ossification grades for determining whether the patient is under the age of majority was analyzed by using receiver operating characteristic (ROC) curves. Two separate inexperienced radiologists assessed the ossification grade in a subgroup of the patients after reviewing the detailed descriptions and image atlases developed for ossification grading. The median value of the ossification grades increased with increasing age (from 16 to 30 years), and the trend was best fitted by a quadratic function (R-square, 0.978). The inter-observer agreements on the ossification grade were 0.420 (right) and 0.404 (left). The area under the ROC curve (AUC) was 0.922 (95% CI, 0.902-0.942). The averaged ossification scores of 2.62 and 4.37 provided 95% specificity for a person < 19 years of age and a person ≥ 19 years of age, respectively. A preliminary assessment by inexperienced radiologists resulted in an AUC of 0.860 (95% CI, 0.740-0.981). The age of majority in Korean adolescents and young adults can be estimated using chest radiographs.

Dental Identification of the Putative Body of a Most Wanted Fugitive / 대한법의학회지

Dental identification was conducted on the putative body of a most wanted fugitive who was considered to be the de facto owner of the ferry MV Sewol. Postmortem examination showed many dental characteristics, including gold crowns, a porcelain-fused-to-metal crown, a gold fixed bridge, and resin restorations. The estimated age of the body was approximately 73 years. Antemortem data collected by the fugitive at private dentist showed that 10 teeth had dental features. When the antemortem data on the 10 teeth were compared with the corresponding teeth by using postmortem data, there was no discrepancy in the remaining teeth. The number of possible combinations was calculated, and the likelihood of this fugitive and any other person having the same dental features was one in 14 billion. Using the results of dental examination, the body was successfully identified.

Harris lines observed in human skeletons of Joseon Dynasty, Korea / 대한해부학회지

The Harris line (HL), caused by bone-growth arrest and manifesting on X-rays as a radiopaque transverse line in the metaphysis of the long bones, is an indicator reflecting stress conditions such as disease or malnutrition. HL frequency has been assumed to differ between pre-modern and modern societies, as reflective of increased caloric intake and overall nutritional improvements attendant on industrialization. To determine if such a change occurred in Korea, in the present study we compared the respective HL statuses in medieval Joseon and modern Korean population samples. HLs were found in 39.4% (28/71) of the Joseon Koreans. Whereas only 27.5% (11/40) of the males showed an HL, fully 54.8% (17/31) of the females exhibited it. Notably, HLs were observed in only 16.4% (35/213) of the modern Koreans; more remarkably still, the HL rate was almost the same between the sexes, 16.7% (20/120) for the males and 16.1% (15/93) for the females. The HL frequency was much higher in the Joseon Koreans than in their modern counterparts, reflecting the improvement of nutritional status that had been achieved in the course of South Korea's modernization. This HL-frequency decrease was much more obvious in the female populations. The higher HL frequency among the Joseon females might reflect the relatively poor nutritional condition of females in pre-modern Korean society.

Long bone fractures identified in the Joseon Dynasty human skeletons of Korea / 대한해부학회지

Fracture is one of the pathological signs most frequently encountered in archaeologically obtained bones. To expand the paleopathological knowledge on traumatic injuries, it is desirable to secure data on long bone fractures from as wide a geographic and temporal range as possible. We present, for the first time, evidence of long bone fractures in a 16th-18th century Joseon skeletal series (n=96). In this study, we found 3 Colles' fractures of the radius in 2 individual cases. The pattern of fractures was unique. Although previous reports show that the ulna is broken more often than the radius, ulnar fracture associated with fending off a blunt attack was rare in our series (1/7 cases). Transverse fractures, typically caused by intentional violence, were also very rare (1/7 cases) in this study. These results may reflect the relatively tranquil lives of the Joseon people in 16th-18th century Korea. We also found post-fracture complications such as deformations, bone length shortening, and osteomyelitis. The present study would be of interest to medical scientists in related fields because it is one of the few studies conducted on long bone fractures among pre-modern societies in East Asian countries, thus far.

Application of 3D Surface Scanners in Forensic Science and Medicine ( I ): Digital Storage of Human Skeletons and Development of Appraisal Methods for Incident Scenes / 대한법의학회지

The aim of this project was to use 3D scanning data collected at incident scenes and various evidence to 1) develop surveying methods based on 3D data consisting of overall and detailed scene evidence, captured by long-range and micros-canner, which can be shared by personnel working in different fields such as forensic medicine, video analysis, physical analysis, traffic engineering, and fire investigation; 2) create digital storage for human skeletons and set the foundation for virtual anthropology; and 3) improve the credibility of 3D evidence by virtual remodeling and simulation of incident scenes and evidence to provide a basis for advanced and high-tech scientific investigation. Two complete skeletons of male and female were scanned using 3D micro-scanner. Each bone was successfully reproduced and assembled in virtual space. In addition, recreating evidence scheduled for invasive examination by creating RP (rapid prototype) was possible. These outcomes could play an important role in setting up the new field of virtual anthropology. Case-specific surveying methods were developed through analysis of 3D scanning data collected by long-range surface scanners at the scenes of vehicular accidents, falls, shootings, and violent crimes. A technique and recording method was also developed for detecting forged seals by micro-scanning the pressure exerted on the seal. Appraisal methods developed in this project could be utilized to secure 3D data of human skeletal remains and incident scenes, create a standard for application, and increase objectivity, reproducibility, and accuracy of scanning methods. We plan to develop case-specific 3D data analysis techniques to improve the credibility of analysis at the NFS and to establish a 3D data collection and analysis team.

Epidemiological Study of Ground-waterborne Norovirus GI.3-associated Gastroenteritis Outbreaks in Gyeonggi Province of South Korea in May 2011

In May 2011, five consecutive gastroenteritis outbreaks were reported at schools in Gyeonggi-do. Epidemiological inspection revealed that one food manufacture company provided 'Kimchi', a traditional Korean side-dish, to these five schools for catering services. Fecal specimens were collected from students and food-handlers to determine causative viral agents. Norovirus genogroup GI was detected from 58 samples out of total 239 specimens by reverse-transcription (RT)-PCR, whereas norovirus GII was found only from one sample. Epidemiological studies also revealed that the Kimchi was processed using groundwater in the food manufacture company. Four groundwater samples were collected from the company and around the area. Norovirus GI was detected from three samples. To determine the norovirus genotypes of positive specimens from clinical and groundwater samples, sequencing and phylogenetic analyses were performed. The genogroup GI from 58 clinical and three groundwater samples and the GII from one food-handler were identified as norovirus GI.3 and GII.18, respectively. Sequence alignment analysis with norovirus GI.3 isolates revealed that identity between clinical and groundwater samples was over than 99.1% in nucleotide level. In conclusion, norovirus GI.3-contaminated groundwater caused the gastroenteritis outbreaks of five schools, through Kimchi. This molecular epidemiological study was an important report in Korea that clearly identified all transmission routes of norovirus GI.3.

Physical Anthropological Study of Excavated Bones from Siheung Cultural Remains / 체질인류학회지

GyeongGi Cultural Foundation was requested the identification of eight excavated human skeletons from Neunggok residential development district within Siheung-si. Those were measured for distinguishing sex, stature, and age at death using metric and non-metric methods. The identification of eight human remains was not easy because the excavated bones were destroyed partly and totally. Six skeletons were excavated from the limed-soiled mixture tomb; five remains among 8 were buried in same grave and 2 skeletons were excavated from the earthen tomb. Four remains were determined female skeletons. One skeleton was assumed adolescence, three skeletons were estimated 40's~50's years old and others couldn't be done. Four among eight remain skeletons, the stature of female remains was around 150~157 cm and male's stature was around 165 cm. Most bones were damaged and destroyed, and the remaining teeth on the maxilla and mandible were not enough for identification. We couldn't identify through metric and non-metric methods. If the human skeletal remains were not found with artifact, those couldn't determine the period. So we couldn't know the relationship between the period of burial and condition of bones. For this reason, we will study the identification using the small and damaged bones. Anthropologists and archeaologists need to work together to make database to determine identification and period.

A Statistical Analysis on Forensic Odontological Examination at the NFS from 2007 to 2010 / 대한법의학회지

Analysis of the cases registered for the Forensic Odontology Lab of the National Forensic Service (NFS) from April 6th, 2007 to December 2010 was performed to observe the trend and pattern of the cases, in order to propose measures for improvement in future cases both in quantity as well as quality. High rate of cases were observed from the capital area, especially in ground and mountains during warmer season from June to October. Most of the cases were of human remains requested and examined for the estimation of age, sex, stature and identification. However, some of the requested criteria were applied forensic methods such as postmortem interval, cause of death, and facial reconstruction which could not be conducted. To better fulfill the needs of the society, reform of the current registration-examination system by introducing a multi-disciplinary team for processing the scene, education of the law enforcement personnel, research and acquiring funds for the relevant areas, developing antemortem dental record database are recommended for improvement in quantity and quality of the information produced by odontology lab.

Anthropological Study on Human Skeletons from Joseon Tomb, for Confirming Ryu Ja-Gwang, a Famous Historical Figure of Medieval Korea / 체질인류학회지

Anthropological study on human skeletons from Joseon tomb, for confirming Ryu Ja-Gwang, a famous historical figure of medieval Korea. Ryu Ja-Gwang was the famous figure of Joseon Dynasty who achieved great successes in royal court. According to the records in Joseon Dynasty, he tried to hide his own tomb after death under the apprehension that the political enemies might do harm to his corpse. In 1974, the descendants of Younggwang Ryu clan discovered a Joseon tomb that was lost for the past several hundred years. Since they suspected if the tomb might be their legendary ancestor's, anthropological studies were asked to be done on the skeletons collected from the tomb. In our study, the estimated stature of a male from the tomb was 160.5+/-3.8 cm. The age at death was estimated to be 58.6+/-5.2. He seems to have been suffered from diffuse idiopathic skeletal hyperostosis (DISH), the disease prevalent among the people taking high-caloric diets. Since nuclear DNA could not be amplified in this case, the personal identification of the dead person could not be successfully traced by molecular techniques. Taken together, we could not conclude that the skeletons were those of Ryu Ja-Gwang because the radiocarbon dating, age at death or height data could not be well matched with those described in historical documents. Even so, this study could be significant to the related researchers because it was one of the first trials to identify debatable historical figure using various anthropological techniques. Considering that the anthropological studies on famous historical people have been performed briskly, our study could be the basis for the similar studies in Korea, performed in near future.

Statistical Analysis of Bone Elements Excavated from the Forensic Context / 체질인류학회지

Forensic anthropology is helpful for correct and fast identification of unknown individuals in mass disaster or from unidentified skeletal remains. It is based on the data of the physical anthropology and applied to the identification in many countries. The purpose of this study is to statistically analyze the 290 forensic records by an office request at NISI during 6 years and to suggest the research model for physical anthropological data that would be helpful to be used at the forensic field. The most common excavated bone was a hard bone as skull and long bones and an unknown place was the most common excavation seat over 50% among the recording place. The probability of excavation with adjacent bone was high and the small sized bones, such as phalanges of hand and foot, were excavated rarely. The incomplete or fragmented bones were found more frequently than of complete. For this reason, we think that will show the priority order of the forensic and physical anthropologic studies in Korea and the necessity of the anatomical education for police officers and inspectors of forensic fields.

Dental Identification of the Victims of the Cold Storage Warehouse Fire in Icheon / 대한법의학회지

The fire broke out in the cold storage warehouse in Icheon, Gyeonggi-do, Korea on January 7th, 2008 and forty workers were died from the fire. Dental identification was carried out to the 25 victims among the 40 ones. The five remains were identified through dental approaches. The public ignorance about the importance of forensic odontology and the difficulty procuring antemortem dental records from the families of the victims were kind of hardships to use the victim's previous dental information. The availability of antemortem data was 12.5%. The public realization about the importance of dental identification and building-up an appropriate co-work system between relevant organizations are required to collect antemortem data more efficiently without wasting time.

Validation of the Demirjian's Method for Dental Age Estimation in Korean Population / 체질인류학회지

Dental development is valuable for age estimation of children because of its low variability and less affection by endocrine and nutritional status. Demirjian reported a new system of dental age assessment in 1973 and this method has been used in many countries. The accuracy of Demirjian's method in dental age estimation may be affected by ethnic difference. For Korean population, the population study of Demirjian technique has not accomplished yet, therefore, we investigate and analyze the validity of Demirjian's method in Korean population. The 155 orthopantomographys which consisted of 87 boys and 68 girls were randomly selected and the age range was 5 to 16 years. The age of radiography was estimated according to criteria presented by Demirjian. Statistical analysis was preformed between real age and estimated age. In boys, there was no significant difference observed (p=0.171) between the real age and estimated age, however in girls, significant difference was shown (p=0.022) in 95% confidence interval. In both groups, there was clear overestimation tendency below 8.0 year, but over 8.0 year the difference pattern is atypical. The Pearson correlation coefficients between real age and estimated age were 0.970, 0.964 in boys, girls, respectively and showed positive relationship. The standards of dental maturation reported by Demirjian may not be applicable in Korean children especially in girls. Establishment of new maturation scores and percentiles curves for Korean population with many samples is required for more accurate age estimation.

Bacteriocin from Purple Nonsulfur Phototrophic Bacteria, Rhodobacter capsulatus

To find whether productivity of bacteriocin is controlled between different species under unusual cultural conditions, we used Rhodobacter capsulatus ATCC 17016 as a producer and Rhodopseudomonas palustris ATCC 17003 as an indicator. Rhodobacter capsulatus was cultured under aerobic conditions in the dark in Lascelles medium containing 0.3% Triton X-100. As a result, bacteriocin productivity increased enormously. The optimal pH range of bacteriocin production was 6~7.8. Through partial purification of bacteriocin, the molecular weight was roughly estimated at 14 kDa. Plasmid had no influence on bacteriocin production by Rhodobacter capsulatus. Our findings indicate that culture conditions affect bacteriocin productivity between more distantly related species, and bacteriocin of Rhodobacter capsulatus is not encoded by a plasmid.