Profile of Forensic Autopsy Practices in Small Towns and Cities in Rural Areas

Park, Sohyung; Choi, Byung Ha; Park, Hyejin; Kim, Hyoung Joong; Choi, Young Shik

doi:10.7580/kjlm.2015.39.3.55

Cited by 2 publications

(4 citation statements)

References 8 publications

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“…Comparative review of all aspects of these findings in each individual manner of death would require extensive elaboration of the manuscript, and was omitted to sharpen focus on particular toxicological findings in this material and other important observations, such as the generally low autopsy rates for violent deaths and the striking regional differences in autopsy rates between the adjacent counties Sør-and Nord-Trøndelag. Recently, however, a similar study investigating forensic autopsy practices in rural areas of Korea was published [156]. This study also presented forensic autopsy rates and toxicological findings in the same material, although toxicology results other than alcohol were not specified as to which drugs and chemicals were detected.…”

Section: Paper I -Autopsy Rates and General Toxicological Findingsmentioning

confidence: 99%

Post-mortem levels and tissue distribution of codeine, codeine-6-glucuronide, norcodeine, morphine and morphine glucuronides in a series of codeine-related deaths

Frost

Løkken

Helland

et al. 2016

Forensic Science International

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This article presents levels and tissue distribution of codeine, codeine-6-glucuronide (C6G), norcodeine, morphine and the morphine metabolites morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) in post-mortem blood (peripheral and heart blood), vitreous fluid, muscle, fat and brain tissue in a series of 23 codeine-related fatalities. CYP2D6 genotype is also determined and taken into account. Quantification of codeine, C6G, norcodeine, morphine, M3G and M6G was performed with a validated solid phase extraction LC-MS method. The series comprise 19 deaths (83%) attributed to mixed drug intoxication, 4 deaths (17%) attributed to other causes of death, and no cases of unambiguous monointoxication with codeine. The typical peripheral blood concentration pattern in individual cases was C6G≫codeine≫norcodeine>morphine, and M3G>M6G>morphine. In matrices other than blood, the concentration pattern was similar, although in a less systematic fashion. Measured concentrations were generally lower in matrices other than blood, especially in brain and fat, and in particular for the glucuronides (C6G, M3G and M6G) and, to some extent, morphine. In brain tissue, the presumed active moieties morphine and M6G were both below the LLOQ (0.0080mg/L and 0.058mg/L, respectively) in a majority of cases. In general, there was a large variability in both measured concentrations and calculated blood/tissue concentration ratios. There was also a large variability in calculated ratios of morphine to codeine, C6G to codeine and norcodeine to codeine in all matrices, and CYP2D6 genotype was not a reliable predictor of these ratios. The different blood/tissue concentration ratios showed no systematic relationship with the post-mortem interval. No coherent degradation or formation patterns for codeine, morphine, M3G and M6G were observed upon reanalysis in peripheral blood after storage.

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Section: Paper I -Autopsy Rates and General Toxicological Findingsmentioning

confidence: 99%

Post-mortem levels and tissue distribution of codeine, codeine-6-glucuronide, norcodeine, morphine and morphine glucuronides in a series of codeine-related deaths

Frost

Løkken

Helland

et al. 2016

Forensic Science International

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“…Although there are isolated sleeping rooms and employees to guide patrons, some visitors lie down on the sauna floor to relax and sometimes fall asleep in the hot sauna rooms. Therefore, forensic pathologists in Korea have reported sauna deaths despite an extremely low medico-legal autopsy rate (1.6%) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Binge drinking (a widespread pattern of alcohol intake accounting for >75.0% of alcohol consumption [ 10 ]) is defined by the National Institute on Alcohol Abuse and Alcoholism [ 11 ] as consuming >4/5 alcoholic beverages within 2 h, elevating the BAC to ≥0.08%. For Korean adults, drinking alcohol is a large part of social culture.…”

Section: Discussionmentioning

confidence: 99%

“…Autopsies are typically only performed in cases of need, as in suspicious deaths associated with a crime. Therefore, the medico-legal autopsy rate was extremely low (1.6%) [ 10 ], preventing us from determining the mortality rate for sauna deaths per 100,000 of the Korean population. Furthermore, l sauna users that have suffered a medical emergency but are not deceased are transferred to a hospital.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of sauna deaths in Korea in relation to different blood alcohol concentrations

Yang

Lee

et al. 2018

Forensic Sci Med Pathol

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Although the benefits of sauna bathing have been demonstrated in epidemiological studies, sauna deaths have been reported. The aim of this study was to determine the demographic and forensic characteristics associated with different blood alcohol concentrations (BACs) in sauna deaths in Korea. In this retrospective analysis, data were collected from a nationwide pool in Korea between January 2008 and December 2015 to determine the role of alcohol intoxication in sauna deaths based on the subjects’ BAC and to evaluate the demographic and forensic characteristics associated with different BACs. One hundred and three deaths were classified into 2 groups: the non-intoxication (NI) group (BAC,<0.08%; n = 27) and the intoxication (I) group (BAC,≥0.08%; n = 76). Demographic and forensic characteristics were compared between the groups using a multinomial logistic regression analysis. The proportions of decedents who were male (odds ratio: 17.4, 95.0% confidence interval: 3.8–79.8) and in a prone position at the scene of death (odds ratio: 11.3, 95.0% confidence interval: 2.1–60.1) were significantly higher (P < 0.001 and P < 0.05, retrospectively) in the I group than in the NI group. However, no significant differences were observed with respect to obesity, coronary artery narrowing, and liver pathology. Sauna deaths exhibited different characteristics according to BACs detected at autopsy. The differences in sauna deaths between the I and NI groups may have implications for the targeted prevention of sauna deaths associated with alcohol consumption.

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Profile of Forensic Autopsy Practices in Small Towns and Cities in Rural Areas

Cited by 2 publications

References 8 publications

Post-mortem levels and tissue distribution of codeine, codeine-6-glucuronide, norcodeine, morphine and morphine glucuronides in a series of codeine-related deaths

Post-mortem levels and tissue distribution of codeine, codeine-6-glucuronide, norcodeine, morphine and morphine glucuronides in a series of codeine-related deaths

Characteristics of sauna deaths in Korea in relation to different blood alcohol concentrations

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