カコ 5ネンカン ニオケル トクシマケンカ デ ハッケン サレタ ミモト フメイ シタイ ノ シンタイ トクチョウ ニツイテ : トウナンカイ ナンカイ ジシン ニ ソナエテ

There is a high probability of Tounankai-Nankai earthquake in the first half of this century,with tremendous damage including many victims. The personal identification of them seems to be difficult. Then, we investigated the main useful ground to identify the unknown cadavers（259 cases）in Tokushima during the past 5 years, from 2002 to 2006. Ninety percent of them were identified : by the fingerprint ; 35%, the dental chart ; 24%, DNA-typing ; 17%, the feature ; 15%, the feature of body ; 9%, respectively. If houses of many victims are broken on the earthquakes, it is difficult to get ante-mortem material for the fingerprint or DNA-typing. So, records kept in the medical institution and feature of body are very important information. The scars, injuries, the Xray images, and the medical equipment inside the body were useful for the actual identification.To observe and record these findings will be the first step for the personal identification. It is important that we cooperate and make the system to get these medical records and images.Doctors, dentists, and police should combine together against the earthquake

Fatal accidental asphyxia

Accidental death from postural or positional asphyxia can occur when an individual’s body compromises their respiration. The diagnosis of positional asphyxia is usually based on circumstantial evidence supported by the absence of other significant underlying causes of death. A female in her twenties was found dead in the so-called bridge position on a chair with wheels. Her jacket had rolled under one of the chair’s wheels. She was 159 cm in height and weighed 28.8 kg. Her body mass index was 11.4 (she was severely emaciated), and her muscles, including the rectus abdominis muscle, were thin. Her head, face, and neck were markedly congested. Her lungs, especially the upper lobes, were also congested. A small quantity of left cardiac blood was detected, which was slightly coagulated. The right cardiac blood was liquid (21 ml), and the right ventricle was slightly enlarged. It was suggested that the circulation from the lungs to the heart had been restricted. Toxicological tests detected psychoactive agents in the deceased’s blood and urine. The concentration of one of them, tofisopam, was slightly higher than normal. It was suggested that the effects of tofisopam and the deceased’s poor physical condition had impaired her motility, trapping her in an abnormal body position, ‘the reverse jack-knife position’. Therefore, her manner of death was considered to be accidental positional asphyxia. We should be aware that chairs with wheels can occasionally cause such accidents

Postmortem Diagnosis of Anorexia Nervosa : An Endocrinological and Immunohistochemical Approach

A female in her 30s was found dead after a fire. She was severely emaciated and had been diagnosed with anorexia nervosa (AN) about 5 years ago, but had not been treated recently. Therefore, we investigated not only her cause of death but also her condition of AN. Some of her organs weighed less than normal although no clear lesions were observed. In the pituitary gland, the number of follicle-stimulating hormone-immunopositive cells was markedly decreased although a normal number of thyroid-stimulating hormone-positive cells were detected. A histological examination of the ovary suggested that she had been suffering from amenorrhea. The thyroid gland was atrophic, and marked variations in follicle size were observed. Because we could not obtain enough volume of her blood for endocrinological examinations, we tried to investigate her endocrinological condition by immunohistochemistry. Immunohistochemical staining detected decreased triiodothyronine immunoreactivity and normal thyroxine immunoreactivity. The adrenal glands were also atrophic. Based on these findings, it was considered that she had been suffering from AN at the time of her death. The autopsy and other findings revealed that she had died of burning with carbon monoxide intoxication

The application of immunohistochemical findings in the diagnosis in methamphetamine-related death : two forensic autopsy cases

Forensic autopsy cases detecting methamphetamine (MA) are usually diagnosed according to its toxicological concentration. It has been reported that the lethal blood concentration of MA is 4.48 μg/ml (3.0μmol/dl). We autopsied two MA-detected cadavers, and immunohistochemical staining was performed on the skeletal muscle with an anti-myoglobin antibody, and on the kidney with an anti-the 70 kDa heat shock protein(HSP70) antibody. One case showed a high rectal temperature (40℃). The toxicological examination revealed 0.75μg/ml of MA in the blood, and 16.8 μg/ml in the urine. Myoglobin was negative and HSP70 was positive in the kidney immunohistochemically. From the toxicological and immunohistochemical findings, it was considered that the subject died of hyperthermia and acidosis caused by muscular hyperactivity. In another case, the autopsy revealed highly congested lungs, with dark-red bloody fluid and foam in the trachea and bronchus. MA (17.0 μg/ml) was detected in the blood. HSP70 was negative and myoglobin was positive immunohistochemically. It was thought that the subject died of acute MA intoxication based on the high MA concentration, although rhabdomyolysis was suspected. It is suggested that myoglobin and HSP70 immunostaining are useful to diagnose MA poisoning

バルプロサン ナトリウム ジョホウザイ ノ タイリョウ フクヨウ ニヨル ジサツ ノ 1ボウケンレイ

A young woman with epilepsy was found dead on her bed. She sent e-mail to her lover to intent to suicide １７ hours before being found dead. On the bed side, empty PTP sheets of ２０２ sustained released preparation tablets containing ２００ mg sodium valproate were left. Many tablets and its capsules were found in stomach and intestine by autopsy. The blood concentration of sodium valproate was １２６３ μg／ml, therefore we diagnosed that she died of sodium valproate intoxication. This case is first autopsy case of sodium valproate intoxication reported in Japan. And we also discuss about sustained released preparation tablets

Sudden cardiac death during first-time jogging

With increased interest in fitness and health care, jogging has become more popular as an exercise to promote health. However, sudden cardiac death during sports or exercise has also been reported. Some apparently healthy elderly individuals take up sports for both recreation and health improvement based only on completion of a questionnaire, without undergoing medical evaluation. We report the case of a 66-year-old Japanese man who suddenly died of acute ischemic heart disease during first-time jogging. He collapsed an hour after starting. A trainer promptly started cardiopulmonary resuscitation. An automated external defibrillator (AED) was applied, and defibrillation was attempted once by bystanders. However, he remained in cardiopulmonary arrest until he reached the emergency department, where he was pronounced dead. The autopsy found concentric hypertrophy of the left ventricular wall without fibrosis or degeneration, atherosclerotic changes in the coronary arteries, and severe lung congestion. We diagnosed death from acute myocardial ischemia. We suspect that many healthy elderly individuals have provoked a heart attack by prematurely attempting moderate or vigorous exercise, as in this case. The elderly require comprehensive medical assessment before exercise can be started. Moreover, this case shows that an AED is not always helpful

The peroxidative DNA damage and apoptosis in methamphetamine- treated rat brain

In this study, we investigated methamphetamine (METH)- induced peroxidative DNA damage in various regions of the rat brain. We injected METH to rats following 2 protocols. For the single administration experiment (group I), 50 mg/kg (i.p.) of METH was administered to observe the acute influence of METH. For the repeated administration experiment (group II), 10 mg/kg/day (i.p.) of METH was injected for 5 days. Immunohistochemically, peroxidative damage DNA, 8-hydroxy-2’- deoxyguanosine (8-OH-dG) was observed, and in situ apoptosis was also observed. In group I, immunoreactivity of 8-OH-dG was only enhanced in neurons of the nucleus accumben of METH-treated rats. On in situ apoptosis detection, positive findings were also enhanced in all examined parts compared to those in the control, though there were no significant increases in 8-OH-dG-immunopositive neurons except in the nucleus accumben. In group II, the nucleus accumben also showed enhanced 8-OH-dG immunopositivity compared to that in the control. There was no significant difference in apoptosis between the control and METH groups. Based on our observations, it is considered that METH induces oxidative DNA damage in the brain, especially in the nucleus accumben. However, those DNA damage might be caused differently between acute and chronic administration

An autopsy case of adrenal insufficiency 20 years after Hypophysectomy:Relation between stress and cause of death

A 63-years-oldman was found dead with the body soaking in water lying face up on a riverbank. Autopsy and diatom examination demonstrated that the cause of death was drowning. He had undergone hypophysectomy 20 years earlier. Autopsy, pathological and endocrinological findings demonstrated secondary and chronic hypothyroidism, hypogonadism, and adrenal in sufficiency. The cadaver had fallen into the river, and received numerous wounds such　as abrasions and subcutaneous hemorrhage. Moreover, it was suspected that he had developed hypothermia before death. Cortisol in the blood and 17-OHCSin urine were within the reference range. We suspect that the adrenocortical hormone was secreted into the blood as a result of various stresses due to wounds and hypothermia. However, it was suspected that sufficient hormone might not be secreted due to chronic adrenal insufficiency. This insufficient cortisol causes the decrease in the stress resistance, and might influence his cause of death. Moreover, as hypothyroidism decreases thermogenesis, he might have fallen into hypothermia easily. In addition, because both adrenocortical insufficiency and hypothyroidism caused the hypoglycemia, he might have fallen into the loss of consciousness. Therefore, it was considered that he had died by drowning, in relation to the adrenocortical insufficiency and panhypopituitarism

トウシ ノ イチボウケンレイ

In 30th April, 72-years-old male was found dead in the grass near a farm road in TokushimaCity. An autopsy revealed that he was very thin, and rectal temperature,22℃, was relativelow against other postmortem changes. Furthermore, the left cardiac blood was brightpink, so there was markedly different between the color of right and left cardiac blood. Thelungs were collapse. From those autopsy findings, his cause of death was diagnosed the fatalhypothermia. Besides cause of death, autopsy also revealed ascites and liver tumor.Histopathologically, adenocarcinoma was observed in liver, pancreas and kidney. His heartwas slackened. Myocardial fibers were thin and intricate, and heart failure cells were observedin lungs, histopathologically. He had been operated stomach cancer, so it seems thatthe cancer has spread to liver and other organs. Those findings suggested that he failed intocachexia with chronic heart failure and metastasis carcinoma. The cachexia strongly contributedhis cause of death, fatal hypothermia

Application of AmpFlSTR ProfilerTM PCR Amplification kit for personal identification of a putrefied cadaver

A putrefied cadaver of q middle-aged woman was found drifting in the “Kii” water course. Autopsy findings indicated that the postmortem duration was about one week, and the cause of death was assumed to be drowning. In this case, a nail was collected as a sample for personal identification. After five months of police investigation, persons thought to be her family, husband and child, were found. A combination of D1S80 and the short tandem repeat (STR) typing system using an AmpFlSTR ProfilerTM PCR Amplification kit was performed for identification. Nine STRs (D3S1358, vWA, FGA, TH01, TPOX, CSF1PO, D5S818, D13S317 and D7S820) and Amelogenin were analyzed by this kit. Those DNA typings successfully confirmed the family relation for personal identification of the cadaver. This analysis system may be useful for identification of a decomposed cadaver