Language：Japanese   Publisher：法医学談話会  

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Language：Japanese   Publisher：日本法医病理学会  

我々は無症状の新型コロナウイルス感染症(COVID-19)の法医解剖症例を経験した。解剖前ならびに解剖時に採取した体液および臓器についてリアルタイムRT-PCR法により新型コロナウイルス(SARS-CoV-2)を検出した。感染性の有無は不明であるが、採取した検体の多くからSARS-CoV-2が検出されたことから、遺体やその検体を扱う際には適切な感染予防対策を講じることが重要である。(著者抄録)

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.legalmed.2020.101821

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.radcr.2020.10.029

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DOI： 10.1016/j.jflm.2019.05.001

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Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications  

Forensic pathologists use post-mortem phenomena to estimate the post-mortem interval (PMI). We have reported on the usefulness of post-mortem lividity spectrophotometric values to estimate PMIs. Here, we focused on blood colour, looking for associations between blood colour, age and PMI. We generated predictive equations for blood-colour values and the PMI. We included data from a total of 129 cadavers (84 males and 45 females). We measured the colour of 124 left ventricular blood ( L*_l, a*_l, b*_l), 123 right ventricular blood ( L*_r, a*_r, b*_r) and 57 femoral blood ( L*_f, a*_f, b*_f) samples. We found no significant associations between blood colour and age or between blood colour and the PMI, but the values of a*_l, b*_l, a*_r and b*_r were significantly increased with increased age, and those of L*_f, a*_f and b*_f were significantly decreased with increased PMI. We created equations to estimate blood colour. The equations for femoral blood colour had higher adjusted R² values and lower root mean square error values than those for left and right ventricular blood colours. We generated equations to estimate PMIs using blood-colour values and autopsy findings. Our estimated PMIs up to 67 hours had accuracies within 8.84 hours, without measuring post-mortem lividity colour or considering the age of the deceased. This is the first study to estimate PMIs based on blood-colour spectrophotometric values.

DOI： 10.1177/0025802418819611

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Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/0025802418819611

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Dragging injuries caused by automobiles involved in an accident are occasionally reported; however, those without injury to the thoracoabdominal organs are rare. We present an autopsy case of a man in his 20s found dead on the road after being dragged by a passenger automobile for a distance of 3.4 km. The accident caused fatal dragging injuries but no thoracoabdominal injuries. The victim appeared to be drunk and was lying on the road in front of the parked automobile. Dragging injuries are a unique type of traffic accident that sometimes result from limited and poor visibility due to darkness, rain, or fog. In particular, lying on the road in a drunken state is a specific risk factor for dragging injuries. The dragging distance, road-surface properties, strength of pressure applied by the underbody of the automobile, and the victim's posture are considered to affect the distribution and degree of dragging injuries. Based on autopsy findings and eyewitness testimonies, we discuss the injury mechanism and attempt to reconstruct the accident.

DOI： 10.1097/PAF.0000000000000423

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Methomyl (S-methyl-l-N-Kmethylcarbamoyfloxylthioacetimidate) is a carbamate pesticide. It has been noted that in some cases of methomyl poisoning, methomyl is either not detected or detected only in low concentrations in the blood of the victims. However, in such cases, methomyl is detected at higher concentrations in the vitreous humor than in the blood. This indicates that methomyl in the blood is possibly decomposed after death. However, the reasons for this phenomenon have been unclear. We have previously reported that methomyl is decomposed to dimethyl disulfide (DMDS) in the livers and kidneys of pigs but not in their blood. In addition, in the field of forensic toxicology, it is known that some compounds are decomposed or produced by internal bacteria in biological samples after death. This indicates that there is a possibility that methomyl in blood may be decomposed by bacteria after death. The aim of this study was therefore to investigate whether methomyl in blood is decomposed by bacteria isolated from human stool. Our findings demonstrated that methomyl was decomposed in human stool homogenates, resulting in the generation of DMDS. In addition, it was observed that three bacterial species isolated from the stool homogenates, Bacillus cereus, Pseudomonas aeruginosa, and Bacillus sp., showed methomyl-decomposing activity. The results therefore indicated that one reason for the difficulty in detecting methomyl in postmortem blood from methomyl-poisoning victims is the decomposition of methomyl by internal bacteria such as B. cereus, P. aeruginosa, and Bacillus sp. (C) 2017 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.legalmed.2017.01.001

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

We investigated temporal changes of adrenal endocrine systems through the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenomedullary (SA) axis in restraint stressed mice. Restraint stress for I day to 3 weeks caused a significant increase in serum levels of ACTH and glucocorticoids accompanied with an increase in adrenal weights, indicating activation of the HPA axis. Reflecting the overproduction of glucocorticoids, adrenal cholesterol content decreased. Moreover, adrenal gene expression involved in cholesterol supply, including scavenger receptor-class B type I, HMG-CoA reductase, and hormone-sensitive lipase, was increased over the same period. After 4 weeks stress, all of these changes returned to control levels. In contrast, adrenal gene expression of chromogranin A, which is cosecreted with catecholamine via the SA axis, was increased with 1 day to 2 weeks of stress, and decreased with 3-4 weeks of stress. Our results suggest that analyses of adrenal endocrine systems based on the combination of several markers examined here would be useful for not only proving prolonged psychological stress experience but also determining its duration. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2014.03.005

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Language：English   Publisher：HUMANA PRESS INC  

DOI： 10.1007/s12024-013-9517-4

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

A 40s-year-old woman with previous history of injury due to contact with crown-of-thorns starfish, Acanthaster planci, was stung on the right middle finger. After immediately losing consciousness, she died 13 h after injury despite intensive medical treatment. Examination of the respiratory system revealed narrowing due to severe edema of the laryngopharynx, as well as alveolar hemorrhage, eosinophilic infiltration, and extensive neutrophil and eosinophil aggregation in the intravascular lumen of the lungs. Examination of the liver revealed severe diffuse hepatocellular necrosis and extremely high levels of liver transaminases, indicating severe liver damage. Based on these findings, we concluded that she had died from anaphylactic shock induced by circulation of crown-of-thorns starfish venom in the bloodstream. Injurious contact with the spine of the crown-of-thorns starfish can cause severe symptoms as well as systematic reactions, including anaphylaxis. To our knowledge, this is the first case of anaphylactic shock or death caused by human contact with the crown-of-thorns starfish reported in the English-language literature. Although rare, anaphylaxis due to injury by marine animals is potentially fatal. Saving lives requires providing education regarding prevention and enabling prompt response to possible anaphylaxis, including preparation of adrenaline for auto-injection. (C) 2014 Published by Elsevier Ireland Ltd.

DOI： 10.1016/j.forsciint.2014.01.001

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Here, we describe a high-performance liquid chromatography/photodiode array detector method for the detection of imidacloprid in biological fluids in a case of suicide by ingestion of liquor mixed with Admire Flowable insecticide (containing 20% imidacloprid). A plastic bottle containing a cloudy liquid (concentration of ethanol in the liquid was 150 mg/ml and that of imidacloprid was 50 mg/ml) was found near the decedent. The biological fluids collected at autopsy were prepared by deproteinization with acetonitrile. Zolpidem was used as an internal standard. The concentrations of imidacloprid in femoral blood and cerebrospinal fluid were 105 and 58.5 mu g/ml, respectively. Ethanol was also detected in the samples, with concentrations of 1.0 mg/ml in femoral blood and 1.4 mg/ml in cerebrospinal fluid. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2013.10.007

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ROMANIAN LEGAL MED SOC  

Objectives. In medico-legal autopsy related to decompression illness (DCI) in divers, it is important to differentiate between postmortem decompression and antemortem decompression; however, definitive criteria for autopsy diagnosis of DCI remain to be established. We aimed to clarify autopsy findings that would aid the diagnosis of DCI.
Methods. A total of 27 Wistar and 33 Zucker fatty male rats were categorized into 3 groups: antemortem decompression group (group AD), postmortem decompression group (group PD), and controls. The AD and PD rats were subjected to antemortem compression (both groups) followed by antemortem and postmortem decompression, respectively, in a hyperbaric chamber. Control rats were kept at atmospheric pressure. Intravascular bubbles and histopathological findings in the 3 groups were compared, and pulmonary emphysema was quantified using ImageJ software.
Results. Intravascular bubbles were observed in both AD and PD groups. In group AD, prolonged hyperbaric exposure increased mortality, intravascular bubbles, and pulmonary emphysema, with Zucker fatty rats showing more marked changes than Wistar rats. Further, intravascular bubbles and pulmonary emphysema in the dead rats were quantitatively greater than those in the rats that survived decompression. Moreover, in Zucker fatty rats, pulmonary emphysema was quantitatively significantly greater in group PD than that in the dead rats of group AD.
Conclusion. Our results indicate that the quantitative evaluation of pulmonary emphysema can potentially distinguish postmortem decompression from antemortem decompression. This technique may be useful in autopsy diagnosis of diving-related deaths, including DCI.

DOI： 10.4323/rjlm.2013.263

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ROMANIAN LEGAL MED SOC  

We present an autopsy case of decompression sickness (DCS). A man in his 50s who was a professional diver died of cardiopulmonary arrest on a ship after solo recreational diving with a hookah dive system. Although he was transported to a medical facility, he was confirmed dead approximately 1 h after cardiopulmonary arrest. At autopsy, the following findings were observed: skin discoloration with subcutaneous hemorrhages; diffuse bleeding in the epicardial fat, greater omentum, and mesentery; fat emboli in the kidneys; and numerous bubbles in the blood vessels. These findings, combined with those of the on-scene investigation, led to the conclusion that the subject died of DCS. The deceased had two distinctive findings related to fat: hemorrhages in the fat tissue and fat embolism. We suggest that these findings are vital reactions indicative of DCS.

DOI： 10.4323/rjlm.2013.23

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Although some previous studies have reported patients who developed compartment syndrome or died because of locally applied negative pressure, no detailed investigation of pathologic changes caused by negative pressure-induced injury has been reported in the literature. The main purpose of this study was to examine the morphologic characteristics of injury caused by local negative pressure and correlate these with systemic changes. A total of 30 male Wister rats were used. Animals were randomly assigned to 6 groups. Negative pressure was applied to the right hindlimb of each animal in each group for periods of 0 (sham-operated), 30, 60, 90, 120, or 180 min using a vacuum pump. Macroscopic and microscopic changes induced by local negative pressure were already observed after 30 min and were exacerbated with time. The proportion of muscle degeneration was highest in the deep tissues, irrespective of exposure time. The observed increase in the weight of the injured hindlimb at 180 min was caused by an approximately 30% fluid shift to the hindlimb, demonstrating that the application of negative pressure to the hindlimb of rats can induce hypovolemic shock. We here reveal the morphologic changes induced by local negative pressure and discuss possible mechanisms of negative pressure-induced injury. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2011.11.001

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

A 48-year-old man died from a transnasal intracranial stab wound caused by an umbrella. The track of the stab passed from the right nostril, through the sphenoid sinus, the left side of the sella turcica and anterior clinoid process, and finally reached the surface of the brain. The stab wound crossed the left internal carotid artery, causing an exsanguination and aspiration of blood into the airway, resulting in death. It is extremely rare that an umbrella tip used during a struggle would stab the nostril of the victim. Transnasal intracranial stab wounds can be overlooked and require sensitive handling. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.forsciint.2011.07.004

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A 77-year-old man underwent percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis as a preoperative procedure
however, he suddenly suffered cardiopulmonary arrest 4 h after the PTGBD and died. There were three centesis scars for the PTGBD,and only one pathway from the most dorsal centesis scar reached the gallbladder. Microscopically, the PTGBD pathway crossed and injured the intrahepaticarterial wall, and hepatic parenchymal bleeding extended along the PTGBD pathway to the inferior surface of the liver. Blood flowed to the peritoneal cavity through a small gap between the liver and gallbladder. Consequently, the PTGBD caused lethal bleeding. When the percutaneous transhepatic cholangio drainage/PTGBD pathway runs close to vessels near the liver surface, it might be necessary to deal with the possibility of rapid and lethal peritoneal bleeding. © 2012 Baishideng.

DOI： 10.4254/wjh.v4.i10.288

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CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2013248957

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

The right upper extremity of a 38-year-old man was entrapped in an underwater intake of a water duct of a dam reservoir, and he died despite being promptly rescued. His right upper extremity was swollen and exhibited purplish-red discolourations. The skin had numerous blisters and increased tension. Severe subcutaneous and muscle bleeding were observed in the right upper extremity. The circumference and volume of the right upper extremity were approximately 1.2 and 1.4 times, respectively, that the circumference and volume of the left upper extremity. The increase in weight of the right extremity was calculated to be approximately 2.1 kg; this finding indicates a severe decrease in the victim's central blood volume. Furthermore, it is possible that much more than 2.1 kg of blood accumulated in the upper extremity upon exposure to vacuum pressure. We conclude that the victim died of circulatory collapse that was attributable to haemorrhage and re-distribution of blood as a result of vacuum pressure on the right upper extremity. Thus, we have examined the cause of death and the effects of vacuum pressure on the human body. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2010.03.004

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Most propeller injuries occur at water recreational facilities such as those with provision for water skiing, boat racing, skin and scuba diving. Propeller injuries resulting from nautical accidents can be fatal. The sharp blades of propellers rotating at high speeds cause multiple and serious injuries such as deep laceration, chop wounds, bone fractures and mutilation of extremities. We present the autopsy reports of three people who died after colliding with boat propellers. (c) 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

DOI： 10.1016/j.jflm.2009.04.006

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DOI： 10.1016/j.legalmed.2009.06.002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BAISHIDENG PUBL GRP CO LTD  

A primary aortoenteric fistula (PAEF), defined as a communication between the native aorta and the gastrointestinal tract, is a rare cause of gastrointestinal bleeding. The preoperative diagnosis of PAEF is extremely difficult. Consequently, PAEF may cause sudden and unexpected death. We present an autopsy case of a 68-year-old man who died of massive gastrointestinal bleeding due to a PAEF. Autopsy revealed a pinhole rupture located on the third part of the duodenal mucosa and fistulized into the adjacent abdominal aortic aneurysm (AAA). Our case indicates that the aortoenteric fistula can result in fatal gastrointestinal bleeding. Consequently, a PAEF should be included in the differential diagnosis of gastrointestinal bleeding. (c) 2008 The WJG Press. All rights reserved.

DOI： 10.3748/wjg.14.4701

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Uterine leiomyoma is the most common rut nor in women of reproductive age, but rarely does it lead to fatal hemoperitoneum. We present an autopsy case in which the cause of death was massive hemoperitoneum due to rupture of a subserosal vein overlying a uterine leiomyoma. We report the case of a 28-year-old Japanese woman who had tuberous sclerosis and was gravida 0, para 0. She had a uterine leiomyoma leading to dysmenorrhea. Autopsy revealed a pinhole-sized rupture of a subserosal vein superficial to the leiomyoma that resulted in fatal hemoperitoneum. Rupture of a subserosal vein overlying a uterine leiomyoma may cause sudden and unexpected death.

DOI： 10.1097/PAF.0b013e3181744091

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DOI： 10.1007/s00414-008-0284-9

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DOI： 10.1016/j.legalmed.2008.01.005

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DOI： 10.1016/j.legalmed.2007.07.003

PubMed

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DOI： 10.1016/j.legalmed.2007.12.008

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DOI： 10.1016/j.legalmed.2007.09.002

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DOI： 10.1016/j.legalmed.2007.03.003

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DOI： 10.1097/01.paf.0000202808.85644.09

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DOI： 10.1016/j.legalmed.2005.12.003

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ PUBLISHING GROUP  

Background: Squamous differentiation/squamous metaplasia is often associated with endometrial adenocarcinoma and benign lesions, such as endometrial hyperplasia and chronic endometritis. Morules have distinct histological characteristics, and are referred to as squamous metaplasia or squamoid metaplasia.
Aim: To focus on the histological characteristics of morules and clarify the difference between morules and squamous differentiation.
Materials/Methods: Twenty endometrioid carcinomas with morules or squamous differentiation, five adenosquamous carcinomas, and eight non-carcinomatous endometrial lesions with morules were investigated. Numerous antibodies for epithelial membrane antigen (EMA), involucrin, cytokeratins, neuropeptides, and oncofetal antigens were used for immunohistochemistry. In situ hybridisation and polymerase chain reaction were used to detect human papillomavirus (HPV).
Results: The morules observed were uniform cell clusters, with no squamous differentiation. They were immunonegative for epithelial antigens including involucrin, EMA, and cytokeratins, but were positive for neurone specific enolase. A few morules were immunopositive for acetylcholine esterase, and one case was positive for somatostatin; neither oncofetal nor proliferative cell markers, including blood group A, B, and AB, or other neuropeptides were demonstrated in the morules. HPV DNA was not found in either the morules in the carcinomas or in the benign lesions. However, true squamous differentiation tissue in four endometrioid carcinomas and two adenosquamous carcinomas was HPV positive using in situ hybridisation.
Conclusion: Morules are histologically distinct from squamous metaplasia/squamous differentiation tissue. Morules are thought to be neuroectodermal-like cell clusters, and are not infected with HPV. In contrast, some of the true squamous differentiation tissue was associated with HPV infection.

DOI： 10.1136/jcp.2004.017996

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

A case where a body with unusual circular injuries was found in the sea is presented. The victim was a 60-year-old woman who had been depressed and had attempted suicide before. She was missing for 6 days before the corpse was found. The body had several almost perfectly circular injuries and C-shaped incision injuries with almost circular flaps of skin. We concluded that the cause of the peculiar circular injuries might be bite marks of Isistius spp. (I. brasiliensis and/or I. plutodus), commonly known as cookie-cutter shark because of its very unusual feeding style.

DOI： 10.1097/01.paf.0000127390.07879.62

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MARY ANN LIEBERT INC PUBL  

Large brain specimens were prepared from 50 head-injured and 50 non-head-injured cases that underwent medicolegal autopsy to critically examine the morphological changes in the periventricular tissue caused by injury to the head. Hemorrhagic damage to the ventricular wall was observed in 30 (60%) of the head-injury cases but was not observed in any of the non-head injured cases. Of 14 cases with only wounds to the scalp, five cases (35.7%) had ventricular wall damage. Of 40 cases in which death occurred within 24 h after injury, 25 (62.5%) showed ventricular wall damage. Of five cases of dying more than 24 h post-injury, only one revealed ventricular wall damage. This ventricular wall damage was frequently detected in the posterior (46%) and anterior horns (19%) of the lateral ventricle, near the attachment of the choroid plexus (19%). These morphological changes are considered primary damage, formed at the moment of impact in that concomitant hemorrhagic damage to the ventricular wall was also observed in all immediate death cases. Accordingly, detection of ventricular wall damage is considered a reliable means for deducing the occurrence of traumatic injury even in the cases where death occurs soon after injury.

DOI： 10.1089/089771504774129919

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Language：Japanese   Publisher：Ryukyu Medical Association  

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2005215474

Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER SOC TESTING MATERIALS  

A rare case of colchicine poisoning resulting from accidental ingestion of meadow saffron (Colchicum Autumnale) is reported. The plant can frequently be found in the woods of the Northern Hemisphere (1), also in Japan. A 48-year-old male was admitted to hospital complaining of vomiting, nausea and diarrhea following ingestion of the plant and died in four days. The most striking histological findings were metaphasic mitotic figures in the mucosa of the large intestine and the liver. Colchicine was detected in the bile with high-performance liquid chromatography/sonicspray ionization mass, spectrometry (HPLC/SSI-MS).

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In an epidemiological survey for Echinococcus multilocularis in rodents and insectivores from the northernmost part of the central mainland of Japan (Honshu), two taeniid species, Taenia crassiceps and Taenia polyacantha, were found in Microtus montebelli and Apodemus argenteus, respectively. The latter is the first record of distribution in Japan, and the former is the second after its first recovery from the central part of Japan. Although we have found neither larval nor strobilar stage of E. multilocularis there, discovery of these taeniid species, having overlapping global distribution with E. multilocularis in red foxes, Vulpes vulpes as well as multiple occurrences of hydatid patients having no history of visits to the endemic areas shows the possibility that the life-cycle of E. multilocularis might be maintained at least in the northernmost part of Honshu. Copyright (C) 2000 Elsevier Science Ireland Ltd.

DOI： 10.1016/S1383-5769(99)00030-6

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DOI： 10.11477/mf.1407905287

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：WILEY-BLACKWELL  

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The right upper extremity of a 38-year-old man was entrapped in an underwater intake of a water duct of a dam reservoir, and he died despite being promptly rescued. His right upper extremity was swollen and exhibited purplish-red discolourations. The skin had numerous blisters and increased tension. Severe subcutaneous and muscle bleeding were observed in the right upper extremity. The circumference and volume of the right upper extremity were approximately 1.2 and 1.4 times, respectively, that the circumference and volume of the left upper extremity. The increase in weight of the right extremity was calculated to be approximately 2.1 kg; this finding indicates a severe decrease in the victim's central blood volume. Furthermore, it is possible that much more than 2.1 kg of blood accumulated in the upper extremity upon exposure to vacuum pressure. We conclude that the victim died of circulatory collapse that was attributable to haemorrhage and re-distribution of blood as a result of vacuum pressure on the right upper extremity. Thus, we have examined the cause of death and the effects of vacuum pressure on the human body. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2010.03.004

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DOI： 10.1016/j.legalmed.2009.06.002

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An 18-year-old male driving an off-road motorcycle died from complete decapitation when his motorcycle tore a roadblock chain from its attachment. The decapitation injuries of the head and the torso corresponded perfectly, without apparent loss of tissue. The severance plane passed horizontally through the upper cervical region and C4, which sustained a comminuted fracture. The sharply delineated severance edge had a band-like abrasion. The decapitation resulted from the rotational movement of the unstrung chain, which struck and strangled the driver's neck. We were able to explain the movement of the chain and the decapitation mechanism. This case emphasizes the importance of discussing dynamics with experts to clarify a causal mechanism.

DOI： 10.1007/s00414-008-0284-9

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A motor scooter carrying two 15-year-old boys collided with the back of an open, parked truck. The tailgate of the truck was down and in a horizontal position. At the autopsy of the driver, horizontal tramline bruises were found on the anterior chest, but the thoracic cage was intact. There was a transverse tear of the ascending aorta with adventitial hematoma, but significant bleeding was not found in the pericardial sac or the thoracic cavities. Therefore, it was obvious that cardiovascular collapse occurred immediately after the accident. Neither injuries nor diseases that would cause the instantaneous death were found on examination of the whole body. We determined that the driver died of commotio cordis due to blunt force to the anterior chest. © 2008 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2008.01.005

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A 53-year-old male died from an explosion of a 66 mm M72 High Explosive Anti-Tank (HEAT) rocket. He had collected various cast-off military weapons and was selling them. There were numerous explosive injuries on the anterior side of the body, thus especially bilateral hands, left toe and right knee were severely crushed and fractured. The location and severity of the injuries suggest that he was down on his left knee and was manipulating the weapon with both hands at the moment of detonation. We consider that 66 mm M72 HEAT rocket accidentally detonated during his handling. Very rarely are civilians killed by a military weapon, except during wartime. Appropriate investigation of various explosive injuries provide not only evidence of the cause of death, but also the position and posture of the body. © 2008 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2007.12.008

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Uterine leiomyoma is the most common tumor in women of reproductive age, but rarely does it lead to fatal hemoperitoneum. We present an autopsy case in which the cause of death was massive hemoperitoneum due to rupture of a subserosal vein overlying a uterine leiomyoma. We report the case of a 28-year-old Japanese woman who had tuberous sclerosis and was gravida 0, para 0. She had a uterine leiomyoma leading to dysmenorrhea. Autopsy revealed a pinhole-sized rupture of a subserosal vein superficial to the leiomyoma that resulted in fatal hemoperitoneum. Rupture of a subserosal vein overlying a uterine leiomyoma may cause sudden and unexpected death. © 2008 by Lippincott Williams &amp
Wilkins.

DOI： 10.1097/PAF.0b013e3181744091

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We reviewed the autopsies of scuba-diving related deaths (SDRDs) that were collected from April 1982 until March 2007. In the period under consideration, a total of 40 SDRDs were registered, out of which 34 were males and 6 females. Ages ranged from 19 to 65 years, with the average of 41.5 years (SD = 12.9). Divers over the age of 40 accounted for 60% of all fatalities. The major cause of death was drowning (62.5%), followed by disease (28.5%). The average age for drowning and disease-related deaths was 38.6 (SD = 12.8) and 48.7 years (SD = 10.1), respectively. Of the 40 fatalities, 24 were beginners who had little or no experience. In this study, we compared SDRDs in the first term, from April 1982 to March 1995, and in the second term, from April 1995 to March 2007. The average age in the first and second terms was 35.4 and 45.2 years, respectively
the average age for the second term was 10 years older than the first. Of those in the first term, 13.3%, and of those in the second term, 40.0%, died from complications arising from already existing conditions. This study revealed that the onset of diseases during diving frequently causes fatal accidents, especially for older divers. © 2007 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2007.09.002

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An HPLC-UV method was established for determination of oseltamivir carboxylate, an active metabolite of oseltamivir, in biological materials. Oseltamivir carboxylate and floropipamide (internal standard) were extracted by using a mixed mode cation exchange extraction cartridge. The recovery yields of oseltamivir carboxylate from spiked blood at concentrations 0.1 μg/ml and 1.0 μg/ml were 103.8 ± 16.9% and 95.0 ± 4.3%, respectively. Linearity was obtained in the concentration from 0.1 to 3.0 μg/ml. The detection limit was 0.04 μg/ml (S/N = 3). This method was applied to a case of death from falling after ingestion of a Tamiflu® capsule containing 75 mg of oseltamivir. Concentration of oseltamivir carboxylate in the femoral blood was 0.4 μg/ml. The highest concentration in all specimens was in the liver at 18.3 μg/g. In all brain samples, the concentrations were not higher than the quantification limit (0.1 μg/g). © 2007 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2007.07.003

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This paper presents a two-rider motorcycle accident in which both riders received injuries around the groin area. In medico-legal autopsies, injuries around the groin area in victims of motorcycle accidents are usually regarded as a "fuel tank injury." Although fuel tank injuries are one of the most useful and important characteristics in determining injuries that have been found to be exclusive to the driver, our study reveals that passengers can also suffer from injuries around the groin area. To distinguish the driver from the passenger, we need to carefully consider each injury in both riders. In addition, we present bilateral traumatic testicular dislocation in the driver. We consider traumatic testicular dislocation as one of the important findings of fuel tank injuries in motorcycle accidents. © 2007 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2007.03.003

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We investigated the stability of 14 organophosphorus insecticides: dichlorvos, fenitrothion, cyanophos, malathion, phenthoate, methidathion, dimethoate, thiometon, isoxathion, diazinon, trichlorfon, EPN, acephate and sulprofos, in fresh blood. The organophosphorus compounds, except for sulprofos, decomposed over time at 37 °C, with varying decomposition speed for each compound. Methyl phosphate types (dichlorvos) decomposed most rapidly, followed by methyl thiophosphate types (fenitrothion and cyanophos) and methyl dithiophosphate types (methidathion, dimethoate and thiometon). Methyl thiophosphate types decomposed faster than ethyl thiophosphate types (isoxathion and diazinon). Of the five methyl dithiophosphate type insecticides (malathion, phenthoate, methidathion, dimethoate and thiometon), the compounds with a carboxylic ester bond (malathion and phenthoate) decomposed faster than the others. Compounds left standing at 37 °C decomposed faster than those left standing at 4 °C. Temperature has a great effect on the decomposition of organophosphorus insecticides in blood. However, the order of the decomposition speeds of each compound was approximately the same at different temperatures. In cases of suspected organophosphate poisoning, it should be considered that the blood concentration of the compound might decrease during the postmortem interval. © 2006 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.legalmed.2005.12.003

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Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

A 15-year-old male died of cardiac rupture due to blunt chest trauma from a traffic accident involving a low-speed scooter carrying 3 people and a head-on collision with a tree. The victim was sitting on the footrest of the scooter. It was concluded that the victim was compressed between the handlebar of the scooter and the other 2 passengers, causing cardiac ruptures via bidirectional compression and intravascular hydrostatic pressure. The victim may have served as a cushion for the other 2 passengers, who were not thrown from the scooter and sustained only minor injuries.

DOI： 10.1097/01.paf.0000202808.85644.09

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Language：English   Publisher：BMJ PUBLISHING GROUP  

Background: Squamous differentiation/squamous metaplasia is often associated with endometrial adenocarcinoma and benign lesions, such as endometrial hyperplasia and chronic endometritis. Morules have distinct histological characteristics, and are referred to as squamous metaplasia or squamoid metaplasia.
Aim: To focus on the histological characteristics of morules and clarify the difference between morules and squamous differentiation.
Materials/Methods: Twenty endometrioid carcinomas with morules or squamous differentiation, five adenosquamous carcinomas, and eight non-carcinomatous endometrial lesions with morules were investigated. Numerous antibodies for epithelial membrane antigen (EMA), involucrin, cytokeratins, neuropeptides, and oncofetal antigens were used for immunohistochemistry. In situ hybridisation and polymerase chain reaction were used to detect human papillomavirus (HPV).
Results: The morules observed were uniform cell clusters, with no squamous differentiation. They were immunonegative for epithelial antigens including involucrin, EMA, and cytokeratins, but were positive for neurone specific enolase. A few morules were immunopositive for acetylcholine esterase, and one case was positive for somatostatin; neither oncofetal nor proliferative cell markers, including blood group A, B, and AB, or other neuropeptides were demonstrated in the morules. HPV DNA was not found in either the morules in the carcinomas or in the benign lesions. However, true squamous differentiation tissue in four endometrioid carcinomas and two adenosquamous carcinomas was HPV positive using in situ hybridisation.
Conclusion: Morules are histologically distinct from squamous metaplasia/squamous differentiation tissue. Morules are thought to be neuroectodermal-like cell clusters, and are not infected with HPV. In contrast, some of the true squamous differentiation tissue was associated with HPV infection.

DOI： 10.1136/jcp.2004.017996

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Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

A case where a body with unusual circular injuries was found in the sea is presented. The victim was a 60-year-old woman who had been depressed and had attempted suicide before. She was missing for 6 days before the corpse was found. The body had several almost perfectly circular injuries and C-shaped incision injuries with almost circular flaps of skin. We concluded that the cause of the peculiar circular injuries might be bite marks of Isistius spp. (I. brasiliensis and/or I. plutodus), commonly known as cookie-cutter shark because of its very unusual feeding style.

DOI： 10.1097/01.paf.0000127390.07879.62

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Large brain specimens were prepared from 50 head-injured and 50 non-head-injured cases that underwent medicolegal autopsy to critically examine the morphological changes in the periventricular tissue caused by injury to the head. Hemorrhagic damage to the ventricular wall was observed in 30 (60%) of the head-injury cases but was not observed in any of the non-head injured cases. Of 14 cases with only wounds to the scalp, five cases (35.7%) had ventricular wall damage. Of 40 cases in which death occurred within 24 h after injury, 25 (62.5%) showed ventricular wall damage. Of five cases of dying more than 24 h post-injury, only one revealed ventricular wall damage. This ventricular wall damage was frequently detected in the posterior (46%) and anterior horns (19%) of the lateral ventricle, near the attachment of the choroid plexus (19%). These morphological changes are considered primary damage, formed at the moment of impact in that concomitant hemorrhagic damage to the ventricular wall was also observed in all immediate death cases. Accordingly, detection of ventricular wall damage is considered a reliable means for deducing the occurrence of traumatic injury even in the cases where death occurs soon after injury.

DOI： 10.1089/089771504774129919

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Language：Japanese   Publisher：(NPO)日本法医学会  

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Other Link： http://search.jamas.or.jp/link/ui/2006125420

DOI： 10.1089/089771504774129919

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Language：English   Publisher：AMER SOC TESTING MATERIALS  

A rare case of colchicine poisoning resulting from accidental ingestion of meadow saffron (Colchicum Autumnale) is reported. The plant can frequently be found in the woods of the Northern Hemisphere (1), also in Japan. A 48-year-old male was admitted to hospital complaining of vomiting, nausea and diarrhea following ingestion of the plant and died in four days. The most striking histological findings were metaphasic mitotic figures in the mucosa of the large intestine and the liver. Colchicine was detected in the bile with high-performance liquid chromatography/sonicspray ionization mass, spectrometry (HPLC/SSI-MS).

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Language：English   Publisher：SPRINGER-VERLAG  

Purpose. The association between hepatic allograft cold ischemia time (CIT) and graft transport distance (GTD) in human liver transplantation was examined by investigating whether extended graft transportation prolongs the CIT and adversely affects graft survival. Methods. We retrospectively analyzed 186 consecutive orthotopic liver transplants (OLTs) done between May 1997 and July 1998. The number of miles from the donor hospital to the University of Pittsburgh Medical Center in a straight line was measured in each case, and defined as the GTD. The OLTs were divided into two groups according to whether the GTD was less than or equal to200 miles or >200 miles. The latter group was then subdivided into groups of GTD 200-400 miles, GTD 400-600 miles, and GTD >600 miles. The CIT and graft outcome within 90 days after OLT were assessed. Results. Extended GTD prolonged the CIT (P<0.001). The rate of hepatic allograft loss in the long GTD group was significantly higher than that in the short GTD group (P=0.018). When the OLTs were subdivided according to GTD, the CIT increased and graft survival decreased as the GTD extended. Hepatic allograft transportation for a long distance prolonged the CIT and decreased the graft survival rate. Conclusion. Since prolonged CIT is a major risk factor, avoiding long-distance graft transportation is recommended when the donor risk factors are high.

DOI： 10.1007/s005950200152

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Language：English   Publishing type：Book review, literature introduction, etc.  

In an epidemiological survey for Echinococcus multilocularis in rodents and insectivores from the northernmost part of the central mainland of Japan (Honshu), two taeniid species, Taenia crassiceps and Taenia polyacantha, were found in Microtus montebelli and Apodemus argenteus, respectively. The latter is the first record of distribution in Japan, and the former is the second after its first recovery from the central part of Japan. Although we have found neither larval nor strobilar stage of E. multilocularis there, discovery of these taeniid species, having overlapping global distribution with E. multilocularis in red foxes, Vulpes vulpes as well as multiple occurrences of hydatid patients having no history of visits to the endemic areas shows the possibility that the life-cycle of E. multilocularis might be maintained at least in the northernmost part of Honshu. Copyright (C) 2000 Elsevier Science Ireland Ltd.

DOI： 10.1016/S1383-5769(99)00030-6

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