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1.
Leg Med (Tokyo) ; 66: 102358, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38056179

RESUMO

Spinal cord injury is difficult to detect directly on postmortem computed tomography (PMCT) and it is usually diagnosed by indirect findings such as a hematoma in the spinal canal. However, we have encountered cases where the hematoma-like high-attenuation area in the cervical spinal canal was visible on PMCT, while no hematoma was observed at autopsy; we called it a "pseudo hematoma in the cervical spinal canal (pseudo-HCSC)." In this retrospective study, we performed statistical analysis to distinguish true from pseudo-HCSC. The cervical spinal canal was dissected in 35 autopsy cases with a hematoma-like high-attenuation area (CT values 60-100 Hounsfield Unit (HU)) in the spinal canal from the first to the fourth cervical vertebrae in axial slices of PMCT images. Of these 22 had a hematoma and 13 did not (pseudo-HCSC). The location and length of the hematoma-like high-attenuation and spinal cord areas were assessed on reconstructed PMCT images, true HCSC cases had longer the posterior hematoma-like area and shorter the spinal cord area in the midline of the spinal canal (P < 0.05). Furthermore, we found that true HCSC cases were more likely to have fractures and gases on PMCT while pseudo-HCSC cases were more likely to have significant facial congestion (P < 0.05). We suggest that pseudo-HCSC on PMCT is related to congestion of the internal vertebral venous plexus. This study raises awareness about the importance of distinguishing true HCSC from pseudo-HCSC in PMCT diagnosis, and it also presents methods for differentiation between these two groups.


Assuntos
Hematoma , Imageamento post mortem , Humanos , Estudos Retrospectivos , Hematoma/diagnóstico por imagem , Pescoço , Canal Medular/diagnóstico por imagem
2.
Forensic Sci Int ; 339: 111419, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35994987

RESUMO

Respiratory viruses can cause fatal systemic infections; therefore, post-mortem diagnosis is essential in forensic autopsy cases. However, little is known regarding the distribution of respiratory viruses in the body. In this study, we investigated the anatomical distribution of respiratory viruses in 48 forensic autopsy cases suspected of viral infections at our institute. Fast Track Diagnostics (FTD) Respiratory Pathogens 21 was used as a screening test for 20 respiratory viruses in nasopharyngeal swabs. In cases with positive results for virus detection by the screening test, the detected viruses were quantified in body fluid and organ specimens by virus-specific real-time reverse transcription polymerase chain reaction (RT-PCR) and digital PCR. Viruses were detected in 33 cases, with the viral distribution and load differing among the cases. Since various respiratory viruses were detected from the nasopharyngeal swab and its viral load was higher than those of other body fluid specimens, the nasopharyngeal swab was suggested as a useful specimen for the post-mortem detection of respiratory viruses. Viruses were detected in almost all specimens including the serum in six cases. Considering the viral distribution in the body, pathological findings, and ante-mortem symptoms, these cases were presumed to be systemically infected, having died in the acute infection phase. In conclusion, the anatomical distribution of respiratory viruses can help indicate ante-mortem systemic conditions and the cause of death.


Assuntos
Infecções Respiratórias , Viroses , Vírus , Autopsia , Humanos , Reação em Cadeia da Polimerase em Tempo Real , Infecções Respiratórias/diagnóstico , Viroses/diagnóstico , Vírus/genética
3.
Leg Med (Tokyo) ; 48: 101821, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33348260

RESUMO

Benzalkonium chloride is widely used in disinfectants. Several toxicological and fatal cases have been reported; however, little is known about its kinetics and distribution. We investigated the kinetic characteristics and distribution of benzalkonium cation (BZK) based on the length of the alkyl chains C12, C14, and C16. Rats were treated intravenously with BZK solution (dose, 13.9 mg/kg) containing equal amounts of the three homologues. Kinetic parameters in the blood were assessed, and BZK distribution in the blood and tissues was examined both in rapid intravenous (IV) and drip intravenous (DIV) administrations. BZK concentrations were analysed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). BZK with longer alkyl chains showed lower elimination tendencies and remained in the blood for a longer duration. Concentrations of BZK were higher in the heart, lung, spleen, and kidney than those in the blood, and lower in the brain and fat. In both the IV and DIV groups, the lung, liver, spleen, and fat samples showed higher concentrations of the longer alkyl chains (BZK-C12 < -C14 < -C16), and the opposite trend was observed in the kidney (BZK-C16 < -C14 < -C12). Only the heart and muscle samples displayed the homologues in ratios comparable to the original administered solutions. Differences between IV and DIV groups could be identified by comparing concentrations of BZK homologues in the heart, lung, spleen, and kidney samples. We found that the kinetics and distribution of BZK were influenced by the alkyl chain length, and analysing each BZK homologues in blood and tissue samples may provide useful information.


Assuntos
Compostos de Benzalcônio/metabolismo , Compostos de Benzalcônio/farmacocinética , Animais , Compostos de Benzalcônio/administração & dosagem , Compostos de Benzalcônio/química , Infusões Intravenosas , Rim/metabolismo , Pulmão/metabolismo , Masculino , Miocárdio/metabolismo , Ratos Wistar , Soluções , Baço/metabolismo , Relação Estrutura-Atividade , Distribuição Tecidual
5.
J Inj Violence Res ; 3(2): 74-9, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21498969

RESUMO

BACKGROUND: It has been pointed out in Japan that criminal punishment in domestic homicide cases, especially in fatal child abuse cases, tends to be more lenient than in public homicide cases that occur outside the home. In recent news accounts of fatal child abuse cases, however, the media has reported that court-imposed sentences have tended to be stricter every year. METHODS: Using the online databases of three major Japanese newspapers, we collected articles about fatal child abuse cases that had been published from January 2008 to December 2009. We analyzed these articles to determine, whether a tendency towards tougher penalties, as was put forward by the media, actually exists at present time in the criminal system in Japan. RESULTS: We found 24 cases, out of which 20 involved only one offender and 4 involved two offenders. These 28 offenders comprised nine biological fathers, 11 biological mothers, and eight other male relatives of the child victims. We found that the sentences handed down by the court clearly tended to be more lenient for female offenders. A new system of criminal jurisprudence, the so-called saiban-in system wherein citizens serve as "lay judges" in criminal trials involving serious crimes, was implemented in Japan at the start of 2009. Each, district court has gradually adopted this new system after a preparation period of approximately five years starting in 2004. CONCLUSIONS: Many figures in the Japanese media predicted that the gap between social expectations and court sentences for sanction against domestic homicide cases would be filled with the present transitional period of the Japanese criminal system. However, the present study found no significant difference in the laws regarding sentencing in fatal child abuse cases before and after the preparation period of the saiban-in system.


Assuntos
Maus-Tratos Infantis/mortalidade , Adolescente , Adulto , Criança , Maus-Tratos Infantis/legislação & jurisprudência , Pré-Escolar , Direito Penal , Feminino , Homicídio/legislação & jurisprudência , Humanos , Lactente , Japão/epidemiologia , Masculino , Pais , Fatores de Tempo , Adulto Jovem
6.
Leg Med (Tokyo) ; 11 Suppl 1: S390-2, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19282215

RESUMO

Kyukei is the prosecutor's suggestion of punishment for the accused in the closing argument in the Japanese criminal court. It is rumored that the court sentence is foreseeable in 8 out of 10 of Kyukei. In this study, the ratio of the average sentence against the Kyukei for Oyako-shinju cases was confirmed to be 0.85 for male offenders and 0.71 for female offenders. Although there is a somewhat lenient tendency observed for female offenders, the ratio may almost be found around 0.8. To make a comparative study, we referred to the Kyukei and sentences of out-of-home murder cases and fatal child abuse cases. In the murder case, the ratio of the average sentence against the Kyukei is 0.83, whereas in the child abuse case it is 0.73. What is called the "myth of 8 out of 10" is more applicable for the male offenders who commit the majority of crimes, than for the females. Most of the crimes committed by women are domestic in nature. Indeed, because most women's domestic cases are due to husbands who are absent, behave violently, or are irresponsible, their circumstances of committing the crimes may be taken into account by the judge.


Assuntos
Direito Penal , Homicídio/legislação & jurisprudência , Prisões , Criança , Maus-Tratos Infantis/legislação & jurisprudência , Feminino , Humanos , Japão , Masculino , Distribuição por Sexo , Fatores de Tempo
7.
Kekkaku ; 79(12): 743-6, 2004 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-15782620

RESUMO

Tuberculosis control program in Japan focuses more on completion of treatment. The activities for patients to complete treatment are being actively done with collaboration between nurses of hospitals and public health nurses of the health centers. In 2000, Ministry of Health Welfare announced DOTS program version Japan. As a result, health centers of big cities implemented DOTS for homeless tuberculosis patients and hospitals DOT for in-patients. In 2003, the government demonstrated the scheme of DOTS strategy Expansion Program version Japan, which includes community DOTS types to be selected depend upon the risk of default with an individual patient. It is necessary to develop and utilize social and human resources in the community to expand surely supporting system for patient's compliance. Mutual understanding and collaboration of the relevant organizations become very important. In this symposium, four panels from hospital, clinic and public health center discuss on the current situation and challenge of supporting system and the assessment of treatment outcome. 1. DOTS implementation with collaboration on nursing activities between hospital and public health center in Kyoto Prefecture: Ikuyo HIROHATA (National Hospital Organization Minami Kyoto National Hospital). 2. From standpoint of clinical practice: Hidenori MASUYAMA (Japan Anti-Tuberculosis Association Shibuya Clinic). 3. The activities for case support based on DOTS Program in Wakayama Prefecture: Kimiko KAWASAKI (Tanabe Public Health Center, Wakayama Prefecture). 4. Assessment of supporting activities for patient's compliance: Tomoko TAKANO (Uki Public Health Center, Kumamoto Prefecture). Three speakers gave additional comments and advice on quality supporting and nursing activities for patient's compliance through good coordination between hospitals and publics health centers.


Assuntos
Terapia Diretamente Observada , Serviço Hospitalar de Enfermagem/organização & administração , Cooperação do Paciente , Enfermagem em Saúde Pública/organização & administração , Qualidade da Assistência à Saúde , Tuberculose/enfermagem , Controle de Doenças Transmissíveis , Centros Comunitários de Saúde/normas , Comportamento Cooperativo , Pessoas Mal Alojadas , Humanos , Pacientes Internados , Japão , Avaliação de Resultados em Cuidados de Saúde
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