Sudden death due to undiagnosed intracranial hemangiopericytoma.

A previously healthy 9-year-old Japanese boy with a 4-day history of vomiting and headache died suddenly and unexpectedly. An external examination revealed no abnormalities other than foam around the mouth and nose. An internal examination revealed severe pulmonary edema and hemorrhagic hemangiopericytoma arising from the choroid plexus of the right lateral ventricle. The cause of death was thought to be neurogenic pulmonary edema caused by the rapid growth of a hemangiopericytoma, with intratumoral hemorrhage.

DNA typing from cigarette butts.

We performed DNA typing for D1S80, HLADQA1, TH01 and PM using the butts of 100 cigarettes that were smoked by ten different individuals (ten cigarettes per individual). The results obtained from DNA typing for D1S80 agreed with the results obtained using bloodstains in 76 cigarette butt samples. Sixteen samples produced false results, showing the loss of the longer allelic hetero-band. When examined using agarose gel electrophoresis, high-molecular weight DNA was not observed in these samples. The same results were also observed for buccal swab samples and saliva stains obtained from the same individuals. In the remaining eight cigarette butt samples, PCR products were not detected. The results obtained from DNA typing for TH01, HLADQA1 and PM agreed with the results obtained using bloodstains in 90 samples. In the remaining ten samples of a specific kind of cigarette (Marlboro), the PCR products were not detected. The extracts from the ends of the Marlboro cigarettes were stained yellow. When the DNA extracted from Marlboro cigarette butts was treated with Microcon-100 (amicon) or SizeSep 400 Span Columns (Amersham Pharmacia Biotech), PCR products could be detected. When PCR amplification was performed after adding extracts from the ends of unsmoked Marlboro cigarettes to DNA extracted from bloodstains, PCR products could not be detected. The present data indicate that the degradation of high-molecular weight DNA and the inhibition of PCR by dyes of the cigarette end should be kept in mind when performing DNA typing using cigarette ends.

Quality and quantity of DNA in cadavers' serum.

We investigated the quality and quantity of DNA in sera obtained from 16 cadavers who were left at room temperature or placed in a refrigerator for cadavers within 3 days of their death. The causes of death were as follows: asphyxia, 4; hemorrhage, 4; fire, 3; cold, 1; subdural bleeding, 1; sepsis, 1; cerebral contusion, 1; and pulmonary thromboembolism, 1. When examined using agarose gel electrophoresis, the samples from the victims who died from sepsis and pulmonary thromboembolism exhibited smear patterns, while the other samples exhibited ladder patterns. The size of each band was an integer multiple of approximately 180 bp, considered to be characteristic of apoptosis. The DNA concentration in the cadavers' sera ranged from 3.0 to 258.9 ng/ml. DNA types (D1S80, HLADQA1, TH01, and PM) were determined for all the samples except for the sample from the victim who died from sepsis. The detected types were the same as those obtained from paired bloodstain samples, except for in the asphyxia victim. D1S80 typing of the serum sample from the asphyxia victim showed the loss of the longer allelic hetero-band. These results suggest that the quantity of DNA in serum from cadavers is sufficient for DNA typing, but that the degradation of DNA may proceed quickly, depending on the temperature of the area in which the cadaver is left as well as the pathological conditions that the victim had experienced.

Sequence polymorphism of mitochondrial DNA in Japanese individuals from Gifu Prefecture.

Sequence polymorphisms of the hypervariable region HV1 in mitochondrial DNA (mtDNA) were analyzed in a sample of 137 unrelated Japanese individuals living in Gifu Prefecture (central region of Japan) using polymerase chain reaction amplification and direct sequencing. Eighty-two different haplotypes resulting from 81 variable sites were found in the mtDNA HV1 region between positions 16061 and 16450. The most frequent haplotype (16223T, 16362C) was shared by ten individuals. The genetic diversity and the genetic identity were 0.985 and 0.022, respectively. The C-stretch region located around position 16189 was observed in 23.4% of this population sample. Sequence heteroplasmy at the position 16103 (A/G) was found in one individual.

Usefulness of postmortem ocular findings in forensic autopsy.

We report three autopsy cases in which the eyeballs were removed and examined macroscopically and microscopically after being cut using the alternate gross examination technique. The first case was a 67-year-old woman who was killed by ligature and manual strangulation. A postmortem opthalmological observation of the left eyeball revealed tiny hemorrhages and congestion in the pars plicae of the ciliary body. These changes were considered to arise by a mechanism similar to that by which facial hemorrhages arise during strangulation. The second case was a 54-year-old man who died from a cerebral contusion received during a traffic accident. A postmortem opthalmological observation of the eyeball using a surgical microscope revealed papilledema and retinal hemorrhages resulting from a rise in intracranial pressure. The third case was a 77-year-old woman who died from cardiac tamponade caused by a stab wound to the heart. A postmortem ophthalmological examination revealed that she had undergone cataract surgery and an intraocular lens implantation. However, her relatives did not know when and where she had received the surgery. An intraocular lens was removed and its material and shape was examined. Based on an examination of the lens, we were able to locate the hospital where she had received the surgery 4 years earlier. This suggests that postmortem opthalmological observations may be useful for forensic pathology and personal identification.

Myocardial damage by resuscitation methods.

Medico-legal autopsy cases were reviewed to detect myocardial changes induced by resuscitation methods. Myofibrillar degeneration (MFD) induced by resuscitation methods was classified into two types according to Luxol fast blue staining: contraction band (CB) and diffuse staining (DS). In the cases in which cardiopulmonary resuscitation had been performed, myocytes showing CB or DS formed small foci and were distributed in the papillary muscles, septum, and inner to middle layers of the myocardium. MFD induced by vasopressors was characterized by solitary distribution of degenerating myocytes that mainly showed DS and sometimes CB. When direct current countershocks had been performed, focal MFD in the subepicardial zone appeared to be a characteristic feature.

Elder abuse and neglect: social problems revealed from 15 autopsy cases.

This study examined the elder abuse cases that occurred in Gifu Prefecture, Japan between 1990 and 2000. We conducted a retrospective study of all the cases in which the victim was 65 years or older and autopsied in the Department of Legal Medicine, Gifu University School of Medicine. Fifteen victims were classified as elder abuse victims: five men and ten women. The victims ranged in age from 66 to 87 years (mean age, 74.5 years). The types of abuse were as follows: physical abuse, 13 cases; emotional abuse, five cases; neglect, four cases; and financial abuse, three cases. In eight cases, the victims were subjected to two or more types of abuse. The cause of death of the victims varied with the type of abuse. In the physical abuse cases, subdural hemorrhage was the most common cause, followed by other violence-related deaths and hypothermia. In the neglect cases, the victims died of either starvation or suffocation after the aspiration of food into the airway. In the domestic abuse cases, one of the victim's sons was the most common perpetrator, and little or no income was considered to be a risk factor for perpetrators. In the neglect cases, dementia and difficulty in performing activities of daily living were considered to be risk factors for victims, in addition to living in social isolation.