Igaku kenkyu. Acta medica最新文献

Records indicate that during the period of 24 years and 3 months (Jan 1963-Mar 1987) Department of Legal Medicine, Kurume University School of Medicine conducted medico-legal investigations on accidental death of 26 cases in total which occurred in process of medical practice, including 24 judicial autopsies and 2 cases by documentary investigations (clinical anamnesis, clinical diary and testimony records). The breakdown of judicial autopsy cases is following. 1) Age and sex of decedents by accident: One year and downward-2 cases (male 2), Teens-8 cases (male 3, female 5), Twenties-4 cases (male 1, female 3), Thirties-5 cases (male 1, female 4), Forties-3 cases (male 3, female 1), Fifties-3 cases (male 2, female 1), Sixties and Seventies-1 case (male) respectively. 2) Causes of accident: Making injection 17 cases (penicillin, procaine, isozol, vaccine etc., male 7, female 10), operation 3 cases (adenoidectomy, push back of the cleft palate, curettage of the nucleus, male 2, female 1), stomach biopsy 1 case (male), blood transfusion (air embolism, female), and erroneous diagnosis 2 cases (male 1, female 1). 3) Some remarks to be taken account in performance of medicolegal activities were stated for the adequate investigation.

The authors summarized 10 our papers on the mechanisms of pulmonary congestion in ligature strangulation. Since old times, a hypothesis based on hypersecretion of adrenaline at agonal stage in asphyxia is well-known. From our investigations, this hypothesis seemed to be applicable to ligature strangulated guinea-pig's lungs at least.

Based on the autoptical investigations conducted various informations were provided for the weight of organs, while the same of those organs were observed to be varied by conditions or causes such as: ages, sex distinction, physique build, time elapsed after death, cause of death and so forth. In consideration of above conditions and/or causes, our approach to judicial autopsies on the weight ratio (weight of organ/weight of body X 100) of the brains, lungs, hearts, livers, spleens, pancreases, kidneys and suprarenal glands for a total of 750 corpse resulted in the followings: 1) In regard to the cases of weight ratio of organs to the bodies within the range of ages (29-40) almost no difference has been observed by the age factor with exception of a certain increasing tendency limited to the heart weight ratio as their ages advance. 2) The weight ratio of lungs to the death group such as: by fire, drowning or asphyxia revealed rather higher level as compared with the same group such as: bleeding caused by external wound, gunshot wound or traffic accidents. 3) The weight ratio of spleens caused by the death of bleeding due to external wound and drowning has shown a lower level than that by the death of asphyxia or death of disease. 4) The weight ratio of kidneys for the group of death by fire, asphyxia and diseases has indicated a higher level than same of death group by bleeding resulting from external wound and gunshot wound. 5) The weight ratio of brains by the death of bleeding due to external wound and gunshot wound has shown a lower level than the same of death by asphyxia.

1. CTD was carried out on 76 intervertebrae of 66 patients with intervertebral disk hernia and its diagnostic merits were discussed. 2. Views in accordance with CTD and myelography are 85% which shows great importance in the diagnosis of intervertebral disk hernias. 3. CTD depicts the relationship between the intervertebral disk and spinal canal as three-dimensional, and furthermore, across-section image of the intervertebral disk can be obtained which makes it possible to know exactly where the prolapsed region of the hernia is located. This is thought to become extremely useful in the diagnosis of exterior hernias and L5-S hernias which are difficult to detect by myelography. Consequently, it is of great value in supplemental diagnosis, aids in the selection of surgical methods, and can provide other useful information.

The authors observed the endothelial cells of the pulmonary veins and the immunoreactions of histamine in the pulmonary blood vessels and measured the 3H-histamine contents of the pulmonary tissues of the guinea-pigs sacrificed by ligature strangulation. Endothelial cells of the pulmonary veins possessed abundant pores and intracytoplasmic vacuoles. Heavy reactions of histamine exclusively demonstrated on the endothelial surface of the pulmonary veins and in the Weibel-Palade body of the pulmonary artery.

Judicial autopsies conducted during the period of 24 years and 3 months (Jan 1963-Mar 1987) at Department of Legal Medicine, Kurume University School of Medicine have been recorded a total of 1,157 cases including 256 cases caused by the traumatic intracranial injury death. In this report statistical investigations conducted on 112 cases caused by traumatic intracranial injury death with exception of 144 cases caused by traffic accidental death, and the outline of several cases on those are stated. 1) Out of 112 death cases including 80 male and 32 female cases, 13 cases--younger than 15 years of age, 4 cases--16 thru 19, 12 cases--20 thru 29, 23 cases--30 thru 39, 22 cases--40 thru 49, 19 cases--50 thru 59, 8 cases--60 thru 69, and 13 cases--older than 70 years of age were specified respectively. 2) The above 112 death cases included 79 murder cases, 29 accidental cases including 1 case occurred in line of duty and 4 suicide cases. Murder cases were further broken down by the arms and/or locations into 39 cases caused by knocking and/or kicking, 12 cases making use of metal tools, 10 cases on the ground or floors, 6 cases making use of glass tools, 5 cases making use of wooden tools, 4 cases making use of sharp blade tools and other 3 unidentified cases. 3) Out of all death cases epidural hemorrhage and subdural hemorrhage indicated such majority in numbers and percentages as 54 cases or 48.2% and followed in the order of 26 cases of contusion with bone fracture or 23.2%, 11 cases of brain edema or 9.8%, 8 cases of subarachnoidal hemorrhage or 7.1%. 4) In case of the death caused by the bruise sustained on the occipital region, casualties on gyrus frontale were recognized by 97%, while the bruise located on other than the occipital region, injuries were recognized by 51% on the opposite region, and the remaining 49% of it showed injuries on the same region of the sustained. 5) In regard to traumatic subarachnoidal hemorrhage, contributing possibilities of the condition of its easy occurrence, especially the region of effect by the pressure elements of external force, the direction of primary dominant function, drinking effects and so forth were discussed. 6) The outlines of some interesting and/or instructive cases encountered during processing investigations were discussed.

The authors measured the iron contents and 3H-water contents of the lung et al.'s tissues of the guinea-pigs sacrificed by ligature strangulation. Congestion of the heart, lung, liver and kidney and anemia of the spleen were clearly recognized. And, the increase of hematocrit value of the heart blood was observed.

The authors measured the minimum diameters of the hepatic, splenic and renal blood vessels of the guinea-pigs sacrificed by ligature strangulation. Constrictions of the splenic central arteries and the splenic trabecular veins, and dilatations of the renal interlobular veins and the renal cortical and medullary capillaries were clearly recognized.

The authors determined by radioimmunoassay, spectrophotometry or fibrin plate method the changes of levels of plasma or serum vasomotor (renin, bradykinin, plasmin, lactic acid and ferritin) of guinea-pigs sacrificed by ligature strangulation. This experiment was a part of the studies on the mechanisms of the pulmonary congestion in ligature strangulation. 1) In the ligature strangulation group, significant high levels of plasma renin was observed when compared with the presacrificed group and the beating on occiput group. 2) In both the ligature strangulation group and the beating on occiput group, significant high levels of plasma lactic acid were observed when compared with the presacrificed group. However, between the above-mentioned two groups, there were no significant differences in the levels of this substance. 3) Between the ligature strangulation group and the presacrificed group, there were no significant differences in the levels of plasma bradykinin and plasmin and serum ferritin.

Serum rheumatoid factors (RF) are occasionally observed in normal individuals. The clinical significance of the appearance of RF in the general population was examined in relation to the pattern of their appearance and the age of the onset of RA. A screening for RA in the residents of Yoshimatsu-Cho, Kagoshima Prefecture (population, 4,798), showed a prevalence of 0.29%, but the sera of 128 (4.0%; 3.4% for males and 4.5% for females) of 3,200 residents obtained at the screening were positive for RF, and the percent positivity tended to increase with age. The age of the onset of RA in 466 patients exhibited a nearly normal distribution with a peak in the 40's. From these findings, RF-positive individuals in the general population may be divided into a small group predisposed to RA and a great majority in whom the positivity is simply an age associated physiologic change.