Nihon hoigaku zasshi = The Japanese journal of legal medicine最新文献

Long distance airplanes hijacked by terrorists suddenly struck the World Trade Center in New York City on September 11, 2001. The city responded with efficient emergency service and there were a number of learning points for future planning. Early activation of the Disaster Mortuary Operation Response Team (DMORT) provided efficient family assistance by setting up a comprehensive Information Database Center and assisted the Medical Examiner in identifying the deceased. DMORT is a federally funded emergency service, made up of volunteer medical examiners and mortuary personnel, which responds to assist the local medical examiners in just such overwhelming emergency situations. We had been warned that Los Angeles was targeted as a probable site for similar attacks by terrorist groups. In response, Los Angeles has setup a far more advanced response system, the Coroner's Special Operation Response Team (SORT). SORT consists of over ten specialized units, one of which is the Weapons of Mass Destruction (WMD) Unit, staffed by qualified personnel, which provide continuing training, using standard procedures, drills and maintenance of many specialized protective equipment. Current urgent preparedness training includes the plans for maintaining government business continuity, safe keeping of electronic records, handling of multiple, widely spread fatalities through wrap, tag and hold program at multiple sites, using body bag, tag and hold procedure. Staff recruitment and training, development of equipment with the newly designed mobile facility for long range storage and field operation is an ongoing process in order to be able to respond effectively to any disaster. We still need expansion of training and equipment for handling cases of exposure to chemicals, biologic agents, radiation and nuclear energy. Plans in process are to have integration with DMORT and establish advance geographic information system, accomplished through the internet, and provide field reporting, commands and resource coordination in real time.

Unlabelled: We actively examine the causes of non-criminal unnatural deaths here at the Department of Legal Medicine in Kitasato University School of Medicine. We dealt with 3565 cases of unnatural deaths during the ten years from 1994 to 2003 (postmortem examinations, 1741 cases; consented autopsies, 1824 cases; autopsy rate, 51.2%).

Contents: deaths by diseases, 2291 cases (64.3%); deaths from external causes or others, 1274 cases (35.7%). The autopsy rate of deaths by diseases is 60.7% and that of deaths from external causes or others is 34.0%. Cardiopulmonary arrest on arrival (CPAOA) accounts for about half of total cases (50.8%), that is 1811 cases. Especially, consented autopsies in cases of non-criminal unnatural deaths performed under the permission (autopsy consent) of the bereaved family are highly significant, since they can contribute to society as greatly as judicial appraisal, and can also contribute to undergraduate and postgraduate medical education. Consented autopsy is a procedure that enhances people's recognition of legal medicine in the society and universities. We expect that other universities will establish their own methods of medicolegal activities in the future by referring to our Kitasato University system as a model.

Chemical Weapons are kind of Weapons of Mass Destruction (WMD). They were used large quantities in WWI. Historically, large quantities usage like WWI was not recorded, but small usage has appeared now and then. Chemical weapons are so called "Nuclear weapon for poor countrys" because it's very easy to produce/possession being possible. They are categorized (1) Nerve Agents, (2) Blister Agents, (3) Cyanide (blood) Agents, (4) Pulmonary Agents, (5) Incapacitating Agents (6) Tear Agents from the viewpoint of human body interaction. In 1997 the Chemical Weapons Convention has taken effect. It prohibits chemical weapons development/production, and Organization for the Prohibition of Chemical Weapons (OPCW) verification regime contributes to the chemical weapons disposal. But possibility of possession/use of weapons of mass destruction by terrorist group represented in one by Matsumoto and Tokyo Subway Sarin Attack, So new chemical terrorism countermeasures are necessary.

Biological terrorism is intentionally to use infectious substances for developing diseases or death in animals or humans, leading to disaster and panic in our community. Bioterrorism-associated diseases are mostly rare or eradicated infectious diseases, and recently, we do not have experience to make a clinical and laboratory diagnosis. In particular, these infectious diseases have incubation periods from infection to development of the disease. The staff working at public health institutions, including legal medicine, must be involved in as a first responder when bioterrorism would happen. The preparedness in general against bioterrorism and the bioterrorism-related diseases, such as anthrax, smallpox, viral hemorrhagic fever, tularemia, and botulinum toxin, important for us are described. Both medical knowledge of bioterrorism and the preparedness with training under simulation should be required in advance.

We reported an autopsy case in which an antemortem thorax roentgenograph and a postmortem photograph of thoracic vertebrae front were available for digital superimposed comparison of contour of the vertebral column and provided a positive identification by the characteristic osteophyte formation. In the elderly, the thorax roentgenograph is often stored in medical institution. Osteophyte formation of the vertebral column has individual features with the aging and formed characteristic profiles of the vertebral column. Photographing of a cadaver's thoracic vertebrae front after removing of the thoracic and abdominal organ should be carried out to make a material for future comparison examination in personal identification.

The essential social and academic task of legal medicine is to devote itself to a multidisciplinary approach to problems at the interface of medicine and law. It includes forensic medical activity, in which one of the social concerns is to investigate the fatal mechanisms, survival time and physical activity, especially in traumatic and unexpected sudden death, by means of forensic pathological procedures. To meet the social requirements through reliable interpretation of those issues, systematic practical investigations are necessary, establishing the evidence-based assessment in forensic pathology. For that purpose, an approach based on the pathophysiochemistry of fatal mechanisms may be useful to aid or support pathomorphological observations. Essential markers in forensic pathophysiochemistry are the indicators of systemic responses involving acute phase reaction to traumas, i.e., circulatory, respiratory and central nervous system (CNS) functions. A comprehensive study based on previous investigations is necessary to establish practical markers and to promote their use in routine forensic casework. In the present paper, reviewing the literature, our data in routine casework are summarized. Routine forensic casework at our institute includes biochemistry on automated analyzer systems, immunohistochemistry using commercial kits and molecular biology by means of RT-PCR: 1) blood and urine biochemistry in general, 2) oxymetry, 3) serum and pericardial myocardial markers (creatine kinase MB, troponin I and T), 4) serum pulmonary surfactants (SP-A and -D), 5) other serum markers including C-reactive protein, neopterin, catecholamines, cortisol, erythropoietin and S-100 protein, 6) pericardial natriuretic peptides, 7) urinary myoglobin, 8) immunohistochemistry of a pulmonary surfactant (SP-A) in the lungs, ubiquitin, S-100 protein and ssDNA in the brain, and 9) RT-PCR for a pulmonary surfactant (SP-A) in the lungs, ischemia- and hypoxia-related factors (hypoxia-inducible factor 1A, vascular endothelial growth factor and erythropoietin) in the brain, heart and kidneys. Further accumulation of practical data may be essentially important to establish evidence for medico-legal assessment in individual cases and to renew forensic pathology in response to potential social requirements.