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The mechanical properties and thickness of adult temporal and occipital bones were examined in modern Japanese forensic samples. Cranial bones were obtained from 293 Japanese corpses (179 men and 114 women). During autopsy, left temporal (LT), right temporal (RT), and occipital (O) bone samples were extracted from each skull. Sample thickness (ST) was measured using multidetector computed tomographic imaging. The fracture load (FL) of each sample was measured by a bending test, in which the flexural strength (FS) was calculated. The FL and ST values for O were significantly greater compared with those of the LT and RT bones. The temporal bones were thinner compared with other parts of the skull and at greater risk for fracture. There is a need to take precautions to prevent temporal bone fractures. There were no significant differences in any of the values between LT and RT, indicating bilateral symmetry of the temporal bones. There were significant negative correlations between age and the FL and FS values for all sites in both sexes, except for O in the male samples, suggesting that older individuals are at increased risk for fractures. No significant correlations were observed between age and ST values in any of the samples. There were significantly positive correlations between FL and ST values at all sites regardless of sex., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

In forensic medicine, hypothermia is a frequently encountered cause of death, and this characteristic provides public health information to prevent similar deaths in the future. Previous studies revealed regional differences in hypothermia occurrence (indoors or outdoors). However, to our knowledge, no recent studies in Japan have directly compared the characteristics of indoor- and outdoor-onset cases based on forensic autopsy reports. Hence, this study aimed to determine the characteristics and risks of unexpected hypothermia-related death. It included 218 cases from the Chiba Prefecture, Japan, wherein forensic autopsies were performed and hypothermia was diagnosed; these cases were categorized into indoor- and outdoor-onset cases, and their characteristics were examined. The results showed no significant differences between the two groups in relation to the age of onset or residential environment (i.e., the presence or absence of cohabitants). The outdoor-onset group tended to have a higher incidence of dementia. Regarding the causes of hypothermia, the indoor group had more internal causes (p < 0.0001), whereas the outdoor group had more primary and external causes (p < 0.0001 and p = 0.0029, respectively). The indoor group was more undressed than the outdoor group. Atypical antipsychotic components were predominantly detected in the blood in the outdoor group (p = 0.0077). The body mass index tended to be lower in the indoor group than in the outdoor group. Broadening public awareness of the present study findings may aid in developing preventative strategies for hypothermia based on the location of onset., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The multinodular and vacuolating neuronal tumor (MVNT) is a recently recognized brain lesion. MVNT has a characteristic appearance in MRI images and is potentially epileptogenic. To the best of our knowledge, no report has yet described this pathological entity in the forensic medicine literature. We present two medicolegal autopsy cases where postmortem MRI (PMMR) was useful to detect this lesion. Case 1: a man in his 30s, with about a 7-year history of intractable epilepsy and known MVNT died suddenly. Although MVNT was not detected in the initial morphological evaluation during autopsy, PMMR of the formalin-fixed brain revealed the lesion in the left frontal lobe. Histopathology confirmed it as a MVNT. Case 2: a man in his 20s hanged himself to death. PMMR prior to autopsy revealed MVNT in his brain, and the diagnosis was confirmed by a detailed histopathological evaluation. In both cases, postmortem CT was not useful for evaluation. The cases suggested that MVNT can cause sudden, unexpected epileptic death, and pre- or post-autopsy PMMR may be useful to detect it., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

A man in his 50 s, who was found vomiting and in a disturbed state when the emergency medical team arrived, then went into cardiopulmonary arrest during transport and died without responding to resuscitation. The hospital initially suspected that the death may have been caused by internal causes, but since the deceased had previously been transported to the hospital in a suicide attempt, the hospital called police regarding suspicions of unnatural death. The police investigation revealed two empty bottles of nicotine liquid for e-cigarettes in his house and a search history of "nicotine suicide" on his cellphone. In a forensic autopsy, he was found to be highly obese, and abundant fat deposits were observed in his organs. A stent was placed in the aorta, but no abnormality was found. There was no obvious stenosis or obstruction in the coronary arteries. Drug screening using liquid chromatography tandem mass spectrometry (LC-MS/MS) was performed on cardiac blood, urine, and stomach contents collected at autopsy, which revealed the presence of some medical products such as aripiprazole, nicotine, and cotinine. Further quantitative testing revealed high concentrations of nicotine in all samples. The left and right femoral venous blood concentrations were above the lethal dose, suggesting that arrhythmia or respiratory failure due to nicotine intoxication was the cause of death. With the widespread use of e-cigarettes, high concentrations of nicotine are readily available, and case reports of serious nicotine addiction are increasing. It is important to always consider addiction when conducting forensic evaluations in the medical field., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: Sternal fractures can have life-threatening complications. To understand chest injury mechanisms, sufficient data regarding the mechanical properties and structure of the sternum are required. The aim of this study was to examine the mechanical properties and size of the sternum in a Japanese forensic sample., Materials and Methods: Sterna were obtained from 120 Japanese dead bodies of known age and sex. The sample thickness (ST) and the sample width (SW) were measured using a computed tomographic image. Three-point-bending tests were conducted using a three-point-bending apparatus to assess the fracture load (FL) of the sample. Then, the flexural strength (FS) was calculated and the natural logarithm of FL (ln FL) and FS (ln FS) were also calculated., Results: The values of ST, ln FL, and ln FS for male samples were significantly greater than those for female samples. Both ln FL and ln FS had significant negative correlations with age regardless of sex; the Pearson product-moment correlation coefficients were larger for female samples than for male samples. Although age was significantly negatively correlated with SW in female samples, there was no significant correlation between age and SW in male samples. No significant correlations were found between age and ST regardless of sex., Conclusion: This is the first study to present quantitative data on the biomechanical properties of the sternum. Because of the smaller sternal strength of elderly women, it is especially important for them to avoid the risk of sternal fractures., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Understanding the actual conditions of methamphetamine (MA)-related death is important from the perspectives of criminal justice and public health. In this report, we review 104 cases of MA-related death handled by our departments between January 2014 and December 2020. Based on information from police and autopsy examinations, we classified the cases into the following categories: "accidental intoxication" ("MA only" and "multiple drugs or alcohol"), "fatal disease" ("definitively MA-related," "possibly MA-related," and "unlikely MA-related"), "accident," "suicide," "homicide," and "undetermined." The total number and annual trends for each category and their respective femoral blood concentrations were investigated. "Fatal disease" was the most common category (48 cases), followed by "suicide" (25 cases), "accidental intoxication" (14 cases), and "accident" (11 cases). "Definitively MA-related" in which MA may have played a role in their onset or exacerbation accounted for the majority of "fatal disease": 12 cases of heart disease, 4 cases of aortic dissection, 12 cases of cerebral hemorrhage, and 4 cases of subarachnoid hemorrhage. Cases classified as "definitively MA-related" died with lower femoral blood concentrations of MA compared with "MA only." Cases with "fatal disease" might have been misdiagnosed as "death by natural causes" if a proper autopsy and toxicology examinations were not performed. In death investigations, it is necessary to keep in mind that there are some MA-related deaths, and efforts should be made to increase awareness about the risk of death in using this drug., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

We report findings from an autopsy case who died from massive bleeding because of splenic peliosis. The case subject was an 80-year-old man who had diabetes mellitus and who was receiving hemodialysis and anticoagulant therapy. Postmortem computed tomography demonstrated massive intra-abdominal hemorrhage especially seen around the spleen. At autopsy, we found abundant hemorrhagic ascites, including a large number of clots, in the abdominal cavity. The spleen had several distinct dark red areas ranging in size from 1.5 to 2.5 cm and showed spontaneous rupture along with hematoma formation on the outside of the splenic capsule on the anterior side. From these findings, we concluded that the cause of death in this case was massive hemorrhage owing to spontaneous rupture of splenic peliosis. Although peliosis itself rarely causes death, but when it is destroyed, massive bleeding leads to death. Thus, it is necessary to know the histopathological characteristics of peliosis, in forensics., (Copyright © 2021 Elsevier B.V. All rights reserved.)

In recent years, there has been an increase in the use of phosphodiesterase type 5 inhibitors (PDE5i) that are purchased from abroad without a doctor's diagnosis via the Internet or other means. We report six cases in which nonprescription use of PDE5i may have led to death. Among the four deceased individuals who were believed to have experienced sudden cardiac death, three (cases 1-3) had a history of cardiovascular disease, which is a contraindication, and the remaining case (case 4) involved combined use of multiple PDE5i. Sildenafil (0.063 µg/mL, 0.087 µg/mL) was detected in two of the four cases of sudden cardiac death. Tadalafil (0.096 µg/mL) was detected in one of the remaining two cases, and tadalafil (0.197 µg/mL) and vardenafil (0.011 µg/mL) were detected in the other case. Sildenafil (0.032 µg/mL), tadalafil (0.062 µg/mL), and ethanol were detected in a traffic accident case with a history of contraindications. In a case of asphyxiation by vomit aspiration, autopsy showed 90% stenosis in the anterior descending branch of the coronary artery, and sildenafil (0.063 µg/mL) was detected. To the best of our knowledge, this is the first report of postmortem blood levels of tadalafil and vardenafil likely contributing to the cause of death. Despite all the warnings about the dangers of using PDE5 inhibitors, cases of PDE5i contributing to death are still identified during autopsies. Therefore, raising public awareness of the risks of the risks associated with the imported drug use by individuals is necessary., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Hypochlorous acid, produced by myeloperoxidase upon neutrophil activation, can oxidize various compounds and exert antimicrobial activity in vivo. To elucidate the mechanisms underlying the reactions of the unsaturated phosphatidylcholines, which abound in cell membranes, with hypochlorous acid, we identified and examined phosphatidylcholine chlorination and oxidation products formed under various reaction conditions. We first investigated the products of unsaturated phosphatidylcholine and hypochlorous acid reaction with respect to hypochlorite concentration and reaction time. Next, we examined the lipids extracted postmortem from human abscesses. For all the analyses, we used liquid chromatography-quadrupole time-of-flight mass spectrometry. Various compounds, including phosphatidylcholine chlorohydrin and phosphatidylcholine hydroxide/epoxide, were detected. Oxidized phosphatidylcholines were mainly detectable upon reaction with low concentrations of sodium hypochlorite, whereas chlorinated phosphatidylcholines formed in the presence of higher concentrations. In human abscesses, oxidized phosphatidylcholines were detected in the cases with high procalcitonin concentration, whereas chlorinated phosphatidylcholines were undetected. The detections of oxidized phosphatidylcholines in human tissues might indicate previous exposure to hypochlorous acid in septic cases. Our results provide insight into the mechanisms underlying pathogen survival following inflammation associated with neutrophil activation and topical myeloperoxidase release and show postmortem biomarkers candidates for sepsis., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Age estimation of cadavers from post-mortem "chest plate" using conventional radiography, which involves radiographic assessment of ossification around the sternum and rib ends, has been evaluated without fruitful results. This study examined the value of images of the chest plate obtained by three-dimensional post-mortem CT for estimation of age at time of death in a Japanese population. Five chest plate ossification scores were evaluated in 320 subjects, including ossification of the first costal cartilage (OF), ossification of the second to seventh costal cartilages at the rib (OR) and sternal (OS) ends, fusion of the manubriosternal joint (FM), and fusion of the xiphisternal joint (FX). OS was found to have the highest correlation with age while FM had no significant correlation. The best composite score for age estimation was the summative score for both sides of the OS and the right side of the OF and FX, for which the coefficient of determination (R 2 ) and the standard error of estimation (SEE) were 0.608 and 12.44 years, respectively, for men and 0.590 and 14.65 years for women. The accuracy of the model was tested in a further 26 male and 24 female subjects, and the accuracy rate within the first SEE was 57.69% and 70.83%, respectively. This rapid and non-invasive method of age estimation in the chest plate area is superior to conventional methods and could be useful for estimation of age at time of death in the Japanese population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Purpose: The purpose of this study was to determine the incidence of three-rooted mandibular first molars in a contemporary Japanese population using multidetector computed tomography (MDCT) and examine whether this characteristic root form may be useful for identification purposes., Methods: Prior to their forensic autopsies, we obtained MDCT scans of 365 cadavers (255 males, 110 females) with mandibular first molars on both sides. Altogether, 730 mandibular first molars were examined morphologically on reconstructed CT images, and the incidence of three-rooted molars was recorded. The results were analyzed statistically to determine sex and left-right differences using the chi-square test., Results: In all, 189 (25.9%) of the 730 mandibular first molars had three roots: 79 (31.0%) in the 255 males and 35 (31.8%) in the 110 females. No statistically significant difference was found between the sexes. In the 39 individuals who had unilateral three-rooted mandibular first molars, 7 (17.9%) were on the left side and 32 (82.1%) were on the right side, indicating a statistically significant predominance on the right side., Conclusions: The incidence of three-rooted mandibular first molars in contemporary Japanese individuals was 25.9%, with no statistically significant sex difference, but in the case of unilateral three-rooted teeth, with a statistically significant predominance on the right side. Our study found that Japanese and northeastern Asians have a high incidence of the three-rooted mandibular first molars among individuals of Mongolian origin; this finding may be a useful screening tool for identification of unknown individuals., (Copyright © 2016. Published by Elsevier Ireland Ltd.)

Traumatic rhabdomyolysis generally occurs after severe blunt trauma and is acute in onset, associated with severe disease, and potentially lethal. Accordingly, diagnosis of traumatic rhabdomyolysis in patients without massive subcutaneous or intramuscular hemorrhage is difficult, especially in the postmortem period, which is limited in terms of the availability of biochemical examination tools and accurate history of illness. To the best of our knowledge, there are no previous reports of death from traumatic rhabdomyolysis among individuals who did not pursue medical consultation. A previously healthy man in his early sixties had been punched and kicked several times in the previous 2months, but he had not gone to a hospital. He suddenly lost consciousness at his workplace approximately 5days after the most recent assault, and cardiopulmonary arrest occurred when the emergency service arrived. He died the same day, and a medicolegal autopsy was performed. Although several sites of minor subcutaneous and muscle hemorrhage were observed, the cause of death was unclear upon macroscopic assessment. Immunohistochemical staining revealed acute renal failure caused by rhabdomyolysis. We herein report a rare case of fatal traumatic rhabdomyolysis, seemingly associated with minor and apparently nonlethal muscle injury., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Blood and tissue samples from a forensic autopsy of a man in his late 60s, who developed dementia and died of multiple head traumas due to a fall from a moving vehicle, contained certain amounts of n-butane and i-butane. The concentration of n-butane was in the range of 0.48-70.5 μL/g, which would be considered as toxic or lethal levels. We had to distinguish whether the cause of his unexplained behavior was due to his pre-existing condition (dementia), or from a confused state induced by butane abuse. No traces of butane use were found at the scene. Police investigation revealed that a propellant used in an anticontagious plugging spray had been administered to him during a postmortem treatment in the emergency hospital. In order to prove the postmortem butane diffusion had resulted from the spray administration and to estimate the diffused concentration, experimental simulation was conducted by using rats. As a result of postmortem treatment with the spray, n-butane at concentrations of 0.54-15.5 μL/mL or g were found in the rat blood and tissues. In this case, we provided further evidence that the postmortem butane diffusion, caused by using the anticontagious plugging spray containing butane gas as a propellant administered to a cadaver during a postmortem procedure prior to forensic autopsy, should be distinguished from cases of actual butane poisoning., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

The aim of this study was to assess the correlation between stature and cranial measurements in a contemporary Japanese population, using three-dimensional (3D) computed tomographic (CT) images. A total of 228 cadavers (123 males, 105 females) underwent postmortem CT scanning and subsequent forensic autopsy between May 2011 and April 2015. Five cranial measurements were taken from 3D CT reconstructed images that extracted only cranial data. The correlations between stature and each of the cranial measurements were assessed with Pearson product-moment correlation coefficients. Simple and multiple regression analyses showed significant correlations between stature and cranial measurements. In conclusion, cranial measurements obtained from 3D CT images may be useful for forensic estimation of the stature of Japanese individuals, particularly in cases where better predictors, such as long bones, are not available., (Copyright © 2015. Published by Elsevier Ireland Ltd.)

Analysis of oxyhemoglobin (O2-Hb) saturation levels in the left and right heart blood is useful in the assessment of exposure to cold surroundings before death. We quantified conventional subjective visual evaluation of O2-Hb saturation levels and developed useful diagnostic criteria for fatal hypothermia: O2-Hb saturation in the left heart blood (L-O2Hb) was ⩾36%, the O2-Hb saturation gap between the left and right heart blood (L-R gap) was ⩾13%, and the O2-Hb saturation ratio of the left to right heart blood (L/R ratio) was ⩾1.8. When we used L-O2Hb of ⩾36% as a basic criterion and applied a further criterion of an L-R gap of ⩾13% or an L/R ratio of ⩾1.8, these criteria registered a sensitivity level of ⩾86% and specificity level of ⩾93% for the diagnosis of fatal hypothermia. This method can be useful for determining fatal hypothermia in connection with conventional autopsy findings, as well as histological and biochemical markers., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

A 56-year-old man was hit by a car while riding a bicycle, immediately brought to the hospital, and treated. Four days after the accident, he reported abdominal pain and vomiting in the night, and he died the next day. A forensic autopsy was performed, and almost of the entire small bowel had gangrenous swelling. The mesentery was twisted 180° with clockwise rotation along the vascular axis, and pre-autopsy computed tomography scan showed a whirl sign., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

The death investigation system in Japan is in the midst of a great transformation. As part of efforts to revise this system, in this study we analyzed the reasons the police refer unnatural death cases for forensic autopsy and, from an understanding of the trends of such referrals, we discuss the future direction of handling unnatural deaths in our country. For 1618 forensic autopsy cases handled by the First Investigation Division of Chiba Prefectural Police that were referred to our institution for forensic autopsy between 2003 and 2012, we tallied the number of autopsies by sex, age group, and reason for forensic autopsy for each year and investigated trends in the referrals over time. The results revealed that the number of autopsies increased annually from 2003 to 2012, with a marked increase from 2010. The number of autopsies increased particularly for cases of suspected criminal deaths, where it was unclear to the police before the forensic autopsy whether or not the death resulted from a criminal act. Our findings suggest that the number of forensic autopsies will continue to increase into the future in Chiba prefecture, and is a trend that is inevitable if we are to prevent criminal death cases from being overlooked. Although referrals for forensic autopsy in Japan are made only when criminal activity is suspected, the original purpose of death investigations is not only to avoid overlooking crimes, but also to flag public health issues. Therefore, together with the police, we need to review the original purpose and conduct more in-depth discussions about when referrals are necessary., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

The aim of our study was to evaluate correlations between cadaver stature (CS) and radial and ulnar lengths based on three-dimensional (3D) computed tomography (CT) images, and to develop modern regression equations for estimating CS in a Japanese population. Measurements were performed on 245 Japanese subjects (123 males and 122 females) who underwent postmortem CT between May 2011 and December 2013. A 3D reconstructed image was used for assessment. The linear distances of the left radial (LR) and right radial (RR) lengths were measured as a straight-line distance from the most anteroproximal point of the head to the most distal end of the styloid process. The linear distances of the left ulnar (LU) and right ulnar (RU) lengths were measured as a straight-line distance from the most posteroproximal point of the olecranon to the most distal end of the styloid process. The correlation between CS and each parameter (LR, LU, RR, and RU) was assessed using Pearson product-moment correlation coefficients and regression analysis was performed for stature estimation. There were significant correlations between CS and each parameter regardless of sex, indicating that the radial and ulnar lengths measured on 3D CT images can be predictive of stature estimation. Simple regression equations for stature estimation calculated from LR provided the lowest standard error of estimation (SEE) (all subjects, SEE=4.18 cm; males, SEE=4.09 cm; females, SEE=4.21 cm). In addition, multiple regression equations were more accurate and reliable than the single linear regression equations., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

We report findings from an autopsy of a male in his 40s who died of a brain stem hemorrhage associated with cerebral amyloid angiopathy (CAA), senile plaques (SPs) and neurofibrillary tangles (NFTs), which are histopathological changes associated with Alzheimer's disease (AD). Our immunohistochemical study demonstrated amyloid β (Aβ) deposition in the small cerebral arteries and SPs. Although hypertension (178/132 mmHg) was detected, the subject was not treated accordingly. CAA coupled with hypertension might have caused the intracerebral hemorrhage (ICH)., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

A man in his twenties was diagnosed with schizophrenia in his late teens. The night before his death, his family reported he drank a large amount of water, vomited, collapsed, and snored loudly while sleeping, but they did not view the event seriously as he did it routinely. The following morning, he was found dead. Autopsy revealed hyponatremia by water intoxication as the cause of death. Water intoxication has various causes. In this case, 610 ng/mL olanzapine was detected in serum samples. Although this concentration is not as high as the fatal concentrations reported in past studies, it might have caused some adverse effects. Furthermore, the observation that excessive drinking behavior started after the dose of olanzapine was increased suggests a possibility that olanzapine aggravated water intoxication., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

The aim of this study was to determine if biomechanical investigations of skull samples are reliable after skulls have been subjected to a freezing and thawing process. The skulls were obtained from 105 Japanese cadavers (66 males, 39 females) of known age that were autopsied in our department between October 2012 and June 2013. We obtained bone specimens from eight sites (four bilaterally symmetrical pairs) of each skull and measured the mass of each specimen. They were then classified into three groups (A, B, C) based on the duration of freezing of the experimental samples. The left-side samples were subjected to frozen storage (experimental group). The corresponding right-side samples were their controls. Bending tests were performed on the controls immediately after they were obtained. The experimental samples were preserved by refrigeration at -20 °C for 1 day (group A), 1 month (group B), or 3 months (group C). Following refrigeration, these samples were placed at 37 °C to thaw for 1 h and then were subjected to bending tests using a three-point-bending apparatus attached to a Handy force gauge. The device recorded the fracture load automatically when the specimen fractured. Statistical analyses revealed that there were no significant differences in sample fracture loads between the frozen preserved/thawed samples and the unfrozen controls for each of the cryopreservation intervals. We eliminated any possible sample mass bias by using controls from the same skull in each case. The results suggest that the freezing/thawing process has little effect on the mechanical properties of human skulls. Thus, frozen storage for up to 3 months is a good method for preserving human skulls., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

We evaluated the relationship between stature and the length of the sacrum and coccyx using multidetector computed tomography (MDCT) and derived regression equations for stature estimation in the modern Japanese population. Two hundred and sixteen Japanese subjects (110 males and 106 females) who underwent postmortem computed tomography with subsequent forensic autopsy between January 2010 and August 2013 were measured. A sagittal-plane image of the sacrum and coccyx was used. Anterior sacral length (ASL) was defined as the linear distance from the anterosuperior edge of the first sacral vertebra (S1) to the anteroinferior edge of the fifth sacral vertebra (S5), and posterior sacral length (PSL) was defined as the linear distance from the posterosuperior edge of S1 to the anteroinferior edge of S5. Anterior sacrococcygeal length (ASCL) was defined as the linear distance from the anterosuperior edge of S1 to the anteroinferior edge of the last coccygeal vertebra (LCV), and posterior sacrococcygeal length (PSCL) was defined as the linear distance from the posterosuperior edge of S1 to the anteroinferior edge of the LCV. The correlation between stature and each parameter was evaluated by simple regression analysis using Pearson product-moment correlation coefficients. Each parameter was significantly and positively correlated with stature among both males and females. Cadaver stature (CS, cm)=0.39×PSL (mm)+123.70 [Corrected] provided the most accurate stature prediction (R=0.507, SEE=5.83 cm) in males. CS (cm)=0.56×PSCL (mm)+85.29 provided the most accurate stature prediction (R=0.659, SEE=6.68 cm) in females. We conclude that sacral/sacrococcygeal length measured with MDCT is a potentially useful tool for stature estimation, particularly in cases where better predictors such as the long bones are not available., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Postmortem computed tomography (PMCT) is often used to diagnose causes of death, especially in nations with a low autopsy rate. To identify the causes of death that can and cannot be determined by PMCT, imaging findings were reviewed in 339 consecutive forensic autopsy cases. Causes of death could be determined based on PMCT findings alone in 7% of these cases, based on suggestive PMCT findings with additional information in 54%, and could not be determined by PMCT in 38%. PMCT screening may be useful for establishment of some causes of death, including traumatic intracranial hematoma, endogenous intracranial hemorrhage, and some cases of cardiac rupture. Suggestive findings from PMCT in other cases, such as those involving subarachnoid hemorrhage or pericardial hematoma, can lead to misdiagnosis and may be a pitfall of PMCT screening. Causes of death including some cases of cervical cord injuries, asphyxiation, burn, drug intoxication, acute myocardial infarction, and pulmonary thromboembolism cannot be diagnosed using PMCT., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

We report two infant deaths attributable to intussusception, but without clear evidence of peritonitis. In the first instance, a 3-year-old girl had presented with abdominal pain, vomiting, and melena before her demise. Aspirated vomitus was subsequently ascertained as the immediate cause of death, due to intussusception-induced ileus. The other infant, a 2-month-old male, showed autopsy evidence of intussusception at two sites, with likely aspiration of gastric mucus. Since the circumstances surrounding his death were vague, timing of the intussusception was difficult to pinpoint. Thus, an inconsequential, agonal event could not be discounted. Taken together, however, death from intussusception, without peritonitis, is the most viable postmortem interpretation for both patients. The causes of death in such cases are established by comprehensive delineation of preceding clinical events, plus autopsy documentation of coexistent intussusception and vomitus aspiration., (Copyright 2010 Elsevier Ireland Ltd. All rights reserved.)

We discuss the usefulness of postmortem computed tomography (PMCT) by reviewing cases of cervical spine injury. A merit of PMCT is that it can identify injury that cannot be found on autopsy; however, peculiar defects of it may exist. While PMCT can identify bone fractures, it cannot indicate whether the injury was inflicted while the deceased was still alive or not because of its inability to clearly image bleeding around the fracture. Furthermore, CT often misses some types of cervical spine injuries, such as laceration of an intervertebral disk and incomplete fracture of the cervical spine. On the other hand, cervical spine injury on CT images occasionally has an appearance similar to subarachnoid hemorrhage due to rupture of the cerebral artery, indicating that cervical spine injury can be misdiagnosed as a disease by PMCT. When PMCT is used for screening trauma, caution must be observed regarding its limitations. If the possibility of trauma of the neck or head is not completely ruled out from the personal history of the victim, autopsy is strongly recommended, even when PMCT findings indicate that the cause of death may be due to disease, such as subarachnoid hemorrhage.

The DNA of aortic tissues collected at the autopsies of unidentified 47 cadavers was examined using a multiplex short tandem repeat (STR) typing kit. The causes of death included drowning, burning and brain injury among others. Tissues samples were stored in ethanol before DNA extraction. DNA was extracted from about 25mg of dried tissues using a Q1Amp DNA Mini kit (QIAGEN). STR typing was performed using an AmpFlSTR Identifiler PCR Amplification kit (Applied Biosystems) and GeneMapper ID software v. 3.2 (Applied Biosystems). The amount of recovered DNA ranged from 0.006 to 3.44 microg/mg. Tissue samples were collected at estimated times between 1 day and 2 years after death. We were able to type 46/47 tissue samples (98%) and all 15 STR alleles and the amelogenin gene were detected in 38 cases (81%). Successful typing was completed for most tissue samples taken less than 1 month and up until 3 months after death. As the days after death increased, the numbers of alleles with longer DNA fragment sizes decreased. These results suggest that the DNA from aortic tissues can be accurately typed for multiplex STR and amelogenin until about 1 month after death. We found that aortic tissues are one of the most useful samples for forensic personal identification of unidentified bodies.

It is thought that there is a close relationship between regionality and DNA polymorphism of H.pylori. The application of H.pylori DNA to estimate the origin of unidentified cadavers may be possible. Previously, we detected H.pylori DNA in five stomach lesions by PCR in 50% of 100 cadavers in forensic autopsies. Furthermore, to see the localization of H.pylori in the digestive system, we tried to assay H.pylori DNA by real-time PCR. Mucous membranes at 14 points of digestive systems (5 points of the stomach, 1 point of the duodenum, 5 points of the small intestine, 3 points of the large intestine) were obtained from three cadavers whose stools were H.pylori-positive by an ImmunoCardST!HpSA detection kit. Genomic DNA was extracted using a DNA extraction kit. The 23Sr-DNA region was PCR-amplified (320 bp) by a TOYOBO Kit and the same region was assayed by real-time PCR using a Taqman probe. The PCR products were detected in 5 points of the stomach and 1 point of the duodenum in each sample. The more peripheral the intestine lesion was the weaker the band became. The quantitative PCR showed that there were more PCR products in 5 points of the stomach and 1 point of the duodenum than in the other tissues. H.pylori DNA was detected not only in the stomach but also in the duodenum and small intestine. There was a difference in the amount of H.pylori DNA detected in each organ. Further study is required for immunohistochemical staining, and to determine the relationship between a persons natural state and the H.pylori DNA polymorphism (which codes for CagA).