Legal medicine
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In recent years, many analogs of narcotics have been widely distributed as easily available psychotropic substances and have become a serious problem in Japan. To counter the spread of these non-controlled substances, the Pharmaceutical Affairs Law in Japan was amended in 2006 to establish a new category, "designated substances", to more strictly control these psychotropic substances. Fifty-one substances have been listed in this category as of December 2010. ⋯ Sixteen synthetic cannabinoids, classified into four groups, have been detected in products purchased up to December 2010 via Japanese-based websites. The distribution of products containing the psychoactive substances described above (so-called "legal highs" in European countries) is a worldwide problem. In this review, we survey current trends in the abuse of psychotropic substances and plants in Japan, focusing especially on synthetic cannabinoids, cathinone derivatives and psychotropic plants.
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We aimed to examine our autopsy data in order to analyze epidemiological and injury characteristics in criminal and suicidal immolation cases. During the 18-year period, we recorded 29 suicides and three homicides due to fire burns. In suicide group there was a majority of men (gender ratio: 3.1:1) and the mean age was 42.8 years (range 20-72). ⋯ Alcohol and drugs intoxication played a minor role. In six cases, the victim associated self incineration with one or more other methods of suicide (complex suicides). The presence of associated trauma raises the problem of vitality and interpretation of the lesions in determining the manner of death.
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Serotonin (5-hydroxytryptamine, 5-HT) is a neurotransmitter in the central nervous system (CNS) and a smooth muscle regulator in the cardiovascular and gastrointestinal systems. The present study investigated postmortem 5-HT levels in cerebrospinal fluid (CSF) and pericardial fluid (PCF) with regard to the cause of death in serial medicolegal autopsy cases within 48 h postmortem (n=351, >20 years of age). ⋯ For other cause of death groups, some cases showed a higher level. These findings suggest elevations in CSF and PCF 5-HT levels due to systemic toxic or hyperthermic neuronal dysfunction, and systemic stress responses to trauma without CNS involvement.
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Review
Forensic biochemistry for functional investigation of death: concept and practical application.
The essential tasks of forensic pathology involve investigation of the cause and process of death, especially in traumatic and unexpected sudden deaths, largely including unwitnessed deaths. Thus, agonal and postmortem interference is inevitable and unpredictable in all forensic procedures; this is not particular to forensic biochemistry, but also occurs in morphology and toxicology. ⋯ The main purpose of using postmortem biochemistry as well as molecular biology is to investigate the systemic pathophysiological changes involved in the death process that cannot usually be detected by morphological methods; these may be called 'pathophysiological vital reactions'. These procedures can provide useful support for pathological evidence by 'visualization' of functional alterations, and are also essential for the pathognomonic assessment of both the cause and process of death as part of routine laboratory investigations involved in 'full autopsy' in the context of social risk management.
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Case Reports
Diagnosis of fatal pulmonary fat embolism with minimally invasive virtual autopsy and post-mortem biopsy.
We report a case of a 78-year-old female with a proximal femur fracture caused by an accidental fall who died suddenly 1h after orthopaedic prosthesis insertion. Post-mortem computed tomography (CT) scan and histological examination of samples obtained with post-mortem percutaneous needle biopsies of both lungs were performed. ⋯ It was determined to be acute right ventricular failure caused by massive pulmonary fat embolism. Although further research in post-mortem imaging and post-mortem tissue sampling by needle biopsies is necessary, we conclude that the use of CT techniques and percutaneous biopsy, as additional tools, can offer a viable alternative to traditional autopsy in selected cases and may increase the number of minimally invasive forensic examinations performed in the future.