The Experts below are selected from a list of 111 Experts worldwide ranked by ideXlab platform
Kimiaki Sumino - One of the best experts on this subject based on the ideXlab platform.
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Recent status of the medical Examiner System in Japan: demographic variation of medicolegal deaths in Hyogo Prefecture and uncertainty in medicolegal investigations conducted by medical practitioners.
Forensic science international, 1991Co-Authors: Wakiko Ajiki, Tatsushige Fukunaga, Kiyofumi Saijoh, Kimiaki SuminoAbstract:The medical Examiner System has been steadily abolished in Japan. Instead, medicolegal investigations are entrusted by the police to medical practitioners, who are not permitted to perform autopsies. The necessity for the medical Examiner System was assessed through inquest records in Hyogo, one of the three prefectures which still have medical Examiner Systems. Standardized mortality ratios (SMRs) for accidents and suicides were negatively associated with population density, being high in rural areas with a large proportion of elderly citizens, while the SMR for natural deaths was high in urbanized areas and associated with the proportion of inquests to total resident deaths. The high proportion of inquests, however, did not always mean that inquest records were of good quality. Significant differences in the quality of medicolegal investigations seemed to exist between medical Examiners and medical practitioners. That is, in order to certify the cause-of-death, medical Examiners performed autopsies in about half of their cases, while only 2% of medical practitioner cases were subjected to autopsies. Medical practitioners, who certified the cause-of-death as "heart failure" without advising an autopsy, were regularly entrusted with inquests. It is likely that the causes-of-death for medicolegal cases may be questionable since more than 85% of all medicolegal deaths were investigated by medical practitioners, which may cause inaccuracy in at least 3-7% of mortality statistics. It is necessary to educate medical practitioners concerning the importance of mortality statistics and ICD and on the validity of autopsies, in order to obtain accurate mortality statistics from medicolegal cases.
Tatsushige Fukunaga - One of the best experts on this subject based on the ideXlab platform.
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Medicolegal death diagnosis in Tokyo Metropolis, Japan (2010): comparison of the results of death inquests by medical Examiners and medical practitioners.
Legal medicine (Tokyo Japan), 2011Co-Authors: Hideto Suzuki, Tatsushige Fukunaga, Takanobu Tanifuji, Nobuyuki Abe, Atsuko Sadakane, Yosikazu Nakamura, Atsushi SakamotoAbstract:Abstract Purpose Japanese methods of death inquests are still in developmental stages and many problems have been uncovered since an inspection error was reported in 2007. In this study, we investigated the latest results of medicolegal deaths in the Tokyo Metropolis, which is composed of areas with and without the medical Examiner System, and compared the results of inquests performed by official medical Examiners with those by medical practitioners to re-evaluate the effectiveness of the medical Examiner System for the Japanese death inquiry System. Methods By using death certificates as inquest records in the Tokyo Metropolis, 2010, we made a comparison of the autopsy rates, causes of death and the numbers of death certificates containing defects between the inquests performed by official medical Examiners and those by medical practitioners. Results Age distributions and male to female ratios were not different between the two groups. The autopsy rate of the medical practitioners' cases was only 5.5%, whereas that of official medical Examiners' cases was 21%. The proportion of deaths due to circulatory System disease was higher in medical practitioners' cases than in official medical Examiners' cases ( P P Conclusions The lower autopsy rate and the higher frequency of defects in death certificates in medical practitioner's cases likely led to the differences in the mortality statistics between the two groups. On the other hand, the medical Examiner System leaves room for further improvement, such as in the autopsy rate. This study supports the necessity for implementation and improvement of the medical Examiner System, and for reinforcement of under/postgraduate medicolegal education in Japan.
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Statistical investigation on cases associated with medical implication in administrative autopsy within the 23 wards of Tokyo: the role of the medical Examiner System in investigation of cases associated with medical implication
Nihon hoigaku zasshi = The Japanese journal of legal medicine, 2009Co-Authors: Yoshimasa Kanawaku, Tomonori Nagai, Kino Hayashi, Kazumi Kuroyanagi, Hajime Mizukami, Yosuke Kikuchi, Shinjirou Mori, Akio Shigeta, Tatsushige FukunagaAbstract:Actual circumstances of administrative autopsies which proved connections between medical implication and death had not been very clear in the past. Therefore, using the records of administrative autopsies performed from 2003 to 2005 at Tokyo Medical Examiner's Office, this study looked into the cases in which a certain level of connection between medical implication and death was proved or suspected. This study dealt with 877 cases. The largest age group among the male was the one between 65 and 74, and the number of female cases increased as the age increased. The percentage of the studied cases among all the administrative autopsy cases has become larger after 2004. As regarding medical departments for implication, "internal medicine" had the largest number of the cases, and "unknown", "psychiatry", and "emergency" followed in order. 30 percent were being hospitalized during the final medical consultations, and the percentage went up to just over 60 when the deaths during and on the day after the final consultations were added to the figure. Regarding the causes of death, the great majority was natural death, and the other causes were 'unknown', 'fall', and 'asphyxia'. Also, about 80 percent of the natural deaths were caused by circulatory, gastroenteric and respiratory diseases. Contradictions between clinical and forensic diagnoses were found in approximately 10 percent of the cases. In any case, medical Examiners are to diagnose the causes of deaths by autopsy, not to evaluate the quality and safety of medical treatment. But if the quality and safety of medical treatment could be improved through the diagnoses of administrative autopsy, the medical Examiner System would function practically as a part of administration for health and welfare. However, as it handles not only deaths by medical treatment but also all the other types of unnatural deaths, the System can also deal with other social problems, for which the correct causes of death must be diagnosed initially. It is socially very unhealthy to focus only on death associated with medical implication, as other types of unnatural death could be seen as relatively less important. Therefore, it is considered that the medical Examiner System is effective for investigation of a variety of unnatural death as well as cases associated with medical implication.
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Recent status of the medical Examiner System in Japan: demographic variation of medicolegal deaths in Hyogo Prefecture and uncertainty in medicolegal investigations conducted by medical practitioners.
Forensic science international, 1991Co-Authors: Wakiko Ajiki, Tatsushige Fukunaga, Kiyofumi Saijoh, Kimiaki SuminoAbstract:The medical Examiner System has been steadily abolished in Japan. Instead, medicolegal investigations are entrusted by the police to medical practitioners, who are not permitted to perform autopsies. The necessity for the medical Examiner System was assessed through inquest records in Hyogo, one of the three prefectures which still have medical Examiner Systems. Standardized mortality ratios (SMRs) for accidents and suicides were negatively associated with population density, being high in rural areas with a large proportion of elderly citizens, while the SMR for natural deaths was high in urbanized areas and associated with the proportion of inquests to total resident deaths. The high proportion of inquests, however, did not always mean that inquest records were of good quality. Significant differences in the quality of medicolegal investigations seemed to exist between medical Examiners and medical practitioners. That is, in order to certify the cause-of-death, medical Examiners performed autopsies in about half of their cases, while only 2% of medical practitioner cases were subjected to autopsies. Medical practitioners, who certified the cause-of-death as "heart failure" without advising an autopsy, were regularly entrusted with inquests. It is likely that the causes-of-death for medicolegal cases may be questionable since more than 85% of all medicolegal deaths were investigated by medical practitioners, which may cause inaccuracy in at least 3-7% of mortality statistics. It is necessary to educate medical practitioners concerning the importance of mortality statistics and ICD and on the validity of autopsies, in order to obtain accurate mortality statistics from medicolegal cases.
Allen P Burke - One of the best experts on this subject based on the ideXlab platform.
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comparison of necropsy findings in patients with sarcoidosis dying suddenly from cardiac sarcoidosis versus dying suddenly from other causes
American Journal of Cardiology, 2009Co-Authors: Fabio Tavora, Nathaniel Cresswell, Mary Ripple, Carol Solomon, Allen P BurkeAbstract:The clinical diagnosis of cardiac sarcoidosis can be difficult and is largely dependent on newer imaging modalities. A retrospective search of sudden cardiac deaths was performed from a reference laboratory and statewide medical Examiner System for a 12-year period. Planimetry was performed on gross photographs of transverse short-axis sections, and the phase of the lesion and the portion of myocardium extent was estimated histologically. Lesions were classified histologically as early (primarily lymphocytic), intermediate (primarily granulomatous), and late (primarily scar). A total of 41 cases were found, including 25 in which the death was ascribed to sarcoidosis of the heart (group 1) and 16 in which sudden death was due to other findings (group 2). No significant differences were found in age or activity at death, although gross scars and epicardial nodules were more frequent in group 1 (p <0.0001). In the hearts with gross scars, the ventricular septum had the largest percentage of involvement (32%) followed by the posterior wall (25%). Histologically, the intermediate phase predominated in group 1, and the late phase predominated in group 2. Approximately 50% of the cases in group 1 had involvement in the right ventricular apex and septum, suggesting a positive yield by biopsy. In conclusion, cardiac sarcoidosis causing sudden death is characterized by extensive active granulomas with a predilection for the subepicardium and ventricular septum.
Wakiko Ajiki - One of the best experts on this subject based on the ideXlab platform.
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Recent status of the medical Examiner System in Japan: demographic variation of medicolegal deaths in Hyogo Prefecture and uncertainty in medicolegal investigations conducted by medical practitioners.
Forensic science international, 1991Co-Authors: Wakiko Ajiki, Tatsushige Fukunaga, Kiyofumi Saijoh, Kimiaki SuminoAbstract:The medical Examiner System has been steadily abolished in Japan. Instead, medicolegal investigations are entrusted by the police to medical practitioners, who are not permitted to perform autopsies. The necessity for the medical Examiner System was assessed through inquest records in Hyogo, one of the three prefectures which still have medical Examiner Systems. Standardized mortality ratios (SMRs) for accidents and suicides were negatively associated with population density, being high in rural areas with a large proportion of elderly citizens, while the SMR for natural deaths was high in urbanized areas and associated with the proportion of inquests to total resident deaths. The high proportion of inquests, however, did not always mean that inquest records were of good quality. Significant differences in the quality of medicolegal investigations seemed to exist between medical Examiners and medical practitioners. That is, in order to certify the cause-of-death, medical Examiners performed autopsies in about half of their cases, while only 2% of medical practitioner cases were subjected to autopsies. Medical practitioners, who certified the cause-of-death as "heart failure" without advising an autopsy, were regularly entrusted with inquests. It is likely that the causes-of-death for medicolegal cases may be questionable since more than 85% of all medicolegal deaths were investigated by medical practitioners, which may cause inaccuracy in at least 3-7% of mortality statistics. It is necessary to educate medical practitioners concerning the importance of mortality statistics and ICD and on the validity of autopsies, in order to obtain accurate mortality statistics from medicolegal cases.
Yang Jixi - One of the best experts on this subject based on the ideXlab platform.
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analysis of external Examiner System in the u k universities
Comparative Education Review, 2006Co-Authors: Yang JixiAbstract:The origins of the external Examiner System of British university can be traced back to 1832 when the University of Durham was established. Through more than one hundred years development, it has become a well organized mechanism. Its effective supervision and guarantee of the quality of teaching and degree awarding are highly valued by universities. It has become an effrctive way of guaranteing the quality of teaching and degree award.
