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Hitoshi Maeda - One of the best experts on this subject based on the ideXlab platform.

  • comprehensive investigation of postmortem glucose levels in blood and body fluids with regard to the cause of death in Forensic Autopsy cases
    Legal Medicine, 2015
    Co-Authors: Jianhua Chen, Tomomi Michiue, Takaki Ishikawa, Osamu Inamorikawamoto, Sayuko Ikeda, Hitoshi Maeda
    Abstract:

    The serum glucose level is regulated within a narrow range by multiple factors under physiological conditions, but is greatly modified in the death process and after death. The present study comprehensively investigated glucose levels in blood and body fluids, including pericardial fluid (PCF), cerebrospinal fluid (CSF) and vitreous humor, reviewing Forensic Autopsy cases (n=672). Right heart blood glucose level was often higher than at other sites, and the CSF glucose level was the lowest, showing greater dissociation in acute/subacute death cases. The glucose level was higher in the diabetic (high HbA1c) than in the non-diabetic (low HbA1c) group at each site (p<0.01-0.0001). Fatal diabetic ketoacidosis cases had evidently high glucose levels at each site; whereas in the non-diabetic group, blood glucose level was higher in fatal alcohol abuse, saltwater drowning, electrocution, cerebrovascular disease and sudden cardiac death due to ischemic heart disease. Fatal methamphetamine (MA) abuse, sepsis, malnutrition (starvation) and hypoglycemia due to antidiabetics showed markedly lower blood glucose levels. Ketones in bilateral cardiac blood and PCF were increased in diabetic ketoacidosis and fatal alcohol abuse as well as in most cases of hyperthermia (heatstroke), hypothermia (cold exposure) and malnutrition. These findings suggest that combined analysis of glucose, HbA1c and ketones in blood and body fluids is useful to investigate not only fatal diabetic metabolic disorders but also death processes due to other causes, including alcohol and MA abuse, as well as thermal disorders, sepsis and malnutrition.

  • Evaluation of the on-site immunoassay drug-screening device Triage-TOX in routine Forensic Autopsy
    Legal medicine (Tokyo Japan), 2015
    Co-Authors: Mariko Tominaga, Tomomi Michiue, Hitoshi Maeda
    Abstract:

    Instrumental identification of drugs with quantification is essential in Forensic toxicology, while on-site immunoassay urinalysis drug-screening devices conveniently provide preliminary information when adequately used. However, suitable or sufficient urine specimens are not always available. The present study evaluated the efficacy of a new on-site immunoassay drug-screening device Triage-TOX (Alere Inc., San Diego, CA, USA), which has recently been developed to provide objective data on the one-step automated processor, using 51 urine and 19 pericardial fluid samples from 66 Forensic Autopsy cases, compared with Triage-Drug of Abuse (DOA) and Monitect-9. For benzodiazepines, the positive predictive value and specificity of Triage-TOX were higher than those of Triage-DOA; however, sensitivity was higher with Monitect-9, despite frequent false-positives. The results for the other drugs with the three devices also included a few false-negatives and false-positives. These observations indicate the applicability of Triage-TOX in preliminary drug screening using urine or alternative materials in routine Forensic Autopsy, when a possible false-negative is considered, especially for benzodiazepines, providing objective information; however, the combined use of another device such as Monitect-9 can help minimize misinterpretation prior to instrumental analysis.

  • cardiac biomarkers in blood and pericardial and cerebrospinal fluids of Forensic Autopsy cases a reassessment with special regard to postmortem interval
    Legal Medicine, 2015
    Co-Authors: Jianhua Chen, Tomomi Michiue, Takaki Ishikawa, Osamu Inamorikawamoto, Sayuko Ikeda, Hitoshi Maeda
    Abstract:

    Previous studies suggested possible application of postmortem biochemistry of myocardial biomarkers to the investigation of sudden cardiac death; however, differences from clinical findings should be considered in Autopsy materials. The present study involved a comprehensive investigation of cardiac troponin T and I (cTnT and cTnI), and creatine kinase MB (CK-MB) in cardiac and peripheral external iliac venous blood, pericardial fluid (PCF) and cerebrospinal fluid (CSF) for reassessment, with special regard to the estimated postmortem interval in relation to the cause of death, reviewing a large number of Forensic Autopsy cases (n=1923). These cardiac biomarkers showed cause-of-death- and postmortem-time-dependent differences: blood and PCF levels of each marker were higher in hyperthermia (heatstroke), bathwater drowning and chronic congestive heart disease in cases of postmortem interval (PMI) <12h. After 12h postmortem, these markers were also higher in fatal drug abuse, spontaneous cerebral/subarachnoid bleeding, electrocution and pulmonary embolism. In addition, most other causes of death, including ischemic heart disease, showed substantial elevations, while these markers remained low in acute hemorrhagic death from sharp instrument injury, hypothermia (cold exposure) and sea-/freshwater drowning during PMI of <48h. CSF cTnI and CK-MB showed similar findings. There was no difference between myocardial infarction and other causes of death to be discriminated, including asphyxiation, drowning and fire fatality. These findings are similar to clinical observations in critical ill patients, suggesting that elevated cardiac biomarkers cannot be a specific finding for death from acute ischemic heart disease, but indicate the severity of myocardial injury in postmortem investigation.

  • Postmortem CT morphometry of great vessels with regard to the cause of death for investigating terminal circulatory status in Forensic Autopsy
    International Journal of Legal Medicine, 2015
    Co-Authors: Nozomi Sogawa, Shigeki Oritani, Tomomi Michiue, Takaki Ishikawa, Osamu Inamori-kawamoto, Hitoshi Maeda
    Abstract:

    Postmortem CT (PM-CT) is useful to investigate the viscera in situ before opening the body cavities at Autopsy. The present study involved a virtual morphometric analysis of thoracic and abdominal great vessels with regard to the cause of death as a possible index of terminal circulatory status in Forensic Autopsy cases, using PM-CT data of Forensic Autopsy cases within 3 days postmortem ( n  = 93). Perimeters and cross-sectional areas of the aorta and vena cava depended on the age and/or gender of subjects; however, when the vessel flattening index (vFI) was calculated as the ratio of the cross-sectional area (a) to the estimated circle area having the same perimeter (l), using the formula vFI = 4πa/l^2, the vFI showed distinct differences among the causes of death without significant postmortem time dependence. The index was low for each vessel in fatal bleeding, while the vFI of the abdominal aorta and inferior vena cava was low in hyperthermia (heatstroke), but higher in drowning, hypothermia (cold exposure) and sudden cardiac death. These CT findings provide quantitative data as supplementary indicators to reinforce Autopsy findings for interpreting terminal circulatory status.

  • Efficacy of drug screening in Forensic Autopsy: retrospective investigation of routine toxicological findings.
    Legal medicine (Tokyo Japan), 2015
    Co-Authors: Mariko Tominaga, Shigeki Oritani, Tomomi Michiue, Takaki Ishikawa, Osamu Inamori-kawamoto, Asmaa Mohammed Hishmat, Masashi Takama, Hitoshi Maeda
    Abstract:

    Abstract Toxicological analysis is indispensable in Forensic Autopsy laboratories, but often depends on the limitations of individual institutions. The present study reviewed routine drug screening data of Forensic Autopsy cases ( n =2996) during an 18.5-year period (January 1996–June 2014) at our institute to examine the efficacy of the procedures and findings in Autopsy diagnosis and interpretation. Drug screening was performed using on-site immunoassay screening devices and gas chromatography/mass spectrometry (GC/MS) in all cases, followed by re-examination using GC/MS and liquid chromatography/tandem mass spectrometry (LC/MS/MS) at a cooperating institute in specific cases in the last 4years. GC/MS detected drugs in 486 cases (16.2%), including amphetamines ( n =160), major tranquilizers ( n =72), minor tranquilizers ( n =294), antidepressants ( n =21), cold remedies ( n =77), and other drugs ( n =19). Among these cases, fatal intoxication ( n =123) involved amphetamines ( n =73), major tranquilizers ( n =37), minor tranquilizers ( n =86), antidepressants ( n =3), and cold remedies ( n =9); most cases involved self-administration, alleged suicide and accidental overdose, while homicide was not included. These drugs were also identified in other manners of death, including homicide ( n =40/372), suicide ( n =34/226), accidental falls ( n =27/129), and natural death ( n =72/514). In these cases, on-site immunoassay screening of drugs of abuse showed negative findings in 2440 cases (81.4% in all cases), while GC/MS detected other drugs in 218 cases (7.3% in all cases), including several antipsychotic drugs, acetaminophen and salicylic acid. Further analysis using LC/MS/MS detected low concentrations of benzodiazepines in 32 cases, and also anti-diabetic and hypertensive drugs in a case of fatal abuse. These observations indicate the efficacy of systematic routine toxicological analysis to investigate not only the cause of death but also the background of fatalities in Forensic Autopsy. The provision of extensive drug screening is needed for Forensic and social risk management, considering the marked diversity of medical and illicit drugs.

Shigeki Oritani - One of the best experts on this subject based on the ideXlab platform.

  • Postmortem CT morphometry of great vessels with regard to the cause of death for investigating terminal circulatory status in Forensic Autopsy
    International Journal of Legal Medicine, 2015
    Co-Authors: Nozomi Sogawa, Shigeki Oritani, Tomomi Michiue, Takaki Ishikawa, Osamu Inamori-kawamoto, Hitoshi Maeda
    Abstract:

    Postmortem CT (PM-CT) is useful to investigate the viscera in situ before opening the body cavities at Autopsy. The present study involved a virtual morphometric analysis of thoracic and abdominal great vessels with regard to the cause of death as a possible index of terminal circulatory status in Forensic Autopsy cases, using PM-CT data of Forensic Autopsy cases within 3 days postmortem ( n  = 93). Perimeters and cross-sectional areas of the aorta and vena cava depended on the age and/or gender of subjects; however, when the vessel flattening index (vFI) was calculated as the ratio of the cross-sectional area (a) to the estimated circle area having the same perimeter (l), using the formula vFI = 4πa/l^2, the vFI showed distinct differences among the causes of death without significant postmortem time dependence. The index was low for each vessel in fatal bleeding, while the vFI of the abdominal aorta and inferior vena cava was low in hyperthermia (heatstroke), but higher in drowning, hypothermia (cold exposure) and sudden cardiac death. These CT findings provide quantitative data as supplementary indicators to reinforce Autopsy findings for interpreting terminal circulatory status.

  • Efficacy of drug screening in Forensic Autopsy: retrospective investigation of routine toxicological findings.
    Legal medicine (Tokyo Japan), 2015
    Co-Authors: Mariko Tominaga, Shigeki Oritani, Tomomi Michiue, Takaki Ishikawa, Osamu Inamori-kawamoto, Asmaa Mohammed Hishmat, Masashi Takama, Hitoshi Maeda
    Abstract:

    Abstract Toxicological analysis is indispensable in Forensic Autopsy laboratories, but often depends on the limitations of individual institutions. The present study reviewed routine drug screening data of Forensic Autopsy cases ( n =2996) during an 18.5-year period (January 1996–June 2014) at our institute to examine the efficacy of the procedures and findings in Autopsy diagnosis and interpretation. Drug screening was performed using on-site immunoassay screening devices and gas chromatography/mass spectrometry (GC/MS) in all cases, followed by re-examination using GC/MS and liquid chromatography/tandem mass spectrometry (LC/MS/MS) at a cooperating institute in specific cases in the last 4years. GC/MS detected drugs in 486 cases (16.2%), including amphetamines ( n =160), major tranquilizers ( n =72), minor tranquilizers ( n =294), antidepressants ( n =21), cold remedies ( n =77), and other drugs ( n =19). Among these cases, fatal intoxication ( n =123) involved amphetamines ( n =73), major tranquilizers ( n =37), minor tranquilizers ( n =86), antidepressants ( n =3), and cold remedies ( n =9); most cases involved self-administration, alleged suicide and accidental overdose, while homicide was not included. These drugs were also identified in other manners of death, including homicide ( n =40/372), suicide ( n =34/226), accidental falls ( n =27/129), and natural death ( n =72/514). In these cases, on-site immunoassay screening of drugs of abuse showed negative findings in 2440 cases (81.4% in all cases), while GC/MS detected other drugs in 218 cases (7.3% in all cases), including several antipsychotic drugs, acetaminophen and salicylic acid. Further analysis using LC/MS/MS detected low concentrations of benzodiazepines in 32 cases, and also anti-diabetic and hypertensive drugs in a case of fatal abuse. These observations indicate the efficacy of systematic routine toxicological analysis to investigate not only the cause of death but also the background of fatalities in Forensic Autopsy. The provision of extensive drug screening is needed for Forensic and social risk management, considering the marked diversity of medical and illicit drugs.

  • postmortem volumetric ct data analysis of pulmonary air gas content with regard to the cause of death for investigating terminal respiratory function in Forensic Autopsy
    Forensic Science International, 2014
    Co-Authors: Nozomi Sogawa, Shigeki Oritani, Tomomi Michiue, Takaki Ishikawa, Osamu Kawamoto, Hitoshi Maeda
    Abstract:

    Abstract Postmortem CT (PMCT) is useful to investigate air/gas distribution and content in body cavities and viscera. The present study investigated the procedure to estimate total lung air/gas content and aeration ratio as possible indices of terminal respiratory function, using three-dimensional (3-D) PMCT data analysis of Forensic Autopsy cases without putrefactive gas formation (within 3 days postmortem, n =75), and analyzed the volumetric data with regard to the cause of death. When 3-D bilateral lung images were reconstructed using an image analyzer, combined lung volume was larger in drowning ( n =12) than in alcohol/sedative-hypnotic intoxication ( n =8) and sudden cardiac death (SCD; n =10), and intermediate in other cases, including mechanical asphyxiation ( n =12), fire fatalities due to burns ( n =6) and carbon monoxide intoxication ( n =7), fatal methamphetamine abuse ( n =7), hyperthermia (heatstroke; n =6) and fatal hypothermia (cold exposure; n =7). Air/gas content of the lung as detected using HU interval between −2000 and −400 (‘effective' lung aeration areas) and between −2000 and −191 (total lung aeration areas) as well as the ratios to total lung volume (‘effective' and total lung aeration ratios, respectively) was higher in mechanical asphyxiation, drowning, fatal burns and hypothermia (cold exposure) than in SCD, and was intermediate in other cases. ‘Effective' and total lung aeration ratios may be useful for comparisons between specific causes of death to discriminate between hypothermia (cold exposure) and drug intoxication, and between SCD and other causes of death, respectively. These findings provide interesting insights into potential efficacy of PMCT data analyses of lung volume and CT density as well as lung air/gas content and aeration ratio with regard to the cause of death, as possible indicators of terminal respiratory function, as part of virtual Autopsy of the viscera in situ.

  • postmortem virtual volumetry of the heart and lung in situ using ct data for investigating terminal cardiopulmonary pathophysiology in Forensic Autopsy
    Legal Medicine, 2014
    Co-Authors: Nozomi Sogawa, Shigeki Oritani, Tomomi Michiue, Takaki Ishikawa, Osamu Kawamoto, Hitoshi Maeda
    Abstract:

    Abstract Postmortem CT (PM–CT) is useful to investigate the viscera in situ before opening the body cavity at Autopsy. The present study investigated heart and lung volumes in situ with regard to the cause of death as possible indexes of terminal cardiopulmonary dysfunction by means of PM–CT data analysis of Forensic Autopsy cases within 3days postmortem ( n =70). Estimated heart volume was larger in sudden cardiac death (SCD; n =10) and fatal methamphetamine abuse ( n =5) than in other groups, including mechanical asphyxiation ( n =12), drowning ( n =11), acute alcohol/sedative–hypnotic intoxication ( n =8), fire fatality ( n =12), hyperthermia (heatstroke; n =6) and fatal hypothermia (cold exposure; n =6). Estimated combined lung volume was larger in drowning, smaller in fire fatality due to carbon monoxide intoxication and SCD, and intermediate in other groups. Volume ratio of the lung to heart was higher in drowning, lower in SCD, and intermediate or varied in other groups; high and low ratios can indicate predominant/antecedent pulmonary and cardiac dysfunctions, respectively. These findings provide quantitative data that are not available at conventional Autopsy or by routine two-dimensional CT morphology to assess three-dimensional gross heart and lung morphologies for interpreting terminal cardiopulmonary pathophysiology, detecting significant difference between SCD and other causes of death, especially mechanical asphyxiation and drowning.

  • Significance of postmortem computed tomography in Forensic Autopsy and its possible issues
    Nihon hoigaku zasshi = The Japanese journal of legal medicine, 2010
    Co-Authors: Tomomi Michiue, Shigeki Oritani, Takaki Ishikawa, Tomokazu Nishiguchi, Terumi Sakurai, Chiemi Yoshida, Shigeki Sakoda, Hitoshi Maeda
    Abstract:

    Postmortem imaging (PMI) including computed tomography (CT) and magnetic resonance imaging (MRI) has become a familiar procedure in Forensic casework. We investigated a short term impact of postmortem CT(PM-CT) in routine Forensic Autopsy cases at our institute during a period of 9 months (n = 121, fetus--92 year-old, 7 h--years postmortem), comparing to Autopsy findings. In identification, PM-CT was useful for matching skeletal/dental characteristics, superimposing, and detection of foreign materials. However, conventional X-ray was often more effective for detection of small metallic foreign bodies. In pathomorphology, PM-CT partly demonstrated important findings for determining the immediate cause of death, which were confirmed by Autopsy, but interpretation to the underlying/initiating/preceding causes of death or contributory factor(s) was mostly difficult or impossible. However, accumulated PM-CT data were useful for retrospective evaluation and review of Autopsy findings. These experiences indicate that PMI is useful for radiographic screening and documentation, to be included in supplementary procedures, employing knowledge and experiences of Forensic Autopsy.

Bao Li Zhu - One of the best experts on this subject based on the ideXlab platform.

  • molecular pathology of brain matrix metalloproteases claudin5 and aquaporins in Forensic Autopsy cases with special regard to methamphetamine intoxication
    International Journal of Legal Medicine, 2014
    Co-Authors: Bao Li Zhu, Tomomi Michiue, Takaki Ishikawa, Qi Wang, Dawei Guan, Hitoshi Maeda
    Abstract:

    Methamphetamine (METH) is a highly addictive drug of abuse and toxic to the brain. Recent studies indicated that besides direct damage to dopamine and 5-HT terminals, neurotoxicity of METH may also result from its ability to modify the structure of blood-brain barrier (BBB). The present study investigated the postmortem brain mRNA and immunohistochemical expressions of matrix metalloproteases (MMPs), claudin5 (CLDN5), and aquaporins (AQPs) in Forensic Autopsy cases of carbon monoxide (n = 14), METH (n = 21), and phenobarbital (n = 17) intoxication, compared with mechanical asphyxia (n = 15), brain injury (n = 11), non-brain injury (n = 21), and sharp instrument injury (n = 15) cases. Relative mRNA quantification using Taqman real-time PCR assay demonstrated higher expression of AQP4 and MMP9, lower expression of CLDN5 in METH intoxication cases and lower expression of MMP2 in phenobarbital intoxication cases. Immunostaining results showed substantial interindividual variations in each group, showing no evident differences in distribution or intensity among all the causes of death. These findings suggest that METH may increase BBB permeability by altering CLDN5 and MMP9, and the self-protective system maybe activated to eliminate accumulating water from the extracellular space of the brain by up-regulating AQP4. Systematic analysis of gene expressions using real-time PCR may be a useful procedure in Forensic death investigation.

  • molecular pathology of brain edema after severe burns in Forensic Autopsy cases with special regard to the importance of reference gene selection
    International Journal of Legal Medicine, 2013
    Co-Authors: Bao Li Zhu, Tomomi Michiue, Takaki Ishikawa, Qi Wang, Dawei Guan, Hitoshi Maeda
    Abstract:

    Brain edema is believed to be linked to high mortality incidence after severe burns. The present study investigated the molecular pathology of brain damage and responses involving brain edema in Forensic Autopsy cases of fire fatality (n = 55) compared with sudden cardiac death (n = 11), mechanical asphyxia (n = 13), and non-brain injury cases (n = 22). Postmortem mRNA and immunohistochemical expressions of aquaporins (AQPs), claudin5 (CLDN5), and matrix metalloproteinases (MMPs) were examined. Prolonged deaths due to severe burns showed an increase in brain water content, but relative mRNA quantification, using different normalization methods, showed inconsistent results: in prolonged deaths due to severe burns, higher expression levels were detected for all markers when three previously validated reference genes, PES1, POLR2A, and IPO8, were used for normalization, higher for AQP1 and MMP9 when GAPDH alone was used for normalization and higher for MMP9, but lower for MMP2 when B2M alone was used for normalization. Additionally, when B2M alone was used for normalization, higher expression of AQP4 was detected in acute fire deaths. Furthermore, the expression stability values of these five reference genes calculated by geNorm demonstrated that B2M was the least stable one, followed by GAPDH. In immunostaining, only AQP1 and MMP9 showed differences among the causes of death: they were evident in most prolonged deaths due to severe burns. These findings suggest that systematic analysis of gene expressions using real-time PCR might be a useful procedure in Forensic death investigation, and validation of reference genes is crucial.

  • molecular pathology of pulmonary edema in Forensic Autopsy cases with special regard to fatal hyperthermia and hypothermia
    Forensic Science International, 2013
    Co-Authors: Bao Li Zhu, Tomomi Michiue, Takaki Ishikawa, Qi Wang, Dawei Guan, Hitoshi Maeda
    Abstract:

    Abstract Fatalities due to an extreme ambient temperature might present with poor or nonspecific pathologies; thus, the diagnosis of the cause of death in such cases is one of the most difficult tasks in Forensic pathology. The present study investigated the molecular pathology of alveolar damage involving pulmonary edema with special regard to hyperthermia (heatstroke) and hypothermia (cold exposure) in Forensic Autopsy cases (total, n  = 122; within 48 h postmortem). Intrapulmonary mRNA and immunohistochemical expressions of matrix metalloproteinases (MMPs), intercellular adhesion molecule-1 (ICAM-1), claudin-5 (CLDN-5) and aquaporins (AQPs) were examined. Relative mRNA quantification using Taqman real-time PCR assay demonstrated higher expressions of all markers except for AQP-5 in fatal hyperthermia, and higher expression of MMP-9 in fatal hypothermia. Acute cardiac death, mechanical asphyxiation, fire fatality and intoxication did not present any characteristic findings. In immunostaining, only MMPs showed evident differences among the causes of death: MMP-9 was intensely positive in most cases of hyperthermia and hypothermia, but MMP-2 expression was evident only in hyperthermia. These findings suggest alveolar damage involving pulmonary edema, characteristic of fatal hyperthermia and hypothermia. Systematic analysis of gene expressions using real-time PCR might be a useful procedure in Forensic death investigation.

  • molecular pathology of pulmonary edema after injury in Forensic Autopsy cases
    International Journal of Legal Medicine, 2012
    Co-Authors: Qi Wang, Bao Li Zhu, Tomomi Michiue, Takaki Ishikawa, Dawei Guan, Hitoshi Maeda
    Abstract:

    The lung is vulnerable to trauma; pulmonary edema starts quickly as part of the systemic responses involved in shock. The present study investigated the molecular pathology of posttraumatic alveolar damage and responses involving pulmonary edema in Forensic Autopsy cases of injury (n = 66) compared with acute cardiac death cases (n = 13). Intrapulmonary mRNA and immunohistochemical expressions of matrix metalloproteinases (MMPs; MMP-2 and MMP-9), intercellular adhesion molecule-1, claudin-5, and aquaporins (AQPs, AQP-1 and AQP-5) were examined. Subacute injury deaths showed an increase in lung weight similar to that in acute cardiac death, but relative mRNA quantification using the Taqman real-time PCR assay demonstrated different findings among the causes of death; higher expressions were detected for all markers, except for AQP-5 in sharp instrument injury, for MMP-2 in blunt brain injury, and for MMP-9 in non-brain blunt injury, but these expression levels were lower in acute cardiac death. In immunostaining, only MMPs showed differences among the causes of death: MMP-2 expression was evident in most subacute deaths due to blunt brain injury and sharp instrument injury, whereas MMP-9 was intensely positive in those of non-brain blunt injury and sharp instrument injury. These findings suggest significant differences in the mechanism of pulmonary edema among fatal injuries and acute cardiac death, especially between blunt and sharp instrument injury. Systematic analysis of gene expressions using real-time PCR in combination with immunohistochemistry may be useful in evaluating pulmonary damage and responses after injury in death investigations, especially in connection with posttraumatic shock.

  • real time rt pcr quantitative assays and postmortem degradation profiles of erythropoietin vascular endothelial growth factor and hypoxia inducible factor 1 alpha mrna transcripts in Forensic Autopsy materials
    Legal Medicine, 2006
    Co-Authors: Dong Zhao, Bao Li Zhu, Li Quan, Takaki Ishikawa, Hitoshi Maeda
    Abstract:

    Abstract Recent advances in molecular biology have suggested the potential usefulness of mRNA analyses in postmortem investigations of fatal mechanisms. The aim of the present study was to establish quantitative assays of oxygen-regulated factors including erythropoietin (EPO), vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 alpha (HIF1A) mRNAs, and to investigate the postmortem stability of these mRNA transcripts in Forensic Autopsy materials. Relative quantification of EPO, VEGF and HIF1A mRNAs, based on the TaqMan reverse transcription-polymerase chain reaction (RT-PCR), was performed on Autopsy tissue specimens from the heart ( n =10), brain ( n =10), kidney ( n =16) and lung ( n =8) after preservation at room temperature for various storage times. VEGF and HIF1A mRNA gradually degraded in patterns similar to glyceraldehydes-3-phosphate dehydrogenase (GAPDH) mRNA used as an endogenous reference. Accordingly, the relative quantification of VEGF/GAPDH and HIF1A/GAPDH changed little up to 48h postmortem in tissue samples from the brain, kidney and lung except for a mild deviation of HIF1A in the myocardium. However, the status was different for EPO mRNA, with extraordinary stability for postmortem degradation and a marked postmortem time-dependent increase in the EPO/GAPDH ratio for all tissue samples. The present study suggested the potential for applying quantitative analyses of mRNA transcripts to Autopsy materials and indicated the significance of investigating degradation profiles prior to carrying out relative quantification of target mRNAs in Autopsy materials.

Shigeyuki Tsunenari - One of the best experts on this subject based on the ideXlab platform.

  • Neuropathology of human immunodeficiency virus infection: a Forensic Autopsy study in Dar Es Salaam, Tanzania.
    Forensic Science International, 2005
    Co-Authors: Paul M. Ng’walali, Kazuhiko Kibayashi, M. P. Mbonde, D. Mwakagile, S. Harada, J. N. Kitinya, Shigeyuki Tsunenari
    Abstract:

    The objective of this study was to examine the neuropathological changes in the brain of patients infected with human immunodeficiency virus (HIV) in the Tanzanian capital Dar Es Salaam, and investigate whether the prevalence of different forms of HIV-related neuropathology varies from other countries. The subjects were patients with risk factors for HIV infection in whom Forensic autopsies were performed between 1997 and 1999. In Dar Es Salaam, Forensic Autopsy constitutes more than 90% of all autopsies, because hospital Autopsy is limited due to socio-cultural and religious reasons. HIV infection was identified in 52 of 143 patients selected from Forensic autopsies. Neuropathological findings were observed in 31 of 52 HIV-infected patients; these include lymphocytic meningitis 19, bacterial meningitis 3, tuberculous brain abscess 3, cryptococcal meningitis 3, basal ganglia calcification 3, and toxoplasma encephalitis 1. HIV encephalitis, lymphoma, and cytomegalovirus encephalitis could not be found in this study. Whereas the findings should be interpreted cautiously because of possible Autopsy bias and a low percentage of cases examined compared to the total number of HIV-infected patients in Tanzania, our observations provide information on the likely diagnostic possibilities to be considered in the evaluation and management of HIV-infected patients with neurological symptoms in Tanzania. In the face of decreased hospital Autopsy, most studies have focused mainly on the end-stage HIV disease; Forensic Autopsy is a potential source of materials for studies on HIV disease spectrum at different stages.

  • hplc analysis of anti malaria agent chloroquine in blood and tissue from Forensic Autopsy cases in tanzania
    Legal Medicine, 2005
    Co-Authors: Kosei Yonemitsu, Kazuhiko Kibayashi, M. P. Mbonde, J. N. Kitinya, Ako Koreeda, Paul M Ngwalali, Shigeyuki Tsunenari
    Abstract:

    Abstract HPLC analysis of anti-malaria agent, chloroquine (CQ) in blood and tissues with a simple HCl back extraction method was applied to three Forensic Autopsy cases in Dar es Salaam, Tanzania. CQ concentrations in femoral vein blood were 8.5, 48.4 and 43.8μg/ml in three cases, respectively, which were high enough to attribute the cause of deaths to an acute CQ poisoning. There were great site dependent variations in blood CQ levels. The right heart blood samples were very high, which may be explained by incomplete distribution of the drug before death or postmortem diffusion from liver and its surrounding blood, as high CQ levels were remarkable in the liver. Suicidal and accidental CQ poisonings are very common and CQ is a very important chemical in the field of Forensic toxicology in Tanzania.

  • Fatal intussusception in infancy: an experience in Forensic Autopsy
    Legal medicine (Tokyo Japan), 2003
    Co-Authors: Paul M. Ng’walali, Kosei Yonemitsu, Shigeyuki Tsunenari
    Abstract:

    Intussusception, although a common cause of pediatric surgical emergencies, is a rarely fatal condition. A 7-month-old infant who was discovered in her cot was unresponsive and pronounced dead after 2 h of uneventful cardiopulmonary resuscitation in an emergency hospital. Forensic Autopsy which was performed in order to clarify the circumstances surrounding the death revealed intussusceptions at two sites of the ileum. Although morbidity and mortality rates from the condition have progressively declined in recent decades but avoidable deaths still occur as was experienced in the present case. The Forensic pathology significance in this case was the occurrence of 'painless intussusception' whereby the affected child clinically exhibited no discomfort or characteristic features of acute abdomen until death. In summary, the present case has exhibited an uncommon fatal occurrence and demonstrated the importance of Forensic Autopsy in such unexpected sudden infant deaths.

  • Neuropathological diagnosis of Alzheimer's disease in Forensic Autopsy of elderly persons with fatal accident
    Legal Medicine, 2002
    Co-Authors: Paul M. Ng’walali, Kazuhiko Kibayashi, Kosei Yonemitsu, Shigeyuki Tsunenari
    Abstract:

    Abstract Cognitive dysfunction in Alzheimer's disease may lead to accidental deaths in the elderly. Neuropathological diagnosis of the disease is, therefore, an important issue in Forensic Autopsy to determine the causal relation to accidents. To evaluate the suitability of the current histopathological diagnostic criteria for Alzheimer's disease by Khachaturian and Mirra et al. in elderly persons dying from accidents and coming for Forensic Autopsy, we studied the brains of nine demented and 12 non-demented persons by silver stain and immunohistochemistry. When the density of senile plaque was applied to the criteria, only four out of nine demented persons met the criteria for definite Alzheimer's disease. The demented persons had significantly higher density of diffuse plaque and higher frequencies of amyloid angiopathy, neurofibrillary tangle and neuropil thread than the non-demented persons. These results indicated that the current diagnostic criteria do not always diagnose Alzheimer's disease in Forensic Autopsy of elderly persons with fatal accident. The presence of abundant diffuse plaque, neurofibrillary tangle, amyloid angiopathy and neuropil thread may help to diagnose Alzheimer's disease in Forensic Autopsy.

  • Pink spots of Hedley-White in the brain. Evaluation of the significance in the Forensic Autopsy
    Legal medicine (Tokyo Japan), 2000
    Co-Authors: Kibayashi K, Paul M. Ng’walali, Kohji Honjyo, Kisei Hamada, Shigeyuki Tsunenari
    Abstract:

    Pink spots are sharply demarcated round to oval discolorations with a white center in the deeper areas of the formalin-fixed brain. In 152 Forensic autopsies with neuropathological examinations, the authors observed pink spots in three of 16 patients with bacterial infectious diseases. Pink spots could not be found in 136 patients without bacterial infectious diseases. These results verify the concept that pink spots correlate with bacterial infections. The presence of pink spots will be used as an indication of infectious diseases in the Forensic Autopsy.

Ghulam Mujtaba - One of the best experts on this subject based on the ideXlab platform.

  • Feature engineering techniques to classify cause of death from Forensic Autopsy reports / Ghulam Mujtaba
    2018
    Co-Authors: Ghulam Mujtaba
    Abstract:

    Forensic Autopsy focuses on revealing the cause of death (CoD) by examining a dead body. This process is performed by medical pathologists during the investigation of criminal and civil law cases. In Forensic Autopsy, pathologists examine corpses externally and anatomically to collect Autopsy findings. Moreover, these experts collect the history of the deceased and death scene-related information from the deceased’s relatives and eyewitnesses. Afterward, the pathologists determine the CoD through their expert knowledge while correlating the current Autopsy findings with previous Autopsy reports. Therefore, determining the CoD from Autopsy findings is laborious, time consuming, and subject to inconsistencies associated with any labor-intensive process. Hence, automated text classification (ATC) techniques must be employed to overcome the aforementioned issues in determining the CoD. This study aimed to employ ATC techniques to classify the CoD from Forensic Autopsy reports. In the ATC technique, feature engineering is a highly important step because the success or failure of any ATC model is heavily dependent on the quality of the features used in the classification task. In ATC, the traditional feature engineering techniques include bag of words (BoW) and n-gram. This study argues that BoW and its variant techniques are inadequate in determining the CoD from Forensic Autopsy reports because these techniques ignore word-order, word-context, and word-level synonymy and polysemy. To overcome the aforementioned issues of BoW and its variant techniques, this study aimed to achieve the following four main objectives. First, this work intended to investigate the existing feature engineering techniques to classify free-text clinical reports, including Forensic Autopsy reports. Second, this study aimed to develop semi-automated expert-driven feature engineering to overcome the issue of word-level synonymy and polysemy. Third, this research sought to propose a fully automated conceptual graph-based feature engineering technique to address issues in word-order and word-context. Finally, this work intended to evaluate the proposed techniques by comparing their performances with existing baseline techniques. For the experimental evaluation, Forensic Autopsy reports of 16 different CoDs were obtained from a very large hospital in Kuala Lumpur, Malaysia. These reports were preprocessed by applying various text preprocessing techniques. The discriminative features were then extracted from the preprocessed reports through the proposed feature engineering techniques and formed numeric master feature vectors. These master feature vectors were fed as input to six machine learning algorithms to construct and evaluate the classification models. Furthermore, to show the effectiveness of the proposed techniques, this study compared their performances with five state-of-the-art baseline feature engineering techniques. Experimental results showed that the proposed techniques outperformed the traditional BoW and its variant techniques. Moreover, support vector machines and random forest algorithms outperformed the four other algorithms. The proposed techniques are feasible and practical in determining the CoD from Forensic Autopsy reports and can assist pathologists to accurately and rapidly determine the CoD from Autopsy findings. Finally, the proposed techniques are generally applicable to other kinds of free-text clinical reports

  • Classification of Forensic Autopsy reports through conceptual graph-based document representation model.
    Journal of Biomedical Informatics, 2018
    Co-Authors: Ghulam Mujtaba, Khairunisa Shaikh, Retnagowri Rajandram, Liyana Shuib, Mohammed Ali Al-garadi
    Abstract:

    Abstract Text categorization has been used extensively in recent years to classify plain-text clinical reports. This study employs text categorization techniques for the classification of open narrative Forensic Autopsy reports. One of the key steps in text classification is document representation. In document representation, a clinical report is transformed into a format that is suitable for classification. The traditional document representation technique for text categorization is the bag-of-words (BoW) technique. In this study, the traditional BoW technique is ineffective in classifying Forensic Autopsy reports because it merely extracts frequent but discriminative features from clinical reports. Moreover, this technique fails to capture word inversion, as well as word-level synonymy and polysemy, when classifying Autopsy reports. Hence, the BoW technique suffers from low accuracy and low robustness unless it is improved with contextual and application-specific information. To overcome the aforementioned limitations of the BoW technique, this research aims to develop an effective conceptual graph-based document representation (CGDR) technique to classify 1500 Forensic Autopsy reports from four (4) manners of death (MoD) and sixteen (16) causes of death (CoD). Term-based and Systematized Nomenclature of Medicine–Clinical Terms (SNOMED CT) based conceptual features were extracted and represented through graphs. These features were then used to train a two-level text classifier. The first level classifier was responsible for predicting MoD. In addition, the second level classifier was responsible for predicting CoD using the proposed conceptual graph-based document representation technique. To demonstrate the significance of the proposed technique, its results were compared with those of six (6) state-of-the-art document representation techniques. Lastly, this study compared the effects of one-level classification and two-level classification on the experimental results. The experimental results indicated that the CGDR technique achieved 12% to 15% improvement in accuracy compared with fully automated document representation baseline techniques. Moreover, two-level classification obtained better results compared with one-level classification. The promising results of the proposed conceptual graph-based document representation technique suggest that pathologists can adopt the proposed system as their basis for second opinion, thereby supporting them in effectively determining CoD.

  • Prediction of cause of death from Forensic Autopsy reports using text classification techniques: A comparative study.
    Journal of forensic and legal medicine, 2017
    Co-Authors: Ghulam Mujtaba, Retnagowri Rajandram, Liyana Shuib, Ram Gopal Raj, Khairunisa Shaikh
    Abstract:

    Abstract Objectives Automatic text classification techniques are useful for classifying plaintext medical documents. This study aims to automatically predict the cause of death from free text Forensic Autopsy reports by comparing various schemes for feature extraction, term weighing or feature value representation, text classification, and feature reduction. Methods For experiments, the Autopsy reports belonging to eight different causes of death were collected, preprocessed and converted into 43 master feature vectors using various schemes for feature extraction, representation, and reduction. The six different text classification techniques were applied on these 43 master feature vectors to construct a classification model that can predict the cause of death. Finally, classification model performance was evaluated using four performance measures i.e. overall accuracy, macro precision, macro-F-measure, and macro recall. Results From experiments, it was found that that unigram features obtained the highest performance compared to bigram, trigram, and hybrid-gram features. Furthermore, in feature representation schemes, term frequency, and term frequency with inverse document frequency obtained similar and better results when compared with binary frequency, and normalized term frequency with inverse document frequency. Furthermore, the chi-square feature reduction approach outperformed Pearson correlation, and information gain approaches. Finally, in text classification algorithms, support vector machine classifier outperforms random forest, Naive Bayes, k-nearest neighbor, decision tree, and ensemble-voted classifier. Conclusion Our results and comparisons hold practical importance and serve as references for future works. Moreover, the comparison outputs will act as state-of-art techniques to compare future proposals with existing automated text classification techniques.

  • automatic text classification of icd 10 related cod from complex and free text Forensic Autopsy reports
    International Conference on Machine Learning and Applications, 2016
    Co-Authors: Ghulam Mujtaba, Retnagowri Rajandram, Liyana Shuib, Ram Gopal Raj, Khairunisa Shaikh
    Abstract:

    Forensic Autopsy focuses on revealing the cause of death (CoD) by examination of a dead body. In this research study, various feature extraction schemes, feature value representation schemes and text classification algorithms have been applied on Forensic Autopsy reports to discover the suitable feature extraction approach, feature value representation approach and text classification approach. From experimental results, it was found that the unigram features outperformed bigram, trigram and hybrids of unigram, bigram and trigram features. Moreover, TF and TFiDF feature value representation schemes were proven more suitable than binary representation and normalized TFiDF schemes. Finally, SVM decision models outperformed RF and NB.

  • ICMLA - Automatic Text Classification of ICD-10 Related CoD from Complex and Free Text Forensic Autopsy Reports
    2016 15th IEEE International Conference on Machine Learning and Applications (ICMLA), 2016
    Co-Authors: Ghulam Mujtaba, Retnagowri Rajandram, Liyana Shuib, Ram Gopal Raj, Khairunisa Shaikh
    Abstract:

    Forensic Autopsy focuses on revealing the cause of death (CoD) by examination of a dead body. In this research study, various feature extraction schemes, feature value representation schemes and text classification algorithms have been applied on Forensic Autopsy reports to discover the suitable feature extraction approach, feature value representation approach and text classification approach. From experimental results, it was found that the unigram features outperformed bigram, trigram and hybrids of unigram, bigram and trigram features. Moreover, TF and TFiDF feature value representation schemes were proven more suitable than binary representation and normalized TFiDF schemes. Finally, SVM decision models outperformed RF and NB.