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Biomedical subjects

B L Zhu

Publications and source records attributed to B L Zhu.

At least 37 records · Page 2Linked to original sources
PubMed2000

Methamphetamine-related fatalities in forensic autopsy during 5 years in the southern half of Osaka city and surrounding areas.

To outline the recent features of methamphetamine-related fatalities from the medico-legal point of view, a retrospective investigation of forensic autopsy cases involving methamphetamine during a 5-year period (1994-1998) in the southern half of Osaka city and surrounding areas (about 1.57 million population) was undertaken. Among 646 autopsy cases, methamphetamine was detected in 15 victims (nine males, six females; 16-71 years of age; most frequently in males in their thirties). Primary scenes of fatal events were concentrated in the middle of the city. About half of them were transferred from emergency medical centers (survival time, up to 30 h). The cause and manner of death were: methamphetamine poisoning (n=4), homicide (n=4), accidental falls and aspiration from drug abuse (n=4), fire death (n=1), myocardial infarction (n=1), and cerebral hemorrhage (n=1) under drug influence. Usually injection scars and fresh puncture sites were found. Blood methamphetamine concentrations were 2.29-17.05 micromol/dl in the fatal poisoning, 0. 44-3.80 micromol/dl in deaths from other extrinsic causes (trauma), and 1.35-2.17 micromol/dl in cardio- and cerebrovascular strokes. Common complications were cardiomyopathy, cerebral perivasculitis and liver cirrhosis/interstitial hepatitis. Fatal and nonfatal methamphetamine poisonings are separately dealt with by the administrative medical examiner's office and in emergency medical centers. Tightly cooperative approaches of clinical and medico-legal experts are required for the effective social and medical management of drug abuse.

Adolescent↗
PubMed2000

Immunohistochemical investigation of a pulmonary surfactant in fatal mechanical asphyxia.

We evaluated the usefulness of pulmonary surfactant protein A (SP-A) as a practical diagnostic marker of fatal mechanical asphyxia in forensic autopsy cases. A total of 27 cases of asphyxia were examined histologically and immunohistochemically and compared with a control group consisting of 16 cases of poisoning (n = 9) and peracute death (n = 7). Both groups showed histological findings of local atelectasis and local emphysema, congestion, intra-alveolar and interstitial edema in most cases and pulmonary hemorrhages in some cases. The mechanical asphyxia group showed a significantly increased intensity of SP-A staining in the intra-alveolar space accompanied by many massive aggregates in approximately 60% of cases, which was not found in the control group. These structures may be interpreted as aggregates of pulmonary surfactant released from the alveolar wall due to enhanced secretion caused by strong forced breathing or over-excitement of the autonomic nervous system by mechanical asphyxia. The results of our investigation suggest the practical usefulness of the immunohistochemical detection of SP-A in distinguishing mechanical asphyxia from other types of hypoxia.

Adolescent↗
PubMed2000

Dental identification in routine forensic casework: clinical and postmortem investigations.

The aim of this study was to examine the factors which may disturb dental identification of unknown human remains and the practical value of dental evidence in routine forensic casework, including the changes due to dental treatment and postmortem interference. In the investigation of changes due to dental treatment on 696 patients' dental history at two clinics, increase of the number of dental restorations was the greatest in the initial 1-2 years. This finding suggests that dental treatments performed in early period after initial examination contributes more to forensic dental identification than those performed afterwards. The lower anterior teeth (incisors and canines) remained relatively unchanged for years compared with other teeth. The molars appeared to be more frequently restored at a relatively younger age and more frequently missing in the elderly. The investigation of 260 unknown remains in 971 forensic autopsy cases during a period of seven years (1992-1998) at our institute indicated the particular usefulness of dental evidence in cases where the candidates were identified from some other evidence, and usually in cases having a postmortem period corresponding to the obligatory preservation term for the clinical dental records and radiographic films. There were non-identity in the status of dental treatments between ante-mortem dental findings due to additional treatments received after the last day of examination recorded in the corresponding clinical dental records. Postmortem damage from decomposition and fire was more frequently observed in the anterior teeth. These observations indicate that precise documentation of dental evidence including postmortem deterioration and the establishment of a well-organized dental database of missing persons together with a suitable screening system is required to more effectively utilize dental evidence in routine forensic casework.

Journal Article↗
PubMed2000

A case of serial homicide by injection of succinylcholine.

The abstract of this paper was presented at the 14th Meeting of the International Association of Forensic Sciences, Tokyo in 1996. We report a bizarre criminal case of suspected serial homicide by injection of a muscle relaxant (succinylcholine). Five victims were found buried in a rural area. In two victims showing moderate decomposition (about three months after death), intense pulmonary oedema with pleural effusion was observed. Evidence of a puncture site was found in one of the victims. Succinylcholine could not be detected in the victims, but was identified in a syringe found near the corpses. The 40-mg ampule dose of succinylcholine administered intramuscularly to the victims, possibly causing prolonged apnea, was considered to be at least around the minimum lethal dose, although the combined effect of the sedation with hypnotics also used was not negligible.

Adult↗
PubMed2000

Wounding dynamics in distorted bitemarks: two case reports.

An essential factor involved in distortion of bitemarks on the skin is the dynamics of biting related to the location on the body. This study describes the comparison between the identification of bitemarks left on different regions of the victims' bodies in two homicide cases. The findings indicated that a stepwise dynamic comparison of serial adjacent marks with a part of the dentition in consideration of movement of the jaws and distortion of the skin was useful in identifying matching points. The identification process indicated possible wounding dynamics of biting.

Adult↗
PubMed1999

Pulmonary embolism: a case of sudden unexpected death in a psychiatric hospital.

We report a case of suspected fatal physical abuse in which the cause of death was proved to be pulmonary embolism. A patient with mental retardation presenting aggressive behavior was admitted to a psychiatric hospital and was treated with major tranquilizers. She suddenly died subsequent to an angina-like attack. For several days before her death, she had been confined to her bed because of very low physical and mental activity. Bruises and abrasions were observed on the extremities, suggesting the recent restraints. There was no positive evidence of physical abuse. At autopsy, the cause of death was elucidated to be pulmonary embolism originating from thrombi in the left popliteal vein. This case indicates the risk of pulmonary embolism in immobilized patients in psychiatric hospitals.

Journal Article↗
PubMed1999

A sudden death due to cardiac conduction system injury from a blunt chest impact.

We report a case of sudden death due to cardiac conduction system injury from a blunt chest impact. A 20 year old male, kicked in the precordial region, lost consciousness, and was confirmed dead on arrival at a hospital emergency care unit. According to his friends, they played a golf competition accompanied with a physical punishment. The victim, losing the game, allowed the winner to give him several kicks in the chest. Although well prepared against each kick, he fell down instantaneously after the final impact, and death was confirmed at a hospital. There was no apparent sign of injury on the body surface. At autopsy, there was no evident subcutaneous or intramuscular hemorrhages, rib or sternum fracture. Subendocardial hemorrhage in the region of the atrioventricular node and a contusion extending from the posterior wall of the left ventricle to the upper ventricular septum were observed. Histological examination revealed injury of atrioventricular node and His' bundle. Although the cardiac injury including contusion of the myocardium itself was not so extensive, it was considered that arrhythmia was induced by the cardiac conduction system failure, which was considered to be the cause of death.

Journal Article↗
PubMed1999

Antiviral effects of rhIFN-alpha 1 against seven influenza viruses.

AIM: To study the antiviral effects of rhIFN-alpha 1 (Chinese silkworm gene recombinant interferon alpha 1) on 7 influenza viruses in MDCK cells and in mouse pneumonia caused by PR8 virus. METHODS: 100TCID50 virus (H1N1, H2N2, H3N3, type B, type C, clinical A1, and clinical B) were inoculated into MDCK cells, PR8 viruses were dropped nasally in mice, the antiviral effects of rhIFN-alpha 1 were observed. RESULTS: The minimal effective concentrations of rhIFN-alpha 1 against these 7 influenza viruses were 12.5, 25, 50, 25, 12.5, 25, and 12.5 kU.L-1, respectively. The infectious therapeutic indices of rhIFN-alpha 1 to these viruses in MDCK cells were 8 x 10(3), 4 x 10(3), 2 x 10(3), 4 x 10(3), 8 x 10(3), 4 x 10(3), and 8 x 10(3), respectively. The inhibitory indices of rhIFN-alpha 1 to the 7 influenza viruses in MDCK cells were 3.6, 4.7, 3.5, 3.3, 3.9, 4.6, and 3.5, respectively. The rhIFN-alpha 1 inhibited the intracellular replication of influenza viruses effectively, but did not kill viruses directly. The rhIFN-alpha 1 prolonged the life span of mice infected with pneumonia by influenza virus A strain PR8 to 94.2%-132.7%. It inhibited the inflammation and hyperplasia of interstitial fibers, and decreased the virus titer. The inhibitory rates of rhIFN-alpha 1 to pulmonary-indice were 14.8%-37.4%. CONCLUSION: rhIFN-alpha 1 inhibited the proliferation of influenza virus and improved the symptom of mouse pneumonia caused by influenza virus.

Animals↗
PubMed1998

Sudden death following psychiatric electroconvulsive therapy: a case report.

We report a case of sudden death following psychiatric electroconvulsive therapy (ECT). A schizophrenic patient with manic excitement (39-year-old male) in a mental hospital died while vomiting immediately after ECT. The cause of death was diagnosed as asphyxia due to aspiration of vomitus (choking). It is now considered that ECT is an effective treatment for a range of psychiatric disorders and the benefit-risk ratio is equal to or greater than that of psychoactive drugs. Recently, however, there have been 2 other forensic autopsy reports of death due to ECT in Japan. These cases suggest that more effort and careful management are necessary to prevent the accidental deaths.

Adult↗
PubMed1998

Infant death presumably due to exertional self-overheating in bed: an autopsy case of suspected child abuse.

We report a case of accidental infant death presumably due to exertional self-overheating in bed. On a winter morning, a 9-month-old female baby was found dead in her bed at home. She had been confined to the bed overnight by her father, totally covered with a blanket and a thick quilt, because her night crying disturbed his sleep. The clothing and bedclothes were extremely wet with sweat. Many petechial hemorrhages were observed in the upper chest and thoracic viscera. The blood was concentrated, indicative of dehydration. Histological and immunohistochemical investigation revealed findings of shock and myolysis in the cardiac and skeletal muscles. There was no evidence of natural diseases. The main cause of death was diagnosed as circulatory collapse from overheating (hyperpyrexia and dehydration; heat stroke/exhaustion) probably precipitated by struggling in the closed space. Although there was no apparent evidence of battering or any other repetitive physical violence, this case was regarded as an atypical type of fatal child abuse.

Bedding and Linens↗
PubMed1997

Evaluation of post-mortem oxymetry with reference to the causes of death.

We examined blood samples of 214 forensic autopsy cases, excluding fire victims, on a CO-oximeter system in order to evaluate post-mortem oxymetric profiles with reference to the causes of death. Oxyhemoglobin (O2-Hb) levels in the left and right heart blood, respectively, ranged from 0 to 97.7% and from 0 to 92.1%, showing no apparent correlation with the post-mortem intervals or rectal temperatures. In nearly 60% of the cases, O2-Hb was lower than 10%. A high O2-Hb level (over 50%) in the left heart blood was most frequently observed in death from cold exposure and occasionally in fatalities from blunt injuries and stab/incised wounds with or without medical care. O2-Hb in the heart blood was usually very low (under 10%) in fatalities from asphyxiation, drowning, poisoning and natural diseases. A greatest oxymetric variation was observed in death from injuries, probably due to varied causal mechanisms of death. In most cases, the differences between blood O2-Hb levels in the heart and iliac vessels were within 15%; whereas O2-Hb in the cerebral venous blood was usually evidently higher than that in the right heart blood. An inverse relation of O2-Hb levels to total hemoglobin contents was observed slightly for the blood in the heart and iliac vessels, and more obviously for the cerebral venous blood. The above post-mortem oxymetric profiles were considered to at least partially reflect the final balance of oxygen uptake and consumption in dying process, possibly also affected by the circulatory status, giving an objective index to the color of cadaveric blood (hypostasis), although it should be assessed in consideration of post-mortem interference and total hemoglobin contents. In any case, however, post-mortem oxymetry seemed to have a limited value owing to severe systemic hypoxia which would be a common final state before death from various fatal traumas and diseases, maybe except for those with extremely short agony.

Adolescent↗
PubMed1996

Estimation of carboxyhemoglobin concentrations in thermo-coagulated blood on a CO-oximeter system: an experimental study.

In order for forensic toxicological application of a CO-oximeter system to carboxyhemoglobin (CO-Hb) analysis of thermo-coagulated blood, an experimental study was performed. Blood samples containing varying concentrations of CO-Hb were gradually heated up to 70-80 degrees C in ca. 1-13 min, and the extracts (soluble fractions) were examined. CO-Hb contents in the extracts did not represent those in whole thermo-coagulated blood, showing a considerable increase especially for the samples with the initial CO-Hb levels of ca. 25-50%. Changes in CO-Hb % measurements depended little on the heating time but greatly on the final temperature of the blood. The apparent increase in CO-Hb measurements proved to be significantly related to the decrease in total soluble hemoglobin due to thermo-coagulation which depended on the CO-Hb contents, not due to CO-Hb formation by heat. Although gas chromatographic analysis of CO combined with appropriate measurement of total hemoglobin would be required for accurate CO-Hb determination of thermo-coagulated blood, a possible method for rough estimation (semiquantitative screening) of CO-Hb content in whole thermo-coagulated blood with the CO-oximeter was proposed on the basis of thermostability of CO-Hb. The estimated CO-Hb values correlated with the contents measured by a gas chromatographic method independently of the heating time or final temperature up to 80 degrees C.

Adult↗
PubMed1996

Immunohistochemical investigation of pulmonary surfactant in perinatal fatalities.

In order to verify forensic pathological significance of immunohistochemical investigation of pulmonary surfactant, 11 forensic and 16 clinico-pathological cases of perinatal death were comparatively examined. Surfactant appeared in some infants of 31-32 weeks gestation and was usually positive thereafter, indicating maturity of fetal lungs, although it may not have fully developed until about the 36th week of gestation. It was negative in all cases of the hyaline membrane disease except for a full-term infant (secondary respiratory distress syndrome). In usual cases, surfactant coating the expanded alveolar epithelia with its diffuse deposit in the intra-alveolar spaces was considered to indicate duration of hypoxia under persistent respiration (agonal state). Such finding was most intensely observed in asphyxia and in severe respiratory failure from intrinsic causes in the infants over ca. 36 weeks of gestation. With reference to pulmonary micromorphology, the amount of intra-alveolar surfactant seemed to be most closely related to the alveolar septal (interstitial) edema.

Cause of Death↗
PubMed1996

Evaluation of post-mortem oxymetry in fire victims.

In order to investigate the pathophysiology of death due to fires, we examined blood samples of 48 fire victims on CO-oximeter systems and evaluated the oxymetric differences between arterial and venous blood as well as those between the heart and peripheral blood. Post-mortem carboxyhemoglobin (CO-Hb) levels in the left and right heart blood, respectively, ranged from 1.2 to 94.7% and from 0.4 to 90.5%. Marked arterio-venous and centro-peripheral differences were observed in the cases of high CO-Hb (above ca. 70%), suggesting an immediate effect of fatal carbon monoxide (CO) poisoning probably accompanied with acute heart failure. A relatively high oxyhemoglobin level was observed in the cases of low CO-Hb (below ca. 30%). In some cases, reduced hemoglobin levels in the left heart blood were paradoxically somewhat higher than those in the right. These oxymetric profiles may assist to consider the final balance of blood gas in fire victims depending on increased CO, carbon dioxide, and reduction of oxygen in the ambient atmosphere due to combustion, although post-mortem interference should be taken into consideration.

Adolescent↗
PubMed1996

An autopsy case of extremely immature newborn covered with fetal membrane.

We report an autopsy case of extremely immature newborn totally covered with fetal membrane. The infant was a female, 32 cm in length, 662 g in weight, accompanied with the intact umbilical cord and placenta. No remarkable pathological findings for disease or anomalies were observed. Floating tests of the lungs and gastro-intestinal tract were completely negative. In histological examination, the alveoli in the lungs were partially slightly open, filled with amniotic fluid. Pulmonary surfactant was negative immunohistochemically. No evidence was found to confirm a live-born. It was diagnosed that the immaturity has caused the delayed rupture of the fetal membrane and the death during the delivery.

Adult↗
PubMed1994

[The value of Sm-153-EDTMP for treatment of metastatic bone pain and improving quality of life].

Sm-153-EDTMP (ethylenediaminetetramethylene phosphonic acid), a beta-particle and gamma-emitting radionuclide, was used for pain control of bone metastasis. Fourty patients with bone metastasis were administrated a single intravenous injection of 29.6 MBq/kg (0.8mCi/kg), and 7 of them received more than one injection. No obvious side effect was observed. The skeletal images obtained with Sm-153-EDTMP were similar to that of Tc-99m-MDP SPECT images. Follow up study (at least 30 days) revealed bone pain relief and improved quality of life in 82.5% of the treated patients.

Adult↗
PubMed1994

Changes of myocardial myoglobin, myosin and creatine kinase in cases of sudden nocturnal death syndrome.

Myoglobin, myosin creatine kinase MM (CK-MM), creatine kinase BB(CK-BB) in cardiac muscle and H chain of myosin in atrial and ventricular muscle were studied in specimens from 8 patients who died of sudden nocturnal death syndrome (SNDS) by avidin-biotin complex (ABC) method to investigate the possible early or very early myocardial ischemia in the syndrome. Hematoxylin-eosin staining was conducted for comparison. The results showed evident loss of CK-MM, CK-BB, myoglobin and myosin from cardiac muscle cells, indicating that occurrence of SNDS is closely associated with acute myocardial ischemia.

Adult↗