proceedings of the first international symposium advances
TRANSCRIPT
Experiences in biochemical diagnosis of suicide by analyzing
Serotonin in cerebrospinal fluid.PROCEEDINGS of The First
international Symposium ADVANCES IN LEGAL MEDICINE
+ Edited by Taizo Nagano
Contents
COMMEMORATIVE S P E C I A L L E C T U R E S J . Kondo (Japan)· Prediction of Science in 21st Century 1
H. Manabe (Japan) · Expectations for Forensic Medicine Approaching the 21st Century 5
G. Schmidt (FRG) : Advances in Forensic Medicine Towards the 21st Century 11
W. Janssen (FRG) : Advances in Forensic Medicine and the Welfare of Human Beings 20
Symposium _Theme I :
COMPARISON O F S Y S T E M S O F L E G A L
MEDICINE IN THE WORLD
Y. Mizoi (Japan) ·
Education, Research and System of Legal Medicine in Japan 31 G. Schewe (FRG) : The Structure and Educational System of German Legal Medicine 34
I — 1. Institution and Practice
M. S . L. Saigado (Sri Lanka) • Undergraduate and Post-Graduate Medico-Legal Education and Practice in Sri Lanka 37
J . E . L. Pinto da Costa (Portugal) :
Medico-Legal Organization in Portugal 40
J . Ζ. Zhu, L. Wang. (P. R. China) The Current System of Forensic Medicine in the P. R. China 43
P. M. Jablonsky (Czechoslovakia) : History, Present Status and Future of Legal Medicine in Slovakia 45
O. Romo (Chile) Psychiatric Forensic Expertise and Imputability 48
G. Schmidt (FRG) : Forensic Medicine As an Interdisciplinary Subject 52
P. Saukko (Finland) · The Medico-Legal System in Finland 54
A. Penttilä, P. J . Karhunen, M. Tenhu,
E . Vuori (Finland) · Deaths of Finns Abroad Revisited in Helsinki * 57
B. Knight (United Kingdom) : The Ideal System of a Medico-Legal Service 60
R. Breitenecker (USA) · The Current Status of Legal Medicine in the USA 62
J . T. J i a (P. R. China) : On the Historical Development of Forensic Medicine in China 65
T. Fukunaga, Y. Ueno, Κ. Yamamoto, Y. Mizoi,
S . Hishida, Y. Yamamoto, M. Yamada,
Y. Tatsuno (Japan) ·
Statistical Analysis of Unnatural Deaths in Hyogo and Shiga Prefectures—Comparison of the Results of Inquests by Medical Examiners and by Others 68
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Y. Katsumata, J . Nudeshima (Japan) · Unnatural Deaths: A Comparison of Medico-
Legal Practices in Japan and the U.S.A. 71
I — 2 . Education
M. S taak , B. Madea (FRG) Undergraduate and Postgraduate Teaching of Forensic Medicine in West Germany 74
P. Chandra Sekharan (India) · Medico-Legal Practice and Education in India 80
Z. Marek (Poland) · Medical Error and Deontological Problems in Undergraduate and Postgraduate Education in Poland · 83
J . E . L . Pinto da Costa (Portugal) Portuguese Medico-Legal Education 88
T. C . Chao (Singapore) · Teaching of Forensic Medicine in Singapore 91
J . T. J i a (P. R. China) : On the Medico-Legal Education in China 93
S . Alteza, J r . (Philippines) - Medico-Legal Education in the Philippines 96
S . Oshida, Y. Ohno, S . Uchigasaki (Japan) :
Video Relay System from Legal Autopsy Room to Lecture Room 99 K. Terazawa, H. Akabane, B. Wu, M. Nagao,
T. Takatori (Japan) :
Citation of Non-English Literatures - On the Obstruction of Arteries by Typical Hanging 100
I ~ 3 . Medical L a w and Ethics
G. Schewe (FRG) : Recent Trends in Medical Law in Germany 103
— in —
Τ. Kanagawa (Japan) · The Present Situation of Informed Consent in japan 108
A. Luna, P. Barroso (Spain) * Attitudes of Doctors towards Death, Euthanasia and Informing Terminal Patients I l l
H. Harada, N. Furumoto, T. Shouman, M. A. Green
(Japan, United Kingdom) - Modeling and Estimation of Breath Alcohol Concentration after Drinking * 114
H. Hattori, N. Yamamoto, J . Furuno (Japan) · Legal and Ethical Aspects of AIDS Affair in Japan · 117
Symposium-Theme II :
P R O B L E M S WITH INSURANCE AND
COMPENSATION A F T E R TRAUMATIC INJURIES
Π — 1. Sequelae of Traumatic Injuries
W. Eisenmenger, G. Beier (FRG) · Medical Insurance Problems after Trauma 121
T. Takatori (Japan) · Vehicle Collision Experiments at Low Speeds and Medical Approaches 124 J . L iu , S . Song (P. R. China) : A Preliminary Study on the Application of Visual Evoked Potential (VEP) in Forensic Practice 127
X. L iu , P. Yu, X. Zhou, Y. Zhang (P. R. China) : Evaluation of Auditory Brainstem Response (ABR) Applied in the Forensic Practice 130
P. D. Niall (Australia) : Medical Tribunals in Workers Compensation Disputes Developments in Australia · 133
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Μ. Hayashida, Μ. Nihira, Κ. Hirakawa,
Ν. Moriya, Υ. Tomita, Τ. Watanabe (Japan) · The Effect of Alcohol on Diagnosis, Severity and Outcome of Injured Patients in Traffic Accidents and Falling Victims 136
N. Ohashi, M. Doi, S . Misawa, K. Ono (Japan) The Relationship between Impact Speed and Injury Severity in Motorvehicle- Pedestrian Accidents 139
Π — 2 . Medical Care of Injuries and Responsibility of Doctors
B. Knight (United Kingdom) : The Medical Malpractice and Negligence Situation in Britain 142
M. C. S . Ribeiro, (Portugal) : Road Traffic Accidents. Insurance and Compensation 144
T. Hiranuma (Japan) :
Medical Care on Traffic Accidents and Its Diagnostic Criteria * 147
C. Wakasugi (Japan) · Damages or Fatal Consequences of External Injuries and Medical Treatment 151
Symposium-Theme IB:
1 - 1 . Time of Death
C. Henssge, B. Madea (FRG) · Estimation of the Time since Death 155
G. Beier, E . TutschrBauer, W. Wiesbock (FRG) Influence of Temperature on Rigor Mortis 159
— ν —
G. Vacchiano, R. Massini, C. Romano (Italy) · The Post-Mortem Demyelinization: A New Method for Estimation of Time after Death 162
G. Kauert, W. Eisenmenger (FRG) Experiences in Biochemical Diagnosis of Suicide by Analyzing Serotonin in Cerebrospinal Fluid 167
A. Sawaguchi , J . Kotani, T. Funao, N. Nakada,
A. Koshizawa (Japan) · Death From Rapid Drowning: Findings of Cerebral Blood Flow and Serum Haptoglobin 170
H. Sugie, T. Funao (Japan) · Ultraviolet Spectrophotometry and HPLC of Vitreous Humor for the Estimation of Hours After Death 173
ffl"~2. Brain Death and Organ Transplantation
K. Hoshino (Japan) :
Bioethical Considerations on Brain Death and Organ Transplantation 176
M. Fukaya, Y. S a s a k i , S . Murakami, T. Nagano,
T. Kanagawa (Japan) - A Proposition Concerning the Brain Death Act Legislation in Japan 179 B. Knight (United Kingdom) : The Present Situation of Organ Transplantation in Great Britain 182
M. J . Carneiro de Sousa (Portugal) Brain Death. The Problem in Portugal 184
D. -X. L i (P. R. China) : Pathology of Brain Death 187
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Involuntary Movements after Brain Death: Pathological Observations in the Cervical Spinal Cord 190 Y. Kinoshita, K. Okamoto, T. Yoshioka,
T. Sugimoto (Japan) :
Long-Term Organ Preservation in Brain Death
Maintained with Vasopressin and Catecholamine 193
R. Breitenecker (USA) : The Current Status of Organ Transplantation in the USA 196
Y. Tatsuno, T. Fukunaga, Y. Yamamoto, M. Yamada,
M. Kane, S . Fu j iwara , J . Adachi, Y. Mizoi (Japan) ·
Neuropathological Studies on Brain Death 198 D. -X . L i (P. R. China) :
Pathology of Brain Death—Delayed Traumatic Intracerebral Hematoma (DTICH) 201
Symposium-Theme IV:
A D V A N C E S IN T H E F I E L D O F
F O R E N S i C PATHOLOGY
IV — 1. Application of Ultramicroscopy and
Enzyme-Histochemistry
M. Oehmichen (FRG) : Application of Immunohistochemisty in
Forensic Medicine 208
S . Shoumura, S . Emura, M. Ustumi, H. Isono,
Y. Bunai , I. Ohya (Japan) · Postmortal Changes of the Fine Structure of the Liver 211
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The Morphological, Biochemical and Immunohistochemical Studies on Asphyxia 214
Τ. Kita, Y. Furuya (Japan) · Vasomotion of the Pulmonary Vessels During Asphyxial Congestion 216
M. Yoshino, T. Kimijima, S . Miyasaka, H. Sato,
B. Miyake, S . Seta (Japan) · Ultrastructural and Cytochemical Changes of Rabbit Brain in Hypoxic State 218
N. Kawaguchi, M. Mukaida, M. Saito, M. Okada,
N. Yamazaki, Y. Takada (Japan) :
The Ultrastructural Basis of Tinctorial Change of Collagen Fibers in the Damaged Dermis 221
Y. Tatsuno, T. Fukunaga, Y. Yamamoto, M. Yamada, S . Fuj iwara, Y. Ueno, Τ. Sawaguchi , Y. Mizoi (Japan) · Immunohistochemical Approach to Alzheimer-Type Dementia 224
K. Yoshida, Y. Ogura, M. Masui, M. Yamazaki,
C. Wakasugi (Japan) :
A Histochemical Study of Calmodulin in Dog Myocardial Ischemia and Autopsy Cases of Sudden Cardiac Death 227
A Luna, E . Osuna (Spain) · Are Biochemical Markers Necessary for Post-Mortem Diagnosis of Myocardial Infarction? 230
U. Hellerich (FRG) : Lectin Histochemistry- A Helpful Method to Differentiate Early Pregnant from Non-Pregnant Endometrium 233
J . Ζ. Zhu, D. C. Wang (P. R. China) : Estimation of Time of Injuries by Microscopic Localization and Quantification of Nonspecific Esterase 235
P. J . Karhunen, A. Penttilä, P. Leinikki,
H. Brummer-Korvenkontio, M. _ L . Kantanen,
M. Nyberg (Finland) > Visually-Read Assay of the Vitreous Humour in Rapid Screening for HIV in Necropsies 238
N. Tabata, M. Morita (Japan) · Studies on Livor Mortis. On the Localization of Hemoglobin in the Human Skin Tissue by Immunohistochemistry 241
M. Ogata, S . Kubo, O. Kitamura, W. Hirose,
I. Nakasono, T. Fukunaga, Y. Tatsuno (Japan) An Immunohistochemical Demonstration of Hemoglobin in the Kidney of Battered Children 243
T. Fukunaga, Y. Yamamoto, M. Yamada,
Y. Tatsuno, Y. Mizoi, A. Yamashita (Japan) · Thymic Involution in Abused/Neglected Children · · — · · 246
A. Nishimura, S . Fuj iwara, Y. Yanagida,
K. Nakanishi, Y. Mizoi (Japan) '· Cerebral Atrophy in Senile Dementia and Normal Aging; A Quantitative Study Using Image Analysing System * 249
O. Kitamura, S . Kubo, M. Ogata, M. Iwasaki,
W. Hirose, I. Nakasono (Japan) · Histopathological Studies of Hypoxic and Ischemic Brain Damage and its Application to Forensic Autopsy Cases 252
— ix —
Τ. Fuj ikura, Υ. Kominato, Η. Takizawa (Japan) · Forensic Application of Post-Mortem Cerebral Angiography. 1. Subarachnoid Bleeding 255
S . Takeichi, A. Tsuj i , Y. Seto, T. Saito (Japan) ·
Histological and Enzyme-Histochemical Studies on Cardiac Sudden Death, Especially Acute Ischemic Cardiac Disease 258
Y. Ueno, Κ. Yamamoto, Τ. Imabayashi, Τ. Fukunaga, Y. Mizoi (Japan) · Biogenic Amine Content of Human Carotid Body in the Cases of Sudden Death 260
H. Fukushima, M. Ota, K. Tanaka ,
H. Hasekura (Japan) :
Using the Immunostaining Method and the Polymerase Chain Reaction Amplification for Identifying Mixed-up Formalin-Fixed, Paraffin-Embedded Tissues 263
K. Matsuura, Y. Bunai, X. J iang, A. Nagai, S . Yamada, I. Ohya, H. Sawada (Japan) · Immunohistochemical Localization of Dihydrodiol Dehydrogenases in the Lens and the Kidney 266
S . Miyasaka, T. Kimijima, M. Yoshino, H. Sato , B. Miyake, S . Seta (Japan) · Immunohistochemical Demonstration of ABH Blood Group Antigens in the Putrefied and Dried Skin Fragments 269
I V - 2 . Present Status of S IDS
A. Takatsu (Japan) :
Advances in Pathological Diagnosis of SIDS 272
G. Sorgo (Austria) · The Unexpected Sudden Death of a Child with Unusual Pathological Findings 275
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P. Μ. Jablonsky, S . Dluholucky (Czechoslovakia) : Present Status of SIDS in Central Slovakia 278
Y. Matsubara, K. Narisawa (Japan) :
Identification of a Common Genetic Mutation Responsible for Sudden Infant Death Syndrome 280
Y. Tsuda (Japan) ·
Several Cases of Pediatric Forensic Study — The Second Report of the Statistic and Sociomedical Review on Sudden Infant and Child Death- • 282
Symposium-Theme V:
A D V A N C E S IN TOXICOLOGICAL ANALYSIS
V —1. Determination of Drugs and Poisons in T issues
H. Käferstein (FRG)
Methodology of Drug Detection in Body Fluids 285
G. Machata (Austria) · Sample Collecter (BSC 1) for Volatile Substances in the Work Environment 288
T. Miyazaki, F . Chikasue, Μ. Yashiki , Τ. Kojima (Japan) · Carbon Monoxide Hemoglobin Saturations in Left and Right Heart Blood from Cadavers not Exposed to Fire or CO Gas 291
Y. Yamamoto, K. Yamamoto, Y. Fukui (Japan) '. Teratogenic Effects of Methamphetamine 294
T. Marcinkowski, K. Borowiak, M. Parafiniuk (Poland) · Microcrystals in the Toxicological and Histological Analysis in Cases of Intoxication with Ethylene Glycol · 297
— xi —
Η. Seno, Ο. Suzuki , Τ. Kumazawa, Μ. Asano (Japan) · Isolation of Medico-Legally Important Drugs with SEP-PAK C i 8 Cartridges Using Chloroform as Elution Solvent 299
B. Hu, M. L i u , Z. Wang, Y. Yang, X. Deng,
G. L i , H. L i , Q. L iang , P. S u (P. R. China) : Studies on Aconitine Toxicology 302
B. Hu, K. Yun, M. L i u , Z. Wang (P. R. China) : Toxicokinetic Studies of Cantharidin in Rabbits 305
C. Moore, K. Sa to , H. Hattori, Y. Katsumata (Japan) · The Determination of Cephalosporins Using Super Microbore High Pressure Liquid Chromatography-Mass Spectrometry 308
J . Adachi , Y. Tatsuno, Y. Ogawa, K. Nakagawa,
Y. Mizoi (Japan) · Greenish Discoloration of Skin and Formation of Sulfhemoglobin Caused by Hydrogen Sulfide Poisoning and Putrefaction 311
K. Ameno, C . Fuke , S . Ameno, T. Kiriu, T. Shinohara, K. Sogo, I. Ijiri (Japan) ;
A Rapid and Sensitive Quantitation of Amitraz in Plasma by Gas Chromatography With Flame Thermionic Detection 3 1 !
T. Kiriu, K. Ameno, C . Fuke , S . Ameno, T. Shinohara, K. Sogo, I. Ijiri (Japan) · In Vivo and in Vitro Studies of Regional Brain Distribution of Toluene 317
Y. Kuroiwa, K. Aoki, T. Watanabe,
Y. Kuroiwa (Japan) ·
Enzyme-Linked Immunosorbent Assay for Methamphetamine, Morphine and Benzoylecgonine 320
Τ. Nagano, Τ. T a k a y a s u , Τ. Ohshima,
Η. Maeda (Japan) :
An Analytical Method for Volatiles in the Biological Materials by Pulse Heating 323
Μ. Nihira, Κ. Hirakawa, Μ. Hayashida,
Υ. Tomita, Ν. Moriya, Τ. Watanabe (Japan) :
Changes of Acetic Acid Concentration of Various Rat Tissues After Ethanol Injection 326
T. Shinozuka, N. Kuroda, T. Murai, S . Takei , K. Kurihara, J . Yanagida (Japan) :
Determination of Microamount of Mefenamic Acid by High Performance Liquid Chromatography 329
K. Terazawa , L . J i , M. Nagao, T. Takator i , K. Aoki, Y. Hirose, Y. Kuroiwa (Japan) - Production and Characterization of Monoclonal Antibodies Reactive with Methamphetamine Raised Against a New Antigen 332
M. Tomita, T. Okuyama, S . Watanabe,
B. Uno, S . Kawai (Japan) '· Liquid Chromatographic Determination of
Glyphosate and its Metabolite in Serum 335
G. Huang, Y. Zhang, L . L i , X. Sung, Z. Wang, L . Qiao (P. R. China) :
Toxicological Pathological Study of Lei Gong Teng (Tripterygium Wilfordii Hook) 338
C . Romano, A. Malorni, A. Acampora,
G. Vacchiano, M. Esposi to , R. De Mercato · Experiences in Legal Medicine about Antiparassites Toxic Substances and Human Nourishment 341
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W. Bonte (FRG) : Advances in Congener Analysis • 311
K. Kimura, T. Nagata, K. Kudo, T. Imamura (Japan) · Determination of Kerosene and Light Oil Components in Blood 317
E . Logemann, C. Müller, Ε. Keller (FRG) : Pharmacokinetics of Diazepam in Patients with Nephrotic Syndrome 350
L. v. Meyer, W. Hanisch, G. Kauert,
G. Drasch (FRG) :
K. Terazawa, K. Miyazaki (Japan) :
Transport Characteristics of Paraquat Across Rat Intestinal Brush Border Membrane 356
C. Fuke, K. Ameno, S . Ameno, T. Kiriu,
T. Shinohara, K. Sogo, I. Ijiri (Japan) '·
Simultaneous Determination of Paraquat and Diquat in Biological Materials Using Second-Derivative Spectroscopy and High-Performance Liquid Chromatography 359 K. Gonmori, N. Yoshioka (Japan) · Effect of Mushroom Toxin on Biogenic Amines of Rat Brain 362
K. Hirakawa, M. Nihira, M. Hayashida,
IM. Moriya, Y. Tomita, T. Watanabe (Japan) · Assesment of the Brain Lesions of the Rats on Acute Ethanol Poisoning Using Magnetic Resonance Imaging (MRI) 365
- x iv —
J . Nishigami, Τ. Ohshima (Japan) ·
Screening and Quantitation of Drugs and Poisons in Blood and Urine in Emergency Medical Care and Legal Autopsy Cases 368
K. Sato, Y. Mizuno, C. M. Moore, K. Tamaki,
Y. Katsumata (Japan) '·
Storage of Blood for Methemoglobin Determination: Effect of Various Buffers on the Storage of Hemolysates 371
I. Yamamoto, T. Matsunaga, H. Kobayashi, K. Watanabe, H. Yoshimura (Japan) · Pharmaco-Toxicity of p-Coumaroyltyramine and Feruloyltyramine in Marihuana 374
K. Yamazaki, E . Tanaka, N. Shimojo,
S . Misawa (Japan) ·
The Validity of Measurements of Locomotor Activity as Evidence of Exposure to Toluene 377
Symposium-Theme VI:
METHODOLOGY IN F O R E N S I C S E R O L O G Y AND
STAIN ANALYSIS
VI — 1. Sero _ Genetic Procedures P. Hooft, H. van de Voorde (Belgium) · The Zinc Spot Test as a Tool for the Primary Identification of Human Seminal Stains 381
R. lida, T. Yasuda, D. Nadano, K. Kishi (Japan) ·
Intensification of Peroxidase-Diaminobenzidine Staining Using Gold-Sulfide-Silver: A Simple and Highly Sensitive Detection Method for Immunoblotting 384
— xv -
Y. Furusawa, Υ. Uchimura, S . Tsunenari (Japan) · Forensic Biology of Human Hepatic Bile: Its Application to the Determination of Species Specificity and ABO Blood Type of Feces 387
S . Kubo, M. Iwasaki, O. Kitamura, M. Ogata,
I. Nakasono (Japan) · The Effect of Soil Fungi on Changes in the Specificity of the ABO Blood Groups and on the Degeneration of Hair 390
Y. Tamaki, T. Kishida (Japan) · Experience with Anti-Mouse IgG/Anti-Peroxidase Bispecific Monoclonal Antibody in ELISA and Dot Immunobinding for GM Typing 393
M. Wu, Z. J in (P. R. China) : Phenotyping of GC in Human Semen Stains Using IEF Followed by Enzyme Immunoassay 396
T. Matsuki, T. Nakajima, K. Furukawa (Japan) · Application of Anti-H Active Antibodies and Lectins to the Detection of Human Blood Group Η Substances 399
T. Kogure, M. Sagi , Y. Kuwaki, K. Yamazaki,
M. Kitahama (Japan) ·
Detection and Activity of Blood Group A and Β Gene-Encoded Glycosyltransferases in Human Seminal Plasma and Cerebrospinal fluid 402 S . Ito. K. Matsui, K. Suzuki , H. Matsumoto,
Y. Mizoi (Japan) '· A Simple Extraction Procedure for ABO Group Typing of Bloodstain by Dot ELISA Method 405
— xvi —
Κ. Sodesaki , Α. Kimura, Τ. Tsuji
F . Matsumura (Japan) Cell Surface ELISA for Detection of Anti-ABO and Anti -MN Blood Group Antibodies 108
Ρ. Κ. Chattopadhyay, Μ. Κ. Thakkar (India) ABO Blood Groups from Hair 111
A. Kimura, M. Osawa, S . Yasuda,
H. Ikeda, T. Uda, S . Nakashima
M. Ohta, T. Tsuji (Japan) ·
On Monoclonal Antibodies to Epitopes Specific for Species in Primates 415 T. Nagano, T. Ohshima, H. Maeda,
Y. Fuj ioka (Japan) '·
Species Identification of Minute Bloodstains by Simultaneous Precipitin Reactions in an Agarose Gel after Electrophoresis 418 B. Wang, J . J i a , D. Chen (P. R. China) On the Species Discrimination of Animal Bloodstains by Polyacrylamide Gel Isoelectrofocusing 421
J . Guo, A. Fan (P. R. China) ' Determination of Phenotypes of Salivary Amylase in Saliva and Saliva Stains by IEF and Silver Staining 424
K. Akiyama, Y. Ito, H. Kimura (Japan) :
Characterization of a New Protein Which Binds Actin in Seminal Plasma and Saliva 427
H. Matsumoto, T. Fukae, S . Kubo, O. Kitamura, M. Iwasaki, I. Nakasono, M. Ogata (Japan) · Subtyping of the Group Specific Component (Gc) in Semen and in Seminal Stains 430
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S . Abe, Κ. Hiraiwa (Japan) ·
New Form of ^Glutamyl Transpeptidase in Human Seminal Plasma and It's Application to Forensic Medicine 433
K. Suzuki , S . Ito, H. Matsumoto,
Y. Mizoi (Japan) ·
Three Hereditary Subtypic Patterns detected in the Ba Fragment of Complement Factor Β 435
S . Nakamura, K. Omoto, O. Ohue, K. Yamashita, J . Ochi, K. Akiyama, A. Sawaguchi (Japan) :
C1R Polymorphism in the Japanese Population 438
H. Nishimukai, K. Shinomiya,
Genetically Controlled Variants of Antithrombin III 441
Κ. Umetsu, I. Yuasa , Τ. Suzuki (Japan) · Orosomucoid (ORM) Typing by Isoelectric Focusing: Effect of Protease Treatment and Stability in Bloodstains 44 1
I. Yuasa , K. Umetsu, N. Nakayashiki, N. Tamaki,
H. Shiono, K. Okada (Japan) ·
Urosomucoid (ORM) Typing by Isoelectric Focusing: An Improved Method for ORM1 Subtyping and the Reactivity of Anti-Human ORM Antibodies with Animal ORM 447 A. Tamura, K. Suzuki , S . Ito, H. Matsumoto, Y. Mizoi (Japan) · Two-Dimensional Polyacrylamide Gel Electrophoresis Analysis of Postmortem Change in Brain Proteins 450
— xviii —
Y. Kamitani, K. Tomita (Japan) ·
Transformation of Genetic Markers in Blood with BMT and Problems in Legal Medicine 453
V I - 2 . DNA Polymorphisms
Κ Sullivan, P. Gill (United Kingdom) The Potential Use of PCR in Forensic Analysis 456
K. Suzuki , S . Ito, H. Matsumoto, Y. Mizoi (Japan) · Restriction Fragment Length Polymorphisms Associated with Immunoglobulin Gamma Switch Regions in Man 459
I. Saka i , K. Kasa i , K. Yoshida, H. Mukoyama, S . Seta (Japan) :
DNA Analysis Using Single Locus VNTR Probes and Its Application to the Individualization of Human Bloodstains 462
C. Rittner, L . Braun _Heimer,
P. M. Schneider (FRG) : The Use of PCR-Amplified DNA in Paternity Testing and Stain Analysis · · — — * — ^-465
T. Yokoi, M. Nata, Y. Aoki, K.
Sagisaka (Japan) ·
Contribution of DNA Analysis on Paternity Test 468 C. Rittner, U. Schacker, G. Rittner,
B. Holtkamp, Ε. Bohnke, Η. Η. Sonneborn,
P. Μ. Schneider (FRG) :
DNA Polymorphisms in Paternity Testing: The Use of Minisatellite Probe MZ 1.3 in Incest, Deficiency, Antenatal and Postmortem Cases 471
— xix —
Μ. Ota, Η. Inoko, Α. Ichinose, Κ. Tsu j i ,
Η. Fukushima, Η. Hasekura (Japan) >
Application of Modified PCR-RFLP Method in Forensic Science ··•· 17 1
S . Harada, T. Nakamura, S . Misawa (Japan) :
Investigation of DNA Polymorphism by Amplification Strategy 177
Y. Yang, X. Wu, C. Luo, X. Liu (P. R. China) :
Differentiation of Sex Origin of Bloodstains by Dot Hybridization with Y-Chromosome Specific Probe · 180
M. Nakai, F . Moriya, Y. Hashimoto, H. Ishizu,
R. Nanikawa (Japan) · Sex Identification from Contaminated Human Bloodstains by DNA Analysis 183
Y. Yamamoto, A. Nakanishi, H. Ishizu (Japan) · Sex Determination of Forensic Biological Materials by Polymerase Chain Reaction (PCR) 186
Μ. Wu, G. Sun (P. R. China) : Sex Determination of Hairs by Analysis of Amplified DNA Sequences 189
K. Honda, S . Harihara, T. Nakamura, M. Hirai, S . Misawa (Japan) · Identification of a Dead by DNA Extracted from a Fragment of Bone or a Single Tooth 192
T. R. Kumari, P. Chandra Sekharan (India) '· Authenticity of DNA Fingerprinting 495
E. Naito, K. Dewa, M. Fukuda, H. Yamanouchi,
R. Kominami (Japan) :
- xx -
J . Ochi, Y. Tatsuno (Japan) •
Detection of DNA Polymorphisms by Using PCR Method and Its Application to Forensic Identification 499
ML Wu, G. Sun (P. R. China) : Application of the Polymerase Chain Reaction in Forensic Science Practice 502
A. Akane, K. Matsubara, H. Shiono, S . Takahashi ,
Y. Nakahori, M. Yamada, Y. Nakagome (Japan) :
Forensic Application of Hyper-Variable DNA Polymorphisms and Sex Determination by Polymerase Chain Reaction 504
A. F . Vuorio, A. Sajant i la , T. Hamalainen,
A " C . Syvänen, L. Peltonen,
C . Ehnholm (Finland) : Amplification of the Hypervariable Region of the Apolipoprotein Β Gene: A Suitable Method for Solving Forensic Problems ·-—··———·———·———·•—• 507
K. Tamaki , T. Yamamoto, R. Uchihi,
Y. Katsumata (Japan) '· Distribution of HLA-DQA1 Genotypes in the Japanese Population · 510 C. Luo , X. Wu, H. Du, Y. Yang,
X. L iu (P. R. China) : The Study on DNA RFLPs Detected by pAWlOl Probe in the Population of Guangdong, China 513
T. Rothämel, W. Keil, Η. D. Tröger (FRG) : DNA-Profiling with VNTR-Probes - Allelic Frequencies of Hinfl-RFLPs Detected by pHINS310, pMUC7 and pMR24/l 516
— xxi —
Th. Riepert, Ch. Rittner (FRG) :
Importance of Identification of Corpses by X-Ray Comparison * 522
R. Neshige, Y. Kuroda, R. Kakigi, F . Fuj iyama,
R. Matoba, K. Takada (Japan) ·
Electroencephalography as an Objective Index of Photograph Recognition. Application to Simulated Criminal Investigation 525
N. Oguri (Japan) '·
— xxii —
EXPERIENCES IN BIOCHEMICAL DIAGNOSIS OF SUICIDE BY ANALYZING SEROTONIN IN CEREBROSPINAL FLUID
G.Kauert and W. Eisenmenqer
I n t r o d u c t i o n :
M E A N V A L U E S O F 5 - H T
ρ '. a . a a c s S = SUICIDES
C = CONTROLS
D i s t u r b a n c e s i n s e r o t o n i n (5-HT) m e t a b o l i s m a r e i m p l i c a t e d i n t h e p a t h o g e n e s i s o f a g g r e s s i v e and a u t o a g g r e s s i v e b e h a v i o u r o f p a t i e n t s . T h i s h a s been e v i d e n c e d by numerous s t u d i e s i n t h e p a s t .
I n e a r l i e r and r e c e n t s t u d i e s we found s i g n i f i c a n t d i f f e r e n c e s between t h e 5-HT c o n c e n t r a t i o n s a n a l y z e d i n lumbar a s w e l l a s c r a n i a l c e r e b r o s p i n a l f l u i d ( CSF) o f s u i c i d e and n o n - s u i c i d e v i c t i m s ( F i g . l ) (KAUERT e t a l . , 1 9 8 6 , 1 9 9 0 ) . T h e s e d i f f e r e n c e s c a n n o t be e x p l a i n e d by a g o n a l s t r e s s , p o s t mortem d e l a y o r age and s e x . T h e a p p l i c a t i o n o f t h i s method i n F o r e n s i c m e d i c a l r o u t i n e work i n o r d e r t o d i f f e r e n t i a t e between a c c i d e n t , h o m i c i d e and s u i c i d e r e q u i r e s a
CRANIAL h i g h e v i d e n t i a l v a l u e o f a s i n g l e r e s u l t . T h e r e f o r e , i n a
F i g . l : from K a u e r t e t a l . 1 9 8 6 v e r y r e c e n t s t u d y we b l i n d l y a n a l y z e d 5-HT i n lumbar CSF o f
38 randomly s e l e c t e d c a s e s ( w i t h o u t knowledge o f t h e a u t o p s y r e s u l t ) and from t h e 5-HT c o n c e n t r a t i o n s m e asured we a s s i g n e d t h e c a s e s t o e i t h e r s u i c i d e o r n o n - s u i c i d e . A f t e r w a r d s we compared t h e b i o c h e m i c a l d i a g n o s i s w i t h t h e a u t o p s y r e s u l t s and a n a l y z e d t h e r a t e c f c o r r e s p o n d e n c e . The d a t a c f t h i s s t u d y a r e p r e s e n t e d on t h e F i r s t I n t e r n a t i o n a l Symposium on Ad v a n c e s i n L e g a l M e d i c i n e , Kanazawa, J a p a n , O c t . 1 2 t h t o 15 t h , 1990.
Methods: A) S a m p l i n g o f CSF: Lumbar CSF i s c o l l e c t e d d u r i n g a u t o p s y by v e n t r a l p e r f o r a t i o n o f t h e i n t r a v e r t e b r a l d i s k L 3/4 o r L 4/5 a f t e r r e m o v a l o f t h e i n t e s t i n a l t r a c t The f i r s t p o r t i o n o f 2 - 4 ml h a s t o be t a k e n f o r a n a l y s i s . The s a m p l e s h a v e t o be f r o z e n d e e p l y w i t h i n o f max. 2 h o u r s . O n l y s a m p l e s a b s o l u t e l y f r e e o f b l o o d c o n t a m i n a t i o n a r e a d m i t t e d . B) A n a l y t i c a l s o f 5-HT: 5-HT i s i s o l a t e d from CSF v i a an i o n exc h a n g e r e s i n and s e p a r a t e d from o t h e r endogenous compounds by HPLC and d e t e c t e d by an e l e c t r o c h e m i c a l d e t e c t o r (WATERS) e q u i p p e d w i t h a g l a s s y c a r b o n w o r k i n g e l e c t r o d e and a AG/AgCl r e f e r e n c e e l e c t r o d e . The w o r k i n g p o t e n t i a l i s s e t on 0.7 V. The d e t e c t i o n l i m i t o f t h e method i s 0.1 ng/ml.
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R e s u l t s and d i s c i s s i o n : I n fig.2 a l l c a s ; s t h e 5- HT v a l u e s o f t h e d i f f e r e n t
5 — HT / CSF g r o u p s a r e s p o t t e d . I n 37 c a s e s i n v e s t i g a t e d t h e r e were 34 c a s e s w i t h u n e q u i v o c a l d i a c n o s e s of d e a t h by a u t o p s i e s . 2 3 o f t h e s e were s u i c i c e s and 11 o f them h o m i c i d e and a c c i d e n t r e s p e c t i v e l y . H i g h 5-HT c o n c e n t r a t i o n s 20ng/ml) f i t t e d i n 17 o f 23 c a s e s o f s u i c i d e , w h e r e a s low 5-HT c o n c e n t r a t i o n s ]5ng/ml we
cameof death: 0 = unclear. I msuckle. 2 - homicide. 3 - accident f O U n d 1Π 9 O f .1 C d S e S . W i t h t h e 4 - f i e l d s c h i s q u a r e t e s t we c a l c u l a t e d a c h i 2 v a l u e c f 9.3745 ( P= 0 . 0 0 2 1 7 ) .
F i g . 2 I n t h e 3 c a s e s w i t h code = 0 t h e s i t u a t i o n s a r e u n c e r t a i n . From t h e 5-HT c o n c e n t r a t i o n s t h e y c o u l d l e s u i c i d e c a s e s . C a s e No 1 i s p r o b l e m a t i c a l l y i n so f a r a s " h i s i s a s u i c i d e committed t o g e t h e r w i t h h i s mother (aut-No Γ21090) on t h e one hand b u t t h i s p e r s o n was m e n t a l l y d i s t u r b e d on t h e o t h e r hand. A l s o a c o n f u s i o n o f t h e CSF s a m p l e s c o u l d n o t be e x c l u d e d . C a s e No 2 m i g h t i n f a c t be a p o s s i b l e s u i c i d e from t h e c i r c u m s t a n c e s a t t h e s c e n e o f c r i m e . C a s e No 3 p r i m a r y was d i a g n o s e d a s a c a r d i o c a s c u l a r f a i l u r e . A p o s t i n v e s t i g a t i o n by t o x i c o l o g i c a l a n a l y s e s r e s u l t e d i i a t o x i c serum l e v e l o f a m i t r i p t y l i n e (428 ng/ml) s u g g e s t i n g an o v e r d o s e ! I n t h e group o f s u i c i d e (code 1) t h e r e a r e some c a s e s w i t h s t r i k i n g low 5-HT c o n c e n t r a t i o n s . 2 o f t h e s e e x h i b i t a c a s e h i s t o r y o f h e a v y i l l n e s s ( c a n c e r and p a r a p l e g i a r?.sp.) and were members o f a german s o c i e t y w h i c h from one c a r g e t s a f e methods f o r c o m m i t t i n g s u i c i d e . I t m i g h t be t h a t t h e low c o n c e n t r a t i o n s o f 5-HT r e s u l t e d from a l a c k i n g a u t o e g g r e s s i o n o r from t h e i l l n e s s i t s e l f . C a s e No.8 i s t h e mother o f above m e n t i o n e d c a s e of m e n t a l l y d i s t u r b e d man, who committed s u i c i d e t o g e t h e r w i t h h e r son by d r i v i n g h e r c a r i n t o a r i v e r . The r e m a i n i n g c a s e s 26 a l l show a t h e r a p e u t i c serum l e v e l o f t r i c y c l i c a n t i d e p r e s s a n t s l i k e a m i t r i p t y l i n e , some o f w h i c h a r e w e l l known t o d e c r e a s e t h e 5-HT s y n t h e s i s a f t e r c h r o n i c a l u p t a k e , however, n o t a f t e r a c u t e d osage (VAN PRAAG, 1 9 8 1 ) . The group o f h o m i c i d e and a c c i d e n t ( c o d e s 2 and 3) c o n t a i n s 2 c a s e s w i t h h i g h 5-HT c o n c e n t r a t i o n s . C a s e No.31 e x h i b i t s a v e r y i n t e r e s t i n g h i s t o r y from s c i e n t i f i c p o i n t o f view. The man was d i s c o v e r e d and t h e n k i l l e d by h i s son, w h i l e he m a l t r e a t e d h i s w i f e p o s s i b l y w i t h i n t e n t i o n of k i l l i n g h e r . T h i s c a s e m i g h t be an i n d i c a t o r t h a t h i g h c o n c e n t r a t i o n s o f 5-HT a r e c o r r e l a t e d w i t h t h e r a t e o f a g g r e s s i o n . The s e c o n d c a s e c o u l d n o t be e l u c i d a t e d . I t i s an a l c o h o l i c and tramp we a r e d e a l i n g w i t h h e r e , who was s t r a n g a l a t e d by
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a n o t h e r tramp. The r e a o n f o r h i s r e l a t i v e h i g h 5-HT c o n c e n t r a t o r ! must r e m a i n u n c l e a r a t p r e s e n t .
Conclusion;: Our method a n a l y z i n g t h e c o n c e n t r a t i o n o f 5-HT i n lumbar CSF p r o v i d e s t i e p o s s i b i l i t y o f d i f f e r e n t i a t i o n between s u i c i d e and non-s'.icide w i t h a h i g h e v i d e n t i a l v a l u e . From our e x p e r i e n c e ; , however, t h e r e a r e some f a c t o r s t o be c o n s i d e r e d a s d e s c r i b e d above. Of p a r t i c u l a r c r i m i n a l i s t i c i n t e r e s t a r e s u s p e c t e d l o m i c i d e s w h i c h a r e p r e t e n d e d a s s u i c i d e . From our h o m i c i d e iases i n v e s t i g a t e d we c o u l d e v i d e n c e t h a t a g o n a l s t r e s s o r >anic r e a c t i o n s , w h i c h p r o v a b l y t o o k p l a c e i n a l o t o f c a s e s , l a s no i n f l u e n c e on t h e 5-HT c o n c e n t r a t i o n i n CSF. T h i s o b s e r v a t i o n i s i n agreement w i t h s t u d i e s o f LUNA e t a l . ( 1 9 8 2 ) , who i n v e s t i g a t e d 5-HT i n CSF a f t e r s h o r t and p r o l o n g e d l e a t h agony. From our r e s u l t s we s u g g e s t t h a t t h e d e g r e e o f a g g r e s s i o n and a u t o a g g r e s ; i o n r e s p e c t i v e l y i s a s s o c i a t e d w i t h t h e r a t e o f 5- HT c o n c e n t a t i o n i n t h e CSF. The c r u c i e l q u e s t i o n o f t h e c e n t r a l o r i g i n o f t h i s 5-HT h a s t o be c l a r . f i e d . And a s p r e l i m i n a r r e s u l t we c o u l d s t a t e t h a t t h e p i n e a l o r g a n may be i n v o l v e d , b e c a u s e i n o u r s t u d i e s we found a n e g a t i v e c o r r e l a t i o n between t h e p i n e a l and lumbar CSF 5-HT c o n c e n t r a t i o n s (KAUERT e t a l . 1 9 9 0 ) . S h o u l d D e s c a r t e s (1596-1650 be r i g h t w i t h h i s a s s u m p t i o n o f t h e p i n e a l b e i n g t h e s e a t o: t h e s o u l ?
L i t e r a t u r e
Kauert,G., Zucker,T. Gilg,T. and Eisenmenger,W.: Measurements o f b i o g e i i c a m i n e s and m e t a b o l i t e s i n t h e c s f o f s u i c i d e v i c i i m s and n o n s u i c i d e s . I n : Moeller,Η.J., Schmidtke,^. and Welz,R. ( e d s ) : C u r r e n t i s s u e s o f s u i c i d o l o c y , pp 252-262, S p r i n g e r V e r l a g B e r l i n - H e i d e l b e r g , New York, jondon, P a r i s , Tokyo, 1986.
Kauert,G and Schmid,K., 1990: S e r o t o n i n , 5- Hydroxyincblessigsäure, N - A c e t y l s e r o t o n i n und C o r t i s o l im L u m b a l l i q i o r von S u i z i d o p f e r n . T h e s i s o f K.Schmid
Van PraagH. : c e n t r a l monoamines and t h e p a t h o g e n e s i s ot d e p r e s s i o n I n : Van Praag,H., Lader,Μ.Η., Rafaelson,0.J. and Sachar,Ε.Ü (eds): Handbook o f b i o l o g i c a l p s y c h i a t r y , P a r t I V : B r a i n mechanisms and abnormal b e h a v i o r - C h e m i s t r y , pp 159-206, p a r c e l D ekker, Inc.New York, B a s e l , 1981.
Luna.A, rillanueva,Ε.,Hernandez-Cueto, Luna,J.D., 1982: V e r h a l t e n d e s 5-HT und d e r 5-Hydroxy-indol-Essigsäure i n Zusammenhang m i t d e r A g o n i e . ( I . ) . Z.Rechtsmed. 89: 215-226
A d r e s s : G.KAUERT ;nd W.EISENMENGER, Department o f L e g a l M e d i c i n e , U n i v e r s i t y o f Munich, F r a u e n l o b s t r a s s e 7a, D-8000 München 2, FRG.
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+ Edited by Taizo Nagano
Contents
COMMEMORATIVE S P E C I A L L E C T U R E S J . Kondo (Japan)· Prediction of Science in 21st Century 1
H. Manabe (Japan) · Expectations for Forensic Medicine Approaching the 21st Century 5
G. Schmidt (FRG) : Advances in Forensic Medicine Towards the 21st Century 11
W. Janssen (FRG) : Advances in Forensic Medicine and the Welfare of Human Beings 20
Symposium _Theme I :
COMPARISON O F S Y S T E M S O F L E G A L
MEDICINE IN THE WORLD
Y. Mizoi (Japan) ·
Education, Research and System of Legal Medicine in Japan 31 G. Schewe (FRG) : The Structure and Educational System of German Legal Medicine 34
I — 1. Institution and Practice
M. S . L. Saigado (Sri Lanka) • Undergraduate and Post-Graduate Medico-Legal Education and Practice in Sri Lanka 37
J . E . L. Pinto da Costa (Portugal) :
Medico-Legal Organization in Portugal 40
J . Ζ. Zhu, L. Wang. (P. R. China) The Current System of Forensic Medicine in the P. R. China 43
P. M. Jablonsky (Czechoslovakia) : History, Present Status and Future of Legal Medicine in Slovakia 45
O. Romo (Chile) Psychiatric Forensic Expertise and Imputability 48
G. Schmidt (FRG) : Forensic Medicine As an Interdisciplinary Subject 52
P. Saukko (Finland) · The Medico-Legal System in Finland 54
A. Penttilä, P. J . Karhunen, M. Tenhu,
E . Vuori (Finland) · Deaths of Finns Abroad Revisited in Helsinki * 57
B. Knight (United Kingdom) : The Ideal System of a Medico-Legal Service 60
R. Breitenecker (USA) · The Current Status of Legal Medicine in the USA 62
J . T. J i a (P. R. China) : On the Historical Development of Forensic Medicine in China 65
T. Fukunaga, Y. Ueno, Κ. Yamamoto, Y. Mizoi,
S . Hishida, Y. Yamamoto, M. Yamada,
Y. Tatsuno (Japan) ·
Statistical Analysis of Unnatural Deaths in Hyogo and Shiga Prefectures—Comparison of the Results of Inquests by Medical Examiners and by Others 68
— ii -
Y. Katsumata, J . Nudeshima (Japan) · Unnatural Deaths: A Comparison of Medico-
Legal Practices in Japan and the U.S.A. 71
I — 2 . Education
M. S taak , B. Madea (FRG) Undergraduate and Postgraduate Teaching of Forensic Medicine in West Germany 74
P. Chandra Sekharan (India) · Medico-Legal Practice and Education in India 80
Z. Marek (Poland) · Medical Error and Deontological Problems in Undergraduate and Postgraduate Education in Poland · 83
J . E . L . Pinto da Costa (Portugal) Portuguese Medico-Legal Education 88
T. C . Chao (Singapore) · Teaching of Forensic Medicine in Singapore 91
J . T. J i a (P. R. China) : On the Medico-Legal Education in China 93
S . Alteza, J r . (Philippines) - Medico-Legal Education in the Philippines 96
S . Oshida, Y. Ohno, S . Uchigasaki (Japan) :
Video Relay System from Legal Autopsy Room to Lecture Room 99 K. Terazawa, H. Akabane, B. Wu, M. Nagao,
T. Takatori (Japan) :
Citation of Non-English Literatures - On the Obstruction of Arteries by Typical Hanging 100
I ~ 3 . Medical L a w and Ethics
G. Schewe (FRG) : Recent Trends in Medical Law in Germany 103
— in —
Τ. Kanagawa (Japan) · The Present Situation of Informed Consent in japan 108
A. Luna, P. Barroso (Spain) * Attitudes of Doctors towards Death, Euthanasia and Informing Terminal Patients I l l
H. Harada, N. Furumoto, T. Shouman, M. A. Green
(Japan, United Kingdom) - Modeling and Estimation of Breath Alcohol Concentration after Drinking * 114
H. Hattori, N. Yamamoto, J . Furuno (Japan) · Legal and Ethical Aspects of AIDS Affair in Japan · 117
Symposium-Theme II :
P R O B L E M S WITH INSURANCE AND
COMPENSATION A F T E R TRAUMATIC INJURIES
Π — 1. Sequelae of Traumatic Injuries
W. Eisenmenger, G. Beier (FRG) · Medical Insurance Problems after Trauma 121
T. Takatori (Japan) · Vehicle Collision Experiments at Low Speeds and Medical Approaches 124 J . L iu , S . Song (P. R. China) : A Preliminary Study on the Application of Visual Evoked Potential (VEP) in Forensic Practice 127
X. L iu , P. Yu, X. Zhou, Y. Zhang (P. R. China) : Evaluation of Auditory Brainstem Response (ABR) Applied in the Forensic Practice 130
P. D. Niall (Australia) : Medical Tribunals in Workers Compensation Disputes Developments in Australia · 133
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Μ. Hayashida, Μ. Nihira, Κ. Hirakawa,
Ν. Moriya, Υ. Tomita, Τ. Watanabe (Japan) · The Effect of Alcohol on Diagnosis, Severity and Outcome of Injured Patients in Traffic Accidents and Falling Victims 136
N. Ohashi, M. Doi, S . Misawa, K. Ono (Japan) The Relationship between Impact Speed and Injury Severity in Motorvehicle- Pedestrian Accidents 139
Π — 2 . Medical Care of Injuries and Responsibility of Doctors
B. Knight (United Kingdom) : The Medical Malpractice and Negligence Situation in Britain 142
M. C. S . Ribeiro, (Portugal) : Road Traffic Accidents. Insurance and Compensation 144
T. Hiranuma (Japan) :
Medical Care on Traffic Accidents and Its Diagnostic Criteria * 147
C. Wakasugi (Japan) · Damages or Fatal Consequences of External Injuries and Medical Treatment 151
Symposium-Theme IB:
1 - 1 . Time of Death
C. Henssge, B. Madea (FRG) · Estimation of the Time since Death 155
G. Beier, E . TutschrBauer, W. Wiesbock (FRG) Influence of Temperature on Rigor Mortis 159
— ν —
G. Vacchiano, R. Massini, C. Romano (Italy) · The Post-Mortem Demyelinization: A New Method for Estimation of Time after Death 162
G. Kauert, W. Eisenmenger (FRG) Experiences in Biochemical Diagnosis of Suicide by Analyzing Serotonin in Cerebrospinal Fluid 167
A. Sawaguchi , J . Kotani, T. Funao, N. Nakada,
A. Koshizawa (Japan) · Death From Rapid Drowning: Findings of Cerebral Blood Flow and Serum Haptoglobin 170
H. Sugie, T. Funao (Japan) · Ultraviolet Spectrophotometry and HPLC of Vitreous Humor for the Estimation of Hours After Death 173
ffl"~2. Brain Death and Organ Transplantation
K. Hoshino (Japan) :
Bioethical Considerations on Brain Death and Organ Transplantation 176
M. Fukaya, Y. S a s a k i , S . Murakami, T. Nagano,
T. Kanagawa (Japan) - A Proposition Concerning the Brain Death Act Legislation in Japan 179 B. Knight (United Kingdom) : The Present Situation of Organ Transplantation in Great Britain 182
M. J . Carneiro de Sousa (Portugal) Brain Death. The Problem in Portugal 184
D. -X. L i (P. R. China) : Pathology of Brain Death 187
— vi —
Involuntary Movements after Brain Death: Pathological Observations in the Cervical Spinal Cord 190 Y. Kinoshita, K. Okamoto, T. Yoshioka,
T. Sugimoto (Japan) :
Long-Term Organ Preservation in Brain Death
Maintained with Vasopressin and Catecholamine 193
R. Breitenecker (USA) : The Current Status of Organ Transplantation in the USA 196
Y. Tatsuno, T. Fukunaga, Y. Yamamoto, M. Yamada,
M. Kane, S . Fu j iwara , J . Adachi, Y. Mizoi (Japan) ·
Neuropathological Studies on Brain Death 198 D. -X . L i (P. R. China) :
Pathology of Brain Death—Delayed Traumatic Intracerebral Hematoma (DTICH) 201
Symposium-Theme IV:
A D V A N C E S IN T H E F I E L D O F
F O R E N S i C PATHOLOGY
IV — 1. Application of Ultramicroscopy and
Enzyme-Histochemistry
M. Oehmichen (FRG) : Application of Immunohistochemisty in
Forensic Medicine 208
S . Shoumura, S . Emura, M. Ustumi, H. Isono,
Y. Bunai , I. Ohya (Japan) · Postmortal Changes of the Fine Structure of the Liver 211
- v i i —
The Morphological, Biochemical and Immunohistochemical Studies on Asphyxia 214
Τ. Kita, Y. Furuya (Japan) · Vasomotion of the Pulmonary Vessels During Asphyxial Congestion 216
M. Yoshino, T. Kimijima, S . Miyasaka, H. Sato,
B. Miyake, S . Seta (Japan) · Ultrastructural and Cytochemical Changes of Rabbit Brain in Hypoxic State 218
N. Kawaguchi, M. Mukaida, M. Saito, M. Okada,
N. Yamazaki, Y. Takada (Japan) :
The Ultrastructural Basis of Tinctorial Change of Collagen Fibers in the Damaged Dermis 221
Y. Tatsuno, T. Fukunaga, Y. Yamamoto, M. Yamada, S . Fuj iwara, Y. Ueno, Τ. Sawaguchi , Y. Mizoi (Japan) · Immunohistochemical Approach to Alzheimer-Type Dementia 224
K. Yoshida, Y. Ogura, M. Masui, M. Yamazaki,
C. Wakasugi (Japan) :
A Histochemical Study of Calmodulin in Dog Myocardial Ischemia and Autopsy Cases of Sudden Cardiac Death 227
A Luna, E . Osuna (Spain) · Are Biochemical Markers Necessary for Post-Mortem Diagnosis of Myocardial Infarction? 230
U. Hellerich (FRG) : Lectin Histochemistry- A Helpful Method to Differentiate Early Pregnant from Non-Pregnant Endometrium 233
J . Ζ. Zhu, D. C. Wang (P. R. China) : Estimation of Time of Injuries by Microscopic Localization and Quantification of Nonspecific Esterase 235
P. J . Karhunen, A. Penttilä, P. Leinikki,
H. Brummer-Korvenkontio, M. _ L . Kantanen,
M. Nyberg (Finland) > Visually-Read Assay of the Vitreous Humour in Rapid Screening for HIV in Necropsies 238
N. Tabata, M. Morita (Japan) · Studies on Livor Mortis. On the Localization of Hemoglobin in the Human Skin Tissue by Immunohistochemistry 241
M. Ogata, S . Kubo, O. Kitamura, W. Hirose,
I. Nakasono, T. Fukunaga, Y. Tatsuno (Japan) An Immunohistochemical Demonstration of Hemoglobin in the Kidney of Battered Children 243
T. Fukunaga, Y. Yamamoto, M. Yamada,
Y. Tatsuno, Y. Mizoi, A. Yamashita (Japan) · Thymic Involution in Abused/Neglected Children · · — · · 246
A. Nishimura, S . Fuj iwara, Y. Yanagida,
K. Nakanishi, Y. Mizoi (Japan) '· Cerebral Atrophy in Senile Dementia and Normal Aging; A Quantitative Study Using Image Analysing System * 249
O. Kitamura, S . Kubo, M. Ogata, M. Iwasaki,
W. Hirose, I. Nakasono (Japan) · Histopathological Studies of Hypoxic and Ischemic Brain Damage and its Application to Forensic Autopsy Cases 252
— ix —
Τ. Fuj ikura, Υ. Kominato, Η. Takizawa (Japan) · Forensic Application of Post-Mortem Cerebral Angiography. 1. Subarachnoid Bleeding 255
S . Takeichi, A. Tsuj i , Y. Seto, T. Saito (Japan) ·
Histological and Enzyme-Histochemical Studies on Cardiac Sudden Death, Especially Acute Ischemic Cardiac Disease 258
Y. Ueno, Κ. Yamamoto, Τ. Imabayashi, Τ. Fukunaga, Y. Mizoi (Japan) · Biogenic Amine Content of Human Carotid Body in the Cases of Sudden Death 260
H. Fukushima, M. Ota, K. Tanaka ,
H. Hasekura (Japan) :
Using the Immunostaining Method and the Polymerase Chain Reaction Amplification for Identifying Mixed-up Formalin-Fixed, Paraffin-Embedded Tissues 263
K. Matsuura, Y. Bunai, X. J iang, A. Nagai, S . Yamada, I. Ohya, H. Sawada (Japan) · Immunohistochemical Localization of Dihydrodiol Dehydrogenases in the Lens and the Kidney 266
S . Miyasaka, T. Kimijima, M. Yoshino, H. Sato , B. Miyake, S . Seta (Japan) · Immunohistochemical Demonstration of ABH Blood Group Antigens in the Putrefied and Dried Skin Fragments 269
I V - 2 . Present Status of S IDS
A. Takatsu (Japan) :
Advances in Pathological Diagnosis of SIDS 272
G. Sorgo (Austria) · The Unexpected Sudden Death of a Child with Unusual Pathological Findings 275
— x —
P. Μ. Jablonsky, S . Dluholucky (Czechoslovakia) : Present Status of SIDS in Central Slovakia 278
Y. Matsubara, K. Narisawa (Japan) :
Identification of a Common Genetic Mutation Responsible for Sudden Infant Death Syndrome 280
Y. Tsuda (Japan) ·
Several Cases of Pediatric Forensic Study — The Second Report of the Statistic and Sociomedical Review on Sudden Infant and Child Death- • 282
Symposium-Theme V:
A D V A N C E S IN TOXICOLOGICAL ANALYSIS
V —1. Determination of Drugs and Poisons in T issues
H. Käferstein (FRG)
Methodology of Drug Detection in Body Fluids 285
G. Machata (Austria) · Sample Collecter (BSC 1) for Volatile Substances in the Work Environment 288
T. Miyazaki, F . Chikasue, Μ. Yashiki , Τ. Kojima (Japan) · Carbon Monoxide Hemoglobin Saturations in Left and Right Heart Blood from Cadavers not Exposed to Fire or CO Gas 291
Y. Yamamoto, K. Yamamoto, Y. Fukui (Japan) '. Teratogenic Effects of Methamphetamine 294
T. Marcinkowski, K. Borowiak, M. Parafiniuk (Poland) · Microcrystals in the Toxicological and Histological Analysis in Cases of Intoxication with Ethylene Glycol · 297
— xi —
Η. Seno, Ο. Suzuki , Τ. Kumazawa, Μ. Asano (Japan) · Isolation of Medico-Legally Important Drugs with SEP-PAK C i 8 Cartridges Using Chloroform as Elution Solvent 299
B. Hu, M. L i u , Z. Wang, Y. Yang, X. Deng,
G. L i , H. L i , Q. L iang , P. S u (P. R. China) : Studies on Aconitine Toxicology 302
B. Hu, K. Yun, M. L i u , Z. Wang (P. R. China) : Toxicokinetic Studies of Cantharidin in Rabbits 305
C. Moore, K. Sa to , H. Hattori, Y. Katsumata (Japan) · The Determination of Cephalosporins Using Super Microbore High Pressure Liquid Chromatography-Mass Spectrometry 308
J . Adachi , Y. Tatsuno, Y. Ogawa, K. Nakagawa,
Y. Mizoi (Japan) · Greenish Discoloration of Skin and Formation of Sulfhemoglobin Caused by Hydrogen Sulfide Poisoning and Putrefaction 311
K. Ameno, C . Fuke , S . Ameno, T. Kiriu, T. Shinohara, K. Sogo, I. Ijiri (Japan) ;
A Rapid and Sensitive Quantitation of Amitraz in Plasma by Gas Chromatography With Flame Thermionic Detection 3 1 !
T. Kiriu, K. Ameno, C . Fuke , S . Ameno, T. Shinohara, K. Sogo, I. Ijiri (Japan) · In Vivo and in Vitro Studies of Regional Brain Distribution of Toluene 317
Y. Kuroiwa, K. Aoki, T. Watanabe,
Y. Kuroiwa (Japan) ·
Enzyme-Linked Immunosorbent Assay for Methamphetamine, Morphine and Benzoylecgonine 320
Τ. Nagano, Τ. T a k a y a s u , Τ. Ohshima,
Η. Maeda (Japan) :
An Analytical Method for Volatiles in the Biological Materials by Pulse Heating 323
Μ. Nihira, Κ. Hirakawa, Μ. Hayashida,
Υ. Tomita, Ν. Moriya, Τ. Watanabe (Japan) :
Changes of Acetic Acid Concentration of Various Rat Tissues After Ethanol Injection 326
T. Shinozuka, N. Kuroda, T. Murai, S . Takei , K. Kurihara, J . Yanagida (Japan) :
Determination of Microamount of Mefenamic Acid by High Performance Liquid Chromatography 329
K. Terazawa , L . J i , M. Nagao, T. Takator i , K. Aoki, Y. Hirose, Y. Kuroiwa (Japan) - Production and Characterization of Monoclonal Antibodies Reactive with Methamphetamine Raised Against a New Antigen 332
M. Tomita, T. Okuyama, S . Watanabe,
B. Uno, S . Kawai (Japan) '· Liquid Chromatographic Determination of
Glyphosate and its Metabolite in Serum 335
G. Huang, Y. Zhang, L . L i , X. Sung, Z. Wang, L . Qiao (P. R. China) :
Toxicological Pathological Study of Lei Gong Teng (Tripterygium Wilfordii Hook) 338
C . Romano, A. Malorni, A. Acampora,
G. Vacchiano, M. Esposi to , R. De Mercato · Experiences in Legal Medicine about Antiparassites Toxic Substances and Human Nourishment 341
- xiii —
W. Bonte (FRG) : Advances in Congener Analysis • 311
K. Kimura, T. Nagata, K. Kudo, T. Imamura (Japan) · Determination of Kerosene and Light Oil Components in Blood 317
E . Logemann, C. Müller, Ε. Keller (FRG) : Pharmacokinetics of Diazepam in Patients with Nephrotic Syndrome 350
L. v. Meyer, W. Hanisch, G. Kauert,
G. Drasch (FRG) :
K. Terazawa, K. Miyazaki (Japan) :
Transport Characteristics of Paraquat Across Rat Intestinal Brush Border Membrane 356
C. Fuke, K. Ameno, S . Ameno, T. Kiriu,
T. Shinohara, K. Sogo, I. Ijiri (Japan) '·
Simultaneous Determination of Paraquat and Diquat in Biological Materials Using Second-Derivative Spectroscopy and High-Performance Liquid Chromatography 359 K. Gonmori, N. Yoshioka (Japan) · Effect of Mushroom Toxin on Biogenic Amines of Rat Brain 362
K. Hirakawa, M. Nihira, M. Hayashida,
IM. Moriya, Y. Tomita, T. Watanabe (Japan) · Assesment of the Brain Lesions of the Rats on Acute Ethanol Poisoning Using Magnetic Resonance Imaging (MRI) 365
- x iv —
J . Nishigami, Τ. Ohshima (Japan) ·
Screening and Quantitation of Drugs and Poisons in Blood and Urine in Emergency Medical Care and Legal Autopsy Cases 368
K. Sato, Y. Mizuno, C. M. Moore, K. Tamaki,
Y. Katsumata (Japan) '·
Storage of Blood for Methemoglobin Determination: Effect of Various Buffers on the Storage of Hemolysates 371
I. Yamamoto, T. Matsunaga, H. Kobayashi, K. Watanabe, H. Yoshimura (Japan) · Pharmaco-Toxicity of p-Coumaroyltyramine and Feruloyltyramine in Marihuana 374
K. Yamazaki, E . Tanaka, N. Shimojo,
S . Misawa (Japan) ·
The Validity of Measurements of Locomotor Activity as Evidence of Exposure to Toluene 377
Symposium-Theme VI:
METHODOLOGY IN F O R E N S I C S E R O L O G Y AND
STAIN ANALYSIS
VI — 1. Sero _ Genetic Procedures P. Hooft, H. van de Voorde (Belgium) · The Zinc Spot Test as a Tool for the Primary Identification of Human Seminal Stains 381
R. lida, T. Yasuda, D. Nadano, K. Kishi (Japan) ·
Intensification of Peroxidase-Diaminobenzidine Staining Using Gold-Sulfide-Silver: A Simple and Highly Sensitive Detection Method for Immunoblotting 384
— xv -
Y. Furusawa, Υ. Uchimura, S . Tsunenari (Japan) · Forensic Biology of Human Hepatic Bile: Its Application to the Determination of Species Specificity and ABO Blood Type of Feces 387
S . Kubo, M. Iwasaki, O. Kitamura, M. Ogata,
I. Nakasono (Japan) · The Effect of Soil Fungi on Changes in the Specificity of the ABO Blood Groups and on the Degeneration of Hair 390
Y. Tamaki, T. Kishida (Japan) · Experience with Anti-Mouse IgG/Anti-Peroxidase Bispecific Monoclonal Antibody in ELISA and Dot Immunobinding for GM Typing 393
M. Wu, Z. J in (P. R. China) : Phenotyping of GC in Human Semen Stains Using IEF Followed by Enzyme Immunoassay 396
T. Matsuki, T. Nakajima, K. Furukawa (Japan) · Application of Anti-H Active Antibodies and Lectins to the Detection of Human Blood Group Η Substances 399
T. Kogure, M. Sagi , Y. Kuwaki, K. Yamazaki,
M. Kitahama (Japan) ·
Detection and Activity of Blood Group A and Β Gene-Encoded Glycosyltransferases in Human Seminal Plasma and Cerebrospinal fluid 402 S . Ito. K. Matsui, K. Suzuki , H. Matsumoto,
Y. Mizoi (Japan) '· A Simple Extraction Procedure for ABO Group Typing of Bloodstain by Dot ELISA Method 405
— xvi —
Κ. Sodesaki , Α. Kimura, Τ. Tsuji
F . Matsumura (Japan) Cell Surface ELISA for Detection of Anti-ABO and Anti -MN Blood Group Antibodies 108
Ρ. Κ. Chattopadhyay, Μ. Κ. Thakkar (India) ABO Blood Groups from Hair 111
A. Kimura, M. Osawa, S . Yasuda,
H. Ikeda, T. Uda, S . Nakashima
M. Ohta, T. Tsuji (Japan) ·
On Monoclonal Antibodies to Epitopes Specific for Species in Primates 415 T. Nagano, T. Ohshima, H. Maeda,
Y. Fuj ioka (Japan) '·
Species Identification of Minute Bloodstains by Simultaneous Precipitin Reactions in an Agarose Gel after Electrophoresis 418 B. Wang, J . J i a , D. Chen (P. R. China) On the Species Discrimination of Animal Bloodstains by Polyacrylamide Gel Isoelectrofocusing 421
J . Guo, A. Fan (P. R. China) ' Determination of Phenotypes of Salivary Amylase in Saliva and Saliva Stains by IEF and Silver Staining 424
K. Akiyama, Y. Ito, H. Kimura (Japan) :
Characterization of a New Protein Which Binds Actin in Seminal Plasma and Saliva 427
H. Matsumoto, T. Fukae, S . Kubo, O. Kitamura, M. Iwasaki, I. Nakasono, M. Ogata (Japan) · Subtyping of the Group Specific Component (Gc) in Semen and in Seminal Stains 430
- xv ii -
S . Abe, Κ. Hiraiwa (Japan) ·
New Form of ^Glutamyl Transpeptidase in Human Seminal Plasma and It's Application to Forensic Medicine 433
K. Suzuki , S . Ito, H. Matsumoto,
Y. Mizoi (Japan) ·
Three Hereditary Subtypic Patterns detected in the Ba Fragment of Complement Factor Β 435
S . Nakamura, K. Omoto, O. Ohue, K. Yamashita, J . Ochi, K. Akiyama, A. Sawaguchi (Japan) :
C1R Polymorphism in the Japanese Population 438
H. Nishimukai, K. Shinomiya,
Genetically Controlled Variants of Antithrombin III 441
Κ. Umetsu, I. Yuasa , Τ. Suzuki (Japan) · Orosomucoid (ORM) Typing by Isoelectric Focusing: Effect of Protease Treatment and Stability in Bloodstains 44 1
I. Yuasa , K. Umetsu, N. Nakayashiki, N. Tamaki,
H. Shiono, K. Okada (Japan) ·
Urosomucoid (ORM) Typing by Isoelectric Focusing: An Improved Method for ORM1 Subtyping and the Reactivity of Anti-Human ORM Antibodies with Animal ORM 447 A. Tamura, K. Suzuki , S . Ito, H. Matsumoto, Y. Mizoi (Japan) · Two-Dimensional Polyacrylamide Gel Electrophoresis Analysis of Postmortem Change in Brain Proteins 450
— xviii —
Y. Kamitani, K. Tomita (Japan) ·
Transformation of Genetic Markers in Blood with BMT and Problems in Legal Medicine 453
V I - 2 . DNA Polymorphisms
Κ Sullivan, P. Gill (United Kingdom) The Potential Use of PCR in Forensic Analysis 456
K. Suzuki , S . Ito, H. Matsumoto, Y. Mizoi (Japan) · Restriction Fragment Length Polymorphisms Associated with Immunoglobulin Gamma Switch Regions in Man 459
I. Saka i , K. Kasa i , K. Yoshida, H. Mukoyama, S . Seta (Japan) :
DNA Analysis Using Single Locus VNTR Probes and Its Application to the Individualization of Human Bloodstains 462
C. Rittner, L . Braun _Heimer,
P. M. Schneider (FRG) : The Use of PCR-Amplified DNA in Paternity Testing and Stain Analysis · · — — * — ^-465
T. Yokoi, M. Nata, Y. Aoki, K.
Sagisaka (Japan) ·
Contribution of DNA Analysis on Paternity Test 468 C. Rittner, U. Schacker, G. Rittner,
B. Holtkamp, Ε. Bohnke, Η. Η. Sonneborn,
P. Μ. Schneider (FRG) :
DNA Polymorphisms in Paternity Testing: The Use of Minisatellite Probe MZ 1.3 in Incest, Deficiency, Antenatal and Postmortem Cases 471
— xix —
Μ. Ota, Η. Inoko, Α. Ichinose, Κ. Tsu j i ,
Η. Fukushima, Η. Hasekura (Japan) >
Application of Modified PCR-RFLP Method in Forensic Science ··•· 17 1
S . Harada, T. Nakamura, S . Misawa (Japan) :
Investigation of DNA Polymorphism by Amplification Strategy 177
Y. Yang, X. Wu, C. Luo, X. Liu (P. R. China) :
Differentiation of Sex Origin of Bloodstains by Dot Hybridization with Y-Chromosome Specific Probe · 180
M. Nakai, F . Moriya, Y. Hashimoto, H. Ishizu,
R. Nanikawa (Japan) · Sex Identification from Contaminated Human Bloodstains by DNA Analysis 183
Y. Yamamoto, A. Nakanishi, H. Ishizu (Japan) · Sex Determination of Forensic Biological Materials by Polymerase Chain Reaction (PCR) 186
Μ. Wu, G. Sun (P. R. China) : Sex Determination of Hairs by Analysis of Amplified DNA Sequences 189
K. Honda, S . Harihara, T. Nakamura, M. Hirai, S . Misawa (Japan) · Identification of a Dead by DNA Extracted from a Fragment of Bone or a Single Tooth 192
T. R. Kumari, P. Chandra Sekharan (India) '· Authenticity of DNA Fingerprinting 495
E. Naito, K. Dewa, M. Fukuda, H. Yamanouchi,
R. Kominami (Japan) :
- xx -
J . Ochi, Y. Tatsuno (Japan) •
Detection of DNA Polymorphisms by Using PCR Method and Its Application to Forensic Identification 499
ML Wu, G. Sun (P. R. China) : Application of the Polymerase Chain Reaction in Forensic Science Practice 502
A. Akane, K. Matsubara, H. Shiono, S . Takahashi ,
Y. Nakahori, M. Yamada, Y. Nakagome (Japan) :
Forensic Application of Hyper-Variable DNA Polymorphisms and Sex Determination by Polymerase Chain Reaction 504
A. F . Vuorio, A. Sajant i la , T. Hamalainen,
A " C . Syvänen, L. Peltonen,
C . Ehnholm (Finland) : Amplification of the Hypervariable Region of the Apolipoprotein Β Gene: A Suitable Method for Solving Forensic Problems ·-—··———·———·———·•—• 507
K. Tamaki , T. Yamamoto, R. Uchihi,
Y. Katsumata (Japan) '· Distribution of HLA-DQA1 Genotypes in the Japanese Population · 510 C. Luo , X. Wu, H. Du, Y. Yang,
X. L iu (P. R. China) : The Study on DNA RFLPs Detected by pAWlOl Probe in the Population of Guangdong, China 513
T. Rothämel, W. Keil, Η. D. Tröger (FRG) : DNA-Profiling with VNTR-Probes - Allelic Frequencies of Hinfl-RFLPs Detected by pHINS310, pMUC7 and pMR24/l 516
— xxi —
Th. Riepert, Ch. Rittner (FRG) :
Importance of Identification of Corpses by X-Ray Comparison * 522
R. Neshige, Y. Kuroda, R. Kakigi, F . Fuj iyama,
R. Matoba, K. Takada (Japan) ·
Electroencephalography as an Objective Index of Photograph Recognition. Application to Simulated Criminal Investigation 525
N. Oguri (Japan) '·
— xxii —
EXPERIENCES IN BIOCHEMICAL DIAGNOSIS OF SUICIDE BY ANALYZING SEROTONIN IN CEREBROSPINAL FLUID
G.Kauert and W. Eisenmenqer
I n t r o d u c t i o n :
M E A N V A L U E S O F 5 - H T
ρ '. a . a a c s S = SUICIDES
C = CONTROLS
D i s t u r b a n c e s i n s e r o t o n i n (5-HT) m e t a b o l i s m a r e i m p l i c a t e d i n t h e p a t h o g e n e s i s o f a g g r e s s i v e and a u t o a g g r e s s i v e b e h a v i o u r o f p a t i e n t s . T h i s h a s been e v i d e n c e d by numerous s t u d i e s i n t h e p a s t .
I n e a r l i e r and r e c e n t s t u d i e s we found s i g n i f i c a n t d i f f e r e n c e s between t h e 5-HT c o n c e n t r a t i o n s a n a l y z e d i n lumbar a s w e l l a s c r a n i a l c e r e b r o s p i n a l f l u i d ( CSF) o f s u i c i d e and n o n - s u i c i d e v i c t i m s ( F i g . l ) (KAUERT e t a l . , 1 9 8 6 , 1 9 9 0 ) . T h e s e d i f f e r e n c e s c a n n o t be e x p l a i n e d by a g o n a l s t r e s s , p o s t mortem d e l a y o r age and s e x . T h e a p p l i c a t i o n o f t h i s method i n F o r e n s i c m e d i c a l r o u t i n e work i n o r d e r t o d i f f e r e n t i a t e between a c c i d e n t , h o m i c i d e and s u i c i d e r e q u i r e s a
CRANIAL h i g h e v i d e n t i a l v a l u e o f a s i n g l e r e s u l t . T h e r e f o r e , i n a
F i g . l : from K a u e r t e t a l . 1 9 8 6 v e r y r e c e n t s t u d y we b l i n d l y a n a l y z e d 5-HT i n lumbar CSF o f
38 randomly s e l e c t e d c a s e s ( w i t h o u t knowledge o f t h e a u t o p s y r e s u l t ) and from t h e 5-HT c o n c e n t r a t i o n s m e asured we a s s i g n e d t h e c a s e s t o e i t h e r s u i c i d e o r n o n - s u i c i d e . A f t e r w a r d s we compared t h e b i o c h e m i c a l d i a g n o s i s w i t h t h e a u t o p s y r e s u l t s and a n a l y z e d t h e r a t e c f c o r r e s p o n d e n c e . The d a t a c f t h i s s t u d y a r e p r e s e n t e d on t h e F i r s t I n t e r n a t i o n a l Symposium on Ad v a n c e s i n L e g a l M e d i c i n e , Kanazawa, J a p a n , O c t . 1 2 t h t o 15 t h , 1990.
Methods: A) S a m p l i n g o f CSF: Lumbar CSF i s c o l l e c t e d d u r i n g a u t o p s y by v e n t r a l p e r f o r a t i o n o f t h e i n t r a v e r t e b r a l d i s k L 3/4 o r L 4/5 a f t e r r e m o v a l o f t h e i n t e s t i n a l t r a c t The f i r s t p o r t i o n o f 2 - 4 ml h a s t o be t a k e n f o r a n a l y s i s . The s a m p l e s h a v e t o be f r o z e n d e e p l y w i t h i n o f max. 2 h o u r s . O n l y s a m p l e s a b s o l u t e l y f r e e o f b l o o d c o n t a m i n a t i o n a r e a d m i t t e d . B) A n a l y t i c a l s o f 5-HT: 5-HT i s i s o l a t e d from CSF v i a an i o n exc h a n g e r e s i n and s e p a r a t e d from o t h e r endogenous compounds by HPLC and d e t e c t e d by an e l e c t r o c h e m i c a l d e t e c t o r (WATERS) e q u i p p e d w i t h a g l a s s y c a r b o n w o r k i n g e l e c t r o d e and a AG/AgCl r e f e r e n c e e l e c t r o d e . The w o r k i n g p o t e n t i a l i s s e t on 0.7 V. The d e t e c t i o n l i m i t o f t h e method i s 0.1 ng/ml.
- 167-
R e s u l t s and d i s c i s s i o n : I n fig.2 a l l c a s ; s t h e 5- HT v a l u e s o f t h e d i f f e r e n t
5 — HT / CSF g r o u p s a r e s p o t t e d . I n 37 c a s e s i n v e s t i g a t e d t h e r e were 34 c a s e s w i t h u n e q u i v o c a l d i a c n o s e s of d e a t h by a u t o p s i e s . 2 3 o f t h e s e were s u i c i c e s and 11 o f them h o m i c i d e and a c c i d e n t r e s p e c t i v e l y . H i g h 5-HT c o n c e n t r a t i o n s 20ng/ml) f i t t e d i n 17 o f 23 c a s e s o f s u i c i d e , w h e r e a s low 5-HT c o n c e n t r a t i o n s ]5ng/ml we
cameof death: 0 = unclear. I msuckle. 2 - homicide. 3 - accident f O U n d 1Π 9 O f .1 C d S e S . W i t h t h e 4 - f i e l d s c h i s q u a r e t e s t we c a l c u l a t e d a c h i 2 v a l u e c f 9.3745 ( P= 0 . 0 0 2 1 7 ) .
F i g . 2 I n t h e 3 c a s e s w i t h code = 0 t h e s i t u a t i o n s a r e u n c e r t a i n . From t h e 5-HT c o n c e n t r a t i o n s t h e y c o u l d l e s u i c i d e c a s e s . C a s e No 1 i s p r o b l e m a t i c a l l y i n so f a r a s " h i s i s a s u i c i d e committed t o g e t h e r w i t h h i s mother (aut-No Γ21090) on t h e one hand b u t t h i s p e r s o n was m e n t a l l y d i s t u r b e d on t h e o t h e r hand. A l s o a c o n f u s i o n o f t h e CSF s a m p l e s c o u l d n o t be e x c l u d e d . C a s e No 2 m i g h t i n f a c t be a p o s s i b l e s u i c i d e from t h e c i r c u m s t a n c e s a t t h e s c e n e o f c r i m e . C a s e No 3 p r i m a r y was d i a g n o s e d a s a c a r d i o c a s c u l a r f a i l u r e . A p o s t i n v e s t i g a t i o n by t o x i c o l o g i c a l a n a l y s e s r e s u l t e d i i a t o x i c serum l e v e l o f a m i t r i p t y l i n e (428 ng/ml) s u g g e s t i n g an o v e r d o s e ! I n t h e group o f s u i c i d e (code 1) t h e r e a r e some c a s e s w i t h s t r i k i n g low 5-HT c o n c e n t r a t i o n s . 2 o f t h e s e e x h i b i t a c a s e h i s t o r y o f h e a v y i l l n e s s ( c a n c e r and p a r a p l e g i a r?.sp.) and were members o f a german s o c i e t y w h i c h from one c a r g e t s a f e methods f o r c o m m i t t i n g s u i c i d e . I t m i g h t be t h a t t h e low c o n c e n t r a t i o n s o f 5-HT r e s u l t e d from a l a c k i n g a u t o e g g r e s s i o n o r from t h e i l l n e s s i t s e l f . C a s e No.8 i s t h e mother o f above m e n t i o n e d c a s e of m e n t a l l y d i s t u r b e d man, who committed s u i c i d e t o g e t h e r w i t h h e r son by d r i v i n g h e r c a r i n t o a r i v e r . The r e m a i n i n g c a s e s 26 a l l show a t h e r a p e u t i c serum l e v e l o f t r i c y c l i c a n t i d e p r e s s a n t s l i k e a m i t r i p t y l i n e , some o f w h i c h a r e w e l l known t o d e c r e a s e t h e 5-HT s y n t h e s i s a f t e r c h r o n i c a l u p t a k e , however, n o t a f t e r a c u t e d osage (VAN PRAAG, 1 9 8 1 ) . The group o f h o m i c i d e and a c c i d e n t ( c o d e s 2 and 3) c o n t a i n s 2 c a s e s w i t h h i g h 5-HT c o n c e n t r a t i o n s . C a s e No.31 e x h i b i t s a v e r y i n t e r e s t i n g h i s t o r y from s c i e n t i f i c p o i n t o f view. The man was d i s c o v e r e d and t h e n k i l l e d by h i s son, w h i l e he m a l t r e a t e d h i s w i f e p o s s i b l y w i t h i n t e n t i o n of k i l l i n g h e r . T h i s c a s e m i g h t be an i n d i c a t o r t h a t h i g h c o n c e n t r a t i o n s o f 5-HT a r e c o r r e l a t e d w i t h t h e r a t e o f a g g r e s s i o n . The s e c o n d c a s e c o u l d n o t be e l u c i d a t e d . I t i s an a l c o h o l i c and tramp we a r e d e a l i n g w i t h h e r e , who was s t r a n g a l a t e d by
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a n o t h e r tramp. The r e a o n f o r h i s r e l a t i v e h i g h 5-HT c o n c e n t r a t o r ! must r e m a i n u n c l e a r a t p r e s e n t .
Conclusion;: Our method a n a l y z i n g t h e c o n c e n t r a t i o n o f 5-HT i n lumbar CSF p r o v i d e s t i e p o s s i b i l i t y o f d i f f e r e n t i a t i o n between s u i c i d e and non-s'.icide w i t h a h i g h e v i d e n t i a l v a l u e . From our e x p e r i e n c e ; , however, t h e r e a r e some f a c t o r s t o be c o n s i d e r e d a s d e s c r i b e d above. Of p a r t i c u l a r c r i m i n a l i s t i c i n t e r e s t a r e s u s p e c t e d l o m i c i d e s w h i c h a r e p r e t e n d e d a s s u i c i d e . From our h o m i c i d e iases i n v e s t i g a t e d we c o u l d e v i d e n c e t h a t a g o n a l s t r e s s o r >anic r e a c t i o n s , w h i c h p r o v a b l y t o o k p l a c e i n a l o t o f c a s e s , l a s no i n f l u e n c e on t h e 5-HT c o n c e n t r a t i o n i n CSF. T h i s o b s e r v a t i o n i s i n agreement w i t h s t u d i e s o f LUNA e t a l . ( 1 9 8 2 ) , who i n v e s t i g a t e d 5-HT i n CSF a f t e r s h o r t and p r o l o n g e d l e a t h agony. From our r e s u l t s we s u g g e s t t h a t t h e d e g r e e o f a g g r e s s i o n and a u t o a g g r e s ; i o n r e s p e c t i v e l y i s a s s o c i a t e d w i t h t h e r a t e o f 5- HT c o n c e n t a t i o n i n t h e CSF. The c r u c i e l q u e s t i o n o f t h e c e n t r a l o r i g i n o f t h i s 5-HT h a s t o be c l a r . f i e d . And a s p r e l i m i n a r r e s u l t we c o u l d s t a t e t h a t t h e p i n e a l o r g a n may be i n v o l v e d , b e c a u s e i n o u r s t u d i e s we found a n e g a t i v e c o r r e l a t i o n between t h e p i n e a l and lumbar CSF 5-HT c o n c e n t r a t i o n s (KAUERT e t a l . 1 9 9 0 ) . S h o u l d D e s c a r t e s (1596-1650 be r i g h t w i t h h i s a s s u m p t i o n o f t h e p i n e a l b e i n g t h e s e a t o: t h e s o u l ?
L i t e r a t u r e
Kauert,G., Zucker,T. Gilg,T. and Eisenmenger,W.: Measurements o f b i o g e i i c a m i n e s and m e t a b o l i t e s i n t h e c s f o f s u i c i d e v i c i i m s and n o n s u i c i d e s . I n : Moeller,Η.J., Schmidtke,^. and Welz,R. ( e d s ) : C u r r e n t i s s u e s o f s u i c i d o l o c y , pp 252-262, S p r i n g e r V e r l a g B e r l i n - H e i d e l b e r g , New York, jondon, P a r i s , Tokyo, 1986.
Kauert,G and Schmid,K., 1990: S e r o t o n i n , 5- Hydroxyincblessigsäure, N - A c e t y l s e r o t o n i n und C o r t i s o l im L u m b a l l i q i o r von S u i z i d o p f e r n . T h e s i s o f K.Schmid
Van PraagH. : c e n t r a l monoamines and t h e p a t h o g e n e s i s ot d e p r e s s i o n I n : Van Praag,H., Lader,Μ.Η., Rafaelson,0.J. and Sachar,Ε.Ü (eds): Handbook o f b i o l o g i c a l p s y c h i a t r y , P a r t I V : B r a i n mechanisms and abnormal b e h a v i o r - C h e m i s t r y , pp 159-206, p a r c e l D ekker, Inc.New York, B a s e l , 1981.
Luna.A, rillanueva,Ε.,Hernandez-Cueto, Luna,J.D., 1982: V e r h a l t e n d e s 5-HT und d e r 5-Hydroxy-indol-Essigsäure i n Zusammenhang m i t d e r A g o n i e . ( I . ) . Z.Rechtsmed. 89: 215-226
A d r e s s : G.KAUERT ;nd W.EISENMENGER, Department o f L e g a l M e d i c i n e , U n i v e r s i t y o f Munich, F r a u e n l o b s t r a s s e 7a, D-8000 München 2, FRG.
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