基本情報

所属

• 医学研究院　社会医学系部門　社会医学分野

職名

• 教授

学位

• 医学博士（北海道大学）

J-Global ID

• 201301029622058897

プロフィール

• 医師、医学博士、死体解剖資格、日本法医学会認定医

研究分野

• ライフサイエンス / 法医学

担当教育組織

•  学士課程　医学部（医学科）
•  修士課程　医学院
•  博士課程　医学院

研究活動情報

論文

• Objective Evaluation of Oral and Pharyngeal Areas in Autopsy Cases of Obstructive Sleep Apnea Syndrome via Postmortem CT.

  Akiko Takeuchi, Hideki Hyodoh, Shigeki Jin, Satoshi Tanaka, Manabu Murakami, Kazuyuki Minowa, Kotaro Matoba

  Current medical imaging 2023年03月28日 

  BACKGROUND: Obstructive sleep apnea syndrome (OSAS) can cause sudden death during sleep. Previous findings have suggested that OSAS development is related to maxillofacial morphology. Evaluation of facial morphology can determine the risk of developing the disease, and establishing an objective method to assess the underlying etiology of OSAS-related death would be advantageous. OBJECTIVE: The objective of this study is to determine the key features of obstructive sleep apnea syndrome (OSAS) using postmortem oral and pharyngeal computed tomography (CT). METHODS: We retrospectively assessed autopsy cases of patients with (n=25) and without (n=25) OSAS-related death. We used oral and pharyngeal CT images to compare the oral and pharyngeal cavity volume (OPCV), oral and pharyngeal soft tissue volume (OPSV), oral and pharyngeal air space volume (OPAV), and OPAV to OPCV ratio (%air). Receiver operating curve (ROC) analysis was used to determine the accuracy of OSAS prediction. We assessed participants with body mass index (BMI) values within the normal range. RESULTS: Among the 50 subjects, we observed significant between-group differences in OPSV, OPAV, and % air, whereas there were significant between-group differences in OPSV and %air among 28 subjects with normal BMI values. Both comparisons suggested that OSAS-related death was associated with low %air and high OPSV values. CONCLUSION: The %air and OPSV are useful for assessing postmortem oropharyngeal CT images. OSAS-related sudden death is likely when %air and OPSV values are ≤20.1% and ≥127.2 ml, respectively. Among those with normal BMI values, % air and OPSV values of ≤22.8% and ≥111.5 ml, respectively, predict OSAS-related sudden death.
• Objective evaluation of chest findings in infants by postmortem computed tomography.

  Shogo Shimbashi, Rina Hayata, Kotaro Matoba, Atsuko Saito, Tomoko Matoba, Akiko Takeuchi, Shigeki Jin, Hideki Hyodoh

  Legal medicine (Tokyo, Japan) 60 102178 - 102178 2023年02月 

  PURPOSE: The purpose of this study was to review the findings of computed tomography (CT) performed early postmortem on infants and to clarify the postmortem CT lung findings that occur in the absence of abnormal histopathological findings. MATERIALS AND METHODS: From July 2016 to March 2022, 72 infants were autopsied with postmortem CT (41 boys 31 girls, aged 0-36 (mean 8.2) months). Autopsy and postmortem CT lung findings were compared with the causes of death identified by the autopsies, namely sudden infant death syndrome (n = 37), acute circulatory system disease (18), drowning (7), asphyxia (5), and dehydration/undernutrition (5). RESULTS: The %aerated lung volume (-700 HU or less) ranged from 0 % to 33 % (mean 1.5 %, median 0 %), being <1 % in 61 cases (84.7 %) and >3 % in 3/5 (60 %) of the dehydration/undernutrition group. The dehydration/undernutrition group showed significant preservation of lung field air content compared with the other causes of death groups (p < 0.05). Receiver characteristic curve analysis showed a cut off value of 0.8 % and area under the curve of 0.88806. The drowning group had significantly greater pleural cavity fluid retention than the other causes of death groups (p < 0.05). No correlation was found between postmortem interval and pleural cavity fluid retention. However, resuscitation time and pleural cavity fluid retention were correlated. CONCLUSION: Evaluation of CT values on postmortem lung fields of infants usually reveals a marked decrease in air content. When air content exceeds 0.8% on infant postmortem CT, dehydration/undernutrition should be considered in the differential diagnosis.
• How Undergraduates Perceive Stress Factors: An exploratory study.

  Manabu Murakami, Akiko Takeuchi, Shigeki Jin, Kotaro Matoba

  Pakistan journal of medical sciences 39 4 1219 - 1220 2023年
• 直腸穿孔の原因特定に死後CT検査が有用であった一剖検例

  的場 光太郎, 神 繁樹, 齋藤 厚子, 的場 智子, 竹内 明子, 赤川 有希, 早田 璃菜, 真橋 尚吾, 兵頭 秀樹

  法医学の実際と研究 65 119 - 123 法医学談話会 2022年11月
• Gluing blood into gel by electrostatic interaction using a water-soluble polymer as an embolic agent

  Zhiping Jin, Hailong Fan, Toshiya Osanai, Takayuki Nonoyama, Takayuki Kurokawa, Hideki Hyodoh, Kotaro Matoba, Akiko Takeuchi, Jian Ping Gong, Miki Fujimura

  Proceedings of the National Academy of Sciences 119 42 2022年10月18日 

  Liquid embolic agents are widely used for the endovascular embolization of vascular conditions. However, embolization based on phase transition is limited by the adhesion of the microcatheter to the embolic agent, use of an organic solvent, unintentional catheter retention, and other complications. By mimicking thrombus formation, a water-soluble polymer that rapidly glues blood into a gel without triggering coagulation was developed. The polymer, which consists of cationic and aromatic residues with adjacent sequences, shows electrostatic adhesion with negatively charged blood substances in a physiological environment, while common polycations cannot. Aqueous polymer solutions are injectable through clinical microcatheters and needles. The formed blood gel neither adhered to the catheter nor blocked the port. Postoperative computed tomography imaging showed that the polymer can block the rat femoral artery in vivo and remain at the injection site without nontarget embolization. This study provides an alternative for the development of waterborne embolic agents.
• 塩素化されたTyrosineのLC-MS/MS分析法の検討

  神 繁樹, 的場 光太郎, 赤川 有希, 早川 璃菜, 魚住 諒

  JSBMS Letters 47 Suppl. 78 - 78 (一社)日本医用マススペクトル学会 2022年08月
• Nonverbal communication skills: New-era education needs of younger generation medical students

  Manabu Murakami, Shigeki Jin, Akiko Takeuchi, Kotaro Matoba

  Pakistan Journal of Medical Sciences 38 6 2022年06月27日 

  doi: https://doi.org/10.12669/pjms.38.6.6058 How to cite this:Murakami M, Jin S, Takeuchi A, Matoba K. Nonverbal communication skills: New-era education needs of younger generation medical students. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.6058 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
• Objective skull fracture evaluation by using the postmortem 3D-CT skull fracture score in fatal falls

  Hideki Hyodoh, Akiko Takeuchi, Kotaro Matoba, Manabu Murakami, Tomoko Matoba, Atsuko Saito, Shigeki Jin

  Legal Medicine 56 102048 - 102048 2022年05月
• The usefulness of measuring n-butyric acid concentration as a new indicator of blood decomposition in forensic autopsy.

  Kotaro Matoba, Manabu Murakami, Emi Fujita, Shigeki Jin, Ryosuke Ogasawara, Tomoko Matoba, Akiko Takeuchi, Sanae Haga, Michitaka Ozaki, Hideki Hyodoh

  Legal medicine (Tokyo, Japan) 57 102071 - 102071 2022年04月15日 

  In forensic medicine, although various alcohols have been reported as indicators of decomposition in collected blood, no studies have examined short-chain fatty acids as indicators. In this study, the blood n-butyric acid concentration was quantified, and the association between n-butyric acid and decomposition was investigated to determine whether the detection of n-butyric acid could be a new indicator of decomposition. Among the forensic autopsies performed from 2016 to 2018 in our laboratory, the cases were divided into decomposed (n = 20) and non-decomposed (n = 20) groups based on macroscopic findings. Blood samples collected at the time of autopsy were derivatized with 3-nitrophenylhydrazine hydrochloride after solid-phase extraction. The n-butyric acid concentration was measured using liquid chromatography-tandem mass spectrometry. In addition, ethanol and n-propanol were measured using a gas chromatography-flame ionization detector. There was a significant difference (p < 0.01) in the concentrations of n-butyric acid between the decomposed and non-decomposed groups (0.343 ± 0.259 [0.030-0.973] and 0.003 ± 0.002 [0.001-0.007] mg/mL, respectively). In the decomposed group, n-butyric acid was detected at high concentrations, even in cases where n-propanol was low. These results suggest that n-butyric acid is more likely to be an indicator of blood decomposition than n-propanol.
• Skills Required of Geriatricians: Why Medical Students Do Not Select Geriatrics as Their Career

  Manabu Murakami, Shigeki Jin, Akiko Takeuchi, Kotaro Matoba

  Acta Médica Portuguesa 35 3 231 - 231 2022年03月02日 

  N/a.
• Poly(ADP-ribose) polymerase (PARP) is critically involved in liver ischemia/reperfusion-injury

  S. Haga, A. Kanno, N. Morita, S. Jin, K. Matoba, T. Ozawa, M. Ozaki

  The Journal of Surgical Research 270 124 - 138 2021年10月 [査読有り]
  
• Generation gaps in medical education: An exploratory qualitative study.

  Manabu Murakami, Kotaro Matoba, Hideki Hyodoh, Makoto Takahashi

  JPMA. The Journal of the Pakistan Medical Association 71 5 1476 - 1478 2021年05月 

  This qualitative study aimed to explore medical students' experience of generation gap in their interactions with senior teachers (aged >55) in Japan. Focus group interviews were conducted with 28 medical students (20 to 30 years, mean age 22 ±2 years, classified as millennials, with only one year of studies since starting specialised courses for medicine. The participants were interviewed in groups of four, with each interview lasting 60 minutes. Topics covered included generation gap experienced in daily life and during their studies, and work-life balance issues. The discussions were recorded and transcribed, and content analysis was applied. Four specific influential generation-gap categories were identified - distinctive sociocultural backgrounds, more recent educational media tools and faster information dissemination speed, new-era values, and challenges in communication - that were consistent with findings from previous studies. More senior personnel involved in medical education need to consider these categories to enhance effectiveness of teaching.
• Problems in implementing interprofessional education in rural areas: an exploratory study.

  Kotaro Matoba, Hideki Hyodoh, Manabu Murakami

  Rural and remote health 21 2 6726 - 6726 2021年04月
• Evaluation of oral air space volume in obstructive sleep apnea syndrome using clinical and postmortem CT imaging.

  Akiko Takeuchi, Hideki Hyodoh, Kotaro Matoba, Manabu Murakami, Kohsuke Kudo, Kazuyuki Minowa

  Oral radiology 38 1 29 - 36 2021年03月20日 

  OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) induces upper airway occlusion and may cause sudden death during sleep. This study sought to clarify the relationship between oral air space volume and OSAS onset, which is influenced by multiple factors, such as jawbone, dentition morphology, and oral soft-tissue volume. METHODS: (1) 50 subjects from deceased cases were divided into two groups: OSAS (25 subjects) and controls (25 subjects). (2) 28 subjects from clinical cases were divided into two groups: OSAS (9 subjects) and controls (19 subjects). In all cases, the Computed Tomography (CT) images of the facial region were obtained, and four parameters of oral area volume were analyzed in deceased and clinical cases, and comparisons and analyses were performed between OSAS and control cases. In addition, the efficiency of measurement of these parameters was evaluated using Receiver Operating Characteristic (ROC) curves in OSAS. RESULTS: (1) In deceased cases, oral soft-tissue volume (OSV), oral air-space volume (OAV), and the ratio of OAV to OSV (%air) showed a significant correlation. (2) In clinical cases, OAV and %air showed a significant correlation. In both postmortem and clinical images, a small %air value indicates a high risk of developing OSAS and a high probability of OSAS-related sudden death. CONCLUSIONS: It was shown that the %air is an index to evaluate OSAS by CT imaging of the oral region. OSAS may be indicated when the %air value is ≦ 16.0% in deceased cases and ≦ 6.6% in clinical cases.
• Do 'The Four Principles' Apply to the Improvement of Short-Term Clinical Electives?

  Kotaro Matoba, Manabu Murakami, Hideki Hyodoh

  Acta medica portuguesa 34 3 238 - 238 2021年03月01日
• クロバエ科の蛆が薬物検査に有用であった一剖検例

  的場 光太郎, 奥谷 菜穂子, 神 繁樹, 齋藤 厚子, 的場 智子, 竹内 明子, 兵頭 秀樹

  法医学の実際と研究 63 103 - 106 法医学談話会 2020年11月 

  症例は60歳代女性で、無職、独居、うつ病の既往、薬物多量服薬の自殺企図歴あり。自宅内に多数のハエが飛んでいると近所の住民から通報があり、警察官が自宅内を確認したところ寝室の床上に左横臥で倒れていた。高度腐敗状態であり、現場で死亡が確認された。警察等が取り扱う死体の死因または身元の調査等に関する法律に基づく調査法解剖が実施された。脾臓を圧迫して採取した血液様液体をQuEChERS法によって前処理を行い、液体クロマトグラフィー質量分析によって分析したところ、エスタゾラム、ブロマゼパム、スルピリド、クエチアピンが高濃度で検出された。検出された薬物の種類は現場にあった空薬包の処方薬と一致しており、処方薬を多量に服用して死亡したものと考えられた。死体を蚕食している蛆から薬物を検出することは可能であり、法医診断に有用であると考えられた。
• 予期せぬ死に直面した遺族への対応 新型コロナウイルス感染による遺族に焦点を当てて

  山田 典子, 兵頭 秀樹, 的場 光太郎

  日本災害看護学会誌 22 1 102 - 102 (一社)日本災害看護学会編集委員会 2020年09月
• 高コルチゾール血症を呈したFamilial Dysalbuminemic Hyperthyroxinemiaの一例

  千葉 幸輝, 亀田 啓, 野本 博司, 曹 圭龍, 中村 昭伸, 神 繁樹, 的場 光太郎, 三好 秀明, 渥美 達也

  日本内分泌学会雑誌 96 1 366 - 366 (一社)日本内分泌学会 2020年08月
• Sample preparation method with ultrafiltration for whole blood thiosulfate measurement.

  Shigeki Jin, Manabu Murakami, Kotaro Matoba, Tomoko Matoba, Sanae Haga, Michitaka Ozaki, Akiko Takeuchi, Hideki Hyodoh

  Legal medicine (Tokyo, Japan) 47 101765 - 101765 2020年07月23日 [査読有り][通常論文]
   

  Quantitative analysis of thiosulfate is useful for diagnosing hydrogen sulfide poisoning. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) enables more rapid and sensitive measurements than previous methodologies. As simple measurements of blood thiosulfate concentration are affected by the blood matrix, blood is used as the solvent to prepare the standard solution for calibration curve generation. Thus, a large amount of blood devoid of thiosulfate is required. We developed a preparation method by incorporating an ultrafiltration step to overcome this limitation and generate a calibration curve using a standard solution prepared with pure water. We used this improved method to investigate the stability of thiosulfate in refrigerated samples. To compare the effects of refrigeration, blood samples were prepared using the following two methods: one sample was treated with a 50-kDa exclusion ultrafiltration membrane and the other was not treated. The samples were stored at 4 °C, and then measured at 0, 3, 6, 24, 48, and 96 h. The incorporation of the ultrafiltration step in the measurement procedure enabled the quantification of thiosulfate, by plotting a calibration curve using a standard of pure water; it did not require a blood standard. Additionally, the reduction in whole blood thiosulfate concentration was within 10% during 2 days of refrigeration. Thus, the need for a large amount of blood to prepare the standard solution was resolved by the ultrafiltration step in test sample preparation. This method is useful to measure thiosulfate concentration and is not hindered by sample refrigeration for a few days.
• Post-mortem computed tomography in sudden death by asthma.

  Casey Smith, Kotaro Matoba, Hideki Hyodoh, Manabu Murakami, Atsuko Saito, Tomoko Matoba, Nahoko Okuya, Shigeki Jin

  Legal medicine (Tokyo, Japan) 44 101694 - 101694 2020年03月19日 [査読有り][通常論文]
   

  Ground glass attenuation (GGA) of the lungs is a common finding of post-mortem computed tomography (PMCT) that is associated with pulmonary congestion and edema due to cardiac failure during the agonal period, or due to post-mortem hypostasis. However, hypo-attenuation of the lung is an atypical finding of PMCT, and is usually a consequence of hypovolemic states before death or postmortem body posture after death. Previous studies have shown a few differential diagnoses, such as hypothermia, massive hemorrhage, asphyxiation by hanging, and dehydration, for hypo-attenuation of the lung. This report presents the case of a woman who died suddenly because of an asthma attack. Our PMCT analysis demonstrated hypoattenuation of the lung in this case. We suggest fatal asthma as a differential diagnosis for the appearance of hypo-attenuation of lungs on PMCT.
• The infusion effect in postmortem lung CT

  Hideki Hyodoh, Kotaro Matoba, Manabu Murakami, Atsuko Saito, Nahoko Okuya, Tomoko Matoba, Shigeki Jin

  Forensic Imaging 20 200367 - 200367 2020年03月
• Evaluation of Fruit Anthocyanin Composition by LC/MS in Interspecific Hybrids Between Haskap (Lonicera caerulea subsp. edulis (Turcz. ex. Herder) Hultén) and Miyama-uguisukagura (Lonicera gracilipes Miq.)

  Ryohei Fujita, Shigeki Jin, Takahiro Hayasaka, Kotaro Matoba, Yoichiro Hoshino

  The Horticulture Journal 89 4 343 - 350 2020年 [査読有り][通常論文]
  
• 溺死事例の死戦期に起きた食物誤嚥が解剖所見や検査結果に与える影響に関する検討

  的場 光太郎, 兵頭 秀樹, 齋藤 厚子, 的場 智子, 奥谷 菜穂子, 竹内 明子, 邵 旻蓉, 神 繁樹

  法医学の実際と研究 62 15 - 19 法医学談話会 2019年11月 

  20歳代男性2名が海水浴中に行方不明となり、翌日、付近の海底において2名とも発見され、死亡が確認された。海水浴中に離岸流によって沖に流されたことが事故の原因である可能性が高いが、発見から約1日後に2名とも司法解剖となった。事例1では、肺は膨隆して左右肺の内側縁が前縦隔において重なっており、パルタウフ斑を認めた。肺重量は左675g、右725g、心重量は296g、左胸水450mL、右胸水460mL、脾臓重量は85g、胃内容は食物650mL、心臓内に360mLの軟凝血を少量に含む暗赤色流動血、気道内に食物片は認めず、気管内に白色細小泡沫を認めた。事例2では、肺は膨隆して左右肺の内側縁が前縦隔において近接しており、パルタウフ斑を認めた。肺重量は左426g、右567g、心重量は264g、左胸水170mL、右胸水130mL、脾臓重量は61g、胃内容は食物750mL、心臓内に280mLの軟凝血を微量に含む暗赤色流動血、咽頭から喉頭に食物片を多量に認め、気管〜気管支に多量の食物を認めた。
• 閉塞性睡眠時無呼吸症候群(OSAS)における口腔領域の画像評価に関する研究

  竹内 明子, 兵頭 秀樹, 的場 光太郎, 箕輪 和行

  北海道歯学雑誌 39 2 159 - 159 北海道歯学会 2019年03月
• Lung weight estimation with postmortem CT in forensic cases.

  Kotaro Matoba, Hideki Hyodoh, Lisa Ishida, Manabu Murakami, Tomoko Matoba, Atsuko Saito, Nahoko Okuya, Sahar Almansoori, Emi Fujita, Mayumi Yamase, Minyo Shao, Shigeki Jin

  Legal medicine (Tokyo, Japan) 35 61 - 65 2018年11月 [査読有り][通常論文]
   

  Postmortem computed tomography (CT) is a minimally invasive technique to examine internal organs before a forensic autopsy. The purpose of our study was to estimate lung weight in a forensic setting in cases of various lung states, including fluid accumulation (congestion, edema, hypostasis, and inflammation etc.) using postmortem CT. From January 2016 to July 2018, 111 deceased bodies (62 males and 59 females, aged from 18 to 95 (average 59.6) years) were examined by CT before autopsy. Both lungs of the 111 deceased were analyzed separately, making it a total of 222 samples. We extracted lung fields from CT images manually after semi-automatic detection using an image workstation. The total lung volume and 6 categories of lung volume divided according to their CT density were measured. Multiple regression analysis was performed with lung weight in autopsy as the response variable, while the 6 categories were labelled as explanatory variables. The relation between lung weight in autopsy and lung weight estimated using postmortem CT showed a high Pearson's correlation coefficient (R2 = 0.9106). Using postmortem CT, the lung weight can be estimated in forensic settings.
• Estimating normal lung weight measurement using postmortem CT in forensic cases

  Kotaro Matoba, Hideki Hyodoh, Manabu Murakami, Atsuko Saito, Tomoko Matoba, Lisa Ishida, Emi Fujita, Mayumi Yamase, Shigeki Jin

  LEGAL MEDICINE 29 77 - 81 2017年11月 [査読有り][通常論文]
   

  Purpose: The aim of this study is to estimate the lung weight using postmortem CT in well aerated lung autopsy cases. The correlation coefficients to the lung weight were also evaluated for the cadavers' height, weight, whole body surface area (WBSA), body mass index, and estimated lung volume. Materials and methods: From October 2015 to July 2016, 31 cadavers (male 12, female 19, age 20-98 (mean 66.9) y.o., postmortem interval 0.3-75.0 (5.7) days) were compared as regards body weight, height, whole body surface area (WBSA), body mass index (BMI), lung volume on CT, and total lung volume classified into several CT number categories, with their lung weight in autopsy. Results: The lung weight (mean +/- SE) was 284.9 +/- 14.8 g in right lung and 249.3 +/- 12.9 g in left lung. The %ALV was 79.9 +/- 0.9 HU (mean standard error (SE)) in both lungs, 80.3 +/- 1.3 HU in right lung, and 77.6 +/- 2.0 HU in left lung. Using a simple linear regression test, there was no statistically significant correlation between the lung weight and the categories (R-2: body height 0.234, weight 0.224, WBSA 0.309, BMI 0.046, lung volume 0.059). The volume for each individual CT density category showed no significant correlation, but the stepwise regression test yielded an excellent correlation coefficient (R-2 = 0.840). Conclusion: The well aerated lung weight was 284.9 +/- 14.8 gin right lung and 249.3 +/- 12.9 gin left lung, and the postmortem CT could estimate the lung weight with high correlation coefficient.
• Freezing preparation for macroscopic forensic investigation in putrefied brain

  Kotaro Matoba, Hideki Hyodoh, Manabu Murakami, Tomoko Matoba, Atsuko Saito, Fei Feng, Shigeki Jin

  LEGAL MEDICINE 26 6 - 10 2017年05月 [査読有り][通常論文]
   

  Purpose: To evaluate the usefulness of the applied freezing technique in putrefied brain for macroscopic investigation. Materials and methods: From October 2015 to September 2016, first the brains of 10 cadavers (control group: male 6, female 4, age 20-80 (mean 61.5), postmortem intervals (PMI) 14-75 (mean 29.7) days) were inspected following the standard practice (without freezing preparation), and then with 10 cadavers (freezing group: male 7, female 3, age 41-88 (mean 60.4), PMI 7-75 (mean 29.2) days) the freezing technique was used before the autopsy. The cut brain was investigated, and the gray-white matter difference was evaluated macroscopically. Results: In the control group, the brain parenchyma leaked out like sludge in 5, and there was difficulty maintaining its structure in 7. The gray-white matter difference was well visible in 3, but hard to distinguish in 3, and the total scores ranged from 0 to 9 (mean 4.4) points. In the freezing group, the entire putrefied brain was extracted as a solid organ, the gray-white matter differences were well visible, and the total scores were 6.7-9 (8.3) points. The gray-white matter difference was preserved in the freezing group (p < 0.05). Conclusion: The freezing procedures to evaluate the putrefied brain have been successfully applied, and it could be statistically more useful in putrefied brain investigation than the ordinary procedure. Postmortem CT can be useful to evaluate not only the degree of brain putrefaction, but also the degree of brain parenchyma freezing. (C) 2017 The Author(s). Published by Elsevier Ireland Ltd.
• Diagnosis of drowning: Electrolytes and total protein in sphenoid sinus liquid

  Akira Hayakawa, Koichi Terazawa, Kotaro Matoba, Kie Horioka, Tatsushige Fukunaga

  FORENSIC SCIENCE INTERNATIONAL 273 102 - 105 2017年04月 [査読有り][通常論文]
   

  In this study, electrolyte (sodium (Na), chlorine (Cl), and magnesium (Mg)) and total protein (TP) concentrations and volume of liquid in the sphenoid sinus were examined to determine their usefulness to elucidate whether drowning occurred in freshwater or seawater. We examined 68 cases (seawater drowning group: 27 cases, freshwater drowning group: 21 cases, non-drowning group: 20 cases). There was a significant difference in Na, Cl, Mg, and TP concentrations of liquid in the sphenoid sinus among the three groups (seawater drowning, freshwater drowning, and non-drowning groups). To distinguish freshwater drowning from seawater drowning, Na, Cl, and Mg concentrations of liquid in the sphenoid sinus might serve as useful indicators. (C) 2017 Elsevier B. V. All rights reserved.
• Experimental evaluation of freezing preparation for the macroscopic inspection in putrefied brain

  Hideki Hyodoh, Kotaro Matoba, Manabu Murakami, Tomoko Matoba, Atsuko Saito, Fei Feng, Shigeki Jin

  LEGAL MEDICINE 24 19 - 23 2017年01月 [査読有り][通常論文]
   

  Purpose: To evaluate the usefulness of freezing preparation for macroscopic investigation in advanced putrefied brain. Materials and methods: After sealing in individual plastic bags, 10 pig heads were stored at 20 degrees C for 5 days allow postmortem change (putrefaction) to progress. After an observation period, they were divided into 2 groups to evaluate the usefulness of the freezing effect in macroscopic investigation. The process over the postmortem period and the freezing process were examined. Results: At day-5, the presence of air density was detected between the inner surface of the cranium and the brain parenchyma. Intra-cranial air accumulation presented on Clin all heads. In the control group, the brain parenchyma leaked out from the hole in the meninges, and the gray white matter difference was clear in 3/72 (4.2%), moderate in 7/72 (9.7%), ambiguous in 17/72 (23.6%), and poor in 45/72 (62.5%). In the freezing group, the brain parenchyma presented homogeneous low density after more than 14 h freezing. On opening the cranium, the entire brains were frozen, and the gray white matter difference was clear in 33/72 (46.0%), moderate in 17/72 (24.0%), ambiguous in 15/72 (21.0%), and poor in 7/72 (10.0%). The freezing group afforded greater clarity in the gray-white matter inspection (p < 0.05). Conclusion: Freezing preparation was useful for the macroscopic investigation of putrefied brain compared with the ordinary autopsy. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
• Liquid chromatography-tandem mass spectrometry method for the determination of thiosulfate in human blood and urine as an indicator of hydrogen sulfide poisoning

  Chikatoshi Maseda, Akira Hayakawa, Katsuhiro Okuda, Masaru Asari, Hiroki Tanaka, Hiromi Yamada, Shigeki Jin, Kie Horioka, Kotaro Matoba, Hiroshi Shiono, Kazuo Matsubara, Keiko Shimizu

  LEGAL MEDICINE 24 67 - 74 2017年01月 [査読有り][通常論文]
   

  Being a stable metabolite of hydrogen sulfide, thiosulfate has been utilized as an index for hydrogen sulfide poisoning (HSP). Thiosulfate analysis is mainly performed using gas chromatography/mass spectrometry (GC-MS) due to its high sensitivity and specificity. The GC-MS analysis requires two-step derivatizations of thiosulfate, and the derivative is not stable in solution as it has a disulfide moiety. To resolve this stability issue, we developed a novel analytical method using liquid chromatography tandem mass spectrometry (LC-MS/MS) for monitoring the pentafluorobenzyl derivative of thiosulfate (the first reaction product of the GC-MS method) in this study. The established method exhibited high reproducibility despite being a more simplified and rapid procedure compare to the GC-MS method. Phenyl 4-hydroxybenzoate was used as an internal standard because 1,3,5-tribromobenzene which had been used in the GC-MS method was not suitable compound for LC-MS/MS with Electrospray ionization (ESI) negative detection. The linear regression of the peak area ratios versus concentrations was fitted over the concentration ranges of 0.5-250 M and 0.25-250 p.M in blood and urine, respectively. The validation results satisfied the acceptance criteria for intra- and inter-day accuracy and precision. Blood and urine samples from 12 suspected HSP cases were tested using this method. The thiosulfate concentration detected in the sample coincided well with that determined at the scene of each HSP accident. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
• Stature estimation from anatomical landmarks in femur using postmortem CT

  Miho Baba, Hideki Hyodoh, Shunichiro Okazaki, Junya Shimizu, Keisuke Mizuo, Masumi Rokukawa, Satoshi Watanabe, Kotaro Matoba, Hiromasa Inoue

  Journal of Forensic Radiology and Imaging 7 28 - 32 2016年12月01日 [査読有り][通常論文]
   

  Objective The present study aims to assess the correlation between stature and partial femur measurements in Japanese population, using three-dimensional (3D) computed tomographic (CT) images. Method A total of 195 cadavers (105 males, 90 females) underwent postmortem CT scanning and subsequent forensic autopsy between April 2013 and June 2014. Five femur length measurements were taken from 3D CT volume rendering (VR) images according to three anatomical landmarks: the greater trochanter, the lesser trochanter, and the adductor tubercle. The correlations between stature and each of the femur length measurements were assessed with Spearman's rank correlation test, and showed significant correlations between stature and femur length measurements. Results Using a mixed-sex regression formula, the R2 was from 0.644 to 0.766 and actual difference was less than 4.6 cm. Conclusion Present study showed that femur length measurements, according to the anatomical landmarks obtained from 3DCT VR images, were useful for estimation of the stature, particularly in cases when a total femur bone was not available.
• Development for the measurement of serum thiosulfate using LC-MS/MS in forensic diagnosis of H2S poisoning

  Shigeki Jin, Hideki Hyodoh, Kotaro Matoba, Fei Feng, Akira Hayakawa, Katsuhiro Okuda, Keiko Shimizu, Sanae Haga, Michitaka Ozaki, Koichi Terazawa

  LEGAL MEDICINE 22 18 - 22 2016年09月 [査読有り][通常論文]
   

  Thiosulfate measurement is crucial to diagnosis of hydrogen sulfide (H2S) poisoning in forensic toxicology. Although GC-MS method is currently regarded as a standard thiosulfate measurement, it requires complicated sample preparation prior to analysis. This study presents a simple, rapid, and highly sensitive method for the quantitative analysis of serum thiosulfate by using liquid chromatography-tandem mass spectrometry (LC-MS/MS). This method is based on selected reaction monitoring and has high sensitivity with a lower quantification limit of 0.5 mu M. Precision and accuracy of this method meet the basic requirements for quantitative analysis (intra- and inter-day tests have a relative standard deviation of <= 10.4%;range of analytical recovery is 94.3-102.6%). On the measurements of serum thiosulfate by our developed method, a thiosulfate concentration as 57.5 mu M was detected clearly in the H2S poisoning case comparing to the non poisoning case in which only a trace amount of thiosulfate was observed. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
• Time-related change evaluation of the cerebrospinal fluid using postmortem CT

  Kohei Morikawa, Hideki Hyodoh, Kotaro Matoba, Keisuke Mizuo, Shunichiro Okazaki, Satoshi Watanabe

  LEGAL MEDICINE 22 30 - 35 2016年09月 [査読有り][通常論文]
   

  Purpose: We retrospectively evaluated the cerebro-spinal fluid (CSF) CT density at the lateral ventricle to compare the postmortem intervals in cadavers. Materials and methods: The number of cadavers enrolled in this study was 189 (male 120, female 69). According to the estimated postmortem time, the cadavers were divided into 13 groups (postmortem day 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 7, 10, 14, 21, 30), and were also re-grouped into 3 groups according to the postmortem time-width: group A (postmortem day 0.5-2.5), group B (day 3-7), and group C (day 10-30). Comparisons between the CSF density and estimated postmortem time were also analyzed. Results: The CSF density was around 20 HU up to day 2.5, and it increased gradually after day 3. Day 3 and 4 presented higher CSF density than day 1 and 1.5 (p < 0.05). Day 7 presented higher CSF density than day 3 (p < 0.05). According to the postmortem time-width, the CSF density increased with postmortem time (p < 0.05). The simple linear regression equations presented negative correlation between CSF density and estimated postmortem time, and R-2 was 0.119. Conclusion: The CSF density increased, but not linearly, according to the postmortem time, and the 3rd postmortem day was the earliest time allowing the difference to be detected. The CSF density needs further evaluation to enable estimation of the postmortem time. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
• Appropriate blood sampling sites for measuring Tg concentrations for forensic diagnosis

  Akira Hayakawa, Kotaro Matoba, Kie Horioka, Manabu Murakami, Koichi Terazawa

  LEGAL MEDICINE 17 1 65 - 69 2015年01月 [査読有り][通常論文]
   

  Previous studies have reported that thyroglobulin (Tg) concentrations in heart blood are high in cases of asphyxia caused by neck compression such as hanging, strangulation, and throttling and in those with fatal traumatic brain injuries. However, even in cases without these findings presumed to increase the Tg concentration in the previous studies, we previously reported that in some cases the Tg concentration in right heart blood (RHB) and left heart blood (LHB) exceeded the standard value for diagnosis (200 ng/mL) defined in previous studies and the Tg concentration in RHB was significantly higher than that in LHB. In the present study, in our 46 forensic autopsy cases without findings presumed to increase Tg concentration, we separately collected external iliac venous blood (IVB) and external iliac arterial blood (IAB) in addition to RHB and LHB, measured Tg concentrations in RHB, LHB, IVB, and LAB (TRHB, TLHB, TIVB, and TIAB, respectively), and investigated the appropriate blood sampling site for measuring Tg concentrations for forensic diagnosis. TRHB, TLHB, TIVB, and TIAB were 3863 +/- 674.1, 105.8 +/- 179.0, 109.2 +/- 166.8, and 43.7 +/- 90.9 ng/mL, respectively. There were statistically significant differences between TRHB and TLHB, TIVB and TIAB, TRHB and TIVB, and TLHB and TIAB. Tg is more readily diffused by the venous system (RHB, IVB) than by the arterial system (LHB, IAB) because the venous system retains more blood volume after death. Tg is more readily diffused to heart blood (RHB, LHB) than to peripheral blood (IVB, IAB) because of the proximity of the heart to the thyroid gland. Therefore, we conclude that Tg leaks into the vessels around the thyroid gland because of the influences of postmortem changes and subsequently diffuses through the blood after death, and therefore the Tg concentration increases after death. When Tg concentration values are used for forensic diagnosis, it is appropriate to measure them using peripheral arterial blood situated distant from the thyroid gland. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
• Unreliability of the use of thyroglobulin concentration in postmortem blood samples in forensic diagnosis

  Akira Hayakawa, Kotaro Matoba, Kie Horioka, Manabu Murakami, Koichi Terazawa

  LEGAL MEDICINE 16 3 164 - 167 2014年05月 [査読有り][通常論文]
   

  Previous studies have reported that the concentration of thyroglobulin (Tg) in heart blood is high in cases of asphyxia by neck compression such as hanging, strangulation, and throttling and in those with traumatic injuries to the head. However, we have experienced cases in which we observed high Tg concentrations without such findings. Therefore, we analyzed the influence of postmortem changes on Tg concentration. Of 253 forensic autopsies conducted at our institution, we analyzed 44 cases without the findings presumed to increase Tg concentration. We collected right heart blood (RHB) and left heart blood (LHB) separately and measured Tg concentrations in each. The Tg concentration of the RHB in 19 (43%) cases and that of the LHB in 10 (23%) cases was higher than the standard value (200 ng/ml) obtained in previous studies. In some cases, we found large differences between the Tg concentrations of RHB and LHB. We suggest that Tg concentration can increase above the standard value and that a difference between the Tg concentration of RHB and LHB arises as a result of postmortem changes. Consequently, if there is a large difference between the Tg concentration of RHB and LHB, the concentration of Tg should not be used as a basis for forensic diagnosis. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
• What younger forensic pathologists need for their training: Valuable comments from our interviews

  Manabu Murakami, Kotaro Matoba, Koichi Terazawa

  LEGAL MEDICINE 15 1 55 - 55 2013年01月 [査読有り][通常論文]
  
• Raising future forensic pathologists (first report): results of a preliminary questionnaire survey.

  Murakami M, Matoba K, Terazawa K

  [Hokkaido igaku zasshi] The Hokkaido journal of medical science 87 4-5 153 - 157 2012年08月 [査読有り][通常論文]
  
• Raising future forensic pathologists (second report): results of a preliminary interview survey.

  Murakami M, Matoba K, Hayakawa A, Terazawa K

  [Hokkaido igaku zasshi] The Hokkaido journal of medical science 87 4-5 159 - 163 2012年08月 [査読有り][通常論文]
   

  Fostering the specialists of forensic pathology has become a worldwide problem. In Japan, factors such as government budget cuts, the introduction of initial postgraduate clinical training system, as well as national policy on increasing autopsy rates, may deter young graduates from entering this specialty. The aim of this study was to look for clues to promote the training of young forensic pathologists. We selected and interviewed five forensic pathologists, with each interview lasting approximately 60 minutes, and picked up common views among them. The interviews topic, based on a prior survey, was: "What do you believe forensic pathologists require to promote the training of their successors." We selected common views on the three themes listed below; 1) standardization of minimum requirements to be independent forensic pathologists, 2) balancing forensic pathologists' time among autopsy practice, research, and education, and 3) preparing positions for younger forensic pathologists. These opinions were the same as those of previous studies conducted overseas and must be discussed at academic conferences in the future, where both junior and senior forensic pathologists participate.
• Application of electrolyte analysis of pleural effusion to diagnosis of drowning

  Kotaro Matoba, Manabu Murakami, Akira Hayakawa, Koichi Terazawa

  LEGAL MEDICINE 14 3 134 - 139 2012年05月 [査読有り][通常論文]
   

  We measured concentrations of sodium (Na), chloride (Cl), calcium (Ca), and magnesium (Mg) in pleural effusion from forensic autopsy cases to examine whether they were useful for a diagnosis of drowning. We analyzed a total of 51 cases (15 seawater drowning, 10 freshwater drowning, and 26 non-drowning), and determined the following reference values. If the concentration of Na or Cl is under 65 mEq/l, a diagnosis of freshwater drowning can be made. If the concentration of Na is higher than 175 mEq/l, or that of Cl is higher than 155 mEq/l, or that of Ca is higher than 16 mg/dl, or that of Mg is higher than 15 mg/dl, a diagnosis of seawater drowning can be made. We recommend that pleural effusion from the left and the right thoracic cavities should be collected and analyzed separately because large differences may be observed between each side in the case of drowning. If one side corresponds to the reference value for seawater or freshwater drowning and the other side does not, a diagnosis of drowning can still be made according to the obtained value. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
• Unusual injuries on the right hand and forearm caused by unidentified wild animals

  Takayuki Kiuchi, Kotaro Matoba, Koichi Terazawa

  Legal Medicine 10 6 301 - 305 2008年11月 [査読有り][通常論文]
   

  An old man was found dead in a rice paddy with his face down in the water. His right forearm and hand were severely injured and the shapes of injuries were unusual. It was initially suspected that the injuries had been caused by a cultivator placed at the site. However, they proved to be postmortem injuries because vital reactions were not observed. The skin was widely torn away. Some edges of the injuries looked like a bite mark and other parts looked like scratches. There were many parallel injuries on the right forearm and hand and footmark-like injuries on the right hand. They were probably caused by wild animals. Judging from the sizes and shapes of the footprint, bite marks and scratches, we estimated that the animal which caused the injuries was weasels. © 2008 Elsevier Ireland Ltd. All rights reserved.
• [Estimation of the time of death of decomposed or skeletonized bodies found outdoors in cold season in Sapporo city, located in the northern district of Japan].

  Matoba K, Terazawa K

  [Hokkaido igaku zasshi] The Hokkaido journal of medical science 83 4 275 - 279 2008年07月 [査読有り][通常論文]
  
• Estimation of the time of death of decomposed or skeletonized bodies found outdoors in cold season in Sapporo city, located in the northern district of Japan

  Kotaro Matoba, Koichi Terazawa

  Legal Medicine 10 2 78 - 82 2008年03月 [査読有り][通常論文]
   

  In Sapporo city, located in the northern district of Japan, it is very difficult to estimate the time of death of decomposed or skeletonized bodies found outdoors in cold season (November-April) because postmortem changes are markedly retarded in the season compared with warm season (May-October), and the bodies are often damaged and skeletonized by carnivorous animals such as wild dogs and foxes. However, they cannot damage the brain in the cranium. The brain is mainly damaged by fly larvae. In Sapporo city, we can estimate that the time of death of a cadaver found outdoors in the cold season is in the beginning of November or before if fly larvae hatched in autumn exist on the cadaver, and that the time of death is in the beginning of November or after if fly larvae hatched in autumn do not exist and most of the brain remains in the cranium. © 2007 Elsevier Ireland Ltd. All rights reserved.
• An autopsy case of intraoperative death due to pulmonary fat embolism - possibly caused by release of tourniquet after multiple muscle-release and tenotomy of the bilateral lower limbs

  Satoshi Watanabe, Koichi Terazawa, Kotaro Matoba, Naoya Yamada

  FORENSIC SCIENCE INTERNATIONAL 171 1 73 - 77 2007年08月 [査読有り][通常論文]
   

  We report a case of a juvenile male with muscle rigidity caused by cerebral palsy who experienced intraoperative sudden death due to pulmonary fat embolism after multiple muscle-release and tenotomy of the bilateral lower limbs. Data were obtained through review of the surgical and anesthesia records, as well as from autopsy and histopathological examination. All surgical procedures were performed within the same operation, beginning with the right lower limb and then proceeding with the left lower limb, with application of a pneumatic tourniquet to avoid intraoperative hemorrhage. Slight changes in the hemodynamics were noticed after release of the right tourniquet. Further, sudden onset of hypotension, severe bradycardia, and a marked decrease in percutaneously monitored oxygen saturation occurred just after release of the left tourniquet when the left limb was raised for casting. The patient died despite immediate and vigorous cardiopulmonary resuscitation. At autopsy performed 20 h after death, examination of the lungs revealed a pale surface, slight edema, and obvious fat droplets in the vessels at the cut surfaces. Histopathological examination with fat staining was notable for the presence of pulmonary fat embolism. These results suggest that restoration of venous return after removal of the tourniquet combined with massive fat embolism from dead spaces was the likely cause of death. (c) 2006 Elsevier Ireland Ltd. All rights reserved.
• Age estimation from quantitative evaluation of atherosclerosis of abdominal aorta in Japanese.

  Watanabe S, Terazawa K, Matoba K

  [Hokkaido igaku zasshi] The Hokkaido journal of medical science 82 2 91 - 98 2007年03月 [査読有り][通常論文]
  
• [Problems in applying a rapid assay kit for cardiac troponin T to medico-legal blood samples].

  Matoba K, Terazawa K, Watanabe S, Yamada N, Ueda M

  [Hokkaido igaku zasshi] The Hokkaido journal of medical science 81 5 359 - 363 2006年09月 [査読有り][通常論文]
  
• [Estimation of time of death by the use of the overwintering of flies].

  Terazawa K, Matoba K, Watanabe N, Watanabe S, Yamada N

  [Hokkaido igaku zasshi] The Hokkaido journal of medical science 81 4 265 - 269 2006年07月 [査読有り][通常論文]
  

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• 腎糸球体毛細血管内のフィブリン血栓証明にMartius-Scarlet-Blue染色が有用であった溶血性尿毒症症候群の一剖検例

  的場 光太郎, 堀岡 希衣, 早川 輝, 寺沢 浩一 法医学の実際と研究 (58) 27 -32 2015年11月 [査読無し][通常論文]
   

  腸管出血性大腸菌に感染し溶血性尿毒症症候群(HUS)で死亡したと思われる幼児期女児の司法解剖を経験した。病理組織検査によって糸球体細胞血管内の微小フィブリン血栓を確認する必要があり、リンタングステン酸ヘマトキシリン染色(PTAH染色)がフィブリンの証明に有用とされていることから、ヘマトキシリン・エオジン染色に加えてPTAH染色を行った。しかし、死後変化やHUSの影響で溶血した赤血球の集塊と微小フィブリンがほぼ同様に染色され、両者の鑑別は容易でなく、両者の違いを司法関係者にわかりやすく説明できる染色法が必要であると考えられた。Martius-Scarlet-Blue染色(MSB染色)は赤血球とフィブリンの染め分けに有用と報告されていることから、本法を施行することとした。まず、本法が法医解剖検体に適した染色方法であるか確認するため、赤血球とフィブリンの区別が容易な肺血栓塞栓症の血栓でMSB染色を行ったところ、組織への染色色素の透過性が不良であった。そこで中間分子色素を変更した。具体的には、従来のブリリアントクリスタルスカーレットから、マッソン染色で使用されるポンソー・キシリジンと酸フクシン混合液に変更し、さらに染色時間なども変更したところ、赤血球とフィブリンの染め分けが可能となった。
• 睡眠時無呼吸症候群が死亡に関与したと考えられる2事例

  早川 輝, 的場 光太郎, 堀岡 希衣, 寺沢 浩一 法医学の実際と研究 (58) 33 -39 2015年11月 [査読無し][通常論文]
   

  事例は幼児期女児と10代男児で、いずれも睡眠中に突然死し、死因となるような明らかな所見は認められなかった。両例とも軽度肥満と咽頭扁桃・口蓋扁桃・舌乳頭の腫大を認め、生前に大きな鼾をかいていたことから、睡眠時無呼吸症候群が死亡に関与した可能性が考えられた。過去2年間に法医学の分野で実施された解剖事例のなかに上記2例と同様のケース、すなわち、睡眠中に突然死し、死因となるような明らかな所見が認められず、睡眠時無呼吸症候群が関与した可能性のあるものが、上記2例を含めて11例あった。その主要な剖検所見を提示し、文献的考察を加えた。11例とも咽頭扁桃・口蓋扁桃・舌乳頭の腫大を認めており、生前に上気道の狭窄・閉塞が存在していた可能性が示唆された。
• トロポニンTに対する死後変化と採血部位の影響に関する検討

  早川 輝, 的場 光太郎, 堀岡 希衣, 寺沢 浩一 法医学の実際と研究 (58) 260 -260 2015年11月 [査読無し][通常論文]
  
• 法医学における血栓の病理組織学的検索 MSB染色の改良とその有用性について

  堀岡 希衣, 的場 光太郎, 早川 輝, 寺沢 浩一 日臨技北日本支部医学検査学会抄録集 4回 138 -138 2015年09月 [査読無し][通常論文]
  
• 嬰児の血液型検査によって母子間血液型不一致の可能性があった1剖検例

  堀岡 希衣, 的場 光太郎, 早川 輝, 寺沢 浩一 日本法医学雑誌 69 (1) 79 -79 2015年05月 [査読無し][通常論文]
  
• 頸部切断後に海中遺棄が疑われた死後変化が進んだ水中死体の一剖検例

  的場 光太郎, 早川 輝, 堀岡 希衣, 寺沢 浩一 日本法医学雑誌 69 (1) 79 -79 2015年05月 [査読無し][通常論文]
  
• 睡眠時無呼吸症候群が死亡に関与したと考えられる2事例

  早川 輝, 的場 光太郎, 堀岡 希衣, 寺沢 浩一 日本法医学雑誌 69 (1) 65 -65 2015年05月 [査読無し][通常論文]
  
• 嬰児の血液型検査を行ない、母子間血液型不一致となった1例

  堀岡 希衣, 的場 光太郎, 早川 輝, 高橋 道範, 坂口 良典, 政氏 伸夫, 寺沢 浩一 日本輸血細胞治療学会誌 61 (1) 30 -30 2015年02月 [査読無し][通常論文]
  
• プロカルシトニン簡易検査キットが法医診断に有用であった1剖検例とプロカルシトニンの値を用いた法医診断への注意点

  早川 輝, 的場 光太郎, 堀岡 希衣, 寺沢 浩一 法医学の実際と研究 57 (57) 167 -172 2014年11月 [査読無し][通常論文]
   

  80歳代女。ベッド上で心肺停止の状態で発見された。救急隊が現場で死亡確認を行っており、蘇生術は行われていない。約2ヵ月前から食事の量が少なくなり、寝返りをするのも困難となり、臀部等に褥瘡を認めていた。死亡から約4時間後に死体検案を行い、適切な介護を受けないで死亡した可能性が考えられたため、死亡から約24時間後に司法解剖となった。解剖所見と検査結果から、褥瘡からの感染による敗血症があり、さらに死亡時には脱水状態と低栄養状態であったと考えられ、死因は敗血症と脱水に伴う循環不全とした。心臓血を用いてプロカルシトニン(PCT)簡易検査キットを行い、PCT値が敗血症の診断基準値を超えていた。
• プロカルシトニン簡易検査キットが法医診断に有用であった1剖検例

  早川 輝, 的場 光太郎, 堀岡 希衣, 寺沢 浩一 法医学の実際と研究 57 (57) 229 -230 2014年11月 [査読無し][通常論文]
  
• クロバエ科の秋季の産卵活動時期に関する調査

  的場 光太郎, 早川 輝, 堀岡 希衣, 寺沢 浩一 法医学の実際と研究 57 (57) 228 -228 2014年11月 [査読無し][通常論文]
  
• 損傷から着地時の姿勢を推定した墜落の1剖検例 上肢の損傷の重要性

  的場 光太郎, 早川 輝, 堀岡 希衣, 寺沢 浩一 法医学の実際と研究 57 (57) 161 -165 2014年11月 [査読無し][通常論文]
   

  40歳代男。鉄道の線路脇の砂利の上で仰向けでうめいているところを発見された。救急隊到着時は心臓停止で、搬送先の病院で発見から約1時間後に死亡が確認された。警察の捜査によると跨線橋から飛び降りた可能性が高いと考えられたが、検視における外表検査では損傷が比較的軽微であり、死因は不明であった。両上肢で頭部や顔面を覆う姿勢であったことから、意識のある状態で跨線橋から墜落した可能性が高いと考えられた。後頭部から背面に損傷がなく、砂利の上にほぼ水平に着地していることを考えると、意識のある状態で、ほぼうつ状での姿勢で墜落し、最初に胸腹部が線路脇の砂利に衝突した後、前腕部から手掌面と膝部から下腿部が砂利に衝突し、その後、顔面が砂利に比較的軽く作用したと考えた。即死ではなく、うつ伏せ墜落した後に自分で仰向けになったと考えられた。
• 法医診断におけるケトン体測定の意義

  堀岡 希衣, 的場 光太郎, 早川 輝, 寺沢 浩一 北臨技会誌 12 (2) 38 -38 2014年08月 [査読無し][通常論文]
  
• 法医学の診断における超音波検査の有用性について

  堀岡希衣, 堀岡希衣, 的場光太郎, 早川輝, 寺沢浩一 北海道大学総合技術研究会報告集 平成26年度(CD-ROM) ROMBUNNO.07-07 2014年 [査読無し][通常論文]
  
• クロバエ科の秋季の産卵活動時期に関する調査

  的場 光太郎, 早川 輝, 堀岡 希衣, 寺沢 浩一 法医学の実際と研究 (56) 27 -32 2013年11月 [査読無し][通常論文]
  
• 損傷から受傷場所を推定した1剖検例

  早川 輝, 的場 光太郎, 堀岡 希衣, 寺沢 浩一 法医学の実際と研究 (56) 33 -37 2013年11月 [査読無し][通常論文]
   

  70代男。自宅の1階居間で死亡しているのを発見された。頭頂部に挫滅創、前額部に表皮剥脱と裂創を認めた。また、背部と四肢に皮下出血と表皮剥脱が散在しており、左の肋骨に多発骨折を認めた。発見現場の周囲と1階の階段手前床面に多量の血痕が存在し、損傷の間隔と階段の間隔がほぼ一致したことから、階段で転倒し受傷したものと推定された。
• 損傷の状態から受傷場所(階段)の推定が可能であった1剖検例

  早川 輝, 的場 光太郎, 村上 学, 寺沢 浩一 法医学の実際と研究 (56) 259 -260 2013年11月 [査読無し][通常論文]
  
• 法医学後継者育成問題に関する探索的調査(予備調査・(第2報))

  村上 学, 的場 光太郎, 早川 輝, 寺沢 浩一 法医学の実際と研究 (56) 262 -262 2013年11月 [査読無し][通常論文]
  
• 胃内から採取された液体の電解質濃度の溺死診断への応用

  的場 光太郎, 早川 輝, 村上 学, 寺沢 浩一 法医学の実際と研究 (56) 265 -266 2013年11月 [査読無し][通常論文]
  
• 石狩川下流域における珪藻分布の解析

  石川 知保, 的場 光太郎, 出村 珠美, 早川 輝, 村上 学, 寺沢 浩一, 山田 直弥 法医学の実際と研究 (56) 266 -267 2013年11月 [査読無し][通常論文]
  
• 北海道沿岸における珪藻分布の解析報告(第三報)

  毎熊 浩二, 浅利 優, 山田 ひろみ, 松田 都久美, 岡 久美子, 北村 麻奈, 吉田 あやか, 土井 大輝, 保科 千里, 大谷 静治, 間瀬田 千香暁, 塩野 寛, 清水 惠子, 大村 友博, 早川 輝, 村上 学, 的場 光太郎, 寺沢 浩一, 山田 直弥, 中村 一, 阿部 祐亮, 三和 正人, 吉田 幸夫 法医学の実際と研究 56 (56) 266 -266 2013年11月 [査読無し][通常論文]
  
• 結晶の析出によって胸腔内に貯留する液体のマグネシウム濃度が低下していた2剖検例

  的場 光太郎, 早川 輝, 村上 学, 寺沢 浩一 日本法医学雑誌 67 (1) 79 -79 2013年05月 [査読無し][通常論文]
  
• 慢性骨髄性白血病が脳内出血の原因と考えられた1剖検例

  堀岡 希衣, 的場 光太郎, 早川 輝, 村上 学, 寺沢 浩一 日本法医学雑誌 67 (1) 81 -81 2013年05月 [査読無し][通常論文]
  
• 胸部に細い金属が刺入していた一剖検例

  早川 輝, 的場 光太郎, 村上 学, 寺沢 浩一 日本法医学雑誌 67 (1) 105 -105 2013年05月 [査読無し][通常論文]
  
• 石狩川下流域における珪藻分布の解析

  石川 知保, 的場 光太郎, 山田 直弥, 出村 珠美, 早川 輝, 寺沢 浩一 北海道醫學雜誌 = Acta medica Hokkaidonensia 88 (2) 87 -87 2013年04月01日 [査読無し][通常論文]
  
• 石狩川下流域における珪藻分布の解析

  石川 知保, 的場 光太郎, 山田 直弥, 出村 珠美, 早川 輝, 寺沢 浩一 法医学の実際と研究 (55) 203 -214 2012年11月 [査読無し][通常論文]
  
• 損傷の自他為事故の区別が問題となった2解剖例

  寺沢 浩一, 的場 光太郎, 村上 学, 早川 輝, 木内 隆之 法医学の実際と研究 (55) 304 -304 2012年11月 [査読無し][通常論文]
  
• 内因性急死と気道閉塞による窒息死の鑑別が必要となった食事中の突然死の1例

  的場 光太郎, 村上 学, 寺沢 浩一, 早川 輝, 木内 隆之 法医学の実際と研究 (55) 305 -305 2012年11月 [査読無し][通常論文]
  
• 胸腔内液体の電解質濃度の溺死診断への応用

  的場 光太郎, 村上 学, 早川 輝, 寺沢 浩一 北海道醫學雜誌 = Acta medica Hokkaidonensia 87 (6) 254 -254 2012年11月01日 [査読無し][通常論文]
  
• 日本人の予防接種痕による年齢推定

  的場 光太郎, 村上 学, 早川 輝, 寺沢 浩一 北海道醫學雜誌 = Acta medica Hokkaidonensia 87 (6) 255 -255 2012年11月01日 [査読無し][通常論文]
  
• 当教室における身元不明死体の年齢推定の適中率

  的場 光太郎, 村上 学, 早川 輝, 寺沢 浩一 日本法医学雑誌 66 (1) 88 -88 2012年05月 [査読無し][通常論文]
  
• 予防接種痕による日本人の年齢推定

  的場 光太郎, 村上 学, 早川 輝, 寺沢 浩一 法医学の実際と研究 (54) 25 -29 2011年11月 [査読無し][通常論文]
   

  種痘痕とBCG接種痕による年齢推定の可能性について探るため、明治時代から現在までの両接種に関する法令を調査するとともに、予防接種痕のある剖検死体213例の接種痕データを分析し、以下の結論を得た。1)第1期の種痘は乳幼児期に右上腕あるいは肩部に実施されることが多く、その瘢痕が明瞭に残存するので年齢推定に有用である。2)第1期の種痘痕の個数が4個または6個であれば1908〜1948年に出生したと推定でき、2個であれば1947〜1970年、1個であれば1947〜1975年に出生したと推定することができる。3)BCGの経皮接種痕があれば1952年以降の出生と推定することができる。
• 胸腔内液体の電解質濃度の溺死診断への応用

  的場 光太郎 北海道醫學雜誌 = Acta medica Hokkaidonensia 86 (6) 251 -258 2011年11月01日 [査読無し][通常論文]
  
• 腹部大動脈アテローム変性の定量的評価による年齢推定(第2報)

  渡邊 智, 寺沢 浩一, 的場 光太郎, 山田 直弥 日本法医学雑誌 60 (1) 62 -62 2006年03月 [査読無し][通常論文]
  
• 予防接種痕による年齢推定

  的場 光太郎, 寺沢 浩一, 渡邊 智, 山田 直弥 日本法医学雑誌 60 (1) 82 -82 2006年03月 [査読無し][通常論文]
  
• 頚部より上方の〓血点の発生機序に関して : 誘発された急性心不全が関与しうる

  寺沢 浩一, 渡邊 智, 的場 光太郎, 山田 直弥 犯罪学雑誌 = ACTA CRIMINOLOGIAE ET MEDICINAE LEGALIS JAPONICA 72 (1) 16 -22 2006年02月25日 [査読無し][通常論文]
  

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