Methamphetamine (MAP) is currently considered to be the major illicit drug in Taiwan, and MAP constitutes the majority of illicit drugs seized by the judicial institutes. Thus, MAP has raised public attention. The purpose of this retrospective study is to observe the trends of MAP-related fatalities in Taiwan with respect to the manners of death so as to determine the epidemiological implications of MAP. Two hundred and forty-four MAP-related fatalities out of a total of 3958 forensic fatalities were collected by the Forensic Medicine Center (Taiwan) during the period of 1991 to 1996. The annual percentages of MAP-related fatalities compared to the total autopsy cases during 1991 through 1996 were 3.4, 10.3, 12.1, 4.2, 4.0 and 5.6%, showing that the number of MAP-related fatalities increased from 1991 to 1993, declined during 1994 and 1995, and rose again in 1996. The mean age of the MAP-related fatalities during this period was 30.7 years and occurred predominantly in males (73%). The manner of deaths included natural, accidental, suicidal, homicidal and uncertain causes of deaths, represented, respectively, by 31 (13%), 143 (59%), 28 (11%), 34 (14%) and 8 (3%) cases. As a consequence of the endemic problem and public hazard created by illicit drug abuse in Taiwan, stronger anti-drug programs and curbs to illicit-drug addiction were required urgently from the government and from the public. The findings of this study represent the results of utilization of an anti-drug program in Taiwan (Support by NSC 85-2331-B-016-092).
In Taiwan, the average prevalence of congenital heart disease (CHD) is 13.08/1000 live births. Most children with CHD die before the age of 5 years; therefore, identifying treatment methods to extend the life of CHD patients is an important issue in clinical practice. The objective of this study is to evaluate the roles of hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), inducible nitric oxide synthase (iNOS), endothelin-1 (ET-1), and CD34 in CHD autopsy cases in comparison with autopsy cases without CHD. The study included 19 autopsy cases, which were divided into the following four groups: acyanotic CHD (n = 11), cyanotic CHD (n = 3), CHD associated with chromosomal abnormalities (n = 3), and complex CHD (n = 2). Heart specimens obtained from 10 autopsy cases without CHD were included as controls. Our results indicated that high percentages of HIF-1α (100%), VEGF (89.5%), iNOS (78.9%), and ET-1 (84.2%) expressions were observed in CHD autopsy cases and this was found to be significant. HIF-1α induced by hypoxia could play a potential role in relating downstream gene expressions in CHD patients. Upregulation of VEGF by HIF-1α could play an important role in triggering angiogenesis to protect myocardial cell survival in a hypoxic microenvironment. Therefore, HIF-1α could be a significant prognosis marker in CHD and be a prospective candidate in the development of target therapy in cardiovascular diseases.
The characteristics of knife tool marks retained on hard tissues can be used to outline the shape and angle of a knife. The purpose of this study was to describe such marks on bone tissues that had been chopped with knives. A chopping stage with a gravity accelerator and a fixed bone platform was designed to reconstruct the chopping action. A digital microscope was also used to measure the knife angle (θ) and retained V-shape tool mark angle (ψ) in a pig skull. The κ value (elasticity coefficient; θ/ψ) was derived and recorded after the knife angle (θ) and the accompanied velocity were compared with the proportional impulsive force of the knife and ψ on the bone. The constant impulsive force revealed a correlation between the V-shape tool mark angle (ψ) and the elasticity coefficient (κ). These results describe the tool marks--crucial in the medicolegal investigation--of a knife on hard tissues.
Falling from a height, usually from a building, occurs ordinarily in suicide, in some accidents, and sometimes as an act of homicide. The point of trajectory, the horizontal distance and the impact point are closely related to the initial velocity, angle and height. This study examines the falling pattern in order to determine the mental status of the jumper as well as the manner of death. Initial velocity is found using horizontal movement and height. A serial study of athletes performing both the running jump (long jump) and standing jump (swimmer's start jump) via biomechanical methods is described. The initial velocity of the running jump and standing jump in normal athletics is 9.15 and 2.70 m/s with initial jumping angles of 21 and 38 deg, respectively. The maximal horizontal velocity of 9.15 m/s is closely related to maximal strength of initial velocity, angle of engaged force, and height. Theoretical estimation of the initial velocity between 2.70 and 9.15 m/s is correlative with the unique initial velocity and running jump to fall from a height that is closely related to the voluntary and attempted jump. Hence, the jumping victim with an initial velocity higher than 2.70 m/s implies suicide. These results indicate that horizontal distance and height are legitimate measures to use in speculating on the falling pattern and the manner of death. A unique case of suicide involving a run and jump with initial velocity greater than 2.70 m/s is illustrated.
This study conducts an investigation of fatal falls from height, examines gender differences, and compares our findings with those of Western countries. We review deaths in Taiwan caused by falls from height that underwent forensic autopsy from 1994 to 2010. Among the examined cases, 182 were suicide, 156 were accidents, and 18 were homicides. Men who fell from greater heights had a lower probability of fatal head trauma (p = 0.045), and women exhibited a lower fatal head trauma rate when falling from heights of between 10 and 25 m in accident group (p = 0.003). There was no significant difference between cases of falling from greater and lower heights within the suicide group (p = 0.834). Psychiatric illness was only reported in 20.3% and 28.8% cases in suicide and accident groups. Only in male cases was the use of psychotropic substances higher in the suicide groups than in the accident groups (p = 0.047).
Two hundred and twenty-three vitreous humor specimens, which were obtained from a medical examiner's office, were found to be opiate positive (cutoff, 50 ng/mL) by fluorescence polarization immunoassay. All samples were analyzed for their free codeine, morphine, and 6-acetylmorphine contents by a gas chromatography-mass spectrometry protocol. 6-Acetylmorphine was found (cutoff, 10 ng/mL) in 41 specimens in the concentration range of 10-125 ng/mL. Twenty specimens had a free codeine-free morphine concentration ratio > or = 1. Eighty-five samples that were found to contain 50 ng/mL free morphine were further analyzed for their total codeine and total morphine contents. Total codeine-total morphine concentration ratios in 8 (of the 85 samples) were > or = 1, whereas this ratio in the others (only those with a codeine concentration high than 15 ng/mL were included) was significantly lower than 1. The codeine-morphine concentration ratio in vitreous humor appears to resemble that reported for blood and urine and can be used as the basis for differentiating between codeine- and morphine- (heroin-) induced fatalities.
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