Fine needle aspiration (FNA) and core needle biopsy (CNB) are recognized to be safe, useful, and inexpensive diagnostic tools for the evaluation of thyroid nodules. However, complications can arise during the procedure, albeit rarely and typically minor in nature. We report here an unusual fatal case of massive hematoma of the neck after FNA and CNB that may have caused airway obstruction. A 68-year-old Japanese woman underwent both procedures and was found dead at home later the same day. Although severe complications of FNA or CNB such as major bleeds or deaths are rarely reported, clinicians and forensic pathologists should be cognizant that complications can arise.
BackgroundThe solitary death rate in Japan is expected to continue increasing because of its growing super-aged society and the rapid growth of home care in the country. To accurately determine the actual status of solitary deaths, we used a novel analysis method of combining vital statistics and ambulatory care information in Yokohama City.MethodsData of persons who died at home in 2013 were obtained from death certificate notifications. We also obtained the emergency transportation records that matched the cases of these death certificate notifications. Then, we gathered information regarding age, gender, marital status, and cause of death for the matched cases.ResultsThere were 1890 “suspected unnatural deaths,” in which most solitary deaths could be included, among all citizens who died at home (n = 4847). We were able to match 1503 of these cases with emergency transportation records. These 1503 cases were divided into two groups, “solitary death” (n = 349) and “un-solitary death” (n = 1154) according to the postmortem interval until finding (PMI-f). Pearson’s χ2 tests conducted for the two groups revealed that there were significant differences regarding the proportion of persons who were elderly, unmarried, male, and had a hepatic disease and senility. A logistic regression analysis also showed that an increased likelihood of a prolonged PMI-f was associated with males and an unmarried status with hepatic diseases.ConclusionsUnmarried, male sex, and liver diseases are independent risks for solitary death in Yokohama City.
Objective: (1) To determine feature vector representations (geometric pattern parameters) that are effective in describing human nasal profiles, (2) to determine the number of code vectors (typical nasal patterns) that are mathematically optimized by applying the vector quantization method to each feature vector extracted for each subject, and (3) to determine the morphological traits of each code. Materials and Methods: Lateral facial photographs of 200 Japanese women recorded for orthodontic diagnosis were selected. Five anatomic landmarks were identified on each image together with a set of data points that constituted the contour of the facial profile. An eight-dimensional feature vector effective in distinguishing differences in nasal profile patterns was extracted from the data set using experts' knowledge of the anatomic traits of the nose. The vector quantization technique was applied to the feature vectors to provide the optimum number of nasal profile patterns. Results: The number of code vectors mathematically optimized was six, and the differences between vectors were maximized by morphological traits of the root, dorsum, tip, and base of the nose. Proportions of the number of image records classified into each code were 25.5%, 24.5%, 21.5%, 15.0%, 10.0%, and 3.5% from code 1 to code 6, respectively. Conclusions: Classifying nasal profile patterns based on knowledge from a linguistic description was found to be more effective than a method based on uniform sectioning. The differences between vectors were maximized by morphological traits of the root, the dorsum, the tip, and the base of the nose.
BackgroundAccording to the dual structure model, the modern Japanese ethnic population consists of a mixture of the Jomon people, who have existed in Japan since at least the New Stone Age, and the Yayoi people, who migrated to western Japan from China around the year 300 bc Some reports show that the Yayoi are linked to a mutation of the aldehyde dehydrogenase 2 gene (ALDH2).Recent viral studies indicate two major groups found in the Japanese population: a group with the CY genotype JC virus (JCV) and a group with the MY genotype JCV. It is unclear whether either genotype of the JC virus is related to the Jomon or Yayoi.In this study, we attempted to detect JCV genotypes and ALDH2 mutations from the DNA of 247 Japanese urine samples to clarify the relationship between the dual structure model and the JCV genotype through ALDH2 mutation analysis and JCV genotyping.FindingsThe ALDH2 polymorphism among 66 JC virus-positive samples was analyzed, and it was found that the ALDH2 variant is significantly higher in the population with CY genotype JCV (51.5 %) than in the population with the MY genotype (24.2 %) (p < 0.05).ConclusionFrom these findings, it may be inferred that the ALDH2 mutation, which is related to the Yayoi, is related to CY genotype JCV. When the Yayoi migrated to the Japanese archipelago, they brought the ALDH2 mutation as well as the CY genotype JCV.
The toxicological detection of the new synthetic cathinone 4′-methyl-α-pyrrolidinohexanophenone (MPHP) in urine samples has been impossible, because much of MPHP is metabolized before its excretion into urine. In this study, we successfully quantified unmetabolized MPHP in urine of an autopsy case using a sensitive method by liquid chromatography–time-of-flight-mass spectrometry. The quantification method showed good linearity in the range of 1.00–100 ng/mL, and the limit of detection was 0.5 ng/mL in human urine. In the autopsy case, the concentrations of MPHP in urine, plasma, and liver tissue samples were determined to be 60.1, 32.9 ng/mL, and 63.1 ng/g, respectively.
Sudden infant deaths might be attributable to adverse reaction to vaccination, but separating them from coincidental occurrences is difficult. This study retrospectively investigated vaccination-related details and postmortem findings for 57 cases of sudden death in children 2 years or younger. Data were extracted from autopsy files at the Department of Forensic Medicine, Tokai University School of Medicine. Vaccination histories were available in 50 cases based on the maternity passbook. Of the 32 cases in which any vaccines were administered, 7 infants (21.9%) had received immunization within 7 days of death. The most frequent vaccine cited as the last immunization before death was Haemophilus influenzae B. Although a temporal association of vaccines with sudden death was present for two 3-month-old and one 14-month-old infants in whom death occurred within 3 days of receiving the H. influenzae type b and other vaccinations, a definitive relationship between the vaccine and death could not be identified. Histopathological examinations revealed pneumonia and upper respiratory infection as contributing to death in their cases. Moreover, all 3 cases showed hemophagocytosis in the spleen and lymph nodes, which are similar features to hemophagocytic lymphohistiocytosis. Judgment of the disorders as truly related to vaccination is difficult, but suspicious cases do exist. Forensic pathologists must devote more attention to vaccination in sudden infant death cases.
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