記述言語：英語   掲載種別：研究論文（学術雑誌）  

Coronary arteritis is an uncommon cause of sudden death in non-atherosclerotic coronary diseases, and is mostly associated with systemic vasculitis or systemic autoimmune diseases; therefore, sudden death due to isolated coronary arteritis rarely occurs. The case described in this report is that of a 34-year-old man with no significant personal medical history who died suddenly after presenting with nausea. Postmortem examination revealed a significant infiltration of lymphocytes predominantly on the adventitia and periadventitial tissues of the coronary arteries in the epicardium. The lymphocytic infiltrate partially extended to the thickened intima with fibrosis, destructing the media and internal elastic lamina, and the lumen was occluded by a thrombus in the left main stem and left anterior descending branch. The arterial walls exhibited focal fibrinoid necrosis with regression in the intima and fibrous scars with angiogenesis in the media and adventitia. Focal myocardial infarction was detected in the left ventricle as a fibrotic change of the myocardium. No findings associated with vasculitis were discerned in the aorta, other peripheral arteries, or major organs. Laboratory tests of postmortem blood samples returned negative results for antinuclear antibodies, cryoglobulin, immunoglobulin G4, and cytoplasmic anti-neutrophil cytoplasmic antibodies for myeloperoxidase and proteinase 3. These autopsy findings suggest that the sudden death was caused by isolated necrotizing vasculitis that is assumed to be polyarteritis nodosa localized at the coronary arteries. However, pathological characteristics may not be exactly the same between isolated necrotizing vasculitis in the coronary arteries and polyarteritis nodosa.

DOI： 10.1007/s12024-019-00099-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report an autopsy-proven case of a 33-year-old man who died of intimal sarcoma of the pulmonary artery. A large mass (5×4 cm) occluded the main and bilateral pulmonary arteries. Tumor cell morphology was consistent with that of undifferentiated pleomorphic sarcoma. Comprehensive histological observation of 18 pulmonary arteries from proximal to distal revealed continuous extension of the tumor from the main to the subsegmental arteries along the intima, forming an arteriosclerosis-like intimal thickening. Distal small arteries were also affected by eccentric intimal thickening or recanalization. Lung parenchyma was not involved, although there were two wedge-shaped small pulmonary infarctions caused by tumorous obstruction of the associated arteries. Histological results indicated that the intimal sarcoma in the pulmonary artery, which appeared occlusive with growth limited to the proximal artery, had in fact already spread more peripherally than expected. Both the proximal lesions and the distal small arteries were affected by peripheral tumor emboli or by pulmonary hypertension induced by the proximal tumor. However, as seen in this case, most of the occlusive tumor was located locally and intraluminally, in the proximal artery, and removing the proximal tumor by pulmonary endarterectomy was considered effective for symptomatic improvement.

DOI： 10.1016/j.carpath.2019.07.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/eurheartj/ehx361

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Epithelioid hemangioma (EH) is a benign vascular lesion. It is generally found in the dermis, subcutis, and rarely in visceral organs. We identified incidental EHs of the right coronary artery and right ventricle during an autopsy of Japanese female whose cause of death was liver cirrhosis. The tumor of the coronary artery originated from the tunica media of the artery and proliferated into the intima and out of the vascular wall. It resulted in marked luminal narrowing of approximately 50%-75% stenosis. However, no evidence of myocardial ischemia was found. Cardiac EH is rare and this is the first report of EH arising in the coronary artery, to our knowledge.

DOI： 10.1016/j.legalmed.2015.09.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

A fall from a great height is often associated with altered mental status. Aside from the usual contributing factors, for example, alcohol consumption or mental illness, natural disease leading to a fatal fall is seldom identified by autopsy. The case described in this report is that of a 57-year-old man who had been clinically diagnosed with presenile Alzheimer disease and fell head first into a river from the bridge. These events were captured by a surveillance camera on the bridge; an acquaintance reported that he had previous suicidal ideation. At autopsy, the cervical spinal cord was determined to have been severely injured, and the sixth cervical vertebra was observed to have been fractured. Histological examination showed chronic meningoencephalitis including neuronal loss, perivascular cuffing, and the proliferation of microglia and astrocytes in the cerebral cortex. Serologic evaluation consisting of the nontreponemal antigen test (rapid plasma reagin [RPR]) and treponemal antibody test (Treponema pallidum latex agglutination) was positive in both cases (RPR: 18.2 RPR units, T. pallidum latex agglutination: 7718 U/mL). These findings suggested that the patient had been affected by a syphilis infection and that his suicidal behavior was associated with parenchymatous neurosyphilis.

DOI： 10.1097/PAF.0000000000000068

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In the medicolegal field, whether a victim was under the influence of ethanol at the time of an accident or injury is an important issue. However, trauma victims may have lost a large amount of blood, or received cardiopulmonary resuscitation or infusions of fluid or blood, making it difficult to interpret the ethanol concentration at the time of sampling. We, therefore, investigated changes in ethanol elimination in a rat model in which variations in circulating blood volume were induced by means of slow hemorrhage or infusion. Animals were divided into four experimental groups: hemorrhage (H), infusion (I), hemorrhage and infusion (H&I), and control (C). All rats were administered ethanol (1 g/kg body weight) intravenously over a period of 5 minutes. Blood (group C and group I: 0.2 ml, group H and group H&I: 0.5 ml/300gBW) was collected from rats in each group every 10 minutes for 4 h. Every 10 minutes after 30 minutes to 4 h of the ethanol administration, the rats in the infusion groups were administered saline (group I: 0.5 ml/300gBW, group H&I: 1.0 ml/300gBW). The concentration of ethanol in the blood samples was determined by using head-space gas chromatography. We found that the ethanol elimination rate did not differ between the groups, indicating that variations in body fluid due to bleeding or infusion have little to no effect on blood ethanol concentrations. Blood ethanol levels obtained after a prolonged state of shock or agonal, however, may need to be cautiously interpreted.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Rigor mortis is an important phenomenon to estimate the postmortem interval in forensic medicine. Rigor mortis is affected by temperature. We measured stiffness of rat muscles using a liquid paraffin model to monitor the mechanical aspects of rigor mortis at five temperatures (37, 25, 10, 5 and 0°C). At 37, 25 and 10°C, the progression of stiffness was slower in cooler conditions. At 5 and 0°C, the muscle stiffness increased immediately after the muscles were soaked in cooled liquid paraffin and then muscles gradually became rigid without going through a relaxed state. This phenomenon suggests that it is important to be careful when estimating the postmortem interval in cold seasons.

DOI： 10.1016/j.legalmed.2013.08.001

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Macroscopic findings of ligature marks are mainly affected by the characteristics of the ligature, the severity of external forces acting on the ligature, and the period that the neck has been pressed by the ligature. Therefore, the appearances of ligature marks formed by ligatures with the same characteristics differ depending on 2 factors: force and time. To examine which of these factors contributes more significantly to the macroscopic findings of ligature marks, a semiquantitative and experimental study using a murine model was performed. We experimentally made artificial ligature marks by hanging different sized weights using a vinyl band on dehaired legs of rats for different periods, both intravitally and postmortemly.After weights of 1, 3, and 6 kg with vinyl bands were hung on the legs of rats for 0 to 24 hours, the depths of ligature marks were semiquantitatively evaluated in 4 grades. Macroscopic examination and statistical analysis revealed that the appearance of ligature marks is not affected by whether they are formed intravitally or postmortemly but that it is equally affected by the severity of force and the duration of force application. We believe that the results of this study will be helpful to determine the characteristics of ligature and the period of hanging or strangulation time in the practice of forensic medicine.

DOI： 10.1097/PAF.0b013e31827d4f41

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

We describe a 50-year-old man who developed ventricular arrhythmia followed by cardiac arrest during laparoscopic distal gastrectomy. Preoperatively, there were no findings suggesting an ischemic heart disease. Anesthesia was maintained using sevoflurane combined with epidural anesthesia. His blood pressure, heart rate, and ECG waves were stable during the initial stage of laparoscopic procedure. After establishment of small laparotomy for stomach resection, the blood pressure decreased to before 60 mmHg without remarkable ST change on lead II. Administration of intravenous ephedrine was not effective and a short run appeared. Then persistent ventricular tachycardia followed by ventricular standstill developed. Chest compression and intravenous adrenalin restored sinus rhythm, and thereafter the patient remained hemodynamically stable with intravenous nitroglycerine and nicorandil. The operation was completed and the patient awoke without neurological deficits. Postoperatively the coronary angiography showed no stenosis of coronary arteries; however, when acetylcholine test was attempted on right coronary artery, paroxysmal ventricular fibrillation in accordance with spasm of #1 segmental coronary artery developed. In the case of abrupt onset of lethal arrhythmia, coronary vasospasm should be suspected even when ST changes are not recognized with routine ECG monitor.

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：日本語   出版者・発行元：(NPO)日本法医学会  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：日本語   出版者・発行元：法医学談話会  

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記述言語：日本語   出版者・発行元：(NPO)日本法医学会  

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