Legal medicine tokyo journal

Asphyxial deaths remain one of the most important areas of investigation of a forensic pathologist.
On the very first page of the book, the author defines asphyxia very aptly - it is in very broad sense a condition in which an abnormality in the arterial blood gases (hypoxemia or hypercapnia) occurs due to a disruption in breathing mechanics, so that the host can no longer maintain normal activities.
Six different methods were employed to asphyxiate these animals and various blood constituents studied after that. Tracheostenotic cannula is again an extremely interesting device (and something of which I for one, heard for the first time!). This is how the cannula is inserted in the animal (This picture does not appear anywhere in the book. Then there is a last group of animals in which the death was caused by compression of major blood vessels and the nerves of the neck.
Abnormal arterial blood gas contents and acid-base equilibrium in acute asphyxia caused by tracheal obstruction pressure. Regarding the depth of study the authors have done on blood gases in asphyxial deaths, I am reproducing just one table on the left. So are we moving towards an era, where in doubtful cases, a pathologist could just order a few routine blood tests (of the corpse) and write out the cause of death?
In December, 2013, Japan National Tourist Organization (JNTO), a governmental body under the Ministry of Land, Infrastructure, Transport, and Tourism released the statistics based on the number of international conventions held in different cities in Japan.
In addition, the number of participants of international conventions held in the City increased by 80,000 from the previous year, amounting to the largest number of 171,049 in total. 2012 was a significant year for Fukuoka City to boost its presence as an international MICE City.
Fukuoka City aims to reinforce its global competitiveness to further attract conventions by consolidated efforts in services as well as in infrastructure. OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members. Regenerative medicine sounds like something from science fiction: using lab-grown cells to replace or repair failing organs and spinal injuries and giving hope for treating hitherto incurable conditions and diseases. In November 2013 the Diet revised the Pharmaceutical Affairs Law and enacted the Regenerative Medicine Law, thereby reforming the organization of regenerative medicine in Japan.
In response to numerous questions from overseas, I explained the new system to Harvard University, the National Institutes of Health, the Institute of Medicine (IOM) and the National Academy of Sciences (NAS) in the US.
The Pharmaceutical Affairs Law aims to guarantee the safety and effectiveness of medicines and medical equipment in Japan, so what impact can it have on the rest of the world to warrant so much interest? Because regenerative medicine is a new technology, internationally, it generally takes longer to approve it for use than for other medicines.
Meanwhile, the new Regenerative Medicine Law regulates regenerative medicines whose effectiveness and safety has not yet been established.
Riding a train in a Japanese city, you can look out the window and see billboards advertising regenerative medicine beauty clinics and their claims for reviving aged skin. At US workshops sponsored by the IOM and NAS cases were cited where clinics have grown cells, made them into cell sheets and used them as cosmetic face packs. Because of this, some people are traveling to countries with looser or no regulations to receive treatment as medical tourists, which is a big problem in terms of safety. Japan's regulation of regenerative medicine has hitherto been loose, which had attracted people from countries with strict regulations, such as South Korea.
Cases like this have caused the world to distrust Japanese regenerative medicine as a whole, which necessitated swift corrective measures as Japan is trying to push stem cell research forward. Stem cell technology makes it possible to create all types of cells, and in having the goals of creating cells and creating organs, is expected to become an extremely useful tool.
There are two types of cells used for these treatments: those taken from the patient being treated (autologous stem cells) and those taken from a different person (allogenic stem cells). Initially, regenerative medicine is expected to provide new treatments for hitherto incurable diseases and broaden treatment options for diseases that offer a scarcity of them.
In Japan there is a great deficiency in donor organs for transplant, so people are talking about a dream for a future where regenerative medicine may enable the creation of various bodily organs for use as transplants. Also, for patients with weakened heart muscles from heart attacks, experiments are being conducted with ‘cell sheets' made from stem cells that can be applied to the heart to rehabilitate the pumping function. Additionally, during the process of experimenting with regenerative medicine, possibilities for treatments beyond organ regeneration may arise, such as for patients with brain hemorrhages or spinal injuries who were thought to be without hope of recovery. Hitherto most pharmaceuticals have been chemical compounds, which has made quality stable and led to set methods for their evaluation. Meanwhile, medical equipment is primarily made of metal and electronic circuits and it is fairly simple to evaluate its capabilities, notwithstanding the technical ability of the doctors who use it. However, with regenerative medicine it is no simple thing to mass produce identical products as you can with chemical products. The most important problem with the cell culturing process is with cells becoming cancerous; if there is one cancerous cell among the thousands of cells being cultured there is a danger that cancer will occur in the patient being treated. In particular, the cells used in regenerative treatments for Japan's dominant method of autologous stem cell transplants are extremely unstable and non-homogenous, which makes conducting scientific evaluations of their effectiveness and safety difficult. On the other hand, the allogenic stem cell transplant method favored in the West is able to produce comparatively stable and homogenous treatments, which enables scientific evaluation, although this evaluation is time consuming.
Some believe that with new technological advances there is a possibility that immuno-suppressive drugs will cease to be necessary for conducting allogenic stem cell transplants.
The inspection standards set by the American FDA for regenerative stem cell treatment are extremely high and place the strongest emphasis on safety inspections.

With a specialized approval system for regenerative medicine the effectiveness of treatments can be anticipated, and if proven safe they will go on to have a global impact.
As global competition in regenerative medicine intensifies there is clearly a need for stronger public-private frameworks to support projects like this. With Japan's new structure for regenerative medicine, it is necessary for relevant ministries to create a framework for more unified support and to merge their related budgets, make an effort to hire the best personnel, and create exit strategies for projects while managing their progress. Why not also consider establishing foundations for collecting public-private funding and private donations? The author is a surgeon who has been involved in numerous innovations, including in the revision of the Pharmaceutical Affairs Law at the Ministry of Health, Labor and Welfare.
In balmy weather at the end of March, a pigeon cleans itself beneath blossoming cherry trees shading a river.
Very few attempts have been made to define diagnostic criteria for pathological diagnoses in forensic pathological practice (criteria for traumatic basal subarachnoid haemorrhage by Leadbeatter being one such example).
The publication of this book was supported in part by a grant from the Ministry of Education in Japan. A number of post-mortem findings have been attributed to asphyxial deaths, such as cyanosis, petechial haemorrhages, congestion and oedema of internal organs, fluidity of blood and engorgement of the right side of the heart1 , but these have been vehemently challenged by a number of pathologists, foremost among them being Bernard Knight2 .
Funded in part by a grant from the Ministry of Education in Japan, this book is based mainly on the work of the author herself. She has taken rabbits and dogs and has asphyxiated them experimentally in a number of ways.
The methods were (i) Pressure on trachea (ii) Asphyxiator (iii) Tracheostenotic cannula (iv) Hanging (v) Strangulation and (vi) Compression of nerves and blood vessels. Instead, by an elaborate surgical procedure the trachea of the animals was exposed which was then occluded by applying pressure with a pair of haemostatic forceps.
Details of how they were hanged are not provided (on page 92, the authors just say that "apparatus for head fixation and hanging..
This was also achieved by first exposing these structures by an elaborate surgical procedure and then directly clamping them.
Well, we will have to wait and see, but what I definitely can say, that about a century ago, one would have refuted this assertion vehemently in relation to clinical diagnosis.
Anyone with an interest in forensic pathology - students, forensic practitioners, death investigators, biochemists. It is essential to read this journal - and especially this review as it contains several tables and high resolution graphics - under a screen resolution of 1600 x 1200 dpi or more. Anil Aggrawal, Professor of Forensic Medicine, at the Maulana Azad Medical College, New Delhi-110002. But although it is gradually becoming realistic, traditional medical standards for testing safety and effectiveness are difficult to apply. The revised law will reduce the time required to evaluate their safety, permitting the effectiveness of treatments to be anticipated more quickly than in the past, ensuring faster effective deployment. Before its introduction insufficient regulation in Japan allowed some regular clinics take up the practice of regenerative medicine. At present, clinics like these, which use regenerative medicine whose efficacy and safety is unproven, abound. Governments in the US and most other advanced countries are strictly regulating this practice. Unfortunately, this led to one case where a Korean died suddenly upon returning home following treatment at a clinic in Kyoto.
Under the new law these risks have been reduced, and the world is now watching to see what we can do in regenerative medicine.
Shinya Yamanaka, who received the 2012 Nobel Prize in Medicine for his work with stem cells. This is why the development of this branch of medicine is so highly anticipated by so many.
Non-homogenized products also have less consistent effects, with different people having varying reactions.
However, because of problems with patients' bodies rejecting cells or organs made from allogenic stem cells, some are of the opinion that scientifically evaluated autologous stem cell transplants would be ideal.
Furthermore, some have expressed concerns that the risk of developing cancer will increase with the use of stem cells and it is well nigh impossible to guarantee 100 percent safety. However, many of the patients seeking regenerative treatment have serious or incurable diseases, and some are very vocal in asking why they can't receive treatment using their own cells in their home country. Masayo Takahashi of the Riken Kobe Institute and venture firms such as Helios are at the center of preparations for a first-in-human trial in patients with age-related macular degeneration, a serious condition of the retina, due to start in early 2014. With Helios working to treat macular degeneration, the Greek myth where the blinded Orion is healed by the god Helios may end up coming true! Prime Minister Shinzo Abe appointed him to the Cabinet Secretariat Office for Healthcare and Medical Strategy in November 2013. The distribution of forensic journals, reflections on authorship practices, peer review and the role of impact factor.
A diagnostic crietria approach has been attempted in surgical histopathology by Tadrous, and it is hoped that such a compendium will be produced in forensic pathology in due course.
Over the years she has conducted a number of elegant experiments on animals and has amassed an amazing wealth of data on the pathophysiology of asphyxial deaths.
Acute asphyxia is said to occur when the time interval between the onset of asphyxia till death ranges from a few minutes to a little over ten minutes.

2 represents the site where a canula or probe is installed for insertion into the carotid artery. In addition a control group was killed by four different methods - by cyanide, strychnine, air embolism and by blows to the neck.
The tube can be surgically inserted in the trachea in such a way that the little nozzle juts out (please refer to accompanying figure).
As Busutill quite rightly points out in his review of this book, these "carefully controlled experimental designs.. The authors have studied an amazing array of biochemical markers including serum proteins, glycoproteins, serum enzymes and isozymes, blood sugar, hormone levels, and blood lipids. At that time the quartet of inspection, palpation, percussion and auscultation was the holy grail of correct diagnosis, but how many clinicians routinely employ it today?
But the ones who are really going to love this book will be those, who plan to reproduce this study in their own labs, and may be take this work further. In an attempt to make standards that reflect this reality and to accelerate new breakthroughs, Japan recently changed and created relevant laws, as Dr.
Regenerative medicine is a treatment that involves cultivating human cells outside of the body, changing or reproducing them, and then introducing them into a patient.
Since, this controversy is not likely to be over soon, many pathologists started looking at other directions for diagnosis of asphyxia - one of them being the search for a perfect "chemical marker".
Most of her work has been published either in the Journal of the Tokyo Women Medical College or in Japanese Journal of Legal Medicine, which is not surprising as she hails from the Tokyo Women's Medical University, Japan. Typical examples are hanging, complete ligature strangulation, and complete airway closure by any other means. As she explains on page 42, an animal had to be chosen, that could withstand the experimental conditions without anesthesia, and rabbits seemed to suit the bill very well. Of these the strychnine group gave several findings similar to those of asphyxia, as strychnine in large amounts is known to paralyze the respiratory center and this effect can be construed as equivalent to asphyxiation. For the rabbits, this was an airtight box measuring 25x40x25 cm (capacity 25 L) and made of clear resin, and for the dog it measured 30x60x30 cm (Capacity 54 L).
Other things studied are the dynamics of body fluid and acid-base equilibrium, serum electrolytes, blood gases, CSF gases and acid-base equilibrium and partial pressures of the gases contained in the brain, liver and kidney tissues. They are just happy to order blood tests, X-rays and other investigations at the drop of a hat without an iota of doubt that they will miss out something. It is strongly advised to switch over to this resolution to read this journal - and especially this review. Is there a "chemical marker" in the body, the presence of which would strongly point to death by asphyxia?
In subacute asphyxia the duration of survival is more than ten minutes as in incomplete airway closure or airway narrowing and delayed death from drowning.
Dogs were chosen for a selected number of purposes only - as for the estimation of blood sugar after asphyxia - because "antibodies may be used in these animals for insulin analysis related to carbohydrate metabolism" (page 81). It could be hermetically sealed by attaching highly elastic rubber pieces to the sections where the main body and its cover came in contact.
To the nozzle can be attached a small vinyl bag (see the figure below) through which 3,400 to 5,000 ml of air could be delivered in strictly measured quantities.
Regarding the results, the reader may want to explore the book himself, but I will give just a sampling here. This book attempts to provide all that valuable data to the English speaking world for the first time. Asphyxia of a still longer duration (typically between 50 and 183 minutes, as the author informs us at several places in her book) results in adaptive and compensatory responses. The typical survival time for the animals in this box was about 2 to 2.5 hours, which mimicked chronic asphyxiating conditions in a closed room. Things could be so arranged, that the animal could be made to breathe either through the nose - in which case, it had to overcome the resistance of the stenotic part of the cannula, although the supply of air remained unlimited - or through the vinyl bag - in which case there was no resistance, but the supply of air was limited. The authors found that the serum total protein level rises immediately after lethal asphyxia which they ascribe to "condensation of the blood during the asphyxial process" (pages 49-50). As can easily be seen, while the latter case simulates locking up in a room, the former corresponds more to conditions like hanging and strangulation.
Although the total protein rises, there is a reduction in the alpha-1 and gamma globulin fractions and an increase in the albumin fraction and alpha-2 and beta globulin fractions.
All her work has to be seen in the context of these definitions set out by her in the beginning. The typical survival period in the latter (in which the animal was made to breathe from air in the vinyl bag) was less than 60 minutes, while in the latter case it was between 50-183 minutes. The authors ascribe the increase in the albumin fraction to the "escape of blood components as a consequence of acidosis ..
Similarly they found an increase in calcium in asphyxial deaths, especially those due to strangulation, and this they ascribe to the pressure on the parathyroid gland!

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