Publications (26)57.08 Total impact
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Article: Potential medical adverse events associated with death: a forensic pathology perspective.
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ABSTRACT: To determine the incidence of potential medical adverse events among patients undergoing forensic autopsy, and to present the characteristics of potential medical adverse events. Retrospective review of consecutive autopsy records. Department of Forensic Medicine, the Jikei University School of Medicine, Tokyo, Japan. A total of 3355 forensic autopsy cases between 1983 and 2006. Incidence of potential medical adverse events identified in decedents undergoing forensic autopsy, classified by actual occurrence as 'confirmed', 'equivocal' and 'negative' cases; proportion of potential diagnostic, performance and system errors among potential medical adverse events. Of 291 autopsies (8.7%) with potential medical adverse events, 66 cases (22.7%) were confirmed, 42 cases (14.4%) were negative and 183 cases (62.9%) were equivocal. Confirmed cases consisted of potential diagnostic errors in 49 cases (74.2%) and performance errors in 17 cases (25.8%). Equivocal cases included 99 cases associated with potential diagnostic errors (54.1%) and 60 cases associated with potential system errors (32.8%). In 38 of the confirmed cases (57.5%), serious exacerbation of patient condition occurred outside the medical facility. Potential medical adverse events are not uncommon in decedents undergoing forensic autopsy. They are particularly associated with potential diagnostic errors. Forensic autopsy may provide information that could be used to improve care and reduce deaths due to potential medical adverse events.International Journal for Quality in Health Care 12/2009; 22(1):9-15. · 1.96 Impact Factor -
Article: A novel method for the diagnosis of drowning by detection of Aeromonas sobria with PCR method.
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ABSTRACT: The acid digestion method has been widely used for the diagnosis of death by drowning, but it is not always sensitive. However, there has been no definitive method to replace acid digestion until now. We speculate that bacteria are more useful markers than plankton for the diagnosis of death by drowning. In this study, from the preserved blood samples of 32 freshwater drowning cases, specific DNA fragments of Aeromonas sobria, one of the most common aquatic bacteria, were examined using PCR. The DNA fragments of the bacterium were detected from 27 of 32 cases with first round PCR or nested-PCR. The remaining 5 cases in which bacterial DNA was not detected had longer storage periods for the blood samples and shorter time intervals from drowning to death. These results indicate that the present method can be applied to the diagnosis of death by drowning.Legal Medicine 09/2009; 11(6):257-9. -
Article: Effects of polymorphisms in untranslated regions of the class I alcohol dehydrogenase (ADH) genes on alcohol metabolism in Japanese subjects and transcriptional activity in HepG2 cells.
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ABSTRACT: Human class I ADH is a dimmer formed by the random association of three types of subunits (alpha, beta and gamma) encoded by ADH1A, ADH1B, and ADH1C, respectively. Different kinetic properties were reported due to polymorphisms of ADH1B Arg47His and ADHIC Ile349Val. Besides these polymorphisms in the coding region, various mutations in the promoter region and 3' untranslated (UTR) region, which possibly affect expression and degradation rate, were recently reported. In this study, to asses the involvement of each genotype in alcohol metabolism in humans, our previously collected data set of blood EtOH and AcH changes were reanalyzed with regard to the ALDH2 Glu487Lys genotype. The effects of genotypes and haplo-types on transcriptional activity were also examined by a luciferase reporter assay by cloning the promoter region and 3' UTR corresponding to each polymorphism and transfecting into HepG2 cells. Among the nine polymorphisms, including ADH1B Arg47His and ADH1C Ile349Val, blood EtOH levels were significantly affected by polymorphisms ADH1B -451G>T, ADH1B +52A>G, ADH1B +531G>A, ADH1B +1176AG>del. and ADH1A -55C>T in ALDH2 Glu/Glu subjects. In the ALDH2 Glu/Lys genotype background, only ADH1C -254G>C and ADH1B His47Arg showed significant effects on blood EtOH. These five loci (and the two loci which had significant effect on blood EtOH in ALDH2 Glu/Glu and Glu/Lys subjects) also showed strong linkage disequilibrium. In comparison to the in vivo study on alcohol metabolism, significantly higher transcriptional activities in ADH1B -451T (rather than C) promoter and ADH1C-254 G (rather than C) promoter were observed in a luciferase assay in HepG2 cells. In conclusion, polymorphisms in the untranslated regions of ADH class I genes were demonstrated to clearly affect individual differences in alcohol metabolism. Especially, ADH1B -451G>T, ADH1C-254G>C polymorphisms were suggested to have functional significance with regard to transcriptional activity to the linkage equilibrium of polymorphisms ADH1B His47Arg and ADH1C Ile349Val.Nihon Arukōru Yakubutsu Igakkai zasshi = Japanese journal of alcohol studies & drug dependence 07/2009; 44(3):139-55. -
Article: Polymorphisms in the promoter region of the human class II alcohol dehydrogenase (ADH4) gene affect both transcriptional activity and ethanol metabolism in Japanese subjects.
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ABSTRACT: Class II alcohol dehydrogenase (pi-ADH), encoded by alcohol dehydrogenase (ADH4), is considered to contribute to ethanol (EtOH) oxidation in the liver at high concentration. Four single nucleotide polymorphisms (SNPs) were found in the promoter region of this gene. Analysis of genotype distribution in 102 unrelated Japanese subjects revealed that four loci were in strong linkage disequilibrium and could be classified into three haplotypes. The effects of these polymorphisms on transcriptional activity were investigated in HepG2 cells. Transcriptional activity was significantly higher in cells with the -136A allele than in those with the -136C allele. To investigate whether this difference in transcriptional activity caused a difference in EtOH elimination, previous data on blood EtOH changes after 0.4 g/kg body weight alcohol ingestion were analyzed. When analyzed based on aldehyde dehydrogenase-2 gene (ALDH2) (487)Glu/Lys genotype, the significantly lower level of EtOH at peak in subjects with -136C/A and -136A/A genotype compared with subjects with -136C/C genotype indicated that -136 bp was a suggestive locus for differences in EtOH oxidation. This effect was observed only in subjects with ALDH2 (487)Glu/Glu. These results suggested that the SNP at -136bp in the ADH4 promoter had an effect on transcriptional regulation, and that the higher activity of the -136A allele compared with the -136C allele caused a lower level of blood EtOH after alcohol ingestion; that is, individuals with the -136A allele may consume more EtOH and might have a higher risk for development of alcohol dependence than those without the -136A allele.The Journal of Toxicological Sciences 03/2009; 34(1):89-97. · 1.52 Impact Factor -
Article: A promoter polymorphism in the ALDH2 gene affects its basal and acetaldehyde/ethanol-induced gene expression in human peripheral blood leukocytes and HepG2 cells.
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ABSTRACT: To assess the effect of the -360G/A polymorphism in the promoter region of the human aldehyde dehydrogenase-2 (ALDH2) gene on its transcription, basal and acetaldehyde/ethanol-induced gene expression was examined by in vivo and in vitro experiments. Human peripheral blood leukocytes were collected before and after alcohol ingestion (0.4 g/kg body weight) in 21 healthy young Japanese volunteers with a deficient phenotype of ALDH2 ((487)Glu/Lys), and the levels of ALDH2 mRNA were quantified by real-time RT-PCR. The transcriptional activity of the ALDH2 promoter was investigated by a reporter assay using HepG2 cells in the presence or absence of acetaldehyde/ethanol. The basal level of ALDH2 mRNA was significantly higher in -360A heterozygous subjects than in -360G homozygous subjects. In all subjects, regardless of the genotype, ALDH2 mRNA increased following ethanol ingestion. The promoter activity of a reporter plasmid for -360G was significantly lower than that of a reporter plasmid for -360A. Exposure to acetaldehyde induced a significant increase in the transcriptional activity of the -360G reporter, but not the -360A reporter. In vivo and in vitro experiments showed that the -360G allele has lower basal transcriptional activity than the -360A allele, whereas acetaldehyde/ethanol-induced gene expression, in general, seems to be more enhanced in individuals homozygous for the -360G allele than in those with the -360A allele. Thus, the promoter polymorphism may be involved in individual differences in acetaldehyde elimination.Alcohol and Alcoholism 02/2009; 44(3):261-6. · 2.95 Impact Factor -
Article: [Causative factors as cues for addressing the rapid increase in suicide in Mie Prefecture, Japan: comparison of trends between 1996-2002 and 1989-1995].
Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica 01/2009; 111(7):733-40. -
Article: Effects of functional polymorphisms related to catecholaminergic systems on changes in blood catecholamine and cardiovascular measures after alcohol ingestion in the Japanese population.
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ABSTRACT: The polymorphism of human aldehyde dehyrogenase-2 (ALDH2) Glu(487)Lys is well known to be a crucial factor underlying the genetic background for alcohol sensitivity in Asian populations. Subjects with the inactive Lys(487) allele show a marked increase in blood acetaldehyde level after alcohol intake, which results in facial flushing and various cardiovascular-related symptoms. However, other polymorphisms related to catecholaminergic systems that tightly regulate the activity of the sympathetic nervous system may also influence the physiological changes after acute alcohol intake. We investigated whether, together with the ALDH2 Gly(487)Lys and ADH1B Arg(47)His genotype, putative functionally important polymorphisms, including 9 loci in 7 human genes, were associated with changes in blood catecholamine levels and cardiovascular measures after alcohol ingestion. Forty-nine young Japanese males were subjected to blood catecholamine analysis after alcohol ingestion. Among them, 28 were also subjected to heart rate variability and blood pressure analysis. The contribution of polymorphisms to the alcohol-induced response was analyzed by multiple regression analysis. Among the polymorphisms examined in this study, haplotypes of the phenylethanolamine N-methyltransferase (PNMT) promoter [(-182bpG/A)_(-387bpG/A)] and catechol-O-methyltransferase (COMT) exon 4 [(Ex4 + 119bpC/G)_(Ex4 + 138bpG/A), Leu(136)Leu_Val(158)Met] are suggested to have functionally important effects on alcohol-induced cardiovascular symptoms by affecting blood catecholamine levels. The neuropeptide Y (NPY) promoter C-1450T genotype is also suggested to be involved in the individual differences in regulation of catecholamine secretion. This study suggested that these common polymorphisms of genes related to catecholaminergic systems, as well as those of the alcohol metabolizing system, are significant for understanding the basis of individual differences in alcohol sensitivity.Alcoholism Clinical and Experimental Research 09/2008; 32(11):1937-46. · 3.34 Impact Factor -
Article: Respiratory disease and temperature are correlated with suicide in Mie Prefecture, Japan.
Journal of Forensic and Legal Medicine 09/2008; 15(6):409-10. · 1.10 Impact Factor -
Article: The report in the correlation between the factor of unemployment and suicide in Japan.
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ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.The American journal of forensic medicine and pathology: official publication of the National Association of Medical Examiners 06/2008; 29(2):202-3. · 0.71 Impact Factor -
Article: The risk factors of suicide by poisoning among psychiatry department outpatients.
Journal of Forensic and Legal Medicine 02/2008; 15(1):65-7. · 1.10 Impact Factor -
Article: The tendency of suicide among the elderly in Mie Prefecture, Japan.
Journal of Forensic and Legal Medicine 02/2008; 15(1):64. · 1.10 Impact Factor -
Article: The importance of the frequency of suicide attempts as a risk factor of suicide.
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ABSTRACT: The number of suicides in Japan has increased from approximately 22,000 per year in 1988-1997 to over 30,000 per year since then. The number has also increased in Mie Prefecture during this period. According to many reports, suicide attempts are one of the risk factors of suicide. In the present study, we investigated the incidences and circumstances of all suicide cases between 1996 and 2002, focusing in detail on the frequency of suicide attempts and general differences in the frequency of all suicide cases. During the 7 years, 1979 male and 969 female suicides were reported to Mie Prefectural Police Headquarters. During the test period, there were suicide attempts in 13.4% of all suicidal cases, 10.7% for men and 18.9% for women. The average age was 48.98 years (SD 17.68), 47.07 years (SD 16.32) for men, and 51.19 years (SD 18.89) for women. Among men, we discovered the risk factors of suicide attempts in completed suicides, which were "single time" of suicide attempts, "living with family" for the family constitution, and "visiting treatment" of the admission statuses. Among women, the risk factors were "living with family" and "visiting treatment". We must pay attention to those risk factors.Journal of Forensic and Legal Medicine 02/2008; 15(1):24-6. · 1.10 Impact Factor -
Article: The correlation between rates of unemployment and the suicide rate in Mie Prefecture, Japan.
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ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.The American journal of forensic medicine and pathology: official publication of the National Association of Medical Examiners 01/2008; 28(4):369-70. · 0.71 Impact Factor -
Article: Sudden death due to undiagnosed acute promyelocytic leukemia: a case report.
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ABSTRACT: Acute promyelocytic leukemia (APL) is associated with severe hemorrhagic coagulopathy induced by the release of procoagulant, plasminogen, and protease from leukemic cells. The case described in this report is of a 15-year-old male who unexpectedly died due to a cerebral hemorrhage caused by underlying APL within 12 h after presentation. This case suggests that underlying APL should be considered as a differential diagnosis when sudden death occurs with a fatal spontaneous hemorrhage, although it is rare.Deutsche Zeitschrift für die Gesamte Gerichtliche Medizin 08/2007; 121(4):311-4. · 2.59 Impact Factor -
Article: The correlation between unemployment and suicide rates in Japan between 1978 and 2004.
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ABSTRACT: The number of suicides in Japan has increased from approximately 22,000 per year from 1988 to 1997 to over 30,000 per year since then; this increase is among the most important problems facing Japan. Moreover, the unemployment rate in Japan has increased rapidly since 1998. In this study, we examined the total number of suicides and both the suicide and unemployment rates in Japan from 1978 to 2004. We also focused on the correlation between annual suicide rates in Japan and the annual unemployment rates during the study period. During that period, 455,357 males and 225,012 females committed suicide in Japan, and the suicide rates by sex were 27.8 males and 13.3 females per 100,000 population (P<0.05). The annual suicide rates among males correlated significantly with the annual unemployment rates: r(27)=0.94, P<0.001, while the female suicide rates did not correlate with the unemployment rates: r(27)=0.39, P=0.05. Thus, when unemployed men are observed to be depressed, it is important for those close to them, as well as their health care professionals, to pay careful attention to their behavior to detect suicidal tendencies or intentions.Legal Medicine 06/2007; 9(3):139-42. -
Article: Suicidal tendencies among the elderly in Mie Prefecture, Japan, between 1996 and 2002.
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ABSTRACT: This study aims to show the causative factors of suicide among the elderly (over 65) in Mie Prefecture, and to discuss the prevention of the factors contributing to suicide in the elderly group. We obtained an agreement from the Mie Prefectural Police Headquarters and investigated all inquest records collected between 1996 and 2002 in Mie Prefecture and focused on suicide in the elderly group. During the test period, the number of suicides in the elderly group was 842. In causative factors, the two major causative factors of suicide were "suffering from physical illness" and "psychiatric disorders". In particular, the three most frequent physical illnesses were "cardiovascular disease", "orthopedic disorder", and "digestive organ disease", and these physical illnesses are mentally stressful, and thus have a psychiatric component, the same as psychiatric illnesses do. Consequently, it is concluded that improvements in the home nursing and mental health care should include the prevention of suicide in the elderly who "suffer from physical illness" and "psychiatric disorders" to prevent suicide. In addition, medical staff and the general public should be educated on the factors that can influence elderly persons' mental condition, and should be cautioned to observe elderly persons for suicidal signs and symptoms.Legal Medicine 06/2007; 9(3):134-8. -
Article: The correlation between rates of unemployment and suicides rates in Japan between 1984 and 2003.
Journal of Forensic and Legal Medicine 06/2007; 14(4):238-9. · 1.10 Impact Factor -
Article: Risk factors, diagnosis and prevention of sudden unexpected infant death.
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ABSTRACT: The diagnosis of the cause of sudden unexpected infant death (SUID) is often difficult work for forensic pathologists. Its misdiagnosis or misclassification is the cause of crucial epidemiological and medicolegal problems. During the sudden infant death syndrome (SIDS) epidemic, many reports described the risk factors of SIDS as well as mechanical suffocation during sleep. Meadow's report has invited worldwide debate over whether the cause of SUID is attributable to SIDS or suffocation. On the basis of this background, the problems concerning causal diagnosis and risk factors, particularly the accidental suffocation of infants during sleep, and the specific pattern of suffocation, was reviewed from the forensic pathological viewpoint. The following tasks remain to be done for the future: (1) to avoid preventable SUIDs, the most effective measure worldwide is to identify high-risk factors for all SUIDs, including SIDS, accidental suffocation and undetermined causes, and then transmit this information to the public. (2) SIDS should be uniformly defined and diagnosed as strictly as possible to gain its reliability in the public health community and in a legal framework.Legal Medicine 04/2007; 9(2):76-82. -
Article: A correlation between increases in suicide rates and increases in male unemployment rates in Mie prefecture, Japan.
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ABSTRACT: The number of suicides in Japan has increased from approximately 22,000 per year in 1988-1997 to over 30,000 per year since then. It has also increased in Mie prefecture during that period. In the present study, we investigated the correlation between annual suicide rates in Mie prefecture, Japan from 1996-2002 and the annual unemployment rate in Japan from 1996-2002 among males. Among the results, annual suicide rates in total correlated with the unemployment rate in Japan, but the relation was not statistically significant: r(7)=0.76, r(2)(7)=0.58, p=0.05 (y=3.54x+6.37); the rates in males, however, correlated significantly with the unemployment rate in Japan: r(7)=0.85, r(2)(7)=0.73, p=0.01 (y=5.72x+4.49). In addition, we found that annual suicide rates in total correlated significantly with the male unemployment rates. When a patient is unemployed and in a bad situation, the medical staff and the family should be aware of the correspondence between suicide rates and unemployment.Industrial Health 02/2007; 45(1):177-80. · 0.94 Impact Factor -
Article: Significant correlation of yearly suicide rates with the rate of unemployment among men results in a rapid increase of suicide in Mie Prefecture, Japan.
Psychiatry and Clinical Neurosciences 01/2007; 60(6):781-2. · 2.13 Impact Factor
Top co-authors
Top Journals
Institutions
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2009
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Kanazawa University
Kanazawa-shi, Ishikawa-ken, Japan
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2006–2009
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Kanazawa Medical University
- Department of Hygiene
Kanazawa-shi, Ishikawa-ken, Japan
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2008
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Osaka City University
Ōsaka-shi, Osaka-fu, Japan -
The Jikei University School of Medicine
Tokyo, Tokyo-to, Japan
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2005–2008
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Mie University
- Department of Psychiatry
Tsu-shi, Mie-ken, Japan
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