Shizuyuki Sugiyama

A sudden death case of laryngocele accompanied by infarction of the dorso-lateral portion of the medulla oblongata

A 70-year-old man, who had a laryngeal tumor discovered by otolaryngological examination during admission for suspicion of facial nerve paralysis was found dead in his bed on the seventh hospital day. Clinical doctors aspirated a large amount of mucous sputum from his larynx during their attempt at resuscitation. Although the direct cause of death was clinically unknown, an autopsy revealed an internal type laryngocele, a type of laryngeal cyst, in the right larynx and infarction of the left dorso-lateral portion of the medulla oblongata. Suffocation resulted from mucous sputum filling his larynx, which had been narrowed by a laryngocele from the right, in an unfortunate association with movement disturbance of the left larynx caused by the infarction of the left dorso-lateral portion of the medulla oblongata. We assumed this to be the direct cause of death, because the heart and lungs showed no remarkable changes that could be ascribed to it. This case offers important suggestions concerning the risks of suffocation due to laryngeal cysts, especially in patients with complications.

An autopsy case of a charred body which committed suicide after arson

A severely burned body was found lying on its right side at the scene of the fire in a 2-story wooden apartment house. The presence of a ligature (an electrical cord) running horizontally around the neck aroused suspicion of arson after homicidal strangulation (murder-arson). The entire body was severely burned and partly charred. The head and neck were severely charred, and the left temporal bone had been consumed exposing the brain. Around the neck was looped an electrical cord, which ran horizontally and canted downward toward the nape, leaving a furrow resulting from the knot being tightened up. No other injuries or pathologic lesions suggestive of the cause of death were noted. No drug, poison or alcohol was detectable in the blood or urine. The peculiar method of making a noose of the ligature around the neck is called clove hitch, which makes the noose tighten further with increased load. The fallen curtain rod had a bend with an acute angle, which was considered to have been the point of suspension in hanging. In addition, a lighter was found under the corpse, which was presumably used to ignite the gasoline that the deceased sprinkled. We speculate, therefore, that the deceased hanged himself by placing the electrical cord around his neck (by clove hitch), suspending it from the curtain rod, sprinkling gasoline in his room, igniting it with a lighter, executing suicidal hanging after the start of the fire. Probably the body was wrapped in flames while dangling, then fell to the floor together with the collapsing curtain rod.

Determination of ABO blood grouping from human oral squamous epithelium by the highly sensitive immunohistochemical staining method EnVision

Using the highly sensitive immunohistochemical staining method EnVision+, which employs a dextran polymer reagent for the secondary antibody, the detection of the ABH antigens was attempted in the oral squamous epithelium. This new technique uses monoclonal antibody as a primary antibody and it takes about three hours for staining. The time is much shorter than conventional absorption-elution testing or absorption-inhibition testing for the determination of ABO blood grouping. Secretor saliva samples were stained at strong intensity by the antibody, which corresponded to its blood group and anti-H. On the one hand, nonsecretor saliva samples were stained at strong intensity only by the antibody that corresponded to its blood group, and at weak intensity only by anti-H. Since human oral squamous epithelium antigens were stained specifically by this method, we can examine the ABO blood group of saliva samples and perform cytodiagnosis at the same time. Our research suggested that the EnVision+ Method is a useful technique for ABO blood grouping of saliva in forensic cases.

Estimation of age by epidermal image processing

Small pieces of human precordial skin were obtained from 266 individuals during autopsy performed in Osaka Prefecture. The area from the stratum corneum to the stratum basale in a unit area of the epidermal cross-section was extracted as a segmented area of white image by image processing. The number of pixels surrounding this area was measured in individuals of various ages, and the age-associated changes were evaluated. The number of pixels around this binary image in the epidermal cross-section showed a strong correlation with age. The number tended to decrease with an increase in age in individuals aged 20 years and above, which could be closely approximated by an exponential function. A formula for estimating age was obtained as an inverse function of the number of pixels and age, and the accuracy of estimation using this formula was examined by comparing the estimated age with the actual age. Such age-associated changes in the epidermis were considered to be closely related with increased roughening of the stratum basale, flattening of dermal papillae, and a decreased percentage of the stratum granulosum per unit area of epidermis observed by light microscopy or scanning electron microscopy.

Presumption of a suspect based on the skin fragment attached the rope

An eight-year-old girl (second-year of elementary school) was strangled in an irrigation canal near her house and was left unconscious. The body of a male who hanged himself to death was discovered on the next day. The hanging mark on the neck of the man and the ligature mark on the neck of the girl were caused by double nooses of a rope, the width of the rope mark was nearly the same, and similar Zwischenkammblutung (subcutaneous bleeding in the middle of the rope mark) was observed in both cases. Therefore, we evaluated whether the marks were caused by the same rope. As a result, the DNA type of the skin fragment (keratinized epithelial cells) attached to the rope used by the man to hang himself was identical to that of the girl. On the basis of this evidence, the man who hanged himself to death was presumed to be the suspect who strangled the girl.