Λ dranees in Leg al Medici η e
PROCEEDINGS of The First international Symposium ADVANCES IN LEGAL MEDICINE
+ Edited by Taizo Nagano
October 11-15,1990 Kanazawa, Japan
Contents
C O M M E M O R A T I V E S P E C I A L L E C T U R E S
J . K o n d o ( J a p a n ) ·
Prediction of Science in 21st Century 1
H . M a n a b e ( J a p a n ) ·
Expectations for Forensic Medicine Approaching
the 21st Century 5
G. S c h m i d t ( F R G ) :
Advances in Forensic Medicine Towards the 21st
Century 11
W . J a n s s e n ( F R G ) :
Advances in Forensic Medicine and the Welfare of
Human Beings 20
S y m p o s i u m _ T h e m e I :
C O M P A R I S O N O F S Y S T E M S O F L E G A L
M E D I C I N E I N T H E W O R L D
P l e n a r y L e c t u r e s
Y . M i z o i ( J a p a n ) ·
Education, Research and System of Legal Medicine
in Japan 31
G. S c h e w e ( F R G ) :
The Structure and Educational System of
German Legal Medicine 34
I — 1 . I n s t i t u t i o n a n d P r a c t i c e
M . S . L . S a i g a d o ( S r i L a n k a ) •
Undergraduate and Post-Graduate Medico-Legal
Education and Practice in Sri Lanka 37
J . E . L . P i n t o d a C o s t a ( P o r t u g a l ) •
Medico-Legal Organization in Portugal 40
J . Ζ. Z h u , L . W a n g . ( P . R. C h i n a )
The Current System of Forensic Medicine
in the P. R. China 43
P. M . J a b l o n s k y ( C z e c h o s l o v a k i a ) :
History, Present Status and Future of
Legal Medicine in Slovakia 45
O. R o m o ( C h i l e ) ·
Psychiatric Forensic Expertise and Imputab i l i ty 48
G. S c h m i d t ( F R G ) :
Forensic Medicine As an Interdisciplinary
Subject 52
P. S a u k k o ( F i n l a n d ) ·
The Medico-Legal System in Finland 54
A . Pentt i lä, P . J . K a r h u n e n , M . T e n h u ,
E . V u o r i ( F i n l a n d ) ·
Deaths of Finns Abroad Revisited in Hels inki * 57
B . K n i g h t ( U n i t e d K i n g d o m ) :
The Ideal System of a Medico-Legal Service 60
R. B r e i t e n e c k e r ( U S A ) :
The Current Status of Legal Medicine
in the USA 62
J . T . J i a ( P . R. C h i n a ) :
On the Historical Development of
Forensic Medicine in China 65
T . F u k u n a g a , Y . U e n o , Κ. Y a m a m o t o , Y . M i z o i ,
S . H i s h i d a , Y . Y a m a m o t o , M . Y a m a d a ,
Y . T a t s u n o ( J a p a n ) ·
Statistical Analysis of Unnatural Deaths in Hyogo
and Shiga Prefectures—Comparison of the Results
of Inquests by Medical Examiners and by Others 68
— ii -
Y . K a t s u m a t a , J . N u d e s h i m a ( J a p a n ) ·
Unnatura l Deaths: A Comparison of Medico-
Legal Practices in Japan and the U.S.A. 71
I — 2 . E d u c a t i o n
M . S t a a k , B . M a d e a ( F R G ) :
Undergraduate and Postgraduate Teaching
of Forensic Medicine in West Germany 74
P. C h a n d r a S e k h a r a n ( I n d i a ) :
Medico-Legal Practice and Education in India 80
Z . M a r e k ( P o l a n d ) ·
Medical Error and Deontological Problems
in Undergraduate and Postgraduate Education
in Poland · 83
J . E . L . P i n t o d a C o s t a ( P o r t u g a l ) :
Portuguese Medico-Legal Education 88
T . C . C h a o ( S i n g a p o r e ) ·
Teaching of Forensic Medicine in Singapore 91
J . T . J i a ( P . R. C h i n a ) :
On the Medico-Legal Education in China 93
S . A l t e z a , J r . ( P h i l i p p i n e s ) ·
Medico-Legal Education in the Philippines 96
S . O s h i d a , Y . O h n o , S . U c h i g a s a k i ( J a p a n ) :
Video Relay System from Legal Autopsy Room
to Lecture Room 99
K . T e r a z a w a , H . A k a b a n e , B . W u , M . N a g a o ,
T . T a k a t o r i ( J a p a n ) •
Citat ion of Non-English Literatures - On the
Obstruction of Arteries by Typical Hanging 100
I — 3 . M e d i c a l L a w a n d E t h i c s
G . S c h e w e ( F R G ) :
Recent Trends in Medical Law in Germany 103
— iii —
Τ. K a n a g a w a ( J a p a n ) ·
The Present Situation of Informed Consent
in japan 108
A . L u n a , P . B a r r o s o ( S p a i n ) ·
Attitudes of Doctors towards Death, Euthanasia and
Informing Terminal Patients I l l
H. H a r a d a , N . F u r u m o t o , T . S h o u m a n , M . A . G r e e n
( J a p a n , U n i t e d K i n g d o m ) ·
Modeling and Estimation of Breath Alcohol
Concentration after Dr inking * 114
H. H a t t o r i , IM. Y a m a m o t o , J . F u r u n o ( J a p a n ) ·
Legal and Ethical Aspects of AIDS Affair
in Japan · 117
S y m p o s i u m - T h e m e II :
P R O B L E M S W I T H I N S U R A N C E A N D
C O M P E N S A T I O N A F T E R T R A U M A T I C I N J U R I E S
Π — 1 . S e q u e l a e o f T r a u m a t i c I n j u r i e s
W . E i s e n m e n g e r , G. B e i e r ( F R G ) :
Medical Insurance Problems after Trauma 121
T . T a k a t o r i ( J a p a n ) ·
Vehicle Collision Experiments at Low Speeds and
Medical Approaches 121
J . L i u , S . S o n g ( P . R. C h i n a ) ·
A Preliminary Study on the Applicat ion of Visual
Evoked Potential (VEP) in Forensic Practice 127
X . L i u , P. Y u , X . Z h o u , Y . Z h a n g ( P . R. C h i n a ) :
Evaluation of Audi tory Brainstem Response (ABR)
Applied in the Forensic Practice 130
P. D. N i a l l ( A u s t r a l i a ) :
Medical Tr ibunals in Workers Compensation
Disputes Developments in Austral ia · 133
— iv —
Μ. H a y a s h i d a , Μ. N i h i r a , Κ. H i r a k a w a ,
Ν. M o r i y a , Υ. T o m i t a , Τ. W a t a n a b e ( J a p a n ) ·
The Effect of Alcohol on Diagnosis, Severity
and Outcome of Injured Patients in
Traffic Accidents and Fall ing Vict ims 136
N. O h a s h i , M . D o i , S . M i s a w a , K . O n o ( J a p a n )
The Relationship between Impact Speed and
Injury Severity in Motorvehicle-
Pedestrian Accidents 139
Π — 2 . M e d i c a l C a r e o f I n j u r i e s a n d R e s p o n s i b i l i t y o f D o c t o r s
B . K n i g h t ( U n i t e d K i n g d o m ) :
The Medical Malpractice and
Negligence Situation in Bri tain 142
M . C . S . R i b e i r o , ( P o r t u g a l ) :
Road Traffic Accidents. Insurance and
Compensation 144
T . H i r a n u m a ( J a p a n ) :
Medical Care on Traffic Accidents
and Its Diagnostic Criteria * 147
C. W a k a s u g i ( J a p a n ) ·
Damages or Fatal Consequences of External
Injuries and Medical Treatment 151
S y m p o s i u m - T h e m e IB:
M O D E R N M E T H O D S F O R D E T E R M I N A T I O N
O F D E A T H
1 - 1 . T i m e o f D e a t h
C . H e n s s g e , B . M a d e a ( F R G ) ·
Estimation of the T ime since Death 155
G. B e i e r , E . T u t s c h r B a u e r , W . W i e s b b c k ( F R G ) :
Influence of Temperature on Rigor Mort is 159
— ν —
G. V a c c h i a n o , R. M a s s i n i , C . R o m a n o ( I t a l y ) ·
The Post-Mortem Demyelinization: A New Method
for Estimation of Time after Death 162
G. K a u e r t , W . E i s e n m e n g e r ( F R G ) ·
Experiences in Biochemical Diagnosis of Suicide
by Analyzing Serotonin in Cerebrospinal F lu id 167
A . S a w a g u c h i , J . K o t a n i , T . F u n a o , N . N a k a d a ,
A . K o s h i z a w a ( J a p a n ) ·
Death From Rapid Drowning: Findings of
Cerebral Blood Flow and Serum Haptoglobin 170
H . S u g i e , T . F u n a o ( J a p a n ) ·
Ultraviolet Spectrophotometry and HPLC of
Vitreous Humor for the Estimation of
Hours After Death 173
I — 2 . B r a i n D e a t h a n d O r g a n T r a n s p l a n t a t i o n
K. H o s h i n o ( J a p a n ) :
Bioethical Considerations on Brain Death and
Organ Transplantation - 176
M . F u k a y a , Y . S a s a k i , S . M u r a k a m i , T . N a g a n o ,
T . K a n a g a w a ( J a p a n ) '·
A Proposition Concerning the Brain Death
Act Legislation in Japan 179
B . K n i g h t ( U n i t e d K i n g d o m ) •
The Present Situation of Organ Transplanta t ion
in Great Bri tain 182
M . J . C a r n e i r o d e S o u s a ( P o r t u g a l )
Brain Death. The Problem in Portugal 184
D. - X . L i ( P . R. C h i n a ) :
Pathology of Brain Death 187
— v i —
J . I s h i s e , S . M u r a k a m i , J . Y a m a s h i t a ( J a p a n ) ·
Involuntary Movements after Brain Death:
Pathological Observations in
the Cervical Spinal Cord 190
Y . K i n o s h i t a , K . O k a m o t o , T . Y o s h i o k a ,
T . S u g i m o t o ( J a p a n ) ·
Long-Te rm Organ Preservation in Brain Death
Mainta ined w i t h Vasopressin and Catecholamine 193
R. B r e i t e n e c k e r ( U S A ) :
The Current Status of Organ Transplantat ion
in the USA 196
Y . T a t s u n o , T . F u k u n a g a , Y . Y a m a m o t o , M . Y a m a d a ,
M . K a n e , S . F u j i w a r a , J . A d a c h i , Y . M i z o i ( J a p a n ) ·
Neuropathological Studies on Brain Death 198
D. - X . L i ( P . R. C h i n a ) :
Pathology of Brain Death—Delayed Traumatic
Intracerebral Hematoma (DTICH) 201
S y m p o s i u m - T h e m e IV:
A D V A N C E S I N T H E F I E L D O F
F O R E N S i C P A T H O L O G Y
IV — 1 . A p p l i c a t i o n o f U l t r a m i c r o s c o p y a n d
E n z y m e " H i s t o c h e m i s t r y
V . S c h n e i d e r ( F R G ) :
Electoron Microscopy and Forensic Medicine 205
M . O e h m i c h e n ( F R G ) ·
Appl ica t ion of Immunohistochemisty in
Forensic Medicine 208
S . S h o u m u r a , S . E m u r a , M . U s t u m i , H . I s o n o ,
Y . B u n a i , I . O h y a ( J a p a n ) ·
Postmortal Changes of the Fine Structure
of the Liver 211
— v i i —
Μ. M o r i t a , Ν. T a b a t a ( J a p a n ) ·
The Morphological, Biochemical and
Immunohistochemical Studies on Asphyxia 214
T . K i t a , Y . F u r u y a ( J a p a n ) ·
Vasomotion of the Pulmonary Vessels During
Asphyxial Congestion 216
M . Y o s h i n o , T . K i m i j i m a , S . M i y a s a k a , H . S a t o ,
B . M i y a k e , S . S e t a ( J a p a n ) ·
Ultrastructural and Cytochemical Changes of
Rabbit Brain in Hypoxic State 218
N. K a w a g u c h i , M . M u k a i d a , M . S a i t o , M . O k a d a ,
N . Y a m a z a k i , Y . T a k a d a ( J a p a n ) ·'
The Ultrastructural Basis of Tinctor ia l
Change of Collagen Fibers in
the Damaged Dermis 221
Y. T a t s u n o , T . F u k u n a g a , Y . Y a m a m o t o , M . Y a m a d a ,
S . F u j i w a r a , Y . U e n o , Τ. S a w a g u c h i , Y . M i z o i ( J a p a n ) ·
Immunohistochemical Approach to
Alzheimer-Type Dementia 224
K. Y o s h i d a , Y . O g u r a , M . M a s u i , M . Y a m a z a k i ,
C . W a k a s u g i ( J a p a n ) ·
A Histochemical Study of Calmodulin in Dog
Myocardial Ischemia and Autopsy Cases of
Sudden Cardiac Death 227
A L u n a , E . O s u n a ( S p a i n ) ·
Are Biochemical Markers Necessary for
Post-Mortem Diagnosis of
Myocardial Infarction? 230
U . H e l l e r i c h ( F R G ) :
Lectin Histochemistry- A Helpful Method to
Differentiate Early Pregnant from
Non-Pregnant Endometrium 233
J . Ζ. Z h u , D. C. W a n g ( P . R. C h i n a ) :
Estimation of T ime of Injuries by
Microscopic Localization and Quantification of
Nonspecific Esterase 235
P. J . K a r h u n e n , A . P e n t t i l a , P . L e i n i k k i ,
H . B r u m m e r - K o r v e n k o n t i o , M . _ L . K a n t a n e n ,
M . N y b e r g ( F i n l a n d ) ·
Visually-Read Assay of the Vitreous Humour in
Rapid Screening for H I V in Necropsies 238
N . T a b a t a , M . M o r i t a ( J a p a n ) ·
Studies on Livor Mort is . On the Localization of
Hemoglobin in the Human Skin Tissue by
Immunohistochemistry 241
M . O g a t a , S . K u b o , O. K i t a m u r a , W . H i r o s e ,
I . N a k a s o n o , T . F u k u n a g a , Y . T a t s u n o ( J a p a n ) :
A n Immunohistochemical Demonstration of
Hemoglobin in the Kidney of Battered Children 243
T . F u k u n a g a , Y . Y a m a m o t o , M . Y a m a d a ,
Y . T a t s u n o , Y . M i z o i , A . Y a m a s h i t a ( J a p a n ) ·
Thymic Involut ion in Abused/Neglected Children 246
A . N i s h i m u r a , S . F u j i w a r a , Y . Y a n a g i d a ,
K . N a k a n i s h i , Y . M i z o i ( J a p a n ) ·
Cerebral Atrophy in Senile Dementia and
Normal Aging; A Quantitative Study Using Image
Analysing System * 249
O. K i t a m u r a , S . K u b o , M . O g a t a , M . I w a s a k i ,
W . H i r o s e , I . N a k a s o n o ( J a p a n ) ·
Histopathological Studies of Hypoxic and
Ischemic Brain Damage and its Applicat ion to
Forensic Autopsy Cases 252
— i x —
Τ. F u j i k u r a , Υ. K o m i n a t o , Η. T a k i z a w a ( J a p a n ) :
Forensic Applicat ion of Post-Mortem
Cerebral Angiography. 1. Subarachnoid Bleeding 255
S . T a k e i c h i , A . T s u j i , Y . S e t o , T . S a i t o ( J a p a n ) ·
Histological and Enzyme-Histochemical Studies on
Cardiac Sudden Death, Especially Acute Ischemic
Cardiac Disease * - 258
Y. U e n o , Κ. Y a m a m o t o , Τ. I m a b a y a s h i ,
Τ. F u k u n a g a , Y . M i z o i ( J a p a n ) :
Biogenic Amine Content of Human Carotid
Body in the Cases of Sudden Death 260
H . F u k u s h i m a , M . O t a , K . T a n a k a ,
H . H a s e k u r a ( J a p a n ) :
Using the Immunostaining Method and
the Polymerase Chain Reaction Ampli f ica t ion for
Identifying Mixed-up Formalin-Fixed,
Paraffin-Embedded Tissues 263
K. M a t s u u r a , Y . B u n a i , X . J i a n g , A . N a g a i ,
S . Y a m a d a , I . O h y a , H . S a w a d a ( J a p a n ) ·
Immunohistochemical Localization of Dihydrodiol
Dehydrogenases in the Lens and the Kidney 266
S . M i y a s a k a , T . K i m i j i m a , M . Y o s h i n o ,
H . S a t o , B . M i y a k e , S . S e t a ( J a p a n ) :
Immunohistochemical Demonstration of
A B H Blood Group Antigens in the Putrefied and
Dried Skin Fragments 269
W - 2 . P r e s e n t S t a t u s o f S I D S
A . T a k a t s u ( J a p a n ) :
Advances in Pathological Diagnosis of SIDS 272
G. S o r g o ( A u s t r i a ) ·
The Unexpected Sudden Death of
a Chi ld w i t h Unusual Pathological Findings 275
— x —
P. Μ. J a b l o n s k y , S . D l u h o l u c k y ( C z e c h o s l o v a k i a ) -
Present Status of SIDS in Central Slovakia 278
Y . M a t s u b a r a , K . N a r i s a w a ( J a p a n ) ·
Identification of a Common Genetic Mutat ion
Responsible for Sudden Infant Death Syndrome 280
Y . T s u d a ( J a p a n ) ·
Several Cases of Pediatric Forensic Study
— The Second Report of the Statistic and
Sociomedical Review on Sudden Infant and
Chi ld D e a t h - • 282
S y m p o s i u m - T h e m e V :
A D V A N C E S I N T O X I C O L O G I C A L A N A L Y S I S
V — 1 . D e t e r m i n a t i o n o f D r u g s a n d P o i s o n s i n T i s s u e s
H . Käferstein ( F R G ) :
Methodology of Drug Detection in Body Fluids 285
G. M a c h a t a ( A u s t r i a ) :
Sample Collecter (BSC 1) for
Volat i le Substances in the W o r k Environment 288
T . M i y a z a k i , F . C h i k a s u e , Μ. Y a s h i k i ,
Τ. K o j i m a ( J a p a n ) "
Carbon Monoxide Hemoglobin Saturations in
Left and Right Heart Blood from Cadavers not
Exposed to Fire or CO Gas 291
Y . Y a m a m o t o , K . Y a m a m o t o , Y . F u k u i ( J a p a n )
Teratogenic Effects of Methamphetamine 294
T . M a r c i n k o w s k i , K . B o r o w i a k , M . P a r a f i n i u k ( P o l a n d ) :
Microcrystals in the Toxicological and
Histological Analysis in Cases of Intoxication wi th
Ethylene Glycol · 297
— x i —
Η. S e n o , Ο. S u z u k i , Τ. K u m a z a w a , Μ. A s a n o ( J a p a n ) ·
Isolation of Medico-Legally Impor tan t Drugs wi th
SEP-PAK C i 8 Cartridges Using Chloroform as
Elut ion Solvent - 299
B . H u , M . L i u , Z . W a n g , Y . Y a n g , X . D e n g ,
G . L i , H . L i , Q. L i a n g , P . S u ( P . R. C h i n a ) :
Studies on Aconi t ine Toxicology 302
B . H u , K . Y u n , M . L i u , Z . W a n g ( P . R. C h i n a ) :
Toxicokinet ic Studies of Canthar id in in Rabbits 305
C. M o o r e , K . S a t o , H . H a t t o r i , Y . K a t s u m a t a ( J a p a n ) ·
The Determination of Cephalosporins
Using Super Microbore High Pressure L i q u i d
Chromatography-Mass Spectrometry · 308
J . A d a c h i , Y . T a t s u n o , Y . O g a w a , K . N a k a g a w a ,
Y . M i z o i ( J a p a n ) ·
Greenish Discoloration of Skin and
Format ion of Sulfhemoglobin Caused by
Hydrogen Sulfide Poisoning and Putrefaction 311
K. A m e n o , C . F u k e , S . A m e n o , T . K i r i u ,
T . S h i n o h a r a , K . S o g o , I . I j i r i ( J a p a n ) :
A Rapid and Sensitive Quant i ta t ion of
Ami t raz in Plasma by Gas Chromatography
W i t h Flame Thermionic Detection - 314
T . K i r i u , K . A m e n o , C . F u k e , S . A m e n o ,
T . S h i n o h a r a , K . S o g o , I . I j i r i ( J a p a n ) -
In V ivo and in V i t ro Studies of Regional Brain
Dis t r ibu t ion of Toluene 317
Y . K u r o i w a , K . A o k i , T . W a t a n a b e ,
Y . K u r o i w a ( J a p a n ) ·
Enzyme-Linked Immunosorbent Assay for
Methamphetamine, Morphine and Benzoylecgonine 320
— x i i —
Τ. N a g a n o , Τ. T a k a y a s u , Τ. O h s h i m a ,
Η. M a e d a ( J a p a n ) ·
A n Analyt ica l Method for Volatiles in
the Biological Materials by Pulse Heating 323
M . N i h i r a , K . H i r a k a w a , M . H a y a s h i d a ,
Y . T o m i t a , N . M o r i y a , T . W a t a n a b e ( J a p a n ) ·
Changes of Acetic A c i d Concentration of
Various Rat Tissues After Ethanol Injection 326
T . S h i n o z u k a , N . K u r o d a , T . M u r a i , S . T a k e i ,
K . K u r i h a r a , J . Y a n a g i d a ( J a p a n ) ·
Determination of Microamount of Mefenamic Ac id
by High Performance L i q u i d Chromatography 329
K. T e r a z a w a , L . J i , M . N a g a o , T . T a k a t o r i ,
K . A o k i , Y . H i r o s e , Y . K u r o i w a ( J a p a n ) ·
Production and Characterization of Monoclonal
Antibodies Reactive w i t h Methamphetamine
Raised Against a New Ant igen 332
M . T o m i t a , T . O k u y a m a , S . W a t a n a b e ,
B . U n o , S . K a w a i ( J a p a n ) ·
L i q u i d Chromatographic Determination of
Glyphosate and its Metaboli te i n Serum 335
G. H u a n g , Y . Z h a n g , L . L i , X . S u n g ,
Z . W a n g , L . Q i a o ( P . R. C h i n a ) ·
Toxicological Pathological Study of Lei
Gong Teng (Tr ip te ryg ium W i l f o r d i i Hook) 338
C . R o m a n o , A . M a l o r n i , A . A c a m p o r a ,
G . V a c c h i a n o , M . E s p o s i t o , R. D e M e r c a t o ·
Experiences in Legal Medicine about
Antiparassites Tox ic Substances and
Human N o u r i s h m e n t - 341
— x i i i —
V — 2 . E m e r g e n c y M e d i c i n e a n d F o r e n s i c T o x i c o l o g y
W . B o n t e ( F R G ) :
Advances in Congener Analysis • 3 1 1
K. K i m u r a , T . N a g a t a , K . K u d o , T . I m a m u r a ( J a p a n ) ·
Determination of Kerosene and
Light Oil Components in Blood 317
E. L o g e m a n n , C . Müller, Ε. K e l l e r ( F R G ) :
Pharmacokinetics of Diazepam in Patients
w i t h Nephrotic Syndrome 350
L . v . M e y e r , W . H a n i s c h , G. K a u e r t ,
G . D r a s c h ( F R G ) :
Determination of T H C in Blood by HPLC 353
M . N a g a o , H . S a i t o h , T . T a k a t o r i , K . I s e k i ,
K . T e r a z a w a , K . M i y a z a k i ( J a p a n ) '·
Transport Characteristics of Paraquat Across
Rat Intestinal Brush Border Membrane 356
C. F u k e , K . A m e n o , S . A m e n o , T . K i r i u ,
T . S h i n o h a r a , K . S o g o , I . I j i r i ( J a p a n ) ·
Simultaneous Determination of Paraquat and
Diquat in Biological Materials Using
Second-Derivative Spectroscopy and
High-Performance Liquid Chromatography 35<)
K. G o n m o r i , N . Y o s h i o k a ( J a p a n ) -
Effect of Mushroom Toxin on Biogenic Amines
of Rat Brain 362
K. H i r a k a w a , M . N i h i r a , M . H a y a s h i d a ,
N . M o r i y a , Y . T o m i t a , T . W a t a n a b e ( J a p a n )
Assesment of the Brain Lesions of the Rats on
Acute Ethanol Poisoning Using Magnetic
Resonance Imaging (MRI) 365
- x iv —
Τ. N a g a n o , Η. M a e d a , Τ. T a k a y a s u ,
J . N i s h i g a m i , Τ. O h s h i m a ( J a p a n ) ·
Screening and Quantitation of Drugs and
Poisons in Blood and Urine in Emergency
Medical Care and Legal Autopsy Cases 368
K. S a t o , Y . M i z u n o , C. M . M o o r e , K . T a m a k i ,
Y . K a t s u m a t a ( J a p a n ) '·
Storage of Blood for Methemoglobin Determination:
Effect of Various Buffers on the Storage
of Hemolysates 371
I . Y a m a m o t o , T . M a t s u n a g a , H . K o b a y a s h i ,
K . W a t a n a b e , H . Y o s h i m u r a ( J a p a n ) ·
Pharmaco-Toxicity of p-Coumaroyltyramine and
Feruloyltyramine in Marihuana 374
K. Y a m a z a k i , E . T a n a k a , N . S h i m o j o ,
S . M i s a w a ( J a p a n ) ·
The Validi ty of Measurements of Locomotor
Act iv i ty as Evidence of Exposure to Toluene 377
S y m p o s i u m - T h e m e VI:
M E T H O D O L O G Y I N F O R E N S I C S E R O L O G Y A N D
S T A I N A N A L Y S I S
VI — 1 . S e r o _ G e n e t i c P r o c e d u r e s
P. H o o f t , H . v a n d e V o o r d e ( B e l g i u m ) ·
The Zinc Spot Test as a Tool for the Primary
Identification of Human Seminal Stains 381
R. l i d a , T . Y a s u d a , D. N a d a n o , K . K i s h i ( J a p a n ) ·
Intensification of Peroxidase-Diaminobenzidine
Staining Using Gold-Sulfide-Silver: A Simple and
Highly Sensitive Detection Method for
Immunoblot t ing 384
— x v -
Y. F u r u s a w a , Υ. U c h i m u r a , S . T s u n e n a r i ( J a p a n ) ·
Forensic Biology of Human Hepatic Bile:
Its Applicat ion to the Determination of Species
Specificity and ABO Blood Type of Feces 387
S . K u b o , M . I w a s a k i , O. K i t a m u r a , M . O g a t a ,
I . N a k a s o n o ( J a p a n ) ·
The Effect of Soil Fungi on Changes in
the Specificity of the ABO Blood Groups and
on the Degeneration of Hair 390
Y. T a m a k i , T . K i s h i d a ( J a p a n )
Experience w i t h Ant i -Mouse IgG/Anti-Peroxidase
Bispecific Monoclonal Ant ibody in ELISA and
Dot Immunobinding for G M T y p i n g 393
M . W u , Z . J i n ( P . R. C h i n a ) :
Phenotyping of GC in Human Semen Stains
Using IEF Followed by Enzyme Immunoassay 396
T . M a t s u k i , T . N a k a j i m a , K . F u r u k a w a ( J a p a n ) ·
Applicat ion of A n t i - H Active Antibodies and
Lectins to the Detection of
Human Blood Group Η Substances 399
T . K o g u r e , M . S a g i , Y . K u w a k i , K . Y a m a z a k i ,
M . K i t a h a m a ( J a p a n ) ·
Detection and Act iv i ty of Blood Group A and
Β Gene-Encoded Glycosyltransferases in Human
Seminal Plasma and Cerebrospinal f luid 402
S . I t o . K. M a t s u i , K . S u z u k i , H . M a t s u m o t o ,
Y . M i z o i ( J a p a n ) ·
A Simple Extraction Procedure for ABO Group
Typ ing of Bloodstain by Dot ELISA Method 405
— x v i —
Κ. S o d e s a k i , Α. K i m u r a , Τ. T s u j i
F . M a t s u m u r a ( J a p a n )
Cell Surface ELISA for Detection of A n t i - A B O and
A n t i - M N Blood Group Antibodies 108
Ρ. Κ. C h a t t o p a d h y a y , Μ. Κ. T h a k k a r ( I n d i a )
ABO Blood Groups from Hair I l l
A . K i m u r a , M . O s a w a , S . Y a s u d a ,
H . I k e d a , T . U d a , S . N a k a s h i m a
M . O h t a , T . T s u j i ( J a p a n ) ·
On Monoclonal Antibodies to Epitopes Specific
for Species in Primates 415
T . N a g a n o , T . O h s h i m a , H . M a e d a ,
Y . F u j i o k a ( J a p a n ) ·
Species Identification of Minute Bloodstains by
Simultaneous Precipitin Reactions in
an Agarose Gel after Electrophoresis 418
B. W a n g , J . J i a , D. C h e n ( P . R. C h i n a )
On the Species Discrimination of Animal Bloodstains
by Polyacrylamide Gel Isoelectrofocusing 421
J . G u o , A . F a n ( P . R. C h i n a ) -
Determination of Phenotypes of
Salivary Amylase in Saliva and Saliva Stains by
IEF and Silver Staining 424
K. A k i y a m a , Y . I t o , H . K i m u r a ( J a p a n ) :
Characterization of a New Protein Which Binds
Act in in Seminal Plasma and Saliva 427
H. M a t s u m o t o , T . F u k a e , S . K u b o , O. K i t a m u r a ,
M . I w a s a k i , I . N a k a s o n o , M . O g a t a ( J a p a n )
Subtyping of the Group Specific Component (Gc) in
Semen and in Seminal Stains 430
- x v i i -
S . A b e , Κ. H i r a i w a ( J a p a n ) -
New Form of r -Glutamyl Transpeptidase in
Human Seminal Plasma and It's Application
to Forensic Medicine · 433
K. S u z u k i , S . I t o , H . M a t s u m o t o ,
Y . M i z o i ( J a p a n ) ·
Three Hereditary Subtypic Patterns detected in
the Ba Fragment of Complement Factor Β 435
S . N a k a m u r a , K . O m o t o , O. O h u e ,
K. Y a m a s h i t a , J . O c h i , K . A k i y a m a ,
A . S a w a g u c h i ( J a p a n ) ·
C1R Polymorphism in the Japanese Population 438
H . N i s h i m u k a i , K . S h i n o m i y a ,
T . S h i n o m i y a ( J a p a n ) :
Genetically Controlled Variants of
Ant i th rombin III 441
Κ. U m e t s u , i . Y u a s a , T . S u z u k i ( J a p a n ) ·
Orosomucoid (ORM) Typ ing by Isoelectric Focusing:
Effect of Protease Treatment and
Stability in Bloodstains ·*· 4 4 1
I . Y u a s a , K . U m e t s u , N . N a k a y a s h i k i , N . T a m a k i ,
H . S h i o n o , K . O k a d a ( J a p a n ) -
Orosomucoid (ORM) T y p i n g by Isoelectric Focusing:
An Improved Method for ORM1 Subtyping and
the Reactivity of An t i -Human ORM
Antibodies w i th Animal ORM 447
A . T a m u r a , K . S u z u k i , S . I t o , H . M a t s u m o t o ,
Y . M i z o i ( J a p a n ) ·
Two-Dimensional Polyacrylamide Gel Electrophoresis
Analysis of Postmortem Change in Brain Proteins 450
— x v i n —
S . I k e m o t o , Ε. K a j i i , A . T a k e t o m i , Ε. F u k u i ,
Y . K a m i t a n i , K . T o m i t a ( J a p a n ) ·
Transformation of Genetic Markers in Blood wi th
B M T and Problems in Legal Medicine 453
V I - 2 . D N A P o l y m o r p h i s m s
Κ S u l l i v a n , P. G i l l ( U n i t e d K i n g d o m )
The Potential Use of PCR in Forensic Analysis 456
K. S u z u k i , S . I t o , H . M a t s u m o t o , Y . M i z o i ( J a p a n ) ·
Restriction Fragment Length Polymorphisms
Associated w i t h Immunoglobulin Gamma Switch
Regions in Man 459
I . S a k a i , K . K a s a i , K . Y o s h i d a , H . M u k o y a m a ,
S . S e t a ( J a p a n ) :
DNA Analysis Using Single Locus V N T R Probes
and Its Applicat ion to the Individualization of
Human Bloodstains 462
C. R i t t n e r , L . B r a u n _ H e i m e r ,
P. M . S c h n e i d e r ( F R G )
The Use of PCR-Amplif ied DNA in
Paternity Testing and Stain Analysis · · — — * — ^-465
T . Y o k o i , M . N a t a , Y . A o k i , K .
S a g i s a k a ( J a p a n ) :
Contribution of DNA Analysis on Paternity Test 468
C. R i t t n e r , U . S c h a c k e r , G. R i t t n e r ,
B . H o l t k a m p , Ε. B o h n k e , Η. Η. S o n n e b o r n ,
P. Μ. S c h n e i d e r ( F R G ) :
DNA Polymorphisms in Paternity Testing:
The Use of Minisatelli te Probe M Z 1.3 in Incest,
Deficiency, Antenatal and Postmortem Cases 471
— x i x —
Μ. O t a , Η. I n o k o , Α. I c h i n o s e , Κ. T s u j i ,
Η. F u k u s h i m a , Η. H a s e k u r a ( J a p a n ) ·
Applicat ion of Modified PCR-RFLP Method
in Forensic Science 17 1
S . H a r a d a , T . N a k a m u r a , S . M i s a w a ( J a p a n ) :
Investigation of DNA Polymorphism by
Amplif icat ion Strategy 177
Y. Y a n g , X . W u , C. L u o , X . L i u ( P . R. C h i n a ) :
Differentiation of Sex Origin of
Bloodstains by Dot Hybridization w i t h
Y-Chromosome Specific Probe · 180
M . N a k a i , F . M o r i y a , Y . H a s h i m o t o , H . I s h i z u ,
R. N a n i k a w a ( J a p a n ) ·
Sex Identification from Contaminated Human
Bloodstains by DNA Analysis 183
Y. Y a m a m o t o , A . N a k a n i s h i , H . I s h i z u ( J a p a n ) ·
Sex Determination of Forensic Biological
Materials by Polymerase Chain Reaction (PCR) 18(>
M . W u , G. S u n ( P . R. C h i n a ) :
Sex Determination of Hairs by Analysis of
Amplif ied DNA Sequences 189
K. H o n d a , S . H a r i h a r a , T . N a k a m u r a , M . H i r a i ,
S . M i s a w a ( J a p a n ) ·
Identification of a Dead by DNA Extracted from
a Fragment of Bone or a Single Tooth 192
T . R. K u m a r i , P . C h a n d r a S e k h a r a n ( I n d i a ) :
Authentici ty of DNA Fingerprinting 495
E. N a i t o , K . D e w a , M . F u k u d a , H . Y a m a n o u c h i ,
R. K o m i n a m i ( J a p a n ) '·
Α PCR Method for Species Identification - 4 9 8
- X X -
Μ. Y a m a d a , Τ. F u k u n a g a , Υ. Y a m a m o t o ,
Κ. K u r o k a w a , Η. U e y a m a , I . O h k u b o ,
J . O c h i , Y . T a t s u n o ( J a p a n )
Detection of DNA Polymorphisms by
Using PCR Method and Its Application to
Forensic Identification 499
M L W u , G . S u n ( P . R. C h i n a ) :
Appl ica t ion of the Polymerase Chain Reaction
in Forensic Science Practice 502
A . A k a n e , K . M a t s u b a r a , H . S h i o n o , S . T a k a h a s h i ,
Y . N a k a h o r i , M . Y a m a d a , Y . N a k a g o m e ( J a p a n ) ·
Forensic Appl ica t ion of Hyper-Variable DNA
Polymorphisms and Sex Determination
by Polymerase Chain Reaction 504
A . F . V u o r i o , A . S a j a n t i l a , T . H a m a l a i n e n ,
A " C . S y v ä n e n , L . P e l t o n e n ,
C . E h n h o l m ( F i n l a n d ) :
Ampl i f i ca t ion of the Hypervariable Region of
the Apol ipoprote in Β Gene: A Suitable Method
for Solving Forensic Problems ·-—·•———·———·—«..«.-.-· 507
K. T a m a k i , T . Y a m a m o t o , R. U c h i h i ,
Y . K a t s u m a t a ( J a p a n ) ·
Dis t r ibu t ion of H L A - D Q A 1 Genotypes in
the Japanese Population · 510
C. L u o , X . W u , H . D u , Y . Y a n g ,
X . L i u ( P . R. C h i n a ) :
The Study on DNA RFLPs Detected by p A W l O l
Probe in the Population of Guangdong, China 513
T . Ro thämel , W . K e i l , Η. D. Tröger ( F R G ) :
D N A - P r o f i l i n g w i t h VNTR-Probes - Allel ic
Frequencies of Hinf l -RFLPs Detected by
pHINS310, pMUC7 and pMR24/ l 516
— x x i —
F r e e T h e m e
Α. G a r m u s ( U S S R ) :
Pelvis Bones Sexing by Inspectional Method 5 1 9
T h . R i e p e r t , C h . R i t t n e r ( F R G ) :
Importance of Identification of Corpses by
X-Ray Comparison * 522
R. N e s h i g e , Y . K u r o d a , R. K a k i g i , F . F u j i y a m a ,
R. M a t o b a , K . T a k a d a ( J a p a n ) ·
Electroencephalography as an Objective Index
of Photograph Recognition. Appl ica t ion to
Simulated Criminal Investigation 525
N. O g u r i ( J a p a n ) '·
Rapid Discrimination Method for the A n i m a l Fats
Using Pyrolyzer-Gas Chromatograph · 528
A u t h o r I n d e x 5 3 1
— x x i i —
MEDICAL INSURANCE PROBLEMS AFTER TRAUMA
W. Eisenmenger and G. Beier
Medical insurance problems after trauma are due both to
the national p a r t i c u l a r i t i e s of insurance law and to
d i f f i c u l t i e s in proving the medical f a c t s . The l a t t e r are
identical world-wide and known to a l l doctors of forensic
medicine, therefore, only the legal aspects of insurance
medicine in the Federal Republic of Germany w i l l be discussed
hereafter.
Due to the fact that already more than 100 years ago social
insurance was introduced in our country and that our economy
i s f l o u r i s h i n g , s o c i a l security in case of injury and death
after accidents i s good. Problems result from the coexistence
of different kinds of h i s t o r i c a l l y established insurances,
from the legal f i e l d s competent for these insurances and
the special concepts of causality in these legal f i e l d s .
In addition to the statutory accident insurance foreseen
within general s o c i a l insurance there i s personal accident
insurance. In case of dispute regarding statutory accident
insurance, the matters are brought before a Social Court,
for the l a t t e r - personal accident insurance - the c i v i l
courts are competent. In so c i a l law the person insured i s
obliged to provide evidence, however, there the requirements
to be met regarding the proof of causality are not very
high. A probable connection between trauma and damage i s
s u f f i c i e n t , i . e . in case there are more things which speak
for i t than against i t .
I f there i s more than one condition concurring as a cause
of damage, then the most important condition i s decisive.
In case a trauma worsened a physical ailment not caused
by an accident such that death occurred, then causality
i s f u l f i l l e d i f the l i f e expectancy was reduced by at least
one year.
- 1 2 1 -
The social accident insurance covers accidents at work as
well as those which occur on the way to work and on the
way back home. Accidents caused by negligence are also
covered but not those caused by gross negligence. This mainly
applies to those kinds of accidents where alcoholization
i s one of the major conditions.
Other accidents apart from those occurring at work can be
covered by personal accident insurance. Each owner of a
motor bike, e.g. has to take out third-party l i a b i l i t y
insurance. Disputes are settled by c i v i l law which e n t a i l s
that the person who i s maintaining something also has to
prove i t . The theory of causality d i f f e r s from that in s o c i a l
law: I t i s not su f f i c i e n t that an incident factually causes
damage but - according to the general experience of l i f e
- t his incident must also normally be apt to cause such
damage. These kinds of insurances do not cover intoxications,
diseases caused by mental influence, by high-energy rays,
effects of l i g h t , temperature and weather nor damage caused
by apoplectic stroke, cramp f i t , fainting or attacks of
vertigo or by mental disturbance or disturbance of
consciousness e.g. neither those caused by alcoholization.
I f , in addition to this natural internal diseases contributed
by more than 25% to the death, then the insurance benefit
can be reduced accordingly.
These complicated legal rules necessitate a number of medical
expert opinions. The l a t t e r deal in particular with questions
relating to causality in the simultaneous presence of natural
deseases and traumatic damage, with the significance of
existing alcoholization and with self-caused r i s k increase
- especially when in case of a t r a f f i c accident a seat belt
was not put on although this i s mandatory in our country.
Regarding this topic our i n s t i t u t e carried out an extensive
f i e l d study of seriously injured or k i l l e d persons who had
put on a seat b e l t . The result of this study i s now used
as a basis for many expert opinions. The questions of the
courts concentrate on the evaluation, whether i t can be
established by means of the i n j u r i e s incurred that no belt
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was worn and what kind of i n j u r i e s could then have been
avoided had a belt been worn.
Address:
W. Eisenmenger and G. Beier
I n s t i t u t e for Forensic Medicine of the University of Munich
Frauenlobstrasse 7a, D-8000 München 2
Federal Republic of Germany
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