1.Comparison of CT Values between Thrombus and Postmortem Clot Based on Cadaveric Pulmonary Angiography.
Zhi-Ling TIAN ; Ruo-Lin WANG ; Jian-Hua ZHANG ; Ping HUANG ; Zhi-Qiang QIN ; Zheng-Dong LI ; He-Wen DONG ; Dong-Hua ZOU ; Mao-Wen WANG ; Zhuo LI ; Lei WAN ; Xiao-Tian YU ; Ning-Guo LIU
Journal of Forensic Medicine 2023;39(1):7-12
OBJECTIVES:
To explore the difference in CT values between pulmonary thromboembolism and postmortem clot in postmortem CT pulmonary angiography (CTPA) to further improve the application value of virtual autopsy.
METHODS:
Postmortem CTPA data with the definite cause of death from 2016 to 2019 were collected and divided into pulmonary thromboembolism group (n=4), postmortem clot group (n=5), and control group (n=5). CT values of pulmonary trunk and left and right pulmonary artery contents in each group were measured and analyzed statistically.
RESULTS:
The average CT value in the pulmonary thromboembolism group and postmortem clot group were (168.4±53.8) Hu and (282.7±78.0) Hu, respectively, which were lower than those of the control group (1 193.0±82.9) Hu (P<0.05). The average CT value of the postmortem clot group was higher than that of the pulmonary thromboembolism group (P<0.05).
CONCLUSIONS
CT value is reliable and feasible as a relatively objective quantitative index to distinguish pulmonary thromboembolism and postmortem clot in postmortem CTPA. At the same time, it can provide a scientific basis to a certain extent for ruling out pulmonary thromboembolism deaths.
Humans
;
Autopsy
;
Thrombosis
;
Pulmonary Embolism/diagnostic imaging*
;
Tomography, X-Ray Computed
;
Angiography
;
Cadaver
2.Changes of 1, 5-AG in Vitreous Humor of Rabbit Cadavers with Hyperglycemic Metabolism.
Fang-Fang LIU ; Hui WU ; Wei WANG ; Ying XIE
Journal of Forensic Medicine 2023;39(1):13-17
OBJECTIVES:
To investigate the concentration and change characteristics of 1, 5-anhydroglucitol (1, 5-AG) in the vitreous humor of rabbit cadavers with hyperglycemic metabolism, and to explore the value of 1, 5-AG in forensic pathology identification of death caused by hyperglycemic metabolism disorders.
METHODS:
A diabetic hyperglycemic rabbit model was established by using alloxan. Eighteen rabbits with fasting glucose concentration ≥13.80 mmol/L (experimental group) and 18 healthy rabbits with fasting glucose concentration ≤6.10 mmol/L (control group) were selected. After death from air embolism. The blood samples were collected immediately, and vitreous humor samples were collected at 0 h, 12 h, 24 h and 36 h after death. The concentration of 1, 5-AG in the blood and vitreous humor of rabbits was determined.
RESULTS:
The blood glucose concentration in the experimental group was (25.10±3.14) mmol/L. At the time of death, there was no significant difference in the concentration of 1, 5-AG in the blood [(0.94±0.20) μg/mL] and in the vitreous humor (0.99±0.05 μg/mL, P>0.05). The concentration of 1, 5-AG in the vitreous humor of the experimental group was lower than that of the corresponding control group at all time points (P<0.05), and there was no significant difference betwwen 1, 5-AG concentration in vitreous humor between earch time point in the experimental group and the control group (P>0.05). Correlation analysis showed that the concentration of 1,5-AG in blood was negatively correlated with blood glucose in both control group and experimental group (control group: r=-0.79, P<0.05; experimental group: r=-0.97, P<0.05).
CONCLUSIONS
Vitreous humor can replace blood as an effective test sample for 1,5-AG detection. The concentration of 1, 5-AG in rabbit vitreous humor remains stable within 36 hours after death and is not affected by the change of postmortem interval. If the concentration of 1, 5-AG decreases significantly, it indicates the existence of hyperglycemia in rabbits before death.
Animals
;
Rabbits
;
Blood Glucose/metabolism*
;
Postmortem Changes
;
Vitreous Body/metabolism*
;
Cadaver
;
Autopsy
3.Utilizing ultra-small volume graft in auxiliary liver transplantation for portal hypertension.
Zhi Jun ZHU ; Lin WEI ; Hai Ming ZHANG ; Wei QU ; Zhi Gui ZENG ; Li Ying SUN ; Ying LIU
Chinese Journal of Surgery 2023;61(3):220-226
Objective: To examine the clinical effect of auxiliary liver transplantation with ultra-small volume graft in the treatment of portal hypertension. Methods: Twelve cases of portal hypertension treated by auxiliary liver transplantation with small volume graft at Liver Transplantation Center,Beijing Friendship Hospital, Capital Medical University between December 2014 and March 2022 were studied retrospectively. There were 8 males and 4 females,aged 14 to 66 years. Model for end-stage liver disease scores were 1 to 15 points and Child scores were 6 to 11 points. The grafts was derived from living donors in 9 cases,from split cadaveric donors in 2 cases,from whole cadaveric liver of child in 1 case. The graft recipient body weight ratios of 3 cadaveric donor livers were 0.79% to 0.90%, and of 9 living donor livers were 0.31% to 0.55%.In these cases, ultra-small volume grafts were implanted. The survivals of patient and graft, complications, portal vein blood flow of residual liver and graft, abdominal drainage and biochemical indexes of liver function were observed. Results: All the grafts and patients survived. Complications included outflow tract torsion in 2 cases, acute rejection in 1 case, bile leakage in 1 case, and thyroid cancer at the later stage of follow-up in 1 case, all of which were cured. The torsion of outflow tract was attributed to the change of anastomotic angle after the growth of donor liver. After the improvement of anastomotic method, the complication did not recur in the later stage. There was no complication of portal hypertension. The measurement of ultrasonic portal vein blood flow velocity showed that the blood flow of residual liver decreased significantly in the early stage after operation, and maintained a very low blood flow velocity or occlusion in the long term after operation, and the blood flow of transplanted liver was stable. Conclusions: Auxiliary liver transplantation can implant ultra-small donor liver through compensation of residual liver. This method may promote the development of living donor left lobe donation and split liver transplantation. However, the auxiliary liver transplantation is complex, and it is difficult to control the complications. Therefore, this method is currently limited to centers that are skilled in living related liver transplantation and that have complete ability to monitor and deal with complications.
Male
;
Child
;
Female
;
Humans
;
Liver Transplantation/methods*
;
End Stage Liver Disease/surgery*
;
Retrospective Studies
;
Living Donors
;
Severity of Illness Index
;
Neoplasm Recurrence, Local
;
Liver/blood supply*
;
Hypertension, Portal/surgery*
;
Portal Vein
;
Cadaver
4.Anatomical relationship between the brachiocephalic trunk and the trachea and the clinical implications.
Jian ZHAO ; Ruxue WANG ; Zeyin NIE ; Feng WU ; Wenjuan LI ; Chenyu LI ; Huaibin LI
Journal of Southern Medical University 2023;43(6):970-974
OBJECTIVE:
To observe the anatomical features and relative position of the brachiocephalic trunk and the trachea to provide an anatomical basis for diagnosis and treatment of mechanical airway obstruction and for facilitating the performance of tracheotomy.
METHODS:
A total of 91 formalin- fixed adult cadavers (70 male and 21 female) were used in this study. The whole length of the larynx and the trachea were separated and exposed from the neck to the chest, followed by separation of the aortic arch and its 3 branches to observe the anatomical position of the brachiocephalic trunk and the trachea.
RESULTS:
The brachiocephalic trunk and the trachea did not intersect in 3.30%, partially intersected in 71.43%, and completely intersected in 25.27% of the 91 cadaveric specimens. The male specimens all showed greater outer diameter of the aortic arch, the brachiocephalic trunk and the trachea with a greater length of the trachea than the female specimens (P < 0.05), while the distances from the aortic arch to the brachiocephalic trunk or the cricoid cartilage did not differ significantly between them (P > 0.05). The number of the tracheal cartilage rings above the brachiocephalic trunk ranged from 3 to 10, and the mean number did not differ significantly between the male and female specimens (P > 0.05).
CONCLUSION
The brachiocephalic trunk has complex anatomical relationship with the trachea, and caution should be taken to avoid injuries of the brachiocephalic trunk and the aortic arch in the diagnosis and treatment of mechanical respiratory obstruction and during tracheotomy.
Adult
;
Female
;
Male
;
Humans
;
Trachea
;
Brachiocephalic Trunk
;
Larynx
;
Cadaver
;
Formaldehyde
5.Modified Latarjet splitting subscapularis muscle under arthroscopy: an anatomical study based on axillary nerve, glenoid, and subscapularis muscle.
Xinzhi LIANG ; Daqiang LIANG ; Zhihe QIU ; Sheng LI ; Bing WU ; Hao LI ; Gang HUANG ; Wei LU ; Denghui XIE ; Haifeng LIU
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(5):556-560
OBJECTIVE:
To testify the spatial relationship between the subscapularis muscle splitting window and the axillary nerve in modified arthroscopic Latarjet procedure, which could provide anatomical basis for the modification of the subscapularis muscle splitting.
METHODS:
A total of 29 adult cadaveric shoulder specimens were dissected layer by layer, and the axillary nerve was finally confirmed to walk on the front surface of the subscapularis muscle. Keeping the shoulder joint in a neutral position, the Kirschner wire was passed through the subscapularis muscle from back to front at the 4 : 00 position of the right glenoid circle (7 : 00 position of the left glenoid circle), and the anterior exit point (point A, the point of splitting subscapularis muscle during Latarjet procedure) was recorded. The vertical and horizontal distances between point A and the axillary nerve were measured respectively.
RESULTS:
In the neutral position of the shoulder joint, the distance between the point A and the axillary nerve was 27.37 (19.80, 34.55) mm in the horizontal plane and 16.67 (12.85, 20.35) mm in the vertical plane.
CONCLUSION
In the neutral position of the shoulder joint, the possibility of axillary nerve injury will be relatively reduced when radiofrequency is taken from the 4 : 00 position of the right glenoid (7 : 00 position of the left glenoid circle), passing through the subscapularis muscle posteriorly and anteriorly and splitting outward.
Adult
;
Humans
;
Shoulder
;
Rotator Cuff/surgery*
;
Arthroscopy/methods*
;
Scapula/surgery*
;
Shoulder Joint/surgery*
;
Cadaver
;
Joint Instability/surgery*
6.Task-oriented learning in head and neck anatomy using virtual, formalin-preserved, soft-embalmed, and plastinated cadavers
Ryner Jose D. Carrillo ; Karen June P. Dumlao ; Jacob Ephraim D. Salud ; Eljohn C. Yee ; Jose V. Tecson, III ; Charlotte M. Chiong
Acta Medica Philippina 2023;57(10):32-38
Background and Objective:
The COVID 19 pandemic has changed the way the human anatomy is taught. A necessary shift towards online instruction, combined with a decrease in cadaver donation has resulted in the need for maximizing formalinized, soft-embalmed, computerized, and plastinated cadaver specimens. Task-oriented activities allow students to demonstrate acquired knowledge and skills. It is the aim of this study to get the perspective of students in the utilization of available laboratory materials.
Methods:
One hundred forty-three students participated in task-oriented activities. Students demonstrated anatomy of the facial nerve, recurrent laryngeal nerve, and phrenic nerve by parotidectomy, thyroidectomy, and posterior neck dissection using formalinized cadaver and VH dissector™. Deep neck and sagittal structures in the plastinated specimen were identified using laser pointers. Ossicular mobility of the middle ear, and endoscopy of the nose and larynx were demonstrated using the soft embalmed cadaver. Students were surveyed on their perceptions on the utility of each cadaver specimen.
Results:
Formalinized and soft-embalmed cadaver were observed to present the most accurate anatomy, while the virtual dissector and plastinated specimens were seen to be the most sustainable and reusable.
Conclusion
Task-oriented learning in head and neck anatomy may use different cadaveric materials with varied accuracy and utility.
Anatomy
;
Cadaver
;
Education, Medical
7.Research Progress on Microbial Community Succession in the Postmortem Interval Estimation.
Qing-Qing XIANG ; Li-Fang CHEN ; Qin SU ; Yu-Kun DU ; Pei-Yan LIANG ; Xiao-Dong KANG ; He SHI ; Qu-Yi XU ; Jian ZHAO ; Chao LIU ; Xiao-Hui CHEN
Journal of Forensic Medicine 2023;39(4):399-405
The postmortem interval (PMI) estimation is a key and difficult point in the practice of forensic medicine, and forensic scientists at home and abroad have been searching for objective, quantifiable and accurate methods of PMI estimation. With the development and combination of high-throughput sequencing technology and artificial intelligence technology, the establishment of PMI model based on the succession of the microbial community on corpses has become a research focus in the field of forensic medicine. This paper reviews the technical methods, research applications and influencing factors of microbial community in PMI estimation explored by using high-throughput sequencing technology, to provide a reference for the related research on the use of microbial community to estimate PMI.
Humans
;
Postmortem Changes
;
Artificial Intelligence
;
Autopsy
;
Cadaver
;
Microbiota
8.Application Progress of High-Throughput Sequencing Technology in Forensic Diatom Detection.
Jie CAI ; Bo WANG ; Jian-Hua CHEN ; Jian-Qiang DENG
Journal of Forensic Medicine 2022;38(1):20-30
Diatom detection is an important method for identifying drowning and throwing corpses after death and inferring the drowning sites in forensic examination of corpses in water. In recent years,high-throughput sequencing technology has achieved rapid development and has been widely used in research related to diatom taxonomic investigations. This paper reviews the research status and prospects of high-throughput sequencing technology and its application in forensic diatom detection.
Cadaver
;
Diatoms/genetics*
;
Drowning/diagnosis*
;
Forensic Pathology/methods*
;
High-Throughput Nucleotide Sequencing
;
Humans
;
Lung
;
Technology
9.Virtual Autopsy Morphological Features of Drowning.
Jun-Qi JIAN ; Dong-Hua ZOU ; Zheng-Dong LI ; Jian-Hua ZHANG ; Zhi-Qiang QIN ; Ning-Guo LIU
Journal of Forensic Medicine 2022;38(1):53-58
OBJECTIVES:
To explore the application value of virtual autopsy to obtain key evidence information on drowned corpses and its application value of virtual autopsy in the diagnosis of drowning.
METHODS:
In this study, 7 corpses were selected as the research objects. The image data of corpses were collected by computed tomography (CT) before conventional autopsy. The characteristics of corpses were observed through image reading, combined with virtual measurement indexes, and compared with 15 non-drowned corpses.
RESULTS:
The postmortem CT of drowning showed the more fluid in respiratory tract than the non-drowning, and ground-glass opacities in the lung. The statistical volume of fluid in the sinus (maxillary sinus and sphenoid sinus) was (10.24±4.70) mL in drowning cases and (2.02±2.45) mL in non-drowning cases. The average CT value of fluid in the sinus, left atrial blood and gastric contents in drowning cases were (15.91±17.20), (52.57±9.24) and (10.33±12.81) HU, respectively, which were lower than those in non-drowning cases (P<0.05).
CONCLUSIONS
The comprehensive consideration of multiple characteristic image manifestations and the virtual measurement indexes are helpful to the forensic pathological diagnosis of drowning. Virtual autopsy can be used as an auxiliary method in the forensic diagnosis of drowning.
Autopsy/methods*
;
Cadaver
;
Drowning/diagnostic imaging*
;
Forensic Pathology/methods*
;
Humans
;
Tomography, X-Ray Computed/methods*
10.Inferring Postmortem Submersion Interval in Rats Found in Water Based on Vitreous Humor Metabolites.
Fu-Yuan ZHANG ; Lin-Lin WANG ; Miao ZHANG ; Wen-Wen DONG ; Zhong-Duo ZHANG ; Xin-Jie LI ; Xing-Yu MA ; Shu-Kui DU ; Hao-Miao YUAN ; Da-Wei GUAN ; Rui ZHAO
Journal of Forensic Medicine 2022;38(1):59-66
OBJECTIVES:
The metabolomics technique of LC-MS/MS combined with data analysis was used to detect changes and differences in metabolic profiles in the vitreous humor of early rat carcasses found in water, and to explore the feasibility of its use for early postmortem submersion interval (PMSI) estimation and the cause of death determination.
METHODS:
The experimental model was established in natural lake water with 100 SD rats were randomly divided into a drowning group (n=50) and a postmortem (CO2 suffocation) immediately submersion group (n=50). Vitreous humor was extracted from 10 rats in each group at 0, 6, 12, 18 and 24 h postmortem for metabolomics analyses, of which 8 were used as the training set to build the model, and 2 were used as test set. PCA and PLS multivariate statistical analysis were performed to explore the differences in metabolic profiles among PMSI and causes of death in the training set samples. Then random forest (RF) algorithm was used to screen several biomarkers to establish a model.
RESULTS:
PCA and PLS analysis showed that the metabolic profiles had time regularity, but no differences were found among different causes of death. Thirteen small molecule biomarkers with good temporal correlation were selected by RF algorithm. A simple PMSI estimation model was constructed based on this indicator set, and the data of the test samples showed the mean absolute error (MAE) of the model was 0.847 h.
CONCLUSIONS
The 13 metabolic markers screened in the vitreous humor of rat corpses in water had good correlations with the early PMSI. The simplified PMSI estimation model constructed by RF can be used to estimate the PMSI. Additionally, the metabolic profiles of vitreous humor cannot be used for early identification of cause of death in water carcasses.
Animals
;
Biomarkers/metabolism*
;
Cadaver
;
Chromatography, Liquid
;
Immersion
;
Postmortem Changes
;
Rats
;
Rats, Sprague-Dawley
;
Tandem Mass Spectrometry
;
Vitreous Body/metabolism*
;
Water/metabolism*


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