A Case of Sudden Infant Death Due to Incomplete Kawasaki Disease

Although Kawasaki disease (KD) is a self‐limiting disease, it may cause sudden cardiac death. Diagnosis of KD is principally based on clinical signs; however, some infant cases do not meet the criteria. Such cases are identified as incomplete KD. The sudden death risk in incomplete KD cases is similar to conventional KD. In our 5‐month‐old case, he had been admitted to a hospital for a fever and suppuration at the site of Bacille de Calmette et Guerin (BCG) vaccination. However, after discharge from the hospital, his C‐reactive protein (CRP) levels declined, he got indisposed and died suddenly. A medico‐legal autopsy revealed myocarditis, coronaritis, platelet‐aggregated emboli in coronary arteries, and myocardial degeneration, suggesting that the fatal myocardial infarction was due to thrombus emboli in the coronary arteries. Forensic pathologists therefore should pay attention to the cardiac pathology originated from incomplete KD as a potential cause in cases of sudden infant death.     

Determination of Both Fetus’ and Mother's Blood Type from an Autopsy Case Immersed in Formalin for Over 50 Years

A female fetus which had been immersed in formalin for more than 50 years was found in Japan. Because no liquid blood could be obtained, we tried to use immunohistochemistry (IHC) methods to tissue samples obtained at autopsy to identify both the fetal and mother's blood type. We detected B antigens on endothelial cells in paraffin sections of the fetal organs. Furthermore, we observed both anti‐A‐ and anti‐B‐positive red blood cells in the intervillous space, which is indicative of the mother's blood type. To our knowledge, this is the first case report on determining the blood type of both the fetus and the mother from tissue immersed in formalin for such a long time. The results suggest that IHC is valuable for the determination of ABO blood type in circumstances of long postmortem duration and unfavorable storage conditions.     

Analysis of mutation of the plasma cholinesterase gene in a man who had died following a traffic accident

We analyzed mutation of the butyrylcholinesterase (BCHE) gene in a 69-year-old man on whom a forensic autopsy had been performed after he had died following a traffic accident. Extremely low plasma cholinesterase activity had been pointed out by the emergency doctor at the hospital prior to his death and based on this, organophosphorus poisoning had been suspected. However, no pesticides, which could have reduced the plasma cholinesterase activity, were detected by toxicological analysis using GC/MS. Subsequently, one base insertion was found in exon 2. The frame shift mutation had occurred because a homozygous extra T had been inserted between nucleotides 1343 and 1344, resulting in the appearance of a stop codon in codon 454 (AGA454TAA, Arg454stop). This heterozygous frame shift mutation at this point was identified in the man's son. It is likely that there may be many such latent patients with abnormal plasma cholinesterase activity, and accordingly we should always bear this fact in mind and should carry out molecular genetic testing for an accurate diagnosis of this deficiency.     

An autopsy case of sudden death due to acute gastric dilatation without rupture

We report the first autopsy case of fatal gastric dilatation without rupture. A 31-year-old woman who lived alone was found dead in her living room. Despite being very thin, she showed marked abdominal distention. Autopsy and histological findings revealed that a severely distended stomach, of which walls notably thin and displayed transmural necrosis, occupied the entire abdominal cavity. Severe congestion was observed in the intestine and cecum. Theses findings suggest that bulimia nervosa together with anorexia nervosa resulted in rapid dilation of the stomach. We conclude that the cause of death was acute circulatory failure from hypovolemic shock that occurred following compression of the inferior vena cava and superior mesenteric vein, and by loss of circulatory volume to the third space.     

Medicolegal aspects of infanticide in Hokkaido District, Japan

Since 1978, a total of 55 infanticides were investigated by our department (16.9% of the total number of medicolegal autopsies). This article describes the infanticides in the Hokkaido district of northern Japan. The characteristic finding for the cause of death was drowning in the toilet. This mode of killing seems to be chosen because of the style of toilet in the district, which includes a collecting tank for feces and urine under the commode.     

Asians for Australia's identity

Australia is now pursuing the task of discovering and creating its own identity, says Keiko Morita, lecturer at the Institute for International Studies, University of Technology, Sydney. Following remarks made by Pauline Hanson during the 1996 federal election, the issue of Asian immigration has been the subject of significant public debate in Australia. Morita argues that the uproar provoked by Hanson's blatant exploitation of racist hostilities has made it pertinent to raise the question of how Australian feelings toward Asian immigrants have changed over the last thirty years.     

Studies on asphyxia: on the changes of the alveolar walls of rats in the hypoxic state. II. The hypoxic state produced by carbon dioxide and methane gases

Experimental studies were presented here concerning death by asphyxia due to the inhalation of carbon dioxide and methane gases. The morphological changes were almost the same as those demonstrated in our previous report. The authors concluded that the morphological changes in the lung tissue were not attributable to the chemical specificity of gases used in the experiment but to the decrease of oxygen.     

Les députés de Lyon en cour et l’art des communications de la ville et du pouvoir royal au XVIe siècle*

In the ancien régime, major municipalities in France constantly sent delegates, or deputies and solicitors to the court to make petitions and refer disputes to arbitration seeking favour for the city. Their mission was to defend the interests of the city. The deputies of Lyon were most often urban elites, who were expected to play an active part in negotiations with the royal government. J.P. Gutton ranked the deputies and clarified the activities during the seventeenth century: ‘The agent responsible for the affairs of the city’ resides permanently in Paris, ‘the ordinary deputy’ resides normally in Lyon and travels with instructions made by the consulate, and the ‘extraordinary envoys’ accompany ordinary deputies. However, in the sixteenth century, the deputies were not yet specialized and the consulate decided which deputy to send to court if necessary. This article aims to clarify the appointment of deputies, their relations with the royal officers in the government, as well as the contents of their business. To this end, the correspondence exchanged between the deputies and the consulate in series AA of the archives municipales de Lyon will be analysed, especially the consular deliberations in series BB, on the selection of deputies and the purpose of dispatch. Finally, this article will focus on understanding the negotiations that were held between the important city, Lyon, and the monarchy through the intermediary of the deputies. An analysis of the deputies of the city would also suggest where they went to get decisions in the royal administration and how consensus was formed in sixteenth-century France.     

Sudden infant death syndrome in Japan

Two autopsied cases are presented, one involving a 5-month-old infant, and a 6-month-old infant both of whom died suddenly and unexpectedly. The incidence of sudden infant death syndrome in Japan is 1.2 per 1,000 babies live births. Among all cases autopsied in the departments of legal or forensic medicine in 78 universities or colleges of Japan, the incidence was 15 (0.5%) per 3,329 in 1984 and 20 (0.6%) per 3,150 in 1985.