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   2015| January-June  | Volume 1 | Issue 1  
    Online since May 29, 2015

 
 
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CASE REPORT
Fat Embolism as a Rare Complication of Large-volume Liposuction in a Plastic Patient
Xiaoliang Fu, Shang Gao, Zhenyu Hu, Yadong Guo, Jifeng Cai
January-June 2015, 1(1):68-71
DOI:10.4103/2349-5014.155553  
Fat embolism is a dreaded complication in of procedures of multiple disciplines including plastic surgery. As the popularity of liposuction increases, cases of pulmonary embolism after liposuction are increasingly reported. However, documents of cerebral embolism after liposuction are rarely presented. The degree of disability with respect to Fat fat Embolism embolism Symdrome syndrome (FES) is a Gordian Knot in the evaluation of legal medicine. Therefore, it is of great significance for us to that we report the case of a 30-year-old woman who underwent a large-volume liposuction that resulted in serious complications, especially cerebral embolism. Untypical symptoms of fat embolism hamper the clinical diagnosis, particularly after a surgical procedure such as liposuction. Such a seldom-seen case would easily trigger medical disputes, especially in countries like China suffering increasing claims of medical malpractice and, medical negligences and lawsuits. Detailed descriptions of this case are presented below along with the discussion of the clinical symptoms and the diagnostic approaches to fat embolism.
  9,662 682 2
ORIGINAL ARTICLES
Characteristics of Suicides Caused by Drug Overdose in the State of Maryland
Ling Li, Xinbiao Liao, Guozhong Zhang, Daming Sun, Tiantong Yang, Keming Yun, Rebecca Phipps, Xiang Zhang, Mary G Ripple, David Fowler
January-June 2015, 1(1):38-42
DOI:10.4103/2349-5014.157910  
Suicidal drug overdose is a major public health issue. In the United States, every year more than 33,000 people commit suicides. Our study focused on the characteristics of suicide victims in the state of Maryland. Material and methods: This study was a retrospective review of autopsy cases of all suicide deaths caused by drug (s) or drug (s) with alcohol intoxication investigated by the OCME in Maryland over a 7-year period from January 2004 to December 2011. All deaths investigated by the OCME that require autopsy examination are subject to comprehensive toxicology testing for drugs and alcohol. The screen tests were performed using gas chromatography (GC) and radioimmunoassay techniques. All detected drugs and/or metabolites were confirmed using GC-mass spectrometry (GC-MS). Results: From 2004 to 2011, 434 deaths were certified as suicide. Of the 434 suicidal overdose deaths, 84% were white, 11% were African-American, and about 5% were either Hispanic or Asian. The male and female ratio was almost equal. Their ages ranged 15-82 years. Of the 434 suicidal drug overdose deaths, 277 victims (63.8%) consumed a single drug type and 157 (36.2%) consumed more than one type of drug. Of the 277 single-drug overdose cases, 71.1% suicides were due to prescription drugs, 23.5% due to over-the-counter drugs, and 5.4% due to street/recreational drugs. Among single-type prescription drugs, analgesic (N = 76), antidepressant (N = 45), and neuroleptic (N = 35) classes were the three leading type of drugs used in suicidal deaths. Oxycodone, morphine, quetiapine, and amitriptyline were the most common prescription drugs in suicidal overdose. Diphenhydramine was the leading over-the-counter drug. Of the 157 victims who consumed more than one drug, combined prescription drugs were present in 54.1%, mixed prescription and over-the-counter drugs in 29.3%, and prescription drugs/over-the-counter drugs and street drugs in 16.6% of cases. Of the multiple-drug overdose suicides, 66.2% cases involved antidepressants. Discussion: Suicide is found in every age, racial, and ethnic group. In the USA, poisoning is thethird-leading method of suicide, following firearm injuries and hanging/strangulation. Our study indicates that prescription drugs, such as those in the opioid analgesic, neuroleptic, and antidepressant class (e.g., oxycodone, morphine, quetiapine, amitriptyline, doxepin, and citalopram), are of special concern in the context of suicidal overdose deaths in the state of Maryland. Therefore, addressing the problems of intentional drug overdose in our society is worthy of public attention.
  4,434 446 -
REVIEW ARTICLES
Chinese Forensic Psychiatry: History, Development and Challenges
Li Xue, Yan-Wei Shi, James L Knoll, Hu Zhao
January-June 2015, 1(1):61-67
DOI:10.4103/2349-5014.155555  
China has a long history of forensic psychiatry, which can be traced even back to Zhou dynasty (11 th century B.C.). However, modern forensic psychiatry has not been set up in China until the 1970s. After the interruption of Cultural Revolution of 1966-1976, there was a period of rapid development. In the past five years, a series of judicial identification system reforms have been taking place. In 2010, China had 225 forensic psychiatry agencies, 2,090 forensic psychiatry experts and 40,822 cases. The experts are organized within the separate agencies of psychiatric hospitals, universities, the Institute of Forensic Sciences of the Ministry of Justice and other forensic agencies. Apart from criminal forensic psychiatry, the experts are often asked to evaluate civil competency for the clients involved in civil litigation. Chinese forensic psychiatry has developed rapidly during the past 30 years, and formed the characteristics of its own under the special legal system. However, there is still much work for Chinese forensic psychiatrists to do for the future.
  3,736 365 -
ORIGINAL ARTICLES
Determination of Electrical Conductivity of Cadaver Skeletal Muscle: A Promising Method for the Estimation of Late Postmortem Interval
Zhiyuan Xia, Xiandun Zhai, Beibei Liu, Yaonan Mo
January-June 2015, 1(1):16-20
DOI:10.4103/2349-5014.155554  
The electrical conductivity (EC) of extracted muscle fluid has been extensively used to evaluate meat freshness and shelf life in the field of food sanitation for decades. The opposite of freshness is the corruption that increases with time. Based on the freshness/corruption principle, we investigated the relationship between long postmortem intervals (PMIs) and EC in cadaver skeletal muscle. EC values of extracted fluid from rat muscles were measured at different PMIs for 10 days. The results indicate that there was a significant correlation between PMI and EC, and the data fit well to the cubic polynomial regression equation y = - 0.01x 3 + 0.264x 2 -13.657x + 1769.148 (R 2 = 0.925). In addition, the EC of different dilutions of these muscle extracts showed strict quadratic correlation (R 2 = 1) with the dilution ratios, suggesting that EC can be measured with very small quantities of muscle sample. Our study suggests that determination of the EC of cadaver skeletal muscle extracts may be a useful method for estimating long PMIs.
  3,164 499 1
Validation of the DNATyper™15 PCR Genotyping System for Forensic Application
Jian Ye, Chengtao Jiang, Xingchun Zhao, Le Wang, Caixia Li, Anquan Ji, Li Yuan, Jing Sun, Shuaifeng Chen
January-June 2015, 1(1):8-15
DOI:10.4103/2349-5014.157903  
We describe the optimization and validation of the DNATyper™15 multiplex polymerase chain reaction (PCR) genotyping system for autosomal short tandem repeat (STR) amplification at 14 autosomal loci (D6S1043, D21S11, D7S820, CSF1PO, D2S1338, D3S1358, D13S317, D8S1179, D16S539, Penta E, D5S818, vWA, D18S51, and FGA) and  amelogenin, a sex-determining locus. Several DNATyper™15 assay variables were optimized, including hot start Taq polymerase concentration, Taq polymerase activation time, magnesium concentration, primer concentration, annealing temperature, reaction volume, and cycle number. The performance of the assay was validated with respect to species specificity, sensitivity to template concentration, stability, accuracy, influence of the DNA extraction methods, and the ability to genotype the mixture samples. The performance of the DNATyper™15 system on casework samples was compared with that of two widely used STR amplification kits, Identifiler™ (Applied Biosystems, Carlsbad, CA, USA) and PowerPlex 16 ® (Promega, Madison, WI, USA). The conditions for PCR-based DNATyper™15 genotyping were optimized. Contamination from forensically relevant nonhuman DNA was not found to impact genotyping results, and full profiles were generated for all the reactions containing ≥ 0.125 ng of DNA template. No significant difference in performance was observed even after the DNATyper™15 assay components were subjected to 20 freeze-thaw cycles. The performances of DNATyper™15, Identifiler™, and PowerPlex 16 ® were comparable in terms of sensitivity and the ability to genotype the mixed samples and case-type samples, with the assays giving the same genotyping results for all the shared loci. The DNA extraction methods did not affect the performance of any of the systems. Our results demonstrate that the DNATyper™15 system is suitable for genotyping in both forensic DNA database work and case-type samples.
  3,185 413 3
REVIEW ARTICLES
Advances in Toxins and Narcotics Determination Techniques in China During 2013
Ling Zeng, Zhicheng Liu, Xu Han, Hongxia Hao
January-June 2015, 1(1):54-60
DOI:10.4103/2349-5014.157904  
Recently, toxin and narcotics detection techniques have been developed in China. A number of new technologies have been applied. The pretreatment technologies such as solid-phase extraction (SPE) techniques, solid-phase microextraction (SPME) techniques, hollow-fiber liquid-phase microextraction (HF-LPME) techniques, etc., have matured, and thus have greatly improved both the accuracy and efficiency of the analysis of toxins and narcotics as well as the technical system of analysis. Based on analyses conducted using the traditional methods of gas chromatography (GC) as well as other conventional methods, various new methods of analysis have been gradually discovered and developed. For instance, ultra-performance liquid chromatography (UPLC)-mass spectrometry (MS) and other combination technologies have enriched the variety of detection methods that are available to researchers. These highly precise methods are developed on the basis of and as extensions of traditional applications and still draw the attention of researchers from a variety of disciplines.
  3,164 294 -
ORIGINAL ARTICLES
Evaluation of the AGCU Expressmarker 16 and 22 PCR Amplification Kits Using Biological Samples Applied to FTA Micro Cards in Reduced Volume Direct PCR Amplification Reactions
Samantha J Ogden, Kathryn L Lamerton, Peter J Tatnell
January-June 2015, 1(1):3-7
DOI:10.4103/2349-5014.155546  
This study evaluated the performance of the  Wuxi AGCU ScienTech Incorporation (HuiShan, Wuxi, China) AGCU Expressmarker 16 (EX 16) and 22 (EX22) short tandem repeat (STR) amplification kits in reduced reaction volumes using direct polymerase chain reaction (PCR) amplification workflows. The commercially available PowerPlex® 21 (PP21) System (Promega, Wisconsin, USA), which follows similar direct workflows, was used as a reference. Anticoagulate blood applied to chemically impregnated  FTA TM Micro Cards (GE Healthcare UK Limited, Amersham Place, Little Chalfont, Buckinghamshire, HP7 9NA, UK) was used to represent a complex biological sample. Allelic concordance, first-pass success rate, average peak heights, heterozygous peak height ratios (HPHRs), and intracolor and intercolor peak height balance were determined. In reduced volume PCR reactions, the performances of both the EX16 and EX22 STR amplification kits were comparable to that of the PP21 System. The level of performance was maintained at PCR reaction volumes, which are 40% of that recommended. The EX22 and PP21 System kits possess comparable overlapping genome coverage. This study evaluated the performance of the AGCU EX16 and EX22 STR amplification kits in reduced PCR reaction volumes using direct workflows in combination with whole blood applied to FTA TM Micro Cards. Allelic concordance, first-pass success rate, average peak heights, HPHRs, and intracolor and intercolor peak height balance were determined. A concordance analysis was completed that compared the performance of the EX16 and EX22 kits using human blood applied to FTA Micro Cards in combination with full, half, and reduced PCR reaction volumes. The PP21 System (Promega) was used as a reference kit. Where appropriate, the distributions of data were assessed using the Shapiro-Wilk test. For normally-distributed data, statistics were calculated using analysis of variance (ANOVA) and for nonparametric data the Wilcoxon/Kruskal-Wallis test was used. Statistical significance was set at P < 0.05. Confidence intervals for mean values were set at 95%. On using reduced volume PCR reactions in combination with dried blood spots applied to FTA sample collection cards, both the EX16 and EX22 kits were shown to generate STR profiles of sufficient quality to allow entry into National DNA databases. The performance of both EX16 and EX22 was comparable to that of the PP21 System. This study demonstrates the successful use of the Wuxi AGCU ScienTech Incorporation EX16 and EX22 kits in reduced PCR reaction volumes with complex biological samples applied to chemically impregnated FTA sample collection cards.
  3,028 338 2
Comparison of the Concentrations of Lidocaine in Different Body Fluids/Tissues after Subarachnoid Space and Intravenous Administration of a Lethal Dose of Lidocaine
Nan Zhang, JunHong Sun, Zhiwen Wei, Wenyan He, Guohua Jin, Xiaohong Zhang, Pengxiang Gao, Longmei Wang, Keming Yun
January-June 2015, 1(1):48-53
DOI:10.4103/2349-5014.157907  
The objective of the study was to compare the concentration of lidocaine in different body fluids/tissues after subarachnoid space and intravenous administrations of a lethal dose of lidocaine. Totally 18 dogs were used in the experiment. Six dogs were given subarachnoid anesthesia, another were given an intravenous injection of a dose of 75 mg/kg weight of lidocaine hydrochloride in 5 min and the last 6 dogs were used as the blank control dogs and given a subarachnoid space injection or a femoral artery injection of the same volume of sodium chloride. As soon as its vital signs disappeared, each dog was dissected and the specimen, such as brain, cerebrospinal fluid (CSF) in lateral ventricle, CSF in subarachnoid space, spinal cord (cervical spinal cord, thoracic spinal cord, lumbar spinal cord, and waist spinal cord), heart, lung, liver, spleen, kidney, bile, urine, heart blood, peripheral blood, muscle in injection location, and muscle in no injection location, were collected for analysis of lidocaine immediately. Analysis was performed with gas chromatography-mass spectrometry (GC-MS). From the maximum to the minimum, the order of lidocaine concentration detected in the subarachnoid space-administered dogs was as follows: CSF in subarachnoid space, waist spinal cord, thoracic spinal cord, CSF in lateral ventricle, lumbar spinal cord, cervical spinal cord, lung, kidney, muscle in injection location, heart, brain, spleen, heart blood, liver, peripheral blood, bile, muscle in no injection location, and urine. The order of lidocaine concentration detected in the intravenously administered dogs was as followed: Kidney, heart, lung, spleen, brain, liver, peripheral blood, bile, heart blood, cervical spinal cord, thoracic spinal cord, muscle in injection location, lumbar spinal cord, muscle in no injection location, CSF in subarachnoid space, urine, and CSF in lateral ventricle. The maximum concentration of lidocaine was detected in the subarachnoid space CSF of subarachnoid space-administered dead dogs, while in intravenously injected dead dogs, the maximum concentration of lidocaine was detected in the kidney. Our study provides some useful data for the forensic identification of epidural anesthesia accidents to decide the way the lidocaine enters the body.
  2,890 343 -
Prediction of Facial Profile Based on Morphometric Measurements and Profile Characteristics of Permanent Maxillary Central Incisor Teeth
N Raghavendra, Venkatesh V Kamath, Krishnanand P Satelur, Komali Rajkumar
January-June 2015, 1(1):26-32
DOI:10.4103/2349-5014.155550  
The computation of facial profile from dental morphometrics has been a subject of great interest in forensic odontology. The use of teeth to draw a profile and facial features is valuable in times of mass disasters when body remains are unavailable due to extreme destruction. This study aims to identify and evaluate applicable parameters in the permanent maxillary central incisors and the face of an individual. A correlation of these parameters establishes a mathematical equation that further charts a tooth-facial profile table. Thirty soft and hard tissue landmarks on the face in the frontal and the lateral profiles (using standardized photographs) and seven landmarks on the facial/labial surface of the clinical crown of the permanent maxillary central incisor (using casts of the maxilla) were identified for the study. Based on these, a set of eight horizontal and seven vertical parameters on the face and four parameters on the tooth were created for the assessment. Internal and external correlations between the two were carried out and statistically analyzed. A logistic regression was made to predict the probability of the parameters most likely to be reproduced in the creation of the facial profile, based on tooth morphometrics. The results indicated a definite correlation between the facial and the tooth parameters. Among the multiple parameters, a definite correlation in the horizontal dimension could be established between the mouth width and the mesiodistal width (MDW) of the tooth. In the vertical dimension, a definite relationship existed between the crown height of the tooth and the width of the midface (zygoma-mandible). There exist divergences in the correlation of tooth and facial parameters.
  2,794 373 -
Analyses of Medical Malpractice in Judicial Appraisal: 505 Cases
Meng You, Xu Wang, Di Lu, Haidong Zhang, Shengli Di, Fengqin Zhang, Zhaoming Guo, Li Yuan, Lin Chang, Jian Xiang, Lili Yu, Yingkai Yang, Tiantong Yang
January-June 2015, 1(1):21-25
DOI:10.4103/2349-5014.157906  
The purpose of this paper is to investigate and analyze the current situation of medical malpractice and make suggestions for preventative measures from a judicial appraisal standpoint. From 2002 to 2011, we conducted and analyzed 505 medicolegal malpractice experiments at the Fada Institute of Forensic Medicine and Science (FIFMS) in Beijing, People's Republic of China (PRC). We found that the occurrence of medical disputes in surgical and obstetrical/gynecological cases seemed more frequent. The main causes of medical disputes included issues regarding medical ethics, poor quality of the medical staff, equipment malfunctions, and dereliction of duty by the medical personnel. The reasons for dissatisfaction varied among the different levels of medical service. Basic medical services garnered the most complaints. If we can work to improve the moral and professional standards of the medical staff members, intensify their ethics, and foster good relationships between patients and medical professionals, the quality of medical care would improve and the number of disputes regarding medical services would be reduced.
  2,351 325 1
Study on Accuracy of Judgments by Chinese Fingerprint Examiners
Shiquan Liu, Christophe Champod, Jian Wu, Yaping Luo
January-June 2015, 1(1):33-37
DOI:10.4103/2349-5014.157908  
The interpretation of fingerprint evidence depends on the judgments of fingerprint examiners. This study assessed the accuracy of different judgments made by fingerprint examiners following the Analysis, Comparison, and Evaluation (ACE) process. Each examiner was given five marks for analysis, comparison, and evaluation. We compared the experts' judgments against the ground truth and used an annotation platform to evaluate how Chinese fingerprint examiners document their comparisons during the identification process. The results showed that different examiners demonstrated different accuracy of judgments and different mechanisms to reach them.
  2,220 303 2
Discrimination of Car Headlight Plastic by Gel Permeation Chromatography
Bo Wang, Yangke Quan, Hongling Guo
January-June 2015, 1(1):43-47
DOI:10.4103/2349-5014.157909  
Car headlight plastic as a kind of evidence often can be seen in traffic accidents and some other cases. We tested 20 brands of car headlight plastic using gel chromatography. The data were processed using the Statistical Package for the Social Sciences (SPSS) one-way analysis of variance (ANOVA) and the discrimination rate was 97.14%. This indicated that we could discriminate between different headlights by the molecular weight of their headlight plastic. Gel permeation chromatography is an effective method of discriminating between headlights, particularly in the case of a traffic accident.
  2,233 274 1
LETTER FROM THE EDITOR-IN-CHIEF
Launching the "Journal of Forensic Science and Medicine"
Ling Li
January-June 2015, 1(1):1-1
DOI:10.4103/2349-5014.157869  
  2,002 357 -
LETTERS TO EDITOR
Mass Disaster: Will Dental Records be Effectively Useful in Developing Nations?
Gaurav Sharma, Archna Nagpal
January-June 2015, 1(1):72-72
DOI:10.4103/2349-5014.155552  
  1,905 225 -
EDITORIAL
Launching a New Journal in 2015: Journal of Forensic Science and Medicine
Yiping Hou
January-June 2015, 1(1):2-2
DOI:10.4103/2349-5014.157902  
  1,795 293 -
LETTERS TO EDITOR
Inquest of Imperial Envoy: The True Depiction of an Inquest During the Qing Dynasty
Xiaochuan Shi, Shifan Wang
January-June 2015, 1(1):73-74
DOI:10.4103/2349-5014.157905  
  1,644 193 -