Correlation of preference- and profile-based quality of life of Japanese oral cancer patients during the perioperative period measured using EQ-5D-5L and FACT-H&N.

The EuroQol 5-dimension 5-level (EQ-5D-5L) instrument is among the most used preference-based quality of life (QOL) measures for cost-utility analysis. Each dimension is evaluated on five levels. The aim of this study was to clarify whether the EQ-5D-5L, which consists of only five items, correlates with profile-based QOL measures in Japanese oral cancer patients during the perioperative period. One hundred participants with oral cancer undergoing radical therapy completed QOL assessments before treatment, at treatment completion, and 1 and 3 months after treatment using the EQ-5D-5L and Functional Assessment of Cancer Therapy - Head & Neck instrument (FACT-H&N, Japanese version). To clarify how the EQ-5D-5L reflects the FACT-H&N, multiple regression analyses were performed using FACT-H&N subscales. The ceiling effect of the EQ-5D-5L was investigated. The EQ-5D-5L moderately correlated with the FACT-H&N over the entire perioperative period (rs = 0.586, P < 0.01). In the multiple regression analysis, the EQ-5D-5L was strongly reflected in the physical wellbeing subscale of the FACT-H&N, excluding social wellbeing. The pre-treatment EQ-5D-5L score was decreased owing to the impacts of the dimensions of pain/discomfort and anxiety/depression. The EQ-5D-5L did not have a ceiling effect in oral cancer patients. The EQ-5D-5L appears to generally correlate with the FACT-H&N for oral cancer patients during the perioperative period.

Evaluation of new primers for CSF1PO.

We describe new primers for the detection of the STR polymorphism at the CSF1PO locus. These primers have been designed to produce shorter amplicons (150-182 bp) than the primers in standard use (295-327 bp). The reliability of the new primers for CSF1PO typing has been demonstrated by testing on known samples and by sequence analysis. These primers are superior to the original primers with regard to electrophoretic resolution and utility for typing of severely degraded DNA.

Computer-assisted skull identification system using video superimposition.

This system consists of two main units, namely a video superimposition system and a computer-assisted skull identification system. The video superimposition system is comprised of the following five parts: a skull-positioning box having a monochrome CCD camera, a photo-stand having a color CCD camera, a video image mixing device, a TV monitor and a videotape recorder. The computer-assisted skull identification system is composed of a host computer including our original application software, a film recorder and a color printer. After the determination of the orientation and size of the skull to those of the facial photograph using the video superimposition system, the skull and facial photograph images are digitized and stored within the computer, and then both digitized images are superimposed on the monitor. For the assessment of anatomical consistency between the digitized skull and face, the distance between the landmarks and the thickness of soft tissue of the anthropometrical points are semi-automatically measured on the monitor. The wipe images facilitates the comparison of positional relationships between the digitized skull and face. The software includes the polynomial functions and Fourier harmonic analysis for evaluating the match of the outline such as the forehead and mandibular line in both the digitized images.

Current research and case work activities of criminalistics in Japan.

The current research and case work activities of criminalistics in Japan are described. The selected forensic science disciplines are forensic osteology including specialized technology of skull identification, forensic serology, forensic DNA analysis of poisonous materials, forensic hair and fiber analysis, trace evidence analysis, document analysis, forensic psychology mainly concerned with the so-called lie-detector, forensic image analysis, voice print analysis, fire and explosion analysis, forensic engineering, firearm and toolmark analysis. The current activity of the Training Institute of Forensic Science at the National Research Institute of Police Science is also briefly described with special regard to the education and training course of forensic DNA typing analysis. Instruments for analytical and methodological use are listed according to the availability in evidence sample analyses.

Evaluation of anatomical consistency in craniofacial superimposition images.

Using 52 skulls in forensic cases, the anatomical consistency of cranio-facial superimposition images was investigated for evaluating the validity in personal identification by the superimposition method. In 35 out of 52 cases the unknown skull was positively identified as the missing person by matching of the outline and anatomical relation in skull and face images taken from frontal, oblique and lateral directions. The unknown skull in two cases was exclusive of the presumed person since the outline of the skull was not anatomically consistent with that of the face. In the remaining 15 cases, the skull in question was examined using only a frontal face photograph of the missing person and matched with it because of the lack of other photographs taken from different angles, giving a probable identification. From our practical examination, it is stated that the outline from the trichion to the gnathion in the lateral or oblique view is the preferable portion for personal identification, and the cranio-facial super-imposition method is reliable for individualization when two or more facial photographs taken from different angles are used in the examination.

The computer-aided facial reconstruction system.

A computer imaging system was introduced into the facial reconstruction process. The system, which consists of the image processing unit for skull morphometry and the image editing unit for compositing facial components on the skull images, was an original construction. The image processor generates the framework for building a face onto the digitized skull image. For reconstructing a facial image on the framework, several possible data sets of facial components suitable for the skull morphology are selected from the database by operating our original application software. The most suitable cutout samples of facial components are pasted up over the framework in accordance with the anatomical criteria. The database of facial components consists of 24 contours, 18 eyes, 9 eyebrows, 27 noses, 9 lips and 16 hairstyles. After provisional reconstruction, the facial image is retouched by correcting skin colors and shades with an 'electronic painting device'. The resulting image is a great improvement on images made by the conventional clay and drawing method, both in the operational aspect and in the flexibility of creating multiple versions. The present system facilitates a rather objective and rapid approach and allows us easily to generate a range of possible faces. The computer-aided facial reconstruction will lead to an increase in chances of positive identification in practical cases.

The modified method of two-step differential extraction of sperm and vaginal epithelial cell DNA from vaginal fluid mixed with semen.

This investigation was undertaken as an efficient method for isolating sperm DNA from a mixed fluid sample which contains vaginal epithelial cells in a greater amount. The modified method of the two-step differential extraction procedure was found to be suitable for separating sperm DNA and vaginal epithelial cell DNA from the mixed stains. As the first step of digestion, vaginal epithelial cells in the mixed stains were lysed with Proteinase K and SDS, and sperm heads remaining in the lysed solution were collected by centrifugation. As the second step digestion, the sperm heads were lysed with the buffer containing Proteinase K, SDS and DTT as reducing agent. DNA fractions extracted from the two lysed solutions were enriched, one with sperm DNA and the other with vaginal epithelial cell DNA. MCT118(D1S80), ApoB VNTR and HLADQ alpha types of sperm DNA were detected and were confirmed by matching with corresponding male blood DNA. In the case of vaginal secretion mixed with semen of two males, the mixture of MCT118 types of the two males was detected in sperm DNA fraction.

Histological estimation of age at death using microradiographs of humeral compact bone.

The purpose of this study is to develop an age estimating method for skeletal remains using microradiographs of compact bone. Compact bones of the humerus were collected from 40 Japanese males ranging from 23 to 80 years of age. Microradiographs taken from cross-sections were histomorphometrically examined by using an image analyzer. Histological parameters used in this study included 10 items, that is, osteon number, double-zoned osteon number, type II osteon number, low-density osteon number, osteon fragment number, resorption space number, total and average osteon area, and total and average Haversian canal area. The osteon fragment number showed the highest correlation coefficient with advancing age (r = 0.786). The measurement data obtained from 10 histological parameters were subjected to multiple regression analysis for producing multiple regression equations for age estimation. In practice, 8 histological parameters were selected for the equation and its multiple correlation coefficient and standard error of estimate were 0.903 and 6.1, respectively.

Drunken driving and breath alcohol test at the scene of violence in Japan.

Road Traffic Law prescribes that no person shall drive any vehicle under the influence of intoxicating liquor. Actually, determination of "influence of alcohol" is based on the standard set by the Cabinet Order that alcohol level exceeds 0.5 mg/ml of blood or 0.25 mg/l of expiration. In 1988, number of traffic accidents by drunken driving is 4,808 cases. Among the accidents by drunken driving the rate of fatal causes is 12%. During about last ten years, both of accidents and fatal cases by drunken driving have been decreasing in number, on the other hand, charged or cited number of violation involved "driving under the influence of alcohol" has been increasing. This fact indicates that the concept of seriousness of driving after heavy drinking has been diffused over Japanese nation, but there is still a tendency among drivers to consider the effect of alcohol on driving operation to be negligible when light drinking. In a sobriety checkpoint, alcohol field test are carried out on breath to screen out impaired driver. The most common device used in Japan is an alcohol detector tube, in which cerite particles coated with chromate are packed. The scale on the detector tube is marked to show a value that is lower by 20% than the actual value concerning its inaccuracy. In our study on accuracy of the alcohol detector tube using samples containing approximately 0.25 mg/l of alcohol, which is legal critical level of alcohol impairment, coefficients of variation were 1.50 to 5.45% and deviations from the analytical results by gas chromatography were 18.2 to 19.5%.

Analysis of Drugs in Unconventional Samples.

Forensic scientists have long detected the presence of drugs in biological materials using body fluids such as urine, blood, and/or tissues. In recent years, remarkable advances in sensitive analytical techniques have prompted the analysis of drugs in unconventional biological samples such as hair, nail, saliva, and sweat. These samples are easily collected, although drug levels are often lower than the corresponding urine, blood, or tissue levels. This article reviews studies on the detection of drugs of abuse in hair, nail, saliva, and sweat. Preparation or pretreatment of samples, analytical procedures, and the interpretation of analytical results are discussed concomitantly..

Microscopical study on estimation of time since death in skeletal remains.

For the purpose of estimating time since death in skeletal remains, postmortem changes in human compact bones were examined by microradiography and electron microscopy. The UV-fluorescence of the peripheral zone of compact bone was also examined by microscopic spectrophotometry. Microradiographic examination revealed no morphological changes in bones left in the open air for long periods, except one of 15 years since death. In bones left in the soil, vacuoles of 5-10 microns diameter, which contained a honeycomb-like structure formed by small vacuoles of 0.5-1 microns diameter, were found in the peripheral zone of the substantia compacta approximately 5 years since death, and in bones of 6 years or more, this change extended to the mid-zone. In bones left in the sea for 4-5 years, vacuoles of 5-10 microns diameter were observed in the outer peripheral zone of the substantia compacta. The relative intensity of UV-fluorescence in bones dwindled with time since death and the correlation coefficient was considerably high.

Identification of infant skeletal remains: case report.

Three cases of infant skeletal remains were described from the view point of personal identification. The age was exactly estimated from union of ossification centers, dental calcification and eruption. While, the sex estimation was not highly reliable, because sex differences had not clearly appeared in infant skeletons, and it was rather difficult in some cases. In infant skeletal remains, age estimation is especially important to help personal identification. The most recent photograph of a presumed person should be used for personal identification by superimposition technique since the size and proportion of infant skull constantly change as a result of its development.

Segmented heterochromia in black scalp hair associated with iron-deficiency anemia. Canities segmentata sideropaenica.

A newly recognized disorder of black scalp hair is characterized by the irregularly alternating segmentation of hair into dark and light bands. A 15-year-old girl had segmented heterochromic scalp hair in association with iron-deficiency anemia. The clinical and laboratory investigations support the view that low serum iron levels play a critical role in reducing eumelanogenesis and in the possible failure of melanin transfer. The segmented heterochromic hair recovered completely after iron supplementation, which coincided with increased eumelanogenesis in the recovered hair. This clinical experience indicated participation of iron in the kinetics of melanogenesis within the follicular melanocytes.

Classification system of frontal sinus patterns by radiography. Its application to identification of unknown skeletal remains.

Frontal sinuses of Japanese skulls were radiographically examined from the view point of identifying individuals. The system of classification of sinus was proposed, basing on the area size, the bilateral asymmetry, the superiority of side, the outline of upper borders, the partial septa and the supraorbital cells. Frontal sinus patterns could be divided into above 20,000 possible combinations by combining the class numbers in each classification item described above. The frontal sinus pattern of a given person was formulated as a code number which was determined by arranging the class numbers in each classification item as serial numbers. This identification system by the frontal sinus pattern should allow one to characterize each person. The application of this identification system to an actual criminal case was also described.

The ABO blood grouping of a minute hair sample by the immunohistochemical technique.

The unlabeled antibody (PAP) immunoperoxidase technique was applied to the ABO blood grouping of human scalp hairs. Hair samples were subjected to longitudinal- or cross-sectioning, thus obtaining suitable samples for subsequent immunostaining. The immunostaining was carried out using rabbit anti-A and anti-B sera as the primary antibodies. With this technique, the group-specific staining which is revealed as a dark brown precipitate was clearly observed within the medullae of the hair shaft, and depending on the presence or absence of these precipitates, respective blood groups of unknown hair samples were determined. At the hair root, on the other hand, positive stainings were observed not only in medullary cells but also in some cortical cells of the keratogenous zone. From the present study, it can be safely said that this technique is of practical use for the ABO blood grouping from a minute (less than 3 mm) hair sample.

SEM/EDX analysis of inorganic elements in human scalp hairs with special reference to the variation with different locations on the head.

In order to obtain additional data for individualizing hair samples collected from the scene of crime, the authors attempted to analyze the inorganic elements in scalp hairs such as sodium, phosphorus, potassium and calcium by a SEM/EDX method. For the purpose of detecting such elements from scalp hairs efficiently, the samples were ashed on a carbon specimen mount for 60 minutes by an oxygen plasma microincineration technique. The characteristic X-ray counts of the elements were investigated as functions of hair location, viz., the frontal, the vertex, the nape, the left and the right lateral, on the head of the same person. The oxygen plasma microincineration method was very efficient in detecting sodium, phosphorus, potassium and calcium from scalp hairs. The characteristic X-ray counts of the elements, especially potassium and calcium, varied from person to person. Within the same location, the variation of X-ray counts was relatively low, with a standard deviation of less than 20%. It was observed that hairs from the frontal and the vertex locations, in general, showed lower X-ray counts for potassium than did those from the nape, the left and the right lateral locations. The calcium X-ray counts varied considerably from person to person but generally tended to give the highest value at the vertex location. The EDX spectrum pattern associated with such elements could be helpful in individualizing hair samples collected as forensic evidence.

Scanning electron microscopy and EDX analysis of exocrine and endocrine gland cells of rat pancreas surface-etched in an oxygen plasma.

Pancreas, double-fixed in glutaraldehyde and osmium tetroxide and embedded in epoxy resin was cut into sections 0.5-1 micron thick. The sections were surface-etched in an oxygen plasma produced by exciting oxygen with a radio frequency generator. Structural components of exocrine and endocrine cells were morphologically investigated in the secondary electron image mode of the SEM. Moreover, in order to identify some cell components such as endocrine granules, the morphological image obtained of the etched surface by the SEM were compared with those seen in a TEM, using the serial sections from the same tissue block and at the same cellular level. For a microanalytical investigation, tissues were fixed with glutaraldehyde alone. The structural components of exocrine and endocrine cells were analyzed by SEM/EDX. A better resolution under the SEM was obtained of 0.5-0.8 micron thick sections after surface-etching in an oxygen plasma for 1 minute. Intracellular structures such as nuclear membranes, nucleolus, mitochondria, rough endoplasmic reticulum and zymogen granules were readily identifiable. Moreover, the internal structure of organelles such as cristae of mitochondria was recognized. In the serial sections, the mode of arrangement of intracellular structures in the SEM was well consistent with those in the TEM. The peaks of phosphorus, sulphur and calcium were clearly detected from the intracellular components such as nucleolus, nuclear membranes and secretory granules.

Morphological comparison of the cross section of the human and animal hair shafts by scanning electron microscopy.

In order to obtain some fine structural informations available for the identification of hair samples collected in small amounts or fragments, the preparation method of the samples for the scanning electron microscopy was investigated. Hair samples of human individuals and animals were mounted between two sheets of celluloid using isoamyl acetate and were sectioned to 20 microns thickness. These sections were collected in a test tube for dissolving the celluloid. After centrifuging in acetone, a small mass of sections was embedded in Spurr's epoxy resin. After polymerization, 1 micron thick sections were made on an ultramicrotome. The sections were mounted on glass slide and were surface-etched by exposure to oxygen plasma for 90 seconds. Observations were made in the secondary electron image mode of a scanning electron microscope. After surface-etching, a good resolution of the cross section was obtained. The arrangement of the cortical cells of human hairs was observed to be fairly irregular with conspicuous interdigitations of cell boundaries as compared with that of animal hairs. The medulla of human and animal hairs were filled with cellular remnants of destroyed medullary cells showing fibrous structures. The lamellar structures of cuticular cells became very clearly visible. The number and the overall thickness of cuticular cell layers in human and animal hairs investigated varied considerably between scalp and pubic hairs and from animal to animal.