Young Japanese females had the highest suicide rate in the world until the end of the 1960s, and ... more Young Japanese females had the highest suicide rate in the world until the end of the 1960s, and it is still extremely high. This paper attempts to explain this phenomenon primarily in terms of vulnerability-in their personalities, social conditions, and role conflicts. Concomitant psychological traits and social conditions are discussed. The cultural conflict of young Japanese women is explicated in terms of psychological and historical information. In addition, the reasons for the differences between the suicide rates among females in the Tokyo area and the Kytot-Osaka area are explored largely in terms of concepts relating to authoritarianism and its correlates.
Nihon hōigaku zasshi = The Japanese journal of legal medicine, 2002
This is a review article dealing with the half-century evolution of the quality assurance program... more This is a review article dealing with the half-century evolution of the quality assurance program to improve patient care in the United States. The author attempted to point out some differences in approach to solving the medical error and medical malpractice problems between Japan and the U.S. In the 1970s, an increase in the medical malpractice claims resulted in such high premiums for medical liability insurance that it threatened the healthcare system in the U.S. Urgent legislative remedy, the Medical Injury Compensation Reform Act (MICRA) was put into place in the State of California. This act was the beginning of the definitive quality improvement in our health care system. It was followed by other improvement programs, such as the National Practitioner Data Bank (NPDB) for tracking physicians with malpractice judgments or settlements against them, or who have problems with the medical licensing Board or other impairments. By comparison, in recent years, in Japan, there has be...
... On june 9, 1970 (approximately seven months before) this individual had left his home and had... more ... On june 9, 1970 (approximately seven months before) this individual had left his home and had never returned. Nothing had been heard from him in spite of a missingperson report filed by his family on June II, 1970. Inquiry ...
The American Journal of Forensic Medicine and Pathology, 1992
A rare iatrogenic complication of subclavian vein catheterization for hemodialysis is massive hyd... more A rare iatrogenic complication of subclavian vein catheterization for hemodialysis is massive hydrothorax. A case is presented that illustrates the need for adherence to a standard procedure of prompt roentgenologic examination in conjunction with catheterization, and emphasizes the importance of the autopsy as a means of quality assurance.
The American Journal of Forensic Medicine and Pathology, 1980
The Milton Helpern International Center for the Forensic Sciences represents a unique self-suppor... more The Milton Helpern International Center for the Forensic Sciences represents a unique self-supporting reference resource available at no cost to any forensic practitioner in the work or any student, faculty member or person in law, medicine, or law enforcement who has an interest in obtaining information in support of their requests for knowledge in the forensic sciences. The Registry of Unusual Cases represents an outstanding resource available at the Center for the collection, registration, and dissemination of information to anyone who reports or inquires about similar cases. This service is explained and illustrated in this article.
The origin of the psychological autopsy was in the late 1950s and the result of a collaboration b... more The origin of the psychological autopsy was in the late 1950s and the result of a collaboration between the Los Angeles County Chief Medical Examiner-Coroner's Office and the Los Angeles Suicide Prevention Center. It was conceptualized as a thorough retrospective analysis of the decedent's state of mind and intention at the time of death. It was used initially in "equivocal" deaths where the manner of death was possibly either suicide or accident. Later, it was used in cases where a party (primarily family members) protested the Medical Examiner-Coroner's suicide determination. Over the past 25 years, the University of Southern California Institute of Psychiatry, Law, and Behavioral Science has served as the psychiatric/psychological consultants to the Coroner's Department. Research findings, the use of this approach in high-profile cases, and the most recent manner in which the psychological autopsy is conducted are discussed.
A reliable and sensitive screening procedure has been developed for drugs of abuse (amphetamines,... more A reliable and sensitive screening procedure has been developed for drugs of abuse (amphetamines, cocaine metabolites, opiates, and phencyclidine [PCP]) in meconium from Infants. The substances in meconlum were extracted with chloroform-lsopropanol (3:1)and screened by enzyme multiplied Immunoassay technique (EMIT). The lower detection limits of the EMIT for benzoylecgonine, d-methamphetamine, morphine, and PCP were 250 ng/g, 730 ng/g, 110 ng/g, and 100 ng/g, respectively. This method was applied to meconium from 50 infants born to mothers suspected of using the drugs of abuse during pregnancy. Of the 50, 12 were positive for bonzoylecgonine, seven for opiates, and one for PCP. The presence of bonzoylecgonlne and PCP in meconium was confirmed by gas chromatography/mass spectrometry and that of opiates by thin-layer chromatography. The routine analysis of meconium for drugs of abuse is recommended in cases where (A) urine can not be obtained or (B) urinalysis is negative for the substances despite a strong suspicion of maternal use of the substances during pregnancy.
The findings of the Los Angeles County Street Drug Identification Program over the period from 19... more The findings of the Los Angeles County Street Drug Identification Program over the period from 1971 to 1980 for analysis of 1163 samples of street drugs represented as stimulants are presented. Of the 614 alleged cocaine samples, cocaine was found to be absent in 19.2%, found combined with stimulant substitutes in 22.5%, and found by itself in 58.3% of these samples. The validity for 473 alleged amphetamine samples was only 27.1%, with 23.0% of samples found to contain stimulant substitutes along with amphetamine, and 49.9% of the samples lacking any of the alleged drug. Seventy-six alleged methamphetamine samples showed 32.9% validity, with 3.9% of samples having mixtures of alleged drug and substitutes, and 63.2% of samples lacking any methamphetamine. A total of 15 different stimulant substitutes were found in 74 combinations. Caffeine, ephedrine, lidocaine, and procaine were the commonest substitutes.
The American Journal of Forensic Medicine and Pathology, 1980
In 10,995 consecutive medicolegal autopsies, there were 19 deaths due to an unsuspected primary i... more In 10,995 consecutive medicolegal autopsies, there were 19 deaths due to an unsuspected primary intracranial neoplasm. Nine (47.4%) of the tumors were in the astrocytoma-glioblastoma category. The remainder included four cases of oligodendroglioma and one case each of medulloblastoma, microglioma, meningioma, teratoma, colloid cyst and pituitary chromophobe adenoma. In six cases, death occurred following abrupt loss of consciousness, or else the patient was found dead. In five of these six cases, there were no known preceding symptoms. The remaining 13 patients exhibited the characteristic symptoms produced by intracranial neoplasms, including symptoms of increased intracranial pressure, epilepsy, and psychiatric manifestations. Only one patient presented with a focal neurologic deficit which resolved in 24 hours. A comparison of the duration and type of symptomatology exhibited by these patients with a hospital patient population in which death was caused by a previously diagnosed primary intracranial neoplasm and an autopsy was performed underscored 1) the shorter duration of acute symptomatology, 2) the nonlocalizing nature of the symptoms manifested, 3) the lack of progression or change in symptoms in those patients in whom epilepsy was the primary manifestation of their underlying disease, and 4) the lower incidence of focal neurologic deficits as the presenting symptoms in our series.
The American Journal of Forensic Medicine and Pathology, 1986
A system is described for coding of anatomic--including forensic--pathologic diagnoses from necro... more A system is described for coding of anatomic--including forensic--pathologic diagnoses from necropsy cases using a microcomputer. The SNOMED software from the College of American Pathologists is utilized. RAM-disk software is employed to enhance the speed of operation of the system. The microcomputer can be operated by clerical staff versed in medical terminology. Speed of entry and retrieval, with minimal manual interaction, is an important aspect of operation. Equipment and storage costs are minimal.
The American Journal of Forensic Medicine and Pathology, 1988
This article presents the significance of cyanide in medicolegal investigation of fires. It discu... more This article presents the significance of cyanide in medicolegal investigation of fires. It discusses the various aspects of fire investigation and the pathophysiology of cyanide toxicity and evidence interpretation in fire investigations.
The American Journal of Forensic Medicine and Pathology, 1988
Hypoglycemia involving a serum glucose of 40 mg/dl or less may lead to death from hypoglycemic co... more Hypoglycemia involving a serum glucose of 40 mg/dl or less may lead to death from hypoglycemic coma. Hypoglycemia may be a factor in sudden or unexpected deaths investigated by a medical examiner. We reviewed the data from 54,850 autopsies in a large acute-care medical center to investigate the range of underlying conditions leading to hypoglycemic coma and found 123 cases, which included complications of alcoholism in 41 (33%), drugs in 26 (21%), neoplasia in 26 (21%), conditions producing chronic passive congestion of liver in eight (7%), debilitating neurologic disease in eight (7%), endocrine disorders in four (3%), and a variety of miscellaneous conditions in ten (8%) cases. The commonest mechanisms producing hypoglycemia included liver disease with impaired carbohydrate metabolism, endogenous or exogenous drug or hormonal effect, and inanition from decreased intake of food.
Young Japanese females had the highest suicide rate in the world until the end of the 1960s, and ... more Young Japanese females had the highest suicide rate in the world until the end of the 1960s, and it is still extremely high. This paper attempts to explain this phenomenon primarily in terms of vulnerability-in their personalities, social conditions, and role conflicts. Concomitant psychological traits and social conditions are discussed. The cultural conflict of young Japanese women is explicated in terms of psychological and historical information. In addition, the reasons for the differences between the suicide rates among females in the Tokyo area and the Kytot-Osaka area are explored largely in terms of concepts relating to authoritarianism and its correlates.
Nihon hōigaku zasshi = The Japanese journal of legal medicine, 2002
This is a review article dealing with the half-century evolution of the quality assurance program... more This is a review article dealing with the half-century evolution of the quality assurance program to improve patient care in the United States. The author attempted to point out some differences in approach to solving the medical error and medical malpractice problems between Japan and the U.S. In the 1970s, an increase in the medical malpractice claims resulted in such high premiums for medical liability insurance that it threatened the healthcare system in the U.S. Urgent legislative remedy, the Medical Injury Compensation Reform Act (MICRA) was put into place in the State of California. This act was the beginning of the definitive quality improvement in our health care system. It was followed by other improvement programs, such as the National Practitioner Data Bank (NPDB) for tracking physicians with malpractice judgments or settlements against them, or who have problems with the medical licensing Board or other impairments. By comparison, in recent years, in Japan, there has be...
... On june 9, 1970 (approximately seven months before) this individual had left his home and had... more ... On june 9, 1970 (approximately seven months before) this individual had left his home and had never returned. Nothing had been heard from him in spite of a missingperson report filed by his family on June II, 1970. Inquiry ...
The American Journal of Forensic Medicine and Pathology, 1992
A rare iatrogenic complication of subclavian vein catheterization for hemodialysis is massive hyd... more A rare iatrogenic complication of subclavian vein catheterization for hemodialysis is massive hydrothorax. A case is presented that illustrates the need for adherence to a standard procedure of prompt roentgenologic examination in conjunction with catheterization, and emphasizes the importance of the autopsy as a means of quality assurance.
The American Journal of Forensic Medicine and Pathology, 1980
The Milton Helpern International Center for the Forensic Sciences represents a unique self-suppor... more The Milton Helpern International Center for the Forensic Sciences represents a unique self-supporting reference resource available at no cost to any forensic practitioner in the work or any student, faculty member or person in law, medicine, or law enforcement who has an interest in obtaining information in support of their requests for knowledge in the forensic sciences. The Registry of Unusual Cases represents an outstanding resource available at the Center for the collection, registration, and dissemination of information to anyone who reports or inquires about similar cases. This service is explained and illustrated in this article.
The origin of the psychological autopsy was in the late 1950s and the result of a collaboration b... more The origin of the psychological autopsy was in the late 1950s and the result of a collaboration between the Los Angeles County Chief Medical Examiner-Coroner's Office and the Los Angeles Suicide Prevention Center. It was conceptualized as a thorough retrospective analysis of the decedent's state of mind and intention at the time of death. It was used initially in "equivocal" deaths where the manner of death was possibly either suicide or accident. Later, it was used in cases where a party (primarily family members) protested the Medical Examiner-Coroner's suicide determination. Over the past 25 years, the University of Southern California Institute of Psychiatry, Law, and Behavioral Science has served as the psychiatric/psychological consultants to the Coroner's Department. Research findings, the use of this approach in high-profile cases, and the most recent manner in which the psychological autopsy is conducted are discussed.
A reliable and sensitive screening procedure has been developed for drugs of abuse (amphetamines,... more A reliable and sensitive screening procedure has been developed for drugs of abuse (amphetamines, cocaine metabolites, opiates, and phencyclidine [PCP]) in meconium from Infants. The substances in meconlum were extracted with chloroform-lsopropanol (3:1)and screened by enzyme multiplied Immunoassay technique (EMIT). The lower detection limits of the EMIT for benzoylecgonine, d-methamphetamine, morphine, and PCP were 250 ng/g, 730 ng/g, 110 ng/g, and 100 ng/g, respectively. This method was applied to meconium from 50 infants born to mothers suspected of using the drugs of abuse during pregnancy. Of the 50, 12 were positive for bonzoylecgonine, seven for opiates, and one for PCP. The presence of bonzoylecgonlne and PCP in meconium was confirmed by gas chromatography/mass spectrometry and that of opiates by thin-layer chromatography. The routine analysis of meconium for drugs of abuse is recommended in cases where (A) urine can not be obtained or (B) urinalysis is negative for the substances despite a strong suspicion of maternal use of the substances during pregnancy.
The findings of the Los Angeles County Street Drug Identification Program over the period from 19... more The findings of the Los Angeles County Street Drug Identification Program over the period from 1971 to 1980 for analysis of 1163 samples of street drugs represented as stimulants are presented. Of the 614 alleged cocaine samples, cocaine was found to be absent in 19.2%, found combined with stimulant substitutes in 22.5%, and found by itself in 58.3% of these samples. The validity for 473 alleged amphetamine samples was only 27.1%, with 23.0% of samples found to contain stimulant substitutes along with amphetamine, and 49.9% of the samples lacking any of the alleged drug. Seventy-six alleged methamphetamine samples showed 32.9% validity, with 3.9% of samples having mixtures of alleged drug and substitutes, and 63.2% of samples lacking any methamphetamine. A total of 15 different stimulant substitutes were found in 74 combinations. Caffeine, ephedrine, lidocaine, and procaine were the commonest substitutes.
The American Journal of Forensic Medicine and Pathology, 1980
In 10,995 consecutive medicolegal autopsies, there were 19 deaths due to an unsuspected primary i... more In 10,995 consecutive medicolegal autopsies, there were 19 deaths due to an unsuspected primary intracranial neoplasm. Nine (47.4%) of the tumors were in the astrocytoma-glioblastoma category. The remainder included four cases of oligodendroglioma and one case each of medulloblastoma, microglioma, meningioma, teratoma, colloid cyst and pituitary chromophobe adenoma. In six cases, death occurred following abrupt loss of consciousness, or else the patient was found dead. In five of these six cases, there were no known preceding symptoms. The remaining 13 patients exhibited the characteristic symptoms produced by intracranial neoplasms, including symptoms of increased intracranial pressure, epilepsy, and psychiatric manifestations. Only one patient presented with a focal neurologic deficit which resolved in 24 hours. A comparison of the duration and type of symptomatology exhibited by these patients with a hospital patient population in which death was caused by a previously diagnosed primary intracranial neoplasm and an autopsy was performed underscored 1) the shorter duration of acute symptomatology, 2) the nonlocalizing nature of the symptoms manifested, 3) the lack of progression or change in symptoms in those patients in whom epilepsy was the primary manifestation of their underlying disease, and 4) the lower incidence of focal neurologic deficits as the presenting symptoms in our series.
The American Journal of Forensic Medicine and Pathology, 1986
A system is described for coding of anatomic--including forensic--pathologic diagnoses from necro... more A system is described for coding of anatomic--including forensic--pathologic diagnoses from necropsy cases using a microcomputer. The SNOMED software from the College of American Pathologists is utilized. RAM-disk software is employed to enhance the speed of operation of the system. The microcomputer can be operated by clerical staff versed in medical terminology. Speed of entry and retrieval, with minimal manual interaction, is an important aspect of operation. Equipment and storage costs are minimal.
The American Journal of Forensic Medicine and Pathology, 1988
This article presents the significance of cyanide in medicolegal investigation of fires. It discu... more This article presents the significance of cyanide in medicolegal investigation of fires. It discusses the various aspects of fire investigation and the pathophysiology of cyanide toxicity and evidence interpretation in fire investigations.
The American Journal of Forensic Medicine and Pathology, 1988
Hypoglycemia involving a serum glucose of 40 mg/dl or less may lead to death from hypoglycemic co... more Hypoglycemia involving a serum glucose of 40 mg/dl or less may lead to death from hypoglycemic coma. Hypoglycemia may be a factor in sudden or unexpected deaths investigated by a medical examiner. We reviewed the data from 54,850 autopsies in a large acute-care medical center to investigate the range of underlying conditions leading to hypoglycemic coma and found 123 cases, which included complications of alcoholism in 41 (33%), drugs in 26 (21%), neoplasia in 26 (21%), conditions producing chronic passive congestion of liver in eight (7%), debilitating neurologic disease in eight (7%), endocrine disorders in four (3%), and a variety of miscellaneous conditions in ten (8%) cases. The commonest mechanisms producing hypoglycemia included liver disease with impaired carbohydrate metabolism, endogenous or exogenous drug or hormonal effect, and inanition from decreased intake of food.
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Papers by Thomas Noguchi