Publications by authors named "Kazuhisa Funayama"

8 Publications

  • Page 1 of 1

The usefulness of postmortem computed tomography angiography for subdural hematoma caused by rupture of the cortical artery: A report of two autopsy cases and a literature review.

Leg Med (Tokyo) 2021 Jul 12;53:101941. Epub 2021 Jul 12.

Division of Legal Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Center of Cause of Death Investigation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Acute subdural hematoma (SDH) occurs following severe head trauma with brain contusion or rupture of bridging veins. Conversely, SDH caused by rupture of a cortical artery without trauma or with minor trauma is also possible. Although over 150 cases of the latter SDH have been reported, they were predominantly diagnosed only during surgery, and therefore, no adequate histological evaluation has been performed. Therefore, essential etiology of this SDH type has remained unclear. In addition, the scarcity of autopsy cases may be attributed to arterial rupture being missed if the macroscopic findings are too minimal to detect during autopsy. Here, we describe two autopsy cases of SDH of cortical artery origin. Extravasation on postmortem computed tomography angiography and arterial leakage on macroscopic observation during autopsy facilitated detection of the ruptured artery and allowed detailed histological evaluation of the ruptured artery and adjacent dura mater. The etiology of arterial rupture is briefly described on the basis of histopathological findings in this study and the available literature.
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http://dx.doi.org/10.1016/j.legalmed.2021.101941DOI Listing
July 2021

Formulas for estimating living stature based on bony pelvic measurements reconstructed from computed tomography images.

Homo 2021 Mar;72(1):33-40

Division of Orthopedic Surgery Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

A major challenge in anthropology is the estimation of human stature based on human bones since the stature of cadavers is slightly different from that of living humans. This study aimed to investigate the feasibility of estimating living stature in Japanese subjects based on sacral and coccygeal lengths as measured on three-dimensional (3D) models of the femur and pelvis reconstructed from cross-sectional computed tomography (CT) images. For this cross-sectional study, 106 healthy Japanese subjects (54 men and 52 women) were recruited. We measured the distances from the anterosuperior iliac spine (ASIS) to the most posterior point of the ischial spine (IS) (ASIS-IS), and from the ASIS to the most inferior point of the ischial tuberosity (IT) (ASIS-IT) on 3D bone models reconstructed from multi-slice CT images. Correlations of living stature with ASIS-IS and/or ASIS-IT on the left and right sides of the pelvis were evaluated. Multiple regression equations were derived and used as formulas for living stature estimation. In men, living stature had strong correlations with ASIS-IS + ASIS-IT on both the left and right sides; Pearson's correlation coefficients were 0.717 and 0.706, respectively. In contrast, in women, living stature showed stronger correlations with all of the studied parameters; Pearson's correlation coefficients were highest for ASIS-IS + ASIS-IT on both the left and right sides (r = 0.753 and 0.744, respectively) compared with those in men. Formulas based on ASIS-IS + ASIS-IT provided the best estimation in both men and women, while ASIS-IS alone demonstrated a better estimation than ASIS-IT on both the left and right sides. This study revealed that ASIS-IS and ASIS-IT measured from CT images were reliable predictors of living stature in the Japanese population. Our estimation formulas were derived from measurements of living stature that were not affected by the physiological changes observed in cadavers. To the best of our knowledge, this is the first study to derive estimation formulas based on living stature. Our method may be useful in the identification of disaster victims, wherein long bones are usually not found intact but pelvic bones are. Furthermore, the findings could be relevant to the field of anthropology for estimating living stature.
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http://dx.doi.org/10.1127/homo/2021/1239DOI Listing
March 2021

Stature estimation formulae based on bony pelvic dimensions and femoral length.

Homo 2020 Apr;71(2):111-119

Division of Orthopedic Surgery Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

We investigated the feasibility of estimating living stature in Japanese subjects using femoral length and pelvic dimensions measured on three-dimensional (3D) pelvic models reconstructed from cross-sectional computed tomography (CT) images. For this cross-sectional study, we recruited 106 healthy Japanese subjects. Maximum and bicondylar femoral length, as well as pelvic width, depth, and height, were measured on 3D bone models reconstructed from multi-slice CT images. The correlation of stature with each parameter was evaluated, and multiple regression equations were derived as formulae for living stature estimation. Prediction accuracy was evaluated as the mean absolute difference (MAD) between the measured and estimated statures. Maximum and bicondylar femoral lengths were similar and showed strong correlations with stature (> 0.8 in both males and females). Among the pelvic dimensions, height (craniocaudal length) showed the strongest correlation with stature in both males ( = 0.649) and females ( = 0.684). Formulae using femoral length plus pelvic height provided the best estimation of living stature in both males and females (MAD, 25-26 mm). Among the studied pelvic dimensions, height provided the best estimation of living stature when used alone (MAD, 34-36 mm) in both males and females. The intraclass correlation coefficients were high (> 0.9) for both intraobserver and interobserver reliability. Femoral length and pelvic height measured on CT images are reliable predictors of living stature in the Japanese population. Such tools are particularly useful in disaster victim identification, when the long bones are often not intact but the pelvic bones are.
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http://dx.doi.org/10.1127/homo/2020/1116DOI Listing
April 2020

An autopsy case of peliosis hepatis with X-linked myotubular myopathy.

Leg Med (Tokyo) 2019 May 18;38:77-82. Epub 2019 Apr 18.

Division of Legal Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan; Center of Cause of Death Investigation, Faculty of Medicine, Niigata University, Niigata, Japan. Electronic address:

This report describes the autopsy case of a 4-year-old boy who died from hepatic hemorrhage and rupture caused by peliosis hepatis with X-linked myotubular myopathy. Peliosis hepatis is characterized by multiple blood-filled cavities of various sizes in the liver, which occurs in chronic wasting disease or with the use of specific drugs. X-linked myotubular myopathy is one of the most serious types of congenital myopathies, in which an affected male infant typically presents with severe hypotonia and respiratory distress immediately after birth. Although each disorder is rare, 12 cases of pediatric peliosis hepatis associated with X-linked myotubular myopathy have been reported, including our case. Peliosis hepatis should be considered as a cause of hepatic hemorrhage despite its low incidence, and it requires adequate gross and histological investigation for correct diagnosis.
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http://dx.doi.org/10.1016/j.legalmed.2019.04.005DOI Listing
May 2019

Ascaris lumbricoides found in ashore corpses from Korean peninsula to Japan.

Parasitol Int 2019 Jun 7;70:1-4. Epub 2019 Jan 7.

Department of Tropical Medicine and Parasitology, Dokkyo Medical University, Mibu, Tochigi, Japan.

Yearly, several reports of unknown boats and corpses brought by the Tsushima Current are found ashore Japanese coast. Niigata prefecture had the highest number of the drifting ashore corpses in Japan with 45.7% (16/35) in 2017. Corpses from North Korea, confirmed by documents and photos were autopsied and in 3/16 was possible to recover worms full of eggs, morphologically identified as ascarids. Further molecular analysis of ITS1, 5.8S rDNA and ITS2 sequences confirmed all specimens were Ascaris lumbricoides. The contamination level by Ascaris lumbricoides eggs in the coast, the health impact and consequences of the epidemiological bridging produced by this forced migration in public health should be investigated. Moreover, control of helminthiases might be a necessary task in North Korea.
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http://dx.doi.org/10.1016/j.parint.2019.01.002DOI Listing
June 2019

An autopsy case of prolonged asphyxial death caused by the impacted denture in the esophagus.

Leg Med (Tokyo) 2016 Nov 20;23:95-98. Epub 2016 Oct 20.

Division of Legal Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medicine and Dental Sciences, Niigata 951-8510, Japan. Electronic address:

A foreign body impacted in the esophagus is not a rare incident among adults or children. In adults, a dental prosthesis is prone to become impacted in the esophagus. The diagnostic difficulty of this often causes a delay in its removal, which can lead to serious complications, including death. This report describes the autopsy case of a man who died of prolonged asphyxiation induced by the delayed removal of an impacted denture, which was misdiagnosed on his first visit notwithstanding that a part of the denture could be seen on X-rays. Cases in which an impacted denture led to death have rarely been reported in contrast to numerous papers about recovered cases.
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http://dx.doi.org/10.1016/j.legalmed.2016.10.006DOI Listing
November 2016

Changes in aortic shape and diameters after death: comparison of early postmortem computed tomography with antemortem computed tomography.

Forensic Sci Int 2013 Feb 30;225(1-3):27-31. Epub 2012 May 30.

Department of Diagnostic Radiology, Niigata City General Hospital, Chuo-ku, Niigata, Japan.

Purpose: The purpose of this study is to evaluate the postmortem deformation of the aorta on postmortem computed tomography (CT) by comparison with the antemortem CT in the same patient.

Materials And Methods: A total of 58 non-traumatic patients without hemorrhagic events who underwent torso CT before and shortly after death were enrolled. Antemortem chest and abdominal CT were obtained in 44 cases and in 57 cases, respectively. The lengths of the major and minor axes of the ascending and descending thoracic aorta and the abdominal aorta were measured on both antemortem and postmortem CT in the same patient. To evaluate the shape of the aorta, the major axis-minor axis ratio (Ma-MiR) was calculated. Mean values of the diameters of the aorta and Ma-MiRs on postmortem CT were compared with those on antemortem CT using the Wilcoxon signed-rank test. We also evaluated the major and minor axes and Ma-MiRs on both antemortem and postmortem CT in two age groups: 65 years and under (n=13) and over 65 years (n=45).

Results: At each level tested, the aorta significantly shrank after death (p<0.001) (ascending thoracic aorta, descending thoracic aorta, and abdominal aorta: 38.5 mm × 33.5 mm, 28.0 mm × 25.9 mm, and 24.4 mm × 21.8 mm on antemortem CT, 30.0 mm × 26.2 mm, 24.4 mm × 20.7 mm, and 21.5 mm × 14.5 mm on postmortem CT, respectively). The postmortem Ma-MiRs significantly increased at the descending thoracic aorta and the abdominal aorta (p<0.001). The diameters of the aorta are longer in older cases at all levels on both antemortem and postmortem CT. The reduction rates were larger in younger cases than older cases at all levels.

Conclusions: After death, the aorta shrunk at all levels, and became oval in shape in descending thoracic and abdominal aorta. The contraction was greater in younger cases than older cases. Investigators who interpret postmortem imaging should be aware of the postmortem deformation of the aorta.
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http://dx.doi.org/10.1016/j.forsciint.2012.04.037DOI Listing
February 2013

The effectiveness of postmortem multidetector computed tomography in the detection of fatal findings related to cause of non-traumatic death in the emergency department.

Eur Radiol 2012 Jan 23;22(1):152-60. Epub 2011 Aug 23.

Department of Diagnostic Radiology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Niigata 950-1197, Japan.

Objectives: To investigate the diagnostic performance of postmortem multidetector computed tomography (PMMDCT) for the detection of fatal findings related to causes of non-traumatic death in the emergency department (ED).

Methods: 494 consecutive cases of clinically diagnosed non-traumatic death in ED involving PMMDCT were enrolled. The fatal findings were detected on PMMDCT and classified as definite or possible findings. These findings were confirmed by autopsy in 20 cases.

Results: The fatal findings were detected in 188 subjects (38.1%) including 122 with definite (24.7%) and 66 with possible finding (13.4%). Definite findings included 21 cases of intracranial vascular lesions, 84 with intra-thoracic haemorrhage, 13 with retroperitoneal haemorrhage and one with oesophagogastric haemorrhage. In three patients who had initially been diagnosed with non-traumatic death, PMMDCT revealed fatal traumatic findings. Two definite findings (two haemopericardiums) and seven possible findings (two intestinal obstructions, one each of multiple liver tumours central pulmonary artery dilatation, pulmonary congestion, peritoneal haematoma, and brain oedema) were confirmed by autopsy. The causes of death were not determined in cases with possible findings without autopsy.

Conclusions: PMMDCT is a feasible tool for detecting morphological fatal findings in non-traumatic death in ED. It is important to know the ability and limitation of PMMDCT.
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http://dx.doi.org/10.1007/s00330-011-2248-6DOI Listing
January 2012
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