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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 李俊億 | |
| dc.contributor.author | Wen-Chien Yen | en |
| dc.contributor.author | 顏妏倩 | zh_TW |
| dc.date.accessioned | 2021-06-13T17:30:07Z | - |
| dc.date.available | 2012-08-24 | |
| dc.date.copyright | 2011-10-05 | |
| dc.date.issued | 2011 | |
| dc.date.submitted | 2011-07-11 | |
| dc.identifier.citation | 1. Knight B. and Saukko P.J., Knight's forensic pathology. 2004, New York: Distributed in the U.S. by Oxford University Press.
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Stuttgart/Jena: Gustav Fischer Verlag. Vol. 4. 1986–1991. 44. Sciences C.A.o. Freshwater diatom identification and information resource. Available from: http://research.calacademy.org/izg/research/diatom/. 45. CIMT. Phytoplankton identification - Saltwater diatoms. Available from: http://cimt.ucsc.edu/habid/phytolist.html. 46. Lunetta P., Smith G.S., Penttila A., and Sajantila A., Undetermined drowning. Medicine, Science, and the Law, 2003. 43(3): p. 207-214. 47. Kringsholm B., Filskov A., and Kock K., Autopsied cases of drowning in Denmark 1987-1989. Forensic Science International, 1991. 52(1): p. 85-92. 48. Wirthwein D.P., Barnard J.J., and Prahlow J.A., Suicide by drowning: a 20-year review. Journal of Forensic Sciences, 2002. 47(1): p. 131-136. 49. Lunetta P., Penttila A., and Sajantila A., Circumstances and macropathologic findings in 1590 consecutive cases of bodies found in water. American Journal of Forensic Medicine and Pathology, 2002. 23(4): p. 371-376. 50. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/39500 | - |
| dc.description.abstract | 僅藉由法醫解剖欲診斷出水中發現屍體之死亡原因著實為一項艱難的任務，尤其水中發現屍體不易被發現，死後變化會因浸泡時間愈長，腐敗狀態愈明顯，解剖病理能得到的資訊相對也更少。為輔助辨別診斷死亡原因是否為生前溺水死亡，關於各種診斷方法之研究層出不窮，其中以矽藻檢驗被認是最具診斷價值的方法之一，但台灣目前仍未將矽藻分析納入輔助診斷生前溺水死亡之常規檢驗流程中。因此本實驗藉由分析疑似溺水案件之法醫解剖檢體矽藻分布情形，包含矽藻定量及矽藻定性分析，探討矽藻檢驗於診斷溺水死亡之實用性。本實驗共收集99件疑似溺水案件及20件非疑似溺水案件，所有案件均收集自台灣法務部法醫研究所法醫解剖案件，由法醫解剖採集矽藻分析用檢體，包含5公克肺臟下葉組織、蝶竇內所含有液體及一段肋骨/鎖骨刮取內部骨髓，以上檢體經酸處理萃取出矽藻製成玻片後，於相位差顯微鏡下計數所有矽藻數量(矽藻定量)及辨識出各種不同的矽藻屬別(矽藻定性)。其中20件非疑似溺水案件之所有檢體均未檢出矽藻。99件疑似溺水案件經法醫解剖及司法調查後，91件確認為生前溺水死亡，其中半數以上案件可同時在蝶竇液及肺臟檢體中檢出矽藻。本研究顯示矽藻分析於蝶竇液、肺臟及肋骨/鎖骨檢體內的敏感度分別為88% (±7.25%)、68% (±9.73%)、6% (±5.5%)；特異度分別為81% (±19.13%)、89% (±14.52%)、100% (±0.0%)。季節分析及水域環境分析結果顯示冬季/春季及海水環境對於肺臟矽藻陽性檢出率有明顯影響，以上因素均會造成肺臟偽陰性機率上升；本實驗中5件肋骨/鎖骨矽藻陽性的案件，其肺臟矽藻密度均達70個矽藻/每5克肺臟以上。矽藻定性結果則顯示不論任何檢體或環境以Nitzschia、Navicula、Cyclotella及Thalassiosira以上四屬矽藻出現頻率最高。綜合以上所述，本研究認為蝶竇液及肺臟內之矽藻分析對於診斷生前溺水死亡有一定的參考價值，但仍需配合其他發現，包含解剖發現、病理發現、毒物學檢驗發現，及現場鑑識調查與司法調查，共同配合以期達到最正確的死亡原因診斷結果。 | zh_TW |
| dc.description.provenance | Made available in DSpace on 2021-06-13T17:30:07Z (GMT). No. of bitstreams: 1 ntu-100-R95452010-1.pdf: 8557071 bytes, checksum: c17a864091ea02c09ecc616c22b12744 (MD5) Previous issue date: 2011 | en |
| dc.description.tableofcontents | 摘要 I
Abstract III 目錄 V 圖次 VIII 表次 IX 第一章 前言 1 第二章 文獻探討 2 第一節 水中發現屍體 (Bodies found in water) 2 一、 水中發現屍體於法醫學領域之意義 2 二、 溺水死亡的定義及機轉 3 三、 法醫鑑定溺水死亡之參考方法 4 第二節 矽藻 (Diatoms) 7 一、 矽藻的結構、特性及分類 7 二、 矽藻於法醫學鑑定溺水死亡之應用 9 第三章 材料與方法 13 第一節 實驗設計 13 一、 實驗設計流程圖 13 第二節 實驗材料 14 一、 案件收集 14 二、 檢體採集 14 三、 矽藻檢驗試劑 15 四、 陽性/陰性水樣來源 15 五、 矽藻檢驗儀器 15 第三節 實驗方法 15 一、 肺臟及肋骨/鎖骨之前處理 15 二、 蝶竇液之前處理 16 三、 陽性/陰性水樣之前處理 16 四、 製作矽藻玻片 16 五、 矽藻定量 17 六、 矽藻定性 17 七、 矽藻檢驗效度指標 17 第四章 結果 18 第一節 疑似溺水案件基本資料分析 18 一、 性別及年齡分布 18 二、 職業分布 18 三、 死者生前精神狀態 18 第二節 疑似溺水案件法醫解剖鑑定報告分析 19 一、 死亡原因鑑定結果 19 二、 解剖發現 19 三、 死亡方式鑑定結果 19 四、 發現屍體地點統計 20 五、 發現屍體月份及季節統計 20 第三節 疑似溺水案件矽藻檢驗結果 20 一、 矽藻定量分析結果 20 二、 矽藻定性分析結果 23 第四節 矽藻檢驗之效度 26 一、 非疑似溺水案件(遠離水源環境之屍體)矽藻檢驗結果 26 二、 效度指標 26 第五章 討論 28 第一節 水中發現屍體之流行病學 28 第二節 水中發現屍體之法醫解剖發現 29 第三節 矽藻定量結果 30 一、 鑑定生前溺水死亡案件分析 30 二、 鑑定非生前溺水死亡案件分析 32 三、 訂定區別生前落水及死後落水矽藻密度值之困難處 33 第四節 矽藻定性結果 34 一、 不同檢體之結果分析 34 二、 不同環境之結果分析 35 第五節 矽藻檢驗之效度分析 36 第六節 實驗限制及未來展望 37 第六章 結論 39 參考文獻 41 附錄(案件矽藻照片) 69 | |
| dc.language.iso | zh-TW | |
| dc.subject | 診斷死亡原因 | zh_TW |
| dc.subject | 矽藻 | zh_TW |
| dc.subject | 溺水 | zh_TW |
| dc.subject | 法醫學 | zh_TW |
| dc.subject | Diatoms | en |
| dc.subject | diagnosis of cause of death | en |
| dc.subject | forensic science | en |
| dc.subject | drowning | en |
| dc.title | 疑似溺水案件法醫解剖檢體矽藻分布之研究 | zh_TW |
| dc.title | Diatom analysis in forensic autopsy samples
from suspected drowning cases | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 99-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 謝幸娟,蔡麗琴,孫家棟 | |
| dc.subject.keyword | 矽藻,溺水,法醫學,診斷死亡原因, | zh_TW |
| dc.subject.keyword | Diatoms,drowning,forensic science,diagnosis of cause of death, | en |
| dc.relation.page | 87 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2011-07-12 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 法醫學研究所 | zh_TW |
| 顯示於系所單位： | 法醫學科所 | |
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