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2. 2 KTV () ( ) X () 3. 3 4. 4 ()( ) ( 1 ) 1 5. 5 2 2 94 299793 6018 6. 6 () ( ) () 7. 7 ( ) () 8. 8 () - 42 91.1.5 2330 2350 KTV 91.1.6 0310 ( ) 0915 0940 () 8 20 ? ? 1040 1200 9. 9 ? 91 53 12 (7) 4 2155 6 23 45 91.1.7 16 91.1.14 0930 23 1440 1700 () 1945 2030 23 () 10. 10 ()119 39 53 34 119 3 1.90.1.6(91.1.6) 4AM D:pt at 0310AM ER Lt footTPR( )36.9 BP( )135/42 2. 90.1.6 5AMpt Lt foot 820 0915-0940 1040-1200 3. 124 4.170830AM 4 1014 3 This 34y/o was male well before .He began to suffered from Lt leg open vid p gun injury accident. He cant walking severe pain was found. He was 119 ambulance brought to our SER for help. The xray showed Lt tibia open Fr. So he was admitted to our word for further evaluate management. 11. 11 201010002960 ()1.9116820 ( ) 2. 09153.1040 4.8 () 5.955 5 () 12. 12 () 12 () () 955 13. 13 4 () 2330 4 32 41 14. 14 15. 15 () ( ) 16. 16 () 91 1 6 8 20 91 1 6 9 15 91 1 6 10 40 ( ) 91 1 6 8 91 1 5 21 KTV KTV KTV 17. 17 91 1 5 21 KTV 1. 2. 18. 18 10 19. 19 1. 23 30 20. 20 2. 3. 21. 21 22. 22 1. 2. 1. 2. 23. 23 24. 24 25. 25 26. 26 () Made in Taiwan 5 5 () 1. 2. 3. 27. 27 2330 28. 28 () (Lidocaine) () ()() ( ) 29. 29 () 30. 30 DNA 6 () A10 A10 6 12 /2011 3 2 16-17 31. 31 A10 32. 32 A10 33. 33 34. 34 1. 2. () () 35. 35 () ( ) () () ( 153-158)1. (1) (2) (3) 36. 36 (4) 2. 1. 2. 37. 37 () ( ) ( ) ( ) ( ) 38. 38 ( ) () () 39. 39 40. 40 ( ) (() ) () 41. 41 7 5 7 2012 4 13 42. 42 8 () Ken Newgard, M.D. 8 There will be some complaints that we're pushing our people too hard. I don't give a damn about such complaints. I believe that an ounce of sweat will save a gallon of blood. The harder we push, the more Germans we kill. The more Germans we kill, the fewer of our men will be killed. Pushing harder means fewer casualties. I want you all to remember that. My men don't surrender. I don't want to hear of any soldier under my command being captured unless he is hit. Even if you are hit, you can still fight. That's not just bullshit either. I want men like the lieutenant in Libya who, with a Luger against his chest, swept aside the gun with his hand, jerked his helmet off with the other and busted the hell out of the Boche with the helmet. Then he picked up the gun and he killed another German. All this time the man had a bullet through his lung. That's a man for you! George S. Patton's speech to the Third Army 43. 43 10% 1995Warren (baroreceptors) () 60% 70 5.560c.c. 44. 44 4200c.c. () 11 20%4.6 20%4.6 4.6 9 1) ()2) 3)4) 5) 6) 9 9 Ken Newgard, M.D.:THE PHYSIOLOGICAL EFFECTS OF HANDGUN BULLETS The Mechanisms of Wounding and Incapacitation, WOUND BALLISTICS REVIEW(journal of the international wound ballistics association) Fall/92, pp.12-17 45. 45 46. 46 47. 47 1. 2. ( 34 ) 3 4 3( ) 429 48. 48 ( )32529 3 () 325 29 9 342529 () 49. 49 () ( ) 3 3 3 3 3 50. 50 5 ( 64) ( AP-9mm- LUGER) (1) ( )() 51. 51 ( )( ) ( ) ( () ) (3 ) ( 4 ) ( 52. 52 ) ( )( ) ( ) ( ) ( ) ( ) ( )(2) ( 53. 53 ) (3) 54. 54 ( ) ( ) ( ) ( ) ( ) () ()() 55. 55 ( ) ( ) ( )( ) (AP -9mm -LUGER) 9mm(AP-9mm-LUGER) Browning-BDM- 9mm-Luger ( 0000000000) 0930005164 56. 56 5 (64 ) ( AP-9mm-LUGER) Forensic Science:An Introduction to Criminalistics -- 57. 57 ( ) ( ) () 58. 58 () () -- 59. 59 () Forensic Science: An Introduction to Criminalistics () 10 10 So-called hand blank studies have shown that very high levels of both antimony and barium can be found on the hands of nonshooters on occasion. Thus, in order to interpret measurements on unknown samples, it is necessary to establish some kind of threshold level below which a case specimen will be interpreted as negative or inconclusive. This threshold level must be established somewhat arbitrarily. As a result, the hands of a nonshooter may contain antimony and barium levels above the threshold, or more commonly, the amounts of these trace elements on the hands of an actual shooter may be below the threshold value. In the first case, a false-positive result is obtained, and in the second case, a false-negative or inconclusive result. 60. 60 () () (Lidocaine) 61. 61 62. 62 91 1 17 8150 91 1 19 () 140 50 90 () l. 0.075%(W/V)2. (Lidocaine)() l.(Morphine)(Heroin) 2.(Amphetamine) (Methamphetamine) () 120 50 70 () 1. 0.160%(W/V) 2. (Lidocaine) () 40 15 25 () l. 0.358%(W/V)2.(Lidocaine) (Lidocaine) 63. 63 ( 155 155) (Lidocaine) C14H22N2O 234.34 g/mol (electrical excitation threshold) (action potential) (refractoriness) 64. 64 1. 11 12 2. 3. GABA13 4. (Lidocaine) 11 (INN Norepinephrine Noradrenaline NE NA) 1-(3,4-)-2- N- 12 (Dopamine)(C6H3(OH)2-CH2-CH2-NH2) 13 -Aminobutyric acid( GABA) 50% GABA 65. 65 () (Lidocaine) () () 66. 66 () A10 KTV A10A16 A10 A10( ) A10A10 A10 A10 A10 A10 67. 67 ( )( )( ) mm( AP-9mm-LUGER) DN-3879BMW () ( ) 68. 68 () () () ( ) ( ) ( ) 69. 69 () 70. 70 34 119 () 38 71. 71 () 1. GLOCK172. GLOCK17 72. 72 () 73. 73 () () () () () ( )( ) (0000000000 ) () A10 () A10() 1. GLOCK17 2. 74. 74 GLOCK17 GLOCK17 () () GLOCK17 ( ) () ( ) 75. 75 ( ) ( )( ) () ( ) ( ) 76. 76 ( ) () ( ) ( ) ()( ) () 77. 77 ( ) KTV KTVA10 A10 ( ) 78. 78 14 () ( ) 8.8MM 8.8MM () TA-9mm- 96(3 ) AP-9mm-LUGER(1 ) ACP-99-9mm- 14 79. 79 LUGER(1)RP-9mm-LUGER(1)90-9mm(1 ) TA-9mm-96(2) AP-9mm-LUGER(2)WIN-9mm-LUGER(1) ACP-96-9mm-LUGER(1) 9MM ( ACP-96- 9mm-LUGER90-9mm) () ( ) () 80. 80 () 910327-1000 () A B ? C : ? ? 81. 81 ? D ? E ? 911028-1520 ( ) A KTV B ? 82. 82 ? 920325-1540 A B () 83. 83 GLOCK17 1. ( ) ( ) 2. ( ) 84. 84 ( ) () () 85. 85 1. I ( ) ( ) () ( ) ( ) ()() ( ) 86. 86 () ( ) ( ) ( ) ( ) () ( ) ( ) ( ) 87. 87 2. ( ) 88. 88 (() ) (() ) ()910201-1030 89. 89 ()910419-1600 () ? () () ? () ()920304-1410 () 90. 90 ( ) ()920311-1435 () ( ) 91. 91 ()920325-1540 () () 92. 92 ( ()) () ( ) 93. 93 () 94. 94 910327-1000 () () ? () : ? () ? 95. 95 () ? ( 319-324) 96. 96 15 1. GAMEOVER 2. () 1. GLOCK17 2. 15 97. 97 GLOCK17 (Lidocaine) 1. GLOCK17 2. GLOCK17 98. 98 99. 99