The forensic medical evaluation of the results of determining diatomaceous plankton in the diagnosis of drowning

Evaluation of demonstrative value of method based on diatom plankton determination as a diagnostical sign of death due to drowning was performed. Plankton was detected in the viscera in 37% of cases (as a whole 376 bodies of people who drowned in fresh water were examined). Plankton was detected in aspiration type of drowning and its mixed variant. In spastic and reflector types of drowning plankton wasn't detected. According to author's opinion this method is an objective diagnostical test to determine the cause of death of people when their bodies are found in water.     

Study of the diagnostic value of iron in fresh water drowning

The aim of our study was to test the diagnostic value of iron (Fe) in fresh water drowning by investigating the postmortem levels of hemodilution in drowning cases compared to control cases. Twenty-six typical fresh water drowning cases were selected from 128 immersion cases autopsied in our Department of Forensic Pathology between 1998 and 2004. The exclusion criteria were a long postmortem interval and other causes of death than drowning. For all selected cases, the diagnosis of drowning was based on the presence of autopsy findings and positive diatom test. A control population of 12 cases was also selected. For each drowning and control case, iron blood levels were measured in the left ventricle (LV) and right ventricle (RV) of the heart. The mean difference of iron concentration (RVFe-LVFe) between the drowning group and the control group was statistically compared. Furthermore, iron measurements were performed in 19 drowning cases showing advanced putrefaction. The mean difference of iron concentration was significantly higher in the drowning cases compared with controls (P<0.001). All drowning cases showed hemodilution. No overlap was found in the RVFe-LVFe levels between the two groups. Resuscitation attempts seemed to have no effect on the results. In cases of drowning showing advanced putrefaction, the iron test was not reliable because biochemical iron measurement was often prevented by no sufficient blood in the heart or postmortem clots. In conclusion, according to our results, iron seems to be a good biochemical marker in fresh water drowning with a short postmortem interval.     

PCR-DGGE法检测浮游生物16S rDNA在溺死鉴定中的应用

目的建立并评估PCR-DGGE法检测浮游生物对溺死鉴定的应用价值。方法大白兔30只随机分为3组:溺死组(n=12),死后抛尸组(n=12)和对照组(n=6);溺死组和死后抛尸组又分为2个亚组:东湖水域组(n=6)和墨水湖水域组(n=6)。死后提取心血和肺、肝、肾、脑等组织,匀浆后,采用Percoll密度梯度离心法分离浮游生物并提取其DNA,PCR扩增浮游生物特异的16S rDNA片段后分别用琼脂糖凝胶电泳及DGGE检测分析。2个溺死案例检材同法检验。结果溺死组各组织器官中浮游生物检测多呈阳性:肺(100%)、肝(83%)、肾(75%)、心血(83%)、脑(42%);死后抛尸组仅2例肺组织(16.7%)检出阳性;对照组全部阴性。溺尸肺组织DGGE分型图谱与相应溺死点水样分型图谱相似,而与非溺死点水样分型结果差异显著。2实际案例均呈阳性。结论本方法不仅有助于定性诊断溺死,而且通过比较产物的多样性可以推断溺死地点,在法医学溺死鉴定中具有较大实用价值。     

Forensic medicine significance of the fluid content of the sphenoid sinuses

In the forensic literature the opinion is often held that the presence of aqueous liquid in the paranasal sinuses in conjunction with other findings (plume of froth around the mouth and nostrils, emphysema aquosum, Paltauf's spots, increased haemolysis etc.) can be regarded as a sign of drowning. Especially the sphenoid sinus is easily accessible at autopsy; its content can be aspirated from the base of the skull with a cannula. The valency of the liquid content in the sphenoid sinuses was consecutively investigated in 60 deaths by drowning and 157 other deaths. The results showed that in 92% of the deaths by drowning between 1 ml and 4 ml of aqueous fluid could be found in the sphenoid sinuses. However, a positive result was also obtained in 52% of the other cases autopsied, but in the control group the average volume of the aspirate was smaller than in the group of deaths by drowning.     

东莞溺死案多发河段硅藻种群分布及其法医学意义

目的调查东莞溺死案多发河段硅藻种群分布,探讨其在溺死地点推断中的意义。方法于2009年6月至9月收集东莞市东江沙田、道滘、麻涌、石碣、石龙、茶山和企石共7个河段采样点江水样本126份,并收集2例已知落水地点溺死尸体;制作各样本硅藻涂片,计算样本间Sprensen相似系数及弦平方距离(SCD),并进行聚类分析。结果 126份水样中共鉴定出70种硅藻,其中优势度>0.02的优势种群有4种;2个案例样本分别与道滘和石碣河段样本的相似度最高,与实际落水地点基本一致。结论建立区域性溺死多发河段硅藻数据库,利用Sprensen相似系数及SCD值及聚类分析进行落水地点推断具有一定可行性。     

SEM/EDAX检测内脏异物元素成分诊断溺死

为探讨溺死诊断的依据和推断入水地点，用扫描电镜／X－射线谱仪（SEM／EDAX）检测19例溺死尸体及28只溺死兔的肺、肾、心、肝等组织异物颗粒及其元素成分和含量，并以陆地上死亡尸体14具及8只陆地上勒死兔（2只勒死后入水浸泡6天）作实验对照。结果发现，19例溺死尸体及28只溺死兔的肺边缘区呼吸性细支气管、肺泡管、肺泡囊及肺泡内均可见高能谱值的异物颗粒，其大小自数微米至数十微米不等，多为无定形异物颗粒或细小异物颗粒集落。其中元素成分为硅、铝、钙、铁、铬、钛、钼、铅、锡、铜、溴等，与入水地点溺液中所含元素成分相同；肾、心、肝组织异物颗粒检出率分别为77％、53％及47％，数量较少，颗粒较小，大小自1微米以下至十数微米。非溺死尸体及实验兔的肺、肾、心、肝组织未检出或偶尔检出异物颗粒，其元素成分多为铁、钙或硅等，可能是病理及生理性异物颗粒，如含铁血黄素、钙化灶等。用SEM／EDAX检测水中尸体组织中异物颗粒及其元素成分和含量，可以诊断溺死，推断入水区域，为明确案件性质和确定侦察范围提供科学依据。     

非溺死尸体肺脏硅藻最大值在溺死鉴定中的应用初探

探讨非溺死尸体肺脏硅藻最大值（即空气吸入与检验污染之和的最大值）在溺死鉴定中的应用价值。用硝化-光镜法检测贵阳地区40例非溺死尸体肺脏硅藻含量的最大值，同时作了8例溺死尸体肺脏硅藻检验。非溺死组肺脏硅藻最大值2个／5g；溺死组有7例为56～463个／5g，1例是2个／5g。表明（1）水中尸体肺脏硅藻检验值大于最大值（2个／5g），可考虑为溺死；显著大于最大值（本文溺死组7例56～463个／5g）则可鉴定为溺死；（2）等于或小于最大值，提示干性溺死或抛尸入水，可结合尸检发现及案情鉴别。     

溺死诊断中浮游生物检验方法的研究现状及进展

法医学实践中,判断是否为“生前溺死”是法医学尸检及鉴定工作中的一个重点和难点,目前尚无能明确诊断溺死的生物学和法庭化学指标。在溺死案件的诊断中,浮游生物检验是常见的方法。尽管目前还存在一些争议,但国内法医工作者认为,器官组织中浮游生物的存在仍然是判断生前溺死的重要证据之一。本文就国内外有关浮游生物的检验方法、检验标准及...     

溺死的法医学检验现状及进展

本文概括阐述了近年来,国内外学者将硅藻的检验、内脏异物颗粒和微量元素成分的检验、血液化学的检验、电子显微镜的观察等方法应用于溺死的诊断,试图为溺死的法医学鉴定提供准确的诊断指标。     

The expert assessment of the sign of the presence of fluid in the basilar sinus in the diagnosis of drowning

Incidence of fluid presence (drowning medium) in basilar bone sinus of dead bodies found in water was studied according to pathogenetic type of drowning. Method of quantitative assessment of this sign in medicolegal evaluation of the cause of death when dead bodies were found in water is suggested.     

溺死诊断中浮游生物检验方法的研究现状及进展

法医学实践中,判断是否为生前溺死是法医学尸检及鉴定工作中的一个重点和难点,目前尚无能明确诊断溺死的生物学和法庭化学指标。在溺死案件的诊断中,浮游生物检验是常见的方法。尽管目前还存在一些争议,但国内法医工作者认为,器官组织中浮游生物的存在仍然是判断生前溺死的重要证据之一。本文就国内外有关浮游生物的检验方法、检验标准及检验结果的判定等研究现状作一综述,旨在使人们更加清晰地认识浮游生物检验在溺死诊断中的作用。     

Organ weight effects of drowning and asphyxiation on the lungs, liver, brain, heart, kidneys, and spleen

An examination of the organ weights associated with victims of drowning, asphyxiation and trauma was undertaken to determine (a) the effects of asphyxiation compared to a trauma group, and in turn, (b) the effects of drowning compared to an asphyxiation group. Included in the study were 217 drowning deaths, 166 pure asphyxiation deaths and 381 trauma deaths. The effects of asphyxiation (compared to trauma) resulted in elevated mean organ weights for the lungs, liver, kidneys and spleen (with mean increases of 17.8, 10.5, 10.3 and 23.4%, respectively). Effects of drowning (compared to asphyxiation) resulted in elevated mean organ weights only with the lungs and kidneys (with mean increases of 30.0 and 4.4%, respectively). Only the mean heart and brain weight remained constant across all experimental groups. A picture of drowning is suggested in which elevated lung and kidney weights are the result of both asphyxiation and the aspiration of water that occurs with drowning, whereas elevated spleen and liver weights in drowning victims are associated with only the effects of asphyxiation. In addition, the common autopsy finding of a small, anemic spleen in drowning, rather than caused by some pathophysiological mechanism of death, is hypothesized to be a postmortem phenomenon.     

水中尸体PMCT最新研究进展

溺水是公安法医日常检案中最常见的死因之一,水中发现的尸体是否为生前入水,是公安法医日常鉴定的要点也是难点,而一旦溺亡的案件中掺杂了其他复杂的案情,其鉴定意见失真也极易引起不良的社会影响。法医鉴定过程中,溺死一般依据尸体征象、组织病理学检验和硅藻检验等综合考虑。PMCT为法医诊断溺死提供了新的思路并被许多国家和地区常规使用于诊断溺死。本文综述了国内外近年来使用PMCT对溺死尸体呼吸系统、消化系统和循环系统等方面的研究成果,讨论了PMCT诊断溺死的应用价值与潜力,并对国内PMCT发展的必要性和前景进行了展望。     

Diagnostic significance of myofibrillar degeneration of cardiocytes in forensic pathology

The incidence of myofibrillar degeneration (MFD) was studied in the following different forensic-pathological diagnostic groups of 25 cases each: acute morphine intoxication, acute carbon monoxide intoxication, hanging, strangulation by hand/ligature, drowning, acute hemorrhagic shock, lethal acute brain injury, explainable death of babies or infants and sudden infant death syndrome, together with 18 cases of intoxication with various drugs. The MFD was demonstrated by the Luxol-fast-blue reaction, with two types of phenomena being differentiated, namely cross-band lesions and diffuse staining. All diagnostic groups included cases of MFD of differing degrees. Cross-band lesions were observed in practically all cases of hanging, strangulation and acute hemorrhagic shock. Diffuse stain was noted particularly in cases of drowning and acute brain injury. The diagnostic significance is discussed.     

Organ weight effects of drowning and asphyxiation on the lungs,liver, brain,heart, kidneys,and spleen

An examination of the organ weights associated with victims of drowning, asphyxiation and trauma was undertaken to determine (a) the effects of asphyxiation compared to a trauma group, and in turn, (b) the effects of drowning compared to an asphyxiation group. Included in the study were 217 drowning deaths, 166 pure asphyxiation deaths and 381 trauma deaths. The effects of asphyxiation (compared to trauma) resulted in elevated mean organ weights for the lungs, liver, kidneys and spleen (with mean increases of 17.8, 10.5, 10.3 and 23.4%, respectively). Effects of drowning (compared to asphyxiation) resulted in elevated mean organ weights only with the lungs and kidneys (with mean increases of 30.0 and 4.4%, respectively). Only the mean heart and brain weight remained constant across all experimental groups. A picture of drowning is suggested in which elevated lung and kidney weights are the result of both asphyxiation and the aspiration of water that occurs with drowning, whereas elevated spleen and liver weights in drowning victims are associated with only the effects of asphyxiation. In addition, the common autopsy finding of a small, anemic spleen in drowning, rather than caused by some pathophysiological mechanism of death, is hypothesized to be a postmortem phenomenon.     

Blood strontium concentration related to the length of the agonal period in seawater drowning cases

The levels of ventricular blood strontium (Sr) from 70 seawater drowning victims were compared with their diagnosis of drowning based mainly on certain criteria selected from their autopsy report. From this comparison, intervals of either the difference of Sr concentration between the left and the right ventricle blood (LVSr-RVSr) or the Sr concentration in the left ventricle blood (LVSr), appear to be related to different time-lapses of the agonal period of drowning. In the aim to diagnose drownings, intervals of both LVSr-RVSr and LVSr were proposed to characterize three different agonal periods in seawater drowning cases: instantaneous death (ID), fast vital-submersion drowning (FVSD) and common vital-submersion drowning (CVSD).     

Serum strontium estimation as a diagnostic criterion of the type of drowning water

The estimation of serum strontium in rabbits before and after death by drowning, in soft or hard water, or by barbiturate intoxication is highly promising as a method in medicolegal practice. It not only diagnoses drowning but also indicates the type of drowning water. Atomic absorption spectrophotometry is a good method for the estimation.     

PCR-DHPLC法检测硅藻SSU基因在溺死鉴定中的应用

目的采用PCR-DHPLC法检测硅藻SSU基因,评估其在溺死鉴定中的应用价值。方法 60只实验兔随机分为生前溺死（水中溺毙）、死后入水（空气栓塞致死后入水）、对照组（空气栓塞致死后不做处理）;溺死人体脏器组织;取各组织检材提取硅藻DNA,PCR扩增硅藻特异的核糖体小亚基（SSU）片段,用琼脂糖凝胶电泳检测、DHPLC检测分析。结果 6份硝酸消化法检测阴性的溺死人体器官组织检材经PCR及琼脂糖凝胶电泳检出5例阳性。生前溺死组肺、肝、肾硅藻检出率分别为100%、90%、85%,死后入水组仅肺检出硅藻（15%）,对照组各组织均为阴性;生前溺死组检出率明显高于死后入水组（P〈0.05）。10份溺死人体器官组织检材采用DHPLC法检出硅藻种类明显多于微波消解-扫描电镜法（P〈0.05）。脏器检出硅藻种类与溺死点水样一致。结论采用PCR-DHPLC法检测硅藻SSU基因,有助于溺死鉴定和溺死地点的推断,具有法医学应用价值。     

微波消解-扫描电镜联用法在溺死诊断中的应用

目的探讨微波消解-扫描电镜联用法在溺死诊断中的应用价值。方法收集已知死因的尸体标本105例,其中水中尸体85例(生前溺死70例,死后抛尸入水15例),陆地自然死亡尸体20例。水中死亡案例同时收集落水处水样。分别用微波消解-扫描电镜联用法(方法 A)和硝酸破机-光镜联用法(方法 B)对上述尸体的离体肺、肝、肾、骨髓组织及水样进行硅藻定性、定量检测。结果①溺死尸体的肺、肝、肾、骨髓中及落水处水样硅藻检出率:A法分别为100%、94.3%、92.9%、82.9%、100%,硅藻检验阳性率为100%;B法分别为90%、62.9%、51.4%、28.6%、92.9%,硅藻检验阳性率为65.7%。②两种方法检出的硅藻种类与落水处水样中硅藻的种类均一致。③两种方法在死后入水尸体离体的肺中也检出少量硅藻(<3个/2g肺组织),但在死后入水尸体的其它脏器及陆地自然死亡尸体脏器中均未检出硅藻。结论微波消解-扫描电镜联用法较硝酸破机-光镜联用法对尸体离体组织脏器中的硅藻检出率高,方法灵敏,定性准确。     

The usefulness of lung surfactant phospholipids (LSPs) in the diagnosis of drowning

The authors have studied the usefulness of some lung surfactant phospholipids (LSPs) isolated from lung tissues as markers of drowning. Two different groups of rabbits were sacrificed by drowning in fresh and salt water, and their phospholipid compositions were compared with those of a non-drowned control series. For the phospholipids studied in lung lavages (phosphatidyl choline, phosphatidyl ethanolamine, and phosphatidyl glycerol) the proportions differed between the control group and the drowned group, and between the fresh-water and salt-water drowned animals. According to these results, the lipids we have analyzed can be employed as markers in forensic autopsies, where it is necessary to differentiate between death by drowning and postmortem immersion and between fresh-water and salt-water drowning. In lung tissue, only phosphatidyl choline and phosphatidyl inositol showed significative differences. These results also confirm that LSPs are strongly affected in drowning.