Eosinophilic myocarditis from a forensic histopathological perspective

Eosinophilic myocarditis (EM) is a rare and potentially fatal form of myocarditis characterized by infiltration of the myocardium with eosinophil leukocytes, often accompanied by eosinophilia. Although the exact underlying cause remains unknown, it has been shown to be associated with hypersensitivity reactions, immune-mediated disorders, infections, or cancer. Due to the differences in symptomatology, it is often diagnosed by postmortem histopathological examination. We aimed to retrospectively examine the histopathological findings of rare cases of EM and to detect accompanying cardiac and other organ pathologies. The histopathological findings of the cases that underwent autopsies between 2012 and 2020 and were diagnosed with EM were assessed. Demographic features, symptoms, causes of death, macroscopical findings at autopsy, toxicologic and microbiological analysis results, accompanying cardiac pathologies, and histopathological findings in other organs were evaluated. Myocarditis was detected on histopathologic examination in 558 (1.1%) of 49,612 forensic autopsies. There were 12 (2.3%) EM cases. There were nine males and four females. The mean age was 42.3 (3–83) years. Heart weights ranged from 82 to 564 g. The most common finding on macroscopic examination was the mottled discoloration and scarring in the myocardium. Microscopic examination revealed perivascular and interstitial infiltration of eosinophils in all of the cases accompanied by myocyte necrosis in four of them. EM was reported as the cause of death in four cases. EM remains a challenging heart disease with its obscure etiopathogenesis and varying clinical presentation and a rare entity diagnosed by postmortem histopathological examination in sudden and unexpected deaths.     

Direct blood group typing of forensic samples using a simple monoclonal antibody assay

A simple direct test for blood group antigens in samples of blood, dried blood, dried blood associated with fabric, semen, vaginal secretions, saliva and fingerprints is described. This test takes advantage of monoclonal antibodies which have been produced in this laboratory, but which are also becoming available commercially in ever increasing numbers. The test is sensitive and reliable as evidenced by its performance in blind studies of more than 700 blood samples. The test requires no special equipment and can be completed in 4 h. The test is sufficiently versatile that new antibodies can be added to the same test format as they become available.     

Quantifying Macrophages and Hemosiderin in Pediatric Dura Mater,

Determining the age of a subdural hematoma at autopsy is of great interest for medicolegal purposes. The appearance of pigment‐laden macrophages is often referenced as evidence that the subdural hematoma is 3–4 days old. However, understanding the significance of macrophages and hemosiderin requires understanding the histology of infant dura. Samples of grossly unremarkable dura taken from 17 pediatric autopsies were identified and histologically confirmed to lack subdural neomembrane. CD68 immunostaining and Prussian blue staining was performed. The CD68‐positive cells per high‐power field were quantified, and the presence of iron‐containing cells was recorded. CD68‐positive cells were present in all cases, even in the dural border layer. Iron‐containing cells were identified in 59% of cases, and in the dural border layer in 29%. Therefore, CD68‐positive and iron‐containing cells can be present in pediatric dura without neomembrane or macroscopic subdural hemorrhage, and this requires consideration when estimating the age of a subdural hematoma.     

The Jurisprudence of Precision: Contrast Space and Narrow Tailoring in First Amendment Doctrine

The United States Supreme Court often requires that laws regulating free speech be narrowly tailored. The narrow tailoring requirement lacks analytical rigor in the Court's opinions, however. This article analyzes narrow tailoring in the context of Alan Garfinkel's model of "contrast space," which facilitates an examination of the precise range of alternatives the Court considers in its decisions. The article offers suggestions for improving narrow tailoring jurisprudence with a more precise account of the process.     

犯罪学转型中研究对象的固化———从科尔曼的“系统行为内部分析说”谈起简

犯罪学是一门兼具综合性与交叉性的新兴学科,自其诞生以来,相关理论问题争议不断.其中,犯罪学的研究对象一直以来就是学者们热议的话题,尤其在我国犯罪学的转型时期,该问题更需亟待解决.犯罪学不再局限于以传统的个体行为或个体现象作为其研究对象,而是立足于从宏观的视角认识其研究对象,将其固化为一种特殊的系统现象,同时采用科尔曼的“系统行为内部分析”说作为分析犯罪学研究对象的方法论,把群体现象或群体行为作为犯罪学微观上的研究对象,旨在实现犯罪学研究的宏观与微观、系统与要素的结合,从而全面认识犯罪这一特殊的社会现象、及其本质和规律.     

律师伪证罪的追诉程序探析

刑法第306条规定的"律师伪证罪",往往成为侦控机关对律师实施职业报复的工具。究其原因,不惟在于实体法之不完善,更在于缺乏正当法律程序的保障。借鉴法治先进国家的经验,有必要在我国刑事诉讼法中增设集体回避及管辖异议制度、排除辩护人程序、追究律师刑事责任的前置程序、对律师采取强制侦查措施的特殊保障等,以保障律师免受非法或不当的刑事追诉,维护其合法执业权利。     

从哲学、书法鉴赏角度把握笔迹鉴定中的“神韵”

笔迹鉴定实践中往往过分关注笔迹的微观细节特征而忽略从整体角度把握笔迹。“神韵”是笔迹整体所具有的特征，它要求我们鉴定笔迹时不但从微观入手而且更要从宏观上把握。     

Fat Transfer and Fatal Macroembolization

Fat embolism is usually associated with long bone fractures or other trauma. The diagnosis is usually clinical, and in most cases, emboli are not fatal and not usually seen on gross examination. At the Los Angeles County Coroner's Office, we autopsied the victim of fatal macroscopic fat embolization to the lungs. The patient died during buttock enhancement surgery when fat from liposuction was injected into her buttocks. Fat embolism from liposuction and fat injection is reportedly rare, and macroscopic embolization is rarer still. Varicose veins can occur in the area of the sciatic notch and are known to cause painful sciatica symptoms. We suggest them as a potential conduit for macroscopic fat to reach the lungs. Simple pre‐operative questioning for sciatica symptoms and possible radiologic study to rule out sciatic varices seem prudent before undertaking buttock‐enhancing surgery. Careful fat injection with pre‐aspiration is always advised.     

论汉字笔迹字群结构习惯及特征

目的字群结构是汉字书写动作系统中高频率书写词汇而形成的特殊单字整体结构。其书写动作的习惯特性不同于单字书写动作系统，具有超出单字书写动作习惯的特性和特殊表现形式。因此对字群结构及其特征的研究有利于完善笔迹鉴定的特征体系，尤其是对签名字迹和具有职业习惯者书写的少量字迹的同一认定有一定价值。     

Application of compact ultrasound imaging device to postmortem diagnosis

In regions with low autopsy rates, forensic examiners often have to rely on external findings. Imaging techniques can assist the external examination and provide a more objective diagnosis. The SonoSite 180, a portable ultrasound device, was used for the examination of dead bodies. The influence of different degrees of decomposition was estimated. Even in cases with intestinal gas formation images of internal organs could be obtained with special techniques. Various pathological findings were detected by ultrasound and verified by autopsy (e.g. pericardial tamponade, cardiac hypertrophy, fatty liver, aortic aneurysm, metastatic liver, etc.). The experiences with the SonoSite 180 are promising. The device can be carried to the death scene or to the morgue and therefore serve as a valuable tool for medicolegal applications.     

Afterword

Contributions to the special issue on race, ethnicity, and the law are reviewed and critiqued via an examination of the paradoxes and contradictions that characterize the relationship among ethnicity, race, and the law in modern, pluralistic societies. Law is discussed in terms of its use as a tool for both group social control and liberation.     

The Forensic Implications of Turner's Syndrome

Turner's syndrome, the most common sex chromosome disorder of females, is caused by complete or partial loss of one X chromosome and is associated with a wide range of internal and external manifestations and increased mortality rates (three to nine times the background population). While individuals with Turner's syndrome may survive for many decades, premature and unexpected deaths can occur that bring decedents to the attention of forensic examiners. Causes of death in Turner's syndrome are often linked to underlying cardiovascular conditions such as aortic dissection, congenital cardiovascular disease, ischemic heart, and cerebrovascular disease, but deaths due to noncardiac causes also occur with increased frequency. The latter include epilepsy, diabetes mellitus, chronic renal disease, pneumonia, chronic liver disease, and malignancy. Thus, the autopsy evaluation of these cases requires careful examination of all major organ systems, with the consideration of confirmatory cytogenetic testing.     

生态保护补偿制度的价值取向和立法选择

生态保护补偿制度从环境法学角度看,是通过制定合理、科学、可行的规则来激励人们的生态环境保护行为,协调其背后各方利益之间的关系,以实现保护生态环境、促进社会公平目的的制度。环境权与生存权、发展权都是人类同时追求的正当人权,但这些权利在现实中往往存在矛盾之处,有效解决环境权与生存权、发展权三者间的矛盾是生态保护补偿制度设立的根本动因,也是生态保护补偿制度在法理学意义上的价值归属。生态保护补偿制度的推进关键在立法,其立法可采取基本法与单行法并举的立法模式,尽快制定《生态保护补偿法》基本法和专门领域、专门类别的生态保护补偿单行法;立法内容上应明确生态保护补偿法律关系主体,确定生态保护补偿标准和方式,完善生态保护补偿的程序,规范生态保护补偿的监管。     

The forensic investigation of propane gas asphyxiation

Two unusual suicides of a 19-year-old white man and a 47-year-old white man, involving propane inhalation and plastic bag suffocation, are described. The special characteristics of propane gas as an asphyxiant agent are discussed, as well as its effect on the human body. The discussion emphasizes the postmortem examination and the collection of samples for toxicologic analysis.     

Sudden cardiac death in a young woman: tumor of the atrioventricular (AV) node or citalopram intoxication?

Atrioventricular (AV) node tumor is a very rare lesion of the cardiac conduction system. Clinically, it is associated with complete AV block and sudden cardiac death, often in apparently healthy young people.We report a case of a 24-year-old woman who developed ventricular fibrillation during sexual intercourse and died before admittance to the hospital. The woman had a medical history of depression and was treated with citalopram.At first, no macroscopic or microscopic pathologic changes were found. Toxicologic analysis showed a toxic level of citalopram in the blood. Further microscopic examination of the cardiac conduction system disclosed a tumor of the AV node. Immunohistochemical staining confirmed endodermal origin in accordance with the latest hypothesis of the pathogenesis of this tumor.It was concluded that this young woman died of cardiac arrhythmia due to the AV tumor and not from citalopram intoxication, as first suspected. This case emphasizes the importance of a microscopic examination of the cardiac conduction system in cases of sudden unexpected death, even in cases with a plausible cause and manner of death at first glance.     

The effects of latent print processing on questioned documents produced by office machine systems utilizing inkjet technology and toner

Counterfeiting of currency and identity documents, death threats, illegitimate business transactions, and terrorist-related activities are some examples of the types of crimes that often involve documents produced from printers and copiers. Although standard protocol typically requires a questioned document (QD) examination prior to latent print (LP) processing, occasionally, items of evidence may be submitted for a QD examination following the application of a series chemicals utilized in the development of latent fingerprints. In such cases, the forensic examiner must take into account any previous treatments prior to initiating an examination on documents produced with a printer or copier. This study was devised to examine the effects of a latent print development technique [ninhydrin, physical developer, and a bleach enhancer] on the physical and chemical examination of documents produced from copiers and printers.     

Unusual skin lesions mimicking bruises caused by Pseudomonas septicemia secondary to undiagnosed peripheral T-cell lymphoma in a young woman

We present a case of a 30-year-old woman with learning difficulties who was found dead at home by her mother. Her body was partially naked and covered in a number of unusual skin lesions with a targetoid appearance with red erythematous centers and well-delineated halos of pallor. These lesions were initially thought to be bruises by the police and by a forensic postmortem instigated. Postmortem examination also identified hepatosplenomegaly, severe lymphadenopathy, and focal patchy colonic ulceration. Histologic examination of the skin and bowel ulcers showed the lesions to be areas of infarction caused by Pseudomonas aeruginosa vasculitis. Pseudomonas was also cultured from the swabs of the abdomen, the spleen, and the blood cultures. Histologic findings of the lymph nodes showed complete effacement of the normal architecture by a population of pleomorphic small lymphoid cells. Immunohistochemistry confirmed the predominant cell type to be T-cells. The diagnosis of peripheral T-cell lymphoma was made. The cause of death was given as Pseudomonas septicemia secondary to immunocompromise resulting from the undiagnosed peripheral T-cell lymphoma. The pathogenesis of Pseudomonas and its association with malignancy is discussed along with a brief review of peripheral T-cell lymphomas. This case report demonstrates the characteristic macroscopic appearance of cutaneous Pseudomonas-associated lesions and how they can be misinterpreted as bruises.     

CHILDREN'S LAWYERS IN CALIFORNIA FAMILY LAW COURTS

There simply is no dos-and-don'ts checklist that will address the myriad issues facing children's attorneys and eliminate the difficult questions that face them. Conscientious lawyering is the key to alleviating potential ethical culpability. This requires the commitment of significant time to learn about the child client and his or her special needs. Unique responses are often required to meet individual problems. Beyond that, attorneys for children are left to determine their own subjective criteria to guide their representation.¹
The child is a person, not an object of concern.²     

Pigmentation of articular surfaces of bones as an identification factor: a unique case report

One of the classic problems of forensic pathology, the identification of a skeletal remains, involves techniques and expertise that span a number of disciplines. This forensic endeavor offers a more challenging and creative exercise because identification with medical and legal certainty often requires thinking beyond routine workups. Identification workups are creative in developing features that are unique as presented by an individual decedent. In this case report, a rare pathologic condition, ochronosis, has helped in the accurate identification of an individual from a systematic skeletal remains examination.