Occlusion of left and right coronary arteries and coronary sinus following blunt chest trauma

Blunt chest trauma from rapid automobile airbag deployment causing coronary artery occlusion and myocardial infarction is a rare but potentially fatal condition. We present the case of a 37-year-old man who developed extensive anterior and inferior myocardial infarction because of occlusion of both left anterior and right coronary arteries following blunt injury to the chest in a car accident. The patient was scheduled for emergency coronary angiography but left and right coronary ostia were not cannulated because of thrombus formation probably. The patient died, and the autopsy revealed external compression by epicardial hematomas involving separately left and right coronary arteries and the coronary sinus without signs of coronary and/or aortic dissection. To our knowledge, this is the first case presenting occlusion of both coronary arteries secondary to blunt chest trauma causing acute myocardial infarction in a young man without signs of prior coronary artery disease.     

A method for defleshing human remains using household bleach

Medical examiners and forensic anthropologists are often faced with the difficult task of removing soft tissue from the human skeleton without damaging the bones, teeth and, in some cases, cartilage. While there are a number of acceptable methods that can be used to remove soft tissue including macerating in water, simmering or boiling, soaking in ammonia, removing with scissors, knife, scalpel or stiff brush, and dermestid beetles, each has its drawback in time, safety, or potential to damage bone. This technical report using the chest plate of a stabbing victim presents a safe and effective alternative method for removing soft tissue from human remains, in particular the chest plate, following autopsy, without damaging or separating the ribs, sternum, and costal cartilage. This method can be used to reveal subtle blunt force trauma to bone, slicing and stabbing injuries, and other forms of trauma obscured by overlying soft tissue. Despite the published cautionary notes, when done properly household bleach (3-6% sodium hypochlorite) is a quick, safe, and effective method for examining cartilage and exposing skeletal trauma by removing soft tissue from human skeletal remains.     

Flail Chest Following Failed Cardiopulmonary Resuscitation

Following the death of a woman with blunt force chest trauma, the question was asked how common was the finding at autopsy of a flail chest in decedents after failed cardiopulmonary resuscitation. It was suggested in court that this was an uncommon occurrence. To address this issue, autopsy cases in adults (>18 years) with rib fractures attributable to cardiopulmonary resuscitation were taken from the files of Forensic Science SA over a 7‐year period from 2008 to 2014. Flail chest injuries were defined as those arising from fractures at two sites in at least three consecutive ribs. From 236 cases with rib fractures attributed to resuscitation, a total of 43 flail chest injuries were found in 35 cases (14.8%). The majority occurred in the 60‐79‐year‐old age group. These data suggest that flail chest injuries are a more common sequelae of cardiopulmonary resuscitation than has been previously appreciated in autopsy cases, particularly in the elderly.     

Death by Ram Attack: A Case Report from Greece and a Brief Review of the Literature

A case of a ram attack that caused injuries to a 73‐year‐old man is presented. The deceased survived the attack and had the opportunity to speak with a friend over the phone before being transferred to the hospital. After a 21‐day hospitalization, the patient passed away. A postmortem examination was performed to ascertain the cause of death. The autopsy findings are presented along with a brief review of the literature. Attacks by agricultural animals (or livestock) around the world are reported in the scientific literature. Fatalities from ram attacks are extremely rare. The need to implement specific codes in the ICD system, relevant to each animal attack, appears to be of great importance, in order to allow tracking of animal‐related deaths.     

Complete Cardiac Rupture Associated with Closed Chest Cardiac Massage: Case Report and Review of the Literature

Chest skeletal injuries are the most frequent complications of external chest massage (ECM) during cardiopulmonary resuscitation, but heart and great vessels lacerations that are indeed very rare. We report the case of a 35‐year‐old workman who collapsed and underwent ECM by his co‐workers for almost 30 min. At autopsy, no external injuries, fractures or bruises of the ribs or sternum, were observed. A hemopericardium with a rupture of the heart was found, with no signs of pre‐existent cardiac disease. Bruises of thoracic aortic wall, lung petechiae, a contusion of the liver, and bruises of lumbar muscles were found. The cause of death was due to sudden cardiac death with an extensive cardiac rupture. This is an unusual report of massive heart damage without any skeletal or muscle chest injuries, secondary to cardiopulmonary resuscitation. This kind of cardiac lesions may be considered when thoracic–abdominal trauma, or medical history, is unclear.     

应用PCR检测羊接触传染性脓疱性皮炎病毒

设计合成了 1对引物 ,建立用于检测羊接触传染性脓疱性皮炎病毒的PCR方法。结果表明 ,PCR对羊接触传染性脓疱性皮炎病毒细胞培养毒的检测与细胞培养CPE、电镜检测的结果相一致。经对扩增产物进行序列分析 ,与已报道NZ 2株的核苷酸序列同源性高达 97%。用此PCR方法扩增羊痘病毒、口蹄疫病毒、蓝舌病病毒 ,结果均为阴性。此方法用于检测羊接触传染性脓疱性皮炎病毒是可行的、特异的     

欧盟“CR”法规的延伸思考

加入WTO,标志着中国的改革开放将进入"高级阶段".我们需要应对WTO,以欧盟"CR"法规为资料研究WTO,以便从容应对,使中国企业在品牌竞争和集团化的发展进程中,最大限度地走向开放和壮大.     

女性胸骨X线变化与年龄关系的研究

研究北京地区137例女性胸骨X线影像学变化，以其与年龄关系密切相关的影像学标志点作为变量，并依据各标志点在不同年龄阶段的变化，制定了各自的评分标准。用该标准观测全部样本，将所得数据与年龄一起输入电子计算机，建立了根据女性胸骨X线变化推算年龄的多元回归方程，即：Y=9．6641＋1．6999X（1）＋2．7486X（2）十1．8929X（3）＋1．5561X（4）＋0.4255X（5）。经方差分析F＞F0.01（5.131），回归高度显著。本研究所建立的预测年龄方程，在无名尸骨的法医学鉴定中具有实用价值。     

Left Diaphragm Laceration Due to Cardiopulmonary Resuscitation

External cardiac massage is the essential life‐saving gesture for the management of any cardiac arrest. Since the 1960s, many recommendations have been published to improve the effectiveness of chest compressions alongside the development of automated systems intended to maximize the chances of survival. The use of these manual and/or instrumental techniques can cause secondary injuries, of which rib fractures are the most commonly observed by forensic pathologists. However, a comprehensive review of the literature seldom highlights reports of injuries to the abdomen, even less so to the diaphragm. In this observation, an iatrogenic left diaphragmatic laceration for the first time is described, as a result of manual and instrumental cardiopulmonary resuscitation, in a victim from an intrathoracic wound caused by a bladed weapon.     

Thoracic Visceral Compression–A Useful Technique for Demonstrating Small Bleeding Points in the Dissected Neck at Autopsy

A 29-year-old man died at the scene of an altercation from a stab wound to the left side of the neck. At autopsy, careful in situ examination of the common carotid artery did not reveal any evidence of hemorrhage or apparent vascular injury. However, applying pressure to the chest wall and underlying thoracic viscera (lungs and heart) resulted in filling of the collapsed vessel with blood causing hemorrhage from a small incision on the medial aspect of the common carotid artery. Release of pressure and drying of the dissection field enabled the artery to be opened and the small defect to be identified. This technique may be used to temporarily restore blood to a vessel to help identify a small bleeding point that may otherwise be difficult to detect.