悬挂双前肢致死兔的膈肌超微结构的研究

目的研究悬挂体位下窒息死亡动物的膈肌超微结构变化。方法取悬挂双前肢体位家兔的膈肌和腓肠肌组织,以勒颈致死家兔的膈肌和腓肠肌组织为对照,采用透射电镜方法观察其超微结构的变化。结果悬挂组膈肌的细胞核、细胞质、细胞膜均有缺氧损伤的征象,其中肌纤维内的肌原纤维、线粒体病变尤为严重;勒颈组膈肌的改变与悬挂组膈肌相类似,但程度上较轻微;悬挂组腓肠肌轻微病变,但肌原纤维无明显改变;勒颈组腓肠肌无明显改变。结论悬挂体位造成了膈肌纤维超微结构的损伤,形成了机体缺氧的病理基础,可导致死亡;本实验的结果可为限制性体位窒息死亡的法医学鉴定标准提供实验性的形态学依据。     

Death from Nitrous Oxide

Nitrous oxide is an inflammable gas that gives no smell or taste. It has a history of abuse as long as its clinical use, and deaths, although rare, have been reported. We describe two cases of accidental deaths related to voluntary inhalation of nitrous oxide, both found dead with a gas mask covering the face. In an attempt to find an explanation to why the victims did not react properly to oncoming hypoxia, we performed experiments where a test person was allowed to breath in a closed system, with or without nitrous oxide added. Vital signs and gas concentrations as well as subjective symptoms were recorded. The experiments indicated that the explanation to the fact that neither of the descendents had reacted to oncoming hypoxia and hypercapnia was due to the inhalation of nitrous oxide. This study raises the question whether nitrous oxide really should be easily, commercially available.     

Why Do People Hang Themselves on Trees? An Evaluation of Suicidal Hangings on Trees in Konya,Turkey, between 2001 and 2008

Hanging is the most common method of suicide in the world, and many public places offer a means or opportunity to carry out the activity. Of 4,452 death examinations and autopsies, there were 378 (8.5%) suicides and suicide method was hanging in 185 (48.9%) cases. In 20 of these (10.8%), the suspension point was the branch of a tree. The incident location was the garden of the victim's house in nine cases, the woodlands in seven cases. The suicides were attributed to psychiatric disorders in nine cases, economic problems in six cases, and family problems in five cases. It is concluded that hanging on a tree as a suicide method is often committed by males and the underlying motive may be different in suicidal hangings on trees occurring at daytime and night. For preventional purposes, the reporting of such suicides in public places by the media may be restricted by local authorities.     

147例凶杀案的法医学分析

通过对上海地区中147例凶杀案尸检的分析,从案件情况、现场勘察及尸体检验等方面进行归纳,总结了此类案件的共同特点,以期为凶杀命案的检验、侦破提供参考。     

The Drowning Index: Implementation in Drowning,Mechanical Asphyxia,and Acute Myocardial Infarct Cases

Drowning is a diagnosis of exclusion based on circumstantial and autopsy correlation. Sugimura proposed a threshold value of 14.1 for the Drowning Index (DI), the ratio of lung and pleural fluid to spleen weight, as a surrogate marker to diagnose drowning. We questioned the use of DI in diagnosing drowning. We compared DI between three groups—drowning, mechanical asphyxia, and myocardial infarct—seen at Broward MEO from 2008 to 2009. Only 9.4% of 53 drownings exceeded the DI threshold of 14.1, while 30% of 10 mechanical asphyxias and 40% of 10 myocardial infarcts had DI >14.1. Sensitivity for the DI test was <10% and specificity 60–70%. Median DI values for all groups were <10. Mann–Whitney U‐test was not statistically significant between groups. The DI is neither sensitive nor specific and lacks any utility in the diagnosis of drowning.     

线粒体缺氧性损伤及其法医学意义

线粒体是真核细胞中特殊的细胞器,主要功能是进行氧化磷酸化合成细胞活动所需的能量,机体所摄入的氧气绝大部分都在线粒体中被消耗。机械性窒息的精准诊断是法医病理学实践中的难点之一,法医病理学工作者一直致力于寻找一种可靠、敏感的标志物用于机械性窒息的确诊。线粒体对于缺氧环境极为敏感,其损伤标志物或可作为诊断机械性窒息的依据。本文旨在综述缺氧环境下线粒体损伤的研究进展,并探索将线粒体损伤标志物用于法医病理学实践的可能性。     

One Hundred and One Cases of Plastic Bag Suffocation in the Milan Area Between 1993 and 2013—Correlations,Circumstances, Pathological and Forensic Evidences and Literature Review

Plastic Bag Suffocation is a rare cause of death in developed countries and almost unknown in the rest of the world. This study aims to retrospectively evaluate cases of PBS _asphyxia in Milan's Department of Legal Medicine from 1993 to 2013. Cases were selected from the database of 21,472 autopsies performed in the considered timeframe. One hundred and one cases were considered to be cases of Plastic Bag Suffocation, comprised of 100 suicides, no accidental events and 1 homicide. The most relevant elements pertaining to this type of death were evaluated for both the corpses and the crime scenes. From this study the typical PBS victim is an adult male, aged 52.3 years on average, depressed or afflicted by chronic or terminal diseases, and found at home. In 42.6% of cases, the victims were found with the plastic bag still positioned over their head, fastened by tying. Also common among these cases are drugs, alcohol and chemical abuses. According to the collected data, it is impossible to outline a pathognomonic detrimental background that leads to this cause of death. Crime scene investigation is, therefore, the one and only technical resource for evaluating these cases.     

Causes and Mechanisms of Death in Fatal Water Buffalo Attacks

Deaths due to buffalo attack have not been well described. A 72‐year‐old man was trampled by a water buffalo (Bubalus bubalis) while attempting to move the animal within an enclosed area at an abattoir. At autopsy, there were numerous injuries involving the chest, head, neck, and left upper arm. Blunt force injury had resulted in multiple rib fractures with a flail chest and fracture/dislocation of the mid‐cervical vertebrae caused either by physical crushing by the animal against the walls of the enclosure or by stomping. There was also evidence of crush asphyxia with bilateral conjunctival hemorrhages and petechial hemorrhages. In addition, there was a deep degloving injury of the upper left arm compatible with goring by one of the buffalo horns. While large animal attacks may result in death from multiple injuries, careful dissection and examination of specific injuries at autopsy may clarify the complex interaction of lethal mechanisms.     

A case of suicidal suffocation simulating homicide

This case concerns an unusual suicidal plastic bag suffocation. An elderly white man was found dead and partially disrobed in his apartment lying supine on a sofa with a plastic bag closed by a rope over the head and the upper and lower extremities tightly tied with two other ropes, the end of both arranged into slipknots (self-rescue mechanism). Police investigations found no pornography in the apartment, and circumstantial data alleged no psychiatric disorders or suicidal intentions. The autopsy excluded signs of struggle and sexual intercourse as well as any type of injury or physical illness. Chemical analyses on the peripheral blood excluded acute drugs and/or alcohol intoxication. A differential diagnosis of the manner of death was performed, including scenarios of accidental autoerotic asphyxiation, homicide during either sexual activity or ritualistic, elderly suicide. The collected data most strongly supported the hypothesis of a suicidal asphyxiation simulating homicide to devolve a life insurance to the victim's sons because of economic difficulties.     

Ventilatory and metabolic demands during aggressive physical restraint in healthy adults

We investigated ventilatory and metabolic demands in healthy adults when placed in the prone maximal restraint position (PMRP), i.e., hogtie restraint. Maximal voluntary ventilation (MVV) was measured in seated subjects (n=30), in the PMRP, and when prone with up to 90.1 or 102.3 kg of weight on the back. MVV with the heaviest weight was 70% of the seated MVV (122+/-28 and 156+/-38 L/min, respectively; p<0.001). Also, subjects (n=27) were placed in the PMRP and struggled vigorously for 60 sec. During the restrained struggle, ventilatory function (V(E)/ MVV) was 44% of MVV in the resting PMRP. While prone with up to 90.1 or 102.3 kg on the back, the decrease in MVV was of no clinical importance in these subjects. Also, while maximally struggling in the PMRP, V(E) was still adequate to supply the ventilatory needs.