Asthmatic deaths in the medical examiner's population

A study of people who die from asthma was performed. The case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, U.S.A., were examined during the 5-year period 1979-1983, and all autopsied cases in which bronchial asthma was the primary or contributory cause of death were collected. These 39 cases were then analyzed as to the age, race, sex, and cause of death of the victim. Additionally, the medication list of the victim, the location of the terminal incident, the scene circumstances, the presence of hospitalization at the terminal incident, and the histopathology of the lungs at autopsy were additionally observed. Essentially, the asthma victim the medical examiner sees at autopsy is an adult white male commonly dying in an acute asthmatic attack. Ninety percent (90%) of the deaths had medications noted with 20% having three or more medicines, one of which was a steroid. The terminal incident occurred at home most frequently with an acute attack or being found dead noted. Most victims received some form of terminal hospitalization. Histopathologically, classical "asthma findings" were noted approximately one half of the time.     

Field recovery and analysis of horse skeletal remains.

In response to a request from an insurance company investigating a claim relative to the death of four race and show horses, allegedly as a result of deliberate starvation, physical anthropologists of the Louisiana State University (LSU) Department of Geography and Anthropology undertook the recovery and analysis of skeletal remains said to be those of the animals. The objectives were to determine the number and kinds of animals represented, their ages, and sexes, and, through morphometric evaluation of bone density at the LSU School of Veterinary Medicine, whether there was evidence of nutritional osteodystrophy. The skeletons were the remains of four horses. In comparisons of data derived from these skeletons with breeding records for the horses described in the insurance claim, it was established that the skeletons were those of mares, as were the insured animals, and that the relative ages of the four approximated those of the insured horses. The skeletal samples submitted for morphometric evaluation showed no evidence of nutritional osteodystrophy and, thus, provided no support for the contention that death had resulted from starvation. In one horse, the superior aspect of the right ascending ramus of the lower jaw below the coronoid process revealed a gunshot wound; the other skeletons showed no evidence of trauma.     

The forensic evaluation of burned skeletal remains: A synthesis

In recent years, research and case experience have greatly augmented knowledge regarding the effects of extreme heat on skeletal remains. As a result of this effort, enhanced interpretation is now possible on such issues as the extent of recovery, reconstruction, trauma, individual identification, size reduction, thermal effects on histological structures, color variation, the determination if remains were burned with or without soft tissue, DNA recovery and residual weight. The rapidly growing literature in this area of forensic science includes experimental research that elucidates the dynamics of the thermal impact on skeletal structure and morphology.     

Heterotopic ossification in unidentified skeletal remains

Heterotopic ossification is a benign, ectopic bone growth that develops in muscle and other soft tissue. The exact cause is poorly understood, but it is a rarely serious complication of soft tissue trauma. Its most common form, myositis ossifications traumatica, occurs as a secondary complication of direct muscle injury. However, other forms are less common and can result from specific pathologic conditions, such as spinal cord trauma and metabolic disorders. In patients who have had spinal cord injury and subsequent paraplegia, heterotopic ossification often results in ankylosis of the hip and a loss in range of motion. Ectopic ossification occurs below the injury site, and, although the specific muscle groups can vary, it usually involves those for which the origin and insertion involve the anterior pelvis and proximal femur. In dried bone, heterotopic ossification can appear as a smooth, irregularly shaped benign tumor of mature bone, extending from the surface but not invading the cortical bone. These tumors range in size from a few millimeters to several centimeters. Because heterotopic ossification is often associated with specific types of injuries, it has a unique anthropological use in forensic cases.     

Detection of drugs using XAD-2 resin. II:Analysis of liver in medical examiner's cases

Liver tends to concentrate drugs in quantities generally higher than those found in blood or other body compartments. This fact as well as the general availability of liver in postmortem cases makes it an important specimen for comprehensive toxicologic investigation. A scheme for the analysis of liver for drugs with tissue hydrolysis, XAD-2 resin extraction, and TLC has been developed and the parameters affecting recovery have been studied. The hydrolysis of liver specimens at various pH conditions resulted in an improved recovery for morphine by using pH 2 (2N hydrochloric acid). Recoveries of barbiturates, codeine, and meperidine were essentially the same at pH 2 and pH 3. A considerable loss (22 to 55%) was observed for four drugs (pentobarbital, morphine, codeine, and meperidine) as a result of drug binding to the tissue pellets during the process of centrifuging the liver homogenates. This method is recommended as a comprehensive screening procedure for drugs in liver tissue. For quantitative purposes, however, it is necessary to determine a correction factor for all the losses occurring at the various steps of the procedure. This procedure compared favorably with other procedures for liver analysis reported in literature.     

Identification of the skeletal remains of Josef Mengele by DNA analysis.

There has been considerable controversy over the identity of the skeletal remains exhumed in Brazil in 1985 and believed to be those of Dr Josef Mengele, the Auschwitz 'Angel of Death'. Bone DNA analysis was therefore conducted in an attempt to provide independent evidence of identity. Trace amounts of highly degraded human DNA were successfully extracted from the shaft of the femur. Despite the presence of a potent inhibitor of DNA amplification, microsatellite alleles could be reproducibly amplified from the femur DNA. Comparison of the femur DNA with DNA from Josef Mengele's son and wife revealed a bone genotype across 10 different loci fully compatible with paternity of Mengele's son. Less than 1 in 1800 Caucasian individuals unrelated to Mengele's son would by chance show full paternal inclusion. DNA analysis therefore provides very strong independent evidence that the remains exhumed from Brazil are indeed those of Josef Mengele.     

The cemetery skeleton. An exercise in the identity of skeletal remains

In this brief case report, we describe the several means used in 1982 to identify the skeletal remains of a person who disappeared In August 1964. This report exemplifies the multidisciplinary, cooperative approach required for a successful result in such cases.     

清代遗骸Y-STR检验1例

法医学实践中经常遇到对骨骼DNA检验的案例,但对保存超过100年的骨骼样本的检验报道较少。本文成功提取到150年前土埋遗骸的骨骼DNA,采用Y—filer试剂盒在9700型扩增仪上进行扩增,3130XL型遗传分析仪进行检测,得到遗骸Y—STR分型,并与对照样本比对,确认了遗骸身份。     

Forensic aspects of aboriginal skeletal remains in Australia

The assessment of Aboriginal skeletal remains and their distinction from whites is an area of major importance to the Australian forensic pathologist. The Aborigines, the indigenous people of Australia, are a distinct racial group with many characteristic anthropological features. The assessment of race is best made from an examination of cranial traits, 20 which are of value. A characteristic pattern of attrition of the teeth provides a method for establishing a skeleton as pre-European contact Aboriginal or postcontact tribal Aboriginal. The limb proportions of Aborigines differ significantly from other races and provide a useful adjunct to other racial discriminants. Quantifiable sex discriminants in the Aboriginal pelvis and femur differ in their ranges of values from other races. The humerus and shoulder girdle are of no value in making a racial distinction and are of limited value in sexing Aboriginal skeletons. Some pathological changes seen in Aboriginal skeletons are of value in corroborating race. These pathological changes include evulsion of incisor teeth, healed "parry fractures" of the ulnae, tibial squatting facets, treponemal changes, and auditory exostoses. The place and manner of burial together with related artefacts, features, and ecofacts may also provide corroboration.     

DNA extraction and sex determination of human skeletal remains

DNA was extracted from human bones remained for 3 to 15 years by using the method developed in our laboratory. A pair of X-Y homologous primer were used to amplify the specific DNA fragments of Amelogenin gene. All the 35 samples yielded correct results. Our method is rapid, sensitive and reliable for the sex determination of skeletal remains.     

Stress deformations of skeletal remains from prehistoric cremation burials

Vertebrae and parts of joints from long bones from prehistoric cremations of the Late Bronze Age and Early Iron Age are presented, showing marked deformations caused by pressure during cremation when bones exposed to temperatures of 400 degrees-500 degrees Centigrade display minimal hardness. The vertebrae with deformation of the arcus parts are only from the lower vertebral column; on account of the weight of this body region, this suggests that the corpse lay in the dorsal position at the place of cremation. The fact that there were deformed arches only on one side might suggest an irregular structure of the surface on which the corpse lay. In the prone position, i.e. in the absence of pressure caused by body weight, all vertebrae should be unaltered; alternatively, if cremation wood was piled on top of the corpse, the arches of thoracic and cervical vertebrae are also likely to be deformed. Deformations resulting from weight bearing were found in the joints of extremities only, with flattening of the heads of joints as well as fissures in the external layers of bones and compression into folds. Some bones show distinct even grooves caused by direct pressure, possibly resulting from the fixation of joint regions for cremation? Evidently the deformations caused by the weighting down of different skeletal regions provide hints that may help in the recognition of cremation rites. It would be helpful if experimental cremations could be performed to establish the pressure necessary to cause deformations.     

Fentanyl concentrations in 23 postmortem cases from the hennepin county medical examiner's office

The purpose of this study was to compare blood fentanyl concentrations in fentanyl-related deaths with fentanyl concentrations found incidentally at autopsy, as well as with fentanyl concentrations found in hospitalized patients receiving fentanyl. Between the years 1997 to 2005, 23 fentanyl-positive postmortem cases were identified. Nineteen of 23 (82.6%) cases were deemed to be drug overdoses. Fentanyl alone was responsible for 8 of the 19 (42.1%) overdose deaths. Mean and median fentanyl concentrations were 36 (SD 38) microg/L and 22 microg/L, respectively, range 5-120 microg/L. Seven of the cases were accidental, one undetermined. The remaining 11 of the 19 (57.9%) cases were mixed drug overdoses. Fentanyl concentrations in these cases were 31 (SD 46) microg/L, range 5-152 microg/L. All of the mixed drug overdoses were determined to be accidental. Four cases where fentanyl was considered an incidental postmortem finding were determined to be natural deaths. In hospitalized inpatients (n = 11) receiving fentanyl 2 of the patients receiving fentanyl for chronic pain for more than 3 months had concentrations of 8.5 microg/L and 9.9 microg/L. The other nine inpatient concentrations were less than 4 microg/L. In conclusion, blood fentanyl concentrations found in cases where fentanyl alone was determined to be the cause of death were similar to cases where fentanyl was part of a mixed drug overdose. There was also considerable overlap between fentanyl concentrations in fentanyl-related overdose deaths compared to hospitalized patients being treated for chronic pain. Fentanyl concentrations in postmortem cases must be interpreted in the context of the deceased's past medical history and autopsy findings.