Amount of postmortem bleeding: an experimental autopsy study

An experimental autopsy study was performed on 64 cases (55 male, 9 female; average age 51.5 +/- 16.2 years) of sudden natural (38 cases) and asphyxic deaths (26 cases). The study objective was the amount of postmortem bleeding from postmortem cutting of the thoracic aorta, related to the time since death. The amount of postmortem bleeding ranged from 100 to 1300 cm, 440.6 +/- 268.1 cm on average. The time since death up to the autopsy time ranged from 4 to 72 hours, 19.4 +/- 12.9 in average. A statistically significant correlation between the amount of postmortem bleeding and postmortem time interval was stated: Pearson correlation test value r = -0.461 (P = 0.000): the shorter the time interval, the larger the amount of bleeding. The formula of linear regression was estimated according to this correlation: amount of postmortem bleeding (cm) = -9.571 x time since death (h) + 626.659. This proves that the amount of postmortem bleeding (eg, from aortic blunt rupture) could be about 620 cm.     

Forensic and chemical determination of methane in cadaveric samples

Conditions were elaborated for the determination of methane, through gas chromatography, in blood and the lung by using a 2% methanol solution as an internal standard and with the below gas-chromatography column being applied: dimensions--200 x 0.3 cm, 15% di-2-ethylhexyl sebacate on Dinochrome II (0.16 x 0.21 mm) at 110 0 degree C. The detector is of the flame-ionization type. The normal content of methane was determined for blood and for the lung--0.122 +/- 0.0074 microgram/ml and 0.20 +/- 0.04 microgram/g, respectively. Biological samples from cadavers of other persons who died due to trauma were suggested for use as controls. The method was used to examine expertise objects, blood and the lung from the cadavers of peoples who died in fire.     

Death during percutaneous transluminal coronary angioplasty (PTCA) and the medicolegal aspects

Coronary embolisation is a very rare complication of the clinically widespread method of percutaneous transluminal coronary angioplasty (PTCA). The well-documented case of a 64-year-old male patient is presented comparing angiographic and morphological findings. The occluded left anterior descending artery (LAD) was successfully dilated during PTCA. Simultaneously the circumflex artery showed acute occlusion. The patient fell into cardiac shock and died after attempted resuscitation and agonal installation of extracorporeal circulation. The autopsy revealed severe residual stenosis of the proximal LAD by parietal thrombosis and occlusion of the proximal circumflex artery by an unattached intraluminal thrombus (0.8 x 0.3 x 0.2 cm) which had been dislocated during PTCA. Autopsy thus confirmed the clinical presumption of coronary embolism and, in addition, disclosed a previously unknown perforation of the femoral artery which had occurred during agonal installation of extracorporeal circulation and contributed to death via severe retroperitoneal hemorrhage. The case is discussed under the aspects of clinical quality control by forensic pathological investigations.     

Evaluation of post-mortem ethanol concentrations in pericardial fluid and bone marrow aspirate

This study confirmed post-mortem ethanol concentrations in pericardial fluid and bone marrow aspirate in comparison with those in the blood in medicolegal autopsy cases (n = 140, within 48 h post-mortem). The specimens were examined by head-space gas chromatography/mass spectrometry. Ethanol concentrations in the pericardial fluid (y) were approximately equivalent to those in peripheral blood (x): y = 0.99x + 0.02, n = 44, r = 0.972. A high stomach ethanol concentration (>10 mg/ml) appeared to mildly affect the pericardial levels. There was no significant interference in drowning cases. Ethanol concentrations in bone marrow aspirates (y) also showed a good correlation with those in the peripheral blood (x): y = 0.77 x + 0.02, n = 20, r = 0.981. A dissociation was observed in cases of delayed death from hemorrhagic/traumatic shock and elderly victims. These findings suggest that pericardial fluid and bone marrow aspirate can be used as an alternative material when adequate blood specimens are not available.     

家兔死后心肌酰胺A带的傅里叶变换红外光谱图像分析

目的 应用傅里叶变换红外光谱成像系统研究家兔心肌酰胺A带变化与死亡时间的关系.方法 将32只家兔处死后取出心脏,20℃保存,于48h内不同时间点取样并制作切片.用傅里叶变换红外光谱成像系统绘制酰胺A带图像,分析研究死后酰胺A带阳性与阴性面积比的变化规律. 结果 48h内随死亡时间(x)的延长,酰胺A带的阳性与阴性面积比...     

Autolytic changes in blood cells and other tissue cells of human cadavers. I. Viability and ion studies

The viability of white blood cells, spermatozoa of the epididymis, cells from minced spleen, lymph node and lung, and cells aspirated from the bone marrow of the sternum was studied using the vital dye exclusion test. The material comprised 123 medicolegal autopsy cadavers which had been stored in a mortuary cold room at +4 °C up to 10 days after death. Cells which excluded trypan blue were found in various specimens from all cadavers. However, there was marked individual variation in the results. The loss of viability of the white blood cells showed a moderate correlation (r = ?0.78) with the increase in the post-mortem (p.m.) time, whereas the results for other tissues were not so significant. The K⁺ and Mg²⁺ and haemoglobin content and the osmotic resistance of the red cells correlated poorly with the p.m. time. The present results suggest that despite the general assumption that autolytic changes proceed rapidly at the cellular level, individual cells and especially blood cells may remain viable for a long time in cadavers kept at +4 °C.     

家兔死后眼玻璃体液锌、镍含量与 PMI关系的研究

目的寻找一种精确推定PMI的方法。方法应用电感耦合等离子体质谱（ICP－MS）,检测了家兔死后96小时内眼玻璃体液锌、镍元素含量,探讨其与PMI的相关性。结果家兔死后24h内眼玻璃体液锌、镍元素含量与PMI显著相关,可作为推定早期PMI的参考指标,其二项式回归方程分别为y=0.1404x2－1.3351x＋3.8298（R2=0.9202）、y=0.0043x2－0.0596x＋0.2665（R2=0.9103）。结论家兔眼玻璃体液中Zn、Ni元素含量变化是推定早期PMI的参考指标之一。     

Thyreoglobulin and violent asphyxia

The concentration of thyreoglobulin (tg) was determined for death caused by hanging, strangulation by ligature, and throttling. Cases of sudden death (traumatic aortic rupture, penetrating wounds of the heart) were used for comparison. The mean values in cases of hanging (149.9±202.3 ng/ml), strangulation by ligature (193.1±173.3), manual strangulation (561.6±173.9) are distinguishable from violent acute deaths (23.3±27.6) and living healthy individuals (17.3±16.1). By means of statistical comparisons, significant differences were found between throttling and strangulation by ligature and between throttling and hanging (adjusted P<0.001). In connection with examination of the bodies high tg values can be regarded as a vital reaction in obstructive asphyxia.     

Prediction of stature based on radiographic measurements of cadaver long bones: a study of the Croatian population

We tested a new approach to the stature prediction that could be used in the identification process of human skeletal remains of unknown identity. The stature of 19 female and 21 male adult cadavers was measured within 24 h after death and considered to be equal to the living stature. The antero-posterior radiographs of all limbs were taken, and the maximum length of the six long bones was measured from radiographs. There was a significant difference in the stature and maximum length of long bones between female and male cadavers (p<0.001 for all). The correlation between the stature and long bone length was the best for the humerus in females (r=0.792) and the tibia in males (r=0.891). Regression equations specific to the Croatian population were computed separately for each long bone in males and females and proven to be reliable in predicting the living stature of the individual.     

Postmortem changes in the levels of monoamine metabolites in human cerebrospinal fluid.

Four monoamine metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG) and 5-hydroxyindoleacetic acid (5-HIAA), were determined in the cerebrospinal fluid (CSF) of cadavers, whose causes of death had been suicidal hanging (SH) or ischemic heart failure (IHF). The concentration of DOPAC increased in parallel with the increment of the postmortem interval (PMI) (r = 0.626), whereas the concentrations of HVA, MHPG and 5-HIAA did not. The correlation coefficient was further increased by considering each cause of death separately: i.e., SH, r = 0.761; IHF, r = 0.705. These findings suggest the possible usefulness of the DOPAC level in CSF for estimating PMI.     

What is the best sample for determining the early postmortem period by on-the-spot flow cytometry analysis?

The level of degradation of DNA as a means for determining the time of death has been proposed as a valid adjunct to the classic thanatochronologic methods. The twofold aim of this work was to determine which organ might reveal both a correlation between the percentage of degradation of the DNA and the time lapse since death, and would be easiest to sample and yield the most reproducible results even in technically unfavorable situations such as on-the-spot investigations at the scene of death. A comparison of the spleen, blood, and liver showed that hepatic tissue best meets these specific needs because it shows a virtually linear correlation between the time elapsed since death and the level of degradation of the DNA, and it can easily be sampled at the scene of death by use of a common biopsy needle.     

A preliminary test of Pearson's formula for estimation of height of Sri Lankans

The validity of Pearson's formula for estimation of height from the length of bones, has not been tested for Sri Lankan populations. Such a validation was attempted on 27 male cadavers using the recumbent heel to vertex height, and the physiological femoral length. The standard Pearson's formula was found to contain an error in the tested population. Based on these findings, a new formula was therefore evolved where S = 27.48 + 3.08F (as opposed to S = 81.306 + 1.88F in the standard formula). The new formula will be tested further on a larger sample, with a view to making further indicated adjustments.     

上、下尖牙髓腔/牙体表面积比值的年龄判定价值研究

目的 通过三维重建测量上、下颌尖牙髓腔/牙体表面积比值(Pulp/Tooth area Ratio,PTR)来推断个体年龄,为临床年龄推断的应用提供科学依据.方法 收集口腔门诊患者年龄在16～65岁200例锥形束CT(Cone beam computed tomography,CBCT)影像资料,以4个尖牙为测量对象并...     

祖孙双单亲比对的匹配概率研究

目的推导祖孙双单亲比对的匹配概率(PMGDS)公式,并以随机模拟法进行验证。方法首先,根据定义推导PMGDS的数学公式,依据此公式在19个基因座上计算PMGDS的数值。其次,以随机模拟法设计实验,在19个基因座上计算PMGDS的模拟值。最后,以模拟值对比公式值的方式,对公式进行实验验证。结果研究获得了PMGDS的数学公式,经模拟实验验证显示出良好的符合。结论祖孙双单亲比对的错判概率较低,具有很好的应用价值。     

大鼠死后心肌和肺脏微管蛋白降解规律的初探研究

目的探讨大鼠死后心肌和肺脏微管蛋白（tubulin）的降解规律与死亡时间（PMI）的关系。方法大鼠经切断股动脉致失血性休克处死后，置于RXZ智能型人工气候箱内，实验条件设定为：20℃恒温，湿度50％。分别于大鼠死后0、1、2、3、5和7d时剖取心肌和肺脏组织，应用Western-Blot法检测心肌和肺脏tubulin的含量，并对所得数据进行统计学分析。结果Tubulin在正常大鼠心肌和肺内高表达，死后1d时其含量已开始下降，至死后7d时仍可检测到微管蛋白的存在，但tubulin在肺脏内的降解速度快于心肌。两种组织内tubulin含量随PMI变化的回归方程及相关系数分别为：心肌Y=-1726．Ix＋14083，r=0．9684；肺脏Y=-1439．89x＋12041，r=0．9808。结论大鼠死后心肌和肺脏tubulin的含量逐渐减少，与PMI具有相关性。     

Postmortem changes in cytochrome c oxidase activity in various organs of the rat and in human heart

Cytochrome c oxidase (COX), a mitochondrial enzyme, is inactivated by cyanide or carbon monoxide (CO) intoxication. To test whether cytochrome c has potential as an indicator of these toxins in cadavers, we measured COX activity in the main organs of the rat, and in the human heart, at various times after death. Each tissue sample or organ was homogenized and the COX activity in the mitochondrial fraction was measured using ferrous cytochrome c as the substrate. COX activity was significantly higher in rat brain, heart and kidney than in lung and liver from 0 to 4 days after death. The loss of COX activity was significantly slower in the brain and heart than in the lung, liver and kidney. Most importantly, COX activity correlated with the time-since-death for each of the rat organs we tested (r2=0.70-0.95), but for the human heart (r2=0.47). It may be possible that COX activity is likely to be a useful indicator of the time-since-death, and is worth pursuing as an indicator of the tissue cyanide and CO content.     

Intrapulmonary aquaporin-5 expression as a possible biomarker for discriminating smothering and choking from sudden cardiac death: a pilot study

The diagnosis of mechanical asphyxia as a cause of death, especially smothering and choking lacking evident injury, is one of the most difficult tasks in forensic pathology. The present study investigated the intrapulmonary expressions of aquaporins (AQPs; AQP-1 and AQP-5), as markers of water homeostasis, in forensic autopsy cases (total n=64, within 48 h postmortem) of mechanical asphyxiation due to neck compression (strangulation, n=24), including manual/ligature strangulation (n=12) and atypical hanging (n=12), smothering (n=7) and choking (n=8), compared with sudden cardiac death (n=14) and acute brain injury (n=11). Quantification of mRNA using a Taqman real-time PCR assay system demonstrated suppressed expression of AQP-5, but not AQP-1, in smothering and choking, compared with that in strangulation as well as sudden cardiac death and acute brain injury death. Immunostaining of AQP-5 was weakly detected in a linear pattern in the type I alveolar epithelial cells in smothering and choking cases, while cardiac and brain injury death showed marked positivity, and most strangulation cases had AQP-5-positive granular aggregates and fragments in intra-alveolar spaces. These observations indicate a partial difference in pulmonary molecular pathology among these causes of death, suggesting a procedure for possible discrimination of smothering and choking from sudden cardiac death.     

Sudden cardiac death following psychoemotional stress

Sudden death from cardiac arrest is described, which occurred after a minor accident. Morphologically, a coronary change was found in the sense of "juvenile coronary atherosclerosis" in connection with intramural bleeding postmortem. As there were no injuries in connection with the accident but psychoemotional stress had occurred, it is concluded that affective resonance resulting from the accident initiated the death. The pathological and pathophysiological relationships are discussed.     

Unexpected death due to intestinal obstruction by a duplication cyst in an infant

An 11-month-old female infant died at home after being diagnosed as having gastroenteritis. Autopsy examination revealed a distended distal ileum filled with a large amount of watery contents, and a 3 cm x 3 cm x 4 cm cyst at the ileocecal part of the cecum that was histologically consistent with a duplication cyst. The cause of death was determined to be acute dehydration due to intestinal obstruction caused by a duplication cyst. This case indicates that intestinal obstruction by a duplication cyst should be recognized as a cause of unexpected death in infants.