Rapid death by mevinphos poisoning while under observation

A case report of fatal ingestion of mevinphos with several points of interest: There was a known ingested dosage of 28 g. Several observers witnessed events from ingestion to death. Death was rapid--apparently within 1 min and certainly within 14 min.     

Sudden death due to cerebral leukemic hemorrhage occurring after acupuncture treatment for gingival bleeding

A 45-year-old woman who experienced stomalgia and gingival bleeding for several days died unexpectedly after acupuncture treatment. At autopsy, trivial injuries on the liver and the stomach and mild hemoperitoneum due to improper acupuncture were found. Also,acute lymphoblastic leukemia and hyperleukocytosis were diagnosed by postmortem examinations. Intracranial hemorrhage due to undiagnosed acute lymphoblastic leukemia was identified as the cause of death.Moreover, the relationship between therapeutic misadventure and death was also determined. We suggest that undiagnosed leukemia should be considered as a differential diagnosis when sudden death occurs owing to intracranial hemorrhage. If therapeutic misadventure was involved,it is also of great importance to assess the relationship between that and death in forensic expertise.     

Post-mortem examination and certification of death under G.D.R. law

Post-mortem examination and certification of death in the G.D.R. are regulated by the Order on the Medical Post-mortem Examination (O.M.P.E.) issued in 1949 and confirmed in 1978. The tasks of the doctor certifying death are described as well as the co-operation between police, district attorney, and pathologist, and legal doctor, respectively, in all cases of death 'under suspicious circumstances.' Medical as well as judicial aspects of post-mortem examination are discussed.     

An unusual accidental death from reverse suspension.

Deaths involving prolonged suspension head downwards have received little or no attention in the English-language literature, doubtless because they are extremely rare. An example, involving alcoholic intoxication as the sole complicating factor, is reported. The mechanism of death is also considered since this is plainly a subject of some interest and likely to provoke further thought and discussion.     

Dental anesthetic death. An unusual autoerotic episode

The details of an unusual autoerotic death are presented; the postulated method of induction of cerebral hypoxia was inhalation of nitrous oxide from a dental anesthetic machine; the theme of dental anesthesia, presumably an elaborate bondage fetish, recurred in documentary material found at the scene.     

Autoerotic death in females. An underdiagnosed syndrome?

Deaths of young women due to autoerotic asphyxia have been rarely reported. The case of a 19-year-old woman is described in which several of the characteristic death-scene features found in cases of male autoerotic asphyxial deaths were absent. An awareness that this syndrome may occur among women with a less obvious presentation than in men is essential so that death will not be incorrectly attributed to nonaccidental causes. This syndrome may be more common than the number of reported cases would suggest.     

Rolled up to death. An unusual autoerotic fatality

Recently, an unusual case of autoerotic death in which a man died of hypoxia after having enclosed himself in plastic was reported in this Journal (1). We present a second case showing many similarities to the one published previously.     

Time since death. An entomological study on corpses

After death, during disintegration, various environmental conditions and fauna play an important role, indicating "time since death." The natural openings of the host body provide the most important breeding place for an agent which could consume the body very quickly, e.g., flies. Wounds are preferred over the natural openings by this agent. In such cases, antemortem wounds become unidentifiable. This paper presents the study of 25 cases in which inferences relating to the maturation of blow fly life stages and the total developmental time of an adult blow fly in breeding experiments in the prevailing environment are drawn. These can be used to help estimate the "time since death" of infested bodies.     

An experimental study of death in a reverse suspension.

To investigate the course of respiration and circulation in a head-down position, 14 rabbits were set in reverse suspension. The respiratory rate increased a little, but the amplitude of the respiratory movements did not change in the beginning of the experiment. The amplitude of respiratory movements then began to reduce gradually, and toward the end of the experiment, it reduced suddenly. PaO2 increased in the beginning of the experiment and then began to decrease in accordance with the reduction of the amplitude of the respiratory movements. The blood pressure decreased with relation to the decrease of PaO2 resulting from the reduction of the amplitude of the respiratory movements. All rabbits died in 17 to 44 hours (average, 26 hours). The results suggested that the cause of death in a head-down position is due to postural asphyxia resulting from hindered respiratory movements, and that it is possible to survive for at least half a day in a head-down position.     

Criminal and suicidal death with bolt gunshot weapons. An experimental and case contribution

Authors report on two cases of homicide and another case of suicide, all committed with captive-bolt livestock-stunners. The investigation of skull caps revealed roundish holes at the entry sites which were beveled-out in a paraboloid-like manner on the inner aspect. These defects were reproducible in test shots with various strengths of ammunition and different materials as targets.     

An autopsy case of infant death due to heat stroke.

We report an autopsy case of infant death due to heat stroke. On a winter day, a 52-day-old female baby was placed under a Japanese electric foot warmer with a coverlet (kotatsu) on an electric carpet warmer in a heated room at home. After about 5 h, the mother noticed that the baby was unconscious and took her to a hospital. Spontaneous respiration, however, was already absent, and the pupils were dilated. The trunk was hot; body temperature was 41.3 degrees C. The skin of the whole body was dry. Autopsy revealed second-degree burn injuries on the left side of the face and the dorsum of the left hand. Numerous marked petechiae and ecchymoses were found in the thymus (capsule and parenchyma), pleurae (visceral and parietal), pericardial cavity (internal and external surfaces), epicardium, and beneath the serosa at the origin of the aorta. In addition, there was congestion in various organs, edema in the brain and lungs, and hemorrhage in the lungs. Histopathologically, macrophages without hemosiderin granules were present in the alveoli. When the heating conditions at the accident were reproduced experimentally, the temperature in the electric kotatsu warmer rose to 50-60 degrees C. Thus, we concluded that misuse of the electric kotatsu caused heat stroke in this infant.     

Splenectomy and sudden death.

Four cases of fatal fulminant Streptococcus pneumoniae septicemia in asplenic individuals have been presented, demonstrating the relative lack of specificity of the symptoms and rapidity of the clinical course. Vigorous specific therapy was without apparent effect in two of the cases. No apparent reticuloendothelial deficiency prior to splenectomy was detected in two cases, and theoretically rather than clinically present in the others. Individual was hyposplenic secondary to splenic atrophy. The rapidity of the course and unexpected death will often bring such cases under the jurisdiction of the coroner or medical examiner, and medicolegal investigators should be alert for this syndrome.     

Arrhythmogenesis and diagnosis of cardiac sarcoidosis. An immunohistochemical study in a sudden cardiac death

We present an uncommon case of sudden cardiac death in a 34-year-old white woman. She was found lifeless at home by her parents. Three months before death she was recovered at the Emergency Room for chest pain, palpitation and loss of consciousness. Subsequent cardiological evaluation with ECG showed sinusal rhythm, QRS deviation to the left, QS aspect, asymmetric and rounded T waves and slight length of QT. During hospitalization she presented some episodes of supraventricular paroxysmal tachycardia and non-sustained ventricular tachycardia. No echocardiography alterations were found. An anti-arrhythmic treatment was prescribed. Autopsy revealed some fibrotic scarring in the myocardium of left ventricle. The histological examination of the heart revealed diffuse and extensive fibrosis with non-caseating sarcoid granulomas. The lungs, kidneys and lymph node also showed the same non-caseating granulomas. The diagnosis of sarcoidosis with massive and extensive cardiac involvement was established as cause of death.     

Dirty diving. Sudden death of a SCUBA diver in a water treatment facility.

We report a case of a sudden death in a SCUBA diver working at a water treatment facility. The victim, an employee of the facility with a specialty in electronics, was a sport diver not qualified in commercial diving. While attempting to clean sludge from a blocked drain 25 ft under water, the diver was suddenly pinned against the drain valve when the sludge plug was broken up. We review the mechanics of the incident and the actual cause of death, asphyxia, as opposed to drowning. We believe this to be the first reported case of traumatic (pressure) asphyxia in a SCUBA diver.     

丁胺卡那霉素与洁霉素联合用药治疗呼吸道感染引起死亡的案例分析

目的分析40例丁胺卡那霉素与洁霉素联合应用治疗呼吸道感染引起死亡的相关因素。方法观察联合应用丁胺卡那霉素和洁霉素治疗呼吸道感染死亡40例,进行常规病理学检查及心血IgE测定。结果所有病例均有呼吸道炎症,常规尸检未发现心、脑、肾等重要脏器有明显疾患。镜下观察肺部及细支气管未见明显嗜酸性粒细胞增多等过敏反应特点。心血IgE测定均在正常范围。结论治疗呼吸道感染时首先应慎重应用丁胺卡那霉素与洁霉素。其次应注意用药方式和控制输液速度。     

Life masks and death masks.

The death of a relative or anyone in a small, tightly knit community with closely shared cultural and religious values has great social impact. As part of the grieving process, people wish to preserve the memory of a loved one or a community leader. Life masks and death masks have been used as art forms to mark life passages, offering permanent reminders of family and continuity with the past. This article discusses the history and technique of life and death masks and their role in 19th-century American culture.     

An initially unexplained death during prison sentence. Diagnostic verification by atomic absorption spectrometry

The authors report on the death of a 25-year-old man due to electric current in prison, which was not recognized at first. The fatal accident was caused by a self-made electric kettle. The only electrothermal skin lesions were some pinhead-sized electric marks on the left thumb. Careful external inspection of the body in combination with an analysis of the conductor material (aluminium) by means of atomic absorption spectrometry (AAS) revealed the cause of death and the source of accidental electrocution.