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.     

An unusual fatal case of accidental asphyxia in a child.

The death of a three-year-old child by asphyctic mechanism is described. The child was accidentally suspended by the neck from a half-opened car window. This report details the form in which the accident occurred. The influence of the type of window and the autopsy findings.     

An unusual autoerotic death: asphyxia with an abdominal ligature

A case of accidental death resulting from an autoerotic episode involving a high abdominal ligature is reported. Pathologic findings, physical evidence, and the psychological investigation are discussed.     

大鼠限制性体位窒息模型中膈肌Fn和HSP70的免疫荧光组化观察

目的观察Fn和HSP70在限制性体位窒息死亡的大鼠膈肌中的表达情况,进一步探讨限制性体位窒息死亡的机理。方法分组建立限制性体位窒息死亡大鼠模型,采用免疫荧光组织化学方法研究大鼠膈肌的Fn和HSP70的表达情况,并将荧光照片进行灰度值分析,比较抗原在不同组别间的表达差异。结果在Fn检测中,限制性体位窒息死亡组大鼠的膈肌肌内膜上有明亮荧光,肌纤维间隙的荧光强度明显大于对照组。在HSP70检测中,肌纤维内的荧光强度随着体位性限制程度的加重而明显增加。结论采用免疫荧光组织化学检测膈肌Fn和HSP70抗原的表达,对判断限制性体位窒息死亡者膈肌的损伤是一种有意义的手段。     

An unusual case of compression asphyxia and smothering

Scene investigation is an important part of the medicolegal autopsy. In many cases the cause of death cannot be determined without knowledge of the circumstances. A case is presented in which the diagnosis of compression asphyxia and smothering was made only after analysis of the scene findings.     

An unusual case of fatal accidental paraquat poisoning

Paraquat, a useful contact herbicide is now used in over 130 countries of the world, including Sri Lanka. The number of cases of accidental poisoning reported with paraquat is small, relative to instances of suicide. When a clear history is not available, accidental paraquat poisoning is sometimes difficult to diagnose. A 9-year-old boy was admitted to a peripheral hospital with a history of diarrhoea and vomiting. He later developed abdominal pain, subcutaneous emphysema and difficulty in breathing. Following transfer to a district hospital and then to a teaching hospital, poisoning with paraquat was suspected only on day 11 of the illness. On persistent questioning, on day 13 of the illness the child remembered that the day prior to the onset of illness, on his way from a shop, he felt thirsty and having found an empty bottle of Gramoxone (paraquat) on the wayside he used it to drink water from a water tank. The child died on day 17 and the histology of the lung showed typical changes of paraquat poisoning. This tragic episode emphasises the need for proper disposal of empty containers of all poisonous substances.     

An unusual death in water

A case of combined suicide involving the explosion of a handgranate in water demonstrates the possible misinterpretation of external injuries.     

The unusual accidental death of a pregnant woman by sexual foreplay.

This is the case of a young pregnant black woman who died during foreplay when her male partner with his hands accidentally forced air from her vaginal cavity into her uterine cavity, causing air embolization in the veins on the surface of her heart and her brain. Her premature infant was removed by cesarean section by emergency-room personnel after she died. The infant survived for 12 days before being declared brain dead.     

Fatal positional asphyxia associated with rollover crashes

Motor vehicle rollover crashes result in complex occupant kinematics with the potential for severe injury. Five cases of fatal asphyxia in occupants suspended from their safety belt upside down after a rollover crash are presented. These fatalities accounted for 13.5% of all motor vehicle related asphyxia deaths in San Diego County over a 10-year period. This study supports previous research noting that incapacitation due to other injuries, alcohol, or obesity may be associated with fatal positional asphyxia due to inversion during rollovers. Safety belts are proven to prevent serious injury in motor vehicle crashes and should always be worn. However, redesign of the buckle could be considered to permit easier release by an occupant. We also suggest that pre-existing heart disease may contribute to the possibility of a fatal asphyxia outcome. Although this is a rare cause of motor vehicle related death, our results suggest that these are potentially preventable deaths.     

An unusual case of double death

The report presents the case of an alleged double homicide or a homicide followed by suicide of a couple, in which the court-ordered autopsy of both victims revealed that the homicide had been committed by the husband immediately before he died himself from cardiac failure. The article gives a short summary of the pathophysiological relations between emotional tension (stress) and physical strain and the effects on the cardiovascular system. The case report describes a homicide by strangulation immediately followed by the perpetuator's death from a natural cause.     

An unusual drug death involving maggots

Toxicologic analysis of decomposed specimens provides greater analytical challenges than those encountered with fresh postmortem specimens. Despite the difficulties involved, in cases in which the cause of death is not determined at autopsy or when there is a strong indication of drug intoxication, all reasonable steps must be undertaken to perform as comprehensive a drug screen as possible. An unidentified white male was found in a field near a river. The body was decomposed and skeletonized, and 3- to 4-mm maggots were present on the body. Near the body was an empty bottle of secobarbital that had been prescribed to a female. There was no evidence of injury. Calf muscle and maggots were sent for toxicologic analysis. No volatile substances or drugs were detected in the calf muscle. Because intoxication due to secobarbital was strongly suggested from the scene investigation, the only other specimen available, the maggots, were tested for acid-neutral drugs. Secobarbital was identified by retention time and was confirmed by full-scan electron ionization gas chromatography/mass spectrometry. Based on the available information, the medical examiner ruled that the cause of death was secobarbital intoxication and the manner of death was suicide.     

An unusual death by propranolol ingestion

A case of acute intoxication with propranolol is reported. A 60-year-old man was found dead in his car with no evidence of trauma or signs of asphyxia. Near the car, a pharmaceutical box of Inderal, a pharmaceutical formulation containing propranolol, was found. The man was not under therapy with this medication, but circumstantial data suggested the use of this medicine by his sister. High blood levels of propranolol confirmed the suspected drug use and induced us to discuss the probable lethal mechanism of this substance. The analysis of this compound was performed by liquid-liquid extraction followed by gas chromatography/mass spectrometry determination.     

An unusual case of accidental poisoning: fatal methadone inhalation

In this report, the authors present a case of unusual, accidental methadone intoxication in a 40-year-old man, who had inhaled methadone powder. The drug dealer was a pharmacy technician; methadone had been stolen from a pharmacy and sold as cocaine. After having inhaled methadone powder, he suffered cardiopulmonary arrest. He was admitted to hospital where he died after 24 h of intensive care. The autopsy revealed congestion of internal organs and cerebral and pulmonary edema. Microscopically, the heart showed no changes. The toxicological analyses performed on blood and urine taken at the hospital revealed methadone, cannabinoids, and ethanol. The blood methadone concentration was 290 μg/L. The urine methadone concentration was 160 μg/L. Midazolam and lidocaine, which were administered to the patient at the hospital, were also detected in the blood. The cause of death was determined to be methadone intoxication. The literature has been reviewed and discussed. To date, and to our knowledge, only very few cases of accidental death resulting from methadone inhalation have been described up to the case presented herein.     

An unusual death caused by strangulation

An accidental case of strangulation is reported in which the victim caught his head in the gap of a wooden shed. Before passing into unconsciousness rescue was attempted.     

体位性窒息对脑血管损伤的实验观察

目的 观察体位性窒息对脑血管损伤的影响。方法 家兔20只,致其中10只体位性窒息,另10只断颈处死进行对照。用兔抗人白蛋白抗体和兔抗人(von Willebrand Factor,vWF)抗体进行LSAB免疫组化法显色。结果抗人白蛋白抗体及抗人vWW、检测均显示出阳性;对照组显示不明显。秩和检验显示,两组间具有显著性差异。结论　在体位性窒息时,呼吸障碍所引起的缺氧,可损害脑血管的正常结构。     

迟发性机械性窒息死亡1例

机械性窒息后，多迅速死亡，或迅速好转，不遗留任何后遗症，迟发性窒息死亡少见。现报道1例皮带勒颈后持续昏迷，后合并肺部感染于14天后死亡的案例。     

迟发性机械性窒息死亡1例

机械性窒息后,多迅速死亡,或迅速好转,不遗留任何后遗症,迟发性窒息死亡少见。现报道1例皮带勒颈后持续昏迷,后合并肺部感染于14天后死亡