不同环境条件下大鼠死后皮肤大体和组织学改变

目的研究观察大鼠在不同环境条件下死后不同时间其皮肤大体、组织学的改变,为推测较长的死后间隔时间建立实验动物依据。方法观察雌性SD大鼠在不同环境条件下的死后变化,并间隔一定死后时间取皮、染色和镜下观察。结果死后发生骨、软组织分离,A组约需35d,B组需13d。皮肤有形细胞成分和附属器完全分解破坏,A组约20d,B组7d。胶原纤维在A组死后40d（B组12d）仍有部分保留完整。结论环境温度差异是造成A、B两组发生死后改变时程不同的主要因素,利用皮肤大体、组织学改变可望较系统和准确的推测晚期死亡时间。     

Evaluation of histologic changes of the skin in postmortem period

ABSTRACT: Determination of the time of death is an important consideration in forensic practice. Many methods have been attempted to accurately and systematically determine the postmortem interval (PMI). Histologic examination of the skin or appendages is one of the methods tried by few researchers. However, no attempt had been made to analyze the histologic changes in the skin and appendages simultaneously and to compare them with PMI. We sequentially studied the histologic changes of the skin and appendages in the early PMI. The results of the present study show that the skin undergoes progressive morphological changes in the postmortem period. The epidermis and the dermis appeared normal for 6 hours after death, and after this period, degenerative changes began. By 6 to 9 hours after death, degeneration began in the dermis, and by the end of 18 hours, the dermis began to disintegrate. The sweat glands appeared normal for approximately 3 to 4 hours. For 18 hours after death, the sebaceous glands and hair follicles appeared normal, and after this period, degeneration began.     

CT‐Guided,Minimally Invasive,Postmortem Needle Biopsy Using the B‐Rob II Needle‐Positioning Robot

CT‐guided, minimally invasive needle biopsy techniques can be used to retrieve tissue or body fluid samples for histologic tissue diagnoses in forensic investigations. The purpose of this study was an evaluation of CT‐guided needle‐positioning robot B‐Rob II. To operate under CT guidance, we adopted the B‐Rob II robotic needle placement system and its workflow. The accuracy and speed of the procedure were tested on a gelatin phantom in a series of 21 biopsies. We achieved an average needle placement accuracy of 1.8 mm (±1.1 mm) using robotic assistance. The procedure required an average of 2 min 21 s. The needle placement accuracy for minimally invasive needle biopsies using the B‐Rob II biopsy robot is sufficiently accurate and fast for forensic postmortem examinations of focal organ changes. Further tests will be performed to test the feasibility of the robot for performing biopsies of focal organ changes in human bodies.     

Comparison of morphological changes in white blood cells after death and in vitro storage of blood for the estimation of postmortem interval.

Estimation of the time of death is one of the most important problems for forensic medicine and law. Physical and chemical postmortem changes are evaluated together while estimating the time of death.In this study, in vitro storage and postmortem changes of white blood cells were aimed to be compared within the given postmortem interval, and a follow-up study was carried out. Blood smears which were obtained from 10 non-refrigerated cadavers (experimental group) and from 40 hospital patients (control group) have been evaluated to observe and compare changes during the in vitro storage and postmortem degenerative morphological changes that white blood cells undergo throughout the given postmortem intervals. The samples were examined by using a light microscope, and blood cells were differentiated by staining blood films with May-Grunwald stain, followed by Giemsa stain. Identifiable degenerated eosinophils and monocytes were first examined at 6h of death and the in vitro storage, and they were unidentifiable beyond 72 h of storage. Identifiable degeneration of neutrophils were first examined at 6h of death and storage while unidentifiable beyond 96 h of storage. Identifiable degeneration of lymphocytes were first examined at 24h of death, and they were still identifiable beyond 120 h.Cellular changes of leukocytes can be useful in the 6-120 h for estimating the time of in vitro storage, and the findings match during the first 21 h for both experimental and control groups. Finally, this follow-up study and the comparison will also be carried out for a longer postmortem interval, and other specific hypothesis that relate cellular changes in tissues other than blood with time since death are various points that needs to be studied.     

水、油污中无电流斑电击死大鼠皮肤和心肌的病变

目的探讨水中、油污中无电流斑电击死法医学鉴定的病理形态学依据。方法 SD大鼠28只,分为水中、油污中无电流斑电击死各1组,典型电流斑组、正常对照组、死后电击组、死后水中、油污中电击各1组共7组。采用肉眼、光镜及投射电镜观察水中、油污中无电流斑电击死大鼠皮肤和心肌组织病理学改变,并与其它各组进行比较。结果采用肉眼观察,生前水中、油污中无电流斑电击死大鼠皮肤未见明显电流斑。普通光镜观察,可见电击中心部位表皮变性坏死、脱落,表皮细胞变薄、致密,表皮细胞或/和毛囊、汗腺、皮脂腺发生极性化改变。电镜观察,透明层和角质层分离脱落,基底细胞肿胀、细胞器减少、核固缩,汗腺导管上皮肿胀,棘细胞中粗面内质网扩张融合成泡状,线粒体肿胀空泡化;但光镜与电镜的变化与生前电击死比较不明显、典型。而死后电击组皮肤则无明显病理学改变。实验各组大鼠心肌的改变与皮肤改变类同。结论采用光镜和投透射电镜观察在潮湿环境中电击死的组织病理学改变,可为无电流斑电击死提供依据。     

Fatal Phenol Toxicity Following Attempted Tattoo Removal

Tattoo removal is increasingly required as the number of, particularly young, people acquiring tattoos is increasing. A 21‐year‐old man is reported who underwent attempted removal of large dragon tattoo utilizing a tattoo machine that injected a phenol‐containing solution. At the end of the 3‐h procedure, he collapsed and died. At autopsy, large areas of white skin discoloration with focal necrosis and sloughing were present overlying areas of previous tattooing. Histological examination showed collections of eosinophilic fluid with a minimal chronic inflammatory infiltrate in better preserved areas, with focal areas of dermal necrosis. Toxicology was positive for phenol in cardiac blood and liver tissue. There were no underlying organic disease or injuries present which could have caused or contributed to death. This idiosyncratic method of tattoo removal involving subcutaneous injection of phenol had resulted in death most likely from cardiotoxicity.     

Fatty degeneration in renal tubule epithelium in accidental hypothermia victims

The diagnosis "death due to hypothermia" is mainly based on circumstances and gross autopsy findings like frost erythema and gastric erosions. Up to now, there are no reliable histologic criteria available to confirm the diagnosis "death due to hypothermia." However, fatty changes of organs have been reported already in the literature as a histological finding contributing to the diagnosis "death due to hypothermia." To evaluate these reports, cases with well-documented hypothermia (study-group; n=83), cases with other causes of death (control-group; n=25) and additionally also seven cases with a past medical history of diabetes mellitus were investigated. Renal tissue autopsy samples were taken from both the left and the right kidney and investigated for signs of fatty degeneration within the renal tubule epithelium. The results were compared with regard to macroscopic signs of hypothermia (Wischnewski-ulcers, erythema), as reported in the autopsy protocols. The results lead to the conclusion, that fatty degeneration is a very reliable histologic diagnostic criterium in cases of hypothermia, comparable to the significance of Wischnewski-ulcers.     

不同环境条件下大鼠死后皮肤生物力学特性改变

目的死亡时间的推测是法医病理学研究的重点和难点。皮肤具有一定生物力学特性,是机体死后分解破坏发生较迟的部分。本研究观察不同环境条件下死后大鼠皮肤生物力学特性的改变,探索其与死亡时间的关系。方法系统测试雌性SD大鼠在不同环境条件下（A组较高环境温度,B组较低环境温度）的死后皮肤生物力学特性。结果 A组大鼠皮肤死后张应力、延伸率在死后1d内先降低后升高,1d～6d逐渐降低,6d～7d略呈上升趋势;B组大鼠皮肤死后张应力在死后2d内先降低后升高,2d～16d逐渐降低,16d～20d略上升。结论 A组的张应力、延伸率和B组的张应力、应变能密度均表现出与死亡时间较好的相关性,是较好的推测死亡时间的生物力学参数。     

Frozen cadaver. Antemortem versus postmortem.

Three categories of skin from Hanford miniature swine were examined microscopically: normal, unfrozen skin; skin exposed to -75 degrees C air for 5 min, 6 h postinjury; and skin frozen postmortem. Frostbitten skin (antemortem freezing) was characterized grossly by a purple discoloration and microscopically by dilated, blood-filled, superficial capillaries. Other changes in the frostbitten skin were vacuolated epithelial cells and dermal edema. Unfrozen skin (controls) and skin frozen postmortem were more difficult to differentiate. However, the epidermis of the latter usually was compressed and more basophilic. We concluded that skin frozen antemortem could be separated from skin frozen postmortem by its intense hyperemia, characterized grossly as a purple discoloration and microscopically by engorged capillaries.     

Sudden death of an alcoholic elderly man with acute esophageal necrosis (black esophagus)

We report a fatal case of acute esophageal necrosis (black esophagus) in an elderly male with alcohol abuse who was found dead with coffee-ground vomiting. A postmortem examination revealed severe anemia and marked black coloring of the esophagus from the upper to the bottom end. This was accompanied by histologic evidence of extensive mucosal necrosis. Alcohol abuse and esophagitis-related vomiting were both considered to be factors that led to the acute fatal esophageal necrosis. The cause of death was undetermined. We discuss the possible role of acute esophageal necrosis in the cause of sudden death.     

Transcellular and extracellular impedances of the intact abdomen in putrefying rat cadavers

Total (Zt) and extracellular (Ze) abdominal impedances of putrefying rat cadavers, stored at 18.0±0.7°C, were measured at 50 kHz and at 1 kHz, respectively, during the first 7 days of death. Transcellular impedance was calculated from the measured values of Zt and Ze. Total impedance and Ze increased during the first day, and then decreased with increasing postmortem interval, while Zi remained unchanged during the first 3 days before increasing more than 4-fold between 3 and 7 days postmortem. These changes are consistent with net gain of electrolyte by the extracellular fluids and with degeneration of cell membranes which occur postmortem. It is concluded that, during putrefaction, Ze is a potentially more useful index of postmortem interval than Zt or Zi, and that measurement of total abdominal impedance at 50 kHz, rather than at 10 kHz, markedly improves the precision and accuracy of impedance measurement.     

Postmortem measurements of thyroid hormones in blood and vitreous humor combined with histology.

The aim of this study was to investigate whether clinical reference premortem values can be used to assess postmortem concentrations of thyroxine, triiodothyronine, and thyroid stimulating hormone (TSH), to compare the postmortem concentrations in blood and vitreous humor, and to study the possibility of diagnosing hyperthyroidism by comparing thyroid histologic appearance and postmortem hormone values. Biochemical analyses of free thyroxine (FT4), free triiodothyronine (FT3), and TSH in femoral blood and vitreous humor were made in 38 cases. In 40 cases, the hormones and thyroid histologic appearance were studied; 22 had no significant pathologic changes, and 18 showed focal hyperplasia of the follicular epithelium. A positive correlation was seen between the femoral blood and vitreous humor concentrations of FT4 (R = 0.66) but not between the corresponding concentrations of FT3 and TSH. A positive correlation was also seen between FT3 and FT4 in femoral blood (R = 0.74). In cases with normal thyroid histologic appearance, 58% were found to have FT4 values >24 pmol/L (clinical reference interval 9-24 pmol/L), mean value 27.5 +/- 9.4 pmol/L), which did not differ from the FT4 values in the cases with hyperplasia, 31.6 +/- 15 pmol/L. Only 5% of the T3 measurements in the group with normal histologic appearance were >9 pmol/L (clinical reference interval 3-9 pmol/L). The mean value of FT3 in cases with normal histologic appearance was 3.4 +/- 1.3 pmol/L, and in the group with hyperplasia 8.6 +/- 6.1 pmol/L. The difference was statistically significant P < .005). It is concluded that postmortem values of FT3 and FT4 in femoral blood are fairly comparable to premortem clinical reference values, but the upper normal limit, especially for T4, has to be adjusted upward. Analysis of vitreous humor cannot be used post mortem to assess thyroid function. Histologically, hyperplastic changes correlate well with elevated FT3 in femoral blood.     

利用人体标本进行死亡时间推断的研究现状

死亡时间(PMI)推断具有重要的法医学意义,但尚无可以应用在实践领域的PMI推断方法。本文从PMI推断的实践应用角度出发,从脏器、骨骼、骨骼肌、牙齿、牙龈以及大体观、毛发、皮肤和血液等角度,对利用人体标本进行死亡时间推断的研究现状进行了综述。希望对我国开展人体标本的PMI推断实践研究提供借鉴。     

春季尸体腹腔腐败气压在法医学死亡时间推断中的应用研究

目的 研究尸体腹腔腐败气压在春季的发展变化规律及其用于推断死后经过时间的方法。方法用实验动物山羊57只,分陆地处死和水中溺死两大组,用自行研制的“腐败气压测定仪”,定时系统测量动物尸体腹腔内的腐败气压。结果 得出尸体腹腔内腐败气压的发展变化规律,并据此建立测量腹腔腐败气压推断死后经过时间的方法。研究了数种死亡方式、尸体所处环境和个体差异等的影响。结论 该研究成果填补了法医学中尸体腐败气压发展变化规律研究、检测腐败气压推算死后经过时间和腐败气压测定仪等的多项空白,丰富了该领域的法医学内容。     

Immunohistochemical study of basic fibroblast growth factor and vascular endothelial growth factor expression for age determination of cutaneous wounds

The authors investigated the expression of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) during skin wound healing using immunohistochemical techniques. After a full-thickness incision was made on the dorsal skin, mice were killed 0.5, 1, 3, 8, 24, 72, 144, or 240 hours after incision, and the wound was excised. To evaluate the influences of postmortem degeneration, cutaneous wound excision was performed 1 to 5 days after the mice were killed. The excised wounds were stained by the conventional streptoavidin-biotinylated peroxidase complex method, using specific antibodies, and the ratio of the number of positive cells to total cells was determined. Expression of bFGF was detected in the nuclei of epidermal cells and fibroblasts in the early 0.5- to 1-hour phases and the late 24- to 144-hour phases. Expression of VEGF was detected in the cytoplasm of epidermal cells in the 24- to 144-hour phases. Immunoreactivity of both cytokines was detected 1 day post mortem and was especially well preserved in the fibroblasts. Time-dependent expression of both factors suggested that they would be useful markers for the determination of wound age. However, bFGF should be superior to VEGF because of its earlier expression and because of its more persistent expression in dermal fibroblasts with increasing postmortem interval.     

家兔急性胰腺炎死后不同时间眼玻璃体液淀粉酶变化

目的探讨急性胰腺炎死后不同时间眼玻璃体液淀粉酶变化。方法用1%牛胆酸钠诱导家兔急性胰腺炎动物模型建立,于死后不同时间和正常对照组,观察其淀粉酶变化。结果家兔急性胰腺炎死后72h眼玻璃体液淀粉酶含量(x)与死亡时间(y)存在相关关系,并导出其二项式回归方程为y=8.7420 0.7699x-0.0083x2(R2=92.62792,F=14.89734,P=0.001)。可作为推定早期损伤时间的参考指标。结论家兔急性胰腺炎死后不同时间眼玻璃体液淀粉酶改变为法医早期死亡时间推断提供了灵敏客观的实验依据。     

家兔烧死后气管、肺及心肌的病理形态学观察

目的探讨烧死的病理形态学依据。方法建立家兔烧死动物模型,用光镜、透射及扫描电镜观察10只生前烧死家兔气管、肺及心肌的病变;并与死后焚尸及非烧死的正常组(各5只)对照。结果透射电镜下,气管粘膜上皮完全脱落,成堆红细胞和纤维蛋白成分粘附在平滑肌表面。肺Ⅰ型上皮细胞结构基本完整连续,线粒体嵴有断裂、缺失;Ⅱ型肺泡上皮细胞微绒毛消失,多数细胞线粒体、板层小体、高尔基体未见异常,少数Ⅱ型肺泡上皮细胞质膜破损、染色质浓集、胞质内容丢失。心肌严重变性坏死,细胞膜破坏,线粒体极度肿胀,肌丝溶解并出现收缩带坏死。扫描电镜下,气管粘膜上皮有完整纤毛,但上皮大片脱落,少数区域纤毛上皮稀疏排列,有脱落柱状上皮附着在纤毛上;肺间皮细胞结构基本完整,微绒毛数量不一致;心内膜的内皮细胞大部脱落,暴露内皮下结缔组织,心肌纤维呈扭曲排列。死后焚尸及正常组对照组未见上述变化。结论烧死兔的光镜和电镜下气管、肺及心肌的病理形态学变化,能为生前烧死与死后焚尸的鉴别提供依据。     

Influenza A virus infection complicated by fatal myocarditis

Influenza virus typically causes a febrile respiratory illness, but it can present with a variety of other clinical manifestations. We report a fatal case of myocarditis associated with influenza A infection. A previously healthy 11-year-old girl had malaise and fever for approximately 1 week before a sudden, witnessed fatal collapse at home. Autopsy revealed a pericardial effusion, a mixed lymphocytic and neutrophilic myocarditis, a mild lymphocytic interstitial pneumonia, focal bronchial/bronchiolar mucosal necrosis, and histologic changes consistent with asthma. Infection with influenza A (H3N2) was confirmed by virus isolation from a postmortem nasopharyngeal swab. Attempts to isolate virus from heart and lung tissue were unsuccessful. Immunohistochemical tests directed against influenza A antigens and in situ hybridization for influenza A genetic material demonstrated positive staining in bronchial epithelial cells, whereas heart sections were negative. Sudden death is a rare complication of influenza and may be caused by myocarditis. Forensic pathologists should be aware that postmortem nasopharyngeal swabs for viral culture and immunohistochemical or in situ hybridization procedures on lung tissue might be necessary to achieve a diagnosis. Because neither culturable virus nor influenza viral antigen could be identified in heart tissue, the pathogenesis of influenza myocarditis in this case is unlikely to be the result of direct infection of myocardium by the virus. The risk factors for developing myocarditis during an influenza infection are unknown.     

应用FTIR光谱技术推断死亡时间

目的 应用傅立叶变换红外(FTIR)光谱技术分析大鼠死后组织、人体离体组织随死亡时间推移的化学降解过程,为死亡时间推断的研究提供新的途径与方法.方法 大鼠断颈处死后置于4℃、20℃、30℃环境,在不同死亡时间点提取大鼠不同组织;收集有同样死亡时间的人尸体组织,离体取材,并运用FFIR光谱仪测定不同化学基团随死后和离体后...