Unusual cases of suicide among health care workers

We describe three unusual cases of suicide committed by health care workers. The aim of this paper was to analyze and evaluate the evidence of general diagnostic elements of poisoning in these cases.     

Unusual fatalities caused by glass splinter injury]

In the case of a thorax stab wound and an intrapulmonal position of the glass fragment (fall from a ladder into a glass door) an extrathoracic cardiac massage had been carried out. The result of which, an extremely unusual "reanimationtrauma" and the problems connected with it are discussed. In another case of a stab wound of the right iliacal vessels and the position of the glass fragment in the minor pelvis (jump through a thermopane glass of a door, followed by a fight) investigations were first conducted because of the suspicion of manslaughter. The autopsy, however, completely excluded death through fault of another. Further an unusual figured glass cut wound on the left side of the head (fall into a glass brick wall) led to death through gradual bleeding. The question arose whether death was caused by failure to give assistance.     

Unusual cases from Dubai, United Arab Emirates.

Dubai is one of the small countries of the United Arab Emirates located on the shores of the Persian Gulf in the Middle East. This report deals with two deaths: one an unusual method of suicide by hanging and the other, a death under investigation into whether it was accidental or suicidal.     

430例四肢损伤法医临床学分析

本文对４３０例四肢损伤的程度进行了统计分析。对致伤原因，致伤物与损伤类型，致伤物与损伤程度等进行了分析讨论。     

Unusual hanging deaths

Four unrelated hanging deaths involving young white males, all in enlisted status in the United States military, are presented. Taken in a military context, one scene served as a suicide note equivalent with the unmistakable message of extreme defiance toward military regulations. In two cases, the elaborate attire of the decedents could have lead to the misclassification of the manner of death if investigative information had not been considered. Extensive background investigation and review of medical records in the fourth case disclosed that the victim had an eight- to ten-year history of compressing his neck to cause unconsciousness. He left an extensive suicide note in which he concluded that "hanging would be good." Each case has certain unique features, as a group, the cases all demonstrate a continuum from obvious suicide to cases where the manner of death is, at first, equivocal.     

Unusual hanging deaths

We describe the circumstances and medical findings of four unusual hanging deaths. In brief, the unusual features are tracheostomy, delayed death, self-mutilation combined with severe neck injury caused by lengthy drop, and homicidal hanging in a young girl.     

Unusual fentanyl patch administration

Fentanyl is an extremely potent narcotic analgesic that is becoming more popular as a drug of abuse. Because of the unique way in which the drug is packaged and delivered, the potential for unusual methods of abuse exists. We report the first case of true fentanyl patch ingestion in the medical literature. Initially, though unusual, cases of fentanyl ingestion were thought to have been reported, but further investigation of the literature revealed that in other case reports the patches had been held in the mouth and chewed. Because no reports of swallowing the patch had been published, suicide was initially a strong consideration in this case; however, further investigation showed that the decedent and his brother enjoyed swallowing the patches for quick "highs." Cases such as these serve to remind medical examiners and law enforcement officials of the value of performing thorough death investigations by performing complete autopsies with toxicological testing and correlating with investigation information to form an opinion with regard to the cause and manner of death.     

Unusual carbon monoxide poisoning

Despite of indicative death scenes or characteristic findings of the external examination, about 40% of the accidental fatal intoxications due to carbon monoxide are not recognized before the performance of the autopsy. Six cases are reported which illustrate possible reasons for the delayed establishment of the diagnosis: unusual circumstances of the intoxication or sources of carbon monoxide, only subtle degree or lack of external signs of the intoxication or a competing cause of death at autopsy.--Cases 1 and 2: 53, respectively 54-year-old couple, found dead in a caravan, extreme putrefaction of the bodies, spectrophotometric detection of the fatal carboxyhaemoglobin level in oedema fluid of the scalp.--Case 3: 23-year-old lorry driver, found dead in the tightly closed cab of his lorry, operation of a source of electricity with "environmentally friendly" fuel, carboxyhaemoglobin level 83%.--Case 4: 19-year-old man, found dead in the flat of friends, removal of the CO-source before alerting the police forces, lack of the bright pink coloration of livor mortis, haemopericardium due to atrial rupture at postmortem examination, carboxyhaemoglobin level 65%.--Case 5: 27-year-old man, found dead in his flat, advanced decomposition of the body, residues of a charcoal fire in a metal bucket in the sink, carboxyhaemoglobin level 80%.--Case 6: 42-year-old woman, lying dead in the garage beside her car, engine switched-off, ignition key next to the body on the floor under the car, carboxyhaemoglobin level 46%.     

不同寻常的英国司法

在三种国家权力中,司法权是最不起眼的一种,其功能和作用一般说来都不如立法权和行政权那样成效显著和引人注目。但在英国,司法权却发挥了不同寻常的巨大作用,特别是在推进法治进程方面,堪称厥功甚伟。司法不但是引领英国法治文明的火车头,而且是支撑现代英国法治大厦的顶梁柱。英国司法之所以能够独树一帜,盖因其自身具有功能强大、结构优良、发展优先三大优势。     

Unusual characteristic patterns of postmortem injuries

Animal scavenging is one of the most significant causes of postmortem injuries. A large variety of scavenging animals have been reported on in previous papers. Although postmortem injuries attributable to birds are well known in the case of "aerial burial," the custom in Tibet, few cases of bird scavenging have been reported. In the two cases discussed herein, postmortem injuries were attributed to crows. Both cases, shared characteristic patterns of postmortem injuries, and in both cases death was attributed to fire. Although massive tissue loss by the crow scavenging made it difficult to determine the cause of the death and rendered personal identification difficult, 1 mL of blood drawn from the intracranial cavity and DNA analysis enabled this information to be determined, albeit with some difficulty.     

Unusual death of a farmer.

A farmer was found dead, in a pool of blood on his farm. Evidence indicated that the farmer had dragged himself or been dragged from the stable to the point where his body was found. With the exception of abrasions in the face, there were no other signs of injury. An autopsy revealed a depressed fracture of the skull and showed a venous air embolism to be the cause of death. The medicolegal interpretation of the findings left no doubt that the farmer was killed by a cow.     

Unusual suicide with a chainsaw

Described here is a case of suicide with the use of a chainsaw. A female suffering from schizophrenia committed suicide by an ingenious use of a chainsaw that resulted in the transection of her cervical spine and spinal cord. The findings of the resulting investigation are described and the mechanism of suicides with the use of a chainsaw is reviewed. A dry bone study was realized to determine the bone sections, the correlation between anatomic lesions and characteristics of chainsaw. The damage of organs and soft tissues is compared according to the kinds of chainsaw used.     

Unusual suicides with chain saws

Two cases of suicide with bandsaws, undertaken by workers in carpenters' workshops are reported and discussed. Their choice of this method was based on the fact that they knew how dangerous such machines were. Both cases were watched by witnesses, who could not intervene due to the speed of the events. It was possible to exclude accident or homicide.     

Unusual deaths associated with polyphagia

Perversion of appetite may be manifest in either qualitative (pica), quantitative (polyphagia), or combined derangements of eating. Ingested materials are capable of serving as dangerous physical agents through interference with normal cardiac and/or respiratory function. Since the mechanisms of injury are similar to those that might occur as a result of violence or serious natural disease, a thorough investigation of the history and circumstances immediately preceding the final event is warranted in addition to a complete autopsy. Three cases of asphyxia of unusual etiology are presented along with a rationale regarding the mechanisms believed to be involved. In case 1, sudden subdiaphragmatic viscus expansion with resultant lung volume displacement and impediment of venous return from the lower half of the body are believed to have been operative. In cases 2 and 3, both asphyxial loci are infraglottic. The common denominator in all of these fatalities is the physical impairment of vital air exchange as a complication of an abnormal eating pattern.     

The Economics of Cruel and Unusual Punishment

It has sometimes been argued that one way to reduce the costs of law enforcement would be to reduce the probability of detection and conviction (hence saving those costs), while at the same time increasing the size of the punishment. Following this strategy would keep the expected costs (to a risk neutral criminal) of committing a crime constant and hence keep the deterrence level constant; it would have the benefit, though, of reducing costs to the rest of society.There are some well-known objections to such a policy. One such objection deals with marginal deterrence: A convicted murderer serving a life sentence with no chance of parole in a jurisdiction which bans capital punishment has nothing to lose from killing a prison guard—there is no marginal deterrence to the commission of a more serious crime or any additional crime for that matter. In fact, so long as there remains any upper limit to the amount of punishment that can be inflicted upon a convicted criminal, the only ways to create some type of marginal deterrence are to reduce the punishments for less serious crimes, which will either reduce the deterrence of those less serious crimes, or alternatively to require the use of more of society's scarce resources to increase the probabilities of apprehension and conviction.It is possible to reduce this marginal deterrence problem, however, by practicing cruel and unusual punishment on perpetrators of serious crimes, i.e. by raising the limits of allowable punishment. Anecdotal evidence suggests this practice is followed unofficially with child molesters and killers of prison guards and hence provides some additional deterrence against these crimes.Despite the theoretical validity of this argument, our society has chosen to impose a constitutional ban on cruel and unusual punishment. Furthermore, over time we seem to have lowered the threshold of what is considered cruel and unusual. Following Dr. Pangloss, the concluding section of the paper examines why rational maximizers would choose to give up this additional potential deterrence. The explanations depend upon an assumed positive income elasticity of demand for humanitarianism or for insurance against the costs of punishing the innocent. While there are some reasons to accept the humanitarianism argument, the insurance argument seems more persuasive.     

特殊火场尸体检验体会1例

在法医命案现场勘验中,火场尸体案件并不鲜见。犯罪嫌疑人为了达到毁灭罪证、逃避打击的目的,可能会选择纵火焚烧现场,处于现场中的人体亦     

Unusual chamber marks on plastic shells

Chamber marks alone can serve for identification. It has been observed that these marks are more clearly imprinted on plastic shells fired through homemade crude weapons. The importance of these marks is crucial when other conventional marks are absent. In the present communication, principles of identification are briefly discussed along with the factors affecting the conventional marks. One such actual case is cited.     

特殊火场尸体检验体会1例

在法医命案现场勘验中,火场尸体案件并不鲜见。犯罪嫌疑人为了达到毁灭罪证、逃避打击的目的，可能会选择纵火焚烧现场。处于现场中的人体亦常常被烧毁。典型的焚尸命案相对容易甄别,而一些比较特殊的案例，检验和甄别的难度较大,尸检过程中容易出现疏漏或者误判。本文就实际检案工作中遇到的一起案例进行报告。     

Unusual suicide by mechanical neck compression

A 36-year-old man was found dead with his neck being jammed between the hydraulic tail lift and the side wall of a truck. Based on the investigations, the technical facilities of the tail lift, the results of the postmortem examination and the autopsy it could be demonstrated that the victim, who suffered drom depression, had intentionally brought himself into this position and committed suicide by compression of the neck. The pathomorphological findings and the technical reconstruction of this unusual death are presented.