Eyelid petechiae and conjunctival hemorrhage after cardiopulmonary resuscitation]

In the last few years, some reports claim that petechial bleedings found in the eyelids and conjunctivae of corpses may be resp. are caused by resuscitation efforts (= RES). Nevertheless, the numbers of cases were small and the selection of the cases presented to demonstrate this relation in our opinion was not convincing. In the material of our institute, the rate of autopsies in which the victims had been tried to resuscitate by professionals increased up to ca. 25%, including a substantial number of victims of homicides. If RES alone would cause petechial bleedings, serious problems would arise for the medical expert. We analyzed all cases of a period of 5 years, which were examined by 1 investigator. Among 474 autopsies, RES was done in 144 cases (31%). 19% of these victims presented petechial bleedings, predominantly in the conjunctivae, compared to only 11% in the non-RES group. However, this was not a consistent finding in all subgroups: If the group of acute cardiac deaths of middle-aged persons was taken separately, in the remaining material a statistically significant difference in the petechial rate between cases with and without RES was not present. The analysis revealed an influence of the following factors in the development of petechial bleedings: cause of death, age, constitution (body mass index). In the RES subgroup with the highest rate of petechial bleedings (acute cardiac deaths of persons between 40-60 years; n = 23; rate of petechiae = 50%) the frequency of petechiae could be explained by a combination of such factors. As a second way we investigated all persons in which RES was done in our Medical School during a period of 5 months. In no surviver petechiae were present; in the group of non-survivers (predominantly cardiac deaths), the petechial rate was 16%. According to the statements of the treating physicians, a development of petechial bleedings under RES was not striking in these cases or according to their general experiences. Although such a statement is of restricted value (because petechial bleedings are mostly not obvious without a special look for them), the complete absence of information of this aspect in the clinical literature is striking. If petechial bleedings would be a common consequence of RES, this finding should be well known in intensive care units. According to our experience, a clear causal relation between resuscitation efforts and petechial bleedings in the face is not likely.     

Time-dependant changes in the protein spectrum of blood from living and dead persons by means of electrophoresis in cellulose acetate (author's transl)]

Protein electrophoresis on cellulose acetate shows that with increasing hemolysis of ante- and postmortem blood an extragradient in the alpha2-globulin field is created, which influences the relative ratio in the electropherogram. Strong hemolysis causes a fusion of the alpha2- and beta-globulin chains. In order to make a diagnostic interpretation of postmortem blood by means of electrophoresis, it is therefore essential to take into account the degree of hemolysis. Changes in the electrophoretic pattern due to hemolysis correlate best with the period of storage. With regard to timing for forensic purposes, the value is, however, limited.     

“If this be living I'd rather be dead”: Enslaved youth,agency and resistance on an eighteenth century Jamaican estate

By the late eighteenth century, enslaved children and young adults had become vital components in the reproduction of Caribbean slavery. Yet the experiences of enslaved children and adolescents have rarely been the focus of scholarship. Indeed, the near-absence of scholarship on enslaved children and youth within the historiographies of slavery, childhood and family history is striking. While we know much about the structure of family life, gender roles, courtship, marriage, and parenting among the enslaved, we know far less about the material worlds of enslaved youth and adolescents. Childhood and adolescence represented critical stages in the lives of enslaved children for it was during these life-stages that young people were inculcated with the racialised ideologies of the wider social order, gained insight into the value systems of their society, were socialized into acceptance of their status as unfree peoples, and prepared for their future roles as labourers. Hence, their experiences of slavery were qualitatively different from those of adult slaves.This paper explores some aspects of adolescent life on the Jamaican estate of Thomas Thistlewood in the late decades of the eighteenth century. Thistlewood, manager of a slave-pen, early recognised the importance of young people in furthering his ambitions to become master of his own estate, and his purchases of young people reflect that market-rational strategy. Thistlewood’s preference for a youthful labour force stemmed from his conviction that young people could be more easily made to submit to his authority than adult slaves. Yet, Thistlewood’s belief in the greater tractability of enslaved youth was often undermined, as his adolescent labour force frequently and forcefully tested the limits of his mastery and asserted their rights to freedom. Thistlewood’s journal not only offers rich insights into the processes of transformation of enslaved children to adolescents and mature adults, but it also sheds light on enslaved youth and their negotiations with, manipulations of, and resistance to the master–slave relationship. This paper argues then, that far from being the passive objects of planter mastery, enslaved youth were active agents in the shaping of their own histories. In exploring these issues, this paper reveals much of the contradictions and ambiguities of enslaved childhood, youth and adolescence.     

Mortuuspolitics: politicization of the dead,capitalism, and inequality

Capitalism has led to the appropriation of oppressed groups, their experiences and narratives. We believe this includes narratives and given value of the dead where there remains a continuation of inequalities of life unto death and being dead. Specifically, we suggest that the discrepancy of the value of the dead is the result of the links between power, politics, and hegemonic discourse embedded in neoliberalism that propagate and reify unequal power edifices that value some groups over others, in life and death, what we refer to as mortuuspolitics. The State, entrenched within the capitalistic neoliberal definition of value, also decides on the value or non-value of the dead.     

Presence of periorbital and conjunctival petechial hemorrhages in accidental pediatric drowning

The pathological findings of drowning are variable and non-specific. Petechial hemorrhages involving the periorbital region and the conjunctiva have been described in many causes of death, but are thought to be exceedingly uncommon in cases of drowning. However, such studies have not specifically addressed the pediatric population. The current study retrospectively examined 79 cases of accidental pediatric drowning for the presence of periorbital/conjunctival hemorrhages and analyzed factors that may have affected their presence. Ten victims had periorbital/conjunctival petechial hemorrhages (13%), with five having periorbital petechiae, three having conjunctival petechiae, and two having both periorbital and conjunctival petechiae. The age and gender of the victim, site of drowning, resuscitation history and the presence of other pathological findings were not significantly associated with the presence of periorbital/conjunctival petechiae. However, as the interval between the drowning episode and autopsy increased, the incidence of periorbital/conjunctival petechiae decreased (28% for <24h; 7% for >24h). The presence of periorbital/conjunctival hemorrhages in a significant proportion of pediatric drowning victims confirms that the pathologist must add this finding to the spectrum of changes seen in pediatric drowning.     

Arising from the dead: challenges of posthumous procreation

The medical capabilities derived from modern reproductive technology, such as in vitro fertilization and cryopreservation, have enabled physicians and scientists to intervene in the procreative process in innumerable ways. However, this intervention in the natural reproductive process raises both moral and legal concerns. In this Article, Professor Schiff explores some of the conflicts that may result when an individual or couple elects to cryopreserve gametes or embryos and subsequently, one or both of the contributors dies, or when gametes are harvested from a dead body. This Article will specifically address the moral and legal responses to circumstances where the decedent has either clearly expressed opposition to posthumous use of the reproductive material or else the decedent's intent regarding posthumous use of the material is ambiguous. By discussing philosophical and moral positions relating to personhood and the body and analyzing legal issues such as reproductive choice and organ donation, Professor Schiff creates the necessary format to examine and recommend the proper legal treatment of this controversial aspect of posthumous procreation.     

死亡大鼠看家基因mRNA时序性降解的组织差异性研究

目的研究死亡大鼠看家基因mRNA时序性降解的组织差异性,评价其用于死亡时间推断的价值。方法SD大鼠20只分为死后0、1、3、5、7d共5组,脊椎脱臼法处死大鼠,提取大鼠心、肝、脾、肺、肾、脑组织,在相应时间段提取RNA,应用一步法RT-PCR技术检测各组织中看家基因GAPDHmRNA和β-actinmRNA的水平,Vilber凝胶图像分析系统测定扩增产物IOD值,SPSS10．0统计软件对数据进行方差分析。结果GAPDHmRNA、β—actinmRNA扩增产物相对灰度与积分光密度值随死后经过时间的延长而逐渐减小,且与死亡时间显著相关,大鼠脾脏和脑组织GAPDHmRNA和β-actinmRNA在死后5d内可检出,心脏和肾脏在死后3d内可检出,而肝脏和肺脏GAPDHmRNA和β-actin mRNA降解较快,仅在死后1d内可检出。结论脑组织和脾脏中mRNA稳定性较好,适用于PMI特别是晚期PMI的推断。除环境温度外,环境湿度也是死亡时间推断中的重要影响因素。     

Trends in the Incidence of Legal Problems and in the Use of Lawyers

Changes in the law, government regulations, socioeconomic changes, increased consumerism, the public's level of awareness—all these and other factors influence the population's demand over time for lawyers'services. This article analyzes the changes over time in the two elements that determine the demand for lawyers: the number of legal problems encountered by the population and the rate of use of lawyers in solving these problems. After showing that sequential occurrences of legal problems are not independent of each other and are age dependent, the author develops a mathematical model that explains the variability in the present number of problems encountered by different age groups. The number of problems is found to result from a relatively mild accumulation with age of legal problems, coupled with a strong increase in the number of problems from generation to generation. The analysis of individual legal problems reveals a variety of patterns from problem to problem in both the level of occurrence and the rate of use of lawyers for such problems. The author concludes that the combined effect of occurrence and utilization will operate toward a continuing increase in the demand for lawyers'services at least for the very near future.     

Use of the dead body in healthcare and medical training: mapping and balancing the legal rights and values

By exploring the central legal principles and issues regarding usage of the dead body in healthcare and especially in medical training, this article aims at drawing some general conclusions on the legal status of the dead body and the protection of the deceased's integrity, dignity and autonomy. The article demonstrates that the use of the cadaveric body for scientific and educational purposes involves a redrawing of the traditional boundaries between the decent and the indecent, making these acts acceptable that would otherwise be regarded as assaults on the sanctity of bodily boundaries. This is made possible by the fact that the underlying principle of dignity is not perceived to be of an absolute nature when applicable to deceased persons.     

Sugar and fatty acid analysis in ecstasy tablets

Sugars and stearates (composed of fatty acids) are both frequent components used in the production of ecstasy tablets. Their analysis can therefore provide supplementary information useful for drug intelligence. Links established using these substances would be very significant as they should give us information about the manufacturer of the tablets. Two methods have been developed for the analysis of sugars and fatty acids by GC-MS and were applied to 109 ecstasy tablets. Characterisation of the samples should allow the differentiation of a certain number of them and furthermore their classification into groups. This is obtained by analysing the raw data using chemometric methods. Several pre-treatments have been tested together with six similarity measures on a small number of ecstasy samples in order to determine which combination would best characterise one ecstasy sample and differentiate it from the others at the same time. Normalisation followed by the fourth square and applied together with the squared cosine function appeared to give the best results and has been applied to all samples. The correlation values obtained of each sample with all others express the probability of a presence of a link between two samples. In order to verify the signification of these values, and thus of a link, all samples have been compared considering the data visually according to three selected criterions. The 109 examined samples could be divided into 67 groups, with 43 of them containing only one sample. Considering the distribution of their correlation values, sample pairs showing a value below 0.23 can be considered as linked. As the excipients are necessarily related to the blending, which also includes the active substance, and variation in the excipient content has been proven by the grouping of the samples, a low similarity value does indicate a link with regard to the producer. In conclusion, it appears that the result obtained with the excipients is certainly very valuable, but all other available information has to be taken into account as well before making any conclusions.     

The incidence and characteristic features of fatal hemorrhage due to ruptured varicose veins: a 10-year autopsy study

Death due to hemorrhage from ruptured peripheral varicose veins is an uncommon event. A review of the files of Forensic Science SA (FSSA) in Adelaide, South Australia, was undertaken over a 10-year period from January 1996 to December 2005 for such cases. A total of 8 cases were found out of a total of 10,686, representing <0.01% of autopsy cases. The male to female ratio was 1:3, with an age range of 58-84 years (mean = 78 years). The victims were all located at their home addresses, where they had been alone at the time of their deaths. Scene investigations revealed considerable blood loss, with pooling around the victims' bodies, and also in other parts of the house, particularly the bathroom/toilet areas. Four ulcers were of an acute perforative type and 2 were of a chronic ulcerative type. In 2 cases, bleeding followed trauma. Toxicologic evaluation was performed in only 3 of the cases, revealing blood alcohol levels of 0.06% and 0.14% in 2 cases, respectively. A further victim had been prescribed anticoagulant drugs for an unrelated condition. Additional findings of significance were ischemic heart disease in 3 cases and deep venous thrombosis of the calf veins on the side of the fatal hemorrhage in another case (with no evidence of pulmonary thromboembolism). One victim had acute gastric erosions, suggesting that hypothermia following collapse played a role in the terminal event. Autopsy evaluation of such cases should include careful layer dissection of the area of hemorrhage to confirm the presence of the ruptured varix and to enable directed histologic sampling.     

Vitality and age of conjunctival petechiae: The expression of P-selectin

Confocal laser scanning microscopy (CLSM) results in displaying multiple ruptures of capillaries and venules define conjunctival petechiae as a rhexis haemorrhage. In order to distinguish between petechiae which have arisen before death as opposed to post-mortem artefacts and the establishment of the age of the vessel's damage, we carried out an investigation on a collection of samples from medico-legal cases (positive petechiae: n = 65; post-mortem artefacts: n = 12; control: n = 19) to establish whether the expression of the endothelial adhesion molecule P-selectin as demonstrated by immunohistochemical methods is influenced by trauma before death and possibly by time. Except for cases with massive congestion in those cases where the victim had survived for around minutes, CLSM examination revealed a strong endothelial reaction at the site where the vessel had ruptured. It was impossible to detect a strong P-selectin expression signal in both those vessels which had not suffered any mechanical insult and those which had experienced post-mortem rupture. Therefore, the elevated expression of P-selectin can be used as a criterion to distinguish between those lesions which have occurred in life and those which are post-mortem artefacts.