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.     

来苏儿经皮肤吸收中毒死亡1例分析

某男 ,6 9岁 ,平素身体健康。 1 999年 4月 1 5日因患天疱疮就诊于当地一个体门诊 (无行医执照 )。门诊将酒精 2 0ｍｌ来苏儿 (市售 ) 40ｍｌ和生理盐水混合成 5 0 0ｍｌ左右的液体作为洗液 ,将皮炎平 1袋、尿素软膏 1袋、酒精 2ｍｌ、来苏儿 4ｍｌ调配成抹液 ,治疗的方法是在全身的皮肤上先洗后抹 ,每天一次 ,每次均将药液用完。连续治疗 3天。其间患者出现皮肤疼痛、浑身发麻、无力、流涎、头疼、眩晕、呕吐、腹痛、腹泻、不能进食 ,并出现茶色尿。经诊者说这是以毒攻毒 ,出现这些症状属正常现象。遂继续以同方治疗。 3天后 ,患者出现脉搏…     

来苏儿经皮肤吸收中毒死亡1例分析

某男,69岁,平素身体健康.1999年4月15日因患天疱疮就诊于当地一个体门诊(无行医执照).门诊将酒精20ml来苏儿(市售)40ml和生理盐水混合成500ml左右的液体作为洗液, 将皮炎平1袋、尿素软膏1袋、酒精2ml、来苏儿4ml调配成抹液,治疗的方法是在全身的皮肤上先洗后抹,每天一次,每次均将药液用完.连续治疗3天.其间患者出现皮肤疼痛、浑身发麻、无力、流涎、头疼、眩晕、呕吐、腹痛、腹泻、不能进食,并出现茶色尿.经诊者说这是以毒攻毒,出现这些症状属正常现象.遂继续以同方治疗.3天后,患者出现脉搏细弱 ,面色苍白继而转青紫,出冷汗,呼吸浅慢,体温下降,时有抽搐,且渐加重,出现虚脱、昏迷,经抢救无效死亡.     

A fatality caused by accidental production of hydrogen sulfide.

A 55-year-old male Caucasian truck driver was dead at the scene after breathing hydrogen sulfide (H(2)S) produced by an accidental transfer of sodium hydrogen sulfide (NaHS) from a tanker truck to a tank containing 4% sulfuric acid (H(2)SO(4)) and iron(II) sulfate (FeSO(4)). Autopsy of the decedent's body revealed pulmonary edema and passive congestion in lungs, spleen, kidneys, and adrenal glands. Postmortem biological samples were analyzed for carbon monoxide, cyanide, ethanol, and drugs. Since a potential exposure to H(2)S was involved, blood was also analyzed for sulfide (S(2-)). The analysis entailed isolating S(2-) from blood as H(2)S using 0.5M H(3)PO(4), trapping the gas in 0.1M NaOH, and determining the electromotive force using a sulfide ion specific electrode. Acetaminophen at a concentration of 14.3 microg/ml was found in blood, and metoprolol was detected in the blood, liver, and kidney samples. The blood S(2-) level was determined to be 1.68 microg/ml. It is concluded that the cause of death was H(2)S poisoning associated with a hazardous material accident in an industrial situation.     

Sudden death caused by myocardial tuberculosis: case report and review of the literature

A 25-year-old fit man died suddenly while playing social soccer. Autopsy revealed an infiltrative lesion involving the left ventricle with overlying pericarditis. No other significant pathologic changes were observed. Histologic examination showed necrotizing granulomatous inflammation. No acid-fast bacilli were demonstrated in the pericardial fluid or on histologic examination. The presence of Mycobacterium tuberculosis DNA complex was confirmed by use of the ligase chain reaction technique. The differential diagnosis of myocardial tuberculosis includes sarcoidosis, rheumatic fever, rheumatoid arthritis, giant-cell-containing tumors, idiopathic (giant-cell) myocarditis, and bacterial infections such as tularemia and brucellosis. This case illustrates the protean manifestations of tuberculosis and highlights the use of molecular biologic techniques in arriving at a definitive diagnosis in cases of suspected tuberculosis.     

病毒性心肌炎累及传导系统致死1例报告

在临床上因心脏疾病致死者死因明确，死者家属一般不要求进行尸体解剖检验，但病毒性心肌炎(viral myocarditis)累及传导系统(cardic conduction svstem，CCS)致死时，一般需借助病理学检验才能明确诊断。本文现介绍一例临床拟诊为病毒性心肌炎，在持续心电监护下死亡的案例。     

病毒性心肌炎累及传导系统致死1例报告

在临床上因心脏疾病致死者死因明确,死者家属一般不要求进行尸体解剖检验,但病毒性心肌炎(viralmyocarditis)累及传导系统(cardicconductionsystem,CCS)致死时,一般需借助病理学检验才能明确诊断。本文现介绍一例临床拟诊为病毒性心肌炎,在持续心电监护下死亡的案例。案例某女,23岁。因“胸闷、腹胀2天”于某年11月10日中午入院,诉2天前出现发热、头昏、呕吐,无腹泻。入院查体:T36.5℃,P120次/分,R22次/分,BP120/64mmHg,双肺叩诊清音,未闻及干、湿性罗音及胸膜摩擦音,心尖区无隆起,心界叩诊不大,心率120次/分,律齐,各瓣膜区未闻及病理性…     

产后孤立性髂动脉瘤破裂致死1例

孤立性髂动脉瘤指仅发生于髂动脉的瘤样扩张性病变，单发或多发性，亦可双侧均受累。     

产后孤立性髂动脉瘤破裂致死1例

孤立性髂动脉瘤指仅发生于髂动脉的瘤样扩张性病变,单发或多发性,亦可双侧均受累,以管径大于2.5cm为诊断标准,其破裂率可高达75%,临床上较少见,并与死亡密切相关。[1]发生于年轻女性剖宫产后的孤立性髂动脉瘤破裂致死者尤为罕见,尚未见有报道,笔者在检案中遇到1例,现报告如下。案例资料某女,27岁,职员。孕1产0,末次月经1999年9月18日,平时月经规律,预产期2000年6月25日,孕期常规产检未发现明显异常。2000年6月9日出现阴道流水,无腹痛及阴道出血,以“孕37+4周待产,胎膜早破”收入院。于当日下午6点30分行剖宫产术,以LO P顺利助娩一女活婴,1…     

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.     

利多卡因蛛网膜下腔麻醉致死的动物模型

目的 建立利多卡因麻醉致死的动物模型。方法 犬蛛网膜下腔注射利多卡因(37.01mg/kg体重),观察麻醉致死过程的生命体征变化及死后各器官的病理改变特点。结果 实验组犬心电、血压和呼吸消失的平均时间分别为23.8min(7-42min)、16.4min(7-35min)和18.6min(10～47min)。各器官病理改变均呈急死征象。结论 所建模型实验动物的表现和生命体征变化符合蛛网膜下腔麻醉致死的生前表现,可应用于利多卡因麻醉意外致死案件法医学鉴定的实验研究。     

A death due to ethchlorvynol abuse. A case report

A fatal case of ethchlorvynol abuse is reported with blood and tissue determinations.     

意外摔跌致颅脑损伤21例尸体检验分析

通过对21例意外摔跌伤所致颅脑损伤的法医学检验资料进行统计分析,探讨意外摔跌伤的损伤特点、发生原因,以及与高处跌倒、交通事故及打斗中摔跌形成的损伤特点进行比较。结果表明意外摔跌饬有其独特的特点。     

硬脑膜窦汇破裂大出血死亡1例

案例材料2004年7月4号下午3时,在运城市盐湖区某中学教室门前,初二学生王某(男,14岁)与同学陶某某(男,14岁)打闹中,陶某某推了王某一下,王某仰面摔倒在地,头枕部撞到教室门前的砖台上,当即意识不清,面色苍白,四肢稀软,呼之不应。老师急忙拨打120急救电话,40分钟后送至医院抢救无效死亡。尸检:体表除腰椎3、4椎体旁左侧有4.5cm×0.6cm条状皮肤擦伤外,余未见异常。解剖检验见:颅骨右枕部人字缝对应处头皮下有3.5cm×1cm出血区,人字缝与矢状缝交界处裂开,流动性血液溢出。取除颅骨见枕骨与硬脑膜之间有10cm×8cm×1.5cm巨大血肿与积血,硬脑膜窦…     

硬脑膜窦汇破裂大出血死亡1例

案例材料 2004年7月4号下午3时，在运城市盐湖区某中学教室门前，初二学生王某（男，14岁）与同学陶某某（男，14岁）打闹中，陶某某推了王某一下，王某仰面摔倒在地，头枕部撞到教室门前的砖台上，当即意识不清，面色苍白，四肢稀软，呼之不应。老师急忙拨打120急救电话，40分钟后送至医院抢救无效死亡。尸检：体表除腰椎3、4椎体旁左侧有4.5cm×0.6cm条状皮肤擦伤外，余未见异常。解剖检验见：颅骨右枕部人字缝对应处头皮下有3.5cm×1cm出血区，人字缝与矢状缝交界处裂开，流动性血液溢出。取除颅骨见枕骨与硬脑膜之间有10cm×8cm×1.5cm巨大血肿与积血，硬脑膜窦汇有0.6cm破裂口，大量积血溢出，脑组织向下挤压形成枕骨大孔疝。脑实质、脑血管未见异常。胸腹腔脏器均未见异常。     

An autopsy case of poisoning by massive absorption of cresol a short time before death

A 65-year-old male patient who was hospitalized with schizophrenia died about 15 min later after ingestion of a large volume of saponated cresol solution in a mental hospital. Fatal levels of free p- and m-cresol in the heart blood were detected at 458.8 and 957.3 microg/ml, respectively, which far exceeded the fatal levels determined previously. The levels in the heart muscle, liver and spleen tissues were also extremely high, and there was 250 ml of cresol-odor-emitting fluid in the stomach. The levels of glucuronic-acid-conjugated p- and m-cresols in the heart blood were 38.2 and 85.6 microg/ml, respectively. Although the high levels of cresols in the heart blood may be due to diffusion from the stomach contents, it is surmised that the essential levels of free and conjugated forms in blood were at least 99 and 240 microg/ml, respectively, considering the results of postmortem examinations and some case reports. It was concluded that about 340 microg/ml of the total cresols was absorbed in a very short period following oral ingestion of saponated cresol solution in this case.     

Delayed sudden death in an infant following an accidental fall: a case report with review of the literature

Several controversies exist regarding ultimately lethal head injuries in small children. Death from short falls, timing of head injury, lucid intervals, presence of diffuse axonal injury (DAI), and subdural hematoma (SDH) as marker of DAI are the most recent controversial topics of debate in this evolving field of study. In this area of debate, we present a case of delayed death from a witnessed fall backwards off a bed in a 9-month-old black male child who struck his head on a concrete floor and was independently witnessed as "healthy" postfall for 72 hours until he was discovered dead in bed. Grandmother, babysitter, and mother all independently corroborated under police investigation that the child "acted and behaved normally" after the fall until death. Autopsy showed a linear nondisplaced parietal skull fracture, diastasis of adjacent occipital suture, subgaleal hemorrhage with evidence of aging, small posterior clotting SDH, marked cerebral edema, and a small tear of the midsuperior body of the corpus callosum consistent with focal axonal injury (FAI). No DAI was seen, and there were no retinal hemorrhages. All other causes of death were excluded upon thorough police and medical examiner investigation. Although this seems to be a rare phenomenon, a delayed, seemingly symptom-free interval can occur between a clinically apparent mild head injury and accidental death in a young child.     

铝合金卷帘门意外电击致人死亡1例

案例孟某某,男,40岁。保定市向阳路幸运彩吧(位于市第二医院东侧)工作人员。2004年7月20日晨7时许店主发现彩吧的铝合金卷帘门下部向外鼓出,无法打开,与他人合作强行开启后发现孟某某死于铝合金卷帘门内。现场勘查:坐西向东临街门脸一间,仅有临街铝合金卷帘门与外界相通。卷帘门内侧面观:铝合金单片宽7.5 cm,接缝处呈均匀分布两两平行的横行铝合金嵴。勘验见卷帘门内侧距地面20 cm、30 cm、94 cm、115 cm横行嵴外突处均有片状的灰白色粉末附着。铝合金卷帘门内侧下边缘锁扣固定在一块15 cm×5 cm铁板上,有4个铁质螺栓向门内面突出,突出高度1…     

腹部闭合性损伤胰腺断裂1例

胰腺属腹膜后器官,受到较好的保护.在腹部损伤尤其是腹部的闭合性损伤中,胰腺的损伤较为罕见.据文献报道,胰腺损伤仅占腹部闭合性损伤的1%～2%.现报告1例.