超生反应阶段人骨骼肌对电刺激反应的形态学研究

利用人骨骼肌在死亡早期阶段能对电刺激产生兴奋和收缩的特点，以加大刺激强度为手段，对18例死亡早期阶段（1小时25分至6小时40分）具有超生反应能力的尸检骨骼肌和17例稍晚阶段（10～60小时）不具有超生反应能力的尸检骨骼肌，进行了电刺激损伤的系列形态学对比研究。结果表明，死亡早期阶段的肢体骨骼肌，经电刺激后，能产生整个肌肉或局部肌肉的收缩；在电极周围以及电路中的肌纤维形成大片的极具特点的收缩带、条带状嗜酸性变、高度变形的节段状和盘片状崩解等改变；稍晚期阶段受刺激的肌纤维则未见上述改变。探讨形态学改变的形成机理及意义，为研究死亡早期阶段的电损伤提供形态学基础。     

远离电击部位电流通路上骨骼肌的病理学研究

研究电损伤时骨骼肌中肌红蛋白(Mb)和纤维连接蛋白(Fn)的异常分布情况。采用大鼠模型和人体电击死标本,对电流通路上骨骼肌组织进行肌红蛋白、纤维连接蛋白免疫组化(LSAB)检测。结果显示:电流通路上肌细胞呈现深浅不同竹节样改变,免疫组化法见Mb脱失,Fn呈阳性,呈蟒蛇状纹理。电流通路上骨骼肌竹节样和蟒蛇纹理改变对无典型电流斑法医学鉴定有实用价值。     

周围神经损伤MCV测定及其法医学意义

目的探讨周围神经损伤后运动神经传导速度(MCV)改变与靶肌肌力级别的相关性。方法 60例病程6个月以上的单侧肢体神经损伤(正中神经12例、尺神经13例、桡神经13例、腓浅神经12例、腓深神经10例)患者,根据Lovett肌力0～5级分级标准,确定受损神经支配的靶肌的肌力;采用DNI-200+型肌电诱发仪行患侧与健侧肢体MCV检查,观察不同级别肌力靶肌MCV指标变化。结果所测5种神经MCV各指标(健侧-患侧)/健侧变化率均与靶肌肌力呈逐渐降低的变化趋势,存在显著负相关性,其中波幅和面积下降率在肌力2级与3级、4级与5级组间存在显著性差异(P<0.05)。潜伏期延长率和传导速度下降率在肌力1级与2级、4级与5级组间存在显著性差异(P<0.05)。结论 MCV与周围神经损伤有较好的相关性,可用于推断神经受损程度,并有助于肌力级别的判定,是评价周围神经损伤程度的客观方法。     

Ultrastructural alterations of skeletal muscles after electric shock

The existence of tracks of electric current in the skeletal muscles was checked by electron-microscopic investigations in animal experiments on rats. Hypercontraction bands alternating with dilated sarcomeres and tumefaction of tubular apparatus and mitochondria with cristiolysis were established. The most severely expressed alterations were found in the vicinity of the electrodes and adjacent to the joints; they are thought to be caused by electrically induced tetanus and local hyperthermia. The forensic aspects of these findings are discussed.     

Cathepsin activity in the myocardium and skeletal muscles as a sign of the time of death

Determination of postmortem interval according to the time course of cathepsins activity within 5 days since death was carried out using myocardium and skeletal muscles of white breedless rats and cadavers of people who died of craniocerebral trauma. Natural time course of changes in cathepsins activity was determined which makes it possible to use these values as one of criteria in determination of postmortem interval.     

肌红蛋白降解与人体死亡时间的相关性

目的检测人体死亡后骨骼肌中肌红蛋白的降解水平,探讨其与死亡时间的关系。方法分别于人体死后0、4、8、12、24、36、48、60、72h取骨骼肌,置于室温25℃,在不同时间点抽提蛋白质,用Western Blot方法检测肌红蛋白,随后利用生物电泳图像分析软件分析。结果肌红蛋白随死后时间逐步降解。结论肌红蛋白降解的检测可用于推断死亡时间。     

Forensic Considerations in Cases of Myotonic Dystrophy at Autopsy

Myotonic dystrophy (DM) is a chronic, slowly progressive, autosomal‐dominant disorder with delayed muscle relaxation after contraction, distal skeletal muscle weakness, and atrophy. It has a reduced life expectancy due predominantly to respiratory failure or sudden cardiac death. The mortality rate is approximately 7.3 times greater than the general population with a mean age at death of 53 years. Degeneration of the cardiac conduction system causes atrioventricular block, arrhythmias, and ventricular failure. A case of sudden death in a 44‐year‐old woman with DM type 1 is reported to demonstrate an alternative lethal mechanism. At autopsy, there was extensive infiltration of skeletal muscles with adipose tissue. The heart was structurally normal. A deep venous thrombosis of the right calf was identified with a large saddle pulmonary thromboembolus and bilateral peripheral thromboemboli. DM1‐related thrombosis had most likely occurred because of the decedent's impaired mobility, possible hypercoagulable state, and serum changes from muscle necrosis.     

大鼠骨骼肌损伤后PMN、MNC及FBC百分率与损伤时间关系

目的：研究大鼠骨骼肌机械性损伤后不同时间点多形核白细胞（polymorphonuclear leucocytes , PMN）、单个核细胞（mononuclear cells,MNC）及成纤维样细胞（fibroblastic cells,FBC）百分率的变化。方法建立大鼠骨骼肌机械性损伤动物模型,随机分为伤后6h、12h、1d、3d、7d、10d、14d及正常对照组。应用HE染色法和图像分析检测大鼠骨骼肌损伤后不同时间点PMN、MNC及FBC百分率。结果伤后6~12 h,损伤区内可见PMN和MNC浸润,PMN百分率达到峰值;伤后1 d,损伤区内主要以MNC浸润为主,MNC百分率达到峰值,而PMN百分率开始下降;伤后3~7 d,FBC百分率开始逐渐增加,PMN和MNC百分率则逐渐下降;伤后10~14 d,FBC百分率达到峰值。结论大鼠骨骼肌损伤区内PMN、MNC及FBC百分率呈时间规律性变化,有望成为骨骼肌损伤时间推断的参考指标。     

The effect of electricity on the myoglobin content of the human heart and skeletal muscles

The myoglobin content of heart muscles was examined by the indirect immunoperoxidase method in eight autopsy cases where death was due to electricity. Seven cases showed a considerable release of myoglobin from the myocardial fibers. In experimental comparison, the heart muscles and skeletal muscles from nine cases where death was natural were exposed to electricity, and considerable deletion of myoglobin was also demonstrated. We believe that the findings of ischemia or thermal effects due to electricity were the cause of the release of myoglobin. Because the demonstration of myoglobin is preferable to estimation of the damaged areas of muscles by hematoxylin-eosin staining, this examination may be more advantageous in forensic examination of death by electricity.     

Acidosis, lactate, electrolytes, muscle enzymes, and other factors in the blood of Sus scrofa following repeated TASER exposures

Repeated exposure to electro-muscular incapacitating devices could result in repetitive, sustained muscle contraction, with little or no muscle recovery period. Therefore, rhabdomyolysis and other physiological responses, including acidosis, hyperkalaemia, and altered levels of muscle enzymes in the blood, would be likely to occur. Experiments were performed to investigate effects of repeated exposures of TASER International's Advanced TASER X26 on muscle contraction and resultant changes in blood factors in an anaesthetized swine model. A total of 10 animals were used. Six swine were exposed for 5 s, followed by a 5-s period of no exposure, repeatedly for 3 min. (In five of the animals, after a 1-h delay, a second 3-min exposure period was added.) The remaining four animals were used for an additional pilot study. All four limbs of each animal exhibited contraction even though the electrodes were positioned in areas at some distances from the limbs. The degree of muscle contraction generated during the second exposure period was significantly lower than that in the first exposure series. This finding was consistent with previous studies showing that prolonged activity in skeletal muscle will eventually result in a decline of force production. There were some similarities in blood sample changes in the current experiments with previous studies of muscular exercise. Thus problems concerning biological effects of repeated TASER exposures may be related, not directly to the "electric output" per se, but rather to the resulting contraction of muscles (and related interruption of respiration) and subsequent sequelae. Transient increases in hematocrit, potassium, and sodium were consistent with previous reports in the literature dealing with studies of muscle stimulation or exercise. It is doubtful that these short-term elevations would have any serious health consequences in a healthy individual. Blood pH was significantly decreased for 1h following exposure, but subsequently returned toward a normal level. Leg muscle contractions and decreases in respiration each appeared to contribute to the acidosis. Lactate was highly elevated, with a slow return (time course greater than 1 h) to baseline. Other investigators have reported profound metabolic acidosis during restraint-associated cardiac arrest. Since restraint often occurs immediately after TASER exposure, this issue should be considered in further development of deployment concepts. On the basis of the results of the current studies, the repeated use of electro-muscular incapacitating devices in a short period of time is, at least, feasible, with the caveat that some medical monitoring of subjects may be required (to observe factors such as lactate and acidosis).     

Determination of the time of death--integration of various partial methods

The criteria for estimating time of death, lividity and rigor mortis according to data worked out by Mallach, together with data concerning the mechanical excitability of skeletal muscles (Prokop), the electrical excitability of face muscles and pharmacologic excitability of the iris (Klein and Klein) were combined with a nomogram of the rectal/brain temperature at time of death to make a rational and practical method of estimating time of death that would be suitable for use at a scene of crime. In each actual case, only a few additional criteria can be used to verify the upper and lower limits of the nomogram readings and to reduce these defined limits. For this reason the outer data from Mallach's tables and Klein's results were separated into upper and lower limits, chronologically arranged and clearly presented. After rectal temperature measurement and corresponding nomogram reading, it is easy to recognize which further criteria must be examined. Analysis of the test results is extremely simple with the aid of the proposed chart.     

电击伤最佳病理取材部位的初步研究

目的探讨日常低电压电击后机体电流通路上极向化等病变规律和最佳病理取材部位。方法SD大鼠随机分为电击组和对照组,建立左前爪-右后爪路径220V电击大鼠模型,取电极接触处皮肤、四肢血管、神经和周边组织及腹腔大血管,常规HE染色病理组织学图像分析。结果电极接触处皮肤基底细胞(skinbasalcell,SBC)核明显极向化改变,长/短径比值与对照组比较差异高度显著,P<0.001;电流通路上腕和踝部血管及腹主动脉内皮、平滑肌细胞核的极向化与对照组比较,差异显著,P<0.05,其中腕和踝部病理改变最明显;周围骨骼肌细胞核的长/短径比值无明显规律性。结论在电击死中最常见的“手-足通路”,腕、踝部血管可能为病理取材的最佳部位。同时,由于腕和踝部距离手脚掌较远,直接接触热源和化学试剂等其他可能引起“极向化”改变的因素机会少,因此,腕和踝部血管及其周边组织的极向化改变更具有电损伤的特异性。     

Feelings of revenge, retaliation motive, and posttraumatic stress reactions in crime victims

Individuals with posttraumatic stress disorder (PTSD) are often said to experience strong feelings of revenge. However, there is a need for confirmatory empirical studies. Therefore, in a study of 174 victims of violent crimes, the relation between feelings of revenge and posttraumatic stress reactions was investigated. Feelings of revenge were correlated with intrusion and hyperarousal but not with avoidance. Feelings of revenge explained incremental variance of intrusion and hyperarousal when the variance explained by victimological variables was controlled. The retaliation motive implied in feelings of revenge did not account for the relation between feelings of revenge and posttraumatic stress reactions. However, the relation was moderated by the time since victimization. Therefore, feelings of revenge must presumably be regarded as a maladaptive coping reaction to experienced injustice, but not in the first period after victimization.     

Lightning Strike as Probable Cause of Death and Determining Identity Based on the Examination of Skeletal Remains

In this article , a case of examining an incomplete human skeleton found in a forest is presented. Based on the assessment of posttraumatic lesions in the skull bones, the cause of death of a man who had died 14 years prior to the examination was determined with high probability to be due to a lightning strike. Moreover, the rare pathological lesions within the skeleton, such as a healed fracture of the humerus and rheumatoid malformations within the hand, in reference to preserved medical records, have also allowed to identify the deceased. Most noteworthy points in this case are, however, initially difficult to comprehend, posttraumatic lesions within the bones of the skull such as carbonization and fracture of the vertex. Their origin can be explained by a lightning strike as the most probable cause of death. Thus, the presented case demonstrates probable cause of death and identity can be established many years after death, based on skeletal remains.     

Postmortem investigation of serum myoglobin levels with special reference to electrical fatalities

The serum myoglobin levels of 58 fatalities were investigated with special reference to correlations of the myoglobin-concentrations with the postmortem interval, the site of blood sampling and the cause of death (especially concerning death caused by electric current). An increase of the myoglobin values with the passage of postmortem time is obvious. The topographical sampling site plays an important role; the highest concentrations are found adjacent to striated muscles (i.e. in blood from the heart or the femoral vein). There was no significant correlation of myoglobin values and death by electric current.     

Expert evaluation of medical documentation data in estimating the severity of injuries

Analysis of false expert conclusions related to unjustified clinical diagnosis is given. Failure of critical attitude of medicolegal experts to X-ray and neurologic symptomatology data in posttraumatic period is stressed.     

The use of circular dichroism and spectrophotometric methods in establishing the time of death

Dynamics of destruction of metal-containing proteins in skeletal muscles depending on storage duration (up to 30 days) of cadaveric material was studied in vitro using spectra of circular dichroism and absorption in visible spectrum area. Dichroic absorption diminishes gradually with increase of storage duration of cadaveric material.     

超生反应阶段骨骼肌机械性损伤的形态学研究

对20例1．25～8．30hpm具有超生反应能力的尸检骨骼肌和17例10～24hpm和48～60hpm不具超生反应能力的尸检骨骼肌进行机械性损伤刺激的形态学系列对比研究。结果表明，经机械打击刺激后，具超生兴奋性的肌肉，受打击部位的肌纤维出现类似典型生前伤征象的形态学改变，而不具超生兴奋性的肌纤维仅出现被动的肌纤维断裂等非活性肌纤维改变。通过对超生形态学反应的形成机理进行探讨，为进一步研究超生形态学的作用提示了前景。     

大鼠死后心肌骨骼肌细胞肌动蛋白变化及与死亡时间的关系

目的　探讨大鼠死后心肌骨骼肌细胞肌动蛋白的变化及其与死亡时间的关系。方法　采用免疫组化S P法和IBSA图像分析系统 ,观测大鼠死后不同时间心肌骨骼肌抗肌动蛋白单克隆抗体 (HHF3 5 )染色变化。结果　在大鼠死后 5 4h内 ,心肌骨骼肌呈不同程度的HHF3 5缺染 ,其面积随死后时间的延长而增大。经对IBSA图像分析数据进行方差分析 (F心肌 =5 88 2 7,F骨骼肌 =3 5 1 2 5 ,P <0 0 5 ) ,具有显著性差异 ;经逐步回归分析 (r心肌 =0 943 ,r骨骼肌 =0 95 8,P <0 0 5 ) ,具有正相关关系。所建方程y心肌 =-3 0 5 68+1 0 0 3x1,y骨骼肌 =-2 4 897+0 986x2 (X为HHF3 5缺染面积均数 )具有统计学意义。结论　在一定时间内 ,大鼠死后不同时间心肌骨骼肌细胞HHF3 5缺染面积 ,随死后时间的延长而增大。     

大鼠死后骨骼肌细胞核DNA降解的彗星电泳检测

目的探讨彗星电泳检测大鼠死后骨骼肌细胞核DNA降解碎片与死后时间的关系。方法建立SD大鼠死亡模型,18只雌性大鼠断颈处死,在25.1℃分别于死后6、12、24、36、48、60提取大鼠骨骼肌组织进行彗星电泳,荧光显微成像系统采集图像,同时获取多个分析参数(Comet4.0),并进行统计学处理。结果在死后6～48h,彗星尾长(TL)在死后各时间点的均数依次为11.56±0.10、17.76±0.18、18.82±0.21、21.68±0.18和23.33±0.07;Oliver尾矩(TM)在各时间点的均数依次为1.63±0.46;2.12±0.90;2.15±1.03;2.22±0.76;3.35±0.80;尾DNA(TDNA)在各时间点的均数依次为29.57±8.42;32.36±10.92;30.11±12.55;37.81±12.03;54.76±8.60。结论细胞DNA降解随着死后时间的延长而增加;彗星尾长用于推断死后时间优于Oliver尾矩和尾DNA。