喉气管支气管炎猝死法医学检验文献回顾

喉气管支气管炎是一种罕见的上呼吸道感染,病变主要涉及上呼吸道声门下至支气管部位,发病多见于学龄前儿童。患者常见的,瞄床表现为喘呜,犬吠样咳嗽甚至呼吸窘迫。严重的喉气管支气管炎可导致急性呼吸道阻塞引起呼吸功能衰竭死亡。喉气管支气管炎所导致猝死在法医学实践中较为罕见。本文回顾了喉气管支气管炎相关的文献报道并结合2例典型喉气管支气管炎急性发作导致猝死的案例进行综述,主要探讨喉气管支气管炎患者临床表现、尸体检验以及法医病理学检查特征。     

Marfan syndrome. A contribution to forensic medicine cases

A 19-year-old school boy suffered from fluctuating uncharacteristic chest pain in the last 20 h before his death. He died unexpectedly within a few minutes of a hemopericardium, which resulted from an aneurysmal rupture of the ascending aorta. The patient's past history as well as the autopsy and ultrastructural findings led to the diagnosis of Marfan's syndrome with alterations of the cardiovascular skeletal system but no ophthalmological involvement ("oligosymptomatic" form of Marfan's syndrome). Appraisal of the cause of death is made more difficult by the fact that medical treatment was undertaken on the same day, whereby subtotal liver crushing was established that had resulted from attempts at resuscitation.     

An autopsy case of infant death due to heat stroke.

We report an autopsy case of infant death due to heat stroke. On a winter day, a 52-day-old female baby was placed under a Japanese electric foot warmer with a coverlet (kotatsu) on an electric carpet warmer in a heated room at home. After about 5 h, the mother noticed that the baby was unconscious and took her to a hospital. Spontaneous respiration, however, was already absent, and the pupils were dilated. The trunk was hot; body temperature was 41.3 degrees C. The skin of the whole body was dry. Autopsy revealed second-degree burn injuries on the left side of the face and the dorsum of the left hand. Numerous marked petechiae and ecchymoses were found in the thymus (capsule and parenchyma), pleurae (visceral and parietal), pericardial cavity (internal and external surfaces), epicardium, and beneath the serosa at the origin of the aorta. In addition, there was congestion in various organs, edema in the brain and lungs, and hemorrhage in the lungs. Histopathologically, macrophages without hemosiderin granules were present in the alveoli. When the heating conditions at the accident were reproduced experimentally, the temperature in the electric kotatsu warmer rose to 50-60 degrees C. Thus, we concluded that misuse of the electric kotatsu caused heat stroke in this infant.     

A death due to ethchlorvynol abuse. A case report

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

安装心脏起搏器致死亡2例的法医病理分析

心包填塞和外周静脉破裂出血致胸腔积血是心脏起搏器植入术中以及术后少见的并发症,特别是在在老年人生理病理性改变的情况下,临床上没有及时做出准确的病因诊断时,即使及时抢救,也容易导致病人突然死亡。所以,熟悉老年患者生理病理性的改变以及在床前随时做X线检查以及超声心动图检测,是及时明确病因、有效减少起搏器安装术后并发症的有效途径。现将近年来在法医实践中偶见的两例因安装心脏起搏器引起患者死亡的病理改变进行分析,为更好预防起搏器安装术并发症的发生提供线索。     

安装心脏起搏器致死亡2例的法医病理分析

心包填塞和外周静脉破裂出血致胸腔积血是心脏起搏器植入术中以及术后少见的并发症，特别是在在老年人生理病理性改变的情况下。临床上没有及时做出准确的病因诊断时，即使及时抢救，也容易导致病人突然死亡。所以。熟悉老年患者生理病理性的改变以及在床前随时做X线检查以及超声心动图检测，是及时明确病因、有效减少起搏器安装术后并发症的有效途径。现将近年来在法医实践中偶见的两例凼安装心脏起搏器引起患者死亡的病理改变进行分析，为更好预防起搏器安装术并发症的发生提供线索。     

Sudden death in infancy due to bicuspid aortic valve

Symptoms of bicuspid aortic valve usually occur in the age group of 50-70 years, but rarely, it can also lead to sudden unexpected death in infancy and early childhood. The autopsy of a 2-month-old baby boy, found dead in his cot, revealed the heart weight as 25 g, and the macroscopic examination showed the circumference of the aortic valve consisting of two leaflets as 8 mm. The thickness of the left ventricle, right ventricle, and septum was measured as 8, 7, and 10 mm, respectively. Microscopically, the heart revealed hypertrophic changes of myocytes. Subendocardial areas displayed necrosis of myocytes, and severe and diffuse ischemic changes characterized by loss of myofibers and vacuolization. Interstitial pneumonia was identified in the lungs. Death occurred as a result of a congenital bicuspid aortic valve obstructing the left ventricular outflow tract complicated by lung infection. As there are only a few reported cases in infancy, and congenital bicuspid aortic valve can lead to sudden unexpected death, this case is presented to the forensic community.     

静滴莪术油注射液过敏致死的法医学鉴定(附2例报告)

莪术油葡萄糖注射液（Zedoary Turmeric Oil and Glucose Injection，ZNG）是以莪术油为主药，加葡萄糖配制而成的一种新型中药抗病毒制剂，以病毒颗粒溶解方式抗病毒，对呼吸道合胞病毒有直接抑制作用，对A1和A3型流感病毒有直接杀灭作用，同时对金黄色葡萄球菌、溶血性链球菌、大肠杆荫等也有抑制作用，目前在临床应用较广泛。然而，莪术油注射液有多种不良反应，可引起过敏性休克和死亡，造成医疗纠纷。目前有关莪术油注射液过敏致死法医学鉴定的报道尚不多见。本文复习有关文献资料，结合2例莪术油注射液过敏致死法医尸体解剖发现，对莪术油过敏原因、配伍禁总、检测方法、法医学鉴定原则进行了分析。     

静滴莪术油注射液过敏致死的法医学鉴定(附2例报告)

莪术油葡萄糖注射液(Zedoary Turmeric Oil andGlucose Injection,ZNG)是以莪术油为主药,加葡萄糖配制而成的一种新型中药抗病毒制剂,以病毒颗粒溶解方式抗病毒,对呼吸道合胞病毒有直接抑制作用,对A1和A3型流感病毒有直接杀灭作用,同时对金黄色葡萄球菌、溶血性链球菌、大肠杆菌等也有抑制作用,目前在临床应用较广泛。然而,莪术油注射液有多种不良反应,可引起过敏性休克和死亡,造成医疗纠纷。目前有关莪术油注射液过敏致死法医学鉴定的报道尚不多见。本文复习有关文献资料,结合2例莪术油注射液过敏致死法医尸体解剖发现,对莪术油过敏原…     

Sudden death due to asphyxia by esophageal polyp: two case reports and review of asphyxial deaths

Asphyxia, not an uncommon cause of sudden death, may result from numerous etiologies. Foreign-body aspiration and strangulation are 2 extrinsic causes. Airway obstruction may also be caused by laryngeal edema, asthma, infection, or anaphylaxis. Chronic causes of asphyxia include musculoskeletal diseases (eg, muscular dystrophy, amyotrophic lateral sclerosis), neurologic disorders (eg, myasthenia gravis, multiple sclerosis), respiratory disease (eg, emphysema, chronic bronchitis), or tumors. The manner of death in cases of asphyxiation may be natural, accidental, homicide, or suicide. For the death investigator, determining the cause and manner of death can often be quite challenging.We report here 2 cases of an esophageal fibrovascular polyp causing sudden asphyxial death, review of the literature, and discussion of other differential diagnoses in the case of asphyxial death.     

特发性高尿钙症性血尿法医学鉴定1例

外伤性血尿临床较为常见,特发性高尿钙症引起的血尿在临床上相对较少,而涉及法医学鉴定的极为罕见,笔者检案中遇到1例,报导如下。案例某男,6岁。某年5月6日在一娱乐城玩“淘气堡”时跌倒致左股骨远端骨折。石膏外固定后住院半月,出院后卧床休息。6月9日因发现肉眼血尿就诊,尿常     

特发性高尿钙症性血尿法医学鉴定1例

外伤性血尿临床较为常见,特发性高尿钙症引起的血尿在临床上相对较少,而涉及法医学鉴定的极为罕见,笔者检案中遇到1例,报导如下.     

Diagnosis of heat stroke in forensic medicine. Contribution of thermophysiology.

The diagnosis of heat stroke is difficult to establish in forensic medicine due to the absence of observations made on the victims whilst alive. A recent case, concerning the death of two children in a vehicle, was restudied by taking into account calculations of thermophysiology. The results obtained allowed some assumptions of the investigation to be checked, and adds to the data provided previously in literature on the subject.     

Histologic findings in the esophagus in infancy. A contribution to the question of gastroesophageal reflux in sudden infant death

In 53 mortalities (1 stillbirth, 2 neonates, 7 cases up to 5 years of age and 43 SIDS cases), systematic histological investigations were carried out on the esophagus. The results comprised a topography of epithelial defects and inflammatory wall changes. In the SIDS cases, focal epithelial defects could be detected in 14% and fresh inflammatory infiltrates in 7% without preferential localization. There were also lymphocytic reactions of varying extent (62%), but mainly in the upper one-third of the esophagus. Similar findings were found in the 10 non-SIDS cases. The results pattern is discussed with regard to its pathological relevance. It appears to be doubtful that the inflammatory changes are the result of reflux, as reflected in morphological terms.     

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。