SCUBA tank corrosion as a cause of death.

Corrosion of compressed air breathing tanks may result in dangerous oxygen depletion. In every SCUBA mishap the residual air should have, as one of the tests, a measurement of oxygen content. The tank should also have a visual inspection. All compressed air breathing tanks should have a routine visual inspection on a regular basis, even if the tank is made or lined with corrosion resistant material.     

Identification and quantification of phenobarbital in a mummified body 10 years after death

Abstract: This article reports the determination of phenobarbital in the mummified body of a 56‐year‐old man found completely mummified 10 years after his death. When alive, he was being treated for epilepsy with phenobarbital, and the recent analyses, performed with both immunochemical techniques and gas chromatography with mass spectrometry (GC‐MS), have revealed the presence of this substance in various tissues: the mean content of barbiturate in the mummified liver tissue was 93 μg/g, 216 μg/g in the heart, 17 μg/g in the lungs, 12 μg/g in muscles, and 31 μg/g in the skin. Preliminary screening tests with immunochemical techniques to evaluate the presence of other drugs were also performed. The sample resulted negative for all substances tested. Phenobarbital can be identified and quantified thanks to its excellent chemical stability and a hypothesis of what the concentrations in the fresh tissue could have been has also been reported.     

Asplenia as a cause of sudden unexpected death in childhood

Sudden unexpected death in childhood is rare. The commonest causes of such deaths are a result of fulminating infections of the respiratory or nervous systems. Other causes include unsuspected congenital abnormalities of the heart, acute metabolic disorders, and rarities such as internal hemorrhages and pulmonary thrombosis. Recognition of children with congenital asplenia who are otherwise normal but have an increased susceptibility to overwhelming sepsis is extremely difficult. We reviewed 1763 autopsy files from our institution over 5 years (1990-1995), of which 293 were classified as pediatric cases. The vast majority of the cases were stillbirths and deaths within the first year of life as a result of complex congenital anomalies. Four cases of asplenia were identified in our entire series, 3 of which were of the congenital syndromal variety and 1 of which was a case of isolated sporadic congenital asplenia. All 4 cases of asplenia were analyzed in detail with respect to autopsy findings and cause of death. Severe complex cardiac malformations were present in the congenital syndromal asplenia patients; these other malformations contributed significantly to their death. In this report, we discuss in detail the autopsy findings in a previously healthy 4-year-old girl who presented with a brief 8-hour history of being unwell and died within 4 hours of admission into the hospital. She had sporadic, isolated congenital asplenia complicated by high-grade type 6B pneumococcemia and acute bilateral adrenal hemorrhage (Waterhouse-Friderichsen syndrome). Previously healthy children who clinically deteriorate very rapidly should have a blood smear done as part of their clinical workup. The detection of Howell-Jolly bodies on a peripheral blood smear can be an indicator of asplenia, and this diagnosis can be confirmed by medical imaging of the abdomen. Such steps may aid in the aggressive management of isolated congenital asplenia and thereby avert untimely death.     

Identification procedures as a part of death investigation in Turkey

Forensic identification techniques include the examination of ID cards, the decedent's private belongings, fingerprints, footprints, lip marks, dental findings, red blood cell enzymes, performing photograph matching, facial reconstruction, visual identification, and DNA "fingerprinting." As part of forensic examinations, the identification of corpses that are fresh, decomposed, fragmented, or skeletonized as well as individual body parts and human remains can be requested. Identification becomes a challenging task for forensic terms particularly in mass-disaster situations. Each identification case should be considered to its own merit and the way to do that should be based on the effectiveness and cost of each method used. In Turkey, one of the major duties of the medicolegal system on the investigation of deaths is to identify the deceased if unknown.This study is undertaken to investigate the procedures, as well as their validities, used to deal with individualization of dismembered bodies directly sent to the Council of Forensic Medicine, Ministry of Justice, for autopsy and/or visual identification, as well as those received from peripheral districts for forensic identification. According to the Turkish Penal Procedural Law, a positive identification of the deceased is mandatory before performing an autopsy. According to the law, the ID cards are not taken to be sufficient for recognition of the deceased, and the major way of identification in daily practice is visual identification by a relative or any recognizant person to approve the identification to the prosecutor. If visual identification fails, fingerprints, dental x-rays or body x-rays, and DNA "fingerprinting" can be used to establish identity when compared with known records of the individual obtained by law enforcement.This retrospective study was carried out into 421 dismembered bodies, among 3063 autopsies performed in year 2002 by the Department of Morgue at the Council of Forensic Medicine, with particular insight into the identification procedures undertaken and their results. The overall negative identification rate was 30.4%, and in 1% of the cases, the visual identification by relatives were not confirmed by DNA identification and taken as misidentified.     

Sudden death in a neonate as a result of herpes simplex infection

This paper describes a case of a neonate with disseminated herpes simplex born to a 14-year-old asymptomatic mother. The infant's physical examination was normal at birth, and subsequent abnormalities were so subtle that infection was not recognized during life. Postmortem cultures of liver and spleen grew herpes simplex virus, and immunofluorescent direct antibody typing revealed Type 2. A cervical culture of the mother obtained after the infant's death was negative.     

Strontium-90 as an indicator of time since death: a pilot investigation.

The results of a pilot investigation are presented. The study aimed to show that the presence of radioactive strontium-90 in human bone could be used as evidence of active uptake during life. In this way the time since death of the individual could be identified as occurring before or after the date when atmospheric levels of radioactive strontium were at a peak in the early 1960s. The results of this initial investigation were encouraging but further detailed analysis is required on a substantially larger sample of material spanning a more controlled time period.     

Autoerotic asphyxial death initially misinterpreted as suicide and a review of the literature.

Death during autoerotic activities is of special concern to law enforcement officials, medical examiners, the family of the decedent, and society in general. As in the probing of any violent demise, accurate identification, management, and preservation of all physical evidence; complete photographic documentation of the scene and the body; reconstruction of the scene; and interviews with the family and acquaintances (psychological autopsy) are mandatory for proper study, evaluation, and interpretation of the case. Because of a lack of knowledge on the part of many people, including professionals, about these activities and the fact that many autoerotic fatalities share common characteristics with suicide and homicide, these cases are often misinterpreted. The authors present a case of autoerotic accidental asphyxial death which was initially misinterpreted as suicide.     

Sudden death in toddlers caused by influenza B infection: a report of two cases and a review of the literature

Sudden fatal cases of influenza B infection in a 4-year-old girl and a 2-year-old boy are presented. Both children complained of abdominal pain without respiratory, neurologic or cardiac symptoms; additionally the girl had vomiting within 2 days of death. Autopsy revealed histological changes in the respiratory system consistent with a viral infection. Influenza B infection was identified by immunohistochemistry in the girl and real-time polymerase chain reaction in the boy. Additional testing including cultures, toxicology, and screening for metabolic disorders were negative. These cases illustrate the usefulness of viral testing, especially for influenza, in the medical legal autopsy of children even when the classic respiratory symptoms of flu are lacking.     

Sudden death in an infant caused by rupture of a basilar artery aneurysm.

Ruptured aneurysms of the cerebrovasculature in infancy and early childhood, except for "giant" aneurysms and arteriovenous malformations, are rare. Seizures, loss of consciousness, and apnea are the usual presenting signs in infancy; symptoms such as headache or visual disturbances and signs such as cranial nerve compression or meningeal irritation commonly found in older children or adults are absent in infants. However, the morphologic findings (i.e., subarachnoid and retinal hemorrhage, and occasionally subdural hemorrhage) may be mistaken for inflicted trauma, especially if the aneurysm is not identified. Sudden death caused by rupture of a cerebral aneurysm has not been previously described in an infant. This report outlines the investigation and autopsy findings in a 7-month-old infant who died unexpectedly as a result of rupture of a complex basilar artery aneurysm.     

The unusual accidental death of a pregnant woman by sexual foreplay.

This is the case of a young pregnant black woman who died during foreplay when her male partner with his hands accidentally forced air from her vaginal cavity into her uterine cavity, causing air embolization in the veins on the surface of her heart and her brain. Her premature infant was removed by cesarean section by emergency-room personnel after she died. The infant survived for 12 days before being declared brain dead.     

Speech by Minister of Justice B.M. Imashev on the Draft Law on the National Preventive Mechanism

On December 5, 2012, Minister of Justice of the Republic of Kazakhstan Berik Imashev introduced the draft law “On Questions Pertaining to the Creation of a National Preventive Mechanism for the Prevention of Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment” in the Majlis (lower house) of Parliament.     

An experimental study of death in a reverse suspension.

To investigate the course of respiration and circulation in a head-down position, 14 rabbits were set in reverse suspension. The respiratory rate increased a little, but the amplitude of the respiratory movements did not change in the beginning of the experiment. The amplitude of respiratory movements then began to reduce gradually, and toward the end of the experiment, it reduced suddenly. PaO2 increased in the beginning of the experiment and then began to decrease in accordance with the reduction of the amplitude of the respiratory movements. The blood pressure decreased with relation to the decrease of PaO2 resulting from the reduction of the amplitude of the respiratory movements. All rabbits died in 17 to 44 hours (average, 26 hours). The results suggested that the cause of death in a head-down position is due to postural asphyxia resulting from hindered respiratory movements, and that it is possible to survive for at least half a day in a head-down position.