港口作业人身损害赔偿纠纷案评析

劳动者因工伤事故遭受人身损害,如果该工伤事故是因用人单位以外的第三人侵权造成的,该劳动者既是工伤事故中的受伤职工,又是侵权行为的受害人,有权同时获得工伤保险赔偿和人身侵权赔偿;用人单位和侵权人均应当依法承担各自所负的赔偿责任,即使劳动者已从其中一方先行获得赔偿,亦不能免除或减轻另一方的赔偿责任。     

Deaths resulting from police pursuit

This study concerns deaths that result from police pursuit i.e., high-speed police chases. The case files from the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during the years 1980-1986, were examined. Presented in some detail are 18 cases, along with a discussion of the "patterns" or types of cases involved. Recommendations for future work are then noted.     

船舶油污损害数额的诉讼认定

船舶油污损害数额的认定存在困难,对此可以损害额酌定制度来解决.从比较法的视角并结合中国现行相关立法、制度及司法实践,对损害额酌定制度如何应用于船舶油污损害赔偿诉讼做了探讨.认为:损害额酌定兼具证明标准降低和自由裁量双重性质,能适用于诸多船舶油污损害赔偿请求权;法院在酌定损害数额时应当综合考虑所排放油类的数量及品质、受污染的海域范围及其污染程度、油污事故与损害之间的因果关系、责任人的偿付能力等因素,并注意规约法院的诉讼行为和切实保障当事人的程序利益,以使酌定的损害数额尽量客观化、合理化.     

A death resulting from trichlorotrifluoroethane poisoning

Fatalities due to accidental exposure to chlorinated hydrocarbon in an industrial setting have been infrequently reported. The deaths in these cases have occurred within poorly ventilated, enclosed compartments or areas. A case is presented of a 16-year-old male who died as a result of exposure to trichlorotrifluoroethane while working in an open pit. Chromatographic results and tissue concentrations are presented.     

Sudden unexpected death resulting from hypothalamic sarcoidosis

The authors report a case of sudden death in a 23-year-old woman in whom autopsy by the medical examiner revealed hypothalamic sarcoidosis. The decedent had experienced 6 months of amenorrhea and a 50-pound weight gain. She sought medical attention when she experienced headache, and after imaging and laboratory studies, she was suspected of having neurosarcoidosis. She appeared to respond well to corticosteroid therapy. However, 6 weeks after the beginning of therapy, she was found dead on the floor of her residence. Autopsy showed extensive granulomatous inflammation of the hypothalamus and adjacent structures. Previously reported cases of hypothalamic sarcoidosis are reviewed. A hypothesis for the mechanism of sudden death is presented.     

Accidental death resulting from acetylene cylinder impact

Acetylene is an inflammable gas commonly used for welding in small-scale industries. We present a case of a 34-year-old male welder who died following injuries sustained from explosion of an acetylene gas-welding cylinder. In this case report, we discuss the circumstances leading to the explosion of the welding cylinder, the autopsy findings, and a brief review of the literature on deaths resulting from blasts of acetylene cylinders.     

Sudden death resulting from epidermoid cyst of the brain

Epidermoid cysts of the brain are rare tumor-like lesions, most often of maldevelopmental origin. They are benign in nature, causing symptoms depending on their localization. Surgical resection leads to excellent results. A case is reported of a 68-year-old-man who died suddenly and unexpectedly. Postmortem examination revealed signs of central dysregulation and a bifrontal epidermoid cyst. To the authors' knowledge, death resulting from epidermoid cyst of the brain has not been reported so far.     

Multiple deaths resulting from shipboard exposure to trichlorotrifluoroethane

During the course of dockside ship maintenance, a compartment was partially flooded with tricholotrifluoroethane gas. One sailor entered the compartment, collapsed, and was then rescued by two other men. All three victims then climbed a 11-m (36-ft) ladder and collapsed. They all experienced a rapid development of cardiac arrest. We report on the pathologic, toxicologic, and pathophysiologic aspects of the incident.     

Sudden unexpected death resulting from previously nonsymptomatic subependymoma

A 34-year-old, previously healthy man died suddenly and unexpectedly. The autopsy showed brain and pulmonary edema, numerous small meningeal meningiomas, bilateral and symmetrical juxtaventricular meningiomas, and a well-demarcated gray tan tumor in the medulla oblongata and upper cervical spinal cord. The latter tumor was a subependymoma with features of ependymoma in places. The authors describe and discuss the characteristics of this rare central nervous system tumor, its histogenesis, and its coexistence with other intracranial tumors. The possible mechanisms of death in the present case include compression of vital centers and acute obstruction of the cerebrospinal fluid flow.     

Sudden death resulting from chicken bone perforation of the esophagus

Sudden death caused by foreign-body perforation of the esophagus is distinctly uncommon. We report the death of an elderly patient in a nursing home who exsanguinated after she swallowed a chicken bone that perforated her esophagus and right common carotid artery.     

Sudden death resulting from lesions of the cardiac conduction system

Sudden unexpected deaths in young persons with noncontributory histories, autopsy results, and drug screen results are a common problem in forensic pathology. As part of the evaluation of such cases, the cardiac conduction system (CCS) should be studied. To determine the type and incidence of lethal CCS lesions, the authors reviewed their files of sudden unexpected cardiac deaths with particular attention to cases with causes of death in the conduction system. Cases of sudden cardiac death in patients aged < or=40 years during a 10-year period (Michigan) and a 4 year-period (Spain) were selected from the files. From this group, cases were identified in which the cause of death was a lethal change in the CCS. The portions of the heart containing the CCS were excised, and at least one hematoxylin and eosin slide and at least one trichrome or elastic trichrome slide per block were studied. In the two centers, 381 cases of sudden cardiac death were identified. The most common causes of sudden cardiac death were arteriosclerotic narrowing of the coronary arteries, cardiomyopathy, and myocarditis. In 82 cases, there was no identifiable cause of death even after complete gross and microscopic autopsy was performed, a medical history was obtained, and a drug screen was performed. In 11 cases, the CCS contained lesions that were considered lethal: narrowing of the atrioventricular node artery by fibromuscular hyperplasia (7 cases) and atrioventricular node tumors (4 cases). The 11 cases accounted for 2.9% of the 381 cases of sudden cardiac death and 11.8% of the indeterminable cases. It was concluded that examination of the CCS in deaths in which the gross and microscopic autopsy, history, and drug screen fail to provide a cause of death can yield a cause of death in a significant percentage of cases. If heart block was not documented during life and no explanatory lesions were found during routine cardiac examination, examination of the CCS can yield valuable information.     

Empirical analysis of the STR profiles resulting from conceptual mixtures

Samples containing DNA from two or more individuals can be difficult to interpret. Even ascertaining the number of contributors can be challenging and associated uncertainties can have dramatic effects on the interpretation of testing results. Using an FBI genotypes dataset, containing complete genotype information from the 13 Combined DNA Index System (CODIS) loci for 959 individuals, all possible mixtures of three individuals were exhaustively and empirically computed. Allele sharing between pairs of individuals in the original dataset, a randomized dataset and datasets of generated cousins and siblings was evaluated as were the number of loci that were necessary to reliably deduce the number of contributors present in simulated mixtures of four or less contributors. The relatively small number of alleles detectable at most CODIS loci and the fact that some alleles are likely to be shared between individuals within a population can make the maximum number of different alleles observed at any tested loci an unreliable indicator of the maximum number of contributors to a mixed DNA sample. This analysis does not use other data available from the electropherograms (such as peak height or peak area) to estimate the number of contributors to each mixture. As a result, the study represents a worst case analysis of mixture characterization. Within this dataset, approximately 3% of three-person mixtures would be mischaracterized as two-person mixtures and more than 70% of four-person mixtures would be mischaracterized as two- or three-person mixtures using only the maximum number of alleles observed at any tested locus.     

Toxicological findings in a death resulting from the ingestion of trimipramine

A fatality following ingestion of the tricyclic antidepressant trimipramine is presented. Whole blood concentrations of trimipramine and its metabolite N-desmethyltrimipramine were measured by gas-liquid chromatography and found to be 400 and 1130 ng/mL, respectively. These findings are compared to those of previous unpublished trimipramine fatalities and fatalities caused by other tricyclic antidepressants.     

Death resulting from ruptured cerebral artery aneurysm: 219 cases

To characterize the demographics of ruptured cerebral artery aneurysm as a cause of death and to examine the effect of improved diagnostic and therapeutic techniques on the incidence of sudden death associated with the condition, the authors reviewed 219 autopsies performed at the Dallas County Medical Examiner's Office between 1977 and 1997 in which the cause of death was ruptured cerebral artery aneurysm. Ruptured cerebral artery aneurysms accounted for 1.5% of 15,033 natural deaths and 0.4% of all deaths (45,492) followed by autopsy during this period. The majority (56%) of cases occurred in females, with Caucasian females composing the largest group (38%). Seventy-seven percent of cases occurred in individuals between the ages of 31 and 70 years, with the highest concentration in the 41- to 50-year decade (29%). The most common location for ruptured aneurysms was the middle cerebral artery distribution (39%). Multiple aneurysms occurred in 22 (9.1%) cases. Other factors, such as medical history, coexisting disease, symptoms, activity at onset of symptoms, survival time, and toxicology results are also presented. Compared with literature reports before 1980, when ruptured cerebral artery aneurysms were reported as the cause of death in approximately 4% to 5% of sudden natural deaths, the results of this study suggest that despite improved diagnostic and therapeutic techniques during the past two decades, morbidity and mortality from ruptured aneurysms remain a significant health problem.     

Death by obstruction: sudden death resulting from impromptu ingestion of drugs

Over an 18-month period, the department of Forensic Medicine and Science at the University of Glasgow investigated four rather unusual drug-related deaths. In all cases, death was due to the obstruction of the airway by a foreign body after an attempt to evade arrest. In all cases, the obstruction was drug packages of various shapes and sizes. Results of toxicology revealed levels of drugs that may have had a significant respiratory effect on the deceased in three of the cases. Rupturing of the packages and hence leakage of drugs being conducive to death was obvious in only one case.     

Sudden death in an infant resulting from torsion of the uterine adnexa

A 2-month-old infant girl died suddenly as a result of torsion of the uterine adnexa. The infant was found unresponsive in bed and was pronounced dead shortly after her arrival at a hospital. There were no antecedent signs of illness. At autopsy, the right ovary and right fallopian tube were twisted and were dark purple, swollen, and necrotic. The right ovary was enlarged by a follicle cyst 4 cm in diameter, which likely precipitated the torsion. The mechanism of death was unclear but may have resulted from the release of cytokines produced in response to necrotic adnexal tissue. Fatal uterine adnexal torsion has been reported rarely in infants; in all those cases there were antecedent symptoms. Torsion of the uterine adnexa should be included in the differential diagnosis of sudden death in infancy.     

Colchicine poisoning resulting from accidental ingestion of meadow saffron (Colchicum autumnale)

A rare case of colchicine poisoning resulting from accidental ingestion of meadow saffron (Colchicun Autumnale) is reported. The plant can frequently be found in the woods of the Northern Hemisphere (1), also in Japan. A 48-year-old male was admitted to hospital complaining of vomiting, nausea and diarrhea following ingestion of the plant and died in four days. The most striking histological findings were metaphasic mitotic figures in the mucosa of the large intestine and the liver. Colchicine was detected in the bile with high-performance liquid chromatography/sonicspray ionization mass spectrometry (HPLC/SSI-MS).     

Necrotizing fasciitis: reports of three fatal cases simulating and resulting from assaults

Necrotizing fasciitis is a progressive, potentially fatal, rapid, necrotizing infection of the subcutaneous tissues and fascia often caused by a mixture of organisms or by infection with group A Streptococcus pyogenes with or without Staphylococcus aureus. Three cases are presented that have been encountered in forensic pathologic practice. Two cases presented after assaults, and the third simulated an assault and burglary. The history, scene, and pathologic findings are presented with a brief review of the literature.     

抗生素救治感染性休克死亡2例分析

笔者在检案实践中,遇到两例在应用抗生素输液救治晚期感染性休克患者过程中,突发病情加重死亡。因死于输液过程中,怀疑用药问题,引发纠纷。但经系统病理尸检证实系常规救治的病情转归结果,现予以报道。案情资料【案例1】某男,58岁。反复咳嗽、咯血、胸痛1年余,加重伴发热、呼吸困难2周入院,诊断为“肺癌晚期,肺部感染,支气管扩张”。回家后,由个体医生继续予氨苄青霉素静滴治疗2周。本次予10%GS250ml+氨苄青霉素6.0g(与前同批号)静滴40分钟时,突然病情加重,抢救无效死亡。死后49h尸检所见:尸斑暗红色,恶病质;脑血管淤血,脑回宽沟窄。双扁桃…