胸部刺创与交通意外同为致死伤1例

某年冬某夜 11时许 ,某县公安局接报称 :城东公路上一人被汽车压死。尸检情况 :尸长 16 7ｃｍ ,发育正常 ,营养一般。死者双睑紧闭 ,右眼睑及眼球挫伤 ,左眼角膜混沌 ,球睑结膜苍白 ,唇及口腔粘膜苍白。右额部有 5ｃｍ× 5ｃｍ头皮撕裂 ,创口哚开。右颧部有 5ｃｍ× 4.5ｃｍ的擦伤 ,呈暗褐色。解剖 :颅骨未见骨折。前胸第 4肋间处有 2ｃｍ长创口 ,创口明显哆开 ,深达胸腔 ,创缘整齐 ,创角较锐。右锁骨第 1,2肋在锁骨中线处骨折 ,其余肋骨自腋中线处骨折 ,断端有出血。腹部有 2 5ｃｍ× 8ｃｍ擦伤 ,呈暗褐色。胸腔内有大量积血 ,心包前区有 1…     

人为挤压致肝破裂1例

李某,女,26岁,汝阳县陶营乡人,痴呆,不会说话,平时学穿衣服,不出家门.2001年6月11日早上6时许被人发现死在距其家100米的麦场中.     

人为挤压致肝破裂1例

李某 ,女 ,2 6岁 ,汝阳县陶营乡人 ,痴呆 ,不会说话 ,平时学穿衣服 ,不出家门。 2 0 0 1年 6月 11日早上 6时许被人发现死在距其家 10 0米的麦场中。尸表检验 :尸体发育中等 ,营养不良 ,两眼球结膜充血 ,胸腹部有 2 2ｃｍ× 40ｃｍ范围散在擦挫伤 ,触诊肋骨有骨擦音 ;左乳头内外侧分别有 0 .4ｃｍ× 0 .7ｃｍ、0 .5ｃｍ× 1ｃｍ排列整齐、呈对称分布的皮下淤血 ,右乳头内外侧分别有 0 .2ｃｍ× 0 .8ｃｍ、0 .3ｃｍ× 0 .8ｃｍ排列整齐呈对称分布的皮下淤血 ;右肩胛骨下侧皮肤有 5ｃｍ× 10ｃｍ范围擦挫伤 ;肛门3点、7点、12点处均有长约 0 .…     

胸部刺创致迟发性心包积血死亡1例

1案例 某男,21岁,某年4月21日晚7时被人用刀刺伤左胸部,伤后半小时到某区医院门诊就诊,查体:神清,检查合作,血压110/70mmHg,脉搏120次/min,呼吸22次/min,心脏听诊未见异常,胸部第四肋间距胸骨左缘1cm处见一长1.5cm刺创口,胸部X光片未见肋骨骨折、左血气胸及心包积血,给予创口清创缝合.     

臀部刺创致死 2例

在法医学检案中,臀部刺创导致死亡的并不多见。笔者在检案中收集到以下 2个案例,现报道如下。 1 案 例 　　例 1：某男, 24岁。与他人争吵时被刺伤右侧臀部,当即到医院行臀部伤口缝合术, 2小时后,伤者感腹痛, 4小时后出现休克,继之死亡。尸表检验所见：头顶部见一 4cm长裂创,创缘整齐,创角锐,已缝合;右侧臀部见一 2.5cm长裂创,创缘整齐,创角锐,已缝合。解剖见：腹腔内积血及盆部腹膜后血肿,积血量约 2 000ml;右侧臀部刺创呈贯通性,通过坐骨大孔达盆腔内,右侧髂内动脉和髂内静脉均破裂,破口边缘整齐;头部解剖见头顶部…     

1例刺创损伤程度鉴定

1案例资料简要案情某男,33岁,农民。2004年9月13日15时许被人用匕首刺伤左上臂,伤后1h送往医院治疗。于受伤3日后进行损伤程度鉴定。病历记载左上臂中段外侧、内侧各见一斜行裂伤,出血,分别长约5cm、1cm,两裂伤相贯通,行清创缝合术。左乳头外侧11cm处有一1.1cm长裂伤,深约1cm,未进入胸腔,缝合裂伤。法医学检验伤者神清,行走正常,自主体位。左上臂中段外侧有一5.3cm长斜行裂伤,其内侧有一1.2cm长斜行裂伤;左胸部腋前线后第5肋间有一1.2cm长斜行裂伤,均已缝合。测量左上臂两裂伤间直线距离为11.2cm。将左上肢自然下垂,左上臂内侧裂伤与左胸部…     

胸部刺创后脑梗塞死亡1例

1 案例 简要案情：某男，41岁，某年3月22日因与妻子发生口角，被其妻刺伤右胸，于当日22：30入院治疗，当时出血总量约为500～1000mL，伴气急、面色苍白，无昏迷，无恶心、呕吐，BP12／6．7kPa（90／50mmHg）。胸部CT：右肺挫伤，右胸腔大量积液，少量气胸。入院后急诊行右胸清创、右肺探查及右侧胸腔闭式引流术。术后一直昏迷，生命体征不稳定，双侧瞳孔散大，对光反射消失。3月25日及4月7日脑电图均呈低平活动，于4月11日死亡。     

心脏左室前壁被刺创漏诊死1例

１案件资料庄某，女，３５岁，职员，于某日下午被他人用单刃刀将其左胸部刺伤，伤后被送往医院。检查见伤者左侧胸壁第五肋间水平锁骨中线偏外有一３．０cm的伤口，仍在出血，于呼吸时喷出大量鲜血及血块，血中带气泡，探查伤口进入胸腔，左侧呼吸运动不明显，左肺呈浊音，听诊呼吸音不清。血压无，心率９８次／分，尚规整，未及病理性杂音、经开胸探查对左肺下叶伤口进行清创缝合，清除积血，给予明胶海绵填塞，查肺无明显漏气及出血，于腋中线第八肋间下胸腔闭式引流管，用温盐水冲冼胸腔。术后血压６０／３０mmHg，脉搏９２次／分。２…     

左心室贯通性刺创存活1例

<正> 李某,男,22岁,既往身体健壮。1996年10月7日22时许,因被人用匕首刺伤左胸部,当即感胸痛,流血不止,伴心慌,气急,全身发冷,手捂伤口处近30min,伤后50min     

左心室前壁刺创合并左肺贯通伤存活1例

心脏刺伤通常危及生命,伤者多在损伤后短时间内死亡。本文报道1例左心室破裂合并左肺贯通创4h后经手术治疗存活的案例,以供同行参考。     

Prevalence of alcohol in blood samples from traffic accident cases in Turkey

Alcohol is one of the main causes of traffic accidents worldwide. With a population of 70 million, 12 million vehicles, and 18 million drivers (16% women), Turkey is one of the European countries that has a high incidence of road traffic accidents.In accordance with Turkish laws, subjects were considered to be positive when alcohol blood concentration exceeded 50 mg/100 mL. The objective of the present study was to obtain reliable and comparable data about alcohol use in traffic cases in Turkey. All cases are admitted to the emergency department at Ege University Medical Faculty. The cases from police officers are described as traffic control cases. Alcohol was detected in the blood of about 54.4% of the traffic-related cases during October 2005 to March 2007. It has been observed that, in 17.4% of the traffic accident cases, the blood alcohol level was 50 mg/dL or less, which is the legal limit in Turkey for car drivers. Alcohol prevalence was 57.2% in male cases and 43.6% in female cases. In alcohol-positive cases; the ratios for males were 1.73 times more frequent in traffic-related cases. Prevalence data will help traffic safety professionals to adequately allocate resources and plan future efforts in reducing drinking-and-driving behavior and thereby reduce traffic accidents.     

A single fatal penetrating chest wound from shattered wind-blown glass

The great majority of penetrating wounds of the thorax result from firearms and bladed weapons. Penetrating wounds of the heart and of the great vessels still have a high immediate mortality. While penetrating chest wounds occasionally result from fragments of glass; most severe and fatal wounds from glass result from one's falling into or through architectural (plate) glass, sustaining wounds of abdomen or extremities, or both. A single, fatal penetrating chest wound resulting from a wind-blown fragment of glass is distinctly uncommon. The unique case of this type reported herein is that of a 12-year-old youth who was struck in his home in the left anterior chest by a single, sharp, slender fragment of glass blown from a window which shattered in a thunderstorm. This resulted in a rapidly fatal penetrating wound involving thoracic viscera. The forensic pathologist must thoroughly investigate and document such accidental deaths, modifying his/her autopsy procedure as necessary for these purposes and to avoid accidental injury at the autopsy table.     

711例道路交通事故死亡案例分析

目的分析711例道路交通事故死亡案例,探讨道路交通死亡事故的特点。方法收集相关市区711例道路交通事故死亡案例,按照死者性别、年龄、死亡原因、死者交通方式等项目分类进行统计分析。结果 711例死者中男性多于女性(2.18∶1),21~60岁占70.6%,气温较低的季节发生交通事故较多,一天中高发时间段为6~8、18~20及23~1时,死者中以非机动车驾乘者和步行者居多,分别占41.4%和29.1%;肇事车辆主要为货车和轿车,分别占38.2%和25.1%;交通事故造成颅脑损伤导致死亡的占损伤致死亡的比例最高(54.7%),联合损伤致死的其次(30.9%)。结论本文数据来源地交通事故造成人员死亡案例的特点,与沿海其他较发达城市的相关调查数据相符,需综合治理以减少相关事故的发生。     

600起重、特大交通事故死亡的法医学分析

本文通过６００起重、特大交通事故中死亡６７２人的检验解剖资料，分析了道路交通事故的一般情况、交通事故与致死的关系、不同类型车辆与致伤方式与损伤部位，以及损伤部位、死亡原因与死亡时间之间的关系。在此基础上，讨论了机动车与自行车相碰、车辆碰行人事故的原因、成伤机理。同时也分析讨论了交通事故的死亡原因和死亡时间的问题。     

深圳市道路交通事故死亡案例特点分析

目的探讨道路交通事故死亡案例特点,为预防事故的发生提供可靠信息和参考数据。方法按照死者性别、年龄、死亡原因、事故发生时间及地点、事故车辆类型等相关参数,对深圳市4184例道路交通事故死亡案例进行回顾性分析。结果事故死亡人员以男性为主,男女比例为2.45∶1;事故在6：00～8：00和18：00～2：00发生最多;72%的案例在城郊主干道发生;死者主要交通行为方式分别为步行占44%,自行车骑车人19%,摩托车驾车人15%;肇事车辆以货车为主;死亡原因83.2%为颅脑损伤死亡,13.3%为多发损伤。结论深圳地区道路交通事故死亡案件具有明显特点,具有可防范性。     

Post-mortem interval estimation using miRNAs of road traffic accident cases: A forensic molecular approach

In forensic examination accurate estimation of post-mortem interval (PMI) is a challenging task, particularly in the advanced stages of decomposition. The existing methods (algor mortis, livor mortis, rigor mortis, putrefaction etc) used for estimating PMI rely on analyzing the physical, biochemical, and metabolic changes that occur in the corpse after death. While these methods have shown some level of effectiveness in estimating PMI during the early stages of decomposition, accurate estimation becomes increasingly challenging during the later stages of putrefaction when the body undergoes significant changes. Recently, microRNA (miRNA) profiling due to its relatively small size and stability has emerged as a promising tool in several areas of forensics. This study demonstrates the potential of miRNA for PMI estimation in advanced stages of death. In this study, miRNA-195, miRNA-206, and miRNA-378 were selected as target miRNAs and miRNA-1 as reference miRNA. Left ventricle tissue (5 g) of the heart from 20 forensic autopsies of traffic accident victims (18–32 years) were collected and processed. The samples were held at room temperature for eight different time intervals (12, 24, 48, 72, 96, 120, 168 and 196 h), and RNA was extracted from all the samples using Trizol-based RNA isolation protocol, followed by cDNA synthesis and amplification with commercially available specific miRNA probes in Real-Time PCR (RT-PCR), Ct was calculated. The result showed that miRNAs were associated with PMI. Over time, there were substantial changes in the Ct values of all three miRNAs, with significant reductions observed at 196 h compared to 12 h. miRNA-206 demonstrated significant changes at multiple time intervals, while miRNA-1 remained stable for up to 196 h and thus holds caas an endogenous marker. In conclusion, miRNA has the potential to serve as a valuable tool for estimating PMI, especially during the advanced stages of decomposition, when used in conjunction with established techniques. However, further validation of the study is required to obtain more accurate estimates of PMI.     

Diffuse vascular injury in fatal road traffic accident victims: its relationship to diffuse axonal injury

The authors have reported a macro- and microscopic study of brain lesions in 120 victims of fatal road traffic accidents, independent of the survival time. Diffuse vascular injury (DVI) was found in 14 patients (11.7%). All patients with DVI died within 24 h after the accident. The 14 patients with DVI also showed severe (Grade 2 or 3) diffuse axonal injury (DAI). Since DVI is restricted to road traffic accidents and incompatible with life, the high frequency observed in our series could be explained by the fact that all 120 patients were victims of road traffic accidents, and 69.2% had died within 24 h after the accident. The association between DVI and severe DAI (Grades 2 and 3) suggests that both lesions depend on the same mechanism, with the degree of axonal and vascular damage being determined by the intensity of the head acceleration. Our results show a relationship between DVI and DAI that suggest there may be a spectrum or at least a continuum between these entities as distinct from DVI being a separate entity.     

Suicide by self-inflicted stab wound of the chest

A case is presented in which a 44-year-old man stabbed himself in the heart with a kitchen knife, then changed his bloody clothes, and ate lunch with his aunt, who did not notice the event. After 2 h he died of cardiac tamponade.