Death by smothering following forced quetiapine administration in an infant

We present a case of smothering of a 2-year-old male infant by his schizophrenic mother who was having a psychotic episode. In addition to the initial autopsy findings of conjunctival petechial hemorrhages, facial linear abrasions and bruises, and mucosal abrasions and bruises, expert odontologic examination revealed indentations of the cusps of central incisors and molars, providing additional evidence of smothering. The postmortem and toxicological examination revealed features of forced quetiapine administration. The case presented is the first case of forced administration of quetiapine described. Our case also highlights the value of expert forensic odontological examination.     

Death following atypical compression of the neck

The authors present 3 cases of asphyxia caused by atypical compression of the neck by the metal bed bars fitted at the sides of the bed to prevent falling out. These occurred in 3 elderly women living in nursing homes, confined to bed by severe neuropsychiatric disturbances. In all 3 cases, the minor nature of the skin lesions and absence of blood infiltrations in the anatomic structures of the neck had made it difficult to diagnose the cause of death. Inspection of the rest homes, together with the autopsy findings (acute pulmonary emphysema, conjunctival petechiae, and dark, fluid blood), enabled identification of asphyxia as the cause of death and its causal agent as the bed bars.     

Chloroquine as a poison in murder. Report of fatalities after criminal or suicidal chloroquine administration

Presented is a case of murder by means of chloroquine, committed on a 36-year-old male. The wife of the deceased had confessed to have secretely administered chloroquine-containing tablets to her husband. She was lawfully sentenced to life-imprisonment. The toxicological findings of this case are compared to the results of two chloroquine suicide cases and discussed in the context of the referring literature. An additional case where chloroquine intoxication was doubtful is introduced because of the unusual circumstances under which it occurred.     

Death due to microvascular occlusion in sickle-cell trait following physical exertion

The heterozygous condition characterized by the presence of hemoglobin AS (sickle-cell trait) occurs in approximately 8% of the American black population. Unlike the homozygous state (sickle-cell disease), sickle-cell trait is not widely recognized as a cause of life-threatening illness or death despite over 30 case reports describing fatal or serious complications of exercise in young black males with this condition. These reports identify heat stress, dehydration, viral illness, and poor physical conditioning as factors which may contribute to exertional rhabdomyolysis and sudden death, suggesting multifactorial etiology. However, since sickling is known to occur postmortem, it remains controversial as to whether the pathogenesis of these exercise related deaths involves microvascular obstruction by sickled erythrocytes. We describe three young black individuals with no significant past medical history who died following physical exertion. In all three cases, postmortem hemoglobin electrophoresis demonstrated hemoglobin AS. In none of the cases was the body temperature found to be elevated. These cases serve to remind the forensic community that, in the proper setting, sickle-cell trait must be viewed as a potentially fatal disorder.     

Sudden death following administration of radio contrast media

Six patients died suddenly following the administration of radio contrast media. All had received the so-called older agents which are being replaced by newer contrast agents, which are characterized by reduced osmolality. Five of the six patients experienced almost immediate difficulty in breathing followed by death.     

尿中氯喹定性定量分析方法的研究

建立了人尿中氯喹的定性定量分析方法,2ml尿样用2ml×2环己烷：乙酸乙酯（8：2）提取净化后,60℃水浴室气吹干,残留物定容溶解后,气相色谱分析,氯喹的保留时间为9．44min。方法最低检测限为200ng／ml,回收率为87．0％,RSD＝7．9％（n＝5）,在0～50μg／ml浓度范围内,有良好的线性关系：A＝1778．9＋13686C,r＝0．999。方法同时可用于血中氯喹的分析。附一例应用报告,测得尿中氯喹的含量为0．745mg／ml,血中氯喹的含量为3．68μg／ml。尿液中同时检出氯喹的N－去单已基代谢物。定性结果经质谱法验证。     

Death due to neurogenic shock following gastric rupture in an anorexia nervosa patient

We report a case of fatal gastric rupture discovered after death, which developed due to a bulimic attack of a 19-year-old woman suffering from anorexia nervosa. An autopsy revealed an acute gastric dilatation and rupture without commonly observed ischemic damage of gastric wall structures. However, it may be difficult to determine the cause of death despite the marked findings. The death as a consequence of neurogenic shock accounts for all the results of gross examination and histologic analysis. This case is the first reported case of fatal gastric rupture of an anorectic patient discovered after death.     

Determination of chloroquine and monodesethylchloroquine in hair

Using thin-layer and gas chromatography and mass spectrometry, chloroquine and its major metabolite (monodesethylchloroquine) were identified in hair samples of numerous patients who received this antimalarial drug for several months. In two patients the amounts of chloroquine were, respectively, 310 and 145 mg/kg hair and those of the monodesethylchloroquine 23 and 11 mg/kg. The respective proportions (93 and 7%) are the same in the two subjects. The chloroquine percentage was near those in the spleen or stomach wall after poisoning. Other metabolites in hair are being identified. Hair analysis may provide a good toxicologic and forensic science complement to the blood, urine, and tissues. It may be useful for the control of chloroquine therapy.     

Pharmacokinetic profile of paraquat following intravenous administration to the rabbit

Pharmacokinetic studies of paraquat in rabbits were performed using [methyl-14C]-paraquat. Plasma concentration of paraquat following i.v. administration to the rabbit was fitted to a 3-exponential function of pharmacokinetic analysis. Distribution and elimination were discussed on the basis of the 3-compartment open model system, which has a central and two peripheral compartments. Computer simulations of paraquat levels in each compartment indicated that the slow-uptake peripheral compartment contained a greater amount of paraquat than the central or the fast-uptake peripheral compartment. On the basis of the present results of the computer simulations in company with tissue distributions of paraquat reported by the other investigators, it is likely that the slow-uptake peripheral compartment contains the lung. In cases of paraquat-induced renal failures, the paraquat levels of the slow-uptake peripheral compartment were remarkably higher than in cases of normal renal functions. Histology of the rabbit tissues 7 days after i.v. administration of paraquat revealed that marked changes were observed only in the kidney, suggesting some renal failures induced by paraquat. In spite of the high concentration of paraquat, which was presumed with the computer simulations in this study, the rabbit lung showed a remarkable resistance to paraquat toxicity. The histology studies suggested the complexities of paraquat toxicity to the rabbit. The lung toxicity in the rabbit would be caused by not only the paraquat concentration in the lung but also some biochemical parameters in the tissue related to the mechanisms of paraquat toxicity.     

Death following spontaneous recovery from cardiopulmonary arrest in a hospital mortuary: 'Lazarus phenomenon' in a case of alleged medical negligence

We report a possibly first forensic autopsy case of death following a spontaneous recovery from cardiopulmonary arrest (CPA) after clinical declaration of death: 'Lazarus phenomenon'. A 65-year-old male with congenital deafness and dumbness was found unconscious in his room at a public home. During pre-hospital and clinical resuscitation including defibrillation and medications for about 35 min, CPA persisted under electrocardiographic (ECG) monitoring and therefore, his death was pronounced. However, about 20 min later, a police officer who had been called for the postmortem investigation found the patient moving in the mortuary. The patient subsequently showed typical ECG signs and laboratory findings of early inferior wall myocardial infarction and died 4 days later. The forensic autopsy, due to alleged medical negligence, revealed myocardial infarction with thrombotic occlusion of the right coronary artery and secondary hypoxic brain damage. The present case and the related clinical literature suggest that, especially in cases of acute myocardial infarction in elderly patients, a careful observation to confirm death after discontinuation of resuscitation is recommended to provide appropriate medical care, irrespective of the quality or duration of advanced life supporting efforts.     

慎用死刑——刑事司法实践中死刑适用问题探讨

慎用死刑是刑事司法中一个十分重要的问题,慎用死刑必须正确掌握死刑的适用条件"罪行极其严重".如何判断"罪行极其严重"是一个难题,应该加强立法和司法的解释.与此同时,正确地适用"死刑缓期二年执行"是正确适用死刑的又一个重要课题.     

Involvement of Amphetamines in Sudden and Unexpected Death

Abstract:  In the present study, the effects of amphetamine-class drugs were examined in cases reported to the Victorian coroner from 2001 to 2005 to determine if death can occur from the use of amphetamine-class drugs alone. A total of 169 cases were reviewed where a forensic autopsy detected amphetamine(s) in the blood. Pathology, toxicology, and police reports were analyzed in all cases to ascertain the involvement of amphetamine-class drugs in these deaths. In Victoria, methamphetamine (MA) is the principal abused amphetamine-class followed by methylenedioxymethamphetamine (MDMA). There were six cases in which a cerebral hemorrhage caused death and three cases in which serotonin syndrome was established as being caused by the interaction of MDMA and moclobemide. There were 19 cases in which long-term use of amphetamines was associated with heart disease. There were three cases where amphetamine-class drugs alone were regarded as the cause of death, of which two cases exhibited high levels of MDMA and lesser amounts of MA and/or amphetamine. There were no cases in which significant natural disease was absent and death was regarded as caused by the use of MA. There was no correlation between blood concentration of drug and outcome.     

Estimating the Time of Death in Domestic Canines

Abstract:  Because 36.1% of U.S. households have dogs, the time of death (TOD) of dogs at crime scenes can be useful to forensic investigators. However, there are few published studies based on postmortem changes in dogs. This study, conducted indoors in still air at approximately room temperature, monitored the postmortem reduction in rectal, liver, brain, and aural temperatures in 16 dogs for 32 h after death. Graphs of temperature reduction were prepared to estimate the TOD of dogs within the first 32 h postmortem. Sex, body mass, and hair coat density did not affect the rate of body temperature reduction, but increased body weight and volume slowed it. Rectal temperature was the most convenient, reasonable site for measuring body temperature. Vitreous humor potassium ion concentration [K⁺] was measured in both eyes at c.  1.5 and 7 h after death. Both eyes had the same [K⁺] when measured simultaneously, and [K⁺] increased after death.     

公共危机管理的行政法治现实课题

本文结合"非典"公共危机管理的新实践、新情况,探讨了我国行政法治发展的若干现实课题,提出应加强我国公共应急法制建设,将行政应急性原则纳入我国行政法的基本原则体系,重视行政指导措施在公共危机管理中的适当运用,系统研究解决诸多后"非典"时期的行政法律问题,并提出了相应的对策建议.     

韩国死刑制度的回顾与展望

韩国现行刑法中共有89个条文以法定刑的形式规定死刑.自从1997年12月对23名死刑犯执行死刑之后,尽管几乎每年仍然有人被判处死刑,但直到今天,韩国将近10年间没有实际执行过一例死刑.韩国国内就死刑存废问题有着激烈的争论,其中官方的宪法裁判所、大法院、法务部以及学界与国民中的部分人仍主张保留死刑制度,但废止死刑的动议在韩国也正在积极酝酿之中.在废除死刑制度之前应该考虑将能够把犯罪人与社会永久隔离起来的绝对终身刑作为替代刑罚,以绝对终身刑代替死刑制度是一个可行的方案.     

论中国死刑发展趋势

现阶段 ,死刑的威慑力和一般预防的作用受到广泛质疑。就中国适用死刑而言 ,死刑不是严重犯罪的杀手锏 ,应在死刑与重刑主义之外寻求和制定更为科学的刑事政策 ;死刑误判危害是巨大的也是双重的 ,不仅给无辜者造成终生难忘的伤痛和屈辱 ,而且严重损害了国家司法公正的形象 ;死刑适用应体现立法中已表达的民意 ,而不是屈从于局部民愤而扭曲法律的规定。中国死刑制度在大幅度削减的基础上 ,最终走向废除 ,这是我国死刑的发展趋势所在。     

窒息死亡的法医病理学分析

目的探讨窒息死亡的法医病理学特点。方法对四川大学华西法医学鉴定中心1982年10月1日～2006年9月30日所作160例窒息死亡尸体剖验病理材料进行统计分析。结果窒息死亡案例占整个法医学检案的9.9%,年龄:30～39岁的死者占整个研究对象的29.4%,平均年龄为31.25岁。性别:男性103例,女性57例。男女比例1.81∶1。死亡方式:意外死亡最多(63.1%),其次为自杀(24.4%)和他杀(12.5%)。死亡原因:缢死最多(21.9%),其次为CO中毒(17.5%)、溺死(16.25%)等。医疗纠纷共计39例,均为新生儿窒息,主要发生在乡镇医院和县级医院(76.92%)。结论加强法制教育,提高安全隐患意识等是减少窒息死亡的重要手段。提高城乡医疗水平,加强窒息急诊抢救的临床技能是防止窒息引起医疗纠纷的关键。     

死刑复核程序中存在的问题

死刑复核程序作为对判处死刑案件审查核准的特殊程序,对于保障死刑适用的正确性起着非常重要的作用,然而现行的复核程序还存在一些影响其作用发挥的问题,文章通过分析,提出一些立法建议,以期死刑复核程序能够更加完善。