A forensic pathological study of eighty-two cases of adrenal hemorrhage

OBJECTIVE: To analyze the relationship between adrenal hemorrhage and the cause of death, age and gender. METHODS: Eighty-two cases of adrenal hemorrhage were statistically analyzed. RESULTS: Adrenal hemorrhage occurred mostly in cases of sudden death, infection, trauma and asphyxia. Male had more chance than female to have adrenal hemorrhage. Adrenal hemorrhage caused by sudden death, trauma and poisoning was more frequently seen in young adults, whereas adrenal hemorrhage in children as well as in fetus and newborns was often caused by infection as well as sudden death and asphyxia respectively. Adrenal hemorrhage caused by sudden death and asphyxia was mainly located in medulla, while the infection usually induced hemorrhage in cortex. Adrenal hemorrhage caused by trauma showed an equal opportunity in either the cortex or medulla. CONCLUSION: Our data indicate that adrenal hemorrhage might provide some clues in searching for the cause of death.     

82例肾上腺出血的法医病理学分析

目的 分析肾上腺出血与个体死亡原因、年龄和性别的关系。方法 对82例。肾上腺出血的案例进行统计学分析。结果 （1）肾上腺出血在猝死、感染、外伤和窒息中最多见。（2）肾上腺出血男性多于女性。猝死、外伤和中毒的肾上腺出血多见于青壮年，感染以幼儿多见，窒息主要为胎儿和新生儿。（3）猝死和窒息的肾上腺出血部位主要在髓质，感染以皮质出血为主，外伤在包膜和髓质的出血概率相等。结论 在法医检案过程中，肾上腺出血可以为寻找死因提供线索。     

Sudden infant death syndrome: Histological studies on adrenal gland and kidney

Histological observations were made on the adrenal glands and kidneys in ten cases of sudden infant death syndrome (SIDS). The amount of fetal cortex was excessive in the adrenal glands and many glomeruli of fetal form were observed in the kidneys. These findings suggest that the adrenal glands and the kidneys in SIDS cases are more or less immature in development. The immature development in these organs, especially in the adrenal glands, was considered to play a role in the cardiac or respiratory mechanisms in SIDS.     

Functional morphology of the hypothalamo-hypophyseal-adrenal system in acute coronary failure]

Histological and morphometric studies of large-cell and small-cell hypothalamic nuclei, adenohypophysis, and adrenal cortex of patients who died from acute coronary failure revealed signs of persistent hyperfunction of small-cell nuclei of the hypothalamus, bundle and retinal adrenocortical zones, and signs of short-term hyperfunction of pituitary adenocytes. These changes indicate disorders in the hypothalamic regulation of adrenal activity.     

Morphofunctional reaction of human adrenals at the pulmonary variation of thanatogenesis

A comparative morphometric study of male adrenals was conducted in case pulmonary thanatogenesis. A response was registered, it was associated with a dominating weight of the left adrenal (LA) and of its cortical substance over the similar parameters of the RA. The intensity and the time of the onset of reactions in different LA morphofunctional zones were found to be different in mechanical asphyxia and in carbon-monoxide intoxication. It is suggested that the occurring changes can reflect the action mechanism and result from the embryogenesis-conditioned specificity of functioning of paired organs.     

Ethanol-oxidizing enzymes of the adrenal glands in acute alcoholic intoxication

Complex morphological-and-histological examinations of the adrenal glands were performed on actual forensic-medical samples in acute alcoholic intoxication (AAI), i.e. 107 death cases of men and women, aged 17 to 60, due to mechanical trauma, lethal ethanol intoxication and somatic complications of chronic alcoholism. A differentiated distribution of ethanol-oxidizing enzymes was defined, i.e. of alcohol-dehydrogenase and acetyl-dehydrogenase in the structural-and-functional zones of the adrenal cortex and medullary substance. A differential activity of enzymes was established that correlated with the level of exogenous alcoholemia. Sets of morphological signs related with examinations of the adrenal glands, which enabled a differential diagnosis of death causes in AAI, were specified.     

毒鼠强中毒大鼠脑神经元GABA_A α1受体的检测

目的探讨GABAAα1受体在毒鼠强中毒大鼠脑组织中的变化及其机制。方法选择健康Sprague-Daw-ley大白鼠30只,分成5组,每组6只;分别以2.0 LD50、1.0 LD50、1/2 LD50、1/10 LD50毒鼠强量,采用灌胃染毒方法制作毒鼠强中毒模型,并以健康大鼠灌服生理盐水为对照;断颈处死大鼠,提取脑皮质、海马及脑干脑桥等脑组织进行免疫组织化学染色,观察GABAAα1受体阳性染色神经元的变化。结果不同LD50量染毒大鼠的皮层、海马及脑干,其GABAAα1受体免疫组化阳性染色神经元较对照组组减少,其中以1.0 LD50、1/2LD50组减少最为显著;相同染毒剂量,以脑干组织减少最多。结论GABAAα1受体表达下降与毒鼠强中毒机制相关。     

人体组织黄递酶Ⅲ分型

应用超薄层PAGIEF对人体组织作DIA3分型，结果显示睾丸、卵巢、子宫肌和牙髓组织均可检出DIA3多型带。脑、肝、肾、肾上腺、脾、肠、胰腺、心肌、肺、皮肤和骨骼肌以及血液、阴道液和毛根均未检测出DIA3。应用紫外分光光度法测定人体不同组织，血液和阴道液中DIA相对活性，结果各组织DIA活性相对值与PAGIEF中DIA显色谱带密度基本一致。作者认为，用PAGIEF对生殖器官和牙髓进行DIA3分型在法医的个人识别中有一定意义，在混合斑鉴定中可以不考虑阴道液对精液DIA3分型的干扰。     

Differential diagnosis SIDS/non-SIDS on the basis of histological findings of petechial thymus hemorrhages

Petechial thymus hemorrhages are found most frequently in SIDS (87%), and very much more rarely in fetuses after abortion and stillbirths (55%) as well as in perinatal deaths (40%). In these groups, there was a uniform histological bleeding pattern with emphasis on the cortical zone. In non-SIDS deaths of natural causes or extrinsic suffocation in babies and infants, it could be demonstrated in 39%. In extrinsic suffocation, the thymus hemorrhages were mostly less pronounced in quantitative terms than in SIDS. In non-SIDS (without extrinsic suffocation), a hemorrhage pattern different from SIDS could be detected with hemorrhagias of different sizes and irregularly distributed over the cortex and medulla.     

Forensic medical diagnostics of chronic narcotic intoxication based on the morphological findings

The objective of the present work was to develop the forensic medical criteria for chronic narcotic intoxication based on the results of morphological studies. The internal organs from 179 cadavers were available for the examination following death from acute poisoning with narcotic substances or as a result of chronic narcotic intoxication. The studies were carried out with the use of routine histological staining techniques and an immunohistological method. The data obtained provided a basis for the development of criteria to be employed in forensic medical diagnostics of acute poisoning with narcotic drugs and chronic narcotic intoxication. These criteria include ischemia of cerebral neurons, pulmonary emphysema with the formation of foreign body-type granulomas and fibrin/erythrocyte thrombi, morphological signs of ventricular fibrillation, the picture of bacterial endocarditis, follicular hyperplasia of the lymphoid organs, chronic portal hepatitis, and nodular degeneration of the adrenal cortex associated with its atrophy.     

The Significance of Adrenal Hemorrhage: Undiagnosed Waterhouse‐Friderichsen Syndrome,A Case Series

A retrospective series of five cases of nontraumatic gross adrenal hemorrhage were identified in 800 consecutive forensic autopsies. All patients were males, of different ethnicities and with ages ranging from 2 to 48 years. All patients had a clinical history and autopsy findings suggestive of sepsis. Pre‐ or postmortem microbiological cultures were variably positive for Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus aureus, and methicillin‐resistant Staphylococcus aureus. The fifth case was positive for yeast and a coagulase negative staphylococcus; contamination of this culture medium cannot be excluded. No cases had a culture positive for Neisseria meningitidis. We find that the reviewed patients with grossly or microscopically identifiable adrenal hemorrhage were otherwise healthy individuals who died suddenly as a consequence of bacterial infection. In each case, signs and symptoms compatible with premortem adrenal insufficiency were reported; in no instance was the adrenal hemorrhage clinically identified.     

大鼠脑外伤后大脑皮质脑红蛋白的定量研究

目的探讨脑外伤后大脑皮质脑红蛋白(Ngb)随时间变化的规律及其法医学意义。方法自由落体硬膜外撞击法复制大鼠中度颅脑损伤模型,采用免疫组化方法和图像分析技术观测脑外伤后不同时间损伤区大脑皮质、损伤周半影区以及损伤对侧皮质的Ngb免疫组化反应及其阳性信号灰度值和阳性信号面积,并对所测数据进行统计学分析。结果脑外伤后大鼠损伤区大脑皮质Ngb阳性反应细胞迅速减少,伤后24h降至最低,至16d维持在较低水平;损伤周半影区Ngb阳性反应细胞迅速增加,伤后12h达高峰,随后逐渐减少,至8d及16d恢复至正常水平;损伤区大脑皮质Ngb阳性信号低于对侧大脑皮质,损伤周半影区Ngb阳性信号强于对侧皮质。结论脑外伤后大鼠大脑皮质Ngb阳性反应细胞随时间延长呈现区域性的增多或减少。     

大鼠脑挫伤后巢蛋白表达与脑挫伤经过时间的关系

目的观察大鼠脑挫伤后不同时间内巢蛋白(nestin)蛋白表达的变化,探讨其与脑损伤经过时间的关系。方法利用自由落体撞击大鼠脑挫伤模型,在脑挫伤后不同时间(0.5,6,12h和1,3,7,14,28d)观察nestin蛋白在伤侧皮质、海马齿状回及胼胝体表达情况。结果伤后0.5h伤侧皮质、海马齿状回及胼胝体nestin阳性细胞表达开始增强,7d达高峰,以后逐渐下降,28d伤侧皮质、海马齿状回恢复至正常组水平,伤侧胼胝体在伤后28d仍有弱表达。结论nestin免疫组化染色可以作为法医学推断早期脑损伤时间的指标之一;nestin可作为判断脑损伤是否存在及区分生前和死后脑损伤的标志。     

大鼠脑外伤后大脑皮质脑红蛋白的表达

目的探讨脑外伤后大脑脑红蛋白（Ngb）的时空变化规律及其法医学意义。方法实验大鼠分为打击后15min、30min、1h、3h、6h、12h、1d、2d 8组,并设正常对照组。采用硬膜外局部打击方法复制SD大鼠外伤性局灶性脑挫伤模型,在各组预设时间点断颈处死,并按损伤区、打击周边缘区和非损伤区皮质分别取材,采用半定量反转录聚合酶链式反应（半定量RT-PCR）方法和图像分析技术观测脑外伤后Ngb mRNA表达的变化规律,并对所测数据进行统计学分析。结果大鼠脑外伤后脑损伤区Ngb mRNA表达在伤后15min开始下降,24h降至最低水平;打击周边损伤区NgbmRNA表达于伤后15min即可见表达增高,12h增高达峰值;非损伤区皮质Ngb mRNA表达强于正常皮质。结论 Ngb在脑损伤的急性阶段对神经细胞有保护作用。     

Evaluation of serum cortisol in the postmortem diagnosis of acute adrenal insufficiency

Normal adrenocortical activity is necessary for electrolyte regulation and the maintenance of cardiovascular function. Although chronic adrenal insufficiency generally presents with the gradual onset of a set of characteristic symptoms and signs, the more sudden loss of adrenal activity can present with acute, rapidly progressive cardiovascular dysfunction that can be fatal if not recognized and treated promptly. We herein describe a patient who had most of his adrenal tissue removed during resection of metastatic renal carcinoma, conventional clear cell type, with much of the remaining adrenal tissue undergoing necrosis during or shortly after surgery. Although the patient appeared to be stable and progressing adequately well, he died suddenly 2 days postoperatively. When the gross autopsy findings suggested the possibility of adrenal insufficiency, clinical laboratory assessment of adrenocortical activity was sought. Analysis of stored antemortem serum samples and of blood obtained at autopsy demonstrated a progressive decrease in cortisol levels which, in this stressed postsurgical patient, proved fatal. The use of both antemortem and postmortem blood in the demonstration of acute adrenal insufficiency at autopsy is discussed.     

Evaluation of two instrumental methods of comparing writing paper

An organization had approved the sample of writing paper, and accordingly the supplier had to execute the supply. The supply received was suspected to be of different quality from approved one. The organization sent the samples for comparison to the Forensic Science Laboratory. Both the approved and supplied samples were compared using Tensile Testing Method with the Material Testing Machine and Fluorescence and spectral analysis using the Video Spectral Comparator (VSC2000). The difference between the mean loads at peak before rupture in the tensile testing mode for the two samples was about 33%. The two samples differed significantly in terms of UV fluorescence, and there was about 5% average difference in the percentage of maximum reflected intensity in the wavelength region of 400-900 nm. It has been observed in this study that these two methods can adequately distinguish paper samples of different origin.     

Individual and collective justice and injustice: Implications for intergroup conflict

This paper focuses on the combined impact of individual and collective justice and injustice on intergroup conflict. The basic premise is that an adequate understanding of the course of intergroup relations requires knowledge not only about relevant conditions on the intergroup level, but also about the intragroup conditions that might predispose each group to assume a particular type of social orientation. It is assumed that an individual is more dissatisfied when both s/he and her/his group are unjustly treated than when only either one is. The consequences of different combinations of justice and injustice for the individual and his/her group are specified for the intensity of conflict between two groups. Sixteen intergroup scenarios are first derived and rank-ordered, via three assumptions, in terms of how aversive they are likely to be from the perspective of one of two interacting groups. The viewpoints of both groups are then taken into account in an attempt to make predictions about the potential for and intensity of intergroup conflict.     

Comparative histologic studies of the origin of petechial thymus hemorrhage

Systematic histological investigations were carried out on the thymus with regard to the incidence and genesis of petechial thymus hemorrhages in 145 cases of death (fetuses from pregnancy terminations and stillbirth, mature and immature neonates, SIDS cases, other baby deaths, deaths during infancy and childhood). Petechial thymus hemorrhages were most frequently found in SIDS cases (87%). Even though distinguishable, a distribution pattern similar to that of thymus hemorrhages in SIDS cases (including hemorrhages mainly in the cortical zone of the lobes) could be detected in the group of fetuses from pregnancy terminations and stillbirth, as well as in mature and immature neonates. Histologically, deaths in babies and infants without extrinsic suffocation showed a different histological bleeding pattern (irregular hemorrhages of varying size in the cortex and medulla of the lobes). In violent extrinsic suffocation of babies and infants, thymus hemorrhages were much rarer and less pronounced in quantitative terms. Acute and subacute or chronic forms of asphyxia, the cause of death and the duration of the death struggle are discussed as pathogenetic factors to explain the different patterns of the findings.     

肾上腺结核猝死的法医学鉴定

通过两例肾上腺结核猝死的案例观察发现：肾上腺和肾上腺以外器官的结核病变均表现为不典型的慢性陈旧性的病理学特征。提示在法医学鉴定中,对患过结核病和“不明死因”猝死尸体剖验时肾上腺的组织病理学检验尤为重要     

A local variance based approach to alleviate the scene content interference for source camera identification

Identifying the source camera of images is becoming increasingly important nowadays. A popular approach is to use a type of pattern noise called photo-response non-uniformity (PRNU). The noise of image contains the patterns which can be used as a fingerprint. Despite that, the PRNU-based approach is sensitive towards scene content and image intensity. The identification is poor in areas having low or saturated intensity, or in areas with complicated texture. The reliability of different regions is difficult to model in that it depends on the interaction of scene content and the characteristics of the denoising filter used to extract the noise. In this paper, we showed that the local variance of the noise residual can measure the reliability of the pixel for PRNU-based source camera identification. Hence, we proposed to use local variance to characterize the severeness of the scene content artifacts. The local variance is then incorporated to the general matched filter and peak to correlation energy (PCE) detector to provide an optimal framework for signal detection. The proposed method is tested against several state-of-art methods. The experimental results show that the local variance based approach outperformed other state-of-the-art methods in terms of identification accuracy.