The causes of death in fire victims

In 169 consecutive cases of autopsied fire victims about 50% had lethal levels of carboxyhemoglobin. Soot in the respiratory tract was found in about 90% of the cases. The age distribution of the fire victims showed significantly less persons in the 15-35-year group than should be expected according to the age distribution of the population, presumably due to greater agility of younger people. More than half of the fire victims had alcohol in the blood exceeding 0.05%, and alcohol intoxication should be considered accessary to many deaths in fire. The characteristic biphasic distribution of carboxyhemoglobin in fire victims together with other observations suggest that the principal causes of death are carbon monoxide followed by carbon dioxide poisoning and/or oxygen deficiency, while the influence of heat is considered to be of minor importance.     

Three unusual neuropathologic-related causes of sudden death

We discuss the autopsy findings of three medico-legal cases of sudden death associated with uncommon neuropathologic findings of which the general forensic pathologist may not be familiar. Case 1 was a 43-year-old man who died of a seizure due to malignant melanoma of the temporal lobe associated with neurocutaneous melanosis (NCM). Case 2 was a 57-year-old woman with a history of mental retardation and incoordination because of chronic lead poisoning, who died of a pulmonary thromboembolism due to deep venous thrombosis status post left leg fracture after a fall down a staircase. Autopsy revealed atrophy and gliosis of her cerebellum as a result of childhood lead poisoning. The third patient was a 75-year-old woman who died as a result of acute bacterial leptomeningitis at the cervico-medullary junction with acute inflammation of the connective tissue of her upper cervical spinal column associated with subluxation of her atlantoaxial (AA) joint, also known as Grisel's syndrome.     

Diagnostic criteria in acute ethanol intoxication as cause of death

There are described, in the paper, morphological, chemical and biochemical signs in acute alcoholic intoxication. A complex approach is suggested to diagnosing an acute alcoholic intoxication as death reason.     

New criteria for diagnostics of sudden cardiac death in forensic medicine

New data on characteristics of sudden cardiac death are provided. It is characterized by hypohydration of the brain, elevated cerebral impedance, a sharp fall of the index of coronary heart arteries passability, mostly areactive affection of the stem nuclei of the brain.     

Empirical criteria for the determination of suicide manner of death

A 16-item instrument was constructed as a tool to assist medicolegal official in their investigations and certifications of suicidal deaths. The Empirical Criteria for the Determination of Suicide (ECDS)--derived from a combined set of the 22 criterion items of the Operational Criteria for the Determination of Suicide (OCDS) and 33 other items obtained from experts and the professional literature--was constructed and validated by using 126 suicide and accident cases obtained from 70 medical examiner participants. Analysis of the cases confirmed that suicide is a manner of death in which there is evidence of both self-infliction and intention to die. The 16 items retained in the ECDS discriminated suicides from accidents best in relation to self-infliction and intention. In analysis of its concurrent validity, the ECDS instrument predicted 100% of the suicides and 83% of the accidents, thus correctly identifying 92% of all cases.     

水中尸体肺组织硅藻检验与死因分析

目的 探讨肺组织中硅藻对于判断水中尸体死亡原因的应用价值.方法 收集水中尸体407例,对死亡原因、案件性质、组织器官中硅藻检验结果进行分析.取45只兔按照生前、死后入水及不同季节入水等随机分为9组,应用硝酸消化法处理检材,检测肺组织中硅藻含量.结果 407例水中尸体,硅藻检验阳性372例,其中意外死亡和自杀351例,他...     

Changing trends in the diagnosis of sudden infant death

A study of 114 consecutive cases of unexpected infant death that occurred in South Australia over a 5-year period from January 1994 to December 1998 was undertaken. There were 45 deaths attributed to sudden infant death syndrome (SIDS), 19 to natural causes, 21 to accidents. and 5 to homicides; 24 cases were listed as "undetermined." Although there has been a genuine and continued decline in SIDS numbers in this population, there has also been an increase in the diagnosis of cases of accidental asphyxia due to unsafe sleeping environments and of cases in which the family background and autopsy findings suggested more complex mechanisms. The change in diagnostic profile has followed the introduction of more rigorous clinical history review, death scene examination, and autopsy testing. Thus, although diagnostic outcomes have altered in this population, it is more likely the result of more careful interpretation of the extensive investigations that are now undertaken rather than arbitrary reclassification.     

不同死因大鼠死后不同时间红细胞溶血速度比较

目的观察不同死亡原因大鼠尸体血液中红细胞溶血速度的变化规律,为死亡原因的法医学推断提供新思路。方法 40只SD大鼠随机分为4组,分别以断髓、置于99%CO的空间、高坠、勒颈方式处死后,取各组大鼠右心室血液,于死后即刻（0h）、8h、16h、24h、32h、40h、48h、56h、64h、72h,采用显微镜数码图像法进行全血红细胞计数（CBC）,并对组内和组间数据进行统计学比较分析。结果 4组血液红细胞数量在死后即刻至72h期间,均随时间的延长因溶血而减少。其中0~16h,各组溶血速度无明显差异（P〉0.05）;16~48h,速度加快,溶血速度以CO中毒组（88.50±25.99）%最快,其次为高坠（69.33±29.52）%和断髓组（48.78±3.17）%,机械性窒息组（41.90±9.61）%最慢,组间比较具有显著性差异（P〈0.05）;56h后,溶血速度再次减慢,至72h机械性窒息组仍有少量红细胞存在。结论 4组不同死因大鼠死后不同时间红细胞计数均减少,各组间差异具有统计学意义,其变化特征可为死亡原因的推断提供新的思路。