Cerebellar agenesis in a suicide

A case of a suicidal death associated with autopsy findings of right cerebellar and vermian agenesis is described. A review of the literature points out the various recurrence of agenesis, symptoms, and the likelihood of motor deficits. The singular coexistence of only behavioral and intellectual deficiency with suicidal inclination in an adult man with partial cerebellar agenesis is discussed.     

Aiding a suicide attempt

This article discusses the way in which substantive criminal law is generally taught in United States law schools and argues that more room should be given in these courses to familiarize students with the horrendous nature of much of our criminal law system—in particular the terrible conditions faced by most prison inmates after conviction.     

Studying survivors of near-lethal suicide attempts as a proxy for completed suicide in prisons

Sex determination is a necessary step in the investigation of unidentified human remains from a forensic context. Teeth, as one of the strongest tissues in the human body, can be used for this purpose. Most studies of sexual dimorphism in teeth are based on the traditional mesiodistal and buccolingual crown measurements. The purpose of this study is to examine the degree of sexual dimorphism in permanent molars of modern Greeks using crown and cervical diagonal diameters, and to evaluate their applicability in sex determination. A total of 344 permanent molars in 107 individuals (53 male and 54 female) from the Athens Collection were examined. Crown and cervical diagonal diameters of both maxillary and mandibular molars were measured. It was found that males have larger molars than females and in 19 out of 24 dimensions measured male molars exceeded female molars significantly (P<0.05). The most dimorphic molars are the maxillary second molar, and the mandibular second and first molars. Although other molars were also sexually dimorphic they did not have a statistically significant difference in all dimensions. Cervical diagonal diameters have found to be more sexually diamorphic than crown diagonal diameters. In discriminant function analysis the variables entered more frequently were the cervical diagonal diameters mainly of mandibular molars. Classification accuracy was found to be 93% for the total sample, 77.4% for upper jaw, and 88.4% for the lower jaw. Accuracy rates were higher for cervical than crown diagonal diameters. The data generated from the present study suggest that this metric method can be useful and reliable for sex determination, especially when the traditional dental measurements are not applicable.     

Unusual circumstances in a fourfold complex suicide

Complex suicides are defined as suicides using more than one method, which may sometimes suggest homicide. We present the case of a 27-year-old man who killed himself by using four different methods. The man was known as a loner and sufferd from bipolar psychosis. An eyewitness saw him afire and falling out of a window on the 4th floor of a hotel. He was wearing a judo dress with the belt wound twice around his neck. He died in a hospital about two hours later. The autopsy showed signs of neck compression typical of (self)-strangulation, several stab and cut wounds in the thoracic and abdominal region from sharp force, extensive first- to third-degree burns caused by the effect of heat, contusions of internal organs, serial rib fractures and several bone fractures of the extremities as signs of blunt force. The CO-Hb value in the blood amounted to 7%; the other toxicological tests were negative. Death was found to be due to exsanguination from a deep stab wound in the abdomen and multiple trauma caused by the fall from a great height in the course of a suicide. Homicide could be excluded due to the circumstances of the case, which demonstrated again that both the medical findings and the investigation results of the police are indispensable for the differentiation between suicide and homicide.     

Unusual suicide with a chainsaw

Described here is a case of suicide with the use of a chainsaw. A female suffering from schizophrenia committed suicide by an ingenious use of a chainsaw that resulted in the transection of her cervical spine and spinal cord. The findings of the resulting investigation are described and the mechanism of suicides with the use of a chainsaw is reviewed. A dry bone study was realized to determine the bone sections, the correlation between anatomic lesions and characteristics of chainsaw. The damage of organs and soft tissues is compared according to the kinds of chainsaw used.     

The cutaneous ink sign: a tipoff to suicide or suicide notes

The presence of smeared or unsmeared ink on the skin resulting from the writing process has been observed in a number of suicide victims who have left suicide notes. The authors report a case of a palmar "cutaneous ink sign" and discuss its forensic science import.     

Physician-assisted suicide in Oregon: a medical perspective

This Article examines the Oregon Death with Dignity Act from a medical perspective. Drawing on case studies and information provided by doctors, families, and other care givers, it finds that seemingly reasonable safeguards for the care and protection of terminally ill patients written into the Oregon law are being circumvented. The problem lies primarily with the Oregon Public Health Division ("OPHD"), which is charged with monitoring the law. OPHD does not collect the information it would need to effectively monitor the law and in its actions and publications acts as the defender of the law rather than as the protector of the welfare of terminally ill patients. We make explicit suggestions for what OPHD would need to do to change that.     

Ingestion of pointed objects in a complex suicide

A 51-year-old woman with a psychiatric history of depression and drug abuse was found hanged in her bedroom. The ligature was a scarf attached to the door handle. The autopsy findings suggested that two methods of suicide had been used one after the other. In the first stage, numerous nails, pins and needles were swallowed; in the second stage, the suicide was completed by hanging.     

Protracted suicide as a criminalistic problem

The authors suggest to reserve the expression "combined" suicide to cases, where a combination of several suicide methods were previously intended. The other cases, where the victims proceed from ohne failing attempt to the other by using different methods and finally succeed after a certain period should be called "protracted" or "prolongated" suicides. Two typical cases are presented. In the first case a young man tried to commit suicide by causing a traffic accident, then tried to stab himself. Afterwards he ingested motor oil and tranquillizers and finally succeeds in jumping from a crane. The second case deals with an elderly man who tried to kill himself by stabbing at the chest and the head. After he failed, he was drinking kerosene and at last he was throwing himself out of a window.     

High thyroglobulin (Tg) concentrations in fatal traumatic brain injuries

It is well known that under physiological conditions, the Tg molecule is the substrate for the hormones triiodothyronine and thyroxine. Its function outside the thyroid gland is unknown. Under certain pathologic conditions, an increase in Tg concentrations in the blood can occur, a phenomenon that is used in the clinical diagnosis of certain thyroid disorders. However, fatal traumatic brain injuries (TBI) can also produce a raised Tg concentration in blood. In such cases, mean (n=151) Tg concentrations of 405.8+/-353.3 ng/mL have been observed, with the values in 57% of these cases exceeding 200 ng/mL. Since it was possible to rule out specifically any thyroid disorders in these cases, the raised values may be explained by the effect of TSH in the spectrum of the "hypothalamic-pituitary-thyroid axis." This assumption has been substantiated by immunohistochemical tests for TSH and Tg. Compared with the controls (sudden unnatural deaths: Tg 23.3+/-27.6 ng/mL), the raised Tg values in the TBI cases were usually accompanied by a reduction in the intensity of immunohistochemical reactions relating to TSH and Tg. The hypophysis showed evidence of significant damage with morphologic changes such as edema, hemorrhages, and focal necrosis in association with reduced TSH levels.     

Reconstruction of a suicide by a homemade firearm

A 34 years old man shot himself by a selfmade muzzle-loader. He pluged one end of a waterpipe, used a cylindrical lead shot (Cal. 1.2 cm, length 2.15 cm, mass 22.7 g), special black powder (about 4 g, from fire-crackers; powder with an admixture of aluminium) and kindled the weapon in front of his chest by a slowmatch. He died immediately by retained missile of chest. The weapon flew away like a rocket. Unused projectils and powder (found in the flat) and the uninjured pipe allowed to copy the event. Velocity and energy of shot and weapon were determined, also the recoil of the pipe and the highest force of a hand to hold it fast. Experimental investigations and calculations correspondet well to the findings af the case.     

Chain link fence impalements in a traffic accident

The impalement of two occupants of a car on chain link fencing during a single-vehicle accident is described. The reexamination of the survivor after 10 months is presented. The Italian Penal Code requirements are discussed regarding the examination of injured persons from the medicolegal standpoint.     

Chronic hydrocephalus and alcohol abuse in a young male suicide

The paper describes a case of suicide in a young man affected by compensated chronic hydrocephalus who was subject to alcohol abuse. The case was studied by means of a complex set of analyses, including circumstantial and clinical data, anatomohistopathological findings, and chemicotoxicologic tests. What clearly emerges in the case is the importance of a continuing neuropsychological follow-up in patients with shunted hydrocephalus. The forensic interest in the case is due to the peculiar autopsy findings discussed in relation to the possible causes of sudden death in subjects with hydrocephalus.     

Unusual suicide caused by a stab wound in the neck

A case is reported of a man with a deep nape stabwound completely severing the medulla of the spine. A strangely formed bottle neck fragment is the assumed weapon. Further investigations allow a scene reconstruktion, police inquiries throw light on a previous acute psychotic disorder of the suicide.     

Elderly suicide: a 10-year retrospective study

The suicide rate in the 65-year and older age group has been increasing since 1980. The elderly attempt suicide less often than younger people but are successful more often. The authors retrospectively reviewed all cases referred to the Forensic Pathology Section of the Medical Examiners' Office at the Medical University of South Carolina (Charleston, SC) from January 1988 through December 1997. The cases of suicide in victims 65 years and older totaled 78, accounting for 11.5% of all suicides reviewed. Of these 78 cases, 41% were autopsied and 59% were externally examined. All of the cases were initially analyzed as to age, race, sex, and method of suicide. Files also were reviewed to determine time of year of the suicide, toxicology results, psychiatric history, social history, medical history, and whether a suicide note was left. The ages of these suicide victims ranged from 65 to 94 years; men comprised 85% of the victims, and whites, 94%. The male-to-female and white-to-black ratios were 6:1 and 15: 1, respectively. The average age of the victim was 73 years. Gunshot wound was the most common method of suicide, accounting for 80.7% of the cases. Other methods included overdose (6.4%), hanging (3.8%), fall from height (2.6%), incised wounds (2.6%), drowning (2.6%), and carbon monoxide poisoning (1.3%).     

Study of an economic issue as a possible indicator of suicide risk: a discussion of stock prices and suicide

There were more than 30,000 suicides in 1998 in Japan, and since then, the numbers have remained high. In 2009, the number of suicides per a day was c. 90. This phenomenon constitutes a major social problem. One of the major reasons for the rapid increase in the number of suicides appears to be the worsening economic problems. It is therefore necessary to research the relationship between economic issues and suicide. In this study, we examined the relationship between the value of the Nikkei Stock Average and suicide rates in Japan. The value of the Nikkei Stock Average may be related to suicide among men. On the basis of the results, relevant researchers and organizations should understand the factors that relate to suicide to better carry out specific suicide prevention measures.     

Childhood suicide: a report of four cases

A study of childhood suicide in individuals aged twelve years or less was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, FL, over the eight-year period from 1977 to the present. Four cases were collected; these are presented in some detail. A discussion then ensues along with a review of pertinent literature concerning this phenomenon.