Histomorphologic lung findings in long-term artificial respiration with special reference to extreme continuous artificial respiration using pure oxygen

The respirator lung is characterized histologically in the first exudative phase by capillary congestion, intra-alveolary edema, hyaline membranes and in most cases by concomitant inflammatory alterations. In the following irreversible phase, fibrous organization processes dominate and show a variable tendency towards pulmonary fibrosis. In 27 cases with long-term artificial respiration from 4 days to 12 weeks, mainly the proliferative alterations were investigated. In 18 cases, the histopathological findings indicated fibrosis of the alveolar septa with disseminated distribution. In 9 cases, focal fibrosis with obliterations of alveoli prevailed. The extent of pathological results in the lungs does not correlate with the duration of artificial respiration. In cases of artificial respiration with pure oxygen, there is a special toxic component, which is illustrated by a young woman with polytraumatism who was administered artificial respiration for 5 weeks with pure oxygen. She died from respiratory insufficiency with severe pulmonary fibrosis. As different pathogenetic factors may cause irreversible pulmonary fibrosis, histomorphological classification is difficult later and, moreover, forensic problems result.     

外伤致乳房假体破裂的法医学鉴定(附1例报道)

随着我国社会经济的发展 ,人们的生活质量不断提高 ,女性对自己形象要求更加完美。乳房作为女性的重要性征 ,其形态和大小更加受到重视。应用置入假体的隆乳术 ,可使乳房发育不良的妇女达到丰乳的目的 ,使她们的美好愿望成为实现 ,加上隆乳技术及填充材料的改进 ,目前女性实施隆乳手术的人数逐年增加。伴随因隆乳带来的医疗纠纷也时有发生 ,相关文献上屡见报道。但在法医学鉴定中 ,外伤造成胸部损伤合并乳房假体破裂的鉴定尚未见到 ,由于此类案件在鉴定过程中 ,缺乏相应依据条款 ,增加了鉴定难度。本文结合 1例胸部损伤合并乳房假体破裂案 ,…     

外伤致乳房假体破裂的法医学鉴定(附1例报道)

随着我国社会经济的发展,人们的生活质量不断提高,女性对自己形象要求更加完美.乳房作为女性的重要性征,其形态和大小更加受到重视.应用置入假体的隆乳术,可使乳房发育不良的妇女达到丰乳的目的,使她们的美好愿望成为实现,加上隆乳技术及填充材料的改进 ,目前女性实施隆乳手术的人数逐年增加.伴随因隆乳带来的医疗纠纷也时有发生,相关文献上屡见报道.但在法医学鉴定中,外伤造成胸部损伤合并乳房假体破裂的鉴定尚未见到, 由于此类案件在鉴定过程中,缺乏相应依据条款,增加了鉴定难度.本文结合1例胸部损伤合并乳房假体破裂案,探讨此类案件的法医学鉴定.     

Factors associated with stalking persistence

The longer stalking persists, the more damaging its effects. Despite this, little research has explored factors associated with stalking persistence, making it difficult to drive strategies that encourage desistance. This study examined risk factors associated with persistence in a sample of 637 participants from Brisbane (Australia) classified as ex-intimate stalkers. A self-report perpetration questionnaire was used to measure stalking duration (low/moderate/high) and risk factors for persistence. Findings identified marked differences in the nature of risk factors for moderate (1–12 months) as opposed to high persistence (>1 year). Ex-intimate stalkers were more likely to be moderately persistent (versus low and high persistence) if they had higher attachment anxiety, amorous motives, constantly ruminated about the victim and were feeling hurt. Ex-intimate stalkers were more likely to be highly persistent (versus low and moderate persistence) if they were aged over 30, had some tertiary education, had higher attachment avoidance, did not have amorous motives, wanted to frighten/hurt the victim and felt angry. Feeling suicidal and/or unable to cope was associated with both moderate and high persistence. Findings suggest it is crucial to differentiate risk factors for moderate and high persistence. Furthermore, ex-intimate stalking that persists the longest may be the most malicious.     

Unusual deaths associated with polyphagia

Perversion of appetite may be manifest in either qualitative (pica), quantitative (polyphagia), or combined derangements of eating. Ingested materials are capable of serving as dangerous physical agents through interference with normal cardiac and/or respiratory function. Since the mechanisms of injury are similar to those that might occur as a result of violence or serious natural disease, a thorough investigation of the history and circumstances immediately preceding the final event is warranted in addition to a complete autopsy. Three cases of asphyxia of unusual etiology are presented along with a rationale regarding the mechanisms believed to be involved. In case 1, sudden subdiaphragmatic viscus expansion with resultant lung volume displacement and impediment of venous return from the lower half of the body are believed to have been operative. In cases 2 and 3, both asphyxial loci are infraglottic. The common denominator in all of these fatalities is the physical impairment of vital air exchange as a complication of an abnormal eating pattern.     

Fatal capnocytophaga infection associated with splenectomy

A case of fatal sepsis due to Capnocytophaga species is described. Capnatophaga canimorsus and C. cynodegmi can cause localized wound infections and/or systemic infections in people who have been bitten, licked, scratched, or merely exposed to cats or dogs, especially splenectomized individuals. A thorough social, medical, and surgical history, the clinical presentation, and cultures are important in making the diagnosis of Capnocytophaga infections. It is important that the forensic pathologist be aware of this zoonotic disease.     

Head injury associated with barbiturate suicide

Two cases of self-inflicted injury, associated with suicide by ingestion of barbiturates, are presented. The head injury was so severe in one of the deceased that the death was at first thought to be due to homicide. It is postulated that barbiturate poisoning may induce a phase of excitation, with headache, prior to induction of coma.     

Fatal seizures associated with trimipramine poisoning

The present report describes a witnessed, fatal attack of seizures. Very high levels of trimipramine were found in the blood collected at autopsy. The cause of death would most likely have been misinterpreted as a suicidal intoxication if the attack had not been witnessed. Conversely, if toxicologic examination had not been undertaken, the fatality would probably have been registered as epilepsia.     

安全带对人体的影响

安全带普遍用于防止交通事故所致伤亡,其交通损伤中与安全带有关的损伤逐渐引起人们关注。通过复习国外相关文献,结合1例尸检案例,对安全带造成人体损伤的特点进行综述和探讨。     

Fatal angioedema associated with captopril.

A markedly hypertensive, 70-year-old, black man had been on captopril for 2 years when he rapidly developed obstructive angioedema. The initial sign of difficulty in understanding his speech progressed to severe laryngeal and glossal edema over a 3 1/2 h period. His airway became obstructed less than a minute after arrival at the emergency room. Oral intubation was unsuccessful, and a difficult tracheostomy was too late to save the patient. The death was reported to the medical examiner because of its sudden and unusual nature. The risk of angioedema while on angiotensin converting enzyme inhibitor therapy has been noted previously in the clinical literature. Because of the sudden onset and possible confusion with an allergic reaction, this entity is brought to the attention of the forensic medical community.     

汽车安全气囊的使用与损伤

交通事故已经成为导致死亡和致残的首要原因,气囊的产生和使用明显的降低了交通事故中的死亡率和致残率。虽然气囊可以降低交通事故中人员的死亡率和损伤程度,但同时也引起很多非致命性的损伤。本文主要阐述了气囊的作用机制,引起的损伤类型以及机制,并提出减少和降低与气囊相关的损伤和死亡的建议。     

Factors associated with the insanity adjudication

Journal of Police and Criminal Psychology -     

Suicide associated with the Antichrist delusion

The Antichrist delusion is a relatively infrequently observed religious delusion. Some cases of the Antichrist delusion have been associated with violence toward others. The aim of this article is to document a case of suicide secondary to the delusion. At age 17 a woman with no history of mental illness developed the belief that she was the Antichrist. For several years she did not discuss this with anyone and functioned appropriately in society. Then, at age 32, after the birth of her first child, her delusion intensified and she ultimately committed suicide to protect others from the harm she felt she was destined to cause them. The Antichrist delusion as a misidentification state may involve danger to a patient who harbors the delusion, as well as to other individuals.     

Postmortem skeletal lesions

Postmortem bone alterations are very frequent and can raise the issue of their nature (antemortem, perimortem or postmortem defects). The aim of this work is to study various aspects of defects which were not assessed as perimortem trauma, from a series of 50 defects examined, resulting from 24 forensic cases. This study emphasizes the variability of size, shape and number of postmortem defects. Usually the diagnosis of antemortem defects is helped by a careful examination of some characteristics as the edges of the defects, the areas of discoloration of the edges and of the whole bone. Elsewhere it appears very difficult to know the true nature (antemortem, postmortem, or perimortem alterations) of the bone.     

车祸致外伤性颈内动脉海绵窦瘘法医学鉴定(附2例报告)

案例资料例 1　张某 ,男 ,2 0岁 ,交警。 1997年 7月 15日张某乘坐的摩托车与一迎面驶来的面面包车相撞。张某头部着地 ,当即昏迷 ,约 30分钟后清醒 ,当即感头痛、头晕、恶心 ,呕吐数次 ,为胃内容物。入医院查体 :神情 ,口鼻出血。下颌有两处均为 2 .0ｃｍ长的皮肤裂伤。右膝关节处皮肤擦伤。神经系统检查 :颈抵抗 ,克氏征 (+) ,瞳孔正常 ,颅神经检查无异常 ,四肢肌力、肌张力正常 ,生理反射存在 ,病理反射未引出。Ｘ线片示 :下颌骨粉碎性骨折。脑电图示 :广泛中度异常。 5天后伤者诉左眼视物不清。眼科会诊为 :左眼球固定凸出 ,上睑下垂 ,…     

车祸致外伤性颈内动脉海绵窦瘘法医学鉴定（附2例报告）

案例资料例1 张某,男,20岁,交警.1997年7月15日张某乘坐的摩托车与一迎面驶来的面面包车相撞.张某头部着地,当即昏迷,约30分钟后清醒,当即感头痛、头晕、恶心,呕吐数次,为胃内容物.入医院查体:神情,口鼻出血.下颌有两处均为2.0 cm长的皮肤裂伤.右膝关节处皮肤擦伤.神经系统检查:颈抵抗,克氏征(+),瞳孔正常,颅神经检查无异常,四肢肌力、肌张力正常,生理反射存在,病理反射未引出.X线片示:下颌骨粉碎性骨折.脑电图示:广泛中度异常.     

Fatal dog maulings associated with infant swings

We present three cases of fatal dog maulings of infants placed in mobile infant swings, a phenomenon not previously described in the literature. In each case, the victim was left in a mobile swing, unsupervised by an adult, and the attacking dog was a family pet. Case 1 involved an 18-day-old male infant attacked by a pit bull; Case 2 involved a 3-month-old male infant attacked by a Chow Chow and/or a Dachshund, and Case 3 involved an 18-day-old female infant attacked by a Labrador-pit bull mix. These cases not only underscore the importance of not leaving young children unattended in the presence of pet dogs, but also raise the possibility that mobile swings may trigger a predatory response in dogs and thus may represent an additional risk factor for dog attack.