Hypophyseal damage in persons with cerebrocranial injuries and who died in the hospital

The pituitary was examined in patients with craniocerebral injuries who died in hospital in various periods after treatment. Control group consisted of victims died at the site of accident. The results indicate the significance of examining the pituitary in craniocerebral injuries for the diagnosis of thanatogenesis, particularly in patients died in hospital. Causes of traumatic changes in the organ were determined, highly incident in the practice of forensic medical experts: directly during injury, as a result of skull bone fractures; during development of dislocation syndrome and in disorders of blood and lymph circulation in the brain matter; resultant from augmenting traumatic edema of the brain.     

两轮摩托车道路交通事故驾驶员损伤特点的观察

目的 观察两轮摩托车驾驶员发生道路交通事故时的损伤形成规律,探讨此类事故确定驾驶人员的法医学依据。方法 对2000年至2002年北京地区408例2人同乘一辆两轮摩托车发生事故造成摩托车人员伤亡的损伤情况进行回顾性研究。结果 两轮摩托车发生道路交通事故时,在驾驶员腹部、会阴部、大腿内侧、胸部、面颈部、小腿胫前会形成能反应摩托车特定致伤部件的特征性损伤,而乘员在这些部位的损伤多为摔跌形成,难以反应摩托车特定部件的特征。结论 在两轮摩托车道路交通事故中,伤者身上反应的摩托车特定部件的特征性损伤,可作为判断两轮摩托车道路交通事故驾驶员的依据。     

Traffic accident vs homicide: The contribution of DNA analysis to clarify this mystery. A case report

A marriage procession was going through the road when the vehicle met with a fatal accident and the wife of the driver died. The autopsy revealed lesions according with fatal traffic accident. But, a second autopsy revealed that there were injuries, but it was not reported in the first autopsy protocol. We analyze several autosomal STRs to typify some evidences collected inside the vehicle of traffic accident which were stained by the blood of the woman mortal victim. The results of the analysis of DNA suggested that the victim bled inside the vehicle and died and then, she was placed on the pavement and her husband simulated an accident.     

Sevoflurane concentrations in blood, brain, and lung after sevoflurane-induced death

Sevoflurane concentrations in blood, brain, and lung were measured in an individual apparently dying from sevoflurane inhalation. Sevoflurane is a volatile nonflammable fluorinated methyl isopropyl ether inhaled anesthetic, chemically related to desflurane and isoflurane. The incidence of abuse of sevoflurane is lower than that of other drugs of abuse possibly due to its inaccessibility to the general public and less pleasurable and addicting effects. The dead subject was an anesthetist found prone in bed holding an empty bottle of sevoflurane (Ultane). Serum, urine, and liver were screened for numerous drugs and metabolites using enzyme immunoassays and gas chromatography-mass spectrometry. Analysis did not reveal presence of any drug, including ethanol, other than sevoflurane. Sevoflurane was determined by headspace gas chromatography and revealed concentrations of 15 microg/mL in blood and 130 mg/kg in brain and lung. Autopsy revealed pulmonary edema and frothing in the lung, pathological findings associated with death by sevoflurane or hypoxia. The cause of death was ruled as sevoflurane toxicity and the manner of death as accident.     

骑跨伤在机动车碰撞自行车事故中的特征及生物力学分析

目的以真实案例为基础,研究自行车与机动车碰撞交通事故中,不同机动车型、交通方式等因子造成自行车骑车人下肢内侧骑跨伤的特征,分析其生物力学机制。方法选取上海地区发生的自行车与机动车碰撞交通事故案例140例,全面收集现场、自行车、机动车、人体、交通方向等信息,运用回顾性研究方法分析,同时,选取其中典型案例,通过计算机仿真技术模拟事故发生过程,提取人体各受伤部位的动力学响应数值,如加速度、力和力矩等,与案例研究结果对比。结果全部事故中出现骑跨伤与无骑跨伤案例频数相等;侧面撞击与前后方向撞击骑跨伤的发生情况无显著性差别;大型车辆撞击事故中出现骑跨伤频率较低;骑跨伤的发生频率随车速加大而增高;就骑跨伤的分布来说,撞击侧下肢骑跨伤位置低(链条、脚蹬管等损伤),而对侧骑跨伤位置高(鞍座损伤),在小型车辆撞击时该特点更明显。结论分析自行车骑车人的骑跨伤特征和生物力学机制有望对道路交通行为方式鉴定提供新依据。     

Injury analyses of fatal motorcycle collisions in south-east Scotland

The timing of death and pathological findings in fatal motorcycle accidents in south-east Scotland between 1987 and 1997 were investigated. Of the 59 motorcyclists who died, 38 were dead when found at the accident scene, six others were alive when found but died at the scene, two died in an ambulance in transit to hospital and 13 died after reaching hospital. Scoring of the injuries according to the Abbreviated Injury Scale revealed Injury Severity Scores (ISS) ranging from 25 to 75. Overall, injuries to the head, neck and chest were responsible for the most severe injuries. Twenty-five motorcyclists had injuries acknowledged to be unsurvivable (ISS = 75), most of which involved the thoracic aorta, brainstem and cervical spinal cord. The greatest potential to reduce the death rate amongst motorcyclists lies with accident prevention/injury reduction measures, rather than through improved treatment of injuries. Efforts to try to alter driving behaviour and to improve the design of vehicles and helmets need to continue.     

Homicide of a supervisor simulating an occupational accident]

An unusual case of homicide is reported. A driver of an excavator killed his foreman by using the scoops of his machine and tried to feign an industrial accident. The man was convicted by the autopsy findings because his testimony could not explain the severe injuries.     

Fatal pedestrian-bicycle collisions

Although, fatal collisions between pedestrians and bicycles are relatively rare, they are still of forensic relevance because of the need to explore the circumstances of the accident. Based on three reconstructed cases, situation and injury patterns are presented that might prove useful in future cases: usually the person causing the accident is the cyclist while the pedestrian generally suffers more severe injuries; the situation at the site of accident is important for its reconstruction: end location of the persons involved in the accident, injuries and traces on pedestrians and cyclists, traces at the site of accident and on the bicycle; because of the lack of pre-crash traces and any eyewitness accounts, the pedestrian's injuries are the best starting point for the reconstruction of the accident; a characteristic wound on the lower leg of the pedestrian that reveals the initial impact between the front wheel and the leg is crucial not because of its seriousness, but because of its external morphology; the injuries that can be expected by the following impact between body and handlebar are unspecific and only minor; the most severe injuries to the pedestrian as a result of the accident are caused secondarily by falling and hitting the head on the road; the fall of the cyclist, however, corresponds to a throw-off followed by a sliding phase with less impact load when the head hits the ground [maximum abbreviated injury scale 1 (MAIS 1)]; the cyclists involved are mainly younger persons on fashionable bicycles (here: mountain bikes); in the great majority of cases, the injured pedestrians are frail, elderly people with a lower tolerance of trauma.     

交通意外事故尸体剖验37例

本文作者报告陆上交通意外尸体剖验37例。事故类型分路人车撞、汽车相撞、汽车撞静物及摩托车事故四种。路人被车撞致死者,损伤分布广,种类多,有5种不同的损伤。摩托车事故死亡者胸腹部损伤多,突出的是胸主动脉横裂。汽车驾驶员的损伤以胸腹部为多。其中因车撞车驾驶员死亡者,头部损伤常不严重。各种不同的损伤各有一定的特征。作者强调了要注意酒精与车祸的关系。     

Influence of alcohol intoxication of pedestrians on injuries in fatal road accidents

Pedestrians belong to the group of road users with the highest mortality rate. The frequency of road accidents involving pedestrians is 2% but pedestrians represent as many as 13% of all road accident deaths. Because of the mechanism and dynamics of injury and the effects of alcohol on physical and mental performance, pedestrians under the influence of alcohol are classed among the road users most at risk.Our retrospective study included 125 pedestrian fatalities treated at the Institute of Forensic Medicine, Faculty of Medicine, University of Ljubljana between 1999 and 2006. We classified the victims into two groups by blood alcohol level Group I (alcohol positive) and Group II (alcohol negative), defined differences in gender, age, incidence of injuries and established causes of death and period of survival following the road accident. In Group I (n = 53) 96% were male and 4% female; the average age was 45.6 years. In Group II (n = 72) 40% were male and 60% female; the average age was 63.1 years. The percentage of injuries to individual parts of the body was higher in Group I than among the deceased pedestrians in Group II. The most common cause of death in both groups was craniocerebral trauma. Death occurred in the first 6 h following the accident in 92% of cases in Group I and in 69% of cases in Group II.Alcohol-positive pedestrians are predominantly younger men, who have a higher level of risk of a road accident, greater incidence of injuries and a shorter period of survival following a road accident.     

Sudden cardiac death following psychoemotional stress

Sudden death from cardiac arrest is described, which occurred after a minor accident. Morphologically, a coronary change was found in the sense of "juvenile coronary atherosclerosis" in connection with intramural bleeding postmortem. As there were no injuries in connection with the accident but psychoemotional stress had occurred, it is concluded that affective resonance resulting from the accident initiated the death. The pathological and pathophysiological relationships are discussed.     

An autopsy case of infant death due to heat stroke.

We report an autopsy case of infant death due to heat stroke. On a winter day, a 52-day-old female baby was placed under a Japanese electric foot warmer with a coverlet (kotatsu) on an electric carpet warmer in a heated room at home. After about 5 h, the mother noticed that the baby was unconscious and took her to a hospital. Spontaneous respiration, however, was already absent, and the pupils were dilated. The trunk was hot; body temperature was 41.3 degrees C. The skin of the whole body was dry. Autopsy revealed second-degree burn injuries on the left side of the face and the dorsum of the left hand. Numerous marked petechiae and ecchymoses were found in the thymus (capsule and parenchyma), pleurae (visceral and parietal), pericardial cavity (internal and external surfaces), epicardium, and beneath the serosa at the origin of the aorta. In addition, there was congestion in various organs, edema in the brain and lungs, and hemorrhage in the lungs. Histopathologically, macrophages without hemosiderin granules were present in the alveoli. When the heating conditions at the accident were reproduced experimentally, the temperature in the electric kotatsu warmer rose to 50-60 degrees C. Thus, we concluded that misuse of the electric kotatsu caused heat stroke in this infant.     

基于3D激光扫描、多刚体重建和遗传算法优化的车-人碰撞事故再现模拟与损伤分析

目的利用3D激光扫描技术,结合多刚体动力学和遗传算法优化对一起汽车与自行车及其骑车人碰撞的交通事故进行再现模拟与损伤分析,为法医学死因鉴定提供生物力学依据。方法利用3D激光扫描技术对肇事汽车进行测量,根据测量数据建立人-自行车-汽车多刚体模型,并设置优化变量的取值范围,利用多目标遗传算法,带精英策略的快速非支配排序遗传算法求最优近似解,并与事故现场附近监控视频记录进行比较。结果事故车辆激光扫描重建结果良好,通过遗传算法优化收敛所获得的最优近似解中的假人、自行车、汽车的动力学行为与监控视频中所记录的三者动力学行为相符合,假人的损伤参数也与事故中骑车人的损伤情况及部位相一致。结论利用3D激光扫描技术,结合多刚体动力学和遗传算法优化可以对人-自行车-汽车碰撞前的运动状态、碰撞致伤过程进行重建,并对受害者的损伤进行力学分析,在交通事故受害人致伤方式鉴定及死因分析中具有应用价值。     

家庭暴力致骨折损伤机制分析1例(英文)

本文报道了一名37岁女性遭受丈夫殴打,造成下肢受伤。医院诊断为右髌骨和左胫骨骨折,伤者遂接受了切开复位内固定术。由于丈夫否认对其实施家庭暴力,声称其下肢骨折系交通事故坠落伤。警方遂委托对该女性的损伤进行法医学鉴定。经过审阅X线和CT检查资料,结果为伤者右侧髌骨骨折、左胫骨骨折,以及左眶内侧壁骨折。鉴定意见为髌骨的横向骨折系由肌肉的牵拉暴力引起,左胫骨损伤符合直接和间接外力所致,左眶内侧壁骨折在施暴期间形成的可能性较大。本文阐述了运用影像学技术对家庭暴力案件与交通事故损伤进行鉴别,强调了影像学技术在法医临床鉴定中的应用价值。     

Pedestrian accident analysis with a silicone dummy block

When a car is parked in an inclined plane in a parking lot, the car can roll down the slope and cause a pedestrian accident, even when the angle of inclination is small. A rolling car on a gentle slope seems to be easily halted by human power to prevent damage to the car or a possible accident. However, even if the car rolls down very slowly, it can cause severe injuries to a pedestrian, especially when the pedestrian cannot avoid the rolling car. In an accident case that happened in our province, a pedestrian was injured by a rolling car, which had been parked on a slope the night before. The accident occurred in the parking lot of an apartment complex. The parking lot seemed almost flat with the naked eye. We conducted a rolling test with the accident vehicle at the site. The car was made to roll down the slope by purely gravitational pull and was made to collide with the silicone block leaning against the retaining wall. Silicone has characteristics similar to those of a human body, especially with respect to stiffness. In the experiment, we measured the shock power quantitatively. The results showed that a rolling car could severely damage the chest of a pedestrian, even if it moved very slowly.     

Decapitation in road traffic accident--a case report

A 20-year-old girl along with four of her friends, all in their early 20s, met with a fatal accident in the early hours of the day. Their car was hit by a speeding truck at a crossing. All the occupants of the car sustained multiple injuries and died on the spot. The girl was decapitated in the accident. Her head was recovered outside the mangled remains of the vehicle and the rest of the body was extracted from the co-driver's seat of the damaged vehicle.     

Fatal dissecting aneurysm of the internal carotid artery with delayed symptoms following facial impact.

A fatal dissecting aneurysm of the internal carotid artery occurred in a 16-year-old male following facial impact in an automobile accident. The patient showed no neurologic deficit until two days after the automobile accident, when he suddenly started having seizures and developed right-sided hemiparesis. There was no evidence of direct trauma to the neck externally or internally. The only injuries observed in the head and face were two skin lacerations in the chin area. His condition rapidly deteriorated, and he expired on the fourth hospital day. The gross and microscopic findings for the internal carotid artery are presented. The possible mechanisms for the vascular lesion and a review of the literature are discussed.     

Computer simulation of the accident with nine victims

In the paper we wish to emphasise the significance of vehicle driving dynamics analysis in the collision phase and occupant load analysis by means of using a software environment. Thereby we also wish to present the results of the simulation of the course of a traffic accident with nine victims that arose from a collision between an Audi A6 passenger car and the VW Caravelle van. In treating the traffic accident the forensic expert was faced with the questions about what caused the injuries to the front passenger in the Audi A6 passenger car, about the way the two vehicles had collided, about their collision velocities, about the way the two vehicles were handled and about the causes that originated the traffic accident. The critical situation on the road was a consequence of the tiredness of the van driver, the inadequate use of the passive safety systems and overloading the van.     

大鼠实验性肺脂肪栓塞的病理学研究

取大鼠皮下脂肪乳化后作自身静脉注射,观察自身脂肪栓子对肺血管的光镜和电镜变化。结果表明,注射后1天肺小动脉及毛细血管内充满大量脂滴。4天时达高峰并伴有肺水肿、灶性出血以及单核细胞吞噬脂滴,中性、嗜酸性白细胞的浸润。7天后脂滴逐渐消失、未见其他脏器栓塞。