Hyperplasia of islets of langerhans and low serum insulin in cot deaths

Of the fifty-seven cases of cot death studied two-thirds were younger than 3 months, which is also the peak age of infantile hypoglycaemia. Findings from routine necropsy and histology were scarce; in eleven cases they could be regarded as potentially fatal. About half of the infants had had a mild virus-type infection approximately one week before death. Special attention was paid to endocrine pancreas. Insulitis or lymphocytes in the septa were discovered in twelve cases. Hyperplasia of the islets of Langerhans was a common observation; the hyperplasia being either nesidioblastosis-like with clusters of islets around ducti, or diffuse. The average proportion of islet tissue in the whole pancreas parenchyma was around 5% in infants aged 1–6 months, the percentage being significantly greater than in age-matched controls (4.3%). The pancreatic insulin content was also higher in the cot death cases. Serum insulin values were low (mean 4.8 ± 1.2 μU/ml) in cot deaths; in the controls they were twice as high (mean 11.6 ± 1.6 μU/ml) (p < 0.005). The cause of death in this group of cot deaths could thus be (congenital?) hyperplasia of the islets, possibly combined with a lesion in the B-cells caused by a virus. The mechanism of death would be hypoglycaemia.     

Variability in cancer death certificate accuracy by characteristics of death certifiers

Death certificates are the source for mortality statistics and are used to set public health goals. Accurate death certificates are vital in tracking outcomes of cancer. Deaths may be certified by physicians or other medical professionals, coroners, or medical examiners. Idaho is one of 3 states that participated in a Centers for Disease Control and Prevention-funded study to assess the concordance between cancer-specific causes of death and primary cancer site among linked cancer registry/death certificate data. We investigated variability in the accuracy of cancer death certificates by characteristics of death certifiers, including certifier type (physician vs coroner), physician specialty, years of experience as death certifier, and number of deaths certified. This study showed significant differences by certifier type/physician specialty in the accuracy of cancer mortality measured by death certificates. Nonphysician coroners had lower accuracy rates compared with physicians. Although nonphysician coroners certified less than 5% of cancer deaths in Idaho, they were significantly less likely to match the primary site from the cancer registry. Results from this study may be useful in the future training of death certifiers to improve the accuracy of death certificates and cancer mortality statistics.     

Wrapped to death. Unusual autoerotic death

Despite the large population of New Orleans, including many homosexual and transsexuals, there have been relatively few cases of autoerotic deaths. The case reported here is an interesting one as it includes a bizarre form of autoerotic behavior from the standpoint of the method used. There have been no deaths reported in the literature in which the victim died as a result of jeopardizing himself by enclosing his body into plastic with an airway out of his "cocoon" in the form of a snorkel tube. He was engaged in masturbation when he apparently lost his mouth piece or airway. He attempted to use a knife to cut himself out.     

论奸淫幼女犯罪既遂的认定标准

法律的正当理性在于保护人的尊严、自由以及个人与社会生活中的实质性价值,引导社会生活和人类文明的健康发展。我国现行刑法关于奸淫幼女犯罪既遂的接触说标准,在根本立场上是非理性主义、重刑主义的表现,无论是从保护被害人的利益、被告人的人权、促进正常性行为方式和性文化的健康发展,还是从充分体现刑法立法的科学合理性、刑法的谦抑性等立场来说都存在诸多弊端。因此,应当在法理上、立法与司法实务上统一强奸犯罪(其中当然包括奸淫幼女犯罪)既遂的插入说标准,反对并废除奸淫幼女犯罪既遂的接触说标准。     

Birth and death in a new land attitudes to infant death in colonial Australia

The goldrush colony of Victoria, Australia, was a favoured destination for aspirational emigrants from nineteenth-century Britain. Yet the persistence of high rates of infant mortality blighted the happiness of many first and second generation immigrant families alone in a new land. Drawing on birth, death and inquest records this paper interrogates the experience of infant death amongst the poorest families in the capital city popularly known as ‘Marvellous Melbourne’ during the second half of the nineteenth century. Although few infants died alone, the familial and community networks in which they were enmeshed were not always committed to their survival. While the paper argues that there was a hierarchy of value which determined the degree to which the death of a child would be welcomed or mourned, it also contests popular notions that evil baby farmers and unfeeling mothers were a major cause of infant death.     

Birth and death in a new land attitudes to infant death in colonial Australia

The goldrush colony of Victoria, Australia, was a favoured destination for aspirational emigrants from nineteenth-century Britain. Yet the persistence of high rates of infant mortality blighted the happiness of many first and second generation immigrant families alone in a new land. Drawing on birth, death and inquest records this paper interrogates the experience of infant death amongst the poorest families in the capital city popularly known as ‘Marvellous Melbourne’ during the second half of the nineteenth century. Although few infants died alone, the familial and community networks in which they were enmeshed were not always committed to their survival. While the paper argues that there was a hierarchy of value which determined the degree to which the death of a child would be welcomed or mourned, it also contests popular notions that evil baby farmers and unfeeling mothers were a major cause of infant death.     

An unusual death in water

A case of combined suicide involving the explosion of a handgranate in water demonstrates the possible misinterpretation of external injuries.     

Sudden death in hemodialysis patients

Hemodialysis patients may die suddenly and unexpectedly from a number of causes. These may be divided into those deaths due directly to and occurring during hemodialysis, those deaths occurring while the patient is not undergoing dialysis, and those deaths that may occur at any time. The first group includes brain herniation, air embolism, acute hemorrhage as a result of machine malfunction or fistula rupture, electrocution, cardiac arrhythmia caused by hypokalemia, complications of subclavian intravenous catheter insertion, third-degree heart block as a result of triglyceride emulsion, and disseminated intravascular coagulation (DIC) or hyperkalemia caused by overheated dialysate. The second group includes deaths due to pericardial tamponade because of effusion and suicidal causes of death (exsanguination, electrolyte imbalance as a result of excessive intake of salt, fluid, or potassium) as well as more conventional methods of suicide. The last category includes people dying of arteriosclerotic cardiovascular disease, hypertensive cardiovascular disease, and internal hemorrhage. Investigation of these deaths, including pertinent historical, laboratory, and autopsy data and investigation of dialysis equipment, is discussed.     

Sudden death in cerebral hemiatrophy

Hemiatrophia cerebri is a rare disease, and the etiology and pathogenesis remain unclear in most cases. In the present case, the marked hemiatrophy of the brain in a 19-year-old patient who died suddenly is attributed to encephalitis during early childhood and subsequent prolonged seizures.     

Sudden death in urticaria pigmentosa

A case of sudden death of a 25-year-old man, with a six years history of Urticaria pigmentosa, is reported. On a cold morning in November he was found lying dead on the lawn. Histology revealed no signs of systemic mastocytosis. The biochemical investigations (high free histamine level in urine) in addition to a BAC of 0,72 mg/g and the scene conditions (cold irritation) explained the mechanism of death, a systemic anaphylactoid reaction.     

Sudden death in cardiac myxoma

Nonmalignant tumour (heart myxoma) is often a cause of sudden death. Morphological investigation of 11 heart myxomas (8 in the left atrium, 1 in the right atrium) was performed. These myxomas were generally attached to endocardium in the area of the oval foramen. Sudden death occurred due to infarction of the brain, heart and other vitally important organs as a result of embolism of greater circulation vessels by disintegrated tumour located at the left side of the heart, then due to lung failure caused by embolism of lesser circulation vessels by tumour located at the right half of the heart, and due to heart failure as a result of occlusion of atrioventricular foramen by big myxoma.     

Sudden death in the alcoholic

A study of victims of alcohol abuse was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida. During the year 1983, all cases in which alcoholism, either acute or chronic, was the cause of death primarily or contributory in a natural or accidental manner of death were collected. These 118 cases were then analyzed as to the age, race, sex, and cause of death of the victim along with the blood alcohol content, the drugs detected at autopsy, the scene circumstances, the geographic location of the terminal incident, noting whether or not there was a history of drinking prior to the terminal incident, the average weights of key target organs, and the histopathology of the liver. The most common victim is an older (greater than 50 years) white male who dies from "chronic alcoholism" with a terminal negative blood alcohol. This victim is usually "found dead" at home with a past history of drinking, and histopathologically the liver depicts fatty metamorphosis rather than cirrhosis.