Sudden Death due to Brainstem Leukemic Hemorrhage: A Case Report

Introduction Leukemia is a hematologic neoplasm character- ized by potential infectious and hemorrhagic com- plications. In adult patients with acute leukemia, in- fection is the most common complication. Intracra- nial hemorrhage （ICH） is the second most common complication. However, ICH has been identified as the major cause of morbidity and mortality in pa- tients with leukemia[1-6].     

Tuberculous Abdominal Aortic Aneurysm with Alimentary Tract Hemorrhage: A Case Report with Medico-legal Implications

An autopsy case of sudden death induced by alimentary tract hemorrhage was presented,which was caused by the unexpected rupture of clinically unrecognized tuberculous abdominal aortic aneurysm(TAAA).The initial diagnosis was made of the syndrome of coronary heart disease and hypertensive disease.The detailed autopsy showed that the alimentary tract hemorrhage was caused by a sudden rupture of the mass after posture changing was ascertained as the cause of death.The diagnosis of TAAA was determined by the autopsy findings.Analysis for the medical dispute of TAAA was described,and the difficulty of the diagnosis and medico-legal implications were also discussed.     

Postmortem MSCT Diagnosis of Whiplash Injuries in a Traffic Accident: A Case Report and Review of the Literature

A 45-year-old male car driver died in a traffic accident of four cars rear-end collision on the highway.He was found to have died after a respiratory and cardiac arrest at the scene.No sign of skin injuries was observed from the external inspection.The autopsy was not permitted by the family members because of the local culture.Multislice computed tomography(MSCT)was applied to the current case,showing dislocation of C3~4cervical vertebrae withⅡdegree,C4vertebral plate fractures,and spinal stenosis.Post-mortem MSCT confirmed the diagnosis as whiplash injuries.MSCT was verified to be effective in showing the severity of whiplash injuries,thus providing certain objective evidence for medicolegal expertise.     

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。     

Missing in Amazonian Jungle: A Case Report of Skeletal Evidence for Dismemberment*

Abstract: This case study presents the results of the recovery and analysis of three sets of disarticulated and incomplete human remains found in Ecuador, within the Amazonian jungle. Recovered body parts sustained extensive sharp force trauma situated on different aspect of the skeleton. The anthropological examination (bone reassembly, biological profile) was followed by a detailed analysis of cut marks, including a basic experimental study on pig bones to demonstrate that dismemberment may have occurred within a certain amount of time after death. Despite the location (deep into the Amazonian jungle) and the perpetrator’s actions (dismemberment and dispersion of body parts in a river), forensic work both on the field and in laboratory allowed identification of the victims and the reconstruction of the sequence of events.     

A Minimally Invasive Technique for the Detection and Analysis of Pulmonary Fat Embolism: A Feasibility Study*

We investigated the feasibility of postmortem percutaneous needle biopsy (PNB) for obtaining pulmonary samples adequate for the study of pulmonary fat embolism (PFE). Samples of both lungs were obtained from 26 cadavers via two different methods: (i) PNB and (ii) the double-edged knife technique, the gold standard at our institute. After water storage and Sudan III staining, six forensic pathologists independently examined all samples for the presence and severity of PFE. The results were compared and analyzed in each case regarding the vitality of the PFE and its relationship to the cause of death. The results showed that PFE was almost identically diagnosed and graded on the samples obtained via both methods. The discrepancies between the two techniques did not affect the diagnoses of vitality or cause of death related to PFE. This study demonstrates the feasibility of the PNB sampling method for the diagnosis and interpretation of PFE in the postmortem setting.     

The Role of Fantasy in a Serial Sexual Offender: A Brief Review of the Literature and a Case Report

Abstract: Extensive research has attempted to elucidate the role of fantasy in sexual offending. In this paper, the authors summarize the main results of the literature, especially the contents, themes, dynamics, etiopathogenesis, and potential functions of fantasy in sexual offending. Further, the authors analyze the case of a serial sexual offender who assaulted 39 women. The forensic‐psychiatric assessment revealed that his fantasies of forced sex, sexual coercion, and dominance, which were linked to narcissistic personality organization and functioning, were the primary drive mechanism in his crimes, because he imagined himself in the role of the aggressor, identified with the power associated with the role of perpetrator, and was sexually aroused by such images of omnipotent control of the victim. In conclusions, the authors suggest that fantasies of sexual aggression, coercion, and dominance of women may stimulate grandiosity and omnipotence and, in a minority of cases, may lead to sexual offending.     

Ricochet of a Bullet in the Spinal Canal: A Case Report and Review of the Literature on Bullet Migration

Abstract: Ricochet of a bullet in the spinal canal is well known by neurosurgeons but relatively not a common event in usual medico‐legal autopsy practice. This article presents a homicide case of a penetrating gunshot injury of the lumbar spine through the T12‐L1 intervertebral foramen with active movement of the projectile within the spinal canal to the L5‐S1 level. This case illustrates a bullet intradural and intramedullary active movement because of a ricochet of the body of T12 with active redirection of the path. In the current literature, different types of migration in caudal or cranial direction, intradural, or intramedullary are reported. If spontaneous migration of T10 to S1 seems to be more frequent, some authors reported a C1 to S2 migration. Such migration could be asymptomatic or induce neurological impairment. The medico‐legal consequences of these migrations within the spinal canal are described.     

23例电击死尸检取材和法医鉴定方法研究

目的在前期动物实验基础上,结合电击死人体尸检病理组织学观察,确定电击死鉴定最佳的组织取材部位。方法选取23例明确"手-足路径"电击死者,明确死于交通事故颅脑损伤和冠心病猝死者各10例为对照组。所有案例提取双腕上前内侧、双踝上后部等部位软组织,观察并分析其骨骼肌(Sk MCs)和动脉血管平滑肌细胞(ASMCs)的核轴比变化。结果 23例电击死案例,年龄19~59岁,男性19例、女性4例;高压电击死3例,日用低压电击死20例;7例出现典型电流斑(31.18%);5例出现胸膜电击纹(22.7%)。电击死组的前腕、内踝的Sk MCs和ASMCs细胞核拉长、扭曲,呈波浪样、栅栏状排列,其核轴比与对照组相同部位比较,有显著性差异(P<0.001),而且ROC曲线分析,Sk MCs和ASMCs的核轴比的诊断临界值为分别4.84、3.81。结论在"手-足路径"电击死的最佳取材部位应为机体电流路径中最狭窄位置,即腕、踝部位,该部位Sk MCs和ASMCs细胞核的极向性拉长、靠近呈串珠状或直线状排列,为最具特征性和诊断价值的电损伤形态学变化。     

Distinguishing Between Damage to Clothing as a Result of Normal Wear and Tear or as a Result of Deliberate Damage: A Sexual Assault Case Study

Abstract:  This paper focuses on bra damage, specifically damage observed in hook and eye fasteners that are generally located at the backstraps of bras. We describe bra design including the method by which hook and eye fasteners are generally constructed. We assess bra damage in two situations where the damage observed was unexpected given the case scenarios. These were: (i) the complainant of an alleged rape attributed damage to her bra hooks to force during a struggle and (ii) the complainant had earlier manipulated her bra hooks in an incident not related to her complaint. Steriomicroscopy and reconstruction experimentation were necessarily used to assess the bra damage. A systematic approach to damage analysis was employed by the forensic practitioners to correctly identify damage as being a result of mechanical manipulation and therefore as falsified. This paper suggests that more examples of falsified damage should be documented.     

The Imprint of Childhood Physical and Emotional Abuse: A Case Study on the Use of EMDR to Address Anxiety and a Lack of Self-Esteem

This article examines the use of Eye Movement Desensitization and Reprocessing (EMDR) in helping a client address problems with persistent anxiety and a lack of self-esteem. During EMDR treatment, the client explored the dichotomous thinking that had plagued her since childhood, and correspondingly, the role of childhood physical and emotional abuse in her chronic feelings of inadequacy and anxiety. The client experienced significant improvement in her levels of anxiety and problems with self-esteem, both at the end of treatment and at 1-year follow up. Qualitative and quantitative data are utilized in this case study outlining the use of EMDR with a client diagnosed with dysthymic disorder.