Hemopericardium caused by endocarditis ulcerosa: an unusual cause of sudden death in adolescence

The authors report on the case of a 18-year-old student who died suddenly and unexpectedly of a pericardial tamponade after perforated ulcer-polypous endocarditis of the aortic valve. The detection of aerococcus urinae--which usually causes urinary tract infection--on the inflamed aortic valve demonstrates an unusual pathogenetic chain linking complexes of findings in the urogenital system and the heart.     

Detection of ketosis in vitreous at autopsy after embalming

Ketosis occurs in ketoacidosis or malnourishment. When either is suspected in relation to a death, it may be important to analyze for ketosis at autopsy. We encountered a case where starvation was suspected in a deceased nursing home resident, where the body had been embalmed prior to autopsy. Gas chromatography (GC) was unable to separate acetone from formaldehyde, a component of embalming fluid. The Acetest is a simple test that can detect acetone and acetoacetate in body fluids. We validated the Acetest with GC on vitreous. The Acetest and GC were consistent except at very low levels of acetone or acetoacetate. The sensitivity of the Acetest for acetoacetate in vitreous was 10 mg/dL, consistent with early starvation. Significant interference from embalming fluid did not occur. The Acetest was negative in the described case. The Acetest is a simple and useful test for the detection of ketosis in embalmed autopsies.     

Antigenic differentiation of blood stains by the Lewis system in practical forensic medical expert evaluation

A modification of quantitative absorption and absorption elution tests with blood stain washing before the absorption phase is presented. Due to washing, the effect of carrier object on anti-Le(a) and anti-Le(b) sera is decreased and the sensitivity of the method is increased. Additional adsorption of the sera and elution into test erythrocytes treated with protease C is suggested for increasing the number of standard sera fit for the absorption-elution test. A new technology for preparing anti-Le(a) and anti-Le(b) immunoreagents is described.     

Infrared spectroscopy of the dry residue of liquor crystallograms in various diseases

The article presents the results of an examination of the dry residue of liquor crystallograms (DRLC) using infrared spectroscopy technique. 36 spectrograms were studied. Elements of similarity and difference were revealed in the spectrograms of organic substance (antifreeze, sodium cyclamate and fatty tissue), of DRLC of the crystal-forming matter CuCl(2)x2H(2)0, of DRLC of a live person and cadaveric liquor (with no brain injury in respective case histories), of DRLC of liquor of live persons with a brain injury, of DRLC of liquor of persons who died of a brain injury and of persons who died of other causes.     

A controlled,problem-solving,group-based intervention with vulnerable incarcerated young offenders

Recent research has indicated that vulnerable incarcerated young offenders--such as those at risk of suicidal behaviour, those on formal protection due to their inability to assimilate into mainstream, and those who are bullied but remain in normal circulation--display impoverished problem-solving abilities. Furthermore, deficits in their problem-solving skills are significantly correlated with levels of anxiety, depression, and hopelessness. This study evaluated the effectiveness of a time-limited, group-based problem-solving training intervention compared with a no-treatment control for vulnerable, incarcerated young offenders. A total of 46 young offenders were equally allocated to intervention or control groups. Intervention participants experienced significant reductions in their levels of anxiety, depression, and hopelessness and improvement in their self-assessed social problem-solving abilities. Gains in aspects of self-assessed problem-solving ability and mental health for the intervention group continued to be evident at 3-month follow-up. Methodological concerns in this study and directions for future research are discussed.     

Bile analysis of drugs in postmortem cases

Bile is, in certain cases, collected together with blood from different sites (heart, brain, femoral), urine and other organs or matrices. This study reports comparative results obtained from the analysis of blood and bile for different drugs found: acetaminophen, amphetamine and related compounds, several antidepressants, several benzodiazepines, cocaine and its metabolites, dextropropoxyphene and its metabolite, hydroxyzine, methadone and metabolite, morphine and codeine, levomepromazine, thioridazine, propranolol, tramadol and its metabolite. Several findings are presented: (1) There were no significant differences in the levels of the compounds among the samples of blood obtained from different sites. (2) Levels in bile are generally several fold higher than those in blood. The mean bile to blood ratios vary from about 1 (for acetaminophen, amphetamine) to about 2000 (for desmethylclobazam). (3) In certain cases (16 over 44), although the drug or its metabolite was not detected in blood from different sites, it was detected in bile. As other authors had advocated, it is very useful to ask the pathologist to take the gall bladder with its contents together with the other samples, in order that the sample of bile can be used in the comprehensive toxicological analysis and therefore be complementary to the other fluids or matrices. An additional advantage for using bile is that the concentrations of drugs or their metabolites are generally several fold higher than their blood concentrations.