An Autopsy Case in Which Self‐Bloodletting Via a Cervical Blood Access Led to a Fatal Outcome*

Abstract: A 48‐year‐old woman was found dead on a chair in her living room. She had received dialysis every day because of chronic renal failure for the past 15 years. On a table beside her, there was a mirror and 10‐mL syringe on a napkin. A stopper was out of place in a portion of a three‐way blood access tube established in the right cervical region, and blood coagulation was noted in the lumen. There was a bloodstained measuring cup on the floor. Autopsy findings included a large number of shunt traces in the bilateral infraclavicular fossae and upper limbs, as well as the cervical blood access terminal reaching the right atrium via the internal jugular vein to superior vena cava. Various organs showed anemia. Neither a fatal lesion nor injury was noted in the main organs. Therefore, this patient may have committed suicide by self‐bloodletting via a cervical blood access.     

The significance of drug analysis of sweat in respect to rapid screening for drug abuse.

Morphine and methamphetamine, which are excreted in the sweat, are detected by the use of routine serological and physicochemical techniques for urinary examinations. Screening for drug abuse can be done with the same accuracy of that of urine. Rapid excretion of the drug via kidney (within one day) is followed by a slow but steady excretion of the sweat gland. Methamphetamine given orally in a dose of 10 mg is excreted in the sweat at a constant rate (1.4 microgram/ml). No significant difference of the amount excreted by both systems is found. Alveolar lining seems to prevent the elimination of the volatile methamphetamine via respiration. Not only narcotics and stimulants, but also many alkaloids and barbituarates are excreted in the sweat and detected quantitatively by the same principles. The toxicological analysis of the sweat promises a new scope of forensic investigation.     

Distribution of A and B antigens in organs of blood group AB individuals: observations disclosed by a double immunoenzymatic labeling method

The localization of A and B antigens in the organs of blood group AB individuals has been studied using a double immunoenzymatic labeling method. Both A and B antigens were found in the various epithelial cells of these organs, but the epithelial cells could be classified into the following four types depending on the reaction pattern with anti-A and anti-B sera: type 1: cells that stained positive with both anti-A and anti-B sera; type 2: cells that stained positive with anti-A serum only; type 3: cells that stained positive with anti-B serum only; type 4: cells that were negative with both sera. The distribution of each of these epithelial cell types varied considerably, even in the same tissue and individual. Our results seem to suggest that a dissociation in the conversion to the A and B antigens occurs in the tissue of individuals belonging to blood group AB and that the degree of this dissociation varies from tissue to tissue and from cell to cell.     

Traumatic rupture of an abdominal aortic aneurysm associated with the use of a seatbelt

Injury to the abdominal aorta after blunt trauma continues to be a relatively infrequent occurrence. In this report, we describe a case of traumatic rupture of an abdominal aortic aneurysm associated with inappropriate seatbelt use.     

An unusual case of fatal gas embolism.

We describe an unusual case of fatal gas embolism, in which a man died by connecting an extension tube supplying oxygen to an indwelling catheter that was inserted into the left cephalic vein.     

Three cases of sudden death due to butane or propane gas inhalation: analysis of tissues for gas components

We report three cases of sudden death due to inhalation of portable cooking stove fuel (case 1), cigarette lighter fuel (case 2), and liquefied petroleum gas (LPG) (case 3). Specimens of blood, urine, stomach contents, brain, heart, lung, liver, kidney, and fat were collected and analyzed for propylene, propane, isobutane, and n-butane by headspace gas chromatography. n-Butane was the major substance among the volatiles found in the tissues of cases 1 and 2, and propane was the major substance in case 3. A combination of the autopsy findings and the gas analysis results revealed that the cause of death was ventricular fibrillation induced by hard muscle exercise after gas inhalation in cases 1 and 2, and that the cause of death in case 3 might be hypoxia. It is possible that the victim in case 3 was under anesthetic toxicity of accumulated isobutane which is a minor component of liquefied petroleum gas.     

Development of fluorescent markers using polycyclic aromatic hydrocarbons with vaseline

Identifiable fluorescent markers were developed as tracers to tail suspects using phenanthrene, anthracene, fluoranthene, pyrene, perylene, and coronene in vaseline. Vaseline was used as a carrier of the marker. Of the six compounds in the vaseline, perylene and fluoranthene were readily observed under ultraviolet (UV) light at a wavelength of 365 nm. All six compounds were identified selectively and sensitively without interference of vaseline using a high performance liquid chromatograph (HPLC) with a fluorescence detector. The detection limit was much less than 1 ng, corresponding to that of the observation behavior under UV light. The results showed that each component with vaseline was more effective than the individual component for the delay in degradation. The case examples of the fluorescent markers are shown.     

Gc subtypes: demonstration using isoelectric focusing. Study of population and formal genetics

Gc-subtypes were determined by isoelectric focusing and immunfixation on samples from 492 unrelated blood donors from Berlin. The frequency of the three genes was found to be GcIF = 0.1270, GcIS = 0.6006, Gc2 = 0.2724. Analysis of 78 parents with 190 children did not show deviations from the expected mode of inheritance. Investigation of the adults from paternity cases and of their children on the other hand obtained similar results. No rare alleles were observed.     

Sudden death caused by tension pneumothorax after rupture of a thoracic aortic aneurysm. Case report

A rare case of fatal tension pneumothorax is reported. An aged Japanese man with marked subcutaneous emphysema of the neck was found collapsed in a betting office. He was ascertained to have left tension pneumothorax, based on radiographic examinations carried out before his death. At autopsy, severe pneumomediastinum was observed, and the descending thoracic aorta with a ruptured dissecting aneurysm was closely adhered to the left lung pleura. The hemorrhage spread into the pulmonary parenchyma and finally spouted out from the surface of the lung apex. Because the blood loss itself was not fatal in quantity, it is concluded that the patient died of tension pneumothorax caused by a lung penetration from the rupture of an aortic aneurysm.