Sudden natural death 'at the wheel': a retrospective study over a 15-year time period (1982-1996).

In order to investigate the incidence and implications of sudden natural death at the wheel, a retrospective study was carried out over a 15-year time period ranging from 1982 until 1996. During this time period 147 drivers of motor vehicles were found out of 34,554 cases examined at the Institute of Legal Medicine, Ludwig-Maximilians University, Munich, Germany. There were 13 females and 134 males and the mean age was 56.8 years (range 20-86 years). The main cause of death was ischemic heart disease which was found in 113 cases. There were mainly minor injuries to the driver, or to other passengers, or to other road users and only minor property damage. Our study confirms previous investigations that sudden natural death at the wheel is a rare event in proportion to unnatural death at the wheel and is not a substantial threat to other road users. Despite existing guidelines for granting a driving licence, medical screening to exclude high risk patients from driving cannot prevent the occurrence of sudden natural death at the wheel.     

Unexpected death in persons with symptomatic epilepsy due to glial brain tumors: a report of two cases and review of the literature.

Two cases of unexpected death in persons with epileptic seizures due to a brain tumor are presented which encompassed an astrocytoma WHO grade II and an anaplastic astrocytoma WHO grade III. A 35-year-old man was found somnolent and disoriented at home. A computed tomography (CT) scan revealed a tumor of the right frontal lobe suggestive for an oligodendroglioma. During an angiographic examination the patient experienced an epileptic seizure. Some weeks later, the man was found dead in front of his house with a fresh bite mark of the tongue. Neuropathological examination revealed an astrocytoma WHO grade II of the right frontal lobe. A 47-year-old man plunged into a swimming-pool and was found submerged some minutes later. After resuscitation he survived comatose for 8 days but finally died due to severe hypoxic brain damage. He had been operated on a brain tumor of the temporal lobe 1 year before the accident. Neuropathological examination revealed residual tumor tissue at the operation site corresponding to an anaplastic astrocytoma WHO grade III. Although rare, death in persons with epileptic seizures due to brain tumors is an important mechanism of death encountered by the forensic pathologist.     

Analysis of psilocybin and psilocin in Psilocybe subcubensis Guzmán by ion mobility spectrometry and gas chromatography-mass spectrometry

A new method has been developed for the rapid analysis of psilocybin and/or psilocin in fungus material using ion mobility spectrometry. Quantitative analysis was performed by gas chromatography-mass spectrometry after a simple one-step extraction involving homogenization of the dried fruit bodies of fungi in chloroform and derivatization with MSTFA. The proposed methods resulted in rapid procedures useful in analyzing psychotropic fungi for psilocybin and psilocin.     

Juvenile Justice and the 'Shift to the Left'

The notion of 'shift' is used as a symbol for procedure in criminal cases, understood as a sequence of legal interferences by the police, the prosecution and by proceedings in court. If this sequence is symbolised by a horizontal line, the procedural stages move from left to right. But the distribution of competences has recently lost its prior balance, due to 'modern' crime and society: The functions of the judge appear reduced, whereas the range of action of the prosecution has widened; also the police has gained more influence. On the symbolic line of procedural stages this all makes for a 'shift to the left'. This paper deals with the question as to whether juvenile justice is undergoing the same changes. The first answer is 'yes', based on the enlarged diversionary competence of prosecutors and the police. From a different perspective, however, juvenile offending is a 'natural' phenomenon connected with young age, which a priori places juvenile justice on a 'left' position of the imagined line. A plea is made for this juvenile justice to stick to its inherent concern for young offenders individually and not to sacrifice this to collective interests in public order and safety.     

Data on the PCR Turkish population based loci: LDLR, GYPA, HBGG, D7S8, and Gc

Allele and genotype frequencies for the five PCR-based loci were analyzed in 157 unrelated Turkish individuals. The five PCR-based loci included LDLR, GYPA, HBGG, D7S8, and Gc. The results of the chi-square and exact tests showed that the genotype distribution at the LDLR, GYPA, D7S8, and Gc loci did not significantly differ from the Hardy-Weinberg Expectation (HWE). However, the genotype distribution at the HBGG locus did not conform to HWE. Moreover, the genotype frequencies calculated in this study were compared with the published genotype frequencies of US African American and US Caucasian populations. The Turkish population was significantly different at the HBGG locus from the US Caucasian population. However, there were highly significant differences at the LDLR, HBGG, and Gc loci between the Turkish and African American populations.     

Unusual injury pattern in a case of postmortem animal depredation by a domestic German shepherd.

A case is presented of a 38-year-old woman with skeletization of the head, neck, and collar region and a circumscribed 26-cm x 19-cm defect on the left chest with sole removal of the heart through the opened pericardium but undamaged mediastinum and lungs. The injuries showed V-shaped puncture wounds and superficial claw-induced scratches adjacent to the wound margins that have been described as typical for postmortem animal depredation of carnivore origin and derived from postmortem animal damage by the woman's domestic German shepherd. The circumscribed destruction of the left chest with unusual opening of the pericardium is explained by the physiognomy of the muzzle of the German shepherd and differs from previous reports. Any case presented as postmortem animal mutilation should be viewed with skepticism and undergo a full autopsy.     

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.     

A distant-range, suicidal shotgun wound of the back

The case being reported is one of a shotgun fatality with a thoracic back wound. A 23-year-old man was shot from a distance with trajectories going from back to front and on a nearly horizontal level. These findings observed in the autopsy could represent homicide, but scene investigation and police records were interpreted and it became clear that the case was suicide. Thus, this case shows that the determination of the manner of death requires a careful forensic investigation including autopsy findings, scene investigation, and reconstruction of the events.     

The influence of site of collection on postmortem morphine concentrations in heroin overdose victims

When assaying for postmortem morphine concentration, significant site sampling variability exists between central and peripheral sampling sites and even within sampling regions of the body. To study the variation, 76 suspected heroin overdoses were identified. Each had femoral artery (FA) and vein (FV), left and right ventricle and pooled heart blood samples obtained at autopsy. Forty-four tested positive for morphine. Morphine concentrations were determined by gas chromatography/mass spectrometry, with sampling site differences reported as log-transformed ratios and compared by signed rank test.The mean FA to FV ratio for total morphine was 1.2 (range 0-4.5). The ratio for left heart to right heart total morphine was 1.1 (range 0.4-3.2). Left ventricular to FV total morphine ratio was 2.0 (range 0.6-6.9). In these opioid overdose deaths, FA and FV morphine concentrations are usually similar, although up to 4.5-fold differences were noted. Centrally obtained morphine concentrations are on average twice as high compared with peripheral morphine concentrations. Left and right ventricular morphine concentrations were usually similar, although up to 3.2-fold differences were noted (left side higher).