Possible Fatal Acetaminophen Intoxication with Atypical Clinical Presentation

Acetaminophen or paracetamol, a commonly used over‐the‐counter analgesic, is known to elicit severe adverse reactions when taken in overdose, chronically at therapeutic dosage or, sporadically, following single assumptions of a therapeutic dose. Damage patterns including liver damage and, rarely, acute tubular necrosis or a fixed drug exanthema. We present a case of fatal acetaminophen toxicity with postmortem blood concentration 78 μg/mL and unusual clinical features, including a visually striking and massive epidermolysis and rhabdomyolysis, disseminated intravascular coagulation and myocardial ischemia. This case is compared with the most similar previous reports in terms of organ damage, clinical presentation, and cause of death. We conclude that a number of severe patterns of adverse effects to acetaminophen are emerging that were previously greatly underestimated, thus questioning the adequacy of the clinical spectrum traditionally associated with acetaminophen intoxication and leading to the need to review this spectrum and the associated diagnostic criteria.     

Postmortem Intervals in Mice Submerged in Aqueous Environments at 20°C

Aqueous submersion can impede decay and produce decomposition stages not seen in terrestrial burials. To further understand the variances, fifty-four mice were submerged in freshwater, marine water, and a control environment at 20°C. The mice displayed sequential stages at differing rates over 6 weeks. Regression plots and comparative t-tests demonstrated that internal putrefaction, weight difference, and abdominal circumference of the aqueous environments varied significantly from the control group. The aqueous subjects did not vary significantly from each other quantitatively. The postmortem intervals were not consistent regardless of temperature or environment although a clear variance was noted between the control and the submerged groups.     

EIIIA＋纤维连接蛋白在大鼠皮肤切创的表达

目的：探讨大鼠皮肤切创纤维连接蛋白EIIIA片段的表达与损伤时间的关系。方法取48只成年SD大鼠并切割大鼠背部皮肤致伤。于伤后即刻、0.5h、1h、2h、3h、4h、6h、8h共8个时间段分别处死大鼠,取其创伤周围皮肤,利用免疫组织化学方法和Western印迹法检测EIIIA＋纤维连接蛋白,观察其表达水平与损伤时间的关系。结果伤后即刻未出现EIIIA＋纤维连接蛋白的表达,伤后0.5 h,皮肤基底细胞开始出现阳性表达,随损伤时间的延长,阳性着色持续增强。 Western印迹法检测发现,所测得的相对光密度值随损伤时间的延长而逐渐增高。结论 EIIIA片段表达变化可以作为法医学早期损伤时间的推断指标。     

Evaluation of skin-related variants in African ancestry populations and their role in personal identification

Pigment-related genetic variants point out their role in personal identification as they can be considered predictors suitable for Forensic DNA Phenotyping (FDP) and mounting evidence suggest also their bio-geographic inferential power for gaining information about the individual geographical origin. As they could be regarded as AIMs (Ancestry Informative Markers) they are powerful tools for inferring genetic composition of admixed population. Despite the huge range of skin tones across our species, little is known about genetic basis in global population and particularly our knowledge is less precise for those showing a complex historical and genomic background. The current research aims to explore the allelic status in several SNPs mapped in selected genes known to be involved in skin pigmentation: OCA2, HERC2, SLC45A2, SLC24A5 and two intergenic regions between BEND7/PRPF18 and EIF2S2/ASIP. The genetic evaluation has been performed on selected African and African derived populations: Fon, Dendi, Bariba and Berba communities from Benin, and Afroecuadorians. Data integration has been made up merging genotypic results with available information from major biological data warehouse as Phase 3–1000 Genomes Project or International HapMap Project in order to obtain a selected populations panel useful for their use as inferential model training set to test the likelihood of correct assignment to geographically differentiated human groups. The proposed variants panel seems to properly interpret the geographic variation and some new interesting evidence could be pointed out in African mixed populations, that seem to be differentially distributed if the total panel is considered. Understanding human pigmentation architecture can provide fundamental insight into genetic interaction of complex traits and the relationship between environmental adaptation and population history. In addition, the results support the use of phenotypic inference along with bio-geographical ancestry information as valid auxiliary tools in personal identification.     

Introducing a semi-automatic method to simulate large numbers of forensic fingermarks for research on fingerprint identification

Statistical research on fingerprint identification and the testing of automated fingerprint identification system (AFIS) performances require large numbers of forensic fingermarks. These fingermarks are rarely available. This study presents a semi-automatic method to create simulated fingermarks in large quantities that model minutiae features or images of forensic fingermarks. This method takes into account several aspects contributing to the variability of forensic fingermarks such as the number of minutiae, the finger region, and the elastic deformation of the skin. To investigate the applicability of the simulated fingermarks, fingermarks have been simulated with 5-12 minutiae originating from different finger regions for six fingers. An AFIS matching algorithm was used to obtain similarity scores for comparisons between the minutiae configurations of fingerprints and the minutiae configurations of simulated and forensic fingermarks. The results showed similar scores for both types of fingermarks suggesting that the simulated fingermarks are good substitutes for forensic fingermarks.     

电流斑的环境扫描电镜X射线能谱分析

目的利用环境扫描电镜-X射线能谱仪(environmental scanning electron microscope and energydispersive X-ray microanalyser,ESEM-EDX)研究电流斑微观形态特征及元素构成,以期为电流斑及电击死的鉴定提供更准确、客观的依据。方法用ESEM-EDX检测5例电流斑的扫描电镜形态、金属颗粒的形态及其元素组成。结果电流斑及周围皮肤可见电穿孔、金属熔珠,熔珠主要由铁、铜、铝等常见金属元素和金、钛、钡等人体少见的金属元素构成。结论 ESEM-EDX检测可为电击死的鉴定提供客观的依据。     

不同高度钝力打击致大鼠皮肤与骨骼肌挫伤的对比

目的探讨不同高度钝力打击下,皮肤与骨骼肌挫伤后的修复过程差异。方法采用自主设计的自由落体打击装置,以打击高度为主要损伤程度考量因素,将自由落体从15、30、50 cm高度打击造成SD大鼠下肢三种不同程度的挫伤。采用组织形态学方法观察损伤后6 h、24 h、3 d、7 d、13 d皮肤及肌肉的修复过程。结果三个打击高度引起实验大鼠下肢挫伤,基本都可形成皮下组织和(或)肌肉内的出血,在伤后24h内修复的过程基本类似,但表现程度随打击高度增加而明显;15 cm挫伤组在3 d时出血区红细胞已基本融解消散,而30 cm挫伤组则延迟至7 d;伤后13 d时,15 cm和30 cm挫伤组表现基本类似,但50 cm挫伤组则仍处于增生旺盛期。结论随着打击高度的增加,皮肤及肌肉同时出血的比例明显增加,挫伤后组织修复的炎症反应、增生反应表现逐渐加重,修复的过程也出现相应的延长。综合法医学实践应用以及本研究结果,推荐以50 cm高度所致挫伤(2.58 J/cm~2)作为今后挫伤损伤时间研究的实验动物参考模型。     

Ochronosis Presenting as Methemoglobinemia

Ochronosis is the blue‐gray discoloration of collagen‐containing tissues due to homogentisic acid (HGA) deposition, secondary to endogenous alkaptonuria or exogenous enzyme inhibition. In renal disease, accumulation of HGA in serum can cause methemoglobinemia. A 60‐year‐old woman with renal disease and anemia presented with 3 days of weakness and months of gray skin discoloration. Her hemoglobin was 8.1g/dl with 24.5% methemoglobin. Despite treatment with methylene blue, exchange transfusion, and continuous renal replacement therapy, the patient died. Autopsy revealed gray discoloration and ochronotic pigment in the ribs and cartilage. Based on these findings, the patient was diagnosed with ochronosis, suggestive of alkaptonuria, complicated by methemoglobinemia. The differential diagnosis for blue‐gray skin discoloration includes argyria, methemoglobinemia, and ochronosis. This patient's clinical and autopsy findings suggested alkaptonuria complicated by methemoglobinemia due to progressive renal dysfunction. Development of methemoglobinemia in the setting of chronic skin discoloration and renal failure should prompt consideration of alkaptonuria.     

皮肤切创愈合中caspase-3表达的免疫组化研究

目的探讨皮肤切创损伤愈合过程中,caspase-3在损伤区内的表达以及不同损伤时间caspase-3的变化规律。方法应用免疫组织化学技术对33例不同损伤时间小鼠皮肤切创组织中caspase-3的表达进行研究。同时以3例非切创小鼠皮肤组织做对照。结果伤后6h的损伤皮肤组织中可见少量中性粒细胞表达caspase-3,伤后12～24h,大部分浸润的中性粒细胞及部分单核细胞为caspase-3阳性。随伤后时间延长,caspase-3阳性细胞以单核细胞及成纤维细胞为主。伤后0～3h,caspase-3阳性细胞比率较低,为(4.53±6.53)%,12h后逐渐增加,伤后3d达高峰,为(62.66±4.84)%,其后逐渐下降。结论小鼠皮肤损伤愈合过程中,caspase-3可能在诱导损伤区内中性粒细胞、单核巨噬细胞及成纤维细胞发生凋亡过程中发挥重要作用,同时,caspase-3的规律性表达可用于损伤时间的推断。     

电感耦合等离子体质谱法检测电流损伤皮肤中金属元素

目的探讨应用电感耦合等离子体质谱(inductively coupled plasma mass spectrometry,ICP-MS)技术检测电流损伤皮肤中金属元素的可行性,建立检测电流损伤皮肤中金属元素的方法。方法用黄铜、紫铜、铝、铁电极材料以220V交流电电击家兔后肢,ICP-MS对电流损伤皮肤中金属元素进行检测。结果与对照组比较:黄铜电击组皮肤中的Cr、Ni、Cu、Zn、Pb含量升高(P0.05),紫铜电击组皮肤中的Cr、Cu、Pb含量升高(P0.05),铝电击组皮肤中的Al、Cr、Mn、Co、Ni、Cu、Pb含量升高(P0.05),铁电击组皮肤中的Cr、Mn、Fe、Ni含量升高(P0.05)。不同电极材料电击后皮肤中元素种类及含量也存在明显差异。结论ICP-MS可作为检测电流损伤皮肤中金属元素的有效方法,且可应用于触电材料的推断。