A Rare Case of Sudden Death Due to Hypotension during Cesarean Section in a Woman Suffering from Pheochromocytoma and Neurofibromatosis

Sudden death following acute hypotension due to an undiagnosed pheochromocytoma (PHEO) is a rare event. Moreover, histopathology of the myocardium in such cases is rarely reported. We present a case of a woman who died during delivery. A 37‐year‐old parturient, who was 38 weeks pregnant, suffering from neurofibromatosis underwent a cesarean section following peridural anesthesia. Acute hypotension, acute intra‐operative pulmonary edema and supraventricular paroxysmal tachyarrhythmia occurred during delivery, followed by death. The autopsy revealed the presence of a PHEO, confirmed immunohistochemically with chromogranin‐A (CgA), CD20 antibody (L26), anti‐Keratocan antibody (KER‐1) and neuron‐specific enolase (NSE), and a PHEO‐induced cardiomyopathy. The physiopathology of both stress‐induced cardiomyopathy and PHEO‐induced cardiomyopathy, as well as the role of anesthesia in provoking the death, are discussed. The association of an undiagnosed PHEO with neurofibromatosis as the cause of sudden death in pregnancy is an obstetric urgency that raises forensic pathology issues.     

中国汉族人耻骨性别判定的研究

目的为了探讨耻骨性别判定的更为简便可靠的方法。方法对96副已知生前确切性别的耻骨进行了性别差异的研究,其中男性耻骨73副,女性耻骨23副。测量项目有:缘枝角,耻骨宽,耻骨联合面的高及厚。结果将耻骨的测量数据输入电脑,用SPSS软件,对耻骨的测量数据进行了统计分析,建立了耻骨性别判定的判别方程。结论其性别判别率最高可达95.5%,该方法可以用于法医学实践。     

A New Method for Determination of Postmortem Interval: Citrate Content of Bone*

Abstract: Few accurate methods exist currently to determine the time since death (postmortem interval, PMI) of skeletonized human remains found at crime scenes. Citrate is present as a constituent of living human and animal cortical bone at very uniform initial concentration (2.0 ± 0.1 wt %). In skeletal remains found in open landscape settings (whether buried or not), the concentration of citrate remains constant for a period of about 4 weeks, after which it decreases linearly as a function of log(time). The upper limit of the dating range is about 100 years. The precision of determination decreases slightly with age. The rate of decrease appears to be independent of temperature or rainfall but drops to zero for storage temperature <0°C.     

Sampling and statistical considerations for the Suchey–Brooks method for pubic bone age estimation: Implications for regional comparisons

Although the Suchey–Brooks (SB) system is currently the most widely used method for age-at-death estimation from the pubic bone, the system continues to evolve through stepwise improvements. Since the system was developed from a pubic bone sample derived mainly from North Americans, it is unclear how well it performs on populations from other continents. During the last decade, studies of the SB system on pubic bone samples from local populations in Europe and Asia have indicated regional differences in the relationship between age and pubic bone development. However, these studies have for the most part followed different research protocols, which make comparisons between their results less meaningful. It would be most useful if future regional analysis of the SB system were done in a rigorous and uniform fashion, following standard procedures. In this paper, sampling and statistical considerations are outlined that hopefully will help to standardize research on the SB system.     

产志贺毒素Ⅱ型变异体大肠杆菌LAMP检测方法的建立

为建立产志贺毒素Ⅱ型变异体(Stx2e)大肠杆菌的环介导恒温扩增(LAMP)检测方法,参照Gen-Bank中12条Stx2e序列和9条Stx2序列,针对Stx2e基因保守区域设计并合成4条引物,分别进行了反应条件优化、特异性试验、敏感性试验及模拟样品检测。结果显示,用所建立的LAMP方法对阳性样品扩增所得产物电泳后呈特征性梯状条带,阴性样品的扩增产物电泳后均无扩增条带。建立的LAMP方法对Stx2e+大肠杆菌的最低检出量为38CFU/管,敏感性高于PCR方法(3.8×103CFU/管)。LAMP和PCR对模拟样品检测结果的符合率为100%。该研究为仔猪水肿病的诊断和Stx2e+大肠杆菌的快速检测提供了新的方法。     

The effects of corrosive substances on human bone, teeth, hair, nails, and soft tissue

Abstract: This research investigates the effects of household chemicals on human tissues. Five different human tissues (bone, tooth, hair, fingernails, and skin/muscle/fat) were immersed into six different corrosive agents. These agents consisted of hydrochloric acid, sulfuric acid, lye, bleach, organic septic cleaner, and Coca‐Cola^® soda. Tap water was used as a control. Tissue samples were cut to consistent sizes and submerged in the corrosive liquids. Over time, the appearance, consistency, and weight were documented. Hydrochloric acid was the most destructive agent in this study, consuming most tissues within 24 h. Sulfuric acid was the second most destructive agent in this study. Bleach, lye, and cola had no structural effects on the hard tissues of the body, but did alter the appearance or integrity of the hair, nails, or flesh in some way. The organic septic cleaner and tap water had no effect on any of the human tissue tested during the timeframe of the study.     

A method for studying knife tool marks on bone

The characteristics of knife tool marks retained on hard tissues can be used to outline the shape and angle of a knife. The purpose of this study was to describe such marks on bone tissues that had been chopped with knives. A chopping stage with a gravity accelerator and a fixed bone platform was designed to reconstruct the chopping action. A digital microscope was also used to measure the knife angle (θ) and retained V-shape tool mark angle (ψ) in a pig skull. The κ value (elasticity coefficient; θ/ψ) was derived and recorded after the knife angle (θ) and the accompanied velocity were compared with the proportional impulsive force of the knife and ψ on the bone. The constant impulsive force revealed a correlation between the V-shape tool mark angle (ψ) and the elasticity coefficient (κ). These results describe the tool marks--crucial in the medicolegal investigation--of a knife on hard tissues.     

正常鼻骨细微解剖结构的MSCT影像学形态及法医学鉴定

目的：通过对正常鼻骨多层螺旋CT （multi-slice spiral CT,MSCT）扫描及三维图像特征的观察,总结鼻骨细微解剖结构。方法对120例鼻骨无外伤史、无疾病史的志愿者行鼻区MSCT横断面扫描,重建层厚0.6 mm、层距0.5 mm的骨窗图像并导入Syngo Imaging XS软件中,进行三维图像重组。观察并分析鼻骨细微解剖结构的形态特征。结果正常鼻骨的细微解剖结构由四缝、两孔及一缘组成。其中四缝包括左、右鼻颌缝,鼻额缝以及鼻间缝,两孔为左、右鼻骨孔,一缘是鼻骨下缘。在某些个体,鼻间缝间会出现游离的缝间骨。鼻骨孔多为小孔状,但也有少数个体为线条状。鼻骨下缘可分为平直型、波浪型、倒尖峰型、月牙铲型以及其他类型。结论鼻骨解剖形态多样化且个体差异性较大,采用MSCT及三维图像重组技术,结合其外伤史有利于正确分辨鼻骨正常解剖结构和骨折。     

Human coxal bone sexual dimorphism and multislice computed tomography: geometric morphometric analysis of 65 adults

The authors studied sexually dimorphic differences in coxal shape using geometric morphometric analysis of 15 osteometric landmarks recorded by multislice computed tomography (MSCT), based on three-dimensional reconstructions of 65 Caucasian adults. Geometric morphometric analysis, principal component analysis, canonical variates analysis, and other discriminant analysis (Goodall's F-test and Mahalanobis distance) were performed for the three separate bones of the left innominate (pubis, ilium, and ischium), the modified pubis (pubis and ischiopubic ramus), the modified ilium (ilium and ischial spine), three bone complexes (ischiopubic, iliopubic, and ilio-ischial), and the complete innominate. A cross-validation test was also performed. All areas studied were dimorphic, but results for sexual dimorphism in decreasing order were as follows: the modified pubis, followed by the ischiopubic complex, the iliopubic complex and the complete innominate, the pubis, the modified ilium, the ilio-ischial complex, the ilium, and finally the ischium. These results show the potential of this approach for future anthropological research.     

Gunshot residues on dry bone after decomposition-a pilot study

Abstract: Very little literature exists concerning radiochemical and microscopic analyses of gunshot wounds in decomposed material, and even less concerning skeletonized samples; the most advanced technologies may provide useful indications for the diagnosis of suspect lesions, especially if gunshot wounds are no longer recognizable. However, we know very little of the survival of gunshot residues (GSR) in skeletonized samples. This study examined nine gunshot wounds produced on pig heads which then underwent skeletonization for 4 years, and four gunshot entries on human heads from judicial cases which were then macerated to the bone in water; the samples underwent scanning electron microscopy coupled with energy dispersive X‐ray (SEM‐EDX) analysis. Positive results for GSR were observed only in four of the nine animal samples and in all four human samples. Among the human samples, two lesions showed Pb and Sb, one lesion only Pb, and one Pb, Sb, and Ba. This pilot study showed the survival of GSR in skeletal material and therefore the crucial importance of SEM‐EDX analyses on skeletonized material. Further studies are needed in order to ascertain the role of environmental modifications of GSR.