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371.
372.
Nadia Arbouche PhD Alexis Walch MD Jean-Sébastien Raul PhD Pascal Kintz PhD 《Journal of forensic sciences》2023,68(3):1077-1083
Insulin glargine is a long-acting insulin analog that is converted after enzymatic cleavage of the arginine pair of the β-chain into its main metabolite M1 (21A-Gly-insulin), which is responsible for the hypoglycemic activity. In all the overdose cases described in the literature, only M1 concentrations have been reported, whereas insulin glargine was always absent or below the limit of quantitation. In this study, we present a case of suicide of a young nurse by injection of insulin glargine in which the parent molecule was found at a toxic concentration in blood. The determination and the discrimination of insulin glargine from human insulin and other synthetic analogs in the blood specimen were performed by liquid chromatography coupled to high-resolution mass spectrometry (Waters XEVO G2-XS QToF) and extraction after precipitation in the presence of bovine insulin (internal standard), with a mixture of acetonitrile/methanol +1% formic acid followed by purification on solid phase extraction cartridges C18. Glargine insulin tested highly positive in the blood with a concentration of 1.06 mg/L. Due to the difficulty in obtaining a M1 pure standard, the metabolite could not be dosed. This unique presence of the parent molecule, reported for the first time, can be explained by inter-individual variability in the rate of conversion to metabolite. Intravenous injection versus subcutaneous injection can also explain the presence of insulin glargine. Finally, the dose injected may have been so high that saturation of the proteolytic enzymes responsible for conversion to M1 should have occurred. 相似文献
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Ashley L. Lukefahr MD Jennifer M. Vollner PhD Bruce E. Anderson PhD David C. Winston MD PhD 《Journal of forensic sciences》2021,66(1):229-235
“Bullet wipe” is the material deposited by a bullet on any surface with which it comes into contact after it is fired and may contain debris from the gun barrel, including particles of primer and metal fragments from previously fired bullets. X‐ray analysis is a non‐destructive method by which traces of metallic elements can be visually detected. The analysis of osseous defects for radiodense bullet wipe (RBW) assists in determining the presence or absence of perforating gunshot wounds, especially in fragmented, skeletonized remains. The aim of our current study was to determine the frequency of RBW around entrance firearms injuries that perforated bone. We prospectively analyzed entrance gunshot wounds for RBW over a three‐year period using digital X‐ray analysis (n = 59). We retrospectively reviewed the corresponding autopsy reports to determine the frequency of RBW by biologic sex, reported ancestry, age‐at‐death, location of wound, manner of death, range of fire, bullet caliber, and presence of bullet jacket. Data were analyzed by Fisher's exact test or Chi‐square test with significance levels accepted at p < 0.05. RBW was present in 66% (n = 39) of examined cases. Decedent characteristics did not significantly alter RBW distribution, including biologic sex (p = 0.75), reported ancestry (p = 0.49), and age‐at‐death (p = 0.43). Additionally, the location of the osseous entrance gunshot wound, manner of death, range of fire, and cartridge caliber did not affect RBW detection. All cases involving non‐jacketed rounds (n = 5) showed RBW (p = 0.30). To our knowledge, this study is the first to report the frequency of RBW detection from osseous entrance gunshot wounds. 相似文献
375.
Adam H. Richard M.A. Jack Hietpas Ph.D. JoAnn Buscaglia Ph.D. Keith L. Monson Ph.D. 《Journal of forensic sciences》2019,64(1):98-107
A study was undertaken using nonhuman mammal specimens to better understand environmental influences on postmortem hair root band (PMRB) formation and to see whether PMRBs would occur in nonhuman mammal hairs in a similar fashion to human hairs. Carcasses from surrounding roadways were the primary source of specimens for this study, augmented by donated deceased domestic pets. Sections of pelt from each specimen were placed in controlled environmental conditions while the remainder of the carcass was left in a secure outdoor setting. Hair samples were collected daily from outdoor and control specimens and examined for evidence of PMRBs. Several environmental factors were also recorded on a daily basis. Results demonstrate PMRBs can occur in nonhuman mammal hairs, and they have microscopic characteristics similar to human PMRBs. Factors found to correlate with PMRB formation include postmortem interval, temperature, pH, and the formation and subsequent volatilization of ammonia from the surrounding tissue. 相似文献
376.
The recognition and visualization of an arterial gas embolism are difficult. We report a case of sudden death caused by paradoxical air embolism of coronary and cerebral arteries, diagnosed by the pre autopsy computed tomography (CT) scanning. A 54-year-old woman suddenly died after the self-removal of the jugular vein catheter. Postmortem imaging examination using CT scanning showed multiple gas embolisms in the cerebral arteries, pulmonary artery, right atrium and ventricle, left ventricle, aorta, and coronary arteries. These findings suggested that the occurrence of acute ischemia of the brain and heart caused by massive air inflow to the artery. Conventional autopsy revealed a patent foramen ovale of the heart. These results indicated that the patient died of paradoxical air embolization of the coronary and cerebral arteries through a patent foramen ovale because of right-to-left shunting. The use of postmortem imaging as an aid for conventional autopsy has proved to be of advantage in the case of gas embolism. 相似文献
377.
Today, little is known about the bacteriological environment of the autopsy room and its potential interest for medico-legal practices. Seven hundred fifty microbiological samples were taken from surface (n = 660), air (n = 48), and water (n = 42) to evaluate it in a French University Forensic Department. Median bacterial counts were compared before and during autopsy for air samples, and before and after autopsy for surface samples, using Wilcoxon matched pairs signed ranks test. Bacterial identification relied on traditional phenotypic methods. Bacterial counts in the air were low before autopsy, increased significantly during procedure, and seemed more linked to the number of people in the room than to an important production of aerosol-containing bacteria. Despite cleaning, human fecal flora was omnipresent on surfaces, which revealed insufficient disinfection. Bacteriological sampling is an easy way to monitor cleaning practices in postmortem rooms, but chiefly a way to improve the reliability of medico-legal proofs of infectious deaths. 相似文献
378.
家兔死后离体血液ATP含量变化与放置时间的关系 总被引:1,自引:1,他引:0
目的探讨恒温(25℃)条件下家兔死后离体血液ATP含量变化与放置时间的关系。方法健康家兔8只,空气栓塞处死后即刻取右心室血液,置于25℃恒温水浴槽中,每4h应用ATP荧光快速检测仪检测血液ATP含量,所得数据应用SPSS17.0统计学软件进行方差检验及回归分析。结果恒温(25℃)环境下,家兔死后离体血液的ATP含量,在8h内从死后即刻的2.46×10-12mol/L升至3.09×10-12mol/L,8h之后则随PMI的延长而下降,直至56h,56~72h ATP含量在0.13×10-12mol/L时趋于稳定。以Log[ATP]为因变量(y),离体放置时间为自变量(x),对死后0~56h的数据进行回归曲线分析,建立了3个推断离体时间方程,即y=-0.019x-11.359(R2=0.763)、y=0.001x2+0.016x-11.666(R2=0.962)和y=-1.281×10-5x3-0.007x-11.576(R2=0.980),其中三元回归方程的系数为0.980,曲线拟合度最好。结论家兔离体血液ATP含量变化与放置时间呈现一定的规律性,有望应用于死亡时间推断。 相似文献
379.
380.
Flach PM Ross SG Bolliger SA Ampanozi G Hatch GM Schön C Thali MJ Germerott T 《Journal of forensic sciences》2012,57(5):1376-1380
Postmortem computed tomography (pmCT) and pmCT angiography (pmCTA) provide a minimally invasive method to determine the cause of death. Postmortem image-guided biopsy allows for precise sampling of histological specimens. This case study describes the findings of lethal systemic fat embolism (FE) on whole-body unenhanced pmCT, pmCTA, and image-guided biopsy, with autopsy and histopathologic correlation. Unenhanced pmCT revealed a distinct fat level on top of sedimented layers of corpuscular blood particles and serum in the arterial system and pulmonary trunk. Subsequent pmCTA showed reproducible results, and image-guided biopsy confirmed fatal FE. pm CT/pmCTA combined with image-guided biopsy established the cause of death as right heart failure as a result of systemic fatal FE prior to autopsy. All imaging findings were consistent with traditional autopsy and histological specimens. This unique case demonstrates new imaging findings in massive, fatal FE and highlights that postmortem imaging, supplemented by image-guided biopsy, may detect the cause of death prior to traditional autopsy. 相似文献