Evaluating the Potential for Unintentional Occupational Exposure to Fentanyl and Fentanyl Analogues Among Medicolegal Death Investigators and Autopsy Technicians

Recent increases in deaths in the United States from synthetic opioids such as fentanyl and fentanyl analogues (fentanyls) have raised concerns about possible occupational exposures to these potent agents. Medicolegal death investigators and autopsy suite staff might perform job tasks involving exposure to fentanyls. The potential for exposure to fentanyls among medicolegal death investigators and autopsy technicians at a state medical examiner's office was evaluated through review of caseload characteristics, injury and illness logs, and procedures and policies and discussions with management and employee representatives. The evaluation showed that this medical examiner's office had low potential for work-related exposure to fentanyls; its standard operating procedures and personal protective equipment requirements should reduce the potential for occupational exposure. Medicolegal death investigation agencies can develop and implement guidance to control exposures and provide workforce education and training to reduce the potential for work-related exposure to fentanyls.     

Sudden Death Caused by Rupture of Spontaneous Ductus Arteriosus Aneurysm in an Adult

A 55-year-old man complained of sudden onset of severe neck pain. This was followed by prompt loss of consciousness and death. Autopsy revealed rupture of a saccular aneurysm, which was considered to have resulted from enlargement of the remaining ductal tissue, and was located on the medial aspect of the uppermost portion of the descending aorta. Dense blood extravasation was noted in the posterior mediastinum and extending to the strap muscles of the neck and larynx. Histological examination of the rupture site revealed disappearance of the medial elastic fibers and thickened intima covered with dense fibrous tissue. Spontaneous ductus arteriosus aneurysm in adults is a rare finding, but widespread use of imaging technologies has revealed that it develops more frequently than previously recognized. Fatal complications may occur even when the aneurysm is relatively small. Therefore, pathologists should be aware of this aneurysm as a potential cause of sudden death.     

Fatal Methemoglobinemia Due to Acute Inhalation of Methyl Nitrite in an Industrial Accident

Methyl nitrite is suggested to cause methemoglobinemia by generating methemoglobin, which may be lethal when the methemoglobin concentration exceeds 70%. However, intoxication with methyl nitrite is seldom reported compared with that with other nitrites. Here, we present an industrial accident involving methyl nitrite inhalation during its synthesis process that resulted in three fatalities and one survivor. The autopsy revealed conspicuous blue-gray discoloration in various parts of the body, including the skin, airway mucosa, vessels, brain, heart, and among other areas. The toxicological tests on the deceased showed methemoglobin concentrations in the blood over the lethal level and increased nitrite ion levels in the blood, gastric contents, liver, and lung tissue compared with those in control samples. The cause of death was determined to be methemoglobinemia-induced hypoxia due to methyl nitrite inhalation. This report provides evidence that in methyl nitrite intoxication, exposure duration has a significant influence on the postmortem changes and likelihood of a fatal outcome may be related to the age of the victim. More attention is required regarding the industrial hazards of this substance.     

多层螺旋CT检查在尸体颈椎损伤中的应用

对需要在尸体检验时进行颈椎多层螺旋CT(MSCT)检查的情形进行讨论,研究利用MSCT对疑有颈椎损伤的尸体进行颈椎检查的方法,并对一例疑似颈椎损伤尸体的颈椎提取后进行MSCT检查。发现对疑似有颈椎骨折尸体提取颈椎进行MSCT检查,可以快速精确地显示颈椎的细微骨折及骨折的空间分布,从而推断致伤方式。解决了传统尸检中费时费力,容易漏诊和误诊的问题。     

交通肇事逃逸性质研究

交通肇事罪已成为一种高发犯罪,其行为本身造成的人身财产损失已令人痛心,而逃逸行为更是为良知和法律所不能容忍。从逃逸行为被纳入刑法的调整范围到最高人民法院司法解释的逐渐细化,逃逸问题凸显其重要性。然而,由于立法技术的问题,司法解释规定逃逸的相关条款在实践应用中问题频出。所以,很有必要还原逃逸行为本来之面目,对逃逸行为进行细致研究和重新厘清。     

Assessing Local Government Capacity for Implementing Sustainable Transportation: The Role of Political Culture

Transportation development increasingly relies on local governments to implement sustainable strategies, yet implementation success varies widely. This begs an important question, why are some cities successful and others not? In response, this study focuses on the political culture characteristics of city leadership and staff pertaining to sustainable transportation. Employing semi-structured interviews with officials in two case study cities—Pomona and Pasadena, California—the study identifies and traces the impact of cultural characteristics on network interactions and the resulting transportation innovation. Finally, this research suggests key political and department characteristics that contribute to political cultures that facilitate sustainable transportation development.     

3D Finite Element Model of Human Knee Injuries in the Traffic Accident

Objective To explore the injury mechanism of the human knee in a traffic accident by estab lishing a 3D finite element （FE） model. Methods The FE model, composed of femur, tibia, fibula, patel la, meniscus, knee ligaments and surrounding soft tissues, was reconstructed by CT scanning data from a male volunteer. Validation was performed by the lateral impact simulation, and the stress and strain re sults were obtained to be compared with those previously reported for injury prediction. Results The re suits derived from the FE model were found to be similar with those previously reported, most of the ligaments and meniscus wounded at 40 m/s collision, which was readily observed. Conclusion The simu lation results generated by FE model can be effectively used for the injury mechanism analysis of initial contact.     

血管内皮细胞生长因子的研究及应用

血管内皮细胞生长因子(VEGF)是一种特异作用于血管内皮细胞的多功能细胞因子,它促使血管内皮细胞分裂增殖、增生、转移,增加血管通透性并促进新血管生成,参与体内的多种生理、病理过程,在临床医学上已获得较多应用,在法医病理学方面将有广泛的应用前景。     

浅析“入户抢劫“和“在公共交通工具上抢劫“

正确界定“户”和“公共交通工具”,对分别认定“入户抢劫”和“在公共交通工具上抢劫”犯罪 ,保障公民的人身安全 ,打击犯罪分子具有现实意义