A Census of Medicolegal Death Investigation in the United States: A Need to Determine the State of our Nation’s Toxicology Laboratories and Their Preparedness for the Current Drug Overdose Epidemic

In 2007, the Bureau of Justice Statistics reported on 2004 data collected from the Census of Medical Examiner and Coroner Offices (CMEC). The CMEC was one of the first comprehensive reports on the state of the medicolegal death investigation system in the United States and included information on administration, expenditure, workload, specialized death investigations, records and evidence retention, and resources. However, the report did not include responses on questions that were related to toxicology such as specimen retention and type of testing. The purpose of this publication is to provide the community with toxicology laboratory-specific responses from nearly 2000 medical examiner and coroner (MEC) offices. Data obtained from a BJS CMEC public use dataset for any remaining information that was not reported in the 2007 BJS report were evaluated specific to the operation of toxicology laboratories within a MEC office or specific to toxicology testing. The CMEC includes information on average operating budget for MEC offices with internal or external toxicology services, budget for toxicology/microbiology services, respondents’ routine uses of toxicology analysis, toxicology specimen retention time, average turnaround times, use of computerized information management systems, and participation in federal data collections. These historical data begin to address the present state of our nation’s toxicology laboratories within the medicolegal death investigation system and their preparedness for the current drug overdose epidemic.     

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.     

无言大地的生命悲歌——浅谈莫言作品的主题蕴含

莫言的作品在历史背景下述说着中华民族的过往,它能深入到我们选择性遗忘的历史图景让我们在其作品的死亡意识和生殖崇拜下去解读莫言及其作品的生命意识,他以鲜明的色彩,大胆的叙述去体悟大地民间的生命强力,莫言代大地立言,去为失去话语权的人们唱响生命的悲歌。     

大鼠脑挫伤后脑组织COX-1/COX-2的表达

目的　观察脑损伤后COX 1和COX 2蛋白表达及其时序性变化 ,探讨脑损伤的分子机制及法医学脑损伤时间推断。方法　以自由落体撞击雄性SD大鼠右顶叶制备脑挫伤模型 ,用免疫组织化学SP法处理脑组织检材 ,观察不同时间 ( 1、 3、 5、 7、 14d)脑组织COX 1/COX 2蛋白的表达情况。结果　正常及手术对照组大鼠 ,脑组织内有低水平的COX 1/COX 2表达 ;脑挫伤后 1～ 5d ,大鼠脑组织内COX 1表达逐渐增加 ,14d时仍维持在高表达水平 ;脑挫伤后 1～ 3d ,大鼠脑组织皮质内COX 2表达逐渐增加 ,1d时海马COX 2表达达高峰。结论　脑挫伤后可诱导COX 1/COX 2蛋白在脑内表达 ,并呈现出时序性变化。     

涉及死亡非医疗过失纠纷的类型,死因和发生原因——27年医疗纠纷法医尸检回?

对1992～1998年间206例非医疗过失尸检资料进行回顾性研究,表明涉及死亡的非医疗纠纷中各类疾病死亡占53.88%,难以避免的并发症占39.81%,医疗意外占6.31%.发生原因中对死因怀疑占44.66%,怀疑输液(血)错误占15.05%,怀疑治疗出问题占9.71%,怀疑用药错误或诊治延误各占8.74%,其它13.11%与医护人员态度不好、医院管理有关.     

冠心病猝死193例尸检分析

本文对193例因冠心病而猝死的尸检材料进行以分析,并对冠状动脉粥样硬化好发部位,病理改变,心脏病理变化,以及冠心病猝死发生机理和诱因等进行讨论。     

A Computational Framework for Age‐at‐Death Estimation from the Skeleton: Surface and Outline Analysis of 3D Laser Scans of the Adult Pubic Symphysis

In forensic anthropology, age‐at‐death estimation typically requires the macroscopic assessment of the skeletal indicator and its association with a phase or score. High subjectivity and error are the recognized disadvantages of this approach, creating a need for alternative tools that enable the objective and mathematically robust assessment of true chronological age. We describe, here, three fully computational, quantitative shape analysis methods and a combinatory approach that make use of three‐dimensional laser scans of the pubic symphysis. We report a novel age‐related shape measure, focusing on the changes observed in the ventral margin curvature, and refine two former methods, whose measures capture the flatness of the symphyseal surface. We show how we can decrease age‐estimation error and improve prior results by combining these outline and surface measures in two multivariate regression models. The presented models produce objective age‐estimates that are comparable to current practices with root‐mean‐square‐errors between 13.7 and 16.5 years.     

水通道蛋白-4研究进展及法医学意义

头颅创伤、脑卒中、脑肿瘤、缺血性脑损伤、出血性脑损伤均伴有脑水肿的发生，严重者可危及患者生命甚至造成死亡。水通道蛋白-4（Aquaporin-4）作为主要在脑组织中表达的水通道蛋白，起着调节脑内水转运的重要功能，参与脑水肿的病理生理过程，提示研究水通道蛋白-4表达水平可能为法医学外伤性脑损伤时间推断提供新的依据。     

人离体肝组织胺类产生与死亡时间和环境温度的关系

目的探讨在不同环境温度下,人离体肝组织中有机胺类产生量随死亡时间变化的规律,为某些碎尸案的死亡时间推断提供参考资料。方法应用高效液相色谱仪外标法,动态检测人离体肝组织中组胺、腐胺、尸胺和未腐败氨基酸含量。结果在8℃、15℃、23℃和32℃环境下,有机胺类产生量分别于人死后肝脏即刻离体69h、54h、40h和33h趋于最大值,并且在到达峰值之前,各温度组离体肝组织中有机胺类生成量均与死亡时间成正比关系。结论人离体肝组织中有机胺类产生量与死亡时间和环境温度在一定范围内均呈正相关。     

An Analysis of the Characteristics of Thoracic and Abdominal Injuries Due to Gunshot Homicides in Israel

De‐identified wound data from 197 homicidal gunshot postmortems were obtained between 2000 and 2008. Forensic ballistics data were only available for cases between 2004 and 2008. Males represent 91% of gunshot victims and were struck in the thorax/abdomen with an average of 2.3 bullets. The type of firearms involved were semi‐automatic pistols in the predominant caliber 9‐mm Luger and assault rifles in caliber 5.56 × 45 mm and caliber 7.62 × 39 mm Soviet, using full metal jacket bullets. The majority of shootings occurred at ranges of 1 m or greater. The most common bullet path was front to back in 66% of cases. Entry wounds occurred more often on the left side of the thorax, abdomen, and back. The most common critical organs/tissues to sustain bullet trauma in descending order were as follows: heart, lungs, liver, aorta, spleen, kidneys, and vena cava. Ribs were struck by most bullets that entered the thorax.