Sudden death in an adolescent due to undiagnosed classic Hodgkin lymphoma

Few cases of natural sudden death presenting as an undiagnosed lymphoma have been reported in the literature, especially in adolescents. Herein we provide a report of sudden death caused by undiagnosed classic Hodgkin lymphoma (cHL). We describe an 18-year-old female who collapsed after several weeks of weight loss, decreased appetite, and dyspnea. At autopsy, a bulky mass arising in the mediastinum and neck compressed the esophagus and trachea, surrounded the great vessels, obliterated the pericardial sac, and infiltrated the myocardium. The lungs were collapsed and large pleural effusions were present. The tumor burden, which weighed at least 2710 g in aggregate, was entirely above the diaphragm. Microscopic examination of the masses showed features typical for nodular sclerosis cHL including large bands of sclerosis, numerous Hodgkin/Reed-Sternberg (HRS) cells, and an eosinophil-rich mixed inflammatory cell infiltrate. Immunohistochemical stains showed the HRS cells to be uniformly positive for CD30 and CD15 and negative for CD3, CD20, CD45, and PAX5. This case exemplifies a rare sudden natural death due to previously undiagnosed cHL in a young patient.     

Eosinophilic myocarditis from a forensic histopathological perspective

Eosinophilic myocarditis (EM) is a rare and potentially fatal form of myocarditis characterized by infiltration of the myocardium with eosinophil leukocytes, often accompanied by eosinophilia. Although the exact underlying cause remains unknown, it has been shown to be associated with hypersensitivity reactions, immune-mediated disorders, infections, or cancer. Due to the differences in symptomatology, it is often diagnosed by postmortem histopathological examination. We aimed to retrospectively examine the histopathological findings of rare cases of EM and to detect accompanying cardiac and other organ pathologies. The histopathological findings of the cases that underwent autopsies between 2012 and 2020 and were diagnosed with EM were assessed. Demographic features, symptoms, causes of death, macroscopical findings at autopsy, toxicologic and microbiological analysis results, accompanying cardiac pathologies, and histopathological findings in other organs were evaluated. Myocarditis was detected on histopathologic examination in 558 (1.1%) of 49,612 forensic autopsies. There were 12 (2.3%) EM cases. There were nine males and four females. The mean age was 42.3 (3–83) years. Heart weights ranged from 82 to 564 g. The most common finding on macroscopic examination was the mottled discoloration and scarring in the myocardium. Microscopic examination revealed perivascular and interstitial infiltration of eosinophils in all of the cases accompanied by myocyte necrosis in four of them. EM was reported as the cause of death in four cases. EM remains a challenging heart disease with its obscure etiopathogenesis and varying clinical presentation and a rare entity diagnosed by postmortem histopathological examination in sudden and unexpected deaths.     

Fatal exsanguination following complete transection of femoral vessels due to angle grinder injury in an industrial accident

Angle grinders are one of the most dangerous and frequently used tools in industrial settings. Angle grinder injuries range from superficial cuts to deep penetrating injuries with underlying fracture-dislocation and vascular trauma. The injuries caused by angle grinders mostly involve the head, face, or upper limbs, while the lower limb is an unusual site. The high-speed rotating disc of the angle grinders does not respect anatomical boundaries or structures; therefore, the injuries caused may be disfiguring, permanently incapacitating, or even fatal. We report a fatal case of an angle grinder injury to the lower limb. The victim sustained a sharp cut over the left thigh while woodworking in an industrial setup. The rotating disc of an angle grinder had transected the skin, subcutaneous fat and muscles, and both the femoral vessels of the left side, which led to fatal exsanguination within 10 min of the incident.     

Skull and Encephalic Injuries Caused by Beach Umbrellas: Case Reports and Review of Literature

This study reports two unusual cases of skull‐encephalic injuries in bathers that were caused by violent impacts with beach umbrellas. The first case concerned a 36‐year‐old man who, while lying on a sun bed, was struck on his left temple by a beach umbrella, which had been blown away by a gust of wind. The second case concerned a six‐year‐old child who was struck on the right temporal region while he was playing on the sand. Both subjects died. A review of the literature was carried out. Various skull and brain injuries caused by several objects were found, but no injuries caused by beach umbrellas were detected. There were only cases of injuries caused by normal umbrellas. These cases showed that several objects can be responsible for traumas causing skull and brain injuries, therefore forensic investigation must be supplemented by circumstantial data.     

致命室性快速心律失常心室肌能量的代谢改变与氧化损伤

目的探讨致命室性快速型心律失常(LVTA)能量代谢相关变化及氧化损伤。方法建立以乌头碱(ACO)注射和冠脉结扎(CAL)心肌缺血诱导的LVTA-心脏性猝死(SCD)SD大鼠模型,以过度麻醉(PI)及冠脉结扎心衰致死(CAL-B)为各自对照,检测心室肌线粒体膜电位(MMP)、活性氧(ROS)、丙二醛(MDA)、磷酸肌酸(PCr)及血清肌钙蛋白I(cTnI)含量,并进行比较。结果成功制备ACO-LVTA及CAL-LVTA大鼠14只及6只。与各自的同行对照比较,ACO-LVTA组及CAL-LVTA组心室肌的ROS及MDA呈升高的趋势,PCr呈下降的趋势,其中CAL-LTVA的MDA显著高于其同行对照(P0.05)。ACO-LVTA组心室肌的MMP低于对照组,但高于CAL处理的两组。CAL-LVTA组血清cTnI高于对照组,且显著高于ACO-LVTA组及其对照与处理前(P0.01),ACO-LVTA组血清cTnI高于对照组与处理前。心肌ROS水平与VT及VF持续时间相关(P0.05),相关系数分别为0.44、0.46。结论发生LVTA后,心室肌MMP及PCr下降、ROS、MDA升高,血清cTnI升高,表明LVTA可导致能量代谢改变及氧化损伤,可能与线粒体功能异常相关。     

区域道路交通事故紧急救援服务体系的构建

近年我国道路交通安全的总体趋势虽然在转好,但仍然呈现出交通事故总量大、死亡人数多的特点。为切实改善这种状况,应借鉴国外经验,在我国构建区域道路交通事故紧急救援服务体系,提高交通事故信息传递、现场急救和急救转运等方面的综合反应和处理能力。     

EXCEL在交通事故分析中的应用

交通安全问题已引起了世界各国的重视,每个国家都在寻求和探索降低交通事故发生率的良策。我国是一个发展中国家,在相当长的一段时间内还会面临着严重的交通安全问题。EXCEL是一种简便、易操作的计算机软件,可以利用EXCEL的数据分析功能,求出道路交通事故中某些推测数据与多因素之间的比例关系,对道路交通事故分析有所帮助。     

142例二轮摩托车驾乘人员损伤特征分析

目的分析二轮摩托车交通事故的现场特点和驾乘人员的损伤特征,为甄别摩托车驾乘人员提供信息。方法收集本区2005年至2014年142例二轮摩托车交通事故人员伤亡资料,包括事故经过、事故类型、现场特点、车辆特点、驾乘人员情况、损伤情况及死亡原因等相关资料,进行分析总结。结果二轮摩托车驾乘人员在各类型事故中的损伤部位和特征、出现率及严重程度有明显的区别,事故现场有规律性。结论通过现场与人体损伤特征的分析,可以甄别摩托车驾乘人员。     

对四起重特大铁路交通事故现场勘查的分析

我局辖区在2004年7月25日京沪线、2004年7月26日京九线、2008年1月23日胶济线、2008年4月28日胶济线先后发生4起重特大铁路交通事故,通过从接警、出警、现场勘查、检验鉴定、案卷制作等工作环节对4起事故现场进行分析总结,从中找出工作中存在的不足和可供今后借鉴的经验,以进一步提高重特大铁路交通事故的现场勘查和检验鉴定水平。     

警察训练的安全保障体系研究

警察训练安全保障体系由训练的事故预防、事故处理、事故保险和保险管理四个部分构成,它的发展建设因受经济、观念等条件的局限和制约,目前只在少数几个西方经济发达的警务管理先进国家践行。其将警察的安全关口前移,推动了借助各种社会力量(社会保险业等)为警察提供更多的职业安全保障。因此,积极创新理念、大胆更新观念、借鉴国外成功经验、努力构建安全保障体系,为今后实践奠定坚实的理论基础,应是明智之选。