A case of aortic dissection caused by blunt chest trauma

A 74-year-old woman was struck by a car travelling at about 50 km/h. On arrival at hospital, a CT scan showed dissection of the ascending and descending aorta. She collapsed and died suddenly 8h later. At autopsy, there was massive bleeding into the left pleural cavity, ruptures of the pericardium and right ventricle, and a type A thoracic aortic dissection. The cause of death was haemorrhagic shock due to rupture of the pericardium and delayed rupture of the right ventricle following trauma to the chest. The thoracic aortic dissection was not the direct cause of death although histological examination did reveal that it occurred in the accident. Traumatic aortic dissection is rare although traumatic aortic rupture is a major cause of death after blunt chest trauma. This paper discusses the mechanisms, and factors involved in aortic dissection caused by blunt trauma.     

An accidental death due to Freon 22 (monochlorodifluoromethane) inhalation in a fishing vessel

We have firstly presented a case using post mortem corrosive method in forensic medical practice after coronary stent implantation. Occlusions, fate of side branches could be detected during the clinical diagnostic angiography, intravascular ultrasound, computed tomography; however, the forensic medical determination of cause of death, identification of complications needs a careful post-mortem investigation. The injection-corrosive method seems to be a useful assistance in the characterisation of pathomorphological changes after stent implantation. Besides the classical techniques of histology, immunohistochemistry, electron microscopic investigation we have introduced a new synthetic resin corrosion cast method. This three-dimensional corrosion cast preparation may provide new data about the actual morphological condition of the coronary vessels and a better understanding of the pathomechanisms of sudden cardiac death after percutaneous coronary intervention.     

Paraquat myopathy: report on two suicide cases.

We describe two suicide cases in which old paraquat was ingested. In conjunction with lung involvement a pronounced degeneration was observed in skeletal muscle of one who died on the 14th day after the ingestion. The following sarcoplasmic or endoplasmic reticulum Ca2+ ATPase (SERCA) monoclonal antibodies were used for skeletal muscle fiber typing by an immunohistochemical method: NCL-SERCA1, reactive with type 2 fiber (fast-twitch), and NCL-SERCA2, reactive with type 1 fiber (slow-twitch). The examination revealed that the remarkably degenerated fibers belonged to type 1 muscle fibers. This case showed an abrupt increase of plasma CK levels (1796 mU/ml) on the fifth day after the ingestion. The authors presume that the damage to the skeletal muscle had occurred in this period. The degeneration of the muscle seemed to be attributable to the long retention of paraquat in the tissue because these findings were not observed in the other case who died on the fifth day. Paraquat-induced myopathy may develop in prolonged paraquat poisoning. The examination of CK levels in plasma will be useful for diagnosis of damage of skeletal muscle.     

Diatom numbers around the continental shelf break

Diatom concentrations in seawater were examined monthly at four aquatic areas. Diatom concentrations inside a bay showed a monthly variation, but these were detectable. On the other hand, in the open sea around the continental shelf break, there were few diatoms in any season. When a person drowns in the open sea, the diatom test cannot be expected to function reliably.     

Dental identification using digital images via computer network

Dental identification is a useful scientific method. In Japan, however, there are only a few forensic odontologists; moreover, until now, forensic dental services have only been offered by general dentists. These dentists may not be able to offer such forensic services during office time. For a quick comparison, the authors tried sending digital photos, taken with a 2-million-pixel digital camera, to dental offices via the Internet. If a dental office has Internet access, it is possible for dental charting to be sent directly to the autopsy room. Of course, digital images only provide the first outline. However, when antemortem dental records of the person in question are available at autopsy, a quick comparison can be made.     

Quantitative evaluation of volatile hydrocarbons in post-mortem blood in forensic autopsy cases of fire-related deaths

Volatile hydrocarbons in post-mortem blood from victims of fires were analyzed quantitatively by headspace gas chromatography mass spectrometry. The benzene and styrene concentrations in the blood were positively correlated with the carboxyhemoglobin (CO-Hb) concentration, which is evidence that the deceased inhaled the hydrocarbons and carbon monoxide simultaneously. By contrast, the concentrations of toluene and CO-Hb in the blood were not significantly correlated. This lack of correlation could be explained by two different sources of toluene, with low blood concentrations of toluene arising when the deceased inhaled smoke and high blood concentrations of toluene arising when the deceased inhaled petroleum vapor or other unknown vapors. The quantity of soot deposited in the respiratory tract was classified into four grades (-, 1+, 2+, 3+). The mean CO-Hb concentration in the 1+ soot group was significantly lower than those in the 2+ (p<0.05) and 3+ (p<0.01) soot groups. The blood CO-Hb concentrations in the 1+ soot group were all below 30%. Those indicated that the deceased aspirated smoke that contained both soot and carbon monoxide. The wide variation in CO-Hb concentrations for each soot classification could be caused by the different types of smoke produced by different materials. For example, petroleum combustion with a limited supply of oxygen, like in a compartment fire, may produce a large volume of dense black smoke that contains a large quantity of soot. Soot deposits in the airways and the blood CO-Hb concentration are basic and essential autopsy findings that are used to investigate fire-related deaths. The quantitative GC-MS analysis of blood volatile hydrocarbons can provide additional useful information on the cause of the fire and the circumstances surrounding the death. In combination, these three findings are useful for the reconstruction of cases.