摘要:

Sudden unexpected death accounts for 200,000-400,000 deaths each year in the United States. Although the vast majority of these fatalities are related to atherosclerotic heart disease, a small percentage (∼0.0025%) stem from primary cardiac neoplasms. There have been 120 cases of sudden death attributed to primary cardiac tumors in the (published) literature. Although 103 of these lesions were histologically benign (86%), their intracardiac locations precipitated conductive and hemodynamic abnormalities that resulted in sudden death. These tumors are usually easily recognized at necropsy. The most common intracardiac lesion causing sudden death, endodermal heterotopia of the atrioventricular (AV) node, however, may not be discovered unless the AV node is microscopically examined. Owing to the rarity of these neoplasms, a brief review of their salient gross and microscopic features is in order.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

We performed analyses of data on 292 homicides by poisoning in the United States. The data, from theUniform Crime Reports(UCR) 1980 through 1989, involved cases of one poisoned victim and one poisoning offender. Demographic factors analyzed for each victim and offender include age, gender, race, relationship of victim to offender, major category of poison, month, year, geographic location, and crime classification. The goal of this study is to identify homicidal poisoner demographics that could assist forensic scientists and law enforcement personnel in their criminal investigations and to serve as the foundation for a more formal investigative analysis of this kind of subtle killer.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The postmortem finding of anal dilation or an exposed pectinate line in children who have died under suspicious circumstances continues to raise the concern of possible sexual abuse. The following multicenter, collaborative study was designed to help address that question. Sixty-five subjects, ranging in age from birth to 17 years, were autopsied at three different sites. A standard protocol along with 35-mm cameras were used to record the results. Thirty-eight (58%) subjects were boys, and 27 (42%) were girls. Forty-two (65%) were white, 10 (15%) African-American, five (8%) Asian, three (5%) white Hispanic, and five (8%) other. Fifty-seven (88%) were in Tanner stage I of secondary sexual development. Thirty-four (52%) died of natural causes, 26 (40%) from accidental injuries, three (5%) from other causes, and four (6%) as a result of a homicide. Forty-eight subjects (74%) had some dilation of the anal sphincters. In 21 children (32%), the entire anal canal, including the rectal ampulla, could be visualized. In another 21 (32%) subjects, the pectinate line was exposed. Only the outer portion of the anal canal opened in six children (10%), whereas 17 (26%) had no dilatation of the anus. Anal laxity led to flattened skin folds in 50 (77%), a shallow anal canal in 40 (62%), the exposure of both the pectinate line in 38 (59%), and the anal mucosa in 24 (37%). Venous congestion was present in 14 (22%), venous pooling in three (5%), erythema in six (9%), and increased pigmentation in eight (12%). Funneling was found in two (3%). Blood was present in three (5%), and an abrasion was discovered in one (2%). No fissures, lacerations, hemorrhoids, or scars were found in any of the children. Anal orifice size varied with the age of the child, the amount of traction applied to the buttocks, and a history of a CNS injury at the time of death. It is suggested, finally, that anal dilatation alone cannot be used as a marker for prior sexual abuse and that exposure of the pectinate line should not be confused with tears or fissures of the anal verge. Further studies of children known to have been sodomized prior to death are required.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Despite the economic importance and hazardous nature of commercial logging in various regions, few medical studies have examined fatalities in this industry. Data derived from the files of the Ontario Chief Coroner's Office revealed 52 deaths, all men, from 1986 to 1991 in the province of Ontario. Forty-four cases were accidents (age range 20-73 years; average, 44 years), the majority involving experienced loggers. Personal error resulting in preventable unsafe work practices was a factor in most accidents (n = 35; 79.5%). Almost one half of injured workers were struck by either dead or cut trees. Although the majority of cases occurred in remote areas, delayed medical attention as a factor contributing to death was uncommon. Many of the injuries were nonsurvivable and most victims (n = 33; 75%) were dead at the scene. Most deaths were caused by either head and neck injuries (n = 20; 45.5%), multiple trauma (n = 10; 23%), chest trauma only (n = 6; 13.5%), or mechanical asphyxia (n = 5; 11%). Blood alcohol was negative in 24 accident victims tested. Eight deaths (age range 42-52 years; average, 49 years) were due to cardiac causes, mainly ischemic heart disease. Disease may have contributed to two accidents.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Fifty-three suicides using plastic bags were identified in a review of cases within the jurisdiction of the King County Medical Examiner's Office, Seattle, Washington from 1984 to 1993. We found that this method was used at a greater frequency by individuals older than 50 in comparison with other methods. The most commonly identified stressor leading to the suicide in this population was failing health. The use of this method as a means of “self deliverance,” as advocated by the Hemlock Society, could be inferred in only a small minority of cases where terminal illnesses were identified. This method may be preferred by those older than 50 years because of the ready availability of plastic bags and the relative nonviolence of the death. Analysis of the autopsy findings showed no specific features for this method of suicide. In particular, petechiae, which are often considered a marker of asphyxia, were present in only a small minority of cases (3%). Furthermore, the scene investigation rarely revealed specific features, other than the plastic bag in place. Thus, if the plastic bag were removed after death, the cause and manner of death would be obscure.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Death in custody frequently raises suspicion of ill-treatment on the part of the custodians. The meticulous postmortem search for evidence of injury is the paramount consideration in objective investigation. Detection and evaluation of hidden subcutaneous hemorrhages facilitates reconstruction of antemortem circumstances. We describe a new postmortem technique for accurate examination of the subcutaneous tissues utilizing a simple X-shaped incision of the back and limbs and reflecting the skin. This technique leaves no noticeable disfigurement.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Leiomyosarcomas of the pulmonary arteries are rare neoplasms seldom diagnosed during the patient's lifetime. We report a case of unexpected death in a 44-year-old man due to a leiomyosarcoma originating from the main pulmonary trunk and involving the right and left arteries as far as the lobar ramifications. The patient died after a 2-year history of bronchiectasis and chronic bronchopneumonia with weight loss and occasional episodes of syncope during the last 4 months. Immunohistochemical demonstration for alpha-smooth muscle actin was necessary to make a histological diagnosis of leiomyosarcoma. A review of pulmonary artery leiomyosarcomas is also presented.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A cause-of-death statement may result in a query by the vital records registrar to clarify cause of death information or to educate the certifier of death in recommended death certification procedures. The level of querying depends on local need and resources, and is usually conducted at one of six query priority levels. When applying International Classification of Disease (ICD) coding to cause-of-death information, nosologists use a General Rule and 12 additional rules, as needed, to identify an underlying cause of death for statistical purposes. Incorrectly or poorly written cause-of-death statements, and even well-written ones, may result in queries that could have been avoided, or in codes for the underlying cause of death that differ from those intended by the certifier of death. In an attempt to foster improvement in cause-of-death statements and to facilitate coding, this article presents basic information about queries and coding rules so that certifiers of death will be aware of potential problems and coding issues. In general, cause-of-death statements that are complete, specific, timely, correct in temporal sequence, and written according to guidelines reduce the need for queries and facilitate the ICD coding process.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Diffuse axonal injury is caused by irreparable shearing of the axons. A case of diffuse axonal injury by a well-witnessed assault is reported. The victim survived for 13 days after the assault. The mode of assault was numerous kicks to the head of the victim lying on the ground. The kicking motion was sideways across the long axis of the body. Thus, on each impact, the victim's head moved with relative freedom or was tossed violently side to side or in a lateral, even angular or rotational, manner. This resulted in a low acceleration/deceleration rate. Grossly, the brain showed no lesions; however, a microscopic lytic lesion was present in the corpus callosum. These injuries were consistent with a grade-2 diffuse axonal injury (Adams classification).

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID