摘要:

Postmortem drug diffusion from gastric residue was assessed in a human cadaver model. Fifty milligrams of amitriptyline (Ami) and 5 g of paracetamol (Par) suspended in 350 ml of 10% methanol, 0.1 N HCl, and 50 ml urograffin with 5 g lithium carbonate (alkaline model) or without lithium (acidic model) was instilled into the stomach through an esophageal tube via a neck dissection. Multiple samples were obtained after 48 h at room temperature (range in mean hourly room temperature: 15.6-20.7°C, n = 9). The pH of the gastric contents (alkaline model range = 8.3-8.9, n = 5; acidic model range = 3.4-3.8, n = 5) had no significant effect. Drug diffusion was most marked in the left lung base, with drug concentrations (μg/g) of 0.1-13.9 for Ami, 65-524 for Par, and 13-161 for lithium. Similarly affected were the left lobe of the liver (Ami, 0.1-54.9; Par, 7-218; lithium, 7-39), the spleen (Ami, 0.6-24.3; Par, 104-663; lithium, 27-106), and pericardial fluid (Ami, 0-4.5; Par, 48-641; lithium, 12-56). Diffusion into gallbladder bile, cardiac blood, aortic blood, and blood of the inferior vena cava was less severe. The left kidney and left lung were more severely affected than the right kidney and lung, and similarly the left and right psoas muscles. Least affected was the right anterior lobe of the liver and the lung apexes. This phenomenon may significantly influence drug concentrations in liver and in blood samples obtained from the torso, and consequently liver/blood drug ratios. To circumvent the problem of postmortem drug diffusion from the stomach, it is recommended that blood be sampled from a peripheral vessel, skeletal muscle from a limb, liver from deep within the right lobe, and lung from the apex rather than the base.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Ethanol analysis is the most frequently performed assay in forensic toxicology laboratories. Interpretation of postmortem ethanol findings are often confounded by postmortem production of ethanol. Many species of bacteria, yeast, and molds are capable of producing ethanol from a variety of substrates. The probability of postmortem ethanol synthesis increases as storage temperature and the interval between death and autopsy increases. It is often difficult to distinguish between postmortem ethanol production and antemortem alcohol ingestion. This review presents a discussion of the criteria for the identification of postmortem ethanol synthesis and factors to consider in the interpretation of postmortem ethanol findings. The criteria include case history, condition of the specimens, types of microbes present, atypical fluid and tissue distribution of ethanol, the concentration of ethanol present, and the detection of other alcohols and volatiles. With careful consideration of all the information available, a valid interpretation of the source of ethanol, whether it be from antemortem ingestion or postmortem production, can be made.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

High-performance liquid chromatography/mass spectrometry enabled us not only to measure bromvalerylurea rapidly, ≤2 h following accumulation of human bone marrow, but also to improve sensitivity without interference. The method can be widely and effectively used in the fields of pharmacy and forensic sciences.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Victims of fires are sometimes discovered to have less-than-lethal levels of carbon monoxide (CO) in the blood and no significant antemortem fire damage. Such occurrences are often linked to flash fires involving volatile hydrocarbon fuels. In this study, the dynamics of hydrocarbon fuel fires are examined, and the results of fullscale room tests ignited with small (<2 L) quantities of flammable liquid are found to confirm the theoretical predictions. These tests showed that flame plumes with temperatures of 500-975°C were produced above flammable liquids. Ignition of their vapors in a carpeted room produced a very short-lived flash of fire throughout the room, followed by intense flames in a layer above the floor ∼1 m deep, which quickly degenerated to isolated pools of low flames. Combustion of hydrocarbon vapors in a room caused oxygen levels to drop below 8.5% in <100 s, while causing carbon dioxide (CO2) levels to increase to 12-16% whether the door to the room was open or closed. Production of CO trailed maximum CO2production by 15-30 s. A victim exposed to such a fire may collapse from extreme heat (aided by the water vapor created by the combustion of hydrocarbons), weakened by oxygen deprivation, before CO inhalation becomes a significant factor.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The medical examination system in Japan covers only four regions (Yokohama, Osaka, Kobe and the 23 wards in Tokyo). In almost all other regions, it is difficult to perform reliable epidemiologic studies. This report presents a chronological analysis of sudden infant deaths, including sudden infant death syndrome, over 30 years (1964-93) in the 23 Tokyo wards.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Spontaneous rupture of thoracic aorta without aneurysm formation is extremely rare. A case of spontaneous rupture through an atheromatous plaque in an 82-year-old woman is reported. She presented with atypical chest pain, and chest radiography revealed no evidence of aneurysm. She died suddenly in the hospital within 24 h after admission. At autopsy, there was an intimal tear and rupture of the descending aorta through an atheromatous plaque, resulting in massive hemothorax. The previous reported cases of spontaneous aortic rupture were reviewed. The pathology of spontaneous aortic rupture are discussed with emphasis on the dating of the rupture, which may have significant medicolegal importance.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Lipomatous hypertrophy of the interatrial septum (“massive fatty deposits in the atrial septum”) may represent an incidental autopsy finding or may be associated with atrial arrhythmias, obstructive symptoms, or sudden death. Antemortem diagnosis is becoming much more common. In a literature review and in a review of our 12 cases, this condition was found to occur more frequently in obese middle-aged or elderly subjects, who frequently demonstrated atherosclerotic coronary artery disease. The unencapsulated mass generally occurred anterior or superior to the fossa ovalis, and histologically was characterized by mature fat with varying quantities of fetal fat, inflammation and fibrosis, and entrapment of myocardial fibers with cytologic atypia. Cases were included that had a minimum atrial septal thickness of 1.0 cm. The septum ranged up to 7.0 cm in maximum thickness (2.6 cm average). In our cases, no deaths were directly attributed to this disorder. It is important that forensic pathologists become more generally aware of this condition. To further delineate the true pathological significance, the atrial septum should be routinely examined by palpation and sectioning to determine its thickness and fat content.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Huntington's disease is a hereditary neurodegenerative disorder characterized by involuntary choreiform movements and progressive dementia. Although controversy exists regarding the exact risk of suicide in patients with Huntington's chorea, the literature supports an increased risk of suicide, especially in the early stages of this disease. We describe a case of homicide-suicide involving a father and son. The 60-year-old father, the homicide victim, suffered from advanced Huntington's disease; his 30-year-old son, the assailant, had a history of depression but had not been diagnosed with Huntington's disease at the time of his suicide. The psychiatric implications of this dementing disease, including the risk of suicide, are discussed. The gross, histologic, and molecular genetic features of this neurodegenerative disease are also described. The recognition of this autosomal dominantly inherited disorder at autopsy can make a profound impact on the lives of surviving family members.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This report describes the autopsy findings in three cases of closed head injury dying of cerebral infarction, with brain swelling and herniation. In each instance the cause of the infarct was found to be subintimal dissection involving intracranial anterior circulation arteries. The autopsy findings underscore the value of histological examination of vessels that macroscopically appear thrombosed. We discuss factors that impact on the reported incidence and make brief mention of problems surrounding the true pathogenesis of this lesion.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Stercoral ulcers result from severe, prolonged constipation. Stercoral ulcer perforation is a rare event resulting in severe peritonitis and has a very high associated mortality rate. We describe a 78-year-old man with severe constipation associated with stercoral ulcer perforation undiagnosed prior to autopsy.

ISSN:0195-7910    

出版商:OVID    

年代:1996

数据来源: OVID