Legal medicine
-
To clarify drowning death, positive evidence for aspiration of the immersion medium and the subsequent fatal mechanism is necessary. This study investigated biochemical findings with regard to lung weight in drowning cases of adults (n=56, >18 years of age, <48 h postmortem: salt water, n=19; fresh water, n=21; brackish water, n=16), using acute cardiac death cases (n=240) as controls. The biochemical markers used in this study were urea nitrogen (UN), sodium (Na), chloride (Cl), calcium (Ca) and magnesium (Mg) in the blood and pericardial fluid (PCF). ⋯ Correlation of the left cardiac serum level with lung weight was positive for Na, Cl and Mg in saltwater and brackish water drowning, and was also positive for Ca in saltwater drowning. There was an inverse correlation with lung weight for PCF Na and Cl levels in freshwater drowning. These findings suggest that analyses of serum and pericardial markers in relation to lung weight are useful for evaluating the composition and amount of aspirated medium when investigating drowning death.
-
Previous studies suggested the usefulness of postmortem cardiac troponin (cTn) and creatine kinase MB (CKMB) levels in blood and pericardial fluid for investigating myocardial damage in the death process. The present study investigated the postmortem levels in cerebrospinal fluid (CSF), using serial medicolegal autopsy cases (n=257, within 48h postmortem). For CSF, the postmortem increase was slight for cTnT and cTnI, and was not significant for CKMB. ⋯ Increased CKMB was apparently independent of the cause of death, and was frequently seen in acute or subacute deaths. These findings suggest that CSF levels of cTnT and cTnI are useful for investigating the progress and duration of myocardial damage in the death process. CKMB may be used as a marker of persistent hypoxic myocardial damage before death.
-
The aim of the present study was to undertake, during routine forensic work, a comprehensive analysis of the serum and cerebrospinal fluid (CSF) levels of thyroid-stimulating hormone (TSH) and to examine hypophyseal TSH immunopositivity in relation to the cause of death, with particular regard to fatal hypothermia. Medicolegal autopsy cases (n=120; within 48 h postmortem; survival time, <24 h), including cases of blunt injury (n=9), sharp instrument injury (n=8), fire fatality (n=18), mechanical asphyxiation (n=10), drowning (n=21), poisoning (n=6), hypothermia (n=10), and acute ischemic heart disease (n=38), were examined. Serum and CSF TSH concentrations were measured using an electrochemiluminescence immunoassay. ⋯ Serum and CSF TSH levels were significantly lower in cases of hypothermia than in the other groups (p<0.05 and p<0.001, respectively). TSH immunopositivity in adenohypophysis was significantly lower in cases of hypothermia, but exhibited a large case-to-case variation for poisoning. These observations suggest that a decrease in serum and CSF TSH levels in hypothermia is related to hypothalamic adenohypophyseal dysfunction.
-
Basic fibroblast growth factor (bFGF) is a highly conserved and ubiquitously distributed mitogen, and much is known at the molecular level. However the available information about in vivo distribution in human tissues and expression changes in relation to causes of death is not sufficient. The present study investigated 35 autopsy cases, comprising five cases for each cause of death: acute myocardial infarction/ischemia (AMI), mechanical asphyxiation, blunt brain injury, drowning, hypothermia, intoxication and sharp instrument injury. ⋯ High positivity in the brain was seen for intoxication, but AMI, mechanical asphyxiation and drowning showed lower positivity. For the heart, spleen and pancreas, there was no evident difference among the causes of death. These findings suggested that bFGF expression in the lung, liver, kidney and brain varies depending on the cause of death, and is useful for investigating deaths.
-
Electric injury may cause different changes from minimal damage (e.g. small burns) to severe complications up to death. Several morphological changes of the skin and the internal organs are used for the diagnosis of electrical injury. However, macroscopic findings and histological changes of the internal organs and the skin may be absent in many cases. ⋯ The differences between first and second-third groups were statistically significant (p<0.05). There was not any significant difference between the second and the third groups. In conclusion, electrocution causes loss of the pyramidal neuronal in CA3-2 and CA1 subdivisions of the rat hippocampus in this study.