Cases reported "Postmortem Changes"

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1/14. Indoor postmortem animal interference by carnivores and rodents: report of two cases and review of the literature.

    We present two cases of nearly total skeletization of the exposed face and neck due to indoor postmortem animal interference and a review of the literature. In the case of a 61-year-old man, inspection of the damaged soft tissue margins revealed serrated edges and parallel cutaneous lacerations caused by rats. In the case of a 40-year-old woman, postmortem examination revealed v-shaped and rhomboid-shaped tunneled wounds in the damaged soft tissue caused by a pit bull terrier. The autopsy in both cases identified natural causes of death. While the morphological feature of postmortem soft tissue artifacts caused by rodents can be ascribed to animal incisors, stab wound-like punctured wounds are characteristic of canine dentition of carnivorous origin. Additional morphological criteria for injuries of carnivorous origin are linear scratch-type abrasions from claws in the vicinity of the injuries. In cases of indoor postmortem animal interference damage is primarily caused to the exposed areas of the body, no self-defense injuries can be found on the deceased's body, only a small amount of blood or the total absence of bloodstains should be expected at the scene, an inquiry of pets living free in the house or wild animals having possible access to the scene should be conducted and rodent excrement found at the scene can give the investigator further information.
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2/14. Postmortem absorption of dichloromethane: a case study and animal experiments.

    A case of accidental death after occupational exposure to an atmosphere containing dichloromethane (DCM) is reported. The concentrations of DCM in the blood and tissues of a 40-year-old man who died while observing an industrial washing machine filled with DCM vapour were blood 1660 mg/l, urine 247 mg/l, brain 87 mg/kg, heart muscle 199 mg/kg and lungs 103 mg/kg which are 3-7 times higher than previously reported fatal levels. The body was left undiscovered in the machine filled with DCM vapour for about 20 h. The present study was designed to determine whether all the DCM detected in the tissues and body fluids had been inhaled while alive using rats as the experimental model. The concentrations of DCM in the tissues and body fluids of a rat that died from DCM poisoning and was left for 20 h in a box containing DCM vapour were the same as those in the tissues and body fluids of a rat that had died from an injected overdose of barbiturates and had then been placed in the DCM box in a similar manner. Moreover, the concentrations of DCM in the tissues and body fluids of the carcasses that were exposed to the DCM vapour increased gradually throughout the period of exposure. These findings imply that DCM is able to penetrate the tissues and body fluids of rat carcasses through a route other than inhalation such as through the skin.
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3/14. Neuropathological findings after continuous intrathecal administration of S( )-ketamine for the management of neuropathic cancer pain.

    Questions have been raised about the potential neurotoxicity of the neuraxial use of ketamine although ketamine and its active enantiomer S( )-ketamine have been used intrathecally and epidurally (caudally) for the management of perioperative pain and in a variety of chronic pain syndromes. Clinical experience following neuraxial administration of S( )-ketamine has been documented without reference to local central nervous system toxicity following this approach. In addition, there are no preclinical safety data regarding stability, compatibility, and neurotoxicity on intrathecal use of single S( )-ketamine or combinations of S( )-ketamine, morphine, bupivacaine, and clonidine. In the present case, the continuous intrathecal administration of S( )-ketamine, in combination with morphine, bupivacaine, and clonidine resulted in adequate pain relief in a patient suffering from intractable neuropathic cancer pain. However, postmortem observation of the spinal cord and nerve roots revealed severe histological abnormalities including central chromatolysis, nerve cell shrinkage, neuronophagia, microglial upregulation, and gliosis. Based on our results, neuraxial administration of S ( )-ketamine cannot be recommended for clinical practise before a systematic study of toxicology of neuraxial S( )-ketamine in animals or humans has been performed.
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ranking = 0.125
keywords = animal
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4/14. Canid scavenging/disarticulation sequence of human remains in the Pacific Northwest.

    Greater understanding of animal scavenging of human remains can assist forensic science investigators in locating and recovering dispersed skeletal elements, in recognizing damage produced by scavengers, and in making more informed estimates of the postmortem interval. The pattern of skeletal damage can indicate whether the body was scavenged while intact or at some time after other natural processes of disarticulation had begun. This study analyzed thirty partially to fully skeletonized human remains with respect to scavenging at the time of body discovery in order to determine if a patterned consumption sequence existed. The scavengers were primarily coyotes (Canis latrans) and domestic dogs (C. familiaris). Sixteen non-carnivore-scavenged remains were also examined and contrasted with the carnivore-scavenged sample. Observed postmortem intervals from death to recovery ranged from 4 h to 52 months. Results demonstrate that canid scavenging of human remains takes place in sequential stages: Stage 0 = no bony involvement; Stage 1 = ventral thorax damaged and one or both extremities removed; Stage 2 = lower extremity involvement; Stage 3 = only vertebral segments remain articulated; and Stage 4 = total disarticulation. Results revealed a clear correspondence between stages of disarticulation and the postmortem interval.
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ranking = 0.125
keywords = animal
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5/14. Studies on the composition of gases in the post-mortem body: animal experiments and two autopsy cases.

    The composition of gases was measured in a cadaver, particularly in the stomach, using gas chromatography. High concentrations of carbon dioxide (CO2) and hydrogen (H2) and a low concentration of methane (CH4) were found. At an environmental temperature of 25 degrees C, the concentrations of CO2 and H2 were approximately 80% and 10%, respectively, at an advanced stage of putrefaction, while at an environmental temperature of 15 degrees C the concentrations were approximately 60% and 35%, respectively. These gases were not produced until the fourth day at 15 degrees C, but after that the volume of gases was greater than that produced at 25 degrees C, the cadaver becoming greatly enlarged. oxygen (O2) in air injected into a body disappeared during putrefaction. This study revealed that H2 was the main component of inflammable gas in a dead body. The mechanisms of production of the gases are also discussed.
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6/14. Postmortem redistribution and degradation of dothiepin. Human case studies and an animal model.

    Two suicides took estimated maximum dothiepin doses of 765 and 1875 mg, respectively. Initial drug levels in nine and 12 blood samples were 0.26-1.85 and 4.08-23.98 mg/L, with highest concentrations in the pulmonary veins. pulmonary artery concentrations rose markedly over 18 h: 0.32 rising to 0.9, and 6.54 rising to 19.53 mg/L. Peripheral blood concentrations were relatively stable. Concentrations in liver, heart, lung, and skeletal muscle were, for case 1, 4.3, 2.92, 18.6, and 1.1 mg/kg; and, for case 2, 52, 16.8, 73.9, and 8.98 mg/kg. new zealand white female rabbits (2.4-3.2 kg) given 20 mg dothiepin hydrochloride intravenously were killed with pentobarbital after 1 h. blood was sampled from the thorax, infra-renal inferior vena cava, and supra-renal inferior vena cava at 0, 1/2, 1, 4, 8, 12, and 24 h postmortem in paired animals. liver, heart, lung, and skeletal muscle were sampled at 0 and 24 h. Mean dothiepin levels in thoracic blood rose from 0.43 mg/L at time 0 to 1.73 at 8 h and then fell to 0.61 at 12 h, likely reflecting initial redistribution from the lungs (63.4 mg/kg at time 0 and 27.3 mg/kg at 24 h) followed by putrefaction-associated bacterial degradation. Falls in blood drug levels associated with putrefaction were not seen in the human cases. Interpretation of postmortem dothiepin blood concentrations is complicated by pronounced interindividual variations in in vivo pharmacokinetics, the postmortem redistribution phenomenon, and variable drug degradation by bacteria.
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7/14. Artefact in forensic medicine: postmortem rodent activity.

    The human body may be attacked by a variety of animals. It is a potential source of confounding marks for forensic practitioners when unmasking criminal activity. A case that posed some problems for the crime scene investigators on discovering a dead body indoors, which had both ears missing is discussed. The suspicion initially was that of homicidal mutilation of the corpse. A general awareness of artefactual postmortem animal activity may avoid their misinterpretation. This short report acknowledges a persistent paucity in the forensic literature on the subject of human remains and postmortem animal activity.
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ranking = 0.375
keywords = animal
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8/14. Diabetic death bed: post-mortem determination of hypoglycaemia.

    The post-mortem biochemical determination of hypoglycaemia in the practice of forensic medicine is notoriously imprecise and attracts perennial criticisms, particularly from those who may be alien to the peculiarities of medical jurisprudence. There has been re-emphasis recently on the neuropathological pathoclisis ascribed to prolonged hypoglycaemia. Unfortunately, the value perceived is limited by pathognomonic unreliability owing to agonal multifactorial influences and rapidly fatal nocturnal hypoglycaemia. The predicament is oppressive to a consideration of preponderant evidence and an unpopular diagnosis of peri-mortem hypoglycaemia, unless audacious, may be precluded simply because the proof is difficult. This is likely to contribute to diagnostic under-estimation of enigmatic diabetic deaths. A suspected case of lethal nocturnal hypoglycaemia in a young diabetic on 'animal' insulin is presented to restore some perspective to the clinico-pathological deference for an endangered post-mortem diagnosis of hypoglycaemia inferred from minimal evidence.
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ranking = 0.125
keywords = animal
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9/14. Postmortem diffusion of tracheal lidocaine into heart blood following intubation for cardiopulmonary resuscitation.

    This study investigated the postmortem diffusion of tracheal lidocaine into the blood after intubation in three individuals whose heart beat was not restored by cardiopulmonary resuscitation. The results are compared with those obtained in animal experiments using rabbits. The first human subject was a 3.5-month-old female baby who died of sudden infant death syndrome. She was autopsied approximately 20 h after death. A toxicological examination revealed the presence of 0.349 mg/L and 0.102 mg/L of lidocaine in the blood in the left and right ventricles of the heart, respectively. No lidocaine was detected in the cerebrum, liver, or right femoral muscle. The second subject was a 44-year-old man who died of brain swelling due to head injuries, and was autopsied approximately 20 h after death. lidocaine concentrations in the hili of the left and right lungs were 10.9 mg/kg and 2.65 mg/kg, respectively, and 1.02 mg/L and 0.209 mg/L in the blood in the left and right ventricles of the heart, respectively. The right femoral vein blood contained only a trace amount of lidocaine; no lidocaine was detected in the cerebrum, liver, or right femoral muscle of this subject. The third subject was a 38-year-old man who died of bleeding due to a stab wound to the left thigh, and was autopsied approximately 20 h after death. lidocaine concentrations were 1.41 mg/kg and 1.37 mg/kg in the hili of the left and right lungs, respectively, and 0.642 mg/L and 0.746 mg/L in the blood in the thoracic aorta and superior vena cava, respectively. No lidocaine was detected in the right femoral vein blood, cerebrum, liver or right femoral muscle. In the animal experiments, rabbits carcasses were left in the supine position at an ambient temperature following application of 1 mg/kg lidocaine hydrochloride into the trachea just above the bifurcation. lidocaine concentrations of 0.550-4.03 mg/L and 3.05-7.30 mg/L were detected in the heart blood, one and three days after the lidocaine treatment, respectively; neither the cerebrum nor right femoral muscle contained detectable amounts of lidocaine. The pH values of body fluids and tissues of the human and animal corpses were below 7.0. This study has demonstrated that following intubation, tracheal lidocaine diffuses into surrounding fluids and tissues, and that this is attributable to postmortem acidosis. We suggest that, in subjects who underwent cardiopulmonary resuscitation with intra-tracheal intubation, heart blood and femoral vein blood should be analyzed for lidocaine. In addition, the pattern of distribution of lidocaine in the surrounding tissues may provide some information on the state of victims during cardiopulmonary resuscitation.
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ranking = 0.375
keywords = animal
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10/14. Threshold-distance measures from electrical stimulation of human brainstem.

    Threshold current levels for electrical stimulation of a single human brainstem via an auditory prosthesis are compared with postmortem measures of the distance between the electrode and stimulated structures. The results compare well with the summary of threshold-distance measures from animal experiments compiled by Ranck. The correspondence between the human and animal data gives confidence that the extent of current spread (distance to stimulable neural units) can be well estimated from the current level at threshold for 200 microseconds/phase biphasic pulses. This is of particular interest in electrical stimulation of the human central nervous system, where localization of stimulation is of paramount importance.
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