Cases reported "Postmortem Changes"

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1/58. 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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2/58. 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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3/58. Demonstration of a chloroquine fatality after 10-month earth-grave.

    A 19-year-old woman suspect of a suicidal drug intoxication was exhumed after a 10-month earth-grave, because the police was accused of manslaughter and neglected help by the relatives of the deceased. Toxicologic analysis revealed as the cause of death an acute chloroquine intoxication. An expert opinion had to deal with the question if the woman would have been saved if the police had appeared earlier. Therefore the duration of agonal period after suicidal chloroquine ingestion was important. An estimation of the time since death was possible on the one hand ex-post from the development of cadaveric changes and supravital reactions and on the other hand, based on premortal changes detectable on the body together with the findings of the authorities. Taking into account all evidence the woman was probably already dead at or prior to the arrival of the police (110 min after ingestion), at least this could not be excluded. chloroquine has to be considered to be useful for fatal poisoning, which is also recommended in some publications on methods to commit suicide.
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4/58. The body buried twice.

    The authors report the case of an unusual reason for an "exhumation." A young person "exhumed" a child's body involved in a road accident because he wanted to test methods for preventing or slowing down the process of postmortem decay.
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5/58. Deaths associated with liposuction: case reports and review of the literature.

    Tumescent liposuction is a common cosmetic procedure that is performed as an outpatient service in physician's offices and is largely believed to be safe. The protuberant areas of the body containing the undesirable fat deposits are injected with normal saline containing lidocaine and epinephrine for pain control and hemostasis, and the waterlogged cells are suctioned out via cannula through a small incision. We recently encountered three cases in which deaths were attributed to this procedure. Two showed fat embolization in the lung and one died from fluid overload. The osmium tetroxide post-fixed lung sections showed fat emboli in the interstitial capillaries and arterioles. We reviewed the recent literature and found that pulmonary thromboemboli, fat embolization, fluid overload, and lidocaine and epinephrine intoxication are found at autopsy in many cases. Forensic pathologists responsible for determining the cause and manner of death should become familiar with the postmortem findings and risks of liposuction therapy and communicate them to their clinical colleagues and communities.
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6/58. Larder beetles (Coleoptera, Dermestidae) as an accelerating factor for decomposition of a human corpse.

    Larder beetles are known to feed directly upon decomposing carrion, with a preference for dried carrion. Under optimal environmental conditions (dry and warm), they can appear in large numbers. In our case, the mummified corpse of a human male was nearly skeletonized in less than 5 months in his apartment with windows closed and a room temperature between 25 degrees C (near the radiator) and 19.4 degrees C (near the body). There were very few empty fly pupae in the apartment, but a lot of adult hide beetles, their larvae and larval cast skins (exuviae) (Dermestes maculatus DEG.) belonging to the family of the larder beetles (Dermestidae). The beetles skeletonized the human corpse in such a short time because of ideal conditions for them in the apartment (dry and warm) making the body an optimal feeding ground because of his mummification.
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7/58. central nervous system consequences of an unusual body disposal strategy: case report and brief experimental investigation.

    The body of a 73-year-old man was dismembered by his female companion for the purpose of covert disposal. The method employed included skillful separation of body parts with hacksaw and knife, piecemeal disposal of fragments, and prolonged boiling of the decapitated head. The latter treatment resulted in marked shrinkage of cranial dura mater, separation of dura mater from skull, and extrusion of brain fragments into the resultant enlarged epidural space through a dural defect due to the disproportionately greater shrinkage of dura mater compared to brain parenchyma. This resulted in curd-like brain fragments filling an enlarged epidural space and overlying a shrunken, leathery dura mater. The cranial dura mater, still adherent to the skull base, resembled a "shrunken brain" in contour but contained only the remnants of brain tissue not already extruded through the dural defect. This unusual thermal artifact is rarely illustrated or mentioned in forensic literature. The development of this postmortem artifact likely requires the presence of a specific combination of conditions which must be, but apparently rarely are, simultaneously present.
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8/58. A fatal case of west nile virus infection in a bone marrow transplant recipient.

    west nile virus (WNV) can cause severe, potentially fatal neurological illnesses, which include encephalitis, meningitis, guillain-barre syndrome, and anterior myelitis. Because of the short viremic phase, WNV infection is most commonly diagnosed by detection of immunoglobulin m antibody to WNV in serum or cerebrospinal fluid (CSF). We describe a patient with T cell lymphoma who had undergone a T cell-depleted bone marrow transplantation and developed fatal WNV infection. The results of serological tests of blood samples and of CSF tests were negative. diagnosis was made postmortem by a positive result of reverse-transcriptase polymerase chain reaction (ABI 7700; TaqMan) for WNV in stored CSF and serum samples.
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9/58. Lethal cyanide inhalation with post-mortem trans-cutaneous cyanide diffusion.

    A 27-year-old worker in a metal processing factory was found dead in a basin, sitting in a solution containing potassium dicyano argentate, potassium cyanide, master batch and brightener 'Elfit 73'. The worker was wearing an acid-resisting overall, rubber boots and a simple dust respirator. While the cyanide concentration in the stomach contents was only 0.05 microg/ml, it was 7.7 microg/g in the lung tissue, 6.3 microg/ml in the heart blood and 31 microg/ml in the femoral vein blood. The different concentrations suggest an initial lethal inhalation of cyanide and an extensive post-mortem diffusion of cyanide through primarily non-injured skin of buttocks and legs. The possibility of a post-mortem cyanide diffusion bars from concluding a vital sign from a high cyanide concentration in a blood sample of one single body site.
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10/58. Fungal tunneling of hair from a buried body.

    Tunnels produced in human head hair by fungal hyphae were examined with a light microscope and with a scanning electron microscope. The tunnels had small diameters and exhibited minimal branching. The use of a backscattered electron detector facilitated the locating of the openings of the tunnels in the surfaces of the hairs. In the backscattered electron image, tunnel openings appeared as dark spots. The tunneling hyphae did not show a preference for a particular location for entering the shaft of the hair. Some hyphae penetrated under the free edges of the cuticular scales, while others burrowed through the surfaces of the scales.
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