Biomedical subjects
Publications and source records attributed to C T Cooke.
We describe a 25-year-old woman with pre-existing mitral valve prolapse who developed intractable ventricular fibrillation after consuming a "natural energy" guarana health drink containing a high concentration of caffeine. This case highlights the need for adequate labelling and regulation of such products.
We present a review of the circumstances and medical findings of 280 fatalities due to hanging in Western Australia (WA) during the 5 yr period 1988-1992. Two hundred and forty one (241) of the cases were examined prospectively; the completed Coroner's files of a further 39 cases, from rural WA, were examined retrospectively. Most of the 280 deaths were in males (88%), and most were in the age range of 15-35 yrs (56%). Seven cases occurred in children aged 15 or less. There was one homicide, 14 cases thought to be accidental, and 261 suicides; in 4 cases the manner of death could not be determined. In one-third of the cases there was a medical history of a psychiatric condition. The majority occurred in or around the decedent's home (71%). The most commonly used ligature was a rope (59%). Alcohol was the most commonly detected drug following post mortem analysis (30%). In WA then, there is one hanging death every 6.5 days, the majority being suicides, in men of young adult age, typically occurring in or around the home.
Previous research showed that the sudden infant death syndrome (SIDS) rate for Aboriginal infants significantly increased during the 1980s in Western Australia (WA) and raised the possibility of a diagnostic transfer of Aboriginal infant deaths from other causes to SIDS over this period. Here, therefore we review the pathology of SIDS and other sudden and unexpected deaths in infancy (SUDI) for Aboriginal and non-Aboriginal infants in WA between 1980 and 1988. The aim was to investigate whether there had been differences in the diagnosis and/or classification of SIDS according to whether the infants were Aboriginal or non-Aboriginal. The study population comprised: (1) all Aboriginal cases of SIDS and other SUDI between 1980 and 1988, and (2) corresponding random samples of non-Aboriginal cases. A two-stage process was employed for the review. First, histology slides were reviewed for each case where the aboriginality of the infant was Aboriginal and the original cause of death were unknown to the pathologists. Second, all paper records (i.e. death scene investigations, laboratory tests and medical reports) except for the original cause of death information were reviewed by the pathologists. The results showed that there was excellent agreement between the final review diagnosis and the original diagnosis for both Aboriginal and non-Aboriginal SUDI. Thus, there was no evidence for a diagnostic shift among Aboriginal infant deaths and the review supported the observed increase in the SIDS rate for Aboriginal infants.
We describe the circumstances and post mortem medical findings of 4 unusual fatalities where death occurred during autoerotic practice. Three cases occurred in young to middle-aged men--hanging, electrocution and inhalation of a zucchini. The manner of death in each was accidental. The fourth case was an elderly man who died of ischemic heart disease, apparently whilst masturbating with a vacuum cleaner and a hair dryer.
We describe the unusual case of a 20-year-old Aboriginal man who was admitted to hospital with chest pain. He died 1 day later. Necropsy showed extensive anterior myocardial infarction in the left ventricle. An isolated diverticulum arising from the subaortic valve region of the left ventricle had compressed the left main coronary artery.
During the 16-year period of 1972-1987, there were 11 hanging deaths in children in Western Australia. We report the circumstances and medical findings of each case.
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Migration of foreign material within the subarachnoid space is a rare event, seldom reported in the medical literature. We report a unique case in which spinocerebral migration of faecal material occurred as a direct consequence of a shotgun injury to the pelvis.
We describe the circumstances and medical findings of four unusual hanging deaths. In brief, the unusual features are tracheostomy, delayed death, self-mutilation combined with severe neck injury caused by lengthy drop, and homicidal hanging in a young girl.
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Shotcup petal abrasions centered around a shotgun wound of entrance are generally thought to occur at a range of 30 to 90 cm. A suicidal .410-caliber shotgun injury of the right eye is described in which typical petal abrasions were noted around the entrance wound. However, significant soot deposition around the wound suggested that the range of fire was less than 30 cm and perhaps closer to 15 cm. Test-firing of the weapon and ammunition used by the decedent showed some spread of the shotcup petals at a range of 7.5 cm, progressing to maximum spread at 30 to 52.5 cm. Further testing with other .410 ammunition, containing shotcups, confirmed the spread of shotcup petals at ranges less than 30 cm, irrespective of manufacturer, shotshell length, and birdshot size. When a variety of shotguns were tested, it was found that one weapon with a very short barrel and cylinder bore did not exhibit petal spread until a range of 30 cm was reached. The remaining shotguns, with longer barrels and full choke, all demonstrated definite petal spread at a range of 12.5 cm. The long, narrow configuration of .410 shotcup petals may explain their early spread and the production of petal abrasions at ranges of less than 30 cm.
A case of ovarian carcinoma that spread to the umbilicus and resulted in Sister Mary Joseph's nodule is described in which the mode of metastasis can be demonstrated. To our knowledge, this is the first report of confirmed contiguous extension from the peritoneal surface.
We report a case of pulmonary asbestosis in a patient who also developed glomerulonephritis and lymphomatoid granulomatosis. The pulmonary reaction was unusual, characterized clinically by an acute onset of symptoms after a prolonged latent period and morphologically by an interstitial pneumonitis with prominent desquamative features and a paucity of fibrosis. The association of pulmonary asbestosis with glomerulonephritis and lymphomatoid granulomatosis has been hitherto unreported.
Morphological and cytogenetic studies undertaken in a case of sex reversed campomelic dysplasia revealed the presence of primary follicles within the dysgenetic gonads and a familial balanced chromosome translocation t(5;8), a hitherto unreported combination of unusual findings.
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