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PubMedDate not supplied

Experimental studies on the presumption of the time after food intake from stomach contents.

A variety of model experiments were conducted in an attempt to obtain reference data for estimating the time of death from the stomach contents. The evidence derived from experiments with artificial gastric juices comparing the rates of digestion of various items of food showed that fish is more quickly digested than meat, with relatively small fish being disintegrated and becoming unrecognizable within a short time. The lower the pH of the gastric juice, the faster the rate of digestion. Experiments with dogs to study the rate of digestion of various food products indicated that, while the residual stomach contents decreased with time, there was still 190 g (approx. 36%) left in the stomach after 8 h. This suggested that, depending on the conditions, food can remain in the stomach for a considerable length of time. The residual contents in a dog's stomach and the changes in the shape of the food ingested may not necessarily concur, as the observations suggested that, after a lapse of eight hours, the stomach contained food that had been half digested as well as that which had virtually retained its original shape. Lumps of meat with a large surface area are digested more quickly than those with a small surface area, indicating the importance of mastication. Experiments on human stomach contents after ingestion of food mixed with a contrast medium showed that these had been discharged almost completely after 5 h. A somewhat larger amount of food had been retained in the stomach following alcohol intake as compared with no alcohol consumption. Experiments performed on dogs to determine their stomach contents after death indicated that, in high-temperature conditions, for example, the ingested chunks of meat are reduced to a mushy-sloppy consistency after three days, suggesting that digestion will proceed to some extent after death as putrefaction continues.

Animals↗

PubMed1994

The detection of petechial haemorrhages of the conjunctivae in dependency on the postmortem interval.

Petechial haemorrhages of the conjunctivae are not specific for lethal throttling or strangulation, but they belong to the important indicators for such mechanisms. In experimental models it is shown that petechial bleedings of the conjunctivae disappear with the occurrence of advanced signs of putrefaction or in cases of fresh-water logging. Therefore, it must be emphasized that the lack of petechial haemorrhages in putrefied or fresh-water-logged corpses is of very restricted meaning for the examination, whether throttling or strangulation has taken place or not, and the autopsy should always be performed in these cases with special regard to the neck.

Asphyxia↗

PubMed1994

Zopiclone poisoning: tissue distribution and potential for postmortem diffusion.

Zopiclone is the first cyclopyrrolone hypnotic and is chemically unrelated to any existing drug. The authors studied the tissue distribution and postmortem redistribution of zopiclone in a fatal suicidal overdose. A 29-year-old female weighing 64 kg had cardiac blood ethanol 153 mg% and zopiclone blood concentrations in the range 0.9-2.0 microgram/ml in 10 distinct sampling sites. After 40 h at room temperature the range was 0.9-1.8 micrograms/ml in 15 samples. Portal venous blood and urine concentrations were 3.0 and 10.5 micrograms/ml, respectively. Tissue concentrations (microgram/g) were spleen 5.8, peri-renal fat 5.0, psoas muscle 3.3, brainstem 2.8, gastrocnemius muscle 1.9, myocardium 1.6, and kidney 1.7. Eight liver samples had concentrations in the range 0.5-4.9 micrograms/g, with highest concentrations in the left lobe and adjacent to the gallbladder, probably reflecting postmortem diffusion from gastric residue (700 ml, 55.1 micrograms/ml) and bile (14.1 micrograms/ml). Of six lung samples, paired upper and middle samples had concentrations in the range 2.1-2.3 micrograms/g, the right postero-basal 1.3 micrograms/g and the left postero-basal 3.4 micrograms/g. Drug concentration in putrefactive pleural fluid was also higher on the left (2.1 micrograms/ml) than the right (1.4 micrograms/ml), probably reflecting postmortem diffusion from gastric residue. The authors conclude that zopiclone showed little preferential concentration in solid organs and consequently has relatively stable postmortem blood concentrations, with little drug redistribution artefacts. Postmortem diffusion from gastric drug residue elevates drug levels in the left lobe of the liver and left lung lower lobe.

Adipose Tissue↗

PubMed1995

Postmortem degradation of administered ethanol-d6 and production of endogenous ethanol: experimental studies using rats and rabbits.

Deuterium-labeled ethanol-d6 was employed to study the metabolism and postmortem change of ethanol in putrefied organ tissues. First, 4 ml/kg body weight of 25% (w/v) solution of ethanol-d6 was administered orally to each of 15 rats. The heart blood and organs were collected 15-90 min after the administration and the ethanol-d6 was analyzed by head space gas chromatography/mass spectrometry. The ethanol-d6 concentration in the organ tissues reached its maximum at 15 min after the administration and then gradually declined, showing the same pattern as human ethanol metabolism. Ethanol-d6 (3 ml of the same solution/kg body weight) was injected into the vein of a rabbit's ear (total of 12 rabbits). The rabbit was killed with carbon monoxide 30 min after the administration and the carcass was allowed to stand for 1-4 days at 30 degrees C in a moist chamber. The concentration of ethanol-d6 decreased moderately. Postmortem ethanol and 1-propanol concentrations, in contrast, showed marked increases 2.5 days and more after sacrifice in line with the degree of putrefaction of each organ tissue including skeletal muscle. This suggests the postmortem activation of micro-organism activity. These results indicate that ethanol concentrations in cadaver tissues must be carefully assessed with due consideration of postmortem degradation and production.

1-Propanol↗

PubMed1996

Gas chromatographic procedures for determination of ethanol in postmortem blood using t-butanol and methyl ethyl ketone as internal standards.

Three gas chromatographic procedures for the determination of ethanol in postmortem blood using alternative internal standards to n-propanol are presented: a direct injection procedure using t-butanol, and two headspace methods using t-butanol and methyl ethyl ketone. t-Butanol and methyl ethyl ketone were well resolved from ethanol, acetone, methanol and other commonly observed putrefactive volatiles using direct injection or headspace analysis. CVs for the direct injection method were below 5% for ethanol and below 10% for the other volatiles. The lower limits of detection (LOD) were 25-50 mg/L. The CVs for the headspace methods were below 5% for ethanol and below 6% for the other volatiles. The LODs were 10 mg/L using either t-butanol or methyl ethyl ketone as internal standards. The use of t-butanol or methyl ethyl ketone as alternatives to n-propanol avoids the possibility of error in the quantitation of ethanol due to the presence of n-propanol and allows for the identification of other volatiles that may aid in distinguishing antemortem ingestion from postmortem production of ethanol.

Butanols↗

PubMed1990

Antioxidant functions of phytic acid.

Phytic acid is a natural plant antioxidant constituting 1-5% of most cereals, nuts, legumes, oil seeds, pollen and spores. By virtue of forming a unique iron chelate it suppresses iron-catalyzed oxidative reactions and may serve a potent antioxidant function in the preservation of seeds. By the same mechanism dietary phytic acid may lower the incidence of colonic cancer and protect against other inflammatory bowel diseases. Its addition to foods inhibits lipid peroxidation and concomitant oxidative spoilage, such as discoloration, putrefaction, and syneresis. A multitude of other industrial applications are based on the antioxidant function of phytic acid.

Animals↗

PubMed2006

Prebiotic effects of neoagaro-oligosaccharides prepared by enzymatic hydrolysis of agarose.

To investigate the prebiotic properties of neoagaro-oligosaccharides (NAOS), obtained from enzymatic hydrolysis of agarose, the in vitro and in vivo effects of NAOS on bacterial growth were studied. In vitro NAOS were found to be highly resistant to enzymes of the upper gastrointestinal tract, which remained intact after 24h incubation with different amylolytic enzymes. NAOS significantly stimulated the growth of bifidobacteria and lactobacilli in Man-Rogosa-Sharp (MRS) medium, anaerobically. Compared with fructo-oligosaccharides (FOS), 1% (w/v) NAOS promoted the specific growth rate of beneficial bacteria by about 100%. The decreases of media pH with NAOS were almost the same as that with FOS. In vivo, NAOS significantly increased the numbers of lactobacilli and bifidobacteria (P<0.05) in fresh feces or cecal content while reducing putrefactive microorganisms. Mice fed with 2.5% (w/v) NAOS for 7 days had larger increases in colonic beneficial bacteria population than those fed with even 5% (w/v) FOS for 14 days. No side effects, such as eructation and bloating, were found. Interestingly, NAOS with higher degrees of polymerization (DP) showed better prebiotic activity. These results indicated that NAOS had great prebiotic effect, which could be beneficial to the host.

Animals↗

PubMed2005

Lactic acid fermentation of food waste for swine feed.

This study was conducted to determine the effects of lactic acid bacteria (LAB, Lactobacillus salivarius) inoculation on the microbial, physical and chemical properties of food waste mixture (FWM) stored at ambient temperature (25 degrees C) for 10 and 30 days. A complete pig diet including restaurant food waste, bakery by-product, barley and wheat bran, and broiler poultry litter was amended with LAB at the levels of 0.1%, 0.2%, 0.5% and 1.0% and fermented anaerobically. These treatments were compared with intact FWM before storage and non-anaerobically stored FWM. Non-anaerobic storage of FWM showed microbial putrefaction with the loss (P < 0.05) of water and water soluble carbohydrate (WSC) and increases (P < 0.005) in protein and fiber. Anaerobic fermentation of FWM with or without LAB seemed effective in both 10- and 30-day-storage. The addition of LAB inoculants to FWM showed a linear trend (P < 0.05) toward an increase in the number of total and lactic acid bacteria and toward the nutritional improvement with WSC increased and fiber decreased. Long-term (30 days) storage resulted in consistent reduction (P < 0.05) in numbers of total and lactic acid bacteria and pH and showed little change in chemical components, compared with short-term (10 days) storage. On the basis of these results, LAB inoculation improved fermentative characteristics of FWM. Among anaerobic treatments, further WSC increase and NDF reduction did not occur (P > 0.05) when LAB-added levels were over 0.2%. Based on these observations the optimum level of LAB addition to FWM was 0.2%.

Anaerobiosis↗

PubMed2004

Interpretation of a 3,4-methylenedioxymethamphetamine (MDMA) blood level: discussion by means of a distribution study in two fatalities.

The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy" is a currently used or abused designer drug and fatalities are frequently encountered in forensic practice. However, the question remains open whether an MDMA blood level can be toxic or even potentially lethal. In order to provide insight in the interpretation of a detected MDMA concentration, the distribution of MDMA and its metabolite 3,4-methylenedioxyamphetamine (MDA) in various body fluids and tissues was studied and discussed in two different fatalities. Apart from peripheral blood samples (such as femoral and subclavian blood), various blood samples obtained centrally in the human body and several body fluids (such as vitreous humour) were examined. In addition, various tissues such as cardiac muscle, lungs, liver, kidneys, and brain lobes were analysed. In contrast to the peripheral blood levels, high MDMA and MDA levels were found in cardiac blood and the majority of the organs, except for the abdominal adipose tissue. The high concentrations observed in all lung lobes, the liver and stomach contents indicate that post-mortem redistribution of MDMA and MDA into cardiac blood can occur and, as a result, blood sampled centrally in the body should be avoided. Therefore, our data confirm that peripheral blood sampling remains "the golden standard". In addition, a distinct difference in peripheral blood MDMA concentrations in our two overdose cases was established (namely 0.271 and 13.508 microg/ml, respectively). Furthermore, our results suggest that, if a peripheral blood sample is not available and when putrefaction is not too pronounced, vitreous humour and iliopsoas muscle can be valuable specimens for toxicological analysis. Finally, referring to the various mechanisms of death following amphetamine intake, which can result in different survival times (e.g. cardiopulmonary complications versus hyperthermia), the anatomo-pathological findings and the toxicological results should be considered as a whole in arriving at a conclusion.

3,4-Methylenedioxyamphetamine↗

PubMed2005

Site-dependent production of gamma-hydroxybutyric acid in the early postmortem period.

This study compared endogenous gamma-hydroxybutyric acid (GHB) concentrations in various postmortem fluid samples of 25 autopsy cases. All bodies were stored between 10-20 degrees C until autopsy, and the intervals between death and autopsy were less than 2 days (6-48 h). GHB concentrations were measured by headspace gas chromatography after GHB was converted to gamma-butyrolactone. Endogenous GHB concentrations were significantly higher in femoral venous blood (4.6+/-3.4 microg/ml, n=23) than in cerebrospinal fluid (1.8+/-1.5 microg/ml, n=9), vitreous humor (0.9+/-1.7 microg/ml, n=8), bile (1.0+/-1.1 microg/ml, n=9) and urine (0.6+/-1.2 microg/ml, n=12). GHB concentrations were similar in blood samples taken from different sites. Cut-off limits of 30 and 10 microg/ml are proposed for blood and urine, respectively, to discriminate between exogenous and endogenous GHB in decedents showing no or little putrefaction (postmortem intervals usually 48 h or less). The criterion established for endogenous GHB in postmortem urine may also be applicable to analytical results in cerebrospinal fluid, vitreous humor and bile from deceased persons.

Adult↗

PubMed2005

An unusual occupational accident: fall into a sewage plant tank with lethal outcome.

Occupational accidents, often presenting with lethal outcomes, are a rarely reported issue in forensic literature. However, these incidents are part of medicolegal casework with special regard to reconstruction, liabilities and insurance law-related issues, respectively. We report on a lethal occupational accident in a metropolitan sewage plant. When performing routine controls, a technician fell into an overflow sewer and was immediately pulled into a 30 cm diameter drain. Rescue efforts were initiated immediately, but had to be terminated due to gas warning. Rescue teams continued the search, however, the body remained undiscoverable. Forty-eight hours later, the cadaver was found in an adjacent digester tank, from where it was finally rescued. It was concluded, that the body had been transported between the overflow sewer and the digester tank through a 120 m pipeline with several 90 degrees bendings and branch connections with a minimum diameter of 25 cm at the discharge valve. On medicolegal examination, the cadaver showed marked signs of advanced decomposition caused by anaerobic microorganisms in the 37 degrees C biomass environment. Moreover, as a consequence of the passage of the pipeline system, signs of massive trauma (several comminuted and compound fractures) were disclosed at autopsy. To us, this is the first report on a lethal occupational accident in a sewage plant; our observations demonstrate the rapid progress of putrefaction in a warm anaerobic bacterial environment and the massive trauma sustained.

Accidents, Occupational↗

PubMed2004

Pneumomediastinum and soft tissue emphysema of the neck in postmortem CT and MRI; a new vital sign in hanging?

Spontaneous pneumomediastinum commonly occurs in healthy young men or parturient women in whom an increased intra-alveolar pressure (Valsalva maneuver, asthma, cough, emesis) leads to the rupture of the marginal pulmonary alveoli. The air ascends along the bronchi to the mediastinum and the subcutaneous space of the neck, causing cervico-fascial subcutaneous emphysema in 70-90% of cases. Ninety-five forensic cases, including five cases of hanging, were examined using postmortem multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) prior to autopsy until December 2003. This paper describes the findings of pneumomediastinum and cervical emphysema in three of five cases of hanging. The mechanism of its formation is discussed based on these results and a review of the literature. In conclusion, when putrefaction gas can be excluded the findings of pneumomediastinum and cervical soft tissue emphysema serve as evidence of vitality of a hanged person. Postmortem cross-sectional imaging is considered a useful visualization tool for emphysema, with a great potential for examination and documentation.

Adult↗

PubMed2005

Comparison of ethanol concentrations in right cardiac blood, left cardiac blood and peripheral blood in a series of 30 cases.

The aim of this study was to compare ethanol concentrations in right cardiac blood, left cardiac blood and peripheral blood. Samples were taken from a series of 30 medicolegal autopsies. Ethanol was measured by headspace GC-FID. In each case, the degree of putrefaction, chest or abdominal injury, and/or regurgitation of gastric contents into the airways were noted. Our results show that there exists in certain cases a marked increase in ethanol concentration in left cardiac blood compared with right cardiac blood and peripheral blood. In these cases, we observed (i) a high concentration of ethanol in the gastric contents and (ii) regurgitation of gastric contents into the airways. The authors discuss the post-mortem redistribution mechanisms which could explain these results and stress the value of sampling right cardiac blood at autopsy.

Central Nervous System Depressants↗

PubMed2005

Is there recent progress in the estimation of the postmortem interval by means of thanatochemistry?

Numerous methods have been proposed in the last 60 years for the determination of the time since death by chemical means. Many of them were reviewed by Schleyer in his monograph on the determination of the time since death by means of thanatochemistry about 40 years ago and none of these early methods has gained any practical value since they do not meet the demands in practice (being precise, reliable, giving an immediate result). While the earlier studies were mainly carried out on blood and cerebrospinal fluid (CSF) since the late 60s most investigations have been performed on vitreous humor (VH). This is mainly due to the fact that vitreous humor is topographically isolated and well protected, and thus, autolytic changes proceed slower compared to blood and CSF. The most studied parameter in VH is potassium and even nowadays reports on the postmortem rise of vitreous potassium are published, proposing new analytical methods or statistical evaluations. Chemical parameters studied for the determination of the time since death have to be differentiated according to the underlying process (catabolism, metabolic processes, pure autolysis and diffusion, putrefactive changes). In the present paper, recent studies on thanatochemistry are discussed regarding the underlying process, the analytical methods (for instance H magnetic resonance spectroscopy (1H MR spectroscopy), immunohistochemistry), the studied fluid compartment, the statistical evaluation and the precision of death time estimation. The value of chemical methods for the determination of the time since death is up to now very limited. This is supported by the fact that field studies on the reliability and precision of death time estimation by chemical means are still scarce in the literature.

DNA↗

PubMed2006

Ethanol production by Candida albicans in postmortem human blood samples: effects of blood glucose level and dilution.

We present two cases in which the ethanol concentration in blood samples taken after death continued to increase in the absence of any remarkable increase in n-propanol concentration. Species of bacteria and yeasts, including Candida albicans were isolated from these samples. We then examined whether C. albicans, the most common yeast in the general environment, was able to produce ethanol in human blood stored at room temperature. Ethanol production increased as the glucose concentration increased, indicating that C. albicans produced ethanol from the glucose. Our results also suggested that C. albicans produced ethanol more easily in blood diluted by intravenous infusions that included glucose than in undiluted blood. These findings are useful for the evaluation of postmortem ethanol production in subjects whose blood has been diluted by infusions with glucose. Furthermore, there was no quantitative relationship between the amount of n-propanol detected and the amount of ethanol production: n-propanol appears to be an unreliable index of putrefaction and postmortem ethanol production by C. albicans. It is possible for the blood ethanol level to be high and n-propanol not to be detected, even if the subject has not been drinking alcohol. We reconfirmed the necessity of immediately adding sodium fluoride to samples for ethanol analysis to prevent postmortem ethanol production.

1-Propanol↗

PubMed2007

The routine use of C-reactive protein in forensic investigations.

In clinical medicine, C-reactive protein (CRP) is extensively used as a general marker for immune system activation, and post-mortem applicability has been established [M.Q. Fujita, B.L. Zhu, K. Ishida, L. Quan, S. Oritani, H. Maeda, Serum C-reactive protein levels in postmortem blood-an analysis with special reference to the cause of death and survival time, Forensic Sci. Int. 130 (2002) 160-166; L. Uhlin-Hansen, C-reactive protein (CRP), a comparison of pre- and post-mortem blood levels, Forensic Sci. Int. 124 (2001) 32-35]. We have analysed the routine use of CRP in non-selected cases. Scarcity of blood available for analysis is a common problem in forensic investigation, and in response to this we have developed a method using liver as a source. In 50 consecutive autopsy cases, we have evaluated method, validated results and discussed their interpretation. In three cases the analysis was not possible. For each of the remaining cases (n=47) we have analysed whole blood, serum and/or liver samples. 57% (n=25) had serum CRP > 10 mg/L. Serum levels were higher than in whole blood or liver. CRP levels in serum and whole blood samples were stable in more than one month after death, making storage for later analysis possible. Liver levels peaked at one week, but after one month putrefaction was obvious. CRP levels were independent of the post-mortem interval. The use of liver as a source has not yet been described in literature. Our results in liver samples correlate well with plasma results, and liver is a good post-mortem alternative when blood is not available. We conclude that CRP measurements are easy, viable and inexpensive in a forensic setting, and that the number of cases with CRP elevation is high in a non-selected forensic material. In cases of doubt, marked elevation of CRP is an indicator of natural mode of death, and in cases of trauma, it indicates vital reaction. It can be used as a pre-autopsy screening, leading to a more extensive search for diseases not easily diagnosed, such as sepsis or ketoacidosis.

Adolescent↗

PubMed2006

Haemolytic staining of the intima of the aortic root-- a useful pathological marker of freshwater drowning?

UNLABELLED: The significance of haemolytic staining of the aorta is unclear. While it has been associated with freshwater drowning, data are lacking. To study this phenomenon further a prospective study looking at the colour of the intima of the pulmonary trunk and aortic root was undertaken in 47 randomly selected coronial control cases and in 13 consecutive fresh drowning deaths. There were 16 putrefied control cases each of which showed haemolytic staining of both great vessels. Of the other 44 non-putrefied cases (31 controls, 9 saltwater drownings, and 4 freshwater drownings), only one (a freshwater drowning) showed marked staining of the aortic root with no staining of the intima of the pulmonary trunk. CONCLUSION: This study has demonstrated that haemolytic staining of the aorta at autopsy, in the absence of significant staining of the pulmonary trunk and putrefaction, may be a pathological feature that is supportive of freshwater drowning. It is not, however, present in all cases. Given the relatively small numbers in this study further work is required to clarify this issue.

Adolescent↗

PubMed2005

Gastric mucosa lesions in drowning: its usefulness in forensic pathology.

In a retrospective study of 52 autopsy cases of drowning fatalities, death circumstances, macroscopical and histological findings of the stomach mucosa were carefully studied. Results were compared with a control group, composed by 80 cases of different kinds of asphyxia (hanging, chocking and suffocation), skull injuries, sudden cardiac death and poisonings. The spectrum of gastric lesions observed during autopsy in drowning group, are presented. Stomach mucosa tears were found in 21.1% of the cases of drowning, preferably on fundus (54.5%). The control group does not show similar lesions. The physiopathological mechanism of its production, are also discussed. On sight of these results, it is concluded that the macro and microscopical examination of the stomach could be useful as an adjunct procedure for drowning diagnosis. The presence of gastric mucosa lesions has an intravital significance and could be correlated with other anatomical or histological signs of drowning for the diagnosis. In every case, necropsic examination must be carried out as soon as possible in order to avoid putrefactive artifacts.

Adolescent↗