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PubMedDate not supplied

[Suicide by intravenous injection of rocuronium-bromide--case report].

Suicides by intravenous injection of an overdose of medicaments are uncommon. In this paper, we present the case of a suicide by rocuronium-bromide injection in combination with an oral overdose of metoprolol. Unfortunately, in Belgrade, there is no toxicological laboratory capable of detecting rocuronium. The interpretation of autopsy and toxicological data in this case was made difficult due to the extreme putrefaction of the body of the deceased. So, by forensic investigation, the case was solved indirectly, through circumstantial evidence: an empty ampoule of rocuronium found near the body, as well as a plastic syringe and cloth-bandage found in the left hand of the deceased.

Adult↗

PubMed1986

Histamine food poisoning: toxicology and clinical aspects.

Histamine poisoning can result from the ingestion of food containing unusually high levels of histamine. Fish are most commonly involved in incidents of histamine poisoning, although cheese has also been implicated on occasion. The historic involvement of tuna and mackerel in histamine poisoning led to the longtime usage of the term, scombroid fish poisoning, to describe this food-borne illness. Histamine poisoning is characterized by a short incubation period, a short duration, and symptoms resembling those associated with allergic reactions. The evidence supporting the role of histamine as the causative agent is compelling. The efficacy of antihistamine therapy, the allergic-like symptomology, and the finding of high levels of histamine in the implicated food suggest strongly that histamine is the causative agent. However, histamine ingested with spoiled fish appears to be much more toxic than histamine ingested in an aqueous solution. The presence of potentiators of histamine toxicity in the spoiled fish may account for this difference in toxicity. Several potentiators including other putrefactive amines such as putrescine and cadaverine have been identified. Pharmacologic potentiators may also exist; aminoguanidine and isoniazid are examples. The mechanism of action of these potentiators appears to be the inhibition of intestinal histamine-metabolizing enzymes. This enzyme inhibition causes a decrease in histamine detoxification in the intestinal mucosa and results in increased intestinal uptake and urinary excretion of unmetabolized histamine.

Animals↗

PubMed1995

Effects of lactitol-oligosaccharides on the intestinal microflora in rats.

Lactitol-oligosaccharide (LO) was prepared from lactitol by a transgalactosylation reaction catalyzed by Aspergillus oryzae beta-galactosidase. The utilization of LO by human intestinal bacteria, the digestion of LO by rat jejunum mucosal homogenates and the effects of LO on the intestinal microflora in rats were compared with those of lactitol. 1) LO was utilized in vitro by Bifidobacterium, but lactitol was not utilized. 2) Neither LO nor lactitol were digested by rat jejunum mucosal homogenates. 3) A significant increase in the fecal counts of Bifidobacterium was observed in the LO diets. 4) The concentration of organic acids in feces and cecal contents significantly increased in the LO diets. 5) The concentration of fecal putrefactive products significantly decreased in the LO and lactitol diets. These findings suggest that LO is effective for improving intestinal conditions.

Acetates↗

PubMed1999

Function of gingival fibroblasts and periodontal ligament cells in the presence of methyl mercaptan.

OBJECTIVE: This study examined the effects of methyl mercaptan, a product of the bacterial putrefaction of protein in periodontal pockets, on the function of cells in culture. METHOD AND MATERIALS: Human gingival fibroblasts and periodontal ligament cells were exposed to a constant, continuous flow of methyl mercaptan in vitro. Control and test cultures were then examined for changes in intracellular pH, an event often associated with alterations in cellular function. Intracellular pH was determined by single-cell image analysis of cells loaded with a fluorescent, pH-sensitive dye. Periodontal ligament cells were also tested for changes in synthesis of total protein and fibronectin. RESULTS: Test cells exhibited a consistent decrease in intracellular pH following exposure to methyl mercaptan. Measurements of total protein production showed that test periodontal ligament cell cultures produced approximately 30% less protein than control cultures (P < 0.05). Western-blot analysis of fibronectin in medium demonstrated that abnormal monomeric fibronectins were a major protein in test, but not in control, cell cultures. CONCLUSION: Exposure to methyl mercaptan induced alterations in intracellular events that paralleled changes in extracellular matrix proteins. The observed changes in extracellular matrix proteins support the hypothesis that methyl mercaptan contributes to the progression of periodontal disease.

Cells, Cultured↗

PubMed1999

Modeling of the oral malodor system and methods of analysis.

Bacterial putrefaction is the central metabolic process involved in oral malodor and can easily be modeled in the salivary sediment system developed from centrifuged whole saliva. Methods used in this system for examining malodor have included measurement of (1) head space (gaseous-phase) and liquid-phase odors, organoleptically; (2) volatile sulfur compounds, by means of an electrochemical sensory instrument; (3) pH, Po2, and oxidation-reduction potential with appropriate respective electrodes; (4) the malodorous compounds indole and skatole, colorimetrically; (5) substrate levels and their effects; and (6) bacterial numbers and types. The simplicity of the system permits other analyses to be easily added, if needed, and the influence of factors and agents that affect oral malodor to be assessed. Addition of odorigenic or non-odorigenic pure cultures to the mixed bacterial flora of the system enables modification of the microflora composition and high- and low-odor-production microflora to be simulated and compared. Modeling validity has been enhanced by the use of complementary in vivo methods, such as a method used to measure the ability or potential of an oral microbial flora to produce malodor. The method involves in vivo challenge testing with cysteine, an amino acid, and measuring the hydrogen sulfide produced. Oral malodor is a multifactorial condition and models enable its systematic study and the quantitative testing of antimalodor agents.

Anaerobiosis↗

PubMed2001

A silica-based mitochondrial DNA extraction method applied to forensic hair shafts and teeth.

The purpose of this study is to evaluate the applicability of a nonorganic DNA extraction method for use in the analysis of environmentally compromised forensic hair shaft and tooth samples. The condition of the samples included cases of water decomposition, severe incineration, and varying stages of putrefaction. Enzymatic amplification and manual sequencing of the first segment of the mitochondrial hypervariable region were performed successfully on each of the 20 autopsied individuals. The results indicate that the silica-based extraction method produces mtDNA suitable for genetic identification from forensic samples including hair shafts and teeth.

Adult↗

PubMed1975

[Drug use leading to death (author's transl)].

23 cases are demonstrated, in which the connection between drug use and sudden death is to be accepted. The victims are only males and juveniles. It is demonstrated by the cases reported, that upon the sudden death of a juvenile increased consideration must also be given to a possible connection between death and drug use. First and foremost the drug used is susceptible of leading to death by way of an intoxication due to too large a dosage or owing to oversensitiveness. Far advanced putrefaction, the combined effects of several drugs including alcohol, the difficulty in furnishing chemical proof of the presence of hashish and LSD in body-fluids and organs can make it nearly impossible to clarify the cause of death. Only what has been related in respect of the manner of living and drug use by members of the family, mates and friends makes the connection between death and drug use appear quite likely. The indirect connection between drug use and the juvenile's death is to be accepted if it comes to the accident under the influence of drugs - be it under the impression of invulnerability or omnipotence or in a state of hallucinations. Depressions under the influence of drugs are also susceptible of resulting in real suicidal actions. In case of inexplicable accidents or entirely unexpected suicide drug effects must, therefore, nowadays be thought of.

Adolescent↗

PubMed2001

Immunostaining by complement C9: a tool for early diagnosis of myocardial infarction and application in forensic medicine.

Before the first 12 hours, diagnosis of early myocardial infarctions is always difficult for forensic pathologists. We tested complement C9 expression in 121 formalin-fixed and paraffin-embedded heart samples by an immunohistochemical procedure. The heart specimens were separated into four groups: 33 cases in group 1 with typical ischemic damages histologically located, 20 cases in group 2 with death related to myocardial infarction on the basis of ischemic presentation on electrocardiogram but no obvious histological ischemic damage, 35 cases in group 3 with severe coronary disease without cause of death found at the autopsy, and 33 cases in group 4 without sign of myocardial infarction and without coronary disease. In the first group, all 33 heart samples showed a well-defined C9 expression in the necrotic areas. The second group in 17 of 20 cases showed positive areas for C9 expression. In the other three heart specimens, only few stained cells were observed whereas the painful symptoms had begun less than 1 h before death. The third group showed C9 immunopositive areas in six of 35 cases, few stained cells in 8 cases, and no C9 deposition in the 21 other cases. The last group showed no staining area. To avoid nonspecific C9 staining due to tissue autolysis, we studied C9 expression during a controlled putrefactive process in four cases included in group 1; staining was found only in infarcted myocardial areas, and was observed up to ten days. Specificity of C9 expression was evaluated to be 100% [89.4 to 100%] and sensitivity to be 85% [62.11 to 96.79%]. In conclusion, evaluation of immunohistochemical expression of C9 appears to be a highly sensitive and specific marker of early myocardial infarction, useful in forensic medicine if survival is more than 1 h after the beginning of myocyte damage.

Autopsy↗

PubMed2001

Effect of bacterial metabolism in the intestine on colorectal tumors induced by 1,2-dimethylhydrazine in transgenic mice harboring human prototype c-Ha-ras genes.

The number of colorectal tumors per mouse induced by 1,2-dimethylhydrazine in transgenic (Tg) mice carrying human c-Ha-ras genes was significantly reduced by ingestion of apple pectin (AP) or a culture condensate of Bifidobacterium longum(MB) compared with a control diet and non-Tg mice. However, there were no differences in the composition of fecal flora, water content, beta-glucuronidase and beta-glucosidase activities, and concentrations of organic acids and putrefactive products in the feces between the AP or MB diet and the control diet, or between the Tg mice and non-Tg mice. The concentration of secondary bile acids in the MB diet group was higher than that in the control group. These results suggested that there was no relationship between prevention of colorectal tumors in Tg mice and the AP or MB diet, or improvement of the intestinal environment due to these functional foods.

9,10-Dimethyl-1,2-benzanthracene↗

PubMed2001

Seasonality of insect succession and pig carcass decomposition in a natural forest area in southeastern Brazil.

In this study, successional patterns, relative abundance of larvae and adults of sarcosaprophagous insects, carcass decay, diversity and seasonality of species, and their potential as forensic indicators were studied. Four experiments were carried out in each season in a natural area of southeastern Brazil. Two pigs (Sus scrofa L.) were used in each experiment and were exposed to sunlight and shade, respectively. The Calliphoridae outnumbered the Sarcophagidae in specimens collected and reared from the carcasses. More insects were collected from carcasses exposed to the sun, while a larger number of specimens were reared from those in the shade. Temperature and rainfall influenced the stages of carcass decay and insect activity and abundance. Chrysomya albiceps was the most abundant species in all four experiments. The carcasses were used as a protein source and substratum for oviposition. The dark putrefaction and fermentation stages yielded more flies than the other stages. These results show that flies are important in carcass decay and are, therefore, also of forensic importance. Seven species can be considered valuable forensic indicators in Southeastern Brazil. However, only three species were useful as forensic indicators in wooded areas: P. intermutans, H. segmentaria, and H. semidiaphana.

Animals↗

PubMedDate not supplied

[Unusual carbon monoxide poisoning].

Despite of indicative death scenes or characteristic findings of the external examination, about 40% of the accidental fatal intoxications due to carbon monoxide are not recognized before the performance of the autopsy. Six cases are reported which illustrate possible reasons for the delayed establishment of the diagnosis: unusual circumstances of the intoxication or sources of carbon monoxide, only subtle degree or lack of external signs of the intoxication or a competing cause of death at autopsy.--Cases 1 and 2: 53, respectively 54-year-old couple, found dead in a caravan, extreme putrefaction of the bodies, spectrophotometric detection of the fatal carboxyhaemoglobin level in oedema fluid of the scalp.--Case 3: 23-year-old lorry driver, found dead in the tightly closed cab of his lorry, operation of a source of electricity with "environmentally friendly" fuel, carboxyhaemoglobin level 83%.--Case 4: 19-year-old man, found dead in the flat of friends, removal of the CO-source before alerting the police forces, lack of the bright pink coloration of livor mortis, haemopericardium due to atrial rupture at postmortem examination, carboxyhaemoglobin level 65%.--Case 5: 27-year-old man, found dead in his flat, advanced decomposition of the body, residues of a charcoal fire in a metal bucket in the sink, carboxyhaemoglobin level 80%.--Case 6: 42-year-old woman, lying dead in the garage beside her car, engine switched-off, ignition key next to the body on the floor under the car, carboxyhaemoglobin level 46%.

Accidents↗

PubMedDate not supplied

[Postmortem roentgen diagnosis of the skull].

In this prospective study, skulls of 164 dead bodies were x-rayed in two different planes. The findings were assessed independent to the results of the subsequent autopsy, however afterwards compared with the autopsy findings. In 86 cases (53.4%) x-ray findings were significant. Dislocated calvarium fractures were clearly visible on the x-rays, however non-dislocated calvarium fractures as well as fractures of the visceral cranium and skull base were difficult to detect. Gas and foreign bodies could easily be observed. Similar to the clinical assessment the indication for a post-mortem x-ray of the skull must consider the case history and the respective condition of the corpse (for example putrefaction, charred body).

Autopsy↗

PubMed2001

[Concealed and simulated trauma fatalities(II)].

A careful investigation of fatal accidents is required due to the relevant financial consequences for the insured as well as for the insurance company. An evaluation of post-mortem cases handled by our institute from 1988 to 1998 showed that 16% of all fatal accidents were not initially classified as such; it was only possible to determine the cause by post-mortem and criminal investigation. The frequency of a relevant alcoholization varied with different types of accidents. Furthermore, of all fatal accidents, 3% were revealed to be deceptive. Those 42 cases in total, presenting themselves as fatal accidents at first glance, were later determined either to be natural deaths (n = 27), homicide (n = 11) or suicide (n = 4). In addition to this, autopsies showed 83 cases of death to be sequelae to accidents. Particularly in cases of a victim plunging out of the window or into water, it can be difficult to make the distinction between natural death--e.g. as a reason for falling--and suicide or homicide. Further difficulties can result from interpretations of the findings in cases of putrefaction, mauling by animals, defects caused by burning or severely deformed corpses. In these cases, the importance of patho-morphological findings from the autopsy must be emphasized. Indirect sequelae of accidents may be pulmonary embolism or pneumonia. The cause of death has to be classified as accidental if the chain of events is of traumatic origin. Mistakes can be avoided if the medical history is taken conscientiously. If no facts are available, the cause of death should be certificated as undetermined. Our evaluation only included autopsy cases from our institute. The concealed fatal accidents which were incorrectly certified as natural deaths or the cases dismissed by the police and the public prosecutor without performing an autopsy were not evaluated.

Accidents, Occupational↗

PubMed1994

[Halitosis (fetor ex ore). A review].

About 15% of the Dutch population has, in a more or lesser degree, complaints about bad breath. This is caused particularly by the anaerobic metabolism of a number of oral microorganisms, in which putrefaction occurs and volatile sulfur compounds will be formed. Some of these compounds are also possibly involved in the pathogenesis of periodontitis. A good oral hygiene is of primary importance to prevent halitosis and to reduce bad breath. Antiseptic mouth-waters can be helpful in the reduction of the bacterial metabolism. In addition, stimulation of the salivary secretion has a dual favourable effect, firstly because of its antimicrobial salivary proteins, and secondly by reduction of the retention of nutrients in the oral cavity.

Bacteria, Anaerobic↗

PubMedDate not supplied

[Gas chromatographic method of quantitative determination of carbon monoxide in cadaver blood].

A gas chromatographic method has been developed for measurement of carbon monoxide in cadaveric blood on a chromatographer with thermal conductivity detector and air oxygen as the internal standard. The error of the method is no more than 4% with the mean quadratic deviation +/- 0.18-0.33 min. The method was studied on 10 model and 30 expert blood samples. Putrefactive products did not influence the accuracy of analysis.

Cadaver↗

PubMed2002

Beta-galactosidase activity in saliva is associated with oral malodor.

Deglycosylation of oral mucins may be a critical initial step leading to their subsequent proteolysis and putrefaction. The present study was undertaken to determine whether activity in saliva of a major glycosidic enzyme (beta-galactosidase) is associated with oral malodor in a group of 64 subjects. Enzyme activity was detected by the use of a chromogenic substrate (X-Gal) impregnated on paper discs. Malodor-related measurements included two odor judges' assessments of whole-mouth and tongue malodor, and volatile sulfide levels measured by a portable sulfide monitor (Interscan Corp.). Beta-galactosidase assay scores were significantly associated with both odor judges' scores for whole-mouth (p < or = 0.002; Spearman) and tongue malodor (p < or = 0.001; Spearman). Beta-galactosidase activity and sulfide monitor measurements both factored significantly into multiple regression equations for odor judge scores, yielding multiple r-values ranging from 0.47 (p = 0.0007) to 0.60 (p < 0.0001). Analysis of the data presented indicates that beta-galactosidase activity in saliva is correlated with oral malodor.

Adult↗

PubMedDate not supplied

[A method for group identification of hair infected with Microsporum].

A method for identifying the group appurtenance of biological objects from subjects suffering from various diseases is developed. The method can be used in examination of putrefactive objects (blood, secretions, hair, etc.) and in cases when the group appurtenance cannot be identified by other methods.

Antigens↗

PubMed2001

Paleoandrology and prostatic hyperplasia in Italian mummies (XV-XIX century).

Prostatic hyperplasia, a very common condition today, was well known in the past as cause for bladder distension. The difficulty to identify, at autopsy of natural or artificial mummies, even a normal-sized prostate is probably the result of putrefaction processes and its usually dramatic size reduction as well. We report two ancient cases of prostatic hyperplasia recently observed in natural mummies from Italy. The first case regards Pandolfo III Malatesta (1370-1427), a leading figure of the Italian Renaissance. He was a valiant soldier and horseman with a very active life style. The tomb, containing his naturally mummified body, has recently been discovered in Fano (Marche, Central Italy). After careful X-ray and videographic examination, the autopsy showed good preservation of the skeletal muscles, cartilage, internal and external organs, included prostate gland and penis. Macroscopic examination revealed a staghorn calculus (calcium urate) of the left kidney and a severe enlargement of the prostate, with calcifications detectable by X-ray and large nodules protruding in the lumen of an ectatic urethra. Histology shows fibrous brands of connective and muscular tissue surrounding circular and oblong lacunae, with no preservation of epithelial structures. The macroscopic and histological picture allowed us to diagnose prostatic nodular hyperplasia. The second case (XIX century) concerns the natural mummy of an anonymous 50-60 years old man, found in ancient friary near L'Aquila (central Italy), which underwent computed tomography and a complete autopsy. Pelvic CT scans showed distended urinary bladder and a ring of dense tissue at the site of the prostate. At autopsy the bladder measured 7 x 6 x 5 cm and the prostate was 4 x 5 x 3 cm; prostatic urethra had a diameter of x 2 cm. Histology revealed dense fibrous tissue containing muscular fibers and roundish cavities of variable size, filled with eosinophil, PAS-positive material. Concretions were also present in some of these spaces. Strong immunohistochemical reactivy for PSA was observed in this material. The existence of glandular structures containing eosinophil, PAS-positive material, immunoreactive for PSA, confirmed the prostatic nature of the specimen, already suspected after CT scan and gross examination. The presence itself of the prostate, its histological picture, the preserved and distended urinary bladder, in addition to the age of the subject, supported the diagnosis of prostatic hyperplasia.

History, 15th Century↗