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The addition of certain amounts of the zeolite mineral klinoptilolith to freshly obtained bird feces led to the retention of nitrogen--up to 14 per cent and more--as compared with feces without zeolite in storage. The addition of the mineral produced also a deodorizing effect in neutralizing the offensive smelling accompanying the putrefaction process.
Tea catechins undergo various metabolic changes after they are taken orally, though a large percentage are excreted intact with the feces. Epidemiological studies suggest a protective effect of tea against various human cancers, including colon and rectum. The bactericidal property of tea catechins plays several roles in the digestive tract. In the small intestine, catechins inhibit alpha-amylase activity, and a certain amount is absorbed into the portal vein. Although catechins are bactericidal, they do not affect lactic acid bacteria. Including tea catechins in the diet for several weeks decreases putrefactive products and increases organic acids by lowering pH. These changes were achieved in tube-fed patients by administering 100 mg of tea catechins (equivalent to a cup of green tea) three times daily with meals for 3 weeks. When catechin administration ceased, the effects reversed after 1 week. Catechins should be considered further in colon carcinogenesis studies.
The authors had opportunities to visit and see the present state of forensic medicine in Dar-es-Salaam, a capital city of United Republic of Tanzania. In this city, Department of Histopathology and Morbid Anatomy in Muhimbili University College of Health Sciences is in charge of education and practice of forensic medicine. All bodies of unusual death, about 3,000 cases per year, are brought to the university mortuary and examined by pathologists. An order of forensic autopsy from the Tanzanian police is submitted to the department with details of the case, i.e. circumstances of death, witnesses, weapons, etc. In each case, a pathologist signs out a death certificate and issues an autopsy report which is standardized throughout the country. Embalming after autopsy is essential in a tropical country. Tanzania in particular, to prevent both putrefaction of the body and dispersion of pathogens during its transportation. Preventive measures against biohazards from human immunodeficiency virus-infected bodies are considered in the autopsy room and laboratory. Although Tanzania is one of the developing countries in the world, the forensic medicine in the capital city is rendering great services in the promotion of public health.
The stability of diltiazem (DTZ) in whole blood and in postmortem samples was investigated. In the first study, an aliquot of outdated Red Cross blood with sodium fluoride added as a preservative was spiked with DTZ and stored for one year under three separate conditions: room temperature, 4 degrees C, and -20 degrees C. DTZ and one of its major metabolites, desacetyldiltiazem (DAD), were quantitated at given intervals during this period. In the second study, case postmortem blood samples (n = 36) that exhibited different degrees of putrefaction were spiked in a similar fashion and the stability of DTZ was determined after storage at 4 degrees C for 92 days. DTZ and DAD were extracted as bases, using mild pH conditions to prevent the hydrolysis of DTZ, and quantitated by an HPLC system equipped with a diode array detector and a Supelcosil LCDP column, 5 microns, 250 mm x 4.6 mm inside diameter. Approximately 50% of DTZ was lost in the Red Cross blood stored at room temperature and 4 degrees C, after 19 and 124 days, respectively. This was associated with concomitant appearance and comparable increase in DAD concentration, presumably due to the in vitro hydrolysis of DTZ to DAD. No significant loss of DTZ was observed in the -20 degrees C samples. Similar changes in DTZ and DAD concentrations were seen in postmortem blood samples stored at 4 degrees C for 92 days, though notably, the extent of loss of DTZ varied from complete to negligible. The data suggest that the potential for in vitro conversion of DTZ to DAD should be considered for proper interpretation of postmortem DTZ/DAD findings. Several cases examined in this laboratory will be used to discuss other forensic implications.
Between-eye differences in electrolyte concentrations were studied in 200 medico-legal autopsies using an ion-specific electrode system. Taking the highest of the paired vitreous potassium concentrations, cases < 15 mM/L were classified as biochemically nonputrefied (Cat.1, n = 124), cases 15 to 20 mM/L as early putrefaction (Cat.2, n = 51), and cases > 20 mM/L as biochemically putrefied (Cat.3, n = 25). Mean paired vitreous sodium for all cases (n = 200) was 112 to 173 mM/L (mean 148, standard deviation (SD) = 8.9); between-eye differences were 0 to 8 mM/L (0% to 5.1% of mean), averaging 1.5 mM/L (1%) and with only one case (in Cat.3) outside instrument accuracy (+/- 3 mM/L). Mean paired vitreous chloride for all cases was 73 to 124 mM/L (mean 109, SD = 7.8); between-eye differences were 0 to 9 mM/L (0% to 8.8% of mean), averaging 1.7 mM/L (1.5%) and with 5 of 200 cases outside instrument accuracy (+/- 3 mM/L). Thus between-eye concentration differences of sodium and chloride are tolerable using this methodology. Previous reports of greater variability likely reflect errors introduced by sample manipulation prior to analysis. By contrast, between-eye differences in potassium in Cat.1 cases were 0 to 2.34 mM/L (0% to 21.8% of mean) averaging 0.37 mM/L (3.3%). Significant and erratic between-eye differences in potassium undermine the usefulness of vitreous potassium in estimation of time of death.
The experience of treatment of 236 patients with cervical phlegmon, in 7 of whom with putrefactive phlegmon, was summarized. The treatment difficulties are due to rapid infection spreading, the possibility absence of timely laboratory confirmation of diagnosis. Operative intervention was conducted during two hour period of time after the hospitalization moment. An adequate detoxication therapy, hyperbaric oxygenation, antibiotic therapy was conducted to all of the patients, metrogyl was administered without fail. Two patients died because of mediastinitis (1) and the pulmonary artery thromboembolism (1).
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