Forensic Science, Medicine and Pathology最新文献_第9页

Corpse or not? Two peculiar cases of misidentification. 是不是尸体？两个奇特的误认案例

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-03-15 DOI: 10.1007/s12024-024-00799-3

S Plenzig, J Helmus, M Weber, M A Verhoff, V Hachmann

{"title":"Corpse or not? Two peculiar cases of misidentification.","authors":"S Plenzig, J Helmus, M Weber, M A Verhoff, V Hachmann","doi":"10.1007/s12024-024-00799-3","DOIUrl":"10.1007/s12024-024-00799-3","url":null,"abstract":"Irrespective of whether they are intended for collectors or for the fetish market, dolls are being produced to look more and more realistic with such a degree of life-like detail that they can be mistaken for a real person. This paper reports two cases of misidentification due to this increasing similarity: In the first case, a sex doll was mistaken for a corpse; in the second case, a corpse was mistaken for a doll. While in the latter case, only medical laypersons were at the discovery site, in the first case, an emergency doctor had issued a medical certificate of death for the purported corpse. The medicolegal examiner who was subsequently called to the scene could still rectify the misconception on-site. Mistakes of this nature are likely rare phenomena. It, however, remains to be seen if the increasingly life-like appearance of dolls on the one hand, and the increasingly doll-like appearance of some people, e.g., through cosmetic surgery, will lead to a rise in such cases. To avoid misidentification as in the first reported case, it is essential to prepare medical students well for the task of performing a primary external postmortem examination; it is equally important that fully-trained doctors regularly refresh their expertise in this respect.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"314-318"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140131129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Added value of postmortem mri in sudden unexpected infant death cases. 死后核磁共振成像在婴儿意外猝死病例中的附加值。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-06-19 DOI: 10.1007/s12024-024-00850-3

Alexia Van Goethem, Kshitij Mankad, Sniya Sudhakar, Günther De Temmerman, Astrid Van Hoyweghen, Wim Volders, Peter Bracke, Vidija Soerdjbalie-Maikoe, Diona D'Hondt, Babette Van Rafelghem, Werner Jacobs

{"title":"Added value of postmortem mri in sudden unexpected infant death cases.","authors":"Alexia Van Goethem, Kshitij Mankad, Sniya Sudhakar, Günther De Temmerman, Astrid Van Hoyweghen, Wim Volders, Peter Bracke, Vidija Soerdjbalie-Maikoe, Diona D'Hondt, Babette Van Rafelghem, Werner Jacobs","doi":"10.1007/s12024-024-00850-3","DOIUrl":"10.1007/s12024-024-00850-3","url":null,"abstract":"We aimed to investigate the potential added value of postmortem MRI (PMMRI) in sudden unexpected infant death (SUID) cases referred to our center between September 2020 and June 2023. Ultimately, 19 SUID cases underwent PMMRI alongside standard autopsy procedures, which included technical examinations such as postmortem CT (PMCT). Four radiologists, two with prior PMMRI experience, provided structured reports following consensus. For each case, the responsible forensic medicine specialist documented the cause of death before and after reviewing the PMMRI report. Additionally, they assessed the overall impact of the PMMRI report and had the opportunity to provide written comments. The results of our study indicate that none of the PMMRI reports altered the prior determined cause of death, which included cases of infection, asphyxia, and sudden infant death syndrome (SIDS). However, we observed a moderate impact in one case and a low impact in 10 cases. The moderate impact arose from the PMMRI report identifying hypoxic-ischemic changes, where histologic examination of the brain was perceived as normal. Conversely, in the 10 cases with a low impact, the PMMRI reports supported the autopsy findings, specifically indicating brain injury and intra-alveolar cellular infiltrates. In conclusion, our study suggests that while PMMRI may not be pivotal in determining the cause of death in SUID cases, it could aid in detecting hypoxic-ischemic changes and reinforcing brain and lung observations. However, distinguishing genuine lung pathology from postmortem changes using PMMRI remains challenging. Further research is warranted to clarify the role of PMMRI in forensic SUID investigations.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"210-218"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterization of a novel SCN5A mutation associated with long QT syndrome and arrhythmogenic right ventricular cardiomyopathy in a family. 一个家族中与长 QT 综合征和致心律失常性右室心肌病相关的新型 SCN5A 基因突变的特征。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-08-12 DOI: 10.1007/s12024-024-00863-y

Rui Li, Da Zheng, Chunxi Lin, Yili Chen, Yang Bai, Nan Zhou, Qianhao Zhao, Wenzhao Wei, Qiuping Wu, Jiacheng Deng, Shuquan Zhao, Hui Yao, Shuangbo Tang, Bin Luo, Shuiping Liu, Li Quan, Xiaoshan Liu, Jianding Cheng, Erwen Huang

{"title":"Characterization of a novel SCN5A mutation associated with long QT syndrome and arrhythmogenic right ventricular cardiomyopathy in a family.","authors":"Rui Li, Da Zheng, Chunxi Lin, Yili Chen, Yang Bai, Nan Zhou, Qianhao Zhao, Wenzhao Wei, Qiuping Wu, Jiacheng Deng, Shuquan Zhao, Hui Yao, Shuangbo Tang, Bin Luo, Shuiping Liu, Li Quan, Xiaoshan Liu, Jianding Cheng, Erwen Huang","doi":"10.1007/s12024-024-00863-y","DOIUrl":"10.1007/s12024-024-00863-y","url":null,"abstract":"Sudden cardiac death represents a significant diagnostic challenge for forensic pathologists, particularly in inherited arrhythmia syndromes or cardiomyopathies resulting from genetic defects. Molecular autopsies can reveal the underlying molecular etiology in such cases. In this study, we investigated a family with a history of sudden cardiac death to elucidate the molecular basis responsible for sudden cardiac death. The proband underwent a comprehensive forensic examination. Family members received thorough clinical evaluations, including electrocardiogram, Holter monitoring, echocardiography, and cardiac magnetic imaging. Whole exome sequencing and genetic analysis were performed on the deceased and her parents. In addition, Western blotting and patch-clamp recordings were employed to evaluate the expression and function of the mutant protein in vitro. Forensic examination diagnosed arrhythmogenic right ventricular cardiomyopathy (ARVC) as the cause of sudden death. Genetic analysis identified a novel missense mutation in SCN5A (p.V1323L), which was assessed as likely pathogenic by the ACMG guideline. Another family member carrying the mutation manifested long QT syndrome and mild cardiac fibrosis. The cellular electrophysiological study demonstrated that the mutation resulted in an enhanced late sodium current, suggesting it was a gain-of-function mutation. This study characterizes a novel SCN5A mutation that putatively causes long QT syndrome and may contribute to the development of ARVC. Our work expands the pathogenic spectrum of SCN5A variants and underscores the importance of molecular autopsy in sudden death cases, especially in those with suspected genetic disorders.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"33-41"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Classification of 3D shoe prints using the PointNet architecture: proof of concept investigation of binary classification of nike and adidas outsoles. 使用 PointNet 架构对 3D 鞋印进行分类：耐克和阿迪达斯大底二元分类的概念验证研究。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-09-05 DOI: 10.1007/s12024-024-00877-6

Ramazan Oğuz, Hakkı Halil Babacan, Faruk Aşıcıoğlu, Hüseyin Üvet

{"title":"Classification of 3D shoe prints using the PointNet architecture: proof of concept investigation of binary classification of nike and adidas outsoles.","authors":"Ramazan Oğuz, Hakkı Halil Babacan, Faruk Aşıcıoğlu, Hüseyin Üvet","doi":"10.1007/s12024-024-00877-6","DOIUrl":"10.1007/s12024-024-00877-6","url":null,"abstract":"Shoe prints are one of the most common types of evidence found at crime scenes, second only to fingerprints. However, studies involving modern approaches such as machine learning and deep learning for the detection and analysis of shoe prints are quite limited in this field. With advancements in technology, positive results have recently emerged for the detection of 2D shoe prints. However, few studies focusing on 3D shoe prints. This study aims to use deep learning methods, specifically the PointNet architecture, for binary classification applications of 3D shoe prints, utilizing two different shoe brands. A 3D dataset created from 160 pairs of shoes was employed for this research. This dataset comprises 797 images from the Adidas brand and 2445 images from the Nike brand. The dataset used in the study includes worn shoe prints. According to the results obtained, the training phase achieved an accuracy of 96%, and the validation phase achieved an accuracy of 93%. These study results are highly positive and indicate promising potential for classifying 3D shoe prints. This study is described as the first classification study conducted using a deep learning method specifically on 3D shoe prints. It provides proof of concept that deep learning research can be conducted on 3D shoeprints. While the developed binary classification of these 3D shoeprints may not fully meet current forensic needs, it will serve as a source of motivation for future research and for the creation of 3D datasets intended for forensic purposes.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"219-228"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case report of complex suicide in physician: attempt drugs poisoning and adhesive tape asphyxia. 一例复杂的医生自杀报告：企图药物中毒和胶带窒息。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-06-05 DOI: 10.1007/s12024-024-00836-1

Gennaro Baldino, Stefano Vanin, Giorgia Burrascano, Elena Forzese, Alessio Asmundo, Elvira Ventura Spagnolo

{"title":"A case report of complex suicide in physician: attempt drugs poisoning and adhesive tape asphyxia.","authors":"Gennaro Baldino, Stefano Vanin, Giorgia Burrascano, Elena Forzese, Alessio Asmundo, Elvira Ventura Spagnolo","doi":"10.1007/s12024-024-00836-1","DOIUrl":"10.1007/s12024-024-00836-1","url":null,"abstract":"Complex suicides are rare occurrences that can be categorized into planned (or primary) cases and unplanned (or secondary) cases. Additionally, individuals often select suicide methods based on their availability and accessibility. The body of a 58-year-old man was discovered deceased inside his medical office. He was found seated on the waiting room sofa, with his airways obstructed by several layers of adhesive tape wrapped around his head. An intravenous needle was observed in his left arm, and on the table in front of him, an empty 50 ml syringe, two empty vials of 10 ml potassium chloride, and an empty 10 mg vial of Valium (diazepam) were found. A roll of adhesive tape, similar to the one around his head, was also present. The autopsy, conducted 36 h after the body's discovery, revealed therapeutic concentrations of diazepam and its metabolite nordiazepam in the blood samples, while potassium chloride was not detected. Integrating forensic findings obtained from autopsy, histology, and other postmortem investigation, including toxicological analysis, can aid in defining suicidal behavior and preventing misinterpretation, particularly in differentiating diagnosis between homicide and suicide. It is crucial to consider circumstantial data and professional knowledge in such cases.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"302-306"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Applications of forensic anthropology methodology: accuracy of virtual face reproductions performed on the Tenchini collection. 法医人类学方法的应用：对 Tenchini 藏品进行虚拟人脸复制的准确性。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-05-25 DOI: 10.1007/s12024-024-00839-y

Laura Donato, Douglas H Ubelaker, Luigi Tonino Marsella, Valentina Bugelli, Jessika Camatti, Michele Treglia, Rossana Cecchi

{"title":"Applications of forensic anthropology methodology: accuracy of virtual face reproductions performed on the Tenchini collection.","authors":"Laura Donato, Douglas H Ubelaker, Luigi Tonino Marsella, Valentina Bugelli, Jessika Camatti, Michele Treglia, Rossana Cecchi","doi":"10.1007/s12024-024-00839-y","DOIUrl":"10.1007/s12024-024-00839-y","url":null,"abstract":"Facial reproduction validation uses the methodology typical of forensic anthropology to confirm the accuracy of three-dimensional reproductions of faces. Achieving high accuracy in virtual facial reproductions is still under study. In the present paper, the Tenchini collection, which contains wax reproductions of prisoners' faces and their skulls, was used. By creating facial reproductions on skulls from this collection, the result was compared with the real face of the person to whom the skull belongs. The three-dimensional volume of each examined skull of Tenchini collection was acquired via CT scan and photogrammetry. Subsequently, the virtual reproduction of each skull was processed using three-dimensional graphics software (ZBrush, Pixologic®). The morphological comparison parameters used in the field of personal identification by forensic anthropology were used. The blind procedure required the operator to see the mask subsequent to the facial reproduction phase, so that the facial reproduction cannot exploit the information that knowledge of the mask would have produced. The parameters used in the study of facial reproductions have shown discrepancies between the characteristics of the masks and the facial reproductions, partly expected because due to the lack of soft tissue on the skull. However, a high degree of accuracy in the facial reproductions performed due to the applied methodology was documented. The present study allowed us to observe how these parameters can be useful to study the accuracy of facial reproduction and identify what difficulties are encountered in producing a result close to the real appearance.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"203-209"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141096875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Forensic significance of VOCs profiling in decayed ante- and post-mortem injuries by GC×GC-TOF/MS. 利用 GC×GC-TOF/MS 分析腐烂的死前和死后伤痕中的挥发性有机化合物的法医学意义。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-07-13 DOI: 10.1007/s12024-024-00843-2

Damascene Nteziryayo, Jing Wang, Hongyan Qian, Ran An, Gao Baoyao, Hua Liu, Min Liang, Xinshe Liu, Tao Li, Jeannette Uwiragiye, Phazha Joseph

{"title":"Forensic significance of VOCs profiling in decayed ante- and post-mortem injuries by GC×GC-TOF/MS.","authors":"Damascene Nteziryayo, Jing Wang, Hongyan Qian, Ran An, Gao Baoyao, Hua Liu, Min Liang, Xinshe Liu, Tao Li, Jeannette Uwiragiye, Phazha Joseph","doi":"10.1007/s12024-024-00843-2","DOIUrl":"10.1007/s12024-024-00843-2","url":null,"abstract":"Accurately identifying and differentiating the types of injuries in decomposed corpses is a major challenge in forensic identification. Forensic investigations involving decomposed cadavers pose challenges in determining the cause of death. Traditional methods often lack conclusive evidence. However, the implementation of advanced analytical techniques, such as comprehensive two-dimensional gas chromatography coupled with time-of-flight mass spectrometry (GC × GC-TOF/MS), shows promise in overcoming these limitations, but the potential in this area remains limited. Therefore, this study aims to bridge this gap by exploring the potential of GC × GC-TOF/MS in the analysis of volatile organic compounds (VOCs) changes within decaying ante- and post-mortem injuries.The research emphasizes the forensic significance of VOCs changes in decomposed cadavers. We used GC × GC-TOF/MS analysis to identify the specific volatile compounds in putrefied corpse tissue samples from mice. The GC × GC-TOF/MS analysis results showed that under winter conditions, PC1 explained 57.16% of the variance, and PC2 explained 25.23% of the variance; while under summer conditions, PC1 explained 71.89% of the variance, and PC2 explained 24.49% of the variance. This demonstrates the potential of GC × GC-TOF/MS in identifying specific VOCs present in tissue samples that can serve as potential biomarkers for distinguishing between antemortem and postmortem injury. GC × GC-TOF/MS analysis revealed distinct VOC patterns in both conditions. Comprehensive use of GC × GC-TOF/MS analysis enhances accuracy in identifying and characterizing ante- and post-mortem injuries in decomposed cadavers. This study can significantly contribute to the field of forensic medicine and improve the accuracy of forensic investigations.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"138-156"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Partial amputation due to tongue bite in death-associated with eclampsia. 与子痫有关的舌咬伤导致部分截肢死亡。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-06-01 DOI: 10.1007/s12024-024-00844-1

Matías Arroyo-Navarrete, Lourdes Gómez-Jiménez, Gabriel M Fonseca

引用次数: 0

Self-mutilation: a systematic review. 自残：系统回顾。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-04-13 DOI: 10.1007/s12024-024-00809-4

Matheus Medeiros Nunes, Caio Rodrigues Maia, Paulo Roberto de Andrade Santos, Antônio de Lisboa Lopes Costa, Sérgio Adriane Bezerra de Moura, Pedro Paulo de Andrade Santos

{"title":"Self-mutilation: a systematic review.","authors":"Matheus Medeiros Nunes, Caio Rodrigues Maia, Paulo Roberto de Andrade Santos, Antônio de Lisboa Lopes Costa, Sérgio Adriane Bezerra de Moura, Pedro Paulo de Andrade Santos","doi":"10.1007/s12024-024-00809-4","DOIUrl":"10.1007/s12024-024-00809-4","url":null,"abstract":"Self-mutilation lesions can represent a clinical diagnosis challenge for healthcare professionals, as patients do not admit to self-mutilation. This leads to failed diagnoses due to the similarity of this condition to other diseases. Searches on the subject were carried out at the PubMed, Periódicos Capes, Scopus, Science Direct and WoS databases, according to the following inclusion criteria: articles in English, Portuguese or Spanish, published from 2018 to June 2023, encompassing case reports, case series and literature reviews. Men are slight more affected by self-mutilation injuries, also presenting the most serious lesions. Self-mutilation injuries are reported globally, mostly in the Asian and American continents. Clinical presentations are varied, but morphology is, in most cases, associated to the form/instrument used for self-mutilation. Greater evidence of diagnosed mental disorders in women and underreporting of these cases in men due to low demands for specialized treatment are noted. A higher prevalence of self-mutilation lesions was verified for men, affecting a wide age range, with the highest number of cases in the USA. The most affected body areas are arms and external genitalia, mostly due to knife use. An association between self-mutilation injuries and mental disorders is clear, with most cases being previously undiagnosed.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"430-442"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prominent black esophagus, Wischnewsky spots, and black duodenum in a fatal hypothermia case with an underlying diabetic ketoacidosis. 在一个伴有糖尿病酮症酸中毒的致命低体温病例中，出现了明显的黑色食管、Wischnewsky斑点和黑色十二指肠。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2025-03-01 Epub Date: 2024-06-13 DOI: 10.1007/s12024-024-00837-0

Shojiro Takasu, Sari Matsumoto, Kimiharu Iwadate

{"title":"Prominent black esophagus, Wischnewsky spots, and black duodenum in a fatal hypothermia case with an underlying diabetic ketoacidosis.","authors":"Shojiro Takasu, Sari Matsumoto, Kimiharu Iwadate","doi":"10.1007/s12024-024-00837-0","DOIUrl":"10.1007/s12024-024-00837-0","url":null,"abstract":"Hypothermia can occur in patients with diabetic ketoacidosis (DKA), and these two conditions can exacerbate each other. Fatal hypothermia and DKA have overlapping features and findings such as Wischnewsky spots (WS), black esophagus, basal subnuclear vacuolization in the renal tubule, dehydration, and increased acetone levels. Therefore, it may be challenging to differentiate or clarify the context of these two conditions. Herein, we report a case of a 49-year-old man with type 1 diabetes who was found lying in his house in mid-winter. He experienced cardiopulmonary arrest 10 h after the initial discovery and died at the hospital. On autopsy, florid left cardiac blood was observed. Black discoloration of the distal part of the esophageal mucosa, widespread WS in the gastric mucosa, and black discoloration of the duodenal mucosa were observed. Histologically, neutrophil infiltration in the esophageal mucosa, neutrophil infiltration and bleeding in the gastric mucosa, basal subnuclear vacuolization and Armanni-Ebstein lesion in the renal tubule epithelium in the kidney, and hyalinization of the islets of Langerhans were observed in the pancreas. Blood acetone and β-hydroxybutyrate levels were 538 µg/mL and 8947 µmol/L, respectively. Glycated hemoglobin A1c and glucose levels were 16.2% and 883 mg/dL, respectively, while C-reactive protein level was 3.64 mg/dL. In conclusion, obnubilation due to DKA was assumed to be the underlying cause of hypothermia, and the combination of these two conditions led to the outcome of death. The concurrent presence of these conditions likely contributed to the conspicuous mucosal findings in the upper gastrointestinal tract.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"307-313"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0