Rubber bullet injury: case report with autopsy observation and literature review.

Rubber bullets are one of the less-lethal (nonlethal) weapons, which are increasingly used to incapacitate dangerous individuals, avoiding use of firearms. An autopsy examination of a man who was shot with improved rubber bullets revealed that the bullet caused pulmonary contusion. The bullet was 30 g in weight and consisted of a sponge foam nose with 40-mm diameter and a plastic body. He was not incapacitated and died of suicidal gunshot wound. The case raised a question as to how severe an injury is necessary to deter a person without causing death. A variety of rubber bullets have been used in the world, and they have occasionally produced severe or lethal injuries. A review of the literature demonstrated that the feature of injuries appeared to be related to the type of missile. It becomes more important for a forensic pathologist to be familiar with rubber bullets and injuries caused by them as the use of less-lethal weapon increases.

A gastric artery aneurysm complicated by a dissection of gastric and hepatic arteries: possible role of adventitial inflammation and disruption of internal elastic lamina in splanchnic artery dissection.

A 77-year-old woman was found deceased at home. An autopsy examination revealed a hemoperitoneum due to a ruptured false aneurysm of a branch of the left gastric artery. A long dissection extending from the aneurysm involved splanchnic arteries including the left gastric, common hepatic, right and left branches of proper hepatic, and intrahepatic arteries. An intimal tear was identified in the common hepatic artery. Neutrophils infiltrating in the adventitia may have been reactive and may have triggered the adventitial rupture of aneurysm or development of the dissection. Disruption of the internal elastic lamina, which has been proposed to cause dissection of intracranial arteries, was seen in the dissected arteries. Little is currently known about aneurysms or dissections of splanchnic arteries; however, observation of adventitial inflammation and internal elastic lamina may help disclose the etiology and pathogenesis.

Primary, extranodal, follicular non-Hodgkin lymphoma of the gallbladder: case report and a review of the literature.

We report the first case of isolated primary extranodal non-Hodgkin lymphoma follicular grade 2 limited to the gallbladder, found in the laparoscopic cholecystectomy specimen from a 70 year old woman with symptomatic cholelithiasis. The pericystic duct lymph node, surgical margins, and other lymph nodes, were not involved with lymphoma. According to the medical literature in English language, mucosa associated lymphoid tissue lymphoma (6 cases) is the most frequent type (38%) of primary gallbladder lymphomas (15 reported cases plus our case). Our case demonstrates that follicular lymphoma can be limited to the gallbladder, and confirm that it can occur in an organ normally devoid of lymphoid tissue.

Correlation between the percentages of myeloblasts in bone marrow obtained by flow cytometry and manual counting on glass slide smears in 74 hematologic patients.

To investigate reliability of calculating percentage of myeloblasts by flow cytometric method, data were obtained from 74 hematologic patients (76 paired data). Myeloblast counts obtained by manual count versus flow cytometry were compared. Our data show that the percentage of myeloblasts in the bone marrow obtained with flow cytometric method correlates well with manual count (correlation coefficient is 0.9912). A very high correlation coefficient means that reliable percentage of myeloblasts in the bone marrow can be obtained by either method alone. Flow cytometry is a useful adjunct (or quality control) to validate manual myeloblast count and vice versa.

Suicidal asphyxiation by using pure helium gas: case report, review, and discussion of the influence of the internet.

Suffocation by inhaled gases has been reported involving a variety of gases. We report a case of suicidal asphyxiation by forced replacement of oxygen with helium by using a complex homemade mask. In this case, a young woman researched suicide on the Internet and found an advocated method of suicide using helium. To our knowledge, there is only 1 previously reported case of suicidal asphyxia by using helium.

Nanobacteria-caused mitral valve calciphylaxis in a man with diabetic renal failure.

We have found that nanobacteria, recently discovered Gram-negative atypical bacteria, can cause local calciphylaxis on the mitral valve in a setting of high-calcium X phosphorous product in the blood. We present the case of a 33-year-old man with diabetic renal failure on continuous ambulatory peritoneal dialysis who died as a result of multiple brain infarcts due to embolizations from mitral valve vegetations. Systemic calciphylaxis was not present. Spectrometric analysis of the mitral valve vegetations showed that they were composed of calcium phosphate, carbonate apatite form, and fibrin. The electron microscopy of the thrombotic vegetation demonstrated nanobacterium as a nidus for carbonate apatite formation. Investigation for the presence of nanobacteria in the multiple organs involved in systemic calciphylaxis may be of help in elucidating the pathogenesis of this frequently fatal disorder.