Natural death in the setting of autoerotic practice.

Deaths in an autoerotic setting are usually due to accidental asphyxia, in which the individual accidently hangs or strangles themselves while inducing hypoxia for the purpose of heightened arousal. Death occurs when the level of hypoxia causes the individual to lose consciousness and is thus unable to prevent the neck compression from becoming lethal. In some cases there is an "escape" mechanism incorporated into the set-up which may fail. In rare cases, death is not as an immediate result of the autoerotic activity and is as a result of natural causes, which may or may not be related to the process. This case demonstrates the death of a 69 year old male which has occurred in the setting of a complex autoerotic environment, not as a result of asphyxiation, but rather as a result of natural causes which is likely to have been brought about by repeated similar activity. The autopsy revealed pulmonary emboli and lower limb deep vein thrombosis. There was no other natural disease of note and no features considered typical of asphyxiation.

Suicide by hydrogen sulfide inhalation.

The authors report a case of suicide by hydrogen sulfide in Australia. A young woman was located in a car wearing protective eyewear. A tub of foamy yellow substance and a quantity of hydrochloric acid and lime sulfur were also located in the rear of the vehicle. Morphological findings at autopsy were nonspecific. Toxicologic analysis of a specimen of leg blood detected elevated levels of methemoglobin. If Australia follows a similar trend to Japan and the United States, it is possible that incidences of such cases will rise, probably because of Internet dissemination. From a public health perspective, emergency service providers and forensic case workers should be aware of the potential hazards to themselves and others when dealing with such cases.

Post mortem CT demonstration of hemoperitoneum caused by rupture of a paraumbilical vein into a paraumbilical hernia in a man with liver cirrhosis and portal hypertension.

In patients with liver cirrhosis and portal hypertension collateral circulation can develop to direct blood from portal to systemic veins allowing decompression of the portal system. A potential complication of portal hypertension is rupture of collateral vessels with subsequent fatal hemorrhage, occurring most commonly in the esophagus. The paraumbilical vein is a recognized collateral pathway in patients with portal hypertension however cases of rupture have been rarely documented. The authors report a case of hemoperitoneum caused by rupture of a paraumbilical vein into a paraumbilical hernia in a man with liver cirrhosis and portal hypertension. Post mortem CT imaging was valuable in localizing the source of hemorrhage in this case.

Detection of morphological changes of the ovine cervix in response to sex steroids using a fluorescence confocal endomicroscope.

OBJECTIVE: This study examined morphological changes of the ovine cervix in response to sex steroids using confocal microscopy. STUDY DESIGN: Experimental animals were ovariectomized, and the hormonal status of 4 groups of ewes (n = 5) was manipulated using sex steroids (no replacement, estradiol, progesterone, estradiol, and progesterone). The results were correlated with control ewes (n = 7) in naturally occurring reproductive states (estrus and midluteal). RESULTS: Plasma progesterone concentrations of experimental animals were comparable with those observed during normal reproduction. Confocal microscopy enabled subcellular resolution of the cervical epithelium and the detection of morphological changes associated with alterations in progesterone and estradiol in both artificially manipulated and naturally cycling ewes. Differences in nuclear size, distribution, and density could be differentiated in confocal images and histologic sections of ectocervix from animals in estrus and in the presence of exogenous estradiol. CONCLUSION: Confocal microscopy has potential diagnostic value for the detection of cellular and subcellular changes of the cervical epithelium.