X-ray analytic microscopy with CT-guided sample extraction to analyze potential projectile fragments in a dead serow.

In forensic pathology, it is important to detect and recover as evidence residual metal particles and projectiles when evaluating potential gunshot wounds. This process can be challenging when the bullets are fragmented. This report presents our experience using multiple modalities to analyze the wound of an illegally killed Japanese serow (Capricornis crispus) found in a mountainous region without its head and hind limbs. We performed postmortem computed tomography (PMCT) and necropsy that showed a distant-range gunshot wound of the neck likely created by a centerfire rifle. A postmortem cut through the neck and absent head precluded a complete evaluation. To determine the composition of the metal-like fragments in the neck, sampling and metal analysis were performed in two ways. Samples extracted from the exposed wound surface without CT guidance were analyzed directly using inductively coupled plasma mass spectrometry (ICP-MS). Samples from the bone, muscles, and cervical cord extracted under CT guidance were analyzed using x-ray analytic microscopy (XGT-9000, HORIBA, Kyoto, Japan). In wound surface samples, silicon and iron were detected as the main components on ICP-MS, suggesting that the materials were gravel. The samples taken under CT guidance and analyzed with XGT-9000 revealed that the high-density CT areas were mainly composed of lead. Combining CT-guided sample extraction and XGT-9000 can be useful for retrieving true projectile fragments and avoiding the confusion created by erroneously sampling non-projectile surface materials.

Fatal bilateral pneumothoraces after electroacupuncture treatment: A case report and literature review.

Acupuncture is practiced as a complementary medicine worldwide. Although it is considered a safe practice, pneumothorax is one of its most common serious complications. However, there have been few reports of deaths due to pneumothorax after acupuncture treatment, especially focused on electroacupuncture. We report an autopsy case of a man in his 60s who went into cardiopulmonary arrest and died immediately after receiving electroacupuncture. Postmortem computed tomography (PMCT) showed bilateral pneumothoraces, as well as the presence of numerous gold threads embedded subcutaneously. An autopsy revealed two ecchymoses in the right thoracic cavity and a pinhole injury on the lower lobe of the right lung, suggesting that the needles had penetrated the lung. There were marked emphysematous changes in the lung, suggesting that rupture of bullae might also have contributed to bilateral pneumothoraces and fatal outcome. The acupuncture needles may have been drawn deeper into the body than at the time of insertion due to electrical pulses and muscle contraction, indicating the need for careful determination of treatment indications and technical safety measures, such as fail-safe mechanisms. This is the first case report of fatal bilateral pneumothoraces after electroacupuncture reported in the English literature. This case sheds light on the safety of electroacupuncture and the need for special care when administering it to patients with pulmonary disease who may be at a higher risk of pneumothorax. This is also the first report of three-dimensional reconstructed PMCT images showing the whole-body distribution of embedded gold acupuncture threads, which is unusual.

Experimental water injection into lungs using an animal model: Verification of the diatom concentration test to diagnose drowning.

BACKGROUND: In forensic medicine, the diatom test is used to diagnose drowning. Drowning and postmortem immersion can be distinguished by calculating the ratio of diatom concentration in the lungs and drowning water (L/W ratio). However, this claim was based on the unproven hypothesis that diatoms may be concentrated in the lungs due to respiratory movements. This study was conducted to examine whether the L/W ratio increased with experimental water injection. METHODS: A total of two experiments was performed using 22 non-drowned cat carcasses found on dry land. First, for the experimental postmortem immersion, we soaked seven whole-body cat carcasses in pond water for an hour. Second, the pond water was experimentally injected one or ten times into each harvested lung from seven and eight cats, respectively. In the diatom test, two diatom species (Aulacoseira ambigua and Discostella asterocostata) that were dominantly observed in pond water as well as other diatom species were counted separately. The L/W ratios of each cat were calculated. Univariate linear regression analysis was performed to demonstrate the association among L/W ratios and the three categories of the experiments. The L/W ratios of the two experiments were compared with those of drowning or postmortem immersion cases of humans or cats. RESULTS: It was revealed that the clear L/W ratio differences between the three groups (experimental postmortem immersion<0.02, 1-injection < 0.2, 10-injection > 0.9 for all diatom counting) were with statistically significant as proven by the univariate regression analyses. In actual cases of cats and humans, L/W ratios were>0.4 for drowning and<0.04 for postmortem immersion. CONCLUSION: The L/W ratio increased with multiple experimental water injections into the lungs, thereby verifying the validity of the diatom concentration test to diagnose drowning. The diatom test can be used to distinguish between drowning and postmortem immersion in humans and cats by calculating the L/W ratio.