Penetration Depth of Projectiles Fired from a Replica of Colt Navy of 1851 in 20% Gelatin Blocks Correlated with Fatal Injuries Assessed in an Autopsy of a 78-Year-Old Man.

Pursuant to the Polish Weapons and Ammunitions Law, muzzle-loading black powder weapons, manufactured before 1885, or their replicas, as well as suitable projectiles, can be possessed legally without registration and special licenses. The aim of the study was to assess the penetration depth of projectiles fired from a black powder weapon, replica of Colt Navy of 1851, in 20% gelatin blocks and to compare the obtained results with the actual injuries found on autopsy of a 78-year-old man who had committed suicide. In the experiments, we used the black powder weapon and ammunitions, as well as gelatin blocks serving as a soft tissue model. We ascertained that solid spherical projectiles fired from black powder weapons cause extensive injuries, especially in the initial segment of the wound canal. Additionally, based on the presence and location of the wad in the wound canal, the distance from which the shot was fired can be determined.

[Accidental intoxication with methotrexate--a case report]. / Przypadkowe zatrucie metotreksatem--opis przypadku.

The report presents a case of a 49-year-old man, who was accidentally intoxicated with methotrexate. The man was admitted to a nephrology ward because of generalized erythema involving the entire body, skin pruritus, face edema, fever and difficulty with breathing. On the day of admission, additional studies demonstrated a moderate degree of anemia, considerable leucopenia, thrombocytopenia and an increased level of C-reactive protein. In the course of hospitalization, doctors suspected the condition of the patient to be possibly caused by generalized infection, toxic lesion of the bone marrow or hematological bone marrow disease. Finally it was established that the cause of the patient's disease was his erroneous taking of a total of 35 mg of methotrexate (5 mg per day for seven days). Despite intensive treatment, the patient died seven days after admission. Autopsy confirmed that the man died from acute circulatory and respiratory insufficiency caused by intoxication with methotrexate.

[Symptomless aspiration of a dental bur in the lower respiratory tract--a case report]. / Bezobjawowa aspiracja wiertla stomatologicznego do dolnych dróg oddechowych--opis przypadku.

In this study, the authors review a case of a man who asymptomatically aspired a dental bur in the lower respiratory tract during dental treatment. Lack of any symptoms of foreign body aspiration erroneously suggested swallowing of the object and its passage to the stomach. This suggestion was not excluded by a control chest radiograph. Further specialist imaging examinations allowed for establishing the definite diagnosis and the patient underwent successful retrieval of the bur using left-sided thoracotomy.

Experimental effect of shots caused by projectiles fired from air guns with kinetic energy below 17 J.

Pursuant to the Polish Weapons and Ammunitions Law (Legal Gazette No 53/1999 item 549 with subsequent amendments), air guns with kinetic energy of the fired projectiles below 17 J are not regarded as weapons. The aim of the study was to assess the potential effect of shots caused by projectiles of various mass and structure fired from air guns with kinetic energy below 17 J on human soft tissues. As a model of soft tissue, we used 20% gelatin blocks. After shooting, we measured the depth of gelatin block penetration by pellets fired from various distances and compared these results with autopsy findings. The results demonstrated that examined pneumatic guns may cause serious injuries, including damage to the pleura, pericardium, liver, spleen, kidneys, femoral artery, and thoracic and abdominal aorta. Experiment shown that gelatin blocks do not reflect fully the properties of the human body.

[Penetration depth of missiles fired from a pneumatic weapon with kinetic energy below 17 J, in 20% gelatine blocks as correlated with injuries found during autopsy of a 9-year-old boy]. / Glebokosc penetracji pocisków, wystrzelonych z urzadzenia pneumatycznego o energii kinetycznej ponizej 17 J, w 20% blokach zelatynowych w korelacji ze stwierdzonymi sekcyjnie obrazeniami ciala 9-letniego chlopca.

In Poland, according to the Act About Weapons and Ammunition, an air weapon which has kinetic energy of the fired projectiles below 17 J does not require registration and can be bought even on the Internet. Sport and recreation shooting with this weapon basically have to be performed in shooting ranges, but can be also carried on outside of shooting ranges, providing "particular caution" is exercised. In this study, we presented a case of fatal shooting of a 9-year-old boy; the weapon was a Chinese pneumatic device weapon with kinetic energy of the fired projectiles below 17 J. The aim of this study was to compare autopsy findings with penetration depth of missiles fired from this pneumatic weapon in 20% gelatine blocks. During the experiment, we used a Chinese pneumatic weapon with kinetic energy below 17 J, five kinds of lead projectiles with different shape and mass and 20% gelatine blocks at the temperature of 10 degrees C, which were the model of human soft tissues.

[Tako-tsubo cardiomyopathy in a man with cerebral haemorrhage]. / Podejrzenie zespolu tako-tsubo u mezcyzny z krwawieniem sródczaszkowym.

BACKGROUND: The Tako-Tsubo syndrome is characterized by a transient left ventricular dysfunction in the absence of obstructive coronary disease, typically precipitated by severe emotional or physical stress. It is characterized by a balloon-like left ventricular appearance on angiography, ECG changes, and elevated cardiac biomarkers. We describe a case, where Tako-Tsubo cardiomyopathy was diagnosed in a patient with subarachnoid haemorrhage. CASE REPORT: A 57-year-old man was brought to the hospital after cardiac arrest and successful resuscitation. After admission, echocardiography was performed that revealed marked impairment of contractility of the left ventricle with akinesis of the apex, interventricular septum, and anterior wall. Subsequent coronary angiography revealed neither coronary pathology nor pulmonary embolism; however, ventriculography showed typical dynamics of the Tako-Tsubo syndrome. Because of a deep cerebral coma (GSG 3), a CT-scan was performed that revealed subarachnoid haemorrhage with a haemotoma in the left temporal lobe, together with symptoms of massive cerebral oedema. The patient died eight days later despite vigorous intensive care. During the autopsy, a ruptured aneurysm of the left central cerebral artery was found. CONCLUSIONS: The Tako-Tsubo syndrome may occur not only during serious stress but also after resuscitation of cardiac arrest following cerebral bleeding.

[Experimental effect of a shot caused by 4.5 mm cartridges fired from a Norica Dragon air-rifle and a Walther PPK/S air-pistol]. / Doswiadczalny efekt postrzalu pociskami kalibru 4,5 mm wystrzeliwanymi z karabinka pneumatycznego Norica Dragon i pistoletu pneumatycznego Walther PPK/S.

In Poland, according to the Weapons and Ammunition Act" an air weapon which has kinetic energy of fired projectiles below 17 J does not require registration and can be bought even on the Internet. Sport and recreational shooting with this weapon does not have to be performed in a special shooting-range, but can be carried on in an open terrain providing "particular caution" is exercised. In this study we presented experimental effects of shooting pneumatic weapons (Norica Dragon air-rifle and Walther PPK/S air-pistol) which had kinetic energy of fired projectiles below 17 J. The aim of this study was to assess the effects of shooting the above weapons at human soft tissues and thin bones of the temple region to empirically evaluate the degree of danger to health and life, which such shots can produce. We used 20% gelatine blocks at 10 degrees C, which were the model of human soft tissues, and fresh calf scapulas, which served as the models of the temporal bone of the human cranium. Before the experiment, we had evaluated the weight of all the projectiles and their initial velocity using a chronograph. By these measures, we calculated the kinetic energy of the fired missiles. After shooting, we estimated if projectiles of different shapes shot from air weapons characterized by different kinetic energy and from different distances penetrated the gelatine blocks and if the said missiles perforated the bones. We also measured the depth of missiles penetration in the gelatine blocks.

[Postmortem bruising]. / Posmiertne podbiegniecia krwawe.

While examining body injuries, a very important issue is to ascertain if they were made ante or postmortem. The majority of authors are of the opinion that the presence of bruises is a proof of an antemortem origin of injuries. Nevertheless, the present authors encountered more than a dozen of cases of postmortem origin of bruises, which had occurred as much as several hours after death. All the observed bruises were inflicted during external examination of bodies at the site where they were found, while examining idiomuscular reactions from biceps brachii and quadriceps femoris muscles. During autopsies carried out in the dissecting room, bruises with central ischaemia and transversal course to the long axis of a limb were noted. Following incision of the integument, we found of shiny ecchymosis (suggilation) in the subcutaneous tissue. Histopathology revealed the presence of blood extravasations in the examined tissues.

[Opinionating errors in forensic medicine]. / Bledy opiniodawcze w medycynie sadowej.

The paper presents selected evident opinionating errors committed by experts in the field of forensic medicine who issued medico-legal opinions in criminal cases, aiming at determining causes of death. The authors analyze the causes of such errors and possibilities of avoiding them, as well as the impact of the said errors on the course of criminal proceedings and the legal position of the suspects or victims. The report emphasizes the potential effect of these opinions on the fate of individuals who have been found suspected or guilty based on such opinions should they be accepted by the court without verification by summoning another expert.

[Accidental intravenous injection of formaldehyde]. / Omylkowe dozylne podanie roztworu formaliny.

BACKGROUND: Formaldehyde can be found in operating theatres where it is used for preservation of biopsied tissues. Several misuse accidents have been described previously.We present a case where formaldehyde was mistakenly injected intravenously. CASE REPORT: A 33-year-old man, scheduled for excision of a knee meniscus under spinal anaesthesia, was to receive an intravenous antibiotic at the end of surgery. The attending anaesthesiologist received a vial of cephazolin, marked with the patient name from a scrub nurse and injected its contents intravenously. Immediately after injection, the patient complained about strong pain at the site of injection and started to cough.The vial was checked again and a piece of meniscus preserved with 4% formaldehyde was found inside. It was intended to be offered to the patient on departure. The possible amount offormaldehyde injected was 400 mg (a lethal dose has been described as 12 g). The patient, despite the lack of cardiorespiratory failure, was intubated, ventilated and dialysed for six hours, and then extubated without further consequences. His biochemical markers remained in the normal range. Based on the case as described, the possible medico-legal consequences of poor organisation and preventive measures are discussed.

Erroneous administration of vinblastine.

This case describes a series of errors which resulted in an avoidable death of the patient. Upon being presented with the 83-year-old patient and her complaints, the physician in charge attempted to prescribe Vasolastine (a complex preparation used, for example, in treatment of angiopathy, which is administered intramuscularly once a day). Unfortunately he misspelled the name of the medicine as Vinplastyna--a non-existent preparation. When the patient's daughter went to collect the prescription from the pharmacist she was dispensed Vinblastin (vinblastine--a cytostatic medicine used, for example, in treating Hodgkin's disease, non-Hodgkin's lymphoma, chronic lymphatic leukemia and testicular cancer). The visiting community nurses administered a dose of this medicine on seven consecutive days. Upon being given the seventh dose, the patient displayed symptoms of myelophthisis, and was admitted to an Intensive Care Ward, where despite the treatment, she died.