Suicidal asphyxiation by using helium - two case reports.

Helium is one of inert gases causing physical asphyxiation, whose excess content in the breathing atmosphere reduces the partial pressure of oxygen and may be fatal after short-term exposure. When breathing a mixture of an inert gas (helium, nitrogen, argon) with a small amount of oxygen, with the possibility of exhaling carbon dioxide, no warning signs characteristic of suffocation are perceived by the subject. Freedom from discomfort and pain, effectiveness, rapid effect and relatively easy availability of required accessories have resulted in the use of inert gases for suicidal purposes. The paper reports two cases of suicide committed by using a special kit consisting of the so-called "suicide bag" (or "exit bag") filled with helium supplied through a plastic tube. In both cases, examination of the sites where the corpses were found and analysis of collected material allowed to establish that before their death the subjects had searched the Internet for instructions on how to commit suicide using helium. Due to the advanced putrefaction process, the autopsies failed to determine the causes of their death unequivocally. However, the circumstances surrounding the deaths suggested rapid asphyxiation as a result of oxygen deficiency in the breathing mixture. Since in cases of the type discussed here the cause of death cannot generally be established by autopsy, knowledge of the circumstances of disclosure of the corpse, as well as examination of the cadaver and the death scene is of utmost importance.

Chylothorax as a rare complication of acute pancreatitis in a 25-year-old woman after cesarean section.

The paper presents the case of a 25-year-old woman who underwent cesarean section for gynecological indications in the 37(th) week of her second pregnancy. The perioperative course was uncomplicated, but one day later the general condition of the patient suddenly deteriorated: she developed respiratory disorders requiring intubation and treatment in an intensive care unit. On the 6(th) day after the surgery, the patient was diagnosed with acute pancreatitis. Appropriate conservative treatment was instituted, resulting in a gradual improvement of her condition. On the 13(th) postoperative day, a cardiac arrest in asystole occurred, with no response to the undertaken resuscitation procedures. An autopsy performed in the Department of Forensic Medicine in Lódz revealed, among other findings, acute pancreatitis with enzymatic necrosis of the adipose tissue, a significant accumulation of lymph in both pleural cavities, and pulmonary atelectasis. As demonstrated by the analysis of the case, chylothorax had most probably developed in the course of acute pancreatitis which was a complication of the cesarean section. Consequently, the prosecutor opened an investigation into the case under Article 155 of the Polish Penal Code to assess the appropriateness of medical management. The medico-legal opinion was issued by experts from outside the Department of Forensic Medicine in Lódz. In their view, the medical management of the patient was correct.

Autoerotic death due to electrocution.

Autoerotic death is a very rare case in forensic medicine. It is usually caused by asphyxia, but other reasons are also possible. Herein we present a case of autoerotic death due to electrocution caused by a self-made electrical device. The device was constructed to increase sexual feelings through stimulation of the scrotal area.

Accidental intoxication with hydrochloric acid and hydrofluoric acid mixture.

The paper describes a fatal case of accidental ingestion of a mixture of hydrochloric acid and hydrofluoric acid. The man was admitted to hospital, where appropriate treatment, adequate to his condition, was instituted. Numerous ventricular fibrillation episodes, for which the patient was defibrillated repeatedly, were observed during the period of hospitalization. The patient was in a critical condition, with progressive symptoms of hypovolemic shock and multiorgan failure. On the next day after admission, signs of electromechanical dissociation progressing to asystole were noted. The instituted resuscitation procedure proved ineffective and the patient died. Autopsy revealed brownish discoloration of the esophageal, gastric, and small intestinal mucous membranes. Numerous ulcerations without signs of perforation were found both in the esophagus and in the stomach. The mucous membrane of the small intestine demonstrated focal rubefactions, whereas no focal lesions of the large intestinal mucosa were seen. Microscopic investigation of the biopsy specimens collected from the stomach, duodenum and small intestine revealed mucous membrane necrosis foci, reaching the deeper layers of the wall of these organs. The mucous membrane of the large intestine was congested. Bioptates obtained from the lungs indicated the presence of hemorrhagic infarcts and focal extravasations. Poisoning with the aforementioned acids with consequent necrosis of the esophageal, gastric, duodenal and small intestinal walls with hemorrhages to the gastrointestinal tract, as well as extravasations and hemorrhagic infarcts in the lungs was considered to be the cause of death.

Donor-derived DNA in hair follicles of recipients after allogeneic hematopoietic stem cell transplantation.

The hair follicles of recipients of allogeneic hematopoietic SCT (HSCT) constitute the tissue with the greatest need for regeneration after high-dose chemotherapy. Previous studies have shown a lack of donor-derived DNA in the hair follicles of recipients. Therefore, we carried out a study to determine whether male donor-derived genetic material can be found in female recipients' hair follicles after HSCT. Fluorescent-based PCR with analyses of Y-chromosome STR (Y-STR) and RQ-PCR with the sex-determining region Y (SRY) were used independently to evaluate chimerism status. Our results proved the existence of donor-derived stem DNA in the recipients' hair follicle cells. This report undermines the validity of data indicating that hair follicle cells maintain 100% of recipient origin.

Will genetic polymorphism of tetranucleotide sequences help in the diagnostics of major psychiatric disorders?

Expecting a significant breakthrough in the diagnosis of complex disorders of neuropsychiatric background, intensive efforts are taking place to establish genetic markers correlated with these disorders. During the last decade, this research was focused on code regions connected with neurotransmission and metabolism of catecholamines. Nowadays big diagnostic expectations are associated with sequences of STR type, which are widespread throughout the genome. These microsatellite sequences do not code proteins, but may have function of regulatory elements in the process of gene transcription and expression. One of these is polymorphic TH01 locus with TCAT tetranucleotide repetitive motive. It is located in chromosomal position 11p15 in the first intron of the tyrosine hydroxylase gene (TH). We examined the existence of the association between polymorphism of TH01 marker and schizophrenia. The results of statistical comparative analysis between neuropsychiatric patients from Poland and their regionally matched healthy subjects were presented.

A coronary artery crossed embolism of bone-marrow origin: proof of connections between pulmonary arteries and veins.

The paper describes a case of exceptionally rare crossed embolism of the coronary artery. The embolus material originated in bone-marrow released from rib fractures which occurred during resuscitation attempts. Autopsy did not reveal any anatomical abnormalities of the circulatory system, nor any disease-related changes, which could explain the occurrence of this embolism type, and therefore the only possible explanation is the presence of direct connections between pulmonary arteries and veins. The confirmation of this theory is the bone-marrow embolism of the pulmonary vein detected in the second case.

Effect of vitamin E and vitamin C supplementation on antioxidative state and renal glomerular basement membrane thickness in diabetic kidney.

The aim of this study was to analyze the effect of vitamins C and E on malondialdehyde (MDA) content and activities of key antioxidant enzymes: superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) as well as glomerular basement membrane (GBM) thickness in streptozotocin-induced diabetic kidney in rats. Wistar male rats were divided into following groups (12 rats each): the control, diabetic rats, diabetic rats whose drinking water was supplemented with vitamin C in a dose of 1.0 g/l or diet was supplemented with 200 mg of vitamin E/100 g fodder. Body weight, blood glucose and HbA1C levels and 24-hour urinary albumin excretion (UAE) were studied every week (0-12 weeks). After 6 and 12 weeks, MDA content and activities of SOD, CAT and GSH-Px were measured in the kidney homogenate supernatants. Electron micrographs of glomeruli were scanned and morphometric investigations were performed by means of computer image analysis system to compare GBM thickness. The blood glucose and HbA1C concentrations and UAE in diabetic rats were significantly higher than in the control group. An increase in the MDA level and decrease in the SOD, CAT and GSH-Px activities in the kidney of diabetic rats were observed after 6 and 12 weeks of experiment. Administration of vitamins C and E did not affect body weight, blood glucose and HbA1C levels. Both vitamin C and vitamin E decreased lipid peroxidation and augmented the activities of antioxidant enzymes studied in the kidneys of diabetic rats as well as reduced UAE, decreased kidney weight and GBM thickness. The results indicate the potential utility of antioxidant vitamins in the protection against the development of diabetic nephropathy.

Genetic diversity and forensic evaluation of 10 STR loci in Lodz region of Poland.

Allele frequency data and forensic efficiency parameters for 10 STR loci: D3S1358, vWA, D16S539, D2S1338, D8S1179, D21S11, D18S51, D19S433, TH01 and FGA, were estimated from a sample of 207 unrelated individuals in Lodz region of Poland.

The effect of verapamil on the antioxidant defence system in diabetic kidney.

BACKGROUND: The aim of this study was to examine the effect of verapamil (VP) on lipid peroxidation and activities of key antioxidant enzymes: superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px); as well as on glomerular basement membrane (GBM) thickness in streptozotocin-induced diabetic kidney in rats. METHODS: Wistar male rats were divided into three groups, 12 rats each: the control (C), diabetic rats (DR), and DR receiving VP, 7 mg/kg body weight in drinking water (DR + VP). Blood glucose (BG) and HbA(1c) levels, 24-h urinary albumin excretion (UAE) and body weight (BW) were measured every week (0-12 weeks). After 6 and 12 weeks, the animals were sacrificed and malondialdehyde (MDA) content and activities of SOD, CAT and GSH-Px were determined in the kidney homogenate supernatants. Electron micrographs of the glomeruli were scanned and morphometric investigations were performed by means of a computer image analysis system to compare the glomerular basement basal membrane (GBM) thickness. RESULTS: The levels of BG, HbA(1c) and UAE in DR were significantly higher than in the C group. A progressive increase in the MDA level and a decrease in the SOD, CAT and GSH-Px activities in the kidney of DR were observed after 6 and 12 weeks. VP administration did not affect BW changes, BG and HbA(1c) levels in DR. VP decreased lipid peroxidation and augmented the activities of antioxidant enzymes studied in the kidneys of DR as well as decreased kidney weight, GBM thickness and albuminuria in DR. CONCLUSIONS: These results confirm the role of oxidative stress in the development of diabetic nephropathy and point to the possible antioxidative mechanism of the nephroprotective action of VP.

Moderate systemic hypothermia and cold crystalloid cardioplegia influence on myocardial ischemic and revascularisative injury.

The number of granulocytes, their ability to generate superoxide anion (O2-) and the activities of Cu, Zn--superoxide dismutase (SOD-1), glutathione peroxidase (GSH-Px), catalase (CAT) as well as malonyldialdehyde (MDA) concentrations in erythrocytes in the blood extracted from the venous sinus and aorta under coronary artery bypass were examined with the use of St. Thomas Hospital cardioplegic solution. Specimens at the peak of ischemia of the right atrium for ultrastructural examination of the endothelial cells of capillary vessels and sarcomers were taken. The blood was obtained during cardiopulmonary bypass (CPB) before the aorta clamping and immediately after aorta declamping (peak of ischaemia) between 1-3 minute and 10-13 minute of reperfusion. Increase of the number of granulocytes both in the coronary sinus and aortal blood at all examined intervals as well as decrease in the number of ones in sinus compared with aortal blood was noted. The ability to produce superoxide anion radical decreased at the peak of ischemia and during reperfusion. The activity of SOD-1 was lower both after the period of ischemia and reperfusion. The increase in aortal blood activity during reperfusion was characteristic of GSH-Px; the activity was higher in the blood sample from the coronary sinus taken during ischemia and initial reperfusion. With the exception of the initial reperfusion the activity of CAT diminished in all observed cases. MDA concentration did not demonstrate any significant changes with the exception of the initial reperfusion in the aortal blood and later towards the end of reperfusion in the blood from the coronary sinus. Ultrastructural studies indicated overhydration of the cells both in the endothelium and the intercellular space. The obtained data demonstrate that the applied cardioplegic solution protects the myocardium from harmful effects of reactive oxygen species produced as a result of ischemia and reperfusion.

[Salivary gland tumor in authors' material]. / Nowotwory slinianek w materiale wlasnym.

The aim this work was to analyze the operated salivary gland tumors, taking into consideration the age and the sex of the patients. From 1980 to 1996 74 patients were operated including 40 women and 34 men, aged 21-78. Out of those 74 salivary gland tumors which were operated, conservative operation was carried out in 62 patients (85.2%) while in 11 patients (14.8%) it was radical operation. Most of the patients who underwent the operation were at the age between 31 and 60 (77.1%). In most cases--77.2% we had to do with mixed tumor of parotid gland and in 4% of submaxillary gland. Postsurgery complications in the from of complete facial paralysis were shown in 14.8% of the patients.

[Consequences of extraocular rectus muscle myotomy in rabbits--in vivo and pathomorphologic studies]. / Nastepstwa przeciecia miesni prostych oka u królików--badania in vivo i patomorfologiczne.

The aim of investigations was to evaluate the changes in the eyeball, after extraocular rectus muscles myotomy. In 16 rabbits two muscles and in 17 four muscles were cut in one eye; the opposite eye was control. In early postoperative period intraocular pressure was statistically significantly lower, as compared with the control eyes and it depended on the number of cut muscles. In histopathological examination, the most constant changes were dilatation of conjunctival vessels and pigment migration in the anterior uvea. Decreased intraocular pressure and pigment migration in iris and ciliary body were considered to be the symptoms of anterior segment ischemia.

[Apudoma: a rare case of the laryngeal tumor]. / W sprawie rzadkiego przypadku guza krtani--apudoma.

The authors present the problem of endocrine function of some neoplasmatic tumors based on their own very rare case of the larynx apudoma. They pay attention to the value of some modern diagnostic methods including radioimmunological determination of the serum peptide hormone levels and some specific immunofluorescence assays with monoclonal antibodies.

[On primarily bifocal laryngeal carcinoma and bronchogenic cyst of the neck]. / W sprawie raka pierwotnego dwuogniskowego krtani i torbieli skrzelopochodnej szyi.

The authors discuss a problem of rarely occurring bifocal carcinomas with the presentation of their own case of laryngeal carcinoma and branchiogenic cyst of the neck. They pay attention to histopathologic features underlying the diagnosis of branchiogenic cyst carcinoma and to the necessity of oncologic alertness in tumors of these kinds.

Morphometric evaluation of myofibrillar mitochondria in experimental administration of ethylene glycol.

The authors carried out morphometric analysis of the surface, area, circumference and shape of myofibrillar mitochondria in rats submitted for acute experimental intoxication with ethylene glycol. The measurements were taken at 12 and 24 hours after intoxication and compared with those in the control group. A significant increase in mitochondrial circumference and surface area was seen as early as 12 hours with their shape being more rounded than elongated. At 24 hours of the experiment the parameters further increased. The use of computer image analysis permitted an objective and measurable confirmation of changes in electronograms and revealed the presence of disorders in the phase in which traditional methods were useless.

Ultrastructural signs of myocardial damage due to acute experimental intoxication with ethylene glycol.

The authors carried out ultrastructural studies of the myocardial sections from inbred Wistar rats in the course of acute experimental poisoning with ethylene glycol. It was shown that slight mitochondrial swelling with clearing of the matrix, myofibrillar edema with decreased electron density of the sarcoplasma and widening of channels of the smooth intraplasmatic reticulum were visible as early as at 12 hours after intoxication with no changes in light microscopy. The changes were located mainly in the subendocardial layer of the ventricles and papillary muscles. At later stages of the experimental ultrastructural changes markedly progressed. Mitochondrial swelling enhanced with destruction of mitochondrial crests, myelin-like figures formed, myofibrillar necrosis and contraction bands developed and segmental or complete dissection of the intercalated disk edges appeared. The chages were scattered all over the myocardium predominating in the subendocardial layer and papillary muscles.