A case of fatal tracheal compression in a patient with Hashimoto's disease under the setting of previous tracheostomy

This autopsy case involved a woman in her 60 s with a history of temporal tracheostomy. During an event in which her son allegedly experienced an epileptic seizure, he grasped the woman around the upper chest for several moments. The woman then experienced breathing difficulties, lost consciousness and died. Postmortem computed tomography revealed a pinhole-like tracheal narrowing at the level of the tracheostomy encircled by the thyroid. Autopsy revealed a modestly enlarged thyroid gland due to previously undiagnosed Hashimoto's disease and an old fracture in a tracheal ring indicating that the trachea had been compressed by the thyroid. Hashimoto's disease rarely causes sudden death through systemic endocrine disturbance, but this case may illustrate that against a background of previous tracheostomy that mechanically weakens the trachea, enlargement of the thyroid (goiter) as a local effect of the disease can also cause sudden death

Usefulness of 2D fusion of postmortem CT and antemortem chest radiography studies for human identification.

To determine the feasibility of human identification through the two-dimensional (2D) fusion of postmortem computed tomography (PMCT) and antemortem chest radiography

Postmortem computed tomography of barium peritonitis due to descending colon perforation

We describe herein the findings from postmortem computed tomography (PMCT) of barium peritonitis due to descending colon perforation. The patient was a woman in her 60s who underwent upper gastrointestinal series with barium swallow for the purpose of physical examination. The patient developed abdominal pain the next day and visited a clinic, but was sent home for later follow-up. She was found dead at home 8 days after upper gastrointestinal series. Based on the corpse phenomena and police investigations of the scene of death, the patient was estimated to have died 6 days after the upper gastrointestinal series. PMCT revealed free gas within the peritoneal cavity. Barium and fat stranding were also observed around a diverticulum in the descending colon. A large amount of residual barium was seen in the ascending colon and was considered to represent antemortem constipation and delayed barium excretion. No gas was detected in the abdominal wall, cardiac chambers or hepatic vasculature. The pancreas and adrenal glands had a normal appearance. We diagnosed barium peritonitis due to descending colon perforation as the cause of death. Diverticular perforation was suspected because barium retention and fat stranding were particularly noticeable around the descending colon diverticulum. In conclusion, we have presented a rare case of postmortem diagnosis of barium peritonitis. In PMCT interpretation, distinguishing between ante- and postmortem intestinal perforations is important

Predictive factors for hyperglycaemic progression in patients with schizophrenia or bipolar disorder

Background: Patients with schizophrenia or bipolar disorder have a high risk of developing type 2 diabetes. Aims: To identify predictive factors for hyperglycaemic progression in individuals with schizophrenia or bipolar disorder and to determine whether hyperglycaemic progression rates differ among antipsychotics in regular clinical practice. Method: We recruited 1166 patients who initially had normal or prediabetic glucose levels for a nationwide, multisite, l-year prospective cohort study to determine predictive factors for hyperglycaemic progression. We also examined whether hyperglycaemic progression varied among patients receiving monotherapy with the six most frequently used antipsychotics. Results: High baseline serum triglycerides and coexisting hypertension significantly predicted hyperglycaemic progression. The six most frequently used antipsychotics did not significantly differ in their associated hyperglycaemic progression rates over the 1-year observation period. Conclusions: Clinicians should carefully evaluate baseline serum triglycerides and coexisting hypertension and perform strict longitudinal monitoring irrespective of the antipsychotic used

Conventional diatom testing using strong acid: (II) Number and types of diatoms detected in closed organs and lungs of 80 autopsy cases using only new Kjeldahl flasks

Citation: Sonoda A, Kakizaki E, Shinkawa N, Matsuda H, Yukawa N. Conventional diatom testing using strong acid: (II) Number and types of diatoms detected in closed organs and lungs of 80 autopsy cases using only new Kjeldahl flasks. Forensic Sci Int. 2022 Dec;341:111510. doi: 10.1016/j.forsciint.2022.111510. Epub 2022 Nov 1. PMID: 36399935