Pathological Changes of Petechial Hemorrhage after High Temperature Treatment / 法医学杂志

Objective To study the main features of mechanical asphyxia——the pathological characteristics of petechial hemorrhage after high temperature effect (roasted, boiled) and its changing rules.Methods Rabbit model of mechanical asphyxia death with choking neck and death from anteposition hanging was established.The experimental rabbits were randomly divided into roasted group and boiled group (n=4, in each group).The laryngeal ventricles and cardiopulmonary tissues in the roasted group were roasted for 3, 6 and 10 min, and the positions of petechial hemorrhage were observed and photographed.The same organs and tissues in the boiled group were heated in boiling water (100℃), and were observed and photographed at 30 and 60 s.Then histopathological examination was performed on all the laryngeal ventricles and cardiopulmonary tissues.Results The petechial hemorrhage originating from laryngeal ventricle, trachea and lung did not disappear after high temperature treatment in the eight rabbits.The deepened color was visible to naked eyes and distinct from the surrounding normal tissues, with bleeding under the microscope.Conclusion Petechial hemorrhage caused by mechanical asphyxia would not disappear under high temperature, which might be related to the manner of death, the intensity and time of action, and the individual differences.

Positional asphyxia: An opinion of exclusion.

The process of normal respiration depends upon three vital components i.e. a patent airway, an intact surface for gas exchange and a normally working ventilatory apparatus. The positional asphyxia has been defined as asphyxia caused due to unusual position of the body which interferes with the breathing and thus pulmonary ventilation. We are reporting a case of an adult female, who under the influence of alcohol positioned herself in such a way which led her to death due to positional asphyxia. The internal and external findings were non-specific. Therefore the exclusion criteria were used to conclude that the death was due to positional asphyxia. The cases of positional asphyxia are difficult to diagnose because of the absence of any specific external findings. The internal findings found in such cases are also non-specific and can be found in any case of an asphyxial death.

Usefulness of Apolipoprotein E4 and Distribution of Petechial Hemorrhages in Differentiating between Cerebral Amyloid Angiopathy and Hypertensive Intracerebral Hemorrhage

BACKGROUND AND OBJECTIVES: Cerebral amyloid angiopathy (CAA) accounts for a significant proportion of spontaneous lobar hemorrhages in the elderly population but hypertension is responsible for most cases of deep-seated hemorrhage. Reportedly petechial hemorrhages (PHs) can be associated with CAA or chronic hypertension. We determined the location of PHs and apolipoprotein E (APOE) genotype in intracerebral hemorrhage (ICH) patients and tried to correlate them with CAA associated or hypertensive ICH. METHODS: One hundred and sixty-two consecutive patients with primary ICH were evaluated clinically and by MRI. PHs were defined as small low-signal lesions (less than 1 cm) seen on T2-weighted or gradient-echo MR images. ICH and PHs were divided into lobar (cortical-corticosubcortical), deep (basal ganglia, thalamus, pons, or cerebellum), or mixed. APOE genotype was determined by polymerase chain reaction. All 162 patients were classified into 4 groups: 1) probable CAA (multiple lobar bleeds without other cause), 2) possible CAA (single lobar bleed), 3) probable hypertensive ICH (deep bleed), and 4) mixed lobar and deep hemorrhages. RESULTS: Among 162 patients, 31 belonged to the probable and possible CAA groups and 17 of them showed PHs (7 lobar, 4 deep, 6 mixed). One hundred and twenty-two patients were the hypertensive ICH group and 63 of them had PHs (2 lobar, 10 mixed, 51 deep). Lobar PHs were more frequently observed in the probable and possible CAA group than the hypertensive ICH group (22.6%: 1.6%, p < 0.01) while deep PHs were seen mainly in the hypertensive ICH group (41.8%: 12.9%, p < 0.01) and these tendencies are also observed in the group who had taken both T2-weighted and gradient-echo MR images (64 patients). The frequency of hypertension was significantly lower in the probable and possible CAA groups with lobar PHs than in the hypertensive ICH group with deep PHs (57.1%: 98 %, n = 7 & 51 respectively, p < 0.01). APOE ?4 frequency was: probable (freq. 0.25, n = 2), possible CAA (freq. 0.21, n = 7), hypertensive (freq. 0.056, n = 9), and mixed hemorrhages (freq. 0.071, n = 7). The frequency of APOE ?4 of probable and possible CAA group seems to be higher than that of normal control (freq. 0.19, n = 146). CONCLUSION: APOE ?4 and PHs in lobar areas may be associated with hemorrhages restricted to lobar regions while hypertension and PHs in deep areas, with hemorrhages restricted to deep regions.