Nineteenth-century Massachusetts coroner inquests.

Coroner is an ancient office, dating back centuries in England; originally financial officers, coroners over time become medicolegal investigators. Coroners in early Massachusetts functioned under English common law and, later, under statute. However, studies of early coroners and inquests are not common, and many details of how coroners actually functioned are unknown. A previously unpublished set of 19th-century Massachusetts inquest records discloses details of coroner function, including administrative and financial details, social conditions surrounding inquests, and increasing use of medical and toxicologic testimony.

Fatal hot coffee scald of the larynx. Case report.

We present a case of fatal upper aerodigestive tract scald sustained by a schizophrenic man who drank hot coffee. After describing the clinical and pathologic findings, we discuss the risks for incurring such injuries.

Splenic odyssey. Traumatic retropharyngeal displacement of thoracoabdominal viscera.

The retropharyngeal space (RPS) is a fascial compartment of the midline of neck, posterior to the pharynx, anterior to the spine. Pathologic involvement of RPS includes tumors, abscesses, and traumatic hematomas, all of which may dissect inferiorly into the thoracic compartment. We describe two cases in which severe trauma of the torso resulted in dissection of thoracoabdominal contents upward into the RPS--an apparently undocumented phenomenon.

Experimental observations on adipocere formation.

Adipocere, "grave wax," is a waxy or greasy decomposition product formed by hydrolysis and hydrogenation of tissue fats. Once formed, it appears stable for extended periods. Adipocere has generally been considered to result from bacterial action, commonly in warm, damp, anaerobic environments. However, its frequency, rate of formation, factors affecting its formation and physical characteristics are not well defined. To study the frequency, time course, and effects of temperature and clothing on adipocere formation, we submerged human adipose tissue samples in aquaria under controlled conditions and conducted serial observations. Adipocere formed with high frequency, within a few months, in tissues submerged in warm tap water; similar changes took longer, 12 to 18 months in cold water submersion. Presence of clothing over the tissue appeared to accelerate adipocere formation.

Electrocution: a review of 155 cases with emphasis on human factors.

A review of 155 cases of electrocution were investigated to determine the role of human factors, such as carelessness and intoxication, as contributions. The cases were retrieved by computer coding from the repository of the Armed Forces Institute of Pathology, covering the period 1955-1988. The cases are predominantly of military origin. Cases were divided into low-voltage electrocution (N = 47), high-voltage electrocution (N = 79), lightning strikes (N = 16), and unclassified (N = 13). For each group, data is presented on the circumstances of the incident and the pathologic findings. Blatant carelessness, misuse or improper maintenance of equipment, and intoxication are analyzed as contributory factors.

Military parachute mishap fatalities: a retrospective study.

Military parachuting is relatively safe. Most injuries involve vertebral bodies or the lower extremity, and fatalities are rare. We studied 49 military parachute accident facilities occurring during 1964-1989. Causes of the accidents included accidental deployment of reserve parachute in aircraft, static line failures and entanglements, equipment (canopy) failures, in-air collisions, landing injuries, drowning, and dragging. Rarely, preexisting illness such as coronary artery disease caused or contributed to an accident. Pathologic findings revealed a high proportion of deceleration and blunt force injuries: cardiac, aortic and liver laceration, and skull, pelvic and extremity fractures. Isolated head injury, strangulation, and post traumatic pulmonary embolus were occasionally noted. Toxicological examination demonstrated contributing factors such as alcohol intoxication or antihistamine use in a small number of cases. Background investigations, scene inspections, autopsy and toxicology studies all yielded important data or pertinent negatives during investigations. We propose an investigation protocol.

Clinically intensive medical training for combat.

Medical training aimed at the rifleman, aidman, and unit operational level for a Ranger Battalion is described. Instruction in patient survey, cardiopulmonary resuscitation, first aid, intravenous resuscitation, and evacuation is given to all Rangers. Approximately one Ranger per rifle squad is trained as a certified Emergency Medical Technician. Aidmen attend advanced formal schooling and the Battalion runs its own medical sustainment training and Expert Field Medical Badge programs. Casualty play is integrated into exercises. We believe this training increases survivability of soldiers in the field and improves their morale and battlefield effectiveness. These programs can be applied to many organizations and situations.

Parachute static line injury with vascular compromise.

Rarely, a military parachutist's arm becomes entangled in his static line, causing biceps muscle injury, as he jumps from the aircraft. This report describes a case of static line biceps transection injury with brachial artery vascular compromise previously unreported in the literature. Physicians working with military parachutists should be aware of the potential for complications with these injuries.

Analysis of low natural killer cell activity in 89Sr-treated mice.

Treatment of mice with the long-lived bone-seeking radioisotope 89Sr results in the selective irradiation and destruction of the bone marrow. This is accompanied by a marked reduction in natural killer cell activity against YAC-1 lymphoma [NK(YAC-1)]. To test for the presence of cellular suppressors of NK(YAC-1) in 89Sr-treated mice, in vitro and in vivo cell mixture protocols were used. In vitro, we did not observe any specific inhibitory effect of spleen cells from 89Sr-treated mice on NK(YAC-1) activity of normal spleen cells. The NK(YAC-1) activity of 89Sr-treated mice, measured in vivo by their ability to clear radiolabeled YAC-1 cells from the lungs, was impaired. However, spleen cells from 89Sr-treated mice, when adoptively transferred with normal spleen cells, failed to inhibit the NK(YAC-1) activity of the latter in the lung clearance assay. Further, when normal spleen cells were injected into 89Sr-treated mice, the ability of the transferred cells to mediate in vivo activity was not suppressed in the 89Sr-treated host. These experiments support the suggestion that the low NK(YAC-1) activity in 89Sr-treated mice is not mediated by suppressor cells, but may be due to the destruction of the marrow microenvironment which is essential for the generation of functional NK(YAC-1) cells.