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Longer period of time the body position of the brake causes of death

1 patient had a history of epilepsy. Detained on suspicion of crimes in specific places, after the detention was due to manic with the lawful use of firearms. 2 cases this was a special seat on the brake, and 1 wooden bed in the supine position the brake, l cases were held hands, standing on the brake in the iron fence. Braking time for the 40-168h range,[link widoczny dla zalogowanych], and 2 cases due to take seats in the transformation into a supine position shortly after the death, 2 patients died of the original position of the brake. Autopsy had scrapes and surface skin, subcutaneous bleeding, located in the head and face, trunk, limbs, damage area of about 3% of body surface area of a 5%, · 294 · JHenanUnivSeiTech (MedSei) December2006Vo1.24No. 4 Multi is a hand injury. Body showed signs of mucous membrane, cyanotic extremities, face, subconjunctival bleeding (2 patients), visceral serosal spotting, congestion and other parenchymal organs. 2 had a huge mixture of the right ventricle thrombus, l patients have a greater right ventricle mural thrombus in 2 cases and a pulmonary artery embolism, 1 patient had left pulmonary artery common carotid artery thrombosis within the mix. Table 1 is generally believed that the brake factors, thrombosis and vascular endothelial cell injury,[link widoczny dla zalogowanych], blood flow velocity changes and slow down the traits related. 4 cases reported in this paper, the mechanism of thrombosis: ① long brake position, especially in the case of sitting or standing position, returning the blood disorder that can lead to deep vein thrombosis, coupled with the reduction of blood Huixin so that the left cardiac output decreased, decreased myocardial contractility, blood flow velocity and further slow down, speed up the thrombosis, a sudden change in position (such as seats become lying) is prone to pulmonary embolism. ② a certain degree of surface damage, the blood clotting factor increases tissue, enhanced blood clotting. ③ fixed position, can not replenish the water, combined with hot weather, increased sweating (2 patients in 7-8 months), resulting in increased blood viscosity. ④ the basis of degree of cardiomyopathy (2 patients had grade Ⅱ atherosclerosis), which are more likely to myocardial ischemia and hypoxia, decreased cardiac output increased effective blood circulation disorders. ⑤ longer held upright on the brake with both hands, so that happened a long stretch artery, easy to damage the vascular endothelial cells, blood sedimentation, blood flow slows down, there is another blood concentration, viscosity increase, thereby lead to thrombosis. This 4 cases, are in mixed thrombus, blood flow velocity changes according to the main theory of the formation of mixed thrombus, a long time position of the brake that is the main cause of thrombosis, followed by vascular injury. This collection of four cases, none of the initial identification of the right or draw clear conclusions, the reasons are: ① pathologist thrombosis of the heart lack of knowledge, often considered the heart after the death of thrombus or clot chicken fat samples coagulation, which is not drawn for the biopsy, resulting in missed. ② autopsy, forensic pathology doctor or pulmonary embolism may occur not considered, or in the anatomical pathology tests,[link widoczny dla zalogowanych], ignoring the pulmonary examination, leading to missed. ③ suspended on the body can cause suffocation and death less understanding. Although there are scholars on this particular type of apnea were reported and a series of cases, but fewer cases, the death mechanism at an exploratory stage, the majority of forensic cases no inspection experience. Therefore, the identification of such cases are difficult. From the reports of cases and experimental studies suggest that suspension is often caused by suffocation shorter. Based on animal models, rabbits suspended 20 ~ 120min, an average of 35min to death. However, 1 case in this article, was held upright on the brake with both hands up to 50h before death, and the pathology specific bilateral pulmonary artery and the left common carotid artery thrombosis. Therefore, identification of the cause of death in this case should be no objection. Pathological examination of the blood clot, we can see a more visible stratification, generally a thin layer of cellulose in the accumulation of white blood cells and red blood cell surface, accumulation of red blood cells in the trabecular formation of platelet-free, no more appear around the trabecular leukocyte infiltration occurs. If the platelet staining in trabecular difficult to confirm in general, you can be identified by immunohistochemical staining. Second, whether there should be a detailed examination of pulmonary emboli in existence. In suspected pulmonary embolism possible, standard cardiopulmonary joint anatomy is drawn first, fixed a few days underwent pathological examination, pulmonary artery and intracardiac thrombus clear link. If two continuous, should be considered, Department of intracardiac thrombosis due to extended growth of the pulmonary artery; if the two are not continuous, should be considered for the right heart or other parts, such as loss of deep venous thrombosis and pulmonary embolism caused in this species of embolism death, not only to determine the cause of death was pulmonary embolism,[link widoczny dla zalogowanych], but also a clear primary site of thrombosis. I believe that the longer the brake position should lead to fatal pulmonary embolism caused by the importance of forensic and law enforcement personnel.
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