IIJFMT 2(3) 2004
Journal Scan
Channelling the Emperor: What really killed Napoleon?
Mari F, Bertol E, Fineschi V Karch SB
JR Soc Med 2004: 97; 397-399.
Arsenic was present in Napoleon’s hair before he arrived on Saint Helena and the findings at necropsy are consistent only with the diagnosis of ulcerating, regionally invasive, gastric carcinoma. The question of whether Napoleon died of, or merely with, arsenic poisoning is illuminated by developments in the treatment of promyelocytic leukaemia. Arsenic trioxide induces remission in many, but treatment can be complicated by QT prolongation, torsades de pointes and sudden death. At clinically relevant concentrations, arsenic blocks both 1kr and 1ks channels and, at the same time, activates 1k-ATP channels. The balance of these forces is easily disrupted and QT prolongation is worsened by hypokalaemia. Napoleon was chronically treated with tartar emetic for gastrointestinal symptoms, and the day before he died he was given a huge dose of calomel (mercurous chloride) as a purgative. Both treatments would have caused potassium wastage. In addition, the Emperor was being treated with a decoction containing ‘bark’ –presumably ‘Jesuit’s bark’. The quinine in Jesuit’s bark is another cause of QT prolongation. It is likely that the immediate cause of the Emperor’s death was torsades de pointes, brought on by chronic exposure to arsenic and a medication error.
Suicidal deaths in childhood and adolescence
Agritmis H, Yayci N, Colak B, Aksoy E
Forensic Sci International 2004:142; 25-31
Suicide has been reported as the second or third most common cause of death in children and adolescents worldwide. In this study, cases of under the age of 19 years submitted to the Institute of Forensic Medicine, First Specialization Board between 1996 and 2000 as suicides by the Board were evaluated retrospectively. The cases included in this study were the cases bearing locally questionable components, so had been submitted to the evaluations by the Board in order to eradicate the doubts. A total of 43 cases were investigated regarding age, gender, cause of death, manner of death, place of death, time of death and the risk factors.
Of the 43 cases evaluated, 31 cases were female and 12 cases were male. The notable suicide method was found to be firearms. Although, it was clear that that not all of the suicide cases in this age group had been submitted to the Institute of Forensic Medicine, the most striking result of this study, nevertheless, was that girls constituted the 72% of suicidal deaths in this age group.
Analysis of fatal injuries to motorcyclists by Helmet type
Hitosugi M, Shigeta A, Takatsu A, Tokoyama t, Toludome S.
Am J Forensic Med Pathol 2004: 25.125-128
To clarify the characteristics of injuries of motorcyclists dying in accidents in relation to helmet type, we retrospectively analyzed forensic autopsies of 36 helmeted motorcycle riders. The presence of major injuries and injury severity were evaluated with the injury severity score and the 1990 revision of the Abbreviated injury Scale. Persons with open-face helmets (19 cases) were significantly more likely to have sustained severe head and neck injuries especially brain contusions, than were persons with full-face helmets (17 cases). Furthermore, major injuries of the chest or abdomen, rib fractures. Lung injuries, and liver injuries were each present in more than one quarter of all cases (26.3% to 70.6%), but their prevalences did not differ significantly between riders with different types of helmet. Because many types of head and neck injuries cannot be prevented and fatal chest and abdominal injuries occur despite the use of full-face helmets, more effective helmets and devices for protecting the chest and abdomen are needed to decrease deaths from motorcycle accidents.
The future of human embryonic stem cell research: addressing ethical conflict with responsible scientific research
Gilbert DM
Med Sci Monitor 2004:10(5); 99-103
Embryonic stem (ES) cells have almost unlimited regenerative capacity and can potentially generate and body tissue. Hence they hold great promise for the cure of degenerative human diseases. But their derivation and the potential for misuse have raised a number of ethical issues. These ethical issues threaten to paralyze pubic funding for cell research leaving experimentation in the hands of the private sector and precluding the publics ability to monitor practices research alternatives and effectively address the very ethical issues that are cause for concern in the first place with new technology being inevitable and the potential for abuse high government must stay involved if the public is to play a role in shaping the direction of research. In this essay, I will define levels of ethical conflict that can be delineated by the anticipated advances in technology. From the urgent need to derive new ES cell lines with existing technology to the most far-reaching goal of deriving generically identical issues from an adult patients cells. Technology specific ethical dilemmas can be defined and addressed. This staged approach provides a solid ethical framework for moving forward with ES cell research Moreover by anticipating the moral conflicts to come one can predict the types of scientific advances that could overcome these conflicts and appropriately direct federal funding toward these goals to offset potentially less responsible research directives that will inevitably go forward via private or foreign funding.