Adam Gross

Urinary cadmium as indicator of renal cadmium in humans: an autopsy study

Objective: To estimate the equivalent cadmium levels in renal cortex and in urine, as based on autopsy analysis of subjects not exposed to cadmium occupationally. Methods: The levels of Cd were determined in renal cortex, liver, urine and urinary bladder of 39 subjects deceased at the age 42+14 years. Flame atomic absorption spectrometry (kidneys, liver) and flameless AAS (urine, bladder) were used. Results: The urinary cadmium level determined post mortem is strongly correlated with the renal Cd levels. Eliminating cases with high urinary proteins and extrapolating from sets of data with elevated urinary protein concentration to its normal range yielded a value of 1.7 mg/g creatinine as equivalent to the renal level of 50 mg/g w.w. Conclusions: It seems possible to use monitoring data for cadmium in urine and in renal cortex in a coherent way.

Death of a female cocaine user due to the serotonin syndrome following moclobemide–venlafaxine overdose

To our knowledge, the majority of evidence supporting the relationship between the serotonin syndrome and medications that effect 5HT is based on case reports. The justification for taking up this subject has been a fatal outcome of a 21 year-old female following an administration of toxic doses of moclobemide (MAOI) and venlafaxine (SNRI). As a result of complex toxicological investigations including antemortem and postmortem material, antemortem clinical observations and postmortem examinations, the cause of death was identified as overdose with antidepressants--moclobemide and venlafaxine--in the mechanism of the clinically fully developed severe toxic serotonin syndrome. The analysis of a hair strand collected from the victim documented the use of the above-mentioned drugs simultaneously with cocaine in the period of at least 20 months preceding death. The fact is a matter of considerable interest in view of the employed pharmacotherapy, giving rise to suspicion that the woman had not developed the serotonin syndrome during the almost 2-year antemortem period until she took toxic doses of both medications.

Suicidal Shooting Masked Using a Method Described in Conan Doyle's Novel

The case of a suicide by gunshot is presented in which the person committing the suicide used a method described by Conan Doyle in one of his novels: conceal the weapon and make the suicide appear to be a homicide.

An epidemic of breast cancer among models of famous artists.

Sir, When a physician casts his professional eye to examine individuals portrayed by various artists, sometimes weird ‘diagnostic conclusions’ are formulated and published [1–5]. Hence, the literature reports spectacular ‘medical diagnoses’, such as the one where a maxillofacial surgeon ascribed the cause of the enigmatic smile of Mona Lisa to an alleged past injury of her upper jaw and teeth, while an anesthesiologist regarded the wound in the neck of a nymph portrayed by Piero di Cosimo as the first illustration of a tracheotomy [3, 4]. The same type of ‘justified medical diagnoses’ is represented by the detection of a malignant tumor involving the left breast of La Fornarina by Raphael [1], the left breast of Rembrandt’s Bathsheba [2] and the left breast of one of the ‘Three Graces’ – the one situated in the extreme right – in the painting by Paul Rubens [3]. Using the same evaluative and diagnostic tools as were employed by the above authors, one might equally easily ask – and receive no answer – why artists of such a great caliber, while portraying beautiful women, were to expose their sickened and deformed breasts, the more so that the females who sat for the said artists were themselves their inamoratas (Margherita Luti posed for Raphael as La Fornarina, Hendrickje Stoeffels was portrayed by Rembrandt as Bathsheba, while Rubens’ wife, Helene Fourment, posed for the Grace). If the artists had been unable or unwilling to replace these models with someone else, it would have been more rational to show the women with their right (normal) versus left (cancerous) breast facing the spectator. For obvious reasons, such deliberations are completely devoid of any sense. The proposed diagnoses of ‘malignant tumors’ in La Fornarina, Bathsheba and the Grace may be, nevertheless, shaken when we perform an ‘ex post’ analysis of the further course of the ‘malignancy’ in the three women. Margherita Luti (La Fornarina) was alive for at least 1 or 2 years after she had been painted by Raphael. In the meantime she said her sad farewell to the artist on his deathbed and later joined a home for solitary women, where she continued living for we do not know how long, as no sources on her later fate are available. The portrait of Bathsheba was painted in 1654, and thus Hendrickje Stoeffels, who had sat for the artist, lived for 9 years after the picture had been completed (she died in 1663); judging by biographical data on her further activities, she continued enjoying quite a good health. Helene Fourment, the Grace of Rubens, met her death in 1673, so she survived the painting and breast cancer, as well as the artist himself, by more than 30 years. Seen from this viewpoint, the survival time of these three women with ‘neoplastic disease’ living in the 16th and 17th centuries rules out the validity of such a ‘medical diagnosis’ based on the analysis of their portraits.

Victim's scalp on the killer's head. An unusual case of criminal postmortem mutilation.

A case of unusual postmortem mutilation of a victim’s body is presented. After killing his father, the son decapitated his body and dissected the scalp free, forming a mask of the father’s head and neck. The young man wore the scalp–mask over his own head to imitate the father. The motive of the murder was revenge, and the postmortem mutilation was the realization of the perpetrator’s fantasies, symbolically representing a penalty for the reprehensible past life of his father.

Forensic medical examination of the corpse of General Władysław Sikorski, a putative victim of assassination in 1943

The Krakow Department of Forensic Medicine was granted a unique opportunity to examine the body of a historical figure, i.e. General Władysław Sikorski, the Prime Minister of the Polish government in exile, deceased in 1943. General Sikorski died in the crash of a Liberator aircraft at Gibraltar, and the British commission investigating the crash decided it had been an accident. In the past several decades, doubts have been repeatedly expressed as to the circumstances of the Generals death and the theory of assassination has become very popular. On November 25, 2008, the Generals corpse buried in the cathedral of the Royal Castle on Wawel Hill in Krakow was exhumed and the body was thoroughly examined. The examinations demonstrated numerous fractures of the cranium, spine and extremities, the character of which corresponded to effects of an air crash. Based on corpse examination alone it was impossible to establish whether the air crash had been an effect of sabotage or an ill-fated accident. Although no typical evidence of intravitality was found, such as bruises or fat embolisms, yet the character of some fractures suggested that they had been incurred intravitally. These were represented by a spiral fracture of the femoral bone shaft, a fracture of the sustentaculum tali of the calcaneal bone and fractures of the transverse processes of the lumbar vertebrae.