Jørn Simonsen

Patho-anatomic findings in neck structures in asphyxiation due to hanging: a survey of 80 cases.

By examining 80 consecutive cases of death due to hanging, fractures of the thyroid cartilage or the hyoid bone or both, were noted in 45%. Fracture of the cricoid cartilage did not occur. No fracture occurred below the age of 25, and the frequency was slightly increasing with increasing age. There was a preponderance of fractures in males. The highest incidence of fractures was noted in typical hangings, while incomplete hanging to a very great extent was combined with congestion to the face, especially if the location of the ligature was atypical. Typical hanging in general did not produce congestion. The lividity in the declivous areas became fixed at the earliest after 5-6 h suspension time, while after 12 h almost all the cases demonstrated fixed lividity in the distal parts, especially in the legs. There is slight indication that the frequency of fractures increases with the length of suspension time.

Determination of the Time of Death by Continuous Post-Mortem Temperature Measurements:

In 20 cases with known times of death continuous post-mortem measurements of the temperature fall in brain, calf, liver, axilla and rectum of the bodies have been made, and, in addition, the environmental temperature has been recorded. The observations were not made under standardized conditions, and the clothing of the bodies was left untouched as far as possible. The measurements of the brain temperatures have given the greatest accuracy in determining the time of death; for temperatures above 25 °C the uncertainty was of the order of magnitude of ±2 1/2 hours, at lower temperatures greater. The other sites of measurement permitted less reliable estimates of the post-mortem time, but none of them were found to be appropriate beyond 20 hours after death. There is one factor which cannot be calculated. It is the temperature at the moment of death. All investigations show that it may vary enormously. In the present study the difference between the maximum and the minimum starting temperature ranges between 5 °C and 8 °C, dependent on the site of measurement. As the fall in temperature—irrespective of the site of measurement—during the first few hours post mortem is of the magnitude of 1 °C per hour, the above variation gives an inaccuracy which by far exceeds what can be achieved of greater accuracy by the aid of brain temperature measurements. For this reason the authors feel justified in concluding that the determination of the time of death will always be encumbered with great uncertainty, but that the most reliable estimate within the first 20 hours after death can be based upon the measurement of the brain temperature associated with an evaluation of the development of the signs of death. None of the other methods tested so far appears to have offered a greater reliability.

Firearms fatalities in Denmark 1970-1979

In the 10-year period from 1970 to 1979 933 firearm fatalities occurred in Denmark which represent an increase of 45% during a little more than 10 years. Eighty-eight per cent were suicides, 8% homicides, and 4% accidents. Accidental shootings have decreased from 8% to 4% and the fall seems to be a result of fewer accidents in connection with hunting, probably due to a more restrictive legislation about hunting. An increasing share of the total number of deaths, now responsible for 57% of the fatalities, are by shotgun. There has been a remarkable increase in the use of sawn-off long barreled weapons. Still considering the marked increase of firearm fatalities, fatal shootings are of very limited importance in Denmark, especially homicidal shootings of which there are 2-3 per year. Shotguns are at the present time the only procurable dangerous weapons which have led to an increased share of the total firearm fatalities. Restrictions in the use of shotguns during hunting seem to have had positive effects on the reduction of hunting accidents. As mentioned above, the most valuable method of bringing the firearm fatalities under further control seems to be increased control over the procurement and possession of shotguns.

The manner and cause of death in a forensic series of chronic alcoholics

Chronic alcoholics account for an increasing number of the cases which are examined in forensic pathology. The manner and cause of death in 122 chronic alcoholics is described and compared with a previous investigation and to a group of non-alcoholics. The percentage of cases in which the manner of death is undetermined is twice as high as in the control group, whilst the percentage of suicide, surprisingly enough is only half that of the control group. The patho-anatomic findings in the liver and the causes of death are discussed in detail.

Early Formation of Adipocere in Temperate Climate

A case is reported in which marked adipocere formation in the body of an adult person occurred within 22 days of death, undoubtedly as a result of the extraordinarily hot summer of 1975. A short survey of the literature concerning this topic is given. It is pointed out that even in the temperate zone the weather conditions can for some period of time simulate those of the tropical climate and create facilities for very rapid adipocere formation.

Sudden unexpected natural death in young persons

In a series of 1920 medico-legal autopsies, 78 cases fulfilled the criteria of sudden unexpected natural death in the age group 2-30 years. In 39 (50%) of these cases a health hazardous condition was known. A large group included epileptics, alcoholics, obstetric/gynecologic conditions, and drug addicts. For prophylactic reasons the medical intervention should focus on earlier detection, if possible, of acute myocarditis, better instruction to epileptics as to thorough medication and information of parents. Physicians should be reminded about the danger of inflammatory processes in the upper respiratory tract, especially acute tracheobronchitis and acute epiglottitis.

Massive Subarachnoid Haemorrhage and Fracture of the Transverse Process of the Atlas

Two cases of traumatic fatal basal subarachnoid haemorrhage accompanied by fracture of the transverse process of the atlas have been described. These cases differ from the cases hitherto known in that fracture of the transverse process was not recognized until the bone was examined after complete removal of the soft tissue. This procedure is highly recommended in all cases in which autopsy findings do not permit definite conclusions concerning the origin of the haemorrhage or no indication of external violence is found.

Chlamydia and sudden infant death syndrome. A study of 166 SIDS and 30 control cases.

SummaryChlamydia inclusions could be demonstrated by an immunofluorescence assay in formalin-fixed lung sections in 32 of 166 cases (19.4%) of Sudden Infant Death Syndrome (SIDS) and in the lungs of only 1 of 30 infants with a known cause of death (3.3%). The difference is statistically significant (P = 0.04).Chlamydia trachomatis is an agent of pneumonia in 1–4 month-old infants who have acquired the disease from an infected cervix during birth, but other chlamydia species are also capable of causing pneumonia. The lung sections of the 32 chlamydia positive SIDS cases did not show typical histological signs of pneumonia. Even though chlamydia inclusions were detected in the lungs of 32 SIDS cases a causal relation between chlamydia infection and SIDS could not be demonstrated.ZusammenfassungChlamydia-Einschlüsse konnten mit Hilfe eines Immunfluoreszenz-Ansatzes in formalinfixierten Lungenschnitten in 32 von 166 Fällen (19,4%) des Syndroms des plötzlichen Kindstodes und in lediglich einem von 30 Fällen von Kindern mit bekannter Todesursache (3,3%) festgestellt werden. Der Unterschied ist statistisch significant (P - 0,04). Chlamydia trachomatis ist ein Erzeuger von Pneumonien bei 1–4 Monate alten Kindern, die die Erkrankung während der Geburt aufgrund einer infizierten Cervix acquiriert haben, aber andere Chlamydia-Arten sind auch imstande, eine Pneumonic zu verursachen. Die Lungenschnitte von 32 Chlamydia-positiven SIDS-Fällen zeigten keine typischen histologischen Zeichen der Pneumonie. Obwohl jedoch Chlamydia-Einschlüsse in den Lungen von 32 SIDS-Fällen gefunden wurden, konnte eine kausale Beziehung zwischen Chlamydia-Infektion und SIDS nicht nachgewiesen werden.

Deaths among narcotic addicts in Denmark in 1978 and 1979

Since 1968 the number of deaths registered among narcotic addicts has increased considerably from 9 deaths in 1968 to 121 in 1979. Data concerning 215 deaths among narcotic addicts in 1978 and 1979 examined at the three Danish University Institutes of Forensic Medicine are presented. Four-fifths of the cases were males; the average age in both males and females was 26 years. In most cases a mixed abuse was present, the predominant drug being heroin. In 27% of the cases there was an abuse of alcohol. The material was divided into two groups. Group A included 181 cases in which the cause of death was poisoning by one or more drugs. In group B (34 cases) narcomania was a contributory factor to death. The place of death, gross autopsy findings and toxicological data are reported. The manner of death was in 62% of the cases stated as accident, in 19% as suicide, in 14% as accident?/suicide?, in 3% as natural death and finally in 1% as homicide. Next to traffic accidents narcotic addiction today is the greatest single cause of death in the age group 18 - 35 years. These facts call for active political steps against narcotic addiction.

Accidental death in fermentation tanks: report of two cases.

Two cases of accidental drowning in fermentation tanks are described. During the fermentation different toxic gases are generated among which carbon dioxide is supposed to be most dangerous since it is colourless and odourless. Special problems concerning fermentation of slurry are pointed out and precaution during work with these tanks is recommended.