Myocardial injury in electrocution.
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Whatever induces general anesthesia, i.e. cerebral arrest, tends to cause respiratory and cardiac arrest also. However, general anesthesia does not necessarily exclude nor block all other mechanisms which can provoke one or more of these three phenomena. Amongst many such more or less equipotent factors are intracranial, intrapleural, intra-abdominal and intratracheal pressures. These mechanical factors occurring but unrecognized in surgical patients cause puzzling complications including, insomnia, coma and unexpected sudden death.
Almost every action in the body involves the nervous system which uses electricity for its speed and versatility. Operating and controlling muscular activity is a major function of the nervous system. Muscles are paired so every normal contraction requires a reciprocal relaxation of its doppelganger (Newton said 'Equal and opposite'). Minor failures of co-operation, i.e. neuromuscular dysfunction make common survivable diseases. Multiple and major stimuli can create chaotic conflicts within these couplings and lead to fatalities. Excessive, abnormal, even ordinary stimulation will cause the (irritable?) partner(s) which should relax also to contract. Thus function is impaired or impossible. In the limbs faulty neuromuscular co-ordination is obvious as stiffness, Parkinson's Disease, Erb's Palsy etc. Less evident, it is even more important in the cardiovascular, gastrointestinal, genitourinary and respiratory systems.
The differentiation of minute current marks from the faint traces of burns may offer some difficulties. Marcinkowski and Wojciechowski (1973) treated the skin of corpses with the same metal objects either heated to a high temperature or exposed to 250 V of alternating current, and determined (by an electrographic method) that metallization appeared only after applying the electric current. The continuation of these observations is linked with the actual experimental studies of Pankowski. By treating the skin of corpses with alternating and direct current of 10, 50, 100 and 250 V for 0.3 sec, 1 sec, 30 sec and 1 min passing through a radioactive electrode of 60Co, he has shown that the radioactivity of the skin at the site of electrode contact increases with the elevation of the voltage and its duration. In the case of direct current the rise was 630-54000-fold at the site of the positive electrode. Using electrodes of copper, aluminium and iron (not radioactive) it has also been shown (by an electrographic method) that metallization intensifies under the same conditions of time and voltage. Metallization could be detected even when no current marks on the skin were evident. Electrography appears to be extremely useful in the detection of metallization. No metallization was detected at the site of the negative electrode (as refers to direct current).
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A wife was found dead by her husband, lying in a tiled bath on a cast concrete floor, with a 1 kW electric radiator immersed in the bath water. Initially the case was treated as accidental death, but the police charged the husband with murder on the grounds that his wife could not have died in the manner he described. Subsequent investigation showed that the bath had a low resistance to earth and that there were faults in both the house wiring and the radiator cable, which, together with a high blood alcohol content, produced a fatal chain of events.
We present a case of acute, unilateral facial nerve paralysis in a patient who had received a low voltage electrical current. This is an extremely rare cause of this neurological condition. The patient regained complete neurological function approximately three months after the incident. Unilateral facial nerve paralysis most commonly occurs due to infection or blunt or penetrating trauma; it has not been previously reported as a result of low voltage electrical injury.
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In late summer several years ago, the county medical examiner was called by the police to view two bodies found in bed in a private home. The home belonged to a 39-year-old caucasian male whose body was one of those found in the bed. The other body was that of a 31-year-old caucasian female. The female body overlaid that of the male. It was obvious that the couple was engaged in sexual relations when they died. The deaths apparently were related to the use of an elaborate apparatus utilizing electrical current for stimulation. A heavy metal rod measuring 22 cm in length and 2.5 cm in diameter was inserted 18 cm into the male's rectum. A small wire was attached by a rubber band leading to a Variac voltage regulator. There was a metal rod 20 cm long with a rounded tip 1 cm wide tapering to 0.75 cm in the shaft. A metal ring was attached to the exposed end and the male partner's index finger was touching it. The rod was inserted 18 cm into the female's rectum with a similar wire attached and leading to the voltage regulator. The regulator was set at 90 volts, but the dial could be turned up to 130 volts. In the room nearby were other stimulation devices, including a La Vida vibrator on a bed table and a Niagara type vibrator found under the bed. On the bed table was also noted a 1-lb. jar of lubricating cream. The couple was last seen alive more than 24 hours before. Third-degree burns were found in the rectum and vagina with perforation of the posterior vagina and anterior rectum in the female victim. In the male victim, third-degree burns were noted on the tip of the left index finger, the rectum, and the penis. The voltage regulator was plugged into a wall socket when the police arrived.
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