远红外线救治海水浸泡性体温中度过低症兔复温效果试验

目的:利用远红外线对海水浸泡性体温中度过低症兔进行复温,观察其复温速度、体温后降幅度及血浆IL-8变化,与现有复温方法比较,综合评价其复温效果。方法:将30只健康新西兰兔随机分为3组:自然组、水浴组和远红外线组,每组10只。将家兔浸泡于(21.0±0.5)℃人工海水中至肛温30℃,制备海水浸泡性体温中度过低症动物模型。分别采用自然、水浴、远红外线3种方法对其进行复温,记录体温后降幅度,以及兔肛温恢复至35℃时各组所用复温时间。复温3 h自颈内静脉采血,测定血浆IL-8含量。结果:各组间复温时间、体温后降幅度、复温3 h血浆IL-8含量均有统计学差异(P<0.01)。结论:远红外线复温法是一种有效救治海水浸泡性体温过低症的方法,具有复温速度适中、体温后降幅度小、血浆IL-8表达少等优点,安全有效复温的同时兼具机体保护作用。     

兔肢体爆炸伤合并海水浸泡后在不同复温速率及维持浅低体温下机体炎症反应的特征

目的 观察不同复温速率及浅低温对兔肢体爆炸伤合并海水浸泡后机体炎症反应的特点.方法 复制肢体爆炸伤合并海水浸泡致低体温[(31.0±0.5℃)]模型.成年家兔24只,随机分为4组,每组6只.Ⅰ组复温至(38.0±0.5)℃,复温速率(8.94±0.93)℃/h;Ⅱ组复温至(38.0±0.5)℃,复温速率(3.88±0.22)℃/h;Ⅲ组复温至(38.0±0.5)℃,复温速率(2.18±0.12)℃/h;H组复温至(34～35)℃并维持至实验结束,复温速率(4.49±0.66)℃/h.以调节环境温度及加温输液的方法将体温恢复到目标体温后维持该体温观察6 h.于致伤前(T0)、浸泡降温后(T1)、复温即刻(T2)、复温后3 h(T3)、复温后6 h(T4)共5个时相点检测血清肿瘤坏死因子(TNF-α)、白介素-1β(IL-1β)、白介素-6(IL-6).实验结束后取动物心、肝、肠、肺、肾组织.测定组织匀浆髓过氧化物酶(MPO)活性.结果 复温后,Ⅰ组、H组IL-1β、IL-6、TNF-α值较Ⅱ组、Ⅲ组明显升高(P<0.01或P<0.05),其中Ⅰ组升高更为显著.Ⅰ组、H组心、肝、肠、肺、肾组织匀浆中,MPO活性较Ⅱ组、Ⅲ组明显增高(P<0.01或P<0.05),Ⅱ组、Ⅲ组比较差异无统计学意义.结论 肢体爆炸伤合并海水浸泡致低体温后,快速复温及维持机体低体温均可导致机体内IL-1β、IL-6、TNF-α水平明显升高,组织中MPO活性明显增高;缓慢复温则可以明显抑制这3种炎症因子的水平及组织中MPO活性.     

The effect of ethanol and cold-adaptation on the survival of guinea pigs in severe cold

Summary An acute ethanol dose of 2g/kg shortened the survival time at –20°C of guinea pigs both adapted to the cold and those reared in the warm, but no significant difference was observed between the adapted and non-adapted groups. Long-term ethanol treatment of 2g/kg/day for 4 weeks, lengthened the survival time of the guinea pigs reared at room temperature, but did not affect the survival of the cold-adapted animals. The acute dose of 2g/kg shortened the survival time of the guinea pigs which had received the 4-week ethanol treatment and had been reared in the warm, but did not have the same effect on the cold-adapted animals. The improved survival rate at severe exposure acquired by adaptation to the cold was abolished by chronic alcohol administration.This work was supported by a grant from the Finnish Foundation for Alcohol Studies     

Comparison of oxygenated perfluorocarbon and humidified oxygen for rewarming hypothermic miniswine

This study examines a method to rapidly rewarm the core using total liquid ventilation with warmed, oxygenated perfluorocarbon. Yucatan miniswine were splenectomized and surgically implanted with telemetry devices to transmit electrocardiographic response, arterial pressure, and core temperature. Hypothermia (core temperature = 25.9 +/- 1.3 degrees C) was induced by placing cold-water circulating blankets over the animals. Control animals (N = 7) were rewarmed using warm (37.8 degrees C), humidified oxygen. Experimental animals (N = 6) were rewarmed with oxygenated perfluorocarbon liquid (37.3 degrees C). The time to rewarm was significantly shorter in experimental animals (1.98 +/- 0.5 vs. 8.61 +/- 1.6 hours, p < 0.0001), with almost no afterdrop in the experimental group. Lactate dehydrogenase and aspartate aminotransferase were significantly increased in the control animals compared with the experimental animals. All animals that survived being chilled to 25 degrees C survived rewarming. This method may provide a means of more rapidly rewarming profoundly hypothermic victims while reducing the risks associated with current methods.     

Hand temperature responses to local cooling after a 10‐day confinement to normobaric hypoxia with and without exercise

The study examined the effects of a 10‐day normobaric hypoxic confinement (FiO₂: 0.14), with [hypoxic exercise training (HT); n = 8)] or without [hypoxic ambulatory (HA; n = 6)] exercise, on the hand temperature responses during and after local cold stress. Before and after the confinement, subjects immersed their right hand for 30 min in 8 °C water [cold water immersion (CWI)], followed by a 15‐min spontaneous rewarming (RW), while breathing either room air (AIR), or a hypoxic gas mixture (HYPO). The hand temperature responses were monitored with thermocouples and infrared thermography. The confinement did not influence the hand temperature responses of the HA group during the AIR and HYPO CWI and the HYPO RW phases; but it impaired the AIR RW response (?1.3 °C; P = 0.05). After the confinement, the hand temperature responses were unaltered in the HT group throughout the AIR trial. However, the average hand temperature was increased during the HYPO CWI (+0.5 °C; P ≤ 0.05) and RW (+2.4 °C; P ≤ 0.001) phases. Accordingly, present findings suggest that prolonged exposure to normobaric hypoxia per se does not alter the hand temperature responses to local cooling; yet, it impairs the normoxic RW response. Conversely, the combined stimuli of continuous hypoxia and exercise enhance the finger cold‐induced vasodilatation and hand RW responses, specifically, under hypoxic conditions.     

Immersion of distal arms and legs in warm water (AVA rewarming) effectively rewarms mildly hypothermic humans

INTRODUCTION: Active rewarming of hypothermic victims for field use, and where transport to medical facilities is impossible, might be the only way to restore deep body temperature. In active rewarming in warm water, there has been a controversy concerning whether arms and legs should be immersed in the water or left out. Further, it has been suggested in the Royal Danish Navy treatment regime, that immersion of hands, forearms, feet, and lower legs alone might accomplish rapid rates of rewarming (AVA rewarming). METHODS: On three occasions, six subjects (one female) were cooled in 8 degrees C water, to an esophageal temperature of 34.3+/-0.8 (+/-SD) degrees C. After cooling the subjects were warmed by shivering heat production alone, or by immersing the distal extremities (hands, forearms, feet and lower legs) in either 42 degrees C or 45 degrees C water. RESULTS: The post cooling afterdrop in esophageal temperature was decreased by both 42 degrees C and 45 degrees C water immersion (0.4+/-0.2 degrees C) compared with the shivering alone procedure (0.6+/-0.4 degrees C; p < 0.05). The subsequent rate of rewarming was significantly greater with 45 degrees C water immersion (9.9+/-3.2 degrees C x h(-1)) than both 42 degrees C water immersion (6.1+/-1.2 degrees C x h(-1)) and shivering alone (3.4+/-1.5 degrees C x h(-1); p < 0.05). CONCLUSION: The extremity rewarming procedure was experienced by the subjects as the most comfortable as the rapid rise in deep body temperature shortened the period of shivering. During the extremity rewarming procedures the rectal temperature lagged considerably behind the esophageal and aural canal (via indwelling thermocouple) temperatures. Thus large gradients may still exist between body compartments even though the heart is warmed.     

兔肢体火器伤受海水浸泡后伤道周围骨骼肌Na ＋ / -K ＋ / -ATP酶活性变化

目的观察兔肢体火器伤合并海水浸泡时伤道周围骨骼肌组织Ｎａ＋－Ｋ＋－ＡＴＰ酶（Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ）活性变化及其影响因素,为防治继发损伤提供依据。方法以高速钢珠射击兔后肢,伤后将实验兔随机分为海水浸泡和单致伤组。将浸泡组（１４只）兔浸泡于人工配制的海水中３０分钟,于伤前及伤后３,６,１２,２４小时分别切取距伤道壁０．５ｃｍ（Ａ区）、１．５ｃｍ（Ｂ区）、２．５ｃｍ（Ｃ区）处组织,测定Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ和超氧化物歧化酶（ＳＯＤ）活性、ＡＴＰ和丙二醛（ＭＤＡ）含量。单致伤组（１０只）除不浸泡外,处理同海水浸泡组。结果海水浸泡组各区骨骼肌组织Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ活性、ＡＴＰ含量均呈伤后３小时较伤前明显下降（Ｐ＜０．０１）,６～１２小时回升,２４小时再次下降的趋势,下降幅度为Ａ区＞Ｂ区＞Ｃ区。ＭＤＡ含量与Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ活性变化呈负相关（ｒ＝－０．７７Ｐ＜０．０１）。单致伤组上述指标变化趋势同海水浸泡组,但变化幅度小。结论肢体火器伤合并海水浸泡时,可加剧伤道周围骨骼肌组织过氧化脂质反应,抑制抗氧化物酶活性,从而导致能量代谢障碍和细胞膜酶活性下降,加剧继发损伤。     

Chlorpromazine-induced alterations in hypothalamic amine metabolism and stress responses in severe cold

Summary To investigate the effects on the central nervous system of severe cold stress with and without chlorpromazine, guinea pigs were treated with chlorpromazine or 0.9% NaCl and exposed to –20°C or +23°C for 1 h. Hypothalamic noradrenaline (NA), dopamine (DA), 5-hydroxy-tryptamine (5-HT), 3-methoxy-4-hydroxyphenyl ethylene glycol (MHPG), homovanillinic acid (HVA) and 5-hydroxy-indoleacetic acid (5-HIAA) were determined by high-performance liquid chromatography. Serum, urinary and vitreous fluid catecholamines, muscle and liver glycogen, and blood glucose were also measured. Chlorpromazine caused distinct hypothermia at –20°C and slight hypothermia at +23°C. The rise in hypothalamic MHPG, 5-HIAA and MHPG/NA and in 5-HIAA/5-HT ratios in the cold indicate increased noradrenergic and serotonergic activity. The latter was inhibited by chlorpromazine and a drug-induced inhibition of noradrenergic neurons could not be ruled out. Chlorpromazine increased the turnover of DA at room temperature and the same tendency was seen in the cold. The hypothermic animals had low serum catecholamines, indicating diminished sympathetic activity. The chlorpromazine-treated cold-exposed animals did not react to the environmental stress by sympathetic activation, as urinary NA and adrenaline were not elevated, but DA was excreted by all the drug-treated animals. Vitreous fluid NA and DA were elevated as an indicator of cold stress, and no drug effect was seen in this fluid.     

The effect of high‐intensity training on mitochondrial fat oxidation in skeletal muscle and subcutaneous adipose tissue

High‐intensity interval training (HIT) is known to increase mitochondrial content in a similar way as endurance training [60–90% of maximal oxygen uptake (VO_2peak)]. Whether HIT increases the mitochondria's ability to oxidize lipids is currently debated. We investigated the effect of HIT on mitochondrial fat oxidation in skeletal muscle and adipose tissue. Mitochondrial oxidative phosphorylation (OXPHOS) capacity, mitochondrial substrate sensitivity (K_m^app), and mitochondrial content were measured in skeletal muscle and adipose tissue in healthy overweight subjects before and after 6 weeks of HIT (three times per week at 298 ± 21 W). HIT significantly increased VO_2peak from 2.9 ± 0.2 to 3.1 ± 0.2 L/min. No differences were seen in maximal fat oxidation in either skeletal muscle or adipose tissue. K_m^app for octanoyl carnitine or palmitoyl carnitine were similar after training in skeletal muscle and adipose tissue. Maximal OXPHOS capacity with complex I‐ and II‐linked substrates was increased after training in skeletal muscle but not in adipose tissue. In conclusion, 6 weeks of HIT increased VO_2peak. Mitochondrial content and mitochondrial OXPHOS capacity were increased in skeletal muscle, but not in adipose tissue. Furthermore, mitochondrial fat oxidation was not improved in either skeletal muscle or adipose tissue.     

Effect of rewarming at various water bath temperatures in experimental frostbite

Studies have been conducted on 72 rats to determine the most suitable temperature at which rapid rewarming should be done as an immediate treatment for frostbite. Animals were put in a harness containing arrangements for warming the body. Their hind limbs were left out of the harness. They were then exposed to -15 degrees +/- 1 degrees C in a deep freeze for 60 min, during which paw temperature was recorded every 5 min. After this, the animals were taken out, the left hind limb was rapidly rewarmed in a water bath maintained at 35 degrees, 37 degrees, 39 degrees, 41 degrees, 43 degrees, or 45 degrees C for different batches and the right hind limb was left free for slow rewarming at room temperature (27 degrees -29 degrees C). The severity of cold injury in the two limbs was compared. The paw temperature showed a drop on cold exposure, followed by a rapid rise and then a second fall. The degree of injury was related to the duration of exposure after the rise in the paw temperature. The rapid rewarming was effective only at water bath temperature of 37 degrees-39 degrees C and was harmful at 45 degrees C. This shows that rewarming at about body temperature is most effective as immediate treatment for frostbite.     

Oxidation of acetate in rabbit skeletal muscle: Detection by 13C NMR spectroscopy in vivo

The results of a proton-decoupled and Overhauser-enhanced ¹³C NMR study of acetate metabolism in skeletal muscle are reported. [2-¹³C]Acetate was infused intravenously over 2 h into anesthetized rabbits, and skeletal muscle in the lateral thigh was monitored by ¹³C NMR spectroscopy at 4.7 T. Stable ¹³C enrichment in carbons 2, 3, and 4 of glutamate was observed at the end of the infusion, and the half-time for enrichment was 17 min for glutamate C4 and 50 min for glutamate C2 and C3. The contribution of exogenous acetate to acetyl-coenzyme A was nearly equal in skeletal muscle and heart in vivo (83–87%, measured in tissue extracts), comparable with earlier perfused heart studies in which acetate was the sole available substrate. Although relative flux through the combined anaplerotic pathways (relative to citric acid cycle flux) was higher in quiescent skeletal muscle (26%) compared with hearts (3%) from the same animals, actual anaplerotic flux was estimated to be substantially higher in heart than in skeletal muscle after correcting for differences in citric acid cycle flux in the two tissues.     

海水浸泡弹道伤骨髓肌组织的超微结构改变

目的 观察火器伤合并海水浸泡后肌组织的超微结构改变。方法 以滑膛枪发射质量为0.38g的钢珠,速度为600～800m/s,钢珠击中兔后肢,分别将致伤兔浸泡于海水中30分钟和1小时,对照组不浸泡。于伤后3、6、12、24小时在距伤道0.2～0.5cm(挫伤区）、0.5～1.5cm(震荡区）处取材,固定于2.5%的戊二醛中作电镜观察。结果 浸泡组弹道伤组织超微结构变化与对照组想像相似,以变性坏死为主,如肌原纤维变性、溶解、变散或发生坏死,形成电子密度高的无结构性团块,内质网扩张,线粒体肿胀、空化、髓鞘样变等,且上述改变随浸泡时间延长而加重。引人注目的是弹道伤组织,尤其是震荡区,伤后6小时出现一些形态结构相对正常的线粒体,12小时最为显著,24小时线粒体再度退变,肌原纤维坏死加重。结论 海水浸泡火器伤肌组织损伤程度较单纯火器伤明显加重,浸泡时间越长,损伤程度越重。伤后6～12小时内弹道伤组织线粒体出现代偿性增生改变。     

Lack of β2‐AR improves exercise capacity and skeletal muscle oxidative phenotype in mice

β₂‐adrenergic receptor (β₂‐AR) agonists have been used as ergogenics by athletes involved in training for strength and power in order to increase the muscle mass. Even though anabolic effects of β₂‐AR activation are highly recognized, less is known about the impact of β₂‐AR in endurance capacity. We presently used mice lacking β₂‐AR [β₂‐knockout (β₂ KO)] to investigate the role of β₂‐AR on exercise capacity and skeletal muscle metabolism and phenotype. β₂ KO mice and their wild‐type controls (WT) were studied. Exercise tolerance, skeletal muscle fiber typing, capillary‐to‐fiber ratio, citrate synthase activity and glycogen content were evaluated. When compared with WT, β₂ KO mice displayed increased exercise capacity (61%) associated with higher percentage of oxidative fibers (21% and 129% of increase in soleus and plantaris muscles, respectively) and capillarity (31% and 20% of increase in soleus and plantaris muscles, respectively). In addition, β₂ KO mice presented increased skeletal muscle citrate synthase activity (10%) and succinate dehydrogenase staining. Likewise, glycogen content (53%) and periodic acid‐Schiff staining (glycogen staining) were also increased in β₂ KO skeletal muscle. Altogether, these data provide evidence that disruption of β₂‐AR improves oxidative metabolism in skeletal muscle of β₂ KO mice and this is associated with increased exercise capacity.     

Cold injuries

There are two categories of cold injury. The first is hypothermia, which is a systemic injury to cold, and the second is frostbite, which is a local injury. Throughout history, entire armies, from George Washington to the Germans on the Russian Front in World War II, have fallen prey to prolonged cold exposure. Cold injury is common and can occur in all seasons if ambient temperature is lower than the core body temperature. In the 1985 Boston Marathon, even though it was 76 degrees and sunny, there were 75 runners treated for hypothermia. In general, humans adapt poorly to cold exposure. Children are at particular risk because of their relatively greater surface area/body mass ratio, causing them to cool even more rapidly than adults. Because of this, the human's best defense against cold injury is to limit his/her exposure to cold and to dress appropriately. If cold injury has occurred and is mild, often simple passive rewarming such as dry blankets and a warm room are sufficient treatment.     

犬颈内动脉内冷灌注脑选择性降温对脑保护的实验研究

目的观察颈内动脉内冷灌注犬脑选择性降温对缺血性脑组织的保护作用。方法夹闭左侧颈总动脉、双侧椎动脉、左侧颈外静脉后,自右侧颈内动脉灌入低温灌注液以选择性降低脑温。将颅脑回流的低温稀释静脉血超滤并复温至３８℃后再输入体循环。结果１８只犬中有１４只完成了脑的选择性降温：（５．０±２．０）分钟内降至２８℃,（１０．３±７．２）分钟内降至２０℃,并维持在（１９±１．０）℃达５０分钟,直肠温度保持在（３２．５±２．０）℃以上。１０只长期存活,分别于术后１,２,８,１２周处死,病理检查示犬脑无神经细胞缺血性损伤改变。另４只实验初期因降温后血压显著下降而死亡。结论颈动脉内冷灌注液灌注,可选择性快速、安全地降低脑温,防止脑组织的缺血性损伤,为开展无血手术提供了实验依据。     

脂肪来源干细胞修复骨骼肌放射损伤的病理学研究

目的 观察CM-Dil标记的脂肪来源干细胞(adipose-derived stem cells,ASCs)植入放射损伤骨骼肌后的病理学改变,探讨ASCs对兔骨骼肌放射损伤的修复影响.方法 64只新西兰兔单侧臀部予9 MeV电子线单次照射80 Gy后采用随机数字表法分为ASCs组和磷酸盐缓冲液(PBS)组,每组32只,照射24 h后照射侧分别肌肉注射1 ml含5×107/ml标记后ASCs的PBS悬液和1 mlPBS缓冲液,未照射一侧作为各组正常对照.分别于照射后1、4、8和26周收集各组实验动物肌肉标本.观察标记后ASCs在骨骼肌组织中的分布及迁移,分析骨骼肌损伤病理学分级,观察4和26周时肌组织超微病理结构改变.结果 标记后的ASCs能在损伤部位迁移.ASCs组受照射骨骼肌组织病理损伤分级较PBS组在照射后1、4、8、26周显著减低(U=11.5、12.0、11.0,P＜0.05).ASCs组26周时再生肌细胞数(27.01土9.36)显著高于PBS组(5.23 ±4.23)(t=15.12,P＜0.05).ASCs组4和26周肌原纤维损伤程度较PBS组轻,26周ASCs组肌细胞肌间隙可见肌原纤维状结构增生.结论 ASCs能减轻受照射骨骼肌的病理组织学损伤,促进肌卫星细胞的代偿增生、再生肌组织,可能是修复骨骼肌放射损伤的部分机制.     

Effet de la castration sur le développement des muscles squelettiques

Introduction – Study the effects of the castration on skeletal muscle.Synthesis of facts – Physical and chemical muscle characteristics of 90 males, females and males rabbits castrated at three days were studied after slaughter when 14 weeks old. Longissimus dorsi muscle was analysed. LD chemical characteristics were insignificantly modified by castration. LD muscle was significantly more tender for females and castrated males than for entire males.Conclusion – The castration affects internal structure of skeletal muscle of rabbits slaughtered at 14 weeks of age.     

Toxicological analysis of drugs and poisons in formalin-fixed organ tissues

Diethylether, chloroform and toluene were administered by inhalation and ethanol intravenously to rabbits. As soon as possible after death, tissue specimens were collected from the brain, lung, liver, kidney and skeletal muscle and fixed in non-buffered 10% formalin at room temperature (10–20° C) for 4 different periods (1, 2, 5 and 14 days). The volatile substances were analyzed and identified by gas chromatography/mass spectrometry (GC-MS). The measured concentrations of ethanol, diethylether, chloroform and toluene in the brain tissue 1 day after fixation decreased to 8, 23, 73 and 84% respectively compared with those in the non-fixed brain tissue (100%). The rank order of the rate of decrease in the fixed state was: ethanol > diethylether chloroform > toluene. These volatile substances could be detected clearly in all the tissue specimens, even after a 14-day fixation period. These results provide useful toxicological information that will help to differentiate whether volatile substances have been administered antemortem or postmortem.     

Effect of altitude acclimatization on thermoregulation efficiency of man

A study has been conducted on 20 sojourners (SJs) at a high altitude (HA) of 3500 m to evaluate the changes in thermoregulation efficiency (ThE) during acclimatization for 3 weeks, by observing the rate and pattern of rewarming of palm skin temperature (Tsk) after dipping the hand in water of 10 +/- 1 degrees C for 2 min (Tromp's water bath test). The ThE of the SJs was compared to that of 10 acclimatized lowlanders (ALs) staying at the same altitude for about 1 year and 10 high-altitude natives (HANs). In SJ, at sea level (SL), the effect of seasonal variation and ambient temperature on ThE was also studied. The initial Tsk of the palm (29.9 degrees C) was lower at altitude as compared to SL value (32.2 degrees C) in SJs inspite of similar ambient temperature (21 +/- 1 degrees C). There was a prolongation of rewarming time in all the subjects during stay at altitude. The rewarming curve showed a shift towards the right, indicating slower rewarming. The rewarming response of ALs and SJs was comparable at altitude. In HANs, the rewarming at altitude was faster and resembled those of SJs at SL. The rewarming improved in the season following cold months, and at higher ambient temperature in the same season, on the plains. It may be concluded that thermoregulation efficiency of man deteriorates at high altitude, and the peripheral vascular responses to local cold stress do not reach the level attained by natives even after 1 year of acclimatization. General cold acclimatization improves the rewarming response.     

Changes in the myocardium and skeletal muscle in guinea pigs in cold exposure with and without ethanol

Summary The effect of hypothermia with and without ethanol on the myocardium and skeletal muscle was studied. Changes were observed in both muscle types. The mildest lesions were discoloration of the muscle cells with acid fuchsin and Heidenhain's iron haematoxylin staining, these being more marked in the skeletal muscle. Waving and contraction bands in the muscle were seen in hypothermia. The most severe lesion was a focus with oedema and haemorrhage, a reduced reaction of-hydroxybutyrate dehydrogenase and fragmentation of the muscle cells, and this was more frequent in the myocardium. Occasionally discoloration, contraction bands and waving were also seen in the controls killed by a blow on the neck. The changes were more numerous in the guinea pigs given ethanol before cold exposure, and serum creatinine phosphokinase was elevated in the same group. Urinary excretion of adrenaline increased in cold exposure, but noradrenaline did not change significantly. Hypoxia, catecholamines, and sludging of the blood are discussed as possible aetiological factors for the lesions.This paper was presented in part at the 8th Scandinavian Meeting of Forensic Sciences, June 1979, in Sandefjord, Norway