Abstract-We examined characteristics or cardiac cell damage in the myocardium obtained from individuals who died due to hypothermia or coldwater immersion. We could find four kinds of histological changes in the heart tissues obtained from hypothermia and coldwater immersion death. Although the red or orange colored cardiac cells, vacuolar cardiac cells and contraction band of the cardiac cells were observed in the heart from individuals with cardiac infarction, the frequency and intensity of the finding was remarkable in hypothermic death, and closely adhered cardiac cells were detected only in the myocardium from hypothermic or coldwater immersion death. We additionally discussed the mechanisms of development of these findings by comparing the results obtained in this examination with some reports in the literatures. Accidental hypothermia is defined as unintentional fall in core temperature under 35℃, and sever hypothermia is usually defined as under 28℃. Without through review of circumstances, the diagnosis of environmentally induced hypothermia is difficult at an autopsy, however hypothermia effects the cardiovascular, hematological, neurological, respiratory, renal, metabolic, and gastrointestinal systems [1] .
Keywords-HypothermicIn this study we examined histo-pathological phenomena of the cardiac muscle obtained from individuals who died due to accidental hypothermia or immersion in cold fresh water. We found several changes occurred in the cardiac tissues in them, and are able to say that Azan staining may give the easily detected characteristics in the cardiac tissues from individuals who died due to hypothermia and/or immersion in cold water as a routine staining compared with HE staining.
II MATERIAL AND METHODSWe performed 16 autopsies of hypothermic death at Department of Legal Medicine, Shiga University of Medical Science and Osaka Medical Examiner's Office during the last 4 years. The myocardium from 13 of 16 cases were examined in this study. Thirteen cases contain two old women who lived alone and died from hypothermia together with head injury after stumbling or fall from a stairs in their houses, and one child who died from abuse. The other 10 victims were found their death inside or around their houses and no remarkable injury was found on their body except the erythema on their knees in some cases. The eliminated three cases in which the victims showed prolonged postmortem interval were not suitable for the histological research. We also examined the myocardium from three cases as the comparative cases in which individuals died from drowning after immersion in a lake or canals in winter, that is, a young man was forced to go into a lake in winter, and in the last two cases young woman and man separately fell into canals with a motorcycle or a bicycle. In the last two cases, climbing traces were remained on the canal banks. Additionally we used the myocardium from traffic accidents cases with or without brain and/or cardiac injury, and cardiac infarction cases with bleeding and leukocyte i...