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 Forum index » Archive » Archive: Perplex City » PXC: General/Updates
[UPDATE] PXCPD Internal Access - 14 Mar 06 - Cymbalisty File
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duckiemonster
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 		I realise that the medical report may have beyond a lot of people's specialist areas... so here's an annotated version of the edited basics Smile

Quote:
FINAL DIAGNOSIS:

I. Cerebral infarction
a. Localized synaptic liquefactive necrosis

II. Minor abrasion of right cheek (pressure).


Basically, the ultimate cause of death was a stroke- in this case a loss of the blood supply to the brain tissue. "Localised synaptic liquefactive necrosis" isn't something that you come across often on the wards, but my best guess is that it's a destruction of the tissues in the brain... basically turning it into soup.



Quote:
CLINICOPATHOLOGIC CORRELATION: Cause of death of this 52 year-old male is synaptic overload associated with excess Ceretin consumption. Death approx 16-24 hours after ingestion.


Synaptic overload- the nerves burnt themselves out.

Quote:
CASE NO. PXC978C675 (CYMBALISTY, ISAAC).

PUTREFIED: NO.

DATE OF INCIDENT: 14/1/269

DATE RECEIVED: 14/1/269

DATE EXAMINED: 16/1/269


The body wasn't decomposed. The examination date was indeed two days after the date of death. This doesn't mess with my theory above, as if PxC bodies are stored like Earth bodies, you refrigerate them to halt the metabolism of the little bacterial beasties that cause decomposition. Therefore it's likely that the body will be in exactly the state in which it was found.

Quote:
EXTERNAL EXAM:
The decedent is clothed in a tweed jacket and coat with a red woollen tie. Shirt is cream cotton. Brown socks. Brown slip-on leather shoes. Jewellery: one watch, one silver enigma ring. Underwear is blue and white striped shorts, urine stained anteriorly over the crotch area and anterior legs.


Wot no trousers?

Quote:
EXTERNAL EVIDENCE OF INJURY:
Decedent is in good physical condition. No sign of external trauma. Some livor mortis around the right cheek. Slight abrasion to right cheek, from pressure or collapse against desktop.


Livor mortis: After death, blood tends to fall due to gravity andpool in the skin. This gives a red/black/brown mark that doesn't go white on pressing. I'm assuming 'abrasion' is used in the sense of graze or bruise.

Quote:
REMAINDER OF EXTERNAL EXAMINATION:
The unembalmed, well developed and well nourished Caucasian male body measures 168cm and weighs an estimated 75kg. The scalp is covered by thinning white hair, closely cropped. The eyes are brown and equally dilated. The sclerae are white with minor reddening. The nostrils are both patent and contain a small amount of green mucous material. The teeth are native. Three fillings. The tongue is pink and granular. On the right cheek is a pattern of dried saliva. The chest is symmetrical. The abdomen is slightly stretched. Greenish marbling of right lower abdomen. The genitalia are those of an adult male. The fingernails on both hands are trimmed short, edges are smooth. Examination of the back reveals nothing remarkable.


Sclerae: the white bits of the eyes. All the rest is normal... except the stretched abdomen and the green mottling, which I mention in the post above.

Quote:
INTERNAL EXAM

Chest muscles, lungs, heart, aorta, spleen, adrenals, kidneys all perfectly normal.

Quote:
Liver: The 1450g liver is red brown. Cut sections disclose centrilobular necrosis. Some hepatocytes have a swollen, edematous appearance. Retained biliary material gives a diffuse foamy swollen appearance. Large metallic deposits have accumulated in viable hepatocytes.


This is a 'nutmeg' liver appearence... it's not a happy liver. The metal has accumulated there and made it swollen and inflamed. The copper could be due to 'Wilson's disease'... this condition is normally congenital, but can arise due to copper poisoning. People with Wilson's can't metabolise copper properly, so build up deposits in the liver, eyes and brain (which would explain his neuro problems over the past couple of months). This disease could have killed him... but not before the stroke Smile

Quote:
Pancreas, bladder, gallbladder, G.I. tract, lymphatics, musculoskel


All normal.

Quote:
Skull and brain: The skull appears to be intact, with no signs of haemorrhage on either the scalp or face. Minimal abrasion to the right cheek just below the occipital area, measuring 30mm. The cerebral vasculature shows signs of apparent liquefactive necrosis. Multiple coronal sections of the cerebral hemispheres, brain stem and cerebellum show this necrosis to be widespread.


Riiight. 1. Nobody whacked him on the head. 2. This 'abrasion' doesn't sound significant, especially as its' just on the cheek. It could have been caused by him collapsing forwards suddenly onto the desk. 3. The blood vessels in the brain aren't working because of the necrosis. This is why he died: No blood to the brain stem, the brainstem dies, no breathing, unconciousness. 4. The whole of the brain appears to have been affected by jellyfication. The report seems to suggest that this necrosis is related to a ceratin overdose and was complete about 16-24 hours after this overdose was taken.

This is a little scary: most brain diseases that destroy nerves generally take many years to become fatal. They work slowly, causing symptoms like dementia. There has, however, been the case of an impure form of heroin which caused the people that used it to develop Parkinson's disease (normally takes many years) overnight. This appears to be the sort of thing that's happened here.


Quote:
MICROSCOPIC DESCRIPTION


Heart, lungs, thyroid, thymus etc all normal.

Quote:
Liver: The lobular architecture of the liver is well preserved. Metallic deposits are confirmed as copper. Consistent with prolonged inhalation of copper-based manuscript preservatives.


Whatever you say, Mr Coroner, Sir.

Quote:
Pancreas: There is some autolysis of the pancreas, which is otherwise unremarkable.


Autolysis: The destruction of tissue by its own enzymes. This is normal after death in the pancreas, which is a hothouse of dissolvey stuff production.

Quote:
Kidney,Bladder


Normal

Quote:
Brain: Sections from the cerebral hemispheres, brain stem and cerebellum show widespread liquefactive necrosis. Synapses are fused. Consistent with synaptic overload. Loss of consciousness assumed to be rapid. Damage reached fatal levels approx 16-24 hours after initiation.


Synapses are fused: Nerves work by passing electrical signals between one another. Ceretin apparently enhances these connections... in an overdose, it looks like the connections are made permenant, leading to the death and degeneration of the nerves.

Quote:
SPECIMENS SENT FOR TOXICOLOGY: blood, vitreous fluid, urine, bile, liver, lung, gastric contents, kidney, spleen, muscle, brain, heart.


All of these tested positive for ceretin...

Looking at the toxicology report, the only significant findings are in the ceretin screen. Don't forget that the 'cyanide 0.10' blah blah blah are just the lab's standard way of communicating the sensitivities of the machine that they're using... doesn't mean that the chemicals have been detected.

Quote:

---> Ceretiva* detected in blood.
---> Ceretiva* detected in brain.
---> Ceretiva* detected in vitreous fluid.
---> Ceretiva* detected in urine.
---> Ceretiva* detected in liver.
---> Ceretiva* detected in gastric contents.
---> Ceretiva* detected in kidney.
---> Ceretiva* detected in exhibit 3a.
*NOTE: Unknown ceretiva derivative - poss black-market.


So we've got ceretin in the coffee, the stomach, liver, kidneys, urine, liver... vitreous fluid is the stuff that fills your eyeballs.

This doesn't mean that the stuff found in the stomach was the coffee; it could be anything with some ceretin dissolved in it. What it does mean is that Cymballisty lived long enough after taking ceretin to digest it, filter it out in the liver, transfer it into his eyes, get it in his urine.

Hope this helps a few of you out Smile
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PostPosted: Tue Mar 14, 2006 6:55 pm
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Uhtoff
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 		Found this quote from a pathology website -

Quote:
Under average conditions in a temperate climate the earliest putrefactive changes involving the anterior abdominal wall occur between 36 and 72 hours after death. Progression to gas formation occurs after about one week. The temperature of the body after death is the most important factor generally determining the rate of putrefaction. If it is maintained above 26oC (80oF) after death then putrefactive changes become obvious within 24 hours and gas formation will be seen in about 2-3 days.


Both the distention and the green colouration suggest he'd been dead for 2-3 days, and of course he would have been kept cool from the 14/1 to the 16/1 so putrefaction would have been arrested. Won't post when I'm on nights any more... Wink

PostPosted: Tue Mar 14, 2006 7:35 pm
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myf
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 		Duckiemonster, thanks for translating all that stuff so I can understand it, at least a bit!
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PostPosted: Tue Mar 14, 2006 7:37 pm
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Uhtoff
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Quote:
There has, however, been the case of an impure form of heroin which caused the people that used it to develop Parkinson's disease (normally takes many years) overnight


Nice to see that at least some lectures in medical school obviously never change! MPTP is the acronym for that chemical and this discovery really helped research into Parkinson's by providing a useful tool, not so good for the junkies, good for the scientists!

PostPosted: Tue Mar 14, 2006 7:43 pm
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psyche
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toongoon wrote:
1) The police never interview Kurt to corroborate Miranda's times although she seems curious as to what answer he gave.

I disagree here. What she said, when asked what time she left the library, was 'It must have been about five. What time did he...?' Which I took to mean 'What time did Cymbalisty die?' It doesn't strike me as a question about any time Kurt may have given.

I don't think anyone's yet mentioned this, from Cymbalisty's key:
Quote:
>>14/1/269 NO CALLS.
>>Document 1

>>13/1/269 NO CALLS.

>>12/1/269 12:38-12:42 Voice call - Heath, Anna.
>>Granier notes 6 (encryp.)

>>11/1/269 NO CALLS.
>>Granier notes 5 (encryp.)

He has notes about the Granier diaries on his key? I wonder what they say. They could just be a transcription, of course, but they may contain theories or similar.

PostPosted: Tue Mar 14, 2006 7:52 pm
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duckiemonster
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Uhtoff wrote:
Nice to see that at least some lectures in medical school obviously never change!


Oxford Uni Lecturers? CHANGE?! They can't change!!!

Thanks for the dead people stuff Wink - nice warm flat, I reckon he was dead for about 1-2 days. But then again, I'm not sure how that fits with the other character's timelines. We might be completely wrong.
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PostPosted: Tue Mar 14, 2006 7:58 pm
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sackofpotatoes
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 		Sorry, I'm a bit confused on the timeline here...

Friday after work, Isaac leaves the library and walks part of his way home with Jason. Violet estimates their time of departure to be around 6:00pm. Jason estimates that he left Isaac at 6:15pm when their paths diverged.

The Sentinel says his body was found on Saturday.

So how exactly was he dead for 2-3 days before his body was found?
Does this mean the time of poisoning was sometime before he left the library on Friday evening?

If someone could clear this up for me, I'd appreciate it. I've obviously misunderstood something.

PostPosted: Tue Mar 14, 2006 8:29 pm
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Juxta
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Quote:

DATE EXAMINED: 16/1/269


There was a delay between the death and the full post mortem being carried out. He died Friday/Saturday, but the PM wasn't performed until the Monday.

J
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PostPosted: Tue Mar 14, 2006 9:03 pm
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duckiemonster
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Juxta wrote:
Quote:

DATE EXAMINED: 16/1/269


There was a delay between the death and the full post mortem being carried out. He died Friday/Saturday, but the PM wasn't performed until the Monday.

J


This is indeed so.

But he was refrigerated between times. This stops the little decomposing beasties. So any greenness or bloating must have been there at the time he was found on the Friday.

So my hypothesis, as written in my posts above, is that Violet *didn't* see him on Friday, reason being that he was already dead. Someone was an imposter.

I also think that this report may have been tampered with by teh sneeky 3P... how else to explain the glaring mistakes?
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PostPosted: Tue Mar 14, 2006 9:18 pm
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sackofpotatoes
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 		Can anyone verify the location of Isaac and Jason's apartments? I can't seem to find their streets (Guardian Lane and Ordinal Lane according to the Wiki) on the Perplex City Map.

I'd like to know for sure that Isaac and Jason live in the same direction from the Library, and on the opposite side of town from Violet, whose apartment it noted on the map.

Yes, I realize that we don't have a map of the entire city yet, or maybe I'm unaware of such info.

PostPosted: Tue Mar 14, 2006 10:13 pm
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Quick Vic
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 		Anyone else read Miranda's statement and wonder whether she's on the level? May be utter spec, but I noticed two things... First, she referred to Cymbalisty as being such a 'sweet' man twice.

Yet I also remember Violet sounding less-than-thrilled to have to work with him on translating the Granier passage. She even called him 'loathsome'.

Also, from Quirky Acuity: "I think Cymbalisty has taken quite a shine to Miranda. He's been talking to her more than he talks to me (which is quite a relief, to be honest)". That was December.

And yet Miranda's statement "I'm only a junior there. He [Cymbalisty] doesn't have much reason to speak to me."

And she was so conveniently absent from the office..

PostPosted: Tue Mar 14, 2006 10:14 pm
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chimera245
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 		Probably O/T for this thread but doesn't anyone else think the Miranda the obsequious is just not kosher.

I have this nagging (completely unsupported as yet) hunch that she is perhaps feeding people Ceretin.

Back O/T as I mentionned in chat this morning I am still surprised that the Autopsy does not mention the apparent inconsistencies between various anatomical findings and the supposed time of death.

These being

A) The physical indications, as mentionned by duckie and others indicating the body as somewhat older than the time of death
B) The convenience of the whole Ceretin in Coffee scenario, with no other stomach contents (despite at 16-24 hour time to take effect)

I really feel that the report may have been nobbled (rather than just produced ineptly). But by whom and for what reason?

What was the source of the cheap Ceretin derivative - can we deduce anything about that and does it lead us anywhere?

PostPosted: Wed Mar 15, 2006 12:06 am
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sackofpotatoes
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Quote:
A) The physical indications, as mentionned by duckie and others indicating the body as somewhat older than the time of death
B) The convenience of the whole Ceretin in Coffee scenario, with no other stomach contents (despite at 16-24 hour time to take effect)


A) I thought the time of death discrepancy was due to fact that the autopsy took place a few days after the body was discovered (on Saturday). There has been some discussion about the fact that chilling the body (in the morgue) should have slowed these processes, but I still think this is the most likely explanation. Unless of course Isaac wasn't really at the Library on Friday.

B) I still don't understand the 16-24 hour delay in Ceretin poisoning. This would imply that he was poisoned on Thursday night / Friday morning. I was under the impression that the murder took place on Friday night. I just can't imagine no one noticing strange behaivor from Isaac throughout the day on Friday at the Library.

PostPosted: Wed Mar 15, 2006 12:27 am
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EvilGenius
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 		OK - color me noob, but that was FUN! This is the first thing that has happened since I started playing. Actually, color me noob Canadian, but what's all this "trout" business about? You wacky Brits . . . Smile Lots to digest in here. Cool that the statements offered are in the writers original hand, suggests that there has been a lot of editing going on for the final report. This should keep us busy for a while . . .

I have a brilliant theory about the poisoning but, in order not to make a fool of myself, I want to review this matter in more detail (I not sure I'm at my best at 4:45 am).

PostPosted: Wed Mar 15, 2006 12:46 am
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EvilGenius
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 		The only reason to believe this is a Ceretin overdose is the presence of Ceretin in Issac's system and that " Localized synaptic liquefactive necrosis" is coorelated with Ceretin overdose. Pretty thin. We know Issac to have been a Ceretin addict so the first of these clinical findings is just what we would expect. Do we know if localized synaptic liquefactive necrosis has other causes? I'd bet this turns out to have been caused by some technological or biological weapon (like that neuro-suppressive device that, among other things, make time of death difficult to establish). Maybe this is why the 3rd Order needed to make a clean room in the tunnels, to develop something nasty.

PostPosted: Wed Mar 15, 2006 12:58 am
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