A 54-year-old woman (165 cm, 37 kg) was found dead in her home during a welfare check after not having been seen for at least three days. The body showed clear evidence of decomposition. Her head was in what appeared to be a pool of blood. The residence was clean, neat, and showed no evidence of violence. Insulin was found in the refrigerator, and syringes were in the kitchen cabinet. In agreement with these physical findings, her clinical history indicated that she suffered insulin-dependent diabetes mellitus. Autolytic changes were noticed at autopsy, and no obvious cause of death was demonstrated. The autopsy heart blood sample screened negative for cocaine and/or metabolite (benzoylecgonine), phenethylamines, opiates, and barbiturates by radioimmunoassay. The alcohol concentration was 0.51 g/dL in the blood, 0.04 g/dL in the brain, 0.08 g/dL in the liver, and 0.05 g/dL in the urine, and acetone levels were 42 mg/dL, 53 mg/dL, 14 mg/dL, and 19 mg/dL, respectively. Isopropanol was also present in all samples analyzed. The cause of death was ruled as metabolic acidosis due to diabetes mellitus. Possible bacterial postmortem production of ethanol is considered as an explanation for the increased concentration of ethanol found in the postmortem heart blood.
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机译：一名54岁的女性（165厘米，37公斤）在至少三天未见后在福利检查中被发现死于家中。身体显示出明显的分解迹象。她的头似乎在血迹之中。住所干净整洁，没有暴力迹象。冰箱中发现胰岛素，而厨柜中则有注射器。与这些物理发现相符，她的临床病史表明她患有胰岛素依赖型糖尿病。尸检时发现自溶改变，没有发现明显的死亡原因。尸检心脏血液样品通过放射免疫分析法对可卡因和/或代谢物（苯甲酰芽子碱），苯乙胺，阿片类药物和巴比妥类药物筛查阴性。血液中的酒精浓度为0.51 g / dL，大脑中的酒精浓度为0.04 g / dL，肝脏中为0.08 g / dL，尿中为0.05 g / dL，丙酮水平为42 mg / dL，53 mg / dL ，14 mg / dL和19 mg / dL。所分析的所有样品中也存在异丙醇。死亡原因被裁定为由于糖尿病引起的代谢性酸中毒。可能的细菌死后生产乙醇被认为是死后心脏血液中乙醇浓度增加的解释。
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