Autoerotic death is an accidental death during sexual pleasure, usually caused by a device or equipment used to enhance pleasure. Autoerotic deaths can be classified as typical or atypical. Typical autoerotic deaths occur due to asphyxiation by mechanical compression, while atypical autoerotic deaths occur by means other than asphyxiation. Narcissism-associated accidental deaths during tube and wire insertion into the urethra and rectum are extremely rare. The victim, a man in his 40s, was found dead at his home. Several tools for masturbation and wires for urethral and rectal insertion were observed around the victim and many pornographic videos were also identified. Family accounts and medical records indicated that he masturbated often by inserting plastic tubes and wires into the urethra and rectum. Moreover, the victim had a history of surgeries to remove foreign objects from the urethra and rectum as well as a history of psychiatric treatment. The autopsy results revealed no specific findings indicative of the cause of death. In conclusion, the investigators determined the cause of death as an atypical autoerotic death based on the death scene investigation, autoerotic sexual behavior, personal history, and autopsy results.

PURPOSE: The aim of this study was to determine the relationship between the injury severity and pain intensity according to age in patients with extremity injuries. METHODS: Adult patients with an extremity injury who visited the emergency department (ED) from June 1, 2016 to November 31, 2016 were analyzed retrospectively. The major injury was defined as structural damage below the muscle layer, such as muscle, ligament, and bone. Minor injury group and major injury group were separated according to this definition. The relationship of age and pain score assessed with the numerical rating scale (NRS) with the injury severity was analyzed. RESULTS: Of a total of 1,441 patients, the number of patients with a minor and major injury was 854 (59.3%) and 587 (40.7%), respectively. The proportion of patients aged 65 and older was 6.1% and 25.7% in the minor and major injury group, respectively. Age and NRS scale showed significantly positive associations with the injury severity (p < 0.001). In all NRS scores, the overall proportion of major injuries in the older age group was higher than that in the younger age group. Regardless of the younger ( < 65 years) or older (≥65 years) age group, the NRS score was positively related to the injury severity (young age group [odds ratio, 3.944]; older age group [odds ratio, 5.754]). CONCLUSION: The pain intensity is positively related to the severity of injury regardless of age. The pain intensity is the important factor of a patient assessment and treatment in the emergency department.
Adult ; Emergency Service, Hospital ; Extremities* ; Humans ; Ligaments ; Pain Measurement ; Retrospective Studies ; Trauma Severity Indices