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PubMedDate not supplied

Cycling fatalities in Western Australia.

OBJECTIVE: To present a review of the circumstances of 64 cycling fatalities in Western Australia (WA) during the nine-year period 1984-1992, and the major injuries sustained by the cyclists. DATA SOURCES: The number of deaths was ascertained from lists maintained by the WA Police Department, Forensic Pathology Division of the Health Department and the Coroner's office. Individual case files held by the Coroner's office and Forensic Pathology Division were then examined for details of the circumstances of each incident, epidemiological data, and medical and toxicological findings. DATA SYNTHESIS: Most of the 64 fatalities (59%) occurred in children or young adults less than 20 years of age. Most fatal injuries (54%) were to the head alone. Forty-seven of the deaths involved collision with a motor car. Alcohol was demonstrated in the blood of five of the 30 cases in which analysis of blood alcohol level was performed. On average, 7.8 cyclists died annually in WA before the introduction of legislation for the compulsory wearing of safety helmets while cycling. In the 12-month period following this legislation, there was only one cycling death. CONCLUSIONS: Most cycling deaths occur in children, primarily from head injury resulting from impact with a motor car. The enactment of legislation for the compulsory wearing of cycling helmets has been associated with a fall in cyclist fatalities.

Accidents, Traffic↗
PubMed1998

Common errors in forensic pediatric pathology.

Medicolegal autopsies in the pediatric age group occur with some frequency. Despite the time-honored and often quoted address by Professor Alan Moritz many years ago, which described mistakes in the forensic autopsy of adults, a comparable discussion of infants and children has not been forthcoming. In this review, ten categories of potential and actual errors are listed, some of which are similar to those given by Moritz. The smaller size of infants as well as their unique growth and development creates problems separate from those in adult autopsies and creates opportunities for mistakes in observation and interpretation. The thorough documentation of all findings, the gathering and proper storage of evidence, and the availability of essential materials (e.g., scene investigation data, complete medical records, all microscopic slides, total laboratory analyses--especially toxicology) help to preclude errors of both omission and commission.

Autopsy↗
PubMed1998

Continuing education programme - Victorian Institute of Forensic Medicine.

With the increasing requirement of the courts for forensic experts to engage in ongoing education, a continuing education programme (CEP) was developed in the field of clinical forensic medicine at the Victorian Institute of Forensic Medicine in 1996. This programme has been described and was initially established to provide a means of education for the contracted forensic medical officers who provide forensic services to the police via the Institute throughout the State of Victoria. Owing to the sparsity of the population and the considerable distances between forensic practitioners, the CEP was designed to cater for individuals who are working alone: in effect, a distance education programme. Forensic pathologists expressed interest in the programme and it was subsequently modified to include forensic pathology cases. Currently, the programme caters for both clinicians and pathologists, and takes the form of four to five cases with related questions which are circulated several times per year. The cases include a mixture of both challenging and ordinary procedural types that may present to practitioners working in either clinical forensic medicine or forensic pathology, or both. The areas covered include: * injury interpretation * procedural matters in relation to adult and child sexual and physical assault * pharmacology/toxicology interpretation of findings * medico-legal issues (e.g. confidentiality, consent, etc.) * issues relating to alcohol and drugs * traffic medicine * clinical and legal aspects of sudden natural death * suspicious deaths * suicide * interpretation of findings at autopsy * fitness for interview * fitness to plead * psychiatric issues * general clinical medical issues. The presentation of each case includes relevant and appropriate details/findings and may include photographs. A series of questions follow which are answered in either short answer or multiple-choice format. The answers are returned and are correlated by a review panel of forensic physicians and pathologists, and a commentary with the response outcomes is distributed to all those involved. This also includes pertinent references. The cases presented here and in subsequent issues are selected from this programme.

Journal Article↗
PubMedDate not supplied

[Correlation of clinical and autopsy diagnosis during a 10-year period at the Institute for Pathology and Forensic Medicine at the Military Medicine Academy in Belgrade].

The comparison between the clinical and pathohistoanatomic diagnosis of 3.929 autopsied cases is performed. In 82.5% of cases the clinical and pathohistoanatomic diagnosis were in the absolute correlation; in 8% of cases the clinical diagnosis of the basic disease has no adequate pathoanatomic characteristics, while in 4.5% of cases the clinical diagnosis of the basic disease, immediate cause of death and condition which was important for the course and outcome of the treatment were not adequate. Among the pathologic states diagnosed as: pulmonary thromboembolism, myocardial infarction and cerebrovascular insult--pulmonary embolism most often was not confirmed by autopsy (47%), while in 58% of cases it remained clinically unrecognized. Malignant tumours of the liver, pancreas and kidneys have been most frequently clinically unrecognized compared to other malignancies. Duration of hospitalization has not had the essential influence on correct establishment of the clinical diagnosis.

Autopsy↗
PubMed2001

Histopathological findings of cardiac conduction system of 150 Finns.

One hundred and fifty heart specimens were collected from the cases submitted for autopsy in the Department of Forensic Medicine in the University of Turku in March-May 1995 and May-July 1996, respectively. The cardiac conduction system (CCS) of these hearts were examined in order to find out the histopathological changes in the CCS of Finnish persons and their forensic pathological significance. There were 94 males and 56 females. Almost all age groups were included. The results revealed that in most of the persons the fibrous tissue and fatty tissue in the CCS increased with aging. In about half of the persons, there was deposition of calcium in the central fibrous body, pars membranacea, and the top of the musculature in the interventricular septum. In seven cases, the atrioventricular node (AVN), His bundle (HB) or bundle branches (RBB, LBB) were compressed by the calcium deposition. Hemorrhage, inflammation, amyloidosis, tumor, fatty infiltration and developmental malformations were observed in 31 cases. Twenty-eight cases died of myocardial infarct, among them, no involvement of the CCS could be observed. The authors concluded that routine examination of the CCS is helpful for revealing diseases of the CCS and improving the quality of forensic pathological diagnosis.

Adult↗
PubMed1995

Enzyme histochemistry of the liver in autopsy material at different post-mortem times.

The authors report the enzyme histochemistry of the liver obtained from autopsy material in 22 corpses (2 to 12 hours post-mortem) and performed to evaluate the sensitivity of enzyme activities to the autolysis process and the use of enzymes to estimate time in forensic pathology. The earliest sample was at 2 hours post-mortem; there was five cases up to 5 hours; eight case up to 8 hours and eight cases up to 12 hours since death. Active phosphorylase (PHYLA a) and total phosphorylase (PHYLA t) were negative two hours after death. PHYLA t reaction represents the activity of PHYLA a increased with the inactive phosphorylase b which can be activated by the addition of ATP and Mg2+ to the incubation medium for phosphorylase a; this activation proved to be ineffective in the post-mortem periods of this study. Glucose-6-phosphatase (G6P-A) also showed a tendency to be sensitive to the autolysis process, displaying a reaction progressively weaker or negative in the post-mortem periods of observation. The results indicate these enzymes as a possible tool to estimate time in forensic pathology deserving further investigation. Lactate dehydrogenase (L-D), alpha-glycerophosphate dehydrogenase (alpha-GP-D) and beta-hydroxybutyrate dehydrogenase (beta-HOB-D) instead showed stronger reactions as the autolysis process evolved.

Adult↗
PubMed1996

The dynamics of inflammatory cytokines in the healing process of mouse skin wound: a preliminary study for possible wound age determination.

The dynamics of inflammatory cytokines such as interleukin-1 alpha (IL-1 alpha), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF alpha) during the healing process of mouse skin wounds were examined using the enzyme-linked immunosorbent assay and immunostaining. The applicability of this examination for wound age estimation is discussed from the perspective of forensic pathology. After wound induction, mice were sacrificed at intervals ranging from 0 to 240 h. The levels of TNF alpha and IL-1 beta began to elevate rapidly after wounding and reached a peak at 3 h. The IL-1 alpha level reached a peak at 6 h, and IL-6 peaked at 12 h. An infiltration of numerous leukocytes, indicating acute inflammation, was observed at 3 and 6 h, and the main source of the cytokines was immunohistochemically identified as neutrophils. These results indicate that TNF alpha and IL-1 beta play an important role in the commencement of inflammation. "Rebound" of cytokine levels, i.e. a re-increase, was observed at 72 h after wounding. Histological examination of the 72-h-old wound showed migration of fibroblasts and the formation of new granulation tissues, indicating the proliferative stage of the wound healing process. These experimental findings indicate that these cytokines have a close relationship to wound remodeling as well as to inflammation. From the viewpoint of forensic pathology, it is considered that inflammatory cytokines may become one of the markers for wound age estimation, but further studies are needed, especially those involving the investigation using human wound specimens with known time intervals after injury.

Animals↗
PubMed1995

Problems in forensic cardiovascular pathology.

Do we have a magic yardstick that will establish whether SCD of the patient is definitely caused by the presence of an underlying abnormality? We are afraid that in most cases of cardiac disease the cause of death is at best probable, or even presumed. It has always been that circumstantial evidence has helped us establish that the cause of death is related to the anatomic abnormality. Even the presence of severe coronary artery disease in a patient who dies suddenly, especially in the absence of a thrombus, cannot be stated categorically to be the cause and effect. With the knowledge we have today, establishing cause and effect are difficult in most cases of SCD.

Adolescent↗
PubMed1984

Ruptured berry aneurysms: a clinical, pathological and forensic review.

A retrospective autopsy survey of 583 cases of ruptured berry aneurysm over a period of 25 years with reference to incidence, circumstances and predisposing factors. Over half of the deaths occurred in the 50-80 year age group, the overall male/female ratio being 2:3, the aneurysms being predominately on the middle and anterior cerebral arteries. Most deaths occurred in the home environment without precipitating factors, one fifth being sudden and unexpected in nature. There was no connection between physical trauma and ruptured aneurysm and no instance of a criminal or civil charge. Autopsy and dissection of the cerebral vessels is vital to diagnosis, particularly when deaths are unexpected in nature.

Adolescent↗
PubMed2002

An inherited metabolic disorder presenting as ethylene glycol intoxication in a young adult.

Despite the abundance of reports emerging in the literature on metabolic disorders, some disorders remain undiagnosed or misdiagnosed, not only in clinical pathology but also in forensic pathology. The authors report a patient who had recurrent episodes characterized by nausea, vomiting, and signs of dehydration necessitating admission to the hospital. At each admission, he was found to have lactic acidosis. On the first admission, glycolic acid was detected in his blood and he was diagnosed as having ethylene glycol intoxication. Only at the third admission, 2 years after the first, was the possibility of an underlying metabolic disorder considered. Laboratory investigations showed a deficiency of complex I in the mitochondrial oxidative phosphorylation. Possible medicolegal implications are discussed.

Acidosis, Lactic↗
PubMed1996

Chromosome-specific panels of tri- and tetranucleotide microsatellite markers for multiplex fluorescent detection and automated genotyping: evaluation of their utility in pathology and forensics.

A set of 391 microsatellite markers (Weber set 6), 85% of which consist of tri- and tetranucleotide repeat markers, were used to design chromosome-specific panels that allowed for a high degree of multiplexing with respect to the fragment size range and fluorophore (FAM, HEX, TET). This marker set has an average coverage of 10.5 cM, with the largest gap being 28.1 cM. The markers were divided into 49 panels, with a maximum degree of multiplexing of 15 markers per panel. The utility of the markers for analysis of DNA from blood, hair, and formalin-fixed archival tissue biopsies was evaluated with respect to amplification efficiency, product yield, and degree of preferential amplification of the shorter allele in heterozygotes. The amplification efficiency was inversely related to repeat length and amplicon length. Based on the analysis of DNA from formalin-fixed biopsies, 51 markers suitable for loss of heterozygosity (LOH) studies were identified. The utility of the marker set for genome scanning, LOH, and forensic analyses is discussed.

Chromosomes↗
PubMedDate not supplied

[Killing a wolf--an unusual case of forensic veterinary pathology].

During a hunt in Western Pomerania in January 1999 a wolf, injured at the left hind leg, was killed by a shot in the chest region. It was a 2-year-old male that probably came to Germany from Poland by crossing the Oder River. The hunter was reported to the police afterwards, because there were doubts as to the legality of the lethal shot. The hunter pleaded relief by reason of section 22 a German Hunting Law (prevention of avoidable pain or suffering of wild animals). After the shooting there was a number of wrong expert statements by a veterinarian and two zoologists concerning the age of the injury on the left hind leg and the direction of the shot to the chest region, which were corrected by subsequent medico-legal examinations performed on the order of the prosecution.

Animal Rights↗