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[Application of virtual reality technique in forensic pathology].

This article reviewed general information, application and progress of the virtual reality (VR) technique. Lectures showed that the VR technique would impact and prompt the teaching, experiment, research and application of forensic pathology with the development of operation guiding system, virtual autopsy, micro-imaging technique. Because of the limitation of software, hardware and the expense, the VR technique needed to be improved and perfected.

Autopsy↗

Diagnostic significance of myofibrillar degeneration of cardiocytes in forensic pathology.

The incidence of myofibrillar degeneration (MFD) was studied in the following different forensic-pathological diagnostic groups of 25 cases each: acute morphine intoxication, acute carbon monoxide intoxication, hanging, strangulation by hand/ligature, drowning, acute hemorrhagic shock, lethal acute brain injury, explainable death of babies or infants and sudden infant death syndrome, together with 18 cases of intoxication with various drugs. The MFD was demonstrated by the Luxol-fast-blue reaction, with two types of phenomena being differentiated, namely cross-band lesions and diffuse staining. All diagnostic groups included cases of MFD of differing degrees. Cross-band lesions were observed in practically all cases of hanging, strangulation and acute hemorrhagic shock. Diffuse stain was noted particularly in cases of drowning and acute brain injury. The diagnostic significance is discussed.

Acute Disease↗

Microwave processing and ethanol-based fixation in forensic pathology.

An ethanol-based fixative (FineFIX) has been used, together with rapid microwave-stimulated processing, in postmortem material, resulting in a rapid fixation and processing of the tissues with morphology, histochemical stains, and immunocytochemistry comparable to formalin-fixed material. Furthermore, this alternative fixation gives better DNA recovery in higher amounts if compared with DNA extracted from formalin-fixed tissue, particularly advantageous in forensic pathology.

Brain↗

Interrupted aortic arch with ventricular septal defect: an unsuspected fatal congenital anomaly in forensic pathology.

Interrupted aortic arch (IAA) is a relatively rare cardiovascular anomaly worldwide and is very rarely encountered in forensic pathology. A case of clinically unsuspected fatal IAA in a 5-day old neonate is described. A full term female baby was declared dead on arrival at an emergency hospital few hours after having been discharged from a maternity hospital following delivery. There were no noticeable signs and symptoms reported during the short postnatal period. Antenatal medical history was unremarkable and there were no abnormalities noticed at birth. Autopsy revealed an unsuspected IAA arch with ventricular septal defect (VSD) as cause of sudden unexpected death. Although amenable to surgical intervention, IAA may not produce obvious clinical symptoms as was the case for this baby. Such sudden unexpected deaths raise medico-legal questions as to the manner and the precise cause of death. The importance of a full forensic autopsy to clarify such a sudden death was re-emphasized.

Journal Article↗

A profile of suspected female homicide cases at the Johannesburg and Diepkloof Forensic Pathology Service Medico-legal Mortuaries for 2020-2022.

This study profiles suspected female homicide victims in Johannesburg, South Africa, during the COVID-19 period marked by socio-environmental changes from lockdown restrictions. Guided by the Socio-Ecological Model, a retrospective case series of 369 victims was reviewed using medico-legal mortuary records from Johannesburg and Diepkloof Forensic Pathology Service facilities. Descriptive analyses were conducted, supplemented by a chi-square test to assess whether distributions of causes of death among women differed between COVID-19 and non-COVID-19 periods. No statistically significant association was found, χ2 (6, N = 339) = 6.68, p = 0.35. Key findings highlight that Black, unemployed, unmarried women aged 21-40 were at greatest risk. Cause of death was established in 97.0% (358/369) of cases, with firearm injuries predominating (43.9%), followed by sharp‑force (24.5%) and blunt‑force trauma (13.1%). Approximately 90% of victims were suspected to have been killed by males, with half of deaths attributed to intimate partner violence. Homicide frequency decreased during strict lockdowns but rose as restrictions eased, suggesting that movement and alcohol controls may reduce risk. Despite temporary disturbance caused by COVID‑19 restrictions, the underlying risk profile of female homicide victims remained unchanged. These findings inform multi-level prevention and intervention strategies in South Africa.

Humans↗

Specimens for teaching forensic pathology, odontology, and anthropology. I. Soft tissue.

A set of specimens has been collected, preserved, and organized specifically for the teaching of forensic pathology, odontology, and anthropology. Plastination of soft tissue, whole organs, bones, and teeth has proven valuable in preserving delicate, friable, and calcined specimens. The dry, odorless, biologically inert specimens are durable and resistant to damage caused by handling. Subtle features of soft tissue pathology are well preserved. Patterned injuries change due to shrinkage, but remain easily recognizable. Plastinated whole jaws are still readily identifiable from antemortem records. Radiographic density is essentially unchanged. Putrid and charred specimens become quite manageable.

Anthropology, Physical↗

Specimens for teaching forensic pathology, odontology, and anthropology. II. Teeth and bone.

A set of specimens has been collected, preserved, and organized specifically for the teaching of forensic pathology, odontology, and anthropology. Plastination of soft tissue, whole organs, bones, and teeth has proven valuable in preserving delicate, friable, and calcined specimens. The dry, odorless, biologically inert specimens are durable and resistant to damage caused by handling. Subtle features of soft tissue pathology are well preserved. Patterned injuries change due to shrinkage, but remain easily recognizable. Plastinated whole jaws are still readily identifiable from antemortem records. Radiograph density is essentially unchanged. Putrid and charred specimens become quite manageable.

Anthropology↗

[Sudden unexpected natural death from a viewpoint of forensic pathology].

Sudden unexpected natural death (SUND) has several characteristics, such as unknown clinical history, very short course to death, evidence of trauma, interference of postmortem changes and social implications of diagnosis. From these points, SUND involves important challenges in forensic pathology. Presented here are the highlights of our SUND studies which allow scientific speculation into the antemortem pathophysiological course to death and a subsequent accurate diagnosis of the cause of death in SUND cases. 1. Forensic problems of SUND of unknown etiology 1) Do sudden infant death syndrome (SIDS) studies continue endlessly? In Japan there are many cases of sudden unexpected infant death (SUID) which were regarded as SIDS, often without postmortem examination. Pure SIDS should be a diagnosis of exclusion under thorough postmortem examination. Additionally, many SIDS studies have focused on pathogenesis of pure SIDS based on the analysis of so-called SIDS cases described above. In this sense, SIDS studies may continue forever. To clarify whether SIDS is an onion type, that is a heterogeneous disease entity, or bamboo shoot type, a single disease entity with a single cause, it is more vital to accurately search autopsy findings to exclude the cause of death, rather than to study pathogenesis of SIDS. Thereafter, pure SIDS will be carved in relief and we could study the pathogenesis, if it remains in the future. Present in 40% of our SUID cases examined was the existence of viral infection as a cause of death. 2) Pokkuri disease It has long been believed that the main branches of coronary arteries in Pokkuri-disease cases are macroscopically hypoplastic and cause sudden cardiac death. However, our two-dimensional morphometric analysis of the main branches, such as wall thickness, degree of stenosis, lumen area, area within internal elastic lamina, showed no significant differences between Pokkuri-disease cases and age and sex-matched control cases. 2. Information for grasping antemortem pathophysiological state in SUND cases 1) Standardization of the degree of cardiac hypertrophy based on heart weight. In the course of our preliminary examination, we found that heart weight correlates significantly with body length and weight. Therefore, we tried to standardize the range of normotrophy, hypertrophy and hypoplasia/atrophy of the heart based on the correlation between heart weight and body type index calculated by body length and weight (Broca's index). 2) Evaluation of the clinical laboratory data in cadaveric blood. We examined 32 clinical laboratory parameters in cadaveric blood samples obtained from 192 autopsy cases. Behaviour of the laboratory parameters in cadaveric blood in relation to postmortem interval was divided into four types: increased, decreased, no particular tendency and remaining between upper and lower normal value. Parameters included in the last type, which is a useful tool for speculation of antemortem pathophysiology were T-Bil, TTT, ZTT, BUN, Cre, UA, alpha 1- and beta 2-microglobin, T-Chol, GHA1c, TP, A/G, Hb and Hct. A case was demonstrated in which values of clinical laboratory parameters in agonar stage were the same as in cadaveric blood obtained at autopsy. This indicates that caution is necessary in evaluating clinical laboratory data in agonar patients in the emergency room. 3) Diagnostic evaluation of immunohistochemical myoglobin staining in the kidney In order to evaluate the diagnostic value of myoglobin (Mb) staining in the kidney in medicolegal autopsy cases, Mb staining was carried out on the kidney sections of 141 victims, including 59 natural and 82 unnatural deaths. At the same time, Serum and Urine GFR parameters were measured and systemic histological changes were observed on some sections of each kidney. The incidence of Mb positive cases was 74.6% in unnatural, and 25.4% in natural death, indicating the importance of nontraumatic rhabdomyolysis in natural death cases.

Brain↗

[Usage of double immuno-enzyme labeled staining method in forensic pathology].

In this paper we report a kind of double immunoenzyme labelled staining method (single enzyme method). The principle of the method is that HPR will show blue-black color when it meet DAB-CoCL2/H2O2, while it will show brown color as it meet DAB/H2O2, two colors constract very remarkably. This method was used to detect the antigens of hearts and brains which obtained from forensic autopsy. The results showed that the method was sensitive, simple and economical. One of the advantages is that the stained sections can keep for a long time. Thus, is very practical for forensic pathology.

Brain↗

Social isolation and delayed discovery of bodies in houses: the value of forensic pathology, anthropology, odontology and entomology in the medico-legal investigation.

The bodies of socially isolated people may remain undiscovered in their own houses for prolonged periods. Occasionally the body is in situ for sufficient time to become skeletonised, or partially so. Medico-legal investigation of these cases is complicated by degradation and contamination of evidence. Thus, a multidisciplinary forensic investigation is recommended. The potential contributions of forensic pathology, anthropology, odontology and entomology are outlined here with reference to two cases that occurred in Victoria, Australia, in 2003. Forensic pathologists are often unable to determine the cause of death in skeletonised bodies, however, they may find evidence to support either a natural or unnatural mode of death, and they may describe skeletal pathology or trauma, and identify skeletal features to support radiological identification of the deceased. Anthropologists can provide supplementary evidence of skeletal trauma. Additionally, they can assess age, sex, stature and racial affiliation from skeletal remains. Odontologists can identify individuals through comparison with ante-mortem dental records; however, potential difficulties exist in identifying the treating dentist of a socially isolated person. Odontologists may also examine the teeth and oro-facial skeleton for trauma. Entomologists may estimate minimum death time and/or season of death. Entomological examination of insect remains may also confirm that a body has lain in situ for a considerable period.

Adipose Tissue↗

Forensic pathological aspects of postmortem imaging of gunshot injury to the head: documentation and biometric data.

To determine the value of imaging procedures such as computer tomography (CT) and magnetic resonance imaging (MRI) of the head in providing additional information of forensic relevance, we examined 17 cadavers of human victims of gunshot wounds to the head. Three of the victims briefly survived the gunshot wound. The weapons involved were all guns with low muzzle energy (<550 J), i.e., handguns and low-velocity rifles. In the majority of cases ( n=15) a penetrating wound to the head was found, only two cases showed the bullet lodged in the brain. In some cases, imaging of the skull and brain was performed prior to autopsy; in others imaging took place after autopsy on the isolated, formalin-fixed brain. The imaging findings were correlated with the criminological data and the results of macroscopic and microscopic examination of the brain. The findings on the bony structures of the head provided imaging criteria for differentiation between entrance and exit of the gunshot wounds, which corresponded to the forensic pathological findings at autopsy. CT scans and MRI of the cerebral parenchyma revealed lanes of opaque bone and missile fragments along the course of the missile, which allowed recognition of the missile track in 3D reconstruction. Biometric reconstruction allowed easy determination of the angle of the missile track in all three planes. Examination of the parenchymal structures and imaging of the isolated, formalin-fixed brain enabled tracking of the missile path directly along the zone of destruction as well as demonstration of secondary changes such as air bubbles along the bullet course, hemorrhage and edema. The significance of a translucent zone surrounding the missile track in several cases remains unclear; it probably represents tissue destruction secondary to temporary cavitation. The imaging procedures described here allowed excellent documentation of in situ conditions, while the storing of data enabled biometric reconstruction for determination of the angle of trajectory, of entrance and exit wounds, and the extent of tissue damage along the missile track and, possibly, in the zone of temporary cavitation.

Adult↗

A profile of abandoned fetal and neonatal remains admitted to the Diepkloof forensic pathology service medico-legal mortuary during the COVID-19 and post-COVID-19 periods.

The abandonment of neonates is a global concern, with a higher prevalence of cases present in South Africa. This study aimed to review cases admitted to the Diepkloof Forensic Pathology Service during the COVID-19 (2020-2021) and post-COVID-19 (2023) periods. A total of 158 cases were analysed to determine prevalence, demographic characteristics, circumstances and causes of death, with a comparative analysis between the COVID-19 and post-COVID-19 periods. Most cases were classified as natural. However, many were undetermined due to decomposition. Non-viable fetuses (< 26 wk gestation) comprised 47% of the cases. Among the viable births (n&#x2009;=&#x2009;72), 23 (32%) were classified as stillbirths, while 11 (15%) were live births. A minority of cases were deemed unnatural, with deaths attributed to trauma (8 cases) or abandonment (2 cases). No statistically significant difference was found between the COVID-19 and post-COVID-19 periods. Decedents were most often found in open spaces, roads or streets, or dumping sites, most commonly wrapped in plastic materials. These findings highlight the severity of fetal and neonatal abandonment. They underscore a pressing need for targeted preventative measures, community outreach, and enhanced support systems in maternal healthcare to address this growing concern.

Humans↗