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Results for “Forensic Pathology”

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At least 685 records · Page 38Linked to original sources
PubMed2006

Correlation between glial fibrillary acidic protein-positive astrocytes and age in the human hippocampus.

The hippocampus is one of the areas most vulnerable to histopathological changes, and such changes may yield useful information in forensic medicine. We found that glial fibrillary acidic protein (GFAP)-positive astrocytes are frequently found in the hippocampus of consecutive series of forensic brains, distributed predominantly in the hippocampal CA4 and hippocampal sulcus (HS) regions. The present study counted GFAP-positive astrocytes in these regions and investigated associations with age, cause of death and postmortem time. Significant correlations were found between age and number of GFAP-positive astrocytes in both CA4 and HS regions. Number of GFAP-positive astrocytes increases in an age-dependent manner, but no correlations were noted between number of GFAP-positive astrocytes and postmortem time and cause of death. Number of GFAP-positive astrocytes in the hippocampus may provide useful information for age estimation.

Adolescent↗
PubMed2007

Differences in postmortem urea nitrogen, creatinine and uric acid levels between blood and pericardial fluid in acute death.

Previous studies showed significant differences in postmortem urea nitrogen (UN), creatinine (Cr) and uric acid (UA) levels in heart blood depending on the causes of death, including acute death. In addition, the levels in pericardial fluid approximated the clinical serum reference ranges, and their elevations may be assessed based on clinical criteria. The present study investigated difference between blood and pericardial levels of these markers. Medicolegal autopsy cases (n=556, within 48h postmortem) of the following causes of death were examined: injury (n=136), asphyxiation (n=50), drowning (n=39), fire fatalities (n=99), hyperthermia (n=11), hypothermia (n=8), poisoning (n=26), delayed traumatic death (n=44) and natural diseases (n=143). When serum UN, Cr and UA levels were compared with the pericardial levels, there was an equivalency for delayed traumatic death and chronic renal failure, although each level was markedly elevated. Parallel increases in serum and pericardial UA and/or Cr levels were also observed for hypothermia and gastrointestinal bleeding. However, in drowning cases, the left cardiac and pericardial UN levels were lower than the right cardiac and peripheral levels, suggesting the influence of water aspiration. Significant elevations in serum and pericardial Cr and UA levels with a higher serum/pericardial UA ratio for fatal methamphetamine intoxication suggest progressive skeletal muscle damage due to advanced hypoxia/acidosis. Similar findings were often observed for other acute and subacute deaths. These findings suggest that a comparison between blood and pericardial nitrogenous compounds would be useful for investigating the cause and process of death.

Adolescent↗
PubMedDate not supplied

Is retrieval of bone material from multiorgan donors effective enough to cover demand for biostatic bone tissue grafts in Poland?

In Poland there is growing demand for biostatic allogeneic bone transplantation mostly for traumatologic operations and orthopedic reconstructions. The bone material is primarily harvested during postmortem examinations in forensic and pathology laboratories. Nevertheless, the collected amounts are not sufficient, so that material needs to be acquired from alternative sources, such as multiorgan donors. Between 1998 and 2003, 2331 potential donors were registered by the Transplantation Coordinating Center in Warsaw, which was adjusted to 1794 donors who would have been accepted as donors of the bone tissue. Unfortunately, due to denials from family members and public prosecutors, the sample was only 1416 donors, which would cover about 40% of the clinical orthopedic demand in Poland.

Bone Transplantation↗
PubMed2005

Autopsy.

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Autopsy↗
PubMedDate not supplied

South-Asian tsunami.

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Communicable Disease Control↗
PubMed2005

[The unusual cause of death--a special assignment for the doctor in emergency service].

The emergeny physician summoned to a sudden, unexpected death is confronted by various uncommon problems such as the certification of death on the "frontline" without destroying important evidence, the estimation of time since death, deciding whether the death must be reported to the authorities as well as taking care of mourning relatives. To all this questions the authors offer answers and practical advices.

Acute Disease↗
PubMedDate not supplied

View of a war from a pathology department: Croatian experience.

This report presents an analysis of autopsy records from the Department of Pathology and Forensic Medicine, Osijek General Hospital, in the period from 2 May 1991, when 12 Croatian policemen were killed in an ambush in Borovo Selo and the war against Croatia unofficially began, until 15 January 1992, when the last cease-fire agreement between Croatia and Serbia, sponsored by the United Nations, became effective. During that time, 651 war-related autopsies were performed, constituting 42 per cent of all the deaths recorded in eastern Slavonia for that period. This number presents an 11-fold increase in the number of violent deaths in comparison to the same period of the pre-war year 1989 to 90. Forty-four per cent of all deaths were civilian ones. Explosive wounds were the most frequent cause of death: they accounted for 60 per cent of the civilian and 49 per cent of all the deaths. This fact and the extensive destruction of the cities in eastern Slavonia, including their hospitals, indicate that a principal characteristic of this and many modern wars is sudden and unexpected ground and air attacks on civilian targets.

Adolescent↗
PubMedDate not supplied

Forensic assessment issues in low level neurological states.

Forensic assessment of persons in low-level neurological state (LLNS) is fraught with limitations and caveats. Examiners must be aware of the nuances of forensic evaluation in the context of the conditions of examination, ethics and responsibilities that they have been charged with as an independent evaluator and fact seeker in the context of litigation-oriented dispute resolution. This article provides an overview of the independent medical evaluation (IME) of persons in LLNS including ethics, contextual limitations, history gathering, corroboratory interviews and suggested examination, as well as report format, among other important issues.

Brain↗
PubMedDate not supplied

Detection of gunshot residues on cadaveric skin using sodium rhodizonate and a counterstain.

We report a staining method for cadaveric tissue using sodium rhodizonate as a skin marker for gunshot residues and a counterstain for the surrounding connective tissue. We studied six well preserved subjects who had died of close range gunshot injury. Skin fragments were removed from the bullet entrance hole including both the disrupted area and adjacent macroscopically intact tissue. Because microscopic examination of postmortem material is difficult after histomorphologic alterations already have occurred as a consequence of postmortem tissue changes, it is necessary to use a staining method that, while detecting gunshot residues, can also make skin cell constituents recognizable from both qualitative and quantitative perspectives. Triphenylmethane dyes (acid fuchsin, aniline blue WS, light green SF yellowish, brilliant green and ethyl green) have proven appropriate for the purpose.

Cadaver↗
PubMed2005

Investigation of an LC-MS-MS (QTrap) method for the rapid screening and identification of drugs in postmortem toxicology whole blood samples.

The QTrap liquid chromatography-tandem mass spectrometry (LC-MS-MS) by Applied Biosystems was investigated as an adjund to enzyme immunoassay (EIA) for the rapid detection of drugs in blood. Thus, a procedure used to identify drugs in whole blood by EIA was extended to LC-MS-MS analysis. A multiple reaction monitoring (MRM) database of over 100 drugs was constructed to analyze for those drugs commonly observed in postmortem toxicology cases. The QTrap method provided for a scan time of only 2.8 s to produce both an MRM and an enhanced product ion scan. Various validation and developmental steps of the method are presented, as well as a concordance study as a final means of validation. This study was conducted to compare the effectiveness of the QTrap versus conventional extraction methods and gas chromatography-MS for the identification of drugs in 95 postmortem samples. The more than 400 drug results in this study showed 100% concordance between the two techniques.

Autopsy↗
PubMed2005

Methylation of 3,4-methylenedioxymethamphetamine in formalin-fixed human liver tissue.

3,4-Methylenedioxymethamphetamine (MDMA or ecstasy) is a commonly consumed recreational drug. As is the case with most secondary amines, MDMA reacts with formaldehyde under acidic conditions to form tertiary amines. This reaction is likely to occur in formalin-fixed tissue. In formalin solutions, MDMA is methylated producing 3,4-methylenedioxy-N,N-dimethylamphetamine (MDDA). MDDA standard was synthesized by treating methylenedioxyamphetamine HCl in formaldehyde solution. Structure confirmation was by electrospray ionization-mass spectrometry (MS) and MS-MS. Randomly chosen human liver pieces (100-200 mg) were injected with 2 microg of MDMA HCl. The liver pieces in centrifuge tubes were covered with 200 microL of formalin solution (20% v/v), held at room temperature for 24 h, and then homogenized. The resulting suspension was sonicated for 5 min and then centrifuged. Controls consisted of substitution of 200 microL of water in place of formalin solution. Supernatant aliquots (10 mciroL) were added to 500 microL of 0.1% formic acid in acetonitrile for MS analysis. Positive ion electrospray spectra recorded in MS, MS2, and MS3 modes were used to confirm the presence of methylated MDMA. Liver tissue containing added MDMA HCl but not treated with formalin did not show a detectable level of methylated MDMA.

Embalming↗
PubMed2005

Tissue distribution of loperamide and N-desmethylloperamide following a fatal overdose.

We report a case involving a fatal intoxication with loperamide (Imodium). Loperamide is a synthetic opioid of the phenyl piperidine class used as an over-the-counter antidiarrheal. It exerts its effects through interaction with micro-opiate receptors in the intestine to reduce peristalsis. Loperamide lacks the typical euphoric opiate effects when administered at recommended doses. Both loperamide and its major metabolite, N-desmethylloperamide, were isolated by liquid-liquid extraction into n-butyl chloride from alkalinized samples. Extracts were analyzed by liquid chromatography-electrospray-mass spectrometry in selected-ion-monitoring mode. Rapid separation of the drug, metabolite, and internal standard (diphenoxylate) was achieved using a high-resolution C18 column with 1.8-microm particle diameter. The mobile phase consisted of 0.1% formic acid in deionized water (60%) and acetonitrile (40%) at a flow rate of 0.5 mL/min. Heart blood concentrations for loperamide and its metabolite were 1.2 mg/L and 3.3 mg/L, respectively. In contrast, reported peak plasma concentrations of loperamide after administration of recommended daily doses of 16 mg did not exceed 0.012 mg/L in controlled trials. Because the heart blood ethanol concentration was 0.08 g/dL, the medical examiner ruled that the cause of death was loperamide and ethanol intoxication, and the manner of death as undetermined.

Adult↗
PubMed1998

Immunohistochemical indicators of early brain injury: an experimental study using the fluid-percussion model in cats.

To detect early changes in neurons and astrocytes by immunohistochemical methods using antibodies against the neuron-specific enolase (NSE), neurofilament, glial fibrillary acid protein (GFAP), and S-100 protein, a fluid-percussion injury model in cats was chosen, in which a severe grade of injury (3.5-5.5 atm) was produced. Neuropathologic changes were produced through brain deformation by pressure gradients at the time of injury. The neuronal NSE immunoreactivity in the parietal cortex and the brain stem began to decrease at 1 to 2 hours after injury and were reduced markedly or even lost 4 hours after injury. Axons in the cerebral white matter and corpus callosum and in the hemorrhage regions at the brain stem were waved and enlarged <4 hours after injury. From 4 hours after injury, retraction balls were found after staining by antibody for the neurofilament. The GFAP-positive astrocytes appeared in the impact site in the parietal cortex and in the brain stem from 4 hours after injury, whereas S-100-positive astrocytes were not markedly changed, indicating that early after the injury, astrocytes manifested reactive hypertrophy without proliferation. These results suggest that immunochemical studies on NSE, neurofilament, GFAP, and S-100 are useful in pathologic and forensic practice in a patient who survives for a short time after a fatal head injury but without obvious focal damage.

Animals↗
PubMed2006

The role of molecular autopsy in unexplained sudden cardiac death.

PURPOSE OF REVIEW: Sudden cardiac death (SCD) is one of the most common causes of death, with many attributable to cardiac/coronary abnormalities evident at autopsy. A significant number of SCDs, however, particularly in young people, remain unexplained following a medico-legal investigation, including autopsy, and are referred to as autopsy-negative sudden unexplained death (SUD). Due to molecular advances, however, a cardiac channel molecular autopsy may potentially provide a pathogenic basis for SUD and establish cause and manner of death. RECENT FINDINGS: Over the past decade, five population-based investigations of sudden death in young people elucidated the frequency of and causes responsible for these tragic events. The most inclusive epidemiologic study concluded that nearly 30% of SCDs in young people are autopsy-negative (i.e. SUD) and most likely secondary to cardiac channelopathies. Case reports on the post-mortem molecular diagnosis of cardiac channelopathies through the use of a molecular autopsy have been presented. Recently, a molecular autopsy series of SUD identified pathogenic mutations in long QT syndrome and catecholaminergic polymorphic ventricular tachycardia-associated genes in over one-third of cases. Similar post-mortem cardiac channel genetic testing in a large population-based cohort of sudden infant death syndrome has elucidated mutations in 5-10% of cases. SUMMARY: With autopsy-negative SUD accounting for a significant number of sudden deaths in young people, a new role for the medical examiner is emerging. An accurate diagnosis, derived from a molecular autopsy, will guide the appropriate initiation of pre-emptive strategies in hopes of preventing future tragedies among those left behind.

Adolescent↗