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[Medicolegal aspects of witnessed suicide due to gunshot to the head. II. Legal medicine aspects and examination of the firing hand].

The second part of the paper on suicides by gunshots to the head in the presence of witnesses focuses on relevant morphological autopsy findings such as entrance site, signs of close range or contact shots, bullet path etc. and also discusses selected aspects of ascertaining gunshot residues. For the identification of the shooter an integral medicolegal assessment of all the facts including the investigation results and the autopsy findings is essential. However, the morphological findings alone do not allow safe diagnosis, as for example in a homicide the temporal region, which was affected in all our cases, may have been deliberately chosen by the perpetrator as a localization typical of suicide. Thus methods to ascertain gunshot residues on the firing hand (by means of adhesive films and the polyvinyl-alcohol collection method--PVAL) are of great practical importance. In seven cases adhesive films and/or the polyvinyl-alcohol collection method were used. In one case the gunshot residues (GSR) were analysed by means of tape lifts and subsequent scanning electron microscopy (SEM). It was found that especially the combined application of topographical (adhesive tape/PVAL) and cumulative (SEM) methods allowed for the doubtless identification of the shooter, thus usually confirming the suicide. By the example of one case it is demonstrated that without the immediate collection of evidence at the scene objective reconstruction of the event becomes impossible. On the basis of the reported cases recommendations are finally given for a differentiated approach in the medicolegal evaluation of alleged witnessed suicide by gunshot (to the head).

Adult↗

Medico-legal investigation of suspected fatal poisonings in Pretoria: 2000-2001.

Accurate data on the incidence and spectrum of fatal poisonings in South Africa is lacking. Most studies focus on "traditional poisons". This is a retrospective study on the medico-legal investigation of suspected fatal poisonings seen at the Pretoria Medico-Legal Laboratory. Post mortem records from January 2000 to December 2001 were examined. There were 153 cases of suspected fatal poisoning or overdose. However, toxicology results were conclusively positive in only 53 (34.64%) cases with some cases testing positive for more than one type or class of "poison". The fatal "poisons" identified in these 53 cases were as follows: pharmaceuticals (47.17%), illicit drugs (41.51%), agricultural poisons (20.75%), alcohol (13.21%), traditional medicines (3.77%) and heavy metals (3.77%). The average delay in completing toxicology analyses was 10 months. This study demonstrates that the current medico-legal investigation of fatal cases of suspected poisoning does not yield adequate results for definitive judicial administration in two-thirds of suspected cases. This creates a legal dilemma, as the primary medical cause of death remains unresolved.

Adolescent↗

[Expression of PDGF-B after fluid percussion brain injury in rats].

OBJECTIVE: To elucidate the changes of PDGF-B chain in the brain injured by fluid percussion. METHODS: The expression of PDGF-B protein was studied by immunohistochemistry and the results were assessed by image analysis system. RESULTS: Enhanced expression of PDGF-B protein induced by fluid percussion injury was seen at 1 h, and its marked up-regulation was noted at 4-7 days, and then the expression became decreased but it remained above the control levels till 14 days after injury. CONCLUSION: Fluid percussion brain injury induced expression of PDGF-B. The regular change pattern of PDGF-B level in time course seems to be of value in estimating the age of brain injury.

Animals↗

[Determination of a mechanism of the coming of death by morphological methods in strangulation mechanical asphyxia].

Described in the paper are morphological data characterizing the tempo and type of thanatogenesis in strangulation asphyxia. The cerebral thanatogenesis was shown to prevail in mechanical asphyxia. The results of determination of a degree of hydration of the brain by drying its samples are described. Medullary substance was demonstrated to be hypohydrated in such death.

Adult↗

[The specificity of healing of fractures in the skull base].

On the basis of actual observations we elucidated the main processes occurring in the reparation of fractures in the skull base. The specificity of reparation was shown to be conditioned by the structure of base bones and of surrounding tissues as well as by the nature of blood supply to them. Criteria are suggested for the determination if the lesions were inflicted in life time and when.

Forensic Pathology↗

[Dynamic morphological changes observed in the respiratory system immediately after craniocerebral trauma].

Microscope and morphometry examinations of specific structural changes observed in the respiratory system in death immediately after severe craniocerebral trauma denoted profound lesions with a certain sequence of progression. The extent of histomorphological changes in the lungs is shown to be influenced by a life span of victims after inflicted trauma, i.e. by the prescription of trauma.

Adult↗

[Morphofunctional reaction of human adrenals at the pulmonary variation of thanatogenesis].

A comparative morphometric study of male adrenals was conducted in case pulmonary thanatogenesis. A response was registered, it was associated with a dominating weight of the left adrenal (LA) and of its cortical substance over the similar parameters of the RA. The intensity and the time of the onset of reactions in different LA morphofunctional zones were found to be different in mechanical asphyxia and in carbon-monoxide intoxication. It is suggested that the occurring changes can reflect the action mechanism and result from the embryogenesis-conditioned specificity of functioning of paired organs.

Adrenal Glands↗

[The specificity of thermometry of cadavers of newborns in prescribing the time of the coming of death].

It is distinctly demonstrated on the basis of 7908 measurements of rectal temperature of cadavers of newborns that such thermometry should be made at a depth of at least 5.5 cm in order to ensure an accurate prescription of the coming of death (PCD) in expertise of cadavers of newborns. An optimal method of calculating the sought results as applicable to different situations and made with the help of correction factors is described. The results of lifetime thermometry of 60 newborns are presented, which prove that the length of intrauterine life of a baby affects essentially its values. An accurate PCD of a newborn is a technical study result.

Body Temperature↗

[ELISA-based determination of opiates in purulent transformation of cadaveric material].

Abuse of drugs has been a topical issue up to the present-day. Opiates like morphine and heroin are still prevalent. The routine methods of determination of drugs in blood made within the forensic medical expertise are time-consuming and samples must be specially prepared for them. ELISA, when used for the determination of opiates in blood and urine, significantly cuts the test time. According to our research results, the diagnosis of opiates by ELISA is advisable at the preliminary stage of the forensic expertise of cadaver; the method is informative, which is of extra importance in cases of purulent transformation of cadaveric material.

Cadaver↗

[Digital photography as an object of forensic medical examination].

The possibility of diagnosing skin lesions by means of digital pictures was investigated. A "Zenit ET" film camera, HP flatbed scanner, amateur "'Panasonic" and "Sony" videocameras, miniature USB camera and digital photocameras were used to obtain images. Above 1000 images were studied. Criteria were fixed for the required quality of images. A method was developed to formalize images by means of a color etalon and mathematical assessment of formalized skin lesions. Stages were suggested for the computer-based analysis of images. Computer software was developed for the automated formalization of images and for the statistical processing of values of image elements. It was demonstrated that digital photography can be an independent informative object of forensic medical examination.

Forensic Pathology↗

[Reasons why the quality of medico-legal autopsy in the medical tangle varies from two areas].

OBJECTIVE: To study reasons that the quality of medico-legal autopsy in the medical tangle varies from different area. METHODS: Collecting the cases of medical tangle in two medico-legal agencies, then counting percent of classes on the ten key-points, analyzing the data of the cases by chi-square test and t-test. RESULTS: It is indicated that the applied methods and standards of the two agencies are different. There are more different in seven keypoint of medicolegal autopsy by chi-square test. CONCLUSION: Six key-points are found to be more important to medico-legal appraiser, standardization of forensic autopsy, standardization of picking up specimen from the body, diagnosis standardization of the cause of death, consultation system and standardization of writing documents on medico-legal autopsy.

Analysis of Variance↗

External injury marks (wounds) on the head in different types of blunt trauma in an autopsy series.

The localization, length and number of deep scalp wounds caused by falls on a flat surface (n = 203), falls down stairs (n = 51) and from blows (n = 51) were examined in a comparative analysis of 305 deaths. This confirmed the common finding in forensic literature that head injuries from blows occur more often (55% of cases) above the so-called hat-brim line (= greatest horizontal head circumference) than injuries from falls on a flat surface. On the other hand, around one third of the wounds caused by falls were located above this line. In blows and falls down stairs, but not in falls on a flat surface, the wounds close to the crown of the head were markedly longer than those in or below the hat-brim line. Regarding wounds inside the hat-brim line, there were hardly any differences between the three trauma types.

Accidental Falls↗

[Medicolegal analysis of ARD mass cases occurred in servicemen].

The article presents the analysis of causes and outcomes of ARD and pneumonia incidence among the servicemen in one of the military units during the period 2002-2003. 95 forensic medical examinations were analyzed. The terms of disease occurrence, complications, unfavorable outcomes are presented. The defects in medical care rendering are shown. The recommendations on prophylaxis of such cases are shown.

Forensic Pathology↗