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PubMedDate not supplied

[Ascertainment of the cause and tempo of death in forensic medical practice].

In order to develop a method of ascertaining a cause of death and of evaluating its tempo the authors undertook a histological study and a study of a dehydration degree in 76 cases of death due to the below reasons: mechanical trauma, mechanical asphyxia, burn shock, and carbon monoxide intoxication. Acute emphysema of lungs, lack of edemas in lungs and brain, desquamation of pulmonary macrophages, hyperemia of renal capillaries, primary urine in some glomerules, prevalence of ischemic changes with karyopyknosis in medulla and hypohydration of brain were typical of fast death. Prevalence of dystelectasis in lungs, emptying of pulmonary capillaries, evident edema of lungs and brain, desquamation of pulmonary macrophages, lack of primary urine in glomerular capsules, acute circulatory disorders of renal hemodynamics with sweating of fibrin and erythrocyte glomerules into cavities, necrotic nephrosis, pigment cylinders in renal tubules, thrombi in vessels, prevalence of chromatolysis, karyolysis and cytolysis in medulla, pronounced glial reaction as well as pronounced edema of brain and its hyperhydration were typical of slow death.

Blood Volume↗
PubMedDate not supplied

[Histomorphometric characteristic of human brain in acute alcoholic intoxication].

Different brain sections were studied in 20 subjects, who died of ethanol intoxication and in 14 subjects who died of injuries of the heart and main vessels, in order to detect histological changes in the brain and for the purpose of defining spatial and quantitative ratios between cerebral tissue structures in alcoholic intoxication. Different histological, stereometric and morphometric tools were made use of. It was demonstrated that, in alcoholic intoxication, there occur severe disorders of the circulation with affection of vessels in the brain; there are also dystrophic and necrotic changes in neurocytes, glial cells and white substance. The square of neurons shrinks due to death of some of them in the cortex of hemispheres, thalamus and cerebellum. As for the medulla, they are more resistant, there, to ethanol. The diameter of capillaries in the studied brain sections diminishes due to a reduced tonus of cerebral arteries; the quantity of such vessels increases within a standard area, which is conditioned by the compensatory opening of reserve capillaries. All this can be important in dealing with issues of thanatogenesis and of forensic medical diagnosis in death of alcoholic intoxication.

Acute Disease↗
PubMedDate not supplied

[Thanatogenesis in poisoning with psychopharmaceuticals].

Discussed in the paper are thanatologically significant morphological signs in intoxication with some of psychic drugs. It was demonstrated that, in intoxication with azaleptin, phenazepam and aminazin, death comes mostly from affection of the brain including its edema and irreversible severe changes of neurons. In intoxication with tizercin, benzodiazepines and barbiturates, cardiac thanatogenesis as fibrillation of heart chambers combined with foci of myocytolysis. Sodium oxybutyrate brings about vascular collapse with subsequent development of fibrillation of heart chambers and of pulmonary edema. Intoxication with amitriptyline causes naturally necrotic nephrosis entailing uremic pneumonia and edema of the brain and heart.

Adolescent↗
PubMedDate not supplied

[Medico-criminal examination of damages to clothes in flight accidents].

Examination of cloths is a permanent sphere in the practice of forensic-medical expert and an indispensable expertise stage providing for decision-making on the key issues set before the expert. Although, the examination of cloth in forensic-medical expertise has been productive, research in this field slowed down during the recent decades; definition of new sets of evident informative signs has been also suspended. The methodological potentialities of examination of cloths items were demonstrated by examples of aviation incidents because such incidents reflect the principle variations of impacts, i.e. blow, explosion, fire, compression and chemical factors etc., which are subject to examination in the forensic-medical practice. Identification of mechanism causing damage and other signs on cloths helps a lot the forensic-medical expert in solving quite a number of issues related with circumstances of an incident and with a nature of an impact encountered by a person.

Accidents, Aviation↗
PubMed2005

The lingual tonsillar hyperplasia in relation to unanticipated difficult intubation: is there any relationship between lingual tonsillar hyperplasia and tonsillectomy?

The lingual tonsillar hyperplasia (LTH) is a rare and dangerous condition of the upper airway because it is one of several risks during intubation which can cause serious complications like cardiac arrest, cerebral anoxia, and death. The LTH is rarely detectable during a routine oropharyngeal examination. The lingual tonsil is of particular interest to forensic medicine to assess cases with malpractice in connection with intubation difficulties. Our study looked at how often autopsy specimens had enlarged lingual tonsils and whether any relationship existed between LTH and tonsillectomies. In total, 497 corpses were examined. Only in 16 cases (3.2%), an enlarged lingual tonsil was detected. Of the 16 cases, 10 (62.5%) had normal palatine tonsils; the other 6 cases (37.5%) had no palatine tonsils or were scarred, atrophied, or only remnants remained. Statistically, it was not possible to prove any relationship between enlarged lingual tonsils and tonsillectomies. From the forensic point of view, a description of the lingual tonsil should appear in special cases in autopsy reports. When reviewing malpractice cases, special anatomic features should be described.

Adolescent↗
PubMed2005

Bite motivation of sharks reflected by the wound structure on humans.

Bite wounds on humans have rarely been comparatively analyzed, and the behavior leading to such bites is virtually unknown. Nevertheless, the behavior of a shark is reflected in the bite structure and should be an essential part of shark-accident analysis. This paper compares 3 nonfatal accidents on humans, caused by bull sharks, Carcharhinus leucas, that occurred within a 12-month period in the same area of the Bahamas. Examination focused on wound analysis and accident reconstruction to determine the most likely bite motivation of the sharks. Two sharks targeted the left calf areas of the victims; another one bit the back area of a person. Although both calf bites had a very similar appearance, examination concluded that one of them showed the same triggering behavior as for the shark who inflicted the very different-looking back bite. Those 2 bites were competitive, whereas the other calf bite was initially of exploratory nature, turning into a stress-related bite.

Animals↗
PubMed2005

Vitreous humor biochemical constituents: evaluation of between-eye differences.

The present study was conducted to investigate the differences in the vitreous humor biochemical concentrations for vitreous electrolytes and calcium in the same pair of eyes at identical postmortem interval (PMI). The vitreous humor samples were collected independently in both eyes from 48 autopsies (PMI range, 4.5-84.3 hours) with documented time of death. The samples were analyzed for potassium, sodium, chloride, and calcium using a Beckman Coulter LX20 Automated Analyzer based on ion-selective electrode methodology. There were no statistically significant between-eye differences at identical postmortem interval. A significantly high correlation was observed between paired potassium concentrations of both the eyes. A highly significant linear correlation was observed between the individual eye and mean potassium concentrations of both the eyes with postmortem interval. The observed differences were not significantly correlated with postmortem interval. The results demonstrated that the between-eye differences for vitreous electrolytes and calcium are insignificant. Therefore, the utility of vitreous biochemistry, particularly potassium in postmortem interval estimation and other forensic applications, cannot be questioned solely on the basis of these differences.

Calcium↗
PubMed2005

West Nile virus encephalitis.

West Nile virus (WNV) is a mosquito-borne virus that has caused a large number of deaths in the United States since the first outbreak in New York City in 1998. The outbreak initially was limited to the northeast but has since spread across the entire continental United States. WNV causes a variety of clinical symptoms, but the most severe consequences result from central nervous system infection, resulting in meningitis, encephalitis, or meningoencephalitis. We present a case of a 62-year-old male with metastatic cancer, who died as a result of WNV encephalitis. This is followed by a discussion on the epidemiology of WNV and a detailed summary of the methods and resources available to make a diagnosis of WNV infection postmortem. The material presented in the discussion should provide the forensic pathologist with all the information necessary to make a diagnosis of WNV infection postmortem. If nothing else, the routine collection and storage of serum, cerebrospinal fluid, and tissue for every case can enable the forensic pathologist to make this diagnosis even in cases in which WNV is not suspected until after autopsy.

Brain↗
PubMed2005

Sudden unexpected death in epilepsy: is death by seizures a cardiac disease?

RESULTS: Sudden unexpected death in epilepsy (SUDEP) gains more and more acknowledgment across the various interdisciplinary fields. Accordingly, we performed in a prospective setting a case-control study of all SUDEP cases in a well-defined part of Denmark (Northern Jutland), between January 1998 and September 2000. We attempted to look into the cardiopathologic mechanism behind this phenomenon by assessing the degree of myocardial fibrosis in SUDEP patients versus controls. The histologic evaluation was possible in 65% of the cases (15/23) whose death was attributed to SUDEP and in 71% (15/21) of controls. Forty percent of the SUDEP cases (6/15) presented several foci of fibrotic changes in the deep and subendocardial myocardium in contrast to 1 control (6.6%, P = 0.03). None of the subjects from the SUDEP group showed fibrotic changes in their conduction system as compared with 1 control (6.6%). The quantitative evaluation of fibrosis demonstrated a trend toward more fibrosis in the deep and subendocardial myocardium of the SUDEP cases. Forty percent of cases in the SUDEP group were men (6/15), characteristically young at time of death (mean age 38 years) and with a late epilepsy onset (mean age 21 years). Antemortem, 73% of the SUDEP patients (11/15) had experienced infrequent seizures (self-reported). We conclude that the SUDEP cases displayed significant fibrosis of the myocardium when this was assessed by qualitative means. This fibrosis may be the consequence of myocardial ischemia as a direct result of repetitive epileptic seizures, which, associated with the ictal sympathetic storm, may lead to lethal arrhythmias.

Adult↗
PubMed2005

On the non-equivalence of documented cadaver lengths to living stature estimates based on Fully's method on bones in the Raymond A. Dart Collection.

Regression equations for stature estimation have been derived from documented cadaver lengths available as part of the demographic information in the catalogue of skeletonised remains in different collections around the world. The Raymond A. Dart Collection is one such collection, but the reliability of documented cadaver lengths in it has been previously questioned. The aim of this study was to compare these lengths with estimated living stature using Fully's anatomical method. Living stature was estimated with this method from a total of 156 complete skeletons obtained from the Collection. These heights were then compared with the documented cadaver lengths. It was observed that the documented cadaver lengths were significantly higher than the estimated living stature using Fully's method.

Adult↗
PubMed2005

Application of the Suchey-Brooks method to three-dimensional imaging of the pubic symphysis.

Age determination is a major field of interest in forensic anthropology. Among the different methods based on macroscopic skeletal study, the Suchey-Brooks method, which analyzes the pubic symphysis, is one of the most reliable. We applied the Suchey-Brooks method to three-dimensional computed tomographic reconstructions of the pubic symphysis. We demonstrated excellent agreement between the results of analysis of bone samples and those of the three-dimensional images, in particular regarding ridges of the articular surface and delimitation of the extremities. The accuracy of age estimation did not significantly differ (Wilcoxon test) between the Suchey-Brooks method applied to bones and the same method applied to CT images. Using high-quality images, this approach seems as reliable as the standard Suchey-Brooks method and offers several advantages: no bone preparation, no damage to bone material, and the possibility of application to living individuals.

Adult↗
PubMed2005

Does sexual dimorphism in facial soft tissue depths justify sex distinction in craniofacial identification?

Separation of male and female soft tissue depths into discrete groups for craniofacial identification implies that males and females differ enough from each other, with respect to this application, for this distinction to be useful. In this study, previously published soft tissue depth data were analyzed for sex separation. It was found that the variation within each sex was large while the variation between the sexes was small. Often the value of two standard deviations of the measurement for either sex was larger than the difference displayed between the means of each sex. Furthermore, opposite sex overlap in regions defined to be close to the male or female mean were found to be large and the amount of variance explained by sex was small (less than 6% on average). These results indicate that while male and female means at single craniofacial landmarks may differ slightly, and even at statistically significant levels, individual male and female soft tissue depths are often the same or very similar. On average, soft tissue depths of the face do display some sexual dimorphism but it is not marked and of little practical meaning for craniofacial identification where a single individual must be independently considered. Thus, there is little use in separate reporting of data for males and females and data should be combined to increase sample sizes.

Adolescent↗
PubMed2005

Multiplex PCR development of Y-chromosomal biallelic polymorphisms for forensic application.

Single-nucleotide polymorphisms of Y chromosome (Y-SNPs) are a class of markers of interest in forensic investigations, because many of them show regional specificity, providing useful information about the geographic origin of a subject or evidence under investigation. A first multiplex with 7 SNPs (M35, M89, M9, M170, M172, M45, M173), which occur in the basal branches of the phylogenetic tree and are able to assign a subject to known most frequent European haplogroups, was designed. SNP genotyping was accomplished by hot-start PCR with primers amplifying fragments between 96 and 136 nucleotides, minisequencing, and capillary electrophoresis of extension products. Ninety seven subjects of known geographic provenance were studied, of which 68 from Europe. Of these, 57 had mutations found more frequently in European haplogroups and 11 more frequent in Asian populations. Subjects from non-European countries were also examined and had haplogroups common in their regions of provenance. Experiments with low molecular weight DNA gave positive amplification from 1 ng of DNA for all seven SNPs.

Africa↗
PubMed2005

Results from the NIST 2004 DNA Quantitation Study.

For optimal DNA short tandem repeat (STR) typing results, the DNA concentration ([DNA]) of the sample must be accurately determined prior to the polymerase chain reaction (PCR) amplification step in the typing process. In early 2004, the National Institute of Standards and Technology (NIST) conducted an interlaboratory study to help assess the accuracy of DNA quantitation in forensic DNA laboratories. This study was designed with four primary purposes: (1) to examine concentration effects and to probe performance at the lower DNA concentration levels that are frequently seen in forensic casework; (2) to examine consistency with various methodologies across multiple laboratories; (3) to examine single versus multiple source samples; and (4) to study DNA stability over time and through shipping in two types of storage tubes. Eight DNA samples of [DNA] from 0.05 ng/microL to 1.5 ng/microL were distributed. A total of 287 independent data sets were returned from 80 participants. Results were reported for 19 different DNA quantitation methodologies. Approximately 65% of the data were obtained using traditional slot blot hybridization methods; 21% were obtained using newly available quantitative real-time PCR (Q-PCR) techniques. Information from this interlaboratory study is guiding development of a future NIST Standard Reference Material for Human DNA Quantitation, SRM 2372.

DNA↗
PubMed2005

mtDNA investigations after differential lysis.

In order to gain information regarding the ethnic origin of an unknown offender in a murder case it was necessary to sequence the HV1 and 2 regions of the mitochondrial DNA (mtDNA). The only evidentiary material that could be linked to the suspect was DNA, extracted from spermatozoa after differential lysis. The observed mtDNA sequences were identical to the sequences of the victim. Therefore, we had to check if this was a coincidence or the result of a technical limitation of the testing procedure. Subsequently, we performed a systematic study. In cases with complete separation of sperm and female cells it wasn't possible to obtain a mtDNA sequence for the sperm fraction. This phenomena is based on the loss of the sperm's flagellum and mid-piece during the first lysis step and a concomitant loss of the sperm's mitochondria. In our murder case, a minor carry-over of female cells to the sperm fraction was responsible for the sequencing result.

Chromosomes, Human, Y↗
PubMed2005

A field diagnostic test for the improvised explosive urea nitrate.

A sensitive, specific and simple color test for the improvised explosive urea nitrate is described. It is based on the formation of a red pigment upon the reaction between urea nitrate and p-dimethylaminocinnamaldehyde (p-DMAC) under neutral conditions. Urea itself, which is the starting material for urea nitrate, does not react with p-DMAC under the same conditions. Other potential sources of false positive response e.g., common fertilizers, medications containing the urea moiety and various amines, do not produce the red pigment with p-DMAC. Exhibits collected from 10 terrorist cases have been tested with p-DMAC. The results were in full agreement with those obtained by instrumental techniques including GC/MS, XRD and IR.

Colorimetry↗
PubMed2005

Suicide: a ten-year retrospective review of Kentucky medical examiner cases.

Suicide, a manner of death, ranked as the eleventh leading cause of death in the United States and accounted for approximately 30,000 deaths in 2001. A host of biological and psychosocial components interplay in a suicide investigation. Precipitating factors may include domestic quarrels, loss of employment, financial difficulties, substance abuse, chronic disease, or mental illness. The authors conducted a ten-year (1993--2002) retrospective review of suicide from all Medical Examiners' Offices in Kentucky. There were 2,864 suicides ranging between 11 and 96 years (average age 42.0 years). The majority of victims were males (81.7%) and Caucasian (94.8%). African-American females comprised the smallest group, consisting of only 0.59%. The preferred mode of death was by firearm (67.5%), followed by hanging (13.7%), overdose (9.9%), and carbon monoxide poisoning (4.4%). This comprehensive study discusses the trends of suicide in the United States during the twentieth century and underscores the importance of a multidisciplinary approach to the investigation and prevention of suicide.

Adolescent↗