[Pathologic affective reactions at the forensic psychiatric clinic].
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Adult↗
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Identification of normal rat organs by two-dimensional protein electrophoresis.
Proteins from nine normal rat organs, including heart, lung thymus, liver, spleen, kidney, prostate, abdominal muscle, and brain, were solubilized, separated by electrophoresis according to their different isoelectric points and molecular weights, and stained with Coomassie blue. Patterns of major proteins unique to each organ were identified. Nine "unknown" samples, chosen from the same sources and submitted for analysis in a single blind study, were easily identified by comparing their protein profiles against the nine "reference" patterns. The ability to identify the origin of a tissue sample without recourse to microscopy, by comparing the pattern of its electrophoresed proteins with a "catalogue" of identified protein profiles, provides a prototype for the identification of histologically indeterminate normal and abnormal cells, tissues, and organs. Application of this technique to problems in human pathology and forensic medicine could prove to be very useful.
Abdominal Muscles↗
Sanitation of the liberated territories in Croatia after the Storm campaign: the example of Lika-Senj County.
More than 6,000 km2 of the central and southern areas of the Republic of Croatia were liberated by the Storm campaign, August 4 to 7, 1995. On August 8, 1995, the Ministry of Health sent expert teams to the newly liberated areas, to ensure the basic conditions for the displaced persons to return and live there. To describe the public health measures taken we used the examples of Lika-Senj County (3,746 km2 and 71,215 population). By October 1, 1995, 50 bodies, killed in action, had been detected, pathologically and forensically examined, and then buried. Two hundred thirty-three mostly elderly and sick persons were admitted to the reception center in Gospić; 93 of them returned to their homes, 133 were accommodated with their relatives and friends, and 7 were referred for treatment (4 of them died). Two hundred ten cattle carcasses were buried using adequate sanitation measures, whereas 5,575 sheep, 3,138 head of horned cattle, 298 head of hoofed animals, and 300 head of other cattle were caught alive. The procedures of disinfection, disinfestation, and deodorization were performed in 720 apartments, 2 hotels, 3 schools, 1 kindergarten, 1 health care unit, 1 sports hall, and 5 shops. The main water pump was cleared of mines and partially repaired, whereas some 20 water supply facilities were placed under surveillance. Three food depots were found and properly treated. The entire territory was closely observed for possible occurrence of infectious disease.
Croatia↗
[Preparation, storage, transportation and use of heart valves for allotransplantation].
UNLABELLED: Thanks to the co-operation with Czech and Slovak Transplant Centres and with some of the Departments of Pathology and Forensic Medicine 274 hearts were collected for allograft heart valves (AHV) processing during 1992-1995. The Cardiac surgeon dissected the aortic valve with the root and the pulmonary artery trunk with the valve. Tissues were antibiotically (ATB) sterilised in cultivation medium E 199 (24 hours at 37 degrees C). ATB concentrations (mg/ml): Cepharin 0.2, Azlocilin 0.2, Tobramycin 0.08 and Amphotericin B 0.1 for harvesting at post-mortem (P) or Miconazol 0.05 for sterile retrieval during multiorgan harvesting (MOH). After sterilisation AHV were stored at 4 degrees C. 49 AHV were infected even after ATB treatment-15 of 35 collected at P (43%) and 35 of 218 procured during MOH (16%)-(p < 0.01-ch2 test). After serological screening of the donor and microbiological testing the AHV were released for clinical use. Most AHV were programmed cooled to the temperature of liquid nitrogen (-196 degrees C), in which they were stored at the Allograft Heart Valves Cryobank. Cryoprotection was achieved by 10% dimethylsulphidoxide. CONCLUSION: A technology of harvesting, processing, storage and transportation of AHV, was introduced. It enabled the routine use in many cardiac surgical units. The AHV Cryobank was established. 131 AHV were used clinically between 1992 and 1995 (transportation as far as 1300 km). 108 AHV (82.4%) were used for repair of complex congenital heart defects, while 23 (17.6%) were used for aortic valve and/or root replacement.
Heart Valves↗
Seatbelt injury to the common iliac artery: case report.
In traffic accident victims, the seat belt syndrome is a well known injury which rarely involves the common iliac artery due to its posterior anatomical position and to protection by the pelvis. We report a case of blunt abdominal trauma related to the type of seat belt worn. The trauma provoked subintimal haemorrhaging of the left common iliac artery, without skeletal lesions or other visceral injuries. Correct diagnosis was delayed for three months after the crash, when an angiogram was performed to investigate disabling claudication and vascular pulse change in the left leg. This arterial injury could have been related to the association of two different types of force created during the crash ("compression/deceleration-type mechanism") that might have produced shearing forces causing a vascular wall discontinuity and/or an intimal flap. The authors speculate that the vascular lesion was observed on the same (left) side as the fastening point of the seat belt (a lap-and-shoulder belt with a three-point attachment) where the shearing forces may have been most intense due to the junction between the lap strap and the diagonal shoulder belt.
Abdominal Injuries↗
[Sudden cardiac death in non-professional athletes].
Sudden death during sports activities in non-professional athletes is a rare occurrence, however it is of great interest in clinical pathology and forensic medicine. We performed chemico-toxicologic and histopathologic investigations in three cases of sudden cardiac death in non-professional athletes, focusing in particular on the cardiac conduction system. Examination of conduction tissue was performed on sections seriated every 150 microns, stained alternately with hematoxylin-eosin and Heidenhain's trichrome (azan). In all three cases diagnostic evidence showed hyperacute myocardial infarction, due to spasm of coronaries with mild atherosclerosis, and myocardial lesions due to reperfusive necrosis. The pathogenesis of sudden death in young athletes is not related only to ischemic-coronary damage that is not exclusively mechanical, but also a dynamic event (spasm and reperfusion), but also to fatal arrhythmias related to abnormal findings in the conduction system. Such findings can therefore be considered the morphologic substrate of sudden cardiac death.
Adult↗
[Improvement of sanitation conditions in the liberated Croatian regions after the "Storm" campaign--the Lika-Senj County example].
More than 6,000 sq km of the central and southern areas of the Republic of Croatia were liberated by the Storm campaign, August 4-7, 1995. On August 8, 1995, the Ministry of Health sent expert teams to the newly liberated areas, in order to ensure the basic conditions for the displaced persons to return and live there. To describe the public health measures taken we used the example of the Lika-Senj County (3,746 sq km and 71,215 population). Until October 1, 1995, 50 bodies, killed in action, were detected, pathologically and forensically examined, and then buried. Two hundred and thirty-three mostly elderly and sick persons were admitted to the reception center in Gospić; 93 of them returned to their homes, 133 were accommodated with their relatives and friends, and seven were referred for treatment (four of them died). Two hundred and ten cattle carcasses were buried using adequate sanitation measures, whereas 5,575 sheep, 3,138 head of horned cattle, 298 head of hoofed animals and 300 head of other cattle were caught alive. The procedures of disinfection, disinfestation and disodoration were performed in 720 apartments, 2 hotels, 3 schools, one kindergarten, one health care unit, one sports hall and 5 shops. The main water pump was cleared of mines and partially repaired, whereas some 20 water supply objects were placed under surveillance. Three food depots were found and properly treated. The entire territory was closely observed for a possible occurrence of infectious diseases.
Croatia↗
Postmortem endoscopy of the ocular fundus. A valuable tool in forensic postmortem practice.
Pathological changes of the ocular fundus in acute severe head or extracranial injury are difficult to document. In vivo examination usually has to be carried out under intensive care conditions. Postmortem ophthalmoscopy is usually impeded by rapid blurring of the cornea. Therefore, endoscopic fundal photography has been applied by using a pars plana approach during forensic postmortem procedures. This technique provides fundoscopic pictures of high quality as a valuable supplement for subsequent macro- and histopathological preparations and sections. Different patterns of fundoscopic findings seem to correspond to different types of injuries such as craniocerebral trauma, traumatic asphyxia and decompression sickness, and may allow some insight into the respective pathogenetic mechanism.
Adult↗
Diagnosis of sudden coronary death in the autopsy room: guidelines for forensic pathologists.
The pathological techniques employed in examining cases of sudden coronary death can vary widely. Visual assessment of coronary narrowing can lead to over-estimation of the true stenosis and may result in overdiagnosis of sudden coronary death. On the other hand, inappropriate examination of the whole epicardial coronary tree while searching for acute coronary lesions may lead to underdiagnosis. The approach recommended in this paper should minimize the possibility of such errors in the diagnosis of sudden coronary death.
Autopsy↗
[Sudden infant death in Austria--status quo and recommendations of the SIDS Consensus Working Group for Improved Registration].
Sudden infant death (SID) is the most common cause of death among infants aged 2 to 12 months in Austria. The complete autopsy required in order to diagnose SID, including the additional investigations, and the comprehensive autopsies needed for epidemiological studies are not common practice because of the different statutory regulations in the provinces and the absence of a uniform federal law in this regard. According to statistics, in the last four years only 83% (1997) to 70% (1999) of the reported SID cases in Austria were autopsied. Our survey in the forensic medicine and pathological institutes of Austria also revealed markedly different practices in regard of the manner in which autopsies are performed and parents are interviewed and followed up. For this reason, the SIDS Consensus Work Group of Austrian centers for the prevention of sudden infant death recommends the following: a) a comprehensive autopsy by a trained specialist to be established as a prerequisite for diagnosing "SIDS"; b) performing autopsies on a centralized basis in those forensic or pathological institutes that have agreed to adhere to protocol-based autopsy standards; c) the introduction of quality control in terms of a regional clinical-pathological conference; and d) standardizing the elements of the interview with parents of SID victims. Implementing these measures and entering the collected information into a data base in which the master data are encoded by the individual institutions, will help to evaluate the role of major epidemiological risk factors that information campaigns are focused upon, namely sleeping in prone position, the role of nicotine, etc. In addition, it will be necessary to formulate federal laws that standardize the divergent provincial regulations.
Austria↗
Crème de la crème in forensic science and legal medicine. The most highly cited articles, authors and journals 1981-2003.
The importance and prestige of a scientific journal is increasingly being judged by the number of times the articles it publishes are cited or referenced in articles published in other scientific journals. Citation counting is also used to assess the merits of individual scientists when academic promotion and tenure are decided. With the help of Thomson, Institute for Scientific Information (Thomson ISI) a citation database was created for six leading forensic science and legal medicine journals. This database was used to determine the most highly cited articles, authors, journals and the most prolific authors of articles in the forensic sciences. The forensic science and legal medicine journals evaluated were: Journal of Forensic Sciences (JFS), Forensic Science International (FSI), International Journal of Legal Medicine (IJLM), Medicine, Science and the Law (MSL), American Journal of Forensic Medicine and Pathology (AJFMP), and Science and Justice (S&J). The resulting forensics database contained 14,210 papers published between 1981 and 2003. This in-depth bibliometric analysis has identified the creme de la creme in forensic science and legal medicine in a quantitative and objective way by citation analysis with focus on articles, authors and journals.
Bibliometrics↗
A review of suicides by burning in Rome between 1947-1997 examined by the Pathology Department of the Institute of Forensic Medicine, University of Rome 'La Sapienza'.
The 34 cases of suicide by self-immolation admitted to the Institute of Forensic Medicine, University of Rome 'La Sapienza', during a 50-year period (1947-1997) were investigated. The nature of this phenomenon in relation to sex, age of the victims, location of the suicides and combination of methods used is discussed. Finally the distribution and extent and characteristics of the lesions are considered from a forensic point of view.
Adult↗
[Pathologic gambling: definitions, explanatory models and forensic aspects].
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Conditioning, Operant↗
[Special features and characteristics of medicolegal pathology].
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Forensic Medicine↗
Anatomic laboratory and forensic aspects of biological threat agents.
Anatomic pathology of surgical and cytologic samples and forensic autopsies is a critical component of our defense against biological terrorism. In many instances, rapid, valuable diagnosis may be obtained by the proper immediate use of the anatomic pathology laboratory. Included in this field is the work of medical examiners and coroners, who are essential public health partners for terrorism preparedness and response. The investigation of sudden, suspicious, violent, unattended, and unexplained deaths may provide the first clue to a deliberate biological attack. Medicolegal autopsies are essential to making organism-specific diagnoses in deaths caused by biological terrorism.
Biological Warfare↗
[IDENTIFICATION THROUGH PATHOLOGICAL FINDINGS].
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Forensic Medicine↗
["Pathological intoxication."Diagnostic artefact or a reliable psychiatric diagnosis?].
"Pathological intoxication" has been a matter of controversial discussions during the last years. On one hand diagnosis of "pathological intoxication" in forensic expertise often is associated with the assumption of legal insanity. On the other hand it has been suggested that the term "pathological intoxication" should be abandoned in favor of more accurate clinical diagnosis, and recently "alcoholic idiosyncratic intoxication" was canceled as a separate diagnosis in DSM-IV. In order to register the diagnostic habits connected with "pathological intoxication" we had sent a questionnaire to all psychiatric institutes (n = 541) in Germany. We were then able to evaluate 338 questionnaires (62.5%) relating to number of diagnoses and diagnostic criteria. In synopsis diagnostic habits turned out to be very inhomogeneous. Nearly two third of psychiatric institutes reported not to have used the diagnostic category between 1991 and 1993, whereas nearly 50% of diagnoses (210 out of 456) were reported by only 13 (3.9%) institutes. Diagnosis of "pathological intoxication" is based predominantly on vague and non-distinct criteria, such as "violent excitation" or "strange unusual behavior". In accordance to DSM-IV we therefore suggest that the diagnostic term "pathological intoxication" should be abandoned, especially in the context of forensic psychiatric expertise. Instead, assessment of intoxication must be based on individual somatic and psychopathological symptoms.
Academies and Institutes↗
Forensic sciences and medicine. The clinical or living aspects.
This presentation of information regarding the application of the forensic sciences and medicine to the evaluation of living persons and its related problems is based on the case experience of a private practitioner of forensic medicine and pathology. Lawyers, law-enforcement personnel, and fellow physicians must be educated regarding the potential role of the forensic physician in the examination of living people. Many examples of the application of forensic expertise to the solution of crimes and civil problems involving living persons are included.
Forensic Medicine↗