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The development of stomach during the fetal period.

The objective of this study was to explore the fetal development of the stomach, its morphology and relationship with neighboring structures. The study is carried out in 2003 using 160 human embryos and fetuses (81 males and 79 females) aged between 9 and 40 weeks of gestation. None of the cases had any external pathology or anomaly. Its topographical localization and relationship with surrounding structures were revealed with anatomical dissections. Width and height of the stomach, lengths of the greater and lesser curvatures, the angle between horizontal and vertical axes of the stomach and types of stomach were established. During the fetal life stomach was most commonly located above the transverse axis passing through the umbilicus, in left and right hypochondrium (81%). There were significant differences among trimester groups with respect to the localization of the stomach in the quadrants (P < 0.001). There were no significant sex differences in parameters. After the second trimester, the height of the stomach increased more than the width of the stomach and anterior abdominal height. The angle of stomach decreased from 100 degrees to 50 degrees throughout the fetal period. During the fetal period, wide angles stomach was more common in the first(f) and second trimesters while acute-angled stomach was more common in the third trimester and term fetuses. Diagnosis and treatment of fetal anomalies and pathologies of the stomach requires knowledge of fetal anatomy of the stomach. Data acquired in this study are believed to contribute to the studies of obstetrics, perinatology, forensic medicine and fetal pathology on fetal development of the stomach, and diagnosis and treatment of its anomalies, pathologies, and variations.

Female↗

The pathology of self-mutilation and destructive acts: a forensic study and review.

Self-destructive behavior of man and its consequences may be presented in various forms, including self-mutilation, injury, and malingering, and with various manifestations, including the Munchausen syndrome, polysurgery, purposeful accidents, impotence, and frigidity. The general subject of focal suicide has been a relatively unknown and unrecognized entity for different reasons, including the fact that most physicians are trained to approach a case in a manner which treats the patient-physician relationship as one of honor and faith regarding the authenticity of the complaints of the patient. The maturity of years and experience may be required before the physician becomes aware of the motivation of patients' behavior. It is hoped that this article will provide new insight into areas which may be unfamiliar to the forensic practitioner and clinician but which might enable them to learn about the background of an unexpected death or the possibilities of motivation in civil suits alleging professional negligence or malpractice.

Forensic Medicine↗

Blood group determination from teeth.

The blood groups of 18 individuals were determined from the dental pulp of extracted teeth, using a microelution technique. This method of identification has obvious implications for forensic science and aerospace pathology because of the individuality of blood groups.

ABO Blood-Group System↗

Pathology of arrhythmogenic right ventricular cardiomyopathy/dysplasia--an autopsy study of 20 forensic cases.

Arrhythmogenic right ventricular dysplasia/ cardiomyopathy (ARVC) is characterized histologically by massive infiltration of the right ventricular wall by fat tissue, with surviving strands of cardiomyocytes bordered by or embedded in fibrosis. ARVC has been recognized as a cause of sudden death, especially in the young. The purpose of our autopsy study was to examine the clinical characteristics and the pathological patterns in the hearts of 20 people who died suddenly of ARVC. In view of our findings and the literature, we discussed the possible causes and pathogenesis of ARVC, as well as the mechanisms by which sudden death occurs in this disease. During the 7-year study period, 20 hearts from 9 men and 11 women fulfilled the criteria for ARVC. The mean age was 41 years (range, 17 to 80). The disease was unknown prior to death in all cases. Fourteen persons died at rest, and six on effort. In 9 of the 20 cases, the trigger of sudden death was an acute emotional stress, sometimes associated with a moderate physical activity. The mean heart weight was 380 g (range, 280 to 520). Both ventricles were involved in 40% of the cases. Inflammatory infiltrates consisting of lymphocytes were present in 60% of the cases, but myocyte necrosis was found in only one case. ARVC is more likely to result from a degenerative process than a congenital disorder. Genetic factors, viral or autoimmune inflammation or both, and apoptosis are also involved in the degenerative disorder.

Adipose Tissue↗

[Problem of abnormal alcoholic intoxication in forensic psychiatric judgment].

The problem of pathological intoxication is discussed. Also considered by the authors in their present paper is the fact that various designations are used in the literature to describe abnormal intoxications of which the intensity is less than that of real pathological intoxication. However, phenomenological or symptomatological classifications provide no information whatsoever about the ability to take decisions and about mental responsibility. An attempt is made to establish criteria for the concept of "pathologically colored intoxication" which is primarily oriented, not in a phenomenological context, but toward a substantially diminished ability to take meaningful decisions.

Alcoholic Intoxication↗

Biomechanically important articular surfaces in the talocrural joint.

The authors investigated the influence of relations between the utile areas of the articular faces in ankle joint in medial twisting of the foot. For their investigation they used the material from the Institute of Anatomy "Drago Perović", Institute of Pathology and Institute for Forensic medicine of the Medical Faculty of Zagreb. Investigations were performed in articular faces of the tibia, fibula and talus on the left and right legs of the adults. Mutual comparing of the joint faces, their areas and altitudes, angles between the medial malleolus and tibia, and the altitudes of the medial and lateral malleolus has shown great individual differences. According to these results the authors concluded that the disproportion of the articular bodies caused habitual medial twisting of the foot. The importance and the role of ligaments, muscles and joint capsule were not the object of this investigation. The obtained results are a contribution to the functional anatomy of the ankle joint, and to the clinical pathology of this region.

Adult↗

Massive acute arsenic poisonings.

Arsenic poisonings are still important in the field of toxicology, though they are not as frequent as about 20-30 years ago. In this paper, the arsenic concentrations in ante- and post-mortem materials, and also forensic and anatomo-pathological aspects in three cases of massive acute poisoning with arsenic(III) oxide (two of them with unexplained criminalistic background, in which arsenic was taken for amphetamine and one suicide), are presented. Ante-mortem blood and urine arsenic concentrations ranged from 2.3 to 6.7 microg/ml, respectively. Post-mortem tissue total arsenic concentrations were also detected in large concentrations. In case 3, the contents of the duodenum contained as much as 30.1% arsenic(III) oxide. The high concentrations of arsenic detected in blood and tissues in all presented cases are particularly noteworthy in that they are very rarely detected at these concentrations in fatal arsenic poisonings.

Adult↗

A new algorithm for use in computer identification.

On 9 May 1987, a Soviet-made IL-62M Polish airliner, LOT Flight 5055, crashed, exploded, and burned, killing the crew and 183 passengers. A forensic science team from the Armed Forces Institute of Pathology, comprised of 6 dental officers, 3 forensic pathologists, and 3 medical photographers, worked in concert with the Polish forensic science team. The small number of antemortem records and the extreme fragmentation of the remains presented a new scenario for computer use. Typically, the Computer-Assisted Postmortem Identification (CAPMI) software is used to compare remains against an antemortem database. Results are listed by the number of tooth-to-tooth matches based on restorative or other characteristics or both. The Polish disaster confounded this approach to some degree, however, and suggested a reconsideration of the theory on which the sort is made, that is, that the cases with maximum number of matches to preexisting dental records would be the most likely identification (ID) match. A hypothesis was constructed that, if searches were accomplished for fragments with a minimum number of mismatches, the correct matches would appear higher in the rank order. Six antemortem records (that had all dental information) were sorted against one hundred and twelve postmortem fragmented records. The resulting report was reordered so that records were listed by minimum number of mismatches. There was significant improvement in rank placement for all of the records. Thus it was accepted that in the situation of highly fragmented remains a different sorting based on the number of mismatches is indicated. Programming changes to make this option available have been implemented in the new version of CAPMI.

Accidents, Aviation↗

Pathological lying revisited.

Although pathological lying was first described in the medical literature over 100 years ago, it remains a poorly understood concept. Psychiatrists continue to grapple with the full ramifications of the condition, even though interest specifically in pathological lying seems to have waned in recent times. The impact of pathological lying deserves critical attention from forensic psychiatrists because of the implications that untruths have in a legal context. In this article, the authors review the considerable vagueness and confusion that has surrounded this concept and examine the extent to which a person can control lying behavior and the related question of whether pathological liars have responsibility for their actions. While providing a structured framework for considering pathological lying in the forensic context, the authors conclude that further systematic research is needed to resolve the questions raised in this article.

Adult↗