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Craniometaphyseal dysplasia in six generations of a German kindred.

Craniometaphyseal dysplasia (CMD) was found in 6 generations of a large German kindred; 24 affected individuals were identified. The clinical diagnosis was confirmed by further examinations in 15 individuals, including 2 exhumed skeletons. Five deceased individuals were considered to be undoubtedly affected by reviewing photographs, and 4 must have had CMD from genealogical considerations. Pedigree analysis was performed over 8 generations back to persons born at the beginning of the 18th century in a central area of Germany. The trait could be traced back to a common male ancestor, born in 1790. Molecular genetic investigations on 3 generations of this kindred are in progress. In the present study we describe the clinical characteristics of the family.

Craniofacial Abnormalities↗

Transverse (Harris) lines in Irish archaeological remains.

Transverse lines were examined in 633 long bones from 73 individuals exhumed from two burial sites in the Republic of Ireland: Waterford City and Tintern Abbey. The burials cover four distinct periods between the 11th and 17th centuries. Lines were most numerous in the tibia, especially in the distal segment, and were not seen in the humerus nor the proximal part of the femur. The number of lines varied between the proximal and distal segments of each long bone, and though apparently equal in number across the midline, there were significant differences in the incidence of lines between corresponding pairs of bones. Thus, it is unwise to rely on the results of a single bone or one type of long bone alone either to indicate the health status of an individual, or as the basis for assessing the health status of a small population. Such results should be used only in association with other indicators.

Adult↗

Influenza A pandemics of the 20th century with special reference to 1918: virology, pathology and epidemiology.

Influenza A virus initiated worldwide epidemics (pandemics) in 1918, 1957, 1968 and 1977. A revised calculation of the 1918-1919 pandemic estimates that 40 million persons died and 500 million were infected. The mortalities in 1957 and 1968 were nearly 6 million. Biological and genetic characteristics of the causative agents of the more recent pandemics, have been well studied but little is known about the causative agent of the Great Pandemic in 1918. Genetic characterisation of the 1918 virus has been achieved by sourcing virus RNA from formalin fixed lung samples or by exhuming frozen victims of the outbreak from Arctic regions. Initial analysis of the HA gene from two USA sources indicates a virus related to swine and human influenza with no base insertion at the HA1-HA2 cleavage junction which, at least in avian influenza A, characterises high virulence. Important unanswered questions are whether the 1918 virus spread pantropically perhaps to include the brain and hence cause encephalitis including the later lethargic forms, or whether infection was confined to the respiratory tract. Re-examination of reports of respiratory disease in England and France in 1916-1917 may indicate a non-Spanish origin of the pandemic and a period of 2 years for the virus to be seeded worldwide. In contrast the other two pandemic viruses in 1957 and 1968 appeared to originate in Asia. New anti-neuraminidase drugs in conjunction with amantadine and novel developments with influenza vaccines would be expected to ameliorate the disease in a future pandemic.

Alaska↗

Chagas' disease in pre-Columbian South America.

The quest for the origin and dispersion of Chagas' disease, the second most important vector-borne disease in Latin America, has epidemiological, immunological, and genetical implications. Conjectures based on accounts of chroniclers, reviews of the archaeological literature and the present distribution of triatomine bugs, the vectors of the disease, held that the origin of the adaptation of Triatoma infestans (a species of the subfamily Triatominae) to human dwellings occurred in prehistoric times. The autopsy of 35 mummies exhumed in the Chilean desert, dated between 470 B.C. and 600 A.D., revealed the presence of clinical manifestations of Chagas' disease and put earlier speculations on a factual basis.

Chagas Disease↗

Brief communication: bioarcheological and biocultural evidence for the New England vampire folk belief.

Folk beliefs associated with death and disease can impact on the bioarcheological record. Unusual postmortem actions by humans and distinctive paleopathological evidence may be clues to these beliefs. This report presents bioarcheological and paleopathological evidence in support of a 19th century New England folk belief in vampires with a particular reference to a colonial period burial. The New England folk belief in vampires revolves around the ability of a deceased tuberculosis victim to return from the dead as a vampire and cause the "wasting away" of the surviving relatives. To stop the actions of the vampire, the body of the consumptive was exhumed and disrupted in various ways. Twelve historic accounts of this activity indicate that the belief was not uncommon in 19th century New England. This creative interpretation of contagion is consistent with the etiology of tuberculosis. Three pieces of evidence are important in this case. The skeletal of a 50- to 55-year-old male from a mid-19th century Connecticut cemetery exhibiting pulmonary tuberculosis rib lesions are discussed. In addition, certain bones in the skeleton were rearranged after decomposition was complete. A historic vampire account from the same time period and geographical location place the belief within the parameters of the cemetery.

Burial↗

[Detection of E 605 several years after burial].

Five cadavers were exhumed 8 months to 20 years after burial, as it was suspected that these persons had been poisoned with E 605. Parathion at doses of between 200 mg and 500 mg might have been administered. Parathion, aminoparathion, paraoxon, p-nitrophenol, and a decomposition product of CI solvent blue 78 (Ceresblau) were found 9 months after burial, and aminoparathion and p-nitrophenol could be detected 3 and 7 years after burial. Neither parathion nor its degradation products were found in postmortem samples 13 and 20 years after burial. As secondary findings, barbital was detected in specimens 20 years after burial. The analytical findings were confirmed by GLC mass spectrometry.

Aged↗

ABO blood grouping of hairs using an avidin-biotin-peroxidase complex technique.

Fifty-nine hair specimens obtained from human autopsies and volunteers were used for the determination of ABO blood group substances using the ABC (Avidin-Biotin Complex) technique. Positive staining for A, B and H blood group substances was detected only in the medulla of the hairs. Blood group antigens could not be detected in seven hair specimens because they possessed no medulla. Forty-seven specimens obtained from fresh cadavers and volunteers gave the correct results corresponding to the blood group of the donor, but some specimens from individuals of blood group A2, Le(a + b-) showed weak reaction with anti-A and strong reaction with anti-H. The staining intensity with anti-B and -H in some individuals of blood group AB was stronger than with anti-A serum. Five hair specimens obtained from decomposed bodies were also examined. The blood group antigens could be specifically detected in hairs obtained from two exhumed and one putrid body, but no positive reactions were obtained from two cases of drowning where the bodies had been in the sea for about 6 months. In a blind trial, hair specimens from 28 individuals were also examined. Twenty-two specimens which possessed a medulla gave the correct result. Six specimens gave no result because they possessed no medulla.

ABO Blood-Group System↗

[Late death in congenital toxoplasmosis].

In spite of a known toxoplasmosis infection rate of up to 90% of the population of the Federal Republic of Germany published T-cases decrease steadily. T-infection during gravidity may cause more pathologic alterations in the infant cerebrum than is commonly assumed. Medico-legal aspects are very rare. A case of connatal toxoplasmosis in a 19 months old infant was found at exhumation (16 days p.m.). In the cerebrum T-parasites, terminal colonies and calcified spots were observed. Specific morphological and immunohistological findings lead to the diagnosis. The medico-legal problems of this case are discussed.

Brain↗

A unique case of naturally occurring mummification of human brain tissue.

When skulls and bones were exhumed from a mass grave in Bulgaria and subjected to medicolegal examination they were found to originate from 39 humans aged 36-60 years old who had been buried approximately 45-50 years ago. Solid structures which strongly resembled shrunken human brain tissue were found inside 2 intact skulls. Among other bones 5 similar structures were found one of which was an almost entirely preserved human brain, and the others were fragments from different regions of the human brain. Samples of these structures were immersed in 15% aqueous glycerol solution to soften and were examined by light and electron microscopy. Samples of this material and of fresh human brain were subjected to elementary atomic spectral analysis. These complex studies indicated the samples to be naturally mummified human brain tissue and that this process had occurred due to specific conditions within the cranial cavities after burial.

Adult↗

[Classification of digoxin concentrations in blood and tissues in cases under suspicion of poisoning].

The clarification of a suspicion of poisoning at all times poses a problem to the forensic toxicologist, when a narrow margin of therapeutic safety and a low dosage coincide as in cases of digoxin poisoning. Statistical methods may serve as an aid. The post mortem digoxin concentration in the tissues of heart, kidney, liver and in blood of 45 patients who had received therapeutic daily doses and of 13 cases of fatal poisoning are compared. After logarithmic transformation of the individual concentration values a two modal distribution is obtained. There is one concentration calculated with equal probability of being classified to "therapeutic or toxic", as well as the probability of observing the "critical" concentrations of 400 ng digoxin/g cardiac tissue, 500 ng/g kidney and 250 ng/g liver after therapeutic dosing. Using the discriminant analysis each of the cases clearly falls into one of the two collectives "therapeutic" and "toxic", when taken as a separate observation. Concentration data of fatal poisonings taken from the literature are as successfully classified as the analytical results of some exhumed bodies under suspicion but not poisoned. As expected the power of discrimination increases with the number of parameters. Because of the relatively slow body distribution of digoxin the blood taken from peripheral vessels is of most important evidence.

Digoxin↗

Demonstration of myocardial necrosis in the presence of advanced putrefaction.

Samples of heart tissue were investigated in two series for the detectability of myocardial necrosis after artificial and natural putrefaction, respectively. In the first series heart tissue with and without infarction was artificially subjected to humid and dry autolysis and putrefaction. In the second investigation heart tissue was obtained from exhumed bodies after periods of burial ranging between 10 and 929 days. Besides histology a variety of immunohistochemical markers were applied and C5b-9 gave positive results even after long periods of artificial and natural putrefaction. From the methods tested, this was by far the most sensitive method with a high robustness against putrefaction. NP57, which indicates neutrophilic leucocytes could be demonstrated considerably longer after humid putrefaction than after dry putrefaction. The time limits of detection were considerably longer than for H&E. These two methods are the methods of choice for the detection of myocardial infarction and leucocyte infiltration in advanced stages of putrefaction.

Adult↗

Odontological identification of human remains from mass graves in Croatia.

This paper reports the results and methods of dental identification of 1000 human remains exhumed from mass graves in Croatia up to July 1998. Personal identification of the victims was performed at the Department of Forensic Medicine and Criminology at the School of Medicine in Zagreb. A forensic odontologist participated in the identification process by carrying out the dental identification. A total of 824 victims were positively identified, while 176 victims remained unidentified. Dental identification based on available dental antemortem data was achieved in 25% of the cases. Dental identification based on dental charts was achieved in 35%, on x-rays in 15%, on photographs of teeth in 22%, on interviews in 18%, and on confirmation by odontologists in 10% of the cases. Teeth, in combination with anthropological parameters, age, sex and height, as well as other specific characteristics such as tattoos, personal identification cards, clothes, jewellery and DNA, were helpful for identification of 64% of the victims, but the significance for the identification was not dominant. Only in 11% of the cases was identification achieved by other relevant means and teeth not used at all. Identification procedures in Croatia will continue until another 1700 people who are still missing or kept as prisoners of war since the aggression on Croatia in 1991 are found and/or identified.

Adolescent↗

Planning the archaeological recovery of evidence from recent mass graves.

Mass graves commonly contain hundreds of putrefying bodies, which bear evidence of torture and extrajudicial execution. These require careful excavation using archaeological techniques to recover the bodies for identification and to obtain associated evidence which document human rights abuses. In order to derive forensically defensible conclusions, exhumation of a mass grave may take weeks or months. Specialized protective suits and breathing apparatus will permit the investigating team to take the time required to retrieve even subtle evidence from repellent remains. Strategies for sampling tissues and bodies which reduce the magnitude of the recovery operation are described.

Archaeology↗

Identification of the cranium of W.A. Mozart.

In 1801 at the cemetery in Vienna, Austria, the skull of W.A. Mozart was exhumed (La Chronique Médicale, 13 (1906) 423), and now it has been examined for identification. The osteometrical and osteological findings correspond with the available data of W.A. Mozart. Superimposition gives evidence that craniofacial distinctiveness of the cranium is consistent with the portrait. Additional individual particularities caused by the premature synostosis of the metopic suture (PSMS) and a bone lesion are described.

Austria↗

Detection of human proteins in buried blood using ELISA and monoclonal antibodies: towards the reliable species indentification of blood stains on buried material.

The survival of human proteins in blood stains on fragments of cloth buried in exposed soil was examined in a 15-month investigation carried out from September 1990 to December 1991. During this period there was a wide variety of weather conditions. Samples were exhumed at 4-weekly intervals for 16 weeks and finally at 65 weeks; extracts of the stains were tested for albumin and IgG using a highly specific and sensitive enzyme-linked immunosorbent assay (ELISA) performed with monoclonal antibodies. Human albumin survived well throughout the 15 months of study, but IgG could be detected only in the 4- and 8-week samples. The reactions for IgG were weaker than those for albumin, although the method's sensitivity (10 ng) was the same for each protein. Appropriate buried and non-buried control experiments were carried out using cloth, either unstained or stained with human blood or animal sera; there was no cross-reactivity between human and the other species investigated and soil did not affect the assay; under laboratory conditions, IgG and albumin survived equally well. The system's versatility was illustrated by using monoclonal anti-bovine-albumin to detect specific albumin in the extracts of buried cloth which has been stained with bovine serum. It was concluded that ELISA performed with monoclonal antibodies could be of great value in identifying blood stains for forensic purposes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

An unusual morphine fatality.

A case is presented of a 90-year-old white female who apparently died of natural causes in a nursing home. Subsequent investigation indicated that the decedent had been administered an unauthorized bolus of morphine just prior to her death. The embalmed body was exhumed, an autopsy performed, and specimens were collected for toxicologic analysis. The liver contained 1.5 mg/kg of free morphine as measured by radioimmunoassay. The presence of morphine was confirmed by gas chromatography/mass spectrometry. A review of the literature as well as in-house data collected from narcotic deaths clearly suggest that the morphine measured in this case was consistent with a lethal concentration. The manner of death was homicide.

Aged↗

Medicolegal reconstruction of the Katyń forest massacre.

The genesis of the massacre of Polish officers, committed by the Soviets in the Katyń forest in 1940, is presented. Medicolegal documentation of the exhumation by the International Committee is contrary to the report by the Special Soviet Committee. The importance of the medicolegal findings concerning the time of the crime is stressed. The report by the Select Committee of the House of Representatives is also referred to.

Forensic Medicine↗

Alleged lethal sorcery in East Timor.

A wide range of cultural and social perspectives exists on the concept of sudden and unexpected death. In countries, without a formal system of death investigation, sudden death is shrouded in mysticism often based on traditional belief systems. This cultural perspective on sudden death is often at variance with medical and forensic concepts and may include explanations such as sorcery, magic, and voodoo. In this case report, the postmortem findings in an alleged victim of lethal 'black magic', known as ema halo by the indigenous people of East Timor, is described. The alleged victim died suddenly in front of witnesses. At autopsy, marked dilation of a bicuspid aortic valve with annuloaortic ectasia and a sinus of Valsalva aneurysm was found after exhumation of the body. The findings mitigated the local belief in witchcraft and established a natural manner of death.

Aortic Aneurysm↗