Forensic Science International Supplement Series最新文献

The human element is increasingly acknowledged as an important factor contributing to accidents at sea. Alcohol and drug abuse is becoming an increasing problem among seafarers in the last few years. Recently we registered a few similar maritime accidents on the Adriatic coast. During the analysis of these incidents, it became apparent that the consumption of alcohol on duty was the main cause of the ship being stranded. We report a maritime accident recently happened in port of Rijeka, where the merchant ship stranded on the main breakwater. During the investigation, forensic alcohol analysis established that master's consumption of alcohol on duty was the main cause of the incident. The BAC–UAC relation we found was not physiologically possible, so further diagnostic workup demonstrated that urine was diluted. Various issues are being discussed, such as urine dilution, retrograde calculation, elimination rate, two subsequent blood samples, drinking after the accident, as well as prevention measures. Our observations indicate a need for stricter and more precise legislation as well as more frequent police control that will hopefully result in prevention of serious maritime accidents caused by alcohol consumption. In our opinion, better understanding of the above mentioned apparent problems in navigation rules and maritime law regulations can prevent similar accidents from happening in the future. Accidents like the one described cause double damage for society: due to acute health problems of the crew and navigation safety, as well as due to the long-term harmful consequences such as suspension of career on ship board and early retirement of employees.

Sarcoglycanopathies are a group of autosomal recessive limb-girdle muscular dystrophies caused by mutations in the genes encoding for α-, β-, γ- and δ-sarcoglycan, which are expressed in skeletal and cardiac muscle. Cardiomyopathy has rarely been reported in patients with mutations in the α-sarcoglycan gene and descriptions of heart pathology are lacking. To our knowledge, this is the first report on characteristic pathomorphological changes in cardiac muscle detected at autopsy in a patient with a proven mutation (nucleotide substitution 229C>T (R77C) in exon 3) in the α-sarcoglycan gene. The patient had the phenotype of Duchenne-like muscular dystrophy. Due to severe weakness of the respiratory muscles, permanent nocturnal mechanical ventilation via a tracheostomy had been necessary since the age of 24 years. The patient also suffered from mild pulmonary and systemic hypertension. At the age of 36, he lost consciousness and was brought to the emergency room in asystolia and unsuccessfully reanimated for half an hour. Gross heart examination disclosed scattered unsharply demarcated grey and yellow areas, characteristically localised in the outer (subepicardial) part of the lateral and posterior left ventricular wall, while the interventricular septum was spared. Similar changes were present in the apical region of the posterior right ventricular wall. Histopathological changes in focal subepicardial myocardial lesions in the free left ventricular wall consisted of myocardial degeneration in the absence of inflammatory infiltrates, fibrosis and fatty replacement of the myocardium, strikingly similar to changes in skeletal muscle. Since autopsy did not reveal any significant coronary stenosis or valvular pathology, both chronic myocardial ischemia and valvular disease could be excluded as causes of the above-described changes, which were ascribed to α-sarcoglycanopathy. Mild myocardial hypertrophy could be attributed to pulmonary and systemic hypertension. The progression of cardiomyopathy in α-sarcoglycanopathy was considered slow, since it had not reached the stage of dilated cardiomyopathy at the time of death. Focal subepicardial myocardial lesions, most pronounced in the posterobasal segment of the left ventricle, were characteristic of cardiomyopathy in α-sarcoglycanopathy. Since focal lesions may spread further, thorough cardiac monitoring is recommended in patients with α-sarcoglycanopathy.

On 21 November 2006 in the Halemba coal mine, Ruda Śląska, a mass industrial accident occurred. The underground catastrophe was probably due to combustion of methane followed by explosion of pulverised coal and resulted in death of twenty-three miners. The occurrence has been acknowledged to be one of the most serious accidents in Polish mining industry. Post-mortem examinations of the deceased were carried out in Department of Forensic Medicine, Medical University of Silesia, and in some cases additional dissecting techniques were employed. Photographs were taken as well as numerous specimens for various laboratory tests were collected. Toxicological analyses of blood samples revealed high levels of carboxyhaemoglobin saturation in seventeen cases, and detected presence of methane in the lungs of seven individuals, whereas microscopic specimens mainly showed lesions characteristic of putrefaction. The post-mortem procedures eventually allowed to establish the cause of death of all victims. The authors attempt to determine a range of requisite medico-legal proceedings and examinations that should be carried out in case of a mass industrial accident, and emphasise the need for development of appropriate guidelines.

In Italy in 2007, 26% of two-wheeled motor vehicle injury/fatalities concerned motorcyclists. However, it is rare (4%) that a motorcycle (MC) crashes with two other road users and even more exceptional is a crash between a MC and three other vehicles. In general, in MC–vehicle crashes, the vehicle driver is at fault in more than 50% of the cases and the motorcyclist in 37%. The study concerns three MC lethal road accidents in which the culpability of the motorcyclist's death was questioned by the prosecutor because it was supposed that one or more vehicles ran over the motorcyclist after a fall. The crucial question in these three cases was if it was possible to assign injuries to a specific crash-aetiology and to assign/exclude the responsibility of motorcyclist's death to a defined subject (motorcyclist himself and/or car drivers) after a crash-dynamics study made by an engineer consultant or by the police authority. Case (1) A 56-year-old motorcyclist on a highway had a front–rear end collision with a car that suddenly stopped; he was therefore projected against a concrete traffic island, thrown on the soil and run over by another car. Case (2) A 29-year-old motorcyclist on the East ring road fell on the soil, perhaps by a supposed front–rear end contact with a car and was run over by two cars in rapid succession. Case (3) A 34-year-old motorcyclist on the North ring road fell suddenly on the soil for unknown reasons; during first aid, the medical team around him was run over by the ambulance which pushed after a rear-end collision with a car. A stepwise analysis of the indicated crash dynamics and an evaluation of all the injuries revealed at autopsy, the study proposed, when possible, injury aetiology for each case and the related responsibility assignments and exclusions.

France ranks as leader country in Europe for the consumption of cannabis as well as of psychoactive medications. Whereas the relationship between psychotropics and road accidents is now well-established, few data are still available on the influence of drugs on occupational accidents. The purpose of the present study was to measure the prevalence of psychoactive drug intake (alcohol excepted) among victims of occupational fatalities (including workplace accidents + traffic accidents, i.e. on the way to and from work) occurred in the region Alsace over the period 2000–2005. Data were collected by compiling files on occupational accidents from two different public agencies (CRAM, Regional Sickness Fund Alsace-Moselle; DRTEFP, Regional Department of Work, Employment and Professional Training) together with those from the Medico-Legal Institute of Strasbourg over the period tested. Data analysis showed that 3% of the victims of workplace fatalities were under the influence of drugs (alcohol excluded) at the time of accident, as well as 5% of the victims of occupational traffic accidents. Our results also highlight a low rate of toxicological analyses, since these investigations were requested by the authorities in 41% of traffic victims and only 15% of workplace victims. In France, the relevance of psychoactive drug intake in occupational deaths is much better targeted in the case of traffic fatalities (due to the existence of specific regulations, e.g. compulsory urinalysis for drugs of abuse in drivers involved in a road accident) than in those occurred at workplace (no specific regulations).

During executing some activities by the police, a mummified human fetus was accidentally revealed on a scrap of paper. It came from pregnancy considerably not carried to term, lasting about 2.5 lunar months. Medical examination did not give evidence of mechanical manipulation such as abortion or disintegration. The aim of the study was the genetic identification of the mummified fetus and an answer to the question if an indicated supposed mother was the mother of the fetus. In the study a relevant factor was maternity confirmation by means of statistic calculations.

Introduction

Nasal polyposis (NP) is considered to be the state of chronic inflammation of nasal mucosa and sinuses presenting with various nasal symptomatology. In most cases, it is treated conservatively. Recently, functional endoscopic sinus surgery (FESS) was developed as the valuable and advantageous surgical procedure to treat NP. Despite the inherited risks of this procedure, its complication rate is considered to be acceptable compared to potential benefits for the patient.

Case

Fifty-five-year-old man was admitted to the hospital for surgical removal of the nasal polypus. After the usual pre-surgery procedures, the patient underwent FESS. Under general anesthesia, left sphenoid sinus was opened and cleaned from the imflammatory discharge, polypus was excised, and following the trepanation the left maxillary sinus was left to drain out. Polypus and pieces of sinonasal mucosa were sent to pathohistological analysis, which yielded in diagnosis of inverted sinonasal papilloma.

The early postoperative recovery was regular, but 2 h upon the surgery, the patient started to lose consciousness gradually falling into the state of coma. CT scan and angiography of the head revealed pneumocranium, defect of the left ethmoidal sinus, hematoma in the left frontal cerebral lobe, as well as the hemorrhage in all four cerebral ventricles. A series of neurosurgical procedures followed in the next 8 days. Despite the attempts to resolve above complications, the patient remained comatous and died 16 days after the polypectomy.

Autopsy revealed the extensive oval-shaped defect on the skull base in the left posterior part of cribrous plate of the left ethmoid bone. The brain appeared swollen and heavily congested, showing the zone of subarachnoidal hemorrhage in basal face of left frontal lobe. Frontal serial sections revealed large intracerebral haematoma in basal periventricular structures of left frontal lobe extending to the whole ventricular system. Apart from the above, most prominent finding was bilateral bronchopneumonia. The cause of death was attributed to bronchopneumonia following the brain trauma, manner of death ruled as violent.

Conclusion

Although majority of the patients suffering from chronic rhinosinusitis or NP recover well after the endoscopic surgery, the possibility of undesirable outcome must not be ignored. This case calls for assessment of potential medical liability caused by malpractice. Having in mind rather high prevalence of chronic rhinosinusitis and NP, legal aspects of postoperative death should be carefully analyzed.

This study aims to contribute to the analysis of the impact of alcohol consumption on road traffic safety in Slovenia and to evaluate the effectiveness of the changes in road traffic safety legislation concerning this issue within the period 1980–2006. For this purpose we have performed a retrospective analysis of 1913 autopsy reports on traffic casualties, with an emphasis on their blood alcohol concentration (BAC), mode of participation in traffic (drivers, pedestrians, etc.) and the impact of legislation changes. In addition, we have analysed the relations between BAC, the time and day of death and the gender of victims. Changes in the legislation were made in 1981, 1985, 1988, 1989, 1990, 1998 and 2005, yet only those made in 1981, 1990 and 1998 resulted in the increase of the actual fines. Within the observed period there was a substantial reduction in the average BAC in almost all of the categories of traffic participants (pedestrians: from 1.20 to 0.73; passengers: from 1.08 to 0.56; cyclists: from 1.11 to 0.56; motorcyclists: from 0.68 to 0.33) except in the category of drivers (negligible reduction from 0.81 to 0.76). Insufficient improvement in the latter category is extremely important, because many sober vulnerable traffic participants become victims of drunk drivers. Further concern arises from the finding that heavily drinking drivers are not responsive to penalty increases. We came to the conclusion that, in addition to raising fines and expanding penalty points, the introduction and effective enforcement of complex legislative measures together with wide community action are necessary to resolve DUI problems in Slovenia.

Allele frequencies, forensic parameters for the 11 STR loci in GenePrint STR Systems—Silver Stain Detection (Promega): CSF1PO, TPOX, TH01, D16S539, D7S820, D13S317, F13A01, FESFPS, VWA, F13B, LPL were determined in a sample of 529–1436 unrelated, dead and alive adults from the Upper Silesia region (Poland). Furthermore, gender identification was carried out. The values of heterozygosity (Ht), polymorphic information content (PIC), power of discrimination (PD), matching probability (PM), mean exclusion chance (MEC) and mean exclusion probability (MEP) were calculated using Dudek's computer programme (FatRec, High Technical School of Częstochowa, Poland). A possible divergence from HWE was determined by χ² and exact tests using Miller's computer programme (TFPGA, Northern Arizona University, Flagstaff, USA). Comparison of allele frequencies between the Upper Silesia population and other Polish populations was performed with Carmody's test.