Soudni Lekarstvi最新文献

Unlabelled: Ethanol is the main psychoactive ingredient of alcoholic beverages. Together with water it makes their major part. The other substances contained in alcoholic beverages are called congeners. Some of them come from the original substance of the beverage, some come from the fermentation or mellowing process. Except giving the drink its specific taste, scent and colour, congeners also have a non-negligible direct influence on the alcohol consumer. Nowadays, methods of identification thousands of alcohol congeners are available. Analyzing chemical compounds of alcoholic beverages have only recently gained its importance, when it helped to estimate the basic chemical composition of the particular alcoholic beverages. Mentioned method is able to identify an exact type of alcoholic beverage which a man consumed before the blood sample necessary for the detection had been taken from him. It becomes irreplaceable especially in forensic assessment of the drunkenness in case an alcoholised person, responsible for any crime, excuses himself that he was drinking only after the act/crime (e.g. traffic accident) had happened. It can also help to aprove/disprove a testimony of an accused person that he/she was unaware of being given alcohol into his/her non-alcoholic beverage. Development of the new chemical methods analyzing alcohol congeners are of a great benefit for any forensic expert-medical doctor dealing with the field of forensic alcohology. However, he/she must be aware that interaction of alcohol congeners with the human organism follows different laws in comparison to alcohol/ethanol itself.

Keywords: alcohol - congener - alcohol congener analysis - forensic alcohology.

In the work we analyze three cases of unusual dyadic deaths when the perpetrator of homicide committed suicide shortly after the murder. In the first case a man stabbed his girlfriend with a knife and subsequently committed a car crash suicide. In the second case an apparent simultaneous hanging of a married couple turned out to be homicide-suicide act. In the last case a man shot his ex-wife while she was on a walk with their dog and in a short time turned the gun against himself.

Stab wounds caused by knives and daggers are usually of different appearances. The knife wound has one edge sharp while the second one is blunt. The wound caused by blow of dagger has both edges sharp. The forensic expert must very often decide whether the knife or dagger was used. The aim of this experimental work was to show how a single-edged knife penetrates the skin and causes the wound typical for the double-edged dagger. The fact was verified. The wound typical for dagger can be found if the knife is used only according to the scheme. The forensic expert can say that a one cutting edge knife was used if the one edge of wound is squared and the other one is sharp. If the both of them are sharp, forensic expert must be very careful in his decision.Key words: stab wounds - knife - dagger - forensic expertise.

Unlabelled: Presented case was a 2-year-old baby girl who had been treated for nearly one year with the indication of multifocal epileptiform anomaly. She was found dead in her bed in morning hours, autopsy was planned after prosecutors investigation. On internal autopsy examination, shrinkage of gyral structures in the frontal, and parietal lobes of the left hemisphere, markedly enlarged sulci, and a hypoplastic appearance were noted. Histopathological examination revealed evidence of pneumonia, brain exposed microgyral formations, disordered cortical stratification, hypercellularity, dysmorphic neuronal structures, balloon cells with diagnosis of cortical dysplasia. Pneumonia was reported as a cause of death. We aimed to discuss in the light of the literature a case with cerebral hypoplasia which is rarely seen at forensic autopsies.

Keywords: cerebral hypoplasia/dysplasia - autopsy - congenital malformation - sudden death.

Introduction: Therapeutic procedures performed during cardiopulmonary resuscitation on patients in cardiac arrest or unconsciousness from any other cause can have serious adverse effects. Scale of injuries scale is very wide - from simple skin lacerations up to serious injuries which can even thwart possibility of successful resuscitation and cause death.

Materials and methods: Comprehensive review of current literature aimed at injuries associated with cardiopulmonary resuscitation.

Results: Authors of this paper offer up-to-date review of possible cardiopulmonary resuscitation associated injuries, which are discussed depending on the method of performed resuscitation - airway management, chest compressions without tools or with automated mechanical devices, and defibrillation. Airway management is frequently associated with subcutaneous hematomas of the neck and head, mucosal membrane lacerations, teeth fractures and airway aspiration. Autopsy findings after cardiac massage are: rib and sternal fractures (very frequent); pleura, lung and cardiac injuries (frequent); cervical spine injuries, pericardial tamponades due to cardiac or aorta rupture, liver, spleen or stomach lacerations (rare). Defibrillation can create skin burns, cardiac or renal injuries due to rhabdomyolysis.

Conclusion: Forensic pathologists as well as clinical practitioners should be aware of the relevance of possible injuries associated with cardiopulmonary resuscitation. The injuries should be avoided if possible, or distinguished from injuries of other origin if they cannot be prevented.

X-ray is the most common, basic and essential imaging method used in forensic medicine. It serves to display and localize the foreign objects in the body and helps to detect various traumatic and pathological changes. X-ray imaging is valuable in anthropological assessment of an individual. X-ray allows non-invasive evaluation of important findings before the autopsy and thus selection of the optimal strategy for dissection. Basic indications for postmortem X-ray imaging in forensic medicine include gunshot and explosive fatalities (identification and localization of projectiles or other components of ammunition, visualization of secondary missiles), sharp force injuries (air embolism, identification of the weapon) and motor vehicle related deaths. The method is also helpful for complex injury evaluation in abused victims or in persons where abuse is suspected. Finally, X-ray imaging still remains the gold standard method for identification of unknown deceased. With time modern imaging methods, especially computed tomography and magnetic resonance imaging, are more and more applied in forensic medicine. Their application extends possibilities of the visualization the bony structures toward a more detailed imaging of soft tissues and internal organs. The application of modern imaging methods in postmortem body investigation is known as digital or virtual autopsy. At present digital postmortem imaging is considered as a bloodless alternative to the conventional autopsy.

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is characterized by progressive fatty and fibrous replacement. A female in her 70s, suddenly found in cardiopulmonary arrest. The heart weighed 452 g and yellow discoloration was observed. Histological examination revealed the replacement of the right ventricular myocardium by adipose tissue and fibrosis. The cause of death was fatal arrhythmia caused by ARVC/D. Tenascin C staining was useful in evaluating myocardial remodeling.

It is occasionally difficult to distinguish between a self-inflicted bruise and true bruise. The important point of diagnosis is a good, thorough history taking and detailed examination of the affected area.

Introduction: Light microscopy and electron microscopy rank among methods to diagnose of cardiomyopathy in forensic medicine, and, recently, the methods of molecular biology.

Methods: Investigation of 27 year old man who collapsed on his way to work. The Rescuers did not succeed resuscitation of vital function. Samples were H-E stained and processed for the electron microscopy. RNA was isolated from the tissue for the alpha, beta, gama actine primer investigation.

Results: By H-E staining we proved irregular hypertrophic cardiomyocytes (disarray) with the links and loci patches of thin fibrosis. Ultrastructurally we diagnosed a disarray of Z-bands, accumulation of mitochondria, rectangular nuclei of cardiomyocytes. We have detected rare plasmocytes and leucocytes with specific granules in cytoplasma. In the electronogrames we can see myofibriles oriented longitudinally and transversally. A genetic examination demonstrated beta actin mutation.

Conclusion: Cardiomyopathy can be a cause of sudden and unexpected death in young individuals and its diagnostics requires an interdisciplinary collaboration.

Keywords: Sudden and unexpected death - hypertrophic cardiomyopathy - ultrastructure of cardiomyocyte - gene mutation.

Unlabelled: Presented case was 57-year-old male reported to be found dead in the watchman cabin in his workplace. At the autopsy, in abdominal cavity dirty green-brown colored fluid with a few particles of intestinal contents and yellow-green colored membranes on abdominal organs were observed, on the anterior wall of the rectum, 2x1.5 cm size perforation area was observed. We aimed to present the rare case of solitary rectal ulcer perforation.

Keywords: solitary rectal ulcer - death - autopsy.