Soudni Lekarstvi最新文献

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.

Background: We aimed to determine specific formulae by which we are able to estimate the body stature from the length of ulna and tibia calculated from the X-rays in order to be a reference for skeletal remains-based identification in Iranian population.

Methods: The length of right ulna and tibia of 49 male and 52 female adults, who were anatomically healthy, were measured on the antero-posterior X-rays. Body height of each subject was also recorded.

Results: Mean stature of the male and female adults was reported to be 171 ± 3.6 and 160 ± 3.9 centimeters (cm), respectively. Four single linear regression equations and 2 multiple regression equations were obtained.

Conclusions: Lengths of ulna and tibia measured on the X-rays may be useful for estimation of the stature in cases of forensic personal identification.

Keywords: stature - length of long bones - ulna - tibia - radiological evaluation - skeletal remains.

We present the case of complete post-mortem decapitation of a 43 years old man killed by gunshots discharged from a distance of 40 - 50 cm. The corpse was left in the courtyard of his isolated carpentry and a mongrel dog lived in that courtyard, maybe attracted by the blood gushed from the wound, got a depredation of the corpse till the complete decapitation and the removal of all intrathoracic organs. The action of the dog was completed by the rats and mice that lived in the place. The case is not rare and sometimes the alteration of the features of the corpse makes it impossible for the investigators, to objectify any other signs of criminal nature.

Unlabelled: Application of molecular genetic methods during the examination of biological traces is irreplaceable for individual identification of their originators. However, this analysis does not provide any clues for further investigation without the possibility to compare the genetic profile of the examined trace with the profile of its potential originator. The age of a searched person represents an important entry for investigators. In this review, the recent methodical molecular genetic approaches are discussed with regards to their practical outputs leading to the estimation of biological age of an individual. The length of telomeric sequences and their attritions correlating with increasing age seemed to be very promising marker if they have been examined using Southern blot analysis. This method is not suitable for forensic casework due to the need of high amounts of DNA input. Recent methods based on quantitative polymerase chain reaction (qPCR) are applicable on samples with minimal DNA concentrations but they provide inconclusive results with regard to the age estimation based on the length of telomeres. Therefore novel methodical approaches were developed. Application of methods based on the examination of deletions in mitochondrial DNA, on the presence of transcripts of gamma hemoglobins or on the quantification of byproducts of somatic rearrangements of genes for T-cell receptors is restricted to special types of biological traces. The age dependent methylation of specific nucleotides in selected gene sequences seems to be the only promising universal marker.

Keywords: age estimation - molecular genetics - telomere attrition - qPCR - array technology - promoter methylation.