Soudni Lekarstvi最新文献

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.

Unlabelled: 83 pacemaker (PM)/14 implantable cardioverter-defibrillator (ICD) autopsied patients, predominantly males, deceased 4.0±3.0/2.8±2.5 years after implantation in hospital. Coronary artery disease was most frequent. Its consequences were more severe in ICD patients. Sclerotic and rheumatic heart changes were present in older PM patients group only. The immediate cause of death was mostly of cardiac etiology. Relatively short implant-death interval should be explained by rather great part of non-cardiac causes of death in hospitalised patients.

Keywords: pacemakers - implantable cardioverter - defibrillators-causes of death - heart pathology - autopsy.

Cannabis consumption has individual influence to cognitive and psychomotor functions of drivers and it has been generally accepted that driving under influence is risky in the perspective of traffic safety. However, rules how to assess fitness to drive are not quite clear. The psychoactive compound delta-9-tetrahydrocannabinol (THC) impairs cognition, psychomotor behaviour and driving performance in a dose-related manner approximately. After a single drug dose, THC blood concentration peaks within minutes, before the end of smoking, with a subsequent rapid decrease to the analytical limit of detection. Peak euphoria is delayed compared to THC peak blood concentration and physiological and behavioural effects return to baseline within 3-5 hours. In chronic users, the lipophilic THC accumulates in fat tissues, where its slow redistribution into blood is the rate limiting process in its terminal elimination. In our experimental study we have attempted to contribute to this discussion with results obtained from human volunteers - cannabis consumers in Czech Republic. Aim of our study was to document the time profile of serum THC level in occasional and chronic cannabis users. The observational interval covered the time immediately after the drug consumption (an own cigarette/joint) till 24 hours after. Our preliminary results have shown that in occasional users, THC serum levels cannot be detected already 4 hours after usual cannabis dose, whereas in chronic users measurable THC concentrations in serum persist longer. Moreover, some chronic consumers were practically with permanent THC detection during our observation period and also the chronic users consumed higher THC doses significantly related to doses in occasional ones. Presented results of the experimental study with human volunteers confirm a great individual variability of the kinetic profile of THC in blood due to complicated redistribution. The practical forensic question is how long the psychotropic effects of THC can persist after the last drug dose. In chronic users there are well documented indications of long term adverse effects to neurocognitive functions. THC blood level itself can not directly document the intensity of impairment of a driver. Moreover, the concentration of THC in blood at the time of driving is probably substantially higher than at the time of blood sampling. Therefore due to the prevention of traffic risk, some countries adopted per se traffic legislation based on analytical principle with minimum tolerance to illegal drugs in blood of drivers at driving. Low blood concentrations of THC close to the limit of detection of a specific toxicological method (GC-MS or LC-MS) are justified in an effective traffic legislation.

Our case was a twenty year-old man, who was injured during the military duty with G3 infantry rifle in the training area. An atypical firearm entry wound on the left side of sternum which was 4.5 cm in diameter, and was surrounded by six irregular skin burn wounds by a flash-suppressor and a 0.7 cm diameter firearm exit wound at space on the left midscapular line. Our case emphasizes that the interpretation of properties of these atypical firearm entry wounds need to be carefully assessed by physicians.

Unlabelled: Alcohol accounts for a great amount of deaths per year either due to the acute intoxication or due to the secondary impacts of acute or chronic alcoholism. Commonly, in large amount of such fatal cases blood alcohol concentration is low or absent and fatty liver disease is frequently the only pathological finding detected at the autopsy of alcohol consumer. We offer a short case report of a case with the following analysis of why we decided to consider alcoholic ketoacidosis in our differential diagnosis.

Keywords: metabolic disturbance - alcoholic ketoacidosis - chronic alcoholism - sudden death.