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An unusual case of functional neurological disorders and psychogenic coma following physical assault: Clinical and medico-legal considerations 一例身体攻击后出现功能性神经障碍和心因性昏迷的罕见病例:临床和医学法律考虑
Q3 Social Sciences Pub Date : 2021-01-01 DOI: 10.4103/jfsm.jfsm_62_20
Fiorella Caputo, R. Barranco, P. Ricci, S. Gratteri, F. Frigiolini, G. Rocca, F. Ventura
Functional neurological disorders can have different clinical manifestations, including coma, in the setting of an unknown etiology. In this article, we present a case of a young man affected by intellectual disabilities who, after a physical assault reported serious neurological alterations and a functional coma. This case shows how a stressful psychophysical event can bring acute and variable neurological manifestations of functional significance to a victim with previous intellectual disabilities. Despite the growing interest in this field, research is still very limited and studies in this field could better explain the nature of the psychogenic coma. From a medico-legal point of view, problems of evaluation may emerge for these disorders emerge as a result of acute psycho-physical stress and without any detectable structural alterations.
在病因不明的情况下,功能性神经系统疾病可能有不同的临床表现,包括昏迷。在这篇文章中,我们介绍了一个受智力残疾影响的年轻人的案例,他在遭受身体攻击后报告了严重的神经系统改变和功能性昏迷。这一案例表明,压力性心理咨询师事件如何给有先前智力残疾的受害者带来具有功能意义的急性和可变的神经表现。尽管人们对该领域的兴趣越来越大,但研究仍然非常有限,该领域的研究可以更好地解释心因性昏迷的性质。从医学和法律的角度来看,这些疾病可能会出现评估问题,因为这些疾病是急性身心压力的结果,并且没有任何可检测的结构变化。
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引用次数: 1
Virtual determination of sex: Estimating cut off value of digital metric traits of foramen magnum on three-dimensional computed tomography with receiver operating characteristic and logistic regression analysis 性别的虚拟确定:用受试者操作特征和逻辑回归分析估计三维计算机断层扫描上大孔数字测量特征的截断值
Q3 Social Sciences Pub Date : 2021-01-01 DOI: 10.4103/jfsm.jfsm_59_20
H. Agarwal, P. Setia, S. Pandey
Background: Radiological imaging plays a pivotal role in forensic anthropology. As have the imaging techniques advances, so have the digital skeletal measurements inched towards precision. Secular trends of the population keep on changing in modern times. Hence, finding the precise technique of bone measurement, with greater reproducibility, in modern population is always needed in making population specific biological profile. Aim and Objective: The aim of this study was to estimate the accuracy of the foramen magnum measurement, obtained by three dimensional multi-detector computed tomography using volume rendering technique with the cut off value of each variable, in sex determination of an individual. Materials and Methods: Two metric traits, an antero-posterior diameter (APD) and transverse diameter (TD), were measured digitally in an analysis of 130 radiological images having equal proportion of male and female samples. Foramen magnum index and area of foramen magnum (Area by Radinsky's [AR], Area by Teixeira's [AT]) were derived from APD and TD. Results: Descriptive statistical analysis, using unpaired t-test, showed significant higher value in males in all the variables. Using Pearson correlation analysis, maximum correlation was observed between area (AT and AR r = 0.999) and between area and TD (AR r = 0.955 and AT r = 0.945 respectively). When used individually, TD had the highest predictive value (67.7%) for sex determination among all the parameters followed by AT (65.4%) and AR (64.6%). Cutoff value of variables TD,AR and AT were 29.9 mm, 841.80 mm2 and 849.70 mm2 respectively. Receiver operating characteristic curve predicted male and female sex with 96.2% and 89.2% accuracy respectively. The overall accuracy of the model was 92.7%. Conclusion: Measurements from 3D CT using volume rendering technique were precise, and the application of logistic regression analysis predicted the sex with more accuracy.
背景:放射成像在法医人类学中起着举足轻重的作用。随着成像技术的进步,数字骨骼测量也越来越精确。在现代,人口的世俗趋势不断变化。因此,在现代人群中寻找精确的、可重复性高的骨骼测量技术是建立特定人群生物图谱的必要条件。目的和目的:本研究的目的是评估大孔测量的准确性,该测量是由三维多探测器计算机断层扫描使用体积绘制技术获得的,每个变量的截断值,用于确定个体的性别。材料与方法:对130张男女样本比例相等的放射图像进行了前后径(APD)和横向径(TD)两种度量特征的数字测量。枕骨大孔指数和枕骨大孔面积(面积由Radinsky’s [AR]计算,面积由Teixeira’s [AT]计算)由APD和TD计算。结果:描述性统计分析,采用非配对t检验,在所有变量中,男性显著高于男性。Pearson相关分析显示,面积(AT与AR r = 0.999)和面积与TD (AR r = 0.955, AT r = 0.945)的相关性最大。单独使用时,在所有参数中,TD对性别的预测价值最高(67.7%),其次是AT(65.4%)和AR(64.6%)。变量TD、AR和AT的截止值分别为29.9 mm、841.80 mm2和849.70 mm2。受试者工作特征曲线预测男性和女性的准确率分别为96.2%和89.2%。模型的总体准确率为92.7%。结论:三维CT体绘制技术测量结果准确,应用logistic回归分析预测性别更准确。
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引用次数: 1
Comparison of computed tomography imaging with traditional autopsy results 计算机断层成像与传统尸检结果的比较
Q3 Social Sciences Pub Date : 2021-01-01 DOI: 10.4103/jfsm.jfsm_70_20
Yang Li, Yang Li, Bin Wu, Bin Wu, Yong Wu, Hongliang Zhu, Jian Wang, Jianjun Li, G. He
The role of computed tomography (CT) images in forensic identification has been widely recognized. Such images can provide an important basis for identification of the cause of death in complicated and difficult cases, including falls from a height, drowning, explosion and gunshot cases, traffic accidents, and sudden death. However, few reports have focused on the application of CT images in cases of death caused by sharp object injuries. Therefore, the CT images and autopsy findings were compared in a case of death caused by sharp object injuries to the chest and abdomen, and the importance of CT images in cases of death from common sharp object injuries is herein discussed.
计算机断层扫描(CT)图像在法医鉴定中的作用已得到广泛认可。这些图像可以为查明复杂和疑难案件的死因提供重要依据,这些案件包括从高处坠落、溺水、爆炸和枪击、交通事故和猝死。然而,很少有报道关注CT图像在锐器损伤致死病例中的应用。因此,本文将一起胸部和腹部锐器伤致死亡病例的CT图像与尸检结果进行对比,并讨论CT图像在常见锐器伤致死亡病例中的重要性。
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引用次数: 0
Morphometric analysis of foramen magnum in the determination of sex using computed tomography 大孔形态计量学分析在计算机断层扫描性别判断中的应用
Q3 Social Sciences Pub Date : 2021-01-01 DOI: 10.4103/jfsm.jfsm_57_20
B. Wani, Nusrat Nazir, R. Sheikh, A. Chalkoo, Tauseefa Jan
Background: sex identification by morphological assessment of various bones of the skeleton had been one of the oldest approaches in forensic anthropology and medico-legal cases. Aim and Objective: The aim of this study was to make the morphometric measurements of the foramen magnum in determining the feasibility of sex determination using computed tomography (CT). Materials and Methods: The data for our study was obtained from 100 patients having CT scan of the head and neck region (Siemens Somatom 256 slice CT scanner) with 1mm contiguous axial scans using bone window settings (2000 HU with 400 HU in centre), scan time of one second and exposure parameters 140 kVp and 70mA. The different measurements taken include the antero-posterior (AP) diameter, transverse diameter and area of the foramen magnum. Results: There were 50 males and 50 females with the age range of 18 to 75 years. Males have a higher average value than females in all of the parameters measured on foramen magnum. By using Student's T-test, all the measured parameters showed significant difference between the sexes (p < 0.01). Conclusion: The expression of sexual dimorphism in the foramen magnum region shows significant difference between the sexes, therefore this area of the skull should be considered a useful area in the identification of sex.
背景:通过对骨骼的各种骨骼进行形态学评估来进行性别鉴定是法医人类学和法医学案件中最古老的方法之一。目的和目的:本研究的目的是对枕骨大孔进行形态测量,以确定使用计算机断层扫描(CT)确定性别的可行性。材料和方法:我们研究的数据来自100名接受头颈部CT扫描的患者(西门子Somatom 256层CT扫描仪),使用骨窗设置(2000 HU,中心为400 HU)进行1mm连续轴向扫描,扫描时间为1秒,暴露参数为140 kVp和70mA。不同的测量包括大孔的前后径、横径和面积。结果:男50例,女50例,年龄18~75岁。在大孔测量的所有参数中,男性的平均值都高于女性。结论:枕骨大孔区两性异形的表达在性别间存在显著差异,应将该区域视为性别识别的有用区域。
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引用次数: 1
Application of virtopsy in forensic pathology virtopsy在法医病理学中的应用
Q3 Social Sciences Pub Date : 2021-01-01 DOI: 10.4103/jfsm.jfsm_67_20
Wang Yucong, Zhu Haibiao, L. Ran, Zhang Haidong, Zhao Dong, Wang Xu, Yang Tiantong
Virtopsy employs computed tomography and magnetic resonance imaging, which are commonly used in clinical medicine, to determine the cause and manner of death. Virtopsy is a multidisciplinary technique that combines forensic medicine, pathology, radiology, computer graphics, biomechanics, and physics. Virtopsy is rapidly gaining importance in forensic science and has been extensively studied in several areas of forensic pathology. In this study, we reviewed domestic and international research on causes of death, traffic injuries, medical disputes, gunshot trauma, postmortem changes, and inference of time of death to discuss with colleagues the role of virtopsy in forensic pathology.
虚拟解剖采用临床医学中常用的计算机断层扫描和磁共振成像技术来确定死因和死亡方式。虚拟解剖是一门结合法医学、病理学、放射学、计算机图形学、生物力学和物理学的多学科技术。虚拟解剖术在法医科学中的重要性迅速增加,并在法医病理学的几个领域得到了广泛的研究。在本研究中,我们回顾了国内外在死因、交通伤害、医疗纠纷、枪击创伤、尸检变化和死亡时间推断方面的研究,并与同事讨论了虚拟尸检在法医病理学中的作用。
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引用次数: 0
Application of virtopsy in the police activities in China virtopsy在中国警务活动中的应用
Q3 Social Sciences Pub Date : 2021-01-01 DOI: 10.4103/jfsm.jfsm_68_20
L. Tang, Zhe Liu, Y. Xue, Leilei Zhang, Dongdong Zhao, Lijiang Diao, Yigang Zhang, Faming Teng, P. Zhao
This review summarizes the mode of application of virtual anatomy technology in the construction of a police system. Local public security organizations have explored the application modes of virtual anatomy construction, such as the multiparty co-construction mode, cooperation mode, and individual construction mode, and reviewed (1) the understanding of public security and application process of virtual anatomy; (2) the problems faced in the construction and application processes, such as those associated with support of human resources, equipment supplies and financial expenditure, the limitations of the technology itself, legal issues with application, shrinkage of the identification business, and appraiser-related problems; and (3) the prospect of application of virtopsy in public security systems.
本文综述了虚拟解剖技术在公安系统建设中的应用模式。各地公安机关探索了多方共建模式、合作模式、个别建设模式等虚拟解剖建设的应用模式,并回顾了(1)对公安的认识和虚拟解剖的应用流程;(2)在建设和应用过程中面临的问题,如人力资源支持、设备供应和财政支出、技术本身的局限性、应用中的法律问题、鉴定业务萎缩、鉴定人员相关问题等;(3)虚拟解剖在公安系统中的应用前景。
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引用次数: 3
A study on a virtual simulation experiment with DNA in a biological evidence technology course during the COVID-19 pandemic 新冠肺炎大流行期间生物证据技术课程中DNA虚拟模拟实验的研究
Q3 Social Sciences Pub Date : 2020-10-01 DOI: 10.4103/jfsm.jfsm_69_20
Zhenjun Jia, G. Chunfang, Dai Peng, Liu Zhuo, Qian Zunlei, Yao Weixuan
Biological evidence technology plays an important role in the field of crime scene investigation. DNA technology is known as one of the important ways to make a breakthrough in the resolution of a criminal case. Nonetheless, there are some problems in on-site experiment-based teaching during the COVID-2019 pandemic, which limits the students' incentives to acquire knowledge about DNA. Under these conditions, the goals and requirements of the Biological Evidence Technology course cannot be achieved. A virtual simulation experiment can solve these problems online. The students can gain a deeper understanding of the process and method of human DNA extraction and identification, and thus, the impact of experiment-based teaching improves. In this paper, we discuss the contents of DNA experiments, specifications of the simulation system, system requirements, the implementation process, and other parameters of the design. We investigated the early teaching effect. A virtual simulation experiment with DNA can overcome the limitations of devices (and other equipment) and spatial and temporal limitations during the COVID-2019 pandemic. Students can participate in the whole process of experiment-based teaching. Teaching mode “Internet + laboratory” increases the open access and sharing of experiment-based teaching resources.
生物证据技术在犯罪现场勘查领域发挥着重要作用。DNA技术被认为是解决刑事案件取得突破的重要途径之一。尽管如此,在2019冠状病毒病疫情期间,现场实验教学仍存在一些问题,这限制了学生获得DNA知识的动机。在这种情况下,生物证据技术课程的目标和要求就无法实现。虚拟仿真实验可以在线解决这些问题。学生可以更深入地了解人类DNA提取和鉴定的过程和方法,从而提高实验教学的效果。在本文中,我们讨论了DNA实验的内容、模拟系统的规格、系统要求、实现过程以及设计的其他参数。我们调查了早期的教学效果。在2019冠状病毒病大流行期间,使用DNA的虚拟模拟实验可以克服设备(和其他设备)的限制以及空间和时间限制。学生可以全程参与实验教学。“互联网+实验室”的教学模式,增加了实验教学资源的开放获取和共享。
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引用次数: 3
Evaluation of pedestrian–train fatalities in the State of Maryland: A 5-year retrospective study 马里兰州行人与火车交通事故死亡率评估:一项5年回顾性研究
Q3 Social Sciences Pub Date : 2020-10-01 DOI: 10.4103/jfsm.jfsm_75_20
Elvira Carias, Claire Hammerschmidt, T. Hall, Xiang Zhang, Rebecca Phipps, Ling Li
Few studies have been done on the incidences of train-related pedestrian fatalities throughout the United States, with no previous studies reported in the State of Maryland. A retrospective study was conducted at the statewide medical examiner's office in Maryland to evaluate the characteristics of train-related pedestrian fatalities from 2014 to 2018. The aim of the study was to analyze circumstances of deaths through the medicolegal death investigation and postmortem examination findings, including toxicological study, to help identify epidemiological characteristics of pedestrian–train-related fatalities. A total of 48 pedestrian-train deaths were identified. Of the 48 cases identified, 21 deaths (43.75%) were determined to be accident, 20 deaths (41.67%) were suicide, and 7 deaths (14.58%) whose manner of death could not be determined. Of the 21 accidental victims, 17 were male and 4 were female (M:F ratio = 4.3:1), 11 (52.38%) were white, 6 (28.57%) African American, and 4 Hispanic (19.05%), with age ranging from 16 to 58 years (mean age = 35). Of the 20 suicide victims, 17 were males and 3 females (M:F ratio = 5.7:1), 16 (80%) were white, 2 (10%) African American, and 2 (10%) Hispanic, with age ranging from 22 to 60 years (mean age = 40). The majority of accidents occurred during weekday evening rush hours between 4:00 pm and 7:00 pm, while the suicides showed no specific time frames. No specific peak for seasons of year was found in suicides or accidents. Postmortem toxicological studies showed that 52.38% (11/21 cases) of accidental victims were positive for alcohol and 30% (6/20 cases) of suicide victims were positive for alcohol. Manner of death could not be determined in 7 cases because of unclear circumstances of death. Thorough death scene investigation and complete postmortem examination, including comprehensive toxicological testing, is very important in all train-related pedestrian fatalities. Determining the manner of death can directly affect the outcome of civil ligation and dispersal of insurance benefits. The characteristic profiles of train-related pedestrian fatalities can also assist effective preventive measures on railway suicides and accidents.
关于美国各地与火车相关的行人死亡事件的研究很少,此前在马里兰州也没有研究报告。在马里兰州的全州法医办公室进行了一项回顾性研究,以评估2014年至2018年与火车相关的行人死亡的特征。该研究的目的是通过法医死亡调查和尸检结果(包括毒理学研究)分析死亡情况,以帮助确定行人与火车相关死亡的流行病学特征。共有48名行人在火车上死亡。48例死亡中,事故死亡21例(43.75%),自杀死亡20例(41.67%),死亡方式无法确定的死亡7例(14.58%)。21例意外死亡者中男性17例,女性4例(M:F比为4.3:1),白人11例(52.38%),非裔6例(28.57%),西班牙裔4例(19.05%),年龄16 ~ 58岁,平均年龄35岁。20例自杀患者中,男性17例,女性3例(M:F = 5.7:1),白人16例(80%),非裔2例(10%),西班牙裔2例(10%),年龄22 ~ 60岁(平均40岁)。大多数事故发生在工作日晚高峰时间下午4点至7点之间,而自杀事件没有具体的时间范围。自杀或事故发生率在一年中没有特定的高峰。死后毒理学研究表明,52.38%(11/21例)的意外受害者酒精检测呈阳性,30%(6/20例)的自杀受害者酒精检测呈阳性。由于死亡情况不明,7起案件的死亡方式无法确定。在所有与火车有关的行人死亡事故中,彻底的死亡现场调查和完整的尸检,包括全面的毒理学测试,是非常重要的。死亡方式的确定直接影响民事诉讼的结果和保险金的分配。与火车有关的行人死亡的特征也有助于有效预防铁路自杀和事故的措施。
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引用次数: 1
Expediting the development of virtopsy identification technology in forensic medicine in China 加快中国法医学虚拟解剖鉴定技术的发展
Q3 Social Sciences Pub Date : 2020-10-01 DOI: 10.4103/jfsm.jfsm_74_20
L. Xin, Zheng Xiechang
Virtopsy technology is noninvasive, noncontact, and can find potential lesions. For these reasons, it has broad application prospects in forensic pathology and forensic clinical science. The present article reviews the brief history of virtopsy development, introduces the application of virtopsy in various fields of forensic medicine, summarizes the current situation regarding virtopsy in China, and puts forward suggestions for strengthening planning, setting standards, strengthening assistance, and promoting scientific research.
虚拟解剖技术是非侵入性的,非接触的,可以发现潜在的病变。因此,它在法医病理学和法医临床科学中具有广阔的应用前景。本文回顾了虚拟解剖的发展简史,介绍了虚拟解剖在法医学各个领域的应用,总结了中国虚拟解剖的现状,并提出了加强规划、制定标准、加强援助、促进科学研究的建议。
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引用次数: 0
A preliminary gas chromatography-mass spectrometry-based metabolomics study of rats ingested diazepam or clonazepam 大鼠摄入安定或氯硝西泮的初步气相色谱-质谱代谢组学研究
Q3 Social Sciences Pub Date : 2020-10-01 DOI: 10.4103/jfsm.jfsm_29_20
S. Fang, Jianxia Chen, X. Dai, Yuzi Zheng, Hao Wu, Yingqiang Fu, Jian Li, Y. Ye, Linchuan Liao
Drug-facilitated sexual assault (DFSA) is a sexual act in which the victim is unable to give or rescind consent due to alcohol or drug intoxication, which involved the abuse of benzodiazepines around the world. Conventional techniques used for the analysis of benzodiazepines have the limitation of short detection time window due to the rapid metabolism of these drugs in body. This study aimed to investigate the characteristic changes of metabolites in the blood of rats after ingesting diazepam/clonazepam through a gas chromatography-mass spectrometry-based metabolomics method, allowing the indirect reveal of the rats ingested diazepam/clonazepam. First, we found that diazepam and clonazepam in the blood of rats could not be detected by liquid chromatography-tandem mass spectrometry after 48 h of ingestion. Then, orthogonal partial least squares discrimination analysis regression models were, respectively, constructed to determine whether the rats ingested diazepam/clonazepam after 48 h. The results showed that 5 metabolites were found to be associated with diazepam exposure, and 7 metabolites were found to be associated with clonazepam exposure, which may be characterization for the evaluation of digestion of diazepam and clonazepam in rat.
药物性侵犯(DFSA)是一种性行为,受害者因酒精或药物中毒而无法给予或撤销同意,涉及世界各地滥用苯二氮卓类药物。用于分析苯二氮卓类药物的常规技术由于这些药物在体内的快速代谢而具有检测时间窗短的局限性。本研究旨在通过基于气相色谱-质谱的代谢组学方法,研究大鼠摄入地西泮/氯硝西泮后血液中代谢产物的特征变化,从而间接揭示大鼠摄入的地西泮和氯硝西仑。首先,我们发现大鼠摄入48小时后,液相色谱-串联质谱法无法检测到血液中的地西泮和氯硝西泮。然后,分别构建了正交偏最小二乘判别分析回归模型,以确定大鼠在48小时后是否摄入了地西泮/氯硝西泮。结果显示,发现5种代谢产物与地西泮暴露有关,7种代谢物与氯硝西仑暴露有关,这可能是评价地西泮和氯硝西泮在大鼠体内消化的特征。
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引用次数: 2
期刊
Journal of Forensic Science and Medicine
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