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Sample records for medicolegal external postmortem

  1. [Medicolegal experiences in external post-mortem examinations before cremation--a retrospective analysis of the years 1998-2008].

    PubMed

    Eckstein, Philipp; Schyma, Christian; Madea, Burkhard

    2010-01-01

    The paper presents a retrospective analysis of 16,541 external post-mortem examinations carried out before cremation by the Institute of Forensic Medicine of the University of Bonn between 1998 and 2008 with regard to different variables (age, sex, place of death, cause of death etc.). In more than 50 % of cases, the individuals had died in a hospital followed by their apartment or a nursing home. The first post-mortem examination was mainly performed by hospital doctors followed by emergency doctors and office practitioners. As to the age distribution, the 6th to 8th decade of life was prevalent. In 99.8 %, a natural death was certified in the first external post-mortem and only in 0.2 % the manner of death was determined to be non-natural or unclear. In more than half of the cases, the non-natural deaths were determined by emergency doctors. Deaths wrongly classified in the first external post-mortem were mostly accidents and deaths associated with medical procedures. Although the second external examination before cremation is very useful in detecting previously overlooked signs of homicide, it is only of limited value in homicides with few external traces or for detecting underlying diseases and causes of death. In this respect, the second external examination before cremation can only check the plausibility of the cause of death given by the attending physician. The gold standard for a reliable certification of the manner and cause of death remains the autopsy.

  2. [The possibility of medico-legal opinionating on medical error in cases of waived postmortem examination].

    PubMed

    Kunz, Jerzy

    2008-01-01

    For several years now, with the introduction of the health care sector reform we have been observing a considerable drop in the number of postmortem examinations performed in patients who died in hospitals. The decrease amounts to as much as 50 to 70%. This is undoubtedly a consequence of financial restrictions imposed on the management of these inpatient facilities. On the other hand, Departments of Forensic Medicine established to evaluate the so-called medical errors are swamped with an increasing avalanche of complaints concerning the appropriateness of therapeutic management. This leads to a growing number of orders from penal prosecution and jurisdiction agencies with requests for assessment whether a medical error has been committed in a particular case. The result of a postmortem examination is practically the only basis for a factual evaluation of a given case. When no autopsy has been performed, the experts are virtually helpless, and in the majority of such instances, they are forced to refuse passing an expert opinion. The report presents basic principles of medico-legal opinionating in criminal cases (including proceedings pertaining to medical errors), the rules governing the medical error assessment, as well as problems encountered in evaluating the appropriate course of treatment when a post mortem examination has been waived.

  3. Unexpected post-mortem diagnosis of systemic sclerosis presenting as pneumatosis intestinalis: revised diagnostic criteria and medicolegal implications.

    PubMed

    Leduc, Charles; Young, Iain D; Joneja, Mala G; Parker, Christopher M

    2015-01-01

    Systemic sclerosis is a challenging diagnosis for clinicians and pathologists alike due to its protean manifestations and often insidious onset, particularly in cases without significant titres of auto-antibodies. Herein we present a case of a female in her sixties who died rapidly following a clinical diagnosis of pneumatosis intestinalis and respiratory failure of unclear etiology. Recently revised clinical diagnostic criteria were applied to the clinical history and postmortem findings to reach an unexpected diagnosis of systemic sclerosis. The diagnosis of systemic sclerosis at autopsy has important medicolegal implications largely related to premature death due to delayed treatment or poor post-operative outcome. Moreover, familial clustering of this disease underscores the importance of maintaining a high index of suspicion in the postmortem setting.

  4. Post-mortem alcohol analysis in synovial fluid: an alternative method for estimation of blood alcohol level in medico-legal autopsies?

    PubMed

    Büyük, Yalçin; Eke, Murat; Cagdir, A Sadi; Karaaslan, Hicran K

    2009-06-01

    To evaluate the effectiveness of synovial fluid alcohol concentration in prediction of blood alcohol concentration, synovial fluid and blood was studied of 50 autopsy cases and the alcohol levels determined by using Head Space Gas Chromatography method. To exclude the effect of decomposition on alcohol levels, corpses with post-mortem intervals less than 24 hours and not showing signs of decomposition were selected. Of 50 cases, alcohol was detected in 15 cases both in blood and in synovial fluid. In 35 cases alcohol analysis was negative both in blood and synovial fluid. No false positive results were seen in terms of synovial fluid. In two of the 15 cases, the alcohol determined was methyl alcohol and in others the alcohol was ethyl alcohol. In these 15 cases, only in one case was SAC level lower than the BAC level, and in 14 cases; SAC levels were higher than those of BAC. BAC (Blood Alcohol Concentration)/SAC (Synovial Fluid Alcohol Concentration) ratios were determined, and in 13 ethanol cases the mean ratio was determined to be 0.95 (0.90 +/- 0.07). The regression analysis showed a fairly linear relationship between the BAC and SAC, with a correlation coefficient of 0.984 (y = 0.86x + 10.4). The present study demonstrates that the synovial fluid is a valuable body fluid that can be used in prediction of blood alcohol concentration in forensic autopsy cases in which blood can not be properly obtained.

  5. Teaching post-mortem external examination in undergraduate medical education--the formal and the informal curriculum.

    PubMed

    Anders, Sven; Fischer-Bruegge, Dorothee; Fabian, Merle; Raupach, Tobias; Petersen-Ewert, Corinna; Harendza, Sigrid

    2011-07-15

    In undergraduate medical education, the training of post-mortem external examination on dead bodies might evoke strong emotional reactions in medical students that could counteract the intended learning goals. We evaluated student perception of a forensic medicine course, their perceived learning outcome (via self-assessment) and possible tutor-dependent influences on the overall evaluation of the course by a questionnaire-based survey among 150 medical students in Hamburg, Germany. The majority of students identified post-mortem external examination as an important learning objective in undergraduate medical education and did not feel that the dignity of the deceased was offended by the course procedures. After the course, more than 70% of the students felt able to perform an external examination and to fill in a death certificate. Respectful behavior of course tutors towards the deceased entailed better overall course ratings by students (p<0.001). Our findings highlight the importance of factors such as clearly defined learning goals and course standardization (formal curriculum) as well as tutor behavior (informal curriculum) in undergraduate education in forensic medicine. Furthermore, we suggest embedding teaching in forensic medicine in longitudinal curricula on death and dying and on the health consequences of interpersonal violence.

  6. [Obligation to report occupational diseases. Importance of external post-mortem examinations before cremation].

    PubMed

    Verhoff, M A; Risse, M; Alles, J-U; Müller, K-M; Stachetzki, U

    2004-05-01

    The practical use of the legally required documentation of occupational diseases is demonstrated by a case of asbestos-related pleural mesothelioma. During the mandatory inquest before cremation, information of manifest pleural mesothelioma had been relayed to the widow of the patient, and an investigation for a possible occupational disease was performed. Reconstruction of the case showed that in the course of 3 months at least 13 physicians had been involved in in-hospital as well as ambulatory therapeutic measures. Until death, none of them informed the trade association about a suspected occupational disease in accordance with BK 4105 of the codex of occupational diseases, although the diagnosis of manifest pleural mesothelioma had been histologically confirmed already 10 weeks prior to the death of the patient. This case demonstrates obvious and evident deficiencies in applying the Code of Social Law VII, which requires physicians to report occupational diseases. In addition, it shows the importance of the post-mortem examination as a control function before cremation.

  7. Postmortem MSCT diagnosis of whiplash injuries in a traffic accident: a case report and review of the literature.

    PubMed

    Chen, Min; Huang, Ping; Wan, Lei; Zhang, Jian-Hua; Liu, Ning-Guo; Zou, Dong-Hua; Li, Zheng-Dong; Shao, Yu; Qin, Zhi-Qiang; Chen, Yi-Jiu

    2014-04-01

    A 45-year-old male car driver died in a traffic accident of four cars rear-end collision on the highway. He was found to have died after a respiratory and cardiac arrest at the scene. No sign of skin injuries was observed from the external inspection. The autopsy was not permitted by the family members because of the local culture. Multislice computed tomography (MSCT) was applied to the current case, showing dislocation of C3-4 cervical vertebrae with II degree, C4 vertebral plate fractures, and spinal stenosis. Post-mortem MSCT confirmed the diagnosis as whiplash injuries. MSCT was verified to be effective in showing the severity of whiplash injuries, thus providing certain objective evidence for medicolegal expertise.

  8. [Two complex suicidal poisonings with drugs and their medicolegal aspects].

    PubMed

    Kłys, M; Skupień, E; Bujak-Gizycka, B; Latacz, B

    2001-01-01

    The main subject of the study was a toxicological investigation of biological specimens coming from two cases of intoxication with mixture of drugs. Two young people decided to commit suicide by the use of mixture of drugs mainly analgesic in approximately equal doses. For one person the dose of drugs administered turned out to be fatal while second person survived with the symptoms of acute intoxication. The analysis carried out with the use of liquid chromatographic method with mass detection (HPLC/MS) confirmed the presence of mixture of drugs in blood of living person and in postmortem specimens of the victim in significant concentrations. The toxicological findings have delivered information for discussion in medico-legal and ethical aspects.

  9. The forensic radiographer: a new member in the medicolegal team.

    PubMed

    Schneider, Benjamin; Chevallier, Christine; Dominguez, Alejandro; Bruguier, Christine; Elandoy, Cristèle; Mangin, Patrice; Grabherr, Silke

    2012-03-01

    Multidetector computed tomography is becoming more widespread in forensic medicine. In most services, autopsy assistants perform the radiological examination. We introduced professional radiographers into the legal medicine service and hypothesized they would also be able to take over duties currently reserved for other specialists. The aims of this study were to evaluate if radiographers could be trained as "forensic radiographers" by (1) integrating graduated medical radiographers into the legal medicine service, (2) investigating the advantages of this collaboration, and (3) defining the duties of the forensic radiographers.The study was performed prospectively on a group of 8 recruited radiographers who underwent a testing period with special training. They learned the basics of medicolegal case treatment, the autonomous execution of postmortem computed tomography angiography, and postprocessing of data. Seven of 8 radiographers finished the training and were integrated into our service. Although all radiographers were able to fulfill the duties demanded after the training period, some radiographers could not enter or complete the program because they were unable to work with dead bodies.Our study presents the advantages of integrating radiographers into the medicolegal team and proposes how to train the forensic radiographers. In addition, the duties and responsibilities of these new specialists are defined.

  10. Dissociative identity disorder: Medicolegal challenges.

    PubMed

    Farrell, Helen M

    2011-01-01

    Persons with dissociative identity disorder (DID) often present in the criminal justice system rather than the mental health system and perplex experts in both professions. DID is a controversial diagnosis with important medicolegal implications. Defendants have claimed that they committed serious crimes, including rape or murder, while they were in a dissociated state. Asserting that their alter personality committed the bad act, defendants have pleaded not guilty by reason of insanity (NGRI). In such instances, forensic experts are asked to assess the defendant for DID and provide testimony in court. Debate continues over whether DID truly exists, whether expert testimony should be allowed into evidence, and whether it should exculpate defendants for their criminal acts. This article reviews historical and theoretical perspectives on DID, presents cases that illustrate the legal implications and controversies of raising an insanity defense based on multiple personalities, and examines the role of forensic experts asked to comment on DID with the goal of assisting clinicians in the medicolegal assessment of DID in relation to crimes.

  11. The First Survey of Forensically Important Entomofauna Collected from Medicolegal Autopsies in South Korea

    PubMed Central

    Shin, Sang Eon; Lee, Hyun Ju; Park, Ji Hye; Ko, Kwang Soo; Kim, Yu-Hoon; Kim, Kyung Ryoul; Park, Seong Hwan

    2015-01-01

    Forensic entomology applies insect evidence to legal problems such as the estimation of minimum postmortem interval (mPMI). For this purpose, knowledge of the insect fauna that are attracted to human cadavers in each geographic region is a prerequisite. Despite many studies investigating the insect fauna attracted to meat, there has been no survey of the entomofauna on human cadavers in the East Asian temperate climate zone, particularly in Korea. Therefore, this study reports the entomofauna collected from medicolegal autopsies in northeastern Seoul and its suburbs. Insect samples were collected from 35 medicolegal autopsies in 2010, 2011, and 2013. Molecular and morphological methods were utilized for taxonomic identification. Among 1398 individual samples belonging to 3 orders, 13 families, 18 genera, and 32 species, the dominant family and species were Calliphoridae and Lucilia sericata, respectively. Despite its limited scale, this study provides a snapshot of the general entomofauna that are attracted to human cadavers in this region. PMID:26185759

  12. Injury-related mortality in South Africa: a retrospective descriptive study of postmortem investigations

    PubMed Central

    Prinsloo, Megan; Pillay-van Wyk, Victoria; Gwebushe, Nomonde; Mathews, Shanaaz; Martin, Lorna J; Laubscher, Ria; Abrahams, Naeemah; Msemburi, William; Lombard, Carl; Bradshaw, Debbie

    2015-01-01

    Abstract Objective To investigate injury-related mortality in South Africa using a nationally representative sample and compare the results with previous estimates. Methods We conducted a retrospective descriptive study of medico-legal postmortem investigation data from mortuaries using a multistage random sample, stratified by urban and non-urban areas and mortuary size. We calculated age-specific and age-standardized mortality rates for external causes of death. Findings Postmortem reports revealed 52 493 injury-related deaths in 2009 (95% confidence interval, CI: 46 930–58 057). Almost half (25 499) were intentionally inflicted. Age-standardized mortality rates per 100 000 population were as follows: all injuries: 109.0 (95% CI: 97.1–121.0); homicide 38.4 (95% CI: 33.8–43.0; suicide 13.4 (95% CI: 11.6–15.2) and road-traffic injury 36.1 (95% CI: 30.9–41.3). Using postmortem reports, we found more than three times as many deaths from homicide and road-traffic injury than had been recorded by vital registration for this period. The homicide rate was similar to the estimate for South Africa from a global analysis, but road-traffic and suicide rates were almost fourfold higher. Conclusion This is the first nationally representative sample of injury-related mortality in South Africa. It provides more accurate estimates and cause-specific profiles that are not available from other sources. PMID:26229201

  13. Postmortem mRNA profiling II: Practical considerations.

    PubMed

    Vennemann, Marielle; Koppelkamm, Antje

    2010-12-15

    Using human postmortem tissues for gene expression studies is particularly challenging. Besides the problem of impaired RNA one has to face a very high degree of biological variance within a sample set. Variations of individual parameters like age, body mass, health, but also the cause and circumstances of death and the postmortem interval lead to a rather inhomogeneous collection of samples. To meet these problems it is necessary to consider certain precautions before starting a gene expression project. These precautions include the sample collection and the determination of the RNA integrity, the number of replicates needed and the methods used for reverse transcription and quantitative polymerase chain reaction, but also the strategy for data normalisation and data interpretation. In this article practical issues are discussed to address some of the problems occurring in the work with postmortem human samples obtained during medico-legal autopsy.

  14. Indoor air quality medicolegal issues.

    PubMed

    Ross, C S; Lockey, J E

    1994-08-01

    The regulatory and legal communities have begun only recently to address the medicolegal issues surrounding indoor air quality. No single governmental agency is responsible for indoor air quality issues. The focus of the federal government's indoor air quality programs is on the gathering and dissemination of information rather than on the regulation of indoor air pollution. State and local regulatory controls vary but may include antismoking ordinances, building codes, and contractor certification programs. Numerous lawsuits involving various parties and legal theories have been filed on the basis of illness allegedly related to indoor air quality. Further regulatory and legal review of indoor air problems will likely occur in the near future, particularly as a result of the characterization of environmental tobacco smoke as a class A carcinogen.

  15. MEDICOLEGAL INTEREST OF THE IMMUNOFLUORESCENT PREGNANCY TEST

    DTIC Science & Technology

    characteristics of an absolutely certain diagnostic test and is recommendable in those conditions of obstetrical and medicolegal interest which cannot be solved unequivocally by means of the usual tests .

  16. [Unusual questions of evidence in a case of offensive post-mortem dismemberment].

    PubMed

    Madea, Burkhard; Schmidt, Peter; Preuss, Johanna; Dietmar, Elenz

    2010-01-01

    In cases of post-mortem dismemberment, the main medicolegal task apart from the identification and assignment of body parts to one or several individuals is the determination of the cause of death and the course of events. Notably in cases of offensive postmortem dismemberment, the medicolegal findings on the victim may be of special importance also for the psychiatric evaluation of the suspect. In a case of offensive post-mortem dismemberment, parts of the body were found in a stone quarry and in the apartment where the victim and the suspect had lived together. Since the suspect refused to make a statement, the medicolegal findings were of great relevance for the psychiatric evaluation. In the first trial, in which the psychiatric expert was not present when the forensic pathologist gave his opinion, the Regional Court acquitted the suspect of murder and committed him to a psychiatric hospital. The accused successfully appealed on points of law, as the form and content of the psychiatric expert opinion did not comply with the requirements of procedural law and the forensic psychiatric state of the art. In a second trial, additional psychiatric experts were summoned. In that hearing, the task of the medicolegal expert was to reconstruct the course of events as far as possible to create a reliable basis for the psychiatric evaluation, as the suspect refused to make a statement both with regard to his personal circumstances and the facts of the case and did not agree to a psychiatric exploration either. The motivational and morphological criteria of the medicolegal classification as offensive post-mortem dismemberment with a cannibalistic background are discussed. In addition, some issues to be answered such as the detection of bloodstains on nonporous surfaces by means of leucocrystalviolet and the time of heat exposure of burned body parts are dealt with.

  17. Estimation of postmortem interval through albumin in CSF by simple dye binding method.

    PubMed

    Parmar, Ankita K; Menon, Shobhana K

    2015-12-01

    Estimation of postmortem interval is a very important question in some medicolegal investigations. For the precise estimation of postmortem interval, there is a need of a method which can give accurate estimation. Bromocresol green (BCG) is a simple dye binding method and widely used in routine practice. Application of this method in forensic practice may bring revolutionary changes. In this study, cerebrospinal fluid was aspirated from cisternal puncture from 100 autopsies. A study was carried out on concentration of albumin with respect to postmortem interval. After death, albumin present in CSF undergoes changes, after 72 h of death, concentration of albumin has become 0.012 mM, and this decrease was linear from 2 h to 72 h. An important relationship was found between albumin concentration and postmortem interval with an error of ± 1-4h. The study concludes that CSF albumin can be a useful and significant parameter in estimation of postmortem interval.

  18. Toward a universal equation to estimate postmortem interval.

    PubMed

    Maile, Amy E; Inoue, Christopher G; Barksdale, Larry E; Carter, David O

    2017-03-01

    Estimating postmortem interval is an important goal in medicolegal death investigations. Although several methods have been developed to achieve this goal, many of these require significant time and advanced expertise to generate a reliable estimate. Unfortunately these techniques do not provide much insight during the early stages of an investigation when critical decisions must be made regarding the allocation of investigative resources. An equation was recently developed to address this problem: provide a preliminary estimate of postmortem interval to initiate an investigation while more advanced techniques are conducted. To evaluate this equation, we used it to estimate postmortem interval at multiple indoor death scenes with known PMI in Nebraska and Hawai'i. This equation allowed us to accurately estimate PMI at 15 of 19 (79%) indoor death scenes. In Nebraska, this equation was accurate at 100% of the scenes. In Hawai'i, this equation was accurate at 60% of the scenes. All inaccurate estimates of postmortem interval were associated with at least 20% mass loss and a postmortem interval of ≥4 days. Although this equation was accurate at the majority of the death scenes attended, we conclude that more research is warranted, particularly the effect of climate on decomposition and the investigators' ability to accurately estimate soft tissue mass loss.

  19. Evaluating medico-legal decisional competency criteria.

    PubMed

    Whiting, Demian

    2015-06-01

    In this paper I get clearer on the considerations that ought to inform the evaluation and development of medico-legal competency criteria-where this is taken to be a question regarding the abilities that ought to be needed for a patient to be found competent in medico-legal contexts. In the "Decisional Competency in Medico-Legal Contexts" section I explore how the question regarding the abilities that ought to be needed for decisional competence is to be interpreted. I begin by considering an interpretation that takes the question to be asking about the abilities needed to satisfy an idealized view of competent decision-making, according to which decisional competency is a matter of possessing those abilities or attributes that are needed to engage in good or effective or, perhaps, substantially autonomous or rational decision-making. The view has some plausibility-it accords with the way decisional competency is understood in a number of everyday contexts-but fails as an interpretation of the question regarding the abilities that should be needed for decisional competence in medico-legal contexts. Nevertheless, consideration of why it is mistaken suggests a more accurate interpretation and points the way in which the question regarding the evaluation of medico-legal competency criteria is to be answered. Building on other scholarly work in the area, I outline in the "Primary and Secondary Requirements" section several requirements that decisional competence criteria ought to satisfy. Then, in the "Applying the Framework" section, I say something about the extent to which medico-legal competency criteria, as well as some models of decisional competency proposed in the academic literature, fulfil those requirements.

  20. The medico-legal scene in Dubai: 2002-2007.

    PubMed

    Benomran, Fawzi A

    2009-08-01

    Various characteristics of the medico-legal scene in Dubai are described, along with an overview of all cases examined over a period of 6 years. During the period of study, a total of 17,683 cases were examined in the Department of Forensic Medicine of Dubai Police General Headquarters. This constituted a yearly average of (2947.16). The average annual increment was 11.13%, the percentage of increase between 2002 and 2007 being 68.96%. Of these 10,165 (57.48%) were clinical cases of injuries, 5404 (30.56%) postmortem examinations, 1525 (8.62%) clinical cases of sexual crimes, 409 (2.3%) age estimations, 58 (0.32%) medical responsibility, 20 (0.11%) criminal abortion, 61 (0.34%) civil actions and 38 (0.21%) miscellaneous cases. Of postmortem examinations, 4846 (89.7%) of them were males and 558 (10.3%) females. The age ranged from (0-90) years, with a mean age of 40.5 years. The peak incidence was in the age group (20-50) years, where the extremes of age were least represented (Fig. 1). Only in 361 cases (6.68% of the grand total) the deceased was a local citizen. Autopsies amounted to 394 cases, which constituted 7.29% of the total deaths examined. The four manners of death in descending order of frequency were natural 3003 (55.57%), accidental 1727 (32%), suicidal 498 (9.2%), homicidal 164 (3%). The manner was undetermined in 12 (0.22%) of the cases over the 6 year period.

  1. Pharmacogenetics in medico-legal context.

    PubMed

    Sajantila, A; Palo, J U; Ojanperä, I; Davis, C; Budowle, B

    2010-12-15

    Medico-legal autopsy is the primary method in determining the cause and manner of death when the death is suspected to be unnatural. In some of these autopsies, the death remains ambiguous, even after a complete autopsy including histological investigation and toxicological screenings. In cases where there are no morphological abnormalities, medico-legal genetics may offer additional means to provide knowledge of possible genetic mutations, which may have initiated the process or predisposed the individual to stress risk conditions leading to death. One class of ambiguous deaths consists of drug-related deaths where the interpretation of the toxicological results are not clear. In such situations post mortem genotyping and the analysis of metabolite rations may provide an insight to the findings. A few cases demonstrating the potential strength of pharmacogenetics in medico-legal context has been published. However, there is a paramount need for serious scientific studies before the field of post mortem pharmacogenetics can be utilized in routine medico-legal analyses casework and brought routinely into courtroom.

  2. Advances in post-mortem CT-angiography

    PubMed Central

    Grimm, J; Dominguez, A; Vanhaebost, J; Mangin, P

    2014-01-01

    Performing a post-mortem multidetector CT (MDCT) scan has already become routine in some institutes of forensic medicine. To better visualize the vascular system, different techniques of post-mortem CT-angiography have been explored, which can essentially be divided into partial- and whole-body angiography techniques. Probably the most frequently applied technique today is the so-called multiphase post-mortem CT-angiography (MPMCTA) a standardized method for investigating the vessels of the head, thorax and abdomen. Different studies exist, describing its use for medicolegal investigations, and its advantages as well as its artefacts and pitfalls. With the aim to investigate the performance of PMCTA and to develop and validate techniques, an international working group was created in 2012 called the “Technical Working Group Post-mortem Angiography Methods” (TWGPAM). Beyond its primary perspective, the goals of this group include creating recommendations for the indication of the investigation and for the interpretation of the images and to distribute knowledge about PMCTA. This article provides an overview about the different approaches that have been developed and tested in recent years and an update about ongoing research in this field. It will explain the technique of MPMCTA in detail and give an outline of its indications, application, advantages and limitations. PMID:24234582

  3. Surgical interventions with fatal outcome: utility of multi-phase postmortem CT angiography.

    PubMed

    Zerlauth, J-B; Doenz, F; Dominguez, A; Palmiere, C; Uské, A; Meuli, R; Grabherr, S

    2013-02-10

    Cases of fatal outcome after surgical intervention are autopsied to determine the cause of death and to investigate whether medical error caused or contributed to the death. For medico-legal purposes, it is imperative that autopsy findings are documented clearly. Modern imaging techniques such as multi-detector computed tomography (MDCT) and postmortem CT angiography, which is used for vascular system imaging, are useful tools for determining cause of death. The aim of this study was to determine the utility of postmortem CT angiography for the medico-legal death investigation. This study investigated 10 medico-legal cases with a fatal outcome after surgical intervention using multi-phase postmortem whole body CT angiography. A native CT scan was performed as well as three angiographic phases (arterial, venous, and dynamic) using a Virtangio(®) perfusion device and the oily contrast agent, Angiofil(®). The results of conventional autopsy were compared to those from the radiological investigations. We also investigated whether the radiological findings affected the final interpretation of cause-of-death. Causes of death were hemorrhagic shock, intracerebral hemorrhage, septic shock, and a combination of hemorrhage and blood aspiration. The diagnoses were made by conventional autopsy as well as by postmortem CT angiography. Hemorrhage played an important role in eight of ten cases. The radiological exam revealed the exact source of bleeding in seven of the eight cases, whereas conventional autopsy localized the source of bleeding only generally in five of the seven cases. In one case, neither conventional autopsy nor CT angiography identified the source of hemorrhage. We conclude that postmortem CT angiography is extremely useful for investigating deaths following surgical interventions. This technique helps document autopsy findings and allows a second examination if it is needed; specifically, it detects and visualizes the sources of hemorrhages in detail, which

  4. Medicolegal Implications of Common Rhinologic Medications.

    PubMed

    Poetker, David M; Smith, Timothy L

    2015-10-01

    As otolaryngologists, we prescribe many medications to our patients. The objective of this article is to review the potential side effects and medicolegal risks of the common medications used to treat chronic rhinosinusitis. The authors evaluate some of the common side effects as well as the published literature on the lawsuits associated with those medications. Finally, the authors review the informed consent discussion and opportunities to improve patient care and decrease the risk of litigation.

  5. [Pre- and perimortem bone trauma vs. postmortem damages-- Principles of differentiation].

    PubMed

    Holz, Franziska; Birngruber, Christoph G; Verhoff, Marcel A

    2015-01-01

    In medicolegal practice, evidence of trauma or damage on human skeletons or single bones raises the question whether this was inflicted in an antemortem, perimortem, or postmortem time frame. Trauma that occurred around the time of death, i. e., perimortem trauma, is of special forensic interest, as it can yield clues about the manner and cause of death. Perimortem traumas thus need to be carefully distinguished both from antemortem injuries that were evidently survived (these can still be useful for identification purposes) and from postmortem damage, as may occur during retrieval of remains. This study offers an up-to-date review of the specialist literature, e. g. textbooks and pubmed-listed publications, identifying differentiation criteria for ante- and perimortem traumas and postmortem damage. The results that are useful for practice in actual medicolegal casework are presented, and an overview of all macroscopically visible criteria (including simple magnifications, i. e., magnifying glass) that can be used to distinguish between ante- and perimortem traumas on the one side, and postmortem damage on the other is given. The difficulty of distinguishing antemortem trauma and postmortem damage from perimortem trauma rises sharply the closer in time they were inflicted to the time of the death event. Additional postmortem changes due to exposure of the bones to the surrounding deposition conditions may also occur after the relevant postmortem damage or antemortem trauma was inflicted and further complicate the problem. In this context, the "perimortem interval" and the "Fracture Freshness Index" (FFI) are discussed as means to classify the time frame of traumas.

  6. Cannabinoids in postmortem toxicology.

    PubMed

    Lemos, Nikolas P; Ingle, Eric A

    2011-09-01

    Cannabinoids are often excluded from postmortem toxicology screens due to their ubiquitous nature, interpretative difficulties and unanswered questions regarding their postmortem redistribution. In this study, we review 30 postmortem cases where a drug screen gave a positive cannabinoids result and a confirmation identified Δ⁹-tetrahydrocannabinol (THC), 11-hydroxy-Δ⁹-tetrahydrocannabinol (11-OH-THC), and/or 11-nor-9-carboxy-Δ⁹-tetrahydrocannabinol (THC-COOH) in peripheral (BL-P) or cardiac/central blood (BL-C) and/or urine (UR). Had cannabinoids not been included in these toxicologic evaluations, incomplete or erroneous inferences would have been drawn in a substantial number of cases regarding cause/manner of death. THC was detected in 28 BL-C and in all 30 BL-P. THC and THC-COOH were confirmed present in 2 and 23 UR, respectively. 11-OH-THC was detected in 4 BL-C, 6 BL-P, and 0 UR. The mean THC concentrations in BL-C and BL-P were 8.0 and 15.8 ng/mL, respectively. The mean THC-COOH concentrations in BL-C and BL-P were 55.2 and 60.6 ng/mL, respectively. The mean 11-OH-THC concentrations in BL-C and BL-P were 17.0 and 12.5 ng/mL, respectively. Postmortem interval (PMI) for each case was determined and evaluated in relation to BL-C/BL-P concentration ratios with THC-COOH exhibiting a possible trend. This study is the first of its kind and demonstrates the usefulness of cannabinoid analyses as part of death investigations. Furthermore, it provides distribution data that will improve the ability of toxicologists and pathologists to evaluate cannabinoid concentrations in human postmortem specimens.

  7. Algor mortis: an erroneous measurement following postmortem refrigeration.

    PubMed

    Wardak, Khalil S; Cina, Stephen J

    2011-09-01

    Determination of the time of death is one goal of medicolegal death investigations. Algor mortis has been used as a measure of the postmortem interval (PMI). We prospectively recorded the core temperatures of 19 adult bodies entering our morgue cooler and at 3, 6, and 9 h of refrigeration. We then compared the cooling rate with the calculated body mass index (BMI). For each individual body, the rate of cooling was fairly linear with no evidence of a plateau. There was fair to moderate correlation between the BMI and the cooling rate: cooling rate = -0.052 (BMI) + 3.52. The probability of linearity in any given case was 36%. Variables affecting this correlation included the presence and the layers of clothing and if the clothing was wet. Our data confirm that algor mortis is of very limited utility in determining the PMI in bodies that have been refrigerated.

  8. [Maternal death of obstetrical origin. Medicolegal aspects].

    PubMed

    Chevrant-Breton, O; Lebervet, J Y; Vialard, J

    1985-01-01

    The authors have become interested in maternal mortality. This study has been carried out solely to look at the medico-legal aspect. Increasingly good health is seen as a right and the doctor the dispenser of this service. The rights of the mother (and of the infant) become of increasing importance. The improvement in obstetrical techniques, which are much better known to the public, have made families far more confident of the results of delivery. This is now seen as something without any danger. But delivering a baby still has lots of risks. Because of this, if an accident happens the obstetrician more than any other doctor perhaps can find himself in the courts. To avoid this he has to know very well the causes of maternal mortality in order to avoid them as far as possible. Furthermore, he must not undertake stupid emergency measures often initiated as measures of desperation caused by his emotional involvement for a patient who is approaching death. Finally, the expert should look for all the causes of death so that he does no wrongly blame the doctor for a maternal death.

  9. Medicolegal aspects of PMA-related deaths.

    PubMed

    Rojek, Sebastian; Bolechała, Filip; Kula, Karol; Maciów-Głąb, Martyna; Kłys, Małgorzata

    2016-07-01

    Unlike amphetamine, amphetamine-like substances accessible on the drug market are less expensive and more easily available; they also produce hallucinogenic effects expected by the users. Such properties render them more attractive as compared to amphetamine. On the other hand, the knowledge of the toxicity of these compounds is very limited, what in consequence generates problems that create ever-expanding research areas, including analytical, clinical and medicolegal issues, thus leading to development of systemic databases. An example here is paramethoxyamphetamine (PMA), which appeared on the drug market in recent years as a result of creative inventiveness of producers of psychoactive substances, who aimed at PMA replacing the popular ecstasy (MDMA) as a less expensive and more available product. It is more potent than MDMA, but has a slower onset of action, which encourages users to take more. The problem is illustrated in the present paper by three fatal cases involving PMA, which were comprehensively investigated taking into consideration case histories, pathological and toxicological findings obtained with the use of LC-MS-MS method. In blood samples taken from all the three victims, very high concentrations of PMA were found (in the range of 10-27mg/L) and thus the cause of deaths was determined as overdoses of PMA with the underlying mechanism of acute cardiorespiratory failure.

  10. Perinatal testicular torsion and medicolegal considerations.

    PubMed

    Massoni, F; Troili, G M; Pelosi, M; Ricci, S

    2014-06-01

    Perinatal testicular torsion (PTT) is a very complex condition because of rarity of presentation and diagnostic and therapeutic difficulties. In presence of perinatal testicular torsion, the involvement of contralateral testis can be present also in absence of other indications which suggest the bilateral involvement; therefore, occurrences supported by literature do not exclude the use of surgery to avoid the risk of omitted or delayed diagnosis. The data on possible recovery of these testicles are not satisfactory, and treatment consists of an observational approach ("wait-and-see") or an interventional approach. The hypothesis of randomized clinical trials seems impracticable because of rarity of disease. The authors present a case of PTT, analyzing injuries due to clinical and surgical management of these patients, according to medicolegal profile. The delayed diagnosis and the choice of an incorrect therapeutic approach can compromise the position of healthcare professionals, defective in terms of skill, prudence and diligence. Endocrine insufficiency is an unfortunate event. The analysis of literature seems to support, because of high risk, a surgical approach aimed not only at resolution of unilateral pathology or prevention of a relapse, but also at prevention of contralateral testicular torsion.

  11. Current medico-legal death investigation system in China.

    PubMed

    Chang, Lin; Zhang, Baosheng; Yan, Ping; Fowler, David; Li, Ling

    2011-07-01

    Medico-legal death investigation in China has a long history that can be traced back to the Chhin era in the third century BC. We conducted a national study on the current medico-legal death investigation system in China. Our study showed that, at present, medico-legal death investigations in China are conducted by c. 12,000 forensic medical experts mainly within five relatively independent agencies: the police organizations, the prosecutors' offices, the departments/divisions of forensic medicine/science in medical colleges and universities, the Institute of Forensic Science in the Ministry of Justice, and the government or private forensic societies. Owing to China's large population and area, the medico-legal death investigation is largely based on the administrative divisions. There is a wide variation in the scope, extent, and quality of investigations among the agencies and at the different levels of county/district, municipal, and provincial governments. This article gives a general overview of medicolegal death investigation in modern China.

  12. Detection of hemorrhage source: the diagnostic value of post-mortem CT-angiography.

    PubMed

    Palmiere, C; Binaghi, S; Doenz, F; Bize, P; Chevallier, C; Mangin, P; Grabherr, S

    2012-10-10

    The aim of this study was to compare the diagnostic value of post-mortem computed tomography angiography (PMCTA) to conventional, ante-mortem computed tomography (CT)-scan, CT-angiography (CTA) and digital subtraction angiography (DSA) in the detection and localization of the source of bleeding in cases of acute hemorrhage with fatal outcomes. The medical records and imaging scans of nine individuals who underwent a conventional, ante-mortem CT-scan, CTA or DSA and later died in the hospital as a result of an acute hemorrhage were reviewed. Post-mortem computed tomography angiography, using multi-phase post-mortem CTA, as well as medico-legal autopsies were performed. Localization accuracy of the bleeding was assessed by comparing the diagnostic findings of the different techniques. The results revealed that data from ante-mortem and post-mortem radiological examinations were similar, though the PMCTA showed a higher sensitivity for detecting the hemorrhage source than did ante-mortem radiological investigations. By comparing the results of PMCTA and conventional autopsy, much higher sensitivity was noted in PMCTA in identifying the source of the bleeding. In fact, the vessels involved were identified in eight out of nine cases using PMCTA and only in three cases through conventional autopsy. Our study showed that PMCTA, similar to clinical radiological investigations, is able to precisely identify lesions of arterial and/or venous vessels and thus determine the source of bleeding in cases of acute hemorrhages with fatal outcomes.

  13. Postmortem imaging: MDCT features of postmortem change and decomposition.

    PubMed

    Levy, Angela D; Harcke, Howard Theodore; Mallak, Craig T

    2010-03-01

    Multidetector computed tomography (MDCT) has emerged as an effective imaging technique to augment forensic autopsy. Postmortem change and decomposition are always present at autopsy and on postmortem MDCT because they begin to occur immediately upon death. Consequently, postmortem change and decomposition on postmortem MDCT should be recognized and not mistaken for a pathologic process or injury. Livor mortis increases the attenuation of vasculature and dependent tissues on MDCT. It may also produce a hematocrit effect with fluid levels in the large caliber blood vessels and cardiac chambers from dependent layering erythrocytes. Rigor mortis and algor mortis have no specific MDCT features. In contrast, decomposition through autolysis, putrefaction, and insect and animal predation produce dramatic alterations in the appearance of the body on MDCT. Autolysis alters the attenuation of organs. The most dramatic autolytic changes on MDCT are seen in the brain where cerebral sulci and ventricles are effaced and gray-white matter differentiation is lost almost immediately after death. Putrefaction produces a pattern of gas that begins with intravascular gas and proceeds to gaseous distension of all anatomic spaces, organs, and soft tissues. Knowledge of the spectrum of postmortem change and decomposition is an important component of postmortem MDCT interpretation.

  14. [Regulatory aspects and medicolegal considerations regarding clinical drug trials].

    PubMed

    Cammarano, Andrea; De Dominicis, Enrico; Marella, Gian Luca; Maurici, Massimo; Arcudi, Giovanni

    2016-01-01

    This article aims to explore the regulatory and medicolegal aspects of experimental drug trials. Firstly, the authors provide definitions of drug according to WHO, the European Community and our official Pharmacopoeia, and that of experimental studies. They then explain the distinction between pure or basic research and drug trials and explain the various phases of the latter. Besides providing definitions, and exploring doctrinal, theoretical but also practical aspects of drug trials, the authors also discuss and analyze legislative aspects, with particular reference to the Italian legislative framework, and medicolegal issues, including informed consent, effects on humans, and professional responsibility.

  15. Incidental Findings in Neuroimaging: Ethical and Medicolegal Considerations.

    PubMed

    Leung, Lawrence

    2013-01-01

    With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a challenge as to how they should be handled to abide by the medicolegal principles of research ethics. This paper reviews the issue from various ethical (do no harm, general duty to rescue, and mutual benefits and owing) and medicolegal perspectives (legal liability, fiduciary duties, Law of Tort, and Law of Contract) with a suggested protocol of approach.

  16. [Post-mortem microbiology analysis].

    PubMed

    Fernández-Rodríguez, Amparo; Alberola, Juan; Cohen, Marta Cecilia

    2013-12-01

    Post-mortem microbiology is useful in both clinical and forensic autopsies, and allows a suspected infection to be confirmed. Indeed, it is routinely applied to donor studies in the clinical setting, as well as in sudden and unexpected death in the forensic field. Implementation of specific sampling techniques in autopsy can minimize the possibility of contamination, making interpretation of the results easier. Specific interpretation criteria for post-mortem cultures, the use of molecular diagnosis, and its fusion with molecular biology and histopathology have led to post-mortem microbiology playing a major role in autopsy. Multidisciplinary work involving microbiologists, pathologists, and forensic physicians will help to improve the achievements of post-mortem microbiology, prevent infectious diseases, and contribute to a healthier population.

  17. Elderly-animal postmortem attachment.

    PubMed

    Peretti, P O

    1990-01-01

    Attachment can be strong between people and their pets. The present study was conducted to determine: (1) specific variables associated with the final rite and disposition of the deceased pet, and (2) those criteria associated with emotional and social factors pertaining to elderly-animal postmortem attachment. Results suggested four most frequently stated variables of final rite and disposition, and eight emotional and social factors of elderly-animal postmortem attachment.

  18. The Clinical and Medicolegal Analysis of Electrical Shocked Rats: Based on the Serological and Histological Methods

    PubMed Central

    Wang, Qiaofeng; Zhao, Ze; Xie, Yanan; Ding, Suzhen

    2016-01-01

    This research was aimed at discovering the serological and histological changes in cardiac and hepatic tissue after electric shock. The CK-MB, ALT, and AMS indexes were tested with serological methods. Moreover, the Bcl-2, Bax, and Hsp-60 expression levels were carefully measured. An electrical injury model was established by giving rats electric shocks at 110 V with alternating electric current. Blood samples from the rats were analyzed for the biochemical indexes. The degrees of pathological changes in the heart and liver were evaluated using IHC staining for Bcl-2, Bax, and Hsp-60. The levels of CK-MB in the electrical injury group rapidly peaked at 0.5 hours after the electric shock. Additionally, the levels of Bcl-2, Bax, and Hsp-60 in the cardiac and hepatic tissues changed regularly after the electrical injury and exhibited apparent differences from the levels in the control group. CK-MB, ALT, and AMS were altered regularly after electric shock, and these results provide significant information for clinical and medicolegal practice. This research has shed light on the assessment of electrical injury without obvious electrical burns. Furthermore, the findings obtained for Bcl-2/Bax and Hsp-60 can also facilitate pathological diagnosis and the identification of antemortem and postmortem electrical injury. PMID:27648446

  19. [Post-mortem examination prior to cremation--an instrument to verify the quality of medical post-mortems and uncover non-natural deaths?].

    PubMed

    Germerott, Tanja; Todt, Melanie; Bode-Jänisch, Stefanie; Albrecht, Knut; Breitmeier, Dirk

    2012-01-01

    The external post-mortem examination, its deficient quality and possible causes have been the subject of numerous political and professional discussions. The external post-mortem examination is the basis for the decision whether further criminal investigations are required to clarify the cause of death. It is thus an essential instrument to ensure legal certainty. Before cremation, a second external post-mortem examination is performed by a public medical officer to make sure that errors of the first post-mortem are corrected. In the present study, cases were retrospectively analyzed in which a forensic autopsy had been ordered on the basis of the results of the post-mortem examination performed before cremation. The entries on the death certificate regarding the manner and cause of death were compared with the autopsy results. Between 1998 and 2007, 387 autopsies were ordered after external examination before cremation. In 55 cases (14.2%), the autopsy revealed a non-natural death, although a natural death had been attested on the death certificate. In descending order, a wrong manner of death was attested by clinicians, general practitioners and emergency physicians. With regard to the place where the first external post-mortem had been performed the lowest error rate was seen in nursing homes. Concerning the cause of death, discrepancies between the first post-mortem and autopsy were found in 59.4% of the cases. In this respect, general practitioners and clinicians were ranking first, whereas in nursing homes the cause of death was wrongly assessed in over 70% of cases. At present, the medical post-mortem does not meet the required quality standards, especially with regard to legal certainty. Determination of the cause of death on the basis of the external post-mortem examination is a challenging task even for the experienced medical examiner. As to the categorization of the manner of death it has to be stated that non-natural deaths are often not recognized or

  20. Postmortem distribution of trazodone concentrations.

    PubMed

    McIntyre, Iain M; Mallett, Phyllis; Stabley, Robert

    2015-06-01

    Non-toxic postmortem trazodone tissue (liver) concentrations have not been previously described. Liver trazodone concentrations were compared to peripheral blood and central blood concentrations in 19 medical examiner cases. Postmortem blood specimens were initially screened for alcohol and simple volatiles, drugs of abuse, and alkaline drugs. Trazodone, when detected by the alkaline drug screen, was subsequently confirmed and quantified by a high performance liquid chromatography procedure. Re-analyses showed that there may be degradation of trazodone in postmortem blood stored at 4°C. There was, on average, about a 20% decrease in samples stored up to eight months. These data suggest that postmortem trazodone peripheral blood concentrations may be considered non-toxic to at least 1.0mg/L with liver concentrations to at least 2.2mg/kg. Overall, trazodone concentrations ranged from 0.08-6.1mg/L in peripheral blood, 0.07-7.1mg/L in central blood, and 0.39-26mg/kg in liver. The median trazodone central blood to peripheral blood ratio was 0.98 (N=19). The liver to peripheral blood ratios showed a median value of 2.8L/kg (N=18). Given that a liver to peripheral blood ratio less than 5L/kg is consistent with little to no propensity for postmortem redistribution, these data demonstrate that trazodone is unlikely to show significant redistribution.

  1. Post-mortem clinical pharmacology

    PubMed Central

    Ferner, R E

    2008-01-01

    Clinical pharmacology assumes that deductions can be made about the concentrations of drugs from a knowledge of the pharmacokinetic parameters in an individual; and that the effects are related to the measured concentration. Post-mortem changes render the assumptions of clinical pharmacology largely invalid, and make the interpretation of concentrations measured in post-mortem samples difficult or impossible. Qualitative tests can show the presence of substances that were not present in life, and can fail to detect substances that led to death. Quantitative analysis is subject to error in itself, and because post-mortem concentrations vary in largely unpredictable ways with the site and time of sampling, as a result of the phenomenon of post-mortem redistribution. Consequently, compilations of ‘lethal concentrations’ are misleading. There is a lack of adequate studies of the true relationship between fatal events and the concentrations that can be measured subsequently, but without such studies, clinical pharmacologists and others should be wary of interpreting post-mortem measurements. PMID:18637886

  2. Prescription opioid abuse based on representative postmortem toxicology.

    PubMed

    Häkkinen, Margareeta; Vuori, Erkki; Ojanperä, Ilkka

    2014-12-01

    Opioids are important medications for pain and opioid maintenance treatment. Increasing use and abuse of prescription opioids has, however, caused worldwide concern. Our aim was to estimate the ratio between prescription opioid abuse and total use, based on representative postmortem toxicology. Our material included all the medico-legally examined deaths in Finland during 2010-2011 involving positive findings involving buprenorphine, codeine, fentanyl, methadone, oxycodone, or tramadol. We studied drug abuse by age group, with "abuse" meaning licit opioids used illicitly as narcotics. Drug-abuse history, drug injecting, or laboratory findings of illicit drugs defined an abuser case. We then compared abuser cases and other opioid-related cases between the opioids with the number of fatal poisonings, accidents, suicides, alcohol findings, concomitant opioid use, and median postmortem blood opioid concentrations. Opioid findings numbered 2499 in 2088 cases. Drug abuse involved 545 opioid-positive cases, which in Finland represented 0.5% of those deceased. The proportion of abuser cases among all opioid-related cases for buprenorphine was 85.5%, for methadone 82.4%, for tramadol 29.4%, for codeine 16.3%, for fentanyl 14.5%, and for oxycodone 6.9%. Abuse in age-groups >60 was rare. Concomitant other opioid findings were more frequent in abuser- than in other cases for codeine, oxycodone, and tramadol, whereas alcohol findings were more frequent in buprenorphine, codeine, and fentanyl abuse. Buprenorphine and methadone were most often related to drug abuse. Every other opioid studied involved some abuse, and especially tramadol. Abuse and fatal poisonings were concentrated in men aged 20-49.

  3. The black soldier fly Hermetia illucens (Diptera: Stratiomyidae) as a potential measure of human postmortem interval: observations and case histories.

    PubMed

    Lord, W D; Goff, M L; Adkins, T R; Haskell, N H

    1994-01-01

    The black soldier fly, Hermetia illucens (L.), has been shown to be a ubiquitous inhabitant of both surface and buried human remains throughout the southern, central and western United States and Hawaii. Unlike most other species of forensically important Diptera, this species frequently dominates bodies in the dry/post decay stage of decomposition. Adults of the black soldier fly appear to initiate oviposition (egg laying) 20 to 30 days postmortem. Even at warm temperatures (27.8 degrees C), subsequent completion of the life cycle can require an additional 55 days. Life history data for H. illucens, when used in combination with data for other cohabiting arthropod species and viewed in the context of local environmental conditions, can provide medicolegal investigators with valuable parameters for estimating the postmortem intervals for badly decomposed remains.

  4. Postmortem in vitro ethanol production-It could be more common than we think!

    PubMed

    Quintas, Maria José; Costa, Pedro; Melo, Paula; Castro, André; Franco, João Miguel; Teixeira, Helena M

    2017-01-05

    The blood alcohol concentration (BAC) is the most frequent determination in a Forensic Toxicology Laboratory. Despite its apparent simplicity, the results interpretation can be complex and always have relevant social and legal implications, particularly in postmortem analysis. In the present report we describe the case of a 55-year-old male with an apparent natural death by myocardial infarction, whose initial BAC was 0.18g/L but, in repeated determinations prompted by discrepancies observed in the first two, it rapidly increased to 0.85g/L three days later, leading to the suspicion of in vitro ethanol production. A microbiological examination of the sample revealed the presence of the bacteria Escherichia coli and Enterococcus faecalis, and yeast Candida parapsilosis, known for their involvement in ethanol production. Although this is a case report and it is not meant to be generalizable, we discuss an existing large body of scientific literature showing the difficulties, limitations and some relevant medico-legal questions regarding BAC determinations in postmortem samples and their interpretation, particularly in the context of plausible in vitro ethanol production. The key conclusion is that evaluating a postmortem BAC is a complex and multifactorial process that always deserves a thorough analysis and a careful interpretation.

  5. Medicolegal investigation of political killings in El Salvador.

    PubMed

    Thomsen, J L; Gruschow, J; Stover, E

    1989-06-17

    An axiom of Thomas Hobbes states that "people are never more helpless than when the force meant to protect their rights turns against them." Hobbes' axiom holds true today, with Amnesty International reporting that hundreds of thousands have been murdered by their governments. This article examines the medicolegal aspects of an investigation into the deaths of two Salvadoran peasants who were reportedly tortured and executed by soldiers in February 1988. One of the authors, Thomsen, participated in the investigation as a court-ordered expert, and as a representative of the American Association for the Advancement of Science and of a Salvadoran legal aid organization. His necropsy findings are reported with observations and comments. The article concludes with suggestions for initiatives that might be undertaken by individual physicians and institutions to improve the quality and impartiality of medicolegal investigations into political killings.

  6. Applications of social network media in medicolegal death investigation.

    PubMed

    Hookano, Ryan; Knight, Laura D; Brunelli, Ronald A; Stoppacher, Robert

    2013-11-01

    With the increased popularity of online social networking services (SNS) such as Facebook, LinkedIn, Twitter, and Google+, we propose that a wealth of new resources is available for medicolegal death investigation. Recognizing this potential, we identified cases in which social media had been useful in the past in our office and asked our investigative staff to consider using social media in current cases. These cases provided illustrative examples for this primer regarding how information from SNS was used in death investigations in our office. Information gleaned from online social media aided in establishing preliminary identification of a decedent, locating next-of-kin, investigating the circumstances of death as relevant to the manner of death, corroborating eyewitness accounts, and providing information relevant to time of death. Potential pitfalls were identified, such as shared accounts or online impostors. SNS proved useful to the medicolegal death investigator and medical examiner, so long as their limitations were recognized.

  7. [Mandatory or voluntary vaccinations? Juridical and medico-legal aspects].

    PubMed

    Molendini, L O; Zanetti, A; Buzzi, F

    2003-01-01

    The Italian juridical and legislative aspects of vaccination based on a compulsory system are presented considering the medico-legal questions. The prospective of a voluntary system, as anticipated by many normatives and other official documents, is examined. The experience of some local health authorities on cases of in observance of the vaccinal obligation are detailed Finally professional risks for vaccinal operators are examined and the need of specific guidelines for parents' consent to compulsory vaccination during infancy is prospected.

  8. [The victim as object of the medico-legal intervention].

    PubMed

    Magalhães, Teresa

    2005-01-01

    We present a reflection about the victim as the object of the medico-legal intervention, that opens perspectives not only to the evidence research (as a techno-scientific contribute to support Justice in what concerns bio-psycho-social questions), but also to the support of victims which, in a last analysis, is no more than another aspect of this the social contribution of this science to ensure the best interest of the victim. This reflection aims to contribute to a better knowledge of the victim in his/her various perspectives. Accordingly, during the exposition, we refer some contributes of Victimology towards the understanding of the victims' behaviour's. Afterwards, we focus on the problems related to the aetiologies (with a particular reference to trauma), levels and consequences (physical, psychological and socio-economical) of victimization, as well as the methodologies of victims approach, medico-legal evaluation and reparation. Considering victims as being not only those who suffer directly the consequences of the victimizing phenomena, but also those that suffer from it indirectly and even secondarily, we shall approach the topic regarding both perspectives. We highlight the importance of understanding the victim as a person, not just understanding him/her confined to the organic aspect (as it used to be until recently in certain fields of medico-legal intervention, and as it still happens due to some legal obligations, for instance in the Labour Law), but considering the person in a global way (body, capacities, life situations and subjectivity). In conclusion, we highlight the importance of this topic to the medico-legal mission, while taking part in various multidisciplinary interventions and being involved in strategies and measures which purpose is to prevent violence, promote safety, avoid secondary victimization and revictimization as well as guarantee the victims' protection and reintegration, in a work attitude that should happen, even more and

  9. Imaging of body packing: errors and medico-legal issues.

    PubMed

    Reginelli, Alfonso; Russo, Anna; Urraro, Fabrizio; Maresca, Duilia; Martiniello, Ciro; D'Andrea, Alfredo; Brunese, Luca; Pinto, Antonio

    2015-10-01

    Body packing is the ingestion or insertion in the human body of packed illicit substances. Over the last 20 years, drug smuggling has increased global and new means of transport of narcotics have emerged. Among these, the most frequent one is the gastrointestinal tract: from mouth to anus, vagina, and ears. Cocaine is one of the most traded drugs, followed by heroin. Condoms, latex gloves, and balloons are typically used as drug packets for retention in the body. There are different radiologic modalities to detect illicit drugs in body packing: Plain radiography, computed tomography (CT), ultrasound, and magnetic resonance. Current protocols recommend the use of radiography to confirm packet retention and, in case of doubt, the use of abdominal CT scan with reduced mAs. In case of packet rupture, catastrophic effects can occur. Management of patients carrying packets of drugs is a recurrent medico-legal problem. To improve diagnostic accuracy and prevent hazardous complications, radiologists and emergency physicians should be familiar with radiologic features of body packing. The radiologist plays both a social and a medico-legal role in their assessment, and it should not be limited only to the identification of the packages but must also provide accurate information about their number and their exact location. In this review, we focus on diagnostic errors and medico-legal issues related to the radiological assessment of body packers.

  10. The importance of medico-legal evaluation in a case with intraabdominal gossypiboma.

    PubMed

    Uluçay, Tarik; Dizdar, Mustafa Gökhan; SunayYavuz, Mehmet; Aşirdizer, Mahmut

    2010-05-20

    Data concerning the incidence of gossypiboma tend to fluctuate and is difficult to estimate because of a low reporting rate lest medico-legal implication. Gossypiboma is frequently located in the abdominal and pelvic cavities after gynecologic and upper abdominal surgical operations but can also follow thoracic, orthopedic, and urological and neurosurgical procedures. In medical literature, there are few articles about the medico-legal evaluation of gossypiboma although it is typically subjected to a medico-legal process. In this article, we reported a 22-year-old female case with intraabdominal gossypiboma following a cesarean procedure and discussed the importance of medico-legal evaluation of gossypiboma.

  11. Self-induced illegal abortion with Rivanol(®): A medicolegal-toxicological case report.

    PubMed

    Koelzer, Sarah C; Held, Hannelore; Toennes, Stefan W; Verhoff, Marcel A; Wunder, Cora

    2016-11-01

    Approximately during the 30th week of pregnancy, a woman gave birth to a still-born child in a hospital. After first citing an extraneous cause for the premature still-birth, the woman later admitted to having self-induced the abortion by injecting the antiseptic Rivanol(®) (active agent: ethacridine lactate) through her abdominal wall into the amniotic cavity. The investigating authorities ordered an autopsy of the fetus along with additional toxicological investigations. To the naked eye, no obvious cause of death was apparent. The main autopsy findings were four skin defects (puncture/stabbing wounds) on the ball of the fetus's left thumb, with slight bleeding around the punctures and into the underlying fatty tissue, and a yellowish discoloration of the fetus's body surface, especially of the umbilical cord and fingernails. On basis of the results, the child would have been viable. Femoral vein blood and urine from the fetus were analyzed for ethacridine, as were an amniotic fluid sample and maternal blood and urine samples, which had been collected as evidence. The concentration of ethacridine in the amniotic fluid was 16mg/l. In the postmortem fetal blood and urine samples, the concentrations were 0.36mg/l and 0.34mg/l, respectively, while concentrations of 0.091mg/l and 0.42mg/l, respectively, were found in the serum and urine samples from the mother. In many countries, foremost in China, ethacridine lactate, to which both mother and child are exposed, is widely used as safe abortion method. Although the ethacridine concentrations found in blood and urine samples of the mother in our case are consistent with published values, we believe to be the first to report postmortem ethacridine concentrations in a fetus. While exposure to ethacridine is not toxicologically relevant for the mother, it is fatal for the fetus because it causes the placental decidua capsularis to separate from the decidua parietalis or decidua placentalis, respectively. Prostaglandins

  12. Diagnostic accuracy of postmortem imaging vs autopsy-A systematic review.

    PubMed

    Eriksson, Anders; Gustafsson, Torfinn; Höistad, Malin; Hultcrantz, Monica; Jacobson, Stella; Mejare, Ingegerd; Persson, Anders

    2017-04-01

    Background Postmortem imaging has been used for more than a century as a complement to medico-legal autopsies. The technique has also emerged as a possible alternative to compensate for the continuous decline in the number of clinical autopsies. To evaluate the diagnostic accuracy of postmortem imaging for various types of findings, we performed this systematic literature review. Data sources The literature search was performed in the databases PubMed, Embase and Cochrane Library through January 7, 2015. Relevant publications were assessed for risk of bias using the QUADAS tool and were classified as low, moderate or high risk of bias according to pre-defined criteria. Autopsy and/or histopathology were used as reference standard. Findings The search generated 2600 abstracts, of which 340 were assessed as possibly relevant and read in full-text. After further evaluation 71 studies were finally included, of which 49 were assessed as having high risk of bias and 22 as moderate risk of bias. Due to considerable heterogeneity - in populations, techniques, analyses and reporting - of included studies it was impossible to combine data to get a summary estimate of the diagnostic accuracy of the various findings. Individual studies indicate, however, that imaging techniques might be useful for determining organ weights, and that the techniques seem superior to autopsy for detecting gas Conclusions and Implications In general, based on the current scientific literature, it was not possible to determine the diagnostic accuracy of postmortem imaging and its usefulness in conjunction with, or as an alternative to autopsy. To correctly determine the usefulness of postmortem imaging, future studies need improved planning, improved methodological quality and larger materials, preferentially obtained from multi-center studies.

  13. [Medicolegal aspects of driving ability and discussion of study methods].

    PubMed

    Berghaus, G

    2008-06-01

    Medicolegal aspects of driving ability primarily concern patients themselves, because they are responsible when driving in traffic while under drug treatment. Pain patients taking analgesic medication prescribed by a doctor do not commit an offence, insofar as they are able to drive. A doctor's main duty consists of informing the patient about the way a given disease or drug intake affects driving ability. Patients have the duty to inform themselves about the drug they are taking and to assess their driving ability each time before they drive a car.

  14. Medicolegal aspects of necrotizing fasciitis of the neck.

    PubMed

    Sperry, K; McFeeley, P J

    1987-01-01

    Necrotizing fasciitis of the neck (NFN) is a relatively rare, fulminating infectious process of the cervicofacial tissues which may cause sudden and unexpected death. Although often the result of a dental infection, injuries of the soft tissues of the neck may also initiate rampant cellulitis, and recognition of the underlying etiology of such cases is necessary to determine properly the manner of death. Five cases of NFN are presented with a review of the causative factors and usual bacteriology, and specific factors of medicolegal interest are addressed.

  15. [Sexual hallucinations and dreams under anesthesia and sedation : medicolegal aspects].

    PubMed

    Schneemilch, C; Schiltz, K; Meinshausen, E; Hachenberg, T

    2012-03-01

    Dreams and hallucinations under sedation or anesthesia have been well known phenomena since the introduction of anesthesia. Sexual hallucinations may lead to allegations of sexual molestation or assault by medical doctors or professional nursing staff. Hallucinations under the influence of sedative or hypnotic drugs may be very vivid and as misinterpreted as being real and it is therefore often difficult to disprove the resulting false allegations. In this report the terms drug-induced dreams and hallucinations are defined and the probable mechanism described. By a historical review and case reports the medicolegal consequences are demonstrated and procedures recommended to avoid allegations of sexual assault.

  16. The medico-legal observation of an aggressive urogenital fibromatosis with isolated development not related to any traumatic event.

    PubMed

    Muccino, Enrico; Gentile, Guendalina; Mantero, Stefano; Marchesi, Matteo; Rancati, Alessandra; Zoja, Riccardo

    2016-03-01

    Desmoid tumor is a fibroproliferative neoplasm with an intermediate malignancy and it can be localized in every bodily district: some locations are considered exceptional, like the urogenital localization. The Author point out a rare case of giant idiopathic scrotal fibromatosis that was found during an autopsy. A widower, that lived alone in poor hygienic conditions, was found dead in his house. The Judicial Authority ordered the autopsy, that was performed two days later at the Medico-Legal Section of Milan University. External examinations revealed only the considerable dimension of the scrotum (cm 24 × 41). The cause of death was fixed in a cardiac tamponade due to a natural heart laceration localized in correspondence of a transmural infarction. The toxicological exam resulted negative, while the histopathological and immunohistochemical analysis qualify the scrotal mass as a desmoids tumor. Due to the absence of predisposing conditions and of fibroproliferative infiltration in bladder and retroperitoneal space, the neoplasm was configured as an idiopathic desmoid tumor. The presented case gives the reason for the discussion concerning medico-legal aspects that are typical of rare neoplasms.

  17. Profiles of pregabalin and gabapentin abuse by postmortem toxicology.

    PubMed

    Häkkinen, Margareeta; Vuori, Erkki; Kalso, Eija; Gergov, Merja; Ojanperä, Ilkka

    2014-08-01

    Pregabalin (PRG) and gabapentin (GBP) are used in the treatment of neuropathic pain and epilepsy, and PRG also in generalized anxiety disorder. There is increasing evidence that PRG possesses considerable abuse potential. PRG may have a higher addiction potential than GBP due to its rapid absorption and faster onset of action. Our objective is to estimate the proportion of all PRG- and GBP-related fatalities attributable to PRG and GBP abuse. We investigated all medico-legal death cases in Finland in which PRG or GBP was found in postmortem toxicology during 2010-2011. PRG was found in 316 cases and GBP in 43 cases. Drug abuse was associated with 48.1% of the PRG and 18.6% of the GBP findings. PRG poisoning accounted for 10.1% of all PRG cases and GBP poisoning for 4.7% of all GBP cases. In the drug abuser cases, PRG poisoning represented 19.1%, and GBP poisoning 12.5%. The median blood concentration of PRG was 15 mg/L in the abuser group and 5.8 mg/L in the other cases. For GBP, these concentrations were 12 mg/L and 8.3mg/L, respectively. In the PRG abuser group, 91.4% of cases showed concomitant opioid use, while in the rest of these cases neither alcohol nor opioids were detected, but other central nervous system acting drugs were found in each abuser case. In the GBP abuser group, 87.5% of cases showed concomitant opioid use. PRG abuse with high doses is increasingly common and can be fatal when combined with opioids.

  18. Sertraline concentrations and postmortem redistribution.

    PubMed

    McIntyre, Iain M; Mallett, Phyllis

    2012-11-30

    Sertraline is a commonly prescribed selective inhibitor of serotonin uptake used for the treatment of mental depression and anxiety. Central blood and liver concentrations of sertraline (norsertraline) are compared to levels in peripheral blood in nine medical examiner cases. Specimens were initially screened for alcohol and simple volatiles by GC-FID headspace analysis, ELISA for drugs of abuse, and alkaline drugs by GC/MS. Sertraline, when detected by the alkaline drug screen, was subsequently confirmed and quantified by a specific GC-NPD procedure. Data suggest that when ingested with other medications, sertraline may be a contributing factor in death. Sertraline (norsertraline) concentrations ranged from 0.13 (0.11) to 2.1 (6.0) mg/L in peripheral blood, from 0.18 (0.12) to 2.0 (6.7) mg/L in central blood, and 21 to 160 mg/kg in liver. Sertraline central blood to peripheral blood ratios averaged 1.22±0.85 (mean±standard deviation). The liver to peripheral blood ratios, on the other hand, were markedly higher and averaged 97±40 (mean±standard deviation). Given that a liver to peripheral blood ratio exceeding 20 is indicative of propensity for significant postmortem redistribution, these data confirm that sertraline is prone to marked postmortem redistribution.

  19. Documentation of postmortem changes in salivary gland architecture and staining characteristics

    PubMed Central

    Agarwal, Swati; Chaudhary, Minal; Gawande, Madhuri; Gupta, Puneet

    2016-01-01

    Context: Estimation of time passed since death continues to be a major problem for the forensic pathologist and its determination plays an important and vital role in medico-legal cases. The histological studies on various tissues after death have been mostly confined to single organ or tissue by individual workers at different atmospheric conditions. Aims: The aim of this study is to determine the best rehydrating solution for dehydrated tissues in postmortem examination. Settings and Design: This study was specific to salivary gland tissues and certain pattern of changes were determined during postmortem time intervals using hematoxylin and eosin stain and special stains like mucicarmine and alcian blue. Materials and Methods: The study was divided into two groups. (1) Group A: Normal tissue samples (twenty normal salivary gland tissue samples left without fixation for varying periods of time). (2) Group B: Control group (twenty normal salivary gland tissue samples immediately fixed in formalin). The three different rehydrating agents used in this study were glycerol, normal saline and modified Ruffer solution. Statistical Analysis Used: Not required. Results: Modified Ruffer solution is the best when compared to glycerol and normal saline for rehydration of dehydrated tissues. Conclusions: Thus in our study we conclude that the tissue which had been dehydrated at the crime scene for a fairly long period showed better rehydration with modified Ruffer solution and yield good cellular and nuclear details. PMID:27555735

  20. Medicolegal response to violence against women in India.

    PubMed

    Prasad, S

    1999-05-01

    This article examines women's experiences in India with health and legal interventions that address domestic violence, dowry-related violence, and rape. By examining the experiences of survivors of abuse with the medicolegal system in New Delhi, it considers the extent to which women are able to access their legal rights within the special protection system constructed specifically for them. The use of primary data highlights the impact of state procedures on women, and it demonstrates how procedures designed to enhance women's access to the law actually inhibit it. Using semistructured interviews with female survivors of abuse, police officers, case workers, nongovernmental organization leaders, lawyers, physicians, and government officials in a 4-year period, this article examines women's access to state services designed to address violence against women, and raises questions about state tolerance of domestic and sexual violence.

  1. The response of relatives to medicolegal investigations and forensic autopsy.

    PubMed

    Plattner, Thomas; Scheurer, Eva; Zollinger, Ulrich

    2002-12-01

    Relatives of deceased persons, on whose body a forensic autopsy had been performed at the Institute of Forensic Science, Bern, Switzerland, were interrogated by a questionnaire. The aim was to investigate the attitude of relatives toward medicolegal investigation procedures in general and toward forensic autopsy in particular. A great majority of the relatives showed a positive or indifferent attitude toward a forensic autopsy. They showed a great interest in autopsy results and wished to be informed. It was concluded that information given before the autopsy is important for better understanding and can, if properly given, improve the relatives' acceptance and collaboration regarding forensic investigations. By contrast, a lack of information before the autopsy and about the autopsy results can cause further suffering on behalf of the bereaved. A forensic autopsy can be of great benefit for relatives and can help them to cope with a tragic loss.

  2. [About medical accidents and their medicolegal implications. Information and consent].

    PubMed

    El Banna, S; Beauthier, F; Beauthier, J P

    2013-01-01

    Medical practice today is not simple because of various factors impinging on the doctor-patient relationship. The concept of consent arises from the ethical principle of patient autonomy and basic human rights. It is also the rule of law (Civil Code article 16-3) that guarantees the patient's right and freedom to decide what should or should not happen to his/her body and to gather information before undergoing a test/procedure/surgery. No one else has the right to coerce the patient to act in a particular way. The authors after a reflexion about medical accidents and their medicolegal implications, discuss the means to display in order to provide to the patients the adequate information about their disease and proposed treatment, therefore protecting the medical practitioner from the consequences of insufficient or ill information.

  3. Adjudication of fibromyalgia syndrome: Challenges in the medicolegal arena

    PubMed Central

    Fitzcharles, Mary-Ann; Ste-Marie, Peter A; Mailis, Angela; Shir, Yoram

    2014-01-01

    The medicolegal challenges surrounding fibromyalgia (FM) arise from the subjectivity of symptoms, causal attribution and reported symptoms sufficiently severe to cause disablement. In the present article, the authors have endeavoured to provide clarification of some current issues by referencing the current literature, including the 2012 Canadian Fibromyalgia Guidelines. While FM is accepted as a valid condition, its diagnosis is vulnerable to misuse due to the subjectivity of symptoms. Without a defining cause, a physical or psychological event may be alleged to trigger FM, but adjudication of causation must be prudent. Although some individuals may experience severe symptoms, the prevalent societal concept of disablement due to FM must be tempered with the knowledge that working contributes to psychosocial wellbeing. Evidence provided in the present report may assist the courts in reaching decisions concerning FM. PMID:25479148

  4. Postmortem Ethanol Testing Procedures Available to Accident Investigators

    DTIC Science & Technology

    2007-08-01

    Forensic Science, Toxicology, Medical, Postmortem Document is available to the public through the Defense Technical Information Center, Ft...Postmortem Ethanol Formation Postmortem ethanol production in human bodies has been well documented by many forensic scientists over the past 70... skull from the microorganisms responsible for postmortem ethanol production (10). Under normal conditions, urine lacks the nutrients required for

  5. Postmortem pulmonary CT in hypothermia.

    PubMed

    Schweitzer, Wolf; Thali, Michael; Giugni, Giannina; Winklhofer, Sebastian

    2014-12-01

    Fatal hypothermia has been associated with pulmonary edema. With postmortem full body computed tomography scanning (PMCT), the lungs can also be examined for CT attenuation. In fatal hypothermia cases low CT attenuation appeared to prevail in the lungs. We compared 14 cases of fatal hypothermia with an age-sex matched control group. Additionally, 4 cases of carbon monoxide (CO) poisoning were examined. Furthermore, 10 test cases were examined to test predictability based on PMCT. Two readers measured CT attenuation on four different axial slices across the lungs (blinded to case group and other reader's results). Hypothermia was associated with statistically significantly lower lung PMCT attenuation and lower lung weights than controls, and there was a dose-effect relationship at an environmental temperature cutoff of 2 °C. CO poisoning yielded low pulmonary attenuation but higher lung weights. General model based prediction yielded a 94% probability for fatal hypothermia deaths and a 21% probability for non-hypothermia deaths in the test group. Increased breathing rate is known to accompany both CO poisoning and hypothermia, so this could partly explain the low PMCT lung attenuation due to an oxygen dissociation curve left shift. A more marked distension in fatal hypothermia, compared to CO poisoning, indicates that further, possibly different mechanisms, are involved in these cases. Increased dead space and increased stiffness to deflation (but not inflation) appear to be effects of inhaling cold air (but not CO) that may explain the difference in low PMCT attenuation seen in hypothermia cases.

  6. Exploring time of death from potassium, sodium, chloride, glucose & calcium analysis of postmortem synovial fluid in semi arid climate.

    PubMed

    Siddhamsetty, Arun K; Verma, Satish K; Kohli, Anil; Verma, Aditi; Puri, Dinesh; Singh, Archana

    2014-11-01

    Estimation of time of death (TOD) with fair accuracy from postmortem changes still remains an important but difficult task to be performed by every autopsy surgeon under different climatic conditions. The environment plays an important role in the process of decomposition and thereby affecting the levels of electrolytes and other biochemical parameters in the postmortem samples. Since, there is limited information available on the levels of these biochemical parameters from semi arid environment, the present study was aimed to explore time of death by analyzing electrolyte, glucose and calcium levels of postmortem synovial fluid collected from samples under such climatic conditions. The synovial fluid samples from two hundred and ten bodies brought to University College of Medical Sciences and associated Guru Teg Bahadur Hospital Delhi for medico-legal postmortem examination, during the period of November 2010 to April 2012, were analyzed for potassium, sodium, chloride, glucose and calcium. Univariate regression analysis of electrolyte concentrations of synovial fluid showed significant positive relationship between time of death and potassium (r = 0.840, p = 0.000). However, there was negative relationship between time of death and sodium (r = -0.175, p = 0.011) & glucose (r = -0.427, p = 0.000) and no significant relationship was found between time of death and calcium (r = 0.099, p = 0.152) & chloride (r = 0.082, p = 0.24) among the samples analyzed.

  7. Differences between postmortem computed tomography and conventional autopsy in a stabbing murder case

    PubMed Central

    Zerbini, Talita; da Silva, Luiz Fernando Ferraz; Ferro, Antonio Carlos Gonçalves; Kay, Fernando Uliana; Junior, Edson Amaro; Pasqualucci, Carlos Augusto Gonçalves; do Nascimento Saldiva, Paulo Hilario

    2014-01-01

    OBJECTIVE: The aim of the present work is to analyze the differences and similarities between the elements of a conventional autopsy and images obtained from postmortem computed tomography in a case of a homicide stab wound. METHOD: Comparison between the findings of different methods: autopsy and postmortem computed tomography. RESULTS: In some aspects, autopsy is still superior to imaging, especially in relation to external examination and the description of lesion vitality. However, the findings of gas embolism, pneumothorax and pulmonary emphysema and the relationship between the internal path of the instrument of aggression and the entry wound are better demonstrated by postmortem computed tomography. CONCLUSIONS: Although multislice computed tomography has greater accuracy than autopsy, we believe that the conventional autopsy method is fundamental for providing evidence in criminal investigations. PMID:25518020

  8. Visualizing sexual assault: an exploration of the use of optical technologies in the medico-legal context.

    PubMed

    White, Deborah; Du Mont, Janice

    2009-01-01

    This article is an exploration of the visualization of sexual assault in the context of adult women. In investigating the production of visual evidence, we outline the evolution of the specialized knowledge of medico-legal experts and describe the optical technologies involved in medical forensic examinations. We theorize that the principles and practices characterizing medicine, science and the law are mirrored in the medico-legal response to sexual assault. More specifically, we suggest that the demand for visual proof underpins the positivist approach taken in the pursuit of legal truth and that the generation of such evidence is based on producing discrete and decontextualized empirical facts through what are perceived to be objective technologies. Drawing on interview and focus group data with 14 sexual assault nurse examiners (SANEs) in Ontario, Canada, we examine perceptions and experiences of the role of the visual in sexual assault. Certain of their comments appear to lend support to our theoretical assumptions, indicating a sense of the institutional overemphasis placed on physical damage to sexually assaulted women's bodies and the drive towards the increased technologization of visual evidence documentation. They also noted that physical injuries are frequently absent and that those observed through more refined tools of microvisualization such as colposcopes may be explained away as having resulted from either vigorous consensual sex or a "trivial" sexual assault. Concerns were expressed regarding the possibly problematic ways in which either the lack or particular nature of visual evidence may play out in the legal context. The process of documenting external and internal injuries created for some an uncomfortable sense of fragmenting and objectifying the bodies of those women they must simultaneously care for. We point to the need for further research to enhance our understanding of this issue.

  9. [Medicolegal considerations about rape as a reason to decriminalize abortion].

    PubMed

    González-Wilhelm, Leonardo; Moreno, Leonardo; Carnevali, Raúl

    2016-06-01

    The Chilean senate is discussing a proposal to decriminalize abortion in 3 causals. One of these is when the pregnancy occurs as a result of a rape. To be legally able to perform the abortion in this circumstance, a health care team must confirm the occurrence of the facts constituting the offence. Regardless of the patient’s will, the accusation will be reported to the justice. In our view, in its current status the proposed rule does not consider certain medicolegal and procedural topics. Those flaws may determine in certain scenarios critical problems, such as: a) a wrongful conviction as a consequence of a false allegation of rape; (b) some pregnant due to a rape will not have access to the abortion procedure; (c) some accusations of rape will not be accredited nor criminally sanctioned. Employing a fictional case, we illustrate how those scenarios can actually be seen in practice. We also emphasize the difficulties and limitations that the health care team will encounter if the project is approved under the current conditions. Finally, we encourage the professional societies implicated in the theme to contribute in the legislatorial debate. Therefore, we give a set of proposals aimed to improve the bill before it may be enacted as a law.

  10. Preventing medico-legal issues in clinical practice

    PubMed Central

    Raveesh, Bevinahalli N.; Nayak, Ragavendra B.; Kumbar, Shivakumar F.

    2016-01-01

    The medical profession is considered to be one of the noblest professions in the world. The practice of medicine is capable of rendering noble service to humanity provided due care, sincerity, efficiency, and professional skill is observed by the doctors. However, today, the patient–doctor relationship has almost diminished its fiduciary character and has become more formal and structured. Doctors are no longer regarded as infallible and beyond questioning. Corporatization of health care has made it like any other business, and the medical profession is increasingly being guided by the profit motive rather than that of service. On the other hand, a well-publicized malpractice case can ruin the doctor's career and practice. The law, like medicine, is an inexact science. One cannot predict with certainty an outcome of cases many a time. It depends on the particular facts and circumstances of the case, and also the personal notions of the judge concerned who is hearing the case. The axiom “you learn from your mistakes” is too little honored in healthcare. The best way to handle medico-legal issues is by preventing them, and this article tries to enumerate the preventive measures in safeguarding the doctor against negligence suit. PMID:27891020

  11. Preventing medico-legal issues in clinical practice.

    PubMed

    Raveesh, Bevinahalli N; Nayak, Ragavendra B; Kumbar, Shivakumar F

    2016-10-01

    The medical profession is considered to be one of the noblest professions in the world. The practice of medicine is capable of rendering noble service to humanity provided due care, sincerity, efficiency, and professional skill is observed by the doctors. However, today, the patient-doctor relationship has almost diminished its fiduciary character and has become more formal and structured. Doctors are no longer regarded as infallible and beyond questioning. Corporatization of health care has made it like any other business, and the medical profession is increasingly being guided by the profit motive rather than that of service. On the other hand, a well-publicized malpractice case can ruin the doctor's career and practice. The law, like medicine, is an inexact science. One cannot predict with certainty an outcome of cases many a time. It depends on the particular facts and circumstances of the case, and also the personal notions of the judge concerned who is hearing the case. The axiom "you learn from your mistakes" is too little honored in healthcare. The best way to handle medico-legal issues is by preventing them, and this article tries to enumerate the preventive measures in safeguarding the doctor against negligence suit.

  12. Medicolegal cases for spinal epidural hematoma and spinal epidural abscess.

    PubMed

    French, Keisha L; Daniels, Eldra W; Ahn, Uri M; Ahn, Nicholas U

    2013-01-01

    Spinal epidural hematoma and spinal epidural abscess are rare surgical emergencies resulting in significant neurologic deficits. Making the diagnosis for spinal epidural hematoma and spinal epidural abscess can be challenging; however, a delay in recognition and treatment can be devastating. The objective of this retrospective analysis study was to identify risk factors for an adverse outcome for the provider. The LexisNexis Academic legal search database was used to identify a total of 19 cases of spinal epidural hematoma and spinal epidural abscess filed against medical providers. Outcome data on trial verdicts, age, sex, initial site of injury, time to consultation, time to appropriate imaging studies, time to surgery, and whether a rectal examination was performed or not were recorded. The results demonstrated a significant association between time to surgery more than 48 hours and an unfavorable verdict for the provider. The degree of permanent neurologic impairment did not appear to affect the verdicts. Fifty-eight percent of the cases did not present with an initial deficit, including loss of bowel or bladder control. All medical professionals must maintain a high level of suspicion and act quickly. Physicians who are able to identify early clinical features, appropriately image, and treat within a 48 hour time frame have demonstrated a more favorable medicolegal outcome compared with their counterparts in filed lawsuits for spinal epidural hematoma and spinal epidural abscess cases.

  13. Medicolegal considerations in the diagnosis of breast cancer.

    PubMed

    Strunk, Albert L; Kenyon, Sharon

    2002-03-01

    From the standpoint of the obstetrician, gynecologist, failure to diagnose breast cancer is a significant medicolegal issue in terms of the number of claims initiated and the indemnity awards paid to successful plaintiffs. The incidence of breast cancer may continue to increase. Without quality care and good risk management on the part or health care providers, claims for failure to diagnose cancer in a timely manner will also increase. The challenge for the health care provider is to formulate a plan that promotes early detection and treatment while allowing for independent clinical judgment. Ideally, the plan should be written and followed for every patient in whom complaints of a breast mass have been documented. It is incumbent upon the physician and office staff to create an atmosphere in which patient complaints are not minimized, the limitations of mammography are recognized. follow-up procedures are in place and strictly followed, and a definitive diagnosis within 4 to 6 weeks of the initial presentation is the ultimate goal. Following these suggestions will improve the quality of health care for the patient and significantly decrease the likelihood of litigation alleging a failure to diagnose breast cancer. In the event breast cancer is diagnosed and a lawsuit is brought for failure to diagnose in a timely fashion, the best defense a physician can have is to be able to demonstrate that the patient's complaints were taken seriously, a consistent treatment plan was followed and documented, and the patient received appropriate care.

  14. Postmortem bacteriology: a re‐evaluation

    PubMed Central

    Morris, J A; Harrison, L M; Partridge, S M

    2006-01-01

    Aim To assess the value of postmortem bacteriology in necropsy practice, with specific emphasis on bacterial invasion of blood and cerebrospinal fluid (CSF). Methods A review of published articles on postmortem bacteriology. Studies were selected to cover the full range of necropsy practice including adults, the perinatal period, and infancy. The review covers over 5000 necropsies, mainly in adults, but including 1108 perinatal cases and 468 cases of sudden unexpected death in infancy. Data are available on 4992 blood cultures, 1168 specimens of CSF, and 743 cultures of spleen. Results Studies in which careful precautions have been taken to reduce contamination show that approximately two thirds of blood cultures are negative, two in nine yield a single isolate, and one in nine have a mixed growth. The postmortem interval has only a small effect on the isolation rate. A pure growth of a known pathogen has a more than 50% likelihood of being found in association with genuine infection in adults and in the perinatal period. Conclusions The main postmortem artefact is contamination, but this can be considerably reduced by careful technique. Agonal spread is less common than is often assumed. Postmortem translocation is not a problem if the body is appropriately stored. A pure growth of a pathogen in blood or CSF should be regarded as a possible contributing factor to death at all ages. PMID:16394274

  15. ESPR postmortem imaging task force: where we begin.

    PubMed

    Arthurs, Owen J; van Rijn, Rick R; Whitby, Elspeth H; Johnson, Karl; Miller, Elka; Stenzel, Martin; Watt, Andrew; Taranath, Ajay; Perry, David H

    2016-08-01

    A new task force on postmortem imaging was established at the annual meeting of the European Society of Paediatric Radiology (ESPR) in Graz, Austria, in 2015. The postmortem task force is separate from the child abuse task force as it covers all aspects of fetal, neonatal and non-forensic postmortem imaging. The main focus of the task force is the guidance and standardization of non-radiographic postmortem imaging, particularly postmortem CT and postmortem MRI. This manuscript outlines the starting point of the task force, with a mission statement, outline of current experience, and short- and long-term goals.

  16. Postmortem abdominal radiographic findings in feline cadavers.

    PubMed

    Heng, Hock Gan; Teoh, Wen Tian; Sheikh-Omar, Abdul Rahman

    2008-01-01

    Postmortem radiographic examinations of animals are commonly performed in judicial investigations to rule out gunshot and fractures. However, there was no available data on radiographic postmortem changes of animals. Forty-one sets of abdominal radiographs of feline cadavers made within 12 h of death were evaluated for postmortem changes. Intravascular gas was detected in 11 of 41 (27%) cadavers. The most common site of intravascular gas was the liver. Intravascular gas was also present in the aorta, femoral artery, celiac and cranial mesenteric arteries, and caudal superficial epigastric artery. Intrasplenic gas was detected in two cadavers. Only two cadavers had distended small intestine. One cadaver had pneumatosis coli. The changes detected were most likely due to putrefaction.

  17. Relatives' attitudes towards medico-legal investigation and forensic autopsy: a study from South Delhi.

    PubMed

    Behera, C; Rautji, R; Dogra, T D

    2008-04-01

    Relatives of deceased persons on whose bodies a medico-legal autopsy had been performed at the All India Institute of Medical Sciences, New Delhi, India were personally asked to complete a questionnaire. The aim of study was to determine surviving family members' attitudes towards medico-legal investigation and forensic autopsy. The majority of the relatives showed a positive attitude towards forensic autopsy but were not aware of the detailed procedure of the autopsy. They wanted sufficient information to be provided before the autopsy. They showed a great interest in autopsy results i.e. the cause of death. It was concluded that sufficient relevant explanations given before the autopsy improves the relatives' acceptance and helps alleviate the suffering of the bereaved. The experience and opinions of relatives may help an autopsy surgeon in more effective management of medico-legal cases.

  18. Postmortem genetic screening for the identification, verification, and reporting of genetic variants contributing to the sudden death of the young.

    PubMed

    Methner, D Nicole R; Scherer, Steven E; Welch, Katherine; Walkiewicz, Magdalena; Eng, Christine M; Belmont, John W; Powell, Mark C; Korchina, Viktoriya; Doddapaneni, Harsha Vardhan; Muzny, Donna M; Gibbs, Richard A; Wolf, Dwayne A; Sanchez, Luis A; Kahn, Roger

    2016-09-01

    Each year in the United States, thousands of cases of sudden and unexpected deaths of infants, children, and young adults are assigned an undetermined cause of death after postmortem investigation and autopsy. Heritable genetic variants have been suggested as the cause of up to a third of sudden death (SD) cases. Elucidation of the genetic variants involved in SD cases is important to not only help establish cause and manner of death of these individuals, but to also aid in determining whether familial genetic testing should be considered. Previously, these types of postmortem screenings have not been a feasible option for most county medical examiners' and coroners' offices. We sequenced full exons of 64 genes associated with SD in the largest known cohort (351) of infant and young SD decedents using massively parallel sequencing at <$600 per sample. Genetic variants were assessed through literature review and clinical evaluation by a multidisciplinary consortium of experts. Thirteen individuals (3.7%), eight infants (2.8% of those <1 yr of age) and five children/young adults (7.0% of those >1 yr of age), were found to have a reportable genetic variant contributing to SD. These percentages represent an estimate lower than those previously reported. Overall yields and results likely vary between studies due to differences in evaluation techniques and reporting. Additionally, we recommend ongoing assessment of data, including nonreported novel variants, as technology and literature continually advance. This study demonstrates a strategy to implement molecular autopsies in medicolegal investigations of young SD decedents.

  19. [Prevention of medico-legal conflicts in medical practice].

    PubMed

    Minossi, José Guilherme

    2009-02-01

    Generally, medico-legal conflicts which occur in surgical and medical practice are a source of worry for both the medical profession and the society as a whole, because on one hand, they could cause high emotional stress for doctors, and on the other hand, patients could be rejected. Once consolidated, defensive medicine increases treatment costs and the doctor-patient relationship could transform into a tragedy. There are many causes for this, including non-treatment factors, such as an unsupported and disorganized health system, lack of participation from society and the doctor in improving this system, the training machine which launches a large number of young unprepared doctors to practice in this noble profession, along with a lack of continuing training, as there are few public or private institutions providing preparation, or further medical training. The related treatment factors are generally, a deficient doctor-patient relationship, poor work condition, power abuse by the doctor, a lack of clear agreement, and poor medical record keeping. These conflicts cannot be solved by simple creating legislation, or by denying the existence of medical error, which occurs at higher frequency than the actual conflicts. It is very important to improve the doctor-patient relationship because an effective fraternal relationship reduces the chance of a judicial demand. The doctor still needs to fully understand his/her conduct obligations and mainly to avoid power abuse. Doctors must also professionally link themselves with politicians who fight for the individual's rights against the system. Society must also understand that health is not just an issue exclusive for doctors, and people must fight to improve living conditions. Society must seriously show its frustration with the increasing disparity between scientific possibilities and actual wellbeing. The training machine needs immediate profound changes to produce professionals with the highest qualifications equipped

  20. Postmortem assay of digoxin by radioimmunoassay.

    PubMed Central

    Holt, D W; Benstead, J G

    1975-01-01

    Analysis of postmortem blood samples from patients previously on maintenance digoxin therapy suggests that the results are of value in assessing the degree of digitalization at the time of death. Control cases gave results within the normal therapeutic range wheras of six cases in which digoxin was suspected of being implicated in the death five had 'serum' digoxin levels above the therapeutic range. Differences in digoxin concentration were noted in blood collected from three sites in the body, and it is suggested that postmortem blood should be collected from the leg veins if assessment of antermortem digitalization is to be made. PMID:1141449

  1. The shifting sands of medico-legal intra-partum Ctg (I-P Ctg) monitoring.

    PubMed

    Buttigieg, George G

    2016-03-01

    Intra-partum (IP) surveillance of the unborn child by cardiotacography (CTG) monitoring is the commonest obstetric procedure in the developed world.(1) It is also the most medico-legally contested obstetric procedure in labour. In 2011, 'birth asphyxia' comprised 50% of the UK National Health Service (NHS) litigation costs,(2) and in the 2000-2010 decade, the same NHS paid out £3.1 billion for maternity medico-legal claims (the highest of any speciality), mostly involving cerebral palsy and CTG misinterpretation.(3) This article looks at a number of characteristics of IP CTG monitoring which argue for its questionable solidity of base in court proceedings.

  2. A minimum data set approach to post-mortem computed tomography reporting for anthropological biological profiling.

    PubMed

    Brough, Alison L; Morgan, Bruno; Robinson, Claire; Black, Sue; Cunningham, Craig; Adams, Catherine; Rutty, Guy N

    2014-12-01

    Anthropological examination of bones is routinely undertaken in medico-legal investigations to establish an individual's biological profile, particularly their age. This often requires the removal of soft tissue from bone (de-fleshing), which, especially when dealing with the recently deceased, is a time consuming and invasive procedure. Recent advances in multi-detector computed tomography have made it practical to rapidly acquire high-resolution morphological skeletal information from images of "fleshed" remains. The aim of this study was to develop a short standard form, created from post-mortem computed tomography images, that contains the minimum image-set required to anthropologically assess an individual. The proposed standard forms were created for 31 juvenile forensic cases with known age-at-death, spanning the full age range of the developing human. Five observers independently used this form to estimate age-at-death. All observers estimated age in all cases, and all estimations were within the accepted ranges for traditional anthropological and odontological assessment. This study supports the implementation of this approach in forensic radiological practice.

  3. Selective culturing and genus-specific PCR detection for identification of Aeromonas in tissue samples to assist the medico-legal diagnosis of death by drowning.

    PubMed

    Huys, Geert; Coopman, Vera; Van Varenbergh, Dirk; Cordonnier, Jan

    2012-09-10

    The detection of autochthonous aquatic bacteria in tissue samples from drowning cases is increasingly considered as an alternative approach to assist the medico-legal diagnosis of death by drowning. Bacteria belonging to the genus Aeromonas may be suitable candidates for this application as they are ubiquitous in natural aquatic environments but are generally not part of the human microbiota. The research aims of this study were (i) to develop a sensitive, specific and rapid screening and confirmation method for Aeromonas species in tissue samples and (ii) to evaluate aseptic sternal puncture as a post-mortem sample technique and bone marrow as an alternative matrix to provide evidence of death by drowning. The presence of Aeromonas in tissue samples was verified by cultivation using the selective media Ampicillin Dextrin Agar (ADA) and Ryan's Aeromonas Medium. The use of ADA medium was found most optimal for the sensitive, inexpensive and quick detection of aeromonads in human tissue samples. Positive culture plates were confirmed by harvesting all colonies for DNA extraction and subsequent PCR amplification using Aeromonas genus-specific primers. Aeromonads were detected in lung swab, blood and bone marrow of drowned bodies (n=3), but were negative in these three matrices for all negative controls (n=90) tested. Bone marrow proved to be a suitable alternative matrix and can be sampled post-mortem by an aseptic sternal puncture. In conclusion, this study confirms previous indications that aeromonads in cultures from blood of water bodies can be considered a potential marker for drowning. Given the fact that the number of immersed bodies (drowned and non-drowned) included in this study is statistically not significant, however, more tissue samples need to be investigated to confirm the validity of these methods to aid the diagnosis of death by wet drowning.

  4. The conclusive role of postmortem computed tomography (CT) of the skull and computer-assisted superimposition in identification of an unknown body.

    PubMed

    Lorkiewicz-Muszyńska, Dorota; Kociemba, Wojciech; Żaba, Czesław; Łabęcka, Marzena; Koralewska-Kordel, Małgorzata; Abreu-Głowacka, Monica; Przystańska, Agnieszka

    2013-05-01

    Computed tomography is commonly used in modern medicine, and thus, it is often helpful for medicolegal purposes, especially as part of the antemortem record. The application of postmortem computed tomography and 3D reconstruction of the skull in challenging cases is reported, and its valuable contribution to positive identification is discussed. This paper presents a case in which the body of an unknown individual is identified. Positive identification had not been possible despite a multidisciplinary examination. The postmortem use of computerized tomography and 3D reconstruction of the skull followed by the comparison of individual morphological characteristics of the viscerocranium showed the concordant points between the deceased and a missing person. Finally, superimposition using a 3D-reconstructed skull instead of the skeletonized skull demonstrated an adequate degree of morphological consistency in the facial images of the analyzed individuals that lead to positive identification. It was concluded that where other methods of personal identification had failed, the use of postmortem computed tomography had proved to be instrumental in the positive identification of the deceased.

  5. The medico-legal investigation of abandoned fetuses and newborns--a review of cases admitted to the Pretoria Medico-Legal Laboratory, South Africa.

    PubMed

    du Toit-Prinsloo, L; Pickles, C; Smith, Z; Jordaan, J; Saayman, G

    2016-03-01

    There is a dearth of literature on the extent of fetal or newborn abandonment or "dumping" and the medico-legal investigation procedures these cases require. This is despite the fact that these occurrences are a worldwide phenomenon and by definition involve criminal law concerns such as illegal abortion, concealment of birth, murder, or neonaticide, depending on the country concerned. This article contributes to current literature in both respects and provides a retrospective case audit for the period 2004-2008 pertaining to all abandoned newborns and fetuses admitted to the Pretoria Medico-Legal Laboratory (PMLL) in South Africa. Demographic details, scope, and nature of the medico-legal investigation as well as formulation of cause of death were recorded. A total of 289 cases were identified for inclusion in this study, 57% of which were considered to have been non-viable fetuses, while 45 of the viable fetuses were deemed to have been stillborn. These instances involve the crimes of concealment of birth and at times illegal abortion, yet prosecution of these cases are relatively unheard of. Signs of live birth were identified in 38 of the cases in the study. Of these infants, 9 were deemed to have died from injuries they have sustained, and in a further 9 cases, no anatomical cause of death could be identified. Homicidal cases should be brought in cases where death ensued as a result of abandonment; however, it is not known how many cases were prosecuted. A comparatively large number of cases were found to have been admitted to the Pretoria Medico-Legal Laboratory. This is alarming because South African abortion laws are liberal and services are free at point of access in the public health care sector. A substantial percentage of cases of abandoned infants were found to have shown signs of life after birth implying a homicidal manner of death or death by abandonment, but it seems these cases are merely shelved.

  6. Comparing Species Composition of Passive Trapping of Adult Flies with Larval Collections from the Body during Scene-Based Medicolegal Death Investigations.

    PubMed

    Sanford, Michelle R

    2017-03-24

    Collection of insects at the scene is one of the most important aspects of forensic entomology and proper collection is one of the biggest challenges for any investigator. Adult flies are highly mobile and ubiquitous at scenes, yet their link to the body and the time of colonization (TOC) and post-mortem interval (PMI) estimates is not well established. Collection of adults is widely recommended for casework but has yet to be rigorously evaluated during medicolegal death investigations for its value to the investigation. In this study, sticky card traps and immature collections were compared for 22 cases investigated by the Harris County Institute of Forensic Sciences, Houston, TX, USA. Cases included all manner of death classifications and a range of decomposition stages from indoor and outdoor scenes. Overall, the two methods successfully collected at least one species in common only 65% of the time, with at least one species unique to one of the methods 95% of the time. These results suggest that rearing of immature specimens collected from the body should be emphasized during training to ensure specimens directly associated with the colonization of the body can be identified using adult stages if necessary.

  7. Lethal envenomation: medicolegal aspects of snakebites and religious snake handlers in Kentucky: a report of three cases with comment on medical, legal, and public policy ramifications.

    PubMed

    Hunsaker, Donna M; Hunsaker, John C; Clayton, Tara; Spiller, Henry A

    2005-11-01

    Ritualistic serpent qua snake handling, which rests upon inveterate religious conviction arising out of literal interpretation of selected passages of the New Testament, is a rare ceremony practiced by a distinct minority of Christians predominantly in rural Appalachian regions of the United States commonly referred to as the Bible belt. The fervent, frenzied pursuit by anointed "sign-followers" of intimate contact with a variety of poisonous snakes, however, puts the handler together with sect members or bystanders at risk for lethal envenomation, particularly when prompt medical attention is held by the congregation of faith to contravene God's will. The authors report three separate cases of death due to envenomation by snakebite during a church service and the handler's faith-based refusal to seek treatment. Postmortem examination of each yielded similar physical findings attributable to various toxic sequelae of the complex venoms. A review of the injurious constituents of these chemical toxins also includes a discussion of complex pathophysiological mechanisms causing death. In addition, the authors review the history of representative legislative and judicial responses to the sensationally mortal phenomenon, all of which ineluctably grapple with fundamental Constitutional issues devolving from such controversial religious practices. We underscore the view that a thoroughly documented medicolegal investigation and autopsy are indispensable to both inform matters of public health and thereby contribute to the formulation of sound public policy.

  8. Death and AIDS: A Review of the Medico-Legal Literature.

    ERIC Educational Resources Information Center

    Huber, Jeffrey T.

    1993-01-01

    Notes that diagnosis of Acquired Immune Deficiency Syndrome (AIDS) continues to denote death sentence. Contends that AIDS is unique terminal illness in that no other single disease in history of American legal system has generated more litigation than AIDS. Examines medico-legal issues associated with AIDS-related death: estate planning,…

  9. Postmortem diagnosis of Marfan syndrome in a case of sudden death due to aortic rupture: Detection of a novel FBN1 frameshift mutation.

    PubMed

    Wang, Yunyun; Chen, Shu; Wang, Rongshuai; Huang, Sizhe; Yang, Mingzhen; Liu, Liang; Liu, Qian

    2016-04-01

    To investigate the sudden death of a 36-year-old Chinese man, a medicolegal autopsy was performed, combining forensic pathological examinations and genetic sequencing analysis to diagnose the cause of death. Genomic DNA samples were extracted from blood and subjected to high-throughput sequencing. Major findings included a dilated aortic root with a ruptured and dissected aorta and consequent tamponade of the pericardial sac. Moreover, arachnodactyly and other skeletal deformities were noted. By sequencing the fibrillin-1 gene (FBN1), five genetic variations were found, including four previously known single nucleotide polymorphisms (SNPs) and a novel frameshift mutation, leading to the diagnosis of Marfan syndrome. The frameshift mutation (c.4921delG, p.glu1641llysFsX9) detected in exon 40 led to a stop codon after the next 8 amino acids. The four SNPs included a splice site mutation (c.3464-5 G>A, rs11853943), a synonymous mutation (p.Asn625Asn, rs25458), and two missense mutations (p.Pro1148Ala, rs140598; p.Cys472Tyr, rs4775765). Genetic screening was recommended for the relatives as it was reported that the father and brother of the deceased had died at the ages of 40 and 25, respectively, from sudden cardiac failure. The son of the deceased lacked the relevant mutations. This report emphasizes the important contribution of medicolegal postmortem analysis on the molecular pathogenesis study of Marfan syndrome and early diagnosis of at-risk relatives.

  10. Postmortem Blood Sugar and Blood Urea Nitrogen Determinations

    PubMed Central

    Fekete, John F.; Kerenyi, Norbert A.

    1965-01-01

    Glucose and urea nitrogen determinations were made on blood and cerebrospinal fluid samples collected during 160 postmortem examinations in order to determine the usefulness of such tests in diagnosing diabetes and uremia at the time of autopsy. The results indicated that: (1) Blood is unsuitable for postmortem glucose determination, and no postmortem normal can be established. (2) Cerebrospinal fluid gave more uniform but very low glucose values. (3) Diabetics as a group had very high postmortem glucose levels but showed a marked overlap with non-diabetics. (4) Infants less than 3 months of age showed high postmortem glucose values. (5) Postmortem blood urea nitrogen and cerebrospinal fluid urea nitrogen levels were within normal limits in previously healthy persons who died suddenly from accidental causes. (6) Hospital autopsy cases had high urea nitrogen levels. (7) Postmortem urea nitrogen levels higher than 100 mg.% were indicative of uremia. PMID:14285288

  11. Postmortem audit in a paediatric cardiology unit.

    PubMed Central

    Russell, G A; Berry, P J

    1989-01-01

    Postmortem examinations performed on 76 children with a clinical diagnosis of congenital heart disease were reviewed retrospectively and compared with the findings before death. Both operated and unoperated cases were studied over a three year period. Despite intensive investigation during life, there was a high rate of unsuspected abnormalities at necropsy (80%): 29 cases had undiagnosed additional cardiac anomalies or surgical flaws, which contributed to death in 13 cases. Defects in surgery were uncommon but permitted modification in surgical technique to avoid recurrence. Myocardial necrosis and pulmonary foreign body embolism were common findings, the importance of which is uncertain and requires further study for their prevention. Even in the most thoroughly investigated cases postmortem examination has a high yield of clinically important pathology which is undetected during life. Images PMID:2794078

  12. The Formation of Ethanol in Postmortem Tissues

    DTIC Science & Technology

    2004-02-01

    for ethanol analysis. The postmortem tissue specimens received by our laboratory have generally been subjected to severe trauma and may have been...Furthermore, the tissue specimens received by our laboratory typically have been subjected to trauma as a result of the violent nature of avia- tion...uoride, t-butanol, acetaldehyde , methanol, 2-propanol, acetone, n-propanol, isobutanol, n-butanol, sec-butanol and ethanol were purchased from Sigma

  13. Postmortem redistribution of Δ9-tetrahydrocannabinol (THC), 11-hydroxy-THC (11-OH-THC), and 11-nor-9-carboxy-THC (THCCOOH)

    PubMed Central

    Holland, Michael G.; Schwope, David M.; Stoppacher, Robert; Gillen, Shane B.; Huestis, Marilyn A.

    2012-01-01

    Introduction Postmortem redistribution (PMR), a well-described phenomenon in forensic toxicology for certain drugs, can result in increased central blood concentrations relative to peripheral blood concentrations. Δ9-tetrahydrocannabinol (THC), the primary psychoactive component in cannabis or marijuana, is the illicit substance most commonly implicated in driving under the influence of drugs (DUID) cases and fatally-injured drivers. No investigation of PMR of THC in human blood has been reported to date. Methods Matched heart and iliac postmortem blood specimens were collected from 19 medical examiner cases (16 Males, 3 Females) with positive cannabinoid urine immunoassay screens. THC, its equipotent metabolite 11-hydroxy-THC (11-OH-THC) and non-psychoactive metabolite 11-nor-9-carboxy-THC (THCCOOH) were quantified by two-dimensional gas chromatography-mass spectrometry with cryofocusing, with 0.5 ng/mL limits of quantification (LOQ) for all analytes. Results 10 cases had quantifiable THC and 11-OH-THC; THCCOOH was present in all 19. Median (range) heart:iliac blood ratios were 1.5 for THC (range: 0.3–3.1); 1.6 for 11-OH-THC (range: 0.3–2.7); and 1.8 for THCCOOH (range: 0.5–3.0). Discussion Cannabinoids, in general, exhibited a mean and median central: peripheral (C: P) concentration ratio of less than 2 following death. A trend was observed for greater PMR with increasing postmortem interval between death and sampling. To our knowledge, these are the first data on THC PMR in humans, providing important scientific data to aid in the interpretation of postmortem cannabinoid concentrations in medico-legal investigations. PMID:21764230

  14. [Determination of death and post-mortem examination on the high seas].

    PubMed

    Buschmann, Claas T; Tsokos, Michael

    2009-01-01

    Usually death has to be determined by a physician. Deaths on board of ocean-going vessels confront the crew with special challenges, as on the high seas--especially in the container and cargo ship business--often no physician will be available and death has to be determined by medical laymen such as the captain or the medical officer. To document the determination of death, a "Provisional Certificate of Death on the High Seas" is presented. Moreover, an algorithm "Provisional Post-Mortem Examination on the High Seas" is presented to document the results and the practical performance of the external post-mortem examination by medical laymen on a ship. With the help of concrete procedural instructions medical laymen on board of sea-going vessels are to be enabled to determine the death of a human being beyond doubt, to perform a preliminary external post-mortem examination and to store the corpse according to forensic requirements until the ship reaches a port and the body is delivered to the harbour physician.

  15. Pitfalls in post-mortem CT-angiography--intravascular contrast induces post-mortem pericardial effusion.

    PubMed

    Berger, Nicole; Martinez, Rosita; Winklhofer, Sebastian; Flach, Patricia M; Ross, Steffen; Ampanozi, Garyfalia; Gascho, Dominic; Thali, Michael J; Ruder, Thomas D

    2013-11-01

    We present a case where multi-phase post-mortem computed tomography angiography (PMCTA) induced a hemorrhagic pericardial effusion during the venous phase of angiography. Post-mortem non-contrast CT (PMCT) suggested the presence of a ruptured aortic dissection. This diagnosis was confirmed by PMCTA after pressure controlled arterial injection of contrast. During the second phase of multi-phase PMCTA the presence of contrast leakage from the inferior cava vein into the pericardial sac was noted. Autopsy confirmed the post-mortem nature of this vascular tear. This case teaches us an important lesson: it underlines the necessity to critically analyze PMCT and PMCTA images in order to distinguish between artifacts, true pathologies and iatrogenic findings. In cases with ambiguous findings such as the case reported here, correlation of imaging findings with autopsy is elementary.

  16. Normal perinatal and paediatric postmortem magnetic resonance imaging appearances.

    PubMed

    Arthurs, Owen J; Barber, Joy L; Taylor, Andrew M; Sebire, Neil J

    2015-04-01

    As postmortem imaging becomes more widely used following perinatal and paediatric deaths, the correct interpretation of images becomes imperative, particularly given the increased use of postmortem magnetic resonance imaging. Many pathological processes may have similar appearances in life and following death. A thorough knowledge of normal postmortem changes is therefore required within postmortem magnetic resonance imaging to ensure that these are not mistakenly interpreted as significant pathology. Similarly, some changes that are interpreted as pathological if they occur during life may be artefacts on postmortem magnetic resonance imaging that are of limited significance. This review serves to illustrate briefly those postmortem magnetic resonance imaging changes as part of the normal changes after death in fetuses and children, and highlight imaging findings that may confuse or mislead an observer to identifying pathology where none is present.

  17. Sudden unexpected death in epilepsy: some approaches for its prevention and medico-legal consideration.

    PubMed

    Verma, Archana; Kumar, Alok

    2015-09-01

    Worldwide, mortality associated with epilepsy is a matter of grave concern. The mortality rate in epileptic population is two to three times more than that of the general population. Sudden unexplained death in epilepsy, better known as sudden unexpected death in epilepsy (SUDEP), is a mysterious and rare condition, in which typically young or middle-aged people with epilepsy die without a clearly defined cause. At times, this may raise a strong suspicion of foul play and raise several medico-legal issues. There may be several different underlying mechanisms but most research has focused on seizure-related cerebral and respiratory depression, cardiac arrhythmia and autonomic dysfunction. In recent years, some significant risk factors have been recognized and strategies have been suggested that could be useful in prevention of SUDEP. Present communication provides some of the updates on new advances in prevention of SUDEP as well as highlights related medico-legal issues.

  18. The clinical management of diabetic foot in the elderly and medico-legal implications.

    PubMed

    Terranova, Claudio; Bruttocao, Andrea

    2013-10-01

    Diabetic foot is a complex and challenging pathological state, characterized by high complexity of management, morbidity and mortality. The elderly present peculiar problems which interfere on one hand with the patient's compliance and on the other with their diagnostic-therapeutic management. Difficult clinical management may result in medico-legal problems, with criminal and civil consequences. In this context, the authors present a review of the literature, analysing aspects concerning the diagnosis and treatment of diabetic foot in the elderly which may turn out to be a source of professional responsibility. Analysis of these aspects provides an opportunity to discuss elements important not only for clinicians and medical workers but also experts (judges, lawyers, medico-legal experts) who must evaluate hypotheses of professional responsibility concerning diabetic foot in the elderly.

  19. Functional and symptomatic assessment of medico-legal claims after upper limb injuries.

    PubMed

    Belcher, Hjcr

    2016-10-04

    A consecutive group of 250 patients underwent medico-legal assessment at a mean of 24 (±13) months following upper limb injuries. Each had completed questionnaires to assess function (Quick-DASH) and cold intolerance (CIQ36) before clinical assessment following which their whole limb impairment percentage was calculated. The mean(±SD) whole limb impairment, QDASH and CIQ36 scores were 9(±14)%, 43(±24) and 17(±10), respectively. There was a significant correlation between whole limb impairment and QDASH, although some patients reported surprisingly high disability levels despite minimal or no objective functional impairment. Whilst useful qualitative information can be obtained from questionnaires, the correlation between subjective and objective scores is weak albeit statistically significant. Individual patients can show marked discrepancies between objective and subjective functional scores. The results of questionnaires in individual medico-legal patients should be treated with caution.

  20. Medico-legal investigations of the Airbus, A320 crash upon Mount Ste-Odile, France.

    PubMed

    Ludes, B; Tracqui, A; Pfitzinger, H; Kintz, P; Levy, F; Disteldorf, M; Hutt, J M; Kaess, B; Haag, R; Memheld, B

    1994-09-01

    The authors present the medico-legal investigations and identification after the aircrash of the Airbus A320 upon the Mount Sainte-Odile (France). The identification team comprising investigators from the gendarmerie, forensic pathologists, odontologists, and scientists of the Institute from Legal Medecine rapidly retrieved and identified 85 of the 87 victims, with 17 being identified through DNA typing, three through fingerprints and the remaining through dental records and specific physical or X-ray findings. Full autopsies were performed on all fatalities to determine patterns of injury and cause of death. Results lead us to point out the importance of a multidisciplinary team of forensic practitioners especially trained for managing medico-legal investigation in mass disaster and the ability of DNA technology to solve complex identification problems.

  1. Barriers to the effective use of medico-legal findings in sexual assault cases worldwide.

    PubMed

    Mont, Janice Du; White, Deborah

    2013-09-01

    Despite the increasing implementation of standardized rape kits across jurisdictions, the medico-legal findings generated by these tools are often not related to positive criminal justice outcomes. Given that there has been no global investigation of the factors that might impede their successful use in cases of sexual assault, we conducted a review of relevant scholarly and "grey" literature from industrialized and less-developed regions. One key theme to emerge from the analysis concerned certain problematic practices and behaviors of professional groups involved in the various stages of the post-sexual assault process. We found that a lack of competence in handling sexual assault cases, contempt for women who have been victimized, and corruption among some forensic examiners, police, scientists, and legal personnel often have shaped the collection, processing, analysis, and use of medico-legal evidence. We discuss recent initiatives and future directions for research that might serve to address these issues.

  2. Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications.

    PubMed

    Vassalini, Marzia; Verzeletti, Andrea; De Ferrari, Francesco

    2016-06-22

    Concerning recent Italian laws and jurisprudential statements, guidelines application involves several difficulties in clinical practice, regarding prevention, diagnosis and therapy of venous thromboembolism. International scientific community systematically developed statements about this disease in order to optimize the available resources in prophylaxis, diagnosis and therapy. Incongruous prevention, missed or delayed diagnosis and/or inadequate treatment of this disease can frequently give rise to medico-legal litigation.

  3. Pre- and postmortem imaging of transplanted cells

    PubMed Central

    Andrzejewska, Anna; Nowakowski, Adam; Janowski, Miroslaw; Bulte, Jeff WM; Gilad, Assaf A; Walczak, Piotr; Lukomska, Barbara

    2015-01-01

    Therapeutic interventions based on the transplantation of stem and progenitor cells have garnered increasing interest. This interest is fueled by successful preclinical studies for indications in many diseases, including the cardiovascular, central nervous, and musculoskeletal system. Further progress in this field is contingent upon access to techniques that facilitate an unambiguous identification and characterization of grafted cells. Such methods are invaluable for optimization of cell delivery, improvement of cell survival, and assessment of the functional integration of grafted cells. Following is a focused overview of the currently available cell detection and tracking methodologies that covers the entire spectrum from pre- to postmortem cell identification. PMID:26366076

  4. Iatrogenic splenic injury: review of the literature and medico-legal issues

    PubMed Central

    Feola, Alessandro; Niola, Massimo; Conti, Adelaide; Delbon, Paola; Graziano, Vincenzo; Pietra, Bruno Della

    2016-01-01

    Abstract Introduction: Iatrogenic splenic injury is a recognized complication in abdominal surgery. The aim of this paper is to understand the medico-legal issues of iatrogenic splenic injuries. We performed a literature review on PubMed and Scopus using iatrogenic splenic or spleen injury and iatrogenic splenic rupture as keywords. Iatrogenic splenic injury cases were identified. Most cases were related to colonoscopy, but we also identified cases related to upper gastrointestinal procedures, colonic surgery, ERCP, left nephrectomy and/or adrenalectomy, percutaneous nephrolithotomy, vascular operations involving the abdominal aorta, gynecological operation, left lung biopsy, chest drain, very rarely spinal surgery and even cardiopulmonary resuscitation. There are several surgical procedures that can lead to a splenic injury. However, from a medico-legal point of view, it is important to assess whether the cause can be attributed to a technical error of the operator rather than being an unpredictable and unpreventable complication. It is important for the medico-legal expert to have great knowledge on iatrogenic splenic injuries because it is important to evaluate every step of the first procedure performed, how a splenic injury is produced, and whether the correct treatment for the splenic injury was administered in a judgment. PMID:28352813

  5. Medico-legal perspectives on sudden cardiac death in young athletes.

    PubMed

    Oliva, Antonio; Grassi, Vincenzo M; Campuzano, Oscar; Brion, Maria; Arena, Vincenzo; Partemi, Sara; Coll, Monica; Pascali, Vincenzo L; Brugada, Josep; Carracedo, Angel; Brugada, Ramon

    2017-03-01

    Sudden cardiac death (SCD) in a young athlete represents a dramatic event, and an increasing number of medico-legal cases have addressed this topic. In addition to representing an ethical and medico-legal responsibility, prevention of SCD is directly correlated with accurate eligibility/disqualification decisions, with an inappropriate pronouncement in either direction potentially leading to legal controversy. This review summarizes the common causes of SCD in young athletes, divided into structural (hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, congenital coronary artery anomalies, etc.), electrical (Brugada, congenital LQT, Wolf-Parkinson-White syndrome, etc.), and acquired cardiac abnormalities (myocarditis, etc.). In addition, the roles of hereditary cardiac anomalies in SCD in athletes and the effects of a positive result on them and their families are discussed. The medico-legal relevance of pre-participation screening is analyzed, and recommendations from the American Heart Association and European Society of Cardiology are compared. Finally, the main issues concerning the differentiation between physiologic cardiac adaptation in athletes and pathologic findings and, thereby, definition of the so-called gray zone, which is based on exact knowledge of the mechanism of cardiac remodeling including structural or functional adaptions, will be addressed.

  6. Postmortem genetic screening for the identification, verification, and reporting of genetic variants contributing to the sudden death of the young

    PubMed Central

    Methner, D. Nicole R.; Scherer, Steven E.; Welch, Katherine; Walkiewicz, Magdalena; Eng, Christine M.; Belmont, John W.; Powell, Mark C.; Korchina, Viktoriya; Doddapaneni, Harsha Vardhan; Muzny, Donna M.; Gibbs, Richard A.; Wolf, Dwayne A.; Sanchez, Luis A.; Kahn, Roger

    2016-01-01

    Each year in the United States, thousands of cases of sudden and unexpected deaths of infants, children, and young adults are assigned an undetermined cause of death after postmortem investigation and autopsy. Heritable genetic variants have been suggested as the cause of up to a third of sudden death (SD) cases. Elucidation of the genetic variants involved in SD cases is important to not only help establish cause and manner of death of these individuals, but to also aid in determining whether familial genetic testing should be considered. Previously, these types of postmortem screenings have not been a feasible option for most county medical examiners’ and coroners’ offices. We sequenced full exons of 64 genes associated with SD in the largest known cohort (351) of infant and young SD decedents using massively parallel sequencing at <$600 per sample. Genetic variants were assessed through literature review and clinical evaluation by a multidisciplinary consortium of experts. Thirteen individuals (3.7%), eight infants (2.8% of those <1 yr of age) and five children/young adults (7.0% of those >1 yr of age), were found to have a reportable genetic variant contributing to SD. These percentages represent an estimate lower than those previously reported. Overall yields and results likely vary between studies due to differences in evaluation techniques and reporting. Additionally, we recommend ongoing assessment of data, including nonreported novel variants, as technology and literature continually advance. This study demonstrates a strategy to implement molecular autopsies in medicolegal investigations of young SD decedents. PMID:27435932

  7. Postmortem Brain: An Underutilized Substrate for Studying Severe Mental Illness

    PubMed Central

    McCullumsmith, Robert E; Hammond, John H; Shan, Dan; Meador-Woodruff, James H

    2014-01-01

    We propose that postmortem tissue is an underutilized substrate that may be used to translate genetic and/or preclinical studies, particularly for neuropsychiatric illnesses with complex etiologies. Postmortem brain tissues from subjects with schizophrenia have been extensively studied, and thus serve as a useful vehicle for illustrating the challenges associated with this biological substrate. Schizophrenia is likely caused by a combination of genetic risk and environmental factors that combine to create a disease phenotype that is typically not apparent until late adolescence. The complexity of this illness creates challenges for hypothesis testing aimed at understanding the pathophysiology of the illness, as postmortem brain tissues collected from individuals with schizophrenia reflect neuroplastic changes from a lifetime of severe mental illness, as well as treatment with antipsychotic medications. While there are significant challenges with studying postmortem brain, such as the postmortem interval, it confers a translational element that is difficult to recapitulate in animal models. On the other hand, data derived from animal models typically provide specific mechanistic and behavioral measures that cannot be generated using human subjects. Convergence of these two approaches has led to important insights for understanding molecular deficits and their causes in this illness. In this review, we discuss the problem of schizophrenia, review the common challenges related to postmortem studies, discuss the application of biochemical approaches to this substrate, and present examples of postmortem schizophrenia studies that illustrate the role of the postmortem approach for generating important new leads for understanding the pathophysiology of severe mental illness. PMID:24091486

  8. Distribution of Oxycodone in Postmortem Fluids and Tissues

    DTIC Science & Technology

    2010-06-01

    Distribution of Oxycodone in Postmortem Fluids and Tissues Sabra R. Botch Robert D. Johnson Arvind K. Chaturvedi Russell J. Lewis Civil Aerospace...Title and Subtitle 5. Report Date June 2010 6. Performing Organization Code Distribution of Oxycodone in Postmortem Fluids and Tissues 7...16. Abstract Introduction: Oxycodone is a heavily used and abused analgesic agent. Its pharmacological effects, including euphoria, respiratory

  9. Nonlesions, unusual cell types, and postmortem artifacts in the central nervous system of domestic animals.

    PubMed

    Wohlsein, P; Deschl, U; Baumgärtner, W

    2013-01-01

    In the central nervous system (CNS) of domestic animals, numerous specialized normal structures, unusual cell types, findings of uncertain or no significance, artifacts, and various postmortem alterations can be observed. They may cause confusion for inexperienced pathologists and those not specialized in neuropathology, leading to misinterpretations and wrong diagnoses. Alternatively, changes may mask underlying neuropathological processes. "Specialized structures" comprising the hippocampus and the circumventricular organs, including the vascular organ of the lamina terminalis, subfornical organ, subcommissural organ, pineal gland, median eminence/neurohypophyseal complex, choroid plexus, and area postrema, are displayed. Unusual cell types, including cerebellar external germinal cells, CNS progenitor cells, and Kolmer cells, are presented. In addition, some newly recognized cell types as of yet incompletely understood significance and functionality, such as synantocytes and aldynoglia, are introduced and described. Unusual reactive astrocytes in cats, central chromatolysis, neuronal vacuolation, spheroids, spongiosis, satellitosis, melanosis, neuromelanin, lipofuscin, polyglucosan bodies, and psammoma bodies may represent incidental findings of uncertain or no significance and should not be confused with significant microscopic changes. Auto- and heterolysis as well as handling and histotechnological processing may cause postmortem morphological changes of the CNS, including vacuolization, cerebellar conglutination, dark neurons, Buscaino bodies, freezing, and shrinkage artifacts, all of which have to be differentiated from genuine lesions. Postmortem invasion of micro-organisms should not be confused with intravital infections. Awareness of these different changes and their recognition are a prerequisite for identifying genuine lesions and may help to formulate a professional morphological and etiological diagnosis.

  10. Antemortem stress regulates protein acetylation and glycolysis in postmortem muscle.

    PubMed

    Li, Zhongwen; Li, Xin; Wang, Zhenyu; Shen, Qingwu W; Zhang, Dequan

    2016-07-01

    Although exhaustive research has established that preslaughter stress is a major factor contributing to pale, soft, exudative (PSE) meat, questions remain regarding the biochemistry of postmortem glycolysis. In this study, the influence of preslaughter stress on protein acetylation in relationship to glycolysis was studied. The data show that antemortem swimming significantly enhanced glycolysis and the total acetylated proteins in postmortem longissimus dorsi (LD) muscle of mice. Inhibition of protein acetylation by histone acetyltransferase (HAT) inhibitors eliminated stress induced increase in glycolysis. Inversely, antemortem injection of histone deacetylase (HDAC) inhibitors, trichostatin A (TSA) and nicotinamide (NAM), further increased protein acetylation early postmortem and the glycolysis. These data provide new insight into the biochemistry of postmortem glycolysis by showing that protein acetylation regulates glycolysis, which may participate in the regulation of preslaughter stress on glycolysis in postmortem muscle.

  11. Distribution of sertraline in postmortem cases.

    PubMed

    Levine, B; Jenkins, A J; Smialek, J E

    1994-09-01

    Sertraline is a potent inhibitor of serotonin reuptake in the central nervous system and is used clinically to treat depression and obsessive-compulsive behavior. Over the course of one year, there were seven cases investigated by the Office of the Chief Medical Examiner, State of Maryland, in which sertraline was identified in postmortem specimens. Heart blood concentrations in the seven cases ranged from 0.23 to 0.46 mg/L; desmethylsertraline concentrations ranged from 0.08 to 0.99 mg/L. One similarity with tricyclic antidepressants is the high liver concentrations of drug and metabolite relative to the blood. One unusual finding is the small concentrations of drug and metabolite in the urine relative to other specimens. In none of these cases was the cause of death related to sertraline intoxication.

  12. Postmortem vitreous humor beta-hydroxybutyrate: its utility for the postmortem interpretation of diabetes mellitus.

    PubMed

    Osuna, Eduardo; Vivero, Guillermo; Conejero, Josefa; Abenza, José M; Martínez, Pedro; Luna, Aurelio; Pérez-Cárceles, María D

    2005-10-29

    Ketoacidotic coma is one of the most serious complications arising from diabetes mellitus, especially type I, and may be the cause of sudden death especially in diabetes type I. Since beta-hydroxybutyrate (beta-OHB) serum concentrations might provide more information on the severity of ketoacidosis, the aim of this study was to evaluate the concentrations of beta-OHB in vitreous humor and its correlation with other biochemical parameters during postmortem examination. We intended to ascertain the sensitivity and the specificity of these markers for diagnosing diabetes mellitus and the presence of ketoacidosis. This study involved 453 cadavers with a mean age of 57.6 years (S.D. 20.7) and a mean postmortem interval of 17.8 h (S.D. 9.6, range 2-61 h). Cases were assigned to two diagnostic groups according to the antemortem diagnosis of diabetes mellitus, based on the patients' medical records. In vitreous humor statistically significant differences were found in biochemical marker concentrations between the two diagnostic groups, the highest values being obtained in the group of subjects with a previous diagnosis of diabetes mellitus. The measurement of beta-OHB in vitreous humor may be a useful alternative to using blood during postmortem analysis. The presence of high levels of beta-OHB may help interpret the cause of death in diabetics when the autopsy result is negative.

  13. Using existing information from medico-legal death investigations to improve care of older people in residential aged care services.

    PubMed

    Ibrahim, Joseph Elias; Bugeja, Lyndal; Ranson, David

    2013-12-01

    The care of older people in residential aged care services could be improved by optimising the use of existing information gathered for medico-legal death investigations. The authors address three myths contributing to underuse of this information: deaths are not preventable; public health gains are too small; and it is someone else's charter or responsibility A significant proportion of deaths are preventable, specifically those occurring prematurely from natural causes or due to injury and trauma. By addressing these preventable deaths, significant public health cost savings and better health outcomes for our growing ageing population can be achieved. Despite substantive monitoring of the provision of aged care, no single entity is explicitly responsible for systematically analysing medico-legal death information. The data and skills for using information from medico-legal death investigations currently exist. Dispelling the myths removes one impediment to investing in this area of public health.

  14. Bio-medicolegal guidelines and protocols: survey and future perspectives in Europe.

    PubMed

    Ferrara, Santo Davide; Bajanowski, Thomas; Cecchi, Rossana; Snenghi, Rossella; Case, Colette; Viel, Guido

    2010-07-01

    The preservation of uniqueness and the enhancement of the value of evidence in legal medicine is based on the implementation and development of a "quality management system," which includes a continuous education of specialists, the introduction and application of guidelines and protocols, as well as mechanisms of internal quality control. This ongoing process shows differences with regard to various fields of knowledge such as forensic genetics, toxicology, forensic pathology or forensic psychiatry, especially if different European countries are compared. To get an overview on the development of legal medicine in different European countries, a questionnaire was developed and sent to representatives of 42 European countries to verify the existence of bio-medicolegal guidelines and protocols. A National Society of Legal Medicine is established in 27 out of 32 countries (84%) which could be included in the final analyses. In 25 countries (78%), a specialisation is necessary as a prerequisite of inclusion in a national register, and 30 of the countries (94%) have guidelines in at least one field of legal medicine. The most common guidelines concern forensic pathology (in the fields of professional qualification and sudden death), forensic toxicology (driving under the influence of drugs and substance testing) and forensic genetics (paternity testing and personal identification). The findings of this study show that comparison is possible and can be a basis for further consensus in the European medicolegal community. The process of harmonisation of the medicolegal autopsy rules in Europe initiated in 1990 was a first step on this way. Further consensus is necessary and might be gained by developing European guidelines for each field within the subdisciplines, based on a standard European Guideline Format.

  15. Trivial trauma, heart disease and medico-legal interpretation of death.

    PubMed

    Kohli, Anil; Mishra, Kiran

    2008-01-01

    Forensic experts are often required to give an opinion on the cause of death and its medico-legal interpretation in cases where an individual dies after receiving non-fatal injuries and at autopsy is discovered to have had a natural disease that alone could have caused death. The significance of this varies in different countries depending on the local laws relating to death in cases of trivial trauma associated with natural disease. This paper discusses this issue from an Indian perspective with the help of an illustrative case report and highlights the importance of the forensic pathologist in such cases.

  16. Tuberculous abdominal aortic aneurysm with alimentary tract hemorrhage: a case report with medico-legal implications.

    PubMed

    Xie, Dan; Xie, Kai; Li, Pei; Peng, Yu-Long; Yang, Xiang; Yang, Li-Ying; Cai, Ji-Feng

    2014-04-01

    An autopsy case of sudden death induced by alimentary tract hemorrhage was presented, which was caused by the unexpected rupture of clinically unrecognized tuberculous abdominal aortic aneurysm (TAAA). The initial diagnosis was made of the syndrome of coronary heart disease and hypertensive disease. The detailed autopsy showed that the alimentary tract hemorrhage was caused by a sudden rupture of the mass after posture changing was ascertained as the cause of death. The diagnosis of TAAA was determined by the autopsy findings. Analysis for the medical dispute of TAAA was described, and the difficulty of the diagnosis and medico-legal implications were also discussed.

  17. E-suicide note: A newer trend and its medico-legal implications in India.

    PubMed

    Behera, C; Karthik, Krishna; Dogra, Td; Lalwani, S; Millo, T; Singh, Sr

    2014-06-01

    Rapid advancements of information and communication technology in the form of electronic mails, mobile phones, social networking sites, etc have an increasing impact on people's day to day life. It has been observed that these readily available applications are used frequently to express suicidal intentions. There are many studies on conventional handwritten suicide notes but suicide note in electronic format is an emerging issue and an under-researched phenomena. The authors have termed it as "E-suicide note" and discuss its medico-legal implications in India with examples from their observations.

  18. Suicide pact by drowning with bound wrists: a case of medico-legal importance.

    PubMed

    Behera, C; Karthik, Krishna; Singh, Hansraj; Deepak, Prakash; Jhamad, Akhilesh R; Bhardwaj, D N

    2014-03-01

    Suicide pacts are uncommon and mainly committed by male-female pairs in a consortial relationship. The victims frequently choose methods such as hanging, poisoning, using a firearm, etc; however, a case of a suicide pact by drowning is rare in forensic literature. We report a case where a male and a female, both young adults, in a relationship of adopted "brother of convenience" were found drowned in a river. The victims were bound together at their wrists which helped with our conclusion this was a suicide pact. The medico-legal importance of wrist binding in drowning cases is also discussed in this article.

  19. Bilateral chemodectoma: medicolegal considerations on a case report of aeromedical concern.

    PubMed

    Landolfi, Angelo; Giovannetti, Arianna; Mancarella, Paola; Conti, Stefano; Morgagni, Fabio; De Angelis, Claudio

    2013-05-01

    The authors describe a case of bilateral carotid chemodectoma occurring in a military pilot who was assessed and evaluated in terms of aeromedical and medico-legal aspects for his fitness to fly. In view of the lack of specific guidelines and/or regulations, both national and international, we choose to follow a multidisciplinary clinical approach that included aero-physiological tests in the hypobaric chamber, in order to identify a standard protocol that could be used as reference for similar future cases, where this kind of assessment is necessary.

  20. Postmortem Examinations for the Etiological Identification of Juvenile Coronary Arteriosclerosis.

    PubMed

    Heide, Steffen; Lessig, Rüdiger; Diers, Verena; Schaefer, Jürgen R; Soufi, Muhidin

    2015-09-01

    The postmortem of suddenly deceased younger adults sometimes reveals that they experienced manifest coronary arteriosclerosis. We looked at 21 cases where stenosis of the coronary arteries was at least 50%. We supplemented our postmortem findings and the results from the postmortem identification of the lipid metabolism parameters with anamnestic details. We also conducted a genetic analysis. The risk factors such as smoking and family history were relatively frequent. In most of our cases, the postmortems showed significantly deviating lipid metabolism parameters. Compared to these findings, the genetic analyses only showed a clearly increased presence of APOE genotypes 3/4, whereas we observed no abnormalities in relation to the LDL receptor. The study results illustrate the multifactor genesis of premature coronary arteriosclerosis. Despite these limitations, the unexpected finding of juvenile coronary arteriosclerosis should entail an effort to establish the individual risk factors involved as this can provide vital information for medically advising other members of the family on their hereditary risks.

  1. New pitfalls of high-density postmortem computed tomography.

    PubMed

    Kanazawa, Ayumi; Hyodoh, Hideki; Watanabe, Satoshi; Fukuda, Marika; Baba, Miho; Okazaki, Shunichiro; Mizuo, Keisuke; Hayashi, Etsuko; Inoue, Hiromasa

    2014-09-01

    An 80-year-old female was transferred to the hospital due to a traffic accident. Multiple cranial bone fractures with intracranial hemorrhage and intracranial air were detected. Despite treatment, the patient died after 6h. Twenty-one hours after the patient died, her whole body was scanned by postmortem CT, and a region of high density was detected within the left putamen. The autopsy revealed a cerebral contusion and multiple skull base fractures. Moreover, superabsorbent polymers (SAPs) were found within the left lateral ventricle and adjacent to the putamen, which appeared as a high-density lesion on postmortem CT at the left putamen, where the SAPs were compacted. Both ante- and postmortem conditions should be considered to prevent misdiagnoses based only on postmortem CT.

  2. 14. VIEW IN THE WEST OPERATING GALLERY OF POSTMORTEM CELL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. VIEW IN THE WEST OPERATING GALLERY OF POST-MORTEM CELL WORK STATION AND MANIPULATOR ARMS. - Nevada Test Site, Engine Maintenance Assembly & Disassembly Facility, Area 25, Jackass Flats, Mercury, Nye County, NV

  3. Maxillofacial Surgeon as Fact Witness for Medico-Legal Cases: Indian Scenario.

    PubMed

    Kedarnath, N S; Shruthi, R

    2015-12-01

    An Oral and Maxillofacial surgeon at any time during the practice will encounter medicolegal cases (MLC). There are lacunae in the knowledge and understanding of the correct method of dealing with such cases. Many of the practitioners are apprehensive and anxious as they have to interact with individuals and systems outside the normal realm of practice. In today's arena, it is of utmost importance to be aware of legal system and law of the land. An OMF surgeon needs to have thorough understanding in recording and maintenance of the details of all MLCs and presenting the same in the court. Professional guidelines for expert witness are often not well recognised as those relating to the clinical practice. Surgeon has an obligation to conduct him/herself to highest ethical standards. This article provides insight into the details of registration of MLC, examination and recording of injuries, collecting medico-legal evidences and writing a medico legal report. Also discusses the court proceedings and possible questions that may be faced by the surgeon in the court.

  4. [Medico-legal features of early discharge in acute myocardial infarction and chest pain].

    PubMed

    Montisci, M; Ruscazio, M; Snenghi, R; Nalin, S; Montisci, R; Iliceto, S; Ferrara, S D

    2001-06-01

    The authors' aim is to outline some of the main medico-legal problems in cardiology, especially those regarding the premature hospital discharge of patients with undefined chest pain and/or with acute myocardial infarction. After a brief overview on the etiology and clinical definition of chest pain and myocardial infarction, premature hospital discharge is defined and the incidental medico-legal risks that physicians operating in such situations are exposed to are pointed out. Next, the profiles regarding both the positive and negative views of professional medical responsibility are described. In the negative frame, the authors outline the most frequent civil and penal aspects of the unpremeditated responsibility. Then the physician's error, in both qualitative (generic or specific guilt) and quantitative (degree) terms, is considered; particularly, negligence, imprudence and inexperience, as qualitatively accepted meanings of generic guilt, are dealt with by adopting illustrative cases settled in the light of the right legal interpretation. The phases of the diagnostic or prognostic error are evaluated, and clinical protocols, as a reference parameter for the identification of error, are considered. Lastly, the problem of causality, essential condition for the judgment about the professional responsibility, and the problem of the patient's consent, including an evaluation of the legal capability or incapability about the declaration of consent, are examined closely.

  5. [Medico-legal opinionating in cases of insobriety in medical personnel].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara; Drozd, Radosław

    2009-01-01

    The authors analyzed the medico-legal opinions in cases of insobriety in medical personnel. The studies were based on the results of 157 medico-legal evaluations in criminal cases performed in the years 2005-2007. Expert appraisals included: correctness of medical management, degree of exposure to direct danger of death or grave detriment to health associated with alcohol intoxication of a physician, regardless of his activities being correct in their merits, as well as influence of insobriety on personnel behavior. Penal responsibility is implemented in case of exposing the patient to direct danger to life or severe detriment to health. The necessary analysis should include activities that have been or should have been performed by a physician with respect to his patients, their health status (degree of danged to life or health) and the effect of the physician's alcohol intoxication on his abilities to perceive and assess the reality, make decisions and perform his duties. The Polish law in force lacking the equivalent of Article 147 found in the Polish penal code of 1969 causes problems in penalization of insobriety in medical personnel.

  6. Medicolegal investigation in New York City. History and activities 1918-1978.

    PubMed

    Eckert, W G

    1983-03-01

    Medicolegal investigation in America can truly be said to have begun in an organized manner in 1918. The Massachusetts medical examiner system, which began in 1877, never developed with the central control and the completeness that characterizes the New York Office of the Chief Medical Examiner, nor did it influence the spread of this form of medicolegal investigation. An overview of the period before the establishment of the New York Office in 1918 and early experiences in coroner's investigation in New York is presented. The roots of the development of the office are discussed, as were the early days of the office under Dr. Charles Norris, whose influence on the spread of knowledge and of providing an important service to the community in general is detailed. The contributions of Alexander Gettler, the father of forensic toxicology in America, are also discussed. The contributions of Gonzales, Vance, Helpern, Umberger, and Wiener are also included. Special problems of New York City are described, including narcotic deaths, gas refrigerator deaths, malaria in addicts, plastic bag hazards, sudden infant deaths, operative deaths, as well as many famous cases involving murder, disasters, and unusual deaths over a period of 60 years. Milestones in the Office of the Chief Medical Examiner of New York City are listed, as are chronological details of major cases and problems. Several comparative figures of the workload and frequency of various types of death are also included. A relationship of deaths to different life-styles is noted.

  7. The postmortem examination of President Kennedy is invalid: the evidence.

    PubMed

    Salerian, Alen J

    2008-10-01

    This paper proves that President Kennedy's postmortem examination is a sham. The sham nature of the presidential autopsy is based upon several findings incompatible with human anatomy, practice of medicine and Newton's second law "an object acted upon by a constant force will move with constant acceleration in the direction of the force". We review the autopsy report and other assassination evidence and demonstrate that the postmortem examination is invalid.

  8. Early neonatal lamb mortality: postmortem findings.

    PubMed

    Holmøy, I H; Waage, S; Granquist, E G; L'Abée-Lund, T M; Ersdal, C; Hektoen, L; Sørby, R

    2017-02-01

    An investigation of stillbirth and early neonatal lamb mortality was conducted in sheep flocks in Norway. Knowledge of actual causes of death are important to aid the interpretation of results obtained during studies assessing the risk factors for lamb mortality, and when tailoring preventive measures at the flock, ewe and individual lamb level. This paper reports on the postmortem findings in 270 liveborn lambs that died during the first 5 days after birth. The lambs were from 17 flocks in six counties. A total of 27% died within 3 h after birth, 41% within 24 h and 80% within 2 days. Most lambs (62%) were from triplet or higher order litters. In 81% of twin and larger litters, only one lamb died. The most frequently identified cause of neonatal death was infectious disease (n=97, 36%); 48% (n=47) of these died from septicaemia, 25% (n=24) from pneumonia, 22% (n=21) from gastrointestinal infections and 5% (n=5) from other infections. Escherichia coli accounted for 65% of the septicaemic cases, and were the most common causal agent obtained from all cases of infection (41%). In total, 14% of neonatal deaths resulted from infection by this bacterium. Traumatic lesions were the primary cause of death in 20% (n=53) of the lambs. A total of 46% of these died within 3 h after birth and 66% within 24 h. Severe congenital malformations were found in 10% (n=27) of the lambs, whereas starvation with no concurrent lesions was the cause of death in 6% (n=17). In 16% (n=43) of the lambs, no specific cause of death was identified, lambs from triplet and higher order litters being overrepresented among these cases. In this study, the main causes of neonatal lamb mortality were infection and traumatic lesions. Most neonatal deaths occurred shortly after birth, suggesting that events related to lambing and the immediate post-lambing period are critical for lamb survival.

  9. When range of motion is not enough: towards an evidence-based approach to medico-legal reporting in whiplash injury.

    PubMed

    Worsfold, Christian

    2014-07-01

    Whiplash injury medico-legal reporting has traditionally been focused upon identifying restrictions in range of motion and identifying the presence of tender areas in the cervical spine in an effort both to diagnose the condition and to offer a prognosis. There have been considerable advances in this field over the last decade however that calls into question such a diminutive approach. This paper reviews the contemporary evidence base for the medico-legal assessment of whiplash injury and identifies a body of literature that strongly implicates a Claimant's physiological and psychological stress response as a key medico-legal marker in predicting prognosis following whiplash injury.

  10. Medical terminology coding systems and medicolegal death investigation data: searching for a standardized method of electronic coding at a statewide medical examiner's office.

    PubMed

    Lathrop, Sarah L; Davis, Wayland L; Nolte, Kurt B

    2009-01-01

    Medical examiner and coroner reports are a rich source of data for epidemiologic research. To maximize the utility of this information, medicolegal death investigation data need to be electronically coded. In order to determine the best option for coding, we evaluated four different options (Current Procedural Terminology [CPT], International Classification of Disease [ICD] coding, Systematized Nomenclature of Medicine Clinical Terms [SNOMED CT], and an in-house system), then conducted internal and external needs assessments to determine which system best met the needs of a centralized, statewide medical examiner's office. Although all four systems offer distinct advantages and disadvantages, SNOMED CT is the most accurate for coding pathologic diagnoses, with ICD-10 the best option for classifying the cause of death. For New Mexico's Office of the Medical Investigator, the most feasible coding option is an upgrade of an in-house coding system, followed by linkage to ICD codes for cause of death from the New Mexico Bureau of Vital Records and Health Statistics, and ideally, SNOMED classification of pathologic diagnoses.

  11. Occupational fatalities in the construction sector: A medico-legal viewpoint.

    PubMed

    Das, Siddhartha

    2015-06-01

    Occupational fatalities are those that occur during the course of a person's occupation. They can occur in any industry or sector. Studies have shown that the construction sector is more dangerous for workers than the industrial sector, and there are more deaths both in the developed and developing countries. The construction sector has seen a boom in countries like India over the past few years and with it an increase in the number of occupational fatalities. Three different types of occupational fatalities pertaining to construction sector are presented here to increase awareness of the different types of occupational fatalities that may occur. The circumstances leading to them are discussed from a medico-legal viewpoint. Specific acts of negligence have been highlighted and suggestions offered with a view to decreasing fatalities.

  12. The assessment of grip strength after upper limb injuries in medico-legal practice.

    PubMed

    Belcher, Hjcr

    2017-03-01

    Four hundred adult claimants underwent medico-legal assessment following upper limb injuries. Dynamometry was performed on each using the Jamar five handle-position test. Injury causes loss of power and there is a significant relationship between the percentage loss of power and the measured whole limb impairment. This paper presents a new approach for the analysis of the tests. The normal physiological length-tension pattern of muscle is maintained in the majority of claimants albeit with modifications due to the specific effects of injury on hand function. This paper provides normative data for the analysis of dynamometry in this population and makes recommendations for parameters that suggest that a test is a true reflection of capacity and thus useable in court.

  13. Danger points, complications and medico-legal aspects in endoscopic sinus surgery.

    PubMed

    Hosemann, W; Draf, C

    2013-12-13

    Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5-1%. A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education.

  14. Medico-legal autopsy of abandoned foetuses and newborns in India.

    PubMed

    Behera, C; Sikary, Asit Kumar; Krishna, Karthik; Garg, Aayushi; Chopra, Saurav; Gupta, S K

    2016-06-01

    Foeticide and the abandonment of newborns are important, albeit frequently neglected, issues. Concealment of childbirth is often seen in the setting of unwanted pregnancy which has been recognised as one of the most important factors in both cases. This study highlights the medico-legal autopsy findings of 238 abandoned foetuses and newborns over a period of 17 years (1996-2012) from the region of South Delhi, India. There was no sex predilection. The majority of the cases were full term. Nearly 35% of the foetuses were still born, about 29% were live born and the remainder were non-viable. Among the live born, death by homicide was more common than a natural death and most were left by the roadside. The abandoning and killing of newborns needs urgent attention, and strict measures are needed to save thousands of innocent lives.

  15. Fetal Alcohol Syndrome in Sudden Unexpected Death in Infancy: A Case Report in Medicolegal Autopsy.

    PubMed

    Tangsermkijsakul, Aphinan

    2016-03-01

    Fetal alcohol spectrum disorder is a range of birth defects associated with prenatal alcohol exposure. Fetal alcohol syndrome (FAS) is the most serious form of fetal alcohol spectrum disorder. Infants with FAS are prone to death because of various physical abnormalities. Consequently, infants with FAS may be presented in the medicolegal investigation as a form of sudden unexpected death in infancy. The author reported a 6-month-old male infant who was found dead at home. The history of maternal ethanol consumption during pregnancy was obtained. The infant was diagnosed with FAS at the autopsy because he was presented with postnatal growth retardation, multiple facial abnormalities, and abnormal brain structures, which met the criteria of FAS. The cause of death was severe aspiration pneumonia. The purposes of this case report are to show an uncommon manifestation of sudden unexpected death in infancy case for the forensic pathologists and to emphasize on the national healthcare problem.

  16. [Medicolegal opinions assessing the ability to undergo imprisonment vs. capacity of the Prison Health Service facilities].

    PubMed

    Jurek, Tomasz; Bujak, Marek; Szostak, Maciej; Swiatek, Barbara

    2008-01-01

    Estimating the subject's ability to undergo imprisonment has become a medicolegal opinionating problem. Polish penal law indicates the presence of negative prerequisites, such as a "serious disease" and "important health-associated reasons". In these cases, the conditions of imprisonment pose a direct danger of death or detriment to health. Interruption of imprisonment or remission of the penalty of imprisonment must constitute the only possibility of avoiding such dangers. In his opinion, the expert should define the health-associated needs of the condemned and the possibilities of meeting such needs in the situation of imprisonment, also taking into consideration the capacity of the prison health service facility and its cooperation with regular health care institutions.

  17. Test security in medicolegal cases: proposed guidelines for attorneys utilizing neuropsychology practice.

    PubMed

    Morel, Kenneth R

    2009-11-01

    In the context of forensic neuropsychological assessments, the professional interaction of law and psychology is viewed primarily as one where the retaining attorney or court dictates its needs to psychologists when resolving legal disputes. While this perspective is conceptually accurate, the positive and practical collaboration of law and psychology also relies on attorneys adhering to basic protections of sensitive psychological assessment procedures and tests. Objective testing is undermined when a practitioner of law engages in actions prior to, during, or following a neuropsychological examination in a manner that threatens the test security. An appreciation among practitioners of law and psychology regarding the necessity of test security is essential. This article reviews attorney actions that can affect test security, proposes a distinction by psychology between appropriate and problematic client preparation for a neuropsychological examination, integrates the available legal precedent regarding test security, and suggests productive measures to protect test security in medicolegal settings.

  18. Danger points, complications and medico-legal aspects in endoscopic sinus surgery

    PubMed Central

    Hosemann, W.; Draf, C.

    2013-01-01

    Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5–1%. A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education. PMID:24403974

  19. [Medico-legal autopsy--selected legal issues: the autopsy protocol].

    PubMed

    Gaszczyk-Ozarowski, Zbigniew; Chowaniec, Czesław

    2010-01-01

    The majority of experts in the field of forensic medicine maintain that the minutes of the medicolegal autopsy should be taken by the forensic pathologist. The authors argue that it is the public prosecutor who is obliged to draw up the minutes, whereas the forensic pathologist issues the expert opinion. To support their stance, the authors make frequent references to several provisions of the Criminal Procedure Code of 1997. The authors also imply that due to organizational reasons and the ratio legis of the aforementioned code, the forensic pathologist should not be assigned the role of the minutes-taker, despite the lack of a specific exclusion rule governing such a case. Possible consequences caused by the lack of the properly drawn up minutes are briefly discussed as well.

  20. Medicolegal considerations in the initiation and termination of resuscitation in Canada.

    PubMed Central

    Gilmour, J M; Rosenberg, P J

    1989-01-01

    Medicolegal issues in cardiopulmonary resuscitation (CPR) and emergency cardiac care were considered in the United States by the National Conference on Cardiopulmonary Resuscitation in 1985. This paper discusses these issues in the Canadian context. Although there is little legislation or case precedent in Canada to guide providers of CPR in decision-making, there appears to be little risk of liability or prosecution for competently rendered care. Providers should be cautious in withholding or withdrawing resuscitative measures from incompetent patients when brain death has not occurred and cardiovascular unresponsiveness has not been demonstrated. However, resuscitation may be withheld when a competent patient refuses it or if there is another medically and legally valid reason to do so. PMID:2644006

  1. Altered AMP deaminase activity may extend postmortem glycolysis.

    PubMed

    England, E M; Matarneh, S K; Scheffler, T L; Wachet, C; Gerrard, D E

    2015-04-01

    Postmortem energy metabolism drives hydrogen accumulation in muscle and results in a fairly constant ultimate pH. Extended glycolysis results in adverse pork quality and may be possible with greater adenonucleotide availability postmortem. We hypothesized that slowing adenonucleotide removal by reducing AMP deaminase activity would extend glycolysis and lower the ultimate pH of muscle. Longissimus muscle samples were incorporated into an in vitro system that mimics postmortem glycolysis with or without pentostatin, an AMP deaminase inhibitor. Pentostatin lowered ultimate pH and increased lactate and glucose 6-phosphate with time. Based on these results and that AMPK γ3(R200Q) mutated pigs (RN⁻) produce low ultimate pH pork, we hypothesized AMP deaminase abundance and activity would be lower in RN⁻ muscle than wild-type. RN⁻ muscle contained lower AMP deaminase abundance and activity. These data show that altering adenonucleotide availability postmortem can extend postmortem pH decline and suggest that AMP deaminase activity may, in part, contribute to the low ultimate pH observed in RN⁻ pork.

  2. Experience with a medicolegal decision-making system for occupational hearing loss-related tinnitus.

    PubMed

    Dejonckere, Philippe H; Coryn, Christiane; Lebacq, Jean

    2009-01-01

    Owing to an increasing number of requests for compensation, a medicolegal decision-making system for tinnitus related to noise-induced hearing loss (NIHL) has been elaborated at the Federal Belgian Institute of Occupational Diseases. Experience with 113 patients, all of them claiming compensation for NIHL and tinnitus, is now available. The patients underwent an exhaustive audiological investigation, and their professional career and noise exposure were carefully and objectively documented. We reviewed the group of 35 "accepted" cases (i.e., with chronic tinnitus recognized as related to NIHL and financially compensated as an occupational disease) and analyzed the medicolegal arguments for acceptance or rejection. In these patients, tinnitus was mostly bilateral, was perceived on average at a frequency of 4 KHz and with a supraliminal intensity of 7.2 dB, and lasted on average for 7.3 years. To gain better insight into the relationship between cochlear damage and chronic tinnitus, we compared our group to a control group of 35 patients with similar hearing thresholds at 3 and 4 KHz but free of tinnitus. The main difference is a significantly steeper slope of the audiometric curve between 2 and 3 KHz in the tinnitus group. Furthermore, a notch in the distortion product-gram is noticed in 60% of the ears affected by tinnitus versus 9% of the ears in the control group. This abrupt discontinuity in the activity along the tonotopic axis of the auditory system-the main characteristic of NIHL-could be a factor eliciting tinnitus, as a correspondence between the audiometric notch and tinnitus frequency appears to exist.

  3. A case of acute subdural hematoma due to ruptured aneurysm detected by postmortem angiography.

    PubMed

    Inokuchi, Go; Makino, Yohsuke; Yajima, Daisuke; Motomura, Ayumi; Chiba, Fumiko; Torimitsu, Suguru; Hoshioka, Yumi; Iwase, Hirotaro

    2016-03-01

    Acute subdural hematoma (ASDH) is mostly caused by head trauma, but intrinsic causes also exist such as aneurysm rupture. We describe here a case involving a man in his 70s who was found lying on the bedroom floor by his family. CT performed at the hospital showed ASDH and a forensic autopsy was requested. Postmortem cerebral angiography showed dilatation of the bifurcation of the middle cerebral artery, which coincided with the dilated part of the Sylvian fissure. Extravasation of contrast medium into the subdural hematoma from this site was suggestive of a ruptured aneurysm. Autopsy revealed a fleshy hematoma (total weight 110 g) in the right subdural space and findings of brain herniation. As indicated on angiography, a ruptured saccular aneurysm was confirmed at the bifurcation of the middle cerebral artery. Obvious injuries to the head or face could not be detected on either external or internal examination, and intrinsic ASDH due to a ruptured middle cerebral artery aneurysm was determined as the cause of death. One of the key points of forensic diagnosis is the strict differentiation between intrinsic and extrinsic onset for conditions leading to death. Although most subdural hematomas (SDH) are caused by extrinsic factors, forensic pathologists should consider the possibility of intrinsic SDH. In addition, postmortem angiography can be useful for identifying vascular lesions in such cases.

  4. Storm-Related Postmortem Damage to Skeletal Remains.

    PubMed

    Maijanen, Heli; Wilson-Taylor, Rebecca J; Jantz, Lee Meadows

    2016-05-01

    In April 2011, human skeletons were exposed to heavy storms at the outdoor Anthropology Research Facility (ARF) in Knoxville, Tennessee. Of the approximate 125 skeletons at the ARF in April 2011, 30 donations exhibited postmortem damage that could be attributed to the storms. At least 20 of the affected donations exhibit postmortem damage clearly associated with hailstones due to the oval shape and similar small size of the defects observed. The irregular shape and larger size of other defects may be a product of other falling objects (e.g., tree branches) associated with the storms. Storm-related damage was observed throughout the skeleton, with the most commonly damaged skeletal elements being the scapula and ilium, but more robust elements (i.e., femora and tibiae) also displayed characteristic features of hailstone damage. Thus, hailstone damage should be considered when forensic practitioners observe unusual postmortem damage in skeletal remains recovered from the outdoor context.

  5. Post-mortem CT and MRI: appropriate post-mortem imaging appearances and changes related to cardiopulmonary resuscitation

    PubMed Central

    Dean, Jonathan

    2016-01-01

    Post-mortem cross-sectional imaging in the form of CT and, less frequently, MRI is an emerging facility in the evaluation of cause-of-death and human identification for the coronial service as well as in assisting the forensic investigation of suspicious deaths and homicide. There are marked differences between the radiological evaluation and interpretation of the CT and MRI features of the live patient (i.e. antemortem imaging) and the evaluation and interpretation of post-mortem CT and MRI appearances. In addition to the absence of frequently utilized tissue enhancement following intravenous contrast administration in antemortem imaging, there are a number of variable changes which occur in the tissues and organs of the body as a normal process following death, some of which are, in addition, affected significantly by environmental factors. Many patients and victims will also have undergone aggressive attempts at cardiopulmonary resuscitation in the perimortem period which will also significantly alter post-mortem CT and MRI appearances. It is paramount that the radiologist and pathologist engaged in the interpretation of such post-mortem imaging are familiar with the appropriate non-pathological imaging changes germane to death, the post-mortem interval and cardiopulmonary resuscitation in order to avoid erroneously attributing such changes to trauma or pathology. Some of the more frequently encountered radiological imaging considerations of this nature will be reviewed. PMID:26562099

  6. Estimation of early postmortem intervals by a multiple regression analysis using rectal temperature and non-temperature based postmortem changes.

    PubMed

    Honjyo, Kohji; Yonemitsu, Kosei; Tsunenari, Shigeyuki

    2005-10-01

    Five general methods based on rectal temperature and a multiple regression analysis using rectal temperature and non-temperature based postmortem changes were applied to 212 postmortem cases of within 24h postmortem (PM) intervals. Non-temperature based postmortem changes of rigidity, hypostasis and corneal turbidity were numerically categorized and used with rectal temperatures as four statistical variables in the multiple regression analysis. The correlation coefficient values between true and calculated postmortem intervals were 0.78-0.82 in the five general methods based on rectal temperature. The multiple regression analysis produced a multiple correlation coefficient value of 0.89 and according to the error ranges of the PM intervals, 72% of the cases were estimated within the error of +/-1.0 h and 92% within +/-5.0 h. Although assessments of non-temperature based PM changes are mostly subjective and have a wide variation, the present study demonstrated a usefulness of non-temperature based PM changes in the estimation of PM intervals.

  7. Sarcomere length influences postmortem proteolysis of excised bovine semitendinosus muscle.

    PubMed

    Weaver, A D; Bowker, B C; Gerrard, D E

    2008-08-01

    The interaction between sarcomere length and postmortem proteolysis as related to meat tenderness is not clear. The extent of thick and thin filament overlap alters actomyosin binding and may alter substrate availability during aging-induced tenderization. The objective of this study was to determine the influence of sarcomere length on proteolytic degradation in beef. Strips from bovine semitendinosus were either stretched 40% and restrained or allowed to shorten unrestrained in an ice bath. After rigor completion, 0.6-cm cross sections were fabricated and were randomly assigned to 2, 4, 7, or 10 d of aging treatments. Myofibrils were isolated for sarcomere length determination. Samples were collected and frozen for shear force analysis, and muscle proteins were extracted for SDS-PAGE and Western blotting analyses to determine troponin T (TnT) proteolysis. Sarcomere length was greater (P < 0.01) in stretched muscle samples compared with shortened samples (2.57 vs. 1.43 microm, respectively). Correspondingly, shear force values were greater (P < 0.05) in shortened samples than stretched samples. Western blots revealed the presence of 3 major intact TnT bands that diminished with time postmortem and 4 bands (TnT degradation products) that accumulated during postmortem storage. Quantification of intact TnT showed increased (P < 0.05) proteolysis at 4 and 7 d postmortem in samples with long sarcomeres. By 10 d, only traces of the greatest molecular weight intact TnT band were evident in both shortened and stretched samples, suggesting this TnT band may be more susceptible to proteolysis than other intact TnT bands. Degradation products of TnT appeared earlier postmortem in samples with long sarcomeres. The 30-kDa TnT fragment appeared after 7 d of postmortem storage in samples with long sarcomeres but not until 10 d in muscle containing short sarcomeres. Collectively, these data show that postmortem TnT proteolysis is sarcomere length-dependent and suggest that thick

  8. Estimation of postmortem interval using an electric impedance spectroscopy technique: a preliminary study.

    PubMed

    Mao, Shiwei; Dong, Xiuzhen; Fu, Feng; Seese, Ronald R; Wang, Zhenyuan

    2011-09-01

    The objective of this study was to develop a rapid method for the estimation of postmortem interval (PMI) using electric impedance spectroscopy. Postmortem rat spleens were studied at 10°C, 20°C, and 30°C; The results obtained demonstrated that postmortem interval negatively correlated with the absolute value of Im Z(//) (capacitive reactance component) in electrical impedance. This suggests that electric impedance spectroscopy may be a sensitive tool to determine the postmortem interval.

  9. To err is human: Quality management practices in surgical oral pathology, a safety net for medico-legal complications.

    PubMed

    Venkatraman, Narayan T; Bhadranna, Abhishek; Shenoy, Sadhana; Mohanty, Leeky

    2013-05-01

    Reading a slide and rendering a diagnosis is not only a science but also requires us to appreciate the constant artifact that is introduced in a controlled manner by tissue processing and obtaining a stained tissue section. There are a number of steps involved in getting the final stained tissue section and all these procedures if not performed properly have the potential to give rise to erroneous picture on the slide. Simple errors in judgments can lead to wrong diagnosis and unwarranted treatment. Such mistakes can put us at risk for Medico-Legal problems. The subject of Medico-Legal issues and practice of pathology has been neglected and amount of information available to the practicing professional in India is scarce. This paper focuses on standardized procedures for the various histopathology laboratory exercises. The paper highlights the importance of proper record maintenance with reporting protocols. A list of do's and don'ts for an Oral Pathologist is provided to help him/her in reducing the probable Medico-Legal issues. It does not in any way address the issue of individual competence and diagnostic abilities: That is an aspect for each individual to introspect upon and take remedial action.

  10. Medicolegal implications of surgical errors and complications in neck surgery: A review based on the Italian current legislation

    PubMed Central

    Polistena, Andrea; Sanguinetti, Alessandro; Buccelli, Claudio; Conzo, Giovanni; Conti, Adelaide; Niola, Massimo; Avenia, Nicola

    2016-01-01

    Abstract Aim of the present paper is the review of the principal complications associated to endocrine neck surgery considering how expertise, full adoption of guidelines, appropriate technology and proper informed consent may limit the medicolegal claims at the light of the incoming new regulation of the medical professional legal responsibility. A literature search, using the Medline/PubMed database for full-length papers, was used. Postoperative recurrent laryngeal nerve (RLN) palsy and hypoparathy-roidism remain the principal causes of surgical malpractice claims . In the procedure of neck lymphadenctomy intra-operative haemorrhage, thoracic duct injury, injuries to loco-regional nerves can be observed and can be source of claims. After many years of increased medicolegal litigations, the Italian government is proposing a drastic change in the regulations of supposed medical malpractice in order to guarantee the patient’s right to a safe treatment and in the meantime to defend clinicians from often unmotivated and prejudicial legal cases. Surgical errors and complications in neck surgery are a relevant clinical issue. Only the combination of surgical and clinical expertise, application of guidelines, appropriate technology and a routinely use of specific informed consent can contain potential medicolegal implications. PMID:28352812

  11. Review of medicolegal cases for cauda equina syndrome: what factors lead to an adverse outcome for the provider?

    PubMed

    Daniels, Eldra W; Gordon, Zachary; French, Keisha; Ahn, Uri M; Ahn, Nicholas U

    2012-03-07

    Cauda equina syndrome is 1 of a few true surgical emergencies involving the lumbar spine. Although treatment within 48 hours has been found to correlate with improved outcomes, recovery of bowel and bladder control does not always occur, and loss of these functions can be distressing to patients. An understanding of factors affecting the legal outcome can aid the clinician in determining risk management for medicolegal cases of cauda equina syndrome. This study is a retrospective analysis of medicolegal cases involving cauda equina syndrome. The LexisNexis Academic legal search database was used to obtain medicolegal cases of cauda equina syndrome to determine risk factors for adverse decisions for the provider. Outcomes data on trial verdicts were collected, as were associated penalties. Case data were also compiled on age, sex, initial presentation site, initial diagnosis, whether a rectal examination was performed, time to consultation with a specialist, time to completion of advanced imaging study, time to surgery, and neurosurgical vs orthopedic consultation. Based on our study of court cases involving cauda equina syndrome, a positive association was found between time to surgery >48 hours and an adverse decision (P<.05). The actual degree of functional loss did not appear to affect the verdicts. Because 26.7% of the cases involved an initial presentation that included loss of bowel or bladder control, this study emphasizes the importance of cautioning all patients with spinal complaints of the potential risk for cauda equina syndrome.

  12. [Medico-legal opinions in penal cases provided by clinicians and forensic medicine specialists--comparative analysis].

    PubMed

    Chowaniec, Czesław; Chowaniec, Małgorzata; Nowak, Agnieszka

    2005-01-01

    From the practice of the Forensic Medicine Department, Medical University of Silesia, Katowice it appears that in criminal cases the level of medico-legal opinions provided by experts appointed by the district court or 'ad hoc' is very low. The analysis of the chosen files shoved a divergence of opinions given to the adopted motions as well as numerous offences to regulations in the nature of a consultative error. In the paper the authors have made an attempt to appraise causes of the above mentioned problems such as: 1. the lack of medico-legal knowledge and experience in court experts. 2. excessive ease of registration to the panel of court experts and the lack of processes which verify the qualifications of experts. 3. the lack of judicial control over expert's opinions and common acceptance of their work. 4. ignorance of the obligatory penal law. 5. ignorance of the basic rules for giving medico-legal opinions (legal consequences, casual nexus). 6. excessive but groundless self-confidence in experts. 7. the lack of a correct way of thinking and conclusion making. The aim of the paper was to pay close attention to the absolute need of verification of court experts' qualifications and work.

  13. Interpretation of postmortem vitreous concentrations of sodium and chloride.

    PubMed

    Zilg, B; Alkass, K; Berg, S; Druid, H

    2016-06-01

    Vitreous fluid can be used to analyze sodium and chloride levels in deceased persons, but it remains unclear to what extent such results can be used to diagnose antemortem sodium or chloride imbalances. In this study we present vitreous sodium and chloride levels from more than 3000 cases. We show that vitreous sodium and chloride levels both decrease with approximately 2.2mmol/L per day after death. Since potassium is a well-established marker for postmortem interval (PMI) and easily can be analyzed along with sodium and chloride, we have correlated sodium and chloride levels with the potassium levels and present postmortem reference ranges relative the potassium levels. We found that virtually all cases outside the reference range show signs of antemortem hypo- or hypernatremia. Vitreous sodium or chloride levels can be the only means to diagnose cases of water or salt intoxication, beer potomania or dehydration. We further show that postmortem vitreous sodium and chloride strongly correlate and in practice can be used interchangeably if analysis of one of the ions fails. It has been suggested that vitreous sodium and chloride levels can be used to diagnose drowning or to distinguish saltwater from freshwater drowning. Our results show that in cases of freshwater drowning, vitreous sodium levels are decreased, but that this mainly is an effect of postmortem diffusion between the eye and surrounding water rather than due to the drowning process, since the decrease in sodium levels correlates with immersion time.

  14. Postmortem levetiracetam (Keppra®) data from North Carolina.

    PubMed

    Bishop-Freeman, Sandra C; Kornegay, Nina C; Winecker, Ruth E

    2012-07-01

    Levetiracetam (Keppra®) is one of the newer anticonvulsant drugs used to treat seizures. Since 2003, the North Carolina Office of the Chief Medical Examiner Toxicology Laboratory has collected quantitative levetiracetam data in samples for 56 postmortem cases. The data presented herein will provide the forensic community with concentrations to assist in the interpretation of levetiracetam in postmortem blood. Decedents were divided into two groups according to manner of death as determined by the medical examiner for the purposes of studying levetiracetam concentrations. There were equal numbers of natural (N = 28) and non-natural deaths (N = 28). These data were subsequently divided into subgroups for further study to explore the therapeutic range of levetiracetam and how it relates to postmortem data. The cases not certified as natural were investigated to study levetiracetam concentrations in cases where it was determined to contribute to the cause of death (attributed) and those where it was not (unattributed). Until now, the literature has only reported levetiracetam overdoses in which the individuals have recovered with respiratory support. Discussed are two suicidal drug deaths from 2010 that are noted to have elevated levels of levetiracetam, 190 and 35 mg/L. Also included in the complete data set are postmortem concentrations for five patients under the age of 10 with levetiracetam ranging from 1.4 to 50 mg/L. This paper will also address the adverse effects of the drug and explore its potential risk for suicide.

  15. 18. Photocopy of photograph. VIEW WITHIN POSTMORTEM CELL OF MANIPULATOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. Photocopy of photograph. VIEW WITHIN POST-MORTEM CELL OF MANIPULATOR ARMS BEING USED TO MOVE METAL BARS FROM ONE LOCATION TO ANOTHER. Photographer unknown, ca. 1965, original photograph and negative on file at the Remote Sensing Laboratory, Department of Energy, Nevada Operations Office. - Nevada Test Site, Engine Maintenance Assembly & Disassembly Facility, Area 25, Jackass Flats, Mercury, Nye County, NV

  16. 13. VIEW OF EAST OPERATING GALLERY ALONG THE POSTMORTEM CELLS. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. VIEW OF EAST OPERATING GALLERY ALONG THE POST-MORTEM CELLS. A NUMBER OF MANIPULATOR ARMS COVERED WITH PLASTIC ARE ON THE LEFT WALL. - Nevada Test Site, Engine Maintenance Assembly & Disassembly Facility, Area 25, Jackass Flats, Mercury, Nye County, NV

  17. Sarcomere length influences postmortem proteolysis of excised bovine semitendinosus muscle

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The interaction between sarcomere length and postmortem proteolysis as related to meat tenderness is not clear. The extent of thick and thin filament overlap alters actomyosin binding and may alter substrate availability during aging-induced tenderization. The objective of this study was to determin...

  18. Diagnosis of neonatal neuroblastoma with postmortem magnetic resonance imaging.

    PubMed

    Davis, James; Novotny, Nathan; Macknis, Jacqueline; Alpay-Savasan, Zeynep; Goncalves, Luis F

    2017-03-01

    Postmortem magnetic resonance imaging (MRI) is emerging as a valuable tool to accompany traditional autopsy and has potential for use in cases when traditional autopsy is not possible. This case report will review the use of postmortem MRI with limited tissue sampling to differentiate between metastatic neuroblastoma and hepatoblastoma which could not be clearly differentiated with prenatal ultrasound, prenatal MRI, or emergent postnatal ultrasound. The mother presented to our institution at 27 weeks gestation after an obstetric ultrasound at her obstetrician's office identified a large abdominal mass. Fetal ultrasonography and MRI confirmed the mass but were unable to differentiate between neuroblastoma and multifocal hepatoblastoma. The baby was delivered by cesarean section after nonreassuring heart tones led to an emergent cesarean section. The baby underwent decompressive laparotomy to relieve an abdominal compartment syndrome; however, the family eventually decided to withdraw life support. At this time, we performed a whole body postmortem MRI which further characterized the mass as an adrenal neuroblastoma which was confirmed with limited tissue sampling. Postmortem MRI was especially helpful in this case, as the patient's family declined traditional autopsy.

  19. 9 CFR 352.11 - Post-mortem inspection.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Post-mortem inspection. 352.11 Section 352.11 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND...

  20. 9 CFR 352.11 - Post-mortem inspection.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Post-mortem inspection. 352.11 Section 352.11 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND...

  1. 9 CFR 352.11 - Post-mortem inspection.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Post-mortem inspection. 352.11 Section 352.11 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND...

  2. 9 CFR 352.11 - Post-mortem inspection.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Post-mortem inspection. 352.11 Section 352.11 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND...

  3. 9 CFR 352.11 - Post-mortem inspection.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Post-mortem inspection. 352.11 Section 352.11 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND...

  4. A Machine Learning Approach for Using the Postmortem Skin Microbiome to Estimate the Postmortem Interval

    PubMed Central

    Johnson, Hunter R.; Trinidad, Donovan D.; Guzman, Stephania; Khan, Zenab; Parziale, James V.; DeBruyn, Jennifer M.

    2016-01-01

    Research on the human microbiome, the microbiota that live in, on, and around the human person, has revolutionized our understanding of the complex interactions between microbial life and human health and disease. The microbiome may also provide a valuable tool in forensic death investigations by helping to reveal the postmortem interval (PMI) of a decedent that is discovered after an unknown amount of time since death. Current methods of estimating PMI for cadavers discovered in uncontrolled, unstudied environments have substantial limitations, some of which may be overcome through the use of microbial indicators. In this project, we sampled the microbiomes of decomposing human cadavers, focusing on the skin microbiota found in the nasal and ear canals. We then developed several models of statistical regression to establish an algorithm for predicting the PMI of microbial samples. We found that the complete data set, rather than a curated list of indicator species, was preferred for training the regressor. We further found that genus and family, rather than species, are the most informative taxonomic levels. Finally, we developed a k-nearest- neighbor regressor, tuned with the entire data set from all nasal and ear samples, that predicts the PMI of unknown samples with an average error of ±55 accumulated degree days (ADD). This study outlines a machine learning approach for the use of necrobiome data in the prediction of the PMI and thereby provides a successful proof-of- concept that skin microbiota is a promising tool in forensic death investigations. PMID:28005908

  5. Postmortem evidence of cerebral inflammation in schizophrenia: a systematic review

    PubMed Central

    Trépanier, M O; Hopperton, K E; Mizrahi, R; Mechawar, N; Bazinet, R P

    2016-01-01

    Schizophrenia is a psychiatric disorder which has a lifetime prevalence of ~1%. Multiple candidate mechanisms have been proposed in the pathogenesis of schizophrenia. One such mechanism is the involvement of neuroinflammation. Clinical studies, including neuroimaging, peripheral biomarkers and randomized control trials, have suggested the presence of neuroinflammation in schizophrenia. Many studies have also measured markers of neuroinflammation in postmortem brain samples from schizophrenia patients. The objective of this study was to conduct a systematic search of the literature on neuroinflammation in postmortem brains of schizophrenia patients indexed in MEDLINE, Embase and PsycINFO. Databases were searched up until 20th March 2016 for articles published on postmortem brains in schizophrenia evaluating microglia, astrocytes, glia, cytokines, the arachidonic cascade, substance P and other markers of neuroinflammation. Two independent reviewers extracted the data. Out of 5385 articles yielded by the search, 119 articles were identified that measured neuroinflammatory markers in schizophrenic postmortem brains. Glial fibrillary acidic protein expression was elevated, lower or unchanged in 6, 6 and 21 studies, respectively, and similar results were obtained for glial cell densities. On the other hand, microglial markers were increased, lower or unchanged in schizophrenia in 11, 3 and 8 studies, respectively. Results were variable across all other markers, but SERPINA3 and IFITM were consistently increased in 4 and 5 studies, respectively. Despite the variability, some studies evaluating neuroinflammation in postmortem brains in schizophrenia suggest an increase in microglial activity and other markers such as SERPINA3 and IFITM. Variability across studies is partially explained by multiple factors including brain region evaluated, source of the brain, diagnosis, age at time of death, age of onset and the presence of suicide victims in the cohort. PMID:27271499

  6. Quality of Life and Medico-Legal Implications Following Iatrogenic Bile Duct Injuries.

    PubMed

    Hariharan, Deepak; Psaltis, Emmanouil; Scholefield, John H; Lobo, Dileep N

    2017-01-01

    In this review we aimed to evaluate quality of life after bile duct injury and the consequent medico-legal implications. A comprehensive English language literature search was performed on MEDLINE, Embase, Science Citation Index and Google™ Scholar databases for articles published between January 2000 and April 2016. The last date of search was 11 April 2016. Key search words included bile duct injury, iatrogenic, cholecystectomy, prevention, risks, outcomes, quality of life, litigation and were used in combination with the Boolean operators AND, OR and NOT. Long-term survival after bile duct injury is significantly impaired (all-cause long-term mortality approximately 21 %) along with the quality of life (especially psychological/mental state remains affected). Bile duct injury is associated with high rates of litigation. Monetary compensation varied from £2500 to £216,000 in the UK, €9826-€55,301 in the Netherlands and $628,138-$2,891,421 in the USA. Bile duct injuries have profound implications for patients, medical personnel and healthcare providers as they cause significant morbidity and mortality, high rates of litigation and raised healthcare expenditure.

  7. The role of fillers in aesthetic medicine: medico-legal aspects.

    PubMed

    Marinelli, E; Montanari Vergallo, G; Reale, G; di Luca, A; Catarinozzi, I; Napoletano, S; Zaami, S

    2016-11-01

    In recent years there has been an exponential increase of fillers use in aesthetic medicine. The popularity of this anti-wrinkle product is based on their capacity to offer significant improvement in the aesthetic field, particularly to skin rejuvenating processes with non-invasive and less expensive techniques, if compared to the surgical methods (i.e. surgical lifting). The great number of fillers on the market is composed of a large heterogenic number of biomaterials. The aim of this review was to provide an overview and a classification of the filling materials that are most commonly used. A synthesis of the literature concerning fillers and related side effects was also reported. The law decree no. 23 of 1998, converted in the law no. 94 of 1998 and the principal judgments of the Italian Court of Cassation have been examined with the medico-legal issues related to fillers use in medicine. With respect to their degradation, filler materials may be classified as temporary (degradable), semi-permanent and permanent (not degradable). The temporary fillers such as hyaluronic acid and collagen are completely degraded by the surrounding tissue in a few months. The permanent fillers, such as the ones derived from silicon oil and minerals are not biodegradable and may cause serious and irreversible side effects. Their use requires a physician with a high level of specialization to perform the treatment, a deep knowledge of face anatomy and a great degree of experience.

  8. Characteristics of victims of violence admitted to a specialized medico-legal unit in Switzerland.

    PubMed

    Hofner, Marie-Claude; Burquier, Raphaelle; Huissoud, Thérèse; Romain, Nathalie; Graz, Bertrand; Mangin, Patrice

    2009-07-01

    To improve care and services to victims of interpersonal violence, a medico-legal consultation unit was set up at the Lausanne University Hospital, Switzerland in 2006. Adult victims of violence are referred to the consultation by the emergency department. Patients are received by forensic nurses for support, forensic examination and community orientation. A descriptive study of medical reports filled for the 2006 population was conducted in 2007 with the aim to explore characteristics of this specific population and to better orient prevention. Among the 422 patients in 2006, 57% were men and 43% women, with a median age of 31 years old. Violent episodes took place in a public place for 90% of male victims and at home for 70% of female victims. The perpetrators were mostly unknown to male victims (62% of all men victims) and mostly known (usually the partner or a former partner) to female victims (90% of all women victims). For 80% of the women and 47% of the men, the violent event which brought them to the consultation, was not the first one. Because 90% of all patients under study were victimized by men., not only is it necessary to target prevention program to match the potential victims, prevention messages must also focus on potential offenders, especially on young men.

  9. [Medico-legal opinionating in cases of medical errors in declaration of death].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara; Drozd, Radosław

    2007-01-01

    Declaration of death is a diagnosis and it has legal consequences. While declaring death, there is a possibility of committing a medical error. The majority of irregularities in declaring an individual dead occur in emergency situations. When a physician declares death, he is released from the professional obligation of saving the individual's life. The studies were based on the results of medico-legal evaluations in criminal cases in medical errors. In case death is erroneously declared, we may face a situation of squandering the chance of saving the life of a human being. Exposure to loss of life or to severe detriment to health are possible charges here, along with failure to offer medical assistance, although a deliberate character of the offence according to article 162 of the Polish penal code renders such a legal qualification dubious in case of medical errors. In both cases verification is needed whether an interest protected by law was still in existence, i.e. whether the individual was still alive when the physician incorrectly declared him dead.

  10. Post-traumatic stress disorder and memory: prescient medicolegal testimony at the International War Crimes Tribunal?

    PubMed

    Sparr, Landy F; Bremner, J Douglas

    2005-01-01

    The nature of remembrance of traumatic events has been particularly controversial during the past decade as vigorous new research has reshaped thinking about trauma and memory. Memory alterations in traumatized individuals have been investigated within both theoretical and biological frameworks. There are different types of memory, and empirical studies have associated post-traumatic stress disorder (PTSD) with a simultaneous weakening and a strengthening of memory. Memory deficiencies in PTSD have been found to be related to problems in new learning (explicit memory), but other specific deficiencies are unvalidated. Recently, accuracy of memory has received particular scrutiny because considerable importance is attached to victims' recollections. In 1998, at the International War Crimes Tribunal in The Hague, The Netherlands, a Bosnian-Croatian soldier was tried for aiding and abetting the rape of a Muslim woman. The defendant's lawyers suggested that the woman's memory was inaccurate, having been adversely affected by her traumatic experiences, and that the defendant whom she identified was not present during her interrogation and abuse. The prosecution disagreed and argued that memories of traumatic experiences in individuals with PTSD are characteristically hyperaccessible. Expert witnesses on both sides were brought in to provide medicolegal testimony about the scientific parameters of stress and its long-term effects on brain regions associated with memory. With the expert witness discussion as background, this article reviews the most recent research about the nature of memory in the aftermath of trauma and the politics of psychological trauma and the law.

  11. Forensic Odontology: A Boon to Community in Medico-legal Affairs.

    PubMed

    Chidambaram, R

    2016-01-01

    Forensic odontology is a sub-discipline of dental science which involves the relationship between dentistry and the law. The specialty of forensic odontology is applied in radiographic investigation, human bite marks analysis, anthropologic examination and during mass disasters. Besides the fact that radiographs require pretentious laboratory, it is still claimed to be a facile, rapid, non-invasive method of age identification in the deceased. The budding DNA technology has conquered the traditional procedures and currently being contemplated as chief investigating tool in revealing the hidden mysteries of victims and suspects, especially in hopeless circumstances. Forensic odontology has played a chief role in solving cold cases and proved to be strong evidence in the court of law. Systematic collection of dental records and preservation of the same would marshal the legal officials in identification of the deceased. To serve the forensic operation and legal authorities, dental professionals need to be familiar with the basics of forensic odontology, which would create a consciousness to preserve the dental data. The aim of this paper is to emphasize the vital applications of forensic odontology in medico-legal issues. Conjointly the recent advancements applied in forensic human identification have been updated.

  12. Long-term RNA persistence in postmortem contexts

    PubMed Central

    2013-01-01

    Ribonucleic acids (RNA) are generally considered fragile molecules that are readily degraded. However, there is growing documentation of long-term (from days to centuries) RNA persistence in a variety of contexts and tissue types, and as such a number of academic disciplines are beginning to exploit degraded RNA. While the reasons for its survival are not fully understood, there are several plausible mechanisms that would safeguard this molecule against degradation. However, after examining the literature available on the postmortem instability and decay mechanisms of RNA, it has become clear that limited experimental studies and no reviews offer an overview of these mechanisms. Hence in this review we outline molecular reasons for RNA surviving long-term postmortem, and provide specific examples of RNA survival in forensic, archival and archaeological contexts. A better understanding of the mechanisms of RNA decay will be crucial for developing expectations on its long-term survival. PMID:23618361

  13. Evaluation of thymic volume by postmortem computed tomography.

    PubMed

    Abe, Shuntaro; Hasegawa, Iwao; Vogel, Hermann; Heinemann, Axel; Suzuki, Koichi; Püschel, Klaus

    2015-07-01

    The thymus is exceedingly sensitive to stress and undergoes abrupt involution as a result of exposure to strong stress in early childhood. Therefore, thymic involution is often utilized to assess the presence of a stressful environment, such as an environment involving child abuse, in forensic medicine. In recent years, computed tomography (CT) has been commonly used in the daily practice of forensic medicine. We have focused on the thymic volume in postmortem CT images to evaluate the presence of a stressful antemortem environment. We calculated the thymus volume from postmortem CT images of children under six years old and demonstrated that the volume showed a positive correlation with the real weight obtained from an autopsy. The evaluation of thymic volume by CT may make it possible for us to identify child maltreatment. The most useful feature of this application of CT is to be able to demonstrate thymic involution less invasively in a surviving victim.

  14. Study on the pupal morphogenesis of Chrysomya rufifacies (Macquart) (Diptera: Calliphoridae) for postmortem interval estimation.

    PubMed

    Ma, Ting; Huang, Jia; Wang, Jiang-Feng

    2015-08-01

    Chrysomya rufifacies (Macquart) is one of the most common species of blow flies at the scene of death in Southern China. Pupae are useful in postmortem interval (PMI) estimation due to their sedentary nature and longer duration of association with the corpse. However, to determine the age of a pupa is more difficult than that of a larva, due to the fact that morphological changes are rarely visible during pupal development. In this study, eggs of C. rufifacies were reared in climatic chambers under four different constant temperatures (20, 24, 28 and 32°C each±1°C, respectively) with same rearing conditions such as foodstuff, substrate, photoperiod and relative humidity. Ten duplicate pupae were sampled at 8-h intervals from prepupae to emergence under the different constant temperatures, respectively. The pupae were sampled, killed, fixed, dissected and with the puparium removed, the external morphological changes of the pupae were observed, recorded and photographed. The morphological characters of C. rufifacies pupae were described. Based on the visible external morphological characters during pupal morphogenesis at 28°C±1°C, the developmental period of C. rufifacies was divided into nine developmental stages and recorded in detailed description. Based on above-mentioned nine developmental stages, some visible external morphological characters were selected as indications for developmental stages. These indications mapped to 8-h sampling intervals at the four different constant temperatures were also described in this study. It is demonstrated that generally the duration of each developmental stage of C. rufifacies pupae is inversely correlated to appropriate developmental temperatures. This study provides relatively systematic pupal developmental data of C. rufifacies for the estimation of PMI. In addition, further work may improve by focus on other environmental factors, histological analysis, more thorough external examination by shortening sampling

  15. The post-mortem pink teeth phenomenon: a case report.

    PubMed

    Soriano, Evelyne-Pessoa; Carvalho, Marcus-Vitor-Diniz de; Santos, Francisco-Bernardo Dos; Mendoza, Clóvis-César de; Araújo, Maria-do Socorro-Dantas de; Campello, Reginaldo-Inojosa-Carneiro

    2009-07-01

    This study presents the case of the post-mortem pink teeth phenomenon observed during an autopsy procedure performed on the body of a man who was kidnapped and murdered approximately 30 days before the examination. The corpse was in an advanced stage of decomposition and putrefaction. Both maxillary and jaw bones were intact, as well as the permanent teeth which presented the "pink teeth phenomenon", probably due to a haemorrhage in the pulp chambers. The pink discolouration was most pronounced at the neck of the teeth. The cause of death was asphyxia. Although the examiners stressed that post-mortem pink teeth must not be considered as a reliable odontological parameter for determining the cause of death, the results of other studies have shown that the pink teeth phenomenon is a common finding related to cases of asphyxia such as strangulation, drowning or suffocation. Thus, the pink teeth phenomenon must be studied in order to determine its role as a post-mortem finding. As of now, an exact relationship between the cause of death and this phenomenon remains unknown.

  16. pH inactivation of phosphofructokinase arrests postmortem glycolysis.

    PubMed

    England, Eric M; Matarneh, Sulaiman K; Scheffler, Tracy L; Wachet, Céline; Gerrard, David E

    2014-12-01

    Fresh meat quality development is influenced by pH decline that results from muscle glycolyzing energy substrates postmortem. The exact reason why glycolysis stops in the presence of residual glycogen remains unclear. We hypothesized that a critical glycolytic enzyme loses activity near the ultimate pH of meat. Porcine longissimus muscle samples were subjected to an in vitro system that mimics postmortem anaerobic metabolism at buffered pH values (7.0, 6.5, 6.0, 5.5 or 5.0). At pH7.0, 6.5, and 6.0, glycogenolysis and glycolysis proceeded normally while pH5.5 stopped lactate formation. Additional experimentation indicated that phosphofructokinase lost activity at pH5.5 while all other glycolytic enzymes remained active. A similar inactivation of phosphofructokinase was observed when using chicken and beef muscle. Elevated temperature hastened pH decline and phosphofructokinase activity loss. Thus, pH inactivates phosphofructokinase and arrests postmortem glycolysis, which may explain the similar ultimate pH across meat of different species.

  17. Analysis of colored teeth from Precolumbian Tlatelolco: postmortem transformation or intravitam processes?

    PubMed

    Mansilla, J; Solis, C; Chávez-Lomeli, M E; Gama, J E

    2003-01-01

    The etiological basis of the abnormal coloration of archaeological teeth has been an unsolved question for a long time. Differences in the appearance of some archaeological teeth from Precolumbian adult and infant skeletons, detected by external optical inspection, led us to study this problem. A blue stain is visible in a few of the deciduous erupted teeth, and a brown color in various unerupted teeth in the collection, while brown spots appear on some permanent teeth. Several processes or factors that may occur during one's life, others around the time of death, and still others resulting from postmortem alterations have been reported as potential causes of abnormal tooth coloration.A sample of 35 colored teeth and two soil layers taken from Tlatelolco were analyzed by particle-induced X-ray emission (PIXE) as well as selective dissolution techniques. Concentrations of total and extractable elements in enamel and soil layers (Cg1-Cg2) were obtained. This paper describes the occurrence and implications of a substantial secondary concentration of Zinc (Zn), manganese (Mn), strontium (Sr), and iron (Fe) in the deciduous erupted and nonerupted teeth as compared to that in the adult teeth. Our interpretation is that, in this archaeological context, the brown spots and blue stains on the teeth are due to differences in tooth enamel porosity and to a postmortem biogeochemical process. The alterations involve cumulization and diagenesis of iron, manganese, and organic matter solutions that were eluviated from the soil and are not the result of antemortem or perimortem conditions such as trauma or disease.

  18. Virtopsy -- noninvasive detection of occult bone lesions in postmortem MRI: additional information for traffic accident reconstruction.

    PubMed

    Buck, Ursula; Christe, Andreas; Naether, Silvio; Ross, Steffen; Thali, Michael J

    2009-05-01

    In traffic accidents with pedestrians, cyclists or motorcyclists, patterned impact injuries as well as marks on clothes can be matched to the injury-causing vehicle structure in order to reconstruct the accident and identify the vehicle which has hit the person. Therefore, the differentiation of the primary impact injuries from other injuries is of great importance. Impact injuries can be identified on the external injuries of the skin, the injured subcutaneous and fat tissue, as well as the fractured bones. Another sign of impact is a bone bruise. The bone bruise, or occult bone lesion, means a bleeding in the subcortical bone marrow, which is presumed to be the result of micro-fractures of the medullar trabeculae. The aim of this study was to prove that bleeding in the subcortical bone marrow of the deceased can be detected using the postmortem noninvasive magnetic resonance imaging. This is demonstrated in five accident cases, four involving pedestrians and one a cyclist, where bone bruises were detected in different bones as a sign of impact occurring in the same location as the external and soft tissue impact injuries.

  19. Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

    PubMed Central

    Jewkes, Rachel; Christofides, Nicola; Vetten, Lisa; Jina, Ruxana; Sigsworth, Romi; Loots, Lizle

    2009-01-01

    Background Health services for victims of rape are recognised as a particularly neglected area of the health sector internationally. Efforts to strengthen these services need to be guided by clinical research. Expert medical evidence is widely used in rape cases, but its contribution to the progress of legal cases is unclear. Only three studies have found an association between documented bodily injuries and convictions in rape cases. This article aims to describe the processing of rape cases by South African police and courts, and the association between documented injuries and DNA and case progression through the criminal justice system. Methods and Findings We analysed a provincially representative sample of 2,068 attempted and completed rape cases reported to 70 randomly selected Gauteng province police stations in 2003. Data sheets were completed from the police dockets and available medical examination forms were copied. 1,547 cases of rape had medical examinations and available forms and were analysed, which was at least 85% of the proportion of the sample having a medical examination. We present logistic regression models of the association between whether a trial started and whether the accused was found guilty and the medico-legal findings for adult and child rapes. Half the suspects were arrested (n = 771), 14% (209) of cases went to trial, and in 3% (31) of adults and 7% (44) of children there was a conviction. A report on DNA was available in 1.4% (22) of cases, but the presence or absence of injuries were documented in all cases. Documented injuries were not associated with arrest, but they were associated with children's cases (but not adult's) going to trial (adjusted odds ratio [AOR] for having genital and nongenital injuries 5.83, 95% confidence interval [CI] 1.87–18.13, p = 0.003). In adult cases a conviction was more likely if there were documented injuries, whether nongenital injuries alone AOR 6.25 (95% CI 1.14–34.3, p = 0

  20. Diagnosis of Asbestos-Related Diseases: The Mineralogist and Pathologist's Role in Medicolegal Field.

    PubMed

    Capella, Silvana; Bellis, Donata; Belluso, Elena

    2016-03-01

    Because asbestos diseases represent a complex pattern of legal, social, and political issue, the involvement of the mineralogist and pathologist for a multidisciplinary assessment of its diagnosis helps investigate the relationship between mesothelioma or lung cancer and occupational or environmental asbestos exposure.In the present study, we consider the concentrations of asbestos bodies (ABs) detected by optical microscopy (OM) and scanning electron microscopy (SEM) and the burden of different kinds of mineral fibers (among which is asbestos) identified by SEM combined with an energy dispersive spectrometer (EDS), in 10 lung tissue samples of subjects with occupational and nonoccupational exposure to asbestos.In all subjects with occupational exposure to asbestos, more than 1000 ABs per gram of dry weight were detected both with OM and SEM; this concentration is internationally accepted as suggesting high probability of past occupational exposure to asbestos.In 9 lung samples of the 10 investigated by SEM-EDS different inorganic fibers were found. Asbestos fibers have been identified too, and more than 100,000 fibers per gram of dry weight were detected in subjects with occupational exposure; this concentration is internationally accepted as suggesting high probability of past occupational exposure to asbestos.Instead, when the ABs burden is low or moderate (such as in subjects with absent or probable asbestos exposure), the correlation between ABs concentration determined by OM and those determined by SEM is lost. Therefore, when the ABs value in OM is borderline, the SEM investigation became essential. Furthermore, the mineralogical analysis by SEM-EDS (identification and quantification of inorganic fibers in general and asbestos in particular) of the fibers detected in the lung tissues is very useful, if not necessary, to complete the pathological diagnosis of asbestos-related malignancies in medicolegal field.

  1. The threat of vaccine associated poliomyelitis in India: medicolegal issues involved.

    PubMed

    Rajput, Meena; Sharma, Luv

    2010-12-01

    India is among the world's large reservoirs of wild poliovirus (WPV) with 559 confirmed cases of poliomyelitis (wild virus) being reported in 2008. The World Health Organization's program for the eradication of poliomyelitis in third world countries like India is associated with major ethical and medico-legal implications. Two vaccines are available in India for poliomyelitis i.e. oral polio vaccine (OPV) and inactivated polio vaccine (IPV), of which OPV is used in the eradication campaign, the case count for 2009 being 36 out of a total of 384 reported cases globally, the case count for mid 2010 being 19 cases out of 84 reported globally. There are widespread reports of vaccine derived poliomyelitis as well as vaccine associated poliomyelitis (VAP) from different parts of the country, which can be linked to resurgence of polio in several states or to the failure of the polio drive (Polio Sundays). Though an extended comprehensive polio campaign is on and both money and manpower are being dumped for achieving the goal of polio eradication, the ground reality is entirely different. The argument that wild polio strains have surfaced to hamper the drive cannot account for all post vaccination cases. The Indian Academy of Paediatrics has forcefully suggested replacement of OPV by IPV, as the effectiveness of IPV far exceeds the cost benefit of OPV. IPV has by and large replaced OPV in many parts of the world. The second issue is the threat of litigation on the health department once the post vaccination cases rise even further. There are certain other socio-ethical issues discussed in this paper on a subject which has an important bearing on the health statistics of this country.

  2. Medicolegal characteristics of cardiac catheterization litigation in the United States, 1985 to 2009.

    PubMed

    Kim, Candice; Vidovich, Mladen I

    2013-11-15

    There are few assessments of patterns of medicolegal cases involving cardiac catheterizations. This descriptive study reviews the patterns of liability and medical outcomes involving cardiac catheterization litigation from the LexisNexis Academic database and the Physician Insurers Association of America registry. From 1985 to 2009, the Physician Insurers Association of America registry documented 1,361 closed coronary angiography claims. The cardiovascular disease specialty was involved in 699 with other specialties involved in the remaining cases. Of the 1,361 closed claims, 301 (22%) resulted in payments to the plaintiff (average indemnity of $230,987). The most common alleged error was for improper performance (35.4%; average indemnity of $255,542). The alleged error with the highest average indemnity of $270,916 was errors in diagnosis. Not performing an indicated procedure had the highest ratio of paid to closed claims (41%) with an average indemnity of $246,988. In regard to the severity of injury, death was the most common outcome (44%). The highest ratio of paid to total closed claims (43%) was for grave injuries (highest average indemnity of $555,625). Of the 116 LexisNexis cases, litigation against physicians occurred in 90.5% of cases with judgments in favor of the patients in 29.5%. When death was the outcome (31% of cases), physicians were highly likely to be sued (97%) and the judgment was more likely in the plaintiffs' favor (44%). In conclusion, in litigation related to cardiac catheterizations, most cases are due to medical malpractice and physicians are sued in a high percentage of cases. Cardiologists should recognize these patterns of litigation as these may impact and improve processes of care.

  3. Identification of Muscidae (Diptera) of medico-legal importance by means of wing measurements.

    PubMed

    Grzywacz, Andrzej; Ogiela, Jakub; Tofilski, Adam

    2017-03-16

    Cadavers attract numerous species and genera of Muscidae, both regular elements of carrion insect assemblages, and accidental visitors. Identification of adult Muscidae may be considered difficult, particularly by non-experts. Since species identification is a vital first step in the analysis of entomological material in any forensic entomology orientated experiment and real cases, various alternative methods of species identification have been proposed. We investigated possibility of semiautomated identification by means of wing measurements as an alternative for classic morphology and DNA-based approaches. We examined genus-level identification success for 790 specimens representing 13 genera of the most common European cadavers visiting Muscidae. We found 99.8% of examined specimens correctly identified to the genus-level. Without error, the following were identified: Azelia, Eudasyphora, Graphomya, Hydrotaea, Musca, Muscina, Mydaea, Neomyia, Polietes, Stomoxys and Thricops. Genus-level misidentifications were found only in Helina and Phaonia. Discrimination of examined material on the species level within Hydrotaea (318 specimens representing eight species) and Muscina (163 specimens representing four species) showed lower, yet still high average identification success, 97.2 and 98.8%, respectively. Our results revealed relatively high success in both genus and species identification of Muscidae of medico-legal importance. Semiautomated identification by means of wing measurements can be used by non-experts and does not require sophisticated equipment. This method will facilitate the identification of forensically relevant muscids in comparison to more difficult and more time-consuming identification approaches based on taxonomic keys or DNA-based methods. However, for unambiguous identification of some taxa, we recommend complementary use of identification keys.

  4. Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder

    PubMed Central

    Anastasia, Annalisa; Colletti, Chiara; Cuoco, Valentina; Quartini, Adele; Urso, Stefania; Rinaldi, Raffaella; Bersani, Giuseppe

    2016-01-01

    Introduction Although adjustment disorder (AD) is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing) often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD. Methods A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry “A. Fiorini” Hospital, Terracina (Latina, Italy), was performed. Results The sample consisted of 93 patients (46 males and 47 females), aged between 26 and 85, with medium–high educational level who were mainly employed. In most cases (54.80%), a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%), was reported. The main stressors linked to the development of AD were represented by working problems (32.30%), family problems (23.70%), and/or somatic disease (22.60%) with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records. Conclusion Confirming previous data from previous reports, our results suggest that AD may have a distinct profile in demographic and clinical terms. Increased scientific attention is hoped, particularly focused on addressing a better definition of diagnostic criteria, whose correctness and accuracy are critical, especially in situations with medicolegal implications. PMID:27099504

  5. Analysis of 756 cases of sexual assault in Tours (France): medico-legal findings and judicial outcomes.

    PubMed

    Saint-Martin, Pauline; Bouyssy, Marie; O'Byrne, Patrick

    2007-10-01

    We describe the medico-legal findings in a population of sexual assault cases assessed in an urban French referral centre, analyse the subsequent legal dispositions in each case and determine whether the characteristics of the assault and the medico-legal findings were associated with conviction of the assailant. We performed a retrospective study of medicolegal reports in all the sexual assault cases reported in Tours (France) during a seven-year period. We defined two groups of victims: children under 15 years old and victims aged 15 years or more. Legal outcomes were obtained from courtroom proceedings. The relationship between the outcomes and the circumstances of the case was analyzed by logistic regression. We enrolled a total of 756 cases during the study period. The mean age of the study population was 16.5 years and 68.3% of the cases involved children under 15 years old. In 57% of these cases, the assailant was a family member. 31.7% of all the victims were aged 15 years or more. The assailant was an acquaintance of the victim in 62.2% of the cases. Drug-facilitated assault was suspected in 2.9% of the cases. In 46.2% of the cases, formal criminal charges were not filed due to insufficient evidence; 36.3% of the assailants were convicted. Examination at the request of the police authorities and previous acquaintance of the assailant by the victim were significantly associated with conviction. Allegations of penetration, the presence of general body trauma and the presence of genital trauma were not necessarily associated with conviction. Medical examiners need to be circumspect when they record non-medical variables. Physical evidence of trauma was neither predictive nor essential for conviction. Successful prosecution depends on the quality of the testimony provided by the victim.

  6. Postmortem memantine concentration in a non-intoxication case, and the possibility of postmortem redistribution: A case report.

    PubMed

    Nagasawa, Sayaka; Yajima, Daisuke; Torimitsu, Suguru; Chiba, Fumiko; Iwase, Hirotaro

    2015-12-01

    In this case study, we measured the concentration of memantine in the heart blood, peripheral blood, urine, liver, thigh muscle, and subcutaneous fat of a 64-year-old woman who was prescribed memantine for early-onset Alzheimer's disease. She died in hospital after an altercation with her husband. Cause of death was clearly not drug intoxication or overdose, so we investigated the postmortem redistribution (PMR) of memantine in the various tissues and blood ratios of the postmortem samples. Memantine concentrations detected were 1.31 μg/mL in the peripheral blood, 3.95 μg/mL in central blood, 2.09 μg/mL in the urine, 25.54 μg/g in the liver, 1.16 μg/g in the thigh muscle and 2.13 μg/g in the subcutaneous fat. In all samples, the concentrations were higher than the accepted therapeutic range (which is approximately 0.09-0.15 μg/mL). The central blood to peripheral blood (C/P) memantine ratio was 3.01 while the liver to peripheral blood (L/P) ratio was 19.5. It is documented that a C/P ratio exceeding 2 and L/P ratio exceeding 20 highlight a propensity for significant PMR. Although this is a single case study, our data suggest that memantine exhibits PMR. Additionally, a lowered pH was found in peripheral blood (pH 6.2) and central blood (pH 6.1). This postmortem reduction in blood pH may also promote the PMR of memantine. Because there is very little available postmortem toxicological data on memantine, our case study will serve as a foundation to assist in future forensic investigations.

  7. Meeting research needs with postmortem biospecimen donation: summary of recommendations for postmortem recovery of normal human biospecimens for research.

    PubMed

    Mucci, Neil R; Moore, Helen M; Brigham, Lori E; Goldthwaite, Charles A; Little, A Roger; Lockhart, Nicole C; Scott, Michael P; Struewing, Jeffery P; Vincent, Stephen L; Compton, Carolyn C

    2013-04-01

    Normal human tissues, bodily fluids, and other biospecimens of known quality are essential for research to understand the development of cancer and other diseases and to develop new diagnostics and therapies. However, obtaining normal biospecimens appropriate for contemporary large-scale molecular and genomic research is one of the most challenging biospecimen acquisition problems for scientists and biospecimen resources that support research. Recognizing this challenge, the U.S. National Cancer Institute recently convened a series of workshops and meetings focused on the acquisition of normal tissues for research and produced an extensive document, Recommendations for Postmortem Recovery of Normal Human Biospecimens for Research. This article summarizes these recommendations, addressing key ethical, operational, and scientific elements for collecting normal reference biospecimens from postmortem donors in the U.S. Awareness of these recommendations can foster more effective collaborations and mitigate potential logistical challenges, while promoting postmortem biospecimen donation options for families and increasing the availability of high quality normal biospecimens for research. The recommendations have been put into practice in the collection of normal human biospecimens for the NIH Genotype-Tissue Expression Program (GTEx), a pilot study of human gene expression and regulation in multiple tissues which will provide valuable insights into the mechanisms of gene regulation and, in the future, its disease-related perturbations (http://commonfund.nih.gov/GTEx/).

  8. Drug-related deaths with evidences of body packing: Two case reports and medico-legal issues.

    PubMed

    Cappelletti, Simone; Aromatario, Mariarosaria; Bottoni, Edoardo; Fiore, Paola Antonella; Straccamore, Marco; Umani Ronchi, Federica; De Mari, Guido Maria; Ciallella, Costantino

    2016-05-01

    Body packing is a general term used to indicate the internal transportation of drug packages, mainly cocaine, heroin, amphetamines, and methamphetamine, within the gastrointestinal tract. We described two cases of accidental drug intoxication, observed over the last year period, with evidence of intracorporeal drug concealment. The first case concerned a body packer transporting 69 drug packages of heroin adulterated with piracetam. The second body packer transported 16 drug packages of cocaine adulterated with levamisole. For both cases, forensic examination and toxicological analysis of drug packages and biological samples were carried out. Authors also wants to highlight the main medico-legal issues that commonly arise in cases of suspected or ascertained body packers.

  9. Do medico-legal truths have more power than war lies? About the conflicts in the former Yugoslavia and in Kosovo.

    PubMed

    de la Grandmaison, G L; Durigon, M

    2001-10-01

    War crimes perpetrated during the conflicts in the former Yugoslavia and in Kosovo prompted medicolegal investigations of mass graves as required by the International Criminal Tribunal (ICT). In spite of natural and methodological boundaries, these investigations were able to help to identify the victims and to discover the clues and evidence that are likely to support objectively the indictments brought by the ICT. However, the medico-legal data cannot explain everything. They should be exploited very carefully in order to avoid any error of interpretation.

  10. [Total permanent or major permanent inability to work in profession. Remarks about the possibility of criteria verification in medico-legal opinionating in criminal cases].

    PubMed

    Nowak, Agnieszka; Chowaniec, Czesław; Chowaniec, Małgorzata; Rygol, Krystian

    2008-01-01

    Despite the fact that some criteria of medico-legal certification in criminal proceedings have been established, there are still some areas that--parallel to changes occurring in contemporary society--have started to be controversial. This phenomenon has prompted the authors to attempt establishing new criteria for certification in total/major permanent inability to work in profession. This work is a continuation of a cycle devoted to interpretation of article 156 of the Penal Code to meet the needs of medico-legal opinionating.

  11. Indications, advantages and limitations of perinatal postmortem imaging in clinical practice.

    PubMed

    Arthurs, Owen J; Taylor, Andrew M; Sebire, Neil J

    2015-04-01

    Just as there is a range of paediatric imaging techniques available during life, a similar repertoire is available as part of the foetal and perinatal postmortem examination. In this article, we review the literature regarding the diagnostic utility of postmortem radiography, US, CT and MRI in this clinical setting. There is limited direct evidence on the diagnostic utility of any of these techniques, apart from postmortem MRI, which when combined with other noninvasive investigations, has been shown to be highly sensitive and specific for many foetal postmortem diagnoses. The main disadvantages of postmortem MRI include the longer duration of imaging, the need for appropriate training in the interpretation of normal postmortem changes, and possible non-diagnostic imaging examinations in early gestation foetuses. As less-invasive autopsy becomes increasingly available, the true utility of these techniques will evolve, and clinical guidelines for maximal diagnostic yield can be developed.

  12. A retrospective analysis of alcohol in medico-legal autopsied deaths in Pretoria over a 1 year period.

    PubMed

    Ehmke, Ursula; Toit-Prinsloo, Lorraine du; Saayman, Gert

    2014-12-01

    The misuse of alcohol has a particularly detrimental effect and is one of the most significant public health problems in South Africa and it also has an impact on the criminal justice system with evidence of association between high levels of alcohol and risk-taking behaviour, committing crimes, or being a victim of crime. A global trend has been set worldwide with alcohol being one of the most common drugs found in post mortem specimens and especially with regard to cases admitted for medico-legal autopsies. The influence of alcohol on the cause of death is either a contributory or an underlying factor in a substantial number of violent deaths. We retrospectively reviewed 1455 cases, in which alcohol was taken, of 2344 medico-legal autopsies done in 2009. We found that 47% of the cases tested positive for alcohol, with the reported blood alcohol concentrations varying from 0.01 to 0.95g per 100ml (mean=0.16±0.11g per 100ml) with the highest proportion being in the 0.10-0.19g per 100ml range. A breakdown of the results showed that road traffic accidents, assaults and firearm-related deaths predominated the alcohol-positive cases. The results showed that there was a definite correlation between alcohol consumption and the incidence of other that natural deaths.

  13. [Remarks about the position of the medico-legal expert in imperative regulations in the Penal and Civil Codes].

    PubMed

    Chowaniec, Czesław; Nowak, Agnieszka; Chowaniec, Małgorzata; Kobek, Mariusz

    2005-01-01

    In the monograph 'Medico-legal opinions--essays on theory', prof. K. Jaegermann wrote that 'the use of an expert requires theoretical or fairly clear knowledge about the mutual relationship between judge and expert'. In his opinion knowledge of this kind plays a significant role in estimating the usefulness of so-called expert evidence. Practical knowledge about the relationship between the judge and expert is necessary but not a decisive condition not only for a lawyer to be a judge but also for a physician to be a medico-legal expert. An expert can be not only a person appointed by the court but must also possess proper knowledge in a particular field, namely, the required professional and specialist qualifications and must also considered to be impartial. On the basis of the analysis of law in force and imperative regulations in Penal and Civil Codes, the authors have presented remarks relating to the expert's status as well as the lack of judicial control over the activity of experts appointed by court. Verification of professional qualifications in court experts and a reduction of those appointed 'ad hoc' are suggested. In the authors opinion co-operation between lawyers and experts should be improved. It is also essential to introduce statutory legal protection of court experts as well as to undertake activities leading to equaling the status of Polish court experts to that of other European countries.

  14. A rodent model of schizophrenia derived from postmortem studies.

    PubMed

    Berretta, Sabina; Gisabella, Barbara; Benes, Francine M

    2009-12-07

    There is compelling postmortem evidence that GABA cell dysfunction plays a role in the pathophysiology of schizophrenia (SZ). Based on a unique distribution of postmortem abnormalities in layer II of the anterior cingulate cortex and sectors CA3/2 of the hippocampus, we postulated that afferent fibers from the basolateral amygdala to these sites may contribute to diminished GABAergic modulation in these disorders. To test this hypothesis, picrotoxin (PICRO), a non-competitive antagonist of the GABA-A receptor, is stereotaxically infused the basolateral complex of the amygdala (BLA) to increase the flow of excitatory activity into stratum oriens (SO) of sectors CA3/2 of the hippocampus. This pharmacological manipulation results in a selective reduction of GABAergic interneurons containing parvalbumin, calbindin and calretinin in CA3/2. Using single cell recordings in a hippocampal slide preparation, these changes in PICRO-treated rats seem to be associated with a reduction in evoked and spontaneous inhibitory post-synaptic potentials (sIPSCs) recorded from pyramidal neurons in sector CA3/2, but not CA1. A lower resting membrane potential and an increased action potential firing rate have been recorded in interneurons in the SO of CA2/3, but not CA1. Additionally, currents associated with hyperpolarization-activated cationic channels (Ih), which help to control neuronal firing rates of GABA cells in the hippocampus, were also increased. Overall, these studies support the view that postmortem studies contribute information for the development of empiric models of SZ, ones that can be used as translational tools for elucidating the functional changes that may be present in GABA cell subtypes their molecular regulatory mechanisms in this disorder.

  15. Smartphone Image Acquisition During Postmortem Monocular Indirect Ophthalmoscopy.

    PubMed

    Lantz, Patrick E; Schoppe, Candace H; Thibault, Kirk L; Porter, William T

    2016-01-01

    The medical usefulness of smartphones continues to evolve as third-party applications exploit and expand on the smartphones' interface and capabilities. This technical report describes smartphone still-image capture techniques and video-sequence recording capabilities during postmortem monocular indirect ophthalmoscopy. Using these devices and techniques, practitioners can create photographic documentation of fundal findings, clinically and at autopsy, without the expense of a retinal camera. Smartphone image acquisition of fundal abnormalities can promote ophthalmological telemedicine--especially in regions or countries with limited resources--and facilitate prompt, accurate, and unbiased documentation of retinal hemorrhages in infants and young children.

  16. Isolation of primary microglia from the human post-mortem brain: effects of ante- and post-mortem variables.

    PubMed

    Mizee, Mark R; Miedema, Suzanne S M; van der Poel, Marlijn; Adelia; Schuurman, Karianne G; van Strien, Miriam E; Melief, Jeroen; Smolders, Joost; Hendrickx, Debbie A; Heutinck, Kirstin M; Hamann, Jörg; Huitinga, Inge

    2017-02-17

    Microglia are key players in the central nervous system in health and disease. Much pioneering research on microglia function has been carried out in vivo with the use of genetic animal models. However, to fully understand the role of microglia in neurological and psychiatric disorders, it is crucial to study primary human microglia from brain donors. We have developed a rapid procedure for the isolation of pure human microglia from autopsy tissue using density gradient centrifugation followed by CD11b-specific cell selection. The protocol can be completed in 4 h, with an average yield of 450,000 and 145,000 viable cells per gram of white and grey matter tissue respectively. This method allows for the immediate phenotyping of microglia in relation to brain donor clinical variables, and shows the microglia population to be distinguishable from autologous choroid plexus macrophages. This protocol has been applied to samples from over 100 brain donors from the Netherlands Brain Bank, providing a robust dataset to analyze the effects of age, post-mortem delay, brain acidity, and neurological diagnosis on microglia yield and phenotype. Our data show that cerebrospinal fluid pH is positively correlated to microglial cell yield, but donor age and post-mortem delay do not negatively affect viable microglia yield. Analysis of CD45 and CD11b expression showed that changes in microglia phenotype can be attributed to a neurological diagnosis, and are not influenced by variation in ante- and post-mortem parameters. Cryogenic storage of primary microglia was shown to be possible, albeit with variable levels of recovery and effects on phenotype and RNA quality. Microglial gene expression substantially changed due to culture, including the loss of the microglia-specific markers, showing the importance of immediate microglia phenotyping. We conclude that primary microglia can be isolated effectively and rapidly from human post-mortem brain tissue, allowing for the study of the

  17. Evaluation of postmortem redistribution phenomena for commonly encountered drugs.

    PubMed

    Han, Eunyoung; Kim, Eunmi; Hong, Hyojeong; Jeong, Sujin; Kim, Jihyun; In, Sangwhan; Chung, Heesun; Lee, Sangki

    2012-06-10

    We described the findings of a study into the post-mortem redistribution (PMR) of 76 drugs found in 129 drug-related cases between 2006 and 2009. Seventy six drugs (psychotropic drugs (n=14), antidepressants (n=9), sedatives (n=6) and so on) were simultaneously quantified in cardiac and peripheral blood by gas chromatography-mass spectrometry (GC/MS) or liquid chromatography-tandem mass spectrometry (LC/MS/MS). The absence, possibility or presence of PMR of drugs was determined according to the ratios of cardiac to femoral blood concentrations (C/P ratios). Proxyphylline (C/P ratio: 0.85) showed no PMR; carbamazepine was not subject to PMR; a potential for PMR of lorazepam and mirtrazapine cannot be excluded; chlordiazepoxide is subject to PMR; acetaminophen and alprazolam exhibit minimal PMR; amitriptyline and benztropine exhibit PMR. Codeine (C/P ratio: 4.9), zolpidem (C/P ratio: 3.74), chlorpromazine (C/P ratio: 2.97), fluoxetine (C/P ratio: 2.83) and propranolol (C/P ratio: 2.72) had the largest C/P ratios. Postmortem drug concentrations showed variations depending on sampling sites and characteristics of the drugs. It is continuously necessary to analyze commonly used or abused drugs in simultaneously collected cardiac and peripheral blood to establish significant reference values for PMR. These findings can be used to reach a conclusion about the cause and manner of death.

  18. Interpretation of postmortem change in cadavers in Spain.

    PubMed

    Prieto, José L; Magaña, Concepción; Ubelaker, Douglas H

    2004-09-01

    Estimating time since death is especially difficult in the examination of poorly preserved cadavers and depends on the experience of the examiner and comparison with previously documented cases showing similar characteristics. The present study reports on information obtained over the past ten years through the work of the Laboratorio de Antropología y Odontología Forense (LAF) of the Instituto Anatómico Forense de Madrid, Spain, in particular evaluating how the type of fracture influences postmortem change. From the original 225 forensic cases examined between 1992 and 2002 in the LAF, a sample of 29 cases were selected from various regions of the Spanish mainland. A data collection protocol was established to reflect factors which the existing specialized literature, documenting the relation existing in the sample analyzed between time since death and the extent of postmortem change, which in the environments examined are distributed into the following phases: Phase 1 (putrefaction): one week to one month on the surface and two months in water. Phase 2 (initial skeletonization): two months on the surface and five to six months in water. Phase 3 (advanced skeltonization): six months to 1.5 years on the surface and 2.5 years buried. Phase 4 (complete skeletonization): about one year on the surface and three years buried. This paper also provide useful information on the impact of carrion insect activity, location, climate, seasonality, and predator.

  19. Postmortem sole incisions - a new sign of heroin overdose?

    PubMed

    Benomran, Fawzi

    2008-01-01

    Postmortem sole incisions have been observed in a number of heroin overdose fatalities. Acqueintance of those victims confessed to producing those incisions as a life saving procedure in a futile attempt to help the comatose overdose victim. They thought that bleeding the unconscious victim would remove the overdose, in manner similar to bloodletting or phlebotomy which is still popular in the Gulf region. The presence of such wounds has become a first indication or rather "sign" of heroin poisoning. In such cases, laboratory investigation confirmed the pathologist's preliminary suspicion. In Dubai, postmortem sole incisions are important sign of death from heroin overdose even in the absence of other classical signs. This sign becomes more credible when accompanied by other signs and/or circumstantial evidence suggestive of heroin use. It is suggested that this should be called "bloodletting sign" of death from heroin overdose. The sign should not be confused with the self-inflicted cuts seen on the arms and forearms of drug misusers which are caused for other reasons.

  20. Evaluation of post-mortem oxymetry in fire victims.

    PubMed

    Maeda, H; Fukita, K; Oritani, S; Nagai, K; Zhu, B L

    1996-08-15

    In order to investigate the pathophysiology of death due to fires, we examined blood samples of 48 fire victims on CO-oximeter systems and evaluated the oxymetric differences between arterial and venous blood as well as those between the heart and peripheral blood. Post-mortem carboxyhemoglobin (CO-Hb) levels in the left and right heart blood, respectively, ranged from 1.2 to 94.7% and from 0.4 to 90.5%. Marked arterio-venous and centro-peripheral differences were observed in the cases of high CO-Hb (above ca. 70%), suggesting an immediate effect of fatal carbon monoxide (CO) poisoning probably accompanied with acute heart failure. A relatively high oxyhemoglobin level was observed in the cases of low CO-Hb (below ca. 30%). In some cases, reduced hemoglobin levels in the left heart blood were paradoxically somewhat higher than those in the right. These oxymetric profiles may assist to consider the final balance of blood gas in fire victims depending on increased CO, carbon dioxide, and reduction of oxygen in the ambient atmosphere due to combustion, although post-mortem interference should be taken into consideration.

  1. Elevated postmortem ethanol concentrations in an insulin-dependent diabetic.

    PubMed

    Collison, Ines B

    2005-10-01

    A 54-year-old woman (165 cm, 37 kg) was found dead in her home during a welfare check after not having been seen for at least three days. The body showed clear evidence of decomposition. Her head was in what appeared to be a pool of blood. The residence was clean, neat, and showed no evidence of violence. Insulin was found in the refrigerator, and syringes were in the kitchen cabinet. In agreement with these physical findings, her clinical history indicated that she suffered insulin-dependent diabetes mellitus. Autolytic changes were noticed at autopsy, and no obvious cause of death was demonstrated. The autopsy heart blood sample screened negative for cocaine and/or metabolite (benzoylecgonine), phenethylamines, opiates, and barbiturates by radioimmunoassay. The alcohol concentration was 0.51 g/dL in the blood, 0.04 g/dL in the brain, 0.08 g/dL in the liver, and 0.05 g/dL in the urine, and acetone levels were 42 mg/dL, 53 mg/dL, 14 mg/dL, and 19 mg/dL, respectively. Isopropanol was also present in all samples analyzed. The cause of death was ruled as metabolic acidosis due to diabetes mellitus. Possible bacterial postmortem production of ethanol is considered as an explanation for the increased concentration of ethanol found in the postmortem heart blood.

  2. Building models for postmortem abnormalities in hippocampus of schizophrenics.

    PubMed

    Benes, Francine M

    2015-09-01

    Postmortem studies have suggested that there is abnormal GABAergic activity in the hippocampus in schizophrenia (SZ). In micro-dissected human hippocampal slices, a loss of interneurons and a compensatory upregulation of GABAA receptor binding activity on interneurons, but not PNs, has suggested that disinhibitory GABA-to-GABA connections are abnormal in stratum oriens (SO) of CA3/2, but not CA1, in schizophrenia. Abnormal expression changes in the expression of kainate receptor (KAR) subunits 5, 6 and 7, as well as an inwardly-rectifying hyperpolarization-activated cationic channel (Ih3; HCN3) may play important roles in regulating GABA cell activity at the SO CA3/2 locus. The exclusive neurons at this site are GABAergic interneurons; these cells also receive direct projections from the basolateral amygdala (BLA). When the BLA is stimulated by stereotaxic infusion of picrotoxin in rats, KARs influence axodendritic and presynaptic inhibitory mechanisms that regulate both inhibitory and disinhibitory interneurons in the SO-CA3/2 locus. The rat model described here was specifically developed to extend our understanding of these and other postmortem findings and has suggested that GABAergic abnormalities and possible disturbances in oscillatory rhythms may be related to a dysfunction of disinhibitory interneurons at the SO-CA3/2 site of schizophrenics.

  3. Use of postmortem human subjects to describe injury responses and tolerances.

    PubMed

    Yoganandan, Narayan; Stemper, Brian D; Pintar, Frank A; Maiman, Dennis J

    2011-04-01

    Traumatic injuries from blunt, penetrating, and blast events expose the human body to unintentional and intentional external mechanical loads. To mitigate trauma and develop safety-engineered devices for clinical and bioengineering applications, it is critical to delineate the structural load-bearing anatomy and biomechanics of the various components of the human body. This article presents advances made in the understanding of the injury responses and tolerances through experiments conducted using intact or segmented tissues from postmortem human subjects (PMHS), and a considerable majority of data for the presentation has been extracted from studies conducted at the Institutions of the authors. The role of the PMHS model for studying traumatic injuries to the head and face, vertebral column (cervical, thoracic and lumbar spines), thorax, abdomen, pelvis, and lower extremities is discussed. Different impact loading scenarios, likely responsible for the initial trauma causation, are considered in the analysis and determination of the human response to injury. Clinical advances made using the PMHS model are discussed. This includes vertebral stabilization system evaluations secondary to traumatic injuries to the spinal column. The critical importance of using data from the PMHS model in developing validated computational models for advancing crashworthiness research, occupant safety in motor vehicle crashes, medical devices, and safety-engineering applications is highlighted.

  4. Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings.

    PubMed

    Zech, Wolf-Dieter; Jackowski, Christian; Schwendener, Nicole; Brencicova, Eva; Schuster, Frederick; Lombardo, Paolo

    2016-01-01

    In their daily forensic casework, the authors experienced discrepancies of tracheobronchial content findings between postmortem computed tomography (PMCT) and autopsy to an extent previously unnoticed in the literature. The goal of this study was to evaluate such discrepancies in routine forensic cases. A total of 327 cases that underwent PMCT prior to routine forensic autopsy were retrospectively evaluated for tracheal and bronchial contents according to PMCT and autopsy findings. Hounsfield unit (HU) values of tracheobronchial contents, causes of death, and presence of pulmonary edema were assessed in mismatching and matching cases. Comparing contents in PMCT and autopsy in each of the separately evaluated compartments of the respiratory tract low positive predictive values were assessed (trachea, 38.2%; main bronchi, 40%; peripheral bronchi, 69.1%) indicating high discrepancy rates. The majority of tracheobronchial contents were viscous stomach contents in matching cases and low radiodensity materials (i.e., HU < 30) in mismatching cases. The majority of causes of death were cardiac related in the matching cases and skull/brain trauma in the mismatching cases. In mismatching cases, frequency of pulmonary edema was significantly higher than in matching cases. It can be concluded that discrepancies in tracheobronchial contents observed between PMCT and routine forensic autopsy occur in a considerable number of cases. Discrepancies may be explained by the runoff of contents via nose and mouth during external examination and the flow back of tracheal and main bronchial contents into the lungs caused by upright movement of the respiratory tract at autopsy.

  5. Postmortem interval (PMI) determined by study sarcophagous biocenoses: three cases from the province of Venice (Italy).

    PubMed

    Turchetto, M; Lafisca, S; Costantini, G

    2001-08-15

    This paper presents and discusses three cases of cadavers found, unburied, in the province of Venice, Northern Italy. In each case, all insect species playing some role in carrion decay processes, both sarcophagous and their predators, found on or in the bodies, were collected and determined. In one case, many larvae of the black soldier fly, Hermetia illucens L. (Diptera: Stratiomyidae) were found and are reported, for the first time in Italy, as necrophagous. Experimental breeding of some fly species was also carried out in controlled temperature and humidity conditions. In particular, it was of interest to know how the Neotropical black soldier fly modified its life-cycle to adapt to a temperate climate. It was thus possible to establish the rate of larval growth and timing of pupation, emergence, oviposition and hatching in various external conditions. The postmortem interval (PMI) established by identifying the life-cycle stages of dipterofauna were later confirmed in all cases through police investigations and the results of forensic analyses.

  6. Colchicine poisoning by accidental ingestion of meadow saffron (Colchicum autumnale): pathological and medicolegal aspects.

    PubMed

    Klintschar, M; Beham-Schmidt, C; Radner, H; Henning, G; Roll, P

    1999-12-20

    Although intoxications with colchicine, the alkaloid of Colchicum autumnale (meadow saffron), are well known, in most cases the intoxications are evoked by oral or parenteral preparations traditionally used as medication against gout. The accidental ingestion of Colchicum autumnale, on the other hand, is a rare event and has to our knowledge only twice been described in detail. We report a further case in which two persons confused this highly poisonous plant with wild garlic (Allium ursinum), a popular spice in the Central European cuisine. While one person merely complained about a 3-day episode of nausea, vomiting and watery diarrhea, the second person died of multi-organ system derangements 48 h after the ingestion of the colchicum leaves. At autopsy hemorrhagic lung oedema, hypocellular bonemarrow, centrilobular fatty necrosis of the liver and necrosis of the proximal convoluted tubuli of the kidneys were observed. A colchicine concentration of 7.5 micrograms/ml was found in the bile whereas no substance was detected in the postmortem blood.

  7. Diptera of Medico-Legal Importance Associated With Pig Carrion in a Tropical Dry Forest.

    PubMed

    Vasconcelos, S D; Salgado, R L; Barbosa, T M; Souza, J R B

    2016-06-20

    The diversity of necrophagous Diptera is largely unknown in seasonally dry tropical forests, despite their medical, veterinary, and forensic relevance. We performed a study in the dry Caatinga forest exclusive to Brazil in order to assess the diversity and temporal pattern of Diptera species using pig carcasses as substrates. Adults were collected daily until complete skeletonization. We collected 17,142 adults from 18 families, 10 of which comprise species with known necrophagous habits. The most abundant families were Calliphoridae (47.3% of specimens), Sarcophagidae (20.8%), and Muscidae (15.5%), whereas Sarcophagidae stood out in terms of richness with 21 species. The native Cochliomyia macellaria (F.) (Diptera: Calliphoridae) and the invasive Chrysomya albiceps (Wiedmann) (Calliphoridae) were the dominant species. A total of 18 species reached the carcass during the first 48 h postdeath. The bloated and active decay stages had the highest richness and abundance of dipterans. From a forensic standpoint, C. macellaria and C. albiceps are likely to aid in establishing postmortem interval due to their early arrival and high abundance on the carcass. Despite harsh environmental conditions, the Caatinga harbors a rich assemblage of dipterans that play a key role in carrion decomposition. Their medico-veterinary importance is strengthened by the poor local sanitary conditions.

  8. Effect of postmortem aging on marination performance of broiler breast pectoralis major categorized by color lightness

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective was to evaluate the effect of postmortem aging on marinade uptake and retention by early-deboned chicken breast fillets with different color lightness. Effects of marination on product yield and muscle shear force were also determined. Early deboned (2 h postmortem) broiler butterflies...

  9. Postmortem ultrasonography of the macerated fetus complements autopsy following in utero fetal demise.

    PubMed

    Cain, Mary Ashley; Guidi, Claude B; Steffensen, Thora; Whiteman, Valerie E; Gilbert-Barness, Enid; Johnson, Dennis R

    2014-01-01

    Postmortem evaluation following an in utero fetal demise is essential for determining cause of death and counseling regarding future pregnancies. Severe maceration and fetal size along with patient desires may limit the physician's ability to perform a complete autopsy. In the cases presented, we demonstrate the utility of postmortem ultrasonography as an adjunct to traditional autopsy following fetal demise.

  10. Postmortem chemical changes in poultry breast meat monitored with visible-near infrared spectroscopy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Chicken meat undergoes significant chemical and structural changes with postmortem time that influence meat quality characteristics. The objective of this study was to measure the visible-near infrared (vis-NIR) spectral differences in broiler breast fillets at 0.5, 4, 24, and 120 h postmortem. Mu...

  11. Developing a UHPLC-QTOF-MS and Automated Library Search Method for Screening Drugs and Toxic Compounds in Postmortem Specimens.

    PubMed

    Liu, Hsiu-Chuan; Yang, Chu-An; Liu, Ray H; Lin, Dong-Liang

    2017-03-24

    Screening and confirming the presence of drugs and toxic compounds in various matrices are important and challenging tasks routinely faced by forensic and clinical laboratories. Recent advances in the liquid chromatographic and mass spectrometric technologies have provided an opportunity for the development of more specific and effective approaches to achieve the "screening" and "confirmation" goals in a single analytical step. The objectives of this study are: (i) the establishment of an ultra-high performance liquid chromatographic, quadrupole time-of-flight mass spectrometric mass spectrometric and MS-MS spectral database, including 1,200 compounds of interest; and (ii) the development of an effective protocol, using this database and three searching algorithms, for general unknown screening of these compounds. The established database and protocol were evaluated through the analysis of 30 external proficiency test and 100 postmortem samples and found to be significantly more effective than the LC-IT-MS and GC-MS approaches previously established in our laboratory.

  12. [Putrefaction in a mortuary cold room? Unusual progression of postmortem decomposition processes].

    PubMed

    Kunz, Sebastian N; Brandtner, Herwig; Meyer, Harald

    2013-01-01

    This article illustrates the rare case of rapid body decomposition in an uncommonly short postmortem interval. A clear discrepancy between early postmortem changes at the crime scene and advanced body decomposition at the time of autopsy were seen. Subsequent police investigation identified a failure in the cooling system of the morgue as probable cause. However, due to the postmortem status of the body, a moderate rise in temperature alone is not considered to have caused the full extent of postmortem changes. Therefore, other factors must have been present, which accelerated the postmortem decomposition processes. In our opinion, the most reasonable explanation for this phenomenon would be a rather long resting time of the corpse in a non-refrigerated hearse on a hot summer day.

  13. [Professional autonomy in the choice and management of therapy. Medicolegal aspects].

    PubMed

    Bolino, G; Alfano, C

    2002-02-01

    Any discussion of the delicate subject of a doctor's autonomy in the choice and management of therapy entails addressing the intimate question of professional and ethical conduct. The professional freedom to choose which therapy to use continues to be the most quintessential expression of the medical professional and, in respect of the primary purpose of safeguarding health, must be aligned with: the choices of the informed patient or his/her legal representatives, existing guidelines and the equitable allocation of resources. On these grounds, the author sets out brief considerations regarding a number of issues frequently raised in the everyday work of the pediatrician and neonatologist: from the doctor's autonomy to adopt a diagnostic-therapeutic approach, with special reference to the prescription of drugs and the subtle differences compared to pharmacological trials, to the promotion and protection of breastfeeding, with explicit reference to the Ministry of Health's recent Circular no. 16 of 24.10.2000 ("Promotion and protection of breastfeeding") which, following a cursory reading of the text, appears to highlight restrictions to the pediatrician's decision-making autonomy. Special emphasis is also given to the medicolegal problems of caring for high-risk neonates. The clinical practice of neonatology often places the doctor in "critical" decision-making situations, with far from negligible ethical and moral implications, not to mention juridical and forensic ones. The author sets out a number of decision-making parameters for use as guidelines: the statistical criterion, the legal criterion and the clinical criterion, the only one capable of adjusting to scientific progress and to the specific technical and professional resources of the medical centre where the doctor is required to intervene in order to preserve even the simple "possibility" of autonomous life for the fetus. From this point of view, the so-called chronological vitality and scientifically

  14. Postmortem Quetiapine Reference Concentrations in Brain and Blood.

    PubMed

    Skov, Louise; Johansen, Sys Stybe; Linnet, Kristian

    2015-09-01

    Brain tissue is a useful alternative to blood in postmortem forensic investigations, but scarcity of information on reference concentrations in brain tissue makes interpretation challenging. Here we present a study of 43 cases where the antipsychotic drug quetiapine was quantified in brain tissue and related to concentrations in postmortem blood. For cases, where quetiapine was unrelated to the cause of death (N = 36), the 10-90 percentiles for quetiapine concentrations in brain tissue were 0.030-1.54 mg/kg (median 0.48 mg/kg, mean 0.79 mg/kg). Corresponding blood 10-90 percentile values were 0.007-0.39 mg/kg (median 0.15 mg/kg, mean 0.19 mg/kg), giving brain-blood ratio 10-90 percentiles of 2.31-6.54 (median 3.87, mean 4.32). Both correspond well to the limited amount of data found in the literature. For cases where quetiapine was a contributing factor to death (N = 5), the median value in brain tissue of 8.02 mg/kg (range 2.69-22.98 mg/kg) was more than 15 times higher than the median of the nontoxic values, and about the same relationship occurred for blood with a median of 3.19 mg/kg (range 1.00-6.90 mg/kg). The brain-blood ratios for toxic concentrations were in the range of 2.08-6.05, which correspond to those of the nontoxic concentrations. A single case, where quetiapine was ruled as the sole cause of death, a suicide by quetiapine overdose, had an even higher value of 25.74 mg/kg in brain tissue. The blood concentration was 8.99 mg/kg, giving a brain-blood ratio of 2.86. Thus, on average the brain concentrations were about four times the blood concentrations. The brain concentrations of quetiapine observed in cases, where quetiapine was unrelated to death, may serve as a reference, when evaluating postmortem cases with no blood available. The recorded concentrations, where quetiapine was contributing to death, give an indication of likely toxic concentrations.

  15. Medicolegal characteristics of firearm homicides in Belgrade, Serbia: before, during, and after the war in the Former Yugoslavia.

    PubMed

    Rancic, Nemanja; Erceg, Milena; Radojevic, Nemanja; Savic, Slobodan

    2013-11-01

    A comparative analysis of firearm homicides committed in Belgrade was performed including four representative years: 1987 (before the civil war in the Former Yugoslavia), 1991 (beginning of the war), 1997 (end of the war), and 2007 (period of social stabilization). The increase in the number of homicides was established in 1991 and 1997 compared with 1987, with the decrease in 2007, but with the continuous increase in the percentage of firearm homicides in the total number of homicides, from 12% in 1987 up to 56% in 2007. The significant increase in firearm homicides during the last decade of the 20th century can be explained by the social disturbances and the high availability of firearms, while their reduction in 2007 could be linked to the gradual stabilization of social circumstances. The results showed that the actual social, political, and economical changes strongly influenced medicolegal characteristics of homicides and particularly firearm homicides.

  16. [Disturbance of the health--an attempt at interpreting the term. Part II--problems in medico-legal opinionating].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara

    2006-01-01

    Interpretative problems are caused by the semantic definition of the term "disturbance of the health" and its usage in the law system context. Judicial decisions show that this term is employed to denote a functional, as well as mental detriment to the health that exceeds the individual's adaptative abilities. A review of medico-legal literature demonstrates various interpretations of the term, starting from general systemic disturbances to definitions allowing for objectivization of the injured person's complaints. The deliberations constitute an attempt at quantification of "disturbance of the health" and defining the upper and lower limits of the medium and slight detriment to the health. The results of the analysis allow for adopting a definition that permits to judge objectively the injured person's complaints and to determine the limits of the compensatory ability of his body.

  17. Risk management in clinical practice. Part 6b. Identifying and avoiding medico-legal risks in removable dentures.

    PubMed

    Stilwell, C

    2010-10-09

    The most likely cause of complaint with prosthodontics is a denture that in some way fails to be accepted. A denture that does not perform as the patient expects can give rise to great disappointment and anger. The problem is that acceptance of a denture is not just a technical issue. Success depends on the individual's ability to tolerate and adapt to the denture. It is therefore essential to make the right assessment for the patient from the outset. This includes discovering the patient's priorities and establishing realistic expectations. With the aim of assisting the dental profession in identifying and avoiding medico-legal risks in removable dentures, this article sets out a systematic, diagnostic and collaborative approach to complete and partial denture assessment and treatment.

  18. The External Degree.

    ERIC Educational Resources Information Center

    Houle, Cyril O.

    This book examines the external degree in relation to the extremes of attitudes, myths, and data. Emphasis is placed on the emergence of the American external degree, foreign external-degree programs, the purpose of the external degree, the current scene, institutional issues, and problems of general policy. (MJM)

  19. Medicolegal study of child sexual abuse in greater Cairo, Egypt, during a 7-year period: 2005-2011.

    PubMed

    Elgendy, Ibrahim Sadik; Hassan, Nermeen Adly

    2013-12-01

    Child sexual abuse has gained public attention and has become 1 of the most high-profile crimes. This study aimed to determine the demographic and medicolegal aspects of child sexual abuse in greater Cairo, Egypt. This is a retrospective study from January 1, 2005, to December 31, 2011. Data were collected from a Cairo medicolegal department and were statistically analyzed. The total number of cases was 1832 victims; 57.9% were males and 42.1% were females. Most assaults occurred in 2010 (16.2%) and 2011 (17.5%). The age group 6 to 12 years accounted for higher rate (49%), mostly in males (71.8%). A total of 83.3% of the victims belonged to low social class, and 72.3% of the victims were out of school. Only 1.9% of the victims had a mental disability. The crime scene was an unknown place in 78.1%. All offenders were males; most cases had 1 offender (82.5 %); and most offenders were extrafamilial (94.2%), of low social level, illiterate, unemployed, and between 18 and 30 years old. The unmarried offenders assaulted the females more than the males, whereas the married assaulted the males more than the females. A total of 5.8% were intrafamilial offenders; 62.7% of these cases were incest against girls and 37.3% were sodomy against boys. Clothes were normal in 48.8%. Anal assault (52.3%) and incomplete vaginal penetration (32%) were the commonest types. There was no significant relation between findings, investigations, and time. In conclusion, child sexual abuse in greater Cairo represents a problem. Therefore,forensic medicine should be a part of a multidisciplinary approach to prevent, investigate, and treat the problem.

  20. Histological appearance of postmortem pink teeth: Report of two cases.

    PubMed

    Gowda, Bk Charan; Sivapathasundharam, B; Chatterji, Ananjan; Chatterji, B L

    2015-01-01

    This article presents images and histological changes in the dentin of two cases involving posmortem pink teeth. Postmortem pink teeth were noted among two deceased male individuals. Pink teeth were noted during autopsy examination after twelve days in one corpse, and eight days following death in the second case. During the examination decomposition and putrefaction of the body was noted. Cause of death was drowning in one case and haemorrhages and shock in another. A central incisor tooth was obtained from each body. Both teeth exhibited a pink appearance and the intensity was more pronounced in the cervical region. Although pink teeth can be noted in death due to asphyxia, carbon monoxide poisoning and so on, it is necessary to study the exact role behind the appearance of pink teeth and try to incorporate the finding medico legally.

  1. Postmortem diagnosis of diabetes mellitus and its complications.

    PubMed

    Palmiere, Cristian

    2015-06-01

    Diabetes mellitus has become a major cause of death worldwide and diabetic ketoacidosis is the most common cause of death in children and adolescents with type 1 diabetes. Acute complications of diabetes mellitus as causes of death may be difficult to diagnose due to missing characteristic macroscopic and microscopic findings. Biochemical analyses, including vitreous glucose, blood (or alternative specimen) beta-hydroxybutyrate, and blood glycated hemoglobin determination, may complement postmortem investigations and provide useful information for determining the cause of death even in corpses with advanced decompositional changes. In this article, we performed a review of the literature pertaining to the diagnostic performance of classical and novel biochemical parameters that may be used in the forensic casework to identify disorders in glucose metabolism. We also present a review focusing on the usefulness of traditional and alternative specimens that can be sampled and subsequently analyzed to diagnose acute complications of diabetes mellitus as causes of death.

  2. The Elusive Universal Post-Mortem Interval Formula

    SciTech Connect

    Vass, Arpad Alexander

    2011-01-01

    The following manuscript details our initial attempt at developing universal post-mortem interval formulas describing human decomposition. These formulas are empirically derived from data collected over the last 20 years from the University of Tennessee's Anthropology Research Facility, in Knoxville, Tennessee, USA. Two formulas were developed (surface decomposition and burial decomposition) based on temperature, moisture, and the partial pressure of oxygen, as being three of the four primary drivers for human decomposition. It is hoped that worldwide application of these formulas to environments and situations not readily studied in Tennessee will result in interdisciplinary cooperation between scientists and law enforcement personnel that will allow for future refinements of these models leading to increased accuracy.

  3. The eyeball killer: serial killings with postmortem globe enucleation.

    PubMed

    Coyle, Julie; Ross, Karen F; Barnard, Jeffrey J; Peacock, Elizabeth; Linch, Charles A; Prahlow, Joseph A

    2015-05-01

    Although serial killings are relatively rare, they can be the cause of a great deal of anxiety while the killer remains at-large. Despite the fact that the motivations for serial killings are typically quite complex, the psychological analysis of a serial killer can provide valuable insight into how and why certain individuals become serial killers. Such knowledge may be instrumental in preventing future serial killings or in solving ongoing cases. In certain serial killings, the various incidents have a variety of similar features. Identification of similarities between separate homicidal incidents is necessary to recognize that a serial killer may be actively killing. In this report, the authors present a group of serial killings involving three prostitutes who were shot to death over a 3-month period. Scene and autopsy findings, including the unusual finding of postmortem enucleation of the eyes, led investigators to recognize the serial nature of the homicides.

  4. Essentials of forensic post-mortem MR imaging in adults

    PubMed Central

    Ruder, T D; Thali, M J; Hatch, G M

    2014-01-01

    Post-mortem MR (PMMR) imaging is a powerful diagnostic tool with a wide scope in forensic radiology. In the past 20 years, PMMR has been used as both an adjunct and an alternative to autopsy. The role of PMMR in forensic death investigations largely depends on the rules and habits of local jurisdictions, availability of experts, financial resources, and individual case circumstances. PMMR images are affected by post-mortem changes, including position-dependent sedimentation, variable body temperature and decomposition. Investigators must be familiar with the appearance of normal findings on PMMR to distinguish them from disease or injury. Coronal whole-body images provide a comprehensive overview. Notably, short tau inversion–recovery (STIR) images enable investigators to screen for pathological fluid accumulation, to which we refer as “forensic sentinel sign”. If scan time is short, subsequent PMMR imaging may be focussed on regions with a positive forensic sentinel sign. PMMR offers excellent anatomical detail and is especially useful to visualize pathologies of the brain, heart, subcutaneous fat tissue and abdominal organs. PMMR may also be used to document skeletal injury. Cardiovascular imaging is a core area of PMMR imaging and growing evidence indicates that PMMR is able to detect ischaemic injury at an earlier stage than traditional autopsy and routine histology. The aim of this review is to present an overview of normal findings on forensic PMMR, provide general advice on the application of PMMR and summarise the current literature on PMMR imaging of the head and neck, cardiovascular system, abdomen and musculoskeletal system. PMID:24191122

  5. Postmortem computed tomography lung findings in fatal of hypothermia.

    PubMed

    Hyodoh, Hideki; Watanabe, Satoshi; Katada, Ryuichi; Hyodoh, Kazusa; Matsumoto, Hiroshi

    2013-09-10

    To identify lung findings specific to fatal hypothermia on postmortem computed tomography (CT) imaging. Whole body CT scans were performed followed by full autopsy to investigate causes of death. There were 13 fatal hypothermia cases (group A) and 118 with other causes of death (group B). The chest cavity (CC), dead space including fluid/pneumothorax (DS), aerated lung volume (ALV), percentage aerated lung (%ALV), and tracheal aerated volume (ATV) were measured. Autopsy findings of groups A and B were compared. Receiver operating characteristics (ROC) curves were used to identify factors specific to fatal hypothermia. There were no differences in age, sex, number with emphysema, or time from death to CT examination between the 2 groups. CC, DS, ALV, %ALV, and ATV were 2601.0±247.4 (mL), 281.1±136.5 (mL), 1564.5±281.1 (mL), 62.1±6.2(%), and 21.8±2.7 (mL) in group A and 2339.2±67.7 (mL), 241.1±38.0 (mL), 739.9±67.0 (mL), 31.4±2.3(%), and 15.9±0.8 (mL) in group B, respectively. There were statistically significant differences between groups A and B in ALV, %ALV and ATV. The multiple comparison procedure revealed that ALV and %ALV differed significantly between fatal hypothermia and other causes of death (p<0.05). Using ROC evaluation, %ALV had the largest area under the curve (0.819). This study demonstrates that the %ALV is greater in fatal hypothermia cases than in those with other causes of death on postmortem CT chest imaging. Based on CT, hypothermia is very likely to be the cause of death if the %ALV is >70%.

  6. Postmortem validation of breast density using dual-energy mammography

    PubMed Central

    Molloi, Sabee; Ducote, Justin L.; Ding, Huanjun; Feig, Stephen A.

    2014-01-01

    Purpose: Mammographic density has been shown to be an indicator of breast cancer risk and also reduces the sensitivity of screening mammography. Currently, there is no accepted standard for measuring breast density. Dual energy mammography has been proposed as a technique for accurate measurement of breast density. The purpose of this study is to validate its accuracy in postmortem breasts and compare it with other existing techniques. Methods: Forty postmortem breasts were imaged using a dual energy mammography system. Glandular and adipose equivalent phantoms of uniform thickness were used to calibrate a dual energy basis decomposition algorithm. Dual energy decomposition was applied after scatter correction to calculate breast density. Breast density was also estimated using radiologist reader assessment, standard histogram thresholding and a fuzzy C-mean algorithm. Chemical analysis was used as the reference standard to assess the accuracy of different techniques to measure breast composition. Results: Breast density measurements using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean algorithm, and dual energy were in good agreement with the measured fibroglandular volume fraction using chemical analysis. The standard error estimates using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean, and dual energy were 9.9%, 8.6%, 7.2%, and 4.7%, respectively. Conclusions: The results indicate that dual energy mammography can be used to accurately measure breast density. The variability in breast density estimation using dual energy mammography was lower than reader assessment rankings, standard histogram thresholding, and fuzzy C-mean algorithm. Improved quantification of breast density is expected to further enhance its utility as a risk factor for breast cancer. PMID:25086548

  7. Essentials of forensic post-mortem MR imaging in adults.

    PubMed

    Ruder, T D; Thali, M J; Hatch, G M

    2014-04-01

    Post-mortem MR (PMMR) imaging is a powerful diagnostic tool with a wide scope in forensic radiology. In the past 20 years, PMMR has been used as both an adjunct and an alternative to autopsy. The role of PMMR in forensic death investigations largely depends on the rules and habits of local jurisdictions, availability of experts, financial resources, and individual case circumstances. PMMR images are affected by post-mortem changes, including position-dependent sedimentation, variable body temperature and decomposition. Investigators must be familiar with the appearance of normal findings on PMMR to distinguish them from disease or injury. Coronal whole-body images provide a comprehensive overview. Notably, short tau inversion-recovery (STIR) images enable investigators to screen for pathological fluid accumulation, to which we refer as "forensic sentinel sign". If scan time is short, subsequent PMMR imaging may be focussed on regions with a positive forensic sentinel sign. PMMR offers excellent anatomical detail and is especially useful to visualize pathologies of the brain, heart, subcutaneous fat tissue and abdominal organs. PMMR may also be used to document skeletal injury. Cardiovascular imaging is a core area of PMMR imaging and growing evidence indicates that PMMR is able to detect ischaemic injury at an earlier stage than traditional autopsy and routine histology. The aim of this review is to present an overview of normal findings on forensic PMMR, provide general advice on the application of PMMR and summarise the current literature on PMMR imaging of the head and neck, cardiovascular system, abdomen and musculoskeletal system.

  8. Postmortem validation of breast density using dual-energy mammography

    SciTech Connect

    Molloi, Sabee Ducote, Justin L.; Ding, Huanjun; Feig, Stephen A.

    2014-08-15

    Purpose: Mammographic density has been shown to be an indicator of breast cancer risk and also reduces the sensitivity of screening mammography. Currently, there is no accepted standard for measuring breast density. Dual energy mammography has been proposed as a technique for accurate measurement of breast density. The purpose of this study is to validate its accuracy in postmortem breasts and compare it with other existing techniques. Methods: Forty postmortem breasts were imaged using a dual energy mammography system. Glandular and adipose equivalent phantoms of uniform thickness were used to calibrate a dual energy basis decomposition algorithm. Dual energy decomposition was applied after scatter correction to calculate breast density. Breast density was also estimated using radiologist reader assessment, standard histogram thresholding and a fuzzy C-mean algorithm. Chemical analysis was used as the reference standard to assess the accuracy of different techniques to measure breast composition. Results: Breast density measurements using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean algorithm, and dual energy were in good agreement with the measured fibroglandular volume fraction using chemical analysis. The standard error estimates using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean, and dual energy were 9.9%, 8.6%, 7.2%, and 4.7%, respectively. Conclusions: The results indicate that dual energy mammography can be used to accurately measure breast density. The variability in breast density estimation using dual energy mammography was lower than reader assessment rankings, standard histogram thresholding, and fuzzy C-mean algorithm. Improved quantification of breast density is expected to further enhance its utility as a risk factor for breast cancer.

  9. Virtual forensic entomology: improving estimates of minimum post-mortem interval with 3D micro-computed tomography.

    PubMed

    Richards, Cameron S; Simonsen, Thomas J; Abel, Richard L; Hall, Martin J R; Schwyn, Daniel A; Wicklein, Martina

    2012-07-10

    We demonstrate how micro-computed tomography (micro-CT) can be a powerful tool for describing internal and external morphological changes in Calliphora vicina (Diptera: Calliphoridae) during metamorphosis. Pupae were sampled during the 1st, 2nd, 3rd and 4th quarter of development after the onset of pupariation at 23 °C, and placed directly into 80% ethanol for preservation. In order to find the optimal contrast, four batches of pupae were treated differently: batch one was stained in 0.5M aqueous iodine for 1 day; two for 7 days; three was tagged with a radiopaque dye; four was left unstained (control). Pupae stained for 7d in iodine resulted in the best contrast micro-CT scans. The scans were of sufficiently high spatial resolution (17.2 μm) to visualise the internal morphology of developing pharate adults at all four ages. A combination of external and internal morphological characters was shown to have the potential to estimate the age of blowfly pupae with a higher degree of accuracy and precision than using external morphological characters alone. Age specific developmental characters are described. The technique could be used as a measure to estimate a minimum post-mortem interval in cases of suspicious death where pupae are the oldest stages of insect evidence collected.

  10. Postmortem concentrations of gamma-hydroxybutyrate (GHB) in peripheral blood and brain tissue - Differentiating between postmortem formation and antemortem intake.

    PubMed

    Thomsen, Ragnar; Rasmussen, Brian Schou; Johansen, Sys Stybe; Linnet, Kristian

    2017-03-01

    Gamma-hydroxybutyrate (GHB) is a recreational drug, a drug of abuse, as well as an endogenous molecule in mammals. The drug has become infamous as a tool for drug-facilitated sexual assault. GHB is found in low concentrations in living humans, while at postmortem the concentration of GHB rises due to fermentation processes. The endogenous nature of GHB leads to difficulty in interpretation of concentrations, as the source of GHB is not obvious. Postmortem brain and blood samples were collected from 221 individuals at autopsy. Of these, 218 were not suspected of having ingested GHB, while GHB intake was reported for the last three (cases A-C). Decomposition level was estimated and cases classified into no/minor and advanced decomposition. Brain samples were extracted from the frontal lobe; only gray matter from the cerebral cortex was used. Blood was drawn from the femoral vein. Brain samples were homogenized and diluted with water. Brain homogenates or femoral blood were then prepared using protein precipitation and GHB was quantified with UHPLC-MS/MS. For 189 cases where ingestion of GHB was not suspected and where no/minor decomposition had occurred the concentrations were in the range 4.8-45.4mg/kg (median 15.3mg/kg) in blood and not-detected to 9.8mg/kg (median 4.8mg/kg) in brain tissue. For case A, where intoxication with GHB was deemed to be the sole cause of death, the concentrations were 199 and 166mg/kg in blood and brain, respectively. For case B, where intoxication with GHB was a contributing factor of death, the respective concentrations were 142 and 78.4mg/kg. For case C, where GHB was ingested but the cause of death was opioid poisoning, the concentrations were 40.3 and 12.7mg/kg. The results demonstrate that postmortem-formed levels of GHB are much lower in brain than peripheral blood. Analysis of GHB in brain tissue thus provides for an improved capability to identify an exogenous source of GHB. By measuring GHB in brain tissue and employing a cut

  11. Postmortem circulation: a new model for testing endovascular devices and training clinicians in their use.

    PubMed

    Chevallier, Christine; Willaert, Wouter; Kawa, Emilia; Centola, Marcos; Steger, Beat; Dirnhofer, Richard; Mangin, Patrice; Grabherr, Silke

    2014-05-01

    The development of new medical devices, such as aortic valves, requires numerous preliminary studies on animals and training of personnel on cadavers before the devices can be used in patients. Postmortem circulation, a technique used for postmortem angiography, allows the vascular system to be reperfused in a way similar to that in living persons. This technique is used for postmortem investigations to visualize the human vascular system and to make vascular diagnoses. Specific material for reperfusing a human body was developed recently. Our aim was to investigate whether postmortem circulation that imitates in vivo conditions allows for the testing of medical materials on cadavers. We did this by delivering an aortic valve using minimally invasive methods. Postmortem circulation was established in eight corpses to recreate an environment as close as possible to in vivo conditions. Mobile fluoroscopy and a percutaneous catheterization technique were used to deliver the material to the correct place. Once the valve was implanted, the heart and primary vessels were extracted to confirm its position. Postmortem circulation proved to be essential in several of the cadavers because it helped the clinicians to deliver the material and improve their implantation techniques. Due to the intravascular circulation, sites with substantial arteriosclerotic stenosis could be bypassed, which would have been impossible without perfusion. Although originally developed for postmortem investigations, this reperfusion technique could be useful for testing new medical devices intended for living patients.

  12. AMP-activated protein kinase (AMPK) α2 subunit mediates glycolysis in postmortem skeletal muscle.

    PubMed

    Liang, Junfang; Yang, Qiyuan; Zhu, Mei-Jun; Jin, Ye; Du, Min

    2013-11-01

    Postmortem glycolysis is directly linked to the incidences of PSE (pale, soft and exudative) and DFD (dark, firm and dry) meats which cause significant loss to meat industry. AMP-activated protein kinase (AMPK) is a major regulator of postmortem glycolysis. However, there are two isoforms of the AMPKα catalytic subunit, and their roles in glycolysis of postmortem muscle remain unclear. The objective was to identify the isoform specific roles of AMPK in postmortem glycolysis. Wild type, AMPKα1, and AMPKα2 knockout (KO) mice were used in the current study. AMPK in Longissimus muscle was activated shortly after death. AMPKα2 but not AMPKα1 KO abolished the activity of AMPK in postmortem muscle. In addition, AMPKα2 KO reduced postmortem pH decline and the generation of lactate, while AMPKα1 KO had no significant effect. Finally, the glycogen content of skeletal muscle was reduced in AMPKα2 KO but not AMPKα1 KO mice. Data clearly demonstrate that AMPKα2 catalytic subunit mainly regulates postmortem glycolysis in muscle.

  13. Application of contrast media in post-mortem imaging (CT and MRI).

    PubMed

    Grabherr, Silke; Grimm, Jochen; Baumann, Pia; Mangin, Patrice

    2015-09-01

    The application of contrast media in post-mortem radiology differs from clinical approaches in living patients. Post-mortem changes in the vascular system and the absence of blood flow lead to specific problems that have to be considered for the performance of post-mortem angiography. In addition, interpreting the images is challenging due to technique-related and post-mortem artefacts that have to be known and that are specific for each applied technique. Although the idea of injecting contrast media is old, classic methods are not simply transferable to modern radiological techniques in forensic medicine, as they are mostly dedicated to single-organ studies or applicable only shortly after death. With the introduction of modern imaging techniques, such as post-mortem computed tomography (PMCT) and post-mortem magnetic resonance (PMMR), to forensic death investigations, intensive research started to explore their advantages and limitations compared to conventional autopsy. PMCT has already become a routine investigation in several centres, and different techniques have been developed to better visualise the vascular system and organ parenchyma in PMCT. In contrast, the use of PMMR is still limited due to practical issues, and research is now starting in the field of PMMR angiography. This article gives an overview of the problems in post-mortem contrast media application, the various classic and modern techniques, and the issues to consider by using different media.

  14. Postmortem CT angiography: capabilities and limitations in traumatic and natural causes of death.

    PubMed

    Ross, Steffen G; Bolliger, Stephan A; Ampanozi, Garyfalia; Oesterhelweg, Lars; Thali, Michael J; Flach, Patricia M

    2014-01-01

    Whole-body postmortem computed tomographic (CT) angiography is a promising new development in forensic radiology that has the potential to improve vascular and soft-tissue imaging beyond levels currently achievable with unenhanced postmortem CT. Postmortem access to the vascular system and injection of contrast medium are different from those steps in clinical (antemortem) radiology. Because there is no circulation in a corpse that could transport or dilute a contrast medium, the injection must be performed by using a roller pump to fill the vasculature (arterial and venous) with a mixture of a water-soluble iodized contrast medium and polyethylene glycol. In contrast to a classic autopsy, postmortem CT angiography is a minimally invasive procedure. It allows the diagnosis of vascular lesions without the disruption or destruction of anatomic structures, which could result in a loss of evidence in a criminal investigation. Furthermore, postmortem CT angiography facilitates the display of vascular pathologic conditions in areas that are not typically covered with autopsy alone, such as the craniocervical junction and the small pelvis. Therefore, postmortem CT angiography adds substantial value to the classic forensic autopsy; cross-sectional data can be reevaluated objectively at any time and are fully reproducible as counterexpertise, which is as useful in the fields of forensic medicine and pathology as in clinical research. Familiarity with the capabilities of postmortem CT angiography may help radiologists working with forensic cases improve their diagnostic performance.

  15. Postmortem computed tomography images of a broken piece of a weapon in the skull.

    PubMed

    Kawasumi, Yusuke; Hosokai, Yoshiyuki; Usui, Akihito; Saito, Haruo; Ishibashi, Tadashi; Funayama, Masato

    2012-02-01

    The use of post-mortem radiological imaging is becoming increasing widespread in forensic medicine. These images can help improve the quality and safety of autopsy. We report two cases of homicide victims that had broken pieces of a weapon in their skull. Postmortem multislice computed tomography (MSCT) demonstrated metal artifacts in the skull of two homicide cases. Autopsy showed that both artifacts were pieces broken off of a sharp instrument. Some possible benefits of postmortem MSCT include the ability to reconstruct visual images of weapons and the possible prevention of injury to autopsy personnel.

  16. [Advances on study of Lucilia species in estimating postmortem interval in forensic medicine].

    PubMed

    Zhang, Lu; Cai, Ji-feng

    2010-08-01

    Sarcosaphagous insects are very important to investigate some criminal cases. They are significant useful in estimating post-mortem interval (PMI) and corpse transfer post-mortem. Lucilia are very common sarcosaphagous insects. They like sunshine and are usually the earliest to touch the cadaver. These characteristics and others such as the stages of their larvae development can offer good evidences for criminal case investigation. This paper summarizes details of their application for estimating postmortem interval in recent years and reviews the methods to identify species and to determine the age of adult Lucilia with molecular biology and entomological morphology.

  17. Cone beam computed tomography (CBCT) as a tool for the analysis of nonhuman skeletal remains in a medico-legal setting.

    PubMed

    Lucena, Joaquin; Mora, Esther; Rodriguez, Lucia; Muñoz, Mariela; Cantin, Mario G; Fonseca, Gabriel M

    2016-09-01

    To confirm the nature and forensic significance of questioned skeletal material submitted a medico-legal setting is a relatively common procedure, although not without difficulties when the remains are fragmented or burned. Different methodologies have been described for this purpose, many of them invasive, time and money consuming or dependent on the availability of the analytical instrument. We present a case in which skeletal material with unusual conditions of preservation and curious discovery was sent to a medico-legal setting to determine its human/nonhuman origin. A combined strategy of imagenological procedures (macroscopic, radiographic and cone beam computed tomography - CBCT-technology) was performed as non-invasive and rapid methods to assess the nonhuman nature of the material, specifically of pig (Sus scrofa) origin. This hypothesis was later confirmed by DNA analysis. CBCT data sets provide accurate three-dimensional reconstructions, which demonstrate its reliable use as a forensic tool.

  18. Padova Charter on personal injury and damage under civil-tort law : Medico-legal guidelines on methods of ascertainment and criteria of evaluation.

    PubMed

    Ferrara, Santo Davide; Baccino, Eric; Boscolo-Berto, Rafael; Comandè, Giovanni; Domenici, Ranieri; Hernandez-Cueto, Claudio; Gulmen, Mete Korkut; Mendelson, George; Montisci, Massimo; Norelli, Gian Aristide; Pinchi, Vilma; Ranavaya, Mohammed; Shokry, Dina A; Sterzik, Vera; Vermylen, Yvo; Vieira, Duarte Nuno; Viel, Guido; Zoja, Riccardo

    2016-01-01

    Compensation for personal damage, defined as any pecuniary or non-pecuniary loss causally related to a personal injury under civil-tort law, is strictly based on the local jurisdiction and therefore varies significantly across the world. This manuscript presents the first "International Guidelines on Medico-Legal Methods of Ascertainment and Criteria of Evaluation of Personal Injury and Damage under Civil-Tort Law". This consensus document, which includes a step-by-step illustrated explanation of flow charts articulated in eight sequential steps and a comprehensive description of the ascertainment methodology and the criteria of evaluation, has been developed by an International Working Group composed of juridical and medico-legal experts and adopted as Guidelines by the International Academy of Legal Medicine (IALM).

  19. [The role, objectives and usefulness of medico-legal determinations in post-accidental procedures in traumatic deaths in hard coal-mining industry].

    PubMed

    Skowronek, Rafał; Chowaniec, Czesław

    2009-01-01

    The underground hard coal-mining sector demonstrates one of the highest rates of fatal accidents, in spite of a decline in coal-mining over the last few years. Post-accidental investigations, including forensic medical expertise, continue to present a significant problem. The objective of the research was to evaluate the role, tasks and usefulness of medico-legal determinations in post-accidental procedures in traumatic deaths in hard coal-mining industry. The study was carried out retrospectively by investigating files and autopsy reports, with attention focusing on the scope of necessary activities and medico-legal examinations in order to determine the cause and manner of death, and on identification of fatalities, especially in the cases of collective occupational accidents. Complex medico-legal determinations (identification, autopsy), supplemented by additional investigations (toxicology, histopathology and hemogenetics) provide a valuable source of evidence for legal authorities and post-accidental commissions. Mutual cooperation of the experts representing various branches of science is the basis of executing appropriate procedures after a traumatic death in the coal mine.

  20. Evaluation of postmortem bacterial migration using culturing and real-time quantitative PCR.

    PubMed

    Tuomisto, Sari; Karhunen, Pekka J; Vuento, Risto; Aittoniemi, Janne; Pessi, Tanja

    2013-07-01

    Postmortem bacteriology can be a valuable tool for evaluating deaths due to bacterial infection or for researching the involvement of bacteria in various diseases. In this study, time-dependent postmortem bacterial migration into liver, mesenteric lymph node, pericardial fluid, portal, and peripheral vein was analyzed in 33 autopsy cases by bacterial culturing and real-time quantitative polymerase chain reaction (RT-qPCR). None suffered or died from bacterial infection. According to culturing, pericardial fluid and liver were the most sterile samples up to 5 days postmortem. In these samples, multigrowth and staphylococci were not or rarely detected. RT-qPCR was more sensitive and showed higher bacterial positivity in all samples. Relative amounts of intestinal bacterial DNA (bifidobacteria, bacteroides, enterobacter, clostridia) increased with time. Sterility of blood samples was low during the studied time periods (1-7 days). The best postmortem microbiological sampling sites were pericardial fluid and liver up to 5 days after death.

  1. Postmortem and Perimortem Cesarean Section: Historical, Religious and Ethical Considerations

    PubMed Central

    Fadel, Hossam E.

    2012-01-01

    Guillimeau was the first to use the term cesarean section (CS) in 1598, but this name became universal only in the 20th century. The many theories of the origin of this name will be discussed. This surgery has been reported to be performed in all cultures dating to ancient times. In the past, it was mainly done to deliver a live baby from a dead mother, hence the name postmortem CS (PMCS). Many heroes are reported to have been delivered this way. Old Jewish sacred books have made references to abdominal delivery. It was especially encouraged and often mandated in Catholicism. There is evidence that the operation was done in Muslim countries in the middle ages. Islamic rulings support the performance of PMCS. Now that most maternal deaths occur in the hospital, perimortem CS (PRMCS) is recommended for the delivery of a fetus after 24 weeks from a pregnant woman with cardiac arrest. It is believed that emergent delivery within four minutes of initiation of cardiopulmonary resuscitation (CPR) improves the chances of success of maternal resuscitation and survival and increases the chance of delivering a neurologically intact neonate. It is agreed that physicians are not to be held legally liable for the performance of PMCS and PRMCS regardless of the outcome. The ethical aspects of these operations are also discussed including a discussion about PMCS for the delivery of women who have been declared brain dead. PMID:23610509

  2. External artery heat pipe

    NASA Technical Reports Server (NTRS)

    Gernert, Nelson J. (Inventor); Ernst, Donald M. (Inventor); Shaubach, Robert M. (Inventor)

    1989-01-01

    An improved heat pipe with an external artery. The longitudinal slot in the heat pipe wall which interconnects the heat pipe vapor space with the external artery is completely filled with sintered wick material and the wall of the external artery is also covered with sintered wick material. This added wick structure assures that the external artery will continue to feed liquid to the heat pipe evaporator even if a vapor bubble forms within and would otherwise block the liquid transport function of the external artery.

  3. Postmortem Concentrations of Tramadol and O-Desmethyltramadol in 11 Aviation Accident Fatalities

    DTIC Science & Technology

    2010-12-01

    Crump University of Central Oklahoma Edmond, OK 73034 December 2010 Final Report Postmortem Concentrations of Tramadol and O-Desmethyltramadol in...Subtitle 5. Report Date Postmortem Concentrations of Tramadol and O-Desmethyltramadol in 11 Aviation Accident Fatalities December 2010 6. Performing...This work was accomplished under the approved task AM-B-10-TOX-204. 16. Abstract Tramadol is a centrally acting analgesic used to treat moderate

  4. Running a postmortem service--a business case and clinical experience.

    PubMed

    Cohen, Marta C; Whitby, Elspeth; Fink, Michelle A; Collett, Jacquelene M; Offiah, Amaka C

    2015-04-01

    The purpose of the postmortem examination is to offer answers to explain the cause and manner of death. In the case of perinatal, infant and paediatric postmortem examinations, the goal is to identify unsuspected associated features, to describe pathogenic mechanisms and new conditions, and to evaluate the clinical management and diagnosis. Additionally, the postmortem examination is useful to counsel families regarding the probability of recurrence in future pregnancies and to inform family planning. Worldwide the rate of paediatric autopsy examinations has significantly declined during the last few decades. Religious objections to postmortem dissection and organ retention scandals in the United Kingdom provided some of the impetus for a search for non-invasive alternatives to the traditional autopsy; however, until recently, imaging studies remained an adjunct to, rather than a replacement for, the traditional autopsy. In 2012, Sheffield Children's Hospital National Health Service Foundation Trust set up the service provision of minimally invasive fetal, perinatal and neonatal autopsy, while a postmortem imaging service has been running in Melbourne, Australia, since 2008. Here we summarise the essentials of a business case and practical British and Australian experiences in terms of the pathological and radiologic aspects of setting up a minimally invasive clinical service in the United Kingdom and of developing a clinical postmortem imaging service as a complementary tool to the traditional autopsy in Australia.

  5. Rapid alteration of protein phosphorylation during postmortem: implication in the study of protein phosphorylation

    PubMed Central

    Wang, Yifan; Zhang, Yanchong; Hu, Wen; Xie, Shutao; Gong, Cheng-Xin; Iqbal, Khalid; Liu, Fei

    2015-01-01

    Protein phosphorylation is an important post-translational modification of proteins. Postmortem tissues are widely being utilized in the biomedical studies, but the effects of postmortem on protein phosphorylation have not been received enough attention. In the present study, we found here that most proteins in mouse brain, heart, liver, and kidney were rapidly dephosphorylated to various degrees during 20 sec to 10 min postmortem. Phosphorylation of tau at Thr212 and glycogen synthase kinase 3β (GSK-3β) at Ser9 was reduced by 50% in the brain with 40 sec postmortem, a regular time for tissue processing. During postmortem, phosphorylation of cAMP-dependent protein kinase (PKA) and AMP activated kinase (AMPK) was increased in the brain, but not in other organs. Perfusion of the brain with cold or room temperature phosphate-buffered saline (PBS) also caused significant alteration of protein phosphorylation. Cooling down and maintaining mouse brains in the ice-cold buffer prevented the alteration effectively. This study suggests that phosphorylation of proteins is rapidly changed during postmortem. Thus, immediate processing of tissues followed by cooling down in ice-cold buffer is vitally important and perfusion has to be avoided when protein phosphorylation is to be studied. PMID:26511732

  6. Remaking the medico-legal scene: a social history of the late-Victorian coroner in Oxford.

    PubMed

    Hurren, Elizabeth T

    2010-04-01

    There have been wide-ranging debates about medicine and the law encapsulated in the figure of the coroner in Victorian England. Recently the historical literature on coroners has been enriched by macro-studies. Despite this important research, the social lives of coroners and their daily interactions remain relatively neglected in standard historical accounts. This article redresses that issue by examining the working life of the coroner for Oxford during the late-Victorian era. Edward Law Hussey kept very detailed records of his time in office as coroner. New research material makes it feasible to trace his professional background, from doctor of the sick poor, to hospital house surgeon and then busy coroner. His career trajectory, personal interactions, and professional disputes, provide an important historical prism illuminating contemporary debates that occupied coroners in their working lives. Hussey tried to improve his medico-legal reach and the public image of his coroner's office by reducing infanticide rates, converting a public mortuary, and acquiring a proper coroner's court. His campaigns had limited success because the social scene in which he worked was complicated by the dominance of health and welfare agencies that resented his role as an expanding arm of the Victorian information state.

  7. An Appraisal of Decomposition Cases Received at the Johannesburg Forensic Pathology Service Medico-legal Mortuary During 2010-2011.

    PubMed

    Keyes, Craig A; Hill, Lawrence; Gordon, Guinevere M

    2016-03-01

    Decomposed bodies pose many questions for researchers regarding environmental effects, cause of death, and patterns. This study aimed to observe the factors associated with decomposed bodies autopsied at the Johannesburg Forensic Pathology Service Medico-legal Mortuary. A total of 4876 autopsies were conducted from 2010 to 2011, of which 109 were decomposed. Black individuals made up the largest proportion (67%) followed by White (26%). Males comprised 86.2%, while 12.8% were female. The mean age was 42.78 years. Most cases were in the early stages of decomposition (49.5%), with 32.1% bloated, 11.9% in active decay, 2.8% in advanced decay, and 3.7% were skeletal. Insect activity was identified in 25.7% of decomposition cases. Cause of death was determined in 48.6% of cases. Of all the cases, 64% were found indoors and 23% outdoors, while 23% had insufficient information regarding the location. Of considerable interest was the number of cases from hospitals and clinics.

  8. Medicolegal aspects of complex behaviours arising from the sleep period: a review and guide for the practising sleep physician.

    PubMed

    Morrison, Ian; Rumbold, John M M; Riha, Renata L

    2014-06-01

    This review is aimed at summarizing the current state of knowledge regarding parasomnias, which have been implicated in medicolegal cases as well as providing guidance to those working within common-law jurisdictions regarding the technical aspects of the law. Sleepwalking and sexsomnia as a defence are being raised more frequently in criminal cases and there has been public debate on their validity. Unfortunately, expert evidence on forensic sleep disorders continues to be heavily opinion-based with the potential for miscarriages of justice seen in recent highly publicized cases. There is an apparent inertia in research into violent sleep disorders. We review the current state of forensic sleep science in the United Kingdom (UK) and abroad and discuss the need to formulate guidelines based on available evidence. We also highlight the pressing necessity for more research in this area as well as the need to reform the law, which is the subject of a recent Criminal Law Commission report in the United Kingdom. In time, this will facilitate the efficient, proportionate, and just disposal of violence arising from sleep, thus benefitting both society and the individual sufferer.

  9. European Council of Legal Medicine (ECLM) principles for on-site forensic and medico-legal scene and corpse investigation.

    PubMed

    Cusack, D; Ferrara, S D; Keller, E; Ludes, B; Mangin, P; Väli, M; Vieira, N

    2016-10-28

    Forensic medical practitioners need to define the general principles governing procedures to be used for the on-site examination of a body where the death has occurred in unnatural, violent or suspicious circumstances. These principles should be followed whenever a medical expert is required to perform an on-site corpse inspection and should be utilised as a set of general guidelines to be adapted to the specific situation in hand and interpreted using common sense and scientific knowledge of the relevant procedures and facts of the case. The aim of these principles is to ensure that forensic evidence at the scene of a death is properly observed and assessed and all necessary relevant evidence gathered in order to ensure that a comprehensive report is available to the judicial authority (investigating judge or coroner) in the justice system. The on-site corpse inspection by a forensic practitioner is a mandatory and essential stage of the forensic and medico-legal autopsy, as it may provide important information for subsequent investigation stages.

  10. [Pharmacological, toxicological, deontologic, and medico-legal aspects of the use of appetite suppressant agents in "weight-loss cures"].

    PubMed

    Carolei, L; Ermio, G; Accorinti, N; Meo, G; Lamberti, V; De Sarro, G

    1997-01-01

    The pharmacological, deontologic and medico-legal aspects in the use of appetite suppressant drugs have been evaluated. Appetite suppressant drugs used in the treatment of obesity are divided into 2 broad pharmacological categories: those acting via brain catecholamine pathways and those acting via serotonin pathways. Of the former group, amphetamines and phenimetrazines are no longer used because of their stimulant properties and addictive potential. The remaining drugs of this group have some sympathomimetic and stimulant properties. Anorectic drugs which promote serotonin neurotransmission have no such stimulant or sympathomimetic properties. They reduce appetite and food intake and are effective in the treatment of obesity. If they are not used appropriately, appetite suppressants can be of no therapeutic benefit and cause marked health risks. As regards to anorectic drugs, the 13/4/1995 act "Rules and limits in preparing drugs containing anorectic substances", precisely defines rules about selling and use of those substances. Behavior of health care personnel neglecting observance of the rule, could be interpreted as "imprudence", "negligence" and "inexpertness" in designing and managing a fat-reducing diet, that may imply, in case of damage to the patient, a professional fault.

  11. Relationship Between Self-Injurious Behaviors and Levels of Aggression in Children and Adolescents Who Were Subject to Medicolegal Examination.

    PubMed

    Ozsoy, Sait; Kara, Koray; Teke, Hacer Y; Turker, Turker; Congologlu, Mehmet A; Sezigen, Sermet; Renklidag, Tulay; Karapirli, Mustafa; Javan, Gulnaz T

    2016-03-01

    Aggression, which is defined as a behavior causing harm or pain, is a behavioral pattern typically expected in children and adolescents who are involved in criminal activities. The aim of this study was to examine the relationship between aggression and self-injurious behavior (SIB) in children and adolescents. The study was performed in 295 cases which were sent for medicolegal examination. The mean age of the subjects was 14.27 ± 1.05 years (age range 10-18 years). The aggression levels of the subjects were determined using the Aggression Questionnaire (AQ), which is an updated form of the Buss-Durkee Hostility Inventory. The mean total AQ score of the subjects with and without SIB was 78.04 ± 21.0 and 62.75 ± 18.05, respectively (p < 0.01). There were significant statistical differences between the two groups with respect to their subscale scores (p < 0.01). It was concluded that the levels of aggression increased in children and adolescents who were involved in criminal activities when the SIBs increased.

  12. Evidential value of postmortem MRI in forensic pathology

    NASA Astrophysics Data System (ADS)

    Schweitzer, Wolf; Schaepman, Michael E.; Ith, Michael; Bruegger, Karin; Thali, Michael J.; Doernhofer, Tanya; Tiefenthaler, Kathrin; Scheurer, Eva; Vock, Peter; Boesch, Chris; Dirnhofer, Richard

    2001-05-01

    We currently evaluate MRI as add-on to dissection. Cases can only build on high evidential values of morphological findings as estimated using Bayesian likelihood-ratios. These values may vary among different cases depending on the quality of the morphology and the discrete hypotheses to be discerned. After scanning 20 bodies using MRI admitted to our institute for autopsy, we reconstructed selected imaging findings from a couple of illustrative cases according to a geometrical model ('Pink Box') designed as an object oriented bridging protocol to enable comparison of autopsy and MRI data. Although it appears obvious that 'three-dimensional imaging yields relevant diagnoses,' comparison of selected findings suggests, that the real evidential value of a postmortem scan depends on basic geometrical features of tissue structures examined. (1) Tissue surfaces are difficult to examine in MRI, including surface features of contact wounds in firearm injuries, lacerations of the pleura, or skin needle marks. (2) Specificity and sensitivity of solid tissue block data depend on contrast and resolution. (3) Tunnels or tubes, such as coronary arteries, linear wound tracks or the aorta offer more degrees of freedom for reconstruction, including spatial reconstruction or cross sectioning in different directions. (4) Three-dimensional rendering of complex objects results in spectacular images. Their evidential value is dependent on the way thresholding of 2D slices is validated. We present illustrative examples which suggest that a possible integration of non-invasive imaging methods into Forensic Pathology in fact need to take basic geometry into consideration when discussing evidential value.

  13. Dystrophic Serotonin Axons in Postmortem Brains from Young Autism Patients

    PubMed Central

    Azmitia, Efrain C.; Singh, Jorawer S.; Hou, Xiao P.; Wiegel, Jerzy

    2014-01-01

    Autism causes neuropathological changes in varied anatomical loci. A coherent neural mechanism to explain the spectrum of autistic symptomatology has not been proposed because most anatomical researchers focus on point-to-point functional neural systems (e.g. auditory, social networks) rather than considering global chemical neural systems. Serotonergic neurons have a global innervation pattern. Their cell bodies are found in the midbrain but they project their axons throughout the neural axis beginning in the fetal brain. This global system is implicated in autism by animal models and by biochemical, imaging, pharmacological, and genetics studies. However, no anatomical studies of the 5-HT innervation of autistic donors have been reported. Our review presents immunocytochemical evidence of an increase in 5-HT axons in post-mortem brain tissue from autism donors aged 2.8 to 29 years relative to controls. This increase is observed in the principle ascending fiber bundles of the medial and lateral forebrain bundles, and in the innervation density of the amygdala and the piriform, superior temporal, and parahippocampal cortices. In autistic donors eight years of age and up, several types of dystrophic 5-HT axons were seen in the termination fields. One class of these dystrophic axons, the thick heavily stained axons, was not seen in the brains of patients with neurodegenerative diseases. These findings provide morphological evidence for the involvement of serotonin neurons in the early etiology of autism, and suggest a diet therapy may be effective to blunt serotonin’s trophic actions during early brain development in children. PMID:21901837

  14. Breast tissue decomposition with spectral distortion correction: A postmortem study

    PubMed Central

    Ding, Huanjun; Zhao, Bo; Baturin, Pavlo; Behroozi, Farnaz; Molloi, Sabee

    2014-01-01

    Purpose: To investigate the feasibility of an accurate measurement of water, lipid, and protein composition of breast tissue using a photon-counting spectral computed tomography (CT) with spectral distortion corrections. Methods: Thirty-eight postmortem breasts were imaged with a cadmium-zinc-telluride-based photon-counting spectral CT system at 100 kV. The energy-resolving capability of the photon-counting detector was used to separate photons into low and high energy bins with a splitting energy of 42 keV. The estimated mean glandular dose for each breast ranged from 1.8 to 2.2 mGy. Two spectral distortion correction techniques were implemented, respectively, on the raw images to correct the nonlinear detector response due to pulse pileup and charge-sharing artifacts. Dual energy decomposition was then used to characterize each breast in terms of water, lipid, and protein content. In the meantime, the breasts were chemically decomposed into their respective water, lipid, and protein components to provide a gold standard for comparison with dual energy decomposition results. Results: The accuracy of the tissue compositional measurement with spectral CT was determined by comparing to the reference standard from chemical analysis. The averaged root-mean-square error in percentage composition was reduced from 15.5% to 2.8% after spectral distortion corrections. Conclusions: The results indicate that spectral CT can be used to quantify the water, lipid, and protein content in breast tissue. The accuracy of the compositional analysis depends on the applied spectral distortion correction technique. PMID:25281953

  15. External radiation surveillance

    SciTech Connect

    Antonio, E.J.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site.

  16. Post-mortem urinary myoglobin levels with reference to the causes of death.

    PubMed

    Zhu, B L; Ishida, K; Quan, L; Taniguchi, M; Oritani, S; Kamikodai, Y; Fujita, M Q; Maeda, H

    2001-01-15

    To evaluate pathophysiological significance of post-mortem urinary myoglobin levels in determining the cause of death, we investigated 210 forensic autopsy cases, partially in comparison with serum levels. Post-mortem serum myoglobin levels were extraordinary high in most cases possibly due to post-mortem change. Urinary myoglobin levels did not correlate with the serum levels, showing possible post-mortem elevation in cases of a prolonged post-mortem period over 48h. A high (>1000 ng/ml), moderate (100-1000 ng/ml), slight (50-100 ng/ml) and not significant (<50 ng/ml) elevation of urinary myoglobin were observed in 26, 43, 31 and 110 cases, respectively. Half the highly elevated cases were those with a survival time over 24h. In cases of minor muscle injury such as head trauma, elevation of urinary myoglobin level was closely related to longer survival. In acute/subacute deaths with a post-mortem interval within 48h, a significant difference was observed in relation to the blood carboxyhemoglobin (COHb) levels of fire victims: myoglobinuria over 100 ng/ml was more frequently and markedly observed in cases with COHb below 60% than over 60%, suggesting muscle damage in fatal burns. Similar elevation was observed in heat stroke victims, and also in some cases of acute and subacute death from polytrauma, asphyxiation, drowning, electricity and spontaneous cerebral bleeding, but not in myocardial infarction. Thus, it was suggested that high post-mortem urinary myoglobin levels in acute and subacute death cases may be a possible indicator of antemortem massive skeletal muscle damage as well as exertional muscle hyperactivity or convulsive disorders associated with hypoxia.

  17. Postmortem ventilation in cases of penetrating gunshot and stab wounds to the chest.

    PubMed

    Germerott, Tanja; Preiss, Ulrich S; Ross, Steffen G; Thali, Michael J; Flach, Patricia M

    2013-11-01

    We sought to determine the effect of postmortem ventilation in combination with a suction pump in cases showing penetrating trauma to the chest with haemo- and/or pneumothorax, for better evaluation of the lungs in postmortem computed tomography (PMCT). The study included 6 subjects (1 female, 5 male; age 32-67years) with a penetrating gunshot or stab wound to the chest and consecutive pneumo- and/or haemothorax. The pneumo- and haemothorax were evacuated by a suction pump, and postmortem ventilation was applied using a home care ventilator. PMCT images with and without postmortem ventilation were compared, as well as the autopsy results. In three cases haemo- and pneumothorax was clearly reduced. Postmortem ventilation led to distinct re-expansion of the lungs in two cases, and to re-expansion of single lung lobes in two cases with shotgun injuries. No visible effect was seen in the remaining two cases, because of extensive destruction of lung tissue and blood aspiration. In two cases the injuries sustained in the individual lung lobes were successfully located during postmortem ventilation. The bullet channel was apparent in one case; in another case, injury of the pericardium became visible by generating pneumopericardium. The present method is capable of improving evaluation of the postmortem lung in the presence of single stab or gunshot wounds and if there is no severe destruction of the respiratory system and aspiration. Forensic autopsy should still be considered as the gold standard, although in some cases the present method might be helpful, especially where no autopsy is required.

  18. External approach to rhinoplasty.

    PubMed

    Goodman, Wilfred S; Charbonneau, Paul A

    2015-07-01

    The technique of external rhinoplasty is outlined. Having reviewed 74 cases, its advantages and disadvantages are discussed. Reluctance to use this external approach seems to be based on emotional rather than radical grounds, for its seems to be the procedure of choice for many problems.

  19. Mechanism of production of troponin T fragments during postmortem aging of porcine muscle.

    PubMed

    Kitamura, Shin-ichi; Muroya, Susumu; Tanabe, Soichi; Okumura, Tomoyuki; Chikuni, Koichi; Nishimura, Toshihide

    2005-05-18

    Troponin T (TnT) is one of the myofibrillar proteins that is easily degraded during postmortem aging of pork. In this study, we determined the N-terminal amino acid sequences of TnT degradation fragments produced during postmortem aging and by m-calpain hydrolysis. The N-terminal amino acid sequences of TnT fragments produced during postmortem aging were EVHEPEEKPRPKLTAP, EKPRPKLTAPKIPEG, and APKIPEGEKVDF. On the other hand, the N-terminal amino acid sequences of TnT fragments produced by the action of m-calpain were APPPPAEV, EVHEPEEK, and APK. These sequences of degradation fragments could be mapped on fast type TnT isoform 2. The peptide bonds of His37-Glu38 and Thr51-Ala52 in fTnT2 were cleaved during postmortem aging as well as by the calpain hydrolysis; therefore, calpain was concluded to have an important role in TnT degradation during postmortem aging. It was also found that the sourness-suppressing peptide APPPPAEVHEVHEEVH (Okumura et al. Biosci. Biotechnol. Biochem. 2004, 68, 1657-1662) derived from TnT degradation could be produced by the action of calpains on Glu21-Ala22 and His37-Glu38 sites.

  20. Influence of porcine circovirus type 2 vaccination on the probability and severity of pneumonia detected postmortem

    PubMed Central

    Raith, J.; Kuchling, S.; Schleicher, C.; Schobesberger, H.; Köfer, J.

    2015-01-01

    To evaluate the influence of porcine circovirus type 2 vaccination (PCV-2) on the probability and severity of pneumonia, postmortem findings of 247,505 pigs slaughtered between 2008 and 2011 were analysed by applying a cumulative link mixed model. Three major effects could be observed: (1) PCV-2 vaccination significantly (P<0.01) reduced the odds (coefficient: −0.05) of postmortem findings of mild, moderate and severe pneumonia for vaccinated pigs. (2) Pigs from fattening farms were less likely (coefficient: −0.44; P<0.05) to exhibit signs of pneumonia at slaughter than pigs from farrow-to-finish farms. (3) When vaccinated, the odds of detecting postmortem signs showed an even more pronounced reduction (coefficient: −0.19; P<0.001) for pigs from fattening farms. Combining PCV-2 vaccination, farm type and interaction effects between these two factors, a pig vaccinated against PCV-2 from a fattening farm had only half the chance (OR 0.51) of pneumonia being detected at postmortem than a non-vaccinated pig from a farrow-to-finish farm. The study demonstrates the benefit of a vaccination programme against PCV-2 as an important tool to reduce the risk of postmortem pneumonia findings and the severity of pneumonia in pigs at slaughter. PMID:25413158

  1. Pig-mentation: postmortem iris color change in the eyes of Sus scrofa.

    PubMed

    Abraham, Elizabeth; Cox, Margaret; Quincey, David

    2008-05-01

    Experienced forensic pathologists and examiners may be familiar with the phenomenon of postmortem iris color change; however, only Knight, Simpson's forensic medicine, Arnold, London, 1997; Ref. 1 and Saukko and Knight, Knight's forensic pathology, 3rd ed., Arnold, London, 2004; Ref. 2 have referred to it in the literature, and to date, there have been no published scientific research studies on this taphonomic artifact. A controlled experiment was conducted of postmortem changes to isolated Sus scrofa eyes. The eyes (n = 137) were separated into three groups and each sample was observed for 3-day postmortem at a different temperature. In addition, a Sus scrofa head was obtained to observe postmortem changes of eyes in situ. All isolated blue eyes in the experiment, at room temperature and higher, changed to brown/black within 48 h. The in situ blue eye, at room temperature, turned brown/black within 72 h. If iris color consistently changes postmortem in humans, then this taphonomic artifact must be incorporated into victim identification protocol, including disaster victim identification software, and autopsy reports to prevent inaccurate victim identification and inappropriate exclusion from the identification process.

  2. Clinical profile of medicolegal cases presenting to the eye casualty in a tertiary care center in India

    PubMed Central

    Tripathy, Koushik; Chawla, Rohan; Venkatesh, Pradeep; Vohra, Rajpal; Sharma, Yog Raj

    2016-01-01

    Purpose: The purpose of this study was to analyze the clinical profile of medicolegal cases (MLCs) presenting to the eye casualty in a tertiary care hospital. Materials and Methods: Retrospective review of records. The cases were grouped according to the Ocular Trauma Classification Group classification system. Results: Out of 188 MLCs, 164 (87.2%) were male. Mean age (±standard deviation) was 31.6 (±12.7) years. Age ranged from 7 to 75 years. Twenty-six (13.8%) patients had bilateral involvement. The fist was the most common mode of injury, which was seen in 109 (58%) cases. A total of 27 (14.3%) patients had associated extraocular injury. No evidence of ocular or orbital trauma (malingering) could be found in 13 (7%) patients. Mechanical trauma was present in 169 (90%) patients with injury to globe in 129 (69%) patients and injury to lid or orbit without damage to the globe in 40 (21%) patients. Chemical injury was observed in 6 (3%) patients. Closed globe injury (CGI) was seen in 116 eyes and open globe injury (OGI) was noted in 29 eyes. The most common type of injury, zone, pupil, and grade of injury in CGI were Type A or contusion (79%), Zone I (72%), Pupil B (absence of relative afferent pupillary defect) in 95%, and Grade A [visual acuity (VA) ≥20/40] in 68% of the eyes, respectively. The most common type of injury, zone, pupil, and grade of injury in OGI were Type B or penetrating (48%), Zone II (38%), Pupil B (59%), and Grade D (VA 4/200-light perception) (42%), respectively. Conclusions: The most common form and mode of ocular injury in MLC were closed globe injury and fist, respectively. The most common type of injury in CGI and OGI was contusion and penetrating injury, respectively. PMID:27488149

  3. Comparison of injuries due to lethal weapons during and after civil strife in Sri Lanka: A medico-legal study

    PubMed Central

    Vidanapathirana, Muditha; Ruwanpura, Rohan P; Amararatne, Sriyantha RRG; Ratnaweera, Ajith RHI

    2016-01-01

    Background and Aims: “Injuries due to lethal weapons” has emerged as a subject of public discussion in Sri Lanka. This study was conducted to describe the nature and characteristics of injuries due to lethal weapons during civil strife and to compare those with injuries after civil strife. Methods: A cross-sectional study was conducted on patients reported with injuries caused by lethal weapons from 2004 to 2014. Periods before and after May 19, 2009 were considered as during and after civil strife periods, respectively. A total of 21,210 medico-legal examination forms were studied. Results: There were 358 (1.7%) injuries caused by lethal weapons. Of them, 41% (n = 148) were during and 59% (n = 210) were after the civil strife. During civil strife, 63% occurred during daytime (P < 0.05). Types of lethal weapons that caused injuries were sharp weapons (n = 282), explosives (n = 49), and firearms (n = 27). Of them, 32% of during and 01% of after civil strife were explosive injuries (P < 0.01). Regarding severity, 73% of during and 57% of after civil strife injuries were severe (P < 0.05). During civil strife, 34% injuries were in lower limbs (P < 0.01) and after civil strife, 37% were in upper limbs (P < 0.05). Conclusions: The presence of many similarities indicated that both groups learnt their basis in a society that breeds violence. During civil strife, more injuries occurred during daytime, to lower limbs by explosive weapons and after the civil strife during nighttime, to upper limbs by nonexplosive weapons. Nonexplosive lethal weapon use after civil strife needs further investigation to develop evidence-based interventions. PMID:27127743

  4. Interpersonal violence in road rage. Cases from the Medico-Legal Center for Victims of Violence in Hamburg.

    PubMed

    Pfeiffer, Joost-Levin; Pueschel, Klaus; Seifert, Dragana

    2016-04-01

    Aggressive behavior in traffic is a widespread phenomenon. Up to 90% of the population are involved in mild forms such as shouting or gesturing. More dramatic cases with injury to individuals affect at least 1100 people in the US annually. Certain factors such as a male sex, a young age and an urban residency have been identified to contribute to the likelihood of road rage. Central to this analysis is the determination of specific features regarding the conflicting parties, the crime scene and the injury pattern in violent offenses related to traffic. In a retrospective study spanning 10 years, cases of road rage-linked injuries were identified amongst patients at the Medico-Legal Center of the Institute of Legal Medicine in Hamburg, Germany. The data were digitized and then analyzed using descriptive statistics via SPSS. There are disproportionately large numbers of males (85.7%) and motorists (61.2%) amongst road rage perpetrators. Usually the conflicting parties have no prior relationship (89.7%). In 68.1% of the cases, the violence applied was exclusively physical. Objects were utilized in 31.0% of all cases, and in more than half (55.6%) of these cases the vehicle was used as a weapon. The resulting trauma in road rage is mostly blunt and applied to the face and the extremities. There are characteristic features regarding the demographics, time and place of incident, as well as severity and pattern of injury in road rage associated offenses. Identifying these factors may lead to appropriate measures in the reduction of road rage.

  5. Postmortem bone marrow analysis in forensic science: study of 73 cases and review of the literature.

    PubMed

    Tattoli, Lucia; Tsokos, Michael; Sautter, Julia; Anagnostopoulos, Joannis; Maselli, Eloisa; Ingravallo, Giuseppe; Delia, Mario; Solarino, Biagio

    2014-01-01

    In forensic sciences, bone marrow (BM) is an alternative matrix in postmortem toxicology because of its good resistance to autolysis and contaminations. Nevertheless, few studies have been focused on postmortem BM morphological changes after pathological stimuli. We examined 73 BM samples from forensic autopsies; causes of death were both natural and traumatic. BM samples were collected from the sternum by needle aspiration and biopsy; in selected cases, immunohistochemistry was performed. Few autolytic changes were found; BM cellularity decreased with increasing age and postmortem interval. Notable cell changes were detected in 45 cases (61.64%): neoplastic (n=4), and non-neoplastic BM findings (n=41), including multiorgan failure/sepsis (n=26), myelodisplastic-like conditions (n=11), and anaphylactic reactions (n=4). The results showed that BM cellularity supported circumstantial and autopsy findings, suggesting that BM samples could be a useful tool in forensic science applications.

  6. [Post-mortem animal predation of the genital region caused by a half-breed dog].

    PubMed

    Buschmann, Claas T; Wrobel, Detlev; Tsokos, Michael

    2008-01-01

    The authors describe and discuss the case of a 51-year-old man, who was lying mummified in his apartment. Beside the corpse, the well-fed half-breed dog of the deceased was found. Only the penis and testicles of the corpse were destroyed by post-mortem animal scavenging, whereas the face and the rest of the body were intact. There was plenty of dog food in the apartment. In contrast to wild animals, with domestic dogs hunger is the cause for post-mortem scavenging only in the minority of cases. It is rather a displacement activity. Frequently, the face and hands are destroyed by post-mortem animal predation, as these body regions are usually unclothed and thus easily accessible. Lesions in other localizations are seldom seen and injuries in the genital region are a rarity.

  7. Imaging in forensic radiology: an illustrated guide for postmortem computed tomography technique and protocols.

    PubMed

    Flach, Patricia M; Gascho, Dominic; Schweitzer, Wolf; Ruder, Thomas D; Berger, Nicole; Ross, Steffen G; Thali, Michael J; Ampanozi, Garyfalia

    2014-12-01

    Forensic radiology is a new subspecialty that has arisen worldwide in the field of forensic medicine. Postmortem computed tomography (PMCT) and, to a lesser extent, PMCT angiography (PMCTA), are established imaging methods that have replaced dated conventional X-ray images in morgues. However, these methods have not been standardized for postmortem imaging. Therefore, this article outlines the main approach for a recommended standard protocol for postmortem cross-sectional imaging that focuses on unenhanced PMCT and PMCTA. This review should facilitate the implementation of a high-quality protocol that enables standardized reporting in morgues, associated hospitals or private practices that perform forensic scans to provide the same quality that clinical scans provide in court.

  8. Usefulness and limitations of postmortem computed tomography in forensic analysis of gunshot injuries: Three case reports.

    PubMed

    Usui, Akihito; Kawasumi, Yusuke; Hosokai, Yoshiyuki; Kozakai, Masataka; Saito, Haruo; Funayama, Masato

    2016-01-01

    Gunshot injury has always been an important field of investigation in postmortem forensic radiology. The localization and retrieval of the bullet and of potentially important fragments are vital to these cases. Using postmortem multidetector-row computed tomography (MDCT) prior to forensic autopsy, we sought to illustrate the importance of this modality in the noninvasive characterization of gunshot wounds. We obtained and analyzed MDCT images in three cases of gunshot wounds (accidental close-range shotgun shooting, suicidal contact gunshot to the head and accidental long-range buckshot shooting). We discuss the value of postmortem MDCT findings in gunshot wound cases by comparing with forensic autopsy findings in Japan, a developing country with miserably low autopsy rate.

  9. Postmortem redistribution of the heroin metabolites morphine and morphine-3-glucuronide in rabbits over 24 h.

    PubMed

    Maskell, Peter D; Albeishy, Mohammed; De Paoli, Giorgia; Wilson, Nathan E; Seetohul, L Nitin

    2016-03-01

    The interpretation of postmortem drug levels is complicated by changes in drug blood levels in the postmortem period, a phenomena known as postmortem drug redistribution. We investigated the postmortem redistribution of the heroin metabolites morphine and morphine-3-glucuronide in a rabbit model. Heroin (1 mg/kg) was injected into anesthetised rabbit; after 1 h, an auricular vein blood sample was taken and the rabbit was euthanised. Following death rabbits were placed in a supine position at room temperature and divided into three groups namely (1) immediate autopsy, (2) autopsy after 30 minutes and (3) autopsy 24 h after death. Various samples which included femoral blood, cardiac blood, lung, liver, kidney, vitreous humour, subcutaneous and abdominal fat, liver, bone marrow and skeletal muscle were taken. The samples were analysed with a validated LC-MS/MS method. It was observed that within minutes there was a significant increase in free morphine postmortem femoral blood concentration compared to the antemortem sample (0.01 ± 0.01 to 0.05 ± 0.02 mg/L).Various other changes in free morphine and metabolite concentrations were observed during the course of the experiment in various tissues. Principal component analysis was used to investigate possible correlations between free morphine in the various samples. Some correlations were observed but gave poor predictions (>20 % error) when back calculating. The results suggest that rabbits are a good model for further studies of postmortem redistribution but that further study and understanding of the phenomena is required before accurate predictions of the blood concentration at the time of death are possible.

  10. Future of External Reporting

    ERIC Educational Resources Information Center

    Powers, Kristina

    2015-01-01

    This chapter builds on prior chapters and focuses on higher education trends on the horizon and the resulting impact on external reporting for institutional researchers. Three practical recommendations and examples for institutional researchers are also presented.

  11. [Reflection of estimating postmortem interval in forensic entomology and the Daubert standard].

    PubMed

    Xie, Dan; Peng, Yu-Long; Guo, Ya-Dong; Cai, Ji-Feng

    2013-08-01

    Estimating postmortem interval (PMI) is always the emphasis and difficulty in forensic practice. Forensic entomology plays a significant indispensable role. Recently, the theories and technologies of forensic entomology are increasingly rich. But many problems remain in the research and practice. With proposing the Daubert standard, the reliability and accuracy of estimation PMI by forensic entomology need more demands. This review summarizes the application of the Daubert standard in several aspects of ecology, quantitative genetics, population genetics, molecular biology, and microbiology in the practice of forensic entomology. It builds a bridge for basic research and forensic practice to provide higher accuracy for estimating postmortem interval by forensic entomology.

  12. Differentiation of ante-mortem and post-mortem fractures with MRI: a case report

    PubMed Central

    Ruder, T D; Germerott, T; Thali, M J; Hatch, G M

    2011-01-01

    We describe a case of a fatal speed flying accident in which the victim was electrocuted, burned and fell from a great height. Post-mortem imaging revealed acute appearing fractures on CT, without bone marrow oedema on MRI. Based on the known clinical imaging findings of bone marrow oedema in acute fractures, we concluded that the speed flyer died from electrocution rather than the fall and that the fractures occurred post-mortem. Radiological imaging augmented the reconstruction of the peri-mortem events. Further research is needed to assess whether bone marrow oedema in acute fractures is a reliable vital sign. PMID:21415297

  13. Conceptual modeling of postmortem evaluation findings to describe dairy cow deaths.

    PubMed

    McConnel, C S; Garry, F B; Hill, A E; Lombard, J E; Gould, D H

    2010-01-01

    Dairy cow mortality levels in the United States are excessive and increasing over time. To better define cause and effect and combat rising mortality, clearer definitions of the reasons that cows die need to be acquired through thorough necropsy-based postmortem evaluations. The current study focused on organizing information generated from postmortem evaluations into a monitoring system that is based on the fundamentals of conceptual modeling and that will potentially be translatable into on-farm relational databases. This observational study was conducted on 3 high-producing, commercial dairies in northern Colorado. Throughout the study period a thorough postmortem evaluation was performed by veterinarians on cows that died on each dairy. Postmortem data included necropsy findings, life-history features (e.g., birth date, lactation number, lactational and reproductive status), clinical history and treatments, and pertinent aspects of operational management that were subject to change and considered integral to the poor outcome. During this study, 174 postmortem evaluations were performed. Postmortem evaluation results were conceptually modeled to view each death within the context of the web of factors influencing the dairy and the cow. Categories were formulated describing mortality in terms of functional characteristics potentially amenable to easy performance evaluation, management oversight, and research. In total, 21 death categories with 7 category themes were created. Themes included specific disease processes with variable etiologies, failure of disease recognition or treatment, traumatic events, multifactorial failures linked to transition or negative energy balance issues, problems with feed management, miscellaneous events not amenable to prevention or treatment, and undetermined causes. Although postmortem evaluations provide the relevant information necessary for framing a cow's death, a restructuring of on-farm databases is needed to integrate this

  14. Postmortem sperm retrieval in context of developing countries of Indian subcontinent

    PubMed Central

    Sikary, Asit Kumar; Murty, O. P.; Bardale, Rajesh V.

    2016-01-01

    There was a request for postmortem sperm retrieval (PMSR) from the wife of a deceased, but we had to decline. We have no guideline in place for the procedure in such cases. When we explored the international scenario on the issue of PMSR, we found that most of the developed countries have their guidelines about it, whether to allow or not to. There is not guideline available in developing countries, as such, for the procedure and various medical, legal, and social issues related thereto. In this article, we have explored the status of postmortem retrieval and feasibility of the procedure in developing countries of Indian subcontinent. PMID:27382231

  15. Estimation of postmortem interval based on colony development time for Anoplolepsis longipes (Hymenoptera: Formicidae).

    PubMed

    Goff, M L; Win, B H

    1997-11-01

    The postmortem interval for a set of human remains discovered inside a metal tool box was estimated using the development time required for a stratiomyid fly (Diptera: Stratiomyidae), Hermetia illucens, in combination with the time required to establish a colony of the ant Anoplolepsis longipes (Hymenoptera: Formicidae) capable of producing alate (winged) reproductives. This analysis resulted in a postmortem interval estimate of 14 + months, with a period of 14-18 months being the most probable time interval. The victim had been missing for approximately 18 months.

  16. Investigation of Post-mortem Tissue Effects Using Long-time Decorrelation Ultrasound

    NASA Astrophysics Data System (ADS)

    Csány, Gergely; Balogh, Lajos; Gyöngy, Miklós

    Decorrelation ultrasound is being increasingly used to investigate long-term biological phenomena. In the current work, ultrasound image sequences of mice who did not survive anesthesia (in a separate investigation) were analyzed and post-mortem tissue effects were observed via decorrelation calculation. A method was developed to obtain a quantitative parameter characterizing the rate of decorrelation. The results show that ultrasound decorrelation imaging is an effective method of observing post-mortem tissue effects and point to further studies elucidating the mechanism behind these effects.

  17. Externally modulated theranostic nanoparticles.

    PubMed

    Urban, Cordula; Urban, Alexander S; Charron, Heather; Joshi, Amit

    2013-08-01

    Externally modulated nanoparticles comprise a rapidly advancing class of cancer nanotherapeutics, which combine the favorable tumor accumulation of nanoparticles, with external spatio-temporal control on therapy delivery via optical, magnetic, or ultrasound modalities. The local control on therapy enables higher tumor treatment efficacy, while simultaneously reducing off-target effects. The nanoparticle interactions with external fields have an additional advantage of frequently generating an imaging signal, and thus such agents provide theranostic (both diagnostic and therapeutic) capabilities. In this review, we classify the emerging externally modulated theranostic nanoparticles according to the mode of external control and describe the physiochemical mechanisms underlying the external control of therapy, and illustrate the major embodiments of nanoparticles in each class with proven biological efficacy: (I) electromagnetic radiation in visible and near-infrared range is being exploited for gold based and carbon nanostructures with tunable surface plasmon resonance (SPR) for imaging and photothermal therapy (PTT) of cancer, photochemistry based manipulations are employed for light sensitive liposomes and porphyrin based nanoparticles; (II) Magnetic field based manipulations are being developed for iron-oxide based nanostructures for magnetic resonance imaging (MRI) and magnetothermal therapy; (III) ultrasound based methods are primarily being employed to increase delivery of conventional drugs and nanotherapeutics to tumor sites.

  18. Externally modulated theranostic nanoparticles

    PubMed Central

    Urban, Cordula; Urban, Alexander S.; Charron, Heather; Joshi, Amit

    2013-01-01

    Externally modulated nanoparticles comprise a rapidly advancing class of cancer nanotherapeutics, which combine the favorable tumor accumulation of nanoparticles, with external spatio-temporal control on therapy delivery via optical, magnetic, or ultrasound modalities. The local control on therapy enables higher tumor treatment efficacy, while simultaneously reducing off-target effects. The nanoparticle interactions with external fields have an additional advantage of frequently generating an imaging signal, and thus such agents provide theranostic (both diagnostic and therapeutic) capabilities. In this review, we classify the emerging externally modulated theranostic nanoparticles according to the mode of external control and describe the physiochemical mechanisms underlying the external control of therapy, and illustrate the major embodiments of nanoparticles in each class with proven biological efficacy: (I) electromagnetic radiation in visible and near-infrared range is being exploited for gold based and carbon nanostructures with tunable surface plasmon resonance (SPR) for imaging and photothermal therapy (PTT) of cancer, photochemistry based manipulations are employed for light sensitive liposomes and porphyrin based nanoparticles; (II) Magnetic field based manipulations are being developed for iron-oxide based nanostructures for magnetic resonance imaging (MRI) and magnetothermal therapy; (III) ultrasound based methods are primarily being employed to increase delivery of conventional drugs and nanotherapeutics to tumor sites. PMID:24834381

  19. Freshwater drowning in a child: A case study demonstrating the role of post-mortem computed tomography.

    PubMed

    Filograna, Laura; Tartaglione, Tommaso; Vetrugno, Giuseppe; Guerra, Claudio; Fileni, Adriano; Bonomo, Lorenzo

    2015-10-01

    In recent years, modern imaging techniques have gained ground in forensics. A crucial question is whether virtual autopsy is capable of replacing traditional autopsy. Forensic diagnosis of freshwater drowning (FWD) is based on the evidence of findings from external inspection (e.g. frothy fluid exuding from the mouth and nostrils), internal examination (e.g. pulmonary congestion, enlargement of heart chambers) and biochemical analysis (haemodilution), findings which are non-specific. The detection of diatoms in organs of the systemic circulation may be of some assistance, but this analysis is rarely performed and is of debatable validity. An 18-month-old child was found dead at home in a swimming pool. Considering the family's wishes to avoid autopsy, the district attorney authorised a whole-body post-mortem computed tomography scan (PMCT). The main imaging findings were frothy fluid in the upper airways, fluid in the trachea and main bronchi, many pulmonary nodular ground glass opacities (GGO) in non-dependent regions and haemodilution. CT imaging did not show any other forensically relevant abnormality.A high concordance was found between the CT findings reported in the literature in cases of FWD and the imaging results. Thus, after the exclusion of other causes of death, advised by the forensic pathologist, the district attorney closed the case and the death was attributed to FWD. This case report demonstrates that PMCT imaging in cases of suspected FWD can provide some important findings for the diagnosis of FWD as the cause of death.

  20. Post-mortem prediction of primal and selected retail cut weights of New Zealand lamb from carcass and animal characteristics.

    PubMed

    Ngo, L; Ho, H; Hunter, P; Quinn, K; Thomson, A; Pearson, G

    2016-02-01

    Post-mortem measurements (cold weight, grade and external carcass linear dimensions) as well as live animal data (age, breed, sex) were used to predict ovine primal and retail cut weights for 792 lamb carcases. Significant levels of variance could be explained using these predictors. The predictive power of those measurements on primal and retail cut weights was studied by using the results from principal component analysis and the absolute value of the t-statistics of the linear regression model. High prediction accuracy for primal cut weight was achieved (adjusted R(2) up to 0.95), as well as moderate accuracy for key retail cut weight: tenderloins (adj-R(2)=0.60), loin (adj-R(2)=0.62), French rack (adj-R(2)=0.76) and rump (adj-R(2)=0.75). The carcass cold weight had the best predictive power, with the accuracy increasing by around 10% after including the next three most significant variables.

  1. Discovery of syn-/anti-cocaine-N-oxide diastereomers in unwashed postmortem hair via LC-MS-MS.

    PubMed

    Marsh, Christine M; Crawley, Lindsey R; Himes, Sarah K; Aranda, Roman; Miller, Mark L

    2014-01-01

    The discovery of two cocaine-N-oxide (CNO) diastereomers, syn- and anti-CNO, is reported for the first time. Prior to this study, only one structural form of CNO was known to exist and has not been analyzed in hair before. CNO is a metabolite of cocaine (COC) and may be considered as an additional biomarker of COC use, along with other known COC metabolites. The analysis of COC in hair for forensic applications is under scrutiny due to the possibility of external contamination. A qualitative liquid chromatography-tandem mass spectrometry method was developed, validated and applied to unwashed postmortem hair samples from drug users. The limit of detection in hair was 8 pg/mg (using 10 mg of unwashed hair) for each CNO diastereomer. The presence of both syn- and anti-forms of CNO was verified in vivo using hair samples collected from known COC-using individuals. Due to the low levels of CNO, it will not always be detectable in COC user hair. In the hair samples analyzed, syn-CNO was detected in more samples than anti-CNO. The stereoselective N-oxidation of COC which favors syn-CNO could have a diagnostic value for COC ingestion determination in hair analysis.

  2. Organ retention and communication of research use following medico-legal autopsy: a pilot survey of university forensic medicine departments in Japan.

    PubMed

    Tsujimura-Ito, Takako; Inoue, Yusuke; Yoshida, Ken-ichi

    2014-09-01

    This study investigated the circumstances and problems that departments of forensic medicine encounter with bereaved families regarding samples obtained from medico-legal autopsies. A questionnaire was posted to all 76 departments of forensic medicine performing medico-legal autopsies in Japan, and responses were received from 48 (63.2%). Of the respondents, 12.8% had approached and communicated with bereaved families about collecting samples from the deceased person during an autopsy and the storage of the samples. In addition, 23.4% of these had informed families that samples might be used in research. Eighteen departments had received enquiries and requests from families about the samples, with most requests concerning their return. The response to such requests varied according to the department. Few departments interacted with the bereaved families regarding the procedure for obtaining autopsy samples, and their methods for handling family concerns differed depending on the person within the department authorised to contact the family. Moreover, the procedures for engaging in such communication have long been unclear, and no legal or ethical consensus or agreement with the general public has been established. It is important for researchers to further discuss the correct way for forensic medicine departments to communicate with bereaved families.

  3. High-mobility group box-1 protein determination in postmortem samples.

    PubMed

    Palmiere, Cristian; Augsburger, Marc; Mangin, Patrice

    2014-06-01

    The aims of this study were to assess whether high-mobility group box-1 protein can be determined in biological fluids collected during autopsy and evaluate the diagnostic potential of high-mobility group box-1 protein in identifying sepsis-related deaths. High-mobility group box-1 protein was measured in serum collected during hospitalization as well as in undiluted and diluted postmortem serum and pericardial fluid collected during autopsy in a group of sepsis-related deaths and control cases with noninfectious causes of death. Inclusion criteria consisted of full biological sample availability and postmortem interval not exceeding 6h. The preliminary results indicate that high-mobility group box-1 protein levels markedly increase after death. Concentrations beyond the upper limit of the calibration curve were obtained in undiluted postmortem serum in septic and traumatic control cases. In pericardial fluid, concentrations beyond the upper limit of the calibration curve were found in all cases. These findings suggest that the diagnostic potential of high-mobility group box-1 protein in the postmortem setting is extremely limited due to molecule release into the bloodstream after death, rendering antemortem levels difficult or impossible to estimate even after sample dilution.

  4. Alterations in the sarcoplasmic protein fraction of beef muscle with postmortem aging and hydrodynamic pressure processing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Capillary electrophoresis (CE) and reversed-phase high performance liquid chromatography (RP-HPLC) analysis were utilized to detect differences in the sarcoplasmic protein profiles of beef strip loins subjected to aging and hydrodynamic pressure processing (HDP) treatments. At 48 h postmortem, stri...

  5. Sarcomere length dynamics of postmortem ovine Psoas major and Longissimus dorsi muscles.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Understanding relationships between biological mechanisms of postmortem events in muscle and meat quality is of enormous importance for the meat industry. Because sarcomere length has been previously related to tenderness issues in lambs, we decided to study two contrasting types of muscle with know...

  6. The Design and Development of a Post-Mortem Room Complex

    ERIC Educational Resources Information Center

    Osborne, A. D.

    1977-01-01

    The design of a post-mortem room complex to serve the needs of three separate organizations on the campus of the University of Bristol's Veterinary Field Station is described. Comments are made on disadvantages that have become apparent during eight years of use. (Author/LBH)

  7. 42 CFR 35.16 - Autopsies and other post-mortem operations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Autopsies and other post-mortem operations. 35.16 Section 35.16 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.16 Autopsies and other...

  8. 42 CFR 35.16 - Autopsies and other post-mortem operations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Autopsies and other post-mortem operations. 35.16 Section 35.16 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.16 Autopsies and other...

  9. 42 CFR 35.16 - Autopsies and other post-mortem operations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Autopsies and other post-mortem operations. 35.16 Section 35.16 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.16 Autopsies and other...

  10. Optoacoustic 3D visualization of changes in physiological properties of mouse tissues from live to postmortem

    NASA Astrophysics Data System (ADS)

    Su, Richard; Ermiliov, Sergey A.; Liopo, Anton V.; Oraevsky, Alexander A.

    2012-02-01

    Using the method of 3D optoacoustic tomography, we studied changes in tissues of the whole body of nude mice as the changes manifested themselves from live to postmortem. The studies provided the necessary baseline for optoacoustic imaging of necrotizing tissue, acute and chronic hypoxia, and reperfusion. They also establish a new optoacoustic model of early postmortem conditions of the whole mouse body. Animals were scanned in a 37°C water bath using a three-dimensional optoacoustic tomography system previously shown to provide high contrast maps of vasculature and organs based on changes in the optical absorbance. The scans were performed right before, 5 minutes after, 2 hours and 1 day after a lethal injection of KCl. The near-infrared laser wavelength of 765 nm was used to evaluate physiological features of postmortem changes. Our data showed that optoacoustic imaging is well suited for visualization of both live and postmortem tissues. The images revealed changes of optical properties in mouse organs and tissues. Specifically, we observed improvements in contrast of the vascular network and organs after the death of the animal. We associated these with reduced optical scattering, loss of motion artifacts, and blood coagulation.

  11. 9 CFR 355.41 - Antemortem and postmortem inspection for mules.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Antemortem and postmortem inspection for mules. 355.41 Section 355.41 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... AND VOLUNTARY INSPECTION AND CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER...

  12. 9 CFR 355.41 - Antemortem and postmortem inspection for mules.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Antemortem and postmortem inspection for mules. 355.41 Section 355.41 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... AND VOLUNTARY INSPECTION AND CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER...

  13. 9 CFR 355.41 - Antemortem and postmortem inspection for mules.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Antemortem and postmortem inspection for mules. 355.41 Section 355.41 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... AND VOLUNTARY INSPECTION AND CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER...

  14. Persistent Angiogenesis in the Autism Brain: An Immunocytochemical Study of Postmortem Cortex, Brainstem and Cerebellum

    ERIC Educational Resources Information Center

    Azmitia, E. C.; Saccomano, Z. T.; Alzoobaee, M. F.; Boldrini, M.; Whitaker-Azmitia, P. M.

    2016-01-01

    In the current work, we conducted an immunocytochemical search for markers of ongoing neurogenesis (e.g. nestin) in auditory cortex from postmortem sections of autism spectrum disorder (ASD) and age-matched control donors. We found nestin labeling in cells of the vascular system, indicating blood vessels plasticity. Evidence of angiogenesis was…

  15. Post-mortem pH decline in different ostrich muscles.

    PubMed

    Sales, J; Mellett, F D

    1996-01-01

    Post-mortem glycolysis, as described by muscle pH decline, was investigated in several ostrich muscles. While the gastrocnemius pars interna, femorotibialis medius, iliotibialis lateralis and iliofemoralis showed the normal descending pH decline pattern, the ambiens as well as the iliofibularis showed a very rapid pH decline until 2 hr post mortem whereafter pH increased.

  16. Unusual infant death: dog attack or postmortem mutilation after child abuse?

    PubMed

    Boglioli, L R; Taff, M L; Turkel, S J; Taylor, J V; Peterson, C D

    2000-12-01

    An unusual form of fatal child abuse is reported in which investigations by the police and the medical examiner were able to distinguish blunt force head trauma followed by postmortem dismemberment from a fatal dog attack. A discussion of the approaches used to ascertain the correct diagnosis is presented, as well as an overview of dog attacks on humans.

  17. 42 CFR 35.16 - Autopsies and other post-mortem operations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... performed on the body of a deceased patient only by direction of the officer in charge and only if consented... death involved. Restrictions or limitations imposed by the person consenting thereto on the extent of the autopsy or other post-mortem operation shall be observed. Documents embodying consent shall...

  18. 42 CFR 35.16 - Autopsies and other post-mortem operations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... performed on the body of a deceased patient only by direction of the officer in charge and only if consented... death involved. Restrictions or limitations imposed by the person consenting thereto on the extent of the autopsy or other post-mortem operation shall be observed. Documents embodying consent shall...

  19. An examination of the postmortem redistribution of fentanyl and interlaboratory variability.

    PubMed

    Krinsky, Clarissa S; Lathrop, Sarah L; Zumwalt, Ross

    2014-09-01

    Fentanyl is a synthetic opioid agonist used for pain control. Often administered as a transdermal patch, it is an interesting drug for study of postmortem redistribution. We hypothesized that fentanyl concentrations would increase over time after death, as measured in blood drawn on the day prior to autopsy and in blood drawn at the time of autopsy in ten cases where fentanyl patches were identified at the scene. Concentrations were compared, and heart blood to femoral blood ratios were calculated as markers of postmortem redistribution. Fentanyl concentrations measured in peripheral blood drawn the day of autopsy (peripheral blood 2 [PB2]) were higher than those drawn the day prior to autopsy (peripheral blood 1 [PB1]) with a mean ratio (PB2/PB1) of 1.80. The ratio of heart blood concentrations (HB) to femoral blood concentrations drawn at autopsy (PB2) had a mean ratio (HB/PB2) of 1.08. Some cases had blood from the same source analyzed at two different laboratories, and concentrations of fentanyl in those samples showed inter- and intralaboratory differences up to 25 ng/mL. Postmortem fentanyl concentrations may be affected by antemortem factors, postmortem redistribution, and laboratory variability. Forensic pathologists must use caution in interpreting fentanyl levels as part of death investigation.

  20. Metasurface external cavity laser

    SciTech Connect

    Xu, Luyao Curwen, Christopher A.; Williams, Benjamin S.; Hon, Philip W. C.; Itoh, Tatsuo; Chen, Qi-Sheng

    2015-11-30

    A vertical-external-cavity surface-emitting-laser is demonstrated in the terahertz range, which is based upon an amplifying metasurface reflector composed of a sub-wavelength array of antenna-coupled quantum-cascade sub-cavities. Lasing is possible when the metasurface reflector is placed into a low-loss external cavity such that the external cavity—not the sub-cavities—determines the beam properties. A near-Gaussian beam of 4.3° × 5.1° divergence is observed and an output power level >5 mW is achieved. The polarized response of the metasurface allows the use of a wire-grid polarizer as an output coupler that is continuously tunable.

  1. Postmortem redistribution of olanzapine following intramuscular administration of olanzapine pamoate in dogs.

    PubMed

    Johnson, Jason T; Everly, Amy G; Kpakima, Felicia E Frazier; Detke, Holland C

    2015-12-01

    The potential for postmortem redistribution of olanzapine was investigated in beagle dogs. Olanzapine pamoate monohydrate was administered once every 14 days by intramuscular injection for 3 months to fed male dogs (n=15) at a dose of 20 mg/kg olanzapine (equivalent to 46 mg/kg olanzapine pamoate monohydrate). Blood samples were collected after the fifth (Day 57) and sixth (Day 71) doses to determine olanzapine and N-oxide olanzapine concentrations. On Day 71 at 72 h postdose, dogs were euthanized and placed on their backs without additional manipulation and held for postmortem blood, urine, and tissue collection at room temperature for up to 168 h postdose (96 h after euthanasia). Concentrations of olanzapine and N-oxide olanzapine were determined by liquid chromatography-mass spectroscopy/mass spectroscopy (LC-MS/MS). Postmortem olanzapine concentrations in blood increased up to seven-fold compared to the last quantified antemortem blood concentration. Olanzapine concentrations in vein tissue samples (surrogates for peripheral blood) also increased, whereas other tissue concentrations, such as myocardium, lung, liver, and kidney decreased over the postmortem period. An increase in blood concentration of olanzapine after death was observed in all but one animal, suggesting that postmortem redistribution may occur in dogs following biweekly intramuscular administration of olanzapine pamoate monohydrate. The rise in olanzapine concentrations in blood after death in this study may potentially be attributed to diffusion from multiple tissues to blood and, to a lesser extent, reduction of the N-oxide olanzapine metabolite back to olanzapine. However, the generalizability of these results to humans cannot be confirmed by the present study.

  2. Meat quality of broiler breast meat following post-mortem electrical stimulation at the neck.

    PubMed

    Owens, C M; Sams, A R

    1998-09-01

    This experiment was conducted to evaluate the effects of electrical stimulation (ES) on breast fillets harvested at 1 h post-mortem and individually quick frozen (IQF) or aged on ice (ICE). Twelve birds were electrically stimulated (450 V, 750 mA, 2 s on/1 s off for 15 s) at the neck in a saline bath. Twenty-four unstimulated birds were used as controls. Breast fillets were harvested at 1 h post-mortem from ES and control carcasses or at 4 h post-mortem from control carcasses and were either IQF or ICE until 24 h post-mortem. Fillets were then analyzed for shear value, pH, R value, and color. Electrical stimulation significantly reduced shear values compared to the 1 h controls for both IQF and ICE treatments. The ICE fillets deboned at 1 h from ES-treated carcasses had shear values similar to those of ICE fillets deboned from the 4 h controls. Electrical stimulation increased the percentage of shear values at or below 8 kg/g for the fillets from ES-treated carcasses compared to the 1 h controls. Electrical stimulation accelerated the normal post-mortem decline in pH and increase in R value. There was no significant difference in L* or a* values between the fillets held for 1 or 24 h. The results suggest that by electrically stimulating carcasses at the neck using a saline bath, the aging period could be eliminated by removing fillets immediately after chilling at 1 h, decreasing the costs associated with aging whole carcasses or front halves.

  3. Working with External Evaluators

    ERIC Educational Resources Information Center

    Silver, Lauren; Burg, Scott

    2015-01-01

    Hiring an external evaluator is not right for every museum or every project. Evaluations are highly situational, grounded in specific times and places; each one is unique. The museum and the evaluator share equal responsibility in an evaluation's success, so it is worth investing time and effort to ensure that both are clear about the goals,…

  4. [Internal and external haemorrhoids].

    PubMed

    Schuurman, J P; Go, P M N Y H

    2011-01-01

    In this article, we present 3 cases of patients with different types of haemorrhoidal disease. The first patient is a 27-year-old woman who had been experiencing incidental rectal blood loss without pain during defecation for 3 months. The second patient is a 76-year-old woman who had been bothered by varying degrees of pain from a swelling nearby the anus for 1 year. The third case involves a 31-year-old man who had had continuous severe pain in the anal area for 3 consecutive days. The first patient appeared to have internal hemorrhoids, whereas different forms of external hemorrhoids affected the patients in the other 2 cases. Internal haemorrhoids develop from the intraluminal corpus cavernosum recti; external haemorrhoids from the perianal marginal veins. Patients with internal haemorrhoids present with symptoms that include blood loss and prolaps feeling during defecation. In patients with external haemorrhoids pain is the prominent symptom. Internal haemorrhoids are treated either conservatively or surgically, depending upon their severity. Considering external haemorrhoidal disease surgical treatment provides the most rapid and persistent relief of symptoms.

  5. External College Survey.

    ERIC Educational Resources Information Center

    Gold, Ben K.

    This report presents the results of a community survey which attempted to determine the demand for another college in the Los Angeles Community College District. The function of this "community campus" or "external college" would be to serve members of the community who are not already served by the eight existing colleges. Questionnaires received…

  6. External Interest Group Impingements.

    ERIC Educational Resources Information Center

    Millard, Richard M.

    The history of the interrelation among state approval, accreditation, and institutional eligibility is considered. It is suggested that faculty and college administrators can be either an internal or external group in relationship to the planning process. The federal government, or the state government, passes legislation that may have both…

  7. Cosmetic surgery: medicolegal considerations

    PubMed Central

    Piras, Mauro; Delbon, Paola; Conti, Adelaide; Capasso, Emanuele; Niola, Massimo; Bin, Paola

    2016-01-01

    Abstract Cosmetic surgery is one of the two branches of plastic surgery. The characteristic of non-necessity of this surgical speciality implies an increased severity in the evaluation of the risk-benefit balance. Therefore, great care must be taken in providing all the information necessary in order to obtain valid consent to the intervention. We analyzed judgments concerning cosmetic surgery found in national legal databases. A document of National Bioethics Committee (CNB) was also analyzed. Conclusion: The receipt of valid, informed consent is of absolute importance not only to legitimise the medical-surgical act, but it also represents the key element in the question concerning the existence of an obligation to achieve certain results/use of certain methods in the cosmetic surgery. PMID:28352816

  8. [Rhinoplasty: medicolegal issues].

    PubMed

    Thomassin, J-M; Bardot, J; Radulesco, T

    2014-12-01

    In rhinoplasty, satisfying the patient both aesthetically and functionally can be complex. In aesthetic surgery, the rhinoplastician has a reinforced obligation of means. In our experience, the functional outcome of the patient is closely linked to the morphological result. When a rhinoplasty provides the patient with full aesthetic satisfaction, even if he/she has breathing difficulties, there will be very few disputes. In primary rhinoplasty, unsatisfactory results occur in 15%-30% of the cases. While orally informing the patient is paramount, the practitioner must also have written proof of the information via documents given or sent to the various players including the patient. The taking of pre- and postoperative photographs is essential and the surgeon must keep them on file for support in case of conflict.

  9. Maximality of shoulder external rotation effort in patients presenting with work related injury: the clinical applicability of the DEC parameter.

    PubMed

    Chaler, Joaquim; Pujol, Eduard; Unyó, Carme; Quintana, Salvador; Müller, Bertram; Garreta, Roser; Javierre, Casimiro; Dvir, Zeevi

    2013-08-01

    The aim of the present study is to examine the applicability of the isokinetic DEC parameter for identifying submaximal effort in workers with potential weakness of the shoulder external rotators. A previous study indicated that the DEC was a powerful identifier of submaximal effort of shoulder external rotation in normal volunteers. Its applicability in shoulder injury patients is of specific interest. Thus, a retrospective study of 74 (33 female and 41 male) patients who claimed compensation for work-related shoulder injury was designed. 52 patients had their injured side DEC values within the normal range and were thus labeled as maximal performers. Ten patients had higher than cutoff DEC values, indicating submaximal effort whereas 12 patients had exceedingly low DEC values. Gender comparison showed a significantly different proportion of maximal performers. Strength deficits registered in patients demonstrating maximal performance correlated with the final outcome. The findings support the application of the DEC for determination of the extent of weakness of shoulder external rotators in male patients. In terms of shoulder external rotators status in male worker injury, the results support the application of isokinetic tests both in the clinical and medicolegal sense. However, the gender discrepancy warrants further research.

  10. Externally heated thermal battery

    NASA Astrophysics Data System (ADS)

    Pracchia, Louis; Vetter, Ronald F.; Rosenlof, Darwin

    1991-04-01

    A thermal battery activated by external heat comprising an anode (e.g., composed of a lithium-aluminum alloy), a cathode (e.g., composed of iron disulfide), and an electrolyte (e.g., a lithium chloride-potassium chloride eutectic) with the electrolyte inactive at ambient temperature but activated by melting at a predetermined temperature when exposed to external heating is presented. The battery can be used as a sensor or to ignite pyrotechnic and power electronic devices in a system for reducing the hazard of ordnance exposed to detrimental heating. A particular application is the use of the battery to activate a squib to function in conjunction with one or more other components to vent an ordnance case in order to prevent its explosion in a fire.

  11. Externally triggered microcapsules

    NASA Technical Reports Server (NTRS)

    Morrison, Dennis R. (Inventor); Mosier, Benjamin (Inventor)

    2011-01-01

    Disclosed are microcapsules comprising a polymer shell enclosing one or more immiscible liquid phases in which a drug or drug precursor are contained in a liquid phase. The microparticles also contain magnetic particles that can be heated by application of an external magnetic field and thus heated to a predetermined Curie temperature. Heating of the particles melts the polymer shell and releases the drug without causing heating of surrounding tissues.

  12. Unusual suicide in Italy: criminological and medico-legal observations-a proposed definition of "atypical suicide" suitable for international application.

    PubMed

    Massaro, Luca

    2015-05-01

    This work is the result of a kind of categorization of suicidal conduct based on an empirical-phenomenological approach, with integrated assessment of certain criteria, such as the dynamics, correlation of types of injury and how they were produced, evidence gathered during official inspections in loco, and case history findings about "suicide." This categorization is an attempt to provide a nosographic definition of atypical suicide, that is, cases in which the parameters of "typical" suicide are missing. Case studies are described, taken from a systematic exploration mainly of the Italian specialized literature of the 20th century, supplemented by earlier references when deemed significant. In-depth analysis of atypical suicide can supply additional interpretations of the problem of differential diagnosis of suicide, homicide, and accidental death, that is, the real punctum dolens in overall medico-legal determination of the cause of death in scenarios in which death cannot be definitely traced to a deliberate act.

  13. Modeling microbial ethanol production by E. coli under aerobic/anaerobic conditions: applicability to real postmortem cases and to postmortem blood derived microbial cultures.

    PubMed

    Boumba, Vassiliki A; Kourkoumelis, Nikolaos; Gousia, Panagiota; Economou, Vangelis; Papadopoulou, Chrissanthy; Vougiouklakis, Theodore

    2013-10-10

    The mathematical modeling of the microbial ethanol production under strict anaerobic experimental conditions for some bacterial species has been proposed by our research group as the first approximation to the quantification of the microbial ethanol production in cases where other alcohols were produced simultaneously with ethanol. The present study aims to: (i) study the microbial ethanol production by Escherichia coli under controlled aerobic/anaerobic conditions; (ii) model the correlation between the microbial produced ethanol and the other higher alcohols; and (iii) test their applicability in: (a) real postmortem cases that had positive BACs (>0.10 g/L) and co-detection of higher alcohols and 1-butanol during the original ethanol analysis and (b) postmortem blood derived microbial cultures under aerobic/anaerobic controlled experimental conditions. The statistical evaluation of the results revealed that the formulated models were presumably correlated to 1-propanol and 1-butanol which were recognized as the most significant descriptors of the modeling process. The significance of 1-propanol and 1-butanol as descriptors was so powerful that they could be used as the only independent variables to create a simple and satisfactory model. The current models showed a potential for application to estimate microbial ethanol - within an acceptable standard error - in various tested cases where ethanol and other alcohols have been produced from different microbes.

  14. Effects of post-mortem and physical degradation on RNA integrity and quality

    PubMed Central

    Sidova, Monika; Tomankova, Silvie; Abaffy, Pavel; Kubista, Mikael; Sindelka, Radek

    2015-01-01

    The precision and reliability of quantitative nucleic acid analysis depends on the quality of the sample analyzed and the integrity of the nucleic acids. The integrity of RNA is currently primarily assessed by the analysis of ribosomal RNA, which is the by far dominant species. The extrapolation of these results to mRNAs and microRNAs, which are structurally quite different, is questionable. Here we show that ribosomal and some nucleolar and mitochondrial RNAs, are highly resistant to naturally occurring post-mortem degradation, while mRNAs, although showing substantial internal variability, are generally much more prone to nucleolytic degradation. In contrast, all types of RNA show the same sensitivity to heat. Using qPCR assays targeting different regions of mRNA molecules, we find no support for 5′ or 3′ preferentiality upon post-mortem degradation. PMID:27077037

  15. Use of Cardiac Injury Markers in the Postmortem Diagnosis of Sudden Cardiac Death.

    PubMed

    Carvajal-Zarrabal, Octavio; Hayward-Jones, Patricia M; Nolasco-Hipolito, Cirilo; Barradas-Dermitz, Dulce Ma; Calderón-Garcidueñas, Ana Laura; López-Amador, Noé

    2017-01-23

    In the daily practice of forensic pathology, sudden cardiac death (SCD) is a diagnostic challenge. Our aim was to determine the usefulness of blood biomarkers [creatine kinase CK-MB, myoglobin, troponins I and T (cTn-I and T), and lactate dehydrogenase] measured by immunoassay technique, in the postmortem diagnosis of SCD. Two groups were compared, 20 corpses with SCD and 8 controls. Statistical significance was determined by variance analysis procedures, with a post hoc Tukey multiple range test for comparison of means (p < 0.05). SCD cases showed significantly higher levels (p < 0.05) of cTn-T and cTn-I compared to the control group. Although only cases within the first 8 h of postmortem interval were included, and the control group consisted mainly of violent death cases, our results suggest that blood troponin levels may be useful to support a diagnosis of SCD.

  16. Investigating the Postmortem Molecular Biology of Cartilage and its Potential Forensic Applications.

    PubMed

    Bolton, Shawna N; Whitehead, Michael P; Dudhia, Jayesh; Baldwin, Timothy C; Sutton, Raul

    2015-07-01

    This study investigated the postmortem molecular changes that articular cartilage undergoes following burial. Fresh pig trotters were interred in 30-cm-deep graves at two distinct locations exhibiting dissimilar soil environments for up to 42 days. Extracts of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joint cartilage from trotters disinterred weekly over 6 weeks were analyzed by Western blot against the monoclonal antibody 2-B-6 to assess aggrecan degradation. In both soil conditions, aggrecan degradation by-products of decreasing molecular size and complexity were observed up to 21 days postmortem. Degradation products were undetected after this time and coincided with MCP/MTP joint exposure to the soil environment. These results show that cartilage proteoglycans undergo an ordered molecular breakdown, the analysis of which may have forensic applications. This model may prove useful for use as a human model and for forensic investigations concerning crimes against animals and the mortality of endangered species.

  17. Postmortem diagnosis of "occult" Klinefelter syndrome in a patient with chronic renal disease and liver cirrhosis.

    PubMed

    Matsuoka, Kentaro; Orikasa, Hideki; Eyden, Brian; Yamazaki, Kazuto

    2002-03-01

    This report describes a patient not suspected of having Klinefelter syndrome during life but diagnosed with it following postmortem examination using fluorescent in situ hybridization (FISH) for sex chromosomes and hormone serum analysis. A 49-year-old Japanese man had a history of nephrosis, heavy alcohol consumption, diabetes mellitus, and liver cirrhosis and had been undergoing dialysis for 10 years. He died of ruptured esophageal varices. Autopsy revealed hypogonadism, suggesting Klinefelter syndrome. This was confirmed by FISH, which showed a mosaic 46XY, 47XXY karyotype, and by serum analysis, which revealed high luteinizing hormone and follicle-stimulating hormone and low testosterone levels. Autopsy also revealed a nodular, bilateral, testicular Leydig cell hyperplasia. This report illustrates the value of postmortem laboratory investigations, particularly FISH for sex chromosomes and serum hormone analysis, for the demonstration of clinically uncertain or "occult" Klinefelter syndrome.

  18. Postmortem Aging of Beef with a Special Reference to the Dry Aging.

    PubMed

    Khan, Muhammad I; Jung, Samooel; Nam, Ki Chang; Jo, Cheorun

    2016-01-01

    Animal muscles are stored for specific period (aging) at refrigerated temperatures, during and after which the living muscles start to convert into meat and thus, attain certain superior properties in the final product. Proteolysis, lipolysis, and oxidation are the major biochemical processes involved during the postmortem aging of meat that affect the tenderness, juiciness, and flavor, as well as sometimes may introduce certain undesirable traits. This review analyzes the role of pre- and post-mortem factors that are important for aging and their effect on the chemical and physical changes in the "dry- and wet-aged meat." Thus, if the meat processing manufacturers optimize the effects of aging for specific muscles, the palatability, color, and the shelf life of the aged meat products could be significantly enhanced.

  19. Postmortem Aging of Beef with a Special Reference to the Dry Aging

    PubMed Central

    Khan, Muhammad I.; Jung, Samooel; Nam, Ki Chang; Jo, Cheorun

    2016-01-01

    Animal muscles are stored for specific period (aging) at refrigerated temperatures, during and after which the living muscles start to convert into meat and thus, attain certain superior properties in the final product. Proteolysis, lipolysis, and oxidation are the major biochemical processes involved during the postmortem aging of meat that affect the tenderness, juiciness, and flavor, as well as sometimes may introduce certain undesirable traits. This review analyzes the role of pre- and post-mortem factors that are important for aging and their effect on the chemical and physical changes in the “dry- and wet-aged meat.” Thus, if the meat processing manufacturers optimize the effects of aging for specific muscles, the palatability, color, and the shelf life of the aged meat products could be significantly enhanced. PMID:27194923

  20. Post-mortem genetic testing in a family with long-QT syndrome and hypertrophic cardiomyopathy.

    PubMed

    Kane, David A; Triedman, John

    2014-01-01

    Pediatric sudden unexplained deaths are rare and tragic events that should be evaluated with all the tools available to the medical community. The current state of genetic testing is an excellent resource that improves our ability to diagnose cardiovascular disorders that can lead to sudden cardiac arrest. Post-mortem genetic testing is not typically a covered benefit of health insurance and may not be offered to families in the setting of a negative autopsy. This unusual case includes two separate cardiovascular disorders that highlight the use of genetic testing and its role in diagnosis, screening, and risk stratification. The insurance company's decision to cover post-mortem testing demonstrated both compassion as well as an understanding of the long-term cost effectiveness.

  1. Viability and infectivity of Ichthyophonus sp. in post-mortem Pacific herring, Clupea pallasii

    USGS Publications Warehouse

    Kocan, Richard M.; Hart, Lucas M.; Lewandowski, Naomi; Hershberger, Paul

    2014-01-01

    Ichthyophonus-infected Pacific herring, Clupea pallasii, were allowed to decompose in ambient seawater then serially sampled for 29 days to evaluate parasite viability and infectivity for Pacific staghorn sculpin, Leptocottus armatus. Ichthyophonus sp. was viable in decomposing herring tissues for at least 29 days post-mortem and could be transmitted via ingestion to sculpin for up to 5 days. The parasite underwent morphologic changes during the first 48 hr following death of the host that were similar to those previously reported, but as host tissue decomposition progressed, several previously un-described forms of the parasite were observed. The significance of long-term survival and continued morphologic transformation in the post-mortem host is unknown, but it could represent a saprozoic phase of the parasite life cycle that has survival value for Ichthyophonus sp.

  2. Persistent Angiogenesis in the Autism Brain: An Immunocytochemical Study of Postmortem Cortex, Brainstem and Cerebellum

    PubMed Central

    Saccomano, Z. T.; Alzoobaee, M. F.; Boldrini, M.; Whitaker-Azmitia, P. M.

    2016-01-01

    In the current work, we conducted an immunocytochemical search for markers of ongoing neurogenesis (e.g. nestin) in auditory cortex from postmortem sections of autism spectrum disorder (ASD) and age-matched control donors. We found nestin labeling in cells of the vascular system, indicating blood vessels plasticity. Evidence of angiogenesis was seen throughout superior temporal cortex (primary auditory cortex), fusiform cortex (face recognition center), pons/midbrain and cerebellum in postmortem brains from ASD patients but not control brains. We found significant increases in both nestin and CD34, which are markers of angiogenesis localized to pericyte cells and endothelial cells, respectively. This labeling profile is indicative of splitting (intussusceptive), rather than sprouting, angiogenesis indicating the blood vessels are in constant flux rather than continually expanding. PMID:26667147

  3. Determination of Human Chorionic Gonadotropin in Postmortem Samples in Ectopic Pregnancies.

    PubMed

    Palmiere, Cristian; Lesta, Maria del Mar; Fanton, Laurent; Ventura, Francesco; Bonsignore, Alessandro; Reggiani Bonetti, Luca

    2016-01-01

    Increased human chorionic gonadotropin levels (HCG) can be detected in femoral blood, bile, and vitreous humor collected during autopsy of pregnant women using a standard kit designed for living patients. In the study herein, the concentrations of HCG were measured in postmortem serum, vitreous, bile, cerebrospinal, and pericardial fluids in 4 cases of fatal ectopic pregnancy and 40 controls using a quantitative electrochemiluminescence immunoassay designed for living patients. No false-negative cases were identified in any of the analyzed samples in any of the ectopic pregnancy cases. No correlations were found between total HCG levels in postmortem serum and the other tested specimens. The results of this study would suggest that higher HCG in bile, vitreous, pericardial, and cerebrospinal fluids may confirm the existence of ectopic pregnancy and therefore identify other situations in which this hormone is increased, although gestational age cannot be reliably estimated using these values.

  4. A microbial clock provides an accurate estimate of the postmortem interval in a mouse model system

    PubMed Central

    Metcalf, Jessica L; Wegener Parfrey, Laura; Gonzalez, Antonio; Lauber, Christian L; Knights, Dan; Ackermann, Gail; Humphrey, Gregory C; Gebert, Matthew J; Van Treuren, Will; Berg-Lyons, Donna; Keepers, Kyle; Guo, Yan; Bullard, James; Fierer, Noah; Carter, David O; Knight, Rob

    2013-01-01

    Establishing the time since death is critical in every death investigation, yet existing techniques are susceptible to a range of errors and biases. For example, forensic entomology is widely used to assess the postmortem interval (PMI), but errors can range from days to months. Microbes may provide a novel method for estimating PMI that avoids many of these limitations. Here we show that postmortem microbial community changes are dramatic, measurable, and repeatable in a mouse model system, allowing PMI to be estimated within approximately 3 days over 48 days. Our results provide a detailed understanding of bacterial and microbial eukaryotic ecology within a decomposing corpse system and suggest that microbial community data can be developed into a forensic tool for estimating PMI. DOI: http://dx.doi.org/10.7554/eLife.01104.001 PMID:24137541

  5. Microtransplantation of neurotransmitter receptors from postmortem autistic brains to Xenopus oocytes

    PubMed Central

    Limon, Agenor; Reyes-Ruiz, Jorge Mauricio; Miledi, Ricardo

    2008-01-01

    Autism is a complex disorder that arises from the pervasive action of genetic and epigenetic factors that alter synaptic connectivity of the brain. Although GABA and glutamate receptors seem to be two of those factors, very little is known about the functional properties of the autistic receptors. Autistic tissue samples stored in brain banks usually have relatively long postmortem times, and it is highly desirable to know whether neurotransmitter receptors in such tissues are still functional. Here we demonstrate that native receptors microtransplanted from autistic brains, as well as de novo mRNA-expressed receptors, are still functional and susceptible to detailed electrophysiological characterization even after long postmortem intervals. The opportunity to study the properties of human receptors present in diseased brains not only opens new avenues toward understanding autism and other neurological disorders, but it also makes the microtransplantation method a useful translational system to evaluate and develop novel medicinal drugs. PMID:18645182

  6. [Basic principles in the formulation of a postmortem diagnosis in HIV-associated infections].

    PubMed

    Parkhomenko, Iu G; Ziuzia, Iu R

    2013-01-01

    If a patient dies from HIV-associated disease, after the heading "Underlying disease" the postmortem diagnosis should contain the heading "Secondary diseases" wherein HIV-associated infection is given with the form, site, extent, and activity of the process being indicated. While comparing clinical and postmortem diagnoses in HIV infection, the discrepancy should be specified in view of a secondary disease. If there are a few HIV-associated infections, they all are indicated in the heading "Secondary diseases", one of them, the complications of which are of crucial importance in tanatogenesis, is better chosen to be encoded in the medical death certificate. In some situations, HIV infection can be mixed, competitive, background, or concomitant regardless of its stage.

  7. Examination of the eye as a means to determine the early postmortem period: a review of the literature.

    PubMed

    Jaafar, S; Nokes, L D

    1994-02-01

    Reported are various techniques to determine the early postmortem period by examining the eye. These include corneal opacity, retinal vessel segmentation, pupil reaction, retinal changes and intraocular pressure. All are subjective, requiring experience to implement the techniques.

  8. Effects of Postmortem Freezing on Passive Properties of Rabbit Extensor Digtorum Longus Muscle Tendon Complex

    DTIC Science & Technology

    1993-06-14

    AD-A266 429 INSTITUTE REPORT NO. 483 Effects of Postmortem Freezing on Passive Properties of Rabbit Extensor Digtorum Longus Muscle Tendon Complex D...Extensor Digtorum Longus Muscle Tendon Complex -- Paul H. Leitschuh, Tammy J. Doherty, Dean C. Taylor, Daniel E. Brooks, John B. Ryan This document has...ABSTRACT The tensile properties of the extensor digitorum longus muscle tendon unit (EDL MTU) were studied in 16 white male New Zealand rabbits in both

  9. Endogenous concentrations of GHB in postmortem blood from deaths unrelated to GHB use.

    PubMed

    Korb, Ann-Sophie; Cooper, Gail

    2014-10-01

    Gamma-hydroxybutyrate (GHB) is an endogenous compound, but its presence in postmortem blood presents a challenge when interpreting elevated levels as GHB is misused as a recreational drug and is also produced postmortem. A total of 387 postmortem cases (273 male and 114 female) submitted to the toxicology laboratory between 2010 and 2012 specifically requested the analysis of the ketoacidosis biomarker, beta-hydroxybutyrate (BHB). No reference to GHB use was identified in any of the case files; however, BHB and GHB are measured simultaneously using deuterated GHB as the internal standard (GHB-d6) within a calibration range of 5-500 mg/L. GHB was not detected or <10 mg/L in 18% of the cases (n = 68), between 10 and 50 mg/L in 73% of the cases (n = 283) and between 51 and 193 mg/L in 9% of the cases (n = 36). The manner of death was classified as accidental (n = 11), alcohol-related (n = 237), drug-related (n = 23), homicide (n = 1), natural (n = 91), suicide (n = 9), medical-related (n = 1) and undetermined (n = 14). Six cases had GHB concentrations in excess of 100 mg/L with advanced decomposition changes noted in five of these cases. Moderate-to-advanced decomposition was also noted in 50% (n = 15) of the cases with GHB concentrations in excess of 50 mg/L but <100 mg/L. Approximately one-third of the blood samples tested contained a preservative and although a higher proportion of these samples had GHB concentrations <10 mg/L or not detected (∼30% preserved versus 11% unpreserved), there were still cases with GHB concentrations >51 mg/L (∼6% preserved versus 11% unpreserved). This study highlights the danger of only using a cutoff to establish endogenous levels compared with exogenous use of GHB in postmortem blood.

  10. Lack of postmortem digestion of tapeworms in Golden hamsters experimentally infected with Taenia solium.

    PubMed

    Garza-Rodríguez, A; Maravilla, P; Mendlovic, F; Mata-Miranda, P; Robert, L; Flisser, A

    2007-04-10

    Taenia solium causes human neurocysticercosis, a public health problem in Mexico and other developing countries. Surprisingly, tapeworm carriers are very rarely found and in necropsy studies practically no tapeworms have been reported. In this paper we analyze the possibility that, after the death of the host, tapeworms could easily be destroyed in the intestine. Our experiments, performed in the hamster model, suggest that the absence of tapeworms in human intestine during necropsy is not due to postmortem digestion.

  11. The Second Seven Years of the FAA’s Postmortem Forensic Toxicology Proficiency-Testing Program

    DTIC Science & Technology

    2008-10-01

    large number of participants, but some false positives of concern were reported, as some of them were abused drugs . Some of the false positives would...challenge survey samples (12 urine , 9 blood, and 7 tissue homogenate) with/without alcohols/volatiles, drugs , drug metabolites, and/or putrefactive...The Second Seven Years of the FAA’s Postmortem Forensic Toxicology Proficiency- Testing Program Arvind K. Chaturvedi Kristi J. Craft Patrick S

  12. Analysis of Sertraline in Postmortem Fluids and Tissues in 11 Aviation Accident Victims

    DTIC Science & Technology

    2012-11-01

    This work was accomplished under the approved task AM-B-12-TOX-204. 16. Abstract Sertraline (Zoloft®) is a selective serotonin reuptake inhibitor ...Desmethylsertraline, Postmortem Distribution, GC/MS, Selective Serotonin Reuptake Inhibitor Document is available to the public through the Internet...methyl-1- naphtalenamine].(Figure.1),.belongs.to.a.class.of.drugs. called. selective . serotonin . reuptake . inhibitors . (SSRIs) .. Other.drugs

  13. Review of Caffeine-Related Fatalities along with Postmortem Blood Concentrations in 51 Poisoning Deaths.

    PubMed

    Jones, Alan Wayne

    2017-02-18

    Publications reporting concentrations of caffeine in postmortem blood were reviewed if the cause of death was attributed to overdosing (poisoning) with drugs. Age and gender of the deceased, the manner of death (accident, suicide or undetermined) and types of co-ingested drugs were evaluated in relation to the concentrations of caffeine in blood (N = 51). The mean age (±SD) of the victims was 39 ± 17.8 years (range 18-84 years) and most were female (N = 31 or 61%). The difference in mean age of males (42 ± 17.2 years) and females (37 ± 18.3 years) was not statistically significant (t = 0.811, P = 0.421). The mean (±SD), median and range of caffeine concentrations in postmortem blood were 187 ± 96 mg/L (180 mg/L) and 33-567 mg/L, respectively. The median concentration of caffeine in males (161 mg/L) was not significantly different from that of females (182 mg/L), z = 1.18, P = 0.235. There was no correlation between the age of the deceased and the concentration of caffeine in postmortem blood (R2 = 0.026, P > 0.05). Manner of death was classified as suicide in 51% of cases (median blood-caffeine 185 mg/L), accidental in 16% (median 183 mg/L) or undetermined in 33% (median 113 mg/L). The median concentration of caffeine in blood was lower when manner of death was undetermined compared with suicide or accidental (P = 0.023). Although other drugs, including ethanol, antidepressants, antipsychotics, benzodiazepines and/or ephedrine, were often identified in postmortem blood, the predominant psychoactive substance was caffeine. The deceased had ingested caffeine in tablet or powder form and it does not seem likely that toxic concentrations of caffeine can be achieved from over-consumption of caffeinated beverages alone.

  14. Decay of sperm obtained from epididymes of wild ruminants depending on postmortem time.

    PubMed

    Martinez-Pastor, F; Guerra, C; Kaabi, M; Diaz, A R; Anel, E; Herraez, P; de Paz, P; Anel, L

    2005-01-01

    We have carried out a study on the effect of postmortem time (PT) in some characteristics of epididymal sperm salvaged from hunted Iberian red deer and roe deer. Testis were collected, identified, refrigerated down to 5 degrees C, and sent to our laboratory by the wardens of the hunting reserves. This way, samples were delivered at different times postmortem. Sperm were extracted from the cauda epididymis by means of cuts. Analyzed parameters were: osmolality, pH, motility-both subjectively and with CASA, HOS test reactivity, acrosomal status and viability (assessed with propidium iodide). Osmolality and pH rose with prolonged postmortem time, possibly due to tissue decomposition. Most sperm quality parameters negatively correlated with PT. Besides, when comparing PT classes (groups of 24 h for red deer and 30 h for roe deer), we could appreciate that motility was more affected by PT than other quality variables. Progressive motility was especially impaired. We also classified the samples in high, medium and low quality for each PT group (considering progressive motility, intact acrosomes and reactivity to the HOS test), and it was clear that after 2 days the number of high quality samples was testimonial, and after several days, we almost found only low quality samples. In conclusion, epididymal sperm from Iberian red deer and roe deer undergo a decrease of quality with PT, but it could stay acceptable within many hours postmortem. There are implications for wildlife conservation programs, as epididymal sperm is a good source of germplasm. If valuable animals die and it is not possible to process their sperm immediately, it may still be possible to obtain viable spermatozoa many hours later.

  15. Biochemical pathways generating post-mortem volatile compounds co-detected during forensic ethanol analyses.

    PubMed

    Boumba, Vassiliki A; Ziavrou, Kallirroe S; Vougiouklakis, Theodore

    2008-01-30

    In this contribution are presented the fermentations of the main substrates present in a decaying corpse, namely carbohydrates, amino acids, glycerol and fatty acids, generating the post-mortem volatile compounds that could be detected along with ethanol during the forensic ethanol analysis. The available literature (preferably reviews) on microbial metabolic pathways (enzymes, substrates, conditions) that are implicated in the formation of these volatiles has been reviewed. The microbial formation of the following volatiles is supported by the presented biochemical data: ethanol, acetaldehyde, acetone, 2-propanol, 1-propanol, 1-butanol, isobutanol, isoamyl alcohol, d-amyl alcohol, acetate, propionate, butyrate, isobutyrate and ethyl esters (mainly ethyl acetate). The extracted information was correlated with the existing forensic literature on the post-mortem detected volatiles. The significance of the microbial produced volatiles on the selection of an appropriate internal standard for the ethanol analysis has been considered. Finally, the possible contribution of the presence of volatiles in the interpretation of ethanol analysis results in post-mortem cases is discussed.

  16. An initial investigation into the ecology of culturable aerobic postmortem bacteria.

    PubMed

    Chun, Lauren P; Miguel, Marcus J; Junkins, Emily N; Forbes, Shari L; Carter, David O

    2015-12-01

    Postmortem microorganisms are increasingly recognized for their potential to serve as physical evidence. Yet, we still understand little about the ecology of postmortem microbes, particularly those associated with the skin and larval masses. We conducted an experiment to characterize microbiological and chemical properties of decomposing swine (Sus scrofa domesticus) carcasses on the island of Oahu, Hawaii, USA, during June 2013. Bacteria were collected from the head, limb, and larval mass during the initial 145h of decomposition. We also measured the pH, temperature, and oxidation-reduction potential of larval masses in situ. Bacteria were cultured aerobically on Standard Nutrient Agar at 22°C and identified using protein or genetic signals. Carcass decomposition followed a typical sigmoidal pattern and associated bacterial communities differed by sampling location and time since death, although all communities were dominated by phyla Actinobacteria, Firmicutes, and Proteobacteria. Larval masses were reducing environments (~-200mV) of neutral pH (6.5-7.5) and high temperature (35°C-40°C). We recommend that culturable postmortem and larval mass microbiology and chemistry be investigated in more detail, as it has potential to complement culture-independent studies and serve as a rapid estimate of PMI.

  17. Perinatal Mortality Associated with Positive Postmortem Cultures for Common Oral Flora

    PubMed Central

    Migliori, Alison R.; Lauro, Patricia; Sung, C. James; Pinar, Halit

    2017-01-01

    Introduction. To investigate whether maternal oral flora might be involved in intrauterine infection and subsequent stillbirth or neonatal death and could therefore be detected in fetal and neonatal postmortem bacterial cultures. Methods. This retrospective study of postmortem examinations from 1/1/2000 to 12/31/2010 was searched for bacterial cultures positive for common oral flora from heart blood or lung tissue. Maternal age, gestational age, age at neonatal death, and placental and fetal/neonatal histopathological findings were collected. Results. During the study period 1197 postmortem examinations (861 stillbirths and 336 neonatal deaths) were performed in our hospital with gestational ages ranging from 13 to 40+ weeks. Cultures positive for oral flora were identified in 24 autopsies including 20 pure and 8 mixed growths (26/227, 11.5%), found in 16 stillbirths and 8 neonates. Microscopic examinations of these 16 stillbirths revealed 8 with features of infection and inflammation in fetus and placenta. The 7 neonatal deaths within 72 hours after birth grew 6 pure isolates and 1 mixed, and 6 correlated with fetal and placental inflammation. Conclusions. Pure isolates of oral flora with histological evidence of inflammation/infection in the placenta and fetus or infant suggest a strong association between maternal periodontal conditions and perinatal death. PMID:28325959

  18. Measurement of Postmortem 1,5-anhydroglucitol in Vitreous Humor for Forensic Diagnosis.

    PubMed

    Takata, Tomoyo; Yamasaki, Yukie; Kitao, Takashi; Miyaishi, Satoru

    2016-01-01

    In forensic diagnosis, postmortem blood glucose is known to be susceptible to change after death. However, the 1,5-anhydroglucitol (1,5-AG) concentrations in plasma and cerebrospinal fluid (CSF) reflect the mean blood glucose level for a short period of time. In this study, we compared the postmortem 1,5-AG concentrations in vitreous humor and CSF in 47 subjects to evaluate the utility of this concentration in the vitreous humor for forensic diagnosis. The postmortem 1,5-AG concentrations in vitreous humor (mean±SD: 20.2 ± 8.7 μg/mL) and CSF (16.8 ± 8.7 μg/mL) did not differ significantly and showed a strong correlation (r(2) = 0.87, p < 0.01). These results suggest that the vitreous humor 1,5-AG concentration provides useful information on the antemortem blood glucose level, in addition to the HbA1c value and the CSF 1,5-AG concentration.

  19. A Pathophysiological Insight into Sepsis and Its Correlation with Postmortem Diagnosis

    PubMed Central

    Pomara, C.; Riezzo, I.; Bello, S.; De Carlo, D.; Neri, M.; Turillazzi, E.

    2016-01-01

    Background. Sepsis is among the leading causes of death worldwide and is the focus of a great deal of attention from policymakers and caregivers. However, sepsis poses significant challenges from a clinical point of view regarding its early detection and the best organization of sepsis care. Furthermore, we do not yet have reliable tools for measuring the incidence of sepsis. Methods based on analyses of insurance claims are unreliable, and postmortem diagnosis is still challenging since autopsy findings are often nonspecific. Aim. The objective of this review is to assess the state of our knowledge of the molecular and biohumoral mechanisms of sepsis and to correlate them with our postmortem diagnosis ability. Conclusion. The diagnosis of sepsis-related deaths is an illustrative example of the reciprocal value of autopsy both for clinicians and for pathologists. A complete methodological approach, integrating clinical data by means of autopsy and histological and laboratory findings aiming to identify and demonstrate the host response to infectious insults, is mandatory to illuminate the exact cause of death. This would help clinicians to compare pre- and postmortem findings and to reliably measure the incidence of sepsis. PMID:27239102

  20. Effect of epididymis handling conditions on the quality of ram spermatozoa recovered post-mortem.

    PubMed

    Kaabi, M; Paz, P; Alvarez, M; Anel, E; Boixo, J C; Rouissi, H; Herraez, P; Anel, L

    2003-10-15

    Post-mortem spermatozoa recovery is an important technique for obtaining germplasm reserves from genetically valuable animals or endangered species. However, there are many factors that influence the outcome of this technique. We have studied the effect of the interval between animal's death and sperm recovery (0, 24 or 48 h) on the quality and freezability of ram spermatozoa from cauda epididymidis. Storage temperature of epididymis (room temperature or 5 degrees C) was also analysed. Spermatozoa were diluted with Tes-Tris-Fructose solution supplemented with egg yolk (10%) and glycerol (4%), and frozen using a programmable biofreezer (-20 degrees C/min). Pre-freeze and post-thaw sperm samples showed viable spermatozoa up to 48 h after the animal's death, although their quality declined significantly as post-mortem storage time increased. Epididymis sperm stored at 5 degrees C showed better motility and a lower percentage of abnormal forms than epididymis stored at room temperature after 24 and 48 h. The fertilizing ability of cauda epididymis ram spermatozoa obtained at 0 and 24h after the animal's death is similar to that of ejaculated spermatozoa. Therefore, a good protocol for post-mortem semen collection in rams when epididymal spermatozoa cannot be collected immediately, is to preserve the epididymis at 5 degrees C and process the samples in the first 24h after the animal's death.

  1. Postmortem findings and opportunistic infections in HIV-positive patients from a public hospital in Peru.

    PubMed

    Eza, Dominique; Cerrillo, Gustavo; Moore, David A J; Castro, Cecilia; Ticona, Eduardo; Morales, Domingo; Cabanillas, Jose; Barrantes, Fernando; Alfaro, Alejandro; Benavides, Alejandro; Rafael, Arturo; Valladares, Gilberto; Arevalo, Fernando; Evans, Carlton A; Gilman, Robert H

    2006-01-01

    There is a paucity of HIV autopsy data from South America and none that document the postmortem findings in patients with HIV/AIDS in Peru. The purpose of this autopsy study was to determine the spectrum of opportunistic infections and the causes of mortality in HIV-positive patients at a public hospital in Lima. Clinico-epidemiological information regarding HIV infection in Peru is also reviewed. Sixteen HIV-related hospital postmortems, performed between 1999 and 2004, were included in this retrospective analysis. The primary cause of death was established in 12 patients: one died of neoplasia and 11 of infectious diseases, including 3 from pulmonary infection, 7 from disseminated infection, and 2 from central nervous system infection (one case had dual pathology). Opportunistic infections were identified in 14 cases, comprising cytomegalovirus, histoplasmosis, cryptococcosis, toxoplasmosis, Pneumocystis pneumonia, aspergillosis, tuberculosis, varicella zoster virus, and cryptosporidiosis. Fourteen patients had at least one AIDS-related disease that had been neither clinically suspected nor diagnosed premortem. Moreover, 82% of the diagnoses considered to be of important clinical significance had not been suspected antemortem. The spectrum and frequency of certain opportunistic infections differed from other South American autopsy studies, highlighting the importance of performing HIV/AIDS postmortems in resource-limited countries where locally specific disease patterns may be observed.

  2. Postmortem findings and opportunistic infections in HIV-positive patients from a public hospital in Peru

    PubMed Central

    Eza, Dominique; Cerrillo, Gustavo; Moore, David A.J.; Castro, Cecilia; Ticona, Eduardo; Morales, Domingo; Cabanillas, Jose; Barrantes, Fernando; Alfaro, Alejandro; Benavides, Alejandro; Rafael, Arturo; Valladares, Gilberto; Arevalo, Fernando; Evans, Carlton A.; Gilman, Robert H.

    2010-01-01

    There is a paucity of HIV autopsy data from South America and none that document the postmortem findings in patients with HIV/AIDS in Peru. The purpose of this autopsy study was to determine the spectrum of opportunistic infections and the causes of mortality in HIV-positive patients at a public hospital in Lima. Clinico-epidemiological information regarding HIV infection in Peru is also reviewed. Sixteen HIV-related hospital postmortems, performed between 1999 and 2004, were included in this retrospective analysis. The primary cause of death was established in 12 patients: one died of neoplasia and 11 of infectious diseases, including 3 from pulmonary infection, 7 from disseminated infection, and 2 from central nervous system infection (one case had dual pathology). Opportunistic infections were identified in 14 cases, comprising cytomegalovirus, histoplasmosis, cryptococcosis, toxoplasmosis, Pneumocystis pneumonia, aspergillosis, tuberculosis, varicella zoster virus, and cryptosporidiosis. Fourteen patients had at least one AIDS-related disease that had been neither clinically suspected nor diagnosed premortem. Moreover, 82% of the diagnoses considered to be of important clinical significance had not been suspected antemortem. The spectrum and frequency of certain opportunistic infections differed from other South American autopsy studies, highlighting the importance of performing HIV/AIDS postmortems in resource-limited countries where locally specific disease patterns may be observed. PMID:16979302

  3. Postmortem tissue samples: an alternative to urine and blood for drug analysis in racehorses.

    PubMed

    Uboh, C E; Rudy, J A; Railing, F A; Enright, J M; Shoemaker, J M; Kahler, M C; Shellenberger, J M; Kemecsei, Z; Das, D N

    1995-09-01

    Although urine is the sample of choice for drug tests in racehorses, it is rarely obtained following the sudden death of a racehorse on the track while racing. The purpose of this study was to demonstrate the significance of postmortem tissue samples as an alternative to urine and blood samples in equine drug analysis following the sudden death of a racehorse on the track while participating in a competitive race. Postmortem tissue samples were frozen (-80 degrees C) until analyzed. A 30-40-g portion of each organ was homogenized in a 0.1 M phosphate buffer (pH 7.4), deproteinized, hydrolyzed with beta-glucuronidase, extracted, and screened by thin-layer chromatography and immunoassay. Samples that initially tested positive for drug(s) were then extracted using high-flow, solid-phase extraction cartridges. The eluates were analyzed by gas chromatography-mass spectrometry. The presence of butorphanol in horses HB355 and CD387, pentobarbital in horse HO940, and ergotamine in horses HO940 and CD387 was detected and confirmed. Thus, in the absence of urine and blood samples following sudden death, postmortem tissue samples are equally useful for forensic toxicological investigations of racehorses.

  4. Methods to optimize the generation of cDNA from postmortem human brain tissue.

    PubMed

    Miller, Christine L; Yolken, Robert H

    2003-02-01

    The analysis of gene transcript levels in postmortem human brain is a valuable tool for the study of neurological and psychiatric diseases. Optimization of the methods of RNA extraction and cDNA generation is particularly important in this application because postmortem human brain tissue is in limited supply and generally yields less RNA than many other human tissues. We compared column extraction and solvent extraction for total RNA, reverse transcription (RT) with random hexamers versus oligo-dT priming, and incubation of the RNA with or without DNase for effect on the cDNA product derived from the same homogenized pool of postmortem human frontal cortex. The total RNA obtained from the solvent method was found to be less stable at room temperature and to contain a higher proportion of non-messenger RNA than that obtained from the column method. Evaluating the RT-PCR results per wet weight of tissue extracted, we found that the signal strength was increased >20-fold by a protocol of Qiagen RNeasy column extraction, random hexamer RT priming and omitting DNase treatment of the RNA.

  5. Quantification of nucleic acid quality in postmortem tissues from a cancer research autopsy program

    PubMed Central

    Fan, Jun; Khanin, Raya; Sakamoto, Hitomi; Zhong, Yi; Michael, Chelsea; Pena, Derwin; Javier, Breanna; Wood, Laura D.; Iacobuzio-Donahue, Christine A.

    2016-01-01

    The last decade has seen a marked rise in the use of cancer tissues obtained from research autopsies. Such resources have been invaluable for studying cancer evolution or the mechanisms of therapeutic resistance to targeted therapies. Degradation of biomolecules is a potential challenge to usage of cancer tissues obtained in the post-mortem setting and remains incompletely studied. We analysed the nucleic acid quality in 371 different frozen tissue samples collected from 80 patients who underwent a research autopsy, including eight normal tissue types, primary and metastatic tumors. Our results indicate that RNA integrity number (RIN) of normal tissues decline with the elongation of post-mortem interval (PMI) in a tissue-type specific manner. Unlike normal tissues, the RNA quality of cancer tissues is highly variable with respect to post-mortem interval. The kinetics of DNA damage also has tissue type-specific features. Moreover, while DNA degradation is an indicator of low RNA quality, the converse is not true. Finally, we show that despite RIN values as low as 5.0, robust data can be obtained by RNA sequencing that reliably discriminates expression signatures. PMID:27602498

  6. Is post-mortem harm possible? Understanding death harm and grief.

    PubMed

    Tomasini, Floris

    2009-10-01

    The purpose of this article is not to affirm or deny particular philosophical positions, but to explore the limits of intelligibility about what post-mortem harm means, especially in the light of improper post-mortem procedures at Bristol and Alder Hey hospitals in the late 1990s. The parental claims of post-mortem harm to dead children at Alder Hey Hospital are reviewed from five different philosophical perspectives, eventually settling on a crucial difference of perspective about how we understand harm to the dead. On the one hand there is the broadly 'analytical' tradition(1) of thinking that predicates the notion of harm on the basis of an existing subject. Since the dead are non-existent persons, it makes little sense to view the dead as being harmed. On the other hand, there is a phenomenological perspective, where the dead, in respect to the experience of grief, are existentially absent. This forms the basis that it is possible to harm grieving parent's experiences of how their dead are treated. The article ends with a short examination of what harming the dead implies for traditional bioethical concerns, namely, obtaining informed consent from significant others when planning medical research on the newly dead.

  7. Sudden death as a late sequel of Kawasaki disease: postmortem CT demonstration of coronary artery aneurysm.

    PubMed

    Okura, Naoki; Okuda, Takahisa; Shiotani, Seiji; Kohno, Mototsugu; Hayakawa, Hideyuki; Suzuki, Atsuko; Kawasaki, Tomisaku

    2013-02-10

    Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that primarily affects the coronary artery (CA) and presents during childhood. The characteristic coronary arterial lesion of KD is an aneurysm. Ischemic heart disease derived from a CA aneurysm is experienced approximately two decades after the onset of acute KD. In recent years, the primary issue of concern has been asymptomatic adults with a CA aneurysm caused by undiagnosed KD. We present a case of sudden death as a late KD sequel in a young adult. A postmortem CT scan revealed a coarse calcification of a left anterior descending CA aneurysm, which was confirmed at the time of autopsy. A postmortem CT scan is useful in cases of sudden death where the detection of a calcified CA aneurysm would suggest to the forensic pathologist that the deceased suffered from a late sequel of KD. The use of screening postmortem CT scans for young people may detect cases of unsuspected CA aneurysms, raising the possibility of untreated KD.

  8. Forensic diagnosis of ante- and postmortem burn based on aquaporin-3 gene expression in the skin.

    PubMed

    Kubo, Hidemichi; Hayashi, Takahito; Ago, Kazutoshi; Ago, Mihoko; Kanekura, Takuro; Ogata, Mamoru

    2014-05-01

    In order to diagnose death associated with fire, it is essential to show that the person was exposed to heat while still alive. We investigated both AQP1 and AQP3 expression in the skin of an experimental burn model, as well as in forensic autopsy cases, and discuss its role in the differential diagnosis of ante- and postmortem burns. In animal experiments, there was no difference in AQP1 gene expression among four groups (n=4): antemortem burn, postmortem burn, mechanical wound, and control. However, AQP3 expression in the antemortem burn was increased significantly compared with that of the other groups even at 5min after burn. Water content of the skin was decreased significantly by the burn procedure. Consistent with animal experiments, AQP3 gene expression in the skin of antemortem burn cases was increased significantly compared with postmortem burns, mechanical wounds, and controls (n=12 in each group). These observations suggest that dermal AQP3 gene expression was increased to maintain water homeostasis in response to dehydration from burn. Finally, our results suggest that AQP3 gene expression may be useful for forensic molecular diagnosis of antemortem burn.

  9. Non-Cell-Autonomous Postmortem Lignification of Tracheary Elements in Zinnia elegans[W][OA

    PubMed Central

    Pesquet, Edouard; Zhang, Bo; Gorzsás, András; Puhakainen, Tuula; Serk, Henrik; Escamez, Sacha; Barbier, Odile; Gerber, Lorenz; Courtois-Moreau, Charleen; Alatalo, Edward; Paulin, Lars; Kangasjärvi, Jaakko; Sundberg, Björn; Goffner, Deborah; Tuominen, Hannele

    2013-01-01

    Postmortem lignification of xylem tracheary elements (TEs) has been debated for decades. Here, we provide evidence in Zinnia elegans TE cell cultures, using pharmacological inhibitors and in intact Z. elegans plants using Fourier transform infrared microspectroscopy, that TE lignification occurs postmortem (i.e., after TE programmed cell death). In situ RT-PCR verified expression of the lignin monomer biosynthetic cinnamoyl CoA reductase and cinnamyl alcohol dehydrogenase in not only the lignifying TEs but also in the unlignified non-TE cells of Z. elegans TE cell cultures and in living, parenchymatic xylem cells that surround TEs in stems. These cells were also shown to have the capacity to synthesize and transport lignin monomers and reactive oxygen species to the cell walls of dead TEs. Differential gene expression analysis in Z. elegans TE cell cultures and concomitant functional analysis in Arabidopsis thaliana resulted in identification of several genes that were expressed in the non-TE cells and that affected lignin chemistry on the basis of pyrolysis–gas chromatography/mass spectrometry analysis. These data suggest that living, parenchymatic xylem cells contribute to TE lignification in a non-cell-autonomous manner, thus enabling the postmortem lignification of TEs. PMID:23572543

  10. Skin analysis following dermal exposure to kerosene in rats: the effects of postmortem exposure and fire.

    PubMed

    Hieda, Yoko; Tsujino, Yoshio; Xue, Yuying; Takayama, Koji; Fujihara, Junko; Kimura, Kojiro; Dekio, Satoshi

    2004-02-01

    To evaluate the usefulness of skin analysis for the forensic examination of cases involving postmortem dermal exposure to kerosene and/or fire, an experimental study using rats was performed. Rats received dermal exposure to kerosene before or after death, and the effect of fire was determined by burning an area of exposed skin after death. Kerosene concentrations in skin and blood were determined by gas chromatography-mass spectrometry and microscopic observation was performed for skin samples. No differences were observed in skin kerosene levels between antemortem and postmortem exposure. Kerosene concentrations in mildly burned skin where the stratum corneum (SC) was retained were approximately 84% compared to those in non-burned exposed skin, whereas concentrations in severely burned skin where the SC was almost completely burned off were 28% of non-burned skin. Even in non-exposed control skin 14% of the original kerosene concentrations could be detected, which was considered to be caused by contamination during the experimental protocol combined with kerosene's property of a high affinity for the SC. These results suggest that (1) skin analysis is useful in estimating the type of petroleum product involved in crimes or accidents even for postmortem exposure, (2) whether the SC is retained or not primarily determined the kerosene levels in burned skin, and (3) attention must be paid to evaluate the results obtained from skin samples in the light of the circumstances surrounding the case.

  11. Forensic pathological evaluation of postmortem pulmonary CT high-density areas in serial autopsy cases of sudden cardiac death.

    PubMed

    Michiue, Tomomi; Ishikawa, Takaki; Oritani, Shigeki; Kamikodai, Yasunobu; Tsuda, Kohei; Okazaki, Shuji; Maeda, Hitoshi

    2013-10-10

    Previous studies suggested substantial postmortem interference with pulmonary CT findings. The present study evaluated postmortem CT (PM-CT) morphology of the lung, compared with histology, in autopsy cases of sudden cardiac death without recovery from cardiac arrest (SCD, n=22) with regard to the posture at the time of death and postmortem interference from a forensic pathological viewpoint. In witnessed cases (n=5), a case of SCD in a prone position had anterior consolidation with weak hypostatic opacification in the posterior about 18 h later. Among unwitnessed deaths (n=17), 8 cases of death lying prone, sitting facedown and lying laterally had possible gravity-dependent opacity about 15-38 h postmortem. Hypostatic opacification with 'niveau' formation was not evident in more than half of the cases (n=15). Histological findings for ground glass opacification and consolidation on PM-CT varied by case, involving intraalveolar edema and hemorrhages, accompanied by marked congestion; however, possible postmortem hypostatic opacification mostly represented intraalveolar edema. CT morphology of acute pulmonary congestion in SCD may often remain without serious postmortem interference in cases without clinical intervention involving massive fluid infusion, suggesting plain PM-CT findings of the lung to be useful for investigating the death process when combined with histology; however, the possible influence of the hydration status of the lungs at the time of death should be assessed by evaluation of CT and autopsy findings.

  12. External Ballistics. Part 1

    DTIC Science & Technology

    1978-07-11

    clcsely related with aezodyzasics, ky gzavtaetry and the thecry cf the figure of Earth , by metecrology. Ballistic calculatica Sives all the bamic data...external tallistics. %he conteaFcrary state of the sciemce of the action cf rcckets and artillery ste]l cf different t)pes is such, that many of the e...height. L- 14near distance ovX tOf surface of thq Earth . ol - crbital velocity. V-1 - escape velocity. 2v_ - range angle. S- eaight of projqctile. Q

  13. External split field generator

    DOEpatents

    Thundat, Thomas George [Knoxville, TN; Van Neste, Charles W [Kingston, TN; Vass, Arpad Alexander [Oak Ridge, TN

    2012-02-21

    A generator includes a coil disposed about a core. A first stationary magnetic field source may be disposed on a first end portion of the core and a second stationary magnetic field source may be disposed on a second end portion of core. The first and second stationary magnetic field sources apply a stationary magnetic field to the coil. An external magnetic field source may be disposed outside the coil to apply a moving magnetic field to the coil. Electrical energy is generated in response to an interaction between the coil, the moving magnetic field, and the stationary magnetic field.

  14. DIRBE External Calibrator (DEC)

    NASA Technical Reports Server (NTRS)

    Wyatt, Clair L.; Thurgood, V. Alan; Allred, Glenn D.

    1987-01-01

    Under NASA Contract No. NAS5-28185, the Center for Space Engineering at Utah State University has produced a calibration instrument for the Diffuse Infrared Background Experiment (DIRBE). DIRBE is one of the instruments aboard the Cosmic Background Experiment Observatory (COBE). The calibration instrument is referred to as the DEC (Dirbe External Calibrator). DEC produces a steerable, infrared beam of controlled spectral content and intensity and with selectable point source or diffuse source characteristics, that can be directed into the DIRBE to map fields and determine response characteristics. This report discusses the design of the DEC instrument, its operation and characteristics, and provides an analysis of the systems capabilities and performance.

  15. Evaluation of post-mortem oxymetry with reference to the causes of death.

    PubMed

    Maeda, H; Fukita, K; Oritani, S; Ishida, K; Zhu, B L

    1997-06-23

    We examined blood samples of 214 forensic autopsy cases, excluding fire victims, on a CO-oximeter system in order to evaluate post-mortem oxymetric profiles with reference to the causes of death. Oxyhemoglobin (O2-Hb) levels in the left and right heart blood, respectively, ranged from 0 to 97.7% and from 0 to 92.1%, showing no apparent correlation with the post-mortem intervals or rectal temperatures. In nearly 60% of the cases, O2-Hb was lower than 10%. A high O2-Hb level (over 50%) in the left heart blood was most frequently observed in death from cold exposure and occasionally in fatalities from blunt injuries and stab/incised wounds with or without medical care. O2-Hb in the heart blood was usually very low (under 10%) in fatalities from asphyxiation, drowning, poisoning and natural diseases. A greatest oxymetric variation was observed in death from injuries, probably due to varied causal mechanisms of death. In most cases, the differences between blood O2-Hb levels in the heart and iliac vessels were within 15%; whereas O2-Hb in the cerebral venous blood was usually evidently higher than that in the right heart blood. An inverse relation of O2-Hb levels to total hemoglobin contents was observed slightly for the blood in the heart and iliac vessels, and more obviously for the cerebral venous blood. The above post-mortem oxymetric profiles were considered to at least partially reflect the final balance of oxygen uptake and consumption in dying process, possibly also affected by the circulatory status, giving an objective index to the color of cadaveric blood (hypostasis), although it should be assessed in consideration of post-mortem interference and total hemoglobin contents. In any case, however, post-mortem oxymetry seemed to have a limited value owing to severe systemic hypoxia which would be a common final state before death from various fatal traumas and diseases, maybe except for those with extremely short agony.

  16. Swimming in external fields

    NASA Astrophysics Data System (ADS)

    Stark, Holger

    2016-11-01

    Microswimmers move autonomously but are subject to external fields, which influence their swimming path and their collective dynamics. With three concrete examples we illustrate swimming in external fields and explain the methodology to treat it. First, an active Brownian particle shows a conventional sedimentation profile in a gravitational field but with increased sedimentation length and some polar order along the vertical. Bottom-heavy swimmers are able to invert the sedimentation profile. Second, active Brownian particles interacting by hydrodynamic flow fields in a three-dimensional harmonic trap can spontaneously break the isotropic symmetry. They develop polar order, which one can describe by mean-field theory reminiscent to Weiss theory of ferromagnetism, and thereby pump fluid. Third, a single microswimmer shows interesting non-linear dynamics in Poiseuille flow including swinging and tumbling trajectories. For pushers, hydrodynamic interactions with bounding surfaces stabilize either straight swimming against the flow or tumbling close to the channel wall, while pushers always move on a swinging trajectory with a specific amplitude as limit cycle.

  17. [External pancreatic fistulas management].

    PubMed

    Stepan, E V; Ermolov, A S; Rogal', M L; Teterin, Yu S

    2017-01-01

    The main principles of treatment of external postoperative pancreatic fistulas are viewed in the article. Pancreatic trauma was the reason of pancreatic fistula in 38.7% of the cases, operations because of acute pancreatitis - in 25.8%, and pancreatic pseudocyst drainage - in 35.5%. 93 patients recovered after the treatment. Complex conservative treatment of EPF allowed to close fistulas in 74.2% of the patients with normal patency of the main pancreatic duct (MPD). The usage of octreotide 600-900 mcg daily for at least 5 days to decrease pancreatic secretion was an important part of the conservative treatment. Endoscopic papillotomy was performed in patients with major duodenal papilla obstruction and interruption of transporting of pancreatic secretion to duodenum. Stent of the main pancreatic duct was indicated in patients with extended pancreatic duct stenosis to normalize transport of pancreatic secretion to duodenum. Surgical formation of anastomosis between distal part of the main pancreatic duct and gastro-intestinal tract was carried out when it was impossible to fulfill endoscopic stenting of pancreatic duct either because of its interruption and diastasis between its ends, or in the cases of unsuccessful conservative treatment of external pancreatic fistula caused by drainage of pseudocyst.

  18. Bevalac external beamline optics

    SciTech Connect

    Kalnins, J.G.; Krebs, G.F.; Tekawa, M.M.; Alonso, J.R.

    1987-04-01

    This handbook is intended as an aid for tuning the external particle beam (EPB) lines at the Lawrence Berkeley Laboratory's Bevalac. The information contained within will be useful to the Bevalac's Main Control Room and experimenters alike. First, some general information is given concerning the EPB lines and beam optics. Next, each beam line is described in detail: schematics of the beam line components are shown, all the variables required to run a beam transport program are presented, beam envelopes are given with wire chamber pictures and magnet currents, focal points and magnifications. Some preliminary scaling factors are then presented which should aid in choosing a given EPB magnet's current for a given central Bevalac field. Finally, some tuning hints are suggested.

  19. External Measures of Cognition

    PubMed Central

    Cairό, Osvaldo

    2011-01-01

    The human brain is undoubtedly the most impressive, complex, and intricate organ that has evolved over time. It is also probably the least understood, and for that reason, the one that is currently attracting the most attention. In fact, the number of comparative analyses that focus on the evolution of brain size in Homo sapiens and other species has increased dramatically in recent years. In neuroscience, no other issue has generated so much interest and been the topic of so many heated debates as the difference in brain size between socially defined population groups, both its connotations and implications. For over a century, external measures of cognition have been related to intelligence. However, it is still unclear whether these measures actually correspond to cognitive abilities. In summary, this paper must be reviewed with this premise in mind. PMID:22065955

  20. Hanford External Dosimetry Program

    SciTech Connect

    Fix, J.J.

    1990-10-01

    This document describes the Hanford External Dosimetry Program as it is administered by Pacific Northwest Laboratory (PNL) in support of the US Department of Energy (DOE) and its Hanford contractors. Program services include administrating the Hanford personnel dosimeter processing program and ensuring that the related dosimeter data accurately reflect occupational dose received by Hanford personnel or visitors. Specific chapters of this report deal with the following subjects: personnel dosimetry organizations at Hanford and the associated DOE and contractor exposure guidelines; types, characteristics, and procurement of personnel dosimeters used at Hanford; personnel dosimeter identification, acceptance testing, accountability, and exchange; dosimeter processing and data recording practices; standard sources, calibration factors, and calibration processes (including algorithms) used for calibrating Hanford personnel dosimeters; system operating parameters required for assurance of dosimeter processing quality control; special dose evaluation methods applied for individuals under abnormal circumstances (i.e., lost results, etc.); and methods for evaluating personnel doses from nuclear accidents. 1 ref., 14 figs., 5 tabs.

  1. External Community Review Committee:

    PubMed Central

    Smith, Maureen A.; Kaufman, Nancy J.; Dearlove, Andrea J.

    2013-01-01

    Background: Major gaps exist between what we know and what we do in clinical practice and community health programs and narrowing this gap will require substantive partnerships between academic researchers and the communities they serve. Objectives: We describe a research pilot award program that makes a unique commitment to community engagement through the addition of an External Community Review Committee to the typical research review process that gives external stakeholders decision-making power over research funding. Methods: Whereas engaging community reviewers in discussion and rating of research proposals is not novel, the ICTR ECRC review process is distinct in that it is subsequent to peer review and uses different criteria and methodology. This method of engagement allows for the community review panel to re-rank scientifically meritorious proposals—such that proposals funded do not necessarily follow the rank order from scientific peer review. The approach taken by UW ICTR differs from those discussed in the literature that present a model of community-academic co-review. Results: This article provides guidance for others interested in this model of community engagement and reviews insights gained during the evolution of this strategy; including how we addressed conflict, how the committee was able to change the pilot award program over time, and individual roles that were crucial to the success of this approach. Conclusions: The advantages of this approach include success through traditional academic metrics while achieving an innovative shared-power mechanism for community engagement which we believe is critical for narrowing the gap between knowledge and practice. PMID:24056512

  2. Meat quality and rigor mortis development in broiler chickens with gas-induced anoxia and postmortem electrical stimulation.

    PubMed

    Sams, A R; Dzuik, C S

    1999-10-01

    This study was conducted to evaluate the combined rigor-accelerating effects of postmortem electrical stimulation (ES) and argon-induced anoxia (Ar) of broiler chickens. One hundred broilers were processed in the following treatments: untreated controls, ES, Ar, or Ar with ES (Ar + ES). Breast fillets were harvested at 1 h postmortem for all treatments or at 1 and 6 h postmortem for the control carcasses. Fillets were sampled for pH and ratio of inosine to adenosine (R-value) and were then individually quick frozen (IQF) or aged on ice (AOI) until 24 h postmortem. Color was measured in the AOI fillets at 24 h postmortem. All fillets were then cooked and evaluated for Allo-Kramer shear value. The Ar treatment accelerated the normal pH decline, whereas the ES and AR + ES treatments yielded even lower pH values at 1 h postmortem. The Ar + ES treatment had a greater R-value than the ES treatment, which was greater than either the Ar or 1-h controls, which, in turn, were not different from each other. The ES treatment had the lowest L* value, and ES, Ar, and Ar + ES produced significantly higher a* values than the 1-h controls. For the IQF fillets, the ES and Ar + ES treatments were not different in shear value but were lower than Ar, which was lower than the 1-h controls. The same was true for the AOI fillets except that the ES and the Ar treatments were not different. These results indicated that although ES and Ar had rigor-accelerating and tenderizing effects, ES seemed to be more effective than Ar; there was little enhancement when Ar was added to the ES treatment and fillets were deboned at 1 h postmortem.

  3. Post-mortem computed tomography and 3D imaging: anthropological applications for juvenile remains.

    PubMed

    Brough, Alison L; Rutty, Guy N; Black, Sue; Morgan, Bruno

    2012-09-01

    Anthropological examination of defleshed bones is routinely used in medico-legal investigations to establish an individual's biological profile. However, when dealing with the recently deceased, the removal of soft tissue from bone can be an extremely time consuming procedure that requires the presence of a trained anthropologist. In addition, due to its invasive nature, in some disaster victim identification scenarios the maceration of bones is discouraged by religious practices and beliefs, or even prohibited by national laws and regulations. Currently, three different radiological techniques may be used in the investigative process; plain X-ray, dental X-ray and fluoroscopy. However, recent advances in multi-detector computed tomography (MDCT) mean that it is now possible to acquire morphological skeletal information from high resolution images, reducing the necessity for invasive procedures. This review paper considers the possible applications of a virtual anthropological examination by reviewing the main juvenile age determination methods used by anthropologists at present and their possible adaption to MDCT.

  4. Analysis of sertraline in postmortem fluids and tissues in 11 aviation accident victims.

    PubMed

    Lewis, Russell J; Angier, Mike K; Williamson, Kelly S; Johnson, Robert D

    2013-05-01

    Sertraline (Zoloft) is a selective serotonin reuptake inhibitor that is a commonly prescribed drug for the treatment of depression, obsessive-compulsive disorder, panic disorder, social anxiety disorder, premenstrual dysphoric disorder and post-traumatic stress disorder. Although the use of sertraline is relatively safe, certain side effects may negatively affect a pilot's performance and become a factor in an aviation accident. The authors' laboratory investigated the distribution of sertraline and its primary metabolite, desmethylsertraline, in various postmortem tissues and fluids obtained from 11 fatal aviation accident cases between 2001 and 2004. Eleven specimen types were analyzed for each case, including blood, urine, vitreous humor, liver, lung, kidney, spleen, muscle, brain, heart and bile. Human specimens were processed utilizing solid-phase extraction, followed by characterization and quantitation employing gas chromatography-mass spectrometry. Whole blood sertraline concentrations obtained from these 11 cases ranged from 0.005 to 0.392 µg/mL. The distribution coefficients of sertraline, expressed as specimen/blood ratio, were as follows: urine, 0.47 ± 0.39 (n = 6); vitreous humor, 0.02 ± 0.01 (n = 4); liver, 74 ± 59 (n = 11); lung, 67 ± 45 (n = 11); kidney, 7.4 ± 5 (n = 11); spleen, 46 ± 45 (n = 10); muscle, 2.1 ± 1.3 (n = 8); brain, 22 ± 14 (n = 10); heart, 9 ± 7 (n = 11); and bile, 36 ± 26 (n = 8). Postmortem distribution coefficients obtained for sertraline had coefficients of variation ranging from 47-99%. This study suggests that sertraline likely undergoes significant postmortem redistribution.

  5. Radiologic-Histopathologic Correlation of Cerebral Microbleeds Using Pre-Mortem and Post-Mortem MRI

    PubMed Central

    Montandon, Marie-Louise; Lazeyras, François; Scheffler, Max; Meckel, Stephan; Herrmann, Francois R.; Giannakopoulos, Panteleimon; Kövari, Enikö

    2016-01-01

    Introduction Cerebral microbleeds (CMB), also known as cerebral microhemorrhages, are small areas of susceptibility on brain magnetic resonance imaging (MRI), that are increasingly detected due to the higher availability of high-field MRI systems and dedicated pulse sequences. The prevalence of CMBs increases in cases with cognitive decline. The current investigation assessed the poorly investigated radiologic–histopathologic correlation of CMBs on MRI. Methods The local ethical committee approved the current investigation. We retrospectively assessed a consecutive series of 1303 autopsy cases hospitalized in Geneva University Hospitals between 2000–2014. Of 112 cases with pre-mortem T2* sequences, we included 25 cases (mean age 77.3 ± 9.6, 9 females) with at least one CMB. We compared pre-mortem CMBs with targeted histopathology and post-mortem MRI. Results 25 cases had 31 CMB lesions detected by pre-mortem MRI. 25 additional CMB were detected on histopathology. 4 CMBs on pre-mortem MRI were false positives, resulting in a total of 52 CMBs. 27 CMBs on pre-mortem MRI were confirmed on histopathology, corresponding to a sensitivity or true positive rate of 51.9% (95% CI 37.6–66.0%). The false negative rate of pre-mortem MRI was 48.1% (95% CI 34.0–62.4%). Post-mortem MRI showed only 3 cases with additional CMBs. Overall, pre-mortem MRI significantly underestimated CMBs (p = 0.0001). Conclusions Routine clinical brain MRI underestimates the prevalence of CMBs by approximately 50%, and 12% of radiologic pre-mortem MRI CMBs were false positives. Post-mortem MRI confirmed that this discordance is not explained by microbleeds occurring after the pre-mortem MRI. PMID:27936213

  6. Factors impacting the success of post-mortem sperm rescue in the rhinoceros.

    PubMed

    Roth, T L; Stoops, M A; Robeck, T R; O'Brien, J K

    2016-04-01

    The goal of this study was to identify factors that influenced the ability to successfully rescue sperm post-mortem from rhinoceroses maintained in North American zoos. Factors considered included procedural technicalities, individual rhinoceros characteristics and timing. Gross testicular pathology was noted in 17.4% of males (4/23) but did not impact sperm recovery except in one case of azoospermia (4.3%). Of the males in which sperm recovery was attempted (n=21), 62% yielded quality samples considered adequate for cryopreservation (≥ 30% motility with ≥ 2.0 forward progressive status). A high percentage of males (70.6%; 12/17) from which reproductive tissue was removed an d cooled ≤ 4 h after death yielded quality sperm samples, whereas only 25% (1/4) of males from which tissue was removed>4h after death yielded quality samples. Quality samples were recovered 1-51 h post-mortem from rhinoceroses 8 to 36 years old. Neither type of illness (prolonged or acute), or method of death (euthanasia or natural) affected the ability to harvest quality samples (P > 0.05). The Indian rhinoceros yielded significantly more sperm on average (40 × 10(9)) than the African black rhinoceros (3.6 × 10(9); P < 0.01) and the African white rhinoceros (3.2 × 10(9); P < 0.05). Across all species and samples assessed (n = 11), mean post-thaw sperm motility (41%), was only 15% less than pre-freeze motility (56%) and only decreased to 22% during the 6h post-thaw assessment period. Rhinoceros sperm rescue post-mortem is relatively successful across a wide range of variables, especially when tissues are removed and cooled promptly after death, and should be considered standard practice among zoos.

  7. Postmortem changes in the neuroanatomical characteristics of the primate brain: the hippocampal formation

    PubMed Central

    Lavenex, Pierre; Lavenex, Pamela Banta; Bennett, Jeffrey L.; Amaral, David G.

    2009-01-01

    Comparative studies of the structural organization of the brain are fundamental to our understanding of human brain function. However, whereas brains of experimental animals are fixed by perfusion of a fixative through the vasculature, human or ape brains are fixed by immersion after varying postmortem intervals. Although differential treatments might affect the fundamental characteristics of the tissue, this question has not been evaluated empirically in primate brains. Monkey brains were either perfused, or acquired after varying postmortem intervals before immersion-fixation in 4% paraformaldehyde. We found that the fixation method affected the neuroanatomical characteristics of the monkey hippocampal formation. Soma size was smaller in Nissl-stained, immersion-fixed tissue, although overall brain volume was larger, as compared to perfusion-fixed tissue. Non-phosphorylated high-molecular-weight neurofilament immunoreactivity was lower in CA3 pyramidal neurons, dentate mossy cells and the entorhinal cortex, whereas it was higher in the mossy fiber pathway in immersion-fixed tissue. Serotonin-immunoreactive fibers were well-stained in perfused tissue but were undetectable in immersion-fixed tissue. Although regional immunoreactivity patterns for calcium-binding proteins were not affected, intracellular staining degraded with increasing postmortem intervals. Somatostatin-immunoreactive clusters of large axonal varicosities, previously reported only in humans, were observed in immersion-fixed monkey tissue. In addition, calretinin-immunoreactive multipolar neurons, previously observed only in rodents, were found in the rostral dentate gyrus in both perfused and immersion-fixed brains. In conclusion, comparative studies of the brain must evaluate the effects of fixation on the staining pattern of each marker in every structure of interest before drawing conclusions about species differences. PMID:18972553

  8. Histology-derived volumetric annotation of the human hippocampal subfields in postmortem MRI.

    PubMed

    Adler, Daniel H; Pluta, John; Kadivar, Salmon; Craige, Caryne; Gee, James C; Avants, Brian B; Yushkevich, Paul A

    2014-01-01

    Recently, there has been a growing effort to analyze the morphometry of hippocampal subfields using both in vivo and postmortem magnetic resonance imaging (MRI). However, given that boundaries between subregions of the hippocampal formation (HF) are conventionally defined on the basis of microscopic features that often lack discernible signature in MRI, subfield delineation in MRI literature has largely relied on heuristic geometric rules, the validity of which with respect to the underlying anatomy is largely unknown. The development and evaluation of such rules are challenged by the limited availability of data linking MRI appearance to microscopic hippocampal anatomy, particularly in three dimensions (3D). The present paper, for the first time, demonstrates the feasibility of labeling hippocampal subfields in a high resolution volumetric MRI dataset based directly on microscopic features extracted from histology. It uses a combination of computational techniques and manual post-processing to map subfield boundaries from a stack of histology images (obtained with 200μm spacing and 5μm slice thickness; stained using the Kluver-Barrera method) onto a postmortem 9.4Tesla MRI scan of the intact, whole hippocampal formation acquired with 160μm isotropic resolution. The histology reconstruction procedure consists of sequential application of a graph-theoretic slice stacking algorithm that mitigates the effects of distorted slices, followed by iterative affine and diffeomorphic co-registration to postmortem MRI scans of approximately 1cm-thick tissue sub-blocks acquired with 200μm isotropic resolution. These 1cm blocks are subsequently co-registered to the MRI of the whole HF. Reconstruction accuracy is evaluated as the average displacement error between boundaries manually delineated in both the histology and MRI following the sequential stages of reconstruction. The methods presented and evaluated in this single-subject study can potentially be applied to multiple

  9. Role of extracellular matrix in development of skeletal muscle and postmortem aging of meat.

    PubMed

    Nishimura, Takanori

    2015-11-01

    The integrity of skeletal muscle is maintained by the intramuscular connective tissues (IMCTs) that are composed of extracellular matrix (ECM) molecules such as collagens, proteoglycans, and glycoproteins. The ECM plays an important role not only in providing biomechanical strength of the IMCT, but also in regulating muscle cell behavior. Some ECM molecules, such as decorin and laminin, modulate the activity of myostatin that regulates skeletal muscle mass. Furthermore, it has been shown that decorin activates Akt downstream of insulin-like growth factor-I receptor (IGF-IR) and enhances the differentiation of myogenic cells, suggesting that decorin acts as a signaling molecule to myogenic cells. With animal growth, the structural integrity of IMCT increases; collagen fibrils within the endomysium associate more closely with each other, and the collagen fibers in the perimysium become increasingly thick and their wavy pattern grows more regular. These changes increase the mechanical strength of IMCT, contributing to the toughening of meat. However, in highly marbled beef cattle like Wagyu, intramuscular fat deposits mainly in the perimysium between muscle fiber bundles during the fattening period. The development of adipose tissues appears to disorganize the structure of IMCT and contributes to the tenderness of Wagyu beef. The IMCT was considered to be rather immutable compared to myofibrils during postmortem aging of meat. However, several studies have shown that collagen networks in the IMCT are disintegrated and proteoglycan components are degraded during postmortem aging. These changes in ECM appear to reduce the mechanical strength of IMCT and contribute to the tenderness of uncooked meat or cooked meat at low temperature. Thus, the ECM plays a multifunctional role in skeletal muscle development and postmortem aging of meat.

  10. Post-mortem detection of gasoline residues in lung tissue and heart blood of fire victims.

    PubMed

    Pahor, Kevin; Olson, Greg; Forbes, Shari L

    2013-09-01

    The purpose of this study was to determine whether gasoline residues could be detected post-mortem in lung tissue and heart blood of fire victims. The lungs and heart blood were investigated to determine whether they were suitable samples for collection and could be collected without contamination during an autopsy. Three sets of test subjects (pig carcasses) were investigated under two different fire scenarios. Test subjects 1 were anaesthetized following animal ethics approval, inhaled gasoline vapours for a short period and then euthanized. The carcasses were clothed and placed in a house where additional gasoline was poured onto the carcass post-mortem in one fire, but not in the other. Test subjects 2 did not inhale gasoline, were clothed and placed in the house and had gasoline poured onto them in both fires. Test subjects 3 were clothed but had no exposure to gasoline either ante- or post-mortem. Following controlled burns and suppression with water, the carcasses were collected, and their lungs and heart blood were excised at a necropsy. The headspace from the samples was analysed using thermal desorption-gas chromatography-mass spectroscopy. Gasoline was identified in the lungs and heart blood from the subjects that were exposed to gasoline vapours prior to death (test subjects 1). All other samples were negative for gasoline residues. These results suggest that it is useful to analyse for volatile ignitable liquids in lung tissue and blood as it may help to determine whether a victim was alive and inhaling gases at the time of a fire.

  11. Breast Tissue Characterization with Photon-counting Spectral CT Imaging: A Postmortem Breast Study

    PubMed Central

    Ding, Huanjun; Klopfer, Michael J.; Ducote, Justin L.; Masaki, Fumitaro

    2014-01-01

    Purpose To investigate the feasibility of breast tissue characterization in terms of water, lipid, and protein contents with a spectral computed tomographic (CT) system based on a cadmium zinc telluride (CZT) photon-counting detector by using postmortem breasts. Materials and Methods Nineteen pairs of postmortem breasts were imaged with a CZT-based photon-counting spectral CT system with beam energy of 100 kVp. The mean glandular dose was estimated to be in the range of 1.8–2.2 mGy. The images were corrected for pulse pile-up and other artifacts by using spectral distortion corrections. Dual-energy decomposition was then applied to characterize each breast into water, lipid, and protein contents. The precision of the three-compartment characterization was evaluated by comparing the composition of right and left breasts, where the standard error of the estimations was determined. The results of dual-energy decomposition were compared by using averaged root mean square to chemical analysis, which was used as the reference standard. Results The standard errors of the estimations of the right-left correlations obtained from spectral CT were 7.4%, 6.7%, and 3.2% for water, lipid, and protein contents, respectively. Compared with the reference standard, the average root mean square error in breast tissue composition was 2.8%. Conclusion Spectral CT can be used to accurately quantify the water, lipid, and protein contents in breast tissue in a laboratory study by using postmortem specimens. © RSNA, 2014 PMID:24814180

  12. The effect of postmortem time on the RNA quality of human ocular tissues

    PubMed Central

    Kim, Byung-Jin; Sprehe, Nicholas; Morganti, Ashley; Wordinger, Robert J.

    2013-01-01

    Purpose Profiling gene expression in human ocular tissues provides invaluable information for understanding ocular biology and investigating numerous ocular diseases. Accurate measurement of gene expression requires high-quality RNA, which often is a challenge with postmortem ocular tissues. Methods We examined the effect of various death to preservation (DP) times on the RNA quality of ten different ocular tissues. We used 16 eyes from eight different human donors. The eyes were preserved immediately in RNAlater or preserved after initial storage at 4 °C to create a range of DP times from 2 to 48 h. Ten ocular tissues were dissected from each eye. After total RNA was extracted from each dissected ocular tissue, the RNA integrity number (RIN) was determined using an Agilent Bioanalyzer. Results The RIN values from corneal and trabecular meshwork tissues were significantly (p<0.05) higher than those from the ciliary body at an earlier DP time (<6 h), but were not different among all tissues after 8 h. Interestingly, the RIN values from non-vascularized tissues were significantly (p=0.0002) higher than those from vascularized ocular tissues at early DP times (<6 h). The RIN value from the cornea was significantly (p<0.05) higher at short DP times compared to longer DP times. The RIN values from corneal tissues were significantly correlated to DP time according to regression analysis (p<0.05). Conclusions In this study, we determined RNA quality from postmortem ocular tissues with various DP times. Our results emphasize the need for rapid preservation and processing of postmortem human donor eye tissues, especially for vascularized ocular tissues. PMID:23805035

  13. Histology-derived volumetric annotation of the human hippocampal subfields in postmortem MRI

    PubMed Central

    Adler, Daniel H.; Pluta, John; Kadivar, Salmon; Craige, Caryne; Gee, James C.; Avants, Brian B.; Yushkevich, Paul A.

    2013-01-01

    Recently, there has been a growing effort to analyze the morphometry of hippocampal subfields using both in vivo and postmortem magnetic resonance imaging (MRI). However, given that boundaries between subregions of the hippocampal formation (HF) are conventionally defined on the basis of microscopic features that often lack discernible signature in MRI, subfield delineation in MRI literature has largely relied on heuristic geometric rules, the validity of which with respect to the underlying anatomy is largely unknown. The development and evaluation of such rules is challenged by the limited availability of data linking MRI appearance to microscopic hippocampal anatomy, particularly in three dimensions (3D). The present paper, for the first time, demonstrates the feasibility of labeling hippocampal subfields in a high resolution volumetric MRI dataset based directly on microscopic features extracted from histology. It uses a combination of computational techniques and manual post-processing to map subfield boundaries from a stack of histology images (obtained with 200 μm spacing and 5 μm slice thickness; stained using the Kluver-Barrera method) onto a postmortem 9.4 Tesla MRI scan of the intact, whole hippocampal formation acquired with 160 μm isotropic resolution. The histology reconstruction procedure consists of sequential application of a graph-theoretic slice stacking algorithm that mitigates the effects of distorted slices, followed by iterative affine and diffeomorphic co-registration to postmortem MRI scans of approximately 1 cm-thick tissue sub-blocks acquired with 200 μm isotropic resolution. These 1 cm blocks are subsequently co-registered to the MRI of the whole HF. Reconstruction accuracy is evaluated as the average displacement error between boundaries manually delineated in both the histology and MRI following the sequential stages of reconstruction. The methods presented and evaluated in this single-subject study can potentially be applied to

  14. A combined post-mortem magnetic resonance imaging and quantitative histological study of multiple sclerosis pathology.

    PubMed

    Kolasinski, James; Stagg, Charlotte J; Chance, Steven A; Deluca, Gabriele C; Esiri, Margaret M; Chang, Eun-Hyuk; Palace, Jacqueline A; McNab, Jennifer A; Jenkinson, Mark; Miller, Karla L; Johansen-Berg, Heidi

    2012-10-01

    Multiple sclerosis is a chronic inflammatory neurological condition characterized by focal and diffuse neurodegeneration and demyelination throughout the central nervous system. Factors influencing the progression of pathology are poorly understood. One hypothesis is that anatomical connectivity influences the spread of neurodegeneration. This predicts that measures of neurodegeneration will correlate most strongly between interconnected structures. However, such patterns have been difficult to quantify through post-mortem neuropathology or in vivo scanning alone. In this study, we used the complementary approaches of whole brain post-mortem magnetic resonance imaging and quantitative histology to assess patterns of multiple sclerosis pathology. Two thalamo-cortical projection systems were considered based on their distinct neuroanatomy and their documented involvement in multiple sclerosis: lateral geniculate nucleus to primary visual cortex and mediodorsal nucleus of the thalamus to prefrontal cortex. Within the anatomically distinct thalamo-cortical projection systems, magnetic resonance imaging derived cortical thickness was correlated significantly with both a measure of myelination in the connected tract and a measure of connected thalamic nucleus cell density. Such correlations did not exist between these markers of neurodegeneration across different thalamo-cortical systems. Magnetic resonance imaging lesion analysis depicted clearly demarcated subcortical lesions impinging on the white matter tracts of interest; however, quantitation of the extent of lesion-tract overlap failed to demonstrate any appreciable association with the severity of markers of diffuse pathology within each thalamo-cortical projection system. Diffusion-weighted magnetic resonance imaging metrics in both white matter tracts were correlated significantly with a histologically derived measure of tract myelination. These data demonstrate for the first time the relevance of functional

  15. Utility of real-time Taqman PCR for antemortem and postmortem diagnosis of human rabies.

    PubMed

    Mani, Reeta Subramaniam; Madhusudana, Shampur Narayan; Mahadevan, Anita; Reddy, Vijayalakshmi; Belludi, Ashwin Yajaman; Shankar, Susarla Krishna

    2014-10-01

    Rabies, a fatal zoonotic viral encephalitis remains a neglected disease in India despite a high disease burden. Laboratory confirmation is essential, especially in patients with paralytic rabies who pose a diagnostic dilemma. However, conventional tests for diagnosis of rabies have several limitations. In the present study the utility of a real-time TaqMan PCR assay was evaluated for antemortem/postmortem diagnosis of rabies. Human clinical samples received for antemortem rabies diagnosis (CSF, saliva, nuchal skin biopsy, serum), and samples obtained postmortem from laboratory confirmed rabies in humans (brain tissue, CSF, serum) and animals (brain tissue) were included in the study. All CSF and sera were tested for rabies viral neutralizing antibodies (RVNA) by rapid fluorescent focus inhibition test (RFFIT) and all samples (except sera) were processed for detection of rabies viral RNA by real-time TaqMan PCR. All the 29 (100%) brain tissues from confirmed cases of human and animal rabies, and 11/14 (78.5%) CSF samples obtained postmortem from confirmed human rabies cases were positive by real-time TaqMan PCR. Rabies viral RNA was detected in 5/11 (45.4%) CSF samples, 6/10 (60%) nuchal skin biopsies, and 6/7 (85.7%) saliva samples received for antemortem diagnosis. Real-time TaqMan PCR alone could achieve antemortem rabies diagnosis in 11/13 (84.6%) cases; combined with RVNA detection in CSF antemortem rabies diagnosis could be achieved in all 13 (100%) cases. Real-time TaqMan PCR should be made available widely as an adjunctive test for diagnosis of human rabies in high disease burden countries like India.

  16. Postmortem distribution of α-pyrrolidinobutiophenone in body fluids and solid tissues of a human cadaver.

    PubMed

    Wurita, Amin; Hasegawa, Koutaro; Minakata, Kayoko; Gonmori, Kunio; Nozawa, Hideki; Yamagishi, Itaru; Suzuki, Osamu; Watanabe, Kanako

    2014-09-01

    We experienced an autopsy case of a 21-year-old male Caucasian, in which the direct cause of his death was judged as subarachnoid hemorrhage. There was cerebral arteriovenous malformation, which seemed related to the subarachnoid hemorrhage. The postmortem interval was estimated to be about 2days. By our drug screening test using gas chromatography-mass spectrometry, we could identify α-pyrrolidinobutiophenone (α-PBP) in his urine specimen, which led us to investigate the postmortem distribution of α-PBP in this deceased. The specimens dealt with were right heart blood, left heart blood, femoral vein blood, cerebrospinal fluid, urine, stomach contents and five solid tissues. The extraction of α-PBP and α-pyrrolidinovalerophenone (α-PVP, internal standard) was performed by a modified QuEChERS (quick, easy, cheap, effective, rugged and safe) method, followed by the analysis by liquid chromatography-tandem mass spectrometry. Because this study included various kinds of human matrices, we used the standard addition method to overcome the matrix effects. The highest concentration was found in urine, followed by stomach contents, the kidney, lung, spleen, pancreas and liver. The blood concentrations were about halves of those of the solid tissues. The high concentrations of α-PBP in urine and the kidney suggest that the drug tends to be rapidly excreted into urine via the kidney after its absorption into the blood stream. The urine specimen is of the best choice for analysis. This is the first report describing the postmortem distribution of α-PBP in a human to our knowledge.

  17. Post-mortem histopathology underlying β-amyloid PET imaging following flutemetamol F 18 injection.

    PubMed

    Ikonomovic, Milos D; Buckley, Chris J; Heurling, Kerstin; Sherwin, Paul; Jones, Paul A; Zanette, Michelle; Mathis, Chester A; Klunk, William E; Chakrabarty, Aruna; Ironside, James; Ismail, Azzam; Smith, Colin; Thal, Dietmar R; Beach, Thomas G; Farrar, Gill; Smith, Adrian P L

    2016-12-12

    In vivo imaging of fibrillar β-amyloid deposits may assist clinical diagnosis of Alzheimer's disease (AD), aid treatment selection for patients, assist clinical trials of therapeutic drugs through subject selection, and be used as an outcome measure. A recent phase III trial of [(18)F]flutemetamol positron emission tomography (PET) imaging in 106 end-of-life subjects demonstrated the ability to identify fibrillar β-amyloid by comparing in vivo PET to post-mortem histopathology. Post-mortem analyses demonstrated a broad and continuous spectrum of β-amyloid pathology in AD and other dementing and non-dementing disease groups. The GE067-026 trial demonstrated 91% sensitivity and 90% specificity of [(18)F]flutemetamol PET by majority read for the presence of moderate or frequent plaques. The probability of an abnormal [(18)F]flutemetamol scan increased with neocortical plaque density and AD diagnosis. All dementia cases with non-AD neurodegenerative diseases and those without histopathological features of β-amyloid deposits were [(18)F]flutemetamol negative. Majority PET assessments accurately reflected the amyloid plaque burden in 90% of cases. However, ten cases demonstrated a mismatch between PET image interpretations and post-mortem findings. Although tracer retention was best associated with amyloid in neuritic plaques, amyloid in diffuse plaques and cerebral amyloid angiopathy best explain three [(18)F]flutemetamol positive cases with mismatched (sparse) neuritic plaque burden. Advanced cortical atrophy was associated with the seven false negative [(18)F]flutemetamol images. The interpretation of images from pathologically equivocal cases was associated with low reader confidence and inter-reader agreement. Our results support that amyloid in neuritic plaque burden is the primary form of β-amyloid pathology detectable with [(18)F]flutemetamol PET imaging. ClinicalTrials.gov NCT01165554. Registered June 21, 2010; NCT02090855. Registered March 11, 2014.

  18. Increased Lactate Levels and Reduced pH in Postmortem Brains of Schizophrenics: Medication Confounds

    PubMed Central

    Halim, Nader D.; Lipska, Barbara K.; Hyde, Thomas M.; Deep-Soboslay, Amy; Saylor, E. Michael; Herman, Mary; Thakar, Jay; Verma, Ajay; Kleinman, Joel E.

    2008-01-01

    A number of postmortem studies have found decreased pH in brains of patients with schizophrenia. Insofar as lower pH has been associated with decreased mRNA expression in postmortem human brain, decreased pH in schizophrenia may represent an important potential confound in comparisons between patients and controls. We hypothesized that decreased pH may be related to increased concentration of lactic acid. However, in contrast to the previous notion that an increase in lactic acid represents evidence for primary metabolic abnormalities in schizophrenia, we hypothesized that this increase is secondary to prior antipsychotic treatment. We have tested this by first demonstrating that lactate levels in the cerebellum of patients with schizophrenia (n=35) are increased relative to control subjects (n=42) by 28%, p=0.001. Second, we have shown that there is an excellent correlation between lactate levels in the cerebellum and pH, and that this correlation is particularly strong in patients (r=− 0.78, p=3e-6). Third, we have shown in rats that chronic haloperidol (0.8 mg/kg/day) and clozapine (5 mg/kg/day) increase lactic acid concentration in the frontal cortex relative to vehicle (by 31% and 22% respectively, p<0.01). These data suggest that lactate increases in postmortem human brain of patients with schizophrenia are associated with decreased pH and that these changes are possibly related to antipsychotic treatment rather than a primary metabolic abnormality in the prefrontal cortex of patients with schizophrenia. PMID:18177946

  19. A Case Report of Postmortem Radiography of Acute, Fatal Abdominal Distension After Binge Eating.

    PubMed

    Usui, Akihito; Kawasumi, Yusuke; Ishizuka, Yuya; Hosokai, Yoshiyuki; Ikeda, Tomoya; Saito, Haruo; Funayama, Masato

    2016-12-01

    This case report describes a woman who developed fatal gastric dilatation after binge eating. She called an ambulance because of stomach pain. When she arrived at the hospital, she did not look seriously ill. However, she rapidly became unconscious and collapsed immediately after she was laid on the examination table in a supine position. Postmortem chest x-ray and computed tomography showed right shift of the mediastinum and raised left diaphragm caused by massive gastric distension. Computed tomography showed no visible inferior vena cava. We think that her sudden deterioration was caused by movement of her stomach contents. Radiographic images provided some clues to the cause of her rapid collapse and death.

  20. Post-mortem study of the hip joint. III. Correlations between observations.

    PubMed Central

    Byers, P D; Contepomi, C A; Farkas, T A

    1976-01-01

    Correlations between alterations in hip joints, described in a post-mortem study, have established the independence of limited and progressive alterations, and in addition have shown that there is a weak association between limited alterations and osteophytes and a strong one between progressive alterations and osteophytes. Nevertheless limited alterations may rarely undergo progressive damage. Cysts relate strongly to osteophytes but only moderately with progressive alterations. Limited alterations of both head and acetabulum can be subdivided. Some implications of these findings are discussed. PMID:942267

  1. Determination of postmortem interval by arthropod succession: a case study from the Hawaiian Islands.

    PubMed

    Goff, M L; Flynn, M M

    1991-03-01

    A postmortem interval of 34 to 36 days was established for remains recovered on the island of Oahu, Hawaii, based on interpretations of patterns of arthropod succession on the remains. This interval was primarily based on the presence of adult specimens of Philonthus longicornis (family Staphylinidae), mature larvae of Piophila casei (family Piophilidae), and empty puparial cases of Chrysomya rufifacies (family Calliphoridae). Species and developmental stages of two additional Coleoptera species and three additional Diptera species were also present, which was consistent with the estimated interval, although not definitive.

  2. Autoradiographic analysis of alpha 1-noradrenergic receptors in the human brain postmortem. Effect of suicide

    SciTech Connect

    Gross-Isseroff, R.; Dillon, K.A.; Fieldust, S.J.; Biegon, A. )

    1990-11-01

    In vitro quantitative autoradiography of alpha 1-noradrenergic receptors, using tritiated prazosin as a ligand, was performed on 24 human brains postmortem. Twelve brains were obtained from suicide victims and 12 from matched controls. We found significant lower binding to alpha 1 receptors in several brain regions of the suicide group as compared with matched controls. This decrease in receptor density was evident in portions of the prefrontal cortex, as well as the temporal cortex and in the caudate nucleus. Age, sex, presence of alcohol, and time of death to autopsy did not affect prazosin binding, in our sample, as measured by autoradiography.

  3. Post-mortem re-cloning of a transgenic red fluorescent protein dog.

    PubMed

    Hong, So Gun; Koo, Ok Jae; Oh, Hyun Ju; Park, Jung Eun; Kim, Minjung; Kim, Geon-A; Park, Eun Jung; Jang, Goo; Lee, Byeong-Chun

    2011-12-01

    Recently, the world's first transgenic dogs were produced by somatic cell nuclear transfer. However, cellular senescence is a major limiting factor for producing more advanced transgenic dogs. To overcome this obstacle, we rejuvenated transgenic cells using a re-cloning technique. Fibroblasts from post-mortem red fluorescent protein (RFP) dog were reconstructed with in vivo matured oocytes and transferred into 10 surrogate dogs. One puppy was produced and confirmed as a re-cloned dog. Although the puppy was lost during birth, we successfully established a rejuvenated fibroblast cell line from this animal. The cell line was found to stably express RFP and is ready for additional genetic modification.

  4. Postmortem findings from Dugong (Dugong dugon) submissions to the University of Queensland: 1997-2010.

    PubMed

    Owen, Helen; Gillespie, Alison; Wilkie, Ian

    2012-10-01

    To better record and characterize mortality in the declining population of dugong (Dugong dugon) in southeast Queensland, Australia, animals were collected and brought to the University of Queensland for postmortem examination. Fifty-five animals were examined over a 14-yr period. Human activities commonly caused the animal death. Several deaths were attributed to primary or secondary infections and idiopathic and degenerative diseases. A significant proportion of animals were found to have nonspecific signs of chronic debility, but the causes of disease and mortality in these cases remains to be identified.

  5. Meta-analysis of brain iron levels of Parkinson’s disease patients determined by postmortem and MRI measurements

    PubMed Central

    Wang, Jian-Yong; Zhuang, Qing-Qing; Zhu, Lan-Bing; Zhu, Hui; Li, Ting; Li, Rui; Chen, Song-Fang; Huang, Chen-Ping; Zhang, Xiong; Zhu, Jian-Hong

    2016-01-01

    Brain iron levels in patients of Parkinson’s disease (PD) are usually measured in postmortem samples or by MRI imaging including R2* and SWI. In this study we performed a meta-analysis to understand PD-associated iron changes in various brain regions, and to evaluate the accuracy of MRI detections comparing with postmortem results. Databases including Medline, Web of Science, CENTRAL and Embase were searched up to 19th November 2015. Ten brain regions were identified for analysis based on data extracted from thirty-three-articles. An increase in iron levels in substantia nigra of PD patients by postmortem, R2* or SWI measurements was observed. The postmortem and SWI measurements also suggested significant iron accumulation in putamen. Increased iron deposition was found in red nucleus as determined by both R2* and SWI, whereas no data were available in postmortem samples. Based on SWI, iron levels were increased significantly in the nucleus caudatus and globus pallidus. Of note, the analysis might be biased towards advanced disease and that the precise stage at which regions become involved could not be ascertained. Our analysis provides an overview of iron deposition in multiple brain regions of PD patients, and a comparison of outcomes from different methods detecting levels of iron. PMID:27827408

  6. Adult post-mortem imaging in traumatic and cardiorespiratory death and its relation to clinical radiological imaging

    PubMed Central

    Adlam, D; Robinson, C; Pakkal, M; Rutty, G N

    2014-01-01

    The use of post-mortem imaging is expanding throughout the world with increasing use of advanced imaging techniques, such as contrast-enhanced CT and MRI. The questions asked of post-mortem imaging are complex and can be very different, for example for natural sudden death investigation will focus on the cause, whereas for trauma the cause of death is often clear, but injury patterns may be very revealing in investigating the background to the incident. Post-mortem imaging is different to clinical imaging regarding both the appearance of pathology and the information required, but there is much to learn from many years of clinical research in the use of these techniques. Furthermore, it is possible that post-mortem imaging research could be used not only for investigating the cause of death but also as a model to conduct clinically relevant research. This article reviews challenges to the development of post-mortem imaging for trauma, identification and cardiorespiratory death, and how they may be influenced by current clinical thinking and practice. PMID:24338941

  7. Externalities of oil imports revisited

    SciTech Connect

    Lemon, R.

    1980-09-01

    A re-analysis of the externalities associated with oil imports reaffirms the major findings of an earlier study: (1) The current externalities of oil imports are large even after several favorable assumptions are made, including the existence of a large buffer stock and enlightened monetary and fiscal policy. (2) The large externalities of oil imports call for increased domestic supplies, including conservation, if they are cost-effective and based on marginal social costs. (3) A corrective public policy could involve oil-import taxes and the subsidization of new domestic energy sources without large government externalities. 20 references.

  8. Optical modulation goes external

    NASA Astrophysics Data System (ADS)

    Loni, A.

    1995-02-01

    Digital or analog modulation of continuous-wave laser sources forms the basis of encoding and transmitting of information through optical fiber link systems. In digital systems, data are formatted in a simple periodic two-bit configuration, represented by high or low light intensities, whereas in analog systems data are represented by selective portions of a time-varying electronic waveform applied to the optical carrier. High speed optical communications and the distribution of cable television (CATV) signals are just two examples of digital and analog systems, respectively, that involve the transmission of data, voice and video over fiber networks. The basic layout of a fiber-optic link system is presented. The optical source wavelength is determined by the characteristics of the optical fiber. If the optical sources used is a semiconductor laser diode, information can be imprinted on the optical output by directly modulating the laser drive current with a radio frequency (RF) signal. In digital systems, the low (off) state generally corresponds to a position just below the lasing threshold on the characteristic intensity-current curve of the diode. This position is preferred to the zero current locus because the turn-on delays are then minimized. Analog systems require a bias current in addition to the threshold current in order to push the modulation into the linear region of the power-current curve. The main disadvantages associated with the direct modulation approach are discussed. The main disadvantage of the solid-state approach is its inability to modulate directly the laser at the data rates nominally entailed in optical communications. This inability causes further limitations associated with the inherently long excited state lifetime of the lasing species. External modulation overcomes this drawback by modulating the optical output from the laser rather than the material properties of the laser itself, and consequently, is set to play an increasingly

  9. The "coffin fly"Conicera tibialis (Diptera: Phoridae) breeding on buried human remains after a postmortem interval of 18 years.

    PubMed

    Martín-Vega, Daniel; Gómez-Gómez, Aída; Baz, Arturo

    2011-11-01

    The "coffin fly,"Conicera tibialis Schmitz (Order: Diptera, Family: Phoridae), is well known for its frequent occurrence on buried corpses, in some cases after postmortem intervals of even 3-5 years. The present report describes the presence of a large amount of individuals of C. tibialis inside the coffin of a buried human corpse exhumed 18 years after death in central Spain. Adults, some of them newly emerged, and empty puparia were found in connection with the remains. Such postmortem interval is significantly longer than previously known for this species and raises the question on the current state of knowledge about the use of insects for estimating the postmortem interval in old, buried remains.

  10. Clinical signs, treatment, and postmortem lesions in dairy goats with enterotoxemia: 13 cases (1979-1982).

    PubMed

    Blackwell, T E; Butler, D G

    1992-01-15

    Enterotoxemia attributable to Clostridium perfringens type D in goats is difficult to diagnose because of a lack of specific clinical signs or postmortem lesions, on which to base the diagnosis. This report describes the clinical signs, postmortem lesions, and clinical responses to treatment and vaccination in 4 goat herds, in which a diagnosis of enterotoxemia was confirmed. Four clinical cases had the diagnosis confirmed on the basis of signs of diarrhea or sudden death and the isolation of C perfringens and epsilon toxin from the feces at the time of admission. The 10 necropsy cases were diagnosed on the basis of the isolation of C perfringens (not typed) or epsilon toxin from the intestinal contents of goats that died with clinical signs compatible with enterotoxemia and without lesions associated with a second serious disease. Enterocolitis was the most consistent lesion reported at necropsy in the 10 goats with enterotoxemia. Ovine enterotoxemia vaccines were of limited value in preventing enterotoxemia. These observations imply that naturally induced enterotoxemia in goats involves a different pathophysiologic mechanism than that associated with enterotoxemia in sheep.

  11. What can post-mortem studies tell us about the pathoetiology of suicide?

    PubMed Central

    Pandey, Ghanshyam N; Dwivedi, Yogesh

    2011-01-01

    Suicide is a major public health concern; however, its neurobiology is unclear. Post-mortem brain tissue obtained from suicide victims and normal controls offers a useful method for studying the neurobiology of suicide. Despite several limitations, these studies have offered important leads in the neurobiology of suicide. In this article, we discuss some important findings resulting from these studies, focusing on serotonergic mechanisms, signal transduction systems, neuroendocrine studies and immune function abnormalities in suicide. These studies suggest that abnormalities of certain receptor subtypes, components of signaling systems such as protein kinase C and protein kinase A, transcription factors such as cyclic AMP response element-binding protein and neurotrophins may play an important role in the pathophysiology of suicide. These studies also suggest abnormalities of hypothalamic–pituitary–adrenal axis system components, feedback mechanisms and cytokines, which are chemical mediators of the immune functions. Post-mortem brain tissue offers an opportunity for future studies, such as genetic and epigenetic studies. PMID:21436961

  12. [Osteological case study to narrow the timing of postmortem trauma to a skull].

    PubMed

    Verhoff, Marcel A; Durschnabel, Melanie; Kreutz, Kerstin

    2007-01-01

    In the course of an exhumation performed 5.5 years after death, several bone fragments were uncovered during the excavation of the clay-rich soil. Amongst others, there was a large piece of the frontal neurocranium. In addition, a so-called coffin stain was discernible. The exhumed coffin was intact. The forensic autopsy revealed a complete corpse with distinct adipocere formation. Consultation with the cemetery administration allowed the conclusion that the additional bone fragments were from the first use of the grave approximately 100 years ago. The heavily soil-encrusted skull fragment bore clear signs of a half sharp force, that could immediately be classified as postmortem. The pattern of injury pointed to an excavator as the cause. However, the question arose whether the postmortem trauma occurred 5.5 years ago during the excavation of the grave or during the current exhumation. First the skull fragment was dried. However, it was then impossible to remove the clay-rich soil without damaging the bone. The fragment was therefore carefully washed and dried again. The cut and fracture areas then showed distinctly lighter surfaces than the rest of the bone, which pointed to the exhumation as the time of origin. For comparison, fresh injuries were inflicted with a hatchet. These distinctly showed even lighter surfaces, so that the time of origin could be assumed to have been during the excavation of the grave 5.5 years ago.

  13. Postmortem Study of a Magnesia-Chromite Brick from a Lead Recycling Furnace

    NASA Astrophysics Data System (ADS)

    Gregurek, D.; Reinharter, K.; Reiter, V.; Wenzl, C.; Spanring, A.

    2015-09-01

    This study provides an example of a detailed postmortem analysis carried out on a used silicate-bonded magnesia-chromite brick out of a lead recycling furnace. The magnesia-chromite brick suffered from a high chemical attack due to the process slag. The high CaO, BaO, and sulfur-bearing silicate slag, as well as a high Na2O supply from soda resulted not only in a deep-reaching infiltration of the brick microstructure but also in a severe corrosion of the brick components. Both the sintered magnesia and chromite were attacked chemically. The FactSage calculations showed the formation of high amounts of liquid phase in the infiltrated microstructure and the formation of various Na-Ca-Al-silicates. A detailed investigation of the wear mechanisms through "postmortem studies" is a crucial prerequisite for every refractory producer to understand the interactions between slag and refractory materials. The obtained information and insights serve as a basis for improving refractory materials (i.e., choice of refractories for individual process and new developments) and consequently furnace operations (i.e., prolonged furnace campaigns).

  14. Distinguishing between perimortem and postmortem fractures: are osteons of any help?

    PubMed

    Pechníková, Markéta; Porta, Davide; Cattaneo, Cristina

    2011-07-01

    The distinction between perimortem and postmortem fractures in forensic anthropology is still a frequently unsolved issue. In the present study, we try to verify if there are differences in the pattern of osteon fracturing between fresh and dry bone which could be used for such a diagnosis. Fresh and dry long bones were fractured by a hammer at the mid-shaft perpendicularly to the long axis of the bone and the fracture margins examined under a light microscope as undecalcified sections. Examination of 982 osteons (505 fresh, 477 dry) showed that twice as often the fracture line crosses the osteons as opposed to travelling around them, independently of whether the bone is fresh or dry. Statistical analysis confirmed that there was no significant difference between fresh and dry bone. This seems to imply that osteon fracture pattern cannot help in the diagnosis of perimortem versus postmortem bone fractures. Further research however must be performed concerning fast and slow energy dispersal which may have an influence on the type of fracture inflicted.

  15. Postmortem evaluation of reintroduced migratory whooping cranes in eastern North America.

    PubMed

    Cole, Gretchen A; Thomas, Nancy J; Spalding, Marilyn; Stroud, Richard; Urbanek, Richard P; Hartup, Barry K

    2009-01-01

    Reintroduction of endangered Whooping Cranes (Grus americana) in eastern North America has successfully established a migratory population between Wisconsin and Florida. Eighty birds (47 males, 33 females) were released between 2001 and 2006, and all birds were tracked following release with satellite and/or VHF monitoring devices. By the end of 2006, 17 deaths (12 males, five females) were recorded from this population. Postmortem findings and field data were evaluated for each bird to determine the cause of death. Causes included predation (n=8, 47%), trauma (n=2, 12%), and degenerative disease (n=1, 6%); the cause of death was undetermined for 35% (n=6) of the birds. Based on physical evidence, the primary predator of the birds was the bobcat (Lynx rufus). Limited roosting habitat availability or bird behavior were likely prime factors in the occurrence of predation. Traumatic injuries and mortality were caused by gunshot, electrical utility lines, and an unknown source. The lone case of degenerative disease was due to chronic exertional myopathy associated with translocation. Available postmortem testing did not indicate the presence of infectious disease in this limited sample.

  16. Measurement of the pH value in pork meat early postmortem by Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Scheier, R.; Schmidt, H.

    2013-05-01

    The pH of a muscle is an accepted parameter to identify normal and deviating meat qualities. In this work, Raman spectroscopy is shown to be suitable for the non-invasive measurement of the early postmortem pH of meat. Raman spectra of ten pork semimembranosus muscles were recorded with a portable handheld device 0.5-24 h postmortem. The spectra were correlated with pH and lactate kinetics measured in parallel. Seven of the muscles were normal, two exhibited accelerated glycolysis and one showed absence of acidification. The pH decline with time could be calculated from the Raman spectra with the Henderson-Hasselbalch equation using only two signals of phosphate vibrations at 980 and 1,080 cm-1 with a close correlation for each muscle, but larger variations between animals. More robust and better correlations for all muscles were obtained with a linear model based on 11 signals from lactate, lactic acid, phosphate, a carbonyl band and nucleotides resulting in R 2 = 0.78 and RMSECV = 0.2 or a partial least-square model using the complete spectrum ( R 2 = 0.94 and RMSECV = 0.2). These results show the potential of Raman spectroscopy for an online detection of the pH and thus meat qualities during meat processing.

  17. Unreliability of the use of thyroglobulin concentration in postmortem blood samples in forensic diagnosis.

    PubMed

    Hayakawa, Akira; Matoba, Kotaro; Horioka, Kie; Murakami, Manabu; Terazawa, Koichi

    2014-05-01

    Previous studies have reported that the concentration of thyroglobulin (Tg) in heart blood is high in cases of asphyxia by neck compression such as hanging, strangulation, and throttling and in those with traumatic injuries to the head. However, we have experienced cases in which we observed high Tg concentrations without such findings. Therefore, we analyzed the influence of postmortem changes on Tg concentration. Of 253 forensic autopsies conducted at our institution, we analyzed 44 cases without the findings presumed to increase Tg concentration. We collected right heart blood (RHB) and left heart blood (LHB) separately and measured Tg concentrations in each. The Tg concentration of the RHB in 19 (43%) cases and that of the LHB in 10 (23%) cases was higher than the standard value (200ng/ml) obtained in previous studies. In some cases, we found large differences between the Tg concentrations of RHB and LHB. We suggest that Tg concentration can increase above the standard value and that a difference between the Tg concentration of RHB and LHB arises as a result of postmortem changes. Consequently, if there is a large difference between the Tg concentration of RHB and LHB, the concentration of Tg should not be used as a basis for forensic diagnosis.

  18. Breast density quantification with cone-beam CT: a post-mortem study.

    PubMed

    Johnson, Travis; Ding, Huanjun; Le, Huy Q; Ducote, Justin L; Molloi, Sabee

    2013-12-07

    Forty post-mortem breasts were imaged with a flat-panel based cone-beam x-ray CT system at 50 kVp. The feasibility of breast density quantification has been investigated using standard histogram thresholding and an automatic segmentation method based on the fuzzy c-means algorithm (FCM). The breasts were chemically decomposed into water, lipid, and protein immediately after image acquisition was completed. The per cent fibroglandular volume (%FGV) from chemical analysis was used as the gold standard for breast density comparison. Both image-based segmentation techniques showed good precision in breast density quantification with high linear coefficients between the right and left breast of each pair. When comparing with the gold standard using %FGV from chemical analysis, Pearson's r-values were estimated to be 0.983 and 0.968 for the FCM clustering and the histogram thresholding techniques, respectively. The standard error of the estimate was also reduced from 3.92% to 2.45% by applying the automatic clustering technique. The results of the postmortem study suggested that breast tissue can be characterized in terms of water, lipid and protein contents with high accuracy by using chemical analysis, which offers a gold standard for breast density studies comparing different techniques. In the investigated image segmentation techniques, the FCM algorithm had high precision and accuracy in breast density quantification. In comparison to conventional histogram thresholding, it was more efficient and reduced inter-observer variation.

  19. Value of postmortem studies in deceased neonatal and pediatric intensive care unit patients.

    PubMed

    Widmann, Raphael; Caduff, Rosmarie; Giudici, Luca; Zhong, Qing; Vogetseder, Alexander; Arlettaz, Romaine; Frey, Bernhard; Moch, Holger; Bode, Peter K

    2017-02-01

    Worldwide, various autopsy studies have shown a decrease in the diagnostic error rate over the last years. The cause of this positive development is mainly due to the improvement of modern medicine. However, intensive care unit patients are thought to have a higher risk for diagnostic errors, which is documented in several studies in the adult population. In contrast, there is only limited information about diagnostic errors in pediatrics, particularly in pediatric and neonatal intensive care units. The aims of this study were to analyze the spectrum of childhood death, determine the prevalence and distribution of autopsy-confirmed diagnostic errors, and describe patient characteristics that might have influenced the discordance between antemortem and postmortem findings. We analyzed 143 autopsy reports from 2004 to 2013 and correlated these with clinical reports. The overall autopsy rate during this interval was 20.3%. The leading causes of death were congenital malformations (28%), diseases closely associated with perinatal disorders (25%), disorders of the cardiovascular system (18%), and infections (15%). Additional findings were obtained in 23% of the autopsies. Major diagnostic errors were found in 6%, the lowest reported value in a developed country as yet. Most cases (75%) showed complete concordance between clinical diagnoses and postmortem findings, in line with improvements in diagnostic and therapeutic processes over the last decades. In conclusion, autopsy of neonates, infants, and children represents an important tool for monitoring the quality of pediatric and neonatal medical care.

  20. Experimental forensic and bioanthropological aspects of soft tissue taphonomy: 1. Factors influencing postmortem tissue desiccation rate.

    PubMed

    Aturaliya, S; Lukasewycz, A

    1999-09-01

    Euthanized rats' carcasses were exposed in an environmental chamber to multiple variables including: (1) position, (2) enveloping clothing, and (3) soil interment in an effort to determine the individual variables' effect on postmortem rate of body and visceral organ water loss. Results indicated that body water loss was enhanced by a horizontal position versus vertical, probably because of wider spread of bacteria- and enzyme-laden abdominal fluid secondary to diaphragm digestion with consequent greater tissue digestion and liquefaction. Clothing also accelerated the desiccation rate. Desiccation was about equally as effective by soil interment as by air exposure, though simulating windy conditions by tripling the air flow rate resulted in much more rapid desiccation in the air-exposed specimen. These studies suggest that the single most important factor influencing postmortem body water loss rate is the environment at the skin surface that acts to enhance or impair water removal from the skin surface and thus influences the water concentration gradient between the skin and underlying deeper tissues.

  1. Breast density quantification with cone-beam CT: A post-mortem study

    PubMed Central

    Johnson, Travis; Ding, Huanjun; Le, Huy Q.; Ducote, Justin L.; Molloi, Sabee

    2014-01-01

    Forty post-mortem breasts were imaged with a flat-panel based cone-beam x-ray CT system at 50 kVp. The feasibility of breast density quantification has been investigated using standard histogram thresholding and an automatic segmentation method based on the fuzzy c-means algorithm (FCM). The breasts were chemically decomposed into water, lipid, and protein immediately after image acquisition was completed. The percent fibroglandular volume (%FGV) from chemical analysis was used as the gold standard for breast density comparison. Both image-based segmentation techniques showed good precision in breast density quantification with high linear coefficients between the right and left breast of each pair. When comparing with the gold standard using %FGV from chemical analysis, Pearson’s r-values were estimated to be 0.983 and 0.968 for the FCM clustering and the histogram thresholding techniques, respectively. The standard error of the estimate (SEE) was also reduced from 3.92% to 2.45% by applying the automatic clustering technique. The results of the postmortem study suggested that breast tissue can be characterized in terms of water, lipid and protein contents with high accuracy by using chemical analysis, which offers a gold standard for breast density studies comparing different techniques. In the investigated image segmentation techniques, the FCM algorithm had high precision and accuracy in breast density quantification. In comparison to conventional histogram thresholding, it was more efficient and reduced inter-observer variation. PMID:24254317

  2. Cloning endangered gray wolves (Canis lupus) from somatic cells collected postmortem.

    PubMed

    Oh, H J; Kim, M K; Jang, G; Kim, H J; Hong, S G; Park, J E; Park, K; Park, C; Sohn, S H; Kim, D Y; Shin, N S; Lee, B C

    2008-09-01

    The objective of the present study was to investigate whether nuclear transfer of postmortem wolf somatic cells into enucleated dog oocytes, is a feasible method to produce a cloned wolf. In vivo-matured oocytes (from domestic dogs) were enucleated and fused with somatic cells derived from culture of tissue obtained from a male gray wolf 6h after death. The reconstructed embryos were activated and transferred into the oviducts of naturally synchronous domestic bitches. Overall, 372 reconstructed embryos were transferred to 17 recipient dogs; four recipients (23.5%) were confirmed pregnant (ultrasonographically) 23-25 d after embryo transfer. One recipient spontaneously delivered two dead pups and three recipients delivered, by cesarean section, four cloned wolf pups, weighing 450, 190, 300, and 490g, respectively. The pup that weighed 190g died within 12h after birth. The six cloned wolf pups were genetically identical to the donor wolf, and their mitochondrial DNA originated from the oocyte donors. The three live wolf pups had a normal wolf karyotype (78, XY), and the amount of telomeric DNA, assessed by quantitative fluorescence in situ hybridization, was similar to, or lower than, that of the nuclear donor. In conclusion, the present study demonstrated the successful cloning of an endangered male gray wolf via interspecies transfer of somatic cells, isolated postmortem from a wolf, and transferred into enucleated dog oocytes. Therefore, somatic cell nuclear transfer has potential for preservation of canine species in extreme situations, including sudden death.

  3. Performance of immunoassays in screening for opiates, cannabinoids and amphetamines in post-mortem blood.

    PubMed

    Hino, Yukiko; Ojanperä, Ilkka; Rasanen, Ilpo; Vuori, Erkki

    2003-01-28

    Several immunoassay methods for screening of abused drugs in whole blood were evaluated in post-mortem forensic toxicology. Blood samples known to be positive or negative for opiates, cannabinoids or amphetamines by gas chromatography-mass spectrometry (GC-MS) were analysed by EMIT II Plus and EMIT d.a.u., Syva RapidTest and Triage 8 after acetone precipitation. In these experiments, the EMIT immunoassay method was modified by using the Dade Behring VIVA analyser to detect substances more sensitively. Low concentrations of abused drugs were detected in blood samples. The sensitivities of the modified EMIT method for opiates, cannabinoids and amphetamines were 100, 86 and 98%, respectively, whereas the values were below 86% with the other methods. The specificities of all immunoassay methods for opiates and cannabinoids were 83% or above but 51-85% for amphetamines. Sample rejection occurred in a few cases with the EMIT amphetamine assays. The modified EMIT immunoassay system presented here seems to be useful for screening of drugs of abuse in post-mortem blood samples, especially when urine is not available.

  4. Experimental taphonomy: post-mortem microstructural modifications in Sus scrofa domesticus bone.

    PubMed

    Kontopoulos, Ioannis; Nystrom, Pia; White, Lorraine

    2016-09-01

    Bone is a highly specialised form of hard and rigid connective tissue whose histological structure undergoes post-mortem modifications. In taphonomic research, histological examination of bone thin sections is used to investigate these post-mortem microstructural changes in skeletal tissues. In this study, diagenetic modifications in pig skeletal remains (Sus scrofa domesticus) which were exposed to different taphonomic conditions as part of a long-term, real-time experiment were examined under light microscope (i.e. plain and cross polarized light). This experiment demonstrated that macroscopic appearance and microscopic preservation of bone may significantly differ. Early microbial attack was identified as enlarged osteocyte lacunae that later coalesce to constitute larger foci. Additionally, microscopic preservation of different skeletal elements varied intra-individually, while within bone differential preservation (i.e. proximal versus distal ends) was also observed. However, no specific patterns of early histological attack (e.g. endosteal and periosteal destruction) and no clear relationship between histological preservation and proximity to the abdominal area were detected. Lastly, the presence and composition of protective textiles had a clear effect on bone preservation. This research project, therefore, provided important evidence for the better understanding of the diagenetic processes that occur within bones whilst buried or exposed on the ground surface.

  5. Genetic analysis in post-mortem samples with micro-ischemic alterations.

    PubMed

    Campuzano, Oscar; Sanchez-Molero, Olallo; Mademont-Soler, Irene; Coll, Monica; Allegue, Catarina; Ferrer-Costa, Carles; Mates, Jesus; Perez-Serra, Alexandra; Del Olmo, Bernat; Iglesias, Anna; Sarquella-Brugada, Georgia; Brugada, Josep; Borondo, Juan Carlos; Castella, Josep; Medallo, Jordi; Brugada, Ramon

    2017-02-01

    Sudden cardiac arrest is a leading cause of death worldwide. Most cardiac arrests happen in patients who have previously suffered a myocardial infarct. The risk of sudden death after infarction may increase in people who carry a pathogenic genetic alteration in cardiac ion channels. We hypothesized that micro-ischemia could trigger lethal arrhythmogenesis, thus we sought to identify genetic alterations in cardiac ion channels in patients with micro-ischemic disease. We studied a cohort of 56 post-mortem samples. Autopsy studies identified myocardial infarction as the cause of death in each case. We used both Sanger sequencing and next-generation sequencing to screen candidate genes associated with sudden cardiac death. We identified six rare missense genetic variations in five unrelated patients. Two variants have been previously reported; one is associated with atrial fibrillation (SCN5A_p.H445D), and the other is predicted to be benign (ANK2_p.T2059M). The novel variants were predicted in silico as benign, except for one (RyR2_p.M4019T), which was classified as deleterious. Our post-mortem, micro-infarction cohort displayed a rate of nearly 10% non-common genetic variants. However, the clinical significance of most of the identified variants remains unknown due to lack of family assessment. Further analyses should be performed in large cohorts to clarify the role of ion-channel gene analysis in samples showing microscopic ischemic alterations.

  6. The assessment of lens opacity postmortem and its implication in forensics.

    PubMed

    Stemberga, Valter; Petaros, Anja; Kovacevic, Damir; Coklo, Miran; Simicevic, Neven; Bosnar, Alan

    2013-11-01

    Visual impairment, mostly due to cataracts, has been demonstrated to be an important factor associated with traffic accidents. Although vision screening is standard procedure during licensing in order to prevent motor vehicle accidents, an eye exam is not typically administered after an accident has already occurred. Postmortem assessment of lens opacity in victims of car accidents would provide helpful information for attesting to the liability of the parties in specific accidents, determining the circumstances of the accident, and developing preventive measures for both drivers and pedestrians alike. In this paper, we explore the use of different methods and their limitations for assessing lens opacity postmortem. We discuss the possible use and benefits of a simple, but as-yet untested method: retrobulbar translucency. The method would be based on the recording of shadows formed by opaque regions of the lens while the eye is illuminated from the back with a rigid source of light. The efficacy and objectivity of the method, its reproducibility, and the inter- and intra-observer error should be tested before implementing such a technique to be regularly used to determine lens opacity in cadavers.

  7. The post-mortem relationship between beta-hydroxybutyrate (BHB), acetone and ethanol in ketoacidosis.

    PubMed

    Elliott, Simon; Smith, Christopher; Cassidy, Diane

    2010-05-20

    A reduced blood pH (ketoacidosis) from the production of beta-oxidative ketone bodies as a result of alcoholism (alcoholic ketoacidosis, AKA) or diabetes (diabetic ketoacidosis, DKA) can feature in many fatalities and analytical evidence can be used to support a pathological diagnosis, or provide a possible cause of death in the absence of other pathologically significant findings. Existing beliefs concerning the relationship of BHB concentrations, acetone and ethanol have been re-examined by analysis of BHB, acetone and ethanol in over 350 fatalities grouped into alcoholics, diabetics, alcoholic diabetics, coupled with speculative cases and those with an alternative cause of death. Uniquely, the concentrations of BHB were measured in post-mortem blood, urine and vitreous humour using selective GC-MS. The results showed that existing beliefs need to be re-evaluated. Ethanol is not always low (<10mg/dL) or absent in cases of AKA. Also, the absence of acetone precludes [corrected] a high BHB (>250mg/L), therefore acetone can be used as an initial marker pathologically significant ketoacidosis. For blood and urine BHB concentrations the following interpretative ranges can be used (in mg/L); normal (<50mg/L), raised (51-249mg/L), high and pathologically significant (>250mg/L). Initial data suggest vitreous humour BHB could be a useful alternative in the absence of blood (same interpretative ranges may also apply). Analytical recommendation for investigation of post-mortem ketoacidosis is also presented.

  8. The time-dependant post-mortem redistribution of antipsychotic drugs.

    PubMed

    Saar, Eva; Beyer, Jochen; Gerostamoulos, Dimitri; Drummer, Olaf H

    2012-10-10

    The post mortem redistribution of ten commonly prescribed antipsychotic drugs (APs) was investigated. Femoral blood was collected from 273 cases at admission to mortuary (AD) and at post-mortem (PM). The PM samples were collected at various times up to nine days after admission and the sample pairs analysed using LC-MS/MS. The drugs included in this study were 9OH-risperidone (paliperidone), amisulpride, chlorpromazine, clozapine, haloperidol, olanzapine, promethazine, quetiapine, risperidone, and zuclopenthixol. Haloperidol, quetiapine and risperidone showed minimal changes between AD and PM specimens, whereas the majority of drugs showed significant changes between the sample pairs collected at different time points post mortem (p<0.01) in addition to an average concentration change greater than the uncertainty of measurement of the applied method. Average increases in blood concentrations after admission to the mortuary ranged up to 112% (chlorpromazine and olanzapine) but also decreases up to -43% (9OH-risperidone) were seen. There were large standard deviations between sample pairs and substantial day-to-day unpredictable changes that highlight the difficulty in the interpretation of drug concentrations post-mortem. Based on the presented data, we recommend that specimens for toxicological analysis should to be taken as soon as possible after admission of a deceased person to the mortuary in order to minimise the effects of the PM interval on the drug concentration in blood.

  9. Bacteria isolated from dugongs (Dugong dugon) submitted for postmortem examination in Queensland, Australia, 2000-2011.

    PubMed

    Nielsen, Kristen A; Owen, Helen C; Mills, Paul C; Flint, Mark; Gibson, Justine S

    2013-03-01

    Microbial infection may contribute to disease in a significant proportion of marine mammal mortalities, but little is known about infectious bacterial species and their prevalence in dugongs (Dugong dugon). This study represents a survey of the species of bacteria and fungi isolated from dugongs submitted to the University of Queensland's School of Veterinary Science for postmortem examination. Thirty-six dugongs were included in the survey, with 23 species of bacteria and four species of fungus cultured from lesions that were suspected of contributing to local infection, systemic infection, or both. The most abundant bacteria included Aeromonas spp., Clostridium spp., Vibrio spp., Enterococcus faecalis, and Pseudomonas spp. In six cases, the microorganism(s) cultured were considered to have been associated with disease. Mixed infections containing Aeromonas spp. and Vibrio spp.; Morganella morganii, Pasteurella multocida, and Serratia marcescens; and Actinomyces spp. and Peptostreptococcus spp. were associated with pneumonia or pleuritis, and Enterococcus faecalis was associated with a multisystemic infection in a neonate. Clostridium spp. was cultured from two animals with peritonitis and likely septicemia. The significance of many of the other isolates is uncertain because the samples were taken after death, and some of the species isolated may represent postmortem overgrowth. It is also difficult to fulfil Koch's postulates through experimental infection in marine mammals. Regardless, this information will assist clinicians working with dugongs to make treatment decisions and the baseline data on the prevalence of bacterial and fungal species is of value for monitoring coastal water habitat health and risks of zoonotic disease transmission.

  10. Estimation of postmortem interval using the data of insulin level in the cadaver׳s blood.

    PubMed

    Kumar, Sachil; Verma, Anoop K

    2016-06-01

    An assessment of levels of Insulin in cadaveric fluids, to estimate the postmortem interval (PMI) was carried out. To profile postmortem changes of Insulin, it was extracted at different intervals i.e. (0, 3, 6, 12, 24 h), from the heart of 22 human cadavers. The cases included were the subjects of accidental deaths without any prior history of disease and their exact time of death was known. Immunoanalyzer Cobas e-411 instrument was used to detect the relationship between the amount of Insulin and PMI. Level of Insulin was measured in cardiac blood. Statically, significant correlations between levels of Insulin and PMI were studied and correlation coefficients were calculated. SPSS (version 12.0) was used for statistical analysis. Insulin levels in cadaver blood are correlated significantly with PMI with a p value of <0.001. When insulin level increases by 1 unit the duration decreases by 0.93 units. The least square regression line is: [Duration(Y)=22.71-0.93 Insulin level (X)].

  11. Social isolation and delayed discovery of bodies in houses: the value of forensic pathology, anthropology, odontology and entomology in the medico-legal investigation.

    PubMed

    Archer, M S; Bassed, R B; Briggs, C A; Lynch, M J

    2005-07-16

    The bodies of socially isolated people may remain undiscovered in their own houses for prolonged periods. Occasionally the body is in situ for sufficient time to become skeletonised, or partially so. Medico-legal investigation of these cases is complicated by degradation and contamination of evidence. Thus, a multidisciplinary forensic investigation is recommended. The potential contributions of forensic pathology, anthropology, odontology and entomology are outlined here with reference to two cases that occurred in Victoria, Australia, in 2003. Forensic pathologists are often unable to determine the cause of death in skeletonised bodies, however, they may find evidence to support either a natural or unnatural mode of death, and they may describe skeletal pathology or trauma, and identify skeletal features to support radiological identification of the deceased. Anthropologists can provide supplementary evidence of skeletal trauma. Additionally, they can assess age, sex, stature and racial affiliation from skeletal remains. Odontologists can identify individuals through comparison with ante-mortem dental records; however, potential difficulties exist in identifying the treating dentist of a socially isolated person. Odontologists may also examine the teeth and oro-facial skeleton for trauma. Entomologists may estimate minimum death time and/or season of death. Entomological examination of insect remains may also confirm that a body has lain in situ for a considerable period.

  12. Medico-legal considerations of canine leishmaniosis in Italy: an overview of an emerging disease with reference to the buying and selling of dogs.

    PubMed

    Passantino, A

    2006-12-01

    Leishmaniosis is a common infection in the canine population. Domestic dogs are the main reservoir hosts for zoonotic human visceral leishmaniosis in both the Old and New Worlds. In fact, canine leishmaniosis is not just a veterinary problem. In the light of some recent advances in the field of diagnosis, the author evaluated the medico-legal aspects of buying and selling dogs that are potentially affected by leishmaniosis. This paper clarifies why it is impossible to attribute redhibitory vice (an essential defect in a product which renders it useless or so diminishes its usefulness or value that it must be presumed that, if he had been aware of it, the buyer would not have bought it, or would have paid a lesser price) to this disease and highlights the necessity to improve Sicilian regional law no. 15 of 3 July 2000 concerning the creation of a dog register by giving every animal a health book. With this aim in mind, the author suggests that leishmaniosis be included in the list of notifiable diseases that appears in article 1 of the Italian Veterinary Police Regulations so as to reduce the possibilities of fraudulent trade in dogs known to be infected before purchase.

  13. The medicolegal importance of enhancing timeliness of documentation when using an anesthesia information system and the response to automated feedback in an academic practice.

    PubMed

    Vigoda, Michael M; Lubarsky, David A

    2006-07-01

    Documentation should ideally occur in real time immediately after completion of a service. Although electronic records often do not print the time that documentation notes were entered on the medical record, automated anesthesia record keeping systems store an audit trail that time stamps events entered by all anesthesia providers. As more lawyers become aware of this fact and requisition audit trails, prospective charting of necessary documentation may undermine the integrity of an anesthesia care team accused of malpractice, with potentially significant medicolegal consequences. We changed existing documentation practices of a large academic practice via a three-step process. Educational sessions increased the percentage of cases with correct timing of emergence documentation from 25% to 60% over a 2-mo period. Automated email performance feedback further increased correct note timing to 70%. When combined with personal contact by a member of the billing office and email copy notification of the chair, the percentage increased to >99.5%. The behavioral change was seen in all individuals, as 95% of attendings had < or = 2 records/mo with untimely documentation at the end of the study period. Once the habits were ingrained, further input was rarely necessary over the next 9 mo. This suggests physician behavioral change related to work process flow, unlike that related to patient care, is easily sustained.

  14. [Medico-legal assessment in neurological malpractice based on casework material collected at the Department of Forensic Medicine, Medical University of Białystok].

    PubMed

    Ptaszyńska-Sarosiek, Iwona; Niemcunowicz-Janica, Anna; Janica, Jerzy; Dopierała, Tomasz; Załuski, Janusz; Wardaszka, Zofia

    2007-01-01

    Medical malpractice results from inadequate professional knowledge, incompliance to the present state of medical knowledge or negligence and inattention. The aim of the paper was the analysis of medical malpractice cases based on material in the field of neurology. The cases were assessed according to the number and type in 32 medico-legal opinions issued by specialist teams of forensic medicine and neurology in the Department of Forensic Medicine, Medical University of Białystok in the years 2001-2006. In 11 cases (34%) medical malpractice was concluded with reference to improper treatment after head injury or brain pathology, inadequate care at neurology unit, lacked or delayed diagnostics of head pathology and injury, non-referral to hospital by neurologists. In the material analysed diagnostic errors predominated. Majority of them originated from the open health care system. Incompetence of neurologists with regard to differential diagnostics resulting in misdiagnosis and improper therapy was noted. In one third of the overall cases medical malpractice was concluded. The most common causes included misinterpretation of disease signs and symptoms, misapplication of available diagnostic potential and unjustified delay before commencing diagnostics.

  15. [Permanent essential defacement--remarks on the possibilities of verification of the accepted criteria in medico-legal certification in criminal and civil law proceedings].

    PubMed

    Chowaniec, Czesław; Nowak, Agnieszka; Jabłoński, Christian; Neniczka, Stanisława

    2007-01-01

    Despite the fact that some criteria of medico-legal certification in criminal and civil proceedings have been established, there are still some topics which are controversial and thus require modification. This is also true of the notion of "permanent essential defacement". In the opinion of the authors, changes in social conventions that are occurring nowadays, as well as a highly diversified, subjective perception of esthetic values indicate the need for discussing a possible modification of the presently obligatory criteria. Apart from the assessment of posttraumatic changes, an important problem is posed by defining the notion of "a part of the body customarily open to the view ". Additionally, the authors bring up for discussion the issue of experts taking into consideration the age and sex of the victims while assessing damages. A separate problem lies in difficulties in assessing the degree of detriment to health because of defacement due to the fact that official tables for evaluating permanent or long-term detriment to health do not include relevant information.

  16. [Application of hair analysis of selected psychoactive substances for medico-legal purposes. Part I. Segmental hair analysis in cases of fatal opioids and amphetamines poisoning].

    PubMed

    Rojek, Sebastian; Kłys, Małgorzata; Konopka, Tomasz

    2009-01-01

    The present experimental investigations were inspired by the necessity of standardizing the procedures and analytical methods employed in hair analysis aiming at a retrospective evaluation of ingestion of various xenobiotics. Thus, in keeping with the principal premises, the main objective of the study was development of unique, novel chemico-toxicological procedures for analyzing hair content of psychoactive substances in two basic groups of substances of abuse: opioids (morphine, 6-monoacetylmorphine, codeine) and amphetamines (amphetamine, methamphetamine, MDA, MDMA, MDEA) by HPLC-APCI-MS-MS, followed by verification of the thus worked out procedures in medico-legal practice through opinionating in selected group of patients deceased due to fatal psychoactive substance poisoning (cause of death determination). Determinations of opioids and amphetamines in the hair biological matrix were performed using high performance liquid chromatography - atmospheric pressure chemical ionization - tandem mass spectrometry (HPLC-APCI-MS-MS). In the group of fatal poisonings by ,,Polish heroine", hair segmental analysis confirmed the abuse profile of the opiate or mixed (opiate-amphetamine) type, which to some measure is characteristic of Polish drug addiction, indicating the presence of these xenobiotics in the investigating hair samples in the premortem period.

  17. Heart Wall Is Thicker on Postmortem Computed Tomography Than on Ante Mortem Computed Tomography: The First Longitudinal Study

    PubMed Central

    Okuma, Hidemi; Gonoi, Wataru; Ishida, Masanori; Shintani, Yukako; Takazawa, Yutaka; Fukayama, Masashi; Ohtomo, Kuni

    2013-01-01

    Objective To evaluate the postmortem changes of the heart wall on postmortem (PM) computed tomography (CT) in comparison with those on ante mortem CT (AMCT), and in comparison with the pathological findings, obtained in the same patients. Materials and Methods We studied 57 consecutive patients who had undergone AMCT, PMCT, and pathological autopsy in our tertiary care hospital between April 2009 and December 2010. PMCT was performed within 20 hours after death, followed by pathological autopsy. The cardiac chambers were measured at five sites on both AMCT and PMCT by two board-certified radiologists who were not provided with clinical information. The differences in heart wall thickness between AMCT with and without contrast medium, between AMCT and PMCT, and between PMCT and pathological anatomy were evaluated statistically. Confounding factors of postmortem change such as gender, presence of arteriosclerosis, the organ related to cause of death, age, and elapsed time since death were examined statistically. Results No significant differences were observed on AMCT in comparison of contrasted and non-contrasted images. The heart wall was significantly thicker on PMCT than on AMCT (p < 0.0001) at all five measurement sites. The heart wall was significantly thicker on PMCT than on pathology specimens when measured in accordance with pathological standard mensuration. However, no significant difference was observed between PMCT measurements and those of pathology specimens at any site when the papillary muscles and epicardial fat were included. No significant association was found between postmortem change in heart wall thickness and gender, presence of arteriosclerosis, the organ related to cause of death, age, or elapsed time since death. Conclusion This is the first longitudinal study to confirm greater thickness of heart wall on postmortem images compared with ante mortem images, in the same patients. Furthermore, the postmortem changes on CT were supported by

  18. External Examining: Fit for Purpose?

    ERIC Educational Resources Information Center

    Bloxham, Sue; Price, Margaret

    2015-01-01

    In a context of international concern about academic standards, the practice of external examining is widely admired for its role in defending standards. Yet a contradiction exists between this faith in examining and continuing concerns about standards. This article argues that external examining rests on assumptions about standards which are…

  19. Choosing a Truly External Evaluator

    ERIC Educational Resources Information Center

    Ray, Marilyn

    2006-01-01

    This scenario discusses a situation in which a proposal has been published by a consortium of foundations for an "external" evaluator to evaluate a replication at two new sites of a program they have been funding for many years. A proposal is received from Dr. Porto-Novo, who has been the external evaluator of the initial program for about 10…

  20. [Postmortem forensic medical diagnostics of fulminant sepsis caused by Gram-negative bacterium (Capnocitophaga canimorsus) following a dog bite].

    PubMed

    Kovalev, A V; Putintsev, V A; Bogomolov, D V; Gribunov, Iu P; Bogomolov, B P; Deviatkin, A V

    2015-01-01

    This article provides the example of postmortem forensic medical diagnostics of fulminant sepsis caused by Gram-negative bacterium (Capnocitophaga canimorsus) following a dog bite. In order to identify the etiological factor of fulminant sepsis, the expert carried out the study of the autopsy materials with the use of polymerase chain reaction (PCR). This method has only recently been introduced into postmortem diagnostics of fulminant sepsis in this country; it has no analogs abroad and can be employed for the purpose of forensic medical expertise and pathological anatomic studies.

  1. Pre- and postmortem tyrannosaurid bite marks on the remains of Daspletosaurus (Tyrannosaurinae: Theropoda) from Dinosaur Provincial Park, Alberta, Canada

    PubMed Central

    Tanke, DH

    2015-01-01

    Trace marks on the bones of non-avian dinosaurs may relate to feeding by large carnivores or as a result of combat. Here the cranium and mandible of a specimen of Daspletosaurus are described that show numerous premortem injuries with evidence of healing and these are inferred to relate primarily to intraspecific combat. In addition, postmortem damage to the mandible is indicative of late stage carcass consumption and the taphonomic context suggests that this was scavenging. These postmortem bites were delivered by a large bodied tyrannosaurid theropod and may have been a second Daspletosaurus, and thus this would be an additional record of tyrannosaurid cannibalism. PMID:25870775

  2. Effects of postmortem aging and USDA quality grade on Warner-Bratzler shear force values of seventeen individual beef muscles.

    PubMed

    Gruber, S L; Tatum, J D; Scanga, J A; Chapman, P L; Smith, G C; Belk, K E

    2006-12-01

    Forty USDA Select and 40 upper two-thirds USDA Choice beef carcasses were used to determine the effects of postmortem aging on tenderness of 17 individual beef muscles. Biceps femoris-long head, complexus, gluteus medius, infraspinatus, longissimus dorsi, psoas major, rectus femoris, semimembranosus, semitendinosus, serratus ventralis, spinalis dorsi, supraspinatus, tensor fasciae latae, teres major, triceps brachii-long head, vastus lateralis, and vastus medialis muscles were removed from each carcass. Seven steaks (2.54-cm thick) were cut from every muscle, and each steak was assigned to one of the following postmortem aging periods: 2, 4, 6, 10, 14, 21, or 28 d postmortem. After completion of the designated aging period, steaks were removed from storage (2 degrees C, never frozen), cooked to a peak internal temperature of 71 degrees C, and evaluated using Warner-Bratzler shear force (WBSF). Analysis of WBSF revealed a 3-way interaction (P = 0.004) among individual muscle, USDA quality grade, and postmortem aging period. With the exception of the Select teres major, WBSF of all muscles (both quality grades) decreased with increasing time of postmortem storage. Nonlinear regression was used to characterize the extent (aging response) and rate of decrease in WBSF from 2 through 28 d postmortem for each muscle within each quality grade. In general, WBSF of upper two-thirds Choice muscles decreased more rapidly from 2 to 10 d postmortem than did corresponding Select muscles. Muscles that had greater aging responses generally had greater 2-d WBSF values. The upper two-thirds Choice psoas major, serratus ventralis, and vastus lateralis muscles required similar aging times to complete a majority of the aging response (< or =0.1 kg of aging response remaining) compared with analogous Select muscles. The upper two-thirds Choice complexus, gluteus medius, semitendinosus, triceps brachii-long head, and vastus medialis muscles required 4 to 6 d less time to complete a

  3. Malignant external otitis: CT evaluation

    SciTech Connect

    Curtin, H.D.; Wolfe, P.; May, M.

    1982-11-01

    Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medially towards the petrous apex leading to multiple cranial nerve palsies. The computed tomographic (CT) findings in malignant external otitis include obliteration of the normal fat planes in the subtemporal area as well as patchy destruction of the bony cortex of the mastoid. The point of exit of the various cranial nerves can be identified on CT scans, and the extent of the inflammatory mass correlates well with the clinical findings. Four cases of malignant external otitis are presented. In each case CT provided a good demonstration of involvement of the soft tissues at the base of the skull.

  4. Enhanced External Counterpulsation (EECP)

    PubMed Central

    2006-01-01

    class I; 35% are in class II; 25%, class III; and 5%, class IV. Surveys (8) suggest that from 5% to 15% of patients with HF have persistent severe symptoms, and that the remainder of patients with HF is evenly divided between those with mild and moderately severe symptoms. To date, the diagnosis and management of chronic HF has concentrated on patients with the clinical syndrome of HF accompanied by severe left ventricular systolic dysfunction. Major changes in treatment have resulted from a better understanding of the pathophysiology of HF and the results of large clinical trials. Treatment for chronic HF includes lifestyle management, drugs, cardiac surgery, or implantable pacemakers and defibrillators. Despite pharmacologic advances, which include diuretics, angiotensin-converting enzyme inhibitors, beta-blockers, spironolactone, and digoxin, many patients remain symptomatic on maximally tolerated doses. (6) The Technology Patients are typically treated by a trained technician in a medically supervised environment for 1 hour daily for a total of 35 hours over 7 weeks. The procedure involves sequential inflation and deflation of compressible cuffs wrapped around the patient’s calves, lower thighs and upper thighs. In addition to 3 sets of cuffs, the patient has finger plethysmogram and electrocardiogram (ECG) attachments that are connected to a control and display console. External counterpulsation was used in the United States to treat cardiogenic shock after acute myocardial infarction. (9;10) More recently, an enhanced version namely “enhanced external counterpulsation” (EECP) was introduced as a noninvasive procedure for outpatient treatment of patients with severe, uncontrollable cardiac ischemia. EECP is said to increase coronary perfusion pressure and reduce the myocardial oxygen demand. Currently, EECP is not applicable for all patients with refractory angina pectoris. For example, many patients are considered ineligible for therapy due to co

  5. Fatal sepsis by Klebsiella pneumoniae in a patient with systemic lupus erythematosus: the importance of postmortem microbiological examination for the ex post diagnosis of infection.

    PubMed

    D'Ovidio, Cristian; Pompilio, Arianna; Crocetta, Valentina; Gherardi, Giovanni; Carnevale, Aldo; Di Bonaventura, Giovanni

    2015-09-01

    The utility of postmortem microbiology has continuously been a topic of controversy. The present study describes a case of fatal sepsis in a patient with systemic lupus erythematosus. Postmortem culture and genotyping analyses allowed us to identify Klebsiella pneumoniae as the cause of sepsis, revealing the inadequateness of antimicrobial therapy.

  6. The difficult task of assessing perimortem and postmortem fractures on the skeleton: a blind text on 210 fractures of known origin.

    PubMed

    Cappella, Annalisa; Amadasi, Alberto; Castoldi, Elisa; Mazzarelli, Debora; Gaudio, Daniel; Cattaneo, Cristina

    2014-11-01

    The distinction between perimortem and postmortem fractures is an important challenge for forensic anthropology. Such a crucial task is presently based on macro-morphological criteria widely accepted in the scientific community. However, several limits affect these parameters which have not yet been investigated thoroughly. This study aims at highlighting the pitfalls and errors in evaluating perimortem or postmortem fractures. Two trained forensic anthropologists were asked to classify 210 fractures of known origin in four skeletons (three victims of blunt force trauma and one natural death) as perimortem, postmortem, or dubious, twice in 6 months in order to assess intraobserver error also. Results show large errors, ranging from 14.8 to 37% for perimortem fractures and from 5.5 to 14.8% for postmortem ones; more than 80% of errors concerned trabecular bone. This supports the need for more objective and reliable criteria for a correct assessment of peri- and postmortem bone fractures.

  7. Has Clinton made externalities extraneous

    SciTech Connect

    Haites, E.

    1993-08-01

    Over the past several years state utility regulators have become increasingly concerned with the environmental externalities associated with electricity generation. Currently, 26 states have requirements in place, although these vary considerably in scope and complexity. The vast majority apply only to the selection of new resources; the most detailed specify a monetary value for each discharge to the environment. Regulatory concern with environmental externalities stems from the desire to minimize the cost of electricity service to society. Externalities requirements focus on the residual discharges after environmental regulations are complied with. Ignoring externalities leads to inefficient use of resources and environmental damage beyond with may be called a [open quotes]socially optimal[close quotes] level of pollution. Adjusting to the cost options for environmental externalities should lead utilities to select a combination of resources that is closer to the socially optimal mix. President Bill Clinton's recent announcement that the United States will limit its emissions of carbon dioxide (CO[sub 2]) to 1990 levels by 2000 may make externalities regulation superfluous. National limits on sulfur dioxide (SO[sub 2]), nitrogen oxide (NO[sub x]), and CO[sub 2] emissions by utilities will likely be in effect by 2000. It will not be possible to comply with emissions limits solely through changes to the mix of resource additions, even though consideration of environmental externalities in resource addition decisions can reduce incremental emissions. Other strategies to reduce the emissions of existing generating stations, as well as new sources, will be needed.

  8. Determination of pesticides in postmortem blood and bone marrow of pesticide treated rabbits.

    PubMed

    Akcan, Ramazan; Hilal, Ahmet; Daglioglu, Nebile; Cekin, Necmi; Gulmen, Mete K

    2009-08-10

    Forensic toxicological analyses have traditionally focused on the use of blood, body fluids, and certain organs in examinations of deaths due to intoxication. However, in some situations, putrefaction and contamination make proper sampling from tissues impossible, such as in exhumation cases. In these cases, bone marrow might be useful as an alternative specimen since it is a potential depot for drugs. This study aims to determine pesticides in postmortem and putrefied bone marrow of pesticide treated rabbits, so as to reveal the diagnostic value of toxicological analysis of bone marrow in exhumation cases. Out of thirteen rabbits, a 110 mg/kg dose of endosulfan was orally given to six through a gavage tool, and a 2500 mg/kg dose of diazinon was given to six using the same method. One rabbit was not treated with anything and served as a control sample. Venous blood, liver, lung, kidney, brain, and bone marrow samples were collected just after spontaneous death or cervical dislocation. After this, the rabbits were buried in soil. All of them were exhumed 1 month later, and putrefied viscera and bone marrow were sampled. Blood and tissue samples underwent solvent extraction and solid phase extraction, and then the samples were analyzed by GC-MS. Mean residue levels of diazinon in early postmortem samples were 85 mg/kg, 71 mg/kg, 23 mg/kg, 21 mg/kg, 19 mg/kg, and 0.4 mg/l in the liver, bone marrow, kidney, lung, brain, and blood, respectively. Mean residue levels of diazinon in the putrefied body were 3327 mg/kg in putrefied viscera and 1783 mg/kg in the bone marrow. Mean residue levels of endosulfan isomers and metabolites in early postmortem samples (blood, liver, lung, kidney, brain, and bone marrow) were 0.46 mg/kg (endosulfan sulfate), 0.32 mg/kg (alpha and beta isomers of endosulfan), and 0.14 mg/kg (endosulfan ether) while the same levels were 0.26 mg/kg (endosulfan sulfate), 0.24 mg/kg (alpha and beta isomers of endosulfan), and 0.1 mg/kg (endosulfan ether) in

  9. Combined Determination of Glucose and Fructosamine in Vitreous Humor as a Post-Mortem Tool to Identify Antemortem Hyperglycemia

    PubMed Central

    Vivero, Guillermo; Vivero-Salmerón, Guillermo; Pérez Cárceles, Maria D.; Bedate, Andrés; Luna, Aurelio; Osuna, Eduardo

    2008-01-01

    In clinical practice, serum glucose levels are used to diagnose diabetes mellitus. In post-mortem diagnosis, however, biochemical markers in vitreous humor are more useful because of the difficulty involved in interpreting blood glucose levels and relatively non-specific pathological features. The aim of this study was to analyze the usefulness of post-mortem determination of glucose and fructosamine combined and to compare the results with those obtained for fructosamine and combined glucose and lactate levels in two diagnostic groups (one diabetic and the other non-diabetic). We studied 377 cadavers (mean age 57.6 yr, SD 20.4, range 15 to 98 yr) with a mean post-mortem interval of 14.9 h. (SD 6.0; range 2 to 24 h). The highest levels were obtained in cases where diabetes mellitus had previously been diagnosed. In relation to diagnostic performance, the most reliable values were those in which glucose and fructosamine were determined jointly. The findings provide information concerning the usefulness of measuring glucose and fructosamine levels as a post-mortem tool for identifying antemortem glycemic control in diabetics. PMID:19290382

  10. Tearing of the left iliac vessels in lumbar surgery revealed by multiphase post-mortem CT-angiography (MPMCTA).

    PubMed

    Vilariño Villaverde, Raquel; Bruguier, Christine; Zerlauth, Jean-Baptiste; De Froidmont, Sébastien; Grabherr, Silke

    2016-05-01

    Lumbar surgery is regularly applied in cases of discal hernia and acquired lumbar stenosis. In this report, we present a case of a laceration in the left common iliac artery and iliac vein during a lumbar surgery and discuss the literature concerning this kind of event. In the present case, the surgical procedure was followed by a sudden decrease in blood pressure, and the surgeon discovered an intra-abdominal haemorrhage that led to the patient's death. Postmortem investigation confirmed the intra-abdominal haemorrhage and revealed a laceration of the proximal portion of the left common iliac artery and left iliac vein. The source of bleeding could be detected especially thanks to multi-phase postmortem CT angiography (MPMCTA), which was performed prior to autopsy. We also found a haemorrhagic path through the intervertebral disc between the L4-L5 vertebrae, caused by the surgeon's instrument (pituitary rongeur). To date, a few cases have been described of iatrogenic death resulting from a tear in the iliac vessels during lumbar surgery, but not from the postmortem perspective. Such investigations have recently been modernized thanks to the introduction of forensic imaging. In particular, MPMCTA offers new possibilities in postmortem investigations and can be considered the new gold standard for investigating deaths related to medical intervention. Here we describe the first case of a death during lumbar surgery using this new method.

  11. The Caspase Proteolytic System in Callipyge and Normal Lambs in Longissimus, Semimembranosus, and Infraspinatus Muscles During Postmortem Storage

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this experiment was to determine whether the caspase proteolytic system has a role in postmortem tenderization. Six ewes and six wethers that were non-carriers and six ewes and six wethers that were expressing the callipyge gene were used for this study. Caspase activities were de...

  12. Post-mortem evidence of idiopathic left ventricular hypertrophy and idiopathic interstitial myocardial fibrosis: is exercise the cause?

    PubMed Central

    Whyte, Gregory; Sheppard, Mary; George, Keith; Shave, Robert; Prasad, Sanjay; O’Hanlon, Rory; Sharma, Sanjay

    2009-01-01

    We report the case of an experienced, highly trained marathon runner who died suddenly while running. On post-mortem examination, left ventricle hypertrophy and idiopathic interstitial myocardial fibrosis was found. We believe that life-long, repetitive bouts of arduous physical activity resulted in fibrous replacement of the myocardium, causing a pathological substrate for the propagation of fatal arrhythmias. PMID:21686644

  13. Metabolomics and neuroanatomical evaluation of post-mortem changes in the hippocampus.

    PubMed

    Gonzalez-Riano, Carolina; Tapia-González, Silvia; García, Antonia; Muñoz, Alberto; DeFelipe, Javier; Barbas, Coral

    2017-03-11

    Understanding the human brain is the ultimate goal in neuroscience, but this is extremely challenging in part due to the fact that brain tissue obtained from autopsy is practically the only source of normal brain tissue and also since changes at different levels of biological organization (genetic, molecular, biochemical, anatomical) occur after death due to multiple mechanisms. Here we used metabolomic and anatomical techniques to study the possible relationship between post-mortem time (PT)-induced changes that may occur at both the metabolomics and anatomical levels in the same brains. Our experiments have mainly focused on the hippocampus of the mouse. We found significant metabolomic changes at 2 h PT, whereas the integrity of neurons and glia, at the anatomical/ neurochemical level, was not significantly altered during the first 5 h PT for the majority of histological markers.

  14. Potential Use of Bacterial Community Succession in Decaying Human Bone for Estimating Postmortem Interval.

    PubMed

    Damann, Franklin E; Williams, Daniel E; Layton, Alice C

    2015-07-01

    Bacteria are taphonomic agents of human decomposition, potentially useful for estimating postmortem interval (PMI) in late-stage decomposition. Bone samples from 12 individuals and three soil samples were analyzed to assess the effects of decomposition and advancing time on bacterial communities. Results indicated that partially skeletonized remains maintained a presence of bacteria associated with the human gut, whereas bacterial composition of dry skeletal remains maintained a community profile similar to soil communities. Variation in the UniFrac distances was significantly greater between groups than within groups (p < 0.001) for the unweighted metric and not the weighted metric. The members of the bacterial communities were more similar within than between decomposition stages. The oligotrophic environment of bone relative to soft tissue and the physical protection of organic substrates may preclude bacterial blooms during the first years of skeletonization. Therefore, community membership (unweighted) may be better for estimating PMI from skeletonized remains than community structure (weighted).

  15. Estimating the postmortem interval of human skeletal remains by analyzing their optical behavior.

    PubMed

    Sterzik, V; Jung, T; Jellinghaus, K; Bohnert, M

    2016-11-01

    The aim of this study was to figure out a new practically applicable method to distinguish between historical and recent human skeletal remains. Therefore, the optical behavior of bone cross sections was investigated using the combination of two methods: a modification of an already established test (UV-induced fluorescence) and a new method (490 nm-induced fluorescence). We evaluated the areal extent of fluorescence of 30 bone cross sections with known postmortem interval (PMI) using ultraviolet light and 490 nm light. For analysis, the areal extend of fluorescent surface was determined using photos of the samples and an image editing software. The results prove that there is a correlation between PMI and the areal extent of fluorescent surface in both tests. Furthermore, the combination of both methods is a good indicator to distinguish within the forensic relevant post mortem interval between PMI < 30 years and PMI > 30 years.

  16. Identification, Collection, and Preservation of Veterinary Forensic Evidence: On Scene and During the Postmortem Examination.

    PubMed

    Touroo, R; Fitch, A

    2016-09-01

    Although it is the obligation of the veterinary forensic pathologist to be competent in identifying, collecting, and preserving evidence from the body, it is also necessary for them to understand the relevance of conditions on the crime scene. The body is just one piece of the puzzle that needs to be considered when determining the cause of death. The information required for a complete postmortem analysis should also include details of the animal's environment and items of evidence present on the crime scene. These factors will assist the veterinary forensic pathologist in the interpretation of necropsy findings. Therefore, the veterinary forensic pathologist needs to have a basic understanding of how the crime scene is processed, as well as the role of the forensic veterinarian on scene. In addition, the veterinary forensic pathologist must remain unbiased, necessitating an understanding of evidence maintenance and authentication.

  17. Pediatric fatality following ingestion of dinitrophenol: postmortem identification of a "dietary supplement".

    PubMed

    Hsiao, Allen L; Santucci, Karen A; Seo-Mayer, Patricia; Mariappan, M Rajan; Hodsdon, Michael E; Banasiak, Kenneth J; Baum, Carl R

    2005-01-01

    Dinitrophenol, a chemical currently used as an insecticide, is known to uncouple mitochondrial oxidative phosphorylation. A component of explosives, it has also been used in the past as a food coloring and clothing dye. In the 1930s, physicians prescribed it for weight loss, but this practice was discontinued when reports of cataracts, deaths, and other adverse outcomes came to light. We describe in our report the overdose and fatality of a teenager who purchased the product as a weight loss dietary supplement by mail order. We also describe a laboratory method that allowed postmortem determination of the dinitrophenol concentration in the victim's serum. Her death, despite prompt medical treatment, underscores the danger of dinitrophenol. The easy accessibility and apparent resurgent interest in dinitrophenol as a weight loss agent is extremely timely and troubling.

  18. Determination of the postmortem interval by Laser Induced Breakdown Spectroscopy using swine skeletal muscles

    NASA Astrophysics Data System (ADS)

    Marín-Roldan, A.; Manzoor, S.; Moncayo, S.; Navarro-Villoslada, F.; Izquierdo-Hornillos, R. C.; Caceres, J. O.

    2013-10-01

    Skin and muscle samples are useful to discriminate individuals as well as their postmortem interval (PMI) in crime scenes and natural or caused disasters. In this study, a simple and fast method based on Laser Induced Breakdown Spectroscopy (LIBS) has been developed to estimate PMI using swine skeletal muscle samples. Environmental conditions (moisture, temperature, fauna, etc.) having strong influence on the PMI determination were considered. Time-dependent changes in the emission intensity ratio for Mg, Na, Hα and K were observed, as a result of the variations in their concentration due to chemical reactions in tissues and were correlated with PMI. This relationship, which has not been reported previously in the forensic literature, offers a simple and potentially valuable means of estimating the PMI.

  19. Postmortem scavenging by the Virginia opossum (Didelphis virginiana): Impact on taphonomic assemblages and progression.

    PubMed

    King, Kama A; Lord, Wayne D; Ketchum, Heather R; O'Brien, R Christopher

    2016-09-01

    The Virginia opossum (Didelphis virginiana) is a highly active scavenger whose behavior has significant impacts on rates of decomposition and skeletonization, which have previously not been addressed. In this study, scavenging by the opossum led to the skeletonization of carcasses in half of the accumulated degree days (ADD) of a comparable non-scavenged control carcass. Opossums used body orifices, as well as natural tears caused by the decomposition process, to access internal tissues and consume them. This activity resulted in little movement of the carcass and the retained appearance of natural undisturbed decomposition. This concealed activity has the potential to cause drastically incorrect estimates of time since deposition and post-mortem interval. Scavenging by opossums was also found to leave distinct tooth mark and other defects on bone, which have not been previously distinguished in the literature. This research suggests, beyond effects on PMI, that scavenging by opossums has been historically overlooked and misattributed to canid scavengers.

  20. Post-mortem surface features in larger foraminiferan Archaias angulatus as paleoenvironmental indicator

    SciTech Connect

    Cottey, T.L.

    1986-05-01

    Larger foraminifera are major contributors to sand-sized carbonate sediments. Archaias angulatus (Fichtel and Moll) is the dominant larger foraminiferan in the Caribbean region. A taphonomic study of this species revealed several stages of preservation from newly unaltered tests to complete destruction of outer calcite layers. Tests collected from contrasting environments in Key Largo, Florida, show different paths of degradation. Impact features and secondary growths predominate on tests collected from well-sorted sediments of the open platform, whereas dissolution features are most common on tests from the calm, muddy environment of Largo Sound. Tests from the open platform show major breakage, abundant scratches, and small, randomly spaced holes. Tests from Largo Sound show little breakage, few scratches, and loss of entire sections of the outer wall. Microborings are present on tests from both environments. This study shows that postmortem alterations of surface textures of larger foraminifera may be useful indicators of paleoenvironments of deposition.

  1. Postmortem analysis of sand grain crushing from pile interface using X-ray tomography

    SciTech Connect

    Silva, I. Matias; Combe, Gaeel; Foray, Pierre; Flin, Frederic; Lesaffre, Bernard

    2013-06-18

    Pile foundations of offshore platforms, wind and water turbines are typically subjected to a variety of cyclic loading paths due to their complex environment. While many studies focus on global pile behaviour, the soil-pile interface is explored here by a micromechanical study of the soil layer in contact with the pile surface. This work is devoted to the analysis of frozen post-mortem silica sand samples recovered at the pile interface following installation and cyclic loading tests in a calibration chamber using x-ray tomography. An experimental procedure developed for three dimensional (3D) snow imaging was adapted for the recovery of the in-situ sand samples to preserve their structure during tomography scans. 3D images at a pixel size of 7 {mu}m were then obtained using a cryogenic cell. Results confirm the presence of a shear band at the pile surface as well as void ratios changes in the direction of the pile's radius.

  2. Lung Postmortem Autopsy Revealing Extramedullary Involvement in Multiple Myeloma Causing Acute Respiratory Distress Syndrome

    PubMed Central

    Ravinet, Aurélie; Perbet, Sébastien; Guièze, Romain; Guérin, Renaud; Gayraud, Guillaume; Aliane, Jugurtha; Tremblay, Aymeric; Pascal, Julien; Ledoux, Albane; Chaleteix, Carine; Dechelotte, Pierre; Bay, Jacques-Olivier; Bazin, Jean-Etienne; Constantin, Jean-Michel

    2014-01-01

    Pulmonary involvement with multiple myeloma is rare. We report the case of a 61-year-old man with past medical history of chronic respiratory failure with emphysema, and a known multiple myeloma (Durie and Salmon stage III B and t(4;14) translocation). Six months after diagnosis and first line of treatment, he presented acute dyspnea with interstitial lung disease. Computed tomography showed severe bullous emphysema and diffuse, patchy, multifocal infiltrations bilaterally with nodular character, small bilateral pleural effusions, mediastinal lymphadenopathy, and a known lytic lesion of the 12th vertebra. He was treated with piperacillin-tazobactam, amikacin, oseltamivir, and methylprednisolone. Finally, outcome was unfavourable. Postmortem analysis revealed diffuse and nodular infracentimetric infiltration of the lung parenchyma by neoplastic plasma cells. Physicians should be aware that acute respiratory distress syndrome not responding to treatment of common causes could be a manifestation of the disease, even with negative BAL or biopsy and could be promptly treated with salvage therapy. PMID:25165587

  3. Enkephalin, dynorphin and substance P in postmortem substantia nigra from normals and schizophrenic patients

    SciTech Connect

    Iadarola, M.J.; Ofri, D.; Kleinman, J.E. National Institute of Mental Health, Washington, DC )

    1991-01-01

    Three peptide neuromodulators that are found in high concentration in the subtantia nigra: dynorphin A 1,8-met5-enkephalin-arg6-gly7-leu8 and substance P, were measured by specific radioimmunoassays in nigral tissue from normals and schizophrenics postmortem. Substance P and dynorphin were unchanged between the two groups. However, the proenkephalin-derived peptide was significantly elevated in the schizophrenic group. The immunoreactivity was identified as authentic met5-enkephalin-arg6-gly7-leu8 by high pressure liquid chromatography. The data suggest that a different set of regulatory controls exists for nigral enkephalin peptides as compared to dynorphin and substance P, and that the former system may be disordered in schizophrenia.

  4. Postmortem analysis of sand grain crushing from pile interface using X-ray tomography

    NASA Astrophysics Data System (ADS)

    Silva, I. Matías; Combe, Gaël; Foray, Pierre; Flin, Frédéric; Lesaffre, Bernard

    2013-06-01

    Pile foundations of offshore platforms, wind and water turbines are typically subjected to a variety of cyclic loading paths due to their complex environment. While many studies focus on global pile behaviour, the soil-pile interface is explored here by a micromechanical study of the soil layer in contact with the pile surface. This work is devoted to the analysis of frozen post-mortem silica sand samples recovered at the pile interface following installation and cyclic loading tests in a calibration chamber using x-ray tomography. An experimental procedure developed for three dimensional (3D) snow imaging was adapted for the recovery of the in-situ sand samples to preserve their structure during tomography scans. 3D images at a pixel size of 7 μm were then obtained using a cryogenic cell. Results confirm the presence of a shear band at the pile surface as well as void ratios changes in the direction of the pile's radius.

  5. Clinical or Postmortem? The Importance of the Autopsy; a Retrospective Study

    PubMed Central

    COSTACHE, Mariana; LAZAROIU, Anca Mihaela; CONTOLENCO, Andreea; COSTACHE, Diana; GEORGE, Simion; SAJIN, Maria; PATRASCU, Oana Maria

    2014-01-01

    Medicine is continually evolving; the new technologies of diagnosis and treatment continue to improve the life expectancy and lead to new information concerning various pathologies. The autopsy is viewed more and more as an ultimate branch of medicine and used only in extreme cases or for forensic purposes. Nevertheless, many studies, including this one, prove the utility and indispensability of the autopsies, without which a complete and accurate diagnosis cannot be made. Finally, the autopsy followed by histopathological examination of the tissues remains the ultimate and most important step for the apprehension of the diseases and for further evolution of medicine. This study reveals the correspondence rate between the clinical and the postmortem diagnosis, as well as between macroscopic and histopathological diagnosis. PMID:25705288

  6. A retrospective study of postmortem findings in red-tailed hawks

    USGS Publications Warehouse

    Franson, J.C.; Thomas, N.J.; Smith, M.R.; Robbins, A.H.; Newman, S.; McCartin, P.C.

    1996-01-01

    We studied necropsy results from carcasses of 163 red-tailed hawks (Buteo jamaicensis) submitted to the National Wildlife Health Center from 1975 through 1992. The most frequent postmortem finding was emaciation of unknown etiology, diagnosed in 33 (20%) carcasses. Proportionally more juveniles than adults were emaciated. Evidence of non-gunshot trauma, often suggestive of collision with vehicles or structures near roadways, was found in 29 (18%) birds. Of 25 (15%) toxicoses, 20 were attributed to agricultural pesticides, including famphur (4), fenthion (3), carbofuran (2), phosphamidon (2), endrin (1), and unidentified organophosphorus compounds (8). Lead and strychnine poisoning were diagnosed in two birds each, and selenium poisoning in one. Diseases, including aspergillosis, tuberculosis, pasteurellosis, and pox, were found in 21 (13%) hawks. Gunshot and electrocution were each diagnosed in six (4%) birds, one (0.6%) was trapped, miscellaneous conditions were found in 10 (6%), and no diagnosis could be determined for 32 (19%) of the carcasses.

  7. Post-mortem investigations on a leatherback turtle Dermochelys coriacea stranded along the Northern Adriatic coastline.

    PubMed

    Poppi, Lisa; Zaccaroni, Annalisa; Pasotto, Daniela; Dotto, Giorgia; Marcer, Federica; Scaravelli, Dino; Mazzariol, Sandro

    2012-08-13

    Leatherback sea turtles Dermochelys coriacea are regularly reported in the Mediterranean Sea but rarely reach the northern Adriatic Sea. In the summer of 2009, a well-preserved carcass of an adult female of this species was found dead along the coast of Lido di Venezia. A complete necropsy was carried out, along with evaluation of levels of tissue trace elements. The the post-mortem revealed acute severe bacterial gastroenteritis caused by Photobacterium damselae ssp. piscicida, an opportunistic agent that infected an apparently debilitated animal weakened by ingested plastic debris. High levels of heavy metals (Hg, Pb, Cd and As) found in the liver and kidneys might have contributed to the animal's demise. These findings support previous indications that marine debris is one of the major threats to marine animals, particularly for critically endangered species such as the leatherback turtle.

  8. Comparison of protocols for measuring and calculating postmortem submersion intervals for human analogs in fresh water.

    PubMed

    Humphreys, Michael K; Panacek, Edward; Green, William; Albers, Elizabeth

    2013-03-01

    Protocols for determining postmortem submersion interval (PMSI) have long been problematic for forensic investigators due to the wide variety of factors affecting the rate of decomposition of submerged carrion. Likewise, it has been equally problematic for researchers to develop standardized experimental protocols to monitor underwater decomposition without artificially affecting the decomposition rate. This study compares two experimental protocols: (i) underwater in situ evaluation with photographic documentation utilizing the Heaton et al. total aquatic decomposition (TAD) score and (ii) weighing the carrion before and after submersion. Complete forensic necropsies were performed as a control. Perinatal piglets were used as human analogs. The results of this study indicate that in order to objectively measure decomposition over time, the human analog should be examined at depth using the TAD scoring system rather than utilizing a carrion weight evaluation. The acquired TAD score can be used to calculate an approximate PMSI.

  9. Gene expression profiling in postmortem prefrontal cortex of major depressive disorder.

    PubMed

    Kang, Hyo Jung; Adams, David H; Simen, Arthur; Simen, Birgitte B; Rajkowska, Grazyna; Stockmeier, Craig A; Overholser, James C; Meltzer, Herbert Y; Jurjus, George J; Konick, Lisa C; Newton, Samuel S; Duman, Ronald S

    2007-11-28

    Investigations of the molecular mechanisms underlying major depressive disorder (MDD) have been hampered by the complexity of brain tissue and sensitivity of gene expression profiling approaches. To address these issues, we used discrete microdissections of postmortem dorsolateral prefrontal cortex (DLPFC) (area 9) and an oligonucleotide (60mer) microarray hybridization procedure that increases sensitivity without RNA amplification. Mixed-effects statistical methods were used to rigorously control for medication usage in the subset of medicated depressed subjects. These analyses yielded a rich profile of dysregulated genes. Two of the most highly dysregulated genes of interest were stresscopin, a neuropeptide involved in stress responses, and Forkhead box D3 (FOXD3), a transcription factor. Secondary cell-based analysis demonstrated that stresscopin and FoxD3 are increased in neurons of DLPFC gray matter of MDD subjects. These findings identify abnormal gene expression in a discrete region of MDD subjects and contribute to further elucidation of the molecular alterations of this complex mood disorder.

  10. Postmortem examination of 22 pancreatic carcinoma patients treated with helium ion irradiation

    SciTech Connect

    Woodruff, K.H.; Castro, J.R.; Quivey, J.M.; Saunders, W.M.; Chen, G.T.; Lyman, J.T.; Pitluck, S.; Tobias, C.A.; Walton, R.E.; Peters, T.C.

    1984-02-01

    Postmortem findings are available in this report in 22 patients with pancreatic carcinoma treated with helium ions at Lawrence Berkeley Laboratory; California. This represents the largest group evaluated histologically in the literature and is the first report evaluating effects of particle radiation in pancreatic tissue. Patient survival after therapy averaged 9 months. Most died of infection and/or pulmonary emboli. Local control was achieved in 27%. The pancreatic tumors had histologically more severe radiation changes than nontumor bearing pancreas. Irradiated bone marrow was severely hypocellular, and irradiated skin was atrophic. Five patients had radiation injury in the gastrointestinal tract. The spinal cord, liver, and kidneys showed no damage. This study demonstrates the safety of helium particle irradiation with present therapeutic planning. Injury to tumor was seen without excessive damage to adjacent tissues.

  11. The effects of soil environment on postmortem interval: a macroscopic analysis.

    PubMed

    Jaggers, Kimberley A; Rogers, Tracy L

    2009-11-01

    Burial environment, in particular soil moisture, has a significant impact on the type, rate, and extent of bone degradation, which ultimately affects estimations of the postmortem interval (PMI). The purpose of this research is to determine the effects of soil moisture on the color, weight, condition, and texture of bone as it relates to the PMI. Bone changes occurring over two different time intervals (2 and 5 months) were examined using 120 sus scrofa leg bones. During each time interval bones were buried in two soil environments, one of which was drier than the other. The bones in both environments lost weight over time but the net weight loss was greater for bones in the higher moisture environment. There was no change in color, texture, or overall condition, indicating that 150 days is not long enough for such alterations to occur, regardless of the moisture level of the burial environment.

  12. Modification of postmortem wounds by Dermestes maculatus (Coleoptera: Dermestidae) activity: A preliminary study.

    PubMed

    Zanetti, Noelia I; Ferrero, Adriana A; Centeno, Néstor D

    2015-11-01

    The purpose of this analysis was to evaluate the effects of insect activity on hacking trauma which was inflicted with a small cleaver and a razor blade under controlled conditions. Three pig hooves were each subjected to a blow with a small cleaver and a cut with a razor blade prior to insect exposure. We used Dermestes maculatus DeGeer 1774 species. These beetles made principally depressions and destruction on both wounds, and bites were observed on the edges of the wounds. As time passed and insects fed and refuge, chop marks were deformed and disappeared, taking this less than a month. Thus, D. maculatus could mask postmortem wounds and probably premortem wounds, and so the cause of death.

  13. Next-Generation Sequencing in Post-mortem Genetic Testing of Young Sudden Cardiac Death Cases

    PubMed Central

    Lahrouchi, Najim; Behr, Elijah R.; Bezzina, Connie R.

    2016-01-01

    Sudden cardiac death (SCD) in the young (<40 years) occurs in the setting of a variety of rare inherited cardiac disorders and is a disastrous event for family members. Establishing the cause of SCD is important as it permits the pre-symptomatic identification of relatives at risk of SCD. Sudden arrhythmic death syndrome (SADS) is defined as SCD in the setting of negative autopsy findings and toxicological analysis. In such cases, reaching a diagnosis is even more challenging and post-mortem genetic testing can crucially contribute to the identification of the underlying cause of death. In this review, we will discuss the current achievements of “the molecular autopsy” in young SADS cases and provide an overview of key challenges in assessing pathogenicity (i.e., causality) of genetic variants identified through next-generation sequencing. PMID:27303672

  14. DNA methylation of Alzheimer disease and tauopathy-related genes in postmortem brain.

    PubMed

    Barrachina, Marta; Ferrer, Isidre

    2009-08-01

    DNA methylation occurs predominantly at cytosines that precede guanines in dinucleotide CpG sites; it is one of the most important mechanisms for epigenetic DNA regulation during normal development and for aberrant DNA in cancer. To determine the feasibility of DNA methylation studies in the postmortem human brain, we evaluated brain samples with variable postmortem artificially increased delays up to 48 hours. DNA methylation was analyzed in selected regions of MAPT, APP, and PSEN1 in the frontal cortex and hippocampus of controls (n=26) and those with Alzheimer disease at Stages I to II (n=17); Alzheimer disease at Stages III to IV (n=15); Alzheimer disease at Stages V to VI (n=12); argyrophilic grain disease (n=10); frontotemporal lobar degeneration linked to tau mutations (n=6); frontotemporal lobar degeneration with ubiquitin-immunoreactive inclusions (n=4); frontotemporal lobar degeneration with motor neuron disease (n=3); Pick disease (n=3); Parkinson disease (n=8); dementia with Lewy bodies, pure form (n=5); and dementia with Lewy bodies, common form (n=15). UCHL1 (ubiquitin carboxyl-terminal hydrolase 1 gene) was analyzed in the frontal cortex of controls and those with Parkinson disease and related synucleinopathies. DNA methylation sites were very reproducible in every case. No differences in the percentage of CpG methylation were found between control and disease samples or among the different pathological entities in any region analyzed. Because small changes in methylation of DNA promoters in vulnerable cells might have not been detected in total homogenates, however, these results should be interpreted with caution, particularly as they relate to chronic degenerative diseases in which small modifications may be sufficient to modulate disease progression.

  15. Postmortem lung volume/body weight standards for term and preterm infants.

    PubMed

    De Paepe, Monique E; Shapiro, Svetlana; Hansen, Katrine; Gündoğan, Füsun

    2014-01-01

    Assessment of lung growth is a critical component of the perinatal autopsy. Increased lung liquid content may lead to overestimation of lung growth based on (wet) lung weight. In contrast, lung volume is not influenced by intraalveolar lung liquid. Our aim was to establish age-specific reference values for postmortem lung volume/BW in preterm and term infants. We performed a retrospective analysis of fetuses/infants (16-41 weeks' gestation) without (N = 134) or with (N = 79) risk factors for pulmonary hypoplasia. Lungs were inflated at standardized pressure and volumes determined by water immersion method. Lung volume increased 11-fold between 16 and 41 weeks' gestation, concomitant with a 16-fold increase in BW. Mean lung volume/BW remained constant at 33-34 ml/kg between 16 and 31 weeks' gestation and decreased to 23.4 ml/kg at term. Lung volume/BW of infants with severe risk factors (renal anomalies, diaphragmatic hernia) was significantly lower than age-matched standards. In this group, all fetuses/infants diagnosed as having lung hypoplasia by lung volume/BW also had lung hypoplasia LW/BW standards. However, in infants with "softer" risk factors (rupture of membranes, chromosomal anomalies), 5/26 cases diagnosed with lung hypoplasia based on lung volume/BW had normal LW/BW ratios. In these discrepant cases, lung sections showed significant inflammation and edema, likely accounting for increased wet lung weight. In conclusion, we determined age-specific lung volume/BW reference values for preterm and term infants. In selected situations assessment of lung volume/BW may represent a useful complementary tool to LW/BW for postmortem evaluation of lung size.

  16. Development of a biomolecular assay for postmortem diagnosis of Taenia saginata Cysticercosis.

    PubMed

    Chiesa, Francesco; Dalmasso, Alessandra; Bellio, Alberto; Martinetti, Manuela; Gili, Stefano; Civera, Tiziana

    2010-10-01

    Bovine cysticercosis is caused by the larval stage of the human tapeworm Taenia saginata. According to European data on meat inspection, the prevalence ranges from 0.007% to 6.8%, but the real prevalence is considered to be at least 10 times higher. Laboratory confirmation of the etiological agent is based on gross, stereomicroscopic, and histological examination of submitted specimens. False identifications may occur, possibly because of death and degeneration of cysts, or because taeniid larvae and other tissue parasites, such as Sarcocystis spp., may cause similar macroscopic morphological lesions. Therefore, tests that can warrant sure identification of taeniid lesions and calcified cysts in the muscle are needed. The focus of our study was to develop a suitable postmortem test that could be applied on putative lesions by T. saginata cysticerci, as ambiguously diagnosed after routine meat inspection. In particular, we proposed a biomolecular assay targeting the mitochondrial cytochrome c oxidase subunit I gene (COI). For developing the polymerase chain reaction assay, viable cysts of Cysticercus bovis (n = 10) were used as positive reference samples, and those of Echinococcus granulosus (n = 3), Cysticercus tenuicollis (n = 3), and Sarcocystis spp. (n = 4) as reference negative controls. Further, to evaluate the applicability of the proposed assay, 171 samples of bovine muscular tissue, obtained from local slaughterhouses and containing lesions recognized as T. saginata cysticerci by macroscopic examination, were tested. The proposed test confirmed the diagnosis at postmortem inspection in 94.7% (162/171) of samples. In conclusion, the assay developed in this study, amplifying a short fragment from the mitochondrial gene COI, showed to be suitable for samples containing both viable and degenerating T. saginata cysticerci, yielding an unequivocal diagnosis.

  17. Evidence for impaired glucose metabolism in the striatum, obtained postmortem, from some subjects with schizophrenia

    PubMed Central

    Dean, B; Thomas, N; Scarr, E; Udawela, M

    2016-01-01

    Studies using central nervous system tissue obtained postmortem suggest pathways involved in energy and metabolism contribute to the pathophysiology of schizophrenia; neuroimaging studies suggesting glucose metabolism is particularly affected in the striatum. To gain information on the status of pathways involved in glucose metabolism in the striatum, we measured levels of glucose, pyruvate, acetyl-CoA and lactate as well as the β subunit of pyruvate dehydrogenase, a rate limiting enzyme, in the postmortem tissue from subjects with schizophrenia and age/sex-matched controls. The subjects with schizophrenia were made up of two subgroups, which could be divided because they either had (muscarinic receptor deficit schizophrenia (MRDS)), or did not have (non-MRDS), a marked deficit in cortical muscarinic receptors. Compared to controls, levels of β subunit of pyruvate dehydrogenase were lower (Δ mean=−20%) and levels of pyruvate (Δ mean=+47%) and lactate (Δ mean=+15%) were significantly higher in the striatum from subjects with schizophrenia. Notably, in subjects with non-MRDS, striatal levels of β subunit of pyruvate dehydrogenase were lower (Δ mean=−29%), whereas levels of pyruvate (Δ mean=−66%), acetyl-CoA (Δ mean=−28%) and glucose (Δ mean=-27%) were higher, whereas levels of lactate (Δ mean=+17%) were higher in MRDS. Finally, discriminate analyses using levels the β subunit of pyruvate dehydrogenase and glucose, or better still, β subunit of pyruvate dehydrogenase and glucose in combination with pyruvate, lactate or acetyl-CoA could separate subjects with non-MRDS from controls with high levels of specificity (up to 93%) and selectivity (up to 91%). Our data show the benefit of being able to study defined subgroups within the syndrome of schizophrenia as such an approach has revealed that changes in glucose metabolism may be a significant contributor to the pathophysiology of non-MRDS. PMID:27845781

  18. Risk Factors for Fatal Hyperglycaemia Confirmed by Forensic Postmortem Examination - A Nationwide Cohort in Sweden

    PubMed Central

    Walz, Lotta; Jönsson, Anna K.; Zilg, Brita; Östgren, Carl Johan; Druid, Henrik

    2016-01-01

    Aims/Hypothesis The aim of this study was to identify risk factors associated with confirmed fatal hyperglycaemia, which could predispose potentially preventable deaths in individuals on glucose lowering drugs. Methods A retrospective register-based case-control study conducted on a nationwide cohort with individuals who died due to hyperglycaemia as determined by forensic postmortem examination, in Sweden August 2006 to December 2012. Vitreous glucose was used to diagnose hyperglycaemia postmortem. The forensic findings stored in the National Forensic Medicine Database were linked to nationwide registers. Cases that died due to confirmed hyperglycemia with dispensed glucose lowering drugs were identified and living controls with dispensed glucose lowering drugs were randomly selected in the Swedish prescribed drug register and matched on age and sex. Information on comorbidities, dispensed pharmaceuticals, clinical data and socioeconomic factors were obtained for cases and controls. Adjusted multiple logistic regression models were used to identify risk factors associated with fatal hyperglycaemia. Results During the study period 322 individuals, mostly males (79%) with the mean age of 53.9 years (SD.± 14) died due to confirmed hyperglycaemia. Risk factors for fatal hyperglycaemia included; insulin treatment (OR = 4.40; 95%CI,1.96, 9.85), poor glycaemic control (OR = 2.00 95%CI,1.23, 3.27), inadequate refill-adherence before death (OR = 3.87; 95%CI,1.99, 7.53), microvascular disease (OR = 3.26; 95% CI, 1.84, 5.79), psychiatric illness (OR = 2.30; 95% CI,1.32, 4.01), substance abuse (OR = 8.85; 95%CI,2.34, 35.0) and/or living alone (OR = 2.25; 95%CI,1.21, 4.18). Conclusions/Interpretation Our results demonstrate the importance of clinical attention to poor glycaemic control in subjects with psychosocial problems since it may indicate serious non-adherence, which consequently could lead to fatal hyperglycaemia. PMID:27768720

  19. Early postmortem volume reduction of adrenal gland: initial longitudinal computed tomographic study.

    PubMed

    Ishida, Masanori; Gonoi, Wataru; Hagiwara, Kazuchika; Okuma, Hidemi; Shirota, Go; Shintani, Yukako; Abe, Hiroyuki; Takazawa, Yutaka; Fukayama, Masashi; Ohtomo, Kuni

    2015-07-01

    We aimed to confirm whether postmortem adrenal volumetric changes occur by measuring adrenal volumes on computed tomography (CT). Fifty-five adrenal glands from 28 subjects who died were included. All subjects underwent antemortem CT (AMCT) and postmortem CT (PMCT) within 94-1,191 min after death, followed by conventional autopsy. CT volumetry was performed using freely-available software. Differences between AMCT and PMCT adrenal volumes were evaluated statistically along with differences in the degree of volume change, elapsed time to PMCT, and presence of underlying malignant disease. The mean volume of the right adrenal gland decreased from 3.8 cm(3) on AMCT to 2.6 cm(3) on PMCT (P < 0.001); the left adrenal gland decreased from 4.2 cm(3) on AMCT to 3.1 cm(3) on PMCT (P < 0.001). Conventional autopsy revealed decreased intracellular lipid components in portions of the adrenal glands. No correlation between the adrenal gland reduction rate and the elapsed time from AMCT to death or from death to PMCT was observed (P = 0.99 and 0.79; P = 0.28 and 0.59 for the right and left adrenal glands, respectively). Significant differences in both the bilateral adrenal gland reduction rates and underlying malignant disease were found for the left adrenal gland (P = 0.015), but not for the right (P = 0.74). Adrenal volume reduction was observed on PMCT compared to AMCT. This highlights the need to further elucidate the mechanism of adrenal shrinkage during the agonal stage and after death. This may be explained by pathological findings of intracellular lipid depletion.

  20. Meiotic maturation of oocytes recovered from the ovaries of Indian big cats at postmortem.

    PubMed

    Rao, Brahmasani Sambasiva; Mahesh, Yelisetti Uma; Suman, Komjeti; Charan, Katari Venu; Nath, Rhisita; Rao, K Ramachander

    2015-01-01

    In order to increase the available sources of genetic material for endangered members of the great cat family, this study was designed to assess the meiotic competence of oocytes recovered from postmortem ovaries of the Indian leopard, tiger and lion. The average number of oocytes that were recovered per ovary was 11.0 ± 5.0, 11.0 ± 3.5 and 21.3 ± 8.8 for tiger, lion and leopard, respectively. The proportion of culture grade oocytes for tiger, lion and leopard were 72.7, 78.8 and 71.9%, respectively. The culture grade oocytes were matured in tissue culture medium 199 modified with sodium bicarbonate supplemented with 0.3% BSA (fatty acid-free) (w/v), 10 μg/ml FSH, 6 IU/ml LH, 1 μg/ml 17β-estradiol, 0.36 mM pyruvate, 2.2 mM calcium lactate, 2.0 mM L-glutamine, 100 IU/ml penicillin and 0.1 mg/ml streptomycin in an incubator with 5% CO2 under humidified air at 38.5°C for 36 h. After in vitro maturation, 56.3, 53.8 and 58.7% of the tiger, lion and leopard oocytes, respectively, were matured. The proportion of oocytes that extruded first polar body was significantly higher when the oocytes were collected from the animals of less than 15 yr of age compared to above 15 yr. These findings suggest that the oocytes recovered from ovaries of tiger, lion and leopard immediately postmortem can be successfully matured to MII stage.

  1. Open chromatin profiling of human postmortem brain infers functional roles for non-coding schizophrenia loci.

    PubMed

    Fullard, John F; Giambartolomei, Claudia; Hauberg, Mads E; Xu, Ke; Voloudakis, Georgios; Shao, Zhiping; Bare, Christopher; Dudley, Joel T; Mattheisen, Manuel; Robakis, Nikolaos K; Haroutunian, Vahram; Roussos, Panos

    2017-03-14

    Open chromatin provides access to DNA binding proteins for the correct spatiotemporal regulation of gene expression. Mapping chromatin accessibility has been widely used to identify the location of cis regulatory elements (CREs) including promoters and enhancers. CREs show tissue- and cell-type specificity and disease-associated variants are often enriched for CREs in the tissues and cells that pertain to a given disease. To better understand the role of CREs in neuropsychiatric disorders we applied the Assay for Transposase Accessible Chromatin followed by sequencing (ATAC-seq) to neuronal and non-neuronal nuclei isolated from frozen postmortem human brain by fluorescence-activated nuclear sorting (FANS). Most of the identified open chromatin regions (OCRs) are differentially accessible between neurons and non-neurons, and show enrichment with known cell type markers, promoters and enhancers. Relative to those of non-neurons, neuronal OCRs are more evolutionarily conserved and are enriched in distal regulatory elements. Transcription factor (TF) footprinting analysis identifies differences in the regulome between neuronal and non-neuronal cells and ascribes putative functional roles to a number of non-coding schizophrenia (SCZ) risk variants. Among the identified variants is a Single Nucleotide Polymorphism (SNP) proximal to the gene encoding SNX19. In vitro experiments reveal that this SNP leads to an increase in transcriptional activity. As elevated expression of SNX19 has been associated with SCZ, our data provides evidence that the identified SNP contributes to disease. These results represent the first analysis of OCRs and TF binding sites in distinct populations of postmortem human brain cells and further our understanding of the regulome and the impact of neuropsychiatric disease-associated genetic risk variants.

  2. The Role of Post-Mortem MRI in the Neonatal Intensive Care Unit

    PubMed Central

    Leadbetter, Kristen; Vesoulis, Zachary A.; White, Frances V.; Schmidt, Robert E.; Khanna, Geetika; Shimony, Joshua S.; Mathur, Amit M.

    2016-01-01

    Objective Post-mortem examination can provide important information about the cause of death and play a significant role in the bereavement process. Autopsies reveal previous unknown medical problems approximately 20–30% of the time. A non-invasive MRI-based post-mortem examination (PM-MRI) may provide an alternative for families who do not consent to an autopsy. Study Design This study was a prospective observational study of recently expired neonates and infants. Subjects underwent a full body MRI scan (brain, chest, abdomen and pelvis) followed by conventional autopsy if the family desired to have one. MRI results were compared to autopsy findings and the ante mortem clinical diagnosis. A follow-up survey was conducted to investigate family perceptions of the PM-MRI process. Result Thirty-one infants underwent full PM-MRI. 19/31 (61%) of infants had complete agreement between the clinician’s impression and PM-MRI. Twenty-four infants also had conventional autopsy, with 14/24 (58%) infants having PM-MRI results consistent with autopsy findings. PM-MRI was superior at detection of free intraperitoneal/intrathoracic air and hepatic iron overload. Whole body PM-MRI did not have the resolution to detect focal/microscopic injury, vascular remodeling and some forms of brain injury. Of those families who remembered the PM-MRI findings, the majority felt that the information was useful. Conclusion PM-MRI studies may provide an important adjunct to conventional autopsy and a substitute when the latter is not possible for personal or religious reasons. Clinicians should be aware of, and communicate with the family, the resolution limits of the whole body PM-MRI to detect certain types of injury. PMID:27654494

  3. Analysis of GHB and 4-methyl-GHB in postmortem matrices after long-term storage.

    PubMed

    Marinetti, Laureen J; Isenschmid, Daniel S; Hepler, Bradford R; Kanluen, Sawait

    2005-01-01

    Postmortem heart blood, peripheral blood, vitreous humor, urine, and bile specimens from 26 autopsy cases were analyzed for the presence of gamma-hydroxybutyric acid (GHB) and gamma-methyl gamma-hydroxybutyric acid (4-Me-GHB) after long-term freezer storage. Cases were selected for which exogenous GHB, gamma-butyrolactone (GBL), gamma valerolactone (GVL), or 1,4-butanediol use was not suspected. One documented positive GHB case subjected to the same storage conditions was also evaluated for comparison. Specimens did not contain any preservatives or additives except heart blood, which contained sodium fluoride (2% w/v). The results of the analysis for GHB in vitreous humor (n = 26) demonstrated, with one exception, concentrations below the limit of detection for the method (5 mg/L). In the exception case, the value was determined to be 7 mg/L. Documented cases of GHB positive fatalities showed vitreous humor concentrations (n = 6) that exceeded this range by a factor of 12 or more. There was no apparent relationship between storage times and GHB concentrations. The data developed in this study demonstrate a postmortem endogenous range for GHB in vitreous humor that is less than or equal to 7 mg/L. Studies of the stored GHB-positive case demonstrated no significant change in concentration over the time period studied. None of the specimens analyzed in this study contained detectable amounts of 4-Me-GHB. This would support the contention that when 4-Me-GHB is detected, it is most likely due to the exogenous consumption of GVL.

  4. 3-D Cytoarchitectonic parcellation of human orbitofrontal cortex. Correlation with postmortem MRI

    PubMed Central

    Uylings, Harry B.M.; Sanz-Arigita, Ernesto J.; de Vos, Koos; Pool, Chris W.; Evers, Paul; Rajkowska, Grazyna

    2010-01-01

    The orbitofrontal cortex (OFC) is located on the basal surface of the frontal lobe and is distinguished by its unique anatomical and functional features. Clinical and postmortem studies suggest the involvement of the orbitofrontal cortex in psychiatric disorders. However, the exact parcellation of this cortical region is still a matter of debate. Therefore, the goal of this study is to provide a detailed description of the extent of borders of individual orbitofrontal cortical areas using cytoarchitectonic criteria in a large sample of human brains, which could be applied by independent neuroanatomists. To make this microscopic parcellation useful to neuroimaging studies, magnetic resonance images of postmortem brains in the coronal plane were collected prior to the preparation of coronal histological sections from the same brains. A complete series of coronal sections from 6 normal human brains and partial sections from the frontal cortex of 21 normal human brains were stained with general histological and immunohistochemical methods specific for different cell-types, These sections were examined microscopically by two independent neuroanatomists (HBMU and GR) to achieve reproducible delineations. After the borders were determined, the tissue sections were superimposed on corresponding MR images. Based on our cytoarchitectonical criteria, Brodmann's areas 47 and 11 were included in the human orbitofrontal cortex. Area 47 was further subdivided into three medial (located on the medial, anterior and posterior orbital gyri) and two lateral (located on the lateral orbital gyrus) subareas. In addition, we observed an anterior-posterior gradient in the cytoarchitecture of areas 11 and 47. The transverse orbital sulcus corresponds roughly to the transition between the subregions of the anterior and posterior OFC. Finally, the present delineation is contrasted with an overview of the different published nomenclatures for the OFC parcellation. PMID:20538437

  5. Postmortem titin proteolysis is influenced by sarcomere length in bovine muscle.

    PubMed

    England, E M; Fisher, K D; Wells, S J; Mohrhauser, D A; Gerrard, D E; Weaver, A D

    2012-03-01

    The calpain protease system, in particular, μ-calpain is involved in the disassembly of specific myofibrillar proteins, resulting in tenderization of meat postmortem. Given the size, complexity, and integral nature of titin to the structure of the sarcomere, it is plausible that the length of a sarcomere may alter the susceptibility of various domains of titin to cleavage by the calpains. Therefore, we hypothesized titin degradation differs in a sarcomere-length-dependent manner in beef. After slaughter, beef carcasses were split and sides were either suspended by the Achilles tendon (normal suspension, NS) or by the aitchbone (hip suspension, HS). Immediately after suspension, samples were dissected from the LM, psoas major (PM), and semitendinosus (STN) muscles to serve as 0-d controls. After 24 h, 4 steaks were removed from each muscle and randomly assigned to 1-, 4-, 7-, or 10-d aging treatments. After the assigned aging period, myofibrils were purified for determination of sarcomere length. Warner-Bratzler shear force analysis was also performed to evaluate differences in tenderness. Muscle proteins were solubilized and subjected to SDS-VAGE (vertical agarose gel electrophoresis) to evaluate titin degradation. Sarcomere lengths differed (P < 0.0001) between contralateral muscles of NS and HS carcasses. Quantification of SDS-VAGE gels revealed less (P < 0.05) intact titin in the PM muscle of NS carcasses at each aging period compared with the PM of HS carcasses. No significant differences (P > 0.05) were detected in the disappearance of intact titin among suspension methods in the LM or STN. These data demonstrate that suspension method alters proteolysis of titin and suggest an increase in sarcomere length may contribute to the susceptibility of titin to postmortem proteolysis in beef.

  6. Postmortem Pittsburgh Compound B (PiB) binding increases with Alzheimer's disease progression.

    PubMed

    Beckett, Tina L; Webb, Robin L; Niedowicz, Dana M; Holler, Christopher J; Matveev, Sergey; Baig, Irfan; LeVine, Harry; Keller, Jeffrey N; Murphy, M Paul

    2012-01-01

    The development of imaging reagents is of considerable interest in the Alzheimer's disease (AD) field. Some of these, such as Pittsburgh Compound B (PiB), were designed to bind to the amyloid-β peptide (Aβ), the major component of amyloid deposits in the AD brain. Although these agents were designed for imaging amyloid deposits in vivo, a major avenue of evaluation relies on postmortem cross validation with established indices of AD pathology. In this study, we evaluated changes in the postmortem binding of PiB and its relationship to other aspects of Aβ-related pathology in a series of AD cases and age-matched controls. We also examined cases of preclinical AD (PCAD) and amnestic mild cognitive impairment (MCI), both considered early points in the AD continuum. PiB binding was found to increase with the progression of the disease and paralleled increases in the less soluble forms of Aβ, including SDS-stable Aβ oligomers. Increased PiB binding and its relationship to Aβ was only significant in a brain region vulnerable to the development of AD pathology (the superior and middle temporal gyri) but not in an unaffected region (cerebellum). This implies that the amyloid deposited in disease-affected regions may possess fundamental, brain region specific characteristics that may not as yet be fully appreciated. These data support the idea that PiB is a useful diagnostic tool for AD, particularly in the early stage of the disease, and also show that PiB could be a useful agent for the discovery of novel disease-related properties of amyloid.

  7. Postmortem measurement of caffeine in bone marrow: influence of sample location and correlation with blood concentration.

    PubMed

    Cartiser, N; Bévalot, F; Chatenay, C; Le Meur, C; Gaillard, Y; Malicier, D; Guitton, J; Fanton, L

    2011-07-15

    Bone marrow (BM) analysis is of forensic interest in postmortem toxicological investigation in case of limited, unavailable or unusable blood samples. However, it remains difficult to determine whether a drug BM concentration is therapeutic or represents overdose, due to the lack of studies on this alternative matrix. Given the variations in BM composition in the body, sample location was suggested to be a relevant factor in assessing BM concentration. The aim of the present study was to compare postmortem caffeine concentrations in various BM sample locations and secondly to consider the correlation between BM and blood concentrations. Six BM samples (right and left side: proximal and medial femur and 5th rib) and a blood sample were collected from 21 forensic autopsies. Gas chromatography coupled to tandem mass spectrometry was performed. Blood caffeine concentrations ranged from 60 to 7591ng/mL. Femoral and rib BM concentrations ranged from 51 to 6171ng/g and 66 to 7280ng/g, respectively. Blood concentrations were always higher than BM concentrations. As a good correlation was demonstrated between blood and rib BM and between blood and the average of the four femoral BM concentrations, blood caffeine concentrations could be correctly extrapolated from BM concentrations. BM caffeine concentration was found to depend on sample location. Rib BM caffeine concentrations appeared to be systematically greater than averaged femur values and concentrations were much more variable between the 4 femur BM samples than between the 2 ribs. From a practical point of view, for caffeine analysis, rib BM appeared more relevant than femoral BM, which requires multisampling to overcome the concentration variability problem.

  8. Differentiation of hemopericardium due to ruptured myocardial infarction or aortic dissection on unenhanced postmortem computed tomography.

    PubMed

    Ampanozi, Garyfalia; Flach, Patricia M; Ruder, Thomas D; Filograna, Laura; Schweitzer, Wolf; Thali, Michael J; Ebert, Lars C

    2017-03-28

    The aim of the study was to evaluate unenhanced postmortem computed tomography (PMCT) in cases of non-traumatic hemopericardium by establishing the sensitivity, specificity and accuracy of diagnostic criteria for the differentiation between aortic dissection and myocardial wall rupture due to infarction. Twenty six cases were identified as suitable for evaluation, of which ruptured aortic dissection could be identified as the underlying cause of hemopericardium in 50% of the cases, and myocardial wall rupture also in 50% of the cases. All cases underwent a PMCT and 24 of the cases also underwent one or more additional examinations: a subsequent autopsy, or a postmortem magnetic resonance (PMMR), or a PMCT angiography (PMCTA), or combinations of the above. Two radiologists evaluated the PMCT images and classified each case as "aortic dissection", "myocardial wall rupture" or "undetermined". Quantification of the pericardial blood was carried out using segmentation techniques. 17 of 26 cases were correctly identified, either as aortic dissections or myocardial ruptures, by both readers. 7 of 13 myocardial wall ruptures were identified by both readers, whereas both readers identified correctly 10 of 13 aortic dissection cases. Taking into account the responses of both readers, specificity was 100% for both causes of hemopericardium and sensitivity as well as accuracy was higher for aortic dissections than myocardial wall ruptures (72.7% and 87.5% vs 53.8% and 75% respectively). Pericardial blood volumes were constantly higher in the aortic dissection group, but a statistical significance of these differences could not be proven, since the small count of cases did not allow for statistical tests. This study showed that diagnostic criteria for the differentiation between ruptured aortic dissection and myocardial wall rupture due to infarction are highly specific and accurate.

  9. Development and validation of a postmortem radiological alteration index: the RA-Index.

    PubMed

    Egger, C; Vaucher, P; Doenz, F; Palmiere, C; Mangin, P; Grabherr, S

    2012-07-01

    This study aimed to derive an index quantifying the state of alteration of cadavers by quantifying the presence of gas in the body using postmortem multidetector computed tomography (MDCT) imaging, and to validate the index by defining its sensitivity and specificity. The RA (radiological alteration)-index was derived from postmortem MDCT data from 118 nontraumatically deceased people. To validate the index, 100 additional scanned bodies (50 % traumatically deceased) were retrospectively examined by two independent observers. Presence of gas at 82 sites was assessed by a radiologist, whereas a forensic pathologist only investigated the seven sites used for the RA-index. The RA-index was highly correlated to the overall presence of gas in all 82 sites (R(2) = 0.98 in the derivation set and 0.85 in the validation set). Semiquantitative evaluation of gas presence in each site showed moderate reliability (Cohen's kappa range, 0.41-0.78); nevertheless, the overall RA-index was very reliable (ICC(2,1) = 0.95; 95 % CI 0.92-0.96). Examiner using the RA-index detected heart cavities full of gas with a sensitivity of 100 % (95 % CI 51.7-100) and a specificity of 98.8 % (92.6-99.9). We conclude that determining the presence of gas at seven sites is a valid means to measure the distribution of gas due to cadaveric alteration in the entire body. The RA-index is rapid, easy-to-use, and reliable for nonexperienced users, and it is a valid method to suspect the normal presence of gas from cadaveric alteration. MDCT can be used to screen for gas embolism and to give indications for gas composition analysis (gas chromatography).

  10. The inferior olivary nucleus: a postmortem study of essential tremor cases versus controls.

    PubMed

    Louis, Elan D; Babij, Rachel; Cortés, Etty; Vonsattel, Jean-Paul G; Faust, Phyllis L

    2013-06-01

    The pathogenesis of essential tremor is poorly understood. Historically, it has been hypothesized that the inferior olivary nucleus plays an important role in the generation of tremor in essential tremor, yet a detailed, controlled, anatomic-pathological study of that brain region has yet to be conducted. A detailed postmortem study was undertaken of the microscopic changes in the inferior olivary nucleus of 14 essential tremor cases versus 15 age-matched controls at the Essential Tremor Centralized Brain Repository. A series of metrics was used to quantify microscopic neuronal and glial changes in the inferior olivary nucleus and its input and output tracts. Olivary linear neuronal density also was assessed. Cases and controls did not differ from one another with respect to any of the assessed metrics (P values ranged from 0.23 to 1.0). Olivary linear neuronal density also was similar in cases and controls (P = 0.62). Paddle-shaped neurons, a morphologic shape change in olivary neurons, which, to our knowledge, have not been previously recognized, occurred to an equal degree in essential tremor cases and controls (P = 0.89) and were correlated with several markers of neuronal loss and gliosis. A systematic postmortem study of the microscopic changes in the inferior olivary nucleus did not detect any differences between cases and controls. These data, along with positron emission tomography data, which have failed to identify any metabolic abnormality of the olive, indicate that, if the olive is involved in essential tremor, then there is no clearly identifiable structural or metabolic correlate.

  11. Antemortem and postmortem examinations of the cattle calf naturally infected with Mycobacterium avium subsp. paratuberculosis

    PubMed Central

    Appana, Gangadhararao; Das, Dipankar; Veerasami, Maroudam; Senthilkumar, Ramachandran Lakshmikanthan; Durishetty, Munishkumar; Ramalakshmi, B.; Bahekar, Vijay; Mukherjee, Falguni; Chandran, Dev; Kumar, P. Uday; Sesikeran, B.

    2013-01-01

    A male cattle calf was detected as subclinically and naturally infected with Mycobacterium avium subspecies paratuberculosis (MAP) by a series of antemortem and postmortem tests. The MAP infection was identified by strong antibody and cell-mediated immune (CMI) response by a commercial ELISA kit and an intradermal Johnin test, respectively, in the initial antemortem examination. The antemortem status of the calf was further confirmed by MAP-specific interferon gamma (IFN-γ) response. For detection of IFN-γ response, MAP-specific IFN-γ release assays (IGRAs): (a) immuno capture ELISA (IC-ELISA) and (b) ELISPOT was employed. In addition, the presence of intracellular cytokine IFN-γ was detected by flow cytometry. For all cytokine assays, MAP-specific recombinant antigens HSP65 and 35 kDa were employed to overcome the poor sensitivity and specificity resulting from the use of Johnin, the crude protein purified derivative of MAP. Postmortem examination of the MAP-infected/suspected cattle calf did not reveal any pathognomonic gross lesions in the gastro-intestinal tract. Histopathological examination of multiple organs showed the presence of epithelioid cells/macrophages and edematous lesions in the mesenteric lymph nodes suggestive of MAP; however, no granulomas were observed in the intestinal tract. The necropsy samples of rectum and mesenteric lymph nodes were positive for isolation of MAP by culture in the BACTEC™ MGIT™ 960 system, and acid fast bacilli were demonstrated by fluorescence microscopy confirming the infection. Due to differential and complex expression patterns of MAP antigens reported in literature, a combination of assays such as those based on IGRAs and antibody detection is essential. Therefore, the current experimental evidence confirms the efficacy of the approach adopted. However, further studies will be needed to understand the optimal combination MAP-specific antigens for use in IGRAs or antibody assays that can be used for detecting

  12. Postmortem magnetic resonance imaging of the heart ex situ: development of technical protocols.

    PubMed

    Bruguier, C; Egger, C; Vallée, J P; Grimm, J; Boulanger, X; Jackowski, C; Mangin, P; Grabherr, S

    2015-05-01

    Postmortem MRI (PMMR) examinations are seldom performed in legal medicine due to long examination times, unfamiliarity with the technique, and high costs. Furthermore, it is difficult to obtain access to an MRI device used for patients in clinical settings to image an entire human body. An alternative is available: ex situ organ examination. To our knowledge, there is no standardized protocol that includes ex situ organ preparation and scanning parameters for postmortem MRI. Thus, our objective was to develop a standard procedure for ex situ heart PMMR examinations. We also tested the oily contrast agent Angiofil® commonly used for PMCT angiography, for its applicability in MRI. We worked with a 3 Tesla MRI device and 32-channel head coils. Twelve porcine hearts were used to test different materials to find the best way to prepare and place organs in the device and to test scanning parameters. For coronary MR angiography, we tested different mixtures of Angiofil® and different injection materials. In a second step, 17 human hearts were examined to test the procedure and its applicability to human organs. We established two standardized protocols: one for preparation of the heart and another for scanning parameters based on experience in clinical practice. The established protocols enabled a standardized technical procedure with comparable radiological images, allowing for easy radiological reading. The performance of coronary MR angiography enabled detailed coronary assessment and revealed the utility of Angiofil® as a contrast agent for PMMR. Our simple, reproducible method for performing heart examinations ex situ yields high quality images and visualization of the coronary arteries.

  13. Postmortem distribution of heroin metabolites in femoral blood, liver, cerebrospinal fluid, and vitreous humor.

    PubMed

    Wyman, John; Bultman, Steve

    2004-01-01

    The presence of 6-monoacetylmorphine (6-MAM) is often used to distinguish between heroin (diacetylmorphine) and morphine exposures. 6-MAM, however, is rapidly metabolized to morphine and may not be present in detectable quantities in blood following heroin exposure. Recent studies have shown that 6-MAM may persist in cerebrospinal fluid (CSF) and this specimen may be preferable for establishing heroin exposure. This study reports postmortem distribution of 6-MAM, unconjugated morphine, and codeine in different tissues from 25 deceased individuals. In all cases, 6-MAM was detected in vitreous humor, and in CSF in 16 of the 25 cases (64%). When 6-MAM was detected in blood (13 of 25 cases), the level of 6-MAM in vitreous humor and CSF was higher than in blood, with a mean concentration ratio of 11.3 (range: 1.7-27) for vitreous humor and 6.6 (range: 2.6-17.3) for CSF. 6-MAM was not detected in liver in any of the cases examined. Free morphine levels were highest in liver, followed by blood, CSF, and vitreous humor. The concentration ratios (mean +/- standard deviation) for free morphine in vitreous humor, CSF, and liver to that in blood were 0.36 +/- 0.18, 0.64 +/- 0.27, and 2.99 +/- 2.12, respectively. The liver/blood ratio was consistent with previously reported values for morphine in heart and femoral blood. Codeine levels following heroin overdose were consistently low relative to the morphine concentration. For blood, liver, and CSF, the ratio of codeine to morphine was essentially the same (0.06), whereas the vitreous codeine/morphine concentration ratio was slightly higher (0.19). These results characterize the distribution of heroin metabolites in postmortem tissues. Vitreous humor appears to be a useful specimen for determining 6-MAM and establishing the morphine was derived from heroin.

  14. Electrical conductivity imaging of lower extremities using MREIT: postmortem swine and in vivo human experiments.

    PubMed

    Woo, Eung Je; Kim, Hyung Joong; Minhas, Atul S; Kim, Young Tae; Jeong, Woo Chul; Kwon, O

    2008-01-01

    Cross-sectional conductivity images of lower extremities were reconstructed using Magnetic Resonance Electrical Impedance Tomography (MREIT) techniques. Carbon-hydrogel electrodes were adopted for postmortem swine and in vivo human imaging experiments. Due to their large surface areas and good contacts on the skin, we could inject as much as 10 mA into the lower extremities of human subjects without producing a painful sensation. Using a 3T MREIT system, we first performed a series of postmortem swine experiments and produced high-resolution conductivity images of swine legs. Validating the experimental protocol for the lower extremities, we revised it for the following human experiments. After the review of the Institutional Review Board (IRB), we conducted our first MREIT experiments of human subjects using the same 3T MREIT system. Collecting magnetic flux density data inside lower extremities subject to multiple injection currents, we reconstructed cross-sectional conductivity images using the harmonic B(z) algorithm. The conductivity images very well distinguished different parts of muscles inside the lower extremities. The outermost fatty layer was clearly shown in each conductivity image. We could observe severe noise in the outer layer of the bones primarily due to the MR signal void phenomenon there. Reconstructed conductivity images indicated that the internal regions of the bones have relatively high conductivity values. Future study is desired in terms of the conductivity image reconstruction algorithm to improve the image quality. Further human imaging experiments are planned and being conducted to produce high-resolution conductivity images from different parts of the human body.

  15. DNA and RNA profiling of excavated human remains with varying postmortem intervals.

    PubMed

    van den Berge, M; Wiskerke, D; Gerretsen, R R R; Tabak, J; Sijen, T

    2016-11-01

    When postmortem intervals (PMIs) increase such as with longer burial times, human remains suffer increasingly from the taphonomic effects of decomposition processes such as autolysis and putrefaction. In this study, various DNA analysis techniques and a messenger RNA (mRNA) profiling method were applied to examine for trends in nucleic acid degradation and the postmortem interval. The DNA analysis techniques include highly sensitive DNA quantitation (with and without degradation index), standard and low template STR profiling, insertion and null alleles (INNUL) of retrotransposable elements typing and mitochondrial DNA profiling. The used mRNA profiling system targets genes with tissue specific expression for seven human organs as reported by Lindenbergh et al. (Int J Legal Med 127:891-900, 27) and has been applied to forensic evidentiary traces but not to excavated tissues. The techniques were applied to a total of 81 brain, lung, liver, skeletal muscle, heart, kidney and skin samples obtained from 19 excavated graves with burial times ranging from 4 to 42 years. Results show that brain and heart are the organs in which both DNA and RNA remain remarkably stable, notwithstanding long PMIs. The other organ tissues either show poor overall profiling results or vary for DNA and RNA profiling success, with sometimes DNA and other times RNA profiling being more successful. No straightforward relations were observed between nucleic acid profiling results and the PMI. This study shows that not only DNA but also RNA molecules can be remarkably stable and used for profiling of long-buried human remains, which corroborate forensic applications. The insight that the brain and heart tissues tend to provide the best profiling results may change sampling policies in identification cases of degrading cadavers.

  16. Do drug users use less alcohol than non-drug users? A comparison of ethyl glucuronide concentrations in hair between the two groups in medico-legal cases.

    PubMed

    Paul, Richard; Kingston, Robert; Tsanaclis, Lolita; Berry, Anthony; Guwy, Alan

    2008-03-21

    Two groups were selected from the remainder of hair samples that had been tested for drugs at TrichoTech for medico-legal cases: samples that tested negative (drug-negative group; N=42, age 33.4+/-7.2 years) and samples that tested positive for drugs (drug-positive group; N=57, age 32.5+/-8.8 years). A rapid, simple method to detect the ethanol metabolite, ethyl glucuronide (EtG) in hair has been developed. The hair samples were sectioned, and then submitted to overnight sonication in water. Samples then underwent SPE using anion exchange cartridges, followed by derivatisation with N,O-bis[trimethylsilyl]trifluoroacetamide (BSTFA), before confirmation by GC-MS/MS. The assay produced excellent linearity and sensitivity over the calibration range 0.02-1.0 ng/mg, assuming a 10 mg hair sample. The mean age of the two groups was not statistically different (p=0.575, Student t-test), indicating a homogeneous group. Twelve of the 57 (21.0%) hair samples of the drug-positive group tested positive for EtG, and 17 of the 42 (40.5%) hair samples of the drug-negative group tested positive for EtG. The mean concentration of EtG in the drug-positive group was 0.011 ng/mg compared to 0.107 ng/mg in the drug-negative group. When the full results of this study were subjected to statistical analysis it was shown that EtG levels in the drug-negative group were statistically higher than those found in the drug-positive group (p<0.05). This preliminary finding may be of use in the study of addiction and adds valuable data to previous studies regarding the use of EtG as a valuable marker for alcohol levels in hair.

  17. Forensic relevance of post-mortem CT imaging of the haemopericardium in determining the cause of death.

    PubMed

    Filograna, Laura; Thali, Michael J; Marchetti, Daniela

    2014-09-01

    The post-mortem diagnosis of pericardial tamponade is associated with several medical legal problems. Thus, we explored whether post-mortem computed tomography might provide useful and reliable information for the diagnosis of this relevant disease in combination with autopsy data. We retrospectively reviewed the post-mortem computed tomography and autopsy reports of 15 autopsy cases with haemopericardium detected at the Institute of Forensic Medicine in Berne from July 2005 to February 2010. Two computer tomography findings were examined in combination with autopsy results. The first was the "hyperdense armoured heart," which has been previously described as post-mortem evidence of heart beating for a time after the initiation of intrapericardial bleeding. The second was the "flattening of the anterior surface" of the heart which has been previously observed in vivo as a sign of the compression effect of the haemopericardium on the heart. Our retrospective analysis showed the combined presence of both of these findings in all cases of autopsy evidence of pericardial tamponade with the exception of one case. In contrast, the concomitance of both of them was never observed in cases of autopsy death due to haemorrhage in which neither the flattening of the anterior surface of the heart was detected except for one case. In conclusion, these results should be considered a first step toward the potentially using post-mortem computed tomography in combination with autopsy data in the diagnosis of pericardial tamponade especially considering the possibility to detect sign as the flattened heart signal which cannot be assessed after opening the pericardium at autopsy.

  18. Cases of fatal poisoning in post-mortem examinations at the Institute of Forensic Medicine in Greifswald--analysis of five decades of post-mortems.

    PubMed

    Below, Elke; Lignitz, Eberhard

    2003-04-23

    Apparently, fatal poisoning as cause of death are still rarely found in unnatural deaths investigated in the institutes of forensic medicine. In the Institute of Forensic Medicine at the University of Greifswald, 10-15% of the post-mortem autopsies displayed an intoxication during the last several decades with a possible decreasing tendency. Thirteen thousand eight hundred and nineteen autopsies were carried out in our institute-situated in a low populated rural area-during the last 50 years with the confirmed death cause intoxication in 1,589 times. In this study, especially the intoxication causes and the substance classes of the poisonous agents have been investigated. In addition, we analyzed the frequency of intoxications as well as sex and age of the deceased. Surprisingly, CO-intoxications were found most frequently with an incidence of 49% followed by alcohol intoxications with 21%. The latter was not unexpected taking into account the habits of the local population. Medical drugs and narcotics take only the third place, although the abuse of modern narcotics drugs is already visible even in the far east of Germany. The spectrum of substances which are abused, taken accidentally or deliberately is continuously changing, reflecting scientific progress in the pharmaceutical industry as well as fashion tendencies. Therapeutic use is almost always followed by abuse. Our results confirm prior experience concentrating mostly on other poisons like heavy metals or herbicides, etc. In addition, we could demonstrate the influence of political conditions on use and distribution of illegal drugs in Germany. Our study clearly demonstrates that insufficient equipment or analytical methods are no longer the reason for any problems uncovering lethal intoxications. They are rather due to insufficient investigations of the corpses (without considering the possibility of an intoxication as differential diagnosis) and to frequent mistakes of the prosecutor's office in death

  19. Martian external magnetic field proxies

    NASA Astrophysics Data System (ADS)

    Langlais, Benoit; Civet, Francois

    2015-04-01

    Mars possesses no dynamic magnetic field of internal origin as it is the case for the Earth or for Mercury. Instead Mars is characterized by an intense and localized magnetic field of crustal origin. This field is the result of past magnetization and demagnetization processes, and reflects its evolution. The Interplanetary Magnetic Field (IMF) interacts with Mars' ionized environment to create an external magnetic field. This external field is weak compared to lithospheric one but very dynamic, and may hamper the detailed analysis of the internal magnetic field at some places or times. Because there are currently no magnetic field measurements made at Mars' surface, it is not possible to directly monitor the external field temporal variability as it is done in Earth's ground magnetic observatories. In this study we examine to indirect ways of quantifying this external field. First we use the Advanced Composition Explorer (ACE) mission which measures the solar wind about one hour upstream of the bow-shock resulting from the interaction between the solar wind and the Earth's internal magnetic field. These measurements are extrapolated to Mars' position taking into account the orbital configurations of the Mars-Earth system and the velocity of particles carrying the IMF. Second we directly use Mars Global Surveyor magnetic field measurements to quantify the level of variability of the external field. We subtract from the measurements the internal field which is otherwise modeled, and bin the residuals first on a spatial and then on a temporal mesh. This allows to compute daily or semi daily index. We present a comparison of these two proxies and demonstrate their complementarity. We also illustrate our analysis by comparing our Martian external field proxies to terrestrial index at epochs of known strong activity. These proxies will especially be useful for upcoming magnetic field measurements made around or at the surface of Mars.

  20. TECHNICAL BRIEF: Isolation of total DNA from postmortem human eye tissues and quality comparison between iris and retina

    PubMed Central

    Wang, Jay Ching Chieh; Wang, Aikun; Gao, Jiangyuan; Cao, Sijia; Samad, Idris; Zhang, Dean; Ritland, Carol; Cui, Jing Z.

    2012-01-01

    Background Recent genomic technologies have propelled our understanding of the mechanisms underlying complex eye diseases such as age-related macular degeneration (AMD). Genotyping postmortem eye tissues for known single nucleotide polymorphisms (SNPs) associated with AMD may prove valuable, especially when combined with information obtained through other methods such as immunohistochemistry, western blot, enzyme-linked immunosorbent assay (ELISA), and proteomics. Initially intending to genotype postmortem eye tissues for AMD-related SNPs, our group became interested in isolating and comparing the quality of DNA from the iris and retina of postmortem donor eyes. Since there is no previously published protocol in the literature on this topic, we present a protocol suitable for isolating high-quality DNA from postmortem eye tissues for genomic studies. Methods DNA from 33 retinal samples and 35 iris samples was extracted using the phenol-chloroform-isoamyl method from postmortem donor eye tissues. The quantity of DNA was measured with a spectrophotometer while the quality was checked using gel electrophoresis. The DNA samples were then amplified with PCR for the complement factor H (CFH) gene. The purified amplified products were then genotyped for the SNPs in the CFH gene. Results Regarding concentration, the retina yielded 936 ng/μl of DNA, while the iris yielded 78 ng/μl of DNA. Retinal DNA was also purer than iris DNA (260/280=1.78 vs. 1.46, respectively), and produced superior PCR results. Retinal tissue yielded significantly more DNA than the iris tissue per mg of sample (21.7 ng/μl/mg vs. 7.42 ng/μl/mg). Retinal DNA can be readily amplified with PCR, while iris DNA can also be amplified by adding bovine serum albumin. Overall, retinal tissues yielded DNA of superior quality, quantity, and suitability for genotyping and genomic studies. Conclusions The protocol presented here provides a clear and reliable method for isolating total DNA from postmortem eye

  1. Space station neutral external environment

    NASA Technical Reports Server (NTRS)

    Ehlers, H.; Leger, L.

    1988-01-01

    Molecular contamination levels arising from the external induced neutral environment of the Space Station (Phase 1 configuration) were calculated using the MOLFLUX model. Predicted molecular column densities and deposition rates generally meet the Space Station contamination requirements. In the doubtful cases of deposition due to materials outgassing, proper material selection, generally excluding organic products exposed to the external environment, must be considered to meet contamination requirements. It is important that the Space Station configuration, once defined, is not significantly modified to avoid introducing new unacceptable contamination sources.

  2. External hydrocephalus in two cats.

    PubMed

    Dewey, Curtis W; Coates, Joan R; Ducoté, Julie M; Stefanacci, Joseph D; Walker, Michael A; Marino, Dominic J

    2003-01-01

    External hydrocephalus describes an accumulation of cerebrospinal fluid (CSF) between the cerebral hemispheres and the overlying arachnoid membrane, rather than within the lateral ventricles. Two young cats with encephalopathic signs were diagnosed with external hydrocephalus, one via magnetic resonance imaging and one via computed tomography. Both cats had abnormally large, broad heads, with no evidence of open fontanelles. A surgical shunt was placed in each cat to divert the accumulated CSF within the cranial cavity to the peritoneal space. Both cats improved dramatically soon after surgical shunting was performed, and they continue to do well clinically, approximately 42 months and 8 months postoperatively, respectively.

  3. Breast density quantification using magnetic resonance imaging (MRI) with bias field correction: A postmortem study

    SciTech Connect

    Ding, Huanjun; Johnson, Travis; Lin, Muqing; Le, Huy Q.; Ducote, Justin L.; Su, Min-Ying; Molloi, Sabee

    2013-12-15

    Purpose: Quantification of breast density based on three-dimensional breast MRI may provide useful information for the early detection of breast cancer. However, the field inhomogeneity can severely challenge the computerized image segmentation process. In this work, the effect of the bias field in breast density quantification has been investigated with a postmortem study. Methods: T1-weighted images of 20 pairs of postmortem breasts were acquired on a 1.5 T breast MRI scanner. Two computer-assisted algorithms were used to quantify the volumetric breast density. First, standard fuzzy c-means (FCM) clustering was used on raw images with the bias field present. Then, the coherent local intensity clustering (CLIC) method estimated and corrected the bias field during the iterative tissue segmentation process. Finally, FCM clustering was performed on the bias-field-corrected images produced by CLIC method. The left–right correlation for breasts in the same pair was studied for both segmentation algorithms to evaluate the precision of the tissue classification. Finally, the breast densities measured with the three methods were compared to the gold standard tissue compositions obtained from chemical analysis. The linear correlation coefficient, Pearson'sr, was used to evaluate the two image segmentation algorithms and the effect of bias field. Results: The CLIC method successfully corrected the intensity inhomogeneity induced by the bias field. In left–right comparisons, the CLIC method significantly improved the slope and the correlation coefficient of the linear fitting for the glandular volume estimation. The left–right breast density correlation was also increased from 0.93 to 0.98. When compared with the percent fibroglandular volume (%FGV) from chemical analysis, results after bias field correction from both the CLIC the FCM algorithms showed improved linear correlation. As a result, the Pearson'sr increased from 0.86 to 0.92 with the bias field correction

  4. Breast density quantification using magnetic resonance imaging (MRI) with bias field correction: A postmortem study

    PubMed Central

    Ding, Huanjun; Johnson, Travis; Lin, Muqing; Le, Huy Q.; Ducote, Justin L.; Su, Min-Ying; Molloi, Sabee

    2013-01-01

    Purpose: Quantification of breast density based on three-dimensional breast MRI may provide useful information for the early detection of breast cancer. However, the field inhomogeneity can severely challenge the computerized image segmentation process. In this work, the effect of the bias field in breast density quantification has been investigated with a postmortem study. Methods: T1-weighted images of 20 pairs of postmortem breasts were acquired on a 1.5 T breast MRI scanner. Two computer-assisted algorithms were used to quantify the volumetric breast density. First, standard fuzzy c-means (FCM) clustering was used on raw images with the bias field present. Then, the coherent local intensity clustering (CLIC) method estimated and corrected the bias field during the iterative tissue segmentation process. Finally, FCM clustering was performed on the bias-field-corrected images produced by CLIC method. The left–right correlation for breasts in the same pair was studied for both segmentation algorithms to evaluate the precision of the tissue classification. Finally, the breast densities measured with the three methods were compared to the gold standard tissue compositions obtained from chemical analysis. The linear correlation coefficient, Pearson's r, was used to evaluate the two image segmentation algorithms and the effect of bias field. Results: The CLIC method successfully corrected the intensity inhomogeneity induced by the bias field. In left–right comparisons, the CLIC method significantly improved the slope and the correlation coefficient of the linear fitting for the glandular volume estimation. The left–right breast density correlation was also increased from 0.93 to 0.98. When compared with the percent fibroglandular volume (%FGV) from chemical analysis, results after bias field correction from both the CLIC the FCM algorithms showed improved linear correlation. As a result, the Pearson's r increased from 0.86 to 0.92 with the bias field correction

  5. Practical experience in post-mortem tissue donation in consideration of the European tissue law.

    PubMed

    Karbe, Thomas; Braun, Christian; Wulff, Birgit; Schröder, Ann Sophie; Püschel, Klaus; Bratzke, Hansjürgen; Parzeller, Markus

    2010-03-01

    In consequence of the European guidelines of safety and quality standards for the donation, retrieval, storing and distribution of human tissues and cells the purpose of tissue transplantation was implemented into German legislation in May 2007. The law came into effect on August 1st 2007 considering of the European rules. The Institutes for Legal Medicine of the University of Frankfurt/Main and the University Medical Center Hamburg-Eppendorf developed a model for tissue retrieval. The Institute of Legal Medicine (I.f.R.) at the University Medical Center Hamburg cooperates with the German Institute of Cell and Tissue Replacement (Deutsches Institut für Zell--und Gewebeersatz DIZG). Potential post-mortem tissue donors (PMTD) among the deceased are selected by standardized sets of defined criteria. The procedure is guided by the intended exclusion criteria of the tissue regulation draft (German Transplant Law TPG GewV) in accordance with the European Guideline (2006/17/EC). Following the identification of the donor and subsequent removal of tissue, the retrieved samples were sent to the DIZG, a non-profit tissue bank according to the tissue regulation. Here the final processing into transplantable tissue grafts takes place, which then results in the allocation of tissue to hospitals in Germany and other European countries. The Center of Legal Medicine at the Johann Wolfgang Goethe-University Medical Center Frankfurt/Main cooperates since 2000 with Tutogen, a pharmaceutical company. Harvesting of musculoskeletal tissues follows corresponding regulations. To verify the outcome of PMTD at the I.f.R. Hamburg, two-statistic analysis over 12 and 4 months have been implemented. Our results have shown an increasing number of potential appropriate PMTD within the second inquiry interval but a relatively small and unvaryingly rate of successful post-mortem tissue retrievals similar to the first examination period. Thus, the aim of the model developed by the I.f.R. is to

  6. Cryopreservation of epididymal sperm collected postmortem in the Tasmanian devil (Sarcophilus harrisii).

    PubMed

    Keeley, T; McGreevy, P D; O'Brien, J K

    2012-07-15

    Effective sperm cryopreservation protocols are limited to a small number of marsupial species. In this study, postmortem gamete rescue (PMGR) epididymal sperm samples from Tasmanian devils (N=34) euthanized due to the fatal Devil Facial Tumor Disease were used to develop long-term sperm storage techniques for the species. Cryoprotectant toxicity associated with equilibration of sperm samples in a TEST yolk diluent (TEST; 189 mM N-Tris(hydroxymethyl)methyl-2-aminoethanesulfonic acid, 85 mM Trizma base [Tris], 11 mM glucose, 20% vol/vol egg yolk; pH 7.1, and 315.0±5.0 mOsm/kg) with a final concentration of 0.06 M trehalose, or 4%, 10%, and 18% vol/vol of either glycerol or dimethyl sulfoxide (DMSO), was examined over 12 h at 15 °C. Trehalose supplementation resulted in an immediate decline (P<0.05) of total motility. After 12 h, total motility was reduced (P<0.05) in treatments containing 18% glycerol, and 10% and 18% dimethyl sulfoxide. The effects of final glycerol concentration (4% and 10%), glycerol equilibration duration (10 min 1 h, or 3 h) prefreeze, freezing rate and the addition of 0.10 M lactose or a combination of 0.10 M lactose and 0.11 M raffinose were assessed during three experiments on the cryopreservation of postmortem gamete rescue samples in TEST. In all experiments, motility and viability were reduced (P<0.01 postthaw). Samples cryopreserved in TEST supplemented with lactose or lactose with raffinose using a fast freezing rate (-8 °C/min from 4 to -40 °C, then -65 °C/min until -165 °C) produced the highest (P<0.05) postthaw motility (18.6±5.5% and 16.9±8.5%, respectively), which represented 35% to 48% retention of prefreeze motility. These results apparently were the best postthaw results of dasyurid sperm reported to date and will help lay the foundations for developing assisted reproductive technologies for marsupial species.

  7. Increased acetyl and total histone levels in post-mortem Alzheimer's disease brain.

    PubMed

    Narayan, Pritika J; Lill, Claire; Faull, Richard; Curtis, Maurice A; Dragunow, Mike

    2015-02-01

    Histone acetylation is an epigenetic modification that plays a critical role in chromatin remodelling and transcriptional regulation. There is increasing evidence that epigenetic modifications may become compromised in aging and increase susceptibility to the development of neurodegenerative disorders such as Alzheimer's disease. Immunohistochemical labelling of free-floating sections from the inferior temporal gyrus (Alzheimer's disease, n=14; control, n=17) and paraffin-embedded tissue microarrays containing tissue from the middle temporal gyrus (Alzheimer's disease, n=29; control, n=28) demonstrated that acetyl histone H3 and acetyl histone H4 levels, as well as total histone H3 and total histone H4 protein levels, were significantly increased in post-mortem Alzheimer's disease brain tissue compared to age- and sex-matched neurologically normal control brain tissue. Changes in acetyl histone levels were proportional to changes in total histone levels. The increase in acetyl histone H3 and H4 was observed in Neuronal N immunopositive pyramidal neurons in Alzheimer's disease brain. Using immunolabelling, histone markers correlated significantly with the level of glial fibrillary acidic protein and HLA-DP, -DQ and -DR immunopositive cells and with the pathological hallmarks of Alzheimer's disease (hyperphosphorylated tau load and β-amyloid plaques). Given that histone acetylation changes were correlated with changes in total histone protein, it was important to evaluate if protein degradation pathways may be compromised in Alzheimer's disease. Consequently, significant positive correlations were also found between ubiquitin load and histone modifications. The relationship between histone acetylation and ubiquitin levels was further investigated in an in vitro model of SK-N-SH cells treated with the proteasome inhibitor Mg132 and the histone deacetylase inhibitor valproic acid. In this model, compromised protein degradation caused by Mg132 lead to elevated histone

  8. [Treatment by external insulin pump].

    PubMed

    Clavel, Sylvaine

    2010-12-01

    Since the recent recommendations by the French speaking association for research on diabetes and metabolic illnesses (Alfediam), treatment by insulin pump has found itself in competition with basal-bolus, a procedure using similar injections of insulin which has become a benchmark treatment. The latest Alfediam guidelines focus on defining ways of treating diabetics with an external insulin pump.

  9. Lupus vulgaris of external nose.

    PubMed

    Bhandary, Satheesh Kumar; Ranganna, B Usha

    2008-12-01

    Lupus vulgaris is the commonest form of cutaneous tuberculosis which commonly involve trunk and buttocks. Lupus vulgaris affecting nose and face, are rarely reported in India. This study reports an unusual case of lupus vulgaris involving the external nose that showed dramatic outcome after six months of anti- tubercular treatment.

  10. External Communication. SPEC Kit 56.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Management Studies.

    One section of a spring 1979 Systems and Procedures Exchange Center (SPEC) survey on communication in Association of Research Libraries (ARL) institutions examined how members exchange information with external groups including the university administration, faculty, users, support groups, other libraries, and the profession in general. According…

  11. 10 Core External Environmental Trends.

    ERIC Educational Resources Information Center

    El Camino Coll., Torrance, CA.

    This is an institutional report summarizing 10 core external environmental trends and their implications for El Camino College and the surrounding community. The report offers a brief description for the following trends: (1) there is more emphasis on colleges becoming learning institutions rather than teaching institutions; (2) the current and…

  12. [Prostate cancer external beam radiotherapy].

    PubMed

    de Crevoisier, R; Pommier, P; Latorzeff, I; Chapet, O; Chauvet, B; Hennequin, C

    2016-09-01

    The prostate external beam radiotherapy techniques are described, when irradiating the prostate or after prostatectomy, with and without pelvic lymph nodes. The following parts are presented: indications of radiotherapy, total dose and fractionation, planning CT image acquisition, volume of interest delineation (target volumes and organs at risk) and margins, Intensity modulated radiotherapy planning and corresponding dose-volume constraints, and finally Image guided radiotherapy.

  13. Internal to external wavelength calibration

    NASA Astrophysics Data System (ADS)

    Sahu, Kailash C.

    1999-01-01

    The spectra of Hen 1357 (the Stingray nebula) were used to check the internal to external wavelength calibration of the STIS first order CCD modes. The radial velocity of the Stingray nebula is known to high accuracy (< 1 km/sec) and the line with of the nebular line is very narrow (< 8 km/sec for the integrated nebula). Thus the observations of the Stingray nebula are ideal to check the internal to external wavelength calibration of the first order modes. The observations were taken in G430L and G750M modes using a 52 x 0.05 arcsec slit covering the wavelength range 2900 to 5700 A and 6295 to 6867 A, respectively. The observed wavelength range includes many nebular emission lines. The wavelengths of the nebular lines derived using the pipeline internal wavelength calibration were compared with the wavelengths derived from other ground based observations. In all cases, the wavelength match between the two is of the same order as the accuracy to which the line center can be measured. These results imply that there is no significant offset between the internal and external wavelength calibrations for these modes. The HDF-S QSO observations were also used for this test both for the first order and the Echelle modes. The results of the HDF-S QSO observations further confirm the above finding for the first order modes, and imply that there is no significant offset between the internal and external wavelength calibration for the Echelle modes.

  14. Difficulties in distinguishing between an atlas fracture and a congenital posterior atlas arch defect in postmortem analysis.

    PubMed

    Sanchis-Gimeno, Juan A; Blanco-Perez, Esther; Aparicio, Luis; Martinez-Soriano, Francisco; Martinez-Sanjuan, Vicente

    2014-09-01

    We found one atlas from a sample of 148 skeletons (0.67%) that presented different anatomical variations which made it difficult to determine whether the vertebra had an atlas fracture, an unusual Type B posterior atlas arch defect, or a combination of both. We carried out a stereomicroscopy, radiographic, and computerized tomography scan study that revealed that the dry atlas we found presented a very uncommon congenital Type B posterior atlas arch defect, simulating a fracture. In short, the present paper has revealed that differentiating Type B posterior atlas arch defects from fractures in post-mortem dry vertebrae is more difficult than expected. Thus we believe that it can be easier than expected to mistake Type B posterior arch defects for fractures and vice versa in postmortem studies.

  15. Post-mortem in the Victorian asylum: practice, purpose and findings at the Littlemore County Lunatic Asylum, 1886-7.

    PubMed

    Cullen, Lynsey T

    2017-04-01

    This article examines the purpose of the post-mortem in the late Victorian asylum and discusses what the findings reveal about contemporary understanding of mental health. By examining the practice at the Littlemore Asylum of Oxford, the definition of the asylum post-mortem will be questioned and issues of consent and ownership of the dead body explored. It will be argued that the purpose of the examination was partly to appease the demands of the Commissioners in Lunacy, to protect the asylum against accusations of malpractice, and to appease the resident assistant medical officer's own morbid curiosity. The examinations would therefore be better defined as dissections. This article will challenge understanding of institutional death, the legal processes required for dissection, and mental healthcare.

  16. Assessment of histological changes in antemortem gingival tissues fixed at various time intervals: A method of estimation of postmortem interval

    PubMed Central

    Mahalakshmi, V.; Gururaj, N.; Sathya, R.; Sabarinath, T. R.; Sivapathasundharam, B.; Kalaiselvan, S.

    2016-01-01

    Introduction: Conventional methods to estimate the time of death are adequate, but a histological method is yet unavailable to assess postmortem interval (PMI). The autolytic changes that occur in an unfixed antemortem gingival tissue which reflects histologically at an early stage are similar to changes that occur in postmortem tissue. These histological changes can be used and applied in a postmortem tissue as a method to assess PMI. Aims: The aim of the study is to assess the histological changes in a gingival tissue left unfixed for various time intervals and to correlate the findings with duration. Materials and Methods: Sixty gingival tissues obtained from patients following therapeutic extractions, impactions, gingivectomy and crown lengthening procedures were used. Each tissue obtained was divided into two pieces and labeled as “A”, the control group and “ B” the study group. Tissues labeled “A” were fixed in 10% formalin immediately and tissues labeled“B” were placed in closed containers and fixed after 15, 30, 45 min, 1, 2, and 4 h time interval. Of the sixty tissues in the study group “ B”, ten tissues were used for each time interval under investigation. All the fixed tissues were processed, stained, assessed, and analyzed statistically using Pearson correlation and regression analysis. Results: Histological changes appear at 15 min in an unfixed antemortem tissue. At 2 h interval, all layers with few cells in basal cell layer are involved. At 4 h interval, loss of stratification and complete homogenization of cells in the superficial layers with prominent changes in basal layer is evident. There was a positive correlation (<1.0) between the time interval and the appearance of the histological changes. Conclusion: Histological changes such as complete homogenization of cells in superficial layers and loss of epithelial architecture at 4 h in unfixed antemortem tissue may be used as a criterion to estimate PMI, after further studies

  17. Sequenom MassARRAY approach in the arrhythmogenic right ventricular cardiomyopathy post-mortem setting: clinical and forensic implications.

    PubMed

    Alcalde, M; Campuzano, O; Allegue, C; Torres, M; Arbelo, E; Partemi, S; Iglesias, A; Brugada, J; Oliva, A; Carracedo, A; Brugada, R

    2015-01-01

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare cardiac disease characterized by myocardial fibrofatty replacement, which can lead to sudden death. Previous studies have described a reduction of plakoglobin (PKG) protein at the level of intercalated disks as the hallmark of ARVC. The main objective of this study was to investigate the involvement of desmosome mutations in the histological phenotype of ARVC. We performed a genetic analysis of ARVC cases, and histological characterization of ARVC heart tissue samples. We genetically analyzed 48 ARVC cases distributed into two groups: 42 human tissue heart samples with conclusive diagnoses of ARVC after post-mortem examination; and six DNA samples from peripheral blood of living patients who were clinically diagnosed. Sequenom MassARRAY analysis revealed three ARVC-associated variants in three patients in 42 tissue samples (7.14 %). Three individuals carried one single pathogenic mutation, p.R811S _PKP2, p.S824L_DSC2, and p.T526M_PKP2 in postmortem samples. In the living patients group, Sequenom MassARRAY revealed no mutation, however, later Sanger sequencing analysis identified three ARVC mutations in 2/6 patients not included in the Sequenom design. In post-mortem tissue samples we performed immunohistochemical labeling for desmosomal proteins and Connexin 43. This study revealed that PKP2 carriers present either absent or clearly reduced PKG immunolabeling, while the DSC2 carrier showed PKG immunolabeling similar to control samples. Immunolabeling for Cx43 did not show any differences compared to controls. The present Sequenom MassARRAY design is a useful tool for post-mortem genetic diagnosis of ARVC. Plakoglobin reduction occurs at intercalated disks, while other desmosome proteins and Cx43 remain unaltered.

  18. Expressional potency of mRNAs encoding receptors and voltage-activated channels in the postmortem rat brain.

    PubMed Central

    Ragsdale, D S; Miledi, R

    1991-01-01

    The stability and integrity of mRNAs encoding neurotransmitter receptors and voltage-activated channels in the postmortem rat brain was investigated by isolating poly(A)+ mRNA, injecting it into Xenopus oocytes, and then examining the expression of functional neurotransmitter receptors and voltage-activated channels in the oocyte membrane by electrophysiological recording. This approach was also used to assess the stability of mRNAs in brains that were incubated in oxygenated mammalian Ringer's solution for various lengths of time and from brains that were freshly frozen and then thawed at room temperature. Oocytes injected with mRNA from up to 21-hr postmortem brains gave large agonist- and voltage-activated responses, indicating that mRNAs encoding neurotransmitter receptors and voltage-activated channels are relatively stable in postmortem brain tissue. In contrast, oocytes injected with mRNA from brains incubated in Ringer's solution exhibited smaller responses, and oocytes injected with mRNA from tissue that was frozen and then thawed displayed very small or undetectable responses. Northern blot analysis using a nucleic acid probe for rat brain Na(+)-channel mRNA indicated that the size of the Na+ currents in injected oocytes reflected the levels of mRNA for Na+ channels in the different mRNA preparations. Thus, the expressional potency of mRNAs encoding neurotransmitter receptors and voltage-activated channels is quite stable in postmortem brains in situ, but it is reduced if the brains are kept in oxygenated saline, and freezing and thawing of tissue results in rapid degeneration of mRNA. Images PMID:1705710

  19. [Postmortem imaging studies with data processing and 3D reconstruction: a new path of development of classic forensic medicine?].

    PubMed

    Woźniak, Krzysztof; Moskała, Artur; Urbanik, Andrzej; Kopacz, Paweł; Kłys, Małgorzata

    2009-01-01

    The techniques employed in "classic" forensic autopsy have been virtually unchanged for many years. One of the fundamental purposes of forensic documentation is to register as objectively as possible the changes found by forensic pathologists. The authors present the review of techniques of postmortem imaging studies, which aim not only at increased objectivity of observations, but also at extending the scope of the registered data. The paper is illustrated by images originating from research carried out by the authors.

  20. Deuterium Inventory in Tore Supra: status of post-mortem analyses

    NASA Astrophysics Data System (ADS)

    Dittmar, T.; Roubin, P.; Tsitrone, E.; Gauthier, E.; Hakola, A.; Likonen, J.; Linez, F.; Martin, C.; Mayer, M.; Pardanaud, C.; Pascal, J. Y.; Pasquet, B.; Pégourié, B.; Roth, J.; Roure, I.; Ruffe, R.

    2009-12-01

    A dedicated study on fuel retention has been launched in Tore Supra which included a D wall-loading campaign and the dismantling of the main limiter (Deuterium Inventory in Tore Supra, DITS project). This paper presents new results of post-mortem analyses performed on selected limiter tiles. Scanning electron microscopy shows thick layers with poloidally oriented tip-shaped structures in deposition zones. In the erosion zone deposits inside the open porosities of the bulk material of the tiles were found. Raman microscopy indicates that hard deuterated amorphous carbon layers are deposited on the limiter tiles and on their gap sides. Secondary ion mass spectrometry D depth profiles show an increase of the D content near the bottom of the gap, in agreement with previous results. The campaign markers (13C and 11B) are found in only 2 out of 7 measurements in the deposited layers. Finally, the agreement of the SIMS data with previous nuclear reaction analysis (NRA) measurements is discussed, especially discrepancies possibly due to the non-uniformity of the samples.