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Summary Objective Laryngeal framework surgery has been a topic of interest since last decades. To succeed with least morbidity, the most important step is mastering the anatomy of larynx. In this study, we aim to show the relation between body height and laryngeal morphometrics that are important during laryngeal framework surgeries. Data Sources Larynges of 187 fresh cadavers were dissected within 24 hours after death at the Council of Forensic Medicine. Methods Age, sex, weight, height, and a total of 12 measurements were taken from each cadaver. Results were subgrouped according to gender, age of 45, body height of 165 millimeters (mm), and thyroid cartilage height of 17 mm. These subgroups were compared for each measurement and ratio. Results A positive correlation was found between body height and thyroid cartilage height (hTC), thyroid cartilage width, vocal fold length, and distance from projection of anterior commissure (pAC) to inferior border of thyroid cartilage (TIB). Male gender, higher body heights, and higher thyroid cartilage heights significantly higher results were obtained. The ratio between pAC-TIB distance to hTC was found to be 0.54 in males and 0.52 in females, and this ratio was not statistically different in subgroups. Conclusion Although all of the laryngeal measurements were found to be statistically significant in patients with higher body height, the ratio between pAC-TIB distance to hTC was independent. Thus, especially in patients with body heights longer than average, it should be safer to use the midpoint of the thyroid cartilage as a landmark for anterior commissure.

Introduction: Salmonella infections are important public health problems and a common cause of mortality affecting millions of people all over the world. In our study; it was aimed to evaluate the serotype distribution and antibiotic susceptibility of Salmonella species isolated from various postmortem specimens and to evaluate its contribution to cause of death with histopathological findings. Materials and Methods: In this study, the identification and antibiotic susceptibility profile results of Salmonella isolates obtained from blood, cerebrospinal fluid, lung tissue, splenic tissue and stool specimens were investigated retrospectively in 12 patients who were sent to Postmortem Microbiology Laboratory. Conventional methods, VITEK 2 Compact® (Biomerieux, France) automated identification system, and Kirby-Bauer disk diffusion methods were used for the identification of strains at species level and for antibiotic susceptibility tests. Results: Among the cases in whom the isolates were identified, 2 (16.7%) were female and 10 (83.3%) were male. Age range was 1 month-71 years. In our study, a total of 28 Salmonella isolates were identified as follows; 20 (71.4%) Salmonella enteritidis, 5 (17.9%) Salmonella serogroup C1, 2 (7.1%) Salmonella paratyphi B, and 1 (3.6%) Salmonella serogroup G complex. There was no resistance to ampicillin, trimethoprim-sulfamethoxazole, ciprofloxacin and ceftriaxone in the isolates. Conclusion: It should be kept in mind that salmonella infections may be encountered with rare infections with high mortality except gastroenteritis. Microbiological investigations of salmonella infections are rare in forensic autopsies. For this reason, determination of serotype distribution and antibiotic susceptibility of salmonella in postmortem cases will contribute to national and international forensic microbiological studies.

Viral respiratory infections are one of the leading causes of morbidity and mortality, especially in children, elderly and immunocompromised patients. The inclusion of post-mortem studies to diagnose the infection causing mortality could be beneficial in specifying new pathogens and determining strategies for treatment and prevention. The aim of this study was to research viral etiology by applying multiplex real-time polymerase chain reaction (Rt-PCR) method in autopsy cases who have been considered to have a respiratory infection and to assess whether the viruses detected are the primary cause of the infection and whether they have any contributory effect on the mortality together with histopathological evidence. In this study, we included a total of 834 cases consisting of sudden death cases from infantile-pediatric age group and autopsy cases from > 18 year age group with suspected respiratory tract infection in our laboratory between January 2013 and May 2017. Of 834 cases, 468 (56.1%) were male and 366 (43.9%) were female, there were 191 (22.9%) cases between 0-1 months, 593 (71.1%) cases between 1 month-18 years, and 50 (6%) cases in the > 18 years age group. In 728 of 834 (87.3%) cases nasopharyngeal/tracheal swab samples and in 106 (12.7%) of them paraffin-embedded lung tissue samples were studied by the use of "FTD Respiratory 21 (Fast-Tract Diagnostics Luxemburg)" kit, with multiplex Rt-PCR method. The post-mortem samples were evaluated for human rhinovirus (HRV), parainfluenza viruses (PIV) (1, 2, 3, 4), influenza virus type A and B (INF-A, INF-B), enterovirus (EV), human bocavirus (HBoV), adenovirus (AdV), human coronavirus (HCoV 229,63,HKU,43), human metapneumovirus A ve B (HMPV-A/B), parechovirus, respiratory syncytial virus (RSV A/B) and Mycoplasma pneumoniae. In our study, at least one respiratory virus was detected by Rt-PCR in 379 (45.4%) of total 834 cases, whereas no viral agent was identified in 455 (54.6%) of the cases. One viral agent was detected in 278 (33.3%), two viral agents were detected in 83 (9.94%) and three viral agents were detected in 18 (2.16%) cases. Overall, the most common viral agent was HRV 110 (13.2%) followed by AdV 39 (4.7%) and RSV A/B 33 (4%). In pediatric cases the rate of positive results for respiratory viruses was 31.8% and in adult group it was 20% (p= 0.032). The most common virus detected among children was HRV and INF-A in adult group. In 101 (12.1%) cases infections caused by two or three agents were diagnosed. Infections with two causative agents were detected as 2.6% (5/191) in 0-1 month age group, 13% (77/593) in 1 month-18 year age group and 2% (1/50) in > 18 age group. The most frequently observed co-infections with double causative agents were HRV and INF-B, HRV and PIV, HRV and HBoV, HRV and AdV combinations. Infections with three causative agents were detected completely among 1 month-18 year age [3% (18/593)] group. In our study, 318 (38.1%) cases had no signs of infection in the postmortem histopathological examination of the lung tissues, while the most common finding was lobular pneumonia/purulent bronchitis in 233 (28%) cases and the second was interstitial pneumonia in 168 (20.1%) cases. When all cases were evaluated in terms of infection, positive results were detected in 469 (56.2%) cases. As a result; postmortem microbiological diagnosis with autopsy and histopathological detection of the patients who are thought to have respiratory tract infection will also determine the infectious agents causing death.

OBJECTIVES: There are various anatomic variations in the tracheobronchial system. The frequency in studies with bronchoscopy was contradictory. This study aimed to investigate the tracheobronchial tree of the deceased patients with anatomical dissection. MATERIAL AND METHODS: We made anatomical dissections on 204 cases in the Council of Forensic Medicine, Ministry of Justice. The deceased patients who were older than 12 years of age and of Turkish origin were included in this study consecutively. RESULTS: Of the 204 cases, 161 (78.9%) were males and 43 (21.1%) were females. The mean age was 44.15±19.23 years. Anatomical variations were found to be present in 200 cases (98% of total). The highest degree of variation of the right upper lobe was noted to be 16.6% (34/204). An anomalous arrangement (with three segments or different placement) of the middle lobe was noted in 16.1% of cases. For the basal lower lobe, b8+(b9+b10) pattern and basal orifice with four segments were noted to be the most frequent anatomical variant in the right and left lungs, respectively. The most frequent tracheobronchial variations were as follows: apical basal lobe with two subsegments in the right and left (39.7%), left lower lobe basal orifice with four segments (34.8%), left upper lobe with three segments (25.5%), and right lower lobe basal orifice with three main segmental bronchi (21.1%). CONCLUSION: The tracheobronchial tree exhibits highly individualistic features. The knowledge of the frequency of different variations obtained in different studies and normal anatomic variants in return makes doing therapeutic or diagnostic interventions easier and more accurate.

BACKGROUND The techniques of total extraperitoneal and transabdominal preperitoneal hernia repair have been conducted for laparoscopic repair of inguinal hernia since long. However, they offer significant disadvantages of requiring general anesthesia, producing negative cosmetic outcomes, and other serious complications. We examined the feasibility of applying an endoscopic method alternative to total extraperitoneal and transabdominal preperitoneal for laparoscopic repair of inguinal hernia in a cadaver model so as to overcome the disadvantages of the presently available techniques. METHODS A total of 4 male and 2 female cadavers [aged 18 y and above, body mass index (BMI)

Purpose Human falx cerebelli is an important anatomical structure in regard to its relations with venous structures during infratentorial approach to reach cerebellar tumors, vascular malformations, traumatic hemorrhage and Chiari malformations. The present study aim to describe the different types of variations of the falx cerebelli, its morphological features and its association with occipital venous sinuses. Method In this study 49 dura mater was obtained from the Institution of Forensic Medicine. The length, width and the depth of the falx cerebelli were measured using a digital compass. The data obtained were statistically analyzed in relation to age and gender. The relations of the falx cerebelli with the occipital sinus was documented. Histological sections from the falx cerebelli were stained with Hematoxylin Eosin to evaluate the fine structure. Results Among the 49 falx cerebelli examined 36 (73.5%) were classified as normal. The average length, width and depth of the normal falx cerebelli was 3.7, 1.0 and 0.4 cm respectively. Of the 49 falx cerebelli in 1 (2%) case it was absent, in 5 cases (10.2%) duplicate, in 5 cases (10.2%) triplicate, in 1 (2%) case quadruplets and in 1 case (2%) it was five-folded. The proximal and the distal attachments of the falx cerebelli showed 3 types of variations; both attachments triangular, the proximal attachments triangular and the distal ramified and distal attachments triangular and the proximal attachments ramified. The drainage of the occipital sinus of falx cerebelli with variations were evaluated. The increased number of falx cerebelli highly corresponded with the increased number of occipital sinus. Conclusions The dural-venous variation in the posterior cranial fossa can be problematic in various diagnostic and operative procedures of this region. Neurosurgeons should be aware of such variations, as these could be potential sources of haemorrhage during the midline suboccipital and infratentorial approaches.

Multidisipliner bir alan olan adli bilimler, adaletin toplum ve toplumu olusturan bireyler arasinda esit olarak saglanabilirligine hizmet eden saglik, fen ve sosyal bilimler gibi egitsel, teknolojik ve pozitif bilimler toplulugunu kapsar. Bu bilimsel alanda teorik ve uygulamanin birbirleriyle ortusen ve ortusmeyen bircok noktasi bulunmaktadir. Teorik bilgilerin havada ucustugu cagimizda bu bilgilerin adli bilimlerin uygulama alanina yansimasi cok onemlidir. Adli tip, hukuk, psikoloji, sosyal hizmet, cocuk gelisimi, kriminoloji, antropoloji, ogretmenlik, medya, polis ve jandarma gibi guvenlik birimlerini de iceren toplumun cok genis bir alaninda birlikte calismaya ve uretmeye gereksinim bulunuyor. Egitim ve ogretimin en onemli parcasini deneyimlerimiz ve uygulama alanlari yani “olgu temelli” yaklasim belirliyor. Olgu, bilgiyi dogru kullanim, gelisim ve degisimin temeli olma yaninda egitim ve ogretimin ayrilmaz bir parcasidir. Bu paradigma ile elinizde tutugunuz “Olgularla Adli Tip & Adli Bilimler” kitabinin tip fakultesi ogrencileri, adli tip asistanlari, adli tip uzmanlari, adli bilimlerin farkli alanlarinda lisans, yuksek lisans ve doktora ogrencileri basta olmak uzere tip, hukuk, psikoloji, dis hekimligi, kriminoloji, sosyal hizmet, antropolojigibi cok cesitli adli bilimler alaninda calisanlara en son guncel literatur bilgileri yaninda olgularla yeni perspektifler de kazandiracagi kanisindayim. Kitabin okuyucuya multidisipliner bir yaklasim yaninda evrensel etik ilkelere de bagli bir adli tip/adli bilimler yaklasimi kazandirmasini diliyorum. Kitabin yaziminda katkilari olan bolum yazari hocalarimiza, meslektaslarimiza, asistanlarimiza, ogrencilerimize ve destek ve katkilari icin Akademisyen Yayinevi sahibi Yasin Dilmen’e sonsuz tesekkur ediyorum. Bilimselligin ve liyakatin gelecegin adli bilimlerini insa etmede tek gercek oldugu bilinciyle kitabin alanimizin bilimsel niteligini daha da yukseklere tasinmasina aracilik etmesi dilegiyle… Prof. Dr. Halis DOKGOZ Mersin, 2020

BACKGROUND To investigate the distribution of the parotid gland's intraglandular lymph nodes using the parotidectomy zones determined by the parotidectomy classification of the European Salivary Gland Society (ESGS). MATERIALS AND METHODS A total of 128 parotid glands were dissected from 64 fresh cadavers, by bilateral parotidectomy without additional incision within the standard autopsy procedure, and categorized. RESULTS Eighty-six percent of the IGLNs were located in the superficial lobe and 14% in the deep lobe. An average of 7.09 ± 3.55 IGLNs were found for each of the gland; there were 6.11 ± 3.28 in the superficial lobe and 0.98 ± 1.46 in the deep lobe. While the most common lymph nodes were found in level 2 with 47.7%, only 5% of IGLNs were at level 4. According to the proposed modification, the most common lymph nodes (35.24%) were located at level 2B. CONCLUSION Level 2B was found to contain significantly more lymph nodes than other levels, which has not been evaluated before in literature.

Objectives: This study aims to describe morphometric measurements of the laryngeal framework and discuss their implications for phonosurgery among Turkish subjects. Patients and Methods: Larynges from 40 male and 20 female fresh cadavers were extracted during autopsy in a forensic science institution between January 2015 and December 2015. Measurements were taken of the length of membranous and cartilaginous vocal fold mVF, cVF , width and thickness of VF wVF, tVF , anterior and posterior subglottic distance AS, PS , width and height of thyroid cartilage wTC, hTC , and distance between projection of anterior commissure to thyroid cartilage inferior border pAC to TIB . Results: For all parameters, median and mean values were higher in male groups, but the differences were significant only in pAC to TIB, wTC, cVF and mVF groups p

Viral respiratory infections are one of the leading causes of morbidity and mortality, especially in children, elderly and immunocompromised patients. The inclusion of post-mortem studies to diagnose the infection causing mortality could be beneficial in specifying new pathogens and determining strategies for treatment and prevention. The aim of this study was to research viral etiology by applying multiplex real-time polymerase chain reaction (Rt-PCR) method in autopsy cases who have been considered to have a respiratory infection and to assess whether the viruses detected are the primary cause of the infection and whether they have any contributory effect on the mortality together with histopathological evidence. In this study, we included a total of 834 cases consisting of sudden death cases from infantile-pediatric age group and autopsy cases from18 year age group with suspected respiratory tract infection in our laboratory between January 2013 and May 2017. Of 834 cases, 468 (56.1%) were male and 366 (43.9%) were female, there were 191 (22.9%) cases between 0-1 months, 593 (71.1%) cases between 1 month-18 years, and 50 (6%) cases in the18 years age group. In 728 of 834 (87.3%) cases nasopharyngeal/tracheal swab samples and in 106 (12.7%) of them paraffin-embedded lung tissue samples were studied by the use of "FTD Respiratory 21 (Fast-Tract Diagnostics Luxemburg)" kit, with multiplex Rt-PCR method. The post-mortem samples were evaluated for human rhinovirus (HRV), parainfluenza viruses (PIV) (1, 2, 3, 4), influenza virus type A and B (INF-A, INF-B), enterovirus (EV), human bocavirus (HBoV), adenovirus (AdV), human coronavirus (HCoV 229,63,HKU,43), human metapneumovirus A ve B (HMPV-A/B), parechovirus, respiratory syncytial virus (RSV A/B) and Mycoplasma pneumoniae. In our study, at least one respiratory virus was detected by Rt-PCR in 379 (45.4%) of total 834 cases, whereas no viral agent was identified in 455 (54.6%) of the cases. One viral agent was detected in 278 (33.3%), two viral agents were detected in 83 (9.94%) and three viral agents were detected in 18 (2.16%) cases. Overall, the most common viral agent was HRV 110 (13.2%) followed by AdV 39 (4.7%) and RSV A/B 33 (4%). In pediatric cases the rate of positive results for respiratory viruses was 31.8% and in adult group it was 20% (p= 0.032). The most common virus detected among children was HRV and INF-A in adult group. In 101 (12.1%) cases infections caused by two or three agents were diagnosed. Infections with two causative agents were detected as 2.6% (5/191) in 0-1 month age group, 13% (77/593) in 1 month-18 year age group and 2% (1/50) in18 age group. The most frequently observed co-infections with double causative agents were HRV and INF-B, HRV and PIV, HRV and HBoV, HRV and AdV combinations. Infections with three causative agents were detected completely among 1 month-18 year age [3% (18/593)] group. In our study, 318 (38.1%) cases had no signs of infection in the postmortem histopathological examination of the lung tissues, while the most common finding was lobular pneumonia/purulent bronchitis in 233 (28%) cases and the second was interstitial pneumonia in 168 (20.1%) cases. When all cases were evaluated in terms of infection, positive results were detected in 469 (56.2%) cases. As a result; postmortem microbiological diagnosis with autopsy and histopathological detection of the patients who are thought to have respiratory tract infection will also determine the infectious agents causing death.

Macroautophagy (autophagy) is an evolutionarily conserved recycling and stress response mechanism. Active at basal levels in eukaryotes, autophagy is upregulated under stress providing cells with building blocks such as amino acids. A lysosome-integrated sensor system composed of RRAG GTPases and MTOR complex 1 (MTORC1) regulates lysosome biogenesis and autophagy in response to amino acid availability. Stress-mediated inhibition of MTORC1 results in the dephosphorylation and nuclear translocation of the TFE/MITF family of transcriptional factors, and triggers an autophagy- and lysosomal-related gene transcription program. The role of family members TFEB and TFE3 have been studied in detail, but the importance of MITF proteins in autophagy regulation is not clear so far. Here we introduce for the first time a specific role for MITF in autophagy control that involves upregulation of MIR211. We show that, under stress conditions including starvation and MTOR inhibition, a MITF-MIR211 axis constitutes a novel feed-forward loop that controls autophagic activity in cells. Direct targeting of the MTORC2 component RICTOR by MIR211 led to the inhibition of the MTORC1 pathway, further stimulating MITF translocation to the nucleus and completing an autophagy amplification loop. In line with a ubiquitous function, MITF and MIR211 were co-expressed in all tested cell lines and human tissues, and the effects on autophagy were observed in a cell-type independent manner. Thus, our study provides direct evidence that MITF has rate-limiting and specific functions in autophagy regulation. Collectively, the MITF-MIR211 axis constitutes a novel and universal autophagy amplification system that sustains autophagic activity under stress conditions. Abbreviations: ACTB: actin beta; AKT: AKT serine/threonine kinase; AKT1S1/PRAS40: AKT1 substrate 1; AMPK: AMP-activated protein kinase; ATG: autophagy-related; BECN1: beclin 1; DEPTOR: DEP domain containing MTOR interacting protein; GABARAP: GABA type A receptor-associated protein; HIF1A: hypoxia inducible factor 1 subunit alpha; LAMP1: lysosomal associated membrane protein 1; MAP1LC3B/LC3B: microtubule associated protein 1 light chain 3 beta; MAPKAP1/SIN1: mitogen-activated protein kinase associated protein 1; MITF: melanogenesis associated transcription factor; MLST8: MTOR associated protein, LST8 homolog; MRE: miRNA response element; MTOR: mechanistic target of rapamycin kinase; MTORC1: MTOR complex 1; MTORC2: MTOR complex 2; PRR5/Protor 1: proline rich 5; PRR5L/Protor 2: proline rich 5 like; RACK1: receptor for activated C kinase 1; RPTOR: regulatory associated protein of MTOR complex 1; RICTOR: RPTOR independent companion of MTOR complex 2; RPS6KB/p70S6K: ribosomal protein S6 kinase; RT-qPCR: quantitative reverse transcription-polymerase chain reaction; SQSTM1: sequestosome 1; STK11/LKB1: serine/threonine kinase 11; TFE3: transcription factor binding to IGHM enhancer 3; TFEB: transcription factor EB; TSC1/2: TSC complex subunit 1/2; ULK1: unc-51 like autophagy activating kinase 1; UVRAG: UV radiation resistance associated; VIM: vimentin; VPS11: VPS11, CORVET/HOPS core subunit; VPS18: VPS18, CORVET/HOPS core subunit; WIPI1: WD repeat domain, phosphoinositide interacting 1.

WOS: 000382182000019 PubMed: 27389692 A lithopedion is a rare complication of pregnancy that occurs when a fetus in an intraabdominal location dies, and it is too large to be reabsorbed by the body. The case was an 87-year-old woman, and she was transferred to the morgue department in April 2014 to determine the cause of death. During autopsy, an intraabdominally located calcified dead fetus and a 12-cm diameter calcified cyst in the right ovary were incidentally detected. It was aged 25 to 29 weeks (according to femur and humerus measurements) with a size of 12.5 x 8 x 5 cm and a weight of 227 g. According to investigation reports, her husband died in 1990, and she had 3 deliveries, the most recent of which was in 1946. Because the menopause age of the case was not exactly known, the retention time of the lithopedion was supposed to be 24 to 68 years according to the date of the most recent pregnancy and the date of her spouse's death. It is the first case that has been incidentally detected and identified during an autopsy in Turkey and also one of the oldest cases in the literature.