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Objective:According to the International Labor Organization, 153 workers are injured and one worker dies because of occupational accidents or diseases every 15 seconds. Every day, 6,300 people die due to occupational accidents or work-related diseases in the world.Methods:Forensic investigation documents and autopsy reports of patients who were autopsied between 2011 and 2015 at the Forensic Medicine Department of Morgue Specialization in Trabzon Group Presidency and whose causes of death were related to occupational accidents were examined retrospectively.Results:It was determined that 111 (99.1%) were male and 1 (0.9%) were female from a total of 112 worker deaths. Their ages ranged between 18 and 64 years. When the distribution of cases by business types was analyzed, it was determined that 61 (54.5%) cases worked in the construction sector and 12 (10.7%) in the energy sector. It was determined that work accidents occurred due to falling from height in 34 (30.4%) cases and electric shock in 19 (17%) cases. There were skull bone fractures in 44 (39.3%) cases and rib cage fractures in 22 (19.6%) cases during autopsies. In histopathological examinations, there were cardiovascular pathologies in 13 (11.6%) cases, edema and bleeding in the lungs in 20 (17.9%) cases.Conclusion:According to the results of this study, construction sector took place on the top, which is consistent with the national work accident statistics. As a cause of death, general body traumas due to falling from high, electric shocks and work machine accidents come to the fore.

Objective: Carbon monoxide related deaths, which are generally preventable accidents, and more common when compared with other toxic substance consumption, arouse public attention in our country. Materials and Methods: In this study, the aim is to investigate different features of carbon monoxide poisoning related deaths autopsied in Trabzon in 8-year period of time and demonstrate medico-legal aspects of this issue. Results: Our study consists of all deaths due to carbon monoxide poisoning and autopsied by Trabzon Morgue Department of the Council of Forensic Medicine of Turkey between 2009 and 2016. Records of a total of 7133 criminal cases who were autopsied between these years were examined and 215 cases who died due to CO poisoning were evaluated for age, sex, the month of the event occurred, origin, death time, CO source and carboxyhemoglobin (COHb) values. 215 criminal cases were constituting 3.01% of 7133 criminal cases who were autopsied within 8 years in Trabzon. 91 of the cases were (42.3%) female and 124 were (57.7%) male and the male/female case ratio was 1.4. Mean age of the cases was 48.8±27.1years. 24.1% of deaths occurred in January 74% at home. CO source was found to be charcoal in 55.3% of cases. Mean COHb level detected in cases was 54.9±17.6%. Conclusion: Carbon monoxide poisoning is an important social problem in our country as in many developing countries. It is concluded that with their medicolegal experiences and suggestions, forensic medicine specialists can play an important role to manage carbon monoxide poisonings which are mainly...

In recent years, drug use has come to the forefront as one of the most important problems of public health. Tianeptine is an antidepressant that is structurally similar to tricyclic antidepressants and is used for the treatment of depression but is also abused because its pleasing feature has been recognized by drug users. Two forensic cases were autopsied with an interval of 25 days. One case had unilateral unusual inguinal lesions. The other case bilateral unusual inguinal lesions. It was understood that these lesions were preformed, improved surgical catheter incisions in order to facilitate intravenous injections for drug abuse. This application, which was detected in the inguinal region, was found to be interesting. It is aimed to raise the awareness of this application, which is not found in the literature. As a result of the intense human transit, substance abuse habits and methods have also been transferred to citizens...

Alüminyum fosfit nemle teması halinde fosfin gazı oluşturan yüksek toksisiteye sahip bir insektisittir. Tarım ürünlerinde kalıntı bırakmaması ve difüzyon kapasitesinin çok yüksek olması nedeniyle uygulandığı ortamdaki tüm canlıları farklı gelişim evrelerinde öldürebilmesi nedeniyle sıkça kullanılmaktadır. Halen özgün bir antidotu bulunmayan alüminyum fosfit zehirlenmelerinde ölüm oranları alınan doza bağlı olarak %30 ile %100 arasında değişmektedir. Bu çalışmada; bir binanın zemin katında bulunan gıda deposunun fumigasyonu sonrasında, birinci kattaki evinde sıra dışı bir şekilde alüminyum fosfit zehirlenmesi sonucu ölen 13 yaşındaki kız olgu ele alınmıştır. Olgunun otopsi raporu, toksikoloji ve patoloji bulguları birlikte değerlendirilerek konunun literatür eşliğinde tartışılması, oral kullanımı ve inhalasyonu halinde yüksek ölüm riski taşıyan alüminyum fosfitin ülkemizde kontrolsüz satışının ve kullanımının sebep olabileceği bazı olumsuzluklarla birlikte bazı çözüm önerilerinin vurgulanması amaçlanmıştır.

İnhalan maddeler (bazen "uçucu maddeler" olarak da adlandırılırlar) yaygın olarak bulunan, kolaylıkla temin edilebilen ve özellikle ergenler tarafından kötüye kullanılan maddelerdir. İnhalan kötüye kullanımı kültürel ve coğrafi sınırlan aşan, dünya çapında bir sağlık sorunudur. Türkiye’de de bu sorunun giderek yaygınlaştığı gözlemlenmektedir. Uçucu maddeleri içeren ürünlerin ucuz olması, temininin yasal yollardan ve kolayca sağlanabilmesi (süpermarket, kırtasiye, ilaç depoları, işyerleri vs), söz konusu maddelerin çabuk etki göstermesi ve istenmeyen bulgularının hızla kaybolması gibi nedenler çocuk ve ergenlerde kullanımını kolaylaştırmaktadır. Arkadaş grubu içerisinde bütan içerikli çakmak gazı dolum tüpünden gaz soluma sonrası ani ölüm meydana gelen on yedi yaşındaki erkek olgu, olay ortamı ve otopsi bulguları ile sunulmaktadır. Bu çalışmada; çocuk ve genç erişkin yaş gruplarında sıklığı giderek artan uçucu maddelerin kötüye kullanım nedenleri ile meydana gelen ölüm olgularında adli otopsinin ölüm nedeninin saptanmasındaki yeri ve öneminin vurgulanması amaçlanmıştır. Anahtar Kelimeler: Çakmak Gazı, Bütan, Uçucu Madde, Ergen, Adli Tıp, Otopsi.

Devletin koruması altındaki yerler olan cezaevleri ve gözaltı merkezlerinde ortaya çıkan ölümlerde otopsi yapılarak detaylı bir araştırmaya gidilmesi, oluşabilecek tüm şüphelerin bertaraf edilmesi açısından önemli ve gereklidir. Bu çalışmanın amacı Adli Tıp Kurumu Trabzon Grup Başkanlığında otopsileri yapılan cezaevi ve gözaltı ölümlerinde ortaya çıkabilecek iddiaların önlenmesi ve yanıtlanması için olguların ölüm nedenleri, orijinleri ve demografik özelliklerinin ortaya çıkarılması ve benzer çalışmalarla karşılaştırılması ile ulusal literatürümüze katkı sağlamaktadır. Adli Tıp Kurumu Trabzon Grup Başkanlığında 1998-2007 yılları arasında otopsileri yapılan hükümlü, tutuklu ve gözaltı ölümlerine ait raporlar ve adli tahkikat verileri retrospektif olarak incelendi. Veriler SPSS 13.0 istatistik programı kullanılarak tanımlayıcı istatistikle değerlendirildi. Yıllar için karşılaştırmada tek örneklem ki-kare test kullanılmıştır. İstatistiksel analizde 0.05 anlamlılık düzeyi olarak kabul edilmiştir. Toplam 36 adet cezaevi ve gözaltı ölümü bulunmaktadır. Bu olguların %97.2‘si (n:35) cezaevinde %2.8’i (n:1) gözaltında iken meydana gelmiştir. Olgularımızın %97.2’si (n:35) erkek, %2.8’i (n:1) kadındır. Ölümlerin türlerine bakıldığında %69,4’ü (n:25) doğal ölüm, %27,8’i (n:10) zorlamalı ölüm olup sadece bir olguda ölüm türü belirlenememiştir (%2,8). Zorlamalı ölümlerin %80’i (n:8) intihar, %20’si (n:2) cinayettir. Türkiye’de cezaevi, tutuklu ve gözaltı ölümlerinde istatistiksel olarak sağlıklı veriler elde edilmesi bu tür ölümleri önleyici tedbirlerin alınmasını kolaylaştıracaktır. Otopsi yapılması ölüm nedeninin belirlenmesi, orijinin saptanması ve daha sonra ortaya çıkacak iddiaların bertaraf edilmesi açısından son derece önemli ve gereklidir. Hükümlü, tutuklu ve gözaltı durumunda olan şahısların her türlü ortamda sağlık koşullarının düzeltilmesi, kısa sürede sağlık hizmetine ulaşmasının sağlanması ve kendilerine zarar verebilmelerini kolaylaştıran her türlü ortamdan uzak tutulmaları önemlidir. Anahtar kelimeler: Cezaevi, ölüm, otopsi

Ası intihar amacıyla sıklıkla seçilen bir yöntem olup, kaza ve cinayet olguları nadirdir. Tanımlayıcı tipteki bu çalışmada; ası sonucu ölen olguların demografik özelliklerinin belirlenmesi ve verilerin benzer çalışmalar ile karşılaştırılarak tartışılması amaçlanmıştır. Bu amaçla; Samsun’da 1997-2004 yılları arasında ölü muayenesi otopsi işlemi uygulanan 3261 adli ölüm olgusundan ası sonucu öldüğü belirlenen 61 olgu ile ilgili Samsun Adliyesi arşivinde bulunan kayıtlar retrospektif olarak incelenmiştir. Olguların 37 (%60,7)’si erkek, 24 (%39,3)’ü kadın olup, yaş ortalaması 32,38 + 14,15 (11-79) yıldır. Tüm olgularda orijin intihar olarak saptanmıştır. Olguların %77, Tinde ası eylemi ev ve eklentilerinde gerçekleştirilmiştir. Olguların %91,8’inde olay yeri inceleme tutanağı ve olay yeri krokisi bulunmakla birlikte, olay yerine veya ölene ait fotoğraflar %55,7’sinde mevcuttur. Olguların %77,1’i “tam ası” ve %82,0’si “tipik ası” şeklindedir. Telem tüm olgularda tespit edilirken, ası vasıtası olarak 32 (%52,5) olguda ip-urgan kullanılmıştır. Otopsi uygulanan 51 (%83,6) olgudan 38’inde boyun yumuşak dokularında ekimoz, 32’sinde hiyoid kemik ve/veya tiroid kıkırdakta kırık ve bir olguda da boyun omurlarında ayrılma saptanmıştır. Adli inceleme sürecinin uzamaması ve hatasız sonuçlara ulaşılabilmesi amacıyla, tüm adli ölümlerde olduğu gibi ası olgularında da, ayrıntılı olay yeri incelemesi yapılarak krokiler çizilmeli, fotoğraflar ile desteklenmeli, ölüm nedeni ve adli soruşturma-kovuşturma sırasında ortaya çıkabilecek olası sorunlarm açıklığa kavuşturulması için konunun uzmanları tarafından eksiksiz ve usulüne uygun otopsi yapılması gerekmektedir. Anahtar kelimeler: Ası, intihar, adli otopsi

Hz. Osman, Hz. Peygambere damat olmuş, zi’n-nûreyn lakabıyla nitelenmiş, Müslümanların üçüncü hâlifesi olarak İslâm tarihinde yerini almış mümtaz bir sahâbedir. Onun şehâdeti Müslümanları psikolojik ve sosyolojik açıdan derinden etkilemiş bir hâdisedir. O şehit edildikten sonra zühd hareketleri ortaya çıkmış ve dünyaya karşı mesâfeli bir tavır takınılmıştır. Hz. Osman zengin olmasına rağmen sâde ve mütevâzı bir yaşam sürmüş, malını Allah’ın rızâsını kazanmak için sonuna kadar sarf etmiştir. Onun gündüzleri oruçlu bir şekilde halka hizmeti, geceleri ise uzun Kur’an tilâvetleriyle Hakk’a ilticâsı sûfîler için örneklik teşkil etmiştir. Yine onun ömrünün sonuna kadar zühd, fakr, verâ’, takvâ, edep ve hayâ dolu yaşantısı, olaylara karşı firâset yüklü bakışı, melâmî neşvesi sûfîlerin örnek aldığı bir başka unsurdur. İlk dönemde yazılan Kitâbü’z-Zühd’ler ve tasavvuf klasiklerinde Hz. Osman’a diğer üç halifeye nazaran pek fazla yer verilmemiştir. Tabakât literatüründe de Hz. Osman’a açılan müstakil başlıklar bir elin parmağını geçmemektedir. Hz. Osman’ın zi’n-nûreyn şeklinde anılmasına sûfîler tarafından hilm-hayâ, tahkik-temkin, ilim-irfan, teslimiyet-ihlas, ikram-iyilik, sıdk-fakir gibi ikili terkiplerle mânevî anlamlar yüklenmiştir. Hz. Osman’ın zâhidâne yaşantısı zühd dönemindeki bazı sûfîlerin tasavvuf anlayışlarına etki etmiş, teşekkül dönemindeki bazı ekollerin temelini oluşturmuş, özellikle Nakşibendiliğin esaslarında kendini göstermiştir.

Objective:The follow-up of patients with cystic echinococcosis (CE) offers the opportunity of evaluating the prognosis of the infection as well as detecting relapse. This study aimed to evaluate the performance of the new multiepitope recombinant peptide (recDipol) antigen in the follow-up of CE patients treated by surgery or percutaneous aspiration injection respiration.Methods:A total of 137 blood samples from 28 patients were evaluated by IgG-ELISA method using recDipol and hydatid fluid (HF) antigens. The patients were simultaneously checked for recurrence by ultrasonography.Results:The seropositivity rate of the 28 patients varied considerably during the follow-up. When the first blood of the patients was evaluated, 4 (14.28%) were seronegative by HF-ELISA and 9 (32.14%) were recDipol-ELISA. During the entire follow-up, only 1 (3.5%) and 6 (21.4%) patients were seronegative by HF-ELISA and recDipol ELISA, respectively.Conclusion:We found that recDipol did not perform as expected in the follow-up due to the higher number of seronegative patients compared to HF-ELISA in the first blood and during the entire follow-up. Our results suggest that imaging methods are gold standards in the diagnosis and that, in parallel, longer-term patient follow-up is required with recombinant antigens that have an improved diagnostic performance.

Iatrogenic hepatic arterial injuries (IHAIs) include pseudoaneurysm, extravasation, arteriovenous fistula, arteriobiliary fistula, and dissection. IHAIs are usually demonstrated following percutaneous transhepatic biliary drainage, percutaneous liver biopsy, liver surgery, chemoembolization, radioembolization, and endoscopic retrograde cholangiopancreatography. The latency period between the intervention and diagnosis varies. The most common symptom is hemorrhage, and the most common lesion is pseudoaneurysm. Computed tomography angiography (CTA) is mostly performed prior to angiography, and IHAIs are demonstrated on CTA in most of the patients. Patients with IHAI are mostly treated by coils, but some patients may be treated by liquid embolic materials or stent-grafts. CTA can also be used in the follow-up period. Endovascular treatment is a safe and minimally invasive treatment option with high success rates. Iatrogenic hepatic arterial injuries (IHAIs) include pseudoaneurysm, extravasation, arteriovenous fistula, arteriobiliary fistula, and dissection. IHAIs are usually demonstrated following percutaneous transhepatic biliary drainage, percutaneous liver biopsy, liver surgery, chemoembolization, radioembolization, and endoscopic retrograde cholangiopancreatography. The latency period between the intervention and diagnosis varies. The most common symptom is hemorrhage, and the most common lesion is pseudoaneurysm. Computed tomography angiography (CTA) is mostly performed prior to angiography, and IHAIs are demonstrated on CTA in most of the patients. Patients with IHAI are mostly treated by coils, but some patients may be treated by liquid embolic materials or stent-grafts. CTA can also be used in the follow-up period. Endovascular treatment is a safe and minimally invasive treatment option with high success rates.

Mandibular arteriovenous malformations (AVMs) are rare and potentially life-threatening vascular lesions. Surgery, embolization, or bone cement implantation is an option for the treatment of mandibular AVMs. We present a case of huge mandibular AVM refractory to multiple embolizations of the supplying arteries, which was treated with polymethylmethacrylate (PMMA) bone cement implantation after the extraction of a molar tooth.

PURPOSEWe aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous fistula, and arteriocaliceal fistula, their management by endovascular embolization, and the clinical results.METHODSFifty-five patients (forty males, fifteen females) with a median age of 40 years (range, 8–85 years), who underwent endovascular embolization of iatrogenic renal arterial lesions between March 2003 and December 2013 were included in this retrospective study. Types of iatrogenic lesions and details of embolization procedures were reported. Estimated glomerular filtration rate (eGFR), renal function tests, hemoglobin, and hematocrit levels before and after embolization were recorded and compared.RESULTSMedian follow-up was 24 months. We identified 53 pseudoaneurysms, 30 arteriovenous fistulas, and 11 arteriocaliceal fistulas in 55 patients, after percutaneous nephrolithotomy (n=26), renal biopsy (n=21), nephrostomy (n=3), renal surgery (n=3), and extracorporeal shock wave lithotripsy (n=2). Median number of pseudoaneurysms was 1 (range, 1–4) with a median size of 7 mm (range, 1.5–35 mm). Fifty-one patients underwent coil embolization. Median number of coils was 5 (range, 2–21) and median renal parenchymal loss was 5% (range, 1%–50%). There were no significant differences between pre- and postoperative eGFR and serum parameters.CONCLUSIONIatrogenic renal arterial lesion can be a life threatening condition. Superselective coil embolization is a safe, minimally invasive treatment option with minimal renal parenchymal loss and without significant change in renal function.

Background: The present study evaluated, in different oestrus cycle phases, the oestrogen receptor alpha (ERα) and progesterone receptor (PgR) in rates with hyperthyroid ovaries and uterus. Materials and Methods: Sixty-four adult female wistar albino rats were used. Animals were randomly separated into eight different groups, four of which constituted the control group and the other four of which were the actual experimental group. Hyperthyroidism was induced by daily s.c. injection of L-thyroxine (L-T4, 250 µg/kg) for 21 days. Results: Hyperthyroidism induced decreased plasma TSH levels and increased plasma free T4 levels (P < 0.001). In addition, it increased plasma oestrogen levels in all cycle phases, and plasma progesterone levels increased in different cycle phases, excluding the oestrus phase, in rats (P < 0.01). By the end of the experiment, ERα percentages were decreased in oestrus days in uterine luminal epithelium; however, ERα percentages were increased in metoestrus phases in hyperthyroid rats. ERα was elevated in proestrus, metoestrus and dioestrus phases in the corpus luteum, and hyperthyroidism also increased ERα percentages in theca folliculi. In uterine luminal epithelium, the hyperthyroidism group showed higher expressions of PgR (P < 0.05) in oestrus and metoestrus phases and decreased oestrus phase compared to control rats. Conclusions: As a result, we conclude that both the levels of plasma estrogen and progesterone as well as the differences in the distributions of relevant receptors in ovarian and uterus tissues have an impact on female infertility due to hyperthyroidism.

This study presents a cellular automata (CA) model to assist decision-makers in understanding the effects of infrastructure development projects on adverse events in an active war theater. The adverse events are caused by terrorist activities that primarily target the civilian population in countries such as Afghanistan. In the CA-based model, cells in the same neighborhood synchronously interact with one another to determine their next states, and small changes in iteration yield to complex formations of adverse event risks. The results demonstrate that the proposed model can help in the evaluation of infrastructure development projects in relation to changes in the reported adverse events, as well as in the identification of the geographical locations, times, and impacts of such developments. The results also show that infrastructure development projects have different impacts on the reported adverse events. The CA modeling approach can be used to support decision-makers in allocating infrastructure development funds to stabilize active war regions with higher adverse event risks. Such models can also improve the understanding of the complex interactions between infrastructure development projects and adverse events.

PURPOSEWe aimed to present our initial experience with a new self-expanding flow diverter device designed for wide-neck aneurysm treatment, assess its safety for intracranial deployment and efficacy of occlusion at mid-term follow-up. MATERIALS AND METHODSForty-five consecutive patients with difficult aneurysmal anatomy underwent an endovascular treatment. Fifty-five intracranial aneurysms were clipped using the Pipeline flow-diverting stent (ev3 Inc., Plymouth, Minnesota, USA) between November 2009 and December 2011. Data including antiplatelet therapy, technical issues, complications, and imaging findings were recorded during the follow-up period. RESULTSTwenty-seven aneurysms were asymptomatic, 13 were symptomatic due to mass effect, seven were recurrent, six had subarachnoid hemorrhage, and two subjects presented with ischemia. There were 45 saccular, six fusiform-dissecting, and four blister aneurysms. The six-month control angiography was available in 34 subjects with an 85.3% (29/34 patients) complete occlusion rate. The overall occlusion rate according to the last angiography was 91.9% (34/37 patients). The following three major technical complications without clinical consequences were encountered: one distal wire fracture of the stent delivery system and two insufficient stent expansion. There was one fatal nonaneurysmal cerebellar hemorrhage. The overall mortality rate was 2.2% with no permanent morbidity. CONCLUSIONThe Pipeline flow-diverting stent represents an important advancement in endovascular therapy for cerebral aneurysms. Standard endovascular techniques are typically not suitable for these types of aneurysms. The device targets primary parent vessel reconstruction rather than endosaccular occlusion to achieve exclusion of the aneurysm and maintain a relatively high occlusion rate at six months.

Chronic granulomatous disease (CGD) is a primary immune deficiency causing predisposition to infections with specific microorganisms, Aspergillus species and Staphylococcus aureus being the most common ones. A 16-year-old boy with a mutation in CYBB gene coding gp91phox protein (X-linked disease) developed a liver abscess due to Staphylococcus aureus. In addition to medical therapy, surgical treatment was necessary for the management of the disease. A 30-month-old girl with an autosomal recessive form of chronic granulomatous disease (CYBA gene mutation affecting p22phox protein) had invasive aspergillosis causing pericarditis, pulmonary abscess, and central nervous system involvement. The devastating course of disease regardless of the mutation emphasizes the importance of early diagnosis and intervention of hematopoietic stem cell transplantation as soon as possible in children with CGD.

Objectives: The early dissection of the descending aorta after the repair of aortic coarctation is very rare. Herein, we present a special endovascular technique used for acute type B dissection complicating graft bypass for aortic coarctation. Methods: The 48 year-old male patient with the diagnosis of adult type aortic coarctation had bypass procedure between the aortic arch and the descending aorta. Six weeks after the first operation, the patient was readmitted with severe back pain and had the diagnosis of acute type B dissection which involved the descending aorta at the distal part of the graft anastomosis. Results: Two separate stent-grafts were deployed respectively 31 × 150 mm and 34 × 200 mm (C-TAG™ WL Gore&Asc., Flagstaff, AZ, USA). The previous Dacron bypass graft was used as a proximal landing zone for the first stent-graft. The distal landing zone for the second stent was the area between the celiac trunk and superior mesenteric artery. Therefore, the covered stent-graft was implanted to the celiac trunk (Viabahn™ 7 × 50 mm WL Gore&Asc, AZ, USA) to maintain its patency before the deployment of the second graft. The segment of coarctation was closed with a vascular plug (Amplatzer™ vascular plug II) to prevent persistent perfusion of aneurysmal false lumen. Conclusion: The endovascular approach offers multiple less invasive options based on a patient-specific problem. Keywords: Aortic coarctation, Bypass graft, Endovascular, Vascular plug