Search

Three intermediate-range shots from a Browning, model 1955, 7.65 mm caliber, pistol were fired from the driver's seat of a car at a woman in the passenger seat. She sustained three wounds: An, ultimately fatal, penetrating head wound, a graze wound across her forehead, and a tangential, perforating, wound, with bullet entry over the medial sternum and exit through the right flank. Neither postmortem CT nor forensic autopsy discovered bony thoracic injuries or perforations of the thoracoabdominal cavities. There was pulmonary contusion in the medial lobe of the right lung and hemorrhage in the adipose tissue around the right kidney. The tangential bullet had left an almost 40-cm-long wound channel through a pronounced layer of subcutaneous fat. Based on 3D reconstructed CT-data determinations, a straight bullet trajectory between entry and exit wounds would have traversed the abdominothoracic cavities, right lung, and liver. The actual trajectory, however, described a prominent curve, without signs of deflection by bone. Postulated explanations for this unusual bullet track are that the woman was twisting her body in a dynamic scene when the bullet struck; further, due to its shallow angle of incidence on the skin, the bullet was deflected to an intracutaneous path. Additionally, soft tissue resistance may have caused the bullet to yaw. Caution should, thus, be exercised when reconstructing bullet trajectories solely from entry and exist wounds, also for bullet wounds through basically homogenous soft tissues. [ABSTRACT FROM AUTHOR]

Mongolian spots (MS) are congenital dermal conditions resulting from neural crest-derived melanocytes migration to the skin during embryogenesis. MS incidences are highly variable in different populations. Morphologically, MS present as hyperpigmented maculae of varying size and form, ranging from round spots of 1 cm in diameter to extensive discolorations covering predominantly the lower back and buttocks. Due to their coloring, which is also dependent on the skin type, MS may mimic hematoma thus posing a challenge on the physician conducting examinations of children in cases of suspected child abuse. In the present study, MS incidences and distribution, as well as skin types, were documented in a collective of 253 children examined on the basis of suspected child abuse. From these data, a classification scheme was derived to document MS and to help identify cases with a need for recurrent examination for unambiguous interpretation of initial findings alongside the main decisive factors for re-examination such as general circumstances of the initial examination (e. g., experience of the examiner, lighting conditions) and given dermatological conditions of the patient (e. g., diaper rash). [ABSTRACT FROM AUTHOR]

A series of new synthetic cannabinoids (SC) has been consumed without any toxicological testing. For example, pharmacokinetic data have to be collected from forensic toxicological case work and/or animal studies. To develop a corresponding model for assessing such data, samples of controlled pig studies with two selected SC (JWH-210, RCS-4) and, as reference, ∆-tetrahydrocannabinol (THC) should be analyzed as well as those of human cases. Therefore, a method for determination of JWH-210, RCS-4, THC, and their main metabolites in pig and human serum, whole blood, and urine samples is presented. Specimens were analyzed by liquid-chromatography tandem mass spectrometry and multiple-reaction monitoring with three transitions per compound. Full validation was carried out for the pig specimens and cross-validation for the human specimens concerning precision and bias. For the pig studies, the limits of detection were between 0.05 and 0.50 ng/mL in serum and whole blood and between 0.05 and 1.0 ng/mL in urine, the lower limits of quantification between 0.25 and 1.0 ng/mL in serum and 0.50 and 2.0 ng/mL in whole blood and urine, and the intra- and interday precision values lower than 15 % and bias values within ±15 %. The applicability was tested with samples taken from a pharmacokinetic pilot study with pigs following intravenous administration of a mixture of 200 μg/kg body mass dose each of JWH-210, RCS-4, and THC. The cross-validation data for human serum, whole blood, and urine showed that this approach should also be suitable for human specimens, e.g., of clinical or forensic cases. [ABSTRACT FROM AUTHOR]

Postmortem computed tomography (CT) is now routinely performed in forensic autopsies. Microfocus computed tomography (mfCT) has attracted recent attention because it can provide more detailed information than routine postmortem CT can. This feasibility study evaluated the usefulness of mfCT for examination of the hyoid bone and thyroid cartilage in cases of suspected strangulation, where advanced decomposition precludes detection of petechial hemorrhages and hemorrhages adjacent to fractures. The results show that mfCT was useful for identification of thin fracture lines in the fragile laryngeal structures. We suggest that mfCT should be considered for forensic autopsies in cases of suspected strangulation with advanced decomposition. [ABSTRACT FROM AUTHOR]

Blunt head trauma secondary to violent actions with various weapons is frequently a cause of injury in forensic casework; differing striking tools have varying degrees of injury capacity. The systematic approach used to examine a 19-year-old student who was beaten with a wooden teeball bat will be described. The assailant stopped beating the student when the teeball bat broke into two pieces. The surviving victim sustained bruises and a forehead laceration. The State's Attorney assigned a forensic expert to examine whether the forces exerted on the victim's head (leading to the fracture of the bat) were potentially life threatening (e.g. causing cranial bone fractures). Physical modeling was conducted using a pigskin-covered polyethylene end cap cushioned by cellulose that was connected to a piezoelectric force gauge. Experiments with teeball bats weighing 295-485 g demonstrated that 12-20 kN forces were necessary to cause a comparable bat fracture. In addition to physical testing, a computer-aided simulation was conducted, utilizing a finite-element (FE) method. In the FE approach, after selecting for wood properties, a virtual bat was swung against a hemisphere comprising two layers that represented bone and soft tissue. Employing this model, a 17.6 kN force was calculated, with the highest fracture probability points resembling the fracture patterns of the physically tested bats. [ABSTRACT FROM AUTHOR]

In forensic anthropological casework, estimating age-at-death is key to profiling unknown skeletal remains. The aim of this study was to examine the reliability of a new, simple, fast, and inexpensive digital odontological method for age-at-death estimation. The method is based on the original Lamendin method, which is a widely used technique in the repertoire of odontological aging methods in forensic anthropology. We examined 129 single root teeth employing a digital camera and imaging software for the measurement of the luminance of the teeth's translucent root zone. Variability in luminance detection was evaluated using statistical technical error of measurement analysis. The method revealed stable values largely unrelated to observer experience, whereas requisite formulas proved to be camera-specific and should therefore be generated for an individual recording setting based on samples of known chronological age. Multiple regression analysis showed a highly significant influence of the coefficients of the variables 'arithmetic mean' and 'standard deviation' of luminance for the regression formula. For the use of this primer multivariate equation for age-at-death estimation in casework, a standard error of the estimate of 6.51 years was calculated. Step-by-step reduction of the number of embedded variables to linear regression analysis employing the best contributor 'arithmetic mean' of luminance yielded a regression equation with a standard error of 6.72 years ( p < 0.001). The results of this study not only support the premise of root translucency as an age-related phenomenon, but also demonstrate that translucency reflects a number of other influencing factors in addition to age. This new digital measuring technique of the zone of dental root luminance can broaden the array of methods available for estimating chronological age, and furthermore facilitate measurement and age classification due to its low dependence on observer experience. [ABSTRACT FROM AUTHOR]

Coronary artery anomalies are found in approximately 1.3 % of symptomatic adult patients undergoing coronary arteriography and encompass a wide variety of anatomic patterns. Single coronary arteries are found in 0.024-0.066 % of this group. The particular type of a single coronary artery with an anatomically correct course of either artery (so-called L/R-I type according to the Lipton and Yamanaka/Hobbs classification) is an especially rare phenomenon and has been described for the left coronary artery and for the right coronary artery in adults. In these anomalies an isolated coronary artery ensuring the blood supply of the entire heart displayed a compensatory widening of the lumen. The case of a 6-year-old boy who collapsed during exercise and died subsequently of acute cardiac death is presented. At autopsy a single right coronary artery with an anatomically correct course (R-I type) arising from the right sinus of Valsalva was found. On microscopic examination myocardial calcifications and scars were found in the papillary muscles of the mitral valve. Common ion channel disorders were excluded by DNA analysis. Sudden cardiac death on the basis of chronic ischemic heart disease was ascertained as the cause of death. Autopsy and microscopic findings, as well as aspects of the underlying pathophysiology, are presented and discussed. [ABSTRACT FROM AUTHOR]

Paradoxical undressing is a phenomenon associated with fatalities due to severe hypothermia, which is characterized by the act of active undressing, despite low ambient temperatures, as a consequence of peripheral vasodilation. A 51-year-old man was found lying naked and inanimate on a road. Articles of his clothing were scattered in surrounding bushes. A nearby handrail showed a partially washed away bloodstain pattern. A forensic autopsy was used to distinguish whether death was due to a hypothermic fatality or whether the deceased was a victim of an accident or homicide. Medicolegal autopsy revealed craniofacial dissociation with injuries to the thorax and extremities and established choking/asphyxia due to deep aspiration of blood in combination with external blood loss as the cause of death. In the absence of hypothermia-related signs and toxicological findings the case was considered to be a homicide. Police investigation led to the conviction of a man who confessed to having kicked and hit the victim and forced him to take off his clothes in a humiliation-related scenario. [ABSTRACT FROM AUTHOR]

Abstract: Because of the increasing lack of recent bone collections, ethical issues concerning maceration procedures, and progress in radiological imaging techniques, computed tomography (CT) scans offer an alternative to traditional anthropological bone collection. The present study examined volume-rendered cranial CT (CCT) scans from 50 crania to morphologically evaluate sex characteristics. CCT scans were performed and scored by two teams (Teams A and B) of two examiners each (2×50=100 examinations) to evaluate the occurrence and/or absence of morphological traits. Altogether, 60 of 100 crania (31 Team A+29 Team B) crania were determined to be male, and 40 (19 Team A+21 Team B) were determined to be female when using the scoring system adapted from Knussmann. These results imply a sex determination accuracy rate of 96%. Only in one case was recalculation of weighting factors necessary to determine one additional correct classification. As a single parameter, arcus superciliaris evaluation permitted the most accurate sex determination (female, 84.2%; male, 85.5%). No significant difference in accuracy rates was observed between the two sexes (p <0.65, χ 2 =0.39, Fisher''s exact test). Interobserver bias rates for both teams were very low (κ =0.83). The present study shows that volume-rendered CCT images are suitable for the collection of data concerning morphologic sex determination of skulls. Thus, this method may be helpful in both actual forensic casework and the systematic reevaluation and improvement of classical anthropological methods and their adaptation to changing populations. [Copyright &y& Elsevier]

The single nucleotide polymorphism 118A>G of the human μ-opioid receptor gene OPRM1, which leads to an exchange of the amino acid asparagine (N) to aspartic acid (D) at position 40 of the extracellular receptor region, alters the in vivo effects of opioids to different degrees in pain-processing brain regions. The most pronounced N40D effects were found in brain regions involved in the sensory processing of pain intensity. Using the μ-opioid receptor-specific agonist DAMGO, we analyzed the μ-opioid receptor signaling, expression, and binding affinity in human brain tissue sampled postmortem from the secondary somatosensory area (S[subII]) and from the ventral posterior part of the lateral thalamus, two regions involved in the sensory processing and transmission of nociceptive information. We show that the main effect of the N40D μ-opioid receptor variant is a reduction of the agonist-induced receptor signaling efficacy. In the S[subII] region of homoand heterozygous carriers of the variant 118G allele (n = 18), DAMGO was only 62% as efficient (p = 0.002) as in homozygous carriers of the wild-type 118A allele (n = 15). In contrast, the number of [[sup3]H]DAMGO binding sites was unaffected. Hence, the μ-opioid receptor G-protein coupling efficacy in S11 of carriers of the 118G variant was only 58% as efficient as in homozygous carriers of the 118A allele (p < 0.00 1). The thalamus was unaffected by the OPRM1 1 18A > G SNP. In conclusion, we provide a molecular basis for the reduced clinical effects of opioid analgesics in carriers of μ-opioid receptor variant N40D. [ABSTRACT FROM AUTHOR]

Abstract: Because serum Procalcitonin is reported to be a valid postmortem marker of sepsis, this prospective study was carried out to determine whether the semi-quantitative PCT-Q®-Test (B.R.A.H.M.S., Germany) is a reliable indicator of postmortem Procalcitonin (PCT) serum levels, thus enabling a quick “tableside” diagnosis of sepsis. Postmortem PCT-levels of 70 forensic and 78 clinical-pathological autopsy cases (n =148) were examined using the B·R·A·H·M·S-PCT-Q®-Test during autopsy. 27 cases were categorized as the cases of sepsis according to the ACCP/SCCM Consensus Conference criteria. 121 cases were assigned to the non-sepsis group. Among the 148 cases, 18 samples could not be analyzed by the reason of strong hemolysis. Using a cut-off point of 2ng/ml, 20 cases of sepsis were identified (true positive) whereas 3 cases of sepsis were not detected (false negative). In the non-sepsis group (107 cases) 6 cases showed a positive testing (false positive). When applied within 48h postmortem, the PCT-Q®-Test showed a sensitivity of 86.96% and a specificity of 94.39% (at cut-off 2ng/ml). Likelihood ratios and positive predictive values proved to be lower in the forensic autopsy group (PPV: 59.3% in forensic case vs. 85.1% in clinicopathological cases; NPV: 98.73% in forensic cases vs. 95.2% in clinicopathological cases). The PPVs using a cut-off point of 10ng/ml were 100% in both groups independent of sepsis prevalences. The results show, that a high NPV for prevalences ranging from 3% to 30% can be reached using a 2ng/ml cut-off point, whereas a cut-off of 10ng/ml ensures a high PPV for the respective prevalences in the absence of exclusion criteria. The study provides strong evidence that the introduction of rapid diagnostic test (RDTs) of postmortem PCT serum levels may be useful in achieving rapid distinction between sepsis and non-sepsis-related causes of death, especially in conjunction with the medical case history and further autopsy results. In addition, the use of RDTs enables clinicians to conduct an evidence-based validation of clinical diagnosis, thus facilitating future clinical decision-making. [Copyright &y& Elsevier]

Marinesco bodies (MB) are intranuclear inclusion bodies predominantly found in melanin-pigmented neurons of the substantia nigra. MB are demonstrable not only in humans but also in nonhuman primates. In the present study MB of aged rhesus monkeys (Macaca mulatta; n = 15; mean age 16 years) and aged baboons (Papio anubis; n = 13; mean age 25 years) were examined immunohistochemically. MB were found to be immunoreactive for ubiquitin, a protein involved in initiation of proteasome-mediated proteolysis. We also demonstrate that MB in monkeys are intensely immunoreactive for the protein ataxin-3 as detected by using two monoclonal anti-ataxin-3 antibodies (1H9 and 2B6). The abnormally expanded form of this polyglutamine protein is known to be causally involved in spinocerebellar ataxia type 3 or Machado–Joseph disease. The monoclonal antibody 1C2 was employed to examine whether ataxin-3 in MB in monkeys contains such an abnormally expanded polyglutamine stretch. MB were consistently 1C2-immunonegative, indicating that they are composed of normal wild-type ataxin-3. In conclusion MB in nonhuman primates permit experimental examination of mechanisms involved in transnuclear localization, intranuclear aggregation, and ubiquitination of nonexpanded polyglutamine proteins. [Copyright &y& Elsevier]

Carbon dioxide ( CO2) is an odorless constituent of air. Higher concentrations can be detected in geothermal and automotive emissions, fermentation, and sublimation of dry ice. An unskilled worker entered a fermentation tank to clean it, which had not been done for about 5 months allowing for high concentrations of CO2 to build up. A second worker entered the tank to rescue the first one. Shortly after both were found the first worker was rescued directly whereas the tank had to be rotated to pull the second worker out. Cardiopulmonary resuscitation was successful only for the first worker. Medico-legal autopsy showed bruises, hematoma, myocardial hemorrhage, and edema of the lungs. The right lung was vacuum degassed in an argon atmosphere and quadrupole-mass-spectrometry showed an elevated CO2 content in lung gases. Thus, CO2 intoxication/asphyxia in a vitiated atmosphere due to fermentation of wine mash was established as the cause of death. [ABSTRACT FROM AUTHOR]

Rapid prototyping (RP) comprises a variety of automated manufacturing techniques such as selective laser sintering (SLS), stereolithography, and three-dimensional printing (3DP), which use virtual 3D data sets to fabricate solid forms in a layer-by-layer technique. Despite a growing demand for (virtual) reconstruction models in daily forensic casework, maceration of the skull is frequently assigned to ensure haptice vidence presentation in the courtroom. Owing to the progress in the field of forensic radiology, 3D data sets of relevant cases are usually available to the forensic expert. Here, we present a first application of RP in forensic medicine using computed tomography scans for the fabrication of an SLS skull model in a case of fatal hammer impacts to the head. The report is intended to show that this method fully respects the dignity of the deceased and is consistent with medical ethics but nevertheless provides an excellent 3D impression of anatomical structures and injuries. [ABSTRACT FROM AUTHOR]

Aspiration of blood is a phenomenon observed in violent and natural death scenarios. Bloodstain patterns evolving from expectoration of aspired blood may look suspicious of a violent genesis and thus mislead crime scene investigators. In the present case, a woman was found lying in a pool of blood on the kitchen floor. Furthermore, bloodstains covered her face, clothing, and surrounding furniture and walls. Bloodstain pattern analysis and medicolegal inspection of the suspected scene of crime were carried out and revealed dispersed stains with enclosed gas bubbles in the absence of signs of physical violence leading to the assessment of a natural manner of death. The bloodstains were attributed to expiration of blood because of an internal bleeding. Medicolegal autopsy confirmed the on-site diagnosis as a fatal esophageal varix rupture was found. [ABSTRACT FROM AUTHOR]

Purpose: A procedure is needed for bodies with disfiguring injuries to the face and the use of their portrait for visual identification. Method: We present the application of a simple image processing procedure, otherwise known as "bubbling," which is based on the concept of "perceptual filling-in," to images for visual identification in the forensic context. The method is straight forward and can be performed using readily available software and hardware.. Results: The method is demonstrated and examples are shown. The visual recognition of known persons using "bubbled" images was successfully tested. Conclusion: The "bubbling" procedure for visual identification enhancement is quick and straightforward and may be attempted before escalating to more involved identification methods and procedures. [ABSTRACT FROM AUTHOR]

In forensic medicine, blood loss is encountered frequently, either as a cause of death or as a contributing factor. Here, risk to life and lethality assessment is based on the concept of relative blood loss (absolute loss out of total volume). In emergency medicine, the Advanced Trauma Life Support (ATLSⓇ) classification also refers to relative blood loss. We tested the validity of relative blood loss benchmarks with reference to lethality. Depending on the quality of the total blood volume (TBV) estimation formula, relative blood loss rates should be reflected in the case cohort as significantly higher absolute blood loss in heavier individuals since all TBV estimation formulas positively correlate body weight with TBV. Method: 80 autopsy cases with sudden, quantifiable, exclusively internal blood loss were retrospectively analyzed and a total of 8 different formulas for TBV estimation were applied. Results: No statistical correlation between body weight and absolute blood loss was found for any of the tested TBV estimation algorithms. All cases showed a wide spread of both absolute and relative blood loss. Discussion: The principle of relative blood loss is of very limited use in casework. It opens the forensic expert opinion to unnecessary criticism and possible negative legal implications. Conclusion: We challenge the use of relative blood loss benchmarks in textbooks and practical casework and advocate for its elimination from the ATLSⓇ 's grading system. If necessary, we recommend the use of BMI-adjusted algorithms for TBV estimation. [ABSTRACT FROM AUTHOR]

In the frame of an experimental setting, the formation of round-shaped compounded glass fragments on the exit site after gunshots through a windshield was examined. For that purpose, a 9 × 19 mm pistol (HK P30) and two different cartridges containing (a) a full metal jacketed round-nosed projectile and (b) a deformation projectile were used. On the basis of 52 gunshots, the morphology, impact angles and terminal ballistics of occurring compounded glass fragments were examined. The results showed that the compounded glass fragments' morphology allowed for the differentiation of two used projectiles. Fragments were able to cause round-shaped defects in a single cotton layer (T-shirt) with subsequent penetration of up to 2.4 cm into ballistic gelatin (10%, 4 °C). As a function of the projectile type, the compounded glass fragments showed different reproducible impact angles that differed notably from the known conical pattern of expelled glass fragments after bullet penetration. These findings might help to explain the atypical morphology of gunshot wounds with laminated glass as an intermediate target and prevent possible misinterpretations when reconstructing the sequence of events. [ABSTRACT FROM AUTHOR]

The concept of nomography was developed around 1880 as a means to compute formulas graphically. Regular use has decreased over time in most fields, mainly owing to progress in electronic computation devices. In forensic pathology, nomography is still used in the so-called "nomogram method" for the estimation of time since death. It is the graphical representation of the formula by Marshall and Hoare with the parameters of Henssge. Here, two nomograms exist (for ambient temperatures below and above 23 °C, no imperial measurements). Rounding for body weight input and result reading introduces errors. In addition, correction factors, applied to body weight, allow to adapt for certain conditions on the crime scene and are essential to the method. They are not directly integrated into the nomograms but must be applied in advance. A formula, scaling correction factors for different body weights, was later added by Henssge, along with a simplified table for case work. In this publication, we present newly designed time since death nomographs as representations of Henssge's parameters with the addition of both metric and imperial measurements, integration of weight adjusted scaling of correction factors, and a geometrically consistent framework for body weight and result reading, which eliminates some rounding steps and reduces the overall rounding-related estimation errors. [ABSTRACT FROM AUTHOR]

Purpose: Prisoners are at a particularly high risk of suicide. In contrast to other psychosocial risk factors it remains unclear to what degree the risk of suicide differs between prisoners with local citizenship and foreigners. In order to provide more detailed information for suicide prevention in prisons, this study aims to compare suicide rates (SR) between these populations in German criminal custody. Methods: Based on a German national database of completed suicide in custody, suicides by prisoners were analysed and compared with epidemiological data of the prison population and the general population, stratified for German and foreign citizenship. Data analysis was adjusted for differences in the age distribution of both populations by calculating standard mortality ratios (SMR) for suicide. Results: SR were higher in prisoners with German citizenship than those with foreign citizenship (SR = 76.5 vs. SR = 42.8, P<0.01). This association was not specific to the prison population, as the higher SR in citizens compared to non-citizens (SR = 19.3 vs. SR = 9.0, P<0.01) were also found in the general population. The association between prison suicide and citizenship was comparable in juvenile and adult prisoners, indicating its relevance to both the juvenile and adult detention systems. Conclusion: Imprisonment is associated with a substantially increased risk of suicide in both German and non-German citizens, a finding which needs to be taken into consideration by the justice system. The lower suicide risk in non-German citizens is independent of whether or not they are in custody. [ABSTRACT FROM AUTHOR]

Synthetic cannabinoids (SCs) are gaining increasing importance in clinical and forensic toxicology. They are consumed without any preclinical safety studies. Thus, controlled human pharmacokinetic (PK) studies are not allowed, although being relevant for interpretation of analytical results in cases of misuse or poisoning. As alternative, in a controlled animal experiment, six pigs per drug received a single intravenous dose of 200 μg/kg BW each of Δ 9 -tetrahydrocannabinol (THC), 4-ethylnaphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-210), or 2-(4-methoxyphenyl)-1-(1-pentyl-indol-3-yl)methanone (RCS-4). In addition, six pigs received a combination of the three drugs with the identical dose each. The drugs were determined in serum using LC–MS/MS. A population (pop) PK analysis revealed that a three-compartment model described best the PK data of all three cannabinoids. Central volumes of distribution were estimated at 0.29 L/kg, 0.20 L/kg, and 0.67 L/kg for THC, JWH-210, and RCS-4, respectively. Clearances were 0.042 L/min/kg, 0.048 L/min/kg, and 0.093 L/min/kg for THC, JWH-210, and RCS-4, respectively. The popPK THC pig model was upscaled to humans using allometric techniques. Comparison with published human data revealed that the concentration-time profiles could successfully be predicted. These findings indicate that pigs in conjunction with PK modeling technique may serve as a tool for prediction of human PK of SCs. [ABSTRACT FROM AUTHOR]

In forensic casework, time since death (TSD) estimations may play a crucial role to establish chains of events as well as for alibi assessment in homicide cases. Classical TSD estimation relies on reasonably stable ambient temperatures and a correct documentation of ambient and rectal temperatures. This constancy is in some cases disturbed by post-discovery alterations of the crime scene, e.g. opening a window. In order to develop a better understanding of this alteration-based detrimental impact on TSD estimation as well as to identify feasible recommendations for casework, the present pilot study examined ambient temperature effects of different window opening scenarios regarding various time intervals (5 to 360 min) in a furnished 10 m2 apartment during winter. In this context, in addition to the ambient temperature and thus the cooling rate of the room, re-approximation to initial room temperature, potential influences on a nomogram-based time since death estimation using a fictitious case, and the impact of the measurement height above the ground were investigated. Our data indicate a significant reduction of the mean temperature decrease rate after 15 min regardless of the remaining opening time and a correlation with the size of the respective opening surfaces. Re-approximation to initial room temperatures was observed with up to three times longer than the initial opening time. There was no evidence of a substantial advantage of temperature measurements above the level of the corpse (> 0.1 m). The limitations of the study and its applicability for forensic casework are critically reviewed. [ABSTRACT FROM AUTHOR]

Within the scope of this technical report, the feasibility of indocyanine green (ICG) as a fluorescent agent for postmortem angiography of the heart is tested. The study included 4 deceased persons with no respective medical history of heart diseases. The basic patterns of findings in ICG fluorescence angiography associated with healthy hearts are presented. The method can easily be integrated into a workflow without restricting the macroscopic or histologic diagnostics. This paper represents the fundamental technical and analytical basis for upcoming studies concerning the possibilities and limitations of fluorescence angiography in the diagnosis of heart pathology. [ABSTRACT FROM AUTHOR]

The hypophysial pars tuberalis (PT) acts as an important interface between neuroendocrine brain centers (hypothalamus, pineal organ) and the pars distalis (PD) of the hypophysis. Recently, we have identified an endocannabinoid system in the PT of hamsters and provided evidence that 2-arachidonoylglycerol is a messenger molecule that appears to play an essential role in seasonal reproduction and prolactin release by acting on the cannabinoid receptors in the PD. We now demonstrate the enzymes involved in endocannabinoid synthesis and degradation, namely sn-1-selective diacylglycerol lipase α, N-acylphosphatidylethanolamine-specific phospholipase D, and monoacylglycerol lipase, in the PT of man by means of immunohistochemistry. High-performance liquid chromatography coupled with tandem mass spectrometry revealed 2-arachidonoylglycerol and other endocannabinoids in the human PT. Furthermore, we detected the expression of the cannabinoid receptor 1 (CB1), a primary receptor for endocannabinoids, in the PD. Double-immunofluorescence staining for CB1 and various hypophysial hormones or S-100, a marker for folliculostellate (FS) cells, revealed that CB1 immunoreactivity was mainly localized to corticotrophs and FS-cells. A limited number of lactotrophs and somatotrophs also showed CB1 immunoreactivity, which was however absent from gonadotrophs and thyrotrophs. Our data thus indicate that the human PT comprises an endocannabinoid system, and that corticotrophs and FS-cells are the main target cells for endocannabinoids. The functional significance of this newly discovered pathway remains to be elucidated in man; it might be related to the control of stress responses and/or reflect a remnant seasonal control of hypophysial hormonal secretion. [ABSTRACT FROM AUTHOR]

Objective: Prisoners constitute a high-risk group for suicide, with suicide rates about 5 to 8 times higher than in the general population. The first weeks of imprisonment are a particularly vulnerable time, but there is limited knowledge about the risk factors for either early or late suicide events. Methods: Based on a national total sample of prison suicides in Germany between 2005 and 2017, suicides within the first 2 (4 and 8) weeks after reception into prison were matched by age and penalty length with cases that occurred later. Factors that potentially influence the timing of suicide were investigated. Results: The study has shown that 16.7% (31.5%) of all 390 suicides in German prisons occurred within the first two weeks (two months) of imprisonment. Factors that facilitate adaptation to the prison environment (e.g. prior prison experience) were negatively associated with early suicide events. Factors that hindered the adaptation process (e.g. withdrawal from illicit drugs) were observed more frequently in early suicide events than in late ones. These factors are active at different times of imprisonment. Conclusion: At reception, particular attention should be paid to the following factors associated with early suicide events: widowed marital status, lack of prison experience, and drug dependency. [ABSTRACT FROM AUTHOR]

The polyvinyl alcohol method (PVAL) is known as an effective technique to thoroughly collect traces of gunshot residue (GSR) from different surfaces, e.g., from hands or gunshot wounds. Despite obvious advantages over other methods using adhesive tapes, PVAL is still not widely accepted and applied in routine case work due to a required acquisition time of at least 15 to 20 min for a single shooting hand. In this study, the feasibility of a modified procedure taking 6 to 8 min per sample is tested within the frame of an experimental setting including (1) the collection of GSR from experimental gunshots with a semi-automatic pistol and lead-containing primer ammunition and (2) a simple experimental setting involving dry and moist artificial blood traces. In a third step, samples of four gun-associated suicide cases and one attempted suicide case were taken and analyzed. Furthermore, an exemplary implementation into a work flow of modern instrumental techniques of GSR analysis is presented. [ABSTRACT FROM AUTHOR]

Purpose: Prisoners have a higher risk of suicide compared to non-incarcerated individuals. One aim of suicide prevention for prisoners is to identify risk factors in order to put stronger support mechanisms in place for the more vulnerable detainees. This study investigates the suicide risk (SR) in offence-related sub-populations in a representative German sample and differentiates between SR for adolescent and adult prisoners. Methods: Conducting a national study with data from public German records on the entire prison population from 2000 to 2016 and suicide numbers in German prisons in the same period, SR was calculated for the total male prison population as well as for both subgroups, adolescent and adult male prisoners. Results: In the study period, male prisoners spent 959.584 life years (LY) in German criminal detention. Among those, 524 prisoners died of suicide. SR was higher for detainees imprisoned for an offence resulting in extensive physical harm for another person, e.g. homicide (suicide rate = 134,8 suicides per 100.000 LY; OR = 2,47; CI95%: 1,98–3,08), bodily injury (suicide rate = 87,3; OR = 1,60; CI95%: 1,29–1,99), and sexual offences (suicide rate = 84,2; OR = 1,54; CI95%: 1,18–2,01) compared with the SR of the total prison population (suicide rate = 54.6). Age differences between offence-related SR were found for theft, with adolescents (suicide rate = 69,3; OR = 1,25; CI95%: 0,85–1,84) showing higher SR than adults (suicide rate = 38,2; OR = 0,7; CI95%: 0,54–0,92). Conclusion: The index offence of detainees is associated with SR and age-related differences exist. Suicide prevention in prisons should take both into account to determine populations at risk. [ABSTRACT FROM AUTHOR]

Cases of sudden cardiac death (SCD) in young and apparently healthy individuals represent a devastating event in affected families. Hereditary arrhythmia syndromes, which include primary electrical heart disorders as well as cardiomyopathies, are known to contribute to a significant number of these sudden death cases. We performed postmortem genetic analyses in young sudden death cases (aged <45years) by means of a defined gene panel using massive parallel sequencing (MPS). The data were evaluated bioinformatically and detected sequence variants were assessed using common databases and applying in silico prediction tools. In this study, we identified variants with likely pathogenic effect in 6 of 9 sudden unexpected death (SUD) cases. Due to the detection of numerous unknown and unclassified variants, interpretation of the results proved to be challenging. However, by means of an appropriate evaluation of the findings, MPS represents an important tool to support the forensic investigation and implies great progress for relatives of young SCD victims facilitating adequate risk stratification and genetic counseling. [ABSTRACT FROM AUTHOR]

A recurrent observation in forensic casework is that culprits and/or their abettors attempt to remove or mask bloodstain patterns, e.g., by painting the walls. The present study was designed to elucidate whether luminol treatment of bloodstains on (a) plastered and (b) wallpapered walls may help with the visualization of respective patterns after being repainted beyond macroscopic recognition. Furthermore, wallpaper punches of luminol-positive spots were analyzed for DNA. The experiments showed that the prospects for visualization after a four- to sixfold paint application declined considerably as the drying time of the paint increased. A compelling explanation for this observation is that paint becomes increasingly resistant to water during the drying process after paint application. In these cases, moistening the surface in question with distilled water for 15 min has been proven to be a promising pretreatment before luminol application. DNA analysis revealed full STR profiles in 74% of luminol-positive wallpaper punches, whereas rubs of the aforementioned positively tested regions (luminol and human blood pretests) demonstrated negative results. [ABSTRACT FROM AUTHOR]

In forensic case work, blood stain pattern analysis frequently aids in deducing the chain of actions or parts thereof taking place during an event leading to blood loss. Wiped single blood stains and/or groups of blood stains are seen at a majority of complex crime scenes. The appearance of wiped blood stains depends on droplet volume and stain age (as a function of blood viscosity and the degree of stain skeletonization) and characteristics of the stained surface (i.e., texture, temperature). Furthermore, based on the biochemical and biophysical properties of blood, not only the drying processes, but also complex coagulation cascades are relevant to the assessment of wiped blood stains. This study was designed to determine if anticoagulation therapies markedly affect the wipeability of blood stains over times elapsed since deposition and the overall drying process. A total of 813 blood stains, originating from donors being treated with acetylsalicylic acid (ASA), clopidogrel + ASA, low-molecular-weight heparin, or rivaroxaban, were dropped on common household tiles. Wipeability at an ambient temperature of 20 °C was tested for 22 time periods (1, 2, 3, 5, 10, 15...105 min since deposition). Whereas stains consisting of untreated blood were dried within 55 min, wipeability of all droplets originating from donors with prior anticoagulation treatment showed pronounced delays compared with the control, ranging from 20 min (ASA and clopidogrel + ASA) to 45 min (rivaroxaban). This pronounced effect was not seen in earlier studies, which might be explained by the higher volume of droplets used in this study, which resulted in a shift in relevance from drying to clotting processes. Significant differences between the drying times of the various anticoagulation regimes might be attributed to anticoagulant activity against different targets in the coagulation cascades. In conclusion, anticoagulation treatment prior to blood loss significantly affected the wipeability of blood stains. Anticoagulation therapy should therefore be taken into account in the analysis of blood stain patterns. [ABSTRACT FROM AUTHOR]

Even when human skeletal remains are found in contexts indicative of body disposal after homicide, none of the bones may manifest injuries. When skeletons are incomplete, there are two possibilities, the injured bones are missing or none were injured. This leads to the question how frequently bones are injured during homicide, where the injuries tend to be placed, and whether the frequency of injury is related to the type of homicide. To answer these questions, the postmortem reports from all autopsies performed for homicide victims at the Institute of Legal Medicine at the University Hospital in Frankfurt am Main, Germany, between 1994 and 2014, were retrospectively evaluated for bony injuries discovered during autopsy. In 90 cases, a preliminary postmortem computed tomography (pmCT) examination had been performed. The cases were categorized into the following five groups by type of fatal trauma: blunt force, sharp force, gunshot injury, strangulation, or other. In total, the postmortem reports for 897 homicides (527 male, 370 female) were evaluated. The number of victims per trauma category were sharp force, 309; blunt force, 179; gunshot injury, 242; strangulation, 92; and other, 75. Bony injuries had been reported in 70.9 % of the homicides. The 'gunshot' category contained the highest proportion of victims with bony injuries (92.6 %). With 80.4 %, the second-highest proportion of victims with bony injuries was in the 'blunt force' category, followed by 66.3 % of victims in the 'sharp force' group. In contrast, with 53.3 %, the second-lowest proportion of victims with bony injuries was in the 'strangulation' category, which contained a preponderance of female victims, followed by 17.3 % of victims with bony injuries in the 'other' category. Bony injuries thus occurred in the majority of homicides. Forensic osteological analysis should, therefore, always be performed on badly decomposed human remains. Where necessary, the additional use of visualization techniques, in particular, pmCT, or maceration may be considered. The absence of bony injuries does not rule out homicide; e.g., in strangulations, bony injuries are manifest in only half the victims, even when the skeleton is intact. The relevant structures are also easily lost to decomposition, scavenging, or scattering. [ABSTRACT FROM AUTHOR]

When blood reaches an extracorporeal surface, a drying process is initiated. Properties of this drying process may be crucial for the correct assessment of case-specific time lapses, however, there is a lack of systematic studies concerning the drying times of blood. We present a study on drying properties of small blood droplets with a standardized size of 25 μl (resembling droplets originating from pointed and sharp objects, e.g. the tip of a knife) under different environmental conditions to elucidate the effect of different ambient temperatures, indoor surfaces and anticoagulant treatment. As a rule of thumb, wiping a typical small blood droplet will not lead to a macroscopically visible smear after a time period of approximately 60 min (time = 45 min; time = 75 min) at an average room temperature of 20 °C. Alteration of the ambient temperature has a remarkable effect, as the time needed for the drying process leading to wipe resistance of the droplets decreases to 30 min (time) at an ambient temperature of 24 °C, and is prolonged up to >120 min (time) at an ambient temperature of 15 °C. As for the surface materials in our study, significant differences in drying periods were only found between wood and linoleum (80th percentile 45 vs. 75 min). Treatment with anticoagulants did not influence extracorporeal drying times. In synopsis, the present study shows that ambient temperature is a major determinant of the drying process of blood droplets and should always be documented accurately and continuously on a crime scene. In certain situations, an estimation of the time elapsed since bloodstain origination may be of importance to answer questions related to the time course of actions. However, further systematic studies are needed to clarify the effect of other properties such as droplet size, humidity, or evaporation. [ABSTRACT FROM AUTHOR]

Background: Detection of myocardial infarction has been the focus of considerable research over the past few decades. Recently developed dual source computed tomography (DSCT) scanners with dual energy mode have been used to detect myocardial infarction, but the studies on this topic are few. Purpose: To evaluate the feasibility and performance of dual energy CT (DECT) during arterial phase in coronary CT angiography for the detection of chronic infarction compared with late enhancement MRI (LE-MRI) and histopathology in a porcine model of reperfused myocardial infarction. Material and Methods: Myocardial infarctions were induced by 30 min occlusion of the proximal left anterior descending coronary artery in eight minipigs. DECT, post-contrast LE-MRI and histopathology were performed 60 days after infarct induction. The CT scan was performed in dual energy mode using a dedicated protocol. Myocardial iodine distribution was superimposed as color maps on grey scale multiplanar reformats of the heart. Two radiologists in consensus interpreted all imaging studies for presence of gadolinium uptake at LE-MRI reduced iodine content at DECT and hypoenhanced areas in the initial 100 kV coronary CT angiography images that were acquired during the DECT-acquisition. Results were compared with histopathology. Results: Based on evaluable segments, DECT showed a sensitivity and specificity of 0.72 and 0.88; LE-MRI showed a sensitivity and specificity of 0.78 and 0.92; and the 100 kV data-set of the DECT scan showed a sensitivity and specificity of 0.60 and 0.93, respectively, for the detection of histological proved ischemia. Conclusion: DECT during arterial phase coronary CT angiography, which is ordinarily used for coronary artery evaluation, is feasible for the detection of a chronic reperfused myocardial infarction. [ABSTRACT FROM AUTHOR]

Backround: Detection of myocardial infarction has been the focus of considerable research over the past few decades. Recently developed dual source computed tomography (DSCT) scanners with dual energy mode have been used to detect myocardial infarction, but the studies on this topic are few. Purpose: To evaluate the feasibility and performance of dual energy CT (DECT) during arterial phase in coronary CT angiography for the detection of chronic infarction compared with late enhancement MRI (LE-MRI) and histopathology in a porcine model of reperfused myocardial infarction. Material and Methods: Myocardial infarctions were induced by 30 min occlusion of the proximal left anterior descending coronary artery in eight minipigs. DECT, post-contrast LE-MRI and histopathology were performed 60 days after infarct induction. The CT scan was performed in dual energy mode using a dedicated protocol. Myocardial iodine distribution was superimposed as color maps on grey scale multiplanar reformats of the heart. Two radiologists in consensus interpreted all imaging studies for presence of gadolinium uptake at LE-MRI reduced iodine content at DECT and hypoenhanced areas in the initial 100 kV coronary CT angiography images that were acquired during the DECT-acquisition. Results were compared with histopathology. Results: Based on evaluable segments, DECT showed a sensitivity and specificity of 0.72 and 0.88; LE-MRI showed a sensitivity and specificity of 0.78 and 0.92; and the 100 kV data-set of the DECT scan showed a sensitivity and specificity of 0.60 and 0.93, respectively, for the detection of histological proved ischemia. Conclusion: DECT during arterial phase coronary CT angiography, which is ordinarily used for coronary artery evaluation, is feasible for the detection of a chronic reperfused myocardial infarction. [ABSTRACT FROM AUTHOR]

As fatalities attributable to novel H1N1/S-OIV infections are currently rising, an increasing number of autopsies will have to be performed on these cases. In view of this challenge, adequate safety precautions and recommendations for autopsy procedures and the sampling and handling of specimens have to be established. Based on current literature, procedures for daily autopsy practice are proposed, particularly in regard to personal protection equipment, swab usage, and autopsy hygiene. [ABSTRACT FROM AUTHOR]