Legal Medicine RSS feed: Current Issue. Legal Medicine provides an international forum for the publication of original articles, reviews and correspondence on subjects that cover practical and theoretical areas of interest relating to the wide range of legal medicine. Subjects covered include forensic pathology, toxicology, odontology, anthropology, criminalistics, immunochemistry, hemogenetics and forensic aspects of biological science with emphasis on DNA analysis and molecular biology. Submissions dealing with medicolegal problems such as malpractice, insurance, child abuse or ethics in medical practice are also acceptable. http://www.legalmedicinejournal.com/?rss=yesElsevier Inc.en © 2011 Elsevier Ireland Ltd. All rights reserved. Legal Medicine1344-6223141January 2012 © 2011 Elsevier Ireland Ltd. All rights reserved. healthpermissions@elsevier.comhttp://www.legalmedicinejournal.com/article/PIIS1344622311001490/abstract?rss=yesEditorial Board10.1016/S1344-6223(11)00149-0Legal Medicine 14, 1 (2012)2012-01-01Legal Medicine2012-01-01141S1344-6223(11)X0007-Xiiiihttp://www.legalmedicinejournal.com/article/PIIS1344622311001118/abstract?rss=yesAbstract: In fatalities with multiple traumatic injuries, it is important to determine the severity of trauma, the main damaged organ, and the antemortem pathophysiological condition. We examined 63 cases within 48h of the postmortem interval, which included assaults, slips and falls and falls from heights, traffic accidents, and sharp instrumental injuries. Immunohistochemically, each kidney was stained against hemoglobin (Hb), myoglobin (Mb), superoxide dismutase (SOD), 8-hydroxy-2′-deoxyguanosine (8-OHdG), 150kDa oxygen regulated protein (ORP150), pulmonary surfactant A (SP-A), and liver-type fatty acid binding protein (L-FABP). Bleeding or circulatory failure induced ORP150, 8-OHdG, and L-FABP in the kidney. Statistical analysis of the immunoreactivity revealed that in battered and/or abused cases, Hb could be considered a specific marker. Hb and Mb were observed in the cases with general severe trauma, such as slips and falls and falls from heights. In traffic accidents, ORP150 could reflect general circulatory failure with bleeding. SP-A was observed in the cases with severe thoracic injuries, such as lung injuries and multiple thoracic fractures. L-FABP appeared in cases with renal circulatory failure as well as renal injury. These findings suggest that immunohistochemical observation of the kidneys could be a useful tool in determining several key factors, such as the severity of injury, the specific damaged organ, and the pathological condition after injury.Renal immunohistochemical investigation for the differentiation of the cause of multiple trauma fatalitiesTomoko Sugimura, Elaine Lu Wang, Masayuki Kashiwagi, Kenji Hara, Aya Matsusue, Brian Waters, Shin-ichi Kubo10.1016/j.legalmed.2011.09.003Legal Medicine 14, 1 (2012)2011-10-14Legal Medicine2011-10-14141S1344-6223(11)X0007-XOriginal Articles15http://www.legalmedicinejournal.com/article/PIIS1344622311001155/abstract?rss=yesAbstract: To protect children from abuse, it is important to identify victims at an early date, but diagnosis is often difficult. We used ultrasonography for objective examination of bruises arising from subcutaneous hemorrhages, and determined whether we could precisely measure the depth and thickness of a subcutaneous hemorrhage. We compared macroscopic findings, microscopic findings and ultrasonographic images of 10 bruises in forensic autopsy cases. In addition, we measured chronologic changes in subcutaneous hemorrhages using ultrasonography of 16 bruises in healthy volunteer children. Mild or moderate subcutaneous hemorrhages spreading along the fibrous partition in subcutaneous fatty tissue were observed by histological examination. There was a thickened fibrous partition or an isoechoic or hyperechoic area in the ultrasonographic images. A good correlation between the thickness of the subcutaneous hemorrhages by macroscopic examination and by ultrasonographic imaging was found in postmortem cases. We were also able to confirm objectively that the thickness of the subcutaneous hemorrhage of healthy children decreased with time. It is possible to measure the depth from the skin surface to the subcutaneous hemorrhage, and the thickness of the subcutaneous hemorrhage accurately using ultrasonography. Thus, the age of a bruise can be estimated more precisely using information on the subcutaneous hemorrhage from ultrasonography in addition to established evaluations by the naked eye and by spectrophotometry.Characterization of bruises using ultrasonography for potential application in diagnosis of child abuseSohtaro Mimasaka, Toru Oshima, Maki Ohtani10.1016/j.legalmed.2011.09.007Legal Medicine 14, 1 (2012)2011-12-22Legal Medicine2011-12-22141S1344-6223(11)X0007-XOriginal Articles610http://www.legalmedicinejournal.com/article/PIIS1344622311001337/abstract?rss=yesAbstract: We selected 16 new X chromosomal SNPs (rs4827155, rs471205, rs7884160, rs16982419, rs985251, rs3813932, rs6630351, rs4132871, rs5966270, rs7471388, rs6641116, rs6521038, rs5990560, rs5959408, rs414960, and rs3006142) and developed the two X chromosomal SNPs Octaplex systems using multiplex single base extension reactions. To make the systems more useful for analyzing degraded DNA samples, we designed primers to render amplicons of 100bp or shorter (shorter PCR products). Statistical analyses of the 16 SNPs indicated a high usefulness for the Japanese forensic practice. In addition, results of tests on degraded DNA confirm the usefulness of this technique in such samples.Development of multiplex assay with 16 SNPs on X chromosome for degraded samplesTakahito Oki, Tokutaro Hayashi, Masao Ota, Hideki Asamura10.1016/j.legalmed.2011.10.001Legal Medicine 14, 1 (2012)2011-12-19Legal Medicine2011-12-19141S1344-6223(11)X0007-XOriginal Articles1116http://www.legalmedicinejournal.com/article/PIIS1344622311001374/abstract?rss=yesAbstract: Isopropyl alcohol (IPA) is widely used as an industrial solvent and cleaning fluid. After ingestion or absorption, IPA is converted into acetone by alcohol dehydrogenase. However, in ketosis, acetone can be reduced to IPA. The aim of this study was to investigate blood IPA and acetone concentrations in a series of 400 medico-legal autopsies, including cases of diabetic ketoacidosis, hypothermia and alcohol misuse-related deaths, to illustrate the extent of ketosis at the time of death. Vitreous glucose, blood 3-β-hydroxybutyrate (3HB) and acetoacetate (AcAc) concentrations were also determined systematically. Additionally, vitreous and urine IPA, acetone, 3HB and AcAc concentrations as well as other biochemical markers, including glycated hemoglobin and carbohydrate-deficient transferrin (CDT) were also determined in selected cases. The results of this study indicate that ketosis is characterized by the presence of IPA resulting from the acetone metabolism and that IPA can be detected in several substrates. These findings confirm the importance of the systematic determination of IPA and acetone levels that is used to quantify biochemical disturbances and the importance of ketosis at the time of death.Blood, urine and vitreous isopropyl alcohol as biochemical markers in forensic investigationsCristian Palmiere, Frank Sporkert, Dominique Werner, Daniel Bardy, Marc Augsburger, Patrice Mangin10.1016/j.legalmed.2011.10.005Legal Medicine 14, 1 (2012)2011-12-19Legal Medicine2011-12-19141S1344-6223(11)X0007-XOriginal Articles1720http://www.legalmedicinejournal.com/article/PIIS1344622311001386/abstract?rss=yesAbstract: Although some previous studies have reported patients who developed compartment syndrome or died because of locally applied negative pressure, no detailed investigation of pathologic changes caused by negative pressure-induced injury has been reported in the literature. The main purpose of this study was to examine the morphologic characteristics of injury caused by local negative pressure and correlate these with systemic changes. A total of 30 male Wister rats were used. Animals were randomly assigned to 6 groups. Negative pressure was applied to the right hindlimb of each animal in each group for periods of 0 (sham-operated), 30, 60, 90, 120, or 180min using a vacuum pump. Macroscopic and microscopic changes induced by local negative pressure were already observed after 30min and were exacerbated with time. The proportion of muscle degeneration was highest in the deep tissues, irrespective of exposure time. The observed increase in the weight of the injured hindlimb at 180min was caused by an approximately 30% fluid shift to the hindlimb, demonstrating that the application of negative pressure to the hindlimb of rats can induce hypovolemic shock. We here reveal the morphologic changes induced by local negative pressure and discuss possible mechanisms of negative pressure-induced injury.Morphologic investigation of injury caused by locally applied negative pressure in a rat modelNinomiya Kenji, Yoko Ihama, Maki Fukasawa, Takumi Nagai, Chiaki Fuke, Tetsuji Miyazaki10.1016/j.legalmed.2011.11.001Legal Medicine 14, 1 (2012)2011-12-28Legal Medicine2011-12-28141S1344-6223(11)X0007-XOriginal Articles2126http://www.legalmedicinejournal.com/article/PIIS1344622311001362/abstract?rss=yesAbstract: The aim of this work is to present some practical, postmortem biochemistry applications to illustrate the usefulness of this discipline and reassert the importance of carrying out biochemical investigations as an integral part of the autopsy process. Five case reports are presented pertaining to diabetic ketoacidosis in an adult who was not known to suffer from diabetes and in presence of multiple psychotropic substances; fatal flecainide intoxication in a poor metabolizer also presenting an impaired renal function; diabetic ketoacidosis showing severe postmortem changes; primary aldosteronism presented with intracranial hemorrhage and hypothermia showing severe postmortem changes. The cases herein presented can be considered representative examples of the importance of postmortem biochemistry investigations, which may provide significant information useful in determining the cause of death in routine forensic casework or contribute to understanding the pathophysiological mechanisms involved in the death process.Usefulness of postmortem biochemistry in forensic pathology: Illustrative case reportsCristian Palmiere, Maria del Mar Lesta, Sara Sabatasso, Patrice Mangin, Marc Augsburger, Frank Sporkert10.1016/j.legalmed.2011.10.004Legal Medicine 14, 1 (2012)2011-12-16Legal Medicine2011-12-16141S1344-6223(11)X0007-XCase Report2735http://www.legalmedicinejournal.com/article/PIIS1344622311001131/abstract?rss=yesAbstract: The DNA extraction performance of three low-throughput extraction systems was evaluated. The instruments and respective chemistries all use a similar extraction methodology that involves binding DNA to a coated magnetic resin in the presence of chaotropic salt, washing of the resin to remove undesirable compounds, and elution of DNA from the particles in a low-salt solution. The AutoMate Express™ (Life Technologies Corporation, Carlsbad, CA), EZ1® Advanced XL (Qiagen Inc., Valencia, CA), and Maxwell® 16 (Promega Corporation, Madison, WI) were compared using a variety of samples including: blood on swabs, blood on denim, blood on cotton, blood mixed with inhibitors (a mixture of indigo, hematin, humic acid, and urban dust) on cotton, blood on FTA® paper, saliva residue on cigarette butt paper, epithelial cells on cotton swabs, neat semen on cotton, hair roots, bones, and teeth. Each instrument had a recommended pre-processing protocol for each sample type, and these protocols were followed strictly to reduce user bias.All extractions were performed in triplicate for each sample type. The three instruments were compared on the basis of quantity of DNA recovered (as determined by real-time PCR), relative level of inhibitors present in the extract (shown as shifts in the CT value for the internal PCR control in the real-time PCR assay), STR peak heights, use of consumables not included in the extraction kits, ease of use, and application flexibility. All three systems performed well; however extraction efficiency varied by sample type and with the preprocessing protocol applied to the various samples.Extraction platform evaluations: A comparison of Automate Express™, EZ1® Advanced XL, and Maxwell® 16 Bench-top DNA extraction systemsCarey P. Davis, Jonathan L. King, Bruce Budowle, Arthur J. Eisenberg, Meredith A. Turnbough10.1016/j.legalmed.2011.09.005Legal Medicine 14, 1 (2012)2011-12-19Legal Medicine2011-12-19141S1344-6223(11)X0007-XBrief Communications3639http://www.legalmedicinejournal.com/article/PIIS1344622311001143/abstract?rss=yesAbstract: DNA transfer and its possible role in explaining the presence of a biological sample at a crime scene is becoming more prevalent in criminal investigations and related court proceedings. To assist understanding of DNA transfer and assess the extent to which we can utilise already available information regarding transfer of DNA we compare transfer rates determined from mock multi-step transfer scenarios with transfer rates predicted by the application of currently available transfer rate data. The transfer results obtained from the scenarios tested were, in some instances, different (both lower and higher rates) from those predicted. These discrepancies are most likely the result of the impact of as yet untested variables. These may include the variations in substrate type, transfer area size and environmental factors such as temperature and humidity among others. Whilst detailed re-enactments of proposed transfer scenarios, that take into account the many possibly relevant aspects affecting transfer are desirable, to provide an accurate likelihood estimate, these are not always possible. The application of detailed transfer rate tables that include data on the many factors affecting transfer could provide a useful substitute for evaluating the likelihood of specific transfer events. The value and accuracy derived from applying such tables will improve as more research in this area is conducted and the tables expanded and refined.Evaluation of multiple transfer of DNA using mock case scenariosMariya Goray, John R. Mitchell, Roland A.H. van Oorschot10.1016/j.legalmed.2011.09.006Legal Medicine 14, 1 (2012)2011-12-21Legal Medicine2011-12-21141S1344-6223(11)X0007-XBrief Communications4046http://www.legalmedicinejournal.com/article/PIIS1344622311001349/abstract?rss=yesAbstract: ABO grouping of biological specimens is informative for identifying victims and narrowing down suspects. In Japan and elsewhere, ABO grouping as well as DNA profiling plays an essential role in crime investigations. In the present study, we developed a new method for ABO genotyping using allele-specific primers and real-time PCR. The method allows for the detection of three single nucleotide polymorphisms (SNPs) at nucleotide positions 261, 796, and 803 in the ABO gene and the determination of six major ABO genotypes. This method required less than 2h for accurate ABO genotyping using 2.0ng of DNA. This method could be applicable for rapid and simple screening of forensic samples.Determination of ABO genotypes by real-time PCR using allele-specific primersTomonori Muro, Junko Fujihara, Shinji Imamura, Hiroaki Nakamura, Kaori Kimura-Kataoka, Tomoko Toga, Reiko Iida, Toshihiro Yasuda, Haruo Takeshita10.1016/j.legalmed.2011.10.002Legal Medicine 14, 1 (2012)2011-12-19Legal Medicine2011-12-19141S1344-6223(11)X0007-XBrief Communications4750http://www.legalmedicinejournal.com/article/PIIS1344622311001350/abstract?rss=yesAbstract: The identification of menstrual blood is important when discriminating menstruation from vaginal trauma in sexual assault cases. The aim of this study was to evaluate two fibrin–fibrinogen degradation product (FDP)-latex agglutination test kits, FDPL® Test (FDP-L) and FDP Plasma “RD” (FDP-P), for their ability to forensically identify menstrual blood. Sensitivity and specificity of the two kits were compared for menstrual blood and various body fluids, and the sensitivity of the FDP-latex agglutination test kit was also compared with that of an immunochromatographic test for human hemoglobin. The robustness of the FDP-latex agglutination test was compared with that of gene expression analysis of menstrual blood specific markers. The FDP-L kit was more sensitive than the FDP-P kit, but it cross-reacted with peripheral bloodstains from healthy volunteers. The FDP-P kit was specific for menstrual blood, with the exception of postmortem blood samples, and was not affected by other body fluids. In an FDP-negative menstrual blood sample, the sensitivity of human hemoglobin detection was lower than for FDP-positive samples and peripheral blood stains, suggesting that determination of human hemoglobin could be useful in interpreting negative results in the FDP-latex agglutination test. In menstrual blood samples incubated in wet conditions, FDP was found to be a robust marker in the identification of menstrual blood compared with mRNA markers. FDP-P testing was shown to be a suitable and highly efficient rapid screening test for the laboratory identification of menstrual blood.Evaluation of latex agglutination tests for fibrin–fibrinogen degradation products in the forensic identification of menstrual bloodTomoko Akutsu, Ken Watanabe, Hisako Motani, Hirotaro Iwase, Koichi Sakurada10.1016/j.legalmed.2011.10.003Legal Medicine 14, 1 (2012)2011-12-21Legal Medicine2011-12-21141S1344-6223(11)X0007-XBrief Communications5154