Legal Medicine

Editorial Board

2010-09-01

Clinical radiology and postmortem imaging (Virtopsy) are not the same: Specific and unspecific postmortem signs

2010-07-14

Abstract: The aim of this article is to disclose the characteristics of postmortem forensic imaging; give an overview of the several possible findings in postmortem imaging, which are uncommon or new to clinical radiologists; and discuss the possible pitfalls. Unspecific postmortem signs are enlisted and specific signs shall be presented, which are typical for one cause of death.Unspecific signs. Livor mortis may not only be seen from the outside, but also inside the body in the lungs: in chest CT internal livor mortis appear as ground glass opacity in the dependent lower lobes. The aortic wall is often hyperdense in postmortem CT due to wall contraction and loss of luminal pressure. Gas bubbles are very common postmortem due to systemic gas embolism after major open trauma, artificial respiration or initial decomposition; in particular putrefaction produces gas bubbles globally.Specific signs. Intracranial bleeding is hyperattenuating both in radiology and in postmortem imaging. Signs of strangulation are hemorrhage in the soft tissue of the neck like skin, subcutaneous tissue, platysma muscle and lymph nodes. The “vanishing” aorta is indicative for exsanguination. Fluid in the airways with mosaic lung densities and emphysema (aquosum) is typical for fresh-water drowning.

Time of fusion of greater cornu with body of hyoid bone in Northwest Indians

Kaur Harjeet, Sanjeev Synghal, Gagandeep Kaur, Anjali Aggarwal, Pratima Wahee — 2010-07-14

Abstract: Time of fusion of hyoid is of considerable interest for forensic experts in estimating the age of an individual when unrecognized decomposed bodies or skeletal remains are available. The present investigation was carried out to study the age of fusion in 200 hyoid bones (133 males and 67 females) varying in age from 18 to 85years. Fusion of greater cornu with the body of the hyoid bone was not seen till the age of 25years in both sexes. In the males complete fusion was seen in 22(16.5%) bilaterally and 16(6.0%) unilaterally while in females it was observed in 18(26.9%) bilaterally and 10(7.5%) unilaterally. No significant sexual and side differences were found between the incidence of fusion of greater cornu with the body of hyoid in almost all the age groups except in the last age group (61 & above) where the sexual difference was highly significant (p<0.001) in unilateral complete fusion and in total cases in bilateral complete fusion (p<0.01). The lesser cornu was not fused with the junction or with greater cornu till the age of 35years in males and 40years in females. The maximum incidence of fusion of lesser cornu was observed in last age group of 61years and above (55.6% males and 66.7% females). In conclusion estimation of age by using hyoid bone is not reliable as time of fusion of greater cornu with the body of hyoid is irregular. Subjects above the age of 60 years had either unilateral (13.2%) or bilateral (42.1%) nonfusion or also fusion (21.1% bilateral, 13.2% unilateral). The present method can be a supplementary approach for estimating age when the other skeletal remains are not available.

Can MRI of the neck compete with clinical findings in assessing danger to life for survivors of manual strangulation? A statistical analysis

2010-07-14

Abstract: Objective: The aim of the study was to examine the clinical forensic findings of strangulation according to their ability to differentiate between life-threatening and non-life-threatening strangulation, compare clinical and MRI findings of the neck and discuss a simple score for life-threatening strangulation (SLS).Materials and methods: Forensic pathologists classified a continuous sample of 56 survivors of strangulation into life-threatening cases by clinical history and examination alone. Subjective, objective and radiological signs were evaluated for discriminating the two groups.Results: In 27% of the cases life was in danger. The most significant signs of danger to life were congestive petechial hemorrhage in the face (eyes); hematoma of the neck and loss of consciousness. The radiological score could compete with the clinical scores.Conclusion: Clinical forensic findings differ significantly in non-life-threatening and life-threatening manual strangulation. Thanks to MRI a rather objective test for life-threatening strangulation can be added to a SLS.

Diagnosis of fatal pulmonary fat embolism with minimally invasive virtual autopsy and post-mortem biopsy

2010-05-24

Abstract: We report a case of a 78-year-old female with a proximal femur fracture caused by an accidental fall who died suddenly 1h after orthopaedic prosthesis insertion. Post-mortem computed tomography (CT) scan and histological examination of samples obtained with post-mortem percutaneous needle biopsies of both lungs were performed. Analysis of the medical history and the clinical scenario immediately before death, imaging data, and biopsy histology established the cause of death without proceeding to traditional autopsy. It was determined to be acute right ventricular failure caused by massive pulmonary fat embolism. Although further research in post-mortem imaging and post-mortem tissue sampling by needle biopsies is necessary, we conclude that the use of CT techniques and percutaneous biopsy, as additional tools, can offer a viable alternative to traditional autopsy in selected cases and may increase the number of minimally invasive forensic examinations performed in the future.

Virtopsy: CT and MR imaging of a fatal head injury caused by a hatchet: A case report

2010-05-24

Abstract: Hatchet blows to the human skull often cause fatal injuries. We present a case of homicide by hatchet blow that underwent CT, MRI, and autopsy examination. Skull fragmentation, fracture lines, and brain injuries were demonstrated prior to autopsy. Many of the hatchet-specific characteristics (flaking, crushing, shattering, and fracture lines) described in literature were observed in the post-mortem imaging of this case.

Unexpected death of a patient with rheumatoid arthritis complicated by a cervical deformity

2010-07-15

Abstract: An elderly female with a 43-year history of rheumatoid arthritis died 2weeks after the onset of chest discomfort, electrolyte disturbance, and interstitial pneumonia. She had frequent premature ventricular contractions, fluctuating heart rate, and hypotension. Ischemic heart disease and interstitial pneumonia were excluded as the cause of death based on clinical course and autopsy findings. A severe cervical deformity with myelopathy likely contributed to circulatory instability, possibly through injury to the intra-spinal sympathetic nervous system, which can induce cardiovascular instability and suppress respiratory function. This likely led to death.

Genetic variation of 15 autosomal STR loci in a population sample from Poland

2010-07-12

Abstract: Fifteen autosomal STR loci included in AmpFℓSTR® NGM™ kit were analyzed in 154 unrelated individuals from Poland. This multiplex kit enables simultaneous amplification of 10 standard STR loci included in AmpFℓSTR® SGM Plus® kit (D3S1358, vWA, D16S539, D2S1338, D8S1179, D19S433, TH01, FGA, D21S11 and D18S51) and five new mini- and midi-STR loci (D10S1248, D22S1045, D2S441, D1S1656 and D12S391). Population study was conducted to evaluate usefulness of the loci (especially the five new microsatellite systems) in forensic genetic identification examinations. All 15 markers were found to be in Hardy–Weinberg equilibrium. The combined probability of match for the 15 studied STR loci was 3.998×10−19. The same parameter calculated for five new microsatellite loci equaled 8.83×10−7. Discrimination power was particularly high in case of D1S1656 (0.975) and D12S391 (0.972) STR loci.

Genetic polymorphisms for 17 Y-chromosomal STR haplotypes in Jammu and Kashmir Saraswat Brahmin population

Bhuvnesh Yadav, Anupuma Raina, Tirath Das Dogra — 2010-07-12

Abstract: In this study 17 Y-chromosomal STRs (including DYS19, DYS389I, DS389II, DYS390, DYS391, DYS392, DYS393, DYS385a/b, DYS437, DYS438, DYS439, DYS448, DYS456, DYS458, DYS635 and Y GATA H4) were analysed using blood samples of 122 unrelated male individuals belonging to Saraswat Brahmin community from Jammu (ID YP000599) and Kashmir (ID YP000600) region of J&K state of India. The allelic frequency distribution and haplotype diversity of 17 Y-chromosomal STR for both the populations were calculated. In the Kashmiri Saraswat group, a total of 109 haplotypes were identified in 122 individuals, of these haplotypes, 101 were found only once. The gene diversity values of STR loci ranged from 0.4813 (DYS391) to 0.8645 (DYS385a/b) for Jammu & Kashmiri Saraswat Brahmins.

Genetic variability of 15 autosomal STR loci in Russian populations

2010-07-14

Abstract: Allele frequencies for 15 STRs (CSF1PO, D3S1358, D5S818, D7S820, D8S1179, D13S317, D16S539, D18S51, D21S11, FGA, Penta D, Penta E, THO1, TPOX, and vWA) in the PowerPlex 16 System (Promega Corporation) were assessed in 386 individuals from five Russian urban populations. No significant between-population differences in frequencies and molecular variance of 15 microsatellites were revealed. For all 15 loci, the combined matching probability is 3.19 × 10−18 and the power of exclusion is 99.99989%.

Population data for Y-chromosome haplotypes defined by 17 STRs in South-East Romania

2010-07-12

Abstract: Haplotypes and allele frequencies for 17 STR loci included in AmpFlSTR YFiler kit (DYS456, DYS389I, DYS390, DYS389II, DYS458, DYS19, DYS385a/b, DYS393, DYS391, DYS439, DYS635, DYS392, Y GATAH4, DYS437, DYS438 and DYS448) were determined in a sample of 122 unrelated males living in the South-East Romania. Genetic distances had been calculated and dendrograms had been generated for South-East Romanian population and other eighteen surrounding populations.

Y chromosome STR allelic and haplotype diversity in five ethnic Tamil populations from Tamil Nadu, India

2010-07-12

Abstract: We have analyzed 17 Y chromosomal STR loci in a population sample of 154 unrelated male individuals of the Tamil ethnic group residing in the state of Tamil Nadu, Southern India using AmpFlSTR® Yfiler™ PCR amplification kit. The population samples consist of the following castes: Kongu Gounder (KOG), Nadar Hindu (NAH), Agamudayar (AGA), Parayar (PAR) and other Tamil individuals (MCT) of mixed castes. A total of 152 unique haplotypes were identified among the 154 individuals studied. The haplotype diversity was found to be 0.9935 or higher for all the five groups. The results of population pairwise Fst p values indicate no statistically significant differentiation between the five populations in this study, but the results were highly significant when compared with 12 other global populations (p<0.05). Comparison of populations in this study with other national and global populations using Principal co-ordinate analysis (PCA) using Rst distance matrix indicates a delineation of all the Indian populations from other unrelated populations.