Forensic Science, Medicine, and Pathology

Postmortem diagnosis of sudden death due to anaphylaxis can be very difficult due to the non-specific pathological findings in forensic practice. Postmortem serum tryptase has been used as an indicator of possible ante-mortem anaphylaxis. Though many previous studies have been conducted to explore the diagnostic significance of serum tryptase for lethal anaphylaxis, inconsistent results were documented. In this study, we made a retrospective study and presented a systematic review and meta-analysis that aims to summarize the diagnostic significance of postmortem serum tryptase in the deceased with and without anaphylactic shock and to calculate a cutoff value for future reference in the identification of deaths due to anaphylactic shock...

No abstract text is available yet for this article.

We present a unique case of suicidal hanging. The deceased was a 31-year-old male who was found hanging from a tree in a dense thicket, with his lower limbs in contact with the ground (partial suspension). There was an apparatus similar to a facial mask placed around his nose and mouth. A strong chemical smell was emanating from the apparatus, which was identified as chloroform (Formyl trichloride/CHCl3 ). A ligature with a soft cloth beneath it was around his neck. A ligature mark was present around the neck...

Pseudoaneurysms arise from a disruption of arterial wall continuity and are most commonly related to a penetrating trauma, an arterial wall inflammation or iatrogenic causes. They differ from real aneurysms due to a lack of one or more layers of the arterial wall. The frequency of peripheral artery pseudoaneurysms in the upper extremities is less than in the lower extremities and its most common cause is a gunshot or a stab wound. The risk of a rupture is higher than in true aneurysms due to a lack of wall layers, therefore requiring surgical treatment in most cases...

After contact shots to the head, biological traces can be found inside the barrel of the firearm. Experimental protocols to generate this sort of staining, using 12 cm gelatin cubes containing thin foil bags filled with acrylic paint, human blood, and radiocontrast agent, have been developed. Previous research on shots fired at a distance has shown the underlay sustaining these gelatin cubes has an influence on experimental results. This study was conducted to investigate the role of the sustaining base of the gelatin blocks during contact shots, and its influence on the staining result inside firearm barrels...

Detection of the vitality of wounds is one of the most important issues in forensic practice. This study investigated mRNA and protein levels of CXCL1 and CXCR2 in skin wounds in mice and humans. Western blot analysis of CXCL1 and CXCR2 protein levels showed no difference between wounded and intact skin. However, mRNA levels demonstrated higher expression of CXCL1 and CXCR2 in contused mouse and human skin, compared with intact skin. At postmortem there were no remarkable changes in CXCL1 and CXCR2 mRNA levels in contused mouse skin...

On 30th March 1902 Police Constable George Doyle and Carnarvon Station manager Albert Dahlke were allegedly gunned down at Lethbridge's Pocket in Central Queensland. Approximately 90 kg of ash and burnt human remains with articles belonging to the two men were later found in saddle bags left at the scene on a police horse. Subsequently two local cattle and horse thieves, Patrick and James Kenniff, were convicted in the Queensland Supreme Court of the wilful murder of Constable Doyle. Patrick was executed by hanging on 12th January 1903 and James had his sentence reduced to life imprisonment with hard labor...

Unidentified bones were donated to the Buchenwald Memorial Museum in Weimar, Germany. The donor thought the bones may have belonged to internees of the concentration camp and had been decoratively carved by camp personnel. Non-destructive forensic anthropological examination was carried out on the bones to identify their possible origin. Comparative human and non-human bones samples were used to determine the provenance of the bones and the anatomical region they may have come from. Literature and internet searches were conducted to trace the origin of the carved motifs on the bones...

A 61-year-old female died in hospital with multiple organ failure 4 weeks following presentation with acute kidney injury, hemolytic anemia and methemoglobinemia. At autopsy, brown to black discoloration of cartilages was observed. Histology revealed brown pigmentation of the hyaline cartilage, with focal full-thickness erosion of the articular hyaline cartilage, characteristic of alkaptonuria (ochronosis). Although alkaptonuria is rarely fatal, this case illustrates a rare acute fatal complication. Accumulation of circulating homgentisic acid secondary to acute derangement of renal function is believed to have overwhelmed the endogenous antioxidant processes, resulting in hemolysis and methemoglobinemia, which were refractory to treatment...

A 56-year-old man with no previous medical history collapsed and was not able to be resuscitated. The major findings at autopsy were enlargement of the heart (weight = 527 g) which contained an infiltrating firm, homogeneous tumor in an epicardial location adjacent to the left anterior descending and right coronary arteries, with further extension into the right ventricular outflow tract, the interventricular septum and left ventricular free wall. Sections showed sheets of small lymphoid cells with scattered large lymphocytes amounting to a low-grade follicular non-Hodgkin lymphoma, as tumor cells were CD20, CD10, Bcl 2 and LMO 2 positive...

The skeletal blunt force trauma resulting from fatal falls involving stairs is complex. There are countless ways an individual may fall when stairs are involved, and thus a variety of ways the skeleton may fracture. Therefore anecdotally, it may be said that there is no specific skeletal trauma characteristic of this fall type. In order to scientifically investigate this anecdotal understanding, this study provides a detailed investigation of the skeletal fracture patterns and morphologies resulting from fatal falls involving stairs...

"Krokodil" is a home-made opioid drug obtained by synthesizing desomorphine from codeine and combining it with other low-cost additives. Initially introduced in the former Soviet countries, it was then imported to Western Europe as a heroin substitute. To our knowledge, this is the first report of an Italian case of lethal krokodil abuse, that occurred in a 39-year-old man, who died suddenly after transportation to the Emergency Department (ED) for hyperthermia associated with sweating, dyspnoea and tachycardia...

No abstract text is available yet for this article.

Vascular air embolism is caused by penetration of air into veins or arteries through a surgical wound or other connection between the external and internal aspects of the body. Vascular air embolism has various causes, and iatrogenic air embolisms are the most frequently described. We report a case of fatal air embolism in an 83-year-old woman who was admitted to hospital. At the time of the incident, she was alone in her ward receiving an intravenous infusion of antibiotics via a peripheral line in her right forearm...

The distinction between self-inflicted injuries and other types of injuries is crucial in forensic medicine, and relevant features of wounds should be identified by pathologists, even when they are observed at atypical sites. Herein we report two cases of self-inflicted injuries of the neck involving two young women who had reported being attacked by men.

Serotonin-specific reuptake inhibitors (SSRIs) are generally considered safe drugs but fatal adverse effects do sometimes occur, often as a consequence of interactions with other serotonin active drugs. Polypharmacy is usually a problem that the elderly encounter, but it can also have dire consequences for young people, especially when an underlying heart condition is present. Thus, failure to diagnose heart disease and the use of contraindicated medications can be a lethal combination, irrespective of age...

A 75-year-old woman was admitted to the emergency room with chest pain and vomiting. An electrocardiogram and laboratory results were suggestive for myocardial infarction of the posterior cardiac wall. Echocardiography was indicative of aortic dissection, and a CT scan of the thoracic arteries showed a massive pulmonary thromboembolism and thrombotic occlusion of the right coronary artery (RCA). The woman died shortly after admission. Autopsy confirmed the presence of thromboemboli in the right pulmonary artery and its lobar branches...

A 40-year-old drug addict, who was being treated with methadone and occupational therapy, committed suicide by striking a wooden pencil into his right eye socket. While still conscious, he hit his head hard against a table, jamming the pencil even deeper into his head. The autopsy showed that the pencil missed the globe and lodged in the inner part of the right eye socket. It pierced the orbital part of the right ethmoid bone, the right ethmoid cells, and the right superior nasal concha, then passed through the body of the sphenoid bone and the clivus of the occipital bone before stopping in the brain tissue...

Plastination is a technique renowned for its use in the preservation of human tissues or organs, and is mainly employed in anatomical training and in research regarding various scientific fields. The advantages of this method are related to the natural appearance, absence of odor, and easy-handling of the plastinated products. The use of plastinates in forensic sciences, their potential role in personal identification, and their usefulness in interpretation of post-mortem findings has been described, although literature on this topic is poor...

The purpose of this study was to examine the neuronal expression of apoptotic markers in the rostral medulla of a newly characterized dataset of sudden unexpected death in infancy (SUDI), and to determine the impact of diagnostic groupings on these findings and whether they pertain to the intrinsic apoptotic pathway. Immunohistochemical staining was quantified to determine the percentage of neurons positive for active caspase-9 (specific to the intrinsic apoptotic pathway), active caspase-3 (common to the intrinsic and extrinsic apoptotic pathways) and Terminal deoxynucleotidyl transferase mediated dUTP nick-end labelling (TUNEL) (labels DNA fragmentation) in nine nuclei of the rostral medulla...