FORENSIC MEDICAL ASSESSMENT OF MORPHOLOGICAL CHANGES AT DIFFERENT POSTMORTEM INTERVAL

Purpose: The postmortem interval (PMI) evaluation is one of priorities while performing a forensic medical examination of corpse. To date, there is lack of information of morphological postmortem changes of some internal organs. Considering the persistent need to develop the method for a precise assessment of PMI, postmortem changes in these potentially informative organs were evaluated. The aim of study was to analyze morphological postmortem changes in prostate and uterus. Materials and Methods: histological samples of 40 prostate tissues and 40 uterus (n=80) from corpses of deceased aged 18-75 years. Only cases with known time of death were included to study, the time of death was taken from police reports. Exclusion criteria were cases of violent death, cases of death with massive blood loss, tumors of studied internal organs, cases when diagnosis was not made by a forensic medical examiner. The PMI of studied cases ranged from 1 to 6 days. Histological slides were made with a staining by hematoxylin and eosin, x200 magnification, using Olympus ВХ41 and Olympus ВХ46 microscopes, Olympus SC50 camera. Postmortem morphological changes were evaluated by a calculation of blank spaces percentage in microscopical structures using a JS-based program. Connection between PMI and morphological changes was calculated by the Spearman’s rank correlation. Results: the average percentage of blank spaces in uterus tissues was smaller than in prostate tissues (1,99 and 9,65 relatively). The slower growing of blank spaces was in uterus. In prostate samples, a notable increase of blank spaces was observed between 48 and 72 hours after the death. After this period, the increase slowed down and then an increase was observed again between 120 and 144 hours after the death. In uterus samples, a slight acceleration observed between 72 and 120 hours after the death and then slowing down between 120 and 144 hours after the death. Blank spaces in evaluated histological slides were increasing directly proportional to the PMI, a statistically significant interconnection was defined (p < 0.05). Conclusions: The morphological postmortem changes in prostate and uterus were developing at certain time frames. Blank spaces percentage, in studied histological slides, were increasing directly proportional to the PMI increase, a statistically significant interconnection was defined. Therefore, the results of study show the possibility of the evaluation of a postmortem time interval by assessing such morphological changes in these organs, which could be used in forensic medical cases.

Considerations for Stable Isotope Analysis of Human Hair

Stable isotope analysis of postmortem hair is performed in order to make inferences about an individual’s diet and geographic travel history prior to death. During analysis and interpretation, investigators assume that the hair collected from a postmortem environment has not been altered by exposure conditions and that the isotopic “signatures” of hair prior to exposure are preserved in postmortem samples. In order to confidently make inferences from postmortem hair samples, it is necessary to know whether their isotope ratios undergo postmortem changes. To address this question, post-exposure hair samples (n = 44) were collected from known body donors at the Anthropology Research Facility in Knoxville, Tennessee, USA, at various time points ranging from 22 to 1,140 days of exposure. These samples were analyzed for carbon (δ13C), nitrogen (δ15N), hydrogen (δ2H), and oxygen (δ18O) isotope ratios, and the results were compared with pre-exposure hair samples collected from the same donors. This study highlights considerations for the interpretation of isotope ratios obtained from postmortem hair samples in forensic contexts. The results indicate that δ13C, δ15N, and δ18O values from human hair remain relatively consistent over periods up to three years of outdoor exposure, while δ2H values changed significantly between pre-and post-exposure hair samples.

A case of male incontinentia pigmenti surviving until 19 weeks of gestation in utero

We experienced a case of a male IP fetus who survived until 19 weeks of gestation. The diagnosis of IP in mother and fetus was made genetically. In the autopsy of the boy, the degree of hepatocellular cytolysis was much more advanced than the postmortem changes of the other organs.

Features of morphological changes of the uterus after the death prescription

Background. Assessing the postmortem interval (PMI) is one of the most problematic issues in judicial practice. Objective. To investigate the morphological changes of uterus tissues to determine the PMI-dependent features of postmortem changes development. Methods. A morphological analysis of 40 uterus tissue samples was performed; consisting of two groups: first group – samples from the corpses of women aged 23 to 70 years (n = 34), second group – comparison group – biopsy material from 6 women with uterine prolapse, uterine leiomyoma, from unaffected areas. Results. In the period from 24 to 48 hours after death, there were changes in the form of a slight change in the structure of cellular elements, changes in their color, the presence of light gaps between connective tissue and muscle fibers. In the period from 48 to 72 hours, the destruction of the border between the muscular and serous membranes, blurred contours and ruptures of cells, severe swelling of muscle fibers, wide gaps between muscle fibers, a significant decrease in fibroblastic cells were observed. In addition, there was no endothelium in a significant number of vessels, loss of clarity of fiber bundles, lack of nuclei in a significant number of myocytes. Desquamed endothelial cells and hemolyzed erythrocytes were seen in the openings of most vessels. Conclusion. Histological examination of uterine tissues showed the presence of specific changes during the studied time intervals after death, which can be used to introduce criteria to determine the time since death in practice.

Postmortem Metabolomics: Strategies to Assess Time-Dependent Postmortem Changes of Diazepam, Nordiazepam, Morphine, Codeine, Mirtazapine and Citalopram

Postmortem redistribution (PMR) can result in artificial drug concentration changes following death and complicate forensic case interpretation. Currently, no accurate methods for PMR prediction exist. Hence, alternative strategies were developed investigating the time-dependent postmortem behavior of diazepam, nordiazepam, morphine, codeine, mirtazapine and citalopram. For 477 authentic postmortem cases, femoral blood samples were collected at two postmortem time-points. All samples were quantified for drugs of abuse (targeted; liquid chromatography-tandem mass spectrometry LC-MS/MS) and characterized for small endogenous molecules (untargeted; gas chromatography-high resolution MS (GC-HRMS). Trends for significant time-dependent concentration decreases (diazepam (n = 137), nordiazepam (n = 126)), increases (mirtazapine (n = 55), citalopram (n = 50)) or minimal median postmortem changes (morphine (n = 122), codeine (n = 92)) could be observed. Robust mathematical mixed effect models were created for the generalized postmortem behavior of diazepam and nordiazepam, which could be used to back-calculate drug concentrations towards a time-point closer to the estimated time of death (caution: inter-individual variability). Significant correlations between time-dependent concentration changes of morphine, mirtazapine and citalopram with individual endogenous molecules could be determined; no correlation was deemed strong enough for successful a posteriori estimation on the occurrence of PMR for specific cases. The current dataset did successfully lead to a significant knowledge gain in further understanding the time-dependent postmortem behavior of the studied drugs (of abuse).

CORRELATION BETWEEN MORPHOMETRY OF PATELLAR LIGAMENT AND PATELLA-AN AID TO TOTAL KNEE ARTHROPLASTY

Background: Patellar ligament is of surgical importance in procedures pertaining to total knee arthroplasty. It is extensively used as an autogenous graft for endoscopic anterior cruciate ligament reconstruction. Patellar ligament is the most preferred autograft owing to sufcient load to failure strength and stiffness. Purpose of the study: Dimensions of patella have been shown to be of anthropometric importance and is also used for personal identication as the bone is resistant to postmortem changes. There is paucity of literature on studies correlating the dimensions of patellar ligament and patella bone in Indian population. This study is the rst of its kind to provide data on the same. 53 prosected lower limbs were used to study the morphome Material and Methods: try of Patellar ligament and Patella using digital vernier calipers. The mean length, width and thickness values of Patellar ligament and bone were recorded. Pearson correlation coefcient was used to test the strength of association between the two variables. It was seen that there was negative correlation between Results: patella length and ligament length and thickness. There was positive correlation between patella length and ligament width. Patella width correlated positively with ligament length and ligament width but negatively with ligament thickness. Patella thickness correlated negatively with ligament length and thickness but positively with ligament width. This Conclusion- study will provide valuable anthropometric data and aid the orthopaedic surgeons performing knee surgeries.

Ultrasound in legal medicine—a missed opportunity or simply too late? A narrative review of ultrasonic applications in forensic contexts

Objectives Conventional autopsies remain the gold standard of postmortem healthcare quality assurance and help gathering extended knowledge on diseases. In answer to constantly declining autopsy rates non- or minimally invasive autopsy methods were introduced. Ultrasound is a well-established tool for imaging commonly used in clinical practice. This narrative review aims to summarize the current literature regarding the feasibility and validity of ultrasound in a forensic context. Material and methods A PubMed database search was carried out. Abstracts were scanned for pre-defined ex- and inclusion criteria, followed by a snowball search procedure applied to the primarily included articles. Results Forty-five publications met our inclusion criteria. The selected articles concern the feasibility of ultrasound in pre- or postmortem settings, forensic age estimation, and minimally invasive approaches. For imaging, ultrasound was deemed a reliable tool for the examination of epiphyses und superficial wounds, with limitations regarding internal organs and image quality due to postmortem changes. Ultrasound-guided minimally invasive approaches yielded higher success rates for adequate tissue sampling. Many investigations were carried out in low- and middle-income countries focusing on infectious diseases. Conclusion Ultrasound seems a promising but underutilized imaging tool in legal medicine to date. Promising approaches on its feasibility have been conducted. Especially for minimally invasive methods, ultrasound offered significant improvements on qualified biopsy sampling and thus appropriate diagnostics. Moreover, ultrasonic evaluation of epiphyses for age estimation offered valuable results. Nevertheless, further assessment of ultrasonic feasibility in forensic contexts is needed.

Episootic situation of dirofilariasis in dogs in Kiev

In most countries, dogs are more likely to have two types of heartworm pathogens: Dirofilaria repens ‒ localized in the subcutaneous tissue and causes skin lesions and Dirofilaria immitis ‒ parasitizes in the right ventricle and pulmonary arteries and is accompanied by cardiovascular disorders in animals. The increase in the number of dogs infected with heartworms occurs with increasing age, depending on the sex and breed of animals. Laboratory tests are important in diagnosing heartworm disease because the clinical signs are nonspecific. Heartworm disease is a global disease, the geographical area of which continues to increase The aim of the study was to clarify the epizootic situation regarding heartworm disease of dogs in Kyiv, to study the dynamics of the disease for the period 2017-2020, depending on the age of dogs, economic use in the city of Kiev, also to analyze the similarity of pathological and anatomical changes of affected animals by parasites Dirofilaria immitis. The material for the epizootic situation were reports on the results of studies of dogs in Kyiv for 2017-2020 and the results of our own research. Pathological and anatomical examinations were performed in the section hall of the Research Pathomorphology Department of the State Research Institute for Laboratory Diagnostics and Veterinary Sanitary Examination. The object of research is 96 dogs of different ages: puppies up to 1 year, dogs from 1 year to 12 years. Autopsies were performed according to generally accepted methods. According to official research results in Kyiv for 2019 - 2020, heartworm disease has decreased significantly (8 - 5.7%). The highest rate of invasion was in 2017 (29.6%) and with each passing year the percentage of the disease decreased, reaching 5.7% in 2020. This situation may be due to changes in weather and climate conditions (reduced rainfall), timely prevention, treatment and treatment of animals from mosquitoes. According to the results of pathological and anatomical studies, it was found that dogs under 1 year of age were not infested, and with increasing age in animals the incidence rate begins to increase and reaches the highest percentage of infestation in adult animals aged 10-12 years to ‒ 60%. Which is due to biological vectors (infested mosquitoes) and reduced resistance of animals. Pathological autopsy was performed on dogs of different breeds. However, 16 dogs were infected, including: German Shepherds ‒ 7, mestizos ‒ 4, outbred ‒ 5. In general, it is not the breed that affects dogs, but the conditions of keeping and economic use. The intensity of the invasion among service dogs ‒ 12,5%, domestic ‒ 18,2%, among homeless dogs were not found, which indicates a higher resistance of the body to this disease. According to the results of pathological and anatomical autopsies in the corpses of 16 affected animals with heartworms, similar postmortem changes were observed: 1. The presence of parasites Dirofilaria immitis approximately 20-30 cm long of light yellow color in the lumen of the right ventricle in aorta and pulmonary artery in 16 corpses ‒ 100% cases; 2. Acute venous hyperemia and pulmonary edema in 12 corpses ‒ 75% of cases; 3. Dilatation of the right ventricle of the heart in 9 corpses ‒ 56.3%; 4. Aneurysm and thrombosis of the pulmonary artery adjacent to the right ventricle of the heart was found in 8 corpses ‒ 50% probability; 5. Myocardial dystrophy among 8 corpses ‒ 50%; 6. Pericarditis was found in 3 carcasses of animals ‒ 18.8%; 7. Endocarditis in one dog, i.e. ‒ 6.3%; 8. With myocarditis one corpse ‒ 6.3%; 9. Gastro-enteritis was observed in 12 corpses in the total number ‒ 75%, but: catarrhal in 8, catarrhal-hemorrhagic in 3, hemorrhagic in 1; 10. Pneumonia in 3 corpses ‒ 18.8%, distinguishing interstitial, serous-catarrhal, catarrhal-purulent in one case. Own research has established the infestation of dogs with parasites, and the similarity of pathological and anatomical changes at the autopsy of animals depending on age, breed and economic use. In the future, it is planned to conduct histological and histochemical studies of organs in which the presence of helminths Dirofilaria immitis was detected in order to study the characteristic morphological changes.