Skin simulants for wound ballistic investigation - an experimental study.

Gunshot wound analysis is an important part of medicolegal practice, in both autopsies and examinations of living persons. Well-established and studied simulants exist that exhibit both physical and biomechanical properties of soft-tissues and bones. Current research literature on ballistic wounds focuses on the biomechanical properties of skin simulants. In our extensive experimental study, we tested numerous synthetic and natural materials, regarding their macromorphological bullet impact characteristics, and compared these data with those from real bullet injuries gathered from medicolegal practice. Over thirty varieties of potential skin simulants were shot perpendicularly, and at 45°, at a distance of 10 m and 0.3 m, using full metal jacket (FMJ) projectiles (9 × 19 mm Luger). Simulants included ballistic gelatine at various concentrations, dental silicones with several degrees of hardness, alginates, latex, chamois leather, suture trainers for medical training purposes and various material compound models. In addition to complying to the general requirements for a synthetic simulant, results obtained from dental silicones shore hardness 70 (backed with 20 % by mass gelatine), were especially highly comparable to gunshot entry wounds in skin from real cases. Based on these results, particularly focusing on the macroscopically detectable criteria, we can strongly recommend dental silicone shore hardness 70 as a skin simulant for wound ballistics examinations.

Fatal intoxication with 1,4-butanediol: Case report and comprehensive review of the literature.

A fatal case of 1,4-butanediol (1,4-BD) oral ingestion is reported here, in which a 51-year-old man was found dead in his bed. According to the police report, the deceased was a known drug user. A glass bottle labeled (and later confirmed to be) "Butandiol 1,4" (1,4-BD) was found in the kitchen. Furthermore, the deceased's friend stated that he consumed 1,4-BD on a regular basis. The autopsy and histological examination of postmortem parenchymatous organ specimens did not revealed a clear cause of death. Chemical-toxicological investigations revealed gammahydroxybutyrat (GHB) in body fluids and tissues in the following quantities: femoral blood 390 mg/L, heart blood 420 mg/L, cerebrospinal fluid 420 mg/L, vitreous humor 640 mg/L, urine 1600 mg/L, and head hair 26.7 ng/mg. In addition, 1,4-BD was qualitatively detected in the head hair, urine, stomach contents, and the bottle. No other substances, including alcohol, were detected at pharmacologically relevant concentrations. 1,4-BD is known as precursor substance that is converted in vivo into GHB. In the synoptic assessment of toxicological findings, the police investigations and having excluded other causes of death, a lethal GHB-intoxication following ingestion of 1,4-BD, can be assumed in this case. Fatal intoxications with 1,4-BD have seldom been reported due to a very rapid conversion to GHB and, among other things, non-specific symptoms after ingestion. This case report aims to give an overview to the published of fatal 1,4-BD-intoxications and to discuss the problems associated with detection of 1,4-BD in (postmortem) specimens.

COVID-19 Infection Induce miR-371a-3p Upregulation Resulting in Influence on Male Fertility.

In December 2019, the first case of COVID-19 was reported and since then several groups have already published that the virus can be present in the testis. To study the influence of SARS-CoV-2 which cause a dysregulation of the androgen receptor (AR) level, thereby leading to fertility problems and inducing germ cell testicular changes in patients after the infection. Formalin-Fixed-Paraffin-Embedded (FFPE) testicular samples from patients who died with or as a result of COVID-19 (n = 32) with controls (n = 6), inflammatory changes (n = 9), seminoma with/without metastasis (n = 11) compared with healthy biopsy samples (n = 3) were analyzed and compared via qRT-PCR for the expression of miR-371a-3p. An immunohistochemical analysis (IHC) and ELISA were performed in order to highlight the miR-371a-3p targeting the AR. Serum samples of patients with mild or severe COVID-19 symptoms (n = 34) were analyzed for miR-371a-3p expression. In 70% of the analyzed postmortem testicular tissue samples, a significant upregulation of the miR-371a-3p was detected, and 75% of the samples showed a reduced spermatogenesis. In serum samples, the upregulation of the miR-371a-3p was also detectable. The upregulation of the miR-371a-3p is responsible for the downregulation of the AR in SARS-CoV-2-positive patients, resulting in decreased spermatogenesis. Since the dysregulation of the AR is associated with infertility, further studies have to confirm if the identified dysregulation is regressive after a declining infection.

Wounding potential of 4.4-mm (.173) caliber steel ball projectiles.

From time to time, severe or fatal injuries caused by small caliber air rifle projectiles are seen. In forensic sciences, the theoretical wounding potential of these weapons and projectiles is widely known. Usually, shots against the skull were reported and, in these cases, penetrating the eyes or thin bone layers of the temporal region. Amongst a huge number of different projectiles available for air guns, sub-caliber 4.4-mm (.173) caliber steel ball projectiles were used in an unusual suicide case. This case led to fundamental questions concerning wound ballistics. An 82-year-old man shot once against his right temporal region and twice into his mouth with a 4.5-mm (.177) caliber air rifle. Because of the exceptionally deep penetration of the base of the skull and the use of spherical-shaped sub-caliber air rifle projectiles, terminal ballistic features were analyzed and compared to results published in forensic literature. Test shots using the same weapon and similar projectiles were fired into ballistic gelatin to measure and calculate basic wound ballistic variables of cal. 4.4-mm (.173) steel balls. In comparison, further test shots with cal. 4.5-mm (.177) steel balls BB (ball bearing), flat-headed and pointed air rifle pellets ("diabolos") were carried out. The theoretical penetration depth in solid bone was calculated with 36.4 mm, and test shots in gelatin from hard contact produced an on-average wound track of 120 mm underlining the potential wounding effect. Furthermore, spherical projectiles could roll back and forth within the barrel, and an air cushion between projectile and breechblock can reduce muzzle velocity by more than half, explaining the retained missile in the temporal region.

Everything clean? Transfer of DNA traces between textiles in the washtub.

Forensic genetic analysis of items possibly handled by a suspect or a victim is frequently inquired by the law enforcement authorities, since DNA left on touched objects can often be linked to an individual. Due to technical improvement, even poor traces, which seemed to be unsuitable for DNA analysis a few years ago, may be amplified successfully today. Yet, DNA can be transferred to a crime scene artificially or unintentionally without any primary contact between the individual and the object found at the crime scene, the so-called secondary transfer or indirect transfer in general. In this study, "secondary transfer" scenarios with cells and DNA of different origins under wet conditions were investigated. Transfer was simulated as either "washing by hand" in a washtub or as "machine laundry" in a washing machine. As expected, major differences were seen between blood stains and epithelial abrasions. DNA from blood donors could be detected clearly both on the donor and on the acceptor textile, regardless of washing method. Regarding epithelial abrasions, simulating worn clothes, after washing by hand, only little residual DNA was found, and partial profiles were displayed on the donor textile, while transfer to the acceptor textile occurred even less and not in noteworthy amount and quality. Single alleles could be found both on donor textiles and acceptor textiles after simulated machine wash, but no reliable DNA profile could be verified after laundry in machine. Therefore, a DNA transfer from one worn cloth (without blood stains) to another textile in the washing machine seems to be extremely unlikely.

Influence of an individual's age on the amount and interpretability of DNA left on touched items.

In crime scene investigations, DNA left by touch on an object can be found frequently and the significant improvements in short tandem repeat (STR) amplification in recent years built up a high expectation to identify the individual(s) who touched the object by their DNA profile. Nevertheless, the percentage of reliably analysable samples varies considerably between different crime scenes even if the nature of the stains appears to be very similar. Here, it has been proposed that the amount and quality of DNA left at a crime scene may be influenced by external factors (like nature of the surface) and/or individual factors (like skin conditions). In this study, the influence of the age of an individual who left his DNA on an object is investigated. Handprints from 213 individuals (1 to 89 years old) left on a plastic syringe were analysed for DNA amount and STR alleles using Quantifiler® and PowerPlex® ESX 17. A full profile of the individual could be found in 75 % of all children up to 10 years, 9 % of adolescents (11 to 20 years), 25 % of adults (21 to 60 years) and 8 % of elderly people (older than 60 years). No person older than 80 years displayed a full profile. Drop-in and drop-out artefacts occurred frequently throughout the age groups. A dependency of quantity and quality of the DNA left on a touched object on the age of the individual could be clearly demonstrated at least for children and elderly people. An epithelial abrasion unexpectedly good to interpret may be derived from a child, whereas the suspected skin contact of an elderly person with an object may be impossible to prove.

A 32-year-old male with brainstem lesions.

Schwannosis is a condition characterized by a benign proliferation of Schwann cells and an incomplete myelination of central nervous system axons following different chronic stimuli. It. has been mainly observed in the spinal cord. Various hypotheses have been put forward with respect to the appearance of Schwann cells inside the central nervous system since they exclusively populate the peripheral nervous system. According to these hypotheses, schwannosis seems to be either the result of aberrant migration under certain conditions, especially in response to spinal cord injury, or as a developmental abnormality in form of ectopia during ontogenesis.We report, for the first time, on the multifocal occurrence of this rare nosological entity in the brain stem. Furthermore we compare the histological and immunohistochemical profile of schwannosis to that of an intracerebral schwannoma taken from our archive.

Good shedder or bad shedder--the influence of skin diseases on forensic DNA analysis from epithelial abrasions.

The successful analysis of weak biological stains by means of highly sensitive short tandem repeat (STR) amplification has been increased significantly over the recent years. Nevertheless, the percentage of reliably analysable samples varies considerably between different crime scene investigations even if the nature of the stains appears to be the same. It has been proposed that the amount and quality of DNA left at a crime scene may be due to individual skin conditions (among other factors). Therefore, we investigated DNA from handprints from 30 patients acutely suffering from skin diseases like atopic dermatitis, psoriasis or skin ulcer before and after therapy by STR amplification using the new and highly sensitive Powerplex® ESX17 kit in comparison to 22 healthy controls. Handprints from atopic dermatitis patients showed a correct and reliable DNA profile in 90% and 40% of patients before and after therapy, respectively. Regarding psoriasis patients, we detected full DNA profiles in only 64% and 55% of handprints before and after therapy. In contrast, in ulcus patients and controls, full DNA profiles were obtained in much lower numbers. We conclude that active skin diseases like atopic dermatitis or psoriasis have a considerable impact on the amplificable DNA left by skin contact with surfaces. Since up to 7% of adults in European countries suffer from one of these diseases, this could explain at least partially the varying quality of DNA from weak stains.

Powerplex® ES versus Powerplex® S5--casework testing of the new screening kit.

The new Powerplex® S5 Mini STR-System from Promega with the four provided STR loci D18S51, D8S1179, TH01 and FGA as well as the Amelogenin marker (PCR products ranging from 80 to 220 bp not considering the longer FGA fragments) is designed as a screening tool especially in difficult casework samples. To test its suitability we amplified highly degraded DNA from casework samples, which had shown no or only poor results in analyses with the Powerplex® ES kit, as well as artificially degraded DNA or DNA samples containing PCR inhibitors. Despite a tendency for allelic drop-ins in the amplification of highly degraded DNA the Powerplex® S5 kit was a reliable tool for the analysis of casework samples with degraded DNA which gave better results than the Powerplex® ES kit in 64% of analysed swabs. Furthermore, it was especially suitable for the investigation of formalin fixed tissue, tissue samples showing advanced putrefaction or telogen hair samples. However, there was no strict relation between positive Powerplex® S5 results and amplification success with the Powerplex® ES kit.

Massive retroperitoneal haemorrhage after extracorporeal shock wave lithotripsy (ESWL).

A 76-year-old male suffering from nephrolithiasis developed a shock syndrome 5 days after extracorporal shock wave lithotripsy (ESWL). CT scan of the abdomen showed massive haemorrhage around the right kidney. Although nephrectomy was performed immediately, the haemorrhage could not be controlled. Numerous units of erythrocytes were transfused, but the patient died. The autopsy revealed massive retroperitoneal haemorrhage around the right kidney. The kidney showed a subcapsular haematoma and a rupture of the capsule. The right renal artery was dissected. The inferior vena cava was lacerated. Accordingly, a hemorrhagic shock as the cause of death was determined, which might mainly have resulted from the laceration of the inferior vena cava due to ESWL. ESWL seems to be a relatively non-invasive modality, but one of its severe complications is perirenal hematoma. The injuries of the blood vessels might have been caused by excessive shock waves. Subsequently, anticoagulation therapy had been resumed 3 days after EWSL, which might have triggered the haemorrhage. Physicians should note that a haemorrhage after an ESWL can occur and they should pay attention to the postoperative management in aged individuals especially when they are under anticoagulation therapy.