[Morphological, microscopic changes in the thyroid gland in the cases of hanging in vertical position with open and closed noose]. / Morfologiczne, mikroskopowe zmiany w tarczycy w przypadkach powieszen w pozycji stojacej w zamknietej i otwartej petli.

The aim of the morphological study was to search for traumatic changes in the thyroid in the cases of hanging in a vertical position with an open and closed noose. These changes would constitute an additional proof of intravital hanging and they would be useful in postmortem diagnosis of the hangings in which other commonly acknowledged features of intravitality are not discovered. In 33% of all cases, petechiae were observed in the thyroid gland. They appeared in 20% of the hangings with the closed noose, and in 13% of the hangings with the use of the open noose. The study showed that there was no difference between the open or closed, hard noose in terms of changes in the thyroid gland. There was also no correlation between the body position and the injury of the thyroid gland. In all the cases, hyperemia of the thyroid was observed and segmental expansion of blood vessels. The histopathological analysis showed that in one third of all the cases with negative macroscopic examination, it was discovered that microscopic changes indicated hanging alive.

[Microscopic diagnosis of pituitary gland damages resulting from cranio-cerebral trauma with the base of the skull fracture]. / Mikroskopowa diagnostyka uszkodzen przysadki u zmarlych w nastepstwie urazu czaszkowo-mózgowego ze zlamaniem podstawy czaszki.

The aim of this research was a macro- and microscopic investigation of pituitary glands in people who died after head injuries with the base of the skull fractures in the sella turcica. No macroscopic changes in the pituitary glands were discovered during an autopsy examinations. Histopathology demonstrated traumatic changes of the pituitary glands in all the cases, which were correlated with sella trurcica fractures. The evolution of traumatic alterations correlated with survival time after the injury. In the pituitary glands of people who died directly after head injuries, hyperemia and focal hemorrhages were discovered. Apart from hyperemia, focal necrosis was found in the pituitary glands among those who survived from 48 to 72 hours after head injury. The examined pituitary glands of those people who lived from 2 to 3 weeks after head injury showed considerable necrotic changes and numerous calcificationss.

[The analysis of neonatal deaths based on autopsy protocols of the Department of Forensic Medicine in Bialystok in the years 1955-2009]. / Analiza zgonów noworodków w oparciu o protokoly sekcyjne Zakladu Medycyny Sadowej w Bialymstoku w latach 1955-2009.

The authors performed an analysis of the causes of deaths of newborns with special emphasis placed on cases when neonaticide was suspected. In the discussed period, 17838 medico-legal autopsies were performed, 124 of them (0.695 per cent of all postmortem examinations) involved children who meet the WHO criteria for newborn - children under 28th day of life. The newborns were divided into two groups according to their exact age at the time of death - newborns who died within a short time after birth and newborns who died after the perinatal period. Their sex, body length and body weight were also taken into consideration. A total of 108 autopsies (87.1 per cent of all autopsied newborns) involved cases of suspected criminal infanticide within the first score of hours postnatally. In the majority of these cases, the cause of death was suffocation, rarely mechanical trauma. The case of death of older newborns was broadly understood trauma.

[Medico-legal assessment in civil lawsuits in patients with neurological disorders in the case material of the Forensic Medicine Department, Medical University of Bialystok, in the years 2004-2008]. / Opiniowanie w postepowaniu cywilnym u osób ze schorzeniami neurologicznymi w materiale Zakladu Medycyny Sadowej UM w Bialymstoku w latach 2004-2008.

Opinionating in civil proceeding is difficult and carries much responsibility, especially in the period of increasing claiming for damages. The authors analyzed civil opinions issued by the Forensic Medicine Department, Medical University of Bialystok, in the years 2004-2008. The above-mentioned opinions addressed neurologic diseases and symptoms. The victims were invited to the Department for examinations which were performed by a forensic medicine expert and a neurologist, alternatively also by other specialists depending on the reported ailments. The paper presents an analysis of the victims' age and sex, type of the event, injuries and ailments, duration of physical and mental suffering, percentage of health impairment. The study comprised 126 civil opinions issued. Occupationally active persons were predominantly subject to injuries. The most common symptoms reported were headache, vertigo and pain in the C, L-S spine.

[Opinionating in cases referring to estimation of ability to participate in legal proceedings and estimation of ability to serve a sentence of imprisonment or restriction of freedom in the material of Department of Forensic Medicine in Bialystok in the years 2005-2009]. / Opiniowanie w sprawach dotyczacych oceny zdolnosci do udzialu w czynnosciach procesowych oraz oceny zdolnosci do odbywania kary pozbawienia lub ograniczenia wolnosci w materiale Zakladu Medycyny Sadowej w Bialymstoku w latach 2005-2009.

In the last years in Poland, the number of medicolegal opinions issued concerning the health status of defendants or convicts with regard to their ability to participate in legal proceedings (taking part in trial) and serve a sentence of imprisonment or restriction of freedom (doing free social labor) has been increasing. In the years 2005-2009, in our department, 115 opinions about defendants, convicts, one witness and one sufferer were issued. In this number, 37 opinions were associated with estimation of ability to serve a sentence of imprisonment, 22--estimation of ability to serve a penalty of restricted liberty or possibility of alternative serving a sentence of imprisonment, 56--estimation of ability to take part in legal proceedings. In 8 cases the experts estimated if the health status allowed a defendant to be detained awaiting trial and be detained in custody pending inquiry. The age, sex, place of residence, diseases the opinioned persons suffered from and the judicial organ that commissioned the opinion were taken into consideration in the analysis. The opinions were issued on the basis of court files and medical documentation only--18 opinions, or on the basis of court files, documentation and medical examination--97 opinions. In 52 cases, only specialists of forensic medicine issued the opinions, but in 63 instances, participation of experts in other medical specialties was necessary. Most often, the opinions of cardiologists were sought.

[The Polish helicopter crash in Belarus--an analysis of the accident]. / Wypadek polskiego smiglowca na Bialorusi--analiza zdarzenia.

The subject of analysis was the crash of a helicopter of the Polish Border Guards, which happened on October 31, 2009, in the Byelorussian territory about two hundred meters from the Polish border. In the accident, three crew members perished: the pilot, navigator and operator. Based on the accounts obtained directly after the crash on the site of the tragedy, it was established that the pilot tried to land, but the impact was so strong that the aircraft sank about one meter into the ground. On November 3, 2009, a committee consisting of two prosecutors from the County Prosecutor Office in Bialystok, a forensic science expert and a representative from the Border Guards, went to Department of Forensic Medicine in Brzesc. The prosecutors and forensic science expert took part in recovering the bodies. During the process of internal and external examination, severe body injuries were noted, without any surviving tissue and intestines. Samples of blood, urine and fragments of internal organs were collected for chemical, biochemical, toxicological and histopathological examinations. Muscle DNA was also taken.

[Declaration of death in a living individual--a case report]. / Stwierdzenie zgonu u zywego czlowieka--opis przypadku.

Declaration of death in a human being is a medical diagnosis, which results in numerous legal consequences. The demise of an individual can only be recognized by a doctor on the basis of a conscientious, personally conduced examination. Declaration of death releases a doctor from the obligation to rescue and save the individual's life. In the case of an incorrect death declaration, necessary aid is neglected by omission and the threat to human life is increased. Incorrect declaration of death in a living woman provided the basis for adopting an erroneous, contrary to current medical standards in force, management strategy.

[Posttraumatic cerebrasthenia and posttraumatic encephalopathy--difficulties in opinionating]. / Cerebrastenia pourazowa i encefalopatia pourazowa-- trudnosci opiniodawcze.

Post-traumatic cerebrasthenia and post-traumatic encephalopathy are the effects of a head trauma. Most physicians overuse these diagnoses. They do not perform differential diagnostic management, what leads to issuing erroneous opinions. The aim of this report is to show the symptoms of posttraumatic cerebrasthenia and posttraumatic encephalopathy and diagnostic investigations, which could be helpful for diagnosing these conditions. Cerebrasthenia (the subjective posttraumatic syndrome, subjective syndrome, posttraumatic neurosis) is usually a functional--"unorganic" disorder. It happens in the cases of many people who had brain concussion. The most common symptoms are: headache, vertigo, irritability, insomnia, attention deficits, fatigability. Posttraumatic encephalopathy is a persistent brain tissues injury which could be caused by more severe trauma (brain contusion, endocranial bleeding). The clinical picture of this disease entity is not unambiguous. The most frequently encountered form is a simple (common) form, which is similar to cerebrasthenia, but with differences in the neurological examination (focal signs) and with persistent changes in EEG.

[Evaluation of visualization of biological stains with the use of alternative light source (ALS) for the purpose of genetic identification. Part II. Semen samples analysis]. / Ocena wizualizacji sladów biologicznych z uzyciem alternatywnego zródla swiatla (ALS) w aspekcie identyfikacji genetycznej. Czesc II. Analiza sladów nasienia.

Detection of seminal stains on items such as clothing and bedding is a significant element of investigation in sexual assault cases. The use of alternative light source may assist in their identification. The objective of the investigation was the evaluation of human semen visualization with the use of alternative light source for the purpose of genetic identification. The tests demonstrated that experimentally prepared semen stains on the bright base could be best seen in the natural light and white light when the semen was diluted at a ratio 1:10. The complete typeability of AmpFISTR SGM Plus kit loci was evaluated in semen which was diluted at a ratio 1:1750 and typeability of AmpFISTR SGM Plus kit loci was incomplete in semen diluted at a ratio 1:2000. After washing with laundry detergents, semen stains were still recognizable under ALS wavelength 455 nm, while wearing orange goggles.

[Evaluation of visualization of biological stains with the use of alternative light source (ALS) for the purpose of genetic identification. Part I. Blood and saliva stains analysis]. / Ocena wizualizacji sladów biologicznych z uzyciem alternatywnego zródla swiatla (ALS) w aspekcie ich identyfikacji genetycznej. Czesc I. Analiza sladów krwi i sliny.

The objective of the investigation was evaluation of visualization of human blood and saliva stains with the use of alternative light source for the purpose of genetic identification. Experimental bloodstains on the bright base were the most clearly seen in the natural light and white light, up to blood dilution of 1:600. Complete typeability of AmpFISTR SGM Plus kit profiles was obtained from bloodstains at dilution 1:1500. Partial AmpFISTR SGM Plus kit profiles were typed from bloodstains at dilutions 1:1750 and 1:2000. Experimental saliva stains on the light-colored base were completely invisible in the natural light and white light, while they were visualized at wavelength range 300-415 nm through yellow goggles, and at wavelength range 300-455 nm through orange goggles at saliva dilution 1: 600. Complete typeability of AmpFISTR SGM Plus kit loci was obtained from saliva stains at dilution 1:1750. Partial AmpFISTR SGM Plus kit profiles were typed from saliva stains at dilution 1:2000. The wavelength of 455 nm and orange goggles were the optimal set for visualization of bloodstains on various, noncontrasting materials. Other useful wavelength/combinations of goggles were CSS light/red goggles. In case of saliva, the most useful general condition for visualization of stains on various, non-contrasting materials was with the wavelength set to 300-415 nm, while wearing yellow goggles. Other useful combinations of wavelength/goggles were 300-455 nm/orange or red goggles, and also CSS light/orange or red goggles.

[Deaths during asphyxia induced to escalate sexual experience. Case reports]. / Zgony w przebiegu asfiksji wywolanej w celu eskalacji doznan seksualnych. Opisy przypadków.

The authors present two cases of deaths resulting from asphyxia of one of the partners in the act of intercourse to escalate their experience. The first case involved a heterosexual intercourse, in which a 30-year-old woman was led to state of hypoxia through choking and closing respiratory orifices. The other case represented a homosexual intercourse between two men, in which the victim's hands and legs were tied. Moreover, the partner put an open knot around the victim's neck and was holding it controlling the state of asphyxia, while performing an anal intercourse. Both presented victims practiced such paraphilia-associated behaviors in the past. The fact of sexual intercourse was confirmed in both cases by genetic analysis of the man's anus and the woman's oral cavity and vagina. This resulted in finding the genetic material of their partners. Escalating of sexual experience through inducing asphyxia of the nervous system is extremely dangerous and may result in death of one of the sexual partners, what has been proven by the present investigation.

[Cases of acute fatal alcohol poisoning in the material of the Department of Forensic Medicine, Medical University in Bialystok, in the years 1984-2004]. / Ostre smiertelne zatrucia etanolem w latach 1984-2004 w materialach wlasnych Zakladu Medycyny Sadowej w Bialymstoku.

The paper presents the analysis of acute fatal ethanol poisonings in the material of the Forensic Medicine Institute in Bialystok. Our study has shown that a predominant majority of the deceased died during the phase of alcohol elimination. Moreover, these people were often in good health and generally fit. In view of the immense material analyzed by the present authors and the 20-year time span under investigation, it may be concluded that middle-aged men constitute a group the highest risk of death resulting from acute alcohol poisoning. The assessment of alcohol concentration in blood and other body liquids, for example in urine, allows for defining the phase when death of an alcohol-imbibing individual occurred. In medico-legal and clinical practice, such a determination is very important in terms of initiating appropriate treatment or specifying the mechanism of death.

[Cases of fatal para methoxy amphetamine (PMA) poisoning in the material of the Forensic Medicine Department, Medical University Of Bialystok, Poland]. / Przypadki smiertelnych zatruc p-metoksyamfetamina (PMA) w materiale Zakladu Medycyny Sadowej Uniwersytetu Medycznego w Bialymstoku.

The issue of sudden deaths due to acute para methoxy amphetamine (PMA) poisoning is presented in the report. The analysis included three cases autopsied at the Forensic Medicine Department in Bialystok at the beginning of 2009. The toxicological analysis of samples of blood and urine did not confirm the presence of MDMA, also known as ecstasy, but it revealed the presence of para methoxy amphetamine (PMA). During post-mortem examinations, the cause of the death was not established in either case. Based on the above investigations it may be said that the common cause of death was acute para methoxy amphetamine (PMA) poisoning.

[Malpractice in neurology in the case material of the Forensic Medicine Department, Medical University of Bialystok]. / Bledy medyczne z zakresu neurologii w materiale Zakladu Medycyny Sadowej UM w Bialymstoku.

The paper presents an analysis of legal opinions compiled by the Forensic Medicine Department, Medical University of Bialystok in the years 2003-2008. The above-mentioned opinions addressed medical treatment in the area of neurology. During this period, opinions were given in 142 cases, the majority of them representing idiopathic diseases (such as strokes, cerebral aneurysms, cerebral infections), followed by falls from high altitudes and traffic road accidents, further followed by fights, medical treatment and work accidents. In sixteen (11.27%) of such cases, the employed medical procedures were found to be incorrect; what might be qualified as medical decisive errors, committed in emergency ambulances or in admission rooms. Incorrect medical treatment consisted in negligence to perform necessary diagnostic examinations. In ten of the analyzed cases, the patients ultimately died.

[Contribution of ethanol in apoptosis induction]. / Udziat etanolu w indukcji procesu apoptozy.

Ethanol is the most common and widespread protoplasmatic poison. The destruction of cells and tissues occurs in both addicted and nonaddicted individuals, who use alcohol occasionally or temporarily. Apoptosis constitutes a very crucial factor in the pathogenesis of acute alcohol poisoning and chronic addiction. Ethanol and its metabolites induce suicidal cell death in crucial internal organs. However, despite extensive research on the role of alcohol and its metabolites in programmed cell death induction, the problem continues to be widely discussed and has no unambiguous explanation. The aim of this study is to present a review of up-to-date literature addressing the inducing influence of alcohol in apoptosis.

[Non-accidental trauma in children. Case report]. / Urazy nieprzypadkowe u dzieci. Opis przypadku.

The aim of this study is to analyze the problem of child abuse. Non-accidental injuries of young children constitute a very important diagnostic issue, which continues to be faced by both clinicians and forensic medicine specialists. This report presents an extremely interesting case of a young boy, in which a very detailed assessment of the files allowed for determining the circumstances of his sustaining injuries.

Serum CD40/CD40L system in Graves' disease and Hashimoto's thyroiditis related to soluble Fas, FasL and humoral markers of autoimmune response.

Activated CD4 T cells' express CD40 ligand (CD154) interacting with CD40 on the B cells surface, protecting them from Fas-mediated apoptosis and in this study, influence humoral response. The aim of the study was to assess soluble CD40 and CD154 in Graves' disease (GD) and Hashimoto's thyroiditis (HT) in relation to Fas and FasL and to the markers of humoral response: aTPO, aTG and aTSHR. The study was carried out in 5 groups of subjects: 1/14 patients with GD in euthyreosis on methimazol (euGD), 2/20 patients with hyperthyroid GD (hrGD), 3/15 patients with HT in euthyreosis on levothyroxine (euHT), 4/16 patients with hypothyroid Ht (hoHT), 5/12 healthy volunteers, age and sex-matched to groups 1-4. The serum levels of CD40, CD154, Fas and FasL, aTPO and aTG were determined by ELISA and aTSHR was determined by the RIA method. CD40 serum concentration was significantly higher in hoHT individuals: 55.8 (24.0-83.2) pg/ml (p<0.01) and euHT patients: 51.2 (20.0-80.1) (p<0.05) as compared to the controls. Also sCD40L values were significantly increased in euHT individuals: 5.1 (1.0-11.8) (p<0.05) and hoHT patients: 3.9 (0.7-11.2) ng/ml (p<0.05) as compared to the controls. There was a positive correlation between sCD40 and sCD154 in the patients studied (r=0.36, p<0.001). In HT patients we found positive correlations between sCD40 and aTPO (r=0.45, p<0.001) and sFas (r=0.36, p<0.05) as well as a negative correlation between sCD40 and FasL (r=-0.24, p<0.05). In GD patients there was a positive correlation between sCD40 and aTSHR (r=0.28, p<0.05). In summary, our results suggest that CD40/CD154 interaction plays an important role in the regulation of autoimmune humoral response, both in Hashimoto's thyroiditis and Graves' disease. Fas-mediated apoptosis seems to be involved in this process especially in Hashimoto thyroiditis. Soluble CD40 may serve as a marker of the active stage of autoimmune thyroid disease.

[Changes in autopsy findings related to reanimation procedures--case report]. / Zmiany zwiazane z zabiegami reanimacyjnymi--opis przypadku.

Reanimation procedures may cause changes of autopsy findings. Disregarding this condition may result in erroneous determination of the cause of death. The paper presents a case of a woman, age 77, complaining of general weakness who reported to the outpatient department. Paroxysmal tachycardia was diagnosed on EKG. The patient was referred to the internal ward. The transfer to the hospital was offered by the neighbour who had brought her to the outpatient department. In front of the department the patient fainted. Reanimation was performed by 5 persons, including non-medical staff. The patient's death was pronounced within an hour. The autopsy findings included numerous injuries within the thorax and the abdomen, which aroused suspicion about their origin during reanimation and about the cause of death. Detailed analysis of medical history, witness testimonies and histological findings, taking into account the knowledge about potential changes caused by reanimation procedures enabled correct assessment of injuries within the thorax and the abdomen.

[The analysis of road accident victims aging between 0-18 in the selection material of the our Forensic Department, Medical University of Bialystok between 1997-2006]. / Analiza ofiar wypadków drogowych w wieku 0-18 lat w materiale sekcyjnym Zakladu Medycyny Sadowej Akademii Medycznej w Bialymstoku w latach 1997-2006.

INTRODUCTION: The authors carried out the analysis of autopsy reports of road accident victims, aging between 0-18, exposed to the post mortal studies made in the above mentioned department between 1997-2006. MATERIAL AND METHODS: The number of victims, aging between 0-18 amounts to 2.97% of all autopsies carried out in this period. Among the analysed 84 victims were male, while 41 female. The victims have been divided into age groups: 0-6, 7-10, 11-15 and 16-18. The largest number appeared in the age range 15-18 (78; 47 males and 31 females), the smallest number in the age range 0-6 (15; 10 males and 5 females) and the age range 7-10 (15; 12 males and 3 females). In the age groups 0-6 and 7-10 pedestrians prevail as victims, while 11-15 car passengers are in majority and the same percentage refers to cyclists. Group 16-18 is predominantly dominated by private car drivers and their passengers. RESULTS: In all age groups the direct causes of death were mainly head injuries, the most frequent among pedestrians, cyclists, two wheeled engine vehicle passengers, drivers and private car passengers as well as other victims of not exactly defined road accidents. The most alarming is the high percentage of road users under the influence of alcohol in the range 16-18 amounting to 21.8 % (27.7% of males and 12.9% of females respectively).

[Analysis of suicide causes in the material of Bialystok Forensic Medicine Department in the years 2004-2006]. / Analiza samobíjstw w materiale sekcyjnym Zakladu Medycyny Sadowej Akademii Medycznej w Bialymstoku w latach 2004-2006.

PURPOSE: The object of analysis were suicide cases autopsied in the department in 2004-2006. MATERIAL AND METHODS: Of the 1331 autopsies, 126 were undertaken in suicide victims. This number constituted 9.47% of the total number of autopsies, of those 87.3% were males and 12.7% females. The highest percent rate of suicide was observed among males in the ages of 19-25 year old, among females 19-25 and 31-45. The greatest number of inebriated males was found in ages of 19-25 and 36-40 years old, whereas for females the corresponding age group was 31-35 years. Among the places of suicide predominance of public places was noted. The most common method of committing suicide was by hanging.