Traumatic basal subarachnoid haemorrhage or ruptured brain aneurysm in 16-year-old boy? - case report

Traumatic basal subarachnoid haemorrhage (TBSAH) represents only 1.8% of all subarachnoid haemorrhage cases diagnosed during autopsy. This report presents such a case from the current practice of the authors. Sixteen-year-old boy was beaten by the aggressors. Suddenly he lost his consciousness and fall after he received a single blow in the neck. He was resuscitated immediately, but died at the scene. During the external examination we did not find any significant external injuries. Autopsy revealed large contusion of right sternocleidomastoid muscle. In the cranial cavity we found extensive subarachnoid haemorrhage, located mainly on brain basis, in the posterior cranial fossa and covering the subtentorial structures. During the preparation of blood vessels we noticed a slight change of morphology suggesting damaged vessel or aneurysm, or vascular malformation located in the basilar artery bifurcation, which was taken to detailed microscopic evaluation using the special stainings. Histological examination showed vital interruption of the basilar artery wall with massive haemorrhage, without the presence of general microscopic pathology. From the medico-legal viewpoint, to determine traumatic background of haemorrhage it is necessary to find the coexistence of the following circumstances: a sustained trauma, post-mortem findings consistent with a time of injury, the presence of temporal relationship between injury and death, and morphological vital injury of the brain vessel, as well as the absence of prior vascular malformations. For this purpose Verhoeff-van Gieson's, Masson's, Turnbull's and Gomori' histological stainings may be successfully used.

[An unusual case of gunshot wounds caused with an air gun]. / Niezwykly przypadek postrzalu z broni pneumatycznej.

A 28-year-old woman was shot in the face with an air gun while driving a car. The patient was examined in the Department of Forensic Medicine in Katowice. An inconspicuous scar was found near the medial angle of the right eye. Further ophthalmological and radiological examinations revealed the presence of small foreign bodies in the vitreous body of the right eye, the sphenoid sinus and the ethmoid cells. The authors issued an expert opinion, in which they stated that the sustained injuries had not caused any significant organ dysfunction.

[Medico-legal assessment of the injuries of fatal victims of building collapse at Katowice International Fair in Katowice/Chorzów on January 28, 2006]. / Sadowo-lekarska ocena obrazen u smiertelnych ofiar katastrofy budowlanej na terenie Miedzynarodowych Targów Katowickich w Katowicach/Chorzowie w dniu 28.01.2006 roku.

On January 28, 2006, during an exhibition of carrier pigeons, the roof of one of the buildings at Katowice International Fair collapsed. At the time of accident, there were 700 people in the building--65 died and 171 were injured. It was the biggest building disaster in the history of modern Poland. The aim of this study was to present the type (character) of the observed injuries, the cause of death of 48 fatal victims and the range of activities and medico-legal examinations performed in the Department of Forensic Medicine, Medical University of Silesia in Katowice. In the period of January 29-February 1, 2006, on February 14, 2006, and February 17, 2006, post-mortem examinations of the 48 deceased were carried out, and in some cases additional dissecting techniques were employed. During autopsies, numerous specimens for various additional examinations (histopathological, toxicological) were collected. For identification purposes, photographic material and specimens, necessary for genetic identification, were secured. Additionally, the bodies were identified by families. The post-mortem procedures eventually allowed for establishing the cause of death of all the victims. The authors emphasize the range of necessary medico-legal procedures and examinations that should be carried out in a Department of Forensic Medicine in case of a building collapse with a large number of fatalities in order to determine the type of injuries, cause and mechanism of death and to identify the deceased.

When DNA profiling is not enough? A case of same-sex siblings identification by odontological assessment after gas explosion-related building collapse.

We aimed to show the usefulness of odontological assessment in forensic investigation. Charred remains of two female siblings were found in a collapsed building after a gas explosion. Due to thermal damage of the bodies, the facial characteristics, fingerprints, height and weight could not be used to distinguish between siblings. Since the victims, 4 and 10-year-old, died simultaneously and all personal belongings were lost, DNA profiling performed with their parents only confirmed the relationship. As dental charts of siblings were not found, we could not easily discriminate which remains would be of the elder and which of the younger sister. The odontological examination enabled us to discriminate between the siblings based on differences in deciduous and permanent dentition. We conclude that although DNA profiling is becoming a standard method of personal identification in some cases it should be supported by additional methods to deliver comprehensive forensic reports.

[Population genetics of 11 STR loci in the Upper Silesia population]. / Genetyka populacyjna 11 loci systemów STR w próbkach badanych na Górnym Slasku.

The report present the results of population studies of 11 STR loci: D16S5539, D7S820, D13S317, CSF1PO, TPOX, TH01, F13A01, FESFPS, VWA, F13B, LPL originating from samples examined in Laboratory of Biological traces, Chair and Department of Forensic Medicine, Silesian Medical University. The examinations were performed in the group of 455 non-consanguinated adults, men and women, from Upper Silesia. The purpose of the investigation was to study the distribution of allele frequencies of 11 short tandem repeat representative sample of the Upper Silesia (Poland) population, to show genetic balance in agreement with Hardy-Weinberg's law for the studied population and to compare homogeneity of the usefulness of 11 STR genetic markers for paternity testing and forensic identification purposes. Genomic DNA was isolated from blood samples and swabs from oral cavity by The Blood DNA Prep Plus kit (A&A Biotechnology) and EZ1 DNA tissue Kit for the use on the BioRobot EZ1. All reactions were carried out according to the manufacturer's recommendations (Silver Stain Detection, Promega). POR amplification was performed following the instructions of the GenePrint STR System kit using a GeneAmp PCR System 2700 Thermal Cykler. PCR products and Promega Ladders were separated by vertical electrophoresis on 6% denaturing polyacrilamide gel (Amresco), electrophoresis and visualized by silver staining (Promega Corporation). Allele frequencies, the values of heterozygosity (Ht), polymorphism information content (PIC), power of discrimination(PD), power of exclusion (PE), paternity index (PI), and matching probability (PM) were calculated using FatRec by Dudek's program and TFPGA of Miller. The concordance with HWE was evaluated using the chi-square test. The compared statistic parameters, which make an important component of research work and opinionating, show that 11 STR loci constitutes a very useful tool for individual identification in crime research and in putative paternity research.

[Total permanent or major permanent inability to work in profession. Remarks about the possibility of criteria verification in medico-legal opinionating in criminal cases]. / "Calkowita lub znaczna trwala niezdolnosc do pracy w zawo- dzie". Uwagi o mozliwosci weryfikacji kryteriów w opiniowaniu sadowo-lekarskim w sprawach karnych.

Despite the fact that some criteria of medico-legal certification in criminal proceedings have been established, there are still some areas that--parallel to changes occurring in contemporary society--have started to be controversial. This phenomenon has prompted the authors to attempt establishing new criteria for certification in total/major permanent inability to work in profession. This work is a continuation of a cycle devoted to interpretation of article 156 of the Penal Code to meet the needs of medico-legal opinionating.

[Limitations in medico-legal appraisal of sobriety or alcohol intoxication in drivers and the use of retrospective calculation. Practical comments based on an analysis of the files investigated in the chair of forensic medicine, Medical University of Silesia, Katowice, in the years 2000-2004]. / Ograniczenia w opiniowaniu sadowo-lekarskim dotyczacym oceny stanu trzezwodci lub nietrzezwosci kierowców i zastosowaniu rachunku retrospektywnego. Uwagi praktyczne na podstawie analizy spraw aktowych Katedry Medycyny Sadowej w Katowicach w latach 2000-2004.

In case of a driver who was involved in and survived a traffic accident, the analysis of expired air or blond sampling for alcohol determination is usually done within a shorter or longer time interval after the event. Thus, that the obtained analytical results are to be referred to the time when the examination or sampling was done, whereas the courts are interested in the driver's sobriety of alcohol intoxication at the critical moment, i.e. at the moment of the accident. Knowledge of alcohol toxicology allows for performing some simplified calculations to determine estimated blood alcohol concentration levels similar to those at the critical moment by using the so-called retrospective analysis. The authors performed a statistical analysis of the court files investigated at the Chair of Forensic Medicine, Medical University of Silesia, Katowice, in the years 2000-2004, especially focusing on difficulties encountered in cases of alcohol intoxication in perpetrators of traffic collisions.

[Double ritual murder by the Satanist cult members based on the casuistry of the Forensic Medicine Department in Katowice]. / Przypadek rytualnego, podwójnego zabójstwa popelnionego przez wyznawców szatana.

In recent years, an increased activity of various sects, especially Satanist ones, has been observed in Poland. This is associated with an increase in the number of various crimes, including offences against life and health. The ideology of Satanism came to Poland in the early eighties of the last century, along with heavy metal music and its variants. In 1999, two cases of the murders of a 21-year-old woman and a 19-year-old man committed by Satanist cult members during their ritual mass were reported at the Forensic Medicine Department in Katowice. In the report, the authors present some issues associated with Satanism, the circumstances of these two murders and the results of medico-legal examinations of the victims.

[Erroneous appraisal of X-ray examination results as the cause of improper legal classification of body injuries]. / Bledna ocena wyników badan radiologicznych jako przyczyna nieprawidlowej kwalifikacji prawnej.

In the paper the authors presented three cases relating to erroneous appraisal of radiograms improperly classifying body injuries. In all these cases medico-legal opinions were given by experts appointed by the court but not at forensic medicine. In one case, the expert regarded only the result of the fibula capitulum fracture radiogram but he disregarded previous and further X-ray films. In another case, cerebral injury and subarachnoid hemorrhage were misrecognized by head computer tomography (HCT) as a result of unsuitable head position. In the last case, on the basis of routine radiograms a fracture of vertebra C2 was firstly misdiagnosed and verified as an anatomical anomaly in the structure of this vertebra. In these three cases conclusive medico-legal opinions changing the legal classification of the injuries experienced were provided by specialist scientific institutions of the Silesian School of Medicine in Katowice.

[Accidents in the workplace caused by alcohol intoxication]. / Wypadkowosc w pracy w zwiazku z nietrzezwoscia.

Fatal accidents in the workplace can be caused by work conditions, aggravation of a chronic disease or alcohol intoxication. The purpose of this paper was to show the influence of ethyl alcohol on accidents in the workplace with regard to the occupation and age of the examined individuals. A group of victims whose deaths resulted from other external factors (suicide, poisoning by non alcoholic agents, etc.) was separated and not included. Statistical analysis of the autopsies carried out in the Forensic Medicine Department, Silesian University of Medicine, Katowice in the years 1992-2001 showed that accidents in the workplace amounted to 4-6% of the total number of deaths in the space of a year with alcohol (ethanol) being the causative factor in 3-15%.