The micro CT evaluation of crown and root pulp volume versus dentin thickness in teeth in postmortem interval (PMI).

Determining the postmortem interval (PMI) is one of the main study subjects of forensic sciences. The main purpose of this prospective in vitro study that was the Micro-CT evaluation of teeth crown and root pulp volume versus dentin thickness in terms of PMI determination. The study involved 60 female Wistar rats, with weights ranging from 270 to 320 g. These rats were grouped into six different post-mortem period categories. Following the animals' sacrifice, they were subjected to a natural putrefaction period, with a control group, in the grounds of a sheltered garden. Hemi-mandible samples were then extracted and placed in glass tubes for Micro-CT evaluations, following the progression of putrefaction processes. The pulp volume and dentin thickness were assessed using Micro-CT, and the gathered data underwent statistical analysis. Micro-CT was employed to analyze sixty right mandibular second molar teeth in the hemi-mandible. The crown pulp volume exhibited a reduction in group 6, with a value of 0.239 mm3 after a three-month period of natural putrefaction (p < 0.001). There is statistically differences among groups in case of pairwise comparison (p < 0.05). However, the root pulp volume and dentin thickness variables did not display any statistically significant changes. Despite certain limitations associated with this study, the Micro-CT findings concerning teeth pulp volume can serve as an objective parameter, especially for late postmortem investigations and the estimation of time of death.

Usability of elemental analysis for antemortem and postmortem bone fracture differentiation.

The differentiation of antemortem and postmortem fractures is a challenging and important issue in forensic medicine. To investigate the usability of chemical element levels in blunt fracture ends for the differentiation of antemortem and postmortem fractures, antemortem and postmortem fractures were created in rats and left to decay in the natural environment. Forty-eight rats were used in this study. The rats divided into six groups, each group containing eight rats. We induced a left mandibular fracture in all rats under anesthesia and then waited for 2 d to become organized to fracture the hematoma. All rats were sacrificed under anesthesia, and a postmortem blunt fracture was created in the right mandible. Samples were taken from the fracture ending at 0, 7, 14, 30, 60, and 90 d after the blunt postmortem fracture. The Mg, S, K, Ca, and Fe contents were measured using inductively coupled plasma/optical emission spectrometry (ICP-OES). In our study, it was observed that antemortem Mg, K, S and Ca levels were generally higher than the post-mortem levels, although not statistically significant in all groups.

Newborn Skin: Common Skin Problems.

The newborn skin can be separated from adult's skin in several ways. In dermatologic examination it can be easily observed that it is thinner, less hairy and has less sweat and sebaceous gland secretions. These differentiations present especially in preterm newborns. Their skin is exposed to mechanical trauma, bacteria and weather, heat alterations. At birth, newborn skin is protected by the coverage of vernix caseosa, which has lubricating and antibacterial features and its pH ranges from 6.7 to 7.4. Beneath the vernix caseosa the skin has a pH of 5.5-6.0. In newborn dermatologic examination it is very important to distinguish transient benign dermatoses and severe diseases, make early diagnosis and treat congenital skin disorders. Although the benign cases are common in this life period, clinical presentations can be much more exaggerated, dramatic and cause a great deal of anxiety to parents. Therefore, as a doctor, knowing the dermatological, pathological and non-pathological common skin rashes guides the family in the right direction, offers advice to reduce uncertainty and time for the treatment of severe conditions and builds a confidential doctor-patient relationship. In this review, our aim is to provide a general overview to common skin rashes in newborn period.

Tissue Expressions of Soluble Human Epoxide Hydrolase-2 Enzyme in Patients with Temporal Lobe Epilepsy.

OBJECTIVE: We sought to simply demonstrate how levels of soluble human epoxide hydrolase-2 show changes in both temporal the cortex and hippocampal complex in patients with temporal lobe epilepsy. METHODS: A total of 20 patients underwent anterior temporal lobe resection due to temporal lobe epilepsy. The control group comprised 15 people who died in traffic accidents or by falling from a height, and their autopsy findings were included. Adequately sized temporal cortex and hippocampal samples were removed from each patient during surgery, and the same anatomic structures were removed from the control subjects during the autopsy procedures. Each sample was stored at -80°C as rapidly as possible until the enzyme assay. RESULTS: The temporal cortex in the epilepsy patients had a significantly higher enzyme level than did the temporal cortex of the control group (P = 0.03). Correlation analysis showed that as the enzyme level increases in the temporal cortex, it also increases in the hippocampal complex (r2 = 0.06, P = 0.00001). More important, enzyme tissue levels showed positive correlations with seizure frequency in both the temporal cortex and hippocampal complex in patients (r2 = 0.7, P = 0.00001 and r2 = 0.4, P = 0.003, respectively). The duration of epilepsy was also positively correlated with the hippocampal enzyme level (r2 = 0.06, P = 0.00001). CONCLUSIONS: Soluble human epoxy hydrolase enzyme-2 is increased in both lateral and medial temporal tissues in temporal lobe epilepsy. Further studies should be conducted as inhibition of this enzyme has resulted in a significant decrease in or stopping of seizures and attenuated neuroinflammation in experimental epilepsy models in the current literature.

Evaluation of ALCAM, PECAM-1 and selectin levels in intracranial meningiomas.

OBJECTIVES: Cell adhesion molecules play a major role in various pathological states. The aim of this study was to evaluate the tissue levels of selectins (E-, L-, and P-Selectins), activated leukocyte cell adhesion molecule (ALCAM) and platelet endothelial cell adhesion molecule-1 (PECAM-1) in intracranial meningiomas and compare with the levels in control tissues. PATIENTS AND METHODS: 20 consecutive patients who were operated on meningiomas (grade-I: 17 and grade-II: 3) and 15 cerebral tissues obtained during the autopsy procedures as a resource for the healthy controls were included in this study. RESULTS: All three selectins', ALCAM and PECAM-1 levels were found to be significantly higher in meningiomas when compared with the control tissues (p<0.001, p<0.001, p<0.001, p<0.05, p<0.001), respectively. CONCLUSIONS: According to our results, the adhesion molecules were found to be higher in meningiomas suggesting that they may be involved in the pathological process of this type of brain tumors. We conceive that developing alternate therapies such as immunotherapeutic approaches against brain tumors might be amendatory in the treatment. Since this is the first study performed in meningioma type brain tumors demonstrating and comparing the levels of various adhesion molecules with control tissues, further clinical and experimental studies are needed to support our current findings with higher number of patients.

Oxidant and anti-oxidant status in common brain tumors: Correlation to TP53 and human biliverdin reductase.

OBJECTIVE: To assess oxidant and antioxidant status in patients with common brain tumors; namely meningiomas, low-grade gliomas (LGG) and high-grade gliomas (HGG) and to compare with normal brain tissues. PATIENTS AND METHODS: Almost nine biomarkers were measured in 59 brain tumors obtained during surgery and 15 normal brain tissues that were collected during autopsy. Results were compared between two groups. RESULTS: In general, protein oxidation and lipid peroxidation increased while antioxidant capacity decreased significantly in tumors compared to the controls (p<0.05) and higher the grade of the tumor, higher the levels of oxidation and lower the anti-oxidation. CONCLUSIONS: Reactive oxygen species may play a crucial role in the pathogenesis of these common brain tumors. As the processes at the molecular level understood, targeted-treatment adjunct to surgical removal will be possible to cope with these devastating brain tumors.

Postmortem Increase in Body Core Temperature: How Inaccurate We Can Be in Time Since Death Calculations.

Postmortem increase in body core temperature is a well-known phenomenon in forensic practice. Despite this, cases of reliably documented postmortem hyperthermia are rarely reported in the forensic literature, and it is still not clear how frequently postmortem hyperthermia occurs and in which cases we may it predict. In routine forensic practice, the standard course of body cooling is expected, and the prediction of normal body core temperature in the time of death is used for back-calculating the time of death by Henssge method. The unexpected rising in body core temperature may considerably misguide the estimation of time since death in the early postmortem period. We present a rare case of nonviolent death in the hospital with exactly recorded unusual elevation of body core temperature after death, although the body temperature shortly before the death was normal. In the presented case, the "standard" cooling of the body began up to 4 hours after death.

The Role of ADAMTS1 and Versican in Human Myocardial Infarction: A Postmortem Study.

OBJECTIVE: To determine the role of a disintegrin and metalloproteinase with thrombospondin type 1 motif (ADAMTS1) and fragmented versican in the myocardial infarction (MI) process in humans and to evaluate the diagnostic efficacy of ADAMTS1 for postmortem diagnosis of MI. METHODS: Thirty autopsied individuals were allocated into 2 groups, namely, a study group of individuals who died of myocardial infarction (n = 20), and a control group who died of trauma (n = 10). We performed standard immunohistochemical staining on myocardial tissue specimens, studying anti-ADAMTS1, anti-versican, and anti-versican C terminal peptide sequence (DPEAAE) fragments. RESULTS: Strong, diffuse staining was observed throughout myocardial tissue for ADAMTS1 in the 2 groups. However, in the study group, we observed no expression for ADAMTS1 around fibrotic areas but detected slight staining in coagulative and necrotic zones. CONCLUSION: Similar localizations of ADAMTS and fragmented versican in human heart tissue indicate that versican presumably is cleaved by ADAMTS1. Hence, ADAMTS1 can be regarded as a new marker for postmortem differential diagnosis of MI.

Right haemothorax related to the rupture of abdominal aortic aneurysm.

Reported case was 63 years old forester died suddenly in the village. Autopsy examination revealed massive coagulated haemorrhage filling the right hemithorax, neither free fluid nor blood were observed in the abdominal cavity. Abdominal aortic aneurysm 20x15x15 cm in size was examined. We aimed to report the rare case of abdominal aortic aneurysm presented with transdiafragmatic rupture and bleeding in the right hemithorax.

Diaphragmatic Eventration: Autopsy Case Report.

Presented case was a 36-year-old deceased man with a sequel of poliomyelitis who was reportedly found death at home. On external examination at autopsy, deformity of the lower extremity secondary to polimyelitis, and an obliquely coursing scar tissue 5 cm in length at the same level with the costal arch on the right axillary line were seen. On internal examination at autopsy, diaphragmatic eventration caused by bilateral elevation of the diaphragm towards thoracic cavity was detected. On the left side, stomach, spleen, and small intestines, and on the right side liver were pushed into the thoracic cavity. Cause of death was reported as heart failure of the patient with bilateral diaphragmatic eventration. We aimed to discuss rarely encountered diaphragmatic eventration in autopsy practice from a perspective of forensic medicine.

Traumatic asphyxia: An autopsy case.

Traumatic asphyxia is a form of asphyxia where respiration is prevented by external pressure on the body. A 19-year-old man was found by relatives compressed by motorboat in the garage. The death was investigated by the prosecutor; body was taken to the Morgue Department for performing autopsy. On gross physical examination; the face, neck and upper part of the chest were congested and many petechiae were observed on the conjunctivae, but not in low extremities. Autopsy macroscopic examination of lungs revealed congestion, sub pleural superficial bleeding areas. In the presented case death was reported as traumatic asphyxia by thorax compression without other lethal factors.

A Case of Death Caused by 2700°C Molten Magnesite Burns.

Magnesite (MgCO3) is a mineral which is theoretically composed of 52.2% CO2, 47.8% MgO, and very scarce amounts of Fe2O3 with a degree of hardness varying between 3.4-4.5 kgf, and specific gravity of 2.9-3.1 g/cm(3). Its color varies between white, yellow or gray, and brown. Magnesite is used in agriculture, and drug industry, brick, iron-steel, paper, and sugar industries. Our case was a 30-year-old male whose dead was reportedly associated with exposure to 2700°C molten magnesite in the melting potansiyel of the plant where he was working as a metal worker. At autopsy, on external examination, except from his left forearm, all over his body was charred from severe burns. Both of his legs from ankles, and right forearm from its middle third were nearly amputated, and body muscles were partly detached because of high temperature. Widespread areas of thermal rupture were observed. On internal examination scalded appearance of internal organs was noted. Blood, and urine analysis did not reveal any substance abuse. Herein, we have aimed to discuss, and evaluate dead events because of exposure to very high temperatures from the perspective of forensic medicine, and occupational safety.

A case of cerebral hypoplasia/dysplasia detected at autopsy.

UNLABELLED: Presented case was a 2-year-old baby girl who had been treated for nearly one year with the indication of multifocal epileptiform anomaly. She was found dead in her bed in morning hours, autopsy was planned after prosecutors investigation. On internal autopsy examination, shrinkage of gyral structures in the frontal, and parietal lobes of the left hemisphere, markedly enlarged sulci, and a hypoplastic appearance were noted. Histopathological examination revealed evidence of pneumonia, brain exposed microgyral formations, disordered cortical stratification, hypercellularity, dysmorphic neuronal structures, balloon cells with diagnosis of cortical dysplasia. Pneumonia was reported as a cause of death. We aimed to discuss in the light of the literature a case with cerebral hypoplasia which is rarely seen at forensic autopsies. KEYWORDS: cerebral hypoplasia/dysplasia - autopsy - congenital malformation - sudden death.

Wischnewsky Spots in Fatal Hypothermia: Case Report.

69-year-old male was found dead at the roadside in October month, death was declared suspicious by local prosecutor and autopsy was mandated. At autopsy, a large number of dark brown colored, ovalshaped lesions ranging from 1-15 mm under the mucosa defined as Wischnewsky spots, when stomach was dissected were observed. For the formation mechanism of Wischnewsky spots, there has no definite conclusions; more studies are needed on a case series.

Retroperitoneal Liposarcoma: an Autopsy Case.

Liposarcoma is very rare mesenchymal tumor that occurs in deep soft tissue and mostly seen in limbs and retroperitoneum, accounts for 24% of extremity and 45% of retroperitoneal soft tissue sarcomas. Retroperitoneal liposarcomas are typically present with advanced disease and often carry a poor prognosis. Retroperitoneal liposarcomas grow slowly in the very expandable retroperitoneal space in the deeply hidden and clinically silent therefore diagnosis is usually made late. Liposarcomas have five histological subtypes; well-differentiated liposarcoma (WDLS), dedifferentiated liposarcoma (DDLS), pleomorphic, myxoid and round cell liposarcoma. Our case is 81-year-old male who was found dead in the village homeless shelter. This was classified as a suspicious death and transferred to our service for autopsy. The external examination revealed rectal prolapse, abdominal distension and scrotal swelling. The internal autopsy showed green membrane on the peritoneum, brown smelly contents in the abdominal space, a perforation area 1.5x1 cm in size that in the first part of the duodenum and the dimension of tumor was 48x30x6 cm in the retroperitoneal space. The pathological report was dedifferentiated liposarcoma. We present a rare case of a dedifferentiated retroperitoneal liposarcoma with duodenal ulcer perforation.

Death Due to Myocardial Bridging.

Myocardial bridging is a congenital coronary pathology described as a segment of coronary artery which courses through the myocardial wall beneath the muscle bridge. Although the myocardial bridging prognosis is benign, have been also reported sudden death in medical literature. ¬A 30-year-old married woman was found dead at her home. After local prosecutors' investigation the death was declared as suspicious and forensic autopsy was obliged. The left anterior descending coronary artery was detected embedded deeply in the myocardium 2 cm from its coronary ostial origin. There were no other pathology to explain death. We analyzed sudden death case occurred because of myocardial bridging and the pathophysiological mechanisms in the light of medico-legal literature.

Medicolegal Approach to Diogenes Syndrome: a Case Report.

Because of the way of life Greek philosopher Diogenes lived, in the medical literature some older individuals characterized with collection of symptoms and the psychopathology associated with the lack of concern about a person's living conditions were called as Diogenes Syndrome. In this study we presented a case in terms of Diogenes Syndrome. We aimed to discuss by using the recent medical literature. Our case was a 62 year old male living alone and there were a variety of diseases he had. Diogenes Syndrome was previously identified in 30 elderly patients for the first time in 1975. As well as the typical clinical features of Diogenes Syndrome were defined, for being of potential forensic value, case characteristics belonging to the crime scene, and also probable changes that may be encountered at autopsy were discussed.

Helicobacter pylori infection and skin disorders.

Helicobacter pylori is a Gram-negative bacterium that has been linked to peptic ulcer disease, gastric lymphoma, and gastric carcinoma. Apart from its well-demonstrated role in gastroduodenal diseases, some authors have suggested a potential role of Helicobacter pylori infection in several extra-intestinal pathologies including haematological, cardiovascular, neurological, metabolic, autoimmune, and dermatological diseases. Some studies suggest an association between Helicobacter pylori infection and skin diseases such as chronic idiopathic urticaria and rosacea. There have also been few case reports documenting association between Helicobacter pylori and psoriasis vulgaris, Behçet's disease, alopecia areata, Henoch-Schönlein purpura, and Sweet's syndrome. However, more systematic studies are required to clarify the proposed association between Helicobacter pylori and skin diseases; most of the studies do not show relevant relationships of these diseases with Helicobacter pylori infections. This review discusses skin diseases that are believed to be associated with Helicobacter pylori.

Death due to perforation of solitary rectal ulcer: case report.

UNLABELLED: Presented case was 57-year-old male reported to be found dead in the watchman cabin in his workplace. At the autopsy, in abdominal cavity dirty green-brown colored fluid with a few particles of intestinal contents and yellow-green colored membranes on abdominal organs were observed, on the anterior wall of the rectum, 2x1.5 cm size perforation area was observed. We aimed to present the rare case of solitary rectal ulcer perforation. KEYWORDS: solitary rectal ulcer - death - autopsy.

Medicolegal aspects of atypical firearm injuries: a case report.

Our case was a twenty year-old man, who was injured during the military duty with G3 infantry rifle in the training area. An atypical firearm entry wound on the left side of sternum which was 4.5 cm in diameter, and was surrounded by six irregular skin burn wounds by a flash-suppressor and a 0.7 cm diameter firearm exit wound at space on the left midscapular line. Our case emphasizes that the interpretation of properties of these atypical firearm entry wounds need to be carefully assessed by physicians.