[Vascular pathology in the aspect of sudden death in young adults and connective tissue dysplasia: anatomical, physiological, and morphological parallels]. / Patologiia sosudov v aspekte vnezapnoi smerti lits molodogo vozrasta i displaziia soedinitel'noi tkani: anatomo-fiziologicheskie i morfologicheskie paralleli.

Vascular pathology in young adults has during the last 10 years been diagnosed more often during forensic medical examination of sudden death. Major morphological alterations are revealed in cerebral vessels, coronary vessels, and at the level of the ascending portion of the aorta. Generally, in the young age there is no stenosing atherosclerosis inducing vascular lesions and the development of complications. It was determined that connective tissue dysplasia is pathology wherein weakness of the vascular wall is genetically preconditioned, thus promoting formation of vascular aneurysms and rupture of the latter under conditions of provoking factors such as going in for sports, physical loads, and psychoemotional stress.

[Characteristic of the fractures of the cervical, thoracic and lumbar vertebrae in the victims of a traffic accident found in the passenger compartment of a modern motor vehicle].

The objective of the present work was to study peculiar features of the injuries to three spinal regions in the victims of a head-on car collision found in the passenger compartments of modern motor vehicles equipped with seat belts and other safety means. It was shown that most frequent fatal injuries to the driver include the fractures of the cervical, thoracic, and lumbar vertebrae. These injuries are much less frequent in the passengers occupying the front and the right back seats. The multilayer and multiple character of the fractures in different parts of the spinal column in the car drivers is attributable to more pronounced spine flexion and extension associated with injuries of this kind. The fractures of the lower cervical vertebrae in the front seat passengers occur more frequently than injuries of a different type whereas the passengers of the back seats most frequently experience fractures of the upper cervical vertebrae. The passengers of the left back seat less frequently suffer from injuries to the thoracic spine than from the fractures of the cervical and lumbar vertebrae. The passengers of the central back seat most frequently experience fractures of the thoracic part of the vertebral column and the passengers occupying the right back seat fractures of the lumbar vertebrae.

[Age-specific changes in the cerebral cortex capillaries].

The present paper reports an attempt to determine the biological age in man based on the results of the studies of the capillary bed of the cerebral cortex in different periods of postnatal ontogenesis (from 1 month to 83 years). The material was investigated by histological and histochemical methods. It is concluded that the data obtained concerning the structural and functional changes in the capillaries of different regions of the olfactory brain can be used for the personality identification for the purpose of forensic medical expertise.

[The new working classification of blood stain patterns].

The results of analysis of the existing classifications of blood stain patterns indicate that systematization of the morphological characteristics of blood stains requires that mechanisms and circumstances of the injury, properties of the surfaces receiving blood stains and the objects leaving them should be taken into consideration. The new working classification of blood stain patterns has been developed for the purposes of forensic medical expertise satisfying the above requirements. It makes it possible to pass to the next stage of research on systematization of the general and specific morphological features of blood stains depending on concrete circumstances of bodily injuries.

[Forensic medical evaluation of hereditary predisposition to thrombophilia in the case of thrombotic complications of a mechanical injury].

The objective of the present work was to develop the forensic medical criteria for the assessment of the significance of hereditary predisposition to thrombophilia in the case of thrombotic complications of a mechanical injury. The results of analysis of the frequency of genes responsible for hereditary predisposition to thrombogenesis (FII, FV, MTHFR, FGB, PAL-1) among the victims of mechanical injuries are presented. A total of 251 subjects were available for the examination. They were divided into 4 groups as follows: the subjects presenting with deep venous thrombosis in the lower extremities (DVTLE) after the injury (group 1), subjects with DVTLE without the preceding trauma (group 2), those with an injury to the locomotor apparatus without a subsequent thrombotic complication (group 3), and practically healthy persons (group 4). It was shown that the subjects of group I had the highest frequency of mutations and polymorphisms of MTHFR and PAl-1 genes. It is concluded that genetic typing for the detection of mutations in these two genes is indispensable for the subjects presenting with thrombotic complications after mechanical injuries to the locomotor organs.

[The general and individual characteristics of the liver ruptures in the case of a blunt injury to the chest and abdomen].

The present study is based on the results of analysis of 150 cases of the fatal blunt injury to the chest and abdomen associated with liver rupture for the purpose of systematization of practical and experimental data concerning this issue. Special attention is given to the diagnostic signs of local major (primary) and additional (secondary) lesions localized at the sites of force application and their long-term consequences. The diagnostic forensic medical criteria are proposed allowing to characterize hepatic injuries depending on the mechanism and conditions of their infliction in different situations.

[The method of three-dimensional modeling for the reconstruction of the circumstances of the event taking into consideration blood stains].

The objective of the present study was to estimate the possibility of using computer-assisted three-dimensional modeling for the solution of selected problems of forensic medical expertise. This approach is illustrated by an example of the reconstruction of the scene of action and circumstances of the injury taking into consideration blood stains.

[Forensic-medical diagnostics of an electrical mark resulting from the injury inflicted by technical electricity in the aqueous environment].

The objective of the present study was to develop the criteria for forensic-medical diagnostics of an electrical injury inflicted in the aqueous environment based on the characteristics of the electrical mark. The specific morphological features of the electrical injuries inflicted in the aqueous environment that were discovered in the materials available for the forensic medical expertise were analysed taking into consideration the results of the relevant research reported in the forensic medical literature. It was shown that an electrical injury inflicted in the aqueous environment results in the formation of an unusual mark in the form of blisters containing no watery liquid associated with electrogenic oedema in the surrounding tissues. Macroscopic and microscopic studies of the electrical mark failed to reveal the signs of grade III and IV grade thermal burning or thermally affected hair. It is concluded that the consistent characteristics of the electrical mark resulting from the injury inflicted by technical electricity in the aqueous environment include cell lengthening, blister formation inside the corneal layer, and the separation of epidermis from the skin proper.

[The morphological characteristic of hepatorrhesis in the subjects with the blunt abdominal injury].

We have elucidated certain consistent patterns of the development of hepatic lesions associated with blunt abdominal trauma including primary and secondary local and distant ruptures of the liver of different localization, e.g. in the direction of the injurious force (central and anti-shock) and apart from it (peripheral). A kick in the stomach causes local (primary and secondary) or distant ruptures of the liver. A strong impact gives rise to local secondary and distant ruptures. Compression of the body with massive objects is associated with local primary ruptures whereas falling down on the stomach results only in anti-shock ruptures. Local (primary and secondary) as well as distant (anti-shock and peripheral) ruptures of hepatic parenchyma have different morphological properties and surface relief which makes it possible to discriminate between them. The consistent patterns of hepatorrhesis provide a methodological basis for the explanation of the physical nature of liver deformation and destruction of its tissue after a blunt abdominal trauma.

[The use of immunological characteristics of the peripheral blood for the purpose of forensic medical expertise of the subjects exposed to ionizing radiation].

The objective of the present study was the comprehensive evaluation of quantitative and functional metabolic characteristics of human leukocytes following in vitro irradiation of peripheral blood samples at a dose of 0.25, 0.50, 1.0, and 4.0 Gy for the development of a rationale for their application as biological markers of radiation exposure in forensic medical expertise of the subjects affected by supernormal ionizing radiation. The total number of leukocytes, lymphocytes, and their subpopulations as well as the functional and metabolic status of neutrophils were determined. The results of the study indicate the possibility of using a set of functional metabolic characteristics of human leukocytes as the additional forensic medical criteria for diagnostics of radiation impact on living subjects.

[Characteristic of the hepatic tissue degradation processes underlying the development of its local and distant lesions].

The processes associated with liver disruption caused by a blunt abdominal injury have been investigated on a model of continuous media deformation. It was shown that local primary injuries to the liver result from stress-induced tissue stretching, compression, and shear in the longitudinal direction. They have a layered relief due to transverse fissures. The peripheral ruptures result from tissue extension under effect of overall liver deformation. They are not deep and have a uniform relief created by alternating low tubercles and superficial fissures oriented at the right angle to the surface. Antishock ruptures are the consequences of tissue extension or stretching/compression during local and overall deformation of the liver surface. They develop in the longitudinal direction, have a non-uniform relief created by alternating high prominences and numerous fissures differing in both the depth and the extension and oriented at the right angle to the liver surface. Central ruptures result from tissue stretching accompanying overall deformation of the organ. They are directed perpendicular to the direction of the surface force, have the longitudinal direction and non-uniform relief.

[Current concepts of the mechanisms of formation of gunshot fractures].

The mechanisms of formation of gunshot fractures in flat bones inflicted by a semispherical bullet were investigated using expert and experimental materials. The process of crack formation was considered in terms of the Hertzian contact problem and the Hill-Johnson model. It was shown that the fracture develops as a result of combination of stresses and strains in the bone tissue leading to the formation of a hydrostatic nucleus prior to tissue fragmentation. Dynamic fluctuations (waves) generated in the zone of hydrostatic compression resulting from the gunshot injury propagate with the velocity of sound from the nucleus in the direction of the bullet movement. According to the Hill-Johnson model, the waves propagate in the direction of the impact within a parabolically expanding space; this accounts for the mechanism of formation of parabolic cracks and the specific shape of the defect that the bullet produces in the flat bones. The dynamic load applied by means of an indentor forms at a higher rate than the velocity of sound in the affected material. It gives reason to consider the effect of a bullet moving with the speed of 250 m/s as quasi-static loading. The results obtained in this study make a contribution to the theory of impact effect of a bullet and provide a deeper insight into the physical nature of the direct and sideway action of a gunshot projectile. Moreover, they explain the cause behind the widening of the outlet part of the perforating fracture in the flat bones.

[The teaching and guiding forensic medical commission: its significance role in the educational process].

The activities of the Educational and Methodological Association (EMA) for pharmaceutical teaching in the Russian higher education institutions were renewed and updated. The Educational and Methodological Commission (EMC) on forensic medicine is an integral part of EMA. EMC was set up with an object of further developing the system of continuous professional education, implementing the federal state educational standard of the third generation, preserving and maintaing the uniform educational environment. The work of EMC in the field of forensic medicine is of primary importance for the optimization of academic activities in medical higher education institutions and research institutes training personnel for forensic medical facilities.

[Forensic medicine as the cradle of toxicology in Russia].

Modern toxicology as a science and educational subject originated from forensic medicine in the middle of the XIXth century. In the beginning, selected toxicological problems were taught in the Emperor's Medical Surgical Academy (presently S.M. Kirov Military Medical Academy, Sankt-Peterburg) and at the Medical Faculty of the Moscow University (presently I.M. Sechenov First Moscow State Medical University, Moscow). The greatest contribution to the development of toxicology was made by such outstanding scientists as professors S.A. Gromov, P.P. Pelekhin, P.P. Zablotsky-Desyatovsky, E.V. Pelikan, Ya.A. Chistovich, G.I. Blosfel'd, I.M. Sorokin, D.P. Kosorotov, A.V. Grigoriev, V.V. Andreev, A.A. Glebovich, A.N. Grigoriev, B.I. Predtechensky, V.M. Rozhkov, S.S. Vail, M.N. Lubotsky, etc. The works of these researchers predetermined the further development of toxicology in this country, its main purpose being provision of medical aid in case of poisoning and diseases of chemical etiology. Another line of toxicological research became industrial and environmental toxicology having the purpose of hygienic rating and prevention of poisoning. Nevertheless, all aspects of the multifaceted science of toxicology are related to forensic medicine as the cradle in which it originated, evolved, and turned into a self-consistent science.

[Characteristics of duodenal ruptures depending on topographical and anatomical properties of this organ and circumstances of blunt abdominal trauma].

We have studied specific morphological properties of duodenal rupture depending on the topographic and anatomical features of this organ and circumstances of blunt abdominal trauma suffered in a car crash (with the victim found in the passenger compartment or involved in an automobile-pedestrian accident) and a railway crash (a train-pedestrian accident) or resulting from a blunt-force trauma, a fall from height, a fall on the stomach, and traumatic compression of the body. We took into consideration the anatomical peculiarities of the duodenal rupture, such as its circular, horseshoe, and loop-like shape. The study has demonstrated that the frequency of duodenal injury associated with a blunt abdominal trauma shows a stronger dependence on the topographical and anatomical peculiarities of duodenum than on the circumstances of the case. Specifically, the circular duodenum and especially its descending portion are more readily subjected to the damage than the organs of a different shape. The position of the break with respect to the duodenal axis is an important diagnostic signs allowing to clarify circumstances of the blunt injury. Transverse ruptures are typical of strong impacts associated with the short-term interaction between the damaging object and the affected part of the body whereas longitudinal ruptures more commonly occur as a result the long-term traumatic impact. Bile imbibition of paraduodenal and peripancreatic retroperitoneal adipose tissue may be used as an additional diagnostic sign of duodenal rupture.

[Bone mineral density as a sign of age-related involution of human bones].

This review of the literature analyzes the current state of a problem of application of various morphological methods for the investigation of age-related involution of human bone system and their use in the course of forensic personality identification. The difficulties of the application of the available methods of quantitative morphology in determination of biological age, are emphasized. The possibilities of the practical use of radiological methods to study the skeleton, including the determination of the bone mineral density as an indicator of age-related changes of bone tissue, are analyzed. An ambiguity of the research results obtained is noted, and the possible reasons for and the factors contributing to the results variability are considered. It is concluded that the application of computer tomogram densitometry to the various regions of the bone skeleton in complex with some other methods, is promising for the determination of age interval in forensic identification examinations.

[The mechanisms of formation of liver injuries associated with the blunt abdominal trauma].

The mechanisms of liver damage associated with the blunt abdominal trauma are considered based on the analysis of the literature publications. The general characteristic of these mechanisms and the processes underlying the development of liver injuries is presented. It is argued that the mechanisms underlying the formation of damages to the liver differ depending on the form of the traumatic impact, the injurious factor, and the processes leading to the destruction of the hepatic tissue. The main forms of traumatic impact in the case of a blunt abdominal trauma include the strike (blow), pressure, and concussion of the organ while the major traumatic factors are deformation, displacement, and "shock-resistant effects". The mechanisms underlying tissue destruction are compression and stretching. These two mechanisms are responsible for the formation of different variants of liver destruction. The results of the study suggest the necessity of the search for other mechanisms of degradation of the hepatic tissue following a blunt abdominal trauma for the improvement of forensic medical diagnostics of its cause and the underlying mechanism.

[The current potential of forensic medical expertise of a local radiation injury].

The present review concerns radiation injury, a most challenging problem facing modern forensic medical expertise. It is shown that its successful solution requires the combined application of all currently available relevant methods including radio- and biodosimetry, forensic histological examination, etc.

[Forensic medical estimation of the morphological changes in the myocardium and hypothalamo-pituitary-adrenal system in case of sudden cardiac death].

This morphological, morphometric, and immunohistochemical study of the myocardium, adrenal gland, and hypothalamus included 50 corpses of men aged from 25-49 years deceased by reason of acute coronary failure associated with coronary heart disease. The commonest lesions in the myocardium were contractures (54.3 +/- 3.5% [51.2; 57.8%]), cyclic deformation (44.7 +/- 6.3% [38.2; 51.4%]), and dissociation of cardiomyocytes (61.2 +/- 2.3% [56.3; 64.8%]). The sinoatrial and atrioventricular nodes of the heart contained large amounts of adrenaline-positive cells (45.6 +/- 4.5% [40.1; 48.7%]) and 34.2 +/- 2.9% [31.2; 37.4%]). The equally large numbers of adrenaline-positive cells were detected in the adrenal medulla (67.2 +/- 6.8% [61.9; 74.3%]). The arcuate, supraoptic, and paraventricular nuclei of the hypothalamus underwent reversible changes of neutron content (the degree of damage 25.6 +/- 4.8% [21.2; 29.8%]) and contained large amounts of noradrenaline-positive and dopamine-positive neural cells (54.2 +/- 3.6% [51.4; 59.3%]) and 28.7 +/- 2.1% [23.4; 31.7%]) respectively. It is concluded that the morphometric and immunohistochemical changes detected in the present study can be used as the additional forensic medical criteria for diagnostics of death from acute coronary failure associated with coronary heart disease.

[The analysis of the unfavourable outcomes of dental care based on the materials of forensic medical examinations carried out by the Bureau of Forensic Medical Expertise, Moscow Department of Health].

The analysis of the unfavourable outcomes of dental care based on the materials of forensic medical examinations carried out by the Bureau of Forensic Medical Expertise, Moscow Department of Health.