[Role of Kraevsky cells in forensic histological diagnostics]. / Znachenie kletok Kraevskogo v sudebno-gistologicheskoi diagnostike.

The study objective is to establish the role of light hepatocytes (Kraevsky cells) for forensic histological diagnosis of glycogen depletion in the liver due to various conditions, including shock. A standard histological examination of liver samples of persons who died from various causes was performed; routine staining with hematoxylin and eosin and additional staining by the PAS method was used. Histotopographic comparison of cross sections was performed to clarify the localization of light hepatocytes with different PAS staining results. It was shown that light hepatocytes have different morphological features, localization, and results of PAS staining, regardless of the cause of death, and are not related to glycogen depletion in them. Light hepatocytes (Kraevski cells) cannot be used as a sign of glycogen depletion and/or shock.

[Models and sculptural casts in forensic medicine and medical criminology]. / Mulyazhi i skul'pturnye slepki v sudebnoi meditsine i meditsinskoi kriminalistike.

The study objective is to present facts from the history of casting art and biographical information about the casting artists S.P. Fiveysky and M.A. Kurbatov, the founders of the casting craft in Russia. The attributes of the technology for making death masks, their features, advantages, and disadvantages as objects that capture appearance are described. The role of models and death masks in forensic practice, forensic science, and pedagogical activity is addressed.

[Adverse outcome in post-operative period (small-shot wound) from arrosive bleeding in forensic practice]. / Neblagopriyatnyi iskhod v posleoperatsionnom periode (ognestrel'noe ranenie drob'yu) ot arrozionnogo krovotecheniya v sudebno-meditsinskoi praktike.

The aim of this work is to draw the attention of forensic experts to the need to use new methodological approaches in postmortem morphological diagnostics of the lifetime injuries and the duration of death rate in forensic medical practice. A case of a fatal outcome from a small-shot gun wound complicated by arrosive bleeding in the postoperative period is considered. The missed opportunity to effectively use new methodological approaches in solving issues related to the completeness and timeliness of medical care is shown. The authors draw attention to the inadmissibility of using the nosological form with the code X94.9 ICD-10 «Attack by shooting from a small-shot gun¼ in the death certificate and suggest discussing the possibility to edit it for the 11th revision of the ICD.

[Certain modern methods for the diagnostics of gunshot injuries]. / Nekotorye sovremennye metody diagnostiki ognestrel'nykh povrezhdenii.

The objective of the present work was the analysis of the literature publications concerned with the modern approaches to the diagnostics of gunshot injuries with special reference to the most promising applications of the immunohistochemical methods. The use of certain antibodies for determining of intravitality and prescription of gunshot injuries is illustrated by concrete examples. It is concluded that further studies on the possibilities for the application of the immunohistochemical methods are needed.

[The forensic medical aspects of the problem of victimization of the elderly persons as exemplified by a case of suicide of an oncological patient]. / Sudebno-meditsinskie aspekty problemy viktimnosti lits preklonnogo vozrasta (na primere samoubiistva onkologicheskogo bol'nogo).

The frequency of suicides is an indirect indicator of the social welfare without distinction as to the social and political system. This problem is of special importance as regards the well-being of elderly people whose numbers grow steadily all over the world. The extending life expectancy at older ages in the combination with the resulting demographic disproportions have widespread repercussions on the older generation because they are associated with the increase of the negative social trends as exemplified by a case of suicide of the 89 year-old man A who had for a long time suffered from an oncological disease and was entirely dependent upon the assistance from other people. The authors emphasize that the most important factors responsible for the currently enhanced frequency of suicidal attempts among the elderly persons include the life below the poverty line, permanent stress, poor housing conditions, family conflicts, the ever increasing prevalence of somato-neurological and psychic pathologies, etc. The comprehensive forensic medical and socio-hygienic analysis of all cases of suicide and numerous relevant risk factors may be instrumental in the systematization of the statistical information on the nosological forms of specific pathologies, and the development of the adequate measures for the prevention of the deviant behaviour among the old-age subjects at the regional level. Such analysis may contribute to the reduction of the mortality among the populations of the advanced age especially in the high-risk groups including the elderly people.

[On the possibilities for the identification of the signs of the thermal impact of a gunshot associated with the formation of the resulting wound]. / O vozmozhnostiakh vyiavleniia priznakov termicheskogo vozdeistviia faktorov vystrela pri formirovanii ognestrel'nykh ran.

The present review of the literature publications is focused on the methods designed for the identification of the signs of the thermal impact of a gunshot associated with the formation of the resulting wound inflicted by various firearm projectiles. The historical and contemporary aspects of this topic are discussed with special reference to the immunodiagnostics as a new method extending the possibilities of forensic medical histology for the evaluation of the injuries to the soft tissues under the influence of thermal factors of the gunshot producing the firearm trauma.

[The principal and auxiliary immunohistochemical markers of intravital mechanical strangulation asphyxia]. / Osnovnye i dopolnitel'nye immunogistokhimicheskie markery prizhiznennosti stranguliatsionnoi mekhanicheskoi asfiksii.

The objective of the present study was the evaluation of the auxiliary methods for the diagnostics of the intravital formation of the constriction marks; the secondary objective was to determine the pace at which the death and asphyxia occur. MATERIAL AND METHODS: The materials on which the study was based included 17 cases of mechanical strangulation asphyxia involving 13 men and 4 women at the age from 8 to 28 years. All cases of hanging were associated with different blood alcohol levels. Their characteristic feature was the formation of the obliquely ascending constriction marks. The group of comparison was comprised of three cases of death by drowning and one case of manual strangulation. The control group consisted of 10 patients who died from the acute form of coronary heart disease and 5 cases of death from traumatic shock. All the corpses were examined with the use of the traditional methods within the first 24 hours after death. The special laboratory studies were performed by means of the standard histological and immunohistochemical methods with the use of the polyclonal antibodies against total cytokeratin, fibrinogen, immunoglobulin-lambda, fibronectin, and CD-117 antigen. The histological preparations were stained by the method of Spielmeyer and with toluidine blue. RESULTS: The results of the study give evidence of the possibility of diagnostics of mechanical strangulation asphyxia making use of the reaction with anti-fibrinogen antibodies in the stromal tissue of the constriction mark even in the absence of other intravital signs of death. Such diagnostics is also possible with the use of the CD-117 antigen in the pulmonary tissue. The expression of this antigen is characteristic of the cases of alveolar hypoxia. The possibility of application of other markers for the differential diagnostics of mechanical strangulation asphyxia from other causes of death is discussed.

[Clinical pathomorphology and tanatogenesis of various forms of alcoholic intoxication]. / Klinicheskaia patomorfologiia i tanatogenez razlichnykh form alkogol'noi intoksikatsii.

The objective of the present study was to identify the clinical and pathomorphological changes in the internal organs for the elucidation of the cause of death associated with various forms of alcoholic intoxication (chronic alcoholic intoxication, poisoning with surrogate alcohols, etc.). The analysis of the clinical conditions resulting from alcohol abuse has demonstrated that the principal pathology underlying the fatal outcome is complemented by a variety of non-lethal somatic disorders aggravating the patients' condition and enhancing its severity. The clinicians are known to give more attention to the accompanying somatic complications than to the cause underlying the main pathology (alcoholism). Such attitude in the absence of the adequate treatment of the alcohol dependency is neither clinically efficient nor economically appropriate. Poisoning with surrogate alcohols is characterized by the pulmonary-cerebral variant of tanatogenesis in the combination with hypercoagulation and the erosive processes in the gastrointestinal tract whereas death from alcoholic intoxication is usually associated with heart tanatogenesis.

[The role of the immunohistochemical investigations in the documentation of intravitality and severity of the gunshot injuries to the soft tissues]. / Rol' immunogistokhimicheskogo issledovaniia v ustanovlenii prizhiznennosti i vyrazhennosti ognestrel'nykh povrezhdenii miagkikh tkanei.

The objective of the present study was to determine intravitality and severity of a gunshot-inflicted trauma making use of the immunohistochemical (IGH) methods for the evaluation of the injury to the soft tissues of the wound canal. The immunohistochemical methods were employed to estimate the expression of fibrinogen and vimentin. The positive immunohistochemical reaction was obtained in the fibrinogen assay whereas the reaction in the zone of necrosis was negative. These findings give evidence of the thermal impact produced by the firearm projectile on the soft tissues. Deformation of the cytoskeleton registered in the IGH test for vimentin suggests its disintegration and therefore the severity of the injury. It is concluded that the investigations with the use of the immunohistochemical methods, make it possible to identify the affected parts of the wound canal.

[The peculiar features of the morphological manifestations of the damage to the liver associated with the death cap mushroom poisoning]. / Osobennosti morfologicheskikh proiavlenii porazheniia pecheni pri otravlenii blednoi pogankoi.

This article is focused on the peculiar features of the morphological manifestations of massive hepatic necrosis associated with the death cap mushroom (Amanita phalloides) poisoning in comparison with similar cases of intoxication. It has been shown that the poisoning is associated with cell proliferation in the peri-portal regions of the liver and induction of the mechanisms of apoptosis responsible for the death of hepatocytes.

[Certain immunohistochemical markers of the intravitality of strangulation mechanical asphyxia]. / Nekotorye immunogistokhimicheskie markery prizhiznennosti stranguliatsionnoi mekhanicheskoi asfiksii.

Thus article was designed to report the results of the investigations into specific histological features of the skin and soft tissue samples taken from the strangulation areas on the neck and from the lungs of the persons who had committed suicide by hanging. The studies revealed the well apparent expression of fibrinogen in the derma and the subdermal cellolocutaneous layer of the skin subjected to intravital strangulation. Similar changes were absent in lung alveoli.

[The morphological diagnostics of the toxic effects of the smoking blends in the cases of fatal intoxication with pyrrolidinovalerophenone]. / Morfologicheskaia diagnostika toksicheskogo vozdeistviia kuritel'nykh smesei v sluchaiakh smertel'nykh otravlenii pirrolidinvalerofenonom.

The objective of the present study was the development of the morphological criteria for the diagnostics of fatal intoxication with the herbal smoking blends (spices) using the samples of the biological materials obtained from the victims of pyrrolidinovalerophenone poisoning. The samples were taken from 13 autopsied cadavers of 11 men and 2 women at the age from 26 to 39 years based at the Astrakhan Regional Bureau of Forensic Medical Expertise during the period from 21011 to 2015. The diagnosis of pyrrolidinvalerpphenon poisoning was verified to the letter. The materials obtained during the standard autopsy procedure were used for the forensic genetic studies in the combination with the mandatory routine forensic chemical investigations with the application of the gas chromatographic techniques. Polymorphism of the morphological picture was attributable to the differences in the chemical composition of the poisons and the combination of narcotic and alcoholic intoxication. The signs of chronic intoxication manifested themselves in the form of mixed gliosis and various lesions of brain neurons. The variety of clinical symptoms and the morphological picture of pyrrolidinovalerophenone poisoning are responsible for different forms of tanatogenesis which suggests the necessity of further research on the mechanisms underlying the toxic effects of herbal smoking blends.

[Forensic medical diagnostics of intra-vitality of the strangulation mark by morphological methods].

The objective of the present study WaS to overview the current domestic and foreign literature concerning the up-to-date methods employed for the expert evaluation of intra-vitality of the strangulation mark. The secondary objective was to propose the new approaches for addressing this problem. The methods of expert diagnostics with a view to determining the time of infliction of injuries as exemplified by mechanical asphyxia are discussed. It is concluded that immunohistochemical and morphometric studies provide the most promising tools for the evaluation of intra-vitality of the strangulation mark for the purpose of forensic medical expertise.

[The role of surrogate alcoholic beverages in the development of hemorrhage in the patients presenting with Mallory-Weiss syndrome].

The objective of the present work was to study the pathological changes in various organs and tanatogenesis associated with Mallory-Weiss syndrome making use of the forensic medical and clinical materials. It was shown that the main cause of unrestrained vomiting resulting from alcoholic intoxication and leading to perfusive bleeding is not only the direct action of ethanol and surrogate alcohol on gastroesophageal mucosa and induced thrombocytopenia. Another cause may be brain oedema with subsequent cerebral herniation and irritation of the pseudobulbar centres responsible for the initiation of the vomiting reflex. The authors propose recommendations for forensic medical diagnostics of the cases of such hemorrhage.

[Postmortem forensic medical diagnostics of fulminant sepsis caused by Gram-negative bacterium (Capnocitophaga canimorsus) following a dog bite].

This article provides the example of postmortem forensic medical diagnostics of fulminant sepsis caused by Gram-negative bacterium (Capnocitophaga canimorsus) following a dog bite. In order to identify the etiological factor of fulminant sepsis, the expert carried out the study of the autopsy materials with the use of polymerase chain reaction (PCR). This method has only recently been introduced into postmortem diagnostics of fulminant sepsis in this country; it has no analogs abroad and can be employed for the purpose of forensic medical expertise and pathological anatomic studies.

[The prospects for the application of the immunohistochemical methods for the establishment of intravitality and prescription of the mechanical injuries in forensic medical practice].

The objective of the present work was the analysis of the literature concerning the application of the immunohistochemical methods for the improvement of diagnostics of intravitality and prescription of the mechanical injuries in forensic medical practice. Special attention is given to the examples of publication dealing with the methods for addressing this issue. The most promising areas of the application of immunohistochemical methods are considered. They are exemplified by the use of specific antibodies for the establishment of intravitality and prescription of the mechanical injuries. The possibility of using the presence of fibrinogen in the pulmonary alveoli as the marker of prolonged strangulation is illustrated. The results of this literature review provided a basis for the conclusion about good prospects of the application of the immunohistochemical methods with the purpose of establishing intravitality and prescription of the mechanical injuries in forensic medical practice.

[The contribution of the scientific school of Yu.I. Pigolkin, corresponding member of the Russian Academy of Medical Sciences, to the development of modern methods for the estimation of the time of death].

The principal characteristics of the investigations performed to specify methods for estimation of the time of death (TD) are presented. The studies included the measurement of electric conductivity of organs and tissues depending on the time of death and the evaluation of contractile activities of smooth muscle cells in response to the application of an electric current. A new method for the estimation of the time of death with the use of morphometric techniques is described. The results of histostereometric measurements are used for the first time to characterize the intensity of autolysis. Forensic medical mycological studies have been carried out. A combined approach to the determination of the time of death is proposed including mathematical simulation.

[The characteristic morphological changes of the internal organs in certain forms of combined poisoning].

The results of forensic medical investigations of 100 corpses of the persons who died from combined intoxication with two and more poisons are presented. They were compared with clinical observations and summarized uisng the methods of tanatogenetic analysis. The main variants of fatal combined poisoning and the underlying tanatogenetic mechanisms were categorized into cardiac (disturbances of rhythm and conductivity, progressive hypotension, flabby heart muscle, extensive fragmentation of cardiomyocytes), cerebral (coma and massive death of brainstem neurons), and pulmonary (of pneumonia- or pulmonary oedema-type with fibrin precipitation in the alveoli and formation of hyaline membranes). This classification was supplemented by a variety of combinations of the above variants with necrotic nephrosis and disseminated intravascular coagulation syndrome. It is concluded that the results of this study may be of use for forensic medical diagnostics of combined poisoning and the elucidation of the contribution of individual toxic substances to the fatal outcome bearing in mind the low informative value of the relevant forensic medical data.

[Characteristics of morphological manifestations of anaphylactic shock in response to the administration of pharmaceutical preparations encountered in the practice of forensic medical expert-histologist].

The authors report the results of a forensic medical investigation of 6 cases of death associated with the administration of pharmaceutical products documented by forensic medical experts of the Russian Centre of Forensic Medical Expertise. The results of the study are compared with the clinical data and summarized using the methods of tanatogenetic analysis. The following main clinical variants of iatrogenic anaphylactic shock (IAS) are distinguished: bronchospastic IAS (n = 1), asphyxic IAS (n = 1), hemodynamic IAS (n = 3), and combined (bronchospastic plus hemodynamic) IAS (n = 1). The signs of all these variants are described allowing for their diagnostics and differentiation diagnostics. These data can be used for the purpose of forensic medical diagnostics and elucidation of the mechanisms of tanatogenesis.

[Pathology of the heart conducting system in the thanatogenesis of sudden death from alcoholic cardiomyopathy and coronary heart disease].

The present literature review is focused on the contribution of various pathological changes in the heart conducting system to the tanatogenesis of sudden death from alcoholic cardiomyopathy and coronary heart disease viewed from the perspective of a forensic medical expert. The currently available data on the disorders in the heart conducting system in the subjects with these diseases are presented. Various aspects of pathology of the heart conducting system are considered in the modern and historical contexts. The prospects for the further investigations into the tanatogenic mechanisms of sudden death by reason of alcoholic cardiomyopathy and coronary heart disease are outlined.