[Forensic characteristics of injuries in cyclists in collisions with other vehicles]. / Sudebno-meditsinskaya kharakteristika povrezhdenii u velosipedistov pri stolknoveniyakh s drugimi transportnymi sredstvami.

In order to identify the features of the injuries formation in cyclists who were injured in a collision of moving vehicles with a blow to the rear wheel area of a bicycle moving at a slower speed in the same direction, the authors analyzed the results of forensic medical examinations in relation to 151 corpses of cyclists who died in road accidents aged 4 to 74 years. It was found that with this type of bicycle injury, the structures of the head, chest, lower extremities, as well as the structures of the abdomen were most often injured. Injuries to the structure of the head were characterized by the formation of depressed-comminuted fractures: more often frontal-temporal, less often occipital bone. Bilateral fractures of the ribs were also quite frequent types of damage, mainly the upper ribs (up to 5-6 ribs) were damaged, most often along the midclavicular and anterior axillary lines. Lung contusions have been identified in most of the injured persons with chest structure injury. Injuries to the abdominal organs and retroperitoneal space were recorded in 22.27% of cases, with liver and spleen ruptures in the majority of cases. Spinal injuries in cyclists were detected in 13.25% of cases, injuries in the cervical spine prevailed: cervico-occipital injuries and fracture-dislocations, mainly between 1-2 and 3-4 or 6-7 cervical vertebrae with separation or contusion of the spinal cord. Injuries to the structure and organs of the pelvis in road accidents in cyclists were observed very rarely, which made it possible to distinguish this type of bicycle injuries from other types of transport and blunt injuries, in particular from automobile injuries. Injuries to the structure of the limbs of the victims were noted quite often: fractures of the upper limbs occurred when falling on the road surface and injury to the lower limbs was formed both during the contact of two vehicles and when the victims fell on the road surface.

[Forensic medical characteristic of articular injuries]. / Sudebno-meditsinskaya kharakteristika sustavnykh travm.

THE AIM OF THE STUDY: Is to refine the mechanism of major joints' damage formation and qualification criteria of harm degree to the health in articular injuries. The number of patients equal 246, suffered in different circumstances, were examined. Damages of skin and soft tissues in the joints region without affection of internal structures (47%), intraarticular fractures with impaired articular surface congruence (18.0%) and periarticular fractures (15.8%) were the most frequent in non-fatal injuries' outcomes in pedestrians and cyclists suffered from collisions with moving vehicles. Dead pedestrians and cyclists injured in road traffic accidents (RTA) from the side of joints structure had the most frequent the periarticular fractures (6.8%), intraarticular fractures with impaired (14.5%) or intact articular surface congruence (6.5%). Dislocations (45.9%) and dislocation-fracture (54.1%) were common in mechanical injuries. Mostly, work ability was recovered for 1.5-2.0 months in the presence of periarticular fracture, and there was no permanent loss of general work ability. The permanent loss of general work ability exceed 33.0% in case of complicated intraarticular fractures of coxofemoral structures, and in the case of a similar injury of other joints was less than this value. The period of work ability recovery in the case of intraarticular fractures was 2.5-3 months, in the presence of complicated dislocations was from 3 to 6 months. The permanent loss of general work ability did not exceed 30%. The period of work ability recovery in patients with fracture-dislocation varied from 3 to 6 months. The permanent loss of general work ability in this case was from 20% to 60%. The severity of harm to the health was classified as moderate degree in the case of uncomplicated isolated injuries of joints structures, and as moderate or severe degree in the presence of complicated isolated injuries. Bruises of joints' soft tissues were evaluated as mild bodily injury causing a health disorder. Bruises of joints' soft tissues, as well as periarticular and intraarticular fractures in pedestrians and cyclists in the case of RTA are formed when falling on the road surface. Dislocations and fractures-dislocations of humerus and forearm occur as a result of an indirect injury mechanism. Articular injuries of femur are formed under the influence of traumatic force to the femur, exceeding the capability of coxofemoral joint (an indirect injury mechanism). Dislocations and fractures-dislocations in ankle joint are occurred as a result of an indirect injury mechanism and are caused by foot's flexion or rotation with great strength.

[Establishment and development of forensic medicine in Uzbekistan]. / Stanovlenie i razvitie sudebnoi meditsiny v Uzbekistane.

The article analyzes and systematizes materials on the establishment and development of forensic medicine in Uzbekistan. It was noted that until the 1960-1970s, no independent forensic medical examinations were conducted in Turkestan, Uzbekistan in particular. The formation of scientific forensic medicine began with the establishment of the Uzbek National University (1918) with the Faculty of Medicine, where forensic medicine was taught. In the 1940-1950s, forensic medical examination bureaus (FME) were established in the regional centers of Uzbekistan. At present, the FME service includes the Republican Scientific and Practical Center for FME with its regional branches in Karakalpakstan and other regions, the departments of forensic medicine, and medical law of medical universities. The regulations and standards for all types of forensic examinations were fully updated in line with the Constitution of the Republic of Uzbekistan and the Forensic Science Act.

[The state of the structure of the cerebral cortex at various times of the postmortem period after massive blood loss complicated by hemorrhagic shock]. / Sostoyanie struktury kory golovnogo mozga v raznye sroki postmortal'nogo perioda posle massivnoi krovopoteri, oslozhnennoi gemorragicheskim shokom.

The aim of this study is to reveal the features of changes in the structure of the cerebral cortex at different periods of the postmortem period after death from massive blood loss complicated by hemorrhagic shock. The morphological and morphometric features of the nervous and vascular structures were determined during death from blood loss complicated by hemorrhagic shock. The brain of 12 corpses of persons who died from stab and cut wounds of blood vessels and internal organs with sharp instruments at various times of the postmortem period were examined. It was found that as the time elapsed after death from hemorrhagic shock increases, an increase in destructive changes in both neurons and intracerebral vessels is observed in the brain. Autolytic processes to a greater extent occur in the intracerebral vessels in comparison with neurons, which is more pronounced in the later periods. The dimensions of the perineuronal and perivascular spaces in the dynamics of the postmortem period increase synchronously after death from hemorrhagic shock.

[Features of damage to the body parts in bicycle riders when falling from moving bicycles]. / Nekotorye osobennosti povrezhdenii struktury chastei tela u velosipedistov pri padenii s dvizhushchikhsya velosipedov.

The study objective is to analyze the results of forensic medical examination (FME) of fatal cases of falling off a bicycle (9 cases) and a similar non-fatal injury (18 cases). All cases were males aged 8 to 74 years. Of the 27 cases, 6 were children aged 8-17 years. Head and chest injuries were the most common. The nature and localization of these injuries, along with strip-like, linear and parallel abrasions on the skin of the anterolateral surface of the body, indicated that they were a result of collisions and slips of the victim's body on the road surface. A few cases of penetrating injury of the abdomen with internal organs damage were observed; they were related to the impact of the handlebars and were the most characteristic of this type of injury. The data presented may help distinguish the fall of bicycle riders from other types of accidents, in particular from collisions between moving vehicles and pedestrians. The nature of the identified injuries can be considered when providing medical care to the victims.

[Damage to the structures of the brain in acute carbon monoxide poisoning]. / Porazhenie struktur golovnogo mozga pri ostrom otravlenii ugarnym gazom.

OBJECTIVE: The aim of the study was to investigate the features of damage to the structures of the brain in acute carbon monoxide (CO) poisoning. The results of forensic, microscopic and morphometric studies of the brain of 78 corpses died from acute carbon monoxide poisoning are presented. The peculiarities of damage to the nervous tissue, the glial complex, as well as changes in the structures of blood vessels and the state of intravascular blood with the formation of aggregates, sludge, and blood clots were revealed. These changes along with perivascular and pericellular edema indicate the agonal death of the victims. When the carboxyhemoglobin concentration in the blood is about 30% the brain structures' lesions begin to appear; their intensity increases when the carboxyhemoglobin concentration is more than 60%. According to the authors, the substantiation of the thanatogenesis of various types of carbon monoxide poisoning requires further research taking into account the age of the victims, the carboxyhemoglobin concentration in the blood, the duration of the agonal period, as well as possible (competing) conditions: for example, acute alcohol intoxication, thermal injury, etc. Still urgent the studies of structures of other target organs of CO - heart and lungs.

[The character and features of the injuries' formation in children-pedestrians in a collision with moving cars]. / Kharakter i osobennosti formirovaniya povrezhdenii u detei-peshekhodov pri stolknoveniyakh s dvizhushchimisya avtomobilyami.

THE AIM OF THE STUDY: Is to determine the features of the injuries formation in children-pedestrians in a collision with moving cars on the basis of studying the nature and localization of injuries on the body of the victims. It was analyzed the materials of the forensic medical examination of 140 children death cases (91 boys and 49 girls) caused by a collision of moving cars with pedestrian-children aged 6 to 17 years. It was found that the majority of children-pedestrians with a car injury develop concomitant craniocerebral trauma (CCT) (78%), concomitant trauma of the chest (CT) (46.4%) and abdomen (50.2%), spinal cord injury (SCI) (25.7%) and fractures of the limb bones (55%). TBI is quite often accompanied by fractures of the bones of the vault and base of the skull. For CT of the chest and organs of the chest cavity, unilateral fractures of the ribs and bruises of the lungs are typical. In the structure of the abdomen organs CT, damage to the parenchymal organs prevails. In SCI, damage to the structures of the cervical and thoracic spinal column is more common, while separation of the spinal cord is quite common. This type of injury is characterized by the formation of femurs fractures, bones of the lower leg and upper limbs.

[Tanatological assessment of long-brain structures in death from hemorrhagic shock at different post-mortal periods]. / Tanatologicheskaya otsenka struktur prodolgovatogo mozga pri smerti ot gemorragicheskogo shoka v razlichnye sroki postmortal'nogo perioda.

Authors determined the morphological and morphometric characteristics of nerve and vascular structures in death from blood loss complicated by hemorrhagic shock. The medulla oblongata of 12 corpses of persons who died from stab wounds of blood vessels and internal organs with sharp instruments at different times of the postmortem period was studied. Studies were carried out at stages of 6-8 hours, 12-14 hours, 18-20 hours, 24 hours or more of the postmortem period. It was found that as the interval after death from hemorrhagic shock increases, there is an increase in destructive changes, both neurons and intracerebral vessels in the medulla oblongata. Autolytic processes to a greater extent capture the intracerebral vessels comparing with neurons, which is more pronounced in the later stages of the study. The sizes of perineural and perivascular spaces in the dynamics of the postmortem period increase synchronously, which reflects the permanence of manifestations of tanatogenesis in different periods after death from hemorrhagic shock.

[Problems of establishing the prescription of death]. / Problemy ustanovleniya davnosti nastupleniya smerti.

Based on the analysis of literature data, demonstrated the relevance of further research to establish the prescription of death, including in a hot arid zone. Taking into account the climate of the seasons of Uzbekistan was stressed the importance of a comprehensive assessment of the dynamics of the development of cadaveric changes and supravital reactions, together with the results of biochemical, morphological and morphometric studies of the brain, other organs and tissues at different times of the postmortem period in certain groups. It could be used to develop additional criteria for establishing the onset of death in a hot arid zone.

[The state of brain ventricles and their ependima in different scenarios of traumatic blood loss].

The objective of the present study was to evaluate the state of ependima and the subependimal layer of the brain ventricles after death from the traumatic blood loss and in the cases of the blood loss under conditions of acute alcoholic and narcotic intoxication. The methods used for this purpose included light and scanning electron microscopy. It was shown that in subjects who died from the traumatic blood loss during acute alcoholic and narcotic intoxication ependima showed the signs of progressive polymorphism and had extensive areas of discontinued cell layers. Neuropil contained numerous vacuoles and blood effusion sites. The surface of ependima exhibited pathological erythrocytes, agglomerations of detritus, and crystalloid structures. The blood loss during combined alcoholic and narcotic intoxication resulted in more pronounced alterations in the ventricular walls.

[Forensic medical assessment of vascular and neuronal lesions in the brain associated with acute blood loss and anemia].

Brain tissues available for examination in the present study were obtained from 30 subjects who died from the blood loss following injuries to blood vessels and internal organs inflicted by sharp objects. The study revealed variable character of tanatogenesis induced by acute blood loss and anemia. Tanatogenesis associated with injuries to the heart and major blood vessels is most likely due to the deficiency of blood in the microcirculatory system developing in the terminal period. The main tanatogenic factors in subjects with multiple injuries to peripheral vessels are vascular dystonia and abnormal rheological properties of blood.

[Tanatogenetic aspects of brain injury associated with hemorrhagic shock in human].

Cadaverous brains of 21 men and women were available for investigation. All the subjects died in a hospital from hemorrhagic shock (HS) caused by stab injuries to internal organs and blood vessels. In 9 cases, blood and urine contained no traces of ethyl alcohol; it was detected in the blood of 12 cases (1.0-3.8 per thousand). Histological methods were used to examine field 6 of the brain hemispheres, the wall of the third ventricle with a fragment of pituitary, the wall of the fourth ventricle with the adjacent portion of medulla oblongata, and pia mater. It was shown that impossibility of reperfusion of cerebral vessels, especially those involved in microcirculation, plays the leading role in tanatogenesis associated with hemorrhagic shock. "Blockade" of the brain vascular system results in metabolic disturbances in neurons and neuroglia and their lesions regarded as the immediate cause of death. Acute alcohol intoxication concomitant with hemorrhagic shock accelerates tanatogenesis due to serious changes in the brain vascular system, neurons, and neuroglia.