Comparison of Frontal Sinuses for Personal Identification in 3 Populations Using Cameriere's Code Number.

ABSTRACT: The identification of unknown individuals is of crucial importance to society, especially in the context of mass disasters involving individuals of different nationalities. The comparison of frontal sinus patterns is an important tool for personal identification. In Cameriere's method, a new personal code number (codC) containing 8 digits was elaborated, based on the measurements of frontal sinus patterns. The present study is an update of this previous work. Digital radiographic images of the skulls of 299 individuals of different nationalities (100 Italians, 99 Kosovars, and 100 Turks) were analyzed, adopting the same maximum-weight dependence tree used in the original work. For comparisons between groups, Fisher exact test and the χ2 test were carried out. The method, applied to different population groups, significantly increases the likelihood of identifying a person by comparison of antemortem and postmortem frontal sinus radiographs. Results demonstrated that the model is more discriminative in identifying individuals of different nationalities.

Assessment of private security guards by Suicide Probability Scale and Brief Symptom Inventory.

AIM: The aim of the present study was to investigate the influence of suicide probability and relevant sociodemographic features and to provide information for preventing suicide in private security guards working under the stressful conditions and continuous exposure to the negative and traumatic life events. METHODS: 200 private security guards and 200 personnels of Ankara University participated in the study. A sociodemographic information questionnaire, the Suicide Probability Scale (SPS) and the Brief Symptom Inventory (BSI) were used to collect the data. RESULTS: Gender, marital status, income, religious beliefs, experiencing a life-threatening situation, history of a suicide attempt, smoking and not having a chronic disease caused statistically significant differences in the scores for SPS between the private security guards group and the controls. Moreover there was a statistically significant positive correlation between the total scores of the subscales of SPS and the total scores of BSI. CONCLUSIONS: Like police officers and gendarmes, private security guards are at high risk of committing and attempting suicide because of being at stressful work settings and also suffering from secondary trauma. It is required that they should be aware of their tendency to commit suicide and have regular psychiatric screenings.

A descriptive study of female suicide deaths from 2005 to 2011 in Van city, Turkey.

BACKGROUND: Female suicide is an important problem not only for women but for public health in general. METHODS: Autopsy reports from the Van Chief Public Prosecutor's Office from 2005 to 2011 were reviewed retrospectively in order to analyse female deaths from suicide. RESULTS: Sixty-six female suicide cases were recorded during 2005-2011. The mean age of the cases was 22.64 (sd = 10.09) years, and nine were below the age of 15. The most common method of suicide was hanging (44 cases, 66.7 %). Five (7.6 %) of the cases were under treatment for depression, and 12 (18.2 %) cases had a previous suicide attempt. CONCLUSIONS: Cultural suppression of females and prevention of their socialization in enclave societies are risk factors for female suicides. The number of female suicide attempts, especially recurring attempts, should be reduced via psychiatric scanning, follow-up sessions and therapy for high-risk individuals.

Analysis and comparison of domestic femicide cases in the cities of Diyarbakir & Tekirdag, Turkey: A preliminary study.

Court decision files from 2007 to 2012 were examined retrospectively in the Criminal High Courts of Diyarbakir and Tekirdag to analyse and compare domestic femicides in Diyarbakir and Tekirdag, Turkey, according to different fundamental characteristics. In total, 58 assailants were convicted of 50 femicides during this period. There were no so-called 'honour killings' in Tekirdag, while 16 (37.2%) of the homicides were honour killings in Diyarbakir. Policies to prevent violence against women, extending the means of access to post-violence services and reinforcing the law, policies and action plans to end this type of violence could be effective in decreasing cases of domestic femicide.

Customary Homicides in Diyarbakir Province.

This study presents an analysis of the causes of so-called honor killings in the context of "customary homicide" and a discussion of preventive measures. Finalized case files of customary homicide between January 1, 2007 and December 31, 2012 were retrospectively examined in Diyarbakir Province, Turkey. Of a total of 28 case victims, 17 (60.7%) were females and 11 (39.3%) were males. All perpetrators were male. There was a significant difference between male and female victims in terms of economic independence (p=0.000). A direct blood relationship or relationship by marriage (such as brother-in-law) was found to have a significant association with the gender of the victim (p<0.001). Multilevel educational activities targeting a transformation of the perception of women by society, replacement of patriarchal models with more modern attitudes, and encouragement of individuality may represent effective strategies that may help reduce the number of customary homicide, which represents a multifaceted problem.

Neonatal line on fetus and infant teeth: An indicator of live birth and mode of delivery.

BACKGROUND: The neonatal line (NL) is an important issue in forensic odontology. It is the sign of a developmental birth defect, which is caused by the effect of metabolic stress on tooth structures when the fetus passes to extrauterine life. AIMS: The aim of this research is to determine the existence and thickness of NL in teeth, as it is a legal necessity to indicate the signs of viability at birth in a forensic examination of a fetus or infant case. STUDY DESIGN AND SUBJECTS: This research was conducted on 48 lower left and right lateral teeth, which were taken from 24 autopsy cases (46% female and 54% male). Left lateral teeth were sectioned in a vertical plane and right lateral teeth were sectioned in a horizontal plane. The NL thickness was measured with a scanning electron microscope (SEM). These cases comprised three conditions as: 70.3% normal birth, 16.7% caesarean sections, and 12.5% still birth cases under the legal and ethical permission. OUTCOME MEASURES: The mean NL thickness of normal birth cases was higher than caesarean cases as 7.7µm and 2.5µm, respectively. RESULTS AND CONCLUSIONS: The results showed a statistical significance between all birth conditions. NL does not exist in still birth cases (p<0.001). Not only is the presence of NL a sign of live birth, but also its thickness is an indicator of the delivery mode where NL thickness of normal birth was found thicker than the caesarean cases.

Age estimation from fetus and infant tooth and head measurements.

Forensic identification comprises legal, social, ethical, and religious aspects where age detection is an important factor. When the case is a fetus or infant, recording various measurements of the body, head, and teeth is essential. The aim of this research is to evaluate the effects of different tooth and body measurements and their implications on the age estimation of fetuses and infants. This research was performed on 96 fetus and infant incisor teeth taken from 24 autopsy cases (54 % males and 46 % females) where age of the subjects were within the range of prenatal 16 weeks to postnatal 72 weeks. The data were statistically processed by regression analysis via curve estimations. According to the results, growing patterns of the head circumference (HC) and the upper central tooth measurements indicate a strong relationship, where there is no significant difference for both sexes. The growth patterns of all variables showed a linear function to a certain age (approximately 56 weeks pre-plus postnatal); the tooth height (TH) slightly increases until the closure of the root apex, and the HC gradually stabilizes in time, therefore a log-linear relation was found considerable. The results revealed eight age estimation formulas, including the combination of HC with the labiolingual, mesiodistal (MD), crown height, and TH measurements. Among these, only MD can be applied to a living. In conclusion, tooth and head measurements are found to be the main factors of age estimation formulas.

Differences in the number of autopsies and causes of death between the months of Ramadan and control months and between two cities, Ankara and Bursa in Turkey.

AIM: To investigate differences in the number of autopsies and causes of deaths affected by spiritual factors and concentration during Ramadan and to compare the results from two cities, Ankara and Bursa. METHODS: Autopsies performed in morgue departments of the Council of Forensic Medicine, Ministry of Justice, in Ankara and Bursa during Ramadan and non-Ramadan (control) months between 2003 and 2006 were retrospectively investigated for age, sex, cause of death, manner of death and blood toxicological analyses. RESULTS: The number of autopsies was significantly higher in Ramadan months than in the control months in Bursa, but low and insignificant in Ankara. A significant decline in traumatic deaths was observed during Ramadan (p less than 0.05). CONCLUSION: During Ramadan, while rates of homicidal deaths displayed a relatively steep decline in females, the rates of homicide were increased in males. This might be due to a decrease in natural deaths and accidents. To make further comments, conducting studies evaluating detailed socio-demographic features and assessing relevant psychological states of the victims can be beneficial.

Age and sex estimation by metric measurements and fusion of hyoid bone in a Turkish population.

The hyoid bone is of great importance in forensic medicine practice and it has been studied for various forensic purposes; however, there have been few studies dealing with age and sex estimation using the hyoid bone. Using discriminant function analysis this study attempts to determine the utility of metric measurements and non-metric variations of the hyoid bone in terms of estimation of sex and age in a Turkish population and to find out differences with other populations by comparison of obtained results with the literature. For this purpose, the hyoid bones of 85 cadavers of known sex and age were extracted and 33 measurements were made with a computer program following photography with a camera. In addition to these measurements, the degree of fusion of the greater cornua to the hyoid corpus was examined. Out of 33 measurements, 18 showed significant sex-related differences. There was a sharp rise in hyoid bone fusion in both males and females after the age of 60 years. However, no marked sex-related differences were observed regarding fusion. The unstandardised canonical discriminant function was estimated based on three variables, and the correct classification ratio was 77.4% for males and 81.3% for females. The obtained findings suggest that measurements of hyoid bone can be used for sex estimation in the Turkish population.

Anatomic relationship between the anterior sylvian point and the pars triangularis.

The aim of this study was to show morphological sulcal variations of the pars triangularis of the inferior frontal gyrus and to provide a clearer description of the anterior sylvian point. Thirty-six hemispheres of 18 adult cadavers were studied. The hemispheres were harvested by the classical autopsy method and fixed in 10% formalin solution for three weeks. In six hemispheres, the arteries and veins were filled with colored silicone. The proximal and distal segments of the sylvian fissure, the perpendicular distance of both the anterior sylvian point and inferior rolandic point to the insular cortex and the distances between the anterior ascending ramus and the precentral, central, and postcentral sulcus were measured. The anterior horizontal and ascending rami were exposed. The sulcus located on the pars triangularis was appraised. The relationship between the anterior sylvian point and the vascular structure around the sylvian fissure was examined. The rising of the anterior horizontal and ascending ramus from the sylvian fissure defines the shape of the pars triangularis. The pars triangularis has three shapes: V, U, and Y. In V- and Y-shaped pars triangularis both rami merge but in U-shaped pars triangularis the rami do not merge. The pars triangularis was Y-shaped in 30.76% (4/13) of the right hemispheres and in 50% (7/14) of the left hemispheres; U-shaped in 20.3% (3/13) of the right hemispheres and in 35.71% (5/14) of the left hemispheres; V-shaped in 40.61% (6/13) of the right hemispheres and in 14.29% (2/14) of the left hemispheres. Minimally invasive procedures use basic anatomic landmarks intracranially to reach the targeted area; therefore, exact and detailed knowledge of the anatomy of the sylvian fissure and pars triangularis is of great importance.

Characterization of the anatomic location of the pituitary stalk and its relationship to the dorsum sellae, tuberculum sellae and chiasmatic cistern.

OBJECTIVE: The normal anatomic relationships characteristic of the pituitary stalk area were previously thought to involve only one location. The purpose of this study was to re-evaluate the anatomic location of the pituitary stalk and possible varying locations in relation to the tuberculum sellae and dorsum sellae using morphometric evaluation and anatomic dissection of human cadaveric specimens. The surgical implications of the variations are discussed. METHODS: The calvaria were removed via routine autopsy dissections, and the brains were removed from the skull while preserving the pituitary stalk. The diaphragma sellae, tuberculum sellae, and the location of the pituitary stalk were examined in 60 human cadaveric heads obtained from fresh adult cadavers. Empty sellae were excluded. RESULTS: The openings of the diaphragma sellae averaged 6.62 +/- 1.606 mm (range, 3-9 mm). The distance between the tuberculum sellae and the posterior part of the pituitary stalk was 1 to 8 mm. The upper face of the diaphragma sellae appeared flat in 26 (43%), concave in 24 (40%), and convex in 6 cases (10%), with a prominent tuberculum sellae in 4 cases (7%). The location of the chiasm was normal in 47 cases (78%), with a prefixed chiasm in 3 cases (5%) and a postfixed chiasm (17%) in the 10 cases. Four cadaver specimens had prominent tuberculum sellae and other parameters were not evaluated. CONCLUSION: When opening the chiasmatic cistern, neurosurgeons should be aware about the relationship between the pituitary stalk and the surrounding structures to prevent inadvertent injury to the pituitary stalk.

Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007.

BACKGROUND: In previous studies, some features of suicidal firearm deaths have been described, but series of suicidal deaths using shotgun are limited in the literature. The aim of the present study was to define several characteristics of suicidal shotgun deaths. METHODS: In this study, we reviewed retrospectively 36,971 autopsy reports recorded by the Mortuary Section of the Forensic Medicine Council of Istanbul between January 1, 1998 and December 31, 2007. RESULTS: Seventy-three shotgun-related suicide cases were evaluated. Of the 73 cases, 46 (63%) were male and 27 (37%) were female. Most of the cases (n=36, 53.4%) were aged 16-20 years (p<0.001). Sixty-two of the suicides (84.9%) occurred in victims' homes (p<0.001). A suicide note was recovered in 7 cases (9.6%). While entry wounds were on the head in the majority of the cases (n=29, 39.8%) (p<0.001), in nearly half of the female victims (n=12; 44.4%), entry wound was in the abdominal region. Fifty-six shots (76.7%) were determined to be from loose-contact range (p<0.001). Ethyl alcohol was detected in 17.8% (n=13) of blood samples of the cases. CONCLUSION: Handling and usage of shotguns should be under strict control, educational efforts should be directed to early and late adolescents and their parents and psychological support centers should also be founded in an effort to prevent suicidal deaths with shotguns.

Autopsy findings of suicidal deaths committed by firearms in Ankara, Turkey.

The purpose of this study was to examine autopsy findings from suicidal deaths using firearms in Ankara, Turkey, and to compare the results with those reported from other studies. We retrospectively evaluated suicidal deaths by firearms referred for autopsy to the Morgue Department, Institute of Forensic Medicine, between 2002 and 2004. Results were subjected to discriminant analyses using SPSS 11.5 package program. One hundred and fifteen cases (83.3%) were male, the ratio of male to female was 5 to 1 and the mean age was 31.96 years (range:12-85 years). Forty cases were aged between 12 years and 20 years, 28 were aged between 0 and 18 (20.29%). One hundred and thirty-three cases (96.4%) had one bullet entry and five cases (3.6%) had two bullet entries. Out of 143 bullet entries, 116 (81.12%) were caused by gunshots fired from contact or near contact range. Regarding bullet entry sites, 103 (72.03%) were on the head with 56 (54.37%) located on the right temporal region. Gunshot related crimes are an increasing cause for concern in Turkey. However, a simple preventive measure may prevent the suicidal deaths of many young people.

Age determination from central incisors of fetuses and infants.

Age at time of death for a fetus or infant is an important issue in the field of forensic science. Dental development can give an accurate measure of infant and fetal age and current literature does not include any studies of dental age from central incisor development. The objective of this study is to determine the age of deceased fetuses and infants by examining metric tooth development of central incisors in deceased fetuses and infants. Five dimensions of 76 maxillary and mandibular central incisors were measured: mesio-distal (MD), bucco-lingual (BL), crown height (CH), crown thickness (CT), and root height (RH). The results showed that 44.45+/-0-2 weeks is a sectional time for age calculations, which corresponds to 40 weeks from conception plus 4 to 5 weeks after birth. Four ATA entitled age formulas are derived to give the relation of age with tooth dimensions before and after 44.45 weeks [ATA is the special name given to the honor of the great Turkish leader Mustafa Kemal Atatürk (1881-1938)]. Age estimation can be calculated from these formulas with an accuracy of the age +/-0-2 weeks. Also, calcification time can be determined from ATA formulas. In conclusion, the age of fetuses and infants can be assessed by the measurements of a single central incisor. According to this research, when estimating age during identification studies, forensic researchers must take into consideration the period of embryonic human growth and development.

Evaluation of forensic perinatal and neonatal autopsies in Istanbul.

OBJECTIVE: Autopsy findings play an important role in prevention of perinatal and neonatal deaths. Therefore, we attempted to reveal demographic and forensic features of these deaths in Turkey. METHODS: We retrospectively reviewed autopsy reports for 184 cases of perinatal deaths released from Istanbul Forensic Medicine Institute Morgue between 2000 and 2002 and investigated demographic and medico-legal features of the cases. RESULTS: The mean age of the cases was 2.98 +/- 6.41 days. Fifteen point two percent (15.2%) of the cases were of murder, 52.7% of the cases were illegitimate children and 41.3% had the ability to survive. CONCLUSION: It can be suggested that autopsy and post-mortem examinations should be performed in order to determine the real causes and contributing factors of perinatal and neonatal deaths. Data obtained in autopsies and postmortem examinations will make great contributions to the prevention of these deaths.

Medico-legal child deaths in Istanbul: data from the Morgue Department.

BACKGROUND: Before determining health policies, finding solutions to problems and taking precautions, one should define the problems and their regional and national dimensions. Data about causes of death vary from country to country and, therefore, it is clear that precautions should be based on regional data and needs, which will be more effective. METHOD: The authors reviewed deaths among children aged 1 month to 18 years, whose autopsies were performed in the Morgue Department, State Institute of Forensic Medicine, Istanbul, Turkey, between 2000 and 2002. RESULTS: The authors evaluated autopsy reports about 736 child deaths. The mean age of the children was 8.77 +/- 6.25 years and 62.8% of the children were male. As to causes of death, the most frequent was asphyxia. Almost half of them were caused by mechanical asphyxia due to drowning. A total of 48.5% of the deaths were accidental. There was a significant difference in causes of death between children aged 11 years or younger and those aged over 11 years. Death due to nontraumatic conditions and poisoning was predominant among children aged 11 years and younger, while death due to gunshot wounds and stab wounds was predominant among children aged more than 11 years. There was a significant difference in causes of death between females and males. CONCLUSION: Asphyxia, poisoning and blunt traumatic injuries were found to be the leading causes of death, which can be prevented or decreased by certain precautions. As a result, new regulations should be enacted to protect children against accidents, injuries and hazards and a child protection program is needed in Turkey.

Determination of gender by measuring the size of the maxillary sinuses in computerized tomography scans.

BACKGROUND: Identification of corpses is a difficult forensic procedure and it is mandated by laws and social rules. Comparison of ante mortem and post-mortem medical records, such as dental documents, plays an important role in the identification of corpses. However, typical identification methods may be inconclusive, especially when certain extreme post-mortem changes have developed. Gender has long been determined from the skull, the pelvis and the long bones with an epiphysis and a metaphysis in unknown skeletons. The aim of this study was to investigate whether the width, the length and the height of the maxillary sinuses could be used for determination of gender. MATERIALS AND METHODS: The width, the length and the height of the maxillary sinuses were measured in 127 adult patients who were admitted to the Department of Radiology for computed tomography scans of their sinuses. Of 127 patients, 62 (48.8%) were females and 65 (51.2%) were males. The width, the length and the height of the maxillary sinuses were measured in Computerized Tomography scans (Hitachi Radix Turbo computed tomography) when the patients were in prone position without sedation or contrast medium. The data were subjected to a discriminative analysis using the SPSS package program (Version 11.5). RESULTS: The discriminative analysis showed that the accuracy of maxillary sinus measurements-i.e. the ability of the maxillary sinus size to identify gender-was 69.4% in females and 69.2% in males. CONCLUSION: Computerized Tomography measurements of maxillary sinuses may be useful to support gender determination in forensic medicine; however, with a relatively low-accuracy rate (less than 70%).

Critical course of the anterior laryngeal branch of the inferior laryngeal nerve.

BACKGROUND: Although in the past few authors stated that the nerve penetrated the ligament of Berry, many new authors have not confirmed this assertion. Because of the clinical importance and indefiniteness of this subject, we aimed to present an anatomical study concerning the course of the inferior laryngeal nerve. METHOD: In 60 specimens, 102 sides were examined for this project, including 41 male and 19 female cadavers between the ages of 40 and 89 years at death. RESULTS: In two sides (one on the right and the other on the left), we found that the anterior (motor) laryngeal branch of the inferior laryngeal nerve penetrated the ligament unilaterally. The branch entered the ligament 5.6, 7.2 mm above its lower border and 3.3, 1.9 mm below its upper border. Distances from the entrance point of the branch to the trachea and thyroid were 9.5, 8.2 mm and 3.1, 2.2 mm, respectively. CONCLUSION: We found two anterior laryngeal branches penetrating the ligament of Berry. This subject is very important during the thyroid surgery, particularly during the division of the ligament for total lobectomy.

Laryngeal branching pattern of the inferior laryngeal nerve, before entering the larynx.

The objective of the present work was to investigate the laryngeal branching pattern of the inferior laryngeal nerve (ILN) in detail before the branches entered the larynx. In 49 specimens 96 sides were examined for this project, including 27 males and 22 female cadavers. In 7 sides (7.3%, 5 on the left and 2 on the right) the ILN passed as a single trunk into the larynx below the inferior constrictor muscle. In 82 sides (85.4%, 40 on the left and 42 on the right) two laryngeal branches originated from the nerve. The nerve divided either just before entering the larynx (58.3%, 24 on the left and 32 on the right) or 15-32 mm below the inferior constrictor muscle (27.1%, 16 on the left and 10 on the right). In 69 sides (71.8%), the anterior and/or posterior laryngeal branches subdivided into one or two sub-branches. The anterior (observed in 49 sides, 51%) and posterior laryngeal branches supplied all intrinsic laryngeal muscles except the cricothyroid muscle and the mucosa below the vocal cords, respectively, while their sub-branches reached the cricopharyngeal part of the inferior constrictor muscle, esophagus and/or the thyroid gland. In 7 sides (7.3%, 4 on the left and 3 on the right) the nerve divided into three laryngeal branches. In conclusion, the branching pattern of the nerve may be important pitfalls of the thyroidal and laryngeal surgery. Owing to this the surgeon should keep in mind the risk of extra laryngeal division of the nerve and not confuse laryngeal and extra laryngeal branches.