[Morphological markers of liver function in alcohol intoxication]. / Morfologicheskie markery funktsional'noi aktivnosti pecheni pri alkogol'noi intoksikatsii.

The aim of this study was to find additional diagnostic markers characterizing the functional state of the liver to substantiate the cause of death from ethanol poisoning. A total of 95 deaths from acute ethanol poisoning and 15 deaths from craniocerebral injury were studied. Signs of steatosis, chronic hepatitis or cirrhosis were taken into account in histological examination of the liver. The histochemical activity of ethano-locking enzymes was determined in structurally functional zones of the acini: portal pathways (Zone 1), liver beams (Zone 2) and central veins (Zone 3). Quantitative indices characterizing functional-metabolic activity of the liver during acute ethanol poisoning were obtained.

[The problems of differential diagnostics and forensic medical expertise of various forms of craniocerebral injuries].

The problem of differential diagnostics and forensic medical expertise of various forms of craniocerebral injuries is discussed. It is concluded that clinical and laboratory studies are insufficient to objectively estimate the results of the examination. The authors emphasize the importance of searching for new and more informative diagnostic techniques.

[Simulation of parameters of alcohol-oxidizing enzyme systems and pathomorphological characteristics in situations of acute ethanol poisoning and ischemic heart disease].

Morphometric characteristics and forensic chemical information used in diagnostics of acute ethanol intoxication and coronary heart disease in conjunction with macro- and microscopic pathomorphological signs of the changes in the heart, liver, and kidneys provide data that may suggest the presence of pathology but do not permit to reliably identify it. In this context, evaluation of activities of alcohol-oxidizing enzyme systems acquires clinical significance. The analysis of correlations between quantitative parameters supplemented by the construction of binary models allows to objectively interpret the conclusions about the cause of death in each concrete case of acute ethanol poisoning and coronary heart disease.

[On the importance of a comprehensive study for diagnostics of death from acute ethanol poisoning and coronary heart disease].

Over 30 000 cases of acute poisoning with ethyl alcohol and its surrogates are recorded annually in this country. Differential diagnostics between fatal poisoning and death from coronary heart disease encounters serious difficulties. The authors report a comprehensive forensic chemical, morphometric, and pathomorphological study of the activity of ethanol-oxidizing enzyme systems in the internal organs. The results of histochemical examination provide a basis for the extension of diagnostic potential of the available methods and the enhancement of the objective value of expert reports.

[Computer analysis of erythrocyte catalase activity in diagnosis of mild brain trauma and concussion].

A complex investigation of catalase activity in erythrocytes was conducted basing on the results of computer quantitative morphometry of histochemical examination of blood samples from persons with mild craniocerebral trauma. It was found that erythrocytic catalase activity correlates with severity of brain trauma. A novel technique of objective histochemical diagnosis of trauma is described. It provides objective grounds for expert conclusions. Differential features of erythrocytic shape were defined in a small series of micropreparations vs the rest blood samples.

[Significance of histochemical parameters of erythrocyte catalase activity for diagnosing mild concussion and contusion of the brain]. / Znachenie gistokhimicheskikh pokazatelei katalaznoi aktivnosti éritrotsitov dlia diagnostiki sotriaseniia i ushiba golovnogo mozga legkoé stepeni.

A total of 227 primary and repeated forensic medical expert conclusions in victims with slight craniocerebral injuries (CCI) are analyzed. Erythrocyte catalase (CTer) activity was analyzed on the basis of the results of computer quantitative morphometry of histochemical analysis of blood smears from 50 victims with slight CCI. CTer activity correlated with the severity of CCI. A new objective method for histochemical diagnosis of slight concussion and contusion of the brain is suggested, which rules out errors in forensic medical expert evaluations in examinations of this category of victims.

[Blood and liver monoamine oxidases in fatal alcoholic intoxication]. / Sostoianie monoaminoksidaz krovi i pecheni pri smertel'nykh alkogol'nykh intoksikatsiiakh.

Biochemical studies of monoamine oxygenases (MAO) were studied in albino rats and in subjects dead from ethanol poisoning, alcoholic cardiomyopathy, and coronary heart disease. Experiments demonstrated that chronic alcoholization leads to increase in the levels of both types of MAO (A and B), the longer the alcoholization, the more pronounced the increase. Intake of high ethanol doses in the course of regular alcohol abuse involves a drop in MAO activity (by 1.9-2-2 times). Study of MAO helps detect chronic alcoholization and differentiate it from coronary heart disease and alcoholic cardiomyopathy and thus make an objective conclusion about the cause of death and thanatogenesis.

[Current trends in the dynamics of violent and nonviolent deaths and the problems in recording them]. / Sovremennye tendentsii v dinamike nasil'stvennoi i nenasil'stvennoi smerti i problemy ikh ucheta.

The number of forensic autopsies in cases with violent and spontaneous deaths increases from 1984 to 1996 by 11.1 and 25.8%, respectively. The rate of increase in the incidence of violent deaths outstripped 1.6 times the total mortality values. This resulted in an essential increase in the work loading of experts, with an increase in the number of complex expert evaluations. The system of registration of violent deaths is imperfect: it does not provide accurate data on the number of murders and suicides, which are overrated at regional statistical departments in comparison with the records of legal organs, while the values recorded at statistical departments are notably underrated in comparison with forensic medical records. The authors offer amendments and revisions for the current form of medical certificate of death and the order of its filling, granting, and storage.

[Specific features of kidney injuries altered by disease]. / Ob osobennostiakh travmaticheskogo povrezhdeniia boleznenno izmenennykh pochek.

The degree of development of subcutaneous fat and muscles of the back, filling of the gastrointestinal tract, increase in intra-abdominal pressure, and pathological processes, specifically, cysts, hydronephrosis, tumors, pelvic stones, etc., play a significant role in the development of renal injuries. A case with a kidney rupture resultant from a slight trauma in a 19-year-old soldier is presented. Analysis of nephrectomy, review and intravenous excretory urography, and pathological examination of the removed kidney showed third-stage hydronephrosis. This diagnosis was significant for evaluation of the severity of corporal injuries and for determining the punishment for the guilty subject.

[The status of the ethanol-oxidizing enzyme systems in fatal alcohol poisonings]. / Sostoianie étanolokisliaiushchikh fermentnykh sistem pri smertel'nykh travleniiakh alkogolem.

The alcohol dehydrogenase, microsomal ethanol-oxidizing, and catalase-peroxidase enzymatic systems of the liver, myocardium, and kidneys were studied in 357 experiments by simulating acute and chronic alcohol poisoning and in 45 forensic medical expert evaluations of acute alcohol poisoning, 17 lethal cases of coronary disease, and 9 lethal cases of alcohol-induced cardiomyopathy. Graphic models representing the activities of ethanol-oxidizing enzymatic systems have been developed. The results appreciably extend the diagnostic potentialities and, together with analysis of pathomorphological and forensic chemical findings, help disclose the numerous variants of thanatogenesis in alcoholic intoxication, alcohol-induced cardiomyopathy, and coronary disease, which are individual and depend on the genetically determined activity of the enzymatic systems, presence and severity of concomitant diseases, duration and regularity of alcohol consumption, and other causes.

[The importance of assessing the morphofunctional state of the liver in the diagnosis of fatal alcoholic intoxication]. / O znachenii otsenki morfofunktsional'nogo sostoianiia pecheni v diagnostike smertel'nykh alkogol'nykh intoksikatsii.

The morphology and function of the liver was studied by pathomorphological, gas chromatographic, and histochemical analysis in 108 forensic medical expert evaluations of alcohol poisoning, coronary disease, alcohol cardiomyopathy, craniocerebral injury, and mechanical asphyxia. Ethanol concentrations in the blood collected from various parts of the venous system varied: in 69% of cases the level of ethanol was higher in the inferior vena cava than in the portal vein. Histochemical analysis of ethanol-oxidizing enzymatic systems together with pathomorphological findings and alcohol measurements in various parts of the venous system help assess the morphology and function of the liver, define the thanatogenesis, and draw objective expert conclusion on the cause of death.