[Establishment of mechanisms for the occurrence of blood imprints, taking into account their qualitative and quantitative indicators]. / Ustanovlenie mekhanizmov vozniknoveniya otpechatkov krovi s uchetom ikh kachestvenno-kolichestvennykh pokazatelei.

The purpose of the study is to establish the mechanisms for the formation of blood imprints, taking into account morphological features and some quantitative indicators of these blood traces. An analysis of the results of experimental modeling of contact marks (blood prints) resulting from the impact of a gloved hand is presented. The type of impact (shock, pressure) and duration of pressure (short-term pressure 1 - 3 sec, long-term pressure 20 - 120 sec) were determined. Under impact, the main elements of prints are formed regardless of the absorbent properties of trace-forming and trace-receiving objects: a) their contours (edges) are uneven, finely and coarsely serrated; b) the central part of the trace with an uneven thickness of the blood layer; c) second splashes are oval, spindle-shaped, ray-shaped (needle-shaped) and in the form of an exclamation mark; d) medium-speed elements - dynamic blood flows encircling or strip-like (long and narrow, short and wide). The absorbent properties of the trace-receiving material under pressure do not have a significant effect on the formation of the main elements of the traces: a) the contours (edges) of the prints are relatively even; b) the central part of the trace is more pronounced than the peripheral part, which is more clearly visualized on non-absorbent materials; c) low-velocity elements - «dynamic streaks¼ of blood are strip-like (short and narrow), appear only with sharp pressure, regardless of the exposure of the contact. For traces-imprints from long-term pressure, in contrast to short-term pressure, the following is characteristic: a) the thickness of the trace is on average 1.3-1.6 times greater with a high degree of significant difference in indicators (p<0.001); b) more uniform distribution of blood over the imprint area with a high degree of significant difference in indicators (from p<0.002 to p<0.001); c) clearer and smoother contours with a high degree of significant difference in indicators (p<0.002).

[Clinical and anatomical analysis of mortality from COVID-19 in sudden death and in those who died in health care facilities]. / Kliniko-anatomicheskii analiz letal'nosti ot COVID-19 pri skoropostizhnoi smerti i u umershikh v lechebno-profilakticheskikh uchrezhdeniyakh.

OBJECTIVE: Assessment of pathological and morphological changes in those who died from COVID-19 including persons received therapy in medical and preventive institutions (LPI) and who died suddenly from this pathology at home. The analysis data of the pathological and anatomical changes in 57 deaths from COVID-19 in hospitals and 74 forensic medical examinations where infectious pathology was established as the main cause of death are presented. For microscopy the sections were stained with hemotoxylin and eosin, OCG, immunohistochemical study with markers for CD3, CD 4, CD 20, SK-7. The mixed viral and bacterial lesions of the lungs were detected more often than pure viral infection in those who died suddenly from COVID-19 compared with people whose death occurred in medical facilities. This allows speaking about the lack of adequate antibiotic therapy out-patiently. Features of mononuclear lung infiltration in COVID-19 with a predominance of a moderately pronounced reaction of T-lymphocytes and a mild B-lymphocytic reaction indicate a decrease in immunological reactivity. Conducting clinical and anatomical analysis allows determining the features of pathogenesis and morphogenesis in each specific fatal case and informing the clinicians of health facilities (clinics and hospitals) allows the autopsy doctor (pathologist, forensic physician) to provide significant assistance in improving the quality of diagnosis and treatment of patients with this highly contagious severe viral disease.

[Morphological diagnosis of obstetric pulmonary embolism]. / Morfologicheskaya diagnostika akusherskoi tromboembolii legochnoi arterii.

Pulmonary embolism (PE) is one of the most common fatal complications in a wide variety of pathologies along the most common death causes of the population - diseases of the circulatory system and oncology. The development of PE in the postoperative and postpartum periods can also be fatal. The diagnosis of PE is very difficult and in 50-80% of cases it is not diagnosed at all. During autopsies it is important not only to diagnose PE but also to establish the source of its origin. An example of PE in a 34-year-old pregnant woman is given; the PE source was thrombosis of the right deep femoral vein facilitated by varicose veins of the lower extremities and severe preeclampsia. The presence of severe preeclampsia in a pregnant woman caused the development of venous sinus thrombosis accompanied by bilateral exophthalmos, necrosis of a pituitary gland part and progressive cerebral edema.

[Actualization of assessment of morphologic features of incisions and chop wounds of 'barrier' tissues of the head]. / Aktualizatsiia otsenki morfologicheskikh osobennostei rezanykh i rublenykh povrezhdenii 'bar'ernykh' tkanei golovy.

Aim of this study is to determine the influence of the basic conditions of the traumatic interaction of cutting and chopping objects with 'barrier' tissues of the scalp on the formation of morphological signs of damage. It was suggested to perform the comparative analysis of the morphological signs of incised and chopped scalp tissue wounds obtained by changing one given parameter in experimental damage modeling. The influence of the basic conditions of the traumatic interaction of cutting and chopping objects with the 'barrier' tissues of the scalp on the formation of morphological signs of the resulting damage was determined. The effectiveness of the proposed comparative analysis of morphological signs of incised and chopped lesions was confirmed.

Association of Polymorphism in SCN5A, GJA5, and KCNN3 Gene with Sudden Cardiac Death.

We studied association of single-nucleotide SCN5A (rs1805124), GJA5 (rs35594137), and KCNN3 (rs13376333) polymorphisms and sudden cardiac death. Humans died suddenly from cardiac causes (N=379) and unrelated sex- and age-matched control subjects were genotyped. No significant intergroup differences were found in the frequency of rs1805124 and rs13376333 genotypes and alleles. In women under 50 years, enhanced risk of sudden cardiac death was associated with rs35594137 GG genotype (OR=3.6; 95%CI=1.2-10.4; p=0.022), while in older women it was associated with rs35594137 AA genotype (OR=3.0; 95%CI=2.3-3.9; p=0.041). In women under 50 years, GA rs35594137 genotype was associated with a protective effect against sudden cardiac death (OR=0.3; 95%CI=0.1-0.8; p=0.036). Thus, GJA5 gene rs35594137 polymorphism is significantly associated with sudden cardiac death in the examined group.

[The expert assessment of kidney damage morphology for the elucidation of the mechanism, intravitality, and duration of the injury]. / Ekspertnaya otsenka morfologii povrezhdenii pochki pri ustanovlenii mekhanizma, prizhiznennosti i davnosti travmy.

The objective of the present study was the expert assessment of the morphological signs of renal lesions depending on the type of deformation associated with a blunt trauma. The authors proposed the algorithm for the description of a kidney damage taking into consideration the specific morphological features associated with a blunt trauma. The pathomorphological changes in the kidney tissue under the normal hemodynamic conditions and in the case of hemorrhagic shock at different times after the injury taking into account its organ specificity make it possible to reliably predict the duration of the post-traumatic period.

Ultrastructure of Cardiomyocytes and Blood Capillary Endotheliocytes in the Myocardium under Conditions of Experimental Mechanical Injury to the Heart.

We studied ultrastructural changes in cardiomyocytes and blood capillary endotheliocytes in the ventricular myocardium in response to mechanical injury of the heart of varying severity in Wistar rats. Acute alterative changes in cardiomyocyte and endotheliocyte ultrastructure indicate impairment of the energy-producing, contractile, and protein-synthesizing functions of the cells after mechanical injury. These disorders play the key role in the development of acute contractile insufficiency of the myocardium in mechanical injury to the heart.

Morphological Characteristics of the Cartilaginous Tissue of Human Auricle in Different Age Periods.

A complex morphological study of the auricle to determine the human age was performed by evaluating the metric sizes between fixed points in each auricle with axial guidelines. The auricular elastic cartilage in different age periods was characterized by thickening of the cartilaginous plate, different mature and immature cartilage zone ratio, variations in the volume density of the intercellular substance and elastic fibers, and change in the numerical density of individual chondrocytes and isogroups. Aggrecan content in the cartilage was shown to increase in different age periods. Age-related structural changes in the auricular cartilage expand the possibilities of forensic medical examination and hold much promise for the identification of personality.

[Pathomorphological characteristics of the myocardium in the heart stab wounds].

Pathomorphological characteristics of myocardium resulting from injuries to the heart are described with reference to their localization in different regions of the wound canal at different time periods after the injury. The studies were carried out with the use of light and polarized light microscopy.

[Assessment of ultrastructural changes in the contractile apparatus of cardiomyocytes after heart contusion].

Experimental simulation of heart contusion accompanied by acute insufficiency of myocardial contractility was followed by examination of myocardial tissue samples using transmission electron microscopy. Analysis of microstructural changes in cardiomyocytes revealed characteristic defects in their contractile apparatus. The results were used to substantiate mechanisms underlying acute insufficiency of myocardial contractility resulting from heart contusion.

[Sudden cardiac death and polymorphism of genes-candidates of cardiovascular diseases].

Aim of the study was to elucidate genetic markers associated with elevated risk of sudden cardiac death (SCD). We collected autopsy material during 1999 - 2001 in a process of forensic medical pathologo-anatomical examination of corpses of 182 men who had died suddenly in Octyabrsky district of Novosibirsk in the age of 25 - 64 years (mean age 53,6 +/- 7,9 years). We studied polymorphisms of the following genes: angiotensin converting enzyme - , glycoprotein IIb/IIIa - GPIIb/IIIa, alpha2b adrenoreceptor - ADRA2B, beta(1)-adrenoreceptor - ADRB1. Control comprised samples of population of men aged 25 - 35 and 55 - 64 years from the same district of Novosibirsk examined within framework of international WHO project MONICA. Comparison of frequencies of genotypes of polymorphism A1/A2 of GPIIb/IIIa gene in combined sample of population and group with SCD revealed in SCD group lowering of portion of A2/A2 homozygotes (5.0 and 1.2%, respectively, =0.029) and elevation of portion of A1/A2 heterozygotes (18.7 and 28.3%, respectively, =0.027). Odds ratio for a heterozygote to enter SCD group was 1.71 (95% confidence interval 1.0 to 2.77). Comparison of frequencies of genotypes and alleles of polymorphism A145G of ADRB1 gene in combined sample of population and group with SCD did not reveal any difference. Comparison of frequencies of polymorphism I/D of ACE gene in combined sample of population and group with SCD revealed significant lowering of frequencies of genotype I/I in SCD group (22.0 and 13.8%, respectively, p=0.033). There were no significant differences between SCD group and control in frequencies of studied polymorphism of alpha2b-adrenoreceptor gene.

[Histochemical study of the myocardium structure in the heart contusion].

The experimental modeling of heart contusion which was accompanied by ventricular fibrillation development was performed in Wistar rats, with the electrocardiographic study and subsequent histological and histochemical examination of the myocardium samples. Following heart contusion, acute circulatory disturbances, muscle fiber fragmentation, cardiomyocyte overcontraction or relaxation were detected in the myocardium. Also, the increase of total and intracellular calcium ion content in the myocardium was demonstrated. It is suggested that the mechanism of ventricular fibrillation development after heart contusion is associated with the increase of calcium concentration in both the cardiomyocytes and intercellular spaces leading to uncoordinated cardiac contractions.

[The use of a morphohistochemical method for the diagnosis of heart contusion].

This morphohistochemical study was carried out using myocardial tissue samples obtained from subjects with heart contusion. The aim of the study was to elucidate the cause of ventricular fibrillation associated with alternative myocardial insufficiency. It is concluded that changes of Ca2+ ion content in the myocardial tissue may be one of the factors contributing to the development of ventricular fibrillation.

[The demographic conditions of the moderately urbanized territory of the Western Siberia].

The investigation of the structure of the premature mortality of the population living on the moderately urbanized territory of the Western Siberia was carried out to determine the major trends in disease prevention and life-span. In Tomsk oblast the mortality continues to remain on higher levels first of all because of higher mortality of population due to accidents, traumatism and intoxications. The impact on the mortality of such factors as alcoholism, tobacco smoking, traffic accidents, violent acts has been increased. The lower indicator of the population life expectancy in Tomsk oblast is an evidence of adverse demographic situation. As estimated, in Tomsk oblast in 2004 this indicator came to 64.8 years (66.8years in the Russian Federation). The growth of absolute and relative numbers of non-able-bodied population leads to increase of demographic burden on the able-bodied population. Recently, this burden increased comparatively not much, yet the children burden decreased and the elderly population increased as well.

[Unfavorable outcome of medical service: study of the problem in forensic medicine].

The main tendencies in the development and study of the problem of unfavorable outcome and expert assessment of quality of medical aid were examined. Russian and foreign forensic medicine and juristic practice were compared. A combined approach to improve of forensic medical expertise and to prevent delinquencies of medical stuff was proposed.

[Morphofunctional interaction of adrenal zones in acute lethal carbon monoxide poisoning in people with alcoholic intoxication].

Morphological examination of human epinephroses at acute lethal poisoning with carbon monoxide against a background of alcoholic intoxication was done. Acute lethal poisoning with carbon monoxide decreases effect of alcoholic intoxication upon morphofunctional state of epinephroses and disorders characteristics of interzonal interaction. Interaction between zones of one epinephros recedes but interaction between both glands increases.

[Genetic variability and discriminating power of four microsatellite loci in Russian population].

Allele and genotype frequencies of 4 STR loci (LPL, vWA, FES/FPS H F 13B), used in forensic medicine, were analyzed in Russian Siberian population. Genetic and molecular diversity of these polymorphic systems were characterized in comparison with US Caucasoid population. High discriminating power (PD = 0.99975) of the system of four studied STR loci was shown. Comparative analysis of genetic diversity in Russian population and Caucasoid US population revealed the significant differences between two populations and demonstrated that STR frequency data for US population should not be used for forensic expertise in Russia. The data obtained in the current investigation may be used as reference data for forensic medicine laboratories in Siberia.

[Pathomorphology of the endocardium and myocardium in the heart injury].

Light, polarization, luminescent microscopy, phase contrast, special staining methods and scanning electron microscopy were used for studying sections and fragments of the endocardium and myocardium from 123 patients who had died of heart contusion and ischemic heart disease and from 50 rats with experimental heart contusion. The morphological classification of heart contusion and differential-diagnostic table of myocardial alterations due to contusion of the heart and ischemic heart disease are proposed to facilitate pathomorphological diagnosis of heart contusion. The classification of pathomorphological signs in heart contusion is presented.

[Forensic-medical assessment of pathomorphological changes in the myocardium in blunt chest trauma with an isolated heart contusion].

A total of 37 autopsy cases were divided into two groups. Group 1 consisted of 17 victims who had died of closed blunt trauma of the chest with isolated heart contusion made by fists, feet in shoes. Group 2 (control) consisted of 20 cases of sudden death of ischemic heart disease because of atherosclerotic cardiosclerosis. Fragments of the heart containing endocardium were studied on the microscope JEIL-SM200 (Japan). Endocardium pathomorphology was represented by relief changes of the endocardium, structural arrangement of separate groups of muscular fibers above the endocardium surface, hemorrhages and blood clots, endotheliocyte desquamation, prelacerations, lacerations and destruction of the endocardium.

[Allele distribution at the HVR-IgH hypervariable locus in unrelated individuals living in the Ural, Siberia, and northern Kazakhstan]. / Analiz raspredeleniia allelei gipervariabel'nogo lokusa HVR-IgH sredi nerodstvennykh predstavitelei naseleniia, prozhivaiushchego na territorii Urala, Sibiri i severnogo Kazakhstana.

Allelic polymorphism at a hypervariable locus mapped to the 5'-region of the gene cluster encoding JH segments of human immunoglobulin heavy chain H (IgH-VNTR) was typed in 462 unrelated individuals living in the Urals, Siberia, and Northern Kazakhstan. Molecular characteristics of the three previously unknown IgH-VNTR alleles is presented. The observed genotype frequencies were concordant with those expected under the Hardy-Weinberg distribution. The data obtained can be used in the work of regional forensic laboratories.