Age at Death Estimation in Adults by Computer-Assisted Histomorphometry of Decalcified Femur Cortex

Abstract:  In 1965, Kerley pioneered histomorphometry of bone as an aging method. The technique has been modified by several authors, and some have used computer-assisted image analysis. Undecalcified bone sections used in these methods are obtained with a diamond wafer saw or by grinding the sections manually or automatically with abrasive paper. In the present study, we examined the application of histomorphometry to decalcified bone sections, routinely obtained in every pathology lab, from paraffin blocks cut with a standard microtome. This study was divided into two parts: in the first, we tested different decalcifying methods to determine the most appropriate for femoral bone; in the second part, we used computer-assisted histomorphometry to estimate age at death in 29 samples of femoral bone. We measured intact osteon density (N.On), fragmented osteon density (N.On.Fg) and percentage of lamellar bone surface per unit area (Lm.B.Ar) in the cortex of the femoral midshaft, on four or 20 fields per section. We found that 20% nitric acid solution at room temperature proved to be the best decalcifying method, with a mean decalcification duration of 1 week. Fragmented osteon density was found to be the morphometric feature most closely correlated with age, followed by intact osteon density; Lm.B.Ar. did not increase accuracy. The best accuracy (4.1 ± 3.5 years) was obtained for individuals under the age of 70 when measurements of 20 fields were used for the analysis. For all individuals, the inaccuracy was 6.1 ± 6.2 years and 8.1 ± 8 years, with 20 and four fields respectively. The present study shows that decalcification of bone sections can be used for age estimation at death. This procedure is particularly useful in case of mass disaster as it is easily done in any pathology department.     

青海藏獒尘肺的病理学观察

采用光镜和电镜技术对青海省果洛藏族自治州达日县的5例成年藏獒的肺、支气管淋巴结和纵隔淋巴结进行了病理学观察.结果表明,5例藏獒肺均有程度不等的尘肺病变,其中3例尘肺病变相对较重.表现为局灶型或弥漫型尘肺病变.局灶型尘灶与尘细胞结节呈星状、散状分布,多位于细支气管周围、肺泡隔和肺胸膜结缔组织中;弥漫型则尘灶与尘细胞弥漫性分布于大范围肺组织中,尘灶周围及尘细胞浸润局部有大量淋巴细胞浸润和结缔组织增生,局部肺泡隔因结缔组织增生而显著增宽,肺泡腔萎缩,肺组织结构破坏.细支气管周围常有慢性炎症,其下段管腔常可形成扩张和肺气肿区.同时,5例尘肺病例中均有程度不等的单核巨噬细胞性肺炎.5例支气管淋巴结和纵隔淋巴结均有严重的尘灶和尘细胞结节.3例出现灶性或较大范围纤维化.电镜观察发现,肺及淋巴结中尘细胞线粒体肿胀空泡化,内质网扩张,细胞中有大量尘粒聚集,尘粒聚集处细胞器破坏.尘细胞周围的肺泡上皮细胞也有程度不等的退行性变化.表明,青海藏獒尘肺为无机尘肺与有机尘肺组成的混合性尘肺,其发生与当地的环境密切相关.     

水、油污中无电流斑电击死大鼠皮肤和心肌的病变

目的探讨水中、油污中无电流斑电击死法医学鉴定的病理形态学依据。方法 SD大鼠28只,分为水中、油污中无电流斑电击死各1组,典型电流斑组、正常对照组、死后电击组、死后水中、油污中电击各1组共7组。采用肉眼、光镜及投射电镜观察水中、油污中无电流斑电击死大鼠皮肤和心肌组织病理学改变,并与其它各组进行比较。结果采用肉眼观察,生前水中、油污中无电流斑电击死大鼠皮肤未见明显电流斑。普通光镜观察,可见电击中心部位表皮变性坏死、脱落,表皮细胞变薄、致密,表皮细胞或/和毛囊、汗腺、皮脂腺发生极性化改变。电镜观察,透明层和角质层分离脱落,基底细胞肿胀、细胞器减少、核固缩,汗腺导管上皮肿胀,棘细胞中粗面内质网扩张融合成泡状,线粒体肿胀空泡化;但光镜与电镜的变化与生前电击死比较不明显、典型。而死后电击组皮肤则无明显病理学改变。实验各组大鼠心肌的改变与皮肤改变类同。结论采用光镜和投透射电镜观察在潮湿环境中电击死的组织病理学改变,可为无电流斑电击死提供依据。     

Usefulness of Systematic Histological Examination in Routine Forensic Autopsy*

Abstract: The forensic community does not agree on the need to perform histological examination at forensic autopsy. The aim of our study was to determine the usefulness of systematic standard histology in forensic autopsies. A prospective study was carried out on 428 autopsy cases for which standard histological examination was systematic. Mechanism of death not shown by gross anatomic findings was discovered by histology in about 40% of the cases. Cause of death was established by only histology in 8.4% of the cases. Microscopic findings affected the manner of death in 13% of the cases. Histology provided complementary information about prior medical condition of the deceased in about 49% of the cases. Traumatic lesions were better documented by histology in about 22% of the cases. According to the results of our study, systematic standard histology for the main organs should be used in routine forensic autopsies.     

探讨急性酒精中毒者的刑事责任能力

我国刑法第18条第四款规定"醉酒的人犯罪,应当负刑事责任。"自从上世纪80年代末期复杂性醉酒的类型从日本引进中国后,司法精神医学界逐渐放宽了相当一部分醉酒者的刑事责任能力评定标准。这似乎有悖于现行法的规定,为了使该范围的鉴定与现行法规保持一致,笔者从医和法的两维角度探讨了如何评定急性酒精中毒者的刑事责任能力。     

剑尾鱼感染嗜水气单胞菌的动态病理变化观察

对剑尾鱼感染嗜水气单胞菌的病理变化进行了全面细致的观察。结果显示 :剑尾鱼感染发病呈急性过程 ,感染后 10～ 15h为发病死亡高峰期 ;病理组织学变化以全身溶血性贫血和广泛的组织细胞变性、坏死为主 ;感染发病死亡时间主要集中在 5～ 2 4h ,感染部位和鳃最先受到损伤 ,最终因各器官结构破坏、功能衰竭和窒息而亡。     

三聚氰胺对小鼠急性毒性试验中消化系统重要组织器官损伤的病理学观察

为探讨三聚氰胺对急性毒性试验中小鼠的胃、小肠和肝的损伤作用,将32只SPF级昆明小鼠随机分为4组,每组8只,雌雄各半,连续灌服不同剂量的三聚氰胺(0、175、350、700 mg/kg),观察试验小鼠的临床表现,剖检死亡小鼠并取材,观察胃、小肠和肝的病理学变化。结果显示,各试验组小鼠48 h内均全部死亡。光镜下可见死亡小鼠胃和小肠的黏膜层弥漫性坏死,肝细胞脂肪变性,肝小叶弥漫性淤血,甚至有片状出血灶,灶内肝细胞坏死。700 mg/kg组小鼠的胃、小肠及肝血管内均可见多个黄色颗粒状结晶体沉着。在透射电镜下,175 mg/kg和350 mg/kg组小鼠的肝细胞胞浆结构疏松,线粒体肿胀,700 mg/kg组小鼠的肝细胞胞浆中充满脂滴,线粒体弥漫性固缩。表明,三聚氰胺可引起小鼠胃肠黏膜发生急性弥漫性坏死,肝淤血,肝细胞变性,散在坏死,高浓度的三聚氰胺可在胃、小肠和肝间质中形成结晶体。     

An assessment of the usefulness of routine histological examination in hanging deaths

A retrospective study was carried out on 100 randomly selected medico-legal autopsies of victims who had committed suicide by hanging. All cases had undergone full police and coronial investigation. Complete external and internal examinations had been carried out including routine histological examination of organs. The age range of victims was 15-94 years (average, 41.7 years) with a male-to-female ratio of 7:1. External and internal injuries were consistent with the reported events. Diagnoses based purely on histology included hepatic steatosis (n = 16), asthma (n = 3), lymphocytic thyroiditis (n = 2), and pulmonary and cardiac sarcoidosis (n = 1). A large cell carcinoma of the lung and a rectal adenocarcinoma were confirmed. Histological evaluation was, however, of limited usefulness in contributing to the medico-legal evaluation of cases, with careful scene, external and internal examinations providing the most relevant information. The results of histological examination of tissues were all incidental to the cause, mechanism, and manner of death.     

Discordance of Gross and Histologic Findings in Estimating the Range of Fire of Gunshot Wounds

Forensic pathologist use soot and/or stippling surrounding entrance gunshot wounds in categorizing range of fire. If absent, some pathologists suggest utilizing histology when the range is diagnostically critical. This study investigates the concordance of macroscopic and microscopic findings in estimating range of fire by evaluating gunshot entrance and exit wounds made through human tissue analogs at defined distances using two handgun calibers. Examination of over 150 entrance wounds verified the ease of visually detecting soot from a muzzle distance of contact to 1 foot (30.5 cm), and its absence at 9 feet (274.3 cm). Distinctly apparent was bullet wipe surrounding the entrance wounds regardless of muzzle distance. Although variations existed, dark material was histologically identified in many skin, soft tissue, and bone sections at all ranges with both calibers. These nonparallel results decrease the dependability of histology for range of fire estimation and reinforce using gross observation.     

Quantifying Macrophages and Hemosiderin in Pediatric Dura Mater,

Determining the age of a subdural hematoma at autopsy is of great interest for medicolegal purposes. The appearance of pigment‐laden macrophages is often referenced as evidence that the subdural hematoma is 3–4 days old. However, understanding the significance of macrophages and hemosiderin requires understanding the histology of infant dura. Samples of grossly unremarkable dura taken from 17 pediatric autopsies were identified and histologically confirmed to lack subdural neomembrane. CD68 immunostaining and Prussian blue staining was performed. The CD68‐positive cells per high‐power field were quantified, and the presence of iron‐containing cells was recorded. CD68‐positive cells were present in all cases, even in the dural border layer. Iron‐containing cells were identified in 59% of cases, and in the dural border layer in 29%. Therefore, CD68‐positive and iron‐containing cells can be present in pediatric dura without neomembrane or macroscopic subdural hemorrhage, and this requires consideration when estimating the age of a subdural hematoma.