Significance of various analytical methods with reference to the causes and manners of death in alcoholics

It was the aim of the present investigation to apply a broad spectrum of analyses to forensic autopsies of alcoholics in order to estimate the significance of the various analytical methods with reference to the cause and manner of death. The analyses were performed on a consecutive series of 73 medico-legal autopsies in alcoholics. Both extensive histology as well as toxicology and microbiology were used. The microbiology did not contribute substantially to the determination of the cause of death, while histology was decisive in six cases. Toxicology analyses were necessary for determining the cause of death in 37 cases. The results of the investigation may help in the selection of analytical priorities.     

Injuries due to deliberate violence in areas of Denmark. III. Lesions. The Copenhagen Study Group

As part of a transcultural investigation of violent behavior in Denmark and South America, the lesions from accidents involving deliberate violence registered in three Danish emergency wards during a 1-year period were studied. A quantity of 2211 lesions were diagnosed in 1316 patients (953 male and 363 female patients). Sixty-five percent of the lesions were in the head/neck region, 13% in truncus, 18% in the upper extremities and 5% in the lower extremities. The most frequent diagnosis was an open wound in the head/neck region. Adding contusions and fractures in the same region this amounted to more than half of the total number of lesions. In the upper extremities 62% of the lesions were contusions or open wounds. Serious lesions of internal arteries were few, however always caused by sharp instruments (knives). Serious lesions due to firearms were not recorded/reported. Strangulation had been used against 1.1% of the victims, the male/female ratio being 1:6. The main part of the lesions were of minor severity when assessed on the basis of the scores in the Abbreviated Injury Scale (AIS). The lesions were, however, more serious compared to other recent studies, and it appeared that the female victims had fewer but more serious lesions than the male victims. The need for treatment and hospitalization was in the range of other recent studies.     

Injuries due to deliberate violence in areas of Denmark. V. Violence against women and children. Copenhagen Study Group

As part of an European-South American study of deliberate violence cases of violence against women greater than or equal to 15 years of age and violence against and among children under the age of 15 years were registered at 3 Danish emergency wards and at the Institute of Forensic Medicine in Copenhagen. 352 cases of violence against women and 46 cases of violence against children were registered in the three emergency wards corresponding to rates of about 1.6/1000 per year for women, 0.6/1000 per year for boys and 0.7/1000 per year for girls in a provincial/rural district, the catchment region of Holbaek County Hospital, 3.4/1000 per year for women, 2.8/1000 per year for boys and 0.6/1000 per year for girls in a mainly middle income area of the metropolis Copenhagen, the catchment region of Frederiksberg Hospital, and 4.0/1000 per year for women, 4.0/1000 per year for boys and 0.9/1000 per year for girls in a mainly low income area of Copenhagen, the catchment region of the Rigshospital. Nineteen live adult female victims and 17 dead adult female victims of violence were registered in the Institute of Forensic Medicine in Copenhagen, where also one was registered as a victim of homicide. Nearly half of the adult live female victims of violence had been injured at home while this was the case for approximately three fourth of the dead victims. In 35% of the live cases the husband was the aggressor and in 12% a former cohabitant. In 71% of the homicide cases the husband was the aggressor. The live women appeared to have fewer but more serious lesions than men. The pattern of deliberate violence against women appears to be associated with socio-economic and cultural factors. In cases with a preceding quarrel there is statistically a link to alcohol intoxication. In half of the cases of violence against children the aggressor was known to the victim, in 15% the aggressor was one of the parents, while 42% of the cases were violence among children. The pattern of violence according to sex, and the distribution and severity of lesions for 10-14 years old children showed resemblance to the situation for adults. The lesions were more serious in young infant victims, especially boys, than in adult victims.     

Intoxication at home due to carbon monoxide production from gas water heaters

Forensic medicine has a role to play in the community not only when dealing with criminal cases. When the forensic scientist observes fatalities that could have been prevented, he has an obligation to respond with the purpose of preventative measures. In a short period in Copenhagen there were a number of fatalities due to the production of carbon monoxide from gas water heaters. The gas water heaters were in most cases malfunctioning due to sooted convectors and installed without a flue, but at the time of installation maintenance checks were not mandatory, and if carried out they were often unprofessional. It is emphasized that even with well functioning equipment, the danger of intoxication exists when using a heater without a flue over an extended period, if the apartment is thoroughly insulated. The oxygen will then be used in the combustion and CO produced. The symptoms are insidious and uncharacteristic. Examples are described where physicians have failed to diagnose the condition in patients in adjoining apartments. The authorities finally responded to the medical reports with new regulations and with a favourable result. The responsibility with regard to the control of technical installations in a technically advanced society is discussed.     

The morphogenesis of electrically and heat-induced dermal changes in pig skin

In order to establish pathological evidence in dermis for distinguishing between sequelae of electrical torture and those of other superficial injuries, the skin of eleven fully anaesthetized Danish Landrace pigs have been exposed to heat and electrical energy from either 50 Hz alternating current (a.c.) or direct current (d.c.) via 12 mm large contact knobs or via a pointed 0.5 mm large electrode (only 50 Hz a.c.). The lesions have been examined from 1 to 126 days after the injury. While heat lesions exposed to energy lower than 60 joule only gave minor changes, heat lesions exposed to more than 60 joule showed changes in both collagen fibres (basophilic or eosinophilic fibres without any birefringence or coarse cross-striation in polarized light, respectively) and dermal cells (granular cytoplasm). Areas exposed to 50 Hz a.c. via 0.5 mm. electrode showed basophilic collagen fibres and in a few biopsies on day 7 calcium salts on collagen fibres. Using 12 mm large electrodes the changes were minor, but basophilic and eosinophilic collagen fibres with no birefringence or with fine/coarse cross-striation respectively were seen. Even cells with 'vesicular nuclei' were seen on day 1 and 2 after the injury. The changes in the anode area showed resemblance to that of heat lesions (basophilic collagen fibres). Eosinophilic collagen fibres with fine densely spaced cross-striation in polarized light and 'vesicular nuclei' as well as collagen fibres with calcium salts were seen in the cathode lesions. It is concluded that the dermal changes in the cathode area are specific for electrical injury from day 1 to 14. However, earlier studies have demonstrated dermal changes specific for electrical injury at day 0 and the presence of calcified collagen fibres up to 2 months after injury. The dermal changes in anode lesions were non specific and could not be differentiated from those found in heat lesions. Alternating current lesions (50 Hz) were specific from day 1 to day 7, when the pointed electrode was used, but only in a few days when the energy was transferred via the 12-mm electrodes.     

Suicide by carbon monoxide from car exhaust-gas in Denmark 1995-1999

In the period 1995-1999 there were 388 car exhaust-gas suicides in Denmark. Of these 343 (88.4%) were men and 45 (11.6%) were women, the average age being 47 years. The car exhaust-gas suicides made up 9.3% of all suicides in Denmark in the period. The corresponding rate was 11.7% for men and 3.7% for women. In rural areas a larger part of all suicides were committed with car exhaust-gas compared to the more densely populated areas. Mental disease was diagnosed in 124 (32.0%) cases. A suicide note was found in 165 (42.5%) cases. A hose was fitted to the exhaust pipe in 334 (86.1%) cases. Of these the 234 (60.3%) occurred outside, typically in a forest area, while 76 (19.6%) occurred in a closed garage. All the 54 (13.9%) cases with no hose fitted to the exhaust pipe occurred in a garage. Seven (1.8%) victims were found in a burning or burnt-out car, where the following investigation revealed that it was actually a car exhaust-gas suicide. Carboxyhemoglobin was measured in 26 (6.7%) victims. In two of these victims no carboxyhemoglobin was found, as they had survived for some time after the poisoning. The average saturation of the remaining victims was 67%, the lowest saturation being 20% and the highest being 84%. In the period 1969-1987 the number of car exhaust-gas suicides in Denmark increased from 50 to approximately 190 per year and the rate of car exhaust-gas suicides compared to all suicides increased from approximately 5% to approximately 13%. In 1987-1999 these figures decreased from approximately 190 to 63 per year and from 13% to approximately 8%. During these 30 years the number of passenger cars in Denmark doubled, which explains the increase in car exhaust-gas suicides during 1969-1987. A possible explanation for the decrease in 1987-1999 is the introduction of the catalytic converter, which was made mandatory in 1990. We anticipate that car exhaust-gas suicides will continue to decrease in numbers, as more cars are equipped with catalytic converters.     

How does Intergroup Contact Generate Ethnic Tolerance? The Contact Hypothesis in a Scandinavian Context

As European majority members are often hostile toward ethnic minorities, it is important to identify sources that reduce opposition to immigrants. First, focusing on Denmark, this article examines whether intergroup contact influences attitudes toward ethnic minority rights (henceforth: ‘ethnic tolerance’). Second, this study tests whether the contact‐tolerance relationship is mediated by self‐disclosure and symbolic threat. Furthermore, contact is measured as workplace contact in order to reduce self‐selection biases. The empirical tests are performed on a Danish high‐quality national probability sample from 2009 (N = 1,929). Analysis shows that intergroup contact generates ethnic tolerance because workplace contact weakens threat perceptions and stimulates disclosure of personal information. Generally, these results suggest that regular intergroup contact can improve ethnic relations in contemporary democracies.     

Sharp Force Homicide in Denmark 1992–2016

Sharp force trauma is a common homicide method. The weapon is typically a knife, which is easily accessible and does not require special skills. We have analyzed all 471 sharp force homicides in Denmark during 1992–2016 with special focus on aspects that are relevant to forensic pathologists, including the distribution of wounds and organ injuries. Most homicides were committed inside with a kitchen knife. The front left thorax was the most common area to be affected by sharp force trauma. In 18.9% of the victims, there was only one sharp injury, the majority on the thorax. The most common trajectory for stab wounds was directly posterior with no deviation to the sides or up/down followed by directly anterior. The heart (including pericardium) and lungs (including hemo- and pneumothorax) had injuries in more than 75% of the victims. 67% of victims were males. Female victims had more sharp force injuries and defense wounds than male victims. Most females were killed in domestic homicides (73.7%), most commonly in partner killings (56.4%). In contrast, many male victims were killed in a setting of nightlife/intoxication (34.0%) most by a friend/acquaintance delivering a few stab wounds. The results clearly show strong sex differences in both victims and offenders. This could be useful for shaping policies and public opinion, and as a route for understanding the developments in interpersonal violence. In the narrow setting of death investigation, our results will provide an evidence-based approach to understanding the injury patterns in sharp force homicide.     

A report of the 2002–2008 paternity testing workshops of the English speaking working group of the International Society for Forensic Genetics

The English Speaking Working Group (ESWG) of the International Society for Forensic Genetics (ISFG) offers an annual Paternity Testing Workshop open to all members of the group. Blood samples, a questionnaire and a paper challenge are sent to the participants. Here, we present the results of the 2002–2008 Paternity Testing Workshops with the objective to evaluate the uniformity of DNA-profiling and conclusions of the participating laboratories as well as to clarify tendencies in typing strategies and biostatistical evaluations of the laboratories. The numbers of participating laboratories increased from 46 in 2002 to 68 in 2008. The results showed an increasing degree of concordance concerning methods and DNA systems used and a high degree of uniformity in typing results with discrepancies in 0.1 and 0.3 % of all submitted PCR-based results. The paper challenges showed uniformity in the calculation of the weight of evidence for simple cases with straight-forward genetic constellations. However, a high degree of variation existed in complex scenarios with rare genetic constellations such as genetic inconsistencies/possible silent alleles, rare alleles and haplotypes.     

The effect of sodium hydroxide and hydrochloric acid on pig dermis. A light microscopic study

In order to compare the dermal changes after exposure to direct current (d.c.) with changes after influence of acid and base influence, the skin of fully anaesthetized Danish Landrace pigs were exposed to acid and basic solutions. Biopsies were obtained immediately after and up to day 7 after the injury. Collagen fibres with increased affinity for eosin and irregular cross-striation in polarized light together with shrunken cells with dark stained nuclei were found just beneath the epidermis immediately after application of 1 N HCl. Immediately after exposure to 1 N NaOH dispersed collagen fibres showed increased eosinophilia and a fine densely spaced cross-striation in polarized light and vesicular nuclei were present within dermal cells. During the following days a narrow demarcation zone of neutrophilic granulocytes separated the zone containing abnormal collagen fibres from normal tissue below. Calcified collagen fibres were not observed and no other abnormal histochemical reactions were present. It is concluded that the morphology of acid induced lesions and base induced lesions shows resemblance to the morphology of anode and cathode lesions, respectively, but not to heat lesions. The reason for not finding depositions of calcium salts on collagen fibres in skin exposed to basic solutions could be a non-optimal pH in the tissue or that other electrochemical processes than shift in pH are necessary for the calcification process.