The morphofunctional changes in the internal organs in the modelling of poisonings by psilocybine-containing mushrooms]

Histological analysis of the viscera in experimental poisoning with psilocybin-containing mushrooms showed nonspecific changes in all examined organs, presenting as expressed hemocirculatory disorders and intracellular dystrophy. Quantitative histochemical analysis showed appreciable shifts in the activities of enzymes involved in the cytoplasmic and mitochondrial redox processes and of specific enzymes involved in nerve tissue metabolism. This may reflect some features in the direct effects of narcotic alkaloids contained in psilocybin-producing mushrooms.     

The characteristic morphological changes of the internal organs in certain forms of combined poisoning

The results of forensic medical investigations of 100 corpses of the persons who died from combined intoxication with two and more poisons are presented. They were compared with clinical observations and summarized uisng the methods of tanatogenetic analysis. The main variants of fatal combined poisoning and the underlying tanatogenetic mechanisms were categorized into cardiac (disturbances of rhythm and conductivity, progressive hypotension, flabby heart muscle, extensive fragmentation of cardiomyocytes), cerebral (coma and massive death of brainstem neurons), and pulmonary (of pneumonia- or pulmonary oedema-type with fibrin precipitation in the alveoli and formation of hyaline membranes). This classification was supplemented by a variety of combinations of the above variants with necrotic nephrosis and disseminated intravascular coagulation syndrome. It is concluded that the results of this study may be of use for forensic medical diagnostics of combined poisoning and the elucidation of the contribution of individual toxic substances to the fatal outcome bearing in mind the low informative value of the relevant forensic medical data.     

Forensic medical estimation of acute blood loss based on morphologic and functional changes in the internal organs

The objective of the present work was to obtain histological and morphometric characteristics of internal organs available for forensic medical examination from 236 corpses of subjects aged between 23 to 48 years whose death was caused by acute blood loss following a mechanical injury and concomitant alcohol or drug intoxication. Diagnostic signs of acute blood loss have been identified that can be used by forensic medical experts to estimate the length of the terminal period and reveal characteristic features of blood loss associated with alcohol and drug intoxication.     

Construct validity and internal reliability of the Finnish risk and needs assessment form

Validation of risk and needs assessment instruments used to predict, and reduce, recidivism and misconduct is of ethical, practical and scientific importance. We argue for a focus on variable (i.e. changeable over time) risk factors, and that validation begins with establishing construct validity. The Finnish Risk and Needs Assessment Form, in Finnish Riski- ja tarvearvio (RITA), is a semi-structured interview form adapted from the Offender Assessment System used in England and Wales and consists primarily of variable risk factors. In this study, we examined the construct validity and internal reliability of RITA. The results suggest that the original RITA sections do not provide an adequate statistical model for describing the relationship between scored questions, and we, therefore, offer an improved model. In our proposed model, several scores are influenced by more than one dimension of risk and the dimensions correlate with each other considerably. We suggest that the dimensions that can be measured with RITA are Problems managing economy, Alcohol problems, Resistance to change, Drug abuse and associated behaviour, Aggressiveness and Employment problems. All factors except Drug abuse and associated behaviour had very good internal reliability. We propose this new model to be used in future research with, and in development of, RITA.     

Sudden death due to a paraganglioma of the organs of Zuckerkandl

A 20-year-old woman died suddenly in a hospital emergency room after presenting with nausea, vomiting, back pain, and hypertension. At autopsy, an extra-adrenal pheochromocytoma (paraganglioma) of the organs of Zuckerkandl was found, with microscopic focal myocardial necrosis similar to that described in death from adrenal pheochromocytomas. Tumors of the organs of Zuckerkandl are extremely rare; less than 100 such cases have been reported in the world's literature, and only six, including the present case, have presented as a sudden, unexpected death. The symptoms of catecholamine storm may mimic those of acute drug intoxications, leading to misdiagnosis by both clinical physicians and pathologists.     

Forensic-medical assessment of the damage to sex organs unrelated to sexual crimes

The analysis was made of forensic medical examinations for assault (427 cases) and commission examinations made in the department of complex expert examinations for decision on the relation between pregnancy interruption and injury (46 cases). A documented posttraumatic stress reaction to assault damage to health is determined with consideration of duration of psychic rehabilitation. The author presents cases from her practice of direct and indirect damage to sexual organs observed in different situations and their effect on pregnancy interruption.     

Quantitative assessment of brain hydration in determination of death speed and type of tanatogenesis in forensic medical practice

Brain hydration was determined in death of strangulation mechanical asphyxia, acute alcoholic poisoning, acute poisoning with opiates, cancer of stage IV, coronary heart disease with acute heart failure, hemorrhagic stroke. Brainstem edema (BSE) occurred in 69.2% cases (upper BSE - 20.2%, lower BSE - 17.3%, BSE of the all parts - 31.7%). BSE was present in all cases of opiate poisoning; 52.9% cases of hemorrhagic strokes, 61.3% cases of coronary heart disease. The data obtained show prevalence of brain tanatogenesis in death of the above diseases. Hypohydration and hyperhydration of the brain were observed in short and slow agony, respectively.     

The nature and the occurrence of birefringent material in different organs in fatal drug addiction

Insoluble birefringent tablet filler materials commonly found in tablets used in solution by drug addicts as intravenous injections were investigated microscopically. The following filler materials were investigated: talc, potato- and maize-starch, microcrystalline cellulose, magnesium stearate and siliciumoxid. The morphological characteristics of the different materials are described. Tissue sections (lung, liver, spleen, heart, bone-marrow, kidney, lymph-nodes and endocrine glands) from 33 consecutive fatality cases of intravenous drug addicts autopsied at the University Institute of Forensic Medicine in Copenhagen were studied with special reference to the occurrence and nature of birefringent material. Birefringent material was most often demonstrated in lung tissue (94%), followed by spleen (76%), liver (55%), lymph-nodes (portal: 39%) and bone-marrow (24%). The material was always localized intracellularly. Granulomatous reaction was only seen in the lungs. Except for one case, talc was the only foreign material seen in other organs than the lungs, undoubtedly due to its smaller size. The presence of insoluble foreign material in lung tissue of drug addicts indicates a habit of intravenous administration and the amount of the material indicates whether the addict usually injects tablets or only does so occasionally. The presence of birefringent material in the organs have only rarely any obvious clinical implications.