Early epidermal changes in heat- and electrically injured pig skin. I. A light microscopic study

In order to find methods applicable for disclosing electrical torture, pig skin was exposed to heat and electricity under controlled circumstances. Biopsies were obtained immediately after exposure and the morphology of the heat lesions was compared to that of electrical lesions. The cytoplasm of epidermal cells in heat lesions appeared granular or fibrillar, while the nuclei were rather unaffected. In electrical lesions the cytoplasm appeared homogeneous often with a peculiar white colour in hematoxylin-eosin stained sections. The nuclei were either dark and shadowy or enlarged and vesicular. The keratin in electrical lesions often showed a bright yellow colour. Small defects in the epidermis were seen in some electrical lesions. Thus the morphology of electrical lesions differed markedly from that of heat lesions. Although some of these differences may be due to differences in distribution and intensity of energy, it is probable that pH shifts in the cells due to electrolysis is the main cause of the specific morphology of electrical lesions.     

Frequency of bone/cartilage lesions in stab and incised wounds fatalities

A retrospective study was carried out on 58 fatalities due to stab or incised wounds. The frequency of bone or cartilage lesions was analysed according to the number of wounds, the circumstances of death and the anatomical site. Our findings showed that bone/cartilage lesions were present in about 53% of the cases. Cartilage lesions were more frequent than bone lesions. The mean number of wounds in the group with bone/cartilage lesions was statistically higher than the mean number of wounds in the group without lesions (P=0.0068). The main cause of death was thoracic injury in the groups with and without bone/cartilage lesions. In case of skeletal remains, only bone or cartilage lesions allow to diagnose stab or incised wounds. The discovery of these lesions, often of small size, justifies a complete and careful examination of skeletal remains with the help of stereomicroscopy.     

Pathological spectrum of the lung in cases of violent death: Part II. Clinicopathologic correlation

The correlation between the type of pathological lesion of the lung and the circumstances which encompass their evolution in 66 cases of violent death have been examined. Pulmonary lesions have been classified into four groups. 1. Inflammatory alveolar lesions without a diffuse interstitial involvement (IAL) which result from direct aggressions in subjects of advanced age. 2. Inflammatory alveolar lesions with a diffuse interstitial affectation (IALW) which are more frequent in younger subjects having a higher defense capacity and with severe lesions requiring admission to an intensive care unit. 3. Edemohemorrhagic lesions (EHL) appearing as a precocious lesion at any age. 4. Unspecific chronic lesions (UCL) previous to the aggression and without any relationship to death. The most obvious feature noted was the frequent occurrence of certain types of acute pulmonary lesions indicative of the rapid and extensive capacity of the lung to react to a lesion agent even when death follows rapidly after the aggression. The scarcity of acute interstitial lesions among the older group can be related to a diminution of biological defense activity leading to a less vigorous response; on the contrary, diffuse lesions of the wall seem to be related to an excess of defense mechanisms, determined more by age, severity of lesion, and type of medical assistance received than by a specific type of aggression.     

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.     

Cardiac lesions in sudden infant death syndrome

Sequential morphological changes as found in the hearts of 250 sudden infant death syndrome (SIDS) infants are described. Detailed examination of macroscopic and microscopic lesions reveal that all SIDS infants had identifiable lesions at the time of their death. The lesions can best be described as selective focal anoxic muscle fibre necrosis at chronologically different developmental stages. The extent of these lesions vary markedly from case to case, from a minimal muscle fibre eosinophilia through contraction band formation, myocytolysis, stromal condensation to scar formation. The morphological variations in the lesions amongst individual cases can be interpreted as relating to the time interval of the development of the lesions. The intramural and coronary arteries in some cases are also affected showing intimal hyperplasia. Although these sequential morphological aberrations are not specific and typical to SIDS infants only, they were present in all SIDS infants in this series.     

Wischnevsky's gastric lesions in accidental hypothermia.

We examine the pathogenesis of Wischnevsky's lesions. These gastric lesions were found in 15 of 17 deaths due to accidental hypothermia. Deaths occurred at various minimum temperatures (-2.4-20.4 degrees C); gastric lesions did not always reflect exposure temperatures. However, all victims exposed to temperatures greater than 10 degrees C had severe lesions. At temperatures less than 5 degrees C, on the other hand, severe gastric lesions were seen in victims younger (43.2 years old) than those with mild lesions (61.0 years old). These findings suggest that gastric lesions develop by exposure to temperatures at which the body's response to cold stress continues, or as result of a strong response to short-term stress. Histopathologic examination demonstrated a characteristic finding of cystic dilatation of the capillaries, presumably due to massive reperfusion after functional collapse of the microcirculation in the gastric mucosa.     

Survival time and acting capability after fatal injury by sharp weapons

Autopsy reports from 109 victims of fatal injury from sharp weapons were investigated with regard to type and number of lesions, blood loss, degree of alcohol intoxication, survival time and acting capability after the injury. Of the 13 who died immediately, nine had penetrating lesions of the heart. This group also had the highest number of lesions. Sixty-four victims survived for some time. The survival time increased with decreasing number of lesions. The greatest blood loss and the highest blood alcohol concentrations were found in those who survived between 0.5 h and 1 h. Twenty-four victims were able to make physical efforts after the injury and the movements varied from a few steps to the running of several hundred meters. Decisive factors for decrease in survival time and acting capability are penetrating lesions to the heart and the great vessels, and multiplicity of injuries.     

Symmetrical hypopigmentation of the nipples secondary to trauma

Deviant sexual behavior may lead to unusual skin lesions. The following is a case report of unusual trauma-related, symmetrical lesions of the nipples in a male homosexual from repeated application of bondage apparatus to his areolae and nipples.     

Dermal surface in electric and thermal injuries. Observations by scanning electron microscopy

The dermal surface (after enzymatic digestion of the dermo-epidermal junction) in electric and heat lesions is described. There do not appear to be elements that help in forming a precise differential diagnosis. It is possible, however, to differentiate these lesions from all traumatic cutaneous injuries and some limited nontraumatic lesions (e.g., verrucae). Remarkably good preservation of the dermal surface even in an advanced state of decomposition does suggest the possibility of certain diagnosis of electric and heat lesions even when postmortem phenomena have greatly damaged or even totally removed the epithelial part of the skin.     

Histopathological differentiation of skin lesions caused by electrocution, flame burns and abrasion

The aim of this study was to reveal histopathological features for differential diagnosis of skin lesions caused by electrocution, flames and abrasions. Based on the causes of the lesions, cases were assigned into three groups. Group 1 included 30 deaths from electric shock. Group 2 included 30 individuals with flame burns who died in the fires. Group 3 included 30 deaths from traffic accidents, from which the individuals had abrasions. Data from the crime scene investigations and macroscopic and microscopic findings from the autopsies allowed determination of the cause of death in all cases. The features of the lesions examined under the light microscope were intraepidermal separation, subepidermal (dermoepidermal) separation, coagulation necrosis in the epidermis, nuclear elongation in the epidermis, dark-staining epidermal nucleus, depth of homogenization in the dermis, and nuclear elongation in the epithelium of hair follicles. A significantly high rate of electrical lesions had intraepidermal separation. The rate of subepidermal separation was slightly more significant in flame burns. A significantly higher rate of electrical lesions had both intraepidermal and subepidermal separation. The rate of coagulation necrosis in the epidermis was significantly the highest in electrical lesions. Although the severity of nuclear elongation was the most significant in electrical lesions, varying degrees of nuclear elongation in the epidermis were present in all three groups. Dark staining of the epidermal nuclei was present in all lesions except for one electrical lesion, though the severity of staining was significant in the abrasion group. The depth of homogenization was slightly more significant in the abrasion group. The rate of nuclear elongation in the epithelium of the hair follicles was significantly lower in the abrasion group. The results of this study revealed that certain morphological changes determined under a light microscope could help the differential diagnoses of electrical lesions, flame burns and abrasions.     

Pathological spectrum of the lung in cases of violent death: Part I. Lesion classification

The results are presented of the pathological study of the lungs in 66 cases of violent death observing the more frequent types of lesions and establishing 4 different groups of postlesioned pulmonary condition. 1. Inflammatory alveolar lesions without a diffused interstitial involvement (IAL) including contusions or direct aggressions, lobular pneumonias, or bronchopneumonias with a predominance of intra-alveolar inflammatory exudation. 2. Inflammatory alveolar lesions with a diffuse interstitial involvement (IALW) including generalized affectation of the parenchyma with lesions in the capillary structure of the wall. 3. Edemohemorrhagic lesions (EHL) presenting phenomena of capillary congestion with hematic extravasation and interstitial and intra-alveolar edema, without inflammatory involvement. This is the most numerous group and it can constitute the preliminary stage of any other. 4. Unspecific chronic lesions (UCL) not related to the cause of death, being chronically inflammatory and fibrotic alterations of limited interest in our study. We emphasize the importance of the inflammatory involvement of the alveolar wall in the pathogenia of diffuse alveolar damage (DAD) and the aggravation of pulmonary lesions by capillary structure alteration, direct lesion of alveolar epithelium, presence of macrophages, and liberation of certain intracellular enzymes.     

Post-mortal lesions in freshwater environment

Postmortem animal feeding activity may cause considerable damage to bodies resulting in the modification of wounds, loss of identifying features and injury. Certain postmortem lesions may appear inflicted or non-inflicted antemortem injuries. At present, apart from cases in sea water, no data are available about post mortal lesions performed by aquatic organisms. This note that represents the first report concerning colonisation of a dead body by crustaceans a few hours after death, describes injuries caused by the amphipod Niphargus elegans on the face, and in particular on the eye region, of a young man dead by drowning. The lesions recorded in this case are comparable with the lesions caused by ants. The high plasticity in the food choice can allow Amphipoda to colonise drowning bodies in every moment after dead, however the benthonic behaviour of these animals suggests a more important role in the colonisation during post-mortem submersion periods.     

Child barbarity and torture: a case report

Penile strangulation with a strand of hair, acting as a tourniquet, and perforation of the eyes with a knife are uncommon accidental injuries in children. In such a situation, a mistreatment must be evoked. We present a case of barbarity and torture involving a young boy 3 years old. He was a victim of penis strangulation and perforation of the eyes, performed on previous surgical and infectious lesions. The mistreatment was performed by his mother's boyfriend. The perpetrator used the previous lesions to hide his misdeed. This amazing case of mistreatment points out the violence of the wounds and their being performed on previous lesions.     

The Corpus Callosum and Forensic Issues—An Overview

The corpus callosum is a large central white matter tract that connects the right and left cerebral hemispheres. It permits placental mammals to have a more sophisticated interhemispheric integration of sensory cortices and allows communication between cortical and subcortical neurons. Search of the literature and the pathology archives at The University of Adelaide was undertaken to identify lesions and injuries within the corpus callosum that may have forensic significance. These include developmental/congenital lesions with agenesis/dysgenesis, vascular malformations, and lipomas; inherited syndromes such as neurofibromatosis; and acquired lesions involving trauma, neoplasia, demyelination, vascular conditions, infections, fat embolism, aging/dementia, and the effects of toxins. The finding of lesions within the corpus callosum should initiate careful examination of the adjacent brain and other organ systems for related phenomena as this may shed some light on the nature of the underlying condition, and also help to determine whether there are any forensic implications.     

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.     

Frequency of bone lesions: an inadequate criterion for gunshot wound diagnosis in skeletal remains

A retrospective study was carried out on 130 fatalities due to gunshot wounds to determine whether the combined absence of bone damage and projectile in a skeleton is sufficient to eliminate a diagnosis of gunshot wound. Our findings showed that bone lesions were present in about 90% of the cases and were associated with intracorporeal projectile(s) in about 70% of the cases. The presence or absence of bone lesions seemed independent of the gun characteristics, the shot conditions, and the type of death. The cause of death was predominantly brain injury in cases with bone lesions whereas thoracic, abdominal, and peripheral vascular causes were more frequently encountered in cases without bone damage. We concluded that the combined absence of bone lesions and intracorporeal projectile (about 5% in our series) cannot exclude a diagnosis of death secondary to gunshot wounds.     

Early epidermal changes in heat- and electrically injured pig skin. II. An electron microscopic study

In order to find methods applicable for disclosing electrical torture, pig skin was exposed to heat and electricity under controlled circumstances. Biopsies for electron microscopy were obtained immediately after exposure. In heat lesions the nuclei were slightly distorted, sometimes with broken nuclear membranes. The tonofilaments were clumped, intracellular oedema was present and cell membranes were ruptured between desmosomes. In electrical lesions the nuclei were usually enlarged with strongly condensed chromatin. Some nuclei were composed of fine, evenly dispersed granular material. The cytoplasm appeared homogeneous, in large magnification finely granular. Cell borders could sometimes be identified located in situ. In the stratum corneum, which appeared normal in heat lesions, single or several cells or large areas had an electron-dense appearance. The difference in ultrastructure of heat and electrical lesions makes it probable that electricity has a specific action on epidermal cells.     

Scanning electron microscopy analysis of experimental bone hacking trauma of the mandible

The authors report on a macroscopic and microscopic study of human mandible bone lesions achieved by a single-blade knife and a hatchet. The aim of this work was to complete the previous data (scanning electron microscopy analysis of bone lesions made by a single-blade knife and a hatchet, on human femurs) and to compare the lesions of the femur with those of the mandible. The results indicate that the mandible is a more fragile bone, but the features observed on the mandible are quite similar to those previously observed on the femur. This work spells out the main scanning electron microscopy characteristics of sharp (bone cutting) and blunt (exerting a pressure on the bone) mechanisms on human bone. Weapon characteristics serve to explain all of these features.     

False rape: a case report

A 16-year-old girl was admitted to the emergency department for sexual assault. The forensic examination revealed genital lesions of an age that were incompatible with her statements. She also presented extragenital lesions that resembled self-inflicted lesions. The reports of false rape allegations in the literature have all dealt with the motivations of the false victims. This case report is a reminder that an allegation of rape can be considered only on the basis of proof and not on speculation.     

The Accuracy and Applicability of 3D Modeling and Printing Blunt Force Cranial Injuries

The purpose of this study was to determine the factors affecting the accuracy of 3D models and 3D prints of cranial blunt force trauma, to evaluate the applicability and limitations of modeling such injuries. Three types of cranial blunt force lesions were documented (hinge, depressed, and comminuted) using three forms of surface scanning (laser, structured light scanner, and photogrammetry) at two different quality settings (standard and high). 3D printed models of the lesions were produced using two different materials (a gypsum‐like composite powder called VisiJet^® PXL and an acrylic engineered composite plastic called VisiJet^® M3 in crystal colour). The results of these analyzes indicate the prints in this study exhibit some statistically significant differences from the actual bone lesions, but details of the lesions can be reproduced to within 2 mm accuracy.