The ageing of bruises: A review and study of the colour changes with time

This work was inspired by a recent case of child abuse where the question of the age of the bruises on the body was raised. The first part of this paper reviews published work on bruises. It illustrates the paucity of work in this field and the absence of studies of the colour changes in bruises of human skin with time. The second part of this paper consists of our own study of the appearance of bruises. The aim was to identify the colour changes which occur in bruises and over what time-scale, in order to determine whether bruises can be aged by appearance. A total of 369 photographs were obtained of bruises aged <6 h and up to 21 days old, in 89 subjects aged 10–100 years. It was found that the development of a yellow colour was the most significant change (subjects aged <65, P < 0.001; subjects aged ≥65 years, P < 0.001). The development of a yellow colour occurred significantly faster in subjects aged < 65 years. (P < 0.001). The appearance of a blue and purple/black colour was of lesser significance. The appearance of a red colour did not alter significantly with time. From this study it was only possible to conclude that a bruise with a yellow colour was more than 18 h old.     

The objective interpretation of histopathological data: an application to the ageing of ovine bruises

Muscle and adipose tissue from a total of 178 experimental bruises inflicted on sheep and aged from 1 to 72 h old were processed for light microscopic examination. Five observed histopathological features of inflammation and repair were scored semiquantitatively on a scale of 1-4 according to their degrees of change from the normal state. These data were evaluated mathematically using a Bayesian probability model designed for the purpose. The model was able to age bruises with an acceptable degree of accuracy only as either 1-20 h or 24-72 h old but within these constraints a degree of confidence in excess of 90% was achieved. The exact performance of the model depended on the nature and number of tissue samples examined but mathematical ageing was superior to interpretative ageing based on personal experience.     

Assaults in the elderly--a population-based study with victim and perpetrator characteristics

The aim of the present epidemiological study was to investigate characteristics of assaults in the elderly aged 65 years and above from the perspective of the victim and perpetrator. This population-based study included 23,142 assaults (according to §§ 224/226 StGB of German criminal law) that were recorded in Bavaria, Germany, from 1999 to 2005. The population-based ratio of serious crimes of battery for the elderly in comparison with the reference population was markedly lower (0.10; 95% CI: 0.09-0.11) in suspects aged more than 65 years and 0.08 (95% CI: 0.07-0.09) for the injured above 65 years. Elderly perpetrators differed significantly concerning the manner of the assault (p < 0.001). They committed less crimes in urban areas (56.1% vs. 68.8%) and were victimized significantly more in rural areas (p < 0.001; 41.2% vs. 30.2%). Violence in the elderly differs from that of the younger population. Further research is warranted to establish prevention measures.     

Burden of Neurodegenerative Diseases in a Cohort of Medical Examiner Subjects*

Abstract: Here we report studies of the burden of neurodegenerative neuropathologies in a cohort of Medical Examiner (ME) subjects from the County of Santa Clara (California) to determine if this unique population of decedents manifested evidence of neurodegeneration that might underlie causes of death seen in an ME practice. We found that 13% of the brains from ME cases showed significant tau pathology, including 55% of those 65 years old and older and 63% of those 70 years old and older. The histochemical and immunohistochemical findings were consistent with Alzheimer’s disease (AD) in 7 subjects and frontotemporal lobar degeneration (FTLD) tauopathy type in six cases. There were no cases of Parkinson’s disease, dementia with Lewy Bodies or other neurodegenerative conditions. Our study suggests that decedents >65 years of age in an ME practice are afflicted by common causes of dementia such as AD and FTLD which could contribute wholly or in part to their causes of death.     

Post-mortem analysis of apoptotic changes associated with human skin bruises

The estimation of the age of skin bruises is of importance in forensic medicine, especially in child abuse cases. Time-dependent changes in bruise colour and/or associated histological features have been used with a limited degree of success. An increased rate of apoptosis in the injured tissue has been considered as a novel time-dependent marker of cell death, by injury inflicted in a rat model. The object of the present study was to apply the TUNEL method of DNA end labelling to identify and enumerate apoptotic cells in bruised and normal skin in order to study the relationship of apoptotic cell density with the age of the bruise. A commercially available DNA end labelling kit, TUNEL method, was standardised, validated and used for this purpose. Twenty unselected post-mortem cases with bruises due to a variety of causes were studied. The apoptotic cells stained with TUNEL reaction were counted in 10 high power fields in the epidermis, as well as in the dermis of formaldehyde-fixed paraffin-embedded skin specimens. The mean positive cell densities (+/- 1 S.E.) were compared with respect to the age of the bruise. In the epidermis, the mean apoptotic cell count was statistically significantly greater in the bruised skin compared to normal skin in 2- to 6-day-old bruises; whilst in the dermis the same was true in 3- to 8-day-old bruises. The overall findings suggest that there is a quiescent period prior to the increase in the apoptotic cell activity that is seen following skin bruising. This is so provided the post-mortem skin samples were collected within a lapse of 6 days or less between the time of death and formalin fixation and paraffin embedding to avoid the bias made by the difference of length of post-mortem interval.     

Supplementary pathway for vitality of wounds and wound age estimation in bruises using the electric impedance spectroscopy technique

Determination of wound vitality and estimation of wound age are central issues in daily forensic practice. The objective of this study was to develop a new and rapid method for determining wound vitality and estimating wound age in bruises using electric impedance spectroscopy. Forty Sprague-Dawley rats (140-170 g) were divided into five groups: group 1 (n=8): controls, group 2 (n=8): postmortem bruises, group 3 (n=8): bruises 1 h before death, group 4 (n=8): bruises 3 h before death, group 5 (n=8): bruises 6 h before death. Measurements of the right gluteus maximus muscle were taken at 6, 24, and 48 h after the rats were sacrificed by cervical dislocation. The results from this study indicate that electric impedance spectroscopy is clearly sensitive enough to differentiate between vital and postmortem wound infliction and to determine the survival time after the infliction of an injury.     

Alternative light source (polilight) illumination with digital image analysis does not assist in determining the age of bruises

The age of a bruise may be of interest to forensic investigators. Previous research has demonstrated that an alternative light source may assist in the visualisation of faint or non-visible bruises. This project aimed to determine if an alternative light source could be utilised to assist investigators estimate the age of a bruise. Forty braises, sustained from blunt force trauma, were examined from 30 healthy subjects. The age of the bruises ranged from 2 to 231 h (mean = 74.6, median = 69.0). Alternative light source (polilight) illumination at 415 and 450 nm was used. The black and white photographs obtained were assessed using densitometry. A statistical analysis indicated that there was no correlation between time and the mean densitometry values. The alternative light source used in this study was unable to assist in determining the age of a bruise.     

The population of coloured fibres in human head hair.

In 2002 a population study of textile fibres in human hair was carried out using 26 volunteers in Cambridgeshire, UK. Over 12,000 fibres were recovered from a variety of hair lengths using low adhesive tape and classified according to colour, generic type and fibre length. The results of the study showed that the most common fibre colours were black/grey (48%), blue (29.1%) and red (12.7%), the least common being green, orange/brown and yellow which each accounted for less than 5% of the total. Natural fibres (mainly cotton) were predominant (72.3%) and man-made fibres were considerably less frequent. When colour and generic type were classified together, the most common combinations were black and blue cottons. The least common were the man-made fibre/colour combinations with the most frequent of these accounting for less than 7% of the sample. Fibre loads carried by long hair were found to be significantly less than that carried by short hair. The results of this study are in accordance with previous fibre population studies using other types of recipient surfaces and are likely to be influenced by factors such as seasonal and geographical variation.     

Decoding of memory traces as a function of witness' intelligence

The paper deals with the problem of the effectiveness of interrogation and identification parade (recall and recognition) as a function of witnesses' Intelligence Quotient. Two experiments in photo identification form were performed to verify a hypothesis that IQ does not affect the ability to recognize a human face. The subjects whose average IQ (according to Wechsler Adult Intelligence Scale WAIS) was 65.9 (females) and 66.3 (males) obtained the same results as the subjects whose average IQ was 105.3 (females) and 99.5 (males); t1 = 13.77, p1 less than 0.001, t2 = 12.13, p2 less than 0.001, chi 2 = 0, P greater than 0.99.     

Travel, time zones, and sudden cardiac death. Emporiatric pathology

In an 11-year retrospective study of coroner's autopsies on the Hawaiian island of Kauai, it was found that an unusual and apparently unique subset of travelers died suddenly. Death was caused by coronary arteriosclerosis, was characterized by acute coronary changes, and occurred in a group younger than the usual age for sudden cardiac death. Visitors with two-vessel disease had an incidence of sudden death nearly four times that of Kauaians (p less than 0.02), with a ninefold increase of coronary thrombosis (p less than 0.001), a sixfold prevalence of old myocardial infarcts (p less than 0.001), and three times the prevalence of cardiomegaly (p less than 0.001). The circadian pattern of these deaths was different from that previously described in acute myocardial infarction or sudden death, with the number of incidents rising steadily through the day in contrast to the morning peak described in previously published series. The syndrome was expressed in decedents with two-vessel coronary disease either with acute coronary artery lesions--thrombosis, hemorrhage in a plaque, or ruptured coronary artery--or no lesions, presumably spasm. Underlying chronic processes included enlarged heart or old myocardial infarct, which both occurred with a significantly greater incidence in travelers than in local residents, and in a totally different pattern from that occurring in subjects with three-vessel disease. It is postulated that the syndrome is caused by stress related to travel and time zone changes.     

Own-race bias in lineup construction

The lineup identification of a suspect is often a critical stage in a criminal investigation. One factor which may affect the fairness of a lineup is bias on the part of the person constructing the lineup. the own-race bias, the tendency of individuals to perceive more similarity in the appearance of other-race members than in their own, may affect lineup development. Black subjects and white subjects were asked to construct lineups using both black and white suspects. On three of four measures, their behavior was very similar while making white lineups but different on black lineups. Relative to their performance on white lineups, white subjects became less selective on black lineups but black subjects became even more selective on black lineups. Both groups displayed own-race bias by being more selective about own-race photos than other-race photos. This lessening of selectivity may make lineups constructed by cross-race lineup constructors less fair than lineups constructed by own-race lineup constructors.     

Incidence of familial hypercholesterolaemia in premature deaths due to coronary heart disease

Cholesterol estimations were performed on blood collected postmortem from a group of subjects coming to autopsy and showing that they had had a high risk for hypercholesterolaemia, and from an unselected group of subjects dying in hospital. Subjects from the first group had apparently been healthy, aged less than 45 years, had had no known risk factors for hyperlipidaemia, and showed extensive coronary artery atheroma (stenosis greater than 50% by diameter). Eleven cases from 485 consecutive autopsies fulfilled these criteria; three showed considerable hypercholesterolaemia (11.2, 11.8, and 21.6 mmol/L). Family studies confirmed the diagnosis of familial hypercholesterolaemia in one case; the other two remain unproven. Cholesterol measurement by cholesterol oxidase and quinoneimine dye production is subject to interference by haemolysis; provided that serum haemoglobin is less than 200 mg/dl, the cholesterol underestimate is less than 5%. The decline in serum cholesterol in the group of unselected subjects was 1.7 (0.3-4.9) mmol/L, 50.4 (28-84) h postmortem. Results are means and ranges for seven subjects. Measurement of cholesterol in serum obtained postmortem (provided that the sample is not grossly haemolysed) is a valid approximation of antemortem levels: this measurement should be made when autopsy reveals evidence of premature coronary heart disease. If hypercholesterolaemia is discovered, the diagnosis of familial hypercholesterolaemia, a common genetic disorder inherited in an autosomal dominant fashion, should be considered and appropriate family studies instituted.     

Fatal occupational inhalation of hydrogen sulfide

A young man aged 22 years, a sewer worker by profession, died after massive inhalation of hydrogen sulfide while at work. He was rescued by the emergency services and admitted to the critical care department, where he died due to massive myocardial necrosis less than 24 h after admission. In this case, where the causes of the accident were not clearly established, autopsy and anatomopathologic examination made it possible to confirm the causal lesions which resulted in death and to question the initial version of the circumstances of the accident. Medicolegal investigation was valuable in determining possible liabilities and repercussions on coverage as an industrial accident by the national health insurance system.     

Intersection between alcohol abuse and intimate partner's violence in a rural Ijaw community in Bayelsa State, South-South Nigeria

According to the 2008 National Demographic and Health Survey, the south-south zone of Nigeria had the highest prevalence of domestic violence. This study is to find out if this is related to the widespread consumption of alcohol in the region. The study was carried out in Okoloba, a rural Ijaw community in Bayelsa State, where alcohol is produced and consumed in large quantities; using a cross-sectional study design. The data was collected from married or cohabitating adults aged between 16 and 65 years, with a structured interviewer-administered questionnaire. A total of 346 subjects, comprising 187 males, and 159 females were studied. They had an average age of 41.4 ± 2.5 years, were mostly Christians (91.9%), farmers/fisher folk (52.3%), and had at most primary school education (64.2%). More than 90% of the subjects took alcohol in the preceding year, while 36% can be classified as alcohol abusers according to their AUDIT score. More than half (55.8%) were perpetrators of intimate partner violence during the preceding 12 months, with a male-to-female prevalence of 83.4%, and female-to-male prevalence of 23.3%. Out of these, 77.2% were under the influence of alcohol during the act. The violence was more likely to be perpetrated by male alcohol abusers (p-value < 0.001), but there were no significant differences in the educational levels and religion of the perpetrators (p-value > 0.05). The study therefore concludes that there is a link between intimate partner abuse and alcohol abuse in the study community.     

Detection of Inflicted Bruises by Alternate Light: Results of a Randomized Controlled Trial

Bruises are often difficult to detect on victims of violence, potentially impacting investigation and prosecution. The purpose of our randomized controlled trial was to measure the effectiveness of an alternate light source (ALS) within visible and long ultraviolet spectrums at improving bruise detection compared to white light over time. We also examined the effects of skin color, age, gender, localized fat, and injury mechanism on bruise detection. Participants included 157 healthy adults with balanced sampling across six skin color categories. Bruises were created under the controlled application of a paintball pellet and dropped weight to one upper and lower arm, respectively. Using a crossover design, both bruises were examined 21 times over 4 weeks. Ten different wavelength (350–535 nm) and filter (yellow, orange, red) combinations were used. Multilevel models were used to analyze 2903 examinations on both upper and lower arms. Results in multivariable models showed after controlling for other covariates 415 and 450 nm using a yellow filter had greater odds of detecting evidence of bruising than white light (Upper Arm: 415 nm: OR = 5.34, 95% CI: 4.35–6.56; 450 nm: OR = 4.08, 95% CI: 3.36–4.96). Under either light source, being female and having more localized fat had increased odds of detecting bruises created by the dropped weight (female: OR = 2.96, 95% CI: 2.37–3.70; fat: OR = 1.21, 95% CI: 1.09–1.34). Our results support ALS as an appropriate tool to enhance concurrent physical assessment of bruises in the presence of known history of injury. Future development and evaluation of clinical practice guidelines for ALS application are needed.     

上、下尖牙髓腔/牙体表面积比值的年龄判定价值研究

目的 通过三维重建测量上、下颌尖牙髓腔/牙体表面积比值(Pulp/Tooth area Ratio,PTR)来推断个体年龄,为临床年龄推断的应用提供科学依据.方法 收集口腔门诊患者年龄在16～65岁200例锥形束CT(Cone beam computed tomography,CBCT)影像资料,以4个尖牙为测量对象并...     

正常人蓝/黄颜色刺激事件相关电位的探讨

目的研究正常人等亮度蓝/黄颜色刺激电生理反应及其头皮分布,探讨大脑处理蓝/黄颜色视觉信息的特征及其法医学价值。方法对20名正常人（40只眼）进行等亮度蓝/黄颜色刺激,同时记录其脑电反应。结果事件相关电位（Event-related potentials,ERP）早期成分显示：与蓝色靶刺激相比,黄色靶刺激引起广泛脑区N1和P2潜伏期显著缩短;此外,黄色靶刺激较蓝色靶刺激诱发出较大N1及P2,且P2振幅右半球优势效应显著。ERP晚期成分显示：与早期成分相似,与黄色靶刺激对比,蓝色靶刺激引起广泛脑区N2和P3潜伏期显著延长,以及较小的N2和P3,同时,P3表现出显著的左半球优势效应。结论以上ERP结果提示,等亮度模式下,大脑对黄色反应更敏感,黄色刺激不仅引起ERP早期成分N1和P2潜伏期的缩短及振幅的升高,同时还引起ERP晚期成分N2和P3潜伏期缩短及振幅升高。颜色ERP可能在未来法医学基础研究及临床鉴定实践中发挥很大的应用价值。     

重庆地区汉族未成年人牙龄推断的研究

目的运用牙齿曲面断层影像技术,研究6周岁～15周岁重庆市未成年人牙齿钙化的规律,从而建立根据牙齿钙化程度推断年龄的方法。方法依据牙齿钙化分级标准对1321名（男性577名,女性744名）重庆市6周岁～15周岁未成年人牙齿曲面断层片上的牙齿钙化程度进行分级评分;将评分值与对应的性别和年龄分别输入SPSS13.0软件进行统计分析,最终建立推断年龄的方程。结果左右侧同名牙齿钙化程度无统计学差异（P〉0.05）,但性别间有统计学差异（P〈0.05）;下颌左右侧8颗牙齿的钙化程度与年龄相关系数均大于0.58;所建利用不同牙齿组合推断年龄的线性回归模型调整拟合优度均大于0.67,估计值标准误男性为0.95周岁～1.11周岁、女性为1.02周岁～1.12周岁。结论该方法可用于法庭科学领域中推断重庆市6周岁～15周岁未成年人活体以及尸体的年龄。     

Topological Variability of Fingerprint Ridge Density in a Sub‐Saharan Population Sample for Application in Personal Identification

Variability in ridge density in a sub‐Saharan population sample was studied by counting ridges in three fingerprint areas (two distal regions, radial and ulnar, and one proximal region) on the epidermal surface of the distal phalanx. Study material was obtained from the fingerprint impressions of 100 male sub‐Saharan subjects aged between 18‐ and 48‐years old. The results were compared with those obtained from a Spanish population sample. Sub‐Saharan males presented lower ridge density than Spanish males in the distal regions (radial and ulnar) of all fingers, whereas differences in the proximal region were only observed on some fingers. Using the differences observed between these populations, the likelihood ratio for inferring membership of one of the populations from a fingerprint of unknown origin was calculated; therefore, a ridge density of 14 or less for both areas (ulnar and radial), support an origin sub‐Saharan versus Spanish population.