CT‐Guided,Minimally Invasive,Postmortem Needle Biopsy Using the B‐Rob II Needle‐Positioning Robot

CT‐guided, minimally invasive needle biopsy techniques can be used to retrieve tissue or body fluid samples for histologic tissue diagnoses in forensic investigations. The purpose of this study was an evaluation of CT‐guided needle‐positioning robot B‐Rob II. To operate under CT guidance, we adopted the B‐Rob II robotic needle placement system and its workflow. The accuracy and speed of the procedure were tested on a gelatin phantom in a series of 21 biopsies. We achieved an average needle placement accuracy of 1.8 mm (±1.1 mm) using robotic assistance. The procedure required an average of 2 min 21 s. The needle placement accuracy for minimally invasive needle biopsies using the B‐Rob II biopsy robot is sufficiently accurate and fast for forensic postmortem examinations of focal organ changes. Further tests will be performed to test the feasibility of the robot for performing biopsies of focal organ changes in human bodies.     

Blood aspiration as a vital sign detected by postmortem computed tomography imaging

Blood aspiration is a significant forensic finding. In this study, we examined the value of postmortem computed tomography (CT) imaging in evaluating findings of blood aspiration. We selected 37 cases with autopsy evidence of blood in the lungs and/or in the airways previously submitted to total-body CT scanning. The CT-images were retrospectively analyzed. In one case with pulmonary blood aspiration, biopsy specimens were obtained under CT guide for histological examination. In six cases, CT detected pulmonary abnormalities suggestive of blood aspiration, not mentioned in the autopsy reports. CT reconstructions provided additional data about the distribution and extent of aspiration. In one needle-biopsied case, the pulmonary specimens showed blood in the alveoli. We suggest the use of CT imaging as a tool complementary to traditional techniques in cases of blood aspiration to avoid misdiagnosis, to guide the investigation of lung tissue, and to allow for more evidence-based inferences on the cause of death.     

Concentration of carbon monoxide (CO) in postmortem human tissues: effect of environmental CO exposure

We studied how carbon monoxide (CO) is distributed within the human body through quantitation of CO concentrations in postmortem tissue samples from fatalities including possible CO exposure. Stored, frozen tissues were diced, sonicated in water, and 0.01-8.0 mg wet weight (ww) tissues were incubated with sulfosalicylic acid in CO-purged, septum-sealed vials. CO released into the headspace was quantitated by reduction gas chromatography. Mean tissue CO concentrations (pmol/mg ww) from subjects diagnosed to have no known CO exposure (control, N=14), died from fire (N=13), and CO asphyxiation (N=7), respectively, were: adipose (2;13;9), brain (3;13;65), muscle (15;97;297), heart (30;99;371), kidney (22;432;709, lung (54;690;2638), spleen (73;1366;3548), and blood (162;2238;5070). Carboxyhemoglobin concentrations were 1.4%, 25.2%, and 69.1% of total hemoglobin, respectively. We conclude that measurements of CO concentration in a variety of tissues can be used as markers for the degree of exogenous CO exposure and the identification of possible causes of death.     

A study of drug detection in a postmortem pediatric population

At The Office of the Cuyahoga County Coroner (CCCO), Cleveland, Ohio, it is customary to perform an autopsy and conduct toxicological testing on decedents less than 19 years of age. This study provides a retrospective evaluation of drugs detected in a pediatric postmortem population between the years 1998 and 2002 (n = 730). Demographic information, cause and manner of death, and toxicological results were examined. Blacks comprised 54% of cases, males 59%, and 48% were less than one year of age or stillborn. Forty-two percent of deaths were ruled natural, 27% accident, 13% undetermined, 5% suicide, and 2% homicide. Of the 640 cases subjected to comprehensive testing, 38% of the cases were positive for at least one compound. Resuscitative/treatment drugs were detected most frequently (56% of positive results), followed by illicit drugs (26%), ethanol (11%), carbon monoxide (8%), and antihistamines (6%). Eighty-seven cases contained more than one drug. The deaths of 47 individuals were drug related (6%). In this population, it is recommended that illicit drugs and ethanol are targeted for testing, especially when limited specimens are available for analysis.     

Disaster victim identification: new applications for postmortem computed tomography

Abstract:  Mass fatalities can present the forensic anthropologist and forensic pathologist with a different set of challenges to those presented by a single fatality. To date radiography has played an important role in the disaster victim identification (DVI) process. The aim of this paper is to highlight the benefits of applying computed tomography (CT) technology to the DVI process. The paper begins by reviewing the extent to which sophisticated imaging techniques, specifically CT, have been increasingly used to assist in the analysis of deceased individuals. A small scale case study is then presented which describes aspects of the DVI process following a recent Australian aviation disaster involving two individuals. Having grided the scene of the disaster, a total of 41 bags of heavily disrupted human remains were collected. A postmortem examination was subsequently undertaken. Analysis of the CT images of all body parts ( n  = 162) made it possible not only to identify and side differentially preserved skeletal elements which were anatomically unrecognizable in the heavily disrupted body masses, but also to observe and record useful identifying features such as surgical implants. In this case the role of the forensic anthropologist and CT technology were paramount in facilitating a quick identification, and subsequently, an effective and timely reconciliation, of body parts. Although this case study is small scale, it illustrates the enormous potential for CT imaging to complement the existing DVI process.     

A Minimally Invasive Technique for the Detection and Analysis of Pulmonary Fat Embolism: A Feasibility Study*

We investigated the feasibility of postmortem percutaneous needle biopsy (PNB) for obtaining pulmonary samples adequate for the study of pulmonary fat embolism (PFE). Samples of both lungs were obtained from 26 cadavers via two different methods: (i) PNB and (ii) the double-edged knife technique, the gold standard at our institute. After water storage and Sudan III staining, six forensic pathologists independently examined all samples for the presence and severity of PFE. The results were compared and analyzed in each case regarding the vitality of the PFE and its relationship to the cause of death. The results showed that PFE was almost identically diagnosed and graded on the samples obtained via both methods. The discrepancies between the two techniques did not affect the diagnoses of vitality or cause of death related to PFE. This study demonstrates the feasibility of the PNB sampling method for the diagnosis and interpretation of PFE in the postmortem setting.     

Is Differentiation of Frequently Encountered Foreign Bodies in Corpses Possible by Hounsfield Density Measurement?

Abstract:  The radiological determination of foreign objects in corpses can be difficult if they are fragmented or deformed. With multislice computed tomography, radiodensities—referred to as Hounsfield units (HU)—can be measured. We examined the possibility of differentiating 21 frequently occurring foreign bodies, such as metals, rocks, and different manmade materials by virtue of their HU values. Gold, steel, and brass showed mean HU values of 30671–30710 (upper measurable limit), mean HU values for steel, silver, copper, and limestone were 20346, 16949, 14033, and 2765, respectively. The group consisting of objects, such as aluminum, tarmac, car front-window glass, and other rocks, displayed mean HU values of 2329–2131 HU. The mean HU value of bottle glass and car side-window glass was 2088, whereas windowpane glass was 493. HU value determination may therefore help in preautopsy differentiation between case-relevant and irrelevant foreign bodies and thus be useful for autopsy planning and extraction of the objects in question.     

Accuracy and reliability of cone beam computed tomography of the jaws for comparative forensic identification: a preliminary study

Conventional computed tomography is an emerging modality in forensic identification but is not sufficiently accurate for use in dental identification primarily because of problems with metallic dental restoration-induced streak artifact. In this study, the accuracy and reliability of recording forensic information from cone beam computed tomography (CBCT) scans of the jaws when compared to conventional panoramic radiographs has been analyzed under experimental conditions. Information could be recorded with near-perfect repeatability and reproducibility. Information could also be recorded accurately, the sensitivity being 96.6% (95% CI, 95.1-98.1) and specificity being 98.4% (95% CI, 96.2-100). The metal dental restoration-induced streak artifact was at a level that permitted, in most cases, accurate observations. This is considered an important step in validating CBCT as a tool in comparative dental identification of bodies. It may have a role in mass fatalities and in chemical, biological, radiological, and nuclear incidents, but further studies are required to assess the feasibility of this.     

Whole body postmortem magnetic resonance angiography

Computed tomography (CT) and magnetic resonance (MR) imaging have become important elements of forensic radiology. Whereas the feasibility and potential of CT angiography have long been explored, postmortem MR angiography (PMMRA) has so far been neglected. We tested the feasibility of PMMRA on four adult human cadavers. Technical quality of PMMRA was assessed relative to postmortem CT angiography (PMCTA), separately for each body region. Intra-aortic contrast volumes were calculated on PMCTA and PMMRA with segmentation software. The results showed that technical quality of PMMRA images was equal to PMCTA in 4/4 cases for the head, the heart, and the chest, and in 3/4 cases for the abdomen, and the pelvis. There was a mean decrease in intra-aortic contrast volume from PMCTA to PMMRA of 46%. PMMRA is technically feasible and allows combining the soft tissue detail provided by MR and the information afforded by angiography.     

The fate of the chemical warfare agent during DNA extraction

Forensic laboratories do not have the infrastructure to process or store contaminated DNA samples that have been recovered from a crime scene contaminated with chemical or biological warfare agents. Previous research has shown that DNA profiles can be recovered from blood exposed to several chemical warfare agents after the agent has been removed. The fate of four toxic agents, sulfur mustard, sodium 2-fluoroacetate, sarin, and diazinon, in a lysis buffer used in Promega DNA IQ extraction protocol was studied to determine if extraction would render the samples safe. Two independent analytical methods were used per agent, selected from GC-MS, 1H NMR, 19F NMR, (31)P NMR, or LC-ES MS. The methods were validated before use. Determinations were carried out in a semi-quantitative way, by direct comparison to standards. Agent levels in the elution buffer were found to be below the detectable limits for mustard, sarin, sodium 2-fluoroacetate or low (<0.02 mg/mL) for diazinon. Therefore, once extracted these DNA samples could be safely processed in a forensic laboratory.     

Pig-mentation: postmortem iris color change in the eyes of Sus scrofa

Experienced forensic pathologists and examiners may be familiar with the phenomenon of postmortem iris color change; however, only Knight, Simpson's forensic medicine, Arnold, London, 1997; Ref. 1 and Saukko and Knight, Knight's forensic pathology, 3rd ed., Arnold, London, 2004; Ref. 2 have referred to it in the literature, and to date, there have been no published scientific research studies on this taphonomic artifact. A controlled experiment was conducted of postmortem changes to isolated Sus scrofa eyes. The eyes (n = 137) were separated into three groups and each sample was observed for 3-day postmortem at a different temperature. In addition, a Sus scrofa head was obtained to observe postmortem changes of eyes in situ. All isolated blue eyes in the experiment, at room temperature and higher, changed to brown/black within 48 h. The in situ blue eye, at room temperature, turned brown/black within 72 h. If iris color consistently changes postmortem in humans, then this taphonomic artifact must be incorporated into victim identification protocol, including disaster victim identification software, and autopsy reports to prevent inaccurate victim identification and inappropriate exclusion from the identification process.     

Fentanyl concentrations in 23 postmortem cases from the hennepin county medical examiner's office

The purpose of this study was to compare blood fentanyl concentrations in fentanyl-related deaths with fentanyl concentrations found incidentally at autopsy, as well as with fentanyl concentrations found in hospitalized patients receiving fentanyl. Between the years 1997 to 2005, 23 fentanyl-positive postmortem cases were identified. Nineteen of 23 (82.6%) cases were deemed to be drug overdoses. Fentanyl alone was responsible for 8 of the 19 (42.1%) overdose deaths. Mean and median fentanyl concentrations were 36 (SD 38) microg/L and 22 microg/L, respectively, range 5-120 microg/L. Seven of the cases were accidental, one undetermined. The remaining 11 of the 19 (57.9%) cases were mixed drug overdoses. Fentanyl concentrations in these cases were 31 (SD 46) microg/L, range 5-152 microg/L. All of the mixed drug overdoses were determined to be accidental. Four cases where fentanyl was considered an incidental postmortem finding were determined to be natural deaths. In hospitalized inpatients (n = 11) receiving fentanyl 2 of the patients receiving fentanyl for chronic pain for more than 3 months had concentrations of 8.5 microg/L and 9.9 microg/L. The other nine inpatient concentrations were less than 4 microg/L. In conclusion, blood fentanyl concentrations found in cases where fentanyl alone was determined to be the cause of death were similar to cases where fentanyl was part of a mixed drug overdose. There was also considerable overlap between fentanyl concentrations in fentanyl-related overdose deaths compared to hospitalized patients being treated for chronic pain. Fentanyl concentrations in postmortem cases must be interpreted in the context of the deceased's past medical history and autopsy findings.     

组织RNA检测用于死亡时间推断的研究进展

近几年来利用RNA的降解程度来推断死亡时间已逐渐成为法医学研究热点.本文复习相关研究文献,对大鼠不同组织(脑组织、心脏组织、肝脏组织和肾组织等)中RNA在推断死亡时间的具体应用方法做出总结,归纳出不同组织中的各类RNA在推断死亡时间方面的适用范围,以及对此种方法在推断死亡时间的过程中产生的问题及可行性的解决方法.     

Estimating the timing of long bone fractures: correlation between the postmortem interval, bone moisture content, and blunt force trauma fracture characteristics*

There is very limited knowledge about how long perimortem fracture characteristics persist into the postmortem interval (PMI). Therefore, in this study, 60 porcine long bones were exposed to natural taphonomic conditions and fractured with a steel bone breaking apparatus every 28 days throughout a 141-day period. Differences between macroscopic blunt force trauma fracture characteristics (fracture angle, surface morphology, and outline) were examined to determine if they varied over time or in relationship to bone moisture content (ash weight) and overall assessment. There are significant relationships between (1) PMI and percent ash weight (%AW), fracture surface, and fracture angle and (2) %AW and fracture surface and fracture angle. Bone moisture content correlates significantly with fracture morphology and other characteristics commonly used by forensic anthropologists to determine the timing of traumatic injuries. However, fracture characteristics normally associated with perimortem trauma can persist long into the PMI.     

A rapid wire-based sampling method for DNA profiling

Abstract: This paper reports the results of a commission to develop a field deployable rapid short tandem repeat (STR)‐based DNA profiling system to enable discrimination between tissues derived from a small number of individuals. Speed was achieved by truncation of sample preparation and field deployability by use of an Agilent 2100 Bioanalyser^TM. Human blood and tissues were stabbed with heated stainless steel wire and the resulting sample dehydrated with isopropanol prior to direct addition to a PCR. Choice of a polymerase tolerant of tissue residues and cycles of amplification appropriate for the amount of template expected yielded useful profiles with a custom‐designed quintuplex primer set suitable for use with the Bioanalyser^TM. Samples stored on wires remained amplifiable for months, allowing their transportation unrefrigerated from remote locations to a laboratory for analysis using AmpFlSTR^® Profiler Plus^® without further processing. The field system meets the requirements for discrimination of samples from small sets and retains access to full STR profiling when required.     

Bayesian adaptive approach to estimating sample sizes for seizures of illicit drugs

A considerable amount of discussion can be found in the forensics literature about the issue of using statistical sampling to obtain for chemical analyses an appropriate subset of units from a police seizure suspected to contain illicit material. Use of the Bayesian paradigm has been suggested as the most suitable statistical approach to solving the question of how large a sample needs to be to ensure legally and practically acceptable purposes. Here, we introduce a hypergeometric sampling model combined with a specific prior distribution for the homogeneity of the seizure, where a parameter for the analyst's expectation of homogeneity (α) is included. Our results show how an adaptive approach to sampling can minimize the practical efforts needed in the laboratory analyses, as the model allows the scientist to decide sequentially how to proceed, while maintaining a sufficiently high confidence in the conclusions.     

人体组织/体液来源的法医学鉴定

生物检材的组织/体液来源鉴定是法医学检验的重要内容之一。法医学组织/体液鉴定的方法较多,无论是基于酶促反应或免疫学检测的传统鉴定方法,还是光谱法或近年来基于mRNA、microRNA或DNA甲基化差异的分子生物学组织鉴定技术,均各有特点。本文就各种法医学组织/体液鉴定方法的特点及其法医学应用价值作一简要综述。     

Investigation into the merits of infrared imaging in the investigation of tattoos postmortem

Infrared imaging has a history of use in the forensic examination of artwork and documents and is investigated here for its wider use in the detection of tattoos on the human body postmortem. Infrared photographic and reflectographic techniques were tested on 18 living individuals, displaying a total of 30 tattoos. It was observed that neither age, sex, age of the tattoo, nor, most significantly, skin color affected the ability to image the tattoos using infrared imaging techniques. Second, a piglet carcass was tattooed and the impact of the decomposition process on the visibility of the tattoos assessed. Changes were recorded for 17 days and decomposition included partial mummification and skin discoloration. Crucially, the discoloration was recorded as greatly affecting the image quality using conventional photography, but was insignificant to the infrared recording of these tattoos. It was concluded that infrared reflectography was beneficial in the investigation into tattoos postmortem.     

Algor mortis: an erroneous measurement following postmortem refrigeration

Determination of the time of death is one goal of medicolegal death investigations. Algor mortis has been used as a measure of the postmortem interval (PMI). We prospectively recorded the core temperatures of 19 adult bodies entering our morgue cooler and at 3, 6, and 9 h of refrigeration. We then compared the cooling rate with the calculated body mass index (BMI). For each individual body, the rate of cooling was fairly linear with no evidence of a plateau. There was fair to moderate correlation between the BMI and the cooling rate: cooling rate = -0.052 (BMI) + 3.52. The probability of linearity in any given case was 36%. Variables affecting this correlation included the presence and the layers of clothing and if the clothing was wet. Our data confirm that algor mortis is of very limited utility in determining the PMI in bodies that have been refrigerated.     

Total Body Mass Estimation from Anthropometric Measurements in Modern Young Adult U.S. Populations with Healthy Body Fat Percentages (NHANES III)

This study presents a method by which to estimate total body mass in modern young adult U.S. populations who self‐identified as non‐Hispanic U.S. White, non‐Hispanic U.S. Black, and Mexican American with anthropometric measurements from the Third National Health and Nutrition Examination Survey (NHANES III) 1988–1994 dataset (N = 2532). Correlations of stature and bi‐iliac breadth with total body mass were stronger among males (r = 0.717–0.774) than among females (r = 0.549–0.661), yet these results were more accurate assessments of total body mass than existing techniques. This study also examined additional anthropometric measurements to estimate total body mass using an information‐theoretic approach demonstrating that some error in the stature–bi‐iliac breadth method is attributed to a nonsupported model with multimodel inference. The limitations of the current total body mass technique are discussed as well as the need for future studies to validate the method.