High-quality Digital 3D Reconstruction of Microscopic Findings in Forensic Pathology: The Terminal Pathway of a Heart Stab Wound*

High-quality digital three-dimensional (3D) reconstructions of microscopic findings have been used in anatomical and histopathologic research, but their use in forensic pathology may also be of interest. This paper presents an application of these methods to better characterize the pathway of a stab wound of the anterior surface of the heart in a case of suicide. A portion of the heart wall including the stab wound was serially sectioned for microscopic analysis along the full extent of the wound. Histologic sections were digitally acquired, and a 3D reconstruction was created with ImageJ software for 3D computer graphics. This showed a full-thickness wound path extending to the endocardial surface of the left ventricle, curvilinear in appearance. After correction for shrinkage, 3D reconstruction allowed estimation of the dimensions of the myocardial injury and comparison of the appearance of the wound with the suspected knife used. The curvilinear appearance was considered to reflect injury during myocardial contraction. Complete microscopic sectioning and 3D reconstruction may allow virtual sectioning through various orientations and also provide useful forensic information for selected injuries.     

SEM and Stereomicroscopic Analysis of Cut Marks in Fresh and Burned Bone

This study documents the prevalence of cut mark characteristics in fresh and burned domestic pig ribs. Stab wounds from single edge serrated and smooth‐edged knives were inflicted in the vertebral and sternal regions of each fresh rib. Each rack of ribs was then divided into vertebral and sternal units. Vertebral units were defleshed and their associated cut marks were examined using a stereomicroscope. Sternal units were burned in an outdoor fire pit and examined with the addition of a scanning electron microscope (SEM). Linear cuts, V‐shaped cross‐sections, mounding, hinge fractures, and wastage were all observed on burned ribs. There was an overall decrease in the prevalence of all features (up to a 40% decrease), regardless of knife type, in burned ribs. Striations within cut marks were not observed in either fresh or burned ribs. Oblique faulting and bone lifts could only be observed using the SEM. Mounding and wastage were obliterated during the burning process. Therefore, cut marks in burned bone should ideally be examined for their characteristics utilizing an SEM.     

Characteristics of Bone Injuries Resulting from Knife Wounds Incised with Different Forces

The aim of this research was to experimentally determine the characteristics of incised bone wounds, which are commonly found in defense injuries. A specially constructed pivoting arm device was used to inflict wounds with controlled forces and direction. Five knives were selected to inflict the wounds on porcine forelimbs. Eight incised wounds were made per knife per force. A larger knife and a greater force caused longer and wider bone wounds. Comparisons of individual knives at the two forces produced varying results in the bone wounds. A correlation was seen between the force and the length (r = 0.69), width (r = 0.63), and depth (r = 0.57) of bone wounds. Serrated‐edge and nonserrated knives can be distinguished from the appearance of the wound. The outcomes may be applicable in forensic investigations to ascertain the forces associated with incised wounds and identify the specific knife used.     

A method for studying knife tool marks on bone

The characteristics of knife tool marks retained on hard tissues can be used to outline the shape and angle of a knife. The purpose of this study was to describe such marks on bone tissues that had been chopped with knives. A chopping stage with a gravity accelerator and a fixed bone platform was designed to reconstruct the chopping action. A digital microscope was also used to measure the knife angle (θ) and retained V-shape tool mark angle (ψ) in a pig skull. The κ value (elasticity coefficient; θ/ψ) was derived and recorded after the knife angle (θ) and the accompanied velocity were compared with the proportional impulsive force of the knife and ψ on the bone. The constant impulsive force revealed a correlation between the V-shape tool mark angle (ψ) and the elasticity coefficient (κ). These results describe the tool marks--crucial in the medicolegal investigation--of a knife on hard tissues.     

Identification from Chest X‐Rays: Reliability of Bone Density Patterns of the Humerus*

Abstract: A critical review of Kahana and Hiss’ study on identification from bone trabecular pattern and a test of their method conducted on the humerus are presented. Bone trabecular pattern was studied through the generation of a numerical file representing the gray scale. Using the correlation coefficient, several pairwise comparisons between numerical files were performed. The test gave nearly 30% of incorrect exclusions (the method did not recognize couples of radiographs belonging to the same subject) and 50% of misidentifications (the method recognized couples of radiographs belonging to different subjects, as belonging to the same subject); therefore, this research shows that at the present time, it is not possible to safely quantify identification through bone density patterns, of the proximal humerus taken from thoracic X‐rays. Thus, an “easy”—but dangerous—use of trabecular density patterns on this specific type of radiogram as an identification method should be currently avoided.     

An Unplanned Complex Suicide by Multiple Blank Cartridge Gunshots and Cutting

Blank firing guns are readily accessible in most countries due to an absence of legal regulations. These weapons are capable of causing lethal injuries. We report a rare case of secondary (unplanned) complex suicide committed with a knife and blank cartridge pistol. A 59‐year‐old man was found dead with three superficial incisions in his neck and a gunshot wound to the chest. The external examination revealed an entrance wound in the left chest region consistent with contact shooting. The appearance of a muzzle imprint suggested two discharges. The autopsy showed a slightly hemorrhaged but otherwise intact pericardium, blood in the pericardial sac, and a channel‐like defect in the anterior wall of the left cardiac ventricle. The cause of death was attributed to cardiac tamponade. To the best of our knowledge, this is the first reported case of unplanned complex suicide involving an unmodified blank firing gun.     

Frozen human bone: a microscopic investigation

The taphonomic effects of prolonged extreme cold and freezing on human bone have received little research attention. Questions of specific interest include whether previously frozen bone can be identified and whether freezing alters the structural integrity enough to prevent histological aging. There is no evidence from previous studies that freezing damages the structural integrity, and to date no research investigating the freezing process on bone microstructure has been undertaken. This research attempts to distinguish histologically previously frozen bone from nonfrozen bone by identifying patterned defects. To determine the effects of freezing in bone microstructure using light and scanning electron microscopy (SEM), several human bone sections were subjected to prolonged freezing and allowed to thaw before thin sectioning. Light microscopy failed to demonstrate statistically significant differences between frozen and nonfrozen specimens. SEM analysis revealed fractures, although these lacked pattern and did not occur systematically throughout the section. Evidence of microstructural changes caused by liquid expansion, however, was remarkable but did not alter the structural integrity of the microstructure. The results of this study suggest that freezing does not alter the process of histomorphological analysis.     

Microscopic Analysis of Sharp Force Trauma in Bone and Cartilage: A Validation Study,,

Sharp force trauma research lacks agreement on reported error rates for correctly identifying toolmark characteristics on bone and cartilage. This study provides error rates for determining blade class (serrated, partially serrated, nonserrated) and type of edge bevel (left, right, even). Three analysts examined cuts to a wax medium, cartilage, and bone using two types of microscopes. Additionally, the observers examined impressions taken from the wax medium and the cartilage. Overall, a total of 504 observations were performed. Serrated blades were distinguishable from nonserrated blades due to their patterned striations. Some difficulties were encountered in distinguishing serrated and partially serrated blades; however, when these groups were considered together as one classification type (serrated), classification accuracy improved from 79% to 96%. Classification accuracy for edge bevel was 65%. Error rates were similar when comparing direct observation of the cut marks versus indirect observation (impressions). Additionally, the type of microscope used did not affect error rates.     

The Cane Sword

This report provides an overview of the injuries caused by a unique blade‐type weapon known as a cane sword. The cane sword usually consists of a blade that is stored in a cylindrical “cane” that can be released at the handle to reveal the hidden blade within. The victim of the case was found to have a stab wound in the left mid‐back that caused perforation of both the lower and upper lobes of the left lung, resulting in a left hemothorax. Upon autopsy, it was concluded that the patient died from injuries caused by the stab wound to the back. Given the shape of the wound and the fact that the weapon itself was found at the site of the homicide, the weapon that caused the injury was believed to be a cane sword. This case will inform forensic pathologists, law‐enforcement officers, emergency medical personnel, and physicians about rare weapon, the cane sword.     

Abdominal Stab Wounds with Tension Pneumopericardium Confirmed by Autopsy and Postmortem Computed Tomography

We present the first report of pneumopericardium observed by autopsy and on postmortem computed tomography (PMCT) images. The subject was a woman who died of self‐inflicted stab wounds to the abdomen. The PMCT scan revealed air in the pericardial sac, a “flattened heart” sign, and retroperitoneal hemorrhage. Medicolegal autopsy revealed two abdominal stab wounds near the xiphoid process that had cut the apical pericardium and adjacent diaphragm and liver. Examination of the open thorax confirmed that the pericardial sac was distended with air. The wound extended to the abdominal aorta, causing retroperitoneal hemorrhage. PMCT images showed that the pneumopericardial volume was 133 mL. We believe that cardiac tamponade occurred resulting from the tension pneumopericardium; however, the effects were mitigated by hypovolemia secondary to the retroperitoneal hemorrhage as well as obstructive shock. Therefore, the cause of death appears to have been low‐pressure cardiac tamponade.     

骨砍创金属颗粒的检测

目的 应用扫描电镜/X射线能谱仪(SEM/EDX)对菜刀砍击骨质后遗留在创面上的金属微粒进行检测.方法 3种不同材质菜刀各取5把,对猪大腿骨进行砍击,使用SEM/EDX对骨创面上附着的金属颗粒元素以及菜刀自身所含元素进行定性及定量检验,并对结果进行比对分析.结果 菜刀样本同型号之间元素重量百分比相比较,结果无统计学差异(P＞0.05);创面附着金属颗粒与菜刀自身所含元素种类特征相同;其所占重量的百分比一致(P＞0.05);结论 骨骼创面遗留金属颗粒的元素种类及其百分比含量,可以作为区分菜刀类致伤工具的重要依据.     

Could Secondary DNA Transfer Falsely Place Someone at the Scene of a Crime?,

The occurrence of secondary DNA transfer has been previously established. However, the transfer of DNA through an intermediary has not been revisited with more sensitive current technologies implemented to increase the likelihood of obtaining results from low‐template/low‐quality samples. This study evaluated whether this increased sensitivity could lead to the detection of interpretable secondary DNA transfer profiles. After two minutes of hand to hand contact, participants immediately handled assigned knives. Swabbings of the knives with detectable amounts of DNA were amplified with the Identifiler^® Plus Amplification Kit and injected on a 3130xl. DNA typing results indicated that secondary DNA transfer was detected in 85% of the samples. In five samples, the secondary contributor was either the only contributor or the major contributor identified despite never coming into direct contact with the knife. This study demonstrates the risk of assuming that DNA recovered from an object resulted from direct contact.     

Multiple Self‐Inflicted Stab Wounds to Neck,Chest and Abdomen as a Unique Manner of Suicide

Abstract: This is a case report of a 30‐year‐old man found dead in his flat lying on the floor with multiple stab wounds over the body, surrounded by an extensive volume of blood. Examination of the scene of death showed a secure flat, locked from inside. A blood‐stained knife was present close to the body and two unstained notes left on the sofa at the locus. A small plastic bag containing white powder (which following toxicological examinations appeared to be cocaine) and an almost full bottle of beer were present on a table. Autopsy revealed more than 40 stab wounds to neck, chest, and abdomen arranged in isolated groups within which the wounds showed similar directions and had a transverse orientation. Together with hesitation marks located on the neck and wrists these characteristics allowed to interpret this case as a suicide.     

Feasibility of Contactless 3D Optical Measurement for the Analysis of Bone and Soft Tissue Lesions: New Technologies and Perspectives in Forensic Sciences

Abstract:  In forensic pathology and anthropology, a correct analysis of lesions on soft tissues and bones is of the utmost importance, in order to verify the cause and manner of death. Photographs, videos, and photogrammetry may be an optimal manner of immortalizing a lesion, both on cadavers and skeletal remains; however, none of these can supply a detailed three-dimensional (3D) modeling of the lesion. Up to now, only the use of casts has given us the possibility of studying deep lesions such as saw marks with an accurate and complete 3D reconstruction of bone structure. The present study aims at verifying the applicability of 3D optical contactless measurement for the accurate recording of soft tissue and bone lesions, in order to develop a unique and precise method of registering and analyzing lesions, both in forensic pathology and anthropology. Three cases were analyzed: the first, a car accident with blunt force skin injuries; the second, a murder with blunt force injury to the head applied with a metal rod; the third, a series of sharp force knife and saw lesions on bone. Results confirm that 3D optical digitizing technology is a crucial tool in the immortalization of wound morphology in the medico-legal context even on "difficult" substrates such as cut marks and saw marks on bone.     

Thoracic Visceral Compression–A Useful Technique for Demonstrating Small Bleeding Points in the Dissected Neck at Autopsy

A 29-year-old man died at the scene of an altercation from a stab wound to the left side of the neck. At autopsy, careful in situ examination of the common carotid artery did not reveal any evidence of hemorrhage or apparent vascular injury. However, applying pressure to the chest wall and underlying thoracic viscera (lungs and heart) resulted in filling of the collapsed vessel with blood causing hemorrhage from a small incision on the medial aspect of the common carotid artery. Release of pressure and drying of the dissection field enabled the artery to be opened and the small defect to be identified. This technique may be used to temporarily restore blood to a vessel to help identify a small bleeding point that may otherwise be difficult to detect.     

Assessment of Wear‐Related Features of the Kerf Wall from Saw Marks in Bone*†

Abstract: Analyses of saw marks in bone may yield important information about the class characteristics of saws used in postmortem dismemberments, yet little research has been directed at identifying saws’ individualizing characteristics. This study adds to existing saw mark analysis methodologies by examining wear‐related features of kerf walls using light‐ and environmental scanning electron microscopy. A crosscut saw and hacksaw were used to create sequences of 30 cuts in bone; these sequences reveal patterns of progressive loss of fine details of kerf wall morphology with increasing saw blade wear, because of the rounding of sharp points and edges. Nevertheless, diagnostic kerf wall features used to establish class characteristics persist despite these wear‐related changes. Unsuccessful attempts at statistical analysis of wear‐related changes, based on striae width and density, suggest these patterns are not readily quantifiable. Additionally, despite the scanning electron microscope’s superior imaging capabilities, it provided few practical, methodological gains over traditional light microscopy.     

Chemical Differentiation of Osseous and Nonosseous Materials Using Scanning Electron Microscopy–Energy-Dispersive X-Ray Spectrometry and Multivariate Statistical Analysis

Identification of osseous materials is generally established on gross anatomical features. However, highly fragmented or taphonomically altered materials may be problematic and may require chemical analysis. This research was designed to assess the use of scanning electron microscopy–energy-dispersive X-ray spectrometry (SEM/EDX), elemental analysis, and multivariate statistical analysis (principal component analysis) for discrimination of osseous and nonosseous materials of similar chemical composition. Sixty samples consisting of osseous (human and nonhuman bone and dental) and non-osseous samples were assessed. After outliers were removed a high overall correct classification of 97.97% was achieved, with 99.86% correct classification for osseous materials. In addition, a blind study was conducted using 20 samples to assess the applicability for using this method to classify unknown materials. All of the blind study samples were correctly classified resulting in 100% correct classification, further demonstrating the efficiency of SEM/EDX and statistical analysis for differentiation of osseous and nonosseous materials.     

Bullet Caliber and Type Categorization from Gunshot Wounds in Sus Scrofa (Linnaeus) Long Bone

Studies on ballistic trauma to the ribs and thorax, cranium, and long bones demonstrate the potential of obtaining a bullet caliber from an entrance wound. In order to validate prior research on caliber estimation in bone tissue and assess the viability of bullet type determination based on the macroscopic evidence at the entrance wound, thirty fleshed pork (Sus scrofa) shoulders (humeri) were shot with either lead or copper jacketed bullets in one of three calibers; 0.22, 9 mm, or 0.38. Overall, our findings are consistent with previous research indicating that calibers can be grouped into “small” and “large” categories. Bullet type, lead or copper jacket, can be ascertained based on cortical flaking and the analysis of materials deposited around the entry wound. The addition of this evidence holds value in cases where no firearm or ballistic evidence is recovered from a crime scene.     

Piercing the surface: A mechanical analysis of stabbing with household tools

Estimating the applied power during a stabbing incident, or estimating the minimal force necessary to penetrate the body with a certain weapon is a challenging task in forensic practice. A thorough forensic evaluation of stabbing forces needs objective numerical experimental data. Stabbing tests of 12 different weapons – including knives, a pair of scissors, a fork, screwdrivers, a rasp, a corkscrew, and a utility knife blade – were performed with a Mecmesin MultiTest-dV material tester on pork loin and ballistic gel to estimate the stabbing forces and dynamics. Penetration force (F_p) and maximal force (F_max) were recorded, and the registered force curves were analyzed. F_max was 159.8–212.07 Newton (N), 30.56–30.58 N, 168.9–185.48 N for various knives; 171.39–190.43 N for the pair of scissors, 233.6 N for the fork; 532.65–562.65 N, 370.31–367.19 N and 314.51–432.89 N for various screwdrivers, 44.14–56.62 N for utility knife during pork loin stabbing. The butter knife, corkscrew and rasp were not able to penetrate the pork loin, and the curved fork bent during stabbing. The results prove that weapon characteristics greatly influence the force necessary for penetration. Maximal stabbing force depends mostly on tip sharpness, and the force sharply decreases after penetration occurs, which indicates that edge sharpness is not as important as tip characteristics during stabbing perpendicular to skin surface. The penetration force during stabbing with a pair of scissors is comparable to the penetration force of knives. Stabbing with screwdrivers generally needs larger force than average knives but depends greatly on screwdriver size.