Mobile autopsy teams in the investigation of war crimes in Kosovo 1999.

On request of the International Criminal Tribunal for the former Yugoslavia (ICTY), the Danish-Swedish forensic teams worked in Kosovo during the summer and the fall of 1999. The teams worked mainly as "mobile teams" at sites with few graves. Only two larger sites were examined. Most of the bodies were buried separately. A few "multiple burial" graves were examined, but no mass graves were encountered. The main purpose of the autopsies was to establish the cause and manner of death. Identification was of less importance, but a majority of the bodies had been identified prior to the autopsy. A total of 308 bodies, mainly males, were examined. The age varied greatly with a mean age of 47 years. The most common cause of death was gun shot wounds and the most common manner of death was homicide.     

Criminal process and legal autopsy for insurance purposes following death in a foreign country

Circumstances of death and results of four autopsies after death abroad and return of the bodies to the Federal Republic are discussed. In two cases an exhumation was necessary since the bodies had been buried without any further formalities. The demand for an official second examination of the bodies after death abroad is strengthened.     

The forensic medical evaluation of the results of determining diatomaceous plankton in the diagnosis of drowning

Evaluation of demonstrative value of method based on diatom plankton determination as a diagnostical sign of death due to drowning was performed. Plankton was detected in the viscera in 37% of cases (as a whole 376 bodies of people who drowned in fresh water were examined). Plankton was detected in aspiration type of drowning and its mixed variant. In spastic and reflector types of drowning plankton wasn't detected. According to author's opinion this method is an objective diagnostical test to determine the cause of death of people when their bodies are found in water.     

The expert assessment of the sign of the presence of fluid in the basilar sinus in the diagnosis of drowning

Incidence of fluid presence (drowning medium) in basilar bone sinus of dead bodies found in water was studied according to pathogenetic type of drowning. Method of quantitative assessment of this sign in medicolegal evaluation of the cause of death when dead bodies were found in water is suggested.     

Roentgen identification of unknown cadavers with advanced postmortem changes

The postmortem changes in the bodies of two individuals were so advanced that the usual identification methods could not be applied; one had drowned and the other died by burning. Antemortem roentgenograms--up to 10 years old--and postmortem X-ray plates were compared and the bodies thus identified. This was possible because the skeleton shows individual, highly specific markers that do not change during life or after death.     

Estimating time of death from measurement of the electrical excitability of skeletal muscle.

Post-mortem contraction was measured using sensitive force transducers inserted into human muscle. The muscle was stimulated using rectangular impulses of 1 sec duration and known current intensity. After some time, a noticeable change of the muscular contraction occurred, from a two-peak to a one-peak shape. The maximum force of the muscular contraction using a stable current intensity decreased with time since death, but relaxation time increased. The decrease of the maximum force and the increase of the relaxation time were used as criteria for extrapolating the time since death in a random sample of 50 bodies. The calculated 95% limits of confidence were 2.85 h (decrease of the maximum force) and 2.7 h (increase of relaxation time) up to 13 hours post mortem. The calculated 95% limits of confidence were checked on an independent sample of 21 bodies and proved to be reliable.     

An Appraisal of Decomposition Cases Received at the Johannesburg Forensic Pathology Service Medico‐legal Mortuary During 2010–2011

Decomposed bodies pose many questions for researchers regarding environmental effects, cause of death, and patterns. This study aimed to observe the factors associated with decomposed bodies autopsied at the Johannesburg Forensic Pathology Service Medico‐legal Mortuary. A total of 4876 autopsies were conducted from 2010 to 2011, of which 109 were decomposed. Black individuals made up the largest proportion (67%) followed by White (26%). Males comprised 86.2%, while 12.8% were female. The mean age was 42.78 years. Most cases were in the early stages of decomposition (49.5%), with 32.1% bloated, 11.9% in active decay, 2.8% in advanced decay, and 3.7% were skeletal. Insect activity was identified in 25.7% of decomposition cases. Cause of death was determined in 48.6% of cases. Of all the cases, 64% were found indoors and 23% outdoors, while 23% had insufficient information regarding the location. Of considerable interest was the number of cases from hospitals and clinics.     

A delayed drowning death with histological findings of shock

A delayed drowning death case with histological findings of shock was described. The person was sustained by continuous positive-pressure respiration and died 2 days after resuscitation from drowning. The histological findings were intravascular microthrombi, hyaline bodies and fibrin thrombi in the brain, multiple megakaryocytes in the pulmonary capillaries, hyaline membranes of the lung, multiple small hyaline bodies in the liver sinusoids, and erosion of the mucous membrane of the stomach as well as histological findings of shock kidney. Drowning and systemic hypotension during resuscitation seemed to cause irreversible oxygen debt of the organs and the tissues to lead to shock.     

Coronal cleft vertebra initially suspected as an abusive fracture in an infant

A case of a four-month-old male infant is described who was found unresponsive at home and brought to the emergency room. He lived for four days. During his hospital admission he was diagnosed by radiography with a fracture of the third lumbar vertebra that was presumed abusive in nature. Autopsy examination failed to confirm a fracture. However, a defect in the development of the vertebral bodies was discovered. He was diagnosed with possible failure of the notochord to regress, a condition with no significant sequelae. The cause of death was certified as sudden infant death syndrome after full investigation, and all autopsy studies were negative.     

Cyanide, carboxyhemoglobin and blood acid-base state in animals exposed to combustion products of various combinations of acrylic fiber and gauze

In order to examine the usefulness of blood cyanide concentrations as an indicator of whether or not a victim was alive at the start of a fire, blood cyanide concentrations were measured in the bodies that we autopsied in our institute between January 1986 and March, 1987. In the present study, bodies with advanced decomposition were excluded. Thirty-six bodies were included: cyanide as well as carboxyhemoglobin (COHb) were detected in four charred bodies found at the scene of a fire. On the other hand, cyanide was not detected in any of the remaining 30 bodies except in two cases suspected of having ingested a cyanide compound. Rats and rabbits were made to inhale the combustion products of various combinations of acrylic fiber (hydrogen cyanide generating material when heated) and gauze (carbon monoxide generating material when heated). The exposure to the combustion products was continued until death in the rat and until apnea in the rabbit. The concentration of hydrogen cyanide in the exposure chamber and that of blood cyanide, at the time the animal died, correlated with the amount of acrylic fiber heated. In addition to differences in blood COHb and cyanide concentrations, there were also differences in blood gas concentrations between the acrylic fiber and the gauze groups. When the rabbits were switched to room air after the occurrence of apnea, the blood gas value began to normalize.     

Percentage of body recovered and its effect on identification rates and cause and manner of death determination

Anthropologists frequently encounter cases in which only partial human remains are recovered. This study reports how the percentage of the body recovered affects identification (ID) rates and cause and manner of death determination. A total of 773 cases involving anthropology consults were drawn from the New Mexico medical examiner's office (1974-2006). Results indicate a significant correlation between body percent recovered and ID rates, which ranged from 89% for complete bodies to 56% when less than half the body was present. Similar patterns were evident in cause/manner determination, which were the highest (83% and 79%, respectively) in complete bodies but declined to 40% when less than half the body was found. The absence of a skull also negatively impacted ID and ruling rates. Findings are compared with general autopsy ID rates (94-96%) and cause/manner determination rates (96-99%) as well as prior published rates for individual casework and mass death events.     

Determination of morphine in postmortem rabbit bone marrow and comparison with blood morphine concentrations

The aim of this study is to predict how long after time of death a buried body could be analyzed for opiates in soft tissues and to show the accessibility and suitability of bone marrow as a useful toxicological specimen from buried bodies. Morphine solutions were injected in nine albino rabbits. Doses ranged from 0.3 to 1.1 mg/kg with 0.1 mg/kg increments. One hour after the injections, the rabbits were sacrificed. Blood, urine and bone marrow samples were collected for analysis. After the whole bodies were buried, femur bone marrow specimens were collected on the seventh and fourteenth days. CEDIA was used to monitor morphine contents of the collected samples. All experimental cases showed that the increase in the given morphine doses correlated with the increase in blood and bone marrow morphine concentrations. High morphine concentrations were detected in urine samples, but there was no correlation between the urine and blood or urine and bone marrow morphine concentrations. Statistically meaningful increases in bone marrow morphine concentrations were found parallel to increase of blood morphine concentrations. Seventh and fourteenth day postmortem morphine concentrations also followed this correlation. Morphine concentrations in bone marrow at 7 and 14 day postmortem decreased consistently when compared with bone marrow morphine concentrations collected immediately after death. We conclude that in sudden death when other specimens are unavailable due to degradation, bone marrow can be a most useful specimen. Further experimental research in this area is required to validate bone marrow as an alternative tissue.     

Suicidal electrocution in Sydney: a 10-year case review

A retrospective study was undertaken of all cases of death due to suicidal electrocution in Sydney, Australia between 1996 and 2005. A total of 25 cases were identified with 20 cases (80%) as a result of direct attachment to an electrical outlet and five cases (20%) as a result of immersion in a body of water with an electrical appliance. Twenty of the 25 individuals were men (mean age = 57 years, range 22-90) and five were women (mean age 67, range 53-88). At least 35% of decedents were either currently working or had worked as electricians. Electrical timers had been used in eight (32%) cases, the fuse blown in one case, but the remaining 16 (64%) bodies were "live" on arrival of witnesses or electricity personnel. This study demonstrates the phenomenon of electrical suicide as a regular occurrence in Sydney. We highlight the need for investigators and emergency workers to remain vigilant upon discovery of electrical suicides, due to the fact that most bodies remain electrically active after death.     

溺死尸体器官硅藻检出率季节性差异

目的 研究溺水死亡者肺、肝、肾、骨髓等器官淡水硅藻检出率可能存在的季节性差异,为法医学解决水中尸体死因鉴定提供技术帮助与科学证据.方法 收集2009～2011年1、4、7、10月沈阳市浑河中溺死尸体每月(组)各5例;45只家兔分相应月份生前、死后入水组及对照组,分别于当月发现水中尸体后第2天入水,取人及兔肺、肝、肾、股骨骨髓及现场水样备检,应用酶消化法检测各组器官中硅藻数量、种属并与现场水样比对.结果 各组溺死尸体肺中均检出多量硅藻且种属与现场水样一致,春、秋及冬季溺死尸体肝、肾中仅可检出少量体积较小的小环藻等中心纲硅藻,夏季肝、肾及骨髓中均未检出硅藻;各组溺死家兔肺中均检出少量小环藻等中心纲硅藻,肝、肾及骨髓中未检出硅藻.结论 硅藻种群的季节性变化及不同种群硅藻体积的差异可能造成肝、肾等大循环器官中硅藻检出率的季节性差异;仅肺中检出硅藻,肝、肾中硅藻检验结果阴性并不能排除溺死可能.     

Homicidal manual strangulation and multiple stun-gun injuries.

Stun guns are electric shock devices that are used by a number of law enforcement agencies to subdue violent offenders, but sometimes are discharged into human bodies as offensive weapons. We autopsied a 22-year-old woman who was strangled and had many stun-gun injuries on her head, chest, abdomen, arms, and legs. The stun-gun injuries consisted of many pairs of round erythemas with or without central paleness, some of which were accompanied by circumferential abrasions. To determine whether the electric shocks were administered before or after her death, we studied stun-gun injuries on pigs before and after death and found that the shocks after death did not mark the animal skin. Based on this experiment, all of the stun-gun injuries on the victim's body were concluded to have been inflicted before her death.     

Postmortem behavior of the rheobase

Own investigations on the postmortem rise of muscular threshold were conducted on 20 bodies with exactly known time of death. Muscular contraction was objectified using a sensitive force transducer. The muscle was excitated using rectangular impulses of 1 second duration of a current intensity which produces a force of muscular contraction of 2.5 mN. These excitations were continued over the postmortem interval until a current intensity of 80 mN doesn't cause a contraction of 2.5 mN any more. Investigations were mainly performed at the thenar muscles. There is a linear relationship between ln of muscular threshold (current intensity) and the time since death (r = 0.965). For any case the linear regression line between ln of muscular threshold and time since death was calculated. With mean values for slope and intercept the time of death was calculated for each measured threshold. Extrapolation of the time since death with mean values also for the slope reveals a much more precise estimation of the time since death than an extrapolation with an individual slope as proposed by Joachim and Feldmann (1980). The method was proved on a random sample of 8 practical cases. The real time since death was always within the 95%-limits of confidence of the extrapolated time since death.     

Autopsy Identification of Viable Mycobacterium Tuberculosis in the Lungs of a Markedly Decomposed Body

Various infectious diseases, including COVID-19, MERS, and tuberculosis, are global public health issues. Tuberculosis, which is caused by Mycobacterium tuberculosis (MTB), is highly contagious and can be transmitted through inhalation of the bacteria. However, it has been assumed that the infectiousness of bacteria and viruses in dead bodies weakens as the time from death increases. In particular, there is little awareness of infection control measures concerning decomposed bodies or even the need for such measures. The deceased, in whom we discovered MTB 3 months following her death, was a woman in her 80s who died at home. We performed judicial autopsy, because police suspected homicide when her husband hanged himself. Obtained organs were used for microscopic examination by hematoxylin–eosin staining and Ziehl–Neelsen staining. In addition, real-time PCR and mycobacterial culture testing using Ogawa's medium were performed for the detection of MTB. We found that the MTB in the decomposed body remained viable and potentially infectious. To identify the bacterial strain further, we performed DNA-DNA hybridization and identified the strain as MTB complex. Potentially infectious live MTB survived in the dead body far longer than had been previously reported. Pathologists should consider microbial culture tests for all autopsied cases in which the decedent's medical history or macro-examination suggests possible infection, even when a long duration of time has passed since death. Pathologists and specialists who perform autopsies should recognize that all dead bodies are potentially infectious, including those in which long periods have elapsed since death.     

Selective culturing and genus-specific PCR detection for identification of Aeromonas in tissue samples to assist the medico-legal diagnosis of death by drowning

The detection of autochthonous aquatic bacteria in tissue samples from drowning cases is increasingly considered as an alternative approach to assist the medico-legal diagnosis of death by drowning. Bacteria belonging to the genus Aeromonas may be suitable candidates for this application as they are ubiquitous in natural aquatic environments but are generally not part of the human microbiota. The research aims of this study were (i) to develop a sensitive, specific and rapid screening and confirmation method for Aeromonas species in tissue samples and (ii) to evaluate aseptic sternal puncture as a post-mortem sample technique and bone marrow as an alternative matrix to provide evidence of death by drowning. The presence of Aeromonas in tissue samples was verified by cultivation using the selective media Ampicillin Dextrin Agar (ADA) and Ryan's Aeromonas Medium. The use of ADA medium was found most optimal for the sensitive, inexpensive and quick detection of aeromonads in human tissue samples. Positive culture plates were confirmed by harvesting all colonies for DNA extraction and subsequent PCR amplification using Aeromonas genus-specific primers. Aeromonads were detected in lung swab, blood and bone marrow of drowned bodies (n=3), but were negative in these three matrices for all negative controls (n=90) tested. Bone marrow proved to be a suitable alternative matrix and can be sampled post-mortem by an aseptic sternal puncture. In conclusion, this study confirms previous indications that aeromonads in cultures from blood of water bodies can be considered a potential marker for drowning. Given the fact that the number of immersed bodies (drowned and non-drowned) included in this study is statistically not significant, however, more tissue samples need to be investigated to confirm the validity of these methods to aid the diagnosis of death by wet drowning.     

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.     

火场中尸体的法医学分析

火场中的尸体是法医病理工作者较常见的案件,在这种案件中,判断是生前烧死还是死后焚尸具有非常重要的意义。本文就相关文献关于火灾死亡案件的尸体内部、外部征象、现场特点、以及以COHb为主的实验室结果加以综述,目的在于阐明这些特征在实际案件中的作用和应用,为法医工作者解决此类案件提供参考。