Bone-dust in autopsies: Reduction of spreading

During autopsies, an open oscillating saw produces large quantities of respirable bonedust, which is able to carry microbes over several metres. Experiments were done using a modified (open) undulation saw (spray tube to moisten the saw-blade with water). Saw-dust was asservated with culture media. Colonies were identified macroscopically. Microbes in the air were quantified (per unit of time). A remarkable reduction of saw-dust is done by an integrated spray tube using water. There remains a contamination at the head of the autopsy table in the level of the table-top. We found a complete decontamination 150 cm above the floor. No spreading of particles carrying microbes was seen over distances of more than 1.5 m. The risk of an airborne infection is minimal when using a manual saw (absence of grinding-dust). The modified type of an ‘oscillating saw with a spray-tube’ may be considered a practicable compromise between a manual saw and an unprotected undulation saw. It is necessary to complete the precautions against airborne infections by breath masks and safety-goggles.     

The role of coronial autopsies in a context of decreasing hospital autopsies: an investigation of the issues

This article scrutinises the argument that decreasing hospital autopsy rates are outside the control of medical personnel, based as they are on families' unwillingness to consent to autopsy procedures, and that, as a consequence, the coronial autopsy is the appropriate alternative to the important medical and educational role of the autopsy It makes three points which are well supported by the research. First, that while hospital autopsy rates are decreasing, they have been doing so for more than 60 years, and issues beyond the simple notion of consent, like funding formulae in hospitals, increased technology and fear of litigation by doctors are all playing their part in this decline. Secondly, the issue of consent has as much to do with families not being approached as with families declining to give consent. This is well supported by recent changes in hospital policy and procedures which include senior medical personnel and detailed consent forms, both of which have been linked to rising consent rates in recent years. Finally, the perception that coronial autopsies are beyond familial consent has been challenged recently by legislative changes in both Australia and the United States of America which allow objections based on religion and culture to be heard by coroners. For these reasons, it is argued that medical personnel need to focus on increasing hospital autopsy rates, while also addressing the complex ethical issues associated with conducting medical research within the context of the coronial autopsy.     

Comparison of near infrared light photography and middle infrared light photography for deciphering obliterated writings

There are obliterated writings that are undecipherable by conventional visible and near infrared monochromatic light photography. Some of them could be deciphered undestructively by middle infrared light photography. Characters were written on paper with 101 kinds of pens. Middle infrared light photographs and near infrared light photographs of them were taken and compared to recognize what kinds of inks is transparent at examined wavelength regions. Based on the results obtained, the combination of ink for drawing and obliterating (which is not deciphered by visible and near infrared light photography, but expected to be deciphered with middle infrared light photography) is selected. From the examined photographs, it is demonstrated that there exist obliterated writings which are undecipherable by conventional near infrared light photography, but decipherable by middle infrared light photography.     

Determining the time and day of photography

Photographs taken by crime victims and perpetrators are at times important evidence. Their time of photography may also affect their value as such. Three methods of determining when a picture was taken by using the content of the picture are presented. The methods utilize solar direction-measured from shadows in the photograph, identifying flowering wild plants and correlating cloudiness with meteorological observations. Solar direction is the most accurate and involved method and therefore is the main part of this paper. A case using all three methods is described.     

试析统筹城乡发展与乡镇政府改革

乡镇政府作为直接面对农民的基层行政机构，在推动统筹城乡发展中具有重要作用。当前乡镇政府存在着一系列制约其作用发挥的问题,为此,要从乡镇政府的设置、乡镇职能的转变、乡镇机构的确定、乡镇工作人员的优化、乡镇财政管理的创新等方面进行改革，以提高乡镇政府的行政能力和服务水平。     

注重细节服务做好疗养院接待工作

本院主要承担军队飞行人员健康疗养任务,每年接收来自全军的飞行人员疗养2000余人,作为"第一窗口"的疗养接待科,始终贯彻"疗养接待工作无小事"的指导思想,坚持"文明热情、规范细致、创新高效"的原则,周密组织,细心计划,通力协作,充分发挥了接待工作的服务与保障作用.     

Value of bacteriologic studies within the scope of forensic autopsies

The various questions regarding bacteriological investigations within the scope of forensic autopsies are discussed in the light of our own cases and with regard to the relevant literature: estimate of the age of the corpse on the basis of decomposition changes caused by bacteria; determination of so-called bacteriograms from the point of view of criminalistics; supplementary investigations of the cause of death. Iatrogenic infections (e.g., gangrene) are gone into in more detail, as is so-called infantile botulism within the scope of the "sudden infant death syndrome". Finally, it is pointed out that when doing forensic autopsies, thought should also be given to illnesses that have only been known for a few years, examples being legionnaires' disease and the toxic shock syndrome ("tampon sickness").     

Medical malpractice as reflected by the forensic evaluation of 4450 autopsies

A multicentre retrospective analysis of 4450 autopsies carried out due to suspicion of medical malpractice in 17 German institutes of forensic medicine from 1990 to 2000 was performed for the German Federal Ministry of Health. During the time period analysed an increase of cases could be mentioned. The main results of the study are: in the cooperating institutes the total number of autopsies due to suspected medical malpractice ranged from 1.4 to 20%. In more than 40% of the cases preliminary proceedings were started because the manner of death was certified as non-natural or not clarified. Hospital doctors were more affected by medical malpractice claims than doctors in private practice. However, the number of confirmed cases of medical malpractice was higher for doctors in private practice than for hospital doctors. Although surgery is still at the top of the disciplines involved in medical malpractice claims the number of confirmed surgical cases was below the average. Mistakes in care were confirmed to be above the average. Medico-legal autopsies are still a very sufficient method to evaluate cases of medical malpractice: 2863 cases could already be clarified by autopsy. Up to now there is no systematic registration of medical malpractice charges in Germany. A systematic registration should be initiated to build up and/or improve error reporting systems and, thus, to improve patient safety. Compared to other sources of medical malpractice claims (arbitration committees of the medical chambers, reference material of health and insurance companies, files of civil courts) the data of the present multicentre study are in so far unique as only lethal cases were evaluated and a complete autopsy report was available as basis of an expert opinion in alleged medical malpractice cases.     

紫外反射照相显现指印与502胶熏显指印方法的比对

目的比较紫外反射照相与502胶熏显两种方法显现指印的成功率,确定在同等条件下优先使用那种显现方法。方法对玻璃、陶瓷、黑白照片上3种类型上的汗液指印,油脂指印和普通指印各100枚,分别用紫外反射拍照显现与502胶熏显,统计两者达到3等级以上的比例,来判断效果的好坏。结果紫外反射照相显现法在3种客体上显现的成功率高于502胶熏显法。结论实验结果为选择指印显现方法提供了科学依据。     

运用数码相机进行分色偏振光摄影

目的研究运用数码相机进行分色偏振光摄影的可能性和方法。方法比较用数码相机拍摄有色地毯上的灰尘鞋印的各种方法的效果。结果分色偏振光摄影方法得到了较理想的效果。结论用数码相机进行分色偏振光摄影是有效的 ,相对传统方法提高了工作效率。     

On the desirable degree of detail in the law

The desirable degree of detail in the law has not been previously discussed. The point of this article is to begin the discussion by raising a number of problems. The first deals with the fact that a highly detailed law cannot, of course, be remembered and, in fact, may be very hard even to discover. Second, if the law is not highly detailed, it is apt to be uncertain in marginal cases, of which there should be many. Detail can be added to the law either by judicial decision or legislation or by some kind of special body as in France. In any event, however, there will certainly be cases in which it is not clear what the law is and there will be at least some obscurities in the law. These problems are discussed and not solved in this paper. It is intended to start the discussion, not finish it.     

Histopathological findings in 851 autopsies of drug addicts, with toxicologic and virologic correlations

This investigation was carried out on 851 consecutive judicial autopsies of drug addicts who died mostly of heroin overdose from 1977 to 1996. Research of anti-HIV/HBV/HCV antibodies was performed, and histologic sections were retrospectively reviewed. More than 65% were HBV/HCV-positive and about 17% HIV-positive; females were HIV-positive more often than males. Intracranial microhemorrhages were frequently found; cerebral infectious diseases were rare. Inflammatory heart lesions, myocardial fibrosis, and acute ischemia were common. Interstitial nephritis (found in about 8%) was more frequent in females, in older patients, and in those carrying HIV infection; glomerular sclerosis was detected in about 12%. Acute bronchitis and/or pneumonia was demonstrated in 12%, without significant association with HIV infection; pulmonary hemorrhages, foreign body granulomas, and food aspiration were also commonly seen; hyperplasia of pulmonary perivascular lymphatic tissue was rather characteristic. Liver was carrying steatosis in 66.3% and/or hepatitis in 64.5%; acute hepatitis was more frequent in females, chronic hepatitis in older subjects and in those proven positive for hepatotropic viruses; cirrhosis occurred more often in older patients, in those carrying virus infection, and in consumers of nonnarcotics drugs such as ethanol. No pathologic finding was clearly related to drug abuse; therefore, during autopsy, drug addiction can be suspected, but anamnestic and circumstantial data are needed to lead pathologists to request toxicologic analysis to ascertain the cause of death. The present investigation emphasizes that, in addition to the risk of death by overdose, the high incidence of acute and chronic diseases could seriously undermine the health status of heroin and/or other drug consumers.     

论近距数码照相放大率的选择

数码近距照相,摄影者需要选择合适的影像放大率,以清晰记录被拍体的细节特征。影像放大率与数码照相机中CCD的分辨率有重要关系,特征大小、影像放大率、CCD分辨率三者的乘积等于1,满足这一关系式的CCD的分辨率就是能分辨景物细节特征的分辨率,拍摄时应据此选择影像放大率。     

Towards molecular autopsies: Development of a FFPE tissue DNA extraction workflow

Sudden unexpected death (SUD) is a devastating event and forms a substantial proportion of the cases investigated at forensic mortuaries each year. Despite post-mortem investigations, the cause of death may remain undetermined. There is potential for these unresolved cases to benefit from retrospective molecular autopsies for investigation into genetic mutations which may have contributed towards death. Often, formalin fixed paraffin embedded tissues (FFPET) are the only archival sources of DNA available for retrospective analyses. However, extracting usable DNA from FFPET is challenging as current methods yield poor quality and quantity DNA. Thus, this study aimed to optimise DNA recovery from FFPET by investigating several variables within the DNA extraction workflow, including the selection of tissue type, number and thickness of tissue sections, deparaffinisation method, and DNA extraction kit. The quantity and quality of DNA recovered were assessed using spectrophotometry, real time PCR, digital capillary electrophoresis and DNA profiling. This study was the first to implement a nuclei quantification using microscopy to guide the selection of the best tissue type to use for DNA analysis. The use of a greater number of thinner tissue sections (100 sections, each 1 μm) significantly improved DNA concentration, purity and fragment length. Additionally, the combination of Deparaffinization Solution with the QIAamp® DNA FFPE Tissue Kit proved most favourable with a median DNA yield of 320 ng and 55% of DNA fragments greater than 400 bp. Isolated DNA was of single source, indicating no contamination in the workflow, and FFPET blocks that were stored for up to 3.5 years did not significantly affect DNA degradation (p = 0.1764). These results are especially informative for designing library preparation and sequencing workflows for determining cause of death in unresolved SUD cases.     

The impact of psychological autopsies on medical examiners' determination of manner of death

This study evaluated the impact of psychological information on medical examiners' determination of manner of death in equivocal cases. Ten cases, a typical and equivocal case for each of five case types (single car, child, autoerotic, psychotic, and Russian roulette death) were evaluated for manner of death by 195 medical examiner subjects. From this sample 95 control subjects received 10 cases made up of physical and circumstantial evidence, while 100 experimental subjects received the same 10 cases expanded with brief psychological autopsies. Psychological information was shown to have a statistically significant impact on subjects' determination (and certainty) of manner of death is equivocal cases and even in some typical cases.     

Air bag injuries--a literature review in consideration of demands in forensic autopsies

Air bags have been implicated in saving lives and reducing morbidity associated with motor vehicle crashes since their introduction in the mid-1970s. However, there is increasing evidence showing that air bags can be a source of injury and even death in certain circumstances. As the number of air bag-equipped vehicles increases, air bag-related injuries have occurred more frequently. Thus, a greater awareness of air bag-related injuries is required in forensic autopsies. Here, we review thoroughly the literature concerning air bag-related injuries with special regard to their nature and causative mechanisms, and summarize air bag-related injuries observed in adults, children and infants.     

Psychological autopsies: the current Department of Defense effort to standardize training and quality assurance

Psychological autopsies have been gathered by the US military for a long time, both for lessons learned after a known suicide and to investigate an equivocal death. The term "psychological autopsies" is now being restricted to define an investigation by mental health to help determine, in an equivocal death, if the manner of death is a homicide, suicide, an accident, or from natural causes. The Department of Defense has developed policy, and is now implementing training and peer review. A sample model curriculum, report format and quality assurance standards are included.