Instructions for the complete preparation of the larynx

A method of preparing the larynx in forensic cases is described especially when death occurs by strangulation (manually or using some form of ligature). After the usual dissection of the hyoid bone and the upper horns of the thyroid cartilage, the complete larynx is clipped and fixed in formaldehyde overnight. The first part of dissection after that is to cut away the thyroid gland and the remaining muscles in front of the larynx, except for the cricothyroid muscle and the esophagus and hypopharynx from the back of the larynx. The complete thyroid cartilage is dissected out, and then a horizontal cut is made through the cricoid cartilage. Median-sagittal halving of the remaining larynx completes the gross dissection. Arytenoid cartilages are exposed by dissection of the arytenoid muscles and opening the cricoarytenoid joints. Now all parts of the laryngeal skeleton and all articulations are examined, and all muscles and soft tissues are visible and can be clipped for histological examination.     

中国汉族6～18周岁女性人群牙齿生长发育的年龄研究

目的研究牙齿钙化程度与年龄的关系,建立利用牙齿推断中国汉族女性人群年龄的方程。方法通过对6923名6～18周岁汉族女性儿童及青少年全口曲面断层影像下颌恒牙的钙化程度进行评分;将分级值及其对应的年龄输入SPSS软件进行分析,最终建立推断年龄的方程模型;从研究样本外随机抽取已知年龄的样本181例进行肓测。结果牙齿钙化评分值与年龄相关分析结果相关系数r均大于0．6,同名牙评分值侧别间统计分析结果P〉0．05且相关系数r均大于0．93,方程拟合优度检验R^2=0．789,估计值标准误为1．28岁,盲测结果与真实年龄的平均误差为0．421±0．272岁。结论本研究所建立的方法在推断中国汉族女性6～18周岁群体年龄方面有良好的应用前景。     

数字X线摄影测量活体脊柱胸段推算身高

目的建立人脊柱胸段长度推算身高的方法。方法应用数字X线摄影技术（DR）摄制514例中国四川汉族人群的胸部DR片，测其脊柱胸段长度，同时准确测量被研究者身高，对测量获得的脊柱胸段长度与身高数据分组进行线性回归分析，建立胸段长度推算身高的回归方程。结果建立了混合组、男性组、女性组、20—45岁男性组、大于45岁男性组、20～45岁女性组和大于45岁女性组7个回归方程，经显著性检验，均有统计学意义（P〈0．01），复相关系数（R）范围0．834～0．624，回归系数（b）范围0．259～0．389，回归方程估计值的标准误在3．88～4．72cm范围内。结论利用人类脊柱胸段长度推算身高的方法在法医学个人识别中具有重要价值。     

Ossification of laryngeal structures as indicators of age

As the role of forensic anthropologists expands to the medical examiner setting, their expertise is being applied beyond the traditional dry skeletal material. In such scenarios radiographic techniques can be applied when maceration is not appropriate. This study explores the use of radiographic analysis of laryngeal structures for age-at-death determination. Isolated human laryngeal structures (n = 104) from individuals between the ages of 15 and 89 were removed at autopsy and radiographically examined. The cricoid and individual regions of the thyroid cartilage were scored according to degree of ossification, and the relationship between age and degree of ossification statistically examined. A previously published study on age-determination from thyroid ossification by Cerny was assessed for accuracy. The results of the study indicate that although a consistent sequence in the ossification of laryngeal structures exists, variations in timing does not permit narrow age range estimates. Consequently the method presented by Cerny is inaccurate and should not be used in the forensic setting.     

Study of Chilean Children’s Dental Maturation*

Abstract: In forensic science, determining a person’s chronological age has become a challenge for researchers. Determining age using dental calcification is becoming increasingly important. The objective of this study is to estimate the dental age of the children’s population in Region VIII, Chile. The sample was randomly taken from children under the care of the Faculty of Dentistry at the Universidad de Concepción in Chile. The study encompasses 159 children between 3 and 14 years of age. The dental age was determined following the Demirjian method. The Bland–Altman method was applied to establish the correlation. It was determined that the range between chronological and dental age is similar, and the degree of correlation between both ages is nearly perfect. In conclusion, the degree of correlation between the chronological and dental ages for each gender is also very good although it is slightly higher for females.     

女性胸骨X线变化与年龄关系的研究

研究北京地区137例女性胸骨X线影像学变化，以其与年龄关系密切相关的影像学标志点作为变量，并依据各标志点在不同年龄阶段的变化，制定了各自的评分标准。用该标准观测全部样本，将所得数据与年龄一起输入电子计算机，建立了根据女性胸骨X线变化推算年龄的多元回归方程，即：Y=9．6641＋1．6999X（1）＋2．7486X（2）十1．8929X（3）＋1．5561X（4）＋0.4255X（5）。经方差分析F＞F0.01（5.131），回归高度显著。本研究所建立的预测年龄方程，在无名尸骨的法医学鉴定中具有实用价值。     

Forensic Facial Reconstruction: Relationship Between the Alar Cartilage and Piriform Aperture

During forensic facial reconstruction, facial features may be predicted based on the parameters of the skull. This study evaluated the relationships between alar cartilage and piriform aperture and nose morphology and facial typology. Ninety‐six cone beam computed tomography images of Brazilian subjects (49 males and 47 females) were used in this study. OsiriX software was used to perform the following measurements: nasal width, distance between alar base insertion points, lower width of the piriform aperture, and upper width of the piriform aperture. Nasal width was associated with the lower width of the piriform aperture, sex, skeletal vertical pattern of the face, and age. The current study contributes to the improvement of forensic facial guides by identifying the relationships between the alar cartilages and characteristics of the biological profile of members of a population that has been little studied thus far.     

Morphology of "asphyxia-induced epiglottis form" in newborn infants, infants and young children

A systematic histological study of cross-sections of the larynx from 52 fatalities (neonates, infants and young children) revealed a broad spectrum of anatomical variants in the epiglottis form, which were caused by variations in the epiglottic cartilage. There was no correlation between the epiglottis form and the age of the child. Furthermore, no differences in shape could be established between cases of SIDS and control cases. The term "asphyxial-related epiglottis form" appears to be inappropriate. The commonly found supraglottic laryngitis on the laryngeal aspect of the epiglottis was seen in combination with histologically proven infections in the upper and lower respiratory tract. Histological investigation of the larynx provides valuable information for the morphological diagnosis in fatal cases in early life.     

Morphologic findings for airway occlusion in strangulation

Report of two cases of strangulation by hand. There were large submucous bleedings of the larynx (both sides of conus elasticus) of symmetrical arrangement, near the vocal processes of the arytenoid cartilages. They are believed to be the result of the violent contact of the vocal folds during laryngeal compression; perhaps while the arytenoid cartilages were subluxated inwards and downwards. Bleedings like this indicate the closure of the airway. In one case (50-year old woman) the ossified cricoid was broken; in the other (21-year old woman) the elastic laryngeal skeleton was intact, but large bleedings of the deeper tissues of both vocal folds indicated the vehement compression too. The analysis of 110 cases of attack against the neck (strangulation by hand -n = 30- or ligature -n = 30- alone or together -n = 32-; blunt force: n = 8, other types: n = 10) showed in 7 additional cases less typical but similar bleedings, especially in strangulation by hand.     

Intra-cartilaginous laryngeal haemorrhages and strangulation

A previously unrecognized laryngeal injury in young female victims of manual strangulation is described. Twelve larynges that were retrospectively and prospectively collected at the Office of the Chief Coroner for Ontario (1982–1997) were used for this study. In all instances, the larynges were from cases of strangulation (mean age 27±10 years, range 20–46) with classical postmortem findings of asphyxia and either manual or combined manual and ligature strangulation. None of the larynges had fractures of the lamina of the thyroid cartilage, superior cornua, or cricoid cartilages. However, in 9 of the 12 cases (75%), sagittal sections revealed multifocal acute haemorrhages into the base of the superior cornua of the thyroid cartilage at the point of origin from the laminae. The presence of acute intra-cartilaginous haemorrhage into the larynx likely represents the disruption of small blood vessels due to elastic deformation of the flexible larynx during strangulation. The recognition of this form of laryngeal injuries broadens the pathological findings in cases of asphyxia associated with pressure on the neck.     

The determination of male adult age at death by central and posterior coxal analysis--a preliminary study

In forensic anthropological analysis, the pelvis is of particular interest as it is often a comparatively well-preserved part of the skeleton. This study in age determination uses the acetabulum, the central element of the pelvis, as a complement to the examination of the auricular surface. The test sample consisted of 30 individuals. First, the authors studied the auricular surface using the Lovejoy criteria. Second, they isolated four criteria based on chronological changes in the acetabulum. Third, they conducted an evaluation of each of these variables. The study examines the correlation between these criteria and the age of the individuals. A significant correlation was found between the acetabular criteria and age, and between the acetabular criteria and the Lovejoy criteria of the auricular surface. For forensic purposes, the acetabulum is an effective predictor in the determination of age. This newly proposed method explores the same criteria of ageing as the Lovejoy method. The combination of the two methods produces relatively consistent results in the estimation of age.     

Estimating age of humans based on telomere shortening

To estimate age using DNA based on telomere shortening, we determined the terminal restriction fragment (TRF) length, as telomere length, using Southern blot analysis of peripheral human blood and blood stains. All blood stains had been stored at room temperature for 5 months. The average TRF length clearly showed a tendency to shortening with aging. The formula for age estimation was based on a correlation between average TRF length and age of the subjects. The estimated age calculated from TRF length widely depends on environmental and genetic factors. However, as long as the DNA is well preserved, use of our method is feasible regardless of age of the subject and can give a rough estimation of age of subjects in forensic samples that carry no morphological information.     

Knitted fractures of the laryngopharynx framework as a medico-legal matter

The article presents the analysis of knitted trauma to the hyoid bone and laryngeal cartilages, revealed while searching for fresh fractures of the laryngopharynx skeleton for medico-legal purposes. Neck organocomplexes (n = 440) were completely prepared after fixation in formalin. Old injuries were found in 17.3% of cases, and in 3.2% of cases two elements of the complex were formerly broken. More often there was consolidated trauma to the thyroid (11.4% of cases) and cricoid cartilages (7.3%) and, rarely, to the hyoid bone (1.6%) and cervical part of the trachea (0.2%). These injuries occurred twice as often in men (20.3% of cases) than in women (P < 0.01). Substantiated conclusions are: (1) people of working age are most prone to neck trauma; and (2) from the 1960s the percentage of such traumas in the St. Petersburg region has grown due to urbanization. This article presents data on the localization and morphology of the injuries, as well as a review of symptoms and the course of blunt neck trauma. Despite the difficulties associated with the complete regeneration of injured tissues, forensic pathologists can obtain certain information which police officials may be interested in.     

Applicability of Greulich and Pyle and Demirijan aging methods to a sample of Italian population

Age estimation in forensics is essential in cases involving both living and dead subjects. For living subjects, age estimation may be used to establish an individual's status as a minor in cases involving adoption, criminal responsibility, child pornography, and those seeking asylum. Criteria for age estimation in the living have recently been put forth by The Study Group on Forensic Age Diagnostics. The group has proposed guidelines with a three-step procedure: a physical examination and anthropometrical analysis; dental analysis by orthopantomogram (OPG); and X-ray study of the left hand and wrist. The board of FASE highlighted advantages and limits of each method, and suggested practical solutions concerning the age estimation process for adults and subadults. The aim of this study was to verify the applicability of the Greulich and Pyle, and Demirjian techniques on a sample group of Italians, whose ages were known, in determining the skeletal and dental age, in addition to evaluating the reliability of these techniques. 535 subjects between the ages of 7 and 15years were examined, each one undergoing both an orthopantomography (OPG) and radiography of the left wrist and hand. The data obtained underwent statistical analysis. The analyses have shown that a correlation exists between skeletal and dental age, and real age. Age estimation carried out using the Greulich and Pyle method has shown itself to be especially accurate on the Italian sample, particularly in the age ranges of 7-9years and 10.4-11.5years. The Greulich and Pyle method has shown itself to be reliable for the sample analyzed notwithstanding the ethnic differences between the original sample of reference and those analyzed in this study. Application of the Demirjian technique resulted in an overestimation of dental age. This difference is shown to be more highly significant in the higher age ranges. The combination of the Greulich and Pyle, and Demirjian methods have revealed a difference regarding real age, which turns out to be more modest in the younger age ranges and more significant in older subjects.     

Planned Complex Occupation‐related Suicide by Captive‐bolt Gunshot and Hanging*

Abstract: Planned complex suicides are committed by using two or more previously planned methods simultaneously to make sure that death will occur even if one method fails. Herein, we presented a case of occupation‐related planned complex suicide, committed by captive‐bolt gunshot and hanging. A 29‐year‐old man, who worked as a butcher, was found dead in the stable, hanging by the neck with a captive‐bolt gun embedded in the forehead region of his head. The hanging was complete. Along the bolt canal were bone fragments, and at the end of the path was the punched‐out fragment of the skin and soft tissue. There were no fractures of the hyoid bone and laryngeal cartilages, and a superficial hemorrhage was present in the right sternocleidomastoid muscle. Our case underlines the utility of forensic autopsy and death scene investigation in reconstructing the mechanism of death, as well as the dynamics of the event.     

Local vital reaction following injuries of the neck

Sixty-one cases of hemorrhaging of the laryngeal muscles are reported among 86 deaths due to compression of the neck (strangulation by ligature and/or with the hands, blunt force); the results of histological examinations of these cases (laryngeal muscles; hemorrhaging of the cervical muscles and tongue in numerous cases) are discussed, as well as 55 comparative cases (natural, violent death) with regard to vital changes from the hemorrhaging aspect. Although sanguineous infiltration of the laryngeal muscles can occur after death (prone position), it differs macroscopically and in some cases also microscopically from the vital type: extensive bleeding on the inside of the larynx or dorsally above the larynx (PCA muscle), possible combined with histologically detectable ruptures of muscle cells, must be viewed as the result of laryngeal compression suffered when still alive. No clear-cut evidence of emigration or infiltration of leukocytes was found in the cases of immediately fatal strangulation, but there was occasional evidence (6 cases) when protracted maltreatment had taken place. Although there was no clear correlation with age, sex, type of impact, cause of death, or amount of laryngeal bleeding, in 25 of the 61 cases leukocytes were sometimes detectable in enormous amounts within the extravasation; the ratio exceeded that to be expected from the composition of the blood. Findings of this nature have also been made in cases of vital bleeding in other violent or natural deaths; they are not a cell reaction in the proper sense but, when distinctly marked, a vital event--at least in the laryngeal region. These findings can support the assumption of the amount of hemorrhaging in deaths in which the survival time was inadequate for a leukocyte emigration. In 20 cases such findings were combined with localized leucocytosis, which is regarded as an early vital reaction.     

放射影像学方法测量活体女性颈椎推算身高

目的测量颈椎高度建立四川汉族女性人群的身高推算方程，为法医学个人识别提供帮助。方法应用计算机X线摄影放射学方法，在209例四川汉族女性颈椎CR片上测量C3～C7椎体高度，并准确测量身高。按年龄是否大于45岁进行分组，对各颈椎的测量数据与身高进行线性回归分析，建立颈椎推算身高的回归方程。结果共建立一元回归方程36个，多元回归方程12个，所有回归方程经线性回归模型假设检验，均有统计学意义（P〈0．05）。所建立的回归方程的复相关系数（r）在0．628～0．280范围内，回归方程的标准误在4．03～5．03cm范围内。结论本研究所建立的回归方程，可用于四川汉族女性颈椎的身高推算。     

Radiographic evaluation of third molar development in relation to chronological age among Turkish children and youth

A sharp increase in forensic age estimation of living persons has been observed in recent years. However, ethnic populations residing in different countries have been insufficiently analyzed. According to 2004 data compiled by the Essen-based Turkey Research Center, there are 3.8 million Turkish people living abroad, and 3.2 million of them reside in European Union countries. Despite the high number of Turks living abroad, little is known about third-molar development for forensic application in this population. Hence, it was considered worthwhile to determine the developmental stages of the third molar in a group of Turkish population, to assess chronological age estimation based on the developmental stages, and to compare third molar development according to sex, age and location. Orthopantomograms of 1134 Turkish patients, ages 4-20 years were examined and third-molar developmental stages were evaluated based on Demirjian's classifications. Orthopantomograms were scored by two different observers, and Wilcoxon matched-pairs signed-ranks test used to test intra- and inter-observer reliability revealed a strong agreement between both intra- and inter-observer measurements. Linear regression analysis was performed to correlate third-molar development and chronological age, and further statistical analysis was performed to determine the relation between sex, age and location. Results showed a strong linear correlation between age and molar development (males: r(2)=0.57; females: r(2)=0.56). Mineralizations of left and right third molars were compared using Wilcoxon tests, and no statistical differences were found. No significant differences were found in third-molar development between males and females. Mandibular third molar crypt formation was observed in 2.4% of patients at age seven and maxillary third molar crypt formation was observed in 1.3% of patients at age seven. A strong correlation was found between third-molar development and chronological age. Among the Turkish population, third molar crypt formation is observable at as early as 7 years in both the mandible and maxilla. Agenesis can be determined conclusively if no radiolucent bud is present by age 14.