Quantitative MRI in Isotropic Spatial Resolution for Forensic Soft Tissue Documentation. Why and How?*

Abstract: A quantification of T1, T2, and PD in high isotropic resolution was performed on corpses. Isotropic and quantified postmortem magnetic resonance (IQpmMR) enables sophisticated 3D postprocessing, such as reformatting and volume rendering. The body tissues can be characterized by the combination of these three values. The values of T1, T2, and PD were given as coordinates in a T1–T2–PD space where similar tissue voxels formed clusters. Implementing in a volume rendering software enabled color encoding of specific tissues and pathologies in 3D models of the corpse similar to computed tomography, but with distinctively more powerful soft tissue discrimination. From IQpmMR data, any image plane at any contrast weighting may be calculated or 3D color‐encoded volume rendering may be carried out. The introduced approach will enable future computer‐aided diagnosis that, e.g., checks corpses for a hemorrhage distribution based on the knowledge of its T1–T2–PD vector behavior in a high spatial resolution.     

Bypassing public procurement regulation: A study of rationality in local decisionmaking

Using private contractors through procurement is common in most public sector areas. Despite the benefits of procurement, officials are sometimes tempted to circumvent procurement regulations. The aim of this article is to examine the strategies used by local governmental decisionmakers to bypass procurement regulations and to analyze the rationality underlying these officials' actions. Interviews, court documents, municipal documents, and newspaper articles describing the actions of Swedish municipal officials concerning special transport service (STS) procurements were collected and analyzed. In a case in which rural municipalities lost regular taxi services after STS procurement, we demonstrate how decisions were driven by pressure from the public and local interest groups, making municipal officials deviate from procurement regulations in striving to secure the existence of regular taxi services. One outcome was that local businesses were given preferential treatment, violating regulations and reducing economic efficiency.     

Sudden or Unnatural Deaths Involving Anabolic‐androgenic Steroids

Anabolic‐androgenic steroids (AASs) are frequently misused. To determine causes of death, characteristics, toxicology, and pathology of AAS positive cases, all cases (n = 24) presenting to the New South Wales Department of Forensic Medicine (1995–2012) were retrieved. All were male, and the mean age was 31.7 years. Deaths were mainly due to accidental drug toxicity (62.5%), then suicide (16.7%) and homicide (12.5%). Abnormal testosterone/epitestosterone ratios were reported in 62.5%, followed by metabolites of nandrolone (58.3%), stanozolol (33.3%), and methandienone (20.8%). In 23 of 24 cases, substances other than steroids were detected, most commonly psychostimulants (66.7%). In nearly half, testicular atrophy was noted, as was testicular fibrosis and arrested spermatogenesis. Left ventricular hypertrophy was noted in 30.4%, and moderate to severe narrowing of the coronary arteries in 26.1%. To summarize, the typical case was a male polydrug user aged in their thirties, with death due to drug toxicity. Extensive cardiovascular disease was particularly notable.     

Contributory and Incidental Blood Concentrations in Deaths Involving Citalopram

All cases presenting to the New South Wales Department of Forensic Medicine between January 1, 2001 and December 31, 2010 in which citalopram was detected were retrieved. A total of 348 cases were identified. Citalopram contributed to death in 21.0%, and was incidental in 79.0%. Cases in which citalopram was contributory to death had significantly higher blood citalopram concentrations than incidental cases (0.50 mg/L vs. 0.30 mg/L). Citalopram concentrations varied significantly by contributory status: sole citalopram toxicity (median = 1.30 mg/L), citalopram/other drug toxicity (0.50 mg/L), and incidental cases (0.30 mg/L). Citalopram concentrations also varied by suicide status, with the highest concentration found in suicides where citalopram contributed to death (0.70 mg/L) compared with 0.50 mg/L for nonsuicide cases where citalopram contributed to death. In almost all contributory cases (69/73), other psychoactive substances were also detected, most commonly benzodiazepines (47.9%), alcohol (45.2%), and opioids (40.1%).     

Sex/gender‐based decision‐making in the criminal justice system as a possible (additional) explanation for the underrepresentation of women in official criminal statistics — a review of international literature

This article represents an analysis of the literature on sex‐based selection processes in the criminal justice system. It is only since the feminist wave of the sixties that sexual discrimination has been considered as an issue of importance in the study of the criminal justice system and that female criminality has been looked at more thoroughly. The article deals with the different assumptions and hypotheses which have come forward in the debate on the possible discrimination of men and women in the criminal justice process. In the first part of the article the various theoretical models are outlined: the chivalry and evil women hypotheses, the legal or etiological model, the social control theory, the family‐based justice model, and a multifactoral model. In the second part of the article, the results of empirical research relevant to these hypotheses are presented. American, British, Belgian, Dutch and some German literature has been taken into account. The review of the literature shows that the chivalry hypothesis cannot offer an all‐embracing explanation for the possibly perceived preferential treatment of women. Similar conclusions can be drawn for the explanatory value of the legal model. Although a more lenient treatment of women can sometimes be explained by legal factors, these factors can offer no more than a partial explanation for observed sex differences in the criminal justice system. Especially in the case of pre‐trial release and sentencing, more particularly when deciding whether or not to send a defendant to prison, a noticeable sex‐effect can still be found. In the literature we find strong suggestions — although not always confirmed — that an (initially observed) more lenient treatment of women at these stages can be explained by stereotypes and expectations about the personality of women as less dangerous and the specific role which women fulfill in western society.     

The Punitive Repertoire of Children's Homes and Reformatories

Although equality before the law is one of the fundamental principles of modern democracy, current Western research has shown that discrimination exists within the justice system when enforcing traditional crimes. However, in Scandinavian research on economic crime, the question of equal treatment has been neglected. Based on Swedish data of suspected offenders during 2003, we examined whether different social groups received differential treatment in investigations of traditional and economic crimes. Further, we compared the Regular Police with the Economic Crimes Bureau (ECB) to examine whether the professional specialization of street-level bureaucrats influence the occurrence of differential treatment. We also examined the efficiency of the authorities and more specifically to what extent they issue a waiver of prosecution, a prosecutor's fine, or a court indictment. Besides supporting earlier research on traditional crime, our results show that differential treatment also exists in relation to economic crime, but the patterns of differential treatment are not identical with the ones for traditional crimes. We also found that the two agencies, the ECB and the Regular Police, treat diverse social groups differently. Although the ECB is somewhat more efficient, professional specialization does not appear to be an important factor concerning the issue of differential treatment. It exists regardless of investigating authority. Further action is being taken more often in relation to men and those with a lower level of education at both agencies. However, in some cases the suspect's background does have a different effect on the work of the two agencies, with the ECB less often taking further action against ‘Swedes’ and those on ‘high incomes’, while the Regular Police less often take further action against ‘immigrants’ and those on ‘low and middle incomes’.     

Stability of drugs in stored postmortem femoral blood and vitreous humor

The stability of 46 drugs in postmortem femoral blood stored for one year at -20 degrees C was investigated. The drugs included benzodiazepines, antidepressants, analgetics and hypnotics. For seven drugs we found a significant change in the concentration between the first and second analysis. Five substances; ethanol, desmethylmianserin, 7-amino-nitrazepam, THC and zopiclone showed a decrease in the concentration whereas the concentrations of two substances; ketobemidone and thioridazine increased. However, the changes observed were not of such an order that it would affect the interpretation in normal forensic casework. We also investigated the possible influence of potassium fluoride on the concentrations of the 46 drugs in vitreous humor after storage for one year. For two substances, ethanol and zopiclone, there were significantly lower concentrations in the samples without potassium fluoride. Furthermore, we also studied the correlation between the concentrations in femoral blood and vitreous humor. For 23 substances there was a significant difference between the concentrations in the vitreous humor and femoral blood. Significant correlations between the concentrations in these two specimens were found for 23 substances, indicating that vitreous humor can be an alternative specimen when blood samples are not available, provided that such correlation exists for the particular substance. Statistical analysis also revealed a correlation between the degree of protein binding of the different drugs and percentage of vitreous/femoral blood concentrations.     

Fatal intoxications in a Swedish forensic autopsy material during 1992-2002

Compilations of substances detected in fatal intoxications are important in order to observe changes in intoxication patterns, to monitor effects of preventive work and to discover new trends in drug usage. The aim of the present study was to describe the current pattern of substances detected in fatal intoxications in Sweden. Fatal intoxications investigated at the Department of Forensic Chemistry, Link?ping, Sweden, during 1992-2002, were analysed. All suicides, uncertain cases and accidents where the cause of death were fatal intoxications (ICD-9: E950, E980 and E859) were included and substances detected in more than 50 fatal intoxications (in femoral blood) were listed. For each substance, a cut off value was set, above which concentrations were considered toxic. Fatal intoxications were detected by forensic-chemical analyses in 12% (6998/60,314) of the forensic autopsies during the study period. Among the suicides, an average of 3.8 substances were detected per case, the corresponding figure for uncertain cases and accidents were 3.5 and 4.1 substances, respectively. Ethanol was by far the most frequently detected substance, detected in 43% (3039) of the fatal intoxications, of which 32% (960) had toxic concentrations, followed by propoxyphene, detected in 27% (1863) of the fatal intoxications of which 74% (1370) had toxic concentrations. The number of cases where ethanol and propoxyphene were detected decreased during the study period. Moreover, other CNS-active drugs such as antidepressants, analgesics and anxiolytics were also frequently detected. The drugs with high proportions of cases with toxic concentrations detected were propoxyphene, amitriptyline, zolpidem, carisoprodol, alprazolam, thioridazine, methadone and ketobemidone. Selective serotonin reuptake inhibitors (SSRI) and tricyclic antidepressants (TCA) were detected in 12% (833) and 10% (665), respectively. A significantly (P <0.001) higher proportion of cases where TCA were detected had toxic concentrations when compared with cases where SSRI were detected (64% versus 31%).     

Sudden death from saccular laryngeal cyst

Laryngeal cysts are benign, uncommon lesions of the larynx that have been reported on rare occasions to cause sudden death in infants and adults by acute airways obstruction. In this report, we document the sudden death of a 36-year-old woman from a previously undiagnosed, asymptomatic laryngeal saccular cyst that presented with acute, and consequent fatal, airway obstruction. Difficulty during intubation, both in theater and in emergency settings, is a frequent presenting problem. This can have significant medicolegal implications in determining possible negligence. The diagnosis, classification, and management of such cysts, and their importance to both the forensic pathologist and clinicians are discussed.