Dental CT imaging as a screening tool for dental profiling: advantages and limitations

The use of dental processing software for computed tomography (CT) data (Dentascan) is described on postmortem (pm) CT data for the purpose of pm identification. The software allows reconstructing reformatted images comparable to conventional panoramic dental radiographs by defining a curved reconstruction line along the teeth on oblique images. Three corpses that have been scanned within the virtopsy project were used to test the software for the purpose of dental identification. In every case, dental panoramic images could be reconstructed and compared to antemortem radiographs. The images showed the basic component of teeth (enamel, dentin, and pulp), the anatomic structure of the alveolar bone, missing or unerupted teeth as well as restorations of the teeth that could be used for identification. When streak artifacts due to metal-containing dental work reduced image quality, it was still necessary to perform pm conventional radiographs for comparison of the detailed shape of the restoration. Dental identification or a dental profiling seems to become possible in a noninvasive manner using the Dentascan software.     

The Legacy of Nuremberg

The Nuremberg trial, later followed by the Tokyo trial, is amilestone in the development of international law. For the firsttime in modern history, the leaders of a defeated country wereindicted for committing serious crimes jeopardizing the basesof peaceful coexistence among individual human beings and peoples:crimes against peace, war crimes and crimes against humanity.German objections criticizing crimes against peace as havingno legal basis and, therefore, contradicting the principle nullumcrimen sine lege, were justified. To date, the legal positionhas not changed, since the international community has consistentlyrefrained from including aggression in the lists of offencesprosecutable under the statutes of the currently existing internationalcriminal courts. However, no well-founded objections could beraised against the indictment for war crimes and crimes againsthumanity. Concerning offences of such abhorrent nature, no offendercan invoke nullum crimen that protects only legitimate confidence.To hold to account political leaders, directly under internationallaw, for criminal actions organized and ordered by them is anecessity in a world where the basic axioms of the internationalsystem have changed: state sovereignty has lost its absolutecharacter and is counterbalanced by the requirements of humanrights protection. The emergence of international criminal justiceembodies the concept of international community in the mostpalpable manner. Fortunately, some of the defects of the Nurembergtrial have been remedied today: no arbitrary picking and choosingof the accused by the prosecution is possible before the InternationalCriminal Court; prosecutors as well as the judges of all existingjudicial bodies are carefully selected by the internationalcommunity with a view to avoiding any illegitimate bias.     

Injury pattern on the hand after slipping onto the blade during a knife attack--a contribution to the differential diagnostic classification of sharp force injuries of the upper extremities

Differential diagnosis of injuries caused by accidental slipping of the hand onto the blade of a knife includes self-inflicted injuries (e.g. to simulate an offense) as well as active and passive defense injuries indicative of the involvement of another party. The injury pattern on the hands of five perpetrators who suffered accidental cuts during knife attacks, as seen by the authors during the clinical forensic examination, is presented. The injuries were localized on the ulnar aspect of the thumb facing the index finger, the radial aspect of the index finger facing the thumb and variable sites on the flexor or extensor side of the middle and ring fingers. Especially in those cases in which the injuries of the victim (e.g. involvement of bony structures) and the dominant hand of the perpetrator are known, additional information for the reconstruction of the course of events may be derived from the cut wounds occurring during the knife attack as the hand slipped onto the blade.     

Serum concentrations of cardiac troponin T in sudden death

Ischemic heart disease is the most common cause of sudden death of natural causes in most western countries. By autopsy, there may be no gross or histologic evidence of acute myocardial damage unless the patient survived for several hours following the event. Cardiac troponin in serum has become the recommended biochemical marker for myocardial injury in the clinical setting. We performed a prospective study on 102 autopsied subjects at the Central Hospital of Rogaland, Stavanger, Norway. Femoral blood was sampled for subsequent analysis of cardiac troponin T (cTnT). In the subjects with morphologic evidence of recent myocardial injury (n = 34), the mean serum cTnT level was 1.95 microg/L compared with 0.16 microg/L in the subjects with a noncardiac cause of death (n = 35) and 0.61 microg/L in the group with probable sudden cardiac death without morphologic signs of acute myocardial injury (n = 33). The observed differences in mean serum cTnT levels between the groups were statistically significant (P < 0.0001). These data suggest that elevated postmortem serum concentration of cTnT reflects ongoing myocardial damage and may support a diagnosis of cardiac-related death in cases associated with sparse or inconclusive morphologic findings postmortem.     

Medicolegal aspects of witnessed suicide due to gunshot to the head. Part 1: Circumstances and psychopathology

In the USA the frequency of witnessed suicide, i.e. suicide committed in the presence of at least one further individual, is reported to range between 5 and 15%. As up to now no detailed analysis of this special issue has been given in the medicolegal literature, this article presents and discusses a number of cases including 8 males and 1 female (age 19-58 years, mean 41.2 years) who had all committed suicide by inflicting a gunshot to the head. In 3 cases post-mortem blood alcohol concentrations of 1.73, 1.88 and 2.23 g/kg respectively were observed. Toxicological tests produced negative results. 5 cases had a medical history of psychiatric disorder with endogenous depression in 3, chronic alcohol abuse and drug abuse with concomitant psychosis in one case each. As far as the motives were known, domestic arguments were of prevailing importance. With one exception the suicides were committed at home. In 6 cases one witness was present, in 2 cases 2 individuals and in one case 22 persons witnessed the suicide. The reported cases are discussed in comparison with the psychiatric-psychological classification according to McDowell et al. with the aim to provide a solid and comprehensive medicolegal method to distinguish between homicide and suicide. Furthermore aspects of psychiatric sequelae and psychological support of the witnesses, which are also of importance for the forensic pathologist called to the scene, are discussed.     

Particle size analysis of soils under simulated scene of crime conditions: the interest of multivariate analyses

Two simulated scenes of crime have been studied. Soil traces adhering to boots, sport shoes and tissues have been compared with control samples using particle size analysis. Comparisons of percentage of particles per class interval and multivariate analyses were used to determine how the size distribution of each suspect sample varied compared to the original distribution. A loss of coarse fractions characterized most of the suspect samples even though they were derived from soils having different distributional patterns. However, the differences between control and suspect samples were found to be more important for soils dominated by extreme size classes than for soils rich in medium size particles. The differences among soil samples from the same source were found to be restricted to the extreme size classes. The finding of significant differences within size classes ranging from 1 to 0.063 mm should be then considered as a dissimilarity sign between trace sample and hypothetic control soil.     

Virtopsy--fatal motor vehicle accident with head injury

A man wearing no protective helmet was struck by a motor vehicle while riding a bicycle. He was loaded on his left side, and the impact point of his head was his occiput on the car roof girder. He was immediately transported to the general hospital, where he passed away. Postmortem examination using multi-slice computed tomography (MSCT) revealed an extensively comminuted fracture of the posterior part and the base of the skull. Observed were deep direct and contrecoup brain bruises, with the independent fractures of the roof of the both orbits. Massive subdural and subarachnoidal hemorrhage with cerebral edema and shifting of the mid-line towards left side were also detected. MSCT and autopsy results were compared and the body injuries were correlated to vehicle damages. In conclusion, postmortem imaging is a good forensic visualization tool with great potential for documentation and examination of body injuries and pathology.     

Demokratisierung und Freiheitsstreben: Die Perspektive der Humanentwicklung

Much of the literature on democratic transitions presumes that mass attitudes are important for the consolidation of democracies but not for the process of democratization. We challenge this premise on the basis of human development theory. From the perspective of this theory, democratization is an emancipative achievement that should be fuelled by broader emancipative forces among the population. Using the Values Surveys we measure these emancipative forces by people’s liberty aspirations, showing that mass liberty aspirations have a causal effect on a society’s democratic development. No other factor, not GDP/capita and not social capital, can explain away the effect of liberty aspirations on democratization. We conclude that human development theory illuminates emancipative forces in democratization that have so far been neglected.