Interpapillary lines--the variable part of the human fingerprint.

The dermatoglyphic pattern of human palms and soles is individually unique and unchanging. Their prints show the course of the papillary ridges as papillary lines. Case reports and a few older studies of repeatedly taken fingerprints could, however, show that so-called interpapillary lines can develop between the papillary lines. The questions of this study were: How often do interpapillary lines occur? Can the differences between papillary and interpapillary ridges be quantified? Five-hundred and two ink prints of the palms and fingers from the archive of the Bochum Police Department were examined retrospectively. In 121 volunteers, the appearance of interpapillary lines was examined prospectively. From the later collective, the fingerprints of 13 people with interpapillary lines and nine people without were examined further by taking two silicon prints and measuring them with laser profilometry In 215 of the 502 ink prints (42.8%) interpapillary lines could be demonstrated. In those subjects younger than 20 years they were less frequently observed (34.1%) than in those above the age of 20 (51.8%). In all cases using laser profilometry the interpapillary lines could be related to a corresponding interpapillary ridge. The interpapillary ridge heights were 24.9 +/- 10.0 microm, significantly lower than the papillary ridges, which measured 59.0 +/- 19.2 microm. Interpapillary ridge widths were with 194.8 +/- 65.1 microm significantly narrower as compared to 435.5 +/- 57.4 microm in the papillary ridge. Those papillary ridges, between which interpapillary ridges were found, were significantly further apart from each other (610.5 +/- 78.9 microm) than those without interpapillary ridges (484.9 +/- 70.6 microm). During the course of a lifetime new ridges between the regular papillary ridges can develop or manifest. The fact that interpapillary lines are more frequently found on the right hands in men and those with increasing age is consistent with the theory that they correspond to degenerative changes and with sensitivity of touch.     

Responding to mental distress in the Third World: Cultural imperialism or the struggle for synthesis?

This paper questions the appropriateness of some of the 'help' that has already been given in mental health in 'developing' countries, particularly Africa, and examines some of the complex ideological issues underlying different cultural understandings of the aetiology and treatment of mental illness. Some personal experiences, illustrating examples of the imposition of culturally inappropriate ideology in the teaching of psychiatry, are described. In conclusion, some principles of good practice are suggested which could form the basis of a synthesis between cultures, and maximise the possibility of Western aid in the field of mental distress being more culturally appropriate.     

Discrimination of falls and blows in blunt head trauma: systematic study of the hat brim line rule in relation to skull fractures

In the discrimination of falls from blows in blunt head trauma, the hat brim line rule is one of the most often used criteria. The present study assesses the validity of the hat brim line rule for skull fractures and looks at other possible criteria. All autopsy cases were retrospectively analyzed on a 5-year period. Cases selected consisted of downstairs falls (n = 13), falls from one's own height (n = 23), and homicidal blows (n = 44). Results show that fractures above the hat brim line are more in favor of blows, while fractures in the hat brim line zone are more difficult to distinguish. The majority of fractures were located on the left side for homicidal blows and on the right side for falls. A higher average number of lacerations was revealed for homicidal blows. In conclusion, this study establishes three criteria in favor of blows: (i) localization of a wound above the hat brim line; (ii) left side lateralization; and (iii) a high number of lacerations.     

Postmortem dental radiography

Comparison of postmortem and antemortem dental radiographic films or digital images is a common procedure for establishing identity of human remains. This article describes some problems with producing postmortem dental radiographs in a medical examiner setting and gives methods for circumventing these difficulties. Resection of the jaws, when permitted, significantly simplifies the postmortem radiographic technique. When producing an actual postmortem panoramic dental radiograph (orthopantomogram) from a dry skull, stabilization of the specimen for exposure by the moving beam source may be accomplished simply by placing the specimen upside down on an anthropologist's skull ring. Image "burnout" in the anterior segment, which results from absence of the tissues of the neck, may be avoided by appropriate placement of radiodense objects such as "zippered" plastic bags filled with water or other fluid material, freezer gel packs, or a block of self-polymerizing acrylic. These methods may increase future postmortem dental radiography efficiency.     

Cerebral traumatism with a playground rocking toy mimicking shaken baby syndrome

Shaken baby syndrome (SBS), one of the most deadly and devastating forms of child abuse, is caused by violent shaking. The combination of subdural hematoma, retinal hemorrhage, brain swelling, and diffuse axonal injury is highly typical of this syndrome and faced with these autopsy findings, induced traumatic lesions are strongly considered. However, it is known that motor-vehicle accidents and falls from great height can also produce this pattern of injury. Nevertheless, stories of arms fall, couch fall, or bumped head while the baby is being carried are generally considered incompatible with SBS. We here report a case of a 2-year-old boy presenting with all the classic autopsy findings of SBS from a playground rocking toy shaken by an older child.     

Postmortem changes mistaken for traumatic lesions: a highly prevalent reason for coroner's autopsy request

Postmortem changes are well known for their possible misinterpretation as traumatic lesions which can mislead to suspicion of violent death and therefore to a forensic autopsy request. As far as we know, a systematic review of the prevalence of such a reason for coroner's autopsy request has not been done yet. A retrospective study of 230 forensic autopsies requested by the Coroner's office from 2002 to 2004 in the province of Quebec, Canada, was conducted by the authors. Of the 230 reviewed cases, postmortem artifacts mistaken for traumatic lesions were found in 18 cases. These misinterpretation were based on 5 categories of portmortem changes: purge fluid drainage in 12 cases (66.7%), bluish discoloration by lividity in 5 cases (27.8%), parchment-like drying of the skin in 4 cases (22.2%), bloating from gas formation in 4 cases (22.2%), and skin slippage in 1 case (5.56%). Therefore, postmortem artifacts misinterpretation occurred in 7.83% (95% confidence interval 0.05-0.12) of all requested forensic autopsies and in 35.29% (95% confidence interval 0.23-0.50) of decomposed autopsy cases. This study clearly establishes the high prevalence of postmortem artifacts as main reason for forensic autopsy request. Hence, in a context of forensic pathologist shortage, the improvement of coroner continuous training may reduce the workload.