Forensic medicine experiences in cremation autopsy in Bonn

2016 coroner's crematorial inquests of the Bonn Institute of Legal Medicine over a 3 years' period were evaluated and the statements in the death certificates were compared to those ones of the Statistical Country Office of Northrhine-Westphalia. No significant differences were found with respect to age, gender and reason of death. However, the number of insufficiently classified deaths with respect to the reason of death were overrepresented especially in cases of older women, while the number of unnatural deaths was generally underrepresented. According to legal medical criteria 2 1/4 per cent of the deaths were falsely classified as natural. Only in 2 cases an autopsy was accomplished. Other author's statements on the validity of death certificates were confirmed.     

Case report of accidental stab wound to the heart

A 33 year-old Polish field-worker was found by his colleagues kneeling in front of his trailer, with a bloody stab wound in the heart region. In spite of prompt surgical intervention, the man died from his injury a few hours later. Upon examination of the dead man's trailer a blood-smeared vegetable-knife was found in the sink, and on the floor, a pullover with a slit-like cut. On the wall hung a jacket on a hook with a cut in the inner surface of the left breast pocket but not in the outside layer. The examination of the clothes, the autopsy and a reconstruction of the sequence of events led to the following conclusion: The knife had been placed into the breast pocket of the jacket with the tip facing downwards. As the man put down a sack of potatoes, the knife hooked into a pre-existing gap in the sack and was driven into the chest cavity by the pressure weight of the heavy sack.     

Distribution of morphine and morphine glucuronides in body tissue and fluids--postmortem findings in brief survival

An intoxication following administration of morphine, tramadol and atracurium in a suicide case is reported. The route of administration and the amount of the particular drug were known from the investigation of the death scene and the findings of the postmortem examination. Tramadol was present in the gastric contents as well as in blood, liver, kidney and brain samples, whereas the drug could not be detected in muscle. All body fluids and tissues investigated contained morphine as well as its 3- and 6-glucuronides with the exception of muscle tissue. The concentrations of morphine and its glucuronide metabolites were determined by LC/MS following solid phase extraction. Interestingly, the concentration of M6G in brain, liver and kidney were close to the concentration of M3G in the particular tissue. This phenomenon might be explained by a preferential hydrolysis of M3G or by a preferential formation of M6G postmortem. Measurement of morphine and M6G in femoral blood and cerebrospinal fluid may be a useful indicator in rapid deaths.     

Using cement-containing powder glue (tile cement) to dispose of a cadaver

A 40 year-old woman was killed by fist and chop blows and buried in a forest area far away from the scene of the homicide. Before covering the body with soil the perpetrator poured 25 kg of tile cement powder over it. When the victim was retrieved 6 weeks later, the cement had hardened covering the body like a plate and encasing it like a sheath. The surface of the tile cement facing towards the body was found to contain two kinds of traces: detailed cast-like reproduction of the textile structures of the victim's clothing and wallpaper-like epidermal adhesions. By means of sequencing the mitochondrial DNA the adherent horny scales could be related to the victim.     

An unusual case of self-harm with petroleum distillate

After surgical treatment of an inguinal hernia, a 26-year-old male was discharged from hospital with a well healing surgical wound. Four weeks later he was admitted again with a major localized painful swelling of the soft tissues, whereas the clinical examination revealed no further local or systemic signs of inflammation. The immediate operation disclosed no abscess formation, but a large colliquation necrosis of the subcutaneous tissue with an outstanding petroleum-like odour. On toxicological examination of the necrotic tissue, a respective petroleum distillate was found. The patient was confronted with the suspicion of having injected the petroleum preparation himself to prolong the wound healing and finally admitted the self-mutilating behaviour. The pathophysiology, clinical history and morphological findings are discussed in comparison with case reports of chemically induced self-mutilation.     

Sex differences in proximal humeral outline shape: elliptical Fourier functions

A method is presented for the numerical analysis of sex differences in size and shape of the proximal humeral outlines using elliptical Fourier functions (EFFs). A skeletal sample consisting of right and left humeri pairs of 69 individuals, 36 males and 33 females, was used. The proximal superior view in the plane of the proximo-distal axis of each humerus was photographed and then 54 boundary points were located on the two-dimensional outline tracings. These points were digitized and used to compute EFFs with 27 harmonics. From the EFFs, a set of expected points on the proximal humeral outline was generated using the centroid as an origin. Superimposition of the male and female outlines on this centroid provided a detailed picture of the relative sex differences in size and shape with respect to that center. The bounded area of the proximal humeral outline showed statistically significant sex differences. Additionally, statistical results of the amplitudes derived from the "area-standardized" EFFs and visual assessments of the mean outline plots indicated significant sex differences in shape of the proximal humeral outlines. Focusing on localized regional differences, the greater tubercle was located more postero-medially and the lesser tubercle was located more anteriorly in the males compared to the females. Sex determinations from the proximal humeri were also examined with discriminant functions based on the amplitudes, which represent shape characteristics of the outline, and the hounded area. Using a cross-validation method, predictions of the percentages of cases correctly classified with the discriminant functions were ranged from 92.8% to 95.7% for the right and left humeral data. These results suggest that differences in size and shape of the proximal humeral outlines may be better predictors of sex when compared with conventional measurements of the humerus.     

Age estimation by occlusal tooth wear

The purpose of the present investigation was to test the accuracy of a new scoring system in recording tooth wear for age estimation. The material consisted of dental stone casts of 383 volunteers who had sound premolars and molars with normal occlusion. The degree of occlusal wear for all premolar and molar teeth was scored with the new system. The high intra- and inter-examiner concordances showed that the new score system was very reliable. The degree of tooth wear showed a significant positive correlation with age in each and every examined tooth of both males and females. Tooth wear scores of males were higher than those of females. Calculating tables for age estimation were designed and the accuracy of age estimation was obtained with the General Linear Models procedures. Our system could provide estimation of an individual's age within +/-3 years in 42.4% of males and 49.4% of females, within +/-5 years in 61.8% of males and 63.3% of females. When the subjects were divided into two age groups and data were re-treated, the accuracy of age estimation was increased. Collectively, it was shown that our new system for scoring tooth wear is a reliable and accurate method for age estimation.