Sex Determination Using the Second Cervical Vertebra—A Test of the Method*

Abstract: Sex is one of the critical questions addressed when unidentified skeletal remains are discovered in forensic or archeological contexts. Continuous testing and re‐evaluation of existing techniques is essential to improve accuracy and precision. The Wescott (J Forensic Sci 2000; 45 (2):462–6) method of sex determination from dimensions of the second cervical vertebra was blind‐tested on 153 adult individuals from the Spitalfields documented collection of human skeletal remains held at the Natural History Museum, London. Significant sex differences were determined for all dimensions measured (independent two‐sample t‐test, p < 0.05–0.001). The discriminant functions developed by Wescott were shown to have an overall accuracy of classification of 76.99%. Using stepwise discriminant analysis, a discriminant function based on the Spitalfields data correctly classified sex in 83.3% of individuals and was able to classify males and females with equal accuracy. Additional discriminant functions are presented for use in instances where preservation of the second cervical vertebra is poor.     

Cervical soft tissue emphysema in hanging--a prospective autopsy study

The underlying mechanism of cervical soft tissue emphysema (CSTE) in hanging remains unclear. The aim of this study was to determine the frequency of CSTE in cases of hanging. The sample included 83 deceased persons, average age 55.3 ± 17.9 years. CSTE was established in 44 cases. CSTE is presented as frothy air, soap bubble-like formations in superficial and/or deep connective tissue between the neck muscles up to the ligature mark, visible during gross neck examination, using special neck autopsy technique-preparation of the neck organs in layers. The interpretation of positive CSTE must be taken with caution: it could be an antemortem phenomenon possibly because of either Macklin Effect or direct or indirect trauma to the cervical airways, as well as an ante- or postmortem artifact.     

放射影像学在颈部损伤尸体检验中的应用

多层面计算机断层成像(MSCT)和磁共振成像(MRI)对尸体骨骼系统和软组织损伤的诊断价值等同于传统的尸体解剖,运用在颈部损伤的尸体检验中可以弥补传统尸体解剖的某些不足,在某些特定的环境、腐败、烧焦或具有传染性的尸体检验中,MSCT和MRI联合使用可以作为机械性窒息、挥鞭样损伤、颈椎损伤及颈部血管损伤的可选择的法医学检查手段之一。     

牵引推拿为主治疗颈椎间盘突出症53例

目的：观察牵引推拿为主治疗颈椎间盘突出症的临床疗效。方法：采用以牵引推拿为主的方法治疗53例颈椎间盘突出症住院患。结果：治愈20例，占37．7％，好转29例，占54．8％，无效4例，占7．5％，总有效率达92．5％。结论：牵引推拿疗法对神经根受压而导致的功能受限、颈臂疼痛、手指麻木，和椎动脉受压而导致的头晕等临床表现疗效较佳，而对出现脊髓压迫症状疗效较差。     

第12胸椎三维重建图像性别判定研究

目的考察计算机断层扫描(CT)技术测量中国汉族第12胸椎判定性别的效果,探索CT技术在法医人类学人体骨骼测量研究中应用的可行性。方法确定11项径线指标测量第12胸椎多层面重组(MPR)三维重建图像,剔除不稳定指标后计算四项比值指标,统计各项指标的数据考察CT测量第12胸椎判定性别的效果。结果剔除两次测量结果不稳定的三项指标后的12项指标性别差异显著,建立了7个性别判定方程,综合判别率在80.0%~91.6%,仅含椎体指标的方程性别判别率最高达91.6%。结论中国汉族人第12胸椎形态学测量指标具有性别差异,CT技术可以准确测量骨骼,对法医人类学人体骨骼测量研究具有应用价值。     

A meta-analytic review of the frequency and patterning of laryngohyoid and cervical fractures in cases of suicide by hanging

The frequency and distribution of fractures are commonly utilized to assist in interpreting the manner of death. In cases of alleged suicide by hanging, however, the evidence base for the frequency and patterning of laryngohyoid and cervical vertebrae fractures resulting from such blunt force traumatic events is limited and so fractures cannot be reliably used to assist in interpreting the manner. Using meta-analytic techniques, this study aimed to estimate frequency and distribution of fractures in the context of relevant intrinsic and extrinsic variables. A systematic review of the literature identified 20 studies with relevant data (8523 cases of suicide by hanging). Meta-analyses identified the frequency and distribution of fractures present and how fracture frequency was affected by the subgroups of age, sex, completeness of suspension, ligature knot position and study design. Results indicated that fracture frequency was variable, there was no unique patterning, and high levels of heterogeneity were present in all variable sub-groups. Age was the only subgroup to show differences. Findings suggest that neck fracture frequency is inconsistent and cannot be predicted by the chosen variables. Subsequently, neck fractures in isolation should not be given weight in medico-legal interpretations of a hanging death as suicidal.     

Sexual Dimorphism in the 7th Cervical and 12th Thoracic Vertebrae from a Mediterranean Population

Sex determination is an important task in physical anthropology and forensic medicine. The study sample comprised 121 individuals of known sex, age, and cause of death from San Jose cemetery in Granada (Spain). Eight dimensions were analyzed, and discriminant function analysis was performed for each vertebra to obtain discriminating functions and study the percentage of correct assignations of these functions. The percentage accuracy was approximately 80% for both vertebrae, but varied according to the sex, being higher for the 7th cervical in males and higher for the 12th thoracic in females. As reported in other populations, the greatest dimorphism values were found for the length of the inferior surface of the vertebral body and the width and length of the vertebral foramen of the 7th cervical vertebra and for the length of the inferior surface of the vertebral body of the 12th thoracic vertebra.     

GnRH受体在山羊颈中神经节的分布特点

为了证实GnRH受体在山羊颈中神经节是否存在,取雄性和雌性成年山羊的颈中神经节各5对,经免疫组织化学SP法染色后,观察GnRH受体在颈中神经节的分布特点。结果表明,山羊颈中神经节的神经元、血管内皮细胞、神经纤维及卫星细胞均有不同程度的阳性染色。神经元中GnRH受体强阳性产物分布于胞膜上,中等阳性产物分布于整个胞质中;血管内皮细胞有中等阳性产物;神经纤维、卫星细胞和施万细胞有弱阳性产物分布。证实,GnRH受体在山羊颈中神经节中分布广泛,提示颈中神经节可能受GnRH调节,这为研究GnRH非生殖调节功能及颈中神经节的神经内分泌调节机制提供了形态学依据。     

Motor Vehicle Occupants,Neck Injuries,and Seat Belt Utilization: A 5‐Year Study of Fatalities in New York City

Abstract: Despite the implementation of numerous safety devices in automobiles, vehicular occupant fatalities following collisions remain common. We reviewed all fatalities of vehicular occupants in New York City over a 5‐year period on whom autopsies were performed (437) to determine the incidence of neck injuries and correlate them with seat belt utilization; 26.5% had neck injuries (mild to severe) and only 10.3% of these occupants were confirmed to be wearing seatbelts. Of those that had documentation of seat belt utilization there were twice as many neck injuries in the unbelted group. We highlight two cases of submarining with severe neck injuries that were related to automatic 2‐point shoulder harness restraints without engagement of the lap belt.     

An Autopsy Case in Which Self‐Bloodletting Via a Cervical Blood Access Led to a Fatal Outcome*

Abstract: A 48‐year‐old woman was found dead on a chair in her living room. She had received dialysis every day because of chronic renal failure for the past 15 years. On a table beside her, there was a mirror and 10‐mL syringe on a napkin. A stopper was out of place in a portion of a three‐way blood access tube established in the right cervical region, and blood coagulation was noted in the lumen. There was a bloodstained measuring cup on the floor. Autopsy findings included a large number of shunt traces in the bilateral infraclavicular fossae and upper limbs, as well as the cervical blood access terminal reaching the right atrium via the internal jugular vein to superior vena cava. Various organs showed anemia. Neither a fatal lesion nor injury was noted in the main organs. Therefore, this patient may have committed suicide by self‐bloodletting via a cervical blood access.