Virtopsy employs computed tomography and magnetic resonance imaging,which are commonly used in clinical medicine,to determine the cause and manner of death.Virtopsy is a multidisciplinary technique that combines foren...Virtopsy employs computed tomography and magnetic resonance imaging,which are commonly used in clinical medicine,to determine the cause and manner of death.Virtopsy is a multidisciplinary technique that combines forensic medicine,pathology,radiology,computer graphics,biomechanics,and physics.Virtopsy is rapidly gaining importance in forensic science and has been extensively studied in several areas of forensic pathology.In this study,we reviewed domestic and international research on causes of death,traffic injuries,medical disputes,gunshot trauma,postmortem changes,and inference of time of death to discuss with colleagues the role of virtopsy in forensic pathology.展开更多
Blunt cardiac rupture is a characteristic of high death rates and rapid death process. But sometimes it is hard to find out the cause of cardiac rupture of traumatized patients, especially when it relates the relation...Blunt cardiac rupture is a characteristic of high death rates and rapid death process. But sometimes it is hard to find out the cause of cardiac rupture of traumatized patients, especially when it relates the relationship between injury and disease. In the 2 cases reported herein, both of the 2 patients had pre-existent cardiac pathological changes when suffered from traumatic injury. Our aim is to evaluate autopsy findings from a medicolegal point of view, and offer our proposals on how to deal with this sort of cases.展开更多
Introduction: Expert opinions presented in legal proceedings should be scientifically accountable, which is known as evidence-based practice (EBP). Although forensic medical expert opinions are essential in legal proc...Introduction: Expert opinions presented in legal proceedings should be scientifically accountable, which is known as evidence-based practice (EBP). Although forensic medical expert opinions are essential in legal proceedings, the methods used to formulate them are not always evidence based or based on standard methods. In forensic medicine, EBP has not been explicitly applied, including in Indonesia. One potential approach to formulate evidence-based expert opinions is called INtegration of Forensic Epidemiology and the Rigorous EvaluatioN of Causation Elements (INFERENCE). In addition, there is also no universal guideline for making forensic pathological reports. One prospective guideline is named the Principles of Evidence-based Reporting in FORensic Medicine-Pathology version (PERFORM-P). Methods: This article describes the validation process of INFERENCE and PERFORM-P in Indonesia. This study uses a mixed method through three interrelated phases, i.e., (1) a cross-sectional survey to determine the characteristics of Indonesian forensic doctors and their current practice, (2) the adaptation and validation process of the two tools through a review by the Indonesian College of Forensic Medicine, and (3) a one-group pre-postintervention study to assess the validity and reliability of forensic medical expert opinions formulated using Indonesian-INFERENCE (i-INFERENCE) and reported using Indonesian-PERFORM-P (i-PERFORM-P). Results and Discussion: In general, both tools received a positive reception and can potentially be used in the Indonesian setting with some additions/clarifications in the user manuals. Participants envision that both tools will be most useful in complex cases. Conclusions: By obtaining the i-INFERENCE and the i-PERFORM-P, it is hoped that Indonesian forensic medical doctors are better equipped in analyzing and reporting complex cases, and the implementation of EBP can be improved.展开更多
<strong>Objective:</strong> To explore the characteristics and mechanisms of serious injuries of chest caused by road traffic accidents. <strong>Methods:</strong> Totally 112 autopsy cases with...<strong>Objective:</strong> To explore the characteristics and mechanisms of serious injuries of chest caused by road traffic accidents. <strong>Methods:</strong> Totally 112 autopsy cases with chest injuries in the urban of Jingzhou road traffic accidents were collected. Systematic review and analysis of the general information, postmortem examinations and assessments of chest injury had carried out from Feb. 2016 to Mar. 2018. <strong>Results:</strong> Average age of the victims was 52.2 years and the ratio of male to female deaths was 2.39:1. The proportion of motor-cyclists and pedestrians increased significantly. The overwhelming majority of accident vehicles were motorcycles and bicycles. Fractures of ribs and pulmonary contusion were the most common injuries. Craniocerebral and abdominal injuries were the most common associated injuries. <strong>Conclusion:</strong> Fractures of ribs and pulmonary contusion were the most common features of fatal road traffic injuries, often associated with vitreoretinal damage and serious multiple damages. These features reflect the characteristics of great violence in traffic accidents, which provides the evidence of identification of violent injuries.展开更多
Postmortem imaging(PMI)technology known as virtual autopsy or virtopsy is regarded as a useful method of noninvasive or minimally invasive autopsy in forensic practice.Postmortem computed tomography is applicable to t...Postmortem imaging(PMI)technology known as virtual autopsy or virtopsy is regarded as a useful method of noninvasive or minimally invasive autopsy in forensic practice.Postmortem computed tomography is applicable to traumatic investigation,acute hemorrhage,pulmonary parenchyma disease,calcification(calculus,atherosclerosis),and gas accumulation.Postmortem magnetic resonance(PMMR)has been proven to have advantages in soft tissue identification.Cardiac death is one of the keys and difficult points in forensic practice.With the introduction and development of PMCT angiography and PMMR,it was proved to be a very promising tool in the investigation of cardiac death,including vascular cavities and ischemic myocardium.This article reviewed the applications of the latest PMI and its related technologies in forensic cardiac pathology,including advantages,limitations,and development prospects.展开更多
The determination of time since death or the postmortem interval(PMI)is one of the most important and frequently asked questions in forensic medicine.Medicolegal scholars and forensic pathologists around the world hav...The determination of time since death or the postmortem interval(PMI)is one of the most important and frequently asked questions in forensic medicine.Medicolegal scholars and forensic pathologists around the world have studied the estimation of PMI extensively in the past,and many novel methods and advanced technologies have now been applied in the field.For several centuries,Chinese forensic examiners have also worked on the estimation of the PMI,and there are a large number of excellent studies published in Chinese rather than in English,and these are not easily accessible or known internationally.Therefore we have conducted a review of relevant studies published by Chinese forensic scholars in the last few decades.The scope of this review is to provide a concise summary of the current progress in the estimation of PMI by Chinese forensic researchers using molecular biology,spectroscopic technology,entomological methods,energy changes,thanatochemistry and other methods.展开更多
This is a multicentre forensic study that identifies all sports-related sudden deaths (SRSDs) in young people,due to myocardial diseases (MDs) that occurred in a large area of Spain.The aim of the study is to assess t...This is a multicentre forensic study that identifies all sports-related sudden deaths (SRSDs) in young people,due to myocardial diseases (MDs) that occurred in a large area of Spain.The aim of the study is to assess the epidemiology,causes of death,and sport activities associated with these fatalities.This is a retrospective study based on forensic autopsies performed in the provinces of Biscay,Seville,Valencia and in the jurisdiction covered by the National Institute of Toxicology and Forensic Sciences in Madrid (Spain).The retrospective study encompasses from 2010 to 2017.All sudden cardiac deaths (SCDs) in persons 1-35years old were selected.The total number of SCDs were divided into death occurred during exercise (SRSD) and death during rest,sleep or normal activities (non-SRSD).Each of these two groups was subdivided according to the cause of death into MD (primary cardiomyopathies and myocarditis) and non-MD.Clinic-pathological,toxicological and genetic characteristics of SRSD due to MD were analysed.Over the 8-year study period,we identified 645 cases of SCD in the young: 75 SRSD (11.6%) and 570 non-SRSD (88.4%).MD was diagnosed in 33 (44.0%) of the SRSD and in 112 (19.6%) of the non-SRSD cases.All cases of SRSD due to MD were males (mean age (24.0±7.6) years) practicing recreational sports (85%).SRSDs were more frequent in arrhythmogenic cardiomyopathy (ACM) (37%) and hypertrophic cardiomyopathy (HCM) (24%),followed by myocarditis (15%) and idiopathic left ventricular hypertrophy (ILVH) (9%).Only in five cases of SRSD the MD responsible of death (HCM) had been diagnosed in life.Cardiovascular symptoms related to the disease were present in other seven patients (six of them with ACM).Postmortem genetic studies were performed in 15/28 (54%) primary cardiomyopathies with positive results in 12 (80%) cases.The most frequent sports disciplines were football (49%) followed by gymnastics (15%) and running (12%).In Spain,SRSD in young people due to MDs occurs in males who perform a recreational activity.Compared with control group we observed a strong association between MDs and exertion.One in three SRSDs are due to cardiomyopathy,especially ACM,which reinforces the need for preparticipation screening to detect these pathologies in recreational sport athletes.Further studies are warranted to understand the causes and circumstances of sudden death to facilitate the development of preventive strategies.展开更多
Atherosclerotic coronary artery disease (CAD) is of great concern in young adults because of its potential to cause great incapacitation.This arena of cardiology has gained importance in South Asian countries,particul...Atherosclerotic coronary artery disease (CAD) is of great concern in young adults because of its potential to cause great incapacitation.This arena of cardiology has gained importance in South Asian countries,particularly India due to increased prevalence that is related to traditional risk factors,altered life styles and inherent risk factors.In this study,we sought to evaluate,at autopsy,the pathology of atherosclerotic CAD in young patients with ischemic heart disease (IHD).A 10-year retrospective autopsy-based study was carried out in a large tertiary-care centre and patients aged ≤45 years with IHD were selected.Out of 545 autopsied cases of IHD,95 patients (17.4%) were young.Among these 95 patients,84 (88.4%) had IHD related to atherosclerotic CAD;the youngest patient was 18years old.Predictably there was sole involvement of left anterior descending artery and the presence of fibrous plaques.Irrespective of the plaque morphology,the commonest complication was thrombosis produced by plaque erosion seen in 36.9% of patients.Acute coronary insufficiency was noted in 52 patients (61.9%),while healed infarctions were surprisingly noted in 28 patients (33.3%).Screening for IHD in the young population may help to improve prognosis by detecting subclinical disease,although more studies are necessary to establish reference limits for this young population.Additional research must also focus on treatment concerns that are specific to young patients.展开更多
In forensic practice,it is difficult to determine whether a dead body in the water resulted from drowning or from disposal after death.Diatom testing is currently an important supporting technique for the determinatio...In forensic practice,it is difficult to determine whether a dead body in the water resulted from drowning or from disposal after death.Diatom testing is currently an important supporting technique for the determination of death by drowning and of drowning sites,even though it is a time-consuming and laborious task.This article reviews the development of diatom testing over the decades and discusses a new method for the potential application of deep learning in diatom testing.展开更多
Sudden death due to valvular heart disease is reported to range from 1% to 5% in native valves and around 0.2%-0.9%/year in prosthesis.The nature of the diseases is varied,from heritable,congenital to acquired.It may ...Sudden death due to valvular heart disease is reported to range from 1% to 5% in native valves and around 0.2%-0.9%/year in prosthesis.The nature of the diseases is varied,from heritable,congenital to acquired.It may affect both genders in multiple age groups.The authors show and comment examples of the major nosologic aetiologies underlying unexpected exitus letalis of valvular nature.展开更多
Interpreting a myocardial inflammation as causal,contributory or as of no significance at all in the cause of death can be challenging,especially in cases where other pathologic and/or medico-legal findings are also p...Interpreting a myocardial inflammation as causal,contributory or as of no significance at all in the cause of death can be challenging,especially in cases where other pathologic and/or medico-legal findings are also present.To further evaluate the significance of myocardial inflammation as a cause of death we performed a retrospective cohort study of forensic and clinical autopsy cases.We revised the spectrum of histological inflammatory parameters in the myocardium of 79 adult autopsy cases and related these to the reported cause of death.Myocardial slides were reviewed for the distribution and intensity of inflammatory cell infiltrations,the predominant inflammatory cell type,and the presence of inflammation-associated myocyte injury,fibrosis,edema and hemorrhage.Next,the cases were divided over three groups,based on the reported cause of death.Group 1(n=27)consisted of all individuals with an obvious unnatural cause of death.Group 2(n=29)included all individuals in which myocarditis was interpreted to be one out of more possible causes of death.Group 3(n=23)consisted of all individuals in which myocarditis was reported to be the only significant finding at autopsy,and no other cause of death was found.Systematic application of our histological parameters showed that only a diffuse increase of inflammatory cells could discriminate between an incidental presence of inflammation(Group 1)or a potentially significant one(Groups 2 and 3).No other histological parameter showed significant differences between the groups.Our results suggest that generally used histological parameters are often insufficient to differentiate an incidental myocarditis from a(potentially)significant one.展开更多
Death due to acute alcohol poisoning lacks specific anatomical characteristics,compared with other deaths due to drug poisoning.We report three forensic cases of death from acute alcohol poisoning due to inhibition of...Death due to acute alcohol poisoning lacks specific anatomical characteristics,compared with other deaths due to drug poisoning.We report three forensic cases of death from acute alcohol poisoning due to inhibition of the respiratory centre and eventual asphyxia.Blood alcohol concentrations in the three fatalities were 5.28,3.33 and 3.78mg/mL,respec-tively.Lethal doses and blood alcohol concentrations showed differences between individu-als.Detailed auxiliary tests besides autopsy were undertaken.These cases show that forensic scientists should exclude other causes of death,combine the autopsy with auxiliary tests,and then make an appraisal.展开更多
Sudden cardiac death(SCD)is a common cause of death due to the high prevalence and mortality of cardiovascular disease(CVD).Currently,the forensic identification of SCD relies on traditional histomorphological examina...Sudden cardiac death(SCD)is a common cause of death due to the high prevalence and mortality of cardiovascular disease(CVD).Currently,the forensic identification of SCD relies on traditional histomorphological examination,lacking stable biomarkers with high specificity and sensitivity.Previous studies have shown that exosomes(Exos)are ideal vectors and the application of Exos provides novel insight as the diagnostic biomarkers and treatment of CVD,and is hot research filed in biomedicine.This review briefly describes the biology of Exos,including the biogenesis of Exos and the mechanisms of action.The research progresses on Exos multi‑omics,i.e.,genomics,proteomics and metabolomics,and their roles in the diagnosis of different types of CVD,especially coronary heart disease and cardiomyopathy,are summarized.In addition,the current difficulties of applications of Exos in forensic identification of SCD and the prospective forensic applications in the future are highlighted.The aim of this review is to summarize the current advances of Exos in CVD in a disease‑oriented manner,and to provide a reference for future forensic pathological identification of SCD,as well as the early diagnosis of SCD in clinic.展开更多
Diatom test(forensic diatomology)is commonly considered as the“gold standard”in the diagnosis of drowning in forensic practices.The diatomology contributes significantly not only in determining the mode of death but...Diatom test(forensic diatomology)is commonly considered as the“gold standard”in the diagnosis of drowning in forensic practices.The diatomology contributes significantly not only in determining the mode of death but also in determining the site of drowning because of various distribution characterizations of diatoms in different water bodies or different seasons.Hence,it is believed that diatomological mapping will be interest to forensic pathologists in the future development.Here,we reviewed the all the studies on the distribution characterizations of diatoms in different water bodies in China recently.The present paper summarized the current situation and the limitations of the previous studies.Moreover,we suggested that it was necessary to establish a systematized and standardized diatomological mapping program nationwide.Our study also encourages diatomological mapping for forensic characterization of water bodies for a prolonged time.展开更多
Coronavirus disease 2019 has already infected tens of thousands of people in China.The existing autopsy laboratories are not qualified to perform autopsies on individuals confirmed or suspected to have died from an in...Coronavirus disease 2019 has already infected tens of thousands of people in China.The existing autopsy laboratories are not qualified to perform autopsies on individuals confirmed or suspected to have died from an infectious disease.When dealing with corpses with uncertain health conditions or unknown contact with a pathogen,the forensic medical practitioners face severe risks of being infected.To meet the requirements of performing autopsies on such bodies,ensure the health and safety of forensic medical practitioners,and study the pathophysiological changes of infected patients,it is necessary to improve the construction requirements and regulations for forensic autopsy laboratories.展开更多
"High-risk"autopsies are those in which the anatomical examination of a corpse entails a substantial risk of contracting a serious infectious disease.Herein,we discuss the risks of infection associated with ..."High-risk"autopsies are those in which the anatomical examination of a corpse entails a substantial risk of contracting a serious infectious disease.Herein,we discuss the risks of infection associated with high-risk autopsies and factors pertaining to risk identification in high-risk autopsies,and we suggest potentially preventative measures focused on anatomy room protection and virtual imaging.展开更多
Smothering,choking,confined spaces,traumatic asphyxia,positional asphyxia,and other kinds of atypical mechanical asphyxia are not rare in forensic practice.However,these are not commonly well demonstrated in forensic ...Smothering,choking,confined spaces,traumatic asphyxia,positional asphyxia,and other kinds of atypical mechanical asphyxia are not rare in forensic practice.However,these are not commonly well demonstrated in forensic monographs worldwide.The authors researched related works and literatures and summarized these with a view to contribute to the existing teaching resources and provide help to forensic practitioners who are involved in scene investigation and identification of such deaths.展开更多
This contribution reports on a case involving the death of a female with a history of depression in treatment found dead in her house,with her neck compressed by a hydraulic lift elevator used for domestic purposes.Th...This contribution reports on a case involving the death of a female with a history of depression in treatment found dead in her house,with her neck compressed by a hydraulic lift elevator used for domestic purposes.The manner of death was determined as suicide based on an on-scene investigation and witness testimony along with a comprehensive postmortem examination.This case is reported on the grounds of its rarity and it highlights the potential danger of using advanced domestic equipment in the elder people’s residencies,especially those having a mental state of self-destruction.展开更多
Goldenhar syndrome(GS)is a rare congenital disorder that is characterized by incomplete development of the ear,eye,nose,soft palate,lip,and jaw.It is also called oculo-auriculo-vertebral syndrome of Goldenhar,the name...Goldenhar syndrome(GS)is a rare congenital disorder that is characterized by incomplete development of the ear,eye,nose,soft palate,lip,and jaw.It is also called oculo-auriculo-vertebral syndrome of Goldenhar,the name describes the common structural problems seen with the eyes,ears,and vertebrae.The outlook for children with GS varies but is generally very positive.Most children can expect to live a healthy life once treatments have been administered.However,certain congenital heart defects seen in this syndrome such as ventricular septal defect(VSD),persistence of arterial conduct,tetralogy of Fallot,and big vessel transposition can lead to sudden death during childhood.These defects are usually diagnosed during intrauterine life by means of fetal echography,leading to termination of such pregnancy or necessary corrective measures after the birth of such child.If such a child dies,it will be certified by the treating pediatrician.Thus,an autopsy pathologist rarely comes across such deaths.One such case of a 45-day-old female infant suffering from craniofacial deformity who became breathless,cyanotic,and died on the way to the hospital is being discussed here.The right ventricle showed double outlets,arising from it were the pulmonary artery and aorta.A small subaortic VSD was seen.Generalized hypoplasia of all internal viscera on the right side was observed.展开更多
Background:Tuberculosis is a disease of great relevance since it is one of the leading causes of morbidity and mortality worldwide.Gastrointestinal tuberculosis is an unusual presentation.It is defined as the involvem...Background:Tuberculosis is a disease of great relevance since it is one of the leading causes of morbidity and mortality worldwide.Gastrointestinal tuberculosis is an unusual presentation.It is defined as the involvement of any segment of the digestive tract,associated viscera,and peritoneum.The study’s main objective is to collect information from autopsies of patients diagnosed with gastrointestinal tuberculosis in a Pathology reference center in Colombia.Methods:This is a retrospective and descriptive study of autopsy reports.A total of 4,500 autopsies were performed between January 2004 and December 2020.The inclusion criteria were authorization of a family member following local law regulations and a final autopsy diagnosis of gastrointestinal tuberculosis using microscopic visualization.Results:Forty-eight patients with gastrointestinal tuberculosis autopsies were included in our study.Most of the patients were male(n=35,72.9%)with a median age of 40.5 years old.Human immunodeficiency virus infection history was reported in 28 cases(58.33%).The most affected gastrointestinal tract site was the terminal ileum.Ulcers and thickened epithelium were common autopsies macroscopic findings.Tuberculosis multiorgan compromise was a relevant finding in patients with gastrointestinal tuberculosis.Conclusions:Gastrointestinal tuberculosis is a disease of great importance,being its diagnosis a clinical challenge.Underdiagnosis can be reported in a high percentage of cases,so autopsy diagnosis can help reveal more accurate data about this condition.展开更多
基金Double First Class-Training of Top Talents(2011-051040)National Natural Science Foundation of China(81971796,81871523)+3 种基金Beijing Natural Science Foundation of China(7192121,7182022)Open Project of Shanxi Key Laboratory of Forensic ScienceProjects Funded by Hubei Key Laboratory of Forensic Science(Hubei University of Police)Academic Innovation Team of Young Teachers of China University of Political Science and Law(19CXTD04,18CXTD09).
文摘Virtopsy employs computed tomography and magnetic resonance imaging,which are commonly used in clinical medicine,to determine the cause and manner of death.Virtopsy is a multidisciplinary technique that combines forensic medicine,pathology,radiology,computer graphics,biomechanics,and physics.Virtopsy is rapidly gaining importance in forensic science and has been extensively studied in several areas of forensic pathology.In this study,we reviewed domestic and international research on causes of death,traffic injuries,medical disputes,gunshot trauma,postmortem changes,and inference of time of death to discuss with colleagues the role of virtopsy in forensic pathology.
文摘Blunt cardiac rupture is a characteristic of high death rates and rapid death process. But sometimes it is hard to find out the cause of cardiac rupture of traumatized patients, especially when it relates the relationship between injury and disease. In the 2 cases reported herein, both of the 2 patients had pre-existent cardiac pathological changes when suffered from traumatic injury. Our aim is to evaluate autopsy findings from a medicolegal point of view, and offer our proposals on how to deal with this sort of cases.
文摘Introduction: Expert opinions presented in legal proceedings should be scientifically accountable, which is known as evidence-based practice (EBP). Although forensic medical expert opinions are essential in legal proceedings, the methods used to formulate them are not always evidence based or based on standard methods. In forensic medicine, EBP has not been explicitly applied, including in Indonesia. One potential approach to formulate evidence-based expert opinions is called INtegration of Forensic Epidemiology and the Rigorous EvaluatioN of Causation Elements (INFERENCE). In addition, there is also no universal guideline for making forensic pathological reports. One prospective guideline is named the Principles of Evidence-based Reporting in FORensic Medicine-Pathology version (PERFORM-P). Methods: This article describes the validation process of INFERENCE and PERFORM-P in Indonesia. This study uses a mixed method through three interrelated phases, i.e., (1) a cross-sectional survey to determine the characteristics of Indonesian forensic doctors and their current practice, (2) the adaptation and validation process of the two tools through a review by the Indonesian College of Forensic Medicine, and (3) a one-group pre-postintervention study to assess the validity and reliability of forensic medical expert opinions formulated using Indonesian-INFERENCE (i-INFERENCE) and reported using Indonesian-PERFORM-P (i-PERFORM-P). Results and Discussion: In general, both tools received a positive reception and can potentially be used in the Indonesian setting with some additions/clarifications in the user manuals. Participants envision that both tools will be most useful in complex cases. Conclusions: By obtaining the i-INFERENCE and the i-PERFORM-P, it is hoped that Indonesian forensic medical doctors are better equipped in analyzing and reporting complex cases, and the implementation of EBP can be improved.
文摘<strong>Objective:</strong> To explore the characteristics and mechanisms of serious injuries of chest caused by road traffic accidents. <strong>Methods:</strong> Totally 112 autopsy cases with chest injuries in the urban of Jingzhou road traffic accidents were collected. Systematic review and analysis of the general information, postmortem examinations and assessments of chest injury had carried out from Feb. 2016 to Mar. 2018. <strong>Results:</strong> Average age of the victims was 52.2 years and the ratio of male to female deaths was 2.39:1. The proportion of motor-cyclists and pedestrians increased significantly. The overwhelming majority of accident vehicles were motorcycles and bicycles. Fractures of ribs and pulmonary contusion were the most common injuries. Craniocerebral and abdominal injuries were the most common associated injuries. <strong>Conclusion:</strong> Fractures of ribs and pulmonary contusion were the most common features of fatal road traffic injuries, often associated with vitreoretinal damage and serious multiple damages. These features reflect the characteristics of great violence in traffic accidents, which provides the evidence of identification of violent injuries.
基金By grants from the National Key Research and Development Program of China(no.2022YFC3302002)the Council of National Science Foundation of China(grant number 82171872)+4 种基金the Council of National Science Foundation of Shanghai(grant number 21ZR1464600)Key Laboratory of judicial expertise of Ministry of Justice and Shanghai Key Laboratory of Forensic Medicine(grant number 21DZ2270800)Shanghai Forensic Service Platform(grant number 19DZ2292700)Central Research Institute Public Project(grant numbers2020Z‑4,2021G‑4)Shanghai Key Laboratory of Forensic Medicine,Key Lab of Forensic Science,Ministry of Justice(grant number KF202120).
文摘Postmortem imaging(PMI)technology known as virtual autopsy or virtopsy is regarded as a useful method of noninvasive or minimally invasive autopsy in forensic practice.Postmortem computed tomography is applicable to traumatic investigation,acute hemorrhage,pulmonary parenchyma disease,calcification(calculus,atherosclerosis),and gas accumulation.Postmortem magnetic resonance(PMMR)has been proven to have advantages in soft tissue identification.Cardiac death is one of the keys and difficult points in forensic practice.With the introduction and development of PMCT angiography and PMMR,it was proved to be a very promising tool in the investigation of cardiac death,including vascular cavities and ischemic myocardium.This article reviewed the applications of the latest PMI and its related technologies in forensic cardiac pathology,including advantages,limitations,and development prospects.
基金supported by National Sciences Foundation of China(NSFC)[grant numbers 81601645,81671869,81072509,81273339 and 81273335]the Science and Technology Commission of Shanghai Municipality[grant number 14DZ2270800].
文摘The determination of time since death or the postmortem interval(PMI)is one of the most important and frequently asked questions in forensic medicine.Medicolegal scholars and forensic pathologists around the world have studied the estimation of PMI extensively in the past,and many novel methods and advanced technologies have now been applied in the field.For several centuries,Chinese forensic examiners have also worked on the estimation of the PMI,and there are a large number of excellent studies published in Chinese rather than in English,and these are not easily accessible or known internationally.Therefore we have conducted a review of relevant studies published by Chinese forensic scholars in the last few decades.The scope of this review is to provide a concise summary of the current progress in the estimation of PMI by Chinese forensic researchers using molecular biology,spectroscopic technology,entomological methods,energy changes,thanatochemistry and other methods.
文摘This is a multicentre forensic study that identifies all sports-related sudden deaths (SRSDs) in young people,due to myocardial diseases (MDs) that occurred in a large area of Spain.The aim of the study is to assess the epidemiology,causes of death,and sport activities associated with these fatalities.This is a retrospective study based on forensic autopsies performed in the provinces of Biscay,Seville,Valencia and in the jurisdiction covered by the National Institute of Toxicology and Forensic Sciences in Madrid (Spain).The retrospective study encompasses from 2010 to 2017.All sudden cardiac deaths (SCDs) in persons 1-35years old were selected.The total number of SCDs were divided into death occurred during exercise (SRSD) and death during rest,sleep or normal activities (non-SRSD).Each of these two groups was subdivided according to the cause of death into MD (primary cardiomyopathies and myocarditis) and non-MD.Clinic-pathological,toxicological and genetic characteristics of SRSD due to MD were analysed.Over the 8-year study period,we identified 645 cases of SCD in the young: 75 SRSD (11.6%) and 570 non-SRSD (88.4%).MD was diagnosed in 33 (44.0%) of the SRSD and in 112 (19.6%) of the non-SRSD cases.All cases of SRSD due to MD were males (mean age (24.0±7.6) years) practicing recreational sports (85%).SRSDs were more frequent in arrhythmogenic cardiomyopathy (ACM) (37%) and hypertrophic cardiomyopathy (HCM) (24%),followed by myocarditis (15%) and idiopathic left ventricular hypertrophy (ILVH) (9%).Only in five cases of SRSD the MD responsible of death (HCM) had been diagnosed in life.Cardiovascular symptoms related to the disease were present in other seven patients (six of them with ACM).Postmortem genetic studies were performed in 15/28 (54%) primary cardiomyopathies with positive results in 12 (80%) cases.The most frequent sports disciplines were football (49%) followed by gymnastics (15%) and running (12%).In Spain,SRSD in young people due to MDs occurs in males who perform a recreational activity.Compared with control group we observed a strong association between MDs and exertion.One in three SRSDs are due to cardiomyopathy,especially ACM,which reinforces the need for preparticipation screening to detect these pathologies in recreational sport athletes.Further studies are warranted to understand the causes and circumstances of sudden death to facilitate the development of preventive strategies.
文摘Atherosclerotic coronary artery disease (CAD) is of great concern in young adults because of its potential to cause great incapacitation.This arena of cardiology has gained importance in South Asian countries,particularly India due to increased prevalence that is related to traditional risk factors,altered life styles and inherent risk factors.In this study,we sought to evaluate,at autopsy,the pathology of atherosclerotic CAD in young patients with ischemic heart disease (IHD).A 10-year retrospective autopsy-based study was carried out in a large tertiary-care centre and patients aged ≤45 years with IHD were selected.Out of 545 autopsied cases of IHD,95 patients (17.4%) were young.Among these 95 patients,84 (88.4%) had IHD related to atherosclerotic CAD;the youngest patient was 18years old.Predictably there was sole involvement of left anterior descending artery and the presence of fibrous plaques.Irrespective of the plaque morphology,the commonest complication was thrombosis produced by plaque erosion seen in 36.9% of patients.Acute coronary insufficiency was noted in 52 patients (61.9%),while healed infarctions were surprisingly noted in 28 patients (33.3%).Screening for IHD in the young population may help to improve prognosis by detecting subclinical disease,although more studies are necessary to establish reference limits for this young population.Additional research must also focus on treatment concerns that are specific to young patients.
基金This work was supported by grants from the National Natural Science Foundation of China[grand numbers 81801873,81722027 and 81671869]the Science and Technology Committee of Shanghai Municipality[grand numbers 17DZ2273200 and 19DZ2292700]Key Laboratory of Forensic Medicine[grand numbers KF1802].
文摘In forensic practice,it is difficult to determine whether a dead body in the water resulted from drowning or from disposal after death.Diatom testing is currently an important supporting technique for the determination of death by drowning and of drowning sites,even though it is a time-consuming and laborious task.This article reviews the development of diatom testing over the decades and discusses a new method for the potential application of deep learning in diatom testing.
文摘Sudden death due to valvular heart disease is reported to range from 1% to 5% in native valves and around 0.2%-0.9%/year in prosthesis.The nature of the diseases is varied,from heritable,congenital to acquired.It may affect both genders in multiple age groups.The authors show and comment examples of the major nosologic aetiologies underlying unexpected exitus letalis of valvular nature.
文摘Interpreting a myocardial inflammation as causal,contributory or as of no significance at all in the cause of death can be challenging,especially in cases where other pathologic and/or medico-legal findings are also present.To further evaluate the significance of myocardial inflammation as a cause of death we performed a retrospective cohort study of forensic and clinical autopsy cases.We revised the spectrum of histological inflammatory parameters in the myocardium of 79 adult autopsy cases and related these to the reported cause of death.Myocardial slides were reviewed for the distribution and intensity of inflammatory cell infiltrations,the predominant inflammatory cell type,and the presence of inflammation-associated myocyte injury,fibrosis,edema and hemorrhage.Next,the cases were divided over three groups,based on the reported cause of death.Group 1(n=27)consisted of all individuals with an obvious unnatural cause of death.Group 2(n=29)included all individuals in which myocarditis was interpreted to be one out of more possible causes of death.Group 3(n=23)consisted of all individuals in which myocarditis was reported to be the only significant finding at autopsy,and no other cause of death was found.Systematic application of our histological parameters showed that only a diffuse increase of inflammatory cells could discriminate between an incidental presence of inflammation(Group 1)or a potentially significant one(Groups 2 and 3).No other histological parameter showed significant differences between the groups.Our results suggest that generally used histological parameters are often insufficient to differentiate an incidental myocarditis from a(potentially)significant one.
文摘Death due to acute alcohol poisoning lacks specific anatomical characteristics,compared with other deaths due to drug poisoning.We report three forensic cases of death from acute alcohol poisoning due to inhibition of the respiratory centre and eventual asphyxia.Blood alcohol concentrations in the three fatalities were 5.28,3.33 and 3.78mg/mL,respec-tively.Lethal doses and blood alcohol concentrations showed differences between individu-als.Detailed auxiliary tests besides autopsy were undertaken.These cases show that forensic scientists should exclude other causes of death,combine the autopsy with auxiliary tests,and then make an appraisal.
文摘Sudden cardiac death(SCD)is a common cause of death due to the high prevalence and mortality of cardiovascular disease(CVD).Currently,the forensic identification of SCD relies on traditional histomorphological examination,lacking stable biomarkers with high specificity and sensitivity.Previous studies have shown that exosomes(Exos)are ideal vectors and the application of Exos provides novel insight as the diagnostic biomarkers and treatment of CVD,and is hot research filed in biomedicine.This review briefly describes the biology of Exos,including the biogenesis of Exos and the mechanisms of action.The research progresses on Exos multi‑omics,i.e.,genomics,proteomics and metabolomics,and their roles in the diagnosis of different types of CVD,especially coronary heart disease and cardiomyopathy,are summarized.In addition,the current difficulties of applications of Exos in forensic identification of SCD and the prospective forensic applications in the future are highlighted.The aim of this review is to summarize the current advances of Exos in CVD in a disease‑oriented manner,and to provide a reference for future forensic pathological identification of SCD,as well as the early diagnosis of SCD in clinic.
文摘Diatom test(forensic diatomology)is commonly considered as the“gold standard”in the diagnosis of drowning in forensic practices.The diatomology contributes significantly not only in determining the mode of death but also in determining the site of drowning because of various distribution characterizations of diatoms in different water bodies or different seasons.Hence,it is believed that diatomological mapping will be interest to forensic pathologists in the future development.Here,we reviewed the all the studies on the distribution characterizations of diatoms in different water bodies in China recently.The present paper summarized the current situation and the limitations of the previous studies.Moreover,we suggested that it was necessary to establish a systematized and standardized diatomological mapping program nationwide.Our study also encourages diatomological mapping for forensic characterization of water bodies for a prolonged time.
基金Funding support came from Grant-in Aids for Scientific Research from Ministry of Public Security of the People's Republic of China(2019SSGG0403)a grant from the Guangzhou Municipal Science and Technology Project(2019030001,2019030012)。
文摘Coronavirus disease 2019 has already infected tens of thousands of people in China.The existing autopsy laboratories are not qualified to perform autopsies on individuals confirmed or suspected to have died from an infectious disease.When dealing with corpses with uncertain health conditions or unknown contact with a pathogen,the forensic medical practitioners face severe risks of being infected.To meet the requirements of performing autopsies on such bodies,ensure the health and safety of forensic medical practitioners,and study the pathophysiological changes of infected patients,it is necessary to improve the construction requirements and regulations for forensic autopsy laboratories.
文摘"High-risk"autopsies are those in which the anatomical examination of a corpse entails a substantial risk of contracting a serious infectious disease.Herein,we discuss the risks of infection associated with high-risk autopsies and factors pertaining to risk identification in high-risk autopsies,and we suggest potentially preventative measures focused on anatomy room protection and virtual imaging.
基金the Open Project of Key Laboratory of Forensic Genetics,Ministry of Public Security(2017FGKFKT05)Program for Young Innovative Research Team from China University ofPolitical Science and Law(2016CXTD05)Project of Interdisciplinary Science Construction-Forensic Psychology from China University of Political Science and Law.
文摘Smothering,choking,confined spaces,traumatic asphyxia,positional asphyxia,and other kinds of atypical mechanical asphyxia are not rare in forensic practice.However,these are not commonly well demonstrated in forensic monographs worldwide.The authors researched related works and literatures and summarized these with a view to contribute to the existing teaching resources and provide help to forensic practitioners who are involved in scene investigation and identification of such deaths.
文摘This contribution reports on a case involving the death of a female with a history of depression in treatment found dead in her house,with her neck compressed by a hydraulic lift elevator used for domestic purposes.The manner of death was determined as suicide based on an on-scene investigation and witness testimony along with a comprehensive postmortem examination.This case is reported on the grounds of its rarity and it highlights the potential danger of using advanced domestic equipment in the elder people’s residencies,especially those having a mental state of self-destruction.
文摘Goldenhar syndrome(GS)is a rare congenital disorder that is characterized by incomplete development of the ear,eye,nose,soft palate,lip,and jaw.It is also called oculo-auriculo-vertebral syndrome of Goldenhar,the name describes the common structural problems seen with the eyes,ears,and vertebrae.The outlook for children with GS varies but is generally very positive.Most children can expect to live a healthy life once treatments have been administered.However,certain congenital heart defects seen in this syndrome such as ventricular septal defect(VSD),persistence of arterial conduct,tetralogy of Fallot,and big vessel transposition can lead to sudden death during childhood.These defects are usually diagnosed during intrauterine life by means of fetal echography,leading to termination of such pregnancy or necessary corrective measures after the birth of such child.If such a child dies,it will be certified by the treating pediatrician.Thus,an autopsy pathologist rarely comes across such deaths.One such case of a 45-day-old female infant suffering from craniofacial deformity who became breathless,cyanotic,and died on the way to the hospital is being discussed here.The right ventricle showed double outlets,arising from it were the pulmonary artery and aorta.A small subaortic VSD was seen.Generalized hypoplasia of all internal viscera on the right side was observed.
文摘Background:Tuberculosis is a disease of great relevance since it is one of the leading causes of morbidity and mortality worldwide.Gastrointestinal tuberculosis is an unusual presentation.It is defined as the involvement of any segment of the digestive tract,associated viscera,and peritoneum.The study’s main objective is to collect information from autopsies of patients diagnosed with gastrointestinal tuberculosis in a Pathology reference center in Colombia.Methods:This is a retrospective and descriptive study of autopsy reports.A total of 4,500 autopsies were performed between January 2004 and December 2020.The inclusion criteria were authorization of a family member following local law regulations and a final autopsy diagnosis of gastrointestinal tuberculosis using microscopic visualization.Results:Forty-eight patients with gastrointestinal tuberculosis autopsies were included in our study.Most of the patients were male(n=35,72.9%)with a median age of 40.5 years old.Human immunodeficiency virus infection history was reported in 28 cases(58.33%).The most affected gastrointestinal tract site was the terminal ileum.Ulcers and thickened epithelium were common autopsies macroscopic findings.Tuberculosis multiorgan compromise was a relevant finding in patients with gastrointestinal tuberculosis.Conclusions:Gastrointestinal tuberculosis is a disease of great importance,being its diagnosis a clinical challenge.Underdiagnosis can be reported in a high percentage of cases,so autopsy diagnosis can help reveal more accurate data about this condition.
