Forensic Science Medicine and Pathology (Forensic Sci Med Pathol)

Publications in this journal

• Article: Toxicological identification of diphenhydramine (DPH) in suicide.

  Lena Eckes, Michael Tsokos, Sieglinde Herre, René Gapert, Sven Hartwig
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  ABSTRACT: Diphenhydramine (DPH), an H1-antihistamine, is identified during postmortem toxicological analyses on a relatively rare but still regular basis. This study examines suicidal intoxications with DPH by analyzing blood and gastric content concentration levels. Twenty cases of DPH intoxications within a 10-year period (2000-2010) were discovered by screening the autopsy records of the Institute of Legal Medicine and Forensic Sciences (ILMFS) in Berlin, Germany. In four cases, DPH levels were lower than 1 μg/mL and hence were not considered likely to be responsible for causing death. In 11 cases, DPH played a role in the fatal episode, and five of these cases were monointoxications. Considering that more than 8,000 autopsies were performed by the ILMFS within the time period under examination, there is only one monointoxication case every 2 years, which makes it a rare occurrence. In two of these intoxications, DPH was only measured in toxic but not "lethal" concentrations in blood, with a concentration of 5 μg/mL being generally used as the cut off between categories according to forensic literature. This raises the question as to whether a strict boundary for a "lethal" blood concentration, as suggested in some literature, can be set and applied in any of these cases. This study shows that an individual interpretation of each case is of utmost importance for correct classification. A thorough toxicological analysis of peripheral venous blood and gastric content, as well as a detailed work-up of the death circumstances, are the basis of an exact interpretation of intoxications with DPH.
  Forensic Science Medicine and Pathology 06/2013; 9(2):145-153.
• Article: Sponge-like appearance of the liver parenchyma due to fatal intrauterine gas gangrene following mechanical abortion.

  Navena Widulin, René Gapert, Michael Tsokos
  Forensic Science Medicine and Pathology 06/2013; 9(2):274-276.
• Article: Suicide with two shots to the head using a rare 'Velo-Dog' pocket revolver.

  Takahito Hayashi, René Gapert, Michael Tsokos, Sven Hartwig
  Forensic Science Medicine and Pathology 06/2013; 9(2):265-269.
• Article: Virtual autopsy.

  Peter Mygind Leth
  Forensic Science Medicine and Pathology 04/2013;
• Article: Sonographic assessment of the ossification of the medial clavicular epiphysis in 616 individuals.

  Ronald Schulz, Manfred Schiborr, Heidi Pfeiffer, Sven Schmidt, Andreas Schmeling
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  ABSTRACT: Establishing radiation-free imaging methods for the assessment of clavicular ossification in forensic age determination is desirable as it reduces radiation exposure in living individuals. For this purpose the stage of ossification of the right medial clavicular epiphysis was determined prospectively using sonography in 309 male and 307 female healthy volunteers. The classification of stages according to Schulz et al. was used for this purpose. Stage 2 was first noticed at the age of 14.4 years in males, and at the age of 14.1 years in females. Stage 3 was first achieved by males at the age of 17.6 years and by females at the age of 17.4 years. Stage 4 first occurred in males at the age of 19.3 years and at the age of 18.9 years in females. The mean age for stage 1 was 13.6 years. The mean age of stage 2 ranged between 17.3 and 17.6 years. For stage 3 the mean age varied from 20.7 to 21.2 years, and for stage 4 from 23.3 to 23.5 years. It was concluded that sonographically determined stage 4 clavicular ossification provides evidence for the completion of the nineteenth year of life in males and the eighteenth year of life in females. In order to increase the reliability of age determination using this method it is recommended that findings be recorded by at least two experienced independent examiners who then reach a consensus.
  Forensic Science Medicine and Pathology 04/2013;
• Article: Cochlear implants in the forensic identification process.

  John Berketa, Helen James, Neil Langlois, Lindsay Richards
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  ABSTRACT: PURPOSE: Decedents who are severely decomposed, skeletonized or incinerated present challenges for identification. Cochlear implants aid hearing and bear unique serial numbers that can be used to assist with identification of bodies that are not visually identifiable. The purpose of this paper was to highlight companies that have or had manufactured cochlear type implants and demonstrate the appearance of the implants to assist crime scene investigators, pathologists, anthropologists and odontologists. METHOD: Investigation of cochlear implants was conducted on the internet and companies were contacted for information regarding their implants. RESULTS: The functional appearance of a cochlear implant is explained, brands of implants are tabulated and pre and post-incineration images are presented. CONCLUSION: The prevalence of cochlear implants is predicted to increase, thus they are likely to become relevant to the identification process. Company brand and serial markings can be retrieved from post-incineration implants making them a valuable aid in identification when other identifiers that may be present are not useful because they are heat-sensitive.
  Forensic Science Medicine and Pathology 04/2013;
• Article: Blood lactate concentration after exposure to conducted energy weapons (including TASER(®) devices): is it clinically relevant?

  James R Jauchem
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  ABSTRACT: In previous studies, blood lactate concentration (BLac) consistently increased in anesthetized animals and in human subjects after exposures to TASER(®) conducted energy weapons (CEWs). Some have suggested the increased BLac would have detrimental consequences. In the current review, the following are evaluated: (a) the nature of muscle contractions due to CEWs, (b) general aspects of increased BLac, (c) previous studies of conventional neuromuscular electrical stimulation and CEW exposures, and (d) BLac in disease states. On the basis of these analyses, one can conclude that BLac, per se (independent of acidemia), would not be clinically relevant immediately after short-duration CEW applications, due to the short time course of any increase.
  Forensic Science Medicine and Pathology 04/2013;
• Article: The unusual appearance of black esophagus in a case of fatal hypothermia: a possible underlying mechanism.

  Vladimir Zivković, Slobodan Nikolić
  Forensic Science Medicine and Pathology 04/2013;
• Article: Use of pacemaker programmers for disaster victim identification.

  Haruka Makinae, Norio Numata, Hirofumi Kitaoka, Masao Daimon, Taira Yamamoto, Atsushi Amano
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  ABSTRACT: Disaster victim identification (DVI) presents a number of physical and legal challenges, involving the degeneration of human remains and legal obstacles to forensic examinations. One non-invasive method for positive identification may be the use of a pacemaker programmer to detect and obtain data from pacemakers recovered from unidentified remains. To test the usefulness of this method, this investigation examined the efficiency and utility of 5 different pacemaker programmers in the positive identification of victims of the March 2011 tsunami in Japan at 8 disaster sites in May 2011. On scanning 148 sets of remains, data were successfully obtained from 1 implant in 1 set of remains, allowing for the rapid positive identification of the individual. Scanning pacemakers with pacemaker programmers can be a non-invasive method of positive identification that meets Japanese legal and institutional requirements, but this method is ineffective without a preceding whole-body X-ray scan.
  Forensic Science Medicine and Pathology 04/2013;
• Article: Test of age-related variation in the craniometry of the adult human foramen magnum region: implications for sex determination methods.

  René Gapert, Sue Black, Jason Last
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  ABSTRACT: Sex differences in the foramen magnum region of the cranial base have been identified with varying rates of success. Recent publications demonstrate a continuing strong interest in metric analysis of the foramen magnum region for sex determination despite the generally low expression of cranial base sexual dimorphism. It is important to identify possible age effects on skull base morphometric variables as most reported discriminant analyses use pooled-age samples without assessing the influence of aging on sexual dimorphism. This study examined 135 adult cranial bases (69 males and 66 females) from the St. Bride's documented skeletal collection in London. Traditional craniometric measurements were recorded and the effect of age on sexual dimorphism of this anatomical region was tested using a variety of statistical analyses including MANOVA and discriminant function analysis. Age-dependent discriminant functions for <50 and >50 years of age were developed and compared. The cross-validated results showed that the <50 years function determined the sex of 69.1 % correctly while the >50 years function achieved 81.3 % correct predictions. However, the high sex biases of these functions (14.4 % and -17.5 %) severely limit their practical application. A pooled-age discriminant function permitted 71.9 % correct prediction with a sex bias of only -1.7 %. The statistical analyses also showed no significant age effect on any of the variables, suggesting that a separation by age is not necessary for the development of sex determination methods.
  Forensic Science Medicine and Pathology 04/2013;
• Article: Virtual autopsy.

  Gregory J Davis
  Forensic Science Medicine and Pathology 04/2013;
• Article: A forensic pathologist's perspective of the Sexual Assault Nurse Examiners (SANE) course.

  Ken Obenson
  Forensic Science Medicine and Pathology 04/2013;
• Article: Cadaveric spasm.

  Marcella F Fierro
  Forensic Science Medicine and Pathology 04/2013;
• Article: Infanticide from intentional choking: the use of evaluating older cases.

  Slobodan Nikolić, Vladimir Zivković
  Forensic Science Medicine and Pathology 04/2013;
• Article: Human remains found in two wells: a forensic entomology perspective.

  Paola A Magni, Matteo Borrini, Ian R Dadour
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  ABSTRACT: When estimating the time since death or manner of death, the identification and the pathological evaluations of a body are generally impeded by post mortem changes. Research and case studies help experts to achieve a more accurate diagnosis, but at present there is scant literature covering topics concerning forensic science and decompositional processes in aquatic environments. The two case studies presented each involve a decomposed body found in a unique aquatic environment; namely wells containing ground water. In Case 1 an entomologist attended the scene and in Case 2 an entomologist was only involved after 20 months when it was decided that the insect evidence collected at the second autopsy may be useful in determining a time frame. The first case highlights the problems associated with body retrieval from aquatic environments as the body was removed it dismembered. Fortunately, the well was able to be drained, so much of the insect evidence was retrieved. In the second case the body was found dismembered but the entomological evidence was overlooked and lost. During the second autopsy insects were found, collected, and sent to an entomologist to help clarify the post mortem interval.
  Forensic Science Medicine and Pathology 04/2013;
• Article: Fatal hemorrhage from an undiagnosed rectal carcinoma in a case of Diogenes syndrome.

  Amanda Freeman, Roger W Byard
  Forensic Science Medicine and Pathology 04/2013;
• Article: Virtual autopsy.

  Carl Winskog
  Forensic Science Medicine and Pathology 04/2013;