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ABSTRACT: Background
In this retrospective autopsy study, we aimed to review the anatomopathological findings observed in cases of hanging death for a five year period and to evaluate the role of contributing factors such as age, sex, type of hanging and localization of the ligature knot.Methods
Autopsy reports of 102 hanging cases performed by the Department of Forensic Medicine, Faculty of Medicine of Pamukkale University, between January 2007 and September 2011, were retrospectively reviewed.ResultsIn the 102 hanging cases 73 of the victims were males (71.6%) and 29 (28.4%) were females, with a mean age of 40.97 ± 17.41 years. All cases were suicidal hanging. Fifty four cases (52.9%) were typical hanging, with the ligature knot located posteriorly. There were petechial hemorrhage on the face and eye lids in 46 (45.1%), ecchymoses of the cervicale muscles in 43 (42.2%), and fractures of the neck structure(s) in 69 cases (67.6%).Conclusions
The incidence of neck structure fractures increased with age. In addition, there was no correlation between the incidence of neck structure fractures and sex or type of hanging.
Medicine, science, and the law 12/2012; · 0.45 Impact Factor
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ABSTRACT: Dichlorvos (DDVP) is an organophosphate compound that causes neurotoxicity. Apoptosis plays an important role in neurotoxic cell death in the brain. The aim of this study was to examine caspase 1, caspase-3 and also cell apoptosis related genes as p53, Tumor Necrosis Factor-alpha, Hypoxia Inducible Factor 1-alpha expressions in hippocampus, cerebellum, cortex, and to estimate total hippocampal neuron number in DDVP treated rats. Ten female albino rats were divided into control (n:5) and dose (n:5) groups. In dose group, single dose of DDVP (25 mg/kg) was administered to the animals via oral gavage. A week later, brains were removed and total neuron number was estimated in the left hippocampus using by optical fractionator method. The right part of the brain was used for gene expression analysis. In dose group, total hippocampal neuron number was significantly decreased compared to control group (p = 0.008). Caspase 1 and TNF-alpha gene expression were increased in all brain tissues and p53 gene expression was decreased in only hippocampus tissue in dose group. Short-term exposure to dichlorvos leads to neuronal loss in hippocampus and TNF-alpha rapidly and potently induces apoptosis and also several caspases as possible participants in the apoptotic cascade.
Molecular Biology Reports 10/2012; · 2.93 Impact Factor
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ABSTRACT: Turkey is one of the richest countries in the world in terms of balneotherapy resources. Thermomineral water baths are preferred by the elderly because of their positive beneficial effects over regulation of musculoskeletal system functions. However, existing cardiovascular and respiratory system diseases may constitute a risk and trigger ischemic changes in the heart.
In this study, 2 cases are presented who suffered sudden cardiac death while having a thermal bath and 1 drowning case that was precipitated by chronic myocardial infarction. While 1 case was 63 years old, 2 cases were above 65 years of age. Two (2) cases had atherosclerotic coronary artery disease, whereas 1 case had heart failure.
The success of spa treatment, which is based on stimulation/harmonization therapy, restores bodily harmony and depends on the health of organs and functions playing a role in this process.
In the elderly, some conditions, particularly limited pulmonary and cardiovascular functionality, should be taken into consideration while applying those treatments.
Journal of alternative and complementary medicine (New York, N.Y.) 07/2012; 18(8):805-7. · 1.69 Impact Factor
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ABSTRACT: The importance of determining time of death is crucial to forensic cases. The ability to use adrenal gland volume changes and adrenal medulla chromaffin cell counts to obtain the postmortem interval was examined in this study. A total of 15 rats were sacrificed by cervical dislocation and divided into three groups. The left adrenal glands were quickly excised in the first group at 0 h, in the second group at 12 h and in the third group at 24 h. Subsequently, the samples were fixed in 10% formalin solution and embedded in paraffin according to standard procedures. Ten to fifteen sections were obtained from each left adrenal gland by taking 30 μm thick sections; then, the sections were stained with hematoxylin-eosin (HE). The adrenal cortex and medullar volumes were calculated by Cavalieri's principle, which is a stereological method. The adrenal medullary chromaffin cell count was evaluated by the optical fractionator method. The total volume of the adrenal gland was determined as 4.82±1 mm(3) at 0 h, 6.32±0.28 mm(3) at 12 h and 8.35±1.73 mm(3) at 24 h. Increases in the adrenal cortex, adrenal medulla and the total volume of the adrenal gland at 12 and 24 h postmortem compared with at 0 h were statistically significant (p<0.05). The difference between the groups in terms of the total number chromaffin cells was statistically significant (p<0.05). In this preliminary study, we evaluated the total volume of the adrenal gland and the number of chromaffin cells of the adrenal medulla. We concluded that these parameters could be used reliably in determining the postmortem interval.
Legal Medicine 04/2012; 14(4):214-8.
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Romanian Journal of Legal Medicine. 04/2012;
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ABSTRACT: Doctors working in emergency services often fulfill the task of preparing judicial reports. For a number of reasons, these reports have undesirable mistakes that become problematic in subsequent judicial processes. This study aimed to evaluate the judicial reports that were prepared over a certain period at a university hospital with regard to any mistakes or deficiencies.
The distribution of the judicial reports prepared between 01 June 2005 and 30 June 2009 in the emergency service of a University Research and Training Hospital was determined with respect to the types of cases, and their contents were studied for mistakes, deficiencies and legibility. Out of 3499 visits to the emergency service during the specified period, 3219 judicial reports that were accessible were considered in the evaluation.
It was determined that the most frequent types of cases were traffic accidents and injuries by sharp and penetrating instruments. Furthermore, many mistakes were made frequently regarding the presence of life-threatening conditions, and personal identification information and times of the event and examination were often incomplete.
The fact that the doctors largely failed to prepare precise reports and tended to write unsatisfactory reports even for cases with adequate information and findings was attributed to their insufficient training in this area. At the same time, mistakes in life-threatening situations and in treatment by using simple medical interventions stem from lack of training and sensibility. Pre- and post-graduate forensic medicine education must be considered highly important, and periodic on-the-job training must be organized, creating a better awareness among doctors regarding their legal responsibilities.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 01/2011; 17(1):23-8. · 0.33 Impact Factor
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ABSTRACT: Immunohistochemical study on fresh cadaver specimens.
Assessment of mechanoreceptor and nociceptor levels and distribution in iliolumbar ligament.
The function of iliolumbar ligament and its role in low back pain has not been yet fully clarified. Understanding the innervation of this ligament should provide a ground which enables formation of stronger hypotheses.
Bilateral 30 iliolumbar ligaments of 15 fresh cadavers were included in the study. Morphologic properties were recorded and the ligaments were examined by focusing on 3 main parts: ligament, bone insertions, and tendon body. Assessment of mechanoreceptor and nociceptor levels and their distribution in iliolumbar ligament were performed on the basis of immunohistochemistry using the S-100 antibody specific for nerve tissue.
Iliac wing insertion was found to be the richest region of the ligament in terms of mechanoreceptors and nociceptors. Pacinian (type II) mechanoreceptor was determined to be the most common (66.67%) receptor followed by Ruffini (type I) (19.67%) mechanoreceptor, whereas free nerve endings (type IV) and Golgi tendon organs (type III) were found to be less common, 10.83% and 2.83%, respectively.
Immunohistochemical staining has shown that iliolumbar ligament had a rich nerve tissue. Those results indicate that ILL plays an important role in proprioceptive coordination of lumbosacral region alongside its known biomechanic support function. Moreover, the presence of type IV nerve endings suggest that the injury of this ligament might contribute to the low back pain.
Spine 02/2010; 35(4):E101-4. · 2.08 Impact Factor
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ABSTRACT: Electric injury may cause different changes from minimal damage (e.g. small burns) to severe complications up to death. Several morphological changes of the skin and the internal organs are used for the diagnosis of electrical injury. However, macroscopic findings and histological changes of the internal organs and the skin may be absent in many cases. Furthermore, neuropsychological changes including deficits of cognitive functions may be seen in survivor victims. The aim of the present study is to examine whether electric injury causes decreasing in the number of pyramidal neurons in the rat hippocampus and whether this decreasing can be demonstrated by stereological method. The rats were separated into three groups: first group, native control group; second group, the points of electrical contact were on the back skin in this group; third group, the points of electrical contact were on the temporal region in this group. The current was the usual city current (110V, 50Hz, 100A AC). On the third day, the rats were decapitated; the brains were removed, and sectioned horizontally through the hippocampus and samples chosen according to the systematic random sampling strategy. Afterwards the samples were stained by H&E and optical fractionator method, one of the unbiased stereological methods, was used to estimate the total pyramidal neuron number. The results showed that the total number of pyramidal neurons in three subdivision of the hippocampus (CA3-2 and CA1) was 242,141+/-31,167, 193,388+/-24,795 and 187,448+/-28,300 in the first, second and third groups, respectively. The differences between first and second-third groups were statistically significant (p<0.05). There was not any significant difference between the second and the third groups. In conclusion, electrocution causes loss of the pyramidal neuronal in CA3-2 and CA1 subdivisions of the rat hippocampus in this study.
Legal Medicine 10/2008; 11(2):59-63.
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ABSTRACT: Fractured ribs and sternum are frequent complications of thoracic compression during CPR (cardiopulmonary resuscitation) in adults. This study was conducted to determine the incidence of rib and sternal fractures after conventional closed-chest compression in the treatment of cardiac arrest.
We reviewed the forensic autopsy findings of 231 deaths referred to the Pamukkale University Department of Forensic Medicine over a 12-month period, 2004-2005. CPR-related chest injuries comprising rib and sternum fractures, ecchymosis and subcostal hemorrhage were compared retrospectively in 104 patients.
Ninety-one (87.5%) of the 104 patients were adults, and 13 patients (12.5%) were children. The mean (SD) age in the pediatric group (5F/8M) was 5.48 (+/-5.96) and in the adult group (18F/73M) was 44.88 (+/-18.31). Forty-four (42.3%) of the 104 patients died of traumatic cause and 60 (57.7%) of non-traumatic cause. Ecchymosis was present in 26 (28.8%) patients, subcostal hemorrhage in 16 (17.6%) patients and fractures (sternal and costal) in 12 (13.2%) patients in adults. There were no significant differences between groups according to age, sex and traumatic-nontraumatic cause in terms of skeletal chest injuries associated with CPR in adult patients (p>0.05).
This study shows a low incidence of rib and sternal fracture after closed-chest compression in the treatment of cardiac arrest in forensic autopsy cases.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 07/2008; 14(3):216-20. · 0.33 Impact Factor
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Journal of palliative care 02/2007; 23(4):286-90. · 0.93 Impact Factor
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Saudi medical journal 01/2006; 26(12):1992-3. · 0.52 Impact Factor
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ABSTRACT: We aimed to investigate the frequency and epidemiological features of deaths due to foreign body asphyxiation (FBA) in childhood, over 1990-2003. Of the victims, 14 (63.6%) were male and 8 (36.4%) females. The mean age of the victims was 2.2 +/- 0.6 years. There were 20 (90.9%) children between 1 and 3 years, and two other cases at 2/12 and 5 years of ages. All aspirations had occurred at home. Eight (36.4%) of the victims were dead on arrival, 11 (50%) on intervention, and 3 (13.6%) after complications. Food material was the most commonly aspirated foreign body in 81.8% of the cases, nuts being the most common (50%). Food asphyxiation remains a common problem particularly in children between 1 and 3 years of age in our region. These fatal accidents can be prevented by parental education and early recognition and management of the situation.
Indian pediatrics 12/2005; 42(11):1131-3. · 1.05 Impact Factor
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ABSTRACT: As there is an increase in modernization, transportation, unskilled, and drunk drivers, injuries from traffic accidents have taken on an epidemic form all over the world. The present study aims to describe the demographic data of childhood pedestrian fatalities in a large urban area in Turkey.
The demographic data of childhood pedestrian fatalities in a large urban area in Turkey was described retrospectively, with respect to age, gender, injury pattern and location. Cases less than 16 years of age were collected retrospectively from the files of the Branch of the Council of Forensic Medicine in Diyarbakir between 1998 and 2003.
There were 232 childhood pedestrian fatalities among a total of 267 children involved in lethal traffic accidents. The mean age of the victims was 7.2 years, most of them being in the 6-10 years of age group (49.1%). Male predominated among our victims (76.3%). With regard to injury location, the most common site was the head (73.7%). There was an increase in pedestrian fatalities in the summer season (33.6%). There was no difference in rates of pedestrian deaths between years.
Child pedestrian deaths have constituted a significant percentage of all child fatalities due to traffic accidents in our region. There were 6.4 deaths per 100,000 populations, and this rate was also higher than in other populations.
Saudi medical journal 08/2005; 26(7):1116-8. · 0.52 Impact Factor
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ABSTRACT: The diagnosis of electrical injuries may be difficult and sometimes we should use some methods to support that. In this experimental rat study; electrical injuries were made in the dorsal skin of rats using 110 V, 100 A ac current. Swabs were taken from these injuries and investigated for iron and copper by using atomic absorption spectrometry. There was a great significance between study and control groups for copper (p<0.01). It was suggested that metallic deposition to skin in electrical injuries can be shown by atomic absorption spectrometry as quantitatively and can be used for improving the diagnostic sensitivity of electrical lesions.
Forensic Science International 12/2004; 146 Suppl:S3-4. · 2.30 Impact Factor
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ABSTRACT: This study sought to determine the frequency and types of violence that occurred during the previous year against health care workers in emergency departments in Denizli, Turkey, and to discern the views of workers on the prevention of such aggressive behavior. This study was conducted from March 1 to April 15, 2003, and included a group of 79 health care workers from the emergency departments of 3 hospitals in Denizli, namely, the Hospital of Pamukkale University Medical Faculty, the City Hospital of Denizli, and the Hospital of the Social Insurance Foundation. Data were collected from a self-administered questionnaire. In all, 88.6% of participants had been subjected to or had witnessed verbal violence, and 49.4% of them had been subjected to or had witnessed physical violence during the previous year. The most frequent reason (31.4%) for violence was abuse of alcohol and drugs by perpetrators. The second most frequent reason (24.7%) was the long waiting times typical of emergency departments. The most common type of violence was loud shouting; swearing, threatening, and hitting were the next most frequent violent behaviors. In all, 36.1% of subjects who had experienced violence reported that they developed psychological problems after the incident. Most participants commented on the insufficiency of currently available security systems within emergency departments and on the need for further training about violence. All health care personnel within emergency departments should be aware of the risk of violence and should be prepared for unpredictable conditions and events; in addition, security systems should be updated so that violence within emergency departments can be prevented.
Advances in Therapy 23(2):364-9. · 2.11 Impact Factor
