Vol 7, No 2 (2021)

PROFESSIONAL REVIEW

Forensic medicine in germany: past and present

Klevno V.A., Nazarov Y.V.

Abstract

This article based on the unique English-language publication “history of forensic medicine,” edited by Doctor of Medical Sciences, Professor Burkhard Madea, continues the series of publications on the state of forensic medicine globally, its past, present, and future. The initial articles were devoted to the organization of forensic medical examination of the United States of America, England, and China. The current article details the development and structure of the forensic expert service in the Federal Republic of Germany (Germany) from its origin to the present state. Both the main stages of its development and the modern organizational structure have been discussed. The article also states the primary points of teaching forensics at German medical universities as well as the order of specialization and postgraduate education of specialists. In addition, publishing activities and the principles for the formation of professional communities of forensic experts are covered. The study concludes that forensic medicine in Germany has over a century-old history and has established the optimal ratio of science and practice in activities. These aspects position forensic medicine in Germany as the best forensic medical service in the world.

Russian Journal of Forensic Medicine. 2021;7(2):68-76
pages 68-76 views

ORIGINAL STUDY ARTICLES

The possibility of molecular genetic identity testing of an unidentified body from the second world war

Zemskova E.Y., Ivanov P.L.

Abstract

Background: In the current forensic scenario, molecular genetic analyzes are used to identify the remains of victims of natural and man-made disasters, emergencies, and war conflicts. Aim: This study aimed to summarize forensic molecular genetic examinations conducted at the RCFME for identifying the victims of the Second World War in the Russian Federation. This was conducted to assess the prospects of using DNA identification analysis for unidentified remains of bodies buried in 1939–1945. Material and methods: We studied 30 expert reports from 2007 to 2021 of 171 skeletal bodies from exhumed graves. The total number of objects studied was 421 (bone fragments and teeth, from 1 to 5 objects from 1 body). Results: Using the remains, genotypes of 167 people were established. The success rate of evidence-based molecular genetic identification was 98% (171 cases). Of these, positive identification was noted for 10 body remains and negative identification for 157 remains. Four skeletal bodies (2%) were deemed unsuitable for research. In most cases, indirect identification schemes were used — a comparative study with putative relatives by biostatistical analysis of allelic variants of polymorphic loci of autosomal DNA as well as by direct comparative analysis of the polymorphism at the Y-chromosome DNA and mitochondrial DNA. Conclusions: Molecular genetic studies are highly effective for identifying the remains of victims of natural and man-made disasters, military conflicts, and other emergencies. The success of molecular genetic studies regarding the identification of victims of the Second World War conducted at the RCFME clearly demonstrate these possibilities. Simultaneously, it should be emphasized that this type of expertise falls to the category of rather complex molecular genetic studies, which requires the use of expanded panels of analytical test systems as well as the use of special methodological techniques and hardware and software.

Russian Journal of Forensic Medicine. 2021;7(2):77-82
pages 77-82 views

Methods for diagnosing the sex of adult human by anatomical and morphological features of arytenoid cartilages

Kalimullin R.R., Zvyagin V.N.

Abstract

Background: One of the main issues of general personality identification is the ascertainment of the sex of impersonated or fragmented bodies. Sporadic studies in the forensic medical literature have reported larynx cartilage sexual dimorphism, among which arytenoid cartilages are absent. The publications have morphometric focus and do not consider the practical aspects of sex diagnostics, which have been determined in this study. Aim: To develop a method for determining sex using the features of sexually dimorphic anatomical and morphological arytenoid cartilage of an adult. Materials and methods: The anatomical and morphological features of arytenoid cartilage from 80 males and 80 females aged 20–78 years were studied. The visual examination revealed differences related to sex based on nine characteristics. The reliability of the sexual dimorphism of traits was verified using the Chi-square test and proportionality coefficients. Results: The informational significance of the features was clarified, and the individual observations were digitized using the formula. The possibility of sex determination by arytenoid cartilage was established in 93.75% of cases. In the remaining 6.25% cases, it was deemed impossible to solve this problem using the given set of features. Conclusion: The method developed for determining sex is highly accurate and can be used in sex diagnostics during a forensic medical larynx examination of a decayed or a fragmented corpse.

Russian Journal of Forensic Medicine. 2021;7(2):83-87
pages 83-87 views

Mathematical modeling of errors for determining time of death based on the Newton’s–Richman’s cooling law

Nedugov G.V.

Abstract

Background: A mandatory factor in the development and implementation of diagnostic technologies for determining the time of death by the thermal method is the assessment of possible errors. For equations of cadaver cooling that have a deterministic character, error estimation is possible using a mathematical model of indirect measurement. Here, a mathematical model has been proposed for estimating the maximum absolute error in determining death on the basis of the Newton's–Richman's cooling law under conditions of constant and changing ambient temperature. Aim: Using a mathematical model of indirect measurement, this study developed a method for estimating errors in determining the prescription of death according to the Newton's–Richman's cooling law. Material and methods: Mathematical modeling of errors in determining the time of death in conditions of constant and changing ambient temperature was conducted according to the Newton's–Richman's law. The computer program code was drafted in the C# programming language using the Microsoft Visual Studio 2019 application. Results: Based on the indirect measurement model, a method for estimating the maximum absolute errors for determining the time of death during cooling according to the Newton's–Richman's law under conditions of constant and changing ambient temperature was developed. The results obtained allowed us to analytically determine errors in time the prescription of death in the early postmortem period. Conclusions: We developed a mathematical model for estimating maximum absolute errors while determining the time of death according to the Newton's–Richman's cooling law under conditions of constant and changing ambient temperature. The developed mathematical model was implemented as an application program Warm Bodies NRN. The proposed method might be used in forensic medical expert practice for determining the time of death.

Russian Journal of Forensic Medicine. 2021;7(2):88-95
pages 88-95 views

CASE REPORTS

Possibility of determining injury duration based on changes in histomorphometric characteristics of the thymus

Khalikov A.A., Kildyushov E.M., Kuznetsov K.O., Komlev D.S., Rahmatullina G.R.

Abstract

Background: Lymphoid tissue is the first to react to stress, which manifests as characteristic morphological manifestations, based on which it is possible to study the duration of damage. Aims: Study of the dynamics of changes in the histomorphometric characteristics of the rat thymus during regeneration of the musculocutaneous tissue during mechanical thigh trauma. Material and methods: In total, 84 sexually mature rats were enrolled. These were divided into two groups (experiment and control), which were further classified into four subgroups depending on the time elapsed since the injury (1, 3, 15, and 25 days). Mechanical damage was simulated using a setup that transferred kinetic energy (comparable to a 5.6-mm rifle bullet) to tissues. Subsequently, the animals were removed from the experiment by decapitation; their thymus was removed and microscopically examined. In arbitrary units, the total area of the lobules as well as the area of the cortical and cerebral zones was determined. Results: Our research results indicate different phases of changes in the histomorphometric characteristics of the thymus, which correspond to the course of the wound and can be used in forensic practice to determine the duration of the injury. Conclusions: Mechanical trauma, considered as a stress reaction, causes involutive changes in the thymus and is characterized by changes in the area of the thymus cortex and medulla as well as regular dynamics of changes in the thymic lobules at different stages of wound regeneration.

Russian Journal of Forensic Medicine. 2021;7(2):96-100
pages 96-100 views

Questions of forensic science and radiology on live births and stillbirths: cases from expert practice

Klevno V.A., Chumakova Y.V., Dubrova S.E., Muranova N.S., Popova O.M.

Abstract

Background: The article discusses the criteria, forensic and radiological “life tests,” difficulties in assessing the results of live births and stillbirths. It also dives into the history of the development of X-ray, including pre-sectional examination of newborn corpses. Two cases of newborn corpses that were subjected to pre-sectional computed tomography (CT) are presented. Case presentation: Case no. 1: Examination of a newborn corpse found in a cardboard box on the unheated terrace of a private house after a secret self-birth. Case no. 2: Examination of the corpse of an infant with massive injuries and the division of the body into two fragments, found on a sorting tape in the premises of a waste sorting shop. Conclusion: Postmortem CT of newborn corpses was an evidence-based and visual addition to the traditional forensic medical study. This helped determine the maturity of fetuses even at the pre-dissection stage to identify injuries and anatomical variants of the structure, to refute the presence of congenital deformities, and to establish and record evidence-based CT signs of live birth and stillbirth.

Russian Journal of Forensic Medicine. 2021;7(2):101-107
pages 101-107 views

Features of the damaging effect of hunting cartridges fired from the KO-98M1 carbine

Leonov S.V., Pinchuk P.V., Guseva S.V.

Abstract

Background: The article presents the results of experimental studies of gunshot injuries of biological tissue simulators in relation to the morphology of the wound channel, which depend on the characteristics of the cartridge used. Aim: To establish the features of the wound channel in the biological simulator caused by semi-shell bullets of cartridges fired from the KO-98M1 carbine under the 8×57 JS cartridge. Material and methods: Experimental shots were fired with 8×57 JS cartridges with shell and semi-shell bullets from the KO-98M1 hunting carbine. The first group of observations consisted of shots of cartridges with shell bullets of two radius ogival shape; the second group-shots of cartridges with semi-shell bullets with a head part in the form of a truncated cone. Shots with shell bullets of a single-radius ogival form formed the control group. In each group of observations, 10 shots were fired from a distance of 5–10 m, and a pig's half-carcass was used as a target. Results: In the first group of observations, the entrance injury had an oval or rounded shape, with a Central tissue defect with a diameter of 6.5±0.5 mm. the Wound channel from the entrance injury expanded conically and reached a maximum at a distance of 6 cm. In the second group of observations, the entrance gunshot injury had a rounded shape, with multiple radial tears, with a Central tissue defect with a diameter of 7.5±0.5 mm. The wound channel from the entrance injury expanded spherically immediately behind the skin, reaching a maximum at a distance of 4 cm. In the control group of observations, the entrance gunshot injury had a rectangular shape, with one or two radial breaks and a Central tissue defect with a diameter of 5.5±0.5 mm. The wound channel throughout corresponded to the diameter of the firearm shell. Conclusion: In the course of experimental studies, it was found that the rounding of the head part of the shell increases the size of the wound canal cavity by about 4 times. The runway occurs at a distance of 6 cm from the input damage. A semi-shell bullet with a head shape in the form of a truncated cone leads to the formation of a runway immediately behind the layer of skin, while the size of the visible cavity of the wound channel exceeds the size of the projectile by 15 times.

Russian Journal of Forensic Medicine. 2021;7(2):108-112
pages 108-112 views

The nature of damage to the structure of the spine and spinal cord in combined blunt trauma

Indiaminov S.I., Pardaev S.N., Ismailov R.A.

Abstract

Background. Vertebral-spinal injuries (VSIs) account for 6.3–26% of skeletal injuries. However, despite the relevance of VSIs in all branches of medicine, the forensic aspects of this injury are insufficiently assessed. Material and methods. The study included three groups: people who died following multiple injuries from falling from a height (82 cases); those who died following collision with moving cars (172 cases); and drivers of passenger cars who died in road accidents (61 cases). Results. The article describes in detail the results of the analysis. As part of combined injury during falls, VSI was observed in 41.5% of cases with lesions of other body parts and often covering 2 or more parts of the spine, and in terms of localization, most often in the lower neck, upper chest, and lumbar regions. Compression fractures were often noted, which resulted from falls on the legs and buttocks. In pedestrians who were injured in collisions with cars, VSI was noted in 25% cases; of these, most cases involved distraction and rotational fractures of the vertebral bodies, with detachments at the level of vertebral fractures prevailing primarily with mainly trauma of the posterior processes. Injuries to the spine structure often included cervical -occipital trauma and damage to the cervical region, as well as combined injuries to the cervical-thoracic regions; VSI in affected drivers was noted in 14.5% cases and was characterized by cervical-occipital trauma as well as lesions of the cervical, upper thoracic, and lumbar vertebrae. Сonclusion: The revealed nature of damage to the noted structures should be taken into account in the process of forensic medical diagnosis and differential diagnosis of blunt injuries, especially in conditions of non-obviousness of the circumstances of the damage. The nature, volume and localization of injuries arising from these types of blunt mechanical trauma can be important in the process of organizing and providing medical care to victims at various stages of treatment, and information on the circumstances of the origin of injuries can become the basis for developing preventive measures to prevent injuries.

Russian Journal of Forensic Medicine. 2021;7(2):113-119
pages 113-119 views

EDUCATION

Clinical and legal analyzes of adverse cases in medical care on criminal cases: an innovative educational activity

Spiridonov V.A., Anisimov A.A.

Abstract

Background: Currently, the Russian Federation is facing an especially acute problem of medical personal undergoing criminal liability (CL) owing to inappropriate medical care. Aim: The goal is to analyze the level of legal training among the Kazan State Medical University (KSMU) students in matters of possible CL resulting from medical malpractice. Material and methods: From January 1, 2018, to March 30, 2018, we surveyed 426 students of KSMU. The survey questionnaire included questions on Russian legislation, the materials of forensic medicine, open investigative, and forensic practice. In total, 122 first-year (28.6%), 51 second-year (12%), 63 third-year (14.8%), 58 fourth-year (13.6%), 68 fifth-year (16%), and 64 sixth-year students (15%) were questioned. Results: Overall, 272 respondents (64%) considered that there should be no CL for medical personnel. In addition, 392 (92%) students were unaware of the Criminal Code articles used to prosecute medical workers. A possibility of CL scared 204 (48%) students from practicing. Moreover, 342 (80%) respondents noted that the study of “medical error” cases would reduce the number of such cases in future practice. We have introduced a new educational project “Medica Law Clinic” at the KSMU Forensic Medicine Department. Its goal is to ensure increase legal and professional training among students through a comprehensive analysis of criminal medical cases. The work presents the personal experience of eight educational events. Conclusions: Our findings revealed a need to increase the level of legal training among students of medical universities regarding criminal matters. A comprehensive analysis of criminal medical cases is a progressive pedagogical format that has proven its efficacy in the Republic of Tatarstan.

Russian Journal of Forensic Medicine. 2021;7(2):120-126
pages 120-126 views

PRESS-RELEASE

Congress "Topical Issues of Forensic Medicine and Expert Practice-2021"

Klevno V.A.

Abstract

21–22 April 2021 in the Moscow Regional Research Institute named after M. F. Vladimirsky was held the International Congress "Topical Issues of Forensic Medicine and Expert Practice-2021". This article an overview of the most important events of the Congress.

Russian Journal of Forensic Medicine. 2021;7(2):127-128
pages 127-128 views


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