[Forensic medical diagnostics of intra-vitality of the strangulation mark by morphological methods]

[Adverse outcome in post-operative period (small-shot wound) from arrosive bleeding in forensic practice]

The aim of this work is to draw the attention of forensic experts to the need to use new methodological approaches in postmortem morphological diagnostics of the lifetime injuries and the duration of death rate in forensic medical practice. A case of a fatal outcome from a small-shot gun wound complicated by arrosive bleeding in the postoperative period is considered. The missed opportunity to effectively use new methodological approaches in solving issues related to the completeness and timeliness of medical care is shown. The authors draw attention to the inadmissibility of using the nosological form with the code X94.9 ICD-10 «Attack by shooting from a small-shot gun» in the death certificate and suggest discussing the possibility to edit it for the 11th revision of the ICD.

[Reliability of the immunohistochemical estimation of vitality and injury age: analysis and perspectives for study]

This review summarizes the literature data on the applicability of various immunohistochemical markers for the diagnosis of vitality and injury age. Current state of the problem of the reliability of the estimation of injury vitality, and the most promising immunohistochemical markers for further study are also considered.

[The principal and auxiliary immunohistochemical markers of intravital mechanical strangulation asphyxia]

The objective of the present study was the evaluation of the auxiliary methods for the diagnostics of the intravital formation of the constriction marks; the secondary objective was to determine the pace at which the death and asphyxia occur.

MATERIAL AND METHODS

The materials on which the study was based included 17 cases of mechanical strangulation asphyxia involving 13 men and 4 women at the age from 8 to 28 years. All cases of hanging were associated with different blood alcohol levels. Their characteristic feature was the formation of the obliquely ascending constriction marks. The group of comparison was comprised of three cases of death by drowning and one case of manual strangulation. The control group consisted of 10 patients who died from the acute form of coronary heart disease and 5 cases of death from traumatic shock. All the corpses were examined with the use of the traditional methods within the first 24 hours after death. The special laboratory studies were performed by means of the standard histological and immunohistochemical methods with the use of the polyclonal antibodies against total cytokeratin, fibrinogen, immunoglobulin-lambda, fibronectin, and CD-117 antigen. The histological preparations were stained by the method of Spielmeyer and with toluidine blue.

RESULTS

The results of the study give evidence of the possibility of diagnostics of mechanical strangulation asphyxia making use of the reaction with anti-fibrinogen antibodies in the stromal tissue of the constriction mark even in the absence of other intravital signs of death. Such diagnostics is also possible with the use of the CD-117 antigen in the pulmonary tissue. The expression of this antigen is characteristic of the cases of alveolar hypoxia. The possibility of application of other markers for the differential diagnostics of mechanical strangulation asphyxia from other causes of death is discussed.