Legal Medicine最新文献

Histological insight into the fatal case of Guillain-Barre syndrome with atypical incidental presence of Marinesco bodies and corpora amylacea: an autopsy case report 组织学洞察格林-巴利综合征的不典型偶然存在的Marinesco体和淀粉体致命病例：尸检病例报告

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-24 DOI: 10.1016/j.legalmed.2025.102646

Pulagura Siva Sai Kumar , Vikas Meshram , Divya Aggarwal , Aasma Nalwa , Kanishka Chaurasia

{"title":"Histological insight into the fatal case of Guillain-Barre syndrome with atypical incidental presence of Marinesco bodies and corpora amylacea: an autopsy case report","authors":"Pulagura Siva Sai Kumar , Vikas Meshram , Divya Aggarwal , Aasma Nalwa , Kanishka Chaurasia","doi":"10.1016/j.legalmed.2025.102646","DOIUrl":"10.1016/j.legalmed.2025.102646","url":null,"abstract":"<div><div>Guillain-Barre syndrome (GBS) is an inflammatory demyelinating polyneuropathy clinically characterized by ascending motor paralysis, autonomic dysfunction, and respiratory failure etc. Though generally associated with a good prognosis, a few cases may turn fatal. On autopsy, gross findings are nonspecific. Hence, autopsy diagnosis is based on clinical manifestations and histopathological examination. We report an autopsy case of GBS, which showed remarkable diagnostic features of unusual incidental neurodegenerative findings atypical for that age. A 43-year-old male presented with fever, respiratory infection, paraesthesia, and motor weakness in both upper and lower limbs. The clinical features were suggestive of GBS with autonomic system involvement; subsequently, the patient developed paralytic ileus and died due to septicemia after two weeks of treatment. Postmortem examination revealed pleural effusion, pulmonary edema, and gangrenous ileal perforation. Histopathological analysis of the brain and cranial nerves, using different special stains and IHC, confirmed demyelination, evident by loss of myelin and myelin-engulfing macrophages. In addition to changes consistent with GB syndrome, the incidental discovery of Marinesco bodies, which are typically found in neurodegenerative diseases, is noted in this case. Corpora amylacea was also reported in multiple sections of the brain and cranial nerves, which are frequent in the old age group. GBS-associated dysautonomia, leading to rare complications such as paralytic ileus, proved fatal in this case. This case gives an account of various histopathological findings that assist in the diagnosis and confirmation of GBS. It also discusses incidental neurodegenerative changes that are atypical for age and unusual in neuroinflammatory cases like GBS.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102646"},"PeriodicalIF":1.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A completed gastromalacia after brainstem hemorrhage within 24 h: A case report and literature review 脑干出血后24小时内完全性胃软化1例并文献复习

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-23 DOI: 10.1016/j.legalmed.2025.102645

Jingzhou Yang , Longjin Zi , Fahui Duan , Ping Wang , Huan Liu

{"title":"A completed gastromalacia after brainstem hemorrhage within 24 h: A case report and literature review","authors":"Jingzhou Yang , Longjin Zi , Fahui Duan , Ping Wang , Huan Liu","doi":"10.1016/j.legalmed.2025.102645","DOIUrl":"10.1016/j.legalmed.2025.102645","url":null,"abstract":"<div><div>Gastromalacia is a postmortem feature characterized by rapid autolysis of the stomach, typically leading to a large rupture, predominantly in the gastric fundus. The pathophysiology of gastromalacia remains enigmatic. This study presents a novel case of a 32-year-old male who succumbed to respiratory failure after brainstem hemorrhage after sexual intercourse, which ultimately resulted in complete gastromalacia. Autopsy revealed hyperpyrexia (38.1 °C, 6 h post-mortem) and a substantial laceration (32 mm × 8 mm, irregular margins) in the inferior ventrolateral region of the pons on the right side. Additionally, the occurrence of complete gastromalacia within 24 h challenged our previous understanding that gastromalacia typically presents as a smaller lesion one day after death. Misdiagnosis of gastromalacia can arise from both forensic and clinical practices. This study raised the potential factors contributing to the rapid development of complete gastromalacia within 24 h. Through a literature review, we identified several key diagnostic indicators that may aid in distinguishing this condition, including a history of gastric ulceration, hyperthermia, and certain neurological disorders.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102645"},"PeriodicalIF":1.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

NF-κB and SIRT1 evaluation to discriminate antemortem from postmortem wounds. Potential markers of skin wound vitality in forensic practice 评价NF-κB和SIRT1对死前和死后伤口的区别。法医实践中皮肤伤口生命力的潜在标志

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-23 DOI: 10.1016/j.legalmed.2025.102635

Gabriella Teti , Filippo Pirani , Simone Gavelli , Alberto Gualandi , Maria Carla Mazzotti , Luca Berti , Mirella Falconi , Susi Pelotti , Paolo Fais

{"title":"NF-κB and SIRT1 evaluation to discriminate antemortem from postmortem wounds. Potential markers of skin wound vitality in forensic practice","authors":"Gabriella Teti , Filippo Pirani , Simone Gavelli , Alberto Gualandi , Maria Carla Mazzotti , Luca Berti , Mirella Falconi , Susi Pelotti , Paolo Fais","doi":"10.1016/j.legalmed.2025.102635","DOIUrl":"10.1016/j.legalmed.2025.102635","url":null,"abstract":"<div><div>Background many studies have been conducted on wound age estimation, but to date no marker has been validated to use in routine forensic practice. To explore novel markers for vitality of wounds, we investigated the expression of the inflammatory-related marker nuclear factor kappa B (NF-κB) and analyzed its correlation with the silent information regulator sirtuin 1 (SIRT1) protein in skin wounds. Methods: on 8 amputated human limbs we collected human skin tissue samples from the amputation site, as antemortem samples, and from wounds produced on the stored corresponding limbs, as postmortem samples. Samples were processed for western blot and immunohistochemistry analysis to evaluate the ex-pression of NF-κB and SIRT1 proteins. Results: cytoplasmic and nuclear staining of NF-κB in epidermal cells of antemortem wounds was higher than in postmortem wounds, where the NF-κB signal was mainly localized in the nuclei of keratinocytes. Quantitative analysis demonstrated a 2-fold increase in NF-κB protein in antemortem wounds. On the contrary, SIRT-1 levels were almost absent in antemortem wounds, while high nuclear staining was detected in keratinocytes in postmortem wounds. Quantitative analysis of the stained area demonstrated a 3-fold increase in SIRT1 protein in postmortem wounds. Conclusions: analysis of NF-κB and SIRT1 showed a different qualitative and quantitative pattern of expression in antemortem and postmortem wounds. They represent good candidates as biomarkers in wound vitality estimation in forensic pathology eventually to include them in a panel of biomarkers.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102635"},"PeriodicalIF":1.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fluorescence melting curve analysis for genotyping of c.1396G > A (rs473267) of phosphoglucomutase-3 gene 磷酸葡萄糖糖化酶-3基因c.1396G > A （rs473267）的荧光熔化曲线分析

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-21 DOI: 10.1016/j.legalmed.2025.102634

Mikiko Soejima , Yoshiro Koda

引用次数: 0

Identification of an unidentified corpse with gingival overgrowth: A case report 一具牙龈过度生长的不明尸体的鉴定：一例报告

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.legalmed.2025.102628

Hiroko Oka , Akira Namera , Narutaka Katsuya , Takahiro Harada , Ayumi Fujii , Wataru Fukumoto , Hiroshi Ito , Takafumi Nagao , Naoya Kakimoto , Masataka Nagao

{"title":"Identification of an unidentified corpse with gingival overgrowth: A case report","authors":"Hiroko Oka , Akira Namera , Narutaka Katsuya , Takahiro Harada , Ayumi Fujii , Wataru Fukumoto , Hiroshi Ito , Takafumi Nagao , Naoya Kakimoto , Masataka Nagao","doi":"10.1016/j.legalmed.2025.102628","DOIUrl":"10.1016/j.legalmed.2025.102628","url":null,"abstract":"<div><div>Drug-induced gingival overgrowth (DIGO) is a common side effect of drugs, such as phenytoin, cyclosporine, and calcium channel blockers, which mainly affect the connective tissue of the gingiva. In some cases, severe gingival enlargement may obscure tooth crowns, which are easily recognizable by clinical internists and dentists. However, there are few reports on personal identification using DIGO and drug analysis. An unidentified Asian woman with a middle-to old-aged appearance was found dead in a river. DIGO was suspected based on the findings of severe gingival overgrowth and the results from liquid chromatography-tandem mass spectrometry, which detected several prescription drugs including a calcium channel blocker, amlodipine. This information led the police to identify potential candidates in nearby hospitals. Prescription and dental records from the investigation confirmed the identity of the deceased. The discovery of gingival overgrowth is an important indication for suspecting the use of calcium channel blockers, anticonvulsants, or immunosuppressants. This case reminds us that not only knowledge of the tooth findings but also of the gingival pathological findings are important for professionals in forensic fields.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"75 ","pages":"Article 102628"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A complex suicide with over 250 sharp force injuries and falling from height 这是一起复杂的自杀，有250多处锐器伤，并从高处坠落

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.legalmed.2025.102631

Maya Neumann, Wolfgang Grellner

引用次数: 0

Diphenidol poisoning in forensic practice: Characteristic, Mechanism, Pathologic changes and organ distribution 法医实践中的苯二酚中毒：特征、机制、病理改变和器官分布

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.legalmed.2025.102632

Yangchang Ou , Ning Wang , Jiahui Li , Yihan Wang , Tingting Mai , Shu-Quan Zhao

引用次数: 0

Sequencing and ranking patterns of morphological dental features radiographically assessed for human identification 牙齿形态特征的序列和排列模式放射学评估，以供人类识别

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.legalmed.2025.102633

Renata Ventura Batista , Priscilla Belandrino Bortolami , Débora Duarte Moreira , Anna Turkina , Rizky Merdietio Boedi , Ademir Franco

{"title":"Sequencing and ranking patterns of morphological dental features radiographically assessed for human identification","authors":"Renata Ventura Batista , Priscilla Belandrino Bortolami , Débora Duarte Moreira , Anna Turkina , Rizky Merdietio Boedi , Ademir Franco","doi":"10.1016/j.legalmed.2025.102633","DOIUrl":"10.1016/j.legalmed.2025.102633","url":null,"abstract":"<div><h3>Background</h3><div>Highly distinctive patterns can result from the combination of dental features. These features are related to dental treatment, morphology or pathological conditions, and in human identification they can be optimally assessed by means of radiographic analysis. This study aimed to classify dental features and rank them based on distinctiveness.</div></div><div><h3>Methods</h3><div>The sample consisted of panoramic radiographs (n = 7212) of females (58,07 %) and males (41;93 %) between 12 e 22.99 years. The permanent teeth, except third molars, were analyzed in each radiograph. A 28-digit sequence was created with the following dental features: non-restored, missing, restored, presenting root dilaceration, impacted, rotated teeth.</div></div><div><h3>Results</h3><div>This study detected 2792 dental patterns (39 % of distinctiveness). The most common pattern was “all non-restored teeth” – corresponding to 30.4 % in males and 26.5 % in females. When a single tooth with rotation occurred, it decreased to 1 % the odds of finding an equal pattern. In general, males had a higher chance of presenting non-restored teeth compared to females (p < 0.05).</div></div><div><h3>Conclusions</h3><div>The distinctiveness of dental patterns was almost twice as high in the mandible compared to the maxilla. Distinctiveness increased with age with the occurrence of less non-restored teeth. Forensic odontologists must be prepared to assess radiographic features related to tooth morphology, especially in mass disasters that involve dental human identification of young individuals.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"75 ","pages":"Article 102633"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of the sacroiliac joint in sex estimation: Analysis of morphometry and variation types using machine learning techniques 骶髂关节在性别估计中的作用：使用机器学习技术分析形态计量学和变异类型

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.legalmed.2025.102630

Orhan Gazi Kocamış , Aynur Emine Çiçekcibaşı , Gülay Açar , Betül Digilli Ayaş , Demet Aydoğdu

{"title":"The role of the sacroiliac joint in sex estimation: Analysis of morphometry and variation types using machine learning techniques","authors":"Orhan Gazi Kocamış , Aynur Emine Çiçekcibaşı , Gülay Açar , Betül Digilli Ayaş , Demet Aydoğdu","doi":"10.1016/j.legalmed.2025.102630","DOIUrl":"10.1016/j.legalmed.2025.102630","url":null,"abstract":"<div><div>This study aimed to evaluate the potential of machine learning algorithms in sex estimation by going beyond the traditional two-dimensional (2D) measurements of the pelvic bone, predominantly preferred in sex prediction, by including measurement data in three-dimensional (3D) images. Measurements were performed on abdominal multidetector computed tomography (MDCT) images of 152 individuals (77 females, 75 males) aged 18–85. 3D-Slicer software was used for measurements on 2D and 3D images. In 2D images, sacroiliac joint surface area, the angle of the joint surface, the distance between the right and left joints, joint space measurements, and joint variation typing were performed. The distances from the sacroiliac joint to the apex of the contralateral linea terminalis and from the joint to the superior and inferior pubic symphysis were measured on 3D images. It was confirmed that sacroiliac joint space measurements were significantly higher in males than in females. Among the sacroiliac joint variations, 46% in males and 28% in females were the most common standard joint. A strong positive correlation was found between sacroiliac joint distance and the distance of the sacroiliac joint to the contralateral linea terminalis apex and the sacroiliac joint to the superior and inferior pubic symphysis. In this study, the support vector machine algorithm gave the most successful result compared to other algorithms, reaching 88% accuracy in sex estimation. We hope our study will guide the use of artificial intelligence on 3D images for forensic identification, especially in sex estimation.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"75 ","pages":"Article 102630"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advancements in estimating post-mortem interval in medico-legal practice: A comprehensive review 在法医实践中估计死后时间的进展：一个全面的回顾

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-04-20 DOI: 10.1016/j.legalmed.2025.102627

Jyotsana Singh , Ambrish Kumar , Shruti Trivedi , Surendra Kumar Pandey

{"title":"Advancements in estimating post-mortem interval in medico-legal practice: A comprehensive review","authors":"Jyotsana Singh , Ambrish Kumar , Shruti Trivedi , Surendra Kumar Pandey","doi":"10.1016/j.legalmed.2025.102627","DOIUrl":"10.1016/j.legalmed.2025.102627","url":null,"abstract":"<div><div>Estimating the Post-Mortem Interval (PMI) is a crucial aspect of forensic investigations, aiding in the resolution of criminal cases, identifying missing persons, and understanding decomposition processes. This review provides an exhaustive analysis of recent advancements in PMI estimation techniques, encompassing both traditional and emerging methodologies. Included in the study is an exhaustive examination of well-established methodologies, including algor mortis, livor mortis, and rigor mortis, as well as their shortcomings and improvements. It also delves into innovative approaches, including forensic entomology, chemical and molecular biology, microbiology, artificial intelligence, etc. Furthermore, this article discusses the integration of multiple disciplines and the potential of interdisciplinary collaboration to enhance PMI accuracy and reliability. By synthesizing the latest research findings and technological innovations, this review aims to provide forensic practitioners, law enforcement agencies, and medico-legal professionals with a comprehensive understanding of the current state-of-the-art in PMI estimation, facilitating more effective crime scene investigations and judicial proceedings.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"75 ","pages":"Article 102627"},"PeriodicalIF":1.3,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0