Biomedical subjects

T Kahana

Publications and source records attributed to T Kahana.

17 recordsLinked to original sources

PubMed2000

Trauma and identification of victims of suicidal terrorism in Israel.

The postmortem examination and identification procedures performed by medical and law enforcement personnel involved in mass disaster management in Israel are reported. The Israel National Police, the Israel Defense Forces, and the L. Greenberg Institute of Forensic Medicine's experts examined 171 victims who died in 21 incidents of suicidal terrorism. The trauma sustained by the victims and perpetrators of suicidal bombings included complete body disruption and explosive, flying missile, and blast injuries. The modus operandi of the perpetrators, reconstructed from the distribution and type of injury of the victims, is discussed. Fifty-five victims perished in open space bombings and 91 inside buses. All perpetrators of these bombings died at the time of the incident regardless of their location. Identification of the victims was achieved using fingerprints, dental records, medical intervention signs, anatomic variation, genetic profile, and personal recognition. Prompt identification of the perpetrators allowed speedy apprehension of the accomplices and prevention of similar attacks. Collaboration between the different forensic, military, and law enforcement teams increased the efficiency of disaster management efforts.

Blast Injuries↗

PubMed1999

Forensic radiology.

Imaging techniques are a powerful tool in forensic science. Medical examiners and forensic anthropologists are less versed in the finer points of radiology than radiologists; nevertheless they are required to interpret findings from imaging studies to further medico-legal investigations. The forensic investigator often should call upon the radiologist whose expertise might prove invaluable in forensic consultations. The radiologist should be aware of the importance of storing radiographs over prolonged periods of time and of efficient record keeping methods, because various legal problems may require the radiographs for additional interpretation or for their presentation in court. Some of the main issues that might be encountered in forensic radiology are discussed in this review.

Anthropology↗

PubMed1999

Marine taphonomy: adipocere formation in a series of bodies recovered from a single shipwreck.

Taphonomy of marine environments has been studied mostly from individual cases. The formation of adipocere, or "grave-wax," is an important indicator of the postmortem interval. In the present paper, the conditions and the timing of adipoceric formation are observed in a series of 15 cadavers recovered at different times, over a period of 433 days, from the same contained environment. Initial foci of adipocere on the subcutaneous tissue of the cadavers were detected as early as 38 days from the time of immersion in cold (10-12 degrees C) sea water. The discrepancies between our findings and previous reports on the correlation between time since death and decomposition stages in marine environments are discussed.

Bone and Bones↗

PubMed1998

Suicide bombers in Israel.

Between 1993 and 1995, 14 suicidal terrorist bombings took place in Israel; 86 victims perished in these attacks, which were carried out by militant Palestinian organizations that oppose peace treaties between the state of Israel and the Palestinian people. The modus operandi of the perpetrators was detonating, in a public area, an explosive device carried on or in close proximity to the terrorist's body. We reviewed the postmortem examinations and identification procedures performed by the medical and law enforcement personnel involved in mass disaster management. The types of injuries sustained by the victims and perpetrators include body disruption, explosive injuries, flying missile injuries, and blast injuries. Blunt trauma directly produced by the explosion and flying missile injuries account for 80.1% of the wounds. The number of fatalities was more closely related to the type of the attack rather than to the amount and type of explosives used. Swift identification of all victims and perpetrators was obtained through collaboration between the different professional teams involved: forensic scientists, law enforcement agencies, and secret service investigators. Based on the analysis of the data obtained from the necroscopic examinations, we observed that most of the wounds sustained fall within the realm of blunt force injuries; emergency medical facilities that might be faced with similar situations should prepare accordingly. Collaboration between the various forensic and law enforcement teams results in swift resolution of disaster management. Prompt identification of the perpetrators allows the authorities to apprehend any accomplices and to prevent similar attacks.

Adult↗

PubMed1998

Quantitative assessment of trabecular bone pattern identification.

The results of the research described in this paper demonstrate that the trabecular architecture is unique to each individual and stable enough to be used as a forensic marker for positive identification of human remains. The trabecular bone architecture depicted on radiographs is often used as an individualizing forensic marker for positive identification of human remains. The aim of the present study was to ascertain the reliability of the trabecular pattern in forensic identification. The trabecular pattern is potentially the best radiographic forensic marker since its presence on a radiograph doesn't depend on a previous pathology or traumatic event. A sample of 305 radiographs of the left wrist of 103 postmenopausal women was studied using an image analyzer. The uniqueness and stability over time of the trabecular architecture was examined by creating line maps or "densitographs" of the ultra-distal point of the radius of each roentgenogram. Pearson's correlation coefficients were calculated for all possible combinations of pairs of radiographs. The correlation coefficient of pairs of radiographs of the same individual, taken at different times (2 to 6 years apart), was always higher than 0.72, while the correlation coefficients of radiographs of different individuals was always below 0.62.

Adult↗

PubMed1997

Radiographic identification of fragmentary human remains from a mass disaster.

Positive identification of human remains is one of the most important tasks in mass disaster management. Here we report on the use of radiography for positive identification of fragmentary human remains recovered from the scene of a terrorist bombing in the Jewish-Argentine Mutual Association Center in Buenos Aires, Argentina, in July 1994. Radiographic examination of all human remains from mass disaster scenes is recommended for identification purposes. Establishing a computerized data bank of antemortem information on missing persons and postmortem findings in disaster victims greatly facilitates and expedites the identification process.

Aged↗

PubMed1997

Forensic medicine in Israel.

We discuss the Israeli medicolegal system, which is rooted in remnants of British jurisprudence. Forensic services for the entire country and the occupied territories (Judea and Samaria), and now the Palestinian Autonomy (Gaza Strip and Jericho), are supplied by one central institute located in Tel Aviv. That organization, the L. Greenberg Institute of Forensic Medicine, is a department of the Ministry of Health and has academic affiliation with the University of Tel Aviv. About 2,000 necroscopic examinations are performed annually, and the types of cases encountered in the forensic practices in Israel are noted. The academic and research activities of the Institute's staff are described, with emphasis on collaboration with overseas forensic scientists. The modern history of the country is reflected in the chronicle of the evolution of its forensic medicine.

Autopsy↗

PubMed1997

Rubber and plastic ammunition lethal injuries: the Israeli experience.

Rubber and plastic ammunition was used by the Israeli Defence Forces between the years 1987 and 1993 (Intifada) almost exclusively as a deterrent to aggression by the Palestinian civilian population in the occupied territories of Gaza, Judea and Samaria. While designed to avoid the serious wounds and deaths caused by the use of conventional military ammunition, the firing of rubber and plastic bullets has resulted in extensive injuries and more than 20 deaths. The data from the autopsies of 17 of these victims, mostly teenagers, were analysed. Ten of the victims died from injuries inflicted by Improved Rubber Bullets, while the other seven succumbed to injuries caused by Plastic Bullets. In most instances, the cause of death was related to injuries to the brain. Ballistic features of non-conventional bullets are discussed, and suggestions to curtail the serious injuries and fatalities arising from their use are given, with emphasis on firing from a safe range. British and South African experience with this type of ammunition is compared with our observations.

Adolescent↗

PubMed1997

Suicidal terrorist bombings in Israel--identification of human remains.

Positive identification of human remains is one of the most important tasks in mass disaster investigations. Religious and jurisdictional demands in Israel, require the identification process to be completed in the shortest possible time. In the 18 suicidal terrorist bombings that took place in Israel between the years 1993-1996, 127 victims and 19 perpetrators were killed, and their severely fragmented bodies were identified within 24 h. The efficient completion of the identification endeavor was enabled by the implementation of a variety of techniques and the close collaboration in the investigation between the different emergency and forensic agencies. This paper presents the mass disaster identification policy and techniques currently used in Israel. The importance of an interdisciplinary approach for the identification of extremely fragmented human remains from mass disasters and the creation of a central data bank of fingerprints and genetic markers is emphasized.

Adolescent↗

PubMed1996

Medicolegal investigation of death in custody: a postmortem procedure for detection of blunt force injuries.

Death in custody frequently raises suspicion of ill-treatment on the part of the custodians. The meticulous postmortem search for evidence of injury is the paramount consideration in objective investigation. Detection and evaluation of hidden subcutaneous hemorrhages facilitates reconstruction of antemortem circumstances. We describe a new postmortem technique for accurate examination of the subcutaneous tissues utilizing a simple X-shaped incision of the back and limbs and reflecting the skin. This technique leaves no noticeable disfigurement.

Cause of Death↗

PubMed1996

Beaten to death: why do they die?

The remains of 53 men that had been beaten to death were examined. Six (11.3%) died of either blood aspiration or intracranial hemorrhage; 15 of the cases (28.3%) succumbed to hypovolemic shock, and 32 of the cases (60.4%) died of fat embolism syndrome (FES). Fractures of long bones were found only in four victims. Fatal FES produced by the mechanical disintegration of adipose tissue that migrates into the bloodstream seems to be a common phenomenon in the fatalities examined in this study. No correlation, however, was found between the presence of long bone fractures and the severity of FES, and no bone marrow emboli were detected on histologic examination of target organs. Scattered subcutaneous hematomata were present in all of the victims, although the volume of extravasated blood could not be calculated from the total surface area of the bruises. Contusions limited to the limbs have the potential of masking fatal volumes of extravasated blood that suffuse the musculature mass. Hypovolemic and neurogenic shock, as well as systemic effects of crush injury, should be considered contributing factors to death from FES. These findings contradict the previously published postulate that victims of blunt force trauma succumb primarily to massive hemorrhages.

Adolescent↗

PubMed1995

Endoscopic autopsy.

In cases in which the family of the deceased objects to the performance of a conventional autopsy for religious or other reasons, or where there are no forensic pathology facilities in the vicinity of the hospital, postmortem endoscopic examination may be an advantageous and cost-effective substitute for conventional necropsy, especially when the alternative is no postmortem examination at all. To test the reliability of postmortem endoscopy, conventional and endoscopic autopsies were performed on 20 cadavers at the L. Greenberg Institute of Forensic Medicine in Israel. Comparison of the findings of the two procedures showed a very high correlation (100%) for intraperitoneal and thoracic hemorrhages and hepatic, splenic, and diaphragmatic injuries; it showed a slightly lower correlation (60-80%) for mesenteric and retroperitoneal hematomas injuries to the great vessels, blood aspiration, and lung injury. Endoscopy failed to reveal the correct site of injury in the retroperitoneum and posterior aspect of the mediastinum. Collection of body fluids and tissue samples was possible by means of laparoscopy. The technique proved to be relatively accurate, more rapid than conventional autopsy, and left the body virtually intact.

Autopsy↗

PubMed1995

The medicolegal implications of bilateral cranial fractures in infants.

There is considerable debate about the possibility of serious injuries associated with skull fractures caused by short-height falls in early childhood. In order to elucidate the mechanism and nature of blunt head trauma from such falls, we have investigated the possible correlation between patterns of skull fractures and the dynamics inducing these injuries. In a 10-year survey of pediatric medicolegal autopsies conducted at the L. Greenberg Institute of Forensic Medicine in Tel Aviv, Israel, we have observed that all victims of alleged falls from low heights exhibited unilateral skull fractures. Only in four instances were bilateral temporoparietal fractures detected. Thorough investigation into the circumstances surrounding these four incidents, along with the evaluation of the forces exerted upon the cranium at the time of impact, suggest that symmetrical cranial fractures in infants are most likely the result of bilateral compression of the head between two surfaces, rather than the result of a localized impact.

Accidental Falls↗

PubMed1994

Suicidal asphyxia by gas mask.

Antichemical warfare kits that were issued to all Israeli residents 6 months before the Gulf War included masks of various types suited to the age of the user. During the war, 10 adults died of suffocation due to mishandling of the filter of the masks despite the offil Defense Authority's repeated instructions to be cautious. These masks remained in the possession of the population after the war. We report on six cases of suicidal asphyxia incurred by donning the gas mask tightly sealed that have occurred since 1991.

Adult↗

PubMed1994

Fatal classic and exertional heat stroke--report of four cases.

Heat stroke is the outcome of impaired heat dissipation which is aggravated by hot and humid environmental conditions. The very young and debilitated on the one hand and healthy individuals under considerable physical stress on the other are vulnerable to heat stroke. Post-mortem findings will depend on the time lapse between the stroke event and death. We report on the deaths resulting from heat stroke in a 12-month-old baby and three 19-year-old soldiers. Reconstruction of the environmental conditions enables elucidation of the circumstances that precipitated exogenous hyperpyrexia. The Discomfort Index presents reliable criteria for the assessment of heat load: values above 28 units are considered as severe heat load and are life threatening. Awareness of the hazards related to severe heat load on the body is helpful in preventing avoidable calamities.

Adult↗

PubMed1994

Positive identification by means of trabecular bone pattern comparison.

Positive identification of human remains is often achieved by comparing antemortem and postmortem radiographs. Usually, radiographs contain a number of markers that can serve as reference for comparison, one of these markers is the trabecular bone pattern depicted in the roentgenograms. In the present case, densitometric analysis of the trabecular bone pattern was used as the sole means of identification. Later on, two other methods confirmed the original positive identification.

DNA↗

PubMedDate not supplied

The fatalities of the Intifada (uprising): the first five years.

The uprising of the Palestinian population (Intifada) against the Israeli occupation of the Gaza Strip and the West Bank, which erupted in December 1987, has resulted in the deaths of hundreds of Israeli citizens and Palestinian residents. The data on dead victims, as reported by two civil rights organizations of opposite political orientation and by the official military authority, are analyzed and compared with the information obtained from post-mortem examinations of some 65% of the victims carried out over the period 1987 to 1992. The agencies' reports were found to differ, sometimes markedly, from the official autopsy data in respect of number of deaths, their cause and manner. The study indicates a generally downward trend in the number of Palestinians killed by the Israeli Defence Forces, which could be the result of the wider use of rubber and plastic bullets, and a steady continuous increase in Israeli victims killed by the Palestinians, possibly accounted for by a shift from the use of "cold weapons" in favour of firearms, and an escalation in violence. It is suggested that the post-mortem examination should be an essential tool for the detection and documentation of possible abuse and bodily harm.

Civil Disorders↗