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PubMed1990

Forensic dentistry--recent development towards an independent discipline in modern dentistry.

Since the late 1890s, forensic odontology has gradually established itself as important, often indispensable, in medicolegal cases, in particular for identification of the dead. The specialty of forensic dentistry generally covers three basic areas, namely, (1) identifications human remains, (2) litigation relating to malpractice, and (3) criminal proceedings, primarily in the areas of bite-mark evaluation and child abuse. Much of its expertise is based on clinical experience, fundamental research and advances in knowledge in relation to dentistry in general. Particularly over the past two decades, there has also been increasing research on specific forensic dental matters. In this paper, the methods of identification used in forensic dentistry are reviewed, and their application in two areas, mass disasters and bite-mark analysis is discussed. Progress in this field in Finland has been relatively slow. It has depended as in other countries on development of training and research facilities in the dental schools, and oral pathology departments.

Forensic Dentistry↗

PubMedDate not supplied

[Medicolegal aspects of witnessed suicide due to gunshot to the head. II. Legal medicine aspects and examination of the firing hand].

The second part of the paper on suicides by gunshots to the head in the presence of witnesses focuses on relevant morphological autopsy findings such as entrance site, signs of close range or contact shots, bullet path etc. and also discusses selected aspects of ascertaining gunshot residues. For the identification of the shooter an integral medicolegal assessment of all the facts including the investigation results and the autopsy findings is essential. However, the morphological findings alone do not allow safe diagnosis, as for example in a homicide the temporal region, which was affected in all our cases, may have been deliberately chosen by the perpetrator as a localization typical of suicide. Thus methods to ascertain gunshot residues on the firing hand (by means of adhesive films and the polyvinyl-alcohol collection method--PVAL) are of great practical importance. In seven cases adhesive films and/or the polyvinyl-alcohol collection method were used. In one case the gunshot residues (GSR) were analysed by means of tape lifts and subsequent scanning electron microscopy (SEM). It was found that especially the combined application of topographical (adhesive tape/PVAL) and cumulative (SEM) methods allowed for the doubtless identification of the shooter, thus usually confirming the suicide. By the example of one case it is demonstrated that without the immediate collection of evidence at the scene objective reconstruction of the event becomes impossible. On the basis of the reported cases recommendations are finally given for a differentiated approach in the medicolegal evaluation of alleged witnessed suicide by gunshot (to the head).

Adult↗

PubMed1982

Research in forensic odontology.

Forensic odontology has established itself as an important and often indispensable science in medicolegal matters and in particular in identification of the dead. Much of its expertise is drawn from clinical experience based on basic research and advances in knowledge in dentistry in general. There has also been, particularly during the past two decades, an increasing body of research in specifically forensic dental matters and these studies form the subject of this review. Progress in this field, as in others, will depend upon development of training pathways and research facilities in our dental schools.

Age Determination by Teeth↗

PubMed1997

Identification of human remains: forensic radiology.

The identification of human remains is of paramount importance in medicolegal investigations. The comparison of antemortem and postmortem radiographic records is one of the main techniques used to achieve a positive identification. The purpose of this paper is to present a comprehensive review of the use of roentgenography in forensic medicine with special emphasis on the nature of the radiographic markers often utilized for identification. Clinical radiologists should be aware of the importance of storing radiographs over prolonged periods of time and of efficient record keeping methods to enable prompt retrieval of X-ray films in mass disaster situations. Furthermore, because of his skills in radiographic evaluation, the radiologist's expertise might prove invaluable in forensic consultations.

Journal Article↗

PubMed2001

Preoperative sonography in presumed thyroglossal duct cysts.

OBJECTIVE: To determine the utility of ultrasonography as a sole diagnostic study in the preoperative preparation of patients with presumed thyroglossal duct cysts. DESIGN: Retrospective chart review. SETTINGS: Children's Memorial Hospital, Chicago, Ill. PATIENTS: Forty-five pediatric patients with midline masses. MAIN OUTCOME MEASURE: Accuracy in the determination of a normally positioned thyroid gland excluding the presence of a solitary ectopic thyroid gland. RESULTS: A retrospective chart review was performed at our institution for the period February 1990 to January 1996. A total of 45 patients with midline masses were identified, 39 of whom had undergone preoperative ultrasonography as their sole diagnostic imaging study. In all 39 patients, both a cyst and a normal thyroid gland were identified. All 39 patients underwent the standard Sistrunk procedure. Thirty-seven patients had pathologically confirmed thyroglossal duct cysts. The remaining 2 had dermoid cysts. There were no cases of postoperative hypothyroidism. CONCLUSIONS: The incidence of ectopic thyroid in the diagnosis of thyroglossal duct cysts has been reported to be as high as 1% to 2%. In our surgical and clinical experience, the actual incidence of solitary ectopic thyroid tissue is substantially lower. Nevertheless, to prevent the inadvertent removal of the only functioning thyroid tissue, with resultant postoperative hypothyroidism and possible medicolegal consequences, we advocate the routine preoperative identification of normal thyroid gland. We recommend ultrasound as an accurate, cost-effective, noninvasive imaging modality in the preoperative evaluation of all patients with neck masses suspicious for thyroglossal duct cyst. Also, it does not require sedation.

Child↗

PubMed1991

Analysis of six Vietnamese trophy skulls.

This report presents morphologic, metric, and contextual information on six documented trophy skull specimens confiscated from U.S. servicemen during the Vietnam War. Additional information on the history and occurrence of trophy skull collecting is provided. This sample, consisting mostly of young Vietnamese males, exhibits graffiti, painting, and other evidence of postmortem decorative modification. Identification of trophy skulls is important to medicolegal and anthropological researchers in distinguishing trophy remains from archaeological and forensic specimens.

Adolescent↗

PubMed1995

Incidence, density and direction of hair on the dorsum of phalanges of the hands in Malays.

In this study 200 Malay subjects (100 males and 100 females) were randomly selected from patients attending outpatient clinics of Hospital USM, Kelantan, Malaysia, to find out the incidence, density and direction of hair on the dorsum of phalanges of the hand. These features have not been studied so far in females nor has such a study been conducted in Malays. The probability of density of hair distribution among the digits of both hands showed significant correlation on proximal phalanges (p < 0.05) in both sexes. Significant correlation was not observed, however, in the middle phalangeal hair (MPH) of the hands. The direction of proximal phalangeal hair, from little finger to the thumb, showed significant changes from ulnar to radial in both sexes (p < 0.05). Identification of isolated digits, which is of medicolegal importance, would be more accurate if the direction and the density of hair on the digits are both considered together. MPH was present in 48% of males and in 33% of females studied. Comparisons with presence of MPH in other populations show that Malays are ethnically similar to other Asiatic populations.

Adolescent↗

PubMed2001

Skeletal remains of Dr. Eugenio Antonio Berríos Sagredo.

It is often noted that even a well-designed osteological technique may not provide accurate results when applied to single forensic cases. Case studies are ideal to test if this concern is valid, and forensic anthropology is a testing ground for applying a population based standard to individual skeletal remains. Secondly, the increasing role anthropologists have played in forensic sciences has aided the medicolegal disciplines in a number of ways. For example, identification of skeletal remains is now more accurate than ever before. Many of these cases have brought perpetrators to court for justice. The purpose of this paper is to use osteological techniques to analyze skeletal remains and make a positive identification. The victim was found partially buried in the sand near El Pinar, Uruguay in 1995. The analysis indicated that the victim was a 45-year old, white, male who was about 170cm tall. Based on preliminary evidence that the victim might be Dr. Eugenio Antonio Berríos Sagredo, a digital superimposition was made using the victim's photograph and the unknown skull. This examination revealed that the skull corresponded consistently with the individual in the photograph. Results were supported by the fact that personal belongings, such as a medal and wrist watch, also pointed to the same individual. Dental records and radiographs when made available later also indicated the same identity. Dr. Berríos was accused of making nerve gas during the dictatorial regime of former Chilean President General Augusto Pinochet. It was also alleged that he made bombs that killed a Spanish diplomat in his laboratory and a Chilean diplomat in Washington, DC. Many complex techniques are often needed to make a positive identification and such was the case for this study. Because of the nature of anthropology as a holistic discipline, such complexity is an integral part of human biology and behavior and can be used successfully in the forensic sciences and medicolegal investigations.

Cause of Death↗

PubMed1996

Gender identification of human hair using fluorescence in situ hybridization.

Identification of the gender of hair represents relevant medicolegal evidence in criminal cases. The efficacy of Fluorescence In Situ Hybridization (FISH) using chromosome X and Y centromeric probes was tested to determine its ability to identify correctly the gender of hair. In this preliminary study, FISH correctly identified the gender of cells from hair as old as 26 days. The technique is accurate, rapid, sensitive, easily performed, and readily available. As a forensic laboratory technique, FISH shows great promise.

Female↗

PubMed1999

Parental knowledge and attitudes of Minnesota laws concerning adolescent medical care.

OBJECTIVE: To determine parents' knowledge and attitudes of medicolegal issues affecting adolescent medical care. DESIGN: An anonymous, mailed survey with 16 questions concerning Minnesota consent and confidentiality laws that affect adolescents' medical care. SETTING: A community of >70 000 in rural, southeastern Minnesota. PARTICIPANTS: Parents of 600 randomly selected 7th- through 12th-grade public school students. RESULTS: Two hundred eighty-eight (48%) parents returned the surveys. Parents achieved a median score of 18.8% (range, 0%-93.8%) correct on a test of knowledge. Opinion was a median of +0.3 on a scale where -1 signified "a bad law," 0 signified "neither a good nor bad law," and +1 signified "a good law." Four questions, however, generated a more intense response. Seventy-seven percent of parents reported that, as a whole, the laws in the survey had no effect on them and/or their children. CONCLUSIONS: These results suggest that parents are not knowledgeable of Minnesota laws that affect adolescent medical care. Overall opinion of these laws was mildly positive, with notable exceptions. Parents also lack a sense of impact of laws affecting adolescent medical care. Lack of knowledge and the presence of certain attitudes allow for identification of issues that clinicians should address by incorporating medicolegal education into the care of adolescents and their families. These results are especially timely in light of the Parental Rights and Responsibilities Act under consideration in Congress, which would provide parents greater authority over their children's medical care.

Adolescent↗

PubMedDate not supplied

Entrance and exit gunshot wounds: incorrect terms for the emergency department?

Gunshot wounds (GSWs) pose significant medicolegal and forensic issues. Mistakes have been made regarding identification of gunshot wounds. We present a case of an atypical gunshot wound and review contact, near contact, intermediate, and distant wounds. There is an objective terminology to describe GSWs in the Emergency Department.

Adult↗

PubMedDate not supplied

[Genomic "dactyloscopy" in the expertise of disputed paternity and the determination of biological relationship].

Genome "dactyloscopy" (DNA fingerprinting) is a principally new way of personal identification based on analysis of human genetic material (DNA); the difference in DNA structure of different subjects is the scientific basis of this method. This ensures opportunity to estimate biological relationship of persons positively. The authors were the first to demonstrate using certain expert material the adequacy and potentials of DNA fingerprinting by M 13 probe for medicolegal expert practice in most complicated cases of relationship determination requiring positive identification of paternity and maternity.

Blood Group Antigens↗

PubMedDate not supplied

Self-neglect: a proposed new NANDA diagnosis.

PURPOSE: To propose a new NANDA diagnosis, self-neglect. DATA SOURCES: Research studies and literature published from a variety of disciplines including nursing as well as primary research. DATA SYNTHESES: This diagnosis can be used to describe a constellation of self-care problems of varying severity and impact on the health and well-being of people who self-neglect. Included are two subtypes of self-neglect based on the degree of intentionality. Clarification of self-neglect is long overdue because self-neglect presents conceptual, identification, and intervention problems for nurses, healthcare workers, and for medicolegal systems across settings and in many countries. CONCLUSION: The proposed diagnosis, self-neglect, fills a gap in current standardized terminology. This diagnosis will contribute significantly to nurses leading the way in the explication of an interdisciplinary and international health concern. PRACTICE AND POLICY IMPLICATIONS: Developing self-neglect as a recognized nursing label is vital to clinicians and policy makers within and across countries. Appreciating less serious/non-life-threatening presentations will give nurses a care perspective to improve the health and well-being of those in earlier stages of self-neglect. Definitions for this phenomenon will contribute to care planning and interventions, leading to consistency in practice and research.

Activities of Daily Living↗

PubMed1991

Tattoos and tattooing. Part I: History and methodology.

Most medical examiners and pathologists who routinely perform autopsies identify tattoos on a daily basis. However, these dermagraphics generally are given only cursory inspection and description, if at all, although many pathologists photograph particularly unique, unusual, or bizarre examples. From a medicolegal perspective, these permanent skin designs are most often used as identification markers, especially in cases of unknown or questionable identity. The majority of pathologists and other physicians are not familiar with the way in which tattoos are applied, much less the history of this unusual art or the various aspects of tattoos that may provide even more complete information as to how, where, why, and when the tattoos were done. This article, the first of three parts, provides a brief but comprehensive history of tattooing from both the worldwide and Western perspectives, describes how professional tattooing is done, and illustrates the machines involved and the various constituents of the inks that are currently used. The second and third articles will explore the gross and histopathology of tattoos, methods of tattoo removal, medical applications and complications associated with tattoos, psychology and psychopathology of tattoos, and the importance of tattoos in forensic medicine.

Europe↗

PubMed2001

Measurements of ulna--a new method for determination of sex.

Identification of sex from skeleton parts is of paramount importance to medicolegal investigations. The present study makes an attempt to assess sex from the ulna by devising new measurements for fragmentary bones. Dry and adult ulnae (100 male and 60 female) of Madhya Pradesh, India were subjected to three measurements (Olecranon--coronoid angle, length, and width of inferior medial trochlear notch) that were devised specifically for this study. The data were analyzed using discriminant function analysis. Direct analysis using single or multiple variables revealed the Olecranon-Coronoid angle as the best single parameter, yielding 85% accuracy. Measurements of the inferior medial trochlear notch have an additional advantage of being used in fragmentary bone where only the upper end is available. The calibrated discriminant functions correctly classified 90.6% of all males and females in an independent test sample.

Adult↗

PubMed2006

Olfaction in rhinology--methods of assessing the sense of smell.

Olfactory disorders frequently occur in rhinological disease. Different subjective and objective test methods are available to assess the sense of olfaction. Among the subjective methods, screening tests and threshold measurements are commonly used to quantify hyposmia or anosmia. Qualitative methods are available using discrimination and identification tests. Objective methods are used in research and in some medicolegal situations. Objective tests include olfactory evoked potentials, functional Magnetic Resonance Imaging and functional Positron Emission Tomography. The measurement of the sense of smell helps to assess the whole spectrum of the effects of nasal disease. This is especially important before rhinological surgery, because a non-detected smell disorder in patients with rhinological disease is common. The assessment of a pre-existing hyposmia or anosmia helps to avoid a postoperative claim that this was caused by surgery. A variety of validated screening tests for olfaction is available and they are a useful tool to document whether a patient is able to smell.

Diagnostic Techniques, Respiratory System↗

PubMed2006

The prevalence of proline iminopeptidase negative Neisseria gonorrhoeae throughout England and Wales.

BACKGROUND: The accurate laboratory identification of Neisseria gonorrhoeae is an essential element of the diagnosis of gonorrhoea and is particularly important for medicolegal cases. The detection of proline iminopeptidase (Pip) activity is widely used as a marker for gonococci, although Pip negative N gonorrhoeae isolates have been shown to generate false negative identifications when using biochemical kits. This study aimed to determine the frequency of Pip negative gonococci in England and Wales. METHODS: A total of 2055 isolates were collected from consecutive patients attending 26 genitourinary medicine centres as part of the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP). Upon receipt the identity of all isolates was confirmed using N gonorrhoeae specific monoclonal antibodies and the Pip status was determined using the Gonochek II kit. RESULTS: The overall prevalence of Pip negative isolates was found to be 4.33%. Significant geographical variation was observed between isolates from centres outside London (p< or =0.001). Variation was also observed within London between the nine different clinics submitting isolates (p = 0.025). There was also a higher frequency of these isolates among men who have sex with men (p< or =0.001), which may account for geographical variations. CONCLUSION: Pip negative N gonorrhoeae isolates are a very serious cause for concern as currently all biochemical test kits available within the United Kingdom require the presence of the Pip enzyme for an unambiguous identification of this pathogen. Raising awareness of the current prevalence of Pip negative N gonorrhoeae isolates is critical for the successful control of gonorrhoea.

Aminopeptidases↗

PubMed1998

Metric and comparative analysis of sexual dimorphism in the Thai femur.

Identification of sex from the skeleton is an important demographic assessment in medicolegal investigations. Studies have demonstrated that populations differ from each other in size and proportions and that these differences can affect the metric assessment of sex. It is therefore vital to determine if population differences are great enough to necessitate group-specific standards. To date, there have been no attempts to create standards of assessment for modern Thais. Therefore the purpose of this research is to establish standards from which to determine sex from the femur using a new skeletal collection housed at the Chiang Mai University Department of Anatomy. The sample is composed of 104 individuals (70 males, 34 females). Six standard osteometric dimensions including maximum length, maximum head diameter, midshaft circumference, midshaft anterior-posterior and transverse diameters, and bicondylar breadth were measured and analyzed by stepwise discriminant function statistics. To understand population differences, formulas derived from Chinese, South African whites and American whites and blacks using the same method and variables were tested on the Thai sample. Results indicated that maximum head diameter and bicondylar breadth are the optimal combination for sex diagnosis and yielded 94.2% accuracy. Direct analysis using predetermined single or multiple variables also revealed bicondylar breadth as the best single dimension (93.3%). In cross-tests on the Thais, the Chinese formula gave the most favorable outcome with unsatisfactory results for all other groups. The present research confirms that sexual dimorphism is better reflected in breadth dimensions than in bone length. Comparisons showed that Thais are very different metrically from whites and blacks, and although they most resemble the Chinese, these two groups are not identical. These findings underscore the need for population-specific formulas for identification of sex from the skeleton.

Adolescent↗