Rhodizonate, histological analysis of gunshot wounds in autopsy cases

See Commentary on here Editor, We thank Dr Wingren et al. [1] for the opportunity to further discuss the topic of indications for histological analyses in medicolegal autopsies, sparked by our study [2] . Although we agree with them on some issues, we disagree with others. We will discuss the most salient points of their critics in the order these appear in their letters. We believe that we can all agree that recommendations regarding diagnostic procedures or treatments must be evidence-based -not random, not value-based, not eminence-based, not consensus-based,

Background: Liver is the principal site of many metabolic activities and is vulnerable to many metabolic, toxic, microbial and circulatory insults. It is frequently involved in metastatic spread of malignancies from all parts of body.Aims: This study aimed to analyze histopathological spectrum of liver diseases in autopsy cases, and correlate with the clinical findings wherever available.Materials and Methods: It was an observational study conducted over a period of 2 years on 283 autopsy cases in department of Pathology of a tertiary care teaching institute in central India. Liver specimens were included in study irrespective of age, sex and cause of death. After fixation in 10% formalin the sections from representative area were submitted for processing, Hematoxylin and Eosin-stained sections were subjected for microscopic examination.Results: Total 283 liver autopsy cases studied showed predominance of male (68.65%). Maximum cases were in the age group of 21 to 30 years (20.14%) followed by 31 to 40 years (18.28%). Fatty change was evident in a majority (32.08%) of the cases while a remarkable (26.49%) number of cases showed changes of congestion on histological examination. Massive hepatocellular necrosis and midzonal necrosis were seen in 2 cases each. Tubercular granulomas and metastasis of adenocarcinoma were seen in 3 cases each.Conclusion: Histological analysis of liver is important learning objective for pathologists to study silent diseases of liver which are incidentally seen in histopathology.

Avulsion injuries of the male external genitalia & rupture of the diaphragm following road traffic accident

The judgment of a gunshot wound with severe post-mortem changes

Considering the high incidence of deaths caused by firearms, forensic pathologists must possess a thorough understanding of the patterns of injuries caused by these weapons. Occasionally, distinguishing between entrance and exit gunshot wounds can be difficult. In our case, a 61-year-old man was killed by a 9 mm calibre gunshot wound to the head during a robbery. At the post-mortem examination the calvarium exhibited an atypical injury that showed both entrance and exit wound characteristics, compatible with a ‘keyhole’ defect of the skull. Keyhole fractures occur when a projectile strikes the cranium tangentially, owing to the vertical and horizontal forces usually generated by the fragmentation of the bullet. Atypically, in our case the bullet showed no fragmentation after the impact with the cranial bones and was still able to result in a keyhole defect. An accurate evaluation of the pattern of atypical lesions found in the post-mortem examination is necessary in order to evaluate the cause and the manner of death.

Layer-specific proteomic profiling of human normal heart

The paper presents a case of a forensic autopsy of a young woman who was murdered and her dismembered body was hidden in soil and water. In the skull of the deceased, in the temporal and occipital regions, the autopsy revealed 3 round, almost identical holes, which looked like small caliber gunshot wounds. Doubts about the cause of these injuries were raised by the fact that despite the decomposition of the body, the continuity of the dura at the site of these holes remained undamaged and the absence of any trace of a bullet’s wound track in the brain, the absence of a foreign body in the cranial cavity, as well as the absence of wounds on the opposite side of the skull that could be exit wounds. A thorough analysis of the investigation and the activities carried out during the search for the missing body allowed to adopt and finally confirm the hypothesis that the above mentioned skull damage occurred during the search for the cut-off head of the deceased in shallow water by means of special tapered conical steel probes used by the rescue/search teams. Due to the structure of such a spike, i.e., a sharp end and then a wide cone, only a superficial puncture of the steel probe tip three times into the skull had taken place, which caused regular, rounded bone damage without damaging the dura and brain. The presented case indicates that sometimes post-mortem artifacts may suggest a completely different origin of wounds, which emphasizes the need for a comprehensive analysis of all possible causes of their occurrence, particularly data concerning the handling of the corpse before it is delivered to the morgue, so as not to make a diagnostic error during autopsy.

Introduction. Shooting ranges are places designated for firearm shooting practice. Regulations outline the technical and structural requirements, that should ensure the safety of individuals inside shooting range. Rules also dictate keeping of user records and firearm issuance records. However, mandatory medical examinations for shooting range users are not required, but they are obligatory for obtaining permits for firearm possession and storage. Outlines of cases. We describe two cases of suicide in a shooting range. The individuals were men, whose autopsies were performed at the Institute of Pathology and Forensic Medicine of the Military Medical Academy. In both cases, the cause of death was the destruction of vital brain centers, in direction of the gunshot wound trajectory. Conclusion. These cases raise the question of whether shooting ranges are truly safe places for training and practice. While technical and structural requirements may be fully met, the health status of individuals who come to these facilities for shooting practice is inadequately monitored.

Determination of bullet caliber becomes increasingly important in homicides where the bullet is missing. In cases with entrance wounds to bone that are circular and well defined it may be tempting to measure the defect and offer suggestions about bullet caliber. For this reason, the relationship between wound diameter and bullet caliber was examined using cranial bones from autopsy cases. The minimum diameter of 35 cranial wounds produced by .22, .25, and .38-caliber bullet was measured. The relationship of minimum wound diameter to bullet caliber was examined using a one way analysis of variance. Fisher's least significant difference test revealed no significant difference between .22-caliber and .25-caliber wounds, while the .38-caliber wounds were significantly different (P < .001) from .22-caliber and .25-caliber wounds. Variation in wound size resulting from such factors as bullet shape, surface treatment, strength characteristics, loss of gyroscopic stability, intermediate targets, tangential impacts, and existing fractures are discussed. Also, the large variety of calibers available are noted as complicating the prediction of caliber from wound size. In view of these factors caution is recommended in any attempt to determine precise bullet caliber from the minimum dimensions of the cranial gunshot entrance wound.

Distinction between entrance and exit wounds by energy dispersive X-ray fluorescence spectrometry.

Primary cardiac lymphoma (PCL), defined as extranodal non-Hodgkin’s lymphoma involving exclusively the heart and/or pericardium, is a neoplasm with an extremely low incidence, a high degree of malignancy, and a poor prognosis. It comprises 0.5% of all extranodal lymphomas and 1–2% of all primary cardiac tumors, while the most commonly reported subtype is diffuse large B-cell lymphoma (DLBCL). The tumor is more common in immunocompromised patients compared with those who are immunocompetent. Modern imaging methods now allow for earlier detection of these tumors, despite their variable clinical manifestation, which is often a cause of misdiagnosis. We present an autopsy case of undiagnosed PCL in an immunocompetent 72-year-old man, where postmortem examination revealed massive tumor infiltration of the right-sided heart chambers extending to the left ventricle. Histological analysis showed microscopic tumor infiltration within the left atrium as well. A diagnosis of DLBCL of non-germinal subtype was made based on immunohistochemistry.

Sudden cardiac death (SCD) is defined as an abrupt and unexpected death caused by cardiovascular disease, regardless of whether the individual has a history of heart disease. The conditions included in this classification are myocardial infarction (MI), coronary atherosclerosis, myocardial hypertrophy, myocarditis, aortic valve dysfunction, and ruptured aortic aneurysm. The objective of this study was to analyze and examine different cardiac illnesses and histopathological abnormalities of the heart that occur in SCDs, based on a 4-year autopsy experience in Jharkhand. A retrospective observational study spanning 4 years was undertaken on autopsy specimens of whole hearts submitted for histological analysis in the Department of Pathology, RIMS, from April 2020 to March 2024. We evaluated several histological alterations in the heart of all the received autopsy specimens. A wide variety of histological abnormalities has been observed, with atherosclerosis being the most prevalent. Additional pathological conditions observed were myocardial infarction (MI), hypertrophy, cardiomyopathy, metastasis, myocarditis, pericarditis, and tuberculosis of the heart. Atherosclerosis is the primary etiology of SCD and predominantly affects middle-aged adult males in the Jharkhand population. Comprehending the histopathological results is crucial for identifying the cause of death, adhering to the minimum autopsy requirements for SCD, and enhancing treatment and preventive efforts to decrease SCD mortality.

The present study aimed at examining neuronal injury and repair in post mortem brain sections of humans who died from fungal central nervous system infections. Histological and immunohistochemical abnormalities in 15 autopsy cases with fungal central nervous system infections from 1990 to 2008 were compared with findings in 10 age- und sex-matched control cases that died from acute non-neurological causes. The fungal pathogens were identified by culture or polymerase chain reaction and morphology in post mortem tissue. Seven patients with fungal encephalitis had either an organ transplantation or a malignant haematological disorder; five out of 15 did not have a classical predisposing illness but suffered from severe septic infections as the principal cause of immunosuppression, and three from alcoholism. Fungal organisms detected were Aspergillus spp. and other moulds, Candida spp. and black yeast-like fungi including Cladosporium spp. Histological analyses identified microglial activation, astrocytosis and axonal injury in the white matter without additional demyelination as characteristic features of this infectious disease. An increased rate of hippocampal neuronal apoptosis was detected in fungal encephalitis, while the number of recently generated TUC-4 and calretinin-expressing neurones in the dentate gyrus did not differ between patients and controls. Unlike in other infectious diseases of the nervous system where a coexistence of damage and repair was observed, fungal encephalitis is characterized by strong damage and minimal neuronal regeneration.

Sudden death due to Crohn's colitis: An autopsy case report.

Epstein-Barr virus (EBV)-associated enteritis is extremely rare and has not been well characterized. Herein, we present the first autopsy case of EBV-associated enteritis with multiple ulcers in a 73-year-old Japanese male. The patient had abdominal pain and was clinically diagnosed with enteritis. An endoscopic examination revealed multiple ulcers at the terminal ileum. His condition worsened due to serosanguinous bowel discharge and the patient was then admitted to the hospital. Ileocecal and subtotal small intestinal resection was performed for repetitive hemorrhage from ulcers. However, the patient died due to uncontrolled hemorrhage. An autopsy was then performed in order to explore the cause of ulcers in the small intestine. Macroscopic findings revealed multiple ulcers with occasional cobblestone-like appearance of the ileum. Histological analysis revealed marked infiltration of lymphocytes and plasma cells around the ulcer. EBV-encoded RNA in situ hybridization (EBER-ISH) revealed positive inflammatory cells. Cytomegalovirus was immunohistochemically negative. Macroscopic and microscopic findings obtained from autopsy specimens showed no foci of inflammation and EBER-ISH-positive stromal cells in the esophagus, stomach, and colorectum. EBV-associated enteritis can cause uncontrolled repetitive hemorrhage from ulcers and result in critical condition of the patient, which can be used for differential diagnosis.