Determination of skin wound age by using cytokines as potential markers.

Interleukin-1 beta (IL-1ß), IL-6, tumour necrosis factor-alpha (TNF-α) and epidermal growth factor (EGF) play important roles in the wound healing process. In the present study, human wound specimens (n = 50) were collected from cases of death due to injuries from firearms, penetrating trauma by sharp objects and blunt trauma with a known time of injury and death identified by forensic autopsy. Full-thickness tissue specimens were obtained from injured skin sites, and equally sized intact tissues obtained from the same person were used as controls. Protein determination was performed using ELISA according to the Bradford method for each specimen, and results were provided for individual proteins. IL-1ß levels did not reach statistical significance in any of the wound groups and were not markedly higher than those in the control group. However, IL-6 showed a biphasic pattern and reached statistical significance in the group with wounds less than 30 min old and in the group with wounds more than 18 h old. IL-6 was consistently higher in all wound groups than in the control group. TNF-α showed a statistically significant increase within the first 30 min and remained at a high level in all groups except for those with wounds 2-4 h old. On the other hand, EGF was high in all groups excluding those with wounds 2-4 h old and more than 18 h old, but statistical significance was not reached. Our results suggest that IL-6 and TNF-α in particular may be used as early-phase markers. We believe that IL-1ß and EGF should be more extensively evaluated in further studies.

Fatal poisoning of chilhood in the Eastern Black Sea region of Turkey (2009-2013).

Poisoning is a major problem worldwide among children. Nonetheless, the offending agent, the associated morbidity and mortality vary from place to place and show changes over a period of time. The aim of this study was to investigate the medico-legal paediatric autopsies of childhood poisonings in the Eastern Black Sea Region of Turkey. Reports of autopsies performed between 2009 and 2013 in the Morgue Department of the Council of Forensic Medicine. All medico-legal paediatric autopsies in Trabzon (n:1049) were retrospectively examined. The study comprised an investigation into 62 deaths from poisoning in children aged 0-18 years. The parameters of age, sex, toxic substance category and origin were evaluated. Poisoning accounted for 5.9% of the deaths of children aged 0-18 years. Of the 62 cases, 32 (51.6%) were male and 30 (48.4%) were female, giving a female to male ratio of 1/1.1. The primary causes of fatal poisoning in children were carbon monoxide (64.5%, n = 40), followed by drugs (16.1%, n = 10), insecticides (9.7%, n = 6), mushrooms (6.5%, n = 4), and snake venom (3.2%, n = 2). The results of this study implicated carbon monoxide poisoning as a serious risk factor for mortality in our region. Childhood poisoning may be prevented by public education and simple precautions in general.

The evaluation of suicide letters in Turkey from a cognitive perspective.

BACKGROUND: Different methods are used to understand the suicidal mind. Suicide note analysis may be most direct way to do this. AIMS: To study the content of suicide letters under forensic evaluation in terms of psychological and cognitive aspects. METHODS: A total of 51 letters were referred to The Council of Forensic Medicine from different cities of Turkey and analyzed by a research group with ten members including forensic medicine specialists and psychiatrists. The Questionnaire of Content Analysis of Suicide Letters (The Q-CAS), developed by researchers, was used to analyze the cognitive and cultural themes of suicide letters. The cognitive distortions about the self, the world, and the future as well as cultural phenomena were evaluated including sociodemographic features. RESULTS: Financial problems in males and relationship problems in females were the most frequent life events related to suicide. Hopelessness, weakness, loneliness--in decreasing order--were the most predominant cognitions and emotions. The total score of females were higher than that of males (p=.002). CONCLUSIONS: These negative cognitions should be taken into consideration when therapeutic interventions are planned on individuals with suicidal thoughts.

Late recognized nail aspiration in a child: case report.

Foreign body (FB) aspiration is common in children aged 0-3 years. Our case, a 2.5-year-old girl, presented with sudden onset of cough, fever and sputum; she had been treated twice for acute bronchitis four months ago. Resisting complaints led to an esophagoscopic examination in our Chest Surgery Clinic after a chest X-ray suggested FB in the esophagus, but no FB could be detected. A lateral chest X-ray revealed a FB with its sharp end targeting the trachea and its round end to the right hemithorax. Removal of the FB with forceps was not possible during rigid bronchoscopy. The FB was removed by thoracotomy and bronchotomy under general anesthesia. The removed FB was a nail measuring 6 cm in length. This case report should serve to stress the diversity of FB aspirations in childhood, the role of parental neglect, and that physicians should be aware of the possibility of FB in children with persistent cough.

Detailed dissection of hepato-caval junction and suprarenal inferior vena cava.

BACKGROUND/AIMS: There are few anatomical studies on hepatic vein compared to hepatic artery and portal vein. The aim of this study is to clarify the branching patterns of hepatic veins, supra and infra-diaphragmatic course of suprarenal inferior vena cava and its relation with the liver. METHODOLOGY: Between March and May 2008, 103 consecutive autopsy examinations were included in the study. Hepatic vein anatomy was classified according to the Broelsch classification. The anatomic relations of supra-diaphragmatic and infra-diaphragmatic (suprarenal) inferior vena cava were revealed. RESULTS: Majority of subjects have Type a (42.7%) variation. The inferior right hepatic vein was presented alone in 26 and together with middle right hepatic vein in 15 subjects. Most of the phrenic veins were drained to the right-anterior sidewall of inferior vena cava (n=21/25 above the diaphragm and, n=144/306 below the diaphragm). Drainage of the right adrenal vein directly into the right side of the inferior vena cava was found in 82 subjects (80%). Most of subjects had 2 lumbar branches in the posterior sidewall of infradiaphragmatic inferior vena cava (n=92/103). CONCLUSIONS: The proposed classification of hepatic veins and obtained anatomical details from this study provides useful assistance for hepatic surgeons in phases of operative planning and vascular control maneuvers required in liver surgery.

Fatal poisonings in Trabzon (Turkey).

The aim of this study was to present the characteristics of medicolegal autopsies of fatal poisonings in Trabzon (Turkey), performed from 1998 to 2008, to contribute to the available data on this topic. A retrospective study of the forensic records and the toxicological data of all autopsies performed over that period revealed that 285 cases (6.34%) of the 4492 total autopsies performed were attributed to fatal poisoning. Major toxic substances were classified in five categories as follows: carbon monoxide (CO), insecticides, prescription medications, narcotic drugs, and alcohol (methyl and ethyl). CO was the most frequent cause of death (63.2%), followed by insecticides (17.2%), prescription medications and narcotic drugs (9.8%), alcohol (7.7%), and others (mushroom, rodenticide, and botulism) (2.1%). Ages of the patients ranged from 1 to 86 years (21.55 ± 36.56).

Methyl alcohol poisoning in Trabzon (Turkey).

The aim of this retrospective study was to examine methyl alcohol intoxications in Trabzon (Turkey) and to determine any relations between the laboratory results and histopathologic changes. A total of 4492 forensic autopsies were performed from 1998 to 2008. Thirteen of the cases (0.3%) were because of methanol poisoning, and all were men. Their ages ranged from 25 to 62 years. The blood methanol concentrations ranged widely, from 15 to 482 mg/dL. In six cases, poisoning was because of consumption of the alcoholic beverage "Raki," while in five cases, poisoning was because of the ingestion of cologne. The products consumed were unknown in the other two cases because of insufficient history and data records. Mortality because of methanol poisoning may be prevented/decreased with the implementation of some precautions, such as public education regarding the harms of methyl alcohol, routine monitoring of the vendors that sell alcoholic beverages and cologne, and appropriate legal retribution for the illegal production of methanol.

Rupture of heart with all layers after a massive blunt thoracic trauma without any lesion on the bones: a case report.

Our case is a male student which was dead because of traffic accident as passenger in October, 01, 2007. His heart was found to be lacerated and ruptured horizontally from atrio-ventricular region through all layer of the wall at autopsy. There were not any changes of skeletal system. Our case is considered as a rare and interesting case because there was no lesion on the bones, though the case was exposed to so massive trauma that cause rupture of heart from all layers.

Detection of human herpesvirus 6 DNA but not human herpesvirus 7 or 8 DNA in atherosclerotic and nonatherosclerotic vascular tissues.

INTRODUCTION: Various viral infections are thought to play a role in the development of atherosclerosis. A number of studies suggest that certain viruses from the Herpesviridae family in particular may lead to atherosclerosis. METHODS: We investigated the presence of human herpesvirus 6 (HHV-6), human herpesvirus 7 (HHV-7), and human herpesvirus 8 (HHV-8) DNA in carotid, iliac, and coronary artery specimens obtained from a group of adult autopsy cases by means of polymerase chain reaction (PCR) analysis and nested PCR techniques. A 28-subject study group with at least type IV atherosclerosis and a 25-subject control group with no visible atherosclerosis were enrolled. RESULTS: HHV-6 DNA was found in the carotid artery specimen of 1 subject with atherosclerosis, in an iliac artery specimen of another subject, and in the iliac artery specimen of one of the control subjects. HHV-7 or HHV-8 DNA was not found in either the atherosclerosis or control cases. CONCLUSIONS: This study is the first to demonstrate the presence of HHV-6 in atherosclerotic vascular tissues. HHV-7 and HHV-8 were not found in atherosclerotic tissues; however, further research on broader study groups and with different protocols is needed to determine whether these viruses play a role in the formation of atherosclerosis.

Handmade guns in Trabzon, Turkey.

A wide variety of handmade firearms have been involved in criminal cases in the city of Trabzon, Turkey. Although they are often very similar to commercially manufactured firearms in terms of design, loading and locking mechanisms, and cocking and firing arrangements, these guns are constructed from cheap materials and are not safe for firing. Handmade firearms manufactured in the Black Sea region of Turkey, particularly in the city of Trabzon, are similar to pistols manufactured by Browning, Luger, Star, Smith and Wesson, Berretta, and MAB. A total of 201 handmade guns referred to the Criminal Police Laboratories for examination from 2003 to 2005 were evaluated with respect to type, number of barrels, size and caliber, rifling, design, mechanism, operability, legality, and similarity to commercial models. We found that most of these handmade guns resembled commercial models in several aspects.

Mole guns in Turkey in 2003-2005.

This study describes the frequency of mole guns in Turkey by examining the cases sent to the Council of Forensic Medicine of Turkey between 2003 and 2005. In total, 11 mole guns were examined. Mole guns are manufactured to be used as a trap against detrimental animals. Although they are not meant to be used as a firearm, they are able to cause death. Mole guns appearing in regular casework were evaluated in terms of type of the gun, number of barrels, size and caliber, rifling, design, mechanism, fitness for use, legality, and geographical distribution. Ninety-one percent of the guns were 12 gauge. Most commonly they originate from Inner Anatolia. Mole guns are typically handmade. Some examples of injuries and deaths caused by mole guns are also offered.

Pen guns in Turkey.

This study describes the frequency and type of pen guns in Turkey by examining the cases sent to the Council of Forensic Medicine of Turkey between 2000 and 2004. In total, 32 cases and 61 pen guns were examined. These guns were evaluated in respect of the type of the gun, size and caliber, rifling, design, mechanism, fitness for use, legality, and geographical distribution. Fifty-nine percent of the guns were 22-gauge. Most commonly, they originate from South Eastern Anatolia. It is suggested that the guns are handmade.