Evaluation of foreign national cases applied to Tokat Gaziosmanpasa University Hospital Forensic Medicine Department, 2014-2022.

INTRODUCTION/AIM: Turkey has experienced a heavy migration burden in recent years due to its location and benevolent policies. This study aimed to retrospectively examine and discuss the reports prepared for foreign nationals who requested assistance at the Forensic Medicine Department of Tokat Gaziosmanpasa University Hospital in Tokat, which is located in the Middle Black Sea Region of Turkey, between 2014 and 2022. MATERIALS AND METHODS: This study retrospectively evaluated reports prepared between 2014 and 2022 in the outpatient clinics of Forensic Medicine at Tokat Gaziosmanpasa University Hospital. RESULTS: Based on the files reviewed, 219 cases were included in the study, of which 70.8% (n = 155) were male and 29.2% (n = 64) were female. Among the 75 cases referred by judicial authorities, 34.6% (n = 26) involved assault, 28% (n = 21) involved determination of the ability to understand the legal significance and consequences of the act, 16% (n = 12) involved traffic accidents, 8% (n = 6) involved poisoning, 9.3% (n = 7) involved abuse, and 4% (n = 3) involved age determinations. DISCUSSION: Problems with immigrants, which have always been a reality due to Turkey's location on migration routes, have increased significantly in recent years. For this reason, we believe that studies with multicenter and larger series should be conducted to determine the current situation that foreigners create for themselves and Turkey to facilitate necessary arrangements, determine proposed solutions, increase the quality of services offered, and develop plans for the future.

The micro CT evaluation of crown and root pulp volume versus dentin thickness in teeth in postmortem interval (PMI).

Determining the postmortem interval (PMI) is one of the main study subjects of forensic sciences. The main purpose of this prospective in vitro study that was the Micro-CT evaluation of teeth crown and root pulp volume versus dentin thickness in terms of PMI determination. The study involved 60 female Wistar rats, with weights ranging from 270 to 320 g. These rats were grouped into six different post-mortem period categories. Following the animals' sacrifice, they were subjected to a natural putrefaction period, with a control group, in the grounds of a sheltered garden. Hemi-mandible samples were then extracted and placed in glass tubes for Micro-CT evaluations, following the progression of putrefaction processes. The pulp volume and dentin thickness were assessed using Micro-CT, and the gathered data underwent statistical analysis. Micro-CT was employed to analyze sixty right mandibular second molar teeth in the hemi-mandible. The crown pulp volume exhibited a reduction in group 6, with a value of 0.239 mm3 after a three-month period of natural putrefaction (p < 0.001). There is statistically differences among groups in case of pairwise comparison (p < 0.05). However, the root pulp volume and dentin thickness variables did not display any statistically significant changes. Despite certain limitations associated with this study, the Micro-CT findings concerning teeth pulp volume can serve as an objective parameter, especially for late postmortem investigations and the estimation of time of death.

On Death and Examination of the Dead in the Ottoman Empire: A Historical Perspective.

ABSTRACT: The aims of this study were to examine the procedures performed during the death examination by scanning the qadi registry books of the Ottoman Empire in the 16th-18th centuries and to compare them with the procedures performed today. In our study, a total of 12 Konya qadi registry records from the period between 16th and 18th centuries (1563-1731) were examined. In our study, a total of 70 cases that underwent death discovery and examination were found out of 12 Konya qadi registry books. When the causes of death were evaluated in the cases in which the dead were discovered, being trapped in the wreckage was found as the most common cause with a total of 9 cases. This was followed by drowning (n = 8), being found dead in the open area (n = 8), and sharp injuries (n = 7). Because of the developments in all fields of medicine, it is understandable that wound descriptions are much more detailed today. However, descriptions such as "black bruise, battery, wounding" were found in the qadi registers as well. This case study is one of the most historic and comprehensive death series.

Usability of elemental analysis for antemortem and postmortem bone fracture differentiation.

The differentiation of antemortem and postmortem fractures is a challenging and important issue in forensic medicine. To investigate the usability of chemical element levels in blunt fracture ends for the differentiation of antemortem and postmortem fractures, antemortem and postmortem fractures were created in rats and left to decay in the natural environment. Forty-eight rats were used in this study. The rats divided into six groups, each group containing eight rats. We induced a left mandibular fracture in all rats under anesthesia and then waited for 2 d to become organized to fracture the hematoma. All rats were sacrificed under anesthesia, and a postmortem blunt fracture was created in the right mandible. Samples were taken from the fracture ending at 0, 7, 14, 30, 60, and 90 d after the blunt postmortem fracture. The Mg, S, K, Ca, and Fe contents were measured using inductively coupled plasma/optical emission spectrometry (ICP-OES). In our study, it was observed that antemortem Mg, K, S and Ca levels were generally higher than the post-mortem levels, although not statistically significant in all groups.

Microanatomic analyses of extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve.

OBJECTIVE: To investigate microanatomic organizations of the extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve. METHODS: Nerve samples were dissected in 12 postmortem autopsies, and histomorphometric analyses were conducted. RESULTS: There was no significant difference between the right and left sides of the nerve samples for the nerve area, fascicle area, number of fascicles and average number of axons. The lowest mean fascicle number was found in the hypoglossal nerve (4.9 ±â€¯1.4) while the highest was in great auricular nerve (11.4 ±â€¯6.8). The highest nerve area (3,182,788 ±â€¯838,430 µm2), fascicle area (1,573,181 ±â€¯457,331 µm2) and axon number (14,772 ±â€¯4402) were in hypoglossal nerve (p < 0.05). The number of axons per unit nerve area was higher in the facial nerve, truncus temporofacialis, truncus cervicofacialis and hypoglossal nerve, which are motor nerves, compared to the sural nerve and great auricular nerve, which are sensory nerves (p < 0.05). The number of axons per unit fascicle area was also higher in motor nerves than in sensory nerves (p < 0.05). CONCLUSION: In the present study, it was observed that each nerve contained a different number of fascicles and these fascicles were different both in size and in the number of axons they contained. All these variables could be the reason why the desired outcomes cannot always be achieved in nerve reconstruction.

Microanatomic analyses of extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve

Abstract Objective: To investigate microanatomic organizations of the extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve. Methods: Nerve samples were dissected in 12 postmortem autopsies, and histomorphometric analyses were conducted. Results: There was no significant difference between the right and left sides of the nerve samples for the nerve area, fascicle area, number of fascicles and average number of axons. The lowest mean fascicle number was found in the hypoglossal nerve (4.9 ± 1.4) while the highest was in great auricular nerve (11.4 ± 6.8). The highest nerve area (3,182,788 ± 838,430 μm2), fascicle area (1,573,181 ± 457,331 μm2) and axon number (14,772 ± 4402) were in hypoglossal nerve (p < 0.05). The number of axons per unit nerve area was higher in the facial nerve, truncus temporofacialis, truncus cervicofacialis and hypoglossal nerve, which are motor nerves, compared to the sural nerve and great auricular nerve, which are sensory nerves (p < 0.05). The number of axons per unit fascicle area was also higher in motor nerves than in sensory nerves (p < 0.05). Conclusion: In the present study, it was observed that each nerve contained a different number of fascicles and these fascicles were different both in size and in the number of axons they contained. All these variables could be the reason why the desired outcomes cannot always be achieved in nerve reconstruction.

Improved drought tolerance of EMS mutagenized Alfalfa (Medicago sativa L.) mutants by in vitro screening at germination stage.

The objectives of this study were to determine drought tolerant novel mutant of alfalfa (Medicago sativa L.) genotypes by screening EMS mutagenized 340675 M3 seeds at germination stages in the presence of osmotic stress of 35% PEG6000. Root growth assay provided several drought tolerant candidate mutants. Of those, 4 mutants were further evaluated at water deficit conditions applied for 24 days after the first cutting at flowering bud stage. The results revealed that mutants determined as drought tolerant at germination stage were also tolerant to water deficit conditions. Protein content and superoxide dismutase values were found to be higher in all mutants than controls. Ascorbate peroxides, glutton reductase and lipid peroxidase values varied based on the mutant genotype and duration of drought stress. Drought stress significantly changed transcriptional levels of MtP5CS, MtDehyd, MseIF-2, MtRD2 and MsNAC genes. These results indicated that in vitro screening of alfalfa mutant seeds for osmatic tolerance at germination and early seedling growth stages was successfully able to determine the drought tolerant alfalfa mutants which were also tolerant to water deficit conditions after the first cutting at flowering bud stage.

Evaluation of the detectability of early mandible fracture healing findings in terms of vitality aspect by using micro-CT technology in postmortem interval.

The purpose of the present study was to investigate the vitality aspect of mandibular fractures using micro-CT in the analysis of bone mineral density and other bone microstructure trabecular parameters in the postmortem interval. This study included 72 female Wistar rats. In the study groups, the rats' mandibles were first fractured and after three days of living, the rats were sacrificed. In the control groups, the rats were sacrificed first and then the mandibles were fractured. All rats were left for a natural putrefaction period according to their group's time as week-0, week-1, week-2, week-4, week-8, and week-12. All fractured hemi-mandibles were scanned by micro-CT and analyzed in terms of BMD and other bone trabecular microstructures. BMD and the other bone trabecular microstructures, such as bone volume, percent bone volume, trabecular separation, and trabecular pattern factor, showed statistically significant differences in both the study and control groups (p ≤ 0.05). There were statistically significant differences between the study and control groups in comparisons of BMD in groups 1, 2, 3, 4 and 5, bone volume and percent bone volume in groups 1 and 3, bone surface and bone surface density in group 6, trabecular separation in group 1, and trabecular number, trabecular pattern factor, and structural model index in group 6. Micro-CT scanning and analysis of BMD and other bone trabecular microstructure parameters for evaluation of vitality aspects of mandible fractures in the PMI has various valuable results that should provide guidance for possible studies in the future.

The micro-CT evaluation of enamel-cement thickness, abrasion, and mineral density in teeth in the postmortem interval (PMI): new parameters for the determination of PMI.

OBJECTIVE: The estimation of time of death or the determination of the postmortem interval (PMI) is one of the most important issues in forensic medicine and odontology. However, evaluation of bone and dental hard tissues in PMI could be challenging due to the lack of objective methods with high accuracy. In this respect, micro-CT analysis which has not been used for postmortem evaluation would be beneficial in evaluating hard tissues such as bones and teeth. Therefore, the aim of the present study was to determine the alterations in the hard dental tissue, mineral density of enamel, and the surface abrasion of hard dental tissues of rats in the PMI period with a relatively novel method, micro-CT. METHODS: The present study included 60 female Wistar rats which were divided into six study groups. The rats were sacrificed at the baseline and were left into nature putrefaction process. The study groups were created based on the PMI period as week-0, week-1, week-2, week-4, week-8, and week-12, which included 10 rats in each group. All hemi-mandibles were collected in the determined timelines and the micro-CT analysis was carried out on each group. Mineral density of enamel and the surface abrasion of hard dental tissues were determined. RESULTS: The enamel and cement thickness remained the same in the examined PMI periods. Mineral density of the enamel tissues were also similar until the 8th week but the decrease was significant at 12th week (2.313 gHAp cm3). Surface abrasion of the dental tissues on weeks 4, 8, and 12 were 0.006, 0.024, and 0.024 mm, respectively. CONCLUSION: The present study indicated that surface abrasion and enamel mineral density evaluation via micro-CT can be considered as objective and precise parameters in PMI evaluation in forensic medicine and odontology.

Diaphragmatic Eventration: Autopsy Case Report.

Presented case was a 36-year-old deceased man with a sequel of poliomyelitis who was reportedly found death at home. On external examination at autopsy, deformity of the lower extremity secondary to polimyelitis, and an obliquely coursing scar tissue 5 cm in length at the same level with the costal arch on the right axillary line were seen. On internal examination at autopsy, diaphragmatic eventration caused by bilateral elevation of the diaphragm towards thoracic cavity was detected. On the left side, stomach, spleen, and small intestines, and on the right side liver were pushed into the thoracic cavity. Cause of death was reported as heart failure of the patient with bilateral diaphragmatic eventration. We aimed to discuss rarely encountered diaphragmatic eventration in autopsy practice from a perspective of forensic medicine.

Two accidental hanging cases of children.

The cases emphasise the implementation of safety measurements which may prevent the occurrence of accidental hanging in children. Two accidental hanging cases were autopsied at The Council of Forensic Medicine, Bursa Group Chairmanship, Morgue Department. The inquest papers written by police were examined and the scenes and autopsy findings are presented. The first case was a four year old girl and the second case was a five year old boy. Their manners of death were determined as an accident. The first accident occurred out of home, but the second accidental hanging occurred at home. It was seen that childhood deaths due to hanging are preventable. Detailed medico-legal investigation in order to elucidate the manner of death is required in similar cases.

Medicolegal Approach to Diogenes Syndrome: a Case Report.

Because of the way of life Greek philosopher Diogenes lived, in the medical literature some older individuals characterized with collection of symptoms and the psychopathology associated with the lack of concern about a person's living conditions were called as Diogenes Syndrome. In this study we presented a case in terms of Diogenes Syndrome. We aimed to discuss by using the recent medical literature. Our case was a 62 year old male living alone and there were a variety of diseases he had. Diogenes Syndrome was previously identified in 30 elderly patients for the first time in 1975. As well as the typical clinical features of Diogenes Syndrome were defined, for being of potential forensic value, case characteristics belonging to the crime scene, and also probable changes that may be encountered at autopsy were discussed.

Death due to perforation of solitary rectal ulcer: case report.

UNLABELLED: Presented case was 57-year-old male reported to be found dead in the watchman cabin in his workplace. At the autopsy, in abdominal cavity dirty green-brown colored fluid with a few particles of intestinal contents and yellow-green colored membranes on abdominal organs were observed, on the anterior wall of the rectum, 2x1.5 cm size perforation area was observed. We aimed to present the rare case of solitary rectal ulcer perforation. KEYWORDS: solitary rectal ulcer - death - autopsy.

Medicolegal aspects of atypical firearm injuries: a case report.

Our case was a twenty year-old man, who was injured during the military duty with G3 infantry rifle in the training area. An atypical firearm entry wound on the left side of sternum which was 4.5 cm in diameter, and was surrounded by six irregular skin burn wounds by a flash-suppressor and a 0.7 cm diameter firearm exit wound at space on the left midscapular line. Our case emphasizes that the interpretation of properties of these atypical firearm entry wounds need to be carefully assessed by physicians.

Anatomical variation of hyoid bone: a case report.

Hyoid bone is a solitary bone localized at the level of cervical 3 vertebrae, connected to the adjacent bone structures with muscles and tendons. Anatomical variations of hyoid bone can cause difficulties in the application of forensic medicine together with clinical and surgical problems. We present a case of a 81-year-old woman, reported to got sick, who died at home. In the autopsy, the neck dissection revealed prolonged right and left greater horns of hyoid bone measured 11 cm and 7 cm respectively. We aimed to present a case with long hyoid bone horns and discuss recent literature.

Spontaneous rupture of a renal cell carcinoma associated with fatal bleeding.

Spontaneous rupture of the renal parenchyma is rarely reported, usually seen as a complication of an underlying disease like the benign and malignant tumors of the kidney, also except from tumors among the causes of spontaneous renal rupture associated with bleeding, there were claimed vascular anomalies affecting the parenchyma, infections and coagulation disorders. Presented case was a 79-year-old male found dead at home. At the autopsy in macroscopic examination; all of the organs with signs of putrefaction, free blood at perihepatic and post hepatic retroperitoneal area, bloody coat at colon serous surface and 25x30x25 cm of hematoma at the right perirenal area were observed. In dissection, 5x2 cm of crescent shaped residual kidney structure was detected at the inferior pole adjacent to the 15x5x8 cm of pale yellow tumor mass settled in the upper pole of right kidney dissection associated with kidney, and 3x3 cm of tumor rupture and bleeding area in the upper part of tumoral pseudo capsule was inspected. Tumor sections were dirty yellow in color, bleeding and a large area of autolysis in appearance were also observed. Histopathological examination of the samples prepared from the tumoral mass taken from on the right kidney revealed renal cell carcinoma. Our aim was to present a rare case of spontaneous rupture of renal cell carcinoma detected at the autopsy.

Death due to combined intake of ethanol and toluene: a case report.

Toluene is a commonly used volatile organic chemical in industry and is the most often chosen illicit substance among volatile substance abusers. Studies involving healthy volunteers suggest that ethanol consumption inhibits toluene metabolism, thus increasing its blood levels. In this study, a lethal case of combined ethanol consumption and toluene inhalation has been reported. Our case was a 30-year-old male who had used volatile substance for 15 years. The autopsy revealed no abnormal findings. Toxicological analysis revealed alcohol and toluene in the blood and the cause of death was considered as toxicity due to acute combined intake of alcohol and toluene. Lethal combined ethanol and toluene intake is rarely reported in the literature. Experimental studies indicate that toluene increases the risk of ethanol dependence and each substance increases the toxic effects of the other.

Death due to Arrhythmogenic Right Ventricular Dysplasia: A case report.

UNLABELLED: Arrhythmogenic right ventricular dysplasia (ARVD) is both a myocardial disease that predominantly affects the right ventricle (RV) and one of the major causes of sudden death in the young and athletes. A 28-year-old man with no signicant medical history, applied to an emergency department with feeling very ill. After his initial examinations, electrocardiography (ECG) showed ventricular extra systoles and he was recommended for admission to a cardiology polyclinic. The next day, his condition worsened and he was dead on arrival at the hospital. A histological examination of heart samples, which were obtained from the RV and LV, revealed the massive replacement of myocardium by fibrous and mature adipose tissue in the RV. In this case, there were no symptoms, family and medical history and its clinical presentation was as an unexpected sudden death. KEYWORDS: Arrhythmogenic right ventricular dysplasia, sudden cardiac death, autopsy.

Scuba diver deaths due to air embolism: two case reports.

Barotraumas and decompression sickness are the two most well-known complications of diving. First presented case was 32 year-old male with recreational diver, who was found floating prone position on the bottom of sea in a depth of 33 m. He had been carried to the surface in a controlled ascent. Second case was a 39 year-old male experienced dive instructor in a diving school, after following an uneventful duration of dive was found unconscious with a floating supine position in a depth of 30 m and there were no signs of life when they were transported to the hospital. Extensive subcutaneous emphysema of the extremities was detected by palpation of the skin. In the autopsy diffuse gas bubbles like beads were seen in the coronary arteries and in ventricles, basilar artery and all of the cerebral arteries. The cause of death was attributed due to gas embolism and drowning.

An unusual case of penetrating intracranial injury due to scissors.

Craniocerebral penetrating non-missile injuries caused by metallic foreign bodies are uncommon events. Healthy 10 year-old boy applied to the hospital emergency service with his parents. Family members stated that the scissors have been stalled his head accidentally by his sister when they had played together. During physical examination the scissors located on left parietal region of the head was examined. There was no loss of consciousness and oriented with normal vital signs. Radiological investigation demonstrated a hyper dense foreign body (scissors) penetrating cranial cavity and ended before reaching posterior region of the left parietal lobe. To our knowledge, the presented was rare case of intracranial penetrating scissor, which was not removed until, injured, reached the hospital. Our goal was to discuss the rare case of penetrating non-missile foreign body cranial injury from medico legal aspect.