[Microscopic myocardial changes and their significance for forensic medical diagnosis].

Morphological myocardial changes essential for diagnosis in forensic medical medicine are listed as well as alterations in the vessels of the myocardium, cardiac muscular fibers and cardiomyocytes important for diagnosis of death of ischemic heart disease, acute alcohol poisoning, alcohol cardiomyopathy, closed cardiac lesions. Changes induced by reflex impacts on the heart and postmortem alterations are also shown.

[Identification of blunt objects according to the injuries caused by them].

The article presents principles of forensic-medical identification of blunt objects by injuries inflicted with them. It is shown that each injury has its own complexes of identifying signs. It is necessary to consider mechanisms of action of blunt objects inflicting contact, noncontact and other injuries. Mathematical methods should be employed to estimate probability of identification of traumatic blunt object.

[Morphological signs of impaired excitation conduction in the myocardium].

The article describes morphological changes in cardiac muscular fibers and cardiomyocytes secondary to disorders in conduction of excitation in the myocardium. These changes may indicate cardiac arrest as a result of reflex impacts including cases of damage which is not lethal.

[The morphological specificity of relaxation of cardiomyocytes and their value in forensic medical diagnostics]. / O morfologicheskikh osobennostiakh rasslableniia kardiomiotsitov i ikh znachenii dla sudebno-meditsinskoi diagnostiki.

The morphological specificity of different conditions of cardiomyocytes was studied in myocardia of 50 cadavers of men who died of a variety of reasons. All conditions, except for the normal relaxation of cardipmyocytes, were found to result from damages in the contractive apparatus. Morphological variations of relaxation of cardiomyocytes are described.

[Topical issues of organisation and implementation of forensic medical expertise]. / Nekotorye aktual'nye voprosy organizatsii i proizvodstva sudebno-meditsinskikh ékspertiz.

The shaped-up experience of management and implementation of expertise as applicable to civil and criminal cases and with respect to the requirements of new legislative acts was analyzed. Issues connected with composing a commission of experts, with the range of competence of forensic medical expert and of clinical practitioner, as well as with the content and form of the expert conclusions are under discussion.

[Significance of changes in the myocardium for the forensic-medical diagnosis of death as a result of alcoholic cardiomyopathy]. / Znachenie izmenenii miokarda dlia sudebno-meditsinskoi diagnostiki smerti ot alkogol'noi kardiomiopatii.

Significance, of the weight and dimensions of heart as well as of fat dystrophy of cardiomyocytes and of the related detection methods is demonstrated for the diagnosis of alcoholic cardiomyopathy (ACMP). When such patients die in a state of alcoholic intoxication, the diagnosis should be death of acute alcoholic intoxication. Lethality of ACMP can be diagnosed only in those who die in the sober condition or with an insignificant level of alcohol.

[Variants of the signs of death from acute alcohol poisoning stipulated by different features of thanatogenesis]. / O variantakh priznakov smerti ot ostrogo otravleniia alkogolem, obuslovlennykh razlichnymi osobennostiami tanatogeneza.

Two variants of thanatogenesis were formulated in cases of death of acute alcohol intoxication; according to the above variants, different combinations of macro- and micro signs as well as of biochemical indices of carbohydrates content in the hepatic tissues and blood are revealed during cadaver examinations. The diagnostic value of the mentioned signs demands that the thanatogenesis specific features must be taken into account in each separate case.

[Definitions of general and professional working ability]. / Ob opredeleniiakh obshchei i professional'noi trudosposobnosti.

The regulating documents and published data were analyzed to define the general and professional working-capacity. New principles were formulated, on this basis, to compose a table of a persistent loss of general working-capacity expressed in percentage.

[Evaluation of severity of harm to health caused by trauma aggravating a preceding disease]. / Otsenka tiazhesti vreda zdorov'iu, obuslovlennogo travmoi, povlekshei obostrenie predshestvovavshego zabolevaniia.

A severity of damage made to the health condition by an injury aggravating a preceding pathology is under discussion. It was demonstrated that such criteria as the time period of temporary disablement as well as the permanent disablement ensure, with respect for clinical data, an objective assessment of a severity done to the health in the discussed cases.

[The significance of ethanolemia for the diagnosis of death from acute ethanol poisoning]. / Otsenka znacheniia urovnia alkogolemii dlia diagnostiki smerti ot ostrogo otravleniia alkogolem.

Foci of myolysis of cardiac muscle fibers are suggested to be used for evaluation of thanatogenetic significance of ethanol concentration in cadaveric blood. This sign of acute ethanol poisoning is absent in case of other cause of death in a state of ethanol intoxication, even in the presence of high ethanolemia. Therefore, foci of myolysis are a sign of ethanol tolerance.

[Forensic medical evaluation of professional working capacity in victims, who needs additional care]. / Ob ustanovlenii nuzhdaemosti poterpevshikh v dopolnitel'nykh vidakh pomoshchi pri sudebno-meditsinskoi ekspertize stepeni utraty professional'noi trudosposobnosti.

The philosophy of evaluating the need of a victim in extra care is discussed. The method for evaluating the need in transport vehicles for the victim is described in detail. Legislative documents which help solve such problems are cited, including those used by committees of forensic medical evaluations.

[Organization and procedure of forensic medical expert evaluation of professional working capacity loss]. / O poriadke organizatsii i proizvodstva sudebno-meditsinskoi ékspertizy ustanovleniia stepeni utraty professional'noi trudosposobnosti.

Sixty-one forensic medical expert conclusions on the loss of professional working capacity are analyzed and typical errors are characterized. The procedure of forensic medical expert evaluation of the degree of loss of professional working capacity in accordance with the Civil Code and Civil Judicial Procedure Code of the Russian Federation and the actual norm-setting documents is described.

[Diagnostic role of acute microscopic changes in myocardium]. / O diagnosticheskom znachenii ostrykh mikroskopicheskikh izmenenii miokarda.

Forensic medical diagnosis of death from coronary heart disease, acute ethanol poisoning, alcoholic cardiomyopathy, closed cardiac injuries, mechanical injuries incompatible with life which may be directly caused by acute cardiac failure, requires identification and evaluation of diagnostic complexes of acute myocardial changes. The diagnostic significance of such complexes of myocardial changes is characterized for the first time. A method for evaluation of such changes, addressed to expert histologists, is presented.

[Criteria for forensic medical evaluation of professional working capacity loss]. / Kriterii sudebno-meditsinkogo opredeleniia stepeni utraty professional'noi trudosposobnosti.

The main and additional criteria used in evaluation (in percent) of loss of professional working capacity are characterized. Criteria common for forensic medical and medical social expert evaluations and differences between them are discussed. These differences are due to the fact that forensic medical expert evaluations are based on the Civil and Civil Processual Codes of the Russian Federation but not on the departamental norm-setting documents.

[The expert assessment of the force of blows by blunt solid objects]. / Ekspertnaia otsenka sily udarov tupymi tverdymi predmetami.

The author distinguishes 4 degrees of strength of strikes inflicted with blunt hard objects. Intervals of strength expressed in newtons correspond to each of these degrees. The scheme is based on experimental data of many authors who determined the parameters of strength of strikes inducing certain injuries. Use of the proposed scheme will render objectiveness and reliability to conclusions of forensic medical experts.

[Morphological sign of cardiac ventricle fibrillation]. / O morfologicheskom priznake fibrilliatsii zheludochkov serdtsa.

An early sign of cardiac ventricle fibrillation is described: numerous surface cracks in the myocardial fibers. The formation of cracks is the initial stage of myocardial fiber fragmentation. The cracks are detected by polarization microscopy in the absence of fragmentation or in myocardial sites without focal fragmentation.

[The histological study of puncture-stab wounds of the skin for establishing the characteristics of the design of the knife blade]. / O gistologicheskom issledovanii koloto-rezanykh ran kozhi dlia ustanovleniia osobennostei konstruktsii klinka nozha.

Histologic studies can help disclose the design of the knife blade by which a cut wound was inflicted. For analysis, thick (25-30 microns) sections are made, parallel to skin surface near the ends of a cut wound. The ends of the wound formed by the blade edge and back are different, and some specific features of the blade back, primarily its thickness, can be distinguished. When the suspected knife is available, a valid conclusion can be made by comparing experimental wounds inflicted by this knife with the studied wounds.

[The forensic medical diagnosis of closed injuries to the heart in blunt chest trauma]. / Sudebno-meditsinskaia diagnostika zakrytykh povrezhdenii serdtsa pri tupoi travme grudnoi kletki.

Describes the morphological changes of cardiomyocytes in contusions and concussions of the heart and reflective heart arrest resulting in rapid sudden death after blunt injury to the chest. Presents the principles and criteria of forensic medical diagnosis of death from heart concussions in such cases.