Myocardial bridges: a prospective forensic autopsy study.

INTRODUCTION: When the coronary artery, located subepicardially, submerges into the myocardium and appears again subepicardially after a short intramural course, it represents an embedded coronary artery, while the part of the myocardium above is a myocardial bridge. OBJECTIVE: We investigated the frequency of the embedded left coronary artery (LAD) in the autopsy material considering the descending branch of the LAD to be the most important one in the nourishment of the myocardium and myocardial bridges to be the most frequent in its area, as well as clinically important. METHODS: A prospective autopsy study of 975 cases was performed, including both, natural (21.33%) and violent (78.67%) deaths. The sample consisted of 74.56% males and 25.44%females. In order to discover myocardyal bridges and their characteristics, the hearts were examined by both transverse cuts and longitudinal openings of the LAD. RESULTS: Myocardial bridge was found in 78 cases (8.00%), more commonly in males (9.35%) than females (4.03%).The average length of the myocardial bridge was 21.85±16.10mm and thickness 3.744±1.48 mm. The common localization of the myocardial bridge was the proximal half of the LAD (89.74%).The upper part of the artery, proximal to the bridge, was a common site of atherosclerotic changes. Myocardial bridge was found in 12.50% of natural deaths, but in 13.38% out of all cases of sudden cardiac deaths. CONCLUSION: Therefore, the presence of the myocardial bridge by itself is not predominant, but it is certainly a contributing factor to a sudden cardiac death.

[Dr. Atanasije Puljo: pioneer of Serbian dentistry].

This paper describes the life and work of Dr. Atanasije Puljo (1878-1944). He was a volunteer in the Balkan wars, an active participant in the First World War; he was the first who noted the importance of team-work of a dentist and a surgeon in the care of jaw and facial injuries. He established primacy in this field, as he came up with this brilliant idea three years before other colleagues. His method of treatment of the upper jaw neglected fractures, called the Balkan method, was recognized worldwide. Dr. Puljo is the pioneer of dental radiology in Serbia, founder of the Odontology Clinic of the Medical Faculty and main supporter of the establishment of the School of Dentistry. Merits of Dr. Atanasije Puljo, medical practitioner with a broad knowledge in different fields, remain within the academic institution that was founded by this pioneer of dentistry in Serbia.

[Forensic interpretation of the maxillary tuberosity fracture caused by tooth extraction].

BACKGROUND: Maxillary tuberosity during teeth extraction can occur in dental practice. The aim of this paper was to present a case of the maxillary tuberosity fracture occurred during tooth extraction, which was the subject of the forensic expertise. CASE REPORT: The maxillary tuberosity fracture created during the extraction of the upper molar was neither timely nor adequately managed by the doctor who started extraction. After the treatment at the specialist institution, the patient sued the doctor for the criminal offense of negligent treatment. The task of the expert was to give a professional answer to the question whether the doctor, who caused a maxillary tuberosity fracture during the tooth extraction, acted negligently and applied inadequate treatment. CONCLUSION: The maxillary tuberosity fracture during molar extraction may be its complication. If it is diagnosed promptly, immediately and adequately managed, there is no possibility for negligence action.

Epidemiological, clinical, and forensic aspects of chainsaw, circular saw, and grinding saw injuries in the maxillofacial region.

The aim of this article was the epidemiological, clinical, and forensic evaluation of the chainsaw, circular saw, and grinding saw maxillofacial injuries. A retrospective analysis of the medical records at the Clinic of Maxillofacial Surgery, School of Dentistry, University of Belgrade, was performed. A total of 133 patients were treated during a period of 19 years (1989-2008). Grinding saw injuries were more frequent (62%) in comparison to chainsaw and circular saw injuries that were present in 23% and 15% of patients, respectively. All injured individuals were men, and most of them were aged 31 to 40 years. Accident by self injuring was the only mechanism of all the analyzed injuries. There were no suicide or homicide attempts. Isolated injuries of the facial soft tissues, which were mainly lacerations, were present in most patients. Less frequently, soft tissues injuries were compounded with bone fractures of the face and teeth injuries. Surgical debridement, revision, and suturing were performed in all patients where only soft tissues were injured. Patients with compound injuries of the soft tissues, facial bones, and teeth were treated according to the common surgical protocol for the type of the injuries. Most often, these injuries were accidental without fatalities. The number of these injuries increased in the recent years owing to the "do-it-yourselfers" for home hobbies. To avoid these types of injuries, users should be carefully instructed, and attention should be paid to the use of accurately guarded saws and appropriate safety equipment.

[Analysis of microsatellite markers D18S70 and D20S116 in DNA isolated from dentin: use in forensic medicine].

INTRODUCTION: Short tandem repeats and more specifically microsatellites represent a powerful tool in forensic medicine. In the past years, they have been extensively used in human identification and paternity testing. OBJECTIVE: The aim of the present study was to analyze two microsatellite markers in the Serbian population, i.e. to determine the number of alleles and the relevant forensic parameters. METHODS: DNA was isolated from teeth samples using standard proteinase K digestion and phenol/chloroform alcohol extraction. PCR products were analyzed on polyacrilamide gels and visualized by AgNO3 staining. Forensic parameters were calculated using the Cervus software. RESULTS: The loci D18S70 and D20S116 were analyzed on a sample of 70 unrelated, healthy adult individuals from Serbia. The number of alleles was determined and Hardy Weinberg equilibrium was confirmed for both loci. D18S70 and D20S116 demonstrated 6 and 8 alleles, respectively. The power of discrimination (PD) and the power of exclusion (PE) for the tested STR loci, D18S70 and D20S116 were 0.92 (PD), 0.41 (PE) and 0.95 (PD), 0.480 (PE), respectively. CONCLUSION: According to the presented data, D18S70 and D20S116 are most informative markers. Based on allelic frequencies and statistical parameters for forensic testing, it may be suggested that these two microsatellites represent useful markers for individual identification and parentage analysis in the Serbian population.

[Alterations of c-Myc and c-erbB-2 genes in ovarian tumours].

INTRODUCTION: According to clinical and epidemiological studies, ovarian cancer ranks fifth in cancer deaths among women. The causes of ovarian cancer remain largely unknown but various factors may increase the risk of developing it, such as age, family history of cancer, childbearing status etc. This cancer results from a succession of genetic alterations involving oncogenes and tumour suppressor genes, which have a critical role in normal cell growth regulation. Mutations and/or overexpression of three oncogenes, c-erbB-2, c-Myc and K-ras, and of the tumour suppressor gene p53, have been frequently observed in a sporadic ovarian cancer. OBJECTIVE: The aim of the present study was to analyse c-Myc and c-erbB-2 oncogene alterations, specifically amplification, as one of main mechanisms of their activation in ovarian cancers and to establish a possible association with the pathogenic process. METHODS: DNA was isolated from 15 samples of malignant and 5 benign ovarian tumours, using proteinase K digestion, followed by phenol-chloroform isoamyl extraction and ethanol precipitation. C-Myc and c-erbB-2 amplification were detected by differential PCR. The level of gene copy increase was measured using the Scion image software. RESULTS: The amplification of both c-Myc and c-erbB-2 was detected in 26.7% of ovarian epithelial carcinoma specimens. Only one tumour specimen concomitantly showed increased gene copy number for both studied genes. Interestingly, besides amplification, gene deletion was also detected (26.7% for c-erbB-2). Most of the ovarian carcinomas with alterations in c-Myc and c-erbB-2 belonged to advanced FIGO stages. CONCLUSION: The amplification of c-Myc and c-erbB-2 oncogenes in ovarian epithelial carcinomas is most probably a late event in the pathogenesis conferring these tumours a more aggressive biological behaviour. Similarly, gene deletions point to genomic instability in epithelial carcinomas in higher clinical stages as the result of clonal evolution and selection.

[Analysis of traffic accidents in children].

INTRODUCTION: Violent health damages of different origin (accidents, murders, suicides) in children and youth are one of the main causes of death and disabilities in this group of population in most countries. OBJECTIVE: Objective of our paper was to analyze all related factors of traffic accidents involving children and to propose adequate measures of their prevention. METHOD: The analysis of fatal traffic accidents of children and youth aged to 18 years on the territory of Belgrade, within the period from 1998 to 2002. RESULTS: In relation to other forms of violent death, the traffic mortality rate in children and youth holds the leading position, accounting for 56.9% with pedestrians as the most frequent category (57.4%). The most frequent age was between 7 and 9 years (46.8%) and the boys were more frequently injured than the girls. It was established that the majority of children (51.9%) was either running across the street outside the pedestrian/ zebra crossings or they were carelessly running out in the street, especially in April, July, August and September. More than a half of them (55.5%), predominantly school children, were injured by the end of working week, on Thursday and Friday. CONCLUSION: Results of our research have shown that the traffic education of children in our region is inadequate. Due to the abovementioned, it is primarily necessary to establish long-term and permanent education of this category of population. In addition, some public investments in the City infrastructure will be required in order to reduce the risk of traffic injuries in children.

Evaluation of maxillofacial weapon injuries: 15-year experience in Belgrade.

The aim of this research was to evaluate maxillofacial weapon-related injuries from the epidemiological, clinical, and forensic points of view. Analysis of medical records of 183 patients treated for weapon-related injuries in Belgrade maxillofacial surgery clinics in the period 1988 through 2002 has been carried out. Most treated patients were male, 21 to 50 years of age, and injured during the war in the territory of the former Yugoslavia. Injuries involving the mandible were the most frequent (40%); firearm (85%) and perforating (70%) wounds occurred more frequently than explosive (25%) and penetrating (30%) wounds; in certain cases, medical records were incomplete and thus useless for forensic court expertise and evidence. A rapid increase in maxillofacial weapon-related injuries was recorded in the period from 1991 to 1995 as a result of war injuries; high-velocity projectiles caused most of the injuries. It is necessary to keep adequate medical records for successful forensic and court expertise and evidence.