[The Polish helicopter crash in Belarus--an analysis of the accident]. / Wypadek polskiego smiglowca na Bialorusi--analiza zdarzenia.

The subject of analysis was the crash of a helicopter of the Polish Border Guards, which happened on October 31, 2009, in the Byelorussian territory about two hundred meters from the Polish border. In the accident, three crew members perished: the pilot, navigator and operator. Based on the accounts obtained directly after the crash on the site of the tragedy, it was established that the pilot tried to land, but the impact was so strong that the aircraft sank about one meter into the ground. On November 3, 2009, a committee consisting of two prosecutors from the County Prosecutor Office in Bialystok, a forensic science expert and a representative from the Border Guards, went to Department of Forensic Medicine in Brzesc. The prosecutors and forensic science expert took part in recovering the bodies. During the process of internal and external examination, severe body injuries were noted, without any surviving tissue and intestines. Samples of blood, urine and fragments of internal organs were collected for chemical, biochemical, toxicological and histopathological examinations. Muscle DNA was also taken.

Loss of heterozygosity (LOH)--implications for human genetic identification.

The aim of this study was assessment of possible effects of loss of heterozygosity on human genetic identification of histolopathogical tissue sections. DNA templates were extracted from tumour tissue specimens excised from oncological patients and from reference blood samples. AmpFlSTR Identifiler PCR Amplification Kit and ABI 310 Genetic Analyzer (Applera) were used to obtain genetic profiles. Frequency of LOH was calculated for respective samples. Fisher's exact test was performed for statistical analysis. Forty-two percent of the 101 cancer cases analysed were found to possess alterations of the microsatellites manifesting with allelic loss. The most frequently altered loci were D3S1358 and D18S51. The alteration was detected in 47% of cases with larynx carcinoma, 44% of cases with uveal melanoma, 60% of cases with cervical cancers, one case of liposarcoma G3 and one case od neurofibrosarcoma. No LOH was found in liposarcoma G1, dermatofibrosarcoma and cystosarcoma protuberans in either primary or recurrent tumours. In benign tumours (lipoma and fibroma) LOH was also absent. During genotyping of DNA extracted from histopathological tissue sections caution should be taken when non-match or exclusion based on few discrepancies is concluded.

[Ethnic variation and forensic usefulness of Y-STR loci in inhabitants of northeastern Poland]. / Polimorfizm loci Y-STR wsród ludnosci Polski pólnocno-wschodniej w aspektach zróznicowania etnicznego i przydatnosci w badaniach medyczno-sadowych.

The objective of the investigation was the calculation of biostatistical indices and parameters of medicolegal usefulness and extension of the knowledge on the genetic structure of the population in view of its historical background and ethnic composition. Polymorphism of Y-STR loci was determined in population samples including the total of 718 males of Polish nationality and belonging to the minorities of Byelorussians, Lithuanians, Polish Tatars and the religious minority of the Old Believers. Statistical analysis of genetic polymorphisms indicated their usefulness in characterizing populations and ethnic groups. The variations in haplotype distribution in northeastern Polish populations should be taken into consideration while evaluating probability of genetic profile matching in medicolegal expert opinions.

Detectability of SGM Plus profiles in heart and lungs tissue samples incubated in different environments.

The aim of the study was assessment of environmental effect on typeability of AmpFlSTR SGM Plus loci: D3S1358, VWA, D16S539, D2S1338, D81179, D21S11, D18S51, D19S433, TH01, FGA and gender marker amelogenin. Heart and lungs specimens collected during autopsies of five persons aged 20-30 years were incubated at 21 degrees C and 4 degrees C in different environmental conditions, fresh different water and soil conditions. DNA was extracted by organic method from tissue samples collected in 7-day intervals and subsequently typed using AmpFlSTR SGM Plus kit and ABI 310. Incubation at 21 degrees C and prevented air access, as well as in peat soil and in sand favoured faster DNA degradation reflected by decrease in typeability rate. In samples with negative genotyping results no DNA was found by fluorometric quantitation. Decomposed soft tissues are potential material for DNA typing.

[Polymorphism of 11 autosomal STRS in a population sample of Belarussian minority residing in the region of Podlasie (Northeastern Poland)--an extension of the STR core set]. / Polimorfizm 11 autosomalnych loci STR w populacji bialoruskiej mniejszosci narodowej zamieszkujacej region Podlasia--rozszerzenie typowego panelu badawczego.

Population genetic data for 11 STRs included in the Humantype Chimera kit were obtained by multiplex PCR and subsequent automated fluorescent detection (ABI 310) from a sample of 200 unrelated individuals of both genders belonging to the Belarussian minority residing in the region of Podlasie (Northeastern Poland). The objective of the investigations was determination of 11 STRs frequency and calculation of parameters of their usefulness in medicolegal examinations. The genotype distributions conformed to HWE for all the analyzed loci. The highly polymorphic systems exhibit a high degree of informativeness and are a potential extension to CODIS loci, particularly in kinship analysis and deficiency cases.

[A rare case of infant poisoning due to accidental administration of 1,2,3-triketohydrinden hydrate (ninhydrin)]. / Rzadki przypadek zatrucia niemowlecia wskutek blednego podania wodzianu 1, 2, 3-trójketohydrindenu (ninhydryny).

The paper presents a case of medical malpractice during the test for phenylketonuria. The authors analyzed all documents collected in the course of the investigation of infant poisoning due to accidental administration of ninhydrin. The medical assessment was based on an extensive review of the case history, as well as on spectroscopy (FT-IR), chromatography and chemical analysis findings that allowed for confirming the presence of the toxic substance in the evidence material collected during the initial investigation. The obtained results confirmed the presence of ninhydrin in the tea cup and in the teaspoon, which were used to prepare the diagnostic medium. No ninhydrin was found in other investigated materials. The employment of routine research methods, including GC-MS, FT-IR and UV-VIS, allowed for detection and identification of the pure chemical form of ninhydrin, as well as its color complex with amino acids. The detailed case analysis, as well as the variability of extensive evidence material collected during the investigation allowed for determining the identity of persons responsible for accidental administration of the poisoning substance to the infant.

[Polymorphism of 10 autosomal Strs in a population sample of Podlasie (NE Poland)--an extension to the STR core set]. / Polimorfizm 10 autosomalnych loci STR w populacji podlasia--rozszerzenie typowego panelu badawczego.

Population genetic data for 10 STRs included in the Humantype Chimera kit were obtained by multiplex PCR and subsequent automated fluorescent detection (ABI 310) from a sample of 220 unrelated individuals of Polish ancestry residing in north-eastern Poland. The genotype distributions conformed to HWE for all the analysed loci. The highly polymorphic systems exhibit a high informativeness and may be helpful in cases requiring an extension of the CODIS loci system, particularly in kinship analysis and deficiency cases.

[Forensic usefulness of four X-chromosomal STR polymorphisms in north-eastern Poland]. / Polimorfizm czterech loci X-sTR wsród ludnosci polski pólnocno- wschodniej w aspekcie przydatnosci w badaniach medyczno-sadowych.

Allele frequencies for four X-chromosomal STR were determined in a population sample of 1308 unrelated males and females from north-eastern Poland by multiplex PCR and subsequent automated fluorescent detection (ABI 310) using a commercially available multiplex PCR kit (Mentype Argus X-UL). The obtained data support the idea of genetic diversity among population groups of north-eastern Poland. The analysed quadruplex is a potential extension of the battery of autosomal systems in forensic applications, especially in the investigation of kinship analysis and deficiency cases.

[Effect of cobalt bomb irradiation on genetic identification]. / Wplyw napromieniowania bomba kobaltowa wybranych tkanek na identyfikacje genetyczna.

The objective of the paper was to assess the effect of gamma-irradiation on typeability of AmpFISTR SGM Plus loci in selected tissue specimens collected during forensic autopsies. Full AmpFISTR SGM profiles were obtained after gamma-irradiation of 150Gy. At the dose of 200Gy a gradual loss of longer amplicons was noted. In terms of AmpFISTR SGM Plus typeability, the thyroid gland and kidney were the most vulnerable to gamma-irradiation.

Vitreous humour as a potential DNA source for postmortem human identification.

PURPOSE: The aim of this study was the assessment of vitreous humor as a potential DNA for forensic human postmortem identification. MATERIAL AND METHODS: Vitreous humor samples were collected using two alternative approaches from 25 corpses of either sex during autopsies. DNA was extracted by standard organic method. Recovered DNA was quantitiated fluorometrically. AmpFlSTR SGM Plus kit and ABI 310 Genetic Analyzer (Applera) were used to obtain genetic profiles. RESULTS: Different DNA yields were quantitated in vitreous body depending on cause of death and sampling approach. CONCLUSION: Vitreous humor is a potential DNA for forensic human postmortem identification depending on a sampling method used.

Typeability of PowerPlex Y (Promega) profiles in selected tissue samples incubated in various environments.

In cases of decomposed bodies, Y chromosomal STR markers may be useful in identification of a male relative. The authors assessed typeability of PowerPlex Y (Promega) loci in post mortem tissue material stored in various environments. Kidney, spleen and pancreas specimens were collected during autopsies of five persons aged 20-30 years, whose time of death was determined within the limit of 14 hours. Tissue material was incubated at 21 degrees C and 4 degrees C in various environmental conditions. DNA was extracted by the organic method from tissue samples collected in 7-day intervals and subsequently typed using the PowerPlexY-STR kit and ABI 310. A fast decrease in the typeability rate was seen in specimens incubated in peat soil and in sand. Kidney tissue samples were typeable in all PowerPlexY-STR loci within 63 days of incubation at 4 degrees C. Faster DNA degradation was recorded in spleen and pancreas specimens. In samples with negative genotyping results, no DNA was found by fluorometric quantitation. Decomposed soft tissues are a potential material for DNA typing.

Effect of soil and water environment on typeability of PowerPlex Y (Promega) in selected tissue samples.

In cases of decomposed bodies Y chromosomal STR markers may be useful in identification of a male relative. The authors assessed typeability PowerPlex Y (Promega) loci in tissue material stored in water and soil environment. Tissue material was collected during autopsies of five persons aged 20-30 years with time of death determined within the limit of 14 hours. Heart muscle, liver and lung specimens were stored in pond water, sea water, sand and peat soil. DNA was extracted by organic method from tissue samples collected in 7-day intervals. Liver specimens were typeable in all PowerPlex Y loci within 100 days of storage in pond water with gradual decline at DYS392 in sea water. Heart muscle specimens stored in pond water exhibited allelic loss at DYS19, DYS385, DYS389II and DYS392, while all loci were typeable in sea water stored samples. For lung specimens allelic loss was noted throughout the profile. Storage of liver specimens in peat soil for more than 14 days resulted in allelic drop-out, and after 21 days no profiles were typeable. Heart muscle specimens were typeable in all PowerPlex Y systems after 35-day storage in sand, while allelic drop-out and subsequent lack of profiles were noted after 14 and 35 days respectively. Lung specimens stored in garden soil exhibited allelic drop-out and subsequent lack of profiles after 7 and 21 days, respectively. All PowerPlex Y loci were typeable in the latter material in sand up to day 35 with gradual decline of longer amplicons (DYS19, DYS385, DYS389II and DYS392).

[Evaluation of Powerplex Y system in genotyping of male component after sexual intercourse]. / Badanie przydatnosci multipleksu Powerplex Y w identyfikacji materialu biologicznego po zgwalceniach.

Y-STRs are of an importance in forensic genetics in cases of selective genotyping of male haplotypes and/or determination of a number of perpetrators. Experimental vaginal swabs containing semen were collected to evaluate the effect of storage conditions and male/female DNA ratio on the efficiency of amplification of Powerplex Y system alleles. The specimens were collected on disposable devices from 20 volunteer pairs of sexual partners. The swabs were stored on selected supports in different temperature conditions. DNA templates were extracted using Chelex and quantitated spectrophotometrically. Powerplex Y system (Promega) ABI Prism 310 (Applera) were used to obtain Y-STR profiles. Vaginal swabs airdryed at room temperature were found the best source of DNA for male identification. Full Y-STR haplotypes were obtained in male/female mixtures prepared in proportion of 1 : 1000.

[Medico-legal assessment of medical malpractice in ambulance service based on the casework material collected at the Department of Forensic Medicine, Medical University of Bialystok]. / Opiniowanie ssdowo-lekarskie w sprawie bledu medycznego pracowników pogotowia ratunkowego w materiale Zakladu Medycyny Sadowej Akademii Medycznej w Bialymstoku.

INTRODUCTION: Emergency medical personnel is particularly concerned about medical malpractice. The objective of the paper was the analysis of casework material assessed at the Department of Forensic Medicine, Medical University of Bialystok in the years 2001-2006 for medical malpractice by ambulance service staff. MATERIAL AND METHODS: A total of 80 opinions assessing improper treatment and diagnostic procedures and the problem of withdrawal and organizational malfunction was reviewed. RESULTS: Medical malpractice was concluded in 38 (47.5%) cases analysed. In 22 cases malpractice of ambulance staff resulted in patients' demise. Most of cases included improper diagnosis of patient's condition. Predominantly, misdiagnosed cases were related to circulatory, nervous and respiratory malfunctions. Diagnostic errors caused by young and inexperienced medical doctors accounted for most of malpractice in the material analysed. CONCLUSIONS: It is concluded, that medical doctors are inadequately prepared to differential diagnostics of pathologies. Errors caused by ambulance dispatchers included denials of service in life threatening cases.

[Medico-legal assessment in neurosurgical malpractice based on the material collected at the Department of Forensic Medicine, Medical University of Bialystok]. / Opiniowanie sadowo-lekarskie w sprawie bledu lekarskiego z dziedziny neurochirurgii w materiale Zakladu Medycyny Sadowej Akademii Medycznej w Bialymstoku.

INTRODUCTION: Medical malpractice results from inadequate professional knowledge, incompliance to the present state of medical knowledge or negligence and inattention. The aim of the paper was the analysis of diagnostic and therapeutic malpractice based on casework material in the field of neurosurgery. MATERIAL AND METHODS: Medical malpractice cases were assessed according to the number and type in 25 medico-legal opinions issued by the Department of Forensic Medicine, Medical University of Bialystok in years 2001-2006. RESULTS: Majority of cases were craniocerebral injuries related to delayed diagnostics, incorrect treatment including withdrawn or improper surgery. In 5 cases (20%) medical malpractice was concluded. In 2 cases the death of patients was pronounced. In most cases medical malpractice was attributed to lacked or delayed diagnostics and improper technique during spinal surgery. CONCLUSIONS: Relatively limited number of malpractice concluded may support correct knowledge and competence of medical doctors. Maximum attention should be kept during the examination of patients after general trauma, with special consideration of potential intracranial injuries. Diagnostic difficulties result from acute supradural hematomas.

[Medico-legal assessment in neurological malpractice based on casework material collected at the Department of Forensic Medicine, Medical University of Bialystok]. / Opiniowanie sadowo-lekarskie w sprawie bledu lekarskiego z dziedziny neurologii w materiale Zakladu Medycyny Sadowej Akademii Medycznej w Bialymstoku.

Medical malpractice results from inadequate professional knowledge, incompliance to the present state of medical knowledge or negligence and inattention. The aim of the paper was the analysis of medical malpractice cases based on material in the field of neurology. The cases were assessed according to the number and type in 32 medico-legal opinions issued by specialist teams of forensic medicine and neurology in the Department of Forensic Medicine, Medical University of Bialystok in the years 2001-2006. In 11 cases (34%) medical malpractice was concluded with reference to improper treatment after head injury or brain pathology, inadequate care at neurology unit, lacked or delayed diagnostics of head pathology and injury, non-referral to hospital by neurologists. In the material analysed diagnostic errors predominated. Majority of them originated from the open health care system. Incompetence of neurologists with regard to differential diagnostics resulting in misdiagnosis and improper therapy was noted. In one third of the overall cases medical malpractice was concluded. The most common causes included misinterpretation of disease signs and symptoms, misapplication of available diagnostic potential and unjustified delay before commencing diagnostics.

[Medico-legal assessment in civil lawsuit concerning patients with neurological disorders]. / Opiniowanie w postepowaniu cywilnym u osób ze schorzeniami neurologicznymi.

INTRODUCTION: The objective of medico-legal assessment in civil lawsuit involves the assessment of health impairment due to a cause under dispute, evaluation of percentage health impairment, assessment of relationship between the cause and the impairment. The objective of the paper was the analysis of medicolegal opinions ordered by civil departments of courts in Poland involving patients with neurological disorders. MATERIAL AND METHODS: The examination criteria included age, sex, type of accident, type of injury and symptoms reported, causative relationship and ability to work. The study comprised 36 civil opinions issued by the Department of Forensic Medicine, Medical University of Bialystok in the years 2001-2003. RESULTS: State of consciousness was assessed at the moment of making important decisions or signing important documents, ability to work, causative relationship between the accident and symptoms reported. Moreover, suitability of treatment was evaluated. No significant differences regarding sex were found between plaintiffs. Occupationally active persons were predominantly subject to injuries. The most common symptoms reported were headache, vertigos and aching pain in the L-S spine. CONCLUSION: No therapeutic incorrectness was found in cases under analysis. In 7/12 cases health impairment was assessed. In 75% of the opinions no cause-effect relationship was concluded between current disorders and accident at work.

[Changes in autopsy findings related to reanimation procedures--case report]. / Zmiany zwiazane z zabiegami reanimacyjnymi--opis przypadku.

Reanimation procedures may cause changes of autopsy findings. Disregarding this condition may result in erroneous determination of the cause of death. The paper presents a case of a woman, age 77, complaining of general weakness who reported to the outpatient department. Paroxysmal tachycardia was diagnosed on EKG. The patient was referred to the internal ward. The transfer to the hospital was offered by the neighbour who had brought her to the outpatient department. In front of the department the patient fainted. Reanimation was performed by 5 persons, including non-medical staff. The patient's death was pronounced within an hour. The autopsy findings included numerous injuries within the thorax and the abdomen, which aroused suspicion about their origin during reanimation and about the cause of death. Detailed analysis of medical history, witness testimonies and histological findings, taking into account the knowledge about potential changes caused by reanimation procedures enabled correct assessment of injuries within the thorax and the abdomen.