[Main mechanisms of secondary ischemic brain damage formation in case of craniocerebral injury]. / Osnovnye mekhanizmy formirovaniya vtorichnykh ishemicheskikh povrezhdenii golovnogo mozga pri cherepno-mozgovoi travme.

OBJECTIVE: To systematize the mechanisms of formation and morphology of secondary ischemic brain damage, formed in the case of craniocerebral injury. MATERIAL AND METHODS: A literature review devoted to the study of formation mechanisms of secondary ischemic brain damage in craniocerebral injury was conducted. The secondary sequential and secondary long-term ischemic brain damage in the posttraumatic period, as well as intracranial and extracranial factors that contribute to their occurrence and progression, were considered. RESULTS AND CONCLUSION: Analysis of the literature has shown that primary lesions occurring at the time of head injury must be differentiated from sequential and long-term secondary ischemic changes in different brain structures.

[Laboratory examinations in forensic medical expertises on crimes against sexual integrity and sexual freedom]. / Laboratornye issledovaniya v sudebno-meditsinskikh ekspertizakh po prestupleniyam protiv polovoi neprikosnovennosti i polovoi svobody lichnosti.

The article presents the results of analysis of 482 forensic biological and forensic cytological expertises on cases of sexual crimes. A presence of different types of such crimes has been noted. Expertises' effectiveness when examining content of vagina, oral cavity and rectum, impression smears and lavages from suspects' genital organs, subungual content of victims and suspects and other objects has been determined. The dependence of expertises' effectiveness on the terms of object removal has been noted. The article presents a number of objects' examination methods (luminescent-microscopic spermatozoids' identification, diagnosis of cells origin from mucous membranes of the vagina and oral cavity, determination of group belonging of specific cells in specimens, diagnosis of fecal masses presence) allowing to improve expertises' quality.

[About the effect of ethanol on the level of substances of low and medium molecular weight]. / O vliyanii etanola na uroven' veshchestv nizkoi i srednei molekulyarnoi massy.

The aim of this work is to study the effect of the concentration of ethanol in the blood on the level of low and medium molecular weight substances in the urine and blood of corpses. The content of LMMWS in the blood and urine of corpses without ethanol in the blood and its concentration of 0.5-1.5 ‰ and 2.0-5.0 ‰ was determined by the method of Malakhova modified by Kopytova at wavelengths of 238-298 nm. The dependence of the concentration of LMMWS in urine on the concentration of ethanol in the blood is shown: the decrease in the parameters of LMMWS in urine is the more pronounced, the higher the concentration of ethanol in the blood. One of the probable mechanisms of such a decrease is the neurotoxic effect of ethanol, leading to polyuria and a decrease in the concentration of various substances in the urine.

[The case of the death of a child due to perforation of the walls of the esophagus and aorta caused by a foreign body - an electric battery]. / Sluchai gibeli rebenka vsledstvie perforatsii stenok pishchevoda i aorty, vyzvannoi inorodnym telom ­ elektricheskoi batareikoi.

The results of a detailed investigation of a casuistic case of fatal perforation of the walls of the esophagus and aorta with subsequent acute blood loss as a result of prolonged presence of a foreign body - an electric battery in the esophagus of a child are presented.

[Age-related differences in the histological structure of children nails in forensic practice]. / Vozrastnye otlichiya gistologicheskogo stroeniya nogtei u detei v sudebno-meditsinskoi praktike.

The purpose of this work is to determine the histological features of the inner surface structure of the nail plates' free edge in children aged 0 to 1 year and from 1 to 17 years for forensic practice. The results of a histological human nail plates' examination by the method of staining with hematoxylin and eosin and microscopy in transmitted light using a biological microscope XSZ-147E at magnification from 54 to 400 were presented. From 0 to 1 year old and from 1 year to 17 years old age differences appear, which can be used in forensic medical practice as an identification feature.

[Differential diagnostics of meconium and feces in traces on material evidences]. / Differentsial'naia diagnostika mekoniia i kala v sledakh na veshchestvennykh dokazatel'stvakh.

The objective of the study was to develop methods of determining the presence of meconium and feces in traces on material evidences and criteria for differential diagnostics of these secretions. The authors studied morphological, enzyme and pigment compositions of the samples of meconium obtained from fetus corpses, alive newborns, and that of feces obtained from adults, with the storage age at the laboratory from three days to two years. There are presented the study outcomes in traces on material evidences obtained by the following methods: light and luminescence microscopy with the use of starch-agar gel samples, substrate film method, a modified Pettenkofer reaction, spectrophotometry, and ascending thin layer chromatography. While studying meconium and feces, the authors revealed differences in their morphological, enzyme and pigment compositions; these data can be used in their differential diagnosis. The authors elaborated methods of determining the presence of the mentioned secretions; these methods could increase the efficiency of forensic biological examinations.

[Application of biochemical research methods for solving questions of forensic medical practice]. / Primenenie biokhimicheskikh metodov issledovaniia pri reshenii voprosov sudebno-meditsinskoi praktiki.

A review of the techniques used by Nizhny Novgorod forensic physicians in studying the possibility of using biochemical methods in expert practice is presented. Changes at the molecular level in pathological conditions precede functional and morphological disorders in tissues and organs. The use of biochemical methods - in particular, the study of the concentration of myoglobin and substances of low and medium molecular weight - significantly expands the possibilities of forensic-medical ekspertise. The authors study investigated the effect of the sampling period and the storage conditions of biomaterial on the results of biochemical studies; the dynamics of myoglobin content in determining whether a victim was dead or alive at the time of injury, and how long ago the injury occurred; and the nature of ischemic myocardial damage. The possibility of using substances of low and medium molecular weight in determining the cause of death was evaluated.

[Social deprivation of persons older than working age in terms of death causes which require forensic medical examination.]

The article analyzes structure of forensic medical research of persons older than working age and its change during period of improving social and economic situation in the country. Persons whose causes of death are determined by forensic medical examination are considered as a deviant group of people who did not adapt to changing socio-cultural conditions and to age changes. That was manifested in causes and circumstances of death (external causes, death at home without witnesses, death on street or in hospital without examination). The information on 72 324 forensic examinations of elderly residents in Nizhny Novgorod region for 2003-2017 was analyzed. It was done in terms of sex, living or not in the regional center and age groups (advanced: 60-74 years for men and 55-74 years for women, senile: 75-84 years, age of longevity: 85 years and older). It is shown that the size of the deviant group of retirees is increasing, and this increase is not a consequence only of the population aging. The contribution of loneliness to formation of the deviant group exceeds the contribution of socioeconomic disadvantages: no correlation was found between the frequency of forensic examinations and the mortality from causes related to alcohol; from 2003 to 2017, the share of external death causes and the proportion of corpses taken for examination from street are decreasing. The structure of external and somatic death causes of persons older than working age established during forensic medical research is determined by age, place of residence as well as social and economic situations in the region, changing for the period studied in direction of reducing differences.

[The analysis of the low and medium molecular weight substances for differential diagnostics of deaths from acute small-focal myocardial infarction and other forms of cardiac pathology]. / Analiz veshchestv nizkoi i srednei molekuliarnoi massy dlia differentsial'noi diagnostiki smerti v rezul'tate ostrogo melkoochagovogo infarkta miokarda i drugikh form patologii serdtsa.

The objective of the present study was to analyze the possibilities for the use of the low and medium molecular weight substances for differential diagnostics of deaths from acute small-focal myocardial infarction and other forms of cardiac pathology. We determined the amount of the low and medium molecular weight substances in the urine obtained from the subjects who had died as a result of chronic coronary heart disease, acute myocardial infarction, and alcoholic cardiomyopathy. The levels of the low and medium molecular weight substances in the urine were measured by the method of N.Ya. Malakhov in the modification of T.V. Kopytova [5]. The study has demonstrated the appearance of the products of cardiomyocyte degradation (giving rise to a peak at a wavelength of 278 nm) in the fraction of the low and medium molecular weight substances of the urine from the patients suffering from acute small-focal myocardial infarction and some other forms of cardiac pathology.

[Determination of the blood myoglobin levels for the purpose of forensic medical expertise: the methodological peculiarities and the prospects for the further use]. / Opredelenie soderzhaniya mioglobina v krovi v sudebno-meditsinskoi praktike: metodicheskie osobennosti i perspektivy.

The objective of the present work was to study the dependence of the blood myoglobin levels on the time of death, gender, and age of the subject, methods employed to analyze this protein, and the duration of storage of the biological materials after autopsy. Myoglobin levels were measured in cadaveric blood of the subjects who had died as a result of acute cardiovascular insufficiency and chronic coronary heart disease in the passive hemagglutination reaction with the use of the erythrocyte diagnosticum and in the immunoturbodimetric test combined with the fixed time method. It was shown that the blood myoglobin level depends on prescription of death coming, duration of storage of the biological materials, age and sex of the deceased subject. It is concluded that the immunoturbodimetric method is characterized by the higher accuracy and better reproducibility than the passive hemagglutination reaction with the use of the erythrocyte diagnosticum.

[The application of the methods for the measurement of tissue pressure during the comprehensive evaluation of the state of cadaveric tissues for the purpose of forensic medical expertise].

The present paper reports the results of the application of measurements of cadaveric tissue pressure (CTP) in forensic medical thanatology for the determination of the initial position of the corpse and the identification of the visually undetectable bleeding sites on the scalp during examination at the place of its discovery. Moreover, the study of the tissue pressure parameters in the affected tissues may be used to determine the intravitality of the injury and dynamics of its prescription. The parameters of intra-organ tissue pressure suggest its dependence not only on the prescription of the death and manifestations of the postmortem processes but also on the character and extent of the pathological process in the tissues of the organ of interest; these findings can be used for the verification of various diagnostic procedures including those for the objective elucidation of the cause of the death. It is concluded that the investigations along these lines extend the possibilities for the use of quantitative parameters of CTP for the substantiation of expert conclusions based on the results of forensic medical examination.

[On the determination of the age of the unidentified corpses].

The objective of the present study was to determine the age of the unidentified corpses based on the investigation of the structure (wall width) of proximal epiphysis of the humeral bone. The results of analysis of the ongoing identification studies suggest the necessity of the development of the new methods for the determination of the human age including those based on the quantitative structural criteria for the long tubular bones. The original method proposed by the authors envisages the preparation of the stains from the frontal sawcuts of the humeral bone on the paper with the identification of the parameters of interest and calculation of the morphometric coefficients (MC). The significant differences in these coefficients suggest the possibility of using the proposed method for the purpose of identification expertise.

[On the mechanisms of formation of the serum structural macroportrait in subjects suffering fatal intoxication with narcotic and potent substances].

Intoxication with narcotic and potent substances was shown to lead to the development of specific features in the serum structural macroportrait. Peculiarities of profiles of low and high molecular weight substances and acoustic-mechanical impedance parameters in blood serum were identified in subjects with drug poisoning. It is demonstrated that streaking pattern in the central zone of a dehydrated serum droplet described in an earlier study of subjects suffering intoxication with narcotic and potent substances result from structural decomposition of immunoglobulins under effect of oxidative modification. The proposed technologies provide a basis for the development of a method for rapid determination of the presence or absence of intoxication with narcotic and potent substances.

[Application of the clinoid dehydration method in forensic medical expert examination of poisoning with narcotic and strong medicine preparations].

The method of clinoid dehydration of biological fluids along with pH measurement is shown to be suitable for the diagnosis of narcotic intoxication and poisoning with narcotic and potent agents. The data obtained by this and conventional methods are compared. Diagnostically significant signs of narcotic intoxication are deduced from the hemogram of a dry blood droplet and serum pH values.