The detection of metallic residues in skin stab wounds by means of SEM-EDS: A pilot study.

The morphological analysis of stab wounds may often not be accurate enough to link it with the type of wounding weapon, but a further evaluation may be performed with the search for metallic residues left during the contact between the instrument and the skin. In this study, Scanning Electron Microscopy-Energy Dispersive Spectroscopy (SEM-EDS) was applied to the study of cadaveric stab wounds performed with kitchen knives composed of iron, chromium and nickel, in order to verify the presence of metallic residues on the wound's edge. Two groups of 10 corpses were selected: group A, including victims of stab wounds and a control group B (died of natural causes). Samplings were performed on the lesions and in intact areas of group A, whereas in group B sampling were performed in non-exposed intact skin. Samples were then analysed with optical microscopy and SEM-EDS. In group A, optical microscopic analysis showed the presence of vital haemorrhagic infiltration, while SEM-EDS showed evidence of microscopic metal traces, isolated or clustered, consisting of iron, chromium and nickel. Moreover, in two cases organic residues of calcium and phosphate were detected, as a probable sign of bone lesion. Control samples (group A in intact areas and group B), were negative for the search of exogenous material to optical microscopy and SEM-EDS. The results show the utility and possible application of the SEM-EDS in theidentification of metallic residues from sharp weapons on the skin.

The Adult Male Rape Victim: Forensic Description of a Series of 57 Cases.

A retrospective analysis on 57 adult male victims of sexual violence has been performed. Age, nationality and anamnesis of the victims, location of the assault, type of violence, number and identity of the assailants, presence of physical injuries, lapse of time between the assault and the request of medical assistance, and toxicological and semen detection tests were analyzed. Victims were mostly in the 31- to 40-year age group. Ten victims referred themselves as either active homosexuals or bisexuals. Forced oral and/or anal penetration was registered in 86.8% of cases, mostly performed by a single assailant. Anogenital injuries were recorded in 61.4% of cases, whereas extragenital injuries in 35.1%: abrasions and perianal reddening were the most frequent acute anogenital marks, whereas the head and lower limbs were the body parts most commonly affected by blunt trauma. No clinically severe injuries were found. Anal and perianal swabs for semen detection tested positive in less than 20% cases, whereas oral swabs always tested negative. When performed, nearly 50% of cases tested positive in drug tests, above all for psychoactive substances. No definite forensic diagnosis in terms of confirmation of rape was possible on the basis of type and topography of injuries.

Lethal Bochdalek hernia in a three-year-old: pathological findings and medicolegal investigation in accusation of malpractice.

Diaphragmatic hernias can be a pitfall for paediatric diagnostics, especially in the cases of late presentation, which can also have medico-legal ramifications as exposed. A three-year-old boy was taken to a children's hospital after an episode of abdominal pain and vomiting of food. A physical examination proved normal, with mild ketonuria being found and he was discharged. Three months later for the same signs and symptoms, he was taken once more to hospital, where he arrived in a state of cardiac arrest and died. A lawsuit was begun against the doctors who had examined him three months earlier. The autopsy found herniation of the abdominal organs into the left pleural cavity through a defect in the left hemidiaphragm. The cause of death was identified as cardiac tamponade caused by mechanical compression of multiple herniated abdominal organs. The histopathological examination revealed marked atelectasis of the left lung, with non-expansion of 60-90% of the alveoli which suggested an acute mechanism that proved fatal, and the doctors were acquitted. The features of this disease and the possible difficulties in its diagnosis highlight the need for the utmost attention in differential diagnosis, even at an age where the discovery of a diaphragmatic hernia is exceedingly rare.

Analysis of 16 years of homicides and suicides involving the use of weapons recorded at the Milan Medicolegal Bureau.

The criminal use of weapons is a very topical issue in the industrialized countries and worldwide, and a reconsideration of the legislation governing their possession is warranted. We retrospectively analyzed the homicides and suicides involving the use of firearms and piercing and/or cutting weapons recorded at the Medicolegal Bureau in Milan from January 1, 1993, to December 31, 2008. First we considered the clinical histories of the deceased and the circumstantial details of their deaths, then we examined the data relating to the cause of death recorded in the autopsy reports. Our case series consisted of 414 homicides (54.2%) and 350 suicides (45.8%). Firearms were responsible for more deaths (64%) than piercing and/or cutting weapons (36%). The firearms involved were legally licensed in 40% of cases (suicides) and illegal in 22% (homicides). Our findings suggest the need to review the criteria considered for the issue of firearms licenses, in Italy at least.

Death by complete decapitation of motorcyclist wearing full face helmet: case report.

We describe a case of complete decapitation following a motorcycle accident in which the victim was wearing a full face helmet. A young man lost control of his motorcycle and was thrown about 20 m, hitting his head against the barrier separating a tramline from the road. The resulting trauma caused his decapitation, the only fatal wound ascertained by the various forensic investigations. The authors present this rare case and compare it against the other two cases reported in the literature, providing some observations on the ways in which this injury can come about. The absence of abrasions or signs that the wound edges came into contact with a metal structure, the presence of signs of impact on the side of the helmet and the finding of a transversal fracture at the base of the skull point to the violent action of a side-to-side opposite force, due to the resistance provided by the lower edge of the protective helmet.

Release of metals from osteosynthesis implants as a method for identification: post-autopsy histopathological and ultrastructural forensic study.

Metal structures--especially of stainless steel, titanium and their alloys (biomaterials)--are widely used in orthopaedic practice and the subject of constant study in bioengineering and preventive medicine. This study presents the first experience of forensic research into the presence of permanent tissue variations around metal implants in various bone structures for the purpose of identification, with particular reference to skeletal remains or severely decomposed corpses in the absence of other identifying elements. The evaluation was conducted on 12 corpses who had undergone osteosynthesis intra-vitam, whose implants were still in place or had been removed, in comparison with five controls who had never undergone osteosynthesis. Bone fragments taken during autopsy were subjected to histopathological and scanning electron microscope-energy dispersive electroscopy examination in order to reveal and characterise any metal particles originating from osteosynthesis. The study enabled the discovery of intra-bone metal particles in tissues treated by osteosynthesis even in bone areas where the implants had been removed and even where there were no longer any radiological signs of their application. These results are therefore of considerable forensic importance, especially in the area of identification, providing a valid means of recognition beyond that of the well-established use of in situ metal implants.

Train-related suicides in Milan, Italy: analysis of cases 1993-2008.

Evidence of the frequent use of mainline and metropolitan trains as a means of suicide in and around Milan prompted the authors to analyse the occurrence of this event between 1993 and 2008 in Milan, examining data from the Institute of Legal Medicine. The 155 selected cases were analysed for various aspects, including the chronology and dynamics of the event, the personal, epidemiological and psychiatric profile of the victims and the features of the injuries found during autopsy.