Ethanol concentration changes in blood samples during medium-term refrigerated storage.

OBJECTIVE: Stability of blood alcohol concentration (BAC) in laboratory samples is of great importance when it is necessary to perform repeated analyses. MATERIALS AND METHODS: We have analyzed the stability of BAC in 50 samples, which were taken from apprehended drivers, kept at -18ºC, without preserving agents. Quantitative analyses were performed using headspace sampling gas chromatography (HS-GC) with flame ionizing detection (FID). Samples were analyzed immediately after collection (C1), and after 60 (C60), 120 (C120) and 180 (C180) days. A group of 50 samples, which were kept closed for 180 days at -18ºC, was utilized as a control. RESULTS: We found a significant decrease in BAC between C1 and C180 (= 0.224; SD= 0.144; t = 10.98; p<0.001), and between C1 and C60, C60 and C120, C120 and C180. There was a significant positive correlation (r=0.8) between starting concentration C1, and the value of BAC changes (ΔC). Linear regression analysis (R2=0.64) implies the degree of validity to the proposed model of ΔC change regarding initial BAC. There were significant changes in ΔC between the two groups. CONCLUSIONS: These data underline the significance of air chamber percent (CA%) and ethanol evaporation due to ventilation between liquid and gas phase as a mechanism of ethanol decay.

HELLP syndrome as a cause of unexpected rapid maternal death--a case report and review of the literature.

Unexpected rapid death after delivery due to HELLP syndrome (HS) may become the subject of a forensic expertise. Since this syndrome is rarely encountered in forensic pathology, our objective was to point to some specific findings which might present forensic aspects of HS. These include unexpectedness, suddenness and fulminant course of this syndrome, which may confuse physicians, and on the other hand these characteristics cast doubt on violent injury, diagnostic oversights or iatrogenic injuries. Absence of classical signs of preeclampsia and non-specific clinical symptoms cause considerable differential diagnostic problems leading to a diagnostic delay or initial wrong non-obstetric diagnosis. A definitive postmortem diagnosis of HS in questionable cases of maternal death and consecutive forensic expertise of suspected medical malpractice should be based on accepted laboratory criteria and characteristic histopathological alterations.

"Cognac alibi" as a drunk-driving defense and medico-legal challenge.

Some drivers with positive forensic ethanol analyses, offer an explanation that they consumed alcohol a short time before a traffic accident or after driving. In medico legal practice this is commonly known as hip-flask defense, but to us as "cognac alibi" defense. In these cases, the lawyers require the medico legal experts to offer as much information as possible so that the court may come to the most reliable conclusions about the driver's blood alcohol concentration at the moment of the traffic accident (BAC(Acc)). At the Institute of Forensic Medicine our own analytical approach was established to study this medico legal problem. It consists of three inter-related phases in which it combines the obtained BAC values, with testimonies of the drunk driving suspect andalso witnesses. A specific algorithm was designed for calculating absorption and elimination of consumed alcohol. All the above-mentioned elements and blood-ethanol values calculated according to Widmark's method were inserted into appropriate cells of MS Excel software in order to calculate BAC in the function of time. The result is a relevant analysis of the drunk driving suspect's BAC in 5-minute intervals, as well as a graphic representation in chart form.

Brain trauma: cause-consequence connection problems.

Despite sophisticated equipment like computerized tomography, in some cases doctors have a problem with the diagnostic procedure in relation to patients with serious injuries of the central nervous system (CNS). There may be no clinical signs of disorders of the CNS, or other evidence of difficulties, but diffuse axonal lesions and demyelinisation processes often exist. This type of lesion is a special pathomorphological entity, known as the syndrome of patient who talks and dies. Macroscopical and microscopical findings are poor and rare, especially in the hours immediately following the injury. The main findings are not evidential and the problem is the explanation of sudden death from unknown causes. The following studies are based on human tissue analyses. They are based on the analyses of the CNS of patients who suffered from brain trauma. The specimens from the brain stem were taken in order to perform histological, microscopic analysis. Percentage value of surface of myelin for the control group was X1 38.62% for HE technique and X1 33.46% for Gomory's method. The value for the test group was X2 16.12% for HE technique and X2 13% for Gomory's technique. Statistical probability for both groups was 95% (P < 0.05; T = 14.9). Application of these procedures helps legal authorities to make trials more objective.

[Characteristics of persons killed by firearms and examined at the Institute of Forensic Medicine in Novi Sad 1989-1993]. / Karakteristike usmrcenih vatrenim oruzjem pregledanih u Zavodu za sudsku medicinu Novi Sad u periodu 1989-1993.

Gunshot wounds present an actual medical problem today. This research deals with a group of deceased persons murdered by firearms examined at the Institute of Forensic Medicine Novi Sad during the period 1989 - 1993 (402 persons). The analysis included sex and age structure as well as forensic medical categories connected to characteristics of gunshot wounds and wounds by explosion. Out of the total number of examined persons murdered during the analyzed period 11.92% of cases were deadly injured by firearms. There is an evident increase of those who die by firearms. During the same period of time correlations among homicides, suicides and accidents changed in favor of homicides. The average increase of homicides in 1991, 1992 and 1993 was 61.28% in regard to the average values of the first two years of the 5-year period.

[Digitalization of histological images as a method of quantifying the demyelinating process]. / Digitalizacija histoloske slike kao metoda za kvantifikaciju procesa demijelinizacije.

The basic aim of this paper was to check the hypothesis whether after head trauma the brain tissue looses myelinic membrane which surrounds the axon, and if this possibly established loss can be quantified, that is if it is possible to determine the degree of disintegration. One of the aims was to examine this method itself. The gathered results show that both the hypothesis and the aims were justified. It has been established that the diffuse axonal lesion in the examined samples reflects in a loss of axon's myelinic membrane. The loss was 50% greater in the test group in regard to the control group. To digitalize histologic pictures we have used Laser Scanner Densitometry Station and software by Biomed. In regard to medical jurisprudence, the laser scanner densitometry offers more relevant data in cases apparently unclear and in sudden deaths after head injuries. Application of this method and further investigations will be directed to further attempts to clear up connections between the mechanism of injury and degree of biologic response of the brain tissue.