Aconitum herbs contain several highly toxic diester-diterpenoid alkaloids, including aconitine, mesaconitine, and hypaconitine. However, finding the cause of death is rather difficult for forensic pathologists during forensic autopsy of aconitine-induced death. Therefore, the ability to determine Aconitum alkaloids is important in these cases. The aim of this study was to review the data for alkaloids in postmortem specimens from 25 aconitine-induced deaths received by the Academy of Forensic Science from 2005 to 2023. Aconitum alkaloids were analyzed using an LC-MS/MS method, which was validated for blood, urine, and liver tissue. Briefly, 0.5 mL (g) of biological sample was subjected to liquid-liquid extraction with diethyl ether at pH 9.2. In 25 aconitine-induced deaths, the blood levels of aconitine, mesaconitine, and hypaconitine were 2.9-470 ng/mL (n = 22), ＜LOQ-30 ng/mL (n = 10), and ＜LOQ-5.0 ng/mL (n = 10), respectively. In some cases, other biological samples (e.g., urine, gastric contents, and liver tissue) and the materials seized on site (e.g., homemade medicinal liquor) were also analyzed. A significant positive correlation was observed between the biological samples and the seized materials for the concentration ratios of aconitine to mesaconitine and of aconitine to hypaconitine. The risk of aconite poisoning is increased by inappropriate administration, including drinking of homemade medicinal liquors containing Aconitum alkaloids, the use of unprocessed or improperly processed Aconitum plant material, and excessive consumption or misuse without doctors' directions. Accidental death caused by misuse of herbal drugs was the main cause of death in the 25 aconitine-induced deaths studied here.

The postmortem identification of drowning in the field of forensic medicine is difficult due to unspecific autopsy findings, and usually, it is a "diagnosis of exclusion". A model of drowning in salt and fresh water was established to discuss the postmortem changes after drowning and the differences between saltwater drowning (SWD) and freshwater drowning (FWD). The organs (brain and 'lung) of 30 rats were extracted at three-time points (0 h, 24 h, and 48 h) after drowning. The histopathological, immunohistochemical,l, and molecular changes in the lung and brain of rats at different time points were investigated. Results show no significant difference in pathological findings between fresh and saltwater drowning. Casp3, JNK, and ERK all showed a rise in their postmortem expression in a time-dependent way; the expression of these three genes is much greater in cases of saltwater drowning compared to cases of freshwater drowning. So, it is concluded that after 24 h and 48 h from death, potent cellular oxidative stress occurred and caused the upregulation of the studied genes.

The focus is on unnatural death in forensic pathology including criminal death. One special field is the murder-suicide or homicide-suicide. It is a relatively rare occurrence worldwide mainly with male perpetrators and female victims. The authors report a case about a special type of homicide-suicide which is so-called intimate partner homicide (femicide)-suicide in which the victim was a 42-year-old woman with more than 55 incised- (cuts, stabs, etc.) and blunt force injuries with external examination. The resuscitation was unsuccessful by the paramedics. Not one of the wounds was incompatible with life, some of them had life-threatening conditions, and numerous self-defense type of wounds were observed. Not so far from the crime scene, the 48-year-old perpetrator's hanging corpse was found on a high voltage electric column who previously committed suicide, talked to one of his daughters from his first marriage, left money at his funeral, and asserted he would not have gone to prison again. The authors compared this case with the international literature data.

Using human cardiac blood from forensic autopsy cases, comprehensive measurements of albumin, vitamins A, B1, B6, B12, C, D, folate, and PIVKA-Ⅱ were performed. Of 128 cases, 83 were male, with an average age of 61.8 years and average postmortem interval of 44 h. The average concentrations of vitamins were 29.8 μg/dL for vitamin A, 32.2 μg/dL for vitamin B1, 278 ng/mL for vitamin B6 (pyridoxamine), 152 ng/mL for vitamin B6 (pyridoxal), 57.2 ng/mL for vitamin B6 (pyridoxal), 17.9 ng/mL for folate, 1188 pg/mL for vitamin B12, 23.5 μg/mL for vitamin C, 15.0 ng/mL for vitamin D, and 1.03 μg/mL for PIVKA-Ⅱ. An autopsy case of a Japanese middle-aged male with beriberi was also presented, where severe edema and effusion of the cavity and a high NT-proBNP serum value were observed; however, cardiac pathology showed no specific abnormal features. In the present case, the blood vitamin B1 concentration was within the standard clinical range. This study revealed that bloodborne water-soluble vitamin levels shows higher to clinical standard value at postmortem, whereas fat-soluble vitamin levels may stay in the standard range or lower. Our findings suggest that postmortem water-soluble vitamin concentrations within the clinical standard may reflect low antemortem vitamin concentrations.

This case presents a unique age estimation involving Chinese Tibetan twins, where one of them has been arrested for alleged rape. His parents claimed he was about 13 years old without providing any official age documentation. Since age is important in criminal proceedings in China, bone age estimation was conducted to determine the chronological age of the twins. The twins underwent a physical examination, X-rays of the left hand/wrist, and pelvis, and a CT scan of the clavicle. Two age estimation standards in China were used: "Skeletal Maturity and Assessment Methods of Hand and Wrist for Chinese" (China-05 standard), and "Technical Specifications for Skeletal Age Evaluation of Han Population Teenagers" (TSSHPT standard). The bone radiographs showed that most of the twins' epiphyseal development was similar, with only slight differences observed in the distal radius, distal ulna, and iliac crest apophysis. The results of the two methods showed differences in the range of predicted ages. Applying the RUS-CHN method to hand/wrist images, the estimated age of the suspect was determined to be 16-16.5 years old, while his brother's age was 15.5-16 years old. Applying the TSSHPT standard to all three images, the estimated age of the suspect was 17-17.5 years old, while his brother's age was estimated to be 16.5-17 years old. In this case, two commonly used methods for age estimation were introduced. The disparity in age estimations using the RUS-CHN and TSSHPT standards, with the age of the suspect ranging from 16 to 17.5 years. This case revealed that the choice of bone age estimation method can significantly impact the result of estimated age, which has important implications for legal proceedings. Additionally, the minor differences in skeletal maturity between the twins emphasize the need to account for individual variations, even among genetically similar individuals. Furthermore, this case contributes to the broader discourse on the effectiveness of skeletal age estimation methods across diverse populations, underscoring the necessity for tailored evaluation standards that consider genetic and environmental diversity.

A common forensic problem is cervical fractures, which sometimes need to be diagnosed only by physical examination of the body, without imaging or autopsy. Despite reports from clinical practice describing the association between cervical fractures and head injury, we could not find any analysis of autopsy cases. In addition, discussion of the cervical fracture diagnosis by postmortem computed tomography (PMCT) appears limited. This study aimed to examine autopsy and PMCT findings and explore valid methods for the diagnosis. We analyzed autopsy cases of cervical fractures during the 7 years before (2004-2010) and after (2014-2020) the PMCT introduction in our department. In 2014-2020, 67 autopsy cases with cervical fractures were recorded, of which 61 (91 %) were related to blunt injury to the head. Those with cervical fractures had a significantly higher incidence of blunt injury to the head (p < 0.001), particularly "forehead" and "face" injury, which accounted for > 50 % of cases. Of the external forces on the neck, "extension" accounted for 82.1 %. The cervical fracture-positive rate in all autopsy cases increased significantly from 11 (4.0 %) in 2004-2010 to 67 (8.2 %) in 2014-2020 (p = 0.021). From December 2015 to December 2020, when "cervical retroflexion" imaging was actively performed in PMCT, the cervical fracture diagnosis rate increased significantly from 57.1 % in the cervical normal position to 81.0 % with the addition of "cervical retroflexion" position (p = 0.021). Blunt head injury and PMCT in the "cervical retroflexion" position may be useful in the diagnosis of cervical fractures.

Owing to the unique inheritance pattern of the X chromosome, X-chromosomal short tandem repeat (X-STR) analysis represents a valuable tool in forensic DNA examination-particularly in complex kinship cases, missing person investigations, and disaster victim identification. We analyzed buccal swabs from 429 unrelated Korean males for forensic statistical parameters of 12 X-STRs. Among the 427 individuals analyzed (2 were excluded), DXS10135 was the most informative marker (polymorphism information content [PIC] = 0.9131) and DXS7423 the least informative (PIC = 0.4250). When analyzed based on the four linkage groups (LGs), each individual had unique 12 X-STR haplotypes, with LG1 showing the highest haplotype diversity (0.9968) and the most common haplotype frequency (0.0164). LG1 was also the most informative (PIC = 0.9945), followed by LG3, LG4, and LG2 (with haplotype diversities of 0.9882-0.9968). Our analysis shows that Koreans clustered with East Asians, displayed strong genetic similarity, but differed significantly from Emirati Arabs, Brazilians, Argentinians, and Europeans, forming three distinct clusters influenced by historical and geographical factors. Within the examined X-STR haplotypes, biallelic patterns were identified in two instances: one involved a duplication at DXS10146, as indicated by relative peak height and normalized peak height ratio analysis, and the other encompassed eight loci, where balanced peak heights (72.51 %) and an X peak height imbalance at the amelogenin locus (59.69 %) were indicative of Klinefelter syndrome with sex chromosome aneuploidy. The 12 X-STR loci are informative and discriminatory in the Korean population, providing critical insights for forensic applications and genetic research.

In the past several years, children and adolescents have increasingly been enticed into playing dangerous and challenging games, particularly through social networks. Epidemiological data regarding this phenomenon are particularly difficult to come by, as is information regarding the somatic and psychological consequences of these activities, which can end up having fatal outcomes. We here report the case of a suspicion of child abuse that turned out to be due to participation in a challenge game known as "The Deodorant Challenge" by a 10-year-old child who presented with burn-like lesions. Collaboration with the police and assessment of the psychopathological profile of the child allowed the self-inflicted nature of the injuries to be identified, thereby allowing intrafamilial abuse to be ruled out as the cause of the injuries.

The aim of this study was to estimate the legal age using the parameters obtained from radiomic analysis of the mandibular condyle in cone beam computed tomography (CBCT) images.

Human-bear conflicts are a growing concern globally, with Russia harboring a significant population of brown bears. This case report details a fatal encounter between a male hunter and a brown bear in the greater Khabarovsk region. On October 2015, the hunter's body was discovered approximately 400 m from a deceased brown bear, indicating a deadly confrontation. Forensic examination revealed extensive trauma and varied patterns of injuries, with the cause of death attributed to mixed shock from traumatic injuries and acute blood loss. Despite the limited dental information due to the missing maxilla, positive identification was achieved through the unique dental patterns in the victim's mandible. This study emphasizes the need for specialized forensic knowledge in wildlife-related fatalities, highlighting the importance of accurate post-mortem examinations and the critical role of dental data in positively identifying victims under challenging circumstances.

We aimed to evaluate the correlation between cadaver stature and mandibular bone measurements using three-dimensional (3D) computed tomography (CT) images and develop a stature estimation formula for a Japanese population. In total, 307 and 72 identified cadavers who underwent postmortem CT were selected as the "training" and "validation" datasets, respectively, to derive a stature estimation formula. Four mandibular bone measurements (linear distances between the bilateral mandibular condyles: C-C, from the mental spine to the mandibular condyle: S-C, between the bilateral mandibular foramen: F-F, and from the mental spine to the mandibular foramen: S-F) were obtained from 3D CT-reconstructed images that included only the mandibular bone. Correlations between stature and each of the mandibular bone measurements were assessed using Pearson product-moment correlation coefficients. Multiple stepwise regression analyses (including and excluding sex status) were performed using all measurements to develop the stature estimation formula, and its accuracy was validated. Significant correlations were observed between the mandibular bone measurements and stature. The correlation coefficients were 0.668, 0.699, 0.705, and 0.669 for C-C, S-C, F-F, and S-F, respectively. R was 0.660 and 0.615, and the standard error of estimation (SEE) was 6.13 and 6.53 cm for including and excluding sex status, respectively. The validation test confirmed its accuracy. In conclusion, mandibular bone measurements based on 3D CT images may be useful for stature estimation in Japanese individuals in forensic investigations, particularly in cases where better predictors, such as long bones, are unavailable.

Motor vehicle accidents (MVA) are the leading cause of death in childhood and young adult age. One of the most important factors behind MVA is driving under the influence of alcohol (DUIA) and drugs (DUID). The importance of DUID is rising together with the increasing drug abuse. The legal approaches to DUID are based on impairment, impairment per se or zero tolerance. In case of impairment, the negative effect of the substance on the driving abilities has to be proven by a forensic expert, which can be challenging. This study compares the medical signs registered during blood sampling with the concentrations of substances detected by toxicological examination to find medical signs indicative of impairment. Statistical analysis did not find a correlation between substance concentration and measured parameters (pupil diameter, blood pressure and pulse rate). No connection was found between substance concentrations and the appearance of medical signs. The results indicate that pupil dilation, heart rate, and blood pressure could not be used as indicators of possible driving impairment by drugs, and no medical sign could reliably indicate the driving impairment by substances other than ethanol.

Waterhouse-Friderichsen Syndrome (WFS) is a rare but life-threatening condition characterized by massive adrenal hemorrhage. WFS represents one of the features of the Overwhelming Post-Splenectomy Infection, which occurs any time after spleen removal and is recognized as the most serious complication in asplenic patients. We report a fatal case of WFS resulting from Streptococcus pneumoniae infection in a vaccinated and splenectomized patient. D.R., a 62-year-old man who had been splenectomized 20 years earlier following a traffic accident and had undergone Streptococcus Pneumoniae vaccination, had an acute febrile episode with chills at home, followed by vomiting. He died suddenly within 12 h of presentation. A multidisciplinary approach was adopted to resolve the case. Autopsy, histological, immunohistochemical, microbiological and toxicological examinations were performed. At autopsy, both adrenal glands presented increased volume and diffuse intraparenchimal hemorrhage. Postmortem bacteriological cultures of blood, cerebrospinal fluid and pericardial fluid showed S. pneumoniae, while serologic and molecular characterization demonstrated that the serotype responsible was serotype 23B, which was not included in the vaccination which D.R. underwent. Accordingly, the cause of death of D.R. was attributed to acute adrenal insufficiency due to Waterhouse-Friderichsen syndrome caused by Serotype 23B Streptococcus pneumoniae infection. In splenectomized patients with fever, accompanied by other nonspecific symptoms, the diagnosis of WFS should be considered, even if the subjects received the recommended vaccinations. The postmortem diagnosis of WFS requires a multidisciplinary approach, including macroscopic examination, histological analysis, and microbiologic investigations, so it is necessary to collect appropriate postmortem biological specimens for microbiological investigation.

Suicide by sodium nitrite poisoning (SNP) is not common. In the last decade, an increase in the number of suicides caused by SNP was observed.

In this case report, the role of a myocardial bridge of the left anterior descending artery (LAD) and recent use of cannabis in a sudden death of a drug user is discussed, also considering the relevance of histopathological pulmonary findings. A 37-year-old man with a history of drug abuse was found dead in his house. External and autoptic examination were performed, as well as histologic and toxicologic analyses of tissues, organs and body fluids samples. Autoptic examination revealed signs of previous endovenous drugs administration and a 0.5 cm deep intramyocardial bridging of a 1.5 cm long segment of the left anterior descending (LAD) artery. Histo-pathologic examination revealed the presence of diffuse alveolar hemorrhage and multiple alveolar macrophages containing brownish pigments. Toxicological analysis of post-mortem blood revealed recent use of ketamine (<0.5 ng/ml) and cannabis derivatives (8.8 ng/ml for THC and 2.2 ng/ml for 11-OH-THC) in a subject with a history of previous abuse of cocaine, MDMA, and ketamine, confirmed through hair analysis. The analysis of forensic literature, thoroughly examined in this paper, along with a comprehensive evaluation of all post-mortem data, indicates that cannabis likely contributed to the cause of death, in conjunction with myocardial bridging. This suggests a dual mechanism involving both cardiac and pulmonary factors. This case could add to the limited body of evidence in the literature and provide insights into the potential contributory role of cannabis in sudden deaths.

Subdural hematoma (SDH) is bleeding between the dura mater and the brain surface, often visualized as a crescent-shaped lesion on computed tomography (CT). However, some SDHs can appear as a biconvex hyperdense lesion mimicking an acute epidural hematoma. Encapsulated acute SDH (EASDH), a rare subtype characterized by a fresh hematoma within the subdural fibrous capsule, presents with similar CT findings. Herein, we describe an autopsy case of EASDH and discuss its etiology based on the case findings and available literature. The autopsy revealed a rupture of the bridging arteries as the SDH bleeding source, confirming the development of an acute-on-chronic spontaneous SDH. To our knowledge, this is the first autopsy report of EASDH and the third case of spontaneous SDH due to bridging-artery rupture.

This paper reports three rare cases of accidental sodium nitrite poisoning, including one fatality, caused by the consumption of aspic purchased from a private vendor. Clinical symptoms included cyanosis, hypotension, and respiratory distress, with methemoglobin (MetHb) levels ranging from 5 % to 41.7 %. Toxicological analysis, performed using gas chromatography coupled with a mass spectrometry in the negative chemical ionization mode (GC-NCI-MS), revealed nitrite concentrations in blood samples ranging from 4.2 to 44 µg/mL and nitrate concentrations from 36 to 256 µg/mL. Urine analysis in the fatal case showed nitrite levels exceeding 100 µg/mL. The patients received symptomatic and supportive care, and methylene blue administration was considered in cases with elevated MetHb levels. One patient died despite aggressive resuscitation efforts, highlighting the rapid progression of severe nitrite poisoning. Postmortem findings included characteristic chocolate-brown discoloration of the blood and brown organ tissues, indicative of methemoglobinemia. This study emphasizes the clinical and toxicological importance of early diagnosis and intervention in nitrite poisoning and discusses the medico-legal implications of such cases, including the forensic challenges in interpreting postmortem toxicology results.

Porcine eyes were examined using postmortem computed tomography (PMCT) under controlled postmortem time and temperature conditions to assess the mechanisms and timing of changes in ocular structure. Eight porcine heads were halved, and PMCT scans were conducted from postmortem interval (PMI) days 0 to 13. CT images were obtained to evaluate the vitreous volumes, vitreous CT values, axial lengths of the eyes, lens dislocation, and intraocular gas. The vitreous volume decreased over time, with the highest median rate of 17.7 % at PMI 1, followed by 12.0 %, 11.7 %, and 11.3 % at PMIs 6, 7, and 8, respectively. There was a significant decrease in the axial eye length from PMIs 0 to 1, while the transverse diameter remained unchanged. Lens dislocation was observed in all cases at PMI 9. Receiver operating characteristic analysis using the PMI as the predictive value for the presence of lens dislocation revealed a cutoff value of PMI 6, with an area under the curve of 0.98. Intraocular gas was observed in four cases. In two cases with intraocular gas, intravascular gas appeared to be continuous with the intraocular gas via the ciliary body. Lens dislocation occurred 6 days postmortem in porcine eyes at moderate temperatures. Intraocular gas was also observed 6 days postmortem, which may have been caused by the influx of intravascular gas into the eye via the ciliary body. These structural changes in the porcine model, may help in estimating the time of death.