[Age prediction based on the examination of bone tissue elemental composition using energy dispersive X-Ray spectroscopy]

THE AIM OF THE STUDY

Was to assess the possibility of using chemical analysis of bone mineral content by the means of an energy dispersive X-Ray spectroscopy to determine the age of unidentified corpses for forensic identification. A semi-quantative chemical microanalysis of bone fragments of 85 male and female corpses aged between 21 and 91 was done through the use of energy dispersive X-Ray spectrometer. The association of bone tissue apatite mineral composition with age is confirmed and a formula, connecting age and chemical composition change, is proposed. The possibility of using quantitive evaluation of chemical elements content in the normative mineral to determine the unidentified corpse's age in a standard laboratory, equipped with an energy dispersive X-Ray spectrometer, was proved.

[Morphofunctional cerebral changes associated with development of suicidal behavior]

THE AIM OF THE STUDY

Was to identify the cerebral areas, which demonstrate the most significant structural changes and damaged functional activity in patients with suicidal behavior. The original studies, presented in PubMed database, were used to analyze the literature. Additional literature in the form of atlases, review articles and publications, written in related spheres, was used to interpret the results. The study identified the 69 cerebral regions, demonstrating significant changes and the structures with the most significant deviations among them were selected. The regions of cerebral grey matter, in particular basal ganglia (structures of striatum and limbic system), as well as selected regions of cerebral cortex, specifically frontal, insularis, singulate and parietal mostly were included in the list. The decrease in grey matter volume, changes of neuronal and glial density, special patterns of activity and variations of functional association with other cerebral regions are described within mentioned structures. The literature review found that there was a lack of postmortem examinations in suicidal cases. Advanced study of the described structures is required in cases of completed suicide using new research methods.

[Forensic medical characteristic of hanging incidents among juvenile]

THE AIM OF THE STUDY

Was to conduct the epidemiological analysis of juveniles' deaths by hanging, registered in the Bureau of Forensic Medical Expertise, Moscow for 2017-2021 years. The number of incidents equal 61 was revealed (2.65% of whole hanging incidents for the researched period). The amount of hanging deaths among juveniles and their percent in the total quantity of deaths from this type of strangulated asphyxia increased in 2017, 2018 and 2019 years to 8 (1.6%), 15 (3.1%) and 18 (3.6%) incidents respectively; decreased in 2020 year to 7 (1.7%) incidents and increased again in 2021 year to 13 (3.0%) incidents. Juveniles died by hanging were mostly male (73.8%) aged from 15 to 18 years (63.9%). The median age for girls was 16 years (IQR 15.0-16.75) and for boys 15 years (IQR 13.0-16.5). Most of juveniles' corps were found in their place of residence: in apartments or residential houses (the whole number was 49 or 80.4%). Generally, juvenile hanging occurred between November and January (36.1% of all incidents) and in April (11.5%); less frequently were in February (1.6%), June and July (9.8%). Alcohol was found in blood of 18.2% juveniles aged from 15 to 18.

[Research and development of Sechenov University forensic medicine department within the program «Priority-2030» implementation]

A comprehensive analysis of research and development results of Sechenov University forensic medicine department for the last 5 years (from 2018 to 2022) was performed. The thematic structure and citation indices of scientific publications were presented. The most promising directions of the department's research activities were identified.

[Dissection technique for organs of the neck in hanging]

The aim of this study is to develop a comprehensive dissection technique to examine the deep structures of the neck in hanging, including extraction of the cervical spine and investigation of the removed segment with access to vertebral arteries and spinal cord. Its advantages include the unnecessity of any special instruments usage, the short period of time, which is necessary for performing dissection techniques, as well as the possible detailed examination of the spine, spinal cord and vertebral arteries. The improved dissection technique simplifies the diagnosis of injuries and increases the objectivity of the forensic medical examination in hanging.

[Age assessment using CT of knee joint and neural network technologies]

Age assessment of living persons plays an important role in clinical and sports medicine, as well as in law practice. Traditional methods have a number of problems: age restrictions, technical difficulties of visualization, low reproducibility and subjectivity of estimation. The proposed approach, which implies the use of multispiral computed tomography (MSCT) and database mining, will eliminate these drawbacks and improve the estimation of age. The aim of the study was to investigate the use of deep learning algorithms to classify the age groups (with a threshold level of 18 years) for CT images of knee joint. The study included 455 MSCT images of the knee joint of male and female subjects aged from 13 to 24. The method included score assessment of the distal femur's epiphyseal synostosis stages, tibia and fibula proximal epiphyses and a preliminary statistical analysis of correlations between age and stages of synostosis. The challenge of binary classification of target age groups with the use of convolutional neural networks was implemented at the second phase of the trial. Various architectures of convolutional neural networks and their ensembles were tested. The result of the study showed that the total score of epiphyseal synostosis has the highest correlation with the age (r=0.88). The proposed method of chronological age assessment on the basis of the knee area CT images research using deep learning algorithms demonstrated a good result. The classification accuracy (threshold level of 18 years) was 0.86.

[Mathematical modeling of the fracture along the length of the femur diaphysis]

THE AIM OF THE STUDY

Was to establish a pattern of femur diaphysis fracture with impact force over the entire front surface in an increments of 25 mm. Transverse, oblique and comminuted femur fractures were studied as a result of mathematical modeling. The application of mathematical modeling using the finite element analysis made it possible to visualize and predict the tension arising in the transient material during the impact force of blunt object, as well as the features of fractures' morphology in different sections of femur diaphysis. Modelled data about the mechanism and morphology of femur fracture were confirmed by the results of original full-scale experiments.

[Mathematical modeling using finite element analysis in forensic medical examination]

The purpose of the work is to develop methods of mathematical modeling using finite element analysis in forensic medical examination. The stages of the methodology for solving problems of deformable body mechanics in forensic medicine are considered, which allows to reliably establish the possibility of formation and morphology of damage under specific conditions and circumstances, to focus the researcher's attention on problem points when creating and evaluating the model. The use of simplified models of the human body makes the expert's conclusion more reasonable, which increases the confidence of law enforcement agencies in the activities of the forensic medical expert service and allows for a new look at solving the problems of forensic medicine and forensic medical examination.

[Professor Dmitry Egorovich Min - physician and poet]

Dmitry Egorovich Min is an outstanding pathologist, forensic physician and hygienist of the Russian Empire, a prominent public figure, professor and vice-rector of the Imperial Moscow University, an outstanding poet-translator and one of the founders of the Russian school of forensic medicine. This article discusses the biography of D.E. Min, his merits and accomplishments in labor and creative activity.

[Forensic medical assessment of lidocaine and bupivacaine systemic toxicity]

THE AIM OF THE STUDY

Was to assess the lidocaine and bupivacaine systemic toxicity in forensic medical practice. The number of patients' clinical observations equal three with local anesthetic systemic toxicity (LAST) from the practice of forensic medical experts were studied, and a search of scientific publications for the last 5 years in PubMed database was conducted. The amount of publications, describing cases with LAST, equal four were selected. Differential diagnostic features between LAST and anaphylaxis were considered. The literature data about relationship between lidocaine's concentration in the blood serum and clinical features are shown. The forensic medical assessment of LAST is proposed.

[Forensic medical assessment of venous thromboembolic complications of mechanical injury of the lower limb after surgery]

In forensic medical practice, venous thromboembolic complications (VTEC) are relatively rare, due to hereditary and acquired factors. The issue of expert evaluation of the VTEC after the performed surgical intervention as an alleged defect in medical care causes discussion. The purpose of this publication is to demonstrate an expert case in the assessment of VTEC mechanical injury of the lower limb after surgery. The above case with the development of PATE after surgery clearly demonstrates the possibility of the appearance of a «medical case». The key to the correct expert assessment of the alleged defect of medical care during the forensic medical examination is not only a thorough and scrupulous study of medical documentation, but also a qualitatively performed forensic medical examination of the corpse.

[Forensic medical diagnostics of age by the Cameriere method]

THE AIM OF THE STUDY

Was to conduct the comparative analysis of the age groups' separation accuracy (<18 years old; ≥18 years old) by orthopantomogram depending on the examination's side in Russian population sample. The number of orthopantomograms equal 600 (190 of male and 410 of female) aged from 14 to 23 were investigated. Index value of third molar (Im³) was calculated by the R. Cameriere method, in female and male, on the right and left sides. Index of third molar on the right and left sides shows a high correlation. In the male sample the result specificity was 0.97 on the left and 1.0 on the right, the sensitivity was 0.96 on the left and 0.94 on the right. In the female sample the values were as follows: the specificity was 0.96 on the left and 0.98 on the right, the sensitivity was 0.92 on the left and 0.94 on the right. The results showed the possibility of Im³ (0.08) use to determine the target age group for Russian citizens of both sexes regardless of examination side.

[Forensic medical characteristic of prevalence and structure of sudden juveniles' death in Moscow Region and St. Petersburg]

THE AIM OF THE STUDY

Was to compare the prevalence and structure of sudden death from cardiovascular diseases (CVD) in the structure of nonviolent death in Moscow Region as a representative of the large region and St. Petersburg as a city of federal importance. Frequency and structure of this parameter, as well as its dynamics were analyzed. The comparison of obtained results with data of Federal State Statistics Service was done. Nonparametric analysis of the initial data has been conducted. Clustering and visualization, based on the following parameters of initial sample, have been done: «death rate from CVD in the structure of nonviolent death», «morbidity rate», «incomes» and «unemployment rate». Correlation dependences between death rate from CVD according to the Form №42 and mentioned parameters of medical and social state of the subject have been determined. Dependences between sudden death rate from CDV and a number of medical and social parameters have been established.

Age-related changes in cationic compositions of human cranial base bone apatite measured by X-ray energy dispersive spectroscopy (EDS) coupled with scanning electron microscope (SEM)

One of the most common scientific methods to study the chemical composition of bone matter is energy-dispersive X-ray spectroscopy (EDS). However, interpretation of the data obtained can be quite complicated and require a thorough understanding of bone structure. This is especially important when evaluating subtle changes of chemical composition, including the age-related ones. The aim of current study is to create a method of processing the obtained data that can be utilized in clinical medicine and use it to evaluate the age evolution of bone chemical composition. To achieve this goal, an elemental composition of 62 samples of cadaver compact bone, taken from the skull base (age: Me = 57.5; 21/91(min/max); Q1 = 39.5, Q3 = 73.75), was studied with EDS. We used the original method to estimate the amount of Mg²⁺ cations. We detected and confirmed an increase of Mg²⁺ cation formula amount in the bone apatite, which characterizes age-related resorption rate. Analysis of cation estimated ratio in a normative bone hydroxylapatite showed an increase of Mg²⁺ amount (R = 0.43, p = 0.0005). Also, Ca weight fraction was shown to decrease with age (R = - 0.43, p = 0.0005), which in turn confirmed the age-dependent bone decalcification. In addition, electron probe microanalysis (EPMA) and X-ray diffraction analysis (XRD) were performed. EDS data confirmed the EPMA results (R = 0.76, p = 0.001). In conclusion, the proposed method can be used in forensic medicine and provide additional data to the known trends of decalcification and change of density and crystallinity of mineral bone matter.

[Forensic medical characteristics of the prevalence of sudden death from cardiovascular diseases in the constituent entities of the Russian Federation]

The purpose of the study is to study the prevalence and frequency of sudden death (SD) from cardiovascular diseases (CVD) in the structure of non-violent death, taking into account the socio-economic development of the constituent entities of the Russian Federation. We analyzed the frequency of this indicator, compared it with the data of the Federal State Statistics Service, and determined the overall dynamics. We conducted a non-parametric analysis of the initial data, carried out clustering and visualization based on the following parameters of the initial sample: «CVD mortality in the structure of non-violent death», «morbidity» and «per capita income level». Correlation dependences of the level of mortality from CVD according to the form 42 on the indicated indicators of the socio-economic condition of the subject were determined. Identified subjects of the Russian Federation with an increase in mortality from CVD; established the dependence of the level of VS on CVD and a number of medical and economic indicators.

[Morphofunctional characteristics of the heart in sudden death of children under 1 year of age in the forensic medical aspect]

The aim of this study is to describe the morphological and functional characteristics of the cardiac in sudden infants death syndrome (SIDS) in children under one year of age. Twenty eight cases of SIDS were studied histologically and immunohistochemically. Histological examination of the sectional material was carried out using standard and additional stains. The study of cardiac muscle tissue with routine staining with haematoxylin-eosin revealed interstitial oedema, uneven plethora of blood vessels: dystonia and weak plethora of part of the coronary arteries, excess of red blood cells in the veins as well as microcirculatory plethora with stasis of the erythrocytes. An immunohistochemical study revealed a mild over expression of p53 in cellular elements, small-focal expression of CD68 in cardiomyocytes apoptosis intramural areas, activation of mast cells (CD117), expression of ki-67 in macrophages, proliferation of fibroblasts. Additional forensic criteria for the diagnosis of SIDS were determined in the form of atrial endocardial fibrosis and interventricular septum; the expression of CD68, CD117 in fibroblasts, mast cells and lymphocytes; apoptosis of cardiomyocytes (expression of p53), proliferation of fibroblasts and remodeling of the heart (expression of ki-67).

[Microcirculation in fractures of long bones of the lower extremity]

The study objective was to investigate soft tissue microcirculation in the area of a lower limb long bone fracture. We studied fractures of the lower limb long bones from 0 to 7 days of age in 17 males and 37 females. The mean age of patients was 57.33±2.53 years. Histological examination of soft tissues from the area of the lower limb long bone fracture and at the distance from the fracture was performed. Standard hematoxylin and eosin staining was used. The thickness and diameter of arterioles, venules, and capillaries were evaluated by morphometry of the sections made. The observed pattern reflects the response of the microcirculation of the soft tissues to the mechanical impact. The relative ratio of the artery diameter to the small-caliber vein diameter was 1.01±0.13, and the artery wall thickness to the vein wall thickness was 2.03±0.28, which can be considered a natural reaction of the microcirculation blood vessels to the mechanical impact in 1-1.5 weeks after the formed fracture of the lower limb long bone.

[Forensic medical characteristics of the rate and structure of sudden death due to cardiovascular diseases in young residents of the Tula region]

The objective is to study the prevalence and rate of sudden death from cardiovascular diseases (CVD) in the structure of non-violent death in people under 35 in the Tula region as a representative of a small region of the Russian Federation. A comparison with the data of the Federal State Statistics Service was made. The overall trend was determined. A non-parametric analysis of the initial data, clustering and visualization were performed based on the following parameters of the initial sample: «mortality rate from cardiovascular diseases (CVD) in the structure of non-violent death,» «morbidity,» and «number of doctors in the region.» The correlation of mortality from CVD according to Form 42 and the specified indicators of the medical and social status of the region was determined. The relationship between the rate of CVD-related sudden death and specified medical and social indicators was established.

Forensic medical characteristics of firearm exit wounds in cases with armour protection

BACKGROUND

The very limited literature about the characteristic morphology of the firearm ammunition wounds in the body armored victims led authors to conduct an experimental study to understand this issue of great forensic and medico-legal importance.

PURPOSE

An autopsy of a male sniper was fraught with a challenge to differentiate between a firearm ammunition entry and exit wound. He was wearing body armour when shot at during a hostage rescue operation. The study was conducted to standardize the findings and answer the queries in such cases of forearms with inherent legal implications.

METHODOLOGY

The modifying effect of the clothing and the armour on the firearm injuries in humans was studied by test firings on animal (pig) cadaver tissues, which has closest simulation to the human body tissues. These firings were preceded by X-ray fluorescence, and followed by stereoscopic and spectroscopic examinations. All the events were recorded by the high-resolution video camera shoots.

RESULTS

An extensive cavitation in the form of a cone shaped crater, and a tissue defect with precipitated edges and patching of the epidermal layers indicated a firearm entry and exit wound, respectively, in victims wearing body armour at the time of the firearm injury.

[Sudden death in school-aged children at physical exercise: forensic diagnosis]

OBJECTIVE

Acomprehensive forensic study of cases of sudden death of school-age children during physical exertion and sports. Investigated 9 cases of sudden death of children aged 8 to 17 years that occurred during exercise. It was studied anthropometric indicators, histological and biochemical studies to identify changes in internal organs and the cardiovascular system. The forensic medical characteristics of sudden death cases of schoolchildren are given. Along with the constitutional features, the characteristic changes in some tissues and internal organs in particular the heart and blood vessels were determined. The data obtained make it possible to develop an algorithm and propose a methodological approach for diagnosing sudden death of school-age children. The results of the study can be used as additional forensic criteria for assessing the risk of sudden death of children during physical activity.

[The current state of the issue on explosive injury]

The review summarizes and systematizes the literature data characterizing the forensic medical aspects in the complex assessment of injuries received because of the impact of damaging factors of explosion in different peacetime conditions. The current state of forensic-medical examination of the explosive trauma is considered; the problems are revealed and the perspective directions in their solution are outlined. The analysis of publications on the issue of forensic examination of blast trauma injuries has shown that a more detailed characterization is given in the domestic literature than in the foreign one. Further study of this problem will make it possible to determine the formation laws of injuries received in explosive trauma, the distance from the epicenter of the explosion, the position of the victims and conditions of body trauma in confined spaces, as well as to refine the classification of explosive trauma depending on the conditions and circumstances of the explosion.

[The study of blood stains at the Department of Forensic Medicine of the Sechenov University over the period of its existence]

The historical analysis and the results of research activities of the Department of Forensic Medicine of the Sechenov University on the study of blood stains as important material evidence in forensic medicine and forensic science are presented. The personal contribution to the solution of this problem of outstanding forensic doctors whose life and work was associated with the department was noted.

[Comparative assessment of technical approaches to estimating the biological age of a person using chromatographic analysis of dentin]

The study of the amino acid composition of dentin is a new approach to determining the biological age of a person in Russia. Abroad, this method is more studied, but the authors in their research use various equipment and reagents, which makes it difficult to find the optimal technical standard for implementation in domestic practice. We studied the literature over the past 5 years on age estimation by the amino acid composition of dentin. The equipment used in the work and the results obtained were compared. A comparative evaluation of the data made it possible to make an assumption about gas chromatography using mass selective or flame ionization detectors as a method of choice for studying the amino acid composition of tooth dense tissues.

[Comparative epidemiology of thermal injury and hypothermia]

The paper presents the results of a comparative epidemiological study of thermal injury and fatal hypothermia based on the results of consolidated reports of the Bureau of Forensic Medicine of the Moscow Department of Health for 2017-2019. It was analyzed the archival material for three calendar years. It was used a continuous retrospective research method with an assessment of the general aggregate of the death incidence from thermal injury and hypothermia in Moscow in 2017-2019 by means of nonparametric statistical methods. Deaths from thermal injury and hypothermia are the most often accidents. The incidence of this type of death is characterized by ups and downs depending on the season. May, January and December are the most dangerous for burns. A similar pattern, with the exception of May, was noted for hypothermia. It was found that men aged 50-70 and women of 70-90 years old die most often. It was determined that most social characteristics (education, being married, etc.) alter the average age when deaths occur. The results obtained provide statistical justification for further more thorough study of thermal injury and hypothermia.

[Activities of the department of forensic medicine of Sechenov University during the great patriotic war]

The purpose of the work is a brief historical and medical analysis of activities of the Department of Forensic Medicine of First Moscow Medical Institute during the Great Patriotic War. The authors presented the scientific, practical and teaching activities of the department during war years. The staff of the department, headed by prof. V.F. Chervakov conducted research relevant to the current historical period. The system of training medical personnel was modernized several times in accordance with the needs of the time. The department successfully coped with all tasks in a military situation and laid the foundations for further development of domestic forensic medicine.

Morphometric Parameters of the Lung Tissue in Isolated Musculoskeletal Injuries under Conditions of Moderate Hyperhomocysteinemia

The combination of inherited and acquired factors of increased thrombosis complicates establishing the cause-effect relationships between mechanical injury and death during forensic medical examination. Morphometric parameters of the lung tissue and pulmonary vessels in isolated mechanical trauma under conditions of moderate hyperhomocysteinemia were studied in an experiment on laboratory animals. A regularity in changes of the morphometry parameters of the pulmonary vessels was found. Morphometric changes in the wall of pulmonary parenchyma veins can be used as an additional marker to assess the causal relationship between isolated mechanical injury and fatal complication in the form of pulmonary embolism.

Analysis of carpal bones on MR images for age estimation: First results of a new forensic approach

Current multifactorial age estimation methods are based on radiography, however, in the forensic field there is growing interest in using magnetic resonance imaging (MRI). With regard to the carpal region, MRI provides more information for defining the individual ossification nuclei and the cartilage surrounding single bones. During the phase of bone growth, the progressive reduction of the cartilage layer is accompanied by the development of a cartilage-bone interface. The aim of our study was to create a new model for age estimation, based on the ratio between the area occupied by the nucleus of ossification (NO) and the surface of growth (SG) of each carpal bone, the latter derived by adding NO to the area of cartilage-bone interface. We analyzed 57 MRI scans of Italian subjects aged between 12 and 20 years, without growth diseases, endocrine disorders or osteodystrophy. Measurements of NO and SG areas were extracted using ImageJ software, and the ratio between the NO and SG of each bone (NOSG) was calculated. A multiple linear regression model was used to estimate the individual's age as a function of the variables: gender and wrist bone measurements. The results showed that the best model was obtained with 6 predictors (nvmax=6): Gender, and the NOSG of the Trapezoid, Trapezium, Scaphoid, Pisiform, and Capitate. The median of the residuals (observed age minus predicted age) was -0.025 years, with an IQR of 0.19 years. Thus a new forensic approach to age assessment using MRI is introduced in this paper, which gives the preliminary results.

[Methodological basis for determining a person's age]

This paper presents a review of modern fundamental research studies investigating the age-related changes of connective, cartilage, nervous and bone tissues. A methodological and mathematical basis for the analysis of the obtained results is proposed. The conducted analysis enabled the formulation of a new scientific direction - the forensic medical determination of age in the identification of individuals in emergency situations with mass casualties. A scientifically grounded theory of digital forensic diagnostics of age, general regularities of development and some differences of age adaptation of connective, cartilage, nervous and bone tissues, including the phenomena of heterochronicity, heterotopy and heterogeneity resulted. The results of this research determine the direction of further research by improving the methods of quantitative age morphology, molecular autopsy, digital technologies and the formation of a technologically based concept for the registration of identifying biological features.

[Morphology of traces of large blood drops on a snow-covered surface with different bleeding source height]

Aim is to study morphology of the traces of a large drop of blood formed on snow-covered surface when it falls from different heights. In the experiment, we studied the morphology of blood drop traces fallen from 20, 50 and 100 cm on a just settled dry snow cover in a moderately frosty environment (-8 °C) Dropping from a height of up to 20 cm, a blood drop formed a cylindrical channel in the snow cover and spread out to form a disc-shaped element. However if the bleeding source was located at a 50 and 100 cm distance, an element close to a ball, consisting of blood crystals and ice was formed in the final section of the cylindrical channel. Morphology of the trace in freshly settled dry snow is due to the realization of the kinetic energy of a falling drop on the one hand, and the cooling of blood and crystallization on the other. Data obtained may be used to identify and describe traces of blood found on the scene in the street in the winter.

[Forensic diagnosis of sudden death of young people based on morphological analysis of the cardiac conduction system]

The aim of study was to develop a comprehensive assessment of the central and peripheral parts of the nervous system with a determination of degree of severity of alterative changes in comparison with the condition of myocardial contractile apparatus. Own observations on modern methods of morphological study of the cardiac conduction system in the sudden death of young people are presented. Particular attention is paid to the technique of isolating and coloring the nervous structures of sympathetic and parasympathetic parts of the autonomic nervous system, including the medulla oblongata, sinus-atrial and atrial-ventricular nodes, atrioventricular bundle (the His bundle), Purkinje fibers. The features of morphological changes in the nerve structures of the heart, due to various etiological factors are highlighted.

[Molecular genetic basis of sudden cardiac death in the young with cardiomyopathy of various origins]

This paper provides a review of the modern literature devoted to the problem of forensic medical interpretation of the molecular genetic research of the young who died suddenly. The authors attempted to draw a parallel between the morphological markers of different variants of cardiomyopathy as the most common disease in sudden death at a young age and the association with genetic mutations in the genes responsible for the synthesis of sarcomer proteins, desmos and membrane channels. Based on the results of the analysis, further research is proposed to improve the accuracy of forensic diagnosis in cases of young deaths.

[Morphofunctional vascular changes associated with sudden death in the young]

Diagnosis of sudden death in the young is based on the results of a set of research methods. Immunohistochemical, histochemical and histochemical methods are fundamental to the diagnosis of hidden forms of connective tissue pathology. These methods allow the sequence of initial and irreversible changes in connective tissue structures to be determined. The aim of this study was to determine the abnormalities of the vascular wall structure when using immunohistochemical and histological methods for the verification of congenital anomalies of various types of vessels, which expand the criteria for the diagnostic detection of individuals with connective tissue dysplasia. These investigation methods allow the diagnosis of hidden forms of congenital connective tissue pathology in the young. The main morphological signs of pathology of the aorta, carotid arteries, coronary and cerebral arteries are the disturbance of structural elements of the connective tissue.

[The sudden death among the young persons under effect of the different forms of physical loads]

The present review of the literature publications concerns the problem of sudden death (SD) among the young persons under effect of the different forms of physical loads. The statistical data on the frequency of sudden death are presented together with information about risk factors of SD, the morphological substrates and structural changes that promote death coming. The cases of sudden death among the young persons associated with the amateur sports activities and the professional sport of records are presented. The role of physical exercises and psycho-emotional stresses in the development of the terminal processes is considered with special reference to the risk factors and genetic predisposition to sudden cardiac death, largely among male athletes. The questions of sudden death in connection with cardiac pathologies as its main causes are discussed.

[Pathological changes in extra- and intracranial vessel in young adults in the aspect of sudden death]

AIM

To determine the main causes and pathomorphological characteristic of extra- and intracranial vessel pathological changes in young adults in the aspect of sudden death (SD).

MATERIAL AND METHODS

The authors investigated 10485 SD cases in young adults in the period from 2012 to 2016 (5 years) according to Moscow coroner bureau autopsy data. Morphological, chemical, histological, histochemical methods (staining with hematoxylin and eosin, van Gieson's stain, Masson's trichrome stain) were used.

RESULTS

Sudden death events of young adults are up to 11.93% of all non-violent death cases (81.18% of males, 18.81% - females). The mean age of the male group was 24.6, the female group 29.1. Intracranial vessel pathology was found in 549 cases (5%). Inborn aneurysms were identified as follows: arterial (69%), arteriovenous (26%) and arteriovenous malformations not diagnosed during lifetime (5%). In 14% of cases, ruptured aneurysms were combined with small extracranial ones on the convexital brain surface that show no signs of impairment. Histological investigation of aneurysms of any localization demonstrated the absence of multilayered vessel wall structure - elastic compartment with signs of disorganization, twists or total connective tissue replacement. In 93% of deaths caused by intracranial vessels rupture, the following signs of connective tissue dysplasia (CTD) were found: tall height, asthenic constitution, breastbone and cardiovascular pathology, mitral valve prolapse, aorta hypoplasia and so on. During the detailed vessel investigation in CTD group, a complex of pathological characteristics (total hypoplasia, wall thinning, S-form vertebro-basilar system vessels) was found.

CONCLUSION

CTD is a pathology that becomes a risk factor for intracranial aneurysms formation and rupture in case of severe physical activity or emotional stress. Hemorrhagic infarct or non-traumatic subarachnoidal hemorrhage development lead to SD in young adults. Prompt CTD markers identification will provide new possibilities to prevent SD of youth.

[Calculation of an individual's biological age with the use of the latest information technologies and construction of a promising intellectual hardware and software complex]

This paper demonstrates the need for an integrated approach to improve the accuracy of corpse age calculation based on measurements of a heterogeneous nature and conditions of partially distorted or incomplete data, using modern information intelligent technologies. A generalized algorithm developed on the basis of various mathematical methods of primary data processing and the extraction of different structures is presented, in addition to the reliability of the information.

[Analysis of dissertations on specialty 14.03.05 'Legal Medicine' (2015-2018)]

An analysis of the defended dissertations on the specialty 'Legal Medicine' for 2015-2018 is provided. The new Dissertation Council on the specialty 'Judicial Medicine' is presented.

[On the occasion of his 180th birthday anniversary of Ivan Ivanovich Neiding]

This article is devoted to the life and professional activities of the internationally renowned forensic doctor Ivan Ivanovich Neiding who became widely known in the early youth as the discoverer of the microscopic diagnostic features of the constriction marks formed in association with hanging and strangulation. During more than 22 years (from 1878 till 1900), I.I. Neiding acted as the head of the Department of Forensic medicine at the Moscow University where a large number of investigations on forensic medical ballistics, toxicology, obstetric and gynecological expertise were carried out under his supervision. At the time when I.I. Neiding headed the Department, the academic process was for the first time organized in the form of the specialized studies conducted by concrete specialists. Ivan Ivanovich Neiding himself was actively involved in the practical expert work and participated in the development of the procedural basis of the forensic medical expertise. In the hard times of political reaction, he managed to strengthen the role and position of the Department that was officially redesignated as the research institute.

[The forensic medical estimation of the biological age of the corpse based on the morphological changes in the skin]

The objective of the present work was the immunohistochemical evaluation of the age-related dynamics of apoptosis-associated proteins contained in the human skin epidermis. We studied the samples of skin tissues obtained during the forensic medical expertises of 100 corpses of the subjects who died in the consequence of acute blood loss in the absence of injuries or pathological changes in the skin (56 men and 44 women at the age varying from 5 to 85 years). The results of this study give evidence that the histoimmunological investigations of the skin tissues can be carried out with the use of the mmunohistochemical Ki67, bcl-2, and p53 markers for the more accurate determination of the biological age of the deceased subjects. The quantitative characteristics thus obtained serve as reliable indicators of the chronic changes in the skin and can be used as the components of the combined diagnostic procedures.

[The morphological characteristic of the cerebellar cortex in the case of a burning injury]

The objective of the present study was the development of the additional forensic medical criteria for the diagnostics of the intravitality and prescription of the burning injury making use of the morphological changes in the cerebellar cortex. A total of 82 cases of the death from the second- and third a, b-degree flame burns in 63 men and 19 women at the age from 20 to 65 years were available for the analysis. The condition of the cerebellar cortex was evaluated within 0 to 72 hours after the trauma had been inflicted. The routine histological staining technique using hematoxylin and eosin were employed as well as the Nisslin staining carried out in the combination with the immunohistochemical reaction based on the application of the antibodies against the glial fibrillary acidic protein (GFAP). In the case of death during the acute period after the burning injury, the histological study revealed a characteristic complex of the morphological features including the acute swelling of neurons, the increasing expansion of perivascular and pericellular spaces, as swell as hyperoxyphilia of microglia. The astrocytes of cortical II-III layers proved highly sensitive to tissue hypoxia as appears from their reaction with anti-GFAP antibodies. It is concluded that the results of the evaluation of the blood supply of the cerebral hemisphere cortex with the use of immunohistochemical methods may be helpful as the additional criteria for the purpose of forensic medical documentation of intravitality and prescription of the burning injury.

[On the occasion of the 200th birthday anniversary of D.E. Min]

This article is dedicated to the memory of the outstanding Russian forensic doctor and literary figure professor D.E. Min on the occasion of his 200^th birthday anniversary. The assignment of D.E. Min to the position of the head of Department of the State Medical Practice at the Emperor's Moscow University coincided with the large-scale judiciary reform carried out in the country at that time which envisaged, among other innovations, the practice of questioning of an expert in the court room. The new developments in the practical expert activities required the revision of the former approaches to the education and training of forensic medical experts. D.E. Min was the first to introduce the practice of public defense of expert judgements by the students of the Department as an indispensable component of their routine learning activities. He founded the museum of forensic medicine and pioneered the method for teaching the intravital forensic examination. D.E. Min initiated and supervised original research on mechanical asphyxia, forensic-medical toxicology, and traumatology. D.E. Min and his co-workers were frequently engaged by the agencies in charge of preliminary investigation to participate in forensic medical expertise associated with the inquiries into the most lurid criminal cases of those times. The scientist made the essential contribution to the development of forensic medicine in this country and the modernization of the academic process at the Department of the State Medical Practice that greatly promoted satisfaction of the basic requirements of practical forensic medical activities.

[Visualization of the reconstruction of a criminal event by means of 3D-modeling]

Forensic medical expertise carried out with a view to reconstruction of an event is a time-consuming procedure because it requires collection of a large amounts of various materials for the institution of a criminal investigation including physical evidence, photoboards of the site of an occurrence, etc. A forensic medical expert may encounter difficulties when reconstructing and scrutinizing the scene of action at a single computer monitor in order to analyze the behaviour of each participant of the event. Of great help in such situations are modern software programs allowing to visualize the site of an occurrence with a maximum approximation to reality, simulate the actions of the victim(s) and alleged offender(s), perform a large number of other forensic studies. The present article provides the practical examples illustrating the possibilities of reconstruction of various events with the use of the three-dimensional modeling based on the MicroSmith Poser and Agisoft PhotoScan software packages for clarifying various circumstances, facts, and conditions of special interest for the preliminary investigation and inquiries.

[The significance of student competitions for the development of motivation for education and the acquisition of professional competences in the students the Department of Forensic Medical Expertise of the Sechenovsky University]

Russia joined the Bologna process in 2003 and since that time has become integrated into the unified European educational space. The key element of the new form of the higher education process is the self-guided unsupervised work of the students. Motivation is needed to promote the involvement of the students in the educational process which implies the necessity of the goal-oriented initiative for the acquisition of professional knowledge and practical experience in the field of forensic medicine. To achieve this goal, the Department of Forensic Medicine of I.M. Sechenov First Moscow State Medical University places special emphasis on the experience with carrying out student competitions. Each such competition consists of several contests focused on the solution of a specific problem, e.g. the inspection of the place of occurrence under investigation with a gunshot or punctured-and-incised wound, forensic medical autopsy, problem studies, and intelligence tests. All the contests and problem studies are held in the form of an interactive game. The experience gained in the course of the student competitions gives practical evidence that the interdepartmental intelligence contests contribute to raising the interest of students in forensic medicine. The open competition provides a highly efficient tool for the popularization of scientific knowledge and the promotion of interest in the participation in the forensic medical research activities. Moreover, the student competitions facilitate formation of the earlier professional skills indispensable for team working and the development of abilities for making decisions under the extreme conditions. In addition, the contests teach the participants the art of public appearance. They improve the quality of vocational training in forensic medicine and help to establish the first professional contacts at the interinstitutional (including international) level.

[The synopsis of results of the 20 year activities of the Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University (Sechenovsky University)]

The present article was designed to summarize the results of the 20 year scientific, practical, and educational activities of the Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University (Sechenovsky University). The main directions of the research work and achievements of the Department's staff are described, and the prospects for its further development are highlighted. The new approaches to and technologies for the teaching and training specialists in forensic medicine are introduced to meet the novel requirements imposed in the framework of the ongoing reform of higher medical education in accordance with the main principles of the Bologna declaration.

[Forensic medical criteria for the evaluation of the unfavourable outcomes of the roentgeno-endovascular operations on the arteries of the lower extremities]

The objective of the present work was to develop the forensic medical criteria for the evaluation of the unfavourable outcomes of the roentgeno-endovascular operations (REVO) on the arteries of the lower extremities. The study included the analysis of the conclusions based on the results of the commission forensic medical examinations, attorney inquiry reports, query response, medical histories of the hospitalized patients who had undergone the roentgeno-endovascular operations on the arteries of the lower extremities. The criteria for the forensic medical evaluation of the unfavourable outcomes of the roentgeno-vascular operations on the arteries of the lower extremities have been proposed together with the indications for REVO, methods and tools for the performance of these surgical procedures. Particular attention was given to the identification of the signs and prognostics of the unfavourable outcomes of the roentgeno-endovascular operations (both intraoperatively and during the early postoperative period and the subsequent stay in the hospital) and to the risks of the development of the unfavourable outcomes of the surgical interventions following the technically adequate REVO. Special emphasis is placed on the cause-and-effect relationship between the actions or a failure to act on the part of an emergency physician and/or an attending surgeon/cardiovascular surgeon and the possibility of the unfavourable outcomes of the roentgeno-endovascular operations.

[The comprehensive evaluation of the age-specific changes in the skin]

The objective of the present study was to evaluate the age-specific changes in the skin at the anterior forearm surface of the men based on the results of the examination of 100 masculine corpses at the age varying from 18 to 80 years with the application of the low invasive techniques. The ultrasonograms were used to identify the qualitative characteristics of each skin layer being visualized with special reference to the thickness and echogenic properties of dermis and epidermis. The following parameters of the age-related changes in the skin microrelief were considered to be of particular interest: Volume (the volume of skin irregularities), SR (skin roughness), SW (skin wrinkling), and SS (skin smoothness). The qualitative characteristics of the age-specific changes in the skin as well as the parameters of its relief recorded during the ultrasound scanning can be used to comprehensively evaluate its age-related condition for the purpose of determination of the biological age of non-identified individuals. The calculation of the squared coefficient of correlation between the age-specific parameters of the skin and their changes taking into consideration the autosolvability requirements made it possible to predict the subject's age with a mean error of around 2.22 years.

[The comprehensive evaluation of the age-specific changes in the skin]

The objective of the present study was to evaluate the age-specific changes in the skin at the anterior forearm surface of the men based on the results of the examination of 100 masculine corpses at the age varying from 18 to 80 years with the application of the low invasive techniques. The ultrasonograms were used to identify the qualitative characteristics of each skin layer being visualized with special reference to the thickness and echogenic properties of dermis and epidermis. The following parameters of the age-related changes in the skin microrelief were considered to be of particular interest: Volume (the volume of skin irregularities), SR (skin roughness), SW (skin wrinkling), and SS (skin smoothness). The qualitative characteristics of the age-specific changes in the skin as well as the parameters of its relief recorded during the ultrasound scanning can be used to comprehensively evaluate its age-related condition for the purpose of determination of the biological age of non-identified individuals. The calculation of the squared coefficient of correlation between the age-specific parameters of the skin and their changes taking into consideration the autosolvability requirements made it possible to predict the subject's age with a mean error of around 2.22 years.

[The dynamics of the dimensional characteristics of the sella turcica in the subjects above 20 years of age]

The objective of the present study was to determine the biological age of the unidentified dead subjects based on the morphometric characteristics of the sella turcica in comparison with other methods available for the purpose in order to narrow the range of the alleged ages of the human remains being examined. The parameters of the sella turcica were measured in the corpses immediately after cephalotomy provided no pathological changes could be identified in the sellar region. A total of 86 skulls of the Caucasoid subjects representing the Eastern-Slavic group at the age varying from 22 to 87 years were available for the examination. The study has demonstrated the undulating dynamics of dimensional characteristics of the sellae turcica during the course of a lifetime. The regression analysis was employed to predict the age of the subjects above 22 years of age based on the measurements of the length and depth of the sella turcica and to classify the sample of interest within a given age period. It is concluded that the morphometric characteristics of the sells turcica can be used as the additional clues for the purpose of age determination in forensic medical investigations.

[The construction of the three-dimensional model of the damaged bone tissue based on its roentgenogram]

The objective of the present work was to develop the method for the visualization of the shape of the bone surface in the region of its traumatic damage based on the results of the analysis of a single X-ray image for the solution of the problems facing forensic medical expertise and traumatology. The three-dimensional models of the fractures of the long tubular bones constructed with the use of the visualization technique were shown to adequately reproduce the morphological picture of the injury. It allowed to enhance the potential of the forensic medical analysis and the accuracy of the diagnostic methods employed for the purposes of forensic medical expertise.

[The forensic medical characteristic of the age based on the results of the comprehensive examination of the thyroid cartilage]

The objective of the present study was the development of the diagnostic model for determining the human age based on the results of the comprehensive examination of the 230 thyroid cartilages (TC) obtained from the corpses of men and women of different age. TC were examined with the use of the anthropometric, X-ray, and histological methods. The anthropometric investigations confirmed the gender-related differences in the structure of human TC. Various characteristics of TC were shown to correlate with the age but these relationships were rather weak even if formally significant. The X-ray studies of TC have revealed the significant correlation of the relative amount of the bone tissue on the images with the age (r=0.8). Of the 27 parameters subjected to the morphometric evaluation, the following ones were shown to significantly correlates with the age: percentage of the bony (r=0,82) and cartilaginous (r=-0.8) tissue areas, average density of the adipose (r=0.76) and reticular (r=0.7) tissues, the maximum length of trabeculae (r=0.67), the width of the mature cartilage zone (r=0.54), the cortical plate thickness (r=0.5), and the mean number of immature chondrocytes in the field of vision (r=0.5). The comprehensive investigation into the structure of the human thyroid cartilage provided a basis for the development of the method for determining the human age with the use of the linear regression equations. It is concluded that the proposed method can be employed as an additional diagnostic tool for determining the human age for the purposes of forensic medical expertise and personality identification.

[Histometric symptoms of age-sensitive changes of bone tissue.]

The study presents the results of a complex histomorphometric research of the features of the age-related dynamics of bone tissue. As a study material we used samples of the distal epiphysis and diaphysis of the left tibia from 348 corpses of males with a known age from 0 to 90 years. A group of microosteometric features, that have the strongest correlation with age, is established in different age groups; their quantitative characteristics are given. It is clarified that the trends of age-related changes in the structural components of bone tissue correspond to the basic patterns of growth, remodeling, depend on the species and their localization. Conceptual positions of age involution of bone tissue are proposed.