Reverse engineering in forensic investigations: a new approach to bite mark analysis

The study of bite marks provides crucial elements that contribute towards identifying the biter. In many cases, it assumes importance when bite marks are detected on the body of a victim of violence, but it could also be relevant when the bite marks are seen on food substances at the crime scene. In both circumstances, comparing the bite marks with a suspect's dentition can be decisive in confirming or excluding the culpability. In this case report, a bun (bread roll) with the sign of a bite was found at the crime scene. We report a pilot study using 3D reproduction of the bite mark on the bun and dental models of the alleged biter and the victim. A reverse engineering process was used to obtain digital 3D models of the bitten bun and the dental models by taking numerous photographs and stitching them together using a software called Metashape by Agisoft. The last step was to compare the bitemark to the two dental models, evaluating the spatial distance, the degree of overlap, and the degree of interpenetration. The results confirmed the usefulness of reverse engineering in forensic investigations showing the compatibility between the victim's teeth and the bite mark on the bun.

Child abuse and neglect: oral and dental signs and the role of the dentist

Historically, the law, dental and forensic literature has included numerous articles concerning abused children. The orofacial structures are injured frequently in the maltreated child. Injuries of the neck, head, face, and oral cavity represent the most affected areas of the victim's body that routinely sustain physical trauma in child maltreatment cases. This literature review aimed to report the state of art of child abuse from the point of view of the dentist with focus on studies in dental aspects of child abuse and neglect of the last ten years. Considering the time slot, 20 papers were included with the following inclusion criteria: papers published in English, all keywords included in the title, articles available on PubMed. Many of the injuries are within the scope of dentistry or easily observed by the dental professional during routine dental treatment, and it is essential that the dentist recognizes them. Concerning neglect, it is appropriate to make a distinction between deliberate parental behavior that has the consequence of unavoidable and voluntary neglect towards their children and those conditions of involuntary carelessness determined by socio-economic and cultural factors such as family isolation, lack of finances, parental ignorance, or lack of perceived value of oral health. Therefore, it is relevant that the dentist pays attention to the cases to report and those that only need help.

Facial approximation for identification purposes: soft tissue thickness in a Caucasian population. Sex and age-related variations

The aim of this study was to collect soft tissue thickness (STT) values of an Italian population from 12 bone landmarks, to improve the facial approximation process for identification purposes. 100 Italian adults (50 males and 50 females), who had undergone head CT for clinical purposes, were analysed in order to expand the database of the Italian population. Average values, standard deviation and range were collected according to gender and age and the obtained values were statistically analysed in order to evaluate any possible significant difference. Only one landmark was statistically significant associated with sex, females showed significantly higher values for para-zygomaxillary. Two landmarks were statistically significant associated with age, upper incisor and pogonion. The obtained results were compared with the existing literature. Such information can be useful in the forensic craniofacial reconstruction process and can facilitate choosing the most suitable STT values according to osteological analysis of the human remains.

Heme Oxygenase-1/High Mobility Group Box 1 Pathway May Have a Possible Role in COVID-19 ARDS (Acute Respiratory Distress Syndrome): A Pilot Histological Study

COVID-19 is a pandemic disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The persistent and excessive inflammatory response can build up a clinical picture that is difficult to manage and potentially fatal. Potent activators of inflammatory phenomena are damage-associated molecular patterns (DAMPs) and, in particular, the high-mobility group box 1 (HMGB1). HMGB1 is an intranuclear protein that is either passively released during hypoxia-related necrosis or actively released by macrophages. Heme oxygenase (HO-1) has an anti-inflammatory effect by inhibiting HMGB1, which could be a therapeutic target to reduce COVID-19 inflammation. In our study, we evaluated CD3, CD4, CD8, HMGB1 and HO-1 in the COVID-19 lung and correlated it to clinical data.

Age estimation from dry bone measurements: evidence from a sample of soldiers exiled in two concentration camps in Bari

The mandible undergoes remodelling and morphological alterations throughout the life of an individual, and it is subjected to sex- and age-related structural changes. Personal identification from skeletal remains represents one of the most difficult challenges for a forensic anthropologist. The study of mandibular morphology is an important aid in determining the sex and age of skeletal remains. The objective of this study was to evaluate the age-related changes of three mandibular dimensions through dry bone measurements: bigonial width, ramus height and gonial angle. A total of 93 skeletal remains were included in this study, from a group of soldiers of Yugoslav origin who lived in two concentration camps in Bari (southern Italy) during World War II. These are included in the collection of the Forensic Anthropology Laboratory of the Institute of Forensic Medicine of Bari. The measurements were recorded after comprehensive examination by a forensic anthropologist and a forensic odonto-stomatologist. The data obtained were analysed statistically using a bivariate test and a multivariate linear regression model, using the Statal 13MP software. The results indicate that the bigonial width and gonial angle vary significantly according to age. In conclusion, this study confirms that the mandible is useful for age estimation in the identification of skeletal remains using these specific mandibular measurements when performed on dry bone without radiological distortion.

Methadone overdose in patients following methadone mainte- nance treatment:A three years overview in the district of Bari (South-Italy)

Background

Methadone maintenance treatment (MMT) is reco-gnized as a reference treatment for opioid dependence. According to Italian Law, at the beginning of the treatment patients must receive medication under the supervision of a physician, to avoid overdose. After a period of stability, patients could be allowed to take methadone at home in pre-arranged and personalized concentrations, in order to empower their self-responsibility. The aim of the present investigation is to underline the presence of a "glitch in the system" of the MMT.

Methods

In the last three years, 7 forensic autopsies and toxi-cological analysis on corpses of regular opioid users were performed into the Institute of Legal Medicine of Bari.

Conclusion

Therefor an improvement of the MMT's guideline is needed to reduce methadone overdose deaths in future.

Results

In all these cases very high methadone concentration in blood were found. All the 7 subjects were following a MMT in a Public Health Institute and the cause of death was respiratory depression by overdose of methadone in 6 cases.

Personal identification through digital photo superimposition of dental profile: a pilot study

The usefulness of teeth for personal identification lies mainly in their vast individual variability, making them virtually unique for every subject. Odontological identification represents a reliable and important complement to forensic inquiries, in particular in the event of unidentifiable human remains. However, this technique is based on the availability of ante-mortem records containing significant evidence. In the absence of dental records, the only available ante-mortem elements are often photographs. In the present study, dental profile photographs of selected smiling subjects were compared to the relevant plaster study models through digital image analysis. In order to ascertain the reliability of the technique, the comparison was carried out both in a homologous and heterologous manner with the Facecomp software. The results confirm the ability of Facecomp software to identify even the smallest variations in dental elements to reach a positive identification. The method is useful in forensic practice since a forensic inquiry may obtain plaster models from cadavers for comparison with photographs of missing people's anterior teeth.

The paleoradiology importance in the study of relics: the unique densitometric analysis of a bone relic of Saint Nicholas

INTRODUCTION

DXA have greatly contributed to the development of paleoradiology, a branch of diagnostic imaging that allows to obtain information about human remains in contexts of archaeological and/or forensic interest. In this manuscript we report the unique experience of DXA performed on the relic of a Saint; in particular we analyzed a skeletal fragment of St. Nicholas, kept in the Basilica of Bari (Italy) since 1087.

MATERIALS AND METHODS

The bone to be examined consisted of the posterior arch of the ninth left rib that was 12cm long, 1.2cm maximum width and 1.7cm thick at the body. The data acquired from the densitometric study were performed using the anthropometric measures reported in historical records of St. Nicholas' life: sex (male), age (75 years), weight (70kg), height (167cm), and ethnicity (Caucasian). In addition to the examination of the relic, a comparison assessment was made with the rib of a healthy 60 years old man (height of 170cm, without known skeletal pathologies). This sample had a length of 19cm, maximum width at the head 1cm, and 0.7cm thick at the body. The analysis of bone fragments is different from the analysis of bones in the context of the human body (where soft tissues are placed around the skeleton); for this reason, one of the most critical issues was to create a support that would allow the analysis of bone fragments. We simulated conditions similar to those occurring in patients: a density scale was established, using a specific plexiglass phantom on which the bone fragments to be examined were placed. From the analysis it was calculated the parameter bone mineral density (BMD), express in g/cm², that indicates the relation between mass of bone mineral content and area of examined bone segment. BMD data was compared to a range normalized by age, sex and ethnicity (BMD-N).

RESULTS

The results of the scannnig of St. Nicholas' rib showed a BMD of 0.97g/cm² with a BMD-N between 0.77 and 1.08g/cm². Simultaneous measurements of the relic compared with a reference rib showed highlighted BMD of 0.84g/cm² for the relic and 0.50g/cm² for the reference rib. The St. Nicholas data are 168% higher than reference bone. All our measurements of the relic indicated a high bone mineral density, most likely due to the presence of a high concentration of calcium salts. A relatively higher mineral density of the relic was seen compared to the healthy subject's rib. From the history of St Nicholas' life, we know of the long imprisonment at the age of 51 in damp and unhealthy environment. The results of this study suggest that a good bone mineral density was maintained by the Saint even in old age. An additional element that can influence bone mineral density is diet, certainly different during the time of St. Nicholas. The good bone densitometry indicates that the Saint maintained a proper diet, with a generally fair state of health.

CONCLUSION

For this first DXA analysis of the rib relic of Saint Nicholas was necessary a long and complex experimental work to modify standard technique procedure to particular and unusual sample and Create specific supports and complementary instruments. Perform DXA analysis on relics permit to obtain additional information to living conditions, economical situation, behaviours, diet, diseaes, conservations conditions of remains, change of life style in different age. Our experimental work, the first of its kind, creates the way to analyze precious relics that often include only few bone fragments and data obtained by our work can be useful for a better management and movement of fragile relics. We ourselves are working on a new challenge for the analysis of bone finds from shipwrecks found at the bottom of the sea.

A singular case of asphyxia by choking on a handkerchief: accidental event or suicide to "shut-up" spirits

Choking in adults can prove fatal, despite resuscitation attempts. The manner of death can be natural, homicide or accident. When a death is due to choking, one must consider what conditions contributed to or predisposed the person to choking (eg. alcohol, drugs and physical and mental impairments). Homicidal deaths by choking are relatively uncommon, being more frequently accidental. The diagnosis of death by choking is made at autopsy when the airway is found occluded. If the individual had an occluded airway and the object or food was removed during resuscitation, the only way to make the diagnosis would be on the history. Here, we present a case of asphyxia (accidental or suicidal) by choking on a handkerchief in a patient with a long history of schizophrenia. The woman had attempted a previous suicide driven by evil spirits coming from inside her body, especially from the head and throat; in order to "shut-up" the spirit, she was trying to suffocate it with her hands or by a belt from her pants.

Early childhood caries (ECC) and neglect in child care: analysis of an Italian sample

AIM

Dental caries was identified as the single most common chronic childhood disease; its prevention should be a priority for dentists. With the aim of describing the correlation between early childhood caries (ECC) and the phenomenon of child neglect, a questionnaire which recorded socio-economic and dental service use data was provided to a randomly chosen sample of parents at three pediatric health service centers in Bari (Italy).

MATERIALS AND METHODS

In order to evaluate the association among risk factors and ECC, contingency tables were created and the value of the Odds Ratio (OR) was calculated, indicating the confidence intervals and chi square values. A student's t-test for independent samples was performed to evaluate the differences between the averages. A value of p≤0.5 was considered to be significant for all tests used.

RESULTS

Of the 63 children examined, 61.9% (n=39; 95%CL=49.9- 73.9) presented with ECC, of which 47.6% (n=30; 95%CL=34.9-60.6) were classified as Wyne's Type I; 12.7% (n=8; 95%CL=5.6-23.5) were classified as Type II; and 1.6% (n=1; 95%CL=0-8.5) as Type III. Interestingly, the frequency of Types II and III were shown to be higher in low-income families (chi-square=8.50; p=0.03).

CONCLUSION

Dentists should recognize children's susceptibility to ECC and their exposure to risk factors for neglect, thus facilitating a primary prevention visit.

Reverse engineering techniques applied to a human skull, for CAD 3D reconstruction and physical replication by rapid prototyping

The production of a copy of an existing object of complex shape is one of the typical applications of the integration between two modern computer-based technologies, reverse engineering (RE) and rapid prototyping (RP). The method is extremely versatile and can be used in various applicative domains (e.g. replacement of anatomical parts with artificial prostheses, replication of skeletal remains). Two different acquisition techniques of images of a skull, by laser and by CT scan, were compared to ascertain which enabled more accurate reproduction of the original specimen. The skull was chosen due to it being the body part most often used in medico-legal investigations (for personal identification, skull-photo superimposition techniques, forensic art, etc). Comparison between the copy and the original yielded satisfactory results for both techniques. However, CT scanning demonstrated some advantages over the laser technique, as it provided a cleaner point cloud, enabling shorter pre-reproduction processing times, as well as data on the internal parts, which resulted in the reproduction of a more faithful copy.

Esthetics and implantology: medico-legal aspects

In recent years the high number of malpractice lawsuits in dentistry has attracted closer attention of dental practitioners to its medico-legal aspects. Implantology, in particular, presents many points of medico-legal concern connected with the difficulties inherent to dental procedures and objectives (both functional and esthetic), as well as full patient collaboration as an essential part of successful treatment. An accurate assessment of each case by the clinician is fundamental, especially in circumstances where esthetic considerations are preponderant as, for instance, in the frontal sectors. In such cases, the options of implantology or of a traditional fixed prosthesis need to be carefully weighed in light of the patient's anatomic condition. The patient should therefore receive complete information and be made fully aware of the risk of treatment failure, as well as possible complications, limits to the procedures, and the fact that successful outcome will also depend on her/his scrupulous observance of the practitioner's instructions. In short, the aim is to make the patient an active ''accomplice'' in treatment. To this end, the use of an extremely detailed information leaflet is strongly advised; after careful clarification of any doubts the patient may have, the patient's written informed consent should be obtained. Nevertheless, there is the risk that excessive intrusion of bureaucracy into medical procedures in defence of the practitioner against malpractice suits may hinder the principal aim of traditional medicine, i.e. to provide the best care for the patient through mutual trust fostered within the doctor-patient relationship.

The forensic entomologist in the context of the forensic pathologist's role

An adequate death investigation requires the combined efforts and cooperation of experts in different disciplines: crime scene technicians, death investigators, forensic pathologists, anthropologists, entomologists, other medical and non-medical professionals. These front-line experts play a crucial role in every death investigation process. The forensic pathologist normally has the legal authority to take charge of the dead body at a death scene and his primary functions are the exterior and interior examination of the cadaver by analyzing the extent of antemortem injuries and the postmortem changes and the recovery of physical evidence. He is responsible for determining how, when and why of any death which is the result of violence, suspicious or unexplained circumstances or a death which is sudden or unattended, defending and explaining the reasons for making these diagnoses in a courtroom. The forensic entomologist can provide invaluable aid in death cases where human remains are colonized by insects and in the overall investigation. His principal role is to identify the arthropods associated with such cases and to analyze entomological data for interpreting insect evidence. He is responsible for determining the period of insect activity according to all the variables affecting insect invasion of remains and their development. The major goal of medico-criminal entomology is to contribute to the determination of the time, cause, manner and place of the investigated death (especially on badly decomposed corpses or skeletonized human remains) with the support of all the elements which can be inferred from the study of insects found on the cadaver or nearby. The application of techniques devised recently in forensic entomology can allow experts in the field to collect strong entomological evidence and provide useful information not only in a death investigation including movement or storage of the remains following death, time of dismemberment, postmortem artifacts on the body but also at the scene, and even more in child neglect, sexual molestation and identification of suspects. As the role of the forensic entomologist at the death scene, at the autopsy and in the laboratory is defined and well known, this paper focuses on the difficulties that could arise if forensic pathologists and entomologists are uncertain about the procedures that they have to follow, do not realize the value of objective findings or fail to evaluate them. Although every forensic case presents a slightly different set of circumstances and has to be tackled individually, the forensic pathologist should work with the forensic entomologist from the visual observations of the cadaver on the scene, through the collection of arthropods and temperature data at the death scene and at the autopsy, up to the final report with the interpretation of entomological and other biological evidence.

Factors affecting decomposition and Diptera colonization

Understanding the process of corpse decomposition is basic to establishing the postmortem interval (PMI) in any death investigation even using insect evidence. The sequence of postmortem changes in soft tissues usually gives an idea of how long an individual has been dead. However, modification of the decomposition process can considerably alter the estimate of the time of death. A body after death is sometimes subject to depredation by various types of animals among which insects can have a predominant role in the breakdown of the corpse thus, accelerating the decomposition rate. The interference of the insect community in the decomposition process has been investigated by several experimental studies using animal models and very few contributions directly on cadavers. Several of the most frequent factors affecting PMI estimates such as temperature, burial depth and access of the body to insects are fully reviewed. On account of their activity and world wide distribution, Diptera are the insects of greatest forensic interest. The knowledge of factors inhibiting or favouring colonization and Diptera development is a necessary pre-requisite for estimating the PMI using entomological data.

Entomotoxicology

Entomotoxicology is a relatively new branch of forensic entomology. The potential use of insects for detecting drugs and other toxins in decomposing tissues has been widely demonstrated. In death investigations, Diptera and other arthropods can be reliable alternate specimens for toxicological analyses in the absence of tissues and fluids normally taken for such purposes. Entomotoxicology also investigates the effects caused by drugs and toxins on arthropod development in order to assist the forensic postmortem interval estimates. However, several remarks on the limitations of entomotoxicology have been highlighted recently. In this paper, the implications for the practice of this forensic procedure are fully reviewed.

Human and insect mitochondrial DNA analysis from maggots

During the course of our forensic investigations, we have encountered situations where it would have been useful to have evidence, other than direct contact between the two, for concluding that a carrion-fly maggot developed on a particular human victim. If a maggot collected during a death investigation did not develop on the victim, then its age is not relevant to estimating the postmortem interval. In this study we demonstrate that mitochondrial DNA (mtDNA) sequence data can be obtained from the dissected gut of a maggot that had fed on human tissue. These data can be used to identify both the human corpse upon which the maggot had been feeding and the species of the maggot itself.

Determination of postmortem interval from old skeletal remains by image analysis of luminol test results

The luminol test is routinely used in forensic serology to locate blood traces and identify blood stains not visible to the naked eye; its sensitivity is reported as ranging from 1:100,000 to 1:5,000,000. To evaluate the possibility of correlating the postmortem interval with blood remnants in bone tissue, the luminol test was performed on 80 femurs with a known time of death, grouped in five classes. Powdered bone (30 mg) was recovered from compact tissue of the mid-shaft of each femur and was treated with 0.1 mL of Luminol solution (Sirchie Finger Print Laboratories, Inc.). The reactions were observed in a dark room and filmed by a TV camera equipped with a recording tape. An intense chemiluminescence was observed after a few seconds in all 20 femurs with a PMI ranging from 1 month to 3 years. On the 20 femurs with a PMI ranging from 10-15 years, a clear chemiluminescence was visible with the naked eye in 80% of the sample. Among the 20 femurs with a PMI ranging from 25 to 35 years, a weaker chemiluminescence appeared in 7 femurs (33% of the sample). In the 10 femurs with a PMI ranging from 50 to 60 years, a faint reaction was observed only in a single femur. In none of the ten femurs with a PMI over 80 years was chemiluminescence observed. The image of each reaction was computerized and analyzed for gray scale. The results of image analysis show a possible quantitative relationship between the PMI and luminol chemiluminescence in powdered bone.

Sex determination by discriminant analysis of patella measurements

The authors have analyzed 80 skeletons (40 males and 40 females) from the collection at the Institute of Legal Medicine of the University of Bari belonging to a known contemporary Southern Italian population; time of death was around 1970 and ages ranged from 25 to 80 years. Seven measurements taken on 80 intact, undeformed right patellae (max height, max width, thickness, height and width of the external facies articularis, height and width of the internal facies articularis) were used to determine sex by multivariate discriminant analysis. One function associating two parameters (max width and thickness) obtained the highest value of correct sex determination with a rate of 83.3%; other functions showed a higher percentage of misclassification (up to 17.5%). This study tests the success rate of correct sex prediction based exclusively on patellar dimensions. The discriminant factors carried out by statistical analysis may aid the forensic anthropologist when no other human skeletal remains suitable for sex determination are available.

Using scapular measurements in regression formulae for the estimation of stature

There are very few papers in forensic literature in which scapular dimensions have been used for estimation of living stature. Allowing the forensic duty to estimate the living stature of skeletal remains, using intact or fragmented scapulae, the Authors have performed multiple regression analysis between the measurements taken from 80 scapula (40 male and 40 female) belonging to a skeletal collection with anthropometric known data. Seven parameters (max length, max breadth, max acrocoracoid distance, length of acromion, max length of coracoid, length of glenoid cavity, width of glenoid cavity) have been recorded. By statistical analysis multiple and linear regressions have been obtained. The results show that living stature may be determined by using regression formulae of single or associated parameters taken from whole or fragmented scapulae. In absence of intact or fragmented long limb bones, scapula sample can be reliably employed for the estimation of stature in forensic practice.

Three case studies in forensic entomology from southern Italy

Three cases of forensic interest regarding the estimation of postmortem interval (PMI) by entomological data are presented. The three cases concerning criminal investigations were performed in Southern Italy by the Entomological Laboratory of the Institute of Forensic Medicine at the University of Bari. For each case the authors present a detailed description of the remains as observed at the crime scene and a description of the arthropods collected from the remains. The PMI estimation was based on comparison of data from autopsy reports (rate of decay), local environmental conditions (temperature, humidity, rainfall) and development times for the immature stages of each species of local arthropod and succession patterns. The collection of insects was performed at the discovery site and during autopsy procedures. In the first case a PMI of 5 to 8 days was established based on the presence of adult specimens of Saprinus aeneus (family Histeridae), and mature larvae of Chrysomya albiceps and Sarcophaga carnaria (3rd instar). In the second case, on the charred remains of a corpse, larvae of Sarcophaga haemorrhoidalis (3rd instar) and Protophormia terraenovae (2nd instar) were observed in different developmental stages, as indicated, giving a PMI of 3 to 4 days based on entomological data. In the third case a PMI of 36 to 48 hours was defined from the evidence of Calliphora vicina 2nd instar on the two burnt bodies. In all cases the entomological evidence alone led to conclusions on PMI.

Sex determination by discriminant analysis of calcanei measurements

Eight measurements taken on the right calcaneus (maximum length, load arm width, minimum width, height of calcaneus, body height, breadth of the facies articularis talaris posterior, breadth and height of the facies articularis cuboidea) of a known contemporary Southern Italian skeletal population (40 males and 40 females) were used to determine sex by multivariate discriminant analysis. Three functions revealed a correct sex-determination of 85%. These functions were obtained by the association of the following parameters: maximum length, load arm width and breadth of the facies art. talaris post. (function no. 1); maximum length and breadth of the facies art. talaris post. (function no. 2); maximum length and height of the facies art. cuboidea and breadth of the facies art. cuboidea (function no. 3). These results may aid the forensic anthropologist when no other remains, useful for skeletal sex determination, are available.

Skeletal sex determination by scapular measurements

Measurements of seven scapular parameters (max. length, max. breadth, max. distance acromion-coracoid, max. length of acromion, max. length of coracoid, length and breadth of glenoid cavity), taken from a known contemporary Italian (Apulian) skeletal population were analyzed to obtain sex determination by discriminant analysis. In the univariate analysis, the maximum scapular breadth shows the best discriminant attitude with lowest percentage of misclassification (8.75%). In the multivariate discriminant analysis it's possible to have a 95% correct sex determination using only three parameters (max. distance acromion-coracoid, maximum length of coracoid and length of glenoid cavity). The association of two measurements of glenoid cavity allows the determination of skeletal sex with 10% misclassification rate. The application of these measurements can therefore be considered quite useful in forensic investigation when just fragmented scapular remains are recovered.

[Determination of height from tibia fragments]

In a study involving the skeletal identification of stature, the Authors have performed multiple regression analysis between the measurements taken from 80 tibias (40 male and 40 female) and the living stature of the subjects to whom the tibias belonged to in life. The goal was to allow the forensic investigator to estimate the living stature by integral tibias or fragments just using association or single tibial measurements. The regression equations obtained allow to estimate living stature from different associations of well defined segments of tibia. This is a useful aid in forensic investigations, where it may be necessary to ascertain the individual's height during his/her life from isolated fragmented or mixed skeletal remains.

[Determination of skeletal sex using discriminant analysis of ulnar measurements]

Twelve ulnar measurements take on a series of 80 skeletons (40 male, 40 female) of a known Southern Italian population have been used in 9 combinations to produce discriminant functions for skeletal sex determination. The highest percentage of correct sex classification (95%) was obtained by the association of the minimum circumference and the maximal length. Using other four discriminant functions sex is correctly identified in 93.75% of the sample; in addition two of these functions, obtained by the associations of: minimum circumference and distal epiphyseal breadth, height of proximal articular surface, superior breadth and corio-olecranic distance, allowed to have a sex determination even by fragmented ulnae. For each discriminant function proposed, coefficients of discrimination, section points, male and female centroid and the percentage of misclassification are reported. Practical applications of this method will be certainly of aid in sexual identification in case of forensic interest.

[Sexual dimorphism of deciduous teeth in medico-legal identification]

Sexual identification of immature skeletal remains is still a difficult problem to solve in Forensic Anthropology. For this reason we have attempted to use sexual dimorphism of deciduous teeth. Mesial-distal and vestibular-palatal crown diameters of maxillary deciduous molars were obtained from 80 (40 male, 40 female) Apulian (southern Italian) children with age included from 3 to 11. In addition, for each tooth, three dental indexes were calculated from crown measurements. Data, so obtained, were separately analyzed using discriminant functions. The results revealed that the combinations of crown diameters were not able to give significant functions for "sexing" immature skeletal remains. Only specific combinations of dental indexes gave significant results. The best function, obtained by the association of crown index of 54, 55, 65 and crown module of 64, allow correct sex determination of prepuberal human skeleton with a misclassification of 20%.

[Determination of height in life using multiple regression of skull parameters]

The Authors have evaluated the possible correlations between cranial diameters and height in a population of 358 young males aged between 17 to 27 years old. The maximum anterior-posterior and lateral cranial diameters were measured along with stature. Then, the data was correlated using the SAS Program (Stepwise method) to obtain a multiple linear regression between height (dependent variable) and the cranial diameters (independent variable). Secondly, the Authors also studied the probable correlation between height and cranial diameters obtained without including the thickness of the soft tissues. In conclusion, they proposed a mathematical formula, applicable in forensic investigation, regarding the determination of the actual living stature of subjects for whom skills are the only skeletal remains available for identification procedures.

Clinical spectrum of accidental hemlock poisoning: neurotoxic manifestations, rhabdomyolysis and acute tubular necrosis

In the past, hemlock poisoning was only known for its neurotoxic effects; quite recently non-neurological features, consisting of rhabdomyolysis and acute renal failure, have been also described. Here we report our experience with these clinical findings, which we frequently observe in accidental hemlock poisoning. Between 1972 and 1990 we studied 18 patients: 17 of them were poisoned by conline (an alkaloid of Conium maculatim) in Apulia (Italy), and one by cicutoxin (the active principle of water hemlock) in New Mexico (USA). In the non-rapidly-fatal cases we tested myoglobinuria, serum muscle enzymes, and renal function. In the patients with acute renal failure we performed microscopical examination of kidney specimens; immunohistochemistry was carried out to identify myoglobin and actin in tubules. Coniine was detected in urine, serum, or tissues. Neurological features were present in all of our cases: coniine had a curare-like effect on the neuromuscular junction, whereas cicutoxin was convulsant on the central nervous system. In addition rhabdomyolysis was noted in the 17 subjects poisoned by coniine. Acute renal failure was observed in five patients; it was confirmed by histological evidence of tubular necrosis with intratubular deposition of myoglobin and actin released by rhabdomyolysis. Our cases seem to be the first with histopathologically proven acute tubular necrosis in coniine intoxication. In conclusion, in hemlock poisoning neurotoxic manifestations may be accompanied by rhabdomyolysis and acute tubular necrosis; increased awareness of these clinical features is recommended in order to improve the diagnostic and therapeutic procedure.

Sarcosaprophagous fly activity in Maryland

Eighty-six successful rearings of sarcosaprophagous flies characteristic of the first successional insect wave of infestation of a corpse were conducted under field conditions in Maryland. Different species were observed to be active during spring and summer. The development times for the immature stages of each species, with the related temperatures at which the development occurred are reported for both seasons studied.

Opiate analysis in cadaveric blowfly larvae as an indicator of narcotic intoxication

Specimens of liver were collected from 40 cases in which the cause of death had been determined to be opiate intoxication. Rearings of Calliphora vicina larvae were then promoted on the decomposing liver. A control group of 10 decomposed liver specimens from non-opiate deaths was treated similarly. Analysis of larvae and liver for opiates (morphine) was conducted by radioimmunoassay. Good qualitative and quantitative correlation was observed in both the positive and negative groups. Regression analysis comparing the concentrations of opiates found in the larvae with those found in the liver in the positive group resulted in a correlation of r = 0.790.

Suicide from multiple gunshot wounds

Nine cases of multiple-shot suicides (suicides involving more than two gunshot wounds) examined in the last 6 years at the Office of the Chief Medical Examiner. State of Maryland, are reported. All victims, with the exception of one, were white: three were women and six were men, with ages ranging from 22 to 81 years. For each case, the results of the scene investigation, the ammunition used, and the autopsy and toxicological findings are described. Each victim suffered 3-5 gunshot wounds. The most common site for the gunshot wounds of entrance was the precordial region, followed by the left chest, the head, and the abdomen. Gunshot wounds were rarely localized exclusively to the head, whereas gunshot wounds scattered on different classic suicide body sites or all confined to the precordial region and the left chest were common. A distinction between instantaneously lethal targets, rapidly lethal targets, and targets of secondary importance is provided, and the guidelines for the proper determination of a multiple-shot suicide are presented.

The "mini-packer" syndrome. Fatal ingestion of drug containers in Baltimore, Maryland

We report seven fatalities resulting from the ingestion of illicit drugs packaged in condoms, rubber balloons, or plastic bags which were observed in the last 4 years at the Office of the Chief Medical Examiner, State of Maryland. All the victims, with the exception of one, were men ranging in age from 19 to 37 years. There was no racial predominance. No drug paraphernalia was found at any scene. In two cases, seizure-like activity was documented. One victim had recently returned from Nigeria; therefore, Lassa fever was initially suspected. Two of the victims were "body packer" contrabanders who had just arrived from Africa. They used body cavities to hide large amounts of heroin to avoid U.S. Customs. The other five cases were "mini-packers," small-time illicit drug dealers who had swallowed a single bag of cocaine to avoid police detection. The possible mechanism of leaking or rupture of the latex container is discussed.

Computer-aided skull/face superimposition

By use of a special optical device coupled with a TV camera to match a skull and a photograph of a face, superimposition for the purpose of personal identification was performed in controlled situations. A computer-aided method to evaluate the fit of the superimposition has been outlined by means of an original Shape Analytical Morphometry (SAM) software package yielding analytical descriptions by kth-order poly-nominal equations and Fourier harmonic analysis. The match was carried out by using point-cross error and sum of differences for the Fourier set amplitude. A final comprehensive evaluation exhibited marked differences between congruent and noncongruent superimpositions.

[Changes in the transparency of dentin: computerized densitometric analysis]

Computerized densitometry was utilized to carry out a quantitative and distributive study of dentin transparency in dental roots from different age individuals. By means of original software S.A.M. (Shape Analytical Morphometry) a densitometric reading of transilluminated whole dental root was performed and so obtained densitometric matrixes were worked for grey level classification and correspondent areas evaluation, false colour restitution, pseudotridimensional and row/column barr graphs, isodensity outlines and density inclination maps. Results are discussed for both age evaluation in forensic application and for altered dentin recognition in pathological conditions.

[Identification by superimposition of the skull on face photography using television: experimental application of a new method]

A new method of skull-face superimposition for forensic positive identification has been carried out. A single TV camera equipment with a special optical device was used. The tested specimens (22) were able to demonstrate the necessity to standardize the method in order to avoid errors.