Accessory Nerve Anatomy in Anterior and Posterior Cervical Triangle: A Fresh Cadaveric Study

Objective: To understand the variations and normal course of the accessory nerve (CNXI) to help more accurate and confident neck dissection.Methods: The course of the CNXI in the neck, its relationship to the surrounding anatomic structures and the factors affecting its course were investigated.Results: A total of 100 neck dissections were performed on 50 fresh cadavers. Eleven division variations were observed at the anterior triangle. The location of CNXI at the posterior border of the sternocleidomastoid muscle (PBSCM) was investigated and the ratio between the distance from the mastoid apex (MAA) to CNXI at the PBSCM and the distance from MAA to the posterior border where the PBSCM is attached to the clavicle increased as height of the subject increased (p<0.05).Conclusion: It must be kept in mind that it is better to search for CNXI in taller subjects more inferiorly at the posterior border of the sternocleidomastoid muscle

Kompleks İntihar Olgusunda Kan Lekesi Model Analizi İle Olay Yerinin Yeniden Yapılandırılması

İki veya daha fazla yöntemin eş zamanlı ya da peşi sıra uygulanması kompleks intihar olarak adlandırılmaktadır. Tek başına kullanıldığında da sonuca ulaşılabilecek iki farklı yöntemin intihar amaçlı kullanılması ölme güdülenmesindeki kararlılığı göstermektedir. 40 yaşındaki erkek olgumuz kurusıkıdan dönüştürülmüş bir silah ile kalbine ateş etmiş ve bu sırada kendini asmıştır. Otopside elde edilen bulgular, olay yeri inceleme raporundan alınan bilgiler, vücuttaki ve olay yerindeki kan lekeleri olay orijininin intihar olduğunu düşündürmüştür. Kompleks intihar olgularında olayın orijinini ortaya çıkarma çalışmaları otopsi masasına geldikten sonra değil, olay yeri incelemesinde, hatta ceset ilk görüldüğü andan itibaren başlamalıdır. Olay yerinin multidisipliner olarak ele alınması, ortamda bulunabilecek her nesnenin/ delilin olayın çözümünde yardımının olabileceğinin akılda tutulması orijin tayininin kolaylıkla yapılmasını sağlayacaktır. Benzer şekilde otopsi yapılacak olan bir cesedin, varsa elbiseleri üzerindeki, yoksa vücudu üzerindeki kan lekelerinin kan lekesi model analizi yöntemleri ile dikkatli bir şekilde incelenmesi ve belgelendirilmesi de orijin tayininde faydalı bilgiler verebilmektedir

Death Caused by Honey Bee Stings: Case Report

A bee sting is always potentially serious. The severity and duration of a reaction can vary from one person to another. In addition, one's own reaction to a bee sting may differ between occurrences. Most persons experience a local non-serious allergic reaction to bee venom. However, depending on the location and number of bee stings received, as well as the ever-present possibility of a severe allergic reaction to bee venom, a serious reaction can be precipitated that can be life-threatening. A 49 years old man having a history of allergic reaction to bee sting was found dead near to 9 nests. There were many dead honey bees on him. External examination of the body showed more than 50 stings all over the body. Upon medico-legal autopsy, pulmonary edema and swelling in laryngeal area were the internal findings. History of allergy, autopsy findings and findings obtained from crime scene investigation were evaluated together and the cause of death was concluded to be anaphylactic shock resulted from bee stings. [Med-Science 2014; 3(2.000): 1305-14

İskemik Kalp Hastalığına Bağlı Ölümde Uçucu Madde Birlikteliği Olgu Sunumu

Uçucu madde kullanımı toplumda yol açtığı sosyal sıkıntı dışında meydana getirdiği ölümlerle de adli tıp çalışanları için ilgi konusu olur. Genellikle genç populasyonda yaygm kullanılan bu maddeler ölüme en sık kalp üzerine yaptıkları toksik etkilerle sebebiyet vermektedirler. Olgumuz 37 yaşında bir erkekti. Ailesinin ifadesine göre uyuşturucu kullanmayan şahsın otopsisinde çok yoğun tiner kokusu alındı. Morfolojik ve his-topatolojik incelemede myokardda nedbe ve koroner arterlerde belirgin daralma saptandı. Yapılan toksikolojik inceleme uçucu madde varlığını doğruladı. Bu tür ölümlerin doğru değerlendirilebilmesi için iyi bir anamnez alınmasının yanı sıra, toksikolojik incelemede de kan ve akciğer örnekleri alınmalı ve mutlaka miktar tayini de yapılmalıdır. Beyin ve böbrek örnekleri ayrı incelenirse maddenin ölümcül dozda alınıp alınmadığı; idrarda madde ve metaboliti aranırsa kullanımdan sonra yaşayıp yaşamadığı hakkında fikir sahibi olunabilir. Anahtar kelimeler: Adli Tıp, patoloji, toksikoloji, istismar, aritmi, koroner arter hastalığ

Foreigners Dying in Istanbul

The study included 411 deaths selected from 14,647 medicolegal deaths autopsied in the Morgue Department of Forensic Medicine Institute Directorate, affiliated with the Ministry of Justice, between 1998 and 2002. Data were collected from court documents, coroner's investigation reports, and autopsy reports. The parameters of age, gender, nationality and origin, cause and place of death in foreigners dying in Istanbul were evaluated in the study. Out of 14,647 medicolegal deaths, 3.5% were foreigners from 34 different nationalities. The nationality with the highest rate of foreigner deaths (34%) was Romanian. Out of 411 deaths, 74.3% were male and 25.7% were female. Of all cases, 64.4% were tourists visiting Istanbul and 35.6% had a job in Istanbul. Of 146 foreigners employed in Istanbul, 94.5% did not have a work permit, while only 5.5% had a work permit

Possible death mechanisms other than respiratory asphyxia in a suicidal hanging case

Hanging is the most common suicide method that has seen in the routine autopsy practice. Known mechanisms of death include asphyxiation due to airway obstruction, cerebral ischemia due to arterial blockage, vagal inhibition (reflex cardiac arrest) due to carotid sinus compression, congestion due to venous blockage, fractures in cervical vertebral column with the cord injury

Spontaneous Coronary Artery Dissection Report of 3 Cases and Literature Review Hormonal, Autoimmune, Morphological Factors

The number of cases with spontaneous coronary artery dissection (SCAD) is considered to be being underestimated because of a large amount of SCAD leading to sudden death without previous diagnosis. Besides, not only in clinics but also in autopsy practice, correct diagnosis of SCAD is important to prevent forensic malpractice. The article is intended to discuss the pathological findings through the forensic point of view for improving the malpractice expertise in scope of clinicians' timely antemortem diagnosis according to risk factors and in scope of forensic pathologists' the cause of death determination ability according to macroscopical and microscopical findings of the autopsy. In 3 cases reported, the main characteristics were the female sex, pregnancy history and a sudden death without any trauma. However, although there are many women giving birth or using oral contraceptives, only some of them are facing with SCAD. This suggests the possibility of some hereditary factors, whereas hereditary characteristics may be understood in many different ways like hormone-releasing regulating mechanisms as well as immunity, morphology, or any other mechanism. For instance, autoimmunity has been also a hereditary underlying factor for vessel injury considered in presented cases