Applicability of proximal humeral epiphysis ossification for forensic age estimation according to the Vieth method: a 3.0 T MRI study

A retrospective study was conducted to explore the possibility of determining the age of majority via examination of the proximal humeral epiphyseal-diaphyseal fusion by 3.0 T magnetic resonance imaging (MRI) using the Vieth classification. Proximal humeral epiphyses were retrospectively studied on 3.0 T MRI in 315 participants (122 females, 193 males) between 10 and 28 years of age, using T1-weighted turbo spin echo (T1W TSE) and proton density fat-saturated TSE sequence (PD FS TSE). A 5-stage scoring system was used following the method of Vieth et al. The relevant statistics were defined, the intraobserver and interobserver agreements were determined (Cohen's kappa) and the differences between the sexes were analyzed (Mann-Whitney U-test, p 0.05). The Vieth classification provides important information in determining whether a person has reached the age of 18 years or not in both sexes through 3.0 T MRI of the shoulder joint.WOS:0006189107000012-s2.0-8510106095

Evaluation of proximal humeral epiphysis ossification in 3.0 T MR images according to the Dedouit staging method: Is it be used for age of majority?

Magnetic resonance imaging (MRI) for forensic age estimation is among the research issues since it does not lead to radiation exposure. In this study, the ossification stage of the proximal humeral epiphysis was determined retrospectively in 178 male and 109 female individuals in the 12 to 30-year age group using 3.0 T MRI. All images were evaluated with the proton density fat saturated turbo spin echo (PD TSE FS) sequence and the T2 TSE FS sequence. A five-stage scoring system was used following the method of Dedouit et al. The relevant statistics were defined as minimum, maximum, mean +/- standard deviation, 95% confidence interval of mean and median and the intra- and interobserver agreement levels were very good (kappa > 0.80). There were no significant age differences between males and females in any of the stages (all p-values>0.05). According to the present study, stage 5 was initially observed at age 22 years for both genders. According to our results, it is possible to determine the completion of the 18th year of life in either gender on the shoulder joint. Proximal humeral epiphysis ossification may be used as an additional method for forensic age estimation through MRI.WOS:0006136185000142-s2.0-85097751141PubMed: 3333880

Ecstasy Intake Related Coagulopathy

3,4-methylenedioxymethamphetamine (MDMA), substance known as "Ecstasy" among the people and used due to entertainment, euphoric and energy booster effect, is one of the famous synthetic stimulants.  22-year-old man was found as unconscious in the early morning. According to the expressions of his family and friends, it was learned that he drank alcohol until late in the previous evening and took ecstasy besides this before he died. It was reported that he was taken to intensive care unit with temperature of 41oC and death occurred 12 hours later. At autopsy in external examination, petechial and purpuric hemorrhages in purple and red color were detected on body. In internal examination, petechial hemorrhages on the surface of the heart and lungs, subendocardial hemorrhage in the heart, hemorrhage on the mucosal surface of the stomach were seen. In the toxicological analyses of the blood, Paracetamol (4870 ng/ml), MDMA (847 ng/ml), MDA (94,2 ng/ml), Lidocaine (23 ng/ml), Pantoprazole (10,5 ng/ml), Midazolam (1,83 ng/ml) were detected. The death occurred due to coagulopathy related MDMA intoxication. Here, we present a case of autopsy, clinical findings and histopathologic findings, laboratory results in medicolegal literature

Evaluation of knee ossification on 1.5 T magnetic resonance images using the method of Vieth et al. A retrospective magnetic resonance imaging study

Magnetic resonance imaging (MRI) is a noninvasive method with the absence of ionizing radiation exposure and is therefore, preferable in studies for forensic age estimation. The purpose of this study was to investigate the degree of ossification of the knee in a Turkish population following the Vieth et al. method. We scanned 709 Turkish patients in the age bracket 12-27 years utilizing a T1weighted (T1W) turbo spin echo sequence (TSE) and a T2-W TSE sequence with fat suppression by spectral presaturation with inversion recovery. Minimum, maximum, mean +/- standard deviation andmedian values were defined. Intraobserver and interobserver correlations were determined (Cohen's kappa). The statistical relevance of sex-related differences was analyzed (Student's t-test, Mann-Whitney U-test, p< 0.05, exact test, two-sided). The kappa statisticswere relatively high, indicating very good agreement for interobserver and intraobserver evaluations. Comparison of male and female data revealed significant between-gender differences for most stages (p< 0.05). The earliest mean ages at which ossification of stages 4, 5 and 6 were evident in the distal femoral epiphysis were 14.84, 15.81, and 20.76 years in males and 13.77, 14.77, and 20.45 years in females, respectively. Proximal tibial epiphysis of stages 4, 5, and 6 ossification was first noted at ages 13.57, 15.59, and 18.91 years in males and 13.29, 14.38, and 16.87 years in females, respectively. In the distal femoral epiphysis, stage 6 was found at 20 years of age for both genders and it can be employed to differentiate above and below the majority age cut-off.WOS:0005833942000012-s2.0-8509382338

Forensic age estimation in living individuals by 1.5T magnetic resonance imaging of the knee: a retrospective MRI study

Our aim is to analyse proximal tibial epiphysis and distal femoral epiphysis patterns according to the Dedouit staging method using 1.5 T magnetic resonance imaging (MRI) with fast spin echo (FSE) for proton density images. In addition, we discuss the results in relation to the literature for forensic age estimation. In this study, images belonging to 195 female and 277 male patients ranging in age from 10 to 30 years who had a knee MRI for any reason in our Radiology Clinic between January 2014 and December 2016 were retrospectively evaluated. According to the Dedouit et al. five-stage method, they were evaluated by two radiologists. The kappa value was calculated for intra-observer and inter-observer compliance. The evaluation of knee epiphysis patterns from MRI is an alternative, efficient, radiation-free and non-invasive method that is helpful in forensic age estimation. In particular, stage 5 in distal femoral epiphysis can determine the 21st year of life in both sexes, and proximal tibial epiphysis could present evidence of age 18 in males. It should be used for evaluation in addition to other methods for determining skeletal system maturity.WOS:0005448927000082-s2.0-8505761476

Applicability of 3.0 T MRI images in the estimation of full age based on shoulder joint ossification: Single-centre study

Skeletal maturity is evaluated by many radiological methods for forensic age estimation. Direct radiography and computed tomography lead to a rise in ethical concerns due to radiation exposure. Therefore, magnetic resonance imaging (MRI) has currently been used in recent studies. In this study, the ossification stage of the shoulder joint was determined retrospectively in 178 male and 109 female individuals in the age group 12 to 30 years using 3.0 T MRI. All the images were evaluated with T1-weighted turbo spin echo (T1 TSE) sequence and T1 fast low angle shot two-dimensional sequence (T1 FL2D). The combined staging method, which was defined by Kellinghaus et al. and Schmeling et al., was used. The infra- and inter-observer agreement levels were very good (kappa and kappa(w)). There were no significant age differences between males and females in all stages. In most of the stages, the ossification of the proximal humeral epiphyses occurred earlier in females than in males. Stage 4 did not occur in either of the sexes before the 18th birthday as the youngest patients in this stage was at 19 and 18 years of age in males and females, respectively. We concluded that evaluating the ossification of the proximal humeral epiphysis with MRI imaging for forensic age estimation may be beneficial. Evaluating the same anatomical structure with different MRI sequences may be useful for accurate staging diagnosis.WOS:0005798551000242-s2.0-85088640574PubMed: 3273616

Pathophysiological Function of Adamts Enzymes on Molecular Mechanism of Alzheimer's Disease

The extracellular matrix (ECM) is an environment that has various enzymes attended in regeneration and restoration processes which is very important to sustain physiological and biological functions of central nervous system (CNS). One of the participating enzyme systems in ECM turnover is matrix metalloproteinases. A disintegrin-like and metalloproteinase with thrombospondin type 1 motifs (ADAMTS) is a unique family of ECM proteases found in mammals. Components of this family may be distinguished from the ADAM (A Disintegrin and Metalloproteinase) family based on the multiple copies of thrombospondin 1-like repeats. The considerable role of the ADAMTS in the CNS continues to develop. Evidences indicate that ADAMTS play an important role in neuroplasticity as well as nervous system pathologies such as Alzheimer's disease (AD). It is hopeful and possible that ADAMTS family members may be utilized to develop therapies for CNS pathologies, ischemic injuries, neurodegenerative and neurological diseases. To understand and provide definitive data on ADAMTS to improve structural and functional recovery in CNS injury and diseases, this review aimed to enlighten the subject extensively to reach certain information on metalloproteinases and related molecules/enzymes. It will be interesting to examine how ADAMTS expression and action would affect the initiation/progression of above-mentioned clinical situations, especially AD.WoSScopu

The Role Of Adamts1 And Versican In Human Myocardial Infarction: A Postmortem Study

Objective: To determine the role of a disintegrin and metalloproteinase with thrombospondin type 1 motif (ADAMTS1) and fragmented versican in the myocardial infarction (MI) process in humans and to evaluate the diagnostic efficacy of ADAMTS1 for postmortem diagnosis of MI. Methods: Thirty autopsied individuals were allocated into 2 groups, namely, a study group of individuals who died of myocardial infarction (n = 20), and a control group who died of trauma (n = 10). We performed standard immunohistochemical staining on myocardial tissue specimens, studying anti-ADAMTS1, anti-versican, and anti-versican C terminal peptide sequence (DPEAAE) fragments. Results: Strong, diffuse staining was observed throughout myocardial tissue for ADAMTS1 in the 2 groups. However, in the study group, we observed no expression for ADAMTS1 around fibrotic areas but detected slight staining in coagulative and necrotic zones. Conclusion: Similar localizations of ADAMTS and fragmented versican in human heart tissue indicate that versican presumably is cleaved by ADAMTS1. Hence, ADAMTS1 can be regarded as a new marker for postmortem differential diagnosis of MI.WoSScopu