Динамика морфологических изменений легких при тяжелой черепно-мозговой травме, осложненной аспирацией крови

26 pieces of corpses' lungs died from acute cerebral trauma had been investigated by morphological methods. The purpose of the research work is to estimate the character and time of morphological signs, which characterize acute lung injury. It was obtained that the most early morphological changes in lung - injuries of bronchial mucosa membrane, circulation damages (microcirculation), atelectasis, distelectasis and acute emphysema. Lung edema and signs of systemic inflammation reaction occur during the first hours after the trauma and aspiration.Морфологическими методами исследованы легкие трупов лиц, погибших в результате тяжелой черепно-мозговой травмы, осложненной аспирацией крови (26 наблюдений). Цель исследования - оценить характер и сроки развития морфологических признаков, характеризующих острое повреждение легких. Установлено, что наиболее ранними морфологическими изменениями легких являются: повреждение слизистой оболочки бронхов и бронхиол, расстройства кровообращения (в том числе микроциркуляции), развитие ателектазов, дистелектазов и острой эмфиземы. Отек легких и признаки системной воспалительной реакции формируются в первые часы после травмы и аспирации

Morphological characteristics of different rates of dying

The purpose of the study: scientific evidence and development of accessible morphological criteria that allow to determine the duration of dying and the rate of dying. Materials and methods. The material of the main study included 206 identified deaths of persons with different pre-known processes of dying, which served as criterion for selection from1500 deaths (n=206, 14%). Of these, 110 cases were observed by the forensic medical expertize, 79 cases were revealed by the forensic medical examination of the dead body and 17 cases were included after the postmortem autopsy. The sample included from 30 to 57 cases subdivided in 5 groups. 53 cases were selected for the first time interval, 30 observations for the second one, 32 observations for the third one, 34 observations for the fourth one and 57 observations for the fifth time interval. The following methods were used to study the material: analysis of information about the circumstances of death (based on the records), retrospective clinical and anatomical analysis, the main (classical) method of autopsy of human corpses in sectional studies and histological examination. In addition, an immunohistochemical test, as well as mor-phometric, macroscopic and photographic methods were used. For the accuracy and reliability of the findings, morphological and statistical analysis was used, which included both statistical analysis of morphological characteristics and tanatogenetic analysis of the cases of the sampled material. Study results. We developed and scientifically proved a methodology for determining 5 rates of dying according to the morphological characteristics systematized in morphological complexes: fulminant rate 30 min — 2 — 6 — 12 h. Approbation of the proposed method on the gross experimental material allowed to set the diagnostic limit of the total significance for each morphological complex, and thereby, to improve the methodology of establishing the rate of dying in accordance to the morphological characteristics for the use in forensic practice. Conclusion. The morphological complexes of the rate of dying established in this work would serve as a base for further development of not only forensic thanatology, but also for the aim of improving the medical and preventive care. © 2018, V.A. Negovsky Research Institute of General Reanimatology. All rights reserved

ОПРЕДЕЛЕНИЕ ВЕРОЯТНОГО ПРИЖИЗНЕННОГО ТИПА ТЕЛОСЛОЖЕНИЯ МУЖЧИН ПО ОСТЕОМЕТРИЧЕСКИМ ПРИЗНАКАМ СКЕЛЕТИРОВАННЫХ КЛЮЧИЦ

One of the major challenges faced by a forensic medical expert when performing the examination of bone remains for the purposes of personal identification is the determination of group characteristics, which include the person’s body type. The present study focuses on a new method for determining the intravitam body type when considering skeletonised remains.Aim. To develop diagnostic mathematico-statistical models that allow the intravitam body type in men to be determined, drawing on the osteometric characteristics of skeletonised clavicles.Material and methods. We studied clavicles from the osteological collection held at the Department of Anthropology, Lomonosov Moscow State University (62 adult male skeletons) according to the expanded osteometric program (15 characteristics). The obtained data were processed by StatSoft STATISTICA 10 using multivariate stepwise discriminant analysis (MDA).Results. We have developed diagnostic models allowing the intravitam body type (ectomorph, mesomorph and endomorph) to be determined on the basis of skeletonised clavicles with an accuracy of 62.9-79 %. Using the proposed models, a more accurate determination of ectomorphs and mesomorphs (90 %) than endomorphs (41-58.8 %) is observed. In order to increase the objectiveness of the expert’s conclusion, we used function Pl showing the probability of correct body type classification in every single case. The diagnostic models were successfully verified using the skeletal samples held at the Peter the Great Museum of Anthropology and Ethnography, with the maximum accuracy level reaching 80 %.Одной из важнейших задач, с которой сталкивается судебно-медицинский эксперт при проведении экспертизы идентификации личности по костным останкам, является установление групповых признаков, к числу которых относится тип телосложения. В настоящей статье впервые показана возможность диагностики прижизненного типа телосложения мужчин при экспертизе скелетированных останков.Цель исследования. Разработка диагностических математико-статистических моделей, позволяющих реконструировать предполагаемый прижизненный тип телосложения у мужчин по остеометрическим признакам скелетированных ключиц.Материал и методы. В исследование вошли данные, полученные при измерении ключиц из остеологического собрания кафедры антропологии МГУ им. М. В. Ломоносова (62 скелета взрослых мужчин) по расширенной программе 15 признаков, которые затем были обработаны в программе StatSoft STATISTICA 10 с помощью многомерного дискриминантного анализа (МДА) в пошаговом варианте.Результаты. В ходе исследования получены диагностические модели, позволяющие восстанавливать прижизненный тип телосложения (грудной, брюшной, мускульный) по изолированным ключицам с точностью от 62,9 до 79 %. Индивиды грудного и мускульного типа телосложения при использовании предлагаемой методики идентифицируются лучше (точность корректной классификации составила 90 %), брюшного - менее точно (41-58,8 %). Вероятность отнесения экспертного случая к конкретному типу телосложения определяется согласно значению статистической функции Pl, что позволяет значительно повысить степень объективности исследования. Полученные диагностические модели тестировались на костяках из собрания Музея антропологии и этнографии РАН им. Петра Великого (Кунсткамера). В ходе верификации было обнаружено, что фактическая степень точности метода совпадает с расчетной и составляет 80 %

ВСЕРОССИЙСКАЯ НАУЧНО-ПРАКТИЧЕСКАЯ КОНФЕРЕНЦИЯ “ДЕКАБРЬСКИЕ ЧТЕНИЯ ПО СУДЕБНОЙ МЕДИЦИНЕ В РУДН: АКТУАЛЬНЫЕ ВОПРОСЫ СУДЕБНОЙ МЕДИЦИНЫ И АНЕСТЕЗИОЛОГИИ-РЕАНИМАТОЛОГИИ”

This article contains information on the Scientific Conference, brief content of the reports.В статье приводится информация о проведенной научно-практической конференции, дано краткое содержание представленных докладов

The results of the scientific and practical conference 'The topical problems of forensic medicine and medical law', Moscow, 23.12. 2016 [O rabote nauchno-prakticheskoĭ konferentsii 'Aktual'nye voprosy sudebnoĭ meditsiny i meditsinskogo prava'. Moskva, 23.12.2016]

[No abstract available

Assessment of lung morphological changes in acute intoxications with clozapine, ethanol and their combination

Objective: to detect lung morphological changes in acute intoxications with clozapine, ethanol, and their combination 3 and 24 hours after poisoning. Materials and methods. Experiments were carried out in outbred male rats weighing 270–300 g. Clozapine was given in a dose of 250 mg per kg animal body weight under chloralose anesthesia. Following 3 and 24 hours, the animals were withdrawn from the experiment by decapitation. Lung histological sections from 6 rats that had received oral clozapine 250 mg/kg, 6 rats that had oral ethanol 8.6 ml/kg, and 6 rats that had a combination of ethanol and clozapine orally in the above doses were examined 3 hours after intoxication. Those from 18 rats that had been orally given the similar agents in the above doses and withdrawn from the experiment were also investigated 24 hours after drug administration. The sections were compared with those from 6 rats that had not received the above agents. Nonparametric methods (χ2 test) were used for statistical processing. The investigators assessed the following morphological signs: circulatory disorders (plethora, hemorrhages), interstitial and alveolar edema, damage to the bronchial and alveolar epithelium and to the endothelium, and a cell reaction. The differences were considered significant at p<0.05. Results. In the control animal group, histological examination did not reveal any circulatory disorders and damage to the bronchial and alveolar epithelium and to the endothelium. Three hours after its administration, the animals that had received clozapine were observed to have acute pulmonary circulatory disorders (plethora in the pulmonary artery system, focal plethora of the capillaries of interalveolar septa and that of veins) that increased 24 hours after its ingestion. If death occurred 3 hours after ethanol intake, there was obvious perivascular edema, plethora, and hemorrhage; some alveoli contained transudate. Moderate venous plethora was seen 24 hours following ethanol administration. The secretory activity of the bronchial mucosa decreased. Three hours after coadministration of clozapine and ethanol, there were acute pulmonary circulatory disorders (marked plethora, multiple hemorrhages, and alveolar edema), bronchial epithelial lesion (desquamation), and no staining of endothelial cell nuclei. Lymphocyte accumulation was observed around the veins and arteriovenous anastomoses. Perivascular edema was absent. The lesions increased 24 hours after coadministration of clozapine and ethanol. Conclusion. The changes found at lung histological examination of the animals receiving clozapine alone and its combination with ethanol in conjunction with the results of forensic chemical analysis may be used to diagnose relevant intoxications and to establish their duration. © 2015 AVES Ibrahim Kara. All rights reserved

ХАРАКТЕРИСТИКА ГИСТОМОРФОЛОГИЧЕСКИХ ИЗМЕНЕНИЙ В СЕРДЦЕ ПРИ ОТРАВЛЕНИИ КЛОЗАПИНОМ

The article deals with the features of histomorphological changes in the heart in poisoning with atypical neuroleptic - clozapine. The relevance of the topic is caused by the large number of poisoning by this substance. The authors conducted a study of heart histological sections of 10 rats treated with clozapine at a dosage of 150 mg / kg in order to assess changes in them. The sections were compared with histological sections of the heart of intact animals (5). The hidtomorphological changes revealed in heart along with the hismimorphological changes in other organs and the results of chemical analysis will hallow to diagnose clozapine poisonings.В статье рассмотрены особенности гистоморфологических изменений в сердце при отравлении атипичным нейролептиком - клозапином. Актуальность темы обусловлена большим количеством отравлений этим веществом. Авторы провели исследование гистологических препаратов сердца 10 подопытных крыс, получавших клозапин в дозе 150 мг/кг с целью оценки изменений в них. Сравнение проводилось с гистологическими срезами сердца интактных животных. Выявлен- ные гистоморфологические изменения в сердце вместе с изменениями в других органах и результатами судебно-химического исследования позволят диагностировать отравления клозапином

ВСЕРОССИЙСКАЯ НАУЧНО-ПРАКТИЧЕСКАЯ КОНФЕРЕНЦИЯ “ДЕКАБРЬСКИЕ ЧТЕНИЯ ПО СУДЕБНОЙ МЕДИЦИНЕ В РУДН: АКТУАЛЬНЫЕ ВОПРОСЫ СУДЕБНОЙ МЕДИЦИНЫ И АНЕСТЕЗИОЛОГИИ-РЕАНИМАТОЛОГИИ”

This article contains information on the Scientific Conference, brief content of the reports.В статье приводится информация о проведенной научно-практической конференции, дано краткое содержание представленных докладов

The results of the scientific and practical conference 'The topical problems of forensic medicine and medical law', Moscow, 23.12. 2016 [O rabote nauchno-prakticheskoĭ konferentsii 'Aktual'nye voprosy sudebnoĭ meditsiny i meditsinskogo prava'. Moskva, 23.12.2016]

[No abstract available