Annie Geraut

Variola Virus in a 300-Year-Old Siberian Mummy

This letter describes a distant lineage of the variola virus (the agent of smallpox) that was identified in a mummy found buried in the Siberian permafrost.

Suicidal hanging resulting in complete decapitation: a case report

Abstract This paper reports the case of a 22-year-old man, weighing 87.5 kg, who committed suicide by jumping from a bridge over a canal with a nylon rope tied around his neck. The drop height was between 3.70 and 5.30 m before the rope tightened and the subject was completely beheaded. The head sank straight under the bridge, while the torso floated 205 m downstream. Pertinent autopsy findings were a sharp decapitation wound with circumferential skin abrasion and cervical spin transection between C1 and C2. Decapitation is a complication of extreme rarity in the event of a suicidal hanging and is always related to a drop of several metres with a poorly extensible line used as the hanging ligature.

Ricochet of a bullet in the spinal canal: a case report and review of the literature on bullet migration.

Abstract:  Ricochet of a bullet in the spinal canal is well known by neurosurgeons but relatively not a common event in usual medico‐legal autopsy practice. This article presents a homicide case of a penetrating gunshot injury of the lumbar spine through the T12‐L1 intervertebral foramen with active movement of the projectile within the spinal canal to the L5‐S1 level. This case illustrates a bullet intradural and intramedullary active movement because of a ricochet of the body of T12 with active redirection of the path. In the current literature, different types of migration in caudal or cranial direction, intradural, or intramedullary are reported. If spontaneous migration of T10 to S1 seems to be more frequent, some authors reported a C1 to S2 migration. Such migration could be asymptomatic or induce neurological impairment. The medico‐legal consequences of these migrations within the spinal canal are described.

Virtual and macroscopical studies of mummies—Differences or complementarity? Report of a natural frozen Siberian mummy

Since 2004, a multidisciplinary Franco-Russian expedition discovered in the Sakha Republic (Yakutiya) more than 60 tombs preserved by the permafrost. In July 2006, an exceptionally well-preserved mummy was unearthed. The coffin, burial furniture and clothes suggested a shamans tomb. Multislice computed tomography (MSCT) was performed before autopsy with forensic and anthropological aims. Forensic study aimed to detect any lesions and determine the manner of death. Anthropological study aimed to determine the mummys gender, age at death, morphological affinity, stature and body mass. She was female and virginity status was assessed. The radiological and forensic conclusions were compared. Imaging confirmed most autopsy findings, suggesting that death followed disseminated infection. MSCT could not formally exclude a traumatic death because close examination of the skin was difficult, but was superior to conventional autopsy in diagnosis of infectious lesions of the left sacroiliac joint and one pelvic lesion. Autopsy detected a post-infectious spinal lesion, misinterpreted on MSCT as a Schmorls node. However, most conclusions of virtual and conventional anthropological studies agreed. Age at death was estimated around 19 years old. The morphology of the mummy was mongoloid. MSCT identified the craniometric characteristics as similar to those of the Buryat population. The deceaseds stature was 146 cm and estimated body mass was 49 kg. MSCT demonstrated its great potential and complementarity with conventional autopsy and anthropological techniques in the study of this natural female mummy buried in 1728.

Tuberculosis epidemiology and selection in an autochthonous Siberian population from the 16th-19th century.

Tuberculosis is one of most ancient diseases affecting human populations. Although numerous studies have tried to detect pathogenic DNA in ancient skeletons, the successful identification of ancient tuberculosis strains remains rare. Here, we describe a study of 140 ancient subjects inhumed in Yakutia (Eastern Siberia) during a tuberculosis outbreak, dating from the 16th–19th century. For a long time, Yakut populations had remained isolated from European populations, and it was not until the beginning of the 17th century that first contacts were made with European settlers. Subsequently, tuberculosis spread throughout Yakutia, and the evolution of tuberculosis frequencies can be tracked until the 19th century. This study took a multidisciplinary approach, examining historical and paleo-epidemiological data to understand the impact of tuberculosis on ancient Yakut population. In addition, molecular identification of the ancient tuberculosis strain was realized to elucidate the natural history and host-pathogen co-evolution of human tuberculosis that was present in this population. This was achieved by the molecular detection of the IS6110 sequence and SNP genotyping by the SNaPshot technique. Results demonstrated that the strain belongs to cluster PGG2-SCG-5, evocating a European origin. Our study suggests that the Yakut population may have been shaped by selection pressures, exerted by several illnesses, including tuberculosis, over several centuries. This confirms the validity and necessity of using a multidisciplinary approach to understand the natural history of Mycobacterium tuberculosis infection and disease.

Destabilization and intracranial fragmentation of a full metal jacket bullet

We report a case with an atypical entrance wound as a result of a destabilized full metal jacket bullet penetration. The destabilized bullet by an impact with the dorsal hand experiences a yawing to tumbling motion in flight. The large angle of yaw induces a larger presenting profile upon impact that contributes, associated to a rapid deceleration, to a greater mechanical force on the projectile structure and a fragmentation into core and jacket. Forensic pathologists have to be aware that the metal jacket bullet could tend to break up outside or inside the body particularly after a shooting through a target. This phenomenon induces atypical entrance wounds and atypical X-ray presentation.

Bone and soft tissue histology: a new approach to determine characteristics of offending instrument in sharp force injuries

This paper describes a new approach to determine characteristics of the implement used to inflict trauma which involves the histological analysis of exogenous particles. Based on Locard’s principle “every contact leaves a trace,” we decided to assess whether histological examination of bone and soft tissue around a penetrating injury (sharp force trauma) could provide evidence of the offending implement. Case reports and experimental studies have demonstrated the potential of cut mark features in bone to identify the causative implement and potentially assist in identifying the perpetrator. Scanning electron microscopy in combination with energy-dispersive X-ray spectrometry (SEM/EDS) have previously been reported to identify exogenous particles from various implements. In medical research, histological techniques are used to study the impact of foreign particles in tissues originating from implants. However, the routine use of histology in forensic medicine focuses on understanding type and timing of injuries. Based on three forensic cases, the results presented in this paper demonstrate that histology offers a cost-efficient and reliable means to detect foreign particles related to offending implement and/or to the environment where the victim was located. The interpretation of histological results was performed in conjunction with the macroscopic autopsy findings and anthropological analysis of bone samples.

The benefits and pitfalls of post-mortem computed tomography in forensic external examination: A retrospective study of 145 cases

OBJECTIVE Nowadays, post-mortem computed tomography (PMCT) has become an integral part of Forensic practice. The purpose of the study was to determine PMCT impact on diagnosis of the cause of death within the context of the external examination of the body, when autopsy has, at first, not been requested. MATERIAL AND METHODS We reviewed the records of 145 cases for which unenhanced PMCT was performed in addition to the external examination of the body from January 2014 to July 2015 at the Institute of Forensic medicine in Strasbourg (France). We confronted final reports from forensic pathologist to the corresponding PMCT reports. Data were collected in a contingency table and the impact of PMCT on the final conclusions of the forensic pathologist was evaluated via a Chi2 test. RESULTS PMCT results significantly impact the final conclusions of forensic pathologist (p<0,001). In some cases, PMCT permits etiological diagnosis by revealing a cause of death hidden from external examination (mainly natural death) or by supporting the clinical findings of the forensic pathologist. In other cases (traumatic death), PMCT enables fast and exhaustive lesion assessment. Lastly, there are situations where PMCT may be ineffective (intoxication, hanging or some natural deaths). CONCLUSION Performing PMCT within the context of the external examination of the body when autopsy has, at first, not been requested could bring significant benefits in diagnosing the cause of death. The impact of PMCT varies depending on the circumstances of death.

Interpretation of Cannabis Findings in the Hair of Very Young Children: Mission Impossible

BACKGROUND Hair has been suggested since the middle of the 90s to be a suitable matrix to document repetitive exposure to cannabis. Because it is possible to detect Δ9-tetrahydrocannabinol (THC), cannabinol (CBN) and cannabidiol (CBD) in cannabis smoke, the identification of the metabolite, 11-nor-Δ9-tetrahydrocannabinol carboxylic acid (THC-COOH) has been considered to allow the discrimination of active use. OBJECTIVE Although the identification of an active compound in a childs hair shows contamination of the local environment, it is a challenge to discriminate between hair incorporation after ingestion or inhalation and environmental external deposition from dust, smoke, or even contaminated surfaces by hand contact. However, it is particularly important in case of children to correctly interpret the data, particularly for a realistic assessment of the health risk. We present here a series of hair tests for cannabis where the interpretation was almost impossible to establish. METHOD Hair specimens were collected during the autopsy of the 12 children, aged 2 to 24 months, either deceased from shaken baby syndrome (SBS, n=4), mechanic asphyxia (MA, n=1) or sudden infant death (SID, n=7) during January 2015 to April 2017. After decontamination, the hair specimens were tested for THC, CBN and CBD and THC-COOH. The whole length of hair was submitted to analysis. RESULTS The amount of hair from children can be as low as 8 mg. This may affect the limit of quantitation of all drugs, but particularly THC-COOH. Eight from twelve hair tests were positive for cannabis markers, i.e. THC (39 to 1890 pg/mg, n=8), CBN (< 5 to 1300 pg/mg n=8), CBD (10 to 2300 pg/mg, n=8) and THC-COOH (not detected to < 0.5 pg/mg, n=5). In 4 cases from 8 positive findings, it was not possible to test for THC-COOH (not enough material). CONCLUSION Establishing a window of detection when testing for drugs in young children is a very complicated task. Hair from children is finer and more porous in comparison with adult (the risk of contamination from sweat and environmental smoke is higher than in adults). The final interpretation of cannabinoid findings in the childrens hair is very complicated as this can result from in utero exposure (although none of the mother admitted cannabis use during pregnancy), oral cannabis administration by the parents to achieve sedation, close contact to cannabis consumers (hands, bedding, dishes) and inhalation of side-stream smoke. Over-interpreting cannabis findings in hair can have very serious legal implication in child protection cases. Practicing scientists have the responsibility to inform the child protection authorities, courts, etc. about these limitations.