Harun Tuğcu

Estimation of stature from body parts

Anthropometric technique commonly used by anthropologists and adopted by medical scientists has been employed to estimate body size for over a hundred years. With the increasing frequency of mass disasters, the identification of an isolated lower extremity and the stature of the person it belonged to has created problems for the investigation of the identity of some of the victims. In spite of a need for such a study, there is a lack of systematic studies to identify fragmented and dismembered human remains. The purpose of the paper is to analyze anthropometric relationships between dimensions of the lower extremity and body height. Analysis is based on a sample of middle class male (N=203) and female (N=108) adult Turks residing in Istanbul. The participants are mostly students and staff members of a medical school, and military personnel. Measurements taken are stature, trochanteric height, thigh length, lower leg length, leg length, and foot height, breadth, and length. Of the five variables entered into the regression analysis, all but foot breadth participate in the analysis with leg length as the first and followed by thigh and foot lengths, and finally foot height in males (R(2)). There were also individually calculated formulae for some of these measurements which provided smaller R(2)-values. Students t-test to assess if there was any intraobserver error in measurements take by individual anthropometrist did not show such any statistically significant difference. In conclusion, the study suggested that estimation of a living height can be made possible using various dimensions of the lower extremity. One must consider differences between populations in order to apply functions as such to others.

Estimation of Stature from Upper Extremity

With the increasing frequency of mass disasters, identification of an isolated upper extremity and determination of the stature of the person it belonged to have created problems for investigation of the identity of some victims. Despite a need for such a study, there is a lack of systematic studies to identify fragmented and dismembered human remains. The purpose of this study was to analyze anthropometric relationships between dimensions of the upper extremity and body height. Analyses were based on a sample of middle class male (n = 202) and female (n = 108) Turks residing in Istanbul, Turkey. Five variables were entered into the analyses. For male subjects, forearm length was selected as the first factor, followed by hand length and finally upper arm length. For female subjects, upper arm length was selected first, followed by forearm length and finally hand length. There were also individually calculated formulae for some of these measurements that provided smaller R2 values. The study suggested that estimation of a living height could be made possible by using various dimensions of the upper extremity. One must consider differences between populations to apply such functions to other populations.

Image analysis as an adjunct to sodium rhodizonate test in the evaluation of gunshot residues: an experimental study.

It is important to investigate the clothing, as well as the body, to determine the range of fire of entry wounds in firearm injuries. Clothing can affect the amount of gunshot residues (GSR) reaching the body and their distribution. The amount and distribution of the GSR also vary according to the distance between the firearm and the target. Sodium rhodizonate test provides valuable data when clothing is available for examination. In the absence of clothing, light microscopic examinations may add additional information regarding the range of fire. In this study, a sodium rhodizonate test was done on 80 garment samples containing the bullet entrance. The 80 calfskin samples were processed histologically and were stained using Alizarin Red S. These were also evaluated with computer-assisted image analysis. Gross residues were seen on military camouflage clothing in samples from ≤45-cm group. White flannel undershirts under the military camouflage contained rhodizonate-positive particles only around the contact wounds. With image analysis, however, the residues could be detected also in the skin samples of the 2.5-cm- and 5-cm-range groups. We suggest that the image analysis can be combined with other techniques and it can provide valuable data in the determination of entry wounds and also in the estimation of firing distance.

Critical course of the anterior laryngeal branch of the inferior laryngeal nerve

Background:  Although in the past few authors stated that the nerve penetrated the ligament of Berry, many new authors have not confirmed this assertion. Because of the clinical importance and indefiniteness of this subject, we aimed to present an anatomical study concerning the course of the inferior laryngeal nerve.

Determination of gunshot residues with image analysis: an experimental study.

In firearm injuries, assessment of the firing range and determination of entrance and exit wounds are important. For this reason, evaluation of the amount and distribution of gunshot residues (GSRs) is necessary. Several methods and techniques for GSR analysis have been developed. Although these methods are relatively sensitive and specific, they may require expensive dedicated equipment. Therefore, a simple, easily applicable, more convenient method is needed. A total of 40 experimental shots were made to calf skin from distances of 0, 2.5, 5, 10, 20, 30, 45, and 60 cm. Eighty samples were taken from the right and left sides of the wounds, and Alizarin Red S dye staining was performed. The amounts of GSR particles were measured with image analysis. GSRs were detected in all shots. The mean size of the distribution area of barium and lead elements around the wound had a significant negative correlation with increasing shooting distance (r = -0.97, p < 0.001). As the distance increased, the amount of GSR decreased, and this decrease rate was nonlinear. Variance analysis suggested significant differences between data groups depending on range (p < 0.001). The image analysis method may solve some of the standardization problems for evaluation of GSRs. GSR detection with the image analysis method does not require experienced personnel and may be a suitable method for scientific studies and for routine purposes.

Nuclear morphometry in epidermal changes due to electrical current and thermal energy: trial for usage of image analysis in histological sections.

Distinguishing between injuries resulted from electrical current versus thermal energy is not only a difficult, but also a controversial issue in forensic medicine practice.In this study, an electrical current and a cautery were applied to dorsal skins of 10 rats and biopsies were taken from the injured sites as well as normal skin. In the histologic sections; some planimetric variables such as the perimeter, area, diameter equivalent circle, minimum feret, maximum feret, and the circular form factor of the nuclei located in normal and injured epidermis were measured with the aid of the computer-assisted image analysis.When compared with normal skin, all of the variables -nuclear area, perimeter, diameter equivalent circle, minimum feret, maximum feret, and circular form factor seemed to be decreased both in the electrical current- and cautery-applied skin samples.The differences between the variables measured in normal skin and in electrical- or cautery-applied skin samples were statistically significant (P < 0.05). However none of the variables showed any meaningful differences between the electrical- and cautery-applied areas.It was concluded that the nuclear changes due to electrical current and thermal injury are identical and morphometric analysis seems not to make any further contributions in the differentiating from each other. Therefore, conventional and more established methods for detection of metallization would be more effective.

Electrocution fatalities in military personnel in Ankara, Turkey

Objectives: To investigate various cases of death caused by electrical injuries among Turkish military personnel. Methods: We retrospectively reviewed fatality cases of military personnel between 1994 and 2013 at the Department of Forensic Medicine, Gulhane Military Medical Academy, School of Medicine, Ankara, Turkey, the only forensic medicine center for the Turkish Armed Forces. Medical records and autopsy reports of cases of electrical fatalities were reviewed and analyzed in terms of age and gender-specific incidence, voltage, contact details, body region distribution, location, and season of incident, site, and severity of injuries sustained, and histopathological and toxicological findings. Results: Sixteen (3.5%) out of the 450 autopsy cases involved electrocution. All deaths were accidental and most frequently occurred outdoors (75%). Eight (50%) died due to high voltage while 6 (37.5%) died due to low voltage. The entry and exit lesions were determined most frequently in cases with high voltage injury. The low voltage deaths commonly occurred at the scene of the event (66.6%), while almost all high voltage deaths occurred in the hospital (87.5%, p=0.03). Electrical burns were most commonly detected in the upper extremities (32.6%, n=14). Conclusion: The present study shows that deaths due to high voltage electrocution are more frequent than low voltage electrocution among military personnel.

Evaluation of Childhood Burns Between 0-15 Ages

Çocukluk ça¤›nda en s›k görülen yan›klar, s›cak bir obje veya s›cak s›v› ile temas sonucu meydana gelmektedir. Çocukluk ça¤› yan›k olgular›nda etiyoloji genellikle kaza olup, ihmale ba¤l› yan›k olgular› %6-20 oran›nda görülmektedir. ‹hmale ba¤l› yan›klar›n en s›k nedeni hafllanma yan›klar›d›r. Hafllanma yan›klar› vücudun s›cak s›v›ya dalmas› veya s›cak s›v›n›n vücuda s›çramas› ile oluflmaktad›r. Bu çal›flmada, Gülhane Askeri T›p Akademisi Yan›k Merkezinde, 2002-2006 y›llar› aras›nda yat›r›larak tedavi edilen, 0-15 yafl aras›, 82 olgunun hasta dosyalar› retrospektif olarak incelendi. Olgular›n yafl, cinsiyet, yan›k nedeni, yan›k derecesi, yan›k yüzdesi, hastanede yat›fl süresi, mortalite ve morbidite özellikleri de¤erlendirildi. Olgular›n, %72’sinin hafllanma yan›¤›, %19’unun alev ve aleve ba¤l› inhalasyon yan›¤›, %5’inin elektrik yan›¤› ve %4’ünün temas yan›¤› oldu¤u saptand›. Olgular›n vücut yan›k yüzde oran›n›n %20.71, mortalite oran›n›n ise %17.1 oldu¤u tespit edildi. Sözlü olarak ifade etme becerileri tam geliflmemifl, küçük yafltaki çocuklarda ihmalin saptanmas› zordur ve bu olgular kolayl›kla kaza fleklinde yorumlanabilmektedir. Yan›¤›n lokalizasyonu, biçimi, yaralanman›n olufl flekli ile yan›¤›n karakteristi¤i aras›ndaki iliflki de¤erlendirilerek, yaralanman›n kaza veya ihmal sonucu meydana gelip gelmedi¤i saptanabilir. Çocuk ihmaline ait kan›tlar›n fark edilmesi ile sa¤l›k personelinin sorumlulu¤u artmakta ve olgular›n adli makamlara bildiriminin yap›lmas› gerekmektedir. Anahtar kelimeler: Çocuk, yan›k, ihmal The most common burn causes of childhood are due to contact to a hot subject and scalding. The injury generally results from an incident but in 6-20% of the cases there may be neglect. Burns due to neglect are generally scalding injuries. Between 2002-2006, 82 patients whose ages were between 015 years old were treated in Gulhane Military Medical Academy Department of Plastic and Reconstructive Surgery and Burn Center. In this study, the patient charts of these 82 patients were retrospectively evaluated. Age, sex, etiology of burn injury, severity of burn injury, hospitalization time mortality and morbidity of the patients were evaluated. Of the patients, 72% had scalding injury, 19% had flame injury with inhalation injury, 5% had electrical injury and 4% had contact injuries. The average total body surface area of burn (TBSA) of the patients was 20.71% and the mortality rate was 17.1%. During childhood period, the detection of the neclegt of the child-sitter or the family is quite difficult. As the patient is not fully able to explain himself, the event is easily misdiagnosed as an accident. The localization and the characteristics of the burn injury will help us to differentiate accident from neglect as an etiology. When an evidence of neglection of children is determined, the judicial responsibility of the health care personnel increases. In such cases the judicial procedures must be started.

A Case of Sudden Death Due to Rupture of A Hydatid Cyst

Deaths due to rupture of hydatid cysts caused by Echinococcus granulosus encountered rarely, mostly in endemic areas. We report a 29-year-old man who died suddenly. A forensic autopsy was performed. The postmortem examination confirmed a ruptured cyst in the liver and a decision was made that death must have been caused by the anaphylactic shock due to rupture of this cyst. This case was presented in order to emphasize the medico-legal issues related to the diagnoses and treatments of the entities which cause sudden death encountered in primary health care services, and to document of the postmortem findings of a sudden death case due to a ruptured hydatid cyst which is rarely occured.