Mete Korkut Gülmen

Bochdalek hernia in adulthood: a review and an autopsy case report.

Bochdalek hernia is rare in adulthood with fewer than 100 cases having been reported in the world literature. We present a delayed case of Bochdalek hernia in an adult leading to sudden death, first diagnosed at medicolegal autopsy.

Sudden death due to a colloid cyst of the third ventricle: Report of three cases with a special sign at autopsy

Colloid cysts of the third ventricle are rare benign cysts but they may be potentially life-threatening. Three cases of sudden death resulting from colloid cysts of the third ventricle are presented. The first and second cases were treated for migraine headaches. In the first case, the patient was a 24-year-old woman who presented to the hospital with a severe headache and was sent back home after medical treatment. Six hours later, she was found dead in her bed. The second case was a 21-year-old woman who experienced a severe headache, dizziness and vomiting 1 day prior to her death. She was transported to the hospital, where she was pronounced dead upon arrival. The third case was a 25-year-old man who experienced headaches and vomiting and was diagnosed with and medically treated for sinusitis. He lost consciousness and was taken to hospital, where he was pronounced dead on arrival. During the autopsy of all three cases, there was a grey transillumination area observed that occurred due to the stretching of tissue at the base of brain between the corpus mamillare and chiasma opticum. Dissection of the brain revealed a colloid cyst of the third ventricle. To avoid such fatal complications, prompt diagnosis using CT or MRI is essential in patients who have a long-standing history of intermittent headaches. During the autopsy of the sudden deaths of people with medical antecedents of headaches, if a grey color is observed between the chiasma opticum and the corpus mamillare in the base of the brain, a colloid cyst should be considered and this region should be dissected and examined carefully.

Childhood deaths due to electrocution in Adana, Turkey

Aim: This retrospective study was conducted to determine the general features of childhood deaths due to electrocution, and draw the attention of community to these preventable deaths.

Padova Charter on personal injury and damage under civil-tort law Medico-legal guidelines on methods of ascertainment and criteria of evaluation

Compensation for personal damage, defined as any pecuniary or non-pecuniary loss causally related to a personal injury under civil-tort law, is strictly based on the local jurisdiction and therefore varies significantly across the world. This manuscript presents the first “International Guidelines on Medico-Legal Methods of Ascertainment and Criteria of Evaluation of Personal Injury and Damage under Civil-Tort Law”. This consensus document, which includes a step-by-step illustrated explanation of flow charts articulated in eight sequential steps and a comprehensive description of the ascertainment methodology and the criteria of evaluation, has been developed by an International Working Group composed of juridical and medico-legal experts and adopted as Guidelines by the International Academy of Legal Medicine (IALM).

Determination of pesticides in postmortem blood and bone marrow of pesticide treated rabbits.

Forensic toxicological analyses have traditionally focused on the use of blood, body fluids, and certain organs in examinations of deaths due to intoxication. However, in some situations, putrefaction and contamination make proper sampling from tissues impossible, such as in exhumation cases. In these cases, bone marrow might be useful as an alternative specimen since it is a potential depot for drugs. This study aims to determine pesticides in postmortem and putrefied bone marrow of pesticide treated rabbits, so as to reveal the diagnostic value of toxicological analysis of bone marrow in exhumation cases. Out of thirteen rabbits, a 110 mg/kg dose of endosulfan was orally given to six through a gavage tool, and a 2500 mg/kg dose of diazinon was given to six using the same method. One rabbit was not treated with anything and served as a control sample. Venous blood, liver, lung, kidney, brain, and bone marrow samples were collected just after spontaneous death or cervical dislocation. After this, the rabbits were buried in soil. All of them were exhumed 1 month later, and putrefied viscera and bone marrow were sampled. Blood and tissue samples underwent solvent extraction and solid phase extraction, and then the samples were analyzed by GC-MS. Mean residue levels of diazinon in early postmortem samples were 85 mg/kg, 71 mg/kg, 23 mg/kg, 21 mg/kg, 19 mg/kg, and 0.4 mg/l in the liver, bone marrow, kidney, lung, brain, and blood, respectively. Mean residue levels of diazinon in the putrefied body were 3327 mg/kg in putrefied viscera and 1783 mg/kg in the bone marrow. Mean residue levels of endosulfan isomers and metabolites in early postmortem samples (blood, liver, lung, kidney, brain, and bone marrow) were 0.46 mg/kg (endosulfan sulfate), 0.32 mg/kg (alpha and beta isomers of endosulfan), and 0.14 mg/kg (endosulfan ether) while the same levels were 0.26 mg/kg (endosulfan sulfate), 0.24 mg/kg (alpha and beta isomers of endosulfan), and 0.1 mg/kg (endosulfan ether) in putrefied samples (putrefied bone marrow and putrefied viscera). Based on these experimental results, it can be concluded that cause of death can be determined as acute pesticide poisoning by toxicological analysis of samples from bone marrow and putrefied viscera in exhumation cases.

Methanol intoxications in adana, Turkey.

Methanol is a highly toxic substance that is commonly used as an industrial solvent and antifreeze in automobiles. Methanol intoxication usually occurs following inhalation or topical exposure of spirit, homemade alcohol, or eau de cologne. The goal of this study was to examine methanol fatalities and methanol poisoning characteristics in our region and to contribute to form a database concerning methanol intoxication cases in our country. The records of the Morgue Department, Council of Forensic Medicine Adana Group Administration, were reviewed retrospectively for all methanol poisoning deaths for the period of January 1, 1997, to December 31, 2003. Age, gender, death places, methanol blood levels of the cases, and consumed products were recorded. Total number of deaths between 1997 and 2003 was 4725 and the number of deaths due to methanol poisoning was 41 (0.86%) during this period; 38 (92.68%) of the total methanol fatality cases were male and three (7.32%) female, with an age range of 16 to 54 years.

The frequencies of mutated alleles of CYP2D6 gene in a Turkish population

Allele and genotype frequency distribution of CYP2D6*3, *4, *5, *6 and *10 variants were analyzed in blood samples of 100 unrelated healthy individuals by Real-Time PCR. The allele frequencies of CYP2D6*3(A2549del), *4(G1846A), *6(T1707del) and *10(C100T) were 1%, 10%, 2.5% and 14.5% respectively, while allele frequency of CYP2D6*5 was 3% of the subjects tested. Extensive, poor and intermediate metabolizer (EM, PM, IM) genotype frequencies were 63%, 4% and 12%, respectively. CYP2D6 gene duplication was 4%. Our results show that the frequencies of the mutated alleles of CYP2D6 in Turkish populations are similar to some European populations. 4% of Turkish people who have two nonfunctional defective allele are a high risk group and 12.5% of Turkish people who have two decreased functional defective allele or one normal and one non functional defective allele were also in the risk group. Findings of this study demonstrate the importance of genetic variation in drug intoxicants.

Pesticide intoxications in Cukurova, Turkey: three years analysis

In Cukurova region, pesticide poisonings still remain an unfortunate cause of death, which led to the present study. The autopsy records of Adana Branch of the Council of Forensic Medicine, between 2006 and 2008, were evaluated retrospectively. Deaths that were attributed to pesticide poisoning were included in the scope of the study to identify the type of pesticide, and etiology of intoxication. The frequency and distribution of intoxications were also analyzed in terms of sex and age. In the studied period, a total of 4199 autopsies were referred to the forensic toxicology laboratory for pesticide analysis. Seventy-two cases were positive for pesticide analysis. Of these, 42 (58.33%) were male and 30 (41.67%) were female, with a mean age of 38.8 ± 20.6 years. Among the inspected pesticides, endosulfan was found to be the most common with 47.2% of prevalence, followed by dichlorvos. This report showed that certain pesticides, endosulfan in particular, remains as common cause of poisonings in Cukurova region.

Polychlorinated biphenyls and organochlorine pesticides in amniotic fluids of pregnant women in south-central Turkey†

The concentrations of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) were determined in amniotic fluid of 200 pregnant women from the Cukurova region of Turkey. The concentrations of OCPs [hexachlorocyclohexane (HCH), hexachlorobenzene (HCB), dichlorodiphenyl trichloroethane (p,p′-DDT), and various metabolites], and different PCB congeners (28, 52, 101, 118, 138, 153, 180) were determined by gas chromatography with electron capture detection as follows: HCB 6.6 ± 4.7, ΣHCH 21.6 ± 14.2, ΣDDT 12.5 ± 7.5, and ΣPCBs 74.0 ± 54 ng mL−1. Correlations of maternal or gestational age and levels of OCPs and PCBs were not significant. The levels of these organochlorine compounds (OCs) were below detection limit for 5% of the samples, 80% contained more than one OC. This study illustrates that prenatal exposure of a fetus to OCs is prevalent in the Cukurova region.

Mitochondrial DNA control region haplotype and haplogroup diversity in South Eastern Turkey

Despite its large geographic and population size only little is known about the mitochondrial (mt)DNA make up of Turkey.orensically relevant data are almost completely absent in the literature. We analyzed the mtDNA control region of 224 volunteers from South Eastern Turkey and compared the data to populations from neighboring countries. The haplotypes will be made available via the EMPOP database (EMP00670) and contribute to the body of forensic mtDNA data.