Nursel Türkmen

Occult papillary thyroid carcinoma: prevalence at autopsy in Turkish people.

The epidemiological features of occult papillary thyroid carcinoma (OPTC) at autopsy have not previously been reported in Turkish people. This study provides data on the prevalence of OPTC in people from the Marmara region in Turkey. The study includes thyroid glands from 93 male and 15 female cadavers between 18 and 80 years of age. The thyroid glands were removed, fixed and sectioned at 2-mm intervals. The sections were stained with hematoxylin and eosin, and were examined by a single pathologist. A total of 108 thyroid glands were examined. Macroscopic lesions were found in 36 (33.3%) glands (95% confidence interval=24–42). OPTC was found in four (3.7%) cases (95% confidence interval=1.0–7.5). It was concluded that in the Turkish people from the Marmara region, the prevalence of OPTC found at autopsy was relatively low. No age or sex predilection was detected.

An analysis of carbon monoxide poisoning cases in Bursa, Turkey

Carbon monoxide (CO) poisoning from coal and gas heaters is a public health concern in Turkey. This study estimated the prevalence, mortality rate and clinical predictors of severity of CO poisoning cases treated at the emergency unit of the Uludağ University Medical School, Bursa from 1996 to 2006. Of 305 patients treated over a 10-year period, only 1 case was recorded as suicide. The CO source was a coal heater in 85.9% of cases. Mean Glasgow coma score (GCS) on admission was 12.8 (SD 0.2) and mean carboxyhaemoglobin level was 21.6% (SD 0.92%). There were statistically significant associations between higher GCS score, older age and higher HbCO level. Better education of the public is vital for the prevention of these injuries.

An unusual cause of sudden death : Cardiac myxoma

Primary tumors of the heart are rare; the most common cardiac tumor is atrial myxoma. Sudden death may occur in patients with atrial myxoma, tumor embolization, or obstruction of blood flow at the mitral or tricuspid valve. This report describes an unusual cause of sudden death and the autopsy findings for a 73-year-old man with left atrial myxoma.

Fatal Methanol Ingestion in a Child: Case Report

The records of Forensic Medicine Council of Turkey Bursa Morgue Department reveal the first case of fatal methanol ingestion in a child. Household methanol exposures are mostly due to accidental ingestion of washing fluids. A 4 year-old girl was admitted to the emergency department with her parents with gastrointestinal symptoms; nausea, vomiting and abdominal pain. Toxicological studies revealed 79 mg/dl blood level of methanol. We presented infant autopsy case of methanol toxicity and discussed the case from medicolegal aspect.

The Significance of Hemosiderin Deposition in the Lungs and Organs of the Mononucleated Macrophage Resorption System in Infants and Children

Hemosiderin deposition is not often recognized on routine examination with hematoxylin and eosin staining; however, iron stains may be helpful in the evaluation of hemosiderin deposition in infant autopsies. This report describes the data obtained from autopsy of 86 infants and children whose deaths were investigated at the Forensic Medicine Council Bursa Morgue Department from January 2000 to January 2003. A histochemical technique was used to identify hemosiderin in lung, liver and spleen specimens, which was correlated with other descriptive variables such as the reported cause of death, postmortem interval, trauma history, gender, and age. There was a weakly positive but significant correlation between lung and liver hemosiderin scores (Spearmans rank correlation coefficient, rho=0.348, p=0.001); i.e., given an increase in lung hemosiderin scores, an increase in liver hemosiderin scores was also observed. Similarly, a marked positive correlation between spleen and liver hemosiderin scores (Spearmans rank correlation coefficient, rho=0.335, p=0.002) was observed. The probability of spleen hemosiderin-positive cases belonging to the age group under 6 months was found to be 4.3 times greater than those who were hemosiderin-negative (95% confidence interval, 1.6-11.8). After the major differential diagnoses were ruled out, this study demonstrated, that depending on the statistically assessed morphometric grounds, the presence of hemosiderin deposits in the liver and spleen were significantly higher in the age group under 6 months.

Myocardial bridging as a possible cause of unexplained sudden death: A case report

A 35-year-old man was found dead on the road by the police patrol. As the cause of his death was unknown, a forensic autopsy was performed in the morgue department. No traumatic change was detected on external or internal examination. Macroscopic investigation of the heart revealed a 2.2 cm extension of the left anterior descending coronary artery embedded in the myocardium 1 cm from its origin; a 1–1.2 cm superficial myocardial bridge overlying the left anterior descending coronary artery was detected. Histological examination of the heart revealed no evidence of acute or chronic ischemia, only mild hypertrophy was detected. We reported that myocardial bridging could be a cause of unexplained sudden death in the presented case.

The postman always rings twice: two cases of shotgun deaths associated with an unconventional home security alarm system.

AbstractInjury and death cases caused by booby traps are not common in forensic medicine practice. Besides, installation of booby traps including firearms is generally for suicidal and rarely for homicidal purposes. Although few patents were described about home security alarm system that were created by firearms in the United States, 1 sample of injury with a similar unconventional mechanism of home safety system was reported by Asirdizer and Yavuz in 2009. In the published case report, the story of an electrical technician who was invited to a summer house by the homeowner to check the home security alarm system was reported. In the so-called report, he was stated to be injured by the shotgun attached to the unconventional home security alarm system while checking the system. As a result, the homeowner was convicted of a possible intent to cause a life-threatening injury to the technician.The so-called homeowner and his wife died by the same shotgun attached to the same unconventional home security alarm system 4 years on from the first event. In the present case report, we have aimed to present the findings of the crime scene and the autopsies of these unusual 2 deaths and to discuss individual and legal factors in paving the way for the deaths of 2 people.

PS10 Medicolegal aspects of atypical firearm injuries: a case report

Our case was a twenty year-old man, who was injured during the military duty with G3 infantry rifle in the training area. An atypical firearm entry wound on the left side of sternum which was 4.5 cm in diameter, and was surrounded by six irregular skin burn wounds by a flash-suppressor and a 0.7 cm diameter firearm exit wound at space on the left midscapular line. Our case emphasizes that the interpretation of properties of these atypical firearm entry wounds need to be carefully assessed by physicians.

PS11 Medicolegal evaluation of elderly trauma patients

Objective: The human body loses flexibility and durability from the pathophysiological changes of aging; therefore, trauma and the risk of injury increase in geriatric individuals. Elderly patients who have been admitted to health centers with trauma and injury require a serious treatment approach. Materials and Methods: A total of 15851 victims who were admitted to Bursa Branch of the Council of Forensic Medicine of the Ministry of Justice between 01/01/2011 and 31/12/2011 were retrospectively evaluated, and 207 of them, who were trauma patients aged 65 years and over, were included in this study. All cases were evaluated according to the cause of the injury, localization of the trauma, bone fractures and type of medical treatment. Results: Two hundred nineteen of the total 15851 forensic patients were 65 years and older. Of these 219 cases, 207 (94.5%) had been exposed to trauma. Of these 207 cases, 138 (66.7%) were male, and 69 (33.3%) were female. The most common types of trauma were physical assault (n=136) and motor vehicle accidents (n=56), which occurred at rates of 65.7% and 27.1%, respectively. For the trauma victims, head injury was the most commonly affected body region. Ninety-seven patients were treated conservatively (46.9%), and 43 patients were treated surgically (20.8%). Traumatic bone injury (31%) was detected in 64 patients. Conclusion: The results of our study indicate that most of the geriatric victims were admitted to the medical centers with traumatic causes. Thus, it is necessary to increase our social sensitivity to trauma and the ways in can be prevented in the geriatric age group.

Ectopic High Origin of a Coronary Artery from the Aorta – A Possible Cause of Sudden Death

Congenital anomalies originating it the coronary arteries are of special interest for forensic specialists. The presented case is a man found dead on the Coast of Marmara Sea. The death was considered to be suspicious and an autopsy was performed. On the macroscopic autopsy, the ostium of the right coronary artery was hole-like, located in a normal position, but the ostium of the left coronary artery was pocket-shaped and located in the left wall of the ascending aorta and above the rim of the sinotubular junction. We describe an asymptomatic, but didactic case with ectopic high origin of the left coronary artery.