Time for a Close

Throughout the last several weeks I have reviewed articles spanning a variety of topics within the field of forensic anthropology. I have covered original studies, debates and case studies. There is so much more to learn since there are countless new studies being formulated to improve forensic methods. As I embark upon my journey to becoming a forensic anthropologist, I plan to continually keep myself up to date with the latest research in my field. Thank you for reading!

Reading:: New Field of Entomotoxicology!

Entomotoxicology: A Review
By Murthy, Dr. C.R. Vasudeva & Mohanty, Manisa.


  This article was not included in my original plan at the start of my project, but it caught my attention and I think it is extremely interesting.

Forensic entomology is the study of the effects that insects have on a decomposing body and the information that these effects can offer to a forensic investigation. This information includes time of death, movement of the body, antemortem injuries, and drugs and toxins present at time of death. It is a fairly new field and there has not yet been extensive research on its reliability for obtaining forensically useable data. Scientists have begun to prove that it is possible to analyze the insects on a decaying body determine the types and amount of drugs that were present or absent in a decadent’s body at the time of death. This is called entomotoxicology. This is helpful as an alternate drug testing method because many drug-related deaths are left undiscovered for a long enough period of time for severe decaying and/or skeletonization to occur, making it impossible to use tissue or blood samples for conventional drug tests. This article reviews the methods and theories of entomotoxicology.

In order to prepare the insects for testing for inorganic substances, they must be cleaned, dried and crushed, then put into storage -20 to 4 degrees Celsius until the actual analysis begins. For testing of organic substances the insects are also cleaned, dried, and cut up into fine pieces, then they are mixed with an interna standard solution. The insects are homogenized in a .9% saline solution then centrifuged. The acids break down the larvae’s exoskeleton, which releases any toxins that are present. Then the acid solution is removed from the specimens and the organic substances can be analyzed.

Methods for analysis include mass spectrometry, high performance layer chromatography, thin layer chromatography, radio immune assay, and gas chromatography.

Different drugs have differing effects of the decomposition rates of carrion insects. Heroine speeds up the growth of larva and slows down the developmental pupal stage, while cocaine and methamphetamine simple speed up the rate of fly development. A lethal dose of cocaine causes larvae to develop faster between 36 and 72 hours after they hatch. In a test-control experiment, it was proven that maggots feeding on flesh rich with methamphetamine fed faster and grew larger than the maggots feeding on flesh without any drugs present.

Although carrion insects are a great source for drug detection, more research needs to be done in order to actually quantify the drug concentrations found in the anthropods. Not only can insects provide valuable forensic information regarding the time since death, they can be helpful in determining if intoxication was an implication of the decadent’s death.

Resource:

Murthy, Dr. C.R. Vasudeva & Mohanty, Manisa (2010). Entomotoxicology: A
             Review. Journal of Indian Academic Forensic Medicine, 32(1), 82-84.

Reading:: Hyperostosis in Females

Rate of Occurrence, Gross Appearance, and Age Relation of Hyperostosis Frontalis Interna in Females: A Prospective Autopsy Study

By Nikolic´, Slobodan MD, PhD,* Djonic´, Danijela MD, PhD,† Z˘ivkovic´, Vladimir MD, MSc,* Babic´, Dragan MD, PhD,‡ Jukovic´, Fehim MD,§ and Djuric´, Marija MD, PhD†

This article is about a study to find out the occurrence rate of hyperostosis frontalis interna (HFI) in females and to determine if there is a correlation of occurrence with age. Although HFI was first described in the 18^th century by Morgagni, it seems to be primarily a 19^th and 20^th century occurrence as it is very rarely discovered in historic populations. The most common causes of HFI are functional disturbances of the gonads, ie, faulty estrogen stimulation or inadequate androgen stimulation by tests. It could also be caused by obesity, arterial hypertension, or genetic predisposition. HFI is often associated with headaches, epilepsy, and dementia. Because hyperostosis progresses very slowly over many years the body is able to activate coping mechanisms, which means there is no sudden onset of symptoms.

There were 248 female individuals included in the sample. During the autopsies the cranial vaults were opened according to standard procedure by way of a cut from the glabella to the occipital protuberance. Macroscopic analysis was performed using Herschkovitz et al’s standard criteria for HFI stage classification, which includes 4 stages of manifestation. Of the 248 deceased females in the study, only 45 presented with HFI. Also, 1220 male craniums were analyzed but only 9 actually had the HFI. Following is a table showing the female distribution of HFI in respect to age groups:

HFI Type				Age (year) <<<|>>>
	<20	21-30	31-40	41-50	51-60	61-70	71-80	>80
Absent	9	19	16	23	31	36	42	27
A	1	1	0	0	1	1	2	1
B	0	0	0	2	3	2	5	2
C	0	0	0	0	1	5	10	3
D	0	0	1	0	1	1	1	1
Total	10	20	17	25	37	45	60	34

Altogether, they discovered an HFI occurrence rate of 3.68% (1468 individuals), and a female rate of 18.14% and .07% in males. According to Herschkovitz et al, the earliest stage of HFI can occur in females as young as 21 years old, while the matured stage of HFI does not appear before the age of 40. HFI occurrences do increase with age and are more common among females now, when compared with older studies. Since post-menopausal women have the highest occurrence rate of HFI, Nikolic et al deducts that it may be associated in some way with hormonal status. While more direct and specific causes of the hyperostosis still need to be studied, Nikolic et al has at the very least established that the occurrence of HFI does have a correlation with age in females.

Reference: 

Nikolic´, Slobodan MD, PhD,* Djonic´, Danijela MD, PhD,† Z˘ivkovic´, Vladimir

             MD, MSc,* Babic´, Dragan MD, PhD,‡ Jukovic´, Fehim MD,§ and 

             Djuric´, Marija MD, PhD† (2010). Rate of Occurrence, Gross 

             Appearance, and Age Relation of Hyperostosis Frontalis Interna in 

             Females: A Prospective Autopsy Study. American Journal of Forensic 

             Medicine and Pathology; 31(3); 205-207.

Reading:: Isolated Hyoid Bone Fracture

Self-induced Vomiting as a Probable Mechanism of an Isolated Hyoid Bone Fracture

By Joseph K. White DO and John Carver MD, JD

Only 0.002% of all fractures in the United States occur in the hyoid bone, which is a U-shaped bone located in the upper neck. When fracture does occur it is most often associated with manual strangulation, choke-holds, or neck hyperextension. Most hyoid fractures have a great deal of forensic value because they are usually associated with the cause and/or manner of death. This article, however analyzes the occurrence of an isolated hyoid fracture that was not associated with the manner or cause of death. This case involves a 37-year-old woman who died from acute ethanol intoxication complications.

The decadent’s boyfriend found her lying in bed unresponsive, pulseless and apneic (no spontaneous breathing). EMS was called to the scene and transported the patient to the nearest hospital where severe anoxic brain injury was assessed. Her condition did not improve and care was withdrawn with consent from family members. The boyfriend reported that she had been drinking heavily all day and that he had seen her alive 20 to 40 minutes before realizing she had stopped breathing.

The woman’s medical history included bipolar disorder and multiple suicide attempts. She had a history of alcohol abuse, drug use, and tobacco use. 8 days prior to her death she was admitted to the hospital for dysfunctional vaginal bleeding. The physical examination reported facial petecheia and subconjunctival hemorrhaging from self-induced vomiting, which she committed in an attempt to lose weight. 2 days before her death she was treated for altered mental status and the petecheia and hemorrhaging was reported again.

Her records show no evidence of any head or neck trauma that could have caused her hyoid to fracture. If a strangulation had occurred bruising would be present as well as damage to the surrounding tissue of the neck and probably defensive wounds on forearms or wrists. However, none of the previous signs presented in her autopsy. The authors referred to a case study in which a “28-year-old man who noted a clicking sensation in his throat after induced vomiting and was found to have a nondisplaced fracture of the hyoid bone.” (White & Carver 2010.) The hyoid bone is connected to the skull by the stylohyoid ligament at the styloid process. Apparently, violent muscular contractions such as those from the act of vomiting can indeed cause stress fractures in the hyoid bone, regardless of the person’s age.

This article concludes by restating the fact that hyoid bone fractures are often valuable in determining the manner and or cause of death. Occurrences of isolated hyoid fractures are extremely rare and the case study presented in this article is an example of such. Previous case reports of stress fractures suggest that that is a likely cause of the isolated fracture in this case. And since the decadent admitted to inducing vomiting only days before her death the authors feel strongly that it is the cause of the hyoid fracture in this woman.

Reference:

White, Joseph K. DO & Carver, John MD, JD (2010). Self-induced Vomiting as
           a Probable Mechanism of an Isolated Hyoid Bone Fracture. American 
           Journal of Forensic Medicine and Pathology; XX(X); 1-3. Retrieved from: http://ovidsp.tx.ovid.com/sp-3.4.1b/ovidweb.cgi?WebLinkFrameset=1&S=KBAAFPNMLMDDJADLNCCLPCJCBNKLAA00&returnUrl=ovidweb.cgi%3fMain%2bSearch%2bPage%3d1%26S%3dKBAAFPNMLMDDJADLNCCLPCJCBNKLAA00&directlink=http%3a%2f%2fgraphics.tx.ovid.com%2fovftpdfs%2fFPDDNCJCPCDLLM00%2ffs046%2fovft%2flive%2fgv023%2f00000433%2f00000433-900000000-99859.pdf&filename=Self-induced+Vomiting+as+a+Probable+Mechanism+of+an+Isolated+Hyoid+Bone+Fracture.&navigation_links=NavLinks.S.sh.15.1&link_from=S.sh.15%7c1&pdf_key=FPDDNCJCPCDLLM00&pdf_index=/fs046/ovft/live/gv023/00000433/00000433-900000000-99859&link_set=S.sh.15%7C1%7Csl_10%7CresultSet%7CS.sh.15.16%7C0

Reading: Sexual Dimorphism in Turkish Forearm Bones

Forearm Bones and Sexual Variation in Turkish Population

By I˙brahim U¨ zu¨ n, MD, Mehmet Yazar I˙zcan, PhD,Þ and Osman C¸ elbiz, MD

In the field of forensic anthropology, professionals know that there is a large degree of skeletal variation between populations. So when building a biological profile of unidentified remains, a forensic anthropologist must familiarize himself with (or create) a model standard for that specific population. This article reports a study that was done to analyze sexual dimorphism in forearm bones of individuals of Turkish descent.

The study consisted of 38 females with an average age of 36, and 42 males with an average age of 40. Various measurements were taken from the radius and ulna from each individual and a standard was established for use in identifying sex. The classification accuracy was 92% for the radius and 91% for the ulna. Other studies on the use of the forearm in determining sex were performed on Japanese, British, and black and white American populations. The Japanese study yielded 96% classification accuracy in the radius, with 90% in the ulna. The British study reported an overall 85% accuracy while the black American study showed 82%, and the white American study came out with an overall 89% accuracy of classification. The value of forearm bones in sex estimation varies depending on the population.

This study has proven that sex can be accurately estimated using the bones of the forearm in the Turkish population. Some other populations, such as Americans, feature less sexual dimorphism thereby making sex determination via forearm bones less accurate. Each population must be studied individually and male/female standards must be established for each population. For example, using the Turkish standard against bones of African descent will likely cause error in the estimation of sex.

Reference:

I˙brahim U¨ zu¨ n, MD, Mehmet Yazar I˙zcan, PhD,Þ and Osman C¸ elbiz, MD 

        (2011). Forearm Bones and Sexual Variation in Turkish Population. 

        American Journal of Forensic Medicine and Pathology; 00(00), 1-4.

Reading:: Can You Test Dry Bone for Drugs?

 Detection of Drugs of Forensic Importance in Postmortem Bone

By Kelly K. McGrath, BS, and Amanda J. Jenkins, PhD

I read an article by McGrath and Jenkins reporting the results of a study to prove whether or not different drugs of forensic value could be detected in bone from cases where the victim presented with drugs in his or her blood. 39 cases were chosen for the study, 25 being male and 14 female.

Methods

Using a scalpel, each bone specimen was cleaned by scraping away overlying muscle and tissue. Next the specimens were rinsed with deionized water then air-dried. The bones were cut into slivers, each weighing 2g, then soaked in methanol for about 16 hours. Using these processed specimens the drugs were identified by electron impact gas chromatography mass spectrometry (GC/MS). The specimens were tested for the presence of benzodiazepines, opiates, and cocaine and metabolites.

Results

The most common drugs discovered in the female remains were opiates (43%) and alkaline drugs (32%). For males the top 4 drugs were opiates (31%), basic drugs (24%), cocaine and metabolites (22%), and benzodiazepines (19%). Drug intoxication followed by disease and carbon monoxide poisoning accounted for the cause of death in 22 of the 39 cases. 19 of those 22 deaths were rules accidental while the remaining 3 were ruled suicidal. As it turned out, 14 cases contained basic drugs in the blood and 8 of the associated bone specimens were positive for those drugs, which is 57%. These basic drugs include amitriptyline, citalopram, diphenhydramine, doxylamine, meperidine, oxycodone, and zolpidem. The drugs dextromethorphan, diltiazem, doxylamine, fentanyl, paroxetine, promethazine, tramadol, and zolpidem all presented in the blood but not the bone.

Conclusion

Although the results were not as consistent as the authors had hoped, it at least proved that current testing methods can detect basic drugs of forensic value. Many factors affect the deposition of drugs into the bone including, but not limited to, distribution at time of death, exposure, drug physiochemical characteristics, and bone type collected. Unstable drugs such as 6-acetylmorphine may not become stored in the bone. More drugs were detected in the blood than the bone, but the drugs that were found contained in the bone presented in higher concentrations. The authors acknowledge that more studies need to be performed to text different methods and to determine the rate and dosage at which certain drugs become deposited into the bone. However, McGrath and Jenkins have accomplished their goal of indicating that it is possible for drugs to be detected in dry bone in cases of skeletonization where soft tissue is not available for testing.

Reference:

McGrath, Kelly K. BS & Jenkins, Amanda J. PhD (2009). Detection of Drugs of 

         Forensic Importance in Postmortem Bone, The American Journal of 

         Forensic Medicine and Pathology 30(1); 40-44. Retrieved from:

         http://ovidsp.tx.ovid.com.ezproxy.lib.usf.edu/sp3.4.1b/ovidweb.cgi?

         &S=GJIMFPMPEPDDLAGMNCCLOFJCLLIFAA00&Link+Set=
         jb.search.28%7c2%7csl_10

Reading:: A New Avenue for Sex Estimation

Identification of Sex Depending on Radiological Examination of Foot and Patella.

By Wafaa M. et al.

One of the forensic anthropologist’s primary goals is to create an accurate biological profile, which includes information about a deceased individual such as age, sex, stature and race. Determining the sex can be difficult as most bones that are used in sex identification are fragmented or absent. This has forced forensic anthropologists to search for new ways to determine sex, using bones that are less easily damaged or lost. The authors of this article have done just that: they have discovered a way to use radiographs of the patella and foot bones to accurately estimate sex in Egyptian populations.

Methods

 Radiographic films of the patella and foot from 160 living individuals (80 male, 80 female) aged 25—65 years were studied. The length and midshaft diameter of each metatarsal bone was measured. The minimum and maximum height and width of the patella was taken and analyzed. A formula was developed by Fisher as a way to determine all possible measurement combinations for each sex.  In addition to the original 160 people included in the study, 80 were randomly selected to further confirm or refute their hypothesis.

Results

The lengths of the first, third, and fifth metatarsals showed the highest percentage of correct classification with each reporting at 100% accuracy. The second and fourth metatarsal length accuracy was 99.4% and 96.9%. The midshaft diameter of the second and third metatarsals were 100% accurate. The patellar height and width had correct classification percentage of 72.5% and 73.8%. The metatarsal bone measurements have proven to be the most reliable for sex estimation.

Discussion

The authors discuss the results of other studies of patellar height and width on differing populations. The results of El Najjar and McWilliam and of O’Connor are similar to the data obtained from the study in focus. Using radiography as away to obtain data is beneficial because it is cost effective, simple, and less time consuming than other methods. However, it may produce less accurate measurements due to differing angles at which the radiographic films are produced.

Conclusion

This study has proven the accuracy of using the patella and metatarsal bones for sex estimation in forensic cases in Egypt. Both types of bones are very often found intact in skeletonized human remains and are easy to measure. Wafaa et al., hopes to have established standards useable by other forensic anthropologists for sex estimation. However, Fisher’s formula should not be used on dry bones as it was developed to be used on conjunction with radiographic data. So, additional patella and metatarsal studies on dry bone is encouraged.

Reference:

Wafaa M. Abdel Moneim, MD, Randa H. Abdel Hady, MD, Ragaa M. Abdel

           Maaboud, MD, Hala M. Fathy, MD,* and Ahmed Mostafa Hamed, 

           MD (2008). Identification of Sex Depending on Radiological 

           Examination of Foot and Patella. American Journal of Forensic 

           Medicine and Pathology 29(2): 136 –140. Retrieved from: http://ovidsp.tx.ovid.com/sp-3.4.1b/ovidweb.cgi&S=FNMMFPBAPMDDDBCGNCCLIFGCMCIJAA00&Link+Set=jb.search.27%7c1%7csl_10

Reading:: Bone Splinters in Hanging Victims

Pericarotid Bone Splinter: A Microscopic Appearance in Hanging.

By Ciprian Lupascu, MD, Nicole Berger, PhD, & Cristian Lupascu, PhD

Much like the article in my previous post, this article by Lupascu et al. is the first to delve into its topic of research. Lupascu et al. (2003) has decided to perform a study to determine the relevance of the occurrence of bone splinters in hanging victims. These 0.25mm to 0.7 mm splinters were detected at the microscopic level and may have forensic value in ruling a death by hanging as homicide or suicide.

The study discussed in this article consisted of 145 individuals who had died from asphyxia (lack of oxygen due to pressure on the neck). 3 of those 145 had been hung from a rope or string with a knot lateral to (on the side of) the neck. In each of these cases microscopic bones splintering had occurred which was caused by the violent traction against the muscle during initial hanging. The authors decided that the splinters most likely broke off from one of the cervical vertebrae as they became forced into the carotid artery.

What makes the presence of the splinters significant to determining manner of death (homicide or suicide) is the presence or absence of fibrin and hemorrhagic tissue around the splinter. If both are present it suggests that the individual was alive when he or she was hung which can rule out a homicide and subsequent hanging of the victim.

Reference:

Ciprian Lupascu, MD, Nicole Berger, PhD, & Cristian Lupascu, PhD (2003). 
           Pericarotid Bone Splinter: A Microscopic Appearance in Hanging. 
          The American Journal of Forensic Medicine and Pathology 24(4): 
           320 –321. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.lib.usf.edu/sp-3.4.1b/ovidweb.cgi?WebLinkFrameset=1&S=MBBOFPOCLJDDEBBONCCLABGCLDOKAA00&returnUrl=ovidweb.cgi%3f%26TOC%3djb.search.26%257c1%257c50%26FORMAT%3dtoc%26FIELDS%3dTOC%26S%3dMBBOFPOCLJDDEBBONCCLABGCLDOKAA00&directlink=http%3a%2f%2fgraphics.tx.ovid.com%2fovftpdfs%2fFPDDNCGCABBOLJ00%2ffs044%2fovft%2flive%2fgv022%2f00000433%2f00000433-200312000-00002.pdf&filename=Pericarotid+Bone+Splinter%3a+A+Microscopic+Appearance+in+Hanging.&link_from=jb.search.26%7c1&pdf_key=B&pdf_index=jb.search.26

Reading:: Detection of Antemortem Wounds on Dry Bones

The Detection of Microscopic Markers of Hemorrhaging and

Wound Age on Dry Bone: A Pilot Study

By Cristina Cattaneo, PhD, MD, Salvatore Andreola, MD, Eloisa Marinelli, MD, Pasquale Poppa, BSc, Davide Porta, BSc, and Marco Grandi, MD

It is easy for forensic pathologists to determine the survival time (time in between incident and death) of an injury largely by the color of the person’s skin—whether pink, reddish purple, blue, brown, yellow, etcetera. Each color represents a different stage of the healing process. This process ceases once the individual loses his/her life. For a short period of time, what you have left of the wound after death is a “snapshot” of the furthest stage of healing that was reached. For a forensic anthropologist working with dry bone versus fresh flesh, trying to make the same assumptions about injury survival time can be more labor-intensive. This is why the authors of this article conducted a pilot study of the evidences of trauma left on dry bone at varying survival interval rates. They used several cadavers to which the trauma survival time was known and conducted comparative analysis of the skeletal remains.

Methods

Fractured bones from 6 autopsies were collected from the Institute of Legal Medicine of Milano.

Case #	Bone Fractured	Survival Time
1	Rib	19 days
2	Tibia	34 minutes
3	Cranium	26 days
4	Cranium	16 days
5	Cranium	5 days
6	Rib	8.5 hours + negative control

A negative control fracture was created postmortem on the rib in case #6 to use for comparison. The bones were then artificially peutrified to remove all soft tissue. Next the specimens were viewed under a stereo microscope with special attention to the edges of the fractures to identify an periosteal (healing) reaction. The bones were then placed in 10% formalin and stained and decalcified. After decalcification, the bone was cut into 5mm blocks.

Results

Macroscopic review revealed that all but one of the bones showed no detectible macroscopic variation, which, anthropologically speaking means that the injuries would be ruled perimortem. Microscopic review, however, provided a great deal of more detail of the time of the injuries.

Case #	Survival Time	Microscopic Results
3	26 days	Blood clots suggestive of fibrin deposits
1	19 days	Foci of new bone formation
4	16 days	Blood clots suggestive of fibrin deposits
5	5 days	Deposition of fibrin
6	8.5 hours	Some deposition of fibrin
2	34 minutes	Slight blood clot

The results show the bones in different stages of healing corresponding to the survival time. This microscopic analysis supplied a great deal more information than the standard macroscopic procedure, which only ruled the fractures as ‘perimortem.’ So, histopathological research has proven by this study to be a worthy avenue to help forensic anthropologists determine traumatic survival time solely from dry bone. Such information can prove to have great forensic value in a death investigation. Of course, many more studies will need to be carried out experimenting with varying factors such as environment, individual healing rates, etcetera, before any scientific standards can be established. This is the very first study of its kind and it has opened the playing field for histopathological research on putrefied or macerated bone.

Source:

Cristina Cattaneo, PhD, MD, Salvatore Andreola, MD, Eloisa Marinelli, MD, 

        Pasquale Poppa, BSc, Davide Porta, BSc, and Marco Grandi, MD (2010), 

        The Detection of Microscopic Markers of Hemorrhaging and Wound Age 

        on Dry Bone: A Pilot Study, Am J Forensic Med Pathol • Volume 31, 

        Number 1.