Axonal injury is detected by βAPP immunohistochemistry in rapid death from head injury following road traffic collision.

The accumulation of βAPP caused by axonal injury is an active energy-dependent process thought to require blood circulation; therefore, it is closely related to the post-injury survival time. Currently, the earliest reported time at which axonal injury can be detected in post-mortem traumatic brain injury (TBI) tissue by βAPP (Beta Amyloid Precursor Protein) immunohistochemistry is 35 min. The aim of this study is to investigate whether βAPP staining for axonal injury can be detected in patients who died rapidly after TBI in road traffic collision (RTC), in a period of less than 30 min.

Multimodal Structural Analysis of the Human Aorta: From Valve to Bifurcation.

Objective: The aims of the present study were to assess the relative proportion of collagen and elastin in the arterial wall and to evaluate the collagen microstructure from the aortic root to the external iliac artery.

Methods: Arterial wall tissue samples sampled during post-mortem examination from 16 sites in 14 individuals without aneurysm disease were fixed and stained for collagen and elastin. Stained sections were imaged and analysed to calculate collagen and elastin content as a percentage of overall tissue area.

Coronial postmortem reports and indirect COVID-19 pandemic-related mortality.

Aims: Widespread disruption of healthcare services and excess mortality not directly attributed to COVID-19 occurred between March and May 2020. We undertook the first UK multicentre study of coroners' autopsies before and during this period using postmortem reports.

Methods: We reviewed reports of non-forensic coroners' autopsies performed during the first COVID-19 lockdown (23 March to 8 May 2020), and the same period in 2018.

Autopsy assessment of pediatric head injury: a proposal for aerosol mitigation during the COVID-19 pandemic.

During the Corona Virus Disease-19 (COVID-19) pandemic, there is still a requirement for post-mortems to continue, including those examinations performed in the context of medico-legal investigations. Currently, very little is known about how long this coronavirus can survive in deceased human bodies or whether un-embalmed human cadavers can be contagious to people who handle them. Therefore, it would appear to be prudent to consider implementation of additional safety measures for all necessary post-mortem procedures.

Compression asphyxia and other clinicopathological findings from the Hillsborough Stadium disaster.

Ninety-six people died following a crowd crush at the Hillsborough Football Stadium, Sheffield, UK in 1989. The cause of death in nearly all cases was compression asphyxia. The clinical and pathological features of deaths encountered in crowds are discussed with a particular focus on the Hillsborough disaster.

A look inside cardiopulmonary resuscitation: A 4D computed tomography model of simulated closed chest compression. A proof of concept.

Aim: To mimic chest compression during cardiopulmonary resuscitation (CPR), this study aimed to produce time-resolved 3D (volumetric) reformats of thoracic and upper abdominal tissue movement during incremental closed chest compression/decompression from 0 to 8 to 0 cm.

Methods: Sequential angiography enhanced computed tomography (CT) scans were acquired from a recently deceased, consented adult cadaver with 1 cm incremental closed chest compression/decompression. Three compression/decompression sequences from 0 to 3 cm, 0 to 5 cm, and 0 to 8 cm, respectively, were scanned using a radio-opaque, manually operated, chest compression device.

Postmortem Computed Tomography: An Overview for Forensic Nurses Involved in Death Investigation.

The traditional invasive autopsy has been considered the "gold standard" for death investigation worldwide. However, this has now been challenged by a new minimally invasive approach that utilizes cross-sectional radiological imaging to investigate the death. Globally, postmortem computed tomography is the most commonly used modality and is becoming increasingly available throughout the world.

Using freely-available 3D software to reconstruct traumatic bone injuries detected with post mortem computed tomography.

Use of post-mortem computed tomography (PMCT) scanning to investigate natural and unnatural death has increased dramatically in recent years. Powerful software exists to allow detailed analysis of the scanned anatomy and pathology, and users of PMCT and other medical imaging will already be familiar with both two-dimensional and three-dimensional (3D) representations of this data. However, standard medical image viewing programs do not allow direct manipulation of the visible anatomy.

Myocardial Infarction Due to Coronary Artery Injury following High Force Blunt Trauma to the Upper Chest: A Case Illustrating the Prehospital, Hospital and Autopsy Findings.

Myocardial infarction (MI) is a rare complication of blunt chest trauma (BCT). We describe an extensive antero-lateral MI due to thrombosis of the left main stem coronary artery following a blow to the lower face and upper anterior chest during an industrial accident in a 52-year-old male. The patient presented with acute left ventricular failure.

Post-mortem computed tomography in adult non-suspicious death investigation-evaluation of an NHS based service.

Objective: Post-mortem CT (PMCT) can replace autopsy in many cases of non-suspicious death. A purely NHS-based service to replace autopsy with PMCT was launched, with the cost met by the family from 2015 to 2017, and subsequently "free at the point of delivery" after local authority funding was secured. The aim of the service was to improve the experience for the families.

Remote post-mortem radiology reporting in disaster victim identification: experience gained in the 2017 Grenfell Tower disaster.

On 14 June 2017 at 00:54 h, the worst residential fire since the conclusion of the Second World War broke out in Flat 16, 4th floor of the 24-storey residential Grenfell Tower Block of flats, North Kensington, West London, UK. Seventy-one adults and children died, including one stillbirth. All victims of the Grenfell Tower disaster who died at the scene underwent post-mortem computed tomography (PMCT) imaging using a mortuary-sited mobile computed tomography scanner.

Post mortem computed tomography: An innovative tool for teaching anatomy within pre-registration nursing curricula.

Background: There is significant change throughout the world regarding Post Mortem Computed Tomography (PMCT) as an adjunct or a replacement to the traditional invasive autopsy. Of interest, is the ability to demonstrate visually two and three dimensional normal soft tissue, organ and skeletal anatomy, as well as natural disease and trauma pathology.

Objectives: The objective was to compare formal traditional methods of teaching anatomy and pathology (pictures and diagrams) to pre-registration student nurses with supplementary PMCT 2/3D generated images, videos and printed anatomical models.

Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study.

Purpose To determine if postmortem computed tomography (CT) and postmortem CT angiography help to detect more lesions than autopsy in postmortem examinations, to evaluate the strengths and weaknesses of each method, and to define their indications. Materials and Methods Postmortem CT angiography was performed on 500 human corpses and followed by conventional autopsy. Nine centers were involved.

How taphonomic alteration affects the detection and imaging of striations in stab wounds.

Stabbing with a kitchen knife is a common method of homicide in Europe. Serrated knives may leave tool markings (striations) in tissues. Documentation of striations is necessary for their use as forensic evidence.

A systematic autopsy survey of human infant bridging veins.

In the first years of life, subdural haemorrhage (SDH) within the cranial cavity can occur through accidental and non-accidental mechanisms as well as from birth-related injury. This type of bleeding is the most common finding in victims of abusive head trauma (AHT). Historically, the most frequent cause of SDHs in infancy is suggested to be traumatic damage to bridging veins traversing from the brain to the dural membrane.

Forces generated in stabbing attacks: an evaluation of the utility of the mild, moderate and severe scale.

The commonest way of killing in the UK is by a sharp instrument. Knight reported in 1975 that it is impossible to discern with any degree of certainty the degree of force used to create a stab wound. Despite this, expert witnesses continue to approximate the degree of force used for their reports and evidence in court.

Could post-mortem computed tomography angiography inform cardiopulmonary resuscitation research?

Aim: Firstly, to develop an optimised chest compression post mortem computed tomography angiography protocol in the adult human during closed chest compression to investigate cardiopulmonary resuscitation blood flow, and secondly to provide preliminary observations of post-mortem anatomical cardiac chamber movement using a novel radiolucent static chest compression device.

Methods: Variable volumes of radiological contrast agent were injected intravenously into a series of consented human cadavers. Each cadaver had chest compressions delivered with a LUCAS™2 mechanical chest compressor.

Diagnostic accuracy of post-mortem CT with targeted coronary angiography versus autopsy for coroner-requested post-mortem investigations: a prospective, masked, comparison study.

Background: England and Wales have one of the highest frequencies of autopsy in the world. Implementation of post-mortem CT (PMCT), enhanced with targeted coronary angiography (PMCTA), in adults to avoid invasive autopsy would have cultural, religious, and potential economic benefits. We aimed to assess the diagnostic accuracy of PMCTA as a first-line technique in post-mortem investigations.

Post-mortem imaging of the infant and perinatal dura mater and superior sagittal sinus using optical coherence tomography.

Infants and young children are likely to present with subdural haemorrhage (SDH) if they are the victims of abusive head trauma. In these cases, the most accepted theory for the source of bleeding is the bridging veins traversing from the surface of the brain to the dura mater. However, some have suggested that SDH may result from leakage of blood from a dural vascular plexus.

Estimation of postmortem interval using vitreous potassium levels in cases of fatal road traffic collision.

Aim Of The Study: To produce a formula that can accurately predict postmortem interval (PMI) based on vitreous potassium levels using road traffic collision fatalities.

Material And Methods: Vitreous humour samples were taken from 78 individuals who had died following road traffic collisions between 2010 and 2015. Samples were obtained from both eyes and were sent for on-site analysis.

Post-mortem computed tomography coaxial cutting needle biopsy to facilitate the detection of bacterioplankton using PCR probes as a diagnostic indicator for drowning.

We report for the first time the use of coaxial cutting needle biopsy, guided by post-mortem computed tomography (PMCT), to sample internal body tissues for bacterioplankton PCR analysis to investigate drowning. This technical report describes the biopsy technique, the comparison of the needle biopsy and the invasive autopsy sampling results, as well as the PMCT and autopsy findings. By using this new biopsy sampling approach for bacterioplankton PCR, we have developed on previous papers describing the minimally invasive PMCT approach for the diagnosis of drowning.

Optical clearing of the dura mater using glycerol: a reversible process to aid the post-mortem investigation of infant head injury.

Purpose: In cases of suspected abusive head trauma, a thorough and systematic study of the cranium and its contents is essential, preferably using the best available methods for observing the brain and its coverings. Building upon recent developments in skull bone removal techniques in infant autopsies, we have assessed the use of two optical clearing agents (OCAs), glycerol and mannitol, on pediatric dura mater in an attempt to increase the transparency of this tissue and thereby enhance the post-mortem assessment of infant head injuries, particularly subdural hematomas.

Methods: Extracorporeal testing revealed glycerol to be the more effective OCA.

Detection of bacterioplankton using PCR probes as a diagnostic indicator for drowning; the Leicester experience.

Bodies found immersed in water can pose difficulties to the investigating authorities. Pathologists may be assisted with the diagnosis by the use of tests such as the analysis for diatoms or the levels of strontium in the blood, although there is a recognised level of uncertainty associated with these tests. Recent work from Japan has shown that using molecular approaches, most recently real-time polymerase chain reaction (PCR) assays with TaqMan probes for bacterioplankton, it is possible to undertake rapid, less laborious, high throughput tests to differentiate freshwater from marine bacterioplankton and in doing so provide a molecular diagnostic test to assist in the diagnosis of drowning.