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Human bite: hate or love
Sixth Cross Channel Conference on Forensic Medicine 1998
Bullet cytology: results of a pilot study R. Visser MD, PhD
Forensic Pathology Laboratory, Rijswijk, Netherlands During perforation, fragments of material may adhere to the bullet's surface (Nichols & Sens 1990). Not only cells, tissue (fragments) and blood, but also other substances like stomach contents and gunshot residue can be detected microscopically. Macroscopically visible tissue fragments are routinely retrieved for D N A typing, but the recognition and collection of minor tissue fragments or nucleus containing cells could also be used for D N A analysis. The aim of this project was to implement bullet cytology in our laboratory and to evaluate the results. Material. During the pilot period, 53 bullets were retrieved from 24 different crime scenes. First the bullets were investigated routinely in the national laboratory of forensic sciences, which is housed in the same building as the laboratory of forensic pathology. Because of the experimental character of the technique, the bullet cytology was performed after the routine examinations. This resulted in an interval of between 12 days and 5 months between the crime and time of receiving the bullets in our laboratory. Methods. After receiving the bullets, they were visually inspected in order to select (visible) tissue fragments. They were then placed immediately in physiological saline solution for rehydration purposes and stirred in a Vortex mixer in order to dissociate the material from the bullet surface. The washing solution was divided into two parts: one for cytology and one for D N A analysis. One of the parts was processed for cytocentrifugation (Cyto-spin) preparations and stained with May Giemsa Grtinwald. The results were scored according to a semi-quantitative scale:
0 1 2 3
No cellular or tissue structures Dubious Presumably Cell(s) and/or tissue are present
Results. With the unaided eye no tissue fragments were seen on the surface of the bullets. In our hands, this method resulted in cytological specimens, appropriate for cytological examination. Contrary to clinical cytology specimens, cells sometimes were damaged (fragmented, or missing nuclei); these were classified a s ' 1' ('dubious') or '2' ('presumably') dependent on the amount of material and morphological appearance. The specimens were investigated by the author in collaboration with a clinical cytologist. Using this protocol, we classified the results of 53 bullets as follows:
Class"
Number (n)
0 1 2 3
26 9 7 11
11
Most of the cells/tissue appeared to be of epithelial origin. If only solitary epithelial cells without nuclei or with pyknotic nuclei were present we regarded these as 'probably contamination' as we were not informed of the procedures of bullet collection. If epithelial cells with relatively large nuclei were present we classified these as 'parabasal epithelial cells, contamination unlikely'. Conclusion:
1. Bullet cytology is a simple, non-destructive method with high specificity and sensitivity. 2. Bullet cytology requires experience in clinical cytology. 3. Bullets may be contaminated with epithelial cells. 4. Two months after the crime, adherent cell material could still be recognized. 5. Cells collected by this method can be used for D N A analysis. 6. Bullet cytology (and collection of material for D N A analysis) is recommended as the first stage of the bullet examination program.
REFERENCE Nichols CA, Sens MA. Recovery and evaluation by cytological techniques of
trace materialretained on bullets.Am J For Med Path 1990; 11 (1): 17-34 Anal condyloms on a child without suspicion of sexual abuse: should the case be reported to the sanitary authorities? Th. Perrin, S. Dorray, A Geraut, M.C. Tortel, A. Tracqui, P. Kintz, B. Ludes.
*Medico-Legal Institute, Strasbourg, France The authors present the cases of three children aged between a few months to a few years, who presented with anal condyloms. In these cases, there was no suspicion of sexual abuse and the presence of condyloms of the same type on the mother's genitalia could suggest non-sexual transmission of this potentially carcinogenic disease, possibly during common bathing. Although this mode of transmission doesn't mean sexual abuse, the authors think that such cases should be reported to the sanitary authorities because they could be a sign of negligence and lack of sanitary care from parents towards their children. KEYWORDS - condylomata acuminata, child, non-sexual transmission, negligence, report to authorities Human bite: hate or love S. Doray*, A. Geraut, A. Tracqui, T. Perrin, P. Kintz, B. Ludes
*Medico-Legal Institute, Strasbourg, France The human bite: act of hate or feature of love? The authors report nine cases of bites of human origin. The severity of these cases ranges from a simple cutaneous print to amputation. This situation needs a very close contact between aggressor and victim. Biting is not an innocuous behaviour and the act often expresses a problematic relationship; thus, it is necessary to distinguish the children's bite from the adult one. For a child, the bite might represent an act of excessive, monopolizing love. For adults, it consists not only of an aggressive act against others, but may also represent a defensive act.
12
Sixth Cross Channel Conference on Forensic Medicine 1998
The authors report an extreme situation with a total amputation of the mobile part of the tongue. We describe another case with a loss of cutaneous substance in the anterior cervical region. The authors note variability in the site of bites but find that they are localised principally to the ears and nose, and also the forearms to some extent. It is, therefore, recognized that a h u m a n bite, inflicted in order to put an aggressor to flight, can lead to serious maiming. The recommended advice for treatment involves: 1. measures to disinfect and decontaminate the wounds 2. prescription of an appropriate course of antibiotics active against the main buccal pathogenic bacteria. Finally, it is necessary to keep in mind the possibility of an HIV contamination as a consequence of a human bite. KEYWORDS
bites, human, after-effects
Collaboration between judicial authorities in cases of sexual assault towards minors
A. Antonietti*, E. Avezzu, C. A. Romano
*Medico-legal Institute, Brescia, Italy A reform to a part of the Penal Code concerning sexual assault has recently come into effect in Italy (L66 of February 15, 1996); it contains many few principles relative to the protection of minors. Among others, Article 609 established that, when an offence of sexual assault toward a minor is proceeded with the Public Prosecutor must immediately inform the Juvenile Court. Moreover, in these cases, it provides for psychological and emotional assistance to the young victim, at every stage of the proceedings, on the part of the parents of another suitable person requested by the minor and admissible by the judicial authorities undertaking the case. The reasoning behind the law is to allow the Juvenile Court to adopt civil provisions within its jurisdiction to ensure that, once the penal proceedings are concluded, the monro does not remain in a family situation which is prejudicial to him or her. In the light of this new legislation the authors have analysed the cases under observation by the Brescia Juvenile Court, on the advice of the origination authority, in the period between the new legislation entering into force (February 1996) and February 1998. Data was extracted from the legal files. The authors utilized reports relative to the characteristics of the victim and the perpetrator, to the relationship between the victim and the perpetrator and to the most important variables regarding the criminal act (type of sexual act, duration, motive for cessation and person who reported crime). Sexual offences
D.*Pinto da Costa, T. Magalh~es, E. Matos, M. J. Carneiro de Sousa, J. Pinto da Costa
*Medico-Legal Institute, Oporto, Portugal Aim. In order to determine the value of the forensic examination in the outcome of the justice process in sexual crimes, the authors worked out a study devoted to collect relevant data concerning reported cases of criminal sexual conduct. The authors analyse the forensic intervention as a particular stage (and the medicine legal services as particular agencies) of the criminal process, treating it as a system.
Material and Methods. The authors studied 28 reported cases of
criminal sexual conduct (rape sexual assault and statutory rape) which occurred between 1992 and 1995 and were rejected at screening by the prosecution service after forensic physical examination of the victims at the Medico Legal Institute of Oporto. Results. (1) Victims
only two victims were male, mean age was 15.6 years (4-33), most were student (16), none of them presented story of deviant behaviour and only two had psychiatric troubles, nine had had previous complete sexual intercourse; (2) offenders - the offender was always a man, mean age was 28 years (1245), 14 w e ~ single and seven married, four were alcoholic and one drug addicted, in 22 cases the offended was previously known by the victim; (3) Crime - information of the victim or her legal representative 20 cases of vaginal penetration, three of anal penetration, two of vaginal penetration attempted, and one of gentia manipulation, in 1 case the crime was denied and in other there was no information; and (4) Forensic examination the forensic examination revealed signs of physical violence, only one case, in the extra and para-genital areas, corresponding to light physical offences, in three cases revealed signs of recent sexual activity, in 14, signs of non-recent sexual activity and in 11, no sign of sexual activity, it detected pregnancy situation, followed by spontaneous abortion. Comments. Essential elements of diagnosis are often lost owing
to excessive delay in the forensic examination (in only eight cases was the interval between the crime and the forensic examination less than 48 h or because procedures to preserve evidence weren't followed by the victim. The medicoMegal examination did not confirm the victim's information in 61.5% of the cases. For each one of the analysed cases the judicial process was filed, even in the three cases which correspond early to recent rape (because the offender was not identified). Child sexual abuse - a preliminary prospective study
T.* Magalhges, M.J. Carneiro de Sousa, A. Gomes da Silva, D. Pinto da Costa, E. Matos, JRG-G, Yebra, AC Grams, C. Ribeiro, J. Pinto da Costa
*Medico-legal Institute, Oporto, Portugal Introduction. A multi-disciplinary protocol devoted to take care
of the children who were victims of sexual abuse was created in 1997 in Oporto, between the Medico Legal Institute (MLI), six hospitals, the Juvenile Court and a group of social support to child inside the family. Material and methods. A study using this protocol was carried
out on all the 52 children victim of sexual abuse observed during 1997 at M L I by requirement of the Police Department, Criminal Court of Juvenile Court (according to the Portuguese law). Results. (1) - Victims 42 were female, mean age was 11.4 years
(3-17), 50 were from low social class, 1 presented a story of physical mistreatment, alcoholic, criminal and addiction family story was referred in 18 eight and two cases respectively (unknown information in 10 cases), one of the parents was absent in 15 cases, girls had voluntary sexual active life; (2) Offenders - all the offenders were male, mean age was 34.9 year (15-70), 22 were married, 24 friends or neighbours, 18 parents and relatives; (3) Event - 30 cases happened at the victim's or at
Bullet cytology: results of a pilot study R. Visser MD, PhD
Forensic Pathology Laboratory, Rijswijk, Netherlands During perforation, fragments of material may adhere to the bullet's surface (Nichols & Sens 1990). Not only cells, tissue (fragments) and blood, but also other substances like stomach contents and gunshot residue can be detected microscopically. Macroscopically visible tissue fragments are routinely retrieved for D N A typing, but the recognition and collection of minor tissue fragments or nucleus containing cells could also be used for D N A analysis. The aim of this project was to implement bullet cytology in our laboratory and to evaluate the results. Material. During the pilot period, 53 bullets were retrieved from 24 different crime scenes. First the bullets were investigated routinely in the national laboratory of forensic sciences, which is housed in the same building as the laboratory of forensic pathology. Because of the experimental character of the technique, the bullet cytology was performed after the routine examinations. This resulted in an interval of between 12 days and 5 months between the crime and time of receiving the bullets in our laboratory. Methods. After receiving the bullets, they were visually inspected in order to select (visible) tissue fragments. They were then placed immediately in physiological saline solution for rehydration purposes and stirred in a Vortex mixer in order to dissociate the material from the bullet surface. The washing solution was divided into two parts: one for cytology and one for D N A analysis. One of the parts was processed for cytocentrifugation (Cyto-spin) preparations and stained with May Giemsa Grtinwald. The results were scored according to a semi-quantitative scale:
0 1 2 3
No cellular or tissue structures Dubious Presumably Cell(s) and/or tissue are present
Results. With the unaided eye no tissue fragments were seen on the surface of the bullets. In our hands, this method resulted in cytological specimens, appropriate for cytological examination. Contrary to clinical cytology specimens, cells sometimes were damaged (fragmented, or missing nuclei); these were classified a s ' 1' ('dubious') or '2' ('presumably') dependent on the amount of material and morphological appearance. The specimens were investigated by the author in collaboration with a clinical cytologist. Using this protocol, we classified the results of 53 bullets as follows:
Class"
Number (n)
0 1 2 3
26 9 7 11
11
Most of the cells/tissue appeared to be of epithelial origin. If only solitary epithelial cells without nuclei or with pyknotic nuclei were present we regarded these as 'probably contamination' as we were not informed of the procedures of bullet collection. If epithelial cells with relatively large nuclei were present we classified these as 'parabasal epithelial cells, contamination unlikely'. Conclusion:
1. Bullet cytology is a simple, non-destructive method with high specificity and sensitivity. 2. Bullet cytology requires experience in clinical cytology. 3. Bullets may be contaminated with epithelial cells. 4. Two months after the crime, adherent cell material could still be recognized. 5. Cells collected by this method can be used for D N A analysis. 6. Bullet cytology (and collection of material for D N A analysis) is recommended as the first stage of the bullet examination program.
REFERENCE Nichols CA, Sens MA. Recovery and evaluation by cytological techniques of
trace materialretained on bullets.Am J For Med Path 1990; 11 (1): 17-34 Anal condyloms on a child without suspicion of sexual abuse: should the case be reported to the sanitary authorities? Th. Perrin, S. Dorray, A Geraut, M.C. Tortel, A. Tracqui, P. Kintz, B. Ludes.
*Medico-Legal Institute, Strasbourg, France The authors present the cases of three children aged between a few months to a few years, who presented with anal condyloms. In these cases, there was no suspicion of sexual abuse and the presence of condyloms of the same type on the mother's genitalia could suggest non-sexual transmission of this potentially carcinogenic disease, possibly during common bathing. Although this mode of transmission doesn't mean sexual abuse, the authors think that such cases should be reported to the sanitary authorities because they could be a sign of negligence and lack of sanitary care from parents towards their children. KEYWORDS - condylomata acuminata, child, non-sexual transmission, negligence, report to authorities Human bite: hate or love S. Doray*, A. Geraut, A. Tracqui, T. Perrin, P. Kintz, B. Ludes
*Medico-Legal Institute, Strasbourg, France The human bite: act of hate or feature of love? The authors report nine cases of bites of human origin. The severity of these cases ranges from a simple cutaneous print to amputation. This situation needs a very close contact between aggressor and victim. Biting is not an innocuous behaviour and the act often expresses a problematic relationship; thus, it is necessary to distinguish the children's bite from the adult one. For a child, the bite might represent an act of excessive, monopolizing love. For adults, it consists not only of an aggressive act against others, but may also represent a defensive act.
12
Sixth Cross Channel Conference on Forensic Medicine 1998
The authors report an extreme situation with a total amputation of the mobile part of the tongue. We describe another case with a loss of cutaneous substance in the anterior cervical region. The authors note variability in the site of bites but find that they are localised principally to the ears and nose, and also the forearms to some extent. It is, therefore, recognized that a h u m a n bite, inflicted in order to put an aggressor to flight, can lead to serious maiming. The recommended advice for treatment involves: 1. measures to disinfect and decontaminate the wounds 2. prescription of an appropriate course of antibiotics active against the main buccal pathogenic bacteria. Finally, it is necessary to keep in mind the possibility of an HIV contamination as a consequence of a human bite. KEYWORDS
bites, human, after-effects
Collaboration between judicial authorities in cases of sexual assault towards minors
A. Antonietti*, E. Avezzu, C. A. Romano
*Medico-legal Institute, Brescia, Italy A reform to a part of the Penal Code concerning sexual assault has recently come into effect in Italy (L66 of February 15, 1996); it contains many few principles relative to the protection of minors. Among others, Article 609 established that, when an offence of sexual assault toward a minor is proceeded with the Public Prosecutor must immediately inform the Juvenile Court. Moreover, in these cases, it provides for psychological and emotional assistance to the young victim, at every stage of the proceedings, on the part of the parents of another suitable person requested by the minor and admissible by the judicial authorities undertaking the case. The reasoning behind the law is to allow the Juvenile Court to adopt civil provisions within its jurisdiction to ensure that, once the penal proceedings are concluded, the monro does not remain in a family situation which is prejudicial to him or her. In the light of this new legislation the authors have analysed the cases under observation by the Brescia Juvenile Court, on the advice of the origination authority, in the period between the new legislation entering into force (February 1996) and February 1998. Data was extracted from the legal files. The authors utilized reports relative to the characteristics of the victim and the perpetrator, to the relationship between the victim and the perpetrator and to the most important variables regarding the criminal act (type of sexual act, duration, motive for cessation and person who reported crime). Sexual offences
D.*Pinto da Costa, T. Magalh~es, E. Matos, M. J. Carneiro de Sousa, J. Pinto da Costa
*Medico-Legal Institute, Oporto, Portugal Aim. In order to determine the value of the forensic examination in the outcome of the justice process in sexual crimes, the authors worked out a study devoted to collect relevant data concerning reported cases of criminal sexual conduct. The authors analyse the forensic intervention as a particular stage (and the medicine legal services as particular agencies) of the criminal process, treating it as a system.
Material and Methods. The authors studied 28 reported cases of
criminal sexual conduct (rape sexual assault and statutory rape) which occurred between 1992 and 1995 and were rejected at screening by the prosecution service after forensic physical examination of the victims at the Medico Legal Institute of Oporto. Results. (1) Victims
only two victims were male, mean age was 15.6 years (4-33), most were student (16), none of them presented story of deviant behaviour and only two had psychiatric troubles, nine had had previous complete sexual intercourse; (2) offenders - the offender was always a man, mean age was 28 years (1245), 14 w e ~ single and seven married, four were alcoholic and one drug addicted, in 22 cases the offended was previously known by the victim; (3) Crime - information of the victim or her legal representative 20 cases of vaginal penetration, three of anal penetration, two of vaginal penetration attempted, and one of gentia manipulation, in 1 case the crime was denied and in other there was no information; and (4) Forensic examination the forensic examination revealed signs of physical violence, only one case, in the extra and para-genital areas, corresponding to light physical offences, in three cases revealed signs of recent sexual activity, in 14, signs of non-recent sexual activity and in 11, no sign of sexual activity, it detected pregnancy situation, followed by spontaneous abortion. Comments. Essential elements of diagnosis are often lost owing
to excessive delay in the forensic examination (in only eight cases was the interval between the crime and the forensic examination less than 48 h or because procedures to preserve evidence weren't followed by the victim. The medicoMegal examination did not confirm the victim's information in 61.5% of the cases. For each one of the analysed cases the judicial process was filed, even in the three cases which correspond early to recent rape (because the offender was not identified). Child sexual abuse - a preliminary prospective study
T.* Magalhges, M.J. Carneiro de Sousa, A. Gomes da Silva, D. Pinto da Costa, E. Matos, JRG-G, Yebra, AC Grams, C. Ribeiro, J. Pinto da Costa
*Medico-legal Institute, Oporto, Portugal Introduction. A multi-disciplinary protocol devoted to take care
of the children who were victims of sexual abuse was created in 1997 in Oporto, between the Medico Legal Institute (MLI), six hospitals, the Juvenile Court and a group of social support to child inside the family. Material and methods. A study using this protocol was carried
out on all the 52 children victim of sexual abuse observed during 1997 at M L I by requirement of the Police Department, Criminal Court of Juvenile Court (according to the Portuguese law). Results. (1) - Victims 42 were female, mean age was 11.4 years
(3-17), 50 were from low social class, 1 presented a story of physical mistreatment, alcoholic, criminal and addiction family story was referred in 18 eight and two cases respectively (unknown information in 10 cases), one of the parents was absent in 15 cases, girls had voluntary sexual active life; (2) Offenders - all the offenders were male, mean age was 34.9 year (15-70), 22 were married, 24 friends or neighbours, 18 parents and relatives; (3) Event - 30 cases happened at the victim's or at