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U članku je na primjerima iz rada vještaka prikazano više realnih slučajeva nesreća koje uzrokuju teške mehaničke ozljede, često s fatalnim ishodom. Prikazane su okolnosti nesreće u proizvodnom pogonu ljevaonice prilikom čišćenja miješalice, nesreće koja je nastala kao posljedica nekontroliranog izlijevanja taline i eksplozije, nesreće na platformi naftnog tornja i nesreće koja se dogodila prilikom rada poljoprivrednog stroja. Dani su podaci o mehaničkim ozljedama koje su često posljedica različitih nesreća, što je područje rada sudsko-medicinskog vještaka. Potom su analizirani uzroci prikazanih realnih slučajeva nesreća na radu., The article presents on the examples from the expert's work several real cases of accidents that cause serious mechanical injuries, often with a fatal outcome. The circumstances of the accident at the foundry production plant when cleaning the blender are presented; accident resulting from an uncontrolled spill of melt and explosion, an accident on the oil tower platform and an accident that occurred during the operation of an agricultural machine. Data on mechanical injuries that are often the result of various accidents are given, which is the field of work of a court medical expert. An analysis of the causes of real cases of accidents at work has been carried out.

This paper is a retrospective analysis of data on 278 persons with fatal outcomes in traffic accidents in Osje~ko- -baranjska County, Croatia, during a five-year period. The observed sample of casualties was divided according to the time of fatal outcome into three groups: immediately deceased (139 or 50.0%), deceased within the first 48 hours (84 or 30.2%) and deceased after 48 hours (55 or 19.8%). A comparison of data was made for the first two groups of casualties, based on the level of alcohol intoxication, and an analysis of the possible influence of alcohol intoxication on an early outcome of severe trauma, which was defined as immediate fatal outcome and fatal outcome within the first 48 hours following the trauma. Casualties from the group of immediately deceased had a significantly higher average blood alcohol level than casualties from the group of persons deceased within the first 48 hours (shown through arithmetic mean of 0.81 g/kg vs. 0.33 g/kg, p=0.000). A binary logistic regression analysis showed that every increase in blood alcohol level by 1 g/kg also increased the odds of an immediate fatal outcome by 1.92 times (p=0.004). Conclusion: Beside increased risks of traffic accidents, the collected data showed that alcohol intoxication of accident participants also increases their chances of an immediate fatal outcome.

Most suicides are solitary and private ; but few result from a pact between 2 people to die together. Two young men made a pact to commit suicide by hanging from a tree. It was the first case among 1320 single suicides in more than 2 decades in eastern Croatia. Double suicide between people of the same gander is an unusual event. It is predominantly made by male-female partners and by less violent methods. One of the 2 members experienced depression. He may have been the initiator and the other partner may have been the dependent. The initiator usually plans the act and stimulates the other party. Whether the decision was evenly shared by both partners and initiative came from one of the two or it was result of 2 independent decisions remains open for analysis. Double suicide is also very interesting from the perspective of medical examiners. They need to make comprehensive postmortem examination to finally conclude the proper cause and the manner of death.

The primary value of DNA profiling significantly increased over the last fifteen years due to introduction of short tandem repeat (STR) loci in routine paternity testing, forensic work and identification of victims of mass disaster. Different methods of forensic DNA testing (known as DNA fingerprinting) have been widely established and accepted as standard procedures of investigation. This lecture presents the experience of the last eighteen years of identification of missing persons in Bosnia and Croatia. The data show that current protocols and procedures optimized for relatively fresh bones and teeth can be used in analysis of much older samples without significant modification. Also, introduction of new technologies (e.g., miniSTR assay) can help recover information from degraded DNA samples that typically result in partial profiles and total loss of information from regular STR amplicons. This approach has already been used in the analysis of highly degraded samples like those from the victims of World Trade Center terrorist attacks and WWII. Now the use of this scientific approach has been proven even for the two millenia old bone samples. In collaboration with Roche Molecular Systems recently we used a new generation of mtDNA strips and were able to get full profiles from several century old bones even in a cases where STR amplification completely failed.

Mineralization Structure of the Hyoid Bone is presented and discussed.

Mineralisation Characteristics of the Hyoid Bone are presented and discussed.

Previous investigations indicated cerebral hemodynamic changes in terms of increased mean blood flow velocities (mBFV) detected with transcranial dopler ultrasonography (TCD) in patients (pts) with posttraumatic stress disorder (PTSD). The aim of this study was to determine correlation between level of stress hormones and cerebral hemodynamic changes in PTSD pts. We examined 50 pts with acute PTSD, aged between 30 and 50 years (yrs), as well as 50 healthy subjects similar ages as control group. On the first day after hospitalization TCD was done and the measures of vanilmandelic acid (VMA) in 24-hour urine (as metabolit of adrenalin and nor-adrenalin) were analyzed in PTSD pts. The same diagnostic procedures were repeated after in PTSD pts 21-day long psychiatric treatment and in control subjects. In the first analysis 34 PTSD pts had increased mBFV, 29 of them (85.26%) had increased level of VMA. After 21-day long psychiatric treatment 9 PTSD pts had increased mBFV and 8 of them (88.88%) had increased level of VMA. The difference between two measures was statistically significant (p

For the layperson no crime is more difficult to comprehend than the killing of a child by his or her own parents. This is a retrospective study of neonaticide and infanticide in Eastern Croatia from 1980 to 2004. Judicial records of infanticide cases stored in Regional and County Courts were analyzed for the circumstances surrounding the offense. Twenty-four babies were discovered in various places during investigating period of time. The victims were almost equally divided between boys (12) and girls (11). The gender of one baby was unknown. The mean weight of babies was 2.7 SD = 0.66 kg. The perpetrators preferred rubbish-heaps (33.4%), burying in soil (16.7%), various premises in or around the house (16.7%) and garbage cans (12.5%) as places for hiding the dead babies. The most dominant cause of death in sixteen cases of live birth was asphyxia (37%) with equal distribution of smothering, stuffing the mouth with rags and strangulation. Other frequent causes of death were placing the child in a plastic bag and abandonment (25%), brain injury (25%) and wounding using a sharp weapon (12.5%). The cause of death for six babies remained unknown due to advanced decomposition. Two babies were stillborn. The age of accused mothers varied from 16 to 33, mean 24 SD=5.2 years. Most of them were unmarried (60%) and had limited formal education. They usually kept the pregnancy a secret (73%) and gave birth (93%) without public welfare assistance. The mother lived in the terror of shame and with the guilt that accompany conception without marriage. Fear seemed to be a pronounced motivating factor for committing infanticide. The data on court proceedings were available in fifteen cases. The mothers were officially indicted in all cases for infanticide under the Croatian Criminal Code. The perpetrator remained unidentified in nine suspicious crimes. The court convicted ten mothers of the crime of infanticide. Often juries were unwilling to punish the mother, citing the mother's lifelong guilt of having killed her child as enough punishment.

In this paper was presented new approach of teh morphological classification of the hyoid bone.

With the advance in typing tools and extraction procedures in the recent years, DNA analysis developed in the amazingly powerful method for forensic analysis. For a number of years we are using autosomal STR typing as a tool to lead the process of identification of war victims in Croatia. Although DNA typing is very effective in finding possible identities of exhumed skeletal remains, this approach bears some risk of false identification. Here we report a case of a match between skeletal remains and son and wife of a missing person in 13 STR loci. Even though these skeletal remains also matched in 13 loci with mother of the same missing person, additional genetic testing (Y-STR and mitochondrial DNA) unequivocally excluded the proposed identity. Although likelihood ratios is the best measure of the significance of a genetic match between exhumed skeletal remains and relatives of a missing person, in database matching the meaning of likelihood ratio is not as clear as in simple paternity cases and great care is needed to avoid wrong interpretation. To reduce the risk of possible false identifications, in addition to DNA evidence we heavily relay on other types of evidence (such as the information about time, place and other conditions of disappearance), as well as anthropological and other "classical" forensic data as a "control mechanism" in the DNA-lead process.

Hyoid bone is a part of viscerocranium placed between the tongue root and thyroid cartilage to which it is connected by thyrohyoid membrane. Widely accepted morphological classification does not exist. Sexual dimorphism was analysed in this study and new guidelines for anatomical classification of hyoid bones based on anthropometric parameters were given. Total number of analysed bones was 70. The bones were classified into three groups: symmetrical U-type, symmetrical V-type and asymmetrical type according to the angle between greater horns and the proportion of greater horns length. In the females incidence of asymmetrical type is considerably higher than in the males, while the incidence of symmetrical V-type is lower. The angle value that is on average higher in males may be the parameter indicating that in puberty hyoid bone, still not completely ossified, to some extent follows development of thyroid cartilage because of their close anatomical relation.

With the advance in typing tools and extraction procedures in the recent years, DNA analysis developed into amazingly powerful method for forensic analysis. For a number of years we are using autosomal STR typing as a tool to lead the process of identification of war victims in Croatia. Although DNA typing is very effective in finding possible identities of exhumed skeletal remains, this approach bears some risk of wrong identification. Here we report a case of a match between skeletal remains and mother, son and wife of a missing person with a cumulative likelihood ratio of nearly 2×109 that was shown to be a false match, since additional genetic testing (Y-STR and mitochondrial DNA) unequivocally excluded the proposed identity. Although we still use likelihood ratios as a main measure of the significance of a genetic match between exhumed skeletal remains and relatives of a missing person, in database matching the meaning of likelihood ratio is not as clear as in simple paternity cases and great care is needed to avoid wrong identification. In addition to DNA evidence we heavily relay on other types of evidence (such as the information about time, place and other conditions of disappearance), as well as anthropological and other "classical" forensic data as a "control mechanism" in the DNA-lead process.

Since February 2001, instead of targeted (presumptive) approach to DNA typing, war victims in Croatia are being identified by comparing their STR genotypes to all genotypes of potential relatives in the database. The database currently contains over 3, 000 nine-loci individual genotypes (D3S1358, vWA, FGA, TH01, TPOX, CSF1PO, D5S818, D13S317 and D7S820). Although this approach significantly increased the pace of identification by DNA typing, non-targeted matching in a database containing several thousand genotypes is associated with a significant risk of false-positive matches, especially in a situation when identifications are based on reverse paternity determination. Here we are presenting four examples where we observed nine, ten or eleven STR loci match between child and spouse of a missing person and skeletal remains that did not originate from that missing person. For three of the four skeletal remains the proposed identity was excluded by analysis of further STR loci (D8S1179, D21S11, and D18S51), while in the fourth case non-DNA evidence was used.

U ovom radu prikazani su uzroci smrti u petogodišnjem razdoblju u Kliničkoj bolnici Osijek.

Domovinski rat u Hrvatskoj imao je sve osobitosti modernih ratova: veliki udio civilnih žrtava, znatnu uporabu artiljerijskih oruđa s posljedičnim višestrukim ranjavanjem i gubitak klasične linije bojišnice. Tijekom istraživanja pregledani su obdukcijski zapisnici Kliničkog zavoda za patologiju i sudsku medicinu Kliničke bolnice Osijek od 1. svibnja 1991. do 30. travnja 1992. U tom je razdoblju provedena 751 obdukcija žrtava nasilne smrti. 414 žrtava (55, 1%) podleglo je ozljedama od eksplozivnih sredstava, dok je u 274 slučaja smrt bila posljedica strijelnih rana. Većina je žrtava bila muškog spola (673 - 89, 6%). Mlađe dobne skupine bile su izloženije ranjavanju - većina žrtava bila je u trećem i četvrtom desetljeću života (399 - 53, 1%). Udio poginulih među vojnicima i civilima bio je gotovo jednak. Broj žrtava u naseljenim područjima nadvisio je gubitke ljudstva na fronti. Najveći broj žrtava zabilježen je u rujnu (128 - 17, 4%) i studenom (150 - 19, 9%) 1991. godine. Većina umrlih nasilnom smrću bili su žrtve ubojstva (94%), dok su samoubojstva (2, 9%) i nesretni slučajevi (3, 1%) bili rijetki. Ozljede nastale djelovanjem eksplozivnih sredstava bile su većinom višestruke, prekrivajući sve dijelove tijela (50%). Pojedinačne strijelne ozljede najčešće su se nalazile na glavi (48%), dok su se višestruke strijelne ozljede najčešće nalazile na trupu i udovima (26, 3%). Razaranje civilnih ciljeva, veliki udio ozljeda nastalih djelovanjem eksplozivnih sredstava i višestruke strijelne ozljede čine se sve tipičnijim osobitostima modernih ratova.

Istraživanjem je obuhvaćeno 2104 bolesnika obduciranih na Kliničkom zavodu za patologiju i sudsku medicinu Kliničke bolnice Osijek, u razdoblju od 1989. do 1995. godine, sa izuzetkom 1991. i 1992. godine zbog ratnih zbivanja. U navedenom je razdoblju učestalost obdukcije iznosila 51, 62% i ne bilježi pad kao u većini razvijenih zemalja. Najviše obduciranih osoba umrlo je u šestom desetljeću života i prethodno je bilo zbrinuto na Internom odjelu. Najčešći pojedinačni neposredni uzroci smrti bili su redom: ishemijska bolest srca, pneumonija, plućna tromboembolija, spontano krvarenje u mozak, respiratorni distres sindrom i iskrvarenje, a sveukupno su kardiovaskularne bolesti prouzročile 40, 30% svih smrti. Podudarnost kliničke i obdukcijske dijagnoze postojala je u 70, 30% slučajeva, a najmanja je bila u osoba čiji je boravak u bolnici iznosio manje od 24 sata. U osoba koje su boravile u bolnici dulje od 24 sata duljina boravka nije imala bitnijeg utjecaja na točnost dijagnoze. Unatoč postojanju suvremenih dijagnostičkih metoda, obdukcija ima vrlo istaknuto mjesto u otkrivanju uzroka smrti i provjeri kliničke dijagnoze.

A rare case of intracranial meningioma coexistent with cholesteatoma, without other signs of von Recklinghausen's disease, is described. Meningioma, a tumor of mesenchymal origin arising from leptomeninges, usually develops as a solitary or multiple tumor, or in the form of meningiomatosis. It is rarely associated with other intracranial tumors. Coexistence with neurinoma, glioma - von Recklinghausen's disease, glioblastoma, pituitary adenoma, and with metastases from pulmonary, mammary and prostatic carcinoma, has been observed. Cholesteatoma develops from congenital epithelial inclusion residues. Its most common supratentorial localization is the parasellar area. In 15%-25% of cases it is found intradiploically, mostly in the frontal and parietal bone, as in the case presented. Our 73-year-old female patient with two CT-verified intracranial tumors underwent a two-act operation. Both operations proceeded well, and the treatment was completed in a rehabilitation center.

Aim. Analysis of homicides committed in eastern Croatia, in order to define the sociodemographic characteristics of homicide acts and their participants. Methods. Homicides committed from 1970 to 1989 in the area of eastern Croatia were retrospectively investigated. Data were collected from the records of Osijek and Požega District Courts, and the Department of Forensic Medicine, Osijek University Hospital. During the study, 301 homicides were analyzed according to both assailant and victim. Results. In a series of 301 homicides, single homicides prevailed (N=275 ; 91.4%). The lowest rate of homicides was recorded in 1977 and 1978 (1.04 per 100, 000 population), and the highest in 1983 (2.65 per 100, 000), with a 20-year mean annual rate of 1.72. Men predominated as both assailants (N=221 ; 91.3%) and victims (N=197 ; 71.6%). Assailants of both sexes were mostly between the age of 20-40, and victims between the age of 30-45 years. Homicide was most commonly motivated by a quarrel between the assailant and the victim (47.8%). Most of the homicides were committed indoors (67.8%). Sharp force and firearms were most frequently used to commit homicide (42.9% and 23.2%, respectively), followed by blunt force (13.2%), ax (9.1%), punching and kicking (6.2%), asphyxia (4.75%), and immolation (2 cases ; 0.7%). In most (63.3%) cases, death occurred instantaneously, i.e., at the moment of homicide. The group of multiple homicides included seven double homicides and one quadruple homicide, as well as eight cases where one victim was attacked by several assailants. Blood alcohol level was determined in 152 offenders immediately after the homicide and in 185 victims on autopsy. The presence of alcohol was recorded in 80.9% of assailants and 72.4% of victims. Conclusion. Homicides most frequently resulted from a spontaneous violence among persons who knew each other, rather than due to a criminally motivated activity. The perpetrators’ aggressiveness could be related to the state of alcohol intoxication.

Northern and southern Croatian sample populations were typed at seven PCR-based loci -- LDLR, GYPA, HBGG, D7S8, Gc, HLA-DQA1 and D1S80. The results show that all loci meet Hardy-Weinberg expectations and that there is little evidence for association of alleles between loci. Allelic frequency distributions at all loci, except HLA-DQA1, show no differences between the northern and southern Croatian sample populations. Moreover, the population data for Croatians are similar to U.S. Caucasians ; only HLA-DQA1 for southern Croatians was statistically different compared with U.S. Caucasians. A Croatian population database(s) has been created and can be used for forensic analyses to estimate the frequency of a multiple locus DNA profile.

Prikaz bioptičkog materijala vezanog za karcinom dojke u razdoblju od 1991-1995 godine.

Izvršena epidemiološka analiza bolesti žučnog mjehura.

U jednostruko slijepo, randomnizirano, prospektivno istraživanje je uključeno 60 ambulantnih bolesnika s recidivantnim duodenalnim ulkusima i Helicobacter pylori infekcijom. Bolesnici su metodom slučajnog izbora podijeljeni u dvije skupine. Prva skupina bolesnika (n=30) liječena je famotidinom 40 mg, navečer prije spavanja, šest tjedana uz amoksicilin 2×1000 mg/dan tijekom 14 dana i metronidazol 2×800 mg/dan tijekom sedam dana. Druga skupina bolesnika (n=30) liječena je famotidinom 40 mg, navečer prije spavanja, tijekom 6 tjedana uz oksitetraciklin 4×500 mg/dan tijekom 14 dana i metronidazol 2×800 mg/dan tijekom 7 dana. Nakon šest tjedana ulkusi su zacijelili u 93, 3% (28/30) bolesnika prve i 96, 6% (29/30) bolesnika druge skupine. Razlika nije statistički značajna. Bolesnici s nezacijeljenim ulkusima dobivali su famotidin 40 mg navečer prije spavanja još dva tjedna. Nakon zacijeljenja ulkusa bolesnici nisu uzimali antiulkusnu terapiju održavanja. Mjesec dana po završetku liječenja eradikacija Helicobacter pylori postignuta je u 73, 3% (22/30) bolesnika prve i u 80% (24/30) bolesnika druge skupine. Razlika nije statistički značajna. Nazočnost H. pylori dokazivana je brzim utreaza testom i histološkim ispitivanjem bioptičkih uzoraka iz antruma i korpusa želuca. Tijekom 12 mjeseci od završetka liječenja, do ponovnog javljanja ulkusa došlo je u 35, 7% (5/14) bolesnika kod kojih nije eradiciran H. pylori i u 2, 2% (1/46) bolesnika s eradiciranim H. pylori. Razlika je statistički značajna (p

This report presents an analysis of autopsy records from the Department of Pathology and Forensic Medicine, Osijek General Hospital, in the period from 2 May 1991, when 12 croatian policemen were killed in an ambush in Borovo Selo and the war against Croatia unofficially began, until 15 January 1992, when the last cease-fire agreement between Croatia and Serbia, sponsored by the United Nations, became effective.During that time, 651 war-related autopsies were preformed, constituting 42 percent of all the deaths recorded in eastern Slavonia for that period.This number presents an 11-fold increase in the number of violent deaths in comparison to the same period of the pre-war year 1989 to 90.Forty-four percent of all deaths were civilian ones.Explosive wounds were the most frequent cause of death: they accounted for 60 percent of the civilian and 49 percent of all the deaths.This facts and the extensive destruction of the cities in eastern Slavonia, including their hospitals, indicate that a principal characteristic of this and many modern wars is sudden unexpected ground and air attacks on civilian targets.

Twenty one civilians, 5 women and 16 men, were found dead in their doorways and yards after Serbian terrorists attacked the village of Četekovac on September 3, 1991. The age of the decedents ranged from 18 to 91 years. The oldest victims were women (aged 63, 68, 72, 86 and 91). The wounds found on 19 decedents were characteristic of long-range gunshot wounds, with projectiles fired mostly from the back or/and the side of the body. The autopsy of one decedent revealed that he died from two stabbing wounds and that those were the only wounds inflicted to the body. The body of the other decedent was heavily carbonized so that the cause of the death and even whether he was alive when his body was set on fire could not be determined.

In the afternoon of November 27, 1991, a sudden heavy artillery attack was launched by the Yuoslav Federal Army from the Baranja region on the Pulmology and Tuberculosis Ward of the Osijek General Hospital. The building was directly hit with two projectiles and four fell into the yard. Four patients were killed and three wounded on the stairway while trying to take shelter in the basement. The dead and the wounded were patients with advanced tuberculosis or carcinoma of the lungs. This brutal attack showed once more that the Yugoslav Federal Army and Serbian terrorists have no respect for human lives and the Geneva Conventions.

On August 1, 1991, the Yugoslav Federal Army and Serbian extremists attacked the village of Dalj, near Osijek.The civilians took refuge in osijek and Hungary, butmany of them were captured by terrorists.Their fate is still unknown, and the number of missing persons is more than 300.the Federal Army denies the entry to the village and permitted only 25 cadavers to be taken to the Osijek Hospital.Two out of 25 were civilians:P.D. a baker of Albanian origin and N.T. a baker assistant, a Croat.The decedent N.T. was killed from the back by rifle fire, while the decedent P.D. was first beaten and than executed by two close-range gunshots in the head.

This report presents the analysis of autopsy records from the Department of Pathology and Forensic medicine, Osijek General Hospital, in the period from May 2, 1991, when 12 Croatian policemen were killed in an ambush in Borovo Selo, until November 30, 1991. In that period, 496 autopsies were performed, constituting 42% of all the deaths recorded in Eastern Slavonia for that period. 96% of all autopsies were cases of violent deaths. Approximately 48% of all deaths were civilian ones. Explosive wounds were the most frequent cause of death, followed by gunshot wounds. In civilian population, 62% died from explosive wounds, indicating that the agressor`s main strategy is the destruction of civilian targets from the air or by heavy artillery fire froma safe distance.

Twenty one civilians, 5 women and 16 men, were found dead in their doorways and yards after Serbian terrorists attacked the village of Cetekovac on 3 September 1991. The age of the decedents ranged from 18 to 91 years. The oldest victims were women (aged 63, 68, 72, 86 and 91). The wounds found on 19 decedents were characteristic of the long-range gunshot wounds, with projectiles fired mostly from the back or/and the side of the body. The autopsy of one decedent (J. B.) revealed that he died from two stabbing wounds and that those were the only wounds inflicted to the body. The body of the decedent (M. S.) was heavily carbonized so that the cause of the death or even whether he was alive when his body was set on fire could not be estimated.

Papilom horoidnog pleksusa je rijedak intrakranijalni tumor (0,4—6%). Prikazana je bolesnica koja je manifestirala simptome povišenog intrakranijalnog tlaka, ataksiju hoda i slabost vida. Kompjuterizirana tomografija (CT) mozga utvrdila je hidrocefalus, a na odbukciji je pronađen papilom horoidnog pleksusa u četvrtoj moždanoj komori., The choroid plexus papillomas 6°/o of brain tumours. The patient manifested clinical evidence of raised intracranial pressure, ataxia and oftalmic dicorders. Computed tomography study revealed hydrocephalus. At autopsy, choroid plexus papilloma was found within the fourth ventricle.

Mitralni prolaps je sindrom koji se relativno često (5 — 10 %) pojavljuje u općoj populaciji. Asimptomatskih je bolesnika više nego li onih simptomatskih. Prikazan je bolesnik koji je imao nespecifične simtome niz godina i naposljetku je zadobio cerebralnu emboliju., Mitral valve syndrome is relatively frequent in general population. Asymptomatic patients predominate over the symptomatic ones. This paper presents a patient who for many years demonstrated non-specific symptoms resulting in a cerebral embolic event.