Cattaneo Cristina, Andreola Salvatore, Marinelli Eloisa, Poppa Pasquale, Porta Davide, Grandi Marco
Laboratorio di Antropologia ed Odontologia Forense, Istituto di Medicina Legale, Università degli Studi, Milano, Italy.
Am J Forensic Med Pathol. 2010 Mar;31(1):22-6. doi: 10.1097/PAF.0b013e3181c15d74.
An example of the barriers and conceptual differences between forensic anthropology and pathology can be seen in determining the vitality of a wound. Pathology can make use of skin color and microscopic techniques; anthropology (as concerns the study of dry bone) needs different criteria. The diagnosis of the vitality of a wound (whether it is produced antemortem or postmortem) as well as determination of the time elapsed between the production of the wound and death is a crucial issue in forensic pathology. In fresh skin, the red-purplish coloration of a cut or bruise will reveal its vitality, whereas the change in coloration, from a macroscopic perspective, will reveal the time of survival. In more difficult cases, microscopic analyses can be performed. Bone follows similar "laws" as concerns the evolution of the histologic picture, but even if the beginning of healing processes (periosteal bone production and callus formation) can be detected macroscopically and radiologically, these processes require a long time.The scope of this pilot study was therefore to collect bone fractures from cadavers with a known time of survival, have them undergo a simulated putrefaction procedure until they became "dry or macerated bone" and perform macroscopic and microscopic analysis to verify the potential of histology in identifying "vital" processes in putrefied soft-tissue-free bone.A total of 6 samples of fractured bone (cranium, rib, and tibia) were taken from cadavers with known time of survival between trauma and death. Time intervals ranged from a few seconds after the bone fracture had been inflicted, to several hours, days, and weeks. A negative control was included (postmortem fracture). The bone was decalcified and stained with hematoxylin and eosin, Perls' (for the demonstration of hemosiderin deposits), Periodic Acid Schiff, phosphotungstic acid-hematoxylin, and Weigert (for the demonstration of fibrin). Immunohistochemistry was performed using a monoclonal antibody antihuman Glycophorin A.Results show the presence of clots and red blood cell residues on the fractured margins, strongly indicative of vital reaction.This study, though certainly not conclusive, shows that it may be worth pursuing the study of bone fractures from a histopathological point of view even on "dry bone" to verify whether the fracture is vital or not, and, if so, if its time of production can be verified.
法医人类学与病理学之间的障碍和概念差异的一个例子可以在确定伤口的生机方面看到。病理学可以利用皮肤颜色和显微镜技术；人类学（就干骨研究而言）则需要不同的标准。伤口生机的诊断（无论其是生前还是死后形成）以及伤口形成与死亡之间经过时间的确定，是法医病理学中的一个关键问题。在新鲜皮肤中，切口或瘀伤的红紫色会显示其生机，而从宏观角度来看，颜色变化会显示存活时间。在更困难的情况下，可以进行显微镜分析。骨骼在组织学图像演变方面遵循类似的“规律”，但即使愈合过程的开始（骨膜骨生成和骨痂形成）可以通过宏观和放射学检测到，这些过程也需要很长时间。因此，这项初步研究的范围是从已知存活时间的尸体上收集骨折样本，使其经历模拟腐败过程直至变成“干骨或浸软骨”，并进行宏观和微观分析，以验证组织学在识别腐败的无软组织骨骼中“有生机”过程的潜力。总共从创伤与死亡之间已知存活时间的尸体上采集了6个骨折骨样本（颅骨、肋骨和胫骨）。时间间隔从骨折后几秒到数小时、数天和数周不等。纳入了一个阴性对照（死后骨折）。对骨骼进行脱钙处理，并用苏木精和伊红、珀尔斯染色剂（用于显示含铁血黄素沉积）、过碘酸希夫试剂、磷钨酸苏木精和魏格特染色剂（用于显示纤维蛋白）进行染色。使用抗人血型糖蛋白A单克隆抗体进行免疫组织化学分析。结果显示骨折边缘存在血凝块和红细胞残余物，强烈表明有生机反应。这项研究虽然肯定不具有决定性，但表明从组织病理学角度研究骨折，即使是“干骨”上的骨折，以验证骨折是否有生机，如果有生机，其形成时间是否可以得到验证，可能是值得的。
