Vol 75, No 4 (1994)

The stages of formation and development of the forensic medical science are considered. The historical information of the outstanding representatives of the Kazan school and their contribution to the forensic medicine of our country are presented. The current developments and advances of the activity of the forensic medicine department of the Kazan medical institute are shown.

The comprehensive clinical picture of diffusive axonal trauma and its morphologic manifestations are given. It is shown that the mechanism of head trauma, the direction of traumatizing object motion and the terms of inflicting injuries may be determined by the localization and distribution of the foci of azones injuries.

The regularities of pelvis bones fractures in children depending on the concrete direction and conditions of the action of a hard obtuse object are revealed. The data provided show the basic mechanisms of fractures and permit solving the controversial problems occurring in concrete injury examinations

A comparative study of the quantity of the fractures of ribs in drivers and passengers of the front seat by front and back anatomic lines during front collisions of cars is performed. The statistically appreciable distinction of the quantity of the fractures of ribs by front and back surfaces in a driver and passenger is proved using the Student’s criterion providing the importance for determining the location of persons in a car during trauma inside it.

The criteria of determination of the distance of the «IZH-38» pneumatic rifle shot by peculiarities of lubricant deposits of the barrel bore on the vertical target wthi regard to its remoteness from the barrel cut are presented. The regularity of lubricant deposits on the target of an elliptic form in three zones: continuous, relatively continuous and solitary drops is revealed. The distance of the shot affects the formation, nature, relative position, combination and sizes of zones. The greatest distance of the shot comprises 185 sm wherein lubricant deposits on the target are revealed. The data obtained testify that for the pneumatic low-speed rifle the nature of lubricant deposits of the barrel bore around inlet bullet may serve as one of signs allowing to judge the distance of the shot.

The results of the analysis of annual accounts of the Republican Bureau of forensic medical examination of the Ministry of Public Health in Tatarstan Republik on the deathrate structure from 1961 to 1992 are presented. The increase of extensive indices of violent death in Tatarstan Republik is established and the data of the dynamics of various types of death are generalized.

The basic differences between pathoanatomical and forensic medical examinations of corpses are surveyed. The importance of histological examinations for diagnosis is stressed, the measures to provide catamnestic findings and the concept of systematic approach to the pathology detected in sudden death cases using forensic medical data are proposed, the diagnostic system developed and introduced by the authors to differentiate ischemic heart disease, alcoholic cardiomyopathy and acute alcoholic poisoning is characterized.

The results of forensic medical examination of the corpses of persons committing suicides are analysed. The seasonal variations of suicides number are revealed, the distribution of the death-roll by sex and age is shown, the rate of various methods of suicides is determined.

The results of years-old investigations devoted to the identification of obtuse metal trauma instruments are presented. The patterns of injuries occuring in various examination situations are systematized, and combined programs for personal computers are developed being a prime applied consideration and may hame a wide application in routine work of experts.

The combined programme of systems created to satisfy many vital needs of the service is characterised. The data presented are of interast to the represantatives of different fields of medicine and may give real help in the introduction of computers in health services institutions.

The estimation of the effect of saliva and breast milk on the adhesion of fungus C. albicans to literal epithelium surface is given. The reduction of adhesive activity of the saliva in newborns, patients with acute respiratory disease and breast wilk in sick mothers is noted. The antiadhesive activity of colostrum is higher than of mature breats wilk.

At present, mechanical and thermal injuries play an important role in the structure of mortality and lethality of the most able-bodied population. This is largely due to the development of multisystem or multiple organ failure after shock damage [20, 24]. One should agree with the opinion of Yu. Shuteu et al. [21] that among the vital organs, the damage of which is of decisive importance in the evolution of shock, the lungs have a primary role. According to numerous literature data, the involvement of the lungs in the pathological process increases the possibility of death in various types of shock from 25.5% to 85-90% [15, 34]. The totality of structural and functional changes in the lung that occur after exposure to the body of extreme factors is designated in the literature by various terms, most often as "acute respiratory failure syndrome", which in foreign literature corresponds to the name "adult respiratory distress syndrome", and in our country - "adult respiratory distress syndrome"(ARDS). In the literature, there are also such definitions of this condition as "wet (wet) lung", "water lung", "perfusion lung syndrome", "respiratory disorders syndrome", "Da Nang lung", "congestive atelectasis", "shock lung" or "lung with shock”, etc. Such an abundance of terms is caused by the often contradictory approach of researchers to the assessment of morphological and functional changes that occur in the lungs at various stages of extreme conditions.

Phagocytic reactions occupy one of the central places in the regulation of homeostasis and play an important role in the formation of pathological processes. Of particular importance among the latter is shock, which develops with powerful aggressive effects on the body and is accompanied by significant structural and functional changes that cover all systems, including phagocytic ones. By origin and structural and functional features, all phagocytic cells are divided into microphages (neutrophils) and macrophages (alveolar, Kupffer cells, monocytes, etc.).

The fibrinolytic system has a number of physiological functions, among which the most obvious and, apparently, important is the dissolution of fibrin clots.

Kazan hosted the XXVII scientific-practical conference of forensic experts and criminalists of Tatarstan, dedicated to the 125th anniversary of the founding of the independent department of forensic medicine at Kazan Medical University. Opening the conference, Deputy Minister of Health of Tatarstan R.G. Yamaleev and Rector of the Medical Institute, Corresponding Member RAMS, prof. N.Kh. Amirov noted the increasing importance of expert research in improving the quality of medical and preventive care in solving crimes. In relation to the head of the Republican Bureau of Forensic Medical Examination of the Ministry of Health of the Republic of Tatarstan Yu.P. Kalinin, the main stages and prospects of the development of forensic medicine in Tatarstan were highlighted, and the speech of the head of the department, prof. G.M. Kharina was devoted to the history of the Kazan school of forensic doctors, its scientific directions and ways to improve teaching. Topical issues of licensing and accreditation of forensic medical institutions were discussed in the comprehensive service of the Chief Forensic Medical Expert of Russia Assoc. IN. Plaksin.

The two years that have passed since the re-election in January 1992 of the composition of the board have turned out to be extremely difficult for the scientific society of surgeons of the Republic of Tatarstan. Despite the difficult economic situation, the society during this time managed to survive and not only continue, but also intensify its activities. In many ways, this became possible thanks to the direct support and assistance from the Ministry of Health of the Republic of Tatarstan, the leadership of the Republican Medical Center of the Ministry of Health of the Republic of Tatarstan, the chief surgeon of the health department, the head of the Kazan administration, for which the board expresses its sincere gratitude.