Erken dönem kırık iyileşme bulgularının postmortem intervalde mikroskobik olarak tespit edilebilirliği ve vitalite açısından değerlendirilmesi
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Date
2013
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Uludağ Üniversitesi
Abstract
Çalışmamızda kırık iyileşmesinin mikroskobik bulgularının postmortem dönemde ne kadar süre ile tespit edilebildiği ve tespit edilen bulguların kırığın antemortem dönemde mi yoksa postmortem dönemde mi meydana geldiğinin ayrımında kullanılıp kullanılamayacağının değerlendirilmesi amaçlandı.Çalışmamızda Yeni Zelanda Beyazı tavşanların fibulalarında antemortem dönemde oluşturulan kırıklarda postmortem 0, 12, 24, 48, 72, 120, 168, 216, 288 ve 360. saatlerde örnekleri alınan 10 grup ve postmortem 1. saatte kırık oluşturulan kontrol grubunda her birinde 10 örnek olacak şekilde kırık iyileşmesinin mikroskobik bulguları değerlendirildi. Sabit sıcaklık ve nem oranına sahip kapalı bir ortamda 15 günlük pütrefaksiyon sürecine bırakılan örneklerde mikroskobik olarak kırık uçlarında inflamasyon bulguları, fibrin, granülasyon dokusu ve periosteal yeni kemik yapımı değerlendirildi. Kemik kırık örnekleri histopatolojik inceleme için hematoksilen & eozin ve fosfotungustik asit hematoksilen ile boyandı.Kontrol grubunda mikroskobik olarak değerlendirilen parametrelerden hiçbirisi saptanmadı. Çalışma gruplarının mikroskobik değerlendirmesinde; inflamasyon bulguları postmortem 120. saate kadar anlamlı olarak tespit edilirken ilerlemiş otoliz ve pütrefaksiyona rağmen postmortem 288. saat örneklerinden 2'sinde de inflamatuar hücre silüetleri görüldü. Fibrin, kontrol grubu dışında postmortem 360. saat örnekleri dahil tüm örnek gruplarında tespit edildi. Granülasyon dokusu ve periosteal yeni kemik yapımına ait bulgular mevcut olduğunda postmortem 288. saat örneklerinde de izlendi.Çalışmamızda sonuç olarak; kemik kırıklarında otoliz ve pütrefaksiyon süreçlerinin ilerlemiş veya yumuşak dokuların ortadan kalkmış olduğu durumlarda bile inflamasyon bulguları, fibrin, granülasyon dokusu ve periosteal yeni kemik yapımı varlığının vitalite açısından histopatolojik inceleme ile anlamlı bulgular ortaya koyduğu gösterildi.
In our study, it is aimed how long do the microscopic findings of fracture healing in postmortem interval can be detected and whether the detected findings can be used in differentiation of fractures occur in the period of antemortem or postmortem or not.In our study, microscopic findings of 10 study groups included manually fractured bone samples that were created in antemortem period in New Zealand White rabbit fibulas and samples taken in the postmortem 0, 12, 24, 48, 72, 120, 168, 216, 288 and 360th hours and the control group included fractured bone samples that were created in the postmortem 1st hour were evaluated by sampling 10 specimens from each group. In the specimens, in a closed environment under constant temperature and humidity that exposed to 15-day process of putrefaction, microscopic signs of inflammation, fibrin, granulation tissue and periosteal new bone formation in fracture edges were evaluated. Samples of bone fractures were stained with phosphotungstic acid hematoxylin and hematoxylin & eozin for histopathological examination.In the control group, none of the evaluated parameters were detected microscopically. In microscopic evaluation of the study groups; although in two of the 288th hour samples inflammatory cell silhouettes were seen in spite of advanced autolysis and putrefaction, statistically significant inflammation findings detected postmortem up to 120th hour. Fibrin was detected in the all sample groups including postmortem 360th hour samples, other than the control group. When the findings of formation of granulation tissue and periosteal new bone are present, they also seen up to postmortem 288th hour samples.As a result in our study; in bone fractures, inflammation findings, fibrin, granulation tissue and the presence of periosteal new bone formation, have vindicated even in cases where advanced processes of autolysis and putrefaction or soft tissue has disappeared, it revealed significant findings in terms of vitality by histopathological examination.
In our study, it is aimed how long do the microscopic findings of fracture healing in postmortem interval can be detected and whether the detected findings can be used in differentiation of fractures occur in the period of antemortem or postmortem or not.In our study, microscopic findings of 10 study groups included manually fractured bone samples that were created in antemortem period in New Zealand White rabbit fibulas and samples taken in the postmortem 0, 12, 24, 48, 72, 120, 168, 216, 288 and 360th hours and the control group included fractured bone samples that were created in the postmortem 1st hour were evaluated by sampling 10 specimens from each group. In the specimens, in a closed environment under constant temperature and humidity that exposed to 15-day process of putrefaction, microscopic signs of inflammation, fibrin, granulation tissue and periosteal new bone formation in fracture edges were evaluated. Samples of bone fractures were stained with phosphotungstic acid hematoxylin and hematoxylin & eozin for histopathological examination.In the control group, none of the evaluated parameters were detected microscopically. In microscopic evaluation of the study groups; although in two of the 288th hour samples inflammatory cell silhouettes were seen in spite of advanced autolysis and putrefaction, statistically significant inflammation findings detected postmortem up to 120th hour. Fibrin was detected in the all sample groups including postmortem 360th hour samples, other than the control group. When the findings of formation of granulation tissue and periosteal new bone are present, they also seen up to postmortem 288th hour samples.As a result in our study; in bone fractures, inflammation findings, fibrin, granulation tissue and the presence of periosteal new bone formation, have vindicated even in cases where advanced processes of autolysis and putrefaction or soft tissue has disappeared, it revealed significant findings in terms of vitality by histopathological examination.
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Keywords
Postmortem değişiklikler, Adli patoloji, Kemik, Kırıklar, Mikroskopi, Postmortem changes, Forensic pathology, Bone, Fractures, Microscopy
Citation
Çetin, S. (2013). Erken dönem kırık iyileşme bulgularının postmortem intervalde mikroskobik olarak tespit edilebilirliği ve vitalite açısından değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.