95

Bangladesh Journal of Medical Science Vol. 20 No. 01 January’21

Original article:
Cholinesterase in different types of the muscle tissue

during the early postmortem period for diagnosis of death coming
Lidiya Cherkashyna1, Anton Shklyar2, Roman Sukhonosov3, Olha Miroshnikova4, Ludmyla Naguta5, Vasyl Olkhovskiy6, 

Nadiia Demikhova7, Larysa Kuts8, Ganna Barchan 9, Ganna Sukhomlyn10, Ludmila Kyptenko11

Summary
The purpose of the research:	consisted	in	study	of	postmortem	regularities	in	the	content	of	cholinesterase	
in	 different	 types	 of	muscle	 tissue	 (MT)	 for	 improving	 accuracy	of	 determination	of	 the	 prescription	
of death coming PDC.Materials and methods: The	 activity/level	 of	 cholinesterase	 was	 determined	
in	 homogenates	 of	 the	 myocardial	 (MMH),	 oesophageal	 (OMH),	 diaphragm	 (DMH)	 and	 intercostal	
muscles	(IMH)within	the	early	PMP	(3-13	hours	after	the	coming	of	death)	on	30	human	corpses.	MT	
was	 sampled	 in	 conditions	 of	 postmortem	 biopsy	with	 use	 of	 special	 instruments;	MT	 homogenates	
were	prepared	following	the	standard	technique	with	subsequent	determination	of	cholinesterase	content	
in	MT	homogenates. Results and discussion:	The	 analysis	 of	 postmortem	 changes	 in	 the	 content	 of	
cholinesterase	in	MT	depending	upon	PDC	revealed	that	after	3	hours	from	the	moment	of	death	coming	
its	highest	content	was	in	muscles	of	the	oesophagus,	the	least	one	being	in	MT	of	the	intercostal	muscles	
(respectively,	(2,717.1±37.1) and (883.5±6.2) U/g, р<0.001). Levels	of	cholinesterase	content	in	MT	of	
the	myocardium	and	diaphragm	were	rather	close,	though	they	differed	(respectively,	(1,213.8±8.8) and 
(1,512.8±11.5) U/g,	р<0.05), and	occupied	an	intermediate	place	between	the	corresponding	values	of	MT	
of	the	intercostal	muscles	and	oesophagus.A	common	pattern	for	the	content	of	cholinesterase	in	different	
types	of	MT	was	characterized	by	a	decrease	of	this	content	with	an	increase	in	PDC	terms;	besides,	the	
dynamic	lines	of	its	changes,	that	we	obtained,	became	basic	ones	for	substantiating	quantitative	time	
dependencies	and	construction	of	relevant	nomograms	for	forensic	diagnosis	of	PDC	by	cholinesterase 
content	in	MT.	Conclusions:	It	was	proved	that	the	content	of	cholinesterase	in	all	MT	homogenates,	
which	we	studied,	changed	regularly	(and	nonlinearly),	but	the	initial	and	final	levels	of	cholinesterase	
content	differed	depending	upon	 the	 type	of	MT.	Besides,	 the	dynamics	 in	 changes	of	 the	content	of	
cholinesterase	within	 the	 time	period	of	3÷13	hours	 from	 the	moment	of	death	coming	differed	upon	
the	 type	 of	MT	 too.	Advantages	 of	 the	 technique	 consist	 in	 theintegrity	 of	 biochemical	 examination	
of	different	types	of	MT	and	simplicity	in	interpretation	of	findings.	The	application	of	the	nomogram	
technique	for	assessing	PDC	by	cholinesterase	content	in	MT	makes	it	possible	to	improve	the	accuracy	
of	diagnosis	for	terms	of	the	coming	of	death	up	to	60	minutes.
Keywords: early	postmortem	period;prescription	of	death	coming;muscle tissue; cholinesterase.

Correspondence to: Nadiia	Demikhova,	Professor,	Department	of	Family	Medicine,	Sumy	State	University,	
Sumy,	Ukraine;	n.demyhova@med.sumdu.edu.ua

1. Lidiya	Cherkashyna,	Associate	Professor	of	the	Department	Family	Medicine,	Folk	and	Alternative	Medicine,	Kharkiv	Medical	Academy	
of	Postgraduate	Education,	Kharkiv,	Ukraine;	serg_shklyar@ukr.net;	Orcid	ID	0000-0002-6414-8077

2. Anton	Shklyar,	Associated	Professor,	Department	of	Human	Anatomy,	Kharkiv	National	Medical	University,	Kharkiv,	Ukraine;	
serg_shklyar@ukr.net

3.	 Roman	Sukhonosov,	lecturer	of	the	Department	of	Human	Anatomy,	Kharkiv	National	Medical	University,	Kharkiv,	Ukraine;	
r.sukhonosov@ukr.net

4. Olha	Miroshnikova,	Associated	Professor,	State	Zooveterinary	Academy,	Kharkiv,	Ukraine;	l.miroshnikova@ukr.net
5. Lyudmyla	Naguta,	Associated	Professor,	Kharkiv	National	Medical	University,	Kharkiv,	Ukraine;	l.naguta@ukr.net
6.	 Vasyl	Olkhovskiy,	Prof.,	Department	of	Forensic	Medicine	and	Medical	Law,	Kharkiv	National	Medical	University,	Kharkiv,	

Ukraine;	vasyl.olkhovskiy@ukr.net
7.	 Nadiia	Demikhova,	Professor,	Department	of	Family	Medicine,	Sumy	State	University,	Sumy,	Ukraine;	n.demyhova@med.sumdu.edu.ua		
8. Larysa	 Kuts,	 Professor,	 Department	 of	 Family	 Medicine,	 Sumy	 State	 University,	 Sumy,	 Ukraine;	 larisa.kuts@fmail.ua. 

Orcid	ID	https://orcid.org/0000-0002-4156-31639.
9.	 Ganna	 Barchan,	 assistant	 professor	 of	 department	 of	 pediatrics,	 Kharkiv	 National	 Medical	 University,	 Kharkiv,	 Ukraine;	

annabarchan@gmail.com
10. Ganna	Sukhomlyn,	Associate	Professor	of	 the	Department	of	 	of	clinical	disciplines,	Donetsk	National	Medical	University,	

Kropyvnytskyi,	Ukraine;	g.sukhomlyn@gmail.com
11. Ludmila	Kyptenko,	Associated	Professor,	Department	of	Morphology,	Sumy	State	University,	Sumy,	Ukraine;	l.kiptenko@med.sumdu.edu.ua

Bangladesh Journal of Medical Science Vol. 20 No. 01 January’21. Page : 95-100
DOI: https://doi.org/10.3329/bjms.v20i1.50352

Introduction:
Determination	 of	 the	 postmortem	 interval	 is	 an	
obligatory	and	important	stage	in	forensic	examination	

(FE)	of	corpses	1-4.	This	parameter	is	one	of	the	basic	
markers	for	an	objective	and	complete	carrying	out	of	
expert	examination,	its	absence	casting	doubt	on	the	



96

Cholinesterase	in	different	types	of	the	muscle	tissue	during	the	early	postmortem	period	for	diagnosis	of	death	coming

legal	significance	of	FE	as	criminal	(civil)	evidence.	
The	paramount	scientific	importance	of	studying	the	
postmortem	interval	consists	in	the	presence	of	this	
problem	 in	 the	 basic	 areas	 of	 scientific	 researches,	
which	 are	 determined	 by	 the	 effective	 Scientific	
Speciality	 Code	 “14.01.25	 –	 Forensic	 Medicine”	
in	Ukraine.	 Item	2.5	of	 the	basic	areas	of	scientific	
researches in the above Code has exactly this 
formulation:	 “Determination	 of	 the	 prescription	 of	
death coming” 5-8. Besides, according to Regulations 
on	the	Office	of	the	Chief	Medical	Examiner	in	health	
administrations of regional executive committees and 
the	Republican	Office	(the	Autonomous	Republic	of	
Crimea),	approved	by	Order	of	the	Ministry	of	Health	
of	Ukraine	“On	 the	development	and	 improvement	
of	 the	 forensic	 service	 in	 Ukraine”	 No.	 6,	 dated	
January	 17,	 1995,	 sub-item	 2.6	 of	 item	 2	 “Tasks	
of	 the	 Office”	 demands	 to	 improve	 the	 quality	 of	
expert	examinations	by	application	of	new	research	
methods	to	forensic	practice	in	order	to	advance	the	
activity of medical examiners. It is for this reason 
that an interest in studying informative criteria in the 
context	of	determination	of	the	prescription	of	death	
coming (PDC) is natural 6,	9-12. On the other hand, the 
activity/level of cholinesterase in the muscle tissue 
(MT)	 from	 positions	 of	 forensic	 investigation	 for	
PDC	during	the	early	postmortem	period	(PMP)	was	
not studied before.
The purpose of the research consisted in study 
of	 postmortem	 regularities	 in	 the	 content	 of	
cholinesterase	in	different	types	of	MT	for	improving	
accuracy of determination of PDC.
Materials and methods:The	 activity/level	 of	
cholinesterase	 was	 determined	 in	 homogenates	
of	 the	 myocardial	 (MMH),	 oesophageal	 (OMH),	
diaphragm	 (DMH)	 and	 intercostal	 muscles	 (IMH)
within	 the	early	PMP	(3-13	hours	after	 the	coming	
of	 death)	 on	 30	 human	 corpses.	MT	 was	 sampled	
in	 conditions	 of	 postmortem	 biopsy	 with	 use	
of	 special	 instruments;	 MT	 homogenates	 were	
prepared	 following	 the	 standard	 technique	 2,	 3,	 13 
with	 subsequent	 determination	 of	 cholinesterase	
content	 in	 MT	 homogenates	 by	 the	 kinetic	
method	 using	 butyrylthiocholine	 with	 help	 of	 the	
commercial	 test	 system	of	SpineLab	Ltd.	 company	
(Ukraine)	 on	 a	 Labline-80	 biochemical	 analyzer	
(Austria)	 in	 accordance	 with	 their	 instructions.	
The	 findings	 were	 also	 analysed	 statistically	 with	
help	 of	 variation	 statistics	 and	 assessment	 of	 the	
normality	 of	 distribution	 and	 reliability	 of	 findings	
14-29.	 Information	 analysis	 of	 the	 pathometric	 sign	

(cholinesterase	content)	was	made	by	calculation	of	
its	comparative	informativeness	(I,	bit)	during	each	
time interval as І=-р×log2p,	where	p is the relation 
between	 the	content	of	cholinesterase	after	3	hours	
and	 its	 content	 in	 the	 relevant	 postmortem	 time	
interval 1,	 2,	 30. Presentation of revealed regularities 
in	changes	of	cholinesterase	content	in	each	type	of	
MT	homogenates	 is	 provided	 by	 building	 dynamic	
lines	with	polynomials	of	different	(2-5)	stages	and	
accuracy	of	 reproduction	R2>0.95	 14,	31.	The	 tabular	
nomogram	 was	 devised	 by	 dynamic	 extrapolation	
of	 polynomial	 dependencies	with	 an	 interval	 of	 30	
minutes.	The	studies	were	conducted	 following	 the	
basic regulations of Ethical Principles for Medical 
Research Involving Human Subjects approved	 by	
the	Declaration	of	Helsinki	(1964-2013),	 ICH	GCP	
(1996),	EEU	Directive	No.	609	(dated	November	24,	
1986),	Orders	of	the	Ministry	of	Health	of	Ukraine	
No.	 690	 (dated	 September	 23,	 2009),	 944	 (dated	
December	 14,	 2009)	 and	 616	 (dated	 August	 03,	
2012).
Ethical clearance:	 (no	 need	 for	 review	 article)	
This	 research	 proposal	was	 accepted	 by	 the	Ethics	
Committee of Kharkiv	 Medical	 Academy	 of	
Postgraduate Education,	Ukraine	
Results and discussion:	The	analysis	of	postmortem	
changes	 in	 the	 content	 of	 cholinesterase	 in	 MT	
depending	upon	PDC	revealed	that	after	3	hours	from	
the	moment	of	death	coming	its	highest	content	was	in	
muscles	of	the	oesophagus,	the	least	one	being	in	MT	
of	the	intercostal	muscles	(respectively,	(2,717.1±37.1)	
and	(883.5±6.2)	U/g,	р<0.001;	Table 1).
Levels	 of	 cholinesterase	 content	 in	 MT	 of	 the	
myocardium	 and	 diaphragm	 were	 rather	 close,	
though	 they	 differed	 (respectively,	 (1,213.8±8.8)	
and	 (1,512.8±11.5)	 U/g,	 р<0.05),	 and	 occupied	 an	
intermediate	place	between	the	corresponding	values	
of	 MT	 of	 the	 intercostal	 muscles	 and	 oesophagus	
(Fig. 1).
A	common	pattern	for	the	content	of	cholinesterase	
in	 different	 types	 of	 MT	 was	 characterized	 by	 a	
decrease	 of	 this	 content	 with	 an	 increase	 in	 PDC	
terms; besides, the dynamic lines of its changes, that 
we	 obtained	 (See	Table 1), became basic ones for 
substantiating	 quantitative	 time	 dependencies	 and	
construction of relevant nomograms for forensic 
diagnosis	of	PDC	by	cholinesterase	content	in	MT.
The	quantitative	 dependencies	 between	 the	 content	
of	 cholinesterase	 and	 PDC,	 that	 we	 statistically	
justified,	 have	 the	 analytical	 form	 (polynomial	



97

Lidiya	Cherkashyna,	Anton	Shklyar,	Roman	Sukhonosov,	Olha	Miroshnikova,	Ludmyla	Naguta,	Vasyl	Olkhovskiy,	Nadiia	Demikhova,	Larysa	Kuts,	Ganna	Barchan,	Ganna	Sukhomlyn,	Ludmila	Kyptenko

stages	2-5)	and	their	use	enabled	us	to	represent	the	
revealed regularity and determine “intermediate” 
(between	time	intervals,	with	an	accuracy	of	at	least	
р<0.01)	values	of	cholinesterase	content,	thereby	in	
its	turn	making	it	possible	to	increase	the	accuracy	in	
diagnosing PDC.
Besides,	 using	methods	 of	 clinical	 informatics,	we	
calculated informational values for dynamic changes 
in	the	content	of	cholinesterase	for	each	time	period	
and	 each	 type	 of	MT.	 In	 particular	 (See	Table 1), 
it	 was	 revealed	 that	 the	 total	 informativeness	 of	
determination of cholinesterase for diagnosing PDC 
by	MT	of	the	myocardium	was	ІМ-6	=	1.782	bits,	by	
MT	 of	 the	 intercostal	 muscles	 ІR-6	=1.706	 bits,	 by	
MT	of	the	diaphragm	ІD-6	=1.364	bits,	by	MT	of	the	
oesophagusІO-6	=	0.914	bits.	It	should	be	noted	that	the	
diagnostic value of determination of cholinesterase 
content	depends	upon	the	type	of	MT	and	the	term	of	
PDC (time interval of PMP).
Thus,	 within	 the	 time	 interval	 from	 5	 to	 11	 hours	
the	 most	 informative	 one	 was	 the	 content	 of	
cholinesterase	in	MT	of	the	myocardium	(І	=	0.419-
0.279	 bits),	while	 during	 the	 time	 interval	 after	 11	
hours	its	content	in	MT	of	the	intercostal	muscles	was	
of	a	high	diagnostic	value	too	(І	=	0.430÷0.446	bits).	
Proceeding from the above, the choice of the criterion 

“cholinesterase	content	 in	MT	of	 the	myocardium”	
in PDC before 11 hours is more reasonable and 
preferred	(a	higher	diagnostic	value),	but	in	concrete	
tasks	of	FE	one	can	use	the	criterion	“cholinesterase	
content	 in	MT	of	 the	 intercostal	muscles”.	 In	order	
to	apply	 to	practice	of	FE	the	regularities,	 revealed	
by	 us	 in	 the	 process	 of	 this	 investigation,	 and	 to	
introduce	them	into	the	work	of	medical	examiners	
we	 constructed	 a	 graphic	 nomogram	 and	made	 its	
simplified	 (traditional),	 tabular	 form	 (Fig. 1) for 
determining PDC by the level of cholinesterase in 
different	types	of	MT.
The	 presented	 nomograms	 make	 it	 possible	 to	
determine PDC by both a single diagnostic criterion 
and	 several	 ones;	 in	 order	 to	 provide	 accuracy	 at	
the	level	of	р<0.05	it	is	enough	to	use	one	criterion	
(for	 example,	 “cholinesterase	content	 in	MT	of	 the	
myocardium”),	but	for	improving	the	accuracy	(and	
in	conditions	of	presence	of	morphological	material)	
it	is	necessary	to	use	several	criteria,	and	first	of	all	
the	 criterion	 “cholinesterase	 content	 in	 MT	 of	 the	
intercostal muscles”.
An	 example	 of	 forensic	 determination	 of	 PDC	
by	 the	 value	 of	 cholinesterase	 content	 in	 different	
types	 of	MT. In natural conditions of examination 
of	 a	 corpse	 the	 following	 morphological	 material	

Table 1. Levels of the content (U/g), quantitative-analytical regularities (Y) in changes and diagnostic 
significance (I, bits) of the content of cholinesterase in different morphological types of the muscle 
tissue during the early postmortem period depending upon the prescription of death coming.

Content (Y6)
of cholinesterase  and 

itsinformativeness

Postmortem time intervals (hours)

3 5 7 9 11 13

In homogenates of the myocardial 
muscles,	MMH,	U/g
ІМ-6=1.782	bits

1213.8
±8.8а

766.3
±79.8а

947.2
±7.0а

862.0
±5.8а

848.5
±5.7а

834.4
±5.4а

0.000 0.419 0.279 0.351 0.361 0.372

YМ-6=-13.68х
5+256.6х4-1825х3+6084х2-9346х+6058;	R2=1.0

In homogenates of the intercostal 
muscles,	IMH,	U/g
ІR-6=1.607	bits

883.5
±6.2

790.4
±7.3а

707.6
±10.2а

645.9
±5.4

544.9
±5.1

525.3
±5.3

0.000 0.144 0.256 0.330 0.430 0.446

YR-6=5.252х
2-110.7х+990.8;	R2=0.99

In	homogenates	of	the	diaphragm	
muscles,	DMH,	U/g
ІD-6=1.364	bits

1512.8
±11.5

1446.4
±11.1

1285.0
±10.0

1224.1
±9.9

973.9
±7.7

900.8
±5.8

0.000 0.062 0.200 0.247 0.409 0.445

YD-6=3.559х
4-45.29х3+182.8х2-378.4х+1754;	R2=0.983

In	homogenates	of	the	oesophageal	
muscles,	OMH,	U/g
ІO-6=0.914	bits

2717.1
±37.1

2497.4
±21.4	а

2127.6
±20.4	а

1840.6
±17.2

1429.1
±15.9

1281.4
±10.1

0.000 0.112 0.197 0.181 0.283 0.141

YO-6=3.447х
2-329х+3081;	R2=0.98

Note: а	–	reliable	differences	from	the	previous	interval	at	the	level	of	р<0.05.



98

Cholinesterase	in	different	types	of	the	muscle	tissue	during	the	early	postmortem	period	for	diagnosis	of	death	coming

(in	 the	 amount	 of	 100	mg)	was	 isolated	 by	means	
of	 postmortem	 biopsy:	 MT	 of	 the	 myocardium,	
MT	 of	 the	 oesophagus,	 MT	 of	 the	 diaphragm,	
MT	 of	 the	 intercostal	 muscles.	 In	 conditions	 of	
biochemical	 laboratory	 the	 above	 MT	 fragments	
(100	 mg)	 were	 homogenized	 in	 a	 saline	 solution	
at the ratio of 20:1 (100 mg in 2.0 cm3). After that 
the	 samples	were	 centrifuged	during	10	minutes	 at	
a	speed	of	3,000	rpm;	2	µl	of	 the	supernatant	fluid	
were	added	to	280	µl	of	the	working	reagent.	After	
their	 mixing	 (30	 seconds)	 at	 a	 room	 temperature	
(T	 =	 18.0-21.0оС)	 we	 measured	 absorbance	 using	
a	 CF-46	 spectrophotometer	 at	 a	 wavelength	 of	
450	 nm;	 then	 during	 2.0	 minutes	 we	 measured	
absorbance	 repeatedly	 every	 30	 seconds.	 Activity	
of	 the	 enzyme	 was	 calculated	 as	 cholinesterase 
= А×10×11,355.0	 (U/g),	 where	 A is the average 
change of absorbance (4 measurements), 10 is the 
factor	for	recalculation	per	1.0	g	of	MT,	11,355 is the 
factor	for	recalculation	to	U/g.	The	following	values	
of	 cholinesterasecontent	 were	 obtained:	 MMHC = 
798.7	U/g,	OMHC	=	2,293.5	U/g,	DMHC = 1,410.8 

U/g,	IMHC =	752.9	U/g.	Proceeding	from	results	of	
biochemical determination of cholinesteraseactivity 
in	MT	homogenates	 and	using	 the	nomogram	 (See	
Fig. 1), one can conclude that the term of PDC varies 
and	 corresponds	 to	 the	 following	 terms	 (See	 the	
tabular nomogram): 1) by cholinesterasecontent in 
MT	of	 the	myocardium	–	from	4	hours	30	minutes	
to	 5	 hours,	 2)	 by	 cholinesterasecontent	 in	 MT	
of	 the	 oesophagus	 –	 from	 5	 hours	 to	 5	 hours	 30	
minutes,	 3)	 by	 cholinesterasecontent	 in	MT	 of	 the	
diaphragm	 –	 from	 4	 hours	 30	minutes	 to	 5	 hours,	
4)	by	cholinesterasecontent	in	MT	of	the	intercostal	
muscles	–	from	5	hours	to	5	hours	30	minutes.
Hence,	 by	 data	 of	 biochemical	 examination	 of	 the	
content	 of	 cholinesterasein	 different	 types	 of	 MT,	
PDC	ranged	from	4	hours	30	minutes	to	5	hours	30	
minutes	 from	 the	 moment	 of	 sampling	 of	 biopsy	
material. It should be noted that extrinsic factors 
(factors	of	the	environment,	where	a	corpse	is	after	
death),	 which	 can	 affect	 the	 dynamics	 of	 changes	
in	 the	content	of	cholinesterasein	different	 types	of	
MT,	were	 not	 taken	 into	 account;	 the	 studies	were	

Prescription of coming Cholinesterase contentin homogenate of muscles (Y, U/g)

Minutes Hours Myocardium, YM Oesophagus, YO Diaphragm,YD Intercostal, YR

1 2 3

Y
М
-6
=-
13
.6
8х

5 +
25
6.
6х

4 -1
82
5х

3 +
60
84
х2 -9

34
6х
+6
05
8;
R

2 =
1.

0

4

Y
O
-6
=3
.4
47
х2 -3

29
х+
30
81
;	R

2 =
0.
98
9

5

Y
D
-6
=3
.5
59
х4 -4

5.
29
х3
+1
82
.8
х2 -3

78
.4
х+
17
54
;	R

2 =
0.
98
3

6

Y
R
-6
=5
.2
52
х2 -1

10
.7
х+
99
0.
8;
	R

2 =
0.
99
1

180 3 hours 901.1 2675.4 1486.6 860.6

210 3	h	30	min. 762.3 2595.6 1462.1 836.6

240 4 hours 733.9 2516.1 1440.6 813.2

270 4	h	30	min. 766.8 2437.1 1420.0 790.4

300 5 hours 825.3 2358.5 1398.4 768.3

330 5	h	30	min. 2280.3 1374.3 746.9

360 6 hours 2202.6 1346.2 726.1

390 6	h	30	min. 2125.3 1313.4 706.0

420 7 hours 2048.5 1275.3 686.5

450 7	h	30	min. 1972.0 1231.4 667.7

480 8 hours 1896.0 1181.7 649.5

510 8	h	30	min. 1820.5 1126.7 632.0

540 9 hours 1745.3 1067.0 615.2

570 9	h	30	min. 1670.6 1003.4 599.0

600 10 hours 1596.3 937.4 583.5

630 10	h	30	min. 1522.5 870.3 568.6

660 11 hours 1449.1 804.2 554.4

690 11	h	30	min. 1376.1 741.3 540.8

720 12 hours 1303.5 684.0 527.9

750 12	h	30	min. 1231.4 635.2 515.7

780 13 hours

Fig.	 1.	 The	 quantitative	 nomogram	 for	 determining	 the	 term	 of	 PDC	 depending	 upon	 the	 content	 of	
cholinesterase	in	different	morphological	types	of	the	human	muscle	tissue	with	different	localizations.



99

Lidiya	Cherkashyna,	Anton	Shklyar,	Roman	Sukhonosov,	Olha	Miroshnikova,	Ludmyla	Naguta,	Vasyl	Olkhovskiy,	Nadiia	Demikhova,	Larysa	Kuts,	Ganna	Barchan,	Ganna	Sukhomlyn,	Ludmila	Kyptenko

conducted	 in	 usual	 conditions	 for	 preservation	 of	
corpses.
Using	morphological	data	from	30	corpses	and	PDC,	
which	was	 verified	 in	 them	 before,	we	 carried	 out	
inverse	approbation	of	the	nomogram	technique	for	
determination of PDC and revealed that the accuracy 
of	determination	for	the	term	of	PDC	ranged	within	
±(0.5÷1.0)	 hours,	 with	 diagnostic	 inaccuracies	 of	
the	first	(α)	andsecond	(β)	type	at	the	level	of	below	
10.0%.
Conclusions:	 It	 was	 proved	 that	 the	 content	 of	
cholinesterase	 in	 all	 MT	 homogenates,	 which	 we	
studied, changed regularly (and nonlinearly), but 
the	 initial	and	final	 levels	of	cholinesterase	content	
differed	depending	upon	the	type	of	MT.	Besides,	the	
dynamics in changes of the content of cholinesterase 
within	the	time	period	of	3÷13	hours	from	the	moment	
of	death	coming	differed	upon	the	type	of	MT	too.	The	
quantitative	analytical	and	graphical	dependences	of	
the	 change	 in	 the	 content	 of	 cholinesterase	 in	MT	
within	the	early	PMP,	revealed	during	the	research,	
made	it	possible	to	substantiate	relevant	nomograms.	
Limitations	for	using	the	nomogram	technique	are	as	
follows:	PDC	more	than	6	hours,	unknown	conditions	
of	 the	 stay	 of	 a	 corpse	 after	 the	 coming	 of	 death	
(influence	of	environmental	factors).	Advantages	of	
the	 technique	consist	 in	 theintegrity	of	biochemical	

examination	of	different	types	of	MT	and	simplicity	
in	 interpretation	 of	 findings.	 The	 application	 of	
the	 nomogram	 technique	 for	 assessing	 PDC	 by	
cholinesterase	 content	 in	MT	 makes	 it	 possible	 to	
improve	 the	accuracy	of	diagnosis	 for	 terms	of	 the	
coming	of	death	up	to	60	minutes.
Prospects of further researches regarding 
improvement	 in	 the	 accuracy	 of	 diagnosis	 of	 PDC	
are related to study of in formativeness of other 
structural-biochemical	markers	of	MT.
Source of Funding: Kharkiv	Medical	Academy	of	
Postgraduate Education
Conflict of interest: None declared
Authors’s contribution:
Data	gathering	and	idea	owner	of	this	study:	
Cherkashyna	L.,	Shklyar	A.
Study	design:	Olkhovskliy	V.,	Cherkashyna	L.,	
Demikhova	N.,	Barchan	G.
Data	gathering:	Sukhomlyn	G.,	Miroshnikova	L.,	
Naguta	L.,	Cherkashyna	L.
Writing	and	submitting	manuscript:	Cherkashyna	
L.,	Shklyar	A.,	Sukhomlyn	G.,	Kuts	L.,	Sukhonosov	
R., Barchan G.
Editing	and	approval	of	final	draft:	Cherkashyna	L.,	
Shklyar	A.,	Demikhova	N.	

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