Beitrage zur gerichtlichen Medizin最新文献

The 12,000 obductions at the Institute for Forensic Medicine of the University of Hamburg from 1981 to 1990 included 30 cases of strangulation in children up to the age of 14 years (16 females, 14 males). 7 of these cases had been accidents (during infancy), 18 children had been murdered (all age groups), 4 children (elder ones) had committed suicide. In one case it could not be decided whether the reason of death had been suicide or an accident. Summarized data concerning epidemiological, phenomenological and morphological aspects are presented. Two case histories give some hints to special aspects of accidental strangulation and homicide among children.

It is reported about a recovering a common grave of 577 skeletons from 1945. Investigations of the age of the victims, the cause of death etc. were carried out. There were gunshot fractures at 541 skeletons. In 93.7% out of all cases there were gunshot fractures of the skull and the cervical vertebra. Difficulties arose from root interpretations in addition to intertwinings owing to the location of the skeletons. Indications to belonging to nationality of the victims are discussed by means the results from AB0-analysis and denture works.

Cases of cardiac death (myocardial infarction, coronary artery thrombosis, coronary artery sclerosis) were investigated with histochemical and immunohistochemical methods. Histochemical staining methods (HE, LFB, CAB) were used, with immunohistochemical methods were detected the proteins Desmin, Myoglobin, Fibrinogen and Complement C5b-9. Macroscopically visible myocardial infarctions were detected with both methods clearly. The damage pattern was associated to the type of destruction. At myocardial infarction the changes were focal at the other groups more disseminated.

Basing considerations on an extremely carefully examined case of toxic shock syndrome (TSS), an analysis of this phenomenon is presented from the clinical and forensic points of view. TSS is often associated with the term "tampon disease" but in the meantime it has turned out that it may also arise as a non-menstrual disorder, caused by local infections, for example after surgical interventions. The inevitable symptoms include: fever, exanthema, desquamation on the palms of the hands and soles of the feet as well as hypotension. The clinical symptoms would initially suggest a septic process, however bacteriological investigations (blood cultures) normally produce negative results. At the source, however, ectotoxin-producing staphylococci (S. aureus) are found. The present case which is described in detail involves a 17-year old woman who had contracted a crucial ligament injury at the knee of the right leg when playing football. She died a few days after the operation, her death being accompanied by high fever. In smears from the area of the operation it was possible to identify staphylococci (S. aureus) which by phagetyping determination were classified as belonging to lysogroup type II/71 and which produced ectotoxin B. It was not possible to culture bacteria from blood from the corpse. Criminal proceedings for involuntary manslaughter were in the end dismissed although the accused resident physician was sentenced to pay 30,000 DM damages to the parents of the young woman. He also had to pay the costs of the civil action incidental to the criminal proceedings.(ABSTRACT TRUNCATED AT 250 WORDS)

In the last 2 years we had some problems to confirm the thin-layer results (amphetamines, opiates, benzodiazepines, barbiturates and cocaine) with the immunoassay system TDx/ADx. Between January 1989 and December 1990 we did 883 screenings in urine samples (pre- and postmortal) and had 157 discrepancies (20%). In regard of the high level of discrepancies, we had to test the compatibility of TDx and ADx, their detection limits and compared the results with a second method, thin-layer chromatography. Determining the correlation coefficients to prove our results statistically, we found that both systems, TDx and ADx, work reproducible.

Forensic physicians are often called upon by the courts and the public prosecutor's office to give expert opinions and carry out post-mortem examinations, e.g. to determine blood groups or cause of death. The expert is simply aiding the court within the framework of its function of hearing evidence. The court, after considering the evidence, must determine whether an allegation is true or false. Since, for example, the determination of cause of death demands qualified specialized knowledge and a high sense of responsibility, the expert should be both scientifically and personally autonomous in order to preclude wherever possible any conflict of interest. The not-too-distant past has demonstrated that justice, even here, can often be miscarried. This is why the autonomy of the expert is of prime importance. The readjustment to section 87, para. 2, clause 2, StPO may represent an infringement of the principle of autonomy, for in addition to calling on forensic physicians or the heads of forensic or pathology institutes to perform autopsies, as required before the 1975 amendment, these heads are now permitted to delegate their assignments to doctors in their own institutes. In compliance with the decisive trial commentary Loewe-Rosenberg, it should be pointed out that the presence of two pathologists is required by the law, one of whom must be a forensic physician or head of a forensic or pathology institute, and that the court presumes that the participation of delegated doctors will be the exception to the rule.(ABSTRACT TRUNCATED AT 250 WORDS)

Although traffic participation of bicycle riders is steadily increasing only few investigations concerning "riding while intoxicated" are available. This study examines the blood sample records of all blood samples submitted to the Duesseldorfer Institute of Forensic Medicine for blood alcohol analysis from 1986 to 1990 with respect to the participation of bicycle riders. As to the most important epidemiologic data: The proportion of samples from bicyclists increased from 2.6% in 1986 to 4.8% in 1990. Women account for 6.5%. 36.8% are younger than 30 years. Most bicycle riders were apprehended during the months of summer, on the days of the weekend and in the hours around midnight. 67.3% displayed a BAC above the legal limit for bicycle riders of 1.7 g/l. In comparison only 34.5% were judged highly drunken on medical examination. Regarding the group with a BAC above 2.5 g/l expected to be highly intoxicated 37.7% only appeared slightly or moderately impaired rising the suspicion of high alcohol tolerance.

Histological evaluation of bone marrow in 30 autopsy cases with a history of chronic alcohol consumption revealed characteristic changes concerning the medullary iron distribution and, first and foremost, the erythropoiesis, which was found to be macroblastic. These autoptic findings reflected the pattern of alcoholic dyshematopoiesis resulting from a toxic effect of alcohol on the bone marrow, well-known from biopsies and aspirates of alcohol-dependent patients and combined with hemochromatosis-associated plasma cell iron in the marrow and elevation of median corpuscular volume of erythrocytes in the peripheral blood. Therefore, this stereotyped morphological findings in the bone marrow of autopsy cases extend the well-known scope of alcohol-induced pathological organ changes.

Nonoxinol 9 effectively inactivates high titres of HIV in vitro, which suggest its use for reducing HIV-transmission via sexual intercourse. Therefore, the suggestion has been made for the treatment of sexual assault victims with a topical anti-HIV agent such as nonoxinol 9 as soon as possible after a sexual assault has occurred. From the forensic point of view it becomes pertinent to determine whether or not nonoxinol 9 would have an adverse effect on the high-molecular weight deoxyribonucleic acid (DNA) in vaginal swabs and thereby impact RFLP results. The study demonstrates that nonoxinol 9 does not have a negative effect on the ability to produce RFLP patterns. Therefore, the early administration of the topical anti-HIV agent nonoxinol 9 has to be considered as an important step in the medical treatment of sexual assault victims.

Spectroreflectometric measurements in the range of 430 to 700 nm were carried out in order to check this new method with regard to its application to determine time of haematomas in living humans. For this purpose 52 cases with artificial superficial skin haematomas and 40 patients with pure "monocle-haematomas" were investigated. Wavelengths of 560 and 580 nm indicate the best results. There are significant differences in cases with "monocle-haematomas" if the age difference of the haematomas is more than two days.