Beitrage zur gerichtlichen Medizin最新文献

Unlabelled: Injuries of the abdominal organs, especially liver and spleen, which were caused by resuscitative measures, can occasionally raise problems if an expert opinion on death is obtained particularly with regard to previous traumatization and if the question arises whether the trauma could have been avoided or not. These questions will be discussed from different points of view by means of ten cases.

Result: Even when lege-artis-cardiac massage is made, the above mentioned complications cannot always be avoided. In none of the ten cases the trauma caused by resuscitative measures was the cause of concomitant cause of fatal outcome.

Macro- and micromorphological findings in cases of death from hypothermia are very questionable and unreliable diagnostical signs. We investigated 42 cases of death from hypothermia that occurred in mountain-ranges between 1974 and 1990. All cases showed erosions of the gastric mucosa ("Wischnewsky-spots"), in one case only we found bleedings in the ileopsoas muscles. In most cases hypothermia was based on natural disease or intoxication. Nine alcoholized persons showed a mean alcohol concentration in the blood of 1.07% and in accordance to a relatively long agonal period the alcohol concentration in urine was considerably higher.

Autopsy of a baby suspicious to SIDS. Most interesting postmortem finding was a congenital malformation of the great vessels, a truncus arteriosus communis typus van Praagh A I. That one is very rare with a clinically frequency of only 1.7%. The malformation was not cause of death and was statistically survived for 2 months. The baby died of aspiration resultant from an incarcerated inguinal hernia.

The predominating hydrophilic physiological body constituents are not interfering severely during the toxicological analysis for organic poisons in biological matrices, whereas coextracted lipids are usually well distinguishable from xenobiotics. But interfering substances increase strongly with autolysis, and some of them behave like toxicologically relevant compounds to be detected by the respective analytical methods. Attempts are reaching from the STAS' isolation procedure through the ptomaines to our chromatographical epoche, to phenomenologically compensate the matrix effects--increasing in the course of putrefaction--by the determination and generalisation of according analytical signals. The paper outlines on the background of Systematic Toxicological Analysis how far a systematic thanatochemical concept should be considered more closely for the futural more effective analytical elimination of such matrix effects.

Using the mixed cell agglutination reaction (MCAR) in a modification by Ishiyama and Okada (MCAR on adhesive tape) we examined single rootless hairs collected from 65 men, women and children (aged 6 months to 80 years). Correct results gave 57 probes (87%). False-positive and false-negative results mainly occurred at non-secretor donors. The modified method is quickly done, reproducible and does not alter the hair.

According to the author's own investigations and to findings reported in the literature, almost all bolus deaths and highly numerous accidental deaths by drowning occur to adults and adolescents under the impact of alcohol. An attempt was made to elucidate the mechanism by which alcohol actually play its role in bolus or drowning death. These two causes of death have in common complete or partial obstruction of respiratory tract. Yet, safety against that life-threatening condition were devised by evolution very early in phylogenesis (respiratory block, cough reflex, circulatory centralisation). They are reflex-triggered for immediate effect and take that effect through the vegetative nervous system. These findings have been secured by animal experiments. However, on account of considerable interference of alcohol with vegetative activity, via action on transmitter metabolism (transmitter synthesis, storage, release, rebonding and bonding by means of products of alcohol metabolism), symptoms of extreme vagotomia may develop, such as bradycardia with circulatory centralisation and apnoea of alcohol-related irreversibility, finally resulting in cardiac arrest. The "reflex-related" process of bolus death has often been described, with reference being regulatory made to individuals staying in water and drowning without any self-rescue attempt.

436 cases were collected, in which both breath alcohol (AAK) as well as blood ethanol levels (BAK) were determined. We studied the correlation between AAK and BAK. Furthermore, the duration between event, breath alcohol analysis and the consecutive blood sampling was investigated.

We tested the accuracy of Alco-Screen dipsticks in comparison to the values of blood alcohol. The dipstick test is based on the reaction of alcohol-dehydrogenase, developing a green to blue color. Saliva as well as urine and liquor are easy to obtain at autopsies. We did not get any false-negative results. Interpretation of the change of color turned out to be a problem, because the tip appeared often to be inhomogenous. The dipstick could be used at autopsies and for emergency units, if a quick, semiquantitative result is required.

We describe a 19-year-old mentally retarded man who after severe starvation (criminally induced by his parents) presented with hypoglycemic coma and eventually experienced death. Biochemical findings and pathophysiology of starvation are discussed. The cause of death was hypoglycemia in combination with terminal infection. The importance of structural-functional conclusions and considerations for determination of the manner and cause of death is demonstrated.

Human blood plasma amino acids and urea levels after repeated ethanol administration were investigated. Under ethanol an increase of several amino acids and urea levels were observed.