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[Pre- and perimortem bone trauma vs. postmortem damages-- Principles of differentiation]. [死前和死后骨损伤与死后损伤——鉴别原则]。
Pub Date : 2015-07-01
Franziska Holz, Christoph G Birngruber, Marcel A Verhoff

In medicolegal practice, evidence of trauma or damage on human skeletons or single bones raises the question whether this was inflicted in an antemortem, perimortem, or postmortem time frame. Trauma that occurred around the time of death, i. e., perimortem trauma, is of special forensic interest, as it can yield clues about the manner and cause of death. Perimortem traumas thus need to be carefully distinguished both from antemortem injuries that were evidently survived (these can still be useful for identification purposes) and from postmortem damage, as may occur during retrieval of remains. This study offers an up-to-date review of the specialist literature, e. g. textbooks and pubmed-listed publications, identifying differentiation criteria for ante- and perimortem traumas and postmortem damage. The results that are useful for practice in actual medicolegal casework are presented, and an overview of all macroscopically visible criteria (including simple magnifications, i. e., magnifying glass) that can be used to distinguish between ante- and perimortem traumas on the one side, and postmortem damage on the other is given. The difficulty of distinguishing antemortem trauma and postmortem damage from perimortem trauma rises sharply the closer in time they were inflicted to the time of the death event. Additional postmortem changes due to exposure of the bones to the surrounding deposition conditions may also occur after the relevant postmortem damage or antemortem trauma was inflicted and further complicate the problem. In this context, the "perimortem interval" and the "Fracture Freshness Index" (FFI) are discussed as means to classify the time frame of traumas.

在医学实践中,人类骨骼或单骨上的创伤或损伤的证据提出了一个问题,即这是在死前、死中还是死后造成的。在死亡前后发生的创伤,即死前创伤,是法医特别感兴趣的,因为它可以提供关于死亡方式和原因的线索。因此,需要仔细区分死前创伤与明显幸存的死前伤害(这些仍然可以用于识别目的)和死后伤害,因为可能在检索遗体时发生。本研究提供了最新的专家文献回顾,例如教科书和公开出版的出版物,确定了死前和死后创伤和死后损伤的区分标准。本文给出了在实际的法医案例实践中有用的结果,并概述了所有宏观可见标准(包括简单的放大,即放大镜),这些标准可用于区分一侧的死前和死后创伤,以及另一侧的死后损伤。越接近死亡事件发生的时间,区分死前创伤和死后损伤与死前创伤的难度就越大。在相关的死后损伤或死前创伤造成后,由于骨骼暴露于周围沉积条件而导致的其他死后变化也可能发生,并使问题进一步复杂化。在这种情况下,“死前间隔”和“骨折新鲜指数”(FFI)作为分类创伤时间框架的手段进行了讨论。
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引用次数: 0
[Obesity--comorbidities and causes of death]. [肥胖——合并症和死亡原因]。
Pub Date : 2015-07-01
Julia Klatte, Jan Sperhake, Axel Gehl, Klaus Püschel

53% of the forensically autopsied decedents in Hamburg were overweight. The cause of death and any comorbidities, especially coronary heart disease, are often associated with the obese condition. This correlation is illustrated by two examples, viz. a 65- and a 56-year-old man with grade III obesity, which do not only show the medical but also the logistical problems that come along with it.

汉堡53%的法医尸检死者超重。死亡的原因和任何合并症,特别是冠心病,往往与肥胖有关。两个例子说明了这种相关性,即一名65岁的男子和一名56岁的男子患有III级肥胖,这不仅表明了医学上的问题,也表明了随之而来的后勤问题。
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引用次数: 0
[A literature review on the Messerer's fracture]. 【关于Messerer骨折的文献综述】。
Pub Date : 2015-05-01
Gunther Geserick, Klaus Krocker, Ingo Wirth

The characteristic wedge-shaped fracture was first described by Messerer (1880) and Bruns (1884) after performing experiments on long bones. Not much later, Messerer (1885) formulated the forensic significance of the direct bending fracture for the detection of the location and direction of blunt impact trauma. He developed the basic biomechanical theory of the origin of this fracture type, which is therefore called Messerer's fracture in the German-speaking world. In the following decades, the findings concerning the origin, specificity and forensic usability of Messerer's fractures were confirmed and supplemented by experiments and case studies. For forensic examinations, it is important to bear in mind that there are exceptions to the rule according to which the level of the wedge-shaped fracture corresponds exactly to the point of impact. The possibility of "false" or "reversed" wedges must also be considered. Already in the 19th century, authors had pointed out the mechanism of indirect formation of wedge-shaped bone fragments. That is why a forensic examination always has to consider the investigation results and medical findings in their entirety. Autopsy of traffic victims is of paramount importance. It must include a thorough examination of clothing, skin, soft tissues and skeletal system using special preparation techniques. The examination of bone injuries in living victims also requires special expertise. If properly applied, valuable results can be obtained by the forensic expert from the wedge-shaped fracture. Until recently, Messerer's fracture was a typical injury sustained by pedestrians hit by vehicles with protruding frontal elements. In modern car production, not only the dimensions of cars have been changed, but the front-end structures have also been modified, e. g. by integrated bumpers. These constructional changes are likely to reduce the frequency of narrow points of impact in collisions. However, further research on the frequency and significance of Messerer's fractures in road traffic accident victims is required.

典型的楔形骨折是由Messerer(1880)和Bruns(1884)在对长骨进行实验后首次描述的。不久之后,Messerer(1885)阐述了直接弯曲骨折对于检测钝性撞击创伤的位置和方向的法医意义。他发展了这种骨折类型起源的基本生物力学理论,因此在德语世界被称为梅瑟尔骨折。在接下来的几十年里,关于Messerer骨折的起源、特异性和法医可用性的发现得到了实验和案例研究的证实和补充。对于法医检查,重要的是要记住,根据楔形骨折的水平与撞击点完全对应的规则有例外。还必须考虑“假”或“反”楔的可能性。早在19世纪,作者就指出了楔形骨碎片间接形成的机制。这就是为什么法医检查总是要全面考虑调查结果和医疗结果。对交通事故受害者的尸检至关重要。它必须包括一个彻底的检查的衣服,皮肤,软组织和骨骼系统使用特殊的准备技术。对活人骨骼损伤的检查也需要特殊的专业知识。如果应用得当,法医专家可以从楔形骨折中获得有价值的结果。直到最近,梅瑟尔骨折是一种典型的行人被车头突出的车辆撞击而造成的伤害。在现代汽车生产中,不仅汽车的尺寸发生了变化,而且车头的结构也发生了变化,例如采用了一体化保险杠。这些结构上的变化可能会减少碰撞中窄碰撞点的频率。然而,道路交通事故受害者发生Messerer骨折的频率和意义有待进一步研究。
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引用次数: 0
[Peranal exenteration of the intestine during a homicide]. [在杀人过程中肛门切除肠道]。
Pub Date : 2015-05-01
Daniela Fröb, Klaus Püschel

A 66-year-old female alcoholic was killed in a sexually motivated homicide. After peranal insertion of the hand large parts of the intestine were torn from the mesentery and pulled out through the anus. The findings are discussed and compared with the pertinent literature.

一名66岁的女酗酒者死于性谋杀。手经肛插入后,从肠系膜上扯出大部分肠,并通过肛门拉出。研究结果进行了讨论,并与相关文献进行了比较。
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引用次数: 0
[Wrong statement of manner of death after insufficient post-mortem examination]. [在验尸不充分后对死亡方式的错误陈述]。
Pub Date : 2015-05-01
Verena Héroux, Katrin Uebbing, Bianca Navarro-Crummenauer, Reinhard Urban, Dirk Breitmeier

When death certificates already completed are submitted during forensic post-mortem examinations or autopsies, blatant errors are often found, especially with regard to the classification of the manner of death. This is partly attributable to insufficient knowledge of the classification criteria, but also to the fact that the post-mortem examination was not properly performed and even clear signs of unnatural death (e.g. a strangulation mark or sharp force injuries) are overlooked. To avoid such misinterpretations, a thorough reformation of the post-mortem examination system and a regular continuing specialized training of the physicians performing post-mortems seem necessary.

在法医验尸或尸体解剖期间提交已经完成的死亡证明时,往往会发现明显的错误,特别是在死亡方式的分类方面。造成这种情况的部分原因是对分类标准了解不足,但也因为没有进行适当的尸检,甚至忽视了明显的非自然死亡迹象(例如勒死痕迹或锐器伤)。为了避免这种误解,有必要彻底改革验尸制度,并定期对验尸医生进行持续的专业培训。
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引用次数: 0
[Diuretics and their potential effect on breath-alcohol concentration--a case report]. [利尿剂及其对呼吸酒精浓度的潜在影响——一例报告]。
Pub Date : 2015-05-01
Georg Schmitt, Gisela Skopp

Many objections were raised to breath-alcohol analysis upon its introduction in the field of traffic law enforcement in Germany, but in the meantime this issue has become less relevant in forensic routine work. In the present case, the defending lawyer claimed that the ethanol concentration in the blood and hence in the breath of his client, which was 0.35 mg/l according to the Dräger Alcotest 7110® Evidential and thus above the legal limit of 0.25 mg/l, had been changed by diuretics taken 4 hours before the breath alcohol test, viz. 10 mg of torasemide, a loop diuretic, and 50 mg of spironolactone, a competitive aldosterone antagonist. According to the literature, the maximum urinary output in healthy subjects within the first 4 hours after 10 mg torasemide was 1450 ml. In patients suffering from heart failure, the urinary volume was reduced by a factor of 2.5-3; after chronic intake of torasemide, water loss did not differ from placebo. Spironolactone, which acts on the distal tubule, has little effect on urinary output. In a publication, the loss of water in excess within 24 hours was 90 ml. Co-administration of 100 mg spironolactone and 20 mg furosemide, which roughly compares to 10 mg torasemide, resulted in a mean urinary volume of 1566 ml within the first 4 hours. In terms of the reported case and provided that no compensatory fluid had been taken, a purely theoretical maximum shift of 0.007 mg/ may occur in the breath-alcohol concentration due to the smaller distribution volume even considering maximum urinary excretion values. On the other hand, already mild levels of dehydration may be associated with negative symptoms affecting driving ability.

在德国交通执法领域引入酒精呼气分析后,许多人提出了反对意见,但与此同时,这一问题在法医日常工作中变得不那么相关。在本案件中,辩护律师声称,根据Dräger Alcotest 7110®证据,其委托人血液和呼吸中的乙醇浓度为0.35 mg/l,因此高于0.25 mg/l的法定上限,已在呼吸酒精测试前4小时服用利尿剂,即10 mg托拉塞米(一种循环利尿剂)和50 mg螺内酯(一种竞争性醛固酮拮抗剂)而改变。据文献报道,健康受试者在服用10 mg托拉塞米后的头4小时内最大尿量为1450 ml。心力衰竭患者的尿量减少了2.5-3倍;长期摄入托拉塞米后,失水与安慰剂无差异。螺内酯作用于远端小管,对尿量影响不大。在一份出版物中,24小时内过量失水为90毫升。同时给药100毫克螺内酯和20毫克呋塞米(与10毫克托拉塞米大致相当)导致前4小时内平均尿量为1566毫升。就所报告的病例而言,在没有补充液体的情况下,呼吸酒精浓度可能出现0.007 mg/的纯理论最大位移,因为即使考虑到最大尿液排泄值,其分布体积也较小。另一方面,已经轻度脱水可能与影响驾驶能力的负面症状有关。
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引用次数: 0
[Sexual assault during sleep: victim asleep/offender asleep--an update]. [睡眠中的性侵犯:受害者睡着/罪犯睡着-更新]。
Pub Date : 2015-05-01
Stefan Troschütz, Klaus Püschel

The topic of sexual assault during sleep is discussed again on the basis of two case reports and several incidents published in the media. The authors support the assumption of Hohner and Püsche1 (2011). There is evidence that it is indeed possible not to wake up during a sexual assault--even without being under the influence of alcohol, illicit drugs or medication--and that a sexual assault during sleep can pass unnoticed. In such cases the outcome of the criminal trial often depends on the careful assessment of the expert, as the faculty of imagination of those passing judgment varies greatly. Based on new findings regarding sexsomnia, even sexual offenders may use the "sleepwalking defense" in specific cases.

在媒体上发表的两个案例报告和几起事件的基础上,再次讨论了睡眠期间性侵犯的话题。作者支持Hohner和p sche1(2011)的假设。有证据表明,即使没有受到酒精、非法药物或药物的影响,在性侵犯期间不醒来确实是可能的,而且在睡眠期间发生的性侵犯也可能被忽视。在这种情况下,刑事审判的结果往往取决于专家的仔细评估,因为作出判断的人的想象力差别很大。根据有关睡眠性交症的新发现,即使是性犯罪者也可能在特定情况下使用“梦游辩护”。
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引用次数: 0
[Reddish discoloration of the vascular intima in charred bodies]. [烧焦尸体血管内膜的红色变色]。
Pub Date : 2015-05-01
Dankwart Stiller, Juliane Lang, Manfred Kleiber, Rüdiger Lessig, Michael Bohnert

During the autopsy of fire victims, one often sees intensive reddening of the inner vascular layers resembling changes due to putrefaction. To determine the frequency of this phenomenon and the circumstances under which it occurs, in particular the presence of putrescence, signs of vitality and the extent of destruction by the fire, the fire fatalities autopsied at the Institutes of Legal Medicine in Freiburg, Halle and Würzburg were analyzed. In the concrete study, 259 fire deaths were investigated retrospectively and 21 prospectively. The study material included 191 males and 68 females aged 0 to 93 years. Vital exposure to the fire was found in 70%, perimortal exposure in 23 % and postmortem exposure in 7% of the cases. Red discoloration of the intima of the central vessels was seen in 106 victims (41%). This finding is most likely caused by postmortem heat-induced hemolysis, which occurs when the temperature in the body rises above 52 °C due to the effect of external heat. Therefore, a reddish discoloration of the intima cannot be regarded as sign of vitality.

在火灾受害者的尸检过程中,人们经常看到内部血管层的强烈变红,类似于腐烂造成的变化。为了确定这种现象发生的频率和发生的情况,特别是有无腐烂、有活力的迹象和火灾造成的破坏程度,对弗莱堡、哈勒和w rzburg法律医学研究所解剖的火灾死者进行了分析。在具体研究中,259例火灾死亡病例进行回顾性调查,21例进行前瞻性调查。研究资料包括年龄在0至93岁之间的191名男性和68名女性。在这些病例中,有70%是生命暴露于火灾,23%是死前暴露于火灾,7%是死后暴露于火灾。106例(41%)患者出现中央血管内膜红色变色。这一发现很可能是由死后热致溶血引起的,当体内温度由于外部热量的影响而上升到52°C以上时,就会发生溶血。因此,内膜的红色变色不能被认为是活力的标志。
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引用次数: 0
[How relevant is the risk of losing evidence due to delayed blood sampling? Conclusions from the evaluation of blood analysis results]. [由于血液采样延迟而丢失证据的风险有多大关系?结论来自血液分析结果的评价]。
Pub Date : 2015-03-01
Stefan W Toennes, Cora Wunder, Alexander Paulke, Marcel A Verhoff

If the order of a judge to take a blood sample can only be obtained with a marked delay after the incident, evidence proving that a suspect had been driving under the influence of alcohol or drugs of abuse may be lost. The evaluation of blood analysis results from the Institute of Legal Medicine in Frankfurt/Main from the years 2012-2014 shows that in 1.6 to 11.6% of positive cases, the drug concentrations were near the legal limits (20.2% of alcohol-positive and 7.5% of illicit drugs-positive samples). A loss of evidence can thus be expected in a large number of cases when the time between the police check of a driver and the collection of a blood sample increases. Blood concentrations of alcohol and drugs of abuse, especially tetrahydrocannabinol, cocaine, methamphetamine, and morphine, may already have dropped significantly after a delay of only half an hour. These delays are typically due to the time elapsing until the order to take a blood sample has been obtained from a judge and a medical doctor becomes available and arrives at the police station to draw a blood sample. The recommendation of medicolegal experts is to keep the time between police check of a suspect and blood sampling as short as possible. In routine cases, a realistic maximum of one hour should not be exceeded.

如果要在事故发生后经过很长一段时间才能得到法官采集血液样本的命令,那么证明嫌疑人是在酒精或滥用药物的影响下驾驶的证据可能会丢失。对法兰克福/美因法律医学研究所2012-2014年血液分析结果的评估表明,在1.6%至11.6%的阳性病例中,药物浓度接近法定限值(酒精阳性样本占20.2%,非法药物阳性样本占7.5%)。因此,在许多情况下,当警察检查司机和采集血液样本之间的时间增加时,可以预期证据的丢失。血液中酒精和滥用药物的浓度,特别是四氢大麻酚、可卡因、甲基苯丙胺和吗啡,可能在仅仅半小时后就已经显著下降。这些延误通常是由于需要一段时间才能从法官那里得到采集血液样本的命令,而医生到达警察局采集血液样本。法医专家的建议是尽可能缩短警方检查嫌疑人和抽血之间的时间。在常规情况下,不应超过一个小时的实际最大值。
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引用次数: 0
[Drying time for human saliva]. 【人唾液的干燥时间】。
Pub Date : 2015-03-01
Katharina Jellinghaus, Linus Blässer, Christian Scheller, Michael Bohnert

In a case of aggravated extortion under threat of force, the medicolegal expert was asked to give an opinion on the drying time of human saliva. Fresh traces of saliva were applied to composite stones similar to those at the scene of the crime and their drying behavior was examined in a climate test chamber. Air temperature and air humidity during the experiment corresponded to the values of the measuring station located nearest to the crime scene. After one hour and 40 minutes no salivary spots were discernible on the stones any more. Depending on various influence factors, the traces could have originated both at the time of the offence and within a time window of up to 3 hours before.

在一起暴力威胁下的严重勒索案件中,请法医专家就人类唾液的干燥时间发表意见。研究人员在与犯罪现场相似的合成石头上添加了新鲜的唾液痕迹,并在气候试验室中检测了它们的干燥行为。实验过程中的空气温度和空气湿度与离犯罪现场最近的测量站的测量值相对应。1小时40分钟后,结石上不再有唾液斑。根据各种影响因素,这些痕迹可能是在犯罪发生时产生的,也可能是在长达3小时之前的时间窗口内产生的。
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引用次数: 0
期刊
Archiv fur Kriminologie
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