Liver rupture caused by isolated blunt force impact: the result of a blow, a kick or a fall?

A total of 5534 protocols of judicial and extrajudicial autopsies performed at the Institute of Legal Medicine of the University of Würzburg between 1974 and 1987 were examined to determine whether an isolated liver rupture can be attributed to a blow, a kick or a fall on a level plane or against a hard edge, based on the nature of the injury alone. From the 5534 autopsies examined, 293 cases of falling on level ground or down staircases were found. In 271 cases the abdomen struck against a flat surface, in 21 cases either against a post or an edge and in one case it was not possible to find out which object the abdomen struck against.

[Fatal child neglect in East Germany 1 January 1985 to 2 October 1990. Results of a multicenter study].

Unlabelled: No reliable data are available on cases of lethal child neglect in the area of the former German Democratic Republic. In a multicenter study we therefore examined the police and court records for such cases occurring in the period 1 January 1985 to 2 October 1990 in the entire area of the former German Democratic Republic.

Results: A total of 9 cases were reported to the study center.

[Lethal child abuse (through the use of physical force) in the German Democratic Republic during the period 1 January 1985 to 2 October 1990. Results of a multicenter study].

Unlabelled: No reliable data are available on cases of lethal child abuse (by active force) in the area of the former German Democratic Republic. In a multicenter study we therefore examined the police and court records for such cases occurring in the period 1 January 1985 to 2 October 1990 in the entire area of the former German Democratic Republic.

Results: The study center received information on 39 cases of lethal child abuse which correspond to approximately 7 cases per year.

[Fatal child neglect in West Germany 1 January 1985 to 2 October 1990. Results of a multicenter study].

Unlabelled: Up to now reliable data were available on cases of lethal child neglect in the area of the Federal Republic of Germany prior to reunification (the former West Germany). In a multicenter study we therefore examined the police and court records for such cases occurring in the period from 1 January 1985 to 2 October 1990 in nearly the entire area of Federal Republic of Germany.

Results: The study center received information on 19 cases of lethal child neglect.

[Inhalation heat shock].

Using the example of a recent case, we examine the possibilities of trace analysis and fire protection techniques in the investigation of fire deaths. The effective cooperation between forensic pathologists and fire inspectors is presented and we discuss the mathematical-physical uses of fire simulation calculations. We review the trace analysis results and discuss the variety of technical possibilities of modern engineering techniques for fire protection.

[Fatal child abuse (caused by physical violence) in Germany during 1 January 1985 to 2 October 1990. Results of a multicenter study].

Unlabelled: No reliable data are available on cases of lethal child abuse (by active force) in the area of Federal Republic of Germany prior to reunification (the former West Germany). In a multicenter study we therefore examined the police and court records for such cases occurring in the period 1 January 1985 to 2 October 1990 in nearly the entire area of Federal Republic of Germany.

Results: The study center received information on 58 cases of lethal child abuse.

A post mortem study on neurochemical markers of dopaminergic, GABA-ergic and glutamatergic neurons in basal ganglia-thalamocortical circuits in Parkinson syndrome.

Functional models of the circuitry of the basal ganglia have recently been proposed to account for the vast spectrum of motor disorders associated with the loss of anatomical or neurochemical integrity within the basal ganglia. On the basis of these hypothetical models, hypokinetic disorders such as Parkinson's disease, are thought to be associated with excessive tonic and phasic inhibition of the output from the basal ganglia to the thalamus. In the present study we have attempted to determine the validity of the proposed model by measuring neurochemical markers of inhibitory and excitatory neurotransmission in post mortem human brain tissue.

Design of the oxygen and substrate pathways. VII. Different structural limits for oxygen and substrate supply to muscle mitochondria.

This paper integrates the results of a series of studies on the supply of O2 and substrates for oxidative muscle metabolism and draws conclusions on the role of structural design in partitioning and limiting substrate supply. The studies compared dogs and goats exercising at different intensities and combined physiological, biochemical and morphometric investigations. In both species, the rate of fatty acid oxidation reached an upper limit at low exercise intensities, and only glucose consumption was increased at higher exercise intensities.

Design of the oxygen and substrate pathways. VI. structural basis of intracellular substrate supply to mitochondria in muscle cells.

This paper quantifies the structures involved in the transport and oxidation of carbohydrates and fatty acids within the muscle cell. The structural capacity is measured on whole-body random samples of the musculature of dogs and pygmy goats and compared with maximal rates of oxygen consumption and substrate oxidation. Comparing dogs and goats of the same body size provided a 1.

Design of the oxygen and substrate pathways. V. Structural basis of vascular substrate supply to muscle cells.

This paper quantifies the structural capacity of the transport steps for oxygen, glucose and fatty acids from the blood in capillaries to the cytosol of muscle cells and compares it with maximal rates of oxygen and substrate transport measured in the same animals and reported in the preceding papers of this series. Dogs have relatively more muscle per unit body mass than goats (37 versus 26%), but the maximal rate of oxidation per gram of muscle is still larger in the dog by a factor of 1.55.

Design of the oxygen and substrate pathways. III. Partitioning energy provision from carbohydrates.

This paper quantifies maximal fluxes through the pathway supplying carbohydrates to the mitochondria of muscle cells. Continuous infusions of D-[3-(3)H]glucose together with indirect calorimetry were used to investigate the partitioning of the supply of carbohydrates through the two branches of the pathway: from circulating glucose and from glycogen stores within the muscle cells to the mitochondria. The relative contribution of circulating glucose to total carbohydrate oxidation was small, accounting for only 13% and 23% of the carbohydrate oxidized at exercise intensities approaching MO2max in dogs and goats, respectively.

Design of the oxygen and substrate pathways. I. Model and strategy to test symmorphosis in a network structure.

This first paper in a series develops a model of structure-function relationships for the oxygen and substrate pathways of oxidative metabolism in working muscle. This will be used in the subsequent experimental papers in asking how biological structures are designed if they serve more than one function and whether one function can be served by more than one structural pathway. We have used the concept of symmorphosis to address this question; in its original form, it postulates that no more structure is built and maintained at each step in a pathway than is required to meet functional demands.

Bordetella pertussis infections and sudden unexpected deaths in children.

Unlabelled: From December 1990 to November 1993 nasopharyngeal specimens were obtained for culture from 50 children (mean 4.9 +/- 3.3 months of age) who had died suddenly.

[At first a clear case: homicide by injury to the neck].

Reported is of a 33 year old female found dead in the basement of her home, manifesting strangulation/throttling marks on the neck. The attack on the throat was, however, not cause of death but a CO intoxication. This woman was killed by direct inhalation of 99% carbon monoxid administered by her husband (via a mask or hose).

(3H)dipyridamole and (3H)nitrobenzylthioinosine binding sites at the human parietal cortex and erythrocyte adenosine transporter: a comparison.

We compared the binding sites of the adenosine transport inhibitors (3H)dipyridamole (DPR) and (3H)nitrobenzylthioinosine (NBI) in human parietal cortex and erythrocytes. In comparison with guinea pig (3H)DPR marked only slightly more binding sites than (3H)NBI with a Bmax of 1080 +/- 29 and 780 +/- 7 fmol/mg protein respectively in parietal cortex and 24288 +/- 2725 and 20875 +/- 1905 fmol/mg protein respectively in erythrocytes. NBI displaced (3H)DPR binding completely from its binding sites at about KD/2 concentrations in parietal cortex as well as erythrocytes with inhibition constants comparable to its dissociation constants.

Massive hemorrhage causes changes in morphometric parameters of lung capillaries and concentration of leukocytes in microvasculature.

The study examines the changes in morphometric lung parameters caused by a massive acute blood loss. Three groups of rats were compared: In one group, massive hemorrhage was elicited prior to instillation of the fixative; in the first reference group, standard instillation fixation was performed, and in the second, the circulation was abruptly stopped before instillation of the fixative by contracting a snare around the atrioventricular sulcus of the heart. The two reference groups showed identical morphometric data except for the capillary erythrocyte volume density and its derived parameters, since the standard lung fixation procedure leads to a certain hemoconcentration in the lung microvasculature, as described previously.

Morphometric model for pulmonary diffusing capacity. I. Membrane diffusing capacity.

The pulmonary diffusing capacity is related to the quantitative design characteristics of the pulmonary gas exchanger. The current model for estimating DLO2 from morphometric data breaks the diffusion path for O2 into four steps, three of which represent the membrane part of DLO2. A critique of this model on the basis of newer evidence leads to a modification of the model where the path from the alveolar surface to the erythrocyte membrane is considered as a single step.

How to run a brain bank. A report from the Austro-German brain bank.

The sophisticated analysis of and growing information on the human brain requires that acquisition, dissection, storage and distribution of rare material are managed in a professional way. In this publication we present the concept and practice of our brain bank. Both brain tissue and information are handled by standardized procedures and flow in parallel from pathology to neuropathology and neurochemistry.

[Liver and splenic ruptures as a complication of heart pressure massage].

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.

[Casuistics of unusual death from loss of blood].

7 cases of unusual natural and unnatural death due to loss of blood are reported. The case reports show the important role of acute and chronic alcohol abuse in this context. They also demonstrate the problems of necropsy caused by the unusual and suspicious situation, in which the corpses are often found; even in cases of natural death sometimes the first aspect arouses the suspicion of a crime.

[Physical capacity following blunt thoracic trauma].

In order to extend the knowledge of possibility of action after blunt thoracic injuries 43 patients with largely isolated collar-bone fractures, rib and serial rib fractures as well as vertebral column fractures were questioned about their posttraumatic possibility of action. Essential result: In general, there is a close correlation between the acuteness of pain, the patient's judgment of severity of the injury and the extent of his ability to act during the first posttraumatic minutes. In the further course the ability to act was limited by the extent and the developmental speed of the hematothorax and/or pneumothorax, unless it was primarily limited or completely missing due to pain.

[2 fatalities due to hyperthermia in infancy. A contribution to forensic medicine case reports of death caused by heat].

Two infants aged 4 1/2 and 8 months are reported to have been exposed to overheating by an electric blanket and a heating fan in bed for a period of up to approx. 19 hours. Dehydration complicated the effects of overheating.