Petechial bleedings in sudden infant death.

The autopsy reports of 484 cases of deceased infants (201 females, 283 males) were analysed retrospectively for the existence of external and internal petechial bleedings (PET). The cases were divided into five groups on the basis of the cause of death (sudden infant death syndrome, sepsis, airway infections, asphyxia and trauma). Internal PET (pleural, pericardial, epicardial, thymic and peritoneal) were observed in each group with a lower prevalence in cases of trauma. The highest prevalence of external (cutaneous and conjunctival) PET was detected in cases of asphyxia (38% and 31%, respectively). However, even if with low prevalence, such bleedings were detected in every group. Factors like sex, age, cardiopulmonary resuscitation and its duration did not influence the presence of PET. The detection of external PET at autopsy is a suspicious finding that suggests asphyxia. Because of the possible natural origin of these bleedings, the medicolegal investigation has to be as complete as possible and has to include histology as mandatory.

Cytogenetic and DNA-fingerprint characterization of choriocarcinoma cell lines and a trophoblast/choriocarcinoma cell hybrid.

We report the successful fusion of human choriocarcinoma cells with normal human trophoblast cells to a choriocarcinoma/trophoblast hybrid. The hybrid cells ACH1P were derived from fusion of primary male trophoblast cells with the HGPRT-defective choriocarcinoma cell line AC1-1. The karyotypes of the parental choriocarcinoma cell line JEG-3, its HGPRT-defective mutant clones AC1-1, AC1-5, and AC1-9, and the choriocarcinoma/trophoblast hybrid ACH1P are presented, together with a detailed characterization of the AC1-specific chromosomal marker add(X)(q26) using conventional cytogenetic banding techniques and multiplex-fluorescence in situ hybridization (M-FISH). To our knowledge, this is the first report of a stably proliferating human cell hybrid of trophoblastic origin, providing a unique cell culture model to study trophoblast-related invasion and its underlying genetic mechanisms.

Interferon-alpha and gemcitabine (2',2'-difluorodeoxycytidine) in adult and pediatric renal tumors.

2',2'-difluorodeoxycytidine (dFdC) is an active anticancer drug in different human malignancies. The present study aimed to evaluate if the activity of dFdC in renal tumors could be improved by interferon-alpha (IFN-alpha). The influence of IFN-alpha (4 h) on the cytotoxicity of dFdC was analyzed in vitro by a colorimetric assay. in vivo, nude mice with xenografts from human nephroblastoma (AC-KLxe-12) and renal cell cancer (ACHN, SN12C) were treated by dFdC +/- IFN-alpha. IFN-alpha alone resulted in no growth inhibition in vitro, but pretreatment with IFN-alpha sensitized SN12C and ACHN cells against dFdC. The additional treatment with IFN-alpha increased the CR rate of ACHN- and SN12C-mice (40%; 7%) compared to dFdC alone (20%; 0%). Xenografts from AC-KLxe-12 did all progress. In conclusion, IFN-alpha increased cytotoxicity of dFdC in vitro and tumor responses of renal cell cancer (RCC) in xenografts. Since therapy lacked activity in nephroblastoma, further studies should focus on RCC to compare the efficacy of dFdC and interferons with other types of biochemotherapy.

GEDNAP IV and V. The 4th and 5th Stain Blind Trials using DNA technology.

In the collaborative exercise GEDNAP IV one EDTA blood sample (2 ml) and 5 bloodstains (0.5 ml on cotton) were investigated and in GEDNAP V, a total of 8 bloodstains (0.5 ml on cotton), including 2 mixed bloodstains. DNA typing was carried out using the RFLP systems YNH24/Hinf I and MS43a/Hinf I and the PCR systems HLA DQ alpha, D1S80, ApoB and YNZ22. In both exercises approximately 20 laboratories obtained results using the RFLP systems. Of the PCR systems, D1S80 was the most commonly used (14 labs in GEDNAP IV; 18 labs in GEDNAP V). The interlaboratory standard deviation for YNH24 in both exercises was approx. 0.6%, for MS43a 0.7-2.2% (GEDNAP IV) and 0.4-1.4% (GEDNAP V), depending on the fragment size. The fragment size calculation performed in each laboratory yielded a standard deviation twice that obtained when the fragment size calculation was performed centrally (IfR, Münster). In GEDNAP III, a system-specific corridor was developed to define the limits of deviation; this was modified for the present study by combining the fragment size ranges of YNH24 and MS43a. In both studies a subgroup of laboratories was involved in preliminary exercises using three PCR VNTRs and the system HLA DQ alpha. Owing to the substantial variation in experience of the participating laboratories with PCR typing the results obtained in these two studies do not fulfil the basic quality criteria of the GEDNAP studies.

[Atypical ventricular septal defect]. / Atypischer Ventrikelseptumdefekt.

A case of a congenital cardiac malformation in form of a single ventricular septal defect is reported and histopathologic findings are presented. The possible origin with regard to its untypical localisation is discussed.

[Forensic medicine and morphologic aspects of fatal amniotic fluid aspiration]. / Arztrechtliche und morphologische Aspekte einer tödlichen Fruchtwasseraspiration.

The massive aspiration of amniotic fluid as one cause of a fatal postpartal asphyxia will be demonstrated under the aspect of preliminary criminal law proceedings against physicians because of medical negligence. The pathomorphologically established diagnosis of a fatal aspiration of amniotic fluid supposes extensive and systematic quantitative histological examination of both lungs. The technique of histological cross sections through the entire lung combined with morphometry is a suitable method to exactly record the alterations of bronchi and lung parenchyma by aspiration of amniotic fluid and their complications, such as interstitial emphysema.

[Selective detection of cytomegalovirus by in situ hybridization]. / Selektiver Zytomegalievirusnachweis durch "in-situ"-Hybridisierung.

In two SIDS autopsy cases, in situ hybridization with biotin-labeled DNA probes was used to demonstrate a specific cytomegalovirus (CMV) infection in paraffin-embedded tissue sections. This technique represents a rapid, specific, and highly sensitive tool for the detection of CMV infections and is recommended for routine examination in other suspected viral infections, particularly in cases connected with SIDS.

[Infanticide as a sequel of long-term unusual parental abuse]. / Kindestötung als Folge mehrzeitiger, ungewöhnlicher elterlicher Misshandlungen.

Reported is an uncommon case of battered-child syndrome by parents which caused the child's death. A lot of signs indicating multifarious and serious injuries are described. The causes of violence against the child--including those on an ethnological background- are discussed.

[The dangers of alcohol - the situation in the Federal Republic of Germany]. / Gefährdung durch Alkohol - Die Situation in der Bundesrepublik Deutschland.

In 1975 an action programme on the prevention and containment of alcohol abuse was decided upon for the Federal Republic of Germany. Many items of this program are tasks of a long standing nature. Many an effort has since then led to success: the population has increasingly become aware of the dangers of alcohol abuse. The number of people drinking alcoholic beverages daily or almost daily decreased, the number of those drinking hardly ever or never increased. The group of people in danger of becoming dependent on alcohol grew smaller and alcohol consumption per head of population remained at the same level. The groups in need of special attention are children and young people and here particularly girls because of the fetal alcohol syndrome, as well as parents and teachers because they are called upon to set an example. Health education for these particular groups of people is of prime importance because it is essentially responsible for the success in combating alcohol abuse. In future, however, even more effective strategies for health education and research will have to be developed.