[Modification of Alcomat breath alcohol determination by benzine]. / Untersuchungen zur Beeinflussbarkeit der Alcomat-Atemalkoholmessung durch Benzin.

We examined the period breath-alcohol values may be falsified owing to gasoline vapors with regard to the Alcomat currently used in routine tests. In a sober test person the breath-alcohol concentration was found to be 0.10/1000 24 min. after the inhalation of gasoline vapors, whereas the value measured after 28 min. was still 0.09/1000. 63 min. after the clothes had been moistened with gasoline, a breath-alcohol concentration of still 0.11/1000 could be identified immediately after inhalation.

[Severe human bite injuries in a 7-day-old newborn infant]. / Schwere Menschenbissverletzungen bei einem 7 Tage alten Neugeborenen.

It is reported about a 7-day-old newborn showing considerable bite wounds in his face. Due to the evidence of blood group characteristics on his pajamas and by means of a dental impression, the 2 1/2-year-old brother was "found guilty" of having caused the injuries. During a short antibiotic treatment the bite wounds cleared, showing very good results. Jealousy is assumed to be the reason for the incidence. Based on a comprehensive and also child-psychiatric examination of the family, other reasons could be excluded. Similar cases of sibling violence with newborns, partly fatal, are reported in literature. If infants fear to loose the security of their homes, jealousy may lead to severe aggressive reactions.

[A drug evaluation and classification program in the USA--also a model for Germany]. / Drogenevaluations- und -klassifizierungsprogramm in den USA--auch ein Modell für Deutschland.

The question of recognition and possibilities of proof regarding impairment by narcotics and drugs is gaining significance also in Germany. Therefore, it is necessary to deal more closely with the United States "Drug Evaluation and Classification Program" and consider its application in Germany as well. The American program is based on standardized education of drug recognition expert trainees and well-tested methods of examination. The results are convincing. The expert reports prepared by the examiners and the chemical-toxicological results correlate in 80 to 97% of the cases. As long as no definite findings regarding dose/concentration effect relationships exist, the classification of behavior, appearance and medical examination plays a significant role. To a great extent, the program makes allowance for the existing possibilities in Germany as well. The authors of this article would consider it to be wrong if, in Germany extensive, time-consuming field studies were undertaken to obtain further knowledge prior to introduction of such a program. On the other hand, despite the existing difficulties, it should be endeavored to find dose/concentration effects.

Bite injuries upon a newborn.

A 2 1/2-year-old boy inflicted on his 7-day-old brother suction and bite injuries of the head with loss of tissue of nose and lips. Place of the incident was the parents' bed. The event motivated us to report on the assignment of such injuries and the reasons for sibling violence.

[Multiple homicide. Forensic medicine and criminal aspects]. / Mehrfachtötungen. Rechtsmedizinische und kriminalistische Aspekte.

36 human beings, of whom the youngest was one and a half years and the oldest 76 years old, fell victims to 16 multiple homicides each committed by one perpetrator. 7 of the homicides were committed outside the family and other lasting relationships. 9 homicides can be assigned to the group of "family tragedies". As far as the victims of the first group are concerned, the course of events in committing the crimes is of particular medical-criminalistic interest. There is a more detailed description of the constellation of two homicides in the course of which the victims were either removed by burying their corpses or a fire was set in order to keep the crime secret. The way the weapon was used, the dependence on the situation of the crime as well as the perpetrator's behavior after committing the crime are discussed and compared in both case groups.

[Case analysis of double or multiple homicides]. / Fallanalyse von Zweifach- und Mehrfachtötungen.

Thirty-six patients (the youngest was about one and a half years old, and the oldest 76 years old) were the victims of double or multiple homicides. These comprised a total of 16 homicides, exclusively involving one perpetrator. Seven of these could not be categorized in the group of "family tragedies". These crimes are of particular medical-criminalistic interest in view of their constellation. The way in which the murder weapon was used, the situation-dependence as well as the behavior of the perpetrator after committing the crime are discussed in detail.

Contrecoup fractures of the anterior cranial fossae as a consequence of blunt force caused by a fall.

Contrecoup fractures of the base of the skull are regarded as rare in the clinical literature. In our material (n = 171 falls on the same level and on or from stairs), the overall frequency of contrecoup fractures of the anterior cranial fossa in fatal cranio-cerebral trauma due to falls was 12%, as compared to 24% with occipital point of impact of the head. The relationships between the impact site on the head, form of fracture at the point of impact with involvement of the skull cap and/or the base of the skull, coup and contrecoup injuries of the brain, localization of contrecoup fractures in the anterior cranial fossa and the occurrence of monocle and spectacle haematomas display a major variability. Fractures occur in the form of simple fractures and as impression fractures (fracture fragments or fracture boundaries displaced to the inside). Clinical diagnosis is difficult because of the concealed position of the anterior skull base. Contrecoup fractures become of forensic medical significance when symptoms of a frontobasal injury occur for the first time after trauma which has occurred some time in the past and when the question arises as to the causal connection with the original trauma. In investigation of living persons, it may be difficult to decide whether haemorrhages in the region of the orbit and its vicinity result from a direct blunt force or derive from fractures of the base of the skull, especially contrecoup fractures.

[Alcohol drinking experiments with men over 60 years of age]. / Alkoholtrinkversuche mit über 60 Jahre alten männlichen Personen.

Alcohol drinking experiments (exposure: 0.68 g alcohol per kg body weight; type of drink: hard liquor and wine) was carried out in 20 men over 60 years old. The peak alcohol concentration, the course of the alcohol curve, co, r and beta 60 were compared with the results of drinking experiments with young persons published in the literature. No appreciable differences between the two age groups could be detected.

[Accidental fall-induced craniocerebral injury]. / Die sturzbedingte Schädelhirnverletzung.

If the effects of force on the head due to falls are subdivided into three subgroups (forehead, lateral parts of the head and occiput), it is to be observed that occipital traumas take first place in falling on or from stairs (51%) and in falling on the same level (57%). Persons under the influence of alcohol fall on the back of the head to a greater extent than persons not under the influence of alcohol. It is noteworthy that the base of the skull is frequently involved in cranial fractures (91%). Subdural hematoma was associated with a cranial fracture in a high percentage of cases (fall on or from stairs 91%, fall on the same level 75%). Epidural hematomas were both found in isolation and in combination with subdural hematomas (fall on or from stairs 12%, fall on the same level 17%). Falling as a fatal cause of death takes first place today before traffic accidents.

[Fatal hemorrhage from ruptured varicose veins of the sigmoid colon in liver cirrhosis]. / Verblutung aus rupturierter Varize des Colon sigmoideum bei Leberzirrhose.

A 41-year-old woman died within a few hours one morning due to massive rectal hemorrhage. At autopsy, complete liver cirrhosis, signs of portal hypertension, liquid blood in the entire colon, and high-grade anemia were detected. The source of bleeding was a ruptured submucosal varix in the sigmoid colon, which was almost invisible even microscopically and had been caused by portal hypertension. In the vicinity, and somewhat further away from the rupture site, numerous, greatly dilated veins with wall sclerosis and intimal thickening, as well as paravascular iron deposits, were found as indications that severe hemorrhages had already occurred earlier. To detect the source of bleeding, meticulous inspection and dissection with hematoxylin and eosin, elastica van Gieson, and iron staining, were necessary.

[Death in a tetany attack]. / Tod im tetanischen Anfall.

A case of latent tetany in a 24-year-old woman is reported. She had suffered several attacks of tetany in the last 12 years, mostly triggered by external stimuli. One evening, the woman was found dead in the hall of her flat beside the telephone with the upper limbs in a tetanic convulsive attitude. The attack of tetany was triggered by a telephone conversation. The parathyroid glands were normal. Day-old purulent myocarditis could be demonstrated in the left ventricle under the light microscope. The two possible pathogenetic explanations of the causal chain leading to death are discussed. It was astonishing that a clinical symptom (tetanic convulsion) was fixed in rigor mortis.