The roughness of the supranasal region--a morphological sex trait.

The supranasal region often attracts attention by a remarkable rough and jagged quality of the bony surface caused by an irregular supranasal suture and additional holes and pores. Some authors point out that there is a positive relation between the supranasal suture, the superciliar arches, and the forehead contour. For this a relation to sex is conceivable. This present study was done to prove the value of this morphological trait for sexing skulls.A total of 80 human skulls of known sex (40 females, 40 males) were collected from autopsy material used in anatomy teaching classes and from forensic cases. The mean age of the female sample was 70.98 years (minimum 38, maximum 93), that of the male sample was 74.10 years (minimum 57, maximum 99). To quantify the roughness of the supranasal region the calculation of the box-counting dimension was used. The results were normally distributed in both, the male and female group. The male dimension values were well grouped (maximum 1.51111, minimum 0.98765, mean 1.26159, S.D. 0.12268, 95% CI 1.22236-1.26604) whereas the female showed a wide range (maximum 1.46744, minimum 0.44755, mean 1.15052, S.D. 0.21388, 95% CI 1.08212-1.21892), widely overlapping the male range. Statistical analysis showed that there was a less than 1% probability that the female box-counting dimension was lower than the male by chance (P-value 0.00593). For this results the admission of the trait 'quality of the supranasal region' into a catalogue of features regarding morphognostic sex determination following the scheme: hyperfemininity: very smooth and regular--femininity: more smooth and regular--indifferent--masculinity: more rough and irregular--hypermasculinity: very rough and irregular, seems to be justified.

Induction of alpha1-antitrypsin synthesis in human articular chondrocytes by interleukin-6-type cytokines: evidence for a local acute-phase response in the joint.

OBJECTIVE: We have previously shown that human articular chondrocytes synthesize large amounts of interleukin-6 (IL-6) upon stimulation with proinflammatory cytokines and that they express the IL-6 receptor. The present study was undertaken to analyze whether different IL-6-type cytokines can induce synthesis of the acute-phase protein alpha1-antitrypsin in human articular chondrocytes. METHODS: Chondrocytes from human articular cartilage, cultured in agarose, were stimulated with IL-6-type cytokines. Total RNA was isolated and analyzed by Northern blotting. Levels of alpha1-antitrypsin protein were determined by enzyme immunoassay. RESULTS: Stimulation of chondrocytes with oncostatin M (OSM) and IL-6 led to a 5-10-fold increase in alpha1-antitrypsin synthesis. This increase was dose and time dependent. Furthermore, OSM and IL-6 induced IL-6 synthesis in chondrocytes, resulting in an autocrine amplification loop. CONCLUSION: Our data strongly suggest the existence of a local acute-phase response in the joint. Synthesis of the acute-phase protein alpha1-antitrypsin, a major inhibitor of serine proteinases, may be an important protective mechanism of articular chondrocytes to prevent cartilage damage in inflammatory joint diseases.

Iliac cancellous bone in drug addicts: a histomorphometric study.

Histomorphometry was used to determine structural bone changes in drug addicts. Iliac crest bone biopsies were obtained at autopsy from 28 subjects (21 male, 7 female, aged 18 to 45 years) who had a history of drug abuse and had died due to overdose of illicit drugs. For histomorphometry, undecalcified sections were investigated using the Merz grid. The following histomorphometric indices were measured and calculated: BV/TV, BS/BV, Tb.Th, Tb.N, Tb.Sp, OV/TV, OS/BS, Ob.S/BS, O.Th, ES/BS, Oc.S/BS, and N.Oc/T.A. In 28 controls (24 male, 4 female, aged 17 to 47 years) trabecular bone specimens were investigated in the same way. The parameters in drug addicts did not show any correlation to age, body weight, height or sex differences. Trabecular bone volume and trabecular thickness were slightly but not significantly increased (BV/TV: 23.37 +/- 5.77% (mean, SD), controls 22.23 +/- 5.08%, p = 0.434; Tb.Th: 172.67 +/- 36.83 mcm, controls 169.73 +/- 36.13 mcm, p = 0.764). Only the eroded surface was significantly different to the controls (ES/BS: 8.16 +/- 2.04%, controls 6.96 +/- 2.17%, p = 0.038). We conclude that the incidence of metabolic bone disease in drug addicts is low.

Measurement of cartilage thickness in the human knee-joint by magnetic resonance imaging using a three-dimensional gradient-echo sequence.

We studied human specimens and compared data on cartilage thickness measurements with magnetic resonance imaging by using an image analysing system with corresponding histological sections in the middle of each sector. The findings are based on 768 measurements in 26 knee joints. Overall, there was very good magnetic resonance/anatomic correlation (r=0.88). The poorest correlation was in the sectors of the femur (r=0.69). The correlation seemed not to be dependent on the grade of osteoarthritic cartilage lesions. Despite good correlation rates, the mean magnetic resonance/anatomic difference (absolute values) was 0.41 mm (standard deviation (SD) 0.34 mm) or 18.08% (SD 18.9%). Imaging techniques need to be improved if the assessment of cartilage thickness by this means is to be of clinical relevance.

Applicability of various brands of mixed-phase extraction columns for opiate extraction from blood and serum.

Four commercially available types of mixed-phase solid-phase extraction (SPE) columns (Bond Elut Certify, Isolute Confirm HCX, Chromabond Drug and Bakerbond Narc-2) were examined in order to compare the extraction efficiencies and chromatographic purity of extracts. The absolute recovery of morphine, 6-monoacetylmorphine and codeine was examined in blood and serum (ten samples each at two concentration levels), using SPE columns of the same batch. GC-MS (ion trap) and HPLC with amperometric detection were used for quantitation. A distinct variability in extraction recovery was observed among the same batches of all brands of SPE columns. All extracts were chromatographically pure and no interfering peaks were observed, neither in GC-MS nor in HPLC examinations, but in some extracts large peaks of plasticizers were identified. The measurements of flow velocities of the same samples of blood or serum through the SPE columns of the same batch showed very large variability of random character. The morphometric analysis of particles was performed for two batches of each sort of SPE columns by means of an image analysing system. Symmetrical distribution of particle size was observed only in Chromabond MN Drug packing, while in other cartridges large fractions of fine particles and nonhomogenous distribution were found. Only in one case the morphometric findings were pretty concordant with the data available from the manufacturer; in two cases, observed data varied considerably from that expected, and in one case no information was available at all. The study showed generally that there was room for improvement in the quality of mixed-phase SPE columns.

Trends in occurrence of drugs of abuse in blood and urine of arrested drivers and drug traffickers in the border region of Aachen.

The region of Aachen is located in a triangle on the German, Dutch and Belgian borders and is heavily exposed to drug traffic, due to the differences in national drug policies. The analysis of toxicological casework in the Institute of Forensic Medicine in Aachen was undertaken for the period 1987-1993, i.e. 6 years before and 1 year after the partial suspension of the border control due to the Maastricht Treaty; 2653 cases were registered, among them 988 automobile drivers. The profile of the casework has changed after the opening of the border: up to 1992 most cases were obtained from the customs. In 1993 the prevalence of police samples was noticed. In the population of drivers, blood samples were only taken in 30% of all the cases. In other cases, concerning mainly motorized drug smugglers, only urine samples or seized drugs have been sent for examination. The urine samples in this group were mostly drug-positive. Drug-smuggling drivers appeared to be a risk-generating group for road traffic safety. The analyses of blood and urine samples revealed multiple drug use in most of the cases. Since 1992, a steep increase in the frequency of cocaine-positive blood samples among drivers was noticed. The results of the study indicate that the abolition of the border control affected the road traffic safety in the region of Aachen.

Iatrogenic fatal outcome of traumatic axillary aneurysm.

Five months after dislocation of the left shoulder a 66-year-old patient noted a swelling in the left axilla. After CT-scan a malignant tumour was suspected and an incisional biopsy was performed. A week later the patient died due to hemorrhaging from the biopsy wound. The autopsy revealed a false aneurysm of the axillary artery. The incision had damaged the external wall of the aneurysm leading to consecutive rupture. Post-mortem findings are presented.

Digital radiography versus conventional radiography for the detection of a skull fracture under varying exposure parameters.

RATIONALE AND OBJECTIVES: The effect of varying exposure parameters on the detectability of a fracture with digital and conventional radiography were examined. METHODS: A macerated fractured skull was imaged by film-screen radiography (FSR) and digital storage phosphor radiography (DR) with various exposure values. Five radiologists traced the course of a fracture line. The length of the fracture was reported and the results were analyzed by Student's t test for paired samples. RESULTS: At 35% of the conventional radiation dose, the standard DR screen displayed an average of 48% of the fracture length. The difference from the conventional image (45%) was not significant in this case. An increase of the dose to ten times the conventional dose (250 mAs) yielded no significant improvement in the detectability of the length of the fracture (51%). CONCLUSIONS: This experiment shows that with use of the DR with the standard screen, a dose reduction of approximately 35% appears to be possible without any resulting loss of image quality compared to FSR. Use of the high resolution screens should be avoided, since they require a higher incident image dose than standard screens without offering any diagnostic advantages. The image dose of digital radiographs can be roughly estimated based on the digital device sensitivity value. As a rule, the sensitivity value should range between 100 and 200.

[Limits for recognizing linear fractures of the cranial vault in radiologic diagnosis]. / Grenzen der Erkennbarkeit von linearen Frakturen der Schädelkalotte in der radiologischen Diagnostik.

In case of failure to detect a vault fracture in fatal head injury the physician is often accused of medical negligence. The material for the study consisted of a macerated vault with fractures in different widths. In order to detect the threshold of perceptibility it underwent radiographic examination taking pictures under different projections. Our finding is that the presence or absence of a radiographic fracture depends on the width and direction of the fracture. Therefore it is impossible to detect every single linear fracture of the vault in routine skull examination. Clinical and medico-legal consequences are discussed.

[Applications of morphometry in forensic medicine]. / Zum Einsatz der Morphometrie in der Rechtsmedizin.

Various histomorphometric methods and their use in clinical-pathological and forensic investigations are described. The methods are 1. manual point counting using an integrating eyepiece, 2. semi-automated histomorphometry using a manual digitizer and 3. automated image-analysing. Although the semi-automated and automated techniques are less time consuming and provide more information about the specimen, every method is regarded as having its specific range of application. It is pointed out that there is often a need for quantitation of histological findings especially in forensic medicine.