Biomechanical assessment of various punching techniques.

Punches without the use of instruments/objects are a common type of body violence and as such a frequent subject of medicolegal analyses. The assessment of the injuries occurred as well as of the potential of the assault to produce severe body harm is based on objective traces (especially the documented injuries of both parties involved) as well as the-often divergent-descriptions of the event. Quantitative data regarding the punching characteristics that could be used for the assessment are rare and originate mostly in sports science. The aim of this study was to provide physical data enabling/facilitating the assessment of various punching techniques. A total of 50 volunteers took part in our study (29 males and 21 females) and performed severe punches with the fist, with the small finger edge of the hand (karate chop), and with the open hand with both the dominant and the non-dominant hands in randomized order. The strikes were performed on a boxing pad attached to a KISTLER force plate (sampling frequency 10,000 Hz) mounted on a vertical wall. The punching velocity was defined as the hand velocity over the last 10 cm prior to the contact to the pad and ascertained by using a high-speed camera (2000 Hz). Apart from the strike velocity, the maximum force, the impulse (the integral of the force-time curve), the impact duration, and the effective mass of the punch (the ratio between the impulse and the strike velocity) were measured/calculated. The results show a various degree of dependence of the physical parameters of the strikes on the punching technique, gender, hand used, body weight, and other factors. On the other hand, a high degree of variability was observed that is likely attributable to individual punching capabilities. In a follow-up study, we plan to compare the "ordinary" persons with highly trained (boxers etc.) individuals. Even though the results must be interpreted with great caution and a direct transfer of the quantitative parameters to real-world situations is in general terms not possible, the study offers valuable insights and a solid basis for a qualified forensic medical/biomechanical assessment.

[Homicides committed by women in the area served by the Munich Institute of Legal Medicine]. / Vorsätzliche Tötungsdelikte von Frauen im Einzugsgebiet des Instituts für Rechtsmedizin München (1990-2010).

According to crime statistics only a small percentage of intentional killings are committed by women. Female emancipation has not changed this finding. In spite of numerous studies in the field of psychiatry and social criminology there are few systematic investigations analyzing homicides committed by women under medico-legal aspects. The presented data include 127 homicides committed by female offenders, which were assessed at the Munich Institute of Legal Medicine between 1990 and 2010. The results of the evaluation are presented with regard to the type of offence, the motive, the means and method used to commit the offence and the sentence imposed.

Position sensitive measurement of lithium traces in brain tissue with neutrons.

PURPOSE: The application of lithium is well known to have an antimanic-depressive effect, however, the influence it has on the human brain is still insufficiently known. The aim of our work is to develop a method to investigate the lithium concentration in the human brain with a very high sensitivity and a submillimeter resolution. Present methods either do not provide spatial resolution or are not sensitive enough to measure the naturally occurring lithium content in the human brain. Our method provides the opportunity to perform postmortem series measurements and obtain a detailed map of the lithium distribution in the human brain. This way possible correlations of the lithium distribution in the human brain and biological reasons for affective disorder can be clarified. METHODS: To study the lithium distribution in different regions of the human brain the authors developed a method to measure lithium traces postmortem with a submillimeter spatial resolution using the neutron capture reaction (6)Li(n, α)(3)H. The lithium is measured by coincident detection of the alpha particles and tritons, emitted in opposite directions. The general concept, the preparation of the brain samples, the experimental setup at the measurement station of the Forschungs-Neutronenquelle Heinz Maier-Leibnitz, and a first measurement on human brain tissue are presented. RESULTS: A first measurement on a brain tissue sample nicely showed a spatial distribution of lithium down to a few hundreds of pg∕cm(3) with a maximal resolution of about σ(x) = σ(y) ≈ 200 µm. Also a direct correlation of lithium and optical tissue structure is observable. Typical measurement times of a few minutes allow for series measurements of up to 20 × 20 mm(2) large samples with a thickness of w = 10-20 µm in medical studies. CONCLUSIONS: The combination of a very high lithium sensitivity with position resolving measurement makes this method well suited for postmortem studies of the microscopic lithium distribution in the human brain and thus to form a microscopic picture of the impact of lithium in different areas of the human brain.

Biomechanics and injury risk of a headbutt.

Headbutt is a relevant type of a criminal assault that can result in injuries. The aim of this study was to collect basic biomechanical data and assess the injury risk associated with a headbutt. Series of measurements were carried out with volunteers with and without relevant soccer heading experience, and the impact velocity of the striking head was measured. A soccer ball was used as a surrogate of the stationary victim's head. Two scenarios were considered: one corresponding to the typical headbutt situation, i.e. short movement of the assailant's head without backswing, and one representing the worst case, i.e. the most severe head impact without time or space constraints for the assailant. The results as well as epidemiological data from court cases and a large Munich's university clinic show that a typical headbutt is not likely to lead to life-threatening injuries, but bony injuries of the face can easily occur. Under certain circumstances (support of the victim's head, secondary impact on the ground etc.), severe injuries with potentially lethal outcomes are possible. A thorough analysis of each case is thus an imperative. The (soccer) heading experience does not influence the velocity of the headbutt.

Deaths due to physical restraint.

BACKGROUND: Physical restraint is used primarily for patients at risk of falling, those with motor unrest and agitated behavior, and those who manifest an intention of doing harm to themselves or are at risk of suicide. The use of freedom-restraining measures (FRM), and, in particular, the use of physical restraints against the patient's will, can be a serious intrusion of basic human rights and, as such, an act of violence against the patient. The improper use of physical restraints can cause injuries of varying severity, which can sometimes be fatal. METHODS: We analyzed all cases of death under physical restraint that were recorded in the autopsy reports of the Institute of Forensic Medicine in Munich from 1997 to 2010. RESULTS: Among the 27 353 autopsies conducted over the period of the study, there were 26 cases of death while the individual was physically restrained. Three of these cases involved patients who died of natural causes while restrained, and one was a suicide. The remaining 22 deaths were caused solely by physical restraint; all of them occurred in patients under nursing care who were not continuously observed. The immediate cause of death was strangulation (11 cases), chest compression (8 cases), or dangling in the head-down position (3 cases). In 19 of these 22 patients, the restraints were incorrectly fastened, including two cases in which improvised non-standard restraints were used. One nursing-home patient died because of an abdominal restraint even though it had been correctly applied: She was mobile enough to slip through the restraint till it compressed her neck, and then unable to extricate herself from it, so that she died of strangulation. CONCLUSION: To prevent such deaths, we recommend from a forensic medical standpoint that all possible alternatives to FRM should be used instead. If direct-contact restraints are truly necessary, they must be applied as recommended and the restrained person must be closely observed.

Lithium and other elements in scalp hair of residents of Tokyo Prefecture as investigational predictors of suicide risk.

The high suicide rates in Japan and several reports of inverse associations of suicide rates with the levels of lithium (Li) in drinking water prompted determinations of Li along with other elements in samples of scalp hair of 100 male and 100 female residents of Tokyo Prefecture. In more than half of the samples of both genders, Li levels were below the instrumental detection limit or below or the lower limit of the laboratory reference ranges. Among other elements, the concentrations namely of cobalt were also frequently below the laboratory reference range, suggesting that low circulating levels of vitamin B(12) were common in this study population. As vitamin B(12) deficiency is associated with depression and other psychiatric conditions, and there is evidence of interactions between Li and vitamin B(12), Li deficiency as well as suboptimal vitamin B(12) status must be considered as potential suicide risk factors. In view of its established positive effects on mood and brain function, an adequate supply of selenium (Se) is important as well. Although the analytical results suggested that the Se status of the subjects was generally adequate, as seafood was a major dietary source of Se, much of it was actually sequestered by mercury and only a fraction was bio-available. In addition, the hair samples were found to contain not insignificant levels of As, Cd, Ni, and Pb, arising from the adventitious presence of these elements in foods and the environment. As these elements also interact with Se in vivo and are known to adversely affect mood and behavior, in investigational studies, subjects at risk need to be evaluated also with respect to these elements.

Selenium and cadmium levels and ratios in prostates, livers, and kidneys of nonsmokers and smokers.

Cadmium (Cd) from cigarette smoke, environmental, and nutritional sources accumulates in the human prostate where it interacts with selenium (Se) in a manner suggesting the formation of a 1:1 Cd-Se-protein complex. At low Cd exposures and adequate Se status, this interaction may be beneficial as it results in the detoxification of Cd. At higher exposures, Cd may weaken or abolish the anticarcinogenic effects of Se and increase prostate cancer risk. In some older men and especially in smokers, Cd levels in prostates reach levels in stoichiometric excess over Se, which may be the reason why heavy smokers are at higher risk of developing lethal forms of prostate cancer. In the liver and the kidneys, Cd accumulates as well, but in these organs, Cd is efficiently sequestered through metallothionein formation. In the prostate, this mode of detoxification is not available or less efficient, causing Cd to interact with Se and to increase prostate cancer risk.

Selenium/cadmium ratios in human prostates: indicators of prostate cancer risk of smokers and nonsmokers, and relevance to the cancer protective effects of selenium.

Selenium (Se) in a large-scale human supplementation trial has been shown to significantly reduce the incidence of prostate cancer in elderly men. Because Se is known to interact with cadmium (Cd), it has been suggested that its cancer protective action could be attributable in part to its interaction with Cd, a toxic and suspected carcinogenic element, which is found in many foods, in drinking water, and in the environment. Cadmium is considered a significant prostate cancer risk factor as it stimulates the growth of prostate epithelial cells and promotes their malignant transformation. Accordingly, prostate cancer risk is determined not only by Se status, but also the degree of Cd exposure. Determinations of Se and Cd in 129 prostates of deceased men aged 15-99 yr revealed Cd to accumulate in the prostate. Whereas the atomic Se/Cd ratios of the prostates of young men were invariably >1, indicating a stoichiometric excess of Se over Cd, they were found to decline with age, approaching the 1:1 ratio in elderly nonsmokers, a fact suggestive of the formation of a 1:1 Cd-Se complex. The associated physiological inactivation of Se could account for the increase of the prostate cancer risk with advancing age. The Se/Cd ratios dropped more steeply and consistently with age in smokers than in nonsmokers. In the prostates of some smokers, Se/Cd ratios even reached values <1, indicating a stoichiometric excess of Cd over Se. The excessive accumulation of Cd in the prostates of smokers along with sub-optimal Se intakes could explain why smokers develop more aggressive and lethal forms of prostate cancer than nonsmokers.