"Blind spots" in forensic autopsy: improved detection of retrobulbar hemorrhage and orbital lesions by postmortem computed tomography (PMCT).

OBJECTIVES: The purpose of this study was to correlate the occurrence of retrobulbar hemorrhage (RBH) with mechanism of injury, external signs and autopsy findings to postmortem computed tomography (PMCT). METHODS: Six-teen subjects presented with RBH and underwent PMCT, external inspection and conventional autopsy. External inspection was evaluated for findings of the bulbs, black eye, raccoon eyes and Battle's sign. Fractures of the viscerocranium, orbital lesions and RBH were evaluated by PMCT. Autopsy and PMCT was evaluated for orbital roof and basilar skull fracture. RESULTS: The leading manner of death was accident with central regulatory failure in cases of RBH (31.25%). Imaging showed a high sensitivity in detection of orbital roof and basilar skull fractures (100%), but was less specific compared to autopsy. Volume of RBH (0.1-2.4ml) correlated positively to the presence of Battle's sign (p<0.06) and the postmortem interval. Ecchymosis on external inspection correlated with RBH. There was a statistical significant correlation between bulbar lesion and RBH. Orbital roof fracture count weakly correlated with the total PMCT derived RBH volume. Maxillary hemosinus correlated to maxillary fractures, but not to RBH. CONCLUSIONS: RBH are a specific finding in forensically relevant head trauma. PMCT is an excellent tool in detecting and quantifying morphological trauma findings particularly in the viscerocranium, one of the most relevant "blind spots" of classic autopsy. PMCT was superior in detecting osseous lesions, scrutinizing autopsy as the gold standard.

[Examination of victims of sexual violence--the problem of false reports]. / Untersuchungen von Opfern sexueller Gewalt- das Problem der Falschanzeige.

Some people claim to be victims of sexual violence and abuse the judicial system by filing a false police report. Generally, motivation for such behaviour is assumed to be that the self-proclaimed victims try to avoid taking responsibility for a sexual act in which they have been an active, willing participant. Concise motivations include attempts to mask a sexual affair from a partner, or to mask a first sexual intercourse by pretending to be the victim of an act of violence. By the nature of many judicial systems that are abused for such purposes, clinical forensic specialists are confronted with such cases far more often than clinical doctors not serving judicial authorities. In adults, history, injuries and other findings often show patterns that can be recognized as evidence of deception or as signs for self-inflicted injury for the trained specialist. This is far less often the case in infants and children.

Into the decomposed body-forensic digital autopsy using multislice-computed tomography.

It is impossible to obtain a representative anatomical documentation of an entire body using classical X-ray methods, they subsume three-dimensional bodies into a two-dimensional level. We used the novel multislice-computed tomography (MSCT) technique in order to evaluate a case of homicide with putrefaction of the corpse before performing a classical forensic autopsy. This non-invasive method showed gaseous distension of the decomposing organs and tissues in detail as well as a complex fracture of the calvarium. MSCT also proved useful in screening for foreign matter in decomposing bodies, and full-body scanning took only a few minutes. In conclusion, we believe postmortem MSCT imaging is an excellent vizualisation tool with great potential for forensic documentation and evaluation of decomposed bodies.

Weekly patterns of drug treatment attendance.

OBJECTIVES: This study examined weekly patterns of drug treatment attendance in relation to date of welfare payment receipt and reason for treatment absence. METHODS: Treatment attendance by Medicaid-eligible pregnant women who were drug dependent was examined by calendar week over a 29-month period. RESULTS: Time series analyses showed that attendance was lower during week 1 than week 4. Drug use was the most frequently reported reason for treatment absence during week 1 (25%) but was not reported as a reason during week 3. CONCLUSIONS: Drug-dependent outpatients had increased absences associated with illicit drug use during the first week of the month when welfare payments were received. The generalizability of the findings is unknown.

Digital 3D image reconstruction of ventriculocapillary communication as revealed in one case after transmyocardial laser revascularization.

TMR (Transmyocardial Laserrevascularization) was performed on the partially dyskinetic left ventricular anterior wall with stenotic coronary blood supply in a 61 year old woman with a history of angina and myocardial infarction. As an ischemic aneurysm developed in the anteroapical region of the TMR treated area, it became clear that TMR did not provide a substitute for coronary blood supply in this very heart region. The aneurysm was removed surgically 7 months after TMR and showed histopathologic features of an acute aneurysm. Three-dimensional image analysis helped prove the presence of linear tracks through several serial sections which were not easily visible in routine histology sections. Also, three-dimensional vessel reconstruction showed a connection between a small endocardial pit on one serial section with the capillary network in the adjacent serial sections. The results should not be generalized, as currently aneurysmectomy is an end point not reached by the majority of TMR-treated patients.

[Transmyocardial laser revascularization. Histopathology of laser channels in 10 postoperatively deceased patients 1 to 18 days after treatment with a CO2 laser]. / Transmyokardiale Laserrevaskularisation. Histopathologische Befunde an Laserkanälen bei 10 postoperativ verstorbenen Patienten 1 bis 18 Tage nach Behandlung mit einem CO2-Laser.

TMLR (Transmyocardial laser revascularization) is a disputed cardiosurgical technique available in Europe since 1994 that aims to deliver additional blood flow to ischemic myocardium from the left heart chamber. Goal of our study is morphological examination of laser channels in human hearts to answer the questions: Are there patent laser channels with communication to the left chamber and to intramural vessels? We examined hearts of 10 patients who died during the first 18 days after TMLR. Channels were examined in histological serial sections under the light microscope. Laser channels in the first days postoperatively have a lumen diameter of about 1 mm and are surrounded by coagulation necrosis about 500 microns thick. Despite phagocytic removal of necrotic tissue the lumen diameter decreases during the following two weeks. Open intramyocardial channels can be shown in all patients. These channels communicate with intramural vessels, but in no instance with chamber lumen. Our results suggest that clinical benefits are based on improved distribution of coronary blood. Additional blood is not delivered from left chamber lumen to the myocardium. However, our patients represent the small subgroup of the decreased. If similar observations can be made in the majority of patients living symptom free after TMLR remains open.

[Corrosion anatomical and scanning electron microscopic studies of the blood vessels in the digital end organ of the hindlimb of cattle]. / Korrosionsanatomische und rasterelektronenoptische Untersuchungen an den Blutgefässen des Zehenendorganes der Beckengliedmasse des Rindes.

By aid of modern corrosion anatomical methods the afferent and efferent blood vessels as well as the microvasculature of the corium of the pelvic limb digit were investigated. The longest papillae are to be found in the perioptic corium. In the coronary corium the length decreases from proximal to distal. In the caudal section of the digital cushion the papillae show a typical, regular wavy form, whorl formation is rare.

[Scanning electron microscopic studies of the kidney glomerulus of Pudu pudu (Molina, 1782), and a comparison with that of cattle, goats, sheep and angora rabbits]. / Rasterelektronenmikroskopische Untersuchungen an den Nierenglomerula von Pudu pudu (Molina, 1782), zudem ein Vergleich mit denen des Rindes, der Ziege, des Schafes und des Angorakaninchens.

The kidney's microvascularization of the Pudu pudu is mostly similar to that of domestic animals. The renal parenchymatous arteries do not give off capsular branches. The majority of the Pudu pudu's glomerula shows spherical shape. Glomerula next to the medulla have a diameter which is an average of 25 microns larger than the diameter of those situated more peripherally. Their volume is comparable to that of the angora rabbit. The capillaries form anastomosis in the inner and outer part of the glomerulus.

Acanthosis nigricans associated with mycosis fungoides.

A case of acanthosis nigricans coexistent with mycosis fungoides, the second report in the literature of such an association, is described.

[Two methods for the determination of working life tables and their problems]. / Verschiedene Verfahren zur Ermittlung von Erwerbspersonentafeln und ihre Problematik

PIP: 2 methods for the determination of tables of working life are presented in this paper. The 1st table is based on individual cohorts of working persons of the same age so that, altogether, a separate table of working life can be established for each of these cohorts. Detailed data are required for this method, and they are unavailable at this time. Thus, a less than perfect approach is presented which is based on Markov chains with homogenous transition probabilties for all working and nonworking individuals. No difference is being made between 1st employment and reemployment. The estimation with available data is possible. (author's)^ieng

Laser wavelength comparison by high resolution interferometry.

High resolution interferometry has been used to determine the wavelength ratio between two molecularly stabilized He-Ne lasers, one locked to a methane absorption at 3.39 microm and the other locked to the k peak of (129)I(2) at 633 nm. An optical beat frequency technique gave fractional orders while a microwave sideband method yielded the integer parts. Conventional (third derivative) peak seeking servoes stabilized both laser and cavity lengths. Reproducibility of the electronic control system and optics was a few parts in 10(12), while systematic errors associated with curvature of the cavity mirrors limited the accuracy of the wavelength ratio measurement to 2 parts in 10(10). The measured wavelength ratio of the methane stabilized He-Ne laser at 3.39 microm [P(7) line, nu(3) band] to the (129)I(2) (k peak) stabilized He-Ne laser at 633 nm was 5.359 049 260 6 (0.000 2 ppm). This ratio agrees with that calculated from the (lower accuracy) results of earlier wavelength measurements made relative to the (86)Kr standard. Its higher accuracy thus permits a provisional extension of the frequency scale based on the cesium oscillator into the visible spectrum.

Description, performance, and wavelengths of iodine stabilized lasers.

A description is given of lasers stabilized to components of the (129)I(2) spectrum in the region of the 633-nm laser lines for (3)He-(20)Ne and (3)He-(22)Ne. Relationships between operational characteristics such as power output, peak size, and peak width are shown, along with their relationships to some of the controllable parameters such as excitation level, iodine absorption, and iodine pressure. We found an iodine pressure broadening of about 13 MHz/Torr with a 2.6-MHz zero-pressure intercept. The frequency shift associated with iodine pressure is roughly 2 x 10(-9) nu/Torr to the red. Power broadening and power shifts are small, about a 10% increase in width and about 2 x 10(-11) nu variation in frequency for a fivefold to sixfold increase in power. These lasers exhibit a frequency stability for 10-sec sampling time of about 2 x 10(-12) nu and a resetability of about 1 x 10(-10) nu. The absolute vacuum wavelength for one iodine component has been measured against the (86)Kr standard-(3)He-(20)Ne:(129)I(2), kappa lambda = 632 991.2670 +/- 0.0009 pm. The wavelengths of several other iodine components have been determined by measuring the frequency difference between them and the (129)I(2), kappa component. Among these are (3)He-(20)Ne:(129)I(2), i lambda = 632 990.0742 +/- 0.0009 pm: and (3)He-(20)Ne:(127)I(2), i lambda = 632 991.3954 +/-0.0009 pm. These results were obtained using the Rowley-Hamon model for asymmetry in the krypton line and assume that the defined value for the standard is axssociated with the center of gravity of the line profile. The indicated uncertainties are statistical. No allowance has been included for imperfect realization of the krypton standard or for uncertainty in the asymmetry model.