The influence of loss of blood and alcohol intoxication on early vital wound reactions (author's transl)]

The influence of loss of blood and alcohol intoxication on wound reactions in the first 12 hours after incisions into the skin of the back of guinea pigs was examined. As the most important result we found differences in the cellular and zymohistochemical reactions: while begin and progression of the dermal leucocytosis were not influenced, the parallel running activation of different structure bound enzymes was significantly delayed and decreased. Considering the first result and the haematogenous origin of the leucocytes there is reason to believe that in the hierarchy of the biological control circuit-at least in guinea pigs-the local reflex hyperaemia of the wound area certainly is primary to the dermal vasoconstriction during collapse. The animals with haemorrhagic shock showed a retardation in the liberation of histamine and serotonin. This decrease of the local mediators of the stromae dissociation is considered the reason of the impaired initial enzyme activities in the mesenchymal tissue.     

Impairment of performance by alcohol and diazepam (author's transl)]

An investigation was carried out on the effect of the intake of diazepam and alcohol on simple performance tests. The combined administration of diazepam and alcohol led to an increase of the plasma diazepam concentration as compared to that obtained after diazepam without alcohol. Furthermore, after combined intake of diazepam and alcohol a decrease of performance was observed, that was significantly higher, than the effects obtained after either alcohol or diazepam alone. This impairment was especially noticeable duirng the first hour of the experiment, i.e. until the plateau of the diazepam plasma concentration was reached, while afterwards a correlation between diazepam plasma concentration and impairment of performance could not be established. The relevance of these findings for the interpretation of diazepam plasma concentrations in relation to the impairment of performance are discussed.     

Delinquency under drug influence (author's transl)]

In delinquency, connected with alcohol, the immediate and acute effect of the substance is prominent, whereas in delinquency connected with drugs, one has to deal with chronic effects. The criteria for judging drunken offenders also stand as a model for judging the responsibility of the addicted offender for his crime. We consider: 1. the personality of the offender 2. the way, the amount and the point of time of the last intake of the drug 3. the potential dependence 4. the psychopathological state at the time of offense and at the time of examination 5. the kind of the offense itself. Most cases, which have to be examined, deal with indictable offenses, which were undertaken, in order to get new supply, i.e. "supply-offenes". These cases surmise, that the offender is physically addicted, that he knows about withdrawal symptoms from own experience, and that he committed the crime purely for securing his personal supply. We differentiate between direct "supply-offenses" (i.e. direct stealing by the addict himself) and indirect "supply-offenses" (i.e. mainly trading and commission business). For the latter offenses the state of consciousness and insight at the time of offense does not serve as a suitable criterion for judging the responsibility for the crime, since these offenders usually are not deprived of their drugs and therefore in a stable state of mind. Therefore the inner situation and the motivation for carrying out the crime has to be analysed carefully. For these indirect "supply-offenses" reduced responsibility for the offense has to be considered, whereas for direct "supply-offenses" a total lack of responsibility can be assumed.     

Effects of alcohol in the embryo, fetus, and newborn infant (author's transl)]

At delivery the newborn infant of a drunken mother had a bloodalcohol concentration of about 2.0%. The elimination rate was calculated to be 0.08%/h. The infant exhibited obvious features of an embryofetal alcohol syndrome. Several cases from literature are cited with ethanol given for therapeutic purpose in obstetrics and bloodalcohol concentration exceeding to 1%-2%. This means that values up to 2% in newborn infants without any other pathological findings should not solely be accepted as cause of death in forensic cases.     

Mesothelioma of the septum interatriale (author's transl)]

Sudden death of a 21-year-old women. The cause of death was mesothelioma situated in the region of the interatrial septum that has been manifested since childhood as a complete heart block. Neither gravidity nor delivery led to the aggravation of her state of health. The cause of this heart lesion, which was the mentioned rare tumor, was discovered only during the autopsy.     

Morphological findings in Zieve's syndrome (author's transl)]

The macroscopic and microscopic findings of a case of Zieve's syndrome are described (fatty liver, icterus, hyperlipemia and hemolytic anemia in chronic alcoholism). The outstanding macroscopic finding is milky turbidity of the blood in arterial and venous vascular channels as well as hepatomegaly and anaemia of internal organs. A prominent feature of the histological picture is the high-grade lipaemia of the large and small vessels (arteries and veins), capillary occlusions resembling fat embolism in all organs and severe diffuse fatty metamorphosis of the liver. Circulatory disorders and the cause of death are discussed.     

Post mortem determination of bromureides (author's transl)]

Concentrations of carbromal, carbromide and bromisoval are determined in blood, urine, brain, kidney and muscle taken at autopsy from 41 fatal cases after overdosage of bromureides. In addition values of total bromine in blood are presented. Contents of total bromine can only lead to the deduction that a chronical abuse of bromureides is existent or not. Concentrations of bromureides and carbromide show a wide range according to the different time between taking the drug and death particularly in cases of pure carbromal intoxications which sometimes cause death after several days. In such cases quantitative determination of carbromide, a pharmacologically active metabolite of carbromal, is the only way to prove an acute carbromal intoxication. Especially in cases of additional foreign substances death may occur in early the phase of poisoning. Bromureides decompose post mortem by putrefaction a high degree so that the condition of the cadaver is important. Brain tissue is the most usable material for examination but other organs, particularly muscle and kidney, can be analysed with success. For differential diagnosis fatal cases are presented which were not caused by drug intake.     

Examinations to phenomenon of shock-lung (author's transl)]

The pathogenesis of shock lung as well as the success of therapy in this condition was studied in 79 cases of extrathoracic trauma. The water-, hemoglobin-, and DNA contents of the lungs were measured in order to determine the extent of edema, the rate of perfusion, and proliferation. The cases were divided into two groups according to whether they had or had not received medical therapy before death. The data from these two groups were compared using statistical methods in which time of survival was especially taken into account. The fluid balance, pO2, pCO2, central venous pressure, pH of the serum, total serum protein and serum creatinine were also studied in these cases. Results of the study are as follows. Three phases of the posttraumatic syndrome of shock-lung could be distinguished: phase I (initial phase): blood perfusion is increased, edema is beginning to form, and medical treatment has not yet begun. Phase II (early phase = sydrome of early respiratory failure): pulmonary edema is developing rapidly while perfusion is decreasing. Phase III (late phase = syndrome of late respiratory failure): proliferative changes predominante and the edema is still increasing. The mean weight of the lungs was 397 g (s = 170) in phase I, 774 G (S = 361) In phase II, and 1124 g (s = 310) in phase III. The survival times correlated significantly and positively with the amount of water and DNS in the lungs and significantly and negatively to the amount of hemoglobin in the lungs. Thus, increasing pulmonary edema and increasing proliferative changes occurred with decreasing pulmonary perfusion. This correlation was even noted in groups of patients who had not received medical treatment and whose survival times were short. In treated cases, the fluid balance was significantly and negatively correlated to the total serum protein.     

Exceptional suicide of a physician (author's transl)]

A 57 years old psychiatrist committed suicide through insufflation of powder from a chemical fire extinguisher his respiratory and gastrointestinal tract. Death was due not to mechanically induced asphyxia but to asystolia. The latter disturbance is explained as a vagal reaction to trauma because of the characteristic position of the corpse at the scene and because the victim did not exhibit any signs of gas or foreign body embolism. A further point of interest in the context of trauma mechanism, is the absence of significant disruptions in spite of the high pressure (10-12 atu) developed by the extinguisher. No conclusive interpretation can be given about the psychological mechanisms behind this suicidal act. On the other side the modality of the procedure used by the victim became manifest already a few months before the critical act.     

Suicides in hospitals of Vienna (author's transl)]

An analysis of the autopsies ordered by the Viennese Forensic and Health Authorities between 1967 and 1976 has shown that 2.3% of all suicides were committed in hospitals. Two thirds of the 77 examined cases were carried out by males. Thirty-five patients were in stationary psychiatric treatment; their average age was 50.7 years. In all other kinds of hospitals 42 (mostly male) patients committed suicide at an average age of 65.3 years. Preferred methods of performance were jump and fall from height (44.1%) and hanging (40.3%). Rare methods used were one case of abdominal incisions (harakiri), one self-strangulation, and one case of suffociation in plastic bags. The act was usually accomplished early in the morning or in the late afternoon. Among the suicidal patients who were hospitalized because of organic diseases those with malignant neoplasms [18] and cardiovascular diseases [12] were predominant. Also taking the suicides outside hospitals into consideration the numerical ratio between natural deaths due to cancer and the suicides of cancer patients is about 1:1,000. Amont the suicides in psychiatric institutions schizophrenics [11] and endogenous depressives [7] were the most numerous. In 4 cases the suicide was preceded by acts of injury or homicide.     

Mechanical tolerance of tentorium cerebelli (author's transl)]

In some cases of accidents primary traumatic brain stem hemorrhages are seen in conjunction with lesions of the tentorium cerebelli. In order to decide, whether accelerations of the infra- or supratentorial brain tissue are actually capable of causing tentorium lesions, burst and teartests of tentorium tissue were conducted. The mean dynamic biaxial tearing force was found to be about 4 bar. This value supports the hypothesis that a main injury causing factor of the tentorium in cases without skull fracture could be the relative motion between the tentorium and the brain hemispheres. The mass of the cerebellum however seems to be insufficient to cause such injury producing deceleration forces on the tentorium.     

About the effect of alcohol and tiredness on the activity of tendon reflexes (author's transl)]

In order to estimate the combined effect of ethanol and fatigue on the activity of tendon reflexes, the mechanical threshhold and the latency of the patellar tendon, the radial and the biceps reflexes as well as the time of contraction of the musculus quadriceps femoris was investigated in men, with an ethanol level in blood at 80 mg % during elimination-period, and with tired subjects meaning that they hade done their usual daywork and had been awake for about 20 to 22 hours. The group, consisting of 21 male students, was then investigated under both these conditions. The patellar reflex was elicited by a specially constructed reflexhammer, by which the mechanical power could by measured exactly, from the angle of the position the hammer was released from and its known weight. The latency and the muscular contraction time were registered with electrodes on the skin by an oscillograph. The mechanical threshhold of the patellar, biceps and radial reflexes and the latency of there reflexes were significantly and equally impaired by ethanol as well as by fatigue. The combination of both these factors resulted in an almost exactly additional effect. The contractiontime of the m. quadriceps was prolonged more by fatigue than by ethanol. Comparing these results with fromer findings, a depressing effect of the formatio reticularis of the brainstem on the activity of the spinal motorcells is to be discussed. This impairment of neuro-muscular coordination and activity obviously is dangerous for drivers. It should especially be noted, that the effect of a wake period of 20 to 22 hours can be compared with that of a bloodlevel of 80 mg % ethanol as to the impairment of the tendon reflexes.     

Coma dépassé: toxicological-diagnostic and forensic aspects of a fenetyllin (captagon) intoxication (author's transl)]

In a case of intoxication by Fenetyllin (captagon) with succeeding coma dépassé it can be shown, that toxicological-diagnostic conclusions can be drawn from the disproportional concentrations between brain and body organs. It may be possible to reveal an unknown intoxication case after autopsy or to contribute to recognition of causality of narcotic incidences after a possible overdose.     

Exhumation for suspected poisoning--reticulum cell sarcoma (author's transl)]

A 57-year-old woman showed somnolence, extreme stiffness of the neck and atypical CSF findings which led to her death within a few days. During legacy controversy the possibility of poisoning was considered. The post mortem, pathological and toxological examinations of the exhumed corpse permitted the diagnosis of reticulum cell sarcoma 16 months after death. Such a diagnosis 16 months after death has, to our knowledge, not previously been reported.