The evidential value of intra-alveolar haemosiderin-macrophages in cases of sudden infant death syndrome (SIDS)

This study aimed to determine the effect of cocaine on the development and growth of immature and adult blowflies, in an attempt to better understand the impacts of such effects on postmortem interval (PMI) estimation. Twice the lethal dose of cocaine was injected into rabbits. The control animals were injected only with saline solution. Experimental and control rabbits were autopsied, and portions of their livers were exposed to newly eclosed larvae of Chrysomya putoria and Chrysomya albiceps. Larvae were weighed individually every 6 h, up 54 h of exposure. The larvae were then placed on an artificial diet to continue their development. Pupariation time, adult emergence and adult longevity were also analysed. The larvae of both species that fed on the cocaine-containing livers developed faster than those that fed on the livers of the control animals, leading to the conclusion that cocaine influences and stimulates larval growth. The difference in growth between the control and treated flies was best observed from 12 h of exposure onward. This finding has important implications for forensic investigations.     

Fall from height--surprising autopsy diagnosis in primarily unclear initial situations

External post-mortem examination and first police assessments are often not consistent with subsequent autopsy results. This is all the more surprising the more serious the injuries found at autopsy are. Such discrepancies result especially from an absence of gross external injuries, as demonstrated by four examples. A 42-year-old, externally uninjured male was found at night time in a helpless condition in the street and died in spite of resuscitation. Autopsy showed severe polytrauma with traumatic brain injury and lesions of the thoracic and abdominal organs. A jump from the third floor was identified as the cause. At dawn, a twenty-year-old male was found dead on the grounds of the adjacent house. Because of the blood-covered head the police assumed a traumatic head injury by strike impact. The external examination revealed only abrasions on the forehead and to a minor extent on the back. At autopsy a midfacial fracture, a trauma of the thorax and abdomen and fractures of the spine and pelvis were detected. Afterwards investigations showed that the man, intoxicated by alcohol, had fallen from the flat roof of a multistoried house. A 77-year-old man was found unconscious on his terrace at day time; a cerebral seizure was assumed. He was transferred to emergency care where he died. The corpse was externally inconspicuous. Autopsy revealed serious traumatic injuries of the brain, thorax, abdomen and pelvis, which could be explained by a fall from the balcony. A 47-year-old homeless person without any external injuries was found dead in a barn. An alcohol intoxication was assumed. At autopsy severe injuries of the brain and cervical spine were found which were the result of a fall from a height of 5 m. Conclusion: On the basis of an external post-mortem examination alone gross blunt force trauma cannot be reliably excluded.     

HIV-1 prevalence in deaths caused by drug overdose in various large cities of West Germany and West Berlin between 1985 and 1988

The development of the HIV-1-prevalence among drug deaths (n = 753) in several German cities (West Berlin, Frankfurt, Munich, Hamburg, Bremen, Cologne and Stuttgart) from 1985 to 1988 was evaluated; in 1988 43% of 674 deceased drug addicts were examined. The regional prevalence rate was between 15 and 25%; only in Berlin 42% of the drug deaths were HIV-infected (cumulated data of all cities over the 4-year-period: 26%). There was no uniform or steady regional development of HIV-1-prevalence in the different cities. The ratio men/women among drug deaths was 3:1. The HIV-1-prevalence among males was 22%, among females 40%. HIV-infected individuals were 2-3 years older than seronegatives. Predictions concerning the trend of prevalence rates are not possible up to now. Continuous monitoring of the HIV-status of drug deaths seems to be a worthful method to evaluate the spread of this disease among the risk group of intravenous drug addicts.     

An unusual finding in a case of hypothermia

Suicide was initiated by several incisions in the skin; the resulting hypovolemia resulted in fatal hypothermia. The unusual autopsy findings in this case due to hypothermia were focal hemorrhages and necrosis of the pancreas and hemorrhagic infarction of the descendending colon. The pathophysiological relevance of the autopsy and histological findings are discussed.     

Immunocytochemical identification of AB0 incompatible erythrocytes following fatal transfusion reaction

A patient with blood group O died 8 h after an accidental transfusion of one unit of A1 erythrocytes. The admixture of group A red cells was not detected during postmortem serology. Paraffin-embedded autopsy material was studied by the indirect immunoperoxidase technique using monoclonal antibodies. Group A red cells were easily identified as circulating agglutinates in the larger vessels, in the capillary vessels of all organs examined, and as closely packed cell aggregations in the sinuses of the spleen. However, there was no clear evidence of erythrophagocytosis in the spleen or in liver.     

Portraits of some founders of the German Society of Legal Medicine

In the preceding paper by W. Krauland the foundation of the German Society of Legal Medicine, which took place at the 76th meeting of the German Naturalists and Physicians in Breslau, 1904, was described in detail. Carl Ipsen, Julius Kratter, Adolf Lesser, Georg Puppe, Emil Ungar and Fritz Strassmann were chosen as the preliminary board of the Society. They were respected scientists in their field, working at different universities in Germany and Austria. Life and scientific work of these founders of the German Society of Legal Medicine shall be described in short portraits.     

MOR1 receptor mRNA expression in human brains of drug-related fatalities-a real-time PCR quantification

The expression of the human micro-opiate receptor (MOR1) in post mortem human brain tissue was examined using real-time PCR technology. Tissue samples from 11 fatalities due to opiate overdose and five normal subjects with different causes of death were analysed in order to elucidate whether chronic opiate abuse is followed by a regulation of MOR1 expression. In each case nine selected brain regions (thalamus, caudate nucleus, hypothalamus, ventral tegmentum, hippocampus, amygdala, frontal cortex, nucleus accumbens, putamen) were evaluated. The MOR1-mRNA level was determined relative to the housekeeping gene beta2-microglobulin. While in most regions the MOR mRNA levels in the brain of addicts were not different from the control group-with varying levels between 0 and 15% of housekeeping gene level-in the brains of three drug-related fatalities an enormous increase was encountered in the thalamus where the MOR-mRNA level amounted for up to 10,000% of the measured housekeeping gene level. The results obtained by toxicological hair analysis in the group of drug-related fatalities indicate that the enormous thalamic MOR1-expression is primarily found in individuals who died from acute heroin overdose but did not show signs of a substantial chronic administration of the drug. Further studies have to be performed to evaluate if the observed MOR1-mRNA up-regulation in the thalamus in a subpopulation of acute lethal intoxications mirrors a state of functional hypersensitivity associated with the occurrence of death.