Mallory-Weiss syndrome as the cause of sudden, unexpected death

The Mallory-Weiss-syndrome is an upper gastrointestinal haemorrhage due to longitudinal mucosal lacerations in the oesophagogastric junction. The mucosal lacerations occur as a sequel of vomiting or any other increase in intraabdominal pressure and account for up to 15% of all upper gastrointestinal bleedings. If death is due to a bleeding Mallory-Weiss-tear, however, massive blood stains on the corpse and around it frequently give rise to the suspicion of an unnatural cause of death. For this reason, autopsy is usually indispensable to elucidate the circumstances in which death occurred. The authors carried out a retrospective analysis of 5958 autopsies performed between 1997 and 2001 at the Institute of Legal Medicine, University of Hamburg, in order to identify all cases of Mallory-Weiss-syndrome as cause of sudden, unexpected death. The results (9 cases, amounting to 0.15% of all autopsies) suggest that Mallory-Weiss-syndrome is probably much more common as a cause of sudden death than previously described. Regarding epidemiological aspects, men clearly predominate; the average age was 48 years. It should also be stressed that in 8 of the 9 cases there was a previous history of chronic alcohol abuse.     

Estimating the Impact of Education on Political Participation: Evidence from Monozygotic Twins in the United States,Denmark and Sweden

In this study we provide new evidence on the much-discussed effect of education on political participation by utilizing the quasi-experiment of twinning. By looking at the relationship between education and participation within monozygotic (MZ) twin pairs we are able to circumvent traditional sources of confounding of the relationship rooted in genes and early life family environment because MZ twins share both. The results of within-twin pair analyses based on surveys from the United States, Denmark and Sweden show that while the relationship between education and political participation is highly confounded by genes and/or familial environment in all three countries, a positive impact remains of years of education in the US and of high school completion in Denmark. No effect is found in Sweden. Robustness checks suggest that the observed effect is not confounded by within-twin pair differences in prenatal environment nor differential treatment during childhood, and, if anything, that it most likely constitutes a lower bound estimate.     

Homicide-suicide by a single gunshot to the head

Apart from typical suicides, there are sometimes unusual deaths from gunshots to the head. The presented case is a double death from the autopsy material of the Institute of Legal Medicine in Berlin. The report deals with a murder-suicide of a man, who killed himself and his 2-year-old daughter by a single gunshot. After having administered a tranquilizer to the child, he held her head to his own and fired a contact shot to his right temple so that the bullet passed through both heads.     

Double homicide by shooting with removal of the victims

Despite strict assault weapons laws shooting deaths are not uncommon in the Federal Republic of Germany. Especially in multiple one-stage homicides shooting is a frequently established cause of death. The described double homicide from the autopsy material of the Berlin Institute of Legal Medicine shows the difficulties in the forensic assessment of gunshot wounds. It is noteworthy under criminalistic aspects how methodically the offender proceeded in the removal of the victims and how extensive the search for the bodies was, which were only found after calling in water search dogs.     

Extensive Petechiae in Attempted Self-Strangulation

Abstract:  A 29-year-old Korean man reported to have been robbed, bound, and gagged by a stranger in his apartment. Clinical findings included extensive petechiae to his face and tramline patterned abrasions and ligature furrows to his neck and face as well as his wrists. Initially, no other leads in the investigation existed and a robbery was assumed to have taken place. The man eventually confessed to fabricating the story and to having self-induced the ligature marks by subluxating his jaw at the temporomandibular joint and hooking the rope closest to the back of his neck on the corner of table. The man demonstrated this unsuspected ability to law enforcement officers. As a motive for his unconventional behavior, he confessed to engaging in autoaggressive behavior as punishment for "losing face" after his ex-girlfriend terminated her pregnancy. This case demonstrates that petechiae due to neck compression also may occur in the living and are due to vascular compression and not lethal hypoxia.