Suicide by 120 stab wounds of the chest?

The case history of a suicide due to 120 stab wounds of the chest is presented. The victim was a 41 years old man with a paranoid-hallucinative psychosis. The problem to distinguish homicides and suicides is discussed by the well-known criminalistic and forensic-medical criterias. Induced by this very unusual case the autopsy material with stab wounds was analyzed retrospectively (n = 246, out of about 14,000 autopsies at the Institut of Forensic Medicine in Hamburg). Cases with more than 40 single lesions are normally homicides. However, the pattern of the injuries is more important than the number--especially in doubtful cases.     

HIV-infection in forensic autopsy cases

Sudden and unexpected death and violent death of persons with a high risk of acquiring HIV-infections, especially homosexual males and intravenous drug abusers, have to be investigated by forensic autopsies. Therefore every forensic pathologist has to be aware of this infection and should try to make the proper diagnosis. Three typical cases are described: (1) suicide by hanging, (2) homicide by cutting the throat and (3) intravenous heroin overdose. Merely retrospectively it could be cleared up that the deceased were homosexual but did not manifestly suffer from AIDS. The morphological findings in the lymph nodes and the postmortem serological findings are described in detail.     

Carbon monoxide poisoning in the automobile--suicide or accident?

In cases of CO-poisoning in vehicles accidents have to be reviewed. Old automobiles or untypical discovery without manipulations have circumstantial evidence. This proceeding is demonstrated by two casuistries. The argumatative force of the first appearance is not sufficient to give reasons for private-law consequences.     

Ultrastructural alterations of skeletal muscles after electric shock

The existence of tracks of electric current in the skeletal muscles was checked by electron-microscopic investigations in animal experiments on rats. Hypercontraction bands alternating with dilated sarcomeres and tumefaction of tubular apparatus and mitochondria with cristiolysis were established. The most severely expressed alterations were found in the vicinity of the electrodes and adjacent to the joints; they are thought to be caused by electrically induced tetanus and local hyperthermia. The forensic aspects of these findings are discussed.     

Pulmonary artery perforations as typical complication in the use of Swan-Ganz catheters

Two cases of pulmonary artery perforation are reported in association with the use of the Swan-Ganz catheter. A 71- and a 95-year-old woman were monitored by a flow-directed catheter pre- and intraoperatively. Both of them died. After taking other cases in the literature into consideration, this severe complication can be classified as "typical" for this examination technique. Possible means of prevention, diagnosis, and treatment of these complications are discussed. A review of incidence and genesis is given.     

Unusual intimal and endocardial damage following suicidal infusion of thiobutabarbital

A suicide is reported that was carried out by i.v. infusion of thiobutabarbital. The most impressive findings were macroscopical alterations in the venous endothelium, the endocardium of the right atrium and ventricle, and the endothelium of the pulmonary artery. The same local cytotoxic side effects could be reproduced in animal experiments. The lesions are most striking after circulatory stagnation in the agonal and supravital period when highly concentrated thiobarbiturates come into contact with the endothelium.     

The Correlates of Life Quality in U.S. Metropolitan Areas

This study analyzes the correlates of life quality differencesin 243 U.S. metropolitan areas. Using an overall index of lifequality developed by Ben-Chieh Liu, it tests the empirical utilityof three competing explanations—racial dualism, economicdevelopment, and political culture. The results show that allthree exert substantial effects on the quality of life regardlessof metropolitan size. Overall the best predictor of life qualitydifferences is the percentage of adults who have received atleast a high school education. In addition, cultural differencesexert significant effects on the quality of metropolitan lifeindependent of racial and developmental differences. These culturaleffects are interpreted within two theoretically seminal theories:Elazar's theory of political culture and Gastil's theory ofcultural regions.     

AIDS fatalities in Hamburg (status: February 1985)--legal medicine aspects

The registration of patients with acquired immune deficiency syndrome (AIDS) and AIDS deaths is centralized for medical research. A short review of the epidemiological state of AIDS in Hamburg is given (situation as of February 1985), and the autopsy results of seven postmortem examinations are referred to. Kaposi's sarcoma was seen in four patients and opportunistic infections in all cases, especially as a result of Pneumocystis carinii and cytomegalovirus. Due to the constellation of groups with an increased risk of acquiring AIDS--homosexual males, intravenous drug abusers and prostitutes--forensic implications have to be expected.