Harmonization of medico-legal autopsy rules. Committee of Ministers. Council of Europe.
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Autopsy↗
Biomedical subjects
B Brinkmann
Publications and source records attributed to B Brinkmann.
Transmission ratio distortion at the INS-IGF2 VNTR.
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Child↗
Use of polymerase chain reaction for postmortem diagnosis of malaria.
Delay or failure in diagnostic or therapeutic management of Plasmodiumfalciparum malaria may result in avoidable deaths, often incurring medicolegal procedures. Advanced postmortem autolytic processes and putrefication may thwart malaria diagnosis by traditional microscopic and histologic examinations. The authors describe the usefulness of polymerase chain reaction to confirm postmortem diagnosis of malaria.
Adolescent↗
Worldwide ethnic distribution of the G protein beta3 subunit 825T allele and its association with obesity in Caucasian, Chinese, and Black African individuals.
Recently, it was demonstrated that one allele (825T) of the gene encoding the G protein beta3 subunit (GNB3) is associated with hypertension in Germans. This study investigates a possible association with obesity in young male Germans, Chinese, and black South Africans with low, intermediate, and high 825T allele frequencies, respectively. In each of these three distinct cohorts, the 825T allele frequency was increased significantly in overweight (body mass index [BMI] > or =25 kg/m2) and obese individuals (BMI >27 kg/m2) compared to those with normal weight. The 825T allele frequencies in these three BMI groups were, respectively, 29.5, 39.3, and 47.7% in Germans, 46.8, 53.9, and 58.6% in Chinese, and 83.1, 87.7, and 90.9% in South Africans. In each of these three distinct groups, the 825T allele was significantly associated with obesity with odds ratios between 2 and 3. More urban than rural black Africans were overweight despite similar 825T allele frequencies in both populations, which underscores the role of both genetic and environmental factors. BP values in young male whites increased significantly with increasing BMI values but were independent of the C825T polymorphism, suggesting that hypertension associated with the 825T allele could be a consequence of obesity. Genotyping of 5254 individuals from 55 native population samples from Africa, the Americas, Europe, Asia, Australia, and New Guinea demonstrated highest 825T allele frequencies in black Africans (82%) and intermediate values in east Asians (47%). It is anticipated that high frequencies of the 825T allele in Africans and Asians may contribute to an obesity and hypertension epidemic if Westernization of lifestyles continues.
Adolescent↗
Population genetic diversity in relation to microsatellite heterogeneity.
Nine populations (Germans, Turks, Moroccans, Ovambos, Ugandans, Chinese, Japanese, Papuans, and Australian Aborigines) were investigated using six microsatellite systems (HumCD4, Hum F13B, HumFES/FPS, HumTH01, HumVWA, and D21S11), so-called STRs (short tandem repeats). Allele frequency data and sequencing results were used to compare the population genetic diversity among these populations. The genetic differences varied depending on the STR applied. According to the systems investigated, we defined three categories of STR microvariation: LOMs (low microvariation systems), INMs (intermediate microvariation systems), and HIMs (high microvariation systems). LOMs (STRs: CD4, FES, F13B, TH01) are characterised by a number of repeats between 5-15 and a stable repeat sequence. INMs and HIMs each showed an increasing number of repeats and additional sequence variation in the repeat motifs. The rate of new mutations was associated with the extent of microvariation. The reconstruction of phylogenetic trees led to a clustering in an early split of the African populations followed by further branching of the Asian/Melanesian and the Caucasian groups.
Africa↗
Experimental bloodstains on fabric from contact and from droplets.
The differentiation between contact bloodstains and stains produced by projected droplets on fabric can be crucial in crime scene reconstruction since suspects can explain bloodstains on their clothing by contact with the victim post mortem. Experimental smear and contact pressure stains on three different types of fabric were compared with stains produced by falling and projected droplets ("dynamic" stains) of equivalent size. The morphology of the small stains (0.1-10 microliters) was investigated with a macroscope. Characteristic for "dynamic" stains are symmetry and rhythmicity (secondary droplets) of the stain and a zonal drying pattern. Contact stains lack the characteristic features of "dynamic" stains and show a clear impregnation of the material resulting in a blood-soaked reverse side of cambric and cotton and in a paler overall colour. The mode of formation of microstains (blood volume 1 < microliter) on irregular surfaces (e.g. terry cloth) can be difficult to determine since the rough surface structure and the small blood volume reduce the characteristics of dynamic stains. In these cases, comparison with experimental stains on the same surface material is recommended.
Blood Stains↗
Detection and analysis of tracers in experimental drowning.
In animal experiments, studies on the mechanisms involved in drowning were carried out using latex and gold tracers of defined size and concentration. The tracers were detectable by fluorescence microscopy (latex tracers) and by electron microscopy (gold tracers) in the lungs, kidneys and lymph nodes and were analysed further by X-ray microanalysis using a transmission scanning electron microscope. Tracers with small diameters were shown to penetrate intercellular gaps of the alveolar epithelium and the larger tracers were incorporated into the epithelial and endothelial cells by active pinocytotic mechanisms thus passing through the air-blood barrier. The detection and analysis of tracers in organs of the systemic circulation originating from the immersion fluid can assist in understanding the pathophysiology of drowning and in some selected cases, in making a more definitive diagnosis.
Animals↗
Ketoacidosis and lactic acidosis--frequent causes of death in chronic alcoholics?
In clinical medicine, severe keto- or lactic acidosis associated with vomiting, nausea, abdominal pain, tachycardia or pathological respiration, has been described in chronic alcoholics. This study reports on fatalities of chronic alcoholics where the cause of death could not be determined by thorough autopsy, histology and toxicology including determination of alcohol concentration. In a first series, acetone was determined in the blood of such chronic alcoholics (n = 24), diabetics with metabolic decompensation (n = 7), cases of hypothermia (n = 7) and controls (n = 218). Among the 24 chronic alcoholics where the cause of death was unknown, 9 cases showed very high levels of acetone (74-400 mg/l). These comprised 6 cases without additional findings and 3 cases where a second patho-mechanism such as intoxication possibly contributed to the cause of death. In a second series, the sum values according to Traub (lactate/glucose) were determined in cerebrospinal liquor of chronic alcoholics with undetermined cause of death (n = 45), diabetics (n = 6) and controls (n = 39). Among the 45 alcoholics, 17 cases showed very high sum values (294-594 mg/dl) including 8 cases where non-lethal intoxications may have contributed to the final outcome. Other causes of a ketoacidosis or lactic acidosis (e.g. diabetes) were excluded in both groups of alcoholics. Consequently, ketoacidosis and lactic acidosis can be the cause of death of chronic alcoholics in a considerable number of cases where no pathomorphological or toxicological changes are present. A scheme for medical and laboratory examination is described.
Acetone↗
A new technique for the postmortem detection of tooth-coloured dental restorations.
Identification of unknown bodies is mainly made by dental examination and comparison with accurate dental records. Therefore it is necessary to examine the jaws carefully and to locate every tooth-coloured dental restoration. Overlooking dental fillings can make positive identification impossible. The technique described prepares the natural dental hard tissue by etching with 37% phosphoric acid. In the next step an indicator colours the roughened dental tissue but not the polished restoration material. In this way all 15 tested dental restoration materials could be detected with high sensitivity.
Acrylic Resins↗
Tetranucleotide STR system D8S1132: sequencing data and population genetic comparisons.
In the present investigation of the D8S1132 locus 31 selected alleles were sequenced. In total there were 9 distinguishable alleles found to increase in size by regular 4 bp increments from 134 to 170 bp with a repeat array following the pattern (TCTA)n TCA (TCTA)n. One-third of the sequenced alleles exhibited an altered repeat sequence TCTG TCTA at the 3' flanking region of the repeat array. A nomenclature for the designation of D8S1132 alleles is proposed on the basis of this sequence data and in accordance with the ISFH recommendations. The allele distribution of the D8S1132 locus has been investigated in three German populations (Halle-, Münster-, and Wiesbaden area) with frequencies ranging from 0.004 to 0.24. No deviation from Hardy-Weinberg equilibrium could be observed. The heterozygosity was 0.83 and the discrimination power 0.96 for the Halle population.
Alleles↗
Proof of fatal air embolism.
Venous air embolism is a rare cause of death. Entry of gas into the circulation is caused by trauma, mostly surgical or therapeutic, and sometimes resulting from criminal intervention. The detection of air embolisms requires special precautions during autopsy. An aspirometer has to be used for the detection, measurement and storage of gas originating from the heart ventricles. The aspirometer has to be filled completely with distilled water containing two drops of Tween 80 to reduce the surface tension of the water and to prevent adherence of small air bubbles to the wall of the aspirometer. Subsequently the gas has to be analysed by gas chromatography. When the results correspond with the main criteria defined by Pierucci and Gherson [2] the diagnosis "air embolism" is justified. The technique for the detection of air embolism is simple but requires a careful procedure which is described in detail.
Autopsy↗
Coordinating Y-chromosomal STR research for the Courts.
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Chromosome Mapping↗
Proof of air embolism after exhumation.
The detection, storage, and analysis of gas taken from the heart ventricle is necessary to diagnose a fatal air embolism and this requires special precautions during autopsy. When the results of gas analysis correspond to the criteria defined by Pierucci and Gherson the diagnosis "air embolism" is justified. In cases showing putrefaction the diagnostic value of gas analysis was negated. In a series of 15 patients who were assumed to have been killed by air injection in a peripheral vein the corpses were exhumed and a full medico-legal examination was carried out including gas analysis. In 8 cases results could be obtained indicating a mixture of embolised air and gases of putrefaction. In two control groups comprising 10 exhumed bodies and 30 cases showing advanced putrefaction, gas analysis showed putrefaction gases except in 5 cases with gas volumes less than 5 ml in the right ventricle. Therefore gas analysis can be helpful to diagnose fatal air embolism even in cases showing putrefaction while the diagnosis of putrefaction gases only does not exclude this diagnosis.
Aged↗
A specific immunoassay for the determination of morphine and its glucuronides in human blood.
The development of specific antisera for immunochemical determination of morphine, morphine-3-glucuronide and morphine-6-glucuronide is described. Morphine was N-demethylated to normorphine and N-alkylated to give N-aminopropyl-normorphine as hapten for antisera against morphine. As haptens for antisera against morphine-3-glucuronide and morphine-6-glucuronide, N-aminopropyl-nor-morphine was glucuronidated in position 3 or 6 respectively. Each of these three haptens were coupled to BSA employing the glutaraldehyde method to obtain three different immunogens. Immunisation of rabbits with these conjugates gave anti-morphine, anti-morphine-3-glucuronide and anti-morphine-6-glucuronide antisera, which were tested in a competitive, heterogeneous radioimmunoassay. Tracers for this radioimmunoassay procedure were synthesised by substitution of morphine and morphine-6-glucuronide in position 2 with 125I and indirect iodination of the morphine-3-glucuronide hapten according to the method of Bolton and Hunter. The resulting antisera show very specific reactions with morphine, morphine-3-glucuronide and morphine-6-glucuronide. Cross reactivities of each antiserum with structurally related opiates and opioides are very low. The cross reactivities of the anti-morphine antiserum against morphine-3-glucuronide, morphine-6-glucuronide, codeine, codeine-6-glucuronide or dihydrocodeine were less than 0.3%, the anti-morphine-3-glucuronide antiserum against morphine, morphine-6-glucuronide, codeine, codeine-6-glucuronide or dihydrocodeine less than 0.1% and the anti-morphine-6-glucuronide antiserum against morphine, morphine-3-glucuronide, codeine or dihydrocodeine less than 0.1%, against codeine-6-glucuronide less than 2.3%. The determination of morphine, morphine-3-glucuronide and morphine-6-glucuronide in blood samples (limit of detection= 3, 1, 0.5 ng/g) of nine cases of fatal heroin overdose with this radioimmunoassay method and the comparison with a GC/MS method is described.
Animals↗
Heteroplasmic substitutions in the mitochondrial DNA control region in mother and child samples.
The sequences of the two hypervariable regions of the mitochondrial DNA control region (HV1 and HV2) from close maternal relatives (mother-child pairs) were compared to determine the frequency of mutations between two generations. A total of 68 blood samples were sequenced only in HVI and 86 were analysed for HV1 and HV2. The intergenerational comparison led to the identification of six heteroplasmic point mutations affecting the children only. In one case a heteroplasmy of the maternal sequence was resolved to homoplasmy in the corresponding sequence of the child.
Adult↗
Basement membrane thickness of the vocal cord in cases of sudden infant death.
In 1991, 1994 and 1997 Shatz et al. reported on a specific and pathognomonic basement membrane (BM) thickening of the vocal cord in cases of sudden infant death syndrome (SIDS). In 40 cases of sudden and unexpected infant death the histological examination of the larynx was performed to identify possible differences between SID (n=26) and non-SID (n=14) cases. The dissection technique of Hohmann (1963) and Maxeiner (1986) was modified for the infant's larynx. Since the normal range of the BM thickness of the vocal cord for the age group younger than 1 year had not yet been exactly defined, a reference interval had to be established (0.5 microm-2.0 microm). In 2 SID and 1 non-SID cases a mean BM thickness (BMT) of more than 2.0 microm could be estimated (2.38 microm-2.95 microm). The BMT in these cases appeared to be highly variable and not harmonically thickened. None of the investigated regions of the BM (cranial to caudal thirds, ventral to dorsal areas) seemed to be preferred thickened. There was no statistically significant difference between the two groups. A specific thickening of the BM of the vocal cord in SID cases could not be confirmed. Therefore, BMT cannot be used as a diagnostic postmortem marker for SID.
Basement Membrane↗
Y-chromosome STR haplotypes in an Italian population sample.
Seven Y-chromosome STRs were investigated in a male population sample from the Modena area by means of one quadruplex reaction (systems DYS19, DYS390, DYS391, DYS393), one duplex reaction (systems DYS389-II, DYS392) and two single PCR reactions (DXYS156 and DYS389-I/II). In 100 males, 71 different haplotypes could be observed, 57 of which were seen only once. The haplotype diversity/discrimination index is 0.97. The resulting database could be used for routine forensic application like paternity testing and stain investigation.
Alleles↗