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Biomedical subjects

B Madea

Publications and source records attributed to B Madea.

At least 19 recordsLinked to original sources
PubMed1999

Allele and genotype frequencies for the STR locus D18S51 in a western German population.

Genetic marker typing based on DNA amplification by the polymerase chain reaction (PCR) increasingly is being employed in forensic casework and for paternity testing. Allele frequencies were determined using PCR for 102 unrelated Germans (Rhine area) for the locus D18S51. Twelve alleles were observed, with frequencies ranging from 0.005 (allele 11) to 0.191 (allele 14). The observed heterozygosity was 0.867, and the power of discrimination was 0.968. There was no deviation from expectations under Hardy-Weinberg assumptions (P = 0.451).

Gene Frequency↗
PubMed1998

Polymorphic sites in human mitochondrial DNA control region sequences: population data and maternal inheritance.

Sequence analysis of the mitochondrial DNA (mtDNA) control region is of central importance for forensic identity testing as well as for studies of human evolution. Here we report the sequencing data of the hypervariable regions I and II from 50 unrelated individuals from a western German population (Rhine area). In regions I and II, 52 and 26 sites of sequence polymorphism, respectively, were noted. Nucleotide substitution rather than insertion/deletion was the majority of variation. The distribution showed a large bias towards transitional changes than transversional changes. Furthermore we investigated uniparental inheritance in seven CEPH families each family with 7-9 maternal descendants. Most maternal relatives shared identical mtDNA sequences. Additionally sequences were compared for father:child pairs and as expected no evidence for paternal transmission of mtDNA was observed. The high variability of mtDNA control region sequences permits utility in forensic identity investigations. The data also indicate that the neomutation rate seems to be very low from one generation to the other.

Base Sequence↗
PubMed1998

Immunohistochemical detection of fibronectin in postmortem incised wounds of porcine skin.

Fibronectin plays an important role in tissue repair and wound healing. Previous literature reports indicated that fibronectin could be a marker of vitality for wounds with a survival time of more than a few minutes. In order to verify these findings were performed immunohistochemical investigations on the expression of fibronectin in incised wounds of porcine skin inflicted into various anatomical regions in the early postmortem interval (0-5 min after circulatory arrest). Tissue specimens were collected 12-14 h postmortem and investigated for fibronectin on paraffin sections (alkaline phosphatase and monoclonal anti-alkaline phosphatase procedure). A markedly positive expression of fibronectin (not only next to the wound margin and clearly stronger than in normal undamaged skin) could be demonstrated in eleven out of 36 samples. A moderately positive fibronectin reaction was detectable in seven further specimens. Muscular contraction bands were observed in nine out of 36 specimens. The various reaction patterns of fibronectin cannot be finally explained, but are probably due to a passive transudation of skin tissue by blood components from injured vessels. As a result of these investigations the specificity and validity of fibronectin as a parameter of vitality has to be questioned. Fibronectin immunohistochemistry again reveals that the validity of parameters as vital criteria decreases when their manifestation time is short; postmortem/supravital induction seems to be possible resembling vital reactions in these cases.

Animals↗
PubMed1998

Sudden death in cases with anomalous origin of the left coronary artery.

UNLABELLED: Ectopic origin of the left coronary artery from the right sinus of valsalva with anterior and posterior courses are thought to be benign anomalies. CASE REPORTS: a 58-year-old woman died suddenly after a car accident without having sustained any injuries. The only abnormal finding was an ectopic origin of the left coronary artery from the right sinus with anterior free wall course. The anomaly was complicated by the absence of a left descending branch and a hypoplastic circumflex artery. A 38-year-old male died suddenly during work. Beside the ostium of the right coronary artery originated the normal calibered circumflex branch of the left coronary artery which passed behind the aorta. The left anterior descending branch had a normal origin. There was a 2 cm in diameter transmural infarct observed microscopically.

Adult↗
PubMed1998

Sudden cardiac death due to atypical isolated coronary arteritis?

A case of probable isolated primary arteritis of the coronary arteries (coronaritis) in a 68-year-old man who died suddenly and unexpectedly is presented. The histologic presentation of the disorder is discussed, especially the differential diagnosis of arteritis of the coronary arteries versus distinct coronary artery sclerosis with concomitant inflammatory change.

Aged↗
PubMed1998

Heroin associated nephropathy--a post-mortem study.

Renal specimens were obtained from 179 autopsies of persons autopsied in the Institute of Forensic Medicine, University of Bonn, from 1987 to 1997. All persons were known as intravenous drug addicts. All renal specimens were examined with hematoxylin-eosin, PAS, Siriusred and Gomori (methenamine silver trichrome stain) and investigated with primary antibody against LCA (leucocyte common antigen), CD 68, IgG and IgM. 105 specimens (61.7%) showed a mono-lymphocytic membranoproliferative glomerulonephritis (MPGN), 48 specimens (45.7%) deposits of IgM. No case with focal segmental glomerulosclerosis (FSGS) as reported in male African-American intravenous drug addicts was found. In 37 out of 54 cases, hepatitis antibodies were detected in serum and three out of these 54 cases were HIV-positive. Chronic hepatitis B and C are known to be associated with glomerulonephritis. We found some cases without detection of hepatitis antibodies but with severe glomerulonephritis. In contrast to African-American drug addicts, European drug addicts do not develop a FSGS but a MPGN, partly due to heroin or other adulterants and apparently independent from hepatitis infection.

Adolescent↗
PubMed1998

Two cases of unexpected sudden death due to cystic medionecrosis of the aorta associated with bloodless aortic dissection.

The autopsy findings from two rare cases of sudden death concerning a 31- and a 44-year-old woman are reported. Autopsy and morphological examination revealed a dissection of the aorta but no rupture into the pericardial sac. In both cases mucoid deposits in all layers of the media and rarefication of the elastic fibers were found, rendering cystic medionecrosis as the cause of the aortic dissection. In these unusual cases, only a very small intimal tear was present, but no blood in the dissected aortic wall. Evidence of left ventricular hypertrophy and a history of hypertension were reported in both cases. No extension of the aortic dissections into the left or right coronary artery and no other clinical or pathological findings associated with aortic dissection were present. Cystic medionecrosis was the cause of the aortic dissection in these cases. The mechanism of death in both cases is discussed.

Adult↗
PubMed1998

Sudden death of an 18-year-old man with homocystinuria and intracranial inflammatory pseudotumor (IPT).

An 18-year-old mentally deficient man with well-known homocystinuria died suddenly within a few minutes. He had a history of severe oligophrenia, bilateral ectopia lentis requiring extraction of both lenses and operatively corrected genu valgum on both sides. In 1993 a hypergammaglobulinemia was noticed and a decortication on the left side after purulent pneumonia became necessary. Four months before death multiple abscesses in the spleen and pancreas lead to splenectomy and resection of the pancreatic tail. Furthermore, an isolated inflammatory pseudotumor (IPT) of the brain was found. Autopsy revealed as cause of death a pulmonary embolism. The pathogenesis of the cause of death and concomitant diseases will be discussed.

Adolescent↗
PubMed1998

Suicide with moclobemide and perazine.

A 51-year-old woman who was diagnosed as suffering from depression was found dead in her flat. The autopsy revealed no morphological changes sufficient to explain death. Toxicological analysis was performed and the drugs moclobemide (49.9 mg/l), perazine (1.27 mg/l) and some metabolites were identified in the blood. A combined drug intoxication resulting in synergistic effects to cardiovascular disorders was proposed as the cause of death.

Antipsychotic Agents↗
PubMed1998

Validation studies and characterization of variant alleles at the short tandem repeat locus D12S391.

Validation studies were carried out on the short tandem repeat (STR) locus D12S391 including the determination of the allele frequencies, forensic application and sequence analysis of variant alleles. A total of 16 alleles were found in a population survey of 158 unrelated individuals from the Rhine area, none of which exceeded the 0.20 frequency level. In 316 alleles analysed so far 18 alleles were found with an incomplete repeat unit in the 5'-end of the repeat region. The statistical values were similar to those of other European populations and no deviation from Hardy-Weinberg equilibrium (HWE) was observed.

Alleles↗
PubMed1998

Intracranial plasma cell granuloma and homocystinuria.

A rare case of plasma cell granuloma (PCG) of the brain is reported. An 18-year-old man with a well known homocystinuria and a history of severe oligophrenia, grand-mal-epilepsia, bilateral ectopia lentis requiring extraction of both lens and operatively correlated genu valgum, died suddenly within a few minutes. In 1993 a hypergammaglobulinemia was noticed and a decortication on the left side after purulent pneumonia became necessary. Four months before death, multiple abscesses in the spleen and pancreas led to splenectomy and resection of the pancreatic tail. Autopsy revealed a pulmonary embolism and an isolated intracranial plasma cell granuloma of the left hemisphere.

Adolescent↗
PubMed1998

First experience with the REMEDi HS urine benzodiazepine assay.

Ninety eight urine samples were analysed with an immunoassay benzodiazepine kit. A total of 68 urine specimens that were presumptively positive for benzodiazepines were evaluated by the REMEDi HS urine benzodiazepine assay (BIO-RAD, Munich, Germany). Of this number, 53 (78%) specimens were found by REMEDi to contain one or more benzodiazepines or their metabolites, and 15 (22%) were found to be negative. From the discordant group of 15 samples, eight were found to be negative using conventional chromatographic procedures (HPLC or GC/MS), while seven contained one or more benzodiazepines or metabolites, each of which were below the individual cut-off level specified by the manufacturer. Additionally 30 urine specimens that were negative for benzodiazepines using immunoassay were also tested by REMEDi. Two samples were found to be positive. These results could not be confirmed by other chromatographic techniques. The REMEDi HS benzodiazepine assay can be a very useful complementary technique in the clinical/forensic toxicology laboratory, especially for the identification of the parent benzodiazepines administered. The assay provides a rapid result in emergency situations and is useful in confirmation of preliminary positive immunoassay results.

Automation↗
PubMed1997

[Fatal post-traumatic alcohol delirium--compensation responsibility in private accident insurance?].

While several case reports about fatal posttraumatic alcohol withdrawal deliriums after minor traumas and compensation by legal insurance have been published this problem has been hardly addressed regarding private accidance insurance. Based on the very comprehensive definition of an accident in the private insurance law posttraumatic deaths by alcohol withdrawal deliriums can be causally related even to minor traumas and compensations by private insurance are justified. However according to section 8 AUB 88 the contribution of preexisting alcoholism and alcohol related organ damage to the lethal outcome must be subtracted.

Adult↗
PubMed1996

Immunohistochemical characterization of alveolar macrophages and pulmonary giant cells in fatal asphyxia.

UNLABELLED: It is in dispute whether the occurrence of numerous alveolar macrophages and in particular pulmonary giant cells in cases of fatal asphyxia is associated with agonal activation and proliferation. The nature of these alveolar cells was investigated in selected fatalities with protracted final oxygen lack using immunohistochemistry (APAAP method) and a semi-quantitative graduation. The study included opiate-involved deaths (n = 22), fatal strangulations (n = 10) and a control group of sudden cardiovascular deaths (n = 10). Positive immunohistochemical reactions were observed with the monoclonal antibodies PG-M1 (general marker of macrophages, detection of nearly 100% of pulmonary macrophages and giant cells in all subgroups) and 25 F 9 (late stage inflammation marker, detection of pulmonary macrophages/giant cells in 70%/50% of opiate-involved fatalities, 70%/20% of strangulations and 40%/30% of control cases). The antibodies LN-4 (macrophages), 27 E 10 (early stage inflammation marker), AMH 152 (activated macrophages) and MIB 1 (proliferation marker) did not react with these cell populations. CONCLUSIONS: pulmonary giant cells and numerous alveolar macrophages are not restricted to asphyxia. Their appearance is not of pathognomonic value for this diagnosis. Both cell types seem to be of heterogeneous nature (different functional state) as only one marker was expressed by all cells. The results do not suggest prefinal immigration, mobilization or proliferation of alveolar cells, but rather point to a longer pre-existence of macrophages and giant cells in pulmonary tissue (25 F 9 as late stage inflammation marker positive).

Antibodies, Monoclonal↗
PubMed1996

Child homicide in Cologne (1985-94).

Twenty five child homicides investigated in the Cologne University Institute of Forensic Medicine from 1985-94 were retrospectively analysed with special reference to the evidential value of the autopsy findings and possible peculiarities related to the infants' physiological condition. About 65% of the victims were boys younger than 3 years. About 65% of the child homicides were committed by the mother in the parental flat, predominantly in the early hours of the evening during the weekend. The mode of death were 10x blunt injury, 6x sharp violence, 6x strangulation, 3x smothering, 2x drowning, 2x gunshot and 5x neglect (starvation). The defenseless, helpless and immobile condition of the infant particularly favours a homicide by manual assault, smothering or neglect (starvation).

Adolescent↗
PubMed1996

Interleukin-1 alpha (IL-1 alpha) and N-formyl-methionyl-leucyl-phenylalanine (FMLP) as potential inducers of supravital chemotaxis.

The phenomenon of artificially induced local leucocyte reactions during the supravital period could be of practical importance, but has not yet been comprehensively investigated. For a more detailed evaluation, experiments with the chemotactic agents interleukin-1 alpha (IL-1 alpha) and N-formyl-methionyl-leucyl-phenylalanine (FMLP) were performed by subcutaneous injection into various anatomical regions (back, abdomen, limbs) of NMRI-mice (National Medical Research Institute) and pigs 0-5 min after circulatory arrest. Phosphate buffered saline (PBS) without effective components was administered to equivalent areas of the animals as a control. Tissue specimens were collected at 6 h postmortem (mice) and 12-14 h postmortem (pigs), cut into serial sections, stained with H & E and examined under the microscope. A leucocyte reaction did not develop in pigs (n = 10, 30 tissue samples) following injection of FMLP, however, dermal, subcutaneous and perivascular infiltration of leucocytes (in particular mononuclear cells and a few granulocytes) was found in 3 out of 30 tissue specimens in murine experiments. In addition intravascular cell accumulations were detected in 2 out of 30 samples. The injection of IL-1 alpha to mice gave similar results, i.e., aggregations of leucocytes and intravascular cell accumulations in 4 out of 30 and 3 out of 30 tissue samples, respectively. In negative controls no leucocyte reaction was detectable. This shows that potent chemotactic factors such as IL-1 alpha and FMLP administered in the early supravital period can induce moderate local leucocyte reactions in animal models in at least some cases. A clear morphological differentiation between vital and supravital chemotaxis does not seem to be possible. The supravitally stimulated accumulations of leucocytes are interpreted as an aggregation of resident macrophages in combination with a slight migration of blood leucocytes. Presumably, these alterations are restricted to the very early supravital period as long as sufficient energy reserves are available. It must be stated that the observed changes are reactions, not spontaneous actions, so that the general validity of the phenomenon of leucocyte infiltration as a vital parameter is not affected.

Animals↗
PubMed1996

Pulmonary histopathology and survival period in morphine-involved deaths.

For an evaluation of the survival period in morphine-involved deaths, changes of pulmonary histopathology were investigated in a total of 90 morphine-associated fatalities. Although pulmonary histopathology proved to be heterogeneous, several distinctive histological patterns emerged. While the subgroup with short courses of intoxication ( < 1 h, n = 15) was mostly characterized by slight/moderate alveolar edema (12/15), severe hemorrhages (12/15) and marked acute emphysema (9/15), the phenomena of massive edema (8/15), missing/slight hemorrhages (8/15) and absent/slight emphysema (11/15) dominated in the group with intermediate survival times (1-24 h, n = 15). Intravascular leukocyte accumulations (shock equivalent) occurred in the first group only once, but in the group with the longer survival time in 10 of 15 cases. Delayed deaths ( > 24 h, n = 4) were mainly characterized by purulent bronchitis/pneumonia. Those fatalities (n = 56) that could not be classified by anamnestic data were assessed by histological criteria. In comparison with the evaluation of the survival period by toxicological analyses, concordance was found in 46 cases. Pulmonary histopathology is not a tool for an exact graduation of survival time, but the combination of several key parameters can provide criteria for a differentiation between short ( < 1 h) and longer courses of intoxication.

Adult↗