Biomedical subjects
Publications and source records attributed to B Madea.
Report on 4 cases with gunshot entrance wounds of the orbit or of periorbital regions. Among these cases is a certain suicide as well as a homicide where the physicians misdiagnosed the real cause of the perforating injury of the bulbus. In cases with single gunshot wounds and entrance in the orbit the diagnostic decision suicide or homicide may be impossible based alone on the anatomic findings.
Human urine is frequently analysed in cases of doping or drug consumption. In this connection the necessity of an adequate urine identification arises. Apart from DNA-polymorphisms it exists a comprehensive repertoire of classic serological methods for this purpose. Human urine samples have been typed successfully in the following blood group systems: antigens of the erythrocytes' membrane (AB0-, Lewis-system), protein polymorphisms (Gc, transferrin, alpha-2-HS-glycoprotein) and enzyme polymorphisms (GPT). The results of the different studies are presented and completed by our own experiences with the Gc-system. In addition it is reported about our investigations concerning PGM1-subtyping of human urine.
For cases with suicidal stab wounds criteria to differentiate homicide from suicide, have been established since long. However in some cases the autopsy findings may differ quantitatively (many stab wounds, singular stab wound) or qualitatively (no hesitation marks, clothing stabbed through, unusual site of stab wounds) from the typical suicidal pattern and the classical criteria may fail. Some rare findings in suicidal stabbing are presented.
7 cases of "dumping" of the bodies of drug addicts are reported. Circumstances of the case, findings at the scene, autopsy findings and confessions raised already the suspicion that the bodies were not found at the scene of death. In 5 cases the "dumping" of the bodies was outside, in 2 cases inside a house. Identification of the bodies was always easy, since personal papers (passport, identity card) were still present and no attempts were made to prevent identification. The prevalent motivation for "dumping" seems to be not to be identified as drug addict or dealer or to be brought in connection with the death of drug addicts.
Report on a case of criminal dismembering of a corpse and the effect of vinyl on postmortem changes. Two years after murder a dismembered body, the body parts wrapped into plastic bags, were found buried 30-50 cm deep into loose earth. The whole body as well as the inner organs were very well preserved. Obviously the air-proof conditions in the plastic bag were a supporting factor for the good preservation.
Practices of binding and gagging can be found in different types of unnatural death; three case reports concerning fatal autoeroticism, suicide and homicide are presented. In such cases investigations are usually concentrated on the question whether binding and gagging could be carried out by the persons themselves. Loosely bound final loops, especially of the hands, missing local haemorrhages and the discovery of binding instructions support the assumption of self-binding. Accompanying injuries and the entire situation must be taken into special consideration.
Six cases of blows with glass bottles on the skull are reported. The glass bottles varied in size, weight, shape and filling level. In all cases the bottles broke, but there were no fractures of the skull or injuries of the brain or meninges. As consequences of the blows with the glass bottles bruises, lacerations and incised wounds were seen. The only cause contributing or leading to death was a fatal bleeding from lacerations of the scalp.
Report of the case of a 78-year-old man who was found dead with complete amputation of the penis and parts of the scrotum. Cause of death was fatal hemorrhage. Since penis and the knife were missing at the scene and the blood stains were confined to the bed but not in the further apartment, further traces were disposed, the son of the deceased was suspicious of murder. The confession of the suspect in trial claimed a suicidal self-castration; this claimed self-inflicted genital mutilation was in part in accordance with objective findings.
In the reported case of criminal dismembering of a corpse the preservation in vinyl-bags allowed seven years after murder, to find out if the body parts fitted to those which were detected years ago. Furthermore, it was possible to find out the presumed cause of death, the morphologic characteristics of the injuries caused by stabbing with a single edged tool and successful DNA typing by PCR amplification for identification of the body parts and for interpretation of the biological stains from the crime scene.
28 autopsy cases with injuries due to blunt trauma comprising kicking or stamping on the victim are analysed for characteristics of the victims, the perpetrator and the assault as well as for the injury pattern. Emphasis is put on patterned contusions which in cases of medium impact reflect the characteristics of the footwear that made them as a mirror image.
In this paper considerations from the view-point of forensic examiners are presented on various issues in fatal traumatic asphyxia such as reconstruction and frequently difficult evaluation of the survival time. The study includes several autopsy cases with diverse mechanisms of compression and graduated importance of asphyxia for death. The reconstruction of the diagnosis of traumatic asphyxia was possible in a case of exhumation after more than 5 months in the synopsis of necropsy and judicial inquiry. Very short survival periods of minutes and compression times of seconds are sufficient for the production of the typical external characteristics. Thoracic compression can cause death within minutes (limiting factor: resuscitation time of the brain). In addition to other well-known local and general vitality markers, clods or parts of plants in the hands of the decedents can point to vain attempts of self-escape and confirm the diagnosis of vitality.
Case report on a rape-homicide by manual strangulation involving a 59 year old female. The autopsy disclosed a peculiar cross-shaped superficial incised wound of the abdomen, encircled by 12 stab-wounds, furthermore multiple superficial and deep incised wounds of the genitalia. The injury pattern was in good agreement with the psychiatric interpretation of the sexual behaviour as outlet of severe aggressive impulses originating from non-sexual motives.
A young nurse was found dead in a bathtub. An autopsy revealed the following results: pulmonary emphysema, severe edema of both lungs, transudation in both pleural cavities. Conspicuous were skin sticks of a white wax material. In chemical-toxicological analysis diazepam, tetrazepam and phenobarbital were detected in this material. After anal-rectal and additionally oral ingestion the following blood concentrations were determined: BAC 0.03/1000; diazepam 500 ng/ml; nordiazepam 65 ng/ml; tetrazepam 180 ng/ml; phenobarbital 9.4 mg/l. In connection with this drug effects an acute, multifocal, suppurating bronchopneumonia in both lungs was revealed as the cause of death.
The retrospective analysis of the Bonn autopsy material from 1992 to 1996 revealed 11 suicides of children and adolescents, 8 girls and 3 boys. The ages ranged from 10 to 19 years. The suicides occurred preferentially outdoors in the warm months of summer, on Monday and in the middle of the week, in the afternoon and early evening hours. Independent from sex, the children unexceptionally applied hard suicide methods like hanging or jump from the height. As for the psychological background, current conflicts within the family or at school on the background of chronically disturbed family structures were encountered as prevailing factors.