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Biomedical subjects

H Bratzke

Publications and source records attributed to H Bratzke.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Sudden cardiovascular death during sexual intercourse--results of a legal medicine autopsy study].

This epidemiologic, retrospective follow-up mortality study is based on the data gathered in the department of forensic medicine at the University Hospital of Johann Wolfgang Goethe University in Frankfurt/Main. Over a period of 21 years (1972-1992), roughly 21,000 forensic autopsies revealed 39 cases (0.19%) of natural deaths occurring during sexual activity. Except for two women, all of these cases were men of an average age of 61.3 years. The most frequent cause of death was myocardial infarction (n = 21/53.8%), three of these cases involving pericardial tamponade accompanied by myomalacia. The medical history of twelve of the deceased showed a previous myocardial infarction. Most of the deaths took place during or after sexual intercourse or manual stimulation. In most cases sudden death occurred during the sexual act with a prostitute. The annual incidence of sudden cardiovascular deaths during sexual activity is estimated to be 0.2/100,000 men. The risk for women is lower by a factor of 12.

Adult↗
PubMed1998

Evolution of Alzheimer's disease related cortical lesions.

Alzheimer's disease is an immutably progressing dementing disorder. Its major pathologic hallmark is the gradual development of neurofibrillary changes in a few susceptible nerve cell types. The cortical changes do not occur inevitably with advancing age. Once the disease has begun, spontaneous recovery or remissions are not observed. The initial changes develop in poorly myelinated areas of the temporal lobe. The destructive process then follows a predictable pattern as it extends into other cortical areas. Advanced age is not a prerequisite for the evolution of the lesions. Alzheimer's disease is thus an age-related, but not an age-dependent disease. The spread of the neurofibrillary changes resembles the process of cortical myelination, however in reverse order.

Aging↗
PubMed1998

Population genetic study of the simultaneously amplified loci HLA DQA1, LDLR, GYPA, HBGG, D7S8, and GC in a German population sample.

A population genetic study of the HLA DQA1 and the "Polymarker" loci LDLR, GYPA, HBG, D7S8, and GC has been performed in a German Caucasian population (Frankfurt am Main area). All loci are in Hardy-Weinberg equilibrium and no unexpected association of loci has been observed. The data of the allele distributions are similar to those of other Caucasian populations. All six loci together have a power of discrimination (PD) of 0.9996 and an exclusion chance in paternity testing of 0.81.

Alleles↗
PubMed1997

Cycles of the uterus mucous membranes and estimation of time of death.

In a case where a 27-year-old prostitute was found stabbed to death, histological examination of the uterus mucous membranes was performed to estimate the time of death after a long postmortem interval. The time of menstruation was obtained from a witness statement. Assuming a regular cycles, the histology of the uterus tissue indicated an early stage of menstruation suggesting that death occurred shortly after the woman disappeared.

Adult↗
PubMed1996

[Drugs and occupational accident].

In a case of a fatal occupational accident (construction worker, fall from roof, urine test positive for cocaine and THC, e.g. cannabis) the question arised to what extent those drug-related occupational accidents occur. In the literature only few cases, mainly dealing with cannabis influence, have been reported, however, a higher number is suspected. Cocaine and other stimulating drugs (amphetamine) are more often used to increase physical fitness. By direct or indirect interference with vigilance these compounds may provoke accidents. Due to the lack of a legal basis proving of the influence of drugs at the working place is still very limited, although highly sensitive chemical-toxicological assay procedures are available to detect even the chronic abuse (in hair). In the general conditions of accident insurances a compensation is excluded when alcohol is involved, but drugs are not mentioned. It is indeed difficult to establish a concentration limit for drugs like that existing for alcohol (1.1%). In each case the assay of the drug involved and exact knowledge of its specific effects is in an essential prerequisite to prove the causal relationship.

Accidents, Occupational↗
PubMed1996

[Use of the ADH/REA method (Abbott Tdx-REA) in forensic blood alcohol determination].

The ethanol determination using the ADH/REA method (Abbott TDx-REA) is based on the principle of radiative energy attenuation (REA) applying the classic ADH-method. However, instead of measuring the extinction of the reaction product NADH, a chromogen formed by a coupled diaphorase reaction is measured. Serum, whole blood and urine are used for ethanol determination without prior treatment. The following analytical procedures such as sampling, addition of reagents and measuring are automated. Sample solutions of 100 to 200 microliters should be used. Daily calibration of the apparatus is recommended. Both precision and reproducibility meet the requirements of BAC-assays in forensic specimens. The results obtained by using gas chromatography and ADH/REA method show an excellent correlation (factor r = 0.9977). The ADH/REA method has proved to be a reliable assay procedure in routine determination of the BAC in forensic samples.

Accidents, Traffic↗
PubMed1995

[Postmortem diagnosis of tropical malaria].

Thirteen days after returning from a four week holiday in Kenya a 35-year-old man consulted his doctor complaining of feeling unwell. The doctor diagnosed influenza and gave him a sickness certificate for three days. Because the patient did not reappear at his workplace a search was made and he was found dead in his flat seven days after seeing his doctor. A medicolegal autopsy was performed two days after the estimated time of death. There was marked swelling of liver and spleen together with jaundice and "dirty grey" colouration of the viscera. Samples of heart blood and spleen puncture material were taken. Giemsa stained preparations (ordinary and thick blood smears) revealed numerous objects 1.2 to 1.5 microns in size with indistinct reddish blue staining, some of them arranged in rosettes reminiscent of schizonts. A few of them contained pigment. In material from the spleen there were masses of blackish-brown pigment. The malaria immunofluorescence test performed on serum gave a weakly positive titre of 1:40. The findings were considered enough to support a diagnosis of fulminant falciparum malaria, and this was confirmed by histological changes in various organs, notably the typical capillary blockages in the brain. Because of the popularity of long-haul tourism, cases of imported malaria are increasingly frequent and, in view of the insidiously progressive course of the disease, it should always be considered in the differential diagnosis. In cases of unexplained death, if there is any suspicion of malaria, blood should always be taken for appropriate investigations, in addition to blocks for histological examination.

Adult↗
PubMed1995

GEDNAP IV and V. The 4th and 5th Stain Blind Trials using DNA technology.

In the collaborative exercise GEDNAP IV one EDTA blood sample (2 ml) and 5 bloodstains (0.5 ml on cotton) were investigated and in GEDNAP V, a total of 8 bloodstains (0.5 ml on cotton), including 2 mixed bloodstains. DNA typing was carried out using the RFLP systems YNH24/Hinf I and MS43a/Hinf I and the PCR systems HLA DQ alpha, D1S80, ApoB and YNZ22. In both exercises approximately 20 laboratories obtained results using the RFLP systems. Of the PCR systems, D1S80 was the most commonly used (14 labs in GEDNAP IV; 18 labs in GEDNAP V). The interlaboratory standard deviation for YNH24 in both exercises was approx. 0.6%, for MS43a 0.7-2.2% (GEDNAP IV) and 0.4-1.4% (GEDNAP V), depending on the fragment size. The fragment size calculation performed in each laboratory yielded a standard deviation twice that obtained when the fragment size calculation was performed centrally (IfR, Münster). In GEDNAP III, a system-specific corridor was developed to define the limits of deviation; this was modified for the present study by combining the fragment size ranges of YNH24 and MS43a. In both studies a subgroup of laboratories was involved in preliminary exercises using three PCR VNTRs and the system HLA DQ alpha. Owing to the substantial variation in experience of the participating laboratories with PCR typing the results obtained in these two studies do not fulfil the basic quality criteria of the GEDNAP studies.

Apolipoproteins B↗
PubMed1995

Evaluation of a rapid assay system, HIV 1/HIV 2 Testpack, Abbott, to detect human immunodeficiency virus antibodies in postmortem blood.

For evaluating the HIV 1/HIV 2 Testpack (Abbott, Chicago, IL) to detect antibodies to human immunodeficiency virus (HIV) in whole postmortem blood 456 samples were collected prior forensic autopsies. All samples were tested using the enzyme-linked immunoassay (ELISA) and the Testpack; positively reactive samples and samples with equivocal results were confirmed by Western blot. Of the 456 samples 21 (4.6 per cent) proved to be reactive in both systems (confirmed by Western blot). In 17 cases (3.7 percent) interpretation of the result was difficult, but no serious misinterpretations occurred. It is concluded that the HIV-Testpack provides accurate results in testing whole postmortem blood for HIV antibodies.

AIDS Serodiagnosis↗
PubMed1995

[Detection of amphetamine derivatives in chemical toxicological studies 1987-1993 in the greater Frankfurt area].

Chemical-toxicological testing during the period from 1987 to 1993 revealed a remarkable increase in amphetamine positive cases in the greater Frankfurt area. Amphetamine abuse is particularly worrying in car drivers, where the proportion of amphetamine positive cases increased from 0.49% in 1987 to 9.40% in 1993. Considering the fact, that the only samples tested were the ones of drivers exhibiting an impaired driving performance, the number of cases remaining undetected is most certainly higher. This study also demonstrated that amphetamine derivatives are rarely consumed on their own. In most cases (80%) they are consumed in conjunction with cannabis. The additional use of tranquillisers occurred more often than that of cocaine. It seems that amphetamine abuse plays only a minor role with heroin users. This is emphasised by the low number of drug fatalities.

Amphetamines↗
PubMed1994

[Attempted fraud in legal identity determination--detection by DNA single locus analysis].

In a case where a mix up of blood samples was claimed, an identity check was carried out by means of four single-locus-probes. DNA analysis produced identical profiles with two of the probes (MS 31 and MS 43). With the two other probes one matching and one differing fragment could be detected respectively (MS 1 and g3) In addition to the unambiguous statement "no identy", the DNA analysis proved that the tested blood samples must have been those of two closely related people, most probably of brothers and sisters. Attempted fraud can be assumed from these findings. Further investigations and additional DNA analysis which included a blood sample of the brother of the accused, revealed that the sample for the identity check had been taken from the brother and not from the accused himself.

Adult↗
PubMed1993

[Reporting and evaluation and a blood alcohol laboratory--automated by using a new databank system].

For the processing and evaluation of a large number of data obtained in the course of blood alcohol determination the use of computerized systems is essential. By applying the software Skylight a data management program was developed under Windows. After entering the case data (name of the person involved, type of offence, time of accident and of blood sampling etc.) and BAC-values the evaluation of the data is automatically performed, e.g. calculation of the mean value, BACs at the time of event (minimum and maximum value). The user is guided by screen menus, which facilitate the entry of data. Reports are created by using predesigned formats retrieved from a report file. The data base system is installed on a local network. Access is permitted by password only to guarantee optimal security of the data.

Accidents, Traffic↗
PubMed1991

[Negligence of the physician's duty to care during "therapeutic local anesthesia"].

Therapeutic local anaesthesia, although a seemingly simple procedure, requires informed consent by the patient as well as proper indication and careful execution. Four cases selected from a medico-legal experience illustrate some severe complications. Nausea, dyspnoea and respiratory arrest (anaphylactic shock) occurred in a 34-year-old woman shortly after injection of 0.5% Bupivacaine into the paravertebral musculature for the treatment of acute neck pain. She had to be hospitalized for 18 days, at times requiring mechanical ventilation. Three other patients (women aged 40, 43 and 52 years, respectively) developed a pneumothorax after supposedly intramuscular injection of a local anaesthetic. They were hospitalized for 7 to 12 days for treatment by drainage. Anatomical variations were excluded by ultrasound in the 40- and 43-year-old patients. These case reports demonstrate that doctors performing such procedures do not always possess the necessary anatomical knowledge, and the possible occurrence of complications is underestimated.

Adult↗
PubMed1991

[Birth injury or congenital brain damage? A case of apparent birth injury with globoid cell leukodystrophy (Krabbe's disease)].

This is a forensic case report of a premature male baby who died at the age of 11 months. He was delivered from his 39-year-old mother by secondary Caesarean section, because of an arm presentation. The baby developed a severe cerebral disease with "saalam" fits (West's syndrome), stiffness of the limbs, and frequent crying. The disease was thought to be a consequence of intrapartum asphyxia. The mother brought a lawsuit against the obstetrician. However, the neuropathological examination revealed as the cause, a globoid cell leucodystrophy.

Adult↗
PubMed1990

[Fatal complications in endoscopic papillotomy].

Medicolegal investigations for possible malpractice were instituted into the death of three patients (two women, aged 59 and 75 years, one man, aged 81 years) after endoscopic papillotomy. In one case the accusation of malpractice had been made by a relative, in the other two the enquiry had been undertaken because the attending doctors had entered the cause of death as "unexplained" on the death certificate. In one patient oesophageal rupture had occurred; in the other two papillary bleeding, with perforation in one, had taken place. Forensic expert opinion failed to find malpractice as the cause of death. There had been the correct indications for the procedure and the patients had been fully informed. Taking into consideration the possible complications of this procedure, it is important to note that insufficient explanations and inadequate experience of the doctor, as well as insufficient capacity for undertaking an emergency operation, may lead to damages being awarded, especially under civil law.

Aged↗