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Biomedical subjects

J Hiss

Publications and source records attributed to J Hiss.

At least 55 records · Page 3Linked to original sources
PubMed1996

Medicolegal investigation of death in custody: a postmortem procedure for detection of blunt force injuries.

Death in custody frequently raises suspicion of ill-treatment on the part of the custodians. The meticulous postmortem search for evidence of injury is the paramount consideration in objective investigation. Detection and evaluation of hidden subcutaneous hemorrhages facilitates reconstruction of antemortem circumstances. We describe a new postmortem technique for accurate examination of the subcutaneous tissues utilizing a simple X-shaped incision of the back and limbs and reflecting the skin. This technique leaves no noticeable disfigurement.

Cause of Death↗
PubMed1996

Beaten to death: why do they die?

The remains of 53 men that had been beaten to death were examined. Six (11.3%) died of either blood aspiration or intracranial hemorrhage; 15 of the cases (28.3%) succumbed to hypovolemic shock, and 32 of the cases (60.4%) died of fat embolism syndrome (FES). Fractures of long bones were found only in four victims. Fatal FES produced by the mechanical disintegration of adipose tissue that migrates into the bloodstream seems to be a common phenomenon in the fatalities examined in this study. No correlation, however, was found between the presence of long bone fractures and the severity of FES, and no bone marrow emboli were detected on histologic examination of target organs. Scattered subcutaneous hematomata were present in all of the victims, although the volume of extravasated blood could not be calculated from the total surface area of the bruises. Contusions limited to the limbs have the potential of masking fatal volumes of extravasated blood that suffuse the musculature mass. Hypovolemic and neurogenic shock, as well as systemic effects of crush injury, should be considered contributing factors to death from FES. These findings contradict the previously published postulate that victims of blunt force trauma succumb primarily to massive hemorrhages.

Adolescent↗
PubMed1995

Concentration and size distribution of insulin-like growth factor-I in human normal and osteoarthritic synovial fluid and cartilage.

The concentration of free insulin-like growth Factor-I (IGF-I) and its complexes was determined in human normal and osteoarthritic synovial fluids, using ultrafiltration through 20- and 100-kDa membranes, followed by a radioimmunoassay of each fraction. In addition, freshly obtained samples of normal and osteoarthritic cartilage were incubated for several days, at both 4 and 37 degrees C. The incubation media (desorbates) were analyzed the same way as the synovial fluid samples to yield the concentration of IGF-I in cartilage in situ. Our findings are (i) Free IGF-I content is extremely low in both human serum and synovial fluid and there is no significant difference between the two; (ii) The concentration of total IGF-I in normal human synovial fluid is an order of magnitude lower than that in serum due mainly to the decrease in the concentration of the large complex; (iii) Preliminary results show that the total IGF-I in osteoarthritic synovial fluids is twice as high as in normal fluids; (iv) In normal human cartilage the levels of IGF-I in all its forms are very low and are consistent with the expected exclusion of large molecules by the extracellular matrix; (v) By contrast, in osteoarthritic cartilage, the concentrations of all forms of IGF-I are high, probably due to increased permeability of the matrix and binding; (vi) The levels of IGF-I found in normal human cartilage are more than an order of magnitude lower than those which stimulate proteoglycan synthesis in human cartilage in culture, while the IGF-I levels in osteoarthritic cartilage lie in the range in which stimulation does occur.

Adult↗
PubMed1995

Insulin-like growth factor-I and its complexes in normal human articular cartilage: studies of partition and diffusion.

Insulin-like growth factor-I (IGF-I) plays a major role in cartilage homeostasis. Our objective was to study the penetration of IGF-I, both alone and bound to serum proteins, into the different zones of normal human cartilage using radioactively labeled IGF-I. The uptake of free IGF-I was higher than that predicted on the basis of excluded volume calculations and showed concentration dependence: we attributed this to reversible binding of the hormone to the tissue. Since the extent of binding was much higher than that calculated for binding to cell receptors, we concluded that IGF-I binds to matrix components. The kinetics of desorption of IGF-I from cartilage confirmed our conclusions regarding binding. The degree of uptake of IGF-I protein complexes prepared by labeling human serum with [125I]IGF-I showed that such complexes are largely excluded from normal cartilage and that the amounts present in the tissue are too low to affect proteoglycan metabolism.

Absorption↗
PubMed1995

Role of immune response as determinant of tumor progression in function of host age in the B16 melanoma.

Aging constitutes the major cause for the development of most neoplastic diseases. However, tumors in aged people present with a lower degree of aggressiveness than in young patients. The reasons for this paradoxical behavior are not clear. We attempted to verify whether the immune system has a role in the relation between host age, immune response and tumor progression. We compared the growth rate of B16 melanoma and a highly malignant variant, the B16/Col/R, in young and aged mice that have or have not undergone splenectomy. The following results were obtained: (1) Splenectomy stimulated growth in the parental melanoma in both young and aged mice, indicating a protective role of the spleen against this tumor at all ages; (2) Spleen ablation provoked inhibition of the highly-metastatic variant growth in young mice, suggesting a stimulatory role of the spleen in this case; (3) By contrast, in aged mice inoculated with the B16/Col/R variant, splenectomy enhanced tumor growth, indicating a defensive role of the spleen. Age favors a positive host response against the aggressive clone of the melanoma. Differential host response in young versus aged mice can explain, in this tumor system, the difference in tumor progression rate as a function of age.

Age Factors↗
PubMed1995

Fabricated homicides in Israel in light of the Intifada.

Fabrication of circumstances surrounding fatal events is not uncommon in forensic medicine. Reasons for this may include financial gain, shame and guilt. The use of a specific sociopolitical phenomenon as a fabricated scenario for lucrative purposes is reported. The importance of thorough scene of crime investigation and documentation, as well as a meticulous autopsy in order to determine the manner of death is emphasized.

Journal Article↗
PubMed1995

Endoscopic autopsy.

In cases in which the family of the deceased objects to the performance of a conventional autopsy for religious or other reasons, or where there are no forensic pathology facilities in the vicinity of the hospital, postmortem endoscopic examination may be an advantageous and cost-effective substitute for conventional necropsy, especially when the alternative is no postmortem examination at all. To test the reliability of postmortem endoscopy, conventional and endoscopic autopsies were performed on 20 cadavers at the L. Greenberg Institute of Forensic Medicine in Israel. Comparison of the findings of the two procedures showed a very high correlation (100%) for intraperitoneal and thoracic hemorrhages and hepatic, splenic, and diaphragmatic injuries; it showed a slightly lower correlation (60-80%) for mesenteric and retroperitoneal hematomas injuries to the great vessels, blood aspiration, and lung injury. Endoscopy failed to reveal the correct site of injury in the retroperitoneum and posterior aspect of the mediastinum. Collection of body fluids and tissue samples was possible by means of laparoscopy. The technique proved to be relatively accurate, more rapid than conventional autopsy, and left the body virtually intact.

Autopsy↗
PubMed1995

The medicolegal implications of bilateral cranial fractures in infants.

There is considerable debate about the possibility of serious injuries associated with skull fractures caused by short-height falls in early childhood. In order to elucidate the mechanism and nature of blunt head trauma from such falls, we have investigated the possible correlation between patterns of skull fractures and the dynamics inducing these injuries. In a 10-year survey of pediatric medicolegal autopsies conducted at the L. Greenberg Institute of Forensic Medicine in Tel Aviv, Israel, we have observed that all victims of alleged falls from low heights exhibited unilateral skull fractures. Only in four instances were bilateral temporoparietal fractures detected. Thorough investigation into the circumstances surrounding these four incidents, along with the evaluation of the forces exerted upon the cranium at the time of impact, suggest that symmetrical cranial fractures in infants are most likely the result of bilateral compression of the head between two surfaces, rather than the result of a localized impact.

Accidental Falls↗
PubMed1994

Suicidal asphyxia by gas mask.

Antichemical warfare kits that were issued to all Israeli residents 6 months before the Gulf War included masks of various types suited to the age of the user. During the war, 10 adults died of suffocation due to mishandling of the filter of the masks despite the offil Defense Authority's repeated instructions to be cautious. These masks remained in the possession of the population after the war. We report on six cases of suicidal asphyxia incurred by donning the gas mask tightly sealed that have occurred since 1991.

Adult↗
PubMed1994

Utility of postmortem computed tomography in trauma victims.

A possible way to circumvent the continuing decline in the number of autopsies is to perform computed tomography after death. The present study compares the pathologic findings of postmortem CT tomography (PMCT) in trauma fatalities with those disclosed upon conventional forensic autopsy. Within 6 hours of death, the bodies of 25 trauma victims underwent total body CT scanning, all with permission of the relatives, followed by conventional autopsy in 13 cases under court order. The pathologist and roentgenologist were unaware of each other's findings. The pathologic findings of PMCT plus conventional autopsy provided more information than either examination alone. Of the total 127 pathologic findings, 44.9% were diagnosed by both conventional autopsy and PMCT, 29.9% were not revealed by PMCT, whereas conventional autopsy missed 25.2%, and PMCT detected more bone injuries than did autopsy, whereas the latter was superior to PMCT in discovering soft-tissue pathologic states. In all, PMCT revealed 70.5% and autopsy 74.8% of the pathologic states. Although PMCT was not more effective than conventional autopsy in exposing pathologic entities, it increased the yield of findings when combined with conventional autopsy. Where conventional autopsy is unattainable, PMCT may be effective in shedding light on the pathologic state and mechanism of death in trauma fatalities.

Adult↗
PubMed1994

Cervical posture and nasal breathing in infancy.

Survival of infants born with bilateral choanal atresia or pyriform aperture stenosis who breathe orally, as well as experimental data, challenge the virtually axiomatic theory of 'obligatory' nose breathing of the neonate. The anatomical parameters leading to the infant's airway patency and to airway obstruction were studied on midsagittal anatomical sections of fetal and adult necks as well as in head and neck radiographs of infants. The most important anatomical parameter found to facilitate the switch from nasal to oral ventilation in human infants is a cervical extension, creating a physiological lordosis of the neck that results in an opening of the veloglossal and veloepiglottic sphincters. This mechanism may explain the relationship between the sleeping posture of the infant and sudden infant death syndrome.

Aged↗
PubMed1994

Fatal classic and exertional heat stroke--report of four cases.

Heat stroke is the outcome of impaired heat dissipation which is aggravated by hot and humid environmental conditions. The very young and debilitated on the one hand and healthy individuals under considerable physical stress on the other are vulnerable to heat stroke. Post-mortem findings will depend on the time lapse between the stroke event and death. We report on the deaths resulting from heat stroke in a 12-month-old baby and three 19-year-old soldiers. Reconstruction of the environmental conditions enables elucidation of the circumstances that precipitated exogenous hyperpyrexia. The Discomfort Index presents reliable criteria for the assessment of heat load: values above 28 units are considered as severe heat load and are life threatening. Awareness of the hazards related to severe heat load on the body is helpful in preventing avoidable calamities.

Adult↗
PubMed1994

Positive identification by means of trabecular bone pattern comparison.

Positive identification of human remains is often achieved by comparing antemortem and postmortem radiographs. Usually, radiographs contain a number of markers that can serve as reference for comparison, one of these markers is the trabecular bone pattern depicted in the roentgenograms. In the present case, densitometric analysis of the trabecular bone pattern was used as the sole means of identification. Later on, two other methods confirmed the original positive identification.

DNA↗
PubMed1993

The microscopic structure and function of the vascular retrodiscal pad of the human temporomandibular joint.

The highly vascular retrodiscal pad attaches the articular disc of the temporomandibular joint to osseous structures posterior to it. There is debate as to whether or not the pad includes erectile tissue. Histological examination of 11 retrodiscal pads revealed thick-walled muscular arteries, thin-walled veins and numerous vascular sinuses, which is different from the erectile tissue of the corpora cavernosa. Its histological features and position within the joint suggest that the retrodiscal pad may function differently from other human joints due to: (1) the large amount of distraction it undergoes relative to its size and (2) its location anterior to the ear.

Adult↗
PubMed1991

Medicoritual trephinations in modern Israel.

Two recent cases of ritual trephinations that were revealed during regular autopsies are described. The osteologic findings are discussed in relation to hospital craniotomy and ancient trephination, and the forensic practitioner is offered a set of criteria to differentiate properly between trephination and craniotomy.

Adult↗
PubMed1991

Basement-membrane thickening of the vocal cords in sudden infant death syndrome.

Sudden infant death syndrome remains the leading cause of death in infants between the ages of 1 month and 1 year. Diagnosis at autopsy is usually reached by process of elimination, as no obvious cause of death is recognized. The larynges of 23 sudden infant death syndrome victims, as well as 6 infants and 3 fetuses who died of other known causes, were examined in this study. While thickening of the basement membrane of the vocal cords was apparent in all sudden infant death syndrome victims, no such finding was present in the larynges of infants and fetuses dying of other causes. Thus, it is suggested that basement-membrane thickening may serve as a diagnostic tool for identification of sudden infant death syndrome at autopsy.

Basement Membrane↗