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Biomedical subjects

M A Rothschild

Publications and source records attributed to M A Rothschild.

At least 19 recordsLinked to original sources
PubMed2006

Expression of heat-shock protein 70 (Hsp70) in the respiratory tract and lungs of fire victims.

Immunohistochemical investigation of the respiratory tract and lungs of 63 fire victims revealed a statistically significant enhanced expression of heat-shock protein 70 (Hsp70) in the epiglottis, the trachea, and the main and the peripheral bronchi compared with a control group. In the fire victims, a strong expression of Hsp70 was discernible not only particularly in the vessels but also in seromucous secretory cells, ciliated epithelial cells, smooth muscle cells, and alveolar cells. The results suggest a vital or supravital reaction due to the inhalation of hot fire fumes.

Adolescent↗
PubMed2005

[Traumatic partial amputation of a penis--a reconstruction of the circumstances of the accident].

A 61-year-old man was admitted to hospital with a partially severed penis. The head of the penis (glans) had been completely severed, and the skin of the shaft and the corpora cavernosa had been ripped open. In the hospital the patient reported that his penis got caught in the hose attachment of an old Kobold vacuum cleaner that he was using to inflate an air mattress. He later made contradictory statements in his report to the insurance company, so we were asked to reconstruct the circumstances of the accident. The literature available to us only makes clinical observations about similar accidents, always with the assumption that the vacuum cleaner was used during masturbation or in order to achieve an erection. According to our reconstruction of the accident and an investigation of the vacuum cleaner attachment, however, we could not rule out the possibility of a household accident as described by the patient.

Accidents, Home↗
PubMed2005

[Value of postmortem computed tomography in comparison to autopsy].

PURPOSE: To assess the diagnostic value of postmortem computed tomography (CT) in comparison to autopsy. MATERIALS AND METHODS: Twenty-seven cadavers were examined by sequential cranial CT and helical CT through the neck, thorax and abdomen and subsequently underwent an autopsy with histomorphologic examination of the pathologic specimens. The findings of CT, autopsy and histology were registered and compared by three radiologists and one specialist for forensic medicine, using a data entry form. RESULTS: In 19 of 27 cases, the findings explaining the cause of death were concordant for CT and autopsy. Intracranial, intraspinal and intracardiac gas accumulations (n = 12) were registered by CT alone. The detection of skull fractures was equal for both methods (n = 3). CT showed diagnostic problems in the assessment of pneumonic infiltrations (n = 16) and pulmonary edema (n = 21). CONCLUSION: CT is a useful and complementary method to autopsy.

Adult↗
PubMed2004

Gunshot injuries as a topic of medicolegal research in the German-speaking countries from the beginning of the 20th century up to the present time.

The 100th anniversary of the foundation of the German Society of Legal Medicine is a good opportunity to review its contributions to forensic wound ballistics. The present article gives an overview of the scientific development in this field with special emphasis on work pioneering new developments and findings valid up to the present day, for example the presence of carboxyhemoglobin in the vicinity of the entrance wound as a sign of a contact or close-range shot [A. Paltauf, Wien. Klin. Wochenschr. 3 (1890) 984-991, 1015-1017]; the correct interpretation of the muzzle imprint [A. Werkgartner, Beitr. Gerichtl. Med. 6 (1924) 148-161] and the retrograde ballooning of the bullet entrance region in contact shots [F. Hausbrandt, Dtsch. Z. ges. Gerichtl. Med. 38 (1944) 45-76; H. Elbel, Med. Welt 20 (1958) 343-345]; wound patterns from captive-bolt livestock stunners [H. Czursiedel, Dtsch. Z. ges. Gerichtl. Med. 28 (1937) 132-133]; singeing of synthetic fiber textiles in close-range shots with nitro powder ammunition [S. Berg, Arch. Kriminol. 124 (1959) 5-8,17-22]; the wound ballistic processes on penetration of the bullet and the origin of the abrasion collar [K. Sellier, Beitr. Gerichtl. Med. 25 (1969) 265-270]. More recently medicolegal research in the German-speaking countries covered the following subjects: studies of the dynamic bullet-target interactions in experimental gunshots to simulants and composite body models; use of modern imaging techniques (CT, MRI) in the pre-autopsy diagnosis of lethal gunshot injuries; injuries from blank guns; mechanisms of incapacitation by gunshot injuries; development of improved methods for the evidence of gunshot residues on the firing hand; backspatter from close-range shots; medicolegal contributions in the discrimination of accidental, homicidal and suicidal gunshot injuries.

Europe↗
PubMed2001

Suicide by self-immolation in Berlin from 1990 to 2000.

We investigated retrospectively the forensic autopsy cases of suicide by self-immolation in Berlin from 1990 to 2000. There were 46 cases (35 men and 11 women), corresponding to 0.76% of all known suicides committed in Berlin during this period. The most common reasons for self-immolation were separation from a partner or financial problems. Two individuals had political reasons. There was a history of mental disturbances in 65% of these suicide cases. The location of the self-immolation was outdoors in 65%, the rest were indoors, except for three victims, who committed suicide in their cars. In nearly all cases, the individuals had doused themselves with an inflammable fluid, usually petrol. One-third of the victims died from burn shock, about 20% from a combination of severe burns and inhalation trauma. The median body surface area burnt was 78% for all cases. The blood had a mean 21% carboxyhemoglobin concentration and 0.07 microg/ml of cyanide. Suicide by self-immolation was committed under the influence of drugs in nine cases and of alcohol in 11 cases.

Adult↗
PubMed2001

Female suicides in Berlin with the use of firearms.

The Statistical Office of Berlin recorded a total of 5488 suicides within the 10-year period 1990-1999 (3550 males, 1938 females). Firearms were used in 238 cases (218 males, 20 females). An autopsy was performed in 19 of the 20 female cases. The women's ages ranged from 21 to 88 years. Their marital status was single (n=6), married (n=5), divorced (n=5) and widowed (n=3). Eight of the women had one or more children. A suicide note was found in eight cases; six women had a history of psychiatric illness, and six had previously attempted suicide. Predominant among the suicide motives were mental (n=5) and organic (n=4) disorders as well as relationship problems (n=3) and financial difficulties (n=2). Most of the women (n=16) committed suicide in their own apartment, mainly in the bedroom. The weapons used were pistol (n=10), revolver (n=6), rifle (n=2) and a blank cartridge gun (n=1). In 16 cases we found a contact discharge at point blank range. Six of the dead women were found with the weapon still in their hands. The site of bullet-entry was the right temple (n=11), high-parietal (n=2), mouth (n=3), neck (n=1), and chest (n=2). A comparison of our results with the data of other authors for male or predominantly male collectives did not indicate any sex-specific differences regarding the type of weapon, location of the entry wound or the scene. However, alcohol was detected at a lower frequency compared with male gunshot suicides.

Adult↗
PubMed2001

Accidental sharp force fatalities--beware of architectural glass, not knives.

In a retrospective evaluation of 799 consecutive autopsies of victims of sharp force performed between 1967 and 1996 in Münster and Berlin, only 18 cases (2.3%) were classified as accidents. A typical pattern was present in 15 cases: inebriated adults (1.4-3.6g/l BAC) fell into an architectural glass surface in the form of a door or window (12 cases), an aquarium, a mirrored wardrobe or a telephone cell. Another man fell into a large drinking glass. Many victims in this group showed multiple scratches, abrasions and superficial incisions as well as one or more deep tear/cut/puncture injury. The wound margins can be clean-cut or irregular and abraded. Death was mostly caused by exsanguination except for one case of air embolism and one case of cerebral injury. The fatal injuries were produced by large and dagger-like slivers of glass, by sharp-edged fragments of glass remaining inside the frame or by a portion of glass which fell down and acted in a way similar to a guillotine. Ordinary types of flat glass were involved in all cases and it is not until the impact that sharp fragments or cutting edges are produced. So the motion of the person commonly provides the force necessary for a fatal injury. This was also true for the remaining two cases not involving architectural glass. A farmer suffered cerebral injury from a fall into the long prong of a pitch fork, and the wounding agent was a knife in only one case. A man who stated that he had fallen into the knife in his hand died from pneumonia after inadequate therapy following a single stab injury to the periphery of the left lung and liver. Accidents where the victim is killed by his own knife therefore appear to be extremely rare.

Accidental Falls↗
PubMed2001

Puncture wounds caused by glass mistaken for with stab wounds with a knife.

Three cases are presented where fatal puncture wounds caused by broken glass were very similar to stab wounds inflicted by a knife with a single-edged blade. Thus, all three cases caused a murder investigation to be initiated. It could only be determined that these wounds had been caused by glass after a detailed forensic autopsy. In two of the three cases, the only evidence for this was the identification of glass fragments in the wounds. The importance of X-ray examinations is underlined because modern glass in common use is radiopaque. Glass fragments lodged in the wounds can reduce the loss of blood and thus, prolong the capacity to act despite severe injuries.

Accidental Falls↗
PubMed2001

Thymopharyngeal duct cyst: an unusual variant of cervical thymic anomalies.

BACKGROUND: The thymus develops from the third pharyngeal pouch and descends from the neck into the anterior-superior mediastinum. Thus, it is possible to have thymic remnants in the neck, which most often present as a cervical mass during childhood. One type of cystic thymic remnant is the thymopharyngeal duct cyst, a remnant of one of the paired tracts of embryological thymic descent. Thymopharyngeal duct cysts are rare lesions that can have a similar presentation to more commonly encountered childhood neck masses. OBJECTIVES: To review the embryological development of cervical thymic remnants and to report our experience with the thymopharyngeal duct cyst. DESIGN: Case series. SETTING: Tertiary care center. PATIENTS: Two children who presented with asymptomatic neck masses that were caused by cystic remnants of the thymopharyngeal duct. RESULTS: Both patients underwent preoperative computed tomography, which revealed a multiloculated mass coursing adjacent to the carotid sheath. Surgical treatment was the definitive therapy for both patients, although neither patient had a definitive preoperative diagnosis. In both cases, the mass was approached through an incision anterior to the sternocleidomastoid muscle, and dissection proceeded along the length of the carotid sheath. A fibrous cord extending into the mediastinum was found in both patients. There were no postoperative complications. Histopathologic evaluation revealed the presence of mature thymic elements within the wall of a multiloculated cyst. CONCLUSIONS: Thymopharyngeal duct cysts must be considered in the differential diagnosis of pediatric neck masses. Computed tomography is helpful to delineate the relationship to the carotid sheath. Complete surgical excision is the appropriate therapy in a majority of cases, with minimal morbidity when careful attention is paid to vital structures.

Child↗
PubMed2001

Bacterial colonization of endotracheal tubes in intubated neonates.

OBJECTIVE: To obtain in vivo bacterial colonization profiles on endotracheal tubes at different sites in the neonatal airway in an attempt to better characterize one potential element of chondritis. DESIGN: A case series in which cultures were obtained from calculated segments of 33 endotracheal tubes immediately following extubation. This allowed for sampling at specific levels of the airway corresponding to the trachea, the subglottis, and the oropharynx. Data collected included gender, race, duration of intubation, use of antibiotic therapy, comorbidities, gestational age at birth and extubation, crown-rump length, weight, radiographic distance from tube tip to carina, and culture results. SETTING: Newborn intensive care unit at a tertiary care medical center. PATIENTS: Twenty-nine neonates intubated for longer than 24 hours (range, 24 hours to 15 days). MAIN OUTCOME MEASURES: Bacterial and fungal cultures obtained from 3 endotracheal tube segments for each extubation. RESULTS: A statistically significant difference (P < .05) was found in colonization rates between patients intubated for less than 4 days and those intubated for longer periods. No significant difference was noted in bacterial profile between the 3 sites. CONCLUSIONS: Data demonstrate that bacterial colonization of an indwelling object in the neonatal airway increases with the duration of intubation. Furthermore, 4 days seems to represent a critical period in the formation of such colonization (possibly in the form of a biofilm). These bacteria may contribute to the chondritis known to precede the development of subglottic stenosis. Further studies are indicated to suggest ways to interrupt this process and reduce the incidence of airway injury.

Bacteria↗
PubMed2001

Influence of minor ear surgery on infrared tympanic thermometry.

BACKGROUND: Infrared tympanic thermometry (ITT) is often used for postoperative recovery room monitoring regardless of recent minor otologic surgery. OBJECTIVE: To evaluate the use of ITT in pediatric patients who have undergone bilateral myringotomy with insertion of pressure-equalizing tubes. DESIGN: A prospective cohort study. SETTING: Tertiary care academic medical center. PATIENTS: Consecutive patients of a staff pediatric otolaryngologist (M.A.R.): (1) ear surgery group, children aged 10 years or younger undergoing bilateral myringotomy with insertion of pressure-equalizing tubes and (2) non-ear surgery group, children aged 10 years or younger undergoing bilateral tonsillectomy with or without adenoidectomy. INTERVENTIONS: Immediate preprocedure temperature measurements included right and left ear ITT. Immediate postprocedure temperature measurements included right and left ear ITT and thermistor probe rectal temperature. MAIN OUTCOME MEASURES: The average difference between the preprocedure and postprocedure tympanic temperature in the ear surgery group was compared with that in the non-ear surgery group. The average difference between postprocedure rectal and ear temperature in the ear surgery group was compared with that in the non-ear surgery group. RESULTS: There were 20 patients (40 ears) in the ear surgery group and 20 patients (40 ears) in the non-ear surgery group. In the ear surgery group, the average difference between the preprocedure and postprocedure tympanic temperature (0.55 degrees C) was not significantly different from that (0.62 degrees C) in the non-ear surgery group (P =.66, 1-way analysis of variance). In the ear surgery group, the average difference between postprocedural rectal and ear temperature (1.94 degrees C) was not significantly different from that (1.89 degrees C) in the non-ear surgery group (P =.76, 1-way analysis of variance). CONCLUSION: Recent minor ear surgery (bilateral myringotomy with insertion of pressure-equalizing tubes) does not have a significant effect on ITT measurements in pediatric patients.

Adenoidectomy↗
PubMed2000

Rapid resolution of fetal goiter associated with maternal Grave's disease: a case report.

The incidence of abnormal fetal thyroid function with maternal Grave's disease is about 2-12%. The development of larger fetal goiters can complicate labor and precipitate life-threatening airway obstruction at delivery. A case is presented of a large stable goiter confirmed by sonography, which unexpectedly resolved by the time of parturition. A 3 x 6 cm fetal goiter was detected at 34 weeks gestation in a mother treated with propylthiouracil for Grave's disease. A repeat sonogram at 36 weeks showed no change in goiter size. Umbilical blood sampling showed the fetus to be markedly hyperthyroid. Planned Cesarean section took place 11 days after the final sonogram. A multi-disciplinary operative team was present including the Otolaryngology service with equipment for emergency intubation, bronchoscopy and tracheotomy. Upon delivery, the infant had no evidence of goiter and no airway compromise. Fetal goiter is a rare entity, and recent advances in the field of maternal-fetal medicine have enabled intra-uterine diagnosis and treatment of such conditions. A review of published case reports demonstrates two trends in treated fetuses: preterm progressive resolution of the goiter, or delivery with gross evidence of goiter. This reported case is unique, as a persistent goiter resolved completely in less than 2 weeks. Otolaryngologic response to and management of potential congenital airway compromise is discussed.

Adolescent↗
PubMed2000

Death caused by a letter bomb.

A 48-year-old man was killed by the explosion of a letter bomb after receiving severe injuries to his face and left hand. The autopsy ascertained that the right eye and orbit had been completely destroyed by a large piece of metal from a tin can that had entered the cranial cavity through the right eye and caused fatal brain damage. The victim had also sustained a severe injury to his left hand. Reconstruction of the metal and plastic fragments showed that the victim had received a padded envelope with a video cassette in which a simple explosive device was hidden in a flat tin. The explosive charge consisted of a mixture (ca. 60 g) of sodium chlorate, sodium chloride and sucrose. The charge was detonated by a nylon cord attached to the inside of the envelope which was stretched when the video cassette was pulled out of the envelope. This removed a piece of plastic from between two contacts, and the explosion was set off immediately by a battery which activated two flash bulbs placed within the charge.

Autopsy↗
PubMed2000

Gunshot wound to the head with full recovery.

A 28-year-old man was shot in the back of the head at close range by a robber who then locked him in a room assuming that he was dead. The man was discovered 2 days later. The entrance wound of the bullet was in the left occipital region and it passed into the periphery of the right temporal lobe, where it lodged. The man was transferred to a rehabilitation centre 3 weeks later in relatively good health with only slight general EEG changes. The mild clinical course in this case is attributable to two major factors: firstly, no important brain structures were injured, and secondly, the kinetic energy of the silver-tip hollow-point bullet was probably rather low. Three years after the incident, the man still has slight sensory disturbances in the fingers of the left hand and left-sided homonymous hemianopia. He is now working again at his old profession (managing director) and the projectile is still lodged in the right temporal lobe.

Adult↗
PubMed2000

An extreme case of necrophilia.

This report presents the case of a young man legally convicted twice on a charge of defiling the dead. All necrophilic acts were committed over a period of around 15 years. The examination results revealed a purely female-fixated necrophilia. In three cases, the perpetrator skinned the trunk of the corpses, placed the skin on his naked body and stimulated himself sexually. In several cases, he also used burial clothes that he had removed from the coffins and kept at home. The perpetrator had a long record of psychiatric treatment for his sexual inclination.

Journal Article↗