In rabbits, intracerebrally applied erythrocytes can move with the cerebrospinal fluid along connecting pathways between the subarachnoid space and the cervical lymph nodes. This study compares the time dependency for the degradation of intracerebrally injected erythrocytes in the brain as well as in the cervical lymph nodes. Rabbits were killed at various predetermined intervals after the intracerebral erythrocyte injection. Microscopic and histologic examination of the brain and the cervical lymph nodes revealed the following findings: (1) Erythrophages first appeared in the brain 24 h after the injection; siderophages, 4 days after the injection. Siderophages were still demonstrable at the conclusion of the study, i.e. 240 days after the injection. (2) In the cervical lymph nodes erythrophages were first observed 1 h after the injection; siderophages, 9 h after the injection. Only isolated erythrophages and siderophages were found in the lymph nodes 12 days after intracerebral injection of red blood cells. Later on no erythrocytes or siderophages were observed in the lymph nodes. The findings indicate that non-phagocytized red blood cells arriving at the lymph nodes were ingested by local macrophages. The extremely rapid ingestion and digestion of the red blood cells by lymph node macrophages as well as the possible reasons were discussed.

Animals↗

PubMedDate not supplied

Natural death.

BACKGROUND: The increasing age of every human being is the beginning of the end of life, an obviously natural process, but any attempt to define the term 'natural death' soon encounters difficulties in defining what is meant by 'natural'. In the industrialized countries of the West, for example 'natural death' is thought of as the opposite of non-natural types of death such as accidental death, suicide, and homicide. OBJECTIVE: The aim of our present survey is to discuss the meaning of the term 'natural death' under a clinical, a forensic and a scientific point of view with regard to recent developments especially in molecular biology. CONCLUSION: If there are 'external' physical influences, a medical-technical manipulation, a therapeutic or molecular biological intervention cannot be definitely ruled out as the cause of death, then use of the term 'natural death' in general is open to question. It will only remain meaningful if it can be applied with a specific meaning in definite practical situations. Current research and medical technology, however, do not allow use of the term 'natural death' in its conventional sense: it can thus be stricken from the medical vocabulary.

Aging↗

PubMedDate not supplied

Life shortening and physician assistance in dying: euthanasia from the viewpoint of German legal medicine.

BACKGROUND: Around the world heated debates have broken out on the topic of active euthanasia. Specialists in the field of 'forensic medicine' have taken full part in these discussions. OBJECTIVE: The present survey from the point of view of forensic medicine begins with a look at current terminology and at the laws pertaining to euthanasia in Germany. These laws are then contrasted with actual practice, including a description of the increasing acceptance of active euthanasia by the German population and its legalization in Holland. The main argument against active euthanasia is that its formal acceptance in law would cause the dam of restraint to burst, culminating in widespread misuse, as already seen in recent serial killings by nurses in hospitals and homes for the elderly around the world. CONCLUSIONS: Contrasted to this are the arguments for taking active steps at the end of life, including emotional considerations such as the revulsion against mechanized medicine and the fear of pain and rational arguments such as the necessity to end a 'life unworthy of life', to save medical costs, and obtaining prior consent in 'living wills'. Such considerations have put in jeopardy the moral integrity of the medical profession - and thus the layperson's trust in physicians - around the world. In Germany especially the history of mass killing during the Nazi era constitutes a fundamental argument against active euthanasia. As a consequence, in Germany active euthanasia will not receive legal sanction, although recommendations on rendering dying more bearable are permitted.

Ethics, Medical↗

PubMedDate not supplied

[Fatal incidences during arrest of highly agitated persons].

We report on four cases of sudden circulatory arrest during the physical restraint of extremely excited and repugnant men by the police. Three persons died, and one became apallic. The excited states resulted from acute schizophrenic disorder in one case, from intoxications (ethanol and drugs including cocaine respectively) in two others, and from encephalitis in the fourth case. In only one case one of the police officers was condemned for involuntary mansloughter, responsability was excluded in the remainder. Similar lethal events in "excited delirium" are given in the American literature, the main etiologic factors being acute psychosis and cocaine intoxication. Most of these events occurred, differing from ours, under "hogtying" which is a technique of physical restraint in a prone position with the wrists and ankles bound behind the back. These events are thought to be cardiac in origin and to result from oxygen-consuming motor hyperactivity, excessive catecholamine release, and impaired breathing. Police officers are recommended to restrict all measures of restraint to a mininum in extremely excited persons, and to avoid any compression of the trunk or neck. A continuous monitoring for vital signs is postulated in order to recognize a medical incident as quick as possible.

Adult↗

PubMedDate not supplied

[Fatal accidental mixed poisoning of 3 men at the same time].

The case history presented reports on three 30- to 40-years-old men, who were found dead in a party like situation in the living room. The toxicological investigation proved alcohol and THC as well as therapeutic Flunitrazepam- and Pentobarbital levels and toxic 7- Amino-Flunitrazepam concentrations. The background of this surprising scene led up to the conclusion of an accidental death caused by a mixed intoxication.

Accidents↗

PubMedDate not supplied

Traumatic induced total myelomalacia of the cervical spinal cord associated with a space-occupying subdural hematoma.

We report the case of a 20-year-old male driver who suffered from a trauma to the cervical vertebral column in a head-on collision with a tree. The injuries included subluxation of the 2nd and 3rd cervical vertebrae and fracture of the odontoid process of the axis with ventrally directed displacement of the proximal fragment and dorsally directed displacement of the distal fragment. Already at admission to hospital a space-occupying spinal subdural hematoma was diagnosed. Clinically, paraplegia was diagnosed with progressive loss of consciousness. Pneumonia led to death 40 days after the accident. Autopsy disclosed a total myelomalacia of the cervical spinal cord obviously resulting from an ischemia caused by a traumatic lesion of the dorsal truncus arteriosus spinalis as well as a compression by the spinal subdural hematoma.

Adult↗

PubMedDate not supplied

Characterization of mononuclear phagocytes in human CSF using membrane markers.

The purpose of this investigation was to demonstrate those membrane receptor sites on mononuclear phagocytes of human CSF which provide additional evidence for their monocytic origin and function. Using a heterologous system, sheep red blood cells were coated with IgG- and IgM-fraction of the anti-Forssman-antiserum of rabbits. In another series of experiments, sheep red blood cells were additionally sensitized with fresh human serum as a source of complement. The possible inhibitory effect of human IgG on the uptake of red cell antibody complexes was tested. Washed and pretreated sheep red cells were added to different fresh CSF specimens from patients, whose CSF exhibited no conspicious biochemical, serologic or cytologic alterations. The percentage of phagocytizing mononuclear phagocytes was evaluated. When the particular IgG EA reagent described was utilized, most of the mononuclear phagocytes consistently exhibited the IgG- and complement-receptor activity which selectively characterizes blood monocytes and related cells.

Binding Sites, Antibody↗

PubMedDate not supplied

[Uncovered bones on the Baltic Sea beach--human or animal?].

Report of an unusual finding of bones on the shore of the Baltic Sea. Although the morphological findings appeared similar to a human foot skeleton, a quick identification as sea dog bone was possible.

Animals↗

PubMedDate not supplied

Reactive astrocytes and macrophages in the brain stem of SIDS victims? Eleven age- and sex-matched SIDS and control cases.

The investigation was carried out on 11 sudden infant death (SIDS) cases which were compared with age- and sex-matched controls. Six brain nuclei were selected for evaluation. Using immunohistochemical methods, macrophages were selectively demonstrated by detection of lysozyme; reactive astrocytes, by detection of intracytoplasmic albumin (marker of prior impairment of blood-brain barrier function) or GFAP. No lysozyme-positive cells were demonstrable in the brain stem of any of the examined cases. Although a greater number of reactive, GFAP-expressing astrocytes were found in the SIDS cases, 3 of the 11 SIDS cases (compared to 5 controls) had no reactive astrocytes in any of examined brain nuclei. Reactive astrocytes, however, were identified in more than half the controls. Sections treated with anti-albumin serum were evaluated quantitatively. Total number of non-neuronal cells, relative proportion of astrocytes, and proportion of albumin-positive astrocytes were determined. Paired brain nuclei were counted on both sides of the brain stem. The number of non-neuronal cells, astrocytes, and albumin-positive astrocytes in the SIDS cases did not differ significantly from those in the controls. No statistically relevant difference was established between the right and left parts of the brain stem. The findings were discussed in light of the literature.

Astrocytes↗

PubMedDate not supplied

[Effect of water exposure on the recognizability of rope marks].

Explore the source record for details and available documents.

Contusions↗

PubMedDate not supplied

[Cytologic findings as indications: morphologic and immunohistochemical identification of human brain tissue on the clothing of a murderer].

A case was described in which a murder was concealed by burning the body. The suspect confessed to committing the crime after being informed that human brain tissue in form of slimy stains as well the same blood group as the victim had been identified on his clothing. Slimy stains (approx. 2 x 3 mm) were identified as brain tissue by sectioning on the cryostat together with the bits of wool fiber. Morphologically, nerve cells were clearly identifiable, particular by demonstrating Nissl's bodies. Application of anti-human serum protein and an anti-human cerebrum serum confirmed this finding and augmented it by confirming that the brain tissue was of human origin. The unusual character of this case and the methods used prompted the authors to publish these findings. The available literature is discussed.

Blood Stains↗

PubMedDate not supplied

[Assisted dying--death on demand: borderline between medicine and law].

In medicine and law the ethical values confront one another: "death with dignity" ("allowing to die") versus the "right to life" ("preservation of life"). An individual's right to self-determination conflicts with the physician's obligation to preserve life. The problematic is discussed from the standpoints of both medicine and law, and current developments in the medical profession and legal practice are presented.

Aged↗