Biomedical subjects

M Risse

Publications and source records attributed to M Risse.

At least 19 recordsLinked to original sources

PubMed2005

Dumping after homicide using setting in concrete and/or sealing with bricks--six case reports.

Homicide with subsequent hiding of the body using setting in concrete or sealing with bricks are rarely seen forensic cases. The article describes the circumstances and findings of six cases in which bodies were encased with concrete and/or bricks. In all cases, the offenders were male, in one case together with his wife and--except for one case--the victims were related to the offender. The causes of death were heterogeneous (suffocation, blunt force, shot) and the motive mainly domestic quarrel. Setting corpses in concrete and/or sealing with bricks does not prevent smell, slows decomposition and therefore complicates the estimation of the post mortem interval.

Adult↗

PubMed2005

Upper limit on the photon fraction in highest-energy cosmic rays from AGASA data.

A new method to derive an upper limit on photon primaries from small data sets of air showers is developed which accounts for shower properties varying with the primary energy and arrival direction. Applying this method to the highest-energy showers recorded by the AGASA experiment, an upper limit on the photon fraction of 51% (67%) at a confidence level of 90% (95%) for primary energies above 1.25 x 10(20) eV is set. This new limit on the photon fraction above the Greisen-Zatsepin-Kuzmin cutoff energy constrains the -burst model of the origin of highest-energy cosmic rays.

Journal Article↗

PubMed2005

Post-mortem evaluation of 415 pacemakers: in situ measurements and bench tests.

AIM: The hypothesis was that there is more undetected dysfunction of implanted pacemaker systems than that detected and corrected. This prompted a research project (sponsored by the German Research Foundation) to detect pacemaker abnormalities and evaluate their complications for patients, thus, proving or disproving the hypothesis. METHODS AND RESULTS: Four hundred and fifteen pacemakers of deceased patients were analyzed assessing their functionality by in situ measurements and bench tests including five measurements and one telemetric interrogation. Results were divided into four categories and statistically evaluated. Life-threatening abnormalities were found in 3.8%, potentially life-threatening in 3.7%, probably symptomatic, divided into atrial and ventricular problems, 13.3% and 2.8%, respectively, and premature exhaustion in 1.2%. Three of 179 bipolar ventricular leads and 2 of 131 bipolar atrial leads had insulation defects corresponding to 1.7% and 1.5%, respectively. The bipolar complication rate was 2.8 times higher than unipolar. CONCLUSION: The pacemaker patients investigated, living 4 years with their pacemaker on average, had a post-mortem evaluated complication rate of the category "life-threatening" of 3.8%. This result corresponds to an annual complication rate of 0.94% compared with a rate of only 0.39% in an earlier investigation.

Aged↗

PubMed2004

[Risks of drug screening using immunoassays].

Now-a-days immunoassays are world wide used for the rapid screening of drugs. Despite the fact that they are a highly valuable tool for the test of legal and illicit drugs, there is a non-negligible risk of false positive and false negative findings and many pitfalls must be taken into account when using these tests in an uncritical manner and without valid confirmation procedures.

Cross Reactions↗

PubMed2004

[Obligation to report occupational diseases. Importance of external post-mortem examinations before cremation].

The practical use of the legally required documentation of occupational diseases is demonstrated by a case of asbestos-related pleural mesothelioma. During the mandatory inquest before cremation, information of manifest pleural mesothelioma had been relayed to the widow of the patient, and an investigation for a possible occupational disease was performed. Reconstruction of the case showed that in the course of 3 months at least 13 physicians had been involved in in-hospital as well as ambulatory therapeutic measures. Until death, none of them informed the trade association about a suspected occupational disease in accordance with BK 4105 of the codex of occupational diseases, although the diagnosis of manifest pleural mesothelioma had been histologically confirmed already 10 weeks prior to the death of the patient. This case demonstrates obvious and evident deficiencies in applying the Code of Social Law VII, which requires physicians to report occupational diseases. In addition, it shows the importance of the post-mortem examination as a control function before cremation.

Germany↗

PubMed2003

[Deaths due to mechanical restraint in institutions for care].

The state of confusion in patients with severe disorientation and brain damage symptoms presents particular problems in gerontologic psychiatry. Six fatalities at different institutions due to improperly employed physical restraint and deficient surveillance are described. The causes of death involved strangulation which was accidentally caused by patients who become stuck between bedrails and mattress or who were fixed in an abdominal restraint belt or in a special protective blanket (mostly used for serious pre-conditions). The reconstruction of the scene of death was based in almost all the cases on the autopsy findings. We assume a considerable number of unreported emergency or fatal cases. The legal, psychiatric and nursing-related issues are discussed in this paper. Furthermore the precise documentation of the on-site appearance of the situation at discovery of death is called for. The indication for physical restraint should be limited as far as possible. Further studies in nursing homes and hospitals should focus on structural conditions with respect to the frequency of physical restraint in order to optimize the protection by quality standards.

Accidents↗

PubMed2001

Multiple homicides as a result of chloroform poisoning: case report and experimental study.

Two cases (involving five murder victims) of multiple homicide by inhalational chloroform intoxication are reported. In the discussion of the findings the valence of toxicological analyses is underlined with regard to the possibility of forcible external suffocation due to occlusion of the respiratory orifices by means of a chloroform-soaked soft covering. In addition storage experiments were performed at +4, +20 and -20 degrees C with cadaver blood mixed with chloroform. The optimal solution for avoiding volatile losses was stored in glass tubes with ground glass stoppers. In cases of unclear death in which involvement of volatile substances is suspected it is, therefore, advisable to preserve an additional blood sample at -20 degrees C in glass tubes that are only opened for the analysis of volatile substances.

Adolescent↗

PubMed2001

Traumatic venous aneurysm of the popliteal vein with outcome: a case report and review of the literature.

A case of sudden death due to recurrent pulmonary thromboembolism is described. The fatality took place three and a half weeks following blunt trauma to the left popliteal region. The patient died unexpectedly. Autopsy revealed the source of the emboli as a sacciform venous aneurysm of the popliteal vein, an entity seldom described, but important to consider in cases of soft tissue popliteal masses or unexplained pulmonary embolism, especially in otherwise healthy individuals.

Adult↗

PubMed1997

Histomorphologic studies of the glottic region to elucidate the pathogenesis and functional significance of fibrinoid vocal cord lesions in infants and young children.

Focal lesions of the vocal cord in form of fibrinoid necrosis and thickening of the basement membrane are morphological findings in infants and young children that receive only scant attention and are also controversially valued. We discuss two causes for the pathogenesis of these findings: (1) recurrent laryngospasms and (2) a laryngeal phonotrauma resulting from frequent spells of shrill, presumably high-frequency crying. The aim of our study therefore was to gain insight into the development and functional significance of these lesions by examining their histological patterns and to draw the pertinent conclusions. In 56 deaths (natural and unnatural causes, fetal life up to 4 years, no pathological or traumatic laryngeal lesions) histological investigations were carried out on putrefaction-free material. For the histomorphological studies, horizontal sections through the region of the vocal cord were obtained and stained according to conventional and immunohistochemical staining methods. In 42 cases the thickness of the basement membrane was determined morphometrically. In 12 of the 56 cases (21%) we observed staged variations of focal lesions, ranging from fibrinoid necrosis to degenerative lesions with pronounced macrophage involvement and deposits of PAS-positive plaques. Measurements at the basement membrane revealed a thickness of 7.9 microm. Separate measurements at the anterior and posterior portions of the vocal fold showed a ratio of 1.7:1. When the cases were subdivided into those with and without fibrinoid necrosis the ratios were 2.5:1 and 1.5:1. This different pattern makes it unlikely that laryngospasm is the sole or essential cause. Pathogenetically more important might be phonatory overstraining due to maximum vibrations in only the anterior portions of the vocal fold, which is not specific for later SIDS victims. This assumption is also supported by the often observed conspicuous phonetic behavior of some later SIDS victims and the absence of these stage-like vocal cord lesions in stillborns and adults. It is presumably an age-specific, temporary finding which is completely reversible.

Basement Membrane↗

PubMed1995

[Disorders of thrombocyte function as a cause of postoperative hemorrhage after tonsillectomy].

Tonsillectomies are the most frequently performed ENT surgical procedures and are potentially beset with a number of possible complications. Post-operative secondary hemorrhage still remains the most frequent complication despite improvements in surgical techniques and preoperative diagnostic evaluations. Besides unsuitable operative techniques, disturbances of circulation and wound infections, disturbances of hemostasis may play an important part. The objective of this paper was to examine the relative frequency of platelet functional disorders as a possible cause for secondary hemorrhage after tonsillectomies. In the past, most of these have been related to medication use. Eighty-nine patients were studied and historically showed no predisposition increased hemorrhage per se or in their families or gave reasons for other factors favoring secondary hemorrhage. The diminution or lack of collagen or ADP-induced agglutination served as an indication for a platelet functional disorder. Ten percent of the 89 patients experienced secondary hemorrhage, with platelet functional disorders proved in 40% of these patients. Because of these results a correlation was attempted between secondary hemorrhage and abnormal deficits of collagen and ADP-induced agglutinations in platelet functional tests, but this was not found. Necessary preoperative studies was attempted screening for hemostasis as well as medico-legal aspects connected with the prescription of medicines inhibiting platelet agglutination, especially use of acetylsalicylic acid before tonsillectomies, are discussed.

Adult↗

PubMed1993

["Iatrogenic" fatal gas gangrene infection].

The problems associated with lethal gas gangrene infections that arise in connection with medical treatment are described and discussed, based on our own observations and on cases reported in the literature. Special emphasis is placed on questions relating to causality and responsibility. The difficulties encountered in the evaluation of such "iatrogenic" gas gangrene infections are due to the fact that clostridia occur ubiquitously, i.e. that they also reside in the human organism, for instance on the skin. For this reason a positive bacteriological diagnosis of gas gangrene does not necessarily mean that a clinically relevant infection and/or disease state is present at the same time. The implications for morphological practice arising from this situation are discussed, especially with regard to the significance of the intravital, agonal or postmortem bacteriological diagnosis of gas gangrene. Questions concerning the obligation to report such cases when encountered during forensic autopsies are also addressed.

Adult↗

PubMed1991

[Epidemiology and morphology of sudden death in infancy in twins and siblings].

429 SIDS cases were investigated in a retrospective study. For this study, the deaths in which at least one brother or sister had died under comparable circumstances were evaluated. The 429 babies who had died comprised 17 multiple birth babies (3.7%) including 15 twin and two triplet babies. Eleven cases (2.6%) were brothers or sisters of SIDS victims. In three cases, relatives of the baby's mother had died of sudden infant death. A comparison of the various case groups did not reveal any patho-morphologically significant differences between the groups or differences from other SIDS cases. All the multiple birth babies were immature and premature babies. There was a raised incidence of poor socio-economic conditions in the sibling group. The results are significant for parent counselling, any preventive measures and the detection of concurrent (in particular, unnatural) causes of death.

Autopsy↗

PubMed1990

[Cause of death during an asthma attack by self-medication with dosing aerosols].

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Adolescent↗

PubMed1990

[Resuscitation measures and petechial thymus hemorrhages in sudden infant death].

In 45 cases of sudden infant death syndrome (SIDS) in which unsuccessful attempts at resuscitation had been made and in 21 cases without attempted resuscitation, systematic histological investigations were carried out on the thymus. In these investigations, petechial hemorrhages were detected in 82% of the cases with attempted resuscitation and in 76% of the cases without attempted resuscitation. The histological distribution pattern of the petechial thymus hemorrhages did not differ notably between the two groups. The pattern of findings indicates that the hemorrhages had already developed during the death agony and that the typical histological distribution pattern with an increased occurrence of petechial in the cortical zone was altered by massive attempts at resuscitation in individual cases.

Hemorrhage↗

PubMed1990

[Age-dependent morphologic findings of the thyroid in sudden infant death].

Age (eight days to 12 months) and degree of colloid depletion or colloid content of the follicles (normal, partially depleted, depleted) were correlated on the basis of 176 thyroid investigations in cases of sudden infant death syndrome (SIDS). In the 176 SIDS cases, a resting thyroid gland with normal colloid content could only be found in 14%, whereas partially depleted follicles were found in 35% and depleted follicles in 51%. 60% of all cases showed a large degree of epithelial desquamation up to collapse of all follicles. A marked capillary hyperemia was found in 48%. 80% of the cases showed a normal colloid content in the first month of life, and colloidfree follicles should not be detected in any case. An increased incidence of thyroid activation was obtained in the total number of cases only from the second month of life. The histomorphological appearance of the thyroid gland thus corresponds to that of healthy infants only in the first month of life. The question as to why there is an evidently raised thyroid activity in the subsequent months of life in SIDS cases is discussed.

Age Factors↗

PubMed1989

[Histologic findings in the esophagus in infancy. A contribution to the question of gastroesophageal reflux in sudden infant death].

In 53 mortalities (1 stillbirth, 2 neonates, 7 cases up to 5 years of age and 43 SIDS cases), systematic histological investigations were carried out on the esophagus. The results comprised a topography of epithelial defects and inflammatory wall changes. In the SIDS cases, focal epithelial defects could be detected in 14% and fresh inflammatory infiltrates in 7% without preferential localization. There were also lymphocytic reactions of varying extent (62%), but mainly in the upper one-third of the esophagus. Similar findings were found in the 10 non-SIDS cases. The results pattern is discussed with regard to its pathological relevance. It appears to be doubtful that the inflammatory changes are the result of reflux, as reflected in morphological terms.

Cause of Death↗

PubMed1989

[Comparative histologic studies of the origin of petechial thymus hemorrhage].

Systematic histological investigations were carried out on the thymus with regard to the incidence and genesis of petechial thymus hemorrhages in 145 cases of death (fetuses from pregnancy terminations and stillbirth, mature and immature neonates, SIDS cases, other baby deaths, deaths during infancy and childhood). Petechial thymus hemorrhages were most frequently found in SIDS cases (87%). Even though distinguishable, a distribution pattern similar to that of thymus hemorrhages in SIDS cases (including hemorrhages mainly in the cortical zone of the lobes) could be detected in the group of fetuses from pregnancy terminations and stillbirth, as well as in mature and immature neonates. Histologically, deaths in babies and infants without extrinsic suffocation showed a different histological bleeding pattern (irregular hemorrhages of varying size in the cortex and medulla of the lobes). In violent extrinsic suffocation of babies and infants, thymus hemorrhages were much rarer and less pronounced in quantitative terms. Acute and subacute or chronic forms of asphyxia, the cause of death and the duration of the death struggle are discussed as pathogenetic factors to explain the different patterns of the findings.

Asphyxia↗

PubMed1989

Differential diagnosis SIDS/non-SIDS on the basis of histological findings of petechial thymus hemorrhages.

Petechial thymus hemorrhages are found most frequently in SIDS (87%), and very much more rarely in fetuses after abortion and stillbirths (55%) as well as in perinatal deaths (40%). In these groups, there was a uniform histological bleeding pattern with emphasis on the cortical zone. In non-SIDS deaths of natural causes or extrinsic suffocation in babies and infants, it could be demonstrated in 39%. In extrinsic suffocation, the thymus hemorrhages were mostly less pronounced in quantitative terms than in SIDS. In non-SIDS (without extrinsic suffocation), a hemorrhage pattern different from SIDS could be detected with hemorrhagias of different sizes and irregularly distributed over the cortex and medulla.

Abortion, Spontaneous↗