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Biomedical subjects

R Dirnhofer

Publications and source records attributed to R Dirnhofer.

At least 73 records · Page 4Linked to original sources
PubMed1983

[Suicide by cutting the radial artery of the wrist. Report of 2 cases].

Suicide attempts made by cutting the wrist artery (A. radialis et ulnaris) are usually unsuccessful if the vessel wall or blood clotting has not changed pathologically. Fatal exsanguination, however, can also result even if the arteries are not completely severed crosswise--which is usually not the case--but are instead slit open lengthwise or partially severed crosswise. For this reason, the invagination processes of the artery stumps controlled by the elastic structure of the vessel walls and consequently the spontaneous arterial hemostasis are obstructed. The importance in establishing the type and position of the cut artery is demonstrated by means of an exactly dissected model limb.

Adult↗
PubMed1981

Isolation of Clostridium botulinum type G and identification of type G botulinal toxin in humans: report of five sudden unexpected deaths.

Clostridium botulinum type G has not been identified until now from humans or animals; it has been isolated only twice, from soil samples in Argentina. Type G organisms were isolated from necropsy specimens in four adults and an 18-week-old infant. Type G botulinal toxin was demonstrated in the serum of three of these individuals. The toxic dose in mice ranged from 2 to 7 50% lethal doses/ml. These persons died suddenly and unexpectedly at home, without any pathologic evidence to account for the cause of death in four cases. Symptoms in two individuals were similar to those observed in food-borne botulism. Thus, a prompt postmortem search for toxin and organisms of C. Botulinum in blood and feces may be worthwhile in determining the etiology of unexplained deaths. More microbiologic, physiologic, and toxicologic data are needed to clarify the role of C. botulinum in the pathogenesis of sudden unexpected death in infants and adults.

Adult↗
PubMed1981

[Rare complications following tracheotomy and intubation (author's transl)].

Report on two cases: Case 1: A young male was tracheotomized because of respiratory insufficiency due to a thoraco-abdominal trauma. The injuries were fatal 8 hours following tracheotomy. Autopsy revealed a tube like formation located in the upper trachea, consisting of coagulated blood. The peculiar shape was caused by a splinting effect of the tracheal cannula. A trickling tracheostomal hemorrhage was found to be the causal factor. --Case 2: After long-term tracheotomy due to a laryngeal trauma a tracheostomal intubation was performed in a young male for the purpose of a surgical revision of the laryngeal injuries. Two days later sudden death occurred. Autopsy revealed a tube like formation in the upper trachea, consisting of fibrin and desquamated necrotic tracheal epithelium, which had occluded the cannula in a valve like manner. The originating mechanism of this pathological state is demonstrated. The significance of preexisting chronic tracheitis and the use of a tube with a rather rigid cuff (nylon spiral tube) as additional promoting factors are discussed.

Airway Obstruction↗
PubMed1979

[Apparently contradictory homozygosity of gc- and esd-markers in three generations (author's transl)].

In a paternity case we found contradictory blood group antigens in the serum- and enzyme-polymorphisms Gc and EsD of the child, her mother and grandparents. A possible accidental exchange of the child could be excluded by biostatistical calculations of the probabilities of motherhood, fatherhood and parenthood, and the descent from the parents was proven in both generations. The serological findings may be explained by the concurrent existence of silent genes or of genes that cannot be determined as yet. The genetic information Gc degrees descended from the grandfather and that for EsD degrees from the grandmother. Both were transmitted from the mother to the child. Thus, the case could be cleared by statistical considerations only.

Antigens↗
PubMed1979

[Mechanical tolerance of tentorium cerebelli (author's transl)].

In some cases of accidents primary traumatic brain stem hemorrhages are seen in conjunction with lesions of the tentorium cerebelli. In order to decide, whether accelerations of the infra- or supratentorial brain tissue are actually capable of causing tentorium lesions, burst and teartests of tentorium tissue were conducted. The mean dynamic biaxial tearing force was found to be about 4 bar. This value supports the hypothesis that a main injury causing factor of the tentorium in cases without skull fracture could be the relative motion between the tentorium and the brain hemispheres. The mass of the cerebellum however seems to be insufficient to cause such injury producing deceleration forces on the tentorium.

Acceleration↗
PubMed1979

[The effect of blood-filled meshwork of arachnoid villi in connection with posttraumatic brain edema (author's transl)].

Based on the Kellie-Munro doctrine according to which the intracranial compartments--blood, brain, and CSF--are in a state of pressure and volume equilibrium, we examined if traumatic lesions of the liquor absorption passages could change the intracranial pressure (ICP). Therefore, we reviewed the arachnoid villi and granulations of patients which died as a result of head injuries. In cases of traumatic subarachnoidal hemorrhages the meshwork of arachnoid villi are filled throughout with blood. By microscopical examination we observed findings in the network of spaces of the villi like they are known in prestatic and static conditions of capillary system (clothing of erythrocytes). The pathophysiological significance of the findings, especially with regard to the dynamic of posttraumatic brain edema, is discussed.

Adult↗
PubMed1978

[Exceptional suicide of a physician (author's transl)].

A 57 years old psychiatrist committed suicide through insufflation of powder from a chemical fire extinguisher his respiratory and gastrointestinal tract. Death was due not to mechanically induced asphyxia but to asystolia. The latter disturbance is explained as a vagal reaction to trauma because of the characteristic position of the corpse at the scene and because the victim did not exhibit any signs of gas or foreign body embolism. A further point of interest in the context of trauma mechanism, is the absence of significant disruptions in spite of the high pressure (10-12 atu) developed by the extinguisher. No conclusive interpretation can be given about the psychological mechanisms behind this suicidal act. On the other side the modality of the procedure used by the victim became manifest already a few months before the critical act.

Heart Arrest↗
PubMed1978

[The enlarged diagnosis of the fatal penicillin accident. Immunehistologic demonstration of antigen-antibody complexes and of antibodies against the tubular basement membrane after administraiton of depot penicillin].

In a case of fatal penicillin allergy it proved possible at autopsy to demonstrate (by immunohistological examination of basal membranes of proximal renal tubuli) antigen-antibody complexes belonging to the penicillin (BPO) group and to an anti-penicilloyl antibody of the IgG type. In addition, complement C3 was detected. Antibodies against the basal membranes or renal tubuli were also demonstrated in material eluted from the kidney, although an inflammatory reaction ot the immunoligical changes had not yet been observed in light microscopy. It is undecided whether this discrepancy is due to the low dose of penicillin administered or the relatively short time lag between first injection and time of fatality. It is assumed that, pathogenetically, a reaction of the serum sickness type is probably involved. For etiological clarification the use of immunohistological methods in addition to serological procedures provides further indices for an antecedent sensitization to penicillin, because assay effectiveness does not decrease even after a lengthy postmortal time-lapse. On the other hand, tissues and serum for examination should be frozen at low temperatures immediately after autopsy.

Antigen-Antibody Complex↗
PubMed1977

[A fatal food poisoning caused by bacillus cereus (author's transl)].

The autopsy of a 37 year old man who had died under extraordinary circumstances showed a bromatoxism by bacillus cereus. The verification of the bacillus was possible although the man had already died 2-3 days before; and that in spite of the existence of early beginning rottenness. With the help of morphological findings the pathogenetic effect of the toxins (exotoxin and enterotoxin) of bacillus cereus is discussed. Blood cultures of the heart alone are not sufficient to prove a causal connexion between infection and death. For this purpose bacteriological examination of the organs (liver, spleen, kidney, lungs and brain) is at the same time necessary. An aseptic method, which is described in detail, is the absolute condition for useful results. The forensic value of proof of the bacteriological examination is secured and improved by an additional verification of bacteria in histological specimen coloured by Gram.

Adult↗
PubMed1977

[Concerning the development of brainstem injuries (author's transl)].

Since the etiology of traumatic brainstem lesions has not been completely clarified we tried to analyse this question from autopsy material with special consideration of the effects of rotational acceleration of the head resulting from an impact force. Seventeen cases without a skull fracture were investigated. We considered the tentorium as a suitable indicator for possible relative movements occuring between cerebral hemispheres and the cerebellum as well as the brainstem since, because of its attachment to the skull, it follows all excursions of the skull directly and simultaneously. The brain, however, due to its inertia, remains stationary in the beginning so that injuries may occur on the structures mentioned. The results of the autopsies confirmed these assumptions, for both uni- and bilateral tears as well as hemorrhages in the tentorium cerebelli were found. Associated were subarchnoid hemorrhages over the upper vermis and thin layered hematomas between the tentorium and the cerebellum. In all cases the brainstems showed both microscopic and macroscopic hemorrhages of the isthmus cerebri and in some cases of the cerebral peduncles and the cerebellar brachia conjunctiva. These hemorrhages are attributed to shearing forces and tension arising from movements between tentorium and the surrounding brain components. The mechanical effects on the brainstem and its surrounding structures at various rotational accelerations of the head (along transversal, vertical and sagital axis) are discussed. The combination of brainstem lesions with injuries of the tentorium suggests that the brainstem injury was a primary result of the impact. Finally the possible significance of rotational acceleration for brainstem injuries caused by whiplash mechanism of the head in connection with improperly used automobile safety belts or inadequate headrests is discussed.

Accidents, Traffic↗
PubMed1976

[The determination of time of death utilizing a considerable difference between urine-and blood alcohol (author's transl)].

Examining a case of death due to a subarachnoidal hemorraghe of a ruptured cerebral aneurysm the approximate time of death could only be determined by a considerable difference between alcohol contents of urine and blood. Since the urinary bladder was filled and a continuous diuresis until the moment of death could be assumed it was possible to calculate the average period of time during which the stated concentration of urine alcohol was formed, and to estimate the survival time.

Adult↗