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Biomedical subjects

T Sigrist

Publications and source records attributed to T Sigrist.

At least 37 records · Page 2Linked to original sources
PubMed1985

Continuous microbiological and pathological study of 70 sudden and unexpected infant deaths: toxigenic intestinal clostridium botulinum infection in 9 cases of sudden infant death syndrome.

As part of a programme to exclude infection as the cause of death in infants who died suddenly and unexpectedly necropsies were carried out on 70 such infants. In 11 cases (15%), a pathological diagnosis could be made at necropsy; in 9 of these, causative bacteria or viruses were found. The 59 cases in which the cause of death could not be found had histological features characteristic of sudden infant death syndrome (SIDS). Botulinum toxin was found in 9 SIDS cases (15%). 8 of these infants had botulinum toxin and organisms of different types (A, B, C, F, G) in the contents of the ileojejunum or colon. 4 of them also had toxin in the serum. No botulinum toxin or organisms were found in the 11 infants who died of identified causes or 18 other infants who died in hospital of known causes.

Botulinum Toxins↗
PubMed1985

[Death by peroral ingestion of soluble glass (sodium silicate)].

The intake of 0.51 of water glass (sodium metasilicate; colloid pH 12.5) led to death within 1-1.5 h. Autopsy revealed alkali burns of the stomach mucosa. The stomach contained a small amount of liquid with a pH of 11.5. Histologically, numerous bronchioles and alveoles were filled with amorphous material. This material was chemically proved to be condensed water glass. The obstruction of large parts of the lungs by water glass led to an inhibition of alveolar gas diffusion, which may have been the cause of death. The transformation of the water glass from liquid to solid occurred in the lungs by means of the carbonic acid of expiration air. This was made possible because the pH of water glass had been changed by gastric secretions from 12.5 to 11.5. Water glass starts to solidify around pH 11.4-11.3.

Aged↗
PubMed1984

[Formation of epidermal damage at entry by gunshot with a contact weapon].

Examination of contact bullet wounds shows the patterned inprint of the muzzle on the skin ("stanzmark") and further ragged structures around the periphery to be the remainders of the abraded epithelium. Usually these are turned outwards and from arch-shaped intraepithelial recesses, which contain residual amounts of propellant. The damage and soiling around the point of entry are the result of two factors in combination: the combustion gases and the gases escaping between the skin surface and the front of the barrel. This leads to different amounts of skin abrasion dependent on the amount and pressure of the gases. In this way, the frequently seen difference in size and shape of the stanzmark and the muzzle front can be explained.

Forensic Medicine↗
PubMed1983

[Intrapartum death or infanticide? A contribution to intrapartum asphyxia].

On occasion of the autopsy of a 32-34-week-old fetus delivered with fetal membrane intact (caul/amnion birth), heavy hypoxic changes in the cardiac muscle, the liver and the kidney epithelia were found. On the other hand, there was no sign of aspiration although a sign of aspiration was to be expected, as the fetus was lying in the amniotic fluids. The systematic examination of 68 cases of intrapartal deaths of various causes demonstrated that intrapartal aspiration in the amniotic fluid only takes place, when the function of the umbilical cord is obstructed. If pressure is lacking, as for example, in amniotic (fluid) substances, or meconium, in the respiratory tract is either found not at all, or only in small quantities. For the purposes of forensic medicine, this means that death by intrapartal asphyxia can also be assumed when findings demonstrate simultaneously that aspiration is absent and hypoxic changes of the organs are present.

Adolescent↗
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

[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

Adrenoleukodystrophy. Preliminary report of a connatal case. Light- and electron microscopical, immunohistochemical and biochemical findings.

This is the first description of a connatal case of adrenoleukodystrophy. The clinical picture consisted of severe psychomotor retardation, convulsions and hypsarrhythmia, but no obvious signs of adrenal insufficiency. Pathologically, the adrenals were small. The entire cortex was largely replaced by large round cells. Ultrastructurally, some cells in the adrenal cortex contained inclusions with electron-lucent clefts surrounded by a membrane. The anterior pituitary lobe could be demonstrated to have produced ACTH. The central nervous system showed extensive zones of demyelination in the brainstem, the cerebellum and the right-sided capsula interna. In the demyelinated areas there was sudanophilic breakdown and an intense gliosis. Ongoing demyelination could also be demonstrated by the chemical analysis. In the gray matter there waere micropolygyria of the insular cortex and swollen nerve cells in the nucleus arcuatus. Ultrastructure revealed the type of inclusions in the microglia of the same type as in the adrenals, and a different type of inclusions in unidentifiable cells, possibly neurons. These latter inclusions consisted of loosely stacked lamellar material. The findings are interpreted as further evidence of storage taking place in this disease.

Adrenal Cortex↗
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↗
PubMed1978

Bilateral renal agenesis in 2 male sibs born to consanguineous parents.

Two boys with bilateral agenesis of kidneys and ureters were the product of a consanguineous marriage. This family and previous reports of familial bilateral renal agenesis support the supposition that a minor proportion of cases of BRA is caused by the homozygous state of an autosomal recessive gene.

Consanguinity↗