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Biomedical subjects

V Schneider

Publications and source records attributed to V Schneider.

At least 73 records · Page 4Linked to original sources
PubMed1994

Cases of death caused by gas or warning firearms.

Five cases of lethal injuries caused by gas or warning firearms are discussed. In one suicide case a modified weapon (elongated barrel) and steel bullets were used to fire a shot into the head, the bullets lodged in the skull and lethal bleeding resulted. In the other cases conventional gas weapons without evidence of alteration were used for contact shots; injuries were caused by the effect of propelling powder gases. Two of these cases were suicides (temporal contact shot and back of the neck contact shot), one was an accident (inguinal contact shot with lethal bleeding), and one was an attack by another person with a contact shot against the neck with bilateral tears of the hypopharynx. After successful surgery, a delayed death occurred 12 days later caused by bleeding into the airways from the ruptured external carotid artery.

Adolescent↗
PubMed1993

Neuropathologic analysis of postmortal brain samples of HIV-seropositive and -seronegative i.v. drug addicts.

Between 1987 and 1992 we performed forensic-pathologic and neuropathologic examinations on 70 cases of i.v. drug addicts who died of an overdose. In almost 25% of the cases HIV-positivity was revealed by serological examinations. In all the cases, irrespective of the result of the serological examination, a diffuse, reactive astrocytosis was the most prominent histologic alteration, accompanied by more or less pronounced regressive changes of this cell type in the deep layers of the white matter. Furthermore, also in all the cases, a slight to moderate, reactive proliferation of microglia could be assessed. In a few cases of the HIV-seropositive group a lymphocytic meningitis, viz. meningoencephalitis was found; these changes may indicate an early invasion of the central nervous system (CNS) by the HIV. In spite of these inflammatory alterations, in the latter cases no HIV-specific antigens (p24 and gp41) could be demonstrated in the brain, most probably because of the small number of infectious particles. In order to reveal the earliest phase of invasion of the CNS by the HIV, we performed a search for HIV-specific nucleic acid sequences by the aid of the polymerase chain reaction (PCR) in 8 HIV-seronegative and 8 normal control cases. Although, most probably due to contamination, also the control cases exhibited some PCR-signals, these were more pronounced and appeared with more primer-pairs within the group of HIV-seronegative drug addicts. It is conceivable that HIV penetrates the CNS and is harboured in it in latent form shortly after the primary infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Diseases↗
PubMed1993

[The circadian profile of ventricular extrasystole].

STUDY OBJECTIVE: to determine the existence of circadian variability (CV) of single ventricular premature beats (VPBs) and study its relationship with the heart rate variation; to compare sub-groups of patients (Pts) with and without antiarrhythmic therapy and with ischemic cardiopathy versus a free structural cardiopathy group. DESIGN: retrospective study. PATIENTS AND METHODS: the CV of VPBs was analyzed by Holter monitoring in 147 Pts, 93 male and 54 female with a mean age of 59 +/- 14.6. Seventy seven Pts were not taking antiarrhythmic drugs while 70 were doing it: Amiodarone 23, Propafenone 30, B-Blockers 9, Quinidine and Disopyramide 7, Flecainide 1. Sixty five Pts had ischemic cardiopathy and 37 were free of any structural abnormality. The selection criteria consisted in: 1--more than 100 VPBs/24h; 2--distribution over more than 12 hours; 3--absence of any hour with more than 35% of the total VPBs in the recording. Data were presented in a percentage form and the results evaluation was made by using single and two-harmonic regression models. MAIN RESULTS: a CV was found to the single VPBs, with minimum values during the nocturnal period and maximum values in the morning, with a significant adjustment to the two-harmonic regression model, defined by the equation y = 4.2 - Q,559 sen (2 pi T/24) - 0.604 cos (2 pi T/24) - 0.417 sen (4 pi T/24) + 0,272 cos (4 pi T/24) (p < 0.001). A strong positive correlation was observed between VPBs and heart rate variability (r = 0.95; p < 0.001). The sub-groups of Pts, whether taking antiarrhythmic drugs or not, also showed a CV with a statistically significant two-harmonic regression pattern, with a major morning increase of VPBs in the antiarrhythmic group. The free structural cardiopathy sub-group displayed a best adjustment to the single harmonic regression model while the ischemic group exhibited a two-harmonic regression pattern. CONCLUSIONS: a significant circadian variability of VPBs with a bi-modality expression was determined. The majority of the analyzed sub-groups showed the same kind of variation. A strong positive correlation with the heart rate variability was observed.

Age Factors↗
PubMed1993

Listeria-associated pericarditis in an AIDS patient.

Listeria monocytogenes is a pathogenic, facultative intracellular gram-positive rod, generally seen in cell-mediated immunocompromised states. In acquired immunodeficiency syndrome (AIDS), it most commonly presents as bacteremia or meningitis. An association with pericarditis has not been described previously in this group of patients. This article describes a case of pericarditis secondary to listeriosis involving a focal pancarditis and necrosis of the A-V node with subsequent refractory ventricular tachyarrhythmias in an immunodeficient patient presenting with altered mental status. Infectious etiologies should be considered for "benign" appearing pericardial effusions in AIDS patients and the diagnosis of listeriosis excluded in the presence of "diphtheroid-like" organisms.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Muscular dystrophy as a risk factor in anesthesia].

Three cases of muscular dystrophy are reported on (8 years, 4 months, 10 months) in which serious conditions arose under anaesthetic (bradycardia, asystolia, hyperkalemia, rising CPK). In the first two cases there was no way of avoiding a fatal outcome, but in the third case the child survived with no permanent damage. The cause of incidents of this kind is discussed first as being hyperkalemia due to acute rhabdomyolysis, and secondly malign hyperthermia. There were no indications of malign hyperthermia in this case. It is hardly possible to distinguish this in an acute clinical ward, as the clinical symptoms are very similar. If it is known that muscular dystrophy is present, depolarising relaxants should be given sparingly. This also applies, as the first case shows, for muscular dystrophy of the Becker type, which can on the whole be regarded as benign in comparison with progressive muscular dystrophy of the Duchenne type. In this instance a forensic and anaesthetic expert's opinion even had to be produced at the request of the Public Prosecutor. The post mortem was carried out under the heading of a possible "mistaken medical treatment" but there was no evidence to justify such an assumption.

Anesthesia, General↗
PubMed1992

Countermeasures against space flight related bone loss.

This paper reviews human data concerning bone loss and attempted countermeasures during spaceflight and bed rest, a commonly employed technique to simulate the effects of weightlessness on the musculoskeletal system.

Bed Rest↗
PubMed1992

HIV-1- prevalence among drug deaths in major cities of central and northern Europe.

Since 1985, a number of Institutes of Forensic Medicine in Germany have cooperated in a multicenter study, to provide a constant monitoring of HIV-1-prevalence among drug related deaths. In 1990/91, the Institutes in Copenhagen, Stockholm, Vienna and Zürich also participated in this study. HIV-1-prevalence is decreasing in the German cities, whereas the epidemiological development is not uniform in the other major cities. Regional differences are obvious. In 1991, the prevalence rates were as follows: Berlin 15% (n = 220), Hamburg 4% (n = 179), Frankfurt 17% (n = 167), Munich 9% (n = 136), Stockholm 10% (n = 79), Copenhagen 14% (n = 130), Vienna 20% (n = 56), and Zürich 23% (n = 84).

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Inflammatory cancer of the breast. Therapy and follow-up].

Inflammatory carcinoma has the highest mortality rate amongst the locally progressed cancers of the female breast. To define it, clinical, pathological and biological criteria have to be considered. The crucial finding is tumour-cell embolism in the subdermal lymphatics of the affected breast. 30 patients with inflammatory breast cancer were treated with three different concepts of therapy. In the first group, initial surgery (mastectomy with axillary dissection) was followed first by 6 cycles of chemotherapy, then by radiation of the thoracic wall, axilla and supraclavicular lymph nodes. The second concept included primary chemotherapy (6 cycles) with mastectomy/axillary dissection after the second or third cycles. In the third group, primary radiation of breast and axilla was performed, followed by 6 cycles of chemotherapy. From all three groups, 9 patients showed receptor-positive tumours; additional tamoxifen therapy (if postmenopausal) or GNRH-analogues (if premenopausal) were given. None of the three therapy managements could improve the average time of survival. Only the patients with hormonal therapy showed a better prognosis, which might well have been the result of a higher differentiation of the tumour. The study proves, that our efforts in therapy have so far been insufficient. Mastectomy, in particular as a psychically traumatizing procedure, fails to improve the patient's prognosis. It might regain its importance, when new, satisfactory methods of therapy of the systemic disease "inflammatory breast cancer" have been found. It is still uncertain, whether better prognosis can be achieved by a treatment with GNRH-analogues.

Adult↗
PubMed1992

Genotype/phenotype association in cystic fibrosis: analyses of the delta F508, R553X, and 3905insT mutations.

A striking clinical phenomenon of cystic fibrosis is the heterogeneous disease expression. It must therefore be assumed that the nature of the mutations associated with cystic fibrosis might partly determine the phenotypic manifestations. The relation between the cystic fibrosis mutations delta F508, R553X, and 3905insT and clinical parameters such as sweat test electrolytes, age at chronic Pseudomonas aeruginosa colonization, Chrispin-Norman x-ray scores, and relative underweight have been investigated in 45 patients homozygous for delta F508 (delta F2), in 12 compound heterozygotes for delta F508/R553X (delta F1/RX1), in three R553X homozygotes (RX2), and in 13 patients compound heterozygous for delta F508/3905insT (delta F16). We have found significant differences between the genetically defined subgroups concerning the mean age at onset and the cumulative incidence of chronic P. aeruginosa colonization and Chrispin-Norman x-ray scores. The significant results as well as some trends regarding the relative underweight demonstrate a milder clinical course in R553X heterozygotes and more severe disease in the delta F16 group compared to delta F508 homozygotes. The three patients homozygous for R553X presented with a two-stage course showing mild progression before P. aeruginosa infection and as severe a course as the delta F16 patients after P. aeruginosa colonization at the age of 12 y. The findings presented here indicate that specific mutations can influence the severity and progression of the disease, implicating the importance of mutation and haplotype analyses. However, wide variations within the genetically homogeneous subgroups illustrate that other determinants of the clinical status do exist.

Adolescent↗
PubMed1992

[Ectotoxin-forming pyogenic Staphylococcus aureus (S. aureus) as a cause of toxic shock syndrome (TSS) in man].

Basing considerations on an extremely carefully examined case of toxic shock syndrome (TSS), an analysis of this phenomenon is presented from the clinical and forensic points of view. TSS is often associated with the term "tampon disease" but in the meantime it has turned out that it may also arise as a non-menstrual disorder, caused by local infections, for example after surgical interventions. The inevitable symptoms include: fever, exanthema, desquamation on the palms of the hands and soles of the feet as well as hypotension. The clinical symptoms would initially suggest a septic process, however bacteriological investigations (blood cultures) normally produce negative results. At the source, however, ectotoxin-producing staphylococci (S. aureus) are found. The present case which is described in detail involves a 17-year old woman who had contracted a crucial ligament injury at the knee of the right leg when playing football. She died a few days after the operation, her death being accompanied by high fever. In smears from the area of the operation it was possible to identify staphylococci (S. aureus) which by phagetyping determination were classified as belonging to lysogroup type II/71 and which produced ectotoxin B. It was not possible to culture bacteria from blood from the corpse. Criminal proceedings for involuntary manslaughter were in the end dismissed although the accused resident physician was sentenced to pay 30,000 DM damages to the parents of the young woman. He also had to pay the costs of the civil action incidental to the criminal proceedings.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Late fatality after CO poisoning].

The report involves a 57-year-old man who was released from in-patient treatment relatively free of complaints 3 days after an attempted suicide with carbon monoxide. After a trouble-free interval, however, more and more organic brain symptoms accompanied by spasms appeared. In the end, the patient died 2 months later of an intermittent fulminating terminal embolism of the pulmonary artery with a thrombosis in the veins of the lower extremities. The clinical course and the anatomicopathological findings are discussed from the pathophysiological point of view. The question of a causal relationship between the "attempted suicide and lethal outcome" had to be answered in the affirmative as regards the insurance law aspects.

Brain↗