[Unusual gunshot injuries]. / Ungewöhnliche Schussverletzungen.

When patients with gunshot injuries are medically treated, it is also important to examine the wound itself to achieve further information concerning the distance and direction from where the bullet was fired. Besides that, it must be remembered that the bullet does not necessarily penetrate the target in a linear direction, but there can be various curves and angles in the bullet channel and subsequently adjacent organs injured.

[Limiting costs of implanted defibrillators]. / Zur Begrenzung der Kosten bei implantierbaren Defibrillatoren.

The use of implanted defibrillators is increasing recently. In view of the costs of a gadget, which amount to DM 40,000 to 45,000, arises the questions which juridical requirement have to exist, that after the death of a patient it is possible to reuse a still functional defibrillator. The solution should be that the health insurance keeps the property, whereas the patient receives merely the defibrillator as loan.

[Drinking trials for back calculation in long elapsed time intervals]. / Trinkversuche zur Rückrechnung bei langen Rückrechnungszeiten.

By evaluating 100 drinking experiments the formula put forward by Zink and Reinhardt for calculating the BAC at the time of the incident (maximum BAC = BAC at the time of blood sampling + 0.2/1000 per hour + 0.2/1000 added value for the first hour) was tested for its validity in cases when long time spans have to be taken into consideration. This evaluation showed that in cases of high BACs the elimination rate of ethanol during 8 or 9 was even higher than expected when the formula was applied. Even when increasing the additional value for the first hour to 0.3/1000, the calculated maximum BAC did not match the actual BAC measured in all cases.

[Sudden cardiac death and occupational activity]. / Plötzlicher Herztod und berufliche Tätigkeit.

4578 persons who died suddenly from natural reason were dissected in the Center of Legal Medicine of the University of Frankfurt am Main between 1979 and 1988. Among those were 2542 with sudden cardiac death. In 776 cases a relation between the occupation and the danger of dying of a sudden cardiac death could be proved. All the others had to be eliminated of the statistics, either because they were already retired when they died or because the occupation couldn't be found out. Altogether 142 different occupations were registered. A great percentage of the dissected people were construction workers, members of the safety duty and the transportation business and managers. Also butchers, bakers and cooks appeared quite often in the exploration, but never a shoemaker or a theologist.

[Psychotic intoxication and a psychotic episode]. / Psychotischer Rausch und psychotische Episode.

A man 27 years with a breath alcohol concentration of 0.7 g/kg had delusional ideas and other signs that indicate a psychotic intoxication. By the end it was a psychotic episode however concerning a patient with a polytoxicomania--the drugs were alcohol, cocaine, and Phencyclidine. There are no indications for the primary manifestation of a psychosis.

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).

[Multifactorial studies of 154 fatalities of psychotropic drug poisoning]. / Multifaktorielle Untersuchungen von 154 Rauschmitteltodesfällen.

The documents of 154 drug victims dissected in the Centre of Legal Medicine of the University of Frankfurt am Main in 1987 and 1988 were examined by computer. The average age i.e. was 26 years, the share of women 23 per cent. In 47 per cent the main cause of death was an overdoses of heroin and in 48 per cent heroin was the first drug that was taken. 58 per cent of the drug victims came from totally intact families.

[Criminal law and forensic medicine in the 16th century]. / Das Strafrecht und die Rechtsmedizin im 16. Jahrhundert.

At the Reichstag of Regensburg the Constitutio Criminalis Carolina was declared empire law in 1532. This was the most important impulse for the development of the legal medicine in Germany as the courts now found themselves constrained to hear physicians, barber surgeons or midwives in cases of abortion, infanticidal, poisoning, murder or manslaughter. Article 147 was chiefly significant because it fixed that in killing crimes the cause of death had to be ascertained by versed medical persons. The consequences for the opinions of the medical experts in the 16th century were examined by evaluating court records from the municipal archives of Frankfurt am Main. It was found out that the medico-legal investigations in cases of killing crimes always were carried out by committees consisting of several barber surgeons. In difficult cases a physician, an academic educated medical person, joined the committee. In the trial the physicians and barber surgeons as experts were interrogated as witnesses and they based on examinations of the victim's lifetime, on autopsies and partial autopsies.

[Alcohol in Turkish society]. / Der Alkohol in der türkischen Gesellschaft.

Since the ruin of the Osmanic empire increased the consumption of alcohol in Turkey considerably. Besides the national drink Raki it concerns above all the consumption of beer in the last two decades. The reasons are alterations of the society in the urbanized regions, the consequences are mighty increasing problems with alcoholics, especially among those, who come from the country into the cities, and among women.

[Blood collection from cadavers]. / Die Leichenblutentnahme.

Withdrawals of blood from corpses are mainly for determinations of blood alcohol but also for toxikological analyses and blood-typing. When the legal conditions for the withdrawals of blood were discussed the technique of withdrawal and the problems of evaluation are debated. Thereby alterations of the samples through putrefaction are especially considered.

[Determination of age based on the skeleton]. / Ein Beitrag zur Bestimmung des Lebensalters bei Skeletten.

A skeleton is reported that was found 40-100 cm under the surface of the earth; the light, porous bones had partially fallen to pieces. The most remarkable point was the discrepancy between the age of the bone and that of the teeth: based on the bones, the age of the living human being was about 30-40 years; on the basis of the teeth, however, the person was much older. The matter was cleared up with the help of a neck chain that was a precursor to the torques worn by the Celts; thus the skeleton was about 2500 years old. As the teeth were worn down much more through more use in prehistoric times than they are today, the age of the living person is likely to be the bone age, which was about 35 years.

[The significance of shock mechanisms for the alcohol opinion (author's transl)]. / Die Schockmechanismen in ihrer Bedeutung für die alkoholbegutachtung.

The alcohol level interpretation on shocked persons concerns almost exclusively cases with hypovolemic shock. For that reason the mechanisms of shock are explained mainly in relation to hemorrhagic shock. With regard to the blood alcohol curve in shock the following points are to be noted: (1) the centralization of the circulation in shock; (2) the alterations of the conditions for the alcohol absorption during the shock; (3) the fact that the liver is a so-called shock organ; and (4) the hemodilution in shock. In a given case besides individual factors the alcoholizing phase at the beginning of the shock and the severity of the shock are the most important circumstances. In severe shock there is the possibility for a temporary considerable decrease and for a long-term plateau of the blood alcohol curve.