Quality of heroin and heroin-related deaths from 1987 to 1995 in Vienna, Austria.

AIMS: To investigate the quality of heroin seized in Vienna between 1987 and 1995 and to examine whether there was a relationship between the quality of heroin and the rate of drug-related deaths. DESIGN: Reports of heroin seizure analysis and post-mortem reports of heroin-related deaths in Vienna from 1987 to 1995 were analysed. RESULTS: There were 386 seizures of heroin comprising a total weight of 25 640.12 g heroin. All the seizures were in the base form. All seizures also contained a diluent, mainly lactose. Additionally, in 95 seizures caffeine, in four seizures paracetamol and in three seizures metaqualon were detected. Of a total of 764 drug-related deaths 506 cases were classified as heroin-related deaths. In 336 cases other central nervous system-depressant drugs and/or alcohol could be detected in the blood in addition to morphine (polydrug heroin-related deaths). There was evidence of a trend towards greater polydrug involvement during the study period. The age of victims of polydrug heroin-related deaths remained unchanged over time while the age of victims of pure heroin-related deaths decreased significantly. The morphine concentration in the medulla oblongata in heroin-related deaths decreased significantly. Finally, there was no statistically significant relationship between the rate of heroin-related deaths per year and the diacetylmorphine concentration of heroin seizures in that year. CONCLUSION: The results did not substantiate the widely held belief that increases in heroin-related deaths could be explained by an increase in the quality of heroin.

[Endogenous strangulation caused by fibromatosis colli]. / Endogene Strangulation durch Fibromatosis colli.

The case report is presented of fatal endogenous strangulation of a seven week-old male infant due to a fibrous sternomastoid tumour. Postmortem examination showed severe congestion of the cerebral veins and conjunctiva with ecchymoses just like after use of concentric force against cervical viscera. On the basis of the results of the histological examination, the possible influence of birth trauma on the aetiology of this type of fibromatosis is discussed.

[Deviations in findings in hanging by interposition of fingers between noose and neck]. / Abwandlung der Erhängungsbefunde bei Interposition von Fingern zwischen Schlinge und Hals.

Fingers wedged between loop and neck produce a characteristic modification of the morphological pattern: in the area where the ligature mark is interrupted there are vertical or oblique impressions, of the width of a finger, that tend to brown-dry only to a slight degree. Between these impressions are ridged strips with ecchymoses and/or blisters filled with serous fluid. The interposed fingers themselves may show vesiculose raised epidermis distally from the ligature groove. The paper demonstrates the macround microscopical findings in 5 cases. In 3 of the 5 cases there was a high degree of intoxication, so that it cannot be ruled out that these suicides, because of staggering, fell into the noose when still engaged in preparing the suspension.

[Aspects, findings and problems in criminal cadaver dismemberment]. / Aspekte, Befunde und Problematik bei krimineller Leichenzerstückelung.

Nine cases of defensive corpse dismemberment are reported. Twice offensive components were regarded. All victims were identified within a short time. Eight crimes were solved, in six cases there had been a relationship between the murderer and the victim. One corpse was dismembered by means of an explosive.

[6 cases of premeditated murder of adults by drowning]. / Sechs Fälle vorsätzlicher Tötung Erwachsener durch Ertränken.

Premeditated murder of adults by drowning is rare and hard to investigate. Six cases are reported. If the aim of the killer is homicide by drowning to begin with (primary drowning), it is usually difficult to prove as morphological findings are missing of may be insignificant and ambiguous. If, on the other hand, the killer opts for drowning only as a conclusion to a primarily differently planned assault (e.g. strangling), the finding patterns are different, and their interpretation is usually easier (secondary drowning).

[Simulation of an attack by self-mutilating cuts and stab wounds]. / Vortäuschung von Uberfällen durch eigenhändig zugefügte Schnitt- und Stichwunden.

Self-inflicted cut or stab wounds may be used by the injured to make credible a feigned assault. In such cases the alleged traces of the crime are found on the body and the clothing of the informant. Occasionally the very pattern of the injuries points to self-infliction. For example the following findings may be indicative of self-infliction: a greater number of very superficial wounds, wounds parallel or grouped, mostly located on the left side of the body (in right-handers) or symmetry in arrangement, intact clothing or lack of correspondence between wounds and damage of clothing, absence of typical defence and protection injuries. In the light of 4 cases observed from the material at hand, special features of the lesion appearance are shown and possible motives for the deed discussed.

[Pump-gun as a weapon. Type of injuries, prohibition of weapons]. / Pumpgun--Waffe, Verletzungsbilder, Waffenverbot.

Pumpguns are shotguns with pump action whose injuries and wound mechanisms have several special features: extremely high kinetic energy of the shot (2500 to 3500 J) frequent cases of "Krönlein shots" (exenteration of the brain) punchmark/imprint immediately adjacent to the entrance wound from the front of the pipe magazine exit wounds from buckshot may be similar to pellet entrance injuries from a distant shotgun discharge the use of various shotgun cartridges (plastic ammunition, slug bullet, various lead pellets) within the same weapon. The change in the Austrian gun law and the banning of the pumpgun in 1995 is also discussed in the article.

Delayed cardiac rupture due to blunt chest trauma.

A 7-year-old boy fell from a 2.5-m height and suffered contusion of the thorax with hematoma in the soft tissues of the lateral chest wall. The rib cage itself remained intact. After 3 days, there was only local pressure sensitivity of the left hemithorax. On day 8 after the trauma, the child, who up to then had seemed to be in good health, suddenly died during lessons at school. Autopsy revealed a full-thickness rupture of the left ventricle with resultant cardiac tamponade. The macroscopic and histopathologic findings are presented and discussed.

[2-stage rupture of the liver as a complication of external heart massage]. / Zweizeitige Leberruptur als Komplikation der äusseren Herzmassage.

A delayed rupture of the liver after resuscitation is reported. In the case of a 27-year-old woman, pulmonary embolism was followed by asystolia, which was remedied by external cardiac massage. This procedure caused ruptures of the liver, which first led to the formation of a subcapsular hematoma and 5 1/2 hours later, due to a secondary rupture of the capsule, led to internal bleeding and death. Degenerative changes of the parenchyma cells in the vicinity of the rupture were recognized, as well as fibrin separations on the detached Glisson's capsule, as signs of a survival period of several hours. Histological investigation of the lungs revealed a hepatocellular embolism and--in the absence of rib or sternum fractures--fat and bone-marrow embolisms. The morphological findings are discussed with reference to pertinent reports in the literature.