The German Stain Commission: recommendations for the interpretation of mixed stains.

In the course of forensic DNA analysis, the interpretation of DNA profiles of mixed stains, i.e. cell material from more than a single donor, has become increasingly more important. The German Stain Commission, a joint commission of Institutes of Forensic Science and Legal Medicine, has therefore developed guidelines aiming to harmonize the evaluation of mixed stains in German criminal cases.

[Patients' mailbox and electronic prescription]. / Patientenfach und elektronisches Rezept.

Electronic prescribing shall contribute essentially to improved healthcare services from 2006 onwards in Germany. The desired improvements, however, can only be achieved with "real" telematic solutions. The alternative of pharmaceutical prescription transmission via secure network connections or via electronic health card provides a considerable empowerment to the patients. Electronic prescribing, however, does not provide direct advantages to patients. Benefits for them can be realised by a drug documentation system, ready to identify contraindications or multiple prescriptions. The patients' acceptance of the system to be established therefore largely depends on the concurrent introduction of both elements.

Textbooks on legal medicine in the German-speaking countries.

In this survey, the textbooks on legal medicine which were published in the German-speaking countries from the 17th century up to now are briefly reviewed. The textbooks with the most impact on the further development of legal medicines were those published by Johann Ludwig Casper in Berlin and Eduard Ritter von Hofmann in Vienna in the 19th century. The main textbooks of the 20th century are addressed as well, also the different development in both German countries.

Paternity testing using Y-STR haplotypes: assigning a probability for paternity in cases of mutations.

In parentage testing with male children, Y-chromosomal STR evidence is gaining more and more importance. In some cases, multilocus haplotypes of related persons can differ at a single locus due to a mutation. In this work, a likelihood approach is presented for the calculation of a probability for paternity under consideration of a single mutation event on the Y-chromosome. The new methodology is applied to two case examples.

Evaluation and application of the AmpF/STR profiler plus PCR amplification kit in a Bavarian population sample.

Allele frequencies for the nine tetrameric STR loci D3S1358, VWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317 and D7S820 were determined in a population sample of 155 unrelated Bavarians using the AmpF/STR Profiler Plus PCR amplification kit. No deviations from the Hardy-Weinberg equilibrium were observed. The influence of the PCR cycle number as well as the template DNA concentration on the performance of the kit was studied. DNA concentrations lower than 75 pg DNA per 25 microliters reaction volume resulted in allelic drop-out.

Identification of the skeletal remains of Martin Bormann by mtDNA analysis.

Contrary to statements of an eye-witness who reported that Martin Bormann, the second most powerful man in the Third Reich, died on 2 May 1945 in Berlin, rumours persisted over the years that he had escaped from Germany after World War II. In 1972, skeletal remains were found during construction work, and by investigating the teeth and the bones experts concluded that they were from Bormann. Nevertheless, new rumours arose and in order to end this speculation we were commissioned to identify the skeletal remains by mitochondrial DNA analysis. The comparison of the sequence of HV1 and HV2 from the skeletal remains and a living maternal relative of Martin Bormann revealed no differences and this sequence was not found in 1,500 Caucasoid reference sequences. Based on this investigation, we support the hypothesis that the skeletal remains are those of Martin Bormann.

Y-chromosomal STR haplotypes in a population sample from Bavaria.

The seven Y-chromosomal STRs DYS 19, DYS385 I/II, DYS389 I/II, DYS390, DYS391, DYS392 and DYS393 were amplified using two multiplex PCRs. The optimization of the PCR conditions led to reliable and sensitive systems. Co-amplification of the amelogenin locus was possible in both multiplex systems. In a population sample of 151 Bavarian males, a gene diversity of 0.99 was observed. Sensitivity studies revealed a detection limit of 50 pg DNA per 25 microl reaction volume. PCR experiments with combinations of male/male and male/female DNA showed that in male/male mixtures, the minor component could be detected up to a ratio of 1:15, whereas in male/female mixtures the male component could be found in a higher ratio up to 1:60.

The diagnostic significance of haemorrhage of the posterior cricoarytenoid muscles.

A number of authors have indicated that haemorrhage of the posterior cricoarytenoid (PCA) muscles can be used as a diagnostic criterion to establish the cause of death. Other authors even consider it to be 'forensic evidence' when differentiating between natural and violent death. They agree on agonal asphyxia or dyspnoea as a developmental mechanism, possibly in combination with a 'convulsive' dilatation of the glottic cleft. In view of this difference of opinion, we conducted a study of our own. Retrospective evaluation of 2060 post-mortem examinations performed in 1996 at the Institute of Forensic Medicine of the University of Munich disclosed 28 cases demonstrating visible haemorrhage of the PCA muscles. The study revealed no correlation between these findings and certain causes of death, nor any indication of certain mechanisms of development.

Hydrocution in a case of Coxsackie virus infection.

An apparently healthy 7-year-old boy attempted to demonstrate his ability to dive into a whirlpool but was retrieved from the water in a state of unconsciousness after several minutes. Resuscitation was unsuccessful. No characteristic signs of drowning were found at the autopsy but examination of the lymph nodes and the cardiac muscle indicated a pre-existent infection. The histological examination revealed a slight degree of predominantly lymphocytic infiltration of the cardiac muscle. IgM antibodies against Coxsackie virus were detected in the serum sample by means of ELISA. The reverse transcriptase polymerase chain reaction (RT-PCR) performed on an extract of formalin-fixed, paraffin-embedded cardiac muscle tissue revealed a DNA sequence specific for Coxsackie B3 virus. Therefore, cardiac failure was due to a myocardial virus infection and the additional strain caused by diving. This case report emphasizes the importance of modern molecular biological methods in cases of sudden death including death by hydrocution.

Haemorrhages in the posterior cricoarytenoid muscles--an unspecific autopsy finding.

Atraumatic haemorrhages in the posterior cricoarytenoid (PCA) muscles can be observed for from 1% to 9% of various causes of death. It has been claimed that there is an association between these findings and the cause of death, particularly coronary death. Additionally it has been assumed that haemorrhages in the PCA muscles may be caused by an asphyxial mechanism and it has even been suggested that the haemorrhages may be a "sign" which could be used to differentiate between natural and unnatural death. Because of the differing views we carried out additional research into the course of these haemorrhages. Six characteristic cases out of 2060 autopsies with macroscopically diagnosed haemorrhages in the PCA muscles are presented. The six cases included acute heart failure, death caused by bolus, drowning, trauma of brain and skull, exsanguination from polytrauma and choking after aspiration of vomit. These cases were completely different with regard to all the circumstances of death. On the basis of these findings and in contrast to the literature it cannot be shown that proofs exist for a correlation between the haemorrhages and the causes and the manner of death. As a consequence it must be stated that haemorrhages in the PCA muscles do not have any diagnostic significance.

Variations of the frontal exit of the supraorbital nerve: an anatomic study.

Until now, it has been taken for granted that the point of emergence of the supraorbital nerve is by way of a notch or a foramen at the border of the inner to the medial third of the supraorbital rim. In contrast to several anatomic textbooks, we noticed that the exit point was repeatedly not at the site where anticipated when implanting lid springs for facial palsy. This gave us the idea of investigating these variations and how big they are, because most open and recent endoscopic forehead lift techniques have relied on a constant exit point of the supraorbital nerve. A total of 507 macerated skulls (1014 orbits) from three anatomic collections in Austria and Germany were studied. All skulls were adult European skulls gathered from the prehistoric age up to the twentieth century. Additionally, 18 fixed cadavers (36 orbits) and 25 fresh cadavers (50 orbits) were studied. These data were not included in the statistical analysis but in the discussion. The anatomic measurements on the skulls were carried out with an anthropometric calliper. The examinations concentrated on the configuration (notch/foramen) and the number of exit point(s) on the supraorbital rim, the vertical distance from the supraorbital rim, and the distance from the nasion to the various exit point(s). Combining all of these parameters, 74 percent of the skulls showed asymmetric findings between the right and left orbits. In 15 percent of both orbits, the supraorbital nerve left the orbital cavity already in its two branches, the medial and lateral branch, either through a notch or a foramen, the foramen being sometimes the exit of a supraorbital canal. The average distance from the nasion to the frontal notch/foramen was 25 mm on both orbits (range 16 to 55 mm) and to the supraorbital notch/foramen 31 mm (range 20 to 49 mm). The largest vertical distance from the supraorbital rim to its farthest exit point was 19 mm. Other than what is cited in literature, the variations concerning the configuration and the distance of the exit point(s) of the supraorbital nerve were so significant that all forehead operations, especially those using endoscopic techniques, must take into account these findings.

DNA typing from stained sperm-positive vaginal smears: four rape cases.

DNA typing from stained sperm-positive vaginal smears was performed in four cases of sexual assault. In Cases 1 and 2, a 6-month-old and a 6-week-old, Papanicolaou-stained vaginal smear with 99% propanol fixation underwent DNA analysis respectively. In Case 1, the HLA-DQalpha type of the sperm fraction of the smear was able to be determined following PCR, and the possibility of the suspect being the rapist could not be excluded. In Case 2, the possibility that the suspect was the rapist in the crime was excluded based on the results of DNA typing by means of two different single-locus probes. In the remaining two cases, H-E-stained smears after air drying for 4 or 5 months were the material for DNA analysis, and DNA typing was attempted by PCR-based STR system. In Case 3, there was no genetic information from sperm fraction of the smear due to the small number of spermatozoa on the glass slide. Therefore, it was impossible to determine whether the suspect was the rapist or not. In Case 4, sperm DNA from the smear was amplified and typed, and the suspect could be excluded. These four cases demonstrate that stained vaginal smears containing many spermatozoa can be used for DNA analysis in sexual assault cases.

[Sudden death caused by an arterial hydatid embolism]. / Plötzlicher Tod durch arterielle Hydatidenembolie.

HISTORY: A 45-year-old woman from Turkey who had been living in Germany for 6 years, suddenly became short of breath, developed seizures and died within 2 minutes. There was no evidence of previous illness. INVESTIGATIONS: At autopsy a large hydatid and many other hydatids of varying sizes were found inside the left heart. Rupture of one of the hydatid cysts in the left atrium had caused embolism to the arterial system. The cyst walls showed typical laminar cuticular structure. The sediments of the cyst fluid contained scolices of Echinococcus granulosus, but no antibodies were demonstrated by indirect haemagglutination. DIAGNOSIS AND CONCLUSION: This is a rare case of Echinococcus granulosus infection, limited to the heart, which had followed an asymptomatic course until sudden death caused by arterial embolism of the hydatids. Such diagnosis should be considered in case of sudden death of persons from areas in which the disease is endemic.

Recombinant human Fab antibody fragments to HIV-1 Rev and Tat regulatory proteins: direct selection from a combinatorial phage display library.

A human Fab phage display library has been produced from peripheral blood lymphocytes of an individual who was asymptomatic after 10 years of infection with human immunodeficiency virus type-1 (HIV-1). The library was panned against the HIV-1 Rev and Tat regulatory proteins and several clones, producing Fab binding to these proteins, were isolated (3 to Rev and 4 to Tat) with binding constants varying from 10(-6)M to 10(-8)M. DNA sequencing demonstrated two unique anti-Rev Fab clones, but the four anti-Tat Fab comprised only two unique IgG1 heavy chain Fd fragments, illustrating redundancy of light chains. Peptide mapping of the epitopes recognized by these Fab indicated that three of the anti-Tat Fab were directed to the functional domain between amino acid residues 22-33 of the Tat molecule, and that binding was inhibited by reduction of this cysteine-rich region with dithiothreitol. The anti-Rev Fab were directed to sites adjacent to the Rev basic nucleolar localization sequence (residues 52-64) and to the Rev activation domain (residues 75-88). Binding constants were of a similar order to that of an anti-Rev single-chain Fv fragment (SFv) used successfully for intracellular immunization, and as such intracellular effects with the human anti-Tat and anti-Rev Fab are not precluded. These newly described human antibody fragments to HIV-1 regulatory proteins may be critical moieties for gene therapeutic protocols, to control HIV-1 replication in human cells.

Evaluation of MHS-5 in detecting seminal fluid in vaginal swabs.

Vaginal swabs taken in 211 cases of alleged sexual assault were examined for seminal vesicle-specific antigen (SVSA) using an MHS-5-ELISA (SEMA kit). The results were compared with those obtained by sperm detection by means of light microscopy and the acid phosphatase reaction (ACP), using Phosphatesmo-KM papers. Especially in fresher samples (duration of storage between 10 days and 2 1/2 months), a high degree of correlation was observed between the results of light microscopic and MHS-5 methods. Several cases with positive MHS-5 showed concurrent positive ACP reactions, even though no spermatozoa had been seen microscopically. The results are displayed in the light of time elapsed between the alleged assault and examination of the swabs. The longest time span after the alleged assault in which MHS-5 yielded a positive result was 47 h; in this case spermatozoa were also seen microscopically. SVSA is not totally stable in vaginal swabs stored over long (9 months to 5 1/2 years) periods of time. Furthermore, results in eight penile swabs are reported. MHS-5 is a useful tool for medico-forensic semen detection in vaginal swabs, probably even in cases of azoospermic or aspermia.

Characterization of haemorrhages at the origin of the sternocleidomastoid muscles in hanging.

Haemorrhages at the periostal-clavicular origin of the sternocleidomastoid muscles were found in 52 out of 54 cases of death by hanging. This cervical haemorrhage is most frequently found in death by hanging, but only seldomly seen in other causes of death and can therefore be regarded as being typical for death by hanging. The frequency of this finding on the side of the highest point of the ligature mark is significantly higher, thereby supporting the hypothesis of extension as the causative mechanism. External cardiac massage and assisted breathing have no influence on the occurrence of haemorrhages. Histology shows the haemorrhages to be mainly directly epiperiostal, however, many cases displayed concurrent sub- and intraperiostal extravasations. Artificial post mortem production of these findings is discussed in the light of the literature.

[Self-castration with suicide]. / Selbstkastration im Rahmen eines Suizids.

Suicide of a 31 year old man with multiple slashes and stab wounds including complete amputation of penis, scrotum and testicles is reported. Wound patterns in genital self-mutilations are discussed. Despite serious loss of blood the reported survival periods are remarkable; death from bleeding seems to be rare. A review of similar cases shows that self-castrations as well as other self-inflicted genital mutilations are usually associated with psychiatric disorders and transsexuality or hypersexuality.

The detection of petechial haemorrhages of the conjunctivae in dependency on the postmortem interval.

Petechial haemorrhages of the conjunctivae are not specific for lethal throttling or strangulation, but they belong to the important indicators for such mechanisms. In experimental models it is shown that petechial bleedings of the conjunctivae disappear with the occurrence of advanced signs of putrefaction or in cases of fresh-water logging. Therefore, it must be emphasized that the lack of petechial haemorrhages in putrefied or fresh-water-logged corpses is of very restricted meaning for the examination, whether throttling or strangulation has taken place or not, and the autopsy should always be performed in these cases with special regard to the neck.