[Homicides committed by women in the area served by the Munich Institute of Legal Medicine]. / Vorsätzliche Tötungsdelikte von Frauen im Einzugsgebiet des Instituts für Rechtsmedizin München (1990-2010).

According to crime statistics only a small percentage of intentional killings are committed by women. Female emancipation has not changed this finding. In spite of numerous studies in the field of psychiatry and social criminology there are few systematic investigations analyzing homicides committed by women under medico-legal aspects. The presented data include 127 homicides committed by female offenders, which were assessed at the Munich Institute of Legal Medicine between 1990 and 2010. The results of the evaluation are presented with regard to the type of offence, the motive, the means and method used to commit the offence and the sentence imposed.

Position sensitive measurement of lithium traces in brain tissue with neutrons.

PURPOSE: The application of lithium is well known to have an antimanic-depressive effect, however, the influence it has on the human brain is still insufficiently known. The aim of our work is to develop a method to investigate the lithium concentration in the human brain with a very high sensitivity and a submillimeter resolution. Present methods either do not provide spatial resolution or are not sensitive enough to measure the naturally occurring lithium content in the human brain. Our method provides the opportunity to perform postmortem series measurements and obtain a detailed map of the lithium distribution in the human brain. This way possible correlations of the lithium distribution in the human brain and biological reasons for affective disorder can be clarified. METHODS: To study the lithium distribution in different regions of the human brain the authors developed a method to measure lithium traces postmortem with a submillimeter spatial resolution using the neutron capture reaction (6)Li(n, α)(3)H. The lithium is measured by coincident detection of the alpha particles and tritons, emitted in opposite directions. The general concept, the preparation of the brain samples, the experimental setup at the measurement station of the Forschungs-Neutronenquelle Heinz Maier-Leibnitz, and a first measurement on human brain tissue are presented. RESULTS: A first measurement on a brain tissue sample nicely showed a spatial distribution of lithium down to a few hundreds of pg∕cm(3) with a maximal resolution of about σ(x) = σ(y) ≈ 200 µm. Also a direct correlation of lithium and optical tissue structure is observable. Typical measurement times of a few minutes allow for series measurements of up to 20 × 20 mm(2) large samples with a thickness of w = 10-20 µm in medical studies. CONCLUSIONS: The combination of a very high lithium sensitivity with position resolving measurement makes this method well suited for postmortem studies of the microscopic lithium distribution in the human brain and thus to form a microscopic picture of the impact of lithium in different areas of the human brain.

Diffusion-tensor imaging of human articular cartilage specimens with early signs of cartilage damage.

PURPOSE: To assess the use of diffusion-tensor (DT) imaging of articular cartilage to detect and grade early cartilage damage in human specimens with early signs of cartilage damage. MATERIALS AND METHODS: This study was approved by the institutional review board. Forty-three cartilage-on-bone samples drilled from 21 human patellae were examined with 17.6-T magnetic resonance (MR) imaging and a diffusion-weighted spin-echo sequence (spatial resolution, 50 × 100 × 800 µm). Subsequently, samples underwent histologic analysis with safranin O staining. Cartilage damage on safranin O histologic slides was quantified with Osteoarthritis Research Society International (OARSI) grades; grades ranged from 0 (healthy) to 6 (bone remodeling). Maps of longitudinal diffusivity (λ(l)), transverse diffusivity (λ(t)), mean diffusivity (MD), and fractional anisotropy (FA) were calculated. Cartilage was segmented, and region of interest (ROI) analysis was performed and compared with histologic findings. Significant differences in MR parameters between the OARSI groups were assessed with the Tukey test. The value of DT imaging in the diagnosis and grading of cartilage damage was assessed with logistic regression analysis. RESULTS: Samples had OARSI grades of 0 (n = 14), 1 (n = 11), 2 (n = 12), 3 (n = 4), and 4 (n = 2). Samples with an OARSI grade greater than 0 had significantly increased λ(l), λ(t), and MD (7%-25% increase) in the superficial cartilage growing deeper into cartilage with increasing OARSI grade. Samples with an OARSI grade greater than 0 showed significantly decreased FA in the deep cartilage (-25% to -35% decrease), suggesting that changes in the collagen architecture may occur early in cartilage degradation. DTI showed excellent performance in the detection of cartilage damage (accuracy, 0.95; 41 of 43 samples) and good performance in the grading of cartilage damage (accuracy, 0.74; 32 of 43 samples). CONCLUSION: DT imaging of articular cartilage can enable physicians to detect and grade early cartilage damage.

Multi-element stable isotope analysis of H, C, N and S in hair and nails of contemporary human remains.

This paper presents a comparison of the isotopic ratios of hydrogen, carbon, nitrogen and sulphur of three pairings of hair and nail tissue taken from contemporary human remains. Our aim was to examine the possibility of a direct comparison of isotopic data in hair with that of nail tissue for forensic purposes. The results indicate that stable isotope ratios of the elements were best comparable between human scalp hair longer than 3 cm and the distal end of the nails. There were no distinct variations between finger and toenails. Our isotopic data for bulk hair and nail confirmed that hair samples were slightly enriched in (13)C but depleted in (15)N compared to nail samples. Furthermore, our data reveal that δ(34)S values in nail samples were more variable than in hair samples. Direct comparison of the corresponding segments of hair and nail samples may be difficult due to individual differences especially for δ(15)N and δ(2)H. Hair may have an isotopic composition more consistent with the ingested food within a specific time than is provided by nail. It can be concluded that once a hair is formed, no further metabolic changes of the isotopic pattern should occur. Nevertheless, our data suggest that there was a change in isotope ratios particularly for δ(2)H along the hair shaft. Interpretation of the isotope data in corresponding segments of hair and nail for forensic purposes must consider particular variations, especially for chronological considerations.

Ultra-high field diffusion tensor imaging of articular cartilage correlated with histology and scanning electron microscopy.

OBJECT: To investigate the relationship of the different diffusion tensor imaging (DTI) parameters (ADC, FA, and first eigenvector (EV)) to the constituents (proteoglycans and collagen), the zonal arrangement of the collagen network, and mechanical loading of articular cartilage. MATERIAL AND METHODS: DTI of eight cartilage-on-bone samples of healthy human patellar cartilage was performed at 17.6 T. Three samples were additionally imaged under indentation loading. After DTI, samples underwent biomechanical testing, safranin-O staining for semiquantitative proteoglycan estimation, and scanning electron microscopy (SEM) for depicting collagen architecture. RESULTS: From the articular surface to the bone-cartilage interface, ADC continuously decreased and FA increased. Cartilage zonal heights calculated from EVs strongly correlated with SEM-derived zonal heights (P < 0.01, r (2)=0.87). Compression reduced ADC in the superficial 30% of cartilage and increased FA in the superficial 5% of cartilage. Reorientation of the EVs indicative of collagen fiber reorientation under the indenter was observed. No significant correlation was found between ADC, FA, and compressive stiffness. CONCLUSIONS: Correlating ADC and FA with proteoglycan and collagen content suggests that diffusion is dominated by different depth-dependent mechanisms within cartilage. Knowledge of the spatial distribution of the DTI parameters and their variation contributes to form a database for future analysis of defective cartilage.

Change of diffusion tensor imaging parameters in articular cartilage with progressive proteoglycan extraction.

OBJECTIVE: To investigate changes of diffusion tensor imaging (DTI) parameters (mean apparent diffusion coefficient [ADC], fractional anisotropy [FA], and first eigenvector) with increasing proteoglycan (PG) extraction of articular cartilage. MATERIAL AND METHODS: Twelve cylindrical cartilage-on-bone samples were drilled from 4 human patellae (3 per patella). Each sample was divided into 2 pieces. One piece underwent histologic examination to assess the PG content of the native sample by safranin-O staining and its collagen architecture by polarized light microscopy. The other underwent magnetic resonance imaging (MRI) at 17.6 T for DTI measurement. After MRI, 2 of the 3 samples from each patella were immersed in a dilute trypsin solution (0.1 mg/mL), whereas the third sample was kept as a negative control in physiological saline. After incubation (6, 48, 72, and 96 hours), the samples were reimaged, stained for PG content and for the collagen orientation. Maps of ADC, FA, and the orientation of the first eigenvector as well as histology were available for each sample before and after incubation. RESULTS: PG loss led to increased ADC and reduced safranin-O staining from the articular surface to the bone-cartilage interface. A significant correlation (r(2) = 0.86, P < 0.01) was observed between the change in bulk ADC and PG loss. Regional analysis from the articular surface to the tide mark demonstrated depth dependent significant correlations of ADC and PG loss. FA and first eigenvector as well as polarized light microscopy showed only small changes in the order of magnitude of measurement errors, not correlating with PG loss. CONCLUSION: Mean diffusivity evidence by the ADC is linearly correlated to progressive PG extraction in articular cartilage. FA and the first eigenvector seem to be specific to the collagen architecture of cartilage. DTI has the potential to become a valuable biomarker for the workup of cartilage degeneration in osteoarthritis, since evaluation of the PG content and collagen architectural properties of cartilage can be performed with a single, non­contrast-enhanced proton-based MRI measurement.

Characterization of osteoarthritic and normal human patella cartilage by computed tomography X-ray phase-contrast imaging: a feasibility study.

OBJECTIVES: Early research in phase-contrast imaging indicates that substantial higher soft-tissue contrast resolution can be obtained compared with conventional absorption radiography. In the present feasibility study, we used the phase contrast analyzer-based technique in tomographic mode to investigate whether structural cartilage matrix properties can be depicted in an ex vivo set-up and whether high resolution CT-phase contrast imaging may enable differentiation of osteoarthritic and intact cartilage matrixes. MATERIAL AND METHODS: Four postmortem osteochondral cylinders (7 mm diameter, 2 osteoarthritic, 2 healthy control samples from 4 human patellae) underwent tomographic phase-contrast analyzer-based imaging at high resolution (voxel size: 8(3) micron3) at 26 keV (European Synchrotron Radiation Facility, Grenoble, France). From the acquired data volumes, sets of reconstructed sagittal slices were selected at 0.5 mm increments from osteoarthritic and control specimens. Two independent, blinded observers assessed structural characteristics (cartilage thickness, topographic chondrocyte distribution homogeneity, zonal height, and surface damage) and differences between the 2 groups were determined. RESULTS: Phase contrast analyzer-based CT showed excellent depiction of the complete volume and of the 3D architecture of the cartilage in all samples. A distinct zonal pattern in the cartilage matrix could consistently be visualized. The osteoarthritic samples showed significantly lower chondrocyte distribution homogeneity (0% vs. 76% homogeneous, P < 0.001), less chondrocyte alignment (0% vs. 59% fully aligned, P < 0.001), lower height of tangential, transitional, and radial zones (all P < 0.001) and a higher prevalence of superficial cartilage damage (84% vs. 10%, P < 0.001). CONCLUSIONS: This first proof-of-concept study demonstrates that high resolution phase contrast CT visualizes structural details in relatively thick ex vivo cartilage samples. Our results suggest that the technique permits differentiation of osteoarthritic and healthy cartilage by enabling assessment of histologic characteristics of cartilage structures.

Voxel-based reproducibility of T2 relaxation time in patellar cartilage at 1.5 T with a new validated 3D rigid registration algorithm.

OBJECT: T2 relaxation time is a promising MRI parameter for the early diagnosis and follow-up of osteoarthritis. Assessing the evolution of osteoarthritis needs exact comparison of datasets acquired at different times and knowledge of the T2 reproducibility. The aims of this work were to establish a method for voxel-wise comparison of T2 datasets and to assess voxel-based T2 reproducibility in healthy patellar cartilage. MATERIALS AND METHODS: A new rigid 3D-registration algorithm was developed. The precision of the registration algorithm was calculated with numerical simulations and in vitro measurements. In vivo T2 reproducibility was assessed in six volunteers measured at seven different times. The voxel-based reproducibility was characterized with the coefficient of variation (CV) of T2, and its regional variations were analyzed. RESULTS: The registration algorithm showed an average registration precision lower than 25% of the voxel size. In vivo voxel-based T2 reproducibility exhibited a median CV of 10.1%. Reproducibility showed significant regional differences. Largest CVs (15.4%) were found near the articular surface. The central regions showed the lowest CVs (7.2%) and the lateral regions intermediate CVs (11.2%). CONCLUSION: Using a rigid 3D-registration algorithm provides voxel-based T2 reproducibility errors comparable to former, 2D region-based approaches, thus opening the possibility of voxel-based monitoring of cartilage degradation in osteoarthritis.

[Suicidal gunshot to the nape from a small-bore rifle]. / Suizid durch Gewehrschuss in den Nacken.

A 55-year-old man was found dead on the bed lying on his side in a pool of blood with a bullet entrance hole in the nape. Behind his body, a semi-automatic rifle Remington Nylon, cal. .22 LR, was detected. As the gunshot entrance site was rather unusual for suicide, a forensic autopsy was performed, which showed a contact shot to the nape with the bullet path running upward to the left frontal area. The man had been treated with citalopram for delusional depression, so that a suicidal act seemed plausible, and the autopsy and criminalistic findings were also compatible with this assumption. A remarkable fact of the present case is that a long firearm had been used. Reports on suicidal shots to the nape are comparatively rare in the medicolegal literature and usually refer to pistols or revolvers.