Dumping after homicide using setting in concrete and/or sealing with bricks--six case reports.

Homicide with subsequent hiding of the body using setting in concrete or sealing with bricks are rarely seen forensic cases. The article describes the circumstances and findings of six cases in which bodies were encased with concrete and/or bricks. In all cases, the offenders were male, in one case together with his wife and--except for one case--the victims were related to the offender. The causes of death were heterogeneous (suffocation, blunt force, shot) and the motive mainly domestic quarrel. Setting corpses in concrete and/or sealing with bricks does not prevent smell, slows decomposition and therefore complicates the estimation of the post mortem interval.

Strength and ductility with {10͞11} - {10͞12} double twinning in a magnesium alloy.

Based on their high specific strength and stiffness, magnesium alloys are attractive for lightweight applications in aerospace and transportation, where weight saving is crucial for the reduction of carbon dioxide emissions. Unfortunately, the ductility of magnesium alloys is usually limited. It is thought that one reason for the lack of ductility is that the development of - double twins (DTW) cause premature failure of magnesium alloys. Here we show with a magnesium alloy containing 4 wt% lithium, that the same impressively large compression failure strains can be achieved with DTWs as without. The DTWs form stably across the microstructure and continuously throughout straining, forming three-dimensional intra-granular networks, a potential strengthening mechanism. We rationalize that relatively easier slip characteristic of this alloy plastically relaxed the localized stress concentrations that DTWs can generate. This result may provide key insight and an alternative perspective towards designing formable and strong magnesium alloys.

[Retinal bleeding and venous stasis in a 10-month-old infant after a fall?]. / Retinale Blutungen und venöse Stase bei einem 10 Monate alten Säugling nach Sturz?

This report describes the case of a 10-month-old infant, who was delivered to our hospital by the emergency physician intubated and in an unclear unconscious state. The father reported that the child had fallen from the couch to the ground. The consulted ophthalmologist reported venous stasis in both eyes including intraretinal and preretinal bleeding in all four quadrants, a diffuse vitreous hemorrhage in the right eye and temporal retinal wrinkling in both eyes. Based on these particular clinical findings a shaken baby syndrome was suspected. This report demonstrates the importance of recognizing and correctly interpreting the typical ophthalmological signs of physical child abuse in order to detect and prevent further mistreatment of children; moreover, the increasing importance of photographic documentation and histological work-up of the findings for forensic reasons are emphasized.

Phase I and pharmacokinetic study of docetaxel and irinotecan in patients with advanced solid tumors.

PURPOSE: We conducted a phase I and pharmacokinetic study of docetaxel in combination with irinotecan to determine the dose-limiting toxicity (DLT), the maximum-tolerated dose (MTD), and the dose at which at least 50% of the patients experienced a DLT during the first cycle, and to evaluate the safety and pharmacokinetic profiles in patients with advanced solid tumors. PATIENTS AND METHODS: Patients with only one prior chemotherapy treatment (without taxanes or topoisomerase I inhibitors) for advanced disease were included in the study. Docetaxel was administered as a 1-hour IV infusion after premedication with corticosteroids followed immediately by irinotecan as a 90-minute IV infusion, every 3 weeks. No hematologic growth factors were allowed. RESULTS: Forty patients were entered through the following seven dose levels (docetaxel/irinotecan): 40/140 mg/m(2), 50/175 mg/m(2), 60/210 mg/m(2), 60/250 mg/m(2), 60/275 mg/m(2), 60/300 mg/m(2), and 70/250 mg/m(2). Two hundred cycles were administered. Two MTDs were determined, 70/250 mg/m(2) and 60/300 mg/m(2); the DLTs were febrile neutropenia and diarrhea. Neutropenia was the main hematologic toxicity, with 85% of patients experiencing grade 4 neutropenia. Grade 3/4 nonhematologic toxicities in patients included late diarrhea (7.5%), asthenia (15.0%), febrile neutropenia (22.5%), infection (7.5%), and nausea (5.0%). Pharmacokinetics of both docetaxel and irinotecan were not modified with the administration schedule of this study. CONCLUSION: The recommended dose of docetaxel in combination with irinotecan is 60/275 mg/m(2), respectively. At this dose level, the safety profile is manageable. The activity of this combination should be evaluated in phase II studies in different tumor types.

Metabolism of irinotecan (CPT-11) by CYP3A4 and CYP3A5 in humans.

7-Ethyl-10[4-(1-piperidino)-1-piperidino] carbonyloxy-camptothecin (CPT-11), a DNA topoisomerase I inhibitor, undergoes several metabolic pathways to generate conjugated and unconjugated derivatives that could be excreted from the body. The objective of this study was to determine the oxidative metabolites of CPT-11 recovered in human urine samples and to identify cytochrome P450 (CYP) involved in their formation. In addition to the already known metabolites of CPT-11 [SN-38, SN-38-G, 7-ethyl-10-[4-N-(5-aminopentanoic acid)-1-piperidino]carbonyloxycamptothecin (APC), and 7-ethyl-10-(4-amino-1-piperidino) carbonyloxycamptothecin (NPC)], we isolated three oxidized metabolites from the urine of two children and two adults given CPT-11. M1 and M2 (molecular weight, 602) were hydroxylated, respectively, on the CPT moiety and on the terminal piperidine ring of CPT-11. M3 had a molecular mass of 602, but its urine concentration in patients was too low to establish its chemical structure by liquid chromatography/mass spectrometry. In vitro incubations with cells expressing CYP2C8, CYP2C9, CYP1A1, CYP1A2, or CYP3A7 did not produce any detectable metabolites. Only CYP3A4 produced both APC and NPC, resulting from the oxidation of the piperidinylpiperidine side chain of CPT-11 along with metabolite M2. The metabolism of CPT-11 by CYP3A5 was markedly different because neither APC or NPC nor M2 was produced, whereas only one new metabolite, M4 (molecular weight, 558), was generated by de-ethylation of the CPT moiety. No previous study has reported the presence of the M4 metabolite. Production of APC, NPC, M2, and M4 was prevented by ketoconazole, a specific CYP3A inhibitor. The parameters of CPT-11 biotransformation into M2 and M4 were examined using cell lines expressing, respectively, with CYP3A4 and CYP3A5, indicating that CPT-11 is preferentially metabolized by CYP3A4. In conclusion, CYP3A plays a major role in the metabolism of CPT-11, with some differences of the metabolic profile exhibited by 3A4 and 3A5.

New aspects concerning the morphology and significance of coronary muscle bridges.

Intramural courses of the coronary arteries in the sense of coronary muscle bridges are frequent autopsy findings, whereas only the more pronounced forms are accessible to clinicoangiographic detection. Functional significance is attributable to morphologic forms that show a pronounced intramural course and to those exhibiting quantitative cross-sectional changes. In addition to the known morphometric findings in the case of coronary muscle bridges, we found a stenosis-like narrowing of intramurally coursing arteries without alterations of the intima. We observed such quantitative coronary artery findings in four cases with different causes of death, and in this paper we discuss the possible functional significance of this special type of coronary muscle bridge.

[Morphometrical examinations in cases of stenosing coronary sclerosis and their importance for evaluation of competing causes of death (author's transl)]. / Morphometrische Untersuchungen bei stenosierender Koronarsklerose und ihre Bedeutung für die Bewertung konkurrierender Todesursachen.

Coronary sclerosis is generally supposed to be the most important factor for coronary thrombosis, myocardial infarction and coronary heart death. Stenosing coronary sclerosis may be postmortally documented by angiography and morphometry. It is possible to obtain sufficient morphological data to suggest acute cardiac insufficiency, if the maximum grade of stenoses as a functional parameter and the heart weight are regarded in addition to the quantitative results of the three main branches of the coronary arteries (lumen and intima areas). Generally the cardiac results of autopsy are used individually and subjectively for the explanation of the cause of death. The conclusiveness of these results of autopsy depends on the circumstances of death and the existence of further pathological findings. Competing causes of death may exist in the form of illnesses, injuries, alcoholic and drug effects, physical strain and emotional stress or medical provisions. The quantitative valuation of the cardiac findings with a critical limit for an acute coronary death permits a more exact interpretation of such competing causes of death. This method of examination may also reveal an unpresumed competing cause of death, for example an intoxication. This was demonstrated by four autopsy cases.

Differential diagnosis SIDS/non-SIDS on the basis of histological findings of petechial thymus hemorrhages.

Petechial thymus hemorrhages are found most frequently in SIDS (87%), and very much more rarely in fetuses after abortion and stillbirths (55%) as well as in perinatal deaths (40%). In these groups, there was a uniform histological bleeding pattern with emphasis on the cortical zone. In non-SIDS deaths of natural causes or extrinsic suffocation in babies and infants, it could be demonstrated in 39%. In extrinsic suffocation, the thymus hemorrhages were mostly less pronounced in quantitative terms than in SIDS. In non-SIDS (without extrinsic suffocation), a hemorrhage pattern different from SIDS could be detected with hemorrhagias of different sizes and irregularly distributed over the cortex and medulla.

Multiple homicides as a result of chloroform poisoning: case report and experimental study.

Two cases (involving five murder victims) of multiple homicide by inhalational chloroform intoxication are reported. In the discussion of the findings the valence of toxicological analyses is underlined with regard to the possibility of forcible external suffocation due to occlusion of the respiratory orifices by means of a chloroform-soaked soft covering. In addition storage experiments were performed at +4, +20 and -20 degrees C with cadaver blood mixed with chloroform. The optimal solution for avoiding volatile losses was stored in glass tubes with ground glass stoppers. In cases of unclear death in which involvement of volatile substances is suspected it is, therefore, advisable to preserve an additional blood sample at -20 degrees C in glass tubes that are only opened for the analysis of volatile substances.

Histomorphologic studies of the glottic region to elucidate the pathogenesis and functional significance of fibrinoid vocal cord lesions in infants and young children.

Focal lesions of the vocal cord in form of fibrinoid necrosis and thickening of the basement membrane are morphological findings in infants and young children that receive only scant attention and are also controversially valued. We discuss two causes for the pathogenesis of these findings: (1) recurrent laryngospasms and (2) a laryngeal phonotrauma resulting from frequent spells of shrill, presumably high-frequency crying. The aim of our study therefore was to gain insight into the development and functional significance of these lesions by examining their histological patterns and to draw the pertinent conclusions. In 56 deaths (natural and unnatural causes, fetal life up to 4 years, no pathological or traumatic laryngeal lesions) histological investigations were carried out on putrefaction-free material. For the histomorphological studies, horizontal sections through the region of the vocal cord were obtained and stained according to conventional and immunohistochemical staining methods. In 42 cases the thickness of the basement membrane was determined morphometrically. In 12 of the 56 cases (21%) we observed staged variations of focal lesions, ranging from fibrinoid necrosis to degenerative lesions with pronounced macrophage involvement and deposits of PAS-positive plaques. Measurements at the basement membrane revealed a thickness of 7.9 microm. Separate measurements at the anterior and posterior portions of the vocal fold showed a ratio of 1.7:1. When the cases were subdivided into those with and without fibrinoid necrosis the ratios were 2.5:1 and 1.5:1. This different pattern makes it unlikely that laryngospasm is the sole or essential cause. Pathogenetically more important might be phonatory overstraining due to maximum vibrations in only the anterior portions of the vocal fold, which is not specific for later SIDS victims. This assumption is also supported by the often observed conspicuous phonetic behavior of some later SIDS victims and the absence of these stage-like vocal cord lesions in stillborns and adults. It is presumably an age-specific, temporary finding which is completely reversible.

Traumatic venous aneurysm of the popliteal vein with outcome: a case report and review of the literature.

A case of sudden death due to recurrent pulmonary thromboembolism is described. The fatality took place three and a half weeks following blunt trauma to the left popliteal region. The patient died unexpectedly. Autopsy revealed the source of the emboli as a sacciform venous aneurysm of the popliteal vein, an entity seldom described, but important to consider in cases of soft tissue popliteal masses or unexplained pulmonary embolism, especially in otherwise healthy individuals.

[Criminal process record Winckelmann (Triest, 1768). Comments on the criminal process dealing with the murder of Johann Joachim Winckelmann from the forensic historical and legal medicine viewpoint]. / Prozessakte Winckelmann (Triest, 1768). Anmerkungen zum Kriminalprozess gegen den Mörder Johann Joachim Winckelmanns aus forensisch-historischer under rechtsmedizinischer Sicht.

Johann Joachim Winckelmann, German historian of ancient art and archaeologist, was born on 9 December 1717 in Stendal, a town in Saxony-Anhalt. At the age of 50 he was murdered on 8 June 1768 in a Trieste hotel. The voluminous original record of the criminal proceedings against his murderer, Francesco Arcangeli, was presumed lost for about 150 years. A new edition in the wording of the original text appeared in 1964. This long sought historical document gives cause for forensic-historical reflections under consideration of the autopsy protocol about Winckelmann, which is likewise a historical document. A considerable change of paradigm in comparison to current autopsy protocols is observed with regard to the evaluation of injuries and the circumstances of death.

[The hydrodynamic effect of gunshots in cranial explosive shots]. / Beitrag zur hydrodynamischen Geschosswirkung bei Schädel-Sprengschüssen.

Case report on five fatal gunshot injuries in which discharge of the cranial contents had occurred owing to a skull blast. Despite an appreciable explosive action with destruction of the bony cranium, the brains were not completely destroyed. In analogy to the "Krönlein shot", comparative reflections were made concerning wound ballistics. The case reports show that injury patterns resembling "Krönlein shot" may arise in cranial blast shots in rare cases despite destroyed projectile parts and even in a mouth shot.

[Irrational behavior in exposure to cold. Paradoxical undressing in hypothermia]. / "Kälteidiotie". Paradoxes Entkleiden bei Unterkühlung.

One December morning the naked bodies of two alcoholics were found on an open place in the center of the city of Essen. The phenomenon of paradoxical undressing due to vital hypothermia is described and the significant influence of alcohol on hypothermia and confusion in connection with hypothermia is pointed out. Compared to the results of other authors, external and internal signs of lethal hypothermia were analysed in a retrospective series of 30 cases (autopsy material in the region of Essen, investigation period from 1979-1989).

[Fatal violence by adolescents toward children--sexual motivation is in the foreground]. / Tödliche Gewalt von Jugendlichen an Kindern--Sexuelle Motivation im Vordergrund.

In seven cases, obtained from the autopsy material of two German institutes of forensic medicine (Hamburg and Berlin-East) the circumstances of manslaughter committed by youth versus children are presented. There is a tendency of sexual background in such an offender-victim-constellation. The cause of death was strangulation in most cases; the perpetrators intended to conceal the sexual misuse. Such cases are very rare; epidemiological conclusions concerning escalating violence of the youth cannot be drawn.

[Rare suicidal death by electrocution using a timer and vital reaction]. / Seltener suizidaler Stromtod mittels Zeitschaltuhr und vitaler Reaktion.

A case of seldom electrocution by using a timer is presented being carried out from a 35 year old woman, who didn't have any professional background. As the fundamental histological result and classical vital reaction a bone marrow embolism was found. Circumstances, results and line of argumentation are presented in detail and discussed.

[Case report of pathologic and criminal self injury]. / Kasuistischer Beitrag zur krankhaften und kriminellen Selbstbeschädigung.

A case of morbid self-violence (Münchhausen Syndrome) leading to death and a case of criminal self-violence (cutaneous emphysema) are reported. The issue of such cases is discussed with regard to the consequences concerning judicial procedure of punishment and insurance.

[Death in the milieu of homeless persons. A comparative retrospective analysis of an autopsy sample of different regional population structures (Middle Hessia/Hamburg)]. / Tod im Obdachlosenmilieu. Vergleichende retrospektive Analyse eines Sektionsgutes unterschiedlicher regionaler Bevölkerungsstrukturen (Mittelhessen/Hamburg).

For an evaluation concerning different regional population and community characteristics, 23 fatalities of homeless individuals were selected from the current autopsy series of the Institutes of Legal Medicine of Giessen/Germany and Hamburg/Germany from 1990 to 1996. The outcome of this retrospective analysis enables to overcome the deficiency of knowledge of causes, manners and circumstances of death among homeless individuals.

[Murder of children by children and adolescents--a rare crime]. / Tötung von Kindern durch Kinder und Jugendliche--ein seltenes Delikt.

Nine case reports obtained from the autopsy material of three German institutes of forensic medicine are presented to illustrate the rare offense "killing of a child by a child" and compared with data from the criminal statistics of the police. In addition, age-specific peculiarities, including adolescence, are also discussed.

[Satellite dish as source of electric current. Case report of a fatal and nearly fatal accident at the work site]. / Satellitenschüssel als Stromquelle. Kasuistik eines tödlichen und beinahe tödlichen Unfalls am Arbeitsplatz.

The authors report on an initially unrecognized fatal accident caused by electric current at the place of work. The source of the current was a satellite dish which had been improperly connected to an old music box with subsequent connection to the household electrocution system (220 V, 50 Hz). Only when a second nearly fatal accident occurred, proper diagnosis and detection of the uncommon source of the electric current was made.