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Biomedical subjects

B Madea

Publications and source records attributed to B Madea.

At least 19 recordsLinked to original sources
PubMed1991

[Postmortem behavior of impulse transmission latency--impulse transmission strength curves].

Strength-duration curves (i/t-curve) are describing the dependence of the threshold intensity of rectangular impulses from their duration; in clinical neurophysiology they help to clarify whether a muscle is denervated or not. In the post-mortem interval from 2 to 9 hpm the pm. changes of strength-duration-curves were investigated on 17 bodies; muscular contraction was objectified using a sensitive force transducer pricked into the muscle. The muscle was stimulated with constant-current rectangular impulses of 5 to 1000 msec. duration and current intensities which produce a force of muscular contraction of 2.5 mN each half an hour. The strength-duration-curves of human bodies taken at the earliest possible time p. m. (2 hpm) show already the pattern of partially or total denervation (steep rise of threshold values for duration of stimuli shorter than 100 msec). As for the rheobase there is a strong linear relationship between ln of the threshold and time since death for duration of stimuli below 1000 msec. Extrapolation of the time since death on the basis of threshold values of different duration of stimulations of an i/t-curve reveals only small rise of precision of death time estimation compared to extrapolation of the time since death just with the rheobase.

Adolescent↗
PubMed1991

[Suicide with a self-constructed shotgun].

A 56 year old man committed suicide in his car with a self constructed weapon ("gun"). Construction and function of the self made gun as well as the main gunshot injuries are described.

Firearms↗
PubMed1990

[Use of rectal temperature-time of death nomograms at the scene of death].

The application of the rectal temperature time of death nomogram at the scene of death by 11 authors from 6 lego-medical institutes resulted in a standard deviation of the differences between nomographic and real death time of +/- 1.3 h in 46 cases (group I) with met requirements and clearly defined points of contact, nevertheless, including 9 cases with a more progressive cooling (0.5 greater than Q greater than or equal to 0.2). In cases with a real death time of more than 4h (N = 26) the standard deviation was +/- 1.0 hours corresponding to permissible variation of 95% of +/- 2.0 hours. Consequently, the permissible variation of 95% was much smaller than that suggested by the nomogram. The nomographic death time interval did not agree with the real one in 5 cases out of additional 30 cases with recognizably unsure points of contact (group II).

Body Temperature Regulation↗
PubMed1990

[HIV-1 prevalence in deaths caused by drug overdose in various large cities of West Germany and West Berlin between 1985 and 1988].

The development of the HIV-1-prevalence among drug deaths (n = 753) in several German cities (West Berlin, Frankfurt, Munich, Hamburg, Bremen, Cologne and Stuttgart) from 1985 to 1988 was evaluated; in 1988 43% of 674 deceased drug addicts were examined. The regional prevalence rate was between 15 and 25%; only in Berlin 42% of the drug deaths were HIV-infected (cumulated data of all cities over the 4-year-period: 26%). There was no uniform or steady regional development of HIV-1-prevalence in the different cities. The ratio men/women among drug deaths was 3:1. The HIV-1-prevalence among males was 22%, among females 40%. HIV-infected individuals were 2-3 years older than seronegatives. Predictions concerning the trend of prevalence rates are not possible up to now. Continuous monitoring of the HIV-status of drug deaths seems to be a worthful method to evaluate the spread of this disease among the risk group of intravenous drug addicts.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Postmortem behavior of the rheobase].

Own investigations on the postmortem rise of muscular threshold were conducted on 20 bodies with exactly known time of death. Muscular contraction was objectified using a sensitive force transducer. The muscle was excitated using rectangular impulses of 1 second duration of a current intensity which produces a force of muscular contraction of 2.5 mN. These excitations were continued over the postmortem interval until a current intensity of 80 mN doesn't cause a contraction of 2.5 mN any more. Investigations were mainly performed at the thenar muscles. There is a linear relationship between ln of muscular threshold (current intensity) and the time since death (r = 0.965). For any case the linear regression line between ln of muscular threshold and time since death was calculated. With mean values for slope and intercept the time of death was calculated for each measured threshold. Extrapolation of the time since death with mean values also for the slope reveals a much more precise estimation of the time since death than an extrapolation with an individual slope as proposed by Joachim and Feldmann (1980). The method was proved on a random sample of 8 practical cases. The real time since death was always within the 95%-limits of confidence of the extrapolated time since death.

Adult↗
PubMed1990

Electrical excitability of skeletal muscle postmortem in casework.

UNLABELLED: The paper gives a review of the development of methods of postmortem electrical excitability of skeletal muscle for determining the time since death. For practical application in casework, the following method can be proposed: position of electrodes in the orbicularis oculi muscle, stimulation by rectangular impulses of 10 ms duration, 30 mA in a repetition rate of 50/s. The muscular reaction on excitation is graded in 6 degrees according to the spread of movement and the intensity of contraction. To each degree a time information is corresponding (95%-limits of confidence). These 95%-limits of confidence were proved to be valid for cases of sudden natural or traumatic deaths. EXCLUSIONS: deaths after chronic lingering disease (shorter times), fatal hypothermia, haematomas, emphysemas of the eyelid (longer times). The practical application in casework together with the temperature method (Henssge 1988, 1) is described. Applying both methods the death time estimation in the early postmortem interval may be much more precise and accurate than using one method alone.

Electric Stimulation↗
PubMed1990

Precision of estimating the time since death by vitreous potassium--comparison of two different equations.

The precision of death time estimation by vitreous potassium using two different formulas [1-3] is compared on an independent random sample of 100 cases. The very flat slope in Sturner's equation is the reason for a systematic overestimation of the time since death with much wider 95%-limits of confidence compared to the results using an own equation with a steeper slope of vitreous potassium.

Forensic Medicine↗
PubMed1990

Search for early lesions following human immunodeficiency virus type 1 infection. A study of six individuals who died a violent death after seroconversion.

Histologic studies supplemented by in situ hybridization for human immunodeficiency virus type 1 (HIV-1), Epstein-Barr virus, cytomegalovirus, and human herpesvirus type 6 were performed on tissues obtained from the autopsy of six patients who died either by homicide or suicide shortly after learning of their seroconversion. Except for mild nonspecific lymphoid tissue reactions, no lesions were noted that would indicate HIV-1 infection. DNA from all viruses was detected in some lymphoid cells. The amount of DNA for Epstein-Barr virus, cytomegalovirus, and human herpesvirus type 6 corresponded to that observed for clinically occult latent infection. Lymphoid cells carrying HIV-1 DNA were even less frequent. Cells positive for HIV-1 were noted in the lamina propria of the large intestine in three male homosexuals and in one female prostitute. The cells were arranged similar to antigen-presenting cells. The present findings are consistent with current theories regarding the pathogenesis of HIV-1-associated disease.

Adult↗
PubMed1990

[Practical value of post-mortem electrical excitability in determining time of death].

In 35 cases (about 200 single excitations) electrical excitibility of mimic muscles was reexamined according to the method developed by Klein and Klein (1978) with subjective grading of muscular reaction according to the intensity and spread of movement. Instead of "rectangular-like impulses" of some ms duration in a repetition of 30 to 70/sec and 50 V constant-current rectangular impulse of 1 sec duration and 30 mA were used. Nevertheless the determination of the time since death is valid within the calculated 95%--limits of confidence. The 95%--limits of confidence are not valid for cases of fatal hypothermia: here are longer (and shorter) times possible for the special degree. In our opinion examination of electrical excitibility belongs to the minimal standard of methods to be used for determining the time since death in the early postmortem interval. This is discussed in 17 cases where the dates for the special degree of electrical excitability could narrow down the time period since death given by the nomogromn method.

Adult↗
PubMed1990

[Parameters for determining the time of death from post-mortem muscle contraction--precision of assessing time of death].

The objectified muscular contraction on excitation with rectangular impulses of 1 sec duration and definite current intensity is in its postmortem course characterised by: 1. Change of the shape of muscular contraction (time-course of muscular contraction) from a two peak to a one peak shape 2. postmortem decrease of the maximum force of muscular contraction on definite current intensity 3. increase of the relaxation time of muscular contraction. On an random sample of fifty bodies decrease of the maximum force and increase of the relaxation time as criteria for extrapolating the time since death were investigated. The extrapolation was performed on the basis of the regression between ln of the maximum force and time using the mean values for slope and intercept and the regression between ln of the relaxation time and the ln of the time since death respectively using the mean values for slope and intercept too. On fifty bodies the calculated 95%--limits of confidence are +/- 2.85 h (decrease of the maximum force) and +/- 2.7 h (increase of relaxation time) up to 13 hpm. The calculated 95% limits of confidence were examined on an independent random sample of 20 bodies and proved to be reliable.

Electric Stimulation↗
PubMed1990

[Calcium concentration in vitreous humor--a means for determining time of death?].

Several authors are in agreement that there is no relationship between calcium concentration in vitreous humor and time since death. Nowak and Balabanova (1989) however established such a relationship on a random sample of 19 cases suffering from heart disease (coronary occlusion) and quote Coe (1969, 1972) who "described also a correlation between PMI and calcium" which is completely wrong. The results of Nowak and Balabanova are compared to own results (n = 270, 69 deaths due to coronary artery disease), results of Sturner et al. (1972) and Schmidt (1988). In conclusion there is a statistically significant correlation between calcium concentration in vitreous humor and PMI (r = 0,356) but the range of scatter of the individual calcium values over the PMI is so great that it becomes clear that vitreous calcium is no aid in estimating the time since death.

Calcium↗
PubMed1990

[Postmortem increase in the galvanic threshold].

The investigations of Joachim and Feldmann (1980) on the postmortem rise of muscular threshold were examined on a random sample of 20 bodies with known time of death. Muscular reaction on excitation was objectified using a sensitive force transducer pricked into the muscle (mostly thenar). The muscle was excitated (each half on hour) using rectangular impulses of 1 sec. duration with a current intensity which causes a muscular contraction of 2.5 mN until a current intensity of 80 mA doesn't reach this force any more. Ln of muscular threshold and time since death show a strong linear relationship (r = 0.965). Time since death was extrapolated with mean values for slope and intercept (calculated from the random sample) for all measured values of muscular threshold. Extrapolation from a single value with mean values also for the slope reveals a much more precise estimation of the time since death than extrapolation with an individual slope (according to Joachim) which requires repeated measurements of muscular threshold in an interval of 30 minutes. The procedure was examined at a random sample of 8 cases. The real time since death war always within the 95% limits of confidence of the calculated time since death.

Electric Stimulation↗
PubMed1990

[Iatrogenic cardiac tamponade in lung embolism].

A 65 year old man with diffuse pleural mesothelioma suffering from acute dyspnoea and chest pain underwent pericardiocentesis to withdraw pericardial effusion. After some mispunctures blood was withdrawn. Exitus in tabula. At autopsy cardiac tamponade with two cuts of the right ventricle. Pulmonary thrombembolism of the right lung. Advanced diffuse pleural mesothelioma with infiltration of lung, mediastinum, pericard, cuirrassing of left pulmonary artery and descendent aorta thoracica. The connection between iatrogenic cardiac tamponade and death couldn't be established without any doubt in the presence of a concurring cause of death (massive pulmonary thrombembolism).

Aged↗
PubMed1989

[An unusual finding in a case of hypothermia].

Suicide was initiated by several incisions in the skin; the resulting hypovolemia resulted in fatal hypothermia. The unusual autopsy findings in this case due to hypothermia were focal hemorrhages and necrosis of the pancreas and hemorrhagic infarction of the descendending colon. The pathophysiological relevance of the autopsy and histological findings are discussed.

Colon↗
PubMed1989

References for determining the time of death by potassium in vitreous humor.

The different statements concerning the slope and intercept of the regression line and the 95% limits of confidence are the reason that potassium in vitreous humor is not used (at least in Germany) as an aid in estimating the time of death. The relationship between the concentration of potassium and the time of death is mainly influenced by antemortem electrolyte imbalances caused by disease and/or duration of terminal episode. The influence of terminal episode is best identified by its duration (Adelson et al., J. Forensic Sci., 8 (1963) 503-514). In order to have a method suitable for every case and to be as precise as possible we looked therefore for parameters in vitreous humor which were stable postmortem and indicating antemortem electrolyte imbalance. Urea is such a parameter, being stable postmortem (Coe, Am. J. Clin. Pathol, 51 (1969) 741-750) and useful as a marker of antemortem electrolyte imbalance. Our investigations on potassium in vitreous humor, including sudden and hospital deaths after chronic lingering disease, revealed 95% limits of confidence of +/- 34 h up to 120 h postmortem. Reviewing only cases with urea less than 100 mg/dl the 95% limits of confidence could be reduced to +/- 22 h. Considering the duration of terminal episode (less than 6 h) the precision was +/- 20 h. In this way our modified procedure is suitable for every case with the resulting precision of estimation being determined only by the duration of the terminal episode and urea concentration.

Death↗
PubMed1989

[Postmortem electrical excitability of skeletal muscle--obtaining precision with reference to influencing factors].

The objective measurement of electrical excitability alone does not solve the problem of the great interindividual variability of the duration of electrical excitability. The whole material was divided into three groups according to the deep rectal temperature at the beginning of the investigation. In these subgroups the interindividual variability of the duration of electrical excitability could be diminished from 8 hours to 4 hours.

Adult↗
PubMed1989

[Objective assessment and quantification of postmortem muscle contraction to electrical stimulation].

UNLABELLED: The muscular contraction on electrical stimulation (rectangular impulses of 1 s duration, 2 to 80 mA current intensity) was objectified using a sensitive force transducer. RESULTS: The shape of the muscular contraction (time course) is changing over the postmortem interval with two peaks (opening and closing contraction according to Pflüger's law) in the early postmortem interval and only one peak in the later postmortem interval. The relaxation period of muscular contraction is increasing over the postmortem interval. The maximum force developed during muscular contraction on definite current intensity is decreasing over the postmortem interval. Increase of the relaxation period a decrease of the maximum force in response to a definite current intensity are criteria allowing a determination of the time since death on an objective basis.

Electric Stimulation↗