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Biomedical subjects

M Risse

Publications and source records attributed to M Risse.

At least 19 recordsLinked to original sources

[Epidemiology and morphology of sudden death in infancy in twins and siblings].

429 SIDS cases were investigated in a retrospective study. For this study, the deaths in which at least one brother or sister had died under comparable circumstances were evaluated. The 429 babies who had died comprised 17 multiple birth babies (3.7%) including 15 twin and two triplet babies. Eleven cases (2.6%) were brothers or sisters of SIDS victims. In three cases, relatives of the baby's mother had died of sudden infant death. A comparison of the various case groups did not reveal any patho-morphologically significant differences between the groups or differences from other SIDS cases. All the multiple birth babies were immature and premature babies. There was a raised incidence of poor socio-economic conditions in the sibling group. The results are significant for parent counselling, any preventive measures and the detection of concurrent (in particular, unnatural) causes of death.

Autopsy

[Resuscitation measures and petechial thymus hemorrhages in sudden infant death].

In 45 cases of sudden infant death syndrome (SIDS) in which unsuccessful attempts at resuscitation had been made and in 21 cases without attempted resuscitation, systematic histological investigations were carried out on the thymus. In these investigations, petechial hemorrhages were detected in 82% of the cases with attempted resuscitation and in 76% of the cases without attempted resuscitation. The histological distribution pattern of the petechial thymus hemorrhages did not differ notably between the two groups. The pattern of findings indicates that the hemorrhages had already developed during the death agony and that the typical histological distribution pattern with an increased occurrence of petechial in the cortical zone was altered by massive attempts at resuscitation in individual cases.

Hemorrhage

[Age-dependent morphologic findings of the thyroid in sudden infant death].

Age (eight days to 12 months) and degree of colloid depletion or colloid content of the follicles (normal, partially depleted, depleted) were correlated on the basis of 176 thyroid investigations in cases of sudden infant death syndrome (SIDS). In the 176 SIDS cases, a resting thyroid gland with normal colloid content could only be found in 14%, whereas partially depleted follicles were found in 35% and depleted follicles in 51%. 60% of all cases showed a large degree of epithelial desquamation up to collapse of all follicles. A marked capillary hyperemia was found in 48%. 80% of the cases showed a normal colloid content in the first month of life, and colloidfree follicles should not be detected in any case. An increased incidence of thyroid activation was obtained in the total number of cases only from the second month of life. The histomorphological appearance of the thyroid gland thus corresponds to that of healthy infants only in the first month of life. The question as to why there is an evidently raised thyroid activity in the subsequent months of life in SIDS cases is discussed.

Age Factors

[Histologic findings in the esophagus in infancy. A contribution to the question of gastroesophageal reflux in sudden infant death].

In 53 mortalities (1 stillbirth, 2 neonates, 7 cases up to 5 years of age and 43 SIDS cases), systematic histological investigations were carried out on the esophagus. The results comprised a topography of epithelial defects and inflammatory wall changes. In the SIDS cases, focal epithelial defects could be detected in 14% and fresh inflammatory infiltrates in 7% without preferential localization. There were also lymphocytic reactions of varying extent (62%), but mainly in the upper one-third of the esophagus. Similar findings were found in the 10 non-SIDS cases. The results pattern is discussed with regard to its pathological relevance. It appears to be doubtful that the inflammatory changes are the result of reflux, as reflected in morphological terms.

Cause of Death

[Comparative histologic studies of the origin of petechial thymus hemorrhage].

Systematic histological investigations were carried out on the thymus with regard to the incidence and genesis of petechial thymus hemorrhages in 145 cases of death (fetuses from pregnancy terminations and stillbirth, mature and immature neonates, SIDS cases, other baby deaths, deaths during infancy and childhood). Petechial thymus hemorrhages were most frequently found in SIDS cases (87%). Even though distinguishable, a distribution pattern similar to that of thymus hemorrhages in SIDS cases (including hemorrhages mainly in the cortical zone of the lobes) could be detected in the group of fetuses from pregnancy terminations and stillbirth, as well as in mature and immature neonates. Histologically, deaths in babies and infants without extrinsic suffocation showed a different histological bleeding pattern (irregular hemorrhages of varying size in the cortex and medulla of the lobes). In violent extrinsic suffocation of babies and infants, thymus hemorrhages were much rarer and less pronounced in quantitative terms. Acute and subacute or chronic forms of asphyxia, the cause of death and the duration of the death struggle are discussed as pathogenetic factors to explain the different patterns of the findings.

Asphyxia

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.

Abortion, Spontaneous

[Injury pattern and identification after airplane catastrophies. Cooperation between forensic medicine and federal criminal investigations. An airplane accident in Mühlheim/Ruhr 8 February 1988].

On February 8th 1988, a two-motor passenger aircraft of Metroliner type with 21 people on board entered a front of heavy weather at an altitude of 900 m and crashed after being struck by lightning which led to complete breakdown of the electrical systems on board. The site of the crash was in the marshy Ruhr meadows. The formation of the terrain enabled a subdivision into plan squares for rescue. The identification of the 21 bodies was carried out in the Essen Institute of Forensic Medicine in collaboration with the identification commission of the Federal Criminal Investigation Office. The experience and recommendations for future (possibly larger-scale) disasters derived from this are described. Furthermore, the accident pattern in the casualties typical for this air crash is discussed.

Accidents, Aviation

[Agonal and postmortem movement sequences in hanging].

The agonal and supravital movement sequences documented are evaluated on the basis of a case of hanging which was recorded with a video camera. This is evidently an autoerotic accident which was initially misinterpreted by the police as suicidal hanging. The process of hanging documented in the film allows inferences with regard to the genesis of concomitant injuries during the various movement phases. In contrast to observations communicated so far in the literature, the inspiratory phase has particular significance. Moreover, the time course underscores the well-known loss of consciousness within seconds.

Accidents

[Quantitative morphologic studies of so-called dynamic, eccentric coronary stenoses in cases of acute coronary death].

The residual normal wall segment of an eccentric stenosis of the coronary artery can reduce the residual lumen by spastic contraction of the media. Such dynamic coronary artery stenoses may consequently cause or intensify myocardial ischemia or may lead to sudden coronary death due to dysrhythmia. In 39 cases of sudden coronary death, the histological cross section of extramural coronary arteries were measured by planimetry after postmortem coronary angiography. Of a total of 382 stenoses wit more than 45% narrowing, 178 (48.6%) were of the eccentric kind. These eccentric stenoses of the coronary artery were localized in the RIVA in 48%. On average, 4.5 eccentric stenoses were found in each case of coronary death. Eccentric stenoses with round (49.4) or elliptically situated (35,3%) restenoses was on average 30.5% of the residual lumen wall. The quantitative findings show that the high percentage of eccentric stenoses with a larger normal wall segment is of functional significance with regard to acute coronary deficiency. The morphological description and evaluation of the coronary sclerosis should also take into consideration the kind of stenosis.

Angina Pectoris

[Hemosiderin findings in the liver, spleen and lung in newborn infants and infants].

The content and distribution of hemosiderin in the liver, spleen and lungs of stillborn children, newborns and infants were determined histologically by Perl's method (Prussian blue reaction). We describe a study of 59 deaths up to the age of 2 years. The hemosiderin content depends on age and decreases with increasing age. No relevant differences were found in cases of sudden infant death syndrome (SIDS). In the liver hemosiderin is localized preponderantly in the periphery of the lobules. The spleen shows a diffuse siderosis of the red pulp. Minimal intrapleural, septal and perivasal depositions of hemosiderin can be found in the lung tissue. The significance of these findings is discussed.

Female

[Lipomatosis cordis as a cause of ventricular perforation in implantation of a pacemaker probe].

A case report is given on lethal perforation of the right ventricle during emergency implantation of a pacemaker probe. The forensic autopsy revealed extensive lipomatous infiltration of the right ventricle in the rupture area. Lethal complications occur occasionally in spite of the standardization of implantation techniques, especially as a result of reanimation attempts. Such cases are discussed with regard to the forensic aspects with reference to the literature. Lipomatosis cordis as "locus minoris resistentiae" has special significance for ventricular perforation.

Aged