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Biomedical subjects

O Peschel

Publications and source records attributed to O Peschel.

17 recordsLinked to original sources
PubMed1999

[When parents decide against therapy for the children. The case of Emil M.: a conflict between parents and medicine].

If parents refuse to allow an accepted, scientifically well-founded treatment for their child, and if this results in obvious negative consequences for the child's welfare, the physician can appeal to the family court. Before doing so, however, a detailed explanation of the situation and counseling of the parents is imperative. In an emergency that brooks no delay, however, the physician can carried out the treatment he considers absolutely necessary even against the wishes of the child's parents. If, as a result of unacceptable parental decisions--e.g. withdrawal of treatment from the child--harm to the child ensues, the parents can hardly be pursued by the law, since, according to the principles of criminal law, this would only be possible if it can be proved without a shadow of doubt that the treatment would definitely have prolonged the child's life, or with certainty protected it from some other prejudice.

Germany↗
PubMed1998

Histological markers in nasal mucosa of patients with Alzheimer's disease.

Neuropathological changes such as dystrophic neurites and the presence of abnormal tau protein in the olfactory system, including primary sensory cells and nerve fibres have previously been demonstrated in nasal mucosa tissue of patients with Alzheimer's disease (AD). These changes were detected in autopsy-derived material from histopathologically confirmed AD cases as well as in biopsy tissue from clinical severely ill AD patients. To investigate the potential usefulness for the early diagnosis of AD, we obtained biopsy tissue from olfactory mucosa from 5 clinically mild to moderate AD patients and stained for the presence of tau or beta-amyloid by immunocytochemistry using a panel of specific antibodies. No positive staining was found in any of the cases. For comparison, post-mortem olfactory tissue from AD patients with severe neuropathological changes (widespread neurofibrillary tangles and amyloid in the brain) was investigated. In these severe cases, tau immunoreactivity was found in fine nerve fibres in the lamina propria and in a few olfactory epithelial cells. These results are consistent with other reports showing that cytoskeletal changes and tau pathology in the olfactory epithelium are not primary (or specific) features of AD and may occur predominantly in late stages of the disease.

Aged↗
PubMed1997

Self-mutilation with needles.

Two cases of self-mutilation with needles are reported. One of the deceased suffered from chronic schizophrenia and committed suicide by plastic bag suffocation. At autopsy several needles were detected grown into the connective tissue of chest or abdominal organs. In the other case a knitting needle was used for repeated manipulations at the forehead leading to a defect of the skin and the skull. At least one vessel was injured leading to an extensive haemorrhage in the left hemisphere of the brain. The forensic and etiologic aspects of the cases are discussed.

Aged↗
PubMed1995

Frequency of blood spatters on the shooting hand and of conjunctival petechiae following suicidal gunshots wounds to the head.

A total of 103 suicidal and 29 homicidal gunshot fatalities were evaluated. In 42% of the suicides, characteristic findings like blood spatters and/or powder soilings, could be found on the shooting hand by naked-eye inspection indicating the importance of an accurate examination of the deceased's hands at autopsy for a preliminary diagnosis. Petechial hemorrhages of the conjunctivae due to the gas pressure after discharge of the weapon were observed in 22% of those cases with contact shot wounds to the head/neck, but not in cases of distant shot injuries following the use of non-high velocity ammunition. Therefore, conjunctival petechiae can be regarded as an additional but optional sign of contact head shots in cases without alterations possibly influencing the development of conjunctival pin-point bleedings. The evidence of such findings can be of practical importance if the entrance shot wound cannot be examined for whatever reason.

Adolescent↗
PubMed1995

Injection of toxic agents: an unusual cause of death.

Self-injection of toxic substances is a rare method of suicide. Since only case reports exist in the forensic literature, an evaluation of the autopsy reports of the Munich Department of Legal Medicine in the period 1976-1994 was performed including 36 suicides and seven homicides due to injection of toxic agents. The majority of the decreased were physicians nurses or, in cases of homicidal intoxication relatives. The commonly used substances were anaesthetic drugs.

Adult↗
PubMed1995

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.

Adolescent↗
PubMed1994

[Rhabdomyolysis in neuroleptic therapy: an abortive malignant neuroleptic syndrome?].

We report on the case of a 24 year old female patient, who, at first developed during 8 weeks of neuroleptic therapy parkinsonism and then, after improvement of psychopathology an acute rhabdomyolysis. Hyper-Ck-aemia up to 11,340 U/l was observed. Laboratory parameters normalized shortly after neuroleptics had been withdrawn and no further complications followed. Symptomatology is discussed with special reference to the possibility of an abortive malignant neuroleptic syndrome.

Adult↗
PubMed1992

Determination of fetal age by immunohistochemical estimation of surfactant-producing alveolar type II cells.

We monitored the immunohistochemically determined amount of surfactant-producing alveolar type II cells in human fetal lung using polyclonal antibodies against apoprotein B and C of human pulmonary surfactant. Lungs of 30 dead-born fetuses without lung affection aged between 15 and 38 weeks of gestation were evaluated and the surface density of surfactant-producing alveolar type II cells was determined by morphometry. In lungs of fetuses with a gestational age less than 22 weeks no relevant number of positively reacting cells could be found. Between the 22nd and 29th week a progressive increase with considerable inter-individual variability was observed. From the 30th week on the number of the type II pneumocytes appeared rather constant without further significant increase. We provide evidence that the immunohistochemical detection of surfactant-producing alveolar type II cells is useful for the determination of the age of unknown and especially fragmented fetuses: The lack of surfactant-producing alveolar type II cells in fetal lungs before the 22nd week allows a rather safe distinction between fetal lungs of higher age from those of lesser age. Between the 22nd and 29th week an age-dependent increase in the number of these cells occurs with wide inter-individual variability allowing only an approximate age determination. In particular, this may be an important piece of information in fragmented fetal corpses. Furthermore, the number of surfactant-producing alveolar type II cells provides additional information on pulmonary maturation and may thus be helpful in the estimation of a theoretical survival chance.

Apoproteins↗
PubMed1992

[Isopropanol and acetone level in serum after preoperative surface disinfection with antiseptics containing isopropanol].

After preoperative skin disinfection in pediatric surgery, serum levels of isopropanol up to 12.2 mg/l (MW 5.0 mg/l +/- 3.37, n = 26) were found. They result from a rapid and prolonged but uncharacteristic percutaneous resorption of the isopropanol-containing disinfectant. In about 50% of the cases, serum levels of acetone showed an increase up to 82 mg/l already before skin disinfection, presumably caused by preoperative starvation. After skin disinfection, raised acetone levels were found in 19 of 26 cases. As increased isopropanol and acetone levels are discussed as alcoholism markers, a falsification of congener analysis after skin disinfection, e.g. in cases of adult victims of accidents, has to be taken into consideration. Endogenous serum levels of methanol (0.87 mg/l +/- 0.49), ethanol (0.32 mg/l +/- 0.09), acetaldehyde (0.31 mg/l +/- 0.10) and others remained unaffected. Some uncharacteristic elevations of propanol-1 levels are caused by contaminated rubber caps.

1-Propanol↗
PubMed1992

[Change in congener analysis caused by percutaneous absorption of propanol-containing antiseptics].

According to the forensic literature, an alteration of blood alcohol concentration through alcohol disinfection before venepuncture is unlikely, however, percutaneous resorption of alcohol containing antiseptics is well documented. There are no investigations available, elucidating to what extent this is also correct for congener alcohols, particularly propanol-1/-2, which have serum levels in range of mg/l. In experiments with surgical hand and local skin disinfection, carried out with and without oral alcohol, relevant levels of propanol-1/-2 between 0.2 and 2 mg/l were measured. We conclude, that the routine clinical use of antiseptics is able to alterate and to falsify congener levels and can lead to incorrect interpretation of congener analysis.

1-Propanol↗
PubMed1989

[Micromorphology of rigor mortis in human skeletal muscle].

Following our examination on rat muscle, it was investigated, whether alterations, observed in semi thin sections and by TEM could be used for forensic purposes. Investigated were extension of stiffened muscles. Samples of various muscle groups were taken at different time intervals before and after breaking the rigor muscle fibers. They were examined by light and electron microscopy. Results on the development and spontaneous disappearance of rigor mortis during the early and intermediate post mortem period are almost equivalent to those found by experiments on animals. Results concerning the breaking of rigor mortis, however, are sometimes considerably more discrete and diverge substantially. Because of artifacts, especially during the transport of the corpse, the interpretation is more difficult. The use of other techniques combined with drawing out muscle samples immediately at the place, where the corpse is found, may optimize the results.

Humans↗
PubMedDate not supplied

The drainage of cerebrospinal fluid into the lymphatic system of the neck in humans.

A histo- and immunohistochemical examination of the superior deep cervical lymph nodes was performed in a group of 19 patients who died from intracerebral haemorrhage. For comparison two control groups without cerebral lesions were studied (n = 17, n = 13). Free iron deposits as shown within the lymph nodes by Prussian blue reaction were seen significantly more often following intracerebral haemorrhage than without bleeding. The expression of CD 68 (a marker for macrophages) or CR 3/43 (microglia) gave a strong reaction, but there are no significant differences between the three groups. Glial fibrillary acidic protein was rarely seen in the three groups. Raising the CSF pressure results in increased CSF drainage into the cervical lymph nodes. The clinical importance of this lymphatic drainage suggests a communication between the brain and the immune system of the head and neck, with a possible selective up- and down-regulation.

Carcinoma↗
PubMedDate not supplied

[Suicidal gunshot wounds--site and characteristics].

117 gunshot suicides (111 male and 6 females) were investigated. The head was the most favorite site of the entrance wounds and some extraordinary cases were observed. 7 cases showed more than one gunshot wounds and in two of these suicides the second shot was placed directly in the first wound. Unusual sites of the gunshot wounds were the dorsal part of the neck, the right nostril and the right ear. In one case a gun powder muzzle-loader was loaded with two projectiles and in another suicide the lethal brain damage was caused by the gas pressure due to shot from a blank gun tightly pressed to the right temporal head.

Adult↗