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Biomedical subjects

R Hausmann

Publications and source records attributed to R Hausmann.

At least 37 records · Page 2Linked to original sources

A contribution to a possible differentiation between SIDS and asphyxiation.

The singular and combined appearance of conjunctival petechiae, of acute pulmonary emphysema and of signs of aspiration was evaluated in resuscitated and non-resuscitated children dying of SIDS (n = 115), of other causes of natural death (n = 17), of severe head injury (n = 10) and of asphyxiation/strangulation (n = 7). Conjunctival petechiae occurred in all of the asphyxiated victims and in five out of 10 children dying of severe head injury, but were exclusively found in four resuscitated babies and one baby with questionable resuscitation trials of the SIDS-group (4%), furthermore in one resuscitated child dying of a congenital heart defect. Acute pulmonary emphysema was detected in six out of the seven children of the asphyxiation/strangulation group, in two resuscitated children with head injury and in five resuscitated babies dying of SIDS. Both parameters were observed exclusively in the asphyxiation/strangulation group (71% of the cases) but not in the control cases. Therefore, it can be concluded that the simultaneous appearance of conjunctival petechiae and of acute pulmonary emphysema strongly indicates death by asphyxiation.

Asphyxia↗

The time-related expression of p53 protein in human skin wounds--a quantitative immunohistochemical analysis.

The time-dependent expression of p53 protein during wound healing has been investigated by immunochemistry in fibroblastic cells of skin wounds ranging between a few minutes and 11 weeks old. When compared to uninjured skin, an increased expression of p53 was found earliest in a wound with a postinfliction interval of 3 days. The ratio (r) of positively stained cells in relation to the total number of fibroblastic cells in the wound area of this specimen was about 0.2. A considerable increase in the expression of p53 (r > 0.5) was first found in a wound aged 8 days and in wounds with postinfliction intervals ranging between 3 and 11 weeks, where the ratio of positive cells was between 0.40 and 0.64. Therefore, it can be calculated that r-values of at least 0.5 indicate a postinfliction interval of approximately 1 week or more. Since comparably low numbers of positively stained fibroblastic cells were found in specimens with an advanced wound duration, reliable information for a forensic wound age estimation can only be provided by positive results.

Adolescent↗

Sudden death associated with myxomatous transformation of the mitral valve in an 8-year-old boy.

An 8-year-old boy suffered a cardiac arrest while playing soccer. In contrast to a similar event at the age of 5 years, resuscitation was not successful. At autopsy, the cardiac findings were of a myxomatous transformation of the mitral valve with lacerations of the posterior cusp and the left vestibular endocardium and left ventricular hypertrophy. Sudden death due to arrhythmias in association with a myxomatous mitral valve is a rare event with only about 100 cases published world-wide. To our knowledge, the present case probably reports the youngest affected individual who died of this pathological condition.

Arrhythmias, Cardiac↗

Fractures at the base of the skull in gunshots to the head.

The distribution of fractures at the base of the skull was investigated in 147 victims with lethal head shot wounds caused by handguns or small calibre low-velocity rifles. In individuals without an impact of the projectile at the base of the skull, bullets lodged in the head were found up to a calibre of 7.65 mm (pistol) or .38 special (revolver), respectively. In cases with a trajectory through the cranial fossae positive results were obtained up to 9 mm (pistol) or even .45 (revolver). Fractures in anterior parts of the base of the skull were a rather frequent finding (82% of the cases) and could also be observed in victims shot by low energy guns. Fracture lines in particular in all cranial fossae, however, indicate a comparatively high energy missile and were found in victims without a direct impact of the bullet at the base of the skull after the use of guns with a calibre of at least 7.65 mm. Severe fractures leading to a hinge-like mobility of the base of the skull point also to projectiles of rather high energy. On the other hand, such fractures were also found in a victim with a contact shot by a .22 rifle. Therefore, it must be emphasized that individual factors such as the constitution of the base of the skull, the path of the bullet, technical parameters of the gun and ammunition used are of great importance if conclusions are to be drawn on an unknown gun by evaluation of fractures at the base of the skull.

Adolescent↗

Radial alveolar count as a tool for the estimation of fetal age.

A total of 53 normal fetuses with a gestational age ranging from 15 up to 39 weeks was investigated and the radial alveolar count (RAC) was estimated as a parameter for lung maturation. Values lower than 2.0 could only be found in lungs of fetuses aged less than 18 weeks. Between 18 and 25 weeks of gestation, relatively constant levels of RAC were observed but with considerable interindividual variation. In fetuses with a gestational age of more than 25 and especially 30 weeks, a slight or rapid increase in RAC occurred respectively. Values lower than 3.0 were found up to a fetal age of less than 30 weeks and a RAC of more than 4.0 was only found in lungs of fetuses aged more than 30 weeks. Values exceeding 6.0 occurred only in fetuses at near full-term birth. Since the estimation of RAC overcomes the effects of varying degrees of alveolar collapse, such an analysis also seems to be useful for the determination for fetal age in cases of advanced putrefaction.

Gestational Age↗

Delayed death after attempted suicide by hanging.

In cases of hanging death usually occurs immediately after strangulation and is caused by ischemic cerebral damage due to neck compression in some cases in combination with respiratory obstruction. We report on a case of delayed death 4 days after an attempted suicide by hanging where the individual was conscious and showed no neurological abnormalities. The cause of death was a cerebral infarction following a traumatic thrombosis of the subtotally ruptured carotid arteries.

Asphyxia↗

Detection of cell death in human skin wounds of various ages by an in situ end labeling of nuclear DNA fragments.

The time-dependent appearance of signs of cell death was investigated in human skin wounds using in situ end labeling of DNA fragments (ISEL). In the dermal layer an average of not more than 0.3 positively stained fibroblastic cells/0.01 cm x 0.01 cm was found up to a postinfliction interval of approximately 6 h. Average numbers exceeding 1 positive cell/0.01 cm x 0.01 cm were first detectable in a skin wound after 24 h. Therefore, average numbers greater than 1 labeled cell/ 0.01 cm x 0.01 cm indicate a postinfliction interval of approximately 1 day. An increase in the average number of positively stained cells occurred with increasing wound age. Values exceeding 3 cells/0.01 cm x 0.01 cm were first detectable 19 days after wound infliction. Accordingly, values of more than 3 labeled cells indicate a postinfliction interval of approximately 3 weeks or more. Since low numbers of labeled fibroblastic cells or even negative results were found in wounds of advanced age, only positive results provide information which can be useful for a forensic age estimation of human skin wounds.

Adolescent↗

Differential diagnosis of postoperative liver failure in a 12-year-old child.

The case of a 12-year-old child who died of fulminant hepatic failure a few days after tonsillectomy is reported. Histological examination revealed large areas of massive centrilobular hepatic necrosis. Hepatotoxicity of postoperatively administered paracetamol in high dosages combined with enflurane exposure is discussed as a cause for the hepatic failure. The fulminant clinical course could have been influenced by an infection with hepatitis G virus which was detected in liver tissue by in situ hybridisation and was probably transmitted via transfusion of blood plasma.

Acetaminophen↗

The forensic value of the immunohistochemical detection of oestrogen receptors in vaginal epithelium.

This study investigated whether oestrogen receptors can be immunohistochemically detected in paraffin-embedded vaginal mucosa samples using monoclonal antibodies and whether the method would be suitable for the identification of vaginal cells in cytological smears. Samples of vaginal mucosa were obtained from living females and female corpses, as vaginal smears. For comparison purposes, resected prepuce samples and samples of postmortem male urethral mucosa were also investigated. Nuclear oestrogen receptors could be regularly detected in the basal, parabasal and deeper intermediate epithelium layers of freshly fixed vaginal mucosa but proved to be highly sensitive to autolytic changes. In the cytological smears obtained from living subjects, no oestrogen receptors were detectable. Oestrogen receptors were also detected in the basal epidermal cells of the male prepuce.

Adolescent↗

Adjuvant intravesical mitoxantrone after transurethral resection of primary superficial transitional cell carcinoma of the bladder. A prospective randomised study.

A prospective randomised controlled clinical trial began in 1989 on 126 patients with superficial transitional cell carcinoma of the bladder (pTa-pT1, grades 1-3) to compare the efficacy of adjuvant topical mitoxantrone after transurethral resection versus no further treatment. 62 patients received no further treatment, 64 patients received weekly 20 mg mitoxantrone intravesically for 6 weeks after differentiated TUR of all visible tumours. The endpoint of the study was any progression of stage or grade or further recurrences. The median follow up was 29 months--the minimum follow up was 24 months. The percentage of recurrences (25.8 versus 23.4), the recurrence rate (1.2 versus 0.9), the overall disease free interval and the tumour progression rate showed no statistically significant differences (P > 0.05 Mantel-Cox test). Only the comparison of time to recurrence in tumours with recurrences showed a statistically significant difference, with a longer disease free interval for the TUR plus mitoxantrone group (P = 0.016 Mantel-Cox test).

Administration, Intravesical↗

Genetic polymorphism of alpha-2-HS-glycoprotein in northern Bavaria (Germany). Simplified AHSG-phenotyping by isoelectric focusing using dry gels.

A simple and practical method of detecting AHSG using isoelectric focusing on dry gels is described. The procedure is both rapid and provides reliable results. AHSG phenotypes were determinated in 215 unrelated individuals from Northern Bavaria. The allele frequencies obtained were: AHSG*1 = 0.7139, AHSG*2 = 0.2697 and AHSG*3 = 0.0164.

Blood Proteins↗

The value of the Lugol's iodine staining technique for the identification of vaginal epithelial cells.

This paper reports on the specificity of the Lugol's iodine staining technique for the detection of vaginal epithelial cells on penile swabs. Air-dried swabs taken from the glans of the penis of 153 hospital patients and from 50 healthy volunteers, whose last sexual intercourse had taken place at least 5 days previously, were stained with Lugol's solution. Glycogenated cells were found in more than 50% of the cases studied, even in healthy volunteers without urethritis. In almost all of these cases the smear contained at least a few polygonal nucleated epithelial cells showing an unequivocal positive Lugol reaction. These cells cannot be distinguished from superficial or intermediate vaginal cells, by cytomorphology or staining. Urinary tract infections had no influence on the glycogen content of male squamous epithelial cells. On the basis of these results the Lugol's method can no longer be assumed to prove the presence of vaginal cells in penile swabs.

Adult↗

Forensic value of the Lugol's staining method: further studies on glycogenated epithelium in the male urinary tract.

This study presents findings from a series of investigations on the presence of glycogenated epithelium in the male urinary tract and on the penile surface in order to assess the forensic value of the Lugol's method for the identification of vaginal cells. Direct smears obtained from the urethral opening, glans penis, and penile shaft, along with post-mortem samples of the fossa navicularis, and histological sections of the penis were examined. The presence of polygonal, glycogenated, Lugol-positive epithelium cells in the male urinary tract was found to be common. Our results suggest that these cells originate from the fossa navicularis. Because of the possibility of exfoliation of glycogenated male cells and transfer to the penile surface a Lugol-positive reaction in epithelial cells on penile swabs can no longer be assumed to prove the presence of vaginal cells.

Adult↗

[The use of the RACE technique for quantitative flow measurements. Evaluation using a clinically relevant flow model].

A phantom has been designed for measuring flow velocities; using pipes of specified diameter and selectable pulse rates, flow rates varying from 0-250 cm/s can be determined. The measurements are made in a superconductive magnet with a field strength of 1.5 Tesla, employing a RACE technique. The reference technique was electromagnetic flow measurement. There was good linear correlation between the electromagnetic and the MRT results with a correlation coefficient of 0.98. It is necessary in the first place to estimate flow speed; if flow velocity is unknown initially, there is no correlation. Hence, in everyday use erroneous results may be obtained, particularly since one cannot always demonstrate vessels in all parts of the body without superimposition. Further clinical studies are required in various vascular territories to evaluate the usefulness of the RACE technique for flow measurements.

Electromagnetic Phenomena↗

Interaction of papain-digested HLA class I molecules with human alloreactive cytotoxic T lymphocytes (CTL).

Acute immunological rejection events of transplanted allogeneic organs are strongly dependent on T cell reactivity against foreign MHC products. The recognition requirements of alloreactive cytotoxic T cells are of particular interest for finding approaches to modulating alloreactivity. The role of the allogeneic MHC molecule itself and/or an associated peptide in the interaction with the T cell receptor is still, however, unclear. Our studies have focused on the interactions of papain-digested HLA class I molecules with alloreactive CD8+ CTL. These polypeptides, consisting of the polymorphic alpha 1 and alpha 2 and the monomorphic alpha 3 domains, were used in both soluble and immobilized form to study their functional effects on anti-HLA-A2 reactive CTL. Purified polypeptides were of molecular mass 32-34 kD. HLA-A2 polypeptides (0.55 micrograms/ml) in soluble form induced half-maximal reduction of CTL cytotoxicity. These concentrations were quantitatively comparable to the effective doses of intact HLA class I molecules, which contain the hydrophobic transmembrane domain and the intracytoplasmic tail. In addition, specific activation requirements of these CTL were investigated in a serine esterase release assay. Maximal degranulation was observed after 2 h of antigen contact. Purified HLA class I molecules allospecifically activated the anti-HLA-A2 CTL to degranulate serine esterase, when immobilized on plastic microtitre plates. Thus, polypeptides containing the polymorphic alpha 1 and alpha 2 domains of human class I molecules potentially modulate the cytotoxic T cell response. This might have implications for the reduction or prevention of allograft rejection in recipients of foreign organs.

Cytotoxicity, Immunologic↗

Clinical relevance of soluble HLA and interaction of papain derived class I molecules with alloreactive CTL.

MHC class I and class II molecules are expressed in soluble form in the serum of both healthy and diseased individuals. Our aim was to investigate whether soluble class I (sHLA) levels in allograft patients correlate with their clinical status. Altogether, 20 renal and 30 cardiac graft recipients were examined. High levels of sHLA were measured at least 5 days preceding acute rejection episodes. Immune complexes between anti-HLA antibodies and sHLA were detected in a patient who died of a severe vascular rejection. In another study the interaction of papain-derived sHLA on alloreactive CTL in vitro was investigated. In a chromium-51-release cytotoxicity assay, 1.25 microg/ml of papain-digested class I molecules reduced CTL cytotoxicity to background levels. On the contrary, immobilized molecules triggered the release of serine esterase allospecifically. These data showed that the MHC molecule alone was a sufficient ligand for the interaction with alloreactive CTL.

Biomarkers↗