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Stephan A Padosch

Publications and source records attributed to Stephan A Padosch.

At least 19 recordsLinked to original sources

Absinthism: a fictitious 19th century syndrome with present impact.

Absinthe, a bitter spirit containing wormwood (Artemisia absinthium L.), was banned at the beginning of the 20th century as consequence of its supposed unique adverse effects. After nearly century-long prohibition, absinthe has seen a resurgence after recent de-restriction in many European countries. This review provides information on the history of absinthe and one of its constituent, thujone. Medical and toxicological aspects experienced and discovered before the prohibition of absinthe are discussed in detail, along with their impact on the current situation. The only consistent conclusion that can be drawn from those 19th century studies about absinthism is that wormwood oil but not absinthe is a potent agent to cause seizures. Neither can it be concluded that the beverage itself was epileptogenic nor that the so-called absinthism can exactly be distinguished as a distinct syndrome from chronic alcoholism.The theory of a previous gross overestimation of the thujone content of absinthe may have been verified by a number of independent studies. Based on the current available evidence, thujone concentrations of both pre-ban and modern absinthes may not have been able to cause detrimental health effects other than those encountered in common alcoholism. Today, a questionable tendency of absinthe manufacturers can be ascertained that use the ancient theories of absinthism as a targeted marketing strategy to bring absinthe into the spheres of a legal drug-of-abuse. Misleading advertisements of aphrodisiac or psychotropic effects of absinthe try to re-establish absinthe's former reputation. In distinction from commercially manufactured absinthes with limited thujone content, a health risk to consumers is the uncontrolled trade of potentially unsafe herbal products such as absinthe essences that are readily available over the internet.

Journal Article↗

Absinthe--a review.

The alcoholic beverage absinthe is recently experiencing a revival after a yearlong prohibition. This review article provides information on all aspects of this bitter spirit and its major components, especially wormwood (Artemisia absinthium L.), which contains the toxic monoterpene thujone. Over 100 references on historic and current literature are provided. The topics comprise the history of the alcoholic drink starting from its invention in the eighteenth century. Historical and modern recipes are discussed in the context of different quality categories and possibilities to reduce the content of thujone are given. The analytical techniques used to verify compliance with the maximum limit of thujone as well as further possibilities for quality control of absinthe are discussed. The toxicology of absinthe is reviewed with regard to the cause of a syndrome called "absinthism," which was described after chronic abuse of the spirit in the nineteenth century. Finally, a food regulatory and food chemical evaluation is provided and minimum requirements for absinthe are suggested. Absinthe should have a recognizable wormwood flavor and after dilution with water the characteristic clouding should arise (louche-effect). Products, which are advertized as being of premium grade should be made by distillation, should have an alcoholic strength of at least 45%vol, and should not contain artificial dye.

Absinthe↗

Accidental autoerotic death by volatile substance abuse or nonsexually motivated accidents?

In contrast to typical autoerotic fatalities, when death is due to asphyxia mostly by mechanical compression of the neck, atypical autoerotic accidental deaths (AADs) involve sexual self-stimulation by other means such as electrocution or inhalation of chemical agents. Especially in lethal cases of volatile substance abuse (VSA), a differentiation between suicide or sexually or nonsexually motivated accident is often complicated in practical casework. Considering the small number of AADs involving chemical substance abuse reported in the literature, the number of unreported cases seems to be very high. We report about 5 lethal cases of VSA; analysis was performed using headspace solid-phase microextraction (HS-SPME) and gas chromatography-mass spectrometry (GC/MS). When headspace sampling is not performed at autopsy, the analysis of volatile substances can be very complicated. In 2 cases, an AAD was diagnosed considering findings at the scene, reconstruction of the event, and discussion of the circumstances of the death. These findings demonstrate the importance of VSA in atypical autoerotic asphyxia. Therefore, in cases of suspected lethal inhalational intoxications, as a matter of principle, headspace asservation should be performed at autopsy and an autoerotic motivational background should be taken into consideration for differential diagnosis.

Accidents↗

An unusual occupational accident: fall into a sewage plant tank with lethal outcome.

Occupational accidents, often presenting with lethal outcomes, are a rarely reported issue in forensic literature. However, these incidents are part of medicolegal casework with special regard to reconstruction, liabilities and insurance law-related issues, respectively. We report on a lethal occupational accident in a metropolitan sewage plant. When performing routine controls, a technician fell into an overflow sewer and was immediately pulled into a 30 cm diameter drain. Rescue efforts were initiated immediately, but had to be terminated due to gas warning. Rescue teams continued the search, however, the body remained undiscoverable. Forty-eight hours later, the cadaver was found in an adjacent digester tank, from where it was finally rescued. It was concluded, that the body had been transported between the overflow sewer and the digester tank through a 120 m pipeline with several 90 degrees bendings and branch connections with a minimum diameter of 25 cm at the discharge valve. On medicolegal examination, the cadaver showed marked signs of advanced decomposition caused by anaerobic microorganisms in the 37 degrees C biomass environment. Moreover, as a consequence of the passage of the pipeline system, signs of massive trauma (several comminuted and compound fractures) were disclosed at autopsy. To us, this is the first report on a lethal occupational accident in a sewage plant; our observations demonstrate the rapid progress of putrefaction in a warm anaerobic bacterial environment and the massive trauma sustained.

Accidents, Occupational↗

Death due to positional asphyxia under severe alcoholisation: pathophysiologic and forensic considerations.

In contrary to "physical restraint", describing a fixed body position due to external devices, "positional restraint" is defined as an abnormal body position, resulting from accidental fixation under unfortunate circumstances. We report on a remarkable case of positional asphyxia of an alcoholised young man after a fall down a staircase. On external examination, the body showed petechiae of the conjunctivae and oral mucosa, abrasions on the left zygomatic region and scratch marks, respectively. Neither broken fingernails, etc. nor signs of external violence against the neck were found. Autopsy revealed haemorrhages in the praevertebral cervical musculature and Simon's sign. Haemorrhagic pulmonary edema and cerebral edema were observed; blood alcohol concentration: 2.60 g/l, urine alcohol concentration: 3.26 g/l. As cause of death, positional asphyxia after blunt head trauma has to be considered as well as lethal ethanol intoxication. To us, alcoholisation attributed to the fall and together with unconsciousness following blunt head trauma circumvented self-rescue efforts, and therefore, aggravated the potentially lethal impact of positional restraint.

Accidental Falls↗

Forensic case profiling aspects on multiple homicides from the Cologne-Bonn metropolitan area 1985-2000.

The medicolegal and subsequent criminologic interpretation of forensic and pathological findings in cases of homicide makes up an important tool of case profiling. In a retrospective study of 26 cases of "multiple homicides" involving 31 perpetrators (30 males, 1 female, mean age 33.5 years) and 73 victims (33 males, 40 females, mean age 36 years, 68 fatalities, 5 survivors), autopsy reports and prosecution authorities' files were investigated with regard to individual characteristics of victims and offenders, circumstances as well as mode of commitment. The major aim of this study was to comprehensively elucidate and characterise relevant forensic and criminologic features, which may gain importance for forensic case profiling. Forty-six victims were found in the close social environment of the perpetrator and 45 homicides were committed either in the victim's, the perpetrator's or the shared domicile. The main motives included concealment of a crime (n=13), personal conflicts/domestic arguments (n=7) and greed (n=12). The relevant injuries with regard to the cause of death were attributable to sharp force (n=13), blunt force (n=7), gunshot wounds (n=24), ligature strangulation (n=3), smothering (n=5), fire/carbon monoxide (n=4) and combined impacts (n=11). In 15 cases, so called defence injuries were found. In 5 victims a post-mortem blood alcohol concentration >1.5 g/l was determined. In six perpetrators, a severe psychiatric impairment of juridical responsibility was ascertained (Section 20 German criminal code, n=2, psychosis; Section 21 German criminal code, n=4, acute alcohol intoxication). As far as conviction data were available, 27 crimes were juridically assessed as murder, 12 as manslaughter and one as bodily harm with fatal consequences.

Adolescent↗

Effects of intracerebroventricular application of brain-derived neurotrophic factor on cerebral recovery after cardiac arrest in rats.

SUBJECT: After transient global cerebral ischemia, selective vulnerable brain areas show delayed neurodegeneration with characteristics of apoptosis. Recent data demonstrate potent neuroprotective effects of the application of endogenous growth hormones such as brain-derived neurotrophic factor (BDNF) after focal cerebral ischemia. To assess possible effects of the intracerebroventricular application of BDNF on cerebral recovery after global cerebral ischemia due to cardiac arrest in rats, various selective vulnerable brain areas were investigated. INTERVENTIONS: Global cerebral ischemia was initiated by ventricular fibrillation in rats under general anesthesia. After 6 mins, the animals were resuscitated by external cardiac massage combined with defibrillation and divided into two groups (BDNF vs. placebo). BDNF or placebo (1 microg/hr) was applied continuously during the complete reperfusion time using an implanted osmotic minipump. After 6 hrs, 24 hrs, 3 days, and 7 days (n = 6-7 per group), coronal brain sections were analyzed by terminal deoxynucleotidyltransferase-mediated d-uracil triphosphate-biotin nick end-labeling (TUNEL) and Nissl staining and a caspase activity assay in the hippocampal cornu ammonis 1 sector, the nucleus reticularis thalami, and the striatum. At 24 hrs, 3 days, and 7 days, animals were tested according to a neurologic deficit score. MEASUREMENTS AND MAIN RESULTS: In all groups, typical delayed neurodegeneration was observed in selective vulnerable brain areas. Neuroscore, TUNEL, and Nissl staining revealed no relevant differences between the groups (BDNF vs. placebo) with regard to neurologic recovery and the number of viable (after 7 days in cornu ammonis 1 sector: BDNF, 110 +/- 32; placebo, 142 +/- 53) and TUNEL-positive neurons (after 7 days in cornu ammonis 1 sector: BDNF, 360 +/- 81; placebo, 253 +/- 62) during the different time points. CONCLUSIONS: Despite the well-known neuroprotective properties of BDNF in ischemic-induced neuronal degeneration, the present study did not reveal any beneficial effects regarding neurologic recovery and neurohistopathologic outcome after global cerebral ischemia in rats. Future investigations should focus on intracellular signaling cascades activated by BDNF after global cerebral ischemia.

Animals↗

Role of virus-induced myocardial affections in sudden infant death syndrome: a prospective postmortem study.

The cause of sudden infant death syndrome (SIDS) is an unresolved problem of high relevance. Previous studies indicate a role of infections. In our prospective study, we investigated the frequency of virus-induced myocardial affections in SIDS. Postmortem samples from SIDS victims and control subjects were investigated prospectively. Pediatric cases of unnatural death served as controls. Samples were studied for enteroviruses, adenoviruses, parvovirus B19, and Epstein-Barr virus applying PCR. Immunohistochemical investigations for inflammatory cells, the necrosis marker C5b-9((m)) complement complex, and the enteroviral capsid protein VP1 were performed. Overall, 62 SIDS victims were studied. As controls, 11 infants were enrolled. Enteroviruses were detected in 14 (22.5%), adenoviruses in 2 (3.2%), Epstein-Barr viruses in 3 (4.8%), and parvovirus B19 in 7 (11.2%) cases of SIDS. Control group samples were completely virus negative. Compared with controls, immunohistochemical investigations partially revealed a significant increase in the number of T lymphocytes in SIDS myocardial samples (p < 0.05). Furthermore, cases with elevated numbers of leukocytes and macrophages, microfocal C5b-9((m))(+) necroses, and enteroviral VP1 capsid protein within the myocardium were detected. Applying a comprehensive combination of molecular and immunohistochemical techniques, our results demonstrate a clearly higher prevalence of viral myocardial affections in SIDS. Our results emphasize the importance of PCR-based diagnosis of viral myocardial affections. We suggest preliminary criteria for cellular immunohistochemical diagnosis of viral myocardial affections derived from our findings. For future investigations in SIDS, we suggest a comprehensive approach that includes PCR and immunohistochemistry. Our results offer novel strategies for diagnosis of pediatric myocardial viral affections.

Adenoviruses, Human↗

Neuronal apoptosis following cerebral ischaemia: pathophysiology and possible therapeutic implications.

PURPOSE OF REVIEW: Neuronal apoptosis following cerebral ischaemia has become an issue of extraordinary scientific interest in the past decade. Besides necrosis, this highly relevant pathomechanism has been shown to be markedly involved in the pathogenesis of delayed postischaemic neuronal damage. As a result, a variety of possible neuroprotective strategies and therapeutic options subsequent to cerebral ischaemia have emerged. This article provides an overview of the pathophysiologic mechanisms underlying delayed neuronal apoptotic degeneration after cerebral ischaemia. Based on these facts, selected therapeutic implications are discussed in detail. RECENT FINDINGS: Recent findings from experimental studies have demonstrated a new therapeutic neuroprotective potential of pharmaceutical blockade of death-inducing ligands (e.g. Fas/CD95 ligand), enhancement of survival signal transduction with endogenous ligands (e.g. erythropoietin) and therapeutically modulating the balance between intracellular anti- and proapoptotic Bcl proteins with intriguing molecular techniques after cerebral ischaemia. SUMMARY: Neuronal apoptosis is highly relevant in the pathophysiology of neurodegenerative disorders, neurotrauma and cerebral ischaemia/reperfusion. Within the past few years, a variety of therapeutic strategies have emerged based on our increasing knowledge of the pathophysiology of apoptosis. Whereas inhibition of single factors in apoptotic cascades (e.g. proteases) has produced rather unsatisfying results, new opportunities have emerged at the molecular level due to advances in molecular medicine. These approaches offer promising opportunities for neuroprotective therapeutic strategies subsequent to cerebral ischaemia. It is tempting to speculate that a combination ('cocktail') of these antiapoptotic interventions might even increase their neuroprotective potential.

Journal Article↗

Planned complex suicide by self-poisoning and a manipulated blank revolver: remarkable findings due to multiple gunshot wounds and self-made wooden projectiles.

A remarkable case of complex suicide with poisoning and multiple self-inflicted gunshot wounds to the head is reported. After ingestion of a liquid insecticide, the victim shot himself twice in the head, once in each temple. Self-manufactured wooden dowels were used as projectiles in combination with conventional blank cartridges. The dowels had been glued on top of the blank cartridges and expelled by propellant gases. Moreover, the blank revolver used had been extensively manipulated in a rarely observed manner. Several occlusive devices had been removed from the barrel and the cylinder chamber to enable the expulsion of the wooden projectiles. The investigation of the methods used and the circumstances found at the scene pointed towards a planned complex suicide. A remarkable case with unusual projectiles, i.e., wooden dowels, fired by an extensively manipulated blank gun is reported, emphasizing the importance of close collaboration between the police firearm laboratory and forensic pathology in practical casework.

Aged↗

[Analysis of 1989-1999 homicide crimes in the catchment area of the Bonn Institute of Forensic Medicine with reference to selected aspects].

195 cases of homicide, grouped according to juridical assessment, were retrospectively analysed with regard to individual characteristics of perpetrators and victims, circumstances, and mode of commitment. The involvement of underage victims and perpetrators as well as differences between the urban and rural areas studied were taken into special consideration. To summarise, the majority of the offences studied was carried out by a male perpetrator with a mean age of 35 years driven by personal motives or greed in his immediate vicinity and affected family members or close acquaintances. The fatal injuries were mainly attributable to sharp or blunt force. With regard to killings of children, a higher prevalence of female victims and male assailants, emotional motives and an even higher importance of the social vicinity were found. Particularly in victims younger 12 years of age, manual modes of commitment without application of any tools were predominantly encountered. The comparison of urban and rural areas revealed a higher homicide rate in municipal areas especially of offences with a loose relationship between victims and assailants (greed, sexual assault). In contrast, rural areas exhibited higher rates of bodily harm with fatal consequences as well as offences by highly intoxicated assailants.

Adolescent↗

[Homicidal alcoholic intoxation versus manual neck compression].

A case of homicide involving a 49-year-old man is reported. In the course of a booze-up he was forced to excessive consumption of alcohol and was pushed back into a sofa by repeated grasping his neck which finally left him dead. The postmortem examination revealed a small abrasion in the right mandibular region, a contusion of the subcutaneous tissue above the left clavicle, a haemorrhage in the deep muscles of the neck at the right side of the cervical spine, a fatty tissue haemorrhage between the left cornus of hyoid and thyroid cartilage as well as petechiae of the eyelids and conjunctivae. The blood alcohol concentration amounted to 4.00@1000, the urine alcohol concentration to 5.26@1000. Thus, a manual strangulation of the neck versus a lethal alcohol intoxication had to be taken into consideration as cause of death. The morphological findings of the postmortem examination and the pathophysiological concepts of the underlying mechanisms of death in manual strangulation versus lethal alcohol intoxication are discussed with regard to their significance for the juridical assessment.

Alcoholic Intoxication↗

[Multiple homicides--forensic and criminologic aspects].

The interpretation of medicolegal findings in homicide is an important tool of case profiling (so-called "operative case analysis"). In 17 cases of "multiple homicides" involving 22 offenders (21 males, 1 female; mean age 33 years) and 45 victims (21 males, 24 females; mean age 35 years; 41 fatalities, 4 survivors), the autopsy reports and the prosecution authorities' files were retrospectively analysed with regard to individual characteristics of perpetrators and victims, circumstances, and mode of commitment in order to comprehensively characterise relevant forensic and criminologic aspects. 31 victims were found to belong to the close social environment of the perpetrator, and 32 killings were committed in the victim's, perpetrator's or the joint flat. The main motives included greed (n = 7), personal conflicts (n = 5) and concealing of a crime (n = 9). The relevant injuries were attributable to gunshot wounds (n = 13), sharp force (n = 11), blunt force (n = 3), ligature strangulation (n = 3), smothering (n = 6), fire/carbon monoxide (n = 2) and combined impacts (n = 7). In 12 victims, defense injuries were found. The blood alcohol concentration exceeded 1.5 g/l in 5 victims. In 5 offenders, a psychiatric impairment of juridical responsibility was assessed (and 20 German criminal code, n = 1, psychosis; and 21 German criminal code, n = 4; acute alcohol intoxication). As far as data were available, 16 crimes were judged as murder, 12 as manslaughter and one as physical injury with fatal outcome.

Adult↗

[Medicolegal aspects of witnessed suicide due to gunshot to the head. Part 1: Circumstances and psychopathology].

In the USA the frequency of witnessed suicide, i.e. suicide committed in the presence of at least one further individual, is reported to range between 5 and 15%. As up to now no detailed analysis of this special issue has been given in the medicolegal literature, this article presents and discusses a number of cases including 8 males and 1 female (age 19-58 years, mean 41.2 years) who had all committed suicide by inflicting a gunshot to the head. In 3 cases post-mortem blood alcohol concentrations of 1.73, 1.88 and 2.23 g/kg respectively were observed. Toxicological tests produced negative results. 5 cases had a medical history of psychiatric disorder with endogenous depression in 3, chronic alcohol abuse and drug abuse with concomitant psychosis in one case each. As far as the motives were known, domestic arguments were of prevailing importance. With one exception the suicides were committed at home. In 6 cases one witness was present, in 2 cases 2 individuals and in one case 22 persons witnessed the suicide. The reported cases are discussed in comparison with the psychiatric-psychological classification according to McDowell et al. with the aim to provide a solid and comprehensive medicolegal method to distinguish between homicide and suicide. Furthermore aspects of psychiatric sequelae and psychological support of the witnesses, which are also of importance for the forensic pathologist called to the scene, are discussed.

Adult↗

[Medicolegal aspects of witnessed suicide due to gunshot to the head. II. Legal medicine aspects and examination of the firing hand].

The second part of the paper on suicides by gunshots to the head in the presence of witnesses focuses on relevant morphological autopsy findings such as entrance site, signs of close range or contact shots, bullet path etc. and also discusses selected aspects of ascertaining gunshot residues. For the identification of the shooter an integral medicolegal assessment of all the facts including the investigation results and the autopsy findings is essential. However, the morphological findings alone do not allow safe diagnosis, as for example in a homicide the temporal region, which was affected in all our cases, may have been deliberately chosen by the perpetrator as a localization typical of suicide. Thus methods to ascertain gunshot residues on the firing hand (by means of adhesive films and the polyvinyl-alcohol collection method--PVAL) are of great practical importance. In seven cases adhesive films and/or the polyvinyl-alcohol collection method were used. In one case the gunshot residues (GSR) were analysed by means of tape lifts and subsequent scanning electron microscopy (SEM). It was found that especially the combined application of topographical (adhesive tape/PVAL) and cumulative (SEM) methods allowed for the doubtless identification of the shooter, thus usually confirming the suicide. By the example of one case it is demonstrated that without the immediate collection of evidence at the scene objective reconstruction of the event becomes impossible. On the basis of the reported cases recommendations are finally given for a differentiated approach in the medicolegal evaluation of alleged witnessed suicide by gunshot (to the head).

Adult↗