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T Riepert

Publications and source records attributed to T Riepert.

At least 19 recordsLinked to original sources
PubMed2005

[Value of postmortem computed tomography in comparison to autopsy].

PURPOSE: To assess the diagnostic value of postmortem computed tomography (CT) in comparison to autopsy. MATERIALS AND METHODS: Twenty-seven cadavers were examined by sequential cranial CT and helical CT through the neck, thorax and abdomen and subsequently underwent an autopsy with histomorphologic examination of the pathologic specimens. The findings of CT, autopsy and histology were registered and compared by three radiologists and one specialist for forensic medicine, using a data entry form. RESULTS: In 19 of 27 cases, the findings explaining the cause of death were concordant for CT and autopsy. Intracranial, intraspinal and intracardiac gas accumulations (n = 12) were registered by CT alone. The detection of skull fractures was equal for both methods (n = 3). CT showed diagnostic problems in the assessment of pneumonic infiltrations (n = 16) and pulmonary edema (n = 21). CONCLUSION: CT is a useful and complementary method to autopsy.

Adult↗
PubMed2001

Identification of unknown dead bodies by X-ray image comparison of the skull using the X-ray simulation program FoXSIS.

The aim of the study was to improve the objectivity of X-ray image comparison for the identification of unknown dead individuals. CT-data were collected for 30 macerated skulls. An already presented computer program which uses CT data to establish virtual X-ray images was used to obtain X-rays with different beam angulations simulating rotation, dorsal flexion, and ventral flexion. Specific parameters were measured on the simulated images. The frontal sinus reveals the highest variability not only between the individual skulls but also within an individual skull in different positions. The most consistent parameters with respect to different positions were the skull breadth, the biorbital breadth and the bizygomatic breadth. In a blind study, three out of 24 skulls could clearly be identified just by measured distances although the positions were different and unknown to the investigator. The dimensions of the frontal sinus do not correlate with the other skull parameters (analysis of covariance). Based on the presented results, we propose a method that will calculate the probability of identity. The presented results demonstrate that the comparison of X-ray images can be undertaken in an objective way by quantifying the probability of identity even when the comparative images were made under different conditions.

Adult↗
PubMed2000

[Delayed aortic rupture following a fall from an examination couch. Clinical and forensic aspects].

BACKGROUND: Physicians frequently have to face an investigation of their work from a judicial point of view. Due to these proceedings the number of cases when they are reproached with malpractice is increasing. CASE REPORT: We report the rare case of a 76-year-old female patient who fell from a 68 cm high couch after a sedative was applied during gastroscopical examination. She died 24 hours after the incident. Forensic necropsy revealed a delayed aortic rupture as the cause of death. The preliminary proceedings against the physician involved for culpable homicide by criminal negligence were suspended after he paid a fine. The possible legal consequences under German law for physicians involved in such cases are discussed as well as strategies to avoid them. CONCLUSION: Physicians who are under investigation for malpractice should act carefully. They are advised to seek professional help at an early stage of preliminary proceedings. A public trial should be avoided if possible.

Accidental Falls↗
PubMed1998

Bone age determination based on the study of the medial extremity of the clavicle.

The development of the medial clavicular epiphysis and its fusion with the clavicular shaft have been a subject of medical research since the second decade of this century. Computed tomography provides the imaging modality of choice in analyzing the maturation process of the sternal end of the clavicle. In a retrospective study, we analyzed normal development in 380 individuals under the age of 30 years. The appearance of an epiphyseal ossification center occurred between ages 11 and 22 years. Partial union was found from age 16 until age 26 years. Complete union was first noted at age 22 years and in 100 % of the sample at age 27 years. Based on these data, age-related standardized age distributions and 95 % reference intervals were calculated. Compared to the experience recorded in the relevant literature, there are several landmarks that show no significant change between different ethnic groups and different periods of publication; these are the onset of ossification, the time span of partial union, and the appearance of complete union. Despite the relatively long time spans of the maturation stages, bone age estimation based on the study of the development of the medial clavicular epiphysis may be a useful tool in forensic age identification in living individuals, especially if the age of the subject is about the end of the second or the beginning of the third decade of life (e. g. in determining the applicability of adult or juvenile penal systems). Another possible use is in identifying human remains whose age is estimated at under 30 years.

Adolescent↗
PubMed1998

Metal pins fired from unmodified blank cartridge guns and very small calibre weapons--technical and wound ballistic aspects.

Blank cartridge guns are generally regarded as being harmless and are not considered to be firearms in most countries. A comparison of the legal situations in Germany and Austria concerning weapons is given. There have been several reports of serious injuries and even fatalities due to these weapons. Ballistic experiments show that even unmodified blank cartridge guns and very small calibre weapons can fire wire nails and can inflict potentially fatal injuries even at distances of 50 cm. Two serious injuries inflicted by metal pins fired from a blank cartridge gun and a very small calibre weapon are reported. These cases suggest that such weapons should also be considered handguns in the legal sense.

Aged↗
PubMed1997

[Computerized tomography of the epiphyseal union of the medial clavicle: an auxiliary method of age determination during adolescence and the 3d decade of life?].

PURPOSE: To establish a reference population for the stages of epiphyseal union of the medical clavicle determined by CT. MATERIAL AND METHODS: Retrospectively, the thoracic CTs of patients under 30 years of age were reevaluated. Basic conditions were the lack of a bone development disorder and a sufficient assessment of the medial clavicle in a bone window setting. The stages of epiphyseal union were categorized as follows: Stage 1 refers to nonunion without ossification of the epiphysis, Stage 2 to nonunion with a separate and ossified epiphysis, Stage 3 to partial, and Stage 4 to complete union. RESULTS: Up to now, 279 individuals could be included in the study. Stage 1 was observed till age 16, Stage 2 occurred from ages 13 through 22, Stage 3 was found from ages 16 through 26. Stage 4 was first noted at age 22, and in 100% of the sample at age 27. CONCLUSIONS: CT is well suitable to determine the stages of epiphyseal union of the medial clavicle. It may become a generally accepted method of age identification during adolescence and the 3rd decade of life. The presented data serve as a reference population at least for white Europeans.

Adolescent↗
PubMed1996

Estimation of sex on the basis of radiographs of the calcaneus.

Lateral and anteroposterior radiographs of the ankles of 800 Central Europeans aged 20 to 79 were analyzed with regard to sexual dimorphism. All the distances, but not the angles, of the calcaneus were much larger in males than in females. Approximately 80% of the study sample could be sexed correctly by classifying all specimens greater than 86.0 mm in length as male and those less than 86.0 mm as female. The prevalence of os tibiale externum was 8.0 and 2.6% and the prevalence of plantar heel spur was 16.3 and 6.5% (increasing with age) for males and females, respectively, being significantly more frequent in females. On the other hand, the bone island frequencies were 9.1% in males and 4.8% in females. Our study suggests that radiographs of the ankle are a convenient, rapid, cheap and non-invasive means for estimating sex.

Adult↗
PubMed1995

Computer-assisted simulation of conventional roentgenograms from three-dimensional computed tomography (CT) data--an aid in the identification of unknown corpses (FoXSIS).

A computer simulation program (Forensic X-ray Simulation and Identification System, FoXSIS) is presented. FoXSIS calculates conventional X-ray summation images using any scanning parameters from three-dimensional CT data records. All those parameters decisive for X-ray morphology are freely selectable for realistic simulations: focus-object distance, object-film distance, centering of the X-ray beam, the location of the object in the patch of rays, brightness and contrast, as well as parallel and central projection. In addition, distance and angle measurements, as well as enlargements of details are possible. The program may be expected to help in the identification of unknown corpses now, and even more in the future on account of the increased use of clinical computed tomographies.

Forensic Medicine↗
PubMed1995

[The identification of unknown corpses by x-ray comparison].

Between 1987 and 1993, 30 unknown bodies were identified by means of pre- and postmortem radiographs at the Forensic Institute in Mainz. Our experience indicates that radiological identification comprises a useful, rapid and cheap method, at least as valuable as dactyloscopy or odontological comparisons. The ages of available radiographs were up to 25 years; the most suitable regions are the skull (11), pelvis and lumbar spine (6), lower femur and knee (5) and distal leg with the ankle joint (5). In respect of the problem of objectifying the probability of identity, possibilities for solutions are shown.

Accidents↗
PubMed1995

[The incidence, age dependence and sex distribution of the calcaneal spur. An analysis of its x-ray morphology in 1027 patients of the central European population].

In 1027 lateral radiograms of the ankle in a Caucasian population, 161 plantar and/or dorsal calcaneal spurs (15.7%) were diagnosed. Plantar spurs were more common than dorsal spurs (11.2 and 9.3% respectively). Prevalence of both spurs increases considerably with the rising age. Dorsal spurs appear slightly earlier than plantar spurs. The spur frequencies are similar in left and right feet. The plantar spurs were significantly (p < 0.0001) more common in women than in men in general, while dorsal spurs were more frequent in men than in women up to the age of 70. The previously reported higher frequencies of plantar and dorsal calcaneal spurs in women than in men are probably a result of a disproportionally higher number of women in higher age in the groups studied. In forensic medicine, calcaneal spurs provide evidence for identity and age of unknown corpses, and to certain extend their profession, physical activities and constitution during life.

Adolescent↗
PubMed1995

Identification of an unknown corpse by means of computed tomography (CT) of the lumbar spine.

For the first time, a case is described in which an unknown corpse is identified by the comparison of antemortem and postmortem computed tomographic (CT) images. A posterolateral disc herniation at L5-S1 on the right side, Schmorl's nodes and a lucency in the ilium were found in identical locations in each case. Additionally there were characteristic morphological similarities in the vertebral bodies, spinous processes, transverse processes and neural arches. In CT identification, as in conventional radiographic identification, one must try to reproduce comparable scanning conditions and images because apparent differences in the roentgenological morphology can occur as a result of different gantry angles or slice thicknesses.

Expert Testimony↗
PubMed1994

[1H-MR spectroscopic imaging: an approach to evaluating alcohol breakdown in the brain].

The local alcohol concentration in the human brain was determined in 10 cases using MR spectroscopic imaging. Therefore 7 subjects with an average blood alcohol concentration of 0.8/000 were examined after oral intake of alcoholic beverages. Varying alcohol concentration was found intracranially which was recorded spectroscopically w.r.t. time. Relatively high ethanol concentrations were determined in the cerebellum as well as in the ventricular system. Contrary to this, lower concentrations were found in the regions of grey and white matter.

Adult↗
PubMed1993

[Correlation between an occupational accident and death 55 years later. Evidence despite 2 1/2 months burial--a contribution to the value of insurance medicine autopsy also after exhumation].

Analysis of 24 autopsy cases ordered by insurances and performed at the Institute of Legal Medicine, Johannes Gutenberg University, Mainz (FRG), in the years from 1985 to 1991 revealed that even if there was a long period of time between accident and death (average: 20.3 years; maximum: 55 years) and in cases of exhumation necropsy was a useful tool in checking the relative's claim to insurance premium. Nevertheless post mortem examination should be performed as soon as possible to ensure evident pathomorphological findings and to avoid unjustified waiting periods with economical problems (e. g. case report: 78 years old widow couldn't pay electricity and call charge; she had a right to a pension due to an accident of her husband 55 years before, proved by exhumation 2 1/2 months after death.

Accidents, Occupational↗
PubMed1989

[Roentgen identification of unknown cadavers with advanced postmortem changes].

The postmortem changes in the bodies of two individuals were so advanced that the usual identification methods could not be applied; one had drowned and the other died by burning. Antemortem roentgenograms--up to 10 years old--and postmortem X-ray plates were compared and the bodies thus identified. This was possible because the skeleton shows individual, highly specific markers that do not change during life or after death.

Adult↗
PubMed1989

Possible association of sudden infant death with partial complement C4 deficiency revealed by post-mortem DNA typing of HLA class II and III genes.

Based on evidence of an increased rate of respiratory infections in sudden infant death (SID) infants as well as the observation of familial occurrence, we analysed in a retrospective study class II and class II genes of the major histocompatibility complex in 40 cases of SID by Southern blot analysis of DNA obtained post mortem from tissue samples. In 24 cases, the parents were interviewed and confirmatory human lymphocyte antigen (HLA) and DNA typing was carried out. Using HLA-DR beta and -DQ beta probes, no evidence of an abnormal HLA-DR frequency distribution in SID infants was detected (P = 0.97). Using DNA probes for the tandemly arranged complement C4 and steroid 21-hydroxylase genes, an increased number of C4B gene deletions in SID cases was found. The increase in C4 gene deletions was significant (P = 0.0125) in infants with recurrent infections. These data indicate a possible role of partial C4 deficiency as a genetically predisposing risk factor in SID.

Complement C4↗