Biomedical subjects

W Grellner

Publications and source records attributed to W Grellner.

At least 37 records · Page 2Linked to original sources

PubMed1994

Individualization of fresh and stored human urine samples by PGM1- and Gc-subtyping.

After 50- to 200-fold concentration by ultrafiltration, 56 fresh urine samples from healthy individuals (26 men, 30 women) and eight samples from corpses were subjected to isoelectrofocusing methods. All the urine samples tested could be correctly typed in both the phosphoglucomatase 1 (PGM1) and Gc system when compared to reference blood samples. The activity of urinary PGM1 revealed intraindividual and interindividual variations. To our knowledge this is the first report of PGM1 detection in urine. A systematic storage experiment over a period of 6 months was carried out at different temperatures (-20 degrees C, 4 degrees C, 20 degrees C); furthermore, aging of urine samples from 4 months to 4 years was investigated. The heterogeneous typing results were as follows. For Gc: after a storage period of 6 months positive results could be obtained in approximately 40% of those samples that were stored frozen (-20 degrees C) or in a refrigerator (4 degrees C). Some samples, however, showed negative analyses already after a 1 month storage period. At room temperature positive results could be achieved up to 3 months. Additional bands can appear in pherograms of urine samples stored at room temperature or in a refrigerator; they may cause misinterpretation, dependent on the original Gc-type. The maximum storage time compatible with successful Gc-typing was 1 year. For PGM1: this polymorphism could be regularly detected up to 1 week, and in some cases up to 1 month, in urine samples stored at 4 degrees C. The PGM1 activity gradually decreased; there were no additional or variant bands.

Female↗

PubMed1994

Pulmonary micromorphology in fatal strangulations.

Pulmonary histopathology was studied in a group of 106 fatal strangulations including cases of hanging (n = 55; typical, n = 20; atypical, n = 35), ligature strangulation (n = 12), throttling (n = 15), combinations of throttling and ligature strangulation (n = 7) and other compressing force against neck (n = 17). The control group (n = 10) consisted of cases of sudden cardiovascular death. The following results were obtained: intra-alveolar edema of different degree and strong hyperemia could be regularly observed in nearly all cases, especially in fatal hanging (apart from the control cases, in this group the highest mean lung weights were observed). Further frequent histological patterns were perivascular and intra-alveolar hemorrhages, local dystelectasis and focal emphysema. Alterations of the lung vessel contents could be detected in a varying extent: fat embolism (n = 7), mainly of minor degree, embolism of bone marrow tissue (n = 5) and intravascular cell accumulations (n = 22). Embolism of fat and bone marrow tissue was nearly always restricted to cases with accompanying blunt force or resuscitation measures. Whereas only 4 out of 55 cases of hanging revealed intravascular cell accumulations (including different types of leukocytes and immature bone marrow cells), 18 out of 51 cases with the other forms of strangulation exhibited this phenomenon. These accumulations mainly occurred in a discrete and widely scattered manner, appeared in 3 out of 10 control cases (resuscitation measures) as well, and were limited to cases with either protracted courses or accompanying blunt violence. The following conclusions are drawn: the regularly observed general changes of lung microstructure (e.g. edema, hyperemia) are undoubtedly non-specific for strangulation; the alterations of blood vessel contents may serve as a general vitality marker, if resuscitation measures are excluded, but not as an evidence of strangulating force. In cases without signs of blunt force they point to protracted agony courses (shock equivalents).

Adult↗

PubMed1994

[Gamma-glutamyltransferase and blood alcohol level--criteria for alcohol risk in automobile drivers. A critical comment on the guidelines for medical-psychological studies of first-time alcohol offenders].

GGT and blood alcohol concentration (BAC) were measured of 2,655 male car drivers using alcoholized their cars during the year 1991 in the area of the city of Cologne. The results were evaluated statistically together with other parameters like age, time of taking blood sample and behaviour while drunken. BAC was 1.6% and more in 30.5% of all cases. Half of them had levels of 2.0% and higher. GGT in serum was increased (> 28 U/l) at 29.5% of the drivers, in 6% even above 100 U/l. 53% were younger than 31 years. Medium BAC and part of GGT higher than 28 U/l were remarkable lower in this group than at the older ones. 50% of all car drivers with blood alcohol levels above 2.0% have alcohol problems regarding GGT. Problem drinkers were found among the younger ones to an extent of 15%, but of 50% among the drivers older than 40 years. But also 25% of all with a BAC lower than 1.6% showed increased GGT levels. They remain undetected on account of the present instructions of MPA though there is a great danger repeating drunken driving. On the other side nearly 50% of those driving with an BAC of 1.6% or more are no driving drinkers regarding GGT but have to undergo MPA. The recommendation of the 30. German Traffic Courts Meeting in 1992 to determine other indicators of alcohol habituation in the blood samples taken after drunken driving like GGT and methanol should be taken in a corrected setting of the instructions. This would regard fairer the problems of an individual case. The connection of MPA with the height of BAC and other circumstances seen as indicators for extraordinary alcohol habituation is a wrong way and unnecessary if alcoholism markers are used like GGT, CDT and methanol.

Adolescent↗

PubMed1993

DNA typing of urine samples following several years of storage.

The possibility of typing DNA polymorphisms on urine samples was investigated in a controlled storage experiment and for samples that were 1-7 years old. Female urine samples showed a higher amount of epithelial cells and therefore a higher DNA yield. Employing the polymerase chain reaction, specific amplification results were achieved for all samples over a 6 month storage period. The microscopical examination of the samples revealed not only differing degrees of contamination with bacteria, yeasts and fungi, but also the presence of still intact epithelial cells. Only 20% of the male samples and 32% of the female samples yielded specific amplification results. By separating the human cells from the contaminating organisms prior to DNA extraction, the number of successfully typed samples could be improved to 35% of the male and 77% of the female samples. This result confirms that excess amounts of co-extracted non-human DNA can inhibit the specific amplification of human target sequences.

Cell Count↗

PubMed1989

[Serodiagnosis of Lyme borreliosis: antibody titer and specificity in the IFT and western blot].

Out of 334 sera from healthy persons from northern Bavaria 6% reacted positive in the indirect immunofluorescence test (IFT, titre greater than or equal to 1:64). The percentage of positive cases in patients with erythema chronicum migrans (ECM), meningoradiculitis (M. Bannwarth), or acrodermatitis chronica atrophicans (ACA) was 43, 83 and 78%, respectively. In other patients with less characteristic symptoms in which an infection with B. burgdorferi was suspected the number of positive cases was only about 20%. A positive IgM-IFT was most often associated with ECM and M. Bannwarth; however, even in these cases IgM was only found in 30%. The serodiagnosis of Lyme disease required simultaneous serum testing of T. pallidum antibodies (TPHA) to exclude a syphilis with cross-reacting antibodies. In cases with a positive B. burgdorferi-IFT and TPHA the final diagnosis of Lyme disease was possible on the basis of Western blot analysis. The prominent antigens detected by sera from patients with Lyme disease--but not with syphilis--had molecular weights of 18, 22, 41 and 60 K; IgM antibodies were mainly directed against the 22 K and 41 K antigens. The antigen pattern was not characteristic for different disease stages.

Acrodermatitis↗

PubMedDate not supplied

[Reasons, circumstances and results of repeat forensic medicine autopsy].

There are only scant literature data on reasons and circumstances of medico-legal second autopsies. The present study includes 12 second autopsies from the period 1992-1997; the first post-mortem examination took place either in the home country (institutes of pathology) or abroad. 7 of the 12 cases of death investigated happened in Germany (exclusively in hospitals) and 5 of them abroad (Netherlands, Romania, Portugal, Libya). Repeat autopsies were ordered by criminal courts (n = 9), private persons (n = 2) and social insurances (n = 1). The main indication was possible medical malpractice (n = 6); acts of violence (n = 3), insurance questions (n = 2) and accidents (n = 1) followed. The time lapse between death and second autopsy was 2-35 days. It was striking, that German institutes of pathology had partially performed autopsies despite the certification of a non-natural death. Clinical autopsies were stopped twice, when evidence of a possible non-natural death occurred. It could be fundamentally stated, that first autopsies in German institutes of pathology had been carefully performed and sufficiently documented. In these cases the second autopsy presented no or only little additional information, as far as the broader taking of (toxicological) samples is not considered. The final medico-legal expertise was then mainly based on the findings of the clinical first autopsy. However, the concurrence of the forensic expert (instead of the clinical pathologist) is undoubtedly essential for the evaluation of these issues involving frequently questions of malpractice. By contrast, the quality of postmortems performed abroad varies widely. 4 of the 5 first autopsies done abroad were regarded as completely or partly insufficient with superficial or almost absent preparation of organs or contradictions in the medical reports, respectively. A repeat autopsy is absolutely necessary in such cases. On the whole, the initial question could be answered in all second autopsies at least in part. This emphasizes the high value of second autopsies and expertises, especially in non-natural cases of death (10 of 12 deaths were finally judged as non-natural).

Adult↗

PubMedDate not supplied

[Comparison of wound morphology following gunshots by machine guns and sub-machine guns].

Automatic weapons such as machine guns and submachine guns are found in the German-speaking region only in special army and police units and appear accordingly rarely in homicides, suicides and accidents. In the following, the findings in two cases of death with the use of machine and submachine guns are presented. The first case was a fatal accident during shooting on a training area (current machine gun of the German army, calibre 7.62 x 51 mm), the second case was a killing during a physical conflict (submachine gun MP 40 from World War II, calibre 9 x 19 mm). In the case with the machine gun autopsy disclosed typical entry holes corresponding to the calibre, but unusually large exit wounds with tissue bridges in the wound ground, measuring 4 x 2.5 cm in diameter. By contrast, the second case (submachine gun) showed "normal" entry and exit wounds. The differences are mainly caused by deviating ballistic data of the ammunition used. They are discussed against the background of literature on wound ballistics.

Firearms↗

PubMedDate not supplied

[Toxicologic findings in suicide with doxepin and paroxetine].

A young nurse was found dead in her flat. In chemical-toxicological analysis the following femoral blood drug concentrations were determined: paroxetine 0.176 mg/l, doxepine 82.12 mg/l, desmethyldoxepine 0.34 mg/l. Additionally the drug concentrations were determined in various body fluids and organs. The results of the described fatality are discussed. For interpretation of toxicologic results in antidepressant fatalities ratios of parent drug to metabolite and postmortem drug redistribution should be taken into account.

Adult↗

PubMedDate not supplied

[Suicide by double bolt gunshot wound to the head: case report and review of the literature].

Suicidal gunshot wounds from a livestock stunner with infliction of two shots against the head are extremely rare events. A case with these characteristics is presented and the corresponding literature is reviewed. A 61-year-old butcher was found dead with two entry wounds of the forehead on the right side and in the centre being typical for captive bolt pistols (symmetrically localized powder burns). The issues of the sequence of shots and the capacity of action are discussed on the basis of morphological findings and pathophysiological considerations. A literature review revealed only 4 case reports with double gunshot wounds of the skull caused by "humane killers" (Tovo 1956, Wolff and Laufer 1965, Schiermeyer 1973, Pollak 1977).

Brain↗

PubMedDate not supplied

[Suicide with a walking cane gun: weapon, injury picture and psychopathology].

In Germany firearms camouflaged as items of daily use are forbidden. While reports on ball-point pen-guns have repeatedly been published in literature, the use of a walking-stick gun is a rarity. The report deals with the suicide of a 31-year-old schizophrenic man who inflicted a shotgun injury to his head with typical morphological characteristics. The weapon used was a normal-looking walking stick with a barrel, cal. .410. Under forensic and criminological aspects the significance of a walking-stick gun is comparable to that of ball-point pen-guns. Both weapons can be carried and used inconspicuously, but from a walking-stick gun also ammunition of larger calibres with a higher potential of injury can be fired.

Adult↗

PubMedDate not supplied

[Suicide bomber using a pipe bomb].

Suicidal deaths caused by pipe bombs are rare. An 18-year-old man was found dead in a forest by hikers. In immediate proximity to the body, a crater was located obviously induced by a detonation. The postmortem examination revealed severe damage of the head, upper-body and both arms and hands along with the extensive presence of soot and dirt. Particularly noticeable were numerous "entry wounds" and the presence of five bullet like pieces of metal in the body. The young man had a history of drug abuse and psychiatric problems. On the basis of autopsy findings, the conclusions of the police investigation and psychopathological considerations regarding the victim's case-history, discussion centers upon the differentiation between suicide by self-explosion, homicide by explosion or death as a consequence of numerous bullet wounds followed by an attempt to burn the body. Also considered is the possibility of paranoid psychosis induced by cannabis use as a cause of suicide.

Adolescent↗

PubMedDate not supplied

[The value of various lung changes in death by strangulation].

Subsequently to previous investigations the value of the parameters lung weight and alterations of pulmonary vessel contents is demonstrated in a group of 106 fatal strangulations including all important subtypes of compressing force against the neck. The mean combined lung weights were generally elevated in a distinct way in all fatalities due to strangulating force (average: 1201 g) exhibiting a great interindividual variability and a slight dependence upon age with lower values in older persons. Significant differences between the various types of strangulation could not be observed. A detailed analysis of the material revealed, that intravascular pulmonary cell accumulations--apart from individual cases with massive concomitant blunt force injuries--in the first place are a correlate for protracted agony courses (shock equivalents). Both pulmonary parameters investigated cannot prove the diagnosis "death due to strangulation".

Adolescent↗

PubMedDate not supplied

[Cause of death in a patient lifting device].

Under the aspect of unusual and primarily obscure finding situations of dead bodies the case of a 81-year-old female occupant of an old people's home is reported. The woman was found dead being suspended by the hook of a patient's lifting machine, which had perforated through the floor of the mouth into the oral cavity. In the course of judicial inquiry first a homicide or a suicide, respectively, were justly considered. The autopsy results and circumstances of the case, however, pointed to a natural death (acute coronary insufficiency) with a preterminal/agonal fall into the hook of the lifting machine. An orthostatic circulatory dysregulation due to the suspension has possibly functioned as an additional mechanism accelerating death.

Aged↗

PubMedDate not supplied

[Child abuse caused by thermal violence--determination and reconstruction].

UNLABELLED: Problems in the judgement of child abuse due to thermal violence are discussed by means of two examined cases. In a baby dermal lesions in the course of a bacterial infectious disease (bullous impetigo) were first misinterpreted as heat effects (cigarette, hot instrument). In the case of an infant presenting with marked imprints of a hot iron abuse was to be differentiated versus an accidental causation. CONCLUSIONS: In the interpretation of possible thermal injuries in children natural preexisting disorders of the skin should be taken into consideration. In cases of doubt an appropriate clinical diagnosis or a subsequent follow-up examination, respectively, is recommended. Thus, the course of events can be observed and an unjustified incrimination of persons having custody is avoided.

Accidents, Home↗

PubMedDate not supplied

["Crows' feet wrinkles" in high voltage electric accident--a sign of survival?].

A "crowsfoot-like" pattern is considered as being a sign of vitality in fatalities due to the effects of smoke, fire or high voltage (active or reflex contraction of mimic muscles). Introducing the autopsy results of a high voltage accident (66,600 V) it is discussed, whether this phenomenon and the underlying contraction of the facial muscles could also be caused by electrical current in the agony or supravital period. It seems possible that this mechanism of direct muscle contraction anticipates a nerval indirect stimulation of muscle fibres by innervating motoneurones--active or on the basis of a polysynaptic extraneous reflex. If the electrophysiological course discussed should be right, a "crowsfoot-like" pattern in equivalent cases could be interpreted as a vital sign only with great reserve.

Accidents, Occupational↗

PubMedDate not supplied

[Possibilities of serologic individual typing of urine].

Human urine is frequently analysed in cases of doping or drug consumption. In this connection the necessity of an adequate urine identification arises. Apart from DNA-polymorphisms it exists a comprehensive repertoire of classic serological methods for this purpose. Human urine samples have been typed successfully in the following blood group systems: antigens of the erythrocytes' membrane (AB0-, Lewis-system), protein polymorphisms (Gc, transferrin, alpha-2-HS-glycoprotein) and enzyme polymorphisms (GPT). The results of the different studies are presented and completed by our own experiences with the Gc-system. In addition it is reported about our investigations concerning PGM1-subtyping of human urine.

Blood Grouping and Crossmatching↗

PubMedDate not supplied

[Physical restraints and gagging in unnatural death].

Practices of binding and gagging can be found in different types of unnatural death; three case reports concerning fatal autoeroticism, suicide and homicide are presented. In such cases investigations are usually concentrated on the question whether binding and gagging could be carried out by the persons themselves. Loosely bound final loops, especially of the hands, missing local haemorrhages and the discovery of binding instructions support the assumption of self-binding. Accompanying injuries and the entire situation must be taken into special consideration.

Adolescent↗

PubMedDate not supplied

[Unusual motivation in double suicide of a lesbian couple. Phenomenology, psychodynamics and influence of contemporary values].

Double suicides are regarded as uncommon phenomena. In particular, homosexuals are very rarely involved. It is reported on the unusual motivation of a dual suicide by hanging among two 20-year-old lesbian women. Due to abnormal psychic development and mutual induced reaction the thought of dying together and being reborn jointly in one person (a contemporary actor) arose. These ideas were influenced by spiritism and metempsychosis. The case is well-documented by diary records and will be discussed under phenomenological and psychodynamic aspects. Typical and atypical criteria of double suicides are featured.

Delusions↗