Edda Ambach

Cardiac troponin I in the diagnosis of myocardial injury and infarction.

We used a cardiospecific enzymoimmunometric assay to measure cardiac troponin I (cTnI) in samples serially drawn from 78 patients with acute myocardial infarction (AMI), 7 patients with unstable angina (Braunwald class III), 22 multi-traumatized patients, and in 30 athletes after eccentric exercise, as well as in 101 non-traumatic chest pain patients on admission to the emergency department. cTnI assay crossreactivity with crude human skeletal muscle homogenates was < 0.1%. cTnI could not be detected in athletes or multi-traumatized patients except for 2 trauma patients with myocardial damage. Increased cTnI concentrations were found in 6 of 7 patients with unstable angina at rest and in all AMI patients. After AMI, cTnI increased about 3.5 h (median) after the onset of chest pain, reached peak values parallel to CKMB, and stayed increased for at least 4 days. Cardiac troponin T (cTnT) increased and mostly peaked parallel to cTnI. cTnT sensitivity on the 7th day after AMI was significantly higher than that of cTnI. In contrast to cTnI, cTnT mostly showed a second, usually smaller, peak about day 4 after AMI. During the first 4 h after the onset of chest pain and before thrombolytic therapy the sensitivities of myoglobin (0.43) and CKMB mass (0.56) were significantly higher than those of both troponins (cTnI, 0.29; cTnT, 0.25). Areas under receiver operator characteristic curves indicated only moderate diagnostic accuracies of bio-chemical markers for early AMI diagnosis in non-traumatic chest pain patients that cTnI is a highly sensitive and specific marker for myocardial damage which is suitable for early and late diagnosis.

Stimulation of human nitric oxide synthase by tetrahydrobiopterin and selective binding of the cofactor

To check the stimulatory potency of the tetrahydro forms of the two major pteridines occurring in human tissues, neopterin and biopterin, NO synthase was purified 6000‐fold from human cerebellum. Tetrahydrobiopterin stimulated the activity up to 4.5‐fold in a concentration dependent manner with a maximum above 1 μM, whereas tetrahydroneopterin was completely inactive in concentrations up to 100 μM. Tetrahydrobiopterin, but not neopterin derivatives, were copurified with the NO synthase activity. Our results demonstrate that human cerebellum contains a tetrahydrobiopterin dependent NO synthase activity.

Austrian Caucasian Population Data for the Quadruplex Plus Amelogenin: Refined Mutation Rate for HumvWFA31/A

Human identification of biological specimens has undergone immense change since the development of PCR typing systems for forensic casework. In contrast to RFLP and VNTRs, STRs are the method of choice when the investigated genomic DNA is present in low quantity or in degraded shape. In the current study, the X-Y homologous gene Amelogenin has been added to a widely used multiplex PCR amplification system consisting of four tetrameric STR loci (Quadruplex-HumTH01, HumvWFA31/A, HumFES/FPS, and HumF13A1). The modified Quadruplex was used to type 382 unrelated Caucasians from Western Austria. The population data meet Hardy-Weinberg and linkage equilibrium expectations, and do not show significant deviations from either US, German, and Turkish Caucasian databases. In an investigation of 382 meioses, two mutations were revealed at the HumvWFA31/A locus. Consequently, the data in this paper provide the conditions for adding Amelogenin to the Quadruplex, and suggest that when doing paternity testing, the mutation rate for the HumvWFA31/A locus must be considered.

Superfecundation and dual paternity in a twin pregnancy ending with placental abruption.

A case of superfecundation and dual paternity in a twin pregnancy is presented. Placental abruption developed at week 33 of gestation and the two boys had to be saved by emergency cesarean section. As they shared one placenta, had almost identical weight and had the same sex, they were assumed to be monozygotic. However, a subsequent paternity suit led to the conclusion, based on DNA-analysis, that the twin brothers had been fathered by two different men. Obstetrical implications are discussed.

Iatrogenic ruptures of the stomach after balloon tamponade. Two case reports: viscoelastic model.

Two cases of gastric rupture as a rare complication of balloon tamponade for esophageal varices are presented. In both cases, the rupture was caused by instillation of irrigation fluid without previous aspiration of stomach contents. In an experimental study, the stomachs of 11 corpses were filled with water to determine rupture pressure and volume. The mean rupture Pressure was 73 ± 13 mm Hg (9.7 ± 1.7 kPa) and the mean rupture volume was 2,670 ± 410 ml. A viscoelastic model was used for the representation of the relations between pressure and volume as well as pressure and time. Measured values are significant particularly for the explanation and medicolegal evaluation of iatrogenic ruptures of the stomach that occur during gastric lavage, positive pressure respiration, incorrect intubation, or forced mask respiration during resuscitation.

Multiplex PCR and Automated Fluorescence Detection of Four Tetrameric STRs in a Western Austrian Population

Short Tandem Repeats (STR) loci, also known as microsatellites, consist of repetitive sequences, generally 2 to 6 nucleotides in lenght. Because of their highly polymorphic nature, STR loci offer high discrimination amongst individuals which can be valuable in forensic matters. The fact that STRs are amplifiable by the Polymerase Chain Reaction (PCR) from small quantities of DNA (about 1 ng or less) and even substantially degraded DNA samples, makes the use of STRs desirable for genetic characterization in a number of forensic cases.

Postmortem Evaluation of Serum and Urine Neopterin Concentrations

Cellular immune response is accompanied by the release of neopterin. Increased neopterin levels in urine and serum are observed in patients during viral infections, autoimmune diseases, and allograft rejections and certain malignant diseases. We investigated postmortem neopterin concentrations in urine and serum samples taken from 32 corpses 3 to 69 h (mean 19.3 h) after death. Urine neopterin concentrations in corpses are similar to those of healthy live controls and are independent of the time after death. In contrast, serum neopterin concentrations are frequently greatly increased in corpses, and the levels are higher in sera collected more than 10 h after death in comparison with samples obtained earlier. Neopterin measurement in urine and serum samples of corpses is feasible. It appears likely that urine neopterin concentrations could aid the diagnosis of inflammatory diseases in corpses.

Postmortem neopterin concentrations: comparison of diagnoses with and without cellular immunological background.

SummaryIncreased neopterin levels in urine and serum of living humans indicate an activation of the cellular immune system. We investigated 119 urine and 48 serum samples from 129 corpses taken at necropsy; 29 cases with a background of cellular immune activation were compared to 100 corpses with no such indication. Our investigations show the feasibility of postmortem neopterin measurements. However, different kinetics of serum and urine concentrations after death were observed. In addition, the data show that urine and serum neopterin concentrations were significantly higher when cellular immunological abnormalities were present when compared to the control group and to living healthy controls. The findings suggest, that increased postmortem urine neopterin concentrations in necropsy indicate pathological processes linked with cellular immune activation.ZusammenfassungErhöhte Neopterinspiegel in Serum und Harn Lebender sind ein Hinweis auf eine gesteigerte Aktivität des zellulären Immunsystems. Wir untersuchten 119 Harn- und 48 Serumproben von insgesamt 129 Leichen; bei 29 Fällen (Gruppe I) konnten Erkrankungen, die bekannterweise mit zellulären immunologischen Veränderungen einhergehen, festgestellt werden, bei den restlichen 100 Fällen (Gruppe II) lieferte die Obduktion keinen Anhalt auf derartige Erkrankungen. Die Auswertung unserer Ergebnisse ergab eine signifikante Erhöhung der Neopterinkonzentrationen in Serum und Harn in Gruppe I, sowohl gegenüber der Kontrollgruppe (Gruppe II) als auch gegenüber gesunden Personen. Da Neopterin im Harn zumindest über 24 Stunden post mortem stabil ist, könnte ein erhöhter Neopterinwert einen diagnostischen Hinweis auf eine Erkrankung, die mit zellulärer Immunaktivierung einhergeht, liefern.

Corpses released from glacier ice: glaciological and forensic aspects

Glaciological and forensic aspects of six corpses released from glacier ice during summer 1991 are discussed in detail. The times of immersion in glacier ice of fatally injured persons can vary from several years to several centuries. The corpses are transported along a flow line beneath the surface of the glacier and emerge on the surface only after reaching the ablation area. Immersion times of more than 1000 years are possible with corpses buried in stagnant or dead ice areas. Adipocere and mummification are characteristic changes to soft tissues and organs. The Homo tyrolensis found on Hauslabjoch (elevation 3200 m (10500 ft), Oetztal Alps, Austria) was determined to be 5000 years old.

Fatal Accidents on Glaciers: Forensic, Criminological, and Glaciological Conclusions

The rare event of a corpse immersed in glacier ice becoming exposed on a glacier surface is closely connected with the glaciological conditions at the scene and the site of the accident. Provided that the time since death is known, certain questions relative to the circumstances of a mountain accident can only be answered by considering glaciological aspects. How the scene of an accident can be reconstructed by inference from the site of discovery is discussed by means of three exemplary cases that occurred on Tyrolean glaciers (Austria) during the past 40 years: (1) Two corpses were discovered close above the equilibrium line in the accumulation area after 25 years. The two victims had fallen down a rock face after the breaking off of a cornice and had come to rest in the uppermost part of the accumulation area. (2) A victim was discovered in the lower ablation area 8 years after falling down a crevasse in the middle part of the ablation area. (3) A female alpinist was discovered at the very end of the glacier after 29 years; it was concluded that the accident must have happened in the accumulation area.