R. Hausmann

Performance enhancing drugs (doping agents) and sudden death – a case report and review of the literature

Abstract The case of sudden cardiac death of a 23-year-old body builder who used anabolic steroids combined with other performance enhancing drugs is reported. Postmortem investigations revealed cardiac hypertrophy, acute cellular necrosis and interstitial fibrosis of the myocardium. The side-effects and interactions of the substances used are discussed.

A quantitative immunohistochemical study on the time-dependent course of acute inflammatory cellular response to human brain injury

The time-dependent inflammatory cell reaction in human cortical contusions has been investigated during the first 30 weeks after blunt head injury. Immunohistochemical staining was carried out using CD 15 for granulocytes and LCA, CD 3 and UCHL-1 for mononuclear leucocytes. In order to provide reliable data for a forensic wound age estimation, the intensity of the cellular reaction was evaluated with a quantitative image analysis system. CD 15-labelled granulocytes were detectable earliest 10 min after brain injury, whereas significantly increased numbers of mononuclear leucocytes occurred in cortical contusions after a postinfliction interval of at least 1.1 days (LCA), 2 days (CD 3) or 3.7 days (UCHL-1), respectively.

Immunohistochemical investigations on the course of astroglial GFAP expression following human brain injury

The course of GFAP expression by astrocytes has been immunohistochemically investigated during the first 30 weeks after human brain injury. In order to provide reliable data for a forensic wound age estimation, a quantitative morphometric analysis was performed considering the different topographic regions of the cortex as well as of the white matter. Compared to the GFAP immunoreactivity in unaltered control tissue, significantly increased numbers of GFAP positive astroglial cells could be detected adjacent to the cortical contusion from 1 day up to 4 weeks after brain injury.

The time course of the vascular response to human brain injury--an immunohistochemical study.

Abstract In a total of 104 individuals who had sustained traumatic brain injury (TBI), the time-dependent vascular response was investigated at the injured cortical area during the first 30 weeks after the trauma. The immunohistochemical staining of the cerebral blood vessels was performed with antibodies against laminin, type IV collagen, tenascin, thrombomodulin and factor VIII associated antigen. Compared to the immunoreactivity in unaltered control tissue, a significantly increased vascular expression could be detected in cortical contusions after a postinfliction interval of at least 3 h for factor VIII, after 1.6 days for tenascin or after 6.8 days for thrombomodulin, whereas the immunostaining for laminin and type IV collagen was regularly positive even in the vascular endothelium of uninjured brain tissue.

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

Abstract 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.

Course of glial immunoreactivity for vimentin, tenascin and α1-antichymotrypsin after traumatic injury to human brain

Abstract In a total of 104 individuals who had sustained traumatic brain injury (TBI), the course of glial immunoreactivity was investigated at the injured cortical area during the first 30 weeks after the trauma, in order to provide data for a forensic wound age estimation. Glial cells were stained with antibodies against the intermediate filament protein vimentin, the extracellular matrix protein tenascin and the serine protease inhibitor α1-antichymotrypsin (α1-ACT). Injury-induced glial staining reactions could be observed, at the earliest, after a post-infliction interval of 3.1 h for α1-ACT, 22 h for vimentin and 7 days for tenascin.

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

Abstract 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 × 0.01 cm was found up to a postinfliction interval of approximately 6 h. Average numbers exceeding 1 positive cell/0.01 cm × 0.01 cm were first detectable in a skin wound after 24 h. Therefore, average numbers greater than 1 labeled cell/ 0.01 cm × 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 × 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.

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.

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.

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

SummaryThis paper reports on the specificity of the Lugols 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 Lugols 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 Lugols method can no longer be assumed to prove the presence of vaginal cells in penile swabs.ZusammenfassungWir untersuchten die Spezifität der Lugolschen Färbetechnik für den Nachweis von Scheidenzellen in Penisabklatschpräparaten. Dazu wurde das luftgetrocknete Material von der Glans Penis von insgesamt 153 Klinikpatienten und 50 freiwilligen Probanden mit Lugolscher Lösung gefärbt. Der letzte Geschlechtsverkehr lag jeweils mindestens fünf Tage zurück. Glykogenhaltige Plattenepithelien waren in mehr als 50% aller untersuchten Fälle nachweisbar, auch bei gesunden Probanden ohne Urethritis. In nahezu allen dieser Fällen waren im Penisabklatsch zumindest einzelne polygonale Epithelzellen mit eindeutig positiver Lugol-Reaktion nachweisbar. Diese Zellen lassen sich morphologisch nicht von superficialen oder intermediären Vaginalzellen unterscheiden. Harnwegsinfekte hatten keinen Einfluß auf den Glykogengehalt männlicher Epithelzellen. Unsere Ergebnisse zeigen, daß die Lugolsche Färbetechnik für den Nachweis von Scheidenzellen in Penisabklatschpräparaten nicht mehr als geeignet angesehen werden kann.