R. Lessig

Medical examination of fitness for police custody in two large German towns

Worldwide, there is a high risk of medical complications or death in police custody. This risk is often increased by unclear legislation, a lack of clearly defined responsibility and medical examination standards. Any solution to these problems requires as a very basis the systematic analysis of the medical examinations that determine whether a person is fit to be detained in custody. We analysed a total of 3,674 medical records on fitness for custody, taken from two large German towns (Halle/S and Bremen). The examined individuals were predominantly males or of a younger age. The indication in the majority of cases was acute alcoholic intoxication or drug withdrawal syndromes. Traumata and internal or mental diseases were also quite frequent. For approximately 50% of all cases, fitness for custody was declared on certain conditions. Only 39.8% were found to be unconditionally fit for detention in custody. In just under 10% of the cases, the person was found unfit for custody. These cases concerned mainly persons with psychological symptoms and advanced alcohol or drug withdrawal syndromes. We were able to show that the recent introduction of new police custody regulations in Halle/S had a significant influence on the medical decision on fitness for custody. Our detailed assessment has provided us with the basis to develop solutions for the improvement of medical care in police custody. The focus lies here on the organisation and legal regulation of the medical aspects of custody but also on policing and medical work.

HPLC–DAD protein kinase inhibitor analysis in human serum

We here describe an HPLC-DAD method to analyse different protein kinase inhibitors. Potential applications of this method are pharmacokinetic studies and therapeutic drug monitoring. Optimised chromatography conditions resulted in a very good separation of seven inhibitors (vatalanib, bosutinib, canertinib, tandutinib, pazopanib, dasatinib - internal standard and erlotinib). The good sensitivity makes this method competitive with LC/MS/MS. The separation was performed with a Lichrospher 100-5 RP8, 250 mm × 4 mm column maintained at 30 ± 1 °C, and with a mobile phase of 0.05 M H(3)PO(4)/KH(2)PO(4) (pH=2.3)-acetonitrile (7:3, v/v) at a flow rate of 0.7 mL/min. A simple and fast sample preparation sequence with liquid-liquid extraction led to good recoveries (73-90%) of all analytes. The recovery hardly reached 50% only for pazopanib. This method can also be used for targeted protein kinase inhibitor quantification. A perfect linearity in the validated range (20-10,000 ng/mL) and an LOQ of 20 ng/mL were achieved. The relative standard deviations and accuracies of all examined drug concentrations gave values much lower than 15% both for between- and within-batch calculations. All analysed PKIs were stable for 6 months in a 1mg/mL dimethyl sulfoxide stock solution. Vatalanib, bosutinib and erlotinib were also stable in human serum in the whole examined concentration range.

International standards in cases of mass disaster victim identification (DVI)

Mass disasters with a large number of unknown victims are among the biggest challenges for the police and forensic disciplines. Historical events illustrate the development of different methods which can be used in such circumstances. The fire in the Ring-Theater of Vienna (Austria) in 1881 with 449 victims of which 284 were subsequently identified [1], or the fire in the Bazar de la Charite in Paris (France) with 126 victims in 1897 [2] are examples of the usefulness of identification procedures such as forensic autopsy, odontology, and finger printing. These two disasters from the nineteenth century were the beginning of modern identification processes in legal medicine [2]. In the following years several major accidents, especially after the introduction of regular civil air transportation services, demanded an effective diaster victim identification (DVI) system. Even today the identification of victims of mass disasters is still one of the most important tasks. Forensic experts are involved in different ways depending on the country of residence, and include forensic pathologists, forensic dentists, forensic anthropologists, forensic molecular biologists and other specialists. The organization of the identification process differs from country to country, and within the countries, depending on the historical and political structures and on the kind of disaster. The success of the identification essentially relies on the organization, the experience, and the documentation of findings. The communication between countries or states can be difficult, particularly in cases where victims have different nationalities. Therefore, the solution to such problems should be a standardized process. The recent natural disaster in Japan, triggered by a massive earth quake, also illustrates the need for standards in cases of radioactive contamination. Nobody has experiences in cases of simultaneous chemical, biological, or radioactive/nuclear (CBRNE) situations and assaults with a large number of contaminated bodies.

Alterations of neuronal precursor cells in stages of human adult neurogenesis in heroin addicts

BACKGROUND Adult neurogenesis has been shown to occur throughout life and different brain pathologies were demonstrated to be associated with altered neurogenesis. Here, an impact of heroin addiction on neurogenesis in humans is hypothesised. METHODS Post mortem hippocampal specimens of drug addicts with known heroin abuse and a group of non-addictive control subjects were analysed, using antibodies indicating different stages of neurogenesis. The subgranular zone of the dentate gyrus was examined qualitatively and quantitatively. RESULTS The data indicate (i) a decreased number of neural precursor cells, (ii) accompanied by low rates of proliferation and (iii) a marked loss of dendritic trees in targeting cells in heroin fatalities. (iv) The age-dependent increase of differentiating cells in the healthy controls was not observed in the addicts. Additionally, double immunofluorescence labelling indicated the precursor nature of Musashi-1 positive cells in the human subgranular zone of the dentate gyrus. CONCLUSIONS Present data firstly demonstrate the influence of drug addiction with known heroin abuse on different developmental stages of progenitors in the dentate gyrus. The patterns of antibody staining suggest a distinct inhibition of neurogenesis at the stage of neural precursor cells and revealed morphological changes in targeting cells in cases of heroin addicts as compared to healthy controls. These alterations could be considerable for memory and cognitive deficits as well as addictive behaviour in chronic drug abusers and may give rise to specific pro-neurogenic therapies.

Long QT syndrome mutation detection by SNaPshot technique

Long QT syndrome (LQTS) is a cardiac disorder with an abnormality of cardiac rhythm associated with sudden death especially in younger, apparently healthy individuals. If there is no clear cause of death detectable during comprehensive coroners inquest (autopsy-negative cases), you have to consider LQTS and other heritable arrhythmia syndromes. A molecular genetic screening regarding mutations in associated genes can help to ensure the cause of death and to protect affected family members. Genetic testing of LQTS, currently performed mainly by sequencing, is still very expensive and time consuming. With this study we present a rapid and reasonable method for the simultaneously screening of some of the most common mutations associated with LQTS, focused on the KCNQ1 and KCNH2 genes. With the method of SNaPshot minisequencing, a total of 58 mutations were analyzed in four multiplex assays which were successfully established and optimized. The comparison with samples previously analyzed by direct sequencing showed concordance. Furthermore, autopsy-negative cases were tested but no mutations could be observed in any of the specimen. The presented method is well suitable for LQTS mutation screening. An enhancement to further mutations and population-based investigations regarding mutation frequencies should be the aim of prospective studies.

Tatwerkzeug Billardqueue – überraschende Diagnose einer überlebten kranialen Pfählungsverletzung

ZusammenfassungEs wird über einen Mann berichtet, der im Rahmen einer Auseinandersetzung mit einem Billardqueue geschlagen und mehrfach gegen Kopf und Körper getreten worden sein soll. Nach der ersten Einschätzung erschienen die Verletzungen zunächst mit dem Tatgeschehen vereinbar. Bei der weiteren kritischen Fallbetrachtung ergaben sich nach der Hinzuziehung der initialen Computertomographie-Originalaufnahmen jedoch klare Hinweise auf eine Pfählungsverletzung des rechten Auges. Die Kasuistik unterstreicht die Bedeutung einer engen Kooperation zwischen dem Rechtsmediziner und der radiologischen Fachdisziplin.AbstractThis article reports the case of a man who was apparently beaten with a billiard cue during an altercation and also repeatedly received kicks to the head and body. After the first assessment, the injuries seemed to be compatible with these facts; however, in the further critical case analysis including the original computed tomography images there were clear indications of an impalement injury to the right eye. The case report emphasizes the importance of close cooperation between forensic pathologists and the discipline of radiology.

Multiple Hämatome als möglicher Hinweis auf Kindesmisshandlung

Ein zwei Monate alter Säugling wird mit zahlreichen hämatomsuspekten Hautverfärbungen eingeliefert. Nach Zeugenangaben war das Kind von der Mutter äußerst grob behandelt worden. Die stationäre Aufnahme des Mädchens erfolgte deshalb unter dem dringenden Verdacht auf eine Kindesmisshandlung.

Traumatologie und gewaltsamer Tod

Forensisch-traumatologische Untersuchungen sind in vielfaltigen rechtlichen Zusammenhangen von Bedeutung; sie dienen der Befunderhebung, Dokumentation und Asservierung. Bei der Beurteilung von Verletzungen sind Suizide, Suizidversuche, Selbstbeschadigungen einerseits, Unfalle und Unglucksfalle sowie Korperverletzungs- und Totungsdelikte andererseits zu differenzieren. Unter Traumatomechanik versteht man eine schadigende Krafteinwirkung, die uber eine Deformation eine Kontinuitatsunterbrechung, also eine Gefugetrennung des Gewebes nach sich zieht. Gewalteinwirkungen werden hinsichtlich ihrer Verursachung eingeteilt in mechanische Insulte (stumpfe und scharfe Gewalt), Schussverletzungen, Erstickungen, Tod im Wasser, thermische Energie (Hitze, Kalte), Elektrizitat, Blitzschlag, Strahlen, Verhungern, Vernachlassigung, Kindstotung, Abtreibung, Tod in abnormer Korperposition etc.