919 resultados para post-mortem inspection
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Food items and nematode parasites were identified from the stomachs of 42 individuals of Phocoena phocoena, 6 of Lagenorhynchus acutus and 8 of L. albirostris stranded off the coastal waters of Northern Scotland between 2004 and 2014. Post-mortem examinations have revealed heavy parasitic worm burdens. Four nematode species complex as Anisakis spp., Contracaeucum spp., Pseudoterronova spp., and Hysterothylacium spp. were recorded. Data on presence of the anisakid species in cetaceans, reported a significative relationship between the presence of Hysterothylacium and the month of host stranding; suggesting a decrease of larval H. aduncum abundance in the period between April and August due to a seasonal effect related to prey availability. Similarly, the parasite burden of the all anisakid genera was related to the year fraction of stranding, and a relationship statistically significant was found just for L. albirostris with an increase between April and October. This finding is explained by a seasonality in occurrence of white-beaked dolphins, with a peak during August, that might be related to movements of shared prey species and competition with other species (Tursiops truncatus). Geographical differences were observed in parasites number of all anisakid species, which was the highest in cetaceans from the East area and lowest in the North coast. The parasites number also increased significantly with the length of the animal and during the year, but with a significant seasonal pattern only for P. phocoena. Regarding diet composition, through a data set consisting of 34 harbour porpoises and 1 Atlantic white-sided dolphins, we found a positive association between parasite number and the cephalopods genus Alloteuthis. This higher level of parasite infection in squid from this area, is probably due to a quantitative distribution of infective forms in squid prey, an abundance of the final host and age or size maturity of squid.
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In den letzten Jahren stieg in Deutschland der Gebrauch bzw. Missbrauch von Opioid-Analgetika zunehmend an. Das entwickelte Verfahren sollte unter Einbeziehung neuer Substanzen möglichst viele verschiedene Opioide und auch ihre pharmakologisch aktiven Stoffwechselprodukte berücksichtigen.rnVor Analyse wurden Blut-, Serum- oder Urinproben mit Phosphatpuffer versetzt und mittels Festphasenextraktion an C18-Säulenmaterial aufgearbeitet. Post-Mortem-Gewebematerial wurde mit isotonischer Kochsalzlösung versetzt, homogenisiert und anschließend durch eine Festphasenextraktion aufgereinigt. Haarproben wurden nach Zerkleinerung mit Methanol unter Ultrabeschallung extrahiert. Die Flüssigchromatographie gekoppelt mit Tandem-Massenspektrometrie (Elektrosprayionisation im positiven Modus) erwies sich als geeignetes Verfahren für die simultane Bestimmung der Opioide in biologischem Probenmaterial (Körperflüssigkeiten, Gewebe und Haaren). Der Multi-Analyt Assay erlaubt die quantitative Analyse von 35 verschiedenen Opioiden. Die Analyten wurden durch eine Phenyl-Hexyl Säule und einen Wasser/Acetonitril Gradienten durch eine UPLC 1290 Infinity gekoppelt mit einem 6490 Triple Quadrupol von Agilent Technologies separiert.rnDie LC/MS Methode zur simultanen Bestimmung von 35 Opioiden in Serum und Haaren wurde nach den Richtlinien der Gesellschaft für Toxikologische und Forensische Chemie (GTFCh) validiert. Im Fall der Serumvalidierung lagen die Nachweisgrenzen zwischen 0.02 und 0.6 ng/ml und die Bestimmungsgrenzen im Bereich von 0.1 bis 2.0 ng/ml. Die Kalibrationskurven waren für die Kalibrationslevel 1 bis 6 linear. Wiederfindungsraten lagen für alle Verbindungen zwischen 51 und 88 %, außer für Alfentanil, Bisnortiliidn, Pethidin und Morphin-3-Glucuronid. Der Matrixeffekt lag zwischen 86 % (Ethylmorphin) und 105 % (Desomorphin). Für fast alle Analyten konnten akzeptable Werte bei der Bestimmung der Genauigkeit und Richtigkeit nach den Richtlinien der GTFCh erhalten werden. Im Fall der Validierung der Haarproben lagen die Nachweisgrenzen zwischen 0.004 und 0.6 ng/Probe und die Bestimmungsgrenzen zwischen 0.1 ng/Probe und 2.0 ng/Probe. Für die Kalibrationslevel 1 bis 6 waren alle Kalibrationsgeraden linear. Die Wiederfindungsraten lagen für die Opioide im Bereich von 73.5 % (Morphin-6-Glucuronid) und 114.1 % (Hydrocodon). Die Werte für die Bestimmung der Richtigkeit lagen zwischen - 6.6 % (Methadon) und + 11.7 % (Pholcodin). Präzisionsdaten wurden zwischen 1.0 % für Dextromethorphan und 11.5 % für Methadon ermittelt. Die Kriterien der GTFCh konnten bei Ermittlung des Matrixeffekts für alle Substanzen erfüllt werden, außer für 6-Monoacetylmorphin, Bisnortilidin, Meperidin, Methadon, Morphin-3-glucuronid, Morphin-6-glucuronid, Normeperidin, Nortilidin und Tramadol.rnZum Test des Verfahrens an authentischem Probenmaterial wurden 206 Proben von Körperflüssigkeiten mit Hilfe der simultanen LC/MS Screening Methode untersucht. Über 150 Proben wurden im Rahmen von forensisch-toxikologischen Untersuchungen am Instituts für Rechtsmedizin Mainz analysiert. Dabei konnten 23 der 35 Opioide in den realen Proben nachgewiesen werden. Zur Untersuchung der Pharmakokinetik von Opioiden bei Patienten der anästhesiologischen Intensivstation mit Sepsis wurden über 50 Blutproben untersucht. Den Patienten wurde im Rahmen einer klinischen Studie einmal täglich vier Tage lang Blut abgenommen. In den Serumproben wurde hauptsächlich Sufentanil (0.2 – 0.8 ng/ml in 58 Fällen) und Piritramid (0.4 – 11 ng/ml in 56 Fällen) gefunden. Außerdem wurden die Proben von Körperflüssigkeiten und Gewebe von 13 verschiedenen Autopsiefällen mit Hilfe des Multi-Analyt Assays auf Opioide untersucht.rnIn einem zweiten Schritt wurde die Extraktions- und Messmethode zur Quantifizierung der 35 Opioide am Forensic Medicine Center in Ho Chi Minh City (Vietnam) etabliert. Insgesamt wurden 85 Herzblutproben von Obduktionsfällen mit Verdacht auf Opiatintoxikation näher untersucht. Der überwiegende Teil der untersuchten Fälle konnte auf eine Heroin- bzw. Morphin-Vergiftung zurückgeführt werden. Morphin wurde in 68 Fällen im Konzentrationsbereich 1.7 – 1400 ng/ml und der Heroinmetabolit 6-Monoactetylmorphin in 34 Fällen (0.3 – 160 ng/ml) nachgewiesen werden.rnSchließlich wurden noch 15 Haarproben von Patienten einer psychiatrischen Klinik, die illegale Rauschmittel konsumiert hatten, mit Hilfe der simultanen Opioid-LC/MS Screeningmethode gemessen. Die Ergebnisse der Untersuchung wurden mit früheren Auswertungen von gaschromatographischen Analysen verglichen. Es zeigte sich eine weitgehende Übereinstimmung der Untersuchungsergebnisse für die Opioide 6-Monoacetylmorphin, Morphin, Codein, Dihydrocodein und Methadon. Mit der LC/MS Methode konnten weitere Substanzen, wie zum Beispiel Bisnortilidin, Dextromethorphan und Tramadol in den Haarproben gefunden werden, die bislang nicht entdeckt worden waren.rn
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Die vorliegende Dissertation ist eine molekulargenetische Studie an humanem neolithischem Skelettmaterial. Im zentralen Blickpunkt stand die Bestimmung der Variabilität der mitochondrialen Haplogruppen einer frühneolithischen Stichprobe aus drei unterschiedlichen Kulturkreisen, welche die Linearbandkeramik (LBK und AVK), die Körös-Kultur und eine Sammelkategorie osteuropäischer spätmeso- und frühneolithischer Kulturen umfasste. Im Vergleich dieser Gruppen untereinander sowie mit Rezentdaten moderner Populationen aus vergleichbaren Gebieten Mittel- und Osteuropas sowie dem Nahen Osten sollten bestehende Modelle und Hypothesen zur Neolithisierung Mitteleuropas geprüft werden. Insgesamt konnte für 43 neolithische Individuen aus 16 Fundorten der reproduzierbare Nachweis endogener DNA erbracht werden. Eine eindeutige Haplogruppenbestimmung konnte durch die Sequenzierung vier überlappender Fragmente der mitochondrialen Hypervariablen Region I sowie durch RFLP-Analyse zusätzlicher charakteristischer Nukleotidpositionen für alle 43 Individuen durchgeführt werden. Die neolithischen Individuen der Linearbandkeramik sowie der Körös-Kultur zeigten eine hohe Diversität an bekannten europäischen Haplogruppen, wohingegen die kleinere Stichprobe aus dem Gebiet Osteuropas eine auffällige Homogenität aufwies. Neben Frequenzunterschieden zur modernen mitteleuropäischen Bevölkerung war innerhalb der LBK/AVK-Stichprobe eine hohe Frequenz der Haplogruppe N1a festzustellen, welche nicht in den beiden anderen neolithischen Stichproben zu finden war und auch in der heutigen Rezentbevölkerung Eurasiens und Nordafrikas nur mit einer durchschnittlichen Frequenz von 0,2% vertreten ist. Innerhalb der Individuen der Körös-Kultur fanden sich zwei Haplotypen, welche heute nicht in Europa bekannt sind, dagegen jedoch in Süd- bzw. Nordostasien gehäuft vorkommen. Die Ergebnisse der aDNA-Analysen bestätigten im Wesentlichen das komplexe Bild der Neolithischen Transition in Mitteleuropa und konnten die, für diesen Raum postulierte, Hypothese der leap frog colonization weitestgehend unterstützen. Auch für den geographischen Vergleichsraum des nördlichen Osteuropa konnten Parallelen zur etablierten Sichtweise der archäologischen Forschung zu diesem Gebiet und den vorliegenden Ergebnissen der aDNA-Analysen aufgezeigt werden. Die zeitlich verzögerte Annahme der neolithischen Lebensweise im waldreichen nördlichen Osteuropa spiegelt sich in der reduzierten Diversität an mtDNA-Haplogruppen wider. Die vorliegende Dissertation konnte nicht nur durch die Ergebnisse der Haplogruppen-Bestimmung, sondern vor allem durch die umfangreichen und elaborierten Reproduktions- und Authentifizierungprotokolle deutlich machen, dass der Nachweis von humaner alter DNA trotz der allgegenwärtigen, methodenimmanenten Kontaminationsgefahr unter streng kontrollierten Bedingungen möglich ist. Gleichermaßen konnte veranschaulicht werden, dass die aDNA-Analyse wertvolle Hinweise auf das genetische status quo einer Population liefern kann, welche nicht bzw. nur in sehr eingeschränkten Maße von rezenten DNA-Daten abgeleitet werden können. Als sekundäres Ergebnis erlaubte der bislang größte vorliegende Datensatz von ~2500 Klonsequenzen zudem einen detaillierten Einblick in Häufigkeiten und Verteilungsmuster von post mortem Sequenzveränderungen. Es konnten für den mitochondrialen Bereich der Nukleotidpositionen 15997-16409 so genannte hot bzw. cold spots definiert werden, welche für die Auswertung und Interpretation von zukünftigen Sequenzierungen der Hypervariablen Region I des mt-Genoms von entscheidender Bedeutung sein werden.
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Clinically, the displacement of intravertebral fat into the circulation during vertebroplasty is reported to lead to problems in elderly patients and can represent a serious complication, especially when multiple levels have to be treated. An in vitro study has shown the feasibility of removing intravertebral fat by pulsed jet-lavage prior to vertebroplasty, potentially reducing the embolization of bone marrow fat from the vertebral bodies and alleviating the cardiovascular changes elicited by pulmonary fat embolism. In this in vivo study, percutaneous vertebroplasty using polymethylmethacrylate (PMMA) was performed in three lumbar vertebrae of 11 sheep. In six sheep (lavage group), pulsed jet-lavage was performed prior to injection of PMMA compared to the control group of five sheep receiving only PMMA vertebroplasty. Invasive recording of blood pressures was performed continuously until 60 min after the last injection. Cardiac output and arterial blood gas parameters were measured at selected time points. Post mortem, the injected cement volume was measured using CT and lung biopsies were processed for assessment of intravascular fat. Pulsed jet-lavage was feasible in the in vivo setting. In the control group, the injection of PMMA resulted in pulmonary fat embolism and a sudden and significant increase in mean pulmonary arterial pressure. Pulsed jet-lavage prevented any cardiovascular changes and significantly reduced the severity of bone marrow fat embolization. Even though significantly more cement had been injected into the lavaged vertebral bodies, significantly fewer intravascular fat emboli were identified in the lung tissue. Pulsed jet-lavage prevented the cardiovascular complications after PMMA vertebroplasty in sheep and alleviated the severity of pulmonary fat embolism.
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INTRODUCTION: Intracisternal blood injection is the most common applied experimental subarachnoid bleeding technique in rabbits. The model comprises examiner-dependent variables and does not closely represent the human pathophysiological sequelae of ruptured cerebral aneurysm. The degree of achieved delayed cerebral vasospasm (DCVS) in this model is often mild. The aim of this study was to characterize and evaluate the feasibility of a clinically more relevant experimental SAH in vivo model. SAH was performed by arterial blood shunting from the subclavian artery into the great cerebral cistern. A total of five experiments were performed. Intracranial pressure (ICP), arterial blood pressure, heart rate, arterial blood gas analysis, and neurological status were monitored throughout the experiments. SAH induced vasoconstriction of the basilar artery was 52.1±3.4% on day 3 compared to baseline (P<0.05). Post-mortem gross examination of the brain showed massive blood clot accumulation around the brainstem and ventral surface of the brain. The novel technique offers an examiner independent SAH induction and triggers high degrees of delayed cerebral vasospasm. The severity of vasospasm attained offers a unique opportunity to evaluate future therapeutic treatment options.
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Determination of the manner of death in case of intraoral firearm wounds can be a challenge, especially if the circumstances of the incident are unclear and crime scene investigation is inadequate. It is a well-known fact that the mouth is one of the selected sites for suicide with firearms. Homicidal shooting through the mouth is said to be rare, but does occur, and can be mistaken for a suicide. For discrimination between suicide and homicide in cases of intraoral firearm wounds, some useful points are the site of entry wound, the direction of the internal bullet path, the range of fire and the circumstances of death. We demonstrate these points in a case of a homicidal gunshot to the mouth assessed by both classical autopsy and post-mortem CT (PMCT).
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Hatchet blows to the human skull often cause fatal injuries. We present a case of homicide by hatchet blow that underwent CT, MRI, and autopsy examination. Skull fragmentation, fracture lines, and brain injuries were demonstrated prior to autopsy. Many of the hatchet-specific characteristics (flaking, crushing, shattering, and fracture lines) described in literature were observed in the post-mortem imaging of this case.
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Varicose vein rupture is a rare cause of death, although varicosities are a common pathology. We present three cases of sudden death due to varicose vein rupture. After a review of the literature, the case circumstances and the findings of imaging examination, performed in two cases, are presented. One of them had undergone a post-mortem computed tomography angiography (PMCTA), and one a PMCTA as well as a post-mortem magnetic resonance (PMMR) imaging prior to conventional autopsy. One of the cases presented herein is, to our knowledge, the youngest known fatality due to varicose vein rupture.
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The authors report on the sudden and unexpected death of a 20-year-old man from atraumatic rupture of the enlarged spleen due to infectious mononucleosis. The case exemplifies the forensic relevance of infectious mononucleosis, atraumatic splenic rupture and post-mortem serological tests.
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Mycobacterium tuberculosis is the main cause of human tuberculosis. Infection in companion animals is mainly acquired from close contact to a diseased human patient and hence rarely diagnosed in countries with low tuberculosis incidence rates. Therefore the general awareness of the disease might be low. Here we report the potential risk of infection for veterinary personnel with M. tuberculosis during the clinical and pathological examination of a dog with unexpected disseminated tuberculosis. The dog had presented with symptoms of a central nervous system disease; rapid deterioration prevented a complete clinical workup, however. Post-mortem examination revealed systemic mycobacteriosis, and M. tuberculosis was identified by PCR amplification of DNA extracts from paraffin-embedded tissue sections and spoligotyping. Contact investigations among the owners and veterinary personnel using an IFN-? release assay indicated that the index dog did not infect humans during its lifetime. Serological and IFN-? release assay results of one of two cats in direct contact with the index dog, however, suggested that transmission of M. tuberculosis might have occurred. Importantly, all three pathologists performing the necropsy on the dog tested positive. Accidental infection was most likely due to inhalation of M. tuberculosis containing aerosols created by using an electric saw to open the brain cavity. As a consequence routine necropsy procedures have been adapted and a disease surveillance program, including tuberculosis, has been initiated. Our results highlight the importance of disease awareness and timely diagnosis of zoonotic infectious agents in optimizing work safety for veterinary personnel.
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Clin Microbiol Infect ABSTRACT: Invasive aspergillosis (IA) is a live-threatening opportunistic infection that is best described in haematological patients with prolonged neutropenia or graft-versus-host disease. Data on IA in non-neutropenic patients are limited. The aim of this study was to establish the incidence, disease manifestations and outcome of IA in non-neutropenic patients diagnosed in five Swiss university hospitals during a 2-year period. Case identification was based on a comprehensive screening of hospital records. All cases of proven and probable IA were retrospectively analysed. Sixty-seven patients were analysed (median age 60 years; 76% male). Sixty-three per cent of cases were invasive pulmonary aspergillosis (IPA), and 17% of these were disseminated aspergillosis. The incidence of IPA was 1.2/10?000 admissions. Six of ten cases of extrapulmonary IA affected the brain. There were six cases of invasive rhinosinusitis, six cases of chronic pulmonary aspergillosis, and cases three of subacute pulmonary aspergillosis. The most frequent underlying condition of IA was corticosteroid treatment (57%), followed by chronic lung disease (48%), and intensive-care unit stays (43%). In 38% of patients with IPA, the diagnosis was established at autopsy. Old age was the only risk factor for post-mortem diagnosis, whereas previous solid organ transplantation and chronic lung disease were associated with lower odds of post-mortem diagnosis. The mortality rate was 57%.
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A feature represents a functional requirement fulfilled by a system. Since many maintenance tasks are expressed in terms of features, it is important to establish the correspondence between a feature and its implementation in source code. Traditional approaches to establish this correspondence exercise features to generate a trace of runtime events, which is then processed by post-mortem analysis. These approaches typically generate large amounts of data to analyze. Due to their static nature, these approaches do not support incremental and interactive analysis of features. We propose a radically different approach called live feature analysis, which provides a model at runtime of features. Our approach analyzes features on a running system and also makes it possible to grow feature representations by exercising different scenarios of the same feature, and identifies execution elements even to the sub-method level. We describe how live feature analysis is implemented effectively by annotating structural representations of code based on abstract syntax trees. We illustrate our live analysis with a case study where we achieve a more complete feature representation by exercising and merging variants of feature behavior and demonstrate the efficiency or our technique with benchmarks.
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Despite the increased use of intracranial neuromonitoring during experimental subarachnoid hemorrhage (SAH), coordinates for probe placement in rabbits are lacking. This study evaluates the safety and reliability of using outer skull landmarks to identify locations for placement of cerebral blood flow (CBF) and intraparenchymal intracranial pressure (ICP) probes. Experimental SAH was performed in 17 rabbits using an extracranial-intracranial shunt model. ICP probes were placed in the frontal lobe and compared to measurements recorded from the olfactory bulb. CBF probes were placed in various locations in the frontal cortex anterior to the coronary suture. Insertion depth, relation to the ventricular system, and ideal placement location were determined by post-mortem examination. ICP recordings at the time of SAH from the frontal lobe did not differ significantly from those obtained from the right olfactory bulb. Ideal coordinates for intraparenchymal CBF probes in the left and right frontal lobe were found to be located 4.6±0.9 and 4.5±1.2 anterior to the bregma, 4.7±0.7mm and 4.7±0.5mm parasagittal, and at depths of 4±0.5mm and 3.9±0.5mm, respectively. The results demonstrate that the presented coordinates based on skull landmarks allow reliable placement of intraparenchymal ICP and CBF probes in rabbit brains without the use of a stereotactic frame.
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The measurement of fluid volumes in cases of pericardial effusion is a necessary procedure during autopsy. With the increased use of virtual autopsy methods in forensics, the need for a quick volume measurement method on computed tomography (CT) data arises, especially since methods such as CT angiography can potentially alter the fluid content in the pericardium. We retrospectively selected 15 cases with hemopericardium, which underwent post-mortem imaging and autopsy. Based on CT data, the pericardial blood volume was estimated using segmentation techniques and downsampling of CT datasets. Additionally, a variety of measures (distances, areas and 3D approximations of the effusion) were examined to find a quick and easy way of estimating the effusion volume. Segmentation of CT images as shown in the present study is a feasible method to measure the pericardial fluid amount accurately. Downsampling of a dataset significantly increases the speed of segmentation without losing too much accuracy. Some of the other methods examined might be used to quickly estimate the severity of the effusion volumes.
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To assess the reliability of radiologic identification using visual comparison of ante and post mortem paranasal sinus computed tomography (CT).