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Up to now reliable data were available on cases of lethal child neglect in the area of the Federal Republic of Germany prior to reunification (the former West Germany). In a multicenter study we therefore examined the police and court records for such cases occurring in the period from 1 January 1985 to 2 October 1990 in nearly the entire area of Federal Republic of Germany.The study center received information on 19 cases of lethal child neglect. Extrapolated to all institutes of legal medicine, this corresponds to 20 cases and thus 3.5 cases a year in the whole of West Germany in the period studied. There is to be added a dark-field which cannot be limited more precisely. However, the cases of fatal child neglect might have occurred much more seldom than fatal child abuse caused by use of physical violence. Slightly more than half the victims were younger than 1 year, the oldest one was 7 10/12 years old. Most frequently the children died of starvation and thirst. Mostly the mothers/nursing mothers killed the child alone or together with the victim's father/stepfather. In the majority of the cases there was not a close affection between parents and child. Nearly 30% female/male perpetrators suffered from chronic alcohol abuse. Only 15 (= 56%) of 27 female/male perpetrators were sentenced to imprisonment (period between 7 months on probation and 10 years). Mitigation circumstances existed for nearly half the persons sentenced to imprisonment. It is true that child neglect is a rarer crime, but the experts of legal medicine always have to indicate errors made during the external inspection of the corpse (among others failures to see indications of neglect).

No reliable data are available on cases of lethal child abuse (by active force) in the area of Federal Republic of Germany prior to reunification (the former West Germany). In a multicenter study we therefore examined the police and court records for such cases occurring in the period 1 January 1985 to 2 October 1990 in nearly the entire area of Federal Republic of Germany.The study center received information on 58 cases of lethal child abuse. Extrapolated to all institutes of legal medicine, this corresponds to 62 cases in all of West Germany in the period studied. An approximately equal number of unreported cases should be added to this figure. Including unreported cases, at least 20 cases of lethal child abuse occurred per year; thus only one in every two cases ever came to light. Almost two thirds of the victims were younger than one year old. At autopsy 59% exhibited signs of repeated abuse at autopsy. By far the most common cause of death was direct impact from a blunt object, usually to the head. Mostly, the male person to whom the victim relates most closely (father, stepfather, partner of the mother) has killed the child. Twenty-one of the 74 persons charged saw the charges against them dropped or were acquitted due to lack of evidence; 51 received sentences ranging from one year probation to life. In the remaining two cases the outcome of the trial was unknown. Signs of abuse were readily apparent at autopsy in almost all cases. The high number of unreported cases underscores the need to educate medical students and practicing physicians to be on the look-out for signs of abuse and argues for an increase in the rate of autopsy.

Based on the description of the findings of four cases of self-strangulation with multiple knotting of the strangling device examined by the authors general criminological and specific forensic criteria for differential diagnosis of suicide and commission of the offence by another person are discussed. Though multiple knotting of the strangling device, caught hair and parts of clothes and concomitant injuries may also be seen in cases of suicide, they primarily justify the suspicion that the death was caused by another person. If it is one of those rare cases of self-strangulation with multiple knotting, the presence of symptoms of congestion in the head area, which may occasionally be absent in other cases of strangulation, is necessary for pathophysiological reasons.

First clinical results of patients with diseases of the lungs. The previous experiences on patients with diseases of the lungs reveal that the regional function diagnostics of the lungs may be extended and improved by functional scintigraphic radiospirometry. Because of the determination of regional lung volumes restrictive lung diseases can be differentiated and analysed more exactly than it has been possible before by the examinations of perfusion and ventilation alone. A further advance of the determination of lung volume is that the question of functional operability can be cleared up exactly. In our opinion the routine use of the functional scintigraphic radiospirometry is justified. A contraindication for this kind of examination should only be pregnancy.

In order to elucidate the contradictory findings in cases of suicide or homicide with firearms, firing tests were performed with various weapons shot at textile samples, block gelatine, animal and human skin, and pigs' heads. Ricochets were produced at different angles of incidence and bullets were shot through various materials introduced between the target and muzzle. The morphology and emission spectrum analyses of the entry holes were investigated, and the projectiles were collected and inspected. The morphological and chemical alterations observed at the entry holes were classified and discussed.

485 women underwent induced abortion by the vacuum aspiration method. 231 underwent the operation with diazepam narcosis and paracervical blockade as an outpatient procedure, 203 were hospitalized and underwent the operation under full anesthesia, and 51 patients comprised a "risk group", and were not included in the analysis. There were no significant differences in the incidence of complications and side effects. Genital infections were the most common complication, occurring in 6.9% of the outpatient group and 5.9% of the hospitalized group. The outpatient technique can be recommended as a safe procedure for the performance of abortions.

Radioiodine therapy and surgical enucleation as a functionally legitimate operation are adequate methods of treatment for the autonomous adenoma of the thyroid. With reference to a series of our own patients, the making of the indication, the operation technique and the carrying out of radioiodine therapy are commented on. The aim of the operation is the enucleation of the autonomous adenoma without traumatizing the healthy thyroid tissue and without ligature of the polar vessels. The aim of radioiodine therapy is the selective destruction of the adenoma. The indication for the operation should certainly be made more liberally to perform the low-risk enucleation.

For the first time results of investigations on rats with radioactive compounds in autochtonal tumors of the central nervous system, induced via placenta by Ethyl-Nitrose-Urea (ENU), are reported. In contrast to transplantation tumors the tumors induced by ENU are comparable in regard to the szintigrafic results with human brain tumors. The radiopharmaceuticals 131I-HSA, 99mTc-Pertechnetate, 203Hg-Chlormerodrin and 113m/111In-DTPA are similar to human brain tumors taken up by the ENU-tumors. For these findings it may be important, that the ENU-tumors are of neurogenic origin and do not differ histologically from the human brain tumors. The accumulation of the radioactive substances in ENU-tumors can be explained with the lesion at the blood-brain-barrier and at the blood-nerv-barrier. Therefore, it is discussed that the mechanism of the uptake is similar in human brain neoplasms and in ENU-tumors of the brain. The ENU-tumor model is suitable for testing new radiopharmaceuticals before their application in men.

Cyclic precordial variations of radiation after i.v. administration of 15 mCi 99mTc-HSA correspond to cyclic volume changes of ventricular volumes of the heart. The "gated blood pool procedure" yields reliable data. Extensive analysis of these data results in subsequent information concerning left ventricular myocardial behaviour: 1. extent of the regional myocardial contraction 2. homogeneity of the contraction 3. regional contraction velocity 4. regional relaxation velocity. Four parametric scans present the distribution of each one of those parameters within the heart. Gated blood pool data have been compared with angiographic data. Reliability of those parameters obtained by extensive analysis of the gated blood pool data could be proven.

The subjects of investigation were 13 dead thorotrast patients, 10 male, 3 female, with ages ranging from 45 to 79 years. Two thousand organ and tissue specimens were investigated by means of autopsy and by both microscopic-autoradiographic and neutron activation analysis in order to detect late effects and to determine on approximate mean concentration of 232Th (mg per g of tissue). A comparison between late effects and concentrations of the dye medium led to the following conclusions: 1. 232Th is, after intravascular injection, deposited in all organs and tissues of the human body. 2. The highest mean concentrations are shown in the spleen, liver, bone marrow, and lymph nodes. 3. The distribution of 232Th is inhomogeneous in all organs and tissues. The variations of maximum and minimum concentration lie around factor 2.2 X 10(0)-2.4 X 10(5). 4. Late effects occur only in spleen, liver, lymph nodes, and bone marrow, but not in organs and tissues that show a mean concentration of 232Th under 10(-1) mg per g tissue. 5. It is highly probable that tumors of thorotrast patients in organs other than spleen, liver lymph nodes, and bone marrow are not caused by deposition of 232Th or ThO2.

It is reported about a female patient with two lipomas of the liver. The special diagnosis and the differentiation against metastases and other malignant tumors of the liver are only possible by means of computertomography. Scintigraphy and sonography do not allow a differential diagnosis. On the one hand lipoma of the liver is a very rare and benign disease but on the other hand a correct diagnosis may be - like in this case - very important because of therapy and prognosis.