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There are more than 120 different theories on the possible causes of sudden infant death (SID). In particular, dysfunctions of the central nervous system, cardiorespiratory insufficiency due to infections including atypical immune reactions, and cardiac dysregulation have been discussed during the previous decade. Reports on disturbances of the cardiac rhythmogenic function due to LQTS were among the most speculative. Based on gross histological, immunohistochemical and molecular genetic investigations of SID cases, the most important and most frequent findings of the heart are shown. The significance of different types of myocarditis, hypoxia-related changes, disturbances of the rhythmogenic function, cardiomyopathy, and other changes is discussed with regard to the cause of death. In conclusion, most of the changes reported in the literature are not sufficient to explain the cause of death. Problems in the diagnosis are shown which influence the classification of these disturbances as well as the classification of SID.

A case of malignant hyperthermia (mh) in a 27-year-old man is described. In a first anaesthesia using isoflurane and succinylcholine, the end-tidal CO(2) rose from 39 to 49 mmHg 2.75 h post-intubation and the body temperature rose to 39.8 degrees C 14 h post-intubation but was normal again the next day. In a second anaesthesia using the same medication, the maximal end-tidal CO(2) was 44 mmHg and the body temperature rose to 39 degrees C after 9 h. After 4 days, the fever rose to 40 degrees C, and to 42 degrees C when death occurred 10 days after the second anaesthesia. Masseter spasms or muscle rigidity were never present. According to the death certificate, death was due to multi-organ failure from sepsis. At autopsy, the skeletal muscles were pale and oedematous. Histology demonstrated focal necroses in the skeletal muscles, shock kidneys with myoglobin excretion and myoglobin clots in small blood vessels of the lungs. Hence, the postmortem diagnosis "malignant hyperthermia" was established but accusations of medical maltreatment were rejected because of the atypical and protracted clinical course and because uncharacteristic signs of malignant hyperthermia were attributable to the clinically suspected sepsis.

The tissue disruption inside the brain after experimental gunshots to the head was investigated with special reference to secondary bone missiles and intracranial pressure effects such as cortical contusion and deep intracerebral haemorrhages. The evidential value of various examination methods is compared. 9 mm Parabellum ammunition was fired to the temporal region of calves (n = 10) from a distance of 0-10 cm. Plain film radiography, CT, MRI, visual inspection and histology were performed on every brain. The tissue disruption of the permanent tract is delineated best by artefact-free MRI. Cortical contusions and deep intracerebral haemorrhages were detected infrequently by visual inspection and imaging techniques although they were present in every brain as verified by histology. These injuries remote from the tract increase cerebral wounding compared to non-confined tissue. In particular, the brain stem and central areas were frequent sites of haemorrhages, which can be expected to have serious and immediate consequences. Ectopic bone fragments were found in all brains using CT scans. Bone fragments were located inside clearly enlarged permanent tracts or were driven into brain tissue. In the latter cases, secondary shot channels up to 4 cm in length could be verified by histology. Cortical contusions and intracerebral haemorrhages can only be detected reliably by histology. The localization of bone fragments requires CT scans. Therefore, a detailed examination is accomplished best by a combination of the methods applied in this study.

Untersucht wurde ein Stromunfall durch Niederspannung mit zunachst erhaltener Handlungsfahigkeit. Als Ursache des verzogerten Todeseintrittes werden Herzrhythmusstorungen mit erst spater einsetzendem Herzkammerflimmern diskutiert. Die Rekonstruktion gelang durch die vergleichende Untersuchung der Metallisation an den Strommarken mit verschiedenen moglichen Stromquellen. Als Verfahren wurden die Stereomikroskopie und Rasterelektronenmikroskopie (REM) mit energiedisperser Mikrobereichsanalyse (EDX) angewendet.

A gunshot wound (.22 long rifle) to the chest including perforation of the aorta ascendens is presented. The small wound tract in soft tissue was characteristic for this type of ammunition and did not show any special peculiarities. However, arterial injury was not restricted to two small perforations, as expected in the light of previous wound ballistic findings. Three large longitudinal ruptures (3.0-4.5 cm in length and two of them independent of the perforations) additionally occurred, which led to rapid exsanguination. This extraordinary extent of vascular injury can be explained by perforation of the artery during the ventricular ejection phase, which causes a considerable dilation of the aorta analogous to a windkessel. The pre-existing dilation enables intraluminal temporary cavitation to have an "explosive" effect despite the high elastic tolerance to the vessel wall. The importance of tissue characteristics in gunshot wounds in general and the possible role of temporary cavitation inside the vessel in vascular gunshot wound production in particular are stressed.

Die Anwendung des Rektaltemperatur-Todeszeit-Nomogrammverfahrens am Leichenfundort durch 11 Autoren aus 6 rechtsmedizinischen Instituten ergab in der Fallgruppe I mit erfullten Voraussetzungen und sicher eingrenzbaren Anknupfungspunkten (N = 46) eine Standardabweichung der Differenzen zwischen realer und nomographisch bestimmter Todeszeit von ± 1,3 Std; im Kollektiv befanden sich 9 Falle mit fortgeschrittener Abkuhlung (0,5 > Q ≥ 0,2). In den Fallen mit enner Todeszeit von mehr als 4 Std (N = 26) betrug die Standardabweichung ± 1,0 Std, entsprechend 95%-Toleranzgrenzen von ± 2,0 Std. Die 95%-Toleranzgrenzen waren somit enger als auf dem Nomogramm angegeben. An weiteren 30 Fallen mit erkennbar nur unsicheren Anknupfungspunkten bzw. nicht erfullten Voraussetzungen (Fallgruppe II) bestand in 5 Fallen keine Uberein-stimmung zwischen berechnetem und ermitteltem Zeitbereich des Todeseintritts.

Three suicides and one homicide from black powder muzzle loading handguns are reported and the muzzle velocities of two weapons are recorded. The fatal head shots caused wide wound tracts traversing the brains and intracerebral haemorrhages remote from the tract were present in every case. The skulls showed considerable fractures which were pronounced in the cases of contact shots but were also present when the range of fire was 5 m. These extensive injuries from soft lead spheres with muzzle velocities of only approximately 200 m/s are attributed to the expansion of the spheres. The regularly occurring deformation resulted in 13-16 mm calibre missiles in the cases of .44 spheres. The special features of black powder such as incomplete and slow combustion resulted in intense soot deposits in the vicinity of the entrance wound and in long ranges the gunshot residues travelled. In contact shots, large pocket-like underminings even in deeper tissue layers, abundant soot along the trajectory and skin burns were observed.

Anhand von am Rontgenbild des menschlichen Brustbeines ermittelter Knochenmase (Langen und Breiten) ist eine Zuordnung zu den Geschlechtern mit ausreichender Sicherheit moglich. Die Bestimmung der Korpergrose aus den am Rontgenbild des menschlichen Brustbeines gewonnenen Mase ist unter Angabe einer breiten Streuung moglich. Die angegebenen Beziehungen und Formeln haben nur Gultigkeit bei Messungen an Brustbeinen erwachsener Menschen.

Es werden 3 Pkw-Unfalle dargestellt, bei denen bei der Abklarung der Sitzposition die Mikrospurenanalyse entscheidenden Stellenwert hatte. In allen 3 Fallen waren jeweils beide Insassen alkoholisiert. Es handelte sich stets um nachtliche Alleinunfalle ohne Zeugen. Die Verletzungsmuster waren in 2 Fallen unspezifisch. Faserspuren waren im 1. Fall mit blosem Auge nicht sichtbar. In den anderen beiden Fallen konnten sie bei genauerem Hinsehen mit blosem Auge erkannt werden. Durch diese Spuren war die Sitzposition in allen 3 Fallen eindeutig bestimmbar.

21 Blocke aus 20%iger Gelatine, an deren Stirnflache eine mit Technetium-99m markierte Textilvorlage angebracht war, wurden mit Faustfeuerwaffen der Kaliber .22 long rifle und .357 Magnum beschossen. Es wurden jeweils 2 Schusserien mit verschiedener Munition auf Sommer-, Ubergangs- und Winterbekleidung abgegeben. Die Radioaktivitat der beschossenen Blocke wurde mit einem Photonenemissions-Computertomographen gemessen. Die Ergebnisse der jeweiligen Schusserien wurden graphisch dargestellt und miteinander verglichen. Initial (bei 2 cm Tiefe) findet sich immer eine hohe Radioaktivitat, die u.a. durch die zwangslaufige Verunreinigung der Geschosoberflache beim Schus durch die technetiummarkierte Textilvorlage bedingt ist (Abstreifvorgang). Hohere Radioaktivitat in den mittleren und tiefen Blockbereichen ist allein auf Fasereinschleppung zuruckzufuhren. Demnach finden sich grosere Faseransammlungen in den mittleren und tieferen Bereichen des Schuskanals hauptsachlich bei dunner Bekleidung (Sommer). Dicke Bekleidung (Herbst und Winter) stellt auch fur Geschosse groserer Auftreffenergie ein erhebliches Hindernis dar. Hierbei schleppen lediglich Projektile mit geringer Deformationsneigung und hoher Auftreffenergie einen wesentlichen Anteil textiler Fasern bis in tiefere Abschnitte des Blocks ein.