Die besonderen konstruktionsmerkmale des japanischen „Tan-to“-(Messers) als Kriterien für dessen Gefährlichkeit

Zusammenfassung Es wird auf die besondere Klingenform japanischer Blankwaffen und auf die Neuentwicklung eines Verwandlungs-Tan-to verwiesen. Bei letzterem läßt sich die Klinge in der Handgriffmitte um 90° drehen und arretieren, eine ideale Fixierung dieses Messers durch Faustschluß am Quergriff. Durch diese Bedingungen ist eine hohe Verletzungsgefährdung mit tödlichem Ausgang gegeben. Diese seit kurzer Zeit im Handel erhältlichen Messer sollten nach § 37 Waff G umgehend als verbotene Gegenstände definiert werden.     

Fatal intoxications in Denmark following intake of morphine from opium poppies

Summary In Denmark it is legal to grow opium poppies for the production of poppy seeds and until 1986 for decoration purposes, too. Danish poppy capsules contain 0.3–5 mg morphine per capsule and the content of morphine in opium exuded from the capsules may amount to 24%. This has resulted in misuse as both fresh and dried poppy capsules have been used for the production of opium tea. During the period 1982–1985, seven casualties occurred among drug addicts in Denmark which were solely or partly caused by these opium poppies.     

Early enzyme changes in skin wounds demonstrated by isoelectric focusing in polyacrylamide gel

Summary Esterase patterns in vital skin wound extracts were observed and compared to those seen in normal skin. Employing the relatively simple method of isoelectric focusing in polyacrylamide gel, it was demonstrated that three, consecutively appearing, characteristic changes were visible in the esterase zymograms of vital (pre-mortally) injured skin as compared with skin which was uninjured or post-mortally damaged. One of these characteristics (characteristic a), since it is found only in wound reactions and not in uninjured skin, may represent an enzyme specifically produced during the wound reaction process. All three features normally appeared within 30 min of trauma and the first change within 5 min, even though it had been generally assumed that vital reactions, i.e. wound reactions, could be demonstrated only after a longer period of time. It was possible therefore to determine victim survival time and distinguish between pre- and post-mortal wounds. Also the isoelectric focusing of enzymes apparently gives a more efficient pattern band separation than previous methods.

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Zusammenfassung Durch isoelektrische Fokussierung der Extrakte aus vital verletzter Haut wurden die -Naphthylacetat-spaltenden Enzyme aufgetrennt und mit gleichartig hergestellten Extrakten unverletzter Haut desselben Menschen verglichen. Es konnten 3 nacheinander auftretende Merkmale im Esterasemuster der verletzten Haut festgestellt werden. Die mit a, b und c bezeichneten Unterschiede im Esterasemuster sind für die frühen Wundreaktionen kennzeichnend. Das Merkmal a ist eine nur in vitalen Hautwunden nachweisbare Esterase-Fraktion, die innerhalb 5 min nach der Wundsetzung auftritt. Die Merkmale b und c erscheinen nach dem Merkmal a innerhalb 30 min nach der Verletzung. Der Nachweis von a, b, c in einer Wunde erlaubt eine Beurteilung der Überlebenszeit und ermöglicht außerdem eine Unterscheidung von vitalen und postmortalen Wunden. Die isoelektrische Fokussierung von Enzymen scheint leistungsfähiger zu sein als die bisher zur Kennzeichnung von Wundenzymen angewandten histoenzymatischen und elektrophoretischen Methoden.

     

Zur Entstehung fluoreszierender Verbindungen in formalinfixierten Organen

Zusammenfassung In formalinfixierten Organen bilden sich fluoreszierende Verbindungen. Wir konnten nachweisen, daß es sich bei diesen Verbindungen um 3,4 Dihydroisochinoline bzw. 3,4 Dihydro--carboline handelt, die durch eine Reaktion des Formaldehyds mit biogenen Aminen des Typs -Phenyläthylamin bzw. -(3 Indolyl)äthylamin entstehen.

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On formation of fluorescent compounds in formaldehyde treated tissues

Summary In formaldehyde treated tissues, fluorescent compounds are formed. We could demonstrate, that these compounds result from a reaction of biogenic amines such as -phenylethylamines or -(3 indolyl) ethylamines with formaldehyde to yield the fluorescent 3,4 dihydroisoquinolines or 3,4 dihydro--carbolines.

Auszugsweise vorgetragen auf der 54. Jahrestagung der Deutschen Gesellschaft für Rechtsmedizin in Frankfurt, September 1975     

Virtopsy

Zusammenfassung Computed-tomography-Verfahren sind während der letzen 10 Jahre weiterentwickelt worden und haben verschiedene Anwendungen im rechtsmedizinischen Fachgebiet gefunden. Die neueste Entwicklung besteht in der multislice computed tomography, kombiniert mit photogrammetry-based surface optical scanning und Image-rendering-Techniken. Diese Kombination kann für die 3-dimensionale Darstellung von Verletzungsmustern zum Vergleich mit infrage kommenden Tatwaffen sowie zum Screening nach pathologischen Befunden in lebenden oder verstorbenen Personen eingesetzt werden. Es handelt sich um ein minimal-invasives Verfahren, mit dem forensisch relevante Bilder erfasst werden können, die auch im Gerichtssaal vorgeführt werden können. Die rasche Weiterentwicklung der Imaging-Technnik könnte in der Zukunft eine Alternative zur konventionellen Obduktionen darstellen.     

Das Problem der a-priori-Wahrscheinlichkeit bei Verwendung der Essen-Möller-Formel zur Berechnung der Vaterschaftswahrscheinlichkeit

Zusammenfassung Die Annahme der a-priori-Wahrscheinlichkeit, daß Nichtväter und wahre Väter gleichhäufig zur Begutachtung gelangen, wird an Hand von 408 Aktenfällen bestätigt.Die Berechnung der Vaterschaftswahrscheinlichkeit bietet, insbesondere bei Mehrverkehrsfällen, wertvolle Hinweise für die Vaterschaft oder Nichtvaterschaft eines Probanden, Hinweise, die durch die Angabe der Vaterschaftsausschlußchance aufgrund der Mutter-Kind-Konstellation nicht erbracht werden können. Auf Beziehungen zwischen der Vaterschaftsausschlußchance und der Vaterschaftswahrscheinlichkeit wird hingewiesen.

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The assumption of prior probability computing the plausibility of paternity by the Essen-Möller equation and its problem

Summary Among objectivists the assumption of firsthand probability, that non-fathers and true-fathers are being given an opinion on with equal frequency, yields to a rejection in calculating the probability of fatherhood according to Essen-Möller. By means of 408 cases it is shown, that this assumption does meet the actual situation. Non-fathers and true-fathers are observed equally frequent. Calculation of fatherhood probability renders a valuable reference to paternity or nonpaternity of a subject in cases of multiple intercourses. These references cannot be brought on by the statement of the exclusion chance of fatherhood based on the mother-child-constellation. The relationship between the exclusion chance and the probability of fatherhood is pointed out.

     

The influence of orthoses on the proprioception of the ankle joint

The ankle joints of 14 healthy volunteers and 16 patients with unstable ankle joints were tested regarding their functional and proprioceptive capabilities. All of them were active athletes. Three tests were used of the study: single-leg stance test, single-leg jumping course test, angle-reproduction test. The influence of three stabilization devices (lace-on-brace/Mikros, stirrup-brace/ Aircast, taping) on the proprioceptivity of stable and unstable ankle joints was evaluated. The scores of the singleleg jumping course without any stabilizing device (category standard) ranged between 8.06 and 13.68 (10.65±1.29). In the categories Mikros (9.85±0.99), and Aircast (9.99±1.14) as well as with the tape bandage (10.27±0.81) better scores were achieved. The differences standard vs. Mikros and standard vs. Aircast revealed a significant reduction of the scores with orthoses (P<0.01). The error rate in the single-leg stance test was within the range of 0–16 (5.12±2.85) for the category standard. It was lower for the categories Mikros (3.65±2.65) and Aircast (4.17±2.59). The error rate was highest in the group with a tape bandage (5.79±3.53). The differences standard vs Mikros as well as standard vs. Aircast were significant (P<0.01). There was also a significant difference between these categories regarding injured and not injured ankle joints (P<0.01). The angle-reproduction-test showed higher values for the category standard (2.36°±0.97) in comparison to the categories Mikros (1.46°±0.72), Aircast (1.62°±0.91) and taping (1.84°±0.41). In the category standard the reproduction error was lower testing not injured ankle joints (2.30°±1.04) than testing the group of unstable ankle joints (2.44°±0.81), whereas in all other categories the reproduction error was higher in the group of not injured joints. The differences in all measurements between standard vs. Mikros and standard vs. Aircast were significant (P<0.01). The results of the three tests showed a highly significant difference between injured and not injured ankle joints (P<0.01).     

Die Lenkbewegungen des Kraftwagenfahrers unter Alkoholeinfluß

Zusammenfassung Für die Lenkweise konnten keine Leistungsfaktoren definiert werden. Die Werte geben nur die Änderung der Lenkweise unter Alkoholeinfluß gegenüber der der Nüchternfahrt an.Die Anzahl der Lenkradauscohläge ist im Mittel bei zunehmender Blutalkoholkonzentration bis 1 um 18%, zwischen 1,0 und 1,5 und im Gipfel um 24%, bei abnehmender Konzentration zwischen 1,5 und 1,1 um 20%, zwischen 1,1 und 0,1 um 18% gegenüber den Werten der Nüchternfahrten verschieden. Die Größe der Lenkradausschläge ist im Mittel bei zunehmender Blutalkoholkonzentration bis 1,0 um 24,5%, zwischen 1,0 und 1,5 um 35%, im Gipfel um 38% und bei abnehmender Konzentration um 28% verschieden.Die Lenkweise ist von derjenigen der Nüchternfahrten auf gerader, breiter Fahrbahn stärker verschieden als auf Schwierigkeiten bietender Strecke.Die Arbeit wurde ermöglicht durch die Unterstützung des Herrn Ministers für Wirtschaft und Verkehr des Landes Nordrhein-Westfalen, des Generaldirektors des Volkswagenwerkes Herrn Prof.Nordhoff sowie der Herren Ober-Ing.Riegger und Dipl.-Ing.Menzel der Firma Kienzle.     

Pulmonary Hypertension Among End-Stage Renal Failure Patients Following Hemodialysis Access Thrombectomy

Purpose: Percutaneous hemodialysis thrombectomy causes subclinical pulmonary emboli without short-term clinical consequence; the long-term effects on the pulmonary arterial vasculature are unknown. We compared the prevalence of pulmonary hypertension between patients who underwent one or more hemodialysis access thrombectomy procedures with controls without prior thrombectomy.Methods: A retrospective case-control study was performed. Cases (n=88) had undergone one or more hemodialysis graft thrombectomy procedures, with subsequent echocardiography during routine investigation of comorbid cardiovascular disease. Cases were compared with controls without end-stage renal disease (ESRD) (n=100, group 1), and controls with ESRD but no prior thrombectomy procedures (n=117, group 2). The presence and velocity of tricuspid regurgitation on echocardiography was used to determine the prevalence and grade of pulmonary hypertension; these were compared between cases and controls using the chi-square test and logistic regression.Results: The prevalence of pulmonary hypertension among cases was 52% (46/88), consisting of mild, moderate and severe in 26% (n=23), 10% (n=9) and 16% (n=14), respectively. Prevalence of pulmonary hypertension among group 1 controls was 26% (26/100), consisting of mild, moderate and severe pulmonary hypertension in 14%, 5% and 7%, respectively. Cases had 2.7 times greater odds of having pulmonary hypertension than group 1 controls (p=0.002). The prevalence of pulmonary hypertension among group 2 controls was 42% (49/117), consisting of mild, moderate and severe pulmonary arterial hypertension in 25% (n=49), 10% (n=12) and 4% (n=5), respectively. Cases were slightly more likely to have pulmonary hypertension than group 2 controls (OR=1.5), although this failed to reach statistical significance (p=0.14).Conclusion: Prior hemodialysis access thrombectomy does not appear to be a risk factor for pulmonary arterial hypertension. Patients with ESRD are more likely to have pulmonary hypertension.     

The “dural tail” adjacent to meningiomas studied by dynamic contrast-enhanced MRI: a comparison with histopathology

We examined 32 patients with intracranial tumors (17 meningiomas, 8 neuromas, 7 pituitary adenomas) by conventional and dynamic contrast-enhanced MRI. Our aim was to clarify whether the pathological dural contrast enhancement adjacent to meningiomas (the dural tail) is specific to meningiomas and, more important, whether it represents neoplastic dural infiltration or hypervascularization as a tumor accompanying reaction. A dural tail was found in 9 of 17 meningiomas. None of the other extra-axial tumours (neuromas, pituitary adenomas) showed comparable dural enhancement. Dynamic examinations with an ultrafast single slice imaging technique (snapshot-FLASH) after a bolus injection of contrast medium showed a dural tail in seven out of these nine meningiomas, while in two cases the dural tail turned out to be a cortical vein with a characteristic dynamic contrast enhancement pattern. In the dynamic study all seven dural tails were found to have earlier, steeper contrast enhancement than the corresponding tumours. All the tumours and part of the adjacent dura mater in four of the seven meningiomas with dural enhancement were examined histopathologically. In none of these four cases was neoplastic tissue found more than 2 mm away from the main tumour. The results strongly support the suggestion that the dural tail adjacent to meningiomas represents a hypervascular, non-neoplastic dural reaction.     

Erhöhter Abfall der Blutalkoholkonzentration nach Verkehrsunfällen

Zusammenfassung An 90 Fällen konnte nachgewiesen werden, daß nach Verkehrsunfällen sehr häufig oberhalb der vonWidmark, Jungmichel undKriebs angegebenen Schwankungsbreite liegt.Die beobachtete höhere Ausscheidungsgeschwindigkeit ist wesentlich abhängig von der Höhe der BAK. Bei Konzentrationen um 1,5 und über 2,0 wurden die höchsten Werte för beobachtet.Die Durchschnittswerte für waren nachmittags, kurz nach Mitternacht und in den frühen Morgenstunden höher als zu den übrigen Tageszeiten; entsprechend verhielten sich die Mittelwerte der gefundenen BAK.Die gröten individuellen Schwankungen von fanden sich im 3. und 5. Lebensjahrzehnt.Auf Grund allgemeiner Beobachtungen wird angenommen, daß auer der Höhe der BAK nervöse und hormonale (Insulin) Störungen, die durch erhebliche Erregung ausgelöst werden, als Ursache für die erhöhte Alkoholausscheidung anzusprechen sind.     

Evaluation of knee ligament injuries with the IKDC form

Various scoring systems have been proposed to quantify the disability caused by knee ligament injuries and to evaluate the results of treatment. None of these systems has found worldwide acceptance, mainly because all scoring systems attribute numerical values to factors that are not quantifiable, and then the arbitrary scores are added together for parameters not comparable with each other. For these reasons a group of knee surgeons from Europe and America met in 1987 and founded the International Knee Documentation Committee (1KDC). A common terminology and an evaluation form was created. This form is the standard form for all publications on results of treatment of knee ligament injuries. It is a concise one-page form. It includes a documentation section, a qualification section and a evaluation section. For evaluation there are four problem areas (subjective assessment, symptoms, range of motion and ligament examination). These are supplemented with four additional areas that are only documented but not included in the evaluation (compartmental findings, donor site pathology, X-ray findings and functional tests). The form can be used pre- and postoperatively and at follow-up. It has been specified that in any publication the minimum follow-up time for shortterm results should be 2 years, for medium-term results 5 years and for long-term results 10 years. The largest part of the sheet is the qualification section. It is called qualification section rather than scoring section because no scores are given. Each parameter is qualified as normal, nearly normal, abnormal or severely abnormal. This qualification is less subjective and emotional than very good, good, fair and poor. No knee and no knee function can be better than normal, and it is rather doubtful whether any knee, once operated on, can ever be normal again. For evaluation, the parameters of the four problem ares subjective assessment, symptoms, range of motion and ligament examination, are qualified for the group qualification. The worst qualification within the group gives the group qualification. The worst group qualification gives the final evaluation. If the knee is abnormal in any of the problem areas, it cannot be a normal knee. For chronic knee conditions there is also the possibility of evaluating the sum of levels of improvement or deterioration of all groups compared with the preoperative evaluation. The committee also recommends that terms describing knee ligament problems should be used according to the definitions of Noyes et al. [32]. The use of the IKDC evaluation form will reveal less favourable results than those evaluated with other current evaluation forms, because a still existing knee problem cannot be hidden with a high numerical score that is added up from other, unrelated parameters. It is to be hoped, however, that the use of this new form will enable us to compare treatment methods in various publications with each other.     

Problems with the “dural tail” sign

Prominent enhancement of the dura mater, the dural tail adjacent to a peripherally located mass on gadolinium-enhanced MRI has been described as being characteristic of meningiomas. We present a cerebral glioma showing the classical dural tail.     

Usefulness of different myocardial sampling zones for the postmortem diagnosis of myocardial infarction

Summary The diagnosis of myocardial infarction requires the use of a group of tests that are very efficient, quick and inexpensive. Another important consideration is the choice of myocardial sampling zones, especially in cases of differential diagnosis between a cardiac injury secondary to a trauma or violent asphyxia and others, secondary to myocardial infarction. The aim of this work was to choose, through discriminant analysis, the most useful zones of cardiac tissue for the quantification of free fatty acids and free carnitine and for the performance of the K/Na quotient, as biochemical parameters for the postmortem diagnosis of myocardial infarction. According to the discriminant analysis performed, seven zones of cardiac tissue are necessary to achieve a differential diagnosis among myocardial infarction, other natural deaths, and violent deaths with a 71.9% efficacy. Greater diagnostic efficacy was found (78.1%) for differentiating between natural deaths and violent deaths. Offprint requests to: E. Lachica     

Morphological detection of X- and Y-chromosomes in smears and paraffin-embedded tissues using a non-isotopic in situ hybridization technique (NISH)

Pharyngeal smears and paraffin-embedded tissue specimens (skeletal muscle, kidney) obtained from 10 male and 10 female individuals were evaluated using non-isotopic in situ hybridization (NISH) with commercial X- and Y-specific biotinylated probes which recognize the pericentromeric regions DXZ1 and DYZ1/DYZ3 of the X- and Y-chromosome, respectively. The results provide evidence that the morphological sex determination of a single cell can be performed by critical application of this staining method leading to one nuclear signal in male cells using the Y-specific probe whereas female cells are negative. In situ hybridization of female tissues with an X-specific probe results regularly in 2 signals whereas male cells show only one spot in the nucleus.     

Short-stop-munition

Zusammenfassung Immer wieder wird Munition zur Verteidigung unter Hinweis auf ihre weniger-tödliche bis nicht-tödliche Wirkung angeboten. Die Praxis zeigt jedoch, daß von diesen Munitionstypen entgegen den oft verharmlosenden Angaben der Hersteller sehr wohl eine konkrete Gefahr ausgeht. Einerseits können daraus schwerwiegende Folgen resultieren, andererseits kann als Einlassung vor Gericht die Vorhersehbarkeit solcher Folgen begrundet in Frage gestellt werden. Unter diesem Aspekt werden eine spezielle Schrotmunition für Revolver des Typs Speer 38/357 Shot Shells des Herstellers CCI, die Patrone Short-Stop der Fa. MB Associates in San Ramon (Kalifornien) and mit eigenem Fallbeispiel eine Munition vom Schock-Defense-Typ der Fa. Rauchalles in Offenburg vergleichend hinsichtlich Aufbau und Wirkung besprochen. Sonderdruckanfragen an: W.Eisenmenger     

Transcatheter Closure of Patent Foramen Ovale in Patients with Platypnea-Orthodeoxia: Results of a Multicentric French Registry

Background Dyspnea and the decrease in arterial saturation in the upright position in elderly subjects is described as platypnea-orthodeoxia syndrome (POS). POS is secondary to the occurrence of an atrial right-to-left shunt through a patent foramen ovale (PFO).Methods This French multicentric study reports on 78 patients (mean age 67±11.3 years) with POS who had transcatheter closure of the PFO; frequently associated diseases were pneumonectomy (n=36) and an ascending aortic aneurysm (n=11). In all patients, the diagnosis was confirmed by transthoracic or/and transesophageal echocardiography. Five different closure devices were used: Amplatz (n=45), Cardioseal (n=13), Sideris (n=11), Das Angel Wings (n=8) and Starflex (n=1). Closure was successful in 76 patients (97%).Results Oxygen saturation increased immediately after occlusion from 84.6±10.7% to 95.1±6.4% (p < 0.001) and dyspnea improved from grade 2.7±0.7 to grade 1±1 (p < 0.001). A small residual shunt was immediately observed in 5 patients (3 with the Cardioseal device, 1 with the Sideris and 1 with the Amplatz) leading to the implantation of a second device in one case (Cardioseal). Two early deaths occurred unrelated to the procedure (one due to sepsis probably related to pneumonectomy, another due to respiratory insufficiency). Other complications were: a small shunt between the aorta and the left atrium, two atrial fibrillations and a left-sided thrombus which disappeared with anticoagulant therapy. At a mean follow-up of 15±12 months, there were 7 late deaths related to the underlying disease.Conclusion Percutaneous occlusion of the foramen ovale is safe and gives excellent results thanks to continuing improvement in available devices. This technique enables some patients in an unstable condition to avoid a surgical closure.     

Ossification and pseudoepiphysis formation in the “nonepiphyseal” end of bones of the hands and feet

Metacarpals, metatarsals, and phalanges were studied to assess the developmental morphology of secondary ossification in the nonepiphyseal ends of these bones as well as the formation of the pseudoepiphysis as an epiphyseal ossification variant. Both direct ossification extension from the metaphysis into the epiphysis and pseudoepiphysis formation preceded, and continued to be more mature than, formation and expansion of the classic epiphyseal (secondary) ossification center at the opposite end of each specific bone. Direct metaphyseal to epiphyseal ossification usually started centrally and expanded hemispherically, replacing both physeal and epiphyseal cartilage simultaneously. In contrast, when remnants of physis were retained, while juxtaposed epiphyseal cartilage was replaced, a pseudoepiphysis formed. There were three basic patterns of pseudoepiphysis formation. First, a central osseous bridge extended from the metaphysis across the physis into the epiphysis and subsequently expanded to create a mushroom-like osseous structure. In the second pattern a peripheral osseous bridge formed, creating either an osseous ring or an eccentric bridge between the metaphysis and the epiphysis. In the third pattern, multiple bridging occurred. In each situation the associated remnant physis lacked typical cell columns and was incapable of significantly contributing to the postnatal longitudinal growth of the involved bone. Pseudoepiphyses were well formed by 4–5 years and coalesced with the rest of the bone months of years before skeletal maturation was attained at the opposite epiphyseal end, which ossified in the typical pattern (i.e., formation of a secondary center de novo completely within the cartilaginous epiphysis). This process may also affect the development and appearance of ossification within the longitudinal epiphyseal bracket (delta phalanx).     

New Retrievable Coil Anchors: Preliminary In Vivo Experiences in Swine

Purpose To design and test retrievable coil anchors to improve the safety and efficacy of coil embolization.Methods Fifty-two 0.038-inch homemade retrievable stainless steel coils were equipped with one of four different pre-shaped nitinol anchors and tested in 38 pigs. All coils with the anchor were completely retrieved and redeployed 3–18 times (median 7 times) prior to release. Types 1 and 2 anchored coils were acutely deployed in the external iliac arteries (n=10 each), and chronically tested (1 week) in the common carotid arteries (n=6 each). Larger type 1 (n=4), type 3 (n=6), and type 4 (n=4) anchored coils were acutely deployed in the abdominal aorta. The largest type 1 anchors (n=6) were acutely tested in the inferior vena cava.Results All anchored coils were successfully retrieved and repositioned several times. All but two coils formed a compact plug and there was no coil migration except with two mechanically defective type 3 anchors.Conclusion The use of retrievable anchors allowed the coils to be retrieved and repositioned, prevented coil migration, and enabled compact coil configuration.     

Zur Interpretation von postmortalen Digoxinspiegeln: Überprüfung eines „Korrekturfaktors“ für postmortal gemessene Digoxinkonzentrationen im Blut

Zusammenfassung Die Interpretation von postmortalen Serumdigoxinspiegeln wird vor allem dadurch erschwert, daß mit einem präfinalen and postmortalen Anstieg der Digoxinkonzentration im Blut zu rechnen ist. Eriksson et al. (1984) dividierten die postmortal gemessenen Digoxinspiegel im Femoralvenenblut durch 1,5, um den postmortalen Anstieg des Serumdigoxinspiegels zu berüicksichtigen; nach Meinung dieser Autoren weisen postmortale Serumdigoxinspiegel, die nach Division durch 1,5 noch über dem therapeutischen Bereich liegen, auf eine Digoxinüberdosierung hin. Der diagnostische Wert des von Eriksson et al. (1984) vorgeschlagenen Korrekturfaktors wurde überprüft. In 56 Fällen mit dokumentierter Digoxin-Medikation wurde postmortal Femoralvenenblut asserviert und eine Serumdigoxinspiegelbestimmung durchgeführt. In keinem der untersuchten Fälle war klinisch eine Digoxin-Intoxikation diagnostiziert worden. 50% der gemessenen Werte lager oberhalb des therapeutischen Bereichs (0,7 ng/ml bis 2,2 ng/ml). Nach Division der gemessenen Werte durch 1,5 lagen noch immer ca. 20% über 2,2 ng/ml, der höchste korrigierte Wert betrug 4,44 ng/ml. Unter Berücksichtigung des Zeitraums zwischen letzter Gabe und Tod, der individuell unterschiedlichen Digitalisglykosidempfindlichkeit sowie der Komplexität präfinaler und postmortaler Verteilungsvorgänge wurde für unser Untersuchungskollektiv festgestellt, daß eine (unerkannte) Digoxinüberdosierung auch darn nicht wahrscheinlich war, wenn der postmortale Wert nach Division durch 1,5 noch über dem therapeutischen Bereich lag. Der vor Eriksson et al. (1984) vorgeschlagene Korrekturfaktor ist nur vor begrenztem diagnostischem Wert; die korrigierten Werte können allenfalls einen Hinweis darauf geben, in welchem Bereich sich die entsprechende antemortale Serumdigoxinkonzentration bewegt haben könnte. Vor allem korrigierte Werte, die nur wenig über dem therapeutischen Bereich liegen, können den Verdacht auf eine Digoxinüberdosierung nicht mit ausreichender Sicherheit stützen.Ausführliche Darstellung siehe Dissertation St. Ritz, Kiel, Dissertation eingereicht Sonderdruckanfragen an: S. Ritz