Identifikation unbekannter Toter durch odontologische Untersuchungen

Bei der Identifikation unbekannter Toter hat die Untersuchung des Zahnsystems einen sehr hohen Stellenwert. Mit Hilfe der Unterlagen aus der zahn?rztlichen Praxis ist es m?glich, pr?- und postmortale Befunde zu vergleichen und somit eine Identifizierung durchzuführen. Durch unvollst?ndige und fehlerhafte Unterlagen aus den zahn?rztlichen Praxen wird aber in vielen F?llen eine Identifizierung unn?tig erschwert oder sogar unm?glich. R?ntgenbilder k?nnen hier Abhilfe schaffen. Pr?mortal angefertigte Panoramaschichtaufnahmen (Orthopantomogramme) eignen sich in besonderer Weise zum Vergleich mit m?glichst deckungsgleichen postmortal angefertigten Bildern. Die Panoramaschichtaufnahme sollte daher schon zu Beginn der vergleichenden Untersuchungen vorliegen und eingesetzt werden.      

Überprüfung der Altersdiagnostik mittels Wurzeldentintransparenzmessung bei unbekannten Toten

For the evaluation of age estimation based on root translucency, prepared upper and lower jaws of 55 clearly identified corpses were examined. In 54 cases 109 teeth were suitable for assessment. The root translucency was measured in 0.5 mm steps. In comparison to relevant referent studies, the measured values were transferred to estimated age. Correctly estimated results could be obtained in 18 cases, 44 age estimates showed a deviation of 10 years. In 7 cases, a deviation of up to 15 years was found, in 2 cases of up to 20 years, and in 1 case of up to 30 years. It can be concluded that this fast, efficient and simple procedure leads to valuable results in the middle age range. To avaoid seriously false estimations in individual cases, age diagnosis should always be verified by an evaluation of all dental features and autopsy findings relevant to age.     

Identifikation eines skelettierten Kleinkind-Schädels durch die molekularbiologische Untersuchung von Hirnresten

The skull of a small child, which was largely devoid of soft tissue, was classified according to forensic/anthropological findings and could be identified on the basis of DNA typing by PCR using residual brain tissue, but not bone. This case illustrates the fact that careful forensic/anthropological investigation is an important basis for molecular biological identification from skeletal remains and that DNA typing by PCR may even be possible on brain tissue that has been exposed to damp conditions and is an advanced state of decomposition.     

Der Einsatz mobiler Röntgentechniken bei der odonto-stomatologischen Identifizierung von Katastrophenopfern

The use of dental radiology in cases of mass disaster is an absolute necessity. Radiographs usually permit identification of dental fragments containing as little as one tooth if a restoration or unique anatomical characteristic is present. Unfortunately the conditions at the scene are usually not adequate to use standard x-ray equipment. The paper presented here gives an overview of different types of mobile x-ray machines and digital radiographic techniques which are useful in disaster victim identification.     

Die elektronische Kennzeichnung von Zahnprothesen – ein Hilfsmittel zur Personenidentifikation

The number of edentulous people is increasing worldwide. In cases of disasters denture wearers may be identified quickly when their dentures are marked. The electronic marking of prosthetics by a microchip is demonstrated.     

Schutz oder Management? Katastrophenschutz in der Bundesrepublik Deutschland 1

The disaster management in Germany is embodied in the constitution. According to the German constitution the ministries of the interior of the federal states coordinate the disaster management by delegating it to the city and county administrations. These elaborate and update a special disaster management calendar, which allows a prompt flow of information to and from the administration and the person in charge of operations and guarantees a smooth collaboration on which the success of the operation depends.     

Wert und Bedeutung der digitalen Vollfeldmammographie im Rahmen eines Mammographie-Screenings

To evaluate the digital technique for screening mammography various experimental studies and clinical examinations were performed by using direct full-field digital mammography (FFDM). The findings concerning the detectability and characterization of microcalcifications and soft tissue masses as well as the radiation exposure were compared to the state-of-the-art conventional screen-film mammography (SFM). The results of these studies revealed a high performance of the digital images, which are at least equivalent to the conventional images, whereas digital spot views were significantly superior to conventional ones particularly in the detection of microcalcifications. This was especially true, when the potential of post-processing was used. In addition, the sensitivity of FFDM should be increased, if computer-aided-diagnosis (CAD) is available. Furthermore, the patient radiation dose can be significantly reduced. Additional advantages are quick and easy handling, efficient data transfer and digital archiving. Thus, FFDM will become an important tool in screening mammography.     

Neue Techniken und Pulssequenzen bei der MRT der Leber

PURPOSE: The MRI techniques which have contributed to increasing utilization of MRI for abdominal imaging are described and recent advances addressed. METHODS: For breath-hold examinations of the abdomen, two basic techniques are required: array coil technology and fast and ultrafast pulse sequences providing T1 and T2 contrast. RESULTS: Circular polarized array coils render high signal-to-noise ratios (SNR) within large imaging volumes. With fast gradient-echo sequences the liver can be scanned with or without fat saturation within one breath-hold. When adequate parameters are selected, T2-weighted fast (turbo) spin-echo sequences allow high contrast between normal liver tissue and focal liver lesions, even if breath-hold acquisition is applied. Moreover, good soft tissue contrast can also be achieved with ultrafast single-shot sequences. Based on this sequence type, MRCP with a 512 matrix could be performed. The "TRUE FISP" allows for high resolution visualisation of vessels without contrast media. Three-dimensional T1-weighted sequences allow for scanning the upper abdomen with a slice thickness of 3 mm within one breath-hold. Diffusion-weighted sequences contribute to the characterisation of focal liver lesions. DISCUSSION: Modern MRI technology including phase-array coils and high-performance gradient systems made it possible to perform all examinations in breath-hold techniques, reducing motion artifacts.     

Die Bedingungen der radiologischen Vergleichsuntersuchung in der rechtsmedizinischen Personenidentifikation

The authors tested the possibilities for forensic personal identification based on the comparison of ante-mortem and post-mortem radiographs. From the Dept. of Radiology University Medical School of Pécs, Hungary 946 randomly selected radiographs of 9 different skeletal regions from 458 patients were examined. The aim of this study was to find the specific parts of the skeleton, which are anatomically variable or which frequently exhibit change due to pathological development, trauma or alterations from surgery. The results of the examinations showed that the skull has the most anatomically variable features. The long bones and the pelvic girdles showed a high number of alterations due to trauma, which suggests the importance and usefulness of these radiographs. However, the radiologically visible degenerations on the vertebral column could also be useful in the personal identification process and the authors recommend using detailed examination and careful analysis of these alterations.     

Käfer an Leichen

The article emphasizes the criminalistic importance of beetles attracted by carrion and presents some groups (families, genera, species) of beetles frequently found on carrion in Middle Europe. The families Silphidae, Staphylinidae, Cleridae, and Dermestidae and some of their species are presented in more detail. As different species of necrophilic beetles prefer different stages of decay and are only attracted by carrion which has reached the preferred condition, the discovery of beetles on a dead body and their determination may provide additional information about time since death/since exposition. Moreover, some beetles do not occur ubiquitously but only in certain biotopes such as woodlands, open country, river banks and lowlands, etc., and may thus provide criminalistic information in cases if a body has been moved. Some collection and preservation methods are also briefly described.     

Bildanalyse bei der Mehrschicht-Spiral-CT der Lunge mit MPR- und MIP-Rekonstruktionen

PURPOSE: To test, whether axial, coronal and sagittal MIP and MPR reconstructions of diagnostic quality can be obtained from 1-mm collimation MSCT data of the chest for the evaluation of thoracic anatomy and pathology. MATERIALS AND METHODS: 1-mm collimation MSCT scans were obtained with a pitch of 6 in an acrylic phantom and in 20 patients. Axial images were reconstructed with 0.6-mm increment. Multiplanar reformations (MPRs) and sliding thin-slab maximum intensity projections (STS-MIPs) were reconstructed in axial, coronal and sagittal planes. Images were printed in lung windows and evaluated by three readers by using a standardized evaluation scheme. RESULTS: Overall, both methods allowed good visualization of anatomic structures. MIP was superior for visualization of the pulmonary arteries (p < 0.05) while central and peripheral bronchi and the lung parenchyma were better depicted on multiplanar reconstructions. A confident diagnosis of thoracic pathology was feasible using both modalities, however MIPs appeared less usefull for evaluation of gross parenchymal abnormalities, such as pneumonic infiltrates or fibrotic changes. No significant difference in the degree of motion artifacts were detected between both modalities. CONCLUSION: MSCT data sets are ideally suited for generating MPR and MIP reconstructions. While MIPs are superior for the evaluation of thoracic vessels, MPR is advantageous for visualizing central and peripheral bronchi and the pulmonary parenchyma.     

Die interventionelle Behandlung der arteriosklerotischen Karotisstenose

PURPOSE: Angioplasty and stent placement of atherosclerotic internal carotid artery stenosis (ICA) are evaluated based on own experiences with the method and reports of other groups and are compared with vascular surgery. METHODS: ICA-stenoses of more than 70% were treated by angioplasty and stent placement mainly using the Wallstent. The patients had follow-up examinations with an angiogram after 6 months and colour-coded duplex ultrasound at regular intervals. RESULTS: In 633 patients 799 ICA stenoses were treated, 70% of them were symptomatic and 30% asymptomatic. In 99% of the patients the stenoses could be removed with a reduction of the degree of stenosis from 82% to 12%. Transient neurological deficits occurred in 5% and permanent deficits in 2.7% of the patients with decreasing incidence over the years. Five-year patency was 91.6%. CONCLUSION: Endoluminal treatment of atherosclerotic ICA stenosis is an efficient procedure which can be applied in patients, in whom carotid surgery is indicated, but also in cases with an increased operative risk or inoperability from technical or medical reasons.     

Carphedon – Identifikation einer neuen Designerdroge

The screening phase of doping analysis is able to reveal other xenobiotics in addition to the prohibited agents to be detected. If the intake of such substances has not been declared, then the suspicion arises of an attempt to circumvent the doping ban by the use of not yet prohibited doping agents. After earlier “grey area” cases with permitted, but unadmittedly used agents without medical indication the semi-legal and meanwhile banned pharmaceutical Bromantan was identified in Atlanta in 1996. In 1997 we could detect and identify by mass spectrometry the semi-legally synthesized Carphedon for the first time in a doping sample. This drug was neither regularly tested for its toxicity, nor registered and it had to be considered as a designer drug combined from two agents with nootropic/psychotropic and analeptic actions. Carphedon is now explicitly prohibited as a doping agent by the I.O.C. definition. Detection and identification of the compound – internationally almost completely unknown until 1997 – are described.     

Aortenruptur bei einem 18-jährigen Mann Postmortale Diagnose eines Ehlers-Danlos-Syndroms Typ IV

We present the case of an 18-year-old male who died due to a non-traumatic rupture of the thoracic aorta. At autopsy the connective tissue of the liver and gastrointestinal tract was extraordinarily fragile, so that the presumptive diagnosis of a hereditary connective tissue disease could be made. In combination with further criteria (no hyperelasticity of the skin, so-called club-feet, spontaneous arterial rupture) the diagnosis of Ehlers-Danlos syndrome (EDS) type IV was considered which was confirmed by immunhistochemical examination of aorta, liver and renal tissue. The EDS type IV (vascular type of EDS) is the result of genetic defects of collagen III metabolism and is the most life-threatening subtype due to spontaneous vascular or intestinal ruptures. Non-traumatic vascular or bowel ruptures may cause (sudden) death even in children or adolescents. The post-mortem diagnosis can be supported by fibroblast cultures (if available) or by immunhistochemical examination of organ tissue.     

Strukturierte Abbildung radiologischer Leistungen im Kontext eines Krankenhausinformationssystems Bietet der DICOM-Standard hierfür die notwendigen Voraussetzungen?

Zusammenfassung Hintergrund: Das im DICOM-Standard vorgegebene Datenmodell wird unter dem Aspekt der Systemintegration betrachtet. Hierbei werden Semantik und Beziehungen innerhalb der Hierarchie der IODs (Information Object Definitions) untersucht. Methodik: Ausgehend von dem im DICOM-Standard (Teil 3) definierten Entit?ten wurde überprüft, wie die dort definierten Klassen in ein gemeinsames Datenmodell der im KIS (Krankenhaus Informationssystem) implementieren elektronischen Patientenakte zu integrieren sind. Anhand der IOD untersuchten wir, wie die für die strukturierte Ablage von Bildinformationen relevanten Entit?ten definiert sind und ob deren Semantik ad?quat ist. Ergebnisse: Da die Semantik nicht eindeutig festgelegt ist, wird für den Kernbereich der radiologischen Leistungserfassung ein Vorschlag zur Strukturierung der Daten unterbreitet. Dieser geht in der Definition der Semantik über den Anwendungsbereich der Bildgebung hinaus, um strukturelle Konflikte bei der KIS/RIS/PACS-Integration zu vermeiden. Durch die Unterscheidung in Behandlungs- und Abrechnungsfall wird die zeitliche Zuordnung der erbrachten Leistungen unter medizinischen und abrechnungsrelevanten Gesichtspunkten gew?hrleistet. Radiologische Leistungen werden in bildgebende Untersuchungen und Zusatzleistungen unterteilt. Schlu?folgerungen: Durch fehlende Angaben zur Semantik der im DICOM-Standard definierten Entit?ten ergeben sich potentielle Konflikte im Rahmen der Systemintegration. Die Behandlung des Themas ist im Hinblick auf die Implementierung der elektronischen Krankenakte notwendig.      

Zur Frage der Differenzierung von Ein- und Ausschuss bei auf fester Unterlage anliegenden bekleideten Opfern

We raised the question whether textile fibres can be found in exit wounds and whether projectiles will be reflected back into the exit wounds of gunshot victims if the body is clothed and in contact with a hard surface. ¶In order to examine this aspect of wound morphology, we fired 85 shots with a pistol (Sig Sauer, 9 mm Luger, jacketed ammunition) into pig cadavers covered with two layers of clothing material while lying on various hard materials. The results of our investigations indicate that clothing fibres could be found in a high percentage of exit wounds of victims shot while the location of the exit wound was in contact with a hard flat surface (particularly a tiled surface). A retrospective analysis of gunshot victims autopsied at our institute confirmed these findings. The fibres found within the exit wounds were forced into the wound by the ricocheting projectiles.     

3-Dimensionale Messungen der Processus mastoidei zur Geschlechtsdiagnostik am Schädel

In sexing of skulls the mastoid process is considered to be an important sex trait because of its greater dimension in males. Quantitative studies of the volume of the process are limited to air cell system investigations. The objektive of the present study was to quantify mastoid processes and test the value for sex determination. The three-dimensional study of the mastoid processes was carried out on 72 human skulls of which 38 were females and 34 males. The surface of the processes, limited to the part which projects from the skull base, was scanned with an optical measurement system. The resulting data were used to reconstruct virtual processes on a personal computer. Volume, suface area and height of the 3-D images were measured. There was no significant difference between the left and right mastoid processes. All of the parameters showed significant differences between the sex groups (volume: male 833.31 mm³, female 647.88 mm³, P = 0.04118; surface area: male 339.51 mm², female 286.80 mm², P = 0.0383; height: male 8.93 mm, female 8.06 mm, P = 0.0039). But the female values for volume and surface area were scattered completely within the male range and the female and male values for the height were widely overlapping. In discriminant function analysis the accuracy was only 65.28%. The results verify the sexual dimorphism of the dimensions of the mastoid processes but because of the widely overlapping range of male and female values the results are not of use for determination by measurement.