Zum „Utilitäts“-Prinzip im Rahmen der gerichtlichen Feststellung von Blutsverwandtschaft mittels Serostatistik

Zusammenfassung Die realistische A-priori-Wahrscheinlichkeit bei serologischer Abstammungsbegutachtung — welche stets ein Akten-a-priori bedeutet — stellt eine Teilinformation im gesamten, dem Richter zur Verfügung stehenden Beweiskonvolut dar und nimmt keine eigentliche Sonderstellung ein. — Eine neutrale A-priori-Wahrscheinlichkeit kann es der Sache nach nicht geben. Entweder ist eine solche mit Nichtwissen gleichzusetzen, dann entfällt sie als Information, oder sie steht mit dem Utilitäts-Prinzip in Zusammenhang und stellt damit keine Wahrscheinlichkeit dar. — Das Utilitäts-Prinzip ist rechtspolitisch definiert; es kann zahlenmäßig nicht ausgedrückt werden. — Das Utilitäts-Prinzip wird nur wirksam, wenn der Richter (unter Benutzung aller ihm zur verfügung stehenden Beweise) eine Entscheidung fällt. Es bestimmt dabei die Gewichtung der im Prozeß zur Debatte stehenden Rechtsgüter der Beteiligten. — Der Gutachter hat eine neutrale Utilitäts-Komponente anzuwenden, d.h. er gibt in Zweihypothesenfällen (welche die Regel sind) der Null- wie der Gegenhypothese dasselbe Bedeutungsgewicht. Null- und Gegenhypothese können dabei aus mehreren Einzelhypothesen zusammengefaßt sein; deren Häufigkeiten werden gemittelt. — Die Mitführung eines Akten-a-priori bei der Berechnung eines W-Werts sollte in aller Regel unterbleiben. — Eine Irrtumserwartung soll einen möglichst realistischen Charakter haben; sie sollte daher unter Mitwirkung eines Akten-a-priori zustandekommen.     

Hemorrhage associated with “bone crisis” in Gaucher's disease identified by magnetic resonance imaging

Children suffering from Gaucher's disease were examined by magnetic resonance imaging (MRI) during a characteristic episode of bone crisis. An unexpectedly high intramedullary as well as subperiosteal signal was observed on both the T1 and T2-weighted sequences in 5 patients, suggesting a subacute hemorrhage or hematoma. It is conceivable that such a painful hemorrhage is an important component of the bone crisis phenomenon. Furthermore, in these cases this is a specific sign which may enable differentiation of bone crises from other types of bone pain associated with Gaucher's disease.     

Magnetic resonance imaging and histopathology of cerebral gliomas

Summary The correlation of magnetic resonance imaging (MRI) with histopathological findings was analysed in 26 patients with untreated cerebral gliomas. In low-grade gliomas, T2-weighted images demonstrated relatively homogeneous high-intensity lesions involving both the grey and the white matter. In high-grade gliomas, especially grade IV, T2-weighted images demonstrated prominent heterogeneity in signal intensity, which consisted of a hyperintense core, less hyperintense or normal intensity rim and surrounding finger-like areas of high intensity. Marked and irregular contrast enhancement was evident in all but one case of these high-grade gliomas in which gadolinium-DTPA was used. Histological examination revealed tumour cells extending as far as the borders of the high-intensity areas shown on T2-weighted images in both high-and low-grade gliomas, but in 5 of 8 low-grade and 4 of 18 high-grade gliomas, isolated tumour cells extended beyond the hyperintense areas shown on T2-weighted images.     

Todeszeitschätzungen durch die mathematische Beschreibung der rektalen Leichenabkühlung unter verschiedenen Abkühlungsbedingungen

Zusammenfassung Von den als Bezug gewählten Standardbedingungen einer Leichenlagerung (unbekleidet — ruhende Luft) abweichende Abkühlungsbedingungen (permanente Luftbewegung — Bekleidung — Bedeckung — feuchte Bekleidung) können durch Korrekturfaktoren des Körpergewichts in der Todeszeitberechnung aus Daten der rektalen Leichenabkühlung angemessen berücksichtigt werden. Die Körpergewichts-Korrekturfaktoren umfassen am vorliegenden Material einen Bereich zwischen 0,7 für vollständig durchfeuchtete Bekleidung+permanente Luftbewegung und 2,4 für bettähnliche Bedeckung.Leicht zu handhabende Temperatur-Todeszeit-Bezugsnomogramme ersetzen die Berechnungen ohne Verlust an Präzision. Die 95%- bzw. 99%-Toleranzgrenzen einer Schätzung des wahrscheinlichen bzw. sehr wahrscheinlichen Todeszeitbereichs wurden ermittelt.Herrn Prof. Dr. O. Prokop zum 60. Geburtstag gewidmet     

Soft tissue pseudotumor following intramuscular injection of “DPT”: a pitfall in magnetic resonance imaging

We report the time-dependent magnetic resonance imaging (MRI) changes that resulted from an intramuscular injection of a commonly-used pediatric sedation regimen (DPT). These changes at the site of injection consist of a focal abnormality characterized by a slight increase in signal intensity on T1 weighted images and markedly increased signal intensity on T2 weighted images. Alterations in signal are detectable almost immediately after the injection and progress over the first 31 hours. This abnormality, which could be mistaken for real disease, persists up to 36 days following injection.     

“Top of the basilar” syndrome: A comparison of clinical and MR findings

Summary Among 100 patients with an infarction of the brain reported on MR and clinically confirmed there were 4 with widespread lesions of the temporal and occipital lobes, thalamus, midbrain, pons and cerebellum, all supplied by arteries originating around the top of the basilar artery. Clinically these patients presented the top of the basilar syndrome, which is caused by a disturbance in circulation at the top of the basilar artery. Which brain areas are involved may be deduced theoretically from the vascular anatomy. These lesions can, we believe, be clearly detected using MR, because of its sensitivity to ischaemic disturbances and in the posterior fossa. We report our 4 patients here to illustrate the clinical presentation and MR findings of the top of the basilar syndrome.     

MRI of pituitary hyperplasia in hypothyroidism

We present a case of a pseudoprolactinoma where administration of thyroid hormone resulted in resolution of symptoms and regression of pituitary hyperplasia seen on MRI.     

Hajdu-Cheney Syndrome: MR imaging

Summary Hajdu-Cheney syndrome is a rare congenital disease with acro-osteolysis, osteoporotic changes of the spine and long bones of extremities and marked basilar invagination with an unusually deformed skull. Magnetic resonance imaging of a 32-year-old male revealed the deformed skull and almost horizontal basal angle and the elongated and upwardly shifted brain stem caused by the tip of the odontoid process of the second cervical vertebra invaginating the base of the skull. In addition there were atrophic pituitary gland, widely open sella turcica and symmetrical fluid collections along the optic nerve sheath.We apologize for the misspelling of Hajdu as Hadju in our previous communication [1].     

MR imaging of eosinophilic granuloma: report of 11 cases

The findings in 11 patients with histologically proven eosinophilic granuloma (EG) examined by magnetic resonance imaging (MRI) are described. In contrast with the variable appearance of EG on conventional radiography and computed tomography (CT), relatively constant features — intermediate to high signal intensity on T1-weighting, high signal intensity on T2-weighting, marked enhancement — were found on MRI. MRI was superior to other imaging methods in demonstrating bone marrow involvement and any accompanying soft tissue mass or inflammation. Intermediate to high signal intensity on Tl-weighting and marked contrast enhancement could not be explained by histological findings. Prediction of the evolutionary phase of EG by MRI remains questionable because of the phase I (proliferative) histology of all 11 lesions.     

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.     

PET and MR imaging in a neuro-behçet syndrome

Positron emission tomography (PET) and magnetic resonance imaging (MRI) studies were performed on a case of neuro-Behçet's syndrome. In accordance with the clinical signs, FDG PET (using¹⁸F-labeled 2-F-2-desoxyglucose) revealed disseminated storage defects in the cerebrum and cerebellum. Focal regions of enhanced signal intensity were demonstrated in the parietal white matter of the cerebrum in T2-weighted images and in the brain stem by MRI.This article was presented at the 1st EEC workshop on accuracy determination in PET, January 19–20th. 1989 Pisa, Italy (COMAC-BME Concerted Project Characterization and Standardization of PET Instrumentation)     

Amnesia due to bilateral hippocampal glioblastoma

Summary The authors report a unique case of glioblastoma which caused permanent amnesia. Magnetic resonance imaging showed the lesion to be limited to the hippocampal formation bilaterally. Although glioblastoma extends frequently into fiber pathways and expands into the opposite cerebral hemisphere, making a butterfly lesion, it is unusual for it to invade the limbic system selectively to this extent.     

Die Abhängigkeit des Faktors β von der Konzentrationshöhe

Zusammenfassung Die Begriffe des Konzentrationsabfalles \ und des Reduktionsfaktors sowie die Variationsbreiten dieser Größen werden diskutiert.Die mittlere Abbaugeschwindigkeit während langer Zeitspannen lag bei Blutalkoholkonzentrationen oberhalb 1,5 mindestens bei 0,16, wenn der errechnete Höchstwert (r = 0,7) annähernd erreicht wurde.Die statistische Auswertung von den 4118 Einzelentnahmen und den Entnahmen in zeitlichem Abstand bei 922 Personen zeigt die am häufigsten beobachtete Blutalkoholkonzentration bei 1,8und ein mittleres \₆₀ von 0,184.Der Faktor nimmt mit steigender Blutalkoholkonzentration zu. Die Unterschiede zwischen den Bereichen 0,41—1,2 und oberhalb 2,0 sind statistisch gesichert, die mittleren \₆₀-Werte von 0,17 bzw. 0,203 damit signifikant.Auszugsweise vorgetragen auf dem Kongreß für Gerichtliche und Soziale Medizim 1954 in Kiel.     

Neuropsychological correlates of brain atrophy in Huntington's disease: a magnetic resonance imaging study

Summary Magnetic resonance imaging and a comprehensive cognitive evaluation were carried out in a series of 29 patients with mild to moderate Huntington's disease (HD). A factor analysis of the neuropsychological test scores provided three factors: a memory/speed-of-processing factor, a frontal factor, and a response inhibition factor. The memory/speed factor correlated significantly with measures of caudate atrophy, frontal atrophy, and atrophy of the left (but not the right) sylvian cistern. There were no significant correlations between the frontal or response inhibition factors and measures of cortical or subcortical brain atrophy. Our findings confirm that subcortical atrophy is significantly correlated with specific cognitive deficits in HD, and demonstrate that cortical atrophy also has important association with the cognitive deficits of patients with HD.     

Fogging on T2-weighted MR after acute ischaemic stroke: how often might this occur and what are the implications?

Fogging is the temporary loss of visibility of an infarct on CT which occurs in the subacute phase at about 2 weeks after stroke. It occurs in up to 40% of medium to large infarcts on CT. It is unclear whether or how often fogging occurs on T2-weighted MR, but if it does occur, it can cause underestimation of true infarct size. This study examined the possible frequency and time scale of fogging on T2-weighted MR. We conducted a blinded, independent review of prospectively collected MR scans from patients with symptoms of cortical ischaemic stroke, scanned sequentially up to 7 weeks after stroke. On each scan maximum infarct area was measured, and the infarct extent and swelling were coded on a validated scale. Fogging was suggested by reduced infarct extent between initial and subsequent scans. In 30 patients (with 74 scans) there was some apparent fogging in 50% of patients between 6 and 36 days (median 10 days) after stroke. Reduction in infarct extent on T2-weighted MR which may be attributed to fogging occurs in a significant proportion of patients with cortical infarcts. This may lead to an underestimation of true final infarct extent. This suggests that true infarct extent on T2-weighted MR can probably only be assessed on scans obtained beyond 7 weeks after stroke.     

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.     

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.     

Proportional anatomical stereotactic atlas for visual interpretation of brain SPET perfusion images

A semi-automatic method was developed to determine the anterior (AC) and posterior (PC) commissures on brain single-photon emission tomographic (SPET) perfusion images, and then to draw the proportional anatomical Talairach's grid on each axial SPET image. First, the AC-PC line was defined on SPET images from the linear regression of four internal landmarks (frontal pole of the brain, inferior limit of the anterior corpus callosum, sub-thalamic point and occipital pole). Second, the SPET position of AC and PC points on the AC-PC line was automatically determined from measurements made on hard copies of magnetic resonance (MR) images of the patients. Finally, a proportional Talairach's grid was automatically drawn on each axial SPET image. To assess the accuracy of localization of AC and PC points, co-registered technetium-99m hexamethylpropylene amine oxime SPET and MR images from 11 subjects were used. The mean displacements between estimated points on SPET and true points on MRI (x=sagittal, y=frontal and z=axial displacement) were calculated. The mean displacements (in mm) were x=–1.4±1.8, y=–1.7±3.3 and z=–1.1±2.5 for AC, and x=–1.8±1.8, y=0.3±3.2 and =–1.3±2.7 for PC. These displacements represented an error of less than 5 mm at the anterior or posterior pole of the brain or at the vertex. Intra- and inter-observer comparisons did not reveal significant differences in mean displacements. Thus, this semi-automatic method results in reproducible and accurate stereotactic localization of SPET perfusion abnormalities. This method can be used routinely for repeat follow-up studies in the same subject as well as in different individuals without requiring SPET MRI co-registration.     

Magnetic resonance images of chronic patellar tendinitis

Chronic patellar tendinitis can be a frustrating diagnostic and therapeutic problem. This report evaluates seven tendons in five patients with chronic patellar tendinitis. The etiologies included jumper's knee and Osgood-Schlatter disease. In all cases magnetic resonance images (MRI) showed thickening of the tendon. Some of the tendons had focal areas of thickening which helped establish the etiology. All cases had intratendinous areas of increased signal which, in four cases, proved to be chronic tendon tears. MRI is useful in evaluating chronic patellar tendinitis because it establishes the diagnosis, detects associated chronic tears, and may help determine appropriate rehabilitation.     

SLAP lesions of the glenoid labrum diagnosed with MR imaging

Tears of the superior portion of the glenoid labrum in patients without shoulder instability have recently been described. These tears, which include the anchor of the biceps tendon to the labrum, have been labeled SLAP lesions (superior /abrum anterior to posterior). This study was performed to determine the magnetic resonance (MR) findings in patients with SLAP lesions. Retrospective review of the shoulder arthroscopy reports on patients who underwent MR imaging using a 1.5-T unit and subsequent arthroscopy by a single surgeon identified six patients with SLAP lesions (average age 36 years, range 17–65 years). MR images demonstrated atypical morphology indicative of tear in the superior portion of the labrum in four of the six patients, but only one tear had been identified preoperatively. Radiologists interpreting MR images of the shoulder should be aware of the MR findings of SLAP lesions as these tears can be a significant cause of patient disability and are difficult to diagnose clinically.