Sudden infant death, Williams-Beuren-Syndrom oder beides?

SummaryThe Williams-Beuren syndrome is a genetic disorder caused by a deletion of the elastin gene mapped on chromosome 7 (7q11.23). This results in multi-organ malformation, mental retardation and generalised elastin arteriopathy, which can lead to cardiac and vascular complications and to sudden death. We present two cases in which a postmortem examination was initially carried out with the presumptive diagnosis of sudden infant death, but cardiac malformations and facial dysmorphisms were recognised that could confirm the diagnosis of Williams-Beuren syndrome. In both cases nearly the same pathological findings were seen in the heart and lungs by histological examination. We will discuss if these findings could have caused death and if they can confirm our presumptive diagnosis of a William-Beuren syndrome which could not be verified by a genetic investigation.     

Wound ballistic evaluation of the TASER® XREP ammunition

The Taser® eXtended Range Electronic Projectile (XREP®) is a wireless conducted electrical weapon (CEW) designed to incapacitate a person from a larger distance. The aim of this study was to analyze the ballistic injury potential of the XREP. Twenty rounds were fired from the Taser®X12 TM shotgun into ballistic soap covered with artificial skin and clothing at different shooting distances (1–25 m). One shot was fired at pig skin at a shooting distance of 10 m. The average projectile velocity was 67.0 m/s. The kinetic energy levels on impact varied from 28–52 J. Depending on the intermediate target, the projectiles penetrated up to 4.2 cm into the ballistic soap. On impact the nose assembly did not separate from the chassis, and no electrical activation was registered. Upon impact, a skin penetration of the XREP cannot be excluded. However, it is very unlikely at shooting distances of 10 m or more. Clothing and a high elasticity limit of the target body area can significantly reduce the penetration risk on impact.     

Can a threshold for 11‐nor‐9‐carboxy‐Δ9 ‐tetrahydrocannabinol in hair be derived when its respective concentration in blood serum indicates regular use?

A 100 μg/L or higher concentration of 11‐nor‐9‐carboxy‐Δ9‐tetrahydrocannabinol (THC‐COOH) in blood serum is generally assumed to be associated with regular and/or heavy use of cannabis. At present, determination of the extent of cannabis use by means of the concentration of THC‐COOH in hair has not been assessed. Therefore, we aimed at establishing a threshold for THC‐COOH concentrations in hair to prove frequent consumption by comparing THC‐COOH concentrations in 129 corresponding serum and hair samples, respectively. The concentration of THC‐COOH in the serum was analyzed by gas chromatography–mass spectrometry and in the hair by liquid chromatography–tandem mass spectrometry. Data were statistically evaluated using receiver operating characteristic curves and contingency tables. Our results suggest that a THC‐COOH concentration of ≥4.2 pg/mg in hair was always accompanied by a THC‐COOH concentration of at least 100 μg/L in blood serum. Should this be confirmed by further studies of a larger study population, a hair concentration of 4.2 pg/mg THC‐COOH can be set as a threshold to predict regular and/or heavy consumption of cannabis even if no corresponding blood sample is available for analysis.     

Epizootiological survey of small mammals as Leptospira spp. reservoirs in Eastern Croatia

In this survey we investigated a population of small mammals in Eastern Croatia in order to determine Leptospira carriage rates and identify circulating serovars. Out of 67 trapped animals, 20 (29.9%) isolates were obtained. Identification of isolates using microscopic agglutination test, pulsed field gel electrophoresis and multi locus sequence typing revealed that 10 (50.0%) isolates belong to serogroup Pomona, serovar Mozdok, 6 (30.0%) isolates to serogroup Australis, serovar Jalna, 2 (10.0%) isolates to serogroup Sejroe, serovar Saxkoebing, and 1 (5.0%) isolate to serogroup Grippotyphosa, serovar Grippotyphosa. One isolate from serogroup Bataviae was unable to be identified to the serovar level. Amplification of a 331-bp region of the locus LA0322 using real-time polymerase chain reaction determined that 12 (60.0%) isolates belong to L. kirschneri, 6 (30.0%) isolates to L. interrogans, and 2 (10.0%) isolates to L. borgpetersenii. Leptospira carriage rate was high (29.9%), which corresponds to a high incidence of human and domestic animal leptospirosis in Eastern Croatia. Furthermore, 90.0% of the isolates belong to serogroups Pomona, Australis and Sejroe which are also the most prevalent serogroups in humans in this area. These findings suggest that small mammals might be an important source of Leptospira spp. infection in Eastern Croatia.     

Elektrowaffe Taser?

Taser? ECDs (electronic control devices) are battery powered, handheld devices, which deliver short high-voltage, low current energy pulses to stimulate motor neurons, causing transient paralysis. This article reports the results of a prospective, non-blinded study, where human volunteers were exposed to the Taser? X26 during a police training exercise. The objective of this study was to determine the immediate effects of the Taser? CEW (conducted electrical weapon) discharges on the heart with possible arrhythmia development and changes in blood parameters. Furthermore, this study gives an overview of the wide range of research works devoted to different subjects surrounding Taser? ECDs, produced by university scientific groups as well as by military and police research departments. The experiments, as well as the literature review showed no indications that Taser? X26 pulses could reach the threshold for causing immediate or delayed onset ventricular fibrillation or any other significant changes in the heart. Furthermore, no pathophysiological changes in blood parameters could be detected. Electronic control devices, such as the Taser? are a relatively safe, less than lethal alternative to the use of firearms.     

Sektionsdaten des Instituts f��r Rechtsmedizin der Universit?t M��nchen aus dem Jahr 2003

In 2003 a total of 2,352 deceased were admitted to the Institute of Legal Medicine of the University of Munich/Germany. Within the framework of several dissertations the applicability of the software WinLIMS.net was reappraised by a retrospective entry of epidemiological data and autopsy findings. These data are presented in this article and the comparison with data from the Federal Statistical Office is discussed. WinLIMS.net proved to be user-friendly software and enabled the user to easily collect statistical data. Some suggestions for improvements of the software are discussed.     

Atrial tachycardia ablated from the non-coronary aortic cusp

We present a case of a patient with drug resistant atrial tachycardia which was ablated from the noncoronary aortic cusp. Tachycardia was adenosine-sensitive and was characterized by a long RP' interval and low amplitude P waves (biphasic in II, III, aVF and V1-V2 leads, and positive in aVL). The earliest atrial activation during tachycardia was recorded at His region and from non-coronary aortic sinus of Valsalva. RF ablation at this area terminated tachycardia and did not impair atrio-ventricular conduction.