1
|
Kolbe V, Bingert R, Märzheuser S, Büttner A. [Caution: aggressive! Dog bite injuries in clinical forensic medicine]. Chirurgie (Heidelb) 2023; 94:246-255. [PMID: 36282329 PMCID: PMC9950238 DOI: 10.1007/s00104-022-01741-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 11/05/2022]
Abstract
Younger children in particular are at risk of becoming victims of dog attacks due to their small size. Such a biting incident can fulfil various criminal offences. In order to be able to satisfy possible legal claims, the injuries should be documented by forensic medicine and thus be legally binding. Therefore, close cooperation between the treating surgeons and forensic experts is recommended. A retrospective analysis of the cases of dog bite injuries in children and adults treated by clinical forensic medicine at the University Medical Center Rostock was carried out under various aspects. Adult casualties were predominantly injured on the lower extremities. The children examined were predominantly bitten on the head, neck and face region as well as the upper extremities. Injury severity ranged from skin redness to severe substance defects with loss of body structures. The biting dog was known in about half of the cases. In order to avoid dog bites in children, parents as well as children should be trained in dealing with dogs.
Collapse
Affiliation(s)
- V. Kolbe
- grid.413108.f0000 0000 9737 0454Institut für Rechtsmedizin, Universitätsmedizin Rostock, St.-Georg-Str. 108, 18055 Rostock, Deutschland
| | - R. Bingert
- grid.413108.f0000 0000 9737 0454Institut für Rechtsmedizin, Universitätsmedizin Rostock, St.-Georg-Str. 108, 18055 Rostock, Deutschland
| | - S. Märzheuser
- grid.413108.f0000 0000 9737 0454Klinik für Kinderchirurgie der Chirurgischen Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - A. Büttner
- grid.413108.f0000 0000 9737 0454Institut für Rechtsmedizin, Universitätsmedizin Rostock, St.-Georg-Str. 108, 18055 Rostock, Deutschland
| |
Collapse
|
2
|
Melcher C, Renner C, Piepenbrink M, Fischer N, Büttner A, Wegener V, Birkenmaier C, Jansson V, Wegener B. Biomechanical comparisons of three minimally invasive Achilles tendon percutaneous repair suture techniques. Clin Biomech (Bristol, Avon) 2022; 92:105578. [PMID: 35093798 DOI: 10.1016/j.clinbiomech.2022.105578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 12/14/2021] [Accepted: 01/11/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND While no gold standard exists for the management of Achilles tendon ruptures, surgical repair is common in healthy and active patients. Minimally invasive repair methods have become increasingly popular, while biomechanical equivalency hasn't been proven yet. METHODS A mid-substance Achilles tendon rupture was created 6 cm proximal to the calcaneal insertion in 27 fresh-frozen cadaveric ankles. Specimens were randomly allocated to 1 of 3 repair techniques: Huttunen et al. (2014) (1) PARS Achilles Jig System, Nyyssönen et al. (2008) (2) Achilles Midsubstance SpeedBridge™, Schipper and Cohen (2017) (3) Dresdner Instrument and subsequently subjected to cyclic loading with 250 cycles each at 1 Hz with 4 different loading ranges (20-100 N, 20-200 N, 20-300 N, and 20-400 N). FINDINGS After 250 cycles no significant differences in elongation were observed between PARS and Dresdner Instrument(p = 1.0). Furthermore, SpeedBridge™ repairs elongated less than either Dresdner Instrument (p = 0.0006) or PARS (p = 0.102). Main elongation (85%) occurred within the first 10 cycles with a comparable elongation in between 10 and 100 and 100-250 cycles. While all repairs withstood the first 250 cycles of cyclic loading from 20 to 100 N, only the PARS (468 ± 175) and Midsubstance SpeedBridge™ (538 ± 208) survived more cycles. Within all 3 groups suture cut out was seen to be the most common failure mechanism. INTERPRETATION Within all groups early repair elongation was seen. While this was least obvious within the SpeedBridge™ technique, ultimate strengths of repairs (cycles to failure) were comparable across PARS and SpeedBridge™ with a decline in the Dresdner Instrument group.
Collapse
Affiliation(s)
- C Melcher
- University Hospital Ulm, Department of Orthopedic Surgery (RKU), Oberer Eseelsberg 45, 89081 Ulm, Germany; University Hospital LMU Munich, Department of Orthopaedics, Physical Medicine and Rehabilitation, Marchioninistr 15, 81377 Munich, Germany.
| | - C Renner
- Arthrex GmbH, Erwin-Hielscher-Straße 9, 81249 München, Germany.
| | - M Piepenbrink
- Arthrex GmbH, Erwin-Hielscher-Straße 9, 81249 München, Germany.
| | - N Fischer
- Arthrex GmbH, Erwin-Hielscher-Straße 9, 81249 München, Germany.
| | - A Büttner
- University Hospital Rostock, Department of Forensic Medicine, St. Georg-Str.108, 18055 Rostock, Germany.
| | - V Wegener
- University Hospital LMU Munich, Department of Orthopaedics, Physical Medicine and Rehabilitation, Marchioninistr 15, 81377 Munich, Germany.
| | - C Birkenmaier
- University Hospital LMU Munich, Department of Orthopaedics, Physical Medicine and Rehabilitation, Marchioninistr 15, 81377 Munich, Germany.
| | - V Jansson
- University Hospital LMU Munich, Department of Orthopaedics, Physical Medicine and Rehabilitation, Marchioninistr 15, 81377 Munich, Germany.
| | - B Wegener
- University Hospital LMU Munich, Department of Orthopaedics, Physical Medicine and Rehabilitation, Marchioninistr 15, 81377 Munich, Germany.
| |
Collapse
|
3
|
Hochheim S, Büttner A, Brockmüller E, Fittkau W, Wellmann F, Weßels P, Neumann J, Kracht D. High-power optical amplifier with enhanced wall-plug efficiency for 10-channel WDM satellite laser communication systems. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226702001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
4
|
von Stillfried S, Freeborn B, Windeck S, Boor P, Böcker J, Schmidt J, Tholen P, Röhrig R, Majeed R, Wienströer J, Bremer J, Weis J, Knüchel R, Breitbach A, Bülow RD, Cacchi C, Wucherpfennig S, Märkl B, Claus R, Dhillon C, Schaller T, Sipos E, Spring O, Braun G, Römmele C, Kling E, Kröncke T, Wittmann M, Hirschbühl K, Heppner FL, Meinhardt J, Radbruch H, Streit S, Horst D, Elezkurtaj S, Quaas A, Göbel H, Friemann J, Hansen T, Titze U, Lorenzen J, Reuter T, Woloszyn J, Baretton G, Hilsenbeck J, Meinhardt M, Pablik J, Sommer L, Holotiuk O, Meinel M, Esposito I, Crudele G, Seidl M, Mahlke N, Hartmann A, Haller F, Eichhorn P, Lange F, Amann KU, Coras R, Ingenwerth M, Rawitzer J, Schmid KW, Theegarten D, Gradhand E, Smith K, Wild P, Birngruber CG, Schilling O, Werner M, Acker T, Gattenlöhner S, Franz J, Metz I, Stadelmann C, Stork L, Thomas C, Zechel S, Ströbel P, Fathke C, Harder A, Wickenhauser C, Glatzel M, Matschke J, Krasemann S, Dietz E, Edler C, Fitzek A, Fröb D, Heinemann A, Heinrich F, Klein A, Kniep I, Lohner L, Möbius D, Ondruschka B, Püschel K, Schädler J, Schröder AS, Sperhake JP, Aepfelbacher M, Fischer N, Lütgehetmann M, Pfefferle S, Jonigk D, Werlein C, Domke LM, Hartmann L, Klein I, Schirmacher P, Schwab C, Röcken C, Langer D, Roth W, Strobl S, Rudelius M, Delbridge C, Kasajima A, Kuhn PH, Slotta-Huspenina J, Weichert W, Weirich G, Stock K, Barth P, Schnepper A, Wardelmann E, Evert K, Evert M, Büttner A, Manhart J, Nigbur S, Bösmüller H, Fend F, Granai M, Klingel K, Warm V, Steinestel K, Umathum VG, Rosenwald A, Vogt N, Kurz F. [Update on collaborative autopsy-based research in German pathology, neuropathology, and forensic medicine]. Pathologie (Heidelb) 2022; 43:101-105. [PMID: 36114379 PMCID: PMC9483541 DOI: 10.1007/s00292-022-01117-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Autopsies are a valuable tool for understanding disease, including COVID-19. MATERIALS AND METHODS The German Registry of COVID-19 Autopsies (DeRegCOVID), established in April 2020, serves as the electronic backbone of the National Autopsy Network (NATON), launched in early 2022 following DEFEAT PANDEMIcs. RESULTS The NATON consortium's interconnected, collaborative autopsy research is enabled by an unprecedented collaboration of 138 individuals at more than 35 German university and non-university autopsy centers through which pathology, neuropathology, and forensic medicine autopsy data including data on biomaterials are collected in DeRegCOVID and tissue-based research and methods development are conducted. More than 145 publications have now emerged from participating autopsy centers, highlighting various basic science and clinical aspects of COVID-19, such as thromboembolic events, organ tropism, SARS-CoV‑2 detection methods, and infectivity of SARS-CoV-2 at autopsy. CONCLUSIONS Participating centers have demonstrated the high value of autopsy and autopsy-derived data and biomaterials to modern medicine. The planned long-term continuation and further development of the registry and network, as well as the open and participatory design, will allow the involvement of all interested partners.
Collapse
Affiliation(s)
- Saskia von Stillfried
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Benita Freeborn
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Svenja Windeck
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Peter Boor
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Medizinische Klinik II (Nephrologie und Immunologie), Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Elektronenmikroskopische Einrichtung, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Zack F, Bernhardt S, Arnold C, Büttner A. Forensisch-medizinische Untersuchungen von Tatverdächtigen. Eine Analyse von 270 Gutachten aus den Jahren 2006 bis 2018. Rechtsmedizin (Berl) 2021. [DOI: 10.1007/s00194-021-00468-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Zusammenfassung
Hintergrund
Zu den Aufgaben in der rechtsmedizinischen Praxis gehören zunehmend forensisch-medizinische Untersuchungen von Lebenden. Im Gegensatz zu Studien über Gewaltopfer findet sich in der Fachliteratur allerdings ein erhebliches Defizit an Ergebnissen über systematische rechtsmedizinische Untersuchungen von Tatverdächtigen.
Fragestellung
Welche relevanten Daten können aus einer retrospektiven Analyse von forensisch-medizinischen Untersuchungen von Tatverdächtigen erhoben und welche Rückschlüsse für die rechtsmedizinische Praxis gezogen werden?
Material und Methode
Es wurden insgesamt 270 Gutachten nach forensisch-medizinischen Untersuchungen von Tatverdächtigen aus dem Einzugsgebiet des Instituts für Rechtsmedizin der Universitätsmedizin Rostock der Jahre 2006 bis 2018 nach vorab definierten Kriterien ausgewertet.
Ergebnisse
Die vorgeworfenen Straftaten waren am häufigsten Körperverletzungen (n = 88 = 30,7 %), gefolgt von vorsätzlichen Tötungen (n = 63 = 22,0 %) und Sexualdelikten (n = 49 = 17,1 %). Von den begutachteten Personen waren 236 (87,4 %) männlich und 34 (12,6 %) weiblich. Die Mehrzahl der Tatverdächtigen (n = 175 = 65,5 %) war in einem Lebensalter von 18 bis 40 Jahren.
Im Hinblick auf die Aussage der rechtsmedizinischen Ergebnisse in Bezug auf den vorgeworfenen Straftatbestand wurden 126 (46,7 %) Gutachten als für den Tatverdächtigen belastend, 13 (4,8 %) als entlastend und 131 (48,5 %) als frei von Be- oder Entlastungsaussagen eingestuft.
Zu den 270 Gutachten über Tatverdächtige gab es 209 (77,4 %) korrespondierende Opferuntersuchungen. Von diesem Teilkollektiv mit Täter-Opfer-Begutachtungen wurden in 193 Fällen (92,3 %) Tatverdächtige und Opfer von demselben Gutachter untersucht.
Schlussfolgerungen
Für die Rekonstruktion eines Tatgeschehens sind rechtsmedizinische Untersuchungen des Opfers und des Tatverdächtigen wertvoller als die nicht selten beobachtete Untersuchung der geschädigten Person allein. Befunde mit belastenden Tendenzen für den Tatverdächtigen werden häufiger festgestellt als solche, die zu einer Entlastung des Beschuldigten führen. Da es in der Fachliteratur im Vergleich zu den Opfern von Gewalttaten ein Defizit an Ergebnissen über systematische forensisch-medizinische Untersuchungen von Tatverdächtigen gibt, sollten weitere Studien folgen.
Collapse
|
6
|
Kolbe V, Boy D, Büttner A. Mongolian Spots - A challenging clinical sign. Forensic Sci Int 2021; 327:110964. [PMID: 34478897 DOI: 10.1016/j.forsciint.2021.110964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/19/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
Mongolian Spots (MS) are the most common birthmarks in newborn children. The condition presents as greenish-bluish to greyish macules, particularly in the lumbosacral area. The incidents of MS can vary in different ethnic groups and normally fade in early childhood. MS can be misinterpreted as hematomas because of the color and the predilection site. This paper discusses the case of a two-month old female admitted to hospital under suspicion of child abuse. The clinical forensic examination of the infant and her two older sisters found the children were in good health and did not show signs of abuse, despite the infant presenting with multiple and extensive greyish-blue macules. Thirteen months later, a welfare officer requested another forensic examination on the now 15-month-old child after noticing greyish-blue macules. Following a second examination, no evidence of abuse was found. This case illustrates the issue of MS as a differential diagnosis of hematomas.
Collapse
Affiliation(s)
- V Kolbe
- Institute of Forensic Medicine, University Medical Center Rostock, Germany.
| | - D Boy
- Institute of Forensic Medicine, University Medical Center Rostock, Germany
| | - A Büttner
- Institute of Forensic Medicine, University Medical Center Rostock, Germany
| |
Collapse
|
7
|
Büttner A, Galster M. [Female patient with dysphagia, Staphylococcus aureus sepsis and thrombophlebitis]. Z Gerontol Geriatr 2021; 54:434-435. [PMID: 34279692 DOI: 10.1007/s00391-021-01919-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/04/2021] [Indexed: 11/28/2022]
Affiliation(s)
- A Büttner
- Universitätsklinik für Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität Nürnberg, Prof.-Ernst-Nathan-Straße 1, 90419, Nürnberg, Deutschland.
| | - M Galster
- Universitätsklinik für Radiologie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität Nürnberg, Nürnberg, Deutschland
| |
Collapse
|
8
|
van Schaick G, Gstöttner C, Büttner A, Reusch D, Wuhrer M, Domínguez-Vega E. Anion exchange chromatography – Mass spectrometry for monitoring multiple quality attributes of erythropoietin biopharmaceuticals. Anal Chim Acta 2021; 1143:166-172. [DOI: 10.1016/j.aca.2020.11.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022]
|
9
|
Zack F, Warnke P, Manhart J, Angeli A, Nizze H, Rudnick JO, Steinhagen I, Kolbe V, Hammer M, Büttner A. Enterokolitis als Ursache eines akuten unerwarteten Todes eines Orang-Utans in Zoohaltung. Rechtsmedizin (Berl) 2020. [DOI: 10.1007/s00194-020-00448-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
ZusammenfassungEs wird von einem 13 Jahre alt gewordenen weiblichen Orang-Utan berichtet, der 4 Tage vor dem Tod an einer akuten Enterokolitis erkrankte. Die tierärztliche Ultraschalluntersuchung einen Tag vor dem Tod erbrachte den Nachweis von vermehrter Flüssigkeit im Zäkum und einer abschnittsweise verdickten Kolonwand. Nach dem für die Veterinärmediziner und die Zoomitarbeiter unerwarteten Todeseintritt erfolgte eine Obduktion durch Rechtsmediziner der Universitätsmedizin Rostock mit Unterstützung von Ärzten weiterer Fachrichtungen. Dabei wurde als Todesursache eine akute Escherichia-coli-Enterokolitis mit massiver Blutung in den Darm festgestellt. Begünstigend oder ursächlich für die letale Enterokolitis dürften wahrscheinlich zahlreiche rezidivierende Durchfallerkrankungen in der Anamnese des Orang-Utans als Folge eines Verweigerns des Stillens durch die Mutter nach der Geburt gewesen sein.
Collapse
|
10
|
Lippold S, Büttner A, Choo MSF, Hook M, de Jong CJ, Nguyen-Khuong T, Haberger M, Reusch D, Wuhrer M, de Haan N. Cysteine Aminoethylation Enables the Site-Specific Glycosylation Analysis of Recombinant Human Erythropoietin using Trypsin. Anal Chem 2020; 92:9476-9481. [PMID: 32578997 DOI: 10.1021/acs.analchem.0c01794] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Recombinant human erythropoietin (rhEPO) is an important biopharmaceutical for which glycosylation is a critical quality attribute. Therefore, robust analytical methods are needed for the in-depth characterization of rhEPO glycosylation. Currently, the protease GluC is widely established for the site-specific glycosylation analysis of rhEPO. However, this enzyme shows disadvantages, such as its specificity and the characteristics of the resulting (glyco)peptides. The use of trypsin, the gold standard protease in proteomics, as the sole protease for rhEPO is compromised, as no natural tryptic cleavage site is located between the glycosylation sites Asn24 and Asn38. Here, cysteine aminoethylation using 2-bromoethylamine was applied as an alternative alkylation strategy to introduce artificial tryptic cleavage sites at Cys29 and Cys33 in rhEPO. The (glyco)peptides resulting from a subsequent digestion using trypsin were analyzed by reverse-phase liquid chromatography-mass spectrometry. The new trypsin-based workflow was easily implemented by adapting the alkylation step in a conventional workflow and was directly compared to an established approach using GluC. The new method shows an improved specificity, a significantly reduced chromatogram complexity, allows for shorter analysis times, and simplifies data evaluation. Furthermore, the method allows for the monitoring of additional attributes, such as oxidation and deamidation at specific sites in parallel to the site-specific glycosylation analysis of rhEPO.
Collapse
Affiliation(s)
- Steffen Lippold
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Alexander Büttner
- Pharma Technical Development, Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | - Matthew S F Choo
- Bioprocessing Technology Institute, Agency for Science Technology and Research, 20 Biopolis Way No. 06-01, Singapore 138668
| | - Michaela Hook
- Pharma Technical Development, Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | - Coen J de Jong
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Terry Nguyen-Khuong
- Bioprocessing Technology Institute, Agency for Science Technology and Research, 20 Biopolis Way No. 06-01, Singapore 138668
| | - Markus Haberger
- Pharma Technical Development, Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | - Dietmar Reusch
- Pharma Technical Development, Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | - Manfred Wuhrer
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Noortje de Haan
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| |
Collapse
|
11
|
Kolbe V, Rentsch D, Boy D, Schmidt B, Kegler R, Büttner A. The adulterated XANAX pill: a fatal intoxication with etizolam and caffeine. Int J Legal Med 2020; 134:1727-1731. [PMID: 32607751 PMCID: PMC7417405 DOI: 10.1007/s00414-020-02352-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/18/2020] [Indexed: 12/29/2022]
Abstract
A 49-year old man was found dead at home next to a glass containing a dried, white, crystalline substance and near a bag containing pills with the imprint XANAX, the trade name of alprazolam. A comprehensive screening of material collected during the autopsy revealed the presence of etizolam and caffeine in lethal concentrations (0.77 μg/mL and 190 μg/mL) but no trace of alprazolam. Benzodiazepine analogue etizolam is rarely prescribed in Germany, and as a result there are not many reports about fatal cases. It has anxiolytic, hypnotic, sedative and muscle-relaxant properties and is used for the short-term treatment of anxiety and panic attacks. The purine alkaloid caffeine, conversely, is the most widely used central nervous system stimulant. The following report outlines potentially the first reported case of a lethal combination of the downer etizolam and the upper caffeine in medical literature.
Collapse
Affiliation(s)
- V Kolbe
- Institute of Legal Medicine, University Medical Center, St.-Georg-Strasse 108, 18055, Rostock, Germany.
| | - D Rentsch
- Institute of Legal Medicine, University Medical Center, St.-Georg-Strasse 108, 18055, Rostock, Germany
| | - D Boy
- Institute of Legal Medicine, University Medical Center, St.-Georg-Strasse 108, 18055, Rostock, Germany
| | - B Schmidt
- Institute of Legal Medicine, University Medical Center, St.-Georg-Strasse 108, 18055, Rostock, Germany
| | - R Kegler
- Institute of Legal Medicine, University Medical Center, St.-Georg-Strasse 108, 18055, Rostock, Germany
| | - A Büttner
- Institute of Legal Medicine, University Medical Center, St.-Georg-Strasse 108, 18055, Rostock, Germany
| |
Collapse
|
12
|
Albiol L, Büttner A, Pflanz D, Mikolajewicz N, Birkhold AI, Kramer I, Kneissel M, Duda GN, Checa S, Willie BM. Effects of Long-Term Sclerostin Deficiency on Trabecular Bone Mass and Adaption to Limb Loading Differ in Male and Female Mice. Calcif Tissue Int 2020; 106:415-430. [PMID: 31873756 DOI: 10.1007/s00223-019-00648-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 12/09/2019] [Indexed: 01/08/2023]
Abstract
A new therapeutic option to treat osteoporosis is focused on Wnt signaling and its inhibitor sclerostin, a product of the Sost gene. In this work, we study the effect of sclerostin deficiency on trabecular bone formation and resorption in male and female mice and whether it affects mechano-responsiveness. Male and female 10- and 26-week-old Sost knockout (KO) and littermate controls (LCs) were subjected to in vivo mechanical loading of the left tibia for 2 weeks. The right tibia served as internal control. The mice were imaged using in vivo micro-computed tomography at days 0, 5, 10, and 15 and tibiae were collected for histomorphometric analyses after euthanasia. Histomorphometry and micro-CT-based 3D time-lapse morphometry revealed an anabolic and anti-catabolic effect of Sost deficiency although increased trabecular bone resorption accompanied by diminished trabecular bone formation occurred with age. Loading led to diminished resorption in adult female but not in male mice. A net gain in bone volume could be achieved with mechanical loading in Sost KO adult female mice, which occurred through a further reduction in resorbed bone volume. Our data show that sclerostin deficiency has a particularly positive effect in adult female mice. Sclerostin antibodies are approved to treat postmenopausal women with high risk of osteoporotic fractures. Further studies are required to clarify whether both sexes benefit equally from sclerostin inhibition.
Collapse
Affiliation(s)
- Laia Albiol
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Berlin, Germany
| | - Alexander Büttner
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - David Pflanz
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nicholas Mikolajewicz
- Department of Dentistry, McGill University, Montreal, Canada
- Research Centre, Shriners Hospital for Children-Canada, 1003 Decarie Blvd, Montreal, QC, H4A 0A9, Canada
| | - Annette I Birkhold
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Continuum Biomechanics and Mechanobiology Research Group, Institute of Applied Mechanics, University of Stuttgart, Stuttgart, Germany
| | | | | | - Georg N Duda
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sara Checa
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Bettina M Willie
- Department of Pediatric Surgery, McGill University, Montreal, Canada.
- Research Centre, Shriners Hospital for Children-Canada, 1003 Decarie Blvd, Montreal, QC, H4A 0A9, Canada.
| |
Collapse
|
13
|
Tischer T, Bebersdorf A, Albrecht C, Manhart J, Büttner A, Öner A, Safak E, Ince H, Ortak J, Caglayan E. Deactivation of cardiovascular implantable electronic devices in patients nearing end of life : Reality or only recommendation? Herz 2019; 45:123-129. [PMID: 31312871 DOI: 10.1007/s00059-019-4836-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/23/2019] [Accepted: 06/21/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Current guidelines recommend considering deactivation of cardiac implantable electronic devices (CIEDs) in patients nearing death. We evaluated the implementation of this recommendation in unselected deceased individuals with CIEDs. METHODS Over a 7-month period in 2016, all deceased persons taken to the Rostock crematorium were prospectively screened for CIEDs and these were interrogated in situ. Pacing rate, pacing mode, and lead output were documented as well as patient data including location and time of death. In implantable cardioverter-defibrillators (ICDs), tachycardia therapy adjustment and occurrence of shocks 24 h prior to death were also recorded. RESULTS We examined 2297 subjects, of whom 154 (6.7%) had CIEDs. Of these subjects, 125 (100%) pacemakers (PMs) and 27 (96.4%) ICDs were eligible for analysis. Death in persons with ICDs occurred most frequently in hospital (55.6%), while this was less frequently the case for individuals with PMs (43.2%). Furthermore, 33.3% of subjects with ICDs and 18.5% with PMs died in palliative care units (PCU). Shock therapies were switched off in three (60%) individuals with ICDs who died in the PCU, whereas antibradycardia therapy was not withdrawn in any PM patient in the PCU. Therapy withdrawal occurred in two patients with PMs (1.3%) who died in hospital. Patients with PMs had high ventricular pacing rates at the last interrogation (69 ± 36.0%) and often suffered atrioventricular block (39.2%). Six (25%) of the 24 active ICDs presented shocks near the time of death. CONCLUSION Many CIED patients died in hospital; nonetheless, in practice, CIED deactivation near death is rarely performed and might be less feasible in subjects with PMs. However, there is still a need to consider deactivation, especially in individuals with ICDs, as one fourth of them received at least one shock within 24 h prior to death.
Collapse
Affiliation(s)
- T Tischer
- Department of Cardiology, University Hospital, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany.
| | - A Bebersdorf
- Department of Cardiology, University Hospital, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - C Albrecht
- Department of Cardiology, University Hospital, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - J Manhart
- Institute of Legal Medicine, Rostock University Medical Center, Rostock, Germany
| | - A Büttner
- Institute of Legal Medicine, Rostock University Medical Center, Rostock, Germany
| | - A Öner
- Department of Cardiology, University Hospital, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - E Safak
- Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany
| | - H Ince
- Department of Cardiology, University Hospital, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - J Ortak
- Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany
| | - E Caglayan
- Department of Cardiology, University Hospital, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| |
Collapse
|
14
|
Büttner A. Hepatopathien und Drogenkonsum. Rechtsmedizin (Berl) 2019. [DOI: 10.1007/s00194-019-0310-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
15
|
Büttner A, Dettmeyer R. Histopathologie des Drogentodes. Rechtsmedizin (Berl) 2019. [DOI: 10.1007/s00194-019-0307-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
16
|
|
17
|
Tischer T, Bebersdorf A, Albrecht C, Manhart J, Caglayan E, Öner A, Ince H, Ortak J, Büttner A, Safak E. Individual programming of current multiprogrammable pacemakers : Still unsatisfactory? Herz 2018; 45:572-579. [PMID: 30255303 DOI: 10.1007/s00059-018-4753-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pacemaker (PM) technology has developed tremendously in recent decades. We evaluated the extent of individual programming in current PMs. METHODS Over a 7-month period in 2016, all deceased persons taken to the Rostock crematorium were prospectively screened for cardiac implantable electronic devices (CIEDs) and these were interrogated in situ. Programming of patient data, leads, and study parameters including mode, lower rate, upper tracking or sensor rate (UTSR), ventricular refractory time, sleeping function, hysteresis, and PM-mediated tachycardia intervention were analyzed and compared with delivery settings. Alterations in atrial/ventricular capture management and atrial/ventricular sensing assurance as well as changes in sensitivity and lead output were evaluated. RESULTS We examined 2297 subjects, of whom 154 (6.7%) had CIEDs, with 125 (81.2%) being PMs. Finally, 72 (57.6%) PMs were eligible for analysis with an operation time of 31.0 ± 27.0 months. We excluded 28 (18.2%) implantable cardioverter defibrillators (ICDs), 51 (41%) PMs presenting elective replacement indicator (ERI), two (1.6%) PMs with programming to insufficient function prior to death, and the left ventricle parameter of one (1.4%) cardiac resynchronization therapy pacemaker (CRT-P); further one CIED (0.6%) was not contactable. PMs offered in mean 75.2% of study parameters thereof 88.0% were to adjust manually, whereof 49.3% stayed unchanged to delivery mode. Lead output, UTSR, lower rate, and mode were the most frequently changed parameters (>85.7%, 65.3%, 54.2%, and 52.8%, respectively) compared with unmodified ventricular refractory time and hysteresis (91.7% and. 85.4%, respectively); 2.8% of PMs had out-of-the-box settings. The most frequent personalized data were last (88.9%) and first name (73.6%), while atrial and ventricular serial lead numbers were rarely entered (18.2% and 23.4%, respectively). CONCLUSION The programming possibilities of PMs have advanced greatly. Nonetheless, improvements in individual PM programming are still needed as demonstrated by the findings in this study, e.g., PMs with manufacturer settings and lack of individual data.
Collapse
Affiliation(s)
- T Tischer
- Department of Cardiology, University Hospital Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany.
| | - A Bebersdorf
- Department of Cardiology, University Hospital Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - C Albrecht
- Department of Cardiology, University Hospital Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - J Manhart
- Institute of Legal Medicine, Rostock University Medical Center, Rostock, Germany
| | - E Caglayan
- Department of Cardiology, University Hospital Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - A Öner
- Department of Cardiology, University Hospital Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - H Ince
- Department of Cardiology, University Hospital Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - J Ortak
- Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany
| | - A Büttner
- Institute of Legal Medicine, Rostock University Medical Center, Rostock, Germany
| | - E Safak
- Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany
| |
Collapse
|
18
|
Zack F, Blaas V, Büttner A. Unusual head injury by a forklift vehicle. J Forensic Leg Med 2018. [PMID: 29525584 DOI: 10.1016/j.jflm.2018.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A case of an unusual head injury by a forklift vehicle is presented.
Collapse
Affiliation(s)
- F Zack
- Institute of Forensic Medicine, Rostock University Medical Center, St.-Georg-Str. 108, 18055 Rostock, Germany
| | - V Blaas
- Institute of Forensic Medicine, Rostock University Medical Center, St.-Georg-Str. 108, 18055 Rostock, Germany
| | - A Büttner
- Institute of Forensic Medicine, Rostock University Medical Center, St.-Georg-Str. 108, 18055 Rostock, Germany.
| |
Collapse
|
19
|
Abstract
ZusammenfassungBekannterweise existiert bei Patienten mit dokumentiertem obstruktiven Schlafapnoe-Syndrom (OSAS) eine Nacht-zu- Nacht-Variabilität der Apnoen/Hypopnoen während der nächtlichen Polysomnografie (PSG). Diese könnte dazu führen, erkrankte Patienten nicht oder nicht rechtzeitig zu erkennen und angemessen zu behandeln und somit ein erhöhtes Risiko für eine massive Verschlechterung des OSAS und/oder Folgeerkrankungen kardiologischer und/oder neurologischer Art zu provozieren. In dieser Studie untersuchten wir, ob bzw. inwieweit die Möglichkeit besteht, dass diese Variabilität aufgrund der fortschreitenden Mittelkürzungen im Gesundheitswesen dazu führen kann, OSAS-Patienten nicht diagnostizieren zu können, zu spät zu behandeln oder unbehandelt zu lassen. Die Untersuchung erfolgte intraindividuell an einer Gruppe von 100 OSAS-Patienten (17 weiblich). Alle Studienteilnehmer wurden polysomnografisch sowohl in der ersten als auch in der zweiten Nacht untersucht und mussten alle zur OSASDiagnose notwendigen Kriterien aufweisen. Das Untersuchungsdesign sah den Vergleich der beiden Diagnosenächte vor. Die Überprüfung ergab einen signifikanten Unterschied (p < 0,001). Bei 72% kam es in der zweiten PSG-Nacht zu einer Erhöhung des AHI. In unserer Untersuchung zeigte sich, dass die nächtlichen Apnoen/Hypopnoen beim OSAS zwischen erster und zweiter PSG-Nacht so stark variieren, dass die Erkrankung bei 40% aller Fälle nach nur einer PSG-Nacht zu einer Fehldiagnostik führen würde.
Collapse
|
20
|
Weber A, Cardone L, Liu S, Büttner A, Rellecke P, Sixt S, Lichtenberg A, Akhyari P. Evaluation of Circulating Exosomes to Predict Emerging Valve Prosthesis-patient Mismatches after Surgical Aortic Valve Replacement. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Weber
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - L. Cardone
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - S. Liu
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - A. Büttner
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - P. Rellecke
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - S. Sixt
- Clinic for Anesthesiology, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - A. Lichtenberg
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - P. Akhyari
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| |
Collapse
|
21
|
Weber A, Büttner A, Cardone L, Schmidt V, Rellecke P, Sixt S, Lichtenberg A, Akhyari P. Evaluation of OPN as a Marker to Predict Adverse Outcomes after Aortic Valve Replacement. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Weber
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - A. Büttner
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - L. Cardone
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - V. Schmidt
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - P. Rellecke
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - S. Sixt
- Clinic for Anesthesiology, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - A. Lichtenberg
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | - P. Akhyari
- Department of Cardiovascular Surgery, Experimental Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| |
Collapse
|
22
|
|
23
|
Bernius A, Blaas V, Rentsch D, Büttner A, Thome J. [Unexpected Complications in the Withdrawal Treatment of the Research Chemical AH-7921]. Fortschr Neurol Psychiatr 2016; 84:S80-S83. [PMID: 27806420 DOI: 10.1055/s-0042-113960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We describe the case of a young male patient who had consumed the morphine-like substance AH-7921 which is available via the internet. He was initially admitted to hospital because of obstipation and presented within a day of inpatient treatment for the first time with a generalized tonic-clonic epileptic seizure with subsequent urinary retention. Within a few hours, the patient then also developed bradycardia, while at the same time describing symptoms of physical opioid withdrawal which gradually deteriorated within the following hours. We initiated a treatment with buprenorphine which resulted in a considerable reduction of withdrawal symptoms, so the patient could be discharged from hospital.
Collapse
Affiliation(s)
- A Bernius
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Rostock
| | - V Blaas
- Institut für Rechtsmedizin, Universitätsmedizin Rostock
| | - D Rentsch
- Institut für Rechtsmedizin, Universitätsmedizin Rostock
| | - A Büttner
- Institut für Rechtsmedizin, Universitätsmedizin Rostock
| | - J Thome
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Rostock
| |
Collapse
|
24
|
Abstract
BACKGROUND Clinical forensic medicine does not only entail examination of patients after physical violence but also the option of clinical autopsies, e.g. after non-notifiable complications of medical interventions, after fatalities closely following medical interventions or fatalities as a result of injuries when the public prosecutor decides not to order a medicolegal autopsy. Based on this routine the Institute of Forensic Medicine at the University of Rostock offers a training course in topographical anatomy to physicians for further training in interventional and surgical disciplines. METHODS At the beginning of autopsies the participants can explore the approaches of interventional puncture techniques as well as surgical techniques and the basic topographical anatomy in small groups of 2-4 persons under the supervision of forensic examiners. The format is essentially oriented to the early further training period but fulfils the requirements for the exploration of complex operative techniques. The course was adapted for physicians and offered separately to students. The explorations are performed manually or by support with autopsy instruments. RESULTS The courses offer an ideal room for individual, discipline-specific topics and result in a great benefit for all participants. A statistical assessment can only be achieved with a larger number of participants. CONCLUSION Making autopsy rooms available for teaching and further training represents an additional feature to the profile of clinical forensic medicine. Lessons in topographical anatomy provide a great benefit for patient safety. It seems to be important to offer the opportunity to address individual interests in a closed meeting to consolidate skills and abilities in a non-judgemental environment. The post-mortem examiners have to ensure that the autopsy is carried out lege artis. Basic ethical principles and all regulations from an accredited scope have to be adhered to.
Collapse
Affiliation(s)
- U Hammer
- Institut für Rechtsmedizin, Universitätsmedizin, St.-Georg-Str. 108, 18055, Rostock, Deutschland.
| | - V Blaas
- Institut für Rechtsmedizin, Universitätsmedizin, St.-Georg-Str. 108, 18055, Rostock, Deutschland
| | - A Büttner
- Institut für Rechtsmedizin, Universitätsmedizin, St.-Georg-Str. 108, 18055, Rostock, Deutschland
| | - M Philipp
- Abteilung für Allgemeine, Thorax-, Gefäß- und Transplantationschirurgie, Chirurgische Klinik und Poliklinik, Universitätsmedizin, Rostock, Deutschland
| |
Collapse
|
25
|
|
26
|
|
27
|
|
28
|
|
29
|
|
30
|
Hammer U, Boy D, Rothaupt D, Büttner A. Distinction between forensic evidence and dermatological findings. J Forensic Leg Med 2015; 33:1-4. [PMID: 26048487 DOI: 10.1016/j.jflm.2015.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 01/05/2015] [Accepted: 02/25/2015] [Indexed: 11/17/2022]
Abstract
The external examination after death requires knowledge in forensics/pathology, dermatology, as well as associated diseases and age-related alterations of the skin. This article highlights some findings with forensic evidence versus dermatological findings. The lectures in forensic medicine should be structured interdisciplinarily, especially to dermatology, internal medicine, surgery, pathology, and toxicology in order to train the overlapping skills required for external and internal postmortem examinations.
Collapse
Affiliation(s)
- U Hammer
- Institute of Legal Medicine, Rostock University Medical Center, St.-Georg-Str. 108, 18055 Rostock, Germany.
| | - D Boy
- Institute of Legal Medicine, Rostock University Medical Center, St.-Georg-Str. 108, 18055 Rostock, Germany
| | - D Rothaupt
- Clinic of Dermatology and Venerology, Rostock University Medical Center, Strempelstr. 13, 18057 Rostock, Germany
| | - A Büttner
- Institute of Legal Medicine, Rostock University Medical Center, St.-Georg-Str. 108, 18055 Rostock, Germany
| |
Collapse
|
31
|
|
32
|
Port A, Olszewski H, Walther U, Büttner A, Rentsch D. Nachweis von γ-Hydroxybuttersäure bei γ-Butyrolacton-Abhängigkeit. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/s00194-014-0966-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
33
|
Büttner A, Stammen S, Dürkop M, Schuller A, Heistinger L. Generation and application of tools for increasing periplasmic soluble product yields of recombinant therapeutic proteins in Escherichia coli. N Biotechnol 2014. [DOI: 10.1016/j.nbt.2014.05.949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
34
|
|
35
|
|
36
|
Abstract
Cocaine abuse represents a significant health issue worldwide. Besides cardiovascular complications, psychiatric and neurologic symptoms are the most common manifestations of cocaine toxicity. In cocaine abusers brain abnormalities have been shown with computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or single photon emission computed tomography (SPECT). The spectrum of neuropathologic alterations seen in cocaine abusers is broad. The major findings consist of vascular complications such as stroke, subarachnoid and intracerebral hemorrhages and cerebral ischemia. Persons with underlying arteriovenous malformation or aneurysm are especially prone for such events. Except for a few incidents of vasculitis, the etiology of cocaine- related cerebrovascular events is still unclear. Cocaine-induced vasospasm, impaired hemostasis and platelet function, as well as decreased cerebral blood flow, have been proposed as possible mechanisms. On the molecular level, alterations in the expression of transcription factors and changes of brain neurotransmitter systems have been reported.
Collapse
Affiliation(s)
- A Büttner
- Institute of Forensic Medicine, University of Rostock, St.-Georg-Strasse 108, 18055 Rostock, Germany.
| |
Collapse
|
37
|
|
38
|
Hammer U, Büttner A. Distinction between forensic evidence and post-mortem changes of the skin. Forensic Sci Med Pathol 2011; 8:330-3. [DOI: 10.1007/s12024-011-9289-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2011] [Indexed: 10/16/2022]
|
39
|
|
40
|
|
41
|
Zill P, Vielsmeier V, Büttner A, Eisenmenger W, Siedler F, Scheffer B, Möller HJ, Bondy B. Postmortem proteomic analysis in human amygdala of drug addicts: possible impact of tubulin on drug-abusing behavior. Eur Arch Psychiatry Clin Neurosci 2011; 261:121-31. [PMID: 20686780 DOI: 10.1007/s00406-010-0129-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 07/23/2010] [Indexed: 10/19/2022]
Abstract
Besides the ventral tegmental area and the nucleus accumbens as the most investigated brain reward structures, several reports about the relation between volume and activity of the amygdala and drug-seeking behavior have emphasized the central role of the amygdala in the etiology of addiction. Considering its proposed important role and the limited number of human protein expression studies with amygdala in drug addiction, we performed a human postmortem proteomic analysis of amygdala tissue obtained from 8 opiate addicts and 7 control individuals. Results were validated by Western blot in an independent postmortem replication sample from 12 opiate addicts compared to 12 controls and 12 suicide victims, as a second "control sample". Applying 2D-electrophoresis and MALDI-TOF-MS analysis, we detected alterations of beta-tubulin expression and decreased levels of the heat-shock protein HSP60 in drug addicts. Western blot analysis in the additional sample demonstrated significantly increased alpha- and beta-tubulin concentrations in the amygdala of drug abusers versus controls (P = 0.021, 0.029) and to suicide victims (P = 0.006, 0.002). Our results suggest that cytoskeletal alterations in the amygdala determined by tubulin seem to be involved in the pathophysiology of drug addiction, probably via a relation to neurotransmission and cellular signaling. Moreover, the loss of neuroprotection against stressors by chaperons as HSP60 might also contribute to structural alteration in the brain of drug addicts. Although further studies have to confirm our results, this might be a possible pathway that may increase our understanding of drug addiction.
Collapse
Affiliation(s)
- P Zill
- Department of Psychiatry, Division of Psychiatric Genetics and Neurochemistry, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336 Munich, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
|
43
|
Büttner A. Neuropsychiatrische Konsequenzen bei OSAS. Pneumologie 2010. [DOI: 10.1055/s-0030-1267747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
44
|
Zill P, Vielsmeier V, Büttner A, Eisenmenger W, Bondy B, Möller HJ. Comparative proteomic analysis with human post mortem brain tissues of drug addicts versus controls: possible impact of beta-tubulin on drug abusing behaviour. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
45
|
Kowalzick L, Eickenscheidt L, Büttner A, Schell B. Photosensitivität bei Pellagroid unter tuberkolostatischer Therapie mit Pyrazinamid. Akt Dermatol 2009. [DOI: 10.1055/s-0028-1103431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
46
|
Zill P, Büttner A, Eisenmenger W, Müller J, Möller HJ, Bondy B. Predominant expression of tryptophan hydroxylase 1 mRNA in the pituitary: a postmortem study in human brain. Neuroscience 2009; 159:1274-82. [PMID: 19233335 DOI: 10.1016/j.neuroscience.2009.01.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Revised: 12/18/2008] [Accepted: 01/04/2009] [Indexed: 10/21/2022]
Abstract
Although the predominant role of tryptophan hydroxylase 2 (TPH2) in the CNS and its influence on the vulnerability to psychiatric disorders have clearly been demonstrated in several studies, the role of TPH1 on neuronal mechanisms, respectively on behavioral traits is still poorly understood. In a previous study of tryptophan hydroxylase 1 (TPH1) and TPH2 mRNA expression in different human brain regions we observed significantly higher TPH1 than TPH2 mRNA concentrations in the pituitary (unpublished observations). Considering the importance of the pituitary in the functional circuits between brain and body, we investigated the TPH1 and TPH2 mRNA expression in more detail, using human postmortem samples of the posterior and anterior pituitary compared to cortex, hippocampus and raphe nuclei. Specimens were available from different psychiatric patients (drug abusers, n=12; suicide victims, n=11; schizophrenics, n=9) and controls (n=15). Additionally we performed immunohistochemical analysis applying monospecific antibodies for both TPH isoforms to verify that the mRNA is of cellular and not just vascular or other origin. Highest TPH2 mRNA levels were observed in the raphe nuclei in patients and controls. By contrast, in the anterior and posterior pituitary TPH1 was found to be the predominantly expressed isoform in all subgroups. TPH1 and TPH2 mRNA expression in the further brain regions was only marginal and nearly identical except in the hypothalamus where higher TPH1 than TPH2 mRNA levels could be measured. Interindividual differences between the subgroups were not detectable. The results of the present study extended our previous findings by the additional immunohistochemical determination of the neuronal TPH1 and TPH2 protein expression in the anterior pituitary and provide evidence against a strictly separated duality of the serotonergic system. It seems that TPH1 might also have an impact on neuronal mechanisms via hypothalamic-pituitary-adrenal axis regulation by its predominant localization in the pituitary. These observations may open up new research strategies not only for several psychiatric disorders, but also for the relationship between psychiatric and somatic diseases.
Collapse
Affiliation(s)
- P Zill
- Department of Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany.
| | | | | | | | | | | |
Collapse
|
47
|
Büttner A. Borreliose & obstruktives Schlafapnoe-Syndorm. Pneumologie 2008. [DOI: 10.1055/s-0028-1083117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
48
|
Büttner A, Schittkowski M. Einseitiger Exophthalmus? Ophthalmologe 2008; 105:676-9. [DOI: 10.1007/s00347-007-1641-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
49
|
Büttner A, Feier C, Galetke W, Rühle K. Ein Fragebogen zur Erfassung der funktionellen Auswirkungen der Tagesschläfrigkeit auf die Lebensqualität beim obstruktiven Schlafapnoe-Syndrom. Functional Outcomes of Sleep Questionnaire (FOSQ). Pneumologie 2008; 62:548-52. [DOI: 10.1055/s-2008-1038172] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
50
|
Zill P, Büttner A, Eisenmenger W, Möller HJ, Bondy B. Differential mRNA expression of the tryptophan hydroxylases 1 and 2 in the human brain: A post mortem study. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|