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Subramaniam JS, Hubig M, Muggenthaler H, Schenkl S, Ullrich J, Pourtier G, Weiser M, Mall G. Sensitivity of temperature-based time since death estimation on measurement location. Int J Legal Med 2023; 137:1815-1837. [PMID: 37336822 PMCID: PMC10567880 DOI: 10.1007/s00414-023-03040-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
Rectal temperature measurement (RTM) from crime scenes is an important parameter for temperature-based time of death estimation (TDE). Various influential variables exist in TDE methods like the uncertainty in thermal and environmental parameters. Although RTM depends in particular on the location of measurement position, this relationship has never been investigated separately. The presented study fills this gap using Finite Element (FE) simulations of body cooling. A manually meshed coarse human FE model and an FE geometry model developed from the CT scan of a male corpse are used for TDE sensitivity analysis. The coarse model is considered with and without a support structure of moist soil. As there is no clear definition of ideal rectal temperature measurement location for TDE, possible variations in RTM location (RTML) are considered based on anatomy and forensic practice. The maximum variation of TDE caused by RTML changes is investigated via FE simulation. Moreover, the influence of ambient temperature, of FE model change and of the models positioning on a wet soil underground are also discussed. As a general outcome, we notice that maximum TDE deviations of up to ca. 2-3 h due to RTML deviations have to be expected. The direction of maximum influence of RTML change on TDE generally was on the line caudal to cranial.
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Affiliation(s)
- J Shanmugam Subramaniam
- Jena University Hospital - Friedrich Schiller University Jena, Institute of Forensic Medicine, Am Klinikum 1, 07747, Jena, Germany
| | - M Hubig
- Jena University Hospital - Friedrich Schiller University Jena, Institute of Forensic Medicine, Am Klinikum 1, 07747, Jena, Germany.
| | - H Muggenthaler
- Jena University Hospital - Friedrich Schiller University Jena, Institute of Forensic Medicine, Am Klinikum 1, 07747, Jena, Germany
| | - S Schenkl
- Jena University Hospital - Friedrich Schiller University Jena, Institute of Forensic Medicine, Am Klinikum 1, 07747, Jena, Germany
| | - J Ullrich
- Zuse Institute Berlin, Takustraße 7, 14195, Berlin, Germany
| | - G Pourtier
- Zuse Institute Berlin, Takustraße 7, 14195, Berlin, Germany
| | - M Weiser
- Zuse Institute Berlin, Takustraße 7, 14195, Berlin, Germany
| | - G Mall
- Jena University Hospital - Friedrich Schiller University Jena, Institute of Forensic Medicine, Am Klinikum 1, 07747, Jena, Germany
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Muggenthaler H, Bismann D, Eckardt N, Gassler N, Hubig M, Subramaniam JS, Mall G. Delayed occurrence of traumatic aortic dissection? Biomechanical considerations and literature. Int J Legal Med 2023; 137:353-357. [PMID: 36527463 PMCID: PMC9902402 DOI: 10.1007/s00414-022-02935-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
Chronic aortic dissections and pseudoaneurysms caused by chest trauma are rare and generally have to be critically distinguished from non-traumatic dissections and aneurysms. We present a well-documented case of a post-traumatic aortic dissection that ruptured about 9 months after chest trauma. A motorcyclist sustained fractures of the forearm and chest trauma with paravertebral rib serial fractures and hemopneumothorax. Nine months after the accident, echocardiography revealed a pseudoaneurysm that ruptured 3 months later and 1 month prior to the planned surgery. An autopsy showed pericardial tamponade following a rupture of the dissected aorta. Accident scene documentation was consistent with a head-on collision of the motorcycle against the left front side of the car. The relative speed was about 55 km/h. Aggravation of unspecific symptoms after discharge, initial CT imaging, and the absence of atherosclerosis or medial necrosis hold for a post-traumatic genesis of the dissection in our case. Initially, the accident insurance company rejected the regulation. In the second instance, they revised rejection based on our interdisciplinary expert opinion.
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Affiliation(s)
- H. Muggenthaler
- Institute of Legal Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - D. Bismann
- DEKRA Automobil GmbH, Auf dem Mittelfeld 3, 98693 Ilmenau Ilmenau, Germany
| | - N. Eckardt
- Department of Radiology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - N. Gassler
- Section Pathology, Institute of Legal Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - M. Hubig
- Institute of Legal Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | | | - G. Mall
- Institute of Legal Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
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Leyendecker G, Wildt L, Laschke MW, Mall G. Archimetrosis: the evolution of a disease and its extant presentation : Pathogenesis and pathophysiology of archimetrosis (uterine adenomyosis and endometriosis). Arch Gynecol Obstet 2023; 307:93-112. [PMID: 35596746 PMCID: PMC9836992 DOI: 10.1007/s00404-022-06597-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE This article presents a novel concept of the evolution and, thus, the pathogenesis of uterine adenomyosis as well as peritoneal and peripheral endometriosis. Presently, no unifying denomination of this nosological entity exists. METHODS An extensive search of the literature on primate evolution was performed. This included comparative functional morphology with special focus on the evolution of the birthing process that fundamentally differs between the haplorrhine primates and most of the other eutherian mammals. The data were correlated with the results of own research on the pathophysiology of human archimetrosis and with the extant presentation of the disease. RESULTS The term Archimetrosis is suggested as a denomination of the nosological entity. Archimetrosis occurs in human females and also in subhuman primates. There are common features in the reproductive process of haplorrhine primates such as spontaneous ovulation and corpus luteum formation, spontaneous decidualization and menstruation. These have fused Müllerian ducts resulting in a uterus simplex. Following a usually singleton pregnancy, the fetus is delivered in the skull position. Some of these features are shared by other mammals, but not in that simultaneous fashion. In haplorrhine primates, with the stratum vasculare, a new myometrial layer has evolved during the time of the Cretaceous-Terrestrial Revolution (KTR) that subserves expulsion of the conceptus and externalization of menstrual debris in non-conceptive cycles. Hypercontractility of this layer has evolved as an advantage with respect to the survival of the mother and the birth of a living child during delivery and may be experienced as primary dysmenorrhea during menstruation. It may result in tissue injury by the sheer power of the contractions and possibly by the associated uterine ischemia. Moreover, the lesions at extra-uterine sites appear to be maintained by biomechanical stress. CONCLUSIONS Since the pathogenesis of archimetrosis is connected with the evolution of the stratum vasculare, tissue injury and repair (TIAR) turns out to be the most parsimonious explanation for the development of the disease based on clinical, experimental and evolutionary evidence. Furthermore, a careful analysis of the published clinical data suggests that, in the risk population with uterine hypercontractility, the disease develops with a yet to be defined latency phase after the onset of the biomechanical injury. This opens a new avenue of prevention of the disease in potentially affected women that we consider to be primarily highly fertile.
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Affiliation(s)
| | | | - Matthias W. Laschke
- Institut für Klinisch-Experimentelle Chirurgie, Universität des Saarlandes, 66421 Homburg, Germany
| | - Gerhard Mall
- Wiesenbacher Str. 10, 69151 Neckargemünd, Germany
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Federspiel JM, Ramsthaler F, Kettner M, Mall G. Diagnostics of messenger ribonucleic acid (mRNA) severe acute respiratory syndrome-corona virus‑2 (SARS-CoV‑2) vaccination-associated myocarditis—A systematic review. Rechtsmedizin (Berl) 2022; 33:125-131. [PMID: 35873498 PMCID: PMC9297279 DOI: 10.1007/s00194-022-00587-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
Background Objective Methods Results Conclusion Supplementary Information
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Affiliation(s)
- Jan M. Federspiel
- Institute of Legal Medicine, Saarland University, Campus Homburg, Kirrbergerstraße, Geb. 49.1, 66421 Homburg Saar, Germany
| | - Frank Ramsthaler
- Institute of Legal Medicine, Saarland University, Campus Homburg, Kirrbergerstraße, Geb. 49.1, 66421 Homburg Saar, Germany
| | - Mattias Kettner
- Institute of Legal Medicine, Goethe University Frankfurt Main, Kennedyallee 104, 60596 Frankfurt Main, Germany
| | - Gerhard Mall
- Medical Care Center for Clinical Pathology, Grafenstraße 9, 64283 Darmstadt, Germany
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Nguyen TD, Mall G, Westphal JG, Weingärtner O, Möbius-Winkler S, Schulze PC. Acute myocarditis after COVID-19 vaccination with mRNA-1273 in a patient with former SARS-CoV-2 infection. ESC Heart Fail 2021; 8:4710-4714. [PMID: 34536056 PMCID: PMC8652969 DOI: 10.1002/ehf2.13613] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 07/17/2021] [Revised: 08/23/2021] [Accepted: 09/01/2021] [Indexed: 12/20/2022] Open
Abstract
We describe a case of a 20-year-old healthy man developing chest pain and classical symptoms of vaccine reactogenicity 12 h after receiving the first dose of mRNA-1273 (Moderna). Cardiac troponin T was increased, and subepicardial inflammation and focal contractile dysfunction were detected by cardiac magnetic resonance imaging and echocardiography. We confirmed the diagnosis of acute myocarditis by endomyocardial biopsy demonstrating significant infiltration of monocytes and T lymphocytes. Although we detected IgG against nucleocapsid protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) indicating prior infection, the patient repeatedly tested negative for SARS-CoV-2 and had been asymptomatic for several months. Furthermore, viral genome analysis of endomyocardial biopsy samples was negative for SARS-CoV-2 and other potential cardiotropic viruses. These findings and the strong temporal relation between the vaccination and the symptom onset imply a potential side effect of mRNA-1273.
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Affiliation(s)
- Tien Dung Nguyen
- Department of Medicine I, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, Jena, 07747, Germany
| | - Gerhard Mall
- MVZ für Klinische Pathologie, Klinikum Darmstadt GmbH, Darmstadt, Germany
| | - Julian Georg Westphal
- Department of Medicine I, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, Jena, 07747, Germany
| | - Oliver Weingärtner
- Department of Medicine I, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, Jena, 07747, Germany
| | - Sven Möbius-Winkler
- Department of Medicine I, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, Jena, 07747, Germany
| | - Paul Christian Schulze
- Department of Medicine I, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, Jena, 07747, Germany
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Wittschieber D, Muggenthaler H, Mall G, Mentzel HJ. [Bridging vein injuries in shaken baby syndrome : Forensic-radiological meta-analysis with special focus on the tadpole sign]. Radiologe 2021; 61:71-79. [PMID: 33289862 PMCID: PMC7810648 DOI: 10.1007/s00117-020-00780-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Shaken baby syndrome is a common variant of the abusive head trauma in infants and toddlers and is still subject of intensive research. In recent years, a number of radiological studies on the diagnostic and forensic relevance of injured bridging veins were conducted using different imaging modalities. The present article will give an overview on the current state of research in this field and will discuss the forensic implications. The meta-analysis of the seven currently existing studies revealed that injuries of the bridging veins and bridging vein thromboses, respectively, frequently appear as rounded, enlarged, and/or tubular structures. The "tadpole sign" may serve as a valuable tool for the identification of these formations. Especially, T2*/SWI (susceptibility-weighted imaging) sequences allow for good detectability of these lesions and should always be generated when abusive head trauma is suspected. In conclusion, it can be recommended that the presence of radiologically detectable bridging vein injuries should give reason to search for other manifestations of physical child abuse.
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Affiliation(s)
- D Wittschieber
- Institut für Rechtsmedizin, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Am Klinikum 1, 07747, Jena, Deutschland.
| | - H Muggenthaler
- Institut für Rechtsmedizin, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - G Mall
- Institut für Rechtsmedizin, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - H-J Mentzel
- Institut für Diagnostische und Interventionelle Radiologie, Sektion Kinderradiologie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Jena, Deutschland
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Abstract
Falls over railings are frequent case scenarios forensic experts are confronted with. An important issue is the differentiation of accidental and non-accidental falling scenarios. From a biomechanical point of view, this is a challenging task and should be addressed in a multifactorial approach. This work presents a simplified mechanical model in terms of a cranked rod that can be used in cases without relevant dynamic components in terms of pushing or jumping. If the anti-slip and the anti-tilt condition are violated, the possibility for a person to get over a railing should be assumed and investigated in more detail. Because our approach also involves uncertainties, the formulae should be understood to be part of a multifactorial approach. Numerical simulation, experimental reconstruction, injury pattern, and trace analysis can yield additional substantial connecting facts.
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Affiliation(s)
- H Muggenthaler
- Institute of Legal Medicine, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
| | - M Hubig
- Institute of Legal Medicine, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - A Meierhofer
- Institute of Legal Medicine, Medical University of Graz, Graz, Austria
| | - G Mall
- Institute of Legal Medicine, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
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Hueck U, Muggenthaler H, Hubig M, Heinrich A, Güttler F, Wagner R, Mall G, Teichgräber U. Forensic postmortem computed tomography in suspected unnatural adult deaths. Eur J Radiol 2020; 132:109297. [PMID: 33035918 DOI: 10.1016/j.ejrad.2020.109297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/03/2020] [Revised: 09/04/2020] [Accepted: 09/18/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE Our study sought to evaluate validity of forensic postmortem CT in establishing cause of death (COD) in suspected unnatural adult death based on the reference standard of autopsy. METHODS In our prospective, single-center study, 64 of 94 consecutive corpses (70.7 % male, mean age: 47.4 years) who underwent CT and autopsy between November 2013 and April 2019 were included in the analysis. Primary objective was agreement between CT and autopsy on primary COD using kappa statistics. Secondary objectives were competing COD and specific pathological findings. RESULTS Agreement on primary COD between forensic CT and autopsy without or in consideration of toxicological and histological findings was strong (85.9 % [55 of 64 corpses]; κ = 0.83 [95 %CI: 0.74 to 0.93] and 95.3 % [61 of 64 corpses]; κ = 0.94 [95 %CI: 0.84-1.04], respectively, McNemar p = 0.03). Sensitivity and specificity of CT in identification of acute heart failure, intracranial bleeding, burns and heat shocks, gunshot wounds, polytrauma, cranio-cerebral trauma, and strangulation or hanging was 100 %, each. Acute respiratory failure was detected with a sensitivity and specificity of 100 % and 96.8 %, cuts and stab wounds with 95.2 % and 100 %, and intoxication, pneumonia, or gastrointestinal bleeding with 60.0 % and 100 %, respectively. Agreement on competing COD was moderate (51.6 %, [33 of 64 corpses]; κ = 0.47 [95 %CI: 0.40 to 0.53], p < 0.001). CONCLUSIONS Forensic postmortem CT, complemented by external, toxicological, and histological examination was sufficiently valid to assess primary COD in the majority of suspected unnatural deaths with few restrictions.
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Affiliation(s)
- U Hueck
- Department of Radiology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - H Muggenthaler
- Department of Forensic Medicine, Jena University Hospital, Jena, Am Klinikum 1, 07747, Jena, Germany
| | - M Hubig
- Department of Forensic Medicine, Jena University Hospital, Jena, Am Klinikum 1, 07747, Jena, Germany
| | - A Heinrich
- Department of Radiology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - F Güttler
- Department of Radiology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - R Wagner
- Department of Forensic Medicine, Jena University Hospital, Jena, Am Klinikum 1, 07747, Jena, Germany
| | - G Mall
- Department of Forensic Medicine, Jena University Hospital, Jena, Am Klinikum 1, 07747, Jena, Germany
| | - U Teichgräber
- Department of Radiology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
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Muggenthaler H, Hubig M, Mall G, Lessig R, Stiller D. Injury pattern and the biomechanical assessment of skull fracture risk in blows with a rubber mallet. Forensic Sci Int 2020; 312:110303. [PMID: 32387869 DOI: 10.1016/j.forsciint.2020.110303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/13/2020] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 11/26/2022]
Abstract
Acts of violence often result in blunt force trauma. On behalf of the court, forensic experts not only have to assess injuries in terms of morphology or severity, but they also have to give statements regarding the risk of potential fatal injuries. We describe a case of domestic violence where a man hit the head of his wife using a rubber mallet. His wife sustained extensive and multiple parietal scalp lacerations and avulsions with exposure of the cranial bone. A CCT revealed neither skull fractures nor intracranial injuries. Biomechanical measurements were performed using a bowling ball and an animal head representing head surrogates. In comparison to steel hammer impacts we hypothesized longer contact durations and lower maximum contact forces in blows with a rubber mallet. However, contact durations in the magnitude of 3ms do not confirm our hypothesis. The contact forces calculated based on mallet and animal head accelerations were between 2.97kN and 4.68kN. These force values are rather below the parietal fracture thresholds, explaining the absence of parietal skull fractures in the case presented. Moreover, the relatively low Young's modulus comes along with a deformation of the rubber mallet and a decrease in contact pressure. In summary, contact times could be reliably estimated, while contact forces remained largely uncertain.
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Affiliation(s)
- H Muggenthaler
- Jena University Hospital - Friedrich Schiller University Jena, Institute of Legal Medicine, Am Klinikum 1, 07747 Jena, Germany.
| | - M Hubig
- Jena University Hospital - Friedrich Schiller University Jena, Institute of Legal Medicine, Am Klinikum 1, 07747 Jena, Germany
| | - G Mall
- Jena University Hospital - Friedrich Schiller University Jena, Institute of Legal Medicine, Am Klinikum 1, 07747 Jena, Germany
| | - R Lessig
- Institute of Legal Medicine, University of Halle-Wittenberg, Franzosenweg 1, 06112 Halle/Saale, Germany
| | - D Stiller
- Institute of Legal Medicine, University of Halle-Wittenberg, Franzosenweg 1, 06112 Halle/Saale, Germany
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Wagner R, Muggenthaler H, Sauer S, Mall G, Hubig M. Pedestrian hit by a car impacted metal pole: reconstructing the head load. Int J Legal Med 2019; 134:1403-1408. [PMID: 31388796 DOI: 10.1007/s00414-019-02133-x] [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: 04/26/2019] [Accepted: 07/26/2019] [Indexed: 11/28/2022]
Abstract
Fatal head injuries are frequently seen in pedestrians hit by motorized vehicles. In our case, the pedestrian sustained a devastating head injury with skull splitting in the mediosagittal plane. A car collided with a traffic sign causing a bending of the pole. The metal pole hit a man standing close beside it; the man had a head injury severity that is more commonly due to falling objects than due to traffic accidents. Assuming a head mass of 5 kg, simplified calculations yield maximum contact forces of ca. 36 kN exceeding mean parietal fracture forces which are in the order of magnitude of 12.5 kN. The influences of the effective body mass and the horizontal distance between the pole and the pedestrian on maximum contact forces are investigated. High contact forces in our case can be mainly explained by the comparably high impact velocity and by a partial mass transfer of the total car mass to the pole.
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Affiliation(s)
- R Wagner
- Institute of Legal Medicine, Jena University Hospital - Friedrich Schiller University Jena, Germany, Am Klinikum 1, 07747, Jena, Germany.
| | - H Muggenthaler
- Institute of Legal Medicine, Jena University Hospital - Friedrich Schiller University Jena, Germany, Am Klinikum 1, 07747, Jena, Germany
| | - S Sauer
- Institute of Legal Medicine, Jena University Hospital - Friedrich Schiller University Jena, Germany, Am Klinikum 1, 07747, Jena, Germany
| | - G Mall
- Institute of Legal Medicine, Jena University Hospital - Friedrich Schiller University Jena, Germany, Am Klinikum 1, 07747, Jena, Germany
| | - M Hubig
- Institute of Legal Medicine, Jena University Hospital - Friedrich Schiller University Jena, Germany, Am Klinikum 1, 07747, Jena, Germany
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Trinh TX, Heinke S, Rode C, Schenkl S, Hubig M, Mall G, Muggenthaler H. Maximum striking velocities in strikes with steel rods—the influence of rod length, rod mass and volunteer parameters. Int J Legal Med 2017; 132:499-508. [DOI: 10.1007/s00414-017-1734-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
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Kuethe F, Franz M, Jung C, Porrmann C, Reinbothe F, Schlattmann P, Egerer R, Mall G. Outcome predictors in dilated cardiomyopathy or myocarditis. Eur J Clin Invest 2017; 47:513-523. [PMID: 28556177 DOI: 10.1111/eci.12772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 02/18/2017] [Accepted: 05/23/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND The objective of this study was to identify parameters of prognostic relevance in patients presenting with chronic left ventricular dysfunction who underwent endomyocardial biopsy. MATERIALS AND METHODS A total of 351 consecutive patients (age 47·7 ± 12·6 years, 281 male) with a chronic left ventricular dysfunction were enrolled. Endomyocardial biopsies were analysed by histopathology according to Dallas criteria and immunohistological WHO criteria. Virus genome was detected by polymerase chain reaction. The combined end point was time to death or heart transplantation. RESULTS About 19% of patients (n = 67) showed positive Dallas criteria and 39% (n = 118) immunohistochemical signs of inflammation. Viral genome was present in 58% (n = 155). During follow-up, 25% (n = 89; 76 death, 13 HTx) reached the end point. Dallas-positive histopathology (hazard ratio: 0·42; 95% CI: 0·29-0·84, P = 0·031), ejection fraction (hazard ratio: 0·97; 95% CI: 0·94-0·99, P = 0·019) and β-blocker therapy (hazard ratio: 0·41; 95% CI: 0·23-0·69, P = 0·003) were independent outcome predictors. For patients under β-blocker therapy, Dallas-positive histopathology (hazard ratio: 0·37; 95% CI: 0·25-0·76, P = 0·009) and NYHA class III and class IV (hazard ratio: 2·11; 95% CI: 1·04-3·12, P = 0·006) were independent predictors. CONCLUSIONS For patients with a chronic left ventricular dysfunction, Dallas-positive histopathology, β-blocker therapy and left ventricular ejection fraction are the most striking parameters for outcome prediction.
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Affiliation(s)
- Friedhelm Kuethe
- Klinik für Innere Medizin I, Ilm-Kreis-Kliniken Arnstadt, Arnstadt, Germany
| | - Marcus Franz
- Klinik für Innere Medizin I, Universitätsklinikum Jena, Jena, Germany
| | - Christian Jung
- Klinik für Innere Medizin I, Universitätsklinikum Jena, Jena, Germany
| | | | | | - Peter Schlattmann
- Institut für Medizinische Statistik, Informatik und Dokumentation, Universitätsklinikum Jena, Jena, Germany
| | - Renate Egerer
- Institut für Medizinische Mikrobiologie, Universitätsklinikum Jena, Jena, Germany
| | - Gerhard Mall
- Institut für Pathologie, Klinikum Darmstadt, Darmstadt, Germany
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Muggenthaler H, Hubig M, Schenkl S, Niederegger S, Mall G. Calibration and parameter variation using a finite element model for death time estimation: The influence of the substrate. Leg Med (Tokyo) 2017; 25:23-28. [DOI: 10.1016/j.legalmed.2016.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/08/2016] [Accepted: 12/19/2016] [Indexed: 11/24/2022]
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Kaltenbach B, Brandenbusch V, Möbus V, Mall G, Falk S, van den Bergh M, Chevalier F, Müller-Schimpfle M. A matrix of morphology and distribution of calcifications in the breast: Analysis of 849 vacuum-assisted biopsies. Eur J Radiol 2016; 86:221-226. [PMID: 28027751 DOI: 10.1016/j.ejrad.2016.11.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 12/10/2015] [Revised: 11/16/2016] [Accepted: 11/22/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this retrospective analysis was to evaluate the likelihood of malignancy in prospectively categorized BI-RADS 4 and BI-RADS 5 calcifications. MATERIAL AND METHODS This analysis included 849 women who underwent vacuum biopsy for BI-RADS 4 (with the subgroups 4A, 4B and 4C) or BI-RADS 5 calcifications between February 2007 and May 2015. Calcifications were classified according to the morphology and distribution descriptors of the BI-RADS lexicon (BI-RADS 4th edition lexicon). A standardized scheme (matrix) was used to combine the characteristics of the grouped calcifications with the BI-RADS assessment category. RESULTS Overall, 275/849 (32%) lesions were found to be malignant. 285/327/208/29 calcified lesions were prospectively classified as BI-RADS 4A/4B/4C/5 indicating a risk for malignancy of 16%/27%/55%/90%, respectively. The morphology descriptors predicted the risk for malignancy as follows: typically benign (n=55): 2%; indeterminate (n=676): 27%; typically malignant (n=118): 80%. The distribution descriptors correlated with a malignant histology as follows: diffuse (n=0); round or oval (n=261): 22%; regional (n=398): 33%; segmental (n=106): 42%; linear or branching (n=85): 55%. There was a significant difference between the descriptor categories (p<0.0001). CONCLUSION A standard scheme combining the morphology and distribution characteristics proved to be a helpful tool in diagnosis of calcifications, bridging the gap between description and classification of these lesions.
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Affiliation(s)
- Benjamin Kaltenbach
- Institute of Radiology (RZI), Klinikum Frankfurt/Main - Höchst, Academic Teaching Hospital of the University of Frankfurt/Main, Germany; Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
| | - Volker Brandenbusch
- Diagnostic Breast Center Turmcarée, Mammography Screening, Frankfurt/Main, Germany
| | - Volker Möbus
- Department of Obstetrics and Gynecology, Klinikum Frankfurt/Main-Höchst, Germany
| | - Gerhard Mall
- Institute of Pathology, Klinikum Frankfurt/Main-Höchst, Germany
| | - Stephan Falk
- OptiPath, Pathology Associates, Frankfurt/Main, Germany
| | | | - Frauke Chevalier
- Institute of Radiology (RZI), Klinikum Frankfurt/Main - Höchst, Academic Teaching Hospital of the University of Frankfurt/Main, Germany
| | - Markus Müller-Schimpfle
- Institute of Radiology (RZI), Klinikum Frankfurt/Main - Höchst, Academic Teaching Hospital of the University of Frankfurt/Main, Germany
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Hubig M, Muggenthaler H, Schenkl S, Mall G. Do multiple temperature measurements improve temperature-based death time estimation? The information degradation inequality. Int J Legal Med 2016; 130:1243-51. [PMID: 26872468 DOI: 10.1007/s00414-016-1323-6] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 01/21/2016] [Indexed: 11/29/2022]
Abstract
The accuracy of the input parameter values limits the accuracy of the output values in forensic temperature-based death time estimation (TDE) like in many scientific methods. A standard strategy to overcome this problem is to perform multiple measurements of the input parameter values, but such approaches are subject to noise accumulation and stochastic dependencies. A quantitative mathematical analysis of advantages as well as disadvantages of multiple measurements approaches (MMAs) was performed. The results are A general stochastic model of MMA. The information degradation inequality quantifying gains and losses of MMAs. Example calculations of the information degradation inequality for the following two MMAs relevant to TDE: o Multiple successive rectal temperature measurements o Multiple synchronous body layer temperature measurements Neither multiple successive rectal temperature measurements nor multiple synchronous body layer temperature measurements seem to significantly improve death time estimation. MMAs are superior to the single measurement approach only in the very early body cooling phase.
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Affiliation(s)
- M Hubig
- Institute of Forensic Medicine, Jena University Hospital-Friedrich Schiller University Jena, Fürstengraben 23, 07743, Jena, Germany.
| | - H Muggenthaler
- Institute of Forensic Medicine, Jena University Hospital-Friedrich Schiller University Jena, Fürstengraben 23, 07743, Jena, Germany
| | - S Schenkl
- Institute of Forensic Medicine, Jena University Hospital-Friedrich Schiller University Jena, Fürstengraben 23, 07743, Jena, Germany
| | - G Mall
- Institute of Forensic Medicine, Jena University Hospital-Friedrich Schiller University Jena, Fürstengraben 23, 07743, Jena, Germany
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Hubig M, Muggenthaler H, Sinicina I, Mall G. With reference to the letter to the editor by Henssge (Leg Med (Tokyo). 2015 Jul 29. http://dx.doi.org/10.1016/j.legalmed.2015.05.005.): "'With reference to the article by Hubig et al.: Temperature based forensic death time estimation: The standard model in experimental test' (Legal Med 2015 XX)". Leg Med (Tokyo) 2015; 17:304-5. [PMID: 26415654 DOI: 10.1016/j.legalmed.2015.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 08/27/2015] [Indexed: 11/20/2022]
Affiliation(s)
- M Hubig
- Institute of Forensic Medicine, Jena University Hospital - Friedrich Schiller University Jena, Fürstengraben 23, 07743 Jena, Germany.
| | - H Muggenthaler
- Institute of Forensic Medicine, Jena University Hospital - Friedrich Schiller University Jena, Fürstengraben 23, 07743 Jena, Germany
| | - I Sinicina
- Institute of Legal Medicine, Ludwig Maximilians-University Munich, Germany
| | - G Mall
- Institute of Forensic Medicine, Jena University Hospital - Friedrich Schiller University Jena, Fürstengraben 23, 07743 Jena, Germany
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Hubig M, Muggenthaler H, Sinicina I, Mall G. Temperature based forensic death time estimation: The standard model in experimental test. Leg Med (Tokyo) 2015; 17:381-7. [PMID: 26028161 DOI: 10.1016/j.legalmed.2015.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 01/28/2015] [Revised: 04/17/2015] [Accepted: 05/12/2015] [Indexed: 10/23/2022]
Abstract
The determination of the time since death is essential to forensic homicide investigations since the time of death represents the presumed time of the offence. Erroneous death time estimates may lead to false acquittal or conviction of suspects. Since its introduction 30years back, the nomogram method by Henßge has been established as the standard procedure of temperature-based death time determination in the early post-mortem period. The present study provides an independent investigation of the validity of its death time estimates and their corresponding 95%-confidence intervals. Comparison to post-mortem cooling curves recorded under controlled conditions of 84 suddenly deceased with known death times yielded the following results: Since in the light of our experiments the validity of the nomogram method seems to be problematic, death time estimates - and particularly their 95%-confidence interval limits - have to be interpreted carefully and should only be restrictively used as court evidence to support or refute alibis. Systematic overestimation of the post-mortem interval in bodies of high mass and large surface area must be taken into account.
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Affiliation(s)
- M Hubig
- Institute of Forensic Medicine, Jena University Hospital - Friedrich Schiller University Jena, Germany.
| | - H Muggenthaler
- Institute of Forensic Medicine, Jena University Hospital - Friedrich Schiller University Jena, Germany
| | - I Sinicina
- Institute of Legal Medicine, Ludwig Maximilians-University Munich, Germany
| | - G Mall
- Institute of Forensic Medicine, Jena University Hospital - Friedrich Schiller University Jena, Germany
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Rambausek M, Kollmar S, Mall G, Ritz E. Blood pressure and uremic cardiomyopathy. Contrib Nephrol 2015; 60:230-5. [PMID: 3278857 DOI: 10.1159/000414807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- M Rambausek
- Médizinische Universitätsklinik, Universität Heidelberg, BRD
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Ritz E, Rambausek M, Mall G, Ruffmann K, Mandelbaum A. Cardiac changes in uremia and their possible relation to cardiovascular instability on dialysis. Contrib Nephrol 2015; 78:221-9. [PMID: 2146078 DOI: 10.1159/000418286] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- E Ritz
- Department of Internal Medicine, University of Heidelberg, FRG
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Leyendecker G, Bilgicyildirim A, Inacker M, Stalf T, Huppert P, Mall G, Böttcher B, Wildt L. Adenomyosis and endometriosis. Re-visiting their association and further insights into the mechanisms of auto-traumatisation. An MRI study. Arch Gynecol Obstet 2015; 291:917-32. [PMID: 25241270 PMCID: PMC4355446 DOI: 10.1007/s00404-014-3437-8] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 08/25/2014] [Indexed: 01/24/2023]
Abstract
PURPOSE In a series of publications, we had developed the concept that uterine adenomyosis and pelvic endometriosis as well as endometriotic lesions at distant sites of the body share a common pathophysiology with endometriosis constituting a secondary phenomenon. Uterine auto-traumatization and the initiation of the mechanism of tissue injury and repair (TIAR) were considered the primary events in the disease process. The present MRI study was undertaken (1) to corroborate this concept by re-visiting, in view of discrepant results in the literature, the association of adenomyosis with endometriosis and (2) to extend our views concerning the mechanisms of uterine auto-traumatization. PATIENTS AND METHODS MRI was performed in 143 women attending our center, in whom, on the basis of transvaginal sonography (TVS) and historical data, such as documented endometriosis and dysmenorrhea of various degrees of severity, the presence of uterine adenomyosis was suspected. In addition to the measurement of the diameter of junctional zone (JZ) of the anterior and posterior walls in the mid-sagittal plane, the diagnosis of adenomyosis was based on visualization, in that all planes were analyzed with scrutiny. By this method of "visualization" all transient enlargement of the JZ, such as peristaltic waves of the archimyometrium and sporadic neometral contractions that might mimic adenomyotic lesions could be excluded. At the same time, this method allowed to lower the limit of detection in terms of thickness of the JZ for assured diagnosis of adenomyosis. Furthermore, the localizations of the individual lesions, their shapes and patterns were described. RESULTS With the method of 'visualization', the diagnosis of uterine adenomyosis could be verified in 127 of the 143 patients studied. The prevalence of endometriosis in adenomyosis was 80.6% and the prevalence of adenomyosis in endometriosis was 91.1%. As concluded from their localization within the uterine wall, the adenomyotic lesions predominantly developed in the median region of the upper two-thirds of the uterine wall. Cystic cornual angle adenomyosis was a distinct phenomenon that was only observed in patients suffering from extreme primary dysmenorrhea. Aside from this, the majority of the patients complained of primary dysmenorrhea (80%). On the basis of these findings and the fact that particularly extreme primary dysmenorrhea is associated with high intrauterine pressure, menstrual 'archimetral compression by neometral contraction' has to be considered as an important cause of uterine auto-traumatization in addition to uterine peristalsis and hyperperistalsis. Both mechanical functions of the non-pregnant uterus exert their strongest power in the upper region of the uterus, which is compatible with the predominant localization of the adenomyotic lesions. CONCLUSIONS The data confirm our previous results of a high association of adenomyosis with endometriosis and vice versa. Our view of the mechanism of uterine auto-traumatization by mechanical functions of the non-pregnant uterus has to be extended, in that 'archimetral compression by neometral contractions' could be realized as the predominant cause of mechanical strain to the non-pregnant uterus. The data of this study confirm our concept of the etiology and pathophysiology of adenomyosis and endometriosis in that the process of chronic proliferation and inflammation is induced at the level of the archimetra by chronic uterine auto-traumatization. Furthermore, with respect to the diagnosis of uterine adenomyosis (and consequently endometriosis) this study shows a high degree of accordance between the findings in real-time TVS and MRI.
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Affiliation(s)
- G Leyendecker
- Kinderwunschzentrum (Fertility Center) Darmstadt, Bratustr. 9, 64293, Darmstadt, Germany,
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Poerner TC, Haase D, Franz M, Goebel B, Otto S, Mall G, Figulla HR. HISTOLOGICAL AND MOLECULAR FINGERPRINTS OF LOW-GRADIENT AORTIC STENOSIS. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60920-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Boländer A, Kieser D, Scholz C, Heyny-von Haußen R, Mall G, Goetschy V, Czech C, Schmidt B. Synthesis of Methoxy-X04 Derivatives and Their Evaluation in Alzheimer's Disease Pathology. NEURODEGENER DIS 2013; 13:209-13. [DOI: 10.1159/000351436] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 04/18/2013] [Indexed: 11/19/2022] Open
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Lange S, Muggenthaler H, Hubig M, Mall G. The forensic relevance of hypothermia in living persons—Literature and retrospective study. Forensic Sci Int 2013; 231:34-41. [DOI: 10.1016/j.forsciint.2013.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 03/19/2013] [Accepted: 04/10/2013] [Indexed: 11/15/2022]
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Franz M, Berndt A, Neri D, Galler K, Grün K, Porrmann C, Reinbothe F, Mall G, Schlattmann P, Renner A, Figulla HR, Jung C, Küthe F. Matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, B⁺ tenascin-C and ED-A⁺ fibronectin in dilated cardiomyopathy: potential impact on disease progression and patients' prognosis. Int J Cardiol 2013; 168:5344-51. [PMID: 23998545 DOI: 10.1016/j.ijcard.2013.08.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [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: 02/06/2013] [Revised: 05/23/2013] [Accepted: 08/03/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) is associated with heart failure and increased mortality and there is no reliable biomarker to estimate patients' prognosis. During cardiac remodeling, an extensive reorganization of the extracellular matrix occurs. The study was aimed to investigate matrix metalloproteinase 9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1) and fetal tenascin-C (B(+) Tn-C) and fibronectin (ED-A(+) Fn) variants known to be involved in that process. METHODS AND RESULTS In 187 patients with DCM, levels of MMP-9, TIMP-1 and B(+) Tn-C in serum as well as B(+) Tn-C and ED-A(+) Fn in tissue were quantified and subjected to univariate analysis. For all serum markers, concentrations above a calculated threshold were associated with decreased survival (MMP-9: p = 0.008, TIMP-1: p = 0.001, B(+) Tn-C: p < 0.001) and a significantly higher risk to die or undergo transplantation. In tissue, a reexpression of B(+) Tn-C and ED-A(+) Fn could be shown. Protein deposition levels of ≥4.5% for B(+) Tn-C and ≥2.1% for ED-A(+) Fn were associated with a significantly decreased survival (p = 0.001 for B(+) Tn-C, p = 0.031 for ED-A(+) Fn) and an increased risk to die or undergo transplantation. In a multivariate analysis, TIMP-1 is the superior parameter to predict transplantation free survival (p = 0.027). CONCLUSIONS Serum levels of MMP-9, TIMP-1 and B(+) Tn-C and tissue levels of B(+) Tn-C and ED-A(+) Fn are promising markers for risk assessment. The reoccurrence of ED-A(+) Fn and the availability of a human antibody usable as a vehicle for targeted drug delivery might be the basis for novel therapeutic strategies.
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Affiliation(s)
- Marcus Franz
- Department of Internal Medicine I, University Hospital Jena, Erlanger Allee 101, 07740 Jena, Germany.
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Pistulli R, König S, Drobnik S, Kretzschmar D, Rohm I, Lichtenauer M, Fritzenwanger M, Mall G, Mall G, Figulla HR, Yilmaz A. Decrease in dendritic cells in endomyocardial biopsies of human dilated cardiomyopathy. Eur J Heart Fail 2013; 15:974-85. [PMID: 23603088 DOI: 10.1093/eurjhf/hft054] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [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] [Indexed: 01/14/2023] Open
Abstract
AIMS Dendritic cells (DCs) are sentinels of the immune system-their role in myocardial disease is unknown as yet. We investigated their myocardial presence in human dilated cardiomyopathy (DCM). METHODS AND RESULTS Endomyocardial biopsies from 72 patients with DCM (EF ∼30%), as well as myocardial specimens from 18 suicide or accident victims were immunohistochemically analysed for myeloid and plasmacytoid DCs, antigen-presenting cells (APCs), and other leucocytes; also tissue fibrosis and apoptosis were histologically quantified. The myocardial viral genome was identified through polymerase chain reaction, and patients underwent clinical follow-up in 3-6 months. We found myocardial DCs of all examined subtypes and maturation stages (fascin, CD11c, CD209, CD83, and CD304), as well as markers for APCs (HLA-DR and CD40) and T-cell activation (CD69) to be significantly decreased in DCM compared with controls. In contrast, regulatory T cells (the GITR epitope), apoptosis (by TUNEL reaction and immunostaining with BCL-2), and a DC chemokine receptor (CCR7) were overexpressed, while no significant differences were observed for macrophages (CD68). Immature myeloid and plasmacytoid DCs strongly correlated with endothelial progenitor cells (CD34), which were similarly reduced in DCM, and inversely correlated with fibrosis. Myeloid DCs were especially reduced in virus-positive biopsies, and their numbers correlated with positive change in EF (ΔEF) at follow-up. CONCLUSION Myocardial DCs are reduced in heart biopsies of symptomatic DCM patients. Such a reduction correlates with an unfavourable short-term outcome in terms of EF, and could result from myocardial tissue damage, cellular death, and insufficient vascularization in chronic heart failure.
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Affiliation(s)
- Rudin Pistulli
- Clinic of Internal Medicine I, Division of Cardiology and Intensive Care Medicine, University Hospital of Jena, Germany.
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Gu J, Anumala UR, Heyny-von Haußen R, Hölzer J, Goetschy-Meyer V, Mall G, Hilger I, Czech C, Schmidt B. Design, synthesis and biological evaluation of trimethine cyanine dyes as fluorescent probes for the detection of tau fibrils in Alzheimer's disease brain and olfactory epithelium. ChemMedChem 2013; 8:891-7. [PMID: 23592568 DOI: 10.1002/cmdc.201300090] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Indexed: 12/21/2022]
Abstract
Shedding light on grey matter: Fluorescent trimethine cyanines were evaluated as imaging probes for neurofibrillary tangles in post-mortem brain sections of Alzheimer's disease patients. These probes bind to neurofibrillary tangles with high contrast and selectivity over amyloid β plaques.
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Affiliation(s)
- Jiamin Gu
- Clemens Schöpf-Institute of Chemistry and Biochemistry, Technische Universität Darmstadt, Darmstadt, Germany
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Abstract
Coronary artery anomalies are found in approximately 1.3 % of symptomatic adult patients undergoing coronary arteriography and encompass a wide variety of anatomic patterns. Single coronary arteries are found in 0.024-0.066 % of this group. The particular type of a single coronary artery with an anatomically correct course of either artery (so-called L/R-I type according to the Lipton and Yamanaka/Hobbs classification) is an especially rare phenomenon and has been described for the left coronary artery and for the right coronary artery in adults. In these anomalies an isolated coronary artery ensuring the blood supply of the entire heart displayed a compensatory widening of the lumen. The case of a 6-year-old boy who collapsed during exercise and died subsequently of acute cardiac death is presented. At autopsy a single right coronary artery with an anatomically correct course (R-I type) arising from the right sinus of Valsalva was found. On microscopic examination myocardial calcifications and scars were found in the papillary muscles of the mitral valve. Common ion channel disorders were excluded by DNA analysis. Sudden cardiac death on the basis of chronic ischemic heart disease was ascertained as the cause of death. Autopsy and microscopic findings, as well as aspects of the underlying pathophysiology, are presented and discussed.
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Affiliation(s)
- Mattias Kettner
- Institute of Forensic Medicine, Goethe-University Frankfurt/Main, Frankfurt/M., Germany.
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Gu J, Anumala UR, Lo Monte F, Kramer T, Heyny von Haußen R, Hölzer J, Goetschy-Meyer V, Mall G, Hilger I, Czech C, Schmidt B. 2-Styrylindolium based fluorescent probes visualize neurofibrillary tangles in Alzheimer’s disease. Bioorg Med Chem Lett 2012; 22:7667-71. [DOI: 10.1016/j.bmcl.2012.09.109] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 09/27/2012] [Accepted: 09/29/2012] [Indexed: 10/27/2022]
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Muggenthaler H, Drobnik S, Hubig M, Reiners J, Mall G. Complete trunk severance of a motorcyclist by a traffic sign post at a comparably low collision speed. Forensic Sci Int 2012; 223:e35-7. [PMID: 23022766 DOI: 10.1016/j.forsciint.2012.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 06/20/2012] [Accepted: 09/05/2012] [Indexed: 10/27/2022]
Abstract
Traumatic limb amputations and transections of the trunk generally indicate high impact velocities. Complete traumatic severances of the trunk in road accidents however are rarely reported in literature. We describe a case where the trunk of a motorcyclist was completely severed as he hit the post of a traffic sign. Based on the documented end position and damage of the motorcycle, an impact velocity range of 52-80 km/h could be determined for the motorcyclist. To our knowledge, this is the first report on the type and mechanism of injury at this comparatively low collision speed range.
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Affiliation(s)
- H Muggenthaler
- Jena University Hospital-Friedrich Schiller University Jena, Institute of Legal Medicine, Fürstengraben 23, 07743 Jena, Germany.
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Boländer A, Kieser D, Voss C, Bauer S, Schön C, Burgold S, Bittner T, Hölzer J, Heyny-von Haußen R, Mall G, Goetschy V, Czech C, Knust H, Berger R, Herms J, Hilger I, Schmidt B. Bis(arylvinyl)pyrazines, -pyrimidines, and -pyridazines as imaging agents for tau fibrils and β-amyloid plaques in Alzheimer's disease models. J Med Chem 2012; 55:9170-80. [PMID: 22913544 DOI: 10.1021/jm300653b] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The in vivo diagnosis of Alzheimer's disease (AD) is of high socioeconomic interest and remains a demanding field of research. The biopathological hallmarks of the disease are extracellular plaques consisting of aggregated β-amyloid peptides (Aβ) and tau protein derived intracellular tangles. Here we report the synthesis and evaluation of fluorescent pyrazine, pyrimidine,and pyridazine derivatives in vitro and in vivo aiming at a tau-based diagnosis of AD. The probes were pre-evaluated on human brain tissue by fluorescence microscopy and were found to label all known disease-related alterations at high contrast and specificity. To quantify the binding affinity, a new thiazine red displacement assay was developed and selected candidates were toxicologically profiled. The application in transgenic mouse models demonstrated bioavailability and brain permeability for one compound. In the course of histological testing, we discovered an AD-related deposition of tau aggregates in the Bowman's glands of the olfactory epithelium, which holds potential for an endoscopic diagnosis of AD in the olfactory system.
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Affiliation(s)
- Alexander Boländer
- Clemens Schoepf-Institute of Organic Chemistry and Biochemistry, Technische Universität Darmstadt, Petersenstrasse 22, 64287 Darmstadt, Germany
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Taghavi A, Nasir S, Pickhardt M, Hauβen RHV, Mall G, Mandelkow E, Mandelkow EM, Schmidt B. N′-Benzylidene-Benzohydrazides as Novel and Selective Tau-PHF Ligands. ACTA ACUST UNITED AC 2011; 27:835-43. [DOI: 10.3233/jad-2011-111238] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ali Taghavi
- Clemens Schöpf-Institute of Chemistry and Biochemistry, Technische Universtität Darmstadt, Darmstadt, Germany
| | - Samir Nasir
- Clemens Schöpf-Institute of Chemistry and Biochemistry, Technische Universtität Darmstadt, Darmstadt, Germany
| | - Marcus Pickhardt
- Max-Planck-Unit for Structural Molecular Biology, c/o DESY, Hamburg, Germany
| | | | - Gerhard Mall
- Department of Pathology, Klinikum Darmstadt, Darmstadt, Germany
| | - Eckhard Mandelkow
- Max-Planck-Unit for Structural Molecular Biology, c/o DESY, Hamburg, Germany
| | - Eva-Maria Mandelkow
- Max-Planck-Unit for Structural Molecular Biology, c/o DESY, Hamburg, Germany
| | - Boris Schmidt
- Clemens Schöpf-Institute of Chemistry and Biochemistry, Technische Universtität Darmstadt, Darmstadt, Germany
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Baumbach SF, Krusche-Mandl I, Huf W, Mall G, Fialka C. Linear intra-bone geometry dependencies of the radius: radius length determination by maximum distal width. Eur J Radiol 2011; 81:947-50. [PMID: 21498015 DOI: 10.1016/j.ejrad.2011.02.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 02/11/2011] [Accepted: 02/11/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of the study was to investigate possible linear intra-bone geometry dependencies by determining the relation between the maximum radius length and maximum distal width in two independent populations and test for possible gender or age effects. A strong correlation can help develop more representative fracture models and osteosynthetic devices as well as aid gender and height estimation in anthropologic/forensic cases. METHODS First, maximum radius length and distal width of 100 consecutive patients, aged 20-70 years, were digitally measured on standard lower arm radiographs by two independent investigators. Second, the same measurements were performed ex vivo on a second cohort, 135 isolated, formalin fixed radii. Standard descriptive statistics as well as correlations were calculated and possible gender age influences tested for both populations separately. RESULTS The radiographic dataset resulted in a correlation of radius length and width of r=0.753 (adj. R(2)=0.563, p<0.001) with sex having a significant (p=0.005, adj. R(2)=0.592) and side no influence on the correlation. Radius length-width correlation for the isolated radii was r=0.621 (adj. R(2)=0.381, p<0.001) with sex significantly influencing this correlation (p<0.001, adj. R(2)=0.598). CONCLUSION A relatively strong radius length-distal width correlation was found in two different populations, indicating that linear body proportions might not only apply to body height and axial length measurements of long bones but also to proportional dependency of bone shapes in general.
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Affiliation(s)
- S F Baumbach
- Medical University of Vienna, Department of Traumatology, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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Benz K, Campean V, Cordasic N, Karpe B, Neuhuber W, Mall G, Hartner A, Hilgers KF, Amann K. Early glomerular alterations in genetically determined low nephron number. Am J Physiol Renal Physiol 2011; 300:F521-30. [DOI: 10.1152/ajprenal.00490.2009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
An association between low nephron number and subsequent development of hypertension in later life has been demonstrated. The underlying pathomechanisms are unknown, but glomerular and postglomerular changes have been discussed. We investigated whether such changes are already present in prehypertensive “glial cell line-derived neurotrophic growth factor” heterozygous mice (GDNF+/−) with lower nephron number. Twenty-six-week-old mice [22 GDNF+/−, 29 C57B6 wild-type control (wt)] were used for in vivo experiments with intra-arterial and tail cuff blood pressure measurements. After perfusion fixation, kidneys were investigated with morphological, morphometric, stereological, and immunohistochemical techniques and TaqMan PCR analysis. As expected at this age, blood pressure was comparable between GDNF+/− and wt. Nephron number per kidney was significantly lower in GDNF+/− than in wt (−32.8%, P < 0.005), and mean glomerular volume was significantly higher (+49.5%, P < 0.001). Renal damage scores, glomerular and tubular proliferation, analysis of intrarenal arteries and peritubular capillaries, expression of relevant tubular transporter proteins, as well as gene expression of profibrotic, proinflammatory, or prohypertensive markers were not significantly different between GDNF+/− and wt. Compensatory glomerular hypertrophy in GDNF+/− was accompanied by higher numbers of endothelial and mesangial cells as well as PCNA-positive glomerular cells, whereas podocyte density was significantly reduced. Further electron microscopic analysis showed marked thickening of glomerular basement membrane. In conclusion, lower nephron number is associated with marked early glomerular structural changes, in particular lower capillary supply, reduced podocyte density, and thickened glomerular basement membrane, that may predispose to glomerular sclerosis.
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Affiliation(s)
| | | | | | | | | | - Gerhard Mall
- Department of Pathology, Hospital of Darmstadt, Darmstadt, Germany
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Amann K, Ridinger H, Rutenberg C, Ritz E, Mall G, Maercker C. Gene expression profiling on global cDNA arrays gives hints concerning potential signal transduction pathways involved in cardiac fibrosis of renal failure. Comp Funct Genomics 2010; 4:571-83. [PMID: 18629021 PMCID: PMC2447303 DOI: 10.1002/cfg.347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2003] [Revised: 09/03/2003] [Accepted: 10/10/2003] [Indexed: 01/07/2023] Open
Abstract
Cardiac remodelling with interstitial fibrosis in renal failure, which so far is only poorly understood on the molecular level, was investigated in the rat model by a global
gene expression profiling analysis. Sprague–Dawley rats were subjected to subtotal
nephrectomy (SNX) or sham operation (sham) and followed for 2 and 12 weeks,
respectively. Heart-specific gene expression profiling, with RZPD Rat Unigene-1
cDNA arrays containing about 27 000 gene and EST sequences revealed substantial
changes in gene expression in SNX compared to sham animals. Motor protein genes,
growth and differentiation markers, and extracellular matrix genes were upregulated
in SNX rats. Obviously, not only genes involved in cardiomyocyte hypertrophy, but
also genes involved in the expansion of non-vascular interstitial tissue are activated
very early in animals with renal failure. Together with earlier findings in the SNX
model, the present data suggest the hypothesis that the local renin–angiotensin system
(RAS) may be activated by at least two pathways: (a) via second messengers and Gproteins
(short-term signalling); and (b) via motor proteins, actins and integrins (longterm
signalling). The study documents that complex hybridization analysis yields
reproducible and promising results of patterns of gene activation pointing to signalling
pathways involved in cardiac remodelling in renal failure. The complete array data
are available via http://www.rzpd.de/cgi-bin/services/exp/viewExpressionData.pl.cgi
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Affiliation(s)
- Kerstin Amann
- Department of Pathology, University of Erlangen-Nürnberg, Krankenhausstrasse 8-10, Erlangen D-91054, Germany.
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Mall G. Zur Toxizität des Serums von Epileptikern. Stereotact Funct Neurosurg 2010. [DOI: 10.1159/000105067] [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: 11/19/2022]
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Abstract
INTRODUCTION This study presents a unifying concept of the pathophysiology of endometriosis and adenomyosis. In particular, a physiological model is proposed that provides a comprehensive explanation of the local production of estrogen at the level of ectopic endometrial lesions and the endometrium of women affected with the disease. METHODS In women suffering from endometriosis and adenomyosis and in normal controls, a critical analysis of uterine morphology and function was performed using immunohistochemistry, MRI, hysterosalpingoscintigraphy, videohysterosonography, molecular biology as well as clinical aspects. The relevant molecular biologic aspects were compared to those of tissue injury and repair (TIAR) mechanisms reported in literature. RESULTS AND CONCLUSIONS Circumstantial evidence suggests that endometriosis and adenomyosis are caused by trauma. In the spontaneously developing disease, chronic uterine peristaltic activity or phases of hyperperistalsis induce, at the endometrial-myometrial interface near the fundo-cornual raphe, microtraumatizations with the activation of the mechanism of 'tissue injury and repair' (TIAR). This results in the local production of estrogen. With ongoing peristaltic activity, such sites might increase and the increasingly produced estrogens interfere in a paracrine fashion with the ovarian control over uterine peristaltic activity, resulting in permanent hyperperistalsis and a self-perpetuation of the disease process. Overt auto-traumatization of the uterus with dislocation of fragments of basal endometrium into the peritoneal cavity and infiltration of basal endometrium into the depth of the myometrial wall ensues. In most cases of endometriosis/adenomyosis, a causal event early in the reproductive period of life must be postulated leading rapidly to uterine hyperperistalsis. In late premenopausal adenomyosis, such an event might not have occurred. However, as indicated by the high prevalence of the disease, it appears to be unavoidable that, with time, chronic normoperistalsis throughout the reproductive period of life leads to the same extent of microtraumatization. With the activation of the TIAR mechanism followed by infiltrative growth and chronic inflammation, endometriosis/adenomyosis of the younger woman and premenopausal adenomyosis share in principle the same pathophysiology. In conclusion, endometriosis and adenomyosis result from the physiological mechanism of 'tissue injury and repair' (TIAR) involving local estrogen production in an estrogen-sensitive environment normally controlled by the ovary.
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Affiliation(s)
- G Leyendecker
- Kinderwunschzentrum (Fertility Center) Darmstadt, Bratustrasse 9, 64295, Darmstadt, Germany.
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Neumann T, Manger B, Schmid M, Kroegel C, Hansch A, Kaiser WA, Reinhardt D, Wolf G, Hein G, Mall G, Schett G, Zwerina J. Cardiac involvement in Churg-Strauss syndrome: impact of endomyocarditis. Medicine (Baltimore) 2009; 88:236-243. [PMID: 19593229 DOI: 10.1097/md.0b013e3181af35a5] [Citation(s) in RCA: 154] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cardiac disease is a major contributor to disease-related death in Churg-Strauss syndrome (CSS). We conducted the current study to determine the prevalence and clinical impact of cardiac involvement in CSS patients. We performed a multicenter, cross-sectional analysis of patients diagnosed with CSS. Cardiac workup included electrocardiography, echocardiography, cardiac magnetic resonance imaging (MRI), and endomyocardial biopsy.We analyzed 49 patients with CSS: 22 patients had clinical evidence of cardiac involvement. A negative antineutrophil cytoplasmic antibodies (ANCA) test and much higher eosinophil counts (9947 vs. 3657/microL, respectively, p < 0.001) distinguished patients with cardiac involvement from those without. Impaired left ventricular function (50%), mild to severe valvular insufficiencies (73%), and pericardial effusions (41%) were common findings in these patients. Endomyocarditis was found in 13 patients (59%) as detected by cardiac MRI, cardiac thrombus formation, and endomyocardial biopsy, and was associated with impaired cardiac function. After a mean follow-up of 47 months, most patients had regained or maintained good cardiac function. However, patients with endomyocarditis had a more severe outcome. Two patients died (61 and 99 mo after diagnosis, respectively), both due to severe cardiomyopathy and heart failure.Cardiac involvement is common in patients with CSS and is associated with the absence of ANCA and high eosinophil counts. Endomyocarditis may represent the most severe manifestation eventually causing fatal outcome. A structured clinical assessment incorporating cardiac imaging with echocardiography and MRI can identify impaired cardiac function and endomyocardial abnormalities.
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Affiliation(s)
- Thomas Neumann
- From Department of Internal Medicine 3 (TN, GW, GH), Department of Internal Medicine 1 (CK), and Institute of Diagnostic and Interventional Radiology (AH, WAK), University of Jena, Jena; Department of Internal Medicine 3 and Institute for Clinical Immunology (BM, GS, JZ), and Department of Internal Medicine 2 (MS), University of Erlangen-Nuremberg, Erlangen; Department of Cardiology (DR), Evangelisches Krankenhaus, Hamm; and Institute of Pathology (GM), Klinikum Darmstadt, Darmstadt, Germany
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Pfeil A, Drobnik S, Aboud A, Rzanny R, Schmidt P, Mall G, Kaiser WA, Hansch A. Experimentelle Studie zur Evaluierung der MRT- Kompatibilität epikardialer Schrittmacherelektroden. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221571] [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: 10/20/2022]
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Hädrich C, Ortmann C, Reisch R, Liebing G, Ahlers H, Mall G. An electronic body-tracking dog? Int J Legal Med 2009; 124:43-7. [PMID: 19322580 DOI: 10.1007/s00414-009-0338-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 02/27/2009] [Indexed: 11/28/2022]
Abstract
The use of tracker dogs is the main method of finding hidden bodies, and in their search the dogs use typical scent patterns. "Electronic noses" can also be used to find and compare such patterns. Highly sensitive scent detectors have been successfully applied, e.g. in the examination of foodstuffs, in environmental tests and in material research. This study examined whether electronic sensors can be used to find bodies under outdoor conditions. The carcasses of two coneys were buried in soil at different depths. Over a period of 4 weeks, regular measurements were taken from the buried carcasses and from the control material. In addition, a "fingerprint" of the scent patterns was taken, and gas chromatography-mass spectrometry analyses were performed. Our findings indicate that it may be possible and viable to construct an "electronic body-tracking dog".
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Affiliation(s)
- C Hädrich
- Institute for Legal Medicine, Universität Leipzig, Leipzig, Germany.
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Ramsthaler F, Kettner M, Mall G, Bratzke H. The use of rapid diagnostic test of Procalcitonin serum levels for the postmortem diagnosis of sepsis. Forensic Sci Int 2008; 178:139-45. [DOI: 10.1016/j.forsciint.2008.03.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Revised: 03/02/2008] [Accepted: 03/10/2008] [Indexed: 01/29/2023]
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Weidauer H, Blobel GA, Nemetschek-Gansler H, Gould VE, Mall G. Das neuro-endokrine Larynxkarzinom vom kleinzelligen (Oat-Cell) Typ. Laryngorhinootologie 2008. [DOI: 10.1055/s-2007-1008099] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Werner CJ, Heyny-von Haussen R, Mall G, Wolf S. Proteome analysis of human substantia nigra in Parkinson's disease. Proteome Sci 2008; 6:8. [PMID: 18275612 PMCID: PMC2265686 DOI: 10.1186/1477-5956-6-8] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Accepted: 02/14/2008] [Indexed: 12/21/2022] Open
Abstract
Background Parkinson's disease (PD) is the most common neurodegenerative disorder involving the motor system. Although not being the only region involved in PD, affection of the substantia nigra and its projections is responsible for some of the most debilitating features of the disease. To further advance a comprehensive understanding of nigral pathology, we conducted a tissue based comparative proteome study of healthy and diseased human substantia nigra. Results The gross number of differentially regulated proteins in PD was 221. In total, we identified 37 proteins, of which 16 were differentially expressed. Identified differential proteins comprised elements of iron metabolism (H-ferritin) and glutathione-related redox metabolism (GST M3, GST P1, GST O1), including novel redox proteins (SH3BGRL). Additionally, many glial or related proteins were found to be differentially regulated in PD (GFAP, GMFB, galectin-1, sorcin), as well as proteins belonging to metabolic pathways sparsely described in PD, such as adenosyl homocysteinase (methylation), aldehyde dehydrogenase 1 and cellular retinol-binding protein 1 (aldehyde metabolism). Further differentially regulated proteins included annexin V, beta-tubulin cofactor A, coactosin-like protein and V-type ATPase subunit 1. Proteins that were similarly expressed in healthy or diseased substantia nigra comprised housekeeping proteins such as COX5A, Rho GDI alpha, actin gamma 1, creatin-kinase B, lactate dehydrogenase B, disulfide isomerase ER-60, Rab GDI beta, methyl glyoxalase 1 (AGE metabolism) and glutamine synthetase. Interestingly, also DJ-1 and UCH-L1 were expressed similarly. Furthermore, proteins believed to serve as internal standards were found to be expressed in a constant manner, such as 14-3-3 epsilon and hCRMP-2, thus lending further validity to our results. Conclusion Using an approach encompassing high sensitivity and high resolution, we show that alterations of SN in PD include many more proteins than previously thought. The results point towards a heterogeneous aetiopathogenesis of the disease, including alterations of GSH-related proteins as well as alterations of proteins involved in retinoid metabolism, and they indicate that proteins involved in familial PD may not be differentially regulated in idiopathic Parkinson's disease.
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Herbert Z, Bötticher G, Aschoff A, Sendemir E, Zermann DH, Arnold R, Mall G, Jirikowski GF. Changing caveolin-1 and oxytocin receptor distribution in the ageing human prostate. Anat Histol Embryol 2007; 36:361-5. [PMID: 17845226 DOI: 10.1111/j.1439-0264.2007.00775.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Several observations suggest that caveolin-1 has an important role in control of cell proliferation and cancerogenesis. For instance, oxytocin provokes a proliferative response in the prostate tissue when the oxytocin receptor is localized mainly in caveolin-1-enriched domains and an anti-proliferative effect when the same receptor is not localized in caveolae. Moreover, oxytocin concentrations are elevated in prostate tissue of patients with benign prostatic hyperplasia (BPH). In this study the expression pattern of the molecules caveolin-1, oxytocin receptor, androgen receptor and p21 (cell cycle arrest indicator) was investigated in the prostate tissue of BPH patients and of young controls. We found that both caveolin-1 and oxytocin receptor expression is drastically increased with age in both smooth muscle and epithelium of the prostate. We also found a significantly increased co-localization of the oxytocin receptor with caveolin-1 in both the muscle and the epithelium, especially in BPH patients. Androgen receptor and p21 staining was found throughout the prostate but did not change significantly with age or in BPH patients. We conclude that oxytocin may have a proliferative effect on the prostate tissue through the caveolae-associated receptors and thus contribute to BPH. This process seems to be androgen receptor independent.
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Affiliation(s)
- Z Herbert
- Department of Biology II, Institute of Neurobiology, LMU, München, Germany.
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Gradinger R, Jung C, Reinhardt D, Mall G, Figulla HR. Toxic myocarditis due to oral ingestion of hydrofluoric acid. Heart Lung Circ 2007; 17:248-50. [PMID: 17822953 DOI: 10.1016/j.hlc.2007.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Revised: 03/03/2007] [Accepted: 04/18/2007] [Indexed: 11/30/2022]
Abstract
We report the case of a 32-year-old man, admitted to cardiac care unit with congestive heart failure, caused by a reduced global cardiac function four months after oral hydrofluoric acid ingestion while attempting suicide. Biopsy results of left ventricular myocardium confirmed toxic myocarditis due to ingestion of hydrofluoric acid. This case represents an uncommon example of toxic myocarditis as a long-term complication of oral hydrofluoric acid ingestion. We recommend cardiological follow-up consultations in patients with hydrofluoric acid intoxication for early detection of cardiac deterioration.
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Affiliation(s)
- Robert Gradinger
- Department of Cardiology/Internal Medicine, Friedrich Schiller University, Erlanger Allee 101, D-07747 Jena, Germany.
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Shah SM, Heyny-von Haußen R, Berger I, Mall G. Multiorgan infestation with macrophages with PAS-negative material inclusions in long-term hemodialysis: a case report. Diagn Pathol 2007. [DOI: 10.1186/1746-1596-2-s1-s23] [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: 11/10/2022] Open
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