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The special field of legal medicine represents a very heterogeneous science, which makes it impossible, that a forensic pathologist could be an "expert" in all areas. The most recent achievements of computer-technology have opened up the possibility of being able to use a PC to produce an "expert system", for with large computer programs are needed. Therefore we wanted to test in a pilot project, if it was possible to establish an expert system, which was suitable for supporting forensic pathological diagnosis. We confined ourselves to the differential diagnosis of "death by hanging" where a clear line between vital and postmortal events, respectively suicide, homicide and accident was drawn. The discrepancy between the relatively scanty amount of statistically reliable data on the one hand and the complexity of the manifestation of death by hanging on the other hand proved to be the main problem. Although we are not yet able to make an expert system available which meets all our requirements, we are convinced, that in the future computer-aided diagnosis may be of great use for work in legal medicine.

The blood levels and the elimination kinetics of flurazepam and its major metabolites in blood were investigated in 10 volunteers after application of 60 mg flurazepam (Dalmadorm). Hydroxyethylflurazepam and desalkylflurazepam are the metabolites suitable for proving a previous flurazepam ingestion. Splitting of glucuronides is helpful for the determination of hydroxyethylflurazepam as the maximum blood concentration of the unconjugated metabolite does not exceed 1/3 of the concentration after glucuronidase splitting. Because of the different half-lives of formation and of elimination a characteristic time dependent pattern of flurazepam and its metabolites is observed in blood during 24 h after a single dosing. From this, conclusions may be drawn about the period of time between ingestion and sampling of the blood specimen. The accumulation of desalkylflurazepam is indicative of the dose applied or of previous multiple dosing. Parallel to the rise of the blood concentration of the metabolites the excretion of the corresponding hydroxyethylflurazepam glucuronide is detectable in urine. Within 30 min the concentrations are suitable for thin-layer chromatographic quantitation. An impaired performance of the volunteers was observed essentially during the absorption and the early distribution phase.

After an accidental injury of the bowel during a hysterectomy, the patients peritoneal cavity was irrigated for disinfection with a solution containing a mercury-compound. The patient died 40 days after this "peritoneal lavage" with a 0.2% solution of mercury-II-oxycanide. The disinfection with the toxic compound during operation can be judged as a medical mistreatment leading to death of the patient. The mercury concentration in blood (0.1 mg Hg per 100 g blood), taken during autopsy, exceeded normal values severalfold. The cause of death was diagnosed as a "multiorgan-failure", caused by an "iatrogenic mercury poisoning". The results of toxicological analysis, histological examination and the findings of autopsy are presented.

Iatrogenic cardiac injury due to diagnostic sternal puncture occurred in 5 patients, 2 women and 3 men, aged 14 to 37 years. Four cases ended fataly but 1 patient survived after immediate thoracotomy and suture of the damaged heart. Perforation of the anterior wall of the right ventricle resulting in pericardial tamponade was present in all patients. All fatalities resulted in conviction, under criminal law, of the clinician who carried out the puncture (Paragraph 222 StGB--causing death through negligence).

Based on the personal computer software "dBase III plus", we have developed a database program for storage and analysis of data obtained from forensic autopsies. It has been designed to handle administrative data as well as aspects of pathological and forensic findings. To assure the comparability of data with those of other institutes, the data were encoded using the SNOMED nomenclature. This system is characterized by a well differentiated, hierarchical structure, and is commonly used internationally. The entry of data is done by choosing among more than 3,000 terms, which are displayed in a system of selective menus. There terms can be supplemented at any time for specific purposes. Thus it is necessary to record the results of an autopsy in a standardized and well-defined way. The data-base can be used for statistical evaluation of autopsy results, but is also intended as a basis for the development of an expert system to help to determine the cause of death.

Investigations comparing dynamics and kinematics in volunteers and postmortem human subjects (PMHS) under the same collision conditions are rare, although such results are of elementary importance in order to estimate the suitability of PMHS as injury indicators in crash tests. Under this aspect, a report on 12 experimental frontal collisions has been made where PMHS were loaded and restrained by a 80 mm broad double shoulder lap-step belt. The impact velocity amounted 60 km/h, the mean vehicle decelerations were at 11 g and 15 g. In the Naval Biodynamics Laboratory in New Orleans, the comparing collective of 9 volunteers in the age range of 18 to 22 years has been investigated by a mean deceleration of 11 g at otherwise comparable conditions. Optical targets have been fixed at the 1st thoracic vertebra, the occiput and the top of the head in the PMHS, the collision phase has been documented by a laterally to the sled mounted high-speed camera with a frame rate of 1000 p/s. The accelerations have been measured tri-axial at the top of the head, at the clivus and the 1st thoracic vertebra. For the simulation of the muscle tonus of the volunteers, formaldehyde has been injected into the neck muscles. In the PMHS as well as in the volunteers no thoracic- or abdominal injuries occurred during the above mentioned loads. However, the spinal column of the PMHS remained uninjured only in 3 cases, in 7 cases hemorrhages in the intervertebral disc, lacerations of the ligamentum flavum or hemorrhages in the vertebral joints were observed.

Percutaneous transluminal angioplasty was performed in 31 hypertensive patients with primary success in 26 patients (83%). Twenty-three patients had a mean follow-up of 13 months. The cure rate was 30% with a further 26% being improved. However, in the group of patients with lateralizing renal vein renin values, the cure rate rose to 47% with a further 33% improved. Of the eight patients with fibromuscular disease, 83% were normotensive without medication at follow-up; in the 13 patients with atherosclerotic disease, 22% were cured and 44% were classified as improved. Patients with fibromuscular disease and lateralization of renin production are the best candidates for long-term success.

We report on the chemical preparation of the NAD+ analog P1, P2-(5'-beta-nicotinamideribofuranosyl-3"-adenosyl)-diphosphate (N3"AD+) by applying the 1,1'-carbonyldiimidazole activation method. The importance of how adenosine is linked to the nicotinamide mononucleotide phosphoriboride (NMNPR+) moiety is discussed with respect to the coenzyme activity in the lactate dehydrogenase catalyzed reaction.