Possibilities of ultrasonic diagnosis in fetal abdominal monstrosities (author's transl)

The diagnostic possibilities of intrauterine ultrasonic assessment of the fetal abdomen by rapid B-scan are described on the basis of two cases (megalocystis/megaloureter syndrome and omphalocele with cloaca formation). Other examination methods of prenatal diagnosis to confirm the findings are also discussed, but their diagnostic significance is even more limited than that of sonography, individual cases excepted. Although early detection of neural tube anomalies is the most important application of ultrasound, pronounced monstrosities of the fetal abdominal region are also definitely recognisable via ultrasonic examination.     

The possibility of using a laser stereolithography method in forensic medicine

The data of computer-aided tomography are proposed to be used in forensic medical diagnostic and identification studies. The technology of making hard copies of objects by laser stereolithography on the basis of tomography data is described.     

Possibilities and limits of the morphological diagnosis of rheumatoid arthritis]

For the morphological diagnostics of rheumatoid arthritis only the judgment of the synovial membrane is of practical importance. Based on the experience gleaned on more than 2,000 synovectomy preparations the following evidence concerning the possibilities and the limits of the morphological diagnostics and the judgment of activity can be enunciated. 1. A certain histological diagnosis of the rheumatoid arthritis is possible only when rheumatoid granulomas or their equivalents are proved. 2. A probability diagnosis results from a definite combination of symptoms of proliferative and exsudative reactions of the synovial membrane. Especially the absence of proliferative signs decreases the degree of probability of the diagnostic evidence. 3. Seropositive and seronegative cases do not reveal any differences in histological respect. The possibility of the class-specific determination of rheumatoid factors by means of an immunofluorescence test and the fact the seronegative cases showed IgM and IgM rheumatoid factors, when this test was used, demands an examination of this evidence. 4. As to the synovial membranes of large joints in the same membrane so distinctive local differences of the findings may exist that thus the value of the needle biopsy is restricted. Only positive findings may be evaluated diagnostically. 5. Apart from a diagnosis the histological findings of the synovial membrane also allow a judgment of the local activity. The basis activity and the actual activity are differentiated. The basis activity is regarded as an expression of the immunological activity, the actual activity as an expression of the inflammatory activity. There are no unambiguous relations to the total clinical activity. Differences in the behaviour of the activity between seropositive and seronegative cases are not to be proved. A revision of this evidence under the aspect of the class-specific proof of the rheumatoid factor is necessary.     

Criminal law problems in forensic medicine

This paper first goes into cases of medical malpractice proceeding from the definition of the subject (forensic medicine). Among the material examined by the author lapses were to be assumed in 6.9% of the cases. A forensic autopsy can, however, also be of significance in countering false accusations. Forensic autopsies are regulated by Sect. 87 of the German Code of Criminal Procedure. Clinical autopsies are performed in Berlin in conformity with the Autopsy Act of 1996. Therapeutic removal of tissue is, moreover, also regulated by the Autopsy Act. Last year's Grafting Act, on the other hand, is Federal Law. Another act promulgated in 1997 has likewise provoked considerable controversial debate: viz. the Criminal Proceedings Amendment Act--keyword: DNA analysis/genetic fingerprint. And, finally, the paper also goes somewhat deeper into the introduction of breath-alcohol tests as evidence admitted in court. Further points discussed: reports prepared in connection with trials involving shootings along the Berlin wall, reports drawn up in connection with matters involving the abuse of anabolic substances by competitive athletes in the German Democratic Republic, reports on former GDR functionaries pertaining to their fitness to plead in court or to undergo detention. To conclude with, the question, whether evidence obtained by coerced vomiting can be used in court, is also discussed (drug couriers).     

Use of personal computers in forensic medicine facilities

The authors present a brief account of possibilities to use computers, type PC, in departments of forensic medicine and discuss basic technical and programme equipment. In the author's opinion the basic reason for using computers is to create an extensive database of post-mortem findings which would make it possible to process them on a large scale and use them for research and prevention. Introduction of computers depends on the management of the department and it is necessary to persuade workers-future users of computers-of the advantages associated with their use.     

Possibilities and risks of genetic diagnosis

In the recent past, cytogenetic and molecular genetic methods led to an enormous increase in knowledge on genetic information. It reveals a correlation between the genetic information and the phenotype of an individual. Therefore, new starting points concerning the origin of diseases arise. A new nosology will develop. It will force researchers to emphasize more and more on the contribution of the--disturbed--genetic information system to the development of diseases. They will routinely carry out genome analyses on the following four already established levels: 1. phenotype level, 2. biochemical level, 3. chromosomal level, 4. molecular genetic level. Practicians mustn't close their mind to these new possibilities and methods: The three classical tasks of medicine--diagnosis, prevention and therapy--will be supplemented considerably by an earlier (presymptomatic) and more precise diagnosis that is furthermore independent of the organ. Moreover, there is the increasing possibility to predict the risk to develop a disease for descendants in certain partnerships more precisely and, if necessary, to diagnose prenatally. From the medical point of view, these advances are predominantly positive and to the patient's benefit. But it is pointed out that the diagnostic progress also raises new problems which were previously unknown. The answers will have to be given by society as a whole.     

Possibilities of ambulation in children with myelodysplasia]

This article reviews four reports that have addressed the efficacy of spinal instrumentation to enhance spinal fusion in patients with degenerative spondylolisthesis. These papers serve to highlight some of the common problems with interpreting and applying the clinical findings of such studies: small, nonuniform patient selection; variable instrumentation techniques; relatively brief follow-up periods (usually less than 5 years); lack of a uniform scale for clinical assessment of patients; and lack of consensus on the definition and clinical documentation of motion segment instability.     

The diagnosis of simulation in forensic psychiatric practice

The author discusses one of the most important problems in practical forensic psychiatry, simulation of mental disorders. Classification of simulation types is presented, major neuromental disorders enumerated which are simulated by subjects accused of crimes, methods of diagnosis and general regularities typical of all types of simulation behavior are described.     

Possibilities of using modern integrated laser systems

Translated from Metallurg, Vol. 39, No. 11, pp. 36–37, November, 1995.     

Possibilities of bronchoscopic diagnosis in bronchogenic carcinoma (author''s transl)

36 malignant tumours of the eyelids (basaliomas, basal-cell carcinomas and squamous-cell carcinomas) have been treated by intrapalpebral injections of a 5% to 25% solution of urea as recommended by E.D. Danopoulos. 1.5 to 3.0 ml of the solutions were injected around the tumours twice per week. Six malignant tumours disappeared completely after a treatment of eleven months; their largest initial diameter averaged 0.53 cm. Considering the protracted treatment, the uncertainty of success, without histological examination of the excised scar tissue, and finally because of the low rate of verified success, injections of dissolved urea around malignant tumours of the eye lids cannot replace radical excision.