E. Miltner

Thoracic trauma assessment formulations for restrained drivers in simulated frontal impacts

Using cadaveric specimens, sixty-three simulated frontal impacts were performed to examine and quantify the performance of various contemporary automotive restraint systems. To characterize the mechanical responses during the impact, test-specimens were instrumented with accelerometers and chest bands. The resulting thoracic injury severity was determined using detailed autopsy and was classified using the Abbreviated Injury Scale.

Technical parameters influencing the severity of injury of front-seat, belt-protected car passengers on the impact side in car-to-car side collisions with the main impact between the front and rear seats (B-pillars)

SummaryAuthentic car-to-car side collisions (n = 30) with the main impact area at the B-pillar were analyzed to find technical parameters corresponding with the injury severities of the front seat, belt-protected car passengers on the impact side. EES (Energy Equivalent Speed) and Av (delta v, change in velocity) were highly significant predictors of the severity of thoracic and abdominal injuries and total injury severity coded according to the Abbreviated Injury Scale (AIS). At an EES or Δ v ≥ 40 km/h all front-seat car passengers on the impact side sustained a total injury severity of Maximum AIS (MAIS) ≥ 4 and died. Although a passenger could survive the crash without injury to one or more body regions up to the highest EES- and Av-values, at EES or Δ v ≥ 40 km/h fatal injuries were sustained in at least one body region. At an EES ≥ 35 km/h or a Av ≥ 15 km/h no front-seat car passenger on the impact side remained uninjured.Zusammenfassung30 reale Pkw-Pkw-Seitenkollisionen mit Hauptanstoßpunkt B-Holm and stoßnah sitzenden angegurteten Frontinsassen wurden mit forensischer Genauigkeit rekonstruiert and die technischen Parameter mit der Verletzungsschwere, codiert nach AIS (Abbreviated Injury Scale) 1985, in Beziehung gesetzt. EES (Energy Equivalent Speed) and Geschwindkeitsänderung Δv waren hochsignifikante Prädiktoren der Thorax-, Abdominal- and Gesamtverletzungsschwere. Ab einer EES oder Δ v ≥ 40 km/h erlitten die stoßnahen Insassen eine Gesamtverletzungsschwere MAIS ≥ 4 and starben. Auch wenn Insassen bis zu höchstens EES- oder Av-Werten in einer oder mehreren Körperregionen unverletzt bleiben konnten, erlitten sie ab einer EES oder Av≥40 km/h tödliche Verletzungen in mindestens einer Körperregion. Ab einer EES ≥ 35 km/h oder einer Av ≥ 25 km/h blieb kein stoßnaher Insasse mehr unverletzt.

Cathepsin D as a vitality marker in human skin wounds

SummaryThis paper shows the results obtained by studying the lysosomal enzyme Cathepsin D as a potential marker for the vitality of wounds in human specimens. We have analyzed 53 samples using enzymological and histological techniques. Our results show the ability of Cathepsin D to establish the vital origin of wounds inflicted 5 minutes or less before death, where the specific activity of cathepsin D reached 0.055 units at the wound edge and 0.01 units in their respective controls (P < 0.001). As previously demonstrated in an experimental series, Cathepsin D seems to be a very useful marker of high forensic interest in especially difficult cases. Further studies are in progress to check the influence of different factors such as drugs intake and clinical conditions on Cathepsin D activity.ZusammefassungDas Manuskript zeigt Ergebnisse, wie sie durch Untersuchung des lysosomalen Enzyms Cathepsin D als potentiellen Marker für Vitalität in menschlichen Hautwunden erzielt wurden. Wir haben 53 Proben mit Hilfe enzymatischer und histologischer Techniken untersucht. Die Ergebnisse zeigen die Fähigkeit von Cathepsin D, den vitalen Ursprung von Wunden zu etablieren, selbst wenn sie 5 Minuten oder geringere Zeit vor dem Tod gesetzt wurden. In den letzteren erreichte die spezifische Aktivität von Cathepsin D 0,055 Einheiten an den Wundränden und 0,01 Einheiten in den entsprechenden Kontrollen (P < 0,001). Wie früher in experimentellen Untersuchungen gezeigt wurde, scheint Cathepsin D ein sehr nützlicher Marker von hoher forensischer Bedeutung besonders in schwierigen Fällen zu sein. Weitere Studien sind in der Bearbeitung, um den Einfluß verschiedener Faktoren, wie Medikamenteneinnahme und klinischer Zustand, auf die Cathepsin D-Aktivität zu überprüfen.

Dissection of the anterior and middle cerebral artery with fatal ischemia following kicks to the head

A 19-year-old male received kicks to his head in the course of a fight with other young people. On admission to hospital he became drowsy and developed a hemiparesis and a facial paralysis on the right. After 3-4 days of continuous improvement the patient suddenly fell unconscious again and died on the seventh day after the trauma due to an increase of the intracranial pressure. Neuropathologic examination revealed an extensive dissection of the wall of the left anterior and middle cerebral artery. The age of the recurring infarction in the dependent areas of blood supply corresponded to the biphasic clinical course.

Liver and spleen ruptures in authentic car-to-car side collisions with main impact at front door or B-pillar.

Seventy-nine belt-protected front seat occupants sustained authentic car-to-car side collisions with impact at front door or B-pillar in which energy equivalent speed (EES) and δ V had a highly significant influence on the occurrence of liver and spleen ruptures. From an EES > 40 km/h the risk of suffering liver and spleen injuries proved to be much higher for occupants on the impact side. Drivers on the impact side often had combined liver and spleen ruptures, front seat passengers had only liver ruptures and combined liver and spleen ruptures. The number of rib fractures on the left or right had a highly significant influence on the occurrence of liver and spleen ruptures. Liver ruptures and combined liver and spleen ruptures were often combined with pelvic ruptures.