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Biomedical subjects

K S Saternus

Publications and source records attributed to K S Saternus.

At least 55 records · Page 3Linked to original sources

[Capacity for activity in penetrating and blunt abdominal injuries].

In the archives of the accident hospitals available, the data of patients who had been hospitalized because of a penetrating or blunt abdominal trauma in the last two years before the surveys were evaluated. Besides the abdominal trauma, at most trivial injuries of other regions were permitted. The data which might give information on how massive the intraabdominal injury was and/or the severity of shock symptoms were taken from the patient record sheets. Afterwards, it was attempted to obtain in an interview details on the external circumstances, the course of the accident event itself and the nature of the reaction to the trauma. Finally, 32 casualties (14 with penetrating and 18 with blunt abdominal injury) were surveyed. Fundamental differences in the behavior of these two subgroups were detected and verified with statistical test techniques. Circumspect behavior after penetrating abdominal trauma was characteristic. Nevertheless, in a few cases there was loss of the ability to act even in limited penetrating injury of the abdominal wall. However, the casualties themselves had the impression of a severe stab injury and this determined the primary reaction to the trauma. A fundamentally different behavior pattern was shown by those who had suffered a blunt abdominal injury. For them, it was typical that they became unable to act immediately or within a few seconds. With regard to the significance of pain, the restriction of motor movements as well as the relation of assumed and clinically verified injury severity is dealt with in respect of the capacity to act in a comparison of the two subgroups.

Abdominal Injuries↗

[Comparative radiologic and pathologic-anatomic studies on the value of discography in the diagnosis of acute intravertebral disk injuries in the cervical spine].

In order to prove the diagnostic value of cervical discography, a postmortem investigation was carried out on 70 trauma fatalities and 30 atraumatic fatalities of comparable age distribution. It was shown that, depending on the functional state of the intervertebral disk, the contrast medium flowed from the central depot into the "degenerative" cleft systems, from there frequently in front of the posterior longitudinal ligament into the uncovertebral joints and from there into the epidural space even in injured movement segments. On the other hand, despite the large number of false positive results only a relatively small percentage of the injuries was investigated. Discography would be a specific diagnostic method merely for central intervertebral disk disruption. However, this injury type is a rare special form.

Autopsy↗

[Injuries of the common carotid artery due to reanimation measures ].

The status of the large vessels of the neck was determined after emergency intubation in 65 primary atraumatic casualties in the endeavor to provide accident surgeons working under extreme conditions with a check on results to optimize their therapy. Besides the findings in the vertebral artery (shown in 35 cases), which was traumatized in one case, the main attention was dedicated to the injury pattern of the common carotid artery. In this artery, intimal ruptures within the bifurcation were found in three cases, combined in one case with a subintimal hemorrhage on the contralateral side. As compared to other forms of force leading to an injury of the common carotid artery, reanimation causing traction and hyperextension of the neck is also considered an injurious stress. The unconscious patient is especially endangered as he has no possibility of pain-elicited defense if a helper hyperextends the neck under pressure from below in the vertex of the lordosis.

Adult↗

[The mechanics of whiplash injury of the cervical spine (author's transl)].

Despite many attempts it has so far not been possible to establish a uniform application of the term "whiplash injury" either for diagnostics, therapy, or medical reports. To obtain a clear, functionally based definition, the most frequently used formulations are compared, taking into account anatomic and mechanical aspects in addition. Whiplash injury is separated from hyperextension injury ("snap" trauma of the cervical spine), even though overlaps in the lesion picture are possible. In the definition suggested, invariable linkage to rear-end collision is dispensed with. Instead, it is emphasized that this accident mechanism is frequent, but can also be substituted. In contrast to other definitions, special emphasis is laid on the biphasic course since a substantial traumatization is to be assumed to occur from the secondary movement. This second movement does not by any means proceed with low energy, but its determined by the mass contraction of the muscle group subject to primary abrupt overextension with their synergists. On the basis of the analysis of the mechanical course and the investigation of a actual accidents, the monosegmental cervical spine injury cannot, therefore, be seen as the characteristic type of damage due to a whiplash injury. Instead of this, the frequent occurrence of multiple injuries is pointed out.

Biomechanical Phenomena↗

[Writing of expertises on whiplash injuries of the cervical spine (author's transl)].

Reflections on the definition of the term "whiplash injury" are followed by comments on the mechanism of accidents. The author emphasizes the importance of the biphasic course of the trauma, involving a mass contraction, triggered by reflex action, of the initially suddenly overstretched muscle groups with their synergist. Reference is made to the ideas developed by Kummer, who considers the neck as an arcuate tendon construction with tractional tension on the dorsal as well as on the ventral side. In the analysis of the injury pattern of the cervical spine, the special forms of intervertebral disc injury are dealt with, the relationship to degenerative lesions prior to the accident and to secondary lesions (spondylosis deformans and osteochondrosis) are discussed in detail, and the consequences for writing medical expertises are mentioned.

Accidents, Traffic↗

[Direct and indirect trauma in resuscitation (author's transl)].

To provide accident surgeons working under extreme conditions with reports on the results of their efforts, the complications of resuscitation measures in 30 atraumatic deaths in which a final fall was to be excluded were analyzed in a fundamental study. According to these results, there are two predilection sites for injuries, viz., the thorax and neck. Thus, injuries to the bones of the thorax, which had occurred in 70% of all cases, were found regularly in rigid emphysematous thorax, and in 40% in elastic thorax after external cardiac massage. The typical secondary injuries are dealt with. Because of the great danger of a liver injury as observed in two cases, resuscitation measures using an extrathoracic cardiac massage machine appear to be problematic even if injuries to the bones of the thorax can be avoided in an elastic thorax. Injury to the neck after intubation occurred nearly as often as injuries to the thorax after external cardiac massage. Local injuries were predominantly small hemorrhages and abrasions at the base of the tongue and in the tonsillar ring on the right. Hemorrhages in the neck musculature are likely to be attributed to the abutment injury, and the retropharyngeal hemorrhages to hyper-extension. The single organ most frequently injured overall was the cervical spine with an injury frequency of 66%. However, there was no indication, not even in a single case, that resuscitation measures had shortened the life of a patient.

Adolescent↗

[Phospholipids in fatal strangulations (author's transl)].

A comparison of phospholipid content of sera from heart blood and sinus blood from the brain with the rate of haemolysis in the blood samples, with age, sex, degree of arteriosclerosis and cause of death, showed a relationship with the cause of death in spite of wide dispersion of the single values. The remaining factors of the 145 unselected human cadavers, which were not putrefied, seemed to have no influence. Small amounts of haemolysis caused a decrease of phospholipid concentration whereas an extensive haemolysis clearly led to an increase. The results of 46 deaths by hanging confirmed the fundamental studies of Berg (1950, 1952), who demonstrated that an increased secretion of phospholipids during the strangulation process is to be interpreted as a vital phenomenon. Compression of cervical vessels resulted in statistically significant differences between phospholipid concentrations in serum of heart and sinus blood.

Adolescent↗

[The importance of Simon's symptom in cases of hanging (author's transl)].

Radiological and patho-anatomical investigations of the spines of 32 corpses of persons who had committed suicide by hanging revealed spine damage in 81% of the cases. The cervical spine was damaged in 69%, the lumbar spine in 56% of the cases. The typical damage of the cervical spine is a loosening of the discs at the dorsal side, usually at the level of C 4/5 to C 6/7. In the region of the lumbar spine, bleeding between the (anterior) ventral ligament and the discs is the most frequently observed damage (Simon's sy;mtpom). Simon bleeding is brought about by traction force and is not dependent on the age at death or on any existing degenerative changes of the spine.

Adult↗

[Morphology of the adult human hyoid bone].

Investigations on 504 human hyoid bones show that there exist three main types, whose occurrence is, to a certain degree, sex-related. The junction between the body and the larger horns of the hyoid often is not ossified even in advanced age. Any determination of age on the basis of the extent of the corpus-cornu maius-ossification is most unreliable.

Adolescent↗

[Injury pattern of the hyoid bone].

Based on the classification of hyoid bone into hyperbola-, parabola-, and horseshoe-shaped types, conditions were stimulated under planar and punctiform ventral force as well as in case of strangulation in photoelastic experiment. The results thus obtained were compared to those from former investigations in the field of bone tissue density. Hence, each hyoid type shows characteristic patterns of lesion of its own. The patterns of fractures and localizations which had been expected theoretically could be verified when compared to lesions that occurred in vital state. Then it turned out that horizontal fractures were typical of lesions of hyperbolic hyoid bones and vertical fractures of the cornu maius typical of lesions of parabolic hyoid bones.

Asphyxia↗