Papers by Rainer P D M Mattern
Shock and Vibration, 1996
The thoracic trauma index (TTl) and the viscous criterion (VC) are injury criteria intended for t... more The thoracic trauma index (TTl) and the viscous criterion (VC) are injury criteria intended for the prediction of torso injury severity. The criteria were assessed in two series of experiments: 90° (lateral) car to car collisions and controlled left trunk impacts against either a rigid or padded wall. Forty-two belt restrained human cadavers in the age range 18-65 years, located in the near-side front passenger seat, were used. The impact velocity was between 40 and 60 kmlh. Left and right side impacts were simulated using standard or modified car side structures. With the second series of experiments, the left side of each subject was impacted under one of two different test conditions: 24 kmlh rigid wall or 32 kmlh padded wall. The thorax deformation was evaluated through the double integration of the accelerated difference at the fourth and eight ribs, near and far side. Deformation maxima of 6-138 mm (mean 69 mm), VC values of 0.3-4.7 mls (mean 1.6 mls), and TTl values of 85-252 (mean 63) occurred. Torso abbreviated injury severity (AIS) values were between 0 and 5. Statistical analyses showed a stronger influence of age on injury severity than the injury criteria or biomechanical responses in the two series of experiments. The TTl showed the highest correlation with thoracic AIS and the number of rib fractures, while VC was the better predictor of abdominal AIS. The results are discussed critically and the strength and robustness of the injury criteria analyzed.
Based on the kinematics in car/pedestrian-dummy accident simulations, a new test rig was pre-deve... more Based on the kinematics in car/pedestrian-dummy accident simulations, a new test rig was pre-developed to create a reproducible head impact on the windscreen of compact cars. During the test head accelerations as well as forces and bending moments to the neck of a Hybrid III dummy were measured. The new test procedure and first test results are shown here. They are discussed with regard to the current test procedure to assess the injury risk of pedestrians with impactors for bonnet, upper leading hood edge as well as hood and a possible future integration of the head impact on the windscreen of compact cars. (A) For the covering abstract of the conference see ITRD E206422.
Thermal Loading of the Skin Due to Side Airbag Deployment
The purpose of the investigation included in this poster is to present some tests about airbag/sk... more The purpose of the investigation included in this poster is to present some tests about airbag/skin interactions due to thermal effects during side airbag deployment. Different airbag modules were used to compare the heat loading to the skin depending on bag and inflator characteristics. After installing and testing of a test setup to deploy modules with a defined position of the venting, Post Mortal Test Objects (PMTO's) were exposed to the modules to see the interaction of the gas with the skin. The tests performed showed that the probability of getting burned in the area of the sidebag during a side collision is very low. For the covering abstract of the conference see ITRD E203597.
Seat Belt Injuries to Elderly Persons in Simulated Frontal Impact
Hefte zur Unfallheilkunde, 1975
A SERIES OF EXPERIMENTS, USING SIMULATED FRONTAL IMPACT WITH UNINJURED HUMAN BODIES OF 12 TO 82 Y... more A SERIES OF EXPERIMENTS, USING SIMULATED FRONTAL IMPACT WITH UNINJURED HUMAN BODIES OF 12 TO 82 YEARS OF AGE, WAS CARRIED OUT TO INVESTIGATE THE EFFECTIVENESS OF SEAT BELTS AND THE REQUIREMENTS FOR THEM: A THREE-POINT ANCHORAGE SYSTEM WAS USED FOR SOME TESTS AND A SYSTEM WITH INCLINED SHOULDER BELTS WITH KNEE CUSHIONS ON OTHERS. THE TESTS SHOWED THAT INJURY RISK IS PARTICULARLY HIGH WITH ELDERLY PERSONS. UP TO 30 YEARS OF AGE THE INJURIES ON THE EXPERIMENTAL OBJECTS REDUCED MARGINALLY. INJURY TYPES VARIED ACCORDING TO THE ANCHORAGE SYSTEM. ON THE INCLINED SHOULDER BELT/KNEE CUSHION SYSTEM THERE WERE NO INJURIES IN THE ABDOMINAL REGION, WHEREAS THERE WERE WITH THE THREE-POINT SYSTEM. WHEN EXAMINING THE FREQUENCY OF OCCURRENCE OF BROKEN RIBS THERE WAS A CLOSE RELATIONSHIP WITH AGE; WITH INCREASING AGE THE SEVERITY OF THE RIB FRACTURES INCREASED. IN SETTING THE STANDARDS NECESSARY FOR SAFETY ATTACHMENTS IN VEHICLES, INCREASED ATTENTION SHOULD BE GIVEN TO THE LOADING LIMIT OF THE OLDER ...
AB0-Genotypisierung einer südwestdeutschen Population
Rechtsmedizin, 1998
Abstract The AB0 blood types, first discovered by Karl Landsteiner in 1901, can be genotyped wi... more Abstract The AB0 blood types, first discovered by Karl Landsteiner in 1901, can be genotyped with the PCR method of Lee and Chang [6]. Using two primer pairs, allele-specific sequences can be amplified and, after digestion with restriction endonucleases, visualized by silver staining on a polyacrylamide gel. In a southwest German population the allele frequencies were: Allele A = 0.2704, allele B = 0.0741 and allele 0 = 0.6556. With the method of Lee and Chang [6] only the nucleotide positions 261 and 703 are considered so that out of 280 individuals 10 (3.57%) showed differences between the AB0 genotype and phenotype, because it was not possible to differentiate between A and 02 alleles.
An In Vitro Experiment for Postmortem Vascular Permeation. The Passage of Morphine and Morphine Glucuronides Across a Vascular Wall
Journal of Forensic Sciences, 1997
A venous blood sample taken at autopsy cannot be considered to represent the antemortem blood con... more A venous blood sample taken at autopsy cannot be considered to represent the antemortem blood concentration of a particular substance. Autolytic processes cause disintegration and increasing permeability of the physiological and anatomical barriers such as vascular walls and lead to changes in substance concentrations. In the present study, the experimental design represents an in vitro postmortem simulation of a drug substance crossing a venous wall. The postmortem behavior of morphine, morphine-3- and morphine-6-glucuronide was investigated. A Chien-Valia-diffusion chamber with a patch of inferior vena cava as diffusion barrier was used. For optimal simulation of postmortem events, vein sampling was restricted to selected autopsy cases. Parameters for the analysis of diffusion across the vascular tissue were dependence on time, temperature, and initial substance concentrations. The penetration behavior simulating venous efflux and influx of the substances was studied by different orientation of the venous wall in the experiments. Rhodamine B was used as a model substance to visualize the binding to the tissue and the passage across the venous wall. The permeation of morphine, morphine-3- and morphine-6-glucuronide across a vein tissue was found to be mainly dependent on the disintegration of the vascular wall and on the postmortem time period as well as on concentration gradients. From the data of this preliminary in vitro study, it can be concluded that a lag time for transvascular diffusion exists postmortem. However, it could be demonstrated, that adsorption to and penetration into the vascular tissue may alter intraluminal blood concentrations even at an early stage of the postmortem time period.
Comparison Between Child Cadavers and Child Dummy by Using Child Restraint Systems in Simulated Collisions
SAE Technical Paper Series, 1976
At present, numerous restraint systems for children applied in vehicles are in general considered... more At present, numerous restraint systems for children applied in vehicles are in general considered for the use on the back seats. Up to now, only impact tests with dummies and animals have been carried through by these systems. Out of the great number of children, seats and belts we used a system (deformable safety impact table combined with a lap-belt) which has been investigated by us during frontal impacts utilizing two dummies and four cadavers of children in the age of 2 5 up to 11 years having body weights of 16 up to 31 kg. The tests have been conducted on the deceleration-sled track at the Institute of Legal Medicine of the University Heidelberg. Impact velocities of 30 km/h and 40 km/h at a medium deceleration of 20g have been chosen. None of the test sugjects showed injuries to the inner organs; however, numerous muscular hemorrhages as well as hemorrhages of discs and ligaments were noticed. The HIC values lay between 100 and 500; accelerations in x-direction up to 44g and in z- direction up to 85g occurred at the head. Lap-belt forces of 160 up to 400 daN were measured. A weak point of the investigated system is that the child's movements are considerably limited, a factor also noticed in other child restraint systems; however, the protective function proved to be an advantage. The movements during the impact, pictured by high-speed cameras, essentially differ from those of adults wearing 3-point belts. The maximum flexion of the vertebral column is, due to the system, located in the transition of the thoracic to the lumbar vertebral column and the flexion angles amounted about 90 degrees. As expected were the maximum head displacements in relation to a sled-fixed axis dependent on the impact velocity and the body height, and ranged between 50 cm (crash velocity 30 km/h, body height 97 cm) and 90 cm (crash velocity 40 km/h, body height 139 cm). The movement will be analyzed; the anatomical and mechanical causes are going to be investigated. Finally, the results will be compared with similar dummy tests investigated by use. Due to these differences in the dummy and cadaver behavior, the necessity is pointed out to examine all restraint systems by cadaver tests. /Author/
Results of 49 Cadaver Tests Simulating Frontal Collision of Front Seat Passengers
SAE Technical Paper Series, 1974
By an acceleration track operated through a falling weight with a crash velocity of 50 km/h and a... more By an acceleration track operated through a falling weight with a crash velocity of 50 km/h and a stopping distance of about 40 cm--corresponding to the crease region of many automobiles--the effect of three-point-retractor belts on 30 fresh cadavers and of two-point belts with kneebar on 19 fresh cadavers had been tested. The age of the cadavers ranged from 12-82 years. Qualitatively, almost all injuries known under the term "seat belt syndrome" could be reproduced. The dependence of the degree of injury in regard to the age was quite evident. It can be expected that persons over 40 years of age will suffer the same dangerous injuries as the tested cadavers, caused by the diagonal belts if the above mentioned crash conditions are existent.
Freie und glucuronidierte Cannabinoide im Urin - Untersuchungen zur Einschätzung des Konsumverhaltens
Rechtsmedizin, 1999
Zusammenfassung Spontanurinproben (n = 135) von 49 Cannabiskonsumenten wurden auf freie und glu... more Zusammenfassung Spontanurinproben (n = 135) von 49 Cannabiskonsumenten wurden auf freie und glucuronidierte Tetrahydrocannabinolcarbonsure (THCCOOH) mittels LC/MS/MS sowie auf freies und glucuronidiertes Tetrahydrocannabinol (THC) und 11-Hydroxytetrahydrocannabinol (11-OH-THC) mittels GC/MS direkt sowie nach enzymatischer Hydrolyse bis zu 10 Tagen nach dem letztmaligen Konsum untersucht. Die Einteilung des Konsumverhaltens erfolgte in schwer, moderat und leicht und orientierte sich an den Zuordnungskriterien neuerer,
[Visualization of bridging veins by means of postmortem computed tomography]
Archiv für Kriminologie
At autopsy, visualization of lesions of the bridging veins, a frequent source of subdural bleedin... more At autopsy, visualization of lesions of the bridging veins, a frequent source of subdural bleeding, is difficult due to their anatomical localization. On the other hand their demonstration is of great importance for the assignment to a chronologically defined trauma. For this reason a postmortem method using computed tomography was developed to visualize the intracranial venous system by means of X-ray contrast media. In subdural bleedings, in which the skull had not been opened up, ruptured vessels could be accurately localized with this method, so that targeted dissection was possible during the subsequent autopsy.
Considerations for a Neck Injury Criterion
SAE Technical Paper Series, 1991
Diseases of the vertebral arteries
Neurosurgical Review, 1990
Case reports and postmortem neuropathological findings of a wide spectrum of diseases affecting t... more Case reports and postmortem neuropathological findings of a wide spectrum of diseases affecting the vertebral arteries, in particular vasculitis, traumatic lesions, degenerative changes and congenital abnormalities, are discussed.
Lesion‐associated accumulation of uPAR/CD87‐ expressing infiltrating granulocytes, activated microglial cells/macrophages and upregulation by endothelial cells following TBI and FCI in humans
Neuropathology and Applied Neurobiology, 2000
Urokinase‐type plasminogen activator receptor (uPAR/CD87) together with its ligand, urokinase‐typ... more Urokinase‐type plasminogen activator receptor (uPAR/CD87) together with its ligand, urokinase‐type plasminogen activator (uPA), constitutes a proteolytic system associated with tissue remodelling and leucocyte infiltration. uPAR is a member of the glycosyl phosphatidyl inositol (GPI) anchored protein family. The functional role of uPAR comprises fibrinolysis by conversion of plasminogen to plasmin. In addition, uPAR promotes cell adhesion, migration, proliferation, re‐organization of the actin cytoskeleton, and angiogenesis. Furthermore, uPAR is involved in prevention of scar formation and is chemoattractant to macrophages and leucocytes. In order to investigate the pathophysiological role of uPAR following human CNS injury we examined necrotic brain lesions resulting from traumatic brain injury (TBI; n = 28) and focal cerebral infarctions (FCI; n = 17) by immunohistochemistry. Numbers of uPAR+ cells and uPAR+ blood vessels were counted. Following brain damage, uPAR+ cells increased...
Journal of Neural Transmission, 2008
Journal of Analytical Toxicology, 2011
Analysis of dried blood spots is an increasingly accepted method in therapeutic drug monitoring, ... more Analysis of dried blood spots is an increasingly accepted method in therapeutic drug monitoring, whereas its application by analogy to forensic samples has not been studied in detail. Therefore, we investigated whether determination of 3,4methylenedioxymethamphetamine (MDMA) and its main metabolite 3,4-methylendioxyamphetamine (MDA) from dried blood spots (DBS) is as reliable as that from whole blood specimens. Analysis was performed by liquid chromatographytandem mass spectrometry following liquid-liquid extraction of blood and corresponding DBS samples from 20 volunteers participating in a controlled driving experiment under the influence of MDMA. The assay was checked for carryover, ion suppression/enhancement, linearity of response, lower limits of detection (LLOD) and quantitation, extraction efficiency and the within-run and between-run assay imprecision for both whole blood and DBS. The LLODs were 2.0 and 1.6 ng/mL for MDMA in whole blood and DBS, respectively, using a volume of 100 µL. LLODs of MDA were determined to be 0.25 ng/mL in whole blood specimens and 0.12 ng/mL in DBS. Extraction efficiency and imprecision did not differ significantly between the two methods for both MDMA and MDA. The mean concentration ratio of corresponding whole blood and DBS samples, t-test, and the Bland-Altman difference plot were used to test hypothesis of equality. Statistical analyses revealed that methods did not significantly differ for MDMA or MDA. Thus, DBS analysis has potential as a precise and inexpensive alternative to whole blood analysis of MDMA. Blood and corresponding DBS specimens from 20 healthy volunteers in a 4-condition cross-over driving experiment were provided by the
Journal of Analytical Toxicology, 1998
The distribution of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) in w... more The distribution of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) in whole blood, plasma, and packed erythrocytes was studied. Parameters investigated were the hematocrit values (10, 42, 44, and 71%) and the water content of the samples. The blood-to-plasma ratio of morphine concentrations was unaffected by variations in hematocrit and water content, whereas the corresponding ratios for M3G and M6G were strongly influenced. Ratios were 0.53 to 0.65 and 0.52 to 0.62 in specimens with average hematocrit values (42 and 44%, respectively), and the ratios were 0.81 or 0.89 (hematocrit 10%) and 0.27 or 0.28 (hemalocrit 71%) in blood samples with different hematocrit values. In contrast to the morphine conjugates, morphine was highly bound to or partitioned into red blood cells (13e = 55.9). Although the present data are limited, they already demonstrate that conclusions drawn from pharmacokinetic studies and transferred to parent drug to metabolite ratios resulting from forensic blood samples may be biased by the particular biological matrix under investigation.
Komplikationen nach Zelltherapie
Zeitschrift f�r Rechtsmedizin, 1989
ABSTRACT Nach wie vor drfen tierische Frischzellprparationen zur sog. Zellulartherapie verabreich... more ABSTRACT Nach wie vor drfen tierische Frischzellprparationen zur sog. Zellulartherapie verabreicht werden unter der Vorstellung einer allgemeinen Vitalisierung und Roborierung des Organismus, insbesondere des Immunsystems. Die Verwendung von Trockenzelltherapeutica hat das Bundesgesundheitsamt bereits 1987 vorlufig verboten, nicht ohne darauf hinzuweisen, da auch gegen die sog. Frischzelltherapie schwerwiegende Bedenken bestnden, da ein generelles Verbot auch dieser Behandlungsweise jedoch nicht in seiner Kompetenz lge. Wiederholt waren z.T. lebensbedrohliche und auch tdliche Komplikationen im Verlauf dieser Therapie beobachtet und beschrieben worden. Den bereits publizierten Beobachtungen werden weitere hinzugefgt: 1. Eine 69jhrige Frau war etwa 9 Jahre lang mit Zellprparationen behandelt worden. Jetzt trat nach einer erneuten Sicca-Zellinjektion ein Kollaps auf und etwa 7 Tage spter eine rasch aufsteigende Landrysche Paralyse mit Schluckstrungen und Atemlhmung. Sie verstarb 3 1/2 Wochen nach dieser letzten Injektion infolge respiratorischer Insuffizienz. Die Obduktion ergab u.a. die typischen Vernderungen eines akuten Landry-Guillain-Barr-Syndroms. 2. Eine 76jhrige Patientin war bereits seit einigen Jahren mit Frischzellprparationen behandelt worden. Jetzt trat nach einer erneuten Injektion eine lokale Schwellung am Injektionsort auf, welche zunchst als iatrogene Blutung gedeutet wurde. Zur operativen Versorgung dieser Komplikation in ein anderes Krankenhaus verlegt, verstarb die Patientin 2 Tage nach der Therapie unter den Zeichen eines perakuten Schocks. Die Obduktion ergab eine Clostridieninfektion; weiterhin fanden sich Vernderungen am peripheren Nervensystem im Sinne eines akuten Landry-Guillain-Barr-Syndroms mit Beteiligung auch des vegetativen Nervensystems. In beiden Fllen knnte die Erkrankung des Nervensystems als allergisch-hyperergische Reaktion nach Sensibilisierung durch Injektion frischer bzw. getrockneter tierischer Zellsuspensionen aufgefat werden. Auch die bereits publizierte perivense Leukoencephalopathie nach Frischzellentherapie ist vermutlich auf immunologische Prozesse zurckzufhren. Die mglichen pathogenetischen Mechanismen werden errtert und gemeinsam mit anderen Beobachtungen aus Mainz und Berlin diskutiert. Auf die entscheidende Rolle des Nervensystems bei diesen Komplikationen, insbesondere des peripheren Nervensystems, und vor allem auf die Bedeutung vegetativer Regulationsstrungen fr die Prognose wird hingewiesen. Es sei betont, da die Aufklrung derartiger Erkrankungen mit tdlichem Ausgang eine besondere Sektionstechnik erfordert mit Entnahme der gesamten Wirbelsule und mit Untersuchung auch der peripheren Nerven, einschlielich des vegetativen Systems.So far, the law in the Federal Republic of Germany still allows the injection of fresh-cell preparations from animals as a roborant to increase the vitality of the organism and to strengthen the body's immune defense system. The use of sicca-cell preparations was provisionally forbidden in 1987 by the Federal Health Organization (Bundesgesundheitsamt; BGA). Prohibition of fresh-cell injections would have exceeded the authority of this office, although the same serious reservations also applied in the case of this treatment method. Several publications that have appeared since 1955 have reported serious complications of this therapy, some life-threatening and some even lethal. Two further cases are now added: (1) A woman aged 69 had been receiving treatment with cell injections for 9 years. Immediately after an injection of sicca cells she collapsed and was hospitalized; 7 days thereafter she developed an ascending paralysis with increasing inability to swallow or breathe. She died 25 days after the injection as a consequence of central and peripheral respiratory failure. Autopsy revealed the alterations typical for acute Landry-Guillain-Barr-Strohl syndrome. (2) A 76-year-old healthy woman had been receiving treatment with fresh-cell preparations for several years. After an injection of cell suspensions a painful local swelling was observed. The symptoms were interpreted as the consequence of an iatrogenic local hematoma, and repeated punctures were performed to obtain blood. The patient was transferred to a surgical department for further therapy. Two days after the injection she suddenly died with signs of acute cardiovascular failure. Autopsy revealed the signs of a fulminating clostridial infection and also the characteristic signs of Landry-Guillain-Barr syndrome with involvement of the autonomic nervous system. In both cases the development of an inflammatory process in the peripheral nervous system could be interpreted as an immune-mediated allergic disease, related to the repeated injection of heterologous antigenic material containing nervous tissues. This hypothesis would also explain the two other cases already published and would be consistent with the observed perivenous leukoencephalopathy of the central nervous…
International Journal of Legal Medicine, 2001
In the present study, concentrations of dihydrocodeine and its metabolites in saliva and serum we... more In the present study, concentrations of dihydrocodeine and its metabolites in saliva and serum were compared after single low-dose and chronic high-dosage administration of the drug. In the first investigation, blood and saliva were collected periodically from six subjects after oral administration of 60 mg dihydrocodeine. In the second study, 20 subjects on oral dihydrocodeine maintenance provided single samples of blood and saliva simultaneously. Serum protein binding of salivary analytes and their recovery from the adsorbing material of the collection device as well as pH values of saliva samples were determined. The fluids were analyzed for dihydrocodeine and the major metabolites by high-performance liquid chromatography. In the single dose study dihydrocodeine was the only analyte found in saliva for up to 12-24 h post-dose. The half-life of dihydrocodeine in saliva was about twice that found in blood. The ratios of saliva/ serum concentrations ranged from 1.2 to 17.0. After chronic high-dosage use, dihydrocodeine was the main salivary analyte and N-nordihydrocodeine was present in a few samples. Saliva/serum concentration ratios of dihydrocodeine were strongly dependent on the pH value of saliva and, to a lesser extent, on serum-protein binding. The saliva/ serum ratios were more similar after chronic administration. The data suggest a passive diffusion process as the underlying mechanism for the transport of dihydrocodeine into saliva. After both single and chronic use, the presence of the drug in saliva can be used as evidence of recent substance administration.
A preliminary study on the stability of benzodiazepines in blood and plasma stored at 4° C
International Journal of Legal Medicine, 1997
An approach to determine the stability of benzodiazepines and some of their metabolites (n = 13) ... more An approach to determine the stability of benzodiazepines and some of their metabolites (n = 13) by means of a routinely applied gas chromatographic method using electron capture detection was made in this preliminary study. Validation data of the method are given. Spiked blood and plasma samples were stored at 4 degrees C and analysed at selected times up to 240 days. The concentrations of all analytes had decreased to at least 60% of the original levels at the end of the observation period. A clear pattern of breakdown could not be established. The data obtained suggest that results from long-term stored samples should be interpreted cautiously. Further investigations concerning the stability of drugs in blood and plasma samples, additional methods of identification and determination as well as the establishment of optimal storage conditions seem necessary.
International Journal of Legal Medicine, 1999
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Papers by Rainer P D M Mattern