[Lethal rupture of an echinococcal cyst of the liver]. / Perforation eines Leberechinokokkus mit Todesfolge.

A 50-year-old man is admitted to the hospital emergency service because of a 24-hour history of right abdominal pain. Ultrasound examination and laboratory tests suggest the perforation of an Echinococcal cyst situated in the subcapsular area of the right hepatic lobe. The patient and his family refuse the recommended hospitalisation and operation and leave the hospital on their own responsibility. 60 hours later the patient dies. Post-mortem examination confirms the diagnosis of a perforated hydatid cyst of the right hepatic lobe. The cause of death was a partly fibrino-purulent, partly nodular peritonitis including the area of liver rupture.

[Ultrasound image of an echinococcus daughter cyst in the gallbladder]. / Sonographisches Bild einer Echinokokkus-Tochterzyste in der Gallenblase.

By the case presented, which is a clear example of a daughter cyst of an echinococcus in the gall bladder lumen, we have extended our knowledge of the possibility of ultrasound for demonstration of abdominal pathology. Besides the well-known sonographic picture of the liver echinococcus, we now know that we are in certain cases in a position to represent also the echinococcus daughter cyst in the biliary tree. Characteristic is its annular pattern. In cases like this one, we give ultrasound preference over the ERCP and CT.

What is a realistic frontal-offset test procedure?

With an increasing number of vehicles satisfying the FMVSS 208 Flat Barrier Impact Test and increasing belt usage, a high reduction of occupant injuries in general and a change from acceleration-induced to intrusion-induced injury mechanisms has been observed in Europe. The significance of intrusion-induced injury mechanisms associated with offset frontal impacts is assuming greater importance. Beginning in 1978, in response to this challenge, Mercedes-Benz has emphasized front structural countermeasures that have been found to be effective in the frequent asymmetrical frontal impacts. As an internal test, an offset impact with 40% overlap against a rigid barrier was defined. The relationship between actual accident frontal-overlap damage and barrier-test overlap values is explored in the paper. The results support the view that if a test of this type and associated design countermeasures were adopted by all vehicle manufacturers, a significant reduction of injuries would take place.

Development of a new injury cost scale.

The Automobile Technique Research Association at Frankfurt, the Institute for Forensic Medicine at Mainz, the Federal Highway Research Institute at Bergisch-Gladbach, the German Motor Vehicle Inspection Association at Stuttgart, and the German Worker's Compensation at St. Augustin have completed a joint research project dealing with injury costs due to automobile accidents. The data for this social cost analysis were based on costs for administrative expenses, medical treatment, rehabilitation measures, social security payment, and loss of income, which were all paid by Worker's Compensation for single, well-documented injuries to the working population in West Germany (15 to 65 years old). The data base used included 15,407 injured and 1,026 fatal road accident victims. Tables are presented which show the costs associated with various injury levels. The result is an injury cost scale (ICS) that might be a base for establishing priorities of safety measures. The ICS has to be seen as supplemental to the AIS.

[Early predictors of outcome in children with head injuries]. / Rani prediktori ishoda trauma glave u djece.

In an attempt to determine whether the clinical data obtained by primary survey may be used as early outcome predictors in children who had sustained head trauma, children aged 0-14 with clinical diagnoses of coma, contusion, comotio, skull fracture or a combination of these diagnoses or who had been hospitalized for at least 3 days, between 1987 and 1990, were reviewed retrospectively. The outcome was defined by the clinical condition of children 6 months following head trauma using a Glasgow outcome scale (GOS), and was classified: good (good recovery and moderate disability) and poor (severe disability, persistent vegetative state, death). Of 70 children with trauma, 43 patients (61.4%) were separated by this method. The pupillary appearance and reactivity, Glasgow coma scale (GCS) and motor response graded by GCS were compared with the outcome. The analysis demonstrated that the early significant predictors of outcome of head trauma are the pupillary appearance and reactivity as well as Glasgow coma scale. Motor response graded by GCS did not achieve statistical significance (z = 1.5, P > 0.05) as a predictor of outcome. In this analysis, we have graded motor response according to the GCS criteria, thus it is not excluded that the use of different criteria could demonstrate the importance of motor response as an outcome predictor. In order to ascertain the significance of predictors in early outcome prognosis of head trauma, a relative risk for poor outcome was calculated. Our results showed that the significant predictors in descending order of preference are: pupillary reactivity, pupillary appearance and GCS.(ABSTRACT TRUNCATED AT 250 WORDS)

[Textile changes in passenger clothing induced by seat belts at 50 km/h frontal impact]. / Gewebeveränderungen der Insassenkleidung durch Einwirkung des Sicherheitsgurts beim 50 km/h-Frontalaufprall.

Sixteen dummies wearing seat belts were exposed to an impact of 50 km/h. Their clothing was examined for traces of melting and other textile changes caused by the seat belt. Such marks were found in the thorax area in 87.5% of the cases and in the pelvis area in 44%. They were located at protruding parts of the body, i.e., parts exposed to high pressure caused by the seat belt.