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Biomedical subjects

R Sprung

Publications and source records attributed to R Sprung.

At least 19 recordsLinked to original sources
PubMed2001

On the diagnosis of hypoglycemia in car drivers--including a review of the literature.

Hypoglycemia may reach forensic relevance concerning the psychophysical ability of running a car and with respect to a possible imputability. Our retrospective study included anamnesis and clinical symptoms observed in drivers with impaired performance to point out correlations between biochemical parameters and the actual course of the disease and its sequelae on roadworthiness. Clinical-biochemical estimations were performed on glucose, lactic acid and ethanol including a toxicological screening. It is proposed to utilize the estimation of glucose and lactic acid (the so-called combined value) in blood samples taken on behalf of the police as an important hint to the actual state of glucose metabolism. The anamnesis and the symptomatology may complete the biochemical analyses.

Accidents, Traffic↗
PubMed2001

Chemiluminescence detection of ATP release from red blood cells upon passage through microbore tubing.

A novel approach for the determination of adenosine triphosphate (ATP) released from red blood cells (RBCs) after passage through microbore capillaries is described. ATP is often released from RBCs in vessels and has been linked to the production of nitric oxide, a known vasodilator. The system described here uses a syringe pump to deliver microliter flow rates (5-15 microl min(-1)) of reagent and sample through fused silica capillary tubing of varying dimensions (25-75 microm) to a photomultiplier tube. The released ATP is characterized by the detection of chemiluminescent emission from the luciferin-luciferase reaction. The amount of ATP released is directly proportional to the number of RBCs injected into the system. Results also suggest that the amount of released ATP decreases from 6.9 microM to 1.4 microM as the tubing diameter is increased from 25 microm to 75 microm. An investigation of capillary lengths ranging from 15 to 35 cm resulted in ATP concentrations of 1.5 microM to 2.4 microM being released. Results also indicate that increases in flow rate also induce increased amounts of ATP release. These results are consistent with those of previous systems attempting to model the physiological release of ATP from red blood cells.

Adenosine Triphosphate↗
PubMed2000

[Follow-up study after enteral manganese poisoning: clinical, laboratory and neuroradiological findings].

Manganese intoxication is an unusual, severe form of intoxication. This report deals with a patient now 80 years old who accidentally ingested a solution of potassium permanganate for a period of at least 4 weeks 14 years ago. Since then, the patient suffers from a mild parkinsonian syndrome and distally accentuated polyneuropathies. Psychiatric disorders, especially demential or depressive symptoms, were not observed. Manganese analysis of his hair still shows a clear increase in manganese concentration. The MRI of his brain showed no pathological changes, in particular none of those often described with symmetric signal elevation in T1 in the area of the basal ganglia. In this study, we present clinical, laboratory, and neuroradiological findings. Unusual in this case with a short exposition is the long duration and clinical improvement without L-dopa treatment.

Aged↗
PubMed1998

Clinical and morphological aspects of death due to liquid nitrogen.

A 24-year-old student died while filling flasks with liquid nitrogen. The arms, legs and back were frozen and the face, ears and neck showed a dark red and livid colour with horizontal lines of demarcation. In the electrocardiogram, the heart showed asystolia followed by wide ventricular complexes. The patient was intubated orally as the situs of the larynx and pharynx showed no pathology findings. Cardiopulmonary resuscitation was carried out and terminated after 90 min. Unfortunately, the body temperature was not measured. The gas analysis of venous blood showed metabolic acidosis and oxygen deficiency. The student had worked alone with nitrogen, without opening the windows and without a working ventilation system. While filling the third flask he lost consciousness. As nitrogen does not cause characteristic prodromal signs he laid on the floor and was unable to help himself. The liquid nitrogen which was still escaping spread over the floor and vaporized. The student died from asphyxia due to oxygen deficiency in an atmosphere of nitrogen.

Adult↗
PubMed1998

[Heavy metal incorporation as an unusual self-injury].

A 19-year-old man was admitted to hospital because of uncharacteristic neurologic symptoms. During the first examination morphologic alterations due to an injection of mercury into the left arm and the left side of the trunk were found. The dose and the manner of application were doubtful and suspected to be a case of self-infliction. The man informed the police only 7 months later because his relatives had finally persuaded him to do so. The description of the infliction by unknown perpetrators was full of contradictions. Initially the patient gave only an indistinct description. But later on, the number of details increased. At the same time there was a change in the characteristics of the perpetrator(s). Other differences existed concerning a loss of consciousness which should have been caused by a single stroke on an arm. Furthermore, the patient told about a swelling as big as an egg, provoked by an injection of liquid mercury. It could be shown by experiments that mercury can be injected into soft-tissue very simply and that it spreaded widely. Arguments for a self-injection were e.g. the technical possibility, the topography of the injection marks, and an easy handling of the syringe. A psychiatric examination furthermore revealed, that the patient had had periods of restriction of thinking, sometimes combined with a lack of appreciation.

Adult↗
PubMed1997

Identification of fatty acid methyl esters (FAMEs) in postmortem tissue. A new marker of alcohol abuse?

Based on a method that combines thin layer chromatography and gas chromatography, it proved possible to detect postmortem fatty acid methyl esters (FAMEs) in human tissues (pancreas, liver, heart and adipose tissue). The highest concentrations were found in the pancreas, medium concentrations in the liver and adipose tissue and the lowest concentration in heart tissue. All tissues contained higher concentrations of unsaturated FAMEs than saturated FAMEs. In order to evaluate the influence of alcohol consumption on the formation of FAMEs, the decreased were divided into three groups: control group, chronic alcoholics (who were alcohol free at the time of death), and acutely alcohol-intoxicated subjects (so intoxicated at the time of death with no evidence of chronic alcohol abuse). In comparison to the control group, the organs of the chronic alcoholics showed only slight values, the tissues of the acutely intoxicated subjects were obviously higher. Based on the varying concentration distribution in the three groups, it seemed that postmortem differentiation of the alcohol consumption which existed before the time of death would be possible. After further investigation with a greater number of samples, FAMEs could become a useful supplement to existing alcohol markers in the future.

Adipose Tissue↗
PubMed1994

[Reliability of forensic evidence in breath alcohol analysis].

Drinking experiments were performed by using a device-combination appreciated by the German National Institut of Health (BGA) as being evidential and proposed as prototype for the future practice of breath-alcohol analysis. Comparing the breath- (BrAC) and blood alcohol-concentrations (BAC), however, there were relevant deviations. Our evaluation of the facts published Schoknecht demonstrated nevertheless distinct divergences in comparison to the blood alcohol determination: A BAC-nominal of 1% gave divergences of the nominal up to 0.25% resulted from the measured BrAC-values of Schoknecht on corresponding conversion. The divergences are distinctly above those that are tolerated by legislation according to previous standards for the blood alcohol determination. Consequently it requires further checking in standardized experiments and field experiments in order to be able to judge the practice usefulness; furthermore such further checking would have to be implemented by unconcerned institutions. Basing on these experiments an evidential breath-alcohol analysis for forensic purposes has not been established yet.

Alcohol Drinking↗
PubMed1992

[Forensic assessment of questionable railway suicides].

Railway deaths only seldom give rise to extensive inquiries. For the police there exists no absolute necessity of differentiating between accident and suicide. The reason is that accidents usually do not result in criminal proceedings. For the railway embankment the normal traffic rules are unvalid, and the guilt of the engine driver usually cannot be proven. In consequence these cases very often are declared as suicides without adequate support. This leads to complications in the field of insurance law. Since the "prima facie" principle in these cases was dropped our medicolegal institutes are increasingly engaged with expert opinions dealing with the question of accident or suicide. According to literature only a straight decapitation is regarded as typical for a suicide. But such can be found rather seldom in reality. That was the reason for us to study our own cases and to examine whether there are additional patterns of morphological findings proving a suicidal action. The respective case circumstances and, if available, testimonies were included in our study as well as the special constructional peculiarities of the engine frontages which logically contribute to the appearance of injuries.

Accidents, Traffic↗
PubMed1992

[Precision control in blood alcohol determination].

The German supreme court (BGH [1]) summons that by proclaiming four or five single measuring values of every blood alcohol determination to prove that the resulting standard deviation lies under the highest amount stated in the official verdict of 1989 (10). On the one hand the control of the proceedings must be guaranteed by the successful participation of the ring tests, yet on the other hand the evidence to retroactively prove the accuracy of every blood alcohol determination from it's single values is always called for anew. In the example case the average value is 1.11 g/1000, the standard deviation is 0.036 g/1000. The standard deviation summoned by the BGH (1) is thereby exceeded. On account of the fundamental scientific regularies the parameter standard deviation is not qualified to retroactively verify the required accuracy of the procedure by means of the single values. The blood alcohol result in question can be used without proviso. A reduction of the present approved 10% variation of the single values is not significant. Only according to todays accuracy requirements does this limit nearly appear to be appropriate.

Alcoholic Intoxication↗
PubMed1991

[Falsification of breath alcohol concentration measurement. An experimental and case report].

As a rule, in our comparison of breath alcohol and blood alcohol concentration levels both readings were in agreement. Nevertheless, we repeatedly observed readings showing significant differences for which there was no apparent explanation. In two cases where discrepancies were extreme (breath alcohol concentration greater than 2.0%; blood alcohol concentration, 0.0%) we discovered that the cause was sniffing. The effects of various pharmaceutical drugs were tested. Experimentally the inhalation of liquid gas resulted in ostensible breath alcohol concentration levels of more than 2%. These experiments were reproducible. Consequences for the exployment of alcohol breath testing devices are discussed.

Adult↗
PubMed1988

[Methanol--an up-to-now neglected constituent of all alcoholic beverages. A new biochemical approach to the problem of chronic alcoholism].

Alcoholism is usually understood as ethanolism. There is some evidence that its oxidation product acetaldehyde may condense with endogenous amines to form tetrahydroisoquinoline (TIQ) and - tetrahydro-beta-carboline (THBC) alkaloids which ultimately might be responsible for addiction. In most animal experiments pure ethanol solutions were fed, but chronic alcoholics prefer normal alcoholic beverages, and it is widely ignored that all these beverages without exception also contain methanol. Its metabolite formaldehyde is a much more potent reaction partner for TIQ and THBC formation than acetaldehyde. As our findings in chronic alcoholics proved that these persons in contrast to healthy subjects are able to oxidize methanol despite high ethanol levels, there must be a continuous leakage of formaldehyde. And it seems possible that methanol plays a more significant role in the pathophysiology and possibly the etiology of chronic alcoholism than ethanol.

Alcohol Dehydrogenase↗
PubMed1986

[Problems in the evaluation of electrocution fatalities in the bathtub].

Forty-eight cases of electrocution in the bathtub are reported which were recorded in Düsseldorf and Göttingen from 1972 to 1986; 19 cases were established to be suicides, with a sex ratio of 1:3 in favor of females. Marks of electricity were found in 8 cases. Five other cases were distinguished by linear marks indicating the water level, and in 10 cases a peculiar restriction of the postmortem hypostasis on the submersed areas could be seen. We presume from our own material that the latter findings can be easily ignored. As linear, circumscribed lividity could not be detected in bath deaths without electricity, it may be a specific finding. We recommend that more attention be paid to this phenomen. In all of our cases, 220 V current was involved, i.e., the usual household supply. The calculated amperage was about 100 to 250 mA, which means that ventricular fibrillation occurred within a few seconds. In 14 cases foam was established at the mouth and the nostrils, or in the air passages. We presume that, in these cases, death by electrocution was finally superimposed by drowning without developing the typical emphysema aquosum.

Accidents, Home↗
PubMed1980

[Lethal barium sulfate embolism after accidental vaginal application (author's transl)].

The case of a 63-year-old woman is presented to whom a barium sulfate enema was administered accidentally into the vagina. During inflation of the stop manchette a deep bilateral laceration of the vaginal mucosa occurred which was neglected initially. Thus, venous vessels were ruptured and the subsequent insufflation of the barium sulfate suspension resulted in a direct injection to the afferent veins and a peracute, massive pulmonary embolism. Within 1 min irreversible heart failure followed. The case differs in some aspects from two similar cases referred to in the literature, where death occurred 15 h and 3 days, respectively, after enema.

Barium Sulfate↗